TIME Heart Disease

A Gut Bacteria Compound Is Linked To Heart Failure

Most Americans know that diet and heart health are connected, but a new study in the Journal of the American College of Cardiology looks at a surprising reason as to why.

When your food gets to your stomach, your gut bacteria get to work. And when those bacteria digest carnitine, which is almost exclusively found in red meat, and choline, found in high-fat dairy products and egg yolks, they produce a metabolite called trimethylamine N-oxide, or TMAO. That’s bad news for your heart, because earlier animal research found that TMAO helps transport cholesterol to the arteries, where it forms dangerous plaques that can lead to heart disease.

Stanley Hazen, MD, PhD, department chair of Cellular and Molecular Medicine at Cleveland Clinic’s Lerner Research Institute, and his team measured the blood levels of TMAO in 720 stable patients with heart failure and followed them over five years, wondering if TMAO would help predict who would be in better shape—and who would be still alive.

It did. TMAO levels predicted mortality rates “very strikingly” over the five-year period: More TMAO in the blood meant a 3.4-fold increased risk of mortality—even after adjusting for all the traditional risk factors, Hazen says.

“It suggests that we’ve now learned a new link in the cause [of heart failure],” Hazen says. “It suggests that the impact of dietary manipulation and changes in gut microbe composition may be a way to impact the development and the adverse prognosis in heart failure.”

TMAO research is still fairly new. Just last year in a study of 2,595 people, Hazen’s team found that meat eaters had higher levels of carnitine and greater risk of heart disease, stroke and heart attack than their vegan and vegetarian peers.

Still, Hazen doesn’t think it’s necessary for everyone to stop eating meat altogether. “What we are now trying to do is come up with a therapy that will prevent formation of TMAO, and hopefully prevent the development of cardiac disease…and the development of heart failure in its adverse prognosis,” Hazen says.

“I like kind of joking around, I’m hoping to come up with the pill that allows me to keep eating steak.”

TIME Diet/Nutrition

Milk Might Not Save Your Bones, Study Says

Glass of milk
Getty Images

Sugars in milk may lead to aging

The bone-strengthening powers of milk have been claimed over and over again in advertisements, pop culture and around the dinner table. But a new study published in the BMJ suggests that the truism may not be true. High milk intake, the study found, doesn’t appear to protect against bone fracture and in fact may lead to increased mortality.

Researchers looked at questionnaires from more than 100,000 people in Sweden on their dairy consumption habits. The study, which followed up with many of the participants after 11 to 20 years, found that high milk intake was associated with higher mortality in both men and women, as well as higher bone fracture in women.

“Our results may question the validity of recommendations to consume high amounts of milk to prevent fragility fractures,” the study says. However, the authors stress that the study is merely observational and not meant to draw causal conclusions.

One possible explanation the authors give for the results is that high levels of the sugars lactose and galactose in milk may cause bones to undergo changes—like inflammation—that resemble aging, leading to the fractures. In animals, supplementing with galactose has been shown to increase aging processes like inflammation and oxidative stress. Data from the study showing a correlation between reduced fractures and low-lactose milk consumption further supports this claim.

More research is needed, of course. “As milk features in many dietary guidelines and both hip fractures and cardiovascular disease are relatively common among older people, improving the evidence base for dietary recommendations could have substantial benefits for everyone,” wrote Mary Schooling, PhD, a professor at the City University of New York, in an accompanying BMJ editorial.

TIME ebola

Scientists Explore 10,000 Compounds for an Ebola Drug

Emory Hospital To Receive American Ebola Patients From Liberia
Dr. Bruce Ribner an epidemiologist and professor in the School of Medicine's Infectious Diseases Division, confirms that Emory University Hospital will be receiving and treating two American patients diagnosed with Ebola virus during a press conference at Emory University Hospital on Aug. 1, 2014 in Atlanta. Jessica McGowan—Getty Images

"Scientists are the only ones who can initiate solving this problem"

Emory University is becoming a one-stop shop for tackling Ebola. The hospital’s infectious disease team has already treated four patients with Ebola, and now a team of biochemists known for their work on HIV wants to take on Ebola.

