Amy Kraft is an award-winning journalist who covers gastrointestinal health, heart health, concussions, meditation, and substance abuse. Prior to Everyday Health, she was on the health and science desk at CBSNews.com where she reported on topics such as the link between an algae bloom toxin and Alzheimer’s disease, and how to boost a baby’s “good bacteria” after a c-section birth. Her writing has appeared in Discover, Scientific American, TheWeek.com, Newsweek, and Popular Science. She has also worked in audio for a number of science podcasts and hosted her own audio show on the history of fairy tales.
Kraft is passionate about creating content that sheds light on invisible illnesses and helps people live their best lives. She has a master’s degree from the City University of New York Graduate School of Journalism. In her spare time, she likes to read, bicycle around the city, and do improv at Second City in Chicago, where she lives with her husband, two daughters, and two cats, Siegfried and Zelda.
While not a solution for egg allergies, as most people are allergic to the whites and not egg yolks, commercial egg whites such as Egg Beaters may be a good substitute if you can eat eggs and you’re following a low-fat diet. These may be cooked the same way as whole eggs, and you pour them right out of a carton.
According to the USDA, one large egg white contains 18 calories, 3.6 g protein, and less than 0.08 g fat.
2. Just Egg
If you’re looking for a plant-based egg substitute, both Kristin Gillespie, RD, who is based in Virginia Beach, Virginia, and Meghan Pendleton, RD, who practices in the Detroit area, recommend Just Egg. The product is available in a 16 ounce (oz) bottle, and you pour it onto a heated skillet to make plant-based scrambled eggs or omelets. Simply refrigerate the bottle after opening to save for your next use.
Per the company’s website, Just Egg is made with mung bean protein, canola oil, and turmeric, as well as onion, salt, sugar, and other flavorings. You can use 3 tablespoons (tbsp) to substitute for one egg. Each 3 tbsp serving has 70 calories, 5 g protein, and 5 g fat, which is close to that of a large egg. But unlike eggs, Just Egg has 0 mg cholesterol.
3. Unsweetened Applesauce
Applesauce may replace eggs that act as binders in recipes, such as drop cookies. According to the AAFA, you can replace one whole egg with ¼ cup applesauce in such recipes. Be sure to look for unsweetened varieties so you don’t end up with added sugars — you will still reap a bit of natural sweetness from the pureed apples.
From a nutritional perspective, the USDA reports that 50 g (about ¼ cup) unsweetened applesauce has 26 calories, 0.1 g protein, 0.1 g fat, and 6 g carbohydrates. The same serving provides 22 mg vitamin C, making it an excellent source of the nutrient.
4. Mashed Avocado
If you’re looking for a non-egg binding agent besides applesauce, consider mixing up your recipes with mashed avocado. Again, you can substitute ¼ cup pureed or mashed fruit per one egg in your recipes. This versatile fruit is recommended by Cedars-Sinai for its high nutrient profile, which includes mono- and polyunsaturated fats that may reduce LDL cholesterol, as well as fiber, folate, potassium, and magnesium.
According to the USDA, a 50 g (¼ cup) serving of mashed avocado offers 84 calories, 1.7 g protein, 5 g carbs, and 7.5 g fat. In addition, you get 3.4 g fiber (a good source) and some potassium, 234 mg.
5. Canned Pumpkin
Yet another binding agent you may already have in your pantry is canned (or pureed) pumpkin. As a rule of thumb, use the same ¼ cup size substitution per egg.
The USDA notes that 50 g pumpkin puree (about ¼ cup) provides 19 calories, 0.4 g protein, and 4.2 g carbohydrates. It furthermore offers a bit of fiber, 1.3 g, and 104 mg potassium.
In a review published in Plants in May 2022, researchers noted the overall health benefits of pumpkin, such as its anti-inflammatory, antioxidative, and antimicrobial effects in the body. Diets that include such foods may reduce the risk of diabetes, cancer, and heart disease.
6. Mashed Bananas
Like applesauce, mashed bananas can substitute eggs as binding ingredients in certain recipes. In such cases, you can substitute ½ a medium banana per egg, per Kids With Food Allergies. This will provide the ¼ cup substitution you need per egg, says Gillespie. Mash the banana well with a fork to prevent clumps in your recipe.
Research published in Food & Function in June 2021 suggested that, like applesauce, bananas offer antioxidants and anti-inflammatory benefits that may reduce your risk of chronic diseases such as diabetes and cancer. According to the USDA, ½ ripe banana offers 57 calories, 0.4 g protein, 0.2 g fat, 13.2 g carbohydrates, and 188 mg potassium.
7. Gelatin
Unless you’re following a vegan diet, you may be able to use gelatin in place of eggs. Gelatin is a type of animal protein–based food additive that acts as a thickening agent in a variety of packaged food items, explains the Academy of Nutrition and Dietetics.
You can also purchase gelatin by itself to use in cooking and baking at home. According to the American College of Allergy, Asthma, and Immunology (ACAAI), you can combine one packet of gelatin with 2 tbsp warm water to substitute one egg.
According to the USDA, a 1 tbsp envelope of gelatin has 23 calories and about 6 g of protein.
8. Ground Flaxseed
While technically a dry ingredient, ground flaxseed may act as a binding agent in recipes. To achieve this, simply combine 3 tbsp warm water with 1 tbsp ground flaxseed and allow to sit one minute before using. This recipe is equivalent to one egg, per Kids With Food Allergies.
