TIME health

How Doctors of the Past Blamed Women for Breast Cancer

Motherhood
Fine Art Photographic/Getty Images 'Motherhood' by Hector Caffieri, circa 1910

Breastfeeding, corsets and aging: the mysterious dangers of womanhood

History Today

 

 

 

This post is in partnership with History Today. The article below was originally published at HistoryToday.com.

‘I congratulate … [my fair countrywomen] on their present easy and elegant mode of dress’, wrote the surgeon James Nooth, in 1804, ‘free from the unnatural and dangerous pressure of stays.’ Nooth’s concern was not aesthetic. The danger he saw in restrictive bodices was cancer: ‘I have extirpated [removed] a great number of … tumours which originated from that absurdity.’

Breast cancer in the 19th century was a consistent, if mysterious, killer. It preoccupied many doctors, unable to state with any confidence the disease’s causes, characteristics or cures. While the orthodox medical profession in Britain were broadly agreed on cancer’s ultimate incurability, they were less uniform in their understanding of its origin. The disease was thought to develop from a range of harmful tendencies and events acting together. Both the essential biology of being female, as well as typically ‘feminine’ behaviors, were understood as causes of breast cancer.

Breastfeeding was a contentious topic at the end of the 18th century. An image of idealised motherhood emerged that infiltrated concepts of femininity: women were by nature loving, maternal and self-sacrificing. This ideology was expressed through changing social and political attitudes to breastfeeding and an outcry against wet-nursing across western Europe. In 1789 only 10 per cent of babies born in Paris were nursed by their own mothers; by 1801, this number had increased to half of all Parisian infants and two thirds of English babies.

Late 18th-century medical men were explicit about the associations between breastfeeding and breast cancer. In 1772, man-midwife William Rowley wrote: ‘When the vessels of the breasts are over-filled and the natural discharge through the nipple not encouraged … it lays the foundation of the cancer.’ Frances Burney – an aristocratic novelist who underwent a mastectomy in 1811 – attributed her disease to her inability to breastfeed properly: ‘They have made me wean my Child! … What that has cost me!’

Menstruation was seen as particularly hazardous. The surgeon Thomas Denman wrote: ‘Women who menstruate irregularly or with pain … are suspected to be more liable to Cancer than those who are regular, or who do not suffer at these times.’ However, their risk only increased after menopause. Denman considered ‘women about the time of the cessation of the menses’ most liable to cancer. Elderly women were blighted by a dual threat: their gender and their age. While surgeons insisted their theories were based on clinical observation, designating these various female-specific processes as causes of cancer supported their broader thoughts about female biology.

Eighteenth-century theory dictated that all diseases were explained by an imbalance in ‘humours’: black bile, yellow bile, blood and phlegm. Into the 19th century the insufficient drainage of various substances continued to be invoked as a cause of cancer; women’s ‘coldness and humidity’ made them particularly prone to disease. Menstruation was the primary mechanism by which the female body cleansed the system of black bile and its regularity was seen as central to a woman’s wellbeing. Certain situations in which the menses were disrupted or had been terminated were, therefore, especially dangerous: pregnancy, breastfeeding and menopause. Similarly, when the female body and its breasts were not used for their ‘correct’ purpose – childbearing and rearing – the risk of breast cancer increased.

The historian Marjo Kaartinen has noted that 18th-century theorists considered just ‘being female and having breasts’ a threat to a woman’s health. This way of thinking about female biology suggested that women were more likely to suffer from all cancers, not just cancer of the breast. Denman wrote: ‘It can hardly be doubted … that women are more liable to Cancer than men.’

This association between womanhood and disease and between breastfeeding, pregnancy, menopause and cancer is still part of our 21st-century understanding of breast cancer; that certain female-specific processes make you more or less likely to succumb to it. On its website, the breast cancer charity Breakthrough lists various ways you can reduce and increase your chances of disease. According to contemporary research, having children early and breastfeeding them reduces your risk. The later a woman begins her family the higher her risk is. The contraceptive pill, growing older and the menopause also increases your risk of breast cancer.

