Scientists Are Getting Closer to a Pill That Can Mimic The Effects of Exercise


But it’s not for lazy people.

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Not everyone can exercise. People with muscle-wasting diseases and movement disorders, the frail, the very obese and post-surgical patients are among those who face a significant challenge when it comes to working out.

This can be frustrating, considering the well-established benefits of exercise.

But what if a drug could stimulate the body into producing some of the same effects of exercise – more endurance and weight control, for example – without the need to run a single step?

Such a pill may be on the way. Several scientists are testing compounds that apparently can do this – and people wouldn’t even have to move at all to benefit.

“Our goal is to understand these circuits,” says Ronald Evans, director of the gene expression laboratory at the Salk Institute for Biological Studies in La Jolla, California.

“We are taking this concept and trying to develop a drug that can help us game the system that is naturally activated during exercise.”

Salk scientists have been working since 2007 on a chemical compound, known as 516, that mimics the effects produced by exercise by triggering a specific genetic circuit, “a back door into the exercise genetic network,” Evans says.

The researchers built upon earlier work that identified a gene mechanism that encourages the muscles to burn fat, rather than carbohydrates, much as highly trained elite athletes do.

“There are many reasons why people cannot run or walk or exercise,” Evans says. “If you can bring them a small molecule that can convey the benefits of training, you can really help a lot of people.”

Several other scientists are studying compounds that work differently from 516, but with the same aim: to give the benefits of exercise to people who aren’t able to do it.

Ali Tavassoli, a professor of chemical biology at Britain’s University of Southampton, has discovered a drug known as compound 14 that works “by fooling cells into thinking they have run out of energy,” Tavassoli says.

It does this through a series of molecular actions that spur cells into metabolizing sugar, which produces energy, he says.

(Harvard cell biologist Bruce Spiegelman, who is working on an approach using exercise hormones, declined an interview, saying it wouldn’t be “wise” when “this area has been hyped so much.”)

Any such drug would require licensing by the Food and Drug Administration, yet the FDA doesn’t recognize “the inability to exercise” as an illness in need of a drug.

So Evans has targeted 516 for young people with Duchenne muscular dystrophy, an approach that he believes offers the best chance for FDA approval.

“This [disease] afflicts kids who can’t exercise and ultimately die of muscle wasting, often at a relatively early age, at 15 or 16,” Evans says. “It’s a disease with a large unmet medical need.”

But the drug, now undergoing a small human safety study, has “a potentially wide application,” he says, including for amyotrophic lateral sclerosis, Parkinson’s disease and Huntington’s disease, and for “people in wheelchairs.”

He says he also thinks it could be a lifesaver for those rare individuals who develop acute kidney injury, or AKI, a potentially fatal side effect of cardio-bypass surgery that results in often irreversible organ damage.

“The organ or tissue changes its metabolic properties and begins to burn sugar, and because it happens quickly, it’s very hard to stop,” Evans says.

“Our drug helps to draw the tissue back to a more healthy state, returning it from a chronic inflammatory damaged state. It soaks up sugar. If you do this carefully and quickly, you can override the damage response.”

Because Tavassoli’s compound breaks down sugar, he says he sees it as a potential treatment for diabetes or metabolic syndrome, a cluster of conditions that include obesity, hypertension, high blood sugar, high triglycerides and elevated LDL, the “bad” cholesterol.

“The most startling results have been the effect of the molecule on glucose tolerance and body weight in a mouse model of diet-induced obesity,” he says.

“It improves glucose tolerance and reduces body mass.”

Compound 14 has not yet been tested in humans. “While our results are promising, we are quite a way from anything going into the clinic,” Tavassoli says.

Any of these drugs would have the potential for abuse. Amateur athletes might want them to get faster or stronger. Elite athletes might seek them out to cheat the system.

Even the sedentary might look for an easy way to “exercise” without having to really do it. The experimental 516 already is banned by the World Anti-Doping Agency, according to Evans, and “I’m sure any [future] version of it will be, too.”

Evans acknowledges that once a drug is licensed, “people who aren’t sick will want it,” he says.

“Everyone knows that whatever exercise they get probably isn’t enough. But we are not developing a drug like this to make someone run faster.”

Tavassoli agrees. “Unfortunately, as with all other pharmaceuticals, there is no way to prevent abuse, but the potential benefit to millions of people suffering from disease outweighs any concern about abuse by athletes,” he says.

Evans – who hikes and plays tennis – has never taken 516. “I like exercising, and that’s good enough for me,” he says, adding: “People are designed to move.”

“But if they can’t, it’s not healthy to be sedentary. That’s why we are developing this drug. We are trying to take science out of the laboratory and bring it into the clinic in a way that can change people’s lives. If we can do that, it would be a game-changer.”

5 Photos That Show Just How Much The EPA Website Has Censored Climate Change


Last year, on January 19th, the Environmental Protection Agency (EPA) began removing key references to climate change from its website. Now, over a year later, the information is still conspicuously missing.

Thankfully, the Environmental Data and Governance Initiative (EDGI) has carefully documented the overhaul and removal of all government documents, webpages and websites regarding climate change – not to mention significant language changes to the information that still exists.

While several other agencies, like the Department of Energy (DOE) and the Department of State, have also removed or significantly reduced climate web content, under administrator and climate denier Scott Pruitt, the EPA has removed the most.

The most drastic changes at the EPA came one day before the People’s Climate March, when the agency made substantial alterations to its climate change website.

Now, when you try to access the EPA climate change web page, it merely reads “This page is being updated.” Plus, the climate change tab is now entirely removed from the EPA homepage.

