Poor diet is a factor in one in five deaths, global disease study reveals

Study compiling data from every country finds people are living longer but millions are eating wrong foods for their health

Poor diet is a factor in one in five deaths around the world, according to the most comprehensive study ever carried out on the subject.

Millions of people are eating the wrong sorts of food for good health. Eating a diet that is low in whole grains, fruit, nuts and seeds and fish oils and high in salt raises the risk of an early death, according to the huge and ongoing study Global Burden of Disease.

The study, based at the Institute of Health Metrics and Evaluation at the University of Washington, compiles data from every country in the world and makes informed estimates where there are gaps. Five papers on life expectancy and the causes and risk factors of death and ill health have been published by the Lancet medical journal.

It finds that people are living longer. Life expectancy in 2016 worldwide was 75.3 years for women and 69.8 for men. Japan has the highest life expectancy at 84 years and the Central African Republic has the lowest at just over 50. In the UK, life expectancy for a man born in 2016 is 79, and for a woman 82.9.

Diet is the second highest risk factor for early death after smoking. Other high risks are high blood glucose which can lead to diabetes, high blood pressure, high body mass index (BMI) which is a measure of obesity, and high total cholesterol. All of these can be related to eating the wrong foods, although there are also other causes.

causes of death graphic

This is really large, Dr Christopher Murray, IHMEs director, told the Guardian. It is amongst the really big problems in the world. It is a cluster that is getting worse. While obesity gets attention, he was not sure policymakers were as focused on the area of diet and health as they needed to be. That constellation is a really, really big challenge for health and health systems, he said.

The problem is often seen as the spread of western diets, taking over from traditional foods in the developing world. But it is not that simple, says Murray. Take fruit. It has lots of health benefits but only very wealthy people eat a lot of fruit, with some exceptions.

Sugary drinks are harmful to health but eating a lot of red meat, the study finds, is not as big a risk to health as failing to eat whole grains. We need to look really carefully at what are the healthy compounds in diets that provide protection, he said.

undernourishment graphic

Prof John Newton, director of health improvement at Public Health England, said the studies show how quickly diet and obesity-related disease is spreading around the world. I dont think people realise how quickly the focus is shifting towards non-communicable disease [such as cancer, heart disease and stroke] and diseases that come with development, in particular related to poor diet. The numbers are quite shocking in my view, he said.

The UK tracks childhood obesity through the school measurement programme and has brought in measures to try to tackle it. But no country in the world has been able to solve the problem and it is a concern that we really need to think about tackling globally, he said.

Today, 72% of deaths are from non-communicable diseases for which obesity and diet are among the risk factors, with ischaemic heart disease as the leading cause worldwide of early deaths, including in the UK. Lung cancer, stroke, lung disease (chronic obstructive pulmonary disorder) and Alzheimers are the other main causes in the UK.

The success story is children under five. In 2016, for the first time in modern history, fewer than 5 million children under five died in one year a significant fall compared with 1990, when 11 million died. Increased education for women, less poverty, having fewer children, vaccinations, anti-malaria bed-nets, improved water and sanitation are among the changes in low-income countries that have brought the death rate down, thanks to development aid.

People are living longer but spending more years in ill health. Obesity is one of the major reasons. More than a billion people worldwide are living with mental health and substance misuse disorders. Depression features in the top 10 causes of ill health in all but four countries.

Our findings indicate people are living longer and, over the past decade, we identified substantial progress in driving down death rates from some of the worlds most pernicious diseases and conditions, such as under age-five mortality and malaria, said Murray Yet, despite this progress, we are facing a triad of trouble holding back many nations and communities obesity, conflict, and mental illness, including substance use disorders.

In the UK, the concern is particularly about the increase in ill-health that prevents people from working or having a fulfilling life, said Newton. A man in the UK born in 2016 can expect only 69 years in good health and a woman 71 years.

This is yet another reminder that while were living longer, much of that extra time is spent in ill-health. It underlines the importance of preventing the conditions that keep people out of work and put their long term health in jeopardy, like musculoskeletal problems, poor hearing and mental ill health. Our priority is to help people, including during the crucial early years of life and in middle age, to give them the best chance of a long and healthy later life, he said.

Read more: https://www.theguardian.com/society/2017/sep/14/poor-diet-is-a-factor-in-one-in-five-deaths-global-disease-study-reveals

Fran works six days a week in fast food, and yet she’s homeless: ‘It’s economic slavery’

Fran Marion and Bridget Hughes are leading voices in Stand Up Kansas City, part of the Fight for $15 movement that aims raise the minimum wage across the US

Once a customer has barked their order into the microphone at the Popeyes drive-thru on Prospect Avenue, Kansas City, the clock starts. Staff have a company-mandated 180 seconds to take the order, cook the order, bag the order and deliver it to the drive-thru window.

The restaurant is on short shift at the moment, which means it has about half the usual staff, so Fran Marion often has to do all those jobs herself. On the day we met, she estimates she processed 187 orders roughly one every two minutes. Those orders grossed about $950 for the company. Marion went home with $76.

Despite working six days a week, Marion, 37, a single mother of two, cant make ends meet on the $9.50 an hour she gets at Popeyes (no apostrophe founder Al Copeland joked he was too poor to afford one). A fast food worker for 22 years, Marion has almost always had a second job. Until recently, she had been working 9am-4pm at Popeyes, without a break, then crossing town to a janitorial job at Bartle Hall, the convention center, where she would work from 5pm- to 1.30am for $11 an hour. She didnt take breaks there either, although they were allowed.

Read more: https://www.theguardian.com/us-news/2017/aug/21/missouri-fast-food-workers-better-pay-popeyes-economics

Billionaire Bloomberg to fund $5m public health projects in 40 cities worldwide

Exclusive: Melbourne, Accra and Ulaanbaatar among cities to benefit from funding pledged by former New York mayor to tackle issues from air pollution to obesity

Michael Bloomberg, the billionaire bte noire of both the sugar industry and the tobacco industry, famously fought for a ban on the sale of large-sized colas and other sweet drinks when he was mayor of New York and lost. Although that is not how he sees it.

We actually won that battle, he says. I have always thought if we had not been stopped by the court, it would have died as an issue. Nobody would have known about it. But the fact that it kept coming back to the newspapers was a gift in disguise because people started to think, Holy God, maybe full-sugar drinks are bad for me.

So what happened was consumption of full-sugar drinks around the world has gone down dramatically. If we had won the thing, I think it would have been less.

Bloomberg did plenty more for public health while mayor of New York, including imposing one of the first bans on smoking in bars and restaurants in 2003. Since then he has widened his sphere of influence, funding successful campaigns through his philanthropic foundation for sugar taxes in Mexico and Philadelphia and for curbs on smoking all over the world.

Now, appointed last year as the World Health Organisations global ambassador for non-communicable diseases meaning anything that can harm or kill you that is not infectious the eighth richest person in the world, worth an estimated $47.5bn, is taking his philosophy and his cash to 40 cities around the globe.

His offer, taken up by about 40 cities so far and officially launched on Tuesday, is $5m in assistance from Bloomberg Philanthropies as well as technical support for cities that choose to focus on one of 10 healthy lifestyle issues, including curbing sugary drink consumption, air pollution, promoting exercise and and bans on smoking. They range from affluent Melbourne in Australia to Cali and Medellin in Colombia, Accra in Ghana, Ulaanbaatar in Mongolia, Khatmandu in Nepal and Kampala in Uganda.

