TIME Research

6 Breath Tests That Can Diagnose Disease

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A new study uses breath to diagnoses diabetes, but other diseases like cancer and obesity may be breath-detectable too

A new study shows that it may be possible to diagnose type 1 diabetes in kids even before the onset of severe illness.

Currently, about one in four kids with type 1 diabetes don’t know they have it until they start having life-threatening symptoms. However, a new study published in the Journal of Breath Research shows researchers might be able to diagnose the disease by detecting a chemical marker (acetone) in the breath that makes it smell sweet, but indicates a build-up of chemicals in the blood (ketones) that occurs when a person’s insulin levels are low. High levels of acetone in the breath can indicate high levels of ketones in the blood. The hope is that if proven effective, this breath test will help physicians make a diagnosis earlier.

Growing research suggests breath tests can be used to detect a variety of diseases, from diabetes to various cancers. Research is still early in some areas—and there are other factors beyond disease that can result in chemical markers in the blood and breath—but some medical institutions are already using the tests of a variety of diagnosis.

Type 1 Diabetes
In the new study, researchers collected compounds in the breath from 113 children and adolescents between the ages 7 and 18. They also measured the kids’ blood-sugar and ketone levels. They found a link between higher levels of acetone in the breath and ketones in the blood. “Our results have shown that it is realistically possible to use measurements of breath acetone to estimate blood ketones,” said study author Gus Hancock, a professor at Oxford in a statement. “We are working on the development of a small hand-held device that would … help to identify children with new diabetes.”

Colorectal Cancer
In a small study published in 2012 in the British Journal of Surgery, researchers from the the University Aldo Moro of Bari in Italy collected the breath of 37 patients with colorectal cancer and 41 healthy control participants. The researchers were measuring the amount of volatile organic compounds (VOCs) in the participants’ breath, with the thought being that cancer tissues and cells may release distinct chemicals. The researchers were able to identify 15 of 58 specific compounds that were correlated with colorectal cancer. Based on this, the were also able to distinguish between cancer patients and healthy patients with 75% accuracy.

Lung Cancer
In 2013, researchers from the University of Latvia used an electronic nose-like device to identify a unique chemical signature in lung cancer patients. As TIME has previously reported, there are several groups who think this process can be standardized for cancer with further research. In June, scientists at the American Society of Clinical Oncology meeting in Chicago presented a device they think has real promise.

Obesity
There are obviously a number of ways that obesity can be diagnosed without a breath test, but a 2013 study published in the Journal of Clinical Endocrinology & Metabolism found that obese people had unique markers in their breath, too. Researchers at Cedars-Sinai Medical Center studied the breath of 792 men and women trying to detect methane. Those with higher levels of methane and hydrogen gases in their breath also tended to be heavier with a BMI around 2.4 points greater than those with normal gas levels. The hope, the researchers say, is that a test could be developed that could detect a type of bacteria that may be involved in both weight and levels of gas in the breath. There may be ways to clinically curb that bacteria growth.

Lactose Intolerance
Johns Hopkins Medicine uses breath testing to help diagnose lactose intolerance. Patients drink a lactose-heavy drink and clinicians will analyzed the breath for hydrogen, which is produced when lactose isn’t digested and is fermented by bacteria.

Fructose Intolerance
Johns Hopkins also uses breath tests to assess whether an individual is allergic or intolerant to fructose, a sugar used to sweeten some beverage and found naturally in foods like onions, artichokes, and wheat. The test is similar to a breath test for lactose intolerance. Patients will drink a cup of water with dissolved fructose and over a three hour period, clinicians will test their breath. Once again, a high presence of hydrogen can indicate that the patient is not properly digesting it.

TIME Obesity

Obesity Now Costs the World $2 Trillion a Year

Half the world's population could be obese by 2030, warns a McKinsey Global Institute report

The global cost of obesity has risen to $2 trillion annually, according to a new report, more than the combined costs of armed violence, war and terrorism.

The McKinsey Global Institute report says currently almost 30% of the world’s population is obese, and that if present trends continue, that almost half the population will be clinically overweight or obese by 2030.

The report cautioned that no single solution would reverse the problem, instead calling for a “systemic, sustained portfolio of initiatives” to tackle the crisis, such as better nutritional label, healthier food at schools, advertising restrictions on fatty foods and beverages, and public health campaigns.

TIME Obesity

You Exercise Less When You Think Life Isn’t Fair

The 'why try' effect gets in the way of weight loss

People who have been the target of weight discrimination—and who believe the practice is widespread—are more likely to give up on exercise than to try to lose weight, according to a new study published in Health Psychology.

