TIME medicine

Here’s What Experts Say About the Advice on Dr. Oz and The Doctors

Experts evaluated the advice given on medical talk shows, and the results were surprising

Many Americans get their health advice not from their doctor, but from daytime television. But how good are those recommendations?

Reporting in the BMJ, Canadian researchers analyzed two medical TV talk shows—The Dr. Oz Show and The Doctors—and found that only 46% of the recommendations on The Dr. Oz Show and 63% on The Doctors were supported by evidence. 15% of advice given on Oz and 14% of advice on The Doctors contradicted the available published evidence in journals.

“The bottom line message is for people to be really skeptical about the recommendations made on these medical television shows,” says study co-author Christina Korowynk, associate professor of family medicine at the University of Alberta. “They should look for more balanced information to be presented, and understand that they need all of that information in order to make an informed decision.”

They measured 80 major recommendations made on the two shows from January to May 2013 against evidence gleaned from published studies in medical databases. They looked at both consistency—how much the conclusion was supported by the studies—and believability, which included the quality, number and type of study.

On average, Korownyk’s group found that both shows mentioned how the advice might specifically help a person in only about 40% of the recommendations, and they mentioned the amount of benefit, another aspect of useful health advice, in less than 20% of recommendations. (Harms were mentioned in less than 10% of the recommendations, and costs in less than 15%). She says that without such information on how much benefit and harm a particular recommendation might have, it’s hard for people to make informed choices about whether the advice is right for them.

Korownyk and her colleagues aren’t the first to cast doubt on the quality of advice given on the shows. In June a Senate subcommittee heard testimony from Oz on false advertising of weight loss claims and Sen. Claire McCaskill queried the doctor about the statements he made on the show. “I do personally believe in the items that I talk about on the show,” he said at the hearing. “We have to simplify complicated information. We have to make the material seem interesting and focus on the ‘wow’ factor.”

Representatives for The Doctors said in a written statement to TIME: “The Doctors was never contacted about the study or the article. Our producers and doctors all do their due diligence to make sure information provided on the show is sound, relevant and timely—often debunking the myriad of medical myths that abound in the media and across the internet.”

Members of The Dr. Oz Show wrote: “The Dr. Oz Show has always endeavored to challenge the so-called conventional wisdom, reveal multiple points of view and question the status quo. The observation that some of the topics discussed on the show may differ from popular opinion or various academic analyses affirms that we are furthering a constructive dialogue about health and wellness.”

Korownyk acknowledges that the exact impact of television health advice isn’t clear, since the study didn’t investigate how many of the recommendations people adopted and whether they had an effect on their health. But the advice is clearly reaching people. “What we’d love to see is a process on these shows where the evidence is reviewed in a critical manner, and presented in a balanced, objective way so the audience can understand,” she says. “As physicians, we are moving toward that, and we’d love to see the broader television personalities doing the same sort of thing.”

TIME ebola

How Your Tablet Can Help Find an Ebola Cure

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Photodisc—Getty Images

Anyone with a computer or Android smartphone can perform cutting edge research on the formidable virus

Mark McCaskill’s daughter is only 11 years old and so far knows only the most basic things about viruses and how they work. But she’s conducting pioneering biological experiments to find a treatment for Ebola. Or at least her Kindle is. When she’s not using it to listen to her favorite singers or watch the latest TV shows, her tablet is scanning thousands of chemical compounds, any one of which could turn out to neutralize, or even destroy Ebola and save thousands of lives.

That’s because her father, Mark, a transportation planning expert for Roanoke Valley in Virginia, signed up her Kindle, two of his own PCs and his mother’s computer to IBM’s World Community Grid (WCG), an innovative mass computing network that allows anyone to contribute in the fight against everything from brain cancer to polluted water and now, Ebola, by essentially offering to WCG their computer’s processing power when it’s not otherwise being used. Nearly 700,000 people have registered their Android phones or PCs on the WCG (the grid isn’t compatible with iOS yet, but IBM says it’s working on it).

“Some people volunteer in a traditional sense with Meals on Wheels. I think of this as my own personal form of volunteering, a new high tech way of volunteering,” says McCaskill.

There’s massive amounts of data out there that could prove revolutionary, but sifting through thousands—or millions—of compounds takes a whole lot of computing power. So every time McCaskill and his family members aren’t on their computers or tablet, their processing power is shunted to combing through the millions of compounds that exist in drug libraries that could be the answer to stopping Ebola in its tracks. Computational engineers call it “distributed computing,” but for the rest of us, it’s an opportunity to make like a world class biologist or immunologist or environmental scientist and indulge our inner science geek. In 1999, the team behind SETI, the Search for Extraterrestrial Intelligence, began using a similar strategy to analyze reams of radio signals from telescopes for possible extraterrestrial communications.

