TIME Diet/Nutrition

How Soda Affects Kids’ Cholesterol Levels

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A new study pinpoints exactly how much drinking sugared beverages can affect cholesterol, which can contribute to heart disease and diabetes

The research is mounting that sugar-sweetened beverages are linked with health problems in adults, including type-2 diabetes, heart conditions and obesity. Now, in a study published in Journal of Nutrition, Maria Van Rompay, an instructor at the Friedman School of Nutrition Science and Policy at Tufts University, decided to focus on children 8 to 15—specifically the effect soda had on their cholesterol.

She and her colleagues took advantage of a large study involving nearly 700 children who answered questions about what they ate. They also had blood tests done at the start of the study and again a year later. Van Rompay and her team were particularly interested in seeing how the children’s soda intake was linked to their cholesterol levels, since previous studies suggested a connection between the carbohydrates found in sugars and fat levels such as cholesterol and triglycerides.

MORE: 7 Amazing Things That Happen to Your Body When You Give Up Soda

Children consuming more sugared drinks had higher levels of triglycerides, which are linked to a higher risk of heart disease, and when Van Rompay looked at children who changed the amount of sugared drinks they consumed over the year, she found that those who drank one serving less on average from the start to the end of the study showed higher levels of HDL, the good cholesterol that can protect against heart problems.

MORE: How Coke Is Subtly Blaming You for Obesity

That suggests the beverages do have an effect on the body, particularly on the balance between the amount of fat that is stored and the amount used as energy. “Dietary intake is one of the modifiable factors that can be targeted in helping to prevent disease,” she says. “Even a small change in one serving per week can be enough to have an effect on HDL,” she says. “So educating children about sugar-sweetened beverages and changing the amount they drink is something that feels manageable and can be done to improve the health status of our children.”

MORE: The Trouble With Sugar Free Kids

Van Rompay suspects that the reason she didn’t see differences in cholesterol levels when simply comparing children who drank more or less sugared drinks may have to do with differences in their starting levels of HDL. Many factors can affect HDL and LDL, of which diet is only one. Other contributors, such as genetics and ethnic backgrounds, may also play a role. In her multi-ethnic study, those with higher cholesterol levels and those with lower levels at the start may have had different cholesterol levels, but these effects might have canceled each other out, leaving little difference in the final outcome. “More research in racially and ethnically diverse samples to investigate sugar-sweetened beverages and blood lipids is needed,” she says.

MORE: Should I Drink Diet Soda?

TIME Heart Disease

Here’s How To Find Out Your Real Heart Age

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So much for being "young at heart"

The age on your birth certificate may say one thing, but the age of your heart is likely significantly older.

A new report from the U.S. Centers for Disease Control and Prevention (CDC) released on Tuesday reveals that three out of four Americans have a predicted heart age that’s older than their real age, which means they are at a greater risk for heart issues like attacks and strokes.

A person’s heart age is based on risk factors like blood pressure levels, whether they smoke and how much they weigh.

(Calculate your heart age here, if you’re between ages 30 and 74.)

In the new study, the researchers analyzed data collected from every state and from the Framingham Heart Study and estimated that about 69 million U.S. adults had a heart age older than their actual age. For men, the average heart age was about eight years older than their chronological age; for women, their hearts were an average of five years older than their real age.

MORE: This is the Worst Type of Fat for Your Heart

The researchers found some notable demographic differences. Heart age was highest among black men and women: black men had hearts three to four years older than white and Hispanic men, while black women had hearts five to seven years older than white and Hispanic women. Southern adults also had notably higher heart ages overall.

In the report, the study authors argue that heart age is a simple way to convey heart disease risk to their patients—one that might motivate Americans to adopt heart-protective lifestyle changes like quitting smoking, eating better or exercising more often.

TIME Careers

Science Says Working Long Hours Is Seriously Bad for Your Health

altrendo images—Getty Images/Altrendo

It's linked to stroke and coronary heart disease

Seriously: stop working so much, for your health’s sake.

