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Zika Cases in the United States | Zika Virus

Background

Prior to 2014, very few travel-associated cases of Zika were identified in the United States.
In 2015 and 2016, large outbreaks of Zika virus occurred in the Americas, resulting in an increase in travel-associated cases in US states, widespread transmission in Puerto Rico and the US Virgin Islands, and limited local transmission in Florida and Texas.
In 2017, the number of reported Zika cases in the United States started to decline.
Since 2018, there have been no reports of Zika virus transmission by mosquitoes in the continental United States.
Since 2019, there have been no confirmed Zika cases reported from US territories.
CDC is notified of cases by state and local health departments using standard case definitions.

Zika cases by year

2026 U.S. Zika cases* reported to ArboNET

Data are preliminary and subject to change. Data are current as of July 21, 2026.

Year	US States Locally acquired	US States Travel-associated†	US Territories Locally acquired††	US Territories Travel-associated
2026	0	6	0	0

*Confirmed and probable disease cases
†Cases acquired through other routes (e.g., laboratory transmission) are classified as travel-associated for reporting.
††Since 2019, all locally acquired cases of Zika in the US territories were diagnosed by antibody testing. Since antibodies against Zika virus can persist for years after infection, serology cannot distinguish between a recent or past infection. Additionally, Zika and dengue virus antibodies cross-react, making it difficult to diagnose which virus is the cause of the current illness. Since 2019, there have been no confirmed Zika virus disease cases reported from US territories.

Historic U.S. Zika cases* reported to ArboNET, 2015–2025

2025 data are preliminary and subject to change. Data are current as of June 2, 2026.

Year	US States Locally acquired	US States Travel-associated†	US Territories Locally acquired††	US Territories Travel-associated
2015	0	62	9	1
2016	224‡	4,944	36,367	145
2017	7‡	445	665	1
2018	0	74	147	1
2019	0	28	73	1
2020	0	4	57	0
2021	0	2	32	0
2022	0	5	17	0
2023	0	7	30	0
2024	0	22	10	0
2025	0	7	1	0

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August 1, 2026

FTC Alleges a Telehealth Company Sent Users’ Health Conditions to Ad Platforms After Promising Discretion

Federal regulators have accused one of the largest direct-to-consumer telehealth companies of routing customers’ health conditions to advertising platforms while marketing itself on privacy.

The Federal Trade Commission, joined by Utah and by California through Los Angeles County Counsel, sued Hims and Hers Health on July 29 in federal court in San Francisco. The complaint alleges the company shared sensitive health information about medical conditions with third-party advertising platforms despite promising privacy, and separately alleges deceptive billing and cancellation practices.

None of this has been proven. The company disputes the allegations and says it will defend itself. A complaint is an accusation, and the court has made no findings.

The reason it matters to readers who have never used the platform is the category. The conditions named are the ones people specifically seek online care for because they do not want to discuss them in person.

What the Complaint Says Moved, and Where

The alleged mechanism is a tracking pixel, a small piece of code embedded in a web page that reports visitor activity back to a third party. Pixels are ordinary infrastructure across commercial websites. They become a health privacy question when the page being tracked reveals a medical condition.

According to the complaint as reported by TechCrunch, the company placed trackers supplied by Meta and Snap as well as Microsoft, Pinterest, Reddit, and X. The FTC also alleges the company uploaded lists of certain customers to advertising platforms, a separate practice from pixel tracking that matches known customer identities against platform user accounts.

The service lines named in reporting on the complaint include erectile dysfunction, premature ejaculation, hair loss, weight management, and mental health. The FTC’s contention is that the company advertised privacy and discretion for exactly these categories while the data pipeline ran the other direction.

Christopher Mufarrige, director of the FTC’s Bureau of Consumer Protection, said in the agency’s announcement that the complaint describes “consumers unknowingly locked into recurring subscriptions” alongside disclosure of private health information without consent.

The Billing Allegations Sit Alongside the Privacy Ones

The complaint pairs the data claims with allegations about money, which is unusual and is part of why the case is being watched.

Regulators allege the company advertised free consultations and displayed language indicating no payment was due at intake, then charged consumers and enrolled them in recurring subscriptions once a provider wrote a prescription, in some cases before any consultation had occurred. The complaint further alleges that cancellation was made difficult, leaving some customers paying for refills they did not want.

The cited legal authorities are the FTC Act and the Restore Online Shoppers’ Confidence Act, a 2010 statute governing online negative-option billing, which requires clear disclosure of terms, informed consent before charging, and a simple cancellation mechanism.

The company has responded firmly. In statements reported by BioPharma Dive and others, Hims and Hers called the claims baseless, said its privacy policy makes clear that users may choose how their data is used, and said it is confident in its position. It did not explicitly deny the specific factual allegations in the statements reported.

A Pattern the Agency Has Pursued Before

This is not a novel theory of enforcement. The FTC brought similar actions against GoodRx and BetterHelp in 2023, and against the telehealth startup Cerebral and the alcohol recovery provider Monument, in each case alleging that consumer health data reached advertising platforms through website technology.

The industry has responded to that pressure. Pixel deployment on hospital websites fell from about 98 percent in 2021 to roughly 30 percent in 2025, according to tracking data compiled by health marketing analytics firm Hedy and Hopp and reported by Bloomberg Law. That figure describes hospitals rather than direct-to-consumer telehealth, and should not be read as a measure of the latter.

One legal point is worth understanding because it surprises people. Most direct-to-consumer telehealth platforms operate in a space where HIPAA’s application is contested or limited, which is part of why the FTC rather than the HHS Office for Civil Rights is the agency bringing this case. Consumers frequently assume that anything involving a prescription is covered by federal medical privacy law. That assumption does not reliably hold for app-based commercial health services.

Steps for Anyone Who Has Used a Telehealth Platform

Nobody should stop needed treatment over a privacy dispute, and nothing here suggests any medication is unsafe. The relevant actions are about accounts and settings.

