TIME Research

Why It’s Bad News That Some Teens Are Choosing E-Cigs Over Real Cigarettes

Tobacco smoking among teens is down nationwide

Fewer teens in the United States are smoking regular cigarettes, according to the results of a federally funded survey released Tuesday, but the popularity of electronic cigarettes suggests that some teens may be choosing e-cigs over traditional smokes.

Daily smoking among teenagers in the 8th, 10th, and 12th grades has been cut almost in half in the last five years, according to data from the annual “Monitoring the Future Survey.” Gathered from more than 40,000 kids in 377 public and private schools nationwide by researchers at the University of Michigan, the data also shows that more than one in six high school seniors, and almost as many sophomores, used electronic cigarettes in the last month.

MORE: E-cigs Are the New Cool Thing for Teenagers

“It is very possible that [electronic cigarettes] could account for some of the decrease in tobacco smoking — that kids that would otherwise start with tobacco cigarettes start by vaping,” said Dr. Nora Volkow, the director of the National Institute on Drug Abuse. “We are facing a completely new pattern of administering drugs.”

The data offers one possible explanation for why high schoolers are so willing to use electronic cigarettes: They think they’re safer. Just over 50% of 10th graders surveyed believed that smoking between one and five cigarettes a day posed a great risk, while only 14% thought the same thing about regular e-cig use.

While some kids may prefer the electronic alternatives, it’s also clear that many kids like to use both, just like adults who use tobacco. Of the high school seniors who said they’d used e-cigs in the last month, more than 40% said they had also smoked a conventional cigarette in the last month, too.

MORE: The Future of Smoking

While we wait for sorely needed regulation from the Food and Drug Administration (FDA), “there needs to be a massive educational campaign to dispel the hype and outright deception from the industry,” says Sen. Richard Blumenthal, (D-Conn.), who as Connecticut’s Attorney General fought to stop deceptive tobacco marketing to children.

“The industry is saying to teenagers that e-cigarettes are healthy and cool, that there is nothing in the vapor that could possibly harm you, and that they are a healthy alternative to cigarettes for people who want to quit,” he adds. “But in fact they may be a very unhealthy gateway to cigarette smoking for people who don’t use tobacco products now.”

Electronic cigarettes are such new products that research is inconclusive about their safety and whether they will act as a gateway to smoking for teens. Though the FDA has proposed plans to begin regulating them, the hundreds of e-cig offerings on the market are currently unchecked, leaving a wide range of safety implications depending on the product.

TIME Research

Doctors’ Offices Lose Millions To Magazine Theft, Study Says

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Gossip mags are most likely to escape the waiting room

It’s not just your doc who’s behind the times: magazines in doctor’s offices really are old, and now a new study in the BMJ proves it.

To test why waiting room mags are so outdated, the University of Auckland researchers equipped a waiting room with 87 magazines, both “gossipy” and news oriented, and tracked the rate at which they disappeared. Three out of five magazines that were published within the last two months were taken, compared with 29% of magazines older than two months. Over a month, an average of 1.3 magazines disappeared each day.

The study also found that people take “gossipy magazines,” defined in this study as periodicals with more than five pictures of celebrities on the cover, over news magazines like TIME and The Economist.

“Another follow-on study should be conducted to examine the effects on receptionists in a waiting room without gossipy magazines,” the study said. “Unfortunately we are not familiar with any clinic willing to participate in that research.”

Researchers decided to take on the unusual topic of magazine disappearance after one of the authors received numerous complaints from patients about the age of his office’s magazines. They concluded that magazine disappearance is widespread and estimated that, at $5 a magazine, it could cost practices in the United Kingdom $19 million—a sum much better spent on healthcare, they add.

While researchers adhered to established practices to conduct the study, they took a humorous tone in sharing their findings.

“Future research in waiting room science would include identifying who or what is responsible for the removal of magazines,” the study said. “This could involve a yet to be developed ‘find my magazine’ smart phone application.”

TIME Obesity

The 10 Healthiest and 10 Least-Healthy States

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Here are the states that are doing it right—and those in real need of a checkup

In some ways, Americans today are healthier than they were in 1990, when the United Health Foundation first published America’s Health Rankings, an annual state-by-state assessment of our nation’s health. Cardiovascular and cancer deaths are down, and the smoking rate has decreased 36%. Plus, life expectancy is at an all-time high—78.7 years. “But although we’re living longer, we’re also living sicker, with preventable illness at an alarming level,” says Reed Tuckson, MD, external senior medical advisor to United Health Foundation. The number-one reason: Obesity. “Since 1990, the obesity rate went from 11.6% to 29.4%, a 153% increase,” Dr. Tuckson says. In the last year alone, it rose 7%. Physical inactivity is also at a new high: 23.5% of Americans do not exercise at all.

Read on for the states that are doing it right—and the 10 that have a lot more work to do to improve their health.

The 10 Most Healthy States

10. Nebraska

2013 Rank: 11
Change: +1

Nebraska is among the healthiest states in America in 2014, coming in at number 10 (a slight increase over last year). Nebraska has a low rate of drug deaths, high rate of high school graduation, and high immunization coverage among children.

