TIME Cancer

Most Cancer Is Beyond Your Control, Breakthrough Study Finds

There’s a lot we can do to protect ourselves from certain cancers — don’t smoke, avoid prolonged exposure to the sun, and try not to breathe or ingest too many chemical pollutants in the air or our food. But scientists have always known that this was only part of the cancer story. There’s also heredity, but that only explains about 5% to 10% of cancer. The truth of the matter is that some tumors emerge simply at random. But how much of malignancy can be attributed to this unfortunate roll of the dice? What really causes cancer?

Christian Tomasetti and Bert Vogelstein at Johns Hopkins University believe they may have found an answer, and it’s likely to turn our understanding of cancer — and how it should be diagnosed and treated — on its head. In a groundbreaking paper published in Science, the duo describe a new factor, a tissue’s stem cells, that may explain as much as two-thirds of the difference in cancer risk among different tissues.

Many tissues in the body have stem cells that serve as factories for churning out more cells of the same kind; it’s what keeps our skin cells refreshed, and our blood and immune cells young and vigorous. This replicative power is the engine that keeps the body going, allowing tissues to replace cells as they die off. But it’s also the process behind cancer, since cancer is caused by cells that pick up mutations in their DNA when they divide — and stem cells are the only population that copy their DNA and divide to make more cells. Only a small proportion of a tissue’s cells are made up of stem cells, so Tomasetti and Vogelstein decided to map out whether the number of stem cells in a specific tissue bears any relationship to its tendency to develop cancer.

MORE Promising New Cancer Treatment Uses Immune Cells

Indeed, when they charted out the stem cell data for 31 types of tissues, they found a dramatic connection between the two — the more stem cells the tissue had, the higher its incidence of cancer over a person’s life time on average. “Think of cancer as the risk of having an accident if you are driving a car,” says Tomasetti, a biostatistician who holds positions in the department of oncology at Johns Hopkins Kimmel Cancer Center and the Johns Hopkins Bloomberg School of Public Health. “If you drive the car on a cross country trip, your risk of an accident is much higher than if you take a local trip to the grocery store. The risk correlates to the length of the trip. The trip to the grocery store might be thought of as bone cancer, which has few stem cell divisions. While the cross country trip might be more like colon cancer, which has many more cell divisions.”

In fact, the correlation held strong among cancers that were both common and more rare. The more likely those cells would divide and develop DNA errors or mutations in the process that led to uncontrolled growth, the more likely that tissue would develop tumors.

“It was quite surprising to us. We think it’s pretty big,” he says. “About 65% of cancer incidence across tissue types appears to be explained by the number of stem cell divisions.”

MORE Stem Cells That Kill

Having a detailed understanding of both how large a tissue’s stem cell population is, as well as how active it is, could be a determining factor in whether it’s likely to develop cancer. Both the brain cells that can cause glioblastoma and medulloblastoma, and the colon contain about the same number of stem cells, Tomasetti estimates — about one hundred million. But the colon stem cells divide about 6000 times on average during lifetime, compared to nearly zero for the brain stem cells. That leads to rates of colon cancer that are 22 times higher than rates of the brain tumors.

PrintCredit: C. Tomasetti, B. Vogelstein and illustrator Elizabeth Cook, Johns Hopkins

Such an explanation could also resolve some of cancer’s mysteries — why people who don’t smoke still get lung cancer in surprising numbers, or why rates of colon cancer are higher than rates of cancer in the small intestine, despite being shorter in length. One reason, says Tomasetti, could have to do with the different stem cell activity in these tissues.

This finding potentially changes the landscape of cancer. In recent decades, cancer rates have come down due to aggressive efforts to educate and motivate people to take positive steps toward preventing cancer in the first place, such as quitting smoking and avoiding the sun’s ultraviolet rays. Have those messages been wrong?

