TIME diabetes

Antibiotics Are Linked To Type-2 Diabetes

Antibiotic use is associated with type-2 diabetes diagnoses, the latest research reveals

A new study published in the Journal of Clinical Endocrinology & Metabolism finds that people who develop type-2 diabetes used significantly more antibiotics—even 15 years before they were diagnosed—than people without the disease.

The researchers used data from citizens of Denmark, since the country has a single-payer national health insurance system with detailed health and pharmacy records. Using national health registries, the researchers looked at 170,504 people who had type-2 diabetes and tracked their prescriptions for antibiotics. They matched those people with 1.3 million other Danish citizens of the same age and sex who did not have diabetes and compared data from the two groups.

People with type-2 diabetes were more likely to receive more courses of antibiotics (0.8 prescriptions per year) than those who didn’t have the disease (0.5 prescriptions per year). An increased use of antibiotics was detected up to 15 years before people with type-2 diabetes were even diagnosed; an increased usage was also found after diagnosis.

MORE: How This Common Drug Can Have Lasting Effects On Kids

The study wasn’t designed to be able to determine a cause, but the authors point out two interpretations of the results. One is that people who go on to develop type-2 diabetes are more vulnerable to infections years before they’re diagnosed, so it would make sense for them to take more antibiotics. The other theory is that antibiotics raise the risk of type-2 diabetes.

This second theory is derived largely from research in rodents, and it’s the one that compels Dr. Martin Blaser, professor of medicine and microbiology at New York University Langone Medical Center and a longtime researcher of the effects of antibiotics. (Blaser was not involved with this study but is familiar with the research.)

“When you take antibiotics,” he says, “you change the composition of the microbiota”—your personal collection of bacteria in the body that communicates with human cells. Blaser has a hypothesis for how this might work in children who develop type-1 diabetes: the change in composition from taking antibiotics also alters metabolism, possibly making people more likely to become diabetic. “This work coming out that antibiotics might be affecting adults in a similar fashion is a little surprising to me, but in no way shocking,” he says. “I thought by the time you’re adult things are pretty much fixed, but maybe they’re not.”

The results of the study are not conclusive. But Blaser says they add to the body of research about the potential risks of antibiotics. “It’s evidence consistent with the idea that antibiotics have cost—not just monetary cost, but a biological cost in terms of potentially causing long-term effects,” he says. “As we’re studying it more and more, it suggests that things may bounce back, but it may not be the same normal, and it may predispose to other diseases—including important diseases, common diseases, like type-2 diabetes.”

TIME Diet/Nutrition

Should I Eat Salmon?

5/5 experts say yes.

This food from the sea is a no-brainer for all five of our experts.

A small 3-oz serving of wild salmon has about 156 calories and 23 grams of protein, plus 6 grams of fat. Omega 3 fatty acids are salmon’s claim to fame, “providing anywhere between 2-3 grams per 3-oz. serving,” says Julia Renee Zumpano, a registered dietitian at the Center for Preventive Cardiology Cleveland Clinic. (To put that into perspective, that’s the nutrient equivalent of taking three days’ worth of soft gels of fish oil in supplement form.) “Omega 3 fatty acids can help reduce blood triglycerides, blood pressure, and reduce swelling.”

“Wild is better than farmed,” says Dr. David Katz, director of the Yale University Prevention Research Center, an assertion with which most of our experts agree. Zumpano points out that farmed salmon may contain more saturated fat, calories, pollutants and antibiotics than wild salmon. (Salmon does have low mercury levels, however, according to the FDA.)

Farmed salmon may not deliver as many omega-3s, says Peter D. Nichols, senior principal research scientist at CSIRO Food, Nutrition & Bioproducts in Australia who’s researched long-chain omega-3 (LC Omega-3) oils. “The content of the LC Omega-3 has generally decreased in farmed salmon both in Australia and globally,” he says. “The LC omega-3 content is about half of what it used to be, although we should also note that this is still generally 10-100 fold higher than most other food groups.”

