Life inside the psychiatric ward

One patient believes a bulldozer is parked inside her forehead. Another thinks an ex-boyfriend has taken custody of their nonexistent septuplet babies.

Creedmoor Psychiatric Center in New York City accepts only adults who are classified as "severely ill" and at high risk of hurting themselves or, less frequently, those around them.

"A kind of laziness brings me back to normal life. I am like a prisoner who is enjoying an imaginary freedom while asleep; as he begins to suspect that he is asleep, he dreads being woke up, and goes along with the pleasant illusion as long as he can."
– Renee Descartes,Meditations on First Philosophy

In the mornings, Creedmoor Psychiatric Center's Ward 3B resonates with a brand of white noise unique to a psychiatric hospital. It is loud with tinkling and crashing pumped in from television speakers: the metallic rush of the Price is Right wheel pulled by the show's spinning, smiling winners. Loud with the snores of still, slumped bodies in sticky vinyl chairs, with the shuffling of the 40 slippered and sneakered feet that pace between the two dayrooms, that wander around the nurses' station. Loud with the rollicking cackles of Caribbean therapy aides. With occasional outbursts over thefts real or perceived — "I wanna see her fit in a size 18! Let me see her breasts fit in my size 18 shirt. I wanna fucking see that right now, hippo!" Fights flame up and flicker out, undulating with moods, obscuring but never quite eclipsing the television and the miniature people who live so noisily inside it. The floor echoes with the game show announcer introducing his grand prize, a state-of-the-art home entertainment system. "If you're anything like us," he booms, "you watch a lot of TV!"

Alice Trovato watches a lot of TV. Sitting here, she looks like any other 52-year-old Queens housewife idling the occasional lazy morning in her living room to the soundtrack of soap operas and sitcoms. But Alice, clad in a navy institution-issued sweatsuit that stretches at the belly and tennis shoes that squeak across the linoleum, can be found here every morning dispensing wisdom to fellow inpatients, her surrogate daughters, from a chair she calls her "therapist couch."

Though Alice's skin is pallid and her cheeks sunken, her brown eyes are comparatively lucid in a room filled with women alternately sedated or enraged. She comforts Shania, who believes a bulldozer is parked inside her forehead, and Sabrina, who thinks an ex-boyfriend has taken custody of their nonexistent septuplet babies, whose names she cannot always remember but each of whom is called a different diminutive form of "Angel." She chides the woman called simply Rodriguez — who scratches and spits during fights and has an unnamed communicable disease the ward psychologist says "you don't want" — for disrupting therapy groups, and counsels Cynthia, an obese 20-something who hears voices, against her meal of Snickers bars — a meat patty, pastries, and Pepsi — even as chunks of cream cheese dangle from the girl's lips and bits of bagel fall to the floor.

The dayroom is not a living room and these women are not Alice's family — her own grown son and daughter live, as does Alice's husband, on their own on the outside. Alice's "daughters" — the three or four young women who call her Mama, waist-deep in depressions and psychoses similar to those Alice herself has battled, for a comparably shorter period, over the last five years — stroke Alice's scalp, tie her hair up for her in a tight bun, and unleash to her their problems, actual and imagined, comprehensibly or unintelligibly. She is the ward's elected president, a self-described advocate for those here contending with disorders she believes are more incapacitating than hers. Most days, she's feeling better.

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Sometimes, though, angry voices and strange images emerge from the tightly folded recesses of her mind. Remnants of an abusive childhood, embedded in her memory the way accustomed-to house mice are in the walls of her old apartment, their presence, though once infuriating, forgotten until one scurries out from a hiding place, irrepressible, and she is forced to admit: "You're here for your own self, too."

Alice arrived at Creedmoor Psychiatric Center in September 2010 after spending eight months in Elmhurst Hospital Center following her latest suicide attempt. By the time she arrived on Creedmoor's 3B, a ward historically known within the hospital as "one of the wildest" wards for its "out of control female patients," she had been living full-time in psychiatric wards for over a year, had tried to kill herself in five separate, violent suicide attempts, and had been admitted to 14 different hospitals. For Alice, Creedmoor is both the latest stop and the last resort on a five-year-long involuntary journey into the depths of her illness.

Creedmoor Psychiatric Center sits on 200 acres in Queens Village, a residential neighborhood spliced by the Grand Central Parkway and Union Turnpike, and bordered by the leafy wetlands of Alley Pond Park in eastern Queens. The land it sits on remains largely unchanged from its depiction in "Creedmoor — Bird's Eye View of the Crowds," a painting reproduced in an 1877 issue of Harper's Weekly: sprawling blond grass, clusters of trees, and flattened acres stretch across a landscape then, as now, as vast and bare as muslin pulled taut over a loom.

The land where Creedmoor's campus now scatters, some of its 50-plus buildings long abandoned, was first a plot of farmland owned by the Creed family before its conversion into a National Rifle Association shooting range and National Guard barracks. A psychiatric hospital opened in 1912 with 32 patients; by 1933, its maximum capacity had exploded to 3,319. In September of 1958, when Alice was born, Creedmoor was in the midst of its busiest and most overcrowded period, serving between 6,000 and 7,000 patients, who paced the sprawling grounds and performed in choral groups, an orchestra, and minstrel shows.

Beginning in the 1960s, however, newly developed antipsychotic drugs and changing social policy led to the rapid deinstitutionalization of psychiatric patients here and throughout the country, shifting the burden of their care as much as legally and medically possible from the shoulders of the state to the backs of their communities. By the end of 1985, Creedmoor's population was down to 1,258. Ten years later, it had dropped to 924, and by 2005, when Alice began having "breakdowns," the population had shrunk to 449. The year she checked in, 2010, Creedmoor's average daily population had dwindled to 393, with 386 admissions and 390 discharges accounted for that year — a statistical success, in the view of the New York State Office of Mental Health, whose goal, according to one staff member and echoed by others, is to "get them in, so we can get them out."

Creedmoor continues to serve its designated district, the 2.3 million-person, 112 square-mile borough of Queens, with 16 wards and 395 beds for longer-term inpatients, in addition to outpatient services, the predominant treatment for the mentally ill in the years following deinstitutionalization. The majority of the patients here are on Medicaid; as a state hospital, Creedmoor cannot turn anyone away, including illegal immigrants and the uninsured. Many suffer from chronic schizophrenia's fixed delusions ("They wouldn't know to come in from the cold," explains Kevin Lynch, the hospital's director of quality management and a licensed social worker), from schizoaffective disorder, or from other thought disorders. Before arriving here, they believe "'this life's not working out for me,'" says Lynch. "Everybody's here because things weren't going well out there."

For employees and visitors, there are a few ways to get here: Exits 23 off the Grand Central or 28A off the Cross Island Parkway, or a combination of subway routes and a handful of buses. Creedmoor evokes for longtime Queens drivers a peculiar curiosity: Framed by the pristine, lonely edges of Alley Pond Park, the two-winged main building cuts a silhouette evocative of the Lincoln Memorial's statue of the seated president, but bereft of any elegance, its color that of sun-blanched sandstone. Dropped, seemingly, into the only remaining area of Queens uncluttered enough to hold both its campus and the expansive grassy radius that seems to protect it, Creedmoor could not be mistaken for anything other than a hospital or a housing project; it remains an unsettling, 17-story question looming high above the low-slung homes that hedge it and that look as though they want to keep their distance.

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To come to Creedmoor as an inpatient is to travel a very different route. The institution accepts only adults who are classified as "severely ill" and at high risk of hurting themselves or, less frequently, those around them. Patients must be referred by another hospital; there are no walk-ins accepted. Sometimes they are transferred voluntarily; other times, with only the consent of their caretakers. While policy may have made the route more labyrinthine, Creedmoor remains for those who find their way here — for Alice and others chronically suicidal like her — the only remaining defense against themselves.

Alice arrived on the admissions ward in September 2010, referred by Elmhurst Hospital Center, a public hospital in Queens. Upon admission, she was, as all new patients here are, analyzed according to Creedmoor's Psychiatric Assessment, a standard 11-page questionnaire that details every aspect of her medical and personal background: Illness onset (early 2005); symptoms and diagnoses (auditory/visual hallucinations, severe depression, suicide attempts; a bipolar disorder misdiagnosis that was recently changed to schizoaffective disorder); marital status (married to her childhood sweetheart, "the only man I ever had," Alice calls him); medication regimen (18 pills, administered throughout the day); hobbies (crochet, reading). Less quantifiable aspects are recorded as well. Question 10 asks, "Does the patient seem motivated for education/treatment?" Alice, says social worker Jacquelyn Smith, a young woman with an eyebrow ring and mousy ponytail, is very motivated.

In October 2010, Alice was transferred to ward 3B, an all-female inpatient unit on the third floor of the main building known for dialectical behavior therapy, a Zen-based cognitive therapy instituted here in 1995 that has since proven effective for reducing suicide attempts and other forms of self-harm. The windows of the activity room on 3B frame a skeletal bustle of leafless trees that separates the parkway from the houses beyond, which are invisible from this vantage point. Muted cars speed across the asphalt in the distance. Before her admission, Alice drove down that parkway often. "I used to live on Long Island," she says. "Whenever my husband and I would drive by Creedmoor, I'd say, 'I wonder what it's like in there?'" Today, in her fourth month living at Creedmoor, she says, "Well… I know."

