TIME Liberia

Liberian Government’s Blunders Pile Up in the Grip of Ebola

People celebrate in a street outside of West Point slum in Monrovia, Liberia, Aug. 30, 2014. Crowds cheer and celebrate in the streets after Liberian authorities reopened a slum where tens of thousands of people were barricaded amid the countryís Ebola outbreak.
People celebrate in a street outside of West Point slum in Monrovia, Liberia, Aug. 30, 2014. Crowds cheer and celebrate in the streets after Liberian authorities reopened a slum where tens of thousands of people were barricaded amid the countryís Ebola outbreak. Abbas Dulleh—AP

President Ellen Johnson Sirleaf's government was forced to lift a quarantine of one of Monrovia's worst slums last week as errors mount

In a cramped bar down a dark alleyway of Monrovia’s sprawling seaside slum West Point, residents are dancing wildly. They shuffle and stomp across a concrete floor sprinkled with cigarette butts and splashed with beer and homemade liquor.

“We celebrating! We are out of jail!” says Mary Goll, a resident and local bar owner, who leans back to the bar crisscrossed with metal for security for another bottle of beer. Goll’s own bar is in ruins on the shoreline, half eaten by the Atlantic Ocean. Just as the ocean has eroded away the land and driven the community inwards, so too did a government-ordered quarantine imposed last week.

On Aug. 20, the Liberian government enforced a 21-day quarantine aimed at preventing the spread of the virus that has claimed close to 700 lives throughout the country, with cases and casualties mounting in the city. Médecins Sans Frontières has described the outbreak in Monrovia as “catastrophic” and the 120 beds in its treatment center in the capital are already full. The World Health Organization has said the epidemic could last for six to nine months and infect up to 20,000 people in the region before the outbreak is over. Liberia is now the only Ebola-affected nation in the region with rising cases in the capital.

On Friday Aug. 30, just 10 days into the quarantine, the government announced on radio it would be lifting the quarantine the next morning. At 6am the next morning, police and soldiers took away their barbed wire and makeshift wooden checkpoints. West Pointers have been celebrating ever since — but the government seems just as unsure how to combat the virus as it has been since the outbreak began.

The plan to cordon off this community of some 80,000 people was made after a holding center for victims was ransacked on Aug. 15, one week after Liberia declared a state of emergency. Suspected Ebola patients escaped, and looters stole infected materials and mattresses from the center. President Ellen Johnson Sirleaf told Katie Couric the attack had motivated the quarantine because the attack “put the entire community at risk, therefore we had to protect them from themselves.”

But sources monitoring the security sector say the decision was less about the community’s safety and more a political attempt to show the government was in control of the situation. It had already blundered early in the outbreak by failing to prevent Patrick Sawyer, a consultant to the Ministry of Finance, from traveling to Lagos, despite the fact he was under observation having been in contact with a sister who died of Ebola. Sawyer, a naturalized U.S. citizen, died in Nigeria July 25 but not before infecting several people in Africa’s most populous country.

The government compounded that error with its lack of transparency. A day before the quarantine was imposed the Minister of Information Lewis Brown said the 17 patients who escaped were found and taken to an Ebola clinic at John F. Kennedy Medical Center, a claim that was denied by a doctor at the clinic. The Ministry of Health has since failed to provide concrete data on the number of suspected or confirmed cases in West Point despite requests.

Then, the first day of the quarantine came. As armed police wearing helmets and riot shields attempted to prevented West Point residents entering the rest of the city, the town commissioner Miatta Flowers attempted to escape with her family, to the fury of onlookers. Some began throwing rocks at police and others attempted to escape across a makeshift checkpoint made of concertina looped between wooden benches.

Security forces opened fire and killed a 15-year-old boy named Shakie Kamara; another two young men were also wounded by gunfire. The teenager’s body was taken by Ministry of Defense officials, according to a news report, and buried without an autopsy. Only later that day did the police commissioner explain to residents food would be distributed and they would be inspected by teams from the Ministry of Health.