Drawing attention to such historical continuities questions the social and cultural environments that make certain medical assumptions possible. The causes of cancer suggested by Denman, Nooth and friends were informed by their understandings of female biology and female inferiority more generally. They were working within a school of thought that suggested any deviation from ‘appropriate’ womanhood could have hazardous consequences for a woman’s health. While the role of the historian might not be to deny the validity of 21st-century medical research, it is part of our remit to question cultural assumptions that continue to have some effect on both the conclusions of scientists and the way those conclusions are accepted by the broader public.

Agnes Arnold-Forster is a PhD candidate at King’s College London.

TIME Diet/Nutrition

Should I Drink Fat-Free Half and Half?

5/5 experts say no.

“Hell no!” says Dr. David Katz, director of the Yale University Prevention Research Center, followed by: “What is it?” Those were sentiments echoed by all of our experts in this week’s burning food question.

Lest you, too, are left scratching your head, here’s the lowdown. Half-and-half math is simple: whole milk plus cream. The fat-free version requires some more advanced calculations, however. “It typically replaces the milk fat with corn syrup and thickeners,” says Julia Zumpano, an RD at Cleveland Clinic’s Heart and Vascular Institute. (Kristi King, senior clinical dietitian at Texas Children’s Hospital, agrees that the real thing is better than additives.) The ingredient list on a typical brand of fat-free half and half contains fat-free milk, corn syrup, carrageenan, cream, artificial color, disodium phosphate, guar gum and vitamin A palmitate. It has half the calories (20) as regular half-and-half and about twice the sodium (20-30 mg), plus sugar (1-2 grams).

“Fat-free half-and-half strikes me as an absolutely unnecessary product,” says Mario Kratz, PhD, a dairy researcher and nutrition scientist at the Fred Hutchinson Cancer Research Center in Seattle. It exists, of course, because people want the rich texture and flavor and calcium benefits without the fat or calories. But that dairy phobia is misguided, according to Kratz’s recent review on dairy. “Our work shows that consuming dairy foods in their full-fat form (rather than nonfat or low-fat) is associated with lower weight gain, a lower risk of obesity, and possibly even lower risks for type 2 diabetes and cardiovascular disease,” he says.

MORE Why Full-Fat Dairy May Be Healthier Than Low-Fat

These findings are largely drawn from observational studies, so they can’t establish cause in the way that a randomized controlled trial can, Kratz cautions. Nor do the findings imply that chugging a carton of regular half-and-half is a good idea—just that drinking the fat-free version might be a worse one.

“I didn’t know there was such a thing as fat-free half-and-half. Sounds awful,” says Andrew Weil, MD, founder of the Arizona Center for Integrative Medicine. Weil steers people away from nonfat dairy products (though he cops to dipping into fat-free sour cream every once in a while) because taking the fat out of dairy, he says, might have hormonal effects. “Milk contains natural sex hormones,” he says. “The centrifugation process for preparing nonfat milk and products made from it causes differential concentration of male and female hormones in the separated watery and fatty components.” Some studies link skim milk to increased risk of type-1 diabetes, male acne and infertility in women, he says.

Without the fat, half and half is a lot like the skim milk that makes it up—it just isn’t quite whole.

fat-free half and half
Illustration by Lon Tweeten for TIME

Read next: Should I Eat Falafel?

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TIME TIME 100

Meet the Women Scientists of TIME 100

Joanne Liu TIME 100 Women Scientists
Bryan Schutmaat for TIME Joanne Liu

These five most influential women are pioneers in the field of science and medicine

It will surprise no one to learn that women are vastly underrepresented in the field of science. But in this year’s TIME 100, five outstanding women who are making huge strides in the fields of medicine, genetics, and infectious disease, made the list.

Read more about these five influential scientists.

Dr. Joanne Liu, International president of Doctors Without Borders/Médecins Sans Frontières (MSF)
Liu and her team at MSF were the first to respond to the Ebola outbreak in Guinea. Liu has become a leader in the outbreak, and has fiercely and publicly criticized the international community for its slow response to the outbreak.

Emmanuelle Charpentier & Jennifer Doudna, Creators of gene-editing technology
Charpentier and Doudna developed a groundbreaking gene-editing technique called CRISPR-Cas9, which allows scientists to add or remove genetic material as they please. The process has major implications for a variety of health problems from HIV to sickle cell anemia to cancer. In theory, CRISPR-Cas9 could be used to edit any human gene.