WCG essentially turns each device into a circuit in a massive virtual supercomputer. Each supercomputing task, such as vetting millions of chemical compounds for any potential activity against Ebola, is broken down into more manageable chunks and shunted to individual devices. The data, which is downloaded to the WCG in real time, is then collected, digitally ‘cleaned’ and delivered to the researcher like a birthday gift, neatly packaged and containing valuable and eagerly awaited information.

The idea for the WCG was born at IBM Foundation, when Stanley Litow, vice president of corporate citizenship and corporate affairs, began getting numerous requests from desperate scientists for IBM to donate supercomputers for their work. Declines in federal science grants meant that few institutes could afford the cost of a supercomputer at the same time that many of the most critical scientific projects—such as querying enormous databases of chemical compounds for potential cancer treatments and compounds that can fight emerging diseases like Ebola—required massive computing power. “We came to the conclusion that it would be possible to try to solve this problem with a virtual super computer using grid technology if we could get enough people to sign up to combine their computing power,” Litow says.

People were more than willing to chip in. More than 3 million devices from 680,000 donors are registered on the WCG. One of the grid’s projects, Help Fight Childhood Cancer, conducted 9 million virtual chemistry experiments in five years and found seven promising agents that are being studied to fight a common childhood brain cancer. The Clean Energy Project evaluated 100,000 molecular shapes of organic molecules to identify formations most suitable for becoming organic solar cells that may emerge as alternative sources of energy. And FightAIDS@Home was launched in 2005 and enlisted individual computers to collectively scan chemical compounds to find new drugs against HIV; it’s 90% complete. The Ebola project, which debuted on the grid the first week of December, completed in one week what it would have taken a PC with a single processor about 35 years to accomplish.

“My biologists cannot look at a million compounds, for one, and even if they could, we couldn’t afford to buy them all. And even if we could, there just isn’t enough time to screen them all,” says Erica Ollmann Saphire from the Scripps Research Institute who is scanning chemical databases for possible Ebola therapies.

Saphire has two Ebola-related projects that she’s hoping the network of devices out there will solve. In 2013, she and her team discovered that the wily Ebola virus actually existed in three different structural forms during its life cycle, changing from a holiday wreath structure to a zig-zagging matrix to a butterfly-like shape, each uniquely designed to optimize its journey from budding new virus to finding cells to infect and finally invading those cells. “It’s like having thread that can be yoga pants in the morning, unraveled and reknitted into a shirt for work, then unraveled and reknitted into slippers for the evening when you go home,” says Saphire.

But understanding how these three complex structures form, and what signals them to materialize at specific times, is a “really complex computational problem,” she says. “The level of complexity of the three entirely different structures is each so big that you can’t even say it might take hundreds of years for a computer to accomplish; it would just be impossible to accomplish since there are just too many atoms and too many variables,“ says Saphire.

But with thousands of people chipping away at a small part of the problem, the large, complex, nearly impossible problem becomes potentially manageable. At least that’s what Saphire and the scientists at IBM are hoping.

And people like McCaskill are happy to do their part. Has the heavy lifting for science put a dent in his computing power? Not at all, he says. Cyber security hasn’t been a concern since IBM monitors the grid and ensures that any private information on PCs isn’t accessed or downloaded. And his daughter hasn’t complained about the grid draining her battery power, since the Kindle is set up to do most of its computing while the device recharges at night.

“You don’t have to be in Silicon Valley, or some megalopolis, you can be in an area like we are, and be doing creative stuff and cutting edge research,” McCaskill says.

TIME Diet/Nutrition

Here’s What Low-Carb Diets Do to Your Heart

The glycemic index distinguishes carbohydrates by how much they raise blood sugar, but the latest study shows it may not matter in lowering the risk of heart problems

We’re accustomed to thinking about the yin and yang of a lot of foods, from fats to carbs. But in the latest report in JAMA on carbohydrate-focused diets, researchers found that the type of carbs may not matter in lowering risk of heart disease.

Dr. Frank Sacks and his colleagues conducted a study involving 163 overweight or obese participants who followed four different diets, for five weeks each, for a total of 20 weeks. Previous studies have linked low-carbohydrate diets to a lower risk of overweight and obesity and lower risk of heart disease, but Sacks wanted to test whether it was simply reducing carbohydrates that helped the heart, or whether being vigilant about what types of carbohydrates dieters ate would make a difference.