According to the USDA, 1 tbsp of ground flaxseed has 37 calories and 1.3 g protein. As the Academy of Nutrition and Dietetics notes, flaxseed is a good plant-based source of alpha-linolenic acid (ALA), a type of omega-3 essential fatty acid.
9. Plain Yogurt
Plain yogurt is another one of Gillespie’s favorite egg substitutes — she suggests swapping ¼ cup in for 1 large egg. This can act as a leavening agent in your recipes, per the Academy of Nutrition and Dietetics.
According to the USDA, 50 g plain yogurt (about ¼ cup) made from whole milk contains 39 calories, 1.9 g protein, 2.2 g fat, and 2.8 g carbohydrates. Plain yogurt is also a good source of calcium.
The key word here is plain — when shopping for yogurt, check ingredient labels carefully to make sure it doesn’t contain any added sugars, fruits, or flavors.
10. Buttermilk
While you might know this fermented dairy product from certain biscuit and pancake recipes, you may also be able to use buttermilk as an egg substitute in a variety of baked goods. Like yogurt, buttermilk may be used as a leavening agent in baked goods. It may work well in both sweet or savory baked goods, such as breads, cookies, muffins, and cakes.Southern Living notes the ¼ cup to 1 egg ratio works for substitution in this case, too.
According to the USDA, a 50 g, or about ¼ cup, serving of low-fat buttermilk has 22 calories, 1.7 g protein, 0.5 g fat, and 2.4 g carbohydrates. Like plain yogurt, buttermilk contains calcium and vitamin D.
11. Tofu
For an easy scrambled egg substitute, try swapping 2 oz of firm tofu for a large egg. The Academy of Nutrition and Dietetics says you can substitute 2 oz extra-firm tofu for a hard-boiled egg, or ¼ cup of silken tofu in baking recipes for added moisture and richness.
According to the USDA, a 50 g, or roughly ¼ cup, serving of silken tofu offers 22 calories, 2.2 g protein, 1.1 g fat, and 0.6 g carbohydrate. Additionally, the same serving size contains 11 mg calcium and 63 mg potassium.
12. Arrowroot Powder
Arrowroot powder, a starch-based cooking agent derived from a tropical plant of the same name, is traditionally used as a thickening agent in recipes. Arrowroot powder is flavorless, making it a useful addition to a variety of dishes. You can use 2 tbsp mixed with 3 tbsp water in place of one egg.
According to the USDA, 2 tbsp of commercially prepared arrowroot powder contains 80 calories and 18 g carbohydrates. This product is naturally free of fat, and it doesn’t offer any protein.
13. Baking Powder and Vegetable Oil
A combination of baking powder and vegetable oil may work as a leavening agent in cooking and baking. According to Kids With Food Allergies, you can mix 1 teaspoon (tsp) baking powder with 1½ tbsp vegetable oil and 1½ tbsp water for each egg you’re replacing.
It’s also important to assess the nutritional value of each ingredient. According to the USDA, baking powder is a high-sodium food, while the agency also reports that 1 tbsp of vegetable oil is more calorie dense than an egg — this amount has 120 calories and 14 g of fat. As a result, the full substitution amount of 1½ tbsp of vegetable oil would come to about 180 calories and 22 g fat.
14. Aquafaba
An unconventional ingredient that may be used as a binding agent to substitute eggs is aquafaba. Pendleton explains that aquafaba is essentially the liquid that’s left over from a can of chickpeas. “Aquafaba can also be whipped into a meringue very similar to eggs,” she says.
To use aquafaba as an egg substitute, U.S. News and World Report recommends 3 tbsp per whole egg. Three tbsp of aquafaba contains approximately 9 to 15 calories and trace amounts of nutrients.
Aquafaba is a low-calorie, low-fat egg substitute — to reduce the salt content, you can choose low-sodium varieties of canned chickpeas, if desired.
15. Margarine or Butter
Finally, if you have a cooking recipe that calls for using egg wash as a glaze, you can substitute melted margarine or butter instead. The ratio is 1:1 in this case. You can use one of these substitutes for eggs in breads, pies, and other baked goods to give them a brown, crispy, and shiny outer crust.
According to the USDA, a 14 g serving (about 1 tbsp) of margarine contains 100 calories, 11 g fat, and 500 IU vitamin A. The same serving of unsalted butter contains 102 calories, 11.5 g fat, and 355 IU vitamin A.
There are two main types of cholesterol in the body: high-density lipoprotein cholesterol (HDL) and low-density lipoprotein (LDL) cholesterol. HDL is often called the “good” cholesterol because it helps move LDL (or “bad” cholesterol) away from the arteries — where it can build up and cause a heart attack or stroke — and to the liver, where it gets broken down and flushed from the body.
A higher level of HDL is linked to a lower risk of heart disease. For women and men, an HDL level of 60 milligrams (mg) per deciliter (dL) of blood is desirable.
Lifestyle changes are an effective way to increase HDL and have been shown to lower the risk of heart attack, notes the Mayo Clinic. Getting more exercise, quitting smoking, and eating a healthy, Mediterranean-style diet can all help raise your HDL.
Read on to find ways to boost HDL cholesterol — and the evidence behind them.