Dr. Pardis Sabeti, Geneticist who sequenced the Ebola genome from the most recent outbreak
Sabeti and her team are responsible for quickly sequencing the genome of the Ebola virus that has ravaged Guinea, Sierra Leone and Liberia. The task was important, since it determined that the disease was indeed spreading from person to person. Many of her collaborators and fellow researchers died during the outbreak. When she’s out of the lab, Sabeti sings in a rock band.

Elizabeth Holmes, Health technology entrepreneur
Holmes is the CEO of Theranos, a blood testing company that has challenged the traditional lab testing model. She studied chemistry before dropping out of Stanford University her sophomore year to start her company, and at age 31 she made Forbes’ Billionaires List as the youngest self-made woman billionaire.

TIME Addiction

E-Cig Flavors May Be Dangerous, Study Says

TIME.com stock photos E-Cig Electronic Cigarette Smoke
Elizabeth Renstrom for TIME

Why you might want to reconsider that cotton candy e-cig

The chemicals used to flavor e-cigarettes may surpass safe levels, a new study says.

The study, which is published in the journal Tobacco Control, reveals that high exposure levels of these chemicals could spur respiratory irritation. The chemicals used to flavor e-cigarettes are the same flavors often added to foods, so the FDA has determined them to be generally recognized as safe in food. However, the authors of the new study say the high levels raise concern for safety and need for regulation and that these chemicals may be more dangerous when inhaled than when they are ingested in food.

“Chronic inhalation of these ingredients has not really been studied much at all,” says study author James F. Pankow, a professor of chemistry and civil & environmental engineering at Portland State University.

In the study, Pankow and his colleagues assessed the levels and types of flavor chemicals used in 30 different e-cigarette refill bottles, including a wide variety of flavors like tobacco, menthol, vanilla, cherry, coffee, chocolate, grape, apple, cotton candy and bubble gum. In 13 of the 30 products, the flavor chemicals made up more than 1% of the refill liquid volume, the researchers found, and the chemical levels were higher than 2% in seven of the liquids. Two of the liquids had levels of flavor chemicals higher than 3%.

The researchers found that some of the flavor chemicals used were benzaldehyde and vanillin, which are known to be respiratory irritants and have exposure limits for the workplace. However, when Pankow and his colleagues estimated consumption rates, they found that an e-cigarette liquid consumption rate of about 5 ml per day puts users at an exposure of twice the recommended occupational limits. “That’s probably not a good thing,” says Pankow.

The study authors point out several concerns about flavoring, including the fear that flavored e-cigarettes might attract young people and the fact that flavored e-cigarettes don’t usually list the levels of specific chemicals that are present in the liquids.

“The point is that when e-cigarettes manufacturers talk about these things as being food grade or food-like, they are sort of suggesting that use of flavors is equivalent to using them in foods,” says Pankow. “Never mind the fact that these things have not really been tested for safety, but in food FDA requires labeling ingredients. If they are going to say these are food-like, then why don’t they list the ingredients? It’s also not food-like product because you are inhaling it not ingesting.”

The researchers note that the small sample size doesn’t necessarily represent the entirety of the growing e-cigarette market. But they conclude that the results are likely what a broad survey would have revealed and that their findings suggest high levels of certain chemicals are likely present in many products.

TIME Biology

Here’s Why You Have a Chin

Gorgeous—and pretty much useless
Chev Wilkinson; Getty Images Gorgeous—and pretty much useless

Hint: You could do perfectly well without it

Nature is nothing if not parsimonious, especially when it comes to the human body. There’s a reason we don’t have webbed feet or nut-cracking beaks like other species, and that’s because we don’t need them. The system isn’t perfect, of course. If you ever wind up having painful abdominal surgery, odds are pretty fair that it will be your good-for-nothing appendix that’s to blame. And wisdom teeth seem a lot less wise when you consider how often they fall down on the job and need to get yanked.

As it turns out, the same why-bother pointlessness is true of what you might consider one of your loveliest features: your chin.

Researchers have long wondered what the adaptive purpose of the chin could possibly be. Sexual selection seems like an obvious answer, since an attractive chin increases your chances of mating. But a feature needs a function before it can appear in the first place. Only then can it be assigned some aesthetic value.

