TIME Heart Disease

How Much Alcohol Is Too Much? A New Study Has Answers

Alcohol, at least in moderation, can help the heart, but too much can be toxic. The latest study tells you where to draw the line

For decades, there’s been a steady line of literature welcomed by anyone who enjoys a regular drink or two: that moderate drinking can actually protect you from having a heart attack by keeping your vessels clear and relatively plaque-free. But there’s another set of data that shows too much alcohol can start to poison the heart. So where does the line between good-for-you and bad-for-you lie?

Researchers led by Dr. Scott Solomon, professor of medicine at Harvard Medical School and director of non-invasive cardiology at Brigham and Women’s Hospital, and his colleagues provide some clues Tuesday in their latest report in the journal Circulation: Cardiovascular Imaging. The scientists combed through data collected from 4,466 elderly people about their alcohol consumption. They also agreed to echocardiograms of their hearts. Solomon wanted to see if there were any changes in the structure of the heart that had anything to do with how much the volunteers reported they drank each week.

MORE: Should Alcohol Be Forced to List Calories?

The not-so-good news: The more the participants drank, the more likely they showed abnormal changes in their heart structure and function. In men, the changes started accumulating after more than two drinks per day, or 14 or more drinks a week. In these men, the pumping chambers of their hearts increased slightly compared to those in non drinkers, a sign that the heart had to work harder to pump the same amount of blood, which can cause it enlarge and weaken. In women, these changes appeared when women drank much less, just above the one drink a day. In addition, among the women who imbibed more than a drink a day, the scientists found slight drops in heart function compared to women who drank less.

“A little bit of alcohol may be beneficial, but too much is clearly going to be toxic,” says Solomon. “Once you get beyond two drinks a day in men, you get into the realm where you start to see subtle evidence of cardiotoxic effects on the heart that might over the long term lead to problems. And that threshold might be lower in women.”

The study provides valuable information about how alcohol affects the heart, and how much alcohol exposure can trigger changes to the heart’s structure and more importantly, how it functions. But where the tipping point lies with each individual between the benefits and harms of a having a few drinks isn’t clear yet. More studies investigating which genetic factors may predispose people, and in particular women, to the toxic effects of alcohol will need to done before more refined advice about how much is too much can be discussed.

Those investigations might start with potential differences in the way men and women process alcohol. The effects Solomon and his team saw remained strong even after they adjusted for body mass index, and other studies have hinted, for example, that the different hormone environments in men and women might be responsible for the increased vulnerability of women’s heart tissues to the toxic effects of alcohol.

Future work may also delve deeper into the question of how long people drink; like any exposure, the effects of alcohol may also be cumulative. Because the participants in the study were relatively elderly, with an average age of 76, their heart changes reflected decades of exposure to alcohol but it’s not clear whether there is a threshold for when the harmful effects dominate over the potentially beneficial ones.

“What is clear is that at more than two drinks a day is the point at which we start to think we are beyond the safe level for men, and with women, it’s likely to be even lower than that,” says Solomon.

TIME Obesity

‘Thrifty’ Metabolisms May Make It Harder to Lose Weight

File photo dated Thursday October 16, 2014. of a young girl using a set of weighing scales as slimmers should forget what they have been told about avoiding rapid weight loss in favour of slow but sure dieting, according to new research.
Chris Radburn—PA Wire/Press Association Images File photo dated Thursday October 16, 2014. of a young girl using a set of weighing scales as slimmers should forget what they have been told about avoiding rapid weight loss in favour of slow but sure dieting, according to new research.

The study marks the first time lab results have confirmed the widely held belief

Losing those love handles may be easier for some people than for others, says a new study that confirmed the theory that physiology plays a role in a person’s ability to lose weight.

According to a press release, researchers at the Phoenix Epidemiology and Clinical Research Branch studied the metabolisms of 12 obese men and women undergoing a six-week 50% calorie-reduction experiment. After measuring participants’ energy expenditure after a day of fasting and then re-examining them during the caloric-reduction period, researchers found that the slower the metabolism works during a diet, the less weight the person loses.

Coining the terms “thrifty” vs. “spendthrift” metabolisms, the experiment marks first time lab results have confirmed a widely held belief that a speedy metabolism plays a role in weight loss.

