Excitement as trial shows Huntington’s drug could slow progress of disease

Hailed as enormously significant, results in groundbreaking trial are first time a drug has been shown to suppress effects of Huntingtons genetic mutation

A landmark trial for Huntingtons disease has announced positive results, suggesting that an experimental drug could become the first to slow the progression of the devastating genetic illness.

The results have been hailed as enormously significant because it is the first time any drug has been shown to suppress the effects of the Huntingtons mutation that causes irreversible damage to the brain. Current treatments only help with symptoms, rather than slowing the diseases progression.

Q&A

What is Huntington’s disease?

Huntingtons disease is a congenital degenerative condition caused by a single defective gene. Most patients are diagnosed in middle age, with symptoms including mood swings, irritability and depression. As the disease progresses, more serious symptoms can include involuntary jerky movements, cognitive difficulties and issues with speech and swallowing.

Currently there is no cure for Huntington’s, although drugs exist which help manage some of the symptoms. It is thought that about 12 people in 100,000 are affected by Huntington’s, and if a parent carries the faulty gene there is a 50% chance they will pass it on to their offspring.

Prof Sarah Tabrizi, director of University College Londons Huntingtons Disease Centre who led the phase 1 trial, said the results were beyond what Id ever hoped … The results of this trial are of ground-breaking importance for Huntingtons disease patients and families, she said.

The results have also caused ripples of excitement across the scientific world because the drug, which is a synthetic strand of DNA, could potentially be adapted to target other incurable brain disorders such as Alzheimers and Parkinsons. The Swiss pharmaceutical giant Roche has paid a $45m licence fee to take the drug forward to clinical use.

Huntingtons is an incurable degenerative disease caused by a single gene defect that is passed down through families.

The first symptoms, which typically appear in middle age, include mood swings, anger and depression. Later patients develop uncontrolled jerky movements, dementia and ultimately paralysis. Some people die within a decade of diagnosis.

Most of our patients know whats in their future, said Ed Wild, a UCL scientist and consultant neurologist at the National Hospital for Neurology and Neurosurgery in London, who administered the drug in the trial.

The mutant Huntingtons gene contains instructions for cells to make a toxic protein, called huntingtin. This code is copied by a messenger molecule and dispatched to the cells protein-making machinery. The drug, called Ionis-HTTRx, works by intercepting the messenger molecule and destroying it before the harmful protein can be made, effectively silencing the effects of the mutant gene.

How the drug works to slow the progress of Huntington’s disease

To deliver the drug to the brain, it has to be injected into the fluid around the spine using a four-inch needle.

Prof John Hardy, a neuroscientist at UCL who was not involved in the trial, said: If Id have been asked five years ago if this could work, I would have absolutely said no. The fact that it does work is really remarkable.

The trial involved 46 men and women with early stage Huntingtons disease in the UK, Germany and Canada. The patients were given four spinal injections one month apart and the drug dose was increased at each session; roughly a quarter of participants had a placebo injection.

After being given the drug, the concentration of harmful protein in the spinal cord fluid dropped significantly and in proportion with the strength of the dose. This kind of closely matched relationship normally indicates a drug is having a powerful effect.

For the first time a drug has lowered the level of the toxic disease-causing protein in the nervous system, and the drug was safe and well-tolerated, said Tabrizi. This is probably the most significant moment in the history of Huntingtons since the gene [was isolated].

The trial was too small, and not long enough, to show whether patients clinical symptoms improved, but Roche is now expected to launch a major trial aimed at testing this.

If the future trial is successful, Tabrizi believes the drug could ultimately be used in people with the Huntingtons gene before they become ill, possibly stopping symptoms ever occurring. They may just need a pulse every three to four months, she said. One day we want to prevent the disease.

The drug, developed by the California biotech firm Ionis Pharmaceuticals, is a synthetic single strand of DNA customised to latch onto the huntingtin messenger molecule.

The unexpected success raises the tantalising possibility that a similar approach might work for other degenerative brain disorders. The drugs like Lego, said Wild. You can target [any protein].

For instance, a similar synthetic strand of DNA could be made to target the messenger that produces misshapen amyloid or tau proteins in Alzheimers.

Huntingtons alone is exciting enough, said Hardy, who first proposed that amyloid proteins play a central role in Alzheimers. I dont want to overstate this too much, but if it works for one, why cant it work for a lot of them? I am very, very excited.

Prof Giovanna Mallucci, associate director of UK Dementia Research Institute at the University of Cambridge, described the work as a tremendous step forward for individuals with Huntingtons disease and their families.

Clearly, there will be much interest into whether it can be applied to the treatment of other neurodegenerative diseases, like Alzheimers, she added. However, she said that in the case of most other disorders the genetic causes are complex and less well understood, making them potentially harder to target.

About 10,000 people in the UK have the condition and about 25,000 are at risk. Most people with Huntingtons inherited the gene from a parent, but about one in five patients have no known family history of the disease.

The full results of the trial are expected to be published in a scientific journal next year.

Read more: https://www.theguardian.com/science/2017/dec/11/excitement-as-huntingtons-drug-shown-to-slow-progress-of-devastating-disease

New Zealand bans vaginal mesh implants

Ministry of Health asks suppliers to stop marketing the mesh until they have proven its safety

New Zealand has become the first major country to effectively ban vaginal mesh implants in response to safety concerns over the surgery.

The countrys Ministry of Health announced on Monday that it had written to leading mesh suppliers asking them to stop marketing the products from January or prove that their products are safe.

Ministry of Health spokesman, Stewart Jessamine, told a New Zealand radio station: Were always cautious about the use of the word ban, but effectively the companies are agreeing no longer to sell these products … in New Zealand from the 4th of January.

The move goes considerably further than recent announcements in other countries, such as Australia and the UK, which only restrict the use of pelvic mesh operations for organ prolapse. In New Zealand, the use of mesh implants to treat urinary incontinence, which accounts for the vast majority of mesh operations, will also be effectively banned, according to an announcement posted on the government website.

The decision has been applauded by campaigners, many of whom argue that the potential complications of mesh surgery, which include chronic pain and implants cutting through the vagina, are unacceptable. However, doctors expressed concern at the far-reaching nature of the ban.

