TIME diabetes

Having The Right Kind of Fat Can Protect Against Diabetes, Study Says

Brown tissue, also known as brown fat
Brown tissue, also known as brown fat Getty Images

People with more "brown fat" were better able to keep blood sugar under control and burn off fat stores

Not all fat is created equal, it seems. When we’re born, we have larger amounts of brown fat, so-called because it contains more dark mitochondria, the cell’s energy factories that pull in glucose and use it as fuel to drive cellular functions. Like a hard-working battery, however, brown fat releases heat as it performs its functions, which is helpful to keep newborn infants warm but gets less useful for adults as we’re better able to regulate our body temperature. So as we get older, this brown fat is gradually lost.

But in a report published in the journal Diabetes, scientists led by Labros Sidossis, professor of internal medicine at University of Texas Medical Branch at Galveston, found for the first time that adults who retained more amounts of brown fat were better able to keep blood sugar under control and burn off fat stores. Previous studies have linked brown fat to better weight control, but these results also hint that the tissue may be important for managing diabetes.

MORE: How Now, Brown Fat? Scientists Are Onto a New Way to Lose Weight

The researchers measured the brown fat in a small group of healthy men and also tracked how much energy they used while resting, how well they metabolized glucose, and their sensitivity to insulin, which breaks down and controls blood sugar. Because brown fat tends to be activated under cold temperatures, the scientists also measured these factors after the men sat at room temperature, and again after they sat at 65 degrees to 70 degrees F for five to eight hours.

The men who had higher amounts of brown fat – about 70g on average – increased their metabolic rate by 15%, meaning they burned more calories when they were exposed to slightly cooler temperatures, compared to the men with little or no brown fat. That alone, says Sidossis, contributed to burning 300 more calories for these men.

Those with higher brown fat were also able to break down more sugar, leading to less of it in their blood, something that hasn’t been shown before in human studies. If the subjects sat in the cooler room for 24 hours, the researchers found, that would lead to a reduction of 25g of sugar in the blood thanks to their brown fat alone. “That’s significant because if you consider people who have diabetes, they only have about 2g to 3g more sugar in the blood,” says Sidossis.

MORE: Study: Scientists Find a Way to Trigger Fat-Burning Fat

Interest in brown fat has exploded in recent years, and investigators found that adults retain more brown fat than previously thought, on either side of the base of the neck. Activating this fat store has become a popular area of research; so far, cold temperatures are the only reliable way to stimulate it, but others are exploring ways to transform white fat into brown fat. As of yet, experts haven’t found a reliable way to turn brown fat on or off in a reliable and metabolically useful way. Genetics may determine how much brown fat people are born with, but if early research is validated, it may also be possible to modify that amount, either with drugs or by transforming white fat.

MORE: Turn Down the Thermostat, Drop a Few Pounds?

If the results of the current study are confirmed, the need to do so might become more urgent. “Our data suggest that brown fat may function as both anti-obesity and anti-diabetic tissue in humans,” says Sidossis. “And that makes it a therapeutic target in the battle against obesity and chronic disease. Anything that helps in this area, we need to pursue and make sure that if there is potential there, we exploit it.”

TIME

You Asked: Are All Calories Created Equal?

Are all calories equal?
Illustration by Peter Oumanski for TIME

Kale or corn dogs, bananas or beer, a calorie is still a calorie. At least, that’s what dieters have been told for the past half-century. Now, experts don't agree

“By and large, we’ve been taking an accounting approach to weight loss,” says Dr. David Ludwig, a professor of nutrition at the Harvard School of Public Health. By that he means, health scientists have traditionally focused on the number of calories coming in versus the number of calories going out. But there are a lot of problems with that approach, he says. For one thing, it’s really tough to accurately keep track of your daily calorie intake. “Being off by just 100 calories a day could add up to a hundred pounds over a lifetime,” he says.

If burning more calories than you consume would keep you skinny, a low-fat diet should be the answer to all your diet prayers. That’s because, compared to protein or carbohydrates, fat contains roughly twice the number of calories, ounce for ounce. But Ludwig says low-fat diets have proved ineffective when it comes to losing weight. “Mediterranean or low-carbohydrate diets outperform a low-fat diet every time, and that wouldn’t be true if calories were the only measure that mattered,” he adds. (Mediterranean diets and others like the now-trendy Paleo diet are both high in fat, comparatively speaking.)