“While behavioral factors such as adherence to diet affect weight loss to an extent, our study suggests we should consider a larger picture that includes individual physiology — and that weight loss is one situation where being thrifty doesn’t pay,” said lead author Dr. Susanne Votruba, Ph.D.

Researchers have yet to figure out if the differences in metabolic speeds are innate traits or develop over time. Also, the study was only focused on weight loss, and the team does not know if the body’s response to caloric reduction can be used to prevent weight gain.

Over one-third of Americans are obese, and it leads to some of the most common forms of preventable deaths in the country.

TIME Diet/Nutrition

This Diet Is Better for Your Brain Than Low-Fat

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Simply adding more olive oil and nuts to your diet may help prevent memory problems and loss of cognitive skills that come with old age

You’ve heard a million times that the modern Mediterranean diet is good for you. Now there’s stronger evidence the diet may be good for your brain, too.

In a study published in JAMA Internal Medicine, Dr. Emilio Ros from the Hospital Clinic in Barcelona, Spain and his colleagues conducted a study of 447 men and women aged 55 to 80 years to see whether changing their diet could affect their performance on cognitive tests. The volunteers were healthy but at higher risk of developing heart-related problems; some smoked or had hypertension, for instance, others had a family history of heart issues. Everyone in the study was randomly assigned to eat, for about four years, a Mediterranean diet supplemented with 1 liter of extra virgin olive oil a week, a Mediterranean diet enhanced with 30 grams of nuts a day, or a low-fat diet. The researchers performed a series of brain functioning tests on the participants at the start of the study and then at the end of the study.

MORE: Here’s Another Reason to Try the Mediterranean Diet

Both Mediterranean diet groups showed improvements compared to the low-fat diet group; those consuming more olive oil showed better memory scores at the end of the study while those eating more nuts showed improvements in executive function skills. The low-fat diet group, on the other hand, showed declines in many of the cognitive measures.

“It’s never too late to change your dietary patterns to improve your health,” says Ros. “This surprised even myself.” The results, he says, are especially encouraging since the people in the study were at higher risk of developing cognitive problems because of their heart-related risk factors, which can also impair cognitive function by increasing risk of stroke and compromising blood flow to the brain. “If you intervene with a healthy dietary pattern in people who are at risk of cognitive failure, even in people who still haven’t had any memory complaints or loss of cognitive function, you can prevent cognitive deterioration,” he says.

MORE: This Diet Has Been Linked to a Longer Life—Again

The findings support a growing body of evidence that connects the Mediterranean diet, which is high in antioxidant-rich foods like rich vegetables and fats, and improved brain function. Because researchers now believe that the brain is damaged by free radicals produced by stress, a diet that is rich in antioxidants may help to counter that harm. A previous study involving the same group of participants found similar brain benefits of olive oil and nuts, but that trial did not follow volunteers over time to measure the change associated with the dietary change.

MORE: Mediterranean Diet Better Than Low-Fat Diet in Keeping Aging Brains Sharp

While these results are promising, Ros says that more work is needed to confirm them; the current study is relatively small and did not find, for example, a strong correlation between the Mediterranean diet and the rate of mild cognitive impairment, a measure of cognitive decline that often precedes conditions like Alzheimer’s. “I think these results contribute to our understanding of healthy aging,” he says. “With a change in lifestyle as simple making some healthy choices in your food, it can make a difference.”

TIME medicine

Hormone Treatments Raise Cancer Risk Even After They’re Stopped

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Estrogen and progestin therapy to treat menopause has led to controversial and confusing recommendations. But in the latest and longest term look at the data, experts say the risks of the hormones may last long after women stop taking them

Researchers admit that when it comes to hormone therapy — estrogen and progestin — to treat the symptoms of menopause for women, they don’t have a lot of consistent or convincing answers. They thought the medications could not only help menopause symptoms but also protect against heart disease, although some studies showed the added hormones could also raise risk of breast cancer. The resulting advice to women seeking answers about whether hormone therapy is for them has been anything but satisfying.

Now the scientists involved in the first large trial of hormone therapy, the Women’s Health Initiative (WHI), have continued to study those women who participated in the 1990s and found some surprising results. Reporting in the journal JAMA Oncology, they say that the risk of breast cancer for women taking the combination of estrogen and progestin remains the same seven to eight years after they stop the drugs than while they were taking them.

