TIME Research

America’s Smoking Rate Continues to Drop

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But there are some at-risk groups, including LGBT people and Native Americans

The smoking rate for American adults has continued to fall, according to a new report.

The national smoking rate stands at 17% this year, a drop from the 18% reported in 2013, the Centers for Disease Control and Prevention found. Smoking rates were actually even lower earlier this year, when they were hovering around 15%, but some say the lower number is attributable to New Year’s resolutions.

Other demographic trends were released in the report. Multiracial people had the highest smoking rates, at 26.8%, with those of Native American ancestry close behind at 26.1%; experts believe that ceremonial use of tobacco affects Native American smoking rates. Men were more likely to smoke than women, as were those who identified as LGBT. More than 29% of smokers were below the poverty line.

The CDC notes that smoking is “the single largest preventable cause of death and disease” in the U.S., with 480,000 deaths per year being traced to cigarettes.

TIME Aging

Weight at Age 50 Connected to When a Person Gets Alzheimer’s

Being overweight may bring symptoms of the disease on earlier

Middle-aged Americans have one more reason to keep an eye on the scale as they age: research shows that people who are overweight when they are 50 years old may be more likely to develop Alzheimer’s sooner than those that are a healthy weight.

Scientists at the National Institutes of Health studied midlife obesity’s connection to Alzheimer’s and announced in a study published Tuesday in the journal Molecular Psychiatry that they had found a connection between being overweight or obese in middle age and developing Alzheimer’s.

“Maintaining a healthy BMI at midlife is likely to have long-lasting protective effects,” Dr. Madhav Thambisetty, lead author of the study and a researcher at the NIH’s National Institute on Aging, told the Associated Press.

BMI stands for body mass index, a common medical indicator that takes the ratio of a person’s weight to height. The medical community normally considers a BMI of 25 to be overweight.

Read More: New Study Identifies 9 Risk Factors for Alzheimer’s Disease

The research team used the Baltimore Longitudinal Study of Aging, a project developed to track how healthy people age, to find the correlation. The study used the records of approximately 1,400 people who’d taken regular cognitive tests for 14 years; 142 of them developed Alzheimer’s. The researchers then used the records of those 142 people to figure out their BMI and discovered that every increasing step up on BMI charts meant Alzheimer’s struck 6 1/2 months sooner.

Researchers aren’t sure if the reverse—having a healthy BMI and being slim—are indicators of not developing Alzheimer’s later on. They’re also not sure if losing weight after age 50 lessens the impact or delays Alzheimer’s.

Regardless, it’s a result that has many worried, particularly given the increasingly large population of obese middle-aged adults across the world. About 46 million people currently suffer from Alzheimer’s disease, with the number projected to double in the next 20 years.

TIME public health

Lack of Sleep Dramatically Raises Your Risk For Getting Sick

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Illustration by Sydney Rae Hass for TIME

Getting six hours of sleep a night makes you four times more likely to get a cold compared to those who sleep more than seven hours a night, finds a new study

If you want to stay healthy, skip sleep at your own risk. According to the new results of a new study, people who slept six hours a night or less were four times as likely to get sick after being exposed to the cold virus compared with those who got more sleep.

The study, published in the September issue of the journal Sleep, looked at 164 healthy adults who volunteered to catch a cold for science. The researchers first equipped the volunteers with a wrist gadget to monitor how much they slept per night over the course of a week. A couple of weeks later, they brought them into the lab and injected live rhinovirus into their nose. They then quarantined them in a hotel for five days and took a virus culture from their nose each day to see who got sick.

MORE: Here’s How Hugs Can Prevent The Flu

How many hours a person slept, it turns out, was one of the strongest predictors of whether or not they got sick—even more than other factors like a person’s age, body mass, stress levels or emotional state. People who slept six hours a night or less were four times as likely to develop a cold compared to people who slept more than seven hours a night. Those who got less than five hours of sleep a night were at 4.5 times that risk.

