TIME Exercise/Fitness

How Exercise Helps Curb Alzheimer’s Symptoms

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Pamplemousse—Getty Images/OJO Images RF

Most studies so far have focused on the importance of physical activity before you develop Alzheimer’s. But can it treat the disease once you are diagnosed? Two studies hint that may be the case

At the annual Alzheimer’s Association International Conference in July 2015, scientists report some encouraging news about the benefits of exercise. In the first studies to look at physical activity among people already diagnosed with the early stages of Alzheimer’s, moderate to high intensity workouts may not only slow down the biological symptoms of Alzheimer’s—but may lead to improvements in cognitive functions as well.

In one study involving 200 people with mild or moderate disease, Dr. Steen Hasselbalch from the University of Copenhagen and his colleagues randomly assigned some participants to an hour of exercise three times a week for 16 weeks, while allowing the remainder to continue without a regular activity regimen. After a phase-in period, the exercisers were working at a moderate to intense level, achieving 70% to 80% of their maximum heart rate for at least half of each session.

MORE: Your School Grades Affect Your Risk of Dementia

That level of intensity is important, says Hasselbalch, to achieve results. Compared to the control group, the exercisers showed fewer symptoms such as anxiety, changes in mood and depression that are common among Alzheimer’s patients. Overall, those who were more active did not show any changes in cognitive functions, but when Hasselbalch looked at the results more carefully, he found that participants with milder disease who exercised actually did perform better on intellectual skills after the 16 weeks. They were tested on memory, language, mental speed and other executive functions.

“It’s been shown with other diseases that exercise can have beneficial effects,” he says. “Now we have shown it’s also important for dementia. So if you now have this alternative treatment, it sends a message that you can do something even after diagnosis to treat dementia.”

MORE: Two New Alzheimer’s Drugs Offer Hope—With Caveats

Because the people exercised in a group setting, he says that simply being part of that social situation and getting out of the house and interacting with others appears to reduce the mood-related symptoms of Alzheimer’s. “But if you really want an effect on cognition, then you have to exercise hard.”

He admits that his study did not delve into how the exercise might be contributing to the improved cognitive changes, but he will be analyzing the blood and cerebral spinal fluid collected from the participants to study that further.

MORE: Alzheimer’s May Show Up in Saliva

Such changes are what Laura Baker, from Wake Forest School of Medicine, and her team did with another group of early stage Alzheimer’s patients. They wanted to see what biological changes exercise might have on the Alzheimer’s process, and focused on 70 patients with mild cognitive impairment and diabetes, both of which significantly increase the risk for Alzheimer’s. Some were randomly assigned to simple stretching exercises, while others were told to exercise four times a week and, like those in Hasselbalch’s study, had to work hard enough to raise their heart rate to 70% to 80% of its maximum for 30 of the 45 minutes of each session. Baker then studied their cognitive function tests, brain imaging and levels of Alzheimer’s proteins in their cerebral spinal fluid.

She found that those who exercise rigorously increased the blood flow in the areas of the brain responsible for memory and higher level processing. The result was a dramatically increased score, by 80%, on average on the cognitive tests than those who just stretched, even after accounting for age-related changes in thinking. More intriguing, the exercisers also showed on average a 14% lower level of the protein tau, which is a good indicator that brain neurons are dying and Alzheimer’s processes are well underway, at the end of the study compared to before they began the exercise regimen.

“What’s encouraging to us is that we don’t have treatments now; there’s nothing for Alzheimer’s patients,” says Baker. “The possibility that a non-medicine intervention could actually change the disease — we’re just very encouraged by these results,.”

While the exercise regimen wasn’t an easy one — it qualifies as moderately intense physical activity, which for a group of older adults who are likely sedentary to begin with is certainly a challenge, both Hasselbalch and Baker say that with the right execution — by working with participants and by gradually increasing their exercise level — achieving the amounts of activity needed to help their brains is possible. Baker also points out that it’s time to start studying the combined effects of new medications that are being tested for Alzheimer’s and increased physical activity. Together, she says, they may hold the key to actually slowing down and possibly even reversing progression of the disease.

