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Vegan vs. Dairy-Free: What’s the Difference?

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Vegan vs. Dairy-Free: What’s the Difference?

Vegan and dairy-free diets place limitations on which animal-derived products — if any — you can consume.

Although these diets share several similarities and are often confused with one another, they aren’t the same thing. As such, you may want to know about their differences.

This article compares vegan and dairy-free diets, explaining how to tell which foods fall into these categories.

Although vegan and dairy-free diets share some basic concepts and restrict your intake of some of the same foods, they aren’t the same.

What is a vegan diet?

Veganism encompasses both dietary and lifestyle choices. Someone who decides to become vegan avoids products that use or exploit animals to the best of their ability.

A vegan diet is based on plant foods, such as fruits, vegetables, nuts, seeds, legumes, and grains. It excludes meat, fish, seafood, dairy, eggs, and often other animal-derived ingredients like honey.

A person might choose veganism for environmental, animal welfare, personal health, and/or ethical concerns.

Vegan lifestyles also tend to exclude consumer products that contain animal-derived ingredients or have been tested on animals. These include certain cosmetics, clothing, and personal care items.

What is a dairy-free diet?

A dairy-free diet excludes all dairy products. This category includes milk from any animal, as well as any product made from this milk, such as cheese, yogurt, butter, and cream.

Yet, people who follow this eating pattern may still eat other animal foods like meat, fish, shellfish, and eggs.

Dairy-free diets are commonly chosen for health reasons, such as a cow’s milk allergy or lactose intolerance — a condition in which your body can’t digest the milk sugar lactose, leading to diarrhea and gas after dairy is consumed (1, 2).

Some people may also follow a dairy-free diet for ethical reasons.

SUMMARY

Vegan diets ban all animal-derived products, such as dairy, eggs, meat, and fish. Dairy-free diets exclude dairy but may allow other animal foods. While all vegan food is dairy-free, not all dairy-free food is vegan.

When grocery shopping, you may want to know whether a food is vegan and/or dairy-free.

Look for a label

Products suitable for either diet are often labeled vegan or dairy-free. Plus, some may have a “certified vegan” seal, ensuring that they haven’t undergone animal testing and don’t contain any animal-derived ingredients or byproducts (3).

Furthermore, the kosher label pareve (or parve) can help you identify dairy-free items. This Yiddish term indicates that a food contains neither meat nor dairy (4).

However, a food with this label may still contain eggs and other animal-derived ingredients, so not all pareve foods are vegan.

Read the ingredient list

If a label isn’t apparent, you can check the ingredient list.

Milk is one of the top eight allergens, along with peanuts, tree nuts, soy, wheat, fish, shellfish, and eggs. Manufacturers are required to identify these clearly on their products’ ingredient lists to alert consumers of their presence. They’re often printed in bold (5).

If a product is free of milk or milk derivatives, it’s dairy-free.

Although vegan products shouldn’t contain any animal foods, it’s still best to read the ingredient list to make sure a product meets your criteria.

Some vegan foods may be manufactured in facilities that handle non-vegan products. Thus, you may see a disclaimer that the food may contain trace amounts of animal products, such as milk, seafood, or eggs, due to the risk of cross-contamination.

SUMMARY

The best way to determine whether a food is vegan and/or dairy-free is to read the label carefully and check the ingredient list.

Today, vegan dairy alternatives are widely available. These include milk made from soy, oats, and peas, as well as cheeses made from cashews or coconut.

These foods are appropriate for both vegan and dairy-free diets, and their flavor and texture are comparable to those of their dairy-containing counterparts.

Some of the most popular vegan dairy alternatives include:

  • Cheese: shreds and slices made using coconut, almonds, cashews, soy, or pea protein
  • Milk: made from oats, hemp, rice, soy, peas, macadamia nuts, sunflower seeds, almonds, or cashews
  • Cream cheese and sour cream: made from beans or cashews
  • Butter: made using vegetable oil, cashews, or pea protein
  • Ice cream: made from soy, oats, cashews, or coconut milk

You can find many of these products on the same shelves as regular dairy products.

SUMMARY

A growing number of vegan dairy alternatives are available, including nondairy options for milk, cheese, cream cheese, sour cream, butter, and ice cream. These are suitable for people on a dairy-free or vegan diet.

While vegan and dairy-free diets have some similarities, they aren’t synonymous.

A vegan diet excludes all animal products, including dairy, eggs, meat, and fish, whereas a dairy-free diet bans all milk products but not necessarily any other animal products.

While all vegan foods are inherently dairy-free, not all dairy-free foods are vegan.

The best way to determine whether a food is vegan and/or dairy-free is to read the label and ingredient list carefully.

Moreover, many vegan dairy alternatives are suitable for both diets.

COVID-19 Safety Protocols Will Also Protect You from Colds, Flu

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COVID-19 Safety Protocols Will Also Protect You from Colds, Flu
Experts say safety measures such as wearing a mask can help reduce droplet transmission of colds, influenza, and COVID-19. Luis Alvarez/Getty Images
  • Experts say the safety protocols used to reduce risk during the COVID-19 pandemic can help protect you from colds and flu this fall and winter.
  • They explain that colds, flu, and COVID-19 are all spread by droplet transmission.
  • They say that’s why mask wearing and physical distancing work against these illnesses.

The same precautions taken to avoid COVID-19 will also help guard against colds and the flu.

As health authorities brace for a cold and flu season that will coincide with COVID-19, experts are encouraging the public to continue practicing good hand hygiene, physical distancing, and mask wearing to not only prevent COVID-19 but also colds and influenza.

“Cold and flu, COVID-19 — they’re all respiratory viruses. There are nuances between them, but basically they are all transmitted in the same way,” Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Tennessee, told Healthline.

The transmission of respiratory illnesses is divided into two categories: droplet transmission and airborne transmission.

“The idea is that respiratory spread via droplet transmission is from larger, heavier droplets, heavier particle size, and they don’t travel very long,” Dr. Dean Blumberg, chief of pediatric infectious diseases at the University of California Davis, told Healthline. “They don’t stay suspended in the air for very long because gravity takes over and they fall to the ground, and that’s why we have all those recommendations relating to social distancing 6 feet or farther away from people.”

“Respiratory spread from airborne transmission refers to viruses and other infections that are suspended in smaller particles in the air,” Blumberg said. “These are smaller and lighter particles so they can remain floating around in the air and carried around by air currents for minutes to even hours.”

When it comes to respiratory droplets, size matters.

“Normal respiratory droplets that carry things like the common cold, SARS-COV-2, or influenza are large and typically cause infection by direct contact or through a contaminated surface where it has landed,” Dr. Jaime Friedman, a pediatrician in San Diego, told Healthline.

The common cold and influenza are both believed to be transmitted through larger droplets.

And although there is still much to learn about COVID-19, it is believed to be spread in the same way.

“With COVID-19, probably at least two thirds of transmission is from the respiratory route via droplets,” Blumberg said.

Experts say the droplet transmission is why mask wearing is so important.

“Within that zone, that breathing zone, of 3 to 6 feet, that’s where the virus is transmitted most efficiently and, of course, since people without symptoms can be shedding the virus, quite as abundantly as people with symptoms, that’s the whole rationale for wearing masks,” Blumberg said.

Masks act as a barrier that stop larger droplets being transmitted to others once exhaled, minimizing the risk of spread.

“They protect against the outgoing. They’re really excellent at that. They’re OK at protecting against the incoming, what it is that you inhale. But they really are very effective at protecting against the outgoing,” he said. “Think about surgeons. The reason they wear facial masks are so that the germs in their mouths and nose don’t drop into the surgical wound. So if everyone wears masks they are protecting themselves, but even more so they’re protecting everyone else around them and if we all did that then the ability of this virus to be transmitted, would not drop to zero, but it would be very substantially curtailed.”

Experts are hopeful mask wearing and other COVID-19 prevention measures will also help reduce the number of influenza cases this winter.

“The same considerations apply between influenza and COVID-19. Wearing a mask and social distancing are the two most important things… to prevent influenza and if people follow that for COVID-19 we may get a break and see less influenza this year,” Blumberg said.

Experts say an effective mask is one that has two or more layers, such as surgical masks that are multi-layered.

The way a mask is worn also matters.

“The best mask… is the one that is worn correctly over the nose and mouth and for the entire duration that person is in a public space,” Friedman said.

Masks should also fit snugly around the cheeks and down under the chin.

Schaffner says mask wearing should become more commonplace in the United States to guard not only against COVID-19, but many other infections.

“I think it’s past time that we begin to adopt those practices here in the U.S. and in the Western world generally,” he said. “Of course, it helps to keep socially distant. Lots of good hand hygiene also helps. In addition, there’s one other thing that we can do against flu which is of course to get vaccinated.”

The Southern Hemisphere is just emerging from their flu season, and Blumberg said the patterns seen there are indicative of the widespread benefits of COVID-19 measures such as mask wearing.

“In Taiwan, there was a 75 percent decrease in influenza… related to the masking and social distancing guidelines. You can see decreases in many different infections by following these guidelines for masking and social distancing,” he said.

As well as getting the flu shot, experts are urging the public to maintain infection prevention measures as cold and flu season begins.

“Continue social distancing when in public, continue to wear a mask, continue to wash your hands and sanitize frequently touched surfaces, continue to avoid large indoor gatherings,” Friedman said.

