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A major trial suggests tailoring screening to individual risk is safe and might reduce unnecessary tests

• A large U.S. clinical trial found that risk-based breast cancer screening where screening frequency is tailored to each womans individual risk is just as safe as yearly mammograms for catching advanced cancers.

• Women were grouped using genetics, lifestyle, and clinical factors; those at highest risk got more intensive screening, while lower-risk women had less frequent imaging.

• Most women preferred risk-based screening when given the choice, and the approach led to fewer mammograms overall without increasing dangerous late-stage cancers.

For decades, routine breast cancer screening in the U.S. has largely meant annual mammograms starting in middle age a one-size-fits-all approach based mostly on age.

But what if screening could be smarter?

Thats exactly what researchers set out to test in the WISDOM trial, a large study coordinated by the University of California, San Francisco (UCSF) that asked a simple question: Can we use individual risk profiles to decide who needs what kind of screening?

Published in JAMA and presented at a major cancer symposium, the trial enrolled tens of thousands of women ages 4074 and compared traditional yearly mammograms with a personalized plan driven by each womans unique risk factors including genetics, breast density, lifestyle, and other health details.

These findings should transform clinical guidelines for breast cancer screening and alter clinical practice, Laura J. Esserman, M.D., MBA, director of the UCSF Breast Care Center, said in a news release. The personalized approach begins with risk assessment, incorporating genetic, biological, and lifestyle factors, which can then guide effective prevention strategies.

How the study worked

Instead of automatically giving everyone a mammogram every year, researchers built risk scores that placed participants into different screening pathways.

Women in the highest risk group based on things like genetic predisposition or very high calculated risk were advised to get imaging every six months, switching between mammograms and MRI.

Those with elevated risk still got annual mammograms plus counseling on ways to lower their risk. Most women fell into the average risk category and were recommended to have mammograms every two years. At the lowest end, women with especially low estimated risk were told they could safely delay screening until later often up to age 50 unless their calculated risk rose.

This design also offered tools for personalized risk reduction, like diet and exercise guidance or conversations about medications that may lower cancer risk. Women who chose not to be assigned randomly could pick their own screening approach in an observational group and most picked the risk-based route.

What the results showed

After about five years of following more than 28,000 women, the core finding was that the risk-based screening plan was as safe as traditional annual mammography.

Researchers looked especially at the number of advanced cancers (stage IIB or higher) detected and found that the risk-based group did not have more of these serious cases in fact, the rate was slightly lower across the study period, meeting the trials main goal of noninferiority.

Interestingly, women in the risk-based strategy had fewer mammograms overall but similar rates of biopsies and cancer detection meaning the personalized approach didnt miss cancers or lead to more invasive follow-ups even with less frequent imaging for many.

Whats more, when given the choice, a large majority of participants opted for the risk-based strategy, showing that many people appreciate tailoring screening to their specific profile.

A new study explains how the sweetener travels from the gut to the liver

• Sorbitol, a common sugar alcohol used in zero-calorie foods and found naturally in some fruits, isnt just a passive sweetener it can be converted inside the body into compounds that stress the liver.

• In experiments with zebrafish, sorbitol formed in the gut moves to the liver and becomes a fructose derivative, which fuels fat buildup linked to liver disease.

• Friendly gut bacteria normally break down sorbitol, but high levels or an imbalance of microbes may allow more sorbitol to reach the liver.

Sorbitol has long been marketed and often enjoyed as a healthier option for people trying to cut calories or manage blood sugar. Its a sugar alcohol that adds sweetness without the glycemic spike of table sugar, popping up in sugar-free candies, gums, and many diet goodies.

But recent research out of Washington University in St. Louis is prompting scientists and consumers alike to rethink that assumption.

The work suggests that sorbitol may not be quite as biologically innocent as its packaging implies especially when it comes to how the liver handles it.

The study

To understand how sorbitol behaves inside the body, the research team used zebrafish a species scientists often study because many of its metabolic processes work in ways similar to humans. The goal was to follow sorbitol step by step and see where it goes after its produced or consumed.

The researchers focused on the gut and the liver, two organs that play major roles in processing sugars. Using advanced lab tools that let them track tiny molecules, they discovered that cells in the intestine can actually turn glucose into sorbitol. That means sorbitol isnt just something we eat it can also be made inside the body.

In simple terms, the study followed sorbitols journey through the body and found that whether it stays in the gut or reaches the liver may depend heavily on the health of the gut microbiome.

What the results mean and dont mean

The researchers discovered that when sorbitol remains in the gut, certain bacteria can break it down before it causes problems. But when those helpful microbes are reduced or overwhelmed, more sorbitol is able to travel from the intestine to the liver.

Once it reaches the liver, sorbitol doesnt just pass through harmlessly. The liver converts it into a compound related to fructose. Unlike glucose, which the body uses widely for energy, fructose is processed almost entirely in the liver. That process can trigger the production of fat inside liver cells.

In the zebrafish studied, this chain reaction sorbitol moving from the gut to the liver and then being converted was linked to fat buildup in the liver, a hallmark of steatotic liver disease.

The findings suggest that sorbitol may contribute to liver fat accumulation under certain conditions, particularly when the gut microbiome isnt able to effectively break it down first.

While the study was conducted in zebrafish and more research is needed to understand how this translates to humans, the results highlight how a sweetener often considered a safer alternative can still have meaningful effects inside the body.