TIME E-Cigarettes

E-Cigarettes May Be Just As Addictive As Cigarettes

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Victor de Schwanber / Getty Images A person "vapes," or smokes an e-cigarette.

The most addictive form of nicotine commonly found in cigarettes is often the same as the one found in cigarettes.

Vapers—or e-cigarette smokers—aren’t any safer from developing addiction, finds a new study released Thursday.

The basis of the pro-vaping argument has been that e-cigarettes don’t contain the harmful chemicals in and byproducts of tobacco cigarettes. There’s nicotine, to be sure, but not all nicotine is the same. Vaping proponents have said that the type found in cigarettes is a highly addictive form, and the type of nicotine in e-cigarettes is less addicting.

“This perception [of e-cigs being safer] stems from the fact that e-cigs are electrically powered devices that heat and vaporize a nicotine-containing flavored liquid to produce an inhalable aerosol, without involving combustion and presumably much of the exposure to combustion-related toxicants,” such as carbon monoxide and nitric oxide, the authors wrote.

But a new study, published in the American Chemical Society’s Chemical Research in Toxicology, indicates that nine out of 17 common, commercially available e-cigarettes contained the most addictive kind of nicotine.

Critics have long held that e-cigs contain ingredients that make them essentially a cigarette in terms of addictive power. There is also evidence that e-cigs may not be an effective means to quitting (some research shows that 75% of Americans who vape also smoke).

TIME Research

Scientists Developing Pill That Could Let Gluten-Free People Eat Pasta

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Getty Images

A trial is slated to begin within the year

People who suffer from celiac disease may not need to avoid pasta forever: scientists are developing a pill that would allow them to eat gluten.

Scientists at the University of Alberta are working on a pill made from chicken egg yolks that could help people with celiac disease digest gluten, Quartz reports.

Hoon Sunwoon, associate professor in the Faculty of Pharmacy and Pharmaceutical Sciences, who worked on the project, explained to Quartz how the pill works: “This supplement binds with gluten in the stomach and help to neutralize it, therefore providing defence [sic] to the small intestine, limiting the damage gliadin causes.” Gliadin is a component of gluten that causes digestive trouble for people with celiac; gluten is a protein found in wheat, rye and barley.

But celiacs, don’t rejoice just yet: the drug is still in development. A trial is slated to begin within the year.

TIME Cancer

When Chemotherapy Does More Harm than Good

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Photo by Selina Boertlein c/o SBPhotography—Getty Images/Flickr RF

Chemotherapy has saved countless lives and is a mainstay of cancer care. But the latest data suggests that it can also do more harm than good for some patients

A cancer diagnosis is a life-altering event, and the news—let alone making decisions about how to manage treatment—is already challenging enough. But with a terminal diagnosis, those choices become even more fraught. At some point, say ethicists, doctors and patient advocates, enough is enough. Meaning the potential for benefit has to be weighed against the quality of what life is likely to be left. But where is that line? And how does each patient find it?

A study published in JAMA Oncology highlights just how agonizing those choices can get. Holly Prigerson, director of the Center for Research on End of Life Care at Weill Cornell Medical College and her colleagues studied the use of chemotherapy among a group of 312 terminal cancer patients. All had been given no more than six months by their doctors, and had failed at least one if not multiple rounds of chemotherapy, seeing their tumors spread to other parts of their body. About half were on chemotherapy, regardless of its ineffectiveness, at the time of the study.