Check advertising controls on the platforms named. Meta, Google, and other services allow users to review and delete off-site activity that businesses have shared, and to limit how that data informs ad targeting. Those controls are typically found under account settings labeled activity, ad preferences, or data sharing.

Review recurring charges. Anyone enrolled in a telehealth subscription can check the current billing terms, the renewal date, and the cancellation process, and should document the date and method of any cancellation request. Consumers who believe they were charged without consent can dispute the charge with their card issuer and file a complaint with the FTC at ReportFraud.ftc.gov.

For future care, consider that browsing a condition-specific page on a commercial health site is not equivalent to a conversation in an exam room. Care delivered through a health system patient portal generally does sit under HIPAA. That is a meaningful difference for anyone who considers the condition itself sensitive.

Several things remain unresolved. The company has not filed its formal response. No court has ruled on any allegation. How many consumers were affected, what specific data elements moved, and what remedy regulators will seek are all matters for the litigation. MedicalDaily will report the company’s answer and any rulings.

Frequently Asked Questions

What did the FTC allege? That Hims and Hers shared consumers’ sensitive health information with third-party advertising platforms despite promising privacy, and separately deceived users about billing and cancellation.

Have the allegations been proven? No. The complaint was filed July 29, 2026, and no court has made findings. The company calls the claims baseless and says it will defend itself.

What is a tracking pixel? A small piece of code embedded in a web page that reports visitor activity to a third party. It becomes a health privacy issue when the page reveals a medical condition.

Which platforms are named? Reporting on the complaint identifies Meta and Snap along with Microsoft, Pinterest, Reddit, and X.

Does HIPAA cover telehealth apps? Not always. Many direct-to-consumer platforms operate outside or at the edges of HIPAA, which is why the FTC rather than HHS is bringing this action.

What can users do now? Review ad and data-sharing settings on the named platforms, check subscription billing terms and cancellation processes, and document any cancellation request.

Has the FTC done this before? Yes. It brought similar cases against GoodRx and BetterHelp in 2023, and against Cerebral and Monument.

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August 1, 2026
The Protein Debate: Why Source Matters More Than Amount

I discuss a public health case for modernizing the definition of protein quality.

In 2019, Dr. David Katz and colleagues, including one of my favorite researchers, David Jenkins, published a “public health case for modernizing the definition of protein quality.” The prevailing deﬁnition seems to have more to do with biochemistry than the overall eﬀects on human health. The common belief that protein is “good,” and the more the better, combined with a definition of protein quality that favors animal protein, gives the impression that eating more meat, eggs, and dairy is desirable and preferable. But this is directly opposed to nutrition guidelines that are instead trying to push more plants. Although protein malnutrition is still common in many areas of the world, it is extremely rare in the industrialized world, where “the most formidable public health threats…are from chronic diseases,” not something like kwashiorkor, severe protein and calorie malnutrition.

In 2016, a landmark study was published out of Harvard, involving more than 100,000 people, that found that replacing animal protein with plant protein was associated with lower risk of dying prematurely. The worst offenders seemed to be processed meat like bacon, as well as egg protein (the egg whites). But swapping in even just 3% plant protein for any of the animal proteins, such as processed meat, unprocessed meat, chicken, fish, eggs, or dairy, was associated with a significantly lower risk of arguably the most important endpoint of all: death. See below and at 1:32 in my video Animal Protein vs. Plant-Based Protein.

But how do we know it’s the protein? The researchers adjusted for factors such as saturated fat intake, which suggested it wasn’t just the animal fat. But how can our body differentiate between protein from a plant and protein from an animal? Isn’t protein…protein? No. Generally, plant protein is low in branched-chain amino acids, unlike animal protein, and decreased consumption of branched-chain amino acids improves metabolic health. It could be the IGF-1, a cancer-promoting growth hormone that is boosted by so-called high-quality animal protein intake, though. We suspect the IGF-1 connection is cause and effect, since people born with higher IGF-1 levels, regardless of what they eat, appear to suffer higher rates of killers like type 2 diabetes and heart disease. Or, it could be something the Harvard researchers didn’t control for, such as toxic pollutants like dioxins and polychlorinated biphenyls (PCBs), since they tend to accumulate up the food chain into cattle, pigs, chickens, and fish and therefore end up on our plates. So, “plant-based protein, besides other health benefits, stands as an important step to lower the body burden of harmful pollutants of dietary animal-protein origin.”

If you don’t think a study with 100,000 people is enough, how about 400,000 people? The U.S. National Institutes of Health–AARP Diet and Health Study is the largest diet cohort study in history, and, again, researchers found that simply replacing 3% of calories from animal protein with plant protein was associated with a 10% lower overall mortality—and you get even twice that benefit if you get rid of eggs, too. That’s not a surprise, since egg consumption is associated with a higher risk of developing cardiovascular disease.

Put all the studies together on dietary protein intake and mortality, and people who eat more protein tend to live shorter lives. But this is “mainly driven by a harmful association of animal protein.” Plant protein intake is actually inversely associated with mortality, meaning those who eat more plant protein tend to live longer lives. More animal protein may mean more mortality, whereas more plant protein is correlated with less mortality, as you can see below and at 3:30 in my video.

So, the best of both worlds would be to increase the intake of plant protein instead of animal protein. In other words, as another meta-analysis concluded, “Persons should be encouraged to increase their plant protein intake to potentially decrease their risk of death.”

Doctor’s Note

The benefits of calorie restriction may arise from the drop in animal protein intake. See Caloric Restriction vs. Animal Protein Restriction for more on this.

I also discuss branched-chain amino acids in Are BCAA (Branched Chain Amino Acids) Healthy?.

Do you need to combine plant proteins, like rice and beans? See The Protein Combining Myth.

How much protein do we need? See Do Vegetarians Get Enough Protein?.

What about plant-based meats? Are Beyond Meat and the Impossible Burger Healthy?

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July 31, 2026
Three Medical Device Categories Established in 2023 Are Now Officially Codified by the FDA

The FDA published three final orders on July 24 creating permanent regulatory categories for a test that estimates how fast chronic kidney disease will progress, a prescription app that delivers behavioral therapy for diabetes, and at-home COVID tests.

