TIME vaccines

This Is How Nigeria Beat Polio

Goodbye to all that: Computer-generated model of a poliovirus
Calysta Images ;Getty Images/Tetra images RF Goodbye to all that: Computer-generated model of a poliovirus

A quarter-century campaign brings the world tantalizingly close to eradicating a disease

It’s easy not to notice a negative. A house burns down on your block and it’s all you can talk about. But a house doesn’t burn down? Where’s the news?

Still, absence can be the stuff of headlines, and that fact has rarely been truer than it is in Nigeria today—where health officials are celebrating a full year without a single case of polio. A polio-free Nigeria means a polio-free Africa, since it was the only country left of the 47 on the continent where the crippling disease was still endemic. The virus, which as recently as 1988 was endemic in 128 countries, crippling 350,000 children per year, has now been cornered in just two places—Afghanistan and Pakistan, and it’s barely hanging on there. Wipe polio out in those last two redoubts and it will become only the second disease in history—after smallpox—to have been vaccinated out of existence.

“We are celebrating the first time ever that Nigeria has gone without a case of polio, but with caution,” said Dr. Tunji Funsho, who leads Rotary International’s anti-polio campaign in Nigeria. “Surveillance takes place in every nook and cranny of this country, even in those areas that have been free for years.”

The victory in Nigeria did not come easy—and it almost didn’t happen at all. For more than a generation, it has been Rotary that has led the drive to eradicate polio, administering vaccinations to 2.5 billion children in 122 countries at a cost of $1.4 billion. With the help of UNICEF, the World Health Organization (WHO), the U.S. Centers for Disease Control, the Bill and Melinda Gates Foundation and other groups, the effort paid off comparatively fast. As long ago as 2003, the virus had been chased out of all but six countries and the global caseload was down to just 732. There was talk of eradication by as early as 2005.

But Nigeria scuttled those plans. In the summer of 2003, Muslim clerics in the country’s northern regions halted all vaccinations, spreading the fiction that the vaccines contained HIV and were designed to sterilize Muslim girls. Quickly, the poliovirus did what all viruses do when they’re given that kind of running room: it spread, and fast. By 2005, cases consistent with the Nigeria strain were appearing in a 16-nation band that stretched as far away as Indonesia, before the outbreak could finally be contained.

“This is a disease that can’t be controlled,” said WHO spokesman Oliver Rosenbauer at the time, “it has to be eradicated.”

While the current victory in Nigeria was a huge milestone, things remained dicey right to the end—again due to politics—when Boko Haram fighters killed nine polio workers and abducted three others earlier this year. But the vaccine program was already too far along for the attacks to reverse things, and as the July 24 anniversary arrived, victory was at last declared—albeit tentatively.

Nigeria is now officially off the list of endemic countries, but the poliovirus can lurk in sewage and elsewhere, and since there can be up to 200 asymptomatic cases of the disease for every paralytic one, there is no telling how many human virus reservoirs are still at large. Only after two more polio-free years pass will Nigeria be declared officially done with the disease.

That leaves Afghanistan and, most troublingly, Pakistan. Currently, there have been only 33 cases of polio recorded worldwide in 2015—28 in Pakistan and 5 in Afghanistan. At the same point last year, those two countries had already had 107 infections, and the Pakistani strain had turned up in at least six other countries.

Progress has been slowed in Pakistan by often-deadly attacks on polio field workers carried out by local Taliban fighters. Since 2012, however, the government has been providing help, committing its military to protecting the vaccinators and recruiting religious leaders to speak out on the moral imperative of ensuring the health of children.

National pride plays no small role too. India—Pakistan’s mortal rival—has not had a case of polio since 2011 and was declared officially free of the disease last year. That the Indians accomplished this in a country with four times the landmass and seven times the population of Pakistan has been galling to many Pakistanis. The dramatic reduction in new infections in Pakistan from 2014 to 2015 has been a point of national pride.

Protecting children should not, of course, be a matter of international bragging rights. It should just be something human beings do. We’re a species smart enough to have invented a vaccine and brave enough to go delivering it in very dangerous places. The effort to eradicate polio has been a halting thing, and we have too often gotten in our own way. But at last, sometimes despite ourselves, we appear to be on the brink of winning.

TIME Mental Health/Psychology

Kids Are Unhappy With Their Bodies as Young as Age 8

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Elizabeth Renstrom for TIME

By age 14, 39% of the girls in the study said they had dieted in the last year

Boys and girls as young as age eight can experience dissatisfaction with their bodies that can predict their risk for eating disorders later in life.

