TIME sexual abuse

Childhood Sexual Abuse Raises Heart Disease Risk In Adulthood

Researchers link early sexual abuse to greater risk of developing blocked heart arteries

Sexual and physical abuse during childhood can have long term effects on both mental and physical health, and previous studies have linked childhood sexual abuse to a greater risk of heart attack and other heart events—but it has been unclear exactly why. New research published Thursday in the journal Stroke adds to the case, showing thatwhether or not women had other risk factors for heart problems, a history of childhood sexual abuse remained a strong potential contributor to their atherosclerosis.

“What was a surprise was that when we controlled for [heart disease] risk factors, such as smoking and obesity, the association didn’t go away. We just couldn’t get rid of the association,” says Rebecca Thurston, director of the Womens’ Biobehavioral Health Laboratory at the University of Pittsburgh, who led the research with a team of colleagues.

MORE: Viewpoint: Why a Mandatory Child Abuse Reporting Law Could Backfire

More than 1,000 middle-aged women of various ethnic backgrounds from across the U.S. had yearly clinical exams beginning in 1996 for 12 years. At the end of the study, they also answered questions about sexual and physical abuse and had an ultrasound of their carotid arteries. About a quarter of the women reported being sexually abused as a child, and a similar percentage reported the experience as an adult.

When Thurston compared the women’s answers to their ultrasound, she found that those who reported childhood sexual abuse showed higher rates of plaque buildup in their arteries. They also had hearts and vessels that looked about two to three years older than those of women who hadn’t been abused.

MORE: Psychological Abuse: More Common, as Harmful as Other Child Maltreatment

Thurston’s findings suggest that whether or not the women had other risk factors for heart problems, their history of childhood sexual abuse remained a strong potential contributor to their atherosclerosis.

Thurston plans to continue the work by studying women who have had heart events – in this study, only women without heart disease were included – to see if the correlation still holds. She also wants to better understand how the early abuse affects women in later life. There is some evidence that traumatic experiences may change the stress response system in lasting, and possibly permanent ways.

While none of the women had signs of heart disease at the start of the study, Thurston says the results hint that physicians should be considering childhood experience, particularly traumatic ones, as part of comprehensive heart care for women. If the results are validated, then they might lead to ways of intervening with stress reduction or other psychological techniques to hopefully slow down the hardening of the arteries and lower their risk of heart disease.

TIME Breast Cancer

Removing Both Breasts May Not Improve Survival From Breast Cancer

The latest study adds support to the data suggesting that in some cases, less may be more in treating breast cancer

Researchers at the University of Minnesota confirm that when it comes to treating some forms of breast cancer, drastic surgery to remove breast tissue may not help in improving survival from the disease.

Reporting in the Journal of the National Cancer Institute, the scientists describe a model for calculating life expectancy based on recent rates of recurrent cancers among women with stage 1 or stage 2 disease. Although previous studies found that among women diagnosed with breast cancer in one breast, removing the other breast can lower risk of breast cancer in that breast by up to 90%, few studies have documented whether that also translated into greater survival of breast cancer, which can recur in other organs.

According to the researchers’ model, the overall difference in survival at 20 years after diagnosis for both women who had their opposing, unaffected breast removed and those who did not, was less than 1%.

The data confirm recent findings from a study of women with metastatic disease, which also showed that women who received additional surgery to remove lymph nodes and their breasts did not survive any longer than those who were treated with chemotherapy only. As TIME wrote about that study,

Researchers from Tata Memorial Hospital in Mumbai, India, recruited 305 women between 2005 and 2013, all of whom had metastatic breast cancer and had responded to six cycles of chemotherapy. The women were split into two groups. One group of 173 women received additional surgery and radiation treatment, and 177 did not. The women who received surgery had partial or total removal of their breasts and lymph nodes followed by radiotherapy.