The other, better answer is all about chewing. The jaw exerts enormous forces when it bites and chews—up to 70 lbs. per sq. in. (32 kg per 6.5 sq. cm) for the molars. Conscious clenching increases the figure, and people who grind their teeth in their sleep may exceed the average force 10-fold. What’s more, the jaw moves in more than just one axis, both chewing up and down and grinding side to side.

That, so the thinking went, might increase bone mass in the same way physical exercise builds muscle mass. And bone mass, in turn, may produce the chin. The problem with the theory, however, is that it doesn’t account for Neanderthals and other primates—including the great apes—which lack prominent chins but in many cases have far more powerful bites than we do.

To answer the riddle, Nathan Holton, a post-doctoral researcher who specializes in craniofacial structure in the University of Iowa school of orthodontics, selected 37 of the many subjects whose facial measurements have been taken regularly from age 3 to young adulthood, as past of the longstanding Iowa Facial Growth Study (yes, there is such a thing).

With the help of basic physics, it’s possible to determine how much force any one jaw exerts without the subjects’ ever having to be tested directly with a bite gauge. Measuring the geometry of what orthodontic researchers call the mandibular symphysis and what everyone else just calls the chin region, and comparing that to what is known as the bending moment arm—or the distance between where a force is initially applied (in this case the muscles in the jaw) and where that force is eventually felt (the chin)—yields a pretty good measure of force exerted.

“Think about removing the lug nuts from a wheel on your car,” Holton wrote in an e-mail to TIME. “The longer the wrench, the easier it is because the longer wrench increases the moment arm, allowing you to create more force.”

And more force, in this case, should mean more bone mass in the chin—but that’s not what the results of the new research showed. Not only did the two turn out to be unrelated in the 37 subjects studied, but Holton and his colleagues even found that as the face matures, the chin is less adept at resisting mechanical forces, which is the whole reason it was assumed to grow more pronounced in the first place.

So why did we grow chins at all? The answer is, we didn’t. Holton and his collaborator, University of Iowa anthropologist Robert Franciscus, instead suspect that the face shrank away from behind the chin as primitive and pre-humans became modern humans, making it appear larger relative to everything else. The reason, as with so many things in the human species, has to do with male behavior—specifically violent male behavior.

As humans migrated from Africa 20,000 years ago and settled down into societies, males had to become less competitive and more cooperative—giving an advantage to those with lower testosterone levels. And reduced testosterone softens and shrinks the craniofacial structure.

“What we are arguing is that modern humans had an advantage at some point to have a well-connected social network,” Franciscus said in a statement accompanying the study. “And for that to happen, males had to tolerate each other. There had to be more curiosity and inquisitiveness than aggression, and the evidence of that lies in facial architecture.”

It wasn’t until we had our chins that we set about assigning value to them—strong ones, weak ones, angular, round, cleft or dimpled, depending on your tastes. Those tastes—and the mating choices that arise from them—ensure that the chin will stay. It might be biomechanically useless, but you’d look awfully silly without one.

Read next: Can Plastic Surgery Make You More Likeable? A Close Look at a New Study

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TIME Research

Can Specks of Dust Help Solve Crimes?

dust microbes dna
Getty Images

Call them the dust busters: Scientists are now able to take a sample of dust, sequence the DNA of its fungi and microbes and figure out where it came from, according to new research published in the journal PLOS ONE. The application might prove useful in solving crimes.

The researchers from North Carolina State University and the University of Colorado, Boulder, had about 1,000 people across the country swab their homes’ outer door frames and send in samples of the dust. A lab sequenced all that dust DNA—fungi, microbes and all—from every state but North Dakota. (The scientists have nothing against North Dakota. It’s just that no one from the state sent in a sample.) Our nation’s door frames are home to a mind-boggling amount of diversity; researchers identified 40,000 unique fungal taxa from the samples. A single home, by comparison, usually only harbors about 700 fungal taxa.

