Health

During our hectic 21st century lifestyles, it can be tricky to make sure we are eating as healthily as possible. Some of us simply do not have enough time in the day to set aside and cook a proper, nutritious meal, and this can mean we turn to quick and easy foods which can have a detrimental affect on out health in the long-term. Negative concequences can include developing type 2 diabetes. Experts are keen to change this and make sure Brits are well equipped with sufficient gastronomical knowledge in order to make better choices.

It is said that everything is okay in moderation, but some foods, experts suggest, are best avoided. Diabetes UK says: “There is no food you can’t eat if you want to prevent type 2 diabetes or help you manage prediabetes. It is a question of choosing healthier foods more often.”

Here is a list of things specialists say it is best not to consume and why.

1. Sugary and sweetened drinks

2. Refined white carbs

3. Red and processed meats

Millions of Americans are now using Wegovy and Mounjaro to lose weight but, for many, the results can be underwhelming.

While some will lose up to a fifth of their body weight on the drugs, others see their weight loss plateau after a few months.

Now, experts say a supplement that costs around 10 cents called psyllium husk could be the answer, which they argue can supercharge weight-loss drugs.

Studies even show that patients not on the shots who take psyllium husk – which is rich in fiber – lose weight.

‘Psyllium husk, as one of the most well-researched supplements out there, is an incredibly effective way for users to do this,’ says John Lukey, a registered nutritionist from King’s College London.

‘It increases feelings of satiety [fullness], reducing the likelihood of overeating and helping regulate appetite. In combination with the jabs it can be quite a potent mix.’

So, what is psyllium husk – and how does it work?

First, it’s important to explain the function of weight-loss medications.

Psyllium husk has become popular thanks to influencers touting its ability to suppress appetite – but experts agree it could make all the difference for weight loss shot uses struggling to shift those last few pounds

These revolutionary medicines are known as GLP-1 injections.

The shots , which initially began as diabetes medicines like Ozempic, work by giving the body an artificial dose of the GLP-1 hormone – often described as the ‘satiety hormone’ – which is made in the gut and released after meals to tell the body it is full.

This sensation of fullness – or satiety – means patients eat less, sparking significant weight-loss.

However, experts say that, in order for the drugs to have the desired effect, they need to be combined with a sensible diet.

One of the most important factors in a healthy weight-loss diet is fiber.

Fiber is a form of carbohydrate found in fruits, vegetables, nuts, seeds, legumes and whole grains. Studies show that a high-fiber diet boosts weight-loss, and may lower the risk of heart disease and bowel cancer.

Yet, despite these various benefits, research shows that only a fraction of US adults eat the recommended 30 grams of fiber a day. For comparison, an apple contains four grams of fiber, while a cup of chickpeas contains six grams. 

Experts say that psyllium husk is one of the easiest – and most effective – ways to get enough daily fiber.

Around 11 percent of adults in the US take GLP-1 drugs, up significantly from three percent in 2024, according to research from Gallup.

Taken as a pill or a powder mixed in water, psyllium husk is made from the outer shell of the seeds of the plantago ovata plant – a type of shrub found in deserts.

Experts say the main reason that psyllium husk is so effective at boosting weight-loss is that, combined with water, the supplement swells to form a thick gel.

This gel then sits in the stomach, reducing space for food and triggering the sensation of fullness, in a similar way to GLP-1 injections.

Studies show that, taken on its own, psyllium husk can lead to weight-loss.

One 2023 review, published in the Journal of the American Association of Nurse Practitioners, found that overweight and obese adults who took psyllium husk before meals lost nearly four-and-a-half pounds in under five months.

And a 2018 meta-analysis also found just 10 grams of psyllium husk a day significantly reduced ‘bad’ cholesterol – the fatty plaque that builds up in the blood vessels, eventually leading to heart attacks and strokes.

It’s for these reasons that experts say combining psyllium husk with GLP-1 jabs can help boost weight-loss when the jabs stop working.

‘The jabs are extremely effective at reducing appetite, but we shouldn’t be assuming that they are a silver bullet,’ says Mr Lukey.

