You just sunk every penny you have into opening a restaurant. After spending years perfecting every detail from menus to music, you forgot one major element: an advertising budget. How will you make sure people experience your culinary genius? Fueled by passion, you do something you know you probably shouldn’t. You write a glowing review of your restaurant on Yelp.

Is the review a lie just because it came from the owner? Not necessarily. Just because a biased party tells you something is good doesn’t necessarily mean it’s not; their recommendation just holds less value than one from a disinterested party.

But, bias fueled by passion and economic interest happens in medical research all the time. Like you and your restaurant review, medical study funders often promote the information best for their cause. They finesse study designs and findings to make results seem more favorable for their product or service. A manufacturer of a new blood pressure drug might play up one specific benefit of their product in a way that makes you believe the drug beats others overall. It’s not fraud or misconduct, it’s just spinning results in a positive way–something any human with a vested interest in an outcome tends to do. Furthermore, data from a study means nothing by itself to most people, so invested parties can play with it as much as they want to tell a good story.

In discussing the interpretation of statistics in Made to Stick, authors Chip and Dan Heath put it this way:

Ethically challenged people with lots of analytical smarts can, with enough contortions, make almost any case from a given set of statistics.

Keep reading for more on funding bias and what you can do about it.

How is scientific research funded?

When you read a juicy new bit of research about something that might kill you or change the world as we know it, the study’s funding probably escapes your interest. But any study you read, whether it’s about drugs, medical treatments, nutrition, or even sleep, costs money. Where does the money come from? It can come from government grants, nonprofits, independent companies, and even you. When you buy dish soap, some of that profit might go to funding a Procter & Gamble study on a new cleaning chemical. Some portion of your taxes might trickle down to a government grant and end up in a laboratory. And of course, if you donate to a charity, that money might fund studies supporting that cause.

Money Talks

Since money fuels science, science itself can be shackled by economic interests, and interests of any kind can lead to bias. Even without fabricating results, funders have tools they can use to sway study results.

In a paper titled “Tobacco industry manipulation of research,” Dr. Lisa A. Bero calls out some reasons why research findings might not be as concrete as they seem:

• Any study has a context that can be skewed by framing the study, defining the problem, and sculpting that language of study questions and results.
• Data doesn’t present itself. It’s up to the funders and researchers to deliver it to the world, and this delivery can be nuanced to serve a given purpose.

That covers underlying reasons why bias happens, but how does it happen? The World Health Organization analyzed thousands of books, articles, and other materials to see how bias can occur in drug studies and promotions. Its paper, “Drug Promotion – What We Know, What We Have Yet to Learn,” outlined several ways researchers can skew results:

• Publishing results in multiple journals and with multiple authors. Different researchers can write papers on the same exact study. The multiplication of evidence revealing the same findings makes the results look more credible and can lead to a general overestimation of the studied drug’s treatment power.
• Leaving out unfavorable conclusions. Industry-funded studies left out negative results more often than their nonprofit counterparts.
• Using retrospective design, which looks backward to prove a determined outcome. With a known outcome, it’s easier to manipulate study designs to show X might cause Y.
• Putting focus on some features and leaving out others. Industry-funded studies tend to focus on acute benefits of drugs and stray away from ranking the drug’s benefits overall.
• Publishing only favorable results. If a study doesn’t achieve the desired outcomes, the industry funder can simply choose not to publish it, like a lie of omission.

Now let’s look at some real-world examples. In practice, a common method of skewing public scientific opinion involves funding counter blows to combat damaging research.

Bias in Practice

So we know bias happens, we know how it happens in theory, and in the real world the skewing attempts get even scrappier. In these examples, the industries used their funding prowess to spin the science of others.

Sugar

This NPR article relays the story of Dr. Christin Kearns, a dentist who was shocked when a handout of government advice about diabetes didn’t mention sugar. Detecting the scent of industry involvement, she began digging for evidence of similar foul play in the dental community.

After months of research and scouring through internal beet and cane sugar documents dating back to the 1950s, Kearns found that the industry does in fact push policy, especially when it concerns potentially damaging research. When the sugar industry caught wind of dental professionals’ intentions to tackle sugar consumption, they launched a counterattack to help people combat tooth decay while eating as much sugar as they wanted. They looked into enzymes that busted up plaque and other ways to fight tooth decay.

Tobacco

No surprise here: the tobacco industry’s efforts to combat damaging research have been fodder for many public health case studies. Tobacco companies specialized in contending with the findings of detrimental studies. Their philosophy read something like this: The longer you argue, the longer it takes to make decisions. And the longer it takes to make decisions, the more time we have to continue business as usual before we’re hampered with new policies. The tobacco industry used this philosophy to fight regulations for decades.

The 1950s and 60s saw tobacco companies fighting claims that smoking was bad for you. After that, they gracefully transitioned to denying the harms of secondhand smoke.

Here’s a commercial for Camel cigarettes showing doctors smoking and enjoying cigarettes and even recommending the Camel brand. Their decision to use a doctor as the main character sends a strong message to the public: If smoking was so bad, would a doctor do it?

In the 1990s, tobacco companies moved to using PR campaigns focusing on “junk science” to criticize reports on the risks of tobacco smoke, even from the government.

In 1998, big tobacco and the United States reached an agreement about how tobacco could be marketed and advertised. This Master Settlement Agreement surfaced documents outlining tobacco’s science-fighting strategy that confirmed what many had already suspected. When it came to steering science dialogue, tobacco’s policy was to:

• Pay for, publish, and promote research supporting their goals; and ,
• Suppress and criticize research going against their goals.

Tobacco’s efforts mark some of the first concerted and funded campaigns against science in history. Their efforts demonstrate the power of manipulating public opinion. Luckily, physician opinion is much harder to shape.

Does funding bias influence practice?

Good news: doctors know how to evaluate medical studies.

In a randomized study of physicians’ interpretations of funding disclosures published in the New England Journal of Medicine, researchers found a majority of physicians were fully capable of evaluating research based on academic rigor and were not fooled by common manipulations. In fact, the knowledge that a study was funded by industry caused their evaluation of the study’s rigor and likelihood of prescribing the studied drug to decrease.

What You Can Do

We can’t ignore oodles of research just because it might be biased. Luckily, there are safeguards in place. Title VIII of the Food and Drug Administration (FDA) Amendments Act of 2007 (FDAAA) made researchers start registering and submitting results to clinicaltrials.gov where you can check them out at any time. Individual journals also have publishing regulations protecting us from misleading science. For example, the New England Journal of Medicine publishes information on funding, protocols, and the funding organization’s involvement in the study with all of their articles.

But if you’re feeling less than trusting, you can develop your own methods of evaluating the research you read. When you see something new, check for other studies on the same subject to see if they coincide and take an extra careful look at the study’s design.

This graphic from Compound Interest ranks study methods on a descending scale. Keep this in mind when you’re evaluating research.

Even if it’s just something you see in a magazine, you can look up the original study to investigate the design for yourself and form your own opinion. We have access to more science than ever before. With that comes great power, but also great responsibility. Science can be biased but it’s still up to you whether or not to buy into the bias.

Resources

Primary

World Health Organization: Drug Promotion: What We Know, What We Have Yet to Learn

Additional

Washington Post: As Drug Industry’s Influence Over Research Grows, So Does the Potential For Bias

NPR: Documents Detail Sugar Industry Efforts to Direct Medical Research

Heath, Chip and Dan: Made to Stick

Plos Medicine: Sugar Industry Influence on the Scientific Agenda of the National Institute of Dental Research’s 1971 National Caries Program: A Historical Analysis of Internal Documents

Journal of the American Medical Association: Association of Funding and Conclusions in Randomized Drug Trials: A Reflection of Treatment Effect or Adverse Events?

University of California Museum of Paleontology: Who Pays For Science?

Public Health Chronicles: Tobacco Industry Manipulation of Research

Scientific American: Can the Source of Funding For Medical Research Affect the Results?

New England Journal of Medicine: A Randomized Study of How Physicians Interpret Research Funding Disclosures

New England Journal of Medicine: The Proposed Rule For U.S. Clinical Trial Registration and Results Submission

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Trusting Scientific Research: Who Funds Our Opinions? appeared first on Law Street.

Imagine the military visiting your hometown for special training exercises. Their activities wipe out your cell signal and keep your car from starting. Their exercises make so much dust and noise, you can’t hear, see, or think straight for days.

That’s okay right?

Probably not. Yet marine mammals have suffered equivalent disruptions to their daily lives during naval exercises for decades. The active sonar used in training exercises interferes with their primary guiding sense of hearing and causes them to flounder during simple tasks like feeding or navigation. As the exercises grow in size and sophistication, so does the extent of the damage they cause. Since marine mammals can’t defend themselves, several environmental organizations stood up to the government agency that’s supposed to defend them. Here’s what happened when environmentalists took on the government to save the whales, dolphins, sea turtles, and other marine animals.

Naval War Games Aren’t Games For Marine Mammals

The Navy strives to “maintain, train, and equip combat-ready Naval forces capable of winning wars, deterring aggression, and maintaining freedom of the seas.” The Navy makes sure it is capable of winning wars through training exercises, often called “war games.” Last year, the Navy planned a series of trainings classified as “military readiness activities” to occur over the next five years in the Hawaii-Southern California Training and Testing (HSTT) study area. A major downside of the trainings? They use active sonar that could potentially kill and injure the marine mammals living in the HSTT region.

Using active sonar just means you’re shooting sounds, called pings, into the water to listen for echoes. Sonar stands for “sound navigation and ranging” because the echoes returned from the pings help people and animals find and navigate around objects in their path. You can’t control the path of a ping; under water they spread out in ripples, touching everything in a given radius. This can get really noisy, really fast, as illustrated by this abstract rendition of sonar below.

If the ping hits a pile of rocks, no harm done. If the ping hits a marine mammal with ultra-sensitive hearing, it can interfere with their basic survival functions.

Marine mammals have evolved with an attuned sense of hearing that enables them to navigate through the murky undersea world, communicate with other animals, and even find food. Hearing is a marine mammal’s primary survival tool. So when military sonar pings rocket through the waves every few seconds, marine mammals can’t perform the most basic functions of life. Ships with sonar cause whales to stop eating and migrating like they should. If the animals get too close, sudden sounds can damage their life-giving hearing permanently and they could be perpetually disoriented forever. For humans, this would be like trying to walk, talk, and drive with continuously fogged-up glasses.

Even the vibrations from the sounds can cause damage under water. You know how the sound of many live drums can make it seem like your whole body is vibrating? Now imagine that times ten. When you hear on land, only your eardrums vibrate. Under water, sound waves rattle and penetrate your entire body. Intense noises–like those used in the naval trainings–can cause deadly hemorrhaging in marine mammals as powerful sounds penetrate their bodies.

This video shows how whales react to the screeching sounds of Navy sonar. They cluster closer to shore, stop diving for food, and change their swimming directions erratically. Some whales even beach themselves in an effort to escape the piercing sounds.

The Navy has been using active sonar in its trainings for years and environmental groups have fought it for almost as long. Past court rulings weighed the need to protect the public over the life of marine mammals. However, the Navy’s latest planned trainings in the HSTT area pushed the marine mammal death toll past levels evaluated in the past. The new exercise plan would include 500,000 hours of sonar, in other words, 500,000 hours of possible damage to marine mammals. According to this Washington Post article, the Navy’s own damage estimate stated 155 animals would die, 2,000 would be permanently injured, and 10 million would have their lives disrupted by the exercises. The Natural Resources Defense Council says this marks an 1,100 perecent increase when compared to other trainings from the past five years.

Armed with new facts and figures, the Natural Resources Defense Council, Cetacean Society International, the Animal Legal Defense Fund, and the Pacific Environment and Resources Center* brought forward a new lawsuit they hoped would succeed where similar efforts had failed in the past. Their case was named Conservation Council for Hawai‘i et al. v. National Marine Fisheries Service et al.

The Case

The plaintiffs didn’t go after the Navy itself, but the regulatory agency that approved the Navy’s training plan, the National Marine Fisheries Service (NMFS). Here’s a snippet from their mission page:

Under the Marine Mammal Protection Act and the Endangered Species Act, NOAA Fisheries works to recover protected marine species while allowing economic and recreational opportunities.

The Marine Mammal Protection Act prohibits the “take” (defined as “to harass, hunt, capture, or kill, or attempt to harass, hunt, capture, or kill) of marine mammals. When the Navy planned its new training exercises, it had to apply for an exception to this rule through NMFS. Their application outlined the potential death and injury counts, but the NMFS deemed those losses negligible. The attorneys on the case countered that the NMFS evaluation of the marine life damage neglected to grasp and acknowledge the full extent of potential damage caused by the Navy trainings.

The Endangered Species Act (ESA) calls for the government to protect endangered and threatened species. According to the Environmental Protection Agency, the “ESA requires federal agencies to ensure that any action they authorize, fund, or carry out, will not likely jeopardize the continued existence of any listed species, or destroy or adversely modify any critical habitat for those species.” Attorneys said the NMFS clearly neglected their duties under the ESA as many of the marine mammals found in the Navy’s massive HSTT study area are endangered.

The Verdict

U.S. District Judge Susan Oki Mollway ruled the NMFS had fallen short of its legal obligations to marine mammals by approving the Navy’s proposed training plan. She called the NMFS decision to refer to marine mammal damages from the naval exercises negligible, “arbitrary and capricious” and in violation of the Marine Mammal Protection Act. She also confirmed NMFS’s violation of the ESA, as eight of the thirty-nine marine mammal species living in the HSTT study area are endangered.

While the ruling affirmed the charges brought against the NMFS, specific remedies won’t be decided for the next few months. The decision marks a battle won, but it’s not quite the end of the war.

A Compromise?

The Natural Resources Defense Council released a statement from case attorney Zak Smith, summarizing what it hopes to get from the case:

The Navy has solutions at its disposal to ensure it limits the harm to these animals during its exercises.  It’s time to stop making excuses and embrace those safety measures.

Environmental groups aren’t asking for a complete cease and desist of all naval trainings involving active sonar. They’re just demanding the military use some of its extensive resources to develop safety measures to mitigate marine mammal damage. One option would be decreasing the test area size. Right now, the HSTT test area covers about 2.7 million square nautical miles, an area about the size of the entire United States. Another option is taking particular care to avoid areas where animals might be mating, giving birth, or feeding.

In the video above, Ken Balcomb from the Center for Whale Research says the Navy just needs to learn when and where to practice. He says just as the government would not test nuclear weapons in a crowded downtown area, they should not test active sonar in oceans teeming with delicate and endangered wildlife. For now, environmental groups remain optimistic that trainings and marine mammals can coexist safely.

Resources

Primary

Federal Register: Takes of Marine Mammals Incidental to Specified Activities; U.S. Navy Training and Testing Activities in the Hawaii-Southern California Training and Testing Study Area

Environmental Protection Agency: Endangered Species Protection Program

Additional

Washington Post: Navy War Games Face Suit Cver Impact on Whales, Dolphins

One Earth: A Silent Victory

Smithsonian Ocean Portal: Keeping An Ear Out For Whale Evolution

Los Angeles Times: Judge Rules Navy Underestimated Threat to Marine Mammals from Sonar

Natural Resources Defense Council: Court Rules Navy War Games Violate Law Protecting Whales and Dolphins

Natural Resources Defense Council: Groups Sue Feds for Putting Whales and Dolphins in Crosshairs throughout Southern California and Hawaiian Waters

Natural Resources Defense Council: Lethal Sounds

Law 360: Navy Loses Training Authorization Over Animal Concerns

Earthjustice: Sonar Complaint

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Government vs. Environmentalists: Who is Protecting Marine Wildlife? appeared first on Law Street.

Treating people when they’re already sick is like beating back invaders who have already breached your defenses. In either scenario, prevention through good defense saves money, time, and lives. But when it comes to boosting our nation’s wellness defenses through public health spending, America falls short.

When it comes to health, concerns abound that we’re wasting money, time, and lives by spending too much on treatment and recovery and not enough on prevention. Public health interventions like smoking cessation programs and disaster preparedness initiatives save lives. The more we learn about the power of these interventions, the more experts call to keep them afloat with better funding. Spending a few dollars to get a person to quit smoking makes more sense than spending thousands of dollars to try to treat their lung cancer several years down the road. Preparing for a natural disaster beforehand is preferable to picking up the pieces afterwards.

So what is public health? It’s something that aims to keep you alive as long as possible. From preventing diseases to preparing for disasters, public health programs keep a wary eye out for threats and then help populations avoid or mitigate them. For example, if data shows a high diabetes risk for a certain population, public health programs will target that population with preventative messages about diet and exercise. Public health departments might also help local school systems prepare for potential natural disasters, like Florida does with its Children’s Disaster Preparedness Program.

Read on to learn about public health spending in the United States, and where we might need to invest some more time and money.

Where’s the money?

In April, the Trust for America’s Health (TFAH) released its report Investing in America’s Health: A State-by-State Look at Public Health Funding and Key Health Facts. The report highlights many ways America falls short on public health spending. They say America’s public health system “has been chronically underfunded for decades.” In Why We Don’t Spend Enough on Public Health, author David Hemenway says this is because the benefits of public health spending today aren’t seen until potentially far in the future. Governments and politicians want to see the benefits of their investments in the present day, so they favor spending on medical treatment and other immediately fulfilling initiatives.

Here are some of the key findings:

Public Health Spending is Actually Shrinking

According to TFAH, when you adjust for inflation, public health spending in 2013 has sunk 10 percent from 2009. Many simply don’t see the benefits of spending on public health programs that yield intangible, future benefits when money could be spent on initiatives that produce immediate results like transportation or construction projects.

All States are Not Created Equal

States vary widely in what they spend on public health as funding is determined by the set-up of each state’s unique public health department. Indiana came in at a low of $15.14 per person, while Alaska spends $50.09 per person. This could be why health levels also vary widely from state to state.

Communities Aren’t Prepared for Public Health Emergencies

Public Health Emergency Preparedness (PHEP) Cooperative Agreement Funding helps communities respond to natural disasters, epidemics, and outbreaks. It was backed by $919 million in 2005. In 2013, it was supported by just $643 million.

Hospitals Aren’t Prepared for Public Health Emergencies

The Hospital Preparedness Program (HPP) gives healthcare facilities funding to beef up their preparedness measures. Funding for this program has been slashed by almost half, dropping from $515 million in 2004 to $255 million in 2015.

It’s estimated that 2/3 of all deaths in the United States result from chronic diseases typically linked to behaviors like diet or substance abuse. These diseases could be prevented by well funded intervention programs to decrease the behaviors that eventually lead to chronic diseases. Public health spending could save Americans millions in treatments for preventable diseases. Likewise public health under-spending could be costing us more than we’re saving.

In this video, the American Public Health Association outlines financial returns on every dollar of public health spending for different activities:

The above video states that every dollar spent on fluoride in our water supply could save $40 in dental care costs and that a dollar spent on nutrition education could save $10 in health care costs. The main point? Public health programs make for a smart investment.

The Consequences of Meagre Public Health Budgets

So, America spends too much money on treatment and not enough on prevention. The results aren’t pretty. In Integrating Public Health and Personal Care in a Reformed US Health Care System, authors Chernichovsky and Leibowitz write,

Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access.

The State of U.S. Health, 1990-2010 report put the U.S. up against other members of the Organization for Economic Cooperation and Development (O.E.C.D.), a program that advocates to improve economic and social outcomes. Since 1990, the U.S. has fallen in rankings for both life expectancy and healthy life expectancy. In 1990, the U.S. stood at the number 20 spot for life expectancy.  By 2010, it was down to number 27.  In 1990, the U.S. also enjoyed the number 14 spot for healthy life expectancy. The year 2010 found us in the 26th spot.

Under-spending in public health doesn’t just lead to generally poor health, it also impedes our ability to respond to emergencies. Assistant professor at the Harvard Business School, Gautam Mukunda, referred to Ebola as a “wake-up call” for the state of U.S. health preparedness. In Ebola as a Wake-Up Call he wrote,

Ebola may serve as a badly needed wake-up call about something the public health and biosecurity community has been banging the drum about for years: the U.S. has massively underinvested in public health.

Mukunda says the Ebola situation highlighted the measly number of extreme disease cases our U.S. hospitals can handle. Hospitals have decreased their capacity for extreme cases to increase their efficiency, only to lose the ability to treat patients when rare diseases strike. Although the need for extreme treatments arises only occasionally, hospitals should always be prepared for them. But with limited funding, it’s hard to be prepared for the unlikely “worst case scenarios.”

How does the future look?

The good news: The Senate finally passed a joint budget resolution after a five year absence of agreement.

The bad news:  Their budget slahes non-defense government spending by about $500 billion over the next 10 years.

The budget cuts spell trouble for discretionary educational public health programs. From disease prevention to health care worker training, programs to promote good health may suffer across the board.

In an APHA press release opposing the measure, Georges Benjamin, executive director of APHA, says,

Simply put, our federal, state and local public health agencies will not be able to do their jobs to protect the health of the American people if these drastic cuts are enacted.

The budget would also annihilate the Affordable Care Act, including the Prevention and Public Health Fund, a program that focused on moving America towards a preventative health model by funding prevention communications, research, surveillance, immunizations, tobacco cessation programs, health-care training, and more.

The resolution isn’t yet a binding law, but indicates a set of collective and alarming priorities that steer America farther from the path of an integrated, preventative public health system. The Appropriations Committee still has to draft the spending bills, so there’s room for opposition. President Obama for one said he’ll veto bills following the restrictive budget.

Evidence to Inform the Future

According to the article, Evidence Links Increases In Public Health Spending To Declines In Preventable Deaths, published in Health Affairs, mortality rates fall anywhere from 1.1 – 6.9 percent for every 10 percent uptick in public health spend. The researchers made observations over thirteen years and found that the localities with the highest upsurges in public health spending had the most significant reductions in preventable deaths. The relationship held true in multiple causes of death and across different demographics. While the study is only a correlation, the linkage presents compelling evidence for the death-decreasing value of public health spending. The researchers believe a lack of substantial evidence for the ROI of public health campaigns may have hindered spending in the past, and their report takes one step towards getting that evidence.

The Trust for America’s Health (TFAH) advocates for an America with increased core public health spending. They also recommend ways to spend the money correctly. They call for a solid public health foundation for all populations in all states so everyone can be healthy no matter where they live. After that’s established, they advise investing in strong, evidence-backed public health programs and efforts to fortify emergency preparedness. Finally, they believe public health expenditures should be completely transparent and accessible to the American public.

Experts at a recent forum of National Public Health Week looked past mere spending to consider the future of public health and consider novel ways of approaching health to make America a healthier nation. The speakers want to stretch health thinking beyond the doctor’s office to focus on environmental and lifestyle factors that promote well-being like employment, housing, education, and even racism.

These experts dream of an improved, 360 degree view of public health. But sadly, their dreams need funding to become reality. If we continue on this path, it will be very hard to become a more healthful nation.

Resources

Primary 

U.S. Department of Health and Human Services: Prevention and Public Health Fund

Additional

American Journal of Public Health: Integrating Public Health and Personal Care in a Reformed US Health Care System

The New Yorker: Why America is Losing the Health Race

Harvard Business School: Ebola as a Wake Up Call

Public Health Newswire: NPHW Forum: Creating Healthiest Nation Requires Addressing Social Determinants of Health

The Trust for America’s Health: Investing in America’s Health

The Washington Post: Senate Passes Budget Even as Impasse on Spending Continues

Public Health Newswire: House Adopts ‘Devastating’ Budget Agreement

Public Health Newswire: Senate Passes Budget that Batters Public Health

American Public Health Association: APHA Calls Budget Agreement Devastating

The Trust for America’s Health: Investing in America’s Health: A State-by-State Look at Public Health Funding & Key Health Facts

Health Affairs: Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths

The National Priorities Project: Military Spending in the United States

New England Journal of Medicine: Why We Don’t Spend Enough on Public Health

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Are We Spending Enough on Public Health? appeared first on Law Street.

The miracle of childbirth morphs into a financial nightmare for mothers without insurance or without maternity coverage in their insurance. While we all know having a baby involves much more than a visit from the stork, you might be shocked by the convoluted web of hidden costs and insurance infrastructure behind pregnancy and early motherhood in the United States. The system favors planned pregnancy and hits unintended mothers hard with unexpected costs and complications.

A woman planning for pregnancy will surely have done her insurance research, selecting a plan to cover the services she wants for pregnancy, delivery, and the baby’s first months. Her monthly insurance premiums will probably run a few hundred more dollars per month, but she’ll be pretty well taken care of. But what happens to those who find themselves pregnant without insurance or locked into plans without maternity coverage? Let’s find out. (Hint: it’s expensive.) And since the CDC estimates about half of all pregnancies in the United States occur unplanned, many women could be burdened with heavy financial woes.

Babies: You Pay for Way More Than Onesies, Diapers, and Toys

How much does having a baby cost? WebMD gives an estimate of up to $15,000 for hospital costs alone. A report from Young Invincibles provides the whopping range of $10,000-$20,000 for delivery, not counting potentially expensive complications during pregnancy and childbirth. Finally, a Truven Health Analytics study put the bill for uninsured vaginal births at a crippling $30,000, and uninsured c-section births broke the bank at $50,000 and up. Estimates fluctuate so much because every little service involved in an American pregnancy gets nailed with a different price hinging on a number of factors. This means that every woman can wind up with a different bill depending on the care she needs, the care her baby needs, her insurance or lack thereof, the hospital she chooses, and even where she lives. This makes planning ahead challenging for both insured and uninsured women.

Even talking directly to service providers might not help matters much. In a New York Times article, Elisabeth Rosenthal recounts the struggle of one uninsured expectant mother trying to get answers:

When she became pregnant, Ms. Martin called her local hospital inquiring about the price of maternity care; the finance office at first said it did not know, and then gave her a range of $4,000 to $45,000. ‘It was unreal,’ Ms. Martin said. ‘I was like, How could you not know this? You’re a hospital.’

Pregnant women might not be able to get exact numbers, but they can expect their baby bills to be pricey.

To put it all into perspective, when Kate Middleton gave birth to Prince George, the bill was only $15,000 and Kate enjoyed a private suite, chefs, and other amenities uncommon in American maternity wards. Where Americans itemize every cost, other countries put a lump-sum premium on births.

Additionally, mothers face many other costs to “having a baby” other than just giving birth. There’s a whole slew of services involved in prenatal care like ultrasounds and other diagnostics tests moms and babies need to stay healthy. If you have maternity coverage through your insurance, many or all of these services will probably be covered. But if you’re uncovered, you could spend up to $2,000 on prenatal care alone. And the payments don’t stop after you’ve given birth. Both new baby and mom could require specialized postnatal care. If you need that, you might have to bump your tab up by a couple grand more.

The Complications of Coverage

Most individual health plans (outside of employer-sponsored healthcare) don’t include maternity coverage. Many women could easily have insurance that lacks maternity care without realizing it. They could also have maternity coverage they haven’t studied closely in the absence of baby plans, leading to many unexpected costs. Investigating maternity insurance is a formidable task, as you have to look at every detail on what the coverage will pay for before, during, and after the actual birth. Even if you do serious calculations for what percentage of the different services will be covered, you could still be surprised by the final bill as costs of medical care can change with the market.

Can you get coverage if you become unexpectedly pregnant?

The short answer? Kind of.

The Affordable Care Act (ACA) made it possible for women to sign up for pregnancy coverage in special enrollment periods. While that’s wonderful,  the coverage doesn’t go into effect until the day the baby is born which doesn’t help the mother at all for care she needs during pregnancy. I did an experiment through Healthcare.gov to see if I qualified for special enrollment under the Affordable Care Act. Sure enough, the questionnaire language read as “had a baby” and not “got pregnant.” At the end of the process, the vague answer I got from the marketplace was hardly what I would want if I were actually a pregnant woman hoping to get coverage:

It looks like you may qualify for a Special Enrollment Period. This means that you can probably enroll in a 2015 health plan through the Marketplace even though the annual Open Enrollment period is over.

The ACA helps when the baby arrives, but not so much with expensive prenatal care and the cost of actually having the baby. Women able to get coverage through special enrollment could still rack up a lot of debt if you don’t have thousands of dollars waiting comfortably in an emergency fund. On the up side, the baby will be covered when it’s born. The ACA does offer an enormous help to women with incomes below a certain amount. Women who qualify can apply to receive coverage through Medicaid and the Children’s Health Insurance Program (CHIP) at any time during their pregnancy. The women who suffer the most in our system are those who make enough on paper, but lack insurance prior to getting pregnant.

Should you be able to get coverage if you become unexpectedly pregnant?

Different stakeholders’ answers to this question shed some light on why the decision involves too many factors to merit a “yes” or “no” answer. To make the discussion simple, let’s see what two major sides of the argument say.

Advocacy Groups

Advocacy groups including Young Invincibles, Planned Parenthood, and March of Dimes believe women should be able to get coverage for being pregnant (not just having a baby) whenever they want. They affirm since nearly half of all pregnancies are unplanned, we need more flexibility in maternity coverage to keep women and newborns in the United States healthy. In addition to the potential for complications in the delivery room, access to prenatal care could help women with heart conditions, diabetes, or who are at risk of preeclampsia (dangerous high blood pressure during pregnancy) get the preventive care they need to stay healthy and also deliver healthy babies.

If a woman doesn’t have coverage, she might forgo the key preventive, yet expensive, medical services she needs to stay healthy. Advocacy groups find the situation unacceptable and look toward the government for change.

Insurance Companies

Insurance companies say if women can get maternity coverage at any time, more people will wait to get coverage. Insurance company costs would spike and eventually trickle down for others enrolled in their plans to absorb. They also argue more flexible maternity coverage would make predicting costs more difficult as the system could become even less predictable.

To this concern, the nonprofit Young Invincibles released a report saying since the Affordable Care Act’s enactment, more women get insurance and fewer leave out maternity coverage, mitigating these risks for insurance companies in offering more open forms of pregnancy coverage.

So, Plan Ahead…If You Can

According to Healthy People 2020 data, about 30 percent of pregnant women do not receive early or adequate prenatal care. While many factors could claim responsibility for this statistic, surely a lack of insurance or lack of ability to get insurance plays a part. Skipping out on prenatal care puts the mother at risk, triples her risk of having an underweight baby, and increases the baby’s risk of death.

So to summarize…what happens if you’re pregnant without insurance?

• You will probably pay a lot of money to have your baby;
• The ACA will help you change coverage once your baby is born; and,
• Calculating your spending will be a headache.

Our system favors planned pregnancy. If you’re a woman of childbearing age, you can start saving for a rainy (or pregnant) day, pay a few hundred dollars more a month for just-in-case coverage, or join the voices of advocates hoping to achieve more flexibility for one of life’s most beautiful accidents.

Resources

Primary

CDC: Unintended Pregnancy Prevention

Healthcare.gov: Health Coverage if You’re Pregnant or Plan to Get Pregnant

Healthcare.gov: Healthcare Insurance Marketplace

Healthy People 2020: Maternal, Infant, and Child Health

Additional

Kaiser Health News: Pregnant and Uninsured? Don’t Count on Obamacare

Childbirth Connection: Better Maternity Care Could Save $5 Billion Annually

Young Invincibles: Without Maternity Coverage

Parents.com: Hospital Birth Costs

WebMD: What it Costs to Have a Baby

U.S. News & World Report: Health Insurance Premiums to Fluctuate Under Obamacare

Childbirth Connection: The Cost of Having a Baby in the United States

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Pregnant Without Insurance? Prepare for a Big Bill appeared first on Law Street.

Many aspects of our lives have escaped the shackles of the real world and gone digital. Most of our music, movies, work files, and even financial data exist in digital and cloud-based worlds with no tangible counterparts. But the transition to the digital realm has been slow and laborious for the largest and possibly most important data set of all: health data. The health care system in the United States has proceeded towards digitization with prudent caution; a glitch in a digital health system means more than a corrupted music file, it could mean the difference between life and death.

It’s easy to get caught up in the vision of a completely digitized healthcare system. Faster and more effective treatments? Fewer forms to fill out? Massive data sets that could vastly improve public health? Who wouldn’t be excited? Most people believe in the benefits, but the digitization of health data involves much more than just desire and ability. Laws, protocols, and privacy concerns slow digitization efforts like well-placed speed bumps.

Here’s an overview of laws affecting health digitization, how some people innovate around them, and what’s coming up next for digital health.

Health Data Laws: Well-placed Speed Bumps

Your own personal health information isn’t always just about you. A doctor can use your health data in two basic ways:

1. To treat you and only you. This is called primary use.

2. To inform broader public health decisions, including things like disease prevention. This is called secondary use.  For example, a University of Pittsburgh project called Project Tycho collected 88 million disease reports from the CDC’s Morbidity and Mortality weekly report and incorporated them into an open-access database. They use it to study the long term implications of interventions, like the polio vaccine, over long periods of time. In this video, the Dean of Pitt Public Health explains that the project is named after Tycho Brahe, a Danish astronomer who mapped stars and planets–data that Johannes Kepler eventually used to derive the laws of planetary motion. He hopes researchers can build on existing work to make groundbreaking discoveries in disease prevention.

Health data gets complicated in secondary use. Laws protect individual privacy and ensure doctors don’t compromise personal health data for the sake of public health or research goals. As the technology for sharing and collecting health data has improved, legal applications have become more complicated.

Overall, different federal and state laws layer on top of each other to create a legal framework that protects health data privacy. The centerpiece of this framework is the Health Information Portability and Accountability Act of 1996 (HIPAA).

The Health Information Portability and Accountability Act of 1996 (HIPAA) and its Privacy Rule

This rule limits the use of protected health information (PHI), which is health information that might be used to figure out your identity. Basically, no one can use your info without your permission. It oversees the gambit of entities that might touch your info in the entire healthcare system.

The rule isn’t a nail in the coffin for the use of data in public health. Entities can use PHI without authorization for the prevention and control of disease, disability, or injury. The law also allows unauthorized use of PHI for matters of national security and for law enforcement activities. Working with these exemptions, public health entities can make brilliant use of PHI. For example, the University of Maryland Center for Substance Abuse Research’s National Drug Early Warning System supplements traditional health data with data found on social media tools to find patterns that indicate emerging drug trends and launches interventions to fight drug use.

The system is just one example of innovation in spite of laws that restrict health data use. But when it comes to innovation, the unregulated types of health data hold the most promise. Current laws do not cover information that is patient generated. Therefore, private companies and organizations have latched onto the idea of patient generated data and what it could mean for overall health.

Innovations in Patient-Generated Data

People share a lot of other things online, why not something as important as health data? That’s the simple philosophy behind many new, and perfectly legal, tools that count on people to opt into sharing their health information for the greater good. With no regulations on the use of patient generated data, the research and preventative implications could be revolutionary.

Here are just a few examples of tools using patient-generated data:

Apple’s ResearchKit

Apple’s new initiative harnesses the research potential of the iPhone, which has sophisticated abilities to track actions and record information. It allows individuals to participate in studies through self-reports using their iPhones instead of traveling to research centers. It’s a goldmine of quantitative data possibilities for researchers trying to understand certain diseases as the ResearchKit framework opens up endless possibilities for accessing patients. Researchers simply build an app that suits their study and launch it.