The study wasn’t designed to figure out the link between sleep and sickness, but Aric Prather, lead author of the study and assistant professor of psychiatry at the University of California, San Francisco, had some theories. “We know that sleep plays an important role in regulating the immune system,” he says. When we don’t sleep enough, our internal environment shifts to make us less effective at fighting off a virus, he explains; studies have shown that important immune cells are increased in the blood, meaning they’re not where we really need them to be—in the immune organs like the lymph nodes—to effectively fight off viruses.

Shortened sleep also seems to alter the inflammatory response, which helps our bodies clear out viruses when it’s functioning properly, he says.

“This is really the first convincing evidence that objectively verified sleep is associated with susceptibility to the common cold, which is a huge deal for the sleep research community,” Prather says.

Sleeping more isn’t quite a cure for the common cold, but it could go a long way in protecting you from getting sick in the first place.

TIME Diet/Nutrition

How to Tell If Your Grass-Fed Beef Is Real

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A range of practices and labels persist amid lack of regulation

When you buy a pound of hamburger in the grocery store, you’re likely to be bombarded by an incredible assortment of labels. With all-natural, grass-fed, free-range, pastured, sustainably sourced, and certified organic options to choose from, it’s not easy to parse which beef is actually the best.

In recent years, demand for grass-fed beef has grown rapidly, thanks to the popularity of high-protein diets and growing consumer awareness about the overuse of antibiotics on farms and other related concerns. Grass-fed beef is also seen as nutritionally superior to its corn-fed counterparts, thanks to the omega-3 fatty acids that cows ingest when they graze on clover and other grasses. Grass-fed burger chains are popping up all over the country, and even Carl’s Jr. began offering a grass-fed burger earlier this year.

But what exactly do we mean when we say “grass-fed”? And is all grass-fed beef the same?

It’s All in the Finishing

“All cattle are grass-fed at one time in their life, until most end up in a feedlot where they’re finished on grain,” says Texas rancher Gerry Shudde. Indeed, most cows spend at least six months eating grass, before they are “finished,” or fattened up, with grain.The National Cattlemen’s Beef Association puts that number at 12 months, but most grain-finished beef cows don’t live beyond 18 months.

According to rancher and the author of Defending Beef Nicolette Hahn Niman, the real number likely falls somewhere in the middle. “On average, the cattle in the U.S. that is going through feedlots is slaughtered at 14-16 months,” she says. “They do grow fatter and faster if they’re being fed grain, so they’re going into feedlots at younger ages to shorten that time as much as possible.” In a feedlot environment, grain causes cows to put on about one pound for every six pounds of feed they eat. In contrast, grass-fed cows are slaughtered anywhere between 18-36 months.

“When you keep cattle on grass their whole lives, and truly have them forage for a diet that their bodies have evolved to eat, you allow them to grow at a slower pace,” says Niman. Not surprisingly, caring for the animal for so long can be expensive for ranchers and consumers.

Many informed eaters will tell you that this slower process results in a signature flavor and distinct leanness that sets it apart from its corn-fed counterpart, but the fact is that beef producers can label their product “grass-fed,” even if the animal is fed grain over the course of its lifetime. Unlike the lengthy auditing process involved in U.S. Department of Agriculture’s (USDA) organic certification, the use of “grass-fed” is only regulated under the agency’s “marketing claim standards.

According to these standards, grass-fed cows are supposed to be given continuous access to rangeland, and they cannot be fed grains or grain by-products. In the event of drought or other “adverse weather conditions,” farmers are allowed to bend these rules if the animal’s wellness is in jeopardy, but they must maintain meticulous records. Unfortunately, these regulations are, for the most part, a paper tiger.

Missing Oversight

Marilyn Noble of the American Grassfed Association argues that beef producers have little incentive to stick with those rules. “It’s a big issue, and there is a lot of misunderstanding. The Agricultural Marketing Service developed the grass-fed standard, but the Food Safety and Inspection Service actually enforces it,” says Noble. “The two organizations, even though they’re both part of the USDA, don’t communicate especially well. You see a lot of beef labeled as ‘grass-fed,’ but whether or not it actually meets that standard is questionable.”