‘Eating enough fiber is absolutely essential for those on the injections.

‘This is why psyllium husk can help users reach optimal levels for weight-loss.’

However, experts also say that psyllium husk needs to be used carefully. Research shows that psyllium husk must be taken alongside plenty of water – typically two glasses.

This is because the supplement expands in the gut and, without adequate water to clear it out of the system, can potentially lead to blockages.

Moreover, experts say that the weight-loss effects of psyllium husk are not instant, meaning that patients need to stick with the supplement.

‘The research shows that consistency matters,’ Dr Rubina Aktar, a neuroscientist at Queen Mary University of London, and co-founder of natural weight-loss drug Elcella.

‘Psyllium tends to be most effective when used over several weeks and alongside plenty of water so that you stay well hydrated.

‘This is especially relevant for those using weight-loss medications.’

Experts say it is also important that patients looking to eventually come off GLP-1 drugs should boost their natural fiber intake too.

Studies show that around two-thirds of people regain the weight they lose on the drugs within a year of stopping.

Experts also say that getting enough protein – a muscle-building nutrient found in meat, dairy, fish, pulses and some vegetables – is crucial for keeping the weight off. So too is regular strength training, such as using weights or resistance bands.

‘Increasing fiber intake while on the medications will serve you when you come off them,’ says Mr Lukey.

‘No one wants to be on these drugs for life – and managing appetite through dietary means will always be better for long-term health.

‘A daily psyllium husk supplement, alongside adequate protein and strength training, could ultimately make the difference between maintaining weight loss – or putting it all back on.’

READ MORE: A third of adults were put off exercise ‘for life’ by trauma of PE

An anti-aging and wellness supplement is being recalled over fears it may be contaminated with toxins. 

The FDA announced a recall of Optimal Balance Pharmacy’s compounded glutathione 200 mg/ml (30 ml) multi-dose vial because testing by the pharmacy revealed elevated bacterial endotoxin levels.

An endotoxin is a toxic molecule found in bacteria such as E.coli and Salmonella. It can cause severe fevers, inflammation and sepsis.  

The FDA stated: ‘There is reasonable probability that injectable products with elevated endotoxin levels could cause significant medical events including fevers, hypotension, inflammatory reactions, anaphylactic shock and death.’ 

As of August 19, Optimal Balance Pharmacy has received reports of adverse events from people using the product. 

Neither the company nor the FDA released how many incidents have been reported, but they include fever, chills, severe headache, nausea, vomiting, pain and symptoms consistent with an allergic reaction.

The injectible was shipped to prescribers and directly to consumers in Arizona, Colorado, Florida, Illinois, Louisiana, Michigan, New York, Nevada, Oklahoma, Pennsylvania, Texas, Utah, Vermont and Washington.

Glutathione injections are often used to help fight cell damage, support the immune system and clear toxins from the liver. 

The FDA announced that Optimal Balance Pharmacy is recalling its compounded glutathione 200 mg/mL (30 mL) multi-dose vials after the pharmacy’s own testing detected elevated bacterial endotoxin levels

Optimal Balance Pharmacy is notifying customers and working to retrieve and properly dispose of the recalled products.

The company is a compounding pharmacy, meaning it prepares customized medications by combining ingredients to meet individual patient needs. 

Unlike FDA-approved drugs, compounded medications are not reviewed for safety, effectiveness, or quality before they reach patients.

For people who currently have a recalled injectible, they should immediately stop using it and contact their prescriber or the company.

Glutathione is a powerful antioxidant that occurs naturally in every cell of the human body. It is composed of three amino acids – cysteine, glycine, and glutamic acid – and plays a vital role in protecting cells from damage caused by free radicals and oxidative stress.

In addition to its antioxidant properties, glutathione supports the immune system, helps the liver remove heavy metals and other toxins and is involved in DNA production and tissue repair.

Injectable glutathione is often marketed in wellness clinics and med spas for a range of off-label uses, including skin lightening, anti-aging, detoxification, and immune support.