It was yet another major mis-step on behalf of the government. The quarantine had not been sanctioned by the international donor community, and Dr. Nestor Ndayimirije, the World Health Organization representative to Liberia, had warned quarantining would only work with the community’s consent, which was neither gained nor sought.

“The force was disproportionate, they were already using batons, sticks, they had access to teargas and equipment to things to control an unarmed crowd,” said Counsellor Tiawan Gongloe, Liberia’s most prominent human rights lawyer. “I find it difficult to believe that there was any justification for shooting a 15-year-old boy who was unarmed. This is not a militarized conflict, it is a disease situation and a biological problem.”

It’s not hard to see why the government felt it needed to act. The cramped quarters, lack of access to running water and poor sanitary conditions of slum communities like West Point put them at a high risk of becoming hot spots for new Ebola infections. But Gongloe says the government has not been clear about what powers it has under a state of emergency, and has not been consistent in how it has used them. “[The government] must have an even handed approach to strengthen public trust in the government in order to fight Ebola,” Gongloe told TIME.

That public trust has been further eroded by the large number of public officials who fled the country after Sawyer’s death. Johnson Sirleaf said on Aug. 11 that government officials who refused to return home from overseas would be declared AWOL, and the Executive Mansion announced last week it had fired all but a handful of those who had still not returned. But she neglected to name those who had been fired, and many are skeptical she will follow through.

The government exodus contributes to a sense among citizens that Liberia’s wealthy and powerful have left the country’s poor to fend for themselves. Many expatriates who work for non-governmental organizations and international companies have been evacuated and their lavish apartments with 24-hour electricity and running water are now empty.

Most Liberians didn’t have that choice. Francis, a 15-year-old homeless youth who sometimes sleeps in one of the roughest communities in West Point, had to grease a palm to escape before the quarantine was lifted. He says he made his way out of West Point by paying an army man 150 Liberian Dollars (about $1.77 in U.S. dollars). The back of Francis’ head aches with an infected wound he says was made by a policeman who hit him with a baton as he tried to break free on the first day of the quarantine. It will be a while before Francis returns to West Point.

TIME Diet/Nutrition

Training Your Brain Could Make You Prefer Healthy Food

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Which is more appealing: cheese pizza or salad? For many, the lure of lettuce hardly matches that of greasy comfort food, but new brain research from Tufts University published in the journal Nutrition & Diabetes suggests that reconditioning can train adults to prefer healthy food and shun the junk.

“We don’t start out in life loving French fries and hating, for example, whole wheat pasta,” said study co-author and Tufts University professor Susan B. Roberts in a press release. “This conditioning happens over time in response to eating – repeatedly! – what is out there in the toxic food environment.”

The researchers studied the brain scans of 13 people, then assigned eight of them to a new behavioral intervention geared toward weight loss. The program taught lessons on portion control and distributed menu plans geared around specific dietary targets, encouraging people to get 25% of their energy from protein and fat and 50% from low-glycemic carbohydrates, with more than 40 g of fiber per day. After six months either on or off the program, a second round of scans showed the part of the brain associated with addiction and learning had changed in people who participated in the program and stayed the same in the control group. That brain region appeared more active and sensitive to healthier foods and less sensitive to caloric foods among people in the weight-loss group.

Though the study acknowledges the need for further research, the findings suggest that it may be possible to recondition our cravings from cheese puffs to carrots. “Our study shows those who participated in it had an increased desire for healthier foods along with a decreased preference for unhealthy foods,” co-author Sai Krupa Das, an assistant professor at Tufts, said in the release, “the combined effects of which are probably critical for sustainable weight control.”

TIME Diet/Nutrition

A Study Shows That You Eat Way More When Watching Action Movies

GUARDIANS OF THE GALAXY, from left: Dave Bautista, Chris Pratt, 2014.
Dave Bautista and Chris Pratt in Marvel's Guardians of the Galaxy Disney

Almost twice as much as when you're watching a talk show, in fact

It’s not watching what you eat, it’s what you watch when you eat if a study released Monday is to be believed.

