TIME Addiction

Health Experts Angry FDA Still Doesn’t Regulate E-Cigarettes

TIME.com stock photos E-Cig Electronic Cigarette Smoke
Elizabeth Renstrom for TIME

Prominent medical groups are asking the government to hurry up

A year has passed since the U.S. Food and Drug Administration (FDA) proposed new regulations for e-cigarettes, cigars and waterpipe tobacco, to prevent them from being sold to minors and to require manufacturers to add health warnings to labels—but the new rules still haven’t gone into effect.

Now, public health experts are urging action, arguing it’s unacceptable that it’s taken so long given data shows use of these products among minors has spiked.

Earlier this week, 31 health and medical groups including the American Academy of Pediatrics, the American Academy of Family Physicians and the American Heart Association wrote a letter to President Obama asking for the federal government to finalize the “long-overdue” regulation. The medical groups say cigar and e-cigarette brands are using marketing tactics that they feel appeal directly to young people, like promoting candy and fruit-flavored products, and they want regulations to put an end to it.

“It’s no wonder use of e-cigarettes by youth has skyrocketed,” the letter reads. “This process has already taken far too long. We cannot afford more delays that allow tobacco companies to target our kids with a new generation of tobacco products.”

Health experts are concerned over a recent U.S. Centers of Disease Control and Prevention (CDC) report that showed e-cigarette use among middle school and high school students tripled between 2013 to 2014 and hookah use doubled. The report showed that e-cigarette use among high schoolers increased from 4.5% in 2013 to 13.4% in 2014, which is a rise from approximately 660,000 students to 2 million.

“My concern is always the first-time users,” says Shyam Biswal, a professor in the department of Environmental Health Sciences at the Johns Hopkins Bloomberg School of Public Health. “It’s bad it took so long to make a dent in [conventional] tobacco users, and we are now starting something else, and we are just waiting and waiting and waiting. We don’t have the data that e-cigarettes are a gateway [to other tobacco products], so we just wait. It should not be like that.”

In a statement sent to TIME, the FDA said it “remains concerned about the significant increase in e-cigarette and hookah usage among youth.” The agency wrote:

These staggering increases in such a short time underscore why FDA intends to regulate these additional products to protect public health. Rulemaking is a complex process, and this particular proposed rule resulted in more than 135,000 public comments for the agency to review and consider. FDA is committed to moving forward expeditiously to finalize the rule that will extend its authority to additional tobacco products such as e-cigarettes, cigars, pipe tobacco, and other currently unregulated tobacco products.

Stanton Glantz, a professor of medicine at the University of California, San Francisco Center for Tobacco Control Research & Education, said he hopes that when the regulation is finalized there are no loopholes. “Given that the White House has blocked eliminating menthol from cigarettes for years despite strong evidence—including from the FDA’s own analysis that doing so would protect public health—I am not holding my breath,” he said.

Several states and local governments have regulated items like e-cigarettes on their own. Data shows at least 42 states and 1 territory currently prohibit the sale of e-cigarettes or vaping/alternative tobacco products to minors.

“I just hope that the final FDA rule does not do anything to make that process more difficult,” said Glantz.

The medical groups concluded in their letter that “further delay will only serve the interests of the tobacco companies, which have a long history of using product design and marketing tactics to attract children to harmful and addictive products.”

When asked for a comment about the letter, the White House’s Office of Management and Budget referred TIME to the FDA.

TIME Diet/Nutrition

Here’s Your Health Excuse to Have a Mint Julep

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Mint is one healthy herb

The Kentucky Derby is this Saturday, and that means mint juleps will be on the menu. While there’s really no great health benefit imparted by bourbon, mint certainly has its qualities. If nutrition is what your after, mint soaked in booze may not be the best source, but if you need an excuse for a second mint julep, we’ve got a few.

“Without a doubt, the mojito is my favorite way to enjoy the fresh flavor of mint, but it’s mint in its natural state that I truly love,” says registered dietitian Tina Ruggiero. “Mint is available as a tea; you can buy peppermint oil and, of course, there’s the mint leaf itself.”

Ruggiero says that used in all these forms, mint has the ability to calm an upset stomach, relieve nasal symptoms from cold or allergies, and it’s a good source of Vitamins C and A. Some studies have even found that peppermint oil can be an effective treatment for irritable bowel syndrome.