Because oral glutathione is poorly absorbed, injections are promoted as a more effective way to reach therapeutic levels.

The injectible was shipped to prescribers and directly to consumers in 14 states. Glutathione injections are often used to help fight cell damage , support the immune system and clear toxins from the liver

However, the FDA has not reviewed or approved any injectable glutathione product for safety or effectiveness for these purposes.

The evidence base for these uses remains thin, and medical organizations have cautioned against off-label use because of limited clinical evidence and significant health risks.

Limited oversight of compounded injectables makes them vulnerable to contamination.

Endotoxins are toxic molecules found in the outer membrane of bacteria like E. coli. They are not the bacteria themselves, meaning a product can pass a sterility test and still be dangerous. Heat does not destroy them.

The risk depends on how the product enters the body. Swallowing endotoxins is generally harmless, but injecting them into the bloodstream triggers an immediate and aggressive immune response. Reactions can begin within minutes.

The FDA warns that injectable products with elevated endotoxin levels can cause fevers, hypotension, inflammatory reactions, anaphylactic shock, and death.

Symptoms typically appear within minutes to hours and include fever, shaking chills, severe headache, nausea, vomiting, body aches and rapid heartbeat.

Seek emergency care for difficulty breathing, throat or facial swelling, chest pain, fainting, confusion, a rapidly spreading rash, or a sudden fever above 102 degrees F.

As of August 19, Optimal Balance Pharmacy has received reports of adverse events from people who used the product but has not disclosed how many incidents have been reported. The reactions include fever, severe headache, nausea, pain and allergic-type symptoms

The Optimal Balance Pharmacy recall comes just two weeks after a separate Texas pharmacy recalled three lots of the same injectable glutathione product for the exact same reason – elevated bacterial endotoxin levels.

A single isolated recall can be seen as a manufacturing slip. Two separate pharmacies failing on the same measure for the same product within weeks points to a potential problem further up the supply chain.

This pattern has raised regulatory questions. Glutathione is not listed as an approved ingredient for compounding by the FDA and is regulated as a dietary supplement rather than a pharmaceutical drug.

The fallout from the first recall has already begun. A Texas woman has filed a lawsuit against the pharmacy, alleging she was hospitalized after receiving an IV infusion from one of the recalled lots.

The lawsuit claims she experienced head and neck pressure, uncontrollable shaking, and elevated heart rate and blood pressure within minutes of the infusion, requiring ambulance transport and a multi-day hospital stay.

The lawsuit has not been heard in court and the pharmacy has not publicly responded.

Subtle changes in the mirror could be the first whispers of trouble in one of the body’s most essential organs.

Roughly 30 million Americans – one in seven adults – are living with kidney disease, and nine out of 10 do not know they have it.

Kidney health underpins nearly every system in the body. These fist-sized organs act as the body’s constant filtration system, removing waste and excess fluid from the bloodstream and expelling it as urine.

When kidneys are damaged, often by diabetes or high blood pressure, their filtering units become scarred and lose the ability to remove waste from the blood. 

Kidney disease is often called a ‘silent killer’ because in its early stages, it rarely shows obvious symptoms.

By the time noticeable issues like fatigue, nausea, or swelling in the legs appear, the kidneys may have already lost significant function.

In recent years, both clinical research and centuries-old medical traditions have pointed to the face as a remarkably revealing window into renal function.

Long before lab tests show abnormal numbers, the mirror may reflect subtle warning signs, from persistent under-eye puffiness to an unexplained dullness in the skin, that warrant a closer look.

About 30 million Americans have kidney disease and 90 percent are unaware. Diabetes and high blood pressure are the top culprits, scarring the kidneys’ filters and impairing their ability to cleanse the blood

Pale or Sallow Complexion

A healthy complexion has a warm, rosy undertone – evidence of oxygen-rich blood circulating close to the surface. But when kidneys begin to fail, that glow can fade.