Mount Sinai, Weill Cornell Medical College, and LifeMap already used ResearchKit to develop the Asthma Help app that allows them to understand what might be aggravating asthma symptoms. It incorporates GPS data from the phones with city air quality data to advise asthma patients of locations where their symptoms could be the worst.

The Robert Wood Johnson Foundation Data for Health Initiative

This initiative doesn’t focus on collecting data, but dives into all of the data already being collected to determine what information has the potential to do the most good. According to the foundation, 40,000 health apps and wearable health devices already exist and produce a lot of useable data. They’re encouraging health professionals to look at data they already have in new ways.

University of Michigan’s Genes for Good Project

This project prospects Facebook as a potential recruiting ground for genetic research participants. The project aims to have people send spit samples to a laboratory and then fill out periodic follow up questions via a Facebook app. The participants’ personal information would still be protected. The researchers chose Facebook because it grants the ability to potentially recruit a more massive amount of participants than usual. As the researchers try to understand how the interplay of genes and the environment influence disease, more data helps make more robust conclusions.

How the Government Encourages Health Information Sharing

The government sees no reason for laws to limit innovation in the digitization of health care and has pushed out new programs that prove its commitment to digital efforts and information sharing.

In April, the HHS announced it would grant a million dollars to support community initiatives that promote the flow and sharing of health information. The money will support projects under what’s called the Community Interoperability Health Information Exchange (HIE) Program. The funds and the program will help the awardees use health information in effective, appropriate, and secure ways.

Additionally, the HHS also announced a new Federal Health IT Strategic Plan for 2015-2020. The plan tackles how to move forward in the collection, sharing, and use of health data in appropriate ways. The Nationwide Interoperability Roadmap came out in draft form this past January.

HHS Secretary Sylvia M. Burwell summarized the key purpose of the roadmap nicely:

A successful learning system relies on an interoperable health IT system where information can be collected, shared, and used to improve health, facilitate research, and inform clinical outcomes. This Roadmap explains what we can do over the next three years to get there.

What can we learn about health on social media?

Some people choose to take health matters into their own hands and social media empowers them to do so. As data and information becomes more readily available through social tools, previously unknown advantages and disadvantages could emerge.

Most recently in Belgium, a man became frustrated with the long wait times necessary to find a kidney donor in the traditional fashion. He took to Facebook to tell his story and recruit his own donors. He found eight volunteers but ultimately doctors refused to perform the surgery because it would be unfair to other patients waiting for traditional donors. This case provides a glimpse into issues of equality that might arise if more people use social tools to their advantage. Can someone use social media tools to find themselves organ donors when others can’t access the tools or even computers?

Social media has also taught us that more data isn’t always better. Not too long ago, Mark Cuban, the Dallas Mavericks owner, tweeted that people should get quarterly blood-work so they can better track their own health.

Doctors responded by saying that doing just that could have dangerous consequences. More testing produces more false or incorrect results and reveals other fluke abnormalities. The abnormalities might lead to unnecessary treatment that comes with potentially harmful side effects. Some did admit that Cuban’s vision might be one for the future–where tests have improved and the average person is well versed in analyzing his or her own medical data.

Prepare for Information Overload

The digitization of health care, whether done under HIPAA regulations or through open-source patient generated data, promises to usher in a new era of big data in health care that brings infinite possibilities for the health field. But more data does comes along with more complications. Will we be able to balance privacy with equality while actually using the data to our advantage? So far, we’re on the right track.

 Resources

Primary

Centers for Disease Control and Prevention: Federal Public Health Laws Supporting Data Use and Sharing

U.S. Department of Health and Human Services: HHS Announces $1 Million in New Grant Programs to Help Improve Sharing of Health Information

U.S. Department of Health and Human Services: New Federal Health IT Strategic Plan Sets Stage for Better Sharing Through Interoperability

National Institute of Drug Abuse: NIH System to Monitor Emerging Drug Trends

Additional

Public Health Reports: Big Data and Public Health: Navigating Privacy Laws to Maximize Potential

Robert Wood Johnson Foundation: Using Data to Build a Culture of Health

Robert Wood Johnson Foundation: Robert Wood Johnson Foundation Launches Initiative to Assess How Data Can Be Used to Improve Health

NPR: Tracking Your Own Health Data Too Closely Can Make You Sick

The Atlantic: Should Patients Be Able to Find Organ Donors on Facebook?

Apple: ResearchKit

Buzzfeed: A New Facebook App Wants To Test Your DNA

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Healthcare Digitization: Balancing Public Health and Privacy appeared first on Law Street.

One decade ago, the iconic Bald Eagle lived up to the American dream by defying extinction.

At the dawn of the 20th century, the majestic bird of prey found itself in peril, and not from natural causes. The Bald Eagle’s plight resulted from man-made difficulties. In the early years, hunting and logging threatened the birds, then the pesticide DDT came onto the scene. DDT ended up in the eagles’ food and caused them to lay weak, inviable eggs. Thus, the eagle population plummeted.

Americans scrambled to protect their favorite bird. The Bald Eagle Protection Act of 1940 outlawed the shooting, poisoning, or killing of Bald Eagles, DDT was banned, and Bald Eagles became one of the first species protected under the new Endangered Species Act of 1973.

In 2007, the government removed them from the endangered species list, proving the success of environmental programs and offering hope to species on the brink.

While Bald Eagles escaped extinction, many other species haven’t been so lucky. Habitat destruction, human construction, poaching, and even climate change close in on animals every day, threatening the balance of our interconnected ecosystem. Here’s an overview of what we’re doing to protect endangered species and what else we could be doing.

What does it mean to be an endangered species?

Here’s a quick rundown on how we define endangered species.

The Basics

“Endangered” is an official government designation created by the Endangered Species Act of 1973.

Animals who earn the title:

• Receive protection from potentially harmful federal activities, meaning that agencies have to consider endangered species in their authorization and funding decisions;
• Can’t be transported, sold, or “taken,” which bans any activities that can kill or harm the animal like shooting, trapping, hunting, and pursuing;
• Become eligible for U.S. Fish and Wildlife Service (FWS) recovery plans. The plans evaluate research and protocols to determine needs for successful species recovery; and,
• Could be supplied with habitats if needed, purchased by the  U.S. Fish and Wildlife Service (FWS).

Protection is enforced by the U.S. Fish and Wildlife Service (FWS), a section of the Department of the Interior and the National Marine Fisheries Service (NMFS), part of the the National Oceanic Atmospheric Administration.

How do animals get the designation?

Endangered species are simply species in imminent danger of becoming extinct. A “threatened” designation refers to species at risk for becoming endangered soon.

Common things that can endanger a species are:

• Destruction or alteration of habitat.
• Overuse for education, scientific, commercial, or recreational purposes.
• Disease.
• Predation.
• Any natural or man-made factors that affect survival, which could cover a number of human activities.

After establishing those factors, “candidates” for the list run through a thorough review process that could take up to two years. In that time, experts submit biological information on the species that will help inform the decision. In the review, experts consider the severity of the threat, how soon the extinction could happen, and the uniqueness of the species. You can check out the current list of candidates here.

Once a species gets on the list, the authorities reevaluate that case every five years to see if a classification should be removed or changed.

The ESA is an American law, yet many endangered species like tigers and gorillas aren’t in the United States. In these cases, the ESA enforces bans and limits on trade in endangered animal body parts.

Opposition to the Current Policies

Protecting species often clashes with other interests. Recently, the government listed the Long-Eared Bat as a threatened species. But farming, timber, oil, and gas interest groups claimed that protecting the bat restricts them from certain practices and would drive up costs of their operations. Use of wind turbines, natural gas wells, and pesticides would all be restricted in order to protect the bat. Organizations plan to continue voicing their concerns as the threatened designation moves toward enforcement next month.

Listen to more about the controversy via NPR:

Problems With the Current Policies 

Like the Bald Eagle, some species have recovered enough to be removed from the endangered species list. Sadly, those successes are mere droplets in an entire ocean of worry. Many of the vulnerable species at risk of extinction don’t even make it on to the endangered species list and have no other source of protection. For example, according to the World Wildlife Federation’s (WWF) 2014 Living Planet Report, the populations of all vertebrate species have declined by 52 percent in the last 40 years.

Extinction means more than the life or death of a given species, as many animals influence our ecosystem, economy, and food security in ways we can’t realize until they’re gone. The loss of one species could create a devastating domino effect. The case of the Bonobo, a type of chimpanzee, makes a perfect example of what can happen when species’ decimation continues unchecked.

The Plight of the Bonobo

Bonobos face extinction as a result of poaching from the bushmeat trade. But Bonobos themselves aren’t the only thing that we need to worry about when considering their extinction. Studies have found that a majority of plants and trees in the Democratic Republic of the Congo need Bonobos to spread their seeds and will not reproduce unless their seeds are first “processed” by the Bonobo; this means that the Bonobos’ stomach acids break down hard seed coatings and enable them to sprout. Plant growth depends on each Bonobo. On average, every Bonobo processes about 11.6 million seeds in its lifetime.

Their extinction would set off a chain reaction: loss of trees and plants, loss of other species that lived among the trees and plants, and eventually we’d reach a stillness known as empty forest syndrome, where large vertebrate populations dwindle to nothing. According to biologist David Beaune, the same thing could happen in ecosystems that unknowingly rely on other chimpanzees, gorillas, and apes that “process” and spread seeds.

U.S. Protective Actions

Last year, President Obama signed an executive order for a National Strategy for Combating Wildlife Trafficking to address the illegal wildlife trade. The strategy emphasized three priorities:

1. Strengthening enforcement of wildlife trafficking bans.
2. Cutting the illegal wildlife trade at home and abroad.
3. Strengthening partnerships in efforts to combat illegal wildlife trade and poaching.

Altogether, the strategy cracks down on the market for illegal wildlife trade as a strategy to protect animals. As Harrison Ford says in the PSA below, “When the buying stops, the killing does too.”

In February 2015, the Departments of State, Justice, and the Interior released the Implementation Plan for the strategy, which outlines specific steps that the President’s Task Force on Combating Wildlife Trafficking need to take and how its progress will be measured. You can access the full plan to read about the specific steps proposed to address the three strategic priorities bulleted above.

One example of the strategy at work is Operation Crash, a proactive criminal enforcement initiative that aims to search and reprimand people who hunt and kill rhinos or traffic their horns. Operation Crash has made 26 arrests and convicted 18 perpetrators. You can check out examples of the convictions here.

While this is excellent progress, the National Wildlife Federation recommends full participation in recovery programs and encourages stakeholders to produce measurable recovery targets that go beyond the safety net features of the Endangered Species Act. It acknowledges the need to stop the killing, but wants to see more proactive recovery assistance options.

Is “de-extinction” possible?

In the introduction of the WWF Living Planet Report 2014, Director General Marco Lambertini encourages people to take up the difficult but crucial responsibility of protecting wildlife.

Difficult, certainly, but not impossible – because it is in ourselves, who have caused the problem, that we can find the solution. Now we must work to ensure that the upcoming generation can seize the opportunity that we have so far failed to grasp, to close this destructive chapter in our history, and build a future where people can live and prosper in harmony with nature. We are all connected – and collectively, we have the potential to create the solutions that will safeguard the future of this, our one and only planet.

After all, we can’t bring species back once they’re gone. Or can we?

In the following video, writer Stewart Brand discusses the possibilities of a “dawn of de-extinction,” the reality of bringing species back from well beyond the brink by reassembling an entire genome using ancient DNA.  He discusses how geneticist George Church has created a multiplex automated genome engineering machine that tests ancient DNA combinations for viability in living organisms. Combinations that win can be used to synthetically hybridize the genome of an extinct species with the genome of its closest living relative.

So theoretically, we might be able to resurrect lost species. But in the meantime, we should focus on protecting the species that are still around.

Resources

Primary

White House: National Strategy for Combating Wildlife Trafficking & Commercial Ban on Trade in Elephant Ivory

U.S. Fish and Wildlife Service: Listing a Species as Threatened or Endangered

U.S. Department of State: Presidential Task Force Releases Implementation Plan for the National Strategy for Combating Wildlife Trafficking

U.S. Department of Justice: The Fight Against Wildlife Trafficking

Additional

National Geographic: Bald Eagles Soar Off Endangered Species List, But Will Act Be Weakened?

World Wildlife Federation: Living Planet Report 2014

National Wildlife Federation: Keeping the Endangered Species Act Strong

Oryx Journal: What Would Happen to the Trees and Lianas if Apes Disappeared?

Scientific American: If Apes Go Extinct, So Could Entire Forests

Society of Environmental Journalists: The Endangered Species Act at 40: Forty Things Journalists Should Know

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Endangered Species Protections: Are We Doing Enough? appeared first on Law Street.

Tumultuous alcohol regulations speckle America’s past. Prohibition alone demonstrates our sometimes love/hate relationship with liquor. Some people loved alcohol enough to succumb to criminal behavior. Others hated it enough to dream of scourging it completely from the nation. Extreme feelings on both sides only led to fleeting Prohibition policies, blemishes on the Constitution, and a case study in alcohol regulation.

Today, we enjoy more balanced alcohol policies, but the system has yet to achieve the perfect balance of  freedom, safety, and economic gain. From a public health perspective, alcohol consumption still presents a regulatory challenge in avoiding preventable alcohol-induced illness and death. Alcohol has unflattering ties to illness, death, and economic burden. Every year in the United States, alcohol consumption causes 1.6 million hospitalizations and 80,000 deaths. Alcohol-related liver cirrhosis alone kills 26,000 a year.

Many interventions place focus on the individual, with programs to treat heavy drinkers or educate people who might become heavy drinkers. Unfortunately, many accidents result when habitually moderate drinkers engage in uncharacteristically risky behavior. To make sure everyone benefits from interventions, many experts seek changes in alcohol regulations that could benefit the entire population. Some recent studies have yielded compelling results on how increasing taxes and adding breathalyzers to cars could yield enormous benefits to our overall well-being.

 Regulation of Alcohol in the U.S.

You can strut around certain streets of Savannah, Georgia clutching an open container with no questions asked. Try that in any city in Virginia and you could face misdemeanor charges. Alcohol policies vary–sometimes dramatically–from state to state.

Alcohol regulations fall into four major subject areas:

• How alcohol is sold and distributed
• How alcohol is purchased and served
• Taxes, usually in the form of excise taxes on wine, beer, and hard liquor
• Blood alcohol content (BAC) laws for operating cars and machinery

Recent studies on the effects of taxes and BAC laws scrutinize current policies and call attention to possible changes. Keep reading to learn about the findings and how they could mix things up.

Higher Alcohol Taxes

One action that could potentially reduce alcohol-related deaths and boost the economy? Sounds like a great idea. Unfortunately, the idea is raising taxes, which immediately puts a sour taste in many mouths. Unpopular or not, the researchers assessing the relationship between alcohol and taxes have found tax increases could yield major benefits.

Increasing Taxes Decreases Alcohol Consumption.  

Raising alcohol taxes decreases alcohol consumption, and therefore indirectly reduces alcohol-related disease and death. Research has proven many times the inverse relationship between alcohol consumption and higher taxes and prices. Compared with other prevention policies, taxation tops the list of the most effective ways to reduce drinking. Models have found increasing alcohol taxes could reduce alcohol-related deaths by about 35 percent, lower crashes by 11 percent, and even reduce transmission of sexually transmitted diseases by 6 percent.

Increasing Taxes Could Actually Create, Not Destroy, Jobs

People who oppose an increase in alcohol taxes often cite job loss and other economic concerns to justify their positions. But researchers have found that the opposite might be true, and increased alcohol taxes could actually stimulate the economy. Researchers from University of Illinois at Chicago and the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health created an online tool that tests how different alcohol tax rates could impact the economies of all 50 states.  According to the model, a $0.05 alcohol tax increase in California could create about 21,500 jobs if the tax revenue goes into the government’s general fund. You can check out the tool here and even find out what increased alcohol taxes could do in your state.

Let’s give a possible increase in alcohol taxes some perspective. Alcohol taxes have pretty much avoided being adjusted for inflation since the 1950s. Since alcohol taxes didn’t adjust with the rest of the economy, in relative terms alcohol costs significantly less than it did in the 1950s. Take beer for example; most states calculate beer taxes per quantity, not based on price. By the year 2000, state beer taxes amounted to relatively about a 1/3 of what they were in 1968 as inflation spiked beer prices but taxes stayed stagnant. While some states adjusted for inflation, most states saw tax profit dwindle by over 50 percent since 1968.

That’s why Alexander Wagenaar, a professor at University of Florida, believes taxes should be raised and automatically adjusted for inflation. He estimates that every drink consumed costs society about $1.90 in healthcare and other burdens, but points out that alcohol consumers aren’t responsible for the extra costs incurred by their actions.

Will it happen?

Any attempts to raise taxes on alcohol have been met with firm opposition from liquor lobbies and the hospitality industry. As a result, most attempts at increasing alcohol taxes have failed, at least 335 out of 364 major attempts since 2001 in New Mexico, Minnesota, Maine, and Hawaii, just to name a few. In 2012, it’s estimated that the liquor industry spent $16 million on political candidates, solidifying their place in regulatory affairs.

Mandatory breathalyzers in our cars?

Had enough of grim DUI-warning commercials and high school “Grim Reaper” days? One policy could put an end to them by physically stopping would-be drunk drivers from starting their cars. One possible alcohol intervention involves installing alcohol ignition interlocks (a.k.a in car breathalyzers) that connect to the car’s ignition and lock it if the driver’s BAC is above a pre-set limit. This might seem extreme, but shine a spotlight on the problems with alcohol-involved motor vehicle crashes (AI-MVCs) and you’ll see why it’s appealing from a policy angle.

AI-MVCs rank as a major public health threat mostly because the dangerous actions of a few can end up hurting many innocent people. Awareness campaigns and laws have decreased the problem since the 1980s, but in 1994 AI-MVCs accounted for 30 percent of all traffic fatalities and since then that percentage hasn’t really budged.

Policies like BAC limits, zero tolerance laws, and license suspension work, but they place the burden of finding and penalizing perpetrators in the hands of police officers. Without a magical drunk radar, this means some people slip through and cause devastation. Some estimates find that repeat offenders often drive drunk as many as 80 times before they’re discovered and apprehended. Even license suspensions don’t stop them, as 50 percent to 75 percent of offenders keep on driving anyway.

Interlock devices cause prevention-minded experts to salivate at the idea of nipping fatal accidents in the bud.  But would interlock devices actually help in the real world?

In 2008, the National Highway Traffic Safety Administration (NHTSA) started a five year test to determine the viability and effectiveness of widespread use of the devices. The Driver Alcohol Detection System for Safety (DADSS) program sought to find out if mandatory adoption policies would have an impact on fatal and non-fatal AI-MCVs and if they could decrease economic costs associated with AI-MCVs.

Here’s what they found out:

Interlock devices would prevent deaths and injuries: 

Using a 15 year implementation model, the DADSS program estimated that 59,000 (83 percent) deaths and 1.25 million (84 percent-88 percent) of nonfatal injuries could be prevented.

Interlock devices would reduce AI-MCV costs: 

Again, assuming a 15 year implementation model, costs associated with fatal injuries could be reduced by $260 billion and costs associated with nonfatal injuries could be reduced by $83 billion. In perspective, if the devices each cost $400 and worked 100 percent of the time, the reduction in injury costs would outweigh the implementation cost after 3 years.

A required interlock device program has already been implemented in France, the wine mecca of the world. Drivers in France need to have breathalyzers on hand or face fines. After implementing the program, France went from having one of the highest alcohol-related traffic fatalities in the world to having one of the lowest.

Will it happen?

The researchers acknowledged that mandatory interlock devices would be a drastic change, would take many years to implement, and would need to pass through the National Highway Traffic Safety Administration as a new safety standard. They recommend strengthening current policies in the interim, such as having all states require interlocks among first time DUI offenders, requiring the device use for longer periods of time, and requiring their use in the pre-conviction time frame. The DADSS found the public receptive to the idea, with 64 percent of people surveyed saying they thought it was a good idea.

 Prevention instead of Punishment  

State alcohol regulations change constantly.  With an alcohol tax system that’s stuck in the 1950s and an AI-MCV rate that hasn’t budged since 1994, more changes are certainly in order. New policies would shift our alcohol intervention system from one of punishment, to one of prevention.

If either of these ideas seem extreme to you, remember that there are already some odd alcohol-related laws on the books. For example, in Massachusetts, discounted alcohol, even during happy hour, is prohibited. When dining at a restaurant in Utah, all alcohol bottles on display must be empty. We’ve endured these and other strange alcohol laws throughout the history of the United States. Surely interventions that could reduce alcohol-related fatalities, disease, and injuries will prove more palatable to many Americans. 

 Resources

Primary

US National Library of Medicine: Effects of Beverage Alcohol Price and Tax Levels on Drinking: a Meta-analysis of 1003 Estimates from 112 Studies 

Additional 

Science Daily: Alcohol Taxes Can Improve Health, Lead to More Jobs

Association of State and Territorial Health Officials: Reducing Alcohol-Impaired Driving Through Ignition Interlock Policies

Mothers Against Drunk Driving: Ignition Interlock Frequently Asked Questions

Pew Charitable Trusts: Liquor Lobby Fights Off Tax Increases on Alcohol

American Journal of Public Health: Modeling the Injury Prevention Impact of Mandatory Alcohol Ignition Interlock Installation in All New US Vehicles

American Journal of Public Health: Effects of Alcohol Tax and Price Policies on Morbidity and Mortality: A Systematic Review

Public Health Law Research: Raising Alcohol Tax Levels to Reduce Drinking

Public Health Law Research: Effects of Alcohol Taxes on Alcohol-Related Mortality in Florida: Time-Series Analyses From 1969 to 2004

Yale Law School: Liquor Laws and Constitutional Conventions: A Legal History of the 21rst Amendment

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Breathalyzers in Cars? Changes in American Alcohol Policies appeared first on Law Street.

Could your surroundings impact your health as much as your diet, genetics, and lifestyle? The field of environmental health seeks to understand how the natural and manmade elements of our homes, work, and leisure environments impact health. To understand environmental impacts on health, experts examine a tremendous range of factors from community noise levels to the availability of public parks; some even look at dust.

I know that seems strange, because when you look at dust, I’m sure you probably see nothing but unsightly grime that makes you sneeze. But when researchers at the California Department of Toxic Substances Control look at dust, they see a possible indicator of chemicals people might be exposed to from various synthetic materials commonly found in homes.

Dust holds clues to multiple facets of your domestic life. Companies use an array of chemicals, including flame retardants, to manufacture your appliances, furniture, and even curtains. Your appliances, furniture, and curtains also contribute to the powdery detritus obscuring your coffee table. Dust offers researchers a way to investigate the holistic chemical composition of the average home atmosphere, all from the contents of a vacuum cleaner.

So why do we spend time studying dust and hundreds of other tiny environmental factors? Well, the experts in the University of Michigan video below estimate that 25-33 percent of disease globally stems from our environments. If we understood what specifically caused that percentage, we could take the first steps toward developing interventions.

With so many aspects to consider, it’s hard to make a solid connection between one environmental factor and a health outcome. But solid connections do make for golden evidence in influencing policy decisions that promote better health outcomes. A relatively new science called biomonitoring could help environmental health scientists make those golden connections by linking a pollutant directly to a health problem.

What is biomonitoring?

Biomonitoring quantifies bodily absorption of pollutants by measuring chemical amounts in human specimens like blood or urine. In the dust example mentioned above, researchers could incorporate biomonitoring by comparing the chemical composition of dust samples with the chemical levels present in residents’ blood or urine samples. This would allow them to look beyond what chemicals are present and find out if people are actually absorbing them, since atmospheric presence doesn’t automatically indicate absorption.

For example, an elemental mercury spill in a Massachusetts school caused panic when air samples revealed high mercury vapor air levels after the initial clean up. The Massachusetts Department of Public Health responded to the panic by offering urine tests. It turned out they had nothing to worry about–none of the samples indicated elevated urine mercury levels.

We worry about chemical levels in the environment because of what they might be doing to human health, but they need to be absorbed in order to cause harm. Environmental health scientists can bypass the need to study the presence of environmental pollutants one by one, by using biomonitoring to directly assess human impact. Outside of individual cases, cross-population biomonitoring data could reveal locations with disproportionate chemical exposures, a red flag that something fishy is going on.

According to the Association of Public Health Laboratories, manufacturers in the United States use more than 100,000 chemicals, yet we don’t understand what they could all do to human health. Combine this uncertainty with the rise of chronic diseases and you have a concerned public that demands many answers. Biomonitoring strives to find out which of these 100,000 chemicals make it into our bodies so we can figure out what to do about it.

How can biomonitoring affect health policy?

In the 1970s when researchers discovered that lead exposure could cause serious health problems, the U.S. implemented laws to bar it from many products like food cans, paint, and gasoline. Biomonitoring through blood testing has confirmed decreased blood lead levels since the laws were enacted, but also pointed out that low income and minority children still have levels above the CDC safe reference value, with lead in housing being the major source. After hearing these results, officials looked to housing policies as a way to decrease the problem:

• The U.S. Department of Housing and Urban Development (HUD) and the U.S. Environmental Protection Agency (EPA) required landlords to disclose lead hazards in all residences built before 1978.
• HUD made lead safety mandatory for federally funded housing and created grants for removing lead hazards from current buildings.
• The EPA began regulating painting and repair practices in all residences built before 1978.

These efforts achieved lower levels of lead hazards in government-funded housing, but did little to decrease levels in low-income or non-assisted housing.

At the state level, officials focused on finding children with elevated blood lead levels and then tried to remove lead from their environments. Some states, including Maryland, Massachusetts, and Rhode Island, implemented more prevention-based laws, but many still struggle with compliance.

To respond to a high concentration of children with elevated blood lead levels, Philadelphia officials combined public health with law in the Philadelphia Lead Court. The court was designed to increase compliance of city health codes related to lead hazards. If the court hears of a lead hazard, it issues an order to the property owner to remedy the situation. If they don’t complete hazard control activities, they’re sent to the Lead Court.

Before the court, property owners complied with lead regulations seven percent of the time. After the court was established, the compliance rate spiked to 77 percent.

These intervention successes were made possible through biomonitoring, and the connections between health and a contaminant that it revealed.

Biomonitoring and Fracking

Hydraulic fracturing (or fracking), a new and unconventional method for extracting natural gas, poses a possible health hazard to the people who live closest to fracking wells. Self reports show a disproportionate amount of respiratory problems like itchy eyes, coughing, and nose bleeds among people living near fracking wells.

Read More: Fracking is Short-Sighted in Light of Temporary U.S. Oil Boom

In this New Haven Register article, researcher Dr. Peter Rabinowitz summarizes the limitations of this self-reported data:

It’s more of an association than a causation. We want to make sure people know it’s a preliminary study. … To me it strongly indicates the need to further investigate the situation and not ignore it.

Use of biomonitoring in this instance could provide more clarity on which chemicals are present and could be causing health problems in the residents. A doctor from Aspen Integrative Health in Colorado has already tested some people who live close to drilling sites for chemical exposures. His results showed some elevated levels, but didn’t provide any conclusive links. The results could serve as a baseline comparison for other communities wishing to test residents.

The new federal rules on fracking don’t include any biomonitoring measures, but they take small steps toward understanding the possible health effects of fracking by requiring more care and accountability from drilling companies. Per the new rules, government workers can inspect fracking wells for safety, companies will have to tell the public what chemicals they use in their extraction processes, and companies will have to abide by new rules on chemical storage and disposal of flowback water.

Making Connections

The future of our health depends on our ability to make connections as we constantly introduce new chemicals into our lives through food, construction, manufacturing, and more. Environmental health scientists, supplemented by biomonitoring, work to make those connections in the hope that their findings will result in legal and policy decisions that keep people healthy.

Daunting as achieving these connections may be, daily advances, like this new University of Miami instrument to detect atmospheric mercury, bring us closer to understanding the interaction of our environment and our health. If we encourage advances in biomonitoring and other new technologies, all the vague correlations of the past could become solid connections.

Resources

 Primary

Environmental Health Perspectives: Proximity to Natural Gas Wells and Reported Health Status: Results of a Household Survey in Washington County, Pennsylvania

The Network for Public Health Law: Environmental Public Health

Additional

Association of Public Health Laboratories: Biomonitoring: Analysis of Human Exposure to Chemicals

Association of Public Health Laboratories: Measuring For Potentially Dangerous Chemicals

Public Health Law Research: Local Housing Policy Approaches to Preventing Childhood Lead Poisoning

Public Health Law Research: Public Health and Law Collaboration: The Philadelphia Lead Court Study

Public Health Law Research: Philadelphia’s Lead Court is Making a Difference

Association of Public Health Laboratories Blog: Biomonitoring and the Public Health Laboratory: Everything You Want to Know

Association of Public Health Laboratories: Biomonitoring: An Integral Component of Public Health Practice

EurekAlert: Researchers Develop New Instrument to Monitor Atmospheric Mercury

The New York Times: New Federal Rules Are Set For Fracking

Washington Post: Obama Administration Tightens Federal Rules on Oil and Gas Fracking

NPR: Interior Department Issues New Federal Rules On ‘Fracking’

The Network for Public Health Law: Environmental Public Health

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Biomonitoring: A New Way to Look at Health Policy appeared first on Law Street.

On July 20, 1969, man set foot on the moon for the first time in what Neil Armstrong famously called “one small step for a man, one giant leap for mankind.” After these first dusty steps, people pondered what giant leaps might be next, dreaming about lunar colonies, outer space tourism, and most recently, space mining.

Read More: Thanks to New Discovery Your Seat on Mars One is Looking Good

Recent unmanned moon expeditions detected a bounty of 1.6 billion tons of water ice and other rare earth elements (REE) lingering beneath the moon’s surface. Combine this enticing bounty with speedily developing technologies that make space travel more accessible and you’ve got a budding space mining industry. Space exploration technology has become infinitely cheaper, better, and smaller than it was back in 1969, pushing what was once only possible for national governments into the hands of private companies gearing up to tap into outer space resources

But one little hitch might hold them back. The only acknowledged international regulation on space travel, the Outer Space Treaty of 1967, left space property rights ambiguous. Companies and nations seem free to embark on all manner of expeditions, but the treaty doesn’t mention if they legally own any resources they pick up on the way. With hefty investments behind their ventures, space-faring companies demand assurance that they’ll be able to profit from the resources they might collect.

Will an old agreement keep businesses from capturing the teeming resources space has to offer?

Businesses With Extra-Terrestrial Aspirations

Lunar mining? Piece of cake. Tapping into outer space resources has officially graduated from being a remote possibility to a reality. Already many commercial companies are wooing investors and toiling over in-depth plans, all gearing up to get a piece of the space pie.

• The Shackleton Energy Company (SEC) plans to build the first space fueling station. Remember that 1.6 billion tons of water ice just waiting on the moon? When converted to liquid form, the hydrogen and oxygen in this ice creates a powerful chemical propellent–the most powerful we know of. Liquid hydrogen and liquid oxygen already power most space shuttle engines. SEC plans to mine the moon’s ice and set up a fuel station in Earth’s orbit. Fueling from this location instead of Earth could decrease costs by a factor of up to 20 to one.

• Moon Express developed a revolutionary vehicle, the MX-1 lunar lander, powered by sunlight and fueled by hydrogen peroxide. It will send the craft on speculating missions to investigate resources that might be mined. This company plans to perfect the safety and efficiency of lunar landings, making the moon as accessible as an eighth continent.
• Planetary Resources fixed its eye on asteroids, the most abundant sources of water that can be converted into hydrogen and oxygen rocket fuel. The company uses an algorithm to find asteroids and determine which ones might be resource rich.
• The Google Lunar X Competition offers incentives for discoveries that make getting to the moon easier and cheaper. Teams hoping to snag the $30 million grand prize have to land a robot on the moon, move it around, and send back HD Mooncasts for earth-dwellers. The competition is well under way and will wrap up in December 2016. Teams have already innovated promising robots, including this animated prototype rover named Uni from Team AngelicvM featured in the short video below.

Despite dazzling technology and high hopes, unclear space property laws pose major risks for commercial companies. Space travel costs have decreased relative to 1960s costs, but it’s still not cheap. Certainly not cheap enough that companies will launch rockets without solid assurance that they’ll own whatever resources they find on their missions. As you can see, these companies listed above, as well as many others, are ready to go. Let’s see what’s holding them back.

The Outer Space Treaty of 1967

The Outer Space Treaty of 1967 stands as the only cooperative international agreement governing space travel. The treaty clearly forbids countries from declaring sovereignty over celestial bodies in Article II:

Outer space, including the Moon and other celestial bodies, is not subject to national appropriation by claim of sovereignty, by means of use or occupation, or by any other means.

Mining isn’t specifically mentioned, but then again mining the moon was an outlandish possibility in 1967. The provision stood to bar nations from lassoing the moon, so to speak. Now as we look to extract resources from these common areas, many desire explicit, legal guarantees that they may do so–both for financial reassurance and to avoid conflict with other nations and companies wrestling over the same resources. Established property rights would provide the certainty necessary to encourage cultivating outer space for abundant natural resources.

Read More: FAA Allowing Companies to Call Dibs on the Moon

One company, Bigelow Aerospace, pushes adamantly for clarification on real property rights in space. In an internal report issued to NASA, Robert Bigelow, founder and president of the company, summarizes its desires well:

Without property rights, any plan to engage the private sector in long-term beyond LEO activities will ultimately fail. Companies and their financial backers must know that they will be able to enjoy the fruits of their labor relative to activities conducted on the Moon or other celestial bodies, and own the property that they have surveyed, developed, and are realistically able to utilize.

Who bears the burden of deciding the fate of Bigelow Aerospace and other hopeful companies? Article 6 of the Outer Space Treaty of 1967 specifies that governments bear responsibility for the activities of their nation and subjects in outer space, including the decision to authorize activities. Many U.S. government entities have a say in space happenings, but it’s the Federal Aviation Administration’s Office of Commercial Space Transportation (FAA-AST) and its advisory committee, the U.S. Commercial Space Transportation Advisory Committee (COMSTAC), that bears the burden of responding to recent requests to clarify commercial space laws.

During the most recent FAA-AST meeting in September 2014, Ken Hodgkins, Director of the Office of Space and Advanced Technology, acknowledged the number of private companies planning commercial ventures and how their activities question the legal frameworks around space exploration. He stressed balancing investment incentives with U.S. foreign policy obligations. Hodgkins stated concerns about proposed commercial activity falling in line with the Outer Space Treaty and encouraged further dialogue between private companies and U.S. agencies. He does not believe attempts at changing the treaty would result in faster resolution of the questions and assured meeting attendees that they are working with foreign nations to discuss the provisions in question.

Past Space Property Challenges

Very few cases have tested the limits of the Outer Space Treaty, so its enforceable interpretations remain unclear. However, a few incidents might influence the direction of space property rights decisions.

In one space property court case, Nemitz v. United States, a San Francisco district court ruled against a man’s claim of ownership on the asteroid 433, also known as Eros. Nemitz had filed a claim of ownership on the asteroid through a now-unpublished online database known as the Archimedes Institute. When NASA landed on his asteroid in 2001, Nemitz attempted to charge them parking fees. When they rejected him, he took his claim to court, where judges also dismissed his claim, stating that his assertion of ownership had no ground in law.

