TIME Diet/Nutrition

New York City Restaurants Are Cleaner Than Ever

18% fewer eateries have been cited for evidence of mice

It’s been five years since New York City instituted a strict grading policy assessing restaurants for cleanliness, food safety and handling—an attempt to address its somewhat unsavory reputation as a mecca for unsanitary eating establishments.

Now, in the latest report, city health officials have some good news: 95% of restaurants now earn A grades, and violations that can contribute to foodborne illnesses have dropped by 11%, giving New York its cleanest report card since the program began.

The requirements and methods of the health inspections are not without critics; even high-end establishments with Michelin-star honored chefs like Per Se were notoriously cited for not maintaining hot foods at high enough temperatures or cold foods at cold enough temperatures, despite commonly used practices of “resting” dishes after they come out of the oven or refrigerator to balance flavor and temperature. But the system works, say health officials. The report says that 37% more new restaurants in the city earn A grades in their first year compared to five years ago, and 18% fewer eateries have been cited for evidence of mice.

The program allows eating establishments one do-over; if they don’t meet criteria for earning an A grade, they have up to 30 days to fix their violations and receive a second inspection before getting the final grade that gets posted on their window. That posting, says Dan Kass, deputy commissioner for environmental health at the New York City Department of Health and Mental Hygiene, is key to the program’s success. “You need transparency in governmental inspection programs,” he says. “It’s the best way to inform the public and encourage them to vote with their feet and the best way to motivate restaurants—especially those that lag behind others in hygiene and food safety practices—to feel motivated to comply [with health regulations.]”

When the letter grading and public posting of the grades began five years ago, says Kass, officials expected about a 5% improvement in grades every year. “We have seen much more rapid change than that,” he says, “and it truly influences the practice of food safety in restaurants.”

The department now plans to launch a food safety workshop for restaurant workers—not just owners—to help them better understand the value and importance of proper handling and storing of food. But the public and prominent posting of letter grades will remain, so diners will still have a quick and easy way of knowing where the restaurant stands with respect to food safety and sanitation. “Inspections and education alone are insufficient to drive restaurants to improve,” Kass says. “Threats of fines may help, but those too are insufficient to move some restaurants to really change practices and put the public’s health first. There is no question that public transparency and making the information available to public at the point of sale is probably the most important driver—at least for the improvements we see.”

In fact, the system is gaining in popularity; Yelp reviews now include the grades or number scores for restaurants in cities that provide them.

TIME Brain

Alzheimer’s May Begin 20 Years Before Symptoms Appear

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PASIEKA—Getty Images/Science Photo Library RM

The two decade mark is the earliest that scientists have placed the beginnings of the disease. The good news is that gives doctors a long window of time in which to slow down or reverse the condition

The latest breakthroughs in Alzheimer’s research focus on the time well before patients even know they might have the neurodegenerative condition. Studies so far have found evidence that the biological processes that cause the mental decline may begin 10 to 12 years before people first notice signs of cognitive decline. But in the most recent report published Wednesday in the journal Neurology, experts say that the disease may actually begin even earlier — 18 years earlier, in fact — than they expected.

MORE: Mental and Social Activity Delays the Symptoms of Alzheimer’s

For 18 years, Kumar Rajan, associate professor of internal medicine at Rush University Medical Center, and his colleagues followed 2,125 elderly people with an average age of 73 and who did not dementia. Every three years, the researchers gave the volunteers mental skills tests, and then compared these results over time.

When the looked at the group that went on to receive an Alzheimer’s diagnosis, they found that these people showed lower scores on their tests throughout the study period. In fact, their scores steadily declined with each test. For each unit that the scores dropped on the cognitive tests, the risk of future Alzheimer’s increased by 85%.

MORE: Many Doctors Don’t Tell Patients They Have Alzheimer’s

Rajan stresses that the results only link cognitive testing scores on broad, group-level risk, and can’t be used to predict an individual’s risk of developing the disease. For one, more research will be needed to find the range of decline that signals potential Alzheimer’s dementia. But the findings do set the stage for studying whether such a non-invasive, easily administered test can, or should be, part of a regular assessment of people’s risk beginning in middle-age.

