TIME medicine

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

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

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

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

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

MORE Stem-Cell Research: The Quest Resumes

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

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

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

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

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

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

TIME Cancer

Many Breast Cancer Patients Get Unnecessary Radiation

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

TIME ebola

How Effective Is Screening for Ebola at Airports?

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

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

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

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

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

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

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

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

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

TIME Heart Disease

The Other Reason Canned Food Is Raising Your Blood Pressure

Tinned sardines
Brad Wenner—Getty Images

Forget sodium—BPA might be the real canned food villain

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

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

MORE: Why Receipts and Greasy Fingers Shouldn’t Mix

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

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

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

MORE: BPA Linked with Obesity in Kids and Teens

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

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

TIME medicine

Genetic Screening Saved This Baby’s Life

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

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

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

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

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

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

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

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

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

MORE: Faster DNA Testing Helps Diagnose Disease in NICU Babies

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

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

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

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

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

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

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

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

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

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

TIME Mental Health/Psychology

Here’s How to Make Waiting A Little Less Excruciating

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Getty Images

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

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

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

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

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

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

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

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

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

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

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

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

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

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

TIME Mental Health/Psychology

Most People With Depression Aren’t Getting Treatment, Survey Finds

The latest depression report shows that the majority are suffering in silence

The latest statistics on depression in the U.S. don’t paint a picture of progress, though the condition is common. Nearly 8% of Americans over age 12 have recently been depressed, finds the new report from the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention, but the vast majority aren’t actively getting treatment.

Of those surveyed between 2009 and 2012, about 3% with depression reported having severe symptoms, and nearly all of these people (90%) said their depression made it difficult to work, go to school or participate in their normal activities at home and in other social settings.

Women are more likely than men to be depressed at any age, and women between 40 and 59 years old had the highest rates of depression among the adults studied. While the survey did not delve into the possible reasons for depression, other studies suggest that for many women in this age group, the pressures of balancing work and family responsibilities, including children as well as aging parents, may lead to added mental health burdens.

Poverty seems to be a factor in depression as well. Those living below the federal poverty level were more than twice as likely to be depressed than those living above the line; this trend applied regardless of race or ethnicity.

But what was most concerning to study co-author Laura Pratt, an epidemiologist at the NCHS, was that 65% of people with severe symptoms of depression were not getting help from a mental health professional. “The fact that people aren’t getting treatment is disturbing,” she says. “People with severe depression should be getting therapy from a mental health professional, and they should also in a lot of cases be on a more complicated medication regimen that requires a psychiatrist to treat them. The fact that only 35% have seen a mental health professional in the last year was pretty alarming.”

The data should raise awareness about the prevalence of depression, she says, and hopefully stress the importance of encouraging those with depression to seek help. “It’s serious, it really affects your life and we need to figure out a way to get people treated appropriately,” she says.

TIME Diet/Nutrition

This Diet Has Been Linked to a Longer Life—Again

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Image Source—Getty Images/Image Source Mediterranean include fresh fruits and vegetables, beans, olive oil and moderate amounts of wine

Fruits, vegetables, beans, grains, fish and olive oil help cells stay biologically young

It’s no coincidence that some of the world’s populations with the longest lifespans live along the Mediterranean coast. The climate there ensures that foods like fruits, vegetables, olives, beans and fish are abundant, which are all rich in the antioxidants that can combat aging triggered by pollution and stress. They’re also powerful fighters against the inflammation driving so many chronic diseases, from heart disease to cancer.

Now, a new study published in the BMJ gives more meat to the biological connection between longevity and the Mediterranean diet. Researchers studied 4,676 women enrolled in the Nurses’ Health Study, an ongoing trial tracking the health and habits of more than 120,000 registered nurses in the U.S. since 1976. The team, led by Immaculata De Vivo, associate professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, found that women who ate a Mediterranean diet had cells that were different from those who ate diets that were heavier in red meats and dairy products. The Mediterranean fans had longer telomeres, bits of DNA located at the tips of chromosomes, in their cells. Telomeres shorten every time a cell divides; they shrink by half from infancy to adulthood, and again by half among the elderly. Previous studies have linked longer telomeres to longer life and shorter telomeres to shorter lifespans.

