TIME Diet/Nutrition

Artificial Sweeteners Aren’t the Answer to Obesity: Here’s Why

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Artificial sweeteners may be contributing to the very health problems they were supposed to prevent, say researchers Tetra Images—Getty Images/Tetra images RF

They’re supposed to be the sweet alternative to high-calorie, diabetes-causing sugar. But the latest science shows that artificial sweeteners may actually set us up for obesity and diabetes

Aspartame, saccharin, sucralose—sugar alternatives go by many names, but share an almost irresistible promise: all the sweetness of sugar without the calories, weight gain and increased risk of diabetes that comes with uncontrolled amounts of sugar in the blood.

But studies on artificial sweeteners and weight loss—as well as research about whether sugar substitutes helped people avoid metabolic disorders like diabetes—have been mixed. And in a paper published Wednesday in Nature, Dr. Eran Elinav from the Weitzmann Institute of Science in Israel found that the sugar stand-ins actually contribute to changes in the way the body breaks down glucose. How? Fake sugars aren’t digested and therefore pass directly to the intestines, impacting the millions of invisible bacteria that live in our gut. And when he and his colleagues gave seven people who didn’t normally use artificial sweeteners the sugar substitutes for seven days, about half of the people showed higher blood glucose levels after just four days.

MORE: 5 Steps to Quitting Artificial Sweeteners

“What our comprehensive genetic profiling of the microbiome pointed to is that exposure to artificial sweeteners directly impacts the microbes,” Elinav says. “We found that the artificial sweeteners we think of as beneficial and that we use as treatment or preventive measures against obesity and its complications are contributing to the same epidemics they are aimed to prevent.”

In the intestines, gut microbes are hard at work, pulling out some nutrients from food that are helpful in stopping tumor growth, for example, and squirreling away others to store as energy for later use. But while artificial sweeteners aren’t absorbed by our own cells, they may be absorbed by our bacteria—and when that happens, things appear to go haywire.

Higher amounts of the sweetener substitutes, Elinav and his team found, can change the makeup of these bacterial communities. And that in turn can change how those bugs behave, leading to weight gain and poorer glucose breakdown. These alterations in intestinal bacteria were the same as those in a group of 400 people who reported using artificial sweeteners—and those changes were the same in mice as well.

MORE: Why Your Brain Isn’t Fooled By Sugar Stand-Ins

In the mouse studies, Elinav’s team found that the artificial sweeteners pushed one particular group of bacteria, Bacteroides, to thrive, while inhibiting growth of another, Clostridiales. Bacteroides are the microbial equivalent of hoarders, hungrily pulling energy out of food and squirreling it away as fat. The end result of a Bacteroides-heavy gut is a physically heavy gut as well. In studies by other research groups, its dominance, and the resulting drop in diversity of other microbes, is typical of obese people compared to normal weight individuals.

MORE: 7 Not-So-Sweet Lessons About Sugar

The metabolic consequences were also dramatic in both the mice and people studied. In the mouse experiments, animals who were fed the same dose of saccharin that the U.S. Food and Drug Administration considers safe for daily use showed a drop in their ability to break down glucose. When he gave those mice antibiotics, their ability to break down glucose returned to normal, suggesting that wiping out the abnormal balance of bacteria could return the animals back to a healthier state.

And to confirm that the changing microbial communities were indeed responsible for the glucose changes, he also transplanted fecal samples from the people using artificial sweeteners into mice whose own guts had been wiped clean. These mice then developed the same abnormalities in glucose breakdown that the human donors and the mice who were fed saccharin did—even though they never actually ate artificial sweeteners. Simply harboring the microbes that had been exposed to the sweeteners was enough to disturb their glucose metabolism.

MORE: Can Sugar Substitutes Make You Fat?

