TIME Obesity

Are Diabetes Rates Really “Leveling Off”?

For the first time in several decades, we’re starting to see a slowing of new diabetes diagnoses, suggests new data published in JAMA.

The study authors examined data collected from more than 600,000 adults between ages 20-79 from 1980 to 2012—part of the Centers for Disease Control and Prevention (CDC)’s National Health Interview Survey. A broad view paints a grim picture: From 1990 to 2008, the prevalence of diabetes as well as new cases of the disease both doubled. But from 2008-2012, those rates of change leveled off. So while people are still being diagnosed with diabetes, the rate of growth is decelerating.

“It’s encouraging that we may be seeing this slowing and plateauing,” says Ann Albright, PhD, RD, director of the division of diabetes translation at the CDC and one of the study’s authors. The study cites a slowing of rates of obesity—one of the biggest contributors to type 2 diabetes, found one study—as a partial explanation for the results. Black and Hispanic adults, however, have continued to see a rise in new diabetes cases, and prevalence also grew among people with a high school education or less. These disparities, Albright says, could get worse.

“This data is telling us that we are doing some things right,” Albright says, which is especially important given that the population is aging, and baby boomers are hitting peak years for diabetes. Driving down diabetes prevalence is great, but the best way to get there is to curb new cases—not to have people in the diabetes pool die off early, she adds.

“[This study] is important to note, but it doesn’t mean we have this licked and we’re all done,” she says. “We still have a lot of work to do.”

TIME Diet/Nutrition

Artificial Sweeteners Aren’t the Answer to Obesity: Here’s Why

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Artificial sweeteners may be contributing to the very health problems they were supposed to prevent, say researchers Tetra Images—Getty Images/Tetra images RF

They’re supposed to be the sweet alternative to high-calorie, diabetes-causing sugar. But the latest science shows that artificial sweeteners may actually set us up for obesity and diabetes

Aspartame, saccharin, sucralose—sugar alternatives go by many names, but share an almost irresistible promise: all the sweetness of sugar without the calories, weight gain and increased risk of diabetes that comes with uncontrolled amounts of sugar in the blood.

But studies on artificial sweeteners and weight loss—as well as research about whether sugar substitutes helped people avoid metabolic disorders like diabetes—have been mixed. And in a paper published Wednesday in Nature, Dr. Eran Elinav from the Weitzmann Institute of Science in Israel found that the sugar stand-ins actually contribute to changes in the way the body breaks down glucose. How? Fake sugars aren’t digested and therefore pass directly to the intestines, impacting the millions of invisible bacteria that live in our gut. And when he and his colleagues gave seven people who didn’t normally use artificial sweeteners the sugar substitutes for seven days, about half of the people showed higher blood glucose levels after just four days.

MORE: 5 Steps to Quitting Artificial Sweeteners

“What our comprehensive genetic profiling of the microbiome pointed to is that exposure to artificial sweeteners directly impacts the microbes,” Elinav says. “We found that the artificial sweeteners we think of as beneficial and that we use as treatment or preventive measures against obesity and its complications are contributing to the same epidemics they are aimed to prevent.”

In the intestines, gut microbes are hard at work, pulling out some nutrients from food that are helpful in stopping tumor growth, for example, and squirreling away others to store as energy for later use. But while artificial sweeteners aren’t absorbed by our own cells, they may be absorbed by our bacteria—and when that happens, things appear to go haywire.

Higher amounts of the sweetener substitutes, Elinav and his team found, can change the makeup of these bacterial communities. And that in turn can change how those bugs behave, leading to weight gain and poorer glucose breakdown. These alterations in intestinal bacteria were the same as those in a group of 400 people who reported using artificial sweeteners—and those changes were the same in mice as well.

MORE: Why Your Brain Isn’t Fooled By Sugar Stand-Ins

In the mouse studies, Elinav’s team found that the artificial sweeteners pushed one particular group of bacteria, Bacteroides, to thrive, while inhibiting growth of another, Clostridiales. Bacteroides are the microbial equivalent of hoarders, hungrily pulling energy out of food and squirreling it away as fat. The end result of a Bacteroides-heavy gut is a physically heavy gut as well. In studies by other research groups, its dominance, and the resulting drop in diversity of other microbes, is typical of obese people compared to normal weight individuals.