Some studies have suggested that carbs with a low glycemic index—such as whole grains—led to fewer spikes in blood sugar, and therefore more efficient breakdown into energy, while higher glycemic index foods—including refined flours—led to larger peaks in glucose that the body couldn’t process and therefore stored as fat.

So two of the diets in the study were high in carbs overall, but one was made up of low-glycemic-index foods while the other was composed of high-glycemic-index foods. The other two diets were low in carbs overall, with the same breakdown or low- and high-glycemic items.

“What we were thinking was that the glycemic index of the carbs would be more impactful if the total amount of carbohydrates was higher,” says Sacks. “But what we found was against what we thought originally. The low glycemic index did not improve any of the things we measured.”

In fact, among those eating the high-carb diets, those consuming low-glycemic-index foods had worse insulin response and higher LDL cholesterol. Among dieters eating the low-carb diets, the high v. low glycemic index foods did not make a difference in insulin response, blood pressure, LDL or HDL cholesterol levels.

Overall, those eating the low-carb diets had lower risk factors for heart disease compared to the group eating more carbohydrates, but the type of carbs didn’t seem to make much difference. “We confirmed previous studies that showed reducing carbs is good, but we did not show that the glycemic index of the carb really had any favorable effect,” says Sacks.

That suggests that all the attention to knowing the glycemic index of various foods—and basing your eating habits on these numbers—may not be worth the effort. While bananas may have a high glycemic index compared to an apple, for example, always choosing the apple over the banana may not lead to benefits for the heart. That’s because glycemic index is only one aspect of how we break down and metabolize food; bananas are also high in potassium and fiber, which have been linked to lowering risk of heart disease.

“Consumers should just look at the food, and not worry whether it has a low glycemic index or a high glycemic index,” says Sacks. “If it’s a fruit or vegetable, or a whole grain, then it’s fine.” He also notes that glycemic index isn’t a set characteristic of a food; it’s how an individual person’s body processes the food so it may vary considerably among different people.

People with diabetes have more trouble breaking down sugar from carbs, so it may help them to avoid foods that cause peaks of blood sugar. But for the rest of us, when it comes to eating to keep your heart healthy, it’s more important to eat healthy whole foods like fruits, vegetables, fish and whole grains, rather than trying to rank individual fruits, for example, by their glycemic index.

TIME Diet/Nutrition

Most Kids Don’t Eat Three Meals A Day, Study Says

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Kids get 42% of their calories from snacks

Eating three square meals a day is the oldest nutrition advice in the book, and some of the most important for staying healthy. But new research shows that children are snacking instead of eating three meals a day on a regular basis, a habit that could be contributing to overweight and obesity and putting them at risk of heart disease later in life.

In a series of reports published in the European Journal of Clinical Nutrition, the International Journal of Obesity and the European Journal of Nutrition, Aino-Maija Eloranta, a PhD candidate at the Institute of Biomedicine and Physiology at the University of Eastern Finland, and her colleagues followed a group of 512 boys and girls enrolled in the Physical Activity and Nutrition in Children (PANIC) Study. The children, ages 6-8, and their parents reported what the kids ate and drank for four days. The researchers also measured their body mass index, waist circumference, blood pressure, cholesterol, blood glucose and insulin levels.

MORE: 7 Eating Habits You Should Drop Now

About 45% of the boys and 34% of girls in the study ate all three meals, meaning a majority of them did not. The most-skipped meal was dinner. “That was a surprise,” says Eloranta. “Among older children, adolescents and even adults, breakfast is the one that is skipped.”

Skipping dinner can have major implications for children’s health, she says, since it’s traditionally the most calorie- and nutrient-rich meal, giving growing children the energy they need to develop. In fact, the children who ate three meals a day had smaller waist circumferences and a 63% lower risk of being overweight or obese than those who skipped some of the major meals.

MORE: 5 Things Everyone Gets Wrong About Breakfast

The scientists also found that among all kids, snacks provided as much as 42% of the children’s daily calories. That’s not necessarily a bad thing, says Eloranta, except that most snacks are high in sugar and low in healthy nutrients like fiber. On average, the children consumed more saturated fat (which has been linked to a higher risk of heart disease) and salt and ate less vitamin D, iron and fiber than guidelines recommend.

MORE: Alice Waters: The Fate of Our Nation Rests on School Lunches

Eloranta did find one positive trend: lunch. Because lunch was provided at school, it was lower in sugar and higher in nutrients and healthier fats than the kids’ other meals on average. This suggests that one of the best ways to help children maintain healthy weights and avoid heart problems later might be to give them three meals a day. “Maybe we don’t have to worry about single nutrients or single foods [like sugar or fat] that much,” she says. “When you eat meals, you automatically receive the good nutrients.”