After just over two and a half years, the scientists found no overall difference in survival between the two groups; in fact, there was a slight, but not significantly significant, increase in risk of death for the women undergoing surgery and radiation. The lack of difference remained strong even after the scientific team adjusted for the types of breast cancer the women had, and the extent to which their cancer had spread to other organs. The findings should provide more confidence to both doctors and patients who choose not to go under the knife or receive radiation in an effort to prolong their lives, since the evidence suggests that the added measures don’t provide significant benefit, and may only expose the women to more complications.

In the current study, the researchers note that survival is only one factor that women may take into account when debating whether to remove an unaffected breast. In an accompanying editorial, other researchers echoed the distinction, saying that quality of life and peace of mind factors may be important reasons for supporting the continued use of prophylactic mastectomy surgery.

TIME heart

Pigs Can Grow Their Own Pacemakers

And the scientists say that the technique, which involves cutting edge reprogramming of cells, may be tested in people soon

+ READ ARTICLE

Pacemakers are remarkable devices that save the lives of 300,000 people in the U.S. each year. They essentially take over for failing hearts, but since the devices require invasive surgery to implant in the heart, researchers have been looking for less invasive approaches to keeping the heart ticking. And now, reporting in the journal Science Translational Medicine, Dr. Eduardo Marban, director of the Cedars-Sinai Heart Institute, has a lead—thanks to pigs.

“We were able for the first time to create a biological pacemaker using minimally invasive methods, and show that the new pacemaker cells suffice to support the demands of daily life,” he said. “When the pigs exercised, the hearts beat faster. When they were at rest, their hearts slowed down.”

He and his colleagues say that a single gene can transform existing heart cells to take over the function of ailing pacemaker cells in the heart, The group tested their theory in mice, and were encouraged enough by the results to predict that human trials may be as close as three years away.

MORE: A ‘Vaccine’ for Heart Disease Could Mean No Pills, Lettuce or a Gym

Marban has been working for more than a decade to find a better way to keep pacemaker patients’ hearts pumping at the right rate. In particular, he was focused on the 2% of them who need to go on antibiotics to treat an infection—because the devices are foreign objects implanted into the body, infections are possible—and in the interim have their pacemakers removed to be cleaned. During that time, these patients receive a temporary pacing device connected to a catheter, but the catheter itself may be an additional source of infection and make the antibiotic treatment less effective.

MORE: Single Gene Responsible for Group of Heart Disease Risk Factors

In Marban’s experiment, he simply loaded deactivated cold viruses, which are able to easily infect cells, with a gene—called TBX18—that is active during fetal development but later shuts off. Earlier studies showed that simply bathing cells in TBX triggered normal heart cells to start morphing into the ones that keep hearts working. That’s exactly what happened in the seven pigs whose hearts were injected with the gene. A small proportion of their normal heart cells, the size of a peppercorn, were transformed into electrically pulsing cells and essentially took over the pacemaker function of the pigs’ hearts.

Dr. Eugenio Cingolani, director of the cardiogenetics-familial arrhythmia clinic at Cedars Sinai and a co-author of the paper, said that while encouraging, more studies on the efficacy of the genetic reprogramming process, as well as a more in-depth analysis of the potential adverse effects are needed.

But the findings represent a promising first step toward a potentially new technique for treating certain life-threatening conditions.

“This development heralds a new era in gene therapy, where genes are used not only to correct deficiency disorders but to convert one cell to another to treat disease,” said Marban. “Now that we and others are hot on the trail of developing therapeutics based on this principle of cell reprogramming, I anticipate that the flood gates will open and people will look for genes of interest to do whatever they want in particular organs or tissues of interest.”

At the very least, he believes that a hardware-free, biological pacemaker based on the technique could become reality.

TIME

5 Groundbreaking Trials Are Testing Ways to Prevent Alzheimer’s

Researchers are testing some promising drug candidates to halt Alzheimer’s dementia – even before symptoms start

At the Alzheimer’s Association International Conference in Copenhagen, scientists described five trials that taking the unprecedented step of testing drugs that may prevent the onset of the neurodegenerative disease in people not yet experiencing cognitive decline.

The participants in the trial are all at high risk of developing Alzheimer’s either because they carry two copies of the ApoE4 gene, which is associated with a strong chance of developing the disease, or a genetic mutation that triggers the condition much earlier in life, during the 40s.