MORE: Your Tiny Roommates: Meet the Microbes Living In Your Home

Their goal was to glean where each fungal species tended to show up, which could be useful information in forensic investigations with this type of evidence. “We wanted to take either the presence or absence of these different species and get a smooth picture of where we expect the fungus to live,” explains Neal Grantham, one of the study’s authors and a PhD student in the department of statistics at North Carolina State University. By estimating the probability of seeing these different species at some location in the U.S., they were able to put a pin in a map of the most likely location of origin, he says. Half of their predictions got closer than 143 miles of the actual place of origin, and about five percent were within 35 miles of the dust’s doorframe.

Down the line, mapping out the microbes of dust could help with forensics and law enforcement investigations, Grantham says. “This is not the first study that shows you can use bacteria and fungi in a forensics setting. But what our work contributes is a more objective statistical way to tackle these problems,” he says.

The scientists are looking into whether the probability method might hold for other samples, like pollen. If it does, law enforcement could use a statistically sound probability instead of relying on pollen experts to divine where a sample might have originated, Grantham says.

“‘Humans are ecosystems’ is the big microbiome message,” Grantham says. Now, our doorframes might be ecosystems, too.

 

TIME Diet/Nutrition

There’s a Record Number of Organic Farms and Processing Facilities in the U.S.

healthiest foods, health food, diet, nutrition, time.com stock, tomatoes, fruits
Danny Kim for TIME

The number of organic producers in the U.S. has risen more than 5% in a year

There are nearly 20,000 certified organic operations in the U.S., which is a new record, officials announced on Wednesday.

The U.S. Department of Agriculture (USDA) counted 19,474 organic farms, ranches and processing facilities, up more than 5% from last year and 250% from 2002, when officials began tracking certified organic producers. Worldwide, there are more than 27,800 organic producers.

“As demand for organic products continues to soar, more and more producers are entering the organic market,” said Agriculture Secretary Tom Vilsack in a statement. “USDA tools and resources have created opportunities for organic farmers and more options for organic consumers. Growing demand for organic goods can be especially helpful to smaller family operations. The more diverse type of operations and the more growing market sectors we have in American agriculture, the better off our country’s rural economy will be.”

Recently, the USDA put forward $66.5 million in funding to support specialty crops and organic food production. The USDA is also creating an organic operations database that will streamline organic certification processes, and keep updated information about certificated facilities in the U.S. The USDA says the database will likely roll out in September.

Other recent data shows that U.S. consumers are continuing to buy organic produce even despite rising prices, which is good news for producers.

TIME medicine

The Scary Connection Between Snoring and Dementia

Sleep disorders, including sleep apnea and snoring, can have harmful effects on the brain over the long term

If you don’t snore, you likely know someone who does. Between 19% and 40% of adults snore when they sleep, and that percentage climbs even higher, particularly for men, as we age. It’s a nuisance for bed partners, but researchers say we shouldn’t be so quick to write off snoring or other forms of disrupted breathing while asleep as mere annoyances; instead, they could be affecting the brain, according to new research.

Snoring is a form of sleep apnea, in which people stop breathing for a few seconds or several minutes dozens of times in an hour. Any disruption of breathing during sleep can affect the brain, say researchers of a new study published in the journal Neurology. They found that people with sleep apnea tended to develop memory problems and other signs of mild cognitive impairment (MCI) earlier than people without such sleep disorders.

MORE The Power of Sleep

Ricardo Osorio, MD, research assistant professor of psychiatry at NYU Center for Brain Health, and his colleagues studied 2,000 people enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI)—a population of 55 to 75 year olds, some of whom are cognitively normal, some who have mild cognitive impairment and others who have Alzheimer’s dementia. Everyone was asked about their snoring or sleep apnea, and researchers followed up every six months for two to three years to record any changes in their cognitive status.

Those who reported having sleep apnea or snoring tended to develop signs of mild cognitive impairment, including memory lapses and slower speed on cognitive skills, about 12 years earlier on average than those who didn’t report any sleep-disordered breathing. Mild cognitive impairment often precedes Alzheimer’s dementia, but not all people who develop MCI go on to get Alzheimer’s. The connection between disrupted sleep breathing and MCI remained strong even after Osorio accounted for the effects of Alzheimer’s-related genes, gender, education, depression and heart disease risk factors, all of which have been associated with increased risk of cognitive decline.