Each one reads like news. None of it happened this month.

All three orders codify classifications the agency already granted in mid 2023. The kidney test category became applicable on June 29, 2023, the COVID test category on June 6, 2023, and the diabetes app category on July 7, 2023. What changed last week is that the classifications now appear in the Code of Federal Regulations, at sections 862.1223, 866.3984, and 880.5735.

That distinction matters because nothing became newly available, newly covered by insurance, or newly recommended. The value in these documents is in the limitations FDA wrote into each category, which are more restrictive than the product names suggest.

What Each Category Actually Covers

The kidney category came from Renalytix AI’s KidneyIntelX.dkd, submitted in August 2020. FDA defines the generic type as an in vitro diagnostic that measures one or more analytes from human samples as an aid in assessing the risk of chronic kidney disease progression.

Then it draws hard boundaries. The regulation states the device is “not intended for diagnosis of any disease,” and separately that it is not intended for serial monitoring of kidney disease progression or for monitoring the effect of any therapeutic product. Labeling must carry those limits.

That is a narrower tool than most patients would assume. Standard kidney measures, estimated glomerular filtration rate and urine albumin, are used both to stage disease and to track it over time. A prognostic test in this category answers a different question once: how likely is this to get worse? It cannot tell a patient whether they are improving or whether a medication is working, and FDA explicitly forbids marketing it for that.

The diabetes category came from Better Therapeutics’ BT-001, submitted in September 2022. FDA defines it as a prescription software device providing digital behavioral therapy to aid diabetes management, and the agency’s own language is strikingly modest: the device is “intended to provide limited secondary benefit” to patients, and is “not intended to replace any primary treatment, such as diet/lifestyle changes or medication.“

Required labeling goes further. It must state the device is not for standalone therapy, not a substitute for prescribed therapy or medication, should not be used by people with unstable psychiatric disorders, and is not intended to treat any psychiatric disorder or symptoms.

Notably, among the risks FDA identified for this category is that treatment could result in anxiety, depressed mood, depression, stress, or suicidal ideation. That is an unusual hazard list for a diabetes product, and it explains the psychiatric exclusions.

The COVID category came from Cue Health’s Cue COVID-19 Molecular Test, submitted in May 2022, and covers at-home tests used by lay users without a health care provider.

The COVID Rule Is Where the Consumer Detail Sits

The at-home test regulation reads like a list of everything that goes wrong when people test themselves, converted into mandatory labeling.

Manufacturers must state that “positive results do not rule out co-infection with other respiratory pathogens,” and that a negative result does not exclude infection with something else. They must warn that the test is not a substitute for consulting a clinician and should not be used to determine treatment without provider supervision.

Two requirements deserve attention from anyone who keeps tests in a drawer. Labels must state that expired tests can produce incorrect results, and that accuracy depends on proper storage, which is a real issue for kits stored in hot cars or unheated garages. Labels must also state that false positives become more likely when community prevalence is low.

The variant requirement is the most interesting. Labeling must name the strain or variant that was dominant when performance was established, warn that accuracy may change as new viruses emerge, and advise that lab-based PCR testing should be considered when a new variant is suspected. Manufacturers must continuously monitor for genetic mutations and, if FDA asks, submit evaluations within 48 hours.

The rule also builds in emergency machinery. If a public health emergency involving SARS-CoV-2 is declared, manufacturers have 30 days from FDA notification to test their device against characterized samples and 60 days to publish results, continuing for three years.

Performance has a floor: clinical studies must show the lower bound of the two-sided 95% confidence interval for positive percent agreement exceeding 70%. That is a meaningful number for readers to hold, because it means a test in this category can legitimately miss a substantial share of infections.

What This Changes for Patients

Almost nothing, immediately, and that is the honest answer.

Class II with special controls means a device type avoids the automatic class III designation that would otherwise require premarket approval. The practical effect is on manufacturers rather than patients: once FDA classifies a device type this way, later companies can use the less burdensome 510(k) pathway instead of filing their own De Novo request. FDA said each action would “enhance patients’ access to beneficial innovation, in part by reducing regulatory burdens.“

Over time, that can mean more competitors and lower prices in a category. It is not a promise, and FDA has not exempted any of these three types from 510(k) review, so individual products still need their own authorization.

For patients, the useful takeaways are about expectations. Anyone offered a kidney progression test should understand it estimates risk once and is not a monitoring tool, and should ask what the result would change about their care. Anyone prescribed a diabetes therapy app should know FDA classified it as providing limited secondary benefit alongside, not instead of, medication and lifestyle change. Anyone using at-home COVID tests should check expiration dates, consider how the kit was stored, and treat a negative result during a new variant wave as less reliable than a PCR.

Nobody should start, stop, or change a medication, or skip a monitoring test, based on any of this.

One thing readers may notice: two of the three companies whose submissions created these categories have had well-publicized business difficulties since 2023, which is worth verifying before publication and which illustrates that a regulatory category outlasts the product that established it.

What Happens Next

Comments are closed on all three orders, which took effect on publication. The categories now function as predicates, so the next observable developments would be 510(k) clearances of similar devices, and any future FDA decision to exempt a type from premarket notification.

The bottom line: FDA codified three device categories on July 24, all of which were actually classified in 2023, covering a kidney progression test, a prescription diabetes therapy app, and at-home COVID tests. Patients considering any of the three should note the limits FDA wrote into each. The reasonable action is to ask what a given test or app would change about care. The central uncertainty is whether these categories attract competing products.

Frequently Asked Questions

What did FDA actually do? It published final orders adding three device categories to the Code of Federal Regulations. The underlying classifications were granted in June and July 2023.

Does this mean new tests are available? No. The devices that created these categories have been legally marketable since 2023. No new product launched.

What does the kidney test do? It estimates the risk that chronic kidney disease will progress. FDA states it is not for diagnosis, not for serial monitoring, and not for tracking whether a treatment is working.