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At what age does a man's sperm quality deteriorate?

Some researchers say the answer is 40. But it might be years earlier.

They may slow down sooner than you think.

We've known for some time that a man's sperm count and quality deteriorates with time, in much the same way Mother Nature hangs a ticking biological countdown over the fairer sex. But at what age a man reaches that precipice has been a matter of contention.

Previous studies have suggested that a man's sperm quality begins to decline around age 40. A new study, however, posits that the drop off may begin much earlier.

The decline in sperm quality may start as early as age 35, according to New Scientist. Researchers at Reproductive Technology Laboratories in Los Angeles reached their conclusion after examining roughly 5,000 men between the ages of 16 and 72.

Why this is, however, isn't explicitly outlined in the findings. But there are a few possibilities.

Sperm, like any other cell, spend their lives constantly regenerating. And with every cell division comes an increased risk of genetic mutation, which is why some studies have linked older fathers (40 and up) to children with diseases like autism and schizophrenia.

"Whether it's 35 or 40, the message from this and other papers is that men should be aware of age-related changes in their reproductive system and if they wish to become fathers they shouldn't leave it too late," says Allan Pacey, a fertility expert at the University of Sheffield in the U.K.

Oddly, the study also found that men older than 55 are more likely to have daughters, due to an increase in sperm carrying the X chromosome. Why this X and Y chromosome imbalance happens, though, is still a mystery.

9 purported health benefits of drinking coffee [Updated]

Java may make you healthier, smarter, and slimmer — but not if you drown it with sugar and cream

That Cup of Joe might have some positive effects — if you're drinking it properly.

"Often people think of coffee just as a vehicle for caffeine," writes Dr. Rob van Dam of the Harvard School of Public Health. "But it's actually a very complex beverage," containing hundreds of different chemical compounds. Grown in more than 70 countries around the world, coffee has something of a contentious history with health experts, who have long cautioned that over-consumption may be detrimental to our health. More recent studies, however, paint a rosier picture for the Coffea plant's roasted berries (they're not actually beans), suggesting that when consumed in moderate amounts — and without heaping on the sugar and cream — the magical stuff can harbor numerous potential health benefits. A look at a few of them:

1. Coffee may help fight depression...
Start your day with a smile: A joint study from the National Institutes of Health and the AARP discovered that folks who quaffed four or more cups of java a day were 10 percent less likely to be depressed than someone who didn't drink coffee at all. Oddly, the same mental-health benefits didn't extend to other caffeinated beverages — particularly cola, which was linked to a higher risk of depression (perhaps because of the high sugar content). Therefore, researchers suggest coffee's "mood-lifting effect might be traced to its antioxidants," reports Prevention.

2. ...and coffee-drinking adults are less likely to commit suicide
Along those lines, a massive public study from the Harvard School of Public Health found an astonishing statistic: Drinking two to four cups of coffee a day reduces the risk of suicide in both men and women by a surprising 50 percent. Researchers combed through the health data of more than 100,000 men and women, and pegged caffeine as the main mood-enhancer in coffee. "Unlike previous investigations, we were able to assess association of consumption of caffeinated and non-caffeinated beverages, and we identify caffeine as the most likely candidate of any putative protective effect of coffee," says lead researcher Michel Lucas, a research fellow at the school's Department of Nutrition. Researchers caution that any more than four cups, though, might actually prove detrimental to your mental health; a separate Finnish study concluded that people who drank eight to nine cups a day were actually at higher risk of suicide than those who drank a more modest amount.

3. It may be good for your liver
Numerous studies have suggested that caffeine helps the liver regulate itself. Research presented this month by the Mayo Clinic found that regular coffee consumption may reduce a person's risk of primary sclerosing cholangitis (PSC), a rare autoimmune disease that can lead to cirrhosis of the liver, liver failure, and even cancer. But that's not all. A separate 22-year-study of 125,000 people found that heavy drinkers who consume one cup of coffee a day were 20 percent less likely to develop alcoholic cirrhosis. Once again, those health benefits did not extend to other caffeinated drinks, including tea.

4. Java may help you (temporarily) lose weight
The use of green coffee-bean extract exploded when Dr. Oz claimed on his show that it "burns fat fast" with no additional diet or exercise. (Sure.) But what is the substance, exactly? Green coffee beans are seeds that haven't yet been roasted, thus preserving a compound called chlorogenic acid that disappears when heated. Although limited research has been done on the extract, and no serious side effects were reported in clinical studies, WebMD cautions that the actual weight-loss research so far is "preliminary and poor quality."

While caffeine products generally do help with appetite suppression, the Mayo Clinic suggests that the results of water loss from caffeine consumption or calorie-burning via thermogenesis — when your body generates heat and energy from digesting food — aren't permanent. When it comes to weight loss, caffeine should be viewed as a supplement, and not a magical cure-all. So don't try this at home:

5. It's a legal performance boost
It's hardly a secret: Athletes and coaches have long used coffee to boost athletic performance before a competition. Caffeine, in particular, "has been proven to increase the number of fatty acids circulating in the bloodstream," reports The New York Times, "which enables people to run or pedal longer." (One study suggests that as many as two-thirds of Olympic athletes were found with caffeine in their urine.)

So: How much should you drink prior to competing? Researchers at Coventry University in England discovered that the magic performance-enhancing ratio appears to be 6 milligrams of caffeine for every 2.2 pounds of body weight. For a 154-pound person, that's about two cups.

6. It may lower your risk of type II diabetes
Consuming three to four cups of coffee a day was found to be associated with a 25 percent lower risk of developing type II diabetes, reports Science Daily. But researchers weren't able to infer a causal effect between coffee and the disease explicitly. They think, though, that the decreased risk may have something to do with the ability of chlorogenic acid and the alkaloid trigonelline to reduce early glucose and insulin responses.

Worth noting: The report in question was published by the Institute for Scientific Information on Coffee, which — you guessed it — is a non-profit devoted to coffee's purported health benefits. Take heed.

7. It may lower your risk of Alzheimer's and Parkinson's
Yes, coffee may help keep your mind sharp as you age by slowing the onset of neurodegenerative disease. Multiple studies have suggested that coffee drinkers have up to a 60 percent lower risk of Alzheimer's and dementia, and the beverage may help reduce a person's risk of Parkinson's by 32 to 60 percent, reports Lifehacker.

Why? Chuanhai Cao, a neuroscientist at the University of South Flordia, has a theory: Cao tells WebMD that caffeine "inhibits production of beta-amyloid," a protein that has been shown to build up in the brain of people with Alzheimer's disease. The older you get, the harder it is to metabolize — or use up — all that excess protein, which causes a log jam in your brain. The stimulant boost from java ensures "your system only metabolizes all of the available protein," says Cao.

8. Coffee might even make you smarter
Time and time again, studies have shown that caffeine — which blocks the neurotransmitters in the brain associated with sleep — can temporarily boost cognition, especially when you're not getting enough shut eye. "When you're sleep-deprived and you take caffeine, pretty much anything you measure will improve" Harris Lieberman, a research psychologist for the military, told CNN in 2006. "Reaction time, vigilance, attention, logical reasoning — most of the complex functions you associate with intelligence. And most Americans are sleep-deprived most of the time."

9. Coffee may ward off skin cancer
So coffee is not only great for managing your mood, weight, and frayed nerves, but it also might decrease your risk of developing basal cell carcinoma — the most common type of skin cancer. A 2012 joint study between Brigham and Women's Hospital and Harvard Medical School followed 112,897 men and women over a 20-year period. What did they find? Women who drank three cups or more a day, for example, were much less likely to develop skin cancer than those who didn't drink coffee, or who only stuck to the decaffeinated sort.

This article, originally published on May 21, 2013, was last updated on July 25, 2013.

Why the FDA might ban menthol cigarettes

Better stock up on those Kools while you still can

Menthol smokers start earlier and quit later.

A comprehensive scientific review of menthol cigarettes released Tuesday by the Food and Drug Administration (FDA) doesn't paint a very rosy picture.

Adding mint flavoring to cigarettes, the years-long review found, makes it easier to take up smoking, harder to quit, and is disproportionately more harmful to public health than regular smokes.

The peppermint oil extract itself probably isn't to blame for causing lung cancer, emphysema, or other smoking-related diseases, the FDA says. But there's something more than just the flavoring at work. People not only start smoking menthols earlier in life; menthol smokers also light up earlier in the morning, wake up to smoke more at night, have lower rates of quitting smoking and higher rates of relapsing if they do quit.

Menthols, which account for about a third of all U.S. cigarette sales, had a near-death experience in 2009. That's when Congress passed the Tobacco Control Act, which gave the FDA new powers to regulate cigarettes and banned several types of flavored cigarettes — clove, chocolate, and fruit-flavored smokes, for example. Lawmakers exempted menthol in part because of lobbying from minority groups.

Menthols, it turns out, are really popular with black smokers, more than 75 percent of whom opt for the minty cigarettes. About 30 percent of Latino smokers also choose menthols. Among white smokers, a little more than 20 percent smoke menthols. Three major African American groups urged Congress to leave menthols alone, arguing that it would unfairly affect black smokers and citing concerns about creating a black market for Kools, Newports, and Salems. Law enforcement groups also endorsed the latter fear.