Challenges:
High prevalence of binge drinking
High incidence of Salmonella
Large disparity in health status by education level

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9. North Dakota

2013 Rank: 9
Change: None

North Dakota is the ninth most-healthy state in the U.S. this year, thanks to its low rate of drug deaths, high immunization coverage among teens, and low prevalence of low birth weight. North Dakota also came in ninth in 2013.

Challenges:
High prevalence of binge drinking
High prevalence of obesity
High occupational fatalities rate

8. Colorado

2013 Rank: 8
Change: None

Colorado is known for its outdoor activities—hiking, skiing, biking—so it should come as no surprise that the state has the lowest rates for obesity and diabetes in the United States. It ranks eighth for the second year in a row.

Challenges:
High prevalence of binge drinking
High prevalence of low birth weight
Large disparity in health status by education level

7. New Hampshire

2013 Rank: 5
Change: -2

New Hampshire comes in at number seven, and is just one of several New England states to rank in the top 10 for 2014. New Hampshire residents are more active than most Americans, enjoy a low rate of infectious disease, and have a low infant mortality rate. There is also high immunization coverage among teens.

Challenges:
High prevalence of binge drinking
High rate of drug deaths
Low per capita public health funding

6. Minnesota

2013 Rank: 3
Change: -3

Minnesota is known for its bitterly cold winters, but that doesn’t stop residents of this snowy state from keeping active, which also helps the state have one of the lowest obesity and diabetes rates in the nation. Minnesota also has a low rate of drug deaths.

Challenges:
High prevalence of binge drinking
High incidence of pertussis
Low per capita health funding

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5. Utah

2013 Rank: 6
Change: +1

Fewer people smoke in Utah than in any other state. Utah also has the second-lowest diabetes rate, the fourth-lowest obesity rate, a low percentage of children in poverty, and a low rate of preventable hospitalizations.

Challenges:
High rate of drug deaths
Low immunization coverage among teens
Limited availability of primary care physicians

4. Connecticut

2013 Rank: 7
Change: +3

Connecticut, the 4th-healthiest state in the U.S. this year, has a low prevalence of smoking, high immunization coverage among children, and a low occupational fatalities rate.

Challenges:
High prevalence of binge drinking
High rate of preventable hospitalizations
Large disparity in health status by education level

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3. Massachusetts

2013 Rank: 4
Change: +1

Massachusetts is the third-healthiest state in the nation in 2014. In the past two years, drug deaths have decreased by 9% and the rate of physical inactivity has decreased 11%. Massachusetts also has more residents with health insurance than any other state.

Challenges:
High prevalence of binge drinking
High rate of preventable hospitalizations
Large disparity in health status by education level

2. Vermont

2013 Rank: 2
Change: None

The runner-up—and the healthiest state in the continental U.S.—is Vermont. Vermont has the highest high school graduation rate in the country, a low percentage of children in poverty, and a low violent crime rate. In the last year, binge drinking has decreased 11% (though it’s still a challenge), and in the last two years, smoking has declined by 13%.

Challenges:
High prevalence of binge drinking
Low immunization coverage among children
Large disparity in health status by education level

1. Hawaii

2013 Rank: 1
Change: None

For the second year in a row, Hawaii earns the honor of healthiest state in America. Relatively few people in the Aloha State are obese, the cancer rate is low, and the state has the lowest rate of preventable hospitalizations in the country. Smoking has decreased by 21% in the last two years, and binge drinking has declined by 15%.

Challenges:
High prevalence of binge drinking
High incidence of infectious disease
Low immunization coverage among children

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The 10 Least Healthy States

41. Indiana

2013 Rank: 41
Change: None

With 31.8% of adults obese, 28.3% of adults never exercising, and a huge air pollution problem, Indiana comes in at number 41.

Strengths:
Low incidence of infectious disease
Low percentage of children in poverty
High immunization coverage among teens

42. South Carolina

2013 Rank: 43
Change: +1

Coming in at 42, South Carolina is struggling to keep its children healthy: it has a low rate of high school graduation, high prevalence of low birth weight, and ranks in the bottom half of the states for the immunization of children. It also has high rates of obesity, diabetes, and physical inactivity.

Strengths:
Low prevalence of binge drinking
Low incidence of pertussis
Low rate of preventable hospitalizations

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The 10 Least Healthy States

43. Alabama

2013 Rank: 47
Change: +4

Ranking 43rd overall, Alabama has the highest diabetes rate in the nation, at 13.8% of adults—a 17% increase over the last two years. The state also has a high prevalence of low birth weight and a limited availability of dentists.

Strengths:
Low prevalence of binge drinking
High immunization coverage among children
Small disparity in health status by education level

44. West Virginia

2013 Rank: 46
Change: +2

With 27.3% of the adult population lighting up, West Virginia has the highest prevalence of smoking in America. It also has more drug deaths than any other state, as well as the second-highest obesity rate.

Strengths:
Low prevalence of binge drinking
Low incidence of infectious disease
High per capita health funding

45. Tennessee

2013 Rank: 42
Change: -3

Tennessee ranks 50th for violent crime, 49th for physical inactivity, 47th for obesity, and 45th overall.

Strengths:
Low prevalence of binge drinking
Low incidence of pertussis
Ready availability of primary care physicians

46. Oklahoma

2013 Rank: 44
Change: -2

Ranking 46th, the Sooner State has a high prevalence of physical inactivity, low immunization coverage among children, and a limited availability of primary care physicians. Since 1990, violent crime has increased 12%, while the nationwide rate dropped 37% during the same time period.