TIME medicine

This New Kind of Stem Cell May Revolutionize How We Treat Diseases

Scientists have created a new type of stem cell that could speed treatments for diseases and make them safer

Ever since Japanese researcher Shinya Yamanaka found a way to treat skin cells with four genes and reprogram them back to their embryonic state, scientists have been buzzing over the promise of stem cell therapies. Stem cells can be coaxed to become any of the body’s cell types, so they could potentially replace diseased or missing cells in conditions such as diabetes or Alzheimer’s. And Yamanaka’s method also meant that these cells could be made from patients themselves, so they wouldn’t trigger dangerous immune rejections.

Now scientists led by Dr. Andras Nagy at Mount Sinai Hospital Lunenfeld-Tanenbaum Research Institute in Toronto report an exciting new advance that could push stem cells even closer to the clinic. In a series of papers in the journals Nature and Nature Communications, the group describes a new class of stem cell, which they called F class, that they generated in the lab.

The F class cells, says Nagy, have a few advantages over the Yamanaka-generated induced pluripotent stem cells, or iPS cells. While the iPS cells are created by using viruses to introduce four genes that reprogram the cells, Nagy’s team relied on a technique they developed several years ago using transposons—small pieces of DNA that can insert themselves into different parts of a genome. Unlike viruses, these transposons can be popped out of the genome if they’re no longer needed, and they don’t carry the potential risk of viral infection.

MORE: Stem-Cell Research: The Quest Resumes

Nagy’s team found that the transposons were much more reliable vehicles for delivering the reprogramming genes exactly where they were needed to efficiently turn the clock back on the skin cells. What’s more, they could use the common antibiotic doxycycline to turn the four genes on and off; adding doxycycline to the cell culture would trigger the transposons to activate, thus turning on the genes, while removing the antibiotic would turn them off.

In this way, says Nagy, he was able to pump up the efficiency of the reprogramming process. Using the Yamanaka method, it was hit-or-miss whether the viruses would find their proper place in a cell’s genome, and more uncertainty over how effectively it could direct the cell to activate the four reprogramming genes. “F class cells are much more similar [in the culture dish], like monozygotic twins while iPS cells are more like brothers and sisters,” he says.

That consistency is a potential advantage of the transposon method, since any stem cell-based treatment would require a robust population of stem cells which can then be treated with the proper compounds to develop into insulin-making pancreatic cells to treat diabetes, or new nerve cells to replace dying ones in Alzheimer’s, or fresh heart muscle to substitute for scarred tissue after a heart attack.

MORE: Stem Cell Miracle? New Therapies May Cure Chronic Conditions like Alzheimer’s

Nagy’s team also described, with the most detail to date, exactly how mature cells like skin cells perform the ultimate molecular feat and become forever young again when exposed to the four genes. They analyzed the changes in the cells’ DNA, the proteins they made, and more. “It’s similar to high definition TV,” he says. “We see things much better with much more detail. We expect that having that high resolution characterization will allow us to better understand what is happening during this process at the molecular level. And obviously that better understanding is going to affect what we can do with these cells to make them better, safer and more efficient in cell-based treatments in the future.”

That may be years away yet, especially since some experts say that transposons may pose their own risk of wreaking DNA havoc on a cell’s genome. But having another type of stem cell that could potentially churn out healthy cells and tissues to replaced diseased ones is a welcome development.

TIME Cancer

Many Breast Cancer Patients Get Unnecessary Radiation

About two thirds of breast cancer patients may be getting more radiation treatment than they really need according to the latest study

When it comes to treating cancer, the common approach is often “more is better.” Throwing everything medically possible at growing tumors can keep them from spreading and, most important, help patients survive their disease.

But in a paper appearing in JAMA on Dec. 10, researchers say it’s time to rethink that strategy. They found that women with early stage breast cancers may not need the usual seven weeks of radiation therapy after surgery to remove their tumors. Instead, a three-week course with higher intensity radiation can be just as effective.

“The fact is, more is not always better in cancer care,” says the study’s lead author Dr. Justin Bekelman, assistant professor of radiation oncology, medical ethics and health policy at Penn Medicine’s Abramson Cancer Center. “Often less is just right. But the challenge in cancer care is that way of thinking is not where we are today.”

MORE: No More Chemo: Doctors Say It’s Not So Far-Fetched

It’s a challenge, he says, because it goes against the intuitive idea that hitting tumors with more radiation or chemo is going to have a better chance of killing them and preventing them from spreading. But in recent years, data is showing that in some cases, there are alternatives that could be just as effective but easier on patients and even less expensive. As four trials have demonstrated, shorter regimens can result in similar survival as the longer course of radiation. Bekelman and his colleagues wanted to know how many women were picking up the shorter regimen.