MORE: Eat Better and Stress Less: It’ll Make Your Cells (and Maybe You) Live Longer

Even after De Vivo and her colleagues adjusted for other factors that could affect telomere length, including age, smoking status and physical activity, the link between the Mediterranean diet and longer telomeres remained strong,

“Our contribution is that we provide a link at the molecular level, at the DNA level, of the association between the Mediterranean diet and longevity and beneficial health effects,” says De Vivo.

And it wasn’t any one element of the Mediterranean diet that was primarily responsible for effect. “We didn’t find that any single component was driving the association,” she says. “It was the entire package, the pattern of eating itself.”

MORE: How to Live 100 Years

That makes sense, since each of the hallmarks of the diet—from fish to olive oil to moderate amounts of alcohol—are strong antioxidants that can fight the oxidative damage connected with aging. Together, it’s possible that the synergistic effect is beneficial for longevity.

It’s also a lesson that diet alone won’t help you live to old age. “I think nothing by itself will do anything. But a good healthy diet that’s good for you and that tastes good, physical activity, and not smoking—I think the whole composite is beneficial,” says De Vivo.

TIME

Here’s How to Remove Ebola Waste From a Hospital

Officials at the University of Nebraska, which treated Ebola patients, issues a case study in how to get rid of Ebola waste

When treating Ebola patients, hospitals have more than their patients and workers to protect. It’s their responsibility to properly dispose of anything involved in caring for the patients that might be contaminated—and that includes liquid waste, protective equipment, anything used in the lab, linens, towels, pillows, mattresses and even the curtains used in the patient’s room.

In the latest issue of the American Journal of Infection Control, John Lowe, associate director of research from the Nebraska Biocontainment Unit at the Nebraska Medical Center, describes how the team there disposed of waste generated while two patients recovered from their infections there. Some of the procedures in place, Lowe says, go beyond the guidelines set by the Centers for Disease Control and Prevention (CDC). The report will undoubtedly be studied by the 35 hospitals that the CDC designated on Dec. 2 as Ebola treatment centers across the nation.

“A number of things came up that surprised us and that we felt really needed to be shared with our colleagues,” he says.

The first of those was the sheer volume of waste generated by each Ebola patient. The group calculated that each patient treated at the Nebraska facility created about 1,010 pounds of solid waste, most of it in the form of personal protective equipment (PPE) — the hoods, face shields, suits and foot covers that doctors and nurses wear. That equipment, as well as towels and linens used for bedding, created around four to eight large bags of waste a day.

Lowe says that the group decided to treat liquid waste generated by the patients even more stringently than required by the CDC. “The lion’s share of calls we took from groups both within our facility and from outside the facility were concerns about exactly what we were doing with all that liquid waste,” he says.

CDC guidelines say that normal waste treatment chemicals in toilets are sufficient to kill Ebola. But the unit’s director Philip Smith and Lowe had two concerns. In the event that the toilets backed up, potentially infectious material could flood into the patient rooms and possibly into other pipes in the hospital as well. Public health groups also wanted assurances that the waste would not be contaminating facilities outside of the hospital. So Smith decided to take extra measures by treating the toilets in the patient’s room with hospital-grade disinfectant. Normally it takes four minutes to sterilize the waste, but to be safe, all Ebola patients’ waste was held in this sterilizing solution for 2.5 times the recommended time before it was flushed.

Flushing, says Smith, is preferable to storing the waste in a separate container and then autoclaving the contents. “You could end up having containers full of liquid that are difficult and hazardous to work with,” he says.

The bags of solid waste, meanwhile, were tied and taped closed, then doused with bleach and handled in very strict ways by workers in full PPE. The Nebraska biocontainment unit is intentionally designed to have its own decontaminating autoclave inside the unit, so soiled waste does not have to be removed from the premises. While Ebola-related waste requires special sterilization and decontamination procedures, it can be turned into normal medical waste that can be disposed of in the hopsital’s normal ways.