Scientists at Emory’s Children’s Center for Drug Discovery have extensively studied the development of drugs for HIV that stop the replication of the virus in the body. The center provided breakthroughs for HIV drug development and, more recently, the development of a drug for Hepatitis C. The viruses, though different, have similar replicating mechanisms (viral RNA replication), and now they think they can do it for Ebola.

The team, led by director Baek Kim, is fast-tracking a program to screen a library of over 10,000 chemical compounds that can treat viruses at the molecular level to see if one or more of them may show promise with Ebola. “We need to start screening many, many compounds,” says Kim, anywhere from 500 to 10,000 of them—each of which will be evaluated one by one. Emory chemist Raymond F. Schinazi, who discovered compounds used in multiple very successful anti-HIV drugs, will be working with five to 10 virologists, chemists and biochemists to get the job done.

And if a compound that can treat Ebola is identified and tested on a live virus in a lab, the next step would be to get that compound into a drug of some kind, and then test it in a clinical trial in West Africa.

And while there are ongoing trials in the works for an Ebola vaccine and industry and scientists are racing to find drugs that can treat the virus, Kim’s team and several other research groups nationwide have been eyeing emerging and re-emerging diseases for years. “It’s good to recognize that scientists are the only ones who can initiate solving this problem,” says Kim. “Other pathogens will emerge and re-emerge one day or another, and this is a good exercise in how academics, government and industry can work together toward a single target when we need a fast response.”

TIME Military

Hagel Orders 21-Day Ebola Quarantine for Returning U.S. Troops

A health worker takes the temperature of U.S. Marines arriving to take part in Operation United Assistance on Oct. 9, 2014 near Monrovia, Liberia.
A health worker takes the temperature of U.S. Marines arriving to take part in Operation United Assistance on Oct. 9, 2014 near Monrovia, Liberia. John Moore—Getty Images

Military commanders had recommended that Hagel implement a quarantine

U.S. troops who are returning from Ebola missions in West Africa will be kept in supervised isolation for 21 days upon their return home, Defense Secretary Chuck Hagel said Wednesday.

Military leaders recommended the 21-day quarantine, which goes beyond precautions advised by the Obama Administration for civilians, the Associated Press reports. President Obama has said that the military’s situation is different, however, partly because the troops are not in West Africa by choice.

“The secretary believes these initial steps are prudent given the large number of military personnel transiting from their home base and West Africa and the unique logistical demands and impact this deployment has on the force,” the Defense Department said in a statement.

Hagel said his order was in response to a recommendation sent to him Tuesday by Army Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff. The policy will be up for review in 45 days.

About 1,000 U.S. troops are in Liberia and Senegal supporting efforts to combat and contain the virus. Some returning soldiers were put on a 21-day quarantine earlier this week.

TIME ebola

Hagel Approves 21-Day Ebola Quarantine for Troops

(WASHINGTON) — Defense Secretary Chuck Hagel on Wednesday approved a recommendation by military leaders that all U.S. troops returning from Ebola response missions in West Africa be kept in supervised isolation for 21 days.

The move goes beyond precautions recommended by the Obama administration for civilians, although President Barack Obama has made clear he feels the military’s situation is different from that of civilians, in part because troops are not in West Africa by choice.

Hagel said he acted in response to a recommendation sent to him Tuesday by Army Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, on behalf of the heads of each of the military services. They cited numerous factors, including concerns among military families and the communities from which troops are deploying for the Ebola response mission.

Just over 1,000 U.S. troops are in Liberia and Senegal supporting efforts to combat the virus.

Hagel also directed the Joint Chiefs to provide him within 15 days a detailed implementation plan for how the supervised isolation of troops will be applied.

He also ordered the chiefs to conduct with 45 days a review of this new regimen, which Hagel called “controlled monitoring.”

“This review will offer a recommendation on whether or not such controlled monitoring should continue based on what we learn and observe from the initial waves of personnel returning from Operation United Assistance,” Hagel’s spokesman, Rear Adm. John Kirby, said in a written statement, using the official name of the military mission against Ebola in Africa.