After the brush with a ban in 2009, menthols faced a new challenge in 2011, when a congressionally mandated group of outside experts empaneled by the FDA found that mentholated cigarettes pose a special public health risk. Many anti-smoking advocates expected the FDA to act after that study, but the tobacco industry pushed back, issuing its own study that found no added risk from menthols. Big Tobacco also sued the FDA over its choice of experts behind the agency's initial study.

The newest study could be the beginning of the end for menthols in the U.S., though. The FDA insisted that a ban isn't inevitable, but it did open a 60-day public comment period to help "determine what, if any, regulatory action with respect to menthol in cigarettes is appropriate." That could mean anything from putting restrictions on advertising to an outright ban. The European Union took a step toward banning menthols earlier this month.

A ban in the U.S., or even new regulation, isn't a slam dunk, though. One thing that is? More studies. One of them will look at whether there's a physiological property to menthol that makes it more addictive or alluring to certain ethnic groups. Marketing plays some role in the black preference for menthols, the FDA concedes, but at least one study suggests that a genetic variant common among African Americans encourages a predilection for menthols.

Two new studies, published Tuesday, also suggest further avenues for study. One, in the journal PLOS One, found that menthol and nicotine affect the same receptors in the human brain, potentially dulling the pleasurable effects of nicotine, and thereby making people smoke more to get the same feeling as regular cigarettes. The other one, in Frontiers in Pharmacology, found that menthol scrambles nicotine's interaction with receptors around the body, amplifying some effects and muting others.

"Today I cannot tell you that menthol cigarettes are more addictive," says Nadine Kabbani at Virginia's George Mason University, who helped write both studies. "But I can tell you that they're increasingly found to have biological and biophysical properties that go beyond flavor." Mixing menthol with tobacco is "almost like spiking your vodka with beer," she adds.

If studies like this bear scrutiny, it will be hard to argue, as the tobacco industry does, that menthols are just the same as regular cigarettes.

And if the FDA bans the minty cigs, we'll find out something else: Are menthols so alluring as to command black-market prices?

WATCH: The 'X-rated' Prancercise video that is far from X-rated

Joanna Rohrback prances back to YouTube for another 15 minutes of fame

Joanna Rohrback took the internet by storm in May when her original "Prancercise" video went viral. Her exercise routine didn't exactly take off, but the clip — demonstrating her horsey moves in spandex that left too little to the imagination — inspired amazement, admiration, and guffaws.

The video got 7.6 million views. It earned the Prancercise lady an appearance on the Today show, where she taught Al Roker to Prancercise, and got her included in John Mayer's new music video.

Now, she's back. Rohrback has released a new video, entitled "Uninhibited Fitness," to show the haters who mocked her online that she will not be laughed off the Prancercise track. And, according to a warning at the start of the clip, this video is "X-rated." Only, it's not.

"Do not fret: The clip is not obscene or lewd, unless a fully-clothed woman frolicking through Florida greenery offends you," says Dodai Stewart at Jezebel. "Basically, she's referencing the fact that her previous video included what some call 'camel toe.' This has been remedied."

Instead of nudity, viewers are treated to more Rohrback. She greets her audience in black tights and a lime-green top, and says, "There are many imitators out there, but there's only one me!" At the end, she prances off into the sunset.

The main takeaway is that Rohrback has had her 15 minutes of fame, and she wants 15 minutes more. By labeling it X-rated, says Terrence McCoy at the Broward-Palm Beach New Times, she's making it clear she's just out to grab an audience. "This places her closer to a one-trick act than ever before," McCoy says, "because she's now conscious people are watching. And that strips her of the earnestness that made her so endearing in the first place."

Still, we can't blame her for trying. In our cover story, we wondered whether Rohrback could parlay the national attention into anything sustainable. This new video, however, won't accomplish it. It's click bait, pure and simple. And if she's going to remain in the spotlight, she has to change tactics. [New Times]

It may be just a sequel, but it's still mesmerizing. Ami Angelowicz at The Frisky says the Prancercise guru has a "specialness I never questioned." Good for Rohrback for "refusing to be embarrassed by her camel toe, a term she admits she was unfamiliar with at the time her Prancercise video went viral," Angelowicz says.

And good for the Broward-Palm Beach New Times for getting an unprecedented full-length interview with her, which includes exercise legend Richard Simmons describing Rohrback as being "like Judy Garland walking down the yellow brick road."

He adds, "If she was here, I'd do her nails."

Kate Middleton probably spent less on childbirth than the average American woman

Estimated cost for stay at Kate Middleton's private birthing suite: $15,000. Cost of average delivery in the United States: $30,000.

The royal baby may have cost less to deliver than your average Joe.

In case you hadn't heard, Kate Middleton recently had a baby boy. The Duchess of Cambridge gave birth at the private Ludo Wing of St. Mary's Hospital in central London, which, according to The Daily Mail, includes complimentary breakfast, satellite TV, internet access, and a comprehensive wine list.

The cost for such royal treatment?

A natural birth is pegged at £4,965, or $7,621, for a one-night stay, with additional nights costing an extra £1,000 each. A long stay by the Duchess could have cost her a whopping £10,000, or just over $15,000, notes The Daily Mail.

That might seem like a princely sum, except when you consider that it is less than what the average U.S. hospital charges to deliver a baby in a non-exclusive room that, presumably, doesn't offer a selection of fine wines.

Elisabeth Rosenthal, who investigated the exceptionally high costs of U.S. childbirth for The New York Times last month, expressed her royal confusion on Twitter:

British royal born in fanciest ward :$15000. Average US birth: billed $30,000; paid $18,000. What's wrong here? http://t.co/Yl7NREkvxh

— Elisabeth Rosenthal (@nytrosenthal) July 23, 2013 Rosenthal is referring to the average total price charged for a vaginal delivery in the United States, which was $30,000, with the average commercial insurer paying $18,329. Granted, we don't know what exactly is included in the Ludo Wing's $7,621 "normal delivery package," but it's still a luxury, private birthing suite charging less than the average U.S. hospital.

If we set aside the royal family, the picture gets even more depressing. At $9,975, the average American woman spends more than triple on childbirth than what the average British woman does. That is despite the fact, according to Rosenthal's report, that women do not get better care in the United States than they do in other developed countries.

The reason American deliveries cost so much is that pregnancies are billed item by item, unlike in Europe, where hospitals charge a flat free for childbirth.

"We’ve created incentives that encourage more expensive care, rather than care that is good for the mother,” Maureen Corry, executive director of Childbirth Connection, told Rosenthal.

Then, of course, there is the issue of what uninsured American women have to pay for childbirth. Renée Martin, whose health insurance didn't include maternity coverage, told The New York Times that her hospital quoted her a price as high as $45,000 for total maternity care.

Unlike Kate Middleton, however, she couldn't have the Royal Family pick up the tab.

Could Dubai's gold-for-pounds weight loss program work?

The fabulously wealthy emirate has taken a novel approach to promoting public health

People in Dubai are seeing dollar signs when they hit the scales.

Some people turn to Weight Watchers to help them stick to their diets. But if you live in Dubai, gold may be a more appealing option.

The city of Dubai has launched the "Your Weight in Gold" program, offering a gram of gold for every kilogram (about 2.2 pounds) shed, with a 2 kilo minimum weight loss to qualify, according to Emirates 24/7. It averages out to about $45 per kilo with no ceiling on the payout. Best of all, people who lose the most weight are entered into a separate lottery to win a gold brick worth over $5,000.

The campaign may be just what a city known for its extreme wealth needs to combat its increasing obesity rates. In the United Arab Emirates, where Dubai is one of the seven emirates, 30 percent of men and 43 percent of women are obese. One in every three children in neighboring emirate Abu Dhabi is obese, and the entire Persian Gulf region is struggling with a growing diabetes epidemic.

Home to the world's most expensive cupcake, Dubai is no stranger to combining opulence with dietary delights, but this time "the tiny emirate has outdone the world in flashy extravagance by tantalizing dieters," writes Charlene Gubash at NBC News.

The weight-loss program started this week and runs through Aug. 16 to specifically overlap with the Muslim holy month of Ramadan. Hussain Lootah, director general of the Dubai municipality, said it "is the most appropriate season to launch such initiatives as it reminds us about many health benefits of reducing weight and encourages us to take strong steps to change our lifestyles."

However, while gold for pounds may sound like a dieter's dream come true, there are potential downsides to the program. For one, since its GDP per capita is the 15th highest in the world at $50,000 per year, "the promised payoff may not be powerful enough to separate citizens from their Big Macs and pistachio-stuffed pastries," writes Carol J. Williams at the Los Angeles Times.

At the same time, paying people in gold to lose weight is somewhat ironic considering that the government allocates only 3.7 percent of its state budget to medical care and ranks 172nd in the world for public health spending, notes Williams.