Before 1Screenshots and red underlines in the sections are by TIME.

According to a statement from the agency, these changes are being made to the website to better “reflect the agency’s new direction under President Donald Trump and Administrator Scott Pruitt.”

After the overhaul, the agency provided archived screenshots of the older pages in order to comply with the Freedom of Information Act. However, some pages which were entirely removed, like the “Student’s Global Guide to Climate Change”, were not included in EPA archives.

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“The EPA’s notice that an overhaul was in progress did represent some degree of transparency, yet it failed to note which domains and pages were being removed or altered,” reads the EDGI report.

“Moreover, it was posted the same day that the overhaul began, preventing stakeholders from being able to download and archive valuable pages and information.”

One of the many websites removed last year was the “Climate and Energy Resources for State, Local, and Tribal Governments” website, which contained 380 pages of information.

About three months after this website was removed, a new website titled “Energy Resources for State, Local, and Tribal Governments” was launched. On the new page, over 200 pages of information were omitted, including references to and descriptions of climate and change change.

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While many of the links contained within the climate change subdomain still exist, they are notoriously difficult to find, buried within pages and pages of government material. Meanwhile, other pages have simply been deleted.

For instance, if you search the term “climate change” on EPA.gov, it produce around 5,000 results. In the past, a similar search would have produced closer to 12,000 results.

Apart from burying and deleting information, the agency has also drastically changed the information available. For instance, a map that detail the regional affects of climate change has now been replaced with a far less-detailed version.

Of the 56 states and territories on the new EPA map, only 19 bother to mention climate change, and out of 19 links, only 8 are functional.

Before

Still, many American states and cities are not letting the federal government get away with such censorship.

Concerned by the lost climate information, for instance, Chicago has copied old EPA web pages over to the city’s own website.

A banner on the site states that “while this information may not be readily available on the EPA’s website, in Chicago we know climate change is real. We are joining cities around the country to make sure citizens have access to information on climate change.”

Alongside Chicago, 14 states and territories have formed the U.S. Climate Alliance, which represents a pledge to uphold the Paris accord and reduce emissions, and 382 cities have joined the Climate Mayors, promising similar sustainable practices.

“Censoring scientific data doesn’t make its threats any less real, it hides the problem from the American people so the Trump administration can wage a dangerous assault on public health safeguards that protect all Americans,” Gina McCarthy, the EPA administrator under President Obama told TIME.

“It is beyond comprehension that they would ever purposely limit and remove access to information that communities need to save lives and property.”

Scientists Have Recreated Déjà Vu in The Lab, And It’s Less Spooky Than You’d Think


Sorry, the Matrix isn’t broken.

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Most of us know it – that weird, sudden feeling of experiencing something not for the first time.

It’s called déjà vu – French for “already seen” – and it’s an uncanny feeling. But according to new research, that’s all it is. Just a feeling.

There have been many explanations, including the supernatural (that the person visited the location in a past life), the peculiar (that the person visited the location in a dream) and the worrying (the person is having a small frontal lobe seizure).

But the most accepted explanation is that it has to do with memory. Much like a word can be on the tip of your tongue, a memory could be on the tip of your mind – there, but not quite accessible.

This is what Anne Cleary, a cognitive psychologist at Colorado State University, has previously investigated through her research.

In a new paper, she’s now demonstrated that the feelings of premonition that accompany the phenomenon are just that – feelings.

A person experiencing déjà vu is no more likely to accurately predict what they’re going to see around the next corner than someone who is blindly guessing.

Other scientists have established that déjà vu is tied in with memories as well, but Cleary’s specific hypothesis, demonstrated in previous research, is that familiarity is a key trigger.

A street layout, spatial layout, or even a face might look similar to a different place or layout or face, without a specific memory immediately coming to mind.

“We cannot consciously remember the prior scene, but our brains recognise the similarity. That information comes through as the unsettling feeling that we’ve been there before, but we can’t pin down when or why,” Cleary said.

“My working hypothesis is that déjà vu is a particular manifestation of familiarity. You have familiarity in a situation when you feel you shouldn’t have it, and that’s why it’s so jarring, so striking.”

According to Cleary, anecdotal reports show that déjà vu is often accompanied by a strong feeling of being able to predict the future. And, in a 1959 experiment that induced déjà vu by stimulating the temporal cortex, participants also reported feeling a sense of premonition.

Now, building on previous experiments, Cleary has put 298 people to the test. The team built environments in the computer game The Sims – layouts that were spatially the same, but thematically different: for example, a garden and a junkyard.

In other studies, such duplication has proven to induce déjà vu feelings in participants.

junkyard garden

In this new study, participants were tasked with watching videos that showed a first-person walkthrough of a series of scenes, each opening with a female voice stating and then repeating the name of the scene, such as a junkyard, or an aquarium.

They were then shown a series of test videos, which were cosmetically different from the study videos, but half of which were laid out exactly the same. At a critical point, the participants were stopped and asked if they were experiencing déjà vu and if they knew what the next turn should be.

Around half of the participants reported feeling a sense of premonition alongside déjà vu – but they were no more likely to hit on the correct answer than participants who chose randomly.

So, that feeling of being able to predict the future just isn’t real.

Cleary and her team will be following up the experiment to find out if déjà vu premonition is accompanied by hindsight bias, whereby people become convinced that they knew what would happen after the fact.

A Mysterious Anomaly Under Africa Is Radically Weakening Earth’s Magnetic Field


This could be precursor to Earth’s poles swapping places.

Above our heads, something is not right. Earth’s magnetic field is in a state of dramatic weakening – and according to mind-boggling new research, this phenomenal disruption is part of a pattern lasting for over 1,000 years.