A new U.K. study published in The British Journal of Psychiatry followed about 6,000 children until they were 14 years old and discovered a pattern of poor body image at a young age and eating disorder behaviors later on. The researchers found that at age eight, 5% of girls and 3% of boys were unhappy with their bodies. When the children reached age 14, 39% of the girls said they had dieted in the last year and 8% said they had binged. Among boys, 12% had dieted in the last year and 3.5% had binged.

“We were surprised about how body dissatisfaction at that young age tracked into eating disorder behaviors at 14 years,” says lead study author Nadia Micali, a senior lecturer and honorary consultant psychiatrist at the University College London Institute of Child Health.

Other factors seemed to influence a child’s body image and eating patterns; the study shows that nearly a fifth of girls reported feeling “quite a lot” or “a lot” of pressure from the media to lose weight. A mother’s history of anorexia, bulimia or both was also predictive of high levels of body dissatisfaction among girls and dieting behaviors among boys. The researchers also found that the among boys, high levels of body dissatisfaction and high BMI were linked to a higher prevalence of eating disorder thoughts and behaviors.

The researchers say the findings speak to a need for interventions early in life. High self-esteem was linked to lower levels of eating disorder behaviors, and the effect was stronger among boys. The researchers write that their findings suggest that some children might be more vulnerable to feeling pressure from media, family and peers than others.

Intervention won’t look the same for all children, Micali says. “The findings suggest that a blanket approach focusing on all adolescents or children might not be best, and that targeted prevention that focused on boys who are overweight/obese rather than all boys might be more useful,” says Micali. “I think that it is important that we adapt our interventions for younger children appropriately, as there is some evidence that for example ‘healthy eating’ classes that are not designed for younger children might be harmful, especially for those who do not have the cognitive ability to adequately process the information.”

More research is needed to understand the best approach. According to the National Institutes of Health (NIH), research is continuing to discover that eating disorders are highly complicated and can be caused by an interaction of genetic, biological, psychological and social factors.

TIME Diet/Nutrition

The 9 Worst Breakfasts for Your Waistline

And what you should eat instead

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Photograph by Danny Kim for TIME; Gif by Mia Tramz for TIME

Recently, food marketers have noticed a new trend. Even as younger consumers have become more kale-curious and health-conscious, they are still clamoring for one particular type of fast food: breakfasts. In response, Taco Bell introduced an A.M. menu—including the new and terrifying Biscuit Tacos, where half the calories come from fat. McDonald’s, meanwhile, announced it was going to experiment with serving Egg McMuffins and pancakes all day long.

The media dubbed this battle for your dollar “The Breakfast Wars”—but you may be the true casualty.

Breakfast can be a good thing. Studies show that people who take time for a morning meal consume fewer calories over the course of the day, have stronger cognitive skills, and are 30 percent less likely to be overweight or obese. But when food marketers get their hands on it, “a hearty breakfast” turns into something more like “a heart-breaking breakfast,” because much of what’s on offer at America’s restaurants—and the grocery aisles—is a collection of fatty scrambles, misguided muffin missiles, and pancakes that look like manhole covers.

It’s time for a wake up call. Eat This, Not That! magazine editors searched out the good, the bad, and the greasy and put together this special report: The Worst Breakfast Foods in America 2015!

  • Worst Sweet Cereal

    Kellogg’s Honey Smacks (1 cup)

    100 calories, .5g fat, 40mg sodium, 24g carbohydrates, 15g sugar

    That’s the Sugar Equivalent of: Scarfing a Mrs. Fields Chocolate Chip Cookie and calling it breakfast.

    The Smacks mascot, Dig’em Frog, needs a smackdown: His cereal has more sugar than Tony the Tiger’s, Fred Flintstone’s or even Cap’n Crunch! Worse, each puff is coated with partially hydrogenated oil, a substance even fast-food chains are about to ban because they contain traces of trans-fats. Smacks also contain caramel color, which has been shown to increase the risk of cancer in animals and is a possible carcinogen for humans, too. General Mills just announced they’d be removing artificial colors from their cereals; ask Kellogg’s to do the same.

    Eat This Instead!

    General Mills’ Kix

    110 calories, 1 g fat, 180 mg sodium, 25 g carbohydrates, 3 g sugar

    Kix is the safest of all sweet cereals, and go great with blueberries.

  • Worst “Healthy” Cereal

    Bear Naked Go Bananas…Go Nuts Granola (1⁄2 cup)

    280 calories, 14 g fat (4 g saturated), 4 g fiber, 10 g sugar

    That’s the Fat Equivalent of: a Dunkin’ Donuts Blueberry Muffin in a bowl—except this granola has more saturated fat!