Strengths:
Low prevalence of binge drinking
Low incidence of pertussis
Low prevalence of low birth weight

47. Kentucky

2013 Rank: 45
Change: -2

While lots of people in Kentucky smoke, very few of them exercise, a combination that lands the Bluegrass State at number 47. Kentucky also suffers from a high percentage of children in poverty and a high rate of preventable hospitalizations.

Strengths:
Low prevalence of binge drinking
Low violent crime rate
High immunization coverage among children

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48. Louisiana

2013 Rank: 48
Change: None

Louisiana ranks 48th in 2014 thanks to its high incidence of infectious disease, high prevalence of low birth weight, and high rate of preventable hospitalizations.

Strengths:
Low incidence of pertussis
High immunization coverage among teens
Small disparity in health status by education level

49. Arkansas

2013 Rank: 49
Change: None

Coming in second to last—same as in 2013—Arkansas has a high incidence of infectious disease, a limited availability of dentists, and low immunization coverage among children. Additionally, obesity has increased 12% over the last two years.

Strengths:
Low prevalence of binge drinking
High per capita public health funding
Small disparity in health status by education level

50. Mississippi

2013 Rank: 50
Change: None

For the third year in a row, the least-healthy state in the U.S. is Mississippi. Mississippi ranks last on six measures: physical inactivity, rate of infectious disease, low birthweight, infant mortality, cardiovascular deaths, and premature deaths.

Strengths:
Low prevalence of binge drinking
High immunization coverage among children
Small disparity in health status by education level

This article originally appeared on Health.com

TIME Research

You Asked: What Is My Poo Telling Me?

you-asked-poop
Illustration by Peter Oumanski for TIME

Your excrement is illuminating

Some say you are what you eat. But really, you are what you poop. “Not only does stool tell you about the health of your diet, but it shows you how your body’s digestive system is handling the foods you eat,” says Dr. Anish Sheth, a Princeton-based gastroenterologist and author of What’s Your Poo Telling You?

From hemorrhoids to cancer, diseases grave and small often show up first in your feces, Sheth says. And in recent years, health experts have learned your excrement also contains a wealth of information about your microbiome, the world of microscopic organisms that live and support your body’s many internal systems.

Put simply, your poop is a window to your health—even if you don’t consider the view all that appealing.

The first thing to consider when assessing your stool (a practice Dr. Sheth heartily advocates) is consistency, both in terms of physical attributes and regularity. “The ideal stool,” Dr. Sheth says, “has been described as a single soft piece.” You’re looking for something log-ish but not too firm, he continues. Imagine dispensing soft serve ice cream into your toilet, and you’ll have the general, somewhat less delicious idea.

This type of stool indicates you’re getting plenty of water and fiber in your diet. An absence of either can produce firmer, broken-up, difficult-to-expel feces or constipation, Sheth says. How hard you have to push is also important, he adds. Ideally, you should “evacuate” your waste with almost zero effort and feel as though you’ve fully emptied yourself.

Of course, everyone has the occasional bout of diarrhea or too-firm poo. But Sheth says neither should worry you much if it happens just once or twice before you’re back to normal. If a week passes without you passing healthy-looking stool, you should speak with a doctor. Even if you’re taking a number-two every day, hard or broken-apart poop is a sign that your diet is probably too low in fiber or water, which can lead to all sorts of gastrointestinal (GI) tract issues, Sheth says.

The color of your feces is also important. If it appears black or tarry, that may be evidence of blood. “The darker the stool, the higher up in your GI tract the blood is likely coming from,” Sheth says. He explains that blood emanating from ulcers or stomach problems will darken as it passes through your digestive system.

If you see maroon or dark red hues or streaks in your poop, that could mean inflammation, colitis, or certain intestinal cancers, Sheth explains. Bright red blood often indicates hemorrhoids or problems localized very near your anus.

Even the buoyancy of your bowel movements can reveal concerns. If your poop usually floats, that may signal an issue with your body’s ability to absorb fat, which in turn might mean your pancreas is having problems, Sheth says. Some particularly bad odors could also be red flags for health issues, although you probably wouldn’t know them if you smelled them. “Some doctors can identify certain GI diseases just by the distinct smell, although people who don’t diagnose them all the time wouldn’t be able to,” Sheth explains.

To keep your poop and your health in top form, Sheth recommends a diet than includes, again, plenty of fiber. “The average American gets about nine grams of fiber a day, when you need 25,” he says. He recommends lots of whole grains, fruits, vegetables, legumes and seeds like flax or chia. “Throw those in a daily smoothie,” he suggests. “And look before you flush!”

TIME Research

Can You Really Trust the Health News You Read Online?

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Sometimes you should take reports with a grain of salt, research found

Are science-backed headlines bad for your health? A new study published in The BMJ shows that you can’t always trust what conclusions news stories draw about the latest research.

Researchers wanted to look at how often press coverage misrepresents scientific studies. So they analyzed 462 press releases from 20 leading research universities in the UK, comparing their claims to those found in the peer-reviewed paper on which they were based. After analyzing the news stories those press releases generated, the researchers traced whether the papers’ claims got inflated in translation to mainstream media. They focused on three main types of exaggeration: flawed health recommendations to change their behavior based on the “findings”; a causal association when a merely correlational one existed; and the application of animal data to the health of humans.

