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2018-08-17T03:11:35.662Z
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{"feed":"Health-or-The-Atlantic","feedTitle":"Health | The Atlantic","feedLink":"/feed/Health-or-The-Atlantic","catTitle":"Fitness","catLink":"/cat/fitness"}

After a while, the true-life horror stories women tell about their struggles to get reproductive health care start to bleed together. They almost always feature some variation on the same character: the doctor who waves a hand and says, “You’ll be fine,” or “That’s just in your head,” or “Take a Tylenol.” They follow an ominous three-act structure, in which a woman expresses concern about a sexual or reproductive issue to a doctor; the doctor demurs; later, after either an obstacle course of doctor visits or a nightmare scenario coming to life, a physician at last acknowledges her pain was real and present the whole time. Sometimes there’s a quietly gloomy boyfriend or husband in a secondary-character role, frustrated by the strain his partner’s health issue is putting on their intimacy.

That many women have stories of medical practitioners dismissing, misdiagnosing, or cluelessly shrugging at their pain is, unfortunately, nothing new. Research cited in the Journal of Law, Medicine & Ethics in 2001, for example, indicated that women get prescribed less pain medication than men after identical procedures (controlling for body size), are less likely to be admitted to hospitals and receive stress tests when they complain of chest pain, and are significantly more likely than men to be “undertreated” for pain by doctors. And there’s a multi-million dollar industry of questionable alternative health remedies that was arguably built at least in part on a history of doctors being dismissive toward women’s bodily health.

Crayons are generally an innocuous children’s product, but a consumer-advocacy group has discovered a dangerous substance in one brand. In a newly released report on 27 back-to-school products, the United States Public Interest Research Group, or PIRG, revealed that some green crayons in packs by Playskool, available at Dollar Tree, Amazon, and eBay, contained a toxic chemical with a deadly history: asbestos. The substance is known to cause mesothelioma and lung cancer, and is suspected to contribute to chronic obstructive pulmonary disease and kidney cancer.

This sort of testing and detection of toxic chemicals is nothing new. Last year, the U.S. PIRG found lead in fidget spinners, and in 2015, the Environmental Working Group found trace amounts of asbestos in crayons. But the new incident highlights a hard-to-nail-down problem in the increasing availability of products on the internet: Enforcing bans with such disparate points of sale is an incredible challenge, and can make keeping kids safe a logistical nightmare.

In their investigation, the U.S. PIRG discovered that two other children’s products containing toxic materials were currently available: a three-ring binder containing phthalates, a plastic that is being investigated for suspected links to asthma and birth defects; and markers containing benzene, a common chemical that’s known to cause leukemia and potentially other types of cancers. The reason these products are available, says Kara Cook-Schultz, a co-writer for the report, is that there aren’t strict laws that protect Americans from every potentially dangerous chemical. Benzene

Among the die-hard skin-care fans on reddit.com’s community SkincareAddiction, there’s a prevailing belief that committing to a dairy-free diet will majorly affect the prevalence of acne. Take the user andbutter, who writes that “giving up dairy was the best thing I’ve done for my skin.” Or the user umidkmybffjill, who claims, “I cut out dairy and switched to almond milk (not soy because I read it can negatively affect skin as well) about 3 years ago and my skin is better than ever!”

Dairy-free is far from the only diet prescribed as a cure-all for problematic skin. An abundance of pimple-treatment advice online has acne sufferers trying a whole variety of unproven diets and taking up anecdotal stories of improvement as gospel. Some people who go on the low-carb ketogenic diet claim that ridding their diet of sugar helps keep acne and oily skin at bay. Conversely, others are convinced that a low-fat diet rich in unrefined carbohydrates such as potatoes almost entirely eliminates acne. A small 2016 study found that 46 of the study’s 49 dermatologic patients believed that diet affects acne, with greasy foods as the No. 1 suspected culprit.

With this abundance of often conflicting advice, acne sufferers’ confusion over treatment tactics seems inevitable. The American Academy of Dermatology, or AAD, doesn’t currently recommend diet changes to manage acne, citing lack of sufficient data. And it doesn’t help that misinterpretations of 1960s-era research has acne sufferers throwing their...