Not all farmed salmon is bad, though, says Tim Fitzgerald, director of impact in the oceans program at the Environmental Defense Fund. “Although most generic farmed salmon—often labeled ‘Atlantic’ in stores—still comes with a variety of environmental concerns, a number of new companies are upping their game and showing that salmon farming doesn’t have to be on everyone’s ‘avoid’ list,” he says. A few of his favorite sustainably farmed salmon standouts are Atlantic Sapphire, Kuterra and Verlasso. Fitzgerald also likes arctic char as an alternative to farmed salmon. “It’s closely related to salmon—so looks and tastes very similar, it’s farmed responsibly, and has a price point somewhere between Atlantic and wild Alaskan salmon.”

For the overall most sustainable salmon, choose wild Alaskan salmon, says Kimberly Warner, a senior scientist at Oceana, a nonprofit focused on ocean conservation. “Wild Alaskan salmon are managed well in the U.S.,” she says. It’s expensive, but you’ll be getting an especially good deal during the summer salmon season (and buying fish in season means the fish is most likely to be honestly labeled, she says).

But don’t forget: not every fish worth eating comes on ice. “Virtually all canned salmon is wild-caught in Alaska,” Fitzgerald says, “so you can get all of the environmental and health benefits for just a few dollars.”

salmon
Illustration by Lon Tweeten for TIME

Read Next: Should I Eat Tilapia?

TIME Sex/Relationships

Couples Who Do This Together Are Happier

A study shows that giggling in tandem is a good indicator the relationship's going to last.

Study after study has shown that laughing is good for the soul. But now we know something else: sharing giggles with a romantic partner keeps the lovey-dovey feelings going, according to a study published in the journal Personal Relationships.

Laura Kurtz, a social psychologist from the University of North Carolina, has long been fascinated by the idea of shared laughter in romantic relationships. “We can all think of a time when we were laughing and the person next to us just sat there totally silent,” she says. “All of a sudden that one moment takes a nosedive. We wonder why the other person isn’t laughing, what’s wrong with them, or maybe what’s wrong with us, and what might that mean for our relationship.”

Kurtz set out to figure out the laugh-love connection by collecting 77 heterosexual pairs (154 people total) who had been in a relationship for an average of 4 years. She and her team did video recordings of them recalling how they first met. Meanwhile, her team counted instances of spontaneous laughing, measured when the couple laughed together as well as how long that instant lasted. Each couple also completed a survey about their relational closeness.

“In general, couples who laugh more together tend to have higher-quality relationships,” she says. “We can refer to shared laughter as an indicator of greater relationship quality.”

It seems common sense that people who laugh together are likely happier couples, and that happier couples would have a longer, healthier, more vital relationship—but the role that laughter plays isn’t often center stage. “Despite how intuitive this distinction may seem, there’s very little research out there on laughter’s relational influence within a social context,” Kurtz says. “Most of the existing work documents laughter’s relevance to individual outcomes or neglects to take the surrounding social context into account.”

Kurtz noted that some gender patterns emerged that have been reported by previous studies. “Women laughed more than males,” she notes. “And men’s laughs are more contagious: When men laugh, they are 1.73 times more likely to make their partner laugh.”

There’s also evidence that laughing together is a supportive activity. “Participants who laughed more with their partners during a recorded conversation in the lab tended to also report feeling closer to and more supported by their partners,” she says. On the flip side, awkward chuckles, stunted grins and fake guffaws all are flags that there may be something amiss.

This harkens back to a classic psychological experiment conducted in 1992, where 52 couples were recorded telling their personal, shared histories. The team noted whether the couples were positive and effusive or were more withdrawn and tired in telling these stories, then checked in with the couples three years later. They saw a correlation in how couples told stories about their past and the success of their partnership: the more giddy the couple was about a story, the more likely they remained together; the less enthusiastic the couple was, the more likely the couple’s partnership had crumbled.

While there are cultural differences in laughter display—Kurtz says that Eastern cultures tend to display appreciation with close-mouthed smiles, not the heartier, toothy laughs that are more Western—there’s no question that laughter is important. “Moments of shared laughter are potent for a relationship,” she says. “They bring a couple closer together.”