Noble’s skepticism is rooted in the fact that, for the most part, the USDA allows producers to determine whether or not their beef meets the grass-fed beef marketing claim standard. Noble says farms “self-certify” their own beef, and the Food Safety and Inspection Service generally goes along with their claim. The ubiquitous “naturally raised” label on meat has no enforceable meaning either, and further muddles a consumer’s ability to find beef that has been exclusively raised on pasture.

The American Grassfed Association, established in 2003, has far more stringent standards for its own label than the USDA, and hires third-party auditors to inspect the farms of its 100-plus certified producers across the country each year.

Farmers’ markets are also often full of vendors offering grass-fed beef from their own pastures. And the rising popularity of meat CSAs and whole animal buying clubs is an indication of how dramatically this trend has grown in recent years. With these options, consumers can talk directly to farmers to find out how their beef was raised. Many of these producers have begun using the term “pasture raised,” another unregulated labeling term that is popular among ranchers.

Even Whole Foods has adopted some of this farm-to-market language in its meat sourcing standards. For example, “pasture-centered” farms score a 4 out of 5 on the grocer’s Animal Welfare Rating scale (owned by Global Animal Partnership). In reality, Niman says, these animals may not be doing much of the foraging that gives grass-fed beef its nutritional benefits.

“[Whole Foods] has been encouraging this segment of beef in the marketplace where animals are roaming on a small area with vegetative cover,” says Niman. “But they’re being provided feed, and not actually getting most of their nutrition from foraging. It’s almost like a feedlot.”

At BN Ranch, which Nicolette operates with her husband, Bill Niman, “the godfather of sustainable meat” and founder of Niman Ranch, cattle is given more time to slowly develop fat over a period of more than two years. For the Nimans, good “eating quality” in the beef is paramount. But, Nicolette says, that’s not always the case on farms where people are “doing it for philosophical reasons. They believe that grazing is ecologically superior, and that it is the right way to raise cattle. The things that are motivating them are not eating quality.”

As a result, grass-fed beef’s lean flavor is often seen as inferior. Some chefs, particularly in fine-dining steakhouses, still resist serving grass-fed beef in favor of corn-fed, USDA prime beef, because of its fat content.

Worth the Wait

Michael Sohocki, chef of Restaurant Gwendolyn in San Antonio, Texas, chooses grass-fed beef over the cheaper, richer, corn-fed cuts because he firmly believes that the process is worth the extra time and money. And his discerning diners come to his restaurant because they know the meat has been properly sourced. “When you eat stockyard beef, all of that beef is the same,” says Sohocki. “It’s done that way to guarantee its consistency. That’s what McDonald’s specializes in.”

Sohocki calls grass-fed beef “the only trustworthy product left in this world.” He sources it from nearby Shudde Ranch, where Jeanne and Gerry Shudde make a point of raising a specialized cross-breed of species suited to naturally develop fat on pasture.

“Our [cows] are on grass when they’re with their mother. And when separated, they stay on the grass,” says Gerry Shudde.

The Shuddes decided to go grass-fed by chance after acquiring a herd of Longhorn cattle that they planned to cross-breed with their own. The offspring did not fare well, but the Shuddes ultimately decided to keep the longhorn cows. When they butchered a six-year-old cow, which had been raised on grass for much longer than usual, Jeanne says, “It was really tender. We thought ‘gosh, this tastes better than what we get in the grocery store.’”

From there, the Shuddes developed their own, new breed of grass-fed cattle. They were already raising cows without antibiotics or hormones, and their farm eventually evolved into a completely grass-fed operation by 2002. Still, they had to find the right cow to produce the quality of beef that they desired. “Most of the animals that you find today have been genetically selected to do well in a feedlot environment,” says Jeanne. “If you take them and put them on grass and think they will [taste good], I’d say maybe, maybe not. But if you take an animal that is genetically survival-oriented, it will become well-marbled on grass.”