A full 40% of press releases contained exaggerated advice, 33% drew causative conclusions from mere correlation, and 36% drew human conclusions from animal data.

Press coverage largely followed suit, based on those flawed releases. While “there actually wasn’t that much exaggeration being invented fresh in the news,” the rates of exaggeration were much lower when press releases stayed true to the research, said the study’s co-author Petroc Sumner, PhD, a professor of neuroscience at Cardiff University in the UK.

“If you ask the scientists who’s to blame when things go wrong, 100% of them say journalists,” says Sumner. “But at least 30% of them admitted that their own press releases had exaggeration, even when they’d been heavily involved in writing them themselves.”

Why would an institution issue an inflated press release? “Universities are now all in competition with each other,” Sumner explains. “Academics have now felt this pressure, and we’re all being encouraged to come out of our ivory towers and make what we do known in the real world.”

Time-crunched journalists also feel pressure to publish, and often do so without fully investigating a university’s claims, he says. Overreaching press releases breed over-promising headlines—bad news for the majority of the population that still get most of their health and science information from media sources, Sumner says.

“That’s an awful lot of people, many, many millions of people, making lifestyle decisions based on information about health or health-related science that they’ve read in papers or heard on the news…much more so than based on actual government-driven or medically-driven public health campaigns,” he says, adding that it’s common for people to ask for certain drugs or stop taking medication based on headlines they’ve heard or read. “The cumulative effect of so much potential exaggeration and misinformation could be very large.”

News outlets didn’t differ much from one another in terms of which ones exaggerated more. Instead, press releases seemed to be the most significant factor. “In a sense, that’s actually good news,” Sumner says. “As academics, we have the power to change universities. We don’t have the power to change the pressures in newsrooms.”

TIME Healthcare

Abortion Complication Rates Are ‘Lower Than That For Wisdom Tooth Extraction’, Study Says

People who get abortions are less likely to have complications than people who have their wisdom teeth removed, finds a new study published in the journal Obstetrics & Gynecology.

Researchers at University of California San Francisco wanted to understand, from a medical standpoint, the safety of abortions, so they analyzed 54,911 of them performed from 2009-2010 on women, as well as the health care services the women received in the six weeks following the abortion.

Of those abortions, only 2.1% resulted in a complication—considerably lower than the 7% complication rate for wisdom tooth removal and 9% rate for tonsillectomy, the authors point out. Major complications that required hospitalization, surgery or a blood transfusion occurred in only 0.23% of the women in the study—126 cases. That’s lower than the rate of major complications for colonoscopy, says study author Ushma Upadhyay, PhD, an assistant professor in the department of obstetrics, gynecology and reproductive sciences at UCSF.

Fewer than 2% of abortions resulted in a minor complication. Medication abortions—a sequence often called the “abortion pill“—had the highest rate of complications at 5.2%, “the vast majority of which were minor and expected,” the study authors write. Those minor complications often mean they come back for another dose to complete the abortion.

According to the study, 23 states now have regulations that an abortion clinic must meet standards for ambulatory surgical centers. 8 states have hospital transfer agreement requirements, and 13 require hospital admitting privileges. The typical explanation for these regulations has been that safety is a factor, but the researchers hope to remove that as an issue. “Across the country, there are a record number of restrictions against abortions,” Upadhyay says. “I think basically that they’re supported by the public because they seem like they are needed”—but abortion providers sometimes can’t get admitting privileges, so abortion clinics often end up being shuttered, she says. “I hope [the data] clarifies that abortion is a safe procedure, and that it’s not this scary procedure it can be made out to be in the media or public policy,”

TIME global health

The 20 Best and Worst Health News Stories of 2014

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Wins, fails, and sensational headlines in medicine and public health

As far as sensational headlines go, the past 12 months provided no shortage of health-related material. Of course, 2014 had its share of doom-and-gloom stories about depression, domestic violence, untimely deaths, and disease outbreaks (at home and abroad), to name a few. But it also gave us reasons to celebrate: Promising new discoveries and legislation, inspiring role models and worthy causes, and healthy trends that are improving lives and changing the future. Here, in a nutshell, are the best and worst health stories of the year.

Best: Obamacare hits one-year milestone

Despite its rocky beginnings in 2013 (and the fact that many Americans still don’t understand it), the Affordable Care Act achieved several of its major goals in its first year, according to a study published in July by the Commonwealth Fund. The report found that the number of uninsured Americans dropped by 25% and that most people like their new plans and find it easier to find a doctor.

Separate studies this year also found that the ACA, also known as Obamacare, has helped young adults receive mental health treatment and could potentially lead to a decline in deaths.

Worst: Ebola outbreak in Africa (and freakout in America)

By far the biggest and most devastating health story this year has been the thousands of West Africans sickened and killed by the Ebola virus, which hit the areas of Liberia, Guinea, and Sierra Leone particularly hard.