A new study of 600,000 individuals in Australia, the United States, and Europe published in the Lancet, a United Kingdom-based medical journal, found that people who more more than 55 hours per week or more have a 33% greater risk of stroke and a 13% greater risk of coronary heart disease.

The study concludes that “more attention should be paid to the management of vascular risk factors in individuals who work long hours.”

The study is the largest so far to examine the relationship between working hours and cardiovascular health and is especially noteworthy because it points to stroke as a risk of working long hours. Earlier studies have linked heart attacks to excessive work.

There are critics of the study, though. Stephen Kopecky, a professor of medicine in the division of cardiology at the Mayo Clinic, told The New York Times, that the analysis did not fully account for the effects of cholesterol, family history, and blood pressure in all cases, so it is possible that long hours are not the only cause of the increased health risks.

TIME Heart Disease

Working Long Hours Could Increase Your Risk of Stroke and Heart Disease

The reasons might be connected to stress, physical inactivity, and higher alcohol consumption

Burning the candle at both ends might impress your boss, but you could be sacrificing your health in the process.

A study published in The Lancet on Wednesday finds a strong connection between people who work 55 or more hours per week and cardiovascular disease. Those who work such long hours were found to have a 33% increased risk of stroke and 13% greater chance of developing coronary heart disease compared to people who work the standard 35- to 40-hour work week.

Researchers from University College London reviewed 42 studies of hundreds of thousands of men and women from Europe, the U.S., and Australia for several years. Their results held even after controlling for demographic factors—age, sex, socioeconomic status—and health behaviors—like smoking, alcohol consumption, and physical activity.

Working overtime in general, even if it’s not the 55 hour maximum the group studied, also affects health outcomes negatively. Working between 41 to 48 hours led to a 10% increased risk of stroke and upping work hours to between 49 and 54 hours a week caused a 27% increased risk of stroke.

The authors aren’t sure exactly what the link is, but noted a few potential causes. For one, working long hours tends to be correlated with risky health behaviors, like drinking more alcohol or sitting for hours at a time. Those behaviors, combined with the stress associated with working overtime, could be a perfect recipe for a stroke or cardiovascular strain.

Read next: Want a Four-Day Workweek? Here’s How to Make it Happen

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TIME Diet/Nutrition

This Is the Worst Kind of Fat for Your Heart

High in fat
Mark Poprocki—Mark Poprocki

Not all fats are created equal, and the latest study shows that one in particular can lead to higher rates of heart disease, deaths from heart related problems, and diabetes.

As confusing as the diet message can be at times, one thing is clear. There are good fats and bad fats in the foods we eat, and some can really wreak havoc on the heart and its delicate vessels.

In a study published in the BMJ, scientists say that trans fats are linked to the highest rates of death from all causes, deaths from heart disease and heart problems. The trans fat risk surpassed even that associated with saturated fat, which is found in formerly taboo-for-the-heart foods like butter, eggs and red meat.

Russell de Souza, a dietician and epidemiologist from McMaster University, and his colleagues sifted through the published studies involving hundreds of thousands of participants on trans and saturated fats and their health effects. They found that those eating more trans fats had a 34% higher rate of dying from any cause compared to those eating less, a 28% higher risk of dying from heart disease, and a 21% greater risk of having heart-related health issues.

MORE: This Is Why FDA Is Banning Trans Fats

In contrast, eating saturated fat was not linked to a higher risk of early death, heart-related problems, stroke, or type 2 diabetes.

That doesn’t mean, however, that saturated fats now get a green light. de Souza points out that many people who try to cut back on saturated fats tend to substitute them with less healthy fats like those from margarine or with carbohydrates, which can contribute to heart disease. So while saturated fats when compared to trans fats did not substantially increase heart disease risk, that doesn’t mean saturated fats are actually heart healthy. It’s just that in the hierarchy of heart-friendly fats, trans fats are the worst and saturated fats are the next worst. “We didn’t find any evidence for increasing the allowable amount of saturated fat in the diet,” says de Souza.