TIME Cancer

Genetic Test Impacts Chemo Choices In Surprising Ways

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Maciej Frolow—Getty Images

A study investigates for the first time how a gene-based test is affecting women’s decisions to get chemotherapy

In the new era of personalized medicine, having more information on hand is considered the ideal situation for making more customized, and ideally, effective decisions about medical care.

And in a new study of breast cancer patients, researchers show that a relatively new genetic test for evaluating tumors is doing just that. It’s just that the test isn’t necessarily leading to the decisions that experts expected.

The Oncotype DX Breast Cancer Assay is a test approved by the U.S. Food and Drug Administration to help women decide how likely their breast cancer is to recur. The score, from zero to 100, is for women with breast tumors that have not spread to the lymph nodes. It places women on a scale of probability, based on an analysis of 21 genes in her tumor. Most doctors and patients use the score to decide, in part, whether the woman should receive chemotherapy following surgery.

MORE: A Major Shift in Breast Cancer Understanding

In previous studies, about 20% to 30% of doctors say they changed their recommendation about chemotherapy based on the Oncotype DX score. But none of the studies looked at how Oncotype DX affected the likelihood a woman would undergo chemotherapy rates in a real-world setting— outside of a trial. In clinics, says Michaela Dinan, assistant professor in medical oncology at the Duke Cancer Institute, many other factors contribute to treatment decisions, including fear, family history and physician advice. So she and her colleagues conducted a review of data on more than 44,044 breast cancer patients to see how the Oncotype test affected chemotherapy decisions.

MORE: Here’s the Amount of Exercise That Lowers Breast Cancer Risk

The results, published in JAMA Oncology, showed that overall, the test had no effect on their decision. Women who were tested were no more or no less likely to opt for chemotherapy than those not getting Oncotype DX. Younger age and a higher risk disease were more likely to predict chemotherapy use than the assay.

While many assumed that the test would lead to fewer treatments, Dinan’s data shows that how the testing affects chemotherapy decisions is less predictable. When Dinan delved further into the numbers, she found an interesting pattern. Those rated as having high-risk breast cancer according to the National Comprehensive Cancer Network guidelines were less likely to get chemo than women who were not tested. And among people with low-risk disease, those getting the genetic test were more likely to get chemotherapy than low-risk patients who did not.

Because the study did not take into consideration what the Oncotype DX scores were, it’s possible, for example, that women considered high risk who received intermediate or low Oncotype DX scores decided not to undergo chemotherapy since the testing showed their response might not be as positive as they might have expected. On the other hand, women who have low risk disease and receive an intermediate test score might decide to undergo chemotherapy since the intermediate risk might represent a slightly higher risk of recurrence than they were anticipating.

“It’s a more nuanced finding,” says Dinan. “The Oncotype DX test is impacting the receipt of chemotherapy, but the impact isn’t in one direction or another in terms of whether people are more or less likely to get chemotherapy.”

As more options for personalized treatments make their way into the clinic, Dinan says it’s worth remembering that they shouldn’t dictate decisions but inform them. “The nuanced finding of the difference between high risk and low risk patients says to me that whether or not a woman with early stage breast cancer undergoes chemotherapy is going to be affected by a number of different factors, not just this assay. It’s a personalized discussion about the individual patient’s case.”

TIME Research

Marijuana Does Not Affect Brain Volume, Study Finds

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Illustration by Sydney Rae Hass for TIME

The latest research adds to the debate over marijuana's effects on the brain

Using marijuana does not cause changes in brain volume, a new study suggests.

Public health experts have cited concerns that using marijuana could be associated with structural changes in the brain. However, a new trial comparing the brains of marijuana users and non-users to their siblings reveals that marijuana use likely does not cause changes in brain volume.

In the study, published in the journal JAMA Psychiatry, researchers looked at a large group of siblings ages 22 to 35. Of the 483 people, 262 reported ever using marijuana, even just once. The researchers then split the men and women into groups: sibling pairs who had never used marijuana, sibling pairs where both had reported using marijuana, and sibling pairs where one had used marijuana and one had not. Overall, they noticed that people who reported using marijuana had smaller volumes in certain parts of the brain—like the left amygdala, which is involved in emotional processing. However, these differences still fell within a range of volume that is considered normal.