The good news is that as easily as the gut microbiome can shift toward an unhealthy state, it can just as easily be brought back into line with the proper balance of bacterial communities. The best way to do that isn’t clear yet, but, says Eran Segal, a co-author of the study and a professor of computer science and applied mathematics at the Weitzmann Insttitute, “We believe that the situation today at the very least needs to be re-examined. We were able to induce glucose intolerance in a few days in some individuals, so this massive, unsupervised and unregulated use [of artificial sweeteners] should at the very least be reassessed and perhaps re-examined in additional studies.”

Elinav, for one, isn’t waiting. Based on his findings, he’s stopped adding artificial sweeteners to his coffee.

 

TIME Cancer

Our Global Cancer Report Card Is Here

In its annual cancer status report, the American Association for Cancer Research highlights new tumor-fighting drugs, and the inevitable spike in cancer cases expected in coming years

The Food and Drug Administration (FDA) approved six new cancer treatments between July 2013 and July 2014, five of them representing innovative ways to target tumors more precisely with fewer side effects. Thanks to those therapies, and advances in understanding how the body’s own immune system can be co-opted into fighting cancer, patients diagnosed with any of the 200 or so forms of the disease have never been in a better position to survive it. In fact, the number of cancer survivors has increased nearly five-fold from when Congress declared a war on cancer in 1971 and 2014. But despite advances in diagnosing and treating cancer, incidence and death rates may start to rise again, say experts in a new report.

That’s in part because most cancers emerge in older age—and the population of people over-65 is expected to double by 2060. “We face a future in which the number of cancer-related deaths will increase dramatically unless new and better ways to prevent, detect, and treat cancer can be developed,” according to the 2014 American Association for Cancer Research (AACR)’s Cancer Progress Report 2014. “These trends are being mirrored globally, and the number of people dying of cancer worldwide is expected to increase from 8.2 million in 2012 to 14.6 million in 2035.”

The (AACR), which has been compiling the report every year since 2011 as an educational tool to update Congress and the public on the progress and needs in the fight against cancer, also provided a “prescription” for addressing this coming wave, and for maintaining the momentum of recent victories against the disease. Noting that research grants from the National Institutes of Health (NIH), the largest funder of basic biomedical research that has contributed to many of the new anti-cancer therapies now on the market, are $3.5 billion lower than where they should be even if the funding only kept up with the rate of inflation for biomedical equipment and personnel, the AACR urges more federal investment in cancer research.

That money, they point out, can also be directed toward training the next generation of cancer researchers, since fewer grants are turning promising young scientists away from the field. They write:

We are now at a crossroads in our country’s long struggle to prevent and cure cancer; we must choose between two paths, but there is only one viable path forward to continue transforming lives.

On the viable path we seize the momentum at this exciting time in biomedical research by committing to budget increases for the NIH and NCI so that the remarkable progress of the past can continue at a rapid pace.

To take the alternative path is simply unacceptable. This particularly dangerous path leads us to a place where federal funding for biomedical research remains stagnant, or even worse, declines, seriously jeopardizing the rate at which we are able to make progress. On this path, breakthroughs and discoveries will be slowed, meaning that delivery of the cures that patients and their loved ones desperately need is delayed.

…Our federal government can do no better than invest robustly in the NIH and NCI so that the path forward will lead us to a brighter future for the millions of people whose lives have been touched by cancer.

TIME Research

Here’s Why You May Be Better Off Taking Generic Cholesterol Drugs

Patients with cheaper drugs tended to take their medicine more consistently

A new study in the Annals of Internal Medicine found that the cost difference between generic and brand-name drugs seems to be a big factor when it comes to sticking with a medication–especially when it comes to statins, one of the most-prescribed drugs in the country. People who got the generic versions of the cholesterol-lowering medication were more likely to consistently take it and avoid cardiovascular disorders than those who filled the brand-name kind.

“Initiating a generic versus a brand-name statin seems to be associated with lower out-of-pocket costs, improved adherence to therapy, and improved clinical outcomes,” the study said.