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Earth’s magnetic field doesn’t just give us our north and south poles; it’s also what protects us from solar winds and cosmic radiation – but this invisible force field is rapidly weakening, to the point scientists think it could actually flip, with our magnetic poles reversing.

As crazy as that sounds, this actually does happen over vast stretches of time. The last time it occurred was about 780,000 years ago, although it got close again around 40,000 years back.

When it takes place, it’s not quick, with the polarity reversal slowly occurring over thousands of years.

Nobody knows for sure if another such flip is imminent, and one of the reasons for that is a lack of hard data.

The region that concerns scientists the most at the moment is called the South Atlantic Anomaly – a huge expanse of the field stretching from Chile to Zimbabwe. The field is so weak within the anomaly that it’s hazardous for Earth’s satellites to enter it, because the additional radiation it’s letting through could disrupt their electronics.

“We’ve known for quite some time that the magnetic field has been changing, but we didn’t really know if this was unusual for this region on a longer timescale, or whether it was normal,” says physicist Vincent Hare from the University of Rochester in New York.

One of the reasons scientists don’t know much about the magnetic history of this region of Earth is it lacks what’s called archeomagnetic data – physical evidence of magnetism in Earth’s past, preserved in archaeological relics from bygone ages.

One such bygone age belonged to a group of ancient Africans, who lived in the Limpopo River Valley – which borders Zimbabwe, South Africa, and Botswana: regions that fall within the South Atlantic Anomaly of today.

Approximately 1,000 years ago, these Bantu peoples observed an elaborate, superstitious ritual in times of environmental hardship.

During times of drought, they would burn down their clay huts and grain bins, in a sacred cleansing rite to make the rains come again – never knowing they were performing a kind of preparatory scientific fieldwork for researchers centuries later.

“When you burn clay at very high temperatures, you actually stabilise the magnetic minerals, and when they cool from these very high temperatures, they lock in a record of the earth’s magnetic field,” one of the team, geophysicist John Tarduno explains.

As such, an analysis of the ancient artefacts that survived these burnings reveals much more than just the cultural practices of the ancestors of today’s southern Africans.

“We were looking for recurrent behaviour of anomalies because we think that’s what is happening today and causing the South Atlantic Anomaly,” Tarduno says.

“We found evidence that these anomalies have happened in the past, and this helps us contextualise the current changes in the magnetic field.”

Like a “compass frozen in time immediately after [the] burning”, the artefacts revealed that the weakening in the South Atlantic Anomaly isn’t a standalone phenomenon of history.

Similar fluctuations occurred in the years 400-450 CE, 700-750 CE, and 1225-1550 CE – and the fact that there’s a pattern tells us that the position of the South Atlantic Anomaly isn’t a geographic fluke.

“We’re getting stronger evidence that there’s something unusual about the core-mantel boundary under Africa that could be having an important impact on the global magnetic field,” Tarduno says.

The current weakening in Earth’s magnetic field – which has been taking place for the last 160 years or so – is thought to be caused by a vast reservoir of dense rock called the African Large Low Shear Velocity Province, which sits about 2,900 kilometres (1,800 miles) below the African continent.

“It is a profound feature that must be tens of millions of years old,” the researchers explained in The Conversation last year.

“While thousands of kilometres across, its boundaries are sharp.”

This dense region, existing in between the hot liquid iron of Earth’s outer core and the stiffer, cooler mantle, is suggested to somehow be disturbing the iron that helps generate Earth’s magnetic field.

There’s a lot more research to do before we know more about what’s going on here.

As the researchers explain, the conventional idea of pole reversals is that they can start anywhere in the core – but the latest findings suggest what happens in the magnetic field above us is tied to phenomena at special places in the core-mantle boundary.

If they’re right, a big piece of the field weakening puzzle just fell in our lap – thanks to a clay-burning ritual a millennia ago. What this all means for the future, though, no-one is certain.

“We now know this unusual behaviour has occurred at least a couple of times before the past 160 years, and is part of a bigger long-term pattern,” Hare says.

“However, it’s simply too early to say for certain whether this behaviour will lead to a full pole reversal.”

AAAAI: Penicillin Allergy Label Linked to MRSA, C. difficile


Increase attributable to use of alternative antibiotics

Patients with general practitioner-reported penicillin allergies had an increased risk for developing methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. difficile) infections mediated by increased use of beta-lactam alternative antibiotics, researchers reported here.

Findings from the newly reported study suggest that addressing patient over-reporting of penicillin allergies could prove to be an effective strategy for reducing MRSA and C. difficile incidence, researchers say.

Kimberly Blumenthal, MD, of Massachusetts General Hospital in Boston, reported the study findings during a presentation at a joint meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) and the World Allergy Organization (WAO).

Blumenthal and colleagues used mediation analysis to estimate the impact of a new penicillin allergy documentation by a general physician on the use of alternative antibiotics and risk of MRSA and C. difficile over 6 years of patient follow-up.

“We found that over a quarter to half of the risk of new infection was attributable to the alternative antibiotics,” Blumenthal told MedPage Today, adding that the study is the first to show a link between new-onset use of antibiotics and a first documentation of MRSA or C. difficile.

Since the patients did not undergo formal testing to confirm their penicillin allergy, many may have needlessly been taking the alternative antibiotics, she said.

Asked for his perspective, David Lang, MD, chairman of the Department of Allergy and Clinical Immunology and director of the Allergy/Immunology Fellowship Training Program at the Cleveland Clinic, who was not involved with the study, told MedPage Today that there is growing evidence that patient over-reporting of penicillin allergy has very real clinical consequences.