Another flaw in the campaign is that a month-long weight-loss challenge suggests an emphasis on short-term results, which may not last. "Losing a bunch of weight that fast is always dubious," writes Meher Ahmad at Jezebel. Yet another is that Ramadan may not actually be a great time to try out that diet. Speaking from her own experiences of fasting from sunrise to sunset, Ahmad writes that "when you eat a million samosas (fried pastries with a spicy filling) and then don't eat for twelve hours, your body is all, 'we're in starvation mode, let's store this grease permanently.'"

Perhaps the most problematic aspect of Dubai's program, though, is that it does not tackle the underlying causes of the country's obesity epidemic. High temperatures (regularly over 100 degrees) that deter exercise coupled with the growing presence of Western fast food have had a toxic effect on weight and health. "Incentivising weight loss with gold seems like an unsustainable solution to a much bigger problem," writes Ahmad.

So, maybe there are certain problems that won't go away when you throw money, or even gold, at them.

The promises and pitfalls of a magic exercise pill

Researchers have discovered a special protein that mimics the physiological effects of a tough workout

One day, these could replace an hour at the gym.

The pipe dream of a do-it-all exercise pill isn't a new idea. Imagine the promise! No more gym locker rooms that smell like moist socks; no more fruitless five-mile runs, especially on hot summer days (looking at you, New York); no more obnoxious trainers hovering over you, twisting you into weird knots while asking you to lift a kettle bell.

Instead, your entire workout would consist of popping a pill and chasing it with a gulp of water.

A new study published in Nature Medicine highlights how close that promise is to becoming a reality. Researchers from the Scripps Institute in Florida found that injecting mice with a protein called REV-ERB accomplished many of the sought-after goals of regular workouts, including weight loss and increased metabolism, even if the rodents were categorically obese beforehand.

Additionally, in early 2012, researchers from the Dana-Farber Cancer Institute found that similar physiological changes could be induced in mice by artificially boosting a hormone called irisin.

A few major caveats: We don't know what kind of side effects such miracle pills would have on the body. And some of the tangential benefits of exercise — the self-imposed discipline, the sudden rush of mind-tickling endorphins, etc. — would be thrown out of the picture.

Still, it's an interesting proposition that could have profound effects on the way we stay healthy. Dr. Richard Gunderman, a health correspondent at The Atlantic and a professor at Indiana University, thinks it's a wonderful idea that "plays to all our strengths: Our love of efficiency, spirit of entrepreneurship, and deep longing to install physicians and scientists as the new priests of the age."

Many of [such a pill's] concerns can be readily addressed through the judicious application of a little good old American innovation. For example, sports stars can simply hawk their favorite brand of exercise pill, creating another basis for fan affinity. Americans who once developed self-discipline through exercise can start working crossword and Sudoku puzzles. We can make other sacrifices in life, such as getting to know our in-laws better. Pill-taking could easily be made into a group activity. [The Atlantic]

Gunderman's assumption that we will use our new free time to our own benefit may be too optimistic. But it's a striking argument.

There are other questions that will need to be asked as well: Will the pill be expensive, a privilege accessible only to society's upper crust? (Who can already afford luxuries like gluten-free diets, gym memberships, and personal trainers?) Is it safe for children, who, in the face of skyrocketing obesity rates, may need it the most? What happens if chiseled physiques are the standard, rather than the exception?

Of course, this is all predicated on an exercise pill becoming a reality. In the case with irisin, Harvey Lodish — a professor of biology and bioengineering at MIT, and a member of the Whitehead Institute for Biomedical Research — says adapting the hormone into a drug form suitable for human consumption may prove harder than anticipated. If we can't put it in a pill, "maybe it could be delivered via gene therapy," writes Karen Weintraub at MIT Technology Review. If that turns out to be the case, the treatment will likely stay expensive (and therefore exclusive) for quite some time.

On the other hand, it's not as if exercise will suddenly disappear overnight. Your legs aren't going anywhere. "I know there are probably plenty of people who would prefer" to pop a pill rather than jog a few miles, Dr. Thomas Burris, who worked on the REV-ERB study, tells the New York Times. But "exercise has so many health benefits," he says, and no drug can re-create all of them.

Will Michael Bloomberg's stair-climbing campaign make a dent in obesity?

The New York City mayor's latest public health initiative is just a suggestion

New York's health crusader can't stop, won't stop.

Michael Bloomberg's attempt to ban massive cups of sugary sodas got blocked by a judge, but the New York City mayor is not giving up on his campaign to battle obesity. On Wednesday, the billionaire health evangelist announced the latest in a long series of public wellness initiatives — encouraging people to swear off elevators and take the stairs.

"I have five floors in my house, I take the stairs," Bloomberg said, at an announcement at the New School in Greenwich Village.

The backbone of the program is the creation of the Center for Active Design, a nonprofit, public-private partnership dedicated to promoting changes to buildings and city streets that will encourage people to be more physically active. The organization — the first of its kind in the nation — also will promote improved access to healthy food in neighborhoods where it can be hard to find.

Advocates say making it easier for people to take the stairs will help them get a tad more fit as they go about their normal routines. Local legislation is being proposed to require building owners to make it easier for people to find stairs, and post signs encouraging them to forego elevators to "burn calories, not electricity."

"Since the invention of the elevator, stairs became relegated to purely [escape] during a fire," David Burney, who heads the city Department of Design and Construction, tells The Wall Street Journal. "So they're minimal in size, they're in the corner of buildings, often dark without windows. So what we'd like to see is the stair being brought back."

Bloomberg's past initiatives — including assaults on cigarettes, trans fats, and sugary drinks — have been controversial, triggering complaints that he was imposing nanny-state rules on people's lives. The mayor says he hopes this program will be an exception, with no backlash.

He might be in luck. Here's James Joyner at Outside the Beltway:

Now, I don't know what all of this costs. Implementation might be more burdensome than it seems at first blush. If so, I might oppose it on those grounds. But, otherwise, this strikes me as a perfectly sensible move. And, unlike some of his previous moves, there's no obvious infringement on the liberty of the citizenry here to put this into "nanny state" territory. [Outside the Beltway]

Actually, maybe Bloomberg should brace for at least a little pushback. Hamilton Nolan at Gawker says the problem with Bloomberg's latest project isn't that it will be a burden to people. It just won't do any good, because you'd have to climb stairs for six hours and 30 minutes to burn the calories in a pound of body fat. "My friend," he says, "you are not even going to come close to that."

Yes, walking up a flight of stairs is better for you, physically speaking, than taking an elevator. You expend more calories climbing a flight of stairs, yes. But the gains that you will make from doing so are negligible. Taking the stairs, as a habit in the course of your day to day life, will make you more fit in the same way that stopping to pick pennies up off the ground will make you more rich. [Gawker]

Still, Bloomberg's defenders say, what's the harm? "You're still free to take the elevator," says Sophie Kleeman at Gothamist. "No one will be standing by the doors with a pair of nun-chucks to ward you off."

Bloomberg is just encouraging New Yorkers to be a little bit greener, and a little bit more active, in the name of public health. If you don't like it, you can always move to one of the many places in America where nobody cares if you live like a slug.

New York's health insurance rates to plummet: Vindication for ObamaCare?

Officials say mandated health care exchanges will cut rates in half

Well, look at that.

I

nsurance rates for New Yorkers who purchase their own coverage will fall by half next year with the implementation of a state-run health care exchange network mandated by the Affordable Care Act, New York Gov. Andrew Cuomo (D) announced Wednesday.

Starting in October — when the health care exchanges will go into place — New Yorkers will be able to buy insurance at rates around 50 percent lower on average than what is currently available. (You can see a full list of the current and future rates here.) The change will not affect those who receive insurance through their employers.

The timing and size of that drop, supporters of ObamaCare said, proved that the law would, in fact, reduce costs for consumers. The sharp decline in costs "demonstrates the profound promise of the Affordable Care Act," Elisabeth Benjamin, vice president for health initiatives with the Community Service Society of New York, told the New York Times.

"Health insurance has suddenly become affordable in New York," she said. "It's not bargain-basement prices, but we're going from Bergdorf's to Filene's here."

Cuomo himself suggested rates would drop specifically because of the ACA, saying in a statement that the exchanges "will offer the type of real competition that helps drive down health insurance costs for consumers and businesses."

In another encouraging sign for ObamaCare fans, New York officials estimated that 615,000 people would sign up for coverage under the reduced rates. Only about 17,000 New Yorkers independently purchase insurance now.

Following the news, the White House announced that President Obama would deliver a speech Thursday to discuss the law's benefits to consumers. The president's Twitter account also crowed about New York's projected rate cuts.

“Health insurance has suddenly become affordable in New York." Read more from @NYTimes on how #Obamacare is working: http://t.co/0FdYY09RGn

— Barack Obama (@BarackObama) July 17, 2013 Yet the magnitude of the drop in New York's insurance rates can't be entirely attributed to ObamaCare. As the Washington Post's Sarah Kliff pointed out, New York has for two decades had the highest insurance premiums in the nation, so there was significant room for rates to fall.

A lot of it seems to trace back to a law passed in 1993, which required insurance plans to accept all applicants, regardless of how sick or healthy they were. That law did not, however, require everyone to sign up, as the Affordable Care Act does.

