TIME Innovation

Five Best Ideas of the Day: January 15

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. India and the U.S. have much to gain from strengthening their “unique but sometimes frustrating partnership.”

By Nicholas Burns in the Boston Globe

2. Big energy is betting on power storage tools that let customers take advantage of variable energy prices and stock up when rates are low.

By Ucilia Wang in Forbes

3. With class replacing race as a dividing line, some find South Africa is a “less equal place” now than under apartheid.

By Jeb Sharp at PRI’s The World

4. Preliminary research with stem cells shows how the versatile therapy could effectively cure type-1 diabetes.

By Haley Bridger in the Harvard Gazette

5. A critical piece of improving American education is improving teacher quality, and that is finally happening.

By Dan Goldhaber and Joe Walch in Education Next

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Environment

Ingested Drugs, Passed Through Sewers, May Threaten Lake Michigan Fish

Study finds exposure to a diabetic drug can throw a minnow's hormones off balance

Researchers warned that a cocktail of ingested medications has slipped past sewage treatment plants and gradually accumulated in Lake Michigan, threatening to alter the hormonal balance of local fish.

Researchers from the University of Wisconsin – Milwaukee’s School of Freshwater Sciences have detected traces of coffee, birth control pills and antibiotics in Lake Michigan’s waters, the Detroit Free-Press reports. The most prevalent drug was Metformin, a medication commonly used to treat Type 2 diabetes.

Fathead minnows exposed to Metformin at the same concentrations found in the lake exhibited unusual hormonal imbalances four weeks later. Male minnows, for instance, began to produce a hormone typically associated with female egg production, though researchers say they have not yet ascertained the long-term effects of the hormonal changes.

“It’s enough to raise an alarm bell that this might be something that causes changes in reproduction of fish,” study author Rebecca Klaper said.

Read more at Detroit Free-Press.

TIME mental health

The Link Between Mental Trauma and Diabetes

BC5544-001
Getty Images

Women with more PTSD symptoms appear to be at a higher risk for Type 2 diabetes, a new study says

Women with symptoms of post-traumatic stress disorder (PTSD) have a two-fold increased risk for type 2 diabetes, according to a new study.

“When we are under stress we are more likely to get sick, but women with PTSD are in this extreme stress response a lot of the time,” says study author Karestan Koenen, an epidemiology professor at Columbia University’s Mailman School of Public Health. The new study, published in the journal JAMA Psychiatry, looked at 49,739 women participating in the Nurses’ Health Study II to assess the link between PTSD symptoms and type 2 diabetes over 22 years. They found that women with the most symptoms had double the risk of developing type 2 diabetes, and that the association increased based on the number of symptoms women experienced.

“It’s so important that people understand PTSD isn’t just in veterans. Most PTSD is just in regular people in the community,” says Koenen. One of the most surprising findings in the study was that using antidepressants and having a higher body mass index (BMI) accounted for about half of the increased risk for type 2 diabetes in women with PTSD. Past research has linked PTSD to having a higher BMI, with some research suggesting that elevated stress response could result in cravings for highly caloric food and lead to weight gain.

The antidepressant link is the most unexpected. An obvious explanation for the link is that some antidepressants cause weight gain, but the researchers argue weight gain isn’t caused by all antidepressants and therefore cannot account for all of the effect. “It’s probably one of the most interesting findings and I don’t have a good explanation for it,” says Koenen.

The researchers say it’s possible that extreme stress can cause changes in the regulation of the body’s immune system, inflammation markers and hormones, which could contribute to the onset of type 2 diabetes.

Ultimately, Koenen believes the study is important because it provides further evidence that medicine can benefit from a more holistic look at patients that includes not just disease but also mental health and psychology. “Our health care system acts like the brain and the body are two separate things. This is just one of hundreds of studies that have now shown that mental health affects physical health and mental health,” she says. “We need a more integrated medical system where the mind and body are worked on together.”

Koenen, who used to work in veterans affairs, says veterans have been asking for such care for a long time, with studies and surveys showing patients often ask for alternative services like yoga. “Patients understand this but the medical system hasn’t caught up,” she says.

