Single-leg deadlift

 

Sculpt your butt with the single-leg deadlift with Holly Barker.

Position weight to left side and raise right foot slightly to take weight off. 

Keeping neck and spine position neutral, tilt your weight forward while reaching your right foot back, leg straight and toe pointing towards the ground.

Use your left arm for balance on left hip and right arm reaching towards the floor.

Return to upright position and repeat.

Switch to alternate side after first side is completed. 20 reps.

Words/Workout: Holly Barker (pictured)

Photography: Noel Daganta

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Pop squat on the sand

 

Challenge yourself with the pop squat on the sand with Holly Barker.

How: Squat to 90 degrees, feet shoulder-width apart, knees in line with toes.

Explode out of your squat and through your heals.

Land softly back to your squat starting position and prepare to repeat. 20 reps.

 

Words/Workout: Holly Barker (pictured)

Photography: Noel Daganta

 

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Walking lunge twist

 

Challenge yourself on the sand with this walking lunge twist by Holly Barker.

How: Step forward into lunge position.

At full lunge, twist torso towards front hip, return to centre and step forward, bringing back leg forward.

Repeat with each step, twisting torso from side to side towards front hip on each side. 20 reps. 

Words/Workout: Holly Barker (pictured)

Photography: Noel Daganta

 

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Workout tips for toned arms

 

If you're looking to mix up your arm workouts, supersetting is key.

Try: Supersetting Antagonising

Supersetting antagonising is the pairing of two opposite muscle groups such as chest and back, triceps and biceps and quads and hamstrings. The science behind this technique is to loosen one muscle while its antagonist contracts. This allows more weight to be used, or additional reps performed.

How: Give this little workout a go:

a. Dumbbell external rotation 10 reps – 4 sets, tempo 3; 0; 2; rest 30 seconds
b. Incline dumbbell preacher curl 10–12reps – 4 sets, tempo 3; 0; 1
c. Tricep rope pushdowns 15 reps – 4 sets, tempo 2; 0; 2; rest 45 seconds
d. Scott curl reverse biceps curls 8–10 reps – 4 sets, tempo 2; 0; 2
e. Overhead dumbbell triceps extension 12–15 reps – 4 sets, tempo 2; 2; 1; rest 45 seconds

Why: Supersetting agonist and antagonist muscle groups is not only time efficient and great for building lean, toned arms, but it also increases the afterburn effect of your workout by up to 24 hours.

Insider’s tip: Try and finish off your arms day with 3 x 500m sprints on the rower to really get your arms burning.

Check out our workout section for fitness tips, exercises and workouts.

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Type 1 Diabetes Linked to Epilepsy Risk, Study Suggests

By Karen Pallarito
HealthDay Reporter

THURSDAY, March 31, 2016 (HealthDay News) — People who have type 1 diabetes may be nearly three times more likely to develop the seizure disorder epilepsy than people without type 1 diabetes, a new study suggests.

The youngest people with type 1 diabetes — under 6 years old — seemed to be six times more likely to develop epilepsy, the researchers reported.

But, those with the highest risk of epilepsy appeared to be children with type 1 diabetes who had to be treated in a hospital for a severe low blood sugar (hypoglycemia). The study found the risk of epilepsy was 16.5 times higher for these children.

It should be noted, however, that the study did not establish a cause-and-effect relationship between the two conditions. And the “absolute” risk of any one person with type 1 diabetes going on to develop epilepsy remains very small.

Epilepsy is a brain disorder affecting less than 1 percent of the U.S. population, according to the U.S. National Institute of Neurological Disorders and Stroke.

“Even though the risk of epilepsy is increased, most type 1 diabetics wouldn’t have it,” said Dr. Scott Stevens, attending neurologist at Northwell Health’s Comprehensive Epilepsy Care Center in Great Neck, N.Y.

Type 1 diabetes is an autoimmune condition that causes destruction of the body’s insulin-producing cells. Insulin is a hormone necessary to use the sugars found in foods. To replace the missing insulin, people with type 1 diabetes must take multiple daily injections of insulin or use an insulin pump with a thin tube inserted under the skin to deliver the insulin, according to the American Diabetes Association (ADA).

However, achieving the correct dose of insulin can be difficult. Too little insulin, and high blood sugar results. Over time, high blood sugar can cause serious damage to blood vessels, especially in the eyes, kidneys and heart. Too much insulin also poses a danger, causing low blood sugar levels, which if left untreated can cause unconsciousness and even death, according to the ADA. Previous research has shown that people with type 1 diabetes experience approximately two episodes of low blood sugar each week. Severe hypoglycemia is much less frequent, however.