“Coronary heart disease is also a woman’s disease, not a man’s disease in disguise,” wrote the cardiologist Bernadine Healy back in 1991. In a rousing editorial, Healy lamented that decades of research that focused almost entirely on men had “reinforced the myth that coronary heart disease is a uniquely male affliction and generated data sets in which men are the normative standard.” As a result, women’s symptoms went underappreciated, their medical problems were misdiagnosed, and their lives hung in the balance.

Three decades on, these problems still persist. In the United States, women are less likely than men to survive the years after a heart attack, even after accounting for age. And, according to a new study, that’s partly because of how women are treated—and the gender of the doctors who treat them.

Brad Greenwood, Seth Carnahan, and Laura Huang analyzed two decades of records from Florida emergency rooms, including every patient who had been admitted with a heart attack from 1991 to 2010. They showed that women are more likely to die when treated by male doctors, compared to either men treated by male doctors or women treated by female doctors.

“These results suggest a reason why gender inequality in heart attack mortality persists: Most physicians are male, and male physicians appear to have trouble treating female patients,” the team writes.

“There are inequalities in a lot of different contexts, but when someone is suffering from a heart attack, you might expect that there would be no gender differences...

BALTIMORE—Inside the Penn North recovery center one day last fall, dozens of recovering addicts propped their feet up on black folding chairs and closed their eyes. An acupuncturist stuck five small gold pins into each person’s ears.

La’Von Dobie, one of Penn North’s addiction counselors, sat down next to me. She told the acupuncturist that her right ankle was hurting, so he stuck two thin needles in her left wrist.

For 15 minutes, there was darkness and sitar music. One man appeared to give himself a silent pep talk; another held out his hand, as though ready to receive something from the sky. When the pins came out, Dobie exclaimed that her ankle felt much better.

Daily acupuncture is a mandatory part of the addiction-recovery program at Penn North, whose staff I recently spent time with as part of a larger story on racial disparities in health. It’s not the only one to employ this unconventional approach: More than 600 addiction-recovery programs in the United States use acupuncture today, according to NADA, the National Acupuncture Detoxification Association.

Some people swear by acupuncture, but recovery facilities’ use of it, along with other non-proven strategies for managing addiction, has grown more controversial as America’s opioid epidemic has raged on. Medications like buprenorphine or methadone are considered the gold standard in treating opioid addiction, which still kills more than 100 people each day. The medications dramatically reduce the likelihood of death from overdose, but they are shockingly underused: Only 3 percent...

“Bro, what kind of muscles you have?” asks Ido Portal in a short video introducing his philosophy. He’s barefoot and shirtless, his long hair pulled back as he tumbles across the frame and does handstand push-ups in the rain. “No—bro, what kind of patterns you have? Can you flip? Can you invert? Can you crawl?”

The 48-year-old Ido Portal has spent the past three decades honing a physical credo and method that’s now practiced by thousands of people all over the world—from office workers, to former CrossFitters, to NBA players, to the ever-controversial UFC titan Conor McGregor. Known as The Ido Portal Method, or simply “movement,” his approach purports to take the “most potent” parts from a range of physical disciplines by shedding the dogmas that often accompany them. As he puts it: “I want the contents, not the container.”

Videos of Portal in motion began circulating in certain physical circles in the mid-2000s—entrancing clips in which he flows along the floor like liquid, playfully combining capoeira-inspired flips, hand-balancing, and animalistic movements. But it’s only in the past few years (in no small part thanks to McGregor’s influence) that his profile has exploded, his following has expanded, and his business has revved up.

Star athletes reportedly pay Portal six-figure sums for two weeks of in-person training. He spent chunks of the past year doing “movement design” (something akin to choreography) for a multi-million dollar Bollywood film, and is set to star in a mini-series in...

The annals of literature are packed with writers who also practiced medicine: Anton Chekhov, Arthur Conan Doyle, William Carlos Williams, John Keats, William Somerset Maugham, and on and on. As doctors, they saw patients at their most vulnerable, and their medical training gave them a keen eye for observing people and what makes them tick.

But if studying medicine is good training for literature, could studying literature also be good training for medicine? A new paper in Literature and Medicine, “Showing That Medical Ethics Cases Can Miss the Point,” argues yes. In particular, it proposes that certain literary exercises, like rewriting short stories that involve ethical dilemmas, can expand doctors’ worldviews and make them more attuned to the dilemmas real patients face.