New York has, for 20 years now, been a long-running experiment in what happens to universal coverage without an individual mandate. It's the type of law the country would have if House Republicans succeeded in delaying the individual mandate, as they will vote to do this afternoon. The result: a small insurance market with very high insurance premiums. [Washington Post]

New York, with its heavily regulated insurance marketplace, already has in place some of the new regulations required by the ACA. Those regulations, which typically drive up insurance costs, therefore won't add costs for New York's consumers, though they will in other states.

"Adding ObamaCare to this mix [in New York] means adding elements like subsidies and the individual mandate that will tend to make insurance cheaper," the New Republic's Jonathan Cohn wrote. "Things won't work out so neatly in states like Florida or Texas, which don't have as many insurance regulations on the books already."

Still, the plummeting rates appeared to show that the health care exchanges are at least increasing competition and driving down costs on one front. And that in itself is a victory for the health care law.

Jenny McCarthy, <em>The View</em>, and anti-vaccination quackery

Critics argue that ABC is wrong to hire the actress, saying her controversial medical beliefs are dangerous

"Think of autism as a fart," Jenny McCarthy once said. "Vaccines are the finger you pull to make it happen."

ABC has confirmed that actress Jenny McCarthy is joining The View in September, replacing conservative co-host Elisabeth Hasselbeck, who left for a job at Fox News. McCarthy has plenty of admirers — founding View co-host Barbara Walters has praised her intelligence and warmth. Others suggest her looks (she's a former Playboy model) and sense of humor (she has had many comedy roles) make her a natural fit for the talk show, where the hosts and guests trade banter about everything from shoes to politics.

Still, McCarthy's hiring has provoked an avalanche of criticism. Why the outrage? McCarthy's now 11-year-old son, Evan, was diagnosed with autism in 2005, and she blames vaccines he was given as a baby. "Think of autism like a fart," she once put it, "and vaccines are the finger you pull to make it happen." She has publicly urged parents not to vaccinate their children, and her critics say that is bad — and potentially deadly — advice.

McCarthy is a supporter of Andrew Wakefield, a British doctor who conducted a 1998 study linking the MMR (Measles, Mumps, and Rubella) vaccine with autism. Many parents bought his theory — that mercury in thimerosol, a preservative in the vaccine, triggered autism — and vaccination rates began dropping.

The trouble is, Wakefield was discredited after his work was found to have been based on fraudulent data. He was stripped of his license to practice medicine in the U.K. in 2010. Other studies have uncovered no evidence of a connection between vaccines and autism.

Yet McCarthy continues her campaign. She has written books, such as Healing and Preventing Autism: A Complete Guide, and explained her beliefs on Oprah. About 1 in 4 U.S. adults reported being familiar with her views in a 2008 USA Today/Gallup poll, and 40 percent of them said her claims made them more inclined to question the safety of vaccines.

That, McCarthy's detractors say, is the problem. "Vaccines don't cause autism," says Alex Pareene at Salon. "Vaccines, instead, prevent disease." And by putting her on The View, he says, ABC is giving her a forum that will help her spread lies that are putting the lives of children at risk.

Vaccines have wiped out a score of formerly deadly childhood diseases. Vaccine skepticism has helped to bring some of those diseases back from near extinction. Children have actually died as a result... It's incredibly irresponsible for a broadcast television network to think Jenny McCarthy should be on television — in a position where her job is to share her opinions — every day. It should seriously be a major scandal. [Salon]

Melissa Healy notes at the Los Angeles Times that McCarthy hasn't just trumpeted discredited claims as fact — she has also promised a cure. She tells parents that they can help autistic children recover by detoxifying their bodies of heavy metals and yeast, and putting them on a gluten-free, dairy-free diet.

This is quackery begotten of fraudulence, exacerbated by mistrust of science, and panic over a disorder that upends parents' lives and their hopes for their children. Add celebrity to that already combustible mix, and you get a fiasco that has already opened the door to the resurgence of preventable childhood diseases such as measles and pertussis. [Los Angeles Times]

The exposure and authority that come with a high-profile talk-show job are expected to provide a boost for McCarthy's controversial cause. Phil Plait at Slate notes that The View, which McCarthy joins in September, has three million viewers, and its daytime slot suggests that many of its fans are "parents of young kids — precisely the demographic most prone to anti-vaccine views." Even if she doesn't say a word about "her nonsensical health ideas on the show," he says, the fact that she's there, on the air, will give her "tacit credibility."

Despite McCarthy's well-meaning intentions and sincerity, her claims are still very, very wrong. So let me be clear: Don't heed the advice of anti-vaxxers. Instead, go to your board-certified doctor and ask about vaccines. And if the doctor recommends you go ahead and get the shots, do it. The life you save may be your own child's, as well of those of children all around you. [Slate]

ObamaCare relies on the honor system. Will Americans cheat?

The government is planning to rely on consumers' self-reported information until 2015

Be honest!

A new delay announced by the Obama administration has ignited another round of fears that the health reform legislation championed by President Barack Obama will not work as he had promised before its passage. Following so closely behind the government's decision earlier this month to postpone the Affordable Care Act's employer mandate by one year, further evidence of implementation difficulties only gave the bill's opponents more reason to suspect the reform would be unsuccessful.

The administration buried a ruling in the Federal Register that delayed the Affordable Care Act's requirement that the new insurance marketplaces verify consumers' health insurance status and their incomes, two pieces essential for the function of the exchange system. Rather, the federal government will rely more heavily on consumers' self-reported information until 2015 — one full year after the individual insurance mandate goes into effect. At that time, the government plans to have a stronger verification system in place.

The verification systems will determine which exchange enrollees qualify for under ObamaCare, particularly the federal subsidies to purchase health insurance that will be made available to those Americans earning less than 400 percent of the federal poverty line, which caps at $45,000 for an individual. Those earning less than 133 percent of the federal poverty line, or about $15,000, will qualify for Medicaid coverage in Washington D.C. and the 23 states that have decided to expand the program.

Additionally, the federal government needs to know who receives health insurance coverage from an employer; workers whose employer-sponsored insurance policy costs less than 9.5 percent of their income do not qualify for tax credits.

But "legislative and operational barriers" have overwhelmed implementation and the federal government will no longer require Washington D.C. and the 16 states operating their own marketplaces to verify a consumer's claim they they do not receive health insurance from their employer. "The exchange may accept the applicant's attestation regarding enrollment in eligible employer-sponsored plan . . . without further verification," according to the final rule.

Additionally, the decision also scaled back states' responsibility to double-check the income level consumers' report, which determines their tax subsidies. The original regulation required each consumer who reported an income 10 percent lower than what federal records indicated to be audited, but the final rule only requires a statistically significant sample of such cases to be audited. For individuals who are not part of that sample, "the Exchange may accept the attestation of projected annual household income without further verification," the rule stated.

This final rule has spawned such headlines as this one, "Not Qualified For Obamacare's Subsidies? Just Lie — Govt. To Use 'Honor System' Without Verifying Your Eligibility," which graced Forbes' website recently.

However, the government has responded by saying that the risk that some applicants could game the system for subsidies and gain unwarranted tax credits is no greater than the risk of any American cheating on his or her tax form.

"The Marketplace will always check the income information submitted by individuals against electronic income data sources such as tax filings, Social Security data, and current wage information," Marilyn Tavenner, administrator of Medicare and Medicaid, wrote in a "Myth vs Fact" question-answer series on the Department of Health and Human Services website. Furthermore, when federal tax returns are filed the following year, the amount of the subsidy is reconciled with their actual income.

Lying on federal exchange forms carries a fine of as much as $25,000, and any individual who misrepresented his or her income would also have to pay back the extra subsidy.

More from Wall St. Cheat Sheet...

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An incredible miracle on Molokai

When a dying Honolulu woman prayed to Father Damien, "Apostle of the Lepers," her cancer disappeared. But could the Vatican be convinced it was a miracle?

Water rushes to the shore at Sandy Beach Park in Honolulu, Hawaii.

It was a little over a decade ago that Audrey Toguchi, a retired Hawaiian schoolteacher, first visited Father Damien's grave on the island of Molokai. Passing through the gate in a low cobblestone wall, where stray cats sometimes rested in the shade of St. Philomena Church, Mrs. Toguchi and her two sisters entered the graveyard. A few palm trees twisted towards the sky; beyond those stretched the open sea. Mrs. Toguchi walked to the side of the church and came to the grave, a tall marble monument festooned with rosaries and leis. She began to silently pray. Please, Father Damien. Put in a good word for me.

She had not traveled far. As an airplane climbs above Honolulu, the island of Molokai is often visible as a small blue mass, though dim and distant enough to waver like a mirage. Approached from the north, Molokai is a fortress: a vast wall of seacliffs rises above the surf, towering thousands of feet high and stretching for miles from end to end. Near the midpoint of that wall there juts from the base, suddenly and improbably, a low, level shelf of land that the early Hawaiians called Kalaupapa ("flat leaf"). That peninsula has a peculiar history. When, in the mid 19th century, leprosy grew rampant in the Hawaiian islands and panicked public health officials sought a suitable place to isolate the ill, they turned to the small tongue of land protruding from the north face of Molokai. Bound by the sea on all sides and walled off from the rest of the island by the tall cliffs to the rear, Kalaupapa was a natural prison.