MORE: 7 Not-So-Sweet Lessons About Sugar

The metabolic consequences were also dramatic in both the mice and people studied. In the mouse experiments, animals who were fed the same dose of saccharin that the U.S. Food and Drug Administration considers safe for daily use showed a drop in their ability to break down glucose. When he gave those mice antibiotics, their ability to break down glucose returned to normal, suggesting that wiping out the abnormal balance of bacteria could return the animals back to a healthier state.

And to confirm that the changing microbial communities were indeed responsible for the glucose changes, he also transplanted fecal samples from the people using artificial sweeteners into mice whose own guts had been wiped clean. These mice then developed the same abnormalities in glucose breakdown that the human donors and the mice who were fed saccharin did—even though they never actually ate artificial sweeteners. Simply harboring the microbes that had been exposed to the sweeteners was enough to disturb their glucose metabolism.

MORE: Can Sugar Substitutes Make You Fat?

The good news is that as easily as the gut microbiome can shift toward an unhealthy state, it can just as easily be brought back into line with the proper balance of bacterial communities. The best way to do that isn’t clear yet, but, says Eran Segal, a co-author of the study and a professor of computer science and applied mathematics at the Weitzmann Insttitute, “We believe that the situation today at the very least needs to be re-examined. We were able to induce glucose intolerance in a few days in some individuals, so this massive, unsupervised and unregulated use [of artificial sweeteners] should at the very least be reassessed and perhaps re-examined in additional studies.”

Elinav, for one, isn’t waiting. Based on his findings, he’s stopped adding artificial sweeteners to his coffee.

 

TIME diabetes

Why Inflammation Matters for Diabetics

Anti-inflammatory medications might someday be used to lower the risk of certain kinds of disease among diabetics, found a new study presented at the American Heart Association’s High Blood Pressure Research Scientific Sessions 2014.

In the laboratory, the researchers studied cultured cells from a human aorta, the blood vessel that comes out of the heart and goes to the rest of the body. They put the cells in a high-glucose environment—similar to a what happens inside a diabetic body—and found that without inflammation present, sugar didn’t enter the cells. And even when glucose was forced into the cells, the cells weren’t damaged.

But inflammation changes everything. When researchers added an inflammatory protein called interleukin-1—a common marker for inflammation in the body, whether you are diabetic or not—the cell did metabolize the glucose, which kicked off a cycle of inflammation. Those effects were blocked once the researchers gave the cells a certain type of anti-inflammatory drug.

“What [the study authors] said was, you need the inflammation in order for the glucose to do the damage to the cells,” explained Mary Ann Bauman, MD, a primary care internist at INTEGRIS Health in Oklahoma City and a spokesperson for the American Heart Association. (Dr. Bauman was not an author on the study.) “That could be one of the reasons why in a diabetic, if we can get them to exercise and lose weight, they will have less damage to their blood vessels.”

In diabetes care, doctors and patients often focus on reducing blood sugar levels, and though this preliminary research occurred only in cells, it shows how inflammation might play a role, Dr. Bauman said.

That means that controlling blood sugar isn’t always enough to avoid the cardiovascular disease that sometimes stems from diabetes, and anti-inflammatory drugs may one day be able to help, said study author Carlos Sánchez-Ferrer, professor of pharmacology at the Universidad Autónoma de Madrid in Spain, in a press release. Lifestyle changes can help, too. “We need to reduce the inflammatory environment associated with diabetes,” Sánchez-Ferrer said. “Changes in lifestyle, such as physical exercise and weight reduction, are important not only because they reduce blood sugar but because they reduce inflammation.”

TIME Cancer

Prediabetes Increases Cancer Risk By 15%

A new study published in Diabetologia shows a link between prediabetes–when blood sugar levels are higher than normal but don’t yet qualify as diabetes–and cancer.

