RSS Feeds

Nobody is immune from the hazards of summer wildfires, even the experts. At the University of Washington, researchers study both how to mitigate and understand wildfire behavior and how air quality degrades as a result of burning blazes. While UW faculty contribute to a rapidly emerging body of research into the risks of fire and smoke season, they also contend with the decisions that the rest of us face: how to protect themselves and their families, where to find reliable information, and how to manage the anxieties of summer smoke. 

Who better to learn from? As fires rage and smoke smothers the Pacific Northwest — including historic and devastating blazes in Spokane — UW News sat down with five UW experts in fire science, forestry, air pollution and more to ask how they manage wildfire season. 

This summer, the U.S. has been inundated with wildfire smoke, sometimes from fires burning hundreds of miles away. What sources do you use to track wildfires and air quality?

Ernesto Alvarado, research associate professor of environmental and forest sciences: The most reliable source, in my opinion, is the Fire and Smoke Map from AirNow.gov. This map consolidates data from various government sources related to wildfires, prescribed burns, smoke emissions and up-to-date models. It serves as a comprehensive resource for smoke emissions information.

Susan Prichard, research scientist in environmental and forest sciences: For smoke forecasts, I often turn to AirNow, but the Washington Smoke Blog is an excellent friend when we have been inundated with smoke for days and I’m looking for extended forecasts and analyses. Purple Air is also an incredibly helpful site. I’m careful to check if the readings are U.S. EPA PM2.5 with the conversion applied — otherwise the readings generally are higher than reality.

Brian Harvey, professor of environmental and forest sciences: For personal use and immediate up-to-date information, I really like Watch Duty. As a free app that has lots of options and configurations, it can be really helpful for getting immediate information on any ongoing fire incident and incorporates information from multiple sources. Second, for more detailed maps, photos, and daily incident updates, I frequently check Inciweb, which is the U.S. government interagency website that provides real-time public information and updates on fire incidents. As a forest fire scientist, I also use these sources for archived information about past fires that can better help us in our research.

Let’s say you’re planning a weekend trip, or a hike you’ve been looking forward to. How do you predict and plan around fire and smoke? 

E. Alvarado: I’ll plan my outdoor activities while considering potential smoke impacts. I’ll choose an area that’s unlikely to be affected by smoke for the duration of the activity. During the fire season, I’ll avoid areas with thermal inversions, which can trap smoke at night. For example, canyons or valleys surrounded by mountains are risky.

To predict future smoke concentrations, the National Weather Service is the most reliable source of information. Their weather predictions can indicate fire weather for the duration of the forecast. This is also important for hiking the rest of the year to stay informed about the weather for any outdoor activity.

BH: FireSmoke.ca has nice maps of the U.S. and Canada with high-resolution smoke forecasts over the coming day or two. These maps can be really helpful for planning ahead, though are always subject to change based on changing fire behavior or weather conditions. With our lab group doing field work outdoors all summer long every summer, these are critical tools for us to be able to do our work. 

Do you have an AQI threshold where you’re no longer comfortable being outside? Does that vary depending on what you’re doing outside? If so, how?

Edmund Seto, professor of environmental and occupational health sciences: The AQI is designed for communicating health risk to both general populations as well as populations that may be more susceptible to smoke.  Rather than focusing on the AQI number, I instead focus on the public health messaging (the “Description of Air Quality” column in this figure):

Elena Austin, associate professor of environmental and occupational health sciences: I generally become more concerned when air quality has remained consistently elevated for about 24 hours, because I think about smoke exposure cumulatively over the course of the day.

SP: If it looks like air quality is going to degrade over an AQI of 80, I start thinking about my health and what level of activity I’m going to do. As the science on smoke and human health only becomes more cautionary, I save strenuous exercise like running or climbing mountains for times when the AQI is below 80. 

If you have to be outside during smoky days, how do you protect yourself? 

E. Alvarado: Starting from AQI in the yellow zone, I may wear a N95 mask. However, above the orange zone, an N95 mask is mandatory.

ES: If working outdoors during smoky days, you and your employer should be aware that in Washington State, Labor and Industries has established rules to protect workers from hazardous smoke exposures. Also be aware that oftentimes smoke and heat co-occur, and there are heat exposure rules for working outdoors too.

E. Austin: I always make contingency plans while hiking and camping. In that case, I identify egress routes prior to departing in case a wildfire event limits my ability to return using the route I had planned. I also sign up for emergency text alerts for the county where I am spending time, and check the current fire activity and nearby evacuation status. 

How do you keep your indoor spaces safe during smoke waves?

ES: Thinking ahead and preparing your indoor space for regularly occurring wildfire smoke episodes is just as important as planning for other emergency events.  Can you close doors and windows tightly and have good weather sealing to avoid smoke from infiltrating indoors? Can you set your ventilation system to recirculate air?  Have you replaced your ventilation system (e.g., furnace) filter recently? Have you considered getting a portable HEPA-rated air cleaner that is sized appropriately for your bedroom or living area?  Have you considered building a DIY box-fan filter?

E. Austin: I create a smoke-ready space in my home. This is a separate area, where I set my ventilation system to recirculate indoor air rather than bringing in outdoor air. I also run a HEPA filter, rated to perform well for the square footage of my space, during wildfire events. Lastly, I try to reduce air exchange between the indoor space and outdoors by closing all windows, only opening outdoor doors when necessary, and weatherizing the space around doors and windows prior to the event.

SP: For indoor air, we make sure our HEPA air filters are clean at the end of each fire season so that they are ready to go the following year. When there’s smoke in the air, we make sure windows and doors are closed and use our air filters. We also just got a heat pump so that we can keep windows closed when smoke is a factor at night.

If you find yourself in close proximity to an active wildfire, what steps do you suggest taking?

BH: I suggest being as conservative and cautious as possible. Conditions can change rapidly, and being in the direct line of where a fire is spreading can be extremely dangerous and life-threatening. So first, I would make sure that there is a clear and safe route to safety via a road, trail, path, etc. Second, assessing the situation through any official information or local authorities is critical. If the fire has not been reported, calling 911 immediately is important to alert responders and others. If an evacuation order is issued, leaving immediately is critical to get to safety ASAP.

E. Austin: Many local districts allow you to register your phone and/or email to receive real-time alerts. I also suggest identifying your evacuation route, any obstacles or bottlenecks that would slow down your evacuation and to preplan and even pack critical items that you would need to take with you in an emergency.

SP: I live in the Methow Valley, and we’ve been evacuated around five times in the last 20 years. As a fire ecologist who studies fire behavior and smoke, one of the most upsetting things for me has been to watch neighbors and friends stay to protect their places. We quickly pack a few valuable things — photo albums, laptops, wallets, and passports — and leave. My main message to friends over the years is that it’s not worth the risk — if flames are close that means that smoke and super-heated air may be close, too, and deadly.

How do you manage the stress and anxiety of fire season both here and elsewhere?

E. Austin: I manage that stress by preparing my home before fire season, relying on a small number of curated information sources rather than trying to identify reliable sources in the moment or checking multiple apps, and I try to make flexible backup plans for outdoor activities. I also suggest planning ahead to learn how to obtain and effectively use an N95 respirator to reduce exposures either at work or when outdoors for recreational activities.