It is now widely accepted that vaginal mesh should not be routinely offered for prolapse, where the pelvic organs bulge into the vagina. But many doctors maintain that mesh surgery to treat stress urinary incontinence can have advantages over traditional surgery and believe that these procedures should continue to be offered.

This makes New Zealand the only country in the world to have banned all of these procedures and will leave women without effective surgical options for these debilitating conditions, said Giovanni Losco, a urologist in Christchurch and spokesman for the Urological Society of Australia and New Zealand.

Carl Heneghan, professor of evidence-based medicine at the University of Oxford, says the medical profession needs to acknowledge that there have been major failings in regulation and act to address the issue. If they dont then other regulators may also react with outright bans.

[New Zealand] is basically saying we cant guarantee patient safety, he added.

Jessamine said that the decision had been taken after reviewing data on mesh safety provided in November by the Australian government, which had been carrying out its own inquiry into the use of pelvic implants. Weve reviewed that data and come to the opinion that the data is sound and we now believe the risks of the use of these products in the pelvis for prolapse and stress incontinence far outweighs the benefits, he said.

Weve got an ability within our legislation to limit the use of those products, to discourage and ultimately remove those products from the market, he added.

Owen Smith, a shadow cabinet minister, who chairs the all-party parliamentary group on surgical mesh implants, described the announcement as hugely significant. Its the first major country to effectively ban mesh for all pelvic operations. Its precisely what weve been calling for in the UK.

Read more: https://www.theguardian.com/science/2017/dec/12/new-zealand-bans-vaginal-mesh-implants

Mass starvation is humanitys fate if we keep flogging the land to death | George Monbiot

The Earth cannot accommodate our need and greed for food. We must change our diet before its too late, writes Guardian columnist George Monbiot

Brexit; the crushing of democracy by billionaires; the next financial crash; a rogue US president: none of them keeps me awake at night. This is notbecause I dont care Icare very much. Its only because I have a bigger question onmy mind. Where is all the food going to come from?

By the middle of this century there will be two or three billion more people on Earth. Any one of the issues I am about to list could help precipitate mass starvation. And this is before you consider how they might interact.

The trouble begins where everything begins: with soil. The UNs famous projection that, at current rates of soil loss, the world has 60 years of harvests left, appears to be supported by a new set of figures. Partly as a result of soil degradation, yields are already declining on 20% of the worlds croplands.

Now consider water loss. In places such as the North China Plain, the central United States, California and north-western India among the worlds critical growing regions levels of the groundwater used to irrigate crops are already reaching crisis point. Water in the Upper Ganges aquifer, for example, is being withdrawn at 50 times its recharge rate. But, to keep pace with food demand, farmers in south Asia expect to use between 80 and 200% more water by the year 2050. Where willit come from?

The next constraint is temperature. One study suggests that, all else being equal, with each degree celsius of warming the global yield of rice drops by 3%, wheat by 6% and maize by 7%. These predictions could be optimistic. Research published in the journal Agricultural & Environmental Letters finds that 4C of warming in the US corn belt could reduce maize yields by between 84 and 100%.

The reason is that high temperatures at night disrupt the pollination process. But this describes just one component of the likely pollination crisis. Insectageddon, caused by the global deployment of scarcely tested pesticides, will account for the rest. Already, in some parts of the world, workers are now pollinating plants by hand. But thats viable only for the most expensive crops.

Then there are the structural factors. Because they tend to use more labour, grow a wider range of crops and work the land more carefully, small farmers, as a rule, grow more food per hectare than large ones. In the poorer regions of the world, people with fewer than fivehectares own 30% of the farmland but produce 70% of the food. Since 2000, an area of fertile ground roughly twice the size of the UK has been seized by land grabbers and consolidated intolarge farms, generally growing crops for export rather than the food needed by the poor.

While these multiple disasters unfoldon land, the seas are being sieved of everything but plastic. Despite a massive increase in effort (bigger boats, bigger engines, more gear), the worldwide fish catch is declining by roughly 1% a year, as populations collapse. The global land grab is mirrored by a global sea grab: small fishers are displaced by big corporations, exporting fish to those who need it less but pay more. About 3billion people depend to a large extent on fish and shellfish protein. Where will it come from?

All this would be hard enough. But as peoples incomes increase, their diet tends to shift from plant protein to animal protein. World meat production has quadrupled in 50 years, but global average consumption is still only half that of the UK where we eat roughly our bodyweight in meat every year and just over a third of the US level. Because of the way we eat, the UKs farmland footprint (the land requiredto meet our demand) is 2.4 times the size of its agricultural area. If everyone aspires to this diet, how exactly do we accommodate it?

Graph from Our World in Data.

The profligacy of livestock farming is astonishing. Already, 36% of the calories grown in the form of grain and pulses and 53% of the protein are used to feed farm animals. Two-thirds of this food is lost in conversion from plant to animal. A graph produced last week by Our World in Data suggests that, on average, you need 0.01m2 of land to produce a gram of protein from beans or peas, but 1m2 to produce it from beefcattle or sheep: a 100-folddifference.

Its true that much of the grazing land occupied by cattle and sheep cannot be used to grow crops. But it would otherwise have sustained wildlife and ecosystems. Instead, marshes are drained, trees are felled and their seedlings grazed out, predators are exterminated, wild herbivores fenced out and other life forms gradually erased as grazing systems intensify. Astonishing places such as the rainforests of Madagascar and Brazil are laid waste to make room for yet more cattle.

Because there is not enough land to meet both need and greed, a global transition to eating animals means snatching food from the mouths of the poor. It also means the ecological cleansing of almost every corner of theplanet.

A
I see the last rich ecosystems snuffed out, the last of the global megafauna lions, elephants, whales and tuna vanishing. Photograph: Douglas Klug/Getty Images

The shift in diets would be impossible to sustain even if there were no growth in the human population. But the greater the number of people, the greater the hunger meat eating will cause. From a baseline of 2010, the UNexpects meat consumption to rise by70% by 2030 (this is three times the rate of human population growth). Partly as a result, the global demand for crops could double (from the 2005 baseline) by 2050. The land required to grow them does not exist.