MORE: Trans Fats Are Hiding All Over Your Grocery List

The group that showed the lowest risk of early death or heart disease were those who consumed the most vegetable oils such as olive and canola. “If there is one message to go away with from these results, it’s that substituting saturated and trans fats with whole grains and vegetable oils is a step in the right direction,” says de Souza.

The results, he says, support current dietary guidelines for how much of different types of fats people should eat to maintain healthy hearts and lower their risk of chronic diseases. For now, he says, the advice to consume no more than 10% of daily calories in saturated fat and to limit trans fats to less than 1% of calories, is reasonable.

TIME Heart Disease

Low-T Drugs and Heart Risk: Here’s the Latest

A new study published Tuesday suggests testosterone drugs for men with low levels of the hormone are not at an increased risk of developing atherosclerosis. However, other studies in the past have suggested an increased cardiovascular risk from using low-T drugs, and in 2015 the FDA finalized a decision that required companies to label their products with the possible risk for heart attack and stroke. So what’s the deal?

“One of the hottest controversies in testosterone therapy is whether it’s associated with cardiovascular risks, and whether there is a higher likelihood for strokes on testosterone,” says Dr. Landon Trost, head of Male Infertility and Andrology at Mayo Clinic, who was not involved in the new study. “Testosterone therapy has a myth and promise of being the fountain of youth, and it’s exploded since 2001. Everyone is trying to address [heart risks] right now.”

MORE: Manopause?! Aging, Insecurity and the $2 Billion Testosterone Industry

The new study, published in the journal JAMA, found that among men with low levels of testosterone, there was no difference in the rate of build up in their artery walls, known as atherosclerosis, between those who used testosterone gel for three years and those who took a placebo. (Ironically, the study authors also found no improvement in overall sexual function, partner intimacy, and health-related quality of life in the men who took low-T drugs, either.)

Still, the case is far from closed. The new research didn’t look at whether testosterone therapy is linked to more heart-related events like strokes, for instance. There is also the reality that many men taking low-T drugs do not, in fact, have clinically low levels of the hormone. What the drugs do in men with normal or high levels of the hormone is unknown.

The new paper also comes with plenty of caveats. It was funded by pharmaceutical companies that sell low-T treatments; one author works for a pharmaceutical company; another consults for Eli Lilly, which makes a low-T drug; and a third scientist has received research and personal fees from pharmaceutical companies, as well as having low-T-drug-related patents pending. (This was all in the mandatory “conflict of interest disclosures” section of study.)

As TIME reported in July 2014, some medical professionals have expressed concern over whether testosterone products are safe or if they even revitalize men like they promise to. Trost, for his part, says he gives patients the evidence and lets them make their own decisions, though he believes the research leans toward safety.

More research is needed.

TIME Heart Disease

5 Recipes That Prove Southern Food Can Be Healthy

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New research suggests a Southern diet may not be good for the heart, so we've rounded up some lighter versions of favorite recipes

A new study suggests eating a Southern-style diet can increase a person’s risk for heart disease.

The new findings, published Monday in the journal Circulation, show that people who regularly consume a diet that’s filled with traditionally Southern fare were at a greater risk of experiencing a heart-related event like a heart attack or heart-related death within around six years of follow-up. In fact, people who ate a lot of Southern cuisine had a 56% greater risk for heart disease compared to people who ate less.

The researchers analyzed data from a longitudinal study of 17,418 people in their 40s between 2003 to 2007. Given the nature of the study, the researchers cannot determine with certainty that a Southern diet alone was responsible for the increased risk of heart-related issues. However, earlier research has shown that processed meat, fried food and sweetened beverages are associated with greater risks of cardiovascular disease.

For those who have no intention of giving up their favorite Southern cuisine staples, we’ve rounded up five “lighter” takes on recipes from our friends at Cooking Light. Bon appétit!

TIME Diet/Nutrition

The Intriguing Link Between Spicy Food and a Longer Life

Spicy chili, Salento, Apulia, Italy in March 2014.
DeAgostini—Getty Images Spicy chili, Salento, Apulia, Italy in March 2014.

People who love chili peppers might be eating their way to a longer life, according to a new study published in The BMJ.