TIME Diet/Nutrition

The Question Your Doctor Should Be Asking You — but Isn’t

Sugar Packet
Siede Preis—Getty Images

Almost half of adults surveyed drank at least one soda a day

The last time you went to the doctor, were you asked how much soda you drink? Probably not, but at Montefiore Medical Center in the Bronx, it’s now among the standard questions doctors will ask—and then log into the patient’s electronic health record. Those records, analyzed in a new study, reveal some interesting connections between sugar-sweetened beverage consumption and a slew of health problems.

“Information about a patient’s diet and physical activity are vitally important in preventing and managing certain diseases, yet it’s rarely captured in medical records,” says Ross Kristal, first author on the paper and medical student at Albert Einstein College of Medicine. Kristal and his colleagues looked at how much sugar-sweetened soda people drank, how many vegetables and fruits they ate and how active they were, among other things and noticed a correlation between a person’s soda habit and other health factors.

A full 40% of the people in the study drank at least one sugar-sweetened beverage every day. And the researchers noted that those who drank more than one per day were more likely to smoke, were more likely to eat no fruits or vegetables, and were more likely to have gone a month without much walking or biking.

READ MORE Weight Loss Supplements Don’t Work for Most People, Study Finds

On the flip side, people who didn’t drink a daily soda were less likely to have been diagnosed with type-2 diabetes and hypertension. It seems a doctor’s diabetes diagnosis may get people to drink less soda.

Right now, these health behaviors aren’t collected systematically, says senior author of the paper Peter Selwyn, MD, chair of family and social medicine at Albert Einstein College of Medicine and Montefiore Medical Center. But the more doctors know about each of their patients’ health habits, the more they can engage them in an honest—and hopefully effective—conversation about their health.

“These associations can help our providers narrow down on perhaps who would be more at risk for some of these unhealthy behaviors which can lead to these poor health outcomes,” Kristal says.

TIME global health

This Is Now the Average Life Expectancy Worldwide

Southern sub-Saharan Africa was the only region worldwide to have a decline in life expectancy

Life expectancy across the globe has increased by more than six years since 1990 to 71.5 years, according to a new study.

“The progress we are seeing against a variety of illnesses and injuries is good, even remarkable, but we can and must do even better,” said lead study author Christopher Murray, a University of Washington professor, in a press release.

The study, published Wednesday in the Lancet journal, showed declines in the number of deaths from cancer and cardiovascular disease in high-income countries as well as in deaths from diarrhea and neonatal complications elsewhere. Both of these trends contributed to the overall decline. Importantly, medical funding for fighting infectious diseases has grown since 1990 and helped drive the improvement, according to Murray.

Still, despite the improvement, the number of deaths from a number of ailments increased. Perhaps most dramatically, deaths from HIV/AIDS joined the list of the top 10 causes of premature death. The number of annual deaths from the ailment rose from 2.07 million in 1990 to 2.63 million in 2013, the equivalent of a 344% increase in years of lost life. The increase in deaths from HIV/AIDS made southern sub-Saharan Africa the only region worldwide to experience a decline in life expectancy.

Other ailments that caused an increased loss of life include liver cancer caused by hepatitis C, which soared 125% since 1990, and deaths from disorders related to drug use, which increased by 63%.

TIME Research

6 Breath Tests That Can Diagnose Disease

129230574
612383—Getty Images

A new study uses breath to diagnoses diabetes, but other diseases like cancer and obesity may be breath-detectable too

A new study shows that it may be possible to diagnose type 1 diabetes in kids even before the onset of severe illness.

Currently, about one in four kids with type 1 diabetes don’t know they have it until they start having life-threatening symptoms. However, a new study published in the Journal of Breath Research shows researchers might be able to diagnose the disease by detecting a chemical marker (acetone) in the breath that makes it smell sweet, but indicates a build-up of chemicals in the blood (ketones) that occurs when a person’s insulin levels are low. High levels of acetone in the breath can indicate high levels of ketones in the blood. The hope is that if proven effective, this breath test will help physicians make a diagnosis earlier.