CBS News reports that the study, published in the Journal of the American Medical Association: Internal Medicine, found that the amount of food people consumed while viewing television was determined by the type of content they were exposed to — people watching an action flick ate almost twice as much as people watching a talk show.

The researchers randomly divided 94 undergraduate students into three groups, each of which was put in front of a TV for 20 minutes. One group was made to watch a part of the Ewan McGregor and Scarlett Johansson thriller The Island, while the second watched the same portion of the same film on mute. The final group watched a 20-minute clip of the interview program Charlie Rose.

All three sets of participants were given M&Ms and cookies, as well as healthier snacks like carrots and grapes, to enjoy while watching TV. Researchers weighed the snacks before viewing, and how much was left afterward.

While the people watching the interview show ate 104.3 g of food, CBS says, those who watched the clip of The Island consumed a total of 206.5 g — nearly twice the amount. Watching The Island on mute did diminish appetites, but at 142.1 g the amount consumed was still 36% more than that of the Charlie Rose group. The total calorie intake of both groups watching the action clip was also higher, at 354 calories with sound and 314 without, compared with just 215 calories for the third group.

Study author Aner Tal, a postdoctoral research associate at Cornell’s Food and Brand Lab, said that stimulating, fast-paced programs with a lot of camera cuts drew viewers in and distracted them from what they were eating. “They can make you eat more because you’re paying less attention to how much you are putting in your mouth,” Tal said.

The researchers suggested measures like bringing predetermined, finite quantities of food to the TV to avoid overeating, while the study’s co-author Brian Wansink, professor and director of the Cornell Food and Brand Lab, offered a silver lining.

“Action-movie watchers also eat more healthy foods, if that’s what’s in front of them,” he said, suggesting that this could be turned to a viewer’s advantage.

[CBS News]

TIME Obesity

Obesity Is A Big Contributor To Diabetes Boom

Diabetes is one of the most common diseases in the U.S., and there’s a single biggest culprit to blame, found a new study released today in Annals of Internal Medicine: our ever-increasing body mass index, or BMI.

The team analyzed data from five National Health and Nutrition Examination Surveys of a nationally representative U.S. sample of 23,932 people. They found that the prevalence of diabetes almost doubled from 1976 to 1980 as well as from 1999 to 2004.

BMI explained most of the increase in the prevalence of diabetes, even more than other big factors like race, ethnicity and age, lead study author Andy Menke, an epidemiologist with Social & Scientific Systems, wrote in an email to TIME. “There has been a substantial increase in obesity in the US population during this study,” he wrote.

Intriguingly, diabetes prevalence increased more in men than in women. And after taking changes in age, race, ethnicity and BMI into account, Menke’s team found that diabetes prevalence still increased in men, but not in women. The reason for that gender gap is not entirely clear, but might be due to factors that fell outside the scope of the study like differences in survival between men and women after being diagnosed with diabetes, physical activity, sleep patterns, vitamin D levels, psychological stress and depression, and exposure to pollutants and toxins, Menke wrote.

“Decreasing the occurrence of being overweight and obesity remains an important intervention to reduce the burden of diabetes,” the study authors wrote. In the fight against diabetes, obesity is a clear place to start.

TIME Diet/Nutrition

Low-Carb Diet Beats Low-Fat for Weight Loss

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How cutting carbs improves your waist and heart

If you’re trying to lose weight, fat might be your friend.

A new study published today in Annals of Internal Medicine found that when people followed either a low-fat or low-carb diet for a year, those who cut carbs lost significantly more weight and fat, while reducing their heart disease risk factors more than dieters who reduced the amount of fat they ate.