While approximately one in 10 people self-report having a penicillin allergy, studies suggest that only perhaps one in 20 actually have a clinically confirmable intolerance to the drug, he said. “As many as 19 in 20 people avoiding penicillin are doing so needlessly. These people are given alternative antibiotics that are more costly, have more side effects, and predispose them to untoward outcomes.”

Lang said the newly reported research provides further evidence that a label of penicillin allergy is not clinically benign: “A large focus of the antibiotic stewardship initiative is to limit the use of these broad-spectrum antibiotics when we can. It is clear that the low-hanging fruit of antibiotic stewardship is de-labeling these people who believe they have penicillin allergy, but don’t.”

For the study, Blumenthal and colleagues used a general practice database in the United Kingdom with patient data spanning 1995 through 2015, and studied a matched cohort of adults without prior MRSA or C. difficile.

Patients with incident penicillin allergy, as reported in their medical records, were matched with up to five penicillin users without allergy by age, sex, and index date.

The researchers calculated relative risks (RRs) for the association of penicillin allergy with incident MRSA and C. difficile, adjusting for potential confounders, and also examined beta-lactam alternative antibiotic use to determine whether it was a mediator for MRSA/C. difficile incidence.

Over a mean follow-up of 6 years, among 64,141 penicillin allergy patients and 237,258 matched comparators, 1,345 developed MRSA and 1,688 developed C. difficile.

Among the main study findings:

  • The adjusted RRs among penicillin allergy patients were 1.62 (95% CI, 1.42-1.85) for MRSA and 1.27 (95% CI, 1.13-1.43) for C. difficile
  • The adjusted RRs for antibiotic use among penicillin allergy patients were 4.08 (95% CI, 4.05-4.10) for macrolides, 3.73 (95% CI, 3.51-3.97) for clindamycin, and 2.13 (95% CI, 2.10- 2.16) for fluoroquinolones
  • Increased beta-lactam alternative antibiotic use accounted for 53% of the increased MRSA risk and 25% of the increased C. difficile risk

“The message from this research and other research to general practitioners, medical specialists, and surgeons is that when they see a patient with a label of penicillin allergy, send them to us to confirm or disprove this label,” Lang said. “Nine out of 10 — or even 19 of 20 — times we will be able to reduce the patient’s risk for bad outcomes by removing this label.”

Muscle Wasting in RA Patients: Who’s at Risk, What’s the Best Treatment?


Men seem to be at greater risk for rheumatoid cachexia, and there’s some evidence to suggest testosterone therapy may have an impact.

Several studies have found that patients with rheumatoid arthritis (RA) are prone to lean body mass deficits, which increase the risk of poor clinical outcomes, disability, and mortality. A recent report that used dual x-ray absorptiometry to measure whole body lean body mass (LBM) and LBM in patients’ arms and legs discovered significantly greater losses in men with RA, when compared to women with the same disease.

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In 1 of the 2 groups of patients studied, Joshua Baker, from the Philadelphia VA Medical Center, and colleagues found the “odds of sarcopenia were 3 to 8 times greater in men….” In their recently published article in Arthritis Care & Research, they explain that among patients in the 2 cohorts, men’s height-adjusted lean mass registered at the 11th and 20th percentiles, respectively. By comparison, women’s height-adjusted lean mass in the cohorts studied was only slightly lower than population norms.

Dr. Baker and his colleagues point out that the reduced LBM “is clinically important since sarcopenia is associated with falls, fracture, and early death among the elderly, and with greater disability.” The researchers hypothesize that the hormonal mechanisms responsible for muscle mass deficits may contribute to the problem to a greater degree in males. Testosterone is one possible candidate as a potential mechanism of action. Dr. Baker and his colleagues say the “levels of testosterone are lower in men with RA and increase in correlation with improvements in disease activity.” With that in mind, some have speculated that testosterone therapy may alleviate the decline and slow down muscle wasting in these patients.

Low levels of free testosterone can cause a loss of muscle mass,

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but that in itself doesn’t prove that administering testosterone to RA patients will have any impact on muscle wasting. Nonetheless, at least 1 pilot study suggests that testosterone therapy does improve muscle mass in male RA patients. When Lemmey and colleagues performed a randomized, double blind trial on 24 adult men with confirmed RA, they administered either 100 mg/week of nandrolone decanoate, a testosterone derivative, or placebo as a deep intramuscular injection for 24 weeks. Their conclusion: The drug produced a “considerable increase in muscle mass and decrease in fat mass,” with a mean increase in total lean mass (TLM) of about 4.2 kg; patients on placebo saw no significant improvement in TLM.

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Despite these positive results, the investigators said they were not able to detect any improvement in patients’ physical functioning at the end of the 24 weeks. Although the researchers did not report adverse effects, it is worth noting that testosterone therapy can cause side effects, including acne, mood changes, and hirsutism.The authors point out that their findings are similar to several other studies of nandrolone and testosterone in a variety of conditions – lean body mass improves, but functional gains are modest or absent. It’s important to note, though, that these other trials weren’t performed in patients with RA.

Orrin Troum, MD, a rheumatologist at Providence Saint John’s Health Center in Santa Monica, California, says the jury is still out on the value of testosterone therapy in RA patients. “Further studies are needed to demonstrate that improving testosterone levels, which are usually lower in men with RA, will help to reduce the risk of falls and improve their overall outcomes.” He does, however, emphasize the value of nonpharmaceutical approaches: “In general, improving … movement and balance with physical therapy may help to reduce the risk of falls and related problems.”