The study, which looked at more than 90,000 patients over age of 65, found that people taking generic drugs were more likely to stick to their medication regimen. Price played a role in this disparity, the study suggests. The average cost to fill a prescription for the consumer was $10 for generic statins versus $48 for brand names.

“Given this substantial cost difference, it is perhaps not surprising that adherence and cardiovascular outcomes were worse among patients receiving brand-name statins,” study authors wrote. Overall, people who took generic drugs had 8% fewer incidents than people who used brand-name drugs.

The study received grant support from drug manufacturer Teva Pharmaceutical (which makes both generic and brand-name drugs) and acknowledges that the results may not be generalizable for certain populations: particularly those with greater incomes or access to insurance plans that provide better coverage for brand-name drugs.

TIME medicine

DIY Drugs: Antibiotics Could Soon Be Made Out of Your Own Bacteria

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Our own gut bacteria may be the next source of antibiotics dra_schwartz—Getty Images

There’s a universe of friendly bacteria living within us, and they may be the next source of powerful drugs, including antibiotics

Scientists have known for a long time that there’s no better drug-maker than nature. A third of our medicines come from plants and microbes so it’s not such a surprise that the millions of bacteria that inhabit our gut, mouths, nose, skin and reproductive tracts—called our microbiome—might be an untapped resource for new drugs. That’s what Michael Fischbach, an assistant professor in the department of bioengineering at the University of California, San Francisco, was counting on, and, he reports in the journal Cell, he was right.

He and his team analyzed the genomes of microbes living in various parts of the human body, and using an algorithm they developed called ClusterFinder, they found 3,118 groups of genes that churned out drug-like molecules. This suggests that these groups of genes could be a rich trove of potentially new drugs or other important compounds that keep our bodies healthy. “When the results of the search came back, it was a eureka moment,” he says. “It was a big surprise to us, because in retrospect the human microbiome was one place we hadn’t thought to look,” he says of the results.

MORE: The Good Bugs: How the Germs in Your Body Keep You Health

Not satisfied with simply identifying the bacteria that make these small molecules, Fischbach also wanted to see if any of them were making drugs that could prove useful in treating human disease. And indeed, he found that some made antibiotics that mimiced those developed by pharmaceutical companies and are already on the market. To see how effective a human microbiome-based antibiotic might be, he isolated one of these gene products from the vaginal microbiome of a Texas woman.

Dubbed lactocillin, it turned out to be a strong antibiotic against some familiar infections, including Staphylococcus aureus and Enterococcus faecalis, but not against E. coli. In fact, a compound similar to lactocillin is being developed by Novartis as a new member of the antibiotic class.

The results were so robust, says Fischbach, that “we completely changed what we are working on. We stopped working on soil bacteria and started working on gut, skin and oral bacteria.” While he doesn’t expect that most of the genes will yield antibiotics, he is confident that they will produce other critically important compounds that are important in regulating our immune systems, for example, and in keeping our metabolism—the way we burn calories and store fat—in check. Those compounds may explain some of the other intriguing things scientists are learning about the microbiome: that the community of bacteria in the guts of normal weight people differ from those of obese individuals, for example, and that different bacterial communities might be responsible for everything from cancer to allergies and asthma.

That’s why he’s eager to move on to the next steps, triaging the thousands of genes he’s identified to tease out those that make drug-like molecules, and then systematically figuring out what those molecule do. That will lead to a better understanding of how we might be able to exploit them—either by making the same molecules in a lab or transplanting the right communities of bacteria to the gut or other places and putting the microbes to work for us.

MORE: Colon Cancer’s Newest Culprit: Gut Bacteria

TIME medicine

Woman Receives First Stem Cell Therapy Using Her Own Skin Cells

A Japanese woman is the first to receive retinal cells made from her own skin cells

Researchers at the RIKEN Center for Developmental Biology in Japan surgically transplanted a sheet of retinal pigment cells into the eye of a 70-year old woman on Friday.