SP: Fire and smoke season are stressful. I’ve dealt with some stress and anxiety not only from fast-moving wildfires but also from long-duration smoke events that feel like they will never clear. We have a strong community that is very supportive and understands how fire season can bring up some PTSD-type symptoms. We take care of our place and make sure that we have as low of risk in and around our home as possible. We also remind ourselves how very lucky we are to be able to have flexibility in our work schedules and plenty of friends and family elsewhere to be able to leave when wildfires hit close to home.

BH: Fire is an integral part of life on earth, and in regions like the Pacific Northwest, fire is a key process that will continue to shape this region well into the future. Knowing that it is not if, but when, fire will return to any given area helps me embrace the reality of fire season. Like anything in life, being informed and prepared is a great way to lower stress and anxiety that comes with uncertainty. 

The UW has dozens of experts in wildfires, smoke and related topics. To reach an expert, contact Alden Woods at acwoods@uw.edu.

Source

Schizophrenia affects approximately 23 million people worldwide, with onset usually occurring during a person’s late adolescence to their 20s. Impairments associated with schizophrenia include hallucinations, delusions and disorganized thinking and behavior.

Now, researchers at the University of Washington are investigating how genetic changes impact the severity of schizophrenia symptoms. A new study, published in the American Journal of Psychiatry, supports the idea that deletions in genes that regulate early brain and neuron development are associated with more severe features of schizophrenia spectrum disorders, particularly lower cognitive abilities.

How schizophrenia manifests — and how severely — differs between patients. Poorer cognitive functioning in schizophrenia is associated with more treatment-resistant forms of the disease. Jennifer Forsyth, co-author and assistant professor of psychology at the UW, said understanding early developmental genetic factors could help identify people who could benefit from earlier, targeted inventions.

“For a subset of individuals, we may need to be thinking about how we can create treatments earlier in brain development that will help compensate for the fact that certain genes are being deleted,” Forsyth said. “Is there some kind of medication that can help with that? Down the road, could there be gene therapies for some of these individuals? I do think this research is going to be important for changing treatment direction.”

The researchers studied the DNA of more than 600 people with schizophrenia spectrum disorders. The team compared these results to data from patients’ relatives, people without schizophrenia and nearly 10,000 children participating in the Adolescent Brain Cognitive Development Study. 

People with schizophrenia who carried the deletions tended to perform worse on cognitive tests — showing poorer memory, thinking and attention skills than people with schizophrenia who didn’t carry the deletions. Similar, weaker associations were also seen in the general population, which suggests these variants may influence brain development more broadly, even in individuals without schizophrenia.

The study also showed these specific genetic deletions were associated with differences in brain structure, including higher gray matter volume and cortical thickness. This is the opposite pattern researchers typically see on average in schizophrenia, Forsyth said, which again suggests variability between patients.

“This study helps us understand the specific way somebody manifests a disorder,” Forsyth said. “It’s sort of a cumulative effect of different risk profiles. We all carry tons of genetic variants, and the specific types of variants we have and how they combine is very complicated. These things aren’t totally deterministic, but I do think understanding which specific aspects of brain development are affected by the genetic variants a person carries, and how this shapes how the disorder manifests, can start to inform how we think about different treatment approaches.”

Other UW co-authors from the Department of Psychology were graduate students Jinhan Zhu, Zachary Trevorrow and Mahnoor Hyat, undergraduate research assistant Ariana Chavannes, research coordinator Sam Sievertsen and research technologist Sophie Ferreira-Ianone. Matthew Conomos, a UW senior research scientist in biostatistics, was also a co-author.

A full list of co-authors is included with the study.

This study was funded by the National Institute of Mental Health, the Brain and Behavior Research Foundation, the National Center for Advancing Translational Sciences UCLA Clinical and Translational Science Institute, the UCLA Brain Research Institute and the Shear Family Foundation.

For more information, contact Forsyth at jenforsy@uw.edu.

Source

Drug development is among the slowest, most failure-prone processes in modern science, with about 90% of drug candidates never reaching the market. Today, artificial intelligence methods have accelerated the first step — plucking promising molecules out of endless possibilities — but countless challenges remain. A successful drug must be not only safe and effective, but also able to bypass the body’s defenses and reach the right target.

Most drug candidates fail such optimizations. That’s where a new research institute at the University of Washington has focused its attention. Housed in the UW School of Pharmacy, the Institute for Innovations in Drug Delivery and Disposition (I2D3) brings together experts in artificial intelligence, drug discovery, pharmacology, data science and biotechnology to ease the bottleneck between promising molecules and successful drugs. 

The Institute opened in July 2026 and is led by three UW faculty members: Gaurav Bhardwaj, an associate professor of medicinal chemistry who oversees the Institute’s AI-enabled molecular design; Nina Isoherranen, the Milo Gibaldi Chair of Pharmaceutics and expert in drug metabolism and disposition; and Marco Pravetoni, a professor of psychiatry and behavioral science in the UW School of Medicine, who leads drug discovery, translation and commercialization efforts.

UW News spoke with the three co-directors about why drug candidates fail, how AI is speeding drug development and how I2D3 hopes to help get drugs to market more quickly.

What separates a promising molecule from a full-fledged drug? What properties need to be considered, and how can a developer work toward them?

Gaurav Bhardwaj: It really depends on the disease indication you are targeting and the therapeutic modality. Let’s say you have a promising molecule that interacts with the disease-causing protein. Delivery becomes equally important — do we need an orally delivered drug? Do we need to cross the blood-brain barrier? If the disease requires daily dosing, then injectable or IV methods aren’t optimal. If it’s delivered orally, then the molecule needs to be able to get across the gut barrier, and also needs to be stable enough that it doesn’t get chewed up by the body. It also needs to stay in the body for a reasonable time. A successful drug molecule has to meet all these and more criteria, and ultimately all these criteria are encoded by the sequence and structure of the molecule.

The Institute is devoted to aspects of drug development that are often overlooked. What problem do you see the Institute being able to help solve? 

GB: Traditional drug discovery and development is a trial-and-error-based process. Either you find a useful molecule in nature and spend years optimizing it for human use, or you create many random combinations of molecules and hope that one of them has the function you need. Both of these approaches are highly unsuccessful, which has created a bottleneck.

Now the field is also focusing on an idea called rational drug design. It started long before AI but is now becoming even more common. People are using AI methods to design new molecules. However, a lot of that work has focused on the first step — finding a molecule that binds to a specific protein, or has a specific function in the body. That’s still not a drug, it’s just more candidates.

The bottleneck has now shifted. It’s no longer finding that first molecule, but now, how do you add all the other drug-like properties? That’s what the Institute is trying to do. Let’s build the models that ultimately make molecules that are going to be successful all the way through the drug development pipeline. 

Marco Pravetoni: I see our work also as accelerating discovery. I work on substance use disorders, and my lab develops vaccines, antibodies and next-generation antibody-like molecules that target drugs in the body. With these new tools, instead of working to design 10 antibody candidates in a lab, we could design 1,000 or more, and then we can accumulate enough data to reduce any risks, so that what we bring to clinical trials is more likely to be successful. AI can do a lot of that.

How can you make it more likely that a drug candidate succeeds in trials? 

Nina Isoherranen: Part of it is predicting what’s going to happen to a drug in humans before it’s ever given to humans. That should increase the success rate and eliminate the waste of doing a lot of unsuccessful trials. 

