TIME Innovation

Five Best Ideas of the Day: January 20

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

1. Is America willing to do the hard work to mend its racial divide?

By Eric Liu in CNN

2. The first new antibiotic developed in 30 years could turn the tide against the rising resistance of many diseases.

By Brian Handwerk in Smithsonian Magazine

3. Adapting to climate change will buy time, but rising sea levels are a major threat to low-lying cities.

By Laura Parker in National Geographic

4. Is four years too much? More college students are jumpstarting careers by graduating early.

By Rachel Rosenbaum in USA Today College

5. The cargo ship of the future will have a hull that acts as a giant sail, slashing fuel consumption and carbon emissions.

By Fraunhofer Center for Maritime Logistics in Phys.org

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

It Doesn’t Matter How Much You Exercise If You Also Do This

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Simon Watson—Getty Images Sitting too much can negate the benefits of exercise

Your workouts may not mean a lot if you sit too much

Most of us know that we need to be more physically active. Only 20% of American adults get the recommend amount of physical activity—150 minutes of the moderately intense aerobic kind—each week.

But simply moving more isn’t enough, according to a new report published in the Annals of Internal Medicine. The benefits of exercise can be blunted if you also spend most of the rest of your day sitting.

MORE Sitting Is Killing You

Dr. David Alter, a heart expert from the University of Toronto and senior scientist at the Toronto Rehabilitation Institute, and his colleagues found that sitting too much—even among people who exercise regularly—led to higher rates of hospitalization, heart disease and cancer, as well as early death.

The researchers looked at 47 studies that asked people how much time they spent sitting and exercising, as well as rates of heart disease, diabetes, cancer and death from any cause. The more hours people in the studies spent sedentary—like watching TV or reclining on a couch—the higher their risk of all of these negative outcomes. Heavy sitters showed a 90% higher risk of developing diabetes than those who sat less, an 18% higher chance of dying of heart disease or cancer, and 24% greater odds of dying from any cause. These rates were the average among people who both exercised regularly and those who did not.

MORE Now There’s Another Reason Sitting Will Kill You

“What struck me, and I was quite surprised by this, was that the deleterious effects of sitting time were almost uniform across the board of total mortality, heart disease mortality, the occurrence of heart disease, the occurrence of cancer and the mortality from cancer,” says Alter. “When we see a consistent effect, that reaffirms that something real is going on.”

What’s happening, he suspects, is that the metabolic effects of sitting are overwhelming any benefits that exercise might have. Even if people exercise regularly for half an hour or an hour a day, how they spend the remainder of that day is also important to their health. Alter says that the unhealthy effects of sitting are somewhat reduced among those who are physically active—by about 15%—but they aren’t completely erased. “You can make a little bit of headway on the bad effects of sedentary time by at least doing some exercise,” he says. “But you can’t completely nullify it.”

MORE Sitting Can Increase Your Risk of Cancer By Up to 66%

The only way to do that is to sit less, and not just exercise more. For so long, the public health message has been to move more and squeeze in as much active time as possible into the day. That message is still important, he says, but it needs to change as new research on the dangers of sitting starts to emerge. “It’s time to modify the public health message,” he says. “We still need more research, but there is a signal there that it’s time to do that. We need two different strategies—one that targets exercise for 30 minutes to 60 minutes a day, and the other is to reduce sedentary behavior.”

For his patients, Alter starts by helping them realize how much of their day they spend in a chair. There’s no prescription for sitting, and no research yet to support the optimal levels for avoiding cancer or heart disease or early death. But studies have shown that standing burns twice as many calories per hour, about 140, as sitting. And burning extra calories is a good way to maintain a healthy weight, one of the key factors in preventing heart disease and some cancers.

“Little things add up to a lot,” says Alter, who says he checks emails while on a elliptical. He also recommends standing up or moving around for several minutes every half hour when you’re at your desk, and aiming to sit two to three hours less in a 12 hour day. If you can’t give up your favorite TV shows, he adds, stand during the commercials.

Read next: Why You Should Start Forcing Your Coworkers to Take a Walk With You

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TIME medicine

This is What Alcohol Does to Your Sleep

It’s a favored way to end a hectic day, but a drink before bed can disrupt your sleep

Having a drink before bedtime might make you fall asleep a little faster. But the sleep you get after imbibing may not be so restful, finds a new paper in the journal Alcoholism: Clinical & Experimental Research.

