TIME medicine

A Drug-Resistant Typhoid Superbug Is Spreading Worldwide, Research Says

A boy infected by typhoid from polluted water, lies at a hospital in al-Qouniya village in Idlib, Syria, May 27, 2013.
Muzaffar Salman—Reuters A boy infected by typhoid from polluted water, lies at a hospital in al-Qouniya village in Idlib, Syria, May 27, 2013.

Typhoid fever is caused by consuming food or drink contaminated with the feces or urine of people who are infected

A drug-resistant strain of typhoid fever is spreading worldwide, according to new research.

A study published in Nature Genetics conducted by a team of 74 researchers in over 12 countries shows that antibiotic resistant typhoid, driven by one family of bacteria called H58, is spreading globally.

“Multidrug resistant typhoid has been coming and going since the 1970s and is caused by the bacteria picking up novel antimicrobial resistance genes, which are usually lost when we switch to a new drug,” said study author Kathryn Holt in a statement. “In H58, these genes are becoming a stable part of the genome, which means multiply antibiotic resistant typhoid is here to stay.”

In the study, researchers sequenced the genomes of 1,832 samples of the Salmonella Typhi bacteria (which causes typhoid fever) that were collected from 63 different countries between the years 1992 and 2013. The researchers discovered that 47% of these strains were from the drug-resistant H58 family. According to their findings, the strain likely first emerged in South Asia roughly 30 years ago and from there spread on to Southeast Asia, Western Asia, East Africa and Fiji. Southern Africa has also been affected.

Typhoid fever is caused by consuming food or drink contaminated with the feces or urine of people who are infected. People who are infected can experience a consistently high fever and can feel weak or have stomach pain and headaches. In the United States there are an estimated 5,700 cases each year, mostly from travelers who became infected abroad.

The U.S. Centers for Disease Control and Prevention (CDC) says typhoid affects 21.5 million people every year.

TIME Diet/Nutrition

This Diet Is Better for Your Brain Than Low-Fat

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Rita Maas—Getty Images

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

How Concussions Can Lead to Poor Grades

Head injuries can have long lasting effects, not just on the field but in the classroom too

When it comes to concussions, the biggest question, especially on the minds of parents of student-athletes, is whether and when their child should get back in the game. But researchers at the Children’s National Health System say that there’s potentially bigger question that parents and educators aren’t asking: how concussions affect children’s performance in the classroom.

In a study published in the journal Pediatrics, Danielle Ransom, a postdoctoral fellow in neuropsychology, and her colleagues found that children who had concussions may experience more problems concentrating, keeping up and paying attention in school. The symptoms are worse for students who have recently been injured, but remained significant even for those who had recovered.

MORE: Longer Rest After Concussions Might Not Be Good, Study Says

“My colleagues and I have been hearing for years that kids with concussions have problems in school, but there was no evidence to show what the problems are, and how frequently they are occurring,” she says.

So she focused on 349 students ages 5 to 18 years old who had all been diagnosed with concussion. Some were still recovering, and experiencing symptoms, while others were no longer feeling any effects from their injury. Of the students who were still recovering, 88% reported more than one symptom including headaches, fatigue, difficulty understanding lessons or problems concentrating. And 77% said they had more trouble taking notes and spent more time completing homework assignments.

MORE: A New Blood Test to Diagnose Concussions on The Field

Students who experienced more-severe head injuries were also more likely to have the most trouble in school. But Ransom admits that diagnosing the severity of concussions is still a challenge. “At this point we really don’t have tools to clinically say, this is what you can expect in your kid’s recovery,” she says.

Still the results highlight the need to pay attention to the extra support that children with concussions need in order to recover. That may include, at least in the first days back from a head injury, a shorter school day, since students may feel more tired and overwhelmed by a full day, and even breaks throughout the day so they can rest when they feel headaches or symptoms occurring.

“Instead of trying to get the kid back to school doing things 100% as they usually would, we need to allow the symptoms to ebb and flow in a more natural way,” says Ransom. “Kids should be paying attention to their bodies, and teachers need to be attuned to their symptoms.”