“We know something about the beneficial effects of spicy foods basically from animal studies and very small-sized human studies,” says study author Lu Qi, associate professor at the Harvard School of Public Health. Some of those preliminary studies have found that spicy food and their active components—like capsaicin, the compound found in chili peppers—might lower inflammation, improve metabolic status and have a positive effect on gut bacteria and weight, he says.

But human evidence remains scant. So Qi and a team of researchers looked at questionnaire data from about half a million adults all across China who participated in the China Kadoorie Biobank study between 2004-2008. Each person in the study reported their health status, alcohol consumption, spicy food consumption, main source of chili intake (fresh or dried, in a sauce or in an oil) as well as meat and vegetable consumption.

The researchers followed up with them about seven years later. Compared to people who ate spicy foods less than once a week, people who ate them just once or twice a week had a 10% reduced risk of death. Bumping up the spice consumption didn’t make much of a difference; those who ate spicy food 3-7 days a week were at 14% reduced risk of death compared to the most spice-averse group.

Eating chili-rich spicy foods was also linked to a lower risk of death from certain diseases, including cancer, ischemic heart diseases and respiratory diseases, they found. Further analysis revealed that fresh chili had a stronger protective effect against death from those diseases.

More research is needed to make any causal case for the protective effects of chili—this does not prove that the spicy foods were the reason for the health outcomes—but Qi finds this observational research valuable. “It appears that increasing your intake moderately, just to 1-2 or 3-5 times a week, shows very similar protective effect,” he says. “Just increase moderately. That’s maybe enough.”

MORE: 3 Reasons You Should Eat More Spicy Food

TIME Heart Disease

Here’s How Much You Should Stand Each Day

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More evidence suggests getting off your seat and moving around is good for your health

We know that the amount of time we spend sitting each day wreaks havoc on our health, and in a new paper, researchers show that spending just two hours standing or moving around instead of sitting may have a real positive impact on our health.

In the new study published Thursday in the European Heart Journal, researchers had 782 men and women wear activity trackers 24 hours a day for seven days. The monitors tracked how much time the men and women spent stepping, sitting, standing, sleeping or lying down. The participants also provided blood samples and other measurements like blood pressure and weight.

With the data gathered from the trackers, the researchers used a mathematical model to estimate how the allotted time in each condition would impact the men and women’s health. Interestingly, they found that spending two extra hours a day standing instead of sitting was linked to better blood sugar levels and lower levels of fat in the blood (triglycerides). Specifically, more time spent standing was associated with a 2% lower average blood sugar levels and a 11% lower levels of triglycerides. Cholesterol levels showed improvement as well.

The findings also showed that spending an extra two hours moving instead of sitting was linked to a significant lower body mass index (BMI) and waist circumference.

The study cannot definitely prove that these tweaks to the amount of time spent sitting directly causes improvements in health markers, but the researchers note that the findings do fall in line with what’s known about the impact on the body of being active (or at least not being sedentary).

More research is still needed, but the findings support the longstanding advice that moving around is better for our health than lounging around, and suggest that any decisions to purchase a standing desk are not made in vain.

TIME heart

This New FDA-Approved Cholesterol Drug Is a Game Changer

The FDA approved the first of a new class of drugs for treating high cholesterol. Here’s the story of how researchers went from a DNA mutation to a drug in 10 years

On Friday, the U.S. Food and Drug Administration (FDA) approved the first new class of cholesterol-lowering drugs since the statins flooded the market beginning in the 1980s. Similar to the way statins work, by binding up cholesterol made in the liver so less of it circulates in the blood, this new class, called PCSK-9 inhibitors, takes advantage of genetic mutations that regulate the level of LDL receptors in the liver. Less PCSK9 leads to more LDL receptors that can soak up LDL and therefore leave less cholesterol in the blood.

The FDA approved alirocumab (Praluent), an injectable drug made by Sanofi and Regeneron, in people with familial hypercholesterolemia, a genetic condition in which cholesterol levels are high, or those with a history of heart disease who can’t reduce their LDL levels enough with existing statin drugs. (Another PCSK9 inhibitor, evolocumab (Repatha) developed by Amgen, received approval in Europe but won’t be evaluated by the U.S. FDA until the end of August.)