The researchers hypothesized that in the sibling pairs where one had used marijuana and one had not, they would see differences in brain volume. But instead, they found that the exposed and unexposed siblings had the same amygdala volume. “We found no evidence for the causal influence of cannabis exposure on amygdala volume,” the authors concluded.

The researchers suggest that differences in volume could be due to other factors, like genetics or living environment. “Our study suggests that cannabis use, or at least the simple index of it that we used, does not directly impact changes in brain volumes,” says study author Arpana Agrawal, an associate professor at Washington University School of Medicine. “Instead, any relationship that we did see between cannabis use and brain volumes was due to predisposing factors that influence both cannabis use and brain volumes.”

The study did not find that brain volume has any effect on whether or not a person uses marijuana.

Another study, also published by different authors in the same journal, found that using marijuana could alter the brains of males at high risk for schizophrenia in potentially meaningful ways.

More research needs to be done to understand whether marijuana does or does not have potentially harmful effects on the brain, or whether the risks are different from one person to the next.

TIME medicine

Boy Who Had First Double Hand Transplant Leaves Hospital With New Hands

Zion with his new hands after the world's first bilateral hand transplant on a child at The Children's Hospital of Philidelphia.
The Children's Hospital of Philadelphia Zion with his new hands after the world's first bilateral hand transplant on a child at The Children's Hospital of Philadelphia

"The challenges facing Zion are new, but his determination should overcome them"

The first child to ever get a double hand transplant went home from the Children’s Hospital of Philadelphia Wednesday, his hands still bandaged but working well enough to let him play with action figures.

Zion Harvey, 8, lost his arms and legs to a life-threatening infection when he was just 2. He later needed a kidney transplant and was put on immunosuppressant drugs for the rest of his life. But this tragic medical history made Zion the ideal candidate to be the first kid in the world to get new hands.

“The challenges facing Zion are new, but his determination should overcome them. He’s already done so many amazing things,” Zion’s mom Pattie Ray said in a statement.

Read more from our partners at NBC News

TIME Diet/Nutrition

Drinking Water Helps You Lose More Weight, Study Finds

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Drinking 16 ounces before meals leads to more weight loss, a new study shows

Chug a couple glasses of water before eating a meal, and you may eat less without even trying.

Those are the results from a new study published in the journal Obesity, in which researchers rounded up obese adults to see if drinking water before eating could help them shed pounds.

“If you look at any sort of weight management programs, they all say drinking lots of water is a really good thing,” says study author Dr. Amanda Daley of the University of Birmingham in the UK. “We said, let’s go see what the actual evidence is for this.”

Finding little in the literature, Daley and her colleagues recruited 84 adults with obesity for a 12-week experiment. Everyone was given general weight loss advice, then assigned to one of two groups. One group was told to drink 500 ml—about 16 oz—of water half an hour before their meals, while the other group was told to simply imagine their stomachs were full before meals.

The researchers monitored everyone’s weight at the start, middle and end of the experiment, along with their urine to make sure the water-boosted group was indeed drinking more water. They kept track of physical activity, too, which didn’t change.

The group that loaded up on water lost about three more pounds than the group that didn’t up their water intake. And the more they drank, the better the results; people who drank 16 ounces before every meal lost about 4.3 kg, or 9 pounds, over the course of the experiment. “That’s about what you get from going to Weight Watchers for 12 weeks,” Daley says. “That’s a real success.” (Weight Watchers counts weekly weight loss of half a pound to two pounds as on track.)

Water might be so effective because, obviously, “it fills you up” and helps increase satiety, Daley says. Drinking a couple glasses of water 30 minutes before a meal gives you time to feel fuller, which can help shape decisions about what you eat, she adds.

This is just a first step at getting good evidence, and more research is needed before the mechanisms are fully discovered. But Daley thinks that drinking more water before meals can help everybody with weight management, regardless of BMI status. “We all get fatter over time, so it might well work as a prevention strategy at a population level,” she says. “We want people to drink more water anyway.”

TIME medicine

No, Selfies Aren’t Causing a Teen Lice Epidemic

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Caiaimage/Tom Merton—Getty Images/Caiaimage

One thing is for certain — we’re all taking more selfies than we ever have before. And while social science experts may debate what that says about us, doctors are more concerned about something else entirely: lice.