In a more powerful non-court precedent, moon materials from the Apollo landings in the 1960s have already been traded and sold. NASA traded lunar samples with the Soviet Union in exchange for their samples from robotic moon missions. Private individuals in Russia have even sold samples. These transactions imply outerspace materials can be owned, traded, and sold, giving hope to mining hopefuls.

New Space Legislation

Representative Bill Posey (R-FL) introduced H.R.1508 on March 15, 2015,

To promote the development of a United States commercial space resource exploration and utilization industry and to increase the exploration and utilization of resources in outer space

A more in-depth summary is not yet available, but you can be certain the measure will tackle legal barriers barring exploration of space resources. The bill now stands with the House Committee on Science, Space, and Technology.

Last month  the House passed the National Aeronautics and Space Administration Authorization Act of 2015, a near repeat of the National Aeronautics and Space Administration Authorization Act of 2014, which died in the Senate. The act authorizes NASA activities like space exploration, research, and education. While the bill doesn’t expressly cover commercial enterprise and space property rights, the sentiment of encouraging space-related innovation will serve commercial interests well.

Where no man has gone before…

As we speak, dreams of space colonies, moon mining, and even landing on Mars come closer to reality. This pulls legal questions and concerns to the surface, but only because we plan to go where no man has gone before. Establishing procedures will take time, cooperation, and patience, but it will be worth it to tackle our final frontier.

Resources

Primary

Federal Aviation Administration: Commercial Space Transportation Advisory Committee

U.S. Congress: Summary: H.R.810 — 114th Congress (2015-2016)

U.S. Congress: Summary: H.R. 1508 — 114th Congress (2015-2016)

United Nations Office for Outer Space Affairs: United Nations Treaties and Principles On Outer Space

Additional

Institute of Physics: Mining the Moon Becomes a Serious Prospect

Space.com: Mining the Moon? Space Property Rights Still Unclear

Washington Post: Looking for an Exotic Vacation? Here’s Why Moon Travel May Be Only 20 Years Away

Space.com: Moon Mining Idea Digs Up Lunar Legal Issues

Space Future: Real Property Rights in Outer Space

Wired: Space Law: Is Asteroid Mining Legal?

NASA Space Flight: Moon Property Rights Would Help Create Lunar Industry

Space Policy Online: Legislative Checklist 114h Congress: Major Space Related Legislation

Moon Express: Missions

Planetary Resources: NASA and Planetary Resources, Inc. Announce Results of the Asteroid Data Hunter Challenge

Space Foundation: U.S. Government Space Programs

SF Gate: Final Frontier For Lawyers — Property Rights in Space/Land Claims, Commercial Schemes and Dreams Have Legal Eagles Hovering

Space Policy online: House Passes 2015 NASA Authorization Bill

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Who Owns the Moon? Space Property Rights Are Nearing appeared first on Law Street.

Imagine ripping into a warm baguette with your bare hands. You owe its intoxicating fluffiness and delectable chewiness to gluten. A water insoluble protein found in wheat, gluten and its compounds bring us everything we expect from bread. It helps dough rise and hold its shape while also lending elasticity, making bread deliciously chewy.

Yes, we’re talking about the same gluten that has become a modern villain, misunderstood and widely hated. Popular books like “Wheat Belly and Grain Brain: The Surprising Truth About Wheat, Carbs” and “Sugar—Your Brain’s Silent Killers” turned gluten into poison in the public eye. Testimonials extolling the virtues of a gluten-free diet crusade the internet, converting many a faithful bread eater. In short, few foods have gained as much notoriety as gluten and many people think it equals anything bad in food.

Far from evil, gluten just presents a digestive challenge. When you digest wheat, the proteins break down into peptides with compact and complicated structures that cause adverse reactions in people with conditions like Celiac Disease, wheat allergies, or IBS. Unfortunately, in the past 60 years these conditions have become more common, stumping manufacturers and regulators who struggle to satisfy growing market demand for safe, gluten-free products. Read on to find out what they’ve done about gluten, and what they still have to figure out.

The anti-gluten craze: trend or reality?

Is gluten-hatred just a viral trend that people flock to like lemmings? Or is there some truth behind the gluten hate?

Scientifically, aspects of gluten-hatred hold water. Celiac Disease has quadrupled in the last 60 years. Celiac Disease is a disorder triggered by gluten that causes intestinal problems and poor absorption of vitamins and minerals.

Unfortunately, these statistics don’t point to an explanation, leaving scientists to toss around possible theories like darts. Some point the finger at wheat-breeding practices, others insist modern processing plays a part. At this point, only more well-controlled studies on the subject will lead to a consensus.

One study ruled out the possibility that the statistical growth in Celiac Disease results from better detection and diagnosis. A researcher at the Mayo Clinic analyzed existing blood samples from Air Force recruits taken between 1948-1954. He searched for the presence of transglutaminase, an enzyme that indicates Celiac Disease, and compared the percentage he found in the retro sample to the percentage he found in a modern sample of similar subjects. The percentage in the retro sample was significantly lower than what he found in the modern sample, leading him to conclude that something has happened since the 1950s to increase the overall rate of the disease–and it has nothing to do with diagnostics and detection.

The increase in Celiac Disease, combined with the increased demand for gluten-free products, even among people without diagnosed conditions, put pressure on regulators and producers. They responded first with better labeling.

Put a Label on it

In August 2013, the Federal Drug Administration (FDA) issued a final rule on gluten-free labeling that became enforceable the following year. The rule took nine years to develop and stems from the Food Allergen Labeling and Consumer Protection Act of 2004. It set a uniform protocol for companies wishing to market their products as gluten-free that established the acceptable gluten threshold at 20 parts per million (ppm). Why not zero ppm? Some processing techniques can remove most gluten from wheat-derived ingredients. The rule ensures these ingredients can’t add up to pass the safe threshold for people with gluten sensitivity. Furthermore, any food bearing a gluten-free label that lists wheat as an ingredient must also provide an explanation of how the wheat has been processed to remove the gluten.

The rule doesn’t expressly require testing and monitoring of gluten levels in ingredients to ensure compliance, but that would certainly be a safe bet for manufacturers. With the substantial list of ingredients from different sources going into processed foods, only diligent testing and monitoring can guarantee a gluten-free product. Even foods that don’t contain gluten can be cross-contaminated at some point in the long supply chain.

Per the rule, if a food labeled gluten-free actually contains gluten, it would be deemed misbranded by the FDA and subject to regulatory action. Depending on the nature of the offense, that could mean anything from a little warning letter to criminal prosecution.

Gluten Outlaws

Gluten labeling has lead to criminal prosecution before, and it happened when no FDA rule existed to break. In 2011, several customers of the Great Specialty Bread Co. in North Carolina found their Celiac symptoms became mysteriously aggravated after eating bread labeled “gluten-free.” These angry customers took their complaints to the North Carolina Department of Agriculture and Consumer Services, which passed it on to the Wake County District Attorney.

During the trial that followed, testimonies from injured customers forged a strong case against the company. One of them was a new mother whose Celiac reaction to the mislabeled bread caused her to prematurely deliver her baby. Other complaints included severe abdominal pain and rashes.

The owner of the company was ultimately found guilty of 23 counts of fraud and sentenced to nine to 11 years in prison.

Gluten: It’s Complicated

So we have an enforceable labeling policy and some criminal precedent for labeling abuse. What we lack to advance policies is a complete understanding of why gluten sensitivity is growing in the first place and how to control it.

Negative reactivity to gluten changes depending on the specific condition a person has and the variety of wheat that they eat, making gluten sensitivity hard to study as an overall subject. Gluten-sensitive conditions like Celiac Disease, wheat allergies, and other wheat sensitivities are also irritated by different compounds in wheat. Furthermore, separate varieties of wheat contain different amounts of gluten compounds and these amounts can fluctuate among the same variety depending on growing techniques and processing methods.

Growing Techniques

Studies have shown that reactivity of a wheat variety can change based on its growing location. Some compounds in wheat even increase with fertilization and in certain weather conditions. We don’t track gluten content from farm to table, so at present it’s impossible to isolate these factors to produce less reactive products.

Processing Techniques

Processing methods influence the reactivity of wheat products and stand as the prime suspect in explaining why wheat-related sensitivity has increased over the last 60 years. Of all the factors affecting the wheat industry, processing methods have changed the most. Today we favor refined white flour, we extract wheat proteins to use as additives, and we shorten the natural fermentation process using fast-acting yeast.

All of these complex factors complicate the study of gluten sensitivity and keep us from determining why conditions are growing. Any and all of these factors could be contributing to the problem. Costs and the complexity of food processing deter researchers and producers from tackling the issue, but only further testing can provide food manufacturers with the guidance they need to improve their growing and processing methods to lessen negative reactivity among their gluten-sensitive customers. While the process would be tedious, it could indicate what wheat varieties and techniques to favor in order to cater to the growing culture of wheat sensitivity.

Gluten, Still a Hot Topic

While many people mock the anti-gluten trend, a growing segment of our population needs to avoid gluten for medical purposes. Even so, a gluten-free lifestyle remains persistently trendy outside of that population. In the National Restaurant Association’s What’s Hot in 2014 survey, gluten-free took the #5 spot.

The trend ultimately helps people with diagnosed conditions as manufacturers and restaurants race to innovate tasty new products. If demand holds steady, it won’t be long until a perfect, gluten-free iteration of an exquisite baguette is within reach.

Resources

Primary

FDA: FDA Defines “Gluten-Free” for Food Labeling

FDA: Food Allergen Labeling and Consumer Protection Act of 2004 Questions and Answers

Federal Register: Food Labeling; Gluten-Free Labeling of Foods

Additional

Food Politics: Good News: FDA Issues Rules for a Gluten-Free Claim on Food Packages

New Yorker: Against the Grain

Comprehensive Reviews: A Grounded Guide to Gluten: How Modern Genotypes and Processing Impact Wheat Sensitivity

Food Liability Law: FDA Issues Gluten Free Labeling Compliance Guide

WRAL: Durham Bread Company Owner Sentenced For Fraud

Institute of Food Technologists: Testing for Gluten in Foods

National Restaurant Association: 2014 Culinary Forecast

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post How to Regulate Gluten, the Modern Food Villain appeared first on Law Street.

Some say a paper cut is the most painful thing in the world. Others would vouch for bullet wounds. Many men moan that a swift kick in the pants trumps it all. Who’s right? No one. Pain is notoriously difficult to assess because many factors play a part in the overall sensation. But that hasn’t stopped us from trying to understand its secrets with new technology.

Functional magnetic resonance imaging (fMRI) allows us to peep inside a brain in action to see what processes and pathways light up during sensation. Pain-specific work with fMRI technology inches closer to a possible objective assessment of pain by carefully studying what happens in the brain during a painful event. This possible objective assessment of pain offers more than just proof that you’re in more pain than your friend with a paper cut. It could change the way we prescribe medications and alter the way we practice law–especially in personal injury cases.

To win a personal injury case, victims must prove that their injury resulted in damages like pain and suffering. You can easily find evidence to support that you’re in pain, but try to apply a price tag and it gets tricky. How do you put a value on pain if you can’t know exactly what the person feels other than what they say? Enter the fMRI pain scan, which provides tangible evidence of a victim’s pain and suffering.

The technology’s critics argue that we have too much to learn about fMRI pain scans before we allow them in court as a valid measure of pain. Proponents wonder if the sophisticated new technology could usurp otherwise primitive methods of assessing pain.

Here’s what you need to know about the intersection of pain, brain, and law to decide your stance.

Pain and the Brain

Pain blinds some people, sending them to bed at the first flutterings of a headache. Yet professional athletes and exercise fanatics actually find it manageable, and even exciting. Some can even meditate their way to a weakened perception of pain. Individual differences like these make pain assessment a jungle, especially when you’re shooting for precision worthy of the courtroom.

Despite these differences, researchers hope we might be able to measure pain more precisely because all human pain begins with a universal neurological process.

Say you’re stung by a bee. The moment that stinger pops through your skin, nerve cells called nociceptors send alert signals racing through your spinal cord and up to your brain. The brain then decides how to react to the alert signals. It activates your motor pathways so you automatically swat the bee away and releases endorphins and other chemicals to help you regulate and reduce the pain you feel. The same process happens in everyone, but the specific competence of your own personal brain circuits and systems determines exactly how you experience the pain. That’s why your friend can brush aside the same bee sting that makes you wail.

How do we assess pain now?

As individuals, the way we evaluate our own pain muddies up assessments. When we feel pain, we want to tell everyone how it makes us feel, which is sometimes like…well, you get the picture. We immediately react to pain with guttural and meaningless expletives like “ouch!” and many other choice words. When prompted, we might be able to describe our pain as “dull” or “sharp,” but these methods could benefit from more precision.

The way professionals evaluate our pain isn’t too much better.  A doctor will usually ask you to rank your pain on a scale of one to ten and then point to the emoticon the best represents your state of mind.

If you’re trying to win a personal injury case with nothing but a number five and a half-frowny face to prove your pain and suffering, you might not see the best results. Wouldn’t it be better if they could just plug you into a machine that described your pain in terms of brain waves instead of your unreliable human emotions and descriptors?

That’s why many believe fMRIs hold the key to objective assessment of pain and would lead to more fair court outcomes.

What fMRIs Teach Us About Pain

All roads leading to pain travel the same neural pathways and fMRIs let us watch those pathways in action. There must be something from those processes we can measure.

A few years ago, researchers from multiple universities came one step closer to pain assessment by finding a marker pattern specific to physical pain stable enough for interpretation. Even if someone can’t talk (like a baby), the pattern they discovered would help us understand their pain using brain scans. The marker distinguished physical pain from other aversive events, meaning they can use brain scans to measure the actual pain experienced as a result of stimulus instead of the clouded emotional judgment that comes with it.

The discovery accelerated understanding and interpretation of fMRI brain scans.

Implications in the Law

We’ve just started to explore the intersection of neuroscience with law–aptly named neurolaw–and the treasure trove of evidence to be found in it.

In the Supreme Court decision in Roper v. Simmons, brain scans revealed distinct differences between adult and juvenile brains in briefs submitted to the court. The court eventually ruled against the use of the juvenile death penalty in that case. On the other hand, judges have ruled against fMRI-based lie detection in the 2010 case, U.S. v. Semrau.

Since many personal injury cases settle outside of court, it’s difficult to find a personal injury case using brain scans that has actually been tried in a courtroom. However, in Carl Koch & Tracee Koch vs. Western Emulsions Inc, a truck driver named Carl Koch sued past employer, Western Emulsions, for damages from a melted asphalt-induced wrist burn. A year after the injury, Koch was still in pain.

The case involved a face off between neuroscientists. Koch’s neuroscientist tested him with a method she developed that distinguishes real, chronic pain from imagined pain by hooking him up to the scanner and lightly tapping both of his wrists to see the different fMRI readings produced by each. The neuroscientist in the Western Emulsions corner disputed the evidence produced by the tests, saying that the mere expectation of pain could have produced the same results.

Ultimately, the judge allowed the scan as evidence and the case settled for more than Western Emulsions originally offered. Koch benefited from evidence provided by the brain scan, but many critics echo the dissenting neuroscientist’s concerns about fMRIs in the courtroom.

What are the problems with fMRIs in court?

Cautious critics serve up many reasons why fMRI scans should not yet be allowed in court. Here are some of the top arguments.

Brain Scans Can Sway a Jury

Evidence shows that neuroscientific evidence interferes with a person’s ability to interpret logic. People receive poor arguments with open minds when they’re backed with illogical neurological evidence. It seems that the mere presence of neurological evidence satisfies people into credulity.

Many Lawsuits Deal with Chronic Pain, a More Difficult Study Than Acute Pain

Scientists breeze through the study of acute pain with fMRIs. Acute pain results immediately from a stimulus. If you’re hooked up to a scanning machine and researchers prod you with a hot poker, there’s no doubt about what action causes the pain patterns in the scan. Most people pursuing personal injury lawsuits aren’t hooked up to machines at the time of their accidents. Chronic pain that comes after the accident often mingles with other issues, like depression, which might interfere with neurological scans and make it harder to attribute to one specific cause.

The Technology is New and Untested

Despite numerous discoveries, neuroscientists still disagree on the reliability of pain scans.

Many believe even the expectation of pain or a slight tilt of the head is enough to skew the results of an fMRI pain scan. Even simply blurting out “ow” has an effect on pain. In a National University of Singapore study, researchers had people sink their hands into alarmingly cold water. People who allowed themselves to say “ow” withstood the pain longer than the silent ones. They believe the effort of forming the expletive might be enough to interfere slightly with brain activities dealing with perception of pain and lessen the effect. Fluctuations like this lead people to question the validity of the scans and demand years of tests before admitting them as evidence.

The Scans Can Be Tricked by Your Emotions

In the NPR story above, David Linden, a neuroscientist at Johns Hopkins University, explains that two different brain systems process the feeling of pain. One system looks at pain with nothing but logic, evaluating where the pain came from and if the sensation burns, stabs, or aches. The other, more emotional, system tells us how to feel as a result of the pain. He also explains that emotions can steer your perception of pain. Negative emotions can make pain feel more intense. Torturers have used this fact to their advantage to make their victims’ pain worse by mixing emotions like humiliation in with already excruciating torture methods. This suggests pliability in a person’s reaction that could twist fMRI scan results.

How will we assess pain in the future?

During the nomination hearing for Chief Justice John Roberts in 2005, then-Senator Joe Biden posed a prescient,yet rhetorical, question:

“Can brain scans be used to determine whether a person is inclined toward criminality or violent behavior?”

His question centered on violent behavior, but now we can replace the last phrase with many other possible scenarios. Can brain scans be used to determine how much pain a person feels? As the technology becomes more widespread, more courts will surely face this question. Pain assessments and pain scans have further to go before they become a precise and trusted method, but they’re on the way. It’s exciting and scary to think of the ways our brain activity might be interpreted in another ten years.

Resources

Primary

New England Journal of Medicine: An fMRI-Based Neurologic Signature of Physical Pain

Journal of Cognitive Neuroscience: The Seductive Allure of Neuroscience Explanations

Additional

NPR: Pain Really is All in Your Head and Emotion Controls Intensity

Telegraph: Saying ‘Ow’ Really Can Ease Pain

Slate: Neuroscientists: Mercenaries in the Courtroom

WebMD: MRI Shows People Feel Pain Differently

Wall Street Journal: Doctors’ Challenge: How Real is That Pain?

All Law: Two Ways to Calculate a Pain and Suffering Settlement

Brainfacts: Neurolaw: Neuroscience in the Courtroom

Duke: Proof and Evaluation of Pain and Suffering in Personal Injury Litigation

Nature: Neuroscience in court: The painful Truth

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Neuroscience in the Courtroom: Can We Measure Pain? appeared first on Law Street.

Like anything with a life, survival is a germ’s end game. When it faces a challenge, it will adapt. Some germs adapt alarmingly well to the challenge of modern medicine. They’re called superbugs because they’ve evolved to survive the challenges we throw at them, including antibiotics.

Do we have a counterattack against these superbugs? Let’s find out.

Superbugs in the News

Superbugs have been making headlines lately. Here’s what’s happening in case you missed it.

CRE Outbreaks

CRE stands for carbapenem-resistant Enterobacteriaceae, a type of bacteria resistant to carbapenem antibiotics. CRE resists nearly all antibiotics and can cause death in about 50 percent of infected patients because most people who become infected are already sick and have weakened immunity. Most recently, CRE killed two people in an outbreak at the Ronald Reagan UCLA Medical Center in Los Angeles and one person in a Charlotte, North Carolina hospital.

A duodenoscope, a device that drains fluids from the pancreatic and biliary ducts, stands out as the main suspect in the UCLA outbreak. Duodenoscopes probe the body, making infection easier for hitchhiking germs, especially superbugs like CRE. The particular duodenoscope implicated in the UCLA outbreak boasts an intricate design that unfortunately makes it difficult to clean properly even through reprocessing, the multi-step sanitation process designed for reusable devices. So this particular model of duodenoscope picked up some potent CRE that withstood reprocessing and infected several patients.

C.difficile Infections on the Rise

C. difficile infections happen when the harmful bacterium Clostridium difficile (C.diff) overpowers the otherwise harmless and helpful bacteria living in the intestines. Antibiotics kill bacteria, including the good kind that help fight off C.diff, so sick people who have taken antibiotics for long periods of time become especially vulnerable to C.diff. Since C.diff resists antibiotics, once good bacteria succumbs, zero defenses stand between it and the multiplication that causes deadly intestinal infections. C.diff preys on the sick and spreads wildly through hospitals. It ranks as one of the three most common infections acquired in hospitals and still cases are growing. Confirmed C. difficile infections doubled from 2000-2009 according the Centers for Disease Control and Prevention.

In Short, Superbugs Threaten Hospitals

As you can see from the cases above, superbugs thrive in hospitals where sick people with weakened immune systems squeeze together in close contact. Our usual sanitation tricks don’t stop them. Even when healthcare workers practice sanitation that could kill the flu virus, these superbugs stick around, hiding out in bathrooms, hospital beds, and on medical equipment. Since superbugs resist antibiotics, once the inevitable infection does occur, it’s extremely hard to fight and could lead to death. For example, CRE kills almost half the people it infects.

Public health officials working on the UCLA outbreak have sprung to action to contain the spread. They’re finding people who might have been exposed to CRE via use of the potentially faulty duodenoscope. They’ve issued warnings about the devices so other hospitals don’t run into similar problems.

But after two deaths in California and one in North Carolina in 2015 so far, many have asked: how can we prevent superbug outbreaks in the first place?

Preventing Superbug Outbreaks

To fight superbugs, experts recommend combating the antibiotic resistance that produced them in the first place, becoming better at monitoring and controlling them, and developing innovative techniques for prevention and control.

Combating Antibiotic Resistance

The CDC’s report Antibiotic Resistance Threats in the United States, 2013, inspired government action that fights the antibiotic resistance that produces threats likes superbugs. Their recommendations include prevention, tracking, changing antibiotic use, and developing new drugs and diagnostics.

In actual practice, the CDC has encouraged hospital antibiotic stewardship programs, which combat overprescribing and incorrect prescribing of antibiotic drugs. The programs push for evidence-based assurance that antibiotics are necessary and effective for the condition in question. For example, in antibiotic “time-outs,” doctors revisit the need for antibiotics after receiving diagnostic lab results. Often antibiotics are prescribed as a precaution while waiting for medical tests, but this practice encourages doctors to reassess the need for the drugs with medical test results in hand. These programs are voluntary, and so far California is the only state that requires antibiotic stewardship programs by law. Experts, including President Obama’s science advisers, are pushing to make stewardship programs a requirement for hospitals and nursing homes that want to receive Medicare payments.

Additionally, President Obama’s FY 2016 budget shoots to double federal spending to fight antibiotic resistance that would help move the National Strategy for Combating Antibiotic Resistant Bacteria along.

Read More: Are We Doing Enough to Prevent Antibiotic Resistance?

Monitoring the Spread of Superbugs

Tracking is crucial to understanding where superbug infections might happen and what efforts might be needed to control them.

One recommended control measure requires all patients admitted to hospitals be screened for CRE. CRE squats in the guts of many people, but only creates problems when they’re weakened by sickness or too many antibiotics. Knowing who carries CRE would help control potential problems before they happen.

In terms of general tracking, there’s no requirement that state health agencies track and monitor antibiotic-resistant bacteria, but luckily, many of them do. According to an Association of State and Territorial Health Officials survey of antibiotic resistance-related state health agency activity, about half of them collect surveillance data about occurring infections. Federal requirements could lead to all states performing valuable surveillance activities.

Implementing Innovative Practices

Superbugs challenge our sanitation practices and antibiotic use. The race is on to develop new techniques to fight them so we can replenish our defenses instead of relying on old practices. Here are a few new interventions considered for fighting superbugs. Warning…don’t read this while eating.

• Fecal transplants: Nope, that’s not a typo. This procedure is exactly what it sounds like. Fecal matter is collected from an ideal donor and placed into the gut of another individual whose population of good bacteria might have been compromised through antibiotic use. In the case of C.diff, a fecal transplant can replace good bacteria that keep infection at bay. It might seem strange, but the procedure has proven 90 percent effective at curing C.diff infections. These unorthodox transplants work better than many other cures.
• Sanitizing robots: A concentrated hydrogen peroxide solution poses a threat to superbugs. It can be toxic to humans, so at Johns Hopkins University Hospital they’ve enlisted impervious robots to help them sanitize hospital rooms. After a human technician seals the room, a bot blasts the air with 35 percent hydrogen peroxide solution that reaches every inch of the room, even cracks and crevices. A second bot dries up the room so no residue remains. This results in a completely pristine hospital room, medical equipment and all.

• New antibiotics and alternative therapies: Superbugs grow accustomed to existing drugs and we haven’t created new ones that shock their systems. This is partly because 99 percent of living species (plants and fungi) that produce promising new antibiotics will not grow in lab conditions. If they can’t grow in a lab, scientists can’t study them to make them into medicine. Recently, scientists tapped into this 99 percent horde of potential antibiotics by tricking the microbes into thinking they were in a natural environment by stuffing dirt in between two membranes. The extracted antibiotic is known as Teixobactin and has proved successful in battling antibiotic resistant MRSA and TB in mice. It hasn’t been tried on humans yet, but the methods scientists used to grow “ungrowable” cultures in laboratory conditions hold promise for the future.

Antibiotics are also overused in agriculture to treat animals raised in conditions that lead to persistent infection. Hyun Lillehoj, an avian immunologist at the Beltsville Agricultural Research Center, has discovered promising new treatments for diseases affecting poultry that would render antibiotics unnecessary. She’s found promise in using food supplements, probiotics, and phytochemicals to enhance a bird’s natural immunity and ward off infection in the first place.

On a sweeter note, Lund University found promise in the lactic acid bacteria hiding in honey bee stomachs. Lactic acid bacteria contains antimicrobial properties and has proven effective in fighting resistant MRSA. Honey processing kills the good bacteria, so store-bought honey has no antibiotic properties. The researchers reintroduced the natural bacteria into honey and used it on horse wounds. All horses were healed when no other antibiotics or steroids had worked.

Legal Challenges of Superbugs

Superbugs involve a liability hotbed because they’re changing the rules. Healthcare professionals adhere to strict rules and protocols proven to prevent the spread of infection. Unfortunately, following those rules doesn’t prevent the spread of infection from superbugs. So when something goes wrong, who is liable? The new proliferation of superbugs presents a legal problem without precedence. Courts will look at whether a hospital has taken reasonable actions to promote safety, unfortunately with a lack of history in the case of antibiotic resistance laws, what actions might be considered reasonable are not yet clear. Upcoming decisions might afford more clarity.

California Congressman Ted W. Lieu requested a hearing from the Committee on Oversight and Government Reform (OGR) to discuss the sterilization issues with duodenoscope that led to the UCLA CRE outbreak. Family members of affected patients are also filing suits against the manufacturer of the duodenoscope that led to their infections, citing grievances like negligence and fraud. Decisions in these cases could influence future arguments.

Are superbugs under control?

As alarming as recent superbug growth might be, so far the situation is under control. However, the outbreak and C.diff growth calls attention to the need to prepare our defenses for the growing threat of superbugs. Antibiotic resistant germs prey on the weak, making hospitals and nursing homes vulnerable targets for devastation.

The government and medical professionals have jumped on the case with their efforts to combat antibiotic resistance, stop the spread of superbugs, and develop new treatments. While antibiotic resistance presents a challenge, consider how antibiotics themselves have been around for less than a hundred years. While their invention was considered a medical miracle, we surely have more miracles up our sleeves to get past this new challenge.

Resources

Primary

CDC: Lethal, Drug-Resistant Bacteria Spreading in U.S. Healthcare Facilities

FDA: Design of Endoscopic Retrograde Cholangiopancreatography (ERCP) Duodenoscopes May Impede Effective Cleaning

U.S. National Library of Medicine National Institutes of Health: Clostridium Difficile Infection: New Insights Into Management

CDC: Vital Signs: Preventing Clostridium Difficile Infections

California Department of Public Health: The California Antimicrobial Stewardship Program Initiative

CDC: Core Elements of Hospital Antibiotic Stewardship Programs

USDA ARS: Alternatives to Antibiotics in Animal Health

Additional

Network for Public Health Law: Superbug Prevention and Hospital Liability

Kaiser: UCLA Bacteria Outbreak Highlights the Challenges of Curbing Infections

USA Today: Dangerous Infections Now Spreading Outside Hospitals

International Business Times: Drug-Resistant Bacteria A ‘National Security Risk’

US News & World Report: Patients File Lawsuit Against Medical Scope Maker in Hospital Superbug Infection

Washington Post: New Class of Antibiotic Found in Dirt Could Prove Resistant to Resistance

CNN: Superbug Cases Reported in North Carolina; One Dead

Food Safety News: The Search For Alternatives to Antibiotics

Food Safety News: White House Wants to Nearly Double Funding for Antibiotic Resistance Fight

Nature: A New Antibiotic Kills Pathogens Without Detectable Resistance

ASTHO: State Strategies to Address Antimicrobial Resistance

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Superbugs: How to Fight the Evolving Menaces appeared first on Law Street.

Out of context, the words “climate change” don’t sound very scary at all. Here’s the context that makes it scary.

The earth’s climate has been in flux since it burst into existence some 4.5 billion years ago. It’s been hot and cold and everywhere in between. Carbon dioxide in the atmosphere danced between 200-300 parts per million (ppm) during the earth’s long lifespan. But starting in the 1900s, carbon dioxide  pushed past the 300 ppm marker and kept climbing. Today, carbon dioxide levels “weigh in” at about 400 ppm. So what? Well, carbon dioxide and other greenhouse gases trap heat and send average temperatures climbing. Even worse, experts believe human activities like burning fossil fuels and deforestation increased carbon dioxide and caused climate change.

We’ve only been on the earth for a fraction of its lifetime. We’ve evolved based on certain conditions, and now those conditions are changing. In other words, we’re not well adapted for the world we’re creating. The changing climate is a crucible of possible human health complications.

Here’s what the future of health looks like if we don’t combat and adapt to climate change.

 Climate Change: What’s Happening?

Before I run away with how climate change will kill us all (just kidding!), let’s do a quick overview.

Greenhouse gases like carbon dioxide hang out in our atmosphere and absorb heat from the sun. Since these gases don’t occur naturally, the extra heat they absorb causes temperatures to increase above normal levels. As of 1900, carbon dioxide emissions from human activities have billowed up by 40 percent and global temperatures keep creeping upward too.

In our interconnected world, increased temperatures have implications beyond needing more A/C. Increased heat warms our oceans, melts polar and alpine ice, and drives up the sea level, which in turn facilitates stronger and more devastating storms.

Why is climate change bad for our health?

Ripples from climate change impact things directly related to your health, like the water and food supply. The World Health Organization predicts that climate change will cause 250,000 additional deaths a year between 2030 and 2050 because of heat stress, malnutrition, malaria, and diarrhoeal disease. Areas with fewer resources to adapt will suffer the most.

Here are some startling health scenarios of the future, and how climate change might cause them.

Diseases Will Become More Virulent

Climate change will make it easier for existing diseases to infect more people by altering their geographic range and lengthening the infection season. For example, ticks carrying Lyme Disease will cover more ground as more regions warm to temperatures where they can survive. Mosquitoes, which carry many diseases like Malaria and Dengue, will also flourish in warmer temperatures. High temperatures increase their reproduction rate, grow their breeding season, and enable them to bite more people. In general, all bacteria multiply faster in warmer temperatures, so many pathogens will find our warming climate suitable for proliferation.

Climate change might also encourage emerging and shifting diseases. Experts at the University of Nebraska-Lincoln say climate change makes it easier for diseases to switch to new hosts. Many assume that the co-evolution of pathogens and specific hosts will make it harder for pathogens to shift and infect a new host with different biological makeup. Alarming evidence has shown that pathogens can shift to new hosts rather quickly when necessary. The researchers offer Costa Rica as an example, where humans decimated the population of capuchin and spider monkeys. A parasite once exclusive to these monkeys was unphased and latched on to howler monkeys, a different genus of monkey. If pathogens need to make rapid shifts, humans might find themselves facing several for which they have no immunity. Climate change threatens to uproot habitats and living patterns, bringing humans, animals, and insects into closer contact with each other–and their unfamiliar pathogens.

More Will Die From Extreme Heat

Heat stroke and heat-associated dehydration are the most common causes of weather-related deaths. People with existing cardiovascular issues are especially vulnerable to extreme heat. Furthermore, heat complications have a cumulative effect; your vulnerability to heat stroke increases after one episode. Cities have been heating up at a higher rate than rural areas in recent years. This leaves some of the world’s most populated areas in danger.

Basic Hygiene Won’t Be Guaranteed

As rainfall becomes less predictable, it will compromise our safe water supply. With less safe water, it won’t be nearly as easy to do simple things that prevent disease, like washing hands. People take hand-washing for granted, but it reduces risk of diarrhoeal disease by 20 percent, which actually kills 760,000 children five and under annually.

Too much water, brought from the climate change risks of severe flooding, also wreaks havoc on sanitation. Floods contaminate freshwater, spread waterborne disease, and create ideal living conditions for mosquitoes–one of the most prolific disease carriers.

Breathing Won’t Be as Easy

Warmer temperatures bring more ground-level ozone, a miasma of pollutants like carbon dioxide and nitrous oxide. Ground-level ozone is also called smog, a term you’re probably more familiar with. It’s been known to damage lung tissue and aggravate respiratory systems. Increased smog will make breathing an excruciating task for people with existing lung diseases and Asthma. It might even encourage the development of Asthma in otherwise healthy people.

People with allergies should also be very afraid of climate change. The spring allergy season has already grown in the United States and it threatens to continue expansion. Ragweed allergies? Tests show that more carbon dioxide and higher temperatures increases the yield of ragweed pollen.

More People Will Go Hungry

Climbing temperatures, patchy rainfall, droughts, and floods will devastate staple crop yields in the world’s poorest regions. Malnutrition and undernutrition will burgeon as a result. By as early as 2020, crop yields in some African countries could be halved.

Increasingly severe weather already destroys crops. Pollinators disappear while pathogens and pests flourish to chomp through human crops. For example, soybean rust, a fungal infection caused by the pathogen P. pachyrhizi, spreads easily in warm, moist environments. Soybean rust has been a scourge in Asia and Africa for years and was introduced to the United States by a hurricane. Winds carry the spores for miles, leaving behind crop devastation. Similar diseases will most likely plague crops in new climates.

911 Might Not Be Working

Scientists believe climate change will lead to much stronger storms. The World Health Organization says that natural disasters reported globally have tripled since 1960, resulting in over 60,000 deaths.

Strong storms and natural disasters destroy medical facilities, cut the electricity that powers medical equipment, interferes with emergency communications tools like 911, and hinders transportation. Many injuries will happen in times when disaster strikes, even though our responsive capabilities will be restricted.

We Gotta Do Something

It’s pretty clear that we have to do something before things get out of hand. Do something…but what?

We’re flooded by climate change recommendations, but here are some key points from the 2014 National Climate Assessment. The assessment distills climate change responses into two main categories:

• Adaptation: Reducing negative impacts of climate change through infrastructure and preparedness planning. An adaptation example is the creation of the State, Local, and Tribal Leaders Task Force on Climate Preparedness and Resilience that aims to prepare communities for the challenges of changing weather.
• Mitigation: Attempting to reduce the climate change itself through updated policies and practices. A mitigation example is the Appliance and Equipment Standards Program, which pushes for energy efficiency.