And although the virus can only be spread through contact with bodily fluids—and despite the fact that no American has yet contracted Ebola who has not spent time treating patients with the disease—that didn’t stop hysteria in the United States. Amid calls for a travel ban and anger directed toward doctors and nurses returning home from Africa, mental health experts stated in October that anxiety about Ebola was now a bigger threat than the virus itself.

Best: Medical devices lose some of their stigma

Women who enter beauty pageants and pose for Internet selfies are often seen as vain and materialistic, but in 2014 two women fought to dispel those notions, while at the same time showcased health conditions that aren’t often seen as beautiful.

In July, Miss Idaho contestant (and eventual winner) Sierra Sandison wore an insulin pump she uses to treat her Type 1 diabetes clipped to her swimsuit during a competition. One month earlier, UK resident and Crohn’s disease sufferer Brittany Townsend had shared her own bikini photo on Facebook, complete with the colostomy bags she needs to remove waste from her body. Both photos went viral, sending messages that women like Sandison and Townsend don’t have to be ashamed.

Worst: Measles outbreak fueled by anti-vaccinators

The CDC reported in May that measles cases in the United States were at a 20-year high so far this year, largely due to unvaccinated people who contracted disease while traveling abroad and then returned home and spread it among unvaccinated members of their communities.

The number of parents who choose not to vaccinate their children in the United States is growing, despite a scientific consensus that childhood vaccines are safe and don’t cause serious health problems like autism or leukemia. Unvaccinated children have also contributed to recent outbreaks of whooping cough and mumps.

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Best: CVS stops selling cigarettes; FDA limits e-cigs

Customers can no longer pick up cigarettes along with their prescriptions at CVS pharmacies, thanks to a ban in all stores implemented in September—four weeks earlier than the date the chain had originally announced. Carnival Cruise lines also jumped on the bandwagon this year, banning smoking on its stateroom balconies in October.

E-cigarettes have seen plenty of regulations this year as well. In April, the FDA proposed regulations to ban the sale of electronic cigarettes to minors and to include health warnings on their packages, and in August, the World Health Organization recommended that countries regulate electronic cigarettes and ban their indoor use.

Worst: Enterovirus outbreak hits children nationwide

At last count, a severe respiratory illness called Enterovirus D68 has been reported in 43 states and the District of Columbia. More than 500 cases have been confirmed across the United States, mostly children, with four suspected deaths (and one confirmed).

ED68 has been described as a polio-like illness that can cause paralysis. Most infected children recover without serious illness, but those with lung conditions like asthma are at increased risk for severe symptoms.

Best: Orthorexia gets mainstream coverage

Being a diligently healthy eater may seem like a good problem to have, but a prominent blogger showed fans this year what can happen when it’s taken to an unhealthy extreme. Jordan Younger, also known as The Blonde Vegan, announced to her readers in June that she was moving away from her strict vegan lifestyle because she’d developed an eating disorder called orthorexia—an obsession with healthy foods that leads to more and more restrictions and, potentially, malnourishment.

Worst: Domestic violence rears its ugly head

The topic of domestic violence made national headlines this year when then-NFL player Ray Rice punched his then-fiancee (now wife) in an elevator; investigations since then have uncovered many more instances of spousal or partner abuse among professional football players, and cover-ups among their teams.

But a survey released in September revealed that one in five American men admits to using violence against his spouse or partner, and that domestic abuse affects people of all professions, races, and classes. A study in April also found that domestic violence can cause fear and anxiety for children who witness it, hear it, or see the resulting injuries.

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Best: Science gets wise to the dangers of sugar, white bread

Doctors and nutritionists have known for decades that added sugar is linked to diabetes and heart disease, but a study published in February really hammered home just how dangerous it can be: The average American diet contains enough added sugar to increase the risk of heart-related death by nearly 20%, reported researchers from the Centers for Disease Control and Prevention.

The health risks of white bread were exposed this year, as well: People who eat two or more servings of the refined stuff a day are more likely to become overweight or obese than those who eat less or who favor whole-grain bread, according to a Spanish study presented in May.

Worst: ‘Biggest Loser’ winner reveals shocking weight loss

When The Biggest Loser contestant Rachel Frederickson surprised viewers with her 155-pound weight loss during the show’s Season 15 finale, not everyone was pleased. Viewers expressed alarm on social media about Frederickson being too skinny, and even the show’s trainers Bob Harper and Jillian Michaels were visibly shocked at her transformation.

Frederickson has since gained back 20 pounds and found her ’perfect weight,’ but the incident seems to have had at least one permanent impact: In April, People reported that Michaels wanted to distance herself from the show because of concern for the participants’ health and wellbeing, and in June, NBC announced that Michaels would not be returning. The celebrity trainer later revealed that the show’s producers weren’t willing to make certain changes she’d requested to the show’s format.

Best: Food labels are changing for the better

The “nutrition facts” box on food packages should soon become easier to understand, thanks to a makeover first proposed by the Food and Drug Administration in February. Under the new guidelines, serving sizes will be more straightforward, calorie counts highlighted more prominently, and “daily values” for nutrients will be revised.

Some food companies have spoken out against part of the proposal that would require “added sugars” to be included on nutrition labels, but a Change.org petition submitted by the American Heart Association in November showed that public support for the measure is still strong.

It’s not yet clear if or when these measures will be put into place, but one major food-label change did happen in 2014: Beginning in August, foods can only be labeled gluten-free if they truly are free of gluten—a major win for anyone with celiac disease or gluten intolerance.