“While mint has trace amounts of potassium, magnesium and calcium, you’d have to eat quite a bit of it to garner any particular benefit,” says Ruggiero. “Instead, use it liberally as an ingredient where appropriate, since it doesn’t add fat, calories or sodium to your meals.” (That probably means mint crushed in your Derby drink isn’t doing you much good).

Besides mint juleps or mojitos, mint can add an extra kick in the kitchen. Try adding some chopped mint to salads or smoothies, or as Ruggiero suggests, infuse cold water with mint for a refreshing and healthy drink.

Gardening enthusiasts also take note: mint is also a great addition to an herb garden.

TIME Diet/Nutrition

5 Foods That Taste Better in May Than They Will All Year

Never know what’s growing now? Let’s take it one season at a time, with the Foods That Taste Better Now Than They Will All Year.

Often we think Spring is the season of abundance, but that’s really not true. While there’s certainly some produce that tastes its best during in spring, summer produces the more abundant yields. While the month of May is still early for some fruits and veggies, it certainly kicks off the season.

“In the produce business, we all kind of wish every month was like May. It’s a time of intense change, and it marks the official start of the summer tree fruit season,” says James Parker, the associate coordinator for Whole Foods Market’s global perishables buying office. “We also see a tremendous increase in local and regional production throughout the U.S. Because it’s domestic season, the product doesn’t have to travel as far.” That means that not only will produce in the grocery store be better quality, but it will likely be a good price too.

Parker says that in May, produce quality is still “contingent on the whims of Mother Nature.” But we will start seeing lots of fruits and vegetables that were in poor supply in the Spring and Winter months. Here are five foods to add to your shopping list this month.

Corn: You may think of July and August as peak corn season, but consider this: “You want to buy corn as close to where it’s grown as possible,” says Parker. “That’s because the longer the corn is held in storage, or the longer it has to travel, the less sweeter it becomes—its sugars convert to starch.” Not only will corn by growing in abundance in California and Florida, but southern states will start seeing large crops too, which means less delivery travel nationwide.

Blueberries: Blueberries tend to taste better if you buy them locally, and domestic production of blueberries will be happening this month in many parts of the country. Not only will blueberries be fresh and sweet, but you’re likely going to get a good deal too since berries will start competing against summer tree fruits for consumers’ attention.

Apricots: Apricots tend to have a pretty short season, but Parker says this year’s weather indicates there will be tasty apricots in May. “Most folks have them in preserves or dried, but the fresh fruit season is touch and go,” he says. If the weather is really inconsistent, Parker says it can affect the apricot quality. “But this year we had a pretty mild winter,” he says. That means there will likely be some delicious apricots available this month.

Cherries: “If you like cherries, chances are you are going to have a really good May,” says Parker. The season for cherries on the west coast is starting earlier this year, so you’ll likely be getting your fix of sweet and sour cherries this month.

Avocados: May kicks off the season for summer salads, and avocados are an especially tasty topper. “We see an overlap in domestic and import avocado production in May,” says Parker. “[Avocados] are in great quality.” In places with more temperate climates, avocados can be in season all year round, but in the U.S. May is a good time to start looking for especially delicious fruits.

TIME Research

This New Drug Might One Day Cure Even the Most Painful UTIs

Desperate lady toilet door sign
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More and more women are getting antibiotic-resistant UTIs

Antibiotic resistance is becoming a growing global problem, and for many women that’s having an unexpected effect. One very common infection among women, the urinary tract infection, is becoming increasingly resistant to the drugs used to treat it. New research published in the journal PLOS Pathogens sheds light on the rise of the antibiotic-resistant UTI and hints at a potentially new treatment that may one day offer women some relief.

More than half of women will experience at least one UTI in their lifetime, and between 30 and 40% of those infections will come back within six months. UTIs account for around eight million visits to the doctor’s office every year, totaling about $450 million in medical costs. Most UTIs are caused by the bacteria Escherichia coli (E. coli), and recent surveillance data shows a significant rise in cases of UTIs caused by E. coli that are resistant to the antibiotics most commonly used to that treat them. One study that looked at cases of UTIs from 2000 to 2010 found that the number of UTIs caused by E. coli that were resistant to the antibiotic ciprofloxacin increased five fold, and the number of UTIs resistant to the commonly used antibiotic trimethoprim-sulfame-thoxazole rose from about 18% to 24% during the same time period.

