TIME Aging

Centenarians Don’t Die for the Same Reasons We Do

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Howard Kingsnorth—Getty Images

Those who survive to see their second century are indeed different from the rest of us, according to the latest research

Researchers in the UK say that people who live to be 100 or more are less likely to die of the chronic conditions that are the leading causes of death, such as heart disease can cancer, but more likely to die of sudden declines in their health caused by infections or frailty.

VIDEO: Watch: The Island That Holds the Secret to Long Life

After reviewing death certificates of 35,867 centenarians who died between 2001 and 2010 in England, the scientists found that around a third died in assisted care homes. The most common cause of death was frailty or old age (28%), followed by pneumonia (18%). Only 8.6% of those over 100 years died of heart disease, and only 4.4% died of cancer, which remain the leading killers in industrialized nations. By comparison, among those between ages 80 to 85, 19% died of heart disease and 24% died of cancer.

MORE: How to Live 100 Years

Understanding that most of the oldest old, among the fastest growing proportions of western populations, are more vulnerable to sudden events such as infections that can land them in the hospital and on a downward health spiral, should help countries to better prepare for the ever-growing proportion of longer-lived individuals, say the authors. Globally, centenarians are expected to grow from 317,000 to more than 3.2 million by 2050.

TIME Research

How Men and Women Feel Pain Differently

Understanding how men and women feel feel pain is clouded by conflicting results and murky interpretations. While some work suggests that women feel more pain than men, other studies have found the opposite to be true. So which gender has the higher threshold? That depends on what’s hurting and how.

Dr. Andreas Sander-Kiesling, in the department of anesthesiology and intensive care at the Medical University of Graz in Austria, reviewed records of more than 10,000 patients undergoing various surgeries over a two year period who were asked to rate their pain within 24 hours of their procedure. The men were 27% more likely to report feeling more pain after major operations such as heart and shoulder surgery, while women were more likely to show higher pain readings after relatively minor or routine ones such as biopsies and even abortions. Interestingly, women reported less pain after invasive procedures. Because the average age of the women was 58—post-menopause when estrogen, which can increase pain sensitivity, drops—that might in part explain the finding.

MORE: Men vs. Women on Pain: Who Hurts More?

Another factor could be psychological. Biopsies, for instance, are done to determine if suspicious growths are cancerous, or life-threatening, says Sandner-Kiesling, so the anxiety of worrying about cancer may be playing a role in how women perceive the relatively minor procedure. The same may apply to abortion, which can be fraught with emotional and psychological implications.

“We were hoping we could answer more about gender and pain,” says Sandner-Kiesling, “and in certain ways we did, and certain ways we did not. We found a [gender] difference but the difference may depend on the procedure. So the whole picture is still completely fuzzy and confusing.” Which means for the time being, at least, there won’t be male or female versions of pain-killing treatments, but if research continues to tease apart how and why men and women perceive pain in different ways, that may not be so far off.

TIME Nutrition

3 Ways to Lose Weight Without Dieting

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Peter Cade—Getty Images

Cutting back on calories sounds good in theory, but not in practice. Here’s what science says about other tricks to bring weight down

No one needs to be told that if they eat less, they’ll probably weigh less. But if it were that simple, we wouldn’t be staring down a national crisis of overweight and obesity, and those at a healthy weight wouldn’t have a hard time tamping down temptation.

Researchers are building the case for unusual approaches to weight loss and while none of these strategies alone are a bull’s-eye, as anyone who’s tried a diet knows, every little bit helps.

Be mindful.

It’s the latest buzzword in health and wellness because it’s an effective way to direct potentially negative behaviors toward more positive, healthy habits. In a review of 21 studies published in the International Association for the Study of Obesity that used mindfulness-based strategies, most showed that the techniques helped to curb binge eating, emotional eating and over-eating in response to outside cues. For weight purposes, it’s based on non-judgmental ways of analyzing why overweight and obese people eat—whether it’s because of stress or other negative emotions, or because you’re responding unconsciously to cues such as the sight or smell of food.