National and state governments collect taxes, but it is city governments that make things happen. 50% of people currently live in cities and that is projected to rise to 70% in the next decade or so. Cities are where the rubber meets the road, Bloomberg told the Guardian. The problems are in the cities and the solutions are in the cities.

Bloomberg is upbeat, indomitable and an independent thinker. He made his money in global financial services and has been a Democrat, a Republican and an independent at various times. He says he believes the war on sugar and tobacco, of which his foundation must be seen as the main global financial backer, is being won.

In parts of the world, clearly yes, and particularly on smoking, he said. In Europe nobody would have thought people wouldnt insist on smoking in an Irish bar or pub or an Italian restaurant, but the smoking campaign has really worked, reducing consumption in all of western Europe, north and south America and even in China.

But there are places where poor people live and they are still smoking and really damaging their lungs and they are going to die young. It is up to us to keep the battle going. Sugar is a little bit less developed but still working.

His attention is on non-communicable diseases more broadly now that includes air pollution and road traffic accidents as well as cigarettes, alcohol and bad food. Cities in poor countries may argue that they have too many other problems to spend time on sugary drinks, but, says Bloomberg, poverty, ill-health and poor education are all interlinked.

It will be harder to get the public behind you because they less understand the damage being done to their own health. But thats the challenge. The cities where its easy have probably already addressed the issue, he said.

Michael
Michael Bloomberg and WHO director-general Dr Margaret Chan Photograph: Bloomberg Phlilantropies

Bloomberg would not suggest it is easy to make the sort of changes he has pushed for in all these years.

I dont remember anybody objecting to the smoking ban when we put it in, although a lot of people wanted to take my picture and a lot of people gave me one finger waves, he said. If there was an easy solution to a complex problem, we wouldnt have the problem. If you want to make things better, youre going to be doing things that are tough.

The cities that commit to the Partnership for Healthy Cities can choose between curbing sugary drink consumption, passing laws to make public places smoke-free or banning cigarette advertising, cutting salt in food, using cleaner fuels, encouraging cycling and walking, reducing speeding, increasing seatbelt and helmet use, curbing drink driving or carrying out a survey to collect data on the lifestyle risks the city population runs.

Cape Town in South Africa was one of the earliest cities to commit and will focus on reducing the intake of sugary drinks. Its mayor, Patricia de Lille, says they are facing an epidemic of type 2 diabetes, caused by obesity. Diabetes is a silent killer, she said. We dont have the luxury to work by trial and error. Unfortunately we have to get it right first time.

London has also said it wants to be involved, although which issue will be the focus has not yet been revealed. It is a city with which Bloomberg says he has a complex relationship his former wife is British and his daughters hold dual nationality. He has an honorary knighthood from the Queen. He also has an honour from the City of London that he intends one day to cash in.

I do have the right to drive sheep across London Bridge and before I die, I want to do it one day at rush hour, just to see what happens, he said.

Read more: https://www.theguardian.com/society/2017/may/16/billionaire-bloomberg-to-fund-5m-public-health-projects-in-40-cities-worldwide

Are smartphones really making our children sad?

US psychologist Jean Twenge, who has claimed that social media is having a malign affect on the young, answers critics who accuse her of crying wolf

Last week, the childrens commissioner, Anne Longfield, launched a campaign to help parents regulate internet and smartphone use at home. She suggested that the overconsumption of social media was a problem akin to that of junk-food diets. None of us, as parents, would want our children to eat junk food all the time double cheeseburger, chips, every day, every meal, she said. For those same reasons, we shouldnt want our children to do the same with their online time.

A few days later, former GCHQ spy agency chief Robert Hannigan responded to the campaign. The assumption that time online or in front of a screen is life wasted needs challenging. It is driven by fear, he said. The best thing we can do is to focus less on the time they spend on screens at home and more on the nature of the activity.

This exchange is just one more example of how childrens screentime has become an emotive, contested issue. Last December, more than 40 educationalists, psychologists and scientists signed a letter in the Guardian calling for action on childrens screen-based lifestyles. A few days later, another 40-odd academics described the fears as moral panic and said that any guidelines needed to build on evidence rather than scaremongering.

Faced with these conflicting expert views, how should concerned parents proceed? Into this maelstrom comes the American psychologist Jean Twenge, who has written a book entitled iGen: Why Todays Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy and Completely Unprepared for Adulthood and What That Means for the Rest of Us.

If the books title didnt make her view clear enough, last weekend an excerpt was published in the American magazine the Atlantic with the emotive headline Have smartphones destroyed a generation? It quickly generated differing reactions that were played out on social media these could be broadly characterised as praise from parents and criticism from scientists. In a phone interview and follow-up emails, Twenge explained her conclusions about the downsides of the connected world for teens, and answered some of her critics.

The Atlantic excerpt from your book was headlined Have smartphones destroyed a generation? Is that an accurate reflection of what you think?
Well, keep in mind that I didnt write the headline. Its obviously much more nuanced than that.

So why did you write this book?
Ive been researching generations for a long time now, since I was an undergraduate, almost 25 years. The databases I draw from are large national surveys of high school and college students, and one of adults. In 2013-14 I started to see some really sudden changes and at first I thought maybe these were just blips, but the trends kept going.

Id never seen anything like it in all my years of looking at differences among generations. So I wondered what was going on.

What were these sudden changes for teens?
Loneliness and depressive symptoms started to go up, while happiness and life satisfaction started to go down. The other thing that I really noticed was the accelerated decline in seeing friends in person it falls off a cliff. Its an absolutely stunning pattern Id never seen anything like that. I really started to wonder, what is going on here? What happened around 2011-2012 [the survey data is a year or two behind] that would cause such sudden changes?

And you concluded these changes were being brought about by increased time spent online?
The high-school data detailed how much time teens spend online on social media and games and I noticed how that correlated with some of these indicators in terms of happiness, depression and so on.

I was curious not just what the correlations were between these screen activities, mental health and wellbeing, but what were the links with non-screen activities, like spending time with friends in person, playing sports, going to religious services, doing homework, all these other things that teens do?

And for happiness in particular, the pattern was so stark. Of the non-screen activities that were measured, they all correlated with greater happiness. All the screen activities correlated with lower happiness.

Youve called these post-millennials the iGeneration. What are their characteristics?
Im defining iGen as those born between 1995 and 2012 that latter date could change based on future data. Im reasonably certain about 1995, given the sudden changes in the trends. It also happens that 1995 was the year the internet was commercialised [Amazon launched that year, Yahoo in 1994 and Google in 1996], so if you were born in that year you have not known a time without the internet.

But the introduction of the smartphone, exemplified by the iPhone, which was launched in 2007, is key?
There are a lot of differences some are large, some are subtle, some are sudden and some had been building for a while but if I had to identify what really characterises them, the first influence is the smartphone.

iGen is the first generation to spend their entire adolescence with the smartphone. This has led to many ripple effects for their wellbeing, their social interactions and the way they think about the world.