Lice, those tiny, barely visible parasites that can cling onto fur and hair, are more common in kids, who tend to have more head-to-head contact and share things like hats and helmets. But some doctors have been reporting — anecdotally — that they’re seeing more lice among teens. A few are, rather dubiously, are blaming selfies.

“People are doing selfies like every day, as opposed to going to photo booths years and years ago. So you’re probably having much more contact with other people’s heads,” Dr. Sharon Rink, a Wisconsin pediatrician, said on a local television show.

But there is no data showing the current lice outbreak—which is in 25 states and features lice resistant to the drugs usually used to kill them—is overwhelmingly affecting selfie-snapping teens, the National Pediculosis (that’s the official scientific name for a louse infestation) Association told the Huffington Post. The Centers for Disease Control says six to 12 million kids, aged three to 11 years, get lice in the U.S. each year. Children, and teens, are more likely to pick up lice during close contact in cars, during sleepovers, or sharing headphones, than they are in the few seconds it takes to take a selfie, say some experts.

And many of those raising the alarm have something to do with nit picking — literally. De-lousing salons have sprung up to help reluctant parents who cringe at the idea of tediously taking to the tweezers to pick out the critters, one by one. What better marketing message than to alert the public to a new population of hosts for the ever-hungry louse?

TIME Diet/Nutrition

You Asked: Why Do I Get Hangry?

Hangry - Peter Oumanski
Peter Oumanski for TIME

Blame your glucose-deprived brain for your rotten mood.

Long-term couples know all too well the perils of the early evening hours: that touchy time after work but before dinner hits the table.

It’s prime time for getting “hangry”, a handy portmanteau for hungry and angry. People commonly feel an uptick in anger or aggression when they’re hungry, says Dr. Brad Bushman, a professor of psychology at Ohio State University. “The brain needs fuel to regulate emotions, and anger is the emotion people have the most difficulty regulating,” he explains.

Your brain’s primary fuel source is glucose, which your body makes from the foods you eat. And as far as fuel consumption goes, “the brain is a very demanding organ,” Bushman says. While your brain constitutes just 2% of your body weight, it uses 20% to 30% of the energy you consume, he says.

MORE: Here’s What Eating Does To Female Desire

So why do you feel hangry in the evening, but not first thing in the morning when you’ve gone the whole night without food? Willpower and self-control tend to flag as the day wears on, which further torpedoes your mood, Bushman says.

That’s bad news for your partner. Bushman’s research has shown that compared to well-fed couples, glucose-deprived people tend to stick more pins into voodoo dolls meant to represent their spouses. The underfed study participants were also more likely to blast their partners with unpleasant noises.

When your brain is struggling to control its emotions, you’re likely to lash out at the people with whom you feel most comfortable, Bushman and his colleagues concluded. So loved ones and close friends tend to bear the brunt of your glucose-starved brain.

There seems to be another, deeper layer to your hunger-induced emotional fragility.

Some of the same appetite hormones that signal to your brain It’s time to eat! also fire up those brain regions linked with stress and anxiety, says Dr. Paul Currie, a professor of psychology and neuroscience at Reed College in Portland, Oregon. In fact, Currie says some of those regions overlap.

MORE: The 14 Worst Kinds of Late People

All of this makes sense, he says, when you look at the necessity of food in “evolutionary” terms. “If you’re an animal and you’re hungry, you need food to survive,” he explains. “So it’s natural that you would feel anxious and irritable and preoccupied until you’ve met that need.”

What’s more, this stress-hunger crosstalk may go in both directions. Research has found that people tend to reach for food (especially energy-dense junk food) when feeling stressed.

Of course, the chemical and neuronal processes going on in your hungry brain are complex and vary from one person to another, Currie says. So while you may have no problem keeping your cool before dinner, your friend may be an anger-grenade with a pulled pin.

Fortunately, there’s a simple solution: eat something. If you know your mood tends to plummet before dinner, a preemptive afternoon snack that includes some carbs and protein—like peanut butter and apple, or some yogurt with berries—can help you hold onto your typically sunny disposition.

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