In reality, Ludwig says the body responds differently to calories from different sources. “Your weight is regulated by a complex system of genetic factors, hormonal factors, and neurological input, and not all calories affect this system the same way,” he explains.

As for fat: “Some naturally high-fat foods are among the most healthful we can eat in terms of promoting weight loss and reducing risk for diabetes and heart disease,” he explains, listing off foods like nuts, avocados, and many types of fish. “If you’re counting calories, you would want to eat these foods sparingly because they’re dense in calories. But they’re also very filing.”

Refined carbohydrates, on the other hand—like those found in white bread, cookies, crackers, and breakfast cereals—raise your blood’s level of the hormone insulin, which signals to your body that it needs to store fat cells. Also referred to as high-glycemic foods, these refined carbs pass through your digestive system quickly—which is why you can eat a whole bag of potato chips and feel hungry 15 minutes later, Ludwig says.

Dr. Richard Feinman, a professor of cell biology at the State University of New York Downstate Medical Center, compares insulin to a faucet handle. The more your blood’s amount of the hormone rises, the more the faucet opens and the more fat your body stores.

Feinman has looked at calories from the perspective of thermodynamics—or the laws that govern heat and energy. Like Ludwig, he says the idea that calories from different macronutrient sources would have the same effect on your body is silly. Put simply, it doesn’t make sense that “a calorie is a calorie” because your body uses the energy from different foods in a variety of ways, Feinman explains.

The big lesson here is that people need to look at food as not just a collection of calories, experts say. By cutting out refined carbs and eating more protein and healthy fats, which help you stay full without triggering the storage of fat cells, “You can work with, as opposed to against, your body’s internal weight-control systems,” he says. “That will make weight loss more natural and easy.”

The best part: You can put away the calculator. No more calories counting.

TIME Research

In 2025, Everyone Will Get DNA Mapped At Birth

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What will the future hold? REB Images—Getty Images/Blend Images

Scientists have scoured trends in research grants, patents and more to come up with these 10 innovations that will be reality in 10 years (or so they think)

Everybody likes to blue-sky it when it comes to technology. Driverless cars! Fat-burning pills! Telepathic butlers! But the folks at Thomson Reuters Intellectual Property & Science do it for a living—and they do it with data.

By examining who’s investing in what, who’s researching what and who’s patenting what, the group has come up with 10 predictions of innovation for 2025, which they presented at the Aspen Ideas Festival. The list included the first attempts at testing teleportation, the ubiquity of biodegradable packaging and electric air transportation.

Here’s what they say will be commonplace in medicine in a decade:

1. Dementia will be on the decline

While the World Health Organization predicts that more than 70 million people will be affected by dementia, much of it related to Alzheimer’s disease, by 2025, that upward trajectory of cases may be blunted somewhat by advances in genetics that will lead to earlier detection and possible treatment of the degenerative brain disorder.

2. We’ll be able to prevent type 1 diabetes

Unlike type 2 diabetes, which generally develops when the body gradually loses its ability to break down sugar properly, type 1 diabetics can’t produce enough insulin, the hormone that dispatches sugar from the diet. Advances in genetic engineering will lead to a more reliable technique for “fixing” genetic aberrations that contribute to type 1 diabetes as well as other metabolic disorders, making it possible to cure these conditions.

3. We will have less toxic cancer treatments

Building on the promise of targeted cancer therapies, which more precisely hone in on tumor cells while leaving healthy cells alone, researchers will have a deeper knowledge of the Achilles’ heels of cancer cells, which will help them to develop more powerful and precise drugs that can dispatch tumors with fewer side effects.

4. Every baby will get its DNA mapped at birth

It’s already a trendy thing to have your genome sequenced, but today there isn’t much you can do with the information. Having that information, however, may prove useful in the near future, both for predicting your risk of developing diseases as well as your ability to respond (or not) to certain drugs. As knowledge about the genome, and what various genes, or versions of genes do, grows, so will doctors’ ability to predict health outcomes and treat patients based on genetic information. So within a decade, getting a baseline DNA map at birth could be a valuable way of preparing to lead a healthier and possibly longer life.