We can also build machine learning and AI approaches to predict drug disposition in an individual person. What we talk about today are ‘digital twins,’ which refers to a computational model of the individual patient and their characteristics. For example, how does your kidney function? What is your body mass index? And so forth. Then we generate a digital version of you. We can then predict how a certain drug would behave in your body and build the best strategy. 

There’s also an access-to-treatment question here. Pregnancy is a great example — we often don’t know how drugs work in pregnant women because we’ve never done trials. To be safe, we say that pregnant people shouldn’t take those drugs, but that means they don’t have access to a potentially hugely beneficial medication. If we can use AI and machine learning to predict how pregnant people respond to medications and how their bodies handle drugs differently from nonpregnant people we can make more medications accessible

Now with AI and machine learning, I think we can get to a place where we can truly sample the full space of possibilities. 

How can the methods you’re building help with these individualized treatments? 

NI: We know that drugs behave differently in different people. Even if we give them the exact same drugs and concentrations, people may still have different responses because of factors inherent to our bodies.

During drug development the candidate drug needs to be studied to see responses in different populations. Before you get a drug approved, you need to understand how liver disease, for example, is going to change exposure to that drug and whether you need to change the dosing. There’s a lot of guidance on drug interactions. Pharmacists manage drug interactions all the time, but it gets very complicated when you combine multiple patient factors. Now, if we have good predictive tools, we can predict what’s going to happen without having to do trials. 

The ultimate goal here is to be able to predict, using model computational tools, what’s going to happen in individual humans before you ever give them a drug. What’s the right dose? The right timing? 

UW has established itself as a leader in these fields already. I’m thinking especially of the UW Medicine Institute for Protein Design, whose director, David Baker, recently won the Nobel Prize in Chemistry. How does I2D3 fit into the broader UW ecosystem? 

MP: IPD is a world leader in designing novel proteins, and the UW also has outstanding capabilities in clinical testing and implementation through the Institute of Translational Health Sciences. However, there remains a critical translational space between discovery and clinical application —  one that focuses on the pharmaceutical development needed to turn promising innovations into viable therapeutic products. That’s where I2D3 can play a leading role.

For example, when researchers at IPD develop a new protein, I2D3 can partner with them early to address formulation, manufacturability, stability, delivery, and other key pharmaceutical considerations that are essential for advancing a discovery toward the clinic and ultimately the marketplace. I2D3 would serve as a core translational partner, helping bridge the gap between innovation and implementation.

IPD brings unmatched strengths in protein design, ITHS provides expertise in clinical translation, and I2D3 contributes the drug development and pharmaceutical sciences capabilities needed to move discoveries across the translational continuum. Together, these organizations can create a powerful and highly integrated ecosystem.

For more information, visit i2d3.washington.edu. To reach the researchers, contact Alden Woods at acwoods@uw.edu.

Source

Over the past five years, the national conversation around health and nutrition has become dominated by the term ‘ultra-processed foods.’ Most prominently, Health and Human Services Secretary Robert F. Kennedy Jr.’s MAHA movement blames these foods for a host of chronic health issues and has launched an often-contradictory campaign to remove some UPFs from the food supply. 

But there’s a glaring problem: Nobody can agree on how, exactly, to define ultra-processed foods. The lack of a clear definition has stymied legislative and regulatory efforts to curb UPF consumption, and caused confusion for people evaluating their own diets. 

This spring, a panel of 14 nutrition, food science, policy and legal experts gathered to create a more practical and operational definition. The panel’s final report, published in May, suggests an ingredient-based approach to identify ultra-processed foods, while also recommending a series of policies to reduce people’s exposure to them. 

The panel was co-chaired by Jim Krieger, clinical professor emeritus of health systems and population health at the UW and executive director of the nonprofit group Healthy Food America. UW News sat down with Krieger to discuss the new definition, the debate around ultra-processed foods and how people can limit their consumption.

How have we traditionally defined ultra-processed foods, and where does that definition fall short? 

Jim Krieger: The ultra-processed food concept was developed by Carlos Monteiro, who’s a physician and epidemiologist at the University of Sao Paolo in Brazil. He was trying to understand an increase in obesity and chronic disease rates, particularly in kids and young adults, and noticed some important changes in the diet that weren’t fully explained by just the usual nutrient profiling — like fat, sugar, salt. Monteiro came up with this concept of ultra-processed foods. The categorization system is called Nova, which means ‘new’ in Portuguese, and classifies foods across a spectrum beginning with unprocessed ingredients and ending in ultra-processed. Ultra-processed foods are the ones that are the most highly processed industrial products, basically. 

The Nova definition is geared toward research, to really examine the effects of ultra-processed foods on a range of health outcomes. Using it, numerous studies have found ultra-processed foods to be associated with a whole host of health problems, like diabetes and heart disease and depression. That’s the basis to say, well, there’s probably sufficient evidence to figure out what we can do to reduce exposure to ultra-processed foods by reducing sales and consumption. That requires policy, and to have policy you need to have a definition of ultra-processed food that’s suitable for regulation or legislation, and that’s where the rub comes. The definition for research doesn’t really work in a policy context, because the Nova research definition uses multiple factors, including ingredients, processing techniques, and other factors to identify products as ultraprocessed. Applying Nova can require individual-level review of ambiguous products by skilled nutrition experts that may not be feasible in policy contexts.

You co-chaired a panel of 14 experts who came up with a new definition. What did that work look like, and what’s your new definition?

One criticism of the movement against UPFs has been that some foods that are technically ultra-processed are actually quite nutritious. I’m thinking of products like yogurts, whole-grain breads and tofu. How does your definition account for that?

JK: You want your definition to be sensitive enough to pick up most UPFs, but also specific — that is, not capture foods that are not truly UPFs or even those that can be part of a healthy diet. The way we addressed that was the FDA, a couple years ago, developed criteria for what they call a ‘Healthy’ claim. If a company wants to say its products are healthy and put that on the package, it has to meet FDA-approved criteria. 

We decided that even if a product is ultra-processed, if it meets the FDA’s criteria for a ‘Healthy’ food, then it should be exempted from policy. That cuts out edge cases — healthier foods that are also UPFs.

Your final report also dives into policy and makes recommendations for lawmakers to consider. What is the current status of ultra-processed food policy across the U.S.? 

JK: Over the last couple of years there has been a flurry of activity, particularly at the state legislative level. Some states say they’re getting rid of ultra-processed foods in school meals, for example, but they have a somewhat random list of ingredients or additives they don’t like. 

A few states have tried to take a more evidence-based approach. The best example of that is California, where they passed legislation to phase out ultra-processed foods in school meals. They used the same kind of ingredient-list approach that we recommend, simplified a little bit. However, for a food to be a UPF under California’s definition, it must also be high in fat, sugar or salt, which raises a problem — about 35% of all ultra-processed foods do not have those levels. Proposed legislation in states like Pennsylvania have avoided this problem by sticking with the Nova-based definition, as recommended by our expert panel, rather than adding on fat, sugar and salt criteria.  

There’s also been a huge amount of movement in a couple of countries, especially in Latin America. Furthest along is Colombia, where the government just issued a regulation to require ultra-processed food labels on packages. They’re basically using the Nova definition as well.