Exercise training has been shown to mitigate the loss of muscle mass seen in patients with RA while“substantially improving function without exacerbating disease activity ….”

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Cooney and associates explain that loss of muscle mass, which they refer to as rheumatoid cachexia, affects about two-thirds of RA patients. Some researchers believe that the complication results from cytokine-driven hyper-metabolism and protein degradation.

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Cooney and her colleagues also believe that reduced insulin action, lowered testosterone levels, poor nutrition, and inadequate physical activity likely contribute to the problem as well.High intensity progressive resistance training (PRT) has been shown to help improve muscle wasting in this patient population.

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A 24-week PRT program significantly increased LBM, reduced trunk adiposity, and improved muscle strength and physical function. 

9 Health Benefits of Oranges Backed By Science


9 Evidence-Based Medicinal Properties of Oranges

The orange is both a literal and symbolic embodiment of the sun, from whose light it is formed. As a whole food it irradiates us with a spectrum of healing properties, the most prominent of which some call “vitamin C activity,” but which is not reducible to the chemical skeleton known as ‘ascorbic acid.’ Science now confirms the orange has a broad range of medicinal properties, which is why the ancients knew it both as a food and a medicine.

As our increasingly overdiagnosed and overmedicated population leaps lemming-like over the cliff of pharmaceutically-driven conventional medicine, with most drugs carrying a dozen or more adverse side effects for every benefit advertised, we can find great wisdom in Meryl Streep’s quote:

“It’s bizarre that the produce manager is more important to my children’s health than the pediatrician.”

~ Meryl Streep

Indeed, many common fruits and vegetables “crouching” at the local produce stand have “hidden healing powers,” and have been used as both medicines and nourishing foods since time immemorial. We’re only just beginning to understand how these foods contain vitally important information-continaing molecules, such as microRNAs, which profoundly impact the expression of our entire genome.

I firmly believe that access to fresh, organic produce is as vital a health necessity as access to water, and clean air. Over the course of hundreds of millions of years, the bodies of our ancestors (whose genes our still within our own) co-evolved with higher, flowering and fruiting plants, and the tens of thousands of phytocompounds (and informational molecules) they contain, many of which now regulate and maintain the expression and health of our genes. Therefore, without the regular consumption of these foods, the developmentn of suboptimal health, and likely many feared acute and chronic diseases, is inevitable.

Orange is one such food-medicine marvel, containing a broad range of compounds increasingly being recognized to be essential for human health. We consider it a sweet treat, its juice a refreshing beverage, but do we ever really reflect on its medicinal properties?  GreenMedInfo.com has indexed no less than 37 distinct health benefits its use may confer, all of which can be explored on our Orange Medicinal Properties research page.  What follows are some of its most well-established therapeutic applications, divided into three parts: the juice, the peel and the aroma:

The Juice of the Orange

Many of us mistakenly look to orange juice today as a dangerous source of highly concentrated fructose – simple “carbs” – without recognizing its profound medicinal properties. We sometimes think we can get the vitamin C activity oranges contain through the semi-synthetic ‘nutrient’ ascorbic acid, without realizing that an orange embodies (as do all whole foods) a complex orchestra of chemistries, the handiwork of millions of years of evolution, which is to say a process of intelligent biological design.  The ‘monochemical nutrient’ – ascorbic acid – is merely a shadow of the vitamin C activity that is carried and expressed through only living foods. The orange, after all, looks like a miniature sun, is formed as a condensation of energy and information from sunlight, and therefore is capable of storing,  and after being eaten, irradiating us with life-giving packets of information-dense gene-regulating nutrition, by a mechanism that will never be fully reducible to or intelligible by the chemical skeleton we know of as ascorbic acid.

The Medicinal Properties of Oranges

Given that thought, here are some of the evidence-based benefits of orange juice:

  • Orange Juice Improves “Good” Cholesterol: While it is debatable that lowering so-called “LDL” cholesterol is nearly as good for heart health as statin drug manufacturers would like for us to believe, raising “HDL” cholesterol does seem to have real health benefits. This is, however, quite hard to do with diet and nutrition, and impossible through medication. Other than taking high-dose fish oil, few things have been studied to be effective. Except, that is, orange juice.  A 2000 study found that the consumption of 750 mL of orange juice a day, over a 4 weeks, improved blood lipid profiles by decreasing the LDL-HDL cholesterol ratio by 16% in patients with elevated cholesterol.[1]
  • Orange Juice Boosts Bone Health: A 2006 animal study in male rats found that orange juice positively influenced antioxidant status and bone strength.[2]
  • Orange Juice (mixed with Blackcurrant Juice) Reduces Inflammation: A 2009 study in patients with peripheral artery disease found that orange and blackcurrant juice reduced C-reactive protein (11%)  and fibrinogen levels (3%), two concrete measures of systemic inflammation.[3] A 2010 study found that Orange juice neutralizes the proinflammatory effect of a high-fat, high-carbohydrate meal and prevents endotoxin induced toxicity.[4]
  • Orange Juice Boosts Weight Loss: A 2011 study found that children who regularly drank orange juice consumed an average of 523 calories a day more than children who did not drink orange juice regularly. Yet surprisingly, there was no difference in the weight levels between the orange juice consumers and the non-orange juice consumers.[5]
  • Orange Juice May Dissolve Kidney Stones: A 2006 study found that orange juice consumption was associated with lower calculated calcium oxalate supersaturation and lower calculated undissociated uric acid, two indices of lowered urinary calcium stone formation.[6]
  • Orange Juice Extract Suppresses Prostate Proliferation: Despite the fructose content, a 2006 study found a standardized extract of red orange juice inhibited the proliferation of human prostate cells in vitro.[7]