    Granola may be the most overrated breakfast food of all time. What do you think is holding all those banana-y clumps together? Sugar and oil. And 4 grams of fiber just isn’t enough to save this bowl. Studies have shown that if you eat more fiber at breakfast, you’ll consume fewer calories throughout the day.

    Eat This Instead!

    Kellogg’s All-Bran Original (1 cup)

    160 calories, 2 g fat, 20 g fiber, 12 g sugar

    It’s called All-Bran! This is as fiber-rich as it gets, with a touch of sweetness, too.

  • Worst Doughnut

    Dunkin’ Donuts Blueberry Butternut Donut

    420 calories, 17 g fat (8 g saturated), 60 g carbohydrates, 35 g sugar

    That’s the Sugar Equivalent of: one serving of Ben and Jerry’s Phish Food ice cream—except this doughnut has 130 more calories, 3 grams more fat and 22 more carbs!

    Good doughnuts hover in the 200- to 300-calorie range, but Dunkin’ Donuts has broken new barriers with this doughy disaster. At 420, it has more calories than a McDonald’s Egg McMuffin with hash browns and nearly as much sugar as 5 bowls of Froot Loops. In fact, it’s the highest-calorie doughnut out there—neither Krispy Kreme nor Tim Horton’s have one that tops 400 calories. Speaking of numbers, here’s another: The Blueberry Butternut has 44 ingredients, including Eat This, Not That! must-avoids like propylene glycol (aka an ingredient in anti-freeze), preservatives and artificial flavors. And how many actual blueberries? Zero.

    Eat This Instead!

    Dunkin’ Donuts Lemon Donut

    260 calories, 15 g fat (7 g saturated), 29 g carbohydrates, 10 g sugar

    This has an equally-long list of artificial ingredients, but it’s one of the lowest-calorie options at Dunkin’ Donuts.

  • Worst Breakfast Burrito

    Taco Bell A.M. Crunchwrap — Sausage

    710 calories, 47 g fat (14 g saturated fat), 1,260 mg sodium, 51 g carbohydrates

    That’s the Calorie Equivalent of: Two regular dinnertime Taco Bell burritos, eaten for breakfast!

    Taco Bell? For breakfast? The news made everyone laugh last year. But the joke’s on you: Most items are more than 500 calories. For the Sausage Crunchwrap, the Bell found a way to stuff sausage and hash browns into this carb vessel, plus shredded cheddar cheese, a pile of eggs and 50 other ingredients, many unpronounceable. The Breakfast Wars are most brutal to your belly.

    Eat This Instead!

    Taco Bell A.M. Grilled Taco — Egg and Cheese

    170 calories, 9 g fat (3 g saturated), 330 sodium, 15 g carbohydrates

    If you’re south of the border, order the Egg and Cheese sandwich, sound advice at any fast food chain in the A.M. hours. This one has 12 grams of tummy-filling protein.

  • Worst Breakfast Sandwich

    Hardee’s Monster Biscuit

    710 calories, 47 g fat (18 g saturated), 2,160 mg sodium, 40 g carbohydrates

    That’s the Sodium and Fat Equivalent of: A 6″ Meat Lovers Personal Pan Pizza from Pizza Hut! In one sandwich!

    This Monster monstrosity has three kinds of pork and more than a day’s worth of sodium. From the bottom up, you’ll find ham, and then cheese, and then a sausage patty, and then more cheese, and then a folded egg, and then bacon, all between a fatty biscuit. A close second for Worst: The Jack in the Box Loaded Breakfast Sandwich, which has the same ingredients between sourdough bread, for the same amount of calories—but with far less sodium.

    Eat This Instead!

    Hardee’s Frisco Breakfast Sandwich

    360 calories, 11 g fat (3 g saturated fat), 1,100 mg sodium, 44 g carbohydrates

    Every single breakfast option at Hardee’s has too much sodium—unless you order the grits—but at least this one also has 19 grams of protein.

  • Worst “Healthy” Breakfast

    Dunkin’ Donuts Multigrain Bagel with Reduced Fat Strawberry Cream Cheese

    500 calories, 17 g fat (6.5), 650 sodium, 78 g carbohydrates

    That’s the Calorie Equivalent of: A Bacon McDouble at McDonald’s, yet without the benefit of its significant protein!

    The worst part about this breakfast is that scores of health-conscious eaters (who somehow wandered into a Dunkin’, perhaps for the coffee) order this thinking they’re making a smart choice. No matter how healthy the bagel or its toppings may appear, there is just no escaping the fact that this one is bogus. In fact, you’re unlikely to find any bagel combination at chain restaurants that register less than 400 calories, because most have refined carbs and low-grade fats.