1. Start a Regular Exercise Routine and Stick With It
Regular exercise is important for maintaining heart health and can also increase HDL cholesterol levels. Research has shown that moderate-intensity aerobic exercise and low-to-moderate endurance exercise can raise HDL levels, though the optimal amount, intensity, and type of exercise varies in studies and can depend on the individual.
The American Heart Association recommends getting at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, throughout the week. It additionally recommends doing moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least two days per week.
Moderate-intensity aerobic activities include:
Walking (at least 2.5 miles per hour)
Water aerobics
Biking slower than 10 miles per hour
Vigorous-intensity aerobic activities include:
Running
Swimming laps
Vigorous aerobic dancing
Cycling 10 miles per hour or faster
Jumping rope
Hiking uphill
“Exercise is excellent because it may independently raise your HDL but also leads to weight loss, which may account for additional gains in your HDL,” says Haitham Ahmed, MD, MPH, a cardiologist at AdvantageCare Physicians in New York City.
2. Lose and Keep Off Any Extra Pounds
If you’re overweight or obese, losing some weight can help to raise HDL cholesterol. Leah Groppo, RD, CDE, a clinical dietitian at Stanford Health Care in California, says that losing around 7 percent of your total body weight is enough to cause a metabolic shift. But, as Groppo notes, “maintaining weight loss is key.”
Abdominal obesity — fat that accumulates around your waist rather than in the hips and thighs — seems to be associated with heart disease risk and lower levels of good cholesterol. While it’s not possible to target belly fat through exercise and diet, weight loss in general will reduce the type of abdominal fat that’s linked to health risks.
Effective weight loss methods include diet, exercise, weight-loss medications such as GLP-1 drugs, and surgery.
3. Quit Smoking
We know that smoking cigarettes can lead to a number of health problems, including lung disease, cancer, and a greater risk of a heart attack. But did you know smoking can also suppress or lower those good cholesterol levels?
“Smoking can reduce HDL cholesterol in many ways, including by inhibiting HDL synthesis in the first place, blocking its maturation, and speeding up its clearance and metabolism,” Dr. Ahmed says. “Quitting smoking can help your HDL synthesis and metabolism to go back to their natural levels so that the HDL can do its job better again.”
A meta-analysis notes there’s “abundant evidence” supporting the link between smoking and HDL levels and that research has found increased HDL levels in those who quit smoking.
If you’re trying to quit smoking, talk to your doctor about the many methods to help you through the process.
4. Include Fatty Fish in Your Diet
Following the Mediterranean diet — eating mainly fish, fruit, veggies, whole grains, legumes, nuts, and olive oil — may positively affect HDL cholesterol. One study concluded that a diet rich in foods including fatty fish showed an increase of HDL particles in the body, especially when compared with lean fish and meat. And another found that increases in fish consumption, along with virgin olive oil, nuts, legumes, and whole grains, were associated with higher HDL levels.
“Omega-3 fatty acids, which are the type of fatty acids found in fish, can help increase your HDL cholesterol,” Ahmed says. “Two servings of fatty fish per week, including salmon, mackerel, or albacore tuna, can help you hit your omega-3 goals.” You’ll also get omega-3s from flaxseed, mixed greens, and walnuts.
5. Cut Back on Sugar and Refined Carbohydrates
Eating foods high in refined grains — such as white rice and products made from refined wheat flour — reduces HDL cholesterol levels, increasing the risk for metabolic disorders, according to research. Refined carbohydrates found in foods labeled “low fat” make these just as bad as full-fat foods, because the fat is often replaced with carbohydrates from added sugar and other starches. Researchers note that when carbohydrates, especially sugars, replace saturated fats, HDL levels tend to decrease.
A study of 2,500 people with diabetes found that following nutritional recommendations to limit added sugar in the diet was linked to significantly higher HDL cholesterol levels.
An observational study that followed 6,000 subjects for an average of 12.5 years found that sugar-sweetened beverages like sodas and fruit juices were associated with low HDL levels.
When trying to reduce added sugar in your diet, Ahmed says, it’s best to slowly replace sugars with fruit and vegetables. He adds, “Also try to avoid trans fats, including fried foods or those prepared with shortening, since these may also reduce HDL.”
6. Cook With Healthy Oils
Not all oils are created equal when it comes to your heart health. Olive oil and sunflower oil are mainly unsaturated fat, which can lower LDL cholesterol and at the same time increase HDL cholesterol. In olive oil, it’s not simply the healthy fats but also polyphenols — plant compounds that have antioxidant effects — that have been shown to increase HDL.
Research also shows that while coconut oil can raise HDL, it isn’t the best heart-healthy oil because of its high saturated fat content, which also raises LDL cholesterol.
The American Heart Association advises sticking with nontropical vegetable oils for cooking and avoiding tropical oils like coconut oil or palm oil.
Groppo agrees. “Coconut oil is best used on the skin,” she says.
7. Eat More Antioxidant-Rich Foods
Research has found that an antioxidant-rich diet raises HDL cholesterol levels and might be associated with a reduced risk of stroke, heart failure, and inflammatory biomarkers. Antioxidant-rich foods include colorful fruits and vegetables, like berries, beets, and avocado, and dark leafy greens like kale and spinach and broccoli. Nuts, seeds, whole grains, and dark chocolate are also good sources of antioxidants.
“Indulge in antioxidant-rich foods to increase HDL cholesterol,” Groppo says. “The more colors that you can get in your diet, the better.”