The mindfulness interventions included things such as figuring out the difference between actually feeling hungry and eating to satisfy emotional needs such as stress, anger or depression. The strategies also helped overweight and obese people to find other outlets, not involving food, for their negative feelings.

MORE: The Mindful Revolution

Slow down.

How you eat can also affect how much you eat, according to a recent study published in the American Journal of Clinical Nutrition. Scientists analyzed 22 studies in which participants were asked to eat either slowly or more quickly, and found that those who took longer to finish a meal tended to eat less than those who wolfed down their food. That’s not so surprising, but the more encouraging part of the study hinted that getting people to slow down may help them to feel full after eating less. People who changed their eating rate to eat more slowly did not report feeling more hungry up to 3.5 hours later. The researchers admit that most of the participants knew the study involved how eating rates affected hunger so the results might have been biased by their thinking that eating more slowly was better for reducing obesity, but the findings still hint that our bodies may process food differently depending on how quickly it comes in.

Drink…vinegar?

Nausea is a good way to make almost any food unappetizing but it’s not necessarily a healthy strategy for weight control. While a study in the International Journal of Obesity found that adding vinegar to milkshakes had the desired effect – the unpleasant taste was enough to quell any hunger people may have felt, and even made them nauseous – the researchers don’t see such deterrents as being an effective way to control eating, at least on a lasting basis. Studies show that negative reinforcement, such as depriving children of things they really want, like toys and treats, doesn’t help to reshape their behavior to like these things less.

Eating, as all of these studies show, is a complex combination of physical need and psychological reaction. Diets may address the physical part of what goes into the body, but any effective, and lasting weight loss program should address how that food is consumed, and why.

TIME

BRCA Gene Can Be A Cancer Triple Whammy, Study Finds

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Ingram Publishing—Getty Images/Vetta

BRCA already boosts risks of breast and ovarian cancer, and now there’s evidence that it may contribute to lung tumors too

In research published in Nature Genetics, scientists report that a version of the BRCA2 gene, which, when mutated, can increase the risk of developing breast and ovarian cancers, also raises the risk of lung cancer.

Led by Dr. Christopher Amos, professor of community and family medicine at Geisel School of Medicine at Dartmouth College, the study included genetic data from 75,750 lung cancer patients and controls. Those with a relatively rare version of BRCA2 found in about 2% of the population, had a 26% increased risk of developing breast cancer, but an 85% higher chance of getting any type of lung cancer, and a 2.5-fold increased risk of developing an aggressive, hard-to-treat lung cancer known as squamous cell carcinoma. The lung cancer risk, says Amos, appears to an independent effect of BRCA on lung tissue, apart from its influence on the breast.

MORE: Lessons From the Woman Who Discovered the BRCA Cancer Gene

“We didn’t see an association to lung cancer with other BRCA2 variants, only this particular one,” says Amos. “What we found is a new effect of BRCA2 on lung cancer.”

Current tests for the BRCA 1 or 2 mutations, which account for about 5% of breast cancer cases in the U.S., already include this variant, so most women will know from their results whether they are at higher risk of developing lung cancer, much in the same way that BRCA mutations confer a higher risk of ovarian cancer.

MORE: The Angelina Effect

For now, however, there aren’t any effective treatments for squamous cell lung cancer. Smokers with the variant have twice the risk of getting lung cancer than those with the BRCA2 version who don’t smoke, so kicking the habit is one way to lower risk. But there are promising studies involving a class of drugs called PARP inhibitors, which is currently being studied to treat BRCA-related breast cancers. These drugs work by preventing tumor cells from repairing damage to their DNA, and given the newly discovered connection between BRCA2 and lung cancers, they might also be effective in treating squamous lung tumors. “It raises the question about how we can do a better job of allocating people to screening, and if [this variant] should become part of a panel for screening,” says Amos. Because squamous cell cancers are so hard to treat, such early detection of potential tumors might become a life-saver.