More than one in three U.S. adults 20 years and over have prediabetes, according to a recent Centers for Disease Control report. Even more concerning, 90% of those affected don’t know they have it. And 15-30% of people with prediabetes will develop full-blown type 2 diabetes within five years, the report says.

The meta-analysis looked at 16 studies, including data from almost 900,000 people. Researchers found a 15% higher risk of cancer associated with prediabetes, especially in the liver, stomach, pancreas, breast, and endometrium. The association stuck even after controlling for body mass index (BMI), a risk factor for both diabetes and cancer.

However, prediabetes was not associated with an increased risk of cancer of the prostate, ovary, kidney, bladder, or lung.

The study authors speculate that the consequences of high blood sugar, like chronic oxidative stress and hyperglycemia, may act as carcinogens. And factors related to insulin resistance, a hallmark of diabetes and prediabetes in which the body becomes less able to use insulin to break down sugars, may cause cancer cells to proliferate.

“Although these results are unlikely to completely explain the epidemiological association between prediabetes and site-specific cancer,” they write, “they provide a new insight into a possible direct causal link.”

TIME Obesity

Obesity Is A Big Contributor To Diabetes Boom

Diabetes is one of the most common diseases in the U.S., and there’s a single biggest culprit to blame, found a new study released today in Annals of Internal Medicine: our ever-increasing body mass index, or BMI.

The team analyzed data from five National Health and Nutrition Examination Surveys of a nationally representative U.S. sample of 23,932 people. They found that the prevalence of diabetes almost doubled from 1976 to 1980 as well as from 1999 to 2004.

BMI explained most of the increase in the prevalence of diabetes, even more than other big factors like race, ethnicity and age, lead study author Andy Menke, an epidemiologist with Social & Scientific Systems, wrote in an email to TIME. “There has been a substantial increase in obesity in the US population during this study,” he wrote.

Intriguingly, diabetes prevalence increased more in men than in women. And after taking changes in age, race, ethnicity and BMI into account, Menke’s team found that diabetes prevalence still increased in men, but not in women. The reason for that gender gap is not entirely clear, but might be due to factors that fell outside the scope of the study like differences in survival between men and women after being diagnosed with diabetes, physical activity, sleep patterns, vitamin D levels, psychological stress and depression, and exposure to pollutants and toxins, Menke wrote.

“Decreasing the occurrence of being overweight and obesity remains an important intervention to reduce the burden of diabetes,” the study authors wrote. In the fight against diabetes, obesity is a clear place to start.

TIME diabetes

Having The Right Kind of Fat Can Protect Against Diabetes, Study Says

Brown tissue, also known as brown fat
Brown tissue, also known as brown fat Getty Images

People with more "brown fat" were better able to keep blood sugar under control and burn off fat stores

Not all fat is created equal, it seems. When we’re born, we have larger amounts of brown fat, so-called because it contains more dark mitochondria, the cell’s energy factories that pull in glucose and use it as fuel to drive cellular functions. Like a hard-working battery, however, brown fat releases heat as it performs its functions, which is helpful to keep newborn infants warm but gets less useful for adults as we’re better able to regulate our body temperature. So as we get older, this brown fat is gradually lost.

But in a report published in the journal Diabetes, scientists led by Labros Sidossis, professor of internal medicine at University of Texas Medical Branch at Galveston, found for the first time that adults who retained more amounts of brown fat were better able to keep blood sugar under control and burn off fat stores. Previous studies have linked brown fat to better weight control, but these results also hint that the tissue may be important for managing diabetes.

MORE: How Now, Brown Fat? Scientists Are Onto a New Way to Lose Weight

The researchers measured the brown fat in a small group of healthy men and also tracked how much energy they used while resting, how well they metabolized glucose, and their sensitivity to insulin, which breaks down and controls blood sugar. Because brown fat tends to be activated under cold temperatures, the scientists also measured these factors after the men sat at room temperature, and again after they sat at 65 degrees to 70 degrees F for five to eight hours.