Researchers watched the waistlines of a diverse population of 148 obese but healthy men and women. Those on the low-fat diet consumed 30% of their daily calories in fat, and those in the low-carb group got 30% of their calories from carbs. A dietitian gave both groups the same nutritional counseling throughout the year and followed up with detailed interviews about what the participants ate.

Though both groups exercised at about the same rates and consumed similar amounts of calories, the low-carb group lost almost 8 pounds more over the course of the year—and more fat as a proportion of their weight. Both groups dropped their levels of LDL cholesterol, but the low-carb dieters had higher increases of the so-called “good” HDL cholesterol. They also had a lower risk of heart disease, measured by markers like glucose and lipid levels.

MORE: Ending The War On Fat

All of these admirable health measurements occurred despite the fact that the low-carb group ate more than 40% of their daily calories in fat, says study co-author Lydia Bazzano, professor of nutrition at Tulane University School of Public Health and Tropical Medicine. People in the low-carb group ate more monounsaturated fat and even more saturated fat than they did before their diet, but still saw a drop in LDL cholesterol. And their good cholesterol levels improved a substantial amount more than the other group.

Why did the low-carb dieters benefit? “As a proportion of the carbs they were having, the low-carb group had a much higher proportion of fiber,” Bazzano says, which helps lower blood pressure and cholesterol. Eating more fat and protein also makes you feel fuller for longer, which may have curbed how many total calories the group ate. Plus, the diets also contained a good amount of healthy monounsaturated fats.

The data highlight how interactive diets really are, which supports the old-fashioned idea of eating everything in moderation to keep the balance of fat, fiber, protein and carbs in check. “The thought that [carbohydrates] are neutral and should be at the base of the food pyramid is not supported by a lot of evidence,” Bazzano says. She suggests restructuring with a foundation of vegetables and fruit — and not forgetting to add in a dose of healthy fats.

TIME Diet/Nutrition

Americans’ Diets Are Improving (Sort Of)

New research shows Americans as a whole are eating healthier, but there's still a lot of room for improvement

Americans have started eating better in the past few years, largely because we’re eating less trans fat, new research shows. But major disparities continue to persist in who’s making the healthier choices.

Harvard Medical School researchers looked at the changing American diet from 1999 to 2010 using national health surveys of 29,124 adults. The surveys used the Alternative Healthy Eating Index, a tool that rates dietary quality on a scale from 1 to 11o. The higher the score, the healthier the diet.

Researchers found that between the study period, diet quality went up from 39.9 to 46.8, and they were able to determine that a lot of that increase came from a significant reduction in consumption of trans fats. In 2006, the FDA required manufacturers to include trans fats on nutrition labels, and more recently the FDA has inched toward banning them altogether–a new study released last week finds that trans fats still lurk in many of our foods. The researchers found the bump encouraging, especially when they also noticed that Americans are eating more fruit, nuts, whole grains, and healthy fats while drinking less sugary beverages.

But the researchers also found significant differences in Americans’ diets based on socioeconomic status. In the study time frame, dietary quality was also lowest among people with 12 years or less of school. Their diets also improved more slowly. The researchers believe the income-related differences are possibly due to the cost of some healthy foods and the fact that healthy food is not always accessible.

“Considering the elevated disease risk associated with poor dietary quality, dietary assessment and counseling in clinical settings deserves greater attention,” the authors write in their study, published in the journal JAMA Internal Medicine.

While the findings show we’re making strides when it comes eating better, it’s worth noting that a score of 46.8 is still pretty bad when optimal is 110. Clearly, Americans still show a lot of room for improvement, regardless of where we fall on the scale.

TIME Mental Health/Psychology

Family Dinners Protect Against The Effects of Cyberbullying

An argument for sitting down to dinner

About 1 in 5 young people experience some form of online bullying, which can have serious effects on mental health and behavior. However, a recent study shows that eating dinner as a family may actually protect against some of the negative effects of being bullied.