There are policies moving now, which is why we felt it was important to say, use a good definition of ultra-processed for what you’re doing, and then think about certain policy ideas as the best bets for doing something about the problem. For us, those ideas include requiring labels on packages identifying a product as ultra-processed and removing UPFs from food served in schools, childcare and in government facilities. 

Many of the factors that lead people to choose ultra-processed foods are systemic. As an example, food deserts leave some people without easy access to affordable fresh foods. How did the panel consider those factors in making your policy recommendations?

JK: Increasing access to healthy foods gets into another set of policies that are well-described and, to varying extents, are being put into place. Our panel focused specifically on UPF policies. We did assess whether any of our policy recommendations would have unintended consequences of making food less available or affordable for people with low incomes and then we figured out strategies for mitigating those effects. 

A great example would be if you tax even a subset of ultra-processed foods, that’s going to make them less affordable, and that’s a challenge. We recommend that the tax revenues raised from these policies go toward vouchers or incentives for people with lower incomes that they can cash in for fruits and vegetables at a more affordable price. 

We also rejected some policy ideas. One was restricting the use of SNAP (the Supplemental Nutrition Assistance Program, commonly known as food stamps) benefits for purchasing ultra-processed foods. We felt that would have too much of a negative impact on food affordability for people using SNAP, so we did not recommend that. 

What comes next for this research? 

JK: Our next step is to share this definition with as many policymakers as we can, and then offer them technical support if they want to figure out how to use this in legislation or regulation. The second thing is if any legislators, policymakers or advocates want to pursue policies, we’re available to provide technical support and assistance. 

There’s also a bunch of additional research that would be useful. We have some of those recommendations at the end of the report, but as an example, there’s controversy right now over different subgroups of UPFs and whether some are more harmful than others. The research that’s been done so far has been somewhat confusing and flawed. There’s also research on how, exactly, ultra-processed foods cause all these problems. There are a lot of great, interesting hypotheses, but I wouldn’t say any of them are definitive. 

As an expert in this field, how do you approach ultra-processed foods in your own life, and how would you recommend people think about reducing their own consumption? 

JK: Right now, about 60% of the calories that Americans consume are ultra-processed foods. Starting there, small and incremental steps are great. You can’t totally change your diet overnight, so the bottom-line message is to think about small things you can do. 

The first challenge is identifying UPFs, which is where we started this conversation. If there are ingredients in food that you don’t have in your kitchen, it’s likely going to be a UPF, and if it’s a long ingredient list that looks like a chemistry lab, it’s probably a UPF. Then you can consider what the food looks like. If it’s super bright, like Froot Loops or Doritos, that probably means it’s a UPF. 

But then once you’ve identified ultra-processed foods, what do you do? Let’s think about one thing you want to do. Say you drink a lot of sweetened beverages. You can think of what you can swap in that works for you, like sparkling water that doesn’t have a lot of additives, or coffee or tea.

As for me, I don’t eat many ultra-processed foods. When I started doing this work, when my kids were younger, I fed them all sorts of UPFs. I certainly wouldn’t do that now and wish I had known better. But if I want to have something that’s ultra-processed, that’s fine, it’s not going to kill you to have just a little bit. As long as your overall dietary pattern is healthy, then that’s great. 

The panel was co-chaired by Krieger and Lindsey Smith Taillie of the University of North Carolina at Chapel Hill and convened by Mary Story and Megan Elsener Lott of Duke University. A full list of panel members is included in the panel’s technical report. This work was funded by Healthy Eating Research and the Robert Wood Johnson Foundation. 

For more information or to contact Krieger, email Alden Woods at acwoods@uw.edu. 

Source

The human mouth is full of wonders. It’s home to hundreds of species of bacteria, fungi, viruses and protozoa, which work in delicate harmony to maintain our oral health. Sometimes, though, this complex system — known as the oral microbiome — can fall out of balance. Anaerobic bacteria build up on the tongue and in the little pockets between our teeth and gums. There, they break down organic matter and spew out a foul odor. This, the current theory goes, is what causes many chronic cases of bad breath, or halitosis.

To rebalance the oral microbiome and cure chronic halitosis, researchers at the University of Washington are embarking on a first-of-its-kind experiment. These clinical trials transplant bacteria and other minuscule critters from healthy donors into patients with halitosis. If successful, the healthy microbiota will crowd out the bad and patients’ bad breath will improve.

“We know the oral microbiome can get out of whack. The question is, can you rebalance it? That is the hypothesis we’re proposing,” said Alvin Wee, a UW professor of restorative dentistry and co-lead of the project. 

The experimental procedures build off recent breakthroughs in fecal microbiota transplants, commonly known as stool transplants, which have become a go-to treatment for gastrointestinal infections and bacterial imbalances. 

The research team has so far completed four transplants, with preliminary evaluations underway. They’re seeking pairs of participants — a patient with chronic halitosis and a donor, ideally an intimate partner, family member or trusted friend — to undergo these relatively simple procedures.

To start, researchers complete a full periodontal exam of the donor to ensure their microbiome is healthy. Then they collect bacteria from the donor and suspend it in a small volume of saline. At the same time, recipients undergo a deep cleaning to remove the harmful bacteria and disrupt the biofilm — the thin, sticky layer of microorganisms that lines surfaces in the mouth. Recipients rinse with the donor solution, and researchers inject a concentrated version into the gumline. Ninety days after the transplant, participants self-report whether their breath has improved. 

“What we’re trying to do is severely disrupt the original bacteria, and then we bring in the new guys to take hold and establish a new biofilm,” said co-lead Alex Pozhitkov, a research scientist and affiliate faculty member in the UW School of Dentistry. “If we bring enough of the new bacteria and they outcompete the ones that we disrupted, the healthy ones will take over. It’s a numbers game.” 

This research was funded by the Dean and Margaret Spencer Clinical Research Fund. Co-investigators include professor of clinical practice Diane Daubert and professor Daniel Chan, both of the UW School of Dentistry. For more information, to reach the researchers or to inquire about participating, contact Pozhitkov at pozhit@uw.edu or Wee at awe@uw.edu.

Source

WASHINGTON y DALLAS (3 de septiembre del 2026) — Las enfermedades cardiovasculares (ECV) son la principal causa médica de muertes en acto de servicio entre los atletas tácticos, como personal militar, bomberos, agentes de la ley, personal de respuesta a emergencias médicas, astronautas y pilotos. Estas personas enfrentan exigencias físicas y ambientales únicas que pueden aumentar el riesgo cardiovascular y requerir enfoques especializados de evaluación y cuidados, según una nueva declaración científica conjunta del American College of Cardiology y la American Heart Association, que se publicó simultáneamente hoy en la principal revista médica del American College of Cardiology JACC (sitio web en inglés) y la revista médica insignia revisada por expertos de la American Heart Association Circulation (sitio web en inglés).

La nueva declaración científica, “Consideraciones clínicas para la atención de atletas tácticos con anomalías cardiovasculares”, es el primer documento detallado que ofrece directrices para ayudar a los médicos en la determinación del riesgo cardiovascular y en la evaluación de las características únicas de los atletas tácticos. En la declaración, se presenta el Manejo clínico táctico (TCM, por sus siglas en inglés), un nuevo esquema en el que se combina atención médica basada en evidencias con exigencias ocupacionales, requisitos de la misión y consideraciones de seguridad pública al momento de evaluar a un atleta táctico con una enfermedad cardiovascular o un riesgo cardiovascular elevado.