The men who had higher amounts of brown fat – about 70g on average – increased their metabolic rate by 15%, meaning they burned more calories when they were exposed to slightly cooler temperatures, compared to the men with little or no brown fat. That alone, says Sidossis, contributed to burning 300 more calories for these men.

Those with higher brown fat were also able to break down more sugar, leading to less of it in their blood, something that hasn’t been shown before in human studies. If the subjects sat in the cooler room for 24 hours, the researchers found, that would lead to a reduction of 25g of sugar in the blood thanks to their brown fat alone. “That’s significant because if you consider people who have diabetes, they only have about 2g to 3g more sugar in the blood,” says Sidossis.

MORE: Study: Scientists Find a Way to Trigger Fat-Burning Fat

Interest in brown fat has exploded in recent years, and investigators found that adults retain more brown fat than previously thought, on either side of the base of the neck. Activating this fat store has become a popular area of research; so far, cold temperatures are the only reliable way to stimulate it, but others are exploring ways to transform white fat into brown fat. As of yet, experts haven’t found a reliable way to turn brown fat on or off in a reliable and metabolically useful way. Genetics may determine how much brown fat people are born with, but if early research is validated, it may also be possible to modify that amount, either with drugs or by transforming white fat.

MORE: Turn Down the Thermostat, Drop a Few Pounds?

If the results of the current study are confirmed, the need to do so might become more urgent. “Our data suggest that brown fat may function as both anti-obesity and anti-diabetic tissue in humans,” says Sidossis. “And that makes it a therapeutic target in the battle against obesity and chronic disease. Anything that helps in this area, we need to pursue and make sure that if there is potential there, we exploit it.”

TIME

You Asked: Are All Calories Created Equal?

Are all calories equal?
Illustration by Peter Oumanski for TIME

Kale or corn dogs, bananas or beer, a calorie is still a calorie. At least, that’s what dieters have been told for the past half-century. Now, experts don't agree

“By and large, we’ve been taking an accounting approach to weight loss,” says Dr. David Ludwig, a professor of nutrition at the Harvard School of Public Health. By that he means, health scientists have traditionally focused on the number of calories coming in versus the number of calories going out. But there are a lot of problems with that approach, he says. For one thing, it’s really tough to accurately keep track of your daily calorie intake. “Being off by just 100 calories a day could add up to a hundred pounds over a lifetime,” he says.

If burning more calories than you consume would keep you skinny, a low-fat diet should be the answer to all your diet prayers. That’s because, compared to protein or carbohydrates, fat contains roughly twice the number of calories, ounce for ounce. But Ludwig says low-fat diets have proved ineffective when it comes to losing weight. “Mediterranean or low-carbohydrate diets outperform a low-fat diet every time, and that wouldn’t be true if calories were the only measure that mattered,” he adds. (Mediterranean diets and others like the now-trendy Paleo diet are both high in fat, comparatively speaking.)

In reality, Ludwig says the body responds differently to calories from different sources. “Your weight is regulated by a complex system of genetic factors, hormonal factors, and neurological input, and not all calories affect this system the same way,” he explains.

As for fat: “Some naturally high-fat foods are among the most healthful we can eat in terms of promoting weight loss and reducing risk for diabetes and heart disease,” he explains, listing off foods like nuts, avocados, and many types of fish. “If you’re counting calories, you would want to eat these foods sparingly because they’re dense in calories. But they’re also very filing.”

Refined carbohydrates, on the other hand—like those found in white bread, cookies, crackers, and breakfast cereals—raise your blood’s level of the hormone insulin, which signals to your body that it needs to store fat cells. Also referred to as high-glycemic foods, these refined carbs pass through your digestive system quickly—which is why you can eat a whole bag of potato chips and feel hungry 15 minutes later, Ludwig says.

Dr. Richard Feinman, a professor of cell biology at the State University of New York Downstate Medical Center, compares insulin to a faucet handle. The more your blood’s amount of the hormone rises, the more the faucet opens and the more fat your body stores.

