I am a cardiology researcher, and my team and I uncovered key mechanisms contributing to the harmful effects of obesity on heart function. Targeting these processes may offer new avenues for treatment.
How obesity stresses the heart
Obesity is far more than a weight issue – it fundamentally alters the body’s biochemistry. This in turn changes your metabolism, or the chemical reactions that allow the body to function.
In particular, the increased presence of fatty acids, a hallmark of obesity, puts additional strain on heart cells. Fatty acids can directly damage heart cells by triggering the increased production of reactive oxygen species – specific molecules that can damage tissues and disrupt normal cellular functions. These effects result in a disruption of the heart’s electrical signals, leading to irregular beating.
When antioxidants aren’t able to keep harmful reactive oxygen species in check, the imbalance leads to more stress on the body.
One major source of reactive oxygen species is NOX2, an enzyme that becomes more active in people with obesity. NOX2 influences the activity of several key proteins that regulate the heart’s rhythm. It also contributes to oxidative stress in the atria – the heart’s upper chambers – altering their size, shape and function. This cardiac remodeling is a key driver of irregular heart rhythms.
A 2-pronged approach
My team and I set out to better understand how NOX2 affects the heart, and whether targeting it could reduce the risk of developing irregular heart rhythms among people living with obesity.
We approached this problem from two directions.
First, we used mice fed a high-fat diet to induce obesity similar to that in people. One group of these mice were able to produce functional NOX2 while another group could not. We tested drugs that specifically inhibit NOX2 and checked how likely the upper chambers of the heart were to develop irregular electrical rhythms.
In parallel, we generated human atrial heart cells from stem cells and treated them with fatty acids to simulate the effects of obesity. While our mouse model would capture the effects of obesity in the body as a whole, our cell model would enable us to study how it affects the heart at the cellular level.
We observed that increased NOX2 activity in both obese mice and treated human heart cells led to significant changes in the heart’s electrical properties. Obese mice without NOX2 had less severe atrial fibrillation than obese mice with NOX2. Similarly, obese mice treated with NOX2 inhibitors also showed improvements in the severity of their irregular heart rhythms, though to a lesser extent. And blocking NOX2 in heart cells exposed to fatty acids reversed the cellular changes caused by fatty acid treatment.
In both mice and human heart cells, inhibiting NOX2 reduced oxidative stress and normalized the heart’s electrical activity. This finding suggests that NOX2 plays a key role in the development of obesity-induced irregular heart rhythms.
Notably, we found that NOX2 plays a significant role in increasing the activity of a gene called PITX2, which is linked to changes in the heart’s electrical function. Our data showed that PITX2 activity was amplified in both obese mice and human heart cells, but reducing NOX2 activity directly lowered PITX2 levels. These findings suggest that oxidative stress and genetic factors play a role in the development of irregular heart rhythms.
Treating atrial fibrillation
Current treatments for atrial fibrillation, particularly for patients living with obesity, have focused more on managing symptoms than addressing the physiological changes that cause it.
Though far from reaching the clinic, our research suggests that targeting NOX2 could offer a new treatment strategy to prevent or reduce the severity of irregular heart rhythms. A further understanding of the genetic pathways involved in atrial fibrillation, such as PITX2, may lead to more personalized treatments in the future.
By delving into the molecular mechanisms behind irregular heart rhythms, researchers can develop more targeted approaches that address the root causes and improve outcomes for patients struggling with both obesity and heart conditions.
But another threat remains less recognized: This collapse could pose a threat to the stability of financial markets well beyond the scope of the fires.
It’s been widely accepted for more than a decade that humanity has three choices when it comes to responding to climate risks: adapt, abate or suffer. As an expert in economics and the environment, I know that some degree of suffering is inevitable — after all, humans have already raised the average global temperature by 1.6 degrees Celsius, or 2.9 degrees Fahrenheit. That’s why it’s so important to have functioning insurance markets.
While insurance companies are often cast as villains, when the system works well, insurers play an important role in improving social welfare. When an insurer sets premiums that accurately reflect and communicate risk — what economists call “actuarially fair insurance” — that helps people share risk efficiently, leaving every individual safer and society better off.
But the scale and intensity of the Southern California fires — linked in part to climate change, including record-high global temperatures in 2023 and again in 2024 — has brought a big problem into focus: In a world impacted by increasing climate risk, traditional insurance models no longer apply.
How climate change broke insurance
Historically, the insurance system has worked by relying on experts who study records of past events to estimate how likely it is that a covered event might happen. They then use this information to determine how much to charge a given policyholder. This is called “pricing the risk.”
Many California wildfire survivors face insurance struggles, as this ABC News report shows.