Se estima que más de 4 millones de estadounidenses actualmente se desempeñan como atletas tácticos, quienes reciben entrenamiento para ejecutar labores exigentes y específicas de la misión en situaciones impredecibles de alto estrés o en condiciones extremas. Su cuidado cardiovascular requiere consideraciones que van más allá de las aplicadas normalmente a los atletas competitivos (sitio web en inglés) o a la población general, puesto que estos profesionales suelen trabajar en entornos de alto riesgo en los que una incapacidad repentina puede afectar a los compañeros de equipo, el éxito de la misión y la seguridad pública.

“Si bien los médicos cuentan desde hace mucho tiempo con directrices para evaluar a atletas competitivos con ECV, los atletas tácticos presentan una serie de desafíos únicos que no se han abordado adecuadamente”, indicó Elizabeth H. Dineen, DO, FACC, FAHA, presidenta del grupo de redacción de la declaración. “Un evento cardiovascular en un bombero, oficial de policía o miembro del servicio militar puede tener consecuencias que van mucho más allá de la persona, como el éxito de la misión y la vida de otras personas”.

Los vicepresidentes Benjamin D. Levine, MD, FACC, FAHA y Mark C. Haigney, MD, FACC, FAHA también mencionan la importancia fundamental de este documento y las contribuciones únicas de expertos que representan a una gran variedad de disciplinas tácticas, cardiólogos deportivos y otros especialistas en ECV.

A los atletas tácticos se les puede exigir que realicen actividad física muy extenuante de manera impredecible mientras cargan equipamiento pesado, realizan operaciones en temperaturas extremas, trabajan en altura, pilotean aeronaves, bucean o responden a emergencias bajo un estrés psicológico intenso, factores que pueden aumentar considerablemente el trabajo cardíaco. 

El tiempo de servicio de los atletas tácticos se puede extender por décadas y, a menudo, continúan en servicio a edades más avanzadas que los atletas competitivos. Estas exigencias pueden aumentar el esfuerzo cardiovascular e influir en las decisiones.

Los autores indican que los factores de riesgo cardiovascular tradicionales, como la hipertensión, la hiperlipidemia, la obesidad, la diabetes tipo 2 y el tabaquismo, siguen teniendo una alta prevalencia entre los atletas tácticos.

“Los atletas tácticos dedican sus carreras a proteger y servir a otros, lo que a menudo implica trabajar en situaciones exigentes desde el punto de vista físico y potencialmente mortales que ejercen un estrés único en el sistema cardiovascular. Las decisiones sobre cuidado cardiovascular deben equilibrar la salud y la seguridad de estas personas con las responsabilidades esenciales para la misión y la seguridad pública que enfrentan cada día”, indicó Dineen.

Recomendaciones y consideraciones clave:

• Use el nuevo esquema de Manejo clínico táctico (TCM) para respaldar una evaluación individualizada y la evaluación del riesgo cardiovascular en el contexto de los requisitos y las exigencias ocupacionales.
• La realización de exámenes de detección antes de la participación en operaciones es fundamental para todos los atletas tácticos e incluye un examen físico y análisis de los antecedentes. Se debe realizar un ECG en atletas tácticos menores de 40 años que estén expuestos a un esfuerzo cardiovascular importante o que desempeñen funciones esenciales para la misión. También es razonable realizarlo en otros atletas tácticos.
• Las determinaciones de aptitud para el servicio no solo deberían contemplar los riesgos de salud individuales, sino también los posibles riesgos para los miembros del equipo, el éxito de la misión y la seguridad pública.
• Se deben considerar las repercusiones cardiovasculares de afecciones como las miocardiopatías, las arritmias, las enfermedades cardíacas congénitas, la enfermedad de las arterias coronarias, la valvulopatía, la miocarditis y el estado de anticoagulación. Se hace énfasis en el monitoreo continuo.
• También se deben considerar los factores operacionales y ambientales, como el calor, la deshidratación, la altitud, la exposición a actividades de buceo o aviación, el riesgo de colisión y la disponibilidad de atención médica de emergencia.
• Las organizaciones deben mantener Planes de Acción ante Emergencias y un acceso rápido a un DEA, ya que los exámenes de detección por sí solos no pueden evitar todos los paros cardíacos súbitos.

Los autores de la declaración destacan que es necesario realizar más investigaciones, como la elaboración de registros, mejores estrategias de detección y modelos de predicción de riesgo cardiovascular adaptados a los atletas tácticos.

Recursos adicionales:

• Después del 3 de septiembre del 2026, consulte el artículo en línea en JACC (sitio web en inglés) y en Circulation (sitio web en inglés)
• Comunicado de prensa en inglés
• Perspectiva: Cardiovascular Disease Risk Assessment in United States Military Service Members (Evaluación del riesgo de enfermedades cardiovasculares en los miembros del servicio militar de Estados Unidos)
• Siga el ACC en @ACCinTouch
• Siga las noticias de JACC, la revista médica insignia del ACC @JACCJournals
• Siga las noticias de la American Heart Association/American Stroke Association en X en @HeartNews
• Siga las noticias de Circulation, la revista insignia de la American Heart Association en @CircAHA

###

Acerca de la American Heart Association

La American Heart Association es una fuerza incansable que trabaja por un mundo con vidas más largas y saludables. La organización ha sido una fuente líder de información sobre salud durante más de cien años y su objetivo es garantizar la equidad en la salud en todas las comunidades. Con el apoyo de más de 35 millones de voluntarios en todo el mundo, financiamos investigaciones vanguardistas, defendemos la salud pública y proporcionamos recursos fundamentales para salvar y mejorar las vidas afectadas por enfermedades cardiovasculares y ataques o derrames cerebrales. Trabajamos incansablemente para promover la salud y transformar vidas cada día mediante el impulso de avances y la implementación de soluciones comprobadas en las áreas de ciencia, políticas y cuidados. Comuníquese con nosotros en heart.org (sitio web en inglés), Facebook o X, o llame al 1-800-AHA-USA1.

Acerca del American College of Cardiology

El American College of Cardiology (ACC) es un líder mundial dedicado a transformar la atención cardiovascular y mejorar la salud cardíaca de todos. Por más de 75 años, el ACC ha impulsado una comunidad de más de 60,000 profesionales del área cardiovascular en más de 140 países con apoyo e información de vanguardia, credenciales profesionales rigurosas y directrices clínicas de confianza. De su revista médica JACC y los Registros Nacionales de Datos Cardiovasculares (NCDR, por sus siglas en inglés) a sus servicios de acreditación, red global de Capítulos y Secciones, además de sus iniciativas para pacientes CardioSmart, el Colegio se compromete a crear un mundo en el que la ciencia, el conocimiento y la innovación permitan optimizar el cuidado y los resultados de los pacientes. Obtenga más información en www.ACC.org (sitio web en inglés) o comuníquese por redes sociales en @ACCinTouch.