When I say this keeps me up at night, I mean it. I am plagued by visions of starving people seeking to escape fromgrey wastes, being beaten back byarmed police. I see the last rich ecosystems snuffed out, the last of the global megafauna lions, elephants, whales and tuna vanishing. And when I wake, I cannot assure myself that it was just anightmare.

Other people have different dreams: the fantasy of a feeding frenzy that neednever end, the fairytale of reconciling continued economic growth witha living world. If humankind spirals into societal collapse, these dreams will be the cause.

There are no easy answers, but the crucial change is a shift from an animal- to a plant-based diet. All else being equal, stopping both meat production and the use of farmland to grow biofuels could provide enough calories for another 4 billion people anddouble the protein available for human consumption. Artificial meat will help:one paper suggests it reduces water useby at least 82% and land useby 99%.

The next green revolution will not be like the last one. It will rely not on flogging the land to death, but on reconsidering how we use it and why. Can we do this, or do we the richer people now consuming the living planet find mass death easier to contemplate than changing our diet?

George Monbiot is a Guardian columnist

Read more: https://www.theguardian.com/commentisfree/2017/dec/11/mass-starvation-humanity-flogging-land-death-earth-food

Acid reflux drug linked to more than doubled risk of stomach cancer study

There are more than 50m prescriptions for proton pump inhibitors in the UK, though they have previously been linked to side-effects and increased risk of death

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics but never in a study that first eliminates a bacteria suspected of fuelling the illnesss development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should exercise caution when prescribing long-term PPIs even after successful eradication of H plyori.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: Many observational studies have found adverse effects associated with PPIs.

The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.

Read more: https://www.theguardian.com/science/2017/oct/31/acid-reflux-drug-linked-to-more-than-doubled-risk-of-stomach-cancer-study

Dyslexia: scientists claim cause of condition may lie in the eyes

In people with the condition, light receptor cells are arranged in matching patterns in both eyes, which may confuse the brain

French scientists claim they may have found a physiological, and seemingly treatable, cause for dyslexia hidden in tiny light-receptor cells in the human eye.

In people with the condition, the cells were arranged in matching patterns in both eyes, which may be to blame for confusing the brain by producing mirror images, the co-authors wrote in the journal Proceedings of the Royal Society B.

In non-dyslexic people, the cells are arranged asymmetrically, allowing signals from the one eye to be overridden by the other to create a single image in the brain.

Our observations lead us to believe that we indeed found a potential cause of dyslexia, said the studys co-author, Guy Ropars, of the University of Rennes.

It offers a relatively simple method of diagnosis, he added, by simply looking into a subjects eyes.

Furthermore, the discovery of a delay (of about 10 thousandths of a second) between the primary image and the mirror image in the opposing hemispheres of the brain, allowed us to develop a method to erase the mirror image that is so confusing for dyslexic people using an LED lamp.

Like being left- or right-handed, human beings also have a dominant eye. As most of us have two eyes, which record slightly different versions of the same image, the brain has to select one of the two, creating a non-symmetry.

Many more people are right-eyed than left, and the dominant eye has more neural connections to the brain than the weaker one. Image signals are captured with rods and cones in the eye the cones being responsible for colour.

The majority of cones, which come in red, green and blue variants, are found in a small spot at the centre of the retina of the eye known as the fovea. But there is a small hole (about 0.1-0.15 millimetres in diameter) with no blue cones.

In the newstudy, Ropars and colleague Albert le Floch spotted a major difference between the arrangement of cones between the eyes of dyslexic and non-dyslexic people enrolled in an experiment.

In non-dyslexic people, the blue cone-free spot in one eye the dominant one, was round and in the other eye unevenly shaped. In dyslexic people, both eyes have the same, round spot, which translates into neither eye being dominant, they found.

The lack of asymmetry might be the biological and anatomical basis of reading and spelling disabilities, said the studys authors.

Dyslexic people make so-called mirror errors in reading, for example confusing the letters b and d.

For dyslexic students their two eyes are equivalent and their brain has to successively rely on the two slightly different versions of a given visual scene, they added.

The team used an LED lamp, flashing so fast that it is invisible to the naked eye, to cancel one of the images in the brains of dyslexic trial participants while reading. In initial experiments, dyslexic study participants called it the magic lamp, said Ropars, but further tests are required to confirm the technique really works.

About 700 million people worldwide are known to have from dyslexia about one in 10 of the global population.

Read more: https://www.theguardian.com/society/2017/oct/18/dyslexia-scientists-claim-cause-of-condition-may-lie-in-the-eyes

Goodbye and good riddance to livestock farming | George Monbiot

As the artificial meat industry grows, the last argument for farming animals has now collapsed, writes Guardian columnist George Monbiot

What will future generations, looking back on our age, see as its monstrosities? We think of slavery, the subjugation of women, judicial torture, the murder of heretics, imperial conquest and genocide, the first world war and the rise of fascism, and ask ourselves how people could have failed to see the horror of what they did. What madness of our times will revolt our descendants?

There are plenty to choose from. But one of them, I believe, will be the mass incarceration of animals, to enable us to eat their flesh or eggs or drink their milk. While we call ourselves animal lovers, and lavish kindness on our dogs and cats, we inflict brutal deprivations on billions of animals that are just as capable of suffering. The hypocrisy is so rank that future generations will marvel at how we could have failed to see it.

The shift will occur with the advent of cheap artificial meat. Technological change has often helped to catalyse ethical change. The $300m deal China signed last month to buy lab-grown meat marks the beginning of the end of livestock farming. But it wont happen quickly: the great suffering is likely to continue for many years.

The answer, we are told by celebrity chefs and food writers, is to keep livestock outdoors: eat free-range beef or lamb, not battery pork. But all this does is to swap one disaster mass cruelty for another: mass destruction. Almost all forms of animal farming cause environmental damage, but none more so than keeping them outdoors. The reason is inefficiency. Grazing is not just slightly inefficient, it is stupendously wasteful. Roughly twice as much of the worlds surface is used for grazing as for growing crops, yet animals fed entirely on pasture produce just one gram out of the 81g of protein consumed per personper day.