Psychology
Psychology professor Jean Twenge. Photograph: Gregory Bull/AP

Why are you convinced they are unhappy because of social media, rather than it being a case of the unhappy kids being heavier users of social media?
That is very unlikely to be true because of very good research on that very question. There is one experiment and two longitudinal studies that show the arrow goes from social media to lower wellbeing and not the other way around. For example, an experiment where people
gave up Facebook for a week and had better wellbeing than those who had not.

The other thing to keep in mind is that if you are spending eight hours a day with a screen you have less time to spend interacting with friends and family in person and we know definitively from decades of research that spending time with other people is one of the keys to emotional wellbeing; if youre doing that less, thats a very bad sign.

A professor at Oxford University tweeted that your work is a non-systematic review of sloppy social science as a tool for lazy intergenerational shaming how do you respond?
It is odd to equate documenting teens mental health issues with intergenerational shaming. Im not shaming anyone and the data I analyse is from teens, not older people criticising them.

This comment is especially strange because this researchers best-known paper, about what he calls the Goldilocks theory, shows the same thing I find lower wellbeing after more hours of screen time. Were basically replicating each others research across two different countries, which is usually considered a good thing. So I am confused.

Your arguments also seem to have been drawn on by the conservative right as ammunition for claims that technology is leading to the moral degradation of the young. Are you comfortable about that?
My analyses look at what young people are saying about themselves and how they are feeling, so I dont think this idea of older people love to whine about the young is relevant. I didnt look at what older people have to say about young people. I looked at what young people are saying about their own experiences and their own lives, compared to young people 10, 20, or 30 years ago.

Nor is it fair or accurate to characterise this as youth-bashing. Teens are saying they are suffering and documenting that should help them, not hurt them. I wrote the book because I wanted to give a voice to iGen and their experiences, through the 11 million who filled out national surveys, to the 200 plus who answered open-ended questions for me, to the 23 I talked to for up to two hours. It had absolutely nothing to do with older people and their complaints about youth.

Many of us have a nagging feeling that social media is bad for our wellbeing, but we all suffer from a fear of missing out.
Teens feel that very intensely, which is one reason why they are so addicted to their phones. Yet, ironically, the teens who spend more time on social media are actually more likely to report feeling left out.

But is this confined to iGeners? One could go to a childs birthday party where the parents are glued to their smartphones and not talking to each other too.
It is important to consider that while this trend also affects adults, it is particularly worrisome for teens because their brain development is ongoing and adolescence is a crucial time for developing social skills.

You say teens might know the right emoji but in real life might not know the right facial expression.
There is very little research on that question. There is one study that looked at the effects of screens on social skills among 11- to 12-year-olds, half of whom used screens at their normal level and half went to a five-day screen-free camp.

Those who attended the camp improved their social skills reading emotions on faces was what they measured. That makes sense thats the social skill you would expect to suffer if you werent getting much in-person social interaction.

So is it up to regulators or parents to improve the situation? Leaving this problem for parents to fix is a big challenge.
Yes it is. I have three kids and my oldest is 10, but in her class about half have a phone, so many of them are on social media already. Parents have a tough job, because there are temptations on the screen constantly.

What advice would you give parents?
Put off getting your child a phone for as long as possible and, when you do, start with one that doesnt have internet access so they dont have the internet in their pocket all the time.

But when your child says, but all my friends have got one, how do you reply?
Maybe with my parents line If your friends all jumped in the lake, would you do it too? Although at that age the answer is usually yes, which I understand. But you can do social media on a desktop computer for a limited time each day. When we looked at the data, we found that an hour a day of electronic device use doesnt have any negative effects on mental health two hours a day or more is when you get the problems.

The majority of teens are on screens a lot more than that. So if they want to use Instagram, Snapchat or Facebook to keep up with their friends activities, they can do that from a desktop computer.

That sounds hard to enforce.
We need to be more understanding of the effects of smartphones. In many ways, parents are worried about the wrong things theyre worried about their kids driving and going out. They dont worry about their kids sitting by themselves in a room with their phone and they should.

Lots of social media features such as notifications or Snapchats Snapstreak feature are engineered to keep us glued to our phones. Should these types of features be outlawed?
Oh man. Parents can put an app [such as Kidslox or Screentime] on their kids phone to limit the amount of time they spend on it. Do that right away. In terms of the bigger solutions, I think thats above my pay grade to figure out.

Youve been accused by another psychologist of cherry-picking your data. Of ignoring, say, studies that suggest active social media use is associated with positive outcomes such as resilience. Did you collect data to fit a theory?
Its impossible to judge that claim she does not provide citations to these studies. I found a few studies finding no effects or positive effects, but they were all older, before smartphones were on the scene. She says in order to prove smartphones are responsible for these trends we need a large study randomly assigning teens to not use smartphones or use them. If we wait for this kind of study, we will wait for ever that type of study is just about impossible to conduct.

She concludes by saying: My suspicion is that the kids are gonna be OK. However, it is not OK that 50% more teens suffer from major depression now versus just six years ago and three times as many girls aged 12 to 14 take their own lives. It is not OK that more teens say that they are lonely and feel hopeless. It is not OK that teens arent seeing their friends in person as much. If we twiddle our thumbs waiting for the perfect experiment, we are taking a big risk and I for one am not willing to do that.

Are you expecting anyone from Silicon Valley to say: How can we help?
No, but what I think is interesting is many tech-connected people in Silicon Valley restrict their own childrens screen use, so they know. Theyre living off of it but they know its effects. It indicates that pointing out the effects of smartphones doesnt make you a luddite.

iGen: Why Todays Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy and Completely Unprepared for Adulthood and What That Means for the Rest of Us by Jean Twenge is published by Simon & Schuster US ($27) on 22 August

Read more: https://www.theguardian.com/technology/2017/aug/13/are-smartphones-really-making-our-children-sad

Stop children bingeing on social media during holidays, parents urged

Childrens commissioner says too much time is spent online as she launches five a day campaign

The childrens commissioner has warned parents that they must intervene to stop their children overusing social media and consuming time online like junk food.

As web use reaches record highs among children, Anne Longfield has attacked the new methods social media giants are using to draw them into spending more time staring at tablets and smartphones. In an interview with the Observer, she said that parents should step up and be proactive in stopping their children from bingeing on the internet during the summer holidays.

Launching a campaign to help parents to regulate their childrens internet use, she said time online should be balanced in the same way that parents regulate their childrens diets. Its something that every parent will talk about especially during school holidays that children are in danger of seeing social media like sweeties, and their online time like junk food, she said.

None of us as parents would want our children to eat junk food all the time double cheeseburger, chips, every day, every meal. For those same reasons we shouldnt want our children to do the same with their online time.

When phones, social media and games make us feel worried, stressed and out of control, it means we havent got the balance right. With your diet, you know that, because you dont feel that good. Its the same with social media.

Her warning comes after a report said that children in all age groups are spending ever-longer periods online. The internet overtook television as the top media pastime for British children last year, according to the media regulator Ofcom. Children aged five to 15 are spending 15 hours a week online.

Last year the time three- and four-year-olds spent online increased from six hours 48 minutes to eight hours 18 minutes a week, while 12- to 15-year-olds now spend more than 20 hours online.

Facebook
Facebook Photograph: Thomas White/Reuters

Longfield said children should be helped to understand that sites encourage them to click on another game or video based on what they had just played. She had been pressuring Facebook to make it easier for children to report things they are worried about or switch off certain features.