The researchers aren’t sure how type 1 diabetes and epilepsy may be linked.

But study author Dr. I-Ching Chou of China Medical University’s Children’s Hospital in Taichung, Taiwan, and colleagues suspect a variety of factors may be at play, including immune abnormalities, brain lesions, genetic factors and metabolic abnormalities.

Blood sugar levels that are too high or too low have also been shown to trigger seizures in elderly people, the study authors added.

And previous studies have suggested that having type 1 diabetes at an early age and having severely low blood sugar are critical risk factors for brain abnormalities, the researchers said.

Dr. Gerald Bernstein, an endocrinologist and coordinator of the Friedman Diabetes Program at Lenox Hill Hospital in New York City, said that when people with diabetes don’t rigidly control their blood sugar levels, tiny blood vessels in the brain can be affected.

Using data from the Taiwan National Health Insurance Research Database, the study authors pulled records on almost 2,600 children and adolescents with type 1 diabetes, and a comparison group of 26,600 people without a type 1 diagnosis.

Children with type 1 diabetes were about 10 years old, while youngsters in the comparison group were about 11 years old, on average.

Each child in the study group was matched with 10 control-group children for factors including sex, and whether they lived in an urban or rural area.

In kids with type 1 diabetes, the risk of developing epilepsy, after adjusting for other factors that might affect the results, appeared to be 2.84 times higher than in people without diabetes.

Children in the study group with intellectual disabilities were also much more likely to develop epilepsy, the study found.

The study authors acknowledged several limitations with the study. The insurance database, for one, didn’t provide information on lifestyle habits, body mass index, physical activity, socioeconomic status and family history. The lack of that information could have skewed the results.

While there may be some connection between type 1 diabetes and epilepsy, the authors concluded that further study is needed.

Based on this study alone, there’s no reason to screen every child and adolescent with type 1 diabetes for epilepsy, Stevens said.

“It would create unnecessary stress and unnecessary testing,” he said.

What parents should do is advocate for the most contemporary management of type 1 diabetes from its onset, Bernstein added. That includes the use of continuous glucose monitoring and insulin pumps, which insurance doesn’t always cover, he said.

With the advantage of those technologies, people might maintain much tighter blood-sugar control over time, he explained.

Findings from the new study were released online March 31 in the journal Diabetologia.

More information

Joslin Diabetes Center has more about type 1 diabetes.

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More of the World’s People Are Now Obese Than Underweight

THURSDAY, March 31, 2016 (HealthDay News) — More people worldwide are obese than underweight, a new study found.

The researchers added that about one-fifth of adults could be obese by 2025.

The number of obese people in the world rose from 105 million in 1975 to 641 million in 2014, with obesity rates rising from 3 percent to 11 percent among men and from 6 percent to 15 percent among women, the study found.

Over the same time, the proportion of underweight people fell from 14 percent to 9 percent of men and from 15 percent to 10 percent of women, according to the study.

More than one-quarter of severely obese men and nearly one-fifth of severely obese women in the world live in the United States, the researchers said.

On average, people worldwide have become an average of 1.5 kilograms (3.3 pounds) heavier each decade. At the current pace, about 18 percent of men and 21 percent of women will be obese, and more than 6 percent of men and 9 percent of women will be severely obese by 2025, the study found.

The findings were released online on March 31 in The Lancet.

“Over the past 40 years, we have changed from a world in which underweight prevalence was more than double that of obesity, to one in which more people are obese than underweight,” said study senior author Majid Ezzati, a professor at Imperial College London’s School of Public Health, in England.

“If present trends continue, not only will the world not meet the obesity target of halting the rise in the prevalence of obesity at its 2010 level by 2025, but more women will be severely obese than underweight by 2025,” he said in a journal news release.

“To avoid an epidemic of severe obesity, new policies that can slow down and stop the worldwide increase in body weight must be implemented quickly and rigorously evaluated, including smart food policies and improved health care training,” Ezzati said.

Despite the findings, extremely low weight remains a serious public health problem in the poorest parts of the world, the researchers noted. For example, nearly one-quarter of people in south Asia are underweight, as are 15 percent of men and 12 percent of women in central and east Africa.

The study findings reflect “a fatter, healthier but more unequal world,” wrote George Davey Smith in an accompanying journal editorial. He is a professor of clinical epidemiology at the University of Bristol, in England.

“A focus on obesity at the expense of recognition of the substantial remaining burden of undernutrition threatens to divert resources away from disorders that affect the poor to those that are more likely to affect the wealthier in low-income countries,” he noted.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases outlines the health risks of being overweight.