Schaffner says if people embrace mask wearing, the benefits to public health and the healthcare system would be significant.

“We would diminish very substantially if we did this consistently,” he said. “That would spare a lot of us from annoying illnesses, the relatively small minority would be spared very serious disease and of course the burden on the healthcare system would be substantially less and we’d save literally millions of dollars.”

But Schaffner says that as well as mask wearing, hand hygiene and physical distancing all have a role to play in avoiding cold, flu, and COVID-19.

“Each of these interventions that we use has utility, they all contribute to it,” he said. “None of them is perfect, but if we use several of them simultaneously then the barrier gets stronger and each compensates for the holes in the others.”

As You Get Older, You Need to Drink More Water. Here’s Why

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As You Get Older, You Need to Drink More Water. Here’s Why
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Experts say as you age your body doesn’t adjust the rate of sweat loss as well, so drinking water even when you’re not thirsty is important. Maskot / Getty Images
  • Researchers say that as people age, they need to drink more water to compensate for changes in their body temperature regulation.
  • They say dehydration can cause a number of ailments, including muscle pain, fatigue, and heat exhaustion.
  • They urge older adults to drink water even when they aren’t thirsty and to limit beverages such as soda, coffee, and alcohol, which can cause dehydration.

As you get older, you need to drink more water.

That’s the advice from a new study published in The Journal of Physiology.

The researchers from the University of Ottawa point out that hydration is key in regulating body temperature and helping fight off a host of other health problems.

The researchers said that dehydration doesn’t reduce heat loss or increase body temperature in older adults during exercise as it does in younger people, which may seem on the surface like a beneficial response.

But that means that when older people exercise, their bodies don’t adjust the rate of sweat loss to prevent further dehydration.

This results in greater strain on the heart, evidenced by a more pronounced increase in heart rate compared to younger men.

The study featured older men, although the results pointed to all older adults as those affected.

The researchers added that “until recently, however, our understanding of the effects of dehydration on body temperature regulation came primarily from studies conducted on young adults.”

“This is an interesting study, as it delivers new insights into fundamental age-related changes to our physiology,” Dr. Scott A. Kaiser, a geriatrician at Providence Saint John’s Health Center in Santa Monica, California, told Healthline.

“While changes in the regulation of body heat, sweating, hydration, and thirst that tend to occur with age are well established, this study probes deeply into the specific changes of underlying mechanisms. In particular, changes in response to dehydration and heat with exercise,” he explained.

“It’s quite remarkable that, at this point in time, we are still learning such fundamental things about the way our bodies change with age,” Kaiser added.

“That said, given our aging population — with a 30-year gain in life expectancy over the last century, [with] roughly 10,000 baby boomers turning 65 each day, and declining birth rates — we are approaching the first time in human history in which our population will have more people over the age of 65 than under the age of 18. We need to continue to increase our understanding of the fundamental physiology of aging.”

Researchers said that a reduced sensitivity in older people to elevated blood osmolality (concentration of salt) could explain the blunted effect of dehydration on hearing loss and body temperature regulation in older adults during exercise and in greater heat.

The researchers found that in contrast to young adults, the regulation of body temperature in the older subjects wasn’t influenced by the increase of saltiness in the blood.

Less efficient regulation of body temperature contributes to an increased risk of heat exhaustion, heat stroke, adverse heart problems.

“When it comes to the elderly, there are a couple things we need to remember,” Dr. Nodar Janas, medical director of Upper East Side Rehabilitation and Nursing Center in New York, told Healthline. “As we get older, our thirst center — which is located in the hypothalamus — isn’t as active as it used to be, so the brain doesn’t always give the signal that we need to drink. We need to make an extra effort to ensure that the elderly consume appropriate amounts of fluids, whether they’re thirsty or not.”

He continued, “If an elderly person gets dehydrated, one of the first organs to suffer are the kidneys, which can cause acute kidney failure. Dehydration also creates electrolyte imbalances, which can be deadly.

“Another anecdotal point to mention is that the elderly seem to have a worse tolerance to cold,” said Janas. “As we age, we prefer warmer temperatures and sometimes too warm of an environment can lead to excessive perspiration without realizing you’re dehydrated.”

Dr. Rand McClain, founder of Regenerative & Sports Medicine in Santa Monica, California, told Healthline that he sees one particular problem among older people, especially men, when it comes to dehydration: They’re not aware or accepting of how their body changes with age.

“They are less likely to be wary and more likely to ignore signs of dehydration and heat-related illness because they have a past history that is unrepresentative of their new status as older adult males,” McClain said.

He added that older men might think, I have been doing it like this my whole life without a problem, so why should I change now?

“Most people have never experienced the severe symptoms associated with dehydration and, if dehydrated, are usually mildly so and able to compensate without much effort,” McClain said.

“We have air-conditioned environments, water fountains, and fluids so easily accessed in most places. However, many people do indeed live in a mildly dehydrated state because of the diuretic beverages they consume, such as coffee, tea, and caffeinated soft drinks and alcohol.”

McClain said we tend to “dry out” as we age, as our water composition can change from roughly 70 percent to as little as 50 percent.

“We need water for everything to operate smoothly and at its best,” he said. “While we can go for weeks or months without food, we can go without water for only days. Even being slightly dehydrated to 98 percent of normal can affect one’s metabolism negatively and reduce athletic and organ performance.”

Dr. Nicole Avena, an assistant professor of neuroscience at Mount Sinai School of Medicine in New York, told Healthline that dehydration can cause other problems, such as fatigue and muscle weakness.

She said a 2015 study found 37 percent of people 65 and older admitted to emergency rooms showed signs of dehydration.

When it comes to how to hydrate, she says sticking to water is best.

“When you drink things like sodas and beverages that contain ingredients other than water, your body needs to work to process those ingredients,” Avena said. “Plain water is the best hydrator because your body can benefit from it without having to simultaneously process sugars, additives, and other ingredients that don’t have any benefit to health.”

Kristin Gillespie, MS, CNSC, a registered dietician with the website Exercise with Style, told Healthline that the abundance of nutrients hyped for health benefits tend to muddy the waters, so to speak, when it comes to how to hydrate.

“This makes it hard for the public to decide what nutrients are more or less important than others,” Gillespie said. “Water consumption and hydration is hard for a lot of people to appreciate because water offers no nutritional value.”

She said that besides thirst, other symptoms of dehydration include dark or infrequent urination, dry skin and lips, muscle cramps (especially in legs, feet, and hands), low blood pressure, elevated heart rate, fatigue, and “general malaise.”

And staying hydrated can also help avoid illnesses.

“An added benefit of drinking lots of water is its positive effect on immunity,” Gillespie said. “Consuming adequate fluids helps keep you healthy by helping your body naturally rid itself of bacteria and other toxins.”

Peanuts for Weight Loss: Are They Beneficial?

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Peanuts for Weight Loss: Are They Beneficial?

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Peanuts are one of the world’s most popular legumes. They’re widely used as a healthy snack or dessert topping and are commonly found on the counter of any bar.

They come in many varieties, such as raw, roasted, boiled, salted, flavored, or plain. While peanuts are known for their high protein and fat content, you may wonder whether they can help you lose weight.

This article tells you whether peanuts are good for weight loss.

Peanuts may help you lose weight in many ways. In fact, many observational studies have shown that eating peanuts is associated with a healthy weight. Plus, they have been linked to lower rates of obesity (1, 2, 3).

Keep you full

Unlike other snack foods that are high in simple carbs, peanuts are rich in healthy fats, proteins, and fiber, which take longer to digest (4).

One small study in 15 participants found that adding either whole peanuts or peanut butter to breakfast led to increased fullness and more stable blood sugar levels (5).

Simple carbohydrates are quickly absorbed into the bloodstream and lead to a quick spike in blood sugar followed by a rapid drop. This may cause you to feel hungry shortly after eating (6).

In contrast, peanuts are digested slowly and remain in your stomach longer. This helps you feel full and satisfied, allowing you to go longer between meals (4, 5).

Finally, peanuts require more chewing, which allows you to eat your food more slowly. As a result, this gives your body time to send fullness signals that may prevent you from overeating (4, 5).

Packed with healthy fats

Peanuts are rich in healthy fats known as monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs).

A diet high in these fats has been linked to reduced rates of inflammation, obesity, and chronic conditions, such as heart disease and diabetes (7, 8).

What’s more, nut consumption is associated with a lower risk of long-term weight gain. Some researchers theorize that the high unsaturated fat content in nuts may improve the body’s ability to use stored fat as energy. Still, more research is needed (9).

Lower calorie intake

Though peanuts are high in calories, you may not absorb all the calories they provide.

When you eat peanuts, your teeth cannot break them down into a small enough size for full digestion, meaning you’re likely absorbing fewer calories while the rest is excreted through waste (10, 11, 12, 13).

In a study in 63 men, participants ate whole peanuts, peanut butter, peanut oil, or peanut flour. After comparing stool samples, those who ate whole peanuts had significantly higher amounts of fat in their stool, indicating a lower absorption of calories (13).

However, this doesn’t mean you should go overboard. Overeating calorie-dense foods, such as peanuts, can still lead to a calorie surplus and ultimately hinder your weight loss efforts.