A paper in Science of the Total Environment reports that livestock production is the single largest driver of habitat loss. Grazing livestock are a fully automated system for ecological destruction: you need only release them on to the land and they do the rest, browsing out tree seedlings, simplifying complex ecosystems. Their keepers augment this assault by slaughtering large predators.

Flock
Sheep supply around 1% of our diet in terms of calories. Yet they occupy around 4m hectares of the uplands. Photograph: Murdo MacLeod for the Guardian

In the UK, for example, sheep supply around 1% of our diet in terms of calories. Yet they occupy around 4m hectares of the uplands. This is more or less equivalent to all the land under crops in this country, and more than twice the area of the built environment (1.7m hectares). The rich mosaic of rainforest and other habitats that once covered our hills has been erased, the wildlife reduced to a handful of hardy species. The damage caused is out of all proportion to the meat produced.

Replacing the meat in our diets with soya spectacularly reduces the land area required per kilo of protein: by 70% in the case of chicken, 89% in the case of pork and 97% in the case of beef. One study suggests that if we were all to switch to a plant-based diet, 15mhectares of land in Britain currently used for farming could be returned to nature. Alternatively, this country could feed 200 million people. An end to animal farming would be the salvation of the worlds wildlife, our natural wonders and magnificent habitats.

Understandably, those who keep animals have pushed back against such facts, using an ingenious argument. Livestock grazing, they claim, can suck carbon out of the atmosphere and store it in the soil, reducing or even reversing global warming. In a TED talk watched by 4 million people, the rancher Allan Savory claims that his holistic grazing could absorb enough carbon to return the worlds atmosphere to pre-industrial levels. His inability, when I interviewed him, to substantiate his claims has done nothing to dent their popularity.

Similar statements have been made by Graham Harvey, the agricultural story editor of the BBC Radio 4 serial The Archers he claims that the prairies in the US could absorb all the carbon thats gone into the atmosphere for the whole planet since we industrialised and amplified by the Campaign to Protect Rural England. Farmers organisations all over the world now noisily promote this view.

A report this week by the Food Climate Research Network, called Grazed and Confused, seeks to resolve the question: can keeping livestock outdoors cause a net reduction in greenhouse gases? The authors spent two years investigating the issue. They cite 300 sources. Their answer is unequivocal. No.

It is true, they find, that some grazing systems are better than others. Under some circumstances, plants growing on pastures will accumulate carbon under the ground, through the expansion of their root systems and the laying down of leaf litter. But the claims of people such as Savory and Harvey are dangerously misleading. The evidence supporting additional carbon storage through the special systems these livestock crusaders propose (variously described as holistic, regenerative, mob, or adaptive grazing) is weak and contradictory, and suggests that if theres an effect at all, it is small.

The best that can be done is to remove between 20% and 60% of the greenhouse gas emissions grazing livestock produce. Even this might be an overestimate: a paper published this week in the journal Carbon Balance and Management suggests that the amount of methane (a potent greenhouse gas) farm animals produce has been understated. In either case, carbon storage in pastures cannot compensate for the animals own climate impacts, let alone those of industrial civilisation. I would like to see the TED team post a warning on Savorys video, before even more people are misled.

As the final argument crumbles, we are left facing an uncomfortable fact: animal farming looks as incompatible with a sustained future for humans and other species as mining coal.

That vast expanse of pastureland, from which we obtain so little at such great environmental cost, would be better used for rewilding: the mass restoration of nature. Not only would this help to reverse the catastrophic decline in habitats and the diversity and abundance of wildlife, but the returning forests, wetlands and savannahs are likely to absorb far more carbon than even the most sophisticated forms of grazing.

The end of animal farming might be hard to swallow. But we are a resilient and adaptable species. We have undergone a series of astonishing changes: the adoption of sedentarism, of agriculture, of cities, of industry.

Now it is time for a new revolution, almost as profound as those other great shifts: the switch to a plant-based diet. The technology is depending on how close an approximation to meat you demand (Quorn seems almost indistinguishable from chicken or mince to me) either here or just around the corner. The ethical switch is happening already: even today, there are half a million vegans in the land of roast beef. Its time to abandon the excuses, the fake facts and false comforts. It is time to see our moral choices as our descendants will.

George Monbiot is a Guardian columnist

Read more: https://www.theguardian.com/commentisfree/2017/oct/04/livestock-farming-artificial-meat-industry-animals

Americans Are Retiring Later, Dying Sooner and Sicker In-Between

The U.S. retirement age is rising, as the government pushes it higher and workers stay in careers longer.

But lifespans aren’t necessarily extending to offer equal time on the beach. Data released last week suggest Americans’ health is declining and millions of middle-age workers face the prospect of shorter, and less active, retirements than their parents enjoyed.

Here are the stats: The U.S. age-adjusted mortality rate—a measure of the number of deaths per year—rose 1.2 percent from 2014 to 2015, according to the Society of Actuaries. That’s the first year-over-year increase since 2005, and only the second rise greater than 1 percent since 1980.

 

At the same time that Americans’ life expectancy is stalling, public policy and career tracks mean millions of U.S. workers are waiting longer to call it quits. The age at which people can claim their full Social Security benefits is gradually moving up, from 65 for those retiring in 2002 to 67 in 2027.

Almost one in three Americans age 65 to 69 is still working, along with almost one in five in their early 70s.

Postponing retirement can make financial sense, because extended careers can make it possible to afford retirements that last past age 90 or even 100. But a study out this month adds some caution to that calculation.

Americans in their late 50s already have more serious health problems than people at the same ages did 10 to 15 years ago, according to the journal Health Affairs.

University of Michigan economists HwaJung Choi and Robert Schoeni used survey data to compare middle-age Americans’ health. A key measure is whether people have trouble with an “activity of daily living,” or ADL, such as walking across a room, dressing and bathing themselves, eating, or getting in or out of bed. The study showed the number of middle-age Americans with ADL limitations has jumped: 12.5 percent of Americans at the current retirement age of 66 had an ADL limitation in their late 50s, up from 8.8 percent for people with a retirement age of 65.

