'Health vs Hype' by Shashi Agarwal, MD

Retired physician. FACC, FCCP, FACP. in past. Authored many posters, manuscripts, & health books. Reviewer. Information does not replace personal doc's advice.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Rain Water Storage: Safe? (3 of 3)
The researchers also found small numbers of (metal) tanks contained levels of cadmium, lead, arsenic, & manganese above Australian health-based drinking water guidelines. (J of Environmental Management 2026)

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Rain Water Storage: Safe? (2 of 3)
A study found Campylobacter in 13% of tanks, Salmonella in 10%, Shigella in 3% (all linked to gastroenteritis) and P. aeruginosa in 12%. Most households surveyed (67%) in Australia used tank water for drinking & cooking.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Rain Water Storage: Safe? (1 of 3)
Rainwater appears clean. Storage tanks are a popular way for many people to save this water, but they can harbor potentially harmful bacteria (linked to gastroenteritis & other infections). Leached metals can also pose health concerns.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Once-Weekly Basal Insulin (3 of 3)
Efsitora has an overall safety profile similar to the daily basal insulins. The most common adverse reactions include hypoglycemia, hypersensitivity reactions, injection site reactions, lipodystrophy, pruritus, rash, edema, & weight gain.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Once-Weekly Basal Insulin (2 of 3)
Efsitora delivers steady basal insulin levels over 7 days - among patients using and not using GLP-1 receptor agonists. It is not approved for pediatric patients or individuals with type 1 diabetes due to a higher risk of severe hypoglycemia.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Once-Weekly Basal Insulin (1 of 3)
The FDA approved the once-weekly basal insulin efsitora (Onswik) - indicated as an adjunct to diet and exercise for adults with type 2 diabetes. This is the second once-weekly basal insulin for this population.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Fasting & Blood Testing (3 of 3)
Most routine laboratory tests are minimally affected by fasting duration. It is suggested that specific rather than uniform fasting requirements be ordered. Adequate fasting should be reserved for a few tests only. (JAMA Intern Med 2026)

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Fasting & Blood Testing (2 of 3)
In a recent study (9,755,547 test results from 101,148 patients across 372 test items, median age 61 years, & 43% women) - prolonged fasting >12 hours confers no measurable advantage for any results. (JAMA Intern Med 2026)

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Fasting & Blood Testing (1 of 3)
Fasting - the time between the last meal & blood collection. A recent study indicates that most tests are minimally affected by <8 hours of fasting duration - only glucose, triglyc., lipase & liver GGT were abnormal with a shorter fast.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Ultraprocessed Food & Depression (3 of 3)
Ultraprocessed foods include sodas, chips, mass-produced breads, frozen ready-to-heat meals, instant noodles, hot dogs, & commercial breakfast cereals. Regular consumption increases the risk of type 2 diabetes, CVD, & many cancers.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Ultraprocessed Food & Depression (2 of 3)
Ultraprocedded foods exhibit improved taste, appearance, & shelf life. They typically contain: high-fructose corn syrup, hydrogenated oils, modified starches, artificial colors, flavors, & emulsifiers.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Ultraprocessed Food & Depression (1 of 3)
An increased consumption of ultraprocessed food (UPF) = an increased risk of developing depression (in a dose-response manner). People have less depression & anxiety after cutting their UPF intake by >85%. (JAMA Psychiatry 2026)

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Risky Cosmetic Procedure - Gel Manicure (3 of 3)
The ultraviolet-emitting nail polish dryers, often employed in gel manicures, may cause DNA damage - increasing the risk of cancer. To lessen this effect, apply broad-spectrum sunscreen on the hands or wear dark, opaque gloves.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Risky Cosmetic Procedure - Gel Manicure (2 of 3)
Gel manicures may result in brittleness, peeling, and cracking. The curing process in gel manicures exposes the hands/fingers to UV rays, elevating the chances of skin cancer & hastening skin aging on the hands.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Risky Cosmetic Procedure - Gel Manicure (1 of 3)
There are several unlicensed and inadequately trained individuals providing non-surgical cosmetic procedures - these procedures include microblading, phenol peel, eyelash extensions, tanning beds, & gel manicures.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Ozempic Tongue (3 of 3)
A change in taste can occur as early as 2 weeks after starting semaglutide therapy and affects up to 6% of patients. People should therefore consume foods with varied flavors and textures to compensate for any changes related to taste. (ENDO 2024)

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Ozempic Tongue (2 of 3)
Semaglutide medications like Ozempic increase sensitivity to sweet flavors. Some people taking Ozempic report that sweet foods taste metallic, sour, or bitter & are less palatable. This discourages eating those types of foods.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Ozempic Tongue (1 of 3)
Ozempic can cause halitosis, dry mouth, and dysguesia, & also a sweet taste in the mouth, which is being dubbed as 'Ozempic tongue'. Obese people may crave sugary foods due to high leptin levels - they have a reduced intensity of sweet taste.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Cancer Blood Test (1 of 3)
FDA advisory panel has endorsed Galleri blood test, which detects signs of various cancers in healthy people. It does not replace standard screenings like mammograms, colonoscopies, or pap smears. It is not covered by health insuran. & costs about $950.

['Health vs Hype' by Shashi Agarwal, MD @usacardiologist]

Cancer Blood Test (3 of 3)
The goal of the cancer detection blood test is to diagnose tumors sooner. For many cancers, 5-year relative survival can exceed 90% when diagnosed at the early Stage I — but falls below 10% when diagnosed at the late Stage IV.