Intermittent energy restriction, time-restricted eating and continuous energy restriction can all improve blood sugar levels and body weight in people with obesity and type 2 diabetes, according to a study being presented Sunday at ENDO 2025, the Endocrine Society’s annual meeting in San Francisco, Calif.
“This study is the first to compare the effects of three different dietary interventions intermittent energy restriction (IER), time-restricted eating (TRE) and continuous energy restriction (CER) in managing type 2 diabetes with obesity,” said Haohao Zhang, PhD, chief physician at The First Affiliated Hospital of Zhengzhou University in Zhengzhou, China.
Although researchers identified improved HbA1c levels, and adverse events were similar across the three groups, the IER group showed greater advantages in reducing fasting blood glucose, improving insulin sensitivity, lowering triglycerides, and strengthening adherence to the dietary interventions.
“The research fills a gap in directly comparing 5:2 intermittent energy restriction with a 10-hour time-restricted eating in patients with obesity and type 2 diabetes. The findings provide scientific evidence for clinicians to choose appropriate dietary strategies when treating such patients,” Zhang says.
Zhang and colleagues performed a single-centre, randomised, parallel-controlled trial at the First Affiliated Hospital of Zhengzhou University from November 19, 2021 to November 7, 2024.
Ninety patients were randomly assigned in a 1:1:1 ratio to the IER, TRE or CER group, with consistent weekly caloric intake across all groups. A team of nutritionists supervised the 16-week intervention.
Of those enrolled, 63 completed the study. There were 18 females and 45 males, with an average age of 36.8 years, a mean diabetes duration of 1.5 years, a baseline BMI of 31.7kg/m², and an HbA1c of 7.42%.
At the end of the study, there were no significant differences in HbA1c reduction and weight loss between the IER, TRE and CER groups. However, the absolute decrease in HbA1c and body weight was greatest in the IER group.
Compared to TRE and CER, IER significantly reduced fasting blood glucose and triglycerides and increased the Matsuda index, a measure of whole-body insulin sensitivity. Uric acid and liver enzyme levels exhibited no statistically significant changes from baseline in any study group.
Two patients in the IER group and the TRE group, and three patients in the CER group, experienced mild hypoglycemia.
The IER group had the highest adherence rate (85%), followed by the CER group at 84% and the TRE group at 78%. Both the IER and CER groups showed statistically significant differences compared with the TRE group.
Zhang said these findings highlight the feasibility and effectiveness of dietary interventions for people who have obesity and type 2 diabetes.
New University of Colorado Boulder research shows the popular sugar substitute erythritol comes with serious downsides, impacting brain cells in numerous ways that can boost the risk of stroke. The study was published in the Journal of Applied Physiology.
“Our study adds to the evidence suggesting that non-nutritive sweeteners that have generally been purported to be safe, may not come without negative health consequences,” said senior author Christopher DeSouza, professor of integrative physiology and director of the Integrative Vascular Biology Lab.
First approved by the Food and Drug Administration in 2001, erythritol is a sugar alcohol, often produced by fermenting corn, and found in hundreds of products made by various brands. It has almost no calories, is about 80% as sweet as table sugar, and has a negligible impact on insulin levels, making it a favourite for people trying to lose weight, keep their blood sugar in check or avoid carbohydrates.
But recent research has begun to shed light on its risks.
One recent Cleveland Clinic study involving 4000 people in the US and Europe found that men and women with higher circulating levels of erythritol were significantly more likely to have a heart attack or stroke within the next three years.
DeSouza and first author Auburn Berry, a graduate student in his lab, set out to understand what might be driving that increased risk.
To test impacts of erythritol on cells, researchers in the lab treated human cerebral microvascular endothelial cells (hCMECs) for three hours with about the same amount of erythritol contained in a typical sugar-free beverage.