TIME diabetes

Here Is the Deal With the Bionic Pancreas

The bionic pancreas consists of a smartphone, top, hardwired to a continuous glucose monitor and two pumps, bottom, that pumps deliver doses of insulin or glucagon every five minutes.
The bionic pancreas consists of a smartphone, top, hardwired to a continuous glucose monitor and two pumps, bottom, that pumps deliver doses of insulin or glucagon every five minutes. Boston University Department of Biomedical Engineering/AP

Boston researchers test a device that could make diabetes treatment easier

Managing type 1 diabetes is an all-day, time-intensive commitment, and scientists are hard at work trying to create one device to take the guesswork—and the hard work—out of keeping blood sugar stable in people with the disease. Now, they’re one step closer, thank to Boston researchers reporting promising results in a recent study.

Researchers at Massachusetts General Hospital and Boston University created a bionic pancreas that automatically measures blood sugar and releases insulin when needed. Here’s how it works. Patients have a sensor that’s implemented under their skin and measures blood sugar in their tissue. The sensor provides that information to an iPhone app, which calculates the amount of insulin needed every five minutes, and that insulin is provided from a pump. Instead of calculating and manually inputting every carb in a meals, the device wearers simply indicate whether their meal size was “typical,” “more than usual,” “less than typical,” or “a small bite” and whether the meal type as “breakfast,” “lunch,” or “dinner.”

The researchers tested the device on two different groups—20 adults and 32 adolescents. The adults wore the implanted pumps for five days and stayed in a hotel room where they could be monitored. They were told to eat and behave however they wanted, with certain limitations on things like alcohol. The adolescents had a similar setup, but they were at a summer camp instead of a hotel. In addition to the bionic pancreas, researchers also monitored the participants’ blood sugar with finger pricks to be sure their blood-sugar levels were being accurately recorded. The results, published in the New England Journal of Medicine, show that the participants had healthier blood sugar when they used the bionic pancreas compared to when they used their standard treatment method.

A diabetic’s pancreas produces very little or no insulin, which is a hormone needed to regulate the body’s blood sugar. That means diabetics have to regulate their blood sugar themselves. For many, this requires pricking themselves throughout the day, then reading their blood sugar levels and determining how much insulin they need to inject. Many diabetics will choose to use an insulin pump, worn outside the body with a catheter attached to an insulin reservoir. The pumps automatically inject insulin into the body, and when diabetics eat, they program the pump with the amount of carbohydrates they’re consuming and their current blood sugar.

The bionic pancreas takes the pump a step further.

The findings are promising, but we are still a far ways off before the bionic pancreas becomes a clinical reality. For one, the study had a relatively small sample size and lasted only five days. What many are hopeful for, is a truly “bionic” and implantable pancreas that could fulfill the role of a functional organ. That’s still a ways off too, but stem cell research is pushing that technology along.

The bionic pancreas doesn’t bring us closer to a cure, but anything that makes this chronic disease easier to manage is a step in the right direction.

TIME Aging

7 Medical Tests Every Man Needs

Medical patient and doctor
Lee Edwards—Getty Images/Caiaimage

Admit it, guys: You don’t even like going to the doctor when there’s something wrong, let alone for preventative check-ups. But being proactive about your health—by getting recommended screenings for serious conditions and diseases—could mean you’ll spend less time at the doctor’s office down the road.

Depending on age, family history, and lifestyle factors, people need different tests at different times in their lives. Here’s a good overview for all men to keep in mind.

Diabetes

You may never need a screening for diabetes if you maintain a healthy weight and have no other risk factors for the disease (such as high cholesterol or high blood pressure). But for most men over 45—especially overweight men—a fasting plasma glucose test, or an A1C test, is a good idea, says Kevin Polsley, MD, assistant professor of internal medicine at Loyola University Health System in Chicago.

The U.S. Department of Health and Human Services also recommends diabetes screenings for overweight adults younger than 45 who have a family history of the disease, or who are of African American, Asian American, Latino, Native American, or Pacific Islander descent.

Fasting plasma glucose and A1C are both blood tests that should be done in your doctor’s office. The A1C test does not require fasting beforehand, but if your doctor wants to test you using fasting plasma glucose, you will be asked not to eat or drink anything but water for eight hours beforehand.