It was a dark chapter in Hawaiian history. Bounty hunters roamed the islands in search of suspected leprosy cases; families were torn apart by what they called "the separating sickness." Since there was no cure for leprosy, to be sentenced to Molokai was to be sentenced to death. The prisoner-patients arrived by the boatload, and if the surf was too rough for landing, they might be cast into the sea and made to swim to shore. Misery reigned on the peninsula, which acquired an unofficial motto: Aole kanawai ma keia wahi — in this place there is no law.

Into this land of exile came Father Damien de Veuster. The young Belgian missionary volunteered, in 1873, to go to the forsaken place — "the self-exiled priest," one admirer later described him, "the one clean man in the midst of his flock of lepers." Newspapers trumpeted his good works, with reports of how he tended to the sick, how he built churches and homes, how he consoled the dying with promises of an afterlife. His bravery and charity became the stuff of legend, and upon his death, many clamored for his canonization. Though he might have seemed a shoo-in for sainthood, a small minority cast doubts on Damien's character, claiming the man had "lived evilly" with women. Without believing the darkest of the charges, some members of Damien's own missionary order of the Sacred Hearts were reluctant, at first, to advance a cause for his sainthood.

(More from The Big Roundtable: My weekend at Adolf's)

But by the mid-20th century, Damien's order finally proposed him for canonization, beginning a long vetting process by the Vatican. Damien's body was exhumed from its grave on Molokai and returned to his native Belgium; soon, the Church began to pore over all writings by and about Damien for clues to his life. By the late 1990s, the Vatican had declared Damien "Blessed," an intermediate step towards sainthood. However, one crucial piece of evidence of Damien's sanctity was still missing: a miracle. According to Catholic doctrine, God is the ultimate font of all miracles, but saints, like members of the president's cabinet, can sometimes persuade the executive to act. If Damien had indeed made it to heaven — if his life had indeed been virtuous — then he ought to have influence with God: he ought to be able to deliver a miracle.

By September of 1998, Audrey Toguchi needed a miracle. An x-ray had revealed three wispy masses in Mrs. Toguchi's lungs: metastases from a tumor originally found near her hip. The doctors told her that surgery was impossible, and that chemotherapy might extend her life a few months at most. Her surgeon, Dr. Walter Chang, told her there was nothing he could do. The cancer would take her life.

Declining the chemo, Mrs. Toguchi turned exclusively to prayer. She had been deeply devout and prayerful from an early age. Throughout her life, she had prevailed on the Holy Spirit, or the Blessed Mother, or Saint Joseph, or many other saints for help in matters great or small: during her exams in college, which she was the first in her family to attend; or much later, when her husband was ill; or most recently, the time she had to negotiate with a rude contractor. She said her rosary three times a day and never missed a weekend mass at St. Elizabeth Church, her vibrant congregation in Aiea, the Honolulu suburb in which she lived. Her whole world was prayer, she'd say.

That piety ran in the family. Her sister Velma could rustle up prayers around the diocese the way a deft canvasser turns out votes, and when she had learned of her sister's illness, Velma had called upon the nuns of Regina Pacis, the retired priests of the St. Patrick Monastery, and the children of Kapahulu Pre-School. She also phoned a Sacred Hearts priest she knew named Father Christopher Keahi, and asked him for advice. Father Keahi suggested that Mrs. Toguchi might pray to Father Damien. Who better, he suggested, than this man who had loved and cared for afflicted Hawaiians?

The idea resonated with Mrs. Toguchi: her own aunt, uncle, and grandfather had all been banished to Kalaupapa. And she could still remember the day when she was only eight years old and Damien's coffin was paraded down 4th Street in Honolulu, passing many tearful observers on its way to the wharf, and then to Belgium. She never forgot how he had earned the people's aloha, their love.

She eagerly told another priest, her longtime friend Dan MacNichol, of her plan to visit Molokai. After they spoke, Father MacNichol, who had seen terminal patients in denial before, got out his calendar to see if he had time next month to perform a funeral.

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Then something remarkable happened. Upon her return to Honolulu, Mrs. Toguchi's doctors noticed something unusual in a follow-up x-ray. It appeared that her cancer — her vicious, aggressive, metastasized cancer — hadn't spread at all. In fact, looking closely, it seemed to the doctors as though one of the masses had become smaller. Another x-ray the following month showed all three masses were shrinking, and one the month after that showed them smaller yet. Finally, an x-ray in early spring showed her lungs to be completely clear. "She appears to have had a spontaneous complete remission, which is unexplained and thus far durable," her oncologist noted in a report.

As word spread from one member to another of Mrs. Toguchi's team of doctors, no one could explain what had happened. It was simply unheard of for someone to survive a pleiomorphic liposarcoma with lung metastases.

"I don't know how you did it," one of her doctors told her.

But it hadn't been her, Mrs. Toguchi explained serenely. She had had help, she said, from above.

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Are we making ourselves miserable trying to live longer?

Our life expectancy has increased, but our quality of life hasn't

Those last years may not be pleasurable ones.

At first glance, it seems like good news: A new study out this week in the Journal of the American Medical Association shows that Americans are living longer than they did two decades ago. The average life expectancy was 78.2 years in 2010, up a full three years from the life expectancy in 1990.

But delve a little deeper into those numbers, and you'll discover that while Americans may be living longer, they are certainly not living better. For one, we're slipping behind our international peers. The U.S. is 27th, down from 20th, in life expectancy among the 34 member nations of the Organization for Economic Cooperation and Development. More importantly, our quality of life has also fallen relative to the rest of the industrialized world.

The quality of life in America gets particularly bad toward the end. The gap between total life span and a healthy life span rose, with Americans spending an average of over a decade of their lives (10.1 years) suffering from short- or long-term disabilities. "We are not very good at preventing them [chronic diseases] or curing them and only mildly good at treating them," says Dr. Christopher Murray, who led the study and is director of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.

The study is a wakeup call for those who have dreamed of their retirement years as a golden age for relaxation. "Don't expect old age to be all golf and cruises," writes Eryn Brown at the Los Angeles Times. "As Americans live longer and longer, more of us should expect to suffer some sort of independence-threatening disability in the final phase of life."

Considering that our increase in life expectancy over the past two decades has also come with jumps in psychiatric disorders, substance abuse, and back, muscle, and joint pain, "many do not feel well enough to enjoy those added years of life," writes Julie Steenhuysen at Reuters. Americans are stretching out their days, but they're not necessarily happy ones.

It may be baffling, if not frustrating, that Americans live a relatively poor and short life for the money spent on health. Americans are actually "outspending our nearest competitors by more than 50 percent," writes Dr. Richard Gunderman at The Atlantic. The disparity between our spending on health and actual life quality can be partly traced to a stubborn, familiar problem. "The portion of Americans who are uninsured, or who are uninsured and lack affordable access to care, is the single biggest difference between the U.S. and developed countries," writes Christopher Flavelle at Bloomberg.

But Gunderman thinks the latest data suggests a larger problem in the way we pour money into lengthening our lives. "Health is not a commodity than can be purchased like automobiles or gallons of gasoline," he writes. Even important debates over health care won't get to the broader issue of changing the paradigm by which we evaluate our lives. "Before we spill too much ink bemoaning the U.S.'s declining standing in the world life expectancy race," writes Gunderman, "we should devote a bit more time to reflection and conversation around what really makes a good life."

Obsessing over how to rack up as many days as possible may ultimately just make us miserable. "The best way to lead a truly full life is not by straining every sinew to keep our hearts beating to the last possible minute," writes Gunderman," but instead by bringing ourselves and others as fully to life as possible."

So, instead of looking to the latest studies and wondering how to lengthen our days, perhaps we should be thinking more about what to do with the ones we have.

Does diet soda actually make you gain weight?

One psychologist says non-calorie sweeteners can make you "metabolically deranged"

If you're always going for the diet option, read on.

A

re you "metabolically deranged"? According to Susan Swithers, a psychologist at Purdue University in Indiana, you might be if you consume diet foods and drinks. Though one might think that non-calorie sweeteners can satiate our desire for sweetness while saving us from the high cost of sugar — i.e. calories — Swithers contends that this may not be true.

Our brains may go, "Hey, I'm digging this guilt-free sweetness," but our bodies might well be responding, "Dude, where are my calories?" In short, our brain connects taste with the actual delivery of energy. If that energy isn't delivered, the means by which taste regulates what we eat — balancing calories in with calories out — is thrown out of whack, such that we end up consuming more energy and gaining weight.

Or so goes the theory. Swithers has been pushing it for a number of years, based upon her own research on non-nutritive sweeteners in rodents. She is, in many ways, the go-to academic if you want to write a counter-intuitive story about gaining weight from diet drinks, and she is back in the news because she has reiterated her theory for an "opinion" piece in the journal Trends in Endocrinology and Metabolism. Why is it an "opinion" piece? Because it is larded with "coulds" and "mights;" it isn't an actual study or experiment — or even a balanced weighing of the evidence. Trends is up front about that.

And yet, the news media and Twitterverse did not trouble its readers with this distinction: "The dark side of diet drinks" was, for instance, the headline used by Fox News; "how diet soda makes you fat," tweeted @DrAseemMalhotra, a cardiologist and "real" food enthusiast.

