TIME global health

The 20 Best and Worst Health News Stories of 2014

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Wins, fails, and sensational headlines in medicine and public health

As far as sensational headlines go, the past 12 months provided no shortage of health-related material. Of course, 2014 had its share of doom-and-gloom stories about depression, domestic violence, untimely deaths, and disease outbreaks (at home and abroad), to name a few. But it also gave us reasons to celebrate: Promising new discoveries and legislation, inspiring role models and worthy causes, and healthy trends that are improving lives and changing the future. Here, in a nutshell, are the best and worst health stories of the year.

Best: Obamacare hits one-year milestone

Despite its rocky beginnings in 2013 (and the fact that many Americans still don’t understand it), the Affordable Care Act achieved several of its major goals in its first year, according to a study published in July by the Commonwealth Fund. The report found that the number of uninsured Americans dropped by 25% and that most people like their new plans and find it easier to find a doctor.

Separate studies this year also found that the ACA, also known as Obamacare, has helped young adults receive mental health treatment and could potentially lead to a decline in deaths.

Worst: Ebola outbreak in Africa (and freakout in America)

By far the biggest and most devastating health story this year has been the thousands of West Africans sickened and killed by the Ebola virus, which hit the areas of Liberia, Guinea, and Sierra Leone particularly hard.

And although the virus can only be spread through contact with bodily fluids—and despite the fact that no American has yet contracted Ebola who has not spent time treating patients with the disease—that didn’t stop hysteria in the United States. Amid calls for a travel ban and anger directed toward doctors and nurses returning home from Africa, mental health experts stated in October that anxiety about Ebola was now a bigger threat than the virus itself.

Best: Medical devices lose some of their stigma

Women who enter beauty pageants and pose for Internet selfies are often seen as vain and materialistic, but in 2014 two women fought to dispel those notions, while at the same time showcased health conditions that aren’t often seen as beautiful.

In July, Miss Idaho contestant (and eventual winner) Sierra Sandison wore an insulin pump she uses to treat her Type 1 diabetes clipped to her swimsuit during a competition. One month earlier, UK resident and Crohn’s disease sufferer Brittany Townsend had shared her own bikini photo on Facebook, complete with the colostomy bags she needs to remove waste from her body. Both photos went viral, sending messages that women like Sandison and Townsend don’t have to be ashamed.

Worst: Measles outbreak fueled by anti-vaccinators

The CDC reported in May that measles cases in the United States were at a 20-year high so far this year, largely due to unvaccinated people who contracted disease while traveling abroad and then returned home and spread it among unvaccinated members of their communities.

The number of parents who choose not to vaccinate their children in the United States is growing, despite a scientific consensus that childhood vaccines are safe and don’t cause serious health problems like autism or leukemia. Unvaccinated children have also contributed to recent outbreaks of whooping cough and mumps.

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Best: CVS stops selling cigarettes; FDA limits e-cigs

Customers can no longer pick up cigarettes along with their prescriptions at CVS pharmacies, thanks to a ban in all stores implemented in September—four weeks earlier than the date the chain had originally announced. Carnival Cruise lines also jumped on the bandwagon this year, banning smoking on its stateroom balconies in October.

E-cigarettes have seen plenty of regulations this year as well. In April, the FDA proposed regulations to ban the sale of electronic cigarettes to minors and to include health warnings on their packages, and in August, the World Health Organization recommended that countries regulate electronic cigarettes and ban their indoor use.

Worst: Enterovirus outbreak hits children nationwide

At last count, a severe respiratory illness called Enterovirus D68 has been reported in 43 states and the District of Columbia. More than 500 cases have been confirmed across the United States, mostly children, with four suspected deaths (and one confirmed).

ED68 has been described as a polio-like illness that can cause paralysis. Most infected children recover without serious illness, but those with lung conditions like asthma are at increased risk for severe symptoms.

Best: Orthorexia gets mainstream coverage

Being a diligently healthy eater may seem like a good problem to have, but a prominent blogger showed fans this year what can happen when it’s taken to an unhealthy extreme. Jordan Younger, also known as The Blonde Vegan, announced to her readers in June that she was moving away from her strict vegan lifestyle because she’d developed an eating disorder called orthorexia—an obsession with healthy foods that leads to more and more restrictions and, potentially, malnourishment.

Worst: Domestic violence rears its ugly head

The topic of domestic violence made national headlines this year when then-NFL player Ray Rice punched his then-fiancee (now wife) in an elevator; investigations since then have uncovered many more instances of spousal or partner abuse among professional football players, and cover-ups among their teams.

