TIME public health

Paying People Could Help Them Quit Smoking

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Researchers offered women more than $1,000 to get them to stop smoking

Paying people to quit their bad health habits may be a powerful way to address public health issues like smoking, according to a new study in the BMJ. In the study, pregnant women were more than twice as likely to quit smoking when offered financial incentives than when they were given regular counseling.

“If financial incentives are effective and cost effective they may well have the future potential to sit with vaccines as an important preventive healthcare intervention strategy,” the study says.

The research, which looked at more than 600 pregnant women in the United Kingdom, offered women up to $1,200 dollars in shopping vouchers for following steps to quit smoking. Nearly a quarter of women who were offered the money successfully quit smoking. In the control group, a separate group of women received free nicotine therapy and were counseled on how to quit. Less than 9% of those women were able to kick the habit.

Read More: What I Learned From My $190,000 Surgery

That success gap remained when researchers followed up a year with the women in both groups who had quit. Fifteen percent of the women who had been paid to quit had stayed away from cigarettes, while only 4% of the counseling group quitters had done the same.

Using financial incentives to encourage better health behavior has been explored in depth in recent years by public health experts, but many remain skeptical due to underlying ethical concerns. Some have argued that such incentives are coercive and diminish a person’s sense of personal responsibility. But the researchers in this study argue that it can help in more ways than one; getting additional funds before a child’s birth helps the people who need financial assistance the most at the time they need help.

“In the developed world there is now a clear socioeconomic gradient in smoking, with tobacco use concentrated among the poorest in society,” the study says. “Receipt of financial incentives can contribute to needed household income in advance of the arrival of a baby in low income households.”

TIME E-Cigarettes

Surgeon General: ‘Desperate Need of Clarity’ on E-Cigarettes

(RICHMOND, Va.) — Public health officials are “in desperate need of clarity” on electronic cigarettes to help guide policies, the nation’s newly appointed surgeon general said Tuesday.

Dr. Vivek Murthy, whose predecessors have been instrumental in guiding tobacco control, addressed the battery-powered devices that heat liquid nicotine during a stop in Richmond as part of a cross-country listening tour. The U.S. Senate confirmed the 37-year-old physician and Harvard Medical School instructor’s nomination as the country’s senior public health official in December.

“There’ve been theories and ideas around the fact that e-cigarettes may be helpful from a harm reduction perspective in helping people who are already on cigarettes (that) have had trouble quitting actually get off cigarettes,” Murthy said. “If the data indeed bears that out, then I think we should absolutely embrace that and use e-cigarettes in targeted ways.”

However, Murthy expressed worry regarding e-cigarettes because he said there are many unanswered questions about their health impacts, specifically their contents, and if they are ultimately a gateway to traditional smoking. He also noted the rapid growth in use of e-cigarettes among both adults and children.

“I’m concerned about e-cigarettes, and I think this is an area where we are in desperate need of clarity,” Murthy said. “I think it’s important for us to understand the impact, particularly on youth, before we allow the full-fledged spread of these e-cigarettes and then later have problems that we have to deal with.”

Last April, the Food and Drug Administration for the first time proposed a set of regulations for e-cigarettes, including banning sales to minors and requiring health warning labels, as well as approving new products. The agency has said its proposal sets a foundation for regulating the products, but the rules wouldn’t immediately ban the wide array of flavors or styles of e-cigarettes or curb marketing on places like TV.

Scientists haven’t finished much research on e-cigarettes, and the studies that have been done have been inconclusive. The government is pouring millions into research to supplement independent and company studies on the health risks of e-cigarettes and other tobacco products — as well as who uses them and why.

Historically, the surgeon general’s office has played an important role in addressing tobacco issues.

A 1964 surgeon general’s report launched the anti-smoking movement. While far fewer Americans are smoking today — about 18 percent of adults — a report last year marking the 50th anniversary of the landmark paper warns that the government may not meet its goal of lowering that rate to 12 percent by 2020.