MORE Alzheimer’s Linked to Sleeping Pills and Anti-Anxiety Drugs

Osorio also saw a connection between sleep apnea or snoring and Alzheimer’s dementia, but it wasn’t as robust as the link to MCI. That might be because other studies have found that not only are sleep disorders a risk factor for Alzheimer’s, but they are also a symptom of the degenerative brain disease—so those who already developed Alzheimer’s dementia may not have been accurately reporting their sleep habits.

Osorio is careful not to implicate all snoring as a precursor to memory problems or Alzheimer’s. But particularly in the elderly, he says doctors should consider the potential effect that disrupted breathing during sleep can have on the brain. While it’s not clear how sleep disorders might be increasing the risk of MCI or Alzheimer’s, it’s possible that the cumulate effects of even the short periods when the person isn’t breathing could deprive brain neurons of critical oxygen, and Alzheimer’s has been linked to slower or abnormal blood flow caused by hypertension and high cholesterol levels. Other studies have also shown that the protein responsible for Alzheimer’s, amyloid, tends to build up during the day when the nerves are active and decline at night during deep sleep. If people are being roused from deep sleep by their apnea or snoring, then they aren’t enjoying prolonged periods of low amyloid production, so the substance can build up and potentially form plaques.

MORE Here’s How Much Experts Think You Should Sleep Every Night

Osorio also found that it’s possible to counteract some of the effects of sleep apnea or snoring. He also studied people who used a device to prevent apnea, known as a continuous positive airway pressure (CPAP) machine, which keeps airways open during sleep. Even though they snored or had sleep apnea, people who used the device developed MCI or Alzheimer’s at the same rate as those who didn’t have these sleep problems. CPAP machines are cumbersome and uncomfortable to use, and many people drop them after a few weeks. But, says Osorio, they may have more reason to stick with them now. “A lot of people don’t use them because they see no benefits,” he says, “but if they know it can improve their memory, they may definitely try to do better.”

Read next: 7 Signs You’re Not Getting Enough Sleep

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TIME Healthcare

Boy of ‘Success Kid’ Meme Fundraises For Father’s Kidney Transplant

The GoFundMe campaign has already raised over $86,000

If you’ve spent time on the Internet, you’re probably familiar with the “Success Kid” meme: A young baby looking confident with a fist full of sand. As it turns out, memes are real people—who face real problems.

The child behind “Success Kid” is 8-year-old Sammy Griner, and his father is in need of a kidney transplant. The Griner family recently launched a GoFundMe campaign to raise money for the medical bills. The family was asking for around $75,000 and has already surpassed that goal. According to ABC News, the site reached about $9,000 in just five days. Currently, funds are at over $86,000 in just a week.

Sammy’s mom, Laney Griner, told ABC News that while at first she wasn’t happy about a photo from her son at the beach had gone viral, today she’s happy it happened. “By now, it’s just out there. What am I going to do? At least it’s positive,” she said. “Without that happening, how much could I get this recognition about my husband’s kidney transplant?”

TIME Diet/Nutrition

Baby Food Recalled for Containing Glass

Beech-Nut Nutrition has recalled approximately 1,920 lb. of baby food

A baby-food company has recalled around 1,920 lb. of its product due to possible contamination with small pieces of glass, according to a news release from the U.S. Department of Agriculture (USDA).

The company, Beech-Nut Nutrition, is recalling its “Stage 2 Beech-Nut Classics sweet potato & chicken” baby food in 4-oz. glass jars. The baby food was made on Dec. 12, 2014, and the recall applies to food expiring December 2016. The company learned of the problem when a customer reported a small piece of glass in their baby food, and the USDA notes that a consumer reported an oral injury from the product.

“Outside of this single report, we have no indication that any other jar of our Classics Stage 2 Sweet Potato & Chicken is affected, but as a company of parents and families we are acting with an abundance of caution,” the company said in a statement posted to its website. “The quality and safety of our products is our number one priority. We know we have not met the expectations of parents who rely on Beech-Nut for quality nutrition for their babies and toddlers in this case, and for that we apologize.”

People who have bought the affected product can return the baby food to the store they purchased it from for a refund or exchange.

The recalled baby food contained the product numbers “12395750815” through “12395750821.” It also contains the inspection code “P-68A.” Customers can get more information on the Beech-Nut Nutrition website.

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