But a survey released in September revealed that one in five American men admits to using violence against his spouse or partner, and that domestic abuse affects people of all professions, races, and classes. A study in April also found that domestic violence can cause fear and anxiety for children who witness it, hear it, or see the resulting injuries.

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Best: Science gets wise to the dangers of sugar, white bread

Doctors and nutritionists have known for decades that added sugar is linked to diabetes and heart disease, but a study published in February really hammered home just how dangerous it can be: The average American diet contains enough added sugar to increase the risk of heart-related death by nearly 20%, reported researchers from the Centers for Disease Control and Prevention.

The health risks of white bread were exposed this year, as well: People who eat two or more servings of the refined stuff a day are more likely to become overweight or obese than those who eat less or who favor whole-grain bread, according to a Spanish study presented in May.

Worst: ‘Biggest Loser’ winner reveals shocking weight loss

When The Biggest Loser contestant Rachel Frederickson surprised viewers with her 155-pound weight loss during the show’s Season 15 finale, not everyone was pleased. Viewers expressed alarm on social media about Frederickson being too skinny, and even the show’s trainers Bob Harper and Jillian Michaels were visibly shocked at her transformation.

Frederickson has since gained back 20 pounds and found her ’perfect weight,’ but the incident seems to have had at least one permanent impact: In April, People reported that Michaels wanted to distance herself from the show because of concern for the participants’ health and wellbeing, and in June, NBC announced that Michaels would not be returning. The celebrity trainer later revealed that the show’s producers weren’t willing to make certain changes she’d requested to the show’s format.

Best: Food labels are changing for the better

The “nutrition facts” box on food packages should soon become easier to understand, thanks to a makeover first proposed by the Food and Drug Administration in February. Under the new guidelines, serving sizes will be more straightforward, calorie counts highlighted more prominently, and “daily values” for nutrients will be revised.

Some food companies have spoken out against part of the proposal that would require “added sugars” to be included on nutrition labels, but a Change.org petition submitted by the American Heart Association in November showed that public support for the measure is still strong.

It’s not yet clear if or when these measures will be put into place, but one major food-label change did happen in 2014: Beginning in August, foods can only be labeled gluten-free if they truly are free of gluten—a major win for anyone with celiac disease or gluten intolerance.

Worst: Smartphones and social media are making us sick

We can’t live without it—but more and more research is suggesting that if we’re not careful, personal technology can really mess with our health. Facebook makes us jealous of our friends and self-conscious of our bodies, texting gives us bad posture, and just having a smartphone in the same room can affect our parenting skills.

No one’s quite figured out the solution to these problems yet, but people are certainly trying; there’s no shortage of writers going on ‘digital detoxes’ and reporting back what they’ve learned. Meanwhile, a new technology-related health risk surfaced this year, as well: A paper published in October describes a man who became addicted to Google Glass.

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Best: Ice Bucket Challenge raises millions for ALS

You probably got tired of seeing the videos in your Facebook feed, but the truth is they worked: Since the Ice Bucket Challenge exploded onto the social-media scene in July, ALS nonprofits and research organizations have received more than $100 million in donations.

Amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, is a fatal neurodegenerative disease with no cure, but ALS researchers are hoping to change that. Nancy Frates, whose son Pete dreamed up the Ice Bucket Challenge after his own ALS diagnosis in 2012, recently shared in a TED Talk how clinical trials have been fast-tracked thanks to funding from the Challenge.

Worst: Robin Williams commits suicide after Parkinson’s diagnosis

America lost one of its most beloved actors in August when Robin Williams took his own life after years of struggling with depression. After his death, Williams’ wife revealed he had also recently been diagnosed with Parkinson’s disease, and an autopsy revealed his brain showed signs of Lewy Body Disease, a form of dementia that can cause hallucinations and concentration problems.

Although it’s not confirmed that these conditions played a role in Williams’ suicide, his death has shed light on several disorders that are often linked and frequently misdiagnosed or understood.

Best: Ninja warrior, curvy ballerina become unlikely fitness stars

When it comes to athlete role models, girls now have more than just soccer players and ice skaters to look up to. In July, Kacy Catanzaro became the first female contestant to reach the finals of NBC’s fitness competition American Ninja Warrior. Catanzaro made the challenging course look easy, and her victory sparked a #MightyKacy Twitter hashtag that trended worldwide.

Then in August, UnderArmour introduced us to its newest spokesperson, American Ballet Theater soloist Misty Copeland. The brand’s first commercial starring the dancer—about how she triumphed over negativity after being told she lacked the right body and was too old to become a ballerina—has more than 6 million views on YouTube, and has been called stunning, mesmerizing, and jaw-dropping.