The paper dissects ethical case studies, which students in nursing and medical school often encounter in classes. Typically, these studies—most based on actual medical cases—summarize a conflict about a course of treatment or another aspect of someone’s care. The students have to decide what the doctor or nurse should do next, or determine what the doctor or nurse did wrong. The idea is to get students thinking about problems they might face in the future, before they actually confront these issues in a pressure-filled clinical situation.

The paper’s author, Woods Nash, a medical-humanities scholar at the University of Houston, points out that ethical case studies have a distinct literary style—or lack thereof. They emphasize action over characterization, and provide a bare minimum of atmosphere. They’re also short—usually a...

Updated on July 28, 2018

23andMe has always planned to sell access to its customers’ DNA—a fact it has not exactly kept secret.

When the company’s DNA-testing service launched in 2007, Wired touted its quest to amass a “treasure trove of data ... to drive research forward” as a “key part of the 23andMe business plan.” Co-founders Anne Wojcicki and Linda Avey outright told the San Francisco Chronicle that selling kits was only the first step. “The long game here is not to make money selling kits, although the kits are essential to get the base level data,” a 23andMe board member said to Fast Company in 2013. “Once you have the data, [the company] does actually become the Google of personalized health care.”

So this week’s announcement that GlaxoSmithKline is investing $300 million in 23andMe and using the DNA company’s de-identified, aggregate customer data for drug research is very much in keeping with the long-term business plan. You don’t make that kind of money selling $99 spit kits.

23andMe customers can opt of out their data being used in research, but the vast majority of its 5 million customers have opted in.

The deal comes at a time as pharmaceutical companies are increasingly looking to DNA for new drug ideas. In 2015, 23andMe announced its first partnership with a pharmaceutical company—in which it would study Parkinson’s with Genentech. The deal was reportedly just the first of ten at the time, according to Forbes. 23andMe has also since...

A vaccine scandal in China began building slowly and then suddenly, this weekend, it was everywhere at once.

The story began back in November, when a large vaccine manufacturer called Changsheng Biotechnology Co. was forced to recall 252,600 ineffective doses of vaccines for DPT (diphtheria, pertussis, and tetanus). Then earlier this July, a government investigation caught Changsheng falsifying data about its rabies vaccine, and a local food and drug administration fined the company 3.44 million yuan, or approximately $500,000, over the faulty DPT vaccines.

Over the weekend, an anonymous post recounting all this and more went viral on the Chinese social network WeChat. In addition to the recent developments, it alleged a complex web of corruption that went back decades, involving other vaccines for hepatitis B and chicken pox. The post was deleted the next day.

But by then, a full-blown national scandal had erupted. The Chinese government this week scrambled to put out statements assuring a prompt investigation. President Xi Jinping described the situation as “vile and shocking.” Police on Monday announced the swift arrest of four of the company’s executives, including its chairwoman.

Changsheng’s vaccines have not yet been tied to any deaths or illnesses, but the story caught on because it so perfectly echoed many scandals that have rocked China in recent years. In 2016, for example, a hospital pharmacist sold two million doses of vaccines improperly stored in an “overheated, dilapidated storeroom.” That came after scandals over tainted...

“We ought to believe in marriage as in the immortality of the soul,” wrote Honore De Balzac in The Physiology of Marriage. For Karam and Kartari Chand, this maxim rang especially true.


“I stumbled across their story about having one of the longest marriages in the world in a local newspaper,” said Glen Milner, who directed Elders, a documentary about the couple, both centenarians at the time of filming. “We met a few times for chapatis, veggie dahl, and tea. After a while, they finally gave in and let me bring a camera.”


Karam and Kartari tied the knot in India in 1925. Their marriage was arranged, according to Sikh tradition. 40 years later, the Chands moved to England. They have eight children and 27 grandchildren. When Karam passed away, in 2016, the couple had been married for 90 years. They are believed to have been in the world’s longest marriage.


“The dynamic between the two…was a beautiful thing to witness,” Milner told The Atlantic. “The tender caring for each other; the playful jokes directed both ways; the ease they have with one another.”

The story goes that Viagra began as a drug for chest pains. It didn’t work very well. But men in those clinical trials noticed a curious side effect of erections—and lo, a blockbuster drug was born.