That way, he says, people may have a longer time period in which to hopefully intervene to slow down the disease process. Rajan plans to study whether brain-stimulating activities like crossword puzzles or learning a new language and social interactions can improve the test scores, and in turn slow the time to diagnosis of Alzheimer’s. At the very least, he says, the current data shows that there is a longer window of time in which people might be able to intervene in these ways and potentially delay Alzheimer’s most debilitating effects.

TIME medicine

Here’s What Science Says About Medical Marijuana

It’s buyer-beware for medical marijuana users, since the data supporting the benefits of cannabinoids are still in flux, and most marijuana edibles aren’t well labeled

There’s a big difference between anecdotal evidence and scientific proof, and the field of medical marijuana research is filled with more of the former than the latter—in part because marijuana is notoriously difficult to study because it’s classified as a schedule-1 drug.

Scientists led by Penny Whiting from University Hospitals Bristol in the U.K. report in JAMA that there is only moderate-quality evidence supporting the benefits of medical marijuana, and only for certain conditions. The majority of studies involving medical marijuana are of lesser quality and therefore more likely to be biased and provide unreliable results.

MORE: Teens Don’t Smoke More Pot After Medical Marijuana Laws Passed, Study Finds

In all, Whiting and her colleagues analyzed 79 randomized trials, the gold standard in medical research in which volunteers are randomly assigned to take a cannabis-related product or a placebo. The studies evaluated marijuana’s ability to relieve a range of symptoms including nausea from chemotherapy, loss of appetite among HIV positive patients, multiple sclerosis spasms, depression, anxiety, sleep disorders, psychosis and Tourette syndrome. Most of the studies showed improvements among the participants taking the cannabinoid products over those using placebo, but in many, the scientists admitted that they could not be sure that the effect wasn’t simply due to chance since the association was not statistically significant.

MORE: The Great Pot Experiment

The strongest trials supported cannabinoids’ ability to relieve chronic pain, while the least reliable evidence involved things like nausea and vomiting from chemotherapy, sleep disturbances and Tourette syndrome. Cannabinoids were, however, connected to more adverse events such as nausea, vomiting, dizziness, disorientation and hallucinations than placebo.

Summing up the state of the evidence, Whiting and her colleagues write that “Further large, robust, randomized clinical trials are needed to confirm the effects of cannabinoids, particularly on weight gain in patients with HIV-AIDS, depression, sleep disorders, anxiety disorders, psychosis, glaucoma, and Tourette syndrome.”

MORE: Even in Colorado Medical Marijuana Can Still Get You Fired

That puts patients who try medical marijuana products at a crossroads — in 23 states and Washington, DC, laws allow doctors to recommend cannabis products for their patients for medical reasons. But with little in the way of solid scientific evidence for which products works best, and in which doses, it’s up to the patients to adopt trial-and-error to figure out which, if any cannabinoids help to relieve their symptoms.

Adding to the confusion for patients, another study published in the same JAMA issue shows that medicinal marijuana food products, which include things such as candies, brownies and teas, aren’t often labeled correctly when it comes to their most active cannabis ingredient, and that the amounts are inconsistent. Ryan Vandrey, associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine and his colleagues evaluated the contents of 75 products from 47 different brands purchased at marijuana dispensaries in San Francisco, Los Angeles and Seattle, where medicinal marijuana use is legal. When they analyzed them for their content of THC and cannabinoids, the two most concentrated chemicals found in marijuana, they found wildly divergent amounts from what was noted on the products’ labels. Among them, only 17% were accurately labeled, with 23% of the products containing more of these compounds than listed, and 60% containing less than advertised. The labels noted that anywhere from 2 mg to 1000 mg of these agents were in the products, while the lab-based analysis revealed readings as low as 1mg to as high as 1237 mg. “When I have a health condition, and need to go buy my medicine, I want to make sure I know what I’m getting,” says Vandrey. “I want to make sure the dose I buy is the same today and the same the next time and the same the next time I buy it. I want reliability and accuracy so I don’t end up with problems.”