Health.com: Could You Have Type 2? 10 Diabetes Symptoms

Sexually Transmitted Infections

Even if you’ve been in a monogamous relationship for years, it’s not a bad idea to get tested if you haven’t already done so. Many common sexually transmitted infections can go undiagnosed for years. For example, people can go as long as 10 years without showing symptoms of HIV. The U.S. Preventive Services Task Force recommends that everyone ages 15 to 65 be screened for HIV at least once. This is especially important, Dr. Polsley says, if you have had unprotected sex, used injected drugs, or had a blood transfusion between 1978 and 1985.

In addition, the Centers for Disease Control and Prevention recommends a one-time hepatitis C screening for all adults born between 1945 and 1965, regardless of risk factors. “Believe it or not, there’s a lot of hepatitis C cases out there in which people either don’t have symptoms yet or don’t know what’s causing their symptoms,” says Dr. Polsley. “Screening for STIs is something I offer as routine at just about every physical, regardless of a patient’s age or health history.”

Health.com: Best and Worst Foods for Sex

Body Mass Index

You don’t need to make an appointment to figure out your body mass index, a measure of body fat based on your height and weight. Regardless of whether you calculate this stat yourself or your physician does the math for you, it’s important to be aware of this number, says Dr. Polsley.

A BMI between 18.5 and 24.9 is considered normal weight. Although this calculation isn’t perfect—and can sometimes label healthy people as overweight or vice versa—most doctors agree that it’s still an important component of assessing overall health. “It can be a very good opportunity to discuss diet and exercise, and to show our patients how important these things are,” Dr. Polsley says.

Health.com: 11 Reasons Why You’re Not Losing Belly Fat

Cholesterol

The American Heart Association recommends men have their cholesterol levels tested every four to six years once they turn 20. “Men have an overall higher risk for cardiovascular disease than women, and high cholesterol is often a big part of that,” Dr. Polsley says. But your doctor may want to screen you earlier (and more often) if you have heart disease risk factors such as diabetes, tobacco use, or high blood pressure.

Cholesterol is measured by a blood test, and your doctor may ask you not to eat for 9 to 12 hours beforehand. Generally, a cholesterol test will measure your levels of total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol, and triglycerides. Depending on your results, your doctor may make dietary recommendations or prescribe a cholesterol-lowering medication like a statin.

Blood pressure

Like high cholesterol, high blood pressure is often a symptomless condition—but luckily, the test for hypertension is quick and painless, involving a rubber cuff that squeezes the arm and measures the flow of blood through a large artery in the bicep. “You should have your blood pressure checked pretty much every time you see your doctor,” says Dr. Polsley, starting at age 18.

Don’t get to the doc often? Have it checked at least every two years, or yearly if your numbers were previously considered borderline (a top “systolic” number above 120 or bottom “diastolic” number higher than 80).

You can check your blood pressure at health fairs, in pharmacies, or at home with a monitoring device. If your systolic pressure cracks 130 or your diastolic goes over 85, your doctor may recommend lifestyle modifications—like exercising more and eating less salt—or they might prescribe medication.

Health.com: 31 Fat-Burning Recipes

Colonoscopy

Most men should be screened for colon cancer beginning at age 50, but those with a family history of the disease may benefit from earlier testing. Men and women alike tend to dread this test—in which a small camera is inserted into the anus and explores the large intestine for polyps or other signs of cancer—but Dr. Polsley says it’s not as bad as it sounds.

“The preparation for the test is actually the worst part,” he says: You’ll need to empty your bowls completely before the exam, which may involve not eating solid foods for one to three days, drinking lots of clear liquids, or taking laxatives. “The actual colonoscopy shouldn’t be too uncomfortable, because you’re sedated through the whole thing.”

But here’s the bright side: If your doctor doesn’t find anything suspicious, you won’t need another colonoscopy for up to 10 years.

Prostate exam

Screening for prostate cancer is more controversial than for other cancers, says Dr. Polsley, and some studies have shown that these tests can be expensive and unnecessary, and may do more harm than good. But he suggests that all men over 50 at least talk with their doctors about the pros and cons of these tests—usually either a digital rectal exam (in which the doctor inserts a gloved finger, or digit, into the rectum to feel for lumps and abnormalities) and a PSA test, which measures a protein called prostate-specific antigen in the blood.