“The secretary believes these initial steps are prudent given the large number of military personnel transiting from their home base and West Africa and the unique logistical demands and impact this deployment has on the force,” Kirby added. “The secretary’s highest priority is the safety and security of our men and women in uniform and their families.”

The Army, acting on its own, put a small number of returning soldiers on a 21-day quarantine in Italy earlier this week.

TIME Mental Health/Psychology

You Asked: Is Scaring Myself Healthy?

Illustration by Peter Oumanski for TIME

A little boo is good for you

For most people, a scare provides more treats than tricks.

When Michael Myers pops up behind Jamie Lee Curtis, your heart beats faster, your pupils dilate and your muscles tense in preparation for action, says Dr. Margee Kerr, a sociologist who studies fear and the ways it haunts our bodies and minds. This happens because fear floods your brain with “a powerful chemical punch” of fight-or-flight hormones and neurotransmitters, she says. Those include endorphins and dopamine—feel-good chemicals that dull pain, excite your mood and create an incredible natural high similar to falling in love (or doing some illicit drugs).

“Even though you knew you were never really in danger, you still feel a sense of euphoria after making it through a frightening event,” says Kerr, who also works with the design team of a haunted house in Pittsburgh called ScareHouse.

When you’re freaked out, your body also starts pumping out a bonding chemical called oxytocin—the same hormone that mothers produce during childbirth. This can make a frightful experience a fantastic way to solidify friendships and other social relationships. “Watch people walking out of a haunted house, and you’ll see lots of smiles and high fives,” Kerr says. Strong social connections have been linked to dozens of health benefits, including a longer life. And friends who are scared together, stay together, she adds. (Lovers, too, so pick the scary movie for a great date.)

There’s even some evidence that experiencing fear can bolster your ability to handle high-stress situations. Whether you’re watching a freaky flick or speaking in public, managing a knee-knocking ordeal builds self-assurance and acclimates your body to high-arousal states. “You become more comfortable with the physical experience of fear, and so you’re better able to work through it during tense situations,” she explains.

In fact, Kerr and colleagues at the University of Pittsburgh are hopeful that exposure to minor sources of fear—like seeing a horror film—could help those suffering from post traumatic stress disorder (PTSD) re-learn how to manage their fear responses in healthy ways. It’s just a hypothesis right now, but if a PTSD sufferer can engage with benign scary experiences and stay in control, he or she may become more comfortable with the deeper sources of their anxieties, she says.

But it’s important to note that not all people respond to freaky situations in healthy ways. “Everyone has a different tolerance level when it comes to fear,” Kerr says. What might be energizing or thrilling to one person might be debilitating to another. “Some people just shut down or are traumatized by their fear,” she adds. This can lead to nightmares, a prolonged inability to sleep, or unhealthy levels of anxiety.

“I worry when I see people being dragged into haunted houses or scary movies,” Kerr says. “They go along because of social pressure, but the type of fear they might experience can create some of these very negative consequences.”

Kerr also says children don’t respond to frightening situations in the healthy ways many adults do. “Kids who are younger than six or seven can’t separate real from make-believe, and seeing something frightening can be really traumatizing,” she explains.

But for many adults, a little scare now and then is a good, healthy way to experience some excitement. It’s just not for everyone. “People know what they enjoy and what they don’t when it comes to fear,” Kerr says. “What you find fun or thrilling, someone else may think is too much.”

TIME ebola

Ebola Nurse Kaci Hickox Plans to Defy Quarantine in Maine

Will challenge her home state's quarantine policy in court if it isn't lifted

The Ebola health worker who was the first person forcibly quarantined under New Jersey Gov. Chris Christie’s controversial health order said Wednesday that she would defy the voluntary quarantine policy of her home state of Maine now that she’s returned there.

In a live interview Wednesday with NBC’s Today, Kaci Hickox said she believes the strict quarantine policy instituted in New York, New Jersey and other states “is not scientifically nor constitutionally just.” Hickox, who helped treat Ebola patients in Sierra Leone, said she will go to court Thursday morning to challenge her quarantine in Maine.