Most will be testing drugs that target amyloid, the protein that builds up in abnormal amounts in the brains of Alzheimer’s patients and triggers other damaging changes that affect memory and cognitive functions. While other scientists reported some encouraging data on the effectiveness of diet, exercise, social support and controlling heart-related risk factors—see our piece about the lifestyle changes that prevented the disease—most experts believe that the best way to prevent Alzheimer’s may involve a combination of such lifestyle approaches with an effective drug.

Here’s the latest information on the five trials.

1. Dominantly Inherited Alzheimer Network Trial (DIAN TU)

Who is enrolled: People with a genetic mutation for Alzheimer’s disease or those who don’t know their genetic status but have a parent or sibling with Alzheimer’s-related mutations

When they should enroll: when they are cognitively normal or have mild cognitive impairment

Drugs tested: Two experimental drugs, gantenerumab and solanezumab, both of which are antibodies designed to bind to amyloid and prevent it from forming brain-damaging plaques

2. Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Study (A4)

Who is enrolled: People aged 65 to 85 years with normal thinking and memory

When they should enroll: Any time they become age eligible

Drugs tested: Solanezumab, an experimental anti-amyloid compound

3. TOMMORROW

Who is enrolled: Healthy seniors

When they should enroll: When they are cognitively normal or have mild cognitive impairment

Drugs tested: The trial will first pilot a screening test for two genes to see if it can accurately predict risk of mild cognitive impairment. The next phase of the trial will test an experimental compound designed to delay symptoms of mild cognitive impairment and Alzheimer’s disease in people without symptoms.

4. Alzheimer’s Prevention Initiative Autosomal Dominant Alzheimer’s Disease Treatment Trial

Who is enrolled: 300 people from a family in Columbia affected by a genetic predisposition to developing Alzheimer’s disease early in life

When they should enroll: Before symptoms begin

Drug tested: Anti-amyloid antibody crenezumab

5. Alzheimer’s Prevention Initiative APOE4 Treatment Trial

Who is enrolled: people with two copies of APOE4, who are at high risk of developing Alzheimer’s disease

When they should enroll: Before cognitive symptoms of Alzheimer’s begin

Drugs tested: An immunotherapy that prompts the body’s immune system to produce antibodies against amyloid protein, and a beta-secretase inhibitor that blocks the production of certain forms of amyloid.

TIME Cancer

Breast-Cancer Drug Has a Surprising New Application, Study Finds

An early study shows that gel-based tamoxifen may be as effective as the oral drug, and have fewer side effects

Tamoxifen is a mainstay of breast cancer treatments: it blocks the effects of the female hormone estrogen on the breast, inhibiting estrogen’s tendency to encourage breast tissue to grow uncontrollably. Now, Dr. Seema Khan, professor of surgery at Northwestern University Feinberg School of Medicine, reports in Clinical Cancer Research that putting the drug in a gel, and applying it directly to the breast tissue, where it needs to work, may have merit.

Doctors generally prescribe tamoxifen for women diagnosed with early breast cancer, including very early-stage ductal carcinoma in situ (DCIS), to prevent recurrent growths. But the drug has also been linked to an increased risk of stroke, blood clots and cancers in other tissues, including the uterus. That’s why more women, including those who have not yet had cancer but are at high risk for the disease could benefit from the drug but are reluctant to take it.

MORE: Why Mammograms Are Less Effective Among Breast Cancer Survivors

Dr. Khan’s study was small—only 26 women—but it provides proof that the principle of applying tamoxifen directly on the breast may be worth investigating. All of the women were diagnosed with DCIS, which generally does not spread. But 30% of DCIS can recur even after surgery and proper treatment, so most women are prescribed tamoxifen. In the current study, about half of the women in the study were randomly assigned to take the oral form of the drug, while the other half were given doses of a tamoxifen gel to apply directly to the breast tissue for six to 10 weeks before their surgery. Khan analyzed the breast tissue after surgery to study markers for tumor growth, and conducted blood tests for levels of tamoxifen metabolites as well.