At the current retirement age of 66, a quarter of Americans age 58 to 60 rated themselves in “poor” or “fair” health. That’s up 2.6 points from the group who could retire with full benefits at 65, the Michigan researchers found.

Cognitive skills have also declined over time. For those with a retirement age of 66, 11 percent already had some kind of dementia or other cognitive decline at age 58 to 60, according to the study. That’s up from 9.5 percent of Americans just a few years older, with a retirement age between 65 and 66.

While death rates can be volatile from year to year, Choi and Schoeni’s study is part of a raft of other research showing the health of Americans deteriorating.

Researchers have offered many theories for why Americans’ health is getting worse. Princeton University economists Anne Case and Angus Deaton, a Nobel Prize winner, have argued that an epidemic of suicide, drug overdoses and alcohol abuse have caused a spike in death rates among middle-age whites.

Higher rates of obesity may also be taking their toll. And Americans may have already seen most of the benefits from previous positive developments that cut the death rate, such as a decline in smoking and medical advances like statins that fight cardiovascular disease.

Declining health and life expectancy are good news for one constituency: Pension plans, which must send a monthly check to retirees for as long as they live.

According to the latest figures from the Society of Actuaries, life expectancy for pension participants has dropped since its last calculation by 0.2 years. A 65-year-old man can expect to live to 85.6 years, and a woman can expect to make it to 87.6. As a result, the group calculates a typical pension plan’s obligations could fall by 0.7 percent to 1 percent.

    Read more: http://www.bloomberg.com/news/articles/2017-10-23/americans-are-retiring-later-dying-sooner-and-sicker-in-between

    Trump Officials Dispute the Benefits of Birth Control to Justify Rules

    When the Trump administration elected to stop requiring many employers to offer birth-control coverage in their health plans, it devoted nine of its new rule’s 163 pages to questioning the links between contraception and preventing unplanned pregnancies.

    In the rule released Friday, officials attacked a 2011 report that recommended mandatory birth-control coverage to help women avoid unintended pregnancies. That report, requested by the Department of Health and Human Services, was done by the National Academies of Sciences, Engineering and Medicine — then the Institute of Medicine — an expert group that serves as the nation’s scientific adviser.

    “The rates of, and reasons for, unintended pregnancy are notoriously difficult to measure,” according to the Trump administration’s interim final rule. “In particular, association and causality can be hard to disentangle.”

    Multiple studies have found that access or use of contraception reduced unintended pregnancies. 

    Claims in the report that link increased contraceptive use by unmarried women and teens to decreases in unintended pregnancies “rely on association rather than causation,” according to the rule. The rule references another study that found increased access to contraception decreased teen pregnancies short-term but led to an increase in the long run.

    “We know that safe contraception — and contraception is incredibly safe — leads to a reduction in pregnancies,” said Michele Bratcher Goodwin, director of the Center for Biotechnology and Global Health Policy at the University of California, Irvine, School of Law. “This has been data that we’ve had for decades.”

    Riskier Behavior

    The rules were released as part of a broader package of protections for religious freedom that the administration announced Friday.

    The government also said imposing a coverage mandate could “affect risky sexual behavior in a negative way” though it didn’t point to any particular studies to support its point. A 2014 study by the Washington University School of Medicine in St. Louis found providing no-cost contraception did not lead to riskier sexual behavior.

    The rule asserts that positive health effects associated with birth control “might also be partially offset by an association with negative health effects.” The rule connects the claim of negative health effects to a call by the National Institutes of Health in 2013 for the development of new contraceptives that stated current options can have “many undesirable side effects.” 

    The rule also describes an Agency for Healthcare Research and Quality review that found oral contraceptives increased users’ risk of breast cancer and vascular events, making the drugs’ use in preventing ovarian cancer uncertain.

    Federal officials used all of these assertions to determine the government “need not take a position on these empirical questions.”

    “Our review is sufficient to lead us to conclude that significantly more uncertainty and ambiguity exists in the record than the Departments previously acknowledged.”

      Read more: http://www.bloomberg.com/news/articles/2017-10-06/trump-officials-dispute-birth-control-benefits-to-justify-rules

      Sixth mass extinction of wildlife also threatens global food supplies

      Plant and animal species that are the foundation of our food supplies are as endangered as wildlife but get almost no attention, a new report reveals

      The sixth mass extinction of global wildlife already under way is seriously threatening the worlds food supplies, according to experts.

      Huge proportions of the plant and animal species that form the foundation of our food supply are just as endangered [as wildlife] and are getting almost no attention, said Ann Tutwiler, director general of Bioversity International, a research group that published a new report on Tuesday.

      If there is one thing we cannot allow to become extinct, it is the species that provide the food that sustains each and every one of the seven billion people on our planet, she said in an article for the Guardian. This agrobiodiversity is a precious resource that we are losing, and yet it can also help solve or mitigate many challenges the world is facing. It has a critical yet overlooked role in helping us improve global nutrition, reduce our impact on the environment and adapt to climate change.

      Three-quarters of the worlds food today comes from just 12 crops and five animal species and this leaves supplies very vulnerable to disease and pests that can sweep through large areas of monocultures, as happened in the Irish potato famine when a million people starved to death. Reliance on only a few strains also means the worlds fast changing climate will cut yields just as the demand from a growing global population is rising.

      There are tens of thousands of wild or rarely cultivated species that could provide a richly varied range of nutritious foods, resistant to disease and tolerant of the changing environment. But the destruction of wild areas, pollution and overhunting has started a mass extinction of species on Earth. The focus to date has been on wild animals half of which have been lost in the last 40 years but the new report reveals that the same pressures are endangering humanitys food supply, with at least 1,000 cultivated species already endangered.

      Tutwiler said saving the worlds agrobiodiversity is also vital in tackling the number one cause of human death and disability in the world poor diet, which includes both too much and too little food. We are not winning the battle against obesity and undernutrition, she said. Poor diets are in large part because we have very unified diets based on a narrow set of commodities and we are not consuming enough diversity.