But the distinction is important for the following reasons: Swithers builds her argument mostly from observational studies with animals, and they are the weakest form of evidence to determine cause and effect. In fact, the inability to replicate observational studies on animals is so widespread that last year, the U.S. National Institute of Neurological Disorders and Stroke convened a workshop to discuss ways of tackling the problem. Its analysis was published in Nature. And Stanley Young, assistant director of bioinformatics at the National Institute of Statistical Sciences, went so far as to say that "any claim coming from an observational study is most likely to be wrong," in a paper for Significance, the journal of the Royal Statistical Society.

This doesn't mean that the observational studies cited by Swithers are "most likely to be wrong." It just means that we can't know if they are likely to be right until the results are replicated in a randomized control trial, a much more robust and reliable way of establishing cause and effect (though not foolproof, either).

And this leads us to the second problem: Because Swithers is writing an op-ed, she doesn't have to address and counter all the evidence from randomized control trials that disagree with her hypothesis. That's important because a major randomized control trial published last year in the American Journal of Clinical Nutrition specifically targeted the issue of whether replacing calorific drinks with diet beverages or water induced weight loss; it found that both did.

The authors — one of whom is a long time food industry scold — went so far as to write, "This strategy could have public health significance and is a simple, straightforward message." Swithers, however, just mentions this study in passing before moving on to say it might not be "always" the case. Another important randomized control trial published last year tested normal versus non-calorie soda in Dutch children and found the latter led to reduced weight gain and lower fat accumulation. Swithers acknowledges this finding but counters it with much older observational, which is to say weaker, study data.

This is the kind of argument you expect in an opinion piece; it's polemical. And that is why it is probably better to give more weight to recent randomized control trials showing weight loss in people who consume diet drinks than to a hypothesis about energy regulation based on a small number of rats eating chocolate pudding.

Explained: Why going for a run reduces stress

A look at how exercise releases a previously unexamined neurotransmitter to help curb anxiety

Feeling better yet?

When you're feeling stressed, going on a long run is perhaps one of the best things you can do to soothe frayed nerves. That much we know. Yet exactly how exercise helps moderate stress levels is less clear. Physical activity — whether you're shooting hoops or pumping iron — certainly gives your endorphins (those feel-good neurotransmitters swimming in your brain) a jolt. But that's just one part of the complicated stress-relief story.

A recent Venezuelan study published in the Journal of Neuroscience takes a look at why moving your legs (or any major muscle group, for that matter) helps curb all that icky anxiety that builds up from life's everyday irritations. In this case, researchers focused on a region of the brain called the ventral hippocampus, which "has been linked to anxiety regulation" but hasn't been explored in too much depth.

Big caveat: Scientists didn't examine the brains of runners. Or humans for that matter. Instead, they turned to the hippocampi of stressed-out lab mice. And since you can't saddle a four-legged rodent with a 30-year mortgage or rising tuition fees, researchers induced anxiety by dropping the little athletes into a bucket of cold water. (They're fine swimmers, it should be noted.)

Per Scicurious, "The authors wanted to examine how exactly exercise can protect the brain from anxiety-inducing (the sciencey word here is anxiogenic, impress your friends!) effects of stress." They examined the neural signals of mice that (1) were allowed to run in a wheel before taking the plunge, and (2) were sedentary before they were dropped in a bucket.

So what happened?

According to the paper's authors, gene markers associated with anxiousness increased noticeably in mice that didn't run, while mice that were forced to hit the exercise wheel beforehand failed to show a significant uptick of those same gene markers. The runner mice were also calmer and more collected than their non-athlete counterparts, especially after their unceremonious soak.

As for what's going on, researchers think the difference may be due to a neurotransmitter called GABA, which as Scicurious notes, is "often associated with inhibiting the activity of other neurons (many current anti-anxiety drugs on the market, for example, increase GABA signaling)."

Since runner mice expressed higher GABA levels than non-runners, researchers artificially suppressed the GABA receptors in their hippocampi. As was theorized, the runner mice with inhibited GABA levels were just as stressed as their sedentary pals after going for an unexpected swim.

Mind you, stress might isn't always a bad thing, especially when it comes to physical activity. A recent study from the University of Chicago found that elevated stress hormones can actually help give your athletic performance a tangible boost.

In any case, it's probably safe to add this study on anxiety regulation to the growing canon of evidence suggesting that exercise is an important ingredient for maintaining your mental health. So lace up your running shoes and hit the gym; unlike our four-legged pals, you probably have enough going on in your life that you don't even need to take a cold-water plunge.

Your cat's poop is even more dangerous than you thought

A harmful bacteria in feline feces turns out to be widespread

More than just passive aggressive.

C

ats — those gif-able, meme-driving, better-than-dog pets — are awesome.*

Their poop? Not so much.

It's long been known that some cats carry a parasite called Toxoplasma gondii, or T. gondii, and that they shed an embryonic form of the parasite, called oocysts, in their feces. When transferred to humans, the parasite can cause a disease known as toxoplasmosis, which results in flu-like symptoms and muscle pains that can last for a month or longer.

Now, a new study published in Trends in Parasitology warns that the danger from T. gondii is a far more troublesome and widespread problem than was previously believed. Citing a spike in cat ownership and the parasite's astounding reproduction rate, Dr. E. Fuller Torrey and Dr. Robert H. Yolken, scientists at Johns Hopkins University Medical Center, warn that the T. gondii oocysts "pose a significant public health hazard," especially for children.

T. gondii can only complete its sexual cycle in cats, meaning they're the only animals that spread the parasite's embryos in their feces. But other animals can still be carriers, and cats often pick up the parasites in the first place by eating infected animals in the wild, such as birds.

Once infected, cats then begin to excrete the oocysts for a median of eight days, dropping as many as 810 million of them in their poop. Those oocysts are tough to kill, too, and can remain viable for at least a year and a half under certain conditions.

Further, the study says a sizable increase in the feline population has made it easier for the parasites to spread. Between 1989 and 2006, the number of house cats in the U.S. rose from 54.6 million to 81.7 million. On top of that, there are another estimated 25 million to 60 million feral cats now living in the wild.

All of those cats drop a combined 2.6 billion pounds of poop every year. And though only about 1 percent of cats are thought to be infected at a given time, that still amounts to a lot of infected cat turds.

Indoor cats are far less likely to become infected. Torrey says that "strictly indoor cats really shouldn't be a problem" because they shouldn't encounter or consume the parasites in the wild.

As for outdoor cats? They can pick up the parasites all over the place — and deposit them just about anywhere, too. The study specifically cautions that, because cats can mistake a sandbox for a litter box, those play areas, "and other places favored by cats for defecation," should be assumed "highly infectious" unless they're covered at all times when not in use.

It's a growing concern because T. gondii infections have been linked to some serious health complications in recent years. Studies have shown a correlation between elevated T. gondii levels and schizophrenia, depression, suicidal behavior, obsessive-compulsive disorder, and brain cancer. In pregnant woman, T. gondii infections have been tied to deafness, retinal damage, and mental retardation in fetuses.

However, that doesn't mean you should go swap your cat for a dog. The authors note that T. gondii infections have fallen in humans over the past two decades. And according to the CDC, most humans' immune systems are strong enough to ward off the infections in the first place.

So remember to wash your hands after you scoop your cat's poop. And if you're not doing that already, you probably have more problems to worry about than just T. gondii.

*The author of this post is a cat owner, and still thinks cats are awesome despite their issues with parasites.

The ethical morass of sexual surrogacy for the disabled

France has banned the hiring of sexual helpers, ruling that "the sexuality of the disabled cannot be considered a right." The Atlantic's James Hamblin isn't so sure.

France's National Ethics Committee effectively banned sexual surrogacy in March, as Stefania Rousselle just documented in a video for The New York Times (watch above). What exactly is sexual surrogacy?

It "involves paying a professional who engages in intimate contact (broadly defined, though certainly not always intercourse) with a patient," says James Hamblin at The Atlantic. Since the 1970s, surrogacy has been used to help "people with extreme anxiety about sex to gradually work past it," but it's now increasingly used to fulfill the needs or desires of seriously disabled people. That raises a lot of ethical issues, says Hamblin, but it's not at all clear that, as the French ethics board ruled, sexual surrogacy is "unethical use of the human body for commercial purposes." Here's an excerpt:

In advanced stages of illness, love and sexual attraction can grow increasingly disparate. Equating them may actually be problematic for the person whose body may be paralyzed and atrophied, but who is no less loved. Were the practice [of sexual surrogacy] more open and mainstream, and for a long while professionally conducted, would concerns over stigma dissipate?

Near the end many of us will pay for people to help us walk, put food in our mouths, change our diapers. We'll lose our relationships that afford close physical contact.... Surrogacy does not replace a loving relationship, and it shouldn't be expected to. We don't refuse the help of a physical therapist because it won't be as good as having never gotten hit by a bus to begin with. When real love is on the table, take it. When the table is missing, or someone's axed the legs, then there are surrogates.

Read the entire article at The Atlantic.

Bagged salad eyed as source of cyclospora outbreak

A bagged salad mix is being investigated as a source of the cyclospora stomach bug outbreak that has caused hundreds of cases of diarrhea.