Worst: Smartphones and social media are making us sick

We can’t live without it—but more and more research is suggesting that if we’re not careful, personal technology can really mess with our health. Facebook makes us jealous of our friends and self-conscious of our bodies, texting gives us bad posture, and just having a smartphone in the same room can affect our parenting skills.

No one’s quite figured out the solution to these problems yet, but people are certainly trying; there’s no shortage of writers going on ‘digital detoxes’ and reporting back what they’ve learned. Meanwhile, a new technology-related health risk surfaced this year, as well: A paper published in October describes a man who became addicted to Google Glass.

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Best: Ice Bucket Challenge raises millions for ALS

You probably got tired of seeing the videos in your Facebook feed, but the truth is they worked: Since the Ice Bucket Challenge exploded onto the social-media scene in July, ALS nonprofits and research organizations have received more than $100 million in donations.

Amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, is a fatal neurodegenerative disease with no cure, but ALS researchers are hoping to change that. Nancy Frates, whose son Pete dreamed up the Ice Bucket Challenge after his own ALS diagnosis in 2012, recently shared in a TED Talk how clinical trials have been fast-tracked thanks to funding from the Challenge.

Worst: Robin Williams commits suicide after Parkinson’s diagnosis

America lost one of its most beloved actors in August when Robin Williams took his own life after years of struggling with depression. After his death, Williams’ wife revealed he had also recently been diagnosed with Parkinson’s disease, and an autopsy revealed his brain showed signs of Lewy Body Disease, a form of dementia that can cause hallucinations and concentration problems.

Although it’s not confirmed that these conditions played a role in Williams’ suicide, his death has shed light on several disorders that are often linked and frequently misdiagnosed or understood.

Best: Ninja warrior, curvy ballerina become unlikely fitness stars

When it comes to athlete role models, girls now have more than just soccer players and ice skaters to look up to. In July, Kacy Catanzaro became the first female contestant to reach the finals of NBC’s fitness competition American Ninja Warrior. Catanzaro made the challenging course look easy, and her victory sparked a #MightyKacy Twitter hashtag that trended worldwide.

Then in August, UnderArmour introduced us to its newest spokesperson, American Ballet Theater soloist Misty Copeland. The brand’s first commercial starring the dancer—about how she triumphed over negativity after being told she lacked the right body and was too old to become a ballerina—has more than 6 million views on YouTube, and has been called stunning, mesmerizing, and jaw-dropping.

Worst: Joan Rivers’ death raises questions about surgery safety

Comedian Joan Rivers was known for her irreverent humor, her biting fashion critiques, and perhaps most famously, her self-proclaimed obsession with plastic surgery. She went under the knife frequently, always pushing the boundaries of what it meant to age healthfully and happily.

But when the 81-year-old stopped breathing during what should have been a routine throat procedure in September (her family eventually took her off life support), her death sparked a new controversy: whether her doctors were to blame—especially after it was suggested that her surgeon took a selfie with an unconscious Rivers before the operation. In November, TMZ reported that staff members did not weigh Rivers before sedating her, potentially giving her too much medication.

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Best: ‘Angelina effect’ increases rates of genetic testing

Actress Angelina Jolie made headlines in 2013 when she had a preventative double mastectomy after testing positive for the BRCA1 gene. But the effects of her decision had wide implications in the months that followed. In September, Canadian cancer researchers revealed that the number of women seeking genetic counseling and testing at their center rose dramatically after Jolie’s announcement.

Although cancer doctors caution that not every woman should be tested, most agree that extra education and awareness is certainly a good thing. Luckily, the increase in genetic testing is coming from women who actually do have a higher risk for breast cancer, and who will get the most benefit from what they might learn.

Worst: Antibiotics still being overprescribed

Despite warnings to physicians about the overuse of antibiotics, the drugs are still being prescribed when they’re not needed. Pediatricians, for example, dole out antibiotics twice as often as needed for throat and ear infections, found a study published in September. Researchers also discovered this year that doctors are more likely to prescribe unnecessary antibiotics later in the afternoon, as their decision-making skills wear down throughout the day.

Regardless of when it’s happening, the consequences could be deadly: Misuse of antibiotics fuels the growth of drug-resistant bacteria, reported the Centers for Disease Control and Prevention in March, as it outlined new recommendations to keep the drugs from being overused in hospitals.

HEALTH.COM: 13 Healthy Reasons to Have More Sex

Best: Air quality is improving in U.S. cities

The Environmental Protection Agency shared some good news in August: The air in American cities has become significantly cleaner since 1990, with major reductions in levels of mercury, benzene, and lead. About 3 million tons per year of pollutants have also been reduced from cars and trucks, as well.

More good news for your lungs: in November, the United States announced a climate change agreement with China that aims to cut both countries’ greenhouse gas emissions by nearly a third over the next 20 years. In announcing the deal, President Obama said he hopes other nations will be inspired to make positive environmental changes, as well.

Worst: Internet flips out over Renee Zellweger’s face

As far as celebrity scandals go, Renee Zellweger’s appearance on the red carpet in October shouldn’t be anywhere near the top of this year’s list, but you’d never know it judging by the reactions she received on Twitter and in the media.