Read more No More Chemo: Doctors Say It’s Not So Far-Fetched

Despite the intuitive sense that any treatment is better than none, there is not much evidence that chemotherapy is the right choice in these cases—and it may very well be the wrong one. Prigerson’s analysis showed that these patients experience a drop in their quality of life if they get chemo, and that they are therefore worse off than if they hadn’t opted for the treatment. On measures of things like whether they could continue to walk on their own and take care of themselves and keep up with their daily activities, those on chemotherapy reported marked declines compared to patients who opted not to receive more chemo.

“The results were counterintuitive to some extent,” says Prigerson. “The finding that the quality of life was impaired with receipt of the toxic chemotherapy was not surprising. The surprising part was that people who were feeling the best at the start of the therapy ended up feeling the worst. They are the ones most harmed and who had the most to lose.”

In other words, the chemo made the patients feel worse without providing any significant benefit for their cancer.

Previous studies have showed that chemotherapy in terminal patients is essentially ineffective; among those with non-small cell lung cancer, for example, third rounds of chemo were associated with a 2% response rate in tumor shrinkage, while fourth rounds showed 0% response. And whatever tumor shrinkage occurred wasn’t linked to a longer life.

Read more How Fish Oil Makes Chemo Less Effective

Groups like the American Society of Clinical Oncologists (ASCO) recently advised doctors to be more judicious with their chemotherapy use in terminal patients. The group’s guidelines recommend limiting it to relatively healthy patients who can withstand the toxic treatment and potentially overcome side effects.

The decision about how long to continue care, including chemotherapy, is up to each cancer patient, but Prigerson hopes that her results help to better inform those choices in coming years. Recent studies showed, for example, that despite explanations from their doctors, many cancer patients still believe that more rounds of chemo will provide some benefit to them, and are therefore—and understandably—reluctant to stop receiving therapy. But at some point, the data shows, more treatment is not better.

That may be especially true of patients with end-stage cancer who are still relatively healthy and not feeling sick. For them, additional chemotherapy will likely make them weaker, not to mention eat up more of the precious time they have left traveling to and from infusion centers. Prigerson plans to continue the study to better understand the dynamics of how decisions about treatments are made toward the end of life, but in the meantime hopes the latest findings at least convince doctors to reconsider how they advise their terminal patients about end-stage chemotherapy.

Read next: Why Breast-Cancer Survivors Gain More Weight

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TIME Diet/Nutrition

Should I Eat Yogurt-Covered Snacks?

5/5 experts say no.

Yogurt-coated fruit sounds like a double-dosage health food. But don’t be fooled—a shell of “yogurt” contains some very un-yogurtlike things, according to all five of our experts.

While these coatings may be called ‘yogurt,’ they are really a kind of ‘frosting’ of which yogurt is an ingredient,” says David Katz, MD, director of the Yale University Prevention Research Center. The real stars of yogurt coatings are sugar—and not the kind that naturally occurs in dairy foods—and oil. “Having the name ‘yogurt’ in the mix is supposed to make it all okay,” Katz says. “It does not.”

In fact, the stuff that makes up yogurt coating—typically sugar, partially hydrogenated palm kernel oil, yogurt powder, emulsifiers and salt—is a far cry from its namesake. “One should definitely not think about these as a health food,” says Mario Kratz, PhD, a dairy researcher and nutrition scientist at the Fred Hutchinson Cancer Research Center in Seattle. “I’d place most of these snacks in the same category as candy bars.”

At first glance, the nutritional stats don’t seem so bad; for a popular brand, a 1/4 cup serving of vanilla yogurt raisins has 19 grams of sugar and 5 grams of fat, while the same serving size of regular raisins actually has more sugar—29 grams of it—but no fat. But that’s far from a nutritional wash. Since yogurt-covered raisins are so much chunkier than their natural, unadulterated peers, you get far fewer raisins per serving and far more of the unnatural kind of sugar.

There’s another danger to these snack food “impostors,” says Dina Rose, PhD, a sociologist and feeding expert of the blog It’s Not About Nutrition: The Art & Science of Teaching Kids to Eat Right. “For kids, yogurt-covered snacks like yogurt-covered (or really, oil-covered) raisins and pretzels teach that these foods should look and taste like candy,” she says. Getting a kid to recognize that a yogurt-covered snack should only be eaten occasionally, she says, is the tricky part.