“I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public,” Hickox said. “I do understand that [Ebola] has created a lot of fear, but we still have to make policies based on evidence.”

Maine Gov. Paul R. LePage, who is in a tight race to seek reelection next week, issued a statement Wednesday saying that his office is seeking “legal authority to enforce the quarantine” on Hickox.

“We are very concerned about her safety and health and that of the community,”said LePage. “We are exploring all of our options for protecting the health and well-being of the healthcare worker, anyone who comes in contact with her, the Fort Kent community and all of Maine.”

LePage said that Maine state police are monitoring the residence where Hickox is staying in Fort Kent “for both her protection and the health of the community.” Reporters confirmed police were parked outside on Wednesday.

Christie and New York Gov. Cuomo hastily announced a plan on Friday night to quarantine all health workers returning from West Africa who, like Hickox, had dealt with Ebola patients. Other states, including Maine, have introduced similar, though less stringent measures.

The policy in New York and New Jersey, which went beyond the Centers for Disease Control and Prevention’s guidelines and was strongly criticized by the medical community and the Obama administration, was instituted after another health worker, Dr. Craig Spencer, developed Ebola symptoms in New York City after returning from west Africa.

Hickox, who has returned home to Ft. Kent, Maine after being quarantined briefly in New Jersey, said she does not plan on sticking to the guidelines for the full 21-day period, but will continue to monitor her own health.

“You know, I don’t plan on sticking to the guidelines,” she said on NBC. “I remain appalled by these home quarantine policies that have been forced upon me, even though I am in perfectly good health and feeling strong and have been this entire time completely symptom-free.”

Doctors Without Borders, the organization that employed Hickox, issued a strongly worded statement Wednesday condemning blanket quarantines for healthcare workers. “Such a measure is not based upon established medical science,” the organizaton said in a statement. Doctors Without Borders “respects Kaci’s right as a private citizen to challenge excessive restrictions being placed upon her.”

Read next: Why Christie’s Ebola Quarantine Gambit Backfired

TIME Diet/Nutrition

The Best Fat-Burning Breakfasts

blueberry oat pancakes
Jennifer Causey—Getty Images/Flickr RF

Nutrient-packed meals that'll keep you full until lunch

You know that eating breakfast jump-starts your metabolism. But did you realize that certain a.m. choices can crank up your fat-burning even more?

The key: eating a breakfast that’s high in Resistant Starch (RS). Found in foods like bananas and oats, RS actually signals your body to use fat for energy.

Start your day skinny with these fat-burning meals from Health’s book, The CarbLovers Diet.

Blueberry Oat Pancakes with Maple Yogurt

Resistant Starch: 4.6g
Ingredients: Old-fashioned rolled oats, low-fat cottage cheese, eggs, vanilla extract, blueberries, cooking spray, Greek-style low-fat yogurt, maple syrup
Calories: 410
Watch the video: Blueberry Oat Pancakes with Maple Yogurt
Try this recipe: Blueberry Oat Pancakes with Maple Yogurt

Banana and Almond Butter Toast

Resistant Starch: 5.6g
Ingredients: Almond butter, rye bread, banana
Calories: 280
Watch the video: Banana & Almond Butter Toast
Try this recipe: Banana and Almond Butter Toast

Breakfast Barley with Banana and Sunflower Seeds

Resistant Starch: 7.6g
Ingredients: Water, pearl barley, banana, sunflower seeds, honey
Calories: 410
Try this recipe: Breakfast Barley with Banana and Sunflower Seeds

In a Rush?

Reach for a Resistant Starch-packed banana and one of these on-the-go options—you’ll still get the healthy carbs and calories you need to start your day in slim-down mode!

Order to go!
• Panera Bread Strawberry and Granola Parfait: 310 calories
• Dunkin’ Donuts Ham, Egg White, and Cheese Sandwich on a Wheat English Muffin: 300 calories
• Jamba Juice Coldbuster Smoothie (16 ounces): 250 calories

Keep a stash in your kitchen:
• Aunt Millie’s Whole-Grain Blueberry Muffins: 170 calories
• Kashi TLC Pumpkin Spice Flax Crunchy Granola Bar: 170 calories
• Amy’s Kitchen Breakfast Burrito: 270 calories

Insider secret

Choose a banana that’s tinged with a little green for even more Resistant Starch. Once the fruit ripens, the starches in it turn to sugar, and the amount of Resistant Starch it contains drops.