At the end of the study, the women in both groups showed similar decreases in tumor-related proteins, but blood levels of tamoxifen were five times lower among the women using the gel than those taking the oral pill. That, says Dr. Khan, suggests that the major side effects of the drug, which occur in the blood and other reproductive organs, may be largely avoided if women use the gel.

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

“Our study showed that applying the drug through the breast skin leads to high concentrations in the breast and low concentrations in the rest of the body,” she says. “The biological effect on the breast is consistent with the benefit of oral tamoxifen, so for that reason, we hope that this kind of approach would make preventive medication more acceptable to women with non-invasive breast cancer and how may be at high risk of developing breast cancer.”

Dr. Khan says that the breast may be uniquely designed for such transdermal therapy, since it is essentially an appendage of the skin, with its own internal lymphatic circulation. That may keep things applied to the breast skin within the breast tissue, and could explain the higher concentrations of tamoxifen metabolites she and her team found after the gel applications.

Still, she says that the small number of participants in the study means more research is needed to confirm the results. Right now, the gel version is not available. The company that provided the experimental doses for the study stopped making that formulation, so Dr. Khan is studying a related, similar metabolite called endoxifen that may have similar cancer-fighting effects on breast tissue.

If the strategy proves effective, it’s possible that cancer treatments, or at least breast cancer treatments, may become useful in preventing cancer as well, as more women at high risk who have yet to be diagnosed with the disease take advantage of them. Applying a gel with relatively few side effects may help more women to eliminate small tumors before they have a chance to grow. And if other types of drugs can be used on the skin as well, that could significantly broaden the therapies available to women looking for ways to prevent the disease.

“For high-risk women who need better prevention strategies, delivering the drug to the breast is a very desirable solution,” says Dr. Khan.

TIME Brain

To Prevent Alzheimer’s, Diet and Exercise Are Effective, Large Study Shows

In a groundbreaking study that looked at how diet, exercise and other non-drug interventions affect cognitive decline, researchers see some hope for relatively easy dementia-fighting strategies

+ READ ARTICLE

No one believes that a disease as complicated as Alzheimer’s can be warded off by an apple a day or by faithfully hitting the weight room. But a breakthrough study presented Sunday at the Alzheimer’s Association International Conference shows that after just two years, people who underwent lifestyle interventions showed improvements in their mental functions, including in memory, executive function and speed tests of their cognitive skills.

Dr. Miia Kivipelto from the Karolinska Institute in Sweden knew that several studies have linked some lifestyle behaviors, such as exercise and a healthy diet, as well as being more socially active, to less cognitive decline and stronger scores on memory and organizational tests. But it wasn’t clear whether people who ate better, exercised more and had more friends also shared something else in common that could explain their ability to slow down dementia symptoms.

So Kivipelto conducted one of the first studies to randomly assign 1,260 older individuals at high risk of developing Alzheimer’s to a lifestyle intervention or to normal health care, to see if the behaviors linked to better brain health actually helped to stave off intellectual decline. “We were surprised that were able to see a clear difference already after two years,” says Kivipelto. She was especially pleased to see the effect since the control group also received adequate and appropriate health care. “We thought that two years may not be enough, but the multi-domain approach seems to be an effective way of doing something to protect memory.”

MORE: New Understanding on Understanding Alzheimer’s

All of the participants, part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study, had some risk factor for developing dementia, including their age, education, and poor heart-health profile. Half were randomly assigned to get an intensive lifestyle makeover, with both group and individual nutrition advice, an exercise trainer, and a nurse or physician who made sure they took their medications. In addition, these volunteers benefited from a social support system. The other half received appropriate health care, but not at the intensive level the intervention group did, and without the social support of their fellow participants.

MORE: New Criteria May Change Alzheimer’s Diagnosis

After just two years, the group that group that got the lifestyle makeover were in much better shape.

MORE: Study: Brain Scans Help Predict Alzheimer’s Disease Early

She and her team plan to continue following up with the participants in another seven years, to see if the effect remains. But she is aware that sticking with a lifestyle plan like the one in the study is a challenge, and says that any such program needs to incorporate ways of keeping patients motivated to comply. That’s why social support may be an important part of any such plan; in this study, for example, if participants missed exercise sessions, others called to find out why they were absent, cementing a pact to adhere to the new behaviors.

