After months of winter, the urge to get outside is hard to ignore, and for many people, that starts with a simple walk.

That includes Paige Linstead, a physician assistant with OSF HealthCare. “A lot of patients have sedentary jobs, as do I,” Linstead says. “So, I try to walk on my lunch, walk my dogs when I get home. I really focus on the calorie aspect of it too, and try to increase the walking speed, the distance that you can cover.”

For years, the targeted goal was 10,000 steps, which originated in the 1960s from a marketing campaign to promote the Tokyo Olympics. While the American Heart Association still recommends 10,000 steps a day, the organization says that just a mile of walking can also provide health benefits.

But now, the prevailing thought is that 7,000 steps a day will still do the trick. Walking improves your cardiac health, lowers your risk for diabetes, improves your circulation, can help improve sleep, decreases appetite and helps with weight management. It’s also enough steps to reduce the risk of dementia, cancer and depression.

“So, 10,000 was the gold standard. It's an easy number for people to say they're going to reach,” says Linstead. “But 7,000 is sufficient for most adults. It's a good goal to help minimize health risks and improve your health.”

It’s especially good for older adults.

Walking is good for heart health

According to a study published in the journal Circulation, older adults who walk three to four miles a day - 6,000 to 9,000 steps - are 40% to 50% less likely to suffer a heart attack or stroke than those who walk a mile (2,000 steps) a day.

This study focused on cardiovascular disease (CVD) risk and the findings were the result of eight studies using data from 20,000 people in the United States and 42 other countries. Their average age was 63 with 52% being women.

“It can improve your cardiovascular health, decrease your risk for diabetes or diabetes progression, help with stability, mobility,” Linstead adds. “It can help with mental health, getting a little bit vitamin D with the sun. Just set small goals for yourself and keep increasing as you can until you can get to that goal of 7,000 steps in a day.”

But if that still seems like a lot, don’t worry. Linstead says the important thing is to get started and work your way up gradually. Start by walking around your block or maybe visiting the local shopping mall.

“Absolutely, any movement is good movement,” she says. “Instead of having a sedentary lifestyle, if you can only get a couple thousand steps in a day, that can help elderly with mobility, stability, mental health, too.”

The Centers for Disease Control encourages people to get in 150 minutes of moderate to vigorous exercise each week. But Linstead says don’t try to squeeze in all 30 minutes at once, at least to start. She recommends breaking up the time into different parts of your day – for example, 10 minutes in the morning, 10 at lunch and another 10 minutes at night might just be the best route to take.

“I think that would be good motivation for people if they had a partner or a group to walk with,” Linstead says. “And you can walk at whatever speed you're comfortable with, the distance that you're comfortable with, but knowing that you have a support system in place.”

Before starting any type of walking program, however, make sure to consult with your medical provider first.


 

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It’s been two decades since the first-ever glucagon-like peptide-1 (GLP-1) medication was approved by the U.S. Food & Drug Administration (FDA).

For years, GLP-1s have been used to help those with diabetes. More recently, GLP-1 producers have begun marketing drugs like Ozempic®, Wegovy® (both semaglutide), Zepbound® or Mounjaro® (tirzepatide) for weight loss. Now heart health experts believe these medications can provide a robust benefit to heart health.

This comes as the American College of Cardiology® (ACC) released its five top trends in cardiovascular medicine in 2025, including “Anti-Obesity Drugs: Cardiovascular Benefit Beyond Weight Loss.”

The ACC reports that semaglutide and tirzepatide both “demonstrate remarkable cardiovascular benefits that extend beyond weight management.” Clinical trials show these medications can reduce the risk of major adverse cardiovascular events by up to 20% in patients with obesity and preexisting cardiovascular conditions.

Christopher Sparrow, MD, is an Advanced heart failure cardiologist with OSF HealthCare. He says he’s seen some remarkable benefits in many of his patients.