MORE: How Much Does Marijuana Impact Your Driving?

But medical marijuana products, he says, aren’t regulated by the same system that vets other pharmaceutical drugs. In fact, cannabinoids are not regulated at all, since the federal government still considers marijuana an illegal substance and therefore does not acknowledge that marijuana-based therapies exist at all. So far, 23 states have legislated such medicinal marijuana into legality, which means that legislation, and not scientific criteria, have “approved” these compounds for medical use. The results? “What we saw was that there cant’ be much if any consumer confidence within the cities we purchased and tested products,” says Vandrey.

For the larger medical marijuana distributors who see the emerging market as a profitable business, there’s the concern that profit motives may push them to under-deliver the amount of THC or cannabinoid they note on the label. And for the smaller outfits, it could be a matter of not knowing how to extract and measure the active ingredients from the cannabis plant and distribute it in a consistent way in a batch of tea or baked goods.

How can consumers know what they’re getting in a medical marijuana edible? They can do their homework and talk to other consumers and the dispensary about dosing of THC and cannabinoids, says Vandrey. Or they can try to test the products themselves, which some states offer in an effort to standardize and gain more control over these products. But ultimately, he says. “if states are going to supersede federal law and say we think there is medical benefit in marijuana, and we want it to be available to our residents, then it should also be the responsibility of the states to set up appropriate programs for regulating and overseeing the quality assurance and manufacturing standards for medications being sold.”

TIME medicine

Here’s How Skinny Jeans Are Hurting Your Health

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Adrianna Williams—Getty Images

They may help you look slimmer and be the perfect partner for tees, but skinny jeans may be damaging your nerves

If we had to point to an unhealthy fashion choice, we’d probably start at our feet, with sky-high heels. But a case study shows we may need to look a little higher, at the skinny jeans that have dominated the market for years.

In the Journal of Neurology, Neurosurgery and Psychiatry, researchers from Australia describe the case of a woman who experienced nerve damage severe enough to cause numbness and hospital care after a day of wearing skinny jeans.

The 35-year-old was helping a relative move, so she spent most of the day squatting while packing. Throughout the day, she felt her jeans get increasingly tight, until, while walking home in the evening, her feet went numb and she fell. Not able to get up, she spent several hours on the ground before she was taken to the hospital.

There, her legs and ankles had become so swollen that emergency room staff had to cut her jeans off. Her ankles and toes were weak, but the rest of her legs, including her knees and hips, were working normally.

When the doctors did studies on how her leg nerves were functioning, they found blockage of the nerve that directs the lower leg and feet. In fact, they say, any compression of the area just under knee can squeeze this nerve and cause weakness, numbness or pain by damaging this nerve. In her case, the squatting probably squashed the nerves feeding into each leg, and the skinny jeans didn’t help when the swelling started, further constricting them and crushing the nerves. After four days in the hospital with IV hydration, the bloating went down and the woman could walk again on her own.

Lesson: don’t wear skinny jeans if you’re going to do a lot of squatting or bending. They might not directly pinch the nerves in your legs but they can make the condition worse — enough to numb your feet and require several days in the hospital.

TIME archeology

The Mystery of a 8,000-Year-Old Skeleton Has Been Solved

KENNEWICK MAN SKULL
Elaine Thompson—AP A plastic casting of a controversial 9,200-year-old skull sits in the basement of archaeologist James Chatter's home July 24, 1997 in Richland, Wash.

He may have lived a simple life back then, but Kennewick Man’s remains have sparked controversy and legal battles that the latest scientific investigation may finally put to rest

Finding a human skull doesn’t happen often, but the skull that two college students stumbled upon in the Columbia River in 1996 proved rarer still. It happened to belong to an ancestor that roamed North America nearly 8500 years ago. Near the skull were remains of practically an entire skeleton belonging to a male who was likely buried along the riverbank by his people in Kennewick, Washington.