Prostate cancer screenings can and do save lives, but they may also result in false-positive or false-negative results. And because many cases of prostate cancer progress very slowly, some men (especially older men) don’t benefit from aggressive treatment. Whether you decide to get screened for prostate cancer should be a decision you make with your doctor, says Dr. Polsley. In the meantime, it’s important to know the symptoms of an enlarged prostate—like having to urinate frequently or having trouble urinating—which could also signal cancer.

This article originally appeared on Health.com.

TIME Research

29.1 Million Americans Now Have Diabetes

The CDC reports an increasing number of Americans are diabetic

About 29.1 million Americans—nearly 10% of the U.S. population—now has type 2 diabetes, according to a new report.

Of those Americans with the illness, 27.8% of them are undiagnosed, according to the U.S. Centers of Disease Control and Prevention’s 2014 National Diabetes Statistics Report released Tuesday. The report uses data collected between 2009-2012, as well as national surveys.

The CDC estimates that the direct and indirect costs of the disease have reached $245 billion, with direct medical costs making up 72% of that amount. People with type 2 diabetes incur medical costs on average 2.3 times higher than people without the disease, the CDC found.

Type 2 diabetes is caused by various factors that result in a heightened amount of blood sugar in the body. The disease is divided into two types; type 1 diabetics do not produce enough insulin, a hormone integral to metabolizing blood sugars, while in type 2, the body cannot use the insulin it makes. Diabetes can in the most severe cases result in serious complications including heart and kidney disease.

TIME cities

Washington D.C. Is The Fittest City In The U.S.

Lower death rates, ample parks and a healthy appetite for fruits and vegetables are just some of the factors that vaulted the nation's capital to the top of the list

Washington D.C. has topped a ranking of America’s 50 largest cities, arranged from fittest to flabbiest.

The new study, released on Wednesday by the American College of Sports Medicine, ranked the cities by two broad measures of public health: Personal health indicators such as prevalence of smoking and diabetes and the average city-dweller’s intake of fruits and vegetables, and environmental health, which included measures such as access to public parks, bike lanes and farmer’s markets. A panel of 26 health experts weighted the measures by importance, and voila, a health index was formed, allowing whole metropolises to size one another up like competitive weightlifters.

Washington D.C. topped the list, knocking Minneapolis-St. Paul’s off of its three-year winning streak (though the Twin cities came in a close second). Oklahoma City, Louisville, and Memphis rounded out the bottom of the list.

The authors stress that some of the rankings capture marginal differences between cities and that they all have areas of strength worth emulating and weaknesses worth addressing.

“We have issued the American Fitness Index each year since 2008 to help health advocates and community leader advocates improve the quality of life in their hometowns,” said Walter Thompson, chair of the AFI Advisory Board.

In other words, they’re all beautiful in their own way, and they all could use some work.

TIME Diet/Nutrition

14 Surprising Causes of Dehydration

Causes of Dehydration
Getty Images

Your body is about 60% water. Lose even 1.5% of that H2O—the tipping point for mild dehydration—and your mood, energy levels, and cognitive function all drop, according to research from the University of Connecticut. And while there are obvious reasons you can end up dehydrated—a sunny day, exercise, or not drinking enough in general—other triggers are less obvious. Check out these 14 surprising causes of dehydration and how to prevent them.

Diabetes

People with diabetes—especially people who don’t yet realize they have it—are at increased risk for dehydration. When levels of sugar in the blood are too high, the body tries to get rid off the excess glucose through increased urine output, says Robert Kominiarek, DO, a board-certified family physician in Ohio. All of those extra trips to the bathroom can be dehydrating. If you’re diabetic and suffer from frequent thirst or urination, talk to your doctor about how you can work together to improve your blood sugar control. And if you’re experiencing excessive thirst along with these other type 2 diabetes symptoms, it’s time to pay a visit to your doctor.

Your period

Is it that time of the month? Drink an extra glass of water. Estrogen and progesterone influence your body’s hydration levels, and when the two are roller-coastering, like when you’re in the throes of PMS, you may need to increase your fluid intake to stay hydrated, Dr. Kominiarek says. What’s more, for some women who have excessively heavy periods, the amount of blood lost is enough to deplete fluid levels, says OB-GYN Marielena Guerra, MD, of Elite OB/GYN in Florida. If you think the latter might be you, start counting your tampons. If you have to change them more than once every two hours, talk to your gyno.