8. Talk to Your Doctor About Supplements
If all other methods of increasing your HDL cholesterol haven’t been effective, you might think of taking dietary supplements. Still, Ahmed cautions that supplements aimed at raising HDL only do so modestly. Also, supplements have not yet been proven to reduce heart attacks or strokes.
Speak to your doctor before taking any supplements to raise HDL cholesterol, because some supplements come with health risks or may interact with medication.
The Takeaway
Lifestyle changes such as regular exercise, weight management, and stopping smoking are proven ways to boost HDL cholesterol — the “good” cholesterol — which can reduce your risk of heart disease.
A diet that is low in refined grains and sugars and that includes fatty fish like salmon, healthy oils, and antioxidant-rich foods can help increase HDL levels.
If you’re considering taking supplements to raise your HDL, it’s important to consult with your doctor to make sure it’s a safe and effective choice for you.
Robert F. Kennedy Jr., a leading voice of the Make American Healthy Again (MAHA) movement, was confirmed today by the Senate to serve as secretary of the Department of Health and Human Services (HHS) under the second Trump administration.
As HHS secretary, the nation’s top health job, Kennedy will have the ability to steer the direction of medical research for years to come and influence access to vaccines, drugs, and health insurance.
With a $1.8 trillion annual budget, HHS runs several agencies, including the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and the Centers for Medicare and Medicaid Services. HHS is also responsible for determining the benefits covered by insurance plans under the Affordable Care Act (ACA).
Here are some key things that might change with Kennedy in charge of HHS.
RFK Jr. Has Been Highly Skeptical of Vaccine Safety
During his Senate confirmation hearings, Kennedy, a longtime vaccine skeptic, said several times, “I am not anti-vaccine.”
But during the hearings, Kennedy repeatedly said that we need better science to prove vaccines are safe and effective, a position that some public health experts believe could undermine confidence in vaccines that actually have decades of evidence supporting their use.
“Vaccines save millions of lives,” says Stephen Morse, PhD, a professor of epidemiology at Columbia University Irving Medical Center in New York City.
Kennedy’s questions about this fact may lead more people to refuse vaccinations, making outbreaks more likely and increasing disability and deaths from measles, whooping cough, and other vaccine-preventable diseases, Dr. Morse says.
“His greatest damage will be in undermining public trust in vaccines,” says Lawrence Gostin, a professor and the director of the WHO Collaborating Center on Global Health Law at Georgetown University in Washington, DC.
As HHS secretary, Kennedy could influence what childhood vaccines are recommended by the CDC, how new vaccines get approved by the FDA, how much the government spends to research new vaccines, and what vaccines are covered for free by health insurance, Gostin says.
“He is unlikely to revoke vaccine approvals, although he could,” Gostin says. “He is more likely to cherry-pick the data and create distrust in vaccinations.”
Kennedy Wants to End the Chronic Disease Epidemic
Throughout his confirmation hearings, Kennedy expressed concern about how many Americans have unhealthy eating habits that have contributed to a surge in chronic health problems like obesity, heart disease, and diabetes.
“President Trump has asked me to end the chronic disease epidemic and make America healthy again,” Kennedy said during his confirmation hearings.
“No other nation in the world has what we have here,” Kennedy said. “We have the highest chronic disease burden of any country in the world.”
As HHS secretary, Kennedy could encourage changes in how the NIH allocates research funding to favor more spending on common chronic diseases. He could also push for changes to government-funded health plans that put more emphasis on chronic disease prevention and management.
Kennedy would have limited influence on food policy as HHS secretary, however, because dietary guidelines and food assistance programs fall under the Department of Agriculture. He could potentially change what ingredients the FDA allows in processed foods or what nutrition information goes on food labels.
“He could require companies to have more informative food labels and also put warnings on unhealthy foods,” Gostin says.
Kennedy Says He Will Follow Trump’s Directives on Reproductive Healthcare and Abortions
Kennedy didn’t provide a lot of clarity during his confirmation hearings about exactly how he might approach access to abortion.
He was asked during his confirmation hearings whether it’s legal under federal law for a pregnant person to get emergency room care for a life-threatening miscarriage, even in states with abortion bans. Kennedy said, “I don’t know.”
Kennedy did say he supported President Donald Trump’s stances on abortion, including letting access be decided by individual states, limiting federal funding, and restricting late-term abortions. He also wants to investigate the safety of the FDA-approved abortion pill mifepristone, which is currently used for the majority of pregnancy terminations.
“I agree with President Trump that every abortion is a tragedy,” Kennedy said. “I serve at the pleasure of the president. I’m going to implement his policies.”
As HHS secretary, Kennedy might be able to impact how the FDA regulates mifepristone.
“While he can revoke approval for mifepristone, I doubt he would do that,” Gostin says. “But he might influence the FDA to limit access to the medication, such as not allowing prescriptions through telemedicine.”
His Plans for Medicare, Medicaid, and the Affordable Care Act Are Unclear
As HHS secretary, Kennedy could play an outsize role in determining how easy it is for people to afford and access care through Medicare, Medicaid, and ACA health plans. He provided few specifics on his plans for these programs during his confirmation hearings.
Medicaid, which is jointly funded by state and federal governments, came up often during Kennedy’s confirmation hearings. Kennedy was critical of Medicaid during his hearings, and said that the program needs an overhaul.