A pale or sallow complexion is one of the more scientifically grounded facial signs of kidney trouble. Healthy kidneys produce a hormone called erythropoietin, or EPO, which signals the bone marrow to make red blood cells.

When kidney function declines, EPO production drops, leading to anemia, or a shortage of oxygen-carrying red cells.

Red blood cells carry oxygen from the lungs to every corner of the body. When there aren’t enough, tissues don’t get the oxygen they need.

The skin, being the body’s largest organ, is often the first place this shortage becomes visible. It loses its healthy pink glow and takes on a pale, dull or sallow appearance.

Ancient healers noticed this too. Traditional Chinese Medicine describes a dull or sallow complexion as a reflection of ‘kidney qi deficiency,’ interpreting it as a sign that the body’s core vitality is waning.

Pale or sallow skin is a well-grounded sign of kidney trouble. Healthy kidneys produce EPO, which drives red blood cell production. When kidney function slips, EPO drops, reducing oxygen-carrying red cells 

Puffy Eyelids & Facial Swelling

A healthy face has defined contours – the eyes sit naturally in their sockets, and the cheeks and jawline are clearly visible. But when the body retains fluid, those contours can soften or disappear entirely.

Puffiness around the eyes and general facial swelling are among the most well-supported signs of kidney trouble.

Healthy kidneys maintain a careful balance of proteins and electrolytes that keep fluid inside blood vessels where it belongs.

When they become damaged, they may lose their ability to filter out excess sodium and water, causing fluid to back up in the tissues.

Damaged kidneys can also leak a protein called albumin into the urine. Albumin normally acts like a sponge, holding fluid inside the blood vessels. When it’s lost, fluid escapes into surrounding tissues, leading to swelling.

The eyelids are particularly vulnerable to this fluid buildup. The skin around the eyes is among the thinnest and loosest in the body, with little underlying muscle to hold fluid in place.

That is why puffiness often shows up there first, especially in the morning, after lying flat all night allows fluid to pool around the eyes.

If the swelling is more generalized, the entire face may appear rounder or fuller, and the skin may temporarily indent when pressed, a classic sign of edema.

Damaged kidneys can leak albumin – a protein that holds fluid inside blood vessels. When lost, fluid seeps into tissues, causing swelling. The eyelids are especially vulnerable due to their thin, loose skin

Dull and Darkened Complexion

A dull, ashen or darkened complexion is another scientifically grounded facial sign of kidney trouble.

When kidney function declines, waste products including urea, creatinine and other toxins begin to accumulate in the bloodstream. This condition is known as uremia.

Because the skin is highly vascular and sensitive to changes in the blood, it often reflects the buildup of waste products long before other organs show signs of trouble.

The waste compounds that accumulate when kidneys fail can interfere with melanin production, the pigment responsible for skin color.

Specifically, elevated levels of a hormone called beta-melanocyte-stimulating hormone stimulate melanocytes, the cells that produce pigment, to work overtime.

Over time, this causes the skin to lose its natural tone and take on a grayish or muddy appearance.

In some cases, the skin may even develop a bronze or yellowish hue, as toxins and pigment-building hormones build up together beneath the surface.

This isn’t rare. Studies show that pigmentary changes affect anywhere from 25 percent to 70 percent of people with chronic kidney disease (CKD).

Among patients on dialysis, the rate climbs to roughly 65 percent, while those not yet on dialysis see changes in about 37 percent of cases.

As waste products build up in the bloodstream, kidney damage can darken the complexion, leaving it looking grayish or even bronze

Abnormal lip pigmentation

Healthy lips typically have a pink or reddish hue, reflecting good circulation and healthy blood. But when the kidneys begin to fail, the lips can sometimes tell a different story.

Abnormal lip pigmentation, ranging from brown patches to a generalized darkening of the lips, is one of the more common oral manifestations of chronic kidney disease.

Studies show that it affects roughly 40 percent of patients with end-stage kidney disease who are undergoing dialysis. In some populations, the prevalence has been reported as high as 48 percent.

This change stems from hormone buildup. Healthy kidneys filter waste products from the blood, including excess hormones.