Their own cows are now a cross between that original herd of Longhorn cattle and a heritage Devon bull. “Our belief is that if they eat what they evolved to eat, and live in the way that they have evolved to, the nutrition for the animal’s survival will be there,” says Jeanne. “If the nutrition is there, humans will get that nutrition when we eat the meat.”

This article originally appeared on Civil Eats

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TIME public health

Turkey Bacon and Six Other Foods to Avoid This Week

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Spoiled turkey bacon and bread with glass bits are being recalled

In our food supply, safety sometimes slips through the cracks. Unfortunately, the U.S. saw quite a few recalls this week, and since not every recall reported to authorities makes headlines, we’ve rounded them up for you. If you purchased a product that’s been recalled, you can often return it from where you bought it for a refund.

Turkey bacon
Brand: Oscar Mayer
Contaminated with: Spoils earlier than indicated.
Kraft Heinz Foods Company is recalling about 2,068,467 pounds of turkey bacon products because the products may spoil before their “best when used by” date. The issue was discovered when consumers complained about spoilage problems. The company has received reports of illness. Read the full report here.

Brands: Sara Lee, Great Value, Kroger, Bimbo, Nature’s Harvest and L’Oven Fresh
Contaminated with: Possible glass fragments
Bimbo Bakeries has recalled some of its breads sold under a variety of brands due to the possible presence of glass from a broken light bulb in one of the company’s bakeries. The company was made aware of the problem after three consumers reported small pieces of glass on the outside of the bread. Read the full report here.

Duck head and neck
Brand: California Qi Li’s Braised Chicken
Contaminated with: Undeclared soy sauce
California Qi Li’s Braised Chicken is recalling about 6,644 pounds of duck head and duck neck products due to undeclared soy sauce. There have been no reports of illness from the product. Read the full report here.

MORE: Why You Shouldn’t Eat Delicious Charred Foods

Macadamia nuts
Brand: Jansal Valley
Contaminated with: Salmonella
Food distributor Sid Wainer and Son of New Bedford, MA is recalling Jansal Valley brand Raw Macadamia Nuts after the bacteria Salmonella was found in a one-pound package of the nuts. So far no illnesses have been reported. Read the full report here.

Gluten Free Chocolate Chip Granola Bars
Brand: Sam Mills
Contaminated with: Undeclared dairy
Sam Mills is recalling 11,083 cases of 4.4 ounce boxes of Gluten Free Chocolate Chip Granola Bars due to possible contamination with dairy. The product currently claims to be dairy-free even though there is a risk of cross contamination with dairy. This could be problematic for people with dairy sensitivities. Read the full report here.

Dark Chocolate covered Honey Grahams with Sea Salt
Brand: Trader Joe’s
Contaminated with: Undeclared milk
Candy retailer Jo’s Candies is recalling Trader Joe’s Dark Chocolate covered Honey Grahams with Sea Salt because the product may contain milk which is not listed on the label. That’s problematic for people who have milk-related allergies. So far there have been two reactions to the product reported. Read the full report here.

Green beans
Brand: Cascadian Farm
Contaminated with: Listeria monocytogenes
General Mills is recalling packages of its Cascadian Farm Cut Green Beans. One package tested positive for the bacteria Listeria monocytogenes. No illnesses have been reported. Read the full report here.

TIME public health

The Downside to the FDA’s Trans Fat Ban

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The new law will make labeling more confusing and make way for more environmentally destructive palm oil

The U.S. Food and Drug Administration (FDA) recently told food manufacturers to stop using partially hydrogenated oils (PHOs), the major source of artificial trans fats in processed foods ranging from nondairy creamers, to baked goods, margarine, and microwave popcorn. The move, the FDA said, “is expected to reduce coronary heart disease and prevent thousands of fatal heart attacks every year.”

Use of these oils has already dropped by a dramatic 78 percent since the FDA required trans fats to be listed on nutrition labels in 2006. This next phase-out won’t happen overnight: Food companies will have until June 2018 to phase them out.