TIME Research

Being Neglected Harms Brain Development in Kids

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Kids put in institutions have different brain compositions than kids in foster care

Childhood neglect leads to harmful changes in the brain, a new study says.

In new research published in the journal JAMA Pediatrics, researchers looked at brain differences between Romanian children who were either abandoned and institutionalized, sent to institutions and then to foster families, or were raised in biological families.

Kids who were not raised in a family setting had noticeable alterations in the white matter of their brains later on, while the white matter in the brains of the children who were placed with a foster family looked pretty similar to the brains of the children who were raised with their biological families.

Researchers were interested in white matter, which is largely made up of nerves, because it plays an important role in connecting brain regions and maintaining networks critical for cognition. Prior research has shown that children raised in institutional environments have limited access to language and cognitive stimulation, which could hinder development.

These findings suggest that even if a child were at a risk for poor development due to their living circumstances at an early age, placing them in a new caregiving environment with more support could prevent white matter changes or perhaps even heal them.

More studies are needed, but the researchers believe their findings could help public health efforts aimed at children experiencing severe neglect, as well as efforts to build childhood resiliency.

TIME Diet/Nutrition

4 Cooking Mistakes That Make You Gain Weight

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Here's how to make home cooking far healthier than takeout

Cooking at home seems like a far healthier option than dining out, right? Maybe not. A recent study found that the more time middle-aged women spent cooking at home, the more likely they were to suffer from metabolic syndrome. The reason for the finding may be that the study didn’t identify exactly what the women were cooking, so there was no way to measure the healthfulness of their homemade meals.

For example, the results wouldn’t be surprising if dinner meals included dishes like lasagna or meatloaf, rather than veggie-filled stir frys or entrée salads. Researchers also say that the participants who cook at home more frequently may also be baking more as well, and therefore consuming more sugary treats like cookies and brownies.

The bottom line is cooking at home is a chance to either eat healthfully—or eat just as poorly as if you had ordered takeout or dined at a restaurant. Avoid these 4 common blunders to take full advantage of the health opportunity home cooking offers.

HEALTH.COM: 11 Reasons Why You’re Not Losing Belly Fat

Nibbling while cooking

Many of my clients start keeping food diaries soon after our first consultation, and some are shocked to discover just how much they eat while prepping and cooking. One client regularly downed a glass of wine (or two) while popping cheese cubes, nuts, or crackers as she prepped. That mindless munching resulted in taking in up to 300-400 extra calories, which is enough to keep her at least two sizes larger than her weight goal.

The fix: If you’re hungry when you start making dinner, munch on low-calorie raw veggies like bell pepper or sliced cucumber. Or factor your prep-time snack into your meal budget. For example, if you want to nibble on nuts, reduce the amount of olive oil you use in your dinner. As for the wine, check out my previous post 7 Eating Habits You Should Drop Now.

Carb overload

Many health-conscious people I talk to have given up white bread and pasta in favor of healthy starches, like quinoa, wild rice, and lentils. The swap is fantastic for your health, but eating excess portions of these superfoods can still prevent weight loss, or lead to weight gain. I don’t advocate ditching carbs altogether, but the amount you eat should be in proportion to your body’s energy needs in the hours after a meal. If you’ll mostly be sitting in the evening, your portion of anything starchy should be somewhere between a half cup to a cup (more if you’re younger, taller, and more physically active; less if you’re older, shorter, and exercise less). I know that seems tiny, but when combined with a generous portion of veggies (think two cups, or the size of two tennis balls) along with lean protein and a bit of healthy fat, it’s completely doable.

The fix: For most of my clients, the trick is swapping the veggie and starch proportions in their meals, so veggies are the main attraction, and the starch is, as I refer to in my upcoming book, an “accessory.”

HEALTH.COM: Try this 7-Move Fat-Melting Workout

Cheese-ing out

I recently challenged a client to go 30 days without eating cheese, because I knew it would be a major key to her success. She, like many other people I counsel, was using far too much cheese in home-cooked meals, and as a result, she was racking up hundreds of surplus calories. Ounce for ounce, cheddar packs four times the calories and nine times the fat of skinless chicken breast. Many of my clients think of it as a protein source, but an ounce of feta contains more fat than protein (6 grams versus 4).