While these two categories encompass different approaches, we need both to achieve the greatest effect. If you’re interested in reading about more climate change adaptation and mitigation initiatives, check out this fact sheet on President Obama’s Climate Change Action Plan. In terms of public health, however, we’ll stick to a few health-related initiatives, most of which fall under the adaptation category.

The Sustainable and Climate-Resilient Healthcare Facilities Initiative

As the name suggests, this plan aims to prepare healthcare facilities for climate change and related complications. The Department of Health and Human Services released an intensive guide with a framework designed to help healthcare facilities revamp their infrastructure and technology. The initiative includes an online planning toolkit that serves as an interactive guide to walk professionals through these steps of resilience:

1. Identify the problem.
2. Determine vulnerabilities.
3. Investigate options.
4. Evaluate risks and costs.
5. Take action.

So far, healthcare industry leaders like Kaiser Permanente have committed to use the guides to help in their resilience planning.

The BRACE (Building Resilience Against Climate Effects) Framework

The Centers for Disease Control and Prevention developed a framework of preparedness geared more toward public health professionals working locally. Their framework involves projecting the impacts of climate change and assessing effectiveness of interventions. The evidence of effectiveness will be especially useful for people planning future interventions. Click here to see a chart made by the CDC to explain the BRACE framework.

NYC Cool Roofs

The NYC Cool Roofs initiative presents a perfect real-world example of an initiative already underway. Reflective surfaces are added to New York City roofs, which mitigate further climate change by reducing cooling energy needed, consequentially lowering greenhouse gas emissions. They’re also adaptive as they’ll help cool the city, and hopefully reduce heat-related deaths.

Controversy in Congress

Many look at the Keystone XL pipeline decision to judge the climate change temperature in Congress. To the dismay of environmentalists, the Senate rejected two amendments related to the Keystone XL pipeline bill that admitted the human role in climate change and called for more government interventions. The President just vetoed the bill and many believe Congress will not override it.

Still, many climate change advocates are alarmed that the bill went as far it did, saying it would contribute to climate change because of the sheer amount of extra energy it would require and carbon pollution it would make. According to this NRDC Issue Brief, building the pipeline would create the same carbon dioxide emissions as Americans driving 60 billion more miles this year.

Conclusion

If you’re frustrated with the accuracy of forecasts now, be prepared. While climate change poses a new challenge without guiding evidence or precedent, the health complications from climate change have already begun. We see more cases of Lyme disease. Allergies grow in severity. We’re not sure what will work, we’re not sure what the future will bring, but we’re sure we need to brace ourselves for coming changes and meet current changes head on. We all need to work together to make sure that we stay healthy in coming years.

Resources

Primary

World Health Organization: Climate Change and Health

Environmental Protection Agency: A Student’s Guide to Climate Change 

U.S. Global Change Research Program: National Climate Assessment 2014

White House: Strengthening the Climate Resilience of the Health Care Sector

City of New York: NYC Cool Roofs

World Health Organization: Diarrhoeal disease

Additional

Emergency Management: How a Warming Climate Impacts Public Health

Science Daily: More Infectious Diseases Emerging in Animals as Climate Changes

Nature: Climate Variation Explains a Third of Global Crop Yield Variability

Nature: Delays in Reducing Waterborne and Water-Related Infectious Diseases in China Under Climate Change

Science Daily: Heat Waves Becoming More Prominent in Urban Areas

Science Daily: Preparing for Hell and High Water: Research Advocate for Climate Adaption Science

New England Journal of Medicine: Climate Change and Human Health

American Meteorological Society: Climate Change Risk Management

American Phytopathological Society: Soybean Rust

The New York Times: Senate Rejects Human Role in Climate Change

Natural Resources Defense Council: Climate Impacts of the Keystone XL Tar Sands Pipeline

BBC News: Obama Vetoes Keystone Oil Pipeline Bill

Politico: President Obama Vetoes Keystone Bill; GOP Plans Override Vote

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Climate Change: How Will it Impact Our Health? appeared first on Law Street.

Picture your Netflix homescreen. Besides some errant selections courtesy of your (ahem, tasteless) roommate, it’s pretty much a haven of your unique preferences. Like a doting butler, it recommends you watch “Breaking Bad” since you enthusiastically plowed through every episode of “Orange is the New Black.” Netflix knows you. Or think about Amazon. It’s your data-powered best friend. It recalls your purchase history and movie preferences better than you do. So what if this data-powered framework for knowing you is applied to healthcare? What if your doctor knows you as well as Netflix?

That’s what the Precision Medicine Initiative aims to do–unleash the full power of science and data to make our healthcare system better, more effective, and more specific to individuals and conditions. The new model proposes a system of health care that treats you like the complex human being you are. Just as Amazon cares deeply about your past purchase behavior, the new healthcare system would care about the science-based reasons you’re you: your genes, your lifestyle, and your environment. Instead of pushing purchases, it would use what it knows about you to determine what treatments and preventions work best for your health.

President Barack Obama announced the Precision Medicine Initiative during his 2015 State of the Union Address and since then people have been discussing the pros, cons, and implications. Here’s an overview of precision medicine and what it means for you.

What is precision medicine?

Take a look at the video below for a summary of precision medicine from Jo Handelsman, Associate Director for Science at the White House.

Precision medicine revolves around you. It uses your genes, environment, and lifestyle to determine what treatments keep you healthy.

The Precision Medicine Initiative may be new, but precision medicine has some history. Doctors already use it to treat conditions like cancer and Cystic Fibrosis. Examples of precision medicine in action include processes like blood typing and medications like Imatinib (Gleevec), a drug for Leukemia that inhibits an enzyme produced by certain genes. The new initiative plans to expand the reach of precision medicine to to tackle other diseases.

The plan stems from a  2011 report from the National Academy of Sciences. The report called out a major healthcare weakness: data suggests possible causes of deadly diseases, yet we don’t treat people until telltale signs and symptoms surface. You don’t wait until your friend’s liver is wrecked to stage an alcoholism intervention. Why wait for symptoms of a deadly disease when early risk factors might be available?

Great idea in theory, right? Of course, the execution promises far more complexity. Experts hope that precision medicine is within our grasp now because of recent scientific advances that make it easier to collect and analyze patient data.

Advances That Make Precision Medicine Possible

Advancement 1: New Methods of Uncovering Biological Data

It’s easier to understand patients and tumors on a cellular and genetic level more than ever before because of things like:

• The Human Genome Project, an initiative that aims to map the DNA sequence of the human genome to determine a sort of biological instruction manual for how humans function. The study of the genome is called genomics.
• Proteomics, a discipline that involves studying proteomes, the entire system of proteins in an organism. The goal is understanding changes, variations, and modifications in proteins over time to determine biomarkers for human diseases, especially cancer.
• Metabolomics, a field that leverages analytical tools to discover and quantify metabolites, which are substances produced by metabolism. Studying them provides experts with a glimpse of an organism’s physiological functioning as metabolism is a huge factor in overall health.

Advancement 2: New Tools For Biomedical Analysis

New analytic tools make it possible to decipher the intricate medical data collected by the disciplines above. Computers and programs help to collect, store, and study biological and medical information. Overall, the discipline is called bioinformatics.

Advancement 3: New Digital Health Tools That Make Large Datasets Manageable

I said large data sets. Sound familiar? Yes, we’re talking Big Data. You’ve probably heard enough about it, but it’s actually an amazing thing, especially when applied to healthcare. Take a look at the video below for more information.

From collecting to analyzing, sophisticated data management tools make the Precision Medicine Initiative possible.

Collectively, these advances create the right environment for the unified national effort that the Precision Medicine Initiative proposes.

How will it work?

The President’s 2016 Budget provides $215 million for the program. Four key agencies slated to do a bulk of the work each get a chunk of the budget.

National Institutes of Health (NIH)

Project Budget: $130 million.

Task: Recruit a volunteer research cohort and leverage existing data.

The National Institutes of Health must find 1 million American volunteers willing to provide medical records, gene profiles, lifestyle data, and more. While data drives the initiative, you need people to get the data. In addition to this, the NIH will find existing studies and research to build a foundation for the initiative. It’ll collaborate with stakeholders to determine approaches for collecting patient information.

National Cancer Institute (NCI)

Budget: $70 million.

Task: Find better cancer treatments.

The National Cancer Institute will explore precision treatments for cancer by increasing genetically based cancer trials, researching cancer biology, and establishing a “cancer knowledge network” to inform treatment decisions.

Food and Drug Administration (FDA)

Budget: $10 million.

Task: Develop safe, new DNA tests.

The Food and Drug Administration will seek technologies that rapidly sequence DNA and the human genome. Tests should make genetic data collection easier and more standardized.

Office of the National Coordinator for Health Information Technology (ONC)

Budget: $5 million.

Task: Manage the data.

The ONC has a tough job. It needs to figure out how to store, use, access, and exchange all of this medical data without any privacy concerns.

What Precision Medicine Could Mean For You

Here’s Notre Dame’s video on precision medicine in action:

Precision medicine could mean treatments more specific to you. For example, about 55-65 percent of women with mutations in the BRCA1 gene get Breast Cancer; only 12 percent of those without the gene get it. If the gene mutation is discovered, doctors can recommend enhanced prevention measures like increased cancer screenings or prophylactic surgery to remove at-risk tissue.

We hope more precise treatments lead to better outcomes. Using precision medicine, we hope to answer many questions, including:

• How can we treat this better?
• Is there a cure?
• Why does this disease happen in the first place?

The Downsides to Precision Medicine

Of course, the Precision Medicine Initiative has some drawbacks. The sheer amount of time it will take to collect and analyze all of this patient data leads the charge of negative comments. Below are some other downsides.

Interpretability

This article from the New Yorker calls out the problem of interpretability. To quote the author,l Cynthia Graber,

Many doctors are simply not qualified to make sense of genetic tests, or to communicate the results accurately to their patients.

Since doctors will be the sole executors of the initiative, more need to become fluent in the human genetic code. Programs like MedSeq have recognized this need and are already working to make genetic information translatable for practitioners.

The Budget Just Isn’t Enough

Experts say that even the $215 million proposed isn’t enough to meet the initiative’s lofty goals, like recruiting one million patient volunteers. One upside? Money can be saved by incorporating existing data, which the initiative plans to do.

Collecting the Data is Going to be Hard (This is an Understatement) 

If they do save money by integrating data from different studies, keeping the data clean will be hard considering the different time frames, constructs, and controls of various studies.

And as a practicing doctor writing for a New York Times blog points out, the lifestyle factors will be especially hard to study because of some uncooperative and intensely complex patients.

Insurance Companies May Not Pay For It

Precise matching of individuals to disease treatments sounds great, and extremely expensive, especially in the early days. Patients will need even more help determining what treatments suit them.

Hope For the Future

Sorry to bring up Netflix up again, but let’s face it, it’s very good at leveraging data to give you what you want. Consider any of its popular original series. Do you think Netflix just guessed what 50 million subscribers would like? Probably not. It used its massive stores of data to make informed decisions.

Early doctors and researchers puzzled over the symptoms of just a few patients, trying to find patterns, causes, and cures. While they did a fair job with the resources they had, trial and error medicine should be relegated to the less fortunate past. Today we have the power and knowledge to access data that helps doctors make more informed decisions on healthcare treatments.

Precision medicine will be complicated, difficult, time consuming, and who knows what else. But imagine what we can learn. We should be cautious, but we can also dare to hope.

Resources

Primary

White House: Infographic: The Precision Medicine Initiative

White House: FACT SHEET: President Obama’s Precision Medicine Initiative

White House: Precision Medicine is Already Working to Cure Americans: These Are Their Stories

National Cancer Institute: BRCA1 and BRCA2: Cancer Risk and Genetic Testing

National Institutes of Health: Precision Medicine Initiative

National Cancer Institute: What is Cancer Proteomics?

Additional

Nature: Obama to Seek $215 Million for Precision-Medicine Plan

New England Journal of Medicine: A New Initiative on Precision Medicine

National Academies: Toward Precision Medicine

National Institutes of Health: Precision Medicine Initiative

Nature: U.S. Precision-Medicine Proposal Sparks Questions

Brookings Institution: The Significance of President Obama’s Precision Medicine Initiative

New Yorker: The Problem With Precision Medicine

The New York Times: A Path For Precision Medicine

National Human Genome Research Institute: What is the Human Genome Project?

BioTechniques: What is Metabolomics All About?

Bioplanet: What is Bioinformatics?

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Precision Medicine: The Future of Health Care? appeared first on Law Street.

Measles probably doesn’t make your list of top Disneyland souvenirs. Unfortunately, many unvaccinated visitors to Disneyland in California brought measles home along with mouse ears this season. It gets worse, because these people unknowingly shared their viral souvenir with other unvaccinated people in schools, banks, and even on public transportation. The result? A multi-state measles outbreak that has sparked a tirade of vaccination discourse. If measles can happen in the “happiest place on Earth” of all settings, we’re all in trouble.

Read on to find out more about these measles everyone’s talking about and why some people choose to opt out of a vaccine that most experts agree is safe and effective.

Why We’re Seeing Cases Now

Once upon a time (in the year 2000), the United States declared measles eliminated. Don’t get too excited. Eliminated in this sense doesn’t mean annihilated or wiped out completely like Dodo birds or Blockbuster stores. In 2000, measles was no longer endemic, or transmitted in the United States for twelve months or more. That happily ever after did not last long. Since then, measles cases have slowly but surely crawled back up; check out the CDC’s breakdown here. Overall, there have been 121 cases reported from January 1 to February 6, 2015.

Why the climbing cases? Although measles was eliminated in the United States, there was still plenty of it going around the rest of the world, especially in places without the same vaccination resources as the United States. In developing countries, measles causes about one million deaths each year.

Measles from the rest of the globe crept back into the United States on the coattails of international visitors or jet-setting residents. For example, experts trace the California outbreak to a traveler who was infected overseas. This person exposed other Disneyland visitors and the virus quickly spread throughout unvaccinated clusters in California.

Why is measles so hard to fight?

We’ll chalk it up to two basic reasons, each individually complicated:

1. Measles spreads like wildfire.
2. Our defenses have some holes, especially from the decrease in herd immunity caused by a growing number of unvaccinated children.

Let’s talk about each in more detail.

Measles is Viral Wildfire

In this most recent outbreak, cases of measles grew by 19 percent in just one week according to the Centers for Disease Control and Prevention.

Here are some other reasons that measles is viral wildfire:

• Measles infects about 90 percent of the unvaccinated people it reaches, making it one of the world’s most contagious diseases.
• It doesn’t require direct contact to spread; the airborne virus jumps easily from person to person through aerosol droplets. (One germ-laden cough or sneeze is all it takes.)
• The first symptoms of measles include coughing, runny nose, and fever–pretty much the same as any other regular, old cold. Infected people will probably still be out and about, infecting other people.
• It has a high reproduction factor. One person can infect about 12 to 18 others. That’s six to nine times more infectious than the flu virus that caused the 1918 flu pandemic.
• Many young doctors have never seen a measles case, so infected people go undiagnosed and spread the disease.
• It’s hard to contain. Health workers have to track down exposed people, a task that gets harder as more become infected.
• It’s also expensive. The National Vaccine Advisory Committee says that Arizona hospitals spent $800,000 to isolate seven measles cases.

What’s more, measles can be severe. Before vaccinations, measles caused about 2.6 million deaths worldwide each year. In populations with malnutrition and poor health care, almost ten percent of measles cases end in death. Death occurs because of complications that result from measles, including encephalitis, pneumonia, and even blindness.

The World Health Organization calls the measles vaccine one of the best buys in public health, attributed to preventing about 15.6 million deaths in 13 years. Vaccines work because measles is considered antigenically stable; it doesn’t shift or drift to get around our immune system like the flu can. So one shot pretty much leads to lifetime immunity.

No antiviral treatment for measles exists. Most often it’s treated with supplements of Vitamin A and proper hydration, but you still have to let the disease run its course. Prevention through vaccinations avoids all of this.

The Breach in Herd Immunity

Tiny, adorable babies (and other vulnerable groups) physically can’t get vaccinated. Without immunization, measles plows through the population, causing the most harm to babies with developing immune systems; however, if many people are immunized, they create a buffer that keeps those who can’t get immunized safe from the disease.  It’s call herd immunity.

Anti-vaccination sentiments cluster in certain geographical areas, breaching herd immunity on a local level. California is one area with clusters of unvaccinated people, thus why the most recent outbreak is so difficult to control. Clusters of unvaccinated people make ideal kindling for measles wildfire.

Watch the video below for a great explanation of why vaccines are important and how opting out is bad for the herd.

The idea of herd immunity puts the public health context back in the very personal choice of vaccination. Cooperation leads to successful herd immunity. The World Health Organization says 95 percent of people should be vaccinated to eliminate measles.

So, why don’t people just get vaccinated?

Downward trends in vaccination rates leave the United States vulnerable to measles attacks as we’re exposed to measles by global visitors and travel. If measles is so serious yet preventable, why do people still opt out?

There are many reasons that parents don’t get their kids vaccinated. They range from distrust of government to fear of negative side effects. In the California outbreak, people cite religious, philosophical, or personal reasons for opting out of vaccinations. Many doctors balk at the generally non-medical tone of these excuses.

Experts respond to doubts with a profusion of facts that counter most fears raised about vaccination. A 12-year study of Measles, Mumps, Rubella (MMR) vaccines found that it does not increase the risk for several suspected health outcomes. The World Health Organization published data that found no association between measles vaccines and Crohn’s disease. And plenty of other studies debunk common vaccination fears.

Here’s an alarming fact: in the anti-vaccination argument, facts don’t necessarily work. In some cases, arguing with facts as weapons makes the outcome worse. Research found that busting vaccine myths actually increases hesitancy around vaccination instead of raising intent to vaccinate. This all means that the sole strategy of many health communicators might actually backfire among this particularly skeptical target audience.

Why Facts Don’t Win the Vaccination Argument

People, unlike computers, pepper even their logical decisions with colorful human emotions. Many social and emotional factors influence how we perceive, interpret, and react to facts and science. Here are some reasons why cold facts don’t work in contentious arguments, like the vaccine debate.

We Cling to Naive Beliefs

People accept facts, but often cling to their intuitions with stunning zeal. This study demonstrates how even people with advanced scientific knowledge express natural delays when asked if the Earth orbits the Sun. From our humble perspective on Earth, this doesn’t look true. That simple intuition influences our initial gut reaction, even when we know facts to the contrary.

We’re Easily Influenced by Personal Anecdotes

Personal stories heighten naive beliefs. We’ll believe a friend’s anecdote about vaccines causing her child’s autism even when numerous facts state that it’s unlikely. Cold, hard facts can’t compete with your emotional reaction to the anecdote. A little intrigue might produce a similar effect. This study found parents less likely to vaccinate their kids after reading conspiracy theories on vaccination.

We Conform to Group Values

People make decisions that affirm their cultural identities and connections to people with shared values. It’s a tendency called cultural cognition. New info will pass through a pre-existing lens and if it’s contrary to fundamental beliefs, it might lead to even more polarization.

We Love to Be Right

The fancy word? Confirmation bias. It’s the tendency to seek out evidence that supports our current beliefs, regardless of accuracy. Emotionally charged issues inflate this tendency. The internet and on-demand television makes this force unstoppable. You can easily ensure you only hear what you want to hear.

Our Resources Hamper Our Decisions

Experts call it bounded rationality. We face difficult scientific issues, yet we still evaluate them with limited information, a fixed set of cognitive abilities, and limited time. Think of reading the terms and conditions before you buy a song on iTunes. You know it’s theoretically a good idea (just in case), but who has 45 minutes for that?

We Love Negative Talk

Negative information inspires more shares than positive information. One bit of negative news can eclipse five bits of positive news. In fact, negative talk about vaccines is more socially contagious than positive talk. Researchers have found that both positive and negative Tweets result in only more negative buzz.

So, now what?

To keep measles cases from increasing, more people need to be vaccinated. We could try to convince more people they should have their kids vaccinated or strengthen immunization laws and policy (e.g. making exemptions harder).

Convince More People They Should Vaccinate

As outlined above, the most avid vaccination opponents might be nearly impossible to turn. In fact, some vaccination opponents actively seek out measles infections for their children by hosting measles parties. The trial and error process involved in developing and testing new communications materials to target this finicky audience would be time consuming. Many experts believe we should move to strengthening immunization laws immediately before measles is able to become a more serious problem in the United States.

Strengthen Immunization Laws and Policy

Vaccination isn’t legally required and exemption allowances vary from state to state and can get pretty complicated. Lawmakers who recognize the need for change are proposing to overhaul vaccination laws in many states.

California is proposing to end personal (as opposed to medical or religious) exemptions. They’re also moving to require that public schools publish the percentage of enrolled children who are vaccinated, an effort that Arizona is also pursuing.

Other states are moving in the opposite direction. Montana and New York have introduced bills that would make parental exemptions easier. You can read more about recent vaccination-related legislation here. Be prepared for some interesting immunization debates in the coming months.

In addition to cracking down on state-by-state exemption policy, the Network for Public Health Law provides a few more suggestions, including pursuing tort claims, and taking a more active role in fighting measles globally.

Conclusion

Whatever path we take, vaccinations are here to stay. Unless we completely eradicate measles globally, vaccines will always be necessary to protect the United States from outbreaks. The recent outbreak in California (and other states) illustrates how important herd immunity really is. Vaccination is a personal choice that affects public health. How will we weigh personal rights against this public responsibility? Only time will tell.

Resources

Primary

World Health Organization: Measles Factsheet

CDC: Measles Cases and Outbreaks

Additional

National Geographic: Why Do So Many Reasonable People Doubt Science?

Wall Street Journal: U.S. Measles Cases for 2015 Rise 18.6% Over Past Week

Center For Food Integrity: “Cracking the Code on Food Issues: Insights from Moms, Millennials and Foodies.”

Family Practice News: Measles Spread in Unvaccinated Clusters

Network for Public Health Law: Measles Control Made Easy: Stronger Laws Equal Less Disease

Family Practice News: Measles Deaths Slide by 74% as Immunizations Reach 82%

Expert Review of Vaccines: Vaccination Against Measles: A Neverending Story

Journal of Family Practice: Sobering Lessons from Two Travel Related Outbreaks

Future Virology: New Insights Into Measles Virus Propagation

Occidental College: Scientific Knowledge Suppresses But Does not Supplant Earlier Intuitions

Expert Review of Vaccines: Measles Elimination

Canadian Medical Association Journal: Measles Vaccination: A Shot of Common Sense

Science Daily: 12-year Study Confirms Overall Safety of Measles Vaccines

New Scientist: Ending MHR Shots Does Not Halt Rise in Autism

Family Practice News: MMR Shot Not Linked to Autism, Large Study Shows

Pediatrics: Neurologic Disorders After Measles-Mumps-Rubella Vaccination

Bulletin of the World Health Organization: Clinical Safety Issues of Measles, Mumps, and Rubella Vaccines

Pediatrics: Has the Measles-Mumps-Rubella Vaccine Been Fully Exonerated?

Infectious Disease Alert: Lack of Association of Measles, Mumps, and Rubella Vaccination with Autism

Ohio State University: Confidence in Government Linked to Willingness to Vaccinate

Huffington Post: Six Dangerous Anti-Vaccination Arguments Analyzed, Explained, and Shut Down

British Medical Journal: MMR Vaccination and Autism 1998: Deja Vu – Pertussis and Brain Damage 1974?

Science Daily: Social Norms Strongly Influence Vaccination Decisions, the Spread of Disease

Science Daily: Resurgence of Measles in U.S. Brings Pain, Suffering to Children

Science Daily: Vaccination Opt Out is a Cop Out That Literally is Making People Sick, Says Infectious Disease Leader

NBC Los Angeles: Timeline of Disneyland Measles Outbreak

Medical News Today: Why Myth-Busting Vaccination Fears is Trickier Than You Think

Science Daily: Anti-Vaccine Conspiracy Theories May Have ‘Detrimental Consequences’ for Children’s Health

EurekAlert: On Twitter, Anti-Vaccination Sentiments Spread More Easily Than Pro-Vaccination Sentiments

Politico: Vaccination Foes on the Defensive

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Measles: Why is it Back and What Can Be Done? appeared first on Law Street.

You just ordered a chargrilled pineapple steak with blue cheese ice cream. If the cost is any indication, it has to taste good. Right?

You take a tentative bite. The flavors mingle on your tongue in an explosion of taste bud pleasure. How do they come up with this stuff?

Some chefs use science to select ingredient pairs that lead to culinary bliss. The odd coupling of pineapple and blue cheese owes its delectable flavor to a compound found in both ingredients: methyl hexanoate. So if you don’t trust your imagination and instincts to prepare food with the reckless elegance of a chef, turn to matching aromatic compounds as a logical guide to selecting ingredients that complement instead of clash.

Here’s your science-based foodie flavor guide.

Getting to Yum

You have it pretty easy when it comes to flavor. You bring a fork to your mouth and experience a burst of flavor instantly. Yum. No thinking. No processing. Meanwhile, your senses work overtime to endow you with the gift of flavor.

When we talk about flavor, we’re talking about the overall sensation that combines smell, taste, temperature, texture, and appearance–the whole delicious bundle of qualities that food delivers to your ravenous senses. While texture and appearance deserve honorable mentions, taste and smell take the flavor trophy. Taste and smell (made possible by the olfactory dream team of nose, mouth, and brain) work together to bring you flavor.

Taste

Your mouth contains a hierarchy of structures that help you taste. You know those bumps you can see on your tongue? They’re not taste buds, they’re called papillae. The papillae contain taste buds, the taste buds contain taste cells, and the taste cells contain even smaller structures called microvilli. And it’s not over yet. The microvilli contain the receptor proteins that tell your brain when you’re tasting something. These little receptors send messages through a network of nerves that ends at the cerebral cortex, which then creates the perception of taste.

We all have about 5,000-10,000 taste buds, but we can only detect five flavors: sweet, salty, bitter, sour, and umami. As the central location for taste, the mouth hogs a lot of credit for flavor. But your underappreciated sense of smell deserves more glory than it receives.

Smell

Your sense of smell helps you perceive flavor more than your sense of taste. Smell works in two ways:

1. Orthonasal olfaction: This happens when you inhale and smell. Think of the aroma of fresh baked bread wafting through the cracks in the floorboards.
2. Retronasal olfaction: This happens when you already have food in your mouth. Once food gets to your mouth, its aroma vapors creep up the back of your throat and make it to your nose. Chewing food accelerates this process. Retronasal olfaction enables most flavor sensations. Imagine how your food tastes like cardboard when you have a cold. It’s because essential aroma vapors can’t reach your nasal passage.

Your nasal passage is home to millions of receptors. They’re standing at attention to attach to odor molecules and send scent signals to your olfactory bulb, the brain’s odor-processing hub. The olfactory bulb translates the scent signals and relays that information to the piriform cortex, which recognizes the odor and lets you know what it is. As complicated as it seems, this all happens in a flash, enabling you to recognize odors instantly.

Bonus fun fact: the olfactory bulb connects to the limbic system, the part of our brain that deals with emotions. That’s why certain scents spark vivid memories.

What makes a flavor?

Your favorite foods contain hundreds of compounds that work together to create flavor. Compounds in food are generally low per unit, but their synergies bring us the flavors we know and love. Some of the aroma molecules in cacao beans smell separately like cooked cabbage or beef. When they merge with the bean’s other molecules and a few key ingredients, they present the flavor of chocolate.

Aroma compounds and taste compounds work together to bring you the impression of flavor. Nonvolatile taste compounds only react with receptors when they dissolve in your mouth, so their range of detection is limited to the five kinds of taste. Volatile aroma compounds become gas at room temperature and reach nasal passage receptors via inhalation. Your nasal odor receptors help your brain detect thousands of different aromas–just one of the ways aroma compounds and our sense of smell bring flavors to life.

Are compounds the key to perfect flavor?

With the number of ingredients at our disposal, our recipes could be infinite. Yet we always return to the same key ingredients and steadfast combinations. Researchers Yong-Yeol Ahn and Sebastian E. Ahnert set out to discover a scientific reason for this inclination.

They explored the world of taste and aromatic compounds to find out why some foods taste wonderful together and end up in recipes while others fade to obscurity. They based their research around a long-standing culinary hypothesis: ingredients that share flavor compounds will taste the best together.

The researchers created a flavor network of ingredients that share compounds. They used over 50,000 recipes to perform their analysis and split cuisines into geographic subgroups to account for cultural disparity.

They found that North American and Western European palettes favor ingredients that share compounds–the more shared compounds, the better. One of the most common compound-sharing triads in North American and Western European cuisine is butter, egg, and vanilla.

In contrast, East Asian and Southern European recipes prefer ingredients without matching compounds. East Asian recipes often feature scallions, sesame oil, and soy sauce–ingredients with no matching compounds.

What does that mean for your cooking?

If you’re really serious about compound-based food pairing and don’t happen to have the equipment to detect aromatic matches in your ingredients, you have other options. You could use the flavor network we already discussed or a website like foodpairing.com, which helps you find ingredients with aromatic-compound matches. According to the site, these ingredients have compound matches:

• Bacon, cranberries, olive oil, chicken, buffalo mozzarella, and strawberries
• Peanuts and Cointreau
• Avocado, tomato, banana, carrot, and rosemary
• Werthers hard candy and beef (seriously)
• Carrot, cilantro, rosemary, and raspberry
• Graham cracker, strawberry, and beef (this might make an interesting pie if you’re feeling adventurous)

When someone doesn’t like your food…

Sadly, you can’t win them all. Some people might not be able to handle your culinary food pairing prowess. Even if you follow compound matching, human preferences remain tenuous, unpredictable, and far from universal.

Here are some reasons why people have different flavor preferences (a.k.a why they’re wrong):

• Many flavor preferences form in infancy: In the first months of life, what the mother eats will be passed through breast milk and influence preferences for life. Bottle feeding takes some of this sensory learning away. If babies are repetitively exposed to the same boring flavors, they might learn to love bland food.
• Some people have more sensitive flavor receptors: Some people have a receptor gene, 6-n-Propylthiouracil (PROP), that makes them especially sensitive to bitter flavors. They’re often called supertasters. Supertasters typically have more papillae on the tongue and feel everything on the tongue more strongly, including pain. The discovery of the receptor gene confirms that flavor preference cannot be universal.
• They might be fooled by appearances: What a food looks like has a huge impact on the flavor you’re expecting. If you’re always taking a gulp of root beer and expecting Coke, you might learn to hate root beer on account of unpleasant surprise.

Beyond all of this, food preferences can be environmental and psychological as well. Positive scent associations, childhood memories, and more can stack the cards for or against different foods. But just remember, it’s not you, it’s them.

True Flavor Appreciation

Going out to dinner in the near future? Keep an eye out for ingredients in your favorite dishes and look them up to see if they have any compound matches. There might be a science behind your preferences.

But mostly remember that even the simplest bite of food is a magical experience. The minute it hits your lips, thousands of compounds trigger a frenzy of processes that course through your nerves on their way to the brain. Thousands of compounds and thousands of internal reactions enable you to say yum or yuck. Even if you don’t like what you’re eating, you can appreciate the process that allowed you to experience its flavor. Now that’s appreciating food.

Bon appetit!

 Resources

Primary

American Chemical Society: Flavor Chemistry Research at the USDA Western Regional Research Center

Additional 

Nature: Flavor Network and the Principles of Food Pairing

Prepared Foods: Altered Senses

Food Processing: Fighting Palate Fatigue

Prepared Foods: Focus on Flavor

Brain Facts: Taste and Smell

Accidental Scientist: Experiencing Flavor

Science of Cooking: What is Flavor?

Food Navigator: The Science Behind Food Pairing

Food Pairing: Home

Bon Appetit: The Science Behind Our Seemingly Weird Food Combinations

Science of Cooking: The Molecular Basis For Taste

Bon Appetit: The Senses – A Primer

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Foodie Flavor: The Science Behind Your Favorite Tastes appeared first on Law Street.

We’re all told that a daily multivitamin supplement packs the same vitamin punch as a varied cornucopia of food. No preparation. Tons of nutrients. Zero calories. No wonder these little short cuts are so popular. Supplements are hard to resist when you’re told they might be the answer to all of your problems.

But are these concoctions too good to be true?

You’ll have to decide for yourself. Here’s what you need to know about vitamin supplements and their long-term effects to get started on your decision.

What are vitamins anyway?

Vitamins aren’t capsules; they’re organic compounds that we need to survive and function. We can’t make them in our bodies; we have to get them from outside sources like food or supplements. Despite what the vitamin aisle of your grocery store might lead you to believe, only 13 recognized vitamins exist.

This infographic from Compound Interest names the 13 vitamins, reveals their alternate names, and summarizes why our bodies need them.

What do they do in our bodies?

We don’t digest vitamins like food, we have to absorb them.

Vitamins A, D, E, and K dissolve in fat, so they need fat to be absorbed. The same stomach acid released to break down fat also breaks down the vitamins so you can absorb them. If a person doesn’t have enough fat in his diet or has digestive problems, he can’t absorb fat-soluble vitamins. On the other end of the spectrum, fat cells store these vitamins long term, and excesses can build up. For example, chronic high intakes of vitamin A can lead to hypervitaminosis A, and symptoms of dizziness, nausea, headaches, and skin irritation.

All of the B vitamins as well as vitamin C dissolve in water. These vitamins are easily absorbed in the bloodstream through water-based blood plasma–no stomach acids required. Unlike fat-soluble vitamins, you can’t store water-soluble ones. Excesses of these vitamins exit the body easily with urine. Since you have no storage system for these vitamins, you have to replenish them often.

How much do we need?

The Food and Drug Administration (FDA) uses Daily Value (DV) as the ultimate guide to how much of each vitamin we need. You’ll see DV on every nutrition label. Don’t worry, they don’t just make them up. They determine DVs using experimental human studies and observational data.

Long-Term Effects of Vitamin Supplements

Studies on the long term effects of multivitamins yield conflicting results, even when the studies focus on the same vitamin. How is that possible? The answer lies in the study’s construction. Conflicting results happen because:

1. The vitamin doses tested were different. A study found vitamin D protects against fractures using a 700-800 IU (international unit) daily dose. If they used a 400 IU dose of vitamin D instead, they might not have seen the same benefits.
2. The study timeframe was different. A study spanning ten years might find benefits that a study over two years missed. Diseases, for example, take a long time to develop. Therefore any benefits a vitamin provides in its prevention would also take a long time to determine.
3. The subjects had different lifestyles. Lifestyle habits, like exercise or smoking, affect disease outcomes and vitamin interactions. If the study fails to control for differing lifestyles, results conflict.
4. The disease or condition was tested at different stages. Vitamins produce results at different times of a disease or condition. Studies show folate supplements might protect against birth defects, but only if taken in the first few weeks of a pregnancy.
5. The results were measured differently. Researchers determine what outcome they’re studying before they begin. They will only pay attention to that outcome and might miss other benefits.

Keep these factors in mind as you read the conflicting good and bad news for vitamin supplements below. Also keep in mind that more studies need to be done on the long-term effects of vitamin supplements, especially as supplement use grows. Currently about half the people in the United States take vitamin supplements; that number may continue to rise.