They observed that the treated cCMEVs were altered in numerous ways:
They expressed significantly less nitric oxide, a molecule that relaxes and widens blood vessels, and more endothelin-1, a protein that constricts blood vessels. Meanwhile, when challenged with thrombin, cellular production of the natural clot-busting compound t-PA was “markedly blunted.” The erythritol-treated cells also produced more reactive oxygen species (ROS), aka “free radicals,” metabolic byproducts which can age and damage cells and inflame tissue.
Previous research has shown that as little as 30g of erythritol (about as much as you’d find in 600mL of sugar-free ice cream) can also cause platelets to clump together, potentially forming clots.
“Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up,” said Berry. “Our research demonstrates not only that, but how erythritol has the potential to increase stroke risk.”
DeSouza notes that their study used only a serving-size worth of the sugar substitute. For those who consume multiple servings per day, the impact, presumably, could be worse.
The authors caution that their study was a laboratory study, conducted on cells, and larger studies in people are now needed.
That said, De Souza encourages consumers to read labels, looking for erythritol or “sugar alcohol” on the label.
“Given the epidemiological study that inspired our work, and now our cellular findings, we believe it would be prudent for people to monitor their consumption of non-nutrient-sweeteners such as this one,” he said.
Researchers found the respiratory syncytial virus (RSV) vaccine, introduced across the UK in late summer 2024, led to a 72% reduction in babies hospitalised with the virus if the pregnant parent was vaccinated.
The findings, published in The Lancet Child and Adolescent Health, are the first to show the real-world effectiveness of the vaccine during pregnancy in the UK.
Uptake of the jab among those who are pregnant could help to limit the number of sick babies each winter, reducing hospital pressures, experts say.
Virus protection
RSV is a common virus that causes coughs and colds but can lead to a severe lung infection called bronchiolitis, which can be dangerous in babies, with some requiring admission to intensive care. The virus is the main infectious cause of hospitalisation for babies in the UK and globally.
Receiving the vaccine during pregnancy helps to protect both parent and baby. Antibodies produced by the parent in response to the vaccine are passed to the foetus, providing protection from severe RSV for the first six months after birth.
Hospital admissions
The research team, led by the Universities of Edinburgh and Leicester, recruited 537 babies across England and Scotland who had been admitted to hospital with severe respiratory disease in the winter of 2024-2025, the first season of vaccine implementation. 391 of the babies tested positive for RSV.
Parents of babies who did not have RSV were two times more likely to have received the vaccine before delivery than the parents of RSV-positive babies – 41% compared with 19%.
Vaccinate early
Receiving the vaccine more than 14 days before delivery offered a higher protective effect, with a 72% reduction in hospital admissions compared with 58% for infants whose pregnant parent was vaccinated at any time before delivery.
Experts recommend getting vaccinated as soon as possible from 28 weeks of pregnancy to provide the best protection, as this allows more time for the parent to generate and pass on protective antibodies to the baby, but the jab can be given up to birth.
With the availability of an effective RSV vaccine shown to significantly reduce the risk of hospitalisation in young infants in the UK, there is an excellent opportunity for pregnant women to get vaccinated and protect themselves and their infants from RSV bronchiolitis this coming winter.
Dr Thomas Williams, Institute for Regeneration and Repair, Paediatric Consultant at the Royal Hospital for Children and Young People
Improve uptake
Previous research has found that only half of expectant parents in England and Scotland are currently receiving the RSV vaccine, despite its high success at preventing serious illness.
The findings highlight the importance of raising awareness of the availability and effectiveness of the new vaccine to help protect babies, experts say.
By Dhevarsha Ramjettan, Partner, Nivaani Moodley, Associate Director and Kanyiso Kezile, Trainee Attorney from Webber Wentzel
The Department of Employment and Labour (the Department) has ushered in a decisive moment for transformation in South Africa’s human health and social work activities sector (the health sector). With the publication of the national economic sectors and sectoral numerical targets, now in effect as of 15 April 2024, employers in this sector face new legal and ethical responsibilities to accelerate transformation and inclusion across all occupational levels.