Before you order that $6.95 latte, read this

• Customize instead of ordering the full drink Order a plain cold brew or latte and add toasted coconut or lavender syrup. This can save $1$2.

• Use Rewards promos Look for Triple Star Days, bonus Star offers, and BOGO deals in the Starbucks app to earn free drinks faster.

• Split it or make it at home Divide a grande into two smaller servings, or recreate the drink at home for about $1$2.

Starbucks spring menu officially landed this week, bringing tropical and floral flavors back into the spotlight.

The headline drinks include:

• Reimagined Chai
• Iced Ube Coconut Macchiato
• Toasted Coconut Cream Cold Brew
• Toasted Coconut Latte
• Iced Lavender Cream Chai
• Lavender Latte
• Lavender Crme Frappuccino

Theyre colorful and theyre definitely social-media ready. And in many cities, theyre pushing $6 to $7 per drink.

Heres how to enjoy the new menu without blowing your coffee budget.

Order smarter (skip the 'full build')

Many of their new seasonal drinks are fairly simple and breakdown like this:

Cold brew or espresso + flavored syrup + flavored cold foam

Instead of paying full-price and ordering the fully branded drink, try this instead:

• Order a plain cold brew
• Add 12 pumps of toasted coconut syrup
• Ask for a light splash of sweet cream cold foam

By ordering this way, youll often save $1$2 compared to the pre-built version.

Same thing goes with their new lavender drinks.

Try ordering an iced chai or latte and add onepump of lavender syrup instead of the full lavender cream foam build.

Ask for half sweet to cut both sugar and cost creep.

Time it with rewards (this is key)

If youre going to try a $6.95 drink anyway, be sure to do it strategically in conjunction with their updated Rewards program.

Watch for:

• Bonus Star promotions
• Triple Star Days
• Try the new drink offers
• BOGO afternoon deals

Sixty stars now gives you $2 off your order, with the goal of stacking stars toward a completely free handcrafted drink (200 stars).

The best way to be kept in-the-know of upcoming promotions, before they hit the app, is to follow Starbucks on social.

Instagram: https://www.instagram.com/starbucks

TikTok: https://www.tiktok.com/@starbucks

Split the drink hack

This tip works especially well with layered drinks like the Ube Coconut Macchiato.

Order a grande and ask for an empty tall cup on the side. Or better yet, instead of asking for a tall cup, order a free water and theyll hook you up with a cup full of ice that you can use for splitting.

Then you can split the drink into two smaller servings. Its not perfect, but it stretches one premium drink into two lighter ones. This is especially helpful with the super-rich flavors like the ube and coconut.

Recreate it at home for 7080% less

While these drinks might look complex, they really arent. You can easily make them at home and save a ton of money.

At-home Ube Coconut Macchiato

• Brew strong coffee or espresso
• Mix coconut milk with a spoonful of ube powder or ube jam
• Add vanilla syrup
• Pour over ice and top with coffee

Estimated cost: $1.50$2 per drink.

At-home Lavender Cream Chai

• Use chai concentrate
• Add milk of choice
• Make cold foam with heavy cream + lavender syrup
• Pour over ice

Estimated cost: About $1 per drink.

Search TikTok or Instagram for Starbucks ube copycat or lavender chai copycat and youll find dozens of step-by-step videos from creators who break it down in under 60 seconds.

The agency points out the compounded drugs are not the same as FDA-approved drugs

By Mark Huffman of ConsumerAffairs

• The FDA has issued 30 warning letters to telehealth companies over misleading claims about compounded GLP-1 drugs.

• Regulators say some companies implied their compounded products were equivalent to FDA-approved medications or obscured where the drugs were made.

• The action is part of a broader crackdown on misleading direct-to-consumer pharmaceutical advertising launched last September.

The U.S. Food and Drug Administration (FDA) has issued warning letters to 30 telehealth companies for making false or misleading claims about compounded GLP-1 drugs promoted on their websites.

The agency said the companies marketed compounded versions of GLP-1 medications in ways that suggested the products were the same as FDA-approved drugs or failed to clearly disclose where the medications were produced.

Its a new era. We are paying close attention to misleading claims being made by telehealth and pharma companies across all media platformsand taking swift action, said FDA Commissioner Dr. Marty Makary.

Dr. Makary said compounded drugs can play an important role in addressing shortages or meeting specific patient needs, but warned that compounders should not attempt to bypass the FDAs drug approval process.

Second wave of actions

The warning letters mark the second wave of enforcement actions targeting telehealth companies since the FDA launched a broader effort last September to police misleading direct-to-consumer pharmaceutical advertising.

Over the past six months, the agency said it has sent thousands of warning letters to pharmaceutical and telehealth companies directing them to remove misleading advertisements more than were sent during the entire previous decade.

According to the FDA, the most common violations involved claims that compounded GLP-1 products were the same as FDA-approved medications. Other companies promoted drugs using their own brand names or trademarks without clarifying that a separate pharmacy actually compounded the medications.

The FDA emphasized that compounded drugs are not FDA-approved, meaning the agency does not review them for safety, effectiveness,or quality before they are sold. The agency also noted that compounded drugs are not equivalent to generic drugs, which must undergo FDA review and approval.

The warning letters require the companies to correct the violations and remove misleading claims from their marketing materials. Failure to comply could result in further regulatory action, the agency said.