The researchers analyzed records from 9 million women provided by Anthem, Inc. Among them, more than 15,000 were diagnosed with early stage breast cancer and had surgery to remove their tumors followed by radiation. While rates of shorter course radiation did increase from 11% in 2008 to 34.5% in 2013, that percentage still represented only a third of the women who could have taken advantage of the shorter radiation treatment.

MORE: Removing Both Breasts May Not Improve Survival From Breast Cancer

Why the reluctance to adopt the therapy that takes less time and allows women to return to their normal lives sooner? “I think physicians are much more comfortable with the longer treatment,” says Bekelman, “I wonder to what extent physicians are engaging with their patients to discuss the pros and cons of treatment schedules because they are so comfortable with the longer treatment.”

One reason they might favor the longer therapy is because they are concerned about potential side effects from the higher intensity radiation exposure in the shorter regimen. That can result in scarring and adverse effects for women decades later, he says.

That might explain why more younger women chose the longer, traditional radiation regimen, since they and their doctors may have been more concerned about scarring in their breast tissue later.

But the studies on the shorter course treatment include follow up with women up to 10 years after their therapy, and there’s no strong evidence that such adverse effects occur.

MORE: High-Tech 3D Mammograms Probably Saved This Woman’s Life

In addition, the women choosing the shorter course spent about 10% less in the first year after their treatment than those who opted for the traditional radiation regimen. “The savings in patient time and hassle and spending were really large, so it was a little surprising that more women weren’t using the [shorter course] of radiation,” says Bekelman.

Having data might help, he says, to convince both doctors and patients that when it comes to radiation, less may actually do more — in saving lives, reducing anxiety and inconvenience, and lowering health care costs.

TIME ebola

How Effective Is Screening for Ebola at Airports?

New York's JFK Airport Begins Screening Passengers For Ebola Virus
A plane arrives at New York's John F. Kennedy Airport (JFK) airport on October 11, 2014 in New York City. Spencer Platt—Getty Images

Since August, 80,000 passengers have been screened for Ebola at various airports around the world. Here’s what health officials found

As the Ebola outbreak in West Africa escalated over the summer, the World Health Organization recommended airport screening as a way to contain spread of the disease. WHO advised that all people leaving the most severely affected countries—Guinea, Liberia and Sierra Leone—should have their temperatures taken and be asked about any Ebola-related symptoms they might have, including fever, headaches, vomiting and diarrhea.

Since the program began in August, more than 80,000 passengers have been screened as they left these countries, 12,000 of them headed for the U.S. Do the screenings work? In a report published in the MMWR, officials at the U.S. Centers for Disease Control reveal the latest information from the program.

Anyone with a fever or other symptoms—or who reported having a high risk of being exposed to Ebola, such as having contact with Ebola patients—was not allowed to fly. According to the CDC report, none of those who were denied boarding were diagnosed with Ebola. But two patients without symptoms when they left West Africa, Thomas Eric Duncan and Dr. Craig Spencer, eventually developed Ebola after arriving in the U.S.

The MMWR report also details the U.S.’s more stringent airport entry screening for all passengers arriving from the three affected countries. Beginning Oct. 11, all passengers coming to the U.S. from these countries were required to fly into one of five airports: John F. Kennedy International Airport in New York, Newark Liberty International Airport in New Jersey, Washington-Dulles International Airport, Chicago O’Hare International Airport or Hartsfield-Jackson Atlanta International Airport. They are also required to take their temperatures for 21 days, the incubation period for the Ebola virus, and report them to local health officials. The designated airports are equipped with trained public health personnel who meet passengers and provide them with a kit to help them record their temperatures, as well as educate them about who to call if they develop symptoms.

From Oct. 11 to Nov. 10, 1, 993 passengers were screened this way, and 4.3% were referred to the CDC for additional evaluation. Seven people had symptoms and were referred to proper medical personnel, but none developed Ebola. “Using these processes to educate each traveler and then link the traveler to public health authorities for the duration of the incubation period is of critical importance to facilitate rapid detection of illness and implementation of appropriate public health control measures,” the authors write.

But the most effective way to prevent the epidemic from spreading is to control it at its source. In a separate MMWR report, researchers at the CDC say that their first assessment of Ebola infection and control in Sierra Leone reveals many gaps. In a review of six of the 14 districts in Sierra Leone that are affected by Ebola, the CDC Ebola Response Team found that none had a dedicated infection control supervisor to oversee training and implementation of infection control procedures, such as wearing protective equipment and isolating patients. There were also no national, district or facility standards for infection control, and screening of patients for Ebola was inadequate. All districts also lacked sufficient personal protective equipment, the gear that is critical for protecting health care workers treating Ebola patients, and many did not have running water, enough chlorine bleach to sanitize contaminated objects, or incinerators for burning disposable medical waste.