When kidney function declines, the body struggles to clear a hormone called beta-melanocyte-stimulating hormone. This hormone stimulates melanocytes – the cells responsible for producing pigment in the skin and lips.

As it accumulates in the blood, it triggers these cells to produce more pigment, resulting in noticeable darkening of the lips and sometimes the inside of the mouth.

Traditional Chinese Medicine has also long observed this connection, describing dark or purplish lips as a sign of ‘blood stasis’ or poor circulation, an observation that aligns with the modern understanding of toxin accumulation.

Chronic kidney disease causes toxin buildup in the blood, triggering inflammation that can worsen acne in those already prone to it

Oily cheeks and acne

Acne and oily skin are incredibly common, and for most people, they have nothing to do with kidney health.

But in Traditional Chinese Medicine, the cheeks and chin are considered reflective of the overall health of the kidneys and reproductive system.

Practitioners sometimes look to these areas for clues when assessing overall kidney function, especially when breakouts are persistent, recurrent or don’t respond to typical acne treatments.

The scientific link, however, is far less clear.

Some hormonal shifts associated with chronic disease, including alterations in androgen levels, can influence sebum production.

But these changes are not specific to kidney disease and can be caused by a wide range of other factors, from stress and diet to polycystic ovary syndrome and simple genetics.

That said, one indirect connection is worth noting. Chronic kidney disease often leads to a buildup of toxins in the blood, which can trigger systemic inflammation. Inflammation, in turn, can worsen acne in people who are already prone to it.

So while a few stubborn pimples on the chin are almost certainly not a sign of kidney trouble, they can be part of a broader pattern when considered alongside other symptoms.

From 2000 to 2019, the annual number of new end-stage kidney disease cases increased by 41.8 percent, from 92,660 to 131,422. Diabetes and hypertension accounted for the majority of cases throughout this period, with hypertension-related cases showing the steepest rise

Plant-based diets are associated with lower kidney disease risk and slower progression. Studies show they’re linked to 20 percent lower albuminuria – a key marker of kidney damage

Science-Backed Steps To Combat Kidney Damage

The good news is that much of the damage to kidneys can be prevented or slowed.

What you eat matters. Plant-based diets have been linked to a lower risk of chronic kidney disease and slower progression. 

In large studies, people who followed predominantly plant-based diets had roughly 20 percent lower levels of albuminuria – a key marker of kidney damage – and 30 percent lower odds of developing kidney disease compared to those who ate more animal protein.

Aim for less than 2,300 mg of sodium per day and limit added sugars. Processed foods often contain hidden phosphorus and potassium additives that can strain damaged kidneys.

Regular physical activity is another frontline defense. The CDC recommends 150 minutes of moderate-intensity exercise per week, plus two days of muscle-strengthening activities.

Recent research confirms that exercise directly benefits kidney function.

A network meta-analysis of 25 randomized trials found that moderate exercise can slow the decline in estimated glomerular filtration rate (eGFR), the key measure of kidney function, by a clinically meaningful amount.

Even 30 minutes of activity five times a week has been linked to better outcomes.

High blood pressure is the second leading cause of kidney failure in the US. Keeping blood pressure below 140/90 mm Hg is a critical goal.

For people with diabetes, the most common reason for needing dialysis or a transplant, tight blood sugar control is equally essential.

Some common over-the-counter pain relievers can damage your kidneys. Nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen should be used with caution, especially in people with kidney disease, diabetes or high blood pressure.

If you take these regularly for chronic pain, talk to your doctor about safer alternatives.

For the past two years, I have suffered from very bad flatulence, which is embarrassing. I read recently that it could be a sign of something called SIBO. What is that?

J. Macey, Salisbury, Wiltshire.

Dr Martin Scurr replies: SIBO – or small intestinal bacterial overgrowth – is where too many, or an abnormal mix of, bacteria normally found in the large bowel move into the small bowel.

These ferment the carbohydrates from your diet, leading to the formation of gases, including hydrogen, methane and hydrogen sulphide. This causes abnormal bloating and malodorous flatulence.