Para consultas de los medios de comunicación: 

American Heart Association: Amanda Ebert: Amanda.Ebert@heart.org

American College of Cardiology: Olivia Walther, owalther@acc.org

Para consultas públicas: 1-800-AHA-USA1 (242-8721)

heart.org (sitio web en inglés) y DerrameCerebral.org

WASHINGTON and DALLAS, Sept. 3, 2026 — Cardiovascular disease (CVD) is the leading medical cause of duty-related deaths among tactical athletes, including military personnel, firefighters, law enforcement officers, emergency medical responders, astronauts and pilots. These individuals face unique physical and environmental demands that can increase cardiovascular risk and require specialized approaches to evaluation and care, according to a new joint American College of Cardiology/American Heart Association Scientific Statement simultaneously published today in the American College of Cardiology’s flagship journal JACC and the American Heart Association’s flagship, peer-reviewed journal Circulation.

The new scientific statement, “Clinical Considerations for the Care of the Tactical Athlete With Cardiovascular Abnormalities,” is the first comprehensive document that offers guidance to help clinicians evaluate cardiovascular risk and assess the unique characteristics of tactical athletes. The statement introduces Tactical Clinical Management (TCM), a new framework that combines evidence-based medical care with occupational demands, mission requirements and public safety considerations when evaluating a tactical athlete with cardiovascular disease or increased cardiovascular risk.

It is estimated that more than 4 million Americans are currently serving as tactical athletes who are trained to perform demanding, mission-specific duties in unpredictable, high-stress situations and/or extreme conditions. Their cardiovascular care requires considerations beyond those typically applied to competitive athletes or the general population because these professionals often work in high-risk environments where sudden incapacitation can affect teammates, mission success and public safety.

“While clinicians have long had guidance for evaluating competitive athletes with CVD, tactical athletes present a unique set of challenges that have not been adequately addressed,” said Elizabeth H. Dineen, DO, FACC, FAHA, chair of the statement’s writing group. “A cardiovascular event for a firefighter, police officer or military service member can have implications far beyond the individual, including the success of the mission and lives of others.”

Vice Chairs Benjamin D. Levine, MD, FACC, FAHA, and Mark C. Haigney, MD, FACC, FAHA, also note the critical importance of this document and unique contributions from experts representing a wide array of tactical disciplines, sports cardiologists and other CVD specialists.

Tactical athletes may be required to perform unpredictable strenuous physical activity while carrying heavy equipment, operating in extreme temperatures, working at altitude, flying aircraft, diving underwater or responding to emergencies under intense psychological stress, factors that can significantly increase cardiac workload.  

Service time for tactical athletes may span decades, often with older ages of participation compared to competitive athletes. These demands can increase cardiovascular strain and influence decisions.

The authors note that traditional cardiovascular risk factors, including hypertension, hyperlipidemia, obesity, Type 2 diabetes and smoking, remain highly prevalent among tactical athletes.

“Tactical athletes dedicate their careers to protecting and serving others, often working in physically demanding and life-threatening situations that place unique stresses on the cardiovascular system. Cardiovascular care decisions must balance the health and safety of these individuals with the mission-critical and public safety responsibilities they carry every day,” Dineen said.

Key recommendations and considerations include:

• Use the new Tactical Clinical Management (TCM) framework to support individualized evaluation and cardiovascular risk assessment within the context of occupational requirements and demands.
• Preparticipation screening is critical for all tactical athletes and includes a history and physical examination. An ECG should be performed in tactical athletes under 40 years old exposed to significant cardiovascular strain or in mission-critical roles and is reasonable for other tactical athletes.
• Fitness-for-duty determinations should not only account for individual health risks but also for potential risks to team members, mission success, and public safety.
• The cardiovascular implications of conditions such as cardiomyopathies, arrhythmias, congenital heart disease, coronary artery disease, valvular disease, myocarditis and anticoagulation status, should be considered. The need for ongoing monitoring is emphasized.
• Operational and environmental factors, including heat, dehydration, altitude, diving and aviation exposures, collision risk, and availability of emergency medical care should also be considered.
• Organizations should maintain Emergency Action Plans and rapid AED access because screening alone cannot prevent all sudden cardiac arrests.

The statement authors highlight that more research is needed, including the development of registries, improved screening strategies and cardiovascular risk prediction models tailored specifically for tactical athletes.

Additional Resources:

• After Sept. 3, 2026, view the manuscript online in JACC and Circulation 
• Spanish news release
• American Heart Association Perspective Article: Cardiovascular Disease Risk Assessment in United States Military Service Members
• Follow the ACC at @ACCinTouch
• Follow news from the ACC’s flagship journal JACC @JACCJournals
• Follow American Heart Association/American Stroke Association news on X @HeartNews
• Follow news from the American Heart Association’s flagship journal Circulation @CircAHA

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1. 

About the American College of Cardiology

The American College of Cardiology (ACC) is a global leader dedicated to transforming cardiovascular care and improving heart health for all. For more than 75 years, the ACC has empowered a community of over 60,000 cardiovascular professionals across more than 140 countries with cutting-edge education and advocacy, rigorous professional credentials, and trusted clinical guidance. From its world-class JACC Journals and NCDR registries to its Accreditation Services, global network of Chapters and Sections, and CardioSmart patient initiatives, the College is committed to creating a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at www.ACC.org or connect on social media at @ACCinTouch.

For Media Inquiries: 

• American Heart Association: Amanda Ebert, Amanda.Ebert@heart.org
• American College of Cardiology: Olivia Walther, owalther@acc.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• A large study in Denmark suggests that people who were diagnosed with a variety of psychiatric disorders after traumatic events were more likely to have increased future cardiovascular risks, such as non-fatal heart attack and stroke or cardiovascular death, compared to those who did not have mental health issues after a traumatic event.
• While alcohol abuse after trauma was the top psychiatric predictor for future cardiovascular risks among both men and women, mood disorders, such as depression, were more prominent predictors among women who experienced trauma.

Embargoed until 4 a.m. CT/5 a.m. ET Wed., Sept. 2, 2026

DALLAS, Sept. 2, 2026 — Mental health conditions, such as posttraumatic stress disorder (PTSD), substance abuse, depression and anxiety, can develop after people experience trauma. These conditions may contribute to a higher risk of future cardiovascular risks, such as non-fatal heart attack and stroke or cardiovascular death, according to new, independent research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

“Traumatic events are common experiences and can include serious fires or explosions, physical assault, transportation accidents, the suicide or death of a loved one, and severe medical illnesses or injuries,” said lead study author Jennifer A. Sumner, Ph.D., an associate professor in the department of psychology at the University of California, Los Angeles. “Experiencing traumatic events can significantly affect mental health as well as cardiovascular health. Although most work to date has focused on PTSD and cardiovascular health, our research suggests that we should think about a wide range of mental health consequences when looking at cardiovascular disease risk after trauma.”

Researchers examined national health registries in Denmark to study how a variety of diagnosed mental health conditions that occurred within three years after a traumatic event were linked to cardiovascular death, heart attacks, strokes or procedures to restore blood flow to the heart.

They conducted a study of adults who did and did not develop major heart or brain conditions following a traumatic event. The goal was to find out which mental health conditions after trauma exposure were the strongest indicators of subsequent cardiovascular outcomes, including procedures to restore blood flow to the heart, heart attack, stroke and cardiovascular death, separately in men and women. A wide range of mental health conditions were considered as possible cardiovascular predictors, and machine learning was used to identify the 15 most important mental health disorder predictors of these heart and brain outcomes.