Before you reach for that donut labeled “trans fat 0 grams,” here’s what you need to know.

1. Trans fats will not disappear from processed food entirely

While the FDA has determined that PHOs will no longer be “generally recognized as safe,” or GRAS, processed food will not be entirely trans-fat-free. There are other sources of trans fats, including fully refined and hydrogenated oils. Some also occur naturally in dairy and meat products.

Food manufacturers have been lobbying to slow down the removal of trans fats since the 1970s, and they are still looking for loopholes. For instance, even with the new ban, companies can petition the FDA to approve specific uses of PHOs, and they will be doing just that. The Grocery Manufacturers Association (GMA) plans to file such a petition on behalf of the industry, “seeking limited and specific use levels to continue using PHOs in food,” said GMA spokesperson Roger Lowe in a recent phone interview. The petition, “will show that the presence of trans fats from the proposed low-level uses of partially hydrogenated oils is safe as the naturally occurring trans fat present in the normal diet,” the GMA explained further in a statement. Any outcome is likely to take several years.

2. “Zero grams” of trans fat per serving does not mean no trans fats

Under current regulations, companies can say “0 grams trans fat” on nutrition labels even if each serving contains up to 0.5 grams of these fats. As the FDA itself explains, “if there is partially hydrogenated oil listed among the ingredients, the product will contain a small amount of trans fat. Selecting foods with even small amounts of trans fat can add up to a significant intake.”

In a 2015 analysis, the Environmental Working Group (EWG) found that 27 percent of the 84,000 foods in its database contain artificial trans fat and another 10 percent were likely to. EWG also found that 87 percent of the more than 7,500 foods that contained partially hydrogenated oils didn’t disclose this on nutrition labels, but showed their trans fat content at 0 grams per serving. While this is not good news for anyone’s health, it’s particularly problematic for children, who tend to take in proportionally more of these fats, said EWG nutritionist and registered dietitian Dawn Underagga.

On a call with reporters, the FDA said it has plans to deal with this labeling issue separately. The agency is now considering a proposed update to nutrition labels, but whether it will change the amount of trans fat per serving allowed under the “0 grams per serving” listing, remains to be seen.

3. The replacement fats have their own problems

One of the attractions of PHOs is their long shelf-life, which is good for processed food manufacturers. It also allows fry oil to be used many times. “Regular soybean oil has a relatively short life before it goes rancid,” explained Center for Science in the Public Interest executive director Michael Jacobsen. But now, he added, “high oleic oils”–soy, canola, cottonseed, and palm–have been engineered to make them last.

According to Chemical and Engineering News, the oils created by Dow, DuPont, and Monsanto through breeding or genetic modification “are low in polyunsaturated fatty acids, which keeps them from going rancid, and enriched in monounsaturated oleic acid,” making them more healthful than trans fats. They are less beneficial than their natural counterparts, however, “because of their reduced levels of α-linolenic acid, a polyunsaturated omega-3 fatty acid, according to Harvard School of Public Health’s website.”

Palm oil, in particular, is likely to be a solution many companies turn to in the coming years. According to the Rainforest Action Network, use of palm oil has already increased by about 500 percent in the past 10 years as labeling rules took effect, and FDA indicated a phase-out might be coming.

This has been bad news in places like Indonesia and Malaysia, where rainforests are being cleared for palm oil plantations. Not only is this destroying habitat for orangutans, elephants, tigers, and other rare species, but it is also removing some of the world’s best natural sources for absorbing atmospheric carbon emissions, significantly contributing to climate change. Human and labor rights abuses are also an ongoing problem in this industry.

During the September 2014 U.N. Climate Summit, dozens of the world’s biggest food producers–including Cargill, General Mills, Kellogg, Mondelez, Mars, Nestlé, and Walmart–pledged to reduce the carbon impacts of their products, including by making a commitment to source only sustainably grown palm oil.