J. Bruce German, PhD, professor and director of the Foods for Health Institute at the University of California, Davis—and a yogurt researcher—says that while yogurt is a “nourishing food product,” the kind that’s dried, mixed with stabilizers and blanketed on dried snacks isn’t the same. “In general most of the attributes of fresh yogurt are lost in making coated snacks,” he says.

That’s why the snacks you buy at the movie theater aren’t the real deal, agrees Jennifer Willoughby, a dietitian at Cleveland Clinic Children’s. But here’s the good part: making your own snacks from real yogurt is a tasty and healthy treat. “Choose a plain or vanilla yogurt to dip fruit or nuts in, and then freeze for a sweet treat with significantly less added sugar and more nutritional benefit,” she says.

yogurt covered pretzels
Illustration by Lon Tweeten for TIME

Read Next: Should I Eat Butter?

TIME Infectious Disease

There’s Another Drug-Resistant Bacteria In Meat

A new study suggests meat sold in grocery stores could be carrying an overlooked pathogen

We’ve heard about listeria in ice cream and E. coli in spinach, but new research suggests there’s another bacterial strain that may be infecting consumers who handle or consume meat sold in grocery stores.

A new study published in the journal Clinical Infectious Diseases shows turkey, chicken and pork sold in grocery stores can contain a bacteria called Klebsiella pneumoniae, which can cause illness in some people, and some strains of which are resistant to antibiotics. According to researchers, the new study is the first to suggest that meat may be a source of K. pneumoniae exposure for Americans. Currently the U.S. government does not routinely test food for that bacteria.

In the study published Thursday, researchers from the Milken Institute School of Public Health and elsewhere compared isolated samples of K. pneumoniae from meat products sold in Flagstaff, Arizona, and compared those to urine and blood samples from people with K. pneumoniae infections during the same time period. The samples were sequenced and the researchers found that 47% of the meat products tested had the bacteria, and some of the sequenced samples from the meat and samples from the humans were almost identical.

The findings underline the need for judicious use of antibiotics in livestock, since some of the strains of K. pneumoniae were discovered to be drug resistant.

The study cannot confirm for certain that the people in the study with Klebsiella pneumoniae got the infection from meat at a grocery store. “What we can say is that there are strains that were isolated from people and from meat that were nearly indistinguishable,” said lead study author Lance B. Price, a professor of environmental and occupational health at Milken Institute School of Public Health in an email.

The authors add that the findings are not necessarily reserved to Arizona where the study was conducted. Price says most of the products were produced outside of the state, which means contaminated meat could be in a variety of places country-wide.

TIME Infectious Disease

‘We Are Not Prepared For Another Epidemic': World Bank Survey

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Getty Images A woman, suspected of carrying ebola, looks on while under quarantine in the red zone of the Elwa clinic, an ebola treatment center in Monrovia on July 20, 2015. AFP PHOTO / ZOOM DOSSO (Photo credit should read ZOOM DOSSO/AFP/Getty Images)

A new World Bank poll reveals many countries are fearful of epidemics like Ebola and do not think the world is prepared to handle them

Correction appended, July 23

Many people living in developed countries do not think the world is prepared to appropriately respond to another infectious disease epidemic like the ongoing Ebola outbreak, a new World Bank survey shows.

The new data comes from a World Bank Foundation survey released Thursday morning. Researchers polled 4,000 people in the general public living in the regions as well as what the organization classified as opinion elites (defined as people with a university diploma who closely follow global news) and discovered that people around the world are highly concerned about global disease outbreaks, are not convinced the global community is well equipped to handle such outbreaks, and are in support of more funding for protections.