"The biggest thing I've seen in my practice is that patients who are obese can take these medications and have dramatic reductions in their weight, while doing it in a healthy fashion with a tolerable treatment," Dr. Sparrow says. "When these patients lose weight, they feel better, their blood pressure gets better, their cholesterol gets better, and their diabetes gets better if they have it. If they don't have it, their risk of getting diabetes goes down. Plus, their quality of life improves."

Dr. Sparrow is also the medical director of both the heart transplant program and adult heart unit at OSF HealthCare Saint Francis Medical Center, a Level 1 Trauma Center in Peoria, Illinois. He describes how GLP-1 drugs promote heart health.

"These medications target GLP-1 receptors. These receptors are primarily in the gastrointestinal system, but they're also in the brain and small amounts in the heart. We're learning more and more that these drugs can have direct impacts on the heart," Dr. Sparrow says. "Particularly in small blood vessels that are prone to effects of inflammation and disease in patients with obesity."

GLP-1s are also referred to as incretin analogues. Incretins are substances that promote insulin release to lower blood sugars. They act in the brain to increase the feeling of satiety (not being hungry anymore), which stops overeating and excessive drinking. Dr. Sparrow says the health benefits are both in how the medications are formulated, and because patients are losing weight. 

“Recent evidence has shown that in the obese population with heart failure, these drugs improve quality of life and improve the ability for these patients to function. That can mean being able to walk further distances," Dr. Sparrow says. "They lower systemic inflammation levels and reduce the risk of worsening heart failure events. For us, this is a brand-new tool in our toolbox to benefit the quality of life in these patients."

While GLP-1s are being seen as the heart’s newest best friend, on the flip side, obesity is one of its worst enemies.

"It (obesity) promotes higher blood pressure, diabetes, abnormal lipids and we know it increases inflammation in the body, which has adverse effects throughout the body," Dr. Sparrow says. "Simply by reducing obesity, we think we're making a huge impact on future cardiovascular risk."

Dr. Sparrow says doctors have known for a long time that patients with diabetes who use these forms of medications have a reduced risk of heart attack, stroke and death from cardiovascular causes like congestive heart failure. Now, that's expanding to patients who are obese or those with heart failure. 

Semaglutide and tirzepatide have been shown to have a better weight loss benefit compared to their GLP-1 predecessors, Dr. Sparrow says. Adding that these drugs can reduce cholesterol levels, improve hemoglobin A1C (a marker of diabetes), as well as lower blood pressure and markers of inflammation to a greater extent.

This treatment option can be used as primary and secondary prevention. That means people can take one of these drugs before anything like heart attack or stroke happens (primary), or after heart attack and stroke that could prevent another from happening (secondary). 

Patients with a body mass index (BMI) over 30, diabetes and/or cardiovascular disease are all patients that could benefit from this treatment, Dr. Sparrow says.

The struggle with getting these drugs to all the patients who want them comes down to two factors. 

1: Pharmacies can't stock enough to keep up with demand

2: Many insurance companies aren't covering these medications for weight loss

When it comes to obesity, Medicare recently announced it would cover these drugs for obese patients who have cardiovascular disease. It’s estimated this could impact roughly 3.4 million Americans.

Dr. Sparrow says it’s not surprising that over time researchers are finding health benefits for these drugs when it was previously meant for another purpose. He says it’s the natural order of scientific discovery that comes from a deeper understanding of these medications obtained through years of research and study. 

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It’s no great surprise to read that men and women both benefit from working out.

But women may receive greater benefits from regular exercise than men, according to a study published in the Journal of the American College of Cardiology.

The study centered on the importance of exercise as a way to avoid dying prematurely. The researchers studied data from 400,000 people and found that women who exercised were 24% less likely to die early from any cause. Men who exercised, however, were 15% less likely to die early.

The study also revealed that the women who exercise had a 36% lower risk of dying from a cardiovascular event, compared to men at 14%. That’s important because women have twice the risk of dying from a heart attack than a man.