Despite what he calls “tremendous changes” in palm oil supply chains, Friends of the Earth international forest campaigner Jeff Conant says the FDA’s trans fat phase-out could lead to more rain forest destruction. The U.S., said Conant, should “create and enforce mandatory environmental and social standards on palm oil investment and palm oil purchasing.” And Rainforest Action Network, which continues to watchdog the companies who’ve pledged to improve their palm oil sourcing, found that many big brands, including Sara Lee, Pepperidge Farm, Top Ramen, Cup Noodles, and Weight Watchers are still using what the group calls “conflict palm oil.”

4. This change probably won’t make Americans healthy on its own

General Mills told Civil Eats that “more than 95 percent of its U.S. retail products are already labeled zero grams trans fat, and work on the rest of the portfolio is already underway.” Kraft and Kellogg’s report similar progress. But the FDA says to truly avoid PHOs, shoppers should read ingredient lists rather than rely only on labels.

Restaurant food is trickier, since it isn’t labeled, but a number of restaurant chains–including McDonald’s–have already moved away from trans fats, partly in response to restrictions imposed by local governments, such as those in New York City, Boston, Philadelphia, Baltimore, California, and King County, in Washington’s Seattle area. But it’s still not clear whether these changes will make a significant enough impact on customers’ health.

Meanwhile, environmental health advocates are calling on FDA to act further. “This is a public health victory, but there are thousands of chemicals in the food supply the FDA should also be reviewing,” said Natural Resources Defense Council health and environment program director Erik Olson. EWG research director Renee Sharp agreed, adding, “there’s so much more that needs to be done.”

As Harvard T.H. Chan School of Public Health professor of epidemiology and nutrition Walter Willett noted in a blog on the Harvard website, while, “elimination of trans fat is an important step forward, much additional effort is needed to improve the quality of the U.S. food supply, which is far too high in refined starch, sugar, salt, and red meat, and far too low in fruits, vegetables, and whole grains.”

Elizabeth Grossman is a Portland, Oregon-based journalist specializing in environmental and science issues. She is the author of Chasing Molecules, High Tech Trash, Watershed and other books. Her work has appeared in a variety of publications, including Scientific American, Environmental Health Perspectives, Yale e360, Ensia, High Country News, The Pump Handle, Chemical Watch, Washington Post, TheAtlantic.com, Salon, The Nation, and Mother Jones.

This article originally appeared on Civil Eats

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TIME global health

Over 46 Million People Now Have Dementia Worldwide

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Dementia is often caused by Alzheimer's Disease

More than 46 million people around the world suffer from dementia, according to a report released Tuesday.

The World Alzheimer Report, published by Alzheimer’s Disease International and King’s College London, says the number of people affected by dementia has increased quickly from the 35 million estimated in 2009, and researchers warn that number could double in the next 20 years.

Dementia is a collective term for progressive, degenerative brain syndromes affecting cognitive functions. Alzheimer’s disease is a common cause of dementia.

The report also noted that 58% of all people with dementia reside in developing countries. By 2050, 68% of those with dementia will be located in low and middle income countries, where services are limited and populations are aging quickly.

There is no cure for dementia.

TIME public health

This Technology Tracks Antibiotic Resistance In Food

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Danny Kim for TIME

Federal officials have created a new public database that tracks superbugs

On Wednesday, the U.S. Centers for Disease Control and Prevention (CDC) rolled out a new interactive tool that allows users to follow the spread of antibiotic resistant bugs nationwide, called NARMS (National Antimicrobial Resistance Monitoring System) Now: Human Data. According to the CDC, every year there are two million reported illnesses and 23,000 deaths associated with antibiotic resistant bacteria. Bacteria in our food accounts for 440,000 of those illnesses.

The CDC has long tracked the travel routes of four of the common types of bacteria transmitted through food: Campylobacter, E. coli O157, Salmonella, and Shigella. The data has already helped researchers investigate the distribution of multi drug resistant strains of salmonella and track down trends in resistance. For instance, the FDA withdrew approval for Enrofloxacin (a fluoroquinolone) in chickens after NARMS data revealed growing fluoroquinolone-resistant bacterial infections among Americans. Now the interactive database is free to the public to examine how these bugs have changed through the past 18 years.