Worst: Joan Rivers’ death raises questions about surgery safety

Comedian Joan Rivers was known for her irreverent humor, her biting fashion critiques, and perhaps most famously, her self-proclaimed obsession with plastic surgery. She went under the knife frequently, always pushing the boundaries of what it meant to age healthfully and happily.

But when the 81-year-old stopped breathing during what should have been a routine throat procedure in September (her family eventually took her off life support), her death sparked a new controversy: whether her doctors were to blame—especially after it was suggested that her surgeon took a selfie with an unconscious Rivers before the operation. In November, TMZ reported that staff members did not weigh Rivers before sedating her, potentially giving her too much medication.

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Best: ‘Angelina effect’ increases rates of genetic testing

Actress Angelina Jolie made headlines in 2013 when she had a preventative double mastectomy after testing positive for the BRCA1 gene. But the effects of her decision had wide implications in the months that followed. In September, Canadian cancer researchers revealed that the number of women seeking genetic counseling and testing at their center rose dramatically after Jolie’s announcement.

Although cancer doctors caution that not every woman should be tested, most agree that extra education and awareness is certainly a good thing. Luckily, the increase in genetic testing is coming from women who actually do have a higher risk for breast cancer, and who will get the most benefit from what they might learn.

Worst: Antibiotics still being overprescribed

Despite warnings to physicians about the overuse of antibiotics, the drugs are still being prescribed when they’re not needed. Pediatricians, for example, dole out antibiotics twice as often as needed for throat and ear infections, found a study published in September. Researchers also discovered this year that doctors are more likely to prescribe unnecessary antibiotics later in the afternoon, as their decision-making skills wear down throughout the day.

Regardless of when it’s happening, the consequences could be deadly: Misuse of antibiotics fuels the growth of drug-resistant bacteria, reported the Centers for Disease Control and Prevention in March, as it outlined new recommendations to keep the drugs from being overused in hospitals.

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Best: Air quality is improving in U.S. cities

The Environmental Protection Agency shared some good news in August: The air in American cities has become significantly cleaner since 1990, with major reductions in levels of mercury, benzene, and lead. About 3 million tons per year of pollutants have also been reduced from cars and trucks, as well.

More good news for your lungs: in November, the United States announced a climate change agreement with China that aims to cut both countries’ greenhouse gas emissions by nearly a third over the next 20 years. In announcing the deal, President Obama said he hopes other nations will be inspired to make positive environmental changes, as well.

Worst: Internet flips out over Renee Zellweger’s face

As far as celebrity scandals go, Renee Zellweger’s appearance on the red carpet in October shouldn’t be anywhere near the top of this year’s list, but you’d never know it judging by the reactions she received on Twitter and in the media.

The 45-year-old actress attended an awards ceremony meant to honor the work of talented women in Hollywood, but all anyone could talk about was how different her face looked and whether she’d had plastic surgery or just, well, gotten old. Zellweger spoke out the following week, telling People that she’s glad people noticed her new look, adding, “I am healthy. For a long time I wasn’t doing such a good job with that.”

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This article originally appeared on Health.com.

TIME Diet/Nutrition

The Truth About Fat

When you want to lose weight or get healthy, what is the first thing you would normally cut from your diet? If you said fat, you’re not alone.

For years, the advice from the USDA has been to reduce the level of saturated fat in your diet, in order to lower your overall cholesterol. However, a new meta-analysis published in the Annals of Internal Medicine has thrown that whole approach in to question.

The removal of fats from our diet has led to an increase in consumption of carbohydrates and processed low-fat alternatives, which has contributed to record levels of diabetes and obesity.

When you consider that most low-fat or non-fat products are laden with salts, sugars and preservatives, continuing to seek out fat-free alternatives could be doing you more harm than good.

MORE: Give (Frozen) Peas a Chance–and Carrots Too

MORE: The Oz Diet

MORE: Further Reading On Fat

TIME Health Fad

Health Fad of the Week: Kids Are Doing Juice Cleanses Now, Too

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Martin Barraud—Getty Images/OJO Images RF

Children used to turn up their noses at spinach, but now they're reportedly begging for kale juice.

When it comes to the latest and greatest in health and fitness, there’s always something new to try. Some trends are more legit than others, while others can’t be backed by any science whatsoever. And then there’s everything else in between. After far too many face palms, eye rolls, and serious questions about fads that sound too good to be true, we’ve decided to start a series that puts these health fads under a microscope.

Not only does it seem like the juice cleanse fad is still going strong–despite its questionable nutritional benefits–kids are now jumping on the trend bandwagon, according to a recent article from the New York Post.