Feinman has looked at calories from the perspective of thermodynamics—or the laws that govern heat and energy. Like Ludwig, he says the idea that calories from different macronutrient sources would have the same effect on your body is silly. Put simply, it doesn’t make sense that “a calorie is a calorie” because your body uses the energy from different foods in a variety of ways, Feinman explains.

The big lesson here is that people need to look at food as not just a collection of calories, experts say. By cutting out refined carbs and eating more protein and healthy fats, which help you stay full without triggering the storage of fat cells, “You can work with, as opposed to against, your body’s internal weight-control systems,” he says. “That will make weight loss more natural and easy.”

The best part: You can put away the calculator. No more calories counting.

TIME Research

In 2025, Everyone Will Get DNA Mapped At Birth

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What will the future hold? REB Images—Getty Images/Blend Images

Scientists have scoured trends in research grants, patents and more to come up with these 10 innovations that will be reality in 10 years (or so they think)

Everybody likes to blue-sky it when it comes to technology. Driverless cars! Fat-burning pills! Telepathic butlers! But the folks at Thomson Reuters Intellectual Property & Science do it for a living—and they do it with data.

By examining who’s investing in what, who’s researching what and who’s patenting what, the group has come up with 10 predictions of innovation for 2025, which they presented at the Aspen Ideas Festival. The list included the first attempts at testing teleportation, the ubiquity of biodegradable packaging and electric air transportation.

Here’s what they say will be commonplace in medicine in a decade:

1. Dementia will be on the decline

While the World Health Organization predicts that more than 70 million people will be affected by dementia, much of it related to Alzheimer’s disease, by 2025, that upward trajectory of cases may be blunted somewhat by advances in genetics that will lead to earlier detection and possible treatment of the degenerative brain disorder.

2. We’ll be able to prevent type 1 diabetes

Unlike type 2 diabetes, which generally develops when the body gradually loses its ability to break down sugar properly, type 1 diabetics can’t produce enough insulin, the hormone that dispatches sugar from the diet. Advances in genetic engineering will lead to a more reliable technique for “fixing” genetic aberrations that contribute to type 1 diabetes as well as other metabolic disorders, making it possible to cure these conditions.

3. We will have less toxic cancer treatments

Building on the promise of targeted cancer therapies, which more precisely hone in on tumor cells while leaving healthy cells alone, researchers will have a deeper knowledge of the Achilles’ heels of cancer cells, which will help them to develop more powerful and precise drugs that can dispatch tumors with fewer side effects.

4. Every baby will get its DNA mapped at birth

It’s already a trendy thing to have your genome sequenced, but today there isn’t much you can do with the information. Having that information, however, may prove useful in the near future, both for predicting your risk of developing diseases as well as your ability to respond (or not) to certain drugs. As knowledge about the genome, and what various genes, or versions of genes do, grows, so will doctors’ ability to predict health outcomes and treat patients based on genetic information. So within a decade, getting a baseline DNA map at birth could be a valuable way of preparing to lead a healthier and possibly longer life.

TIME diabetes

Here Is the Deal With the Bionic Pancreas

The bionic pancreas consists of a smartphone, top, hardwired to a continuous glucose monitor and two pumps, bottom, that pumps deliver doses of insulin or glucagon every five minutes.
The bionic pancreas consists of a smartphone, top, hardwired to a continuous glucose monitor and two pumps, bottom, that pumps deliver doses of insulin or glucagon every five minutes. Boston University Department of Biomedical Engineering/AP

Boston researchers test a device that could make diabetes treatment easier

Managing type 1 diabetes is an all-day, time-intensive commitment, and scientists are hard at work trying to create one device to take the guesswork—and the hard work—out of keeping blood sugar stable in people with the disease. Now, they’re one step closer, thank to Boston researchers reporting promising results in a recent study.