Can a diabetes app replace my medication? No. FDA classified this device type as providing limited secondary benefit and requires labeling stating it is not a substitute for prescribed therapy or medication.

Who should not use a diabetes therapy app? FDA requires labeling stating it should not be used by people with unstable psychiatric disorders and is not intended to treat psychiatric conditions.

What changed for at-home COVID tests? Nothing you buy changed. The codified rule requires labeling about expiration, storage, variant limitations, co-infection, and when to seek PCR testing.

How accurate must an at-home COVID test be? Clinical studies must show the lower bound of the two-sided 95% confidence interval for positive percent agreement above 70%, meaning some infections will be missed.

Does class II mean FDA approved it? Class II devices generally require premarket notification, a 510(k), rather than premarket approval. FDA has not exempted any of these three types from that requirement.

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July 31, 2026
Preparing for Wildfires | Wildfires
Be prepared for wildfires

Take steps to be ready for a wildfire and prepare your home and landscaping to reduce your risk from a wildfire.

Know your community’s evacuation plans.

Find several ways to leave your area.

Drive the evacuation routes and find shelter locations.

Have a plan for pets and livestock.

Gather emergency supplies, including respirators.

Can children wear respirators?

Children ages 2 years and older can wear respirators and masks. However, NIOSH Approved respirators do not come in suitable sizes for very young children. Choose a comfortable respirator or mask that your child can wear properly. If a respirator or mask fits poorly or is uncomfortable, a child might take it off or wear it incorrectly (for example, pulling it down from their nose). This reduces the intended benefits.

Choose a size that fits over the child’s nose and under the chin but does not impair vision.

Follow the user instructions for the respirator or mask. These instructions may show how to make sure it fits properly.

NIOSH Approved respirators and international respirators may be available in smaller sizes that fit children. However, manufacturers typically design them to be used by adults in workplaces. They may not have been tested for broad use in children.

Download Infographic PDF: English | Español

Plan to keep wildfire smoke outside.

Choose a room you can close off from outside air.

Set up a portable air cleaner or a filter to keep the air in this room cleaner even when it’s smoky outdoors or in the rest of your home.

Schools and commercial buildings‎

Keep track of fires near you.

Listen to the Emergency Alert System (EAS) and National Oceanic and Atmospheric Administration (NOAA) Weather Radio for emergency alerts.

Monitor fires in your area using mapping tools. AirNow’s Fire and Smoke Map has a map of fires throughout North America. NOAA’s Fire weather outlook page maps fire watches and warnings.
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July 31, 2026
Following Hailuo, Can Hyper-Realistic AI Videos Change How We Think, Feel, or Even What We Trust?

Chinese artificial intelligence company MiniMax has expanded its push into AI-assisted filmmaking with the launch of MiniMax Hub, an all-in-one creative platform powered by its Hailuo AI models. Introduced during the 2026 Shanghai International Film Festival, the platform brings together AI-generated images, video, audio, and editing tools within a single workspace, allowing users to move through much of the production process without switching between multiple applications. Users can describe a project using natural language or upload reference materials, while Hub’s AI agent helps coordinate different stages of production.

The launch comes as MiniMax continues to promote Hailuo as a platform for filmmakers and other creative professionals seeking to streamline content creation. At the same time, the company remains involved in an ongoing copyright lawsuit brought by Disney, Universal, and Warner Bros. Discovery, which allege that MiniMax used copyrighted works to train its AI system without authorization. MiniMax disputes those allegations, and the litigation remains ongoing.

Artificial or Real? MiniMax’s Hailuo Renews Questions About AI Videos and Mental Health

MiniMax has highlighted Hailuo and MiniMax Hub at film industry events, presenting the platform as a way to assist creators throughout the filmmaking process. According to the company, Hub integrates multiple AI capabilities into a single environment so users can generate visual assets, create videos from text prompts or reference images, produce audio, and edit projects without relying on several separate AI applications.

The platform is designed to generate a wide variety of creative content, including cinematic video clips, animated sequences, stylized visuals, and other multimedia assets for film and digital media production. MiniMax says the goal is to simplify production workflows by allowing an AI agent to coordinate multiple creative tasks within one interface.

The launch has also arrived amid broader debate surrounding generative AI. Supporters argue that integrated AI tools could help reduce production time and lower technical barriers for creators, while critics have raised concerns about copyright, artistic ownership, misinformation, and the growing realism of AI-generated media. Those discussions have intensified alongside legal challenges involving several AI companies, including MiniMax.

The Continued Studies on the Psychological Effects of Increasingly Realistic AI-Generated Media

As generative AI systems become capable of producing increasingly realistic images and videos, psychologists and digital media researchers are examining how synthetic content may influence mental well-being and public trust. While research is still emerging, existing evidence suggests that prolonged exposure to highly convincing AI-generated media may contribute to information overload and make it more difficult for people to distinguish authentic material from synthetic content.

Research has suggested that this growing uncertainty could contribute to cognitive overload and reduce confidence in digital information, particularly as AI-generated content becomes more common online. However, scientists have not established that AI-generated media alone directly causes these outcomes, and they continue to emphasize the need for long-term research to better understand its psychological effects.

Mental health experts have also raised concerns that highly convincing synthetic media, particularly when used to spread misinformation or create deceptive content, could contribute to anxiety, stress, or emotional manipulation in some situations. Current research suggests these are plausible concerns, but the evidence remains limited, and researchers continue to investigate how AI-generated media may affect emotional well-being over time. Many experts have also called for greater transparency and clear disclosure when AI-generated content is presented to the public.

Creativity In the Age of Generative AI

MiniMax Hub reflects the rapid evolution of generative AI from standalone image and video generators into integrated creative platforms capable of supporting larger portions of the production process. For filmmakers and other creative professionals, these tools may offer new ways to speed up production and experiment with visual storytelling.

At the same time, the technology has renewed discussion about copyright, authenticity, transparency, and public trust in digital media. As AI-generated content becomes increasingly difficult to distinguish from real footage, ongoing research and thoughtful safeguards will be important to understanding both the opportunities and the potential risks associated with this technology.