An underripe banana has 12.5 grams of RS (enough to take care of the minimum 10 grams of RS daily that’s recommended in The CarbLovers Diet); a ripe one has 4.7 grams.

This article originally appeared on Health.com.

More from Health.com:

13 Comfort Foods That Burn Fat

The 20 Best Foods for Breakfast

11 Reasons Why You’re Not Losing Belly Fat

TIME Asia

Learning From Past Viral Epidemics, Asia Readies for Possible Ebola Outbreak

Philippines Ebola
Government health workers practice wearing Ebola protective suits on the first day of training on hospital management for Ebola virus at the Research Institute for Tropical Medicine in the Philippine city of Muntinlupa on Oct. 28, 2014 Bullit Marquez—AP

Recent experiences with SARS and bird flu make Asian nations especially skittish when faced with the possibility of an Ebola outbreak

As Ebola continues to play global hopscotch, Asian countries are seeking to make good on the advanced notice that the deadly virus could turn up anywhere, anytime.

At issue in Asia — and everywhere — is not just that medical scaffolding varies across and within nations, with some lacking robust medical facilities, but that even sophisticated cities boasting top-notch hospitals are foundering. The infections of two health care workers in Dallas, as well as a nurse in Madrid, have illustrated that even highly developed nations are not immune.

“Perceived preparedness and actual preparedness are not the same thing,” says Stephen Morse, professor of epidemiology at the Columbia University Medical Center.

“We thought the U.S. would be well prepared, but certainly our first case [in Dallas] was not a good model for replication, and I don’t think Spain did too well either,” explains Morse. “But that’s what happens when you haven’t seen this before. You don’t know what to do.”

Still, Asia has some advantages as it readies itself for Ebola. Flight patterns suggest that the influx of travelers from Ebola-stricken West African countries to the Asian continent is far less than it is to Africa, Europe or North America.

Asian nations also have an edge in that they have been through epidemics before: SARS tore through the West Pacific in 2003, killing almost 800 people worldwide, mostly in Hong Kong and mainland China. Avian flu also pummeled this area around the same time, and outbreaks of virulent influenza strains perennially menace the region.

“The most likely scenario, if we have an imported case of Ebola, is that there will be some risk of having secondary cases, but I don’t think we will have a big outbreak at this point in time,” says Hitoshi Oshitani, professor of virology at Tohoku University Graduate School of Medicine in Sendai, Japan.

In part, that’s because Ebola is much more straightforward to contain than the airborne SARS — spread through coughing and sneezing — if procedures are followed rigorously, says Oshitani, who from 1999 to 2005 was the regional adviser for communicable-disease surveillance and response at the WHO’s Western Pacific Regional Office during the SARS and avian-flu outbreaks. When SARS first appeared “we didn’t know what to do at first,” he says.

But having weathered these outbreaks now makes Asian nations stronger. “After SARS and Avian flu, Asian countries have invested quite a lot in infectious disease control,” says Oshitani. “Before 2003, many countries in Asia had very limited capacity, and today they have much more capacity.”

That said, much depends on where across Asia’s socioeconomic smorgasbord a hypothetical Ebola case makes landfall.

For example, Hong Kong, blistered by the memory of SARS, has made significant preparations, says Malik Peiris, director of the School of Public Health at the University of Hong Kong. “Infectious diseases, especially diseases coming from the outside, have been a constant threat to Hong Kong and have kept people on their toes,” he says.

Hong Kong, which had just “a handful” of isolation beds in 2003, now has about 1,400, plus a designated infectious disease hospital, says Peiris. At that hospital, he adds, the facilities are “more than adequate to deal with SARS and certainly more than adequate to deal with Ebola.”

