Health & Fitness

The Centers for Disease Control and Prevention published their first Antibiotic Resistance Threats Report in 2013 with the intention of sounding the alarm to the dangers of antibiotic resistance. Experts have been warning about the advent of superbugs for decades, which is the term coined by the media for antibiotic-resistant bacteria.

The resistance happens when bacteria begin to adapt to the chemicals and drugs in the environment making treatment less effective. When bacteria become resistant, treatment is ineffective. In the first CDC report it was estimated 2 million antibiotic-resistant infections in 2013 were responsible for 23,000 deaths.

However, the 2019 report calculates this data missed nearly half the cases and deaths. New estimates find 3 million each year are infected and 35,000 die. Still other researchers believe this number is too low and a true number is likely much higher. The 2019 report identified the secondary infection linked to the use of antibiotics, Clostridioides difficile (C. diff).

This infection triggers deadly diarrhea after antibiotics have upset the natural balance of bacteria in the digestive system. If the number of deaths attributed to C. diff are added to the 2019 totals, 48,000 deaths may be attributed to antibiotic-resistant bacteria. The CDC has linked misuse of antibiotics to the impressive rise in resistant infections.

Superbugs may be found in the hospital and community where they increase your risk of a potentially deadly infection. Anyone with a compromised immune system is at greater risk of infection, including children, those who are ill and the elderly.

How Contaminated Are Your Cosmetics?

Research published in the Journal of Applied Microbiology¹ addresses the extent of contamination in cosmetics, including lip and eye products as well as beauty blenders. The goal was to identify the risks consumers in the U.K. may experience using these cosmetic products.

The study team tested donated, used products and found that 79% to 90% of all the products were contaminated. They found Staphylococcus aureus (S. aureus), Escherichia coli (E. coli) and Citrobacter freundii, as well as fungi and Enterobacteriaceae in the makeup.

These types of bacteria may trigger illness and infections when they come in contact with your eyes, mouth or near breaks in the skin. The researchers believe consumers are unwittingly putting themselves at risk for infection and illness by using products that are past their expiration date.²

The EU guidelines adhere to strict standards to prevent the contamination of new cosmetics, in particular concentrations of E. coli, but there is limited protection for consumers after the products have been opened and are in use. The shelf life or expiration of a product is the amount of time you may expect the product to act as expected and be safe to use.

When a product expires may vary depending on several factors, including how it's stored, the type of product and how it's used. The researchers expressed concern U.K. consumers may be at a greater risk after Brexit as they will no longer have the protection of EU regulations and may be purchasing more products from the U.S. where regulations are lax.

For instance, the U.S. Food and Drug Administration,³ responsible for regulating the industry, does not require cosmetics to have a specific shelf life or have printed expiration dates on products. The FDA considers "determining a product's shelf life to be part of the manufacturer's responsibility."

The law doesn't require manufacturers to share their testing or tracking information. In other words, the FDA has made manufacturers responsible for the safety of the products they sell, which allows them to regulate themselves.

Beauty Blenders Worst Offenders

The researchers evaluated 467 individual items,⁴ including beauty blenders — contoured blending sponges used to apply makeup foundation. The data revealed the highest level of harmful bacteria on these sponges, which may be the result of the products being put away damp after use, creating a perfect area for bacteria to multiply.

Additionally, the researchers found two-thirds of the users reported dropping the sponges on the floor at some time during use, but 93% of the beauty blenders had never been cleaned. Amreen Bashir, Ph.D., from Aston University was lead researcher and commented on the results:⁵

"Consumers' poor hygiene practices when it comes to using make-up, especially beauty blenders, is very worrying when you consider that we found bacteria such as E.coli - which is linked with fecal contamination - breeding on the products we tested.

More needs to be done to help educate consumers and the make-up industry as a whole about the need to wash beauty blenders regularly and dry them thoroughly, as well as the risks of using make-up beyond its expiry date."