      The new report sets out how both governments and companies can protect, enhance and use the huge variety of little-known food crops. It highlights examples including the gac, a fiery red fruit from Vietnam, and the orange-fleshed Asupina banana. Both have extremely high levels of beta-carotene that the body converts to vitamin A and could help the many millions of people suffering deficiency of that vitamin.

      Quinoa has become popular in some rich nations but only a few of the thousands of varieties native to South America are cultivated. The report shows how support has enabled farmers in Peru to grow a tough, nutritious variety that will protect them from future diseases or extreme weather.

      Mainstream crops can also benefit from diversity and earlier in 2017 in Ethiopia researchers found two varieties of durum wheat that produce excellent yields even in dry areas. Fish diversity is also very valuable, with a local Bangladeshi species now shown to be extremely nutritious.

      Read more: https://www.theguardian.com/environment/2017/sep/26/sixth-mass-extinction-of-wildlife-also-threatens-global-food-supplies

      The shorter your sleep, the shorter your life: the new sleep science

      Leading neuroscientist Matthew Walker on why sleep deprivation is increasing our risk of cancer, heart attack and Alzheimers and what you can do about it

      Matthew Walker has learned to dread the question What do you do? At parties, it signals the end of his evening; thereafter, his new acquaintance will inevitably cling to him like ivy. On an aeroplane, it usually means that while everyone else watches movies or reads a thriller, he will find himself running an hours-long salon for the benefit of passengers and crew alike. Ive begun to lie, he says. Seriously. I just tell people Im a dolphin trainer. Its better for everyone.

      Walker is a sleep scientist. To be specific, he is the director of the Center for Human Sleep Science at the University of California, Berkeley, a research institute whose goal possibly unachievable is to understand everything about sleeps impact on us, from birth to death, in sickness and health. No wonder, then, that people long for his counsel. As the line between work and leisure grows ever more blurred, rare is the person who doesnt worry about their sleep. But even as we contemplate the shadows beneath our eyes, most of us dont know the half of it and perhaps this is the real reason he has stopped telling strangers how he makes his living. When Walker talks about sleep he cant, in all conscience, limit himself to whispering comforting nothings about camomile tea and warm baths. Its his conviction that we are in the midst of a catastrophic sleep-loss epidemic, the consequences of which are far graver than any of us could imagine. This situation, he believes, is only likely to change if government gets involved.

      Walker has spent the last four and a half years writing Why We Sleep, a complex but urgent book that examines the effects of this epidemic close up, the idea being that once people know of the powerful links between sleep loss and, among other things, Alzheimers disease, cancer, diabetes, obesity and poor mental health, they will try harder to get the recommended eight hours a night (sleep deprivation, amazing as this may sound to Donald Trump types, constitutes anything less than seven hours). But, in the end, the individual can achieve only so much. Walker wants major institutions and law-makers to take up his ideas, too. No aspect of our biology is left unscathed by sleep deprivation, he says. It sinks down into every possible nook and cranny. And yet no one is doing anything about it. Things have to change: in the workplace and our communities, our homes and families. But when did you ever see an NHS poster urging sleep on people? When did a doctor prescribe, not sleeping pills, but sleep itself? It needs to be prioritised, even incentivised. Sleep loss costs the UK economy over 30bn a year in lost revenue, or 2% of GDP. I could double the NHS budget if only they would institute policies to mandate or powerfully encourage sleep.

      Why, exactly, are we so sleep-deprived? What has happened over the course of the last 75 years? In 1942, less than 8% of the population was trying to survive on six hours or less sleep a night; in 2017, almost one in two people is. The reasons are seemingly obvious. First, we electrified the night, Walker says. Light is a profound degrader of our sleep. Second, there is the issue of work: not only the porous borders between when you start and finish, but longer commuter times, too. No one wants to give up time with their family or entertainment, so they give up sleep instead. And anxiety plays a part. Were a lonelier, more depressed society. Alcohol and caffeine are more widely available. All these are the enemies of sleep.

      But Walker believes, too, that in the developed world sleep is strongly associated with weakness, even shame. We have stigmatised sleep with the label of laziness. We want to seem busy, and one way we express that is by proclaiming how little sleep were getting. Its a badge of honour. When I give lectures, people will wait behind until there is no one around and then tell me quietly: I seem to be one of those people who need eight or nine hours sleep. Its embarrassing to say it in public. They would rather wait 45 minutes for the confessional. Theyre convinced that theyre abnormal, and why wouldnt they be? We chastise people for sleeping what are, after all, only sufficient amounts. We think of them as slothful. No one would look at an infant baby asleep, and say What a lazy baby! We know sleeping is non-negotiable for a baby. But that notion is quickly abandoned [as we grow up]. Humans are the only species that deliberately deprive themselves of sleep for no apparent reason. In case youre wondering, the number of people who can survive on five hours of sleep or less without any impairment, expressed as a percent of the population and rounded to a whole number, is zero.

      The world of sleep science is still relatively small. But it is growing exponentially, thanks both to demand (the multifarious and growing pressures caused by the epidemic) and to new technology (such as electrical and magnetic brain stimulators), which enables researchers to have what Walker describes as VIP access to the sleeping brain. Walker, who is 44 and was born in Liverpool, has been in the field for more than 20 years, having published his first research paper at the age of just 21. I would love to tell you that I was fascinated by conscious states from childhood, he says. But in truth, it was accidental. He started out studying for a medical degree in Nottingham. But having discovered that doctoring wasnt for him he was more enthralled by questions than by answers he switched to neuroscience, and after graduation, began a PhD in neurophysiology supported by the Medical Research Council. It was while working on this that he stumbled into the realm of sleep.

      Matthew
      Matthew Walker photographed in his sleep lab. Photograph: Saroyan Humphrey for the Observer

      I was looking at the brainwave patterns of people with different forms of dementia, but I was failing miserably at finding any difference between them, he recalls now. One night, however, he read a scientific paper that changed everything. It described which parts of the brain were being attacked by these different types of dementia: Some were attacking parts of the brain that had to do with controlled sleep, while other types left those sleep centres unaffected. I realised my mistake. I had been measuring the brainwave activity of my patients while they were awake, when I should have been doing so while they were asleep. Over the next six months, Walker taught himself how to set up a sleep laboratory and, sure enough, the recordings he made in it subsequently spoke loudly of a clear difference between patients. Sleep, it seemed, could be a new early diagnostic litmus test for different subtypes of dementia.