MORE: Hormone Replacement Therapy After Menopause: What Women Need to Know

The estrogen helps to maintain levels of that hormone as natural amounts start to drop during menopause, and the progestin protects the uterus from potential tumors arising from excess amounts of estrogen. They also found that for the quarter or so post-menopausal women who have had a hysterectomy, and can take estrogen alone, the hormone can lower their risk of breast cancer.

The WHI was created to study the health effects of hormone therapy on the millions of women taking them. Some small studies had suggested that the hormones could protect women from heart disease; women tend to have heart attacks about a decade or so later than men on average, and researchers believed some of that protection came from estrogen. But doctors were concerned about the known connection between estrogen and breast cancer, since during puberty estrogen contributes to breast tissue growth, and wanted to understand how the benefits for the heart matched up against the risks to the breast, so they enrolled more than 26,600 women aged 50 to 79 years in the WHI.

MORE: Estrogen After Menopause Lowers Breast Cancer Risk for Some Women

They intended to study them until 2005, but in 2002, they stopped the trial when it became clear that there was a group of women experiencing higher heart disease rates. It turned out that these were the women taking hormones, either the combination or estrogen alone.

MORE: The Truth About Hormones

The results completely changed menopause treatment, and led to a precipitous drop in the use of the medications; in the U.S., where about 40% of women turned to the hormones, only 15% did after most experts agreed that they should only be used in the short term, for about a year or so during and just after menopause. The assumption was that the benefits in lowering breast cancer risk would be similar — if women stopped taking the hormones, then their risk would decline.

That seemed to be true, at least for the first year or so after discontinuing the therapy. But in 2013, Dr. Rowan Chlebowski, an oncologist at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, and one of the initial investigators on WHI, reported that the benefit didn’t hold for long. He found that if women who had previously been on estrogen and progestin therapy were studied for more than eight years, their risk of breast cancer started climbing back up, to levels that were on par with when they were taking the medications.

That finding, however, contradicted other results from studies. And to make matters more confusing, the women who had had a hysterectomy, and no longer had a uterus so could take estrogen alone, did not seem to experience the same increased risk of breast cancer. All of this data prompted Chlebowski to do a more detailed analysis of the WHI data on women who agreed to continue to participate years after they stopped taking the hormone therapy.

MORE: Making Sense of Hormone Therapy After Menopause

In the current study, it’s clear that the combination of estrogen and progestin increases breast cancer risk, he says. The drop in risk that occurs immediately after the therapy is stopped is likely due to the changing hormone environment. Any small or emerging tumors that were already present before hormone treatment started may eventually start growing again years later.

For women who have had a hysterectomy, taking estrogen alone does not increase breast cancer risk and may, according to the latest results, even provide some protection against the disease.

“It looks like hormones have longer term lingering effects,” says Chlebowski. “For estrogen and progestin together, we see an increase in risk even years after you stop. But for estrogen alone, it looks like the hormone may be more favorable in reducing breast cancer risk than we thought before. The estrogen alone findings are now quite compelling that we may had to call lit risk reduction.”

The results should stress the importance of defining what menopausal symptoms are, and how much they interfere with women’s daily lives. Most health groups now recommend short term hormone therapy, but it’s clear that the risks of breast cancer remain even after exposure. So doctors and patients need to weigh the relief of symptoms against the unhealthy legacy of taking these medications. “There is a little more risk than we thought with estrogen and progestin,” says Chlebowski. “But it’s always difficult to figure out how to categorize that risk. It’s different for each woman.”

TIME Heart Disease

What Divorce Does to Women’s Heart Health

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When it comes to the fallout from a divorce, one spouse is harmed more by it’s biological and psychological effects on the heart

Dissolving a marriage is hard on everyone, but researchers say the psychological stress of a divorce can have serious physical effects on the heart, especially for women.

Women who divorced at least once were 24% more likely to experience a heart attack compared to women who remained married, and those divorcing two or more times saw their risk jump to 77%. In the study published in the journal Circulation: Cardiovascular Quality and Outcomes, Matthew Dupre of Duke University and his colleagues found that men weren’t at similar risk. Men only saw their heart attack chances go up if they divorced two or more times compared to men who didn’t split with their spouses. If men remarried, their heart risk did not go up, while for women who remarried, their chances of having a heart attack remained slightly higher, at 35%, than that of divorced women.

