Health

Here's what you're really getting when you buy cage-free, vegetarian or the new California-certified varieties

Whether you like your eggs sunny side up or hard-boiled, deciphering the claims on the carton has never been such a scramble. You’ve already seen everything from “organic” to “Omega-3-enriched.” Now, there’s a new designation that debuted on January 1, when California began requiring all eggs sold there to come from hens with room to move around without bumping into each other. While the law technically applies only to the Golden State, the new labeling is already popping up on eggs sold across the country.

No matter which variety of egg you choose, remember that all are good sources of protein (6g per) as well as choline and lutein, which promote brain and eye health, respectively. There’s no nutritional difference between brown and white eggs, and you can eat one—or two, depending on who you ask—per day, yolks included, without running up your cholesterol. (Check out “Should I Eat Eggs?” for more on this.)

Here’s your cheat sheet to popular label claims, some of which come with legal definitions and health benefits—and some of which do not.

“Omega-3″: This label claim comes when these fatty acids, linked to heart, brain and eye health, are fed to hens in the form of flaxseed, algae or fish oil. A regular egg has about 30mg of Omega-3s, while an “enriched” one can have as much as 350mg. “That might make it a tad healthier,” says Keri Gans, RD, a dietitian in New York, “but you are probably better off eating lots of fish, nuts and seeds.” While the FDA regulates egg labeling and requires truthfulness, it typically only checks if there is a complaint.

Organic: These eggs must come from uncaged hens that have access to the outdoors and are fed a diet grown without synthetic pesticides or fertilizers. Unlike most other label claims, which are voluntary and without strict legal definition, USDA certification for organic eggs is mandatory for producers with more than $5,000 in annual sales. Farms get inspected regularly for compliance. “Organic does mean something,” says Pat Curtis, a poultry scientist at Auburn University.

Vegetarian: This voluntary label means that the hens are not fed any animal protein and have a diet typically consisting of corn and soybeans. Interestingly, free-range chickens are unlikely to be 100% vegetarian because birds are scavengers, notes Purdue University poultry scientist Todd Applegate. That means they will naturally seek out worms, bugs and larvae found outdoors. That’s why, the Humane Society says, “This label often signifies that the hens spend no time outside foraging.”

Cage-Free: Chickens raised in cage-free environments stay indoors but have unlimited access to food and water. “They can be packed in as tightly as on the subway, but they are not in a cage,” notes Gans. While no federal regulations define how much space cage-free chickens get, industry groups such as the United Egg Producers offer voluntary certifications requiring that each bird has at least one square foot of space – more than twice as much as hens in standard “battery cages” – along with perches and nesting areas for laying eggs.

Free-Range: “These chickens have a shelter but can go outside,” explains Mayo Clinic dietitian Katherine Zeratsky. There are no regulations on how long the birds stay outside—just that they can if they want to. Free-range hens with eggs that are “Certified Humane,” meanwhile, must have access to at least two square feet of outdoor space for up to six hours a day. And while cage-free eggs were shown in a study to have slightly higher Omega-3 levels (thanks to those worms and insects they forage outside), “the difference would have no impact whatsoever on humans,” notes study author Ken Anderson of North Carolina State University.

California Shell Egg Food Safety Compliant: Enacted on January 1, the new state regulation means that eggs sold in California must come from hens that have enough room to lie, stand, turn around and spread their wings without touching another bird. State farm inspectors check cage sizes and animal control officers can cite violations, which are misdemeanors. Cartons may use the abbreviation “CA SEFS COMPLIANT” to indicate compliance.

Pasture-Raised: There’s no federal regulation for the term “pasture-raised,” but many farmers who use this claim appear to raise their birds in lush, open spaces. Whereas free-range birds may get only a few feet of outdoor space, pasture-raised hens get more than 100 square feet each on fields where they can forage on plants and insects. Nutritionally, however, pasture-raised eggs have not been shown to be any different from factory-farmed ones.

That’s only if current hospitalization rates continue, say researchers

Understanding the ebb and flow of the Ebola outbreak that erupted in West Africa last year—and continues to percolate in the three hardest hit countries—is critical to stopping it. That means knowing who’s getting infected, where the highest rates of transmission are occurring and which strategies work best to control its spread.