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Cold Weather Can Spike Football Injuries, Study Finds

THURSDAY, March 31, 2016 (HealthDay News) — NFL players are more likely to suffer concussions and ankle injuries during games played on colder days, a new study finds.

Canadian researchers analyzed data on the five most common injuries that occurred during two National Football League seasons between 2012 and 2014.

Players had a two times higher risk of concussion and a 1.5 times higher risk of ankle injuries when the temperature was 50 degrees Fahrenheit (10 degrees Celsius) or colder compared to games played in 70 degrees (21 degrees Celsius), the findings showed.

The researchers also found that players were 1.36 times more likely to suffer shoulder injuries during games played on natural grass instead of synthetic turf.

“There has been a lot of discussion recently about the significant risk of injury in the NFL and general player safety, particularly regarding concussions,” said lead study author Dr. David Lawrence, a clinical fellow at St. Michael’s Hospital in Toronto.

“The first step in improving player safety and lowering that risk is to identify the factors affecting injury rates. Once we can answer those questions, we can begin to modify player exposure,” he said in a hospital news release.

“There is limited research looking at the external risk factors for injuries in the NFL,” Lawrence said. “Given this is one of the first studies to look at these variables, we can only speculate at this time on the underlying causes for the associations we observed with specific injuries on game-days.”

For example, equipment may have less give at colder temperatures, which may increase the force of impact, the researchers suggested. Players may be more likely to report injuries during colder games because they tend to have more contact with athletic staff when it’s colder. It’s also possible that in warmer weather, players may mistake concussion symptoms for heat-related illness.

“Our findings contribute to the growing body of evidence surrounding this topic, but further research is needed,” Lawrence said.

“Applying this information may help inform future injury prevention strategies in the NFL, or other professional sports, and highlight the effects of these seemingly small external factors,” he added.

The study was published in the March 31 issue of the Orthopaedic Journal of Sports Medicine.

More information

The American Academy of Family Physicians has more on concussion.

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Do You Always Call Out Typos? Science Says You’re the Worst

Does your skin crawl whenever you spot a dangling modifier, or “its” in place of “it’s”? If so, you’re probably not going to like this new research from the University of Michigan.

The small study—titled “If You’re House Is Still Available, Send Me an Email” (see what they did there?)— explores which personality types are most sensitive to grammar mistakes. The researchers had 83 people read emails with typos (such as “teh” vs. “the”), grammar errors (like “there” vs. “they’re”), or no mistakes. After reading all the emails, participants were asked if they’d spotted any errors and, if so, how much it irritated them.

Next, the researchers considered the subjects’ dispositions. Participants were asked to complete the Big Five personality assessment (which determines a person’s level of extraversion, agreeability, conscientiousness, neuroticism, and openness). They were also asked to judge the writers of the emails, by rating them on traits like intelligence and friendliness.

RELATED: 10 Ways Your Personality Affects Your Weight

The (perhaps unsurprising) results? Subjects with personalities deemed “less agreeable” were more irritated by errors than other participants. The researchers believe it’s because people with this personality type are “less tolerant of deviations from convention”—which appears to be a nicer way of saying members of the grammar police are kind of jerks.

They also found that extroverts were more likely to breeze past spelling and grammar errors, while introverts tended to notice mistakes and negatively judge the writer who made them. Meanwhile, people who scored high on conscientiousness and low on openness were more sensitive to typos. Yet, how neurotic someone was appeared to have no affect on the way they detected and interpreted mistakes.

RELATED: 15 Ways Being an Introvert Can Affect Your Health

Some people (including Health‘s entire editorial staff) find this study a bit insulting. But since the sample size was slim, we’re taking the findings with a grain of salt until further research backs up the claims.

 

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Scientists Reduce Alzheimer’s-Linked Brain Plaques in Mice

By Randy Dotinga
HealthDay Reporter

THURSDAY, March 31, 2016 (HealthDay News) — Scientists working with mice report preliminary progress in efforts to eliminate brain-clogging proteins linked to Alzheimer’s disease.

By tweaking genes in the brains of mice, researchers say they reduced levels of a substance called beta amyloid that’s closely tied to Alzheimer’s.

There’s no guarantee the findings will be relevant to people with Alzheimer’s disease because results of animal studies often aren’t replicated in humans, experts say.

Still, “we can now target amyloids from a different angle,” said study co-author Guojun Bu, a neuroscientist and professor of medicine at the Mayo Clinic in Jacksonville, Fla. The approach “can be explored for Alzheimer’s disease prevention and therapy,” he added.

Clumps of beta-amyloid proteins, known as plaque, are believed to disrupt brain functioning in people with Alzheimer’s disease, the most common form of dementia.