Growing research suggests breath tests can be used to detect a variety of diseases, from diabetes to various cancers. Research is still early in some areas—and there are other factors beyond disease that can result in chemical markers in the blood and breath—but some medical institutions are already using the tests of a variety of diagnosis.

Type 1 Diabetes
In the new study, researchers collected compounds in the breath from 113 children and adolescents between the ages 7 and 18. They also measured the kids’ blood-sugar and ketone levels. They found a link between higher levels of acetone in the breath and ketones in the blood. “Our results have shown that it is realistically possible to use measurements of breath acetone to estimate blood ketones,” said study author Gus Hancock, a professor at Oxford in a statement. “We are working on the development of a small hand-held device that would … help to identify children with new diabetes.”

Colorectal Cancer
In a small study published in 2012 in the British Journal of Surgery, researchers from the the University Aldo Moro of Bari in Italy collected the breath of 37 patients with colorectal cancer and 41 healthy control participants. The researchers were measuring the amount of volatile organic compounds (VOCs) in the participants’ breath, with the thought being that cancer tissues and cells may release distinct chemicals. The researchers were able to identify 15 of 58 specific compounds that were correlated with colorectal cancer. Based on this, the were also able to distinguish between cancer patients and healthy patients with 75% accuracy.

Lung Cancer
In 2013, researchers from the University of Latvia used an electronic nose-like device to identify a unique chemical signature in lung cancer patients. As TIME has previously reported, there are several groups who think this process can be standardized for cancer with further research. In June, scientists at the American Society of Clinical Oncology meeting in Chicago presented a device they think has real promise.

Obesity
There are obviously a number of ways that obesity can be diagnosed without a breath test, but a 2013 study published in the Journal of Clinical Endocrinology & Metabolism found that obese people had unique markers in their breath, too. Researchers at Cedars-Sinai Medical Center studied the breath of 792 men and women trying to detect methane. Those with higher levels of methane and hydrogen gases in their breath also tended to be heavier with a BMI around 2.4 points greater than those with normal gas levels. The hope, the researchers say, is that a test could be developed that could detect a type of bacteria that may be involved in both weight and levels of gas in the breath. There may be ways to clinically curb that bacteria growth.

Lactose Intolerance
Johns Hopkins Medicine uses breath testing to help diagnose lactose intolerance. Patients drink a lactose-heavy drink and clinicians will analyzed the breath for hydrogen, which is produced when lactose isn’t digested and is fermented by bacteria.

Fructose Intolerance
Johns Hopkins also uses breath tests to assess whether an individual is allergic or intolerant to fructose, a sugar used to sweeten some beverage and found naturally in foods like onions, artichokes, and wheat. The test is similar to a breath test for lactose intolerance. Patients will drink a cup of water with dissolved fructose and over a three hour period, clinicians will test their breath. Once again, a high presence of hydrogen can indicate that the patient is not properly digesting it.

TIME Diet/Nutrition

The Link Between Yogurt and Lower Diabetes Risk

New research highlights a positive trend for those who consume yogurt

Eating a daily serving of yogurt is associated with an 18% lower risk of type 2 diabetes, says a new study published in the journal BMC Medicine.

Some research has suggested that calcium, magnesium and fatty acids found dairy products may lower the risk of type 2 diabetes, which develops when the body stops making insulin. So researchers from Harvard School of Public Health took a closer look at the possible relationship between yogurt consumption and diabetes, hypothesizing that yogurt’s probiotics and antioxidants may have a positive effect.

Researchers at looked at data from three cohorts of people who had their health and lifestyles followed. At the start of the studies, the participants filled out a questionnaire about their diets and history of chronic diseases. Every two years, researchers followed up with participants and updated the data.

MORE: Yogurt May Lower Your Blood Pressure

The researchers did not find that dairy consumption in general affected diabetes risk, but they did find that yogurt was specifically associated with a lower risk of developing the disease. With further calculations, the researchers concluded that consuming one serving of yogurt per day was associated with an 18% lower risk of type 2 diabetes.