MORE: Divorce More Likely When Wife Falls Ill

These findings remained strong even after Dupre’s team adjusted for other potential contributors to heart attack, including age, social factors such as changes in occupation and job status and health insurance coverage, and physiological factors including body mass index, hypertension and diabetes. Previous studies have found links between divorce or widowhood and heart disease that were explained, at least in part, by changes in people’s access to health care and their ability to keep up healthy eating and exercise habits.

But these are the first results from tracking people over a longer period of time—18 years—to capture the cumulative effects of changes in marital status, says Dupre. “We looked at lifetime exposure to not only current marital status, but how many times someone has been divorced in the past. What we found was that repeated exposure to divorce put men and women, but particularly women, at higher risk of having a heart attack compared to those who were married.”

MORE: Study: Marriage is Good For The Heart

And it wasn’t simply changes in health insurance coverage or financial status resulting from the divorce that explained the higher heart risk. Even after Dupre’s group accounted for these, the relationship held. While he admits that the trial did not investigate exactly how divorce is seeding more heart attacks, other studies hint at a possible explanation. Dramatic life changes such as divorce, which signal an end to not only a significant relationship but potentially to stable financial and social circumstances as well, can lead to spikes in the stress hormone cortisol, which in turn can push blood pressure, cholesterol and blood sugar to unhealthy heights.

The long term scope of the study revealed the impact that social and life events can have on the physical functioning of the body. “The health consequences of social stresses are real,” says Dupre. For women, the 77% higher risk of heart attack connected to multiple divorces was on par with well-established factors such as hypertension (which boosts risk by 73%) and diabetes (which elevates heart problems by 81%).

MORE: Do Married People Really Live Longer?

That’s doesn’t mean, of course, that women should avoid getting divorced to save their hearts. “Another way to put it is to say that women who are stably married are at an increased advantage of preventing heart attacks than women who may have had to go through transitions where they weren’t,” says Dupre.

It also makes a good case for doctors including discussion about potential stressors, including lifestyle and social circumstances, in their health assessment of patients. Recognizing that divorce may be a life event that can contribute to higher heart attack risk, for example, they can monitor patients experiencing divorce more carefully, and be alert to the first signs of potential problems with cholesterol, blood pressure or blood sugar. “Understanding all of the factors that lead to a physiological response are equally important,” says Dupre. And potentially life saving.

TIME

Shorter People More at Risk From Heart Disease Says Study

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Roy Hsu—Getty Images/Uppercut Short business man standing next to tall man

"If you're 6ft 1in, you still need to stop smoking"

A study of nearly 200,000 men and women found that shorter people have a higher risk of heart disease than their taller counterparts.

Every 2.5 inches up reduce the risk of heart disease by 13.5 percent, according to the study published in the New England Journal of Medicine on Wednesday.

Scientists have long considered there to be a link between height and heart health, but the latest research found that genes controlling height were directly linked to heart disease risks.

To be sure, height is only one of many factors that affect the level of risk.

“In the context of major risk factors this is small – smoking increases the risk by 200-300% – but it is not trivial,” Nilesh Samani, a professor of cardiology at the University of Leicester and lead author of the study, told the BBC News website. “If you’re 6ft 1in, you still need to stop smoking.”

TIME Exercise/Fitness

This Study Busts Your Work Out Excuse

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Brent Winebrenner—Getty Images/Lonely Planet Images

Air quality may not be the best in cities, but the benefits of physical activity can outweigh the harms of breathing in pollutants

Exercising outdoors is certainly preferable to being cooped up in a stuffy gym, but if you live in an urban area, the pollution from cars and buses may give you pause. It shouldn’t. Zorana Andersen from the center for epidemiology and screening at the University of Copenhagen and her colleagues report in the journal Environmental Health Perspectives that being active trumps some of the negative health effects that breathing in polluted air might have.