“I have to buy extra because I know she’s going to take it,” Sandra Davella, a 44-year-old banker, tells the Post about her 6-year-old daughter and “junior juicer” Sofia. “If I’m doing a three-day cleanse and I order for her, she goes [to the bathroom] every day.”

While the Post doesn’t offer numbers on how many kids are adopting this adult dieting habit, there are a few cleanse companies that cater specifically to children. California-based company Dherbs.com sells a set of four Children’s Cleanse liquid extracts for $99. Consumed with a raw diet, they company claims it cleanses the entire body. The package is meant for kids ages 2 to 12, and can be customized for up to 14 days.

“For adults and kids alike who are trying to lose weight, these raw and organic drinks are a great kick-starter,” Stephanie Walczak, founder of Rawpothecary, a New York City-based health food company, tells the Post.

So is it better that kids are reaching for these juice cleanses over the sugary stuff? When it comes to juice cleanses and the “juicing” trend, there’s a spectrum for safety. Many of these juices are in fact healthier than sugary beverages, since they’re purely blended vegetables and fruit, with no additional ingredients. The benefits are less so when, as in many juicing methods, the juice is extracted, stripping the fruits and veggies of their natural fiber. Even so, they can provide a nutritional benefit and be part of a well-balanced diet.

The trouble is when people, children especially, use them as meal replacements, for which no juice is adequate. “There’s nothing wrong with a child having these as a beverage,” says registered dietitian Keri Gans. “When they step over the line and use it as a cleanse, that’s when it gets insane.” A growing child won’t get their full nutrition from a juice; not even adults will. There’s also the possibility that a young juicing habit can set the stage early for disordered eating, says Gans.

It’s no secret that cleanses aren’t the best source of nutrition or a weight-loss strategy. People typically lose water weight on a cleanse, but quickly gain it back when they re-introduce solid foods. As for those who argue that cleanses detoxify the body, that job should be left to one’s liver.

Children are, of course, susceptible to mimicking their behavior after the adults around them. But what’s the excuse or adults who continue to adopt, and spend hundreds on, trends that have little evidence to support them?

Let’s turn to some brand and psychology experts. Douglas Van Praet, author of Unconscious Branding: How Neuroscience Can Empower (and Inspire) Marketing, points out that we tend to make decisions based on emotional associations rather than logical ones. “In the case of adults, [the decision to cleanse] is often driven by the desire to be thin, and that’s so strong it flies in the face of logical analysis,” he says.

“We are very swayed by specific situations,” says Arthur Markman, professor of psychology at the University of Texas at Austin. “Your friend may say they did a juice cleanse and felt great after. Even though that’s only one person telling an anecdote, it’s very specific and we are often driven by specific situations. It doesn’t necessarily need to be someone you know,” he says. Think weight-loss ads and celebrity endorsements.

That goes for other health myths people cling to, like anti-vaccination. “There’s no compelling evidence that vaccines are causing autism, and yet you find a significant number of people who are making the argument on the basis of anecdotes,” says Markman, who notes that evidence is sometimes just too abstract for many to understand.

Often, those who claim they don’t partake in juice cleanses for weight loss say they just “feel better” and “have more energy.” While it’s hard to argue with someone’s personal experience, Gans says it does need to be put into perspective. “What were they eating before?” she asks. Cleanses typically come after an overindulgent weekend. And don’t forgot the placebo effect. Often, a benign activity can make us feel better simply because we think it should.

But if none of that can convince people of the empty promises of a juice cleanse, maybe the bottom line will: “They’re expensive, up to $80 a day,” says Davella. And if your children want in on it too, keep multiplying that number and maybe the evidence will finally add up.

TIME Health Fad

Health Fad of the Week: The Real Scoop on the Ice Cream Cleanse

People have reported losing weight after eating five pints of ice cream for four days straight. Can it really be true?

When it comes to the latest and greatest in health and fitness, there’s always something new to try. Some trends are more legit than others, while others can’t be backed by any science whatsoever. And then there’s everything else in between. After far too many face palms, eye rolls, and serious questions about fads that sound too good to be true, we’ve decided to start a series that puts these health fads under a microscope.

(Above: Kippy’s Master Cleanse ice cream: lemon, cayenne pepper, honey. Via Instagram.)

Our first deep dive is into the world of the Ice Cream Cleanse, which Brent Rose at Gizmodo and his anonymous girlfriend tried–and lived to write about. They even lost weight, as did another writer at Splash Magazine who tried the creamy diet.

When I heard about an ice cream cleanse–eating five pints of ice cream a day over four days–I thought it had to be a joke (but secretly hoped it wasn’t). Unfortunately, I live very far from Venice, California, home to Kippy’s and the geniuses behind the fad, so trying it didn’t actually come to fruition. I did however, have a nice long chat with the two women who developed it, raw ice cream connoisseur Kippy Miller and yogi Guru Jagat.