Many questions remain unanswered; however, MiniMax’s latest announcement shows how advances in generative AI are reshaping creative work while underscoring the importance of continued scientific research, responsible development, and informed public discussion as these tools become more widely adopted.

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July 30, 2026
How do oil spills impact people? Coastal Pollution Tutorial
Oil spills can cause closures of recreational and commercial areas (Credit: NOAA).

In addition to the lives that can be lost during an oil spill event (like the explosion that led to the Deepwater Horizon spill), spills can impact the livelihoods of communities that rely on commercial or subsistence fishing, tourism, or recreation.

Recreational activities affected by the spill in the Gulf states impacted by Deepwater Horizon included boating, fishing, and beach-going experiences like swimming, surfing, and wildlife viewing. Some beaches and recreational fisheries were closed due to oiling and cleanup activities. A group of federal and state agencies, known as Trustees, were responsible for assessing the impact of the spill. The Trustees estimated that the spill impacted recreational activities from April 2010 through November 2011. During that time, the Deepwater Horizon spill caused the public to lose more than 16 million user days of boating, fishing, and beach-going experiences. Total recreational use damages due to the spill through November 2011 were estimated at $693.2 million.

Deepwater Horizon also devastated the commercial fishing industry. The U.S. Bureau of Ocean Energy Management estimated that the spill caused a loss of between $7.5 million and $141.1 million in revenue for harvesters across the Gulf in the eight months following the oil spill. Many people rely on Gulf fisheries for their income, from the harvesters who catch the seafood to the restaurants who serve it. Across the seafood industry, Deepwater Horizon cost up to $952.9 million in total sales, up to $309.8 million in income, and as many as 9,315 jobs from May through December 2010.

These economic impacts can also lead to health and emotional impacts. After the destruction of the Deepwater Horizon spill, the people in Gulf coast communities experienced increases in stress and depression. Residents worried about the economy, their way of life, and the stability of their communities. All of these factors play a role in affecting their health.

Oil spills can cause stress or depression in people who live or work in affected areas (Credit: Florida Sea Grant/Anna Hinkeldey). View and print this infographic and see the description below.

Indigenous communities—including Native American tribes, Alaska Natives, and Pacific Islanders—as well as other cultural groups have ties to natural resources that go beyond recreational or commercial activities.

The Exxon Valdez oil spill fouled the critically important ecosystem of Prince William Sound, Alaska, with 11 million gallons of crude oil. Native peoples account for nearly a fifth of Alaska’s overall population. Alaska Native people and cultures stretch throughout the state, intertwined with the unique land and the waters that surround it, including Prince William Sound. This area is home to several of Alaska’s tribal groups, including Aleuts, Athapaskans, Eskimos, Eyaks, and Tlingits. It offers many natural and cultural resources these groups look to for both subsistence and to uphold their way of life.

The Exxon Valdez oil spill significantly harmed these natural and cultural resources. A U.S. Department of the Interior study found that subsistence fishing and harvesting took a long time to recover in Prince William Sound. Wild foods harvested in the villages of Tatitlek and Chenega Bay declined from more than 600 pounds per person before the spill, to 225 pounds in 1989, and 150 pounds in 1990. Years later, harvests had still not recovered to pre-spill levels.

Infographic Description
This graphic shows a simple map of Louisiana, Mississippi, Alabama, and Florida, with text describing the mental health impacts of the Deepwater Horizon oil spill on communities in each of these states.

In Louisiana, the oil spill disrupted the work, school, and social life of some coastal residents, which resulted in symptoms of anxiety, depression, and posttraumatic stress.

In Mississippi, some coastal residents experienced worsened financial situations, social relationships, and health issues including more mentally unhealthy days compared to residents in the rest of the state.

In Alabama, some coastal residents felt stress, anxiety, and depression and had more mentally unhealthy days compared to residents in the rest of the state. Residents were also worried about air quality, safe seafood and their income or economic future.

In Florida, some coastal residents felt anxious and depressed especially if they experienced income loss from the spill. These feelings were observed even in areas where oil did not reach the shore.

Beneath the map, there are three icons:

An off-shore oil rig labeled “Oil and gas.”

A plane and suitcase labeled “Tourism.”

And a fishing vessel labeled “Fishing.”

These icons are accompanied by text reading, “Regionally, some coastal county residents reported decreased income, lost jobs, and a disruption in their work or family life, which resulted in mental health distress in themselves and their children. People that relied on the jobs connected to the Gulf were more likely to suffer from negative mental health symptoms after the oil spill. Of these industries, negative impacts were most common in fishing communities.”

Key Takeaway: The Deepwater Horizon oil spill affected communities in many different ways, but all reported increased mental health concerns.
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July 29, 2026
Are Potassium Chloride Salt Substitutes Safe and Effective?

Healthy kidneys are required for potassium excretion. If you aren’t sure if you’re at risk, ask your doctor about getting your kidney function tested.

Based on how we evolved, the optimum dietary potassium intake likely greatly exceeds current and even recommended intakes. The problem is we replaced many of the potassium-rich plant foods that used to fill our diets—fruits, vegetables, leafy greens, roots, tubers—with calorie-dense junk heavy with added fats and sugars, and stripped not only of fiber but also potassium.

In a traditional, mostly plant-based diet, potassium intake is high and sodium intake is low. But now, high blood pressure is the second leading risk factor for death worldwide, killing more than 10 million people each year. Only unhealthy diets rank higher among global risk factors for death, as you can see below and at 0:41 in my video Potassium Chloride Salt Substitute Side Effects.

We can improve both by eating more whole, healthy plant foods like greens and beans, which are packed with potassium and help lower blood pressure. But since most of us are getting too much sodium along with too little potassium, what about using salt substitutes? Potassium chloride is the most common salt substitute, so you’d be swapping out sodium for potassium.