Prescription meds

Check your prescription’s list of side effects. Many medications act as diuretics, upping your urine output and your risk for dehydration, Dr. Kominiarek says. Blood pressure medications are a common example. Plus, any drug that lists diarrhea or vomiting as a potential side effect could end up causing dehydration if you experience those side effects. If your prescription hits any of the above, increase your fluid intake.

Low-carb diets

Carbohydrates are stored in your body right along with fluids. That’s why you drop a couple pounds of water weight when you eliminate carbs. That might look good on your scale, sure, but it’s bad news for your hydration levels, says dietitian Jaime Mass, RD. Plus, since whole carbs such as oatmeal, whole grain pasta, and brown rice all soak up water during the cooking process, eating them can actually increase your hydration levels. Cut them from your diet and you could be unwittingly reducing your fluid intake, too.

Health.com: 6 ‘Bad’ Carbs That Are Actually Good for You

Stress

When you’re under stress, your adrenal glands pump out stress hormones. And if you’re constantly under pressure, eventually your adrenals become exhausted, causing an adrenal insufficiency, Dr. Kominiarek says. Problem is, the adrenals also produce the hormone aldosterone, which helps regulate your body’s levels of fluid and electrolytes. So as adrenal fatigue progresses, your body’s production of aldosterone drops, triggering dehydration and low electrolyte levels, he says. While increasing fluid intake can help in the short term, mediating your stressors is the only real long-term solution.

Irritable bowel syndrome

As if irritable bowel syndrome wasn’t terrible enough on its own, its symptoms (such as nausea and chronic diarrhea) can cause dehydration, Kominiarek says. What’s more, many people who suffer from this conditions place themselves on elimination diets to avoid what they believe may be trigger foods, Mass adds. If those diets nix any fluids or fluid-rich foods, they could end up further contributing to dehydration.

Your workout

We typically think of post-workout dehydration as a problem reserved for endurance athletes, but any time you break a sweat, be it an hour-long spin class or quick jog around the block, you’re losing water, Mass says. And, week after week, if you are sweating out more than you’re sipping, you could become dehydrated. Try this: Weigh yourself immediately before and after your workout. For every pound you’ve lost (the goal is not to!), drink 16 to 20 ounces of water, she suggests.

Pregnancy

Has your baby got you feeling bloated? Chances are your body is retaining water in an attempt to offset dehydration, Guerra says. During pregnancy, your overall blood volume and cardiac output increase, which can thereby increase your fluid requirements. What’s more, nausea and vomiting associated with morning sickness can also take their toll on hydration levels, she says. If you are suffering from morning sickness, don’t just accept it as a given. Talk to your doc about how to ease your symptoms.

Aging

As you age, your body’s ability to conserve water as well as its sensation for thirst declines, meaning it’s easier so become dehydrated and more difficult to tell when you’re fluids are low, says Mass. If you have trouble remembering to drink water throughout the day, try making a game of it. Keep a bottle of water near you at all times and, each day, keep a running total of how much you’ve consumed.

Health.com: 13 Everyday Habits That Are Aging You

Dietary supplements

Just because it’s “natural” doesn’t mean is can’t send your bladder into overdrive. For example, parsley, celery seed, dandelion, and watercress have all been shown to increase urine output, which could potentially lead to dehydration, Mass says. If you are thinking about taking a dietary supplement—or are already taking one—it’s best to speak with a nutritionist, primary care doctor, or naturopathic physician about any potential side effects.

High altitudes

When you travel to high altitudes, your body acclimates by speeding up your breathing as well as increasing your urine output. While both are necessary to a healthy adjustment to the altitude and its oxygen levels, constantly peeing and panting—which causes you to exhale more water vapor than usual—can cause dehydration.