The Peel of the Orange

The peel of the orange contains a broad range of potent, potentially therapeutic compounds.  These include pectin and flavonoid constituents, such as hersperiden, naringin, polymethoxyflavones, quercetin and rutin, various carotenoids, and a major odor constituent known as d-limonene, which makes up 90% of the citrus peel oil content, and is a compound that gets its name from the rind of the lemon, which contains a significant quantity of it. It is listed in the US Code of Federal Regulations as generally recognized as safe (GRAS), and is commonly used as a flavoring agent.  D-limonene has been studied to have potent anti-cancer properties, including against metastatic melanoma.[8]

The whole peel extract has been studied to have a wide range of benefits:

  • Orange Peel exhibits Anti-Arthritic Properties: A 2010 study found that orange peel extract significant suppressed vaccine adjuvant-induced arthritis in a preclinical model.[9]
  • Orange Peel (Flavonoids) Exhibit Anti-Cancer Properties:  A 2007 study found that orange peel extract inhibited tumorigenesis in a preclinical mouse model of adenomatous polyposis and increases programmed cell death.[i]  Two additional 2007studies found that orange peel extract has anti-breast cancer properties. The first, by exhibiting chemopreventive properties against mammary tumor lesions in an animal model.[10] The second, by inhibiting breast cancer cell lines in vitro.[11] Additionally, a 2000 study found that flavanone intake is inversely associated with esophageal cancer risk and may account, with vitamin C, for the protective effect of fruit, especially citrus fruit, on esophageal cancer. [12] Finally, a 2005 study found that carotenoids from orange may help to reverse multidrug resistance.

The Aroma of the Orange

The physiological mechanisms by which aromas may have therapeutic properties (aroma-therapy) are well-established. The small molecules that comprise the aroma of things, are capable of entering directly through the nostrils and into the olfactory lobe, thus enabling them to have profound affects on deep structures within our brain, and as a result our entire bodily and emotional infrastructure.

  • Orange Scent Reduces Anxiety, Boosts Mood:  A 2000 study found that the aroma of orange essential oil reduces anxiety, generates a more positive mood, and a higher level of calmness in women exposed to it in a dental office waiting room.[13]  This finding was confirmed again in a 2005 study, where ambient odors of reduced anxiety and improved mood in patients waiting for dental treatment.[14]

Clearly oranges have a lot to offer as a medicinal food, beyond the obvious aesthetic pleasures they afford. Science may never plumb the depths of their value to our body and mind, but what has been revealed thus far is compelling enough to put it back on the list of ‘super foods’ which we aspire to consume more of in order to nourish ourselves on a deep level.


References


[1] E M Kurowska, J D Spence, J Jordan, S Wetmore, D J Freeman, L A Piché, P Serratore. HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Am J Clin Nutr. 2000 Nov;72(5):1095-100. PMID: 11063434

[2] Farzad Deyhim, Kristy Garica, Erica Lopez, Julia Gonzalez, Sumiyo Ino, Michelle Garcia, Bhimanagouda S Patil. Citrus juice modulates bone strength in male senescent rat model of osteoporosis. Nutrition. 2006 May;22(5):559-63. Epub 2006 Feb 10. PMID: 16472977

[3] Christine Dalgård, Flemming Nielsen, Jason D Morrow, Henrik Enghusen-Poulsen, Torbjörn Jonung, Mogens Hørder, Moniek P M de Maat. Supplementation with orange and blackcurrant juice, but not vitamin E, improves inflammatory markers in patients with peripheral arterial disease. Br J Nutr. 2009 Jan;101(2):263-9. Epub 2008 May 28. PMID: 18507878

[4] Husam Ghanim, Chang Ling Sia, Manish Upadhyay, Mannish Upadhyay, Kelly Korzeniewski, Prabhakar Viswanathan, Sanaa Abuaysheh, Priya Mohanty, Paresh Dandona. Orange juice neutralizes the proinflammatory effect of a high-fat, high-carbohydrate meal and prevents endotoxin increase and Toll-like receptor expression. Am J Clin Nutr. 2010 Apr;91(4):940-9. Epub 2010 Mar 3. PMID: 20200256

[5] O’Neil CE, Nicklas TA, Rampersaud GC, Fulgoni VL 3rd. One hundred percent orange juice consumption is associated with better diet quality, improved nutrient adequacy, and no increased risk for overweight/obesity in children. Nutr Res. 2011 Sep;31(9):673-82.associated with better diet quality, improved nutrient adequacy, and no increased risk for overweight/obesity in children. Nutr Res. 2011 Sep;31(9):673-82.

[6] Clarita V Odvina. Comparative value of orange juice versus lemonade in reducing stone-forming risk. Clin J Am Soc Nephrol. 2006 Nov;1(6):1269-74. Epub 2006 Aug 30. PMID: 17699358

[7] Federica Vitali, Claudia Pennisi, Antonio Tomaino, Francesco Bonina, Anna De Pasquale, Antonella Saija, Beatrice Tita. Effect of a standardized extract of red orange juice on proliferation of human prostate cells in vitro. Fitoterapia. 2006 Apr;77(3):151-5. Epub 2006 Feb 23. PMID: 16530345

[8] GreenMedInfo.com, D-Limenone’s Anti-Cancer Properties

[9] Gang Chen, Zhongyi Yin, Xuxu Zheng. [Effect and mechanism of total flavonoids of orange peel on rat adjuvant arthritis]. Zhongguo Zhong Yao Za Zhi. 2010 May;35(10):1298-301. PMID: 20707201