The researchers were not able to determine exactly what was providing the health benefit, and it’s likely that maintaining a healthy diet in general has a positive effect on type 2 diabetes risk, considering weight gain is one of the most prominent risk factors for the disease. More research is needed—but not before making yogurt a dietary staple for health.

TIME diabetes

Why 3 in 10 People with Diabetes Don’t Know They Have It

The surprising similarities between diabetes and HIV/AIDS

New research on diabetes suggests that nearly 30% of adults with diabetes remain undiagnosed—the same rate as people with HIV. And just like many HIV patients, only about 20% of diabetes patients are treated satisfactorily, finds the new study published in the Annals of Internal Medicine.

The study used the cascade of care method, which aggregates data on people’s treatment for a particular disease and has been used to guide treatment of HIV/AIDS. Study leaders say that the new diabetes research is the first time the method has been applied to another disease.

The research found a lot of similarities between the two diseases and how they’re managed. To start, the consequences can be grave for patients who don’t receive treatment for either disease. HIV/AIDS weakens the immune system and allows patients to develop other ailments, while diabetes can lead to problems with the kidney, heart and brain. Researchers showed where people with diabetes fall through the cracks on the path from the onset of a condition to the development of other serious illnesses. Millions aren’t diagnosed, more than a million people haven’t been to the doctor in years despite a diagnosis and millions of others don’t take the proper medication.

“As health care systems move from fee-for-service to fee-for-quality, something like the cascade can really aid in that shift and help both providers and patients be more motivated and spot the gaps and close the gaps in care,” said study co-author Mohammed Ali, an assistant professor at Emory University. Incentives could encourage both patients and health care providers to screen and then treat diabetes.

“They’re extremely similar because they both require patients to be extremely proactive in managing their own condition,” said Ali, specifically citing diet, exercise and taking medication. “If you’re a good patient, you’re actually going to prevent a lot of those diseases that come with diabetes and a lot of those bad outcomes that come with HIV.”

As electronic records make it easier for doctors to look at large sets of data, the cascade-of-care method has potential to aid in understanding where the health system has failed at treating diseases, Ali said.

“This should be easy to do for anything,” he said.

Corrected Nov. 11, 2014: This piece has been updated. An earlier version of the story mischaracterized statements from Ali.

MONEY Health Care

The 7 Biggest Health Problems Americans Face—And Who is Profiting

Bottles of prescription medicine in cabinet
Kim Karpeles—Getty Images/age fotostock

Here are the most-prescribed drugs in America.

Americans include two health-related issues among the 10 most important problems facing the U.S., according to a recent Gallup survey. Healthcare in general ranked fourth on the list, with Ebola coming in at no. 8. But is Ebola really among the biggest health problems for Americans? Not when we look at the chances of actually being infected.

So, what are the actual biggest health problems that Americans face? One way to answer this question is to look at what drugs are prescribed the most. Here are the seven top health problems based on the most-prescribed drugs in the U.S., according to Medscape’s analysis of data provided by IMS Health.

1. Hypothyroidism

AbbVie’s ABBVIE INC. ABBV 0.6407% Synthroid ranks at the top of the list of most-prescribed drugs. Synthroid is used to treat hypothyroidism, a condition caused by an underactive thyroid gland.

The American Thyroid Association estimates that 2%-3% of Americans have pronounced hypothyroidism, while 10%-15% have a mild version of the disease. Hypothyroidism occurs more frequently in women, especially women over age 60. Around half of Americans with the condition don’t realize that they have hypothyroidism.

2. High cholesterol and high triglycerides

Coming in at a close second on the list is AstraZeneca’s ASTRAZENECA PLC AZN -0.1698% Crestor. The drug is used to help control high cholesterol and high triglyceride levels.

According to the American Heart Association, nearly 99 million Americans age 20 and over have high cholesterol. Elevated cholesterol levels are one of the major risk factors for heart attacks and strokes. The problem is that you won’t know if you have high cholesterol unless you get tested — and around one in three Americans haven’t had their cholesterol levels checked in the last five years.