MORE: Football Players Have More Concussions Than Are Diagnosed, Study Suggests

Such strategies could not only help to ease the transition back to school, and but also potentially lessen the effects of the concussion, says Ransom. There is evidence that children who push themselves to return too quickly to their normal workload can slow recovery and even make symptoms worse.

Unfortunately, she says, there is no magic threshold for when students can handle working at their full capacity; it varies with each child and with the injury. But recognizing that concussions can affect how children do in school could lead to better ways of helping them to return to their normal workload sooner. “We really think the findings in our study highlight the importance of targeting specific problems, and can ease the transition back for kids,” says Ransom.

TIME medicine

Many Americans Aren’t Getting Cancer Screenings, Gov Says

Numbers are below national targets

A new federal report shows a high number of Americans are not undergoing recommended screenings for colorectal, breast and cervical cancers.

New data released Thursday from the U.S. Centers for Disease Control and Prevention (CDC), shows that in 2013, which is the latest data available, screening for the three cancers either dropped lower than previous rates or showed no improvement. The numbers show that around 20% of women said they were not up to date with cervical-cancer screenings, and a quarter of women were not getting recommended breast cancer screening. Overall, two in five adults had not had their recommended colorectal screening. The new report was published in the CDC’s Morbidity and Mortality Weekly Report.

The CDC looked at data from the 2013 National Health Interview Survey and compared the screening rates to the target numbers for “Healthy People 2020,” a national disease prevention initiative that has based cancer screening goals on the U.S. Preventive Services Task Force (USPSTF) guidelines.

Current USPSTF recommendations are mammography every two years among women between the ages of 50–74 years, a Pap test every three three years for women between the ages of 21 to 65 without hysterectomy, and screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults between age 50 to 75.

The number of mammography screenings remained fairly unchanged from previous years, whereas Pap test use among women between the ages of 21 to 65 was lower than it was in 2000. Colorectal cancer screening was unchanged in 2013 compared to what it was in 2010.

The percentages are below the target numbers for Healthy People 2020. The mammography target is 81.1%, and the 2013 data shows the number is currently at 72.6% for the recommended age group. Nearly 81% of women ages 21 to 65 had a Pap test, but the Healthy People 2020 target is 93%. Around 58% of adults between age 50 to 75 reported they had undergone screening for colorectal cancer, and the target for that group is 70.5%.

Though the new report doesn’t explain why the numbers are not meeting national goals, there are some hints. For instance, the data also showed that people without health insurance or a source of health care had the lowest rates of cancer screening test use.

“Though the [USPSTF] does not consider costs or insurance coverage in its evaluation of the evidence, it will be interesting to see whether declines in the number of uninsured in the U.S. since 2013 will be reflected in improved prevention in these populations,” says Dr. Albert L. Siu, the chairperson of the USPSTF. “As clinicians, we also hope that our nation will continue to strive to help all individuals get access to those preventive services that can enable people to live healthier, longer lives.” Siu was not involved in the CDC report.

TIME Research

Some Premature Babies Can Survive After Only 22 Weeks, Study Says

premature baby
Getty Images

Roughly 5,000 babies are born at 22 or 23 weeks in the U.S. each year

A new study has found that some premature babies can survive outside the womb with medical treatment as early as 22 weeks into pregnancy.

The study, published on Wednesday in the New England Journal of Medicine, raises questions about treatment practices for premature babies while also adding a new layer to the abortion debate.

Hospitals vary in how they approach treatment for babies born before 24 weeks, widely viewed to be the minimum age of viability, the New York Times reports. But the study, which analyzed almost 5,000 babies born at between 22 and 27 weeks, found that a small number of babies born at 22 weeks could survive with treatment, some with long-term impairment. Those that were not treated died.

Each year, roughly 5,000 babies are born at 22 or 23 weeks in the US, according to the Times.

[NYT]

TIME medicine

Exclusive: Meet the World’s First Baby Born With an Assist from Stem Cells

This newborn is the first baby in the world born using a breakthrough IVF treatment

Doctors in Canada have begun a new chapter in medical history, delivering the first in a wave of babies expected to be born this summer through a technique that some experts think can dramatically improve the success rate of in vitro fertilization (IVF).