TIME Cancer

Lessons From the Woman Who Discovered the BRCA Cancer Gene

Mary Claire King presents at World Science Festival 2014 in New York City Courtesy of the World Science Festival

The legendary researcher on work-life balance, the importance of trusting hunches, and her stunning scientific discovery

Sometimes the most stunning advances in science are based on a hunch that a dedicated investigator just can’t shake.

That was the case with Mary-Claire King, professor of genome sciences and of medicine at University of Washington. King discovered the region on the genome that eventually became known as BRCA1, the first gene linked to a higher than average chance of developing breast cancer and ovarian cancer. While it seems obvious now that genes can be tied to cancer, at the time King conducted her studies, the idea was too radical to have many supporters.

MORE: Angelina Jolie’s Double Mastectomy: What We Know About BRCA Mutations and Breast Cancer

But King was used to being unusual. As a graduate student at the University of California Berkeley, where she first studied mathematics and then switched to genetics, she petitioned the university protesting the U.S.’s invasion of Cambodia during the Vietnam War. When the National Guard removed demonstrating students, King dropped out and helped consumer rights advocate Ralph Nader to study how pesticides affected farm workers.

She returned to Berkeley and contributed to groundbreaking genetic work that showed humans and chimps shared 99% of the same DNA.

Today, BRCA1 and the related BRCA2 are responsible for about 5% of breast cancer cases in the U.S., or up to 25% of inherited breast cancer, and screening for changes in the genes can help steer women toward potentially lifesaving treatments. The Supreme Court recently ruled that BRCA1 and BRCA2 are not patentable, since they are products of nature, a decision that King supports so that more companies can now devise tests for the cancer-causing mutation.

We spoke with King when she was in New York for the World Science Festival. Here’s what we learned:

On how she discovered BRCA1, and the importance of believing in your gut instincts:

“If we cast our minds back to the 1970s, when my work [on BRCA] began, the mainstream theory was that breast cancer was viral. And some cancers are, so it wasn’t a crazy theory.

My thinking—and, believe me, this was not a theory in the field but just a notion I had—was that there was good evidence that there were some families in which breast cancer was especially common. There was no evidence of a smoking gun. That opened the possibility that there was something else. That went side by side in my mind with the logical way of thinking about cancer, that all cancer is genetic in the sense that it’s a consequence of changes in DNA. That also was not mainstream thinking at the time. But that was the basis of my own thinking, and I’m a stubborn person, so it allowed me to keep pushing my little idea in a very quiet way.”

MORE: 4 Ways The Supreme Court Gene Patent Decision Will Change Medicine

On seeing her little idea become a big one:

“I was absolutely convinced that cancer had to be genetic. I did not see any other way the relationship between a tumor and host could possibly persist. But I honestly didn’t appreciate at all how important and directly useful the inherited component would be. The idea that oncologists and medical geneticists would take that information and systematically be able to put into place screening programs that enable women to learn that they had mutations, and do something about it to save their lives, wasn’t the way I thought. If somebody had said that this was possible, I would have said, ‘Golly, maybe it was.’ But nobody said that to me.”

 

On whether every woman 30-plus should have a BRCA1 and BRCA2 screening:

“I am increasingly convinced that it is both feasible and a good idea to offer a blood test, a sequencing test for BRCA1 and BRCA2 and some of their sister genes for every woman after about age 30. Once a young woman reaches 30 or so, if she has a mutation in one of the genes, she should know about it. … These mutations are inherited from fathers half the time, and from mothers half the time. Because families in America are so small, we did a study that showed that in exactly half of women who had BRCA1 or BRCA2 mutations, there was no family history that would have led them or anyone in their family to think they carried the mutation. All of these women inherited the mutation from their father, and their fathers either didn’t have sisters or had sister who didn’t inherit the mutation.