Mary O’Meara is a nurse practitioner with OSF HealthCare. She says society still views heart attacks more as a man’s disease. That’s simply not true.

“Usually, a male is feeling this really bad chest pressure, chest pain going in the left arm into the jaw, very pale. Women, very often, will just complain of fatigue, nausea or heartburn. ‘I feel wiped out. I just can't walk across the room. I need to sit down,’” explains O’Meara. “Unfortunately, that can be a sign of a heart attack in a female, and it gets missed quite often.”

While any movement is good, O’Meara stresses the importance of women incorporating strength and/or resistance training, such as lifting weights. Frequency and the amount of weight depend on the person and their situation.

“For a long time, women were encouraged to do more aerobics-calisthenics. We were always thought of as the weaker sex, I guess you can say, and we weren't really encouraged to do any weight bearing exercise,” says O’Meara. “A lot of research has come back that states that women should be focusing on weight bearing exercises for several different reasons.”

Strength training can also help women as menopause becomes an issue. According to O’Meara, hormones start changing between the ages of 40 and 50 – a time when women start losing muscle and see an increase in body fat. Strength training can help with that change, along with other health issues.

“We found that weight bearing exercise can reduce our risk of dementia and Alzheimer's, and also reduce our risk of osteoporosis, which is a big one,” says O’Meara.

O’Meara also has a nutrition tip for her patients. Protein, she says, is important for women to prevent muscle loss, especially during menopause. O’Meara recommends 30 grams of protein before and 15 grams after a workout, to help rebuild muscle that has been naturally broken-down during exercise.

Additionally, O'Meara is a proponent of healthy fats. She encourages patients to incorporate grape seed oils, olive oils, fish oils, flax seed oils, nuts and avocados into their diets.  Her philosophy is that good fats battle bad fats, and good fats protect our heart.

O’Meara stresses that it's never too late for women to start exercising. Even a short walk or work around the home, for instance, can go a long way to a healthier future.

“You read many testimonials from people who were couch potatoes and never exercised,” she says. “And then, they go into these exercises and do wonderful things that have really made a difference.”

For more information on women’s health, visit the OSF HealthCare website.

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Early menopause (menopause that occurs before age 45) has been found to increase the risk of heart disease. 

According to a study by the American Diabetes Association, that included data from nearly 10,000 postmenopausal women, researchers looked at the connection between early menopause, Type 2 diabetes, and cardiovascular disease (CVD) risk in women. The data showed that women who experienced early or premature menopause had a higher risk of heart disease, especially if they also had Type 2 diabetes.

According to Kathleen Meade, APRN, a nurse practitioner with OSF HealthCare, estrogen helps protect the heart. The drop in estrogen levels that occur during menopause can lead to higher cholesterol, blood pressure and body fat levels — all of which are factors leading to heart disease.

Cardiovascular disease is the leading cause of death among women of all ages. More than 60 million women in the U.S. have some type of heart disease. “For women, heart disease is very serious,” says Meade. “A lot of times we think of the other things that might potentially affect our life and our quality of life, like cancers, but with heart disease, it’s the most prevalent cause of death in women.”

For women who encounter early menopause, these changes happen over a longer period. They increase the lifetime heart disease risk compared with those who reach menopause around the average age of 50 to 52. When hormonal changes occur with menopause, blood vessels can stiffen, blood pressure can rise and cholesterol balance may change, all of which increase the risk of heart disease.

“When women go through menopause, they fail to produce any estrogen,” explains Meade. “Estrogen is a vital link between vascular flexibility, and that would increase their chances of having hypertension. And it increases their risk of plaque buildup, or if they have high cholesterol or hyperlipidemia. So, you put those together, that's what causes the increased risk of heart disease.” 