When asked to rank which global issues are most concerning, the people polled collectively ranked global health and epidemics third, after climate change and terrorism. Concern over epidemics was higher than that for global poverty and human rights abuses. When asked specifically about which global health problems concerned people most, global infectious diseases beat out other issues including HIV/AIDS, obesity and hunger.

Not only is concern over epidemics high, but twice as many people think there will be another epidemic like Ebola than people who do not. In addition, a high proportion of the people surveyed expect there could be an epidemic in their own country. That’s especially interesting, the researchers pointed out in a press conference, given that most of the countries had very few people with Ebola if any at all.

People living in the United States, France and the United Kingdom were especially unconvinced that the world is prepared to handle another outbreak. The Ebola outbreak has infected over 27,700 people and killed over 11,260. It’s been widely acknowledged that the world did not react fast enough, and a recent report cited major cultural problems at the World Health Organization (WHO) that interfered with the agency’s leadership during the outbreak and contributed to its failures to adequately respond.

The poll highlights the fact that members of the general public recognize the risk epidemics pose and support investment to prevent them. Nearly 60% of those surveyed said they support funding and policy changes in developing countries that will help protect their own country from risk, and about 70% say strengthening the health systems in developing countries will save money.

Pledges from countries to aid in the Ebola outbreak as well as vows from global agencies to reform their processes to better respond in the future have been made throughout the last year. Whether these translate to real changes and increased capacities to prevent and respond to the next outbreak remains to be seen, but it’s clear from the new poll that it’s what the people want.

Correction: The original version of this story misstated group that conducted the poll. It’s the World Bank Group.

TIME medicine

There’s Yet Another Downside To Overusing Antibiotics

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BSIP/UIG—Getty Images/Universal Images Group

Scientists have found yet another reason not to overuse the drugs—they’re turning bacteria into better infectious agents

Scientists have been warning for decades that we use too many antibiotics, both in people to treat relatively mild infections and in agriculture to bulk up farm animals and keep them free of disease. The consequences, they caution, are dire—and already emerging in hospitals with bacteria that can’t be treated with any of our existing antibiotic medications.

But the thinking went that to become resistant to the drugs we use on them, bacteria have to pay a price. They may be able to survive the pharmaceutical onslaught, but they’re less fit and therefore less able to reproduce, less likely to remain for long in their host of choice and otherwise sapped of the energy needed to really wreak havoc on human or animal immune systems.

MORE: Study Links Widely Used Pesticides to Antibiotic Resistance

At least, that was the theory (and perhaps the hope) until now. In a study published in Science Translational Medicine, however, researchers show how misguided that belief is. Delving into the genetic code of certain common bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii — both of which are resistant to multiple antibiotics— and Vibrio cholerae, the researchers identified genes that change in the presence of these drugs. In animal models, they observed how these changes affected the different bacteria’s ability to infect and populate in hosts.

To their surprise, rather than being compromised, the antibiotic-resistant bacterial strains seemed to be stronger, more robust and better able to infect cells than less resistant strains.

MORE: Why Reducing Antibiotic Resistance Is Harder Than It Seems

“With all the possible mutations in the bacteria, there is a battle royale, a competition among all the mutants, and we see that the most fit, the most virulent were the ones that were resistant to the antibiotics,” says Dr. David Skurnik, senior author of the paper and assistant professor of medicine at Brigham and Women’s Hospital and Harvard Medical School. In the case of P. aeruginosa, he says, “the acquisition of antibiotic resistance was associated with the most increased fitness in all the possible mutations in P. aeruginosa.”

That means that the problem of antibiotic-resistant bugs just got more complicated. Overuse of antibiotics increases the number of bacterial strains that have mutations which make them better able to withstand the drugs, and this latest research shows that these strains may also be more adept at infecting hosts and causing disease. “We’ve gotten a double whammy with the acquisition of antibiotic resistance,” says Gerald Pier, a co-author of the paper and professor of medicine, microbiology and immunobiology at Brigham and Harvard Medical School. “Not only does antibiotic resistance make it more difficult to treat infections because we have fewer drugs they will respond to, but it makes the organism better able to cause infection.”