The online study of more than 800 Americans specifically looked at whether participants believed in “a just world,” or in this case, the belief that their positive actions will lead to good results. People who experienced weight bias in the past and didn’t believe in a just world were more likely to say they didn’t plan to exercise than those who did believe the world is just. In a separate part of the study, participants primed with anecdotes designed to suggest that the world is unjust were more likely to say they didn’t plan to exercise.

Experiencing discrimination leads some people to adopt a pessimistic view of the world, and they accept negative stereotypes about themselves, including the belief that they’re lazy, said study author Rebecca Pearl. “When someone feels bad about themselves and is applying negative stereotypes to themselves, they give up on their goals,” said Pearl, a researcher at Yale University, referring to a phenomenon known as the “why try” effect.

It’s an area of conflicting research. Some previous studies found that weight discrimination leads to weight loss, while others concluded that weight discrimination discourages exercise. Belief in a just world may be the factor that distinguishes between the two, Pearl said. People who think their exercise will pay off are more likely to try.

Because believing in a just world is key to losing weight, Pearl said that legislation and other public policy efforts could act as a “buffer against loss of sense of fairness.”

“It’s important for doctors to be aware of what people are experiencing, to know that these experiences might have real effects on people’s confidence,” Pearl said.

TIME ebola

Ebola Among Top 3 Health Concerns for Americans: Study

A protester dressed in protective equipment demonstrates in Brisbane
A protester dressed in protective equipment demonstrates, calling for for G20 leaders to address the Ebola issue, near the G20 leaders summit venue in Brisbane Nov. 15, 2014 Jason Reed—Reuters

Health care costs and access came in first and second places

The U.S. may only have seen four cases of Ebola, but the virus is still one of the top three health worries for Americans, according to a new poll.

The disease was mentioned by 17% of adults surveyed by Gallup’s annual Health and Health Care survey as their principle medical concern, coming after only health care cost (19%) and access (18%).

The cost of health care in particular has been prominent on the list for over a decade and is likely to remain so, says Gallup. Next came obesity and cancer, which were both cited by 10% of respondents as the nation’s “most urgent health problem.”

The Gallup poll was based on 828 telephone interviews conducted Nov. 6-9 with Americans aged 18 and older living in all 50 U.S. states and the District of Columbia.

TIME Obesity

Why You Probably Can’t Donate a Kidney Even If You Want To

When it comes to kidney donation, deciding you want to go through with it is actually the easy part. Most Americans couldn’t donate a kidney even if they wanted to, finds a new study presented at the American Society of Nephrology’s Kidney Week conference in Philadelphia.

Dr. Anthony Bleyer, professor of internal medicine at Wake Forest Baptist Medical Center, and his son Anthony Bleyer, Jr., an economics major at Wake Forest University, looked at data from a representative sample of 7,000 U.S. adults from the National Health and Nutrition Examination Survey survey. They discovered that a full 55% of the U.S. population would be ineligible to donate a kidney because of medical conditions—most of them preventable. Based on the criteria the Bleyers used, 15% of adults would be excluded due to obesity, 19% to hypertension, 12% to excessive alcohol use and 12% to diabetes.

That’s not necessarily because a medical condition has rendered the organs damaged. “Our number one thing is we want to preserve the health of the donor,” says Dr. Bleyer. “The donors have to be in really pristine condition.”

The more you weigh, the more strain you’ll put on your remaining kidney, and obese people also have a higher risk of complications after surgery and wounds that heal more slowly, he says.

The Bleyer team also looked at how financial concerns might prevent donation. Because kidney donors don’t receive compensation for lost work time in the U.S., 36% of healthy, medically eligible people make less than $35,000 per year, so they probably couldn’t afford to donate, the study found.

“Only 6% of patients who need a transplant get a living-donor kidney transplant,” Dr. Bleyer says.

That might not be because people are getting more stingy about their organs—but poorer and sicker instead.

TIME Obesity

New York’s New Speed Limit Means a Healthier City

A car traveling 30 mph that hits a pedestrian is eight times as likely to kill that person than if it were traveling 20 mph

The difference between traveling 25 and 30 miles per hour may seem minute for the average car driver. The faster speed would save you about five minutes in a trip down the length of Manhattan. But the difference is profound if you’re hit by a car–maybe even the difference between life and death.

In effort to curb traffic fatalities, New York City lowered its default speed limit to 25 mph effective Nov. 7. It’s a move that, if properly enforced, experts say could inspire similar moves in other urban areas across the country—making a dent in the more than 4,000 pedestrians killed by cars each year in the U.S. “All eyes are on New York right now to see if we can tame our infamously mean streets,” says Paul Steely White, executive director of New York-based Transportation Alternatives.

The move is perhaps the biggest effort yet from Mayor Bill DeBlasio to reduce the number of traffic-related deaths in New York City. Hundreds of New Yorkers die annually in traffic accidents and, in recent years, a number of highly publicized deaths have inspired public relations campaigns. Most dramatically, DeBlasio recently introduced Vision Zero, a program designed to eliminate traffic fatalities altogether in New York.