For example, a 1/4-cup (146-gram) serving of peanuts contains 207 calories. Even if only 50–75% of the calories are absorbed, this is still 104–155 calories (14).

Therefore, it’s still important to be mindful of portion sizes to prevent calories from adding up. It’s best to stick to 1–2 handfuls per serving since they’re easy to overeat.

summary

Research has shown that eating peanuts may help you manage your weight better. Peanuts are rich in fiber, protein, and healthy fats, which can help you feel full and prevent you from overeating.

It’s always best to select unflavored peanuts that have undergone minimal processing and don’t contain any added salt or other ingredients. Avoid candied peanuts, which contain a sugar coating and provide additional calories.

For extra fiber and antioxidants, enjoy peanuts with the skins on. The extra fiber can help increase fullness.

Boiled peanuts contain fewer calories than raw or roasted peanuts, with around 116 calories per 1/4 cup (146 grams), compared with 207 and 214 calories for raw and roasted peanuts, respectively (14, 15, 16).

However, boiled peanuts contain 50% less fat than raw and roasted peanuts, meaning they may not have the same filling effect. Therefore, choose the type you like the best and always be mindful of your portion sizes (14, 15, 16).

Select unshelled peanuts, as they take longer to open, which may prevent mindless eating and, ultimately, help you better manage your portion sizes and calorie intake.

Though peanut butter can be a healthy option, stick with natural peanut butter that contains no added salt, processed oils, or other ingredients.

summary

Raw, roasted, and boiled peanuts are great options as a healthy snack. Be sure to pick peanuts that are free of added salt and flavoring, and always be mindful of your portion sizes.

Peanuts are full of nutrition and make for a healthy snack.

They’re full of fiber, protein, and healthy fats, which can aid weight management by keeping you full longer.

For best results, choose raw, roasted, or boiled peanuts free of added salt and flavoring, and be mindful of your serving size.

Peanuts are an excellent alternative to other high calorie and processed snacks to help you with your weight loss goals.

Shop for unsalted, in-shell peanuts online.

Eating Meals Early May Lead to Weight Loss

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Eating Meals Early May Lead to Weight Loss

A small study suggests that eating all of your meals earlier in the day may suppress hunger and boost fat reduction.

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Early time-restricted feeding may help curb appetite and promote fat burning. Getty Images

In recent years, a growing number of people are trying intermittent fasting as a strategy to lose weight.

Intermittent fasting is a term used to describe several eating patterns in which people cycle between periods of fasting for 12 hours or more and periods of eating.

Early time-restricted feeding is one type of intermittent fasting in which people eat all of their meals during the morning and early afternoon before fasting for the rest of the day.

According to a new study published in the journal Obesity, early time-restricted feeding may help curb appetite and promote fat burning.

“Prior to this study, we had evidence that both intermittent fasting and eating earlier in the day help with weight loss, but we didn’t know why they seem to help,” Courtney Peterson, PhD, lead investigator of the study and assistant professor in the department of nutrition sciences at the University of Alabama at Birmingham, told Healthline.

“The main goal of this study was to learn whether these meal-timing strategies help with weight loss by helping people burn more calories, by lowering their appetite, or both,” she said.

To conduct this study, Peterson’s research team enrolled 11 people who had good general health but were considered overweight, with a body mass index between 25 and 35.

Each participant tried two meal-timing schedules for four days each. Participants ate the same types and amounts of food while following each schedule.

On the early time-restricted feeding schedule, participants ate all of their meals between 8 a.m. and 2 p.m. each day. On the comparison schedule, participants ate their meals between 8 a.m. and 8 p.m.

The researchers found that when participants ate all of their meals between 8 a.m. and 2 p.m., it had no effect on the number of calories they burned — but it did appear to reduce their appetite.

“What we found is that the hunger hormone, ghrelin, was lower in the morning and tended to be lower in the evening [when people followed the early time-restricted feeding schedule],” Peterson said.

“We also found that the desire to eat was lower when people tried early time-restricted feeding, and the only time of day when they were hungrier than the comparison schedule was right before bedtime, around 10:30 at night,” she continued.

Early time-restricted feeding also appeared to increase the amount of fat participants burned over a 24-hour period.

Although more research is needed, these findings suggest that coordinating mealtimes with the body’s circadian rhythm might help curb appetite and support weight loss.

“Data suggests that you have this internal biological clock that makes you better at doing different things at different times of the day, and there are a bunch of metabolic processes that are a little more efficient in the morning,” Peterson said.

To learn more about the potential effects of early time-restricted feeding, Peterson’s team is conducting ongoing research.

In the meantime, she suggests that many people might find it easier to follow a meal-timing schedule with a larger eating window than the specific schedule they studied.

“We were trying to take an eating schedule that we thought would maximize the benefits, so we tested six-hour eating periods with 18 hours of daily fasting,” she said.

“But the data that we have from studies in my lab and other peoples’ labs suggests that 8 to 10 hours is a better target for many people to aim for,” she continued.

Some people might find early time-restricted feeding helpful for managing their appetite or weight, but experts warn it’s not the right approach for everyone.

“Athletes or anyone who is fairly active may have a hard time with this, depending on when they eat and exercise,” Liz Weinandy, MPH, RDN, LD, lead outpatient dietitian in the department of nutrition services at Ohio State University Wexner Medical Center, told Healthline.

“Other potential barriers would be if a person has a condition that requires them to eat more frequently, like diabetes,” she continued.

People who are pregnant or managing medical conditions such as cancer may also find it difficult to meet their nutritional needs while only eating during short windows of time.

Intermittent fasting may make it harder to partake in meals with family members and friends or navigate social situations that involve food.

“This style of eating may also lead to an unhealthy relationship with food,” Caroline West Passerrello, MS, RDN, LDN, a registered dietitian nutritionist and spokesperson for the Academy of Nutrition and Dietetics, warned.

“Therefore, anyone with a history or an eating disorder should avoid this approach,” she said.

Before they try intermittent fasting, Passerrello encourages people to speak with a registered dietitian.

When her clients express interest in intermittent fasting, Passerrello advises them to reflect on their goals and motivations for trying it. She also counsels them to consider the changes they’ll need to make to their daily routines to accommodate an intermittent fasting schedule.

Weinandy advises interested clients to start with an eating window of 12 to 14 hours before trying more restrictive fasting schedules.

She also encourages people to avoid skipping breakfast and pay close attention to how they feel while fasting.

If someone develops signs of low blood sugar while fasting, it may not be the best approach for them.

Some people may also eat more during their eating windows to try to limit hunger later on, which can potentially lead to weight gain.

“A better approach for this group is to go back to smaller, frequent meals and snacks,” Weinandy said.

Intermittent Fasting and Inflammation

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Intermittent Fasting and Inflammation
Researchers say fasting can help reduce a certain type of cell associated with inflammation. Getty Images
  • Researchers say intermittent fasting can reduce inflammation in the body.
  • Inflammation is one way the body fights infection, but if there is too much inflammation that can lead to various diseases.
  • Experts say many people have an excess of inflammation because they eat too much and eat too often.

Intermittent fasting and related diets are having a moment. And there might be some good reasons to extend their 15 minutes of fame.

A new study has concluded that intermittent fasting reduces inflammation, a condition that can lead to various diseases such as diabetes, multiple sclerosis, and inflammatory bowel syndrome.

That reduction, the study found, was due to a reduction in cells that cause inflammation — called “monocytes” — in the blood.

Researchers also said the monocytes that were in the blood were less inflammatory than they were in people and mice not on an intermittent fasting diet.

The reason for the difference may be not so much that it’s good to starve yourself as that everyone else is eating too much.

“Especially in the Western world, people eat all the time and that’s a fairly recent habit in human evolution,” Dr. Miriam Merad, an author of the new study and director of the Precision Immunology Institute at the Icahn School of Medicine at Mount Sinai in New York, told Healthline.

Inflammation is a useful tool our bodies use to fight infections.

But, Merad suggested, the quantity of inflammation-causing cells we typically have today may be more a product of this overeating than necessity.

“We wondered whether the number of monocytes we call normal is, in fact, not normal — in fact puts us at risk… and may be unnecessary, may reflect our recent dietary habits,” Merad said. “Somehow we have acquired dietary habits that are putting us at risk for inflammation.”

The study findings answer how that connection between diet and inflammation works.

But the lessons that eating less can reduce inflammation and problems associated with it aren’t new.

“We’re consistently over-fueling, and that then leads to what I would call inflammatory pathways,” Kristin Kirkpatrick, MS, RDN, who manages wellness nutrition services at the Cleveland Clinic Wellness Institute, told Healthline. “So time-restricted eating limits that.”

“That’s not to say that food isn’t important,” she added.

It’s just about moderation.

One thing Kirkpatrick has recommended to some of her clients is to only eat between certain hours of the day as well as avoiding sugars.

She suggested only eating between 11 a.m. and 7 p.m. as an example, which somewhat mimics circadian rhythms.

This time-restricted eating has “been shown to improve overall gut health and microbiota, which has been shown to have big impact on health,” she said.

In the new study, the human participants did something a bit different.

They weren’t allowed to eat between noon and 3 p.m. on the first day, and then not between 8 p.m. that same day until 3 p.m. of the following day. They were allowed to drink water.

At 3 p.m. on both days, blood was drawn to test white blood cell levels. White blood cells, of which monocytes are one type, are the body’s protection against infection and typically indicate inflammation.

