What is ‘eating jet lag’? Plus, why hospitals want your money upfront

Welcome to Health(y) Discourse.

Last week, I covered Florida’s rollback of school vaccine requirements, why the FDA is approving more drugs with less evidence and how early-life sugar consumption may shape health decades later.

This week, I’m taking a look at “eating jet lag,” why the FDA is inspecting fewer foreign food producers and what you can do when a hospital asks you to pay before receiving care.

Other stories that caught my eye this week:

• Health officials have recorded 6,250 Ebola cases and more than 3,000 deaths in the Democratic Republic of Congo. Researchers there are using anonymized mobile phone data to track population movements and predict where new clusters could emerge.
• Michigan reported another 208 Cyclospora infections in the past week, bringing its outbreak to 14,718 cases and two deaths. The nationwide total has climbed to more than 18,400 cases and nearly 1,000 hospitalizations.
• People who exercised at least 150 minutes a week before catching COVID were less likely to have difficulty with everyday activities two years later, according to Brazilian researchers. The study was observational meaning it did not prove exercise was responsible.
• Researchers used AI to design an experimental drug aimed at slowing aging by clearing out senescent, or “zombie,” cells that accumulate as we age  — an intriguing approach that is now being tested in an early-stage human trial.

Peer Review

Rehashing the week’s health headlines

 🍔 Worth Watching

What is “eating jet lag” — and could it affect your heart? 

You may already know about “social jet lag,” the mismatch between your biological clock and your social schedule when you sleep at different times on workdays versus days off. Researchers are now looking at a similar phenomenon involving when you eat.

“Eating jet lag” describes shifts in the timing of your first and last meals between workdays and days off. Think eating breakfast at 7 a.m. and dinner at 6 p.m. during the week, then pushing both meals several hours later on the weekend.

In a new study, researchers followed 104,000 adults in France and compared their weekday and weekend eating schedules with their risk of developing cardiovascular disease. Over about eight years, each additional hour of “eating jet lag” among men was associated with a 14% higher risk of cardiovascular disease and a 21% higher risk of coronary heart disease. Researchers did not find the same association among women. 

The study was observational, so it can’t prove that shifting meal times caused heart disease. The participants also weren’t representative of the broader population — nearly 80% were women and they tended to be more health-conscious than the general French population. Researchers aren’t sure why the association appeared only in men. 

Still, the findings held even after accounting for factors including diet quality, sleep and social jet lag.

There is a plausible explanation: Just as light helps set the body’s central clock, eating helps regulate circadian clocks in organs involved in metabolism. Regularly changing when we eat could disrupt those rhythms. But researchers say the finding needs to be replicated before anyone starts setting an alarm for dinner.

Bottom line: Don’t panic if you eat brunch on Saturday instead of breakfast at 7 a.m. This study doesn’t prove irregular meal times cause heart disease. But it adds to emerging evidence that when we eat — and how consistent we are about it — may be important for heart health.

🥬 Public Health Watch

Who is inspecting the food America imports?

The massive Cyclospora outbreak linked to iceberg lettuce from Mexico has exposed a broader problem in America’s food-safety system: The FDA is inspecting fewer foreign food facilities than it did before the pandemic. 

FDA inspections of foreign food sites fell nearly 35% since 2019, according to agency records reviewed by the Associated Press. The agency was already struggling to meet its international inspection targets before COVID-19 disrupted inspections and accelerated retirements and departures among inspectors.

The farm in central Mexico linked to the current outbreak illustrates the challenge. FDA inspectors hadn’t visited the Taylor Farms facility since 2019. They finally arrived in mid-August — about a month after the company recalled the implicated lettuce. The outbreak has sickened thousands of people across multiple states.

Inspections aren’t the only safeguard. The FDA also samples food at the border, works with foreign regulators and requires importers to take steps to verify that their suppliers meet U.S. safety standards. Mexican authorities have also said their own testing hasn’t identified Cyclospora at the farm.

But the scale of the job is enormous. Congress has long set ambitious targets for inspecting foreign food facilities, while the FDA has never come close to meeting them. The agency conducted about 1,700 foreign food inspections at its pre-pandemic peak in 2019; by fiscal year 2025, that number had fallen to 1,140.

Bottom line: The Cyclospora outbreak highlights an important vulnerability in a food system that increasingly stretches across borders: The FDA is responsible for helping ensure imported food is safe while physically inspecting only a fraction of the foreign facilities that produce it.

💰 Consumer Watch

Why your hospital may ask you to pay before treating you 

Going to the hospital used to mean being treated first and receiving the bill later. But, increasingly, hospitals and doctors want at least some money upfront.

A recent survey found that 92% of healthcare providers now encourage or require patients to pay in advance or place a payment method on file during the cost-estimate process, up from 81% a year earlier. About 17% said they formally require prepayment.

As deductibles and other out-of-pocket costs rise, hospitals have become responsible for collecting larger sums directly from patients — and collecting after treatment can be difficult. Nearly half of patient balances remain unpaid after a year, according to data cited by The Wall Street Journal.

The problem for patients is that the amount requested upfront is generally an estimate. Your insurer may ultimately determine that you owe more or less after processing the claim. Some patients have paid thousands of dollars before a procedure only to discover later that the initial estimate was wrong.

What can you do if you’re asked to pay first? 

For scheduled, nonemergency care, ask whether prepayment is actually required or simply requested. You can also ask to pay after your insurer processes the claim, request a payment plan or financial assistance, or negotiate how much you pay upfront. And check the estimate against your insurer’s information about your deductible and coverage. 

Emergency care is different. Under federal law, hospitals generally cannot delay the medical screening and stabilizing treatment required for an emergency because you haven’t paid.

Bottom line: Don’t assume an upfront hospital bill is the final amount or that you always have to pay the entire estimate immediately. Ask what is actually required, compare the estimate with your insurance benefits and find out what payment or financial-assistance options are available before paying.

Have your say

To view this week’s poll, read this newsletter in a web browser.

Last week, we asked how your trust in federal health agencies has changed in recent years. Here’s how you responded:

What else I’m watching

Get in Touch

That’s all for this week. If you have questions about a health-related story or study you saw in the wild, send me an email at jcraig@san.com or share them below.
— Jess