She also criticised a feature on Snapchat, known as the Snapstreak, that she said encouraged children to increase their internet use. A streak is created when friends share photos over three consecutive days, but it is destroyed if a day is missed. Longfield compared the feature to a chain letter.

You find children saying to parents that they have 30 people that they have to do every day and if they dont, they drop the streak, and everyone will see, she said. And then does that mean they dont like me any more? Its almost like chain letters. There are children who say they cant not be online, and I think thats really worrying.

I want Facebook and all the other social media companies to be as proactive as they can about creating a good place and a safe place for kids to be. At the same time I want them to stop using the algorithms and the targeting that get kids addicted all those things that we know can be very stressful and very destructive. However, it doesnt mean that parents themselves can step aside and wait for that to happen.

Longfield said it was not helpful to recommend an absolute time limit on how long children should be online. Instead, she is announcing a digital five-a-day campaign, designed to advise parents and children on a healthy online diet. Rather than switching off the wifi, parents should help children to use their internet time to learn new skills, interact positively with friends and be creative.

Were not saying its parents fault, or that they should tell their children what to do, because ultimately this is part of life. All of those kids will have grown up with that being the normality. But we do think there is a role here for parents to step up, to stop waiting for others to come up with the solution, be that government or [social media] companies. We want [children] to feel informed, confident and empowered, and have the confidence to say, no, Im not going to do that. That same confidence we want for children, we want for parents, too.

She said Facebook and other social media giants are not coming forward at quite the speed I would like them to on making it easier to protect children.

There is so much more they could do, she said. These are clever, clever people, who know their industry well, their tech abilities well. They can do things if they want that I dont even know exist, and there are some very good examples of them using their expertise, for example by spotting people who have suicidal tendencies. But they are not doing [enough] yet.

Snapchat and Facebook declined to comment.

Read more: https://www.theguardian.com/society/2017/aug/05/children-bingeing-social-media-anne-longfield-childrens-commissioner

Rule that patients must finish antibiotics course is wrong, study says

Experts suggest patients should stop taking the drugs when they feel better rather than completing their prescription

Telling patients to stop taking antibiotics when they feel better may be preferable to instructing them to finish the course, according to a group of experts who argue that the rule long embedded in the minds of doctors and the public is wrong and should be overturned.

Patients have traditionally been told that they must complete courses of antibiotics, the theory being that taking too few tablets will allow the bacteria causing their disease to mutate and become resistant to the drug.

But Martin Llewelyn, a professor in infectious diseases at Brighton and Sussex medical school, and colleagues claim that this is not the case. In an analysis in the British Medical Journal, the experts say the idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by evidence, while taking antibiotics for longer than necessary increases the risk of resistance.

There are some diseases where the bug can become resistant if the drugs are not taken for long enough. The most obvious example is tuberculosis, they say. But most of the bacteria that cause people to become ill are found on everybodys hands in the community, causing no harm, such as E coli and Staphylococcus aureus. People fall ill only when the bug gets into the bloodstream or the gut. The longer such bacteria are exposed to antibiotics, the more likely it is that resistance will develop.

The experts say there has been too little research into the ideal length of a course of antibiotics, which also varies from one individual to the next, depending in part on what antibiotics they have taken in the past.

In hospital, patients can be tested to work out when to stop the drugs. Outside hospital, where repeated testing may not be feasible, patients might be best advised to stop treatment when they feel better, they say. That, they add, is in direct contravention of World Health Organisation advice.

Other experts in infectious diseases backed the group. I have always thought it to be illogical to say that stopping antibiotic treatment early promotes the emergence of drug-resistant organisms, said Peter Openshaw, president of the British Society for Immunology.

This brief but authoritative review supports the idea that antibiotics may be used more sparingly, pointing out that the evidence for a long duration of therapy is, at best, tenuous. Far from being irresponsible, shortening the duration of a course of antibiotics might make antibiotic resistance less likely.

Alison Holmes, a professor of infectious diseases at Imperial College London, said a great British authority, Prof Harold Lambert, had made the same point in a Lancet article entitled Dont keep taking the tablets as early as 1999. It remains astonishing that apart from some specific infections and conditions, we still do not know more about the optimum duration of courses or indeed doses in many conditions, yet this dogma has been pervasive and persistent.

Jodi Lindsay, a professor of microbial pathogenesis at St Georges, University of London, said it was sensible advice. The evidence for completing the course is poor, and the length of the course of antibiotics has been estimated based on a fear of under-treating rather than any studies, she said. The evidence for shorter courses of antibiotics being equal to longer courses, in terms of cure or outcome, is generally good, although more studies would help and there are a few exceptions when longer courses are better for example, TB.

But the Royal College of GPs expressed concerns. Recommended courses of antibiotics are not random, said its chair, Prof Helen Stokes-Lampard. They are tailored to individual conditions and in many cases, courses are quite short for urinary tract infections, for example, three days is often enough to cure the infection.

We are concerned about the concept of patients stopping taking their medication midway through a course once they feel better, because improvement in symptoms does not necessarily mean the infection has been completely eradicated. Its important that patients have clear messages and the mantra to always take the full course of antibiotics is well known. Changing this will simply confuse people.

The UKs chief medical officer, Prof Dame Sally Davies, said: The message to the public remains the same: people should always follow the advice of healthcare professionals. To update policies, we need further research to inform them.

[The National Institute for Health and Care Excellence] is currently developing guidance for managing common infections, which will look at all available evidence on appropriate prescribing of antibiotics.

The Department of Health will continue to review the evidence on prescribing and drug-resistant infections, as we aim to continue the great progress we have made at home and abroad on this issue.

Read more: https://www.theguardian.com/society/2017/jul/26/rule-patients-must-finish-antibiotics-course-wrong-study-says

Hunger by Roxane Gay review how the world treats fat people

A catalogue of horrors and public humiliations, Gays memoir responds to societys condescension and disgust about her body size

This is a book its author Roxane Gay has, over many years, earned the right not to publish. Even though she has found great success as an essayist, writer of fiction and university teacher, and attracted a large, passionate online following, its clear from her account that her weight is still the first thing strangers notice about her, and that she must spend much of her time dealing with their unsolicited responses to it. These range from rude to abusive, encompassing all sorts of casual mockery, faux concern and outright aggression along the way.

Shopping for clothes or food, visiting a restaurant or getting on a plane frequently involve a humiliating ordeal. Doctors not only patronise her but routinely refuse her basic care. Simply leaving the house means navigating a physical and emotional obstacle course. No doubt Gay is thoroughly sick of being reduced to her body and of enduring constant inquiries, prejudices and criticism, and she has evidently worked hard to make space for herself to talk and write about other things. People asking those kinds of questions dont deserve an answer, and yet here Gay has decided to give them one.

Hunger comprises at least two stories: a partial but more or less linear telling of Gays life so far, and a more halting, spiralling description of her everyday experience as a fat woman. The first of these hinges on the horrifying rape visited on her as a 12-year-old by her boyfriend and several of his friends. Gay blames herself, and her suffering is compounded when the boys report their version of events to their peers at school; she keeps hers quiet, unable to say anything about it to her family. The brief evocation of her childhood before this point conjures an almost fairytale-like atmosphere of love and optimism, peopled with adoring parents and siblings. I fell asleep most nights, Gay writes, flush with the joy of knowing I belonged to these people and they belonged to me.