MORE: The Next Big Drug to Treat Heart Disease

While PCSK9 drugs help to lower cholesterol, the story of how these medications developed began in a French family with the opposite problem. Their members had exceptionally high levels of LDL and greater than average rates of heart disease. But unlike others with similar cholesterol problems, this family did not have the usual mutations in cholesterol-regulating genes. Instead, French researchers studying them in 2003 found they had aberrations in PCSK9, a gene that produces a protein found primarily in the liver, kidneys and intestines.

An ocean and half a continent away, Jonathan Cohen and Dr. Helen Hobbs at the University of Texas, Southwestern Medical Center in Dallas (coincidentally the same institute where scientists discovered LDL, or the heart-disease contributing cholesterol and earned the Nobel Prize for their work), read the description of PSCK9 and wondered whether those with lower levels of PCSK9 would show the opposite effect of the French family and actually enjoy decreases in levels of LDL in the blood.

MORE: New Class of Cholesterol Drugs Shows Promise For Heart Disease

Cohen and Hobbs were involved in a large heart disease study involving nearly 15,000 participants, and decided to look for the PCSK9 mutations among their participants. They homed in on those with the highest and lowest levels of LDL cholesterol, and sequenced their genomes to see if any patterns emerged. Sure enough, they found 33 people whose LDL levels were about 40% lower than average and who shared mutations that effectively silenced PCSK9. Essentially, their LDL amounts were about the same as those who relied on statins to drop their cholesterol.

These PCSK9 mutations associated with the lowest LDL appeared predominantly in African-American participants. Those with one copy of the mutation in this gene showed an 88% lower risk of heart disease. Another mutation in the same PCSK9 gene that appeared more commonly in whites had the same effect, but to a lesser extent, dropping LDL by 15% and the risk of heart events by 47%.

“The results were quite compelling,” says Cohen, who published the findings along with his colleagues in the New England Journal of Medicine (NEJM) in 2006. “They told us that PCSK9 was likely an attractive therapeutic target.” Even more encouraging, in all of the people with the mutations and lower LDL levels, there didn’t seem to be any significant side effects. For all intents and purposes, these participants were healthy and had the added advantage of being at very low risk of heart disease.

To confirm this, Cohen searched for anyone in the study with two copies of the mutation, to see if having double the effect would trigger any adverse events. He found one woman, a 32 year old daughter of one of the participants, who had two different mutations in each of the PCSK9 copies she inherited from her mother and father. The result? An LDL of 14 and no other health problems. “If you measure the amount of PCSK9 in her blood, it’s basically absent, you can’t see any,” says Cohen. That contributed to an unprecedented low level of LDL cholesterol as well.

So far, he says, only one other individual has been described with two mutant copies of PCSK9, a 21 year old woman living in south Africa with an LDL of 20.

Those descriptions piqued the interest of researchers at Regeneron, a biotech company that specializes in turning genetic discoveries like this one into drugs. To confirm and better understand the effects of PCSK9, researchers there studied the effect of human versions of PCSK9 in mice, and then began trials of antibodies they developed that inhibit the function of this gene, much like the mutations do, in several thousand people.

Those results, published in the NEJM last April, showed that PCSK9 inhibitors can lower LDL cholesterol by an additional 60% on average beyond that achieved by statins. Those findings formed the basis of the companies’ application to the FDA for approval of these first-in-class drugs.

For now, the agency says the drugs should only be prescribed to people with familial hypercholesterolemia, or those who have failed to reduce their LDL levels sufficiently using statins. For many, the new drugs will be taken in combination with statins and a heart-healthy diet. But doctors say they anticipate many patients outside of these groups, who have family histories of heart disease or other risk factors, such as hypertension or diabetes, may start asking about the medications. For them, doctors will have to weigh how well they are doing on statins before considering adding a PCSK9 inhibitor.

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