Preparing for Ebola is also foremost on health officials’ agendas in mainland China, Peiris says, while noting that health care is uneven across the world’s most populous nation, with world-class hospitals in major cities but spotty health care in rural areas. Dense populations and an incubation period of up to 21 days make Ebola potentially extremely problematic.

Chinese officials told state media in August that security at the airport in China’s southern Guangdong province, which does roaring business with African traders, had been bolstered.

India also presents a problem. Peter Piot, director of the London School of Hygiene and Tropical Medicine who co-discovered Ebola, told the Guardian earlier this month that Ebola outbreaks in Europe or North America could quickly be brought under control. However, “I am more worried about the many people from India who work in trade or industry in West Africa,” he said.

Indian Health Minister Harsh Vardhan told Parliament in August that some 4,700 Indians are working in Guinea, Liberia and Sierra Leone. India is using thermal scanners at its airports similar to those used at Nigeria, which was declared Ebola-free earlier this month. The country has also designated hospitals for handling the virus, and has also held preparedness drills, though a paltry ratio of 0.07 hospital beds per person does not bode well for any significant outbreak.

“The big problem is in high-density populations with low health coverage,” says Peiris. “In Mumbai, you have areas of quite significant poverty, and if Ebola enters such a situation, you could have a problem on your hands. Major cities really need to be prepared.”

The Philippines, boasting an estimated 1,700 nationals working in West Africa, is also bolstering readiness. Lyndon Lee Suy, spokesman at the Philippines Department of Health, says that three hospitals are designated to handle any Ebola cases, plus a training workshop is being run at 19 government hospitals, about 50 private hospitals and numerous local government clinics. All hospitals in the Philippines, which battled SARS in 2003 and H1N1 in 2009, have isolation rooms, he says.

“No country can ever rate how prepared it is for something like this,” says Lee Suy. “But the health system here is not the same as the one in West Africa. We are in a better position.”

Even Asian countries that have no direct flights to West Africa, and have limited ties to the region, are wary of being caught off guard.

Krishna Kumar, president of the Malaysian Medical Association, says his country was jolted by the Nipah virus in 1999, which killed more than 100 people nationwide, and has learned “hard but important lessons.”

“We weren’t expecting it,” he says. “It woke us up.”

Krishna says public alarm is low in Malaysia, but health officials are yet mindful “anything could happen.” All airports have thermal checks, and 28 government hospitals have isolation rooms and are fully equipped with protective gear.

“We have the systems in place,” he says, “but to know how ready you are — well, it’s only when something happens, then you know if you were ready.”

TIME ebola

U.S. Ambassador ‘Blown Away’ by New Ebola Clinic in Liberia

The ambassador is visiting West Africa to draw support for international aid against the Ebola outbreak

The U.S. Ambassador to the United Nations said Tuesday that she was “blown away” by a new American-built clinic in Liberia being used to treat Ebola-infected healthcare workers.

On Twitter, Ambassador Samantha Power also provided one of the first glimpses into a much-needed facility.

Power is traveling across the Ebola-infected countries of Liberia, Guinea and Sierra Leone to demonstrate U.S. support for West Africa and to draw support for international aid, according to a statement by the U.S. Mission to the UN. During her weeklong visit, Power will visit Ebola coordination centers and meet with international and U.S. leaders to discuss international aid efforts.

The new hospital will open in November, with a staff of 65 officers, Power said. The facility will have 25 beds for any healthcare workers who fall ill from Ebola in West Africa, according to the USAID’s blog, which released additional photos of the clinic. USAID added that the clinic, consisting of several tents linked by passageways, was built in the style of military trauma care but was customized to treat highly infectious patients.

The intention to create a separate clinic for ill health workers was announced in September by the U.S. Department of Defense and the U.S. Public Health Service as a means to protect frontline workers, who are often made vulnerable to the virus by the sheer amount of exposure and a lack of resources.

As of Oct. 23, a total of 450 health-care workers have been infected with the virus as of Oct. 23, and 244 have died, according to the World Health Organization. Almost 5,000 have died of the virus in the current outbreak, almost entirely in the affected West African nations hit hardest by the disease, according to WHO estimates.

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