UTIs typically cause women to have a severe urge to urinate, and to do so frequently. It’s also often very painful when they do, and many experience a burning sensation in their bladder or urethra. Uncomplicated UTIs usually go away with drugs within two to three weeks, but in some cases women may take antibiotics for 6 months or longer if their UTIs keep coming back.

“It’s definitely a growing problem,” says Dr. Victor Nizet, a professor of pediatrics and pharmacy at the University of California, San Diego School of Medicine. “Some women get them over and over again, year in and year out.”

In the new study, Nizet and his colleagues looked at an alternative way to treat UTIs. The researchers tested an experimental drug—not an antibiotic but an immune-boosting agent. The drug stabilizes a protein called HIF-1alpha, which was shown to protect mice and human bladder cells from infection with a common UTI pathogen, a kind of E. coli. The researchers found that using the experimental drugs in healthy human urinary tract cells made the cells more resistant to infection by the pathogen. The researchers also discovered that using the stabilizers directly in the bladders of mice protected against infection and that mice who were treated saw a 10-fold reduction in bacteria colonization in their bladders compared to untreated mice.

“A classic antibiotic is something that targets the bacteria directly,” says Nizet. “This [new drug] would be a treatment that would stimulate the body to produce its natural antimicrobials, which are many.” Nizet says the next step is to explore testing in humans and learn more about the effectiveness of oral versions of the drugs.

Dr. Mamta M. Mamik, an assistant professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai (who was not involved in the study) says she’s seen more and more women with UTIs that are resistant to drugs. In those situations, physicians will sample and isolate the bacteria to see what it’s sensitive to and then recommend a drug based on those results, she says. In a worst-case scenario, they may need to give women intravenous antibiotic therapy.

“I think use of antibiotics should be monitored strictly,” says Mamik. “Very judicious use of antibiotics is really necessary or we will end up in a situation that’s really terrifying. If everyone starts attracting these bacterial-resistant infections, we don’t have the resources. We can’t give intravenous antibiotics to everybody—that’s not a solution.”

Mamik says that women who think they have a UTI should schedule an appointment to see their doctor in person, and not to ask their physician to call them in a prescription for antibiotics. Doctors should insist on seeing their patients too, if they want to cut down on the risk, she says. “It’s uncomfortable but not life-threatening, so [women] don’t go in,” says Mamik. “That’s a practice that has to stop. It perpetuates the problem. You don’t know what you’re treating.”

TIME movies

Watch the Trailer for Woody Allen’s New Movie Irrational Man

The film stars Joaquin Phoenix and Emma Stone

The trailer for Woody Allen’s upcoming film, Irrational Man, shows the relationship between a philosophy professor played by actor Joaquin Phoenix and his student Emma Stone. Phoenix’s character appears troubled, and possibly has an alcohol problem. “You suffer from despair,” Stone’s character tells him. But the new trailer for the film, which opens in U.S. theaters in July, also hints at a transition for the professor, who finds new purpose.

TIME Diet/Nutrition

Weight Watchers Founder Dies at 91

Jean Nidetch
Alan Diaz—AP In this photo taken July, 18, 2011, Jean Nidetch, founder of Weight Watchers, is shown at her home in Parkland, Fla.

Jean Nidetch made weekly weight loss meetings into a big business

Jean Nidetch, the founder of the popular diet plan Weight Watchers, died Wednesday at the age of 91.

Nidetch, who struggled to lose weight, started Weight Watchers after hosting weekly meetings with overweight friends at her home to talk about their issues with weight and dieting. She went from 214 pounds to 142, and before long, Weight Watchers was founded. Nidetch and her fellow founders became millionaires when the company went public in 1968, the New York Times reports. The company was eventually sold to H.J. Heinz.

Nidetch died at her home at in Parkland, Fla., CBS News reports.