Afterwards, everything changes: she begins to overeat and her weight gain is swift and dramatic, to her familys dismay. Various attempts to reverse it, some undertaken willingly, others under parental pressure, never last long, and both the traumatic event and her highly visible response to it overshadow everything else that happens to her. Gays mother and father are well-to-do Haitian Americans who clearly have high expectations of their children. Gay, who attends an elite boarding school followed by Yale, drops out and moves to another state without letting anyone know where she is. She eventually completes a PhD and garners acclaim as a writer, but this book is still a catalogue of horrors large and small: there are abusive relationships and public humiliations. Particularly striking are the depictions of what its like for Gay to go to the gym or on a date. Unable to fit on a restaurant chair and denied a more comfortable booth, she spends an entire meal holding herself up in an excruciating squat. At the supermarket, random people entitle themselves to remove foods they deem unsuitable from her cart.

Gays tone shifts between a breezy, conversational style and something harsher, and she recounts painful events in short, almost incantatory sentences: There was a boy. I loved him. His name was Christopher. Thats not really his name. You know that. She occasionally makes light of the cliches that surround public discussion of weight loss (though she herself cant avoid some of these). Scoffing at Oprah Winfreys metaphor of the cheerful, skinny alter ego lurking inside every fat person, she notes, I ate that thin woman, and she was delicious but unsatisfying.

But in general theres not much to laugh about. Gay alludes to or summarises difficult conversations, but rarely recounts them in full, and the overall effect is often one of claustrophobic intensity, as if the reader is trapped inside her head much the way she describes feeling caged in her flesh. Some of the books repetitions may be due to its origin in shorter pieces written for various publications, but most reflect the near-constant frustrations of living in a body the world both fixates on and refuses to accommodate. One of the few scenes rendered in detail is the gruesome early description of her father taking her to a group consultation with a doctor who performs gastric bypass surgeries. They must watch a video of patients steamy red and pink and yellow insides being carved up in an exorbitantly expensive and devastating procedure that even in the best case scenario will leave them permanently malnourished.

Though Gay does not owe anyone a single explanation of her size, she gives her readers an abundance of them. If some can seem a little too neat and familiar, that effect is complicated by how many accumulate, often directly contradicting each other. She characterises her initial weight gain as an attempt to take up more space, growing bigger and more powerful, but also as an effort to disappear and avoid ever attracting male attention again. She deliberately eats to create a protective shield of flesh, or simply cannot resist using food to soothe unbearable emotions. Gays mixed feelings often feel inevitable, though, in a culture that gives fat women no safe place to stand: you must feel bad about your size, but not enough to make anyone else uncomfortable; you must feel good about yourself as you are, but not too good. I am a product of my environment, she writes, explaining why her feminist convictions cant protect her from the cycle of selfblame, from longing to be thinner and accusing herself of weakness or lack of discipline when her body doesnt change.

Elna
Elna Bakers 2016 account of her own extreme weight loss sheds light on Hunger.

Most of what Gay endures is neither her fault nor within her control, but since she believes society will not change fast enough, if at all, she makes no apology for yearning to adjust herself to it. And of course, much of the more or less veiled fear and disgust expressed by others is a self-fulfilling reaction to their own conditioning: People know how they see and treat and think about fat people and dont want such a fate to befall them. The book is crammed with agonising ironies, some more strongly emphasised than others. Gay gains weight as an outward expression of her unhappiness, but those around her dont get the message, and only make her more miserable in their reactions to her changing body. In trying to develop a defence mechanism after her rape, she inadvertently invites half a lifetime of invasive threats to her physical autonomy and violations of her consent. When her parents want her to go on a liquid diet or to a fat camp, she agrees because I had learned that saying no meant nothing.

As she has before, in her hit essay collection Bad Feminist, Gay proclaims her refusal to represent anyone but herself. Among other things, that means she isnt interested in trying to make anyone feel better including other people of size who would rather not hear that she hates her body and blames herself for her inability to change it. This is not, as she notes repeatedly, a story of triumph neither of triumphant weight loss nor triumphant self-acceptance.

Stories that skirt those two possibilities are far rarer than they should be, and the exceptions, whatever their individual failings, stick in the mind. Reading Hunger reminded me of radio producer Elna Bakers 2016 account of her own extreme weight loss and its aftermath, which in some ways holds up a funhouse mirror to Gays experience. Its only after losing a huge amount of weight that Baker fully discovers the miseries the world inflicts on fat people. As a thin woman, she finds her love life, job prospects and everyday existence suddenly transformed. And she encounters head-on the stubborn denial that enables other people to enforce sadistic norms: when Baker insists to her husband that hed never have fallen for her at her previous weight, he tries to weasel out of it, suggesting that all the benefits Baker derives from being thin are simply due to how much happier and more confident she must now feel. But that isnt true, she says she was fine before, whereas now she must live with the knowledge that her new life and relationship require her to keep up an unnatural (and unhealthy) struggle with her weight for ever. Bakers story helps shed light on one of the most intractable knots in Hunger. Gay knows that losing the weight would not solve everything or grant her happiness, and yet she longs for the entirely different, less painful life she imagines she could have had without it.

Early in the book, Gay characterises it as a confession, that term so often flung as an insult at women who write about themselves. These, she writes, are the ugliest, weakest, barest parts of me. Its more a provocation than a promise. There are certainly flashes of confession, passages in which Gay lays out, say, the precise effects her rape has had on the formation of her sexual desires. But mostly she is not prepared to be so bare and weak as all that. Its the world around her that comes off as out of control in its appetites hate-filled, obsessed with womens body parts, eager to punish what it helps create.

Hunger is published by Harper. To order a copy for 11.89 (RRP 13.99) go to bookshop.theguardian.com or call 0330 333 6846. Free UK p&p over 10, online orders only. Phone orders min p&p of 1.99.

Read more: https://www.theguardian.com/books/2017/jul/19/hunger-by-roxane-gay-review

Journalist under fire for calling it ‘crazy’ not to be disgusted by homeless people

Prominent Mother Jones writer Kevin Drum says critics deliberately misreading his response to study on peoples reaction to seeing homelessness

A high-profile Mother Jones writer has suggested that it would be crazy not to have a reflexive disgust of homeless people, stirring the anger of those who say he is perpetuating the worst kinds of stereotypes.

Writing on Friday, Kevin Drum was responding to a study which found that some people with a propensity for feeling disgust might experience it when faced with someone living on the street.

Glenn Greenwald reacted by posting photographs of homeless people who have performed altruistic acts alongside a screen shot from Drums story. The two authors of the study, meanwhile, say Drum glossed over subtleties in their work.

outside in america

He seemed to just be endorsing the worst stereotypes without any nuance or without any humanization of these people, said Scott Clifford, one of the authors and an assistant professor of political science at the University of Houston.

Drum said his critics were guilty of deliberately misreading what I wrote.

The authors of the study which is admittedly eyebrow-raising owing to its lexicon set out to untangle a contradiction. Across the country, cities seek to aid homeless people by providing shelters and millions of dollars in funding, while also passing laws against sitting or lying on sidewalks, or restricting where RVs can park, which serve to exclude them.

They examined survey data and focused on a particular feeling that seemed to play a role in perpetuating this paradox: While most of the public wants to help homeless people, they write, sensitivity to disgust drives many of these same people to support policies that facilitate physical distance from homeless people.