MORE: Pollution: Dangerous to Joggers

In a study involving 52,061 people who were followed for around 13 years, Andersen found that those who were more active were less likely to die during the study than those who were more sedentary, regardless of the pollutant levels where they lived. The researchers asked the participants to detail their physical activities, including their leisure sports, how much they walked, whether they biked or walked to work, and whether they spent time gardening. They compared these responses to the levels of nitrogen dioxide near their homes; NO2 is a gas produced from the burning of fossil fuels in cars, and is an ingredient for other harmful pollutants such as ozone and particulate matter, which can cause respiratory illnesses. Previous studies found that walking along a busy London street, for example, caused a drop in lung function and that cycling or running near high traffic roadways also compromised people’s respiratory functions slightly.

In Andersen’s study, however, people who participated in sports showed a 22% lower risk of dying from any cause during the 13-year followup, while those who cycled regularly showed a 17% lower risk and people who spent time gardening showed a 16% lower risk compared to those who didn’t do either of those activities — and regardless of the pollution levels where they lived.

MORE: Ozone Can Harm the Heart in as Little as Two Hours

“We found an even more positive message around physical activity than we even hoped for,” says Andersen. “Physiologically it’s plausible that you inhale more particles [of pollution] when you exercise in polluted areas, and we thought maybe the accumulated lifetime effect of this would reduce the benefit of exercise. But we don’t see that.”

Essentially, the benefits of being active were strong enough to overcome some of the negative effects of breathing in pollutants. That makes sense, she says, because even if people aren’t exercising to avoid inhaling pollutants, they are still exposed to them, and Andersen’s study shows that even if exercises might be exposed to slightly higher levels of compounds like NO2, that still doesn’t negate the positive effects of physical activity on their heart, blood sugar levels and more. In fact, for specific conditions, the benefits of exercising remained quite high; active people even in highly polluted areas had a 66% lower chance of dying early from diabetes compared to those who didn’t exercise.

She notes, however, that some cities may have significantly higher pollution levels than Copenhagen, where the participants lived, and it’s not clear yet how greater concentrations can affect the exercise-pollution-mortality balance. So if you have a choice for working out, biking or walking in a less polluted area, however, such as a park or a quieter side street, that might be a good idea. But don’t worry too much if you don’t. “Being active prolongs life more than staying away from air pollution,” says Andersen. “So pollution shouldn’t be a barrier to exercise.”

TIME Diet/Nutrition

Eating Eggs With Raw Veggies Boosts Nutritional Benefits, Study Says

Fern salad made from fern with quail eggs.
Noel Celis—AFP/Getty Images

Cooked eggs increase carotenoid absorption in salads

Next time you’re eating a raw-vegetable salad, consider adding cooked eggs to the mix. A new study suggests that mixing eggs with raw vegetables increases carotenoid absorption almost ninefold, entailing a range of benefits including a longer life span, fewer chronic illnesses and a reduced cancer risk.

Researchers at Purdue University in Indiana served 16 subjects three different varieties of the dish: an eggless salad, a salad with 1½ scrambled eggs and a salad with three scrambled eggs. There was a threefold to ninefold increase in carotenoid absorption from the salad containing the most eggs, according to Science Daily.

The salubrious ingredients — from beta-carotene to lycopene — serve as antioxidants protecting against cancer and heart disease.

“Americans underconsume vegetables, and here we have a way to increase the nutritive value of veggies while also receiving the nutritional benefits of egg yolks,” said the study’s researcher Wayne Campbell.

“Next time you visit a salad bar, consider adding the cooked egg to your raw veggies,” added Campbell. “Not only are lutein and zeaxanthin available through whole eggs, but now the value of the vegetables is enhanced.”

[Science Daily]

TIME medicine

Who Should—And Who Shouldn’t—Take Vitamin D

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Here's what experts say, based on the latest evidence

Does your diet need a little extra D? For researchers, it’s one of nutrition’s most vexing questions. “It’s the wild, wild west,” says Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School. “The issue has become murkier over time rather than clearer.” Research is mixed about whether doctors should routinely test for vitamin D levels, like they do for cholesterol, and whether people should be supplementing their diets with vitamin D pills.

Case in point: a study just released in JAMA Internal Medicine showed that vitamin D did not lower the risk of falls among an elderly population in Finland. The study, which compared the effects of exercise against vitamin D supplements on falls and resulting injuries, did find, however, that exercise cut the chances of more severe injury from falls in half compared to those who didn’t exercise.