The Good News For Vitamin Supplements

Most of the good news for vitamin supplements involves specific populations. Here are some groups found to benefit the most from vitamin supplements.

Coronary Heart Disease Patients

Studies have shown that supplements of vitamin E decrease incidence of cardiovascular events in patients with a history of coronary heart disease.

Smokers

Male smokers given a supplement of alpha-tocopherol (a type of Vitamin E) had a 32 percent lower incidence of prostate cancer than those who took a placebo.

Older Adults

One study found supplements of vitamin D reduced bone fractures in older adults. People who took vitamin D had a 22 percent lower fracture rate in general, and a 33 percent lower fracture rate for vulnerable areas like hips, wrists, and vertebrae.

Diabetes Patients

Multivitamin use in people with diabetes might reduce the risk of minor infections. Based on the subjects’ logged reports, all people taking a multivitamin had a lower infection rate than those in the control group. The benefit increased in diabetes patients within the group. Only 17 percent of diabetes patients in the supplement group reported an infection, compared with 93 percent of diabetes patients taking placebos.

Breast Cancer Patients

Women diagnosed with breast cancer who took supplements of vitamins E and C, as well as multivitamins shortly after diagnosis had an 18 percent reduced mortality risk and 22 percent reduced recurrence risk. This study adjusted for multiple lifestyle factors to maintain consistency.

The Bad News For Vitamin Supplements

Suspicions about the long-term benefits of multivitamins have led to numerous studies over the years. Here are some highlights of the not-so-good studies on multivitamins.

Bad News for Breast Cancer

Although a study above indicates that it might be good for people who have breast cancer to take vitamins, this study suggests that multivitamin use might actually increase the risk for breast cancer in the first place. In a study of Swedish women, researchers found that multivitamin use increased the risk of breast cancer. Folic acid surfaced as a possible risk factor. Results from epidemiological studies have not confirmed this association.

Vitamin Supplements Offer No Benefits to People With Balanced Diets 

A found sparse evidence that vitamin supplements benefit people with balanced diets. A systematic evidence review for the U.S. Preventive Services Task Force also found that vitamin supplements failed to reduce cancer and cardiovascular disease risk in adults without nutritional deficiencies.

Vitamin Supplements Do Little For Memory

A long-term, randomized trial of cognitive function in men aged 65 years or older found zero differences in cognitive function between men taking a multivitamin and men taking a placebo. They used established tests to measure cognitive function and memory. Another study sought to test a connection with folic acid, B6, B12 and memory. Previous studies connected deficiencies in these vitamins with memory problems and confusion. They tested supplements on people with normal blood levels of the vitamins, and found no additional benefits after a three-year trial.

Vitamin Supplements Don’t Reduce Risk of Heart Attack

Researchers evaluated the benefits of a high dose multivitamin supplement in men and women with a history of heart attack. After nearly five years, the supplement group and the placebo group had the same number of cardiovascular events.

Why You Need to Do Your Own Research

Although vitamin supplements come in medicinal pill-like bottles, they aren’t regulated like drugs that are thought to be unsafe until proven otherwise. Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), supplements are assumed safe until proven otherwise.

• Drugs: need to be proven safe. The FDA approves of any new drug entering the market. Manufacturers must show evidence of a drug’s safety and ability to treat a condition based on clinical trials. Once a drug makes it to the market, the FDA monitors it for doctor-reported side effects and possible problems.
• Supplements: need to be proven unsafe. Dietary supplements can be sold if they don’t contain any ingredients that pose a significant risk when used as directed. So if a vitamin supplement incorporates a food substance that’s generally recognized as safe, no worries. If manufacturers wanted to use a completely new substance, they do have to show that it’s safe, but they don’t have to perform any clinical trials. The FDA can’t stop a company from selling a supplement until someone proves that it causes harm. So don’t assume something is safe just because it’s on a shelf. Since supplements aren’t tracked as closely as drugs, their interactions, side effects, and other consequences aren’t as readily noticed.

Hidden Vitamins

We have a lot left to learn about vitamin supplements before we can tell if they’re the answer to all of our problems. We do know they’re not one-size fits all. People with certain deficiencies and conditions benefit more from supplements than healthy people with well-rounded diets.

We also know that taking excess vitamins could be harmful, especially if they’re the fat-soluble kind that your body stores. But controlling your added vitamin intake might not be as simple as controlling your supplements. Many foods, like breakfast cereals and snack bars, are fortified to contain vitamins and minerals. Pair those foods with a max-dose vitamin supplement and you could be on your way to getting too much of a good thing. The nonprofit Environmental Working Group reports that about half of American kids consume harmful amounts of vitamins because they’re added to foods.

So think twice before reaching for a second bowl of those addictive Cocoa Krispies, especially if you already took a vitamin supplement. Also, keep in mind that vitamins are good for you, but you still need to be careful and smart with all dietary choices.

Resources

Primary

American College of Physicians: Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements

Additional

Harvard School of Public Health: Supplement Studies: Sorting Out Confusion

Compound Interest: The Chemical Structures of Vitamins

Men’s Health Adviser: Do You really Need Those Vitamin Supplements? 

Mind, Mood & Memory: Straight Talk About Vitamin and Mineral Supplements For Memory

Nursing Standard: Women Being Treated For Breast Cancer Benefit From Vitamins

Trial: Over the Counter and Under the Radar

Nature Reviews Endocrinology: Vitamin Pills May Raise Cancer Risks

New Scientist: Pills Are Pointless

Web MD: Vitamins and Minerals: How Much Should You Take?

Scientific American: Fact or Fiction?: Vitamin Supplements Improve Your Health

Live Strong: Digestion of Vitamins and Minerals

Original Internist: To E or Not to E, That is the Question

Clinician Reviews: Who Will Benefit Most From Vitamin Supplementation?

Medical Daily: Vitamin D Benefits Are Enhanced if Meal Contains Fat; Absorbing More From Supplements

Gallup: Half of Americans Take Vitamins Regularly

American Cancer Society: FDA Regulation of Drugs Versus Dietary Supplements

Environmental Working Group: How Much is Too Much?

Environmental Magazine; Over-Fortified Processed Foods

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Vitamin Supplements: Are They Worth It? appeared first on Law Street.

If you had the chance to change your brain, would you? If you said yes, meditation might be the answer. Meditation involves sustained thinking aimed to relax or achieve religious or spiritual purposes. It’s a simple and ancient practice; paintings found in the Indus Valley from 5,000-3,500 BCE depict people reposing in meditative postures. Throughout its long history, meditation has been lauded for virtues like improved moods and decreased anxiety. But how does meditation produce these benefits aside from just making people more relaxed?

How can you change your brain?

It turns out that meditation actually changes your brain. This might sound a little strange at first, but many things you do can change your brain thanks to a concept called neuroplasticity. Neuroplasticity refers to the brain’s ability to change through experiences or repeated practice. When exposed to a stimuli, the brain can actually create new neurons and form new neural connections that change its structure. When you learn to play new instruments or memorize complicated dance moves, you’re restructuring your brain’s neural pathways.

Think of it this way: when you lift weights repeatedly, your muscles probably get bigger or more toned. They change. Meditation exercises the brain, and like lifting weights, it can produce desired changes.

Funding for research on alternative medicine and meditation surged in the past several years. With healthier budgets and burgeoning new technologies, researchers discovered new scientific connections between meditation and changes in the brain. Below are some summaries of their findings.

Meditation Changes Gray Matter

Massachusetts General Hospital documented that meditation causes changes in the brain’s gray matter. Researchers there measured differences in gray matter concentration in subjects’ brains before and after an eight-week Mindfulness-Based Stress Reduction (MBSR) Program using magnetic resonance (MR) images. After meditation, subjects displayed more concentration in the gray matter of different brain regions, including the left hippocampus. They also took before and after images of a control group that practiced no meditation and saw zero notable changes.

Time out. I have gray stuff in my brain?

Yup. Gray matter tissue surrounds the cerebrum. It’s also called the cerebral cortex, but was dubbed gray matter because of its dull tone. This is the part of your brain that wrinkles. The cerebral cortex is responsible for many functions including motor movements, sensory processing, language, and cognitive skills.

After meditation, gray matter in the subjects’ brains became more concentrated in these regions:

• The left hippocampus: The hippocampus is a vital component of the brain’s limbic system, the portion of the brain that handles emotions and memories. It also connects emotions and memories so you can form associations and experience a wave of happiness when recalling your favorite childhood memories. Meditation induced changes in only the left side of the hippocampus. Unfortunately, the function of the different sides eludes explanation. One study found that synapses in the left and right regions are asymmetrical with distinct structural differences, suggesting that they have separate but interrelated functions.
• The posterior cingulate cortex: Many agree that the posterior cingulate cortex plays a role in cognition, specifically attention direction and rewards systems. Brains at rest, brains planning for the future, and brains reflecting on the past show increased activity in this region. A Duke University study suggests this region might be what keeps you motivated when learning something challenging. Posterior cingulate cortex activity in monkeys increased when they made errors in a test and needed to learn something new to improve their performance.
• The temporo-parietal junction: The temporo-parietal junction is often associated with empathy. Studies have found activity in this region increases when subjects read stories about people who were accidentally or intentionally harmed.
• The cerebellum: A large brain region called the cerebellum helps you make coordinated movements and communicates with several other structures in the brain. It’s how you can run, walk, eat, and throw a  football without thinking of all of the tiny movements you need to perform to accomplish these seemingly simple tasks.
• The amygdala: The researchers also found decreased gray matter density in the amygdala, a region associated with anxiety and stress.

Meditation Reduces Anxiety

The Wake Forest Baptist Medical Center found that meditation reduces subjects’ anxiety ratings by as much as 39 percent. They studied 15 volunteers with normal stress levels, no diagnosed issues, and no meditation experience. The volunteers learned the proper way to practice mindful meditation and took just four 20-minute classes. Scientists noted changes in the brain areas associated with worrying and emotions during and after the meditation.

Scientists noticed increased activity in the areas noted below. While each perform many complex functions, their associations with emotions, guilt, and conflict control contributed to the subjects’ decreased anxiety ratings.

• The ventromedial prefrontal cortex: The ventromedial prefrontal cortex has been connected with decisionmaking and cognitive control as well as complex social interactions like emotional processing and guilt. Most people would be incensed after witnessing a poisoning attempt. Studies have shown that people with damage to their ventromedial prefrontal cortexes don’t find a moral problem as long as the potential poisoner failed to kill the victim. They view the transaction only as deep as the outcome.
• The anterior cingulate: The anterior cingulate activates during conflict. Recent research has found that it’s also active when we find something humorous. Researchers believe this points to its role in coping with situations. Your brain might not see the difference between trying to understand the punchline of a joke and trying to detect why your spouse could be mad at you.

Meditators Have Different Brains

Other studies from Massachusetts General Hospital reported that meditators’ brains differ structurally from non-meditators’ brains. Meditators have thicker regions for sensory processing and attention than non-meditators. Older people showed even more pronounced differences, suggesting that meditation might be able to reduce thinning of certain structures as the brain ages.

The study showed that you can change the structure of your brain, making certain areas thicker and stronger with constant practice. Why is that so special? Well, Albert Einstein might have owed some of his genius to thicker connective structures in his brain.

These regions indicated below were thicker in the meditators studied:

• The prefrontal cortex: The prefrontal cortex engages when you’re involved in complex and abstract thought, emotions, planning, and introspection. It’s basically your decision center, taking information provided by your senses and deciding what to do with it. It might also play a role in creativity. Scientists studied brain images of jazz artists to see what the brain does during the spontaneous performance of music. During improvisation, the scans revealed a flurry of activity in the medial prefrontal cortex. To make things more interesting, they noticed activity in the dorsol lateral prefrontal cortex decreased; this area of the brain manages inhibitions and detailed planning.
• The insula: The insula is a mysterious prune-sized brain tissue thought to be important in integrating thoughts, senses, and emotions. For example, when you smell something you find repulsive, it’s probably the insula that relays the distaste to your brain in reaction to the odor. It also lights up during arousal–when people feel pain, crave drugs, listen to jokes, and even make financial decisions.

What else can meditation do?

Other studies have suggested fascinating effects of meditation without pinning down the actual brain structures responsible. According to these compelling findings, meditation might…

Allow You to Expand Limited Brain Resources

Our brains have limited capacity for processing synchronous stimuli. For example, when presented with two visual targets in close proximity, you can’t detect the second. This is called attentional blink. See for yourself:

But some studies suggest meditation reduces attentional blink. Attentional blink happens because the two targets compete for your limited brain resources. Meditators allocate their resources across the targets more effectively and therefore can detect both.

Make Us Masters of Pain

Meditation might influence reaction to pain. Researchers pitted 12 thirty-year meditation veterans against 12 normal, yet meditation-less control subjects. The meditation veterans showed a 40-50 percent lower response in their brains when exposed to pain than those in the control group. After the 12 members of the control group practiced meditation for five months, their brains’ responses to pain decreased by 40-50 percent, as well.

Mind Over Matter

Mind over matter. Believe and achieve. Mantras like this stare us down from classroom posters and self help tomes. While the statements are inspiring, few people take them literally. But evidence that you can change your brain through meditation gives these words new life. From changing your gray matter concentration to thickening certain regions of your brain, the emerging studies on meditation are compelling–even for the most skeptical of potential practitioners.

You have the power to change your brain. How’s that for an empowering meditation mantra?

Resources

Primary

Mind, Mood & Memory: Meditation–the Relaxation Remedy: Research Suggests Meditation Can Help Ease Stress, Improve Health and Well-Being, and Even Boost Brain Activity

Townsend Letter: Transcendental Meditation Reduces the Brain’s Reaction to Pain

New Scientist: How Life Shapes the Brainscape: From Meditation to Diet, Life Experiences Profoundly Change the Structure and Connectivity of the Brain

Mind, Mood & Memory: The Neuroscience of Meditation: Spending Time Consciously Directing Awareness to Present-Moment Experience Can Change the Brain’s Activities and Structure

Mind, Mood & Memory: Eight Ways to Improve Your Focus–and Your Memory; These Suggestions For Boosting Concentration Can Help You Strengthen Your Ability to Absorb Information

NIH: Buddha’s Brain: Neuroplasticity and Meditation

PLos Biology: Mental Training Affects Distribution of Limited Brain Resources

NIH: Mindfulness Practice Leads to Increases in Regional Brain Gray Matter Density

Journal of Neuroscience: The Role of the Ventromedial Prefrontal Cortex in Abstract State-Based Inference During Decision Making in Humans

Additional

Psych Central: Meditation That Eases Anxiety? Brain Scans Show Us How

Harvard: Eight Weeks to a Better Brain

Reference and User Services Quarterly: Meditation and Health: an Annotated Bibliography

Brain Facts: Mapping the Brain

Brain Facts: The Cerebellum

Education Portal: Hippocampus: Definition, Function & Location

Science Daily: How is Our Left Brain Different From Our Right?

Medical Daily: Motivation Stems From Single Brain Region: The Posterior Cingulate Cortex Keeps You Going When Learning is Tough

Brain Facts: The Moral Brain

Brain Facts: Neuroeconomics: Money and the Brain

Brain Facts: No Laughing (Gray) Matter: Laughter, the Brain, and Evolution

Brain Facts: Unlocking Creativity in the Brain

Psychology Today: An Overview of Meditation: Its Origins and Traditions

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Can Meditation Change Your Brain? appeared first on Law Street.

Wine tasting can be an abstract art. As the pourer dribbles a tragically small amount of wine into your glass, you glance at the tasting notes. You definitely taste the dark cherries. After another sip you detect leather and possibly a hint of dirt.

Your friends think you’re a wine tasting genius. But truthfully, you kind of just made all of that up. In fact, while drinking the same wine alone later on, you start to wonder if it ever tasted like leather at all. Maybe you were just carried away by a tide of wine snobbery. It’s been known to happen.

Your wine tasting experience can be more than just an effusive bubbling of wine poetry. While wine tasting is an art, science explains everything you see, smell, and taste. Here’s what you need to know about the science of wine tasting to back up your assertions.

How to Taste Wine

Before we get into the science behind wine tasting, let’s review how to do it. Winefolly.com has an excellent infographic with some basic steps to keep in mind when wine tasting: look, smell, taste, and conclude.

Now let’s find out what scientific factors contribute to each step.

Look

When you look in your glass, your wine should be red, white, or something in between. Step one complete. Now, why the different colors when all grape juice is essentially clear? The answer lies in grape skin.

Grape skins contain little compounds called anthocyanins. During winemaking, acids in the wine react with anthocyanins to produce velvety red hues. The acid level of the wine is especially important in achieving this red color; when anthocyanins meet an alkaline solution, they’ll produce completely different colors like blue and green. Anthocyanins are highly reactive, they’re even responsible for the changing colors of autumn leaves.

Anthocyanins continue their complex reactions during aging, forming complexes that create subtle differences in wine color. While anthocyanins decrease over time, the complexes they’ve formed ensure the wine will stay a shade of red.

Many other subtle factors contribute to the range of red wine colors you see, including:

• Variations in grape skin thickness and pigment;
• How long the grape was on the vine;
• How long the skins were soaked in the wine before and after fermentation; and
• The handling of the grape skins. For example, macerating the skins brings out other pigment compounds, like carotenoids, that add even more color to the wine.

To make white wine, juice is pressed and separated from the skins very early on and no red pigmentation develops. For a rosé, winemakers leave skins in the grape juice for a short time.

What to remember? Grape skins, and the reactions among different compounds they contain, determine wine color.

Smell

Wine aroma stems from the complex interaction of volatile compounds present in the wine.

When you smell a glass of wine, odor-active volatiles travel through your nose and connect with odor-binding proteins in your olfactory epithelium, or the area in your nose that recognizes odors. From there, receptors pass the odors onto the brain for processing and interpretation.

But there’s more to the aromatic experience than the first smell. Much of the liquid’s perceived aroma releases after you swallow and exhale. The motion releases even more aroma compounds into your system.

Variations in the enzymes, microflora, and mucus in your mouth further complicate aroma, altering how different people perceive odors. So aroma might be relative after all. It’s one of the most abstract aspects of tasting wine.

You can make wine tasting more concrete by recognizing and articulating what you smell. Ann C. Noble’s wine wheel will help you do this. She took information from several wine descriptive analysis studies and picked concrete terms over abstract ones to create the wheel. Take a look at the video below for more information on the wheel.

Aroma judgement might also be clouded by other senses. Researchers from the National Institute for Agronomic Research in Montpellier, France found that perceived smell is highly influenced by appearance. They noticed that wine critics frequently used red or dark objects to describe the smell of red wine, like raspberries or tobacco. The critics similarly used golden hues as descriptors when tasting white wine, like honey and apricots. When they asked students with little wine-drinking experience to describe wine, they saw similar results.

Then the researchers gave subjects two white wines, one of which had been colored with unobtrusive red dye. The subjects still described the disguised white wine in terms of red-hued objects, proving that our noses might be highly influenced by our eyes.

What to remember? Just because the person next to you smells asparagus doesn’t mean you have to. If they try to argue with you, tell them that wine aromas are subject to complex interactions of volatile compounds that people perceive differently. You could both be right.

Taste

Now it’s time for the best part–the tasting. But how did the wine in your glass end up tasting so much different from the grape juice it once was? Wine is made through an intricate series of interactions between different compounds in grapes. These compounds are released and heightened during various winemaking processes like crushing, fermentation, and aging.

Since many compounds are released and intermingle in the process of making wine, it’s hard to pinpoint a flavor or aroma to its chemical cause. But knowing some of the basic compounds is step one. The chemical classes of compounds found in wine include esters, alcohols, acids, lactones, carbonyl compounds, acetals, phenols, sulfur-containing volatiles, nitrogen-containing volatiles as well as other miscellaneous substances. Below are some examples of how different substances affect the flavor of wine. (Please note that aroma and flavor are closely linked. Many of the compounds below contribute to both the flavor and aroma of wine.)

• Acids: Acid in wine comes from what is naturally present in the grape and what is produced as a byproduct of fermentation. Other than yielding tart flavors and balancing sweetness, acid’s role in wine is highly reactive. When acid meets substances like esters and alcohols, the subsequent reactions can produce a range of flavors from fruity to tart. Acid also plays a key role in fighting off microorganisms that cause wine spoilage.
• Tannins: Tannins are the phenol polymers that are extracted from grape skins during fermentation. They’re more closely associated with “mouthfeel” than actual flavor. Tannins don’t react with olfactory receptors, but bind to the proteins on the surface of mouth cells and change their viscosity temporarily. This dries out the tongue and provides that familiar “puckery” sensation.
• Sugars: Sugars do more than just determine the overall sweetness of wine. Sugar enables wine’s alcohol content. During fermentation, yeast converts the glucose and fructose in grape juice into alcohol and carbon dioxide. The exact sugar content of the grape can vary based on subtle differences in ripeness, making fermentation a very complicated process to perfect.
• Esters: Esters are naturally occurring aromatic compounds in grapes that are heightened through fermentation and when exposed to acid. A multitude of esters are released during the winemaking process that interact to produce fruity and floral flavors and aromas along with other subtle variations. For example, lactones are the specific esters that impart creamy smells like vanilla, coconut, and butter.
• Pyrazines: Pyrazines produce herbaceous smells in wine. Think green peppers and green beans. They’re found in extremely low quantities in grapes but they have such a low flavor threshold that even small amounts can emerge and alter the flavor of the wine.
• Terpenes: Terpenes are organic compounds that can make wine smell and taste sweet, floral, resinous, or herbaceous. A specific example is pinene, the terpene that gives pine trees their familiar aroma.
• Thiols: Thiols are organosulfur compounds that can taste and smell fruity or earthy when controlled. As these are the same compounds that give skunks their signature scents, too much thiol in wine produces an unpleasant odor.

That was just a sampling of the compounds that interact in a glass of wine to provide the symphony of aromas and flavors you experience. In addition to the interactions of compounds, tiny variations in fermentation and an individual’s unique flavor receptors further impact perceived flavor. That’s why two people can taste two different things in the same bottle of wine.

What to remember? Wine can contain a full range of robust flavors that taste like anything from vanilla to green beans. It’s not because wine is stuffed with additives, these flavors are a result of natural compounds interacting in the magic of wine making.

Why do we put wine in barrels?

Any wine tasting will inevitably include what sort of barrel or tank the wine was aged in, including where it came from. But what does it mean?

Even when wine is in a cask or a barrel, it’s changing chemically and absorbing qualities of the wood. The barrel’s wood contains compounds and tannins of its own that influence the wine. Barrel wood contains the following:

• Vanillin, which imparts vanilla notes. It’s released when lignin in oak breaks down. Toasting the wood accelerates the degradation and release of vanillin and the developing of flavors.
• Furfural, which is a byproduct of carbohydrate degradation. It gives wine a toasty-sweet aroma.
• Lactones, which are esters that impart woody aromas.
• Terpenes, which provide tea and tobacco flavors.
• Hydrolysable tannins, which combine with tannins in grapes to affect the mouthfeel of the wine. The types of tannins in wood are heat sensitive, so winemakers can manipulate them through various barrel-making processes.
• Hemicellulose, which are wood polymers that convert into sugars when heated. They add more toasty, caramelized aromas.

As no two trees are the same, no two wine barrels will be exactly the same. Different types of wood are know for different characteristics, such as those described below.

• French oak contains the highest levels of tannins. French oak is more porous than other types of wood, providing more opportunity to impart elements of the wood into the wine. Caryophyllene and copaene are examples of compounds found in French oak that are responsible for some popular spice flavors.
• American oak is a sturdier wood with more hemicellulose and lignin which typically results in warm vanilla flavors.
• Eastern European oak is similar to French oak but is smaller and grows slowly. The hemicellulose in this wood breaks down easily to form more intense toasty aromas.

Apart from these reactions, wine slowly and slightly oxidizes in the barrel. This tames bitterness and can often change color. Aging wine in stainless steel doesn’t produce nearly as many reactions. That type of container is typically used to preserve the unique flavors of the fruit and keep all oxygen out.

How about terroir?

Terroir refers to the conditions that grapes were grown in including soil, sunlight, and water. Many believe the grapes’ milieu contributes to the final flavor of the wine. The word terroir originated as a name for soil, but it turns out wine terroir might be more dependent on climate than dirt.

Some experts argue that climate might have more impact than soil because it’s very difficult to prove that vines absorb minerals from the ground. Rocks and soil would have to undergo multiple reactions for their elemental particles to become soluble. From there, they would have to get to the vine’s roots and then to various parts of the grapevine. Fermentation and other winemaking processes could mask any small effect the minerals in soil had on the vine.

None of these speculation are conclusive and even geologists are getting into the terroir mystery. This would just be a fun tidbit to throw out if the subject comes up.

Whoa whoa whoa, what about the swirling?

Don’t worry, swirling wasn’t invented just to make you spill wine on yourself. Swirling and aerating exposes wine to oxygen, which is actually good just before tasting. The actions lead to evaporation. In this case, undesirable compounds like sulfites, sulfides, and ethanol typically evaporate first. These substances can make wine smell rotten or taste too alcoholic. Exposing the wine to oxygen before sipping helps to decrease these bitter notes.

Conclude (AKA Talk About it Pompously)

This is when you leverage what you know about wine tasting to have a grounded discussion instead of indiscriminately spewing impressive adjectives.

Let’s go back to the cherry-tobacco-dirt wine we started with. Now you can explain to your friends that its brilliant ruby color is a result of grape skin compounds called anthocyanins. You can tell them you’re not just swirling your glass to look cool, but to get rid of sulfides and other potentially bitter compounds. Explain that the dark cherry flavor is probably a result of esters reacting with acids in the wine. And that dirt smell? Let’s call it earthy and chalk it up to just the right amount of the organosulfur compounds.

Every glass of wine is full of science. Chemical reactions in every step of the winemaking process work in unison to produce the magical liquid set before you. Even if your palate needs work, appreciating the scientific wonder in wine is the first step toward becoming a true connoisseur.

Resources

Primary

Analytical and Bioanalytical Chemistry: Beyond the Characterization of Wine Aroma Compounds

PLOS One: How Subtle is the “Terroir” Effect? Chemistry-Related Signatures of Two “Climats de Bourgogne”

New Scientist: A Whiff of Untruth

Nature: Alcohol and Science: The Grapes of Rock

Ronald S. Jackson: Wine Science: Principles and Applications

U.S. Forest Service: Oak Aging and Wine

Additional

Chemical Heritage Foundation: Scientia Vitis

Popular Science: Does A Wine’s ‘Terroir’ Really Matter? Study Says Yes

Compound Chem: The Key Chemicals in Red Wine – Colour, Flavour, and Potential Health Benefits

Wine Folly: Where Wine Flavors Come From: The Science of Wine Aromas

Science News: Wine’s Chemical Secrets: Can Science Bring Us Better Wine?

Restaurant Business: Wine Aging

Wines and Vines: Exploring the Science of Terroir: Science May Support Link Between Climate and Wine Quality–Not Soil-Minerality

Wines and Vines: Picking Out the Pepper: How Aussie Researchers Uncovered a Key Red Wine Aromatic Compound

Wine Spectator: Ask Dr. Vinny

Napa Valley Register: What Makes a Red Wine?

Practical Winery: Persistence of Vegetal Characters in Winegrapes and Wine

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post The Science of Wine Tasting appeared first on Law Street.

Move over marijuana, there’s a new form of contraband in town.

Milk.

Not just any milk, but raw milk, which is simply milk that hasn’t been pasteurized or heated to a temperature that kills illness-causing bacteria. It’s illegal to sell raw milk directly to consumers in about half of the United States. It’s also illegal to distribute raw milk packaged for consumption across state lines. Still, raw milk advocates stand up for their right to consume it. For example, protesters from a private buying club, Grassfed on the Hill, milked a cow on the Capitol lawn back in 2011 to protest the Food and Drug Administration’s action against a Pennsylvania farmer accused of selling raw milk across state lines.

Raw milk proponents say pasteurization kills flavor, nutritional benefits, and beneficial bacteria in addition to killing the harmful bacteria that it’s supposed to eradicate. Opponents say there’s simply no proof that raw milk has any benefits that pasteurized milk can’t confer, and that drinking it isn’t worth the health risk as it contains potentially dangerous bacteria. Both sides stand firm, creating controversy around one of America’s most wholesome and common commodities.

If you haven’t heard anything about raw milk yet, chances are you will. Warnings from regulatory and public health agencies are increasing, raw milk crusaders are banding together, and politicians are jumping on board to take a stand. As early as 2012, Ron Paul was using the topic of raw milk to rally a Wisconsin crowd, as seen in the video below.

Here’s what you need to know about the raw milk debate before it escalates to a full scale food fight.

Why do we pasteurize milk in the first place?

To understand the raw milk controversy, you need some background on pasteurization and why we do it in the first place.

Before milk makes its way to a carton, it starts in a cow’s udders, which are basically saggy mammary glands. (Yuck.) Like other bodily fluids, the milk produced in these glands contains bacteria, both good and bad. Unlike many other farm foods, milk isn’t usually cooked before consumption. Since cooking kills pathogens, many people ended up drinking a cocktail of bacterial specimens before pasteurization was invented.  In the early 1800s, illnesses like tuberculosis, scarlet fever, and typhoid fever were often transmitted through milk because of the unclean dairy practices common at the time.

Luckily for the American dairy industry, the French love their wine. They love it so much that Emperor Napoleon III gave a scientist by the name of Louis Pasteur the noble task of stopping wine spoilage. Pasteur soon became famous for nuancing a process that would keep wine from spoiling without changing its flavor. It involved heating the liquid to the right temperature for the right amount of time to destroy spoilage bacteria. He called it pasteurization.

Pasteurization was applied to dairy in the late 1800s, and incidence of disease caused by milk decreased drastically. At first it was only used for dairy farmed in unsafe conditions, but soon it was leveraged to reduce risk of illness for nearly all dairies. From there, pasteurization grew to dominate the dairy industry.

What are the laws regarding raw milk?

Although individual states have always regulated their own dairy processing, the Standard Milk Ordinance, now called the Grade A Pasteurized Milk Ordinance (PMO), was implemented in 1924 to help each state meet certain standardized quality recommendations to ensure public safety.

Raw milk didn’t become a truly legal issue until the 1980s when Public Citizen filed a petition with the Food and Drug Administration that requested a ban on raw milk and raw milk products. The FDA had been trying to require that all products labeled “milk” be pasteurized since the 1970s, but met resistance and delays from the Department of Health and Human Services and certified raw milk producers. After hearing witness accounts and testimonies, the courts concluded that raw milk posed a serious threat to public health and should be banned from interstate sale.

It has been illegal to distribute raw milk from state to state ever since.

Since each state makes its own rules about the sale of raw milk, commerce within state borders gets a bit more complicated. Some states, like Florida and Virginia, prohibit all sales of raw milk. In Kentucky, you can only purchase raw goat milk straight from the farm. In New Hampshire, you can buy raw milk at a retail outlet, but it must adhere to uniform coliform standards. Things like cow-share agreements, where customers pay a fee for a percentage of cow’s milk, make things even more complicated. Alaska is an example of one state that allows “share” operations. Check out this chart for state-by-state raw milk regulations.

What Proponents Say About Raw Milk 

The supporters of raw milk tout benefits like taste and nutrition with religious fervor. Some even claim other benefits like decreased allergies and less acne.

The Taste Argument

People who’ve tasted raw milk and liked it keep going back for more. In this study of dairy producers who drink raw milk, 72 percent cite taste as their primary motive.

Raw milk lovers say it’s richer, sweeter, and more complex. Connoisseurs credit subtle flavors to a cow’s diet of natural greens. Many raw milk producers  “pasture” their cows, allowing them to eat greens as nature intended, as opposed to feeding them popular corn- and grain-based feeds.

Beyond drinking milk, raw milk cheese has a cult following, especially in France. Many of the country’s legendary cheeses are made with raw milk, which savants say imparts enticing characteristics unmatched in pasteurized varieties. In this 1998 New York Times article on the subject, cheese maker Bernard Antony said, ”Pasteurized cheese is not cheese; it’s like plastic.”

The Health Argument

In addition to being a holy grail of nuanced flavors, many raw milk advocates flock to raw milk because of its purported health benefits. They believe pasteurization kills beneficial enzymes and good bacteria. They also say raw milk can help quell body pains, reduce allergies, cure lactose intolerance, and more as evidenced from this Realmilk.com testimonials page.

Supporting studies for the claims are patchy. This study does suggest there might be an association with consumption of farm milk and asthma and allergies, but not enough to be conclusive. A Standford University School of Medicine study found that raw milk does not reduce lactose intolerance, in direct conflict with some testimonials and surveys. Why the clash between testimony and science? More research is needed to find out.

The Liberty Argument

Back in 2011, FDA officials raided Rawesome Foods and arrested its owner, James Stewart, and other raw milk suppliers for selling raw milk directly to customers. Apparently, Stewart had failed to show up for previous court appearances to face charges of shady fundraising, among other things. Even so, the arrest struck a cord with raw milk advocates who showed up to Stewart’s hearing wearing “raw milk heals” t-shirts.

They didn’t care if Stewart’s actions were illegal, they cared that he was fighting for their rights to consume raw milk. They believe that it should be individuals, not the government, who dictate what consumers put in their bodies.

What Opponents Say About Raw Milk  

Opponents, most specifically regulatory officials, argue that consuming raw milk and dairy products pose a serious threat to health, a threat that exceeds any potential benefits. And why take an unnecessary risk?

Watch the emotional video below that plays to the fear of what can come from taking unnecessary risks.

They also say that there aren’t any benefits of raw milk that you can’t get from pasteurized milk. These quotes from the Centers for Disease Control and Prevention Raw Milk Questions and Answers page address some common raw milk proponent beliefs:

Many studies have shown that pasteurization does not significantly change the nutritional value of milk — pasteurized milk is rich in proteins, carbohydrates, and other nutrients. Heat slightly affects a few of the vitamins found in milk– thiamine, vitamin B12, and vitamin C– but milk is only a minor source of these vitamins.

While it’s true that the heating process of pasteurization does inactivate some enzymes in milk, the enzymes in raw animal milk are not thought to be important in human health.

There are no health benefits from drinking raw milk that cannot be obtained from drinking pasteurized milk that is free of disease-causing bacteria. The process of pasteurization of milk has never been found to be the cause of chronic diseases, allergies, or developmental or behavioral problems.

Why do they say raw milk is such a threat to health?

Unlike many other farm foods (e.g. milk and eggs), milk isn’t usually cooked before consumption, so there isn’t a step to kill illness-causing bacteria. Milk’s low acid content and high protein levels make it easier for pathogens to grow.

Even if milk comes out of the cow without bacteria, it can become contaminated easily during the farming process. Dairy farms breed pathogens naturally, even when they take necessary precautions. Pathogens can be transferred on multiple occasions on the farm:

• The milk might accidentally come in contact with cow feces
• The cow might have an udder infection (mastitis)
• The cow might have an undetected illness
• Bacteria on the cow’s skin might get into the milk
• Dirt from the barns and processing equipment might get on the milk
• Animal pests living in barns, like rats and insects, might contaminate the milk
• Humans with soiled hands or clothing might contaminate the milk

For these reasons and more, officials cite that pasteurization is the only way to make sure the pathogens in milk won’t pose a threat to human health. They say even farmers who follow hygienic practices and test their raw milk cannot guarantee safety.