The clumps, which appear to kill brain cells, may develop years before someone shows signs of the progressive brain disease. Some research has suggested that the brains of Alzheimer’s patients can’t easily get rid of the gunk, allowing it to build up and impair their ability to think and move.

In the new study, Bu and colleagues manipulated the genes of mice and removed a gene linked to molecules called heparan sulfates that appear on cell surfaces. The molecules serve a biological purpose, Bu said, but they’ve also been found within clumps of beta amyloid and related “tangles” in the brains of Alzheimer’s patients.

“We found that removing heparan sulfates from the nerve cells vastly reduced amyloids,” he said. And according to Bu, this confirms that the molecules play a role in the formation of the amyloid clumps.

The findings suggest that scientists could reduce levels of the brain-clogging material by disrupting the interaction between the molecules and beta amyloid, Bu said. But this would need to happen without “disturbing the normal biological function.”

Bu said the next step is to look for a compound that can block the molecules and beta amyloid from interacting without hurting the patient. And, “such preclinical studies can takes years before they can be translated to humans,” he explained.

There are other caveats, too. Since it hasn’t been proven that beta amyloid actually causes Alzheimer’s, stopping amyloid production might not necessarily stop the disease. Also, nothing is known about the cost of the approach or side effects.

Bu said any treatment would need to be given in the early days of Alzheimer’s disease before symptoms appear.

Testing could determine whether someone shows signs of early Alzheimer’s disease without obvious symptoms, said study co-author Dr. David Holtzman. He is chair of neurology at Washington University School of Medicine in St. Louis.

Scientists could test the treatment, he said, by giving it to people who don’t exhibit disrupted thinking but do show signs of amyloid buildup. Then, he said, researchers could follow the participants to see if they develop dementia or if the treatment halted Alzheimer’s progression.

Dr. Howard Fillit, executive director and chief science officer at the Alzheimer’s Drug Discovery Foundation, praised the study. “In more sophisticated and modern ways, it confirms previous knowledge” about how the molecules interact with beta amyloid, he said.

However, he cautioned that it’s very difficult to target the molecules in question with medication. Also, since the heparan sulfate molecules bind with other molecules in the body, getting rid of them “could have many effects we don’t know about,” Fillit said.

The study was published March 30 in the journal Science Translational Medicine.

More information

For more about beta amyloid’s role in Alzheimer’s disease, see the Alzheimer’s Association.

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Sweat to Khloé Kardashian’s Fitspirational Playlist

Khloé Kardashian’s Instagram pics alone have become a serious source of fitspiration. And now we can all steal her playlist, and sweat to the same songs that helped Khloe get here:

And here:

And here:

RELATED: Here’s How Khloé Kardashian Works Out 

Well, you get the picture.

The Kocktails with Khloé star and spinning devotee has posted her “spin-spirational” Spotify playlist, filled with gym faves like Beyoncé’s “Run the World.”

“I don’t just love SoulCyle and Cycle House for the workout—for me, spinning is all about the music!” she writes. “The playlist makes or breaks my spin experience. The right songs pump me up, get me in the groove, and make me push through the pain.”

If your spin instructor is open to music suggestions, Khloé suggests taking her playlist to class. Of course, you could always just crank it up while you ride on your own, too—or during any workout for that matter. Because who couldn’t use a little of Khloé’s motivation?

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The ‘Not Face’ Needs No Translation

THURSDAY, March 31, 2016 (HealthDay News) — One type of facial expression expresses negative emotion in a wide range of cultures, researchers say.

They found that a furrowed brow, pressed lips and raised chin was interpreted as an expression of negative feelings, such as “I do not agree,” to native speakers of English, Spanish, Mandarin Chinese and American Sign Language.

The Ohio State University team dubbed this expression the “not face.”

The research involved manually tagging images of students speaking, frame by frame, to find which facial muscles were moving and in which directions when they disagreed. Computer algorithms then looked through thousands of resulting frames to find commonalities.

The “not face” that emerged displayed the same three muscle movements: the furrowed brows of “anger,” the raised chin of “disgust” and the pressed-together lips of “contempt,” the researchers said.

They also found that people automatically make this face as if it were part of their spoken or signed language, and that American Sign Language speakers sometimes make the face instead of signing the word “not.”

This is the first time that use of facial expression in American Sign Language has been documented, according to the authors of the study in the May issue of Cognition.

“To our knowledge, this is the first evidence that the facial expressions we use to communicate negative moral judgment have been compounded into a unique, universal part of language,” said Aleix Martinez, a cognitive scientist and professor of electrical and computer engineering.