The cells are the first induced pluripotent stem cells, or iPS cells, given to a human patient. They were made by Masayo Takahashi, who grew them from the patient’s own skin cells, which were treated with four genetic factors to revert back to an embryonic-like state. Takahashi then soaked the cells with the appropriate growth factors and other compounds so they developed into retinal pigment cells.

The patient was losing her sight due to macular degeneration, because her retinal pigment endothelial cells were damaged by an overgrowth of blood vessels. Replacing them with a new population of cells can restore her sight.

MORE: Stem-Cell Research: The Quest Resumes

Stem cell scientists are starting to test their treatments in eye-related diseases, because parts of the eye are protected from the body’s immune system, which could recognize the introduced cells as foreign and destroy them. That’s not a problem with the iPS cells, since they are made from the patient’s own skin cells, but it’s an added safety net to ensure that the therapy is safe and hopefully effective.

Because iPS cells are genetically treated to erase their skin cell development and revert them back to an embryonic-like state when they can become any type of cell, there are still concerns about their safety when transplanted into patients. The U.S. Food and Drug Administration has not yet approved a trial involving iPS cells – so far, only stem cells made from excess IVF embryos have been approved for treating macular degeneration. A 19-member committee of the Japanese ministry of health approved the experimental procedure four days ago, according to Nature, after Takahashi made her case, with the help of Dr. Shinya Yamanaka of Kyoto University, who shared the 2012 Nobel Prize for discovering iPS cells.

MORE: Stem Cell Miracle? New Therapies May Cure Chronic Conditions like Alzheimer’s

Japan’s stem cell scientists are hoping the surgery is a success; the field has been struggling since a well-publicized paper about a new way to make iPS cells was retracted amid allegations of fraud.

It’s not known whether the cells will continue to grow and form abnormal tumors, or whether they will migrate to other parts of the body. But now that the first patient has received them, those questions – and more, about the effectiveness of stem cell therapy – might be answered soon.

TIME medicine

Kate Middleton Has Morning Sickness—Again

It’s déjà vu for Duchess of Cambridge. Another pregnancy, another battle with morning sickness.

Along with the good news that Kate Middleton is pregnant and expecting her second child, who would be fourth in line to the throne, Middleton also revealed that she is suffering from hyperemesis gravidarum, a severe form of morning sickness that landed her in the hospital during her first pregnancy.

Having the condition during a previous pregnancy increases the chances that it will recur, which may explain Middleton’s circumstances. Consistent nausea and vomiting can lead to dehydration and deficiencies in some important nutrients, say experts, so expectant moms who can’t keep food down are treated with IV fluids. It’s generally not dangerous to the developing fetus, unless the mom-to-be doesn’t gain enough weight during pregnancy, which can lead to lower-birth weight babies. (George, her first child, was born at a healthy 8 pounds, 6 ounces.)

This time, the Duke and Duchess’ office says, she is being treated at home, which for her is Kensington Palace.

For those who might have forgotten, hyperemesis gravidarum can be caused by hormonal changes occurring during the first three months of pregnancy—specifically the steep rise in human chorionic gonadotropin (HCG), which is released by the placenta as it readies to nourish the fetus.

Presence of hydatidform moles, or a growth inside the uterus, can also trigger the severe nausea and vomiting.

There’s something else that often triggers the morning sickness: twins. No word just yet from the royals on whether George will be joined by more than one sibling.

TIME Infectious Disease

Officials Urge Use of Ebola Survivors’ Blood to Treat Patients

Amid outbreak that has killed more than 2,000

Health officials on Friday recommended the use of Ebola survivors’ blood to treat those suffering from an outbreak of the deadly disease in West Africa.

“We have to change the sense that there is no hope,” Marie-Paule Kieny, an assistant director-general of the World Health Organization, said during a conference of health experts, the Associated Press reports.