Sequencing is now cheap, prices are coming down and the quality is going up. So there’s no reason not to do this. The point is to have a process that is benign enough to the individual—a blood draw—and inexpensive enough to identify people who are really at high genetic risk and then move them into very good screening programs to enable them to make a plan about preventive surgery or other options.”

On how being a woman in science has changed, and remained the same:

“I always assumed I would be an assistant to someone else, because there have always been women in those roles. I always assumed I would work for someone else. And I assumed implicitly that ‘someone else’ would be a man. There are obviously many more women in the field now. Acceptance in principle of women in the field is completely different and that’s absolutely fabulous; it’s just splendid.

The thing that hasn’t changed is the number of hours in a day. The coincidence of one’s child-bearing years with exactly the time one needs to build a career—that’s challenging. Science is also a very demanding child—you can’t just walk away from either. That hasn’t changed. It’s not realistic to say one can drop out of science and drop back in.

Really good child care is incredibly important. Creating a context in which young women scientists have child care they can rely on, and can afford, and that’s close enough to where they work, is enormously difficult, and institutions are working on it. One thing I try to do is run a family-friendly lab. I think it’s the responsibility of those of us whose children are now grown to remember what it was like, and to run family-friendly labs. When women in my lab get pregnant, we know they simply will not be there for a while. But you need the infrastructure in place so their experiments won’t rot when they’re not there, and so they can come back when they are ready.”

On being a mother and being a scientist:

“You never get over the guilt. My daughter would come into the lab when she was six or seven, and she had an area in my office with books, picture books and toys. She made posters that went on the door to my office. One was the First Mommy to Walk on Land. Another was the Sister of the First Mommy to Walk on Land. And there was the Brother of the First Mommy to Walk on Land. When I asked her why she was making the posters, she said, ‘They are to keep people happy while they have to wait for you.’

You have to have an environment in which it’s clear that having children is a part of life, and welcomed. You have to recognize that a scientific career can be very long, and you need to go into the business of being there for your child when you have a child. It’s possible. It’s not possible to do and get enough sleep, but it’s possible to do.”

TIME

Being Bilingual Keeps You Sharper As You Get Older

Picking up a second language, even later in life, can have benefits for the brain

People who speak more than one language tend to score higher on memory and other cognitive function tests as they get older, but researchers haven’t been able to credit bilingualism as the definitive reason for their sharper intellects. It wasn’t clear, for example, whether people who spoke multiple languages have higher childhood intelligence, or whether they share some other characteristics, such as higher education overall, that could explain their higher scores.

Now, scientists think they can say with more certainty that speaking a second language may indeed help to improve memory and other intellectual skills later in life. Working with a unique population of 853 people born in 1936 who were tested and followed until 2008-2010, when they were in their 70s, researchers found that those who picked up a second language, whether during childhood or as adults, were more likely to score higher on general intelligence, reading and verbal abilities than those who spoke one language their entire lives. Because the participants, all of whom were born and lived near Edinburgh, Scotland, took aptitude tests when they were 11, the investigators could see that the effect held true even after they accounted for the volunteers’ starting levels of intelligence.

Reporting in the Annals of Neurology, they say that those who began with higher intellect scores did show more benefit from being bilingual, but the improvements were significant for all of the participants. That’s because, the authors suspect, learning a second language activates neurons in the frontal or executive functions of the brain that are generally responsible for skills such as reasoning, planning and organizing information.

Even more encouraging, not all of the bilingual people were necessarily fluent in their second language. All they needed was enough vocabulary and grammar skills in order to communicate on a basic level. So it’s never too late to learn another language – and you’ll be sharper for it later in life.

TIME Infectious Disease

Here’s What’s Lurking In the Pool Water

Heading to the pool? It turns out that people aren’t the only ones who find that cool water inviting when the temperatures soar.