Besides menopause, other major risk factors for cardiovascular disease for women include high blood pressure, high cholesterol, an unhealthy diet, obesity, smoking and physical inactivity. “Women can take several steps to decrease their cardiovascular risk,” Meade says. “One would be to maintain an active lifestyle. We recommend 150 minutes of exercise per week. Follow a low fat, heart healthy diet. The Mediterranean diet is an excellent way to provide healthy oils and low fat and good protein.” Meade also recommends limiting alcohol and processed foods, increasing fruits and vegetables and getting at least eight hours of sleep.

Tailoring a treatment plan 

Knowing the link between menopause and heart disease can help health care providers like Meade treat her patients more effectively now and in the future.

“You can more individually tailor their care accordingly to when they went through menopause and when you possibly put them on hormone replacement therapy,” she says. “Look at all the other cardiovascular risk factors – address hypertension, hyperlipidemia or cholesterol, look at their sleep patterns, at exercise routines and weight management. We can put all that together to try to reduce their chances of having a heart attack or a stroke.”

Hormone replacement therapy is medicine prescribed to replace the estrogen the body stops making after menopause, which is when periods finally stop for good. This therapy is used to treat common symptoms, such as hot flashes. It’s also been used to prevent bone loss after menopause. Meade says for the best results, hormone replacement therapy should be tailored to each person but first discussed with your health care provider.

Meade can relate to her patients who experience menopause issues. She has traveled along a similar journey. “I’ve gone through menopause, and I'm happy to say that I feel great,” she says. “I generally bring it up in our conversations when the time is right. A lot of times they bring it up, because it does impact our lives in every aspect. I feel like I can walk beside them, help them and give them expert advice and treatment options.”

For more information on women’s health, visit the OSF HealthCare website.

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Are you the type of person who can’t wait to kickstart your day with that piping-hot cup of coffee in the morning? If so, there’s good news for you.

According to a recent study published in the European Heart Journal, one perk of morning coffee is it’s healthier for you than any other part of the day.

Early risers – coffee connoisseurs who pour their first cup of java between 4 a.m. and noon – have a 16% lower chance of dying from any cause compared to non-coffee drinkers.

According to the study, coffee drinkers also had a 31% lower risk of dying from heart disease compared to non-coffee drinkers.

“The study identified that one of the aspects of coffee lowers inflammation, and we have more inflammation in the morning. And so that's why the benefit was shown in this study,” says Nancy Dagefoerde, a nurse practitioner with OSF HealthCare Cardiovascular Institute. “I do agree that that's a good benefit of drinking coffee in the morning.”

The findings were the result of work done by researchers from Tulane University who analyzed dietary and health data from 40,000 adults between 1999 and 2018. The research team studied two groups – morning-only coffee drinkers and all-day coffee drinkers.

Researchers focused on patterns of drinking coffee throughout the day rather than the amount of coffee consumed. Dagefoerde recommends drinking no more than two or three cups a day.

Another important aspect of coffee is how it’s made. Past studies have shown evidence of a link between coffee brewing methods, heart attacks and longevity. For example, unfiltered coffee that’s boiled contains higher amounts of chemicals that can raise triglyceride levels and low density lipoprotein (LDL) cholesterol levels.

“Filtered coffee is more beneficial. Boiled can actually be more harmful. There are many compounds in coffee that are beneficial to health in general,” says Dagefoerde. 

But a cup of brew isn’t everything when it comes to heart health. Dagefoerde says there are other things you should be doing including exercising, treating your blood pressure and cholesterol.

“Coffee can lower inflammation, increase your metabolism and decrease the absorption of fats,” she adds. “But you definitely want to work on all your risk factors, not just drinking coffee.”

It’s better to drink black coffee, but if you take it with sugar or cream, make sure you are using the ones that are as healthy as possible such as unsweetened almond milk, raw honey or cinnamon. Cream adds 50 calories and three grams of saturated fat per tablespoon. And a teaspoon of sugar contains 16 calories, which adds up quickly.