Kivipelto also recognizes that genetic factors can play a role in cognitive decline and risk of memory loss, but she says there may be a role for lifestyle interventions in helping people who may be at high risk of developing dementia or Alzheimer’s disease—before their symptoms start.

“These findings show that prevention is possible, and that it may be good to start early,” she says. “With so many negative trials for Alzheimer’s drugs reported lately, it’s good that we may have something that everyone can do now to lower their risk.”

 

TIME fitness

Sitting All Day Isn’t As Bad If You Do This

African American businessman using laptop
Jetta Productions/Blend Images RM/Getty Images

Getting to the bottom of sitting on your bottom: the latest study shows that fitness matters

There’s a growing drumbeat to get all of us out of our chairs and off our bottoms. Some studies, including the most recent analysis, suggest that something about being sedentary can lead to poor health outcomes, including heart disease and things like obesity, diabetes and overall “fitness”—which, in technical terms, is a measure of how strong the heart and respiratory system are. Those studies found that even people who exercised weren’t immune to the dangers of sitting—though exercise did help.

But were the effects of sitting actually independently lowering fitness and causing health problems, or was the sitting just a reflection of the fact that people who sat more spent less time being active?

MORE: Sitting Can Increase Your Risk of Cancer By Up to 66%

Kerem Shuval, a research specialist in nutrition and physical activity at the American Cancer Society, and his colleagues wanted to address that question. So they turned to the Cooper Center Longitudinal Study, an ongoing trial of white men that measures how lifestyle behaviors affect disease and longevity. They asked the men about how many hours they spent in a car or watching TV (the sedentary part) and then put them on a treadmill to record their fitness levels, as well as tested their blood for cholesterol and blood sugar. The scientists also calculated the participants’ body fat percentage, their waist circumference and their body mass index (BMI).

When they adjusted for the amount of physical activity that the men reported, they found that those who spent more hours each week in a car or watching TV showed higher triglyceride levels, a higher BMI, waist circumference and more body fat compared to those who reported less than nine hours a week of sedentary behavior.

MORE: An Hour of Exercise Can Make Up for a Day of Sitting Down

But when Shuval then factored in the mens’ fitness levels, he found that most of the interaction with negative health outcomes went away. “Once we controlled for fitness, the effects of sedentary behavior were a lot less pronounced on health outcomes,” he says.

So there’s no question that people who are fit, which means they are physically active, and those who exercise regularly, enjoy better health. The question is whether you can get fitter not just by becoming more active, but also by sitting less. “The jury is still out in my mind about what to do about decreasing sitting,” says Shuval, who published his results in Mayo Clinic Proceedings.

There are some studies that follow people over time that found that more sitting time is linked to a higher risk of early death. But that could be due to the fact that people who sit more are less physically active, so sitting is displacing exercise. Shuval found, for example, no strong association between how much time people spent sitting and their risk of metabolic syndrome – the constellation of risk factors connected to heart disease – nearly nine years later. That suggests that physical activity, and not something unique about sedentary behavior, may be the driving factor in that syndrome.

MORE: Now There’s Another Reason Sitting Will Kill You

That’s supported by a study published in PLOS ONE in January 2014 in which researchers from the U.S. and Australia found that when they included all levels of physical activity – not just moderate or vigorous activity, but even the light forms that make up most of what people do during the day – the negative effect of sitting on adverse health measures like blood pressure, cholesterol levels, blood sugar and waist circumference disappeared. In other words, how active people are – and the more active they are, the less they sit – likely has the strongest effect on health.

Shuval, however, admits that his results likely aren’t the definitive ones that will resolve the question of how sitting affects our health. The men in the Cooper study, for example, were only asked about the time they spent in their cars or watching television; they didn’t account for time spent sitting at their jobs, for instance, so the sedentary time could have been underestimated. They also only asked about sedentary habits once, so the study couldn’t account for any changes the participants had in the amount of time they spent in chairs.