    Eat This Instead!

    Dunkin’ Donuts Egg and Cheese English Muffin Sandwich

    240 calories, 7 g fat (3.5 g saturated), 490 mg sodium, 32 g carbohydrates

    With 12 grams of protein and less sodium than in years past, this is a Dunkin’ Do.

  • Worst Pancakes

    Denny’s Peanut Butter Cup Pancake Breakfast

    1,670 calories, 105 g fat (33 g saturated), 2,765 mg sodium, 148 g carbohydrates, 64 g sugar

    That’s the Fat Equivalent of: 33 McDonald’s Hotcakes stacked high!

    Wait, doesn’t this belong on a list of the Worst Desserts in America? IHOP has New York Cheesecake Pancakes. Perkins sells ones called Apple Pie. But Denny’s Peanut Butter Cup Pancake Breakfast out-sweets them all. They’ve stuffed two buttermilk pancakes with chocolate and white chocolate chips, and then topped it with hot fudge and peanut butter sauce. The result is a dish with more sugar than 5 servings of Edy’s Ice Cream. (Throw in eggs, hash browns and two sausage links, and the sodium count soars, too.) Craziest part: They offer maple syrup on the side.

    Eat This Instead!

    Denny’s Build-Your-Own-Grand-Slam with 2 Pancakes (370 calories) and 2 egg whites (60 calories).

  • Worst Breakfast Omelette

    IHOP Chorizo Fiesta Omelet

    1,300 calories, 106 g fat (34 g saturated, 1 g trans), 3,220 sodium, 33 g carbohydrates. But if you also order the accompanying side of pancakes and syrup, it’s 1,990 calories and 42 grams of saturated fat.

    That’s the Sodium Equivalent of: Eating 273 Cheetos for breakfast

    IHOP was one of the last chains to release its nutritional numbers, and given the national-debt-level calorie counts of much of its menu, we can see why. This overstuffed omelette is bursting with chorizo, roasted peppers, pepper jack cheese and onions and then smothered in sour cream and chili sauce. Throw in the three additional pancakes, and you’ve got a “healthy” meal with a day’s worth of calories.

    Eat This Instead!

    IHOP Simple & Fit Vegetable Omelette

    310 calories, 12 g fat (4.5 saturated), 750 mg sodium, 6 g carbs

  • Worst Breakfast in America

    Cheesecake Factory Bruleéd French Toast

    2,780 calories, N/A fat (93 g of saturated fat), 2,230 mg sodium, 120 g sugar

    That’s the Saturated Fat Equivalent of: 6 Sonic cheeseburgers, and the calorie equivalent of 40 Dunkin Donuts’ Munchkins.

    Speaking of dessert for breakfast! This “rustic” dish will rust your arteries. It has a full day’s worth of sodium, more than a day’s worth of calories, three to four days worth of sugar and a week’s worth of saturated fat. Cheesecake Factory won’t reveal the total fat count—maybe because they can’t count that high? Meet the absolute Worst Breakfast in America.

    Eat This Instead

    Cheesecake Factory Plain Omelette

    490 calories, other nutritionals N/A

    This article originally appeared on Eat This, Not That!

    More from Eat This, Not That!

TIME medicine

The First-Ever Malaria Vaccine Just Got a Big Break

Drugmakers received a thumbs up from European regulators, moving the vaccine closer to human use

After nearly 30 years of development and testing, the world’s first malaria vaccine got a major push forward on Friday morning.

Drug maker GlaxoSmithKline announced that a European Medicines Agency (EMA) committee has given a positive recommendation for the company’s vaccine for malaria called Mosquirix (scientifically known as RTS,S). The drug is intended for children ages six weeks to 17 months living in Sub-Saharan Africa. Because the vaccine is not intended for countries outside of Africa, the European regulatory agency is not “approving” the vaccine, but offering a positive opinion that the World Health Organization (WHO) will use to create its own recommendation for the vaccine’s use. Countries in Africa will then approve the vaccine through their own regulatory agencies.

Mosquirix is the first vaccine to prevent malaria in humans and was first created in 1987.

The data assessed by the EMA was primarily from a phase III clinical trial of the vaccine in about 16,000 kids in multiple African countries. After 18 months, GSK reported that the vaccine had about 46% efficacy against clinical malaria and 36% efficacy against severe malaria in kids ages five to 17 months. In babies ages six to 12 weeks, the drug had a 27% efficacy against clinical malaria and 15% against severe malaria.