“An increasingly coordinated and comprehensive [infection and prevention control] program with district and health facility level support is urgently needed to prevent Ebola in districts where the prevalence is low and to strengthen the existing…response in areas with high prevalence of Ebola,” the CDC officials write.

TIME Heart Disease

The Other Reason Canned Food Is Raising Your Blood Pressure

Tinned sardines
Brad Wenner—Getty Images

Forget sodium—BPA might be the real canned food villain

If your food or drink comes out of a can, chances are it’s not the healthiest choice for your blood pressure (thanks to all that salt preserving your beans, for example.) But the latest research suggests there may be another reason to avoid canned goods. In a study published in Hypertension, researchers from South Korea found that drinking from cans, many of which have linings that contain the chemical bisphenol A (BPA), can raise blood pressure by 16 times compared to drinking from glass bottles.

The data isn’t the first to implicate BPA as a potential health hazard. Previous studies have connected the chemical, which can be found in plastics, the linings of cans and coating some cash register receipts, to disruptions in reproductive hormones such as estrogen, as well as a higher risk of asthma, obesity and disruptions in brain development in children. Exposure is almost unavoidable. Most studies show that people living in the U.S. have high exposures to BPA, and the chemical has been found in the urine of more than 95% of adults. One study found that eating canned soup for five days in a row can boost BPA levels in the urine by more than 1,000% compared to those eating soup prepared with fresh ingredients.

MORE: Why Receipts and Greasy Fingers Shouldn’t Mix

But those studies have compared different populations of people at different times. The Korean scientists decided to study the same group of 60 older people who drank the same beverages from both cans and glass bottles. Because the same people were being studied, it was unlikely that other factors that can affect BPA concentrations were influencing the results.

Senior author Yun-Chul Hong from the department of preventive medicine and the environmental health center at Seoul National University and his colleague found that the containers the drinkers used made a big difference in their BPA levels. Each was given two servings of soy milk during each of three visits. The milk was served in either two cans, two glass bottles, or one can and one glass bottle. The volunteers’ urine BPA levels were lowest after drinking from the two glass bottles, and highest after consuming milk from the two cans.

This difference translated to a change in 5 mmHg in blood pressure. Hong notes that an increase of 20 mmHg doubles the risk of heart disease, so the rise from BPA exposure is concerning.

MORE: BPA Linked with Obesity in Kids and Teens

“Because hypertension is a well-known risk factor for heart disease, our study showing the link of BPA exposure to elevation in blood pressure strongly suggests that BPA exposure may increase the risk of heart disease,” Hong writes in an email discussing the results.

When doctors evaluate patients for high blood pressure, asking them how many canned products they consume may be worthwhile, since the exposure to BPA from those containers could be pushing their blood pressure higher. “Clinicians and patients, particularly hypertension or heart disease patients, should be aware of the potential clinical problems for blood pressure elevation when consuming canned foods or using plastics containing BPA,” Hong says. And if you have a choice of getting your vegetables from the preserved aisle or the produce aisle, it might be better for your heart to kick the can.

TIME medicine

Genetic Screening Saved This Baby’s Life

Researchers say sequencing genomes can lead to quicker diagnoses and effective treatments for more than half of children affected by brain disorders

Mya Burkhart was only six months old when she went into cardiac arrest. Fortunately, she was in the hospital when it happened, brought there by her parents because she had trouble breathing. It was her eighth or ninth visit to the emergency room for her respiratory problems, but each time the doctors had sent the Burkharts home with more questions than answers.

Mya wasn’t developing at the normal rate. She couldn’t lift her head and wasn’t responding to people and things around her. Doctors thought she might have a muscle disorder, but her other symptoms did not fit with that diagnosis.

After her heart scare, Mya spent three weeks, including her first Christmas, in the ICU on a ventilator. “I couldn’t pick her up or anything,” says her mother Holly. Still unable to solve the mystery of what was ailing her, the doctors finally suggested she have her genome tested. Maybe, they hoped, her DNA would offer some clues about why she wasn’t growing normally.

MORE: The DNA Dilemma: A Test That Could Change Your Life

Holly knew the test was still in the research stages, and that there was a chance that even it might not yield any more answers about her daughter’s condition. “At that point, I just wanted to try anything to find out what was wrong with her,” she says. It boiled down to balancing a chance that their baby would live or die.