Now 22 days old, Zain Rajani was born through a new method that relies on the discovery that women have, in their own ovaries, a possible solution to infertility caused by poor egg quality. Pristine stem cells of healthy, yet-to-be developed eggs that can help make a woman’s older eggs act young again. Unlike other kinds of stem cells, which have the ability to develop into any kind of cell in the body, including cancerous ones, these precursor cells can only form eggs.

In May 2014, Zain’s mother, Natasha Rajani, now 34, had a small sliver of her ovarian tissue removed in a quick laproscopic procedure at First Steps Fertility in Toronto, Canada, where she lives. Scientists from OvaScience, the fertility company that is providing Augment, then identified and removed the egg stem cells and purified them to extract their mitochondria.

Mitochondria are the powerhouses of the cell, a molecular battery that energizes everything a cell does. Adding the mitochondria from these egg precursor cells to Natasha’s poor-quality eggs and her husband Omar’s sperm dramatically improved their IVF results. In the Rajanis’ first traditional-IVF attempt, Natasha produced 15 eggs, but only four were fertilized—just one of those matured to the point were Natasha’s doctor felt comfortable transferring it. “I knew it wasn’t the best-quality embryo, but it was what she had,” says. Dr. Marjorie Dixon, of First Steps Fertility.

With Augment, the Rajanis produced four embryos, two of which have been frozen should the couple decide to have more children. Another one became baby Zain.

It’s not currently available in the U.S., since the Food and Drug Administration (FDA) considers the process of introducing mitochondria a form of gene therapy, which it regulates. So far, some three dozen women in four countries have tried the technique, and eight are currently pregnant. All of the women have had at least one unsuccessful cycle of IVF; some have had as many as seven.

“We could be on the cusp of something incredibly important,” says Dr. Owen Davis, president of the American Society of Reproductive Medicine (ASRM). “Something that is really going to pan out to be revolutionary.”

The Next Big Thing in IVF

The technique is indeed poised to usher in the next big advance in IVF; since the first baby, Louise Brown, was born using the process in 1978, the procedure has changed little. Scientists have made incremental advances in fine-tuning the procedure, but taken together, these improvements have nudged pregnancy rates upward by only a percent or two over the course of 35 years. As it stands, the IVF success rate is about 38% for women in their late 30s and 18% for those in their early 40s. Natasha’s first IVF cycle differed little from the one that produced Brown more than 35 years ago.

Augment emerged from a breakthrough made in 2004 by biologist Jonathan Tilly, then at Harvard Medical School and now chair of biology at Northeastern University. He found that cells scraped from the outer surface of the ovary contain the precursor cells that can provide a more reliable source of energy to older eggs. “The technique addresses a void now in IVF,” says Tilly. “No cell culture can circumvent poor egg quality or an egg that is simply too tired to execute what it is capable of doing. We are taking patients with a zero percent pregnancy rate, patients who have failed IVF because of poor egg quality, and getting them pregnant.”

The Rajanis had tried for four years to get pregnant, turning to fertility drugs, intrauterine insemination, and a naturopath before trying their first attempt at IVF. Natasha became pregnant once, but miscarried a few weeks later. “I tried to remain positive, thinking there is a light at the end of the tunnel, and that a baby will be there at the end,” she says of all the misses.

What finally made the difference wasthe population of her own egg stem cells. What makes these cells so enticing to scientists is that they come from the mother herself. Mitochondria contain their own DNA, and in a controversial decision the U.K. government recently approved so-called “three-person babies,” where mitochondrial DNA from a donor is introduced into the egg of a woman with mitochondrial disease. When the egg is then fertilized and results in a live birth, it can raise ethical questions, biological concerns and conflicts about parenthood.

With Augment, the cells used—and their mitochondrial genes—are from the mother’s own ovaries. Still, the FDA requested more studies on the effect of adding mitochondria, even from the mother who provides the egg, to the IVF process. OvaScience plans to conduct 1000 cycles using Augment this year, and generate more data that will help bring the procedure to the U.S.

Because the procedure is so new, some reproductive science experts are skeptical. What’s lacking, they say, is convincing evidence comparing pregnancy rates of women undergoing Augment to those with similar infertility problems who didn’t use the technique. So far, no formal clinical trials have been conducted; the only data on the procedure comes from recent presentations by Dr. Robert Casper of University of Toronto and Dr. Kutluk Oktay from Gen-ART IVF in Ankara, Turkey, both of whom are advisors to OvaScience.