The researchers wrote this study is the first in which scientists have looked at the relatively new beauty blender products, which are often endorsed by celebrities. The researchers concluded:⁶ "Significant levels of microbial contamination occur during use of cosmetic products and presence of pathogenic organisms pose a potential risk to health."

Your Makeup May Also Contain Poisons

Personal care and cosmetic products are notorious for the number of chemicals used in their creation and manufacture. You might be surprised to learn the average American woman uses 12 distinct personal care products each day, which combined contain nearly 168 different chemicals.

While the EU proactively regulates the number of chemicals their consumers are exposed to, the U.S. does not. Personal care products reach the store shelves without authorization by any federal agency and only after harm has been demonstrated may the FDA take action. Unfortunately, this has led to a large number of dangerous chemicals in cosmetics marketed to the public.

In one study, researchers enrolled 100 young women in a community-based research intervention study to determine if using products with lower levels of chemicals such as parabens, triclosan, phthalates and phenols could result in lower urinary concentrations. Before the start of the study, researchers found 90% of the participants had detectable levels of phthalates, parabens and BP-3.

After using alternative products labeled paraben- and phthalate-free for three days, the concentrations reduced by over 40% for parabens and over 27% for monoethyl phthalates. Unfortunately, there were increases of butyl and ethyl parabens detected in nearly half the participants, suggesting these may have been contaminants in the cosmetics or unlabeled ingredients.

This supports a further study in which researchers evaluated 49 different makeup items and found serious heavy metal contamination in nearly all the products analyzed. Contaminants included lead, beryllium, thallium, cadmium and arsenic.

In 2015, the Personal Care Products Safety Act was first proposed to Congress as an amendment to the Food, Drug and Cosmetic Act by Senators Dianne Feinstein, D-California and Susan Collins, R-Maine. The bill included a system requiring manufacturers to register their products and ingredients, requiring the FDA to review five chemicals in personal care products each year for safety.

However, the bill was never approved. It was reintroduced in May 2017 and again in March 2019. Unfortunately, Skopos Labs for GovTrack estimates only a 3% chance the bill will be enacted as a result of the March 2019 introduction.⁷

Strategies You Can Use to Prevent Contamination

It is important to take precautions to prevent your cosmetics and personal care products from becoming contaminated with bacteria to reduce your potential risk of a skin infection. Keeping your beauty blenders clean and dry between uses is especially important as the data showed these were prone to bacterial growth, including bacteria commonly found in feces.

How you use your cosmetics and the precautions you take are integral to the shelf life of your products.⁸ Cosmetics can degrade or breakdown over time related to use and storage. Here are some precautions to reduce your risk of infection and extend the life of your cosmetics:^9,10

Ensure anything you use to apply your makeup is dry and clean before dipping into the product. Wet fingers or applicators may add bacteria and other pathogens.

Most makeup is manufactured with preservatives that break down over time, increasing the risk of bacterial growth. Look for an expiration date. A better choice is to seek out safe makeup products from the Environmental Working Group (EWG)11 and heed the expiration dates.

Applicators for mascara and eyeliner are exposed to bacteria with each use, which are then reintroduced to the product. Purchase small sized products and use mascara and eyeliner only for three months before disposing of it. Mascara and eyeliner have the shortest shelf life since they are exposed to bacteria with each use and are moist. If it smells strange before three months, it's time to buy new products.

If your mascara dries out, don't add water or saliva as this introduces bacteria.

Store your makeup in a room with low humidity, which means outside the bathroom where a daily hot shower causes consistent temperature changes and rising humidity can affect bacterial growth.

Do not share makeup with anyone, even those in your immediate family. This easily spreads bacteria and increases the bacterial load in your products.

Keep your applicators clean, washing beauty blenders with soap and water and allowing them to dry with each use. Brushes and other applicators should also be routinely washed and dried.

Purchase your products only from trusted vendors. If you are purchasing online buy directly from the manufacturer or licensed distributor to reduce the potential you are sold a fake product that may be past the expiration date, tampered with or diluted.

If you develop an eye infection or skin infection on your face, stop using all your makeup, especially eye makeup. Seek medical attention quickly to reduce the potential of an infection that may lead to loss of eyesight.