“I don’t have a proposal for dismantling the program,” Kennedy said. “I think what we need to do is we need to experiment with pilot programs in each state. We need to keep our eye on the ultimate goal, which is value-based care, which is transparency, accountability, access.”
He would also oversee implementation of ACA health plans and could push Congress to eliminate subsidies that make these plans more affordable. In his role as HHS secretary, Kennedy could also change how easy it is to enroll, how hard the government works to promote these plans, and what benefits are covered.
Kennedy could implement coverage changes that increase out-of-pocket costs, Gostin says. For example, “He could influence which vaccines are covered by the ACA cost-free.”
He Has Made Conflicting Statements About Ozempic and Other Weight Loss Drugs
During his confirmation hearings, Kennedy called GLP-1 drugs like Wegovy and Ozempic “miracle drugs,” a departure from prior statements he’s made criticizing weight loss medications.
“If we just gave good food, three meals a day, to every man, woman, and child in our country, we could solve the obesity and diabetes epidemic overnight,” Kennedy said in an interview on Fox News before the election. He also said that Ozempic’s developer, Novo Nordisk, is “counting on selling it to Americans because we are so stupid and so addicted to drugs.”
Medicare currently covers the GLP-1 drug Wegovy for people who have both obesity and heart disease and the GLP-1 drugs Ozempic and Mounjaro for diabetes. Kennedy could influence whether these drugs are covered, and whether people with obesity can get them when they don’t have other chronic medical conditions.
The ongoing treatments for polycythemia vera (PV) can sometimes interfere with appetite. But if you’re getting regular blood withdrawals or undergoing chemotherapy, there’s no understating the importance of eating a healthy diet.
In particular, “Eating a well-balanced, Mediterranean-based diet” can help minimize some of the complications from PV, says Stacy Morig, RD, an oncology dietitian with Dartmouth Cancer Center in Lebanon, New Hampshire. Plus, “Making small changes to their diet can also help people feel better overall.”
Here are four things you can do today to shore up your diet.
1. Follow a Mediterranean Style of Eating
Eating a Mediterranean-style diet — rich in fish, fruits and vegetables, nuts, vegetable oils and whole grains — can help prevent heart disease. That makes it a particularly good choice for people with PV, because the cancer causes an overproduction of red blood cells. And that increases the risk of heart attack, stroke, or pulmonary embolism (a blood clot in the lungs).
Even if you don’t follow a Mediterranean diet plan exactly, try eating plenty of fruits and vegetables, olive oil, and whole grains, while limiting added sugar, highly processed foods, and saturated fat, says Morig.
2. Try to Eat a Little Bit, As Often As You Can
Some people with PV will lose weight from the disease, because the spleen has to work overtime to clear out the extra red blood cells, which can cause the organ to grow larger. That can then lead to abdominal pain, bloating, and feelings of fullness, even after you’ve only eaten a little bit.
If you’re struggling with weight loss, try to eat nutritious, high-calorie foods, such as a nutritional supplement or protein-rich snack (think: peanut butter and a banana, full-fat yogurt with fruit and nuts, or cheese and crackers), whenever you’re able. You can also work with a registered dietitian experienced in both nutrition and oncology. Together, you can create a balanced eating plan that gives you the nutrition you need.
3. Pay Attention to Iron Intake
As many as 60 percent of people with PV have an iron deficiency, which can cause fatigue.
But while many people with an iron deficiency can take an iron supplement or a multivitamin containing iron, people with PV can’t.
“We generally try to avoid supplementing with iron, because that will cause you to make more red blood cells and add fuel to the fire,” says Jacqueline S. Garcia, MD, a medical oncologist at Dana-Farber Cancer Institute in Boston.
You can get extra iron from food, such as beans, meat, and spinach. Just be sure not to eat too much of it. For example, Dr. Garcia suggests steering clear of any fad diet that features excessive amounts of red meat. “I don’t restrict the amount someone eats, but I recommend eating a regular amount within the daily requirements,” she says. (Also, be sure to eat plant-based, iron-rich foods along with a food or drink containing vitamin C, such as a glass of orange juice, to help with iron absorption.)
For adults, the Recommended Dietary Allowance for iron is usually 8 milligrams per day, but women ages 19 to 50 need 18 milligrams.
4. Focus on Certain Types of Fiber if You Have Gastrointestinal Side Effects
Treatments such as chemotherapy may cause gastrointestinal side effects, including diarrhea and constipation, says Morig.
To address diarrhea, she recommends prioritizing foods that contain soluble fiber. “Soluble fibers act like a gel and can help absorb water in the intestines, [which adds bulk to the stool]” she says. Foods that contain soluble fiber include applesauce, citrus, pears, cooked carrots, green beans, and sweet potatoes.
If you are dealing with constipation, Morig recommends dried fruit, vegetables, and whole grains, which provide both insoluble and soluble fibers to encourage bowel movements.
If diet alone isn’t helping, talk to your clinician about stool softeners or laxatives to improve regularity, she adds.
The Takeaway
A Mediterranean-style diet may help ward off heart complications from polycythemia vera and improve your overall well-being.
Include more fruits and vegetables, nuts, olive oil, and whole grains in your diet.
Iron-rich foods, such as spinach and meat, can boost your iron intake and help prevent iron deficiency.