“We’re not yet sure the scientific model has proven what the outcomes would be if you use the mitochondria of a younger egg, or from an egg stem cell,” says Davis of ASRM. “It’s a fascinating concept but we just haven’t seen the studies yet.”

In the world of infertility, however, such data are historically hard to come by. A lack of regulation of most reproductive technologies—the ones that don’t fall under the jurisdiction of the FDA as either drugs, devices or gene therapy—and the dominance of business-minded scientists has rushed new methods to clinics, often before their effectiveness has been fully proven.

Tilly counters doubters with evidence from other species that these cells can do what OvaScience has said they can. Egg precursor cells extracted from ovarian tissue from rats, mice, monkeys, pigs and women, for instance, have developed into immature eggs and, in the case of rats and mice, those eggs have mature and produced viable offspring. “Mitochondria from egg precursors rejuvenate the egg to bring it back to a high quality state,” says Tilly.

That appears to be the case with the Rajanis, and time will tell whether that ends up holding true for the other women trying Augment, too. “We see Zain as a symbol of hope for all couples struggling with infertility,” says Natasha. “While the process is long, emotional and physically draining, there is light at the end of the tunnel—and that light for us is Zain.”

For more on Zain and this new approach for infertility, see the May 18, 2015, issue of TIME.

TIME medicine

The Obesity Paradox: Can Body Fat Ever Be Good For You?

TIME.com stock photos Weight Loss Health Exercise Scale
Elizabeth Renstrom for TIME

More and more data suggests there may be a protective benefit from body fat. What's going on?

When it comes to a medical consensus on body fat here’s what we know: There isn’t one. The research is conflicting, interpreting the results can be confusing and even leading experts disagree about whether or not you can be healthy at any size.

More than one third of U.S. adults are obese. And being overweight or obese can put people at a greater risk for other health complications like heart disease and diabetes. Yet, in the last decade or so, there’s increasing data suggesting body fat may, in some cases, impart a kind of protective benefit. This has led to what’s known as the “obesity paradox”—the fact that moderately obese people with chronic diseases are often outliving normal-weight people with the same health issues.

The most recent example is a study published this week in the journal Annals of Internal Medicine. In the study, researchers looked at over 10,500 patients with type 2 diabetes who were followed for around 10 years. They found that overweight or obese people in the study had a higher rate of cardiac events like heart failure compared to people who were a normal weight. However, people who were overweight—but not obese—lived longer than the people who were of normal weight or underweight. In fact people who were underweight had the worst prognosis, the researchers showed.

“The explanation for these results is unknown and does not mean that patients with diabetes should try to become overweight,” the editors of Annals write. “Patients should continue to follow a healthy lifestyle.”

That doesn’t answer the question of why heavier people fared better by some measures, however—a question that has been plaguing researchers for more than a decade. Some researchers say they’ve had trouble getting their initial findings published in medical journals because it raises so many challenging questions. And for average joes, this emerging body of evidence continues to confuse.

Can Fat Help the Heart?

The latest study does not dispute the fact that being overweight puts people at risk for heart problems. But how can it be that the very factors that put people at risk for heart disease could also add years to their life?

In a 2014 study, a team of researchers conducted a meta-analysis of 36 studies and found that a that low BMI in thousands of patients with coronary artery disease who underwent surgery was associated with up to a 2.7-fold greater risk of heart attack and heart-related death over a follow up period of close to two years. But overweight and obese patients had better outcomes and heart-related death risk was lowest among overweight patients with a high BMI compared to people with a normal BMI.

When asked what’s going on, study author Dr. Abhishek Sharma said his team could only speculate. “One explanation may be that overweight patients are more likely to be prescribed cardioprotective medications such as beta blockers and statins and in higher doses than the normal weight population. Further, obese and overweight patients have been found to have large coronary vessel damage, which might contribute to more favorable outcomes,” he said.