Scientists initially thought that even if almost every infected person could be hospitalized, it wouldn’t stop the rapid spread of the Ebola virus for months to come. But researchers in the U.S. are now predicting in the journal PLOS Biology that the epidemic in Liberia, which at one point had the biggest explosion in Ebola cases, could peter out by June 2015.

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In coming up with their predictive models, the researchers, led by John Drake University of Georgia, took into account data from previous outbreaks of Ebola, as well as probabilities about infection rates among healthcare workers, family members of the infected and those who are exposed to the virus during burials.

In order for Liberia’s Ebola outbreak to end, new hospital beds would have to be added at the same current rate (300 were provided between July and September 2014), the study authors concluded. That would allow 85% of infected patients to be treated with the nutritional and hydration therapy that is critical to overcome the infection. If new beds aren’t continually added, then hospitalization rates could drop back down to 70%, and cases may start to outpace public health workers’ ability to contain the disease.

MORE: U.N. Official Says Ebola Can Be Beat in 2015

Burial practices need to change as well. Cultural norms include touching the bodies of the deceased, which spreads the Ebola virus in a community. Safer burial practices, in which infected patients are isolated from healthy people, are keeping transmission levels under control, the authors say.

MORE: Ebola Vaccine Is Safe and Effective, According to First Study

The key to reducing the number of Liberia’s Ebola cases by summer is ensuring that anyone who is sick is hospitalized. “These modeling exercises suggested that in the absence of rapid hospitalization of most cases, none of the proposed scenarios for increasing hospital capacity would have been likely to achieve containment,” the authors write. “Continuing on the path to elimination will require sustained watchfulness and individual willingness to be treated.”

The United States may no longer be the leader in medical research due to lack of funding

Funding for medical research in the United States is in a sorry state, but other parts of the world are experiencing the opposite, according to a new study published Tuesday in the journal JAMA.

Limited funding is one of the reasons there was no Ebola vaccine approved when the current outbreak got so bad and it’s why already hard-to-fund research for infectious diseases and addiction don’t often make it to clinical trials. For decades the U.S. was responsible for over half of the world’s total funding for medical research. But looking at funding for U.S. and international research from 1994 to 2012, the study authors found current trends are telling a different story.

Research funding from the United States dropped from 57% of the global pool in 2004 to 50% in 2012. Asia on the other hand tripled its investment in research over the same period, from $2.6 billion in 2004 to $9.7 billion 2012. America also experienced a drop in its share of life science patients, with its share of highly value patents filed by American inventors dropping from 73% to 59% from 1981 and 2011.

Overall, research funding in the United States has dropped 0.8% every year from 2004 to 2012.

The data shows that globally, most countries are cutting back. But the United States used to have a unique edge when it comes to science innovation and funding.

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The researchers argue that the United States needs to start looking for other ways to fund research, whether it be through taxes, tax breaks or the adoption of bonds for biomedical research, in a similar way to how bonds have helped build environmentally sustainable infrastructure. In a corresponding editorial, Dr. Victor J. Dzau, the president of the Institute of Medicine, and Dr. Harvey V. Fineberg, the presidential chair of University of California, San Francisco, say researchers themselves need to be part of the solution too. They write: “It is the responsibility of the research community to ensure that money for research will be used effectively and efficiently. A first step is to reduce redundancy and duplication of research through better grant selection and coordination.”

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Ultimately, if the United States wants to maintain its standing as a leader in medical innovation, it needs to start considering non-traditional approaches to research funding, the authors say. They add that even public support has dropped for biomedical research, being replaced with concerns like domestic security, immigration and the economy, possibly due in part to the fact that in the public eye, there haven’t been many breakthroughs in areas like cancer and Alzheimer’s disease.

“Given global trends, the United States will relinquish its historical innovation lead in the next decade unless such measures are undertaken,” the authors conclude.