Work with an oncology dietitian to develop an eating plan for your nutritional needs.
Just like any chronic health condition, polycythemia vera (PV) can have a negative impact on your everyday life. Research has shown that PV is associated with a lower quality of life in measures, including health, cognitive, emotional, and physical functioning.
Symptoms such as fatigue, itchy skin, and mental health issues can make it difficult to function, but they can be managed. “This is a chronic condition that people can live with,” says Jacqueline S. Garcia, MD, a medical oncologist at Dana-Farber Cancer Institute in Boston.
Here are some common challenges of living with PV and ways to cope, so you can stay healthy and live well as you manage this condition.
1. Fatigue Can Interfere With Daily Activities
Fatigue is one of the most common symptoms of PV. “Polycythemia vera is a blood disorder that stems from an error in the bone marrow,” says Dr. Garcia. As a result, bone marrow overproduces red blood cells, causing the body to use up your iron supply. This results in iron deficiency, which leads to fatigue, she explains.
Another factor that can contribute to fatigue is phlebotomy treatment, which is a procedure that involves drawing blood to reduce blood cells and blood volume. A common side effect of this treatment is increased fatigue and iron deficiency, according to Garcia.
The degree of fatigue can vary from one person to another and depend on age, menopausal status, other health conditions — such as cardiovascular disease or diabetes — and more factors, says Garcia.
What to do about it: When it comes to polycythemia vera fatigue, research found that fatigue was a bigger problem for people who had a higher BMI, continued to drink alcohol or use tobacco, and didn’t exercise.
Maintaining healthy lifestyle habits may help you feel more energized every day. For instance, Garcia recommends exercising in moderation, as long as you have your doctor’s okay and don’t push yourself if you feel faint.
Another way to combat fatigue is by making sure you’re eating enough iron, which is important for energy production. “Food sources of iron are recommended instead of an iron supplement, and patients should not exceed the dietary reference intake of iron,” says Stacy Morig, an oncology dietitian with Dartmouth Cancer Center in Lebanon, New Hampshire. (Over time, too much iron can also lead to problems, such as damage to the heart, liver, and pancreas.)
The recommended dietary allowance (RDA) for iron is 8 milligrams for adult men and women, but that number increases to 18 milligrams for women ages 19 to 50.
In addition, Morig recommends eating a well-balanced diet, consuming regular meals throughout the day, managing stress (to the best of your ability), and getting adequate sleep to help reduce fatigue.
2. Itchiness Can Cause Discomfort
As many as 68 percent of people with PV may experience itchiness, especially when skin gets wet, according to research. And in up to 15 percent of cases, the itching may be particularly severe. Frequent itching can be distracting and may even interfere with your sleep. Plus, scratching your skin can put you at risk for bleeding, infection, skin discoloration, and more.
What to do about it: To reduce itching, the Leukemia & Lymphoma Society recommends bathing or showering in cool water with gentle soap, frequently moisturizing your skin, and avoiding hot tubs and whirlpools. If lifestyle tweaks don’t help, talk to your doctor about medications and in-office treatments, such as antihistamines and phototherapy.
3. Regular Blood Draws Can Be a Burden
A common treatment for PV is regular blood draws, which are used to reduce the risk of blood clots — one of the main complications of PV — which can cause life-threatening events, such as a heart attack, stroke, or pulmonary embolism. These blood draws are crucial, but they can also affect the quality of your life.
For one, having to schedule your life around blood draws — as frequently as once a week initially, before they can gradually be spaced out to about once every 4 to 8 weeks — can affect your work and home routines, especially since these appointments can take hours out of your day. Then, there are side effects to contend with: Research has shown that more than half of patients reported experiencing fatigue within 24 hours after a phlebotomy. Many other side effects were also cited, including bruising, dizziness, and dehydration.
What to do about it: Regular visits for phlebotomy are not pleasant and can have an impact on every aspect of your life — work, home, social routines — but Garcia notes that the frequency will decrease over time. After initial treatment, your provider will introduce a medication that helps control blood cell counts. This will eventually reduce the need for phlebotomy treatment, potentially to as little as one or two times a year, if PV is managed well.
“The burden decreases. We tailor the frequency based on what the patient’s needs are,” says Garcia.
In the meantime, she says, there are ways you may be able to work with your medical providers to reduce the treatment burden, such as finding a local blood center for the phlebotomy procedure. “There are ways we can do this to avoid interrupting someone’s life too much,” she says. Bottom line: Be honest with your doctor about your barriers to treatment, so they can work with you to find a solution.
4. The Stress of PV Progression and Complications Can Affect Mental Health
PV is a blood cancer, and that word itself can lead to distress. “Anyone with a cancer diagnosis will have an appropriate amount of stress associated with it,” says Garcia. “Our job is to get patients into a controlled situation, so they’re at a much lower risk for disease progression and blood clots.”
Potential PV complications can also be stressors. These include blood clots and progression to other diseases, such as acute myeloid leukemia, a fast-growing blood cancer.
What to do about it: Perspective and knowledge can be helpful in managing stress. While research has shown that people with PV may have a shorter life expectancy, experts say that with the treatments that are available today, that doesn’t have to be the case. According to an article in the journal Leukemia, normal life expectancy is possible.