And it works. Based on a meta-analysis of more than a dozen randomized controlled trials, replacing sodium chloride with potassium chloride lowers blood pressure. Most of the trials involved swapping out regular salt for substitutes with less than 30% potassium chloride, and they still got results. And at less than 30% potassium chloride, most people can’t even tell the difference between regular salt and the potassium salt. So, it can taste the same yet still lower blood pressure? What’s the catch?

Potassium chloride is “generally regarded as safe” (GRAS) by the U.S. Food and Drug Administration. The only major concern for healthy people is that if you go 100% sodium-free and use potassium chloride salt substitutes exclusively, you may find it can taste kind of funny, adding a bitter or metallic taste. I’ve found that it depends on what I’m seasoning. Potassium chloride works perfectly well on some dishes and snacks, but I find it makes other foods inedible. When I learned about the sodium science and threw out my salt shaker for good, within a few weeks, my palate totally changed. Everything tasted fine without salt—except pesto. For some reason, pesto without salt didn’t have the same taste that I loved. So, I tried the potassium chloride salt substitute, and it worked perfectly. I couldn’t tell the difference at all! So, I had the best of both worlds. Then, I remembered how, as a kid, I used to put a tiny sprinkle of salt on watermelon like they do in the South to make it even sweeter. I tried it with the potassium salt and almost gagged. The salt substitute is definitely not for everything.

The reason healthy people don’t have to worry about getting too much potassium is that they just pee out the excess, thanks to the kidneys. But that’s with the potassium in food—what about supplements? No adverse effects have been shown with long-term potassium supplementation at doses as high as 3,000 mg a day. In fact, blood levels of potassium are maintained in the normal range by healthy kidneys even when potassium intake is increased to about 15,000 mg a day. That’s no surprise since we evolved eating so many potassium-rich plant foods that the natural intake of potassium for the human species may have been on the order of 15,000 mg a day.

Basically, the normal range for potassium levels in the blood is between 3.5 and 5.0 mmol/L; it becomes concerning when it starts creeping up towards 6 mmol/L. But give people potassium supplements—like the salt substitution trials where participants receive an average of about 2,000 daily milligrams—and blood levels only increase by 0.14 mmol/L. So, they might go from 4 to 4.14 mmol/L, not something that would push levels into the danger range.

Now, there is a limit. Someone with a “massive banana eating habit” could bump their potassium from a normal level to above 6 mmol/L, but this specific case was evidently the result of eating little else besides up to 20 bananas a day for years. Eating 10 pounds of carrots every day is also probably not a good idea. That’s like 75 carrots in one day—only really possible with a juicer, which is what one person attempted as part of a quack cancer cure. What about overdoing salt substitutes?

A 1940s report focused on lithium poisoning from the use of salt substitutes. Why? Because lithium chloride was used as a salt substitute. Yikes! But what about potassium chloride, which is what’s used today? There is one case where someone committed suicide by taking a little more than a tablespoon of a potassium chloride salt substitute. That doesn’t seem like a lot—just a tablespoon? I mean, how can we keep that on the shelves if only a tablespoon will kill you? Well, even smaller amounts of regular salt, if taken all at once, can kill you, too. In fact, ingesting salt water was evidently a traditional suicide method in ancient China.

Having said all that, a small number of the population may run into problems, primarily people with severely impaired kidney function. That’s why there’s been such a reluctance to push potassium‐based salt substitutes on a population level. If your kidneys can’t regulate potassium, then it can definitely become a serious issue. We’re talking about folks with known kidney disease, diabetes (since diabetes can lead to kidney damage), severe heart failure, those on medications that impair potassium excretion, older adults, and people with adrenal insufficiency. If you aren’t sure if you’re at risk, ask your doctor about getting your kidney function tested.

Ironically, potassium is so good at reducing deaths from high blood pressure—even among those with kidney disease—that using potassium chloride salt substitutes would probably still save more lives despite the risk, as you can see below and at 5:45 in my video.

Traditional dietary recommendations to kidney patients limited the consumption of fruits and vegetables because they were high in potassium. However, this paradigm is changing quickly given the many beneﬁts of a fundamentally plant-based diet. A whole food, plant-based diet may even ameliorate chronic kidney disease. For example, there’s increasing evidence that a whole food, plant-based diet may help slow the progression of chronic kidney disease and delay kidney failure. So, the practice of restricting dietary potassium in kidney patients should really be reserved for patients with documented hyperkalemia, a potassium level of 6 or higher, because the key to halting the progression of chronic kidney disease might in fact lie in the produce aisle.

Doctor’s Note

If you are in crisis, you can call the National Suicide Prevention Lifeline 24 hours a day, seven days a week, at 800-273-8255.

This is the final blog in a three-part series. If you missed the first two, check out The Mineral Intake Recommendations Only 1 in 6,000 U.S. Adults Meet and Are Potassium Chloride Salt Substitutes Worth Trying?.

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July 29, 2026
Repeated Weight Loss and Regain Was Tied to Four Times More Thigh Muscle Loss in a Four-Year MRI Study

People whose weight repeatedly went down and back up over four years lost nearly four times as much thigh muscle as people whose weight stayed steady, and they ended the period weighing about the same as when they started.

That is the central finding of an imaging study of 1,433 middle-aged adults, published in Radiology by a team from the University of California, San Francisco, and described in a UCSF release.

The number that matters: weight cyclers lost about 3.7% of thigh muscle volume over 48 months, compared with about 1% among people whose weight remained relatively stable.

Two clarifications belong immediately. This is an observational study, not a trial, so it shows an association rather than proof that weight cycling caused the muscle loss. And nobody in it was taking a GLP-1 medication, which matters given how the finding is being framed elsewhere.

What the MRI Study Measured

The researchers drew on the Osteoarthritis Initiative, a long-running, NIH-funded cohort of adults at elevated risk for knee osteoarthritis. That is a specific population, not a general sample of American adults.

Participants received MRI scans over four years. Using artificial intelligence to analyze the images, the team measured thigh muscle volume, fat located within the muscle, and fat surrounding the knee. Direct imaging is the methodological advance here, since most weight-cycling research has relied on scales, body-composition estimates, or self-reported dieting history.