In the new research published in the journal JAMA Pediatrics, the researchers surveyed 18,834 students between the ages of 12 and 18 from 49 schools in the Midwest. Their findings showed a positive association between cyberbullying and problems like anxiety, depression and self-harm as well as substance abuse like frequent drinking and prescription drug abuse.

Interestingly, the researchers found teens eating dinner with their families reduced the effects of cyberbullying. The data show that when there are no family dinners, there’s an increase in the rates of problems with cyberbullying, but four or more family dinners a week resulted in fewer problems.

“With more frequent dinners comes more regular family contact, which facilitates parental guidance and support, open communication with parents and siblings, and opportunities for adolescents to express problems and concerns as they arise,” the study authors write.

The researchers acknowledge that their findings do not conclude that bullying on its own is enough to increase the risk for mental health and behavioral problems, nor are family dinners necessarily enough to protect against them, since there are several other factors in an adolescent’s environment that could play a role.

It’s likely that having family dinners can serve as a release for young people, and that they benefit from communicating their problems and frequently interacting with their family. It’s an argument for seeing family meals as more than just an opportunity to eat.

TIME Jobs

A Leafy Office is a Happier Office, Study Finds

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Green begets green

The world’s first study of the “long-term impacts of plants in an office environment” suggests that a simple arrangement of a few plants around the office can pay huge dividends.

Researchers measured a 15% increase in productivity after “lean offices”—or workplaces with a desert-like aesthetic—were spruced up with leafy, green plant life. Over the course of several weeks, workers in three commercial spaces in the U.K. and the Netherlands reported higher levels of air quality, improved powers of concentration and a general increase in workplace satisfaction.

“It appears that in part this is because a green office communicates to employees that their employer cares about them and their welfare,” said study author Alex Haslam, a psychology professor at the University of Queensland. “The findings suggest that investing in landscaping an office will pay off through an increase in office workers’ quality of life and productivity.”

Researchers also noted the findings contradicted a movement among interior designers towards severely stripped down and unadorned workspaces. “Sometimes less is just less,” Haslam concluded.

 

TIME Heart Disease

New Heart Drug Saves More Lives Than Standard Treatment

A new drug may replace the current standard of treatment for heart failure

Drug maker Novartis released highly anticipated results from its clinical trial, PARADIGM-HF, showing its new heart failure drug cut cardiovascular deaths by 20%. The results were announced at the European Society of Cardiology meeting on Saturday.

Novartis has been testing a drug called LCZ696 for chronic heart failure in hopes of replacing ACE inhibitors, one of the mainstays of heart failure treatment. In March, an ethics council that was monitoring the trial data simultaneously requested the company end the trial since it was clear that participants using LCZ696 lived longer without being hospitalized for heart failure compared to those using the standard-care ACE inhibitor, enalapril.

Anticipation over the drug’s results has been mounting since the recommended closure of the trial; results were so impressive that the treatment showed potential to become the next standard of care. The latest trial showed significantly more patients on LCZ696 were alive, and they had 21% fewer hospitalizations compared to people on enalapril. They also found that the drug doubled the effect enalapril had on all-cause mortality, which is the holy grail of trial end points.

About 20 to 26 million people live with heart failure across Europe and the U.S., and even with treatment it has a poor prognosis and costs $100 billion to treat globally. The majority of those costs come from hospitalizations.

“We thought, what if we could replace the cornerstone of heart failure treatment, ACE inhibitors,” says Patrice Matchaba, development head for Novartis’ critical care franchise. “That’s why we designed PARADIGM and it was a bold decision to make.”

LCZ696 is a pill taken twice a day and is part of a new class of drugs that blocks receptors exerting harmful effects on the heart. The treatment protects the heart by reducing muscle strain, which allows the heart muscle to recover.

Fewer patients using LCZ696 discontinued the trial for adverse events, but the group did have more hypotension and non-serious angioedema compared to patients on enalapril. They had less renal impairment, hyperkalemia and cough.

Matchaba says Novartis will be submitting to the FDA by the end of 2014 and that they’ve already received fast-track status. They will submit in Europe the first quarter of 2015.