As of July 29, 372 people have developed a cyclospora infection, or cyclosporiasis, the Centers for Disease Control and Prevention announced Tuesday. Cases have been found in at least 16 states: Iowa, Texas, Nebraska, Florida, Wisconsin, Illinois, Georgia, Missouri, Arkansas, Connecticut, Kansas, Minnesota, New Jersey, New York, and Ohio.

The most cases -- 143 -- have been reported in Iowa. An investigation by the Iowa Department of Public Health has implicated a prepackaged salad mix as the source of the state's outbreak. Investigators determined that about 80 percent of the cases had been exposed to this same type of prepackaged salad mix.

Health officials have not revealed the brand or manufacturer of the mix, but have said it contains iceberg and romaine lettuce, carrots and red cabbage. The salad mix is no longer in Iowa's food supply chain, the health department said.

Federal health officials have yet to conclude this bagged salad is responsible for the nationwide outbreak,

FDA proposes stricter food safety rules for imports CDC: Cyclospora parasite behind more than 275 illnesses Cyclospora case count climbs to 353, outbreak's source still unknown "FDA will continue to work with its federal, state and local partners in the investigation to determine whether this conclusion applies to the increased number of cases of cyclosporiasis in other states," the agency said in a statement. "The goal will be to combine information collected from other affected states with that provided by the state health authorities in Iowa to identify a specific food item linked to the illnesses."

The FDA added it is following other leads as well. A seven-person team at the agency's headquarters is working to solve the outbreak.

"This is labor intensive and painstaking work, requiring the collection, review and analysis of hundreds and at times thousands of invoices and shipping documents," the FDA said.

Cyclosporiasis is caused by the parasite, cyclospora, found in contaminated food or drinking water.

Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University, previously told CBS This Morning Thursday that cyclospora is a "tenacious critter because it can produce a prolonged, watery, very uncomfortable diarrhea" in addition to other symptoms like cramping, bloating, gas, nausea and fatigue.

Iowa health officials said the diarrhea can last up to 57 days.

The Food and Drug Administration urges people to practice safe food handling and preparation, including washing hands, utensils and surfaces with hot, soapy water before and after handling foods.

Rep. Beutler's "miracle" baby: What is Potter's sequence?

Rep. Jaime Herrera Beutler, R-Wash. has welcomed a 2 lbs., 12 ounce "miracle" baby.

Abigail Rose Beutler was born on July 15 at Emanuel Legacy hospital in Portland. The infant suffered from a severe form of Potter's sequence as a fetus, and was not expected to live long after birth.

However, the two-week-old infant is reportedly thriving in neonatal intensive care unit at Lucile Packard Children's Hospital in San Francisco. Not only does the infant seem to be in stable condition, but she is breathing on her own -- something that doctors say has never have been seen before in a patient of her condition.

Potter's sequence or syndrome is a condition that occurs when the fetus experiences kidney dysfunction or failure while in the womb. In Abigail's case, she had developed without kidneys.

Dr. Charles Kwon, director of the Center of Pediatric Nephrology at the Cleveland Clinic, explained to CBSNews.com that the fetus' kidneys are especially important in the second trimester of pregnancy because they maintain the balance of amniotic fluid. The protective fluid that surrounds the fetus while it is growing is mostly made up of the fetus' urine during this time, and if the fetus' kidneys cannot function, the fluid levels dip dangerously low.

There are no established rates on the condition because most of these children die in utero and may not be diagnosed with the condition before their demise, Kwon added.

Potter's sequence patients could end up having cosmetic issues due to the lack of amniotic fluid, including a flattened nose and ears and some restriction of their limbs. The most concerning part of the defect -- besides the lack of kidney function -- is that the lungs do not fully develop. Without amniotic fluid for the fetus to breathe, the lungs cannot expand and do not grow.

Beutler explained on her Facebook page that she was given two choices by her original doctors: terminate the pregnancy or do "expectant management," meaning wait for the child to die. They decided to pray and search for other options.

A perinatologist at Johns Hopkins, Dr. Jessica Bienstock, suggested that they attempt to re-fill the amniotic sac with a saline solution in order to reconfirm the diagnosis. With the added fluid, doctors were able to see the child's cosmetic defects which included a deformed chest and head. Her doctors came to the same conclusion, but asked Beutler to return after a week.

When Beutler returned, doctors were surprised to find that there was still some of the saline and amniotic fluid left and that the child's head and chest seemed to be developing more normally. Beutler asked for another injection of saline. While there were risks like infection that came with the procedure, Bienstock agreed that there might be some added benefit for the fetus and she performed the infusion.

The process was repeated until Beutler had been injected with saline five times. Then, she went into labor. Four days after trying to stall delivery, Abigail was born. Despite her medical team's worries, she surprisingly drew breath in her lungs and cried, Beutler recalled.

"This case is unprecedented," Bienstock,who is also a professor of maternal-fetal medicine in the Department of Gynecology and Obstetrics at the Johns Hopkins University School of Medicine, said in a press release. "It would be premature to say bilateral renal agenesis (failure of both kidneys to develop) should always be treated using serial amnioinfusion, but this suggests it can be part of the conversation when that is the diagnosis. Hopefully, science will evolve to the point where we will be able to save babies with this defect. But so far, this is just one isolated case whose ultimate outcome is still unknown."

Kwon, who didn't assist in Abigail's case, added that there have been some children who have Potter's sequence who have survived. These babies normally have some limited kidney function, and their situation is nowhere as dire as Abigail's. This is the first case he has heard of in which the child has survived past a few moments after birth. Other doctors concurred that this is the first time that a child who did not have both kidneys develop was able to breathe on their own, Beutler said.

"This (amniotic fluid infusion) had been attempted, but this case seems to be the most successful," Kwon said.

Because she had no kidneys, Abigail is currently receiving dialysis. The process is not impossible to do in infants, Kwon explained, but it does come with added risks because of her young age.

Kwon said the next steps are to watch Abigail's lung development and get her to a size where she can receive a kidney transplant. In order to provide her with the greatest chance for success, she will need to receive an adult kidney, which ranges in size from 10 to 12 centimeters.

For most children, this means reaching about 15 to 20 pounds in weight. This milestone is usually met around age 1, but can happen as early as nine months.

"They (the babies) need to have an abdomen big enough to accommodate a relatively large organ," Kwon explained.

Beutler wrote that they have every hope that Abigail will be able to make it to that day.

"Although Abigail will need ongoing care after she comes home, we have every expectation that she will lead a full and healthy life," she said.

13-year-old dies at Sacramento camp from peanut allergy despite receiving medicine

SACRAMENTO, Calif.A 13-year-old with a peanut allergy died at a popular summer camp in Sacramento after taking a bite of a Rice Krispies treat containing peanuts.

Natalie Giorgi died Saturday in her father's arms at Camp Sacramento after eating the snack, even after her parents administered multiple doses of medicine, the Sacramento Bee reported.

Natalie Giorgi died Saturday in her father's arms at Camp Sacramento after eating a Rice Krispies treat that contained peanut butter, CBS Sacramento reported.

/ CBS Sacramento

The treat was iced with chocolate and peanut butter, CBS Sacramento reported.

A family friend told the Bee that Giorgi was diligent about her allergy, and spit out the treat right away after tasting peanuts.

"She never put any dessert or anything that was questionable into her mouth without consulting someone," said Augusta Brothers, the family friend.

Giorgi found her mother, who gave her a dose of Benadryl and monitored her. For a short time the girl seemed fine, but 20 minutes later she had trouble breathing.

Her father, a doctor, administered an EpiPen, which contains epinephrine, three times before she stopped breathing.

The sheriff's office cited laryngeal edema, or a swelling in the throat, as the cause of death.

Giorgi's parents, Louis and Joanna Giorgi, hoped their daughter's death would focus attention on the dangers of food allergies.

"While our hearts are breaking over the tragic loss of our beautiful daughter Natalie, it is our hope that others can learn from this and realize that nut and food allergies are life-threatening," the couple said in a statement. "Caution and care for those (afflicted) should always be supported and taken."

TheCenters for Disease Control and Prevention estimates that about 3 million American children under the age of 18 had some type of food allergies in 2007.

Most result from exposure to eight kinds of foods: eggs, milk, peanuts, tree nuts, soy, wheat, shellfish and fish.

Peanuts are the most prevalent allergen in food allergic children, followed by milk and shellfish, according to the American Academy of Allergy, Asthma & Immunology. Reactions could range from minor irritation to life-threatening anaphylaxis, a dangerous immune system reaction that requires immediate treatment with an EpiPen and trip to the emergency room.

Symptoms may include skin reactions like hives, redness or swelling or itching and tingling in the mouth and throat, digestive problems like diarrhea, cramps or vomiting, tightening of the throat, shortness of breath and runny nose, the Mayo Clinic notes.

Being born in United States raises allergy risk, study suggestsClassifying food allergies as disabilities could make restaurants more liable N.Y. student attends class remotely via robot Linda Tucker, a Sacramento city spokeswoman, said in a statement to the Bee that "staff is not aware of a death of a camper ever (before) occurring in its 90 year-plus history. The city added, "Our thoughts are with the family."