Disgust, they propose, might help explain nimbyism in this casea desire among housed people to prevent camps or housing being built in the vicinity of their own homes. And they argue that the media exacerbates disgust with stories that mention disease and unsanitary conditions.

But they do not say that this kind of reaction of reaction is universal: while some people are prone to feeling disgust in the presence of homelessness, others are less likely to.

In his brief response to a summary that the authors published in the Washington Post, Drum said he found their results unsurprising. About half the homeless suffer from a mental illness and a third abuse either alcohol or drugs, he wrote, before commenting how crazy it would be not to not to be disgusted by a population like that.

He finished by suggesting that it was the work of a decent human being to overcome these reflexive feelings and find empathy.

It certainly is the work of of a good human being not to act fully based on immediate reactions, said Maria Foscarinis, executive director of the National Law Center on Homelessness & Poverty. She said the study seems to make sense, though she had some reservations. But she did not agree with Drum, calling the post really over the top and not true to what the paper is saying.

Its just a manifestation of the worst kinds of stereotypes. As a subscriber to this publication, Im really disappointed.

Pete White, head of the Los Angeles Community Action Network, said he thought Drums conclusions risked tarring an entire group of people, as if every houseless person is addicted to drugs and had a mental illness.

Both of the studys authors expressed displeasure. He appears to believe that everyone will in all circumstances feel disgust towards homeless people, said Spencer Piston, the other author and an assistant professor of political science at Boston University. Theres a clear irony here, which is that we argue that the connection between disgust and attitudes about the homeless depend in part on media coverage and the extent to which homeless people are portrayed as disgusting.

In an email, Drum said that he did not think his blogpost was unfaithful to the study. He also pushed back at those condemning him. Please note that I didnt say I was disgusted by the homeless, nor that they are inherently disgusting, he said. Only that, given the nature of the demographic, its not surprising that most people find them disgusting.

Clara Jeffery, the editor-in-chief of Mother Jones, said that the anger was fueled by the terms used in the study and not Drums writing itself. But it is one brief post about a study, she added in her email. Mother Jones has an extensive body of work on the homeless, the housing and mental health and opioid crisis fueling it.

Do you have an experience of homelessness to share with the Guardian? Get in touch

Read more: https://www.theguardian.com/us-news/2017/jul/17/homelessness-kevin-drum-mother-jones-disgust

How the middle class hoards wealth and opportunity for itself

American society is dominated by an elite 20% that ruthlessly protects its own interests

When I was growing up, my mother would sometimes threaten my brother and me with electrocution. Well, thats not quite right. In fact, the threat was of lessons in elocution, but we wittily, we thought renamed them.

Growing up in a very ordinary town just north of London and attending a very ordinary high school, one of our several linguistic atrocities was failing to pronounce the t in certain words. My mother, who was raised in rural north Wales and left school at 16, did not want us to find doors closed in a class-sensitive society simply because we didnt speak what is still called the Queens English. I will never forget the look on her face when I managed to say the word computer with neither a p nor a t.

Still, the lessons never materialised. Any lingering working-class traces in my own accent were wiped away by three disinfectant years at Oxford University. (My wife claims the adolescent accent resurfaces when I drink, but she doesnt know what shes talking about shes American.) We also had to learn how to waltz. My mother didnt want us to put a foot wrong there either.

In fact, we did just fine, in no small part because of the stable, loving home in which we were raised. But I have always been acutely sensitive to class distinctions and their role in perpetuating inequality. In fact, one of the reasons I came to the United States was to escape the cramped feeling of living in a nation still so dominated by class. I knew enough not to think I was moving to a socially mobile utopia: Id read some of the research. It has nonetheless come as something of a shock to discover that, in some important respects, the American class system is functioning more ruthlessly than the British one I escaped.

In the upper-middle-class America I now inhabit, I witness extraordinary efforts by parents to secure an elite future status for their children: tutors, coaches and weekend lessons in everything from French to fencing. But I have never heard any of my peers try to change the way their children speak. Perhaps this is simply because they know they are surrounded by other upper-middle-class kids, so there is nothing to worry about. Perhaps it is a regional thing.

But I think there is a better explanation. Americans tend to think their children will be judged by their accomplishments rather than their accents. Class position is earned, rather than simply expressed. The way to secure a higher status in a market meritocracy is by acquiring lots of merit and ensuring that our kids do, too. What ones parents are like is entirely a matter of luck, points out the philosopher Adam Swift. But he adds: What ones children are like is not. Children raised in upper-middle-class families do well in life. As a result, there is a lot of intergenerational stickiness at the top of the American income distribution more, in fact, than at the bottom with upper-middle-class status passed from one generation to the next.

Drawing class distinctions feels almost un-American. The nations self-image is of a classless society, one in which every individual is of equal moral worth, regardless of his or her economic status. This has been how the world sees the United States, too. Historian Alexis de Tocqueville observed in the early 19th century that Americans were seen to be more equal in fortune and intelligence more equally strong, in other words than they were in any other country, or were at any other time in recorded history. So different to the countries of old Europe, still weighed down by the legacies of feudalism.

British politicians have often felt the need to urge the creation of a classless society, looking to America for inspiration as, what historian David Cannadine once called it, the pioneering and prototypical classless society. European progressives have long looked enviously at social relations in the New World. George Orwell noted the lack of servile tradition in America; the German socialist Werner Sombart noticed that the bowing and scraping before the upper classes, which produces such an unpleasant impression in Europe, is completely unknown.

This is one of many reasons socialist politics struggled to take root in the United States. A key attraction of socialist systems the main one, according to Orwell is the eradication of class distinctions. There were few to eradicate in America. I am sure that one reason Downton Abbey and The Crown so delight American audiences is their depictions of an alien world of class-based status. One reason class distinctions are less obvious in America is that pretty much everyone defines themselves as a member of the same class: the one in the middle. Nine in ten adults select the label middle class, exactly the same proportion as in 1939, according to the pollsters Gallup. No wonder that politicians have always fallen over each other to be on their side.

But in recent decades Americans at the top of the ladder have been entrenching their class position. The convenient fiction that the middle class can stretch up that far has become a difficult one to sustain. As a result, the modifications upper or lower to the general middle class category have become more important.

Class is not just about money, though it is about that. The class gap can be seen from every angle: education, security, family, health, you name it. There will also be inequalities on each of these dimensions, of course. But inequality becomes class division when all these varied elements money, education, wealth, occupation cluster together so tightly that, in practice, almost any one of them will suffice for the purposes of class definition. Class division becomes class stratification when these advantages and thus status endure across generations. In fact, upper-middle-class status is passed down to the next generation more effectively than in the past, and in the United States more than in other countries.

One benefit of the multidimensional nature of this separation is that it has reduced interdisciplinary bickering over how to define class. While economists typically focus on categorisation by income and wealth, and sociologists tend more towards occupational status and education, and anthropologists are typically more interested in culture and norms, right now it doesnt really matter, because all the trends are going the same way.

It is not just the top 1% pulling away, but the top 20%. In fact, only a very small proportion of US adults 1% to 2% define themselves as upper class. A significant minority about one in seven adopts the upper middle class description. This is quite similar to the estimates of class size generated by most sociologists, who tend to define the upper middle class as one composed of professionals and managers, or around 15% to 20% of the working-age population.