Dagefoerde says while the studies are encouraging, it doesn’t mean you should race to your local coffee shop and start guzzling mugs of java purely for the health benefits.

“Coffee is popular in our nation, and in many countries. And the social aspect is nice too,” she says. “But don’t overdo it, and just know the risks if you do.”


 

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Heart disease remains the leading cause of death in the United States. That’s from a new study in Circulation, a journal published by the American Heart Association (AHA).

According to the AHA, 941,00 people died from heart disease in the U.S. in 2022. Cancer deaths are second followed by accidental deaths.

Nancy Dagefoerde is a nurse practitioner with OSF HealthCare Cardiovascular Institute who closely monitors these trends. While the findings weren’t surprising, Dagefoerde says it’s a great reminder to patients and clinicians that heart health remains a top priority.

“It gives us information to talk to our patients about and for the public to see things that they might want to work on,” she says. “I think many people are concerned about other illnesses like cancer, but then we have these reports that tell us heart disease is still leading cause of death.” 

There are several risk factors for heart disease. The greatest risk is genetics, followed by threats that are preventable such as diabetes, high cholesterol and blood pressure, stress, lack of exercise and obesity. Nearly 47% of U.S. adults have high blood pressure, 57% have Type 2 diabetes or prediabetes and 42% have obesity.

And the risks impact all ethnicities, but some more than others.

“For example, many Hispanics are higher risk for diabetes,” says Dagefoerde. “African American women tend to have higher risk for obesity and hypertension. So, we really need to target those risks and realize that these are some things that we can work on to prevent that risk.”

There is, however, some good news.

High cholesterol rates have declined over the past few years. Dagefoerde credits that to more awareness about diet and lifestyle factors, as well as medications used to control cholesterol. And smoking rates are also on the decline. That includes both cigarettes and e-cigarette use.

“I was pleased to see that the smoking rates and vaping rates were down, and not only for adults but teenagers,” she says. “As for cholesterol, we have good treatment plans that are being utilized. Those are two very important things that are exciting.”

While there has been some progress, experts warn that if recent trends continue, hypertension, obesity and diabetes will reach staggering numbers. This will greatly impact people’s health as they age.

Dagefoerde adds that 80% of heart problems can be prevented. It starts by working on lifestyle issues – diet, exercise, sleep, no smoking and limit your alcohol consumption. It starts by educating yourself and working with your doctor to develop a plan.

“Bottom line, know your numbers, know your risks,” Dagefoerde says. “If you have a family risk, then you're going to be more diligent with working on your risk factors. And when I say know your numbers, you want to know your blood pressure, your blood sugar and your cholesterol levels. Those are some things that you and your health care provider can work on and when they make recommendations, listen to them, ask questions and work together on a good treatment plan that you're comfortable with.”

Because heart disease remains the number one killer, more reason everyone should know how to do CPR and be prepared to know where defibrillators are when you’re at a public event. Download the PulsePoint app to see where defibrillators are located.

For more information on heart and vascular services, visit the OSF HealthCare Cardiovascular Institute website.

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You may have heard that tea is good for you, but when walking through the grocery aisle and being confronted by a barrage of options, it can be hard to choose.

Ashley Simper, the manager of dietetic services with OSF HealthCare, has done the research and has some helpful guidance.

To start, it’s best to understand the different kinds of teas and where they come from. Simper says black, white, oolong and green tea all come from the Camellia sinensis plant. Herbal teas come from root, stems and flowers of various plants, and they all have different benefits.

What’s the overall healthiest tea?

Overall, Simper says green tea shines above the rest. But diving into the specific benefits of each tea can help people choose what’s right for them.

“Consuming three or more cups of green tea a day leads to the most health benefits when it comes to cardiovascular disease, cancer and the overall risk of mortality,” Simper says. “The research is a little stronger when it comes to promoting heart health. The consumption of three to five cups of green tea a day has also been shown to lower blood pressure, stroke risk, and LDL (bad cholesterol),” Simper says.