The 3.7% versus 1% gap held after the researchers accounted for age, sex, baseline body mass index, physical activity, diet, and other health factors. The published conclusion states that among participants who maintained stable weight over 48 months, “weight cycling was associated with an increased loss of MRI-based thigh muscle volume.”

Notably, the team found no evidence of a difference between groups in the change in intermuscular fat proportion. The signal was in muscle volume, not fat infiltration.

Why the Muscle Did Not Come Back

The detail driving the coverage is directional. Weight came back. Muscle did not.

“When people’s weight cycled, they lost tremendous amounts of muscle along with the fat,” said Thomas Link, MD, PhD, professor of radiology, who led the study with co-first authors Adrian A. Marth, MD, and Gabby Joseph, PhD. He noted the muscle was not regained.

The mechanism is plausible and long suspected. Weight lost through calorie restriction includes lean tissue as well as fat, and regain is more efficiently deposited as fat than as muscle unless resistance training and adequate protein intake are part of the process. Repeat that cycle several times and the composition of a stable-looking body weight shifts.

The illustrative case UCSF released is striking but is a single participant, not a study result: one 62-year-old man’s thigh muscle volume fell 16% over 48 months while his BMI dropped only 1.6%. It shows how invisible this can be on a bathroom scale.

Worth stating carefully: the study followed people for four years. It did not establish that the loss is permanent, only that it had not reversed within that window.

The GLP-1 Question the Study Did Not Answer

This study is being widely presented as a warning about weight-loss drugs. It is not one, and the distinction matters for anyone currently taking these medications.

No participant was on a GLP-1 medication. Link’s own framing was that the insight addresses a question likely to grow in importance as more people start and stop weight-loss therapies, which is a hypothesis about relevance, not a finding about the drugs.

That said, the question is legitimate. People do stop and restart GLP-1s because of cost, coverage changes and side effects, and that pattern resembles weight cycling. MedicalDaily has previously reported on concerns about muscle loss and malnutrition in adults over 65 taking GLP-1 drugs and on the absence of muscle, bone and nutrition screening requirements in the Medicare GLP-1 Bridge program.

What this study adds to that conversation is imaging evidence that repeated cycles compound muscle loss in people not on medication at all. What it does not do is quantify anything about GLP-1 users, and no professional society has issued new guidance in response.

What the Study Cannot Tell You

The limitations are worth holding onto.

It is observational. People who cycle weight may differ from people who do not in ways the adjustments did not capture, including illness, medication use, and eating patterns.

The cohort was middle-aged adults at risk for knee osteoarthritis, a group that may be less mobile and more prone to muscle loss than the general population. The findings may not transfer cleanly to younger or healthier people.

Thigh muscle volume is a reasonable proxy for overall skeletal muscle but is not the same as measured strength, physical function, or fall risk. The study did not report those outcomes.

And four years is the observation window. Longer follow-up would be needed to say anything about permanence.

What to Do With This If You Are Losing Weight

Nobody should stop a prescribed medication because of this study. That includes GLP-1 drugs taken for diabetes or cardiovascular risk, where the consequences of stopping are concrete and immediate.

The reasonable response is to make muscle preservation part of any weight-loss plan rather than an afterthought. That generally means resistance training at least twice weekly and adequate protein intake, and it is worth asking a clinician or a registered dietitian what those targets should be for your age, kidney function and medical history rather than adopting numbers from an article.

People who anticipate a coverage or cost interruption in a weight-loss medication can raise it with a prescriber before it happens, since an unplanned stop and restart is the pattern this research suggests is worth avoiding.

Simple in-office measures of muscle function, including grip strength and a chair-stand test, are available and inexpensive if you want a baseline.

Researchers will need studies that follow people through medication-driven weight loss and regain, with imaging, to answer the question this one raised. That work has not been done.

Frequently Asked Questions

What did the study find? Adults whose weight repeatedly fluctuated over four years lost about 3.7% of thigh muscle volume, compared with about 1% among adults whose weight stayed relatively stable.

Does this prove weight cycling causes muscle loss? No. This was an observational imaging study. It found an association after adjusting for several factors, but it cannot establish cause.

Was the muscle loss permanent? The study found the muscle had not returned within its four-year window. It did not follow participants long enough to establish permanence.

Did the study include people on GLP-1 drugs? No. No participant was taking a weight-loss medication. The connection to GLP-1 use is a question the lead author raised, not something the study measured.

Who was studied? 1,433 middle-aged adults enrolled in the Osteoarthritis Initiative, a cohort of people at elevated risk for knee osteoarthritis. Results may not apply equally to younger or healthier populations.

Should someone stop a weight-loss medication because of this? No. Do not stop or change a prescribed medication based on a news report. Discuss any concerns with the prescribing clinician.

How can someone protect muscle during weight loss? Resistance training and adequate protein intake are the established approaches. Specific targets should come from a clinician or registered dietitian, not from an article.

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July 29, 2026
Resting in the Flow With A Guided Meditation
Stress reduction, helping with depression, coping with illness and adversity, improved relational skills, and an ability to make better, less bias-prone decisions—all of these benefits can flow from mindfulness training. But they might all be seen like by-products of travelling along a path to deeper awakening, which flows from the recognition that nothing in life, including ourselves, is stuck in the way we habitually think.

In mindfulness practice, we train in letting go of our stories about stress and pain, learn that thoughts are not facts, and watch sensations change from moment to moment. We notice that experience is ﬂuid, and can be perceived without taking it so personally. We learn that pain, stress, thoughts and everything else that occurs in the mind and body are not “me.”

Why “Me” Always Changes

So what kind of “me” is there? When we ask ourselves this question, most of us will come up with a list of identities—perhaps a name, a profession, a family role, a nationality. Already there are problems with this—as Jon Kabat-Zinn puts it, your name is “just a sound that your parents gave to you when you were born.” It may be applied consistently, for convenience, throughout a lifetime, but what it refers to certainly shifts over the years. I am not the same “me” who had my name as a baby.