Researchers at Massachusetts General Hospital and Boston University created a bionic pancreas that automatically measures blood sugar and releases insulin when needed. Here’s how it works. Patients have a sensor that’s implemented under their skin and measures blood sugar in their tissue. The sensor provides that information to an iPhone app, which calculates the amount of insulin needed every five minutes, and that insulin is provided from a pump. Instead of calculating and manually inputting every carb in a meals, the device wearers simply indicate whether their meal size was “typical,” “more than usual,” “less than typical,” or “a small bite” and whether the meal type as “breakfast,” “lunch,” or “dinner.”

The researchers tested the device on two different groups—20 adults and 32 adolescents. The adults wore the implanted pumps for five days and stayed in a hotel room where they could be monitored. They were told to eat and behave however they wanted, with certain limitations on things like alcohol. The adolescents had a similar setup, but they were at a summer camp instead of a hotel. In addition to the bionic pancreas, researchers also monitored the participants’ blood sugar with finger pricks to be sure their blood-sugar levels were being accurately recorded. The results, published in the New England Journal of Medicine, show that the participants had healthier blood sugar when they used the bionic pancreas compared to when they used their standard treatment method.

A diabetic’s pancreas produces very little or no insulin, which is a hormone needed to regulate the body’s blood sugar. That means diabetics have to regulate their blood sugar themselves. For many, this requires pricking themselves throughout the day, then reading their blood sugar levels and determining how much insulin they need to inject. Many diabetics will choose to use an insulin pump, worn outside the body with a catheter attached to an insulin reservoir. The pumps automatically inject insulin into the body, and when diabetics eat, they program the pump with the amount of carbohydrates they’re consuming and their current blood sugar.

The bionic pancreas takes the pump a step further.

The findings are promising, but we are still a far ways off before the bionic pancreas becomes a clinical reality. For one, the study had a relatively small sample size and lasted only five days. What many are hopeful for, is a truly “bionic” and implantable pancreas that could fulfill the role of a functional organ. That’s still a ways off too, but stem cell research is pushing that technology along.

The bionic pancreas doesn’t bring us closer to a cure, but anything that makes this chronic disease easier to manage is a step in the right direction.

TIME Aging

7 Medical Tests Every Man Needs

Medical patient and doctor
Lee Edwards—Getty Images/Caiaimage

Admit it, guys: You don’t even like going to the doctor when there’s something wrong, let alone for preventative check-ups. But being proactive about your health—by getting recommended screenings for serious conditions and diseases—could mean you’ll spend less time at the doctor’s office down the road.

Depending on age, family history, and lifestyle factors, people need different tests at different times in their lives. Here’s a good overview for all men to keep in mind.

Diabetes

You may never need a screening for diabetes if you maintain a healthy weight and have no other risk factors for the disease (such as high cholesterol or high blood pressure). But for most men over 45—especially overweight men—a fasting plasma glucose test, or an A1C test, is a good idea, says Kevin Polsley, MD, assistant professor of internal medicine at Loyola University Health System in Chicago.

The U.S. Department of Health and Human Services also recommends diabetes screenings for overweight adults younger than 45 who have a family history of the disease, or who are of African American, Asian American, Latino, Native American, or Pacific Islander descent.

Fasting plasma glucose and A1C are both blood tests that should be done in your doctor’s office. The A1C test does not require fasting beforehand, but if your doctor wants to test you using fasting plasma glucose, you will be asked not to eat or drink anything but water for eight hours beforehand.

Health.com: Could You Have Type 2? 10 Diabetes Symptoms

Sexually Transmitted Infections

Even if you’ve been in a monogamous relationship for years, it’s not a bad idea to get tested if you haven’t already done so. Many common sexually transmitted infections can go undiagnosed for years. For example, people can go as long as 10 years without showing symptoms of HIV. The U.S. Preventive Services Task Force recommends that everyone ages 15 to 65 be screened for HIV at least once. This is especially important, Dr. Polsley says, if you have had unprotected sex, used injected drugs, or had a blood transfusion between 1978 and 1985.