“Compulsive eating is an emotional problem, and we use an emotional approach to its solution,” said Nidetch in a 1972 article published in TIME. The first version of Weight Watchers focused on foods like lean meats and fruits and vegetables, but as the New York Times writes, the emotional support was always one of the distinguishing parts of the program.

Today Weight Watchers remains a very popular diet, and continues to offer weekly meetings. Recent studies have shown that Weight Watchers tends to work better than other diets for people trying to slim down.

TIME Infectious Disease

Most Countries Are Unprepared for Superbugs, Report Says

Only 34 countries have a comprehensive plan

Only 34 countries have plans in place to tackle antibiotic resistance and prevent superbug infections, according to a report.

The report, released on Wednesday by the World Health Organization (WHO), surveyed 133 countries about their level of preparedness for the growing global issue of antibiotic resistance. Only a quarter of countries that responded to the study said they have comprehensive plans.

“Scientists, medical practitioners and other authorities including WHO have been sounding the warning of the potentially catastrophic impact of ignoring antibiotic resistance,” said Dr. Keiji Fukuda, WHO’s assistant director-general for health security in a statement. “Today, we welcome what has been achieved so far, but much more needs to be done to avoid losing the ability to practice medicine and treat both common and serious illnesses.”

The overuse of antibiotics can contribute to the development of disease strains that are resistant to the very drugs used to treat them. Many countries do not have the necessary infrastructure to do proper surveillance of drug resistant diseases, according to the report. The issue of antibiotic sales without a prescription is also widespread and can contribute to overuse.

In 2013, there were an estimated 480,000 new cases of multidrug-resistant tuberculosis (TB). Another strain of drug resistant TB has been discovered in 100 countries, the WHO said. Other drug-resistant diseases have been identified around the world, including infections like gonorrhea and pneumonia.

The agency will be ask countries to declare their commitment to attempting to control the problem, and implement necessary steps to keep superbugs at bay.

TIME Infectious Disease

Americas Region Becomes World’s First to Eliminate Rubella

The last major endemic cases in the region were in 2009

The Americas region has become the first to successfully eliminate rubella, a contagious viral infection with similar symptoms to measles, health officials announced on Wednesday.

Medical experts are calling the milestone against the endemic transmission of the infection a “historic achievement.” Rubella and congenital rubella syndrome (CRS) are now the third and fourth vaccine-preventable diseases to be eliminated in the Americas, following small pox in 1971 and polio in 1994, and experts say it also speaks to the success of a 15-year initiative to provide widespread vaccination against mumps and rubella (MMR) in the area.

“It shows how important it is to make vaccines available even to the remotest corners of our hemisphere,” Carissa F. Etienne, Pan American Health Organization/World Health Organization (PAHO/WHO) director, said during a news conference.

Before mass vaccination was available, medical experts say an estimated 16,000 to 20,000 children were born with CRS in Latin America and the Caribbean. The last major endemic cases in the region were in 2009. The virus is usually mild, but it can cause birth defects and miscarriages when women are infected during pregnancy.

Rubella is less contagious and typically less severe than the measles, but health officials say measles is the next target and that many countries have set a goal to eliminate the disease in their borders as well. The U.S. has experienced new clusters of measles outbreaks in the last year, with low vaccination rates blamed among some communities.

Though rubella has been eliminated in the Americas, it’s still prevalent in other regions in the world. Dr. Susan E. Reef, the team leader for rubella in the Global Immunization Division at the U.S. Centers for Disease Control and Prevention (CDC), told reporters on Wednesday that the Americas region and the European region are the only two regions that have an official elimination goal for the disease.

“Now that we have achieved this goal,” Reef said, “the next step is to continue to maintain it.”

TIME Health Care

Inside Nepal’s Next Challenge: Overflowing Hospitals

The country's health care system is under enormous pressure after a deadly earthquake

Hospitals throughout Nepal are flooded with patients, with thousands in need of care for acute injuries after a massive earthquake that the country’s leader said may have killed up to 10,000.

“Most public and private hospitals sent all of their pertinent staff surgeons to Kathmandu Teaching Hospital, which is the trauma center, and it’s so overrun that they are treating people in the streets,” says Cindy Aliza Stein, director of global programs at Real Medicine Foundation (RMF), who is helping coordinate the response. Other hospitals in the area are doing the same, partially because of high numbers of patients and partially because of structural damage and trepidation among many to be inside buildings amid the risk for aftershocks.