Supporting Data

According to the CDC, outbreaks caused by raw milk  have increased from 30 in 2007-2009 to 51 in 2010-2012. The outbreaks are most commonly caused by Campylobacter, Escherichia coli, and Salmonella and include symptoms like diarrhea, vomiting, muscle aches, and fever. Relative to the amount of raw milk that is consumed, the risk of an outbreak from raw milk is 150 times greater than the risk of an outbreak from pasteurized milk.

Shouldn’t science stop this debate?

Advocates from both sides point to studies, surveys, testimonials, and data to prove their points, but still each side clings to their beliefs with evangelical conviction. In a literature review requested by the Maryland House of Delegates’ Health and Government Operations Committee, the authors point to a need for both raw milk advocates and regulatory agencies to be open to discussion and compromise. Surely both sides of this contentious debate can find some common ground in the future.

Will raw milk become a substance relegated to the black market? Will federal lawmakers cave and loosen boundaries on interstate trade? Only time will tell, but 2015 promises to be an interesting year for those on both sides of the aisle in the raw milk debate.

Resources

Primary

CDC: Raw Milk Questions and Answers

Rev Sci Tech Off Int Epiz: Milk Pasteurisation and Safety: A Brief History and Update

CDC: Increased Outbreaks Associated with Nonpasteurized Milk, United States, 2007–2012

NIH: Food Safety Hazards Associated With Consumption of Raw Milk.

NIH: A Survey of Foodborne Pathogens in Bulk Tank Milk and Raw Milk Consumption Among Farm Families in Pennsylvania.

CDC: Raw (Unpasteurized) Milk

U.S. District Court: Public Citizen v Heckler

Additional

New Yorker: Raw Deal

Chris Kresser: Raw Milk Reality: Benefits of Raw Milk

How Stuff Works: How Pasteurization Works

Raw Milk Facts: State by State Raw Milk Legislation

USDA: How Do Cows Make Milk?

The New York Times: How We Poison Our Children

NPR: Unlocking France’s Secrets to Safer Raw Milk Cheese

The New York Times: The French Resist Again: This Time, Over Cheese

Marler Clark: A Legal History of Raw Milk in the United States

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post What’s the Deal With Raw Milk? appeared first on Law Street.

We’re all familiar with “A Christmas Carol” and the old miser named Ebenezer Scrooge who achieves enlightenment after a night of ghostly visits. But it turns out that Scrooge’s haunts might have been helped along by something he ate or drank.

Eating and drinking (especially the extreme forms practiced throughout the holiday season) can impact your body enough to cause memorable dreams, nightmares, and sometimes hallucinations.

Below, I’ll explore the mental effects of holiday food through the lens of Scrooge’s misadventures. What actions might explain Scrooge’s nocturnal visits from a troupe of formidable ghosts? What does it mean for you? Let’s find out…

He Could Have Eaten a Hallucinogenic Food

I’m not saying that old Ebenezer was purposefully tripping on magic mushrooms. Quite a few foods might have contributed to his visions, or even cause you to see some weird things after Christmas dinner.

Moldy Bread

Specifically, Moldy rye bread. Ergot or (Claviceps Purpurea) is a fungus common on grasses, cereal crops, and ryes. It’s also the source of lysergic acid diethylamide (LSD). Scrooge’s cold, wet, pantry would have favored the growth of this fungus, which causes hallucinations when ingested.

Ergot has such extreme effects that researchers Linnda Caporael and Mary L. Matossian have linked it to the Salem Witch Trials. If it could have caused that hysteria, it could have caused Scrooge’s ghostly episode.

Nutmeg

Nutmeg becomes psychoactive when taken in large quantities. How much? More than the amount that usually dusts a mug of eggnog. It would take more than two tablespoons (two whole seeds) to produce any hallucinogenic effects. Nutmeg has mind altering properties because it contains myristicin, a chemical similar to amphetamine and mescaline.

Would Scrooge consume enough nutmeg to trip? In his day, men were sometimes known to carry around their own nutmeg graters in case an appropriate beverage presented itself. Nutmeg was used for headaches, and turkeys were even stuffed with it. While it’s unlikely that he was judiciously grinding copious amounts of nutmeg into his eggnog, it’s almost certainly something he could access. You shouldn’t worry though, unless you’re really planning on overindulging in nutmeg this holiday season.

Fish

Hallucinatory fish poisoning, or ichthyoallyeinotoxism, is a rare type of food poisoning that causes central nervous system disturbances, especially hallucinations and nightmares. Ciguatera poisoning is the most well-known type of hallucinatory fish poisoning. Fish become contaminated with ciguatoxins when they eat the toxin-producing seaplant, dinoflagellates. They can also become contaminated by eating another fish with ciguatoxins in its system.

Eating exotic fish usually causes hallucinatory fish poisoning, so it’s unlikely that London-dwelling Scrooge would have this to blame for his visit by ghosts.

What this means for your holiday: If you’re hoping to avoid holiday hallucinations, steer clear of strange new fish, don’t overdose on the nutmeg, and check your bread twice for suspicious mold spores.

He Could Have Been Over-Caffeinated

If Scrooge was in fact such a “tight-fisted hand at the grindstone”, maybe he owed his disciplined work ethic to profuse amounts of caffeine. And too much caffeine could lead to hallucinations, says this Durham University Study.

The researchers found that heavy caffeine users–those who drink the amount in seven cups of coffee or more a day–were more likely to have hallucinations or hear voices than low caffeine users.

Why does this happen? It might be stress, which caffeine tends to heighten, even physiologically. A stressed body releases the hormone cortisol, and a stressed and caffeinated body releases even more. The researchers believe the extra release of cortisol might be where the hallucinations come in, but they need to do more research to tell for certain.

What it means for your holiday: If you’re sleep deprived over the holidays, go ahead and have more caffeine, but draw the line at seven cups.

He Could Have Eaten Some Cheese

Could cheese cause vivid dreams? A study by the British Cheese Board suggests there might be some truth to this–if Scrooge had nodded off and dreamt of Marley, that is. The study found that consuming different types of cheese could encourage different types of dreams. Listen to this NPR spot to find out more.

Other scientific studies investigating a cheese-dream connection are limited. But preliminary results of a study on vitamin B-6, of which cheese is an excellent source, produced some compelling information. The results showed that people taking higher doses of vitamin B-6 reported higher dream salience; their dreams were more vivid, emotional, colorful, or just plain bizarre.

What it means for your holiday: If you want to have vivid dreams, taking a tour through the old holiday cheese plate might not be a bad idea.

He Might Have Just Eaten Too Much and Nodded Off

Scrooge lived alone. He also was trying to save money by keeping his house sparsely lit. Darkness + quiet = a perfect recipe for nodding off in the easy chair. Scrooge could have drifted off to sleep as soon as the stimulation provided by his sparse dinner had ended. Eating just before bed might be the perfect recipe for weird dreams, including those featuring the return of a deceased former boss.

Food has been shown to affect the levels of neurotransmitters in the brain that control time spent in rapid eye movement, or REM, sleep. You are most likely to dream in REM sleep.

For example, the chemical tyramine-a (found in dairy, meat, poultry and fish) increases brain levels of noradrenaline, also called norepinephrine. Noradrenaline produces the body’s response to fear and is sometimes even referred to as the “fight or flight” chemical. If your noradrenaline levels peak and you have a nightmare, your heart rate increases and your muscles tense up in response. Your heightened response to the visions in your nightmares would make them more memorable upon waking. Noradrenaline also makes blood pressure rise which could make dreams more nightmarish.

Other experts suggest a less complex explanation for vivid dreams following a late night binge. With an uncomfortably full stomach, you tend to toss and turn more, waking yourself up and interrupting your dreams. Dream interruptions often lead to heightened memories of the dream and the general sense that you’ve had more dreams than usual.

What it means for your holiday: If you tend to have nightmares, you might want to steer clear of the fridge on your way to bed. Those holiday leftovers could wreak havoc on your dreams.

He Might Have Had Too Much “Holiday Spirit”

It was hardly uncommon for gentlemen in those days to have a “nightcap” (stiff drink) before bed. They thought it might keep them warm throughout their nights like the actual nightcaps they wore on their heads. Scrooge wanted to save money on coal for heating, so he might have indulged in this nightly ritual. Little did he know that drinking so close to bedtime can lead to disturbed sleep and nightmares.

Alcohol interferes with REM sleep and leads to frequent sleep interruptions, just like overeating. So again, you can remember your dreams more vividly. Also drinking alcohol suppresses REM sleep and your brain tries to make up for lost time later on. So, in the morning, your brain might try to cram in some REM sleep and your dreams might become more bizarre and frightening as result.

What it means for your holiday: Craving a holiday night cap? Just drink it at least three hours before bedtime or prepare for some nightmares.

He Might Have Had an Alcohol Problem

Without any concerned family or friends to stage an intervention, Scrooge could have been a closet alcoholic. In rare cases, chronic alcohol abuse could lead to psychosis, the state of losing contact with reality.

Alcohol is a neurotoxin that can have many damaging effects on the brain. It can even induce alcohol related psychosis. Psychosis has been observed:

• during heavy intoxication
• as a symptom of alcohol withdrawal
• in disorders resulting from years of alcohol dependency

Long time alcoholics might be thiamine (B1) deficient which could lead to Korsakoff syndrome, a brain disorder associated with hallucinations, loss of memory, and confabulation.

What it means for your holiday: Even if you’ve had one too many eggnogs, you probably won’t start having visions. Alcohol induced psychosis is a concern for chronic alcohol abusers.

He Could Have One of These Conditions

Aside from one-off actions that might lead strange visions, some seemingly commonplace medical conditions cause hallucinations. Many of them could result from dietary choices like, gastroenteritis, gastritis, peptic ulcers, vitamin B12 deficiency, and low blood sugar. Scrooge could have suffered from any of these, and been none the wiser.

What it means for your holiday: Having a blood sugar crash after a unwise cookie binge? It might be the reason you’re hearing friendly voices telling you to eat even more…

A Hallucination Sidenote  

Don’t get too scared. Food-induced hallucinations like these occur rarely. But experiencing a hallucination doesn’t automatically diagnose you with mental illness.

This video explains how anyone can hallucinate:

Pass the Sugar Plums, Please

So there could be an easy explanation for what happened to Ebenezer Scrooge. The ghosts he saw might have been encouraged by beef, gravy, or an underdone potato. Now that you know what you know about the possible effects of holiday eating, you can prepare accordingly.

The hallucinations are pretty rare so you probably don’t need to worry about that. The worst your holiday eating and drinking will probably do is cause nightmares and disturbed sleep. Luckily, it’s not totally out of your control. This blogger has some advice to ensure your dreams are full of sugar plums and not sinister spirits:

• Eat dinner about 4 hours before bed.
• Stop drinking (everything) 90 minutes before bed.
• If you do have late night snacks, keep them high in carbohydrates and medium to low on the protein. A slice of whole wheat toast topped with peanut butter or cheese is an excellent choice.
• Steer clear of anything too acidic, like pasta with red sauce, that might lead to acid reflux.

Sweet dreams and happy holidays!

Resources

Primary

Durham University: High Caffeine Intake Linked to Hallucination Proneness

Med Scape: Alcohol-Related Psychosis

Centre Antipoison: Hallucinatory Fish Poisoning (ichthyoallyeinotoxism): Two Case Reports From the Western Mediterranean and Literature Review

NIH: Effects of Pyridoxine on Dreaming: a Preliminary Study

Additional

Bon Appetit: Foods That Make You Hallucinate

New Scientist: The Nightmare Before Christmas

Psychology Today: Psychoactive Spices – Bon Appetite!

NPR: Study: Eating Cheese Can Alter Your Dreams

Live Strong: Do B Vitamins Give People Vivid Dreams?

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Holiday Hallucinations: Can You Really Have Visions of Sugar Plums? appeared first on Law Street.

Start saving up your sick days. The Centers for Disease Control and Prevention (CDC) says that the upcoming flu season could be severe. The agency expects influenza A (H3N2) to dominate this year. H3N2 causes more hospitalizations and deaths than other flu types and has mutated since this year’s vaccine was created. Is it time for a quarantine? Probably not. But even if you’re vaccinated, you could be purchasing more tissues than usual from now until March as flu season peaks. I’ll break down what you need to know below.

How bad will it be?

Here’s some perspective: last year’s vaccine was only about 50-55 percent effective and experts estimate we won’t even reach those levels this year.

Here’s why

• Ninety-one percent of recent samples are influenza A (H3N2), an influenza (flu) subtype that typically causes more hospitalizations and deaths than other subtypes. (Don’t worry, I’ll explain subtypes later!)

• Over half of these samples don’t match this year’s vaccine because they’re drift variants; they’ve “drifted” to become structurally different from the H3N2 virus used to create this year’s vaccine. The drift could make this season’s vaccine less potent but it’s certainly not useless. In past flu seasons where influenza A (H3N2) drifted, vaccines were about 40 percent effective in stopping the virus. The vaccine still protects against other flu subtypes that haven’t drifted, like influenza A (H1N1) a.k.a the “swine flu.”

So, what is the flu anyway?

The flu we’re talking about should not be confused with the stomach flu, which is really just slang for gastroenteritis. It’s also not a blanket term for any ailment. You only have the flu if you’ve been infected with the flu virus.

A true flu is a viral infection that preys on your nose, throat, and lungs. The flu sees these mucous membranes as ideal ports of entry. Even innocently rubbing your eyes invites the flu into your body. Once the flu gets in, it causes an infection that leaves your respiratory system hampered and makes you feel generally miserable–sneezing, coughing, weak, and sluggish.

This video from Health 360 explains the flu virus and how it invades your body.

Flu Mechanics

Google a picture of a flu virus and you’ll see a circle covered in spikes, kind of like a balding koosh ball. Just like the koosh ball’s rubber fingers make the toy easier to catch, the flu virus’ spikes make the infection easier to catch. The flu virus would be nothing without its spikes.

The viral protein hemagglutinin (H) makes up most of the virus’ spikes. Hemagglutinin causes red blood cells to stick together (hema is heme molecules found in red blood and agglutinate means to stick together). Hemagglutinin enables the virus to attach to a host cell. Viruses can only spread if they hijack a host cell and replicate within it, so you can see why hemagglutinin’s role in host cell attachment is of the utmost importance…to a virus.

The viral protein neuraminidase (N) makes up the rest of the virus’ spikes. After the virus has infected a host cell and replicated itself, neuraminidase (N) allows the replicated virus to escape the host and infect other cells.

So hemagglutinin (H) assists in infecting the host cell and neuraminidase (N) helps the replicated virus proliferate. They work together to infiltrate as many immune systems as possible. Different subtypes of these viral proteins–Hs and Ns–are behind all of the confusing names for different flu viruses like H3N2, H1N1, etc. Let’s end that confusion once and for all.

H?N?: Naming flu types and subtypes

Three types of flu affect humans: A, B, and C.

• Influenza A: Infects both animals and humans and is usually responsible for large epidemics because of its ability to change.
• Influenza B: Infects only humans and is typically less severe than influenza A.
• Influenza C: Infects humans but is the least severe of all the types.

The ABC’s are the least of your worries in understanding flu names. Naming the flu gets complicated when we look at all of the subtypes of the viral proteins (spikes), hemagglutinin (H), and neuraminidase (N) that we just learned about above.

There are 16 possible subtypes of H and nine subtypes of N that can recombine to form 144 different subtypes of the flu virus that are named based on which H and N subtypes they contain. The influenza A virus dominating this year is named H3N2 because it has the viral protein subtypes H3 and N2 decorating its surface.

Viral proteins also come into play when we’re looking at how this year’s vaccine ended up being mismatched with this year’s dominant flu. Even among the 144 different subtypes, something called antigenic drift can cause different strains to form. The drift changes the structure of the viral proteins H and N to be different enough to befuddle your immune system, but not different enough for separate classification.

For example, this year’s dominant strain of influenza A (H3N2) drifted antigenically from the strain used to create the vaccine. So even if you’re vaccinated, your immune system might respond differently if you’re exposed to the newly drifted virus.

The Drifts and Shifts of the Flu

The flu virus has a sneaky habit of changing and tricking the immune system into letting it pass. The change happens through antigenic drift or antigenic shift. The preceding “antigenic” refers to antigens, which trigger your immune response. So the drifts and shifts produce a virus strain with altered antigens that your immune system will respond to differently. The antigens in this case are the viral proteins H and N. Your immune system responds to the shape of H and N subtypes you were vaccinated with. If those shapes change enough, you could have a problem.

Antigenic Drift

Antigenic drift happens when small changes naturally accumulate over time as a virus copies itself. At first, the drifted virus will be antigenically similar enough that a vaccinated immune system can recognize it. But small changes can compound over time so the shapes of the proteins drift enough that even a vaccinated immune system can’t recognize the drifted virus.

Think of a close friend getting a radically different haircut. She’s the same person, but at first glance you might not realize it because she looks completely different. If a virus drifts enough to create an antigenically different strain, the immune system might not be able to recognize and bind to the new shape of the viral proteins.

The flu drifts adeptly so we need to create a new vaccine every year. Drift is also why you’ll probably get the flu more than once in your life.

Antigenic Shift

An antigenic shift causes fast changes that make completely new H and N viral proteins. The virus is so altered that humans have no immunity to it, even if they were vaccinated. This happens when viruses shift from animal populations to infect humans.

Antigenic shift occurs rarely, but it can be devastating. Pandemics and epidemics like the 2009 H1N1 flu pandemic often happen when a flu virus shifts suddenly. Flu viruses usually shift to humans from domestic pigs and poultry. Don’t worry, this year’s dominant influenza A (H3N2) has only drifted not shifted.

Making a Vaccine

Since it takes so long to develop the vaccine, experts have to pick the virus strain they’ll use months in advance. There’s always a good chance the virus will drift in the interim as it has this year.

Private companies make flu vaccines but are subject to FDA safety and efficacy requirements. The FDA has approved three flu vaccines: egg-based, cell-based, and recombinant flu vaccines. The processes vary, but here are the basic steps:

• The CDC or other Influenza Collaborating Center provides the vaccine manufacturer with the vaccine viruses chosen.
• The viruses replicate in a controlled environment.
• The viruses are extracted from their growth host (eggs or cells).
• The manufacturer kills the virus and purifies the viral antigen to produce a vaccine that will not make people who take it sick.
• The manufacturer tests the vaccine before it goes to market.

Historyofvaccines.org has a great animated walk-through of the process. Check it out here.

Then what?

When you get your vaccine–the flu shot–it kind of tricks your body. Immunity builds when you’re exposed to a pathogen, such as a virus. In most cases you have to get sick to build this immunity. When your immune system fights off a virus once, it keeps a memory of the virus in case it returns.

A vaccination gives you the benefits of exposure and immunity building without making you suffer through the actual illness by exposing you to a harmless version of a pathogen. It won’t make you sick, but your immune system responds like a feisty dog that barks at anyone who knocks on your door. The overprotectiveness eventually pays off. If a harmful version of the virus tries to take you down, your immune system will have an immune memory to use in the fight.

That sounds OK, why doesn’t everyone do it?

There’s just something inherently scary and untrustworthy about getting injections. People come up with many fears and excuses for not getting vaccinated. Take a look at the video below.

And the list continues with NPR’s 32 Myths About The Flu Vaccine You Don’t Need To Fear. The good news? Most fears and excuses for not getting vaccinated are unfounded. The bad news? People don’t care if their fears are unsubstantiated.

Researchers have found that foiling flu vaccine myths doesn’t increase a skeptic’s intent to get a vaccine. It actually reduces it. The study suggests that explaining the facts about vaccines might remind people of why they were fearful of getting them in the first place or even give them new information to worry about. This only solidifies their anti-vaccination stance.

So what are we doing about this flu mess?

The CDC maintains that a flu shot is still the best way to protect yourself, but it also urges doctors to prescribe antivirals to people coming in with flu-like symptoms or those at high risk such as children, pregnant women, and adults 65 and older. Antivirals work best within 48 hours of flu symptom appearance, so most doctors will not wait for a positive test to prescribe them.

Is antiviral resistance a problem?

With doctors prescribing medication without lab test confirmation of the ailment, you might be wondering if antiviral resistance is a concern. Yes, it’s actually an inherent problem since the rapid replication process of viruses leads to mutations that can evade antivirals as well as immune systems and vaccines. Some strains of influenza have already become resistant to drugs that have been on the market for a while like oseltamivir, amantadine,  and rimantadine.

What are the benefits?

Results from past flu seasons and the 2009 H1N1 flu pandemic show that these drugs can reduce potentially devastating effects of influenza. Clinical trials and observation show reductions in symptoms, complications, and deaths from influenza with antiviral use.

All Things Considered, It’s Not So Bad

With its fast and unpredictable changes and complicated subtypes, the flu presents a formidable enemy for modern medicine. Flu shots and antivirals aren’t the perfect weapons, but they’re more effective than entering the battle unarmed. So how bad is this flu season going to be? Probably worse than last year’s, but a pandemic doesn’t seem likely.

Resources

Primary

CDC: Early Data Suggest Potentially Severe Flu Season

CDC: Health Advisory Regarding the Potential for Circulation of Drifted Influenza A (H3N2) Viruses

CDC: Types of Influenza Virus

CDC: How the Flu Virus Can Change: “Drift” and “Shift”

CDC: How Influenza (Flu) Vaccines Are Made

NIH: New Vaccine Technologies

Additional

Mayo Clinic: Influenza Treatments and Drugs

Synapse: “Flu” – Recombinant Genes on the Loose!

Science Daily: Correcting Myths About the Flu Vaccine: Effective?

Virology: Structure of Influenza Virus

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Are We in for a Bad Flu Season? appeared first on Law Street.

Dinosaurs are hard to keep up with despite their extinction more than 65 million years ago. We discover a new dinosaur about every two weeks. Yet experts estimate only 28 percent of dinosaurs that existed have been identified. Frequent  findings bring these animals to life, providing us with clues on how they might have looked and lived.

With these fast-paced discoveries, it should come as no surprise that the original Jurassic Park featured outdated dinosaurs. Audiences were expecting to see some tweaks in the look of the creatures in the forthcoming Jurassic World movie set to release in June 2015.

Disgruntled experts claim the dinosaurs appearing in the trailer are “stuck in the 1980s.” Jack Horner, paleontologist and scientific consultant on the film, isn’t worried. He states that the movie is purely fiction, not a documentary.

As someone who hasn’t given much thought to dinosaurs since elementary school, the outcries made me curious. How much do we really know about them? How do we even know what we do know? I explore these questions below.

How much can you find out from a bone?

Fossils go beyond bones to include anything that provides evidence of prehistoric life. They can be physical remains, trace remains (footprints and teeth marks), animal feces, pollen, spores, or even ripple marks from a long-dry prehistoric ocean.

The paleontologists who study fossils incorporate computer science, archaeology, biology, geology, ecology, anthropology, and more to explore evidence of the past. Like investigators on a crime scene, they detect clues where most people would see rubbish.

What do they look at?

• Microscopic fossils. They’re small but make up a large proportion of fossils just as microorganisms make up a large proportion of biomass.
• Traditional fossils. These include imprints, bones, shells, molds, exoskeletons, and other petrified remains of ancient life.
• Plant fossils. These reveal much about prehistoric lifestyles and ecologies.
• Plant spores. Plant spores, or palynomorphs, resist decomposition better than other types of fossils. Due to their resistance to decomposition, they’ve been useful in oil and gas exploration.
• Trace fossils. The study of trace fossils, or ichnology, focuses on tracks, footprints, and trails. Since many animals don’t leave behind anything that will fossilize, trace fossils provide the best evidence of how ancient creatures lived.
• Formation of fossils. Taphonomy is the study of how and why fossils form.

How do they study the fossils?

Fossils are rare, fragile, and require meticulously attentive handling. New, high-resolution X-ray computed tomography (CT) enables scientists to create complete and detailed scans of fossils so they can be examined in new ways by many people without fear of damage. The scans operate like extremely powerful medical X-rays that produce unbelievably vivid images.

To tout the benefits of the technology, Dr. Timothy Rowe uses the example of a dinosaur skull. With the scan, he can cut apart the skull digitally, without harming the fossil to explore different structures that might indicate how its brain worked and so much more.

The Fossil Record: An Incomplete Puzzle

The collective pieces of the dinosaur puzzle are called the fossil record and it’s definitely missing some pieces.

Producing fossils requires rare conditions. Most animals were eaten, leaving nothing behind to fossilize. Many animals and entire animal groups, like soft-bodied and small-boned organisms, never became fossils. Furthermore, wind and water erosion often swept away buried remains, especially in mountainous areas.

So while we know a great deal from what clues we do have, the clues are patchy. One scientist even estimated that only 2,100 adequate dinosaur skeletons exist. It’s extremely rare to find a whole dinosaur skeleton.

How do we figure out what they looked like?

The Basics

Using clues from the past and knowledge of modern animals, scientists make educated guesses about what dinosaurs may have looked like.

All reconstructions start with the foundation–the skeleton. It’s rare to find a complete skeleton, so scientists piece together an anatomically correct dinosaur from what fragments and pieces they have along with their knowledge of modern animals. Body parts made from cartilage are never fossilized; we can recreate skeletons, but we don’t know with absolute certainty how their joints moved.

After the skeleton comes the meat and muscle. Markings on the fossils where muscles were attached indicate their past location and size. The fossils tell them where the muscles should go, and studying modern animals helps them determine how much muscle mass to add.

The Embellishments

After the basic shapes come the embellishments: skin, colors, feathers, and more. Reconstructing these embellishments is less of an exact science since there is typically less evidence.

• Skin. A fossil is rarely surrounded by impressions made by the animal’s skin. If found, the impressions provide good indication of skin texture.
• Armor. Plates and spikes are fossilized easily relative to other features. When found with good skeletons, scientists can get a clear picture of how the armor might have been arranged on the body.
• Feathers. Fossils have shown impressions that indicate theropod (beast-footed) dinosaurs had feathers or feather-like structures. And a Siberian unearthing presents compelling evidence that other dinosaurs, and not just theropods, were feathered. The finding was significant because it contained the remains of many different ancestrally distinct species with feather imprints. It suggests that almost all dinosaurs had some kind of feathers. Even skeletons of the fierce and familiar Velociraptor have been found with quill knobs similar to what anchors feathers to the bones of modern birds. While the absence of these knobs doesn’t indicate a lack of feathers, their presence almost certainly confirms the feathers existed.
• Color. A rare feather fossil has been found that contains two types of the organelles that pigment hair, skin, and feathers called melanosomes. They two types were: elanosomes, which give zebras their stripes; and phaeomelanosomes, which make human hair red. The findings suggest that the particular Sinosauropteryx studied had a dark orange striped tail. A breakthrough like this is rare, so many artists are free to take license when choosing how to color their depictions.

How does dinosaur science affect dinosaur art?

Artists do what they can to make their depictions as accurate as possible, but because new developments happen so frequently and art takes time, renditions become outdated at a fast pace.

Thomas Holtz, a University of Maryland paleontologist, walks through some depictions of dinosaurs featured in past issues of National Geographic Magazine to call out what would now be different in artist renditions. Here are just a few examples:

• Many old dinosaur depictions feature them dragging their tails, yet we haven’t found any trace fossils of tail drag marks. Scientists believe that dinosaurs kept their tails upright and above the ground.

• Early dinosaur art often shows them in upright postures similar to humans. We now know such an upright posture is unlikely for any dinosaur–most of them moved in a nearly horizontal fashion.

• Depictions of a blunt-headed Brontosaurus are invalid. Brontosaurus was actually found to be simply a type of Apatosaurus and had a long, tapered skull.

New discoveries happen every day. The dinosaur toys kids are playing with in a handful of years will probably look completely different from the ones we enjoyed.

What’s new in dino world?

Dinosaur knowledge updates come fast and frequent. Here’s some of the latest dinosaur news.

• Researchers used computational fluid dynamics to create the first model of dinosaur breathing. The study suggests that dinosaurs had such long snouts to accommodate very deep breaths and lots of mucus. The mucus kept foreign particles out of their nostrils and the deep breaths cooled the blood to prevent their brains from overheating.

• A new pot-bellied dinosaur almost as big as Tyrannosaurus Rex was found. The strange new creature, Deinocheirus, had a large belly, big feet, and a sizable beak instead of teeth.

• A peculiar puncture wound in an Allosaurus suggests that Stegosaurus might have used its spiked tale to strike hungry predators below the belt.

• A nearly whole skeleton of what might be the largest terrestrial animal ever was discovered. Dreadnaughtus would have been about the size of a dozen elephants and seven times the size of a Tyrannosaurus Rex. Its bones reveal the particular animal might have been growing at the time of death.

A Mysterious Future For a Long-Dead Animal

As I mentioned earlier, of all the dinosaur bones that probably exist, only 28 percent have been identified. The potential for future discovery is huge. Even questions that seem simple remain mysterious to us. Were dinosaurs hot blooded or cold blooded? How did they mate? Why did they have horns, spikes, armor, or feathers? We still don’t even know exactly how they all went massively extinct.

The new Jurassic World trailer inspired me to look into what we know about dinosaurs. I found that we know quite a bit, but have much left to learn. Now I’m just wondering what new information we’ll have by the time the movie is released in June.

Resources

Primary

Smithsonian: Dinosaurs in the Backyard: How Do We Know?

Idaho Museum of Natural History: What is a Fossil?

Smithsonian: Reconstructing Extinct Animals

Additional

The New York Times: Many More Dinosaurs Still to Be Found

National Geographic: ‘Jurassic World’ Dinosaurs Stuck in the 1980s, Experts Grumble

BBC: Fossils

Science Mag: Feather Quill Knobs in the Dinosaur Velociraptor

Pubmed: An Early Cretaceous Heterodontosaurid Dinosaur With Filamentous Integumentary Structures

National Geographic: Siberian Discovery Suggests Almost All Dinosaurs Were Feathered

Nature: Fossil Feathers Reveal Dinosaurs’ True Colours

National Geographic: What’s Wrong With This Picture? An Audio Critique

Scientific American: New “Dreadnought” Dinosaur Most Complete Specimen of a Giant

Teachers: Unearthing Dinosaur Bones and Fossils

Carlton College: Taphonomy: The Study of Preservation

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Jurassic Park Realism: What Do We Really Know About Dinosaurs? appeared first on Law Street.

Every Thanksgiving, you might put down your fork for few seconds to ponder some puzzling mysteries. How did I eat this much? Why can’t I stop thinking about pie? Why should I bother laboring with fresh cranberries when cranberry sauce comes in an easy-to-open can?

We know you’d rather keep eating than answer these questions, so we’ve answered them for you. Here are some of Thanksgiving’s greatest mysteries explained by science.

 What makes turkey skin turn that luscious golden brown?

Home chefs across the nation aim to achieve that perfect golden turkey. They may not realize the same reaction that makes turkey’s skin golden also makes your skin golden when you apply self tanner: the Maillard reaction.

The Maillard reaction describes the interaction of sugars and amino acids that makes meat turn brown and tasty. When cooking a turkey, the heat catalyzes a reaction between simple sugars and amino acids and produces melanoidins. These chemical compounds give the turkey that beautiful golden skin. When applying a self tanner, the dihydroxyacetone (DHA) replaces the heat to catalyze the process. DHA reacts with the amino acids found in your dead skills cells to create a glowing (and sunless) tan.

This infographic from Compound Interest explains the chemistry of a fake tan:

Why does anyone bother making cranberry sauce from scratch?

It turns out that fresh cranberries are incredibly good for you. Keep these points in mind the next time you’re tempted to turn to a can.

But before we make the other Thanksgiving dishes jealous by praising cranberries too much,  let me ask just one question:

Have you ever eaten an unsweetened cranberry?

If not, suffice to say they rely on sugar as much as your neighborhood donut shop. But they have a wealth of other remarkable qualities that make their bitterness easy to forgive and explain why many people take the time to make cranberry sauce from scratch.

• They have antibacterial properties: A study from the Worcester Polytechnic Institute found that a compound in cranberries can render E.coli’s infectious powers useless. Tannins in cranberries were shown to interact with the bacteria cells molecularly and stop them from clinging to healthy cells. For example, cranberry juice compressed E.coli’s fimbriae (kind of like fingers) so they couldn’t get a grip on cells. Furthermore, E.coli grown in cranberry juice couldn’t form the biofilms (groups of concentrated bacteria) that lead to infection.
• They protect your brain: A Chinese study observed that the ursolic acid in cranberries could protect brain cells. First they injected mice with domoic acid, a toxin in shellfish that causes learning and memory problems. Then, the same mice were given ursolic acid and it helped reverse the cognitive damage.
• They might fight cancer: In addition to reversing cognitive damage, the ursolic acid in cranberries might also help fight cancer. One study found that ursolic acid has both preventative and therapeutic potential for cancer.

How did you eat so much?

You thought you were taking just a little bit of everything, but when you look at your plate, you realize the sum of its parts equals far more than a typical dinner. There’s no way you’ll eat it all.

Less than an hour later you’re staring at an empty plate. How did this happen?

It happened because of sensory specific satiety, the idea that your stomach (or really your brain) makes selective room for new flavors.

Humans evolved to eat a variety of foods, ensuring a full range of nutrients. You think you’re stuffed after eating a bowl full of spaghetti but when someone plops a piece of chocolate cake on your plate, you tuck in without hesitation. Your fullness caves to cravings for something new.

The Guardian quotes Laurent Brondel from the European Centre for Taste Sciences, asserting that even something as simple as a condiment can create the flavor variety that keeps you eating.

“I gave subjects some french fries and when they didn’t want them any more, I put some ketchup near the french fries and then the subjects started eating them again.”

The more variety, the more you can eat. And the typical abundance of choices on a Thanksgiving table exemplifies dining variety at its finest. That’s how you miraculously manage to clean your plate.

Did somebody say pie?

On that note, why do you always want more pie?

Pie. The grand finale of Thanksgiving dinner that you inevitably always have room for (thanks sensory specific satiety!). How many times have you heard or said, “I’ll just take a sliver…?” But that sliver tastes so good, why don’t you have just one more sliver? Half a pie later, you can’t believe you could have been so weak. Don’t worry, it’s not your fault.

No matter what type of pie you prefer, you can bet it has sugar in it. Maybe more than you thought. And this sugar content plays a huge role in why eating just a sliver of pie makes you crave even more.

Here’s the per-slice sugar content of America’s favorite pies, based on the highest rated Allrecipes.com iterations:

• Apple Pie: 40.3 grams of sugar (about 10 teaspoons)
• Strawberry Pie: 50.6 grams of sugar (about 12 1/2 teaspoons)
• Pumpkin Pie: 25.8 grams of sugar (about 6 teaspoons)
• Cherry Pie: 32 grams of sugar (about 8 teaspoons)
• Blueberry Pie: 14 grams of sugar (about 3 1/2 teaspoons)
• Pecan Pie: 37.8 grams of sugar (about 9 1/2 teaspoons)
• Lemon Meringue: 35.2 grams of sugar (about 9 teaspoons)
• Chocolate Pie: 25.5 grams of sugar (about 6 teaspoons)
• Chess Pie: 38 grams of sugar (about 9 teaspoons)

Current United States dietary guidelines don’t weigh in on recommended sugar intake. To give you some perspective, the World Health Organization recommends that adults consume no more than 25 grams of sugar a day. That’s about 6 teaspoons. Most of these pies cover that, and then some.