The efficacy rates may seem low, but the researchers tell TIME that the vaccine is the only one available thus far and will save a significant number of lives that would be lost to the mosquito-borne disease. The vaccine also shows efficacy for a few years after initial vaccination. “Is there room for improvement? Yes. We can improve a lot,” says Moncef Slaoui, co-inventor of the vaccine and the Chairman of GSK Vaccines, in an interview with TIME. At the end of the study period, the researchers found that more than 6,000 cases of clinical malaria were prevented for every 1,000 children who were vaccinated in areas of high transmission. The efficacy of the vaccine was also assessed in a safe study context in which children slept with bed nets treated with insecticide, a measure not always taken.

According to data provided by GSK, there were 584,000 deaths worldwide from malaria in 2013, and 90% of those deaths took place in Sub-Saharan Africa. More than 80% of the deaths occurred in kids under age five.

Currently, the vaccine Mosquirix requires four doses. The first three happen a month apart from each other, and the fourth happens about 18 months later. Ensuring that parents get their children the full dosage can be challenging, but Slaoui notes that most infant vaccines require multiple doses, and while not ideal, there’s still a significant benefit with just three doses.

Slaoui says GSK also has a second generation version of the vaccine in the works—one that may have even better efficacy rates. “It’s a tweak of the current vaccine,” he says. “We know the next generation is close by.”

TIME Food

Court Recommends ‘Unprecedented’ Life Sentence for Peanut Executive Behind Salmonella Outbreak

Stewart Parnell peanut corporation america
Don Petersen—AP In this March 12, 2009 file photo, Peanut Corporation of America's president Stewart Parnell, arrives at United States Federal Court in Lynchburg, Va.

The salmonella outbreak prompted one of the largest food recalls in U.S. history

(SAVANNAH, Ga.) — Federal court officers have recommended a sentence of life in prison for a peanut company executive convicted of selling salmonella-tainted food, a move that attorneys on both sides called “unprecedented” for a food-poisoning case.

The potential life sentence for former Peanut Corporation of America owner Stewart Parnell was disclosed by prosecutors in a court filing Wednesday.

Parnell, 61, is scheduled to be sentenced Sept. 21 by a federal judge in Albany, Georgia. Prosecutors filed a legal brief Wednesday in U.S. District Court revealing that the U.S. Probation Office, which prepares pre-sentencing reports to help guide federal judges, concluded the scope of Parnell’s crimes “results in a life sentence Guidelines range.”

Parnell’s defense attorneys confirmed the recommendation Thursday to The Associated Press, calling the possible punishment “unprecedented.” Bill Marler, a lawyer for victims sickened by peanut butter from Parnell’s southwest Georgia plant, used the same word.

In fact, Marler and other experts say the trial of Parnell and two co-defendants last year was the first federal food-poisoning case to be tried by an American court. A jury convicted Parnell of 71 counts including conspiracy, obstruction of justice, wire fraud and other crimes related to a salmonella outbreak in 2008 and 2009. The Centers for Disease Control linked the outbreak to nine deaths and 714 illnesses. It prompted one of the largest food recalls in U.S. history.

Justin Lugar, one of Parnell’s defense attorneys, confirmed Thursday that the recommendation before Judge W. Louis Sands is for life in prison, with no lesser range. Parnell’s lawyers are trying to persuade the judge to disregard numbers used as aggravating factors to boost the suggested sentence to its maximum: an estimate that Parnell’s customers suffered $144 million in losses as well as health officials’ tally that 714 people got sick.

Parnell’s attorneys say the cost estimate was “based on speculative, incomplete, and untrustworthy information” compiled by investigators and that none of Parnell’s customers were asked to testify about the losses in court. Parnell’s lawyers similarly questioned the reliability of the CDC’s tally of how many people got sick, noting that no medical doctors were called to testify and only one victim took the stand.

“That recommendation is truly absurd,” said Ken Hodges, an attorney on Parnell’s defense team. “We hope the judge will see that Stewart Parnell never meant to hurt anyone. He ate the peanut butter himself. He fed it to his children and to his grandchildren.”

In their court filing, prosecutors stood by their numbers for victims injured and financial losses — and insisted they possibly understate the impact.

“Life in prison, especially in a food case, it’s frankly unprecedented,” said Marler, who has represented victims of food-borne illnesses for two decades. “But the case itself, on a factual basis, is unprecedented.”

Marler said he suspects the judge and prosecutors will think carefully before deciding to pursue a life sentence for Parnell. Still, he said, even the possibility of such a stiff sentence sends a message to food companies.