Since then, the uses of Viagra, or its non-brand name sildenafil, have continued to morph. Clinicaltrials.gov currently lists 60 planned and ongoing sildenafil trials, and already it's a common treatment for high blood pressure in the lungs. Until this week, one of the many trials in progress was for pregnant women in the Netherlands whose babies grew too slowly in the womb. But after 11 of those babies died from lung problems after birth, the trial was swiftly terminated, as was a similar one in Canada.

Why was a drug best known for treating erectile dysfunction being tested in pregnant woman at all? There is an answer rooted in biology and another rooted in economics.

On the basic biology: Sildenafil works by relaxing blood vessels and increasing blood flow—hence its effectiveness against erectile dysfunction and high blood pressure in the lungs. In the 2000s, as Viagra was working miracles for men, scientists became interested in how it might help unborn babies. In a condition called intrauterine growth restriction, the fetus doesn’t get enough blood and fails to grow.  Fetuses that don’t grow can die. The only real treatment hardly seems like a treatment at all: inducing a premature delivery before the fetus dies. If sildenafil could increase blood flow...

With the prospect of a more conservative Supreme Court on the horizon, some progressive women have begun to fear what will happen if Roe v. Wade, the case that legalized abortion, is overturned. Some of these prophecies have centered on a popular meme in the pro-choice community: The coat hanger.

During a recent rally, New York gubernatorial candidate Cynthia Nixon held up a wire coat hanger as a warning that we should not return to the previous generation’s means of obtaining illicit abortions. And Representative Lois Frankel, a Democrat from Florida, banged a coat hanger on the table at a briefing while discussing the latest Supreme Court nominee, Brett Kavanaugh.

And this isn’t counting the many happy hours in progressive cities that have become peppered with gallows-humor cracks about coat hangers and back alleys.

But medical technology has progressed significantly since Roe was decided in 1973, and we—realistically, fortunately—won’t see a return to women using coat hangers or other implements to self-abort. Instead, it’s more likely that more and more women will turn to shady online pharmacies to buy abortion pills through the mail—a practice that is already occurring with surprising frequency and effectiveness around the world.

Women who want to have an abortion early in their pregnancies can take a combination of two drugs: misoprostol, whose brand name is Cytotec, and mifepristone, which is also called RU-486. They are both on the World Health Organization’s “List of Essential Medicines,” which means they are considered safe and effective. The combination can...

Completing a marathon has long been the ultimate feather in the cap of an amateur endurance athlete. But the idea of trotting along a boring old paved road for 26.2 miles doesn’t thrill everyone. For the endurance athlete who gets bored easily, a new genre of race has emerged—peppered with obstacles requiring feats of strength and dexterity (Crawling under barbed wire! Climbing a rope! Throwing a spear! Burpees!), and designed to be an over-the-top spectacle where participants emerge covered in mud (and maybe blood), as if they’ve survived a battle.

The two biggest names in the world of obstacle-course races (OCRs) are Spartan and Tough Mudder. These organizations put on OCRs that cover distances between three and 30 miles with the addition of up to 35 obstacles along the way. In some of the most intense races, participants might be asked to army crawl under live electrical wire or carry 60-pound sandbags up a ski slope in the middle of running a half marathon.

Participation in traditional road races such as marathons and 5K’s, while still high, is on the decline in the United States. After peaking at 19 million finishers in 2013, participation fell to just over 17 million in 2016, according to The New York Times. Running USA’s annual report stated that only 3 percent of those running road races in 2016 completed a marathon. At the same time, participation in Spartan, Tough Mudder, and other OCRs are on the rise. Since each was founded...

For people with bipolar disorder, manic episodes can be euphoric, but they can also be terrifying. In the throes of mania, some people feel they are superhuman. They start new projects and stay up all night to work on them. In the worst cases, they cease thinking coherently: They might attempt to walk into the sea or fly off the roof.

Though medications can help manage the symptoms, no pill is perfect, and all of them have side effects. Bipolar disorder appears to be at least partly genetic, but environmental factors also play a role, perhaps by switching different genes on and off that might spark manic episodes. And the thing that might be switching on some of these genes, according to a new study, is rather surprising: a category of preservatives in beef jerky called nitrates.