MORE: 12 Answers to Ebola’s Hard Questions

To do that, health care workers send the bags into a sterilizing room. Each bag is handled at arm’s length so the workers don’t get contaminated by virus that may be on the bag and so that workers who may have virus on their PPE don’t contaminate the bags further. The bags are then treated with high temperatures and sterilizing chemicals. Once decontaminated, the bags are placed into another bag and into a watertight container and marked as biohazardous material. In this state, the waste can be disposed of as any other hospital waste in the proper medical waste removal sites.

So far, those strategies are working. Two Ebola patients, Ashoka Mukpo and Dr. Richard Sacra, were treated there and recovered, and no health care workers were infected with the virus.

TIME ebola

Here Are The 35 U.S. Hospitals Approved To Treat Ebola

Emory University Hospital in Atlanta, seen in august 2014.
Jessica McGowan—Getty Images Emory University Hospital in Atlanta, seen in August 2014.

These treatment centers are specially equipped to care for Ebola patients

The Centers for Disease Control (CDC) has designated 35 hospitals across the U.S. as Ebola treatment centers: facilities that will take in Ebola patients from wherever they first present and provide the more intensive care in isolation wards that the cases require.

The hospitals were evaluated by the CDC’s Rapid Ebola Preparedness team, and staff were trained in infection control, use of personal protective equipment and removal of waste from patient rooms. The CDC reviewed 50 hospitals in 15 states.

About 80% of people entering the U.S. from the affected West African countries live within 200 miles of one of the centers, according to the agency. Every person returning from these regions is required to take their temperature daily for 21 days, the incubation period for the virus. More than 3,000 travelers have been monitored by the CDC and state health departments since the program was implemented in November.

More Ebola treatment centers may be added in coming weeks, but for now, here is a list of the approved facilities:

  • Kaiser Oakland Medical Center; Oakland, California
  • Kaiser South Sacramento Medical Center; Sacramento, California
  • University of California Davis Medical Center; Sacramento, California
  • University of California San Francisco Medical Center; San Francisco, California
  • Emory University Hospital; Atlanta, Georgia
  • Ann & Robert H. Lurie Children’s Hospital of Chicago; Chicago, Illinois
  • Northwestern Memorial Hospital; Chicago, Illinois
  • Rush University Medical Center; Chicago, Illinois
  • University of Chicago Medical Center; Chicago, Illinois
  • Johns Hopkins Hospital; Baltimore, Maryland
  • University of Maryland Medical Center; Baltimore, Maryland
  • National Institutes of Health Clinical Center; Bethesda, Maryland
  • Allina Health’s Unity Hospital; Fridley, Minnesota
  • Children’s Hospitals and Clinics of Minnesota; St. Paul, Minnesota
  • Mayo Clinic Hospital; Minneapolis, Minnesota
  • University of Minnesota Medical Center, West Bank Campus, Minneapolis;Rochester, Minnesota
  • Nebraska Medicine; Omaha, Nebraska
  • North Shore System LIJ/Glen Cove Hospital; Glen Cove, New York
  • Montefiore Health System; New York City, New York
  • New York-Presbyterian/Allen Hospital; New York City, New York
  • NYC Health and Hospitals Corporation/HHC Bellevue Hospital Center; New York City, New York
  • Robert Wood Johnson University Hospital; New Brunswick, New Jersey
  • The Mount Sinai Hospital; New York City, New York
  • Children’s Hospital of Philadelphia; Philadelphia, Pennsylvania
  • Hospital of the University of Pennsylvania; Philadelphia, Pennsylvania
  • University of Texas Medical Branch at Galveston; Galveston, Texas
  • Methodist Hospital System in collaboration with Parkland Hospital System and the University of Texas Southwestern Medical Center; Richardson, Texas
  • University of Virginia Medical Center; Charlottesville, Virginia
  • Virginia Commonwealth University Medical Center; Richmond, Virginia
  • Children’s Hospital of Wisconsin, Milwaukee; Milwaukee, Wisconsin
  • Froedtert & the Medical College of Wisconsin—Froedtert Hospital, Milwaukee; Milwaukee, Wisconsin
  • UW Health—University of Wisconsin Hospital, Madison, and the American Family Children’s Hospital, Madison; Madison, Wisconsin
  • MedStar Washington Hospital Center; Washington, DC
  • Children’s National Medical Center; Washington DC
  • George Washington University Hospital; Washington DC

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