The fix: If you don’t want to give up cheese completely, think of it as a condiment, and use it sparingly. For easy cheese-free dinner ideas check out my previous post 5 Delicious Pasta Alternatives.

HEALTH.COM: 9 Low-Fat Foods You Shouldn’t Eat

Indulging in dessert too often

Over the years, many clients have told me that they just need a little something sweet after dinner. But one cookie can easily turn into three, and one serving of ice cream can easily become the whole pint. And once an after-dinner dessert pattern forms it can be challenging to break.

The fix: In my experience, the desire for sweets is often fueled by emotions, such as the need for reward or comfort. If that’s the case, focus on the feelings, not the food. If you can find other healthy ways of meeting your emotional needs, your desire to indulge may naturally wane (check out my previous post 5 Ways to Shut Down Emotional Eating). And if you really just need a treat, opt for a few tasting squares of dark chocolate, or make room for occasional desserts by cutting the carbs and fat in your meal, which is what most desserts are made from.

One of my clients recently tried this and was thrilled with the balance it created—a real switch from her usual “all or nothing” pattern (e.g. a full dinner, wine, and dessert; or a restrictive meal with no alcohol or sweets). After eating baked fish and steamed veggies she enjoyed one cupcake. When she got dressed the next morning her clothes fit perfectly, and she didn’t have a “food hangover.” Here’s the best part: because she had learned how to eat dessert without going overboard, she didn’t feel like she needed to indulge every night. Balance feels great!

Cynthia Sass, MPH, RD, is Health’s contributing nutrition editor, and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Rangers NHL team and the Tampa Bay Rays MLB team, and is board certified as a specialist in sports dietetics.

This article originally appeared on Health.com.

TIME Cancer

Here’s Why It’s Important That Scientists Have Figured Out How to Unboil Egg Whites

Scientist Brown moves a 3D model of a HSP90 protein on a screen at the Institute of Cancer Research in Sutton
Scientist Nathan Brown moves a 3D model of a HSP90 protein on a screen at the Institute of Cancer Research in Sutton, England, on July 15, 2013 Stefan Wermuth—Reuters

The discovery could mean cheaper production of cancer-fighting antibodies

A group of University of California, Irvine, and Australian chemists have discovered how to unboil egg whites, potentially slashing costs for cancer treatment and food production.

The discovery could be a financial boon to the biotechnology industry because scientists have long struggled to efficiently recycle molecular proteins, forcing manufacturers of cancer antibodies to use more expensive methods, according a press release by UC Irvine.

Cheap proteins have a tendency to fold into structurally flawed shapes and the current recycling process is both expensive and time consuming. By contrast, the new method could make utilizing cheap proteins viable for many types of research.

For cancer treatments, pharmaceutical companies currently use expensive hamster ovary cells because they rarely fold incorrectly. The hope is that the boiled egg method can be applied to cheaper proteins such as yeast or E. coli bacteria, facilitating the more efficient and economical production of antibodies.

“In our paper, we describe a device for pulling apart tangled proteins and allowing them to refold,” said Gregory Weiss, UC Irvine professor of chemistry, molecular biology and biochemistry. “The new process takes minutes … It speeds things up by a factor of thousands.”

Industrial cheese producers could also use the method to achieve a larger yield.

TIME Autism

Siblings With Autism Less Similar Than Previously Thought, Study Says

Surprising study has implications for care

The majority of siblings diagnosed with autism do not share the same genetic mutation, according to a new study.

Using whole-genome sequencing technology, scientists looked at the genetic material of 85 families that had two children diagnosed with autism, the New York Times reports. Of those sibling pairs, about 30% shared the same genetic glitch, while roughly 70% did not. Those who shared the same genetic issue had similar habits compared to those who didn’t.