For the study recently published in the journal Molecular Psychiatry, researchers asked people being treated for psychiatric disorders at the Sheppard Pratt Health System in Baltimore whether they had ever eaten dry cured meat, undercooked meat, or undercooked fish. Those who had eaten cured meats—which includes jerky and meat sticks—were 3.5 times more likely to be in the group that was hospitalized for mania, compared to a control group.

Meanwhile, cured meats were not significantly associated with other types of psychiatric disorders, like major depression, and none of the other foods participants were asked about were significantly correlated with mania.

Here is where I pause and let you compose your tweet: “Correlation does not imply...

No single wolf can take down a bison on its own, but the pack has strength in numbers. A lone army ant is little threat, but an entire colony is a mighty destructive force. The natural world abounds with examples of predators that cooperate to take down their prey. And such teamwork also exists at a microscopic scale, among things that some scientists wouldn’t even classify as alive: viruses.

Most viruses don’t infect humans; instead, they target bacteria. These viruses, known as phages, are like miniature syringes. They commandeer bacteria by landing on them and injecting their genetic material inside. But bacteria can defend themselves from these incursions. They can store phage genes within their own DNA to build up a dossier of enemies past. They then use this cached information to guide destructive, scissor-like enzymes, which seek out any matching viruses and slice them up.

This defense system is known as CRISPR. It’s the basis of the gene-editing technique that is being used to treat human diseases, control invasive species, and inspire movie plots. But for billions of years before scientists realized that CRISPR could be used to alter DNA, bacteria were using it as part of their immune systems.

CRISPR doesn’t always work. In 2010, the microbiologist Joseph Bondy-Denomy pitted phages against CRISPR-wielding bacteria. Some of the viruses were destroyed, but others unexpectedly survived and infected the bacteria. Bondy-Denomy showed that those phages succeeded by relying on proteins that could shut down...

As a young child I missed a question on a psychological test: “What comes in a bottle?”

The answer was supposed to be milk. I said beer.

Milk almost always came in cartons and plastic jugs, so I was right. But this isn’t about rehashing old grudges. I barely even think about it anymore! The point is that the test was a relic of a time before me, when milk did come in bottles. It arrived on doorsteps each morning, by the hand of some vanishing man. And just as such a world was alien to me as a kid, the current generation of small children would likely miss a similar question: “Where does milk come from?”

Many would likely answer almonds or beans or oats.

Indeed, the already booming nut-milk industry is projected to grow another 50 percent by 2020. Much of this is driven by beliefs about health, with ads claiming “dairy free” as a virtue that resonates for nebulous reasons—many stemming from an earlier scare over saturated fat—among consumers lactose intolerant and tolerant alike. The dairy industry is now scrambling to market milk to Millennial families, as the quintessential American-heartland beverage once thought of as necessary for all aspiring, straight-boned children has become widely seen as something to be avoided.

Should it be?

It all happened quickly. In the 1990s, during the original “Got Milk?” campaign, it was plausible to look at a magazine, see supermodels with dairy-milk mustaches, and think little of it. Now many people would cry...

In 1907, the German psychiatrist Alois Alzheimer published a description of a 50-year-old woman who suffered from memory problems, hallucinations, and delusions. In the woman’s brain, Alzheimer noticed unusual lumps, or “plaques,” which “were caused by the deposition of an unusual substance.” Eight decades later, the mystery substance was finally identified as a protein called amyloid beta. Though small, it can accumulate in large clusters that are somehow toxic to neurons. Those harmful plaques are one of the hallmarks of the disease that bears Alzheimer’s name.

What amyloid beta normally does in the brain isn’t clear. Robert Moir, a neurologist at the MassGeneral Institute for Neurodegenerative Disease, says that many researchers have cast it as a villainous molecule with no beneficial function.  “It’s just bad, bad, bad,” he says. “But it has become increasingly obvious that this isn’t true.” Moir thinks that amyloid beta has a more heroic role, as a foot soldier of our immune system. It protects neurons from infectious microbes—and from herpes viruses, in particular.

William Eimer, a member of Moir’s team, demonstrated this protection by injecting the common herpes virus HSV–1 into the brains of two kinds of mice: normal rodents and ones that were genetically engineered to produce high levels of amyloid beta in their brains. The latter were better at resisting the viruses. Eimer then got similar results when he injected a different herpes virus, HHV–6, into human cells growing in a dish.