Genetic screening, especially whole-genome screening in which people can learn about their possible risk for certain diseases, remains controversial, since the information is neither definitive nor always accurate. In most cases, genes can only predict, with a limited amount of certainty, whether a disease such as breast cancer or Alzheimer’s looms in a person’s future. As the Food and Drug Administration (FDA) contemplates the merits and efficacy of such screening, some doctors and researchers are using it with great success, according to a new study published in the journal Science Translational Medicine.

Researchers at Children’s Mercy Hospital in Kansas City, where Mya was treated, say that for 100 families, including the Burkharts, with children affected by either unknown disorders or brain abnormalities, genome screening helped 45% receive a new diagnosis, and guided 55% to a different treatment for their child’s disorder. Of the 100 families, 85 had been going from doctor to doctor in search of a diagnosis for an average of six and a half years.

“I was surprised by how many cases we found where a specific intervention can make a difference,” says Sarah Soden from the Center for Pediatric Genomic Medicine at Children’s Mercy and the study’s lead author. “For me it’s compelling enough to push the envelope and get younger kids diagnosed.”

MORE: Faster DNA Testing Helps Diagnose Disease in NICU Babies

In Mya’s case, her genome revealed a mutation in a gene responsible for transporting citrate; without it, her cells could not get the energy they needed. So far, only 13 babies have been confirmed with the condition, and all died before their first birthday after having seizures and respiratory infections. Once the genetic analysis revealed the deficiency, however, Mya was started on citrate supplements. She’s now 18 months old, having already lived nearly twice as long as the other confirmed cases. She has some developmental delays but she has not had any seizures and managed to avoid getting any serious respiratory infections.

Their success at Children’s Mercy are encouraging Soden and the study’s senior author, Dr. Stephen Kingsmore, to push ahead and determine how such screening can benefit more babies. About 5% of the 4 million babies born in the U.S. each year are admitted to the neonatal intensive care unit (NICU), and between those who are born with a genetic disorder and those who may have adverse drug interactions, he and his team anticipate that about 30%, or 60,000, may benefit from the personalized screening they offer.

For now, he and his team are targeting babies like Mya who are sick almost from the minute they enter the world, with symptoms and abnormalities that doctors simply cannot explain. For them, the screening can save families from uncertainty as well as the financial burden of having many different experts perform many different tests looking for a diagnosis. The average genetic sequencing for newborns costs around $5,000, but the average cost of a night’s stay in the Neonatal Intensive Care Unit (NICU) hovers around $8,000, and most babies spend days, if not weeks, in the units awaiting a diagnosis.

Kingsmore received a $1.5 million grant from the NIH to expand the screening program to other institutes, and he has reached out to hospitals in Florida, at the University of Maryland and in Oklahoma City to test the strategy in more babies. “If we can decrease the length of stay in the NICU it could certainly lead to huge potential cost savings,” says Dr. Alan Shuldiner, associate dean of personalized medicine at the University of Maryland.

In the latest study, Soden says that on average, families spent more than $30,000 on genetic testing alone to figure out what was ailing their babies; those who had their genomes screened paid about $3,000 for an answer.

The key to Kingsmore’s success is a system that starts with a doctor punching in a newborn’s baffling symptoms and ends with a genetic readout. The “magic juice,” as he calls it, is a database of 10,000 symptoms that typically affect infants, from simple coughs and fevers and enlarged hearts to all manner of abnormal lab readings. The baby’s unique combination of these symptoms is mapped onto the 3,000 genes that experts have so far connected to about 4,000 diseases. “No physician on the planet earth could carry that database around in his head,” says Kingsmore. But that’s what desperate parents, whose babies’ lives are at stake, expect them to do. So Kingsmore’s program accomplishes the feat, spitting out, in rank order, a list of potential genetic diagnoses. That targeted tally of diseases then directs doctors to focus on a much more manageable list of 10 or, at the most, 50 genes (from a possible 20,000 or so) that could be mutated and responsible for the baby’s condition.

While there is no argument that such testing can save lives, the more challenging question is who should be tested, and when. There is also still debate among those in the genetics and medical communities about how to interpret genomic data. “Some people would argue that he is still reporting his experimental findings, and moving too soon from the research arena into the clinical arena,” says Dr. Edward McCabe, chief medical officer of the March of Dimes.

Ethicists are concerned about the coerciveness inherent in any hand extended to parents whose babies would otherwise die; no matter how carefully and comprehensively doctors word their request, parents in that situation may not fully process the risks and benefits and be unable to provide a truly informed consent. What if the baby falls into the minority for whom the testing doesn’t yield a diagnosis or treatment? When faced with inevitable death on the one hand, and a chance, however, small, of avoiding that death on the other, can there ever really be a choice?