“We anticipated that, more often than not, there would be shared inheritance” said Dr. Stephen Scherer, professor of medicine at the University of Toronto and the project’s research director. “That wasn’t the case.”

Some experts say the study, which appears in the journal Nature Medicine, will likely lead to changes in hospitals, whose staff sometimes study the oldest child with autism to gain insight into the younger child’s diagnosis. Hospitals also use genetic profiles to advise parents about the likelihood of having another child with the same diagnosis.

“This study makes us step back and realize we’re not necessarily going to get as much predictive value out of genetic mapping as we thought,” Helen Tager-Flusberg, a Boston University developmental neuroscientist who didn’t work on the study, told the Times.

[NYT]

TIME heart

High Cholesterol Can Be Dangerous Even If You’re Young

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High cholesterol levels in older age are a familiar risk factor for heart attacks, and doctors warn that the danger can start much sooner for many. But how soon should you start worrying?

Most of us know that too much cholesterol in the blood can bring on dangerous clots that lead to heart attacks and stroke. And recent studies show that the build up of these fats in the blood vessels doesn’t happen overnight — it takes years of gradual deposits to narrow a vessel. So in 2013, when heart experts expanded the criteria for who over the age of 60 should consider taking cholesterol-lowering statins, Michael Pencina, a professor of biostatistics at the Duke University Clinical Research Institute, began wondering about those, including himself, who were younger. How long should they wait before taking the drugs?

In the latest study of healthy people who were followed for about 15 years on average, researchers report Monday in the journal Circulation that having even mildly elevated cholesterol levels can increase risk of having later heart problems by as much as 40%.

The researchers argue that having high cholesterol for many years—even if it starts when you’re young—should be a new risk factor that doctors and patients consider when discussing their risk of heart disease.

Even people with moderately high levels of lipids, who might not qualify for treatment for high cholesterol levels, could be at higher risk of heart attacks later in life simply because they harbor these elevated lipid levels for a long period of time.

MORE: Should I Take a Statin? What You Need to Know About the New Cholesterol Guidelines

Among a group of 1,478 people aged 55 years old from the Framingham Heart Study’s Offspring Cohort, those who had higher cholesterol levels for 11 to 20 years (beginning when they were about 35 years old) had a 16.5% higher risk of having a heart attack about 15 years later, compared to a 4.4% risk for those whose cholesterol levels never veered beyond the normal range during middle age. That’s an almost fourfold greater risk, and one that Pencina and his colleagues argue might be reason enough to be more aggressive in discussing ways to lower cholesterol with these patients so they can reduce their risk of heart trouble later on.

MORE: New Cholesterol Guidelines May Put 13 Million More on Statin Drugs

“We identified a patient population whom the guidelines might miss,” he says. It’s another dimension of cardiovascular health that needs to be looked at, and yes, I would say that it should be considered a risk factor.” In the study, the researchers considered LDL levels above 130 mg/dL as elevated, which falls into line with previous professional heart organization criteria.

But he stresses that this factor won’t fall easily into a threshold below which patients won’t need to worry about their cholesterol and above which they will. “There are so many components like family history and other factors that go into the decision of what kind of intervention people may need, such as lifestyle, diet or pharmacologic,” says Pencina. “But if you are measuring your cholesterol, even if it’s fine at an early age, it lets you build that history.”

TIME Diet/Nutrition

5 Cookies That Are Actually Pretty Good For You

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These cookies come with surprising amount of nutritional benefits

Unless you’re bent on eliminating sweets from your diet (and we know a doctor who thinks you shouldn’t), you’ll agree that almost any dessert can be healthy when consumed in moderation. But we can do better. Here, five recipes for delicious cookies that pack legit nutritional benefits.

1. Oatmeal-Raisin Cookies with Flax
Flax seed meal and whole flax seeds add nutritional value to these gooey oatmeal raisin cookies.

2. Chocolate Coconut Snap Cookies
There’s no butter in these ultra-chocolaty cookies. Instead, the recipe calls for coconut oil.