The analysis found:

• Alcohol abuse was the most important mental health risk linked to serious heart or brain conditions for men and women.
• Mood disorders, like depression, were strong indicators of posttraumatic psychiatric issues associated with cardiovascular outcomes for both men and women. However, these mood disorders were a more prominent predictor for women than for men.
• Other psychological conditions that can arise after trauma exposure that were connected to a higher risk of heart and brain conditions in the future included PTSD, mental disorders caused by brain or physical issues, non-substance-induced confusion, different substance use disorders, personality disorders, schizophrenia, bipolar disorder and anxiety disorders.

Researchers were surprised to find that alcohol abuse was the top psychiatric predictor of serious heart and brain conditions for both men and women.

“After a traumatic life experience, individuals may turn to alcohol to cope and help manage their emotions,” Sumner said. “Over time, this new behavior might develop into alcohol abuse, thus increasing their risk of a serious heart or brain condition.”

Glenn N. Levine, M.D., FAHA, chair of the 2025 American Heart Association scientific statement Post–Myocardial Infarction Psychological Distress writing group, said, “Traumatic experiences which lead to mental health disorders can have lasting effects on the risk of developing heart disease. By recognizing trauma, seeking mental health support and managing cardiovascular risk factors, we may help mitigate this risk.” Levine, who was not involved in this study, is also master clinician and a professor of medicine at Baylor College of Medicine and Cardiology Section Chief at the Michael E. DeBakey VA Medical Center, both in Houston. “This study provides additional data emphasizing the links and interdependence between psychological and cardiovascular health and risk.”

“This study is unique in that it covers a wide range of traumatic experiences and considers a variety of mental health conditions that can start after these events as potential predictors of cardiovascular disease,” Sumner said. “Ultimately, recognizing and treating a variety of psychiatric conditions resulting from trauma is important, and it may have positive effects on both mental and cardiovascular health over the long term.”

Study details, background, design and limitations:

• The study examined health data for 219,866 adults in Denmark aged 18 and older from 1995 to 2019.
• 43,994 of the 219,866 participants experienced a non-fatal heart attack, non-fatal stroke, procedures to restore blood flow to the heart or cardiovascular death between 1995 and 2019.
• The researchers compared 175,872 people who experienced a trauma but not a cardiovascular event to peers who experienced a heart attack, stroke, procedures to restore blood flow to the heart or cardiovascular death during the 24-year period.
• The national health system in Denmark provides free healthcare for all residents, and the results from this analysis of people in Denmark may not apply to other groups of people living in other countries or regions. Another limitation is that the study did not explore why individuals with these posttraumatic mental disorders may have an increased risk of cardiovascular problems.

Co-authors, disclosures and funding sources are listed in the manuscript.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of release link.
• After Sept. 2, view the manuscript online.
• American Heart Association scientific statement news release: Psychological distress common after a heart attack, may lead to future heart conditions (Sept. 2025)
• American Heart Association news release: Depression, anxiety and stress linked to poor heart health in two new studies (Nov. 2023)
• American Heart Association news release: Mental wellness is important for a healthy heart and brain (May 2023)
• American Heart Association scientific statement: Psychological Health, Well-Being, and the Mind-Heart-Body Connection (Jan. 2021)
• American Heart Association health information: Understanding how stress affects the body
• Follow American Heart Association/American Stroke Association news on X @HeartNews
• Follow news from the Journal of the American Heart Association on X @JAHA_AHA

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and American Heart Association Expert Perspective: 214-706-1173

Karen Astle: Karen.Astle@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• A new study found that nearly 8 out of 10 young adult participants, average age 23 years, had cardiovascular-kidney-metabolic syndrome (CKM syndrome) stages 1 – 3.
• Participants in higher CKM syndrome stages had early signs of arterial injury.
• Young adults with more advanced CKM syndrome stages also had lower cardiovascular health scores, as measured by the American Heart Association's Life's Essential 8™ metrics.

Embargoed until 4 a.m. CT/5 a.m. ET, Thursday, Aug. 20, 2026

DALLAS, Aug. 20, 2026 — A new scientific study found that nearly 8 out of 10 young adult participants, average age 23 years, had cardiovascular-kidney-metabolic syndrome (CKM syndrome), according to new independent research published today in Circulation: Population Health and Outcomes, a peer-reviewed scientific journal of the American Heart Association.

Participants with more advanced CKM syndrome had early signs of arterial injury, the researchers report, highlighting the urgent need for cardiovascular disease prevention efforts to begin earlier in life.

Investigators assessed participants’ cardiovascular health status in two ways: determining their CKM syndrome stage and their Life’s Essential 8 cardiovascular health score. They checked for signs of arterial injury with ultrasound imaging of the carotid arteries (large arteries in the neck that carry blood to the brain).

“The study shows that CKM syndrome staging and Life’s Essential 8 are complementary for identifying adults younger than age 30 who may be on the fast track for arterial injury, plaque build-up and, ultimately, at higher risk for future cardiovascular events,” said study author Donald Lloyd-Jones M.D., M.S., an American Heart Association volunteer who is a cardiologist at Boston Medical Center, professor of medicine at Boston University’s Chobanian & Avedisian School of Medicine, director of the Framingham Center for Population and Prevention Science, and principal investigator of the Framingham Heart Study.

CKM syndrome describes the interconnected relationship among obesity, diabetes, chronic kidney disease and cardiovascular disease. CKM syndrome is categorized by stages that reflect a person’s risk factors, ranging from 0 (no risk factors) to 4 (existing cardiovascular conditions such as coronary heart disease, heart failure or stroke).

The American Heart Association’s Life's Essential 8™ comprises two major areas,  health behaviors and health factors, that provide a framework for measuring, monitoring, and improving cardiovascular health.

Measuring and monitoring cardiovascular health in your 20s

American Heart Association/American College of Cardiology guidelines for preventing and managing high blood pressure, high cholesterol and CKM syndrome recommend clinicians use the Predicting Risk of cardiovascular disease EVENTs (PREVENT™)  equations to estimate a person's 10- and 30-year risk of cardiovascular disease. However, those equations were developed and validated for use in people aged 30-79 years. Because of the young age of participants in this study, the PREVENT equations are not applicable, Lloyd-Jones said.

“In my practice, and what I would recommend, is that the conversation focuses on Life’s Essential 8 and optimizing as many of those metrics as possible for better health today and long term,” said Lloyd-Jones, who is also a former volunteer president of the American Heart Association.

The health behaviors and health factors in Life's Essential 8 are:

• healthy eating
• physical activity
• avoiding tobacco
• healthy sleep
• healthy weight
• healthy cholesterol
• healthy blood sugar
• healthy blood pressure

“For people in their 20s, we want to focus on improving cardiovascular health,” Lloyd-Jones said. He explained that the Life’s Essential 8™ framework is designed “for measuring, monitoring, and improving cardiovascular health at any age, but especially in adolescents and young adults” and has been linked to their health now and in the long-term.

Lloyd-Jones added that these everyday health measures help people understand how lifestyle choices influence heart, kidney, and metabolic health over time and provide practical steps to improve overall health.

Study Details

Scientists analyzed health data from 1,283 participants in the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, a diverse cohort of adults with an average age of 23 years and found:

• Nearly 80% of participants met criteria for CKM syndrome stage 1, 2 or 3, meaning they already had excess adiposity, metabolic risk factors, and/or evidence of subclinical cardiovascular disease. About 21% had no identifiable CKM risk factors (Stage 0). None were in stage 4.
• Young adults with more advanced CKM syndrome stages had poorer Life's Essential 8 scores.
• More advanced CKM syndrome stages were associated with early arterial injury, including thicker carotid artery walls, which is an early marker of atherosclerosis, even among people in their early 20s.