Be on the look out for these work-related waistline expanders

Packing on pounds while climbing the corporate ladder? You’re in good company: in a 2013 Harris Interactive survey of more than 3,000 workers conducted for CareerBuilder, 41% of respondents said they’d gained weight in their current jobs. Workers who spend long hours sitting at a desk (like administrative assistants) and have high stress levels (like engineers and teachers) were more likely to have gained weight.

The truth is, there are lots of reasons your work could be affecting your waistline. “It really has to do with diet, physical activity, and behavior,” says Katherine Tryon, a medical doctor with the Vitality Institute, a global research organization based New York City. Here are some potential factors, and how to steer clear of their consequences.

Hours of sitting

The most obvious cause of work-related weight gain is the lack of physical activity many employees get from (at least) 9 to 5, and in the CareerBuilder survey, workers pointed to “sitting at my desk most of the day” as the number-one reason for their expanding waistlines. Though it’s true that research shows people who stand or walk throughout the day burn more calories, which can translate to fewer pounds gained over time, a 2013 British study failed to find a strong link between time spent sitting and obesity. The authors say that while sedentary behavior certainly doesn’t help, there are clearly other factors fueling weight gain as well.

Your long commute

In addition to time spent at a desk, the average American spends 25.4 minutes commuting to work and then again to get home, according to the US Census Bureau, and the American Community Survey shows that 86% of workers commute by car. Those who take public transportation to and from work tend to have lower BMIs than those who drive or ride in a car, found a 2014 study published in the British Medical Journal, as do those who walk or ride their bikes. “Businesses need to think about ways to turn commuting into a healthy activity, like offering bike racks and showers to their employees,” says Dr. Tryon.

On-the-job stress

Boss on your case again? Try not to freak out: High levels of the stress hormone cortisol can trigger fat and sugar cravings, and can also cause the body to hang onto fat and store it around the midsection. And a 2014 German study found that work-related stress is a risk factor for type 2 diabetes.

You may also feel like you need to forget healthy habits in order to get ahead, says Frances Largeman-Roth, RD, author of Eating in Color. “Maybe you used to go for a walk at lunch but then you change jobs or get a promotion, and suddenly all eyes are on you,” she says. “You may feel like your daily break from the office is no longer acceptable, so you put in the extra time and your weight suffers.”

HEALTH.COM: 11 Reasons Why You’re Not Losing Belly Fat

Late nights

Employees who burn the midnight oil to meet deadlines or keep up with heavy workloads may also blame their restricted sleep schedule for excess weight gain. In a 2013 University of Pennsylvania study, adults who got only four hours of shuteye a night for five nights in a row gained more weight than those who got eight hours, thanks to the extra meals (and higher-calorie foods) they consumed during late-night hours.

Adults who work multiple jobs, who start work early in the morning, or who commute longer distances are more likely to go without full nights’ sleep, according to a 2014 study also by University of Pennsylvania researchers. The authors suggest that flexible start times may help workers get more sleep overall.

Your lunch options

People who work in or commute through neighborhoods with a lot of drive-thrus are more likely to stop at them, and they’re also more likely to have higher BMIs, according to a 2014 British study. In fact, the study group with the most exposure to takeout joints on the way to and from work was almost twice as likely to be obese, compared to those with who were least exposed. “If you don’t have healthy lunch options nearby, you may need to make a real effort to prepare and pack your own food ahead of time,” says Largeman-Roth.

Lack of wellness programs

Dr. Tryon’s own research suggests that employers have a unique opportunity to improve public health by offering incentives and tools, like reduced insurance premiums and weight-loss support groups. But a 2014 research review from Hampshire College found that only 25% of large companies, and only 5% of small businesses, offer comprehensive wellness programs. Why? Companies say the programs cost too much and that they don’t want to meddle in their employees’ business.

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Candy jars and freebie tables

In any office, there’s someone who always keeps a bowl of candy out, says Largeman-Roth, and if you’re a dieter or a binger or a stress eater, that person is the enemy. “We know that when you put something delicious out on prominent display, people are going to eat much more of it than if it was tucked away in a desk drawer out of sight.” The same goes for the leftover desserts or doughnuts lurking in the kitchen, she adds. “If there’s a common area for sweets and you know it’s a weakness, you may need to steer clear and not let yourself be tempted.”