What causes SIBO is not fully understood, but often it is due to another problem (e.g. surgery or illness) that damages the cells involved in gut motility.

Apart from SIBO, excess gas can also be due to diverticular disease – which you have, as you say in your longer letter. This is where small pouches form in the colon, usually as a result of age and lack of fibre – any material inside these pouches ferments, causing gas.

Your flatulence may even be down to the extra fibre you’ve been advised to consume to combat the constipation caused by diverticular disease.

For this reason, I often suggest patients increase intake of fibre – from, for example, bran, grains and vegetables – slowly, over several weeks and months, rather than overnight.

SIBO – or small intestinal bacterial overgrowth – sees bacteria normally found in the large bowel move into the small bowel, fermenting carbohydrates and causing gases to form

I’d suggest discussing your gas problems with your GP, with a view to being tested for SIBO.

This involves having a breath test to measure levels of hydrogen and methane.

If SIBO is diagnosed, you may need to see a dietitian for advice (one approach is a low FODMAPs diet – which involves gradually identifying, then eliminating, foods that are not absorbed properly by the small intestine and may cause gas).

In exceptional cases, GPs may prescribe antibiotics to reduce bacteria in the intestine.

In the meantime, try a more soluble form of fibre, such as psyllium husk. It’s available in health food shops and is better tolerated than, say, wheat bran, because it gets only minimal fermentation by gut bacteria – producing less gas.

I have (self-diagnosed) crepitus in my neck – and neck exercises hurt every time. Is this just something to accept at 74, or is there anything that can ease the stiffness and ache?

Debra Arnell, Alicante, Spain.

Dr Martin Scurr replies: ‘Crepitus’ is the term for crunching, grating or cracking sounds in a joint.

In the neck, it’s usually caused by cervical spondylosis – age-related arthritis affecting the small joints between the vertebrae. Small bony spurs (osteophytes) often develop as part of the body’s response to the inflammation in the arthritic joints. The crunching or grating noise is caused by the bones grinding against each other.

You don’t mention how much pain you’re experiencing and there is a difference between mild pain during exercise that eases quickly, and constant, more severe pain – the latter is a sign you should see a doctor.

Applying heat, such as a hot water bottle wrapped in a towel for 20 minutes, before exercising can help, and taking two 500mg paracetamol tablets at the same time may also ease things.

You might also consider the Alexander Technique, a posture-focused approach for improving movement and stance through guided exercises and breathing.

It has encouraging evidence for chronic neck pain. It won’t reverse the arthritic changes, but it can reduce muscular tension and improve how you move.

An MRI scan is only needed if the pain gets worse, spreads down your arm – or if your hands are becoming less dexterous. These could be a sign that nerves are being irritated and would need to be investigated.

You certainly should not just ‘accept’ this discomfort as there are measures you can take to improve matters.

In the neck, crepitus is usually caused by cervical spondylosis – age-related arthritis affecting the small joints between the vertebrae

In my view… why GPs should work for the NHS

Did you know that GPs are not NHS employees? Unlike hospital doctors, each GP practice is a subcontractor to the state, a small business responsible for income and expenditure, contracted to provide services.

Each GP is a partner, paid a salary out of the profits of that small business.

According to a report from the charity the Health Foundation, a GP practice receives £219 per year per patient, which makes up the bulk of its income – there are 18,000 GP partners in England and 1,000 are paying themselves over £300,000 annually; 4,000 draw more than £200,000. That’s an astonishing amount.

Surely, as with any owner-operated small business, there’s an incentive to minimise expenditure to maximise profit?

Take the example of the fact that GPs no longer provide out-of-hours care – seven-day and night cover was expensive and reducing it to a five-day daytime-only service inevitably meant that each GP business now has funds for higher salaries.

If GPs were employed like hospital consultants we might see a return to out-of-hours cover – as consultants provide. This system must be changed.

• Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: drmartin@dailymail. co.uk. Replies should be taken in a general context. Always consult your own GP with any health worries.