That year, Dr. Kamyar Kalantar-Zadeh, a professor of medicine at the University of California, Irvine, wrote an editorial in the journal Mayo Clinic Proceedings likening body fat to an unscrupulous friend. He writes: “Metaphorically, we can liken such cardiovascular risk factors as obesity to a friend who is a negative influence, causing the two of you to misbehave and be sentenced to jail, but once imprisoned, the friend remains loyal and protects you against poor prison conditions and other inmates.”

Still, not everyone is convinced. Dr. JoAnn E. Manson, chief of the division of preventive medicine at Brigham and Women’s Hospital, says that the finding that obese people with diabetes live longer is not consistent. Other studies have found the opposite to be true, and studies that look at a snapshot may not reveal the full story either she says.

In 2o12 researchers reported in the European Heart Journal that there are groups of people who are obese who are also metabolically healthy—people do not suffer from problems like insulin resistance or high blood pressure. “Physicians should take into consideration that not all obese people have the same prognosis,” the study authors wrote. The individuals they studied had higher fitness levels and better heart and lung function than other obese individuals, suggesting that perhaps it’s exercise that’s providing benefit for some.

“Metabolic health is on a continuum. People who are obese, even if they haven’t gotten to the level of hypertension, will still tend to have a higher blood pressure and blood sugar on average. Even if it’s within the normal range, it tends to be at a less healthy level overall,” says Manson. “People can cross over from being metabolically healthy to unhealthy over time. I think there are few, if any, circumstances where you would recommend that a patient be overweight or obese rather than a healthy weight.”

The Belly Fat Burden

It’s also possible that body fat may be more complicated than our currently understanding of it allows. Some experts have speculated that it may be that the type of fat we carry on the inside is important. A 2013 study showed normal-weight people with heart problems who also have belly fat have worse survival rates compared to obese people who carry their weight elsewhere, like on their thighs or rear.

Belly fat, also called visceral fat, is more harmful than fat that sits right under the skin because it’s embedded in muscles and organs. Some argue that our reliance on BMI is part of the problem. Many agree it’s an imperfect measurement, partially because it doesn’t distinguish between fat and muscle.

A measure of belly fat may be a better indicator for overall health. Some people of different weights may carry fat of varying degrees of risk and, as Brigham and Women’s Mason points out, weight alone can’t tell the full story of someone’s health. After all, someone with a low BMI who is thin may be thin because of another underlying illness or factor.

The Bottom Line (For Now)

Right now, there’s still lots of speculation and few definitive answers regarding the obesity paradox. But what hasn’t changed is that being overweight and obese are risk factors for chronic diseases—and belly fat specifically may be a contributor.

“There’s no question that if you are overweight or obese you have a higher risk of heart disease and diabetes. There will be people who fall into the metabolically healthy category, but it’s not a large proportion of people who are overweight or obese,” says Manson.

“If you start early by encouraging a healthy weight through the lifespan, you are going to have a lower incidence of diabetes and heart failure to begin with,” she continues. “Maintaining a healthy weight throughout life is the optimal approach to preventing chronic disease. That would be the public health recommendation.”

TIME Pain

You Asked: Do High Heels Actually Damage My Feet?

You Asked: Do High Heels Actually Damage My Feet?
Illustration by Peter Oumanski for TIME

Yep. And the damage doesn’t end at your toes.

High heels hurt. If you’ve worn them (I have not) then you probably know this already. But are high heels also bad for you? A 2014 survey from the American Podiatric Medical Association—composed of the nation’s top foot and lower-leg docs—found heels were far and away the most common cause of foot pain among women.

Unsurprisingly, much of that pain comes from contorting your foot into a steep “plantarflexed” position, concludes a study from the Journal of Applied Physiology. Like standing on your tiptoes for hours, that high-heeled posture may lead to painful muscle fatigue and strain injuries, the authors of that study say.

Calluses, blisters, bunions, and ingrown nails are all common among high heel wearers, adds Dr. Rodney Stuck, division director of podiatry at Loyola University Chicago. The higher the heel, the more trouble you’re likely to run (or walk) into, Stuck says.

But the most significant risks of your high-heel habit may begin higher up your leg. According to research from the U.K. and Austria, lots of time spent walking in heels actually changes the structure of the muscles and tendons in your calves—and not for the better.