The speed limit reduction plays a key role in Vision Zero, though no one expects the city to change overnight. Police first need to enforce the rule, something some city-dwellers think isn’t likely. But if it’s enforced, the lower speed limit could have profound effects. A car that hits a pedestrian while traveling 30 mph is twice as likely to kill that person as if it were traveling 25 mph. And it’s eight times as likely to kill a pedestrian than if it were traveling 20 mph, the average top speed that a sprinting human might collide into another object.

“The five-mile per hour difference makes a huge difference between life and death,” says White. “Moving forward, in terms of enforcement, it’s a question of whether we’ll save dozens of lives or scores or perhaps hundreds if we do enforce the speed limit.”

Slowing the roads may being about other unintended consequences, too. “What we’re trying to say is this is not just about changing speed, it’s about changing what goes on in people’s heads,” said John Whitelegg, a professor at the University of York who has helped implement programs to lower the speed limit in Germany and the United Kingdom. Whitelegg said that in the places he’s worked, researchers have found links between lower speed limits and increased physical activity. In turn, rates of obesity and diabetes are also down.

“There’s a tremendous value to being able to walk to work, walk to school,” White said. “Dare I say, that’s becoming the new American dream.”

TIME Obesity

How Weight Loss Changes Your Taste Buds

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A strange phenomenon occurred after obese patients underwent bariatric surgery

Dr. John M. Morton noticed a strange phenomenon among some of his obese patients after they underwent bariatric surgery: they seemed to taste food differently.

To find out what was going on, Morton, chief of bariatric and minimally invasive surgery at the Stanford University School of Medicine, devised a study looking at 55 bariatric patients and 33 normal-weight people. He measured how well they could identify the five tastes—sweet, sour, bitter, salty and umami—both before and after surgery. The results, presented during ObesityWeek 2014, showed that taste perceptions can change with weight loss.

People who were obese actually did taste food differently—less intensely—than their normal-weight peers. “The clinical implication of that for me was that perhaps the obese patients make up for the taste depreciation through volume,” Morton says. “That’s how they get satisfied.” Overexposure to flavors might lead to tastebud burnout, and when flavors of food aren’t intense, people might have to eat more of it to feel satiated.

After undergoing bariatric surgery, 87% of patients said they had a change in taste, and almost half of them said that food didn’t taste as good, so they ate less. Those who said their tastebuds had dulled lost 20% more weight over three months than their peers who said their tastes got sharper. And, after surgery, people had less of a preference for salty foods.

This is one of the first studies of its kind, Morton says, and more research is needed. But he hopes that mindful eating practices might help restore some taste pleasure in a way that doesn’t contribute to weight gain. “Theoretically, if you teach people to have better appreciation for food—taking your time when you eat and really savoring those flavors—perhaps people will gain satisfaction through appreciation rather than through volume,” he says.

TIME Obesity

The Link Between Weight Loss Surgery and Headaches

Weight loss surgery may be a risk factor for a specific kind of headache, according to a new study published in the journal Neurology.

Researchers looked at 338 patients with a history of spontaneous intracranial hypotension—headaches typically caused by a cerebrospinal fluid leak—and found that 11 of those patients had undergone a form of bariatric surgery. Though 11 people, 3.3% of the sample, is a seemingly small number and certainly not enough to change clinical practice, it was still significant enough for the researchers to warn physicians of the possible relationship.

If someone is experiencing spontaneous intracranial hypotension, they typically feel a headache when they are upright, and the pain goes away when they lie horizontal. That’s due to the leaking spinal fluid, which can cause pain, nausea and neck stiffing. Body weight is thought to play a role in cerebrospinal fluid pressure, and it’s possible, the study authors suggest, that fat tissue loss may increase susceptibility to the headaches.

“It’s important for people who have had bariatric surgery and their doctors to be aware of this possible link, which has not been reported before,” said study author Wouter I. Schievink, MD, of Cedars-Sinai Medical Center in Los Angeles, in a press release. “This could be the cause of sudden, severe headaches that can be treated effectively, but there can be serious consequences if misdiagnosed.”

TIME Diet/Nutrition

Soda May Age You as Much as Smoking, Study Says

The link between soda and telomere length

Nobody would mistake sugary soda for a health food, but a new study published in the American Journal of Public Health just found that a daily soda habit can age your immune cells almost two years.

Senior study author Elissa Epel, PhD, professor of psychiatry at University of California San Francisco, wanted to look at the mechanisms behind soda’s storied link to conditions like diabetes, heart attack, obesity, and even higher rates of death. She studied telomeres, the caps at the end of chromosomes in every cell in our body, from white blood cells. Shorter telomeres have been linked to health detriments like shorter lifespans and more stress, cardiovascular disease, diabetes and cancer, the study notes.