Consuming three to five cups of green tea or black tea has also been shown to lower the risk of developing diabetes.

In 2022, a large study in the Annals of Internal Medicine showed that drinking black tea resulted in a modest reduction of overall death. A research team from the National Institutes of Health’s (NIH) National Cancer Institute (NCI) investigated roughly half a million adults, ages 40-60, in the United Kingdom (UK), who enrolled in the UK Biobank study between 2006-2010. The researchers followed participants until 2020 and found a 9-13% lower risk of death among people who drank at least two cups of tea per day than non-tea drinkers.

What makes tea so healthy?

“The compound in tea that leads to these health benefits is polyphenols. Polyphenols are a type of antioxidant, and antioxidants are linked to decreased inflammation and reduced risk of chronic disease,” Simper says. “The highest antioxidant compounds are in the green tea, followed by the oolong, black and then white teas.”

She adds that green tea and white tea contain an amino acid called L-theanine. Amino acids are the “building blocks” of protein, Simper adds.

“L-theanine has been linked to decreased anxiety, improved sleep and boosting mental clarity,” Simper says.

Cancer: Mixed reviews, additional safety tips

“When it comes to cancer, the research is conflicting. People who drank higher amounts of green tea had a decreased risk of liver, ovarian, lung and breast cancers. But it is important to keep in mind, that if you’re drinking really hot tea, you have a higher risk of esophageal and gastric cancers,” Simper says.

To avoid the tea being scalding hot, Simper recommends allowing the just-boiled water to cool down for an appropriate amount of time before taking a sip.

Tea’s impact on the flu

“In lab and animal studies, they have found an antiviral effect with the consumption of green tea. In Japan, they did a study with kids that showed anywhere from one to five cups of green tea a day lowered the risk of flu,” Simper says. “There was also a study where they gargled green tea in a bottle, green tea extract or black tea extract, and there was a 30% decreased risk of flu.”

How to prepare your tea

As Simper mentioned, scalding hot tea can come with its own risks, more than just burning your mouth. But there are other ways, she says, to make sure you’re receiving the most benefit from drinking tea.

“They recommend boiling your own water and steeping it yourself instead of putting the water in the microwave to heat it up. They found you lose some health benefits if you microwave the water in your tea. Fresh is best, steep your own, and boil your own water. But let it cool down to a comfortable temperature before you consume it. “Freshly brewed tea with minimal additives, especially things like sugar and milk, is the way to go when it comes to adding tea to your daily intake,” Simper adds.

Benefits of herbal teas

Depending on which symptoms you’re dealing with, or health benefit you’re looking for, different herbal teas have different purposes.

-          Peppermint teas – Helps with upset stomach

-          Ginger tea – Helps with nausea

-          Chamomile teas – Can help decrease cardiovascular disease and some cancers. It can also help with premenstrual syndrome and help boost immunity, Simper says.

But what about all the caffeine?

“The caffeine in tea is about half the amount of coffee. You would have to drink eight or more cups of tea a day to get to that highest level we would recommend for caffeine. So, it’s not that much of a risk for people,” Simper points out. “However, if you’re going to start drinking three to five cups of tea a day, and you’re not normally a caffeine consumer, you might notice the effects of the caffeine.”

Connection to weight loss

If you’re looking to tea for weight loss, you might be waiting for some time, Simper says. She says the research is conflicting, and weight loss is minimal due to drinking tea. However, switching out caffeinated tea for sodas and coffees filled with sugar would be the healthier choice.

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Nearly 47 million people are prescribed statins, a class of drugs that help lower blood cholesterol, which can lessen the risk of heart attack and stroke.

But not all patients are taking their statins as prescribed. According to a study led by researchers at Beth Israel Deaconess Medical Center and the University of Pittsburgh, only 35% of people eligible for statins are taking them.