Miller has been making raw ice cream and selling it to vendors like Whole Foods for five years. She opened Kippy’s Ice Cream Shop in Venice this past July. The ice cream is 100% raw (meaning nothing is heated or cooked), organic, and vegan. Miller imports coconuts from Mexico and ferments them for five days, turning them into a coconut yogurt. She then sweetens the yogurt with raw honey. “You’re getting a probiotic and a raw fat,” Miller says. “We need more raw products to replenish our gut and help our digestion and our immune system.”

Right next door to Kippy’s is RA MA Institute, a Kundalini yoga studio led by Guru Jagat, Miller’s cleanse co-creator. Kundalini yoga is sometimes referred to as “the yoga of awareness” and is meant to work the body, mind, and spirit. The ice cream diet follows a strict regiment of Kundalini (which Gizmodo writer Rose didn’t follow, Miller points out). “It’s a double whammy of detoxification,” Miller claims, even better than the effects she’s seen when the ice cream diet is coupled with Bikram yoga.

The cleanse starts with a raw coconut cream flavor in the morning, followed by an orange creamsicle, then dark chocolate with Himalayan sea salt, “master cleanse” (lemon and cayenne), and finally “super food” (bee pollen, cinnamon, raw honey). Each pint of ice cream serves a specific purpose. For example, the vitamin C from the orange eaten with a fat like ice cream means the body absorbs more nutrients, and the sea salt provides the body with iodine that’s good for the thyroid.

Jagat and Miller say the cleanse will detoxify your organs. “Day one, we are starting with the colon and the lower intestine,” Jagat says. “The first day we work specifically to loosen up anything that’s lodged in there. Most people are dealing with some level of constipation, so we do colon and low-intestine type work.”

“Raw coconut cream along with the exercises of yoga–to be blunt–takes old fecal matter and plaque out of colon” Miller adds.

Rose and his girlfriend definitely noticed some intestinal rumblings on their first day:

And then, suddenly, Poopintimes! I don’t know if it was the salt or just the accumulated saturated fat, but it was like, “Hey! You need to go, like, now!” Not emergency style, but it was definitely assertive. It wasn’t horrible or acidic, but it was a long way from solid. Is this why they call it a cleanse? Girlfriend reported that she was in the same boat.

Hence, the weight loss results.

Kippy’s ice cream is unsurprisingly packed with saturated fat: 32 grams in a pint of Truly Raw Coconut. And remember, ice cream cleansers are consuming five pints in a single day, so that’s about 160 grams a day–820% of your recommended daily amount of saturated fat. Miller points out that there is significantly less honey in her cleanse pints than in their dessert flavors.

(Above: Kundalini Yoga. Via Instagram.)

I called up nutritionist Keri Gans, author of The Small Change Diet, to help sort fact from fiction with this ice cream cleanse. She was skeptical at best. “There’s inconclusive evidence about the health benefits of the fat from coconut. However, it is rich in saturated fat, and saturated fat is linked to heart disease, plain and simple,” Gans says. Some experts argue that not all saturated fat is created equal, and that coconuts and coconut oil have great benefits. But it’s a matter that’s still up for debate.

Here’s how Kippy’s other claims break down:

The raw honey (different from heated honey) used to sweeten the ice cream offers amino acids and living enzymes.

Honey is still sugar, and that just means extra calories, says Gans. It’s also considered added sugar, not natural, which makes a difference. “Is there a little value to honey? Yes, but the bottom line is that it’s sugar just by a different name.”

Fat solubility helps your body more efficiently absorb nutrients in the ice cream.

While true that you need fat to better absorb fat-soluble vitamins, there are none to be found in coconut. “Coconut has water-soluble vitamins like vitamin C and B vitamins. So, yes, fat does help absorb fat-soluble vitamins, like A, E, K, but I could not find that coconut is a good source of these,” Gans says.

Your body will release heavy metals, plastics, and other toxins during the cleanse.

Our liver is constantly working to detox our body. “It filters our blood every single day and removes toxins from it,” says Gans. We don’t need cleanses to do this for us.

Final Verdict:

Alas, eating ice cream–even the raw and vegan kind–to lose weight and clear your system is too good to be true. “I won’t doubt is that it might taste very good and not seem like torture,” says Gans. But just because you might not feel terrible after the first round, doesn’t mean you should try it again. “Four days, ok, not the end of the world. But we all know that with the cleanses, if people see success, they keep going.”

Updated March 20, 2014, 11:36 p.m.

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