Coworkers’ eating habits

If you frequently go to lunch with your colleagues, their unhealthy dietary choices may rub off on you. A 2014 review study published in the Journal of the Academy of Nutrition and Dietetics found that people tend to conform to “eating norms” in social settings. In other words, if you know other people are ordering high-fat foods, you’re more likely to do the same. This makes sense, especially in a work setting, says Largeman-Roth. “You want to fit in—no one wants to be known as the girl who only eats tofu or drinks green smoothies, so you go along with the crowd even if it’s not what you’d normally order,” she says.

Constant office parties

If your workplace is the type that marks every single birthday, anniversary, and promotion with cake and cookies, watch out: Nearly one in five respondents to the CareerBuilder survey said that these celebrations contributed to their weight gain.

“Employers may see these events as fun perks that boost company morale, so it can be quite controversial to suggest that they may not be so good for their health,” says Dr. Tryon. “The challenge here is in finding ways to celebrate and reward workers that doesn’t necessarily involve forcing sugary foods on them.”

HEALTH.COM: 11 Foods That Make You Hungrier

The vending machines

When you’ve got back-to-back meetings and even the cafeteria is too far away, the vending machine can be your savior—at least temporarily. But most of those packaged snack options are high in calories and low in nutrients, says Largeman-Roth.

Instead, try to keep healthy snacks like apples or fruit-and-nut bars at your desk. Before you give into a soda craving, drink a glass of cold water. (Chances are you don’t actually need the caffeine, not to mention the calories.) And if you must visit the vending machine, opt for a small pack of unsalted nuts or trail mix, which has protein and healthy fats to fill you up.

The elevator

When’s the last time you took the stairs at work? Taking the stairs, even if that means changing into sneakers on your lunch break or getting off the elevator a flight or two early in an office high-rise, can add valuable calorie-burning steps to your day, says Dr. Tryon. Employers should take note, too. “Simple environmental changes, like lighting stairwells to make them more appealing for people to use, can create a healthier environment and healthier workers,” Dr. Tryon says.

Lack of sunlight

If you work in a windowless cubicle and you arrive at work before the sun comes up, you could be missing out on a powerful, all-natural weapon against obesity. A 2014 Northwestern University study found that exposure to the sun was associated with BMI, and that getting bright light in the morning hours seemed to have a slimming effect. Light helps to regulate circadian rhythms, which in turn regulate energy balance and expenditure, say the study authors. They suggest getting 20 to 30 minutes of sunlight between 8 a.m. and noon each day to avoid unwanted weight gain—yet another argument for walking to work or taking that mid-morning break!

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Business trips

All the wining-and-dining on business trips can add up: dinners on the company tab, lavish meals with clients or associates, and the lure of regional cuisine are all likely to trigger overeating, even for someone who’s normally very healthy at home, says Largeman-Roth. Plus, traveling for work two weeks or more a month was linked to higher BMI, higher rates of obesity, and lower self-reported health in a 2011 Columbia University study. The authors note that 81% of business trips are taken in cars, and that travelers are likely sitting for long hours and making poor food choices.

Overnight shifts

Night-shift workers may be at an even higher risk of obesity than daytime desk jockeys, according to a 2014 University of Colorado at Boulder study. Researchers found that participants burned fewer calories over a three-day period when they slept during the day and stayed up (and ate) through the night than when they followed a normal schedule. The body’s circadian clock can shift over time, the researchers say, but because shift-workers tend to revert to a normal schedule on their days off, their bodies never fully adapt to their work schedules.

Distracted eating

Eating at your desk every day works against your waistline in more ways than one. Not only do you miss out the exercise you would have gotten by walking a few blocks to the sandwich shop, but you’re likely missing out on the full experience of eating. “You’re multitasking—answering emails, making phone calls, doing online shopping—and you’re not focusing on the enjoyment or the fulfillment of your food,” says Largeman-Roth. “And an hour later, you’ve almost forgotten you ate lunch and you’re already grabbing something else, not realizing you just had a full meal.”