Not exactly. Tomasetti says that the study shows that it’s time to redirect that cancer strategy a bit — not abandon it. For example, he and Vogelstein propose looking at cancers in two categories, those that are primarily due to genetic bad luck, and those that are due to that unfortunate roll of the genetic dice plus environmental or hereditary factors. So melanoma, ovarian cancer, many brain cancers, lung cancer among non-smokers, the most common leukemias and bone cancers, for example, are pretty much out of people’s control. They’re the result of the random mutations caused by the stem cells dividing in these tissues — bone, blood, ovaries, brain and skin — that make mistakes that turn malignant. For these cancers, changing your lifestyle or trying other interventions to stop the cancer from occurring in the first place won’t help. But being vigilant about screening, and picking up the first signs of trouble early, can be life saving.

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

For the other type of cancers, those that are the product of both stem cell mutations and heredity or other exposures, continuing with proven prevention methods, which include screening in cases of inherited disease, as well as quitting smoking and reducing exposure to radiation and carcinogens, is still critical. That’s what has lowered rates of lung cancer among smokers, for example, and colon cancer among those with hereditary disease.

“Everything we know about altering lifestyles to prevent cancer from the environmental point of view we absolutely need to continue doing,” says Tomasetti. “If anything it puts more stress on the need to spend even more money on early detection. It may be the key tool for quite a few cancer types.”

Tomasetti admits that two common cancers are missing from the study — breast cancer and prostate cancer. That’s because knowledge about their stem cell populations, and how often those tissues renew, isn’t quite as solid as it is for tissues such as colon. “We are working on that,” he says. “We hope this type of work highlighting the importance of self renewal will cause others to investigate these stem cell populations in more detail as well.”

In the meantime, he stresses that while we may not be able to prevent the tumors from forming, it’s still possible to treat them and potentially save lives by finding them early and removing them or using chemotherapy or radiation to keep them under control. “My biggest fear is that people will say forget about it, and then do nothing. The opposite is true. We need to do everything we did before, but we want to do it even more than before,” he says.

Read next: Your Chances of Surviving Cancer May Depend on Where You Live

TIME Obesity

Weight Loss Supplements Don’t Work for Most People, Study Finds

A Consumer Reports survey shows that most people who use weight loss supplements aren’t aware of how potentially unsafe or ineffective they are

In a survey of 3,000 Americans, researchers at Consumer Reports report Tuesday that most are confused about how weight loss supplements make it to market, and that means they aren’t fully informed about how safe or effective the pills are. What’s more, of those Americans who have tried such pills to lose weight, very few met—and maintained—their goal.

About 20% of those who use diet supplements to lose weight believed they were safe and tested by the Food and Drug Administration. But unlike prescription drugs, supplements aren’t regulated under the strict criteria that require manufacturers to perform rigorous safety and effectiveness testing before getting approved. Instead, supplements are regulated more like foods, so they are assumed to be safe unless they’re shown not to be by reports from users.

Meanwhile, roughly 20% of those surveyed believed that the supplements were safer than more stringently regulated prescription drugs because they were “natural.” But recent studies revealed that many supplements contain substances that have been banned because of safety concerns; in one study two-thirds of weight loss supplements contained banned ingredients. And the supplements aren’t always benign. About half of users reported at least one side effect, ranging from dry mouth to more serious digestive issues including diarrhea and constipation, as well as rapid heart rate.

When it comes to actually losing weight, the supplements didn’t fare so well either. A third didn’t shed any pounds at all, and only 9% of the respondents said they lost their target weight and were able to keep it off. But the supplements may not even take all of the credit for that success — 85% of the people who lost weight while taking a supplement also changed their diet and had an exercise plan.

Which goes back to the advice that most doctors give to anyone serious about getting slimmer: weight loss doesn’t come in a pill, it comes with a healthy diet and regular exercise program.

TIME medicine

The Surest Way to Cure Your Hangover

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The holidays. A new year. There’s a lot to celebrate, so don’t ruin it with a hangover or a food coma. Here's how to avoid both

A night of too much booze often comes with a side of queasiness and a pounding headache. We’ve all heard rumors about what helps, from hot sauce to burnt toast to more alcohol, but here’s what doctors say really works as a morning-after remedy.