Even if you’re not particularly worried about your weight, this sugar surplus could have some interesting effects on your brain. Sugar activates your brain’s reward system in similar ways to alcohol, drugs, and hanging out with friends. The chemical dopamine underlies this elated feeling. If you’ve never eaten sugar before, an ice cream cone will cause a spike in dopamine and you will feel amazing. The more you eat ice cream, the more you need to get that amazing feeling back. It’s the same process that makes people addicted to alcohol and drugs, except far less extreme. Trying to eat just a sliver of pie? You better have some amazing willpower.

What happens in your body when you overeat?

According to Dr. Sasha Stiles, a physician at Tufts Medical Center, icy beverages cause your stomach to contract. The contractions massage the food in your stomach and push it along the gastrointestinal tract more quickly than usual. With an empty stomach, your body will think it’s hungry again. And that’s just the tip of the overeating iceberg.

Don’t get too scared. Thanksgiving only comes once a year. If you had Thanksgiving dinner every day though, it could wreak havoc on your body. NPR has the full story:

Overeating can easily spiral out of control until your body can’t adjust. For example, when you eat too much sugar, your pancreas produces extra insulin to get it out of the blood stream. When the brain senses a return to safe blood sugar levels, insulin production stops. Often too much sugar was taken away however, and cravings for even more sugar return with a vengeance.

Chronic overeating can even stop the receptors in your stomach from recognizing it’s full. Tissue at the top of the stomach sends a signal to the brain when the stomach fills up. Overeating frequently disrupts the messaging system and your brain doesn’t get the full stomach red flag.

 Why are you so sleepy after Thanksgiving dinner?

We thought we had this one figured out with tryptophan in turkey. It turns out that’s a myth. What makes you sleepy is actually the tryptophan in carbohydrates.

The tryptophan in turkey doesn’t actually get to your brain

It turns out, talking MORE about tryptophan in turkey might make you more sleepy than the actual tryptophan in turkey.

When you consume the amino acid tryptophan, your body metabolizes it to make niacin and serotonin. Serotonin produces a lovely relaxed feeling and helps create melatonin, a hormone that controls sleep cycles. Thus where the sleepy-turkey myth probably comes from.

Eating turkey is not equivalent to taking an IV of concentrated tryptophan. Turkey contains many other amino acids that compete with it to get into the bloodstream. So when you eat turkey, you don’t absorb enough tryptophan to even produce serotonin.

WebMD quotes Elizabeth Somer, MA, RD:

“Tryptophan, which is a bulky amino acid, would have to stand in line to get through the blood-brain barrier with a whole bunch of amino acids. It would be like standing in line when the Harry Potter movie comes out and you didn’t get in line early enough. The chances of getting in [to see the movie] are pretty slim. That’s what happens when you eat a protein-rich food. Tryptophan has to compete with all these other amino acids. It waits in line to get through the blood-brain barrier and very little of it makes it across.”

Furthermore, many other foods like chicken, pork, cheese, eggs, fish, and tofu pack the same tryptophan punch as turkey. Soybeans actually contain twice the tryptophan as turkey. So you can’t blame the turkey for your Thanksgiving sluggishness.

You do absorb tryptophan from carbohydrate-laden sides

Mashed potatoes, multiple stuffings, crescent rolls…

An assortment of delectable carbohydrates usually round out our Thanksgiving plates. It turns out they don’t just taste good, they make us feel good too.

Remember how we don’t really absorb the tryptophan in turkey? Well, you can absorb it from carbohydrates–absorb it and use it to make serotonin. A study by Richard Wurtman confirmed that consuming carbohydrates stimulates serotonin production. This happens thanks to the hormone insulin.

Carbohydrates convert to glucose in the intestines and then glucose enters the bloodstream, triggering the release of insulin. Insulin decreases the blood plasma levels of other amino acids–AKA tryptophan’s competitors. Without the competition of other aminos, tryptophan can cross the blood brain barrier and convert to serotonin. Serotonin has been linked to relaxed moods and sleep, among other things.

So it’s your stuffing, and not the turkey itself, that causes that elated, post-dinner sleepiness.

Bon Appetit!

That should be enough conversation starters to keep everyone from falling asleep in their mashed potatoes. Don’t forget to steer clear of icy beverages and double up on the cranberries. If you’re getting bored of turkey leftovers, just buy more condiments. But mostly, enjoy your Thanksgiving dinner!

Resources

Primary

NIH: Tryptophan

NIH: Ursolic Acid in Cancer Prevention and Treatment: Molecular Targets, Pharmacokinetics and Clinical Studies

Additional

About: Does Eating Turkey Make You Sleepy

WebMD: The Truth About Tryptophan

CompoundChem: How Do Tanning Lotions Work? The Chemistry of a Fake Tan

Guardian: The Science Behind Stuffing Your Face at Christmas

Psychology Today: Cranberries are a Smart Choice for Your Brain

Psychology Today: Serotonin: What It is and Why It’s Important for Weight Loss

LSUAG Center: Nutraceutical Compounds and Antioxidant Content of Sweet Potatoes

Rodale News: Your Recommended Sugar Intake: Less Than a Soda Per Day

Medical Daily: How Does Sugar Affect Your Brain? Turns Out in a Very Similar Way to Drugs and Alcohol

NPR: Gut Reaction: Overeating Can Impair Body Function

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post This is Why You’re Sleepy at Thanksgiving (Hint: It’s Not the Turkey) appeared first on Law Street.

Some problems have tormentingly evasive solutions. You think if you spend just five more minutes on it, everything will become clear. Five minutes turns into an hour. An hour after that, you’re brewing a fresh pot of coffee in a frenzy. You’re just drowsy. Once you’ve pumped yourself full of caffeine, you’ll wipe this sucker out in an hour tops.

The next morning you wake up feeling numb. You stayed up five hours past your bedtime and made little progress. What went wrong? We’re trained to think that if we keep our nose to the grind, stick with it, and push through our hard work will bloom into satisfying insight. But the truth is, focusing too hard for too long may be chasing away the insight you need to solve that niggling little problem.

What if I said you might be better off taking a warm shower instead of sucking down more caffeine? Or that too much focus might be making you less creative?

ADHD and the Creative Connection

If you don’t believe that NOT focusing might actually be a good thing, what studies have shown about creativity and people with ADHD might surprise you.

ADHD, or Attention Deficit Hyperactivity Disorder, affects how the brain receives and processes information and how a person behaves as a result. The underlying causes haven’t been confirmed, but differences in the brain’s left prefrontal cortex and motor cortex have been proposed as possibilities. Symptoms of ADHD vary from person to person but many of the most typical qualities are inattentiveness, fidgeting, and impulsiveness.

While it is considered a disorder, studies have pointed to certain benefits that are associated with ADHD, one of which is creative thinking.

White and Shah found that people with ADHD are good at coming up with more divergent and creative solutions to problems than people without ADHD. People with ADHD out-performed their “normal” counterparts in certain tests, especially the Alternative Uses Task. In this task, subjects are asked to brainstorm alternative uses for mundane household items like paperclips. People with ADHD were able to come up with more (and more original) uses for the items.The researchers concluded that unrestrained brain function was a key driver of creative thought in those with ADHD. Why not use a brick as a “toilet submarine”? In other words, people with ADHD practiced more relaxed thinking, and came up with unique ideas.

Intrigued by their findings, the same researchers revisited the subject a few years later. In addition to administering controlled tests, they investigated the real-world creativity of their subjects by measuring creative achievements. People with ADHD had achieved more and earned more creative awards than those without it. They also found people with ADHD gravitated toward creating novel solutions to problems rather than working toward developing extant ideas.

Other researchers have tackled this subject to come up with more compelling links between ADHD and creativity:

• Bonnie Cramond compared behavioral indicators of ADHD to behaviors indicative of creativity and found several links.

• Darya Zabelina found that creativity is associated with relaxed attention–one of the trademark symptoms of ADHD.

Why is there a connection between relaxed focus and creative thought? It’s about letting go. “Over-focusers” get bogged down in minutiae and end up fixating on the wrong things. Relaxed people are able to make the broad, big-picture connections that too many extraneous details tend to hamper.

What “Aha” Moments Tell Us

Joydeep Bhattacharya, a psychologist at Goldsmith’s in London, sought to answer why interrupting focus might actually be a good thing. He used an EEG (electroencephalogram) test to detect electrical activity in the brain as it solved verbal puzzles. In an EEG, metal disks called electrodes are attached to your scalp to detect the electrical impulses flashing through your brain. (You’ve probably seen this in at least one science fiction movie.) The EEG records the impulses in a series of lines that doctors and scientists are miraculously able to decode.

The test revealed that our brains know a lot more than we’re consciously aware of. A flurry of activity in the right frontal cortex indicated precognition of a solution eight seconds before subjects indicated they had solved the problem. This only happened when the subjects were about to solve the problem through insight. The other subjects were given hints and proceeded to solve the problems analytically. An eight-second lag in awareness of insight? Maybe that’s where that “tip of the tongue” feeling comes from.

Other studies aimed to dissect exactly how these subconscious insights occur. Dr. Kounios and Mark Jung-Beeman at Northwestern University also turned to the EEG and fMRI to eavesdrop on brain activity.

The wired-in subjects toiled away at word puzzles as their brain waves were measured. They found widely distinct brain patterns associated with problems solved analytically versus those solved by insight. Insight solutions were associated with activity in the temporal lobes of both hemispheres and the mid-frontal cortex. Analytic solutions were associated with more activity over the posterior (visual) cortex.

Increased neural activity in the posterior cortex of those who solved problems analytically lead the researchers to believe that these subjects prepared for problem solving by directing attention outward–toward the next problem. On the other hand, the brain activity of those who solved the problems through insight did so through internal retrieval of solutions. In problems solved by insight, outward sensory awareness was dulled. It appeared as though the brain was barricading itself from distractions that might disrupt the treasured insight.

In the video below, Dr. John Kounios refers to this concept as “insight” vs “outsight.”

How does creativity work?

To figure out WHY certain people might naturally solve problems by insight vs analytical methods, Kounios turned back to the trusty old EEG to study people’s brain waves as they sat comfortably without knowledge of an upcoming test. After recording their resting-state brain activity, the subjects were given a problem.

The researchers predicted that people who solved more problems by insight would display:

1. Greater activity in the right hemisphere of the brain.
2. Greater diffuse activation of the visual system.

They were correct and not altogether surprised. A body of research pointed them to these predictions in the first place. In 1962, Mednick proposed that creativity stemmed from remote associations between ideas. In 2003, Ansburg & Hill found that the most creative people deploy their focus in a diffuse way. In 2005, Jung-Beeman connected loose association processing to the right hemisphere. The left hemisphere was found to process tight association.

Loose association and diffuse thinking are time and time again linked with creativity.

A relaxed brain is a creative brain…but why?

In the studies above, insights often came along with a  stirring of alpha waves in the right hemisphere of the brain. Alpha waves are just a type of brainwave. At the root of all our thoughts, emotions, and behaviors is the communication between neurons in our brains. Brainwaves are produced when neurons communicate through synchronized electrical pulses. Alpha waves are often associated with relaxing activities like warm showers. They are also key to making insights. Research has shown that if there is a lack of alpha wave activities, subjects won’t get any closer to solving a given problem–even when they are provided with ample hints.

Alpha waves represent non-arousal. They’re slower and higher in amplitude than beta waves. Completing a test, meditation, and walks are often associated with increased alpha wave activity. A relaxed mind contains alpha waves directing thought inward toward loose associations associated with the right hemisphere.

In contrast,  an actively focused brain is directed outward toward extraneous details of the problem at hand. This is great for tedious problems that require an analytical touch, but it spoils the possibility for connections that lead to creativity and insight.

What is all this talk of the right hemisphere?

It’s a myth that people exhibit dominance on one side of their brains or the other. While different hemispheres are associated with different types of thought processing, it’s not true that creative people only use their right brains. Everyone uses both.

This video explains it…plus a few bonus brain myths.

The myth stems back to Roger W. Sperry who split the brain by cutting the corpus callosum in an effort to study the effects of epilepsy. In doing this, seizures were reduced, but other curious consequences arose that caused Sperry to think about the functions of the different brain hemispheres.

His “split brain experiments” revealed that the different brain hemispheres carried out different functions. Without the ability for the hemispheres to communicate with each other, he could tell what function each of them served in isolation. For example, the left brain specializes in detecting sounds that form words and understanding syntax, but it doesn’t control the whole language process. The right hemisphere is needed to determine the emotional undertones of the language and produce rhythms that promote melody and emphasis.

The hemispheres don’t operate independently. Recent research shows the best performance occurs when the two sides work together via uninhibited communication through the corpus callosum. That means everyone–from painters to accountants–has to use their whole brain.

Manipulating Focus

Drugs that increase focus could also decrease insight and the likelihood of epiphanies. Adderall and Ritalin are stimulants that shift attention away from right hemisphere are steer people away from broad insights and toward minute details.

Can you mentally control your focus levels? Beeman and Kounios did tests on a Zen Buddhist that suggest you can. At first the Buddhist was failing the tests miserably, diligently focusing on the possible solutions. When he realized that focus was against him, he was able to control his mind so acutely from his meditation training that he could deliberately not focus. He began solving problems with ease, his meditation creating just the alpha waves he needed for insight.

Don’t Worry, Be Happy

So what unbelievable truths about your brain have we uncovered?

• Not focusing has been tied with creative thought and insight.
• Your brain knows if an insight is coming and you can’t force it to make one.
• Brain activity in relaxed mental states has been shown to lead to insight.

Remember those points the next time you need an excuse to take a walk or warm shower before hitting the books.

Resources

Primary

Sage: The Aha! Moment: The Cognitive Neuroscience of Insight

Jonah Lehrer: Imagine: How Creativity Works

MIT: Posterior Beta and Anterior Gamma Oscillations Predict Cognitive Insight

Child Neuropsychology: Creative Thinking in Adolescents With Attention Deficit Hyperactivity Disorder

Additional 

Scientifica American: The Creative Gifts of ADHD

Science Direct: Uninhibited Imaginations: Creativity in Adults With Attention-Deficit/Hyperactivity Disorder

Healthline: The Benefits of ADHD

Psychology Today: Is the ADHD Brain More Creative?

Brain World Magazine: The Aha! Moment – The Creative Science Behind Inspiration

Scientific American: What is the Function of the Various Brainwaves?

Brain Waves Blog: Alpha Brain Waves: Definition, Functions, & Benefits

Science Direct: Creative Style and Achievement in Adults With Attention-Deficit/Hyperactivity Disorder

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Is Too Much Focus Making You Less Creative? appeared first on Law Street.

Mental illness and criminal law mix as well as oil and vinegar. Law desires reason and cause. The reason and cause of mental illness is often difficult to detect. While our scientific grasp on mental illness is growing, the evidence of how and why it might influence an individual’s behavior is often more nebulous than a legal professional might prefer, especially in the case of violent crime.

That’s what makes the insanity defense such a controversial topic.

Mental illnesses are real and often incapacitating, but how can you definitively prove they exist in courtroom arguments?

Below we’ll dig into why the brain is so mysterious, what this mystery means for the insanity defense, and what scientific steps we’re taking to de-mystify our own brains.

The Brain: Anatomy’s Rubik’s Cube

Our brain and its team of 100 billion neurons puppet our every move, thought, and action. It’s truly a wondrous biological mechanism, allowing us to solve a number of puzzles–except the puzzle that the brain itself presents. It’s one of anatomy’s cruelest jokes. Our body’s own mechanism for logic doesn’t quite understand itself. Yet.

After years of research and remarkable breakthroughs, many aspects of the brain and mind remain tauntingly elusive. This is not an insult to scientists, but more of a testament to the brain’s enormous complexity.

John Cleese’s parody video below captures the brain’s mystique.

Time out…the brain AND the mind?

Are the brain and the mind different? Don’t worry, I’m not opening a philosophical debate. But for the purpose of the following discussion, we need to view the brain and the mind as separate entities.

In discussing mental illness and criminal law, the difference between the brain and the mind comes down to the difference between psychology and physiology.

The physiology of the brain refers to those biological functions it performs. Neurons using electrical impulses to communicate with other cells is a biological function. Some illnesses, like psychosis, can be traced to physiological malfunctions that result from things like brain tumors.

Dr. Allan Reiss discusses the physiological aspects of mental illness in the video below, as well as his ambitions for pinpointing the specific diseases instead of symptoms.

Psychology, on the other hand, refers to the more nebulous mind. While scientists do believe the mind is influenced and even dependent on the physiological functions of the brain, it’s difficult to make a direct connection. Many individuals exhibit symptoms of behavioral disorders that can be linked only to the mind and have no known physiological causes. In these cases, psychological diagnoses usually rely on observations and questions about a person’s feelings, moods, actions, and behaviors.

This will be important later, when we’re talking about hard evidence in insanity pleas.

Communication Breakdown

The mind is associated with will power and “the self.” It’s hard to accept that complex mechanisms in our brains might drive the show instead of us.

The brain is unfathomably complex. It contains billions of neurons whose interactions determine your body’s functioning by communicating through a series of electrical signals. Everything we do relies on how neurons communicate with one another. Disruptions in this communication because of abnormal functioning of brain circuits may be an underlying cause of mental illness. If connections between certain messaging pathways in the brain are disrupted, the way it processes information might also be disrupted and abnormal perception, moods, or behaviors can result.

In summary, mental illness happens when the brain cannot effectively coordinate the billions of cells it controls.

Mental Illness and Crime

So mental illness results when the brain cannot effectively coordinate some of the billions of cells it controls. Unfortunately, figuring out exactly where the coordination faltered among the brain’s billions of cells and functions is like figuring out who lead the applause in a crowded stadium.

This lack of certainty creates a convoluted intersection for mental health and criminal law. The insanity defense exists to make sure no one is imprisoned who didn’t truly understand the consequences of their actions due to mental illness. If mental illness did impair their sense of consequence and right and wrong, they may be declared not guilty by reason of insanity (NGRI). People found NGRI do not walk free–many are committed to mental institutions for at least as long as their criminal sentence would be.

For an insanity plea to hold weight, the defense must prove that the criminal’s mental condition directly influenced their actions at the time of the crime and inhibited their ability to appreciate that their actions were wrong.

Disorders with the most potent insanity defenses are those with physiological evidence that the condition caused an altered perception of reality or impaired ability to control behavior. For example, an X-ray clearly depicting a brain tumor that might have caused hallucinations is stronger evidence than a patchy history of emotional disturbances. If there is trauma, injury, tumors, or physical elements like epilepsy, the case will hold more weight than just a mere history of psychological episodes.

According to Richard McNally, PhD, a clinical psychologist at Harvard University:

“Certain disorders such as schizophrenia, bipolar disorder and autism fit the biological model in a very clear-cut sense.”

If you have biological indicators from dissections and imaging scans, you have more evidence that connects a disorder with a behavior.

Which disorders have the necessary elements?

While we don’t know the absolute and irrefutable causes of many mental illnesses, we do have evidence that some are more rooted in biology than others.

Voluntary intoxication doesn’t cut it.  Neither do pedophilia or pyromania, which are considered strictly antisocial personality disorders and are linked to thoughts, emotions, and behaviors and not dysfunctions of the brain.

People with psychosis have a skewed sense of reality. They are plagued by delusions and hallucinations that can severely impact their behavior. People with severe depression, bipolar disorder, and schizophrenia often suffer from psychosis. It has many possible causes rooted in biology including tumors, cysts, dementia, and stroke.

Those suffering from severe depression experience constant feelings of sadness or apathy. It affects how they feel, think, and react to many aspects of life. In some cases, like postpartum depression, victims can suffer from delusions and hallucinations. Chemical imbalances, changes in genes, and traumatic events are all possible causes.

Mania or bipolar disorder is associated with abnormally elevated moods that can lead to unpredictable behavior and impaired judgement. The severity of the disorder is determined by how fervent and incapacitating the abnormal moods are. Scientists haven’t discovered a single cause for bipolar disorder, but they’ve found compelling evidence that genetics and brain structure might play a role.

People with anxiety disorders suffer from anxiety that exceeds normal functional levels. They are unable to control it and it subsequently controls them. Post traumatic stress disorder is a type of anxiety disorder. While it’s triggered by an environmental trauma, some say genetics might play a major role in susceptibility.

Andrea Yates was suffering from postpartum psychosis when she murdered her children by drowning them. She was convicted at first, but her long, undeniable history of mental illness, attempted suicides, and extensive medical records led to a reversed decision that she was not guilty by reason of insanity.

Advances in Detection

There isn’t a test for detecting mental illness as finite as a blood test or an X-ray, but scientists are working on it. The idea is to prove that the mind and brain are one and the same and that all mental processes are brain processes. The brain is a biological organ so mental illness must have a testable, biological component and explanation. This would provide that solid link and evidence that forensic psychologists everywhere would cheer for.

Thomas R. Insel, MD, director of the National Institute of Mental Health, doesn’t think mental illnesses should be treated any differently from other chronic illnesses. He says,

“The only difference here is that the organ of interest is the brain instead of the heart or pancreas. But the same basic principles apply.”

Insel argues that EKGs and CT images allow us to explore the heart in ways unthinkable 100 years ago, and that similar breakthroughs could be coming down the pike for the brain. Advancements are already being made in neuroimaging that enable studies of brain structure and function. Positron emission tomography (PET), single-photon emission computer tomography (SPECT), and functional magnetic resonance imaging (fMRI) get us as close as we can possibly get to peering into the brain. Using this imaging, scientists have been able to make possible connections between brain pathways and mental disorders. They’ve also uncovered the functioning of previously mysterious brain regions.

The video below shows how scientists are also making waves in understanding how brain circuits might lead to mental illness.

Solving the Rubik’s Cube

Every advancement in detecting biological clues for mental illness would provide more evidence and substantial links for criminal cases involving people who are mentally ill.

With every advancement we make in solving the brain’s mysteries, another piece of the billion-square Rubik’s cube clicks into place. Earlier, I called the brain one of anatomy’s cruelest jokes because it doesn’t quite understand itself. But just like a real Rubik’s cube, even seemingly unsolvable puzzles can be cracked. Just because we don’t understand all of the intricate workings of our brains now, doesn’t mean we won’t ever. If any entity in the world is able to figure out the human brain, it’s the wondrous human brain itself.

Resources

Primary

APA: The Roots of Mental Illness

NIH: Brain Basics

APA: Assessing the Evidence of a Link Between Mental Illness and Violent

 Additional

Psychology Today: The Insanity Defense

WebMD: The Brain and Mental Illness

ABA: Criminal Justice Section Standards: Mental Health

Find Law: Current Application of the Insanity Defense

BrainFacts: Understanding Mental Disorders as Circuit Disorders

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post What Brain Science Tells Us About the Insanity Defense appeared first on Law Street.

Is whether or not you survive Ebola all about your genetics? A new study on mice indicates that it might be. Scientists found that certain genetic factors determine if the disease manifests as mild or devastating.

To reach this conclusion, scientists injected mice with the same strain of Ebola that caused the 2014 West Africa Outbreak. The expressed severity of the disease among the mice was scattered although they were all injected with the same unaltered and unmutated strain. Why did some resist the disease while others surrendered?

One correlation posits a provocative answer. Scientists noticed a strong correlation between symptom expression and the genetic lines of the mice. Dr. Michael Katze, a researcher on the project, declared that their data suggest disease outcomes are largely dependent on genetic factors.

It seems that the genes of the mice determined their immune response. In some mice, the genes that promote blood vessel inflammation and cell death became agitated and ultimately these mice succumbed to the disease. In other mice, the white blood cells were more lively and the genes that promote blood vessel repair were activated. These mice were able to fight back. As they observed the mice over multiple generations, they found that the ability to survive was tied to genetic lines. The continuous correlation of immunity in genetic lines presents a puzzle. Did the mice pass specific immunity on to their offspring?

Immune responses to specific pathogens, like Ebola, only develop after exposure. Specific immunity is an acquired trait, and so far, science has told us that acquired traits cannot be passed on through DNA. Traits we acquire in our lifetimes are not written into DNA and therefore not built into genes. Acquired traits result from environmental influences, like memories or even tans. If you’re a bronze goddess while pregnant, you won’t have a baby with a gorgeous tan.

So it is intriguing to think that mice who were exposed to Ebola had somehow passed on their specific, acquired, immunity to offspring through their genes. Below we’ll explore the possibility of inheriting acquired immunity.

Your Two-Sided Immune System

We’re all born with an innate immune system. It’s responsible for the classic immune response that recognizes and eliminates foreign invaders with the help of killer cells and cytokines. Skin, mucus, cells, and molecules all present at birth innately protect your body from foreign pathogens. Think of any computer you buy. It comes with a built in operating system. But that doesn’t mean you can’t upgrade, right?

Environmental factors prompt us to make little upgrades to our basic innate immune system like we do to our computer’s operating system. This is called adaptive or acquired immunity. Adaptive immunity activates in response to a specific problem that the innate immune system isn’t able to overcome. As it works, it also forms memories, so it can remember how to fight a specific pathogen if it ever returns for vengeance. A classic example is the Chickenpox. It doesn’t take much for most people to catch it the first time, but after that, many are resistant for life.

Acquired immunity, like other acquired traits, is not inherited. Even though you might have had the chickenpox, your kid will probably still get it, just like they can’t inherit your amazing tan or stellar vocabulary. With that said, we return again to the mice in the study above. Is it possible that they passed on their acquired immunity to their offspring?

“Lamarck-y” malarkey! Or maybe not….

If you’re intrigued by the study above, one historical figure would be absolutely riveted. Jean Baptiste Lamarck had this idea a long time ago — in 1801 to be specific. He theorized that evolution takes place when species develop traits to adapt to their environment and then transmit those adaptations to their offspring. Per his theory, giraffes developed long necks to feed from the tallest trees and then passed the “long neck” trait to their offspring.

Somebody else thought that evolution occurred in a different way. Charles Darwin proposed that evolution occurs through random mutations that bestow a competitive advantage for survival over a long time. Per his theory, the giraffes didn’t develop long necks to feed. It was just that the giraffes that happened to have slightly longer necks were able to survive to make more offspring. Eventually, the long neck became a dominant feature of all giraffes.

Darwin’s theory eclipsed Lamarck’s as the favorite theory of evolution. But were there some nuggets of truth in Lamarck’s musings? A growing body of evidence is creating a whisper of renewed interest in Lamarckian evolution. Collectively, it’s a young field called epigenetics.

For example, observations of starving Dutch mothers during the famine of World War II revealed that they had offspring and grandchildren more susceptible to obesity. Experiments on rats have found that obesity in mice might be caused by the high fat diets of their fathers. And there’s more where that came from.

The proof is in…the roundworm?

Dr. Oliver Hobert was curious to find out if Lamarck might have been right about the heritability of acquired traits. He suspected that ribonucleic acid, or RNA, and its role in genetic expression might shed some light on the subject.

Hobert was specifically interested in RNA interference (RNAi). Cells use RNAi to turn down or suppress certain genes. Watch the video below to see how it works.

Hobert and his team of Columbia University Medical Center (CUMC) researchers turned to roundworms to study RNAi’s influence on immunity. Roundworms have a unique capacity to battle viruses using RNAi that made them ideal for the study. The team found that a RNA molecule memory of instructions on fighting off certain viruses could be passed on from one generation of roundworms to the next.

Here is a quote from Dr. Oded Rechavi, lead author of the study, courtesy of the CUMC newsroom:

In our study, roundworms that developed resistance to a virus were able to pass along that immunity to their progeny for many consecutive generations.The immunity was transferred in the form of small viral-silencing agents called viRNAs, working independently of the organism’s genome.

More Pieces in the Puzzle

Studies like this one give scientists pause on long standing notions about the heritability of acquired traits and what we know about our genes. While many more studies are needed to completely vindicate Lamarck and his ideas, some puzzling clues are coming together. Here are some highlights from other studies that tackle similar ideas:

SardiNIA Study of Aging: Researchers at the National Research Council’s Institute of Genetic and Biomedical Research in Italy found that genetics play a key role in our ability to fight off disease. According to the study, the immune system has evolved to reject certain pathogens and cancers. The basis of the study is that several adaptive immune cells are regulated by genetics. They found 89 gene variants with significant ties to the production of specific immune system cells.

Chief of NIA’s Laboratory of Genetics, David Schlessinger, Ph.D., sums it up nicely:

If your mother is rarely sick, for example, does that mean you don’t have to worry about the bug that’s going around? Is immunity in the genes? According to our findings, the answer is yes, at least in part.

Natural Environment Research Council UK: This study demonstrates that genetic variations in cytokines are a crucial component of individual variation in pathogen resistance and immune function. During both adaptive and innate immune responses, cytokines carry messages. They directly determine how an immune system will respond to a given challenger. So variations in the genes that control these cytokines, therefore, ultimately affect the immune system.

Analysis of Genetic Variation in Animals: A study of hemophiliac individuals infected with HCV showed that genetic factors determine the outcome of the disease. The researches studied siblings and found correlative rates of disease recovery among siblings was much higher than the pairs of randomly paired individuals, concluding that people who share genes might also share higher resistance to certain diseases.

Innate Immune Activity: Another study looked at the genome sequence that regulates expression of genes involved in the immune system. The study found that sometimes genes of interest reveal themselves when certain cells involved in fighting an infection are stimulated.

Back to the E-word…

Ebola usually depletes a person’s immune cells. Some immune systems stand up against the initial attack and their bodies are able to maintain some immune cells. These people are more likely to survive. We learned from the study on mice that it could be genetic factors that determine the disease outcome. What about people?

One study found that people with certain variations of the human leukocyte antigen-B  gene survived Ebola while those with another variation did not. Another finding deals with a mutation in the NPC1 gene. Cells taken from people with this gene are resistant to Ebola. The mutation is relatively common in certain populations in Europe and Nova Scotia.

More research is needed, but studying these genetic variances might reveal more secrets of why some survive Ebola and others do not.

Immuno Synergy

These findings do more than just play with our ideas of how traits can be inherited. If doctors were able to browse through your genetic catalog of specific pathogen resistance, they could administer therapies that create synergies among treatments. We might be able to predict what ailments you’re more susceptible to and take appropriate preventive actions. We might be able to study the genetic factors that make some people resistant to illnesses like Ebola, and synthesize them to construct even more effective treatments.

Is this science fiction? We don’t know yet, but no theories should be completely forgotten. As we’ve learned from Lamarck, even formerly discarded ideas can make a splash centuries after their inception.

 Resources

Primary

PLOS Genetics: Genetic Diversity in Cytokines Associated with Immune Variation and Resistance to Multiple Pathogens in a Natural Rodent Population

The Royal Society: Variation in Immune Defence as a Question of Evolutionary Ecology

NIH: Genetic Variability of Hosts

University of Western Australia: Genetic Variation of Host Immune  Response Genes and Their Effect on  Hepatitis C Infection and Treatment Outcome

Additional

Science Daily: Genetic Factors Behind Surviving or Dying From Ebola Shown in Mouse Study

Broad Institute: Scientists Make Connection Between Genetic Variation and Immune System in Risk for Neurodegenerative and Other Diseases

Wellcome Trust Centre for Human Genetics: Study Tracks Effects of Immune Activity Across the Genome

MNT: Immune Response Determined by Our Genes, Study Shows

History of Vaccines: Viruses and Evolution

LiveScience: How Do People Survive Ebola?

Research Gate: What is the Scientific Position on the Inheritance of Acquired Characteristics (Lamarckism)?

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Is the Key to Surviving Ebola in Your Genes? appeared first on Law Street.

Petri dishes do far more than indicate if you have strep throat. They were a key prop in the theater of antibiotic discovery. A mere glance in a petri dish ushered in the antibiotic revolution.

On a bright and sunny (just a guess) day in 1928, Alexander Fleming puzzled over what he saw in a petri dish of Staphylococcus bacteria. One small, moldy area of the dish had somehow dodged the enterprising colonization of the bacteria. Fleming speculated this was not a coincidence. He wondered if the mold, Penicillium Notatum, was somehow inhibiting bacterial growth. He experimented some more and eventually published his findings in the British Journal of Experimental Pathology. Fleming’s brick wall had been isolating the penicillin from the mold to use as a drug. Luckily his research eventually ended up in the hands of two scientists at Oxford who were ready to take up the challenge.

Penicillin — the first antibiotic — was used to treat a human patient in 1941. We’ve probably all taken them, but what are they really? Antibiotics are microorganisms (and now synthesized drugs) that attack the bacteria that cause infection in your body. Just as bacteria couldn’t grow on the moldy part of Fleming’s petri dish, bacteria cannot grow in a body on antibiotics.

World War II soldiers were among the first to benefit from penicillin before it was released to the general public in the late 1940s. Newspapers hailed it as a miracle drug.

The potential downside of this miracle drug had not evaded the experts, however. Alexander Fleming himself warned of microbes developing penicillin resistance in his acceptance speech for the Nobel Prize in Physiology or Medicine in 1945.

Miracles Happen

Antibiotics thwarted some of the leading causes of death in human existence. Childbirth, ear infections, and even simple skin scrapes were often deadly before these saviors entered the fray. Many children didn’t see their first birthdays, succumbing to infections we don’t think twice about today. Having surgery in the early 1900s? Just kiss your family goodbye before you go under the knife.

Antibiotics are microorganisms ideally adapted to kill other microorganisms while causing little or no harm to the host. The word “antibiotic” actually means “against life.”

Scientists design synthetic versions of these antibiotic microorganisms so we may have a profusion of drug options. About 150 million prescriptions are written for antibiotics every year.

And that’s a problem because…?

Antibiotics may be miraculous, but bacteria are not taking the challenge lying down. They’re fighting back by developing mechanisms to resist antibiotics. Don’t take it personally, it’s what any organism would do for the sake of survival. It turns out that bacteria are marvelous adaptors. Two million people in the United States suffer from antibiotic-resistant infections every year and many die as a consequence. Additionally, the CDC estimates a cool $20 billion in resulting economic burdens.

In short, our arsenal of antibiotics is losing efficacy. If this continues unchecked, we risk being thrust back into the dark ages of medicine when common ailments put many a healthy body six feet under. Antibiotic resistance is also detrimental to treatments for more serious illnesses. Therapies for cancer and organ transplants are often complicated with infection. Doctors rely heavily on antibiotics to keep their patients’ strained bodies free of infection. If antibiotics become ineffective, these life-saving treatments might be relegated to the past. It would mark one monumental step back in health care.

If you’re not scared yet…

Everyone loves a good villain to embody their fears. Emerging “superbugs” epitomize scary. When antibiotics were new, development was explosive. New drugs essentially kept microbes on their toes and resistance was less prolific. Invention of new drugs has now stagnated enough that bacterial evolution threatens to overtake our developmental countermeasures.

Welcome to the world of superbugs, aka resistant germs. These include nightmares like:

Carbapenem‐resistant Enterobacteri‐aceae (CRE): Literally nicknamed “nightmare bacteria.” It’s resistant to nearly all antibiotics and kills about half of the people infected by it.

Staphylococcus aureus (MRSA): MRSA usually manifests as a skin infection. Because of its resistant capabilities, it can wreak havoc by spreading through medical facilities.

These monsters aren’t made up, they’re frighteningly real and we may soon lose our ability to fight them.