[10] Sadanori Abe, Kunhua Fan, Chi-Tang Ho, Geetha Ghai, Kan Yang. Chemopreventive effects of orange peel extract (OPE). II: OPE inhibits atypical hyperplastic lesions in rodent mammary gland. J Med Food. 2007 Mar;10(1):18-24. PMID: 17472462

[11] Igor N Sergeev, Chi-Tang Ho, Shiming Li, Julie Colby, Slavik Dushenkov. Apoptosis-inducing activity of hydroxylated polymethoxyflavones and polymethoxyflavones from orange peel in human breast cancer cells. Mol Nutr Food Res. 2007 Dec;51(12):1478-84. PMID: 17979096

[12] Marta Rossi, Werner Garavello, Renato Talamini, Carlo La Vecchia, Silvia Franceschi, Pagona Lagiou, Paola Zambon, Luigino Dal Maso, Cristina Bosetti, Eva Negri. Flavonoids and risk of squamous cell esophageal cancer. Arch Intern Med. 2000 Apr 10;160(7):1009-13. PMID: 17192901

[13] J Lehrner, C Eckersberger, P Walla, G Pötsch, L Deecke. Ambient odor of orange in a dental office reduces anxiety and improves mood in female patients. Physiol Behav. 2000 Oct 1-15;71(1-2):83-6. PMID: 11134689

[14] J Lehrner, G Marwinski, S Lehr, P Johren, L Deecke. Ambient odors of orange and lavender reduce anxiety and improve mood in a dental office. Physiol Behav. 2005 Sep 15;86(1-2):92-5. PMID: 16095639


[i] Kunhua Fan, Naoto Kurihara, Sadanori Abe, Chi-Tang Ho, Geetha Ghai, Kan Yang. Chemopreventive effects of orange peel extract (OPE). I: OPE inhibits intestinal tumor growth in ApcMin/+ mice. J Med Food. 2007 Mar;10(1):11-7. PMID: 17472461

Biologics in Pregnancy: Are They Safe?


Study shows no increased risk for preterm delivery or small for gestational age

Exposure to biologic therapies among women with autoimmune diseases was not associated with increased risks of preterm delivery or having small for gestational age babies, a population-based Canadian study found.

Among 109 women who had 120 pregnancies and who received a biologic medication during or 3 months prior to pregnancy, the odds ratio for preterm delivery after high-dimensional propensity score matching was 1.13 (95% CI 0.67-1.90), which was not significantly different from the risk seen among women not receiving biologics, according to Mary A. De Vera, PhD, of the University of British Columbia in Vancouver, and colleagues.

And also after propensity score matching, the risk of small for gestational age birth compared with nonuse of biologics was 0.91 (95% CI 0.46-1.78) among users, they reported online in Annals of the Rheumatic Diseases.

A critical component of autoimmune disease is the dysregulation of regulatory cytokines and chemokines, with tumor necrosis factor (TNF) being key.

“In pregnancy, TNF-alpha controls cyclo-oxygenases that affect blastocyst implantation, endometrial permeability and decidualization, and contributes to the process of labor. Abnormally high levels of TNF-alpha and other cytokines have been implicated in pregnancy complications including preterm delivery, fetal growth retardation, early and unexplained spontaneous abortions, and miscarriages,” De Vera’s group explained.

This suggests that these undesirable outcomes correlate with levels of disease activity, which is held in check by effective treatments such as TNF inhibitors.

To see if these two adverse outcomes associated with infant morbidity and mortality were influenced by biologic use shortly before or during pregnancy, the researchers analyzed data from Population Data British Columbia, which contains longitudinal data on health services for all residents of British Columbia.

Additional information was obtained from the Medical Services Plan database, the Discharge Abstract Database, Population Data BC, PharmaNet, and the BC Perinatal Database Registry.

The study cohort included women with recorded diagnoses of rheumatoid arthritis (RA), inflammatory bowel disease (IBD), psoriasis/psoriatic arthritis, juvenile idiopathic arthritis, systemic lupus erythematosus, and other connective tissue diseases.

Preterm delivery was birth before 37 weeks’ gestation, and small for gestational age was weight below the 10th percentile of age- and sex-specific neonatal weight.

High-dimensional propensity score matching was used to limit the likelihood of confounding by indication. This was based on an algorithm that took into account the use of multiple medications, concurrent disorders and symptoms, and previous adverse obstetric outcomes.

The analysis included 6,218 women with autoimmune disease and their 8,607 pregnancies.

Mean maternal age at delivery was 31, and the majority of women had either RA or IBD. The most commonly used biologics were infliximab (Remicade) in 37%, etanercept (Enbrel) in 31%, and adalimumab (Humira) in 26%.

A total of 21 of the 120 babies with biologic exposure (18%) were born preterm, as were 95 of 600 (16%) not exposed, for an unadjusted odds ratio of 1.64 (95% CI 1.02-2.63). Small for gestational age births were seen in 11 of 120 (9%) of babies who were biologics exposed, and in 60 of 600 (10%) of those who were unexposed, for an unadjusted OR of 1.34 (95% CI 0.72-2.51). After propensity score matching, however, neither outcome was statistically significant.

Among the small for gestational age neonates, mean Apgar scores for those who were biologics exposed were 8.1 and 9 at 1 and 5 minutes, respectively, while for the nonexposed, the corresponding scores were 7.7 and 8.7.

An important feature of this study was the use of high-dimensional propensity scoring, so that differences in baseline characteristics were taken into account. Earlier studies found odds ratios for preterm delivery of 2 to 2.71. However, those studies did not attempt to adjust for the effects of disease severity or other confounders and therefore had limited generalizability.