As David Azerrad of the Heritage Foundation writes: There is little appetite in America for policies that significantly restrict the ability of parents to do all they can, within the bounds of the law, to give their children every advantage in life. That is certainly true. But then Azerrad has also mis-stated the problem. No one sensible is in favour of new policies that block parents from doing the best they can for their children. Even in France the suggestion floated by the former president, Franois Hollande, to restore equality by banning homework, on the grounds that parents differ in their ability and willingness to help out, was laughed out of court. But we should want to get rid of policies that allow parents to give their children an unfair advantage and in the process restrict the opportunities of others.

Most of us want to do our best for our children. Wanting ones childrens life to go well is part of what it means to love them, write philosophers Harry Brighouse and Adam Swift in their 2014 book Family Values: The Ethics of Parent-Child Relationships. But our natural preference for the welfare and prospects of our own children does not automatically eclipse other moral claims. We would look kindly on a father who helps his son get picked as starting pitcher for his school baseball team by practising with him every day after work. But we would probably feel differently about a father who secures the slot for his son by bribing the coach. Why? After all, each father has sacrificed something, time in one case, money in the other, to advance his child. The difference is team selection should be based on merit, not money. A principle of fairness is at stake.

So, where is the line drawn? The best philosophical treatment of this question I have found is the one by Swift and Brighouse. Their suggestion is that, while parents have every right to act in ways that will help their childrens lives go well, they do not have the right to confer on them a competitive advantage in other words, to ensure not just that they do well but that they do better than others. This is because, in a society with finite rewards, improving the situation of one child necessarily worsens that of another, at least in relative terms: Whatever parents do to confer competitive advantage is not neutral in its effects on other children it does not leave untouched, but rather is detrimental to, those other childrens prospects in the competition for jobs and associated rewards.

The trouble is that in the real world this seems like a distinction without a difference. What they call competitive advantage-conferring parental activities will almost always be also helping-your-kid-flourish parental activities. If I read bedtime stories to my son, he will develop a richer vocabulary and may learn to love reading and have a more interesting and fulfilling life. But it could also help him get better grades than his classmates, giving him a competitive advantage in college admissions. Swift and Brighouse suggest a parent should not even aim to give their child a competitive advantage: It would be a little odd, perhaps even a little creepy, if the ultimate aim of her endeavours were that her child is better off than others.

I think this is too harsh. In a society with a largely open, competitive labour market, it is not creepy to want your children to end up higher on the earnings ladder than others. Not only will this bring them a higher income, and all the accompanying choices and security, it is also likely to bring them safer and more interesting work. Relative position matters it is one reason, after all, that relative mobility is of such concern to policymakers. Although I think Brighouse and Swift go too far, they are on to something important with their distinction between the kind of parental behaviour that merely helps your own children and the kind that is detrimental to others. Thats what I call opportunity hoarding.

Opportunity hoarding does not result from the workings of a large machine but from the cumulative effect of individual choices and preferences. Taken in isolation, they may feel trivial: nudging your daughter into a better college with a legacy preference [giving applicants places on the basis of being related to alumni of the college]; helping the son of a professional contact to an internship; a single vote on a municipal council to retain low-density zoning restrictions. But, like many micro-preferences, to borrow a term from economist Thomas Schelling, they can have strong effects on overall culture and collective outcomes.

Over recent decades, institutions that once primarily served racist goals legacy admissions to keep out Jewish students, zoning laws to keep out black families have not been abandoned but have been softened, normalised and subtly re-purposed to help us sustain the upper-middle-class status. They remain, then, barriers to a more open, more genuinely competitive and fairer society. I wont insult your intelligence by pretending there are no costs here. By definition, reducing opportunity hoarding will mean some losses for the upper middle class.

But they will be small. Our neighbourhoods will be a little less upmarket but also less boring. Our kids will rub shoulders with some poorer kids in the school corridor. They might not squeak into an Ivy League college, and they may have to be content going to an excellent public university. But if we arent willing to entertain even these sacrifices, there is little hope. There will be some material costs, too. The big challenge is to equalise opportunities to acquire human capital and therefore increase the number of true competitors in the labour market. This will require, among other things, some increased public investment. Where will the money come from? It cant all come from the super-rich. Much of it will have to come from the upper middle class. From me andyou.

This is an extract from Dream Hoarders: How the American Upper Middle Class is Leaving Everyone Else in the Dust, Why That is a Problem, and What To Do About It by Richard V Reeves (Brookings Institution Press, 2017)

HOW TO STAY AHEAD – OR PLAY FAIR

As parents, we naturally want our children to flourish. But that laudable desire slides into opportunity hoarding when we use our money, power or position to give our own children exclusive access to certain goods or chances. The effect is to strengthen class barriers.

1. Fix an internship using our networks. Internships are becoming more important but are too often stitched up privately. Its worse if theyre unpaid. Instead: insist on paid internships, openly recruited.

2. Take our own kids to work for the day. Children learn what work is from adults. Instead: try bringing somebody elses kid to work, perhaps by partnering with local charities.

3. Be a Nimby. By shutting out low-income housing from our neighbourhoods with planning restrictions, we keep less affluent kids away from our local schools and communities. Instead: be a Yimby, vote and argue for more mixed housing in your area.

4. Write cheques to PTA funds. Many of us want to support the school our children attend. This tilts the playing field, however, since other schools cant do the same. Instead: get your PTA to give half the donations to a school in a poor area.

Read more: https://www.theguardian.com/inequality/2017/jul/15/how-us-middle-classes-hoard-opportunity-privilege

Health effects of coffee: Where do we stand?

(CNN)It’s one of the age-old medical flip-flops: First coffee’s good for you, then it’s not, then it is — you get the picture.