“Where did language come from? This is a question that the scientific community has grappled with for a very long time,” he said in an Ohio State news release. “This study strongly suggests a link between language and facial expressions of emotion.”

In ongoing research, the team will try to identify other facial expressions, including positive ones, which are used as part of language.

“That will likely take decades,” Martinez said. “Most expressions don’t stand out as much as the ‘not face.'”

More information

The American Psychological Association has more about facial expressions.

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Even Controlled, Epilepsy May Still Cause Problems for Kids

THURSDAY, March 31, 2016 (HealthDay News) — Even when their seizures are well-controlled, children with epilepsy can still have learning and behavioral disorders that lead to social and educational problems when they’re young adults, a new study finds.

“Frequency and intensity of seizures remain important predictors of how well a child does into adulthood. But, somewhat to our surprise we also found seizures are by no means the sole influencers of social and educational outcomes among adults with childhood epilepsy,” said study lead author Anne Berg.

Berg is a scientist with the Ann and Robert H. Lurie Children’s Hospital of Chicago, and professor of pediatrics and neurology at Northwestern University Feinberg School of Medicine.

The research included 241 children and teens in Connecticut who were diagnosed with uncomplicated epilepsy from 1993 to 1997. They were followed for an average of 12 years.

Thirty-nine percent of the participants had excellent seizure control, with no seizures one year after diagnosis, the study showed. About 23 percent had good seizure control, with no seizures up to five years after diagnosis. Nearly 30 percent had seizures that came and went but generally responded to medication, and 8 percent had recurrent, drug-resistant seizures, the study found.

As young adults, more than 90 percent of the participants with excellent seizure control were either pursuing a college degree or had full-time or part-time jobs, compared with 60 percent of those with poor seizure control. More than 90 percent of those with good or excellent seizure control had a driver’s license, compared with 60 percent of those with poor seizure control, researchers said.

Those with a history of learning problems were nearly 50 percent more likely to be unemployed, the study revealed.

Regardless of seizure control, participants with a history of emotional, behavioral or psychiatric conditions such as anxiety, depression, bipolar disorder or attention-deficit/hyperactivity disorder (ADHD) were 60 percent less likely to complete college and 50 percent less likely to be living independently.

Level of seizure control didn’t affect the chances of trouble with the law. Participants with disruptive behavioral disorders, such as oppositional defiant disorder, had a nearly three-times increased risk of trouble with the law, regardless of seizure control.

The findings show the need to screen all children with epilepsy for learning problems, regardless of how well their seizures are controlled, the researchers said. Doing so could help prevent problems later in life.

“Physicians caring for those patients should not assume kids are doing fine just because their seizures are under control. Seizures really don’t tell the whole story,” Berg said in a hospital news release.

The findings were published online recently in the journal Pediatrics.

More information

The U.S. Centers for Disease Control and Prevention has more on epilepsy.

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Clues to Zika Virus’ Structure May Point to Weaknesses

THURSDAY, March 31, 2016 (HealthDay News) — With the emergence of the Zika virus’ devastating effect on newborns, the race for a vaccine has acquired a new urgency.

Now, U.S. scientists say they’ve uncovered secrets to the germ’s physical structure that might help researchers reach that goal.

“The structure of the virus provides a map that shows potential regions of the virus that could be targeted by a therapeutic treatment, used to create an effective vaccine or to improve our ability to diagnose and distinguish Zika infection from that of other related viruses,” study lead author Richard Kuhn, of Purdue University, said in a university news release.

The mosquito-borne virus — which generally doesn’t cause serious illness in adults — has been associated with thousands of cases, mostly in Brazil, of a severe birth defect called microcephaly. Babies with microcephaly have abnormally small heads, and most wind up with stunted brain development, the U.S. Centers for Disease Control and Prevention said.

Zika infection has also been linked to an increased risk for the autoimmune disease Guillain-Barre syndrome, according to the CDC.

So, the race is on to investigate this otherwise little-understood germ and develop a vaccine to counter its potentially devastating effects.

In their research, Purdue biological scientists Kuhn and Michael Rossmann led a team that mapped the structure of the Zika virus. The two have studied flaviviruses — the family of pathogens to which Zika belongs — for 14 years. They said they were the first to discover the structures of two other flaviviruses, dengue and West Nile.

In the new research, Kuhn and Rossmann collaborated with Theodore Pierson, chief of viral pathology at the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID).

The team focused on a sample of Zika virus taken from a patient infected during an outbreak in French Polynesia. Looking at the virus with “near-atomic resolution,” the researchers discovered that Zika has many chemical and genomic structures that are found in better-known, related viruses such as dengue, West Nile, yellow fever and Japanese encephalitis.