Even the weather has become a roadblock to care. “It’s monsoon season, so the rain has started,” Stein says, stressing that hospitals need more tents and tarps to do medical care and triage effectively and to prevent survivors from being exposed to the elements. Many physicians working the crisis have slept very little since the earthquake struck Saturday.

MORE: Medics Race Against Time to Save Nepal’s Quake Survivors

“There are very complicated fractures and not enough medical personnel to actually handle them,” says Dr. Martina Fuchs, the CEO of RMF. “Often in these situations there are more amputations than actually needed. That’s really sad and means longer-term rehabilitation. Being handicapped in a developing country is really difficult.”

If patients are not immediately attended to, the fear is that injuries can become infected, result in long-term complications or even prove fatal. And medical responders are struggling to access people in rural areas. “There are areas in villages where they are saying up to 80% or more of structures are demolished,” Stein says. “Over the next few days that’s the focus.”

Aid groups are also trying to care for survivors with pre-existing conditions, like cancer or diabetes, who may need special medical attention or medication. “The impact of the earthquake has dramatically reduced the capacity of the health system to resume the delivery of health services, as well as other services such as water and sanitation,” says Jim Catampongan, an Asia-Pacific health coordinator for the International Federation of Red Cross and Red Crescent Societies.

MORE: 6 More Ways to Give to Nepal Earthquake Relief

Overcrowding issues are not only reserved to trauma centers. Bottlenecks of volunteers at the Kathmandu Airport have also caused some organizational headaches. “The vast majority of organizations have not registered beforehand through the ministry’s process and they are arriving with a lot of staff and large amounts of supplies,” Stein says. “When they hit the airport, the import of goods that were unsolicited has actually caused a bunch of logistic problems. We are trying to prevent that by coming by land and trying to procure things as local as possible.”

Catampongan adds that Nepal has made significant health gains in the past 10 years despite being a poor country with weak health infrastructures. “The risk is that many of these gains could be lost,” he says. “We could see resurgence in epidemic-prone diseases likes malaria and cholera, which Nepal has worked hard to control. Spikes in malnutrition is a major issue in the country especially for pregnant women and children. We could also see a drop in services for issues like noncommunicable disease, HIV and tuberculosis.”

TIME Diet/Nutrition

Should Alcohol Be Forced to List Calories?

Chris Mellor—Getty Images/Lonely Planet Images

Your booze is full of "invisible calories"

Right now, alcoholic beverages in the U.S. and the European Union aren’t required to spell out what’s in the bottle. But they should be, argues a public health expert in a new paper calling for calorie counts on all alcoholic beverages.

Fiona Sim, chair of the Royal Society for Public Health in the U.K. argues in her paper published in The BMJ that alcoholic beverages should be required to display calorie labels, since alcohol in general plays a contributing role to obesity. Many adults do not know how many calories they are consuming when they drink alcohol, she says. In people who drink regularly, that proportion can be significant: an estimated 10% of their daily calories come from booze.

“Most women, for example, do not realize that two large glasses of wine, containing 370 calories, comprise almost a fifth of their daily recommended energy intake, as well as containing more than the recommended daily limit of alcohol units,” Sim writes. “With the insidious increase in the size of wine glasses in bars and restaurants in the past decade, it seems likely that many of us have unwittingly increased the number of ‘invisible’ calories we consume in alcohol.”

Sim’s argument is aimed at the U.K., which currently does not require restaurant menus or bottles of alcohol to list their calorie content. The United States does require that calories for alcoholic beverages be listed in restaurants that have 20 or more locations. In the U.S. calories are not required to be listed on the bottle, though manufactures can voluntarily do so. U.S.-based consumer groups have called on industry players and regulators to include them.

Sim says that the calories in alcohol should be treated the same as calories in other foods and beverages. If regulation is not implemented, she says that people in the medical community have a responsibility to set the record straight.

“Those of us in clinical practice regularly ask patients about their weight, eating habits, and exercise in the context of primary or secondary prevention, but how many of us routinely ask about their calories from alcohol?” she writes. “It is time that we started.”

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