“We use them to learn whether someone is sick and there are numbers that are considered normal,” Merad said. “People with an infection have big numbers. What we saw here is a very strong drop in monocytes.”

Other studies have found somewhat similar things.

A 2013 study concluded that fasting for more than 24 hours may lower inflammation by reducing oxidative stress in cells.

A 2014 study found that both intermittent fasting and alternate-day fasting were as effective as limiting calorie intake at reducing insulin resistance.

But Merad hopes to look further into different diets — including into any potential negative impacts they may have.

“And then we will really start to understand whether we can make strong recommendations to the public,” she said.

Unlike diets that cut out or down on certain foods, intermittent fasting typically involves just not eating at certain times.

Typically, that means refraining for 16 to 24 hours, usually twice a week. At its most extreme, people will refrain from food for 48 hours.

“Intermittent fasting is becoming very fashionable, but some people are doing crazy things like not eating for days,” Merad noted.

But the point isn’t to stop eating.

“What I’m saying is we probably eat too much and too often — definitely we eat too often,” she said.

‘Dry Fasting’ Urges You to Not Drink Water. Why This Isn’t a Good Idea

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‘Dry Fasting’ Urges You to Not Drink Water. Why This Isn’t a Good Idea
Supporters of dry fasting say it can improve your overall health, but other experts say it’s potentially dangerous. Getty Images
  • A diet fad known as “dry fasting” recommends people get their daily water intake from fruits and vegetables and not from the tap.
  • Supporters say the diet helps with weight loss and strengthens the immune system as well as reduces inflammation.
  • Opponents, however, say the diet can lead to dehydration, low blood pressure, and other serious health issues.

You’ve probably heard of losing water weight. But can you lose weight by not drinking water?

“Dry fasting” is a diet fad being promoted online by lifestyle influencers.

The idea behind dry fasting is to forgo drinking any water. Instead, you get water only from food sources, such as fruits and vegetables.

But it’s a dieting approach that many health experts say is dangerously misguided.

Dry fasting is inspired in part by Muslim abstention from food and water during the month of Ramadan.

In a 2013 study published in the Journal of Human Nutrition and Dietetics, Iranian scientists concluded that Ramadan fasting led to bodyweight loss and reduced body fat — the latter primarily among young and male individuals.

“Proponents of dry fasting point to studies that looked at Ramadan religious fasting, which did find specific metabolic benefits to fasting and intermittent fasting in general,” Robin Foroutan, MS, RDN, HHC, an integrative dietitian, nutritionist, and spokesperson for the Academy of Nutrition and Dietetics, told Healthline.

“However, there have never been studies that compared regular intermittent fasting with dry intermittent fasting, so there’s no way to know if there are indeed additional benefits to dry fasting beyond that of regular intermittent fasting,” she said.

Proponents say there’s a wide range of health benefits from dry fasting.

These include weight loss, reduced body mass index (BMI), strengthened immunity, and lower levels of inflammation.

Sophie Partik, a yoga teacher and nutrition coach, says she hasn’t had a drink of water in more than a year.

She says that water derived from food is superior to that consumed from the tap.

“I get my living water and cell hydration from fruits, veggies, and coconuts, the purest form of H3O2,” she said in a story published by Daily Mail.

Others, such as Susan Schenck, author of “The Live Food Factor: The Comprehensive Guide to the Ultimate Diet for Body, Mind, Spirit & Planet,” recommend dry fasting for limited periods of time, saying that such fasts “detox” the body.

“In a true dry fast, nothing at all is consumed, neither fruit nor water,” Schenck told Healthline. “Inflammation cannot survive without water, whereas a wet environment enables bad bacteria, viruses, and worms to thrive. When dry fasting, all or many of these critters exit your body. Also, all dead or dying tissues are expelled from the body.”

On the other hand, experts such as Aurielle James-Sarpong, RD, LDN, an outpatient oncology dietitian at the Cancer Institute at the University of Maryland St. Joseph Medical Center, say dry fasting isn’t only scientifically suspect but potentially harmful or fatal.

“Our bodies are 70 to 80 percent water,” James-Sarpong told Healthline. “Dry fasting would make it difficult for our bodies to complete daily tasks, such as flushing out toxins or helping nutrients enter cells. Our kidneys, heart, lungs — and every other bodily organ on which we rely for normal, healthy living — would suffer greatly without adequate hydration.”

James-Sarpong says that people need to consume at least 64 ounces of water daily — even more if engaging in physical activity, if they’re sick, or if they’re being treated for diseases, such as cancer.

“Dry fasting increases a person’s risk for dehydration, which could lead to kidney stones, seizures, low blood volume and low blood pressure, electrolyte imbalance, and even death,” she said.

Foroutan says it’s likely that dry fasting would lead to dehydration.

“While fruits and vegetables do contain water, it would be difficult to get enough water that way to be optimally hydrated,” she said.

“It would be silly and dangerous to forego auxiliary fluid,” Monica Auslander Moreno, MS, RD, LD/N, a nutrition consultant for RSP Nutrition, told Healthline. “That’s where the bulk of our day’s hydration comes from, and most people already aren’t drinking enough water.”

Lisa Richards, CNC, a nutritionist and creator of The Candida Diet, doesn’t dismiss dry fasting out of hand.

However, she told Healthline, “The weight loss claim likely occurs from a reduction in calories from drinks as well as loss of fluid retention.”

“Dry fasting may have some benefits, but the risks and negative side effects should be thoroughly understood,” Richards said.

“Dehydration is a serious risk when it comes to dry fasting. Excessive hunger, fatigue, and irritability are common side effects among those actively dry fasting. A lack of water and fluid, especially when done frequently, can lead to an increase in urinary tract infections as well as kidney stones,” she said.

Moreno says that increasing water intake is actually a better dieting strategy than abstaining from drinking water.

“Drinking more fluid fights bloat and is associated with better weight outcomes, so drink up,” she said.

“If you’re preparing to do some kind of diet or eating plan that is really limiting or rigid, it really should have solid evidence backing up the benefits that you hope to gain,” Foroutan added.

9 Foods and Drinks to Promote Better Sleep

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9 Foods and Drinks to Promote Better Sleep

Getting good sleep is incredibly important for your overall health.

It may reduce your risk of developing certain chronic illnesses, keep your brain healthy, and boost your immune system (1, 2, 3).

It’s generally recommended that you get between 7 and 9 hours of uninterrupted sleep each night, though many people struggle to get enough (4, 5).

There are many strategies you can use to promote good sleep, including making changes to your diet, as some foods and drinks have sleep-promoting properties (6).

Here are the 9 best foods and drinks you can have before bed to enhance your quality of sleep.

Almonds are a type of tree nut with many health benefits.

They’re an excellent source of many nutrients, as 1 ounce (28 grams) of the dry roasted nuts contains 18% of an adult’s daily needs for phosphorus and 23% for riboflavin (7, 8, 9).

An ounce also provides 25% of the daily manganese needs for men and 31% of the daily manganese needs for women (10).

Eating almonds regularly has been associated with lower risks of a few chronic diseases, such as type 2 diabetes and heart disease. This is attributed to their healthy monounsaturated fats, fiber, and antioxidants.

Antioxidants may protect your cells from harmful inflammation that can lead to these chronic diseases (11, 12).

It’s been claimed that almonds may help boost sleep quality as well. This is because almonds, along with several other types of nuts, are a source of the hormone melatonin. Melatonin regulates your internal clock and signals your body to prepare for sleep (13).

Almonds are also an excellent source of magnesium, providing 19% of your daily needs in only 1 ounce. Consuming adequate amounts of magnesium may help improve sleep quality, especially for those who have insomnia (6, 14, 15).

Magnesium’s role in promoting sleep is thought to be related to its ability to reduce inflammation. Additionally, it may help reduce levels of the stress hormone cortisol, which is known to interrupt sleep (6, 15).

Yet, despite this, research on almonds and sleep is sparse.

One study examined the effects of feeding rats 400 milligrams (mg) of almond extract. It found that the rats slept longer and more deeply than they did without consuming almond extract (16).

The potential sleep-related effects of almonds are promising, but more extensive human studies are needed.

If you want to eat almonds before bed to determine if they affect your sleep quality, a 1-ounce (28-gram) serving, or about a handful, should be adequate.

Summary

Almonds are a source of melatonin and the sleep-enhancing mineral magnesium, two properties that may make them a great food to eat before bed.

Turkey is delicious and nutritious.

It’s high in protein, with roasted turkey providing almost 8 grams of protein per ounce (28 grams). Protein is important for keeping your muscles strong and regulating your appetite (17, 18).

Additionally, turkey is a modest source of a few vitamins and minerals, such as riboflavin and phosphorus. It’s an excellent source of selenium, with a 3-ounce serving providing 56% of the Daily Value (DV) (19).

Turkey has a few properties that explain why some people become tired after eating it or think it encourages sleepiness. Most notably, it contains the amino acid tryptophan, which increases the production of melatonin (20, 21).

The protein in turkey may also contribute to its ability to promote tiredness. There’s evidence that consuming moderate amounts of protein before bed is associated with better sleep quality, including less waking up throughout the night (22).

More research is necessary to confirm turkey’s potential role in improving sleep.