This strong similarity to other flaviviruses is reassuring, Kuhn said, because scientists are already busy looking for vaccines for those pathogens.

However, Zika also differs in key ways from those viruses, the research team noted.

“Most viruses don’t invade the nervous system or the developing fetus due to blood-brain and placental barriers, but the association with improper brain development in fetuses suggest Zika does,” said study co-author and Purdue graduate student Devika Sirohi.

“It is not clear how Zika gains access to these cells and infects them, but these areas of structural difference may be involved. These unique areas may be crucial and warrant further investigation,” Sirohi said.

The scientists uncovered a key spot on the virus’ surface that seems to set Zika apart from other flaviviruses. This projecting structure might act as a unique “lure,” the research team explained, drawing in human cells for contact and infection.

“If this site functions as it does in dengue and is involved in attachment to human cells, it could be a good spot to target an antiviral compound [treatment],” Rossmann said. “If this is the case, perhaps an inhibitor [vaccine] could be designed to block this function and keep the virus from attaching to and infecting human cells.”

The study was funded by NIAID and published online March 31 in the journal Science.

More information

For more on Zika virus, visit the U.S. Centers for Disease Control and Prevention.

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Fridge-Sized Machine Makes Prescription Drugs ‘On Demand’

By Amy Norton
HealthDay Reporter

THURSDAY, March 31, 2016 (HealthDay News) — Scientists have created a compact machine that can churn out thousands of doses of prescription medication in a day — putting the capabilities of a drug-manufacturing plant into a device the size of a kitchen refrigerator.

Experts said the advance could eventually allow on-the-spot drug production in special circumstances — on the battlefield, during epidemics, after natural disasters, or in cases where a drug is needed for a rare medical condition, for instance.

The research, detailed in the April 1 issue of Science, took a new approach to producing prescription drugs — which, right now, is often an inefficient, time-consuming process.

Chemical engineers at the Massachusetts Institute of Technology (MIT) used so-called “flow technology” to develop a compact machine that can automatically turn raw materials into a finished pharmaceutical-grade medication.

For now, the system is limited to making liquid versions of four common prescription drugs: the antidepressant fluoxetine (Prozac); diphenhydramine hydrochloride, an antihistamine that includes brand-names like Benadryl; the sedative diazepam (Valium); and lidocaine, a widely used local anesthetic.

But the researchers say that drug list can be expanded.

“We’re also working on producing tablets, which are more complicated to manufacture than liquid drug formulations,” said Klavs Jensen, a professor of chemical engineering at MIT who worked on the study.

Other technologies — such as 3D “bioprinters” — could help make that happen, according to Jensen.

Many drug companies are already looking into alternative processing methods — ones that are “continuous” and can be done at one location, Jensen said.

The traditional way of drug-making is similar to cooking, according to Rainer Martin, a senior scientist with drug company Hoffmann-La Roche, in Basel, Switzerland.

Martin, who wrote an editorial published with the study, explained the process this way: Drugs are made in “batches,” and the ingredients — broad groups of chemicals known as reagents, catalysts and solvents — are gradually added into a vat, stirred and heated. Then, the brew is analyzed to see if the chemical reactions are complete.

The problem, Jensen said, is that batch manufacturing has “little flexibility to respond to surges in demand” — such as epidemics. Plus, he added, there can be “severe disruptions” in the drug supply if one plant has to shut down.

The compact system his team developed is continuous, Jensen explained. Chemical reactions take place as chemicals flow through small tubes, instead of sitting in large vats.

The result, according to Martin, is that complex and “laborious” drug-making steps are all done in “fully automated fashion.”

Martin said he could envision the compact system being used in a number of scenarios: During a disease outbreak in a refugee camp or remote area, for example, or by individual hospitals that need large amounts of a particular drug on a regular basis.

Matthew Osterhaus, immediate past president of the American Pharmacists Association, agreed that the technology might prove useful in special circumstances.

As an example, he pointed to “orphan drugs” — medications used to treat rare diseases. “Let’s say there’s a condition that’s treated at five medical centers in the U.S.,” Osterhaus said. “It’s possible those hospitals would be able to use this.”

When it comes to everyday health care, though, it’s difficult to see how an appliance-sized drug machine could fit in, according to Osterhaus. As a pharmacist, he said, he has access to about 6,000 drugs right now.

“So it’s a stretch to see how this could change my practice,” Osterhaus said.

Jensen agreed that the technology could be used in specialized cases, like humanitarian crises and orphan-drug production — since “small-volume” batch processing is usually not cost-effective for large plants.