Proper Hand-Washing Helps Prevents Spread of Infection

E. coli is one of the bacteria researchers found in contaminated makeup. Some scientists call it the Dr. Jekyll and Mr. Hyde of bacteria since there's such a wide spectrum ranging from harmless to fatal. Hand-washing is one of the primary strategies you may use to prevent the spread of disease, yet several studies have found many of those who use a public restroom leave without washing their hands.

In a study by the U.S. military, after two years of using proper hand-washing techniques, 45% of the participants had fewer respiratory illnesses. It is important to wash your hands before putting on makeup and to routinely clean your makeup applicators. Using the correct technique helps reduce the number of harmful bacteria. To be truly effective, consider using the following guidelines.

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Most of us have some idea about the dangers of inactivity — the too common lifestyle that consists of going from the "couch to the car to the cube." But many think the alternative to a sedentary life is active working out and a gym membership.

The excellent documentary "The Walking Revolution," which grew out of the Kaiser Permanente Every Body WALK! campaign,¹ shows that the alternative to inactivity can be a simple, fun and free activity. It is called walking.

From "mall walking" to "walking school buses" made up of school children who walk to school as a group with a supervising adult, "The Walking Revolution" shows many ways you can incorporate walking into your everyday life. Implementing standing desks, which we use at Mercola.com, and using the stairs rather than the elevator are also great ways to combat a sedentary lifestyle.

"The Walking Revolution" also reveals health benefits of walking, some not that well-known. You may realize walking can lower your blood pressure and reduce your susceptibility to diabetes, but do you realize walking can also lower your risk of developing cancers and cognitive decline and that it can work as an "instant antidepressant," as experts say in the video?

In addition to benefits to your health, "The Walking Revolution" stresses the environmental benefits of walking. Pedestrian-designed environments like transit-oriented development (TOD), a type of urban development that situates housing within walking distance of public transportation, result in fewer cars and less pollution.

"Walk friendly" environments even help the local economy by enabling people to more easily visit stores that are not in malls and strip malls, says the film. Best of all, unlike some other forms of exercise, you can begin walking immediately with no particular training and do not need any special equipment.

How Did Americans Stop Walking?

When I grew up, children walked to school and were not typically driven by their parents. I still walk every day, usually barefoot, to receive the benefits of grounding along with the benefits of walking.

While fear of child-focused crime is a major reason parents say they began driving their children almost everywhere, and many children no longer live within walking distance of their school, the physical effects on children have been catastrophic.

Obesity now affects 13.7 million children and adolescents,² and children are developing what used to be thought of as "adult" diseases like Type 2 diabetes and high blood pressure.³

U.S. inactivity and the obesity caused by sedentary lifestyles can be traced back 40 to 50 years as the U.S. highway system matured. That is when car culture and "bedroom communities" sprang up with breadwinners commuting to their jobs and returning to their suburban or exurban homes. Here is how Kaiser Permanente's "Every Body WALK!" describes the unfortunate evolution:⁴

"For the past 75 years, and in order to sell land, cars and a new concept of consumer-driven lifestyle, America’s city planners favored the sprawl: Suburbia, individualized traffic, brand- new freeways and loose zoning laws won out over Main Street, USA — where people once lived, worked and shopped in relative proximity to their homes ...

While it took our communities less than a century to make that shift, what happened to our bodies after evolving for thousands of years as hunter - gatherer - transportation machines was severe ...

Raised in industrialized societies with little need to move and exercise, the human body is now paying a heavy price. Our natural bodies are mismatched to our constructed environment of comforts dooming us to live out our days in the golden cage of a sedentary lifestyle ...

Once upon a time our cities were designed on a human scale. As more and more people took to the roads, we moved into the suburbs. Sidewalks were removed. Drive-in mini-malls were created. Homes and business moved farther and farther apart. The Result: urban sprawl so expansive it could not be walked in a single day."