TIME health

5 Things That Make You Overeat

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We eat solo about half of the time, according to a recent report. We dine alone 60% of the time at breakfast, 55% of the time at lunch, and up to 70% of the time when eating snacks. The solitary dining trend is due in part to on-the-go lifestyles, as well as the fact that nearly one third of households consist of just one person.

Whether you live alone or with your significant other or family, you may find yourself eating in a different way when you dine by yourself. Specifically, if you’re like many of my clients, you’re probably falling into some unhealthy eating traps. Here are five common dine-alone conundrums, along with practical ways to thwart them.

Health.com: 10 Weight Loss Mistakes Everyone Makes

Relying on processed convenience food

I’ve had numerous clients tell me that they don’t make meals from scratch when they dine alone, because they think, ‘why bother going to the trouble just for one person?’ As a result, they find themselves relying on frozen dinners or packaged products, and that quality difference can negatively affect your waistline. One recent study found that we burn about 50% more calories metabolizing whole foods versus processed foods. In other words, it’s not just about the total calories you consume; some prep and cooking time is a worthy investment, even for a solo meal. To keep it fresh, simple, and relatively fast, consider whipping up breakfast for dinner. You can sauté fresh veggies like tomatoes, onion, spinach, and mushrooms in low sodium organic veggie broth with garlic and herbs, and then pair it with either scrambled organic eggs or mashed white beans. Serve this over a small portion of healthy starch, such as quinoa or brown rice, and top with sliced avocado for healthy fat.

Health.com: 14 Ways to Cut Portions Without Feeling Hungry

Making too much

One of the biggest challenges many of my clients face when dining solo is making more than they need, which results in eating extra portions. I know it’s really a pain, or sometimes impossible, to make just a half cup of quinoa, for example. So if you cook more than you need for a single meal, keep a BPA-free storage container at the ready to stash your surplus in the fridge. And to check yourself, consider pulling out your measuring cups and spoons. Eating just 20% more than you need meal after meal can keep you about 20 pounds heavier–so while quality food rules, managing quantity is still key for weight control.

Eating while distracted

Eating alone often involves eating while doing something else–watching TV, checking email, reading, or surfing the web. And distracted eating is a major setup for overeating. When you aren’t paying attention, it’s easy to become disconnected from how much you’re eating, or how full you feel. And when you’re out of touch with the eating experience–not noticing the aromas, flavors, and textures because you’re multitasking–you’re more likely to feel unsatisfied, which can lead to post-meal snacking. I know it may feel awkward, but when dining alone, try to sit at a table and just eat. You may be surprised at how much more you enjoy your meal, and how much more satisfied you feel. In fact, many people have told me that establishing this habit resulted in getting excited about cooking again, so they could experiment with new recipes or seasonings.

Health.com: 10 Types of Hunger and How to Control Them

Gobbling too fast

Since dining alone isn’t social, you may be tempted to rush through a meal, in order to get onto your next task. But in addition to potentially triggering bloating and acid reflux, speed eating is a recipe for weight gain. One study of 3,000 people found that fast eaters were 84% more likely to be overweight. Set a goal to simply slow down; put your utensil or food down between bites, take a few breaths between forkfuls, and chew more thoroughly.

Mindless nibbling

Another common pitfall associated with eating solo is mindlessly nibbling, especially on snacks. One of my clients who often worked from home found herself grabbing whatever was within reach throughout the day, an apple from the fruit bowl, one of her son’s granola bars or hubby’s energy bars, a handful of jarred nuts…. If you’re in the same boat, the best remedy is to keep food out of your sightline, and schedule your meals and snacks. When this client began working from a desk rather than a kitchen stool, and set her cell phone alarm for a designated lunch and afternoon snack time, the extra noshing went away, and so did the excess pounds.

Health.com: A Slacker’s Guide to Losing Weight Without Trying

This article originally appeared on Health.com.

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