“The same shock or sobering impact that you and I have talking about it, you multiply that by 100 for some food executive sitting in an office,” Marler said.

Even if objections raised by Parnell’s attorneys to the sentencing recommendation are denied, it’s still possible the judge could impose a lighter sentence. Federal judges are required to consider recommendations based on complex sentencing guidelines, but they are not bound by them.

Parnell and his co-defendants were never charged with sickening or killing anybody. Instead prosecutors used the seven-week trial to lay out a paper trail of emails, lab results and billing records to show Parnell’s company defrauded customers by using falsified test results to cover up lab screenings that showed batches of peanut butter contained salmonella. The tainted goods were shipped to Kellogg’s and other food processors for use in products from snack crackers to pet food.

Prosecutors wrote that court officers “correctly calculated” Parnell’s recommended sentence, but stopped short of saying whether they plan to ask the judge to impose a life sentence. A spokeswoman for the Justice Department in Washington, Nicole Navas, declined to comment.

Prosecutors’ legal brief also noted stiff sentences were recommended for Parnell’s two co-defendants. Punishment of 17 to 21 years in prison was recommended for Parnell’s brother, food broker Michael Parnell, who was convicted on fewer counts. The recommendation for Mary Wilkerson, the Georgia plant’s quality control manager, was eight to 10 years. She was convicted of obstruction of justice.

According to the CDC, deaths linked to the outbreak were reported in Idaho, Minnesota, North Carolina and Virginia.

TIME Cancer

Top Cancer Doctors Call for Lower Drug Costs

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Getty Images

“It’s time for patients and their physicians to call for change"

A group of cancer doctors are joining grassroots organizers and politicians in pleading with pharmaceutical companies to reduce the cost of cancer treatments.

In an editorial that ran Thursday in the Mayo Clinic Proceedings journal, 118 cancer experts produced a series of recommendations they say would lead to a reduction in treatment expenses. The doctors say that one in three individuals will be burdened with cancer in their lifetime, but out-of-pocket drug costs could easily exceed the average household income of an insured patient.

Four doses of one particular cancer drug, according to a report published in Mayo Clinic Proceedings in 2012, costs a staggering $120,000.

“It’s time for patients and their physicians to call for change,” said Dr. Ayalew Tefferi, a Mayo Clinic hematologist in a press release.

Among the recommendations are allowing Medicare to negotiate prices, permitting cancer drug imports for individual patients, and passing laws to keep drug companies from delaying access to generic drugs.

The physician’s recommendations come on the heels of a change.org petition led by patients that calls for a reduction in drug costs, particularly for cancer patients.

TIME Research

You Can Now Inhale Caffeine Instead of Drink It

Eagle Energy Vapor
Matt Lang—Eagle Energy Eagle Energy Vapor

A new e-cigarette-like inhaler gives users a boost of caffeine. But how safe is it?

Forget coffee and energy drinks—now you can inhale your caffeine.

Perhaps taking a cue from increasingly popular e-cigarettes, marketers have now created a way for people to vape their energy. The New York Times reported on Wednesday that products like Eagle Energy Vapor allow people to forgo their morning cup o’ joe and puff their caffeine instead. Each inhaler boasts a pretty small amount of caffeine, which the company says comes from natural sources like guarana, taurine, and ginseng (stimulants that are also common among energy drinks). As the Times describes it: “Think of it as a Red Bull for the lungs.”

No surprise, some experts in the medical community find this trend problematic. America is, evidently, a nation in need of a pick-me-up, at least if you consider the boom of products that contain caffeine, like energy drinks, caffeinated water and snacks and powdered caffeine. As I recently reported in TIME, the U.S. energy drink business is estimated to grow more than 11% by 2019 to an estimated $26.6 billion in yearly revenue.

So what’s the big deal?

From a health perspective, caffeine is tricky business. Many experts are concerned about some caffeinated products—particularly energy drinks. One of the primary arguments is that unlike coffee or soda, many energy drinks (and the new caffeine inhalers) contain multiple stimulants aside from synthetic caffeine. How these ingredients interact in combination is largely unknown. In addition, many doctors and health watchdogs are dissatisfied with the way these products are regulated. Manufacturers can choose to market their products as dietary supplements or as beverages, neither of which require pre-market safety approval by the FDA or any other public-health agency. According to the Times, the FDA has not reviewed the new caffeine inhalers for safety, either.

The effects of inhaling caffeine are also a gray area. “The way our bodies handle caffeine that is inhaled can be very different from when caffeine is in our food or drink,” says Mary M. Sweeney, a postdoctoral research fellow at Johns Hopkins University School of Medicine. “Even if an inhaled product delivers the same dose of caffeine as a cup of coffee, it may have different subjective effects for people because the time-course might be different.”