Kennewick Man, as he is known, quickly became the subject of a custody battle between scientists eager to study his remains, which are among the oldest and most complete of a human ancestor in North America, and a group of five Native American tribes who claimed the bones as the Ancient One, one of their own forebears. The U.S. Army Corps of Engineers, which manages the land on which the remains were found, intended to return the ancient bones to the Native Americans. The archeologists sued for the right to study them, and in 2004, a judge ruled that the fossils should be studied further.

MORE: Ice Age Infant’s Genes Show That Native Americans First Came From Asia

The results of that analysis were published in a popular book that detailed the lifestyle that Kennewick Man likely led, but since then, advances in genetic sequencing made it possible to do a complete genome study of his DNA. And those results, published in the journal Nature, resolve a long-standing dispute over where Kennewick Man came from — Europe or Asia, or whether he was, as the Native American tribes claimed, an early ancestor who gave rise to some of the Native American populations that subsequently resided in North America.

His genes show that Kennewick Man was more closely related to Native Americans than to European or Asian populations. “It’s very clear the genome sequence shows that he is most closely related to contemporary Native Americans,” says Eske Willerslev, from the Center for GeoGenetics at the University of Copenhagen, who led the analysis.

MORE: A Tale Told by Ancient Bones

Hints of these results first leaked in January, when emails obtained from a Freedom of Information Act request by reporters at the Seattle Times revealed that Willerslev’s group shared some of their early findings with the Army Corps of Engineers to update them on the genetic analysis, which was done in Copenhagen. And presumably, it puts to rest any lingering questions about Kennewick Man’s origins.

Those began when the first archeologist to evaluate the skull’s anatomical features declared it to be more Caucasian than Native American, and continued when Douglas Owsley, a physical anthropologist at the Smithsonian Institution who is considered the expert on North American human remains, agreed with that conclusion. Owsley pointed out that the prominent forehead of Kennewick Man and thinner brain case made him more like Japanese Ainu or Polynesians rather than Native Americans.

His genes tell a different story, however, and when Willerslev’s group also compared Kennewick Man’s DNA to that of the Ainu, Polynesians and Europeans, they found that it did not share the same similarities as it did with those of the contemporary Colville, a Native American tribe from the Columbia River area that agreed to provide DNA samples. No other Native American groups provided genetic material, so it’s possible that other tribes have an even closer connection to the ancient remains than the Colville.

The results do not show that Kennewick Man was a direct ancestor of any tribe living today, says Willerslev. It’s not known whether, for example, an older population of Native Americans living in North America then split into a branch that led to Kennewick Man, and another to the contemporary tribes such as the Colville, or whether Kennewick Man is the ancestor of the Colville and other modern Native Americans.

The genetic analysis does little to change archeologists’ current theories about the first North Americans. The first people to spread into the Americas likely came 5,000 to 6,000 years before Kennewick Man’s time, probably from Siberia via a now non-existent land bridge that allowed them to traverse the Bering Strait.

As for Kennewick Man’s future, Willerslev says that he has been in contact with several members of the Colville throughout the analysis and says that “To me, they seemed pretty excited, and found it interesting.” Whether the remains will now go back to the Native American groups under the Native American Graves Protection and Repatriation Act isn’t clear. But Willerslev acknowledges the irony in the findings. “The reason why we came to this conclusion scientifically speaking is because the remains were almost kept out of science,” he says.

TIME medicine

Scientists Find a Gene That Regulates Sleep

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Vincent Besnault—Getty Images

It's a study in flies but it could have implications for us, too

Flies, it turns out, sleep about as much as young children do. Males need about 12 hours a day, while females can do with about 10 hours. To find out which genes might be responsible for guiding how much slumber flies get a night, Kyunghee Koh did a massive experiment that you can only do with fruit flies.

She and her team at Thomas Jefferson University reported in the journal Current Biology that they took 3,000 flies, introduced random mutations in them and then monitored how well they slept. That allowed them to zero in on the genes that most directly affected slumber, and they found one, taranis, that may become an important target for sleep-related research even in people.