Microbes, including bacteria that live on our skin and in our noses, get dropped into the pool whenever we take a dip. Not all of them make us sick, and chlorine can kill germs, but sometimes it takes days for that to happen. And if your pool smells like chemicals, that’s not a sign that it’s clean. In fact, the stronger the odor, the harder the chlorine is working to eliminate things like urine, sweat, dirt, poop and other things that swimmers trail in.

Here’s a handy (and slightly scary) rundown of the bugs and other things that every swimmer brings into the pool, from the Centers for Disease Control. Their advice? Take a dip and enjoy your swim. But shower before you jump in. And don’t drink the water.

 

14_247050-B_Healthy Swimming final

TIME Weight loss

Good News! You Weigh Less Than You Think

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Dkal Inc.—Getty Images

Call it the clothing effect, or the clothing discount – we all do it. We make allowances for the fact our clothes are probably pretty heavy

As swim suit season gets underway, more of us are probably stepping on the scale and squinting at the number that flashes back at us. Then, we do some quick mental math and adjust for the fact that we’re wearing jeans, maybe a robe, and oh, yes, that heavy sweater. So, minus 5lbs?

It turns out that scientists have actually done a real study, published in the International Journal of Obesity, to figure out how many pounds we should be subtracting for what we wear. Led by a team at University of North Dakota (because it gets really cold there, and they’re probably pretty bundled up when they step on a scale), not only did they set up an experiment to weigh people, both clothed and nearly nude, at various times of the year, they also wanted to answer the critical question of whether weighing yourself in the winter gives you more leeway to do this kind of math than in the summer, when we tend to wear less.

It turns out that, as with so many things, men and women are different when it comes to how much our clothes weigh. Men, it seems, prefer to swathe themselves in heavier garments while women tend to adorn themselves more lightly. Men can lop off nearly 2.5 lbs to account for their clothing while women can only subtract around 2. And this holds true, unfortunately, no matter what the weather outside.

So no more making allowances for that thick wool sweater. Now you know exactly how much your clothes weigh.

TIME Cancer

Some Chemotherapy Is More Toxic Than Others

Chemotherapy
Getty Images

Chemotherapy is a necessary evil for most breast cancer patients, but some are worse than others when it comes to side effects

Researchers at the University of Texas MD Anderson Cancer Center compared six breast cancer chemotherapy regimens to determine which caused more toxic side effects by requiring the patients to be hospitalized for infections, fever, dehydration or low blood counts.

In order, from the regimen that caused the most hospitalizations among 12,894 patients who were treated for early stage breast cancer, to the one that caused the fewest, the chemotherapies were:

  • Docetaxel and cyclophosphamide cycled every three weeks (TC)
  • Doxorubicin and cyclophosphamide cycled every three weeks (AC)
  • Docetaxel, doxorubicin and cyclophosphamide cycled every three weeks (TAC)
  • Doxorubicin and cyclophosphamide cycled every three weeks, followed or preceded by docetaxel cycled every three weeks (AC+T)
  • Doxorubicin and cyclophosphamide cycled every two weeks, followed or preceded by paclitaxel cycled every two weeks (ddAC+P)
  • Doxorubicin and cyclophosphamide cycled every three weeks followed or preceded by weekly paclitaxel (AC+wP)

The treatments are interchangeable, says the study’s lead author, Dr. Carlos Barcenas, from the department of Breast Medical Oncology at MD Anderson, so knowing which ones are associated with more toxicity may help some patients and doctors to choose more tolerable therapies. Other factors may also play a role; the TC regimen, for example, is linked to the most hospitalizations but that’s because it involves more intensive doses of chemotherapy in half the time – 12 weeks – of all of the other options, which are spread out over 24 weeks. For women who prefer to have their chemotherapy finished sooner, the higher risk of side effects may be worth the time savings.

Women with heart disease also have to use the TC regimen, since the others include a drug that is toxic to the heart.

The results, published in the Journal of Clinical Oncology, should help patients to be more informed about their chemotherapy options, says Barcenas, and prompt more research into ways that the right treatments can be matched to the right patients.

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