3. Heartburn and gastroesophageal reflux disease

AstraZeneca also claims the third most prescribed drug in the nation — Nexium. The “purple pill” helps treat hearburn and gastroesophageal reflux disease, or GERD, also commonly referred to as acid reflux.

Around 20% of Americans have GERD, according to the American Society for Gastrointestinal Endoscopy. A lot of people take over-the-counter medications, but that’s not enough for many others. Medscape reported that over 18.6 million prescriptions of Nexium were filled between July 2013 and June 2014.

4. Breathing disorders

The next two highly prescribed drugs treat breathing disorders. GlaxoSmithKline’s GLAXOSMITHKLINE PLC GSK 0.3999% Ventolin HFA is used by asthma patients, while the company’s Advair Diskus treats asthma and chronic obstructive pulmonary disease, or COPD.

More than 25 million Americans have asthma. Around 7 million of these patients are children. Meanwhile, COPD, which includes chronic bronchitis and emphysema, ranks as the third-leading cause of death in the U.S.

5. High blood pressure

Novartis NOVARTIS AG NVS -0.3923% claims the next top-prescribed drug with Diovan. The drug treats high blood pressure by relaxing and widening blood vessels, thereby allowing blood to flow more readily.

Around one-third of American adults have high blood pressure. Many don’t know that they are affected, because the condition doesn’t usually manifest symptoms for a long time. However, high blood pressure can eventually lead to other serious health issues, including heart and kidney problems.

6. Diabetes

Several highly prescribed drugs combat diabetes, with Sanofi’s SANOFI S.A. SNY -0.32% Lantus Solostar taking the top spot for the condition. Lantus Solostar is a long-acting basal insulin that is used for type 1 and type 2 diabetes mellitus.

According to the National Diabetes Statistics Report released in June 2014, 29.1 million Americans had diabetes in 2012. That’s a big jump from just two years earlier, when 25.8 million Americans had the disease. Diabetes ranks as the seventh leading cause of death in the U.S.

7. Depression and anxiety

Eli Lilly’s ELI LILLY & CO. LLY -0.0277% Cymbalta fell just below Lantus Solostar in number of prescriptions. Cymbalta is the leading treatment for depression and generalized anxiety disorder.

The Anxiety and Depression Association of America estimates that 14.8 million Americans ages 18 and older suffer from a major depressive disorder each year. Around 3.3 million have persistent depressive disorder, a form of depression that lasts for two or more years. Generalized anxiety disorder affects around 6.8 million adults in the U.S.

Common thread for common diseases

One thing that stands out about several of these common diseases affecting millions of Americans is that many people have one or more of these conditions — but don’t know it. This underscores the importance of getting a checkup on a regular basis.

Regardless of what the Gallup survey found, the odds of you getting Ebola are very low. On the other hand, the chances of you or someone in your family already having one of these seven conditions could be higher than you might think. Perhaps the truly biggest healthcare challenge facing Americans is knowing the status of their own health.

TIME Innovation

Five Best Ideas of the Day: November 10

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. Food touches everything in our lives. Yet we have no national food policy. That must change.

By Mark Bittman, Michael Pollan, Ricardo Salvador and Olivier De Schutter in the Washington Post

2. Electronic Medical Records should focus more on patient care and less on meeting the needs of insurance companies and billing departments.

By Scott Hensley at National Public Radio

3. Anonymous social media often hosts vicious harassment targeting women and minorities. A new plan to monitor threats online is working for a solution.

By Barbara Herman in International Business Times

4. “You can’t wear a Band-Aid for long, particularly when the wound keeps bleeding.” Two years after Hurricane Sandy, New York is far from stormproof.

By Lilah Raptopoulos in the Guardian

5. China and the U.S. should take aim at a new “grand bargain” to head off tensions and mistrust in their relationship.

By Wei Zongyou in the Diplomat

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

Your browser, Internet Explorer 8 or below, is out of date. It has known security flaws and may not display all features of this and other websites.

Learn how to update your browser