      After this, sleep became his obsession. Only then did I ask: what is this thing called sleep, and what does it do? I was always curious, annoyingly so, but when I started to read about sleep, I would look up and hours would have gone by. No one could answer the simple question: why do we sleep? That seemed to me to be the greatest scientific mystery. I was going to attack it, and I was going to do that in two years. But I was naive. I didnt realise that some of the greatest scientific minds had been trying to do the same thing for their entire careers. That was two decades ago, and Im still cracking away. After gaining his doctorate, he moved to the US. Formerly a professor of psychiatry at Harvard Medical School, he is now professor of neuroscience and psychology at the University of California.

      Does his obsession extend to the bedroom? Does he take his own advice when it comes to sleep? Yes. I give myself a non-negotiable eight-hour sleep opportunity every night, and I keep very regular hours: if there is one thing I tell people, its to go to bed and to wake up at the same time every day, no matter what. I take my sleep incredibly seriously because I have seen the evidence. Once you know that after just one night of only four or five hours sleep, your natural killer cells the ones that attack the cancer cells that appear in your body every day drop by 70%, or that a lack of sleep is linked to cancer of the bowel, prostate and breast, or even just that the World Health Organisation has classed any form of night-time shift work as a probable carcinogen, how could you do anything else?

      There is, however, a sting in the tale. Should his eyelids fail to close, Walker admits that he can be a touch Woody Allen-neurotic. When, for instance, he came to London over the summer, he found himself jet-lagged and wide awake in his hotel room at two oclock in the morning. His problem then, as always in these situations, was that he knew too much. His brain began to race. I thought: my orexin isnt being turned off, the sensory gate of my thalamus is wedged open, my dorsolateral prefrontal cortex wont shut down, and my melatonin surge wont happen for another seven hours. What did he do? In the end, it seems, even world experts in sleep act just like the rest of us when struck by the curse of insomnia. He turned on a light and read for a while.

      Will Why We Sleep have the impact its author hopes? Im not sure: the science bits, it must be said, require some concentration. But what I can tell you is that it had a powerful effect on me. After reading it, I was absolutely determined to go to bed earlier a regime to which I am sticking determinedly. In a way, I was prepared for this. I first encountered Walker some months ago, when he spoke at an event at Somerset House in London, and he struck me then as both passionate and convincing (our later interview takes place via Skype from the basement of his sleep centre, a spot which, with its bedrooms off a long corridor, apparently resembles the ward of a private hospital). But in another way, it was unexpected. I am mostly immune to health advice. Inside my head, there is always a voice that says just enjoy life while it lasts.

      The evidence Walker presents, however, is enough to send anyone early to bed. Its no kind of choice at all. Without sleep, there is low energy and disease. With sleep, there is vitality and health. More than 20 large scale epidemiological studies all report the same clear relationship: the shorter your sleep, the shorter your life. To take just one example, adults aged 45 years or older who sleep less than six hours a night are 200% more likely to have a heart attack or stroke in their lifetime, as compared with those sleeping seven or eight hours a night (part of the reason for this has to do with blood pressure: even just one night of modest sleep reduction will speed the rate of a persons heart, hour upon hour, and significantly increase their blood pressure).

      A lack of sleep also appears to hijack the bodys effective control of blood sugar, the cells of the sleep-deprived appearing, in experiments, to become less responsive to insulin, and thus to cause a prediabetic state of hyperglycaemia. When your sleep becomes short, moreover, you are susceptible to weight gain. Among the reasons for this are the fact that inadequate sleep decreases levels of the satiety-signalling hormone, leptin, and increases levels of the hunger-signalling hormone, ghrelin. Im not going to say that the obesity crisis is caused by the sleep-loss epidemic alone, says Walker. Its not. However, processed food and sedentary lifestyles do not adequately explain its rise. Something is missing. Its now clear that sleep is that third ingredient. Tiredness, of course, also affects motivation.

      Sleep has a powerful effect on the immune system, which is why, when we have flu, our first instinct is to go to bed: our body is trying to sleep itself well. Reduce sleep even for a single night, and your resilience is drastically reduced. If you are tired, you are more likely to catch a cold. The well-rested also respond better to the flu vaccine. As Walker has already said, more gravely, studies show that short sleep can affect our cancer-fighting immune cells. A number of epidemiological studies have reported that night-time shift work and the disruption to circadian sleep and rhythms that it causes increase the odds of developing cancers including breast, prostate, endometrium and colon.

      Getting too little sleep across the adult lifespan will significantly raise your risk of developing Alzheimers disease. The reasons for this are difficult to summarise, but in essence it has to do with the amyloid deposits (a toxin protein) that accumulate in the brains of those suffering from the disease, killing the surrounding cells. During deep sleep, such deposits are effectively cleaned from the brain. What occurs in an Alzheimers patient is a kind of vicious circle. Without sufficient sleep, these plaques build up, especially in the brains deep-sleep-generating regions, attacking and degrading them. The loss of deep sleep caused by this assault therefore lessens our ability to remove them from the brain at night. More amyloid, less deep sleep; less deep sleep, more amyloid, and so on. (In his book, Walker notes unscientifically that he has always found it curious that Margaret Thatcher and Ronald Reagan, both of whom were vocal about how little sleep they needed, both went on to develop the disease; it is, moreover, a myth that older adults need less sleep.) Away from dementia, sleep aids our ability to make new memories, and restores our capacity for learning.