When they conceived their commuter-based environments, urban planners probably never realized that the ultimate "labor-saving device," the car, would produce negative health effects, pollution, urban sprawl and social isolation. As wealthier people fled to the suburbs, it also produced impoverished, crime-ridden inner cities too dangerous for safe outdoor exercise, says “The Walking Revolution.”

The poor areas were also food deserts. What an irony that suburbanization, which was supposed to improve people's lifestyles, meant people could no longer walk in their neighborhoods. Wealthier people ended up walking indoors on treadmills and poorer people often ended up not walking at all.

Walkable Neighborhoods Are Making a Comeback

The good news, says "The Walking Revolution," is the U.S. is reversing the trend of urban sprawl including in neglected downtown areas across the nation. Some of the reversal, says the film, stems from millennials who are notorious for rejecting isolated suburban living and car culture.

In Chicago, the downtown campuses of Roosevelt, Loyola and DePaul universities and Columbia College have kept downtown housing, shopping, eateries and nightlife thriving.

Adding to the revival of walking communities, corporations have also relocated to urban centers in a move to attract the many employees who want short commutes to work instead of spending hours driving on the highway. The trend is taking off in Chicago, says Chicago Business:⁵

"McDonald’s is one of many local companies that have left longtime headquarters campuses in suburbia or downstate for new locations in Chicago’s expanding central business district. ADM, Kraft Heinz and Motorola Solutions have made the move, and snackmaker Mondelez plans to follow next year.

Others, notably including drugstore giant Walgreens — which is moving more than 1,000 workers from Deerfield to the Old Main Post Office — are setting up sizable downtown offices."

Another trend that shows the resurgence of walking is that public parks are coming back, often with citizen-led management, says “The Walking Revolution."⁶ The public park movement is likely to be as influential on public health as the availability of clean, piped water in cities and the creation of Central Park.

New and Old Walking Ideas

"The Walking Revolution" showcases many people, including older people, who have made "mall walking" their primary physical activity, with positive results. Certainly, the climate-controlled environment, free from traffic risks, can be ideal, although it means you’re missing out on the benefits of outdoor exercise, like sunlight exposure and grounding.

Several people in the film testify, however, that they have mall-walked for years, lowering their blood pressure and beating their diabetes.⁷ It is also free, unlike a gym membership. The film also reminds us of the practically unlimited exercise opportunities that come from owning dogs. Not only do dogs need to go out several times each day, but they also want to play with us and other dogs.

They put a lift in our step, help us meet people and lift our spirits. We all know the benefits of exercise, says Preston, a young man in the video happily walking his dog, so, "Why not do it with a beautiful companion?"

Citizen-led park initiatives are addressing some of the barriers to walking, says the film. For example, traffic-calming devices, shade trees and better sidewalk lighting make walking a much more enjoyable activity.

"When there are trees between me and the roadway I feel safer," agrees one committed walker. Building walkable, safe paths should be as much a priority of city governments as building roads, says Neha Bhatt of Smart Growth America.

And speaking of roadways, the replacement of railroad-transported freight with truck lines has left many railway corridors abandoned, and they are easily transformed into walking paths. One shining example in the film is New York City's High Line, operated by Friends of the High Line in partnership with the New York City Department of Parks & Recreation.⁸

Built on a retired elevated freight line, the High Line starts in the Lower West Side of Manhattan and runs all the way to the northern edge of the West Side Yard on 34th Street.⁹ Many people called for the abandoned freight tracks to be demolished because they were an eyesore but instead, in 2006, ground was broken on the first section of the High Line.¹⁰

Now dotted with art and food vendors, it has become an inspiration to all cities that want to transform their industrial infrastructure into walkable public spaces.

Many Medical Benefits of Walking

The medical risks from a sedentary lifestyle are significant. "The sedentary lifestyle is blamed for as many deaths as smoking," says one newscaster who begins the film. "Prolonged sitting is linked to breast cancer and colon cancer," says another.