Another strategy that may help is talking to your medical team. “Having a good relationship with your clinician can help you live with your disease, as opposed to waiting for something to happen,” says Garcia. “We can get people to have a good life expectancy with adequate support to reduce the anxiety surrounding it,” she says. If you’re experiencing stress, anxiety, or depression that’s affecting your daily life, ask your doctor to refer you to a mental health professional, support group, and other resources.
The Takeaway
Polycythemia vera is a chronic, rare blood cancer that can be managed with proper treatment.
Due to symptoms such as fatigue and the possibility of complications and progression, though, the disorder can negatively affect your quality of life.
With proper treatment and management strategies, PV can be controlled so that symptoms such as anxiety, fatigue, and stress can be reduced and quality of life can be improved.
Diabetes-related excess sweating can also be managed or prevented with good diabetes management.
Monitor Your Glucose Levels
“The most important way to help reduce nerve damage that’s causing the excessive sweating is to understand your glucose levels, especially if they are staying above your personalized target range or goal,” says Shetal Desai Rautela, RDN, CDCES, a diabetes coach in private practice.
If your specific target range isn’t clear for you, book an appointment to see a diabetes healthcare professional. Good blood sugar control protects the nerves and can help prevent perspiration issues.
Adjust Your Diet
“Nutrition can help reduce the symptoms of excessive sweating, and is a cornerstone to lifestyle changes to keep glucose levels in check,” says Rautela.
Avoiding or limiting sugary foods is a must, but you don’t have to give them up entirely. “While occasional desserts to satisfy that sweet tooth is not a concern, frequent consumption can make it harder to manage glucose levels,” she says.
If you’re feeling hot and sweaty, Rautela suggests cooling down by eating moisture-rich produce such as cucumber, watermelon, strawberries, celery, and leafy greens. Drinking water throughout the day can also reduce excessive sweating and may lower high glucose levels.
Exercise Regularly
Working out when your body’s sweat glands are already in overdrive may not seem appealing, but it is a great way to improve post-meal glucose levels, says Rautela.
“Try low-to-moderate intensity workouts, and it can be as simple as getting some steps in during the day to break up the work hours,” she says. “All and any steps taken aid in regulating the body temperature and improving glucose levels.”
Manage Stress Levels
Sweating is a common reaction to stress, anxiety, or nervousness. “High stress levels can further aggravate the sweat glands and induce excessive sweating,” says Rautela.
To lighten your load, learn how to recognize your stressors and find ways to practice relaxation exercises, such as deep breathing and meditation, or talking to a friend. People with diabetes are significantly more likely to experience mental health conditions such as anxiety and depression. Sessions with a mental health provider should be considered a normal and important part of diabetes management.
The bulk of tea’s immunity-boosting and overall health benefits are tied to a group of antioxidants known as polyphenols. “A significant amount of epidemiological data has shown that a diet rich in polyphenols is protective against chronic health conditions such as cardiovascular disease and type 2 diabetes,” says Megan Meyer, PhD, the Durham, North Carolina–based senior director of science communications for the International Food Information Council. Her past research examined the effects of nutritional antioxidants on the immune system’s response to influenza.
One review study found that teas are especially rich in polyphenols known as flavonols. These plant chemicals have been shown to help lower blood pressure and cholesterol.
As far as your immune system is concerned, antioxidants (like the flavonols in tea) can help protect your body against free radicals generated by pollution, cigarette smoke, and ultraviolet rays. Free radicals can have harmful effects on the body, including contributing to a weakened immune system.
There are many tea varieties that may support your immune system’s health. Popular options like green, black, white, and oolong tea all come from the same evergreen plant, Camellia sinensis. “What makes them distinct is how they are prepared,” Dr. Meyer says. Differences in processing, geographical location, and plant varieties account for the unique flavors and nutritional compositions of tea, and those differences may mean that some teas offer more immunity benefits than others.
Herbal teas may also support your immune system’s health. “Most herbal teas are known to have health-supporting qualities,” Lee says.
Herbal teas are not made from the Camellia plant but instead from dried herbs, spices, roots, seeds, fruits, or leaves from other plants. Depending on the nutritional makeup of a given plant, some herbal teas may be better for your immune system’s health than others.
More Research on Tea and Immune System Health Is Needed
While the research on tea and immune system health sounds promising, the studies thus far either haven’t used humans or the population sizes involved were relatively small. Many studies also use tea in capsule or tablet forms, both of which usually pack a far greater dose of plant compounds than you’d find in a tea bag. Given these limitations, it’s tough to know whether a cup of tea will benefit a typical person’s immune system health. More large studies of humans using brewed tea are needed.
That said, health experts generally agree that brewed tea without a sweetener is a healthy beverage choice. “I personally believe that teas are a great way to add functional foods and herbs to your diet on a daily basis,” Lee says. So drink up! And if immune system health is your top concern, you might want to start with this list of the five top teas for a healthy immune system, in order of strongest evidence to weakest.
“While intentional weight loss can be beneficial for health, unintentional weight loss, especially in older adults, may reflect underlying neurodegeneration or other health conditions,” says lead study author Zimu Wu, PhD, a research fellow at Monash University in Australia.
Brain changes that start years before dementia symptoms appear may affect metabolism, appetite, mobility, and daily function, Dr. Wu says. All of these things can lead to unintended weight loss.
“Rather than causing dementia, it may be an early warning sign of dementia” Wu says.