Summary

Turkey may be a great food to eat before bed due to its high amounts of protein and tryptophan, both of which may induce tiredness.

Chamomile tea is a popular herbal tea that may offer a variety of health benefits.

It’s well known for its flavones. Flavones are a class of antioxidants that reduce the inflammation that often leads to chronic diseases, such as cancer and heart disease (23).

There’s also some evidence that drinking chamomile tea may boost your immune system, reduce anxiety and depression, and improve skin health. In addition, chamomile tea has some unique properties that may improve sleep quality (23, 24, 25).

Specifically, chamomile tea contains apigenin. This antioxidant binds to certain receptors in your brain that may promote sleepiness and reduce insomnia (23, 26).

One 2011 study in 34 adults found those who consumed 270 mg of chamomile extract twice daily for 28 days fell asleep 15 minutes faster and experienced less nighttime wakening compared to those who didn’t consume the extract (27).

Another study found that women who drank chamomile tea for 2 weeks reported improved sleep quality compared to non-tea drinkers.

Those who drank chamomile tea also had fewer symptoms of depression, which is commonly associated with sleep problems (28).

Drinking chamomile tea before going to bed is certainly worth trying if you want to improve the quality of your sleep.

Summary

Chamomile tea contains antioxidants that may promote sleepiness, and drinking it has been shown to improve overall sleep quality.

Kiwis are a low-calorie and very nutritious fruit.

One fruit contains only 42 calories and a significant amount of nutrients, including 71% of the DV for vitamin C. It provides men and women with 23% and 31%, respectively, of the vitamin K they need each day.

It contains a decent amount of folate and potassium as well as several trace minerals too (29, 30, 31).

Furthermore, eating kiwis may benefit your digestive health, reduce inflammation, and lower your cholesterol. These effects are due to the high amounts of fiber and carotenoid antioxidants that they provide (32, 33).

According to studies on their potential to improve sleep quality, kiwis may also be one of the best foods to eat before bed.

In a 4-week study, 24 adults consumed two kiwifruits one hour before going to bed each night. At the end of the study, participants fell asleep 42% more quickly than when they didn’t eat anything before bedtime.

Additionally, their ability to sleep through the night without waking improved by 5%, while their total sleep time increased by 13% (34).

The sleep-promoting effects of kiwis are sometimes attributed to serotonin. Serotonin is a brain chemical that helps regulate your sleep cycle (22, 34, 35).

It’s also been suggested that the anti-inflammatory antioxidants in kiwis, such as vitamin C and carotenoids, may be partly responsible for their sleep-promoting effects (34, 36).

More scientific evidence is needed to determine the effects that kiwis may have in improving sleep. Nevertheless, eating 1–2 medium kiwis before bed may help you fall asleep faster and stay asleep longer.

Summary

Kiwis are rich in serotonin and antioxidants, both of which may improve sleep quality when eaten before bed.

Tart cherry juice has some impressive health benefits.

First, it provides modest amounts of a few important nutrients, such as magnesium and phosphorus. It’s a good source of potassium too.

An 8-ounce (240-milliliter) serving contains 17% of the potassium a woman needs each day and 13% of the potassium that a man needs each day (37, 38).

Additionally, it’s a rich source of antioxidants, including anthocyanins and flavonols (39, 40, 41).

Tart cherry juice is also known to promote sleepiness, and it’s even been studied for its role in relieving insomnia. For these reasons, drinking tart cherry juice before bed may improve your sleep quality (6, 20).

The sleep-promoting effects of tart cherry juice are due to its high amounts of melatonin (6, 20, 42).

In a small study, adults with insomnia drank 8 ounces (240 ml) of tart cherry juice twice a day for 2 weeks. They slept 84 minutes longer and reported better sleep quality compared to when they didn’t drink the juice (43).

Although these results are promising, more extensive research is necessary to confirm the role of tart cherry juice in improving sleep and preventing insomnia.

Nevertheless, drinking some tart cherry juice before bed is worth a try if you struggle with falling or staying asleep at night.

Summary

Tart cherry juice contains the sleep-promoting hormone melatonin and may help induce a good night’s sleep.

Fatty fish, such as salmon, tuna, trout, and mackerel, are incredibly healthy. What makes them unique is their exceptional amounts of vitamin D.

For example, a 3-ounce (85-gram) serving of sockeye salmon contains 570 international units (IU) of vitamin D. That’s 71% of your DV. A similar serving of farmed rainbow trout contains 81% of your DV (44).

Additionally, fatty fish are high in healthy omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

EPA and DPA are known for reducing inflammation. In addition, omega-3 fatty acids may protect against heart disease and boost brain health (45, 46).

The combination of omega-3 fatty acids and vitamin D in fatty fish has the potential to enhance sleep quality, as both have been shown to increase the production of serotonin (22, 47, 48).

In one study, men who ate 10.5 ounces (300 grams) of Atlantic salmon three times a week for 6 months fell asleep about 10 minutes faster than men who ate chicken, beef, or pork.

This effect was thought to be the result of vitamin D. Those in the fish group had higher levels of vitamin D, which was linked to a significant improvement in sleep quality (49).

Eating a few ounces of fatty fish before bed may help you fall asleep faster and sleep more deeply. More studies are needed to make a definite conclusion about the ability of fatty fish to improve sleep.

Summary

Fatty fish are a great source of vitamin D and omega-3 fatty acids, both of which have properties that may improve the quality of your sleep.

Walnuts are a popular type of tree nut.

They’re abundant in many nutrients, providing over 19 vitamins and minerals, in addition to 1.9 grams of fiber, in a 1-ounce (28-gram) serving. Walnuts are particularly rich in magnesium, phosphorus, manganese, and copper (50).

Additionally, walnuts are a great source of healthy fats, including omega-3 fatty acids and linoleic acid. They also provide 4.3 grams of protein per ounce, which may be beneficial for reducing appetite (18, 50, 51).

Walnuts may also boost heart health. They’ve been studied for their ability to reduce high cholesterol levels, which are a major risk factor for heart disease (12).

What’s more, some researchers claim that eating walnuts improves sleep quality, as they’re one of the best food sources of melatonin (52, 53).

The fatty acid makeup of walnuts may also contribute to better sleep. They provide alpha-linolenic acid (ALA), an omega-3 fatty acid that’s converted to DHA in the body. DHA may increase serotonin production (48, 54).

There’s not much evidence to support the claims about walnuts improving sleep. In fact, there haven’t been any studies that focus specifically on their role in promoting sleep.

Regardless, if you struggle with sleep, eating some walnuts before bed may help. About a handful of walnuts is an adequate portion.

Summary

Walnuts have a few properties that may promote better sleep. For instance, they’re a great source of melatonin and healthy fats.

Passionflower tea is another herbal tea that’s been traditionally used to treat a number of health ailments.

It’s a rich source of flavonoid antioxidants. Flavonoid antioxidants are known for their role in reducing inflammation, boosting immune health, and reducing heart disease risk (55).

Additionally, passionflower tea has been studied for its potential to reduce anxiety.

The antioxidant apigenin may be responsible for passionflower’s anxiety-reducing effects. Apigenin produces a calming effect by binding to certain receptors in your brain (56).

There’s also some evidence that passionflower increases the production of the brain chemical gamma aminobutyric acid (GABA). GABA works to inhibit other brain chemicals that induce stress, such as glutamate (57).

The calming properties of passionflower tea may promote sleepiness, so it may be beneficial to drink it before going to bed.

In a 7-day study, 41 adults drank a cup of passionflower tea before bed. They rated their sleep quality significantly better when they drank the tea compared to when they didn’t drink the tea (58).

More research is needed to determine whether passionflower promotes sleep.

Summary

Passionflower tea contains apigenin and has the ability to increase gamma aminobutyric acid (GABA) production. This may influence sleep.

White rice is a grain that’s widely consumed as a staple food in many countries.

The major difference between white and brown rice is that white rice has had its bran and germ removed. This makes it lower in fiber, nutrients, and antioxidants.

Nevertheless, white rice still contains a decent amount of a few vitamins and minerals.

A 4-ounce (79-gram) serving of white rice provides 19% of your daily needs for folate. It also provides provides 21% of the daily thiamine needs for men and 22% of the daily thiamine needs for women (59, 60, 61).

A 4-ounce (79-gram) serving of long-grain white rice contains 13% of your DV for manganese (10).

White rice is high in carbs, providing 22 grams in a 4-ounce (79-gram) serving. Its carb content and lack of fiber contribute to its high glycemic index (GI). The glycemic index is a measure of how quickly a food increases your blood sugar (59, 62).

It’s been suggested that eating foods with a high GI, such as white rice, at least 1 hour before bed may help improve sleep quality (20).

One study compared the sleep habits of 1,848 people based on their intake of rice, bread, or noodles. Higher rice intake was associated with better sleep than bread or noodles, including longer sleep duration (63).

Despite the potential role that eating white rice may have in promoting sleep, it’s best consumed in moderation due to its comparative low amounts of fiber and nutrients.

Summary

White rice may be beneficial to eat before bed due to its high glycemic index (GI). A high GI may promote better sleep.

Several other foods and drinks have sleep-promoting properties. For example, they may contain high amounts of nutrients such as tryptophan.

However, in some cases, there’s little research into their specific effects on sleep.