Building upon earlier research, Christian Nicholas and his colleagues at the University of Melbourne found that alcohol just before sleep can lead to poorer quality slumber.

While most people know from experience that having a drink before hitting the sack can help you feel drowsy, Nicholas and his team were interested in learning how the brain physiologically reacts to the alcohol while you’re sleeping. They had 24 (presumably eager) young adults ages 18 to 21 to spend several nights at the Melbourne School of Psychological Sciences Sleep Laboratory. On one of the nights, they would be given a nightcap (orange juice and vodka) and on another night, they’d only get a placebo (orange juice with a straw dipped in vodka). They were allowed to go to bed at their normal time, but their heads were dotted with electrodes to measure their sleeping brainwave patterns on an electroencephalogram (EEG).

MORE The More Hours You Work, the More You Drink, Study Says

Not surprisingly, on the nights they drank alcohol, people showed more slow wave sleep patterns, and more so-called delta activity—a process linked to the restorative aspects of deeper sleep, when memories are firmed up, the brain’s detritus is cleared out and hard-working neurons get some much-needed replenishment.

But that wasn’t the only thing going on in their brains. At the same time, alpha wave patterns were also heightened, which doesn’t happen during normal sleep. Alpha activity tends to occur when the brain is awake but quietly resting, in metabolic break mode. Having both delta and alpha activity together therefore leads to disrupted sleep, since the alpha functions tend to offset any restorative efforts the brain neurons are trying to squeeze in.

MORE Alcohol Poisoning Kills 6 Americans a Day

In fact, such dual activity patterns are typically seen among people with chronic pain conditions and in lab-based studies where people are intentionally given electric shocks while they slept. “People tend to feel that alcohol helps them fall asleep a little quicker, and therefore people associated that with helping them sleep,” says Nicholas. “But when you actually go and look at what is happening while they sleep, the quality of that sleep isn’t good.”

In previous studies, such warring alpha-delta brain patterns during sleep have been linked to daytime drowsiness, waking up not feeling rested, and symptoms like headaches and irritability. Whether similar outcomes occur among people who drink before bed isn’t clear yet, says co-author Julia Chan, but it’s reasonable to think that they might. “When you see alpha activity alongside delta activity during sleep, it suggests there might be some kind of wakefulness influence that could compete with the restorative nature of delta sleep,” she says.

This doesn’t mean that you should avoid alcohol at night all the time; occasionally indulging in a nightcap probably won’t disrupt your sleep too much. But, “if somebody is doing this night after night after night, the effects can be cumulative, not only for alcohol use but on sleep disruption as well,” says Nicholas.

Read next: School Should Start Later So Teens Can Sleep, Doctors Urge

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TIME animals

This X-ray Shows How Hamsters Can Fit So Much Food in Their Tiny Cheeks

From the BBC documentary Pets Wild At Heart

Thanks to the Internet, we’ve seen tiny hamsters eat tiny burritos, tiny pizzas and tiny Thanksgiving dinners. We’ve even seen tiny hamsters best competitive eating champion Kobayashi in a food face-off and watch them feast in a tiny mansion. But what is going on inside their tiny heads and tiny mouths while they eat those giant meals?

A recent BBC documentary takes you inside a hamster’s mouth via x-ray, revealing what is happening inside that tiny head while it fills its cheeks with those burritos, pizzas or whatever else it is having for lunch. The documentary, Pets Wild At Heart, which is narrated by once-and-future Doctor Who David Tennant, explains that hamsters come equipped with built-in travel coolers — incredibly stretchy cheek pouches that stretch all the way down to their hips. The cute little rodents can also turn off their saliva glands, which means they can preserve their fancy feasts for any time they are feeling peckish. That probably explains why hamsters aren’t allowed anywhere near the Sizzler salad bar.

TIME Research

Duke Researchers Hail Breakthrough After Growing Muscle Tissue in Lab

Advancement may form bedrock for future personalized medicines

Scientists at Duke University announced this week that human skeletal muscle has been successfully grown in the laboratory that is able to react to stimuli just like native tissue.

The lab-grown muscle will allow researchers to study the effects that drugs and disease have on muscle tissue without having to endanger the health of a potential patient, reports Science Daily.