Experts appearing in "The Walking Revolution" repeat the warnings. Inactivity is skyrocketing rates of "obesity, heart disease, high ... blood pressure, diabetes," says Shellie Y. Pfohl, from the President's Council on Fitness, Sports & Nutrition. The diseases that threaten the public's health today are no longer infectious but "primarily rooted in inactivity," warns Dr. Robert E. Sallis, who practices both family and sports medicine.

Luckily, the effects of walking are just as eye-opening and include the reversal or diminishment of many sedentary-linked diseases, says the film. Jesus Lopez, an RN at Kaiser Permanente Fontana Medical Center, says walking helped him lose an astounding 70 pounds and that he feels like he has been "reborn."

Dr. Karim Khan, from the University of British Columbia, says activities like walking can "reduce some cancers by 50%." Dr. Lynn Kostecki-Csanyi of Kaiser Permanente Rehabilitation Center says dementia patients "are better in terms of their memory" when they walk.

John Arden, Ph.D., an author and psychologist, stresses the significant and underreported antidepressant benefits of walking. Compared to antidepressants, he says, "a better quick fix is walking," which he calls "an immediate antidepressant" that is the "cheapest and easiest way to get relief immediately."

Sallis adds that relying on pills instead of exercise to reduce health risks is no solution to health ills and can even be dangerous. Studies show, he says, that people who are put on blood pressure medication exercise less and don't eat as well as those who aren't on the pills. The reason is that they think they don’t have to worry about their health problem anymore when they are on medication, says Sallis.

All told, says the video, the benefits of walking are unarguable and available to all. In fact, if the benefits that come from walking were available in a pill, those pills would be flying off the shelves, says Dr. JoAnn E. Manson, of Harvard Medical School.

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A first-of-its-kind study on molecular interactions by biomedical engineers will make it easier and more efficient for scientists to develop new medicines and other therapies for diseases such as cancer, HIV, and autoimmune diseases.

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A new study with over 3,700 people in India associates air pollution with a higher risk to develop osteoporosis.

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New research reveals a key insight into the development of hair bundles, the intricately complex assemblies in the inner ear responsible for hearing. Researchers found that stereocilia, roughly 100 of which are assembled into a hair bundle, widened simultaneously with the onset of mechanotransduction. The stereocilia only elongated to their mature lengths after transduction had been established.

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A study provides new evidence of an association between cardiorespiratory fitness and brain health, particularly in gray matter and total brain volume -- regions of the brain involved with cognitive decline and aging.

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Worldwide, more people die from tuberculosis than any other infectious disease, even though the vast majority were vaccinated. The vaccine just isn't that reliable. But a new study finds that simply changing the way the vaccine is administered could dramatically boost its protective power.

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Researchers have demonstrated how bacteria coordinate cell division with the replication of their genetic material. In an interdisciplinary study they explain why the current concept of the bacterial cell cycle has to be rewritten.

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A vaccine to ward off dementia may proceed to clinical trials after successful animal testing. The research is looking to develop effective immunotherapy via a dual vaccine to remove 'brain plaque' and tau protein aggregates linked to Alzheimer's disease. It is showing success in begenic mice models, supports progression to human trials in years to come.

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Human noroviruses, the leading viral cause of foodborne illness and acute diarrhea around the world, infect cells of the small intestine by piggybacking on a normal cellular process called endocytosis that cells use to acquire materials from their environment.

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New research strengthens prior findings on the link between vitamin E acetate and EVALI (E-cigarette or vaping product use-associated lung injury).

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Did you ever wonder why medical research seems to flip-flop so often? Eggs used to be terrible for your health; now they’re not so bad. Stomach ulcers were thought to be due to stress and a “type A personality” but that’s been disproven. I was taught that every postmenopausal woman should take hormone replacement therapy to prevent heart disease and bone loss; now it’s considered way too risky. It can make you question every bit of medical news you hear.

But maybe that’s not such a bad thing. Questioning what you read or hear is reasonable. And maybe medical reversals — when new research leads to a complete turnaround regarding a widespread medical practice or treatment — are not as common as they seem. Perhaps they get more attention than they deserve and drown out the consistent and “non-reversed” medical research that’s out there. For example, it seems unlikely that the health benefits of regular exercise, smoking cessation, or maintaining a healthy weight will ever be reversed.