The uncertainly probably explains why there aren’t yet any guidelines about healthy and unhealthy amounts of sitting time, as there are for physical activity. “We haven’t established yet by how much we need to reduce sedentary behavior and how to do it,” says Shuval. But one thing is clear – sitting less means you are probably more physically active. And there is plenty of evidence suggesting that’s good for your health.

 

TIME Sex

The Strange Social Science of the Color Red

Women walking
Getty Images

There's plenty of research connecting the color with sex. Here's why

When it comes to sex and women, red is the first color you think of, right? Red lips, red lingerie, red dress. Studies show men perceive women who wear red on dating profiles as both sexier and more open to a sexual encounter.

Red, it seems, sends a very clear message—about sex. And now scientists add to the scarlet sex literature with this piece of data, which we reported on earlier, in the Personality and Social Psychology Bulletin – turns out it’s not just men, but women too who see women who dress in red as more overtly sexual and open to having sex. Not only that, women perceive other women who sport red clothing as sexual rivals (i.e. after their mates), which raises their competitive instincts and leads them to think negatively about their ability to maintain relationships and be loyal.

What? Does that mean every time I grab the red dress my female friends see me as a romantic threat who is about to move in on their partners? “I don’t think it’s the case that women who wear red are always advertising sexual interest,” says Adam Pazda, a social psychologist at University of Rochester who led the study. “But there is evidence that people make judgments about other people in general based on clothing. You can see how color might easily fit into that.”

MORE: The Science of Dating: Wear Red

Pazda says that studies have also shown that people who view pictures of female news anchors in loose or tight-fitting clothing perceived those wearing the form-fitting outfits as less competent, possibly some derivation of the idea that they were dressing for sex and therefore somehow less able to do their jobs.

One thing to remember about that study, and Pazda’s as well: You probably react differently to strangers you pass on the street than those you’re confronted with in a lab setting, where the questions the scientists are asking can’t help but be leading.

If someone sticks a picture of a news anchor wearing a loose top in front of you, asks you to rate her competence, you’re going to grasp at any possible clue to make your decision, because you have to make a decision, or a judgment. You have no other information on the anchor—you don’t know her, you don’t know her background, and you certainly don’t know her experience, which would be more reasonable measures of her competence. Instead, you’re making a snap judgment and for that, you tend to rely on your cultural experience.

And when it comes to the color red and women, that cultural background tells you that red equals sex. In Pazda’s study, he ran three experiments, one to test whether women perceived other women dressing in red as more sexually receptive than those clothed in the same outfit but in white; another to determine if that perception of being more open to sex implied sexual promiscuity, and a final experiment to test whether another color (green) and outfit changed the results.

Each participant was shown either the red-clothed image or the white- or green-clothed one, and then asked to rate, on a sliding scale, the woman’s openness to sexual encounters and her promiscuity. But since they knew nothing else about the women in the pictures. They couldn’t hear their voices, or watch their behaviors. With no other information to go on what were the participants basing their decisions on?

They were likely relying on deeply ingrained, and even unconscious biases connecting the color red to sex. “When we asked, ‘Is this person interested in sex,’ or how seductive or flirtatious is this person, they are drawing on whatever cues are available to make judgments about them,” says Pazda. “One of the only cues is using the dress or shirt color.”

That may only play a small part in people’s first impressions of others in real life, however, where they have facial expressions, behavior, conversations and other information on which to base their decision. Pazda admits that “people aren’t always making judgments about others automatically. But if we stop and make a judgment, color may influence how that judgment is processed.”

TIME Pain

Achy Back? Don’t Blame the Weather

Changes in the weather don’t cause back pain, say researchers.

Some people insist they know when it’s going to rain because they can “feel” it in their bones. Or their knees start aching. Or their back. Their explanation? They’re more attuned to changes in air pressure, precipitation, and the like. But a new study reveals that might be nothing more than magical thinking.