In 2013, the FDA announced that amid a growing trend of manufacturers adding caffeine to food products (like gum, for example), the agency was launching a safety investigation into the matter. It’s now 2015, and that information is still not available to consumers. The FDA says it is continuing to look into it.

The Eagle Energy Vapor inhaler’s aesthetic similarities to e-cigarettes are undeniable. And while the jury is still out in regards to the overall danger of e-cigarettes, recent federal data has shown use tripled among middle and high school students in just one year. Could caffeine inhalers attract young people in a similar way? Are they as dangerous as medical experts believe other caffeinated products are? We don’t know. But what Americans should know is that just because a new caffeinated product is on the market doesn’t mean that it’s undergone a rigorous safety testing or approval process, or that doctors think it’s safe.

“What troubles me most about this particular product is that the flavor composition appears to be similar to candy; thus, it could be attractive to children and adolescents,” says Steven Meredith, a postdoctoral fellow at the University of Connecticut School of Medicine. “The long-term effects of caffeine on the developing brains of children and adolescents are still relatively unknown. But, caffeine consumption interferes with sleep, and sleep is necessary for learning. Thus, long-term cognitive effects of excessive caffeine consumption at a young age is certainly plausible.”

While the FDA says it’s continuing to investigate caffeinated products, it may be in your best interest to stick to stimulants that most medical experts can get behind: coffee.

TIME medicine

Doctors Say Cancer Drug Costs Are Out Of Control

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JUAN GARTNER—Getty Images/Science Photo Library RF Illustration of cancer cells in middle of dividing

Prescription drug prices rose 12% in 2014

A group of 118 oncologists put their foot down on the rising costs of cancer medication in an editorial in the Mayo Clinic medical journal, the Mayo Clinic Proceedings, on Thursday. The editorial threw its support behind a grassroots patient effort to push for fairer prices from drug companies.

According to the editorial, many cancer patients are bankrupted by the high cost of care. Even for insured patients, a treatment that costs $120,000 a year might only be reduced to $30,000 in out-of-pocket expenses–more than half the average U.S. household income. The cost of drugs is so high that as many as 20% of oncology patients don’t take their medication as prescribed.

Cancer drugs were not always so expensive. Over the past 15 years, according to one study in the Journal of Economic Perspectives, the cost of cancer drugs rose by 10% (or about $8,500) every year. In 2014 alone, prescription drug prices rose 12%.

“High cancer drug prices are affecting the care of patients with cancer and our health care system,” the lead author, Dr. Ayalew Tefferi, who is a hematologist at Mayo, said. The doctors designed a list of ideas that would make cancer drugs more affordable for the people they treat.

The group’s solutions included a proposal to allow individuals to import cancer drugs from other countries, where the medicine is far cheaper. In Canada, for example, oncology drugs are half the price of American ones.

Other solutions included creating a regulatory body that would propose fair pricing after a drug gains F.D.A. approval, allowing Medicare to negotiate drug prices, and preventing pharmaceutical companies from delaying access to generics.

“It’s time for patients and their physicians to call for change,” Dr. Tefferi said.

TIME Exercise/Fitness

This No-Gym Workout Gets the Job Done in 10 Minutes

woman-pushup-outdoor
Getty Images

High-intensity interval training (HIIT) gets results in less time

Can’t get to the gym? No problem!

There’s a notion out there that you need to belong to a gym in order to maintain a fitness routine, but that couldn’t be further from the truth. While there’s certainly nothing wrong with leaving your house to get your sweat on, it’s also completely possible to get a great workout in the comfort of your own living room.

This HIIT (high-intensity interval training) workout is the perfect fat-burning addition to any exercise program you’re currently doing. The best part? It will only take you 10 minutes, you can do it in front of the TV, and the only equipment you need is a stopwatch (or the timer on your phone).

Perform each move below for 20 seconds, trying to get as many reps in as you can, followed by 10 seconds of rest. Do two full sets (meaning 20 seconds of work, 10 seconds of rest, then repeat once) of each exercise before moving on to the next. Let’s HIIT it!

Squat jumps

Stand tall with your feet slightly wider than shoulder width apart. Squat down, keeping the weight in your heels, until you have reached the bottom of a squat. From here, jump straight up into the air as high as you can. Land softly on your toes and repeat.

Push-ups

Get into a standard plank position, with your arms slightly wider than your shoulders and your feet just a few inches apart. Slowly lower yourself down, getting as close to the ground as possible. From here, push back up through your chest and arms to starting position. Keep your core tight throughout the entire movement and fight the urge to allow your mid-section to either arch up or sag.