“The beauty of this work is that it can serve as a test bed for clinical trials in a dish,” says Nenad Bursac, associate professor of biomedical engineering at Duke University.

Bursac said the development would hopefully allow doctors to begin prescribing personalized medicine to patients in the future.

“We can take a biopsy from each patient, grow many new muscles to use as test samples and experiment to see which drugs would work best for each person,” he explained.

[Science Daily]

TIME Heart Disease

Popping Aspirin for Heart Health Could Be a Waste of Time for Some

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Tetra Images—Getty Images/Tetra images RF

The drug is overused in about 12% of heart patients, study finds

Study after study documents the wonders of aspirin for the heart—it can lower levels of inflammation, the trigger that sets off the unstable events of a heart attack, and it also helps blood remain free of viscous traps that can block vessels and slow the flow of blood to the heart. But these studies only support the benefits of aspirin in low daily doses for those who have already had heart events. For people who haven’t yet run into trouble but may be a higher risk of heart issues—including people who are overweight and those with high blood pressure or diabetes—the evidence isn’t so clear.

MORE: Who Should and Who Shouldn’t Take Daily Aspirin

That hasn’t stopped doctors from recommending aspirin to these patients. In a study published in the Journal of the American College of Cardiology, researchers looked at more than 68,000 people in 119 medical practices in the U.S who hadn’t had any previous heart events, but who were receiving aspirin therapy. 11.6% of them were given the drug inappropriately, the authors concluded; even though they did not meet the criteria that various groups of medical experts established as the threshold for starting the medication, they were still taking it.

Though aspirin is available over the counter, the drug comes with potential side effects that can pose serious health risks, including bleeding in the gastrointestinal tract and brain. “With aspirin being so widely used and being available over-the-counter, the concern I have is that a lot of the use may be leading to side effects that could be preventable by having a discussion between the provider and patient,” says Dr. Salim Virani, from the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine.

MORE: Daily Aspirin May Not Prevent Heart Attacks

Virani says that aspirin use among patients with no history of heart disease varies widely across the country. Among two similar patients randomly assigned to two different doctors, one would have a 63% higher chance of being given an aspirin to prevent a first heart event than the other patient.

Currently, the American Heart Association recommends that aspirin be used in such primary prevention cases only if the person has a greater than 10% chance of having a heart attack or stroke in the next 10 years. This calculation is based on the person’s age, sex, cholesterol levels, blood sugar levels, blood pressure and whether he or she smokes. Based on a review of the available literature, in 2009 the U.S. Preventive Services Task Force criteria advised starting aspirin for anyone with a great than 6% chance of having a heart attack or stroke in the next 10 years.

Despite these guidelines, most doctors are likely not making the calculations necessary to come up with this score, suspects Virani—regardless of whether they are primary care physicians or heart experts. “We know from prior data that we as providers are not good at calculating the risk of every patient because it takes time,” he says. “You have to get the equations and put all the patient’s numbers in, and in a very busy practice that could be a time drain. So most of the variation we see could be doctors just determining risk by looking at the patient rather than going to the actual data to tell them what the person’s 10 year risk [of heart disease] is.” In fact, 73% of the people in the study, which only looked at heart doctors’ practices, did not have enough information for their physicians to calculate their 10 year risk score. Of those without score data, 97% were missing critical cholesterol level readings.

The overuse of aspirin is concerning, Virani says, because it persists even after he and his colleagues adjusted for potential confounding factors, including the proliferation of statins, the cholesterol-lowering drugs that can also reduce inflammation. Because more people are on statins, including those who have not yet had a heart event, it’s possible that the drugs are lowering the 10-year risk of a heart attack or stroke by more than the other factors that doctors usually use to calculate risk and the need for aspirin. In other words, there may be more people who no longer need aspirin because they are taking statins.

Virani admits that his study still leaves a lot of questions unanswered, like dosage and whether a doctor recommended the drug or the person started taking it on their own.

Part of the reason for the inappropriate use could be an artifact of the aggressive prevention and awareness campaigns surrounding heart disease. Though they’ve been extremely effective at informing people about the many ways to avoid heart trouble, like changing your diet, exercising regularly and taking drugs like statins or aspirin, the message isn’t one-size-fits-all. That’s important for aspirin in particular, since the medication can come with harmful side effects that overshadow any potential benefit they might have. It’s enough of a concern that the Food and Drug Administration recently rejected a request to add primary prevention of heart disease as a benefit of aspirin therapy on the drug’s label.