While still important, the conventional solution of cutting back on antibiotic use may not be enough, he says. Using antibiotics more appropriately will certainly reduce the appearance of new drug-resistant strains, but it won’t be enough to tamp down the emergence of these fitter, more virulent bacteria that also happen to be adept at evading the effects of antibiotics. For that, he says, other infection-fighting strategies, including boosting the immune system with vaccines or antibody treatments, may be needed.

That’s what Pier and Skurnik are working on currently, and so far, they’ve developed encouraging options for treating infections that may keep the more robust bacteria at bay. They’re targeting parts of bacteria that many strains have in common and developing new says to recognize these targets and neutralize the bacteria so they can’t cause serious infections and disease. “These results show that, yes, the problem of multi-drug resistant bacteria is more complex than we thought, but there are solutions,” says Skurnik.

TIME Diet/Nutrition

False Advertising Lawsuit Claims This Almond Milk Brand Doesn’t Have Enough Almonds

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Ross Hailey—MCT/Getty Images

A false advertising suit claims Almond Breeze is only 2 percent almonds

How much of your almond milk is actually made from almonds? A new false advertising lawsuit against Almond Breeze maker Blue Diamond alleges it’s far less than the packaging would have you believe.

Blue Diamond doesn’t list what percentage of Almond Breeze is made from almonds in the U.S., but a U.K. Almond Breeze website says it’s only 2 percent, FoodNavigator-USA reports.

The lawsuit, filed July 14 in New York, doesn’t specify what percentage the average customer would deem acceptable for purchase, but it does say “upon an extensive review of the recipes for almond milk on the internet, the vast majority of the recipes call for one part almost and three or four parts water, amounting to 25-33% of almonds.”

Plaintiffs Tracy Albert and Dimitrios Malaxianis argue in the suit that the product’s packaging, which includes pictures of almonds and the phrase “made from real almonds,” deceives customers into thinking they’re buying a product made mostly from almonds. The lawsuit also claims “that consumers allegedly purchased the product based on the belief that it was a healthy and premium product,” food law attorney David L. Ter Molen told the site.

When the issue came up in the U.K. three years ago, its Advertising Standards Authority said customers likely understood how much water was needed to create almond milk: “We considered that, whilst consumers might not be aware of exactly how almond milk was produced, they were likely to realize… that the production of almond milk would necessarily involve combining almonds with a suitable proportion of liquid to produce a ‘milky’ consistency.”

In a statement to TIME, Blue Diamond said, “The primary ingredient in nearly all popular beverages including coffee, tea, soda, juice and sports drinks is water. Cow’s milk is 85% to 95% water and the same can be said for most soy and almond milks which is why our brand is not alone in responding to recent claims.”

[FoodNavigator-USA]

TIME neuroscience

Diabetes Drugs May Offer Hope for Parkinson’s Disease Treatment

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Levin/Papantonio

Diabetes patients who took these medications had a 28% lower chance of developing Parkinson's

Two forms of diabetes medication may reduce risk of developing Parkinson’s disease, according to a new study.

Researchers analyzed data on more than 160,000 diabetes patients in the U.K. and found that patients who took rosiglitazone or pioglitazone had a 28% lower chance of developing Parkinson’s than their counterparts who took other diabetes medication, according to the study, published in the journal PLOS Medicine. The drugs were originally developed by GlaxoSmithKline and Takeda, respectively, but they are now off patent.

The research does not suggest that people with Parkinson’s take the diabetes drugs directly. Rather, the findings offer hope for future Parkinson’s research.

“We often hear about negative side effects associated with medications, but sometimes there can also be unintended beneficial effects,” senior researcher Ian Douglas from the London School of Hygiene & Tropical Medicine told Reuters.

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