Today, the verdict is thumbs up, with study after study extolling the merits of three to five cups of black coffee a day in reducing risk for everything from melanoma to heart disease, multiple sclerosis, type 2 diabetes, Parkinson’s disease, liver disease, prostate cancer, Alzheimer’s, computer-related back pain and more.
To stay completely healthy with your coffee consumption, you’ll want to avoid packing it with calorie laden creams, sugars and flavors. And be aware that a cup of coffee in these studies is only 8 ounces; the standard “grande” cup at the coffee shop is double that at 16 ounces.
    And how you brew it has health consequences. Unlike filter coffee makers, the French press, Turkish coffee or the boiled coffee popular in Scandinavian countries fail to catch a compound called cafestol in the oily part of coffee that can increase your bad cholesterol or LDL.
    Finally, people with sleep issues or uncontrolled diabetes should check with a doctor before adding caffeine to their diets, as should pregnant women, as there is some concern about caffeine’s effect on fetal growth and miscarriage. And some of the latest research seems to say that our genes may be responsible for how we react to coffee, explaining why some of us need several cups to get a boost while others get the jitters on only one.
    But as you know, the news on coffee has not always been positive. And the argument over the merits of your daily cup of joe dates back centuries. Let’s take a look at the timeline.
    1500’s headline: Coffee leads to illegal sex
    Legend has it that coffee was discovered by Kaldi, an Ethiopian goatherd, after he caught his suddenly frisky goats eating glossy green leaves and red berries and then tried it for himself. But it was the Arabs who first started coffeehouses, and that’s where coffee got its first black mark.
    Patrons of coffeehouses were said to be more likely to gamble and engage in “criminally unorthodox sexual situations,” according to author Ralph Hattox. By 1511 the mayor of Mecca shut them down. He cited medical and religious reasons, saying coffee was an intoxicant and thus prohibited by Islamic law, even though scholars like Mark Pendergrast believe it was more likely a reaction to the unpopular comments about his leadership. The ban didn’t last long, says Pendergrast, adding that coffee became so important in Turkey that “a lack of sufficient coffee provided grounds for a woman to seek a divorce.”
    1600’s headline: Coffee cures alcoholism but causes impotence
    As the popularity of coffee grew and spread across the continent, the medical community began to extol its benefits. It was especially popular in England as a cure for alcoholism, one of the biggest medical problems of the time; after all, water wasn’t always safe to drink, so most men, women and even children drank the hard stuff.
    Local ads such as this one in 1652 by coffee shop owner Pasqua Rose popularized coffee’s healthy status, claiming coffee could aid digestion, prevent and cure gout and scurvy, help coughs, headaches and stomachaches, even prevent miscarriages.
    But in London, women were concerned that their men were becoming impotent, and in 1674 The Women’s Petition Against Coffee asked for the closing of all coffeehouses, saying in part: “We find of late a very sensible Decay of that true Old English Vigour. … Never did Men wear greater Breeches, or carry less in them…”
    1700’s headline: Coffee helps you work longer
    By 1730, tea had replaced coffee in London as the daily drink of choice. That preference continued in the colonies until 1773, when the famous Boston Tea Party made it unpatriotic to drink tea. Coffeehouses popped up everywhere, and the marvelous stimulant qualities of the brew were said to contribute to the ability of the colonists to work longer hours.
    1800’s headline: Coffee will make you go blind. Have a cup of hot wheat-bran drink instead
    In the mid-1800s America was at war with itself and one side effect is that coffee supplies ran short. Enter toasted grain-based beverage substitutes such as Kellogg’s “Caramel Coffee” and C.W. Post’s “Postum” (still manufactured). They advertised with anti-coffee tirades to boost sales. C.W. Post’s ads were especially vicious, says Pendergrast, claiming coffee was as bad as morphine, cocaine, nicotine or strychnine and could cause blindness.
    1916 headline: Coffee stunts your growth
    While inventions and improvements in coffee pots, filters and processing advanced at a quick pace throughout the 1900s, so did medical concerns and negative public beliefs about the benefits of coffee.
    Good Housekeeping magazine wrote about how coffee stunts growth. And concerns continued to grow about coffee’s impact on common aliments of the era, such as nervousness, heart palpitations, indigestion and insomnia.
    1927 headline: Coffee will give you bad grades, kids
    In Science Magazine, on September 2, 1927, 80,000 elementary and junior high kids were asked about their coffee drinking habits. Researchers found the “startling” fact that most of them drank more than a cup of coffee a day, which was then compared to scholarship with mostly negative results.
    1970’s and ’80’s headline: Coffee is as serious as a heart attack
    A 1973 study in the New England Journal of Medicine of more than 12,000 patients found drinking one to five cups of coffee a day increased risk of heart attacks by 60% while drinking six or more cups a day doubled that risk to 120%.
    Another New England Journal of Medicine study, in 1978, found a short-term rise in blood pressure after three cups of coffee. Authors called for further research into caffeine and hypertension.
    A 38-year study by the Johns Hopkins Medical School of more than a 1,000 medical students found in 1985 that those who drank five or more cups of coffee a day were 2.8 times as likely to develop heart problems compared to those who don’t consume coffee. But the study only asked questions every five years, and didn’t isolate smoking behavior or many other negative behaviors that tend to go along with coffee, such as doughnuts. Or “Doooonuts,” if you’re Homer Simpson.
    Millennium headline: Coffee goes meta
    Now begins the era of the meta-analysis, where researchers look at hundreds of studies and apply scientific principles to find those that do the best job of randomizing and controlling for compounding factors, such as smoking, obesity, lack of exercise and many other lifestyles issues. That means that a specific study, which may or may not meet certain standards, can’t “tip the balance” one way or another. We take a look at some of the years. The results for coffee? Mostly good.
    2001 headline: Coffee increases risk of urinary tract cancer
    But first, a negative: A 2001 study found a 20% increase in the risk of urinary tract cancer risk for coffee drinkers, but not tea drinkers. That finding was repeated in a 2015 meta-analysis. So, if this is a risk factor in your family history, you might want to switch to tea.
    2007 headline: Coffee decreases risk of liver cancer
    Some of these data analyses found preventive benefits for cancer from drinking coffee, such as this one, which showed drinking two cups of black coffee a day could reduce the risk of liver cancer by 43%. Those findings were replicated in 2013 in two other studies.
    2010 headline: Coffee and lung disease go together like coffee and smoking
    A meta-analysis found a correlation between coffee consumption and lung disease, but the study found it impossible to completely eliminate the confounding effects of smoking.
    2011 headline: Coffee reduces risk of stroke and prostate cancer
    A meta-analysis of 11 studies on the link between stroke risk and coffee consumption between 1966 and 2011, with nearly a half a million participants, found no negative connection. In fact, there was a small benefit in moderate consumption, which is considered to be three to five cups of black coffee a day. Another meta-analysis of studies between 2001 and 2011 found four or more cups a day had a preventive effect on the risk of stroke.
    As for prostate cancer, this 2011 study followed nearly 59,000 men from 1986 to 2006 and found drinking coffee to be highly associated with lower risk for the lethal form of the disease.
    2012 headline: Coffee lowers risk of heart failure
    More meta-analysis of studies on heart failure found four cups a day provided the lowest risk for heart failure, and you had to drink a whopping 10 cups a day to get a bad association.
    2013 headline: Coffee lowers risk of heart disease and helps you live longer
    For general heart disease a meta-analysis of 36 studies with more than 1.2 million participants found moderate coffee drinking seemed to be associated with a low risk for heart disease; plus, there wasn’t a higher risk among those who drank more than five cups a day.
    How about coffee’s effects on your overall risk of death? One analysis of 20 studies, and another that included 17 studies, both of which included more than a million people, found drinking coffee reduced your total mortality risk slightly.
    2015 headline: Coffee is practically a health food
    As a sign of the times, the U.S. Department of Agriculture now agrees that “coffee can be incorporated into a healthy lifestyle,” especially if you stay within three to five cups a day (a maximum of 400 mg of caffeine), and avoid fattening cream and sugar. You can read their analysis of the latest data on everything from diabetes to chronic disease here.
    2017 headline: Yes, coffee still leads to a longer life
    The largest study to date on coffee and mortality surveyed 520,000 people in 10 European countries and found that regularly drinking coffee could significantly lower the risk of death.
    Another study with a focus on non-white populations had similar findings. That study surveyed 185,000 African-Americans, Native Americans, Hawaiians, Japanese-Americans, Latinos and whites. The varying lifestyles and dietary habits of the people observed in both studies led the authors to believe that coffee’s impact on longevity doesn’t have to do with how its prepared or how people drink it — it has to do with the beverage’s biological effect on the body.
    But stay tuned. There’s sure to be another meta-study, and another opinion. We’ll keep you updated.

    Read more: http://www.cnn.com/2015/08/14/health/coffee-health/index.html