These latest results only reinforce that decision. It’s clear that when it comes to whether aspirin can prevent a first heart attack, neither doctors nor patients are being guided by the evidence—and that could mean more health complications for more people.

TIME medicine

69 People Die From Drinking Poisoned Beer

Some believe the beer was contaminated with crocodile bile

Sixty-nine people died following a funeral in Mozambique, after drinking traditional beer now thought to have been contaminated. An additional 196 people have been admitted to hospitals.

Area emergency rooms experienced an influx of patients complaining of diarrhea and muscle pain after a funeral on Saturday, Northeast Tete province Health, Women and Social Welfare Director Paula Bernardo told media. The Mozambique government has declared three days of mourning following the deaths.

The cause of the fatalities is still being investigated, but it’s believed that funeral-goers drank contaminated, and possibly poisoned, local beer. The beer is called Pombe and is made with millet or corn flour. The source of the contamination is not yet known, but the Associated Press reports that authorities believe the drink may have been contaminated with crocodile bile during the funeral.

There is no clear evidence recorded of how poisonous crocodile bile may be, and there are contradictory reports of its true toxicity.

Forbes reports that the woman who owned the beer stand, her daughter, nephew and a few members of close families were some of the first fatalities reported.

Read next: The AirAsia Flight 8501 Data Recorder Has Been Retrieved

TIME Infectious Disease

Unlicensed Cambodian Medic Charged With Murder After Allegedly Spreading HIV

212 HIV cases were found in the community where he practiced

An unlicensed medic is being charged with murder after Cambodian medical authorities found 212 cases of HIV in the district where he had been treating patients, allegedly with contaminated equipment.

Yem Chrin treated poor patients and was believed to have healing powers, Reuters reports. However, he did not have a medical license and was allegedly delivering injections and blood transfusions using unclean equipment. Authorities tested 1,940 people in the northwestern province where Yem Chrin worked, and 212 tested positive for HIV. Some children as young as 6 years old tested positive for the virus, according to al-Jazeera.

Yem Chrin allegedly told police that he sometimes used the same syringe on two or three patients before disposing of it.

The World Health Organization and UNAIDS found that “the percentage of people that reported receiving an injection or intravenous infusion as part of their health treatment was significantly higher among the people who tested positive for HIV than the people who were HIV negative,” in the area in which Yem Chrin treated patients, Reuters reports.

The development is a setback in Cambodia’s largely successful efforts to eradicate the virus since it first spread through the country in the 1990s.

[Reuters]

TIME HIV/AIDS

This Contraceptive Is Linked to a Higher Risk of HIV

Depending on the contraceptive they’re using, women may be at higher risk of getting HIV

When it comes to the double duty of preventing both pregnancy and HIV, condoms are the best option, especially in the developing world where treatment for the infectious disease is harder to access. But the same isn’t true of other contraceptive methods, according to the latest study in Lancet Infectious Diseases.

Lauren Ralph, an epidemiologist at University of California San Francisco, and her colleagues conducted a review of all of the available studies on hormonal contraceptive methods—including injections of Depo Provera and Net-En that work to prevent pregnancy for about 12 weeks, as well as the pill. Among 12 studies involving nearly 40,000 women in sub-Saharan Africa, those using Depo showed a 40% higher risk of getting HIV than those using other methods or no contraception at all.

Previous studies suggested that Depo, which is made up of a hormone that mimics the reproductive hormone progesterone, was linked to higher risk of infection, but other studies showed conflicting results. Ralph found that only Depo was associated with a higher risk of HIV infection; there was no similar increase among women using the pill, which is composed of two hormones, estrogen and a form of progesterone. The correlation remained even after they considered potentially confounding factors, such as the women’s condom use.

While the study didn’t address the reason for the difference between oral contraception and Depo, some research suggests that their differing hormone combinations may have varying effects on the structure of the genital tract, a woman’s immune response or her vaginal flora, all of which could influence her vulnerability to acquiring HIV.