Researchers in Australia put to the test the idea that weather triggers back pain. They recruited 993 people who saw doctors because of low back pain and matched those visits to national meteorological data on temperature, humidity, air pressure, wind direction and precipitation. They also checked the same weather parameters one week and one month before the patients reported their pain. It turns out there was no statistically significant correlation between weather changes and back pain.

MORE: This Is the No. 1 Cause of Disability Worldwide

“We had an open mind on the issue,” Daniel Steffens, from the George Institute for Global Health at the University of Syndey, told TIME in an email. “We had heard many patients attribute their worsening pain to the weather, but we also knew there was limited research. In our very rigorous study we found no evidence that weather is associated with an increased risk of back pain.”

One of the strengths of the study, published in the journal Arthritis Care & Research, involved the fact that the same participants were evaluated during stable and changing weather, meaning that most of the other variables that could affect pain, such as people’s lifestyles, behaviors and genetics, remained the same.

MORE: Aching Back? Try Massage for Chronic Pain

So why do so many patients believe that weather affects their joints? Some studies have found an association between cold or humid conditions and people’s symptoms of chronic pain, but the reason for the link from a physiological point of view isn’t known.

Steffens and his colleagues aren’t discounting the potential role that weather could play. They admit that Sydney, where the study was conducted, is blessed with relatively temperate conditions.

But for now, it looks like back pain sufferers can’t blame the weather. Steffens notes that other factors, including the way people move and lift heavy objects, as well as stress and fatigue, may be more important for triggering aching backs.

TIME Smoking

This Is The New Best Way to Quit Smoking, Study Finds

Combining varenicline and the nicotine patch was more effective in helping smokers quit after six months than the drug alone

Quitting smoking can be a frustrating challenge, and no single therapy works dramatically well. Nicotine replacement strategies – the patch, gum or lozenges—can help wean smokers off nicotine gradually, but don’t often work in keeping smokers abstinent over the long term. The prescription drug varenicline, or Chantix, which curbs smoking by occupying and blocking the same nicotine receptors in the brain used by the nicotine in cigarettes, makes nicotine less pleasurable. But studies show that it’s only about 33% effective in keeping smokers off cigarettes after 12 weeks.

Researchers in South Africa, however, report in JAMA that combining varenicline with the nicotine patch boosted that quit rate to 49% among a group of 435 smokers who were randomly assigned to take either the pills and the patch or the pills and a placebo patch. Smokers on the pills and patch were nearly twice as likely to be abstinent after six months than those who took the pills alone with a dummy patch.

MORE: Nicotine Gum and Patch Don’t Help Smokers Quit Long Term

“The efficacy of combining the two drugs cannot be readily explained,” Dr. Coenraad Koegelenberg, lead author of the study from Stellenbosch University in Cape Town, wrote in an email response to questions about the findings.

It’s possible that the timing of the pills and the patch worked in the smokers’ favor. While both varenicline and the nicotine patch target the same nicotine receptors in the brain, they have different effects; the nicotine from the patch activates the nicotine receptors and provides the same pleasurable sensations that cigarettes would, while varenincline is designed to bind and block the effects of nicotine on the brain. Varenincline is more effective at binding to these receptors, while nicotine from the patch is slower to activate, so starting on the patch may wean smokers from nicotine, and the varenicline may have helped them to drop cigarettes completely.

MORE: Hope for Quitters? Scientists Devise a New Nicotine Vaccine

Interestingly, the one-two punch didn’t work by lowering craving for nicotine. They also did not find a significantly increased risk of side effects, including depression or nausea, in the varenicline group. The U.S. Food and Drug Administration in 2009 added a black box warning alerting users to the potential for suicidal thoughts, although a 2013 study found no greater risk of depression among smokers with depression or who had had depression in the past.

The results raise important questions about how current smoking cessation treatments might be more effective if used in combination. Currently, varenicline is not recommended with other nicotine-replacement strategies; for that to change, other studies showing similar results to this one would be needed.

Your browser, Internet Explorer 8 or below, is out of date. It has known security flaws and may not display all features of this and other websites.

Learn how to update your browser
Follow

Get every new post delivered to your Inbox.

Join 46,421 other followers