Flies with abnormal forms of taranis only get about 25% of their daily sleep; removing the gene keeps the flies buzzing almost non stop.

Koh’s team found that taranis works with a couple of other proteins to balance sleeping and waking. Normally, taranis and cyclin A pair up to keep the activity of another enzyme down. That enzyme generally keeps the flies awake. So when all three are working in concert, taranis and cyclin A shut down the enzyme so flies can get 10 to 12 hours of sleep. But when taranis is mutated, it doesn’t do its job as well, and the enzyme keeps the flies alert and unable to sleep.

It turns out that taranis has a related gene in mammals that may work in similar ways. The gene typically controls the way cells divide, “We don’t know yet whether these genes have a role in sleep in mammals or humans, but our hope is that somehow these genes we find in flies may have similar roles in people, and might ultimately give us some novel drug targets to help us sleep better,” says Koh.

TIME Diet/Nutrition

This Kind of Fat Messes With Your Memory

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Samuel Kessler—Getty Images

These fats can build up in artery walls and spell disaster for the heart, but they can also harm the brain

The latest study gives support to the Food and Drug Administration’s (FDA) decision to phase out the fats in three years. In a report published Wednesday in the journal PLOS One, researchers say that eating any amount of trans fats, such as those found in processed baked goods and cookies and some margarines, can wreak havoc on your memory.

Dr. Beatrice Golomb, professor of medicine at University of California San Diego, and her colleagues analyzed diet information on 1018 healthy men and women who were part of a study on cholesterol-lowering drugs. The participants answered detailed information about what they ate, including how their food was prepared, and the scientists then calculated the amount of trans fats the volunteers consumed based on their responses. Each participant also took part in a word recall test to measure their memory; they were presented with a series of word cards; the first time they saw a set of 104 cards, then they saw another set in which only 22 words remained the same, and were asked to identify which were new and which were repeats.

MORE: This Is Why FDA Is Banning Trans Fats

When the researchers matched up trans fat consumption with performance on the memory test, they found that those with the highest trans fat in their diet labeled the most words incorrectly. And, this effect seemed to be worse among younger volunteers than older ones.

“These results fit with other work showing that trans fats are key to brain function, including mood and behavior,” says Golomb. “And now we have another outcome showing that they adversely impair cell energy and oxidative stress.”

MORE: You’re Eating More Trans Fat Than You Think, Study Finds

While her study didn’t delve into how the trans fats are impeding memory, there is ample evidence that trans fats promote oxidative damage to cells. The presence of the fats can lead to a higher level of unstable oxygen molecules which can in turn destabilize DNA, proteins and other fats, prompting affected cells to die off. Some studies show that the memory center of the brain, in the hippocampus, is particularly vulnerable to such changes, which could explain the results Golomb saw.

The fact that the younger participants seemed to show worse effects than older ones may simply reflect the fact that older people are already experiencing declines in memory due to other, cumulative effects of brain injury, from poor sleep to a lifetime of traumatic injuries. In older people, the difference in memory changes won’t be as robust as they are in younger people.

MORE: Trans Fats Are Hiding All Over Your Grocery List

Essentially, for every gram per day of dietary trans fat the participants ate, the volunteers were able to accurately recall 0.76 fewer words. The FDA currently allows companies whose products contain 0.5g of trans fats to label them as having zero trans fats; even if a person eats eight such products (a reasonable amount, considering they’re found in canned chili, frozen cheesecake and popcorn) for a total of 8g of trans fats, that would mean they might remember three fewer words on the memory test on average. “That association does not appear to be tiny in my view,” says Golomb.

“There is no good consumption or exposure level; there is no positive purpose in my view of trans fat consumption,” says Gololmb.

The FDA, it seems, finally agrees.

TIME Infectious Disease

South Korea’s Latest Fashion Accessory: Face Masks

Residents of the country’s densely packed capital are relying on face masks for protection. But how effective are they?