  • Dairy products: Dairy products, such as a glass of milk, cottage cheese, and plain yogurt, are known sources of tryptophan. Milk has been shown to improve sleep in older adults, especially when paired with light exercise (64, 65, 66).
  • Bananas: Banana peels contain tryptophan and the fruit itself is a modest source of magnesium. Both of these properties may help you get a good night’s sleep (14, 67).
  • Oatmeal: Similar to rice, oatmeal is high in carbs with a bit more fiber and has been reported to induce drowsiness when consumed before bed. Additionally, oats are a known source of melatonin (13).

Summary

Other foods and drinks, such as dairy products, bananas, and oatmeal, also contain nutrients known to improve sleep quality. Specific research into their effects on sleep may be limited, though.

Getting enough sleep is very important for your health.

Several foods and drinks may help. This is because they contain sleep-regulating hormones and brain chemicals, such as melatonin and serotonin.

Some foods and drinks contain high amounts of specific antioxidants and nutrients, such as magnesium and melatonin, that are known to enhance sleep by helping you fall asleep faster or stay asleep longer.

To reap the benefits of sleep-enhancing foods and drinks, it may be best to consume them 2–3 hours before bed. Eating immediately before going to sleep may cause digestive issues, such as acid reflux.

Overall, more research is necessary to conclude the specific role that foods and drinks have in promoting sleep, but their known effects are very promising.

Flu Vaccine (Flu Shot) Effectiveness 2020, Side Effects & COVID-19

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Flu Vaccine (Flu Shot) Effectiveness 2020, Side Effects & COVID-19

What Is the Influenza (Flu) Vaccine?

A flu shot can greatly reduce your risk of getting the flu.

A flu shot can greatly reduce your risk of getting the flu; image by Getty Images.

Influenza (flu) vaccines are nasal sprays or injections currently composed either of live attenuated (rendered much less able to cause infection) flu viruses or killed viruses or virus components (both are unable to reproduce) that, when administered to individuals, generate an immune response that will be strong enough to protect that individual from developing influenza disease. The design of the vaccine depends on how health care providers usually administer it; health care professionals usually administer the live attenuated vaccine by a nasal spray (intranasal), while health care providers typically administer the killed virus by an intramuscular injection (shot), usually into the deltoid (arm) muscle. People cannot get the flu from the injected vaccine because the vaccine contains no live virus. However, nasal sprays use attenuated viruses (meaning that the viruses are live but cannot effectively cause disease) that, in some people (immunosuppressed people), may cause mild flu-like symptoms. Note that health care providers previously did not recommend nasal sprays because of poor immune responses in people as compared to those who get the shots. However, in 2018, health care professionals approved the improved nasal sprays for use in some individuals (see below).

Facts

  • Flu vaccines can be quite different based on the viral type (or strains of the flu virus) used to make the vaccine. For example, seasonal vaccines usually are now made up of a combination of three or four different influenza viruses (flu strains that differ in some of their surface molecules), also termed as three or four-component vaccines. Experts choose the viruses in each year’s vaccine because the chosen strains represent the most likely viruses to emerge in an upcoming flu season.
  • Pandemic flu vaccines are created in response to a specific strain of flu virus that is causing widespread disease. They differ from seasonal vaccines in several ways. First, health researchers usually made the vaccines from new flu virus, not detected in previous flu seasons by flu experts and not included in the seasonal flu vaccines. These flu viruses are usually so new that most human immune systems do not easily recognize them, allowing viruses to quickly spread globally. Pandemic flu vaccines contain only a single strain of the pandemic virus (for example, H1N1 virus) instead of the usual three or four flu types used in a seasonal vaccine mixture. Seasonal vaccines are synthesized and distributed before the start of flu season (designated as Oct. 4 each year until May of the following year) while pandemic vaccines, unfortunately, have to be synthesized and distributed only after the pandemic virus has been identified and started its global spread.
  • Until 2013, health researchers made all commercially available flu vaccines from viruses cultivated in chicken eggs and then collected, purified, tested for safety and efficacy, and once approved, distributed to care providers. This process usually takes about six months to accomplish, which gives a pandemic flu virus a long time to circulate and infect populations before researchers can develop a vaccine. In 2013, Flublok was approved for use; this vaccine is a trivalent vaccine made from insect cells (cell-based) that have recombinant DNA that produces viral proteins in an egg-free system (the egg-free system avoids problem of egg allergy in some patients). Researchers may synthesize future vaccines differently like Flublok. Current techniques are time-consuming, expensive, and yield vaccines that usually protect against only those viral strains present in the vaccine; the protection does not extend to the wide spectrum of flu virus strains. This limited protection is the reason that health researchers develop new flu vaccines each year.

What Is the History of Flu Vaccine Development?

In 1933, researchers discovered that viruses (influenza virus types A, B, and rarely C) cause influenza (flu). Prior to 1933, people thought a bacterium named Haemophilus influenzae caused the flu. In 1938, Jonas Salk and Thomas Francis developed the first vaccine against flu viruses. This first flu vaccine protected the U.S. military forces against the flu during World War II. Dr. Salk used his experience with influenza vaccine to develop an effective polio vaccine in 1952. Vaccines produced from the 1940s to the 1960s were not as purified as more modern vaccines, and the impurities in vaccines were thought to contribute to side effects such as fever, aches, and fatigue. Since these symptoms were similar to those that accompanied the flu (flu symptoms usually were more severe and lasted longer), people mistakenly thought they got the flu from the vaccination. However, they did not get the flu from the vaccines since the vaccines used killed virus.

In a public vaccination program designed to prevent a pandemic swine flu outbreak in 1979, about 25% of people in the United States received flu vaccinations. Unfortunately, the 1979 vaccine was associated with a small increased risk of Guillain-Barré syndrome, a serious neurological condition, with the risk estimated to be one to nine excess cases per million doses of vaccine, but no cause for this increase in risk was ever discovered. Fortunately, no pandemic developed, and the vaccination program for that flu virus was cancelled. Since that time, researchers have improved vaccine purification, and millions of people have continued to be vaccinated every year. Currently, influenza viruses are inoculated into eggs, where they multiply; afterward, they are harvested and separated from most egg particles and egg antigens, but some people who have an egg allergy may get a reaction to such a flu vaccination; however, most people who have a mild egg allergy usually have no reaction to the vaccines. Attenuated viruses (for nasal sprays like FluMist) are grown similarly, but strains are selected that only replicate under cool or cold temperatures so they can survive in the cool nasal passages long enough to stimulate an immune response but do not easily replicate and spread to warmer body regions like the lungs.

Because of the potential for widespread infection, life-threatening complications, and deaths that the H1N1 pandemic virus strain seemed to possess, health researchers accelerated the H1N1 tests so that the vaccine could be provided before the usual six-month timeline. However, all of the steps (cultivation, safety, efficacy, approval, and distribution) were done in the same way as for seasonal vaccines but over a shorter period with fewer people involved in the initial trials. Tested and approved H1N1 vaccine started to become available in late September 2009 (in Europe) and in October 2009 in the Americas and Asia.

A major change in terminology (naming conventions or abbreviations for influenza vaccines) occurred in the 2014-2015 vaccine year. Since then, vaccine abbreviations have continued to change. The new terminology (abbreviations) are as follows, according to the CDC
established in 2019-2020:

  • IIV = Inactivated Influenza Vaccine
    • IIV3 = Trivalent Inactivated Influenza Vaccine
    • IIV4 = Quadrivalent Inactivated Influenza Vaccine
  • RIV4 = Quadrivalent Recombinant Influenza Vaccine
  • LAIV4 = Quadrivalent Live Attenuated Influenza Vaccine
  • aIIV3 refers specifically to adjuvanted IIV3
  • ccIIV4 refers specifically to cell-culture based IIV4
  • HD-IIV3 refers specifically to high-dose IIV3
  • SD-IIV3 and SD-IIV4 refer specifically to standard-dose IIVs




QUESTION

Which illness is known as a viral upper respiratory tract infection?
See Answer

Why Are There New Flu Vaccines Each Year?

Although only a few different influenza virus strains circulate in human populations at any given time, people may continue to become ill with the flu throughout their lives. The reason for this continuing susceptibility is that the eight RNA strands that comprise the influenza virus genome are continually mutating through the mechanisms of antigenic shift and drift. Antigenic drift is a series of mutations that occurs over time and causes a gradual evolution of the virus. Antigenic shift is an abrupt change in the RNA genome that usually results in significant changes in the hemagglutinin and/or the neuraminidase proteins (surface components of the flu virus). In this case, a new subtype of the virus suddenly emerges. Influenza A virus mutates the most with both of the mechanisms, while influenza B changes mainly by the slower process of antigenic drift and doesn’t cause pandemics like influenza A.

Each year, health researchers update the seasonal vaccine to include the most current influenza virus strains that are infecting people worldwide. The fact that influenza viral genes continually change is one of the reasons people must get a flu vaccine every year, because often the immune response to one flu viral strain will not protect against other flu strains. Another reason is that antibodies produced by the host in response to the vaccine decline over time, and antibody levels are often low one year after vaccination. However, within about two weeks of receiving the vaccine, most people are protected against the viral strains that compose the vaccine. Vaccines produce immunity that lasts for at least a year; some people are protected by the vaccine against the strains of viruses for many years. Although most individuals need only one vaccine administration (flu shot) per year, the Centers for Disease Control and Prevention (CDC) recommends that children aged 6 months to 8 years obtain two doses. Please see the section on viral strains and vaccine producers in this article for the current composition of flu strains used in the 2020-2021 seasonal flu vaccines; however, if you have any questions, please check any CDC updates that may happen during the flu season.