In line with section 15A (2) of the Employment Equity Act, 1998 (EEA), numerical targets have been introduced to promote the equitable representation of suitably qualified individuals from designated groups across all occupational levels. For a sector so deeply connected to the nation’s wellbeing, the implementation of sector-specific employment equity targets marks more than just regulatory change; it signals a foundational shift toward greater inclusion and accountability. The health sector, as classified by the Department, encompasses three key sub-sectors: human health activities, residential care activities, and social work activities without accommodation. Each plays a vital role in delivering healthcare and social support services across South Africa.
The newly gazetted targets place designated groups, namely black people, women, and persons with disabilities, at the centre of a new equity framework. Designated groups are defined as citizens of the Republic of South Africa by birth or descent, or those who became citizens by naturalisation. Designated employers in this sector are now legally required to integrate clearly defined sector-specific numerical targets into their Employment Equity Plans (EEPs), with accountability measures to track progress and enforce compliance.
What are the targets for the health sector?
The targets are as follows:
Occupational Level
Target % (Designated Groups)
Male (%)
Female (%)
Top Management
71.3%
27.6%
43.7%
Senior Management
85.9%
39.8%
46.1%
Professionally Qualified & Middle Management
95.9%
49.8%
46.1%
Skilled Technical Workers
95.9%
49.8%
46.1%
All Levels (Disability Inclusion)
Minimum 3%
–
–
As illustrated above, the targets are set for the top four occupational levels. Employers may elect to use either national or regional Economically Active Population (EAP) data, depending on the geographic spread of their operations, as a benchmark when setting their numerical targets.
These targets are legally binding, not aspirational. Designated employers must actively report progress towards these thresholds in their annual submissions to the Department. Failure to meet or demonstrate sustained progress may result in increased scrutiny, the withholding of employment equity compliance certificates, and disqualification from doing business with the State. These figures therefore provide a compliance yardstick for designated employers.
Key implications for health sector designated employers
Designated employers must update their EEPs to reflect the numerical targets applicable to their workforce size and sector classification. These targets are legally binding and will inform compliance assessments and the issuing of compliance certificates, without which employers may be barred from doing business with the State.
All designated employers in the health sector are required to prepare and implement EEPs for the period 1 September 2025 to 31 August 2030. This plan must outline the employer’s strategy to achieve equitable representation across occupational levels, in line with the newly introduced sectoral targets.
Employers who become designated after 1 April 2025 will still be required to develop an EEP that covers the remainder of the five-year cycle, up to 31 August 2030. In drafting these plans, employers must refer to the relevant Codes of Good Practice issued under section 54 of the EEA.
The 3% disability target is a mandatory sector-wide requirement. Given the health sector’s role in driving inclusive care, employers are now expected to model disability-friendly workplaces and proactively recruit and retain persons with disabilities.
What should employers in the health sector do now?
Employers in the health sector should act swiftly to align with the new sectoral targets by reviewing and updating their existing EEPs. This includes conducting workforce audits to identify representation gaps and barriers that hinder the attainment of an equitable, non-discriminatory workplace.
Meaningful engagement with Employment Equity Committees is essential to developing practical implementation strategies. Employers should also invest in targeted skills development, retention, and succession programmes that support the advancement of designated groups in both clinical and administrative roles.
Finally, senior leadership must be equipped with the necessary training and held accountable for driving and sustaining transformation across all levels of the organisation. Transformation within the health sector is not just about meeting targets, it is about building a more inclusive and responsive health system. Employers must lead decisively and ensure that their employment practices reflect both the spirit and the letter of the law. Employers should conduct a thorough analysis of their workforce, policies, and procedures to identify and address any barriers to employment equity compliance.
The demands placed on South African frail care and retirement villages are tougher than ever. These establishments must consistently provide high-quality care, while addressing persistent staffing issues and adapting to an increasingly complex regulatory environment.
The limitations of traditional care models heavily reliant on individually employed caregivers can no longer be ignored. In response, a strategic shift towards collaborating with experienced healthcare professional service agencies is gaining momentum, providing a welcome pathway for facilities to greatly enhance care provision, optimise operational workflows, and mitigate potential liabilities.