When Americans try to borrow money to buy a home, they expect that mortgage lenders will make them purchase and maintain a certain level of homeowners insurance coverage, even if they chose to self-insure against unlikely additional losses. But thanks to climate change, risks are increasingly difficult to measure, and costs are increasingly catastrophic. It seems clear to me that a new paradigm is needed.
California provided the beginnings of such a paradigm with its Fair Access to Insurance program, known as FAIR. When it was created in 1968, its authors expected that it would provide insurance coverage for the few owners who were unable to get normal policies because they faced special risks from exposure to unusual weather and local climates.
But the program’s coverage is capped at US$500,000 per property – well below the losses that thousands of Los Angeles residents are experiencing right now. Total losses from the wildfires’ first week alone are estimated to exceed $250 billion.
How insurance could break the economy
This state of affairs isn’t just dangerous for homeowners and communities — it could create widespread financial instability. And it’s not just me making this point. For the past several years, central bankers at home and abroad have raised similar concerns. So let’s talk about the risks of large-scale financial contagion.
In that event, the value of opaque bundles of real estate derivatives collapsed from artificial and unsustainable highs, leaving millions of mortgages around the U.S. “underwater.” These properties were no longer valued above owners’ mortgage liabilities, so their best choice was simply to walk away from the obligation to make their monthly payments.
Forewarned by that experience, the U.S. Federal Reserve Board wrote in 2020 that “features of climate change can also increase financial system vulnerabilities.” The central bank noted that uncertainty and disagreement about climate risks can lead to sudden declines in asset values, leaving people and businesses vulnerable.
At that time, the Fed had a specific climate-based example of a not-implausible contagion in mind – global risks from sudden large increases in global sea level rise over something like 20 years. A collapse of the West Antarctic Ice Sheet could create such an event, and coastlines around the world would not have enough time to adapt.
In a 2020 press conference, Federal Reserve Chair Jerome Powell discusses climate change and financial stability.
The Fed now has another scenario to consider – one that’s not hypothetical.
We will now see if the plans borne of those stress tests can work in the face of enormous wildfires burning throughout an urban area that’s also a financial, cultural and entertainment center of the world.
theconversation.com – Vanessa Crossgrove Fry, Associate Research Faculty/Interim Director, Boise State University – 2025-01-21 07:41:00
Social Border Grill delivers food as part of World Central Kitchen relief efforts at an Eaton Fire temporary shelter in Pasadena, Calif., on Jan. 9, 2025. Kirby Lee/Getty Images
Los Angeles is reeling after fires of historic proportions raced through many communities in January 2025, destroying thousands of homes. The Conversation U.S. asked Vanessa Crossgrove Fry, an associate research professor and director of the Idaho Policy Institute at Boise State University, and an expert on sustainable management and nonprofit administration, to explain what role nonprofits can play in staving off disasters and dealing with them when and after they occur.
What’s the role of nonprofits when disasters strike?
They play a critical role by complementing government efforts and filling gaps in immediate and long-term recovery needs.
Collaboration is a hallmark of how nonprofits respond to disasters. These organizations often work alongside government agencies and private sector partners in coordinated efforts. This approach ensures that aid is distributed efficiently, directing resources where they are needed most.
Often, national groups lead efforts to establish emergency shelters, distribute food and water, and offer mental health support. In a best-case scenario, these large organizations partner with local nonprofits that are uniquely positioned to mobilize quickly, leveraging their deep understanding of community needs and established trust with residents.
In some disasters, especially large ones like the Lahaina, Hawaii, fire in 2023, nonprofits also act as coordinators. They make sure that volunteers, donations and other resources flow to people who need help.
Nonprofits’ flexibility and community-based networks enable them to respond to local challenges, such as supporting displaced families or addressing unmet needs in underserved areas. Beyond immediate relief, many nonprofits remain involved in long-term recovery efforts, assisting with rebuilding homes, restoring livelihoods and fostering community resilience.
While surrounded by food donations, Evangeline Balintona, left, and her sister Elsie Rosales, sit inside a hotel-condo after they both lost homes in Lahaina to the wildfire, Sept. 1, 2023, in Kahana, Hawaii. AP Photo/Marco Garcia
In fire-prone regions like the Los Angeles foothills, organizations often focus on educating the public, helping residents understand fire risks and creating evacuation plans. They also implement fire mitigation strategies, such as spreading awareness about the importance of clearing brush and replacing wooden roofs.
With CERT training, a local fire department might equip volunteers to prepare for the hazards they’re likely to face in their communities. That kind of exercise empowers them with essential disaster-response skills, including fire safety and light search and rescue know-how. During Sound the Alarm events, smoke detectors are installed in vulnerable communities and residents get help creating evacuation plans.