The results raise a difficult question about whether the increased risk of HIV infection warrants removing Depo from a woman’s contraceptive options in places like Africa. Worldwide, according to the authors, 41 million women use injectable contraception, and they have played a role in lowering death and health complications among women of child-bearing age. “Whether the risk of HIV observed in our study merits complete withdrawal of hormonal contraception, especially Depo, needs to be balanced against the known benefits of highly effective contraception in reducing maternal morbidity and mortality worldwide,” says Ralph, who conducted the research while at University of California Berkeley. More research needs to be done to quantify the risks and benefits of providing Depo, and these calculations also have to be adjusted for specific regions and even particular clinics. “One thing to consider is whether women have access to other contraceptive options, whether they will be willing to take up these contraceptive options, and ensuring that women will be comfortable with them,” she says. “I would love to see these findings applied to specific regions. I think that would help women make the most informed decisions.”

TIME medicine

Genetic Testing Company 23andMe Finds New Revenue With Big Pharma

The company’s database of genetic information is worth $10 million to Genentech

The past two years have been a rough and transformative time for the controversial DIY genetic testing company 23andMe. At the end of 2013, the Food and Drug Administration requested that the company shut down its main service, an analysis of a person’s genome gleaned from spit samples that anyone who purchased a kit could send in, noting that interpreting human genes—understanding what changes in DNA mean, and how they contribute or don’t contribute to disease—is still too much of a black box.

But things may be looking better for the company in 2015. On Jan. 6, it announced a $10 million partnership with biotech company Genentech, which will sequence the entire genomes of 3,000 23andMe customers with a higher risk for developing Parkinson’s disease. Genentech is hoping the information will speed development of more effective drugs against the neurodegenerative disorder, in which motor nerves in the brain start to deteriorate. “What attracted us to 23andMe and this opportunity is the work 23andMe has done together with the Michael J. Fox Foundation in the Parkinson’s space,” says Alex Schuth, head of technology innovation and diagnostics for business development at Genentech. “They have built a community of individuals and their family members who have contributed DNA samples. What is unique about this cohort is that it gives us an opportunity to connect clinical data on how patients feel and how their disease is progressing, with their genomic data. That’s unique.” The 23andMe customers will be asked to sign new consent forms as part of any Genentech studies.

MORE Time Out: Behind the FDA’s Decision to Halt Direct to Consumer Genetic Testing

The agreement is one of many that 23andMe CEO and co-founder Anne Wojcicki says are in the works, and hint at the company’s most valuable asset—the genetic information on the 800,000 customers who have sent in their DNA-laden saliva since the company began selling kits in 2006. “Databases, and big data, is suddenly trendy,” says Wojcicki, “especially in health care where people are recognizing that when you have really large numbers, you can learn a lot more. I think we are leading part of that revolution.”

But for the past year, the company hasn’t been sending back health information to customers who pay the $99 for an analysis. Instead, customers are getting reports on their genetic ancestry, with the promise that when the FDA permits it again, they will receive health-related information based on their genetic profile. Wojcicki says that since the FDA action, sales of the kits have been cut by about half, and while they are slowly climbing back up, they haven’t yet reached pre-2013 levels.

Regaining that market is a top priority for 23andMe, says Wojcicki. “Everyone at the company has some kind of role, some involvement, in thinking about the FDA,” she says. “It has transformed the entire company—our product, our execution, how to think about marketing, every aspect of it.” The two entities are exchanging requests and responses, and while she hopes to have a resolution in 2015, it’s not clear yet when the health-related services will be offered.

In the meantime, the genetic information 23andMe has already collected is becoming a potential gold mine for academic researchers and for-profit drug developers. The company has more than 30 agreements with academic researchers for which they receive no monetary compensation, so that scientists can learn more about certain diseases and contribute to basic knowledge about what goes wrong in those conditions. Wojcicki says she’s balancing opportunities with both non-profit and for-profit companies to optimize the value of 23andMe’s database. “Some research has absolutely no monetary capacity, and we should still do those, because fundamentally what 23andMe does is represent the consumer,” she says. “And some research does have monetary capacity, and we should do those too. Because the reality is that the group that is going to develop a drug or treatment or therapy for something like Parkinson’s disease is going to be a for-profit company.”

Read next: These GIFs Show the Freakishly High Definition Future of Body Scanning

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