HEALTH.COM: 13 Comfort Foods That Burn Fat

Your digital devices

Job-related obesity triggers don’t always disappear when you leave the office. In an ever-connected society, many employees find themselves tied to a mobile phone even in their so-called off hours, making it harder for them to escape work stress and demands.

Frequent use of these devices has also been linked to increased rates of sedentary behavior, which can in turn lead to unwanted weight gain. In a 2013 Kent State University study, people who used their cell phones most often were also most likely to forego opportunities for physical activity.

Happy hours and networking events

In many offices, after-work drinks are an expected part of the job—it’s where you bond with your coworkers, earn points with your boss, or blow off steam when a project doesn’t go your way. “You feel like you can’t say no, because you don’t want to be the person who’s killing the party,” says Largeman-Roth.

But calories from alcohol—and from those appetizers Susie in accounting just ordered for the table—can add up quickly. And because booze lowers inhibitions and stimulates appetite, the more you drink, the harder it will be to resist those pre-dinner snacks.

This article originally appeared on Health.com.

A new federal report reveals holes in how we treat chronic pain

Jeffrey Kluger is Editor at Large for TIME.

The happiest place on Earth catches a bad case of measles—and the usual suspects are to blame

Somewhere in Orange County, Mary Poppins may be running a fever. The same could be true for her coworkers—an unsuspecting Ariel, say; a suddenly swoony Goofy or Pluto or any of the other 23,000 people (OK, or characters) who punch in for work at Disneyland every day. And the same could be true too for any one of the estimated 16 million people who will pour into the theme park this year.

The reason? Measles. The cause? This may not come entirely as a surprise: the anti-vaccine crowd.

Just when you think they’ve been run to ground, shamed into silence, and just when you can watch a whole evening of Jenny McCarthy co-hosting the New Year’s Eve celebration in Times Square and not hear her utter a word of unscientific nonsense, the anti-vaxxers come roaring back. Less than two weeks into 2015 come the year’s first stories about the latest victims of the nation’s declining vaccine rate. And this time, ground zero is the self-proclaimed Happiest Place on Earth, which is in danger of becoming the decidedly less consumer-friendly Most Expensive Disease Vector on Earth.

The epidemiological numbers seem small, but the implications are big: from Dec. 15 to Dec. 20, at least 20 people are reported to have have entered Disneyland’s gates healthy and exited with measles. Of those victims, 15 were unvaccinated. Those infections occurred in a year in which California as a whole had its highest measles caseload in two decades—66, with 23 of them in Orange County. The U.S. recorded 610 cases total in 2014, triple the number as recently as 2011.

It’s no coincidence, as TIME has reported, that the areas of the country with the highest vaccine refusal rates—Orange County; New York City; Columbus, Ohio; Silicon Valley—have higher rates of outbreaks of vaccine-preventable diseases, too. What gives the anti-vaccinators so much power to do so much harm is that once vaccine rates fall below 95%, herd immunity—the protection that a well-vaccinated community offers to the few people in its midst who must remain unvaccinated for legitimate medical reasons—starts to break down. In 2012, California was right at that baseline 95% vaccination rate for measles and whooping cough. It’s now at 92%.

Those small percentages can make huge differences. In 2003, a few provinces in northern Nigeria banned polio vaccines, when local religious leaders claimed the drops were designed to sterilize Muslim girls and transmit AIDS. Within three years, 20 previously polio-free countries recorded cases of the disease—all of them the Nigerian strain.

American anti-vaxxers seem impervious to this and other warning flags, like the ongoing whooping cough epidemic in California or last year’s outbreaks of measles in New York and mumps in Columbus. As the Disneyland outbreak is reported here and here and here and here, the reaction is likely to be more of the same—which is to say denial coupled with a lot of echo-chamber prattle about a bought-off media carrying water for big pharma, plus the usual scattering of glib Twitter code like #CDCWhistleblower, which purports to be final proof of the great vaccine coverup, but which is nothing of the kind.

Hashtag science is not real science, and conspiracy theories have nothing to do with facts. The problem is, children infected with measles—or polio or whooping cough or mumps—are indeed very real. In the age of vaccines, there ought to be no place they feel unsafe—least of all Disneyland.