In addition, the Centers for Disease Control and Prevention recommends a one-time hepatitis C screening for all adults born between 1945 and 1965, regardless of risk factors. “Believe it or not, there’s a lot of hepatitis C cases out there in which people either don’t have symptoms yet or don’t know what’s causing their symptoms,” says Dr. Polsley. “Screening for STIs is something I offer as routine at just about every physical, regardless of a patient’s age or health history.”

Health.com: Best and Worst Foods for Sex

Body Mass Index

You don’t need to make an appointment to figure out your body mass index, a measure of body fat based on your height and weight. Regardless of whether you calculate this stat yourself or your physician does the math for you, it’s important to be aware of this number, says Dr. Polsley.

A BMI between 18.5 and 24.9 is considered normal weight. Although this calculation isn’t perfect—and can sometimes label healthy people as overweight or vice versa—most doctors agree that it’s still an important component of assessing overall health. “It can be a very good opportunity to discuss diet and exercise, and to show our patients how important these things are,” Dr. Polsley says.

Health.com: 11 Reasons Why You’re Not Losing Belly Fat

Cholesterol

The American Heart Association recommends men have their cholesterol levels tested every four to six years once they turn 20. “Men have an overall higher risk for cardiovascular disease than women, and high cholesterol is often a big part of that,” Dr. Polsley says. But your doctor may want to screen you earlier (and more often) if you have heart disease risk factors such as diabetes, tobacco use, or high blood pressure.

Cholesterol is measured by a blood test, and your doctor may ask you not to eat for 9 to 12 hours beforehand. Generally, a cholesterol test will measure your levels of total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol, and triglycerides. Depending on your results, your doctor may make dietary recommendations or prescribe a cholesterol-lowering medication like a statin.

Blood pressure

Like high cholesterol, high blood pressure is often a symptomless condition—but luckily, the test for hypertension is quick and painless, involving a rubber cuff that squeezes the arm and measures the flow of blood through a large artery in the bicep. “You should have your blood pressure checked pretty much every time you see your doctor,” says Dr. Polsley, starting at age 18.

Don’t get to the doc often? Have it checked at least every two years, or yearly if your numbers were previously considered borderline (a top “systolic” number above 120 or bottom “diastolic” number higher than 80).

You can check your blood pressure at health fairs, in pharmacies, or at home with a monitoring device. If your systolic pressure cracks 130 or your diastolic goes over 85, your doctor may recommend lifestyle modifications—like exercising more and eating less salt—or they might prescribe medication.

Health.com: 31 Fat-Burning Recipes

Colonoscopy

Most men should be screened for colon cancer beginning at age 50, but those with a family history of the disease may benefit from earlier testing. Men and women alike tend to dread this test—in which a small camera is inserted into the anus and explores the large intestine for polyps or other signs of cancer—but Dr. Polsley says it’s not as bad as it sounds.

“The preparation for the test is actually the worst part,” he says: You’ll need to empty your bowls completely before the exam, which may involve not eating solid foods for one to three days, drinking lots of clear liquids, or taking laxatives. “The actual colonoscopy shouldn’t be too uncomfortable, because you’re sedated through the whole thing.”

But here’s the bright side: If your doctor doesn’t find anything suspicious, you won’t need another colonoscopy for up to 10 years.

Prostate exam

Screening for prostate cancer is more controversial than for other cancers, says Dr. Polsley, and some studies have shown that these tests can be expensive and unnecessary, and may do more harm than good. But he suggests that all men over 50 at least talk with their doctors about the pros and cons of these tests—usually either a digital rectal exam (in which the doctor inserts a gloved finger, or digit, into the rectum to feel for lumps and abnormalities) and a PSA test, which measures a protein called prostate-specific antigen in the blood.

Prostate cancer screenings can and do save lives, but they may also result in false-positive or false-negative results. And because many cases of prostate cancer progress very slowly, some men (especially older men) don’t benefit from aggressive treatment. Whether you decide to get screened for prostate cancer should be a decision you make with your doctor, says Dr. Polsley. In the meantime, it’s important to know the symptoms of an enlarged prostate—like having to urinate frequently or having trouble urinating—which could also signal cancer.

This article originally appeared on Health.com.

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