MORE Want to Stay Healthy? Don’t Rely on Vitamins

But that doesn’t mean that vitamin D isn’t worth taking at all. The Institute of Medicine (IOM), and the U.S. Preventive Services Task Force (USPSTF) both recently reviewed all of the evidence on vitamin D and its health effects and concluded that in many cases, D supplementation is beneficial—with some important caveats. The two groups say that 600 international units (IU) are generally enough for most healthy adults and that higher doses of vitamin D don’t necessarily produce more health benefits. They also stress that those benefits are limited to bone health; there isn’t enough evidence to support the idea that taking the vitamin can protect against heart disease, cancer, diabetes or cognitive decline, all benefits suggested by some smaller studies.

“More isn’t necessarily better,” says Manson, who served on the IOM committee. “In some cases, it can be worse.”

Overdoing vitamin D can lead to calcium in the urine, which can cause kidney stones. Extremely high doses—around 10,000 IU a day—can trigger calcium deposits in the blood vessels, which can lead to clots that cause heart attacks. The IOM panel recommended no more than 4,000 IU of vitamin D daily to avoid these potential problems.

MORE Want to Build Endurance? Cut Back on Vitamin C and E Supplements

When people are tested for vitamin D deficiency and come up short, some researchers caution against treatment. In addition to the dosage risks, there’s also evidence that the lab tests for the type of vitamin D circulating in the blood, 25-hydroxyvitamin D, may not be the most reliable measure of a person’s D levels. Plus, not all labs use the same standard test for picking up 25 hydroxy D, and they set different standards for what are considered normal levels. “Clinicians are often left chasing a number, and trying to get patients’ blood levels up to a certain point,” says Manson. “But when you think about how many people are screened for vitamin D, and the concerns about the reliability in how it’s measured, and the differences in what is considered normal ranges across laboratories, it’s really concerning.”

Better data may be coming soon, however. Several large trials are underway in which people are randomly assigned to take different levels of vitamin D supplements so researchers can study their health outcomes, from bone problems to heart disease, cancer, diabetes and more. Manson is overseeing the largest of these, called VITAL, which has 26,000 participants. The results from these studies, which are being conducted in the U.S., Europe, Australia and New Zealand, should be available in 2017. “We should have conclusive answers in about three years,” Manson says.

The studies will also look specifically at whether vitamin D levels and metabolism differ across racial and ethnic groups. Some studies have hinted that disparities by race in heart disease and certain cancer risks may be due to vitamin D, and the randomized trials will hopefully provide more information on whether that’s true.

In the meantime, Manson says doctors and patients should follow the IOM and USPSTF guidelines: doctors should not order vitamin D blood tests for all of their patients, and people shouldn’t take more than 600 IU of the vitamin if they are otherwise healthy. The only people who may need regular testing for vitamin D deficiency, and possible supplementation, are those with malabsorption problems like Celiac disease, those who have had bypass surgery, or people who have already had fractures and have been diagnosed with osteoporosis. People taking certain medications, including treatment for tuberculosis, may also need to consider vitamin D pills.

For everyone else, however, universal screening isn’t necessary—and there isn’t any reason to take more than the recommended daily allowance of vitamin D.

Read next: The 4 Most Confusing Things About Sugar

Listen to the most important stories of the day.

TIME Innovation

Five Best Ideas of the Day: March 26

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

1. Al Qaeda and ISIS are locked in an ideological war, and for once, it’s good to be their mutual enemy.

By Daniel Byman and Jennifer Williams in Lawfare

2. For the millions left behind by America’s new economy, disability claims — legitimate or otherwise — are skyrocketing.

By Chana Joffe-Walt in Planet Money by National Public Radio

3. Maybe universities shouldn’t measure prestige by the number of applicants they turn away.

By Jon Marcus in the Hechinger Report

4. When younger women have heart attacks, they’re twice as likely to die as their male counterparts. Is medicine’s gender bias to blame?

By Maya Dusenbery in Pacific Standard

5. Can the triumph and tragedy of soccer help Harvard students appreciate the humanities?

By Colleen Walsh in the Harvard Gazette

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.

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