It may be more psychological than logical. Everyone from school children to the nation’s famously fashion-forward teens are covering up in the face of MERS, or Middle East Respiratory Syndrome, a coronavirus that aims straight for the lungs and makes breathing a challenge. The culprit? Virus particles that spread between people who are in close contact, presumably from saliva and secretions that are released when people cough or sneeze.

Most cases, including the 154 reported so far in South Korea, are spread from infected patients in hospitals to health care personnel or close caregivers. But that hasn’t stopped Korean residents from buying out the supply of face masks in the capital city of Seoul, where the first patient sough medical care after becoming ill.

According to the U.S. Centers for Disease Control and Prevention, health care personnel or others who come in contact with MERS patients should wear something called an N-95 respirator, which has a disposable, fitted facepiece filter that can prevent users from breathing in droplets that may contain the virus.

Paper face masks, which fit loosely over the face, can also block large droplets or splatter but can’t completely prevent someone from inhaling viruses, especially if they are in close contact with an infected person for a relatively long time. Public areas in South Korea aren’t particularly high-risk locales, but the idea that some barrier is better than no barrier is likely driving the sales of these masks, some of which come adorned with popular cartoon characters and other logos. It’s also an extension of the Asian habit of donning masks when you’re sick—not so much to protect yourself from getting infected with something, but to prevent you from infecting others.

Read next: This Photo Symbolizes Just How Much MERS Is Taking Over South Korea

TIME Aging

This Is When Women Using IVF Should Consider Donor Eggs

The latest study says success rates decline considerably after this age

In a report presented at the European Society of Human Reproduction and Embryology, researchers provided some much-needed information that they hope will help couples using IVF to make more informed decisions about how best to use the reproductive technology.

Infertility increases with age, and while there are many reasons why couples have a hard time conceiving, one important contribution is the quality of the woman’s eggs. Because women are born with all of the eggs they use throughout their lifetime, the older the eggs are, the more vulnerable they are to developing genetic and other abnormalities that make them weaker candidates for getting fertilized by sperm and developing into a healthy baby.

But at what age does this process truly decline? Most reproductive data shows that live birth rates start to decline when the woman reaches 35, so Dr. Marta Devesa from the department of obstetrics and gynecology at Women’s Health Dexeus in Barcelona, Spain and her colleagues decided to analyze birth rates by age and whether women used fresh or frozen embryos in their IVF cycle. They found that the cumulative live birth rate—which includes every transfer of an embryo from a single stimulation cycle (most women produce multiple eggs and many of these are fertilized to become embryos, one of which is usually transferred to the womb and the rest of which are frozen for future transfer)—dropped with age.

MORE: Exclusive: Meet the World’s First Baby Born With an Assist from Stem Cells

But they also learned that the live birth rate was really driven by the first transfer of the fresh embryo, and wasn’t significantly increased by transferring additional frozen embryos if the first transfer didn’t result in a pregnancy. In other words, the first, fresh embryo provides the best chance for pregnancy, particularly in women age 42 or older. “The benefit from the frozen embryos is very limited,” says Devesa.

The findings don’t suggest that freezing embryos isn’t worth the effort or the cost, however. For women ages 38-39, the extra benefit from transferring frozen embryos a live birth was 13%; for women ages 40-41, 9%, and for women 42-43, 2%. For women 42 years or older, the frozen embryos only added a 1% increased chance of a live birth. For them, their chances of pregnancy may be higher with a donor egg.

The number of embryos may also be an indicator of a couple’s chances of having a baby. “If we have more embryos to freeze, the live birth rate from the fresh embryo is significantly higher than if we didn’t have any embryos to freeze,” she says. “Why? Because more embryos means we have a better chance of selecting the best embryo.”

The findings, she hopes, will help doctors and patients to better assess their chances of pregnancy and provide more accurate information for couples about whether they should continue with IVF using their own eggs and sperm and when they should consider using donor eggs. While each couple decides on how they want to proceed with IVF, with the current findings, “at least we can give them real expectations about their chances of a live birth, so they can manage their expectations correctly and properly,” Devesa says.

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