What Are Indications for Flu Vaccines?

The CDC recommends that anyone (except for certain groups, see below and people allergic to eggs) over 6 months of age be vaccinated against the flu. This is particularly important for certain people, including those who are at high risk of having serious seasonal flu-related complications or people who live with or care for those at high risk for serious seasonal flu-related complications. During flu seasons when vaccine supplies are limited or delayed, the Advisory Committee on Immunization Practices (ACIP) makes recommendations regarding priority groups for vaccination. The most recent ACIP recommendations presented by the CDC for 2020-2021 are as follows:

  • Routine annual influenza vaccination is recommended for all people aged ≥6 months who do not have contraindications.
  • A licensed, age-appropriate influenza vaccine (IIV, RIV4, or LAIV4) should be used.
  • Emphasis should be placed on vaccination of high-risk groups and their contacts/caregivers. When vaccine supply is limited, vaccination efforts should focus on delivering vaccination to (no hierarchy implied by order listed) the following:
    • Children aged 6-59 months
    • Adults aged ≥50 years
    • People with chronic pulmonary (including asthma), cardiovascular (excluding isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus)
    • People who are immunocompromised due to any cause, (including medications or HIV infection)
    • Women who are or will be pregnant during the influenza season
    • Children and adolescents (aged 6 months through 18 years) receiving aspirin– or salicylate-containing medications and who might be at risk for Reye syndrome
    • Residents of nursing homes and other long-term care facilities
    • American Indians/Alaska natives
    • People who are extremely obese (BMI ≥40)
    • Caregivers and contacts of those at risk:
      • Health care personnel in inpatient and outpatient care settings, medical emergency-response workers, employees of nursing home and long-term care facilities who have contact with patients or residents, and students in these professions who will have contact with patients;
      • Household contacts and caregivers of children aged ≤59 months (for example, <5 years), particularly contacts of children aged <6 months, and adults aged ≥50 years; and
      • Household contacts and caregivers of people with medical conditions that put them at high risk of severe complications from influenza.

There is a high-dose IM vaccine for people 65 and older (contains more viral antigen to stimulate the possibly less responsive immune system in people age 65 and older).

What Are Indications for the Nasal-Spray Flu Vaccine (FluMist, Live Attenuated Influenza Virus or LAIV4)?

Healthy people 2-49 years of age who are not pregnant may get the nasal spray vaccine. The term FluMist is another name for the seasonal flu nasal spray vaccine. LAIV4 does not contain thimerosal or other preservatives. According to the CDC, the following people should not get the nasal-spray vaccine and note current CDC recommendations:

  • People less than 2 years of age
  • People 50 years of age and over
  • People with a medical condition that places them at high risk for complications from influenza, including those with chronic heart disease like history of a heart attack or lung disease, such as asthma or reactive airways disease
  • People with medical conditions such as diabetes or kidney failure
  • People with illnesses that weaken the immune system or who take medications that can weaken the immune system
  • Children <5 years of age with a history of recurrent wheezing
  • Children or adolescents receiving aspirin therapy
  • People with a history of Guillain-Barré syndrome that occurred after receiving influenza vaccine
  • Pregnant women
  • People who are allergic to any of the components of the nasal-spray vaccine
  • It is important to note that if the vaccine’s recipient sneezes immediately after administration, the dose should not be repeated.

In addition, the package insert states that people allergic to gentamicin (Gentak, Garamycin), arginine, or gelatin should not use the nasal spray. These recommendations also apply to the new quadrivalent vaccines. However, because of the poor performance as a vaccine, the CDC has not recommended the nasal mist vaccine for the last few years; however, in 2020, this recommendation
was changed.

Please see the two extensive tables in reference 1 for details about all vaccines approved for use in the United States against the flu for the 2020-2021season. You should discuss which flu vaccine is best for you with your doctor.

What Are Potential Side Effects or Reactions to Flu Vaccines and Flu Vaccine Safety (Seasonal and Pandemic)?

In general, all medications, including intramuscular and nasal-spray vaccines, have side effects and the potential for allergic reactions. For most medicines and vaccines, the side effects or reactions are infrequent and are minimal if they do occur. Consequently, the pros far outweigh the cons for vaccination. The seasonal and pandemic vaccines are no different. What is different about the side effects of flu vaccines is that the occasional side effects seen with all flu vaccines usually resemble the flu disease. About 5%-10% of people experience mild side effects, such as headache, nasal congestion, low-grade fever, sore throat, or muscle cramps. Some individuals may experience short-term (hours to about a day) dizziness, nausea, and/or soreness or a mild rash at the inoculation site as vaccination side effects. Although these are short-lived, some people think they contracted the flu from the vaccine. This is a myth. The intramuscular vaccines contain no live virus, so the vaccine cannot transmit the disease. Although the nasal-spray vaccines contain live virus, it contains weakened (attenuated) virus. The vast majority of attenuated viruses (altered so they will not replicate or do so poorly) will not be able to cause influenza in people with normal immune systems and good health because the attenuated viruses replicate poorly or not at all in these people. These side effects are most likely to occur in children who have not been exposed to influenza virus in the past, but they can occur in some adults.

About one-third or fewer of those vaccinated develop soreness and occasional redness at the injection site. Allergic reactions are rare. Intramuscular vaccine shots are usually mildly painful when injected into muscle tissue.




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How Effective Are Seasonal and Pandemic Flu Vaccines?

Flu vaccine effectiveness is judged by the ability of the vaccine to generate an immune response (measured by a blood test known as a hemagglutination-inhibition assay; protection is deemed effective if assay titer of antibodies reaches 1:40 or greater). This applies to both seasonal and pandemic flu vaccines. A titer of 1:40 is considered to be protective 21 days after vaccination. Vaccine efficacy also varies from one person to another; one person’s titer could be different from another person’s titer, even if both were given vaccine from the same batch.

Previous studies of healthy young adults have shown influenza seasonal vaccine to be 70%-90% effective in preventing illness. In the elderly and those with certain chronic medical conditions such as HIV, the vaccine is often less effective in preventing illness. However, studies show the vaccine reduces hospitalization by about 70% and death by about 85% among the elderly who are not in nursing homes. Among nursing home residents, vaccine can reduce the risk of hospitalization by about 50%, the risk of pneumonia by about 60%, and the risk of death by 75%-80%.

However, experience with the vaccine, studied each year, can show a wide variation in effectiveness. The 2014-2015 vaccine demonstrated this point. Health researchers designed the vaccine to protect against those major flu viruses that emerged in 2014. Unfortunately, new strains arose in late 2014 so that the vaccine synthesized for the 2014-2015 season was only about 23% effective. However, the CDC still recommended utilization of the vaccine, as it seemed to reduce the severity of the flu in people who were vaccinated but still became infected with the flu virus.

The American Academy of Pediatrics (AAP) recommends that children all children 6
months and older receive a seasonal flu vaccine (some children under the age of
9 will need two doses). AAP and others recommend both inactivated influenza
vaccine (IIV) and live attenuated influenza vaccine (LAIV) as vaccine options
for the 2020-2021 season with no preference. For additional information, see
https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunizations/Influenza-Implementation-Guidance/Pages/Annual-AAP-Influenza-Policy.aspx
or your child’s doctor.

The FDA, CDC, and other institutions in the U.S. continuously monitor the effectiveness and safety of vaccines, and recommendations may change.

Viral Strains and Producers of the Seasonal Flu Vaccines for
2020-2021

The following changes and updates are taken from the first reference from the CDC:

The composition of the 2020-21 U.S. influenza vaccines includes updates to the influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B/Victoria lineage components. These updated components will be included in both trivalent and quadrivalent vaccines. Quadrivalent vaccines will include an additional influenza B virus component from the B/Yamagata lineage, which is unchanged from that included in quadrivalent influenza vaccines used during the 2019-20 season. For the 2020-21 season, U.S. egg-based influenza vaccines (for
example, vaccines other than ccIIV4 and RIV4) will contain hemagglutinin (HA) derived from an influenza A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus, an influenza A/Hong Kong/2671/2019 (H3N2)-like virus, an influenza B/Washington/02/2019 (Victoria lineage)-like virus, and (for quadrivalent egg-based vaccines) an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus. U.S. cell culture-based inactivated (ccIIV4) and recombinant (RIV4) influenza vaccines will contain HA derived from an influenza A/Hawaii/70/2019 (H1N1)pdm09-like virus, an influenza A/Hong Kong/45/2019 (H3N2)-like virus, an influenza B/Washington/02/2019 (Victoria lineage)-like virus, and an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus.

Two new influenza vaccine licensures are described:

In November 2019, FDA licensed Fluzone High-Dose Quadrivalent (HD-IIV4). Fluzone High-Dose Quadrivalent is approved for use in persons aged ≥65 years. For the 2020-21 season, Fluzone High-Dose Quadrivalent is expected to replace the previously available trivalent formulation of Fluzone High-Dose (HD-IIV3). The dose volume for Fluzone High-Dose Quadrivalent (0.7 mL) is slightly higher than that of trivalent Fluzone High-Dose (0.5 mL). Fluzone High-Dose Quadrivalent, like Fluzone High-Dose, contains
four times the amount of HA per vaccine virus in each dose compared with standard-dose inactivated influenza vaccines (60 µg per virus, versus 15 µg in standard-dose IIVs).