Adults Who Developed Dementia More Likely to Experience Rapid Weight Loss
For the study, researchers followed 5,390 older adults for more than a decade, starting when they were 77 years old on average and free of dementia. All of the participants were cognitively healthy at the start of the study and had multiple tests over time for several dementia risk factors such as body weight, waist circumference, blood pressure, and cholesterol levels.
A total of 1,078 people developed dementia. Compared with people who didn’t develop dementia, those who did had more rapid declines in body weight and waist circumference during the study period, according to findings published in JAMA Network Open.
Along with faster weight loss, dementia patients also experienced a significantly bigger reduction in waist circumference in the decade before their diagnosis than their cognitively healthy peers did over that same time period, the study found.
While obesity in middle age is a risk factor for dementia, it’s not uncommon for people with this condition to have a lower body mass index (BMI) right before their diagnosis than cognitively healthy people the same age, says Mika Kivimaki, PhD, an epidemiology professor at University College London in England, who wasn’t involved in the new study.
“Lower weight does not indicate protection against neurodegeneration if it results from unintended weight loss due to preclinical neurodegeneration,” Dr. Kivimaki says. “However, healthy weight in midlife is protective, reducing the risk of diabetes and vascular diseases, which both are dementia risk factors.”
Cholesterol Levels Also Shifted in the Decade Before Dementia Diagnosis
One other risk factor also appeared to impact dementia risk. People with lower levels of high density lipoprotein (HDL) cholesterol, the good kind that helps keep blood vessels free of debris, were more likely to develop dementia, the study found.
People with lower blood pressure also appeared more likely to develop dementia, although this finding wasn’t statistically significant, meaning it’s possible that this connection was due to chance.
Findings Are ‘Surprising,’ Given Existing Knowledge on Dementia
The study wasn’t designed to prove whether or how any specific risk factors such as declines in body weight or waist circumference might directly cause dementia. It also didn’t examine the underlying causes for weight loss or lower HDL levels.
“The results of this study are surprising,” says Andrew Budson, MD, chief of cognitive behavioral neurology at the VA Boston Healthcare System and associate director of the Boston University Alzheimer’s Disease Research Center.
That’s because a lower body mass index, higher levels of HDL cholesterol, and lower blood pressure can all reduce dementia risk, says Dr. Budson, who wasn’t involved in the new study.
It’s possible that dementia patients in the study were losing weight and dropping their blood pressure because they were sick with some type of chronic illness, Budson says.
“Many illnesses, including but not limited to infectious diseases, increase the risk of dementia,” Budson says. “These are the only reasons that I can see as to why the results should have come out this way.”
How to Maintain Good Cognitive Health
Even so, there are many steps older adults can take to stay cognitively healthy as they age, such as eating a healthy diet, staying physically active, engaging in social and mental activities, managing stress, and maintaining a positive mood, Wu says.
The study findings also suggest that it makes sense to get a checkup if your weight drops and you’re not sure why, Wu adds. “Unexpected weight loss may be an early sign of dementia, so it is important to seek medical advice if it occurs,” Wu says.
Both dietary fiber and sugar alcohols are thought to have little or no impact on blood sugar, which is why those numbers aren’t included in a net carb count.
Fiber
Dietary fiber is a type of carbohydrate that the human body does not digest. It’s considered extremely healthy, and is mainly found in fruit, grains, legumes, and vegetables, especially when they are minimally processed. In theory, it has no impact on blood sugar.
“While fiber may not impact blood sugar directly, the idea for including fiber in meals is to allow for a more blunted response versus a straight spike or rise in blood sugar,” says Kimberlain. “In general, the more fiber a meal contains, the better.”
There are two types of dietary fiber: soluble and insoluble fiber. Soluble fiber feeds good gut bacteria, and is found in foods such as apples, barley, and oats. Insoluble fiber helps promote softer and regular stools, and is found in foods such as whole-wheat flour, vegetables, and berries. Sometimes food packaging lists the amount of each of these different fibers, but sometimes it does not. Both types of fiber are believed to help lower blood sugar levels in the long-term, but you may find that your body tolerates one type of fiber better than the other.
Sugar Alcohols
Sugar alcohols are used as an alternative sweetener in many packaged low-carb foods. They can occur naturally in foods, but most are produced industrially. Foods that are labeled “sugar-free,” including hard candies, cookies, chewing gum, and soft drinks may contain sugar alcohols.
Sugar alcohols are carbohydrates that are hybrids between sugar molecules and alcohol molecules. They are generally thought to have zero calories and zero blood sugar impact. Examples of sugar alcohols include:
Sorbitol
Xylitol
Lactitol
Mannitol
Erythritol
Maltitol
Sugar alcohols are converted to glucose more slowly than other types of carbohydrates, and they require little to no insulin to be metabolized. “This creates a minimal impact on blood glucose,” says Lori Zanini, RD, CDCES, a certified diabetes care and education specialist based in Los Angeles, and author of Eat What You Love Diabetes Cookbook. “When calculating net carbs, individuals can subtract half or all of the amount of sugar alcohols from the total carbohydrates.”
In many ways, sugar alcohols such as erythritol are attractive alternatives to sugar and often quite helpful in supporting people’s health and nutrition goals when used in moderation. When eaten in excess, sugar alcohols can cause gas, bloating, and diarrhea. And higher blood levels of erythritol have been associated with a greater heart attack and stroke risk.