“This is an educational tool for people who want to learn more about foodborne pathogens,” says Regan Rickert-Hartman, senior epidemiologist and program coordinator for NARMS. “This is [also] a good tool for health departments that are looking to compare their data to other states.”

Interactive maps, some of the most consumer-friendly aspects of the database, allow users to watch the spread and growth of antibiotic resistant bacteria like Salmonella and Campylobacter over time through the United States.

The database was launched partly in response to calls from academics, Congress and consumer groups for more transparency and better access to data on antibiotic resistance, the CDC says. Rickert-Hartman says the database is part of the agency’s response to President Obama’s Open Government Initiative to establish more participation and open collaboration.

Though the current data only goes through 2013, Rickert-Hartman says the CDC hopes to add 2014 and 2015 data by the end of the year.

TIME Heart Disease

Working Long Hours Could Increase Your Risk of Stroke and Heart Disease

The reasons might be connected to stress, physical inactivity, and higher alcohol consumption

Burning the candle at both ends might impress your boss, but you could be sacrificing your health in the process.

A study published in The Lancet on Wednesday finds a strong connection between people who work 55 or more hours per week and cardiovascular disease. Those who work such long hours were found to have a 33% increased risk of stroke and 13% greater chance of developing coronary heart disease compared to people who work the standard 35- to 40-hour work week.

Researchers from University College London reviewed 42 studies of hundreds of thousands of men and women from Europe, the U.S., and Australia for several years. Their results held even after controlling for demographic factors—age, sex, socioeconomic status—and health behaviors—like smoking, alcohol consumption, and physical activity.

Working overtime in general, even if it’s not the 55 hour maximum the group studied, also affects health outcomes negatively. Working between 41 to 48 hours led to a 10% increased risk of stroke and upping work hours to between 49 and 54 hours a week caused a 27% increased risk of stroke.

The authors aren’t sure exactly what the link is, but noted a few potential causes. For one, working long hours tends to be correlated with risky health behaviors, like drinking more alcohol or sitting for hours at a time. Those behaviors, combined with the stress associated with working overtime, could be a perfect recipe for a stroke or cardiovascular strain.

Read next: Want a Four-Day Workweek? Here’s How to Make it Happen

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TIME medicine

Pharmaceutical Giant Amgen Settles for $71 Million For Misleading Consumers

Amgen Pharmaceutical
Robert Galbraith—Reuters Amgen's office in San Francisco on Oct. 21, 2013.

The company was accused of "making unapproved and unsubstantiated claims about prescription drugs" Aranesp and Enbrel.

Pharmaceutical company Amgen Inc. has settled with 48 states and the District of Columbia for $71 million after being accused of illegally promoting two drugs for “off-label” uses, New York State Attorney General Eric Schneiderman announced Tuesday.

The pharmaceutical company was accused of promoting its two brands, Aranesp and Enbrel, for uses not approved by the FDA.

“Pharmaceutical companies are prohibited from making unapproved and unsubstantiated claims about prescription drugs,” Schneiderman said in a press release. “Consumers need to have confidence in the accuracy of claims made by pharmaceutical companies.”

Aranesp is an anemia medication that works by stimulating bone marrow production of red blood cells. Enbrel is used to treat multiple conditions, notably chronic and severe plaque psoriasis.

A complaint filed against Amgen said Aranesp was promoted for longer dosing frequencies and for cancer-caused anemia, for which it had neither FDA approval nor scientific proof. Enbrel was promoted for mild cases of plaque psoriasis, despite being only approved for severe cases; it was also advertised to be far more effective than scientifically shown, according to the complaint.

As part of the settlement Amgen will have to change its advertising strategy to exclude it of its current misleading intent and is forbidden from continuing its current claims.

In a statement, Amgen responded by saying it “is pleased to have this matter resolved, and remains committed to fulfilling its mission to serve patients.”

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