The composition of our bodies is in continual flux. Over the last few weeks, your epidermis (the layer of skin that covers your body) has completely regenerated. Cells in the stomach are replaced after about five days, while our livers regenerate every year. Our entire skeleton is replaced every ten years. The brain changes all the time, too. Over the last fifteen years, researchers have learned that neural shifts occur as a consequence of events in the mind, body, and life. An experienced taxi driver will develop an unusually large hippocampus (a part of the brain associated with learning, memory, and spatial processing), while a skilled musician’s fine motor cortex will reﬂect their years of practice. Even learning to juggle over the course of a week produces observable neural changes in the brain. Many people believe that the core of their “self” resides in the brain, but if we never have the same brain from one moment to the next, how could there be such a core?

What Makes Up “Me”?

The evidence from neuroscience research suggests that what feels like “me” is in fact an infinite number of changing aspects of mind, brain and body, working in harmony to produce a sense of coherence and agency from the events of life. The experience of being “me” is a projection—a bit like when a film appears on a screen from the projection of different colours. This projected “me” assumes responsibility for actions that actually occur as a ﬂuid interchange of indefinable aspects of mind,
body, brain, and environment.

There are heavy costs to this assumption. You don’t have to get depressed to witness how close identification with thoughts, emotions, and sensations creates suffering. Every time we turn a thought into a fact in our minds by calling it “mine,” we become blinded to the reality that it is influenced (and often biased) by myriad causes and conditions in our past and present. When we identify with a thought, it becomes difficult to see its biases, and we become trapped in a virtual version of life, doomed to self-righteousness, paranoia, negativity, or other patterns of distorted thinking. Similarly, when we identify with an emotion, we become prisoners of our moods. And when we get caught up with our bodies, we feel at their mercy, struggling with a journey through life that inevitably proceeds towards infirmity and breakdown.

Why Losing Control Can Make You Happier

Relief is attainable by shifting perception and letting go of the falsehood that we are in complete control. By recognizing the conditioning that deeply affects our lives, we can start to give ourselves—and others—a break. At the same time, realizing we are multi-faceted beings that change from moment to moment, in ﬂow with an ever-shifting biological, psychological, social, and environmental context, we can start to practice riding with the changes. We can hold our beliefs and opinions lightly, rather than construct blindingly fixed identities from them.

As soon as we are aware of thoughts and sensations arising in experience, rather than getting caught in attempts to grasp or reject them, a glimmer of space emerges between the events of our lives and our reactions to them.

As soon as we are aware of thoughts and sensations arising in experience, rather than getting caught in attempts to grasp or reject them, a glimmer of space emerges between the events of our lives and our reactions to them. In this space, reactions can become responses, and tension and resistance can fall away, along with the stress they generate. Life becomes a dance with the world, rather than a war against it; a ﬂow, rather than a struggle. By dropping our tight identification with what comes up in our minds, bodies and lives, we can start to feel better. As a famous meditation teacher once put it: “If you let go a little, you will get a little happiness. If you let go a lot, you will get a lot of happiness. And if you let go completely, you will be completely happy.”

You can watch a video of me speaking for Action For Happiness about this and other mindfulness-related themes here. And below is a practice you can try to train in resting in the changing flow of moment-to-moment experience.

Resting in the Flow of Experience

Being human is like flowing as a river—many moving droplets make up the stream. The river changes all the time, yet there is continuity as it follows well-worn grooves through the landscape. A river cannot suddenly shift its direction, just as we humans tend to follow a course set by past events and patterns. Yet, the more we become aware of how the ﬂow occurs and the grooves are followed, the more we can relax into the ride. As we see more clearly, we also become more able to steer our way skilfully through the current. A good way to begin is to practice resting in the ﬂow, as in this meditation.

Read and practice the guided meditation script below, pausing after each paragraph. Or listen to the audio practice.
1. Settle into a posture for sitting meditation, feeling the connection of your body to the ﬂoor, cushion, or seat. At any time during this practice, especially if you feel disconnected or disembodied, come back to this sense of groundedness, anchoring your experience.
2. Begin paying attention to breathing, noticing how each breath—indeed, each moment of each breath—is a unique experience, not the same as the previous one or the next. Notice how the breath happens without you controlling it—your breath is happening within you; “you” are not choosing to breathe. Know, too, that all of the automatic processes of the body—oxygenation of the cells, blood ﬂow, heartbeat, and so on—are happening in the same way. As best you can, relax into this experience.
3. Open awareness now to the whole body. As sensations rise into consciousness and pass through, recognize that they are all impermanent, continually transforming in intensity, location, and quality. Let them be experienced, moment by moment, and allow them to pass through, as best you can, without attachment or rejection. Recognize too that the physical constituents of your body are in ﬂux—skin is being shed, cells are growing and dying, some neural connections are strengthening, others are weakening.
4. Now bring awareness to thoughts. With a friendly interest, observe the patterns of thinking that are running through the mind, like clouds passing across the sky of the mind, making up its weather. Like the weather, these patterns are always changing, depending on atmospheric conditions. Realize that the thoughts you had a year ago, five years ago, a decade ago—each of which may have seemed extremely important back then—are now merely memories, and that thoughts appearing in the mind right now will share that fate.
5. Finally, open up your mindfulness to every aspect of conscious experience—sensations, sights, sounds, tastes, smells, and thoughts. Let go into the space within and around you, remaining alert and present to whatever comes. Allow the play of experience to happen by itself, resting in the ﬂow, moment by moment. When you notice attention wandering to a particular place, acknowledge the wandering and open out to the whole panorama of experience once more.
This post was adapted from Into The Heart of Mindfulness, by Ed Halliwell, published by Piatkus. Download a set of 14 guided audio meditation practices from Ed’s books here.
An Election Day Meditation

Follow along as Rhonda Magee guides us through a S.T.O.P. practice for focused awareness. The invitation is to be kind to yourself, take a conscious breath, and gently relate to thoughts, emotions, and sensations that arise. Read More

Rhonda Magee

November 5, 2024
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July 29, 2026