      And then there is sleeps effect on mental health. When your mother told you that everything would look better in the morning, she was wise. Walkers book includes a long section on dreams (which, says Walker, contrary to Dr Freud, cannot be analysed). Here he details the various ways in which the dream state connects to creativity. He also suggests that dreaming is a soothing balm. If we sleep to remember (see above), then we also sleep to forget. Deep sleep the part when we begin to dream is a therapeutic state during which we cast off the emotional charge of our experiences, making them easier to bear. Sleep, or a lack of it, also affects our mood more generally. Brain scans carried out by Walker revealed a 60% amplification in the reactivity of the amygdala a key spot for triggering anger and rage in those who were sleep-deprived. In children, sleeplessness has been linked to aggression and bullying; in adolescents, to suicidal thoughts. Insufficient sleep is also associated with relapse in addiction disorders. A prevailing view in psychiatry is that mental disorders cause sleep disruption. But Walker believes it is, in fact, a two-way street. Regulated sleep can improve the health of, for instance, those with bipolar disorder.

      Ive mentioned deep sleep in this (too brief) summary several times. What is it, exactly? We sleep in 90-minute cycles, and its only towards the end of each one of these that we go into deep sleep. Each cycle comprises two kinds of sleep. First, there is NREM sleep (non-rapid eye movement sleep); this is then followed by REM (rapid eye movement) sleep. When Walker talks about these cycles, which still have their mysteries, his voice changes. He sounds bewitched, almost dazed.

      During NREM sleep, your brain goes into this incredible synchronised pattern of rhythmic chanting, he says. Theres a remarkable unity across the surface of the brain, like a deep, slow mantra. Researchers were once fooled that this state was similar to a coma. But nothing could be further from the truth. Vast amounts of memory processing is going on. To produce these brainwaves, hundreds of thousands of cells all sing together, and then go silent, and on and on. Meanwhile, your body settles into this lovely low state of energy, the best blood-pressure medicine you could ever hope for. REM sleep, on the other hand, is sometimes known as paradoxical sleep, because the brain patterns are identical to when youre awake. Its an incredibly active brain state. Your heart and nervous system go through spurts of activity: were still not exactly sure why.

      Does the 90-minute cycle mean that so-called power naps are worthless? They can take the edge off basic sleepiness. But you need 90 minutes to get to deep sleep, and one cycle isnt enough to do all the work. You need four or five cycles to get all the benefit. Is it possible to have too much sleep? This is unclear. There is no good evidence at the moment. But I do think 14 hours is too much. Too much water can kill you, and too much food, and I think ultimately the same will prove to be true for sleep. How is it possible to tell if a person is sleep-deprived? Walker thinks we should trust our instincts. Those who would sleep on if their alarm clock was turned off are simply not getting enough. Ditto those who need caffeine in the afternoon to stay awake. I see it all the time, he says. I get on a flight at 10am when people should be at peak alert, and I look around, and half of the plane has immediately fallen asleep.

      So what can the individual do? First, they should avoid pulling all-nighters, at their desks or on the dancefloor. After being awake for 19 hours, youre as cognitively impaired as someone who is drunk. Second, they should start thinking about sleep as a kind of work, like going to the gym (with the key difference that it is both free and, if youre me, enjoyable). People use alarms to wake up, Walker says. So why dont we have a bedtime alarm to tell us weve got half an hour, that we should start cycling down? We should start thinking of midnight more in terms of its original meaning: as the middle of the night. Schools should consider later starts for students; such delays correlate with improved IQs. Companies should think about rewarding sleep. Productivity will rise, and motivation, creativity and even levels of honesty will be improved. Sleep can be measured using tracking devices, and some far-sighted companies in the US already give employees time off if they clock enough of it. Sleeping pills, by the way, are to be avoided. Among other things, they can have a deleterious effect on memory.

      Those who are focused on so-called clean sleep are determined to outlaw mobiles and computers from the bedroom and quite right, too, given the effect of LED-emitting devices on melatonin, the sleep-inducing hormone. Ultimately, though, Walker believes that technology will be sleeps saviour. There is going to be a revolution in the quantified self in industrial nations, he says. We will know everything about our bodies from one day to the next in high fidelity. That will be a seismic shift, and we will then start to develop methods by which we can amplify different components of human sleep, and do that from the bedside. Sleep will come to be seen as a preventive medicine.

      What questions does Walker still most want to answer? For a while, he is quiet. Its so difficult, he says, with a sigh. There are so many. I would still like to know where we go, psychologically and physiologically, when we dream. Dreaming is the second state of human consciousness, and we have only scratched the surface so far. But I would also like to find out when sleep emerged. I like to posit a ridiculous theory, which is: perhaps sleep did not evolve. Perhaps it was the thing from which wakefulness emerged. He laughs. If I could have some kind of medical Tardis and go back in time to look at that, well, I would sleep better at night.

      Why We Sleep: The New Science of Sleep and Dreamsby Matthew Walker is published by Allen Lane (20). To order a copy for 17 go toguardianbookshop.com or call 0330 333 6846. Free UK p&p over 10, online orders only. Phone orders min p&p of 1.99

      Sleep in numbers

      Two-thirds of adults in developed nations fail to obtain the nightly eight hours of sleep recommended by the World Health Organisation.

      An adult sleeping only 6.75 hours a night would be predicted to live only to their early 60s without medical intervention.

      A 2013 study reported that men who slept too little had a sperm count 29% lower than those who regularly get a full and restful nights sleep.

      If you drive a car when you have had less than five hours sleep, you are 4.3 times more likely to be involved in a crash. If you drive having had four hours, you are 11.5 times more likely to be involved in an accident.

      A hot bath aids sleep not because it makes you warm, but because your dilated blood vessels radiate inner heat, and your core body temperature drops. To successfully initiate sleep, your core temperature needs to drop about 1C.

      The time taken to reach physical exhaustion by athletes who obtain anything less than eight hours of sleep, and especially less than six hours, drops by 10-30%.

      There are now more than 100 diagnosed sleep disorders, of which insomnia is the mostcommon.

      Morning types, who prefer to awake at or around dawn, make up about 40% of the population. Evening types, who prefer to go to bed late and wake up late, account for about 30%. The remaining 30% lie somewhere in between.

      Read more: https://www.theguardian.com/lifeandstyle/2017/sep/24/why-lack-of-sleep-health-worst-enemy-matthew-walker-why-we-sleep