The 45-year-old actress attended an awards ceremony meant to honor the work of talented women in Hollywood, but all anyone could talk about was how different her face looked and whether she’d had plastic surgery or just, well, gotten old. Zellweger spoke out the following week, telling People that she’s glad people noticed her new look, adding, “I am healthy. For a long time I wasn’t doing such a good job with that.”

HEALTH.COM: 5 Fat-Burning Body Weight Exercises

This article originally appeared on Health.com.

TIME Diet/Nutrition

Why Farmed Salmon Is Losing Its Omega-3 Edge

Two fresh salmons
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Closing the fish oil gap

When Amanda West Reade was pregnant with her now two-year-old son, she started eating farmed salmon. As a vegetarian, she knew that getting enough protein, omega-3s, and folic acid to boost her growing baby’s development might be tricky.

“My doctor listed a few meal ideas and I thought I could handle the salmon,” says Reade. “She said to lean more towards farmed salmon because it was higher in omega-3s.”

Reade followed her doctor’s advice and added farmed salmon to her diet three times a week. “It became something I really craved,” she says.

Long-chain omega-3 fatty acids are good for the brain and eye development of growing babies and salmon has been a go-to meal for those looking for a reliable a low-mercury fish source. When it comes to omega-3 fatty acids, the message is the clear: All salmon is a good choice.

But that might soon change. A piece of farmed salmon today may contain as little as half the amount of omega-3s than it did a decade ago.

This is according to the International Fishmeal and Fish Oil Organization (IFFO), a trade group that represents stakeholders in the marine ingredient industry. The group is sounding the alarm over declining levels of omega-3s in farmed salmon.

A 2008 paper showed that for every 3.5 ounces of farmed salmon you ate, you would get about 2-2.5 grams of EPA [eicosapentaenoic acid] and DHA [docosahexaenoic acid], and that was down from 3 grams three years earlier. Since 2008, it has come down further,” says Andrew Jackson, technical director at IFFO. “You’re probably only going to get 1.5 grams per serving now.”

It’s a problem the industry has been aware of for several years.

“As the producers of fish oil, we thought it would be a good idea to inform everybody. Some retailers put it on the package. Some don’t,” says Jackson. “We’re pushing for informed decision making.”

Steady pressure on the farmed salmon industry from environmentalists has pushed producers to become more eco-friendly, including efforts to reduce the quantity of forage fish like anchovy, sardines or menhaden in their feed. These small wild fish are ground up and made into fish oil and fishmeal—a critical part of the farmed salmon’s diet. And while they are the very source of the omega-3s consumers seek, most consumers choose larger fish like salmon and tuna, rather than eating sardines themselves.

Worldwide, forage fish stocks continue to shoulder enormous pressure, and environmental groups have been calling for better management of these tiny but important fish. Dwindling numbers have also led the price of fishmeal to rise by more than doubled in recent years.

In October, Peru, the largest producer of fishmeal, shut down its anchovy fishery because the stocks simply weren’t there. Weeks later, traders saw prices soar as high as a dizzying $2,370 a metric ton—66 percent higher than prices at the year’s start.

It’s understandable that salmon farmers are racing to find a replacement for forage fish. Soy, algae, barley protein, insects, trimmings from seafood processing, and even mixed nut meal from California’s pistachio and almond industry are all appearing in feed.

Verlasso, a joint venture between ag-chemical giant DuPont and farmed-salmon giant AquaChile, has also developed a genetically modified yeast which carries genes from an omega-3 producing algae and has dramatically reduced the company’s reliance on forage fish as a component of the salmon’s diet.

“I’ve never seen so much development for aquaculture,” says Rick Barrows, research nutritionist at U.S. Department of Agriculture’s Agricultural Research Service. “There are a lot of ingredients being evaluated and developed. The whole question is, can they be scalable?”

So far, the alternatives are expensive, and most don’t solve the problem of how to keep the omega-3s in farmed salmon.

“There’s a lot of research on what we can do to address the fish oil gap. Unfortunately there’s not a good answer to that,” says Steven Hart, executive director, Soy Aquaculture Alliance. One solution is what’s called a “finishing feed.” Producers use vegetable oil for most of the salmon’s life, and then “switch it to fishmeal to keep the omega-3 levels up.”

The Dietary Guidelines Advisory Committee also have their eyes on declining levels of omega-3s in farmed salmon as they work on the 2015 recommendations for Americans.

J. Thomas Brenna, professor of human nutrition, chemistry and food science, Cornell University and committee member, says the committee plans to comment on in the change in its upcoming report to the secretaries of HHS and of agriculture. “While changes in feeds is certainly an issue, recent scientific studies do not appear to support the view that omega-3 in farmed salmon is lower than in wild salmon.”

That’s an important point.

Even if today’s farmed salmon carries far less omega-3 fatty acids than it once did, it’s now on par with wild salmon, and still packs more than species like tilapia, lobster or catfish.

So how is a consumer to know if their salmon dinner is indeed rich with omega-3s? Don’t bother looking at the label.

“Omega-3s are not labeled, so consumers can’t possibly have any idea how much farmed fish contain,” says Marion Nestle, author and New York University professor of nutrition, food studies, and public health. Levels can vary from farm to farm, depending on in-house feed recipes and the time of year salmon are harvested.