A new study examines medical reversals

A remarkable new study explored the phenomenon of medical reversals to determine how common they are, and to identify what types of conditions were most involved.

Researchers collected more than 3,000 randomized controlled trials; these are considered the most reliable types of research because they randomly assign otherwise similar study subjects to different treatment groups and try to account (control) for factors other than the treatments that might affect the results. For example, a trial comparing two treatments to prevent heart attacks would need to have a similar proportion of people with high cholesterol or high blood pressure, because these can affect the risk of heart attack.

In this new study, the analysis was limited to three of the top medical journals in the world: JAMA (formerly known as the Journal of the American Medical Association), The Lancet, and the New England Journal of Medicine. For each medical reversal identified, the authors searched for later studies refuting the findings and only counted those that had stood the test of time (so far!).

Here’s what they found:

• Of 3,017 studies analyzed from the last 15 years, 396 came to conclusions that reversed prior treatments or practice recommendations. This represented about 13% of randomized controlled trials appearing in these journals and about 6% of their original research papers.
• The most common conditions were cardiovascular disease, preventive medicine, and critical care medicine (such as care received in an intensive care unit).
• Medications, procedures, and vitamins accounted for about two-thirds of the reversals.

Examples of medical reversals

Among the nearly 400 medical treatments or practices that were reversed during the years of this new study, here are some notable examples.

• Wearable technology for weight loss. When fitness trackers first became widely available, recommendations to use them to help with weight loss were common. But a study in 2016 found that they were no more effective (and perhaps less so) than a standard weight-loss program that did not use an activity tracker.
• Hormone replacement therapy (HRT). For more than 50 years, HRT was thought to prevent chronic disease, such as cardiovascular disease, in menopausal women. A number of more recent (and more powerful) studies have demonstrated that HRT provides no such benefits, and that some combinations of hormonal therapy may increase the risk of certain cancers, stroke, and blood clots. HRT may still be recommended for women with significant menopausal symptoms, such as hot flashes, but it is no longer prescribed to prevent chronic disease.
• Surgery for a meniscal (cartilage) tear with osteoarthritis of the knee for adults ages 45 and older. This combination of problems is common among middle-aged and older adults and is frequently detected when MRI scans are performed to evaluate knee pain. While surgery was often recommended and performed to remove or repair the torn meniscus, it was uncertain whether this was truly necessary. A study in 2013 found that initial treatment with physical therapy was just as effective as immediate surgery. Guidelines soon changed to advise nonsurgical treatment as the initial approach for most middle-aged or older patients with meniscal tears and osteoarthritis of the knee.

Medical myth or medical fact?

Myth and misconception are common in matters of health and medical practice. But it’s also true that medical fact is a moving target. Things we accepted as fact years ago sometimes turn out to be wrong, as these medical reversals demonstrate. Meanwhile, certain myths could turn out to have credence if well-designed research concludes as much.

The reason this study about medical reversals is so important is that it points out how vital rigorous research is, not only for new treatments or innovative procedures, but also to evaluate older, well-established ways of doing things.

What’s next?

Hearing medical experts flip-flop on their recommendations or conclusions about medical news seems common — but is 6% of original research or 13% of all randomized controlled trials “too high”? I’d argue that it’s not. In fact, rather than casting doubt on all research, this new study about medical reversals should serve as a measure of reassurance that skepticism is alive and well in the research community, and that “low-value medical practices” will be uncovered if the right research is designed, funded, and implemented.

You can bet that there will be more head-scratching, mind-bending medical reversals in the future. Just keep in mind that most of this is simply a reflection of how researchers are continuing to clarify what works in medicine — and what doesn’t. The best they can do is to keep at it. The best we can do is to consider medical news with a critical eye and to keep an open mind.

The post Why medical research keeps changing its mind appeared first on Harvard Health Blog.

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