This doesn’t come as a surprise to Nancy Dagefoerde, APRN, a nurse practitioner at OSF HealthCare Cardiovascular Institute. She says people are hesitant because of misinformation about statins, particularly the side effects. This comes from the internet and/or family and friends and can feed already existing fears.

“People worry about muscle pain. That's a common side effect,” she says. “They think it's going to do something to their liver or their kidneys. It's going to cause diabetes; it's going to cause dementia. There's a lot of misconceptions out there and reading that (wrong) information scares people and then they choose not to take the medication and they don't look at the benefits.”

While the chance of developing serious side effects is low, Dagefoerde says there are other options for patients if they do develop muscle pain, including adjusting the dosage or trying another statin. The muscle pain, however, could be coming from another health issue, such as arthritis or a thyroid problem. That’s why it’s important to communicate with your care team.

Statins are typically recommended for people with elevated levels of LDL cholesterol; individuals with known cardiovascular disease, including heart attacks, strokes, or peripheral artery disease, and people with a high risk of cardiovascular diseases. Statins work by blocking the production of cholesterol as it is pulled from the bloodstream preventing damage to organs and blood vessels. Dagefoerde says that 80% of our cholesterol is manufactured in the liver and that is determined by our genetics.

But medication can have a dramatic, positive effect. “By lowering your cholesterol, the patient gets the benefit of reducing their heart attack and stroke risk or any blood vessel risk,” she says. “We could lower their heart attack and stroke risk in some cases up to 50%.”

Statins are important because in many cases dieting and exercise alone don’t lower our cholesterol numbers. “Oftentimes, it’s not going to budge with just diet and exercise so we have to figure out an adequate treatment plan for you,” says Dagefoerde. Still, most medical experts recommend 150 minutes of moderate exercise each week, the same amount of exercise for people who do not take statins.

In some cases, adults who are considered healthy can also benefit from taking statins as an added measure against future cardiovascular episodes. Some patients only take statins a few days a week to get protection for their blood vessels against heart attacks and strokes.

Dagefoerde says the bottom line when it comes to cholesterol issues is to have a frank discussion with your medical providers. Come to your appointment prepared with plenty of questions and ask about your potential risk – even if you haven’t had any heart issues. 

“If your risk is high, then we want to do more preventive cardiology,” she says.  “Let’s treat the cholesterol, the blood pressure, the sugar – and get active and eat healthy. These are all components for overall health and hopefully we can prevent problems down the line.”

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If you’re thinking about using sugar substitutes to help with weight loss, think again. That’s the word from the World Health Organization (WHO).

According to new guidelines, replacing free sugars with non-sugar sweeteners (NNS) doesn’t help people control their weight long-term. The WHO first issued guidelines on sugar intake in 2015, recommending that adults and children reduce their daily intake of free sugars to less than 10% of their total energy intake.

The latest review added that there might be "potential undesirable effects" from the long-term use of sugar substitutes such as an increased risk of type 2 diabetes and cardiovascular diseases. There were 283 studies included in the review.

Jason Crum, a dietitian with OSF HealthCare, agrees and adds there could be other potential risks.

“When you look at sugar substitutes, it's more why am I using the sugar substitutes? If I'm quickly replacing calories because I don't want calories from a can of Coca Cola or Pepsi, a sugar substitute would be something quicker to use,” he says. “However, most people are doing it for a long time, which is creating other problems.”

Those problems start with the gut. 

“We create dysbiosis – that altered gut bacteria,” Crum says. “They use the energy differently, and they make other products out of it, which we in turn absorb. And that messes with our receptors, our ability to understand what's going on in our gut. It triggers more cravings for those sugary foods anyway, it even helps us eat more, which can be an adverse thing for most people.”

Instead, experts say that other ways to reduce free sugars intake include consuming food with naturally occurring sugars, like fruit, or unsweetened food and beverages. Crum says it comes down to making a lifestyle change.