Partnerships with government agencies, private companies and other nonprofits should ideally be in place before a disaster occurs to ensure a coordinated response when the time comes.
For example, nonprofits may establish agreements about setting up emergency shelters or accessing and distributing food supplies. They also build networks to ensure vulnerable populations – such as low-income residents, people experiencing homelessness, and those with disabilities – are included in disaster planning and response efforts.
Other roles include advocating for more funding for disaster preparedness and infrastructure, like wildfire-resistant construction or community-wide firebreaks – areas of cleared vegetation.
In some cases, nonprofits may help coordinate the use of government resources. For instance, Idaho Department of Insurance Director Dean Cameron recently drafted a bill that’s pending in the Idaho Legislature that would provide funding for homeowners to make fire mitigation upgrades on their property.
Additionally, nonprofits often develop detailed contingency plans for their own operations so they can continue to deliver services during a crisis.
Through these proactive measures, nonprofits help communities prepare for the worst while fostering resilience that can temper the long-term impacts of disasters.
What does the situation in LA have in common with what happens in Idaho?
Los Angeles and Idaho might seem worlds apart, but when it comes to handling disasters like wildfires, they face surprisingly similar challenges.
Both places grapple with dry seasons, rising temperatures and increasing invasive vegetation that amplify wildfire risks. Climate change is exacerbating these conditions, making fires more frequent and intense.
In Los Angeles, urban sprawl has expanded development into fire-prone areas, known as the wildland-urban interface. Similarly, Idaho has seen increased development in the wildland-urban interface surrounding Boise – where the population is surging.
This type of growth poses significant risks to both homes and lives as seen in Idaho’s 2016 Table Rock Fire and the more recent 2024 Valley Fire.
In addition, wildfires in Idaho’s forested and rural areas put not only people and infrastructure at risk, but can impact valuable grazing land, as occurred in the 2024 Wapiti Fire.
In both regions, balancing the demand for housing with the need for fire-resilient planning and mitigation measures is a critical challenge.
Another shared concern for nonprofits in Idaho and California is ensuring that vulnerable populations receive enough support during and after disasters. In both urban and rural settings, people experiencing homelessness, low-income families, and those in remote areas may have a lot of trouble evacuating, accessing resources and rebuilding after disasters.
What are some common misconceptions about nonprofits in disasters?
Many people tend to think that nonprofits only provide immediate relief, such as food, shelter or medical care. While these services are critical in the early stages of a disaster, many nonprofits also focus on long-term recovery and rebuilding efforts.
Nonprofits may help communities rebuild homes, restore livelihoods or address emotional trauma months – or even years – after a disaster occurs.
There is also a tendency to overlook the role of local nonprofits. High-profile national organizations often command the public’s attention, but local nonprofits are often better positioned to address community-specific needs and work directly with vulnerable populations.
These misunderstandings can lead to the underfunding – and underappreciation – of local nonprofits.
Should people still donate to established organizations?
There are more ways to give to people experiencing a crisis than there used to be.
You might hesitate to donate to large nonprofits after a big disaster like the Los Angeles fires, for several reasons. Maybe you’re concerned about transparency or the group’s effectiveness. It might feel less personal to you than giving money, say, to a GoFundMe campaign.
I think that people should still consider donating to large and established organizations, but I also believe that it’s important to do so thoughtfully. Large nonprofits, such as the American Red Cross or Salvation Army, often have the infrastructure, expertise and logistical capacity to mobilize quickly and scale their operations to address disasters effectively.
These organizations also maintain established relationships with government agencies, local nonprofits and international partners. Those networks facilitate coordinated responses that smaller or newer groups might struggle to achieve.
However, the emergence of giving options, such as crowdfunding platforms, grassroots campaigns and community-based nonprofits, has expanded opportunities for individuals to direct their support to specific causes or populations. These avenues can make a big difference, particularly when donors want to address local or niche needs. Still, newer or less established groups may lack transparency or accountability.
Established organizations tend to have robust financial oversight and accountability systems in place. They are often better equipped to address not only immediate relief needs but also long-term recovery efforts, which smaller or informal groups may not have the capacity to support.
Ultimately, the choice depends on your own priorities. Do you want to support immediate relief, contribute to systemic solutions or help a specific community?
By donating to both large organizations and local efforts alike, you can maximize your impact and help ensure everyone in a community gets support. And that’s important, especially after a disaster as big as the Los Angeles wildfires.
For generations, Gatorade and similar electrolyte beverages have been helpful tools for athletes seeking a competitive edge.
In 1965, Dr. Robert Cade and a team of scientists at the University of Florida College of Medicine created Gatorade to help their football players combat heat exhaustion and muscle cramps during long practices in extreme temperatures.