And then there’s the potential for battlefield use. Jensen said “national defense needs” are what spurred the quest for such a compact system: The research was funded by the Defense Advanced Research Project Agency, which is aiming to fortify medical care available on the front lines.

But Jensen said he also envisions larger health systems, like a hospital network or a health plan, being able to manufacture their own drugs.

Martin went deeper into visionary territory — seeing a future where people can use smartphone apps and a microwave-sized device to cook up an antibiotic for their feverish toddler (in consultation with a doctor).

But that, he stressed, won’t be happening any time soon.

For now, there are more pressing issues, according to Martin. One is how the raw materials for making the drugs would be delivered: “Would it be, for example, in the way of cartridges, similar to ink for inkjet printers?” he said.

And at the other end of the process, Martin said, there would have to be ways to safely dispose of waste products.

More information

The U.S. Food and Drug Administration has more on how drugs are developed.

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Diabetes Meds Vary in Safety and Effectiveness, Study Shows

THURSDAY, March 31, 2016 (HealthDay News) — A study of nearly a half-million people with type 2 diabetes shows there are pros and cons to nearly every form of drug therapy for the disease.

In the British study, researchers looked at patient outcomes from a large U.K. database of almost 470,000 adults with type 2 diabetes, tracked between 2007 and 2015.

Julia Hippisley-Cox and Carol Coupland, of the University of Nottingham, sought to parse out differences among a variety of diabetes drugs. They accounted for complicating patient factors such as age, sex, smoking and poverty, as well as how long a person had been diagnosed with type 2 diabetes.

The researchers also focused on five major outcomes linked to diabetes: blindness, amputation, severe kidney failure, and high or low blood sugar.

Reporting March 30 in BMJ, they found that when a class of drugs called glitazones (Actos, Avandia) was prescribed along with the standard diabetes drug metformin, there was a higher risk for kidney failure than with metformin alone.

The same was true when another class of meds called gliptins (Januvia, Onglyza and others) was combined with metformin.

However, there were “up” sides to these drug combos as well. People who took a gliptin or a glitazone plus metformin had “significantly lower” risks for high blood sugar than those who took metformin alone, the research found.

Finally, the study looked at “triple” therapy: patients taking metformin, a gliptin or a glitazone, and a sulphonylurea, another type of diabetes drug. This combination was linked to “significantly higher” odds for episodes of potentially dangerous low blood sugar, the British researchers said, compared to people taking metformin alone.

On the other hand, triple-therapy users had a reduced risk for diabetes-linked blindness, compared to the metformin-only group.

The study doesn’t establish direct cause-and-effect relationships between the various drugs and these outcomes. Still, according to experts, the findings support the notion that diabetes care is never a “one-size-fits-all” endeavor.

“There are many treatment options for diabetes — they have the benefit of lowering blood sugar levels, but they also carry risk,” said Dr. Robert Courgi, an endocrinologist at Northwell Health’s Southside Hospital in Bay Shore, N.Y.

He said that standard guidelines typically list metformin as a first-line therapy against type 2 disease, but additional drugs may be needed. “Ultimately, the physician and the patient need to work together to find the best treatment possible,” Courgi said.

Dr. Gerald Bernstein coordinates the Friedman Diabetes Program at Lenox Hill Hospital in New York City. He believes the field of diabetes care is constantly evolving.

“Treating type 2 diabetes used to be like a singles pingpong game — give a pill, lower blood sugar,” he said.

However, “over the last 75 years or so we have learned that it is more of a team effort, because the process of safely lowering blood sugar is more complicated than previously thought,” Bernstein explained. “The goal of treatment for all diabetes is to prevent complications and have a high quality of life.”

Different medications have different targets and effects, he said, and “the art of treatment today mixes and matches these medications depending on age, weight, activity.”

More information

For more on the treatment of type 2 diabetes, head to the American Diabetes Association.

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‘Listeria on Rye’? Many U.S. Deli Meat Slicers Cut Corners on Cleanliness

THURSDAY, March 31, 2016 (HealthDay News) — The next time you sidle up to the deli counter for a sandwich, you may want to think about how often the meat slicer gets cleaned.

That’s because a new federal government survey of a sample of delis across the United States found that about half fail to clean their slicing equipment every four hours, as recommended.

Leaving machines cleaned and unsterilized for longer than four hours raises the odds for potentially deadly listeria, according to the report released Thursday by the U.S. Centers for Disease Control and Prevention.

“Meats sliced and packaged at retail delis are the major source of listeriosis illnesses” because of the potential for cross-contamination, a team led by researcher Laura Brown said in the report.