Researchers concluded that the findings highlight the urgent need for prevention efforts to begin earlier in life, suggesting there are opportunities to improve cardiovascular health and prevent disease progression long before cardiovascular disease becomes clinically apparent.

Study limitations

The study has several limitations, including its cross-sectional design, which shows association but cannot establish cause and effect, multiple outcomes were evaluated simultaneously, and the use of some self-reported health behavior data. In addition, because the study population intentionally included many individuals from disadvantaged backgrounds, the findings may not be generalizable to all young adults. Researchers say additional long-term studies are needed to determine how CKM syndrome stage in young adulthood relates to future cardiovascular disease risk.

Co-authors, disclosures and funding sources are listed in the manuscript.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study’s authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.

Additional Resources from the American Heart Association:

• Multimedia is available on the right column of release link
• After August 20, 2026, view the manuscript online. 
• What is CKM syndrome, and why should young adults pay attention?
• Obesity rates in the U.S. climbed to about 40% of adults and 20% of youth in 2023 (July 2026)
• First-ever guideline on cardiovascular-kidney-metabolic syndrome issued (June 2026)
• Daily Habits That Protect CKM Health
• American Heart CKM Initiative
• Follow American Heart Association/American Stroke Association news on X @HeartNews
• Follow news from the American Heart Association’s Circulation: Population Health and Outcomes journal @CircOutcomes

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and AHA/ASA Expert Perspective: 214-706-1173

Maggie Francis: Maggie.Francis@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• Being physically active was tied to a 9% to 19% lower risk of stroke or death for moderate to high physical activity levels, in an analysis of more than 87,000 adults in Norway.
• Study participants had nearly the same health benefits from physical activity, regardless of whether they had an irregular heart rhythm known as atrial fibrillation or not.
• While the largest benefit was noted among study participants who were the most active, benefits were also noted for people reporting low to moderate activity levels.

Embargoed until 4 a.m. CT/5 a.m. ET Wednesday, Aug. 5, 2026

DALLAS, Aug. 5, 2026 — Being physically active was linked to a lower risk of stroke and death for adults with atrial fibrillation, or AFib, according to new, independent research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

“In general, people with AFib appear to be less active than the general population,” said lead study author Kristoffer Johansen, Ph.D., a researcher at the School of Sport Sciences, Faculty of Health Sciences at UiT The Arctic University of Norway, Tromsø. “The results from our study indicate that physical activity was associated with a reduced risk of stroke and death in individuals with and without atrial fibrillation. So, regular physical activity is important for all and could be an important preventive strategy for people with AFib.”

AFib is a quivering or irregular heartbeat that occurs in the heart’s upper chamber known as the atria. According to the American Heart Association, it can lead to blood clots, stroke and other heart-related conditions. The prevalence of AFib in the U.S. was estimated at 10.55 million, equivalent to 4.48% of the adult U.S. population, according to data reported in the American Heart Association’s 2026 Heart Disease and Stroke Statistics.  

The American Heart Association recommends all adults spend less time sitting and get

at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week. In addition, adults should participate in moderate muscle-strengthening activity at least twice a week.

The study tracked more than 87,000 adults in Norway for about 15 years, capturing information about AFib, stroke and death from national health registries.

What did the analysis find?

• Compared to adults who were inactive, adults with a low, moderate or high level of physical activity had a 9%, 19% and 18% lower risk of stroke, respectively.
• Having a low, moderate or high level of physical activity was associated with an 11%, 18% and 22% lower risk of death from any cause, respectively.
• These benefits were similar regardless of whether a person had AFib or not. This suggests that having AFib does not change the relationship between physical activity and stroke.
• For people with AFib, staying active was tied to living an average of 0.5 to 1.2 years longer compared to those who were inactive.

Previous research has suggested that people with AFib derive health benefits from regular physical activity. However, results have been somewhat inconclusive regarding the association between physical activity and stroke, Johansen said. This study suggests a positive impact of physical activity for people with AFib on both stroke risk and living longer.

“I hope our results will increase awareness among clinicians and people with AFib about the benefits of even low levels of physical activity,” Johansen said. “Real health benefits can happen no matter when a person starts getting active, and even a little exercise is better than nothing.”

Mina Chung, M.D., FAHA, co-chair of a 2023 joint guideline for Diagnosis and Management of Atrial Fibrillation from the American Heart Association and other organizations, said this study “adds important evidence linking physical activity with lower risks of stroke and death in people with and without AFib.  

“It’s important to remember that physical activity may also reflect overall health. Still, the results motivate patients to be as active as they can – even lower levels of activity were associated with benefit, while moderate to high levels were linked to greater benefit,” added Chung, who is also a professor of medicine at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and cardiologist in the department of cardiovascular medicine, the section of cardiac electrophysiology & pacing within the Heart, Vascular & Thoracic Institute and the Department of Heart, Blood & Kidney Research at the Cleveland Clinic Research and the Cleveland Clinic.

What are the study details, background, design and limitations?

• The study included health information for 87,340 participants from two large Norwegian health studies: the HUNT Study (including participants from the third and fourth survey conducted in 2006-08 and 2017-19) and the Tromsø Study (including participants from the sixth and seventh survey conducted in 2007-08 and 2015-16). Participants’ average age was about 51 years at time of enrollment in the studies. About 47% were men and more than 6,500 participants had AFib.
• Researchers divided people into four groups based on the level of regular physical activity participants reported, ranging from inactive to highly active. They specifically noted their frequency of physical activity ranging from never to almost every day; the duration of exercise ranging from less than 15 minutes to more than one hour; and the intensity of the exercise, ranging from “I take it easy without breaking into a sweat or losing my breath” to “I push myself to near-exhaustion.”
• The study used a multiple-records approach, meaning that if someone developed AFib during the follow-up, they were reclassified to the AFib group to ensure that the results of the AFib group were more accurate.
• Limitations: Instead of randomly assigning people to a specific treatment or control group in a lab, individuals reporting different physical activity levels at the start of the study were followed over time. The consequence of this participant non-randomized  grouping is that other unmeasured or imprecisely measured factors may have influenced the relationship between physical activity and stroke/death. For example, more active individuals tend to live a healthier lifestyle in general. Therefore, despite the fact that a statistical correction was made for several factors, the authors cannot exclude the possibility that other factors could have partially explained why physically active individuals had a lower risk of stroke and death. Also, people in the study reported their own activity levels, meaning they might have said they exercised more than they really did.

Johansen said similar results would be expected if this analysis was conducted based on adults in the U.S.

Co-authors, disclosures and funding sources are listed in the manuscript.

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of release link.
• After Aug. 5, view the manuscript online.
• American Heart Association health information: Getting Physically Active
• American Heart Association health initiative: Healthy for Good™
• American Heart Association news release: Move more for your health, not just for the scale (June 2026)
• Follow American Heart Association/American Stroke Association news on X @HeartNews
• Follow news from the Journal of the American Heart Association on X @JAHA_AHA

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and AHA/ASA Expert Perspective: 214-706-1173

Bridgette McNeill: bridgette.mcneill@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org