Let’s Get “Sciencey”

Microbes are tricky little beasts. They will always evolve to develop resistance to what threatens them. The more bacteria are exposed to antibiotics (which we just learned is quite frequently), the more chances they have to develop resistance. When bacteria are exposed to antibiotics, susceptible strains die, leaving zero competition for the resistant ones so they are free to survive and flourish. Scientists call this selective pressure.

Resistant bacteria get that way by acquiring resistance genes through genetic mutation or getting the resistance from another bacterium. They can even get multiple resistant traits and end up developing resistance to multiple families of antibiotics.

Watch the video below for a perfect explanation of how this happens.

Why is this happening?

1. They’re over-prescribed: Antibiotics are some of the most commonly prescribed drugs used in medicine. For example, the first Ebola patient in the United States was sent home on antibiotics before doctors knew what he had. Antibiotics won’t do anything for Ebola or even the sinus infection they believed he had. Most sinus infections are viral so antibiotics don’t do anything — unless it was 1 out of the 100 cases where the sinus infection is caused by bacteria.
2. They’re mis-prescribed: Physicians often have to use incomplete or imperfect information. They prescribe antibiotics as a an all-purpose band-aid.
3. They’re used heavily: The chance of bacteria developing resistance increases with antibiotic use. Unfortunately, doctors must rely heavily on antibiotics to reduce risk of infection in critically ill patients. Furthermore, close proximity among sick patients in hospitals creates an ideal environment for resistant germs to spread.
4. They’re used in agriculture: Agriculture use accounts for half of the antibiotics produced in the United States. Scientists agree that adding antibiotics to feed is a key problem in developing antibiotic resistance. Agriculturally, antibiotics are used to promote animal growth and proactively prevent infections in addition to just treating sick animals.

Who is going to save us?

The CDC released a report on the threat of antibiotic resistance in 2013. It was the first exhaustive compilation of the health threats antibiotic resistance presents. If you’re not up to reading the whole 100 pages, here is a snapshot of the strategies they recommend to save us all from antibiotic resistance:

1. Prevent infections from happening in the first place: No infection, no antibiotics, and consequently less risk that resistance develops.

2. Track antibiotic resistance: Tracking will shed light on the specific mechanisms of resistance development. With this knowledge, intervention strategies will be more informed and more effective.

3. Change the way antibiotics are used: Antibiotics are generally overused. Up to 50 percent of antibiotic prescriptions are unnecessary. Physicians can take up the mantle of antibiotic stewardship by using antibiotics only when necessary.

4. Develop drugs and diagnostic tests: Bacteria develop antibiotic resistance as they evolve — it’s a natural process resulting from biological pressure. Introduction of new drugs will slow down this natural evolution. Diagnostic tests will allow us to understand and track the evolution in a more timely way.

Hey…did we budget for all of this?

Federal spending to combat antimicrobial* resistance has been limited. In 2014, the budget was $450 million. That figure sounds grand, but it amounts to just about $1.04 per American. On the other hand, antibiotic resistance costs the United States an estimated $55-70 billion each year.

A little bit lopsided, don’t you think?

*Antimicrobial resistance includes antibiotic resistance but also refers to resistance of other microbes like parasites and viruses. Antibiotic resistance refers specifically to bacteria that cause infection. Most strategies cover the more comprehensive antimicrobial resistance.

Making plans…

The Obama Administration announced a game plan in September for facing antimicrobial resistance. Here’s the to-do list:

• Leverage findings from the President’s Council of Advisors on Science and Technology (PCAST) report on combating antimicrobial resistance. The report suggests doubling the current federal investments from $450 million to $900 million a year. It also outlines recommendations for strong federal leadership, effective surveillance, research, clinical trials, increasing economic incentives for development, increasing stewardship for current antibiotic use, limiting agricultural use of antibiotics, and increasing international coordination.

• Implement the National Strategy for Combating Antibiotic Resistant Bacteria. The PCAST report was used to create a National Strategy for Combating Antibiotic Resistant Bacteria. The strategy focuses on five major goals:

Slow the development of resistant bacteria and prevent the spread of resistant infections; strengthen national one-health surveillance efforts to combat resistance; advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria; accelerate basic and applied research and development for new antibiotics, other therapeutics, and vaccines; and improve international collaboration and capacities for antibiotic resistance prevention, surveillance, control, and antibiotic research and development.

• Form a task force that combats antibiotic resistant bacteria. Established by Executive Order, the task force is responsible for implementing the National Strategy for Combating Antibiotic Resistant Bacteria. It is working on a detailed report of specific action plans due in February 2015.

• Finance diagnostic innovation. A $20 million prize, co-sponsored by the National Institutes of Health and the Biomedical Advanced Research and Development Authority, will be granted for a point-of-care diagnostic test that identifies antibacterial-resistant infections.

A little legal setback…

The July ruling in the NRDC v. US FDA case was marked as a major setback in the fight against antimicrobial resistance. The plaintiffs (including the Natural Resources Defense Council and Center for Science in the Public Interest) were dismayed that the court ruled against compelling the FDA to ban the use of antibiotics in healthy animals used for food.

The case overturned two other district court rulings that would have required the FDA to rescind approved use of antibiotics for purposes other than to treat sick animals. Companies could have gotten around the ruling if they proved the drug in question posed little risk for contributing to the development of antimicrobial resistance in humans.

Some other hangups

There are a few other pesky issues that might hinder some of the strategies for reducing antimicrobial resistance:

• Individual privacy could potentially get in the way of optimal surveillance of antibiotic resistance. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) guarantees privacy of health information that is individually identifiable. Patient preferences could determine what information can be used to track antimicrobial resistance.

• Companies lack incentives to create new antibiotics because the traditional sales volume and price linkage is missing. Because fighting antibiotic resistance forbids overusing one particular drug, companies would probably not get a good return on investment.

• Ponderous approval processes for new drugs might also hinder the speed of new antibiotic drug development. A balance will need to be struck in ensuring speed of innovation without compromising safety.
  

  ---

So the government has antimicrobial resistance under control?

It has a robust plan for taking action against antibiotic resistance, but being an informed patient never hurt anybody. The CDC recommends a few steps you can take, including abstaining from antibiotic use for viral infections, not saving leftover antibiotics, and not taking antibiotics prescribed for someone else.

The fight against antimicrobial resistance is really no fight at all, but a call for permanent change in our medical and agricultural systems. As long bacteria exist and want to survive, our desire to survive must be stronger.

Resources

Primary

CDC: Antibiotic Resistance Threats in the United States, 2013

President’s Council of Advisors on Science and Technology: Report to the President on Combating Antibiotic Resistance

Additional

Cochrane Summaries: Antibiotics for Acute Maxillary Sinusitis

Food Safety News: White House Calls for Action Plan to Address Antibiotic Resistance

The White House: New Executive Actions to Combat Antibiotic Resistance and Protect Public Health

CDC: Untreatable: Today’s Drug Resistant Health Threats

Explorable.com: History of Antibiotics

American Chemical Society: Discovery and Development of Penicillin

National Institute of Allergy and Infectious Diseases: Antimicrobial Drug Resistance

World Health Organzation: Antimicrobial Resistance

Huffington Post: Feds Failing to Act on Antibiotic Resistance Despite Grave Threat

Natural Resources Defense Council: Food, Farm Animals and Drugs

CDC: Legal Issues Associated with Antimicrobial Drug Resistance

CDC: White House Announces National Strategy for Combating Antibiotic Resistance

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Are We Doing Enough to Prevent Antibiotic Resistance? appeared first on Law Street.

This question might conjure chilling images of flavorless fixed rations, compulsory exercise regimes, and the foreboding scales of a totalitarian weight monitoring mechanism.

Take a deep breath. Mandatory weigh-ins have no place in your near future. However, the government already influences your weight in indirect ways using methods more subtle than scales. It’s not because they’re nosy or superficial, it’s because weight, specifically being overweight, is a burgeoning public health plight in the United States.

What’s the big problem with obesity?

In the not-too-distant past, being overweight was a harmless stigma — a matter of aesthetics and not health. Today we know that obesity comes along with a load of serious health complications like heart disease, high blood pressure, Type 2 Diabetes, and some types of cancer. The Centers for Disease Control and Prevention (CDC) estimate that 112,000 deaths a year are associated with obesity. Related medical expenses burden the United States with more than $100 billion annually. Ouch.

What’s even scarier? Obesity prevalence is overwhelming the United States population. According to the CDC, more than one third of American adults are obese. That’s more than double the rate of the last decade.

Before you brush it off as an unfortunate fact of life, here’s some visual perspective from the CDC on this explosive growth:

Obesity prevalence in 1990. The darkest blue represents a rate of 10%-14% population obesity.

Obesity prevalence in 2009. Note all of the completely new colors. Obesity rates of all states have surpassed those seen in 1990.

Previous efforts to confront obesity have focused on individual interventions like nutrition education. The climbing rate of obesity despite these efforts revealed some missing pieces in the strategy. Experts realized obesity wasn’t just a matter of willpower. Recognizing the multi-faceted approach needed to combat obesity, officials fixed their attention on underlying causes that escape an individual’s control.

How is obesity out of individual control?

Obesity isn’t just about individual choices, it’s about individual options. The fight against obesity is futile for those without the right options. For example, poor access to supermarkets because of zoning complications may make smart food choices a hopeless pursuit. A simple jog isn’t an option for those with nowhere to do it safely.

Furthermore, we have a hard time helping ourselves. One study found that concern over weight isn’t a sufficient catalyst for behavioral change. Concerned people who lack access to healthy foods are stripped of the power for change. The pervasiveness of fast food establishments peddling calorie-dense foods present an invincible double threat.

Government regulations can interfere when individual resolve falls short. Large-scale policies to create healthier communities could help those who can’t help themselves.

What can the government do?

The Standard Toolkit

The Commerce Clause of the Constitution bestows the federal government with the right to regulate state commerce. This translates practically to weight-related regulations like food labeling mandates and subsidies on foods. On a more local level, the Constitution grants states the power to regulate the health, safety, and welfare of their populations. This broad power translates to a variety of possible actions.

Here are some examples of perfectly legal government actions that affect what we eat and consequently what we weigh:

Taxes and Subsidies

Some cities and states already have taxes on sugary drinks. Opinions are split on extending taxes on junk food. James Carville thinks it might be a good idea to tax “Twinkies more than apples.”

The government subsidizes certain crops, often increasing their prevalence in our diets. Corn is a popular example of the power of subsidies. In Michael Pollan’s The Omnivore’s Dilemma, one researcher likens Americans to corn chips with legs.

Bans: New York City made history when it took measures to strike trans-fats from restaurant menus.  After the rule survived backlash, other states and cities followed suit. In the next few years, the FDA will undertake a national trans-fat phase out.

Labeling: New York City again led the way by requiring restaurants to disclose nutrition information on their menus. The federally-mandated nutrition label is probably the best known example of enforced food labeling.

Zoning and Land Planning: In some areas, large supermarkets and farmers markets are zoned out, making healthy food hard to come by. Developing parks and sidewalks is a proven way to get people moving without the conscious choice to exercise more.

Transportation: Some studies have shown that people who use public transportation weigh less than those who commute in cars. Unfortunately, more money is invested in highways than in public transportation.

Health Care and Benefits: Tennessee and West Virginia have reimbursement programs for Weight Watchers and 42 states provide gastric bypass surgery for the morbidly obese.

Alternative Approaches

Not all approaches that aim to reduce obesity target diet and exercise. Some of them appear unrelated to obesity at first glance. For example, a breastfeeding facility law requires employers to provide proper accommodations to encourage breastfeeding. While the law helps new mothers in many ways, it’s also a CDC priority strategy to prevent obesity as breastfeeding has been tied to reduced early childhood obesity.

Numerous policies and campaigns aspire to shrink obesity rates. They focus on a broad range of factors from diet specifically to overall health and wellness. CDC’s Division of Nutrition, Physical Activity, and Obesity database lists state-by-state activities if you want to get an idea of what’s in place.

What are lawmakers suggesting?

What does the future hold for the fight against obesity? Check out these examples of what policymakers have been cooking up:

Healthy Lifestyles and Prevention America (HELP) Act: Proposes a multi-pronged intervention strategy to enhance overall wellness of the American people. Children would enjoy enhanced nutrition and physical activity programs in schools and in childcare settings. Adults would benefit from workplace wellness programs. Everyone would benefit from proposed attacks on both salt and tobacco.

FIT Kids Act: Would fund grants for physical education programs that are based on scientific research. States would be required to analyze and identify specific student needs and develop their programs accordingly. The act would also require states to develop indicators of progress.

Reduce Obesity Act of 2013:  Suggests an amendment to title XVIII of the Social Security Act that would require the Medicare and You handbook to include information on behavioral therapy for obesity. It would allow physicians and other experts on Diabetes prevention to provide behavioral therapy outside of the primary care setting.

Stop Childhood Obesity Act of 2014: Seeks to deny financial benefits for companies to advertise and market certain food products to children. Tax deductions granted under the Internal Revenue Code would be barred for advertising to children that promotes consuming foods of poor nutritional quality. The Secretary of the Treasury and the Institute of Medicine would determine what constitutes foods of poor nutritional quality.

Beyond regulations and policies…

Some suggest that legal approaches may fill in the gaps left after regulations. The paper Innovative Legal Approaches to Address Obesity presents techniques that leverage law to  tackle obesity:

Regulating conduct: The Massachusetts decision to ban self-service displays of tobacco was upheld in the case of Lorillard Tobacco v. Reilly. Perhaps courts would uphold similar decisions to remove processed foods from checkout aisles.

Ingredient caps: The government can limit the alcohol content of beer. They might do something similar with sugar if it’s proven to be harmful and addictive.

Limits on food marketing: Advertising messages are protected under First Amendment rights. As early as 1978, the FTC attempted a rule to limit advertising of sugary products to children. The rule was struck down after massive industry opposition. Many hope to revisit similar rules as obesity-related health consequences surface.

Compelling industry speech: A near opposite to limiting advertising would be to compel industry speech and require companies to disclose information that might affect consumption. The United Kingdom’s traffic light system provides an extreme example.

Increasing government speech: Government speech could be leveraged to counteract the prevalence of advertising messages by encouraging the consumption of healthy foods. The “5 a Day” fruit and vegetable campaign in the United States is one such example.

Purchase limits: The Supreme Court has allowed individual purchase limits on items like prescription drugs. Perhaps a limit on the amount of sugary beverages a minor can purchase could also be enacted.

Penalties for causing addiction: The government has a right to restrict sales of certain products to minors that it finds harmful or addictive — like alcohol and cigarettes. Some studies have suggested certain food additives are addictive. Companies could be vulnerable to litigation if they have been knowingly manipulating ingredients to encourage overconsumption.

Nuisance law: Pollution is considered a public nuisance. Likewise, the creation of obesogenic foods proven to be harmful to health could be deemed a public nuisance, punishable by fines or criminal sentences.

Performance-based regulation: Performance-based regulations would put responsibility in the hands of industry. A company might be given a measurable goal related to reducing obesity rates. Businesses that fail to meet assigned outcome goals would be financially penalized.

Where do we go from here?

Let’s be honest, the obesity issue has been confounding us for years. Explosions of diet fads that vilify certain ingredients don’t help matters. Fat? Sugar? Gluten? Carbs? Most people just don’t know what to eat even though they’re being showered with ample advice.

Obesity lacks a simple cause, making it a convoluted case to crack. An array of dimensions in behavior, lifestyle, and environment contribute to it. Policy makers have their work cut out for them in innovating a range of initiatives that might control it. Consumers have their work cut out for them in sorting through all of the advice thrust at them to make sound decisions. Neither can stand alone. Consumers need all the help they can get from carefully designed government regulations that don’t infringe on privacy.

Should the government do more to help the population control their weight? Should they do less? Comment to tell us what you think.

Resources

Primary

CDC: State Legislative and Regulatory Action to Prevent Obesity and Improve Nutrition and Physical Activity

Yale University: Innovative Legal Approaches to Address Obesity

Additional

Millbank Quarterly: Public Health Law and the Prevention and Control of Obesity

Yale University: Improving Laws and Legal Authorities for Obesity Prevention and Control

CDC: Adult Obesity Facts

CDC: Overweight and Obesity Policy Resources

George Washington University: Review of Obesity Related Legislation & Federal Programs

Washington Post: U.S. Sugar Subsidies Need to be Rolled Back

The New York Times: Proposed Tax on Sugary Beverages Debated

Coalition for Sugar Reform: Reform Legislation

Intelligence Squared: Obesity is the Government’s Business

NIH: Evidence for Sugar Addiction: Behavioral and Neurochemical Effects of Intermittent, Excessive Sugar Intake

SAGE: The Role of Self-Efficacy in Achieving Health Behavior Change

Georgetown University Law Center: Assessing Laws and Legal Authorities for Obesity Prevention and Control

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post How the Government Regulates Obesity appeared first on Law Street.

Our adventures in genetics began with a monk named Gregor Mendel.  Mendel systematically bred pea plants to demonstrate the concepts behind genetic transmission before “gene” was even a word. He brandished a paint brush to cross breed plants that exhibited inheritance of exciting traits like wrinkly peas and inflated pods. Mendel was confined to pea plants in his search for potential traits. Today, we aren’t bound to the same species in our search for traits. We can bend the rules of nature as we know them using recombinant DNA technology. Welcome to the world of genetically modified organisms.

OMG…what are GMOs, anyway?

GMO is more than just a backwards OMG. GMO stands for genetically modified organism. Other terms used to describe them include bioengineered, transgenic, genetically engineered (GE), or just genetically modified (GM). All of these terms describe an organism created through genetic engineering. Genetic engineering allows us to transfer genes that yield desirable traits from one organism to another. Technology has granted us power to cross species barriers, so unlike Mendel, we don’t have to choose traits from just one species.

How are traits transferred?

Genetic engineering uses recombinant DNA technology to splice a piece of DNA from one species and insert it into the DNA of another species. Scientists identify the piece of DNA responsible for the desired trait, clone it, modify it to make it more compatible with the destination organism, and then insert it into the new organism. The modification occurs on a cellular level and the borrowed gene transforms to fit the destination organism’s DNA. Other methods involve repressing a gene that causes a certain characteristic, like they did to make a tomato that ripened after harvesting.

The Great Health Debate

Genetic engineering enables us to create crops with ideal characteristics, taking yields far beyond the possibilities of even the most resourceful farmers. Everyone must be thrilled! Not so much. In fact, many people are concerned about what GMOs might be doing to our health. Even with hazy understanding of GMOs, worries run rampant.

Leave it to Jimmy Kimmel to delve deep into society’s perceptions of hot-button issues.

What’s behind all of these worries?

No studies have proven that GMOs pose a significant health threat. There were some false alarms, but the studies were flagged for faulty mechanisms. In the absence of clear-cut science, why are people still worried about GMOs and their health?

Most people fear that a reason to be concerned just hasn’t been found yet, not that it doesn’t exist. Common misgivings are that gene transfer might also transfer antibiotic resistance and allergens, and that GMOs might not be as nutritious as their natural counterparts. While many of these apprehensions remain unsubstantiated, they’re still putting GMOs under scrutiny.

Are we right to worry about GMOs and our health? It turns out we may not know enough. Experts agree that the completed studies fall short in meriting total confidence. GMO testing has no minimal length requirement, even for crops cultivated on a large scale. Many point to a need for more long-term, quality, and transparent studies done on possible health effects of GMOs.

This article from University of California San Francisco quotes Patrice Sutton, a public health expert, to summarize concerns regarding GMOs and public health:

“Many people could rightly look at the existing science and see that it’s extremely weak,” Sutton said. “However, weak science does not prove safety; it just demonstrates that the public health impacts of GMOs are uncertain. It’s an overall public health principle that in the face of scientific uncertainty to expose everybody to something is a legitimate concern that should give us pause.”

Some contend that labeling food containing GMOs could fill in information gaps. After all, 97 percent of edible GMOs are cultivated in the United States and South America where no labeling requirement exists. Without labeling, long term studies and traceability are impossible. Which leads to our next point…

Should we label GMOs?

The FDA says “no” and hasn’t changed its mind since 1992. It adheres to substantial equivalence, the concept that a GMO doesn’t merit concern if it’s substantially equivalent to an existing food. This view was challenged in the court case, Alliance for Bio-Integrity v. Shalala. The court sided with the FDA, deferring to  its technological expertise in this complicated matter.

These decisions did little to quell budding concerns from the public. Today, 93 percent of Americans desire GMO labels on food, according to an ABC News poll.

The “Yes” People

The “yes” people rally behind the “right to know” battlecry, using it as the basis for GMO labeling initiatives. They believe consumers have a right to know what their products contain and make informed decisions for themselves.

At present, GMO ingredients in food are credence qualities — those that a consumer cannot evaluate let alone leverage in their purchase decisions. Labeling proponents say consumers can’t make informed decisions at the point of purchase without labels.

Doctors have also chimed in on the “right to know,” asserting that GMO labeling could affect how they study and treat their patients. It could be challenging to detect potential health impacts, including food allergies, if consumers don’t know what they’re eating.

Of course the worries mentioned above — allergies, antibiotic resistance, and nutrition — also factor into the “yes” arguments. Without labeling, it will be taxing to discern if these worries ever manifest as realistic concerns.

The “No” People

The “no” people suppose that a consumer’s “right to know” could lead to a consumer’s “right to be confused.” They think labels might give people a false reason to worry since no evidence suggests GMOs are harmful to health. A label doesn’t guarantee an informed consumer, especially when people are already confused. Furthermore, some argue that a GMO label only treats a symptom of consumers’ grander problem with industrial farming techniques.

And there’s more where that came from. The “no” people have a whole laundry list of concerns surrounding GMO labeling. Here’s a preview:

• A GMO label may inspire worry, leading to decreased demand and therefore production. Poor market acceptance could prematurely cripple a promising technology.
• A GMO labeling requirement could cause costs to skyrocket — some estimate by 10 percent of an annual grocery bill.
• A GMO label isn’t necessary. Concerned consumers can just buy certified organic foods that prohibit the use of GMOs.
• The food system infrastructure in the United States would need to be overhauled if a GMO label is required. Producers would need to implement extensive tracking and reporting systems to accommodate the new requirement, possibly with unforeseen costs and consequences.

So that covers “yes” and “no,” but the question of GMO labeling is far too complex for  monosyllabic responses. The decision packs a load of potential economic, legal, and societal implications.

From lawyers to farmers, this NPR spot explores why voters in Colorado and Oregon are answering “yes” or “no” to the deceptively simple question of GMO labeling that they’re facing on upcoming ballots:

There you have the gist of both sides. Now, what decisions have actually been made concerning GMO labeling?

Decisions…decisions…

States are buzzing with proposals to require GMO labeling. The Center for Food Safety keeps track of the status of proposed bills on this page if you’re curious. So far, GMO labeling bills have been rejected in California and Washington. Connecticut and Maine have passed laws, but they lack potency until neighboring states also pass labeling laws. Vermont stands alone as the only state to pass a GMO labeling law, no neighbors required. The labels will start popping up in 2016. Or maybe not. Food manufacturing heavyweights have filed a lawsuit against Vermont’s GMO labeling law. The groups purport that Vermont exceeded its constitutional authority by forcing costs and undermining the authority of federal agencies like the FDA. The results of the lawsuit will determine the temperature of GMO labeling measures in other states. Oregon is up to bat next as it makes a statewide ballot decision about GMO labeling on November 4, 2014.

Umm…what about the rest of the United States?

If you’re thinking state-by-state labeling laws could get complicated, you’re not alone. Two bills from the 113th Congress address GMO labeling on a nationwide scale. They’re on opposite ends of the spectrum:

1. The Safe and Accurate Food Labeling Act was introduced by Representative Mike Pompeo (R-Kan.) in April 2014. The bill would require producers to notify the Secretary of Health and Human Services of the use of a bioengineered organism intended for consumption. It would then be up to the Secretary to determine if a label should be required based on whether or not there is a material difference between the bioengineered product and the traditional food. The bill would nullify any previous state laws passed requiring mandatory labeling. Some critics have called the bill the DARK or Deny Americans the Right to Know  act because many GMOs would likely escape labeling.
2. Conversely the Genetically Engineered Food Right to Know Act introduced by Senator Barbara Boxer (D-Calif.) and Representative Peter DeFazio (D-Ore.) would require any food with one or more genetically modified ingredients to be labeled as such or be deemed misbranded.

Some companies have decided to take GMO matters into their own hands. After all, the customer is always right!

GMO Labeling Trailblazers

Private companies don’t have to wait for a state or federal government to make company-wide GMO decisions. According to the NPD Group, 11 percent of primary shoppers would pay more for non-GMO products. Some companies commit to serving this hyper-concerned segment.

• General Mills announced its original Cheerios are GMO free.
• Whole Foods plans to move to full GMO transparency by 2018.
• Ben and Jerry’s fully supports mandatory GMO labeling and wants to remove GMOs from its products. The company believes happy ingredients = happy ice cream.

Will labels determine the fate of GMO ingredients?

Consumer concerns will remain regardless of decisions on GMO labeling. With most American consumers saying they deserve the right to know, the search for information will continue whether it’s slapped on the front of a package or not.

But GMO labeling decisions and subsequent market reactions could determine if GMO technology skyrockets or stalls.

Conclusion

What will GMOs mean to future generations? A Pandora’s Box of unnatural selection? A budding innovation that ends world hunger? Right now, we really don’t know. In this circumstance, not knowing simply means we have many more exciting things to learn in the years to come.

Resources

Choices: Genetically Modified Organisms: Why All the Controversy?

UC San Francisco: Genetically Modified Food Labeling Through the Lens of Public Health

National Geographic: The GMO Labeling Battle is Heating Up–Here’s Why

International Journal of Biological Sciences: Debate on GMOs Health Risks After Statistical Findings in Regulatory Tests

WebTV: Food Fight: The Debate Over GMOs in Colorado

Slate: The Price of Your Right to Know

World Health Organization: Frequently Asked Questions on Genetically Modified Foods

Denver Post: GMO Labeling Measure in Colorado Triggers Heated Debate

NPR: Voters Will Get Their Say On GMO Labeling In Colorado And Oregon

AgBioForum: Labeling Policy For GMOs: To Each His Own?

Colorado State University: Labeling of Genetically Modified Foods

Center for Food Safety: Ben & Jerry’s, GE-Labeling Advocates Protest Anti-GE Labeling Bill

Politico: GMO Labeling Bill Would Trump States

Politico: Food Industry to Fire Preemptive GMO Strike

Los Angeles Times: General Mills Drops GMOs from Cheerios

Institute of Food Technologists: Most Consumers Won’t Pay More For Non-GMO Food

National Academies Press: Genetically Modified Organisms: An Ancient Practice on the Cusp

Science Meets Food: What You Need to Know About GMOs, GM Crops, and the Techniques of Modern Biotechnology

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Yes or No? GMO Labeling Is Not That Simple appeared first on Law Street.

Cancer. Just one little word that sets hypochondriacs everywhere on edge. To some, the word means nothing but certain death. If that seems a little dramatic to you, guess what’s the second most common cause of death in the United States? That’s right, cancer.

What about the word “virus”? Scary…but not nearly as scary as cancer. It’s certainly not a word that evokes hope. But that may change as medical breakthroughs present a compelling question: can we use viruses to treat cancer?

How could we use viruses to cure cancer?

I know what you’re thinking. How can two negatives combine to achieve something as positive as a cure for cancer? The answer lies in your immune system.

Your immune system pinpoints a virus as a foreign invader, and works to eliminate it. Kind of like how our government would react to an alien spaceship entering Earth’s atmosphere.

On the other hand, your immune system has a harder time detecting cancer. Cancer cells share more characteristics with your own harmless cells than viruses. After all, cancer does originate from your own cells. It’s not in your body’s best interest to attack its own cells, so your immune system may overlook cancer as a threat. Kind of like how the government would react to a standard American aircraft filled with aliens. Seeing the aircraft as one if its own, they would leave it alone, and we’d have an invasion.

In summary, your immune system recognizes and fights viruses, but often not cancer.

So where does the cancer treatment part come in?

Our bodies can fight off viruses efficiently. What if we could hijack that fighting spirit and direct it towards cancer cells? What if we could manipulate our marvelous immune systems to fight off cancer?

That is the basis for how we may use viruses to treat cancer in a process known as oncolytic virotherapy.

Let’s go back to our surreptitious alien friends (cancer). They’ve made it into our atmosphere in their inconspicuous plane and are having a lovely joy ride when that alien spaceship (virus) joins them to transfer some of its passengers. Someone is bound to notice this suspicious activity and alert the authorities. Now the government (immune system), is wise to the presence of foreign invaders in both aircrafts and prepares for attack.

In oncolytic virotherapy, a virus infects a cancer cell. Distressed by this turn of events, the tumor cell releases cytokines which are really just messenger proteins. The cytokines raise the inflammation red flag and the immune system dispatches its sniper-like white blood cells to eliminate the source of inflammation–the infected tumor cell.

That was just one cell. What about an entire cancerous tumor? That’s where a virus’s prodigious replicating power is actually a good thing. Viruses don’t reproduce per se, but inject their own genetic material to commandeer host cells and replicate with their help. Replicating is a virus’s raison d’etre, host cells beware. After one cancer cell is successfully infected, the virus uses it as its replication puppet, consequentially infecting more cancer cells. So one transmission of a virus to a patient could cause destruction of many cancer cells and possibly an entire tumor.

To truly understand this process, take a moment to brush up on your viral replication knowledge. This video will help you out:

Will any virus work?

Any virus can infect and destroy a cancer cell, but it can also infect and destroy healthy cells. Successful oncolytic virotherapy requires a more selective virus–an oncolytic virus. The word oncolytic stems from oncolysis, which means the destruction of tumor cells. Oncolytic viruses are specifically attracted to tumor cells and leave your normal, healthy cells alone. This type of virus combats cancer cells without making patients sick.

That’s a new thing, right?

Yes and no. The concepts underlying virotherapy have been recognized for years. Doctors have pondered the use of viruses to treat cancer for more than a century as they discovered tumor remissions after viral episodes. As early as 1904, researchers noted a remission of cervical cancer in a woman given the rabies vaccination. But while early observations were strong, patient tests yielded erratic results. Then, technological breakthroughs took off in the 1940s and transformed oncolytic virotherapy from dream to possibility.

Scientists began studying genetic material in vitro by the 1970s, opening doors for new experiments and tests. The discovery of recombinant DNA technologies in the 1990s sparked an explosion of breakthroughs in genetic engineering. Genetic engineering took oncolytic virotherapy to new levels.

Genetically Engineering a Cancer-Killing Virus

Genetic engineering empowered scientists to devise oncolytic viruses with certain ideal characteristics for safer, more specific, and more effective oncolytic virotherapy. Scientists created viral vectors that target tumors in the body even more specifically than naturally occurring oncolytic viruses by isolating the human genes that code for tumor antigens. This heightened specificity diminished risk of infection in healthy cells and the toxicity witnessed in early murine (family of rats and mice) and human experiments was mitigated.

With engineered super viruses in tow, interest in oncolytic virotherapy soared.

Fear of engineered viruses  

Many find the concept of engineering viruses a bit on the scary side. I Am Legend, both the book and the movie, epitomizes distrust of viral engineering. The story features some possible side effects of tinkering with nature. Spoiler alert: it doesn’t go well for the people in this story.

But fear not, scientists aren’t cooking up a myriad of franken viruses in their labs unchecked. The field is regulated by the Food and Drug Administration with detailed oversight from the Recombinant DNA Advisory Committee reporting through the Office of Biotechnology Activities. To conduct a human study, researchers have to file an investigational new drug application with the FDA. They must provide ample evidence of human safety from prerequisite lab and animal tests. Rest assured they are working hard to prevent a virus induced apocalypse.

Other than oversight…

What other government activities could possibly affect the future on oncolytic virotherapy? Well, if there’s one thing cancer research requires other than brilliant brains, it’s money. In that vein, organizations like the American Society of Clinical Oncology find the stagnant growth in federal funding for cancer research disheartening.

In fact, 75 percent of oncologists in the United States say that current funding slumps impact their ability to conduct cancer research. Check out this infographic from the American Society of Clinical Oncology that sums up the situation.

Even so, proposed legislation to invest in biomedical research, encourage innovation in biotechnology, and fight off the deadliest cancers proves confronting cancer remains a priority for representatives. It looks like the War on Cancer started by the Nixon administration in 1971 is still going strong today.

Does oncolytic virotherapy work?

Mayo Clinic announced a great success in oncolytic virotherapy last May. One nearly hopeless woman saw complete remission of her multiple myeloma after injection with the measles virus – enough to vaccinate 100 million people. Speaking of vaccines, Dr. Mark Federspiel actually came up with the proper concentration of the virus by building up a strain of the measles virus used safely in vaccines. Watch to find out how this success is giving doctors hope for a one-shot cure for cancer:

Hungry for more evidence? Check out Table 1 of this article for a list of published clinical trials in the field of oncolytic virotherapy. One major critique of the therapy is that lab successes often don’t translate to human trials.

What are we waiting for?

There are a few kinks to work out in the field of oncolytic virotherapy before the procedure gains mainstream acceptance.

Here are a few key hurdles:

• The explosion of engineered viruses created by pharmaceutical and biotech companies have presented scientists with more options than they have time or money to test. Furthermore, modifications come so fast, a state of the art engineered virus can quickly become obsolete.
• Treatment toxicities are always possible when using a virus to treat a disease. Healthy cells risk infection as even meticulously engineered viruses have the ability to mutate.
• Finding the right balance of immune suppression and aggression is difficult. The immune system must be weak enough to allow the virus to get to the host, yet also strong enough to combat the infected tumor once the virus has reached it.

Conclusion

A one-shot cure for cancer? Who wouldn’t love that? While it seems like a fairy tale, recent successes are creating buzz that we may be getting closer. Even if one shot doesn’t do it, many believe oncolytic virotherapy can be used synergistically with other cancer therapies to induce tumor remission.

Hope is the most important part of our War on Cancer. Hope drives us to continue fighting in the face of a daunting adversary. Is there reason to hope viruses may be used to treat cancer? Absolutely. Is further research and testing needed? Again, absolutely. The field of oncolytic virotherapy has made incredible progress since the first whispers began over 100 years ago. Surely the next century will bring more advancements than we can possibly imagine today.

Resources

Primary 

Cancer Research Institute: Cancer and the Immune System: The Vital Connection

Journal of Vascular and Interventional Radiology: Oncolytic Virotherapy

Additional

American Cancer Society: Cancer Facts & Figures 2014

Genelux: What is Oncolytic Virotherapy?

BBC: How Does the Body Fight Off a Virus?

American Cancer Society: Immunotherapy

The New York Times: Viruses Recruited as Killers of Tumors

UC San Francisco: Killing Cancer Through the Immune System

Clinical and Translational Oncology: Viruses in Cancer Treatment

Mayo Clinic: Harnessing Viruses to Treat Cancer

Dove Press: Applications of Coxsackievirus A21 in Oncology

Dove Press: Reovirus in Cancer Therapy: an Evidence-Based Review

NIH: Oncolytic virotherapy

Multidisciplinary Digital Publishing Institute: Oncolytic Viruses for Cancer Therapy: Overcoming the Obstacles

BMJ: Fighting Cancer With Oncolytic Viruses

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Fighting Fire With Fire: Can Viruses Cure Cancer? appeared first on Law Street.