Drinking alcohol

Forget hangovers. Even a well-behaved happy hour could deplete your fluid levels. Why? Because drinking makes you go to the bathroom. Alcohol inhibits an antidiuretic hormone that would normally send some of the fluid you’re consuming back into the body, and instead sends it to your bladder. Meanwhile, thanks to the diuretic effect of alcohol, your cells shrink, pushing more water out to your bladder. All this lowers your body’s hydration levels, Mass explains. What’s more, since alcohol impairs your ability to sense the early signs of dehydration—such as thirst and fatigue—it’s easy to drink well past your dehydration point.

Health.com: 15 Signs You May Have an Iron Deficiency

Eating too few fruits and vegetables

Filling half of your plate at each meal with produce can score you up to two extra cups of water a day. So, put another way, if you don’t eat your five-a-day, and don’t compensate (at least from a fluid perspective) by drinking extra water, you could easily wind up dehydrated.

Breastfeeding

Breastfeeding is all about moving water—not to mention electrolytes, proteins, minerals, and other ingredients—from mom’s body to baby’s. So of course it can lower your hydration levels, Dr. Guerra says. If you start to have trouble producing, increase your fluids and talk to your doc. It may be a sign of serious dehydration.

This article originally appeared on Health.com.

TIME Heart Disease

Women Diabetics Have More Heart Problems Than Men

Female diabetics are at higher risk of developing heart disease than males with the disease, and here’s why

Scientists led by Dr. Sanne Peters at the University of Cambridge report that when it comes to how type 2 diabetes affects men and women, the sexes are not created equal. Peters’ colleagues conducted an extensive survey of data going back 50 years, to 1966, that involved more than 858,000 people. While the risk of heart disease among diabetics is well known, the comprehensive study confirms smaller studies that hinted at a difference in risk between the genders.

Even after accounting for the fact that women tend to develop heart disease at different rates than men, the researchers report in Diabetologia that women with diabetes were 44% more likely to develop heart problems than men with the disease. Historically, women aren’t treated for heart risk factors as well as men, partly because their symptoms are different – many women don’t experience the chest pains and shortness of breath that are a hallmark of a heart attack among men, for example. So women may actually have more advanced, untreated heart disease when they are diagnosed with diabetes than men when they are diagnosed.

That suggests that screening for prediabetes in women may help to lower rates of heart disease, and ensuring that their diabetes symptoms are treated may also close the gap between heart disease rates in men and women.

TIME

Single Gene Responsible for Group of Heart Disease Risk Factors

It’s rare, but a genetic mutation may explain the collection of heart-harming factors, including obesity, known as metabolic syndrome

Researchers have been pretty successful at identifying individual genes that can contribute to obesity, diabetes, high blood pressure or high cholesterol levels. Having any—or a combination of these risk factors—can significantly increase the risk of heart disease and stroke.

But by studying three families whose members had higher than average rates of heart disease, diabetes and obesity, researchers zeroed in on a single gene, DYRK1B, that when mutated, can contribute to nearly all of these risk factors, which together are known as metabolic syndrome.

“Historically, there has been debate about the existence of metabolic syndrome. The question is, are the [risk factors] together coincidentally or are they here because the patient has a unifying [problem that explains them all],” says Dr. Ali Keramati, a resident in internal medicine at the Yale University School of Medicine. “This study shows that it’s possible for one patient to have all the risk factors that are all explained by one mutation.”

Normally, that gene is responsible for taking stem cells and turning them into fat or muscle, and for directing the liver to produce glucose to balance out insulin levels. In the aberrant form found among members of the three families, it became overactive, pushing the body to produce more fat cells, and driving the liver to pump out more glucose, raising blood sugar levels. The result is likely metabolic syndrome; family members with the mutated gene were more likely to be obese, have diabetes and early heart disease compared to those who did not.

For those who might think that their genes are to blame for their obesity, hypertension or diabetes, Keramati stresses that the mutation is rare, and likely only explains metabolic syndrome in a very small percentage of people. But for people who are affected, the good news is that a drug may help to control the hyperactivity of the gene. “It may be possible to develop a drug that knocks down the function of this gene,” he says.

And for the vast majority who don’t have the DYRK1B mutation, the finding may still lead to other drug treatments by improving doctors’ understanding of how various risk factors form the perfect storm of conditions for heart. In the meantime, the strongest ways to avoid metabolic syndrome are the most familiar – keeping weight, blood pressure, blood sugar and cholesterol levels under control with a healthy diet and plenty of exercise.

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