Gavin Gibbons, spokesperson for the National Fisheries Institute says even with lower levels of omega-3s, farmed salmon remains a “super food.”

“The fact is, despite any increase in plant oil ingredients in salmon feed, it still contains very high levels of omega-3s,” says Gibbons.

That’s true for now, but with a finite supply of forage fish, continued worldwide growth in aquaculture, and the absence of a holy-grail, keeping our farmed fish brimming with omega-3s could be a persistent problem. But that also assumes that farmed fish will continue to be our primary source of omega-3s.

“Should [farmed] fish have to carry the omega-3 burden?” Barrows asks.

It’s an important question to consider. As Nestle points out, “They can also be synthesized in the body from shorter chain fatty acids widely available in plants, but slowly,” says Nestle. “So eating vegetables is a slow but steady way to get omega-3s.”

This article originally appeared on Civil Eats.

TIME Research

How Sharing Your Health Data Could Change Medical Research

health data smartphone
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"There is an increasing appreciation by people that they actually own their data"

In the field of health research, data have long been held closely by the researchers who collected it. The knowledge is considered proprietary information owned by whoever conducted and funded the study, even if it has the potential to lead to future health advances.

Now, a slew of new companies and organizations promise to tear down the barriers to data collection and sharing by encouraging patients to give away their data. In addition to fostering diverse research projects, data donation helps patients learn about themselves and improve their own treatment, the companies say. The change has taken root in the medical community, and if roadblocks to privacy and data ownership can be overcome, data sharing efforts may just change the nature of research.

“Increasingly people are realizing this is an ethics issues,” says Yale Professor Harlan Krumholz of the need for relevant data to be shared among researchers. “If our job is to save lives, then it doesn’t make sense that we not share data and get as many people working on the problems as possible.”

Generally, here’s how it works: Patients contribute information about their health and receive a personal benefit of some sort. At PatientsLikeMe, for instance, patients can get treatment tips from others who have the same ailment. 23andMe, another service, provides participants with genetic information that can be used to trace ancestry. There’s also the benefit of knowing you’re contributing to medical advances.

Garth Callaghan, who suffers from kidney cancer and shares his data with PatientsLikeMe, says sharing gave him a sense of control over an ailment that he felt had taken over. “Other patients help me direct my medical team instead of me just being a participant and listening to my doctors and saying yes,” he says, adding that he hopes that sharing his data means other patients won’t need to “reinvent the wheel.”

With data in hand, the companies collecting information then act as intermediaries, deciding which research projects are worthy and facilitating access. But unlike in the long-standing research model, in which a single set of data is typically used for one study, data can be used for many projects with many different goals. In most cases, participants are also notified of the results of studies in which their data was used.

Collecting data without an initial driving question also upends traditional procedures of medical research, says James Heywood, co-founder of PatientsLikeMe.

“The world is built on this old model of raise a question, design an experiment, recruit a group of people to solve it…not in this model that we’ve built,” he says, which he calls an integrative learning model.

Health data sharing companies are only a few years old, but their influence has grown quickly. Prominent academic institutions like Yale University have signed on, along with big pharmaceutical companies like Johnson & Johnson and Pfizer.

“When we started this, it was seen as amusing. People were thinking ‘Are you kidding me?’” says Stephen Friend, who runs a non-profit he co-founded that builds platforms to facilitate data sharing. Now, he says “hubris has turned into humility” as researchers have realized the potential.

Still, Friend acknowledges there’s a long way to go and that research money spent on data intended to be shared still represents the “0.1%” of research funding.

Privacy and the question of who owns medical data are some of the concerns holding back data-sharing efforts. Typically, scientific data has been owned by whoever collects it, often universities or academic institutions that fund research. Each company has its own philosophy about who owns data when it’s shared.

Emily Drabant Conley, director of business development at 23andMe, says her company’s policy is “you own your data.” PatientsLikeMe has a policy of “mutual license,” in which both patients and the organization have rights to the data. Regardless of which model prevails, the notion that study participants have any right to their data is a noteworthy change.

“There is an increasing appreciation by people that they actually own their data, and that can actually be useful to them,” says Krumholz. “All these things are coming together in a movement to empower patients and people.”

TIME Obesity

Study: Obesity May Shorten Life Expectancy by Up to 8 Years

Young obese people are at most risk

A new study has found that obesity can shorten one’s life by almost a decade.

Researchers at McGill University linked obesity with an increased risk of developing heart disease and type 2 diabetes — ailments that dramatically reduce both life expectancy and the number of years spent free of chronic illnesses.

Obesity and extreme obesity can reduce life expectancy by up to eight years and deprive people of as many as 19 years of healthy living, the study published Thursday in The Lancet Diabetes & Endocrinology concludes.

Researchers used data from the U.S. National Health and Nutrition Examination Survey to create a model to estimate the risk of disease based on body weight and then examined how excess weight contributed to years of life lost. The model found that the younger someone becomes obese, the more years he or she ultimately loses.

“The pattern is clear,” Dr. Steven Grover, lead author and Professor of Medicine at McGill University, said in the published study. “The more an individual weighs and the younger their age, the greater the effect on their health, as they have many years ahead of them during which the increased health risks associated with obesity can negatively impact their lives.”

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