Addressing the shortcomings of traditional models
Modern senior care facilities face growing challenges that necessitate efficient resource management. Rising operating costs, stricter regulatory demands, and persistent staffing shortages (particularly for specialised roles) create significant operational burdens. To maintain high standards of care and ensure resident well-being, facilities must adopt innovative solutions that address both operational and care-related needs.
Exceptional care can only be built on in personalised attention, and outsourcing allows facilities to raise their care standards by accessing a pool of highly trained and compliant caregivers in collaboration with a reputable healthcare professional staffing services provider. The right agency partner makes it possible for facilities to prioritise personalised care, ensuring each resident receives the attention required for the best outcomes.
Putting personalised care at the top of the quality scale
Caregiving agencies have an important role to play in implementing robust care plans in collaboration with doctors. By placing caregivers that work under the instructions of the facility’s matron or registered nurse, agencies assume responsibility for ensuring care plans are followed diligently, while clinical facilitators provide continuous training that ensures caregivers are competent and confident in their roles. Such a collaborative approach greatly enhances resident wellbeing and safety. With the expertise of such specialist agencies, retirement villages and frail care facilities can be assured that consistent, high-quality care will be delivered, a critical factor in building trust with residents and their families.
Ensuring competency, continuity of care and flexibility
Traditional work models, where facilities directly recruit and employ caregivers, often struggle with operational logistics in continuity of care and training. Here, staffing shortages due to unforeseen absences can greatly disrupt daily routines. In contrast, partnering with a staffing solutions organisation provides access to a reliable pool of caregivers on-demand.
A professional agency partner handles all scheduling requirements, while ensuring extra caregivers are oriented to the facility. This enables quick replacements (often within two hours) to minimise disruptions and maintain consistent care, while such flexibility also gives the facility the room to scale up or down on caregiving resources in direct response to the changing needs of residents without significant cost.
Critically, a key benefit of partnering with a staffing provider is the comprehensive administrative relief they offer. Agencies manage the entire recruitment process, onboarding, payroll, and continuous training, freeing facilities from these burdens. Here, the agency steps in to simplify processes and mitigate risk by handling everything from start to finish, with thorough criminal and reference checks to minimise security risks and comprehensive recruitment processes that ensure caregivers are proficient in English and possess the necessary skills and attributes for the job.
Outsourcing to continually enhance personalised care standards
One of the most compelling advantages to partnering with a staffing services agency is the fact that the facility has guaranteed access to pre-screened, trained, and compliant caregivers who have been through a rigorous upskilling course to ensure they are well-prepared for the frail care environment. The right staffing partner takes time to understand each facility’s unique needs and matches caregivers accordingly, with business unit managers actively participating in the selection process to ensure the perfect fit.
Equipped with comprehensive training on essential skills, including dementia care, palliative care and rehabilitation, these caregivers can address the specific needs of residents with confidence and compassion. Their specialised training relieves pressure on facilities and ensures residents receive appropriate care, which enhances family satisfaction.
The right partner also employs clinical facilitators designated to provide on-site training and support, so that the facility is assured caregivers are up to date with the latest care practices and technologies to continuously enhance the overall quality of care. Facilities benefit from collaborative training opportunities, further upskilling their own staff at no additional cost. Significantly, these specialised care services can supplement the core offerings of the facility to better meet the diverse needs of residents, attract a broader clientele and strengthen their market position.
An essential shift toward high-quality care
For the future of senior care, strategic partnerships with healthcare staffing providers are no longer optional, but essential. These collaborations ensure the long-term success of retirement villages and frail care facilities by optimising staffing, enhancing care, and mitigating risks. They are the foundation for delivering exceptional resident experiences and building a culture of safety and trust. These partnerships will allow facilities to meet the demands of today, while building a forward-thinking model for the dignified and compassionate senior care of tomorrow.