The CDC notes that infection with the listeria bacterium is the third largest cause of deaths linked to food-borne illness in the United States. Each year, about 255 Americans will die from the illness.

Since meat slicers are a potential breeding ground for listeria, Brown’s team asked managers and workers at 298 randomly selected delis across the country about their daily safety measures.

The researchers noted that only 43 percent of the nearly 700 deli managers contacted in California, Minnesota, New York, New York City, Rhode Island and Tennessee agreed to be part of the survey.

Interviews with the managers and staff at the delis that did agree to the survey found that “approximately half of delis fully cleaned their slicers less often than the FDA’s specified minimum frequency” of every four hours, Brown’s team reported.

Deli chains seemed to be more likely to adhere to the 4-hour rule than independent outlets, the study found. And — perhaps unexpectedly — busier delis were actually more likely to be fastidious about cleaning the slicer than delis with a lower customer turnover.

Other things to look for when assessing whether your local deli is cleaning meat slicers on time:

• Multiple slicers — having more of the machines upped the chances they were cleaned regularly. And slicers deemed “easy to clean” by workers also raised cleaning rates, the CDC said.
• More workers per shift, plus a food safety training program for both management and workers.
• Higher turnover of meat products per day.
• Having written slicer-cleaning policies in place.

The CDC researchers noted that the problem may even be more widespread than the survey picked up, because of “social desirability bias” — respondents giving investigators answers that reflected well on their particular deli.

What to do? Brown’s team said education is key to improving deli safety, and “because frequencies of slicer cleaning were lower at independent and smaller delis, prevention efforts should focus on these types of establishments.”

The study was published in the April 1 issue of the CDC’s journal Morbidity and Mortality Weekly Report.

More information

Find out how you can avoid foodborne illness at the U.S. Food and Drug Administration.

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U.S. Autism Rate Unchanged at 1 in 68 Kids: CDC

THURSDAY, March 31, 2016 (HealthDay News) — The autism rate among school-aged children in the United States has held steady in recent years, but it’s too early to determine whether rates are stabilizing, according to a federal government report released Thursday.

The autism rate was 1 in 68 children in 2012, the same as it was in 2010, according to the latest data from the U.S. Centers for Disease Control and Prevention.

The CDC gets its numbers from monitoring autism among 8-year-olds in 11 communities in Arizona, Arkansas, Colorado, Georgia, Maryland, Missouri, New Jersey, North Carolina, South Carolina, Utah and Wisconsin.

“What we know for sure is that there are many children living with autism who need services and support now and as they grow into adolescence and adulthood,” Dr. Stuart Shapira, chief medical officer for the CDC’s National Center on Birth Defects and Developmental Disabilities, said in an agency news release.

One expert has a theory as to why the numbers haven’t budged since 2010.

“This probably reflects the fact that screening methods — which have been implemented in pediatric primary care as well as in early childhood centers — are identifying the correct number of children,” said Dr. Ron Marino, associate chair of pediatrics at Winthrop-University Hospital in Mineola, N.Y.

He believes that, prior to 2010, there was a “learning curve” among doctors when it came to properly diagnosing autism spectrum disorders.

The CDC noted that autism rates varied widely between communities.

For example, black and Hispanic children are less likely to be identified with autism, or they receive development evaluations later, compared to white children, the agency said.

Better, targeted methods are needed to spot minority kids with autism and make sure they are “connected to the services they need,” said study lead author Daisy Christensen, a CDC epidemiologist.

She and her colleagues also found that only 43 percent of children identified with autism receive developmental evaluations by age 3. That suggests that many kids with autism may not be identified as early as they could be.

“The most powerful tool we have right now to make a difference in the lives of children with (autism) is early identification,” Shapira said.

“Parents, childcare professionals and doctors can monitor each child’s development and act right away on any developmental concerns,” he added. “It’s important to remember that children can be connected to services even before an official diagnosis is made.”

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center in New Hyde Park, NY., said the new report offered some good news.

“For many years, it seemed that the prevalence of autism spectrum disorders was consistently rising; it is encouraging that this trend has ceased and that the prevalence of autism spectrum disorders has not increased in the past two years,” he said.

But, he added, “the rate remains alarmingly high.”

And he agreed that parents should remain vigilant to spot symptoms of autism early on in their children.

“If parents have concerns about the language development, eye contact or social responsiveness of their toddler or preschooler, they should discuss their concerns with their pediatrician and seek out a developmental evaluation,” Adesman said.

The CDC report was published March 31 in the agency’s journal, Morbidity and Mortality Weekly Report.

More information

The National Alliance on Mental Illness has more about autism.

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