Epel and her team analyzed data from 5,309 adults in the National Health and Nutrition Examination Survey (NHANES) from about 14 years ago. They found that people who drank more sugary soda tended to have shorter telomeres. Drinking an 8-ounce daily serving of soda corresponded to 1.9 years of additional aging, and drinking a daily 20-ounce serving was linked to 4.6 more years of aging. The latter, the authors point out, is exactly the same association found between telomere length and smoking.

Only the sugary, bubbly stuff showed this effect. Epel didn’t see any association between telomere length and diet soda intake. “The extremely high dose of sugar that we can put into our body within seconds by drinking sugared beverages is uniquely toxic to metabolism,” she says.

She also didn’t see a significant link between non-carbonated sugary beverages, like fruit juice, which Epel says surprised her. But she thinks the results might be different if the data were more modern. “We think that the jury’s still out on sugared beverages—theoretically they’re just as bad,” she says. “But 14 years ago people were drinking a lot less sugared beverages…they were mostly drinking soda.” At the time of the study, 21% of adults in the study reported consuming 20 ounces or more of sugar-sweetened soda each day, but soda consumption has been on the decline for years.

Telomere length dwindles naturally as we age, but it may not be an irreversible process. Previous research shows that it’s possible to increase telomere length by as much as 10% over 5 years by stressing less and eating a healthy diet—no soda included.

Read next: Here’s How to Stop Teens From Drinking Soda

TIME Diet/Nutrition

How Healthy Are ‘Secret Menus’ at Restaurants?

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The answer is more complicated than we expected

For years, Jamba Juice has marketed healthy and nutritious smoothies blended with 100% fruit juice. But the website Hack the Menu points out a “secret menu” with items like “Red Gummy Bear” and “Pink Starburst“—both allegedly blended to taste like their candy namesakes. The rumored off-menu offerings sound a little sweeter, but potentially less healthy.

Jamba Juice is not alone in its reputation for having a secret menu: according to Hack the Menu, restaurant chains like Starbucks, In-N-Out Burger and Chipotle also oblige off-menu requests for those in the know. TIME looked into why restaurants might bother with a whole other menu, and whether secret menu options are always less healthy than their advertised counterparts. The answer is more complicated than we expected.

MORE: Try Ordering These Delicious-Sounding Drinks From Starbucks’ Secret Menu

Surprisingly, most nutritionists we spoke to had never heard of the concept of secret menus. Their feelings were mixed, but most said they were concerned about the lack of readily accessible nutritional information for off-menu items.

“So many consumers are looking for transparency,” said Keri Gans, a registered dietitian and author of The Small Change Diet. “If you want a secret menu, at least make it obvious what the calories are and [put] the nutrition analysis where it’s available for people to see.”

MORE: There’s a $10 Secret Menu Item At Arby’s Called the Meat Mountain

Excluding unhealthy items from a menu helps avoid having to disclose their lack of nutritional value. This is especially true in places like New York, where the law requires restaurant chains to display certain nutritional information in menus. That regulation doesn’t apply to items that aren’t on the menu, or those listed on a menu for less than 30 days, the New York City Department of Health and Mental Hygiene wrote in an e-mail to TIME. Secret menu items “undermine the intention of the rule,” though they’re technically legal, it said.

A lack of transparency becomes a potential problem for people with allergies, who may not be aware of what ingredients are included in the item they’re ordering, nutritionists said.

“To me, the most important thing is that the staff would be educated on what the ingredients are,” said Gans.

Spokespeople for most of the chains contacted by TIME denied the existence of a “secret menu,” but acknowledged that customers can customize their orders.

“Our people are trained to make what customers want with the ingredients we have,” said Chipotle communications director and spokesperson Chris Arnold in a statement. Nachos and a quesarito, a mammoth burrito blanked inside a quesadilla, are among the items that customers order off-menu at Chipotle, according to Hack the Menu.

MORE: Taco Bell Is Adding A Quesarito To Its Menu

But despite their shroud of secrecy, secret menus don’t appear to be all bad news, nutritionists said. Some have options that appear healthy, while others allow customers to modify a menu offering in a way that makes it healthier, said Jessica Levinson, founder of nutrition consulting business Nutritioulicious. She cited an option to swap out mayo for mustard at Burger King as one such option.

Registered dietitian Judy Caplan praised efforts to offer healthy options, but said she wasn’t surprised that some fast food restaurants would offer less healthy options off the menu. While fast food has become more nutritious in recent years, and chains have recently cut calories in new menu items by 12%, there are still many customers who want unhealthy food, she argued.

“When you’re in business,” she said, “the customer is always right.”

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