The use of blood was one method on a long list of experimental treatments suggested at the conference. RNA-based treatments and pre-existing drugs designed for other diseases were among the other potential options. The experts stressed the need for rigorous data-keeping and evaluation to determine the efficacy of each potential solution.

Kent Brantly, an American doctor who survived an Ebola infection, was given blood from another Ebola survivor during his infection. He also received ZMapp, a vaccine that has been developed to address the disease.

Experts said it will take time to produce more ZMapp and another promising vaccine that could stem the spread of Ebola, which has already killed more than 2,000 people in West Africa. The Obama Administration has asked Congress to provide funds to accelerate the development of ZMapp.

 

TIME medicine

What May Have Caused an American Pilot to Crash

Socata Plane
A Socata TBM-900 (700N) at Glasgow airport in Scotland on March 14, 2014. Iain Marshall

An unresponsive pilot whose plane crashed off Jamaica may have suffered from hypoxia

A New York real estate executive was piloting his his small plane from Rochester to Florida on Friday when he stopped communicating with air traffic controllers before eventually crashing near Jamaica.

Larry Glazer, who frequently flew that route, was traveling with his wife. FAA officials said the private plane had reached an altitude of 25,000 feet, prompting some officials to speculate he may have suffered from something known as hypoxia, in which parts of the brain are deprived of adequate oxygen.

It’s far too early to know for sure. But at that altitude, oxygen is so thin that brain cells can only survive for several minutes before they start dying off. Without enough oxygen, people become inattentive, show poor judgment and eventually stop breathing. With extended exposure at high altitudes, the brain shuts off and slips into a coma. Military pilots dispatched to track the aircraft after it failed to respond to air traffic control signals reported seeing the pilot slumped over.

The FAA has warned non-commercial pilots of the dangers of high altitude changes and hypoxia—in its first phases, the pilot won’t necessarily be aware that he’s experiencing oxygen deprivation. On the FAA site’s training section, a member of the agency’s education team urges more physiology training of pilots so they are aware and prepared for the dangers of hypoxia.

According to an official 1991 FAA report, Civilian Training in High-Altitude Flight Physiology, “Some National Transportation Safety Board staff members have expressed a concern that high-altitude flight physiology training for civilian flight personnel should receive greater emphasis than it currently does.” The report goes on to say, “When pilots combine their private flying skills with their business transportation needs and use their aircraft to meet those needs, it is inevitable that in order to meet a schedule, arrive at a destination, or get home after a meeting, the urge to complete a mission will lead the pilot into a physiologically-unsafe altitude or into conditions for which there has been insufficient training or experience.”

TIME viral

Watch a 7-Week-Old Baby Hear Mom’s Voice For The First Time After Getting Hearing Aids

The miracle of life meets the miracle of hearing

This video reveals the emotional moment when a seven-week-old baby hears his parents’ voices for the first time after getting hearing aids.

Diagnosed with moderate-to-severe hearing loss in both ears at birth, the little boy named Lachlan looks unhappy to have something shoved into his ear canal. But when his mother and father, Michelle and Toby Lever of Victoria, Australia, start talking to him, his eyes widen and a giant smile spreads across his face.

While this YouTube video is dated August 31, 2014, the moment happened back in July 2012, and is just starting to go viral now. A Facebook video that mom Michelle Lever posted on November 18, 2012, now boasts nearly 300,000 “likes” and has been shared 440,000 times.

Lachlan, now two years old, has worked with therapists at Taralye “the oral language centre for deaf children,” in Blackburn Victoria. Michelle Lever told Daily Mail Australia that she hopes the video, by going viral, will reassure parents in similar situations: “I want them to realise that there is a lot of support and help available to them.”