A summary of 2020-2021vaccines is available in an extensive table at https://www.cdc.gov/flu/professionals/acip/2020-2021/acip-table.htm.

Caregivers are strongly advised to read the package inserts to check for indications and contraindications before administering any type of vaccine, especially new vaccines, as sometimes the indications for use and contraindications change. Some vaccines have additional names like Fluad (Seqirus), Fluzone (Fluzone High-Dose), Fluarix, and others. In addition, the CDC occasionally makes updates about who should get what type of vaccine.

In August 2014, the FDA approved use of a jet injector for flu vaccination. The jet injector uses high-pressure fluid to penetrate the skin instead of a hypodermic needle and can be powered by gas or springs. Certain vaccine preparations (Afluria) may be used in the injector and can be used in people 18-64 years of age.

Thimerosal and Mercury in Seasonal and Pandemic Vaccines

Thimerosal is a preservative that contains mercury. Multidose vials of conventional and pandemic flu vaccines often contain thimerosal to prevent contamination when the vial is repeatedly used to extract the vaccine. Although thimerosal is being phased out as a vaccine preservative, it is still used in flu vaccines in low levels. There is no data that indicate thimerosal in these vaccines has caused autism or other problems in individuals. Consequently, the FDA has indicated the following:

  • There is no convincing evidence of harm caused by the small doses of thimerosal preservative in influenza vaccines, except for minor effects like swelling and redness at the injection site.
  • A study of influenza vaccination examining over 2,000 pregnant women demonstrated no adverse fetal effects associated with influenza vaccine.

However, single-dose vials and the nasal-mist formulations of both the seasonal and pandemic vaccines contain no thimerosal. These vaccine options are available to individuals who still want thimerosal-free vaccine. For thimerosal levels in flu vaccines, the reader should see the CDC table in the reference under “mercury content.”

What Is the Value for Individuals Getting Seasonal and Pandemic Vaccine?

The best chance for protection against seasonal (conventional) and pandemic flu is vaccination. The value of vaccination is very high for many individuals and even for the world’s population. For individuals, seasonal flu often causes about 12,000 to 56,000 deaths in the U.S., with about 140,000 to 710,000 people hospitalized every year. There are from 9.2 million to 35.6 million flu illnesses in the U.S. population gets the seasonal flu each year and misses school, work, and vacation time, while productivity nationwide can decline. Seasonal flu takes the lives of our population 65 years of age and older; about 90%-95% of seasonal flu deaths occur in this age group. Without yearly seasonal flu vaccine, the illness and death rates would likely be much higher.

Pandemic flu in some instances can be far worse on world populations than seasonal flu. For example, the Spanish flu or 1918 flu pandemic killed about 45 million to 100 million people from 1918-1920. Commerce, economic systems, and travel were shut down in many areas of the world for months at a time during those years. In the recent H1N1 pandemic that began in Mexico in April 2009, the disease caused deaths “out of the usual flu season” and caused a shutdown in travel to Mexico that brought the country economic hardship. For many individuals, pandemic H1N1 flu was just a nuisance that makes people feel feverish and tired with sneezing and coughing that lasts for about a week; they recovered without any problems. For others, the pandemic H1N1 flu was disastrous and deadly. The H1N1 virus has behaved quite differently from the seasonal flu. It began in April 2009 (near the end of the seasonal flu season) and spread worldwide by September. H1N1 flu affected a different population than the seasonal flu. It caused the hospitalization and deaths of a markedly younger population (pediatric population, pregnant individuals, and young adults). Worldwide, H1N1 vaccine became available in limited amounts in late September and early October 2009. The H1N1 vaccine was initially given to those people at highest risk for complications (pediatric/children, pregnant women, caregivers). Researchers suggest the H1N1 vaccine was effective in reducing the effects of this flu virus, even though it was not as deadly as first estimated.

Vaccination against seasonal flu and the infrequent pandemic flu (1918 [no vaccine], 1957, 1968, and 2009) has been improved since it was first tried in the 1940s. Vaccination provides the best chance (about 70%-90%) to prevent the symptoms and complications (including pneumonia) of influenza infection from developing; the value of vaccinations is in the numbers of people who live and do not get sick from the disease as a result of their successful vaccination.

About 80% of the 172 children who died from the flu in 2017 did not receive the flu vaccine.

In the future, researchers may make vaccines differently; however, the vaccine hastily made in 2009 to protect people from H1N1 was deemed successful and can serve as a vaccine synthesis method until newer and faster vaccine synthesis methods are widely accepted.

Where Can People Obtain the Flu Vaccine?

Seasonal vaccines are usually available at most physician offices, urgent care clinics, and in the past few years, from some pharmacies (usually associated with pharmacy chains and grocery stores). Availability for the new flu seasonal vaccine starts in the late summer or early fall and if demand is normal, supplies are available well into the spring of the following year. This is not the situation for pandemic flu. As seen with the 2009 H1N1 pandemic, vaccine was not readily available and was rationed out to specific distribution sites that were tasked to vaccinate the most susceptible individuals initially until vaccine production was adequate to allow broad distribution. It is possible such circumstances could reoccur. If you need or want a specific vaccine, it is best to call the clinic, doctor’s office, pharmacy or other health care professional to determine if the vaccine you want is available.

In fact, another influenza A H3N2v strain was noted in 2012 to be transmitted from pigs to humans. Fortunately, it causes symptoms similar to the seasonal flu, but there is no current development into a strain that easily transmits from person to person.

Future Flu Vaccines

There are many researchers looking for ways to protect humans with vaccines against both seasonal and pandemic flu outbreaks. It is likely that new developments in vaccine synthesis and production will be used in the next few years, like the recombinant DNA Flublok vaccine introduced for the 2013-2014 flu season; it is available in both the trivalent and quadrivalent vaccine formulations in 2017 and in the quadrivalent in 2018.

Questions and Answers About the Flu Shots and COVID-19 (Coronavirus)

COVID-19 is currently a pandemic disease caused by SARS-CoV-2 virus that has symptoms that can mimic flu symptoms. There is no FDA-approved vaccine against COVID-19, but several vaccines may be approved in a few months in late 2020 to early 2021. The flu vaccine (2020-2021 formulations) will not protect you from COVID-19 because the flu virus and the coronavirus are different viruses. Researchers comment that it is possible to be infected with both the flu virus and coronavirus at the same time. Currently, if you get a flu shot and then get a coronavirus vaccine, it would be safe to do based on experience with previous vaccines. However, since coronavirus vaccines are still being evaluated, there is no data available to confirm this widely held opinion.

From WebMD Logo

Flu Prevention

Personal hygiene

  • Wash hands frequently with soap and water.
  • Avoid touching one’s eyes, nose, or mouth before washing one’s hands.
  • Avoid close contact with people who are ill.
  • Do not share clothes or other personal items with another person during a flu outbreak.
  • Those infected with influenza should stay at home for 24 hours after fevers have resolved.

Vaccination

The best means of preventing the flu is getting an influenza vaccination. The CDC recommends an annual flu vaccine for everyone 6 months of age and older. Two general types of vaccines are available. One is the injectable vaccine (known as the flu shot) made from inactivated virus. The flu shot contains only killed influenza viruses A and B. The other is a live attenuated, or weakened, virus that is squirted into the nose. This is called intranasal vaccine or nasal spray vaccine. The intranasal form is available for certain people who may prefer it to a shot, and it is approved for people from 2 through 49 years of age. It is not recommended for people who are immunosuppressed or have other conditions.

Reviewed on 9/16/2020

References

United States. Centers for Disease Control and Prevention. “Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2020-21 Influenza Season.” MMRW 69.8 Aug. 21, 2020: 1-24. .

United States. CDC. “Influenza Vaccines -– United States, 2019-2020 influenza Season, 2019.” .

United States. Centers for Disease Control and Prevention. “Influenza (Flu).” Aug. 23, 2018. .

United States. Centers for Disease Control and Prevention. “Influenza Vaccines — United States, 2015-16 Influenza Season*.” Aug. 11, 2015. .

United States. Centers for Disease Control and Prevention. “Intradermal Influenza (Flu) Vaccination.” July 6, 2011. .

United States. Centers for Disease Control and Prevention. “The Nasal-Spray Flu Vaccine (Live Attenuated Influenza Vaccine [LAIV]).” Sept. 21, 2011. .

United States. Centers for Disease Control and Prevention. “Preventing Seasonal Flu With Vaccination.” Oct. 9, 2015.
.

United States. Centers for Disease Control and Prevention. “Update: ACIP Recommendations for the Use of Quadrivalent Live Attenuated Influenza Vaccine (LAIV4) — United States, 2018-19 Influenza Season.” MMWR June 8, 2018. .

United States. Centers for Disease Control and Prevention. “What You Should Know for the 2015-2016 Influenza Season.” Oct. 8, 2015.
.

United States. Centers for Disease Control and Prevention. “Who Should Get Vaccinated Against Influenza.” Sept. 9, 2011. .

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Wellbeing Nutrition

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Wellbeing Nutrition

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