Amyloid beta protects against these viruses by latching onto them...

It was an issue over which a strong show of American exceptionalism wasn’t exactly expected: breast milk.

According to a recent report from The New York Times’ Andrew Jacobs, American officials at the World Health Assembly in Geneva this spring wanted to modify a breastfeeding resolution, and they went to the mat to do it, threatening other countries unless they promised to drop it.

The American delegates wanted to ditch language in the nonbinding resolution that called on governments to “protect, promote, and support breastfeeding” and another passage that called on policymakers to restrict the promotion of unhealthy food products. When that didn’t work, they threatened Ecuador, the country that intended to introduce the breastfeeding measure, with punitive trade and aid measures. Ultimately, it was Russia that agreed to introduce the breastfeeding resolution, and the U.S.’s efforts were “largely unsuccessful,” the Times reported.

A spokesperson for the U.S. Department of Health and Human Services, which led the negotiation on the resolution, denied that trade sanctions were part of the discussion about the resolution. “Recent reporting attempts to portray the U.S. position at the recent World Health Assembly as ‘anti-breastfeeding’ are patently false,” HHS national spokesperson Caitlin Oakley told me. “The United States was fighting to protect women’s abilities to make the best choices for the nutrition of their babies.”

Nevertheless, the episode shocked health-policy advocates because breastfeeding seems so, well, wholesome. To some critics of the U.S. delegation’s actions, it seemed like an example of the Trump administration...

ČELADNÁ, Czech Republic—The Beskid Rehabilitation Center sits on a rolling plot of land in the boomerang-shaped Beskid mountain range, a stretch of the Carpathians reaching from the Czech Republic across Poland and Slovakia, fading into western Ukraine and the Transylvanian Alps. Full of “alternative” therapies, the BRC is the kind of place you might visit if you were feeling fine, but wanted to feel great, or if you were suffering from a low-level chronic ailment that standard Western medicine had failed to resolve. There’s a cryotherapy chamber kept at a brisk -184 degrees Fahrenheit. There’s an open-air “healing pyramid,” a bare-bones wooden-beam structure said to have healing properties. (“Research shows that pyramid energy, thanks to its deeply relaxing effects, harmonizes the psyche,” the website alleges.) And famously, there’s Vila Mátma, or “My Darkness Villa,” where clients spend seven days or longer alone and in complete absence of light.

Many modern-day practitioners of what Czechs now call terapie tmou, or “darkness therapy,” point to a 49-day Tibetan retreat called yang-ti as its most important forebear. In the modern West, the therapy was promulgated in the 1960s by the German anthropologist Holger Kalweit as Dunkeltherapie (literally: “dark therapy”). The concept has particularly taken hold in the Czech Republic, where darkness-therapy centers now can be found across the country to serve a population of just 10.6 million, according to Marek Malůš, a psychologist who researches the technique. Staff at the best-known of these centers, the Vila Mátma at the BRC, say that...

It’s fairly well known that a bad diet, a lack of exercise, and genetics can all contribute to type 2 diabetes. But a new global study points to an additional, surprising culprit: the air pollution emitted by cars and trucks.

Though other research has shown a link between diabetes and air pollution in the past, this study is one of the largest of its kind, and it’s unique because it both is longitudinal and includes several types of controls. What’s more, it also quantifies exactly how many diabetes cases in the world are attributable to air pollution: 14 percent in 2016 alone. In the United States, it found, air pollution is responsible for 150,000 cases of diabetes.

The study, published in The Lancet Planetary Health, linked data from 1.7 million American veterans who had been followed for a median of 8.5 years with air data from the EPA and NASA. It also aggregated past international research on diabetes and air pollution to devise a model to estimate diabetes risk based on the level of pollution, and it used the Global Burden of Disease study to estimate how many years of healthy life were lost due to this air-pollution-induced diabetes. Globally, 8.2 million years of healthy life were lost in 2016 to pollution-linked diabetes, it showed.

The study authors controlled for things like obesity and BMI, so it wasn’t the case that heavier people simply lived in more polluted neighborhoods and were also more likely to get diabetes.

The...