WATCH: Boy Hears His Dad’s Voice for First Time

MORE: Science Gave My Son the Gift of Sound

TIME medicine

Whistleblower Claims CDC Covered Up Data Showing Vaccine-Autism Link

The claim, however, may just be more unsubstantiated fuel from the anti-vaccination movement

If you haven’t noticed, there’s a war going on between those who believe in the health benefits of vaccines – that they can prevent deadly infectious diseases such as measles and polio – and those that believe that the immunizations do more harm than good. Now one of the authors of a 2004 government study that found similar vaccination rates among children with and without autism says the study omitted some important data.

The vaccine war is being fought on social media, in social circles and increasingly in doctor’s offices, as physicians are faced with doubts and questions from parents who find themselves being recruited onto the side of skepticism. Skepticism is healthy, and the sign of curious minds, but not when it flies in the face of evidence. Especially gold standard, rigorous scientific evidence that has been accumulating for decades and shows that vaccines are not linked with an increased risk of the developmental disorder.

William Thompson, a senior scientist at the Centers for Disease Control (CDC) and one of the authors of a 2004 study published in the journal Pediatrics, spoke with Brain Hooker, who serves on the board of Focus Autism (which was founded to “put an end to the needless harm of children by vaccination and other environmental factors”), about the data that was not included in the final report. The study looked at both healthy children and those with autism, to see if there were any differences in their rates of being vaccinated against measles, mumps and rubella (MMR), and found none. That suggested that childhood immunizations likely were not contributing to an increased risk of autism. Hooker and Thompson, however, discussed a subset of the 624 children with autism and 1824 without the condition who were studied and Thompson admitted that among African-American boys, the incidence of autism was higher among those who were vaccinated than among those who weren’t. But that information was not part of the paper. Thompson claims he was not aware that the discussion was being recorded, and his statements appeared in a video released on YouTube on August 22 entitled “CDC Whistleblower Revealed.”

Did the CDC cover up the data, as Hooker claims? A couple of things to keep in mind, both about the people behind the video and about how epidemiological studies like the one published in Pediatrics work (and explained in more detail in this article from Science-Based Medicine). For starters, the video was narrated by Andrew Wakefield, the British researcher responsible for seeding the questions about vaccines and autism in the first place. In 2010, the General Medical Council in the UK revoked his license to practice medicine and a year later, the journal that published his paper concluded that his findings were fraudulent.

Next, any time scientists take the original population of participants in a study, however large, and drill down to analyze trends in a subgroup – in this case the African-American boys – the power of the associations they find dwindles. That’s because the numbers get smaller, and in order to be statistically relevant – something known as statistical significance to statisticians – certain threshold numbers and confidence intervals for the connection have to be reached. In the 2004 study, the scientists looked at a smaller set of 355 children with autism and 1020 without for whom they had Georgia state birth certificates, which included additional information that might be relevant for any associations, such as birth weight, gestational age, and mother’s age, race and education. “This information was not available for the children without birth certificates; hence the CDC study did not present data by race on black, white or other race children form the whole study sample. It presented the results on black and white/other race children from the group with birth certificates,” the CDC notes in a statement responding to the video. Thompson claims that the findings were statistically significant, but results from smaller numbers of subjects still don’t hold as much weight as correlations found in the larger group.

In addition, it’s important to note that the study simply correlated age at vaccination and reports of autism, which says nothing about the direction of the connection. For example, the authors of the 2004 study note that “Case children, especially those 3 to 5 years of age, were more likely than control children to have been vaccinated before 36 months of age.” The association between vaccination and symptoms, however, was more likely due to the fact that the children had to be immunized in order to register in preschool, and doesn’t necessarily indicate that the shots contributed to the autism.

In a statement issued through his attorneys, Thompson says “Reasonable scientists can and do differ in their interpretation of information.” He calls for transparency in the data collecting and reporting process, but says that the way that the 2004 study was presented does not negate the importance of vaccination. “I want to be absolutely clear that I believe vaccines have saved and continue to save countless lives. I would never suggest that any parent avoid vaccinating children of any race. Vaccines prevent serious diseases, and the risks associated with their administration are vastly outweighed by their individual and societal benefits.”

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