High heels lead to shorter muscle fibers and a toughening of the Achilles tendon, says Dr. Marco Narici, a professor of clinical physiology at the University of Nottingham (and coauthor of that study). Narici says these muscle changes reduce your ankle’s range of motion, and contribute to your risk for strains and sprains. Stuck says these sorts of muscle adaptations may also up your risk for other lower-body injuries. A sore ankle or leg you blamed on running may actually have more to do with your high heels, he says.

More research shows walking in heels puts a great deal of force on your kneecaps. This force can lead to the early onset of osteoarthritis, says Dr. Constance Chu, a professor of orthopedic surgery at Stanford.

Chu says this risk increases among heavier women. “Combining walking in very high heels for long periods of time every day with obesity and aging would be a perfect storm for knee osteoarthritis, as well as foot, back, and other joint problems,” she says.

Of course, tossing your stilettos is the one surefire way to dodge all these potential health hazards. But if you’re not willing to part with your pumps, Chu says lower heels lowers your risk. For formal or work events when you feel heels are a must, she recommends wearing flats beforehand and changing into your heels only when you’ve arrived at your destination. “Taking time to sit and move the knees through a full range of motion may also be helpful,” she says.

Loyola University’s Stuck also suggests standing against a wall or with one foot on a step and stretching your feet for a few minutes every day.

But don’t swap your heels for flip-flops. An Auburn University study found the way those loose summer sandals shorten your gait and force you to grip with your toes may lead to all sorts of heel, ankle, and sole problems.

Feet sure don’t have it easy.

Read next: These High-Tech High Heels Change Color With the Click of an App

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TIME Innovation

Are “Micro-Schools” the Future of Education?

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

These are today's best ideas

1. Are personalized “micro-schools” the future of education?

By Anya Kamenetz at NPR

2. Millions of Americans get tests, drugs, and operations that won’t make them better.

By Atul Gawande in the New Yorker

3. Can bacteria help us fight the ravages of climate change?

By Esther Ngumbi in Scientific American

4. Here’s a drone you can fly with your phone, from the designer of the Roomba.

By Jessica Leber in Fast Co.Exist

5. What’s killing the growth of mobile banking?

By Herb Weisbaum in NBC News

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

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

TIME medicine

The Best Way to Quit Smoking Isn’t E-Cigs

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Peter Dazeley—Getty Images

In the latest in-depth review of studies investigating which smoking cessation methods work best, experts say there isn’t enough evidence to support using e-cigarettes to kick the habit

The U.S. Preventive Services Task Force, a government-convened group of experts, says that if you want to quit smoking, you’re better off with drug-based methods, behavior modification programs or a combination of both—not puffing on e-cigarettes. There isn’t enough evidence to support claims that e-cigs, which have been touted as the latest way to wean people off tobacco, can actually help people quit.

The task force focused on studies that investigated how effective various smoking cessation methods are, for both adults and pregnant women. Drugs that address nicotine’s effects on the body, as well as nicotine replacement options, are better ways to quit, and the data suggest that they are even more effective if used together. In addition, behavioral interventions, including support groups and counseling sessions, can boost quit rates from 7-13% compared to rates of 5-11% among those who don’t use them.

MORE: E-Cigs Are Smokers’ Favorite Quitting Tool

“We have an embarrassment of riches in terms of a menu of things to offer patients who want to quit smoking,” says Dr. Francisco Garcia, director and chief medical officer of the Pima County Health Department in Arizona and member of the task force. “But every individual is different; some might respond better to behavioral therapy, some might respond better to varenicline, some might feel nicotine replacement is important to bridge them away from tobacco use.” For most people, it’s a matter of discussing with the smoker which method has the most appeal, and which one they are more likely to stick with long enough to go smoke-free.

But for certain populations, there isn’t enough data to support one strategy over another. Among pregnant women, for example, there haven’t been many studies to show how drug-based methods might affect the developing fetus, so it’s hard to determine if the benefits of quitting outweigh he risks represented by the medications. So for now, the task force advises that pregnant women rely on behavioral, non-drug strategies to help them stop smoking.

MORE: This Is The New Best Way to Quit Smoking, Study Finds

And for e-cigarettes, the data is sparse. The panel concluded that there was “insufficient” evidence to determine whether e-cigarettes improve or hinder quit rates.

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