“For most of my clients we don’t want to expect weight loss by just simply avoiding the sugars and using sugar alcohols or sugar substitutes of a different type,” says Crum. “It's looking at why they are consuming the sugary form in the first place? They could have an imbalanced dietary intake, it could be eating foods at the wrong times, it could be emotionally eating. If you're going to have a sugar substitute, you're not quelling that emotional response anymore. So it makes those cravings worse later in the day, and you might end up eating more total calories then if you had something that had the sugar in it.”

Crum recommends people pay close attention to food labels when making decisions about sugar substitutes.

“What are the nutrition facts label telling me? Do I understand what a total carb is? Do I understand what the sugar is under there? Every four grams of added sugar is equivalent to one teaspoon, so if you have 12 grams of added sugar you have three teaspoons of sugar right there,” he says. “So, understanding that gives people an idea of where am I really at here.”

Crum says the bottom-line is don’t rely on sugar substitutes. If you do, you’ll end up craving more and eating more. Instead, evaluate why you’re selecting the foods you eat in the first place. It will make things easier in the long run rather than cutting out certain foods all at once. Going cold turkey, he adds, seldom works for most people.

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 Researchers used data from a National Health and Nutrition Examination Survey, combined with 2020 U.S. Census counts for years 2025-2060 to make these projections. Using these two data points, researchers estimated the rates of cardiovascular risk factors and rates of cardiovascular disease. They estimate that by the year 2060, compared with the year 2025, coronary heart disease will increase by 31%, heart failure by 33%, heart attacks will go up by 30%, and stroke by more than 34%.

“It's eye opening,” remarks Darrel Gumm, M.D., an OSF HealthCare cardiologist and vice president of the OSF HealthCare cardiovascular service line. “And I think we, in the cardiology community, over the last 50-60 years have been seeing a steady decline in deaths from heart attack because of our rapid response to people who come in with a heart attack. So to now see that even though we're reducing the death rate, the total number is going to keep going up, it's a big deal.”

These numbers, however, vary depending on race and ethnicity. Predicted cardiovascular risk factors and cardiovascular disease are generally expected to rise in racial and ethnic minorities, whereas its prevalence in the white population could decrease.

“These are populations that are underserved. So they're maybe not getting the early screening visits with a physician to be told, you know, ‘Your sugar is too high; your blood pressure, your cholesterol is too high. You're a little bit overweight. We’ve got to work on this.’ So they may not be getting those visits. And instead, they're finding out when it's a full-blown disease, as opposed to very early on when there was really an opportunity to prevent it from becoming a full-blown disease,” says Dr. Gumm.

One possible solution to this disparity, according to Dr. Gumm, involves education and outreach – both by health care providers and communities at large. This could include improving access to quality health care for at-risk individuals, along with educating people on cardiovascular risk factors.

“Education, outreach, and changing habits of people and families really could have a potential huge impact in the future,” he says.

While some risk factors like family history and age cannot be controlled, eating healthily, exercising regularly and quitting smoking can all drastically reduce the risk of heart disease. Dr. Gumm recommends making healthy changes now, starting with learning your numbers.

“If we start prevention today, we then look at how that will have a ripple effect in the future,” explains Dr. Gumm. “So number one is know your numbers. What's your blood pressure? What's your fasting glucose, your fasting blood sugar level? And what is your cholesterol count in your blood? And then step on the scale  - and be honest.  Are you carrying a few pounds too many? So those are really big risk factors. And of course, if you're smoking, we got to quit smoking immediately.”

Because the projection goes nearly four decades into the future, Dr. Gumm also recommends getting the entire family involved. Talk to kids about the importance of eating right, exercising and staying away from tobacco products. Taking these steps now can have a huge impact on our health and the health of future generations.

OSF HealthCare Cardiovascular Institute provides a free online heart health profiler that can help you learn important information about your personal cardiovascular health and risk factors. Go to osfhealthcare.org/heart to learn more.

Interview Clips - Dr. Darrel Gumm