The stakes are especially high since in some cases, the disorders won’t lead to established and approved treatments, but experimental ones without known risks and benefits. But as the value of such testing becomes more obvious, more centers may consider sequencing more newborns’ genes. “These babies, because they are brand new, are salvageable,” says Kingsmore. “Many patients we see with genetic illnesses already have ravaged organs. In contrast, with newborn babies we have the opportunity to halt a disease early in its progression,” he says.

“I think this testing is definitely something that everybody should consider,” Holly Burkhart says. “Without it, we probably never would have figured out what was wrong with Mya. We probably would be in the same place we were a few months ago.” Instead, Mya is now smiling at her mom and making progress. “The testing helped us find answers, and tell us where we need to go from here,” she says.

TIME Mental Health/Psychology

Here’s How to Make Waiting A Little Less Excruciating

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Some people are better at waiting than others, and there’s a reason for that

We’ve all been there—whether it’s a job interview or an exam or a medical test, once it’s over, there’s nothing we can do but worry and wait.

Some people are better than others at weathering these periods, able to go about their normal lives while only occasionally dwelling on what might happen. The rest of us are nearly paralyzed by the uncertainty, riding waves of hope and despair as we ruminate over every possible outcome.

Kate Sweeny, an associate professor of psychology at University of California Riverside, has made a career out of studying these differences in waiting behaviors. And she’s identified the personality traits that may make distinguish those who are better and worse at waiting—some of which, thankfully, may be adaptable.

In Sweeny’s latest study, published in the Journal of Personality and Social Psychology, she and a colleague studied 50 law school graduates who were waiting for the results of the California bar exam in 2011. The lawyers filled out detailed personality questionnaires that revealed how well they managed uncertainty, whether they were more optimistic or pessimistic, and their self-esteem. She and her colleague also explored how well the lawyers managed their emotions and expectations, and the coping mechanisms they tended to use when they were anxious, among other things.

Not surprisingly, they found that having an optimistic outlook and being more comfortable with uncertainty helped people handle waiting periods better. But they also found that self-esteem did not seem to have much effect on tempering anxiety during the waiting period. In other words, it didn’t matter whether the participants had reported having high self-esteem or not; what mattered more was whether they tended to have a positive outlook and expect the best.

“I was surprised, since plenty of other research suggested that high self-esteem should help people get through difficult periods when their ego is threatened,” says Sweeny.

It also turned out that people’s states during the waiting period were dynamic, changing depending on how close they were to finding out the outcome. At the beginning of the wait, it was harder for all of the participants to distract themselves from thinking about the possible outcomes, and all of them—even the optimists—became more pessimistic or entertained more negative thoughts about the result as they got closer to the moment of truth.

Sweeny and her colleague also learned some interesting things about the coping mechanisms that people use to get through the uncertainty and anxiety of waiting. While distracting yourself with other unrelated tasks or thoughts was a common tactic, it didn’t prove very successful, especially if the participants were trying very hard to consciously distract themselves. “The fact that they are trying so hard to not feel so anxious actually backfires, because it anything it keeps the uncertainty in mind,” she says.

Anticipating bad news and trying to find the positive in it—preparing ahead of time for failure, in other words—may not help to ease the anxiety during the waiting period, but can be helpful once the result comes, since it gives people a sense of control over their future.

And the same is true for distancing your sense of self worth from the outcome. The more space you put between the result and your sense of self, the easier the final outcome may be. “If you convince yourself the bar exam is not that important, and that it’s just a silly exam you have to take and doesn’t reflect on your or your abilities, that space might help you not have a crushing blow to your ego if the news is bad,” she says.

But for all the worriers out there who can’t distract themselves from the anguish of “what if”’ while waiting, there’s also some solace. The study found that those who had a harder time during the waiting period fared better emotionally after the result, regardless of whether it was bad or good. The participants in the study who had more anxiety and frustration while waiting for their bar exam results and ended up failing, for example, were more likely to turn around and start studying for the test again compared to those who didn’t worry as much about the outcome. And if they passed, the relief was sweeter. “There’s a relief when the waiting is over and things turned out well, and you don’t feel as bad if you get bad news,” says Sweeny. “Either way, it’s a little less of a harsh blow if you had a tough waiting period.”

Still, to make that period less painful, she’s currently studying the effects of mindfulness meditation to help those who can’t stop obsessing over the outcome while they wait. The technique, she says, is perfectly designed for managing such waits, since it focuses on helping people to accept their negative emotions but not be driven by them. So while waiting will never be easy, some things in your control, at least, may make it more bearable.

Read next: 5 Signs You Should Take a Break From Social Media

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