The drink’s winning formula of water, sodium, potassium and sugar works effectively with the human body to keep users hydrated, refueling them with energy and optimizing muscle function.
While I don’t work for or receive funding from Gatorade, as a registered dietitian and nutrition instructor, I’ve watched how specific electrolyte beverages can be handpicked to boost hydration in hospitalized patients, student athletes and even myself.
And while Gatorade was one of the first electrolyte beverages heavily marketed to consumers, its ingredient combination has paved the way for the creation of even more sport and electrolyte beverages on the grocery store shelves today. If you’re looking to gain a specific nutritional edge from a sports drink, you can seek out a registered dietitian for an individualized plan. Otherwise, if you’ve ever wondered what makes these colorful beverages a nutrition attraction, here’s a closer look at some key ingredients.
The importance of hydration
Whether people are athletes or not, the human body is constantly losing water through normal human functions such as sweating, urinating and even breathing. When water is lost, the body also excretes key electrolytes such as potassium and sodium. These electrolytes are crucial for everything from heart function to muscle contractions.
Electrolytes get their “electro” name from having an electrical charge when dissolved in water. This charge allows them to work throughout the body in chemical reactions that maintain normal brain functioning, balance fluids inside and outside of body cells and even balance how acidic or alkaline your blood is.
Electrolytes can help you rehydrate after a workout by balancing fluids in our cells.
Major stress on the body can accelerate the dehydration process – whether it’s intentional, like running a 5K, or unintentional, like getting a nasty stomach bug. If left unchecked, dehydration can cause more serious complications, such as fainting and irregular heartbeats.
To prevent these complications, you need to replenish the fluids and electrolytes you’re losing. Stressful scenarios such as exercise and sickness are a perfect time to consider an electrolyte replacement drink.
A closer look at Gatorade’s ingredients
Water, the main ingredient in most sports drinks, hydrates you. The human body is made up of approximately 60% water, so to stay hydrated, it is important to listen to your body and drink water regularly. When the body’s water volume is decreased, it sends thirst signals to the brain.
However, these signals often lag behind your hydration status. So, once you feel thirsty, your body is likely already slightly dehydrated. For a more accurate hydration assessment, check the color of your urine. Darker yellow or golden urine? Grab some water. Pale yellow or clear urine? Keep up the good hydration.
When you have a lower blood volume, your blood vessels don’t expand as much as they normally would – ultimately lowering blood pressure. If blood pressure drops too quickly due to dehydration, you might feel dizziness, lightheadedness, nausea or weakness.
The good news is that sodium actively pulls water into the bloodstream. So during an intense workout or while dealing with a dehydrating illness, consuming a salty snack or sports beverage can help.
The potassium in Gatorade regulates muscle contractions. This electrolyte is especially critical for regulating your heartbeat, and it also aids in normal skeletal muscle contractions. If the body lacks enough potassium, painful muscle cramps or dizziness can disrupt your workout or day.
Sugar provides quick energy and nutrient absorption power. A traditional Gatorade beverage contains glucose and dextrose, which are both known as simple sugars. A simple sugar is one that the body can quickly digest and absorb, with the goal of quickly increasing blood sugar.
Strenuous aerobic exercise or strength training for longer than 60 minutes, performing activities in very hot or humid climates, or the physical strain of an unwelcome illness can all rev the body’s metabolism and quickly deplete blood glucose. When glucose levels drop, you may experience fatigue, weakness, lightheadedness, nausea or difficulty concentrating.
The nutrient combination found in Gatorade was designed with athletes in mind, but it is also sometimes discussed as a remedy to consider during an unpleasant bout of gastrointestinal illness. Diarrhea and vomiting are easy routes for electrolytes such as sodium and potassium to escape.
Energy drinks’ combination of simple sugars, water and electrolytes may be one strategy to maintain hydration during a time when food and fluids are difficult to stomach.
However, be cautious – many traditional sports drinks have a high sugar content aimed at refueling lost energy during a workout. When that same sugar content is introduced to an upset gastrointestinal tract, it can pull in extra water, leading to more diarrhea. If you find yourself in this situation, here are some other options to consider.
Opt for a lower-sugar electrolyte beverage. Beverages to consider include Pedialyte or even a broth-based soup. Both will hydrate with minimal added sugar content.
The human body is incredibly efficient at managing nutrients in the blood. In most cases, balanced meals and water consumption are enough to meet your daily nutrient needs. During intense physical exercise or an unexpected illness, however, the body may struggle to maintain its usual balance.
If you notice unusual symptoms such as dizziness, fatigue or persistent thirst, your body will need attention. In specific cases of dehydration from exercise or illness, a sports drink like Gatorade can be a simple tool to help you bounce back to your best self.