Jumping lunges

Start in a lunge position with your right foot in front and left foot behind you with your left knee about an inch from the floor. From here, explode straight up out of the lunge, switching your legs mid-air and landing softly on your toes. You will now have your left leg in front and right leg behind you. Remember to keep your front knee at a 90 degree angle and try not to let it go past your toes.

Sit-ups

Lie on your back with your knees bent and hands behind your head. While keeping your chin angled towards the sky, use your core to sit up until your elbows touch your knees. Lower back down to the ground and repeat.

Burpees

Stand with your legs slightly wider than shoulder-width apart. Squat down to the floor and place your hands on the ground in front of you. From here, jump back into a pushup position. Jump your feet forward until you are at the bottom of a squat again, then jump straight into the air.

Want more moves like this? Check out 6 Moves That Burn More Fat in Less Time

This article originally appeared on Health.com

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These States Have The Biggest Drops In Teen Pregnancy

Connecticut leads the effort with the biggest 5-year decline in teen births

Teen pregnancy in the U.S. has been declining continuously over the past 20 years. According to the U.S. Department of Health & Human Services (HHS), America’s average teen birth rate has dropped from 61.8 births for every 1,000 adolescent girls in 1991 to 26.5 in 2013. And this most recent 2013 stat is an impressive 10 percent drop from 2012.

Despite these encouraging statistics, unplanned teen pregnancy is still a major public health issue. Many health experts and economists argue that it is a principal driver of poverty and inequality, as well as high abortion rates and number of children put up for adoption.

Some states have worked to find ways to combat teen pregnancy more efficiently, though. Using data from the National Vital Statistics System (NVSS), HealthGrove mapped the change in teen births (girls 15-19 years old) over the last five years.

Why are some states making bigger strides than others? Colorado’s effort against unwanted pregnancy, for example, has been successful due to programs that offer adolescents and poor women long-acting birth control. After being given this choice, the birthrate among these women fell by 37.9%, and abortions plunged by 42%, according to Colorado’s Department of Public Health and Environment.

The correlation between early motherhood and poverty was pretty strong in Colorado’s case. Before women were offered intrauterine devices (IUDs) from the free program in 2009, 50% of births to women in low income areas happened before age 21. In 2014, that age jumped to 24. And according to Sabrina Tavernise of the New York Times, this difference “gives young women time to finish their educations and to gain a foothold in an increasingly competitive job market.”

Many of the states that have a low 5-year change—meaning they still haven’t reduced teen pregnancies—also have relatively high poverty levels. New initiatives like the one in Colorado may help states make progress on both goals.

HealthGrove ranked the top 10 states that are setting a good example for the rest of the country, ordered by the biggest 5-year declines in teen births.

  • 10. Wisconsin

    Teen birth rate in 2013: 1.96%
    Population: 5,706,871

    Wisconsin reduced adolescent pregnancies by 33.3% in five years.

  • 9. Oregon

    Teen birth rate in 2013: 2.16%
    Population: 3,868,721

    Oregon reduced adolescent pregnancies by 33.5% in five years.

  • 8. District of Columbia

    Teen birth rate in 2013: 3.21%
    Population: 619,371

    The District of Columbia reduced adolescent pregnancies by 33.8% in five years.

  • 7. Virginia

    Teen birth rate in 2013: 2.01%
    Population: 8,100,653

    Virginia reduced adolescent pregnancies by 33.9% in five years.

  • 6. North Carolina

    Teen birth rate in 2013: 2.84%
    Population: 9,651,380

    North Carolina reduced adolescent pregnancies by 35.0% in five years.

  • 5. Georgia

    Teen birth rate in 2013: 3.05%
    Population: 9,810,417

    Georgia reduced adolescent pregnancies by 35.1% in five years.

  • 4. Maryland

    Teen birth rate in 2013: 1.94%
    Population: 5,834,299

    Maryland reduced adolescent pregnancies by 36.8% in five years.

  • 3. Colorado

    Teen birth rate in 2013: 2.34%
    Population: 5,119,329

    Colorado reduced adolescent pregnancies by 37.9% in five years.

  • 2. Massachusetts

    Teen birth rate in 2013: 1.21%
    Population: 6,605,058

    Massachusetts reduced adolescent pregnancies by 37.9% in five years.

  • 1. Connecticut

    Teen birth rate in 2013: 1.29%
    Population: 3,583,561

    Connecticut reduced adolescent pregnancies by 39.2% in five years.

    This article originally appeared on FindTheBest

     

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