3. Chewy Cinnamon-Spelt Cookies with Sea Salt
A vegan twist on the classic snickerdoodle, these cookies are ultra-chewy with crinkly sugary tops.

4. Cocoa Nib-Almond Lace Cookies
Coconut oil, cocoa nibs and sliced almonds combine together to make these lace cookies extra crispy. They’re rich and butter (yet butterless) and full of almond flavor.

5. Gluten-Free Strawberry and Chia Seed Newton Cookies
These gluten-free cookies have a delicious filling of dried fruit, strawberry jam and chia seeds.

This article originally appeared on Food & Wine.

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TIME public health

Medical Pot May Have a Place for Very Ill Kids, Says Pediatric Group

Medical Marijuana
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'The Academy recognizes some exceptions should be made for compassionate use'

In an update to its 2004 policy statement on marijuana legalization, the American Academy of Pediatrics (AAP) now says that in some cases, children with certain debilitating illnesses should be allowed derivatives of marijuana to ease their suffering.

The group of pediatricians announced the change in position today in a statement reaffirming its opposition to the legalization of marijuana. It now includes several exceptions for “compassionate use” in children dealing with debilitating or life-limiting conditions. Compounds found in pot, known as cannabinoids, have become a method of stopping seizures for children suffering from epilepsy.

“Given that some children who may benefit from cannabinoids cannot wait for a meticulous and lengthy research process, the Academy recognizes some exceptions should be made for compassionate use in children,” the organization said in a press release.

Read More: Pot Kids: Inside the Quasi-Legal, Science-Free World of Medical Marijuana for Children

The organization stopped short of explicitly endorsing the practice and called for further research into its effectiveness.

“While cannabinoids may have potential as a therapy for a number of medical conditions, dispensing marijuana raises concerns regarding purity, dosing and formulation, all of which are of heightened importance in children,” said policy statement co-author William P. Adelman in the press release.

The organization maintained its steadfast opposition to recreational marijuana use, arguing that allowing its use for adults is more likely to lead to increased use among teenagers.

“Just the campaigns to legalize marijuana can have the effect of persuading adolescents that marijuana is not dangerous, which can have a devastating impact on their lifelong health and development,” said Seth D. Ammerman, another author of the statement, in the release.

TIME ebola

Doctors Without Borders Sees Fewer New Ebola Cases

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Health workers of the International Federation of Red Cross (IFRC) and medical charity Doctors Without Borders take part in a pre-deployment training for staff heading to Ebola areas on Oct. 29, 2014 in Geneva. Fabrice Coffrini—AFP/Getty Images

“We are on the right track," said Brice de la Vingne, the group's director of operations

The medical aid group Doctors Without Borders, or Médecins Sans Frontières (MSF), says it’s seeing declines in new cases of Ebola in its centers in Guinea, Liberia, and Sierra Leone.

There are just over 50 patients currently in MSF’s Ebola treatment centers across the three countries, the organization announced on Monday.

“This decline is an opportunity to focus efforts on addressing the serious weaknesses that remain in the response,” Brice de la Vingne, MSF director of operations said in a statement. “We are on the right track, but reaching zero cases will be difficult unless significant improvements are made in alerting new cases and tracing those who have been in contact with them.”

There is still work to do on that score; in Guinea and Liberia only half of the new cases are people who are known contacts of people with Ebola. Since just a single case can spur an outbreak, more contact tracing is needed.

MORE: TIME Person of the Year: Ebola Fighters

In Sierra Leone, incidences of Ebola have dropped to their lowest levels since August, though there are still hot zones like the country’s capital of Freetown. Guinea’s caseloads are also dropping, but more cases are coming from regions that were previously thought to be leveling out. Liberia has experienced some of the greatest drops out of all three countries. MSF says that on Jan. 17, there were no Ebola cases at the organization’s ELWA 3 Ebola management center in the capital city of Monrovia, and currently there are only two patients.

The latest case numbers from the World Health Organization (WHO) show cases have reached 21,724 with 8,641 deaths.

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