First, it’s important to recognize what your hungover body is trying to tell you. Alcohol makes you urinate more, and that depletes your body of much-needed fluids. At the same time, impurities in the fermenting alcohol essentially flood your body with toxins, causing those painful side effects.

It’s not always easy in practice, but the best way to avoid that nasty hangover in the first place is to alternate your alcoholic drinks with water.

Too late for that? On the morning after, the very best way to ease your stomach is to drink water. Water will rehydrate you, dilute the toxins that have built up overnight and flush them out.

Eating is also key, whether you want to fight or prevent a hangover. Filling your stomach before you drink, especially with heavier, greasier foods, can line the stomach and slow down the absorption of alcohol. And noshing after a night out, even if it’s last thing you feel like doing, can replenish your body with nutrients so it starts to function better.

READ MORE Should You Eat Whatever You Want For The Holidays?

If you remember, try taking two aspirin before going to bed, and another couple when you wake up. That can ease some of the head pounding that comes from the drop in blood alcohol and being dehydrated from all that drinking.

As for overeating, it’s sometimes inevitable, especially at holiday feasts. Try to cut down on your portions, or at least eat more slowly. That can help your brain and body stay in sync and work together to determine when you’re no longer hungry. Extra points if you load up on high-fiber foods like whole grains, vegetables and nuts; they’ll make you evacuate your bowels more frequently and make you feel less uncomfortable. Just remember not to bring it up during one of those big meals.

TIME

Why You Shouldn’t Read a Tablet Before Bed

If reading is your way of easing into sleep, pick up a printed book instead of a digital one

There’s nothing wrong with settling down with a good book at the end of day to melt away tension and help you to unwind. But if you’re picking up an e-reader or a tablet, then you’re doing it all wrong.

That’s what Anne-Marie Chang, associate professor of biobehavioral health at Penn State University, and her colleagues found when they compared digital readers with the printed word. Reporting in the Proceedings of the National Academy of Sciences, they say that people who use the electronic devices such as an iPad had more disrupted sleep patterns and were more tired the next morning than those who read from traditional books.

Chang, who conducted the study while at Brigham and Women’s Hospital, designed the trial to be as objective as possible. What Chang found was a marked difference between each participant’s sleep patterns and alertness depending on whether they read from a digital reader or from a book. When they read from an iPad, their evening levels of melatonin failed to drop as much as they should, while they remained at expected levels when they read from a book. That led to a delay in body’s biological signal to go so sleep of about an hour and a half, making the participants more alert and therefore not ready for bed.

And when the scientists looked at their sleep patterns, they found that the differences went even deeper. When the volunteers read from electronic devices, they had shorter REM sleep, the stage in which memories are consolidated and the brain refreshes itself, than when they read from printed books. This occurred even though the volunteers slept for the same amount of time, eight hours, every night.

MORE: 3 Reasons To Keep Your Phone Away from the Bed

What’s more, the effect of those differences in sleep patterns spilled over into the next morning. When they read from digital readers, the participants reported feeling sleepier and were less alert (as measured on standardized testing of alertness) than when they used books. “What was surprising to me was that we would see effects the next day. There was no difference in total sleep duration between the two conditions, but there was a significant amount of REM sleep difference,” says Chang. “This may indicate that these effects are longer term than we thought.”

Previous studies showed that one reason for the disrupted sleep linked to the electronic devices may be due to the type of light they use. It’s in the blue wavelength, and some researchers have connected this light to a disruptions in the melatonin system, similar to those Chang found in the study. She says it’s also possible that having the light shine directly into the eyes, as backlit electronic readers do, may also keep the body’s sleep signals from activating — reading lamps or room lights reflect light so aren’t as disruptive to the body’s wake-sleep cycle.

The findings hint at why sleep — getting enough, and getting good quality sleep — is becoming more a of challenge and potentially a growing health problem. “There is an easy answer but it’s not a popular one that’s easy to hear,” says Chang. “Using electronic devices is not a train that is slowing down any time soon. So the important thing is to know more about them, and how they are affecting our lives, our health and our well being.” And in the meantime, maybe put the tablet down in the hours before you go to bed. Or buy a book.

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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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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.

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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.

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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.

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