“Indeed, addressing confounding by indication is of utmost importance in the population of women with autoimmune disease, given the association between disease activity and adverse pregnancy outcomes,” De Vera’s group stated.

Despite being limited by relatively small numbers, the study “represents an important contribution to the accumulation of evidence on the safety of the use of biologics in pregnant women, which may lead to increased prescriber comfort and patient acceptance, decreased uncertainty, and improved maternal and neonatal outcomes in this population,” they concluded.

People Don’t Actually Know Themselves Very Well


Chances are, your coworkers are better at rating some parts of your personality than you are.When Donald Trump tweeted that he was a “very stable genius,” he was accused of lacking self-awareness by journalists and comedians. But the truth is that no one has perfect self-awareness—you probably believe more than a few things about yourself that are false.

Whether it’s in trying to land a job or impress a date, people spend a staggering amount of time making claims about themselves. It makes sense: You’re the only person on Earth who has direct knowledge of every thought, feeling, and experience you’ve ever had. Who could possibly know you better than you? But your backstage access to your own mind sometimes makes you the last person on Earth others should trust about it. Think of it like owning a car: Just because you’ve driven it for years doesn’t mean you can pinpoint when and why the engine broke down.

Sixteen rigorous studies of thousands of people at work have shown that people’s coworkers are better than they are at recognizing how their personality will affect their job performance. As a social scientist, if I want to get a read on your personality, I could ask you to fill out a survey on how stable, dependable, friendly, outgoing, and curious you are. But I would be much better off asking your coworkers to rate you on those same traits: They’re often more than twice as accurate. They can see things that you can’t or won’t—and these studies reveal that whatever you know about yourself that your coworkers don’t is basically irrelevant to your job performance.

Humans’ blind spots are predictable: There are certain types of traits where people can’t see themselves clearly, but others where they can. The psychologist Simine Vazire asked people to rate themselves and four friends on a bunch of traits, ranging from emotional stability and intelligence to creativity and assertiveness. Then, to see if they had predicted their own personalities better than their friends had, they took a bunch of tests that measured these traits.The good news: You have some unique insight into your emotional stability. In the study, people outperformed their friends at predicting how anxious they’d look and sound when giving a speech about how they felt about their bodies. But they did no better than their friends (or than strangers who had met them just eight minutes earlier) at forecasting how assertive they’d be in a group discussion. And when they tried to predict their performance on an IQ test and a creativity test, they were less accurate than their friends.

People know themselves best on the traits that are tough to observe and easy to admit. Emotional stability is an internal state, so your friends don’t see it as vividly as you do. And although people might not want to call themselves unstable, the socially acceptable range is fairly wide, so we don’t tend to feel terribly anxious about being outed as having some anxiety. With more observable traits, we don’t have unique knowledge. If you’re a raging extrovert or a radical introvert, we don’t need to ask you—we can pick it up pretty quickly from your impromptu karaoke performances or your complaints that your husband types too loudly. And with the most evaluative traits, you just can’t be trusted. You probably want to convince everyone—and yourself—that you’re smart and creative.

This is why people consistently overestimate their intelligence, a pattern that seems to be more pronounced among men than women. It’s also why people overestimate their generosity: It’s a desirable trait. And it’s why people fall victim to my new favorite bias: the I’m-not-biased bias, where people tend to believe they have fewer biases than the average American. But you can’t judge whether you’re biased, because when it comes to yourself, you’re the most biased judge of all. And the more objective people think they are, the more they discriminate, because they don’t realize how vulnerable they are to bias.Any time a trait is easy to observe or hard to admit, you need other people to hold up a mirror for you. Romantic partners and close friends might be more informed, because they’ve observed you more—but they can also have blurrier vision, because they chose you and often share that pesky desire to see you positively. You need people who are motivated to see you accurately. And I’ve come to believe that more often than not, those people are your colleagues. The people you work with closely have a vested interest in making you better (or at least less difficult). The challenge is they’re often reluctant to tell you the stuff you don’t want to hear, but need to hear.

Over the past few months, I’ve learned a lot about how to overcome those barriers. While recording a podcast, I invited myself into some unconventional workplaces. I was surprised that in each workplace, they made a it big priority to help people gain self-awareness—sometimes it was even part of their performance evaluations. And I walked away with new insights on how people can see themselves more clearly.

One: If you want people to really know you, weekly meetings don’t cut it. You need deep dives with them in high-intensity situations. When I talked with a crew of astronauts who went to the International Space Station together, I found out that NASA prepared them by sending them into the wilderness for 11 days together. Their guides promptly let them get lost, and they said they came out of that experience knowing each other better than colleagues they’d worked with for years. At Morning Star, a leading tomato-paste plant that has operated successfully for decades without a single boss, I was stunned to discover that the founder often interviews job applicants at their own homes for three to five hours.Two: Looking under your own hood at what makes you tick and writing it down can provide a useful reference. I’ve seen a growing number of managers write their own user manuals to help people understand what brings out the best and worst in them. But it’s even better to have the people who know you well write your user manual for you. On a visit to the hedge fund Bridgewater Associates, I got to see people rate each other daily on up to 77 different dimensions. It sounds intense, but it forces people to be honest with themselves. And at Morning Star, employees get to write their own job descriptions based on how they plan to contribute to the company’s mission that year. But they have to get their closest colleagues to buy in on it, and then their coworkers rate their performance and determine their salary.

Three: Put yourself in situations where you can’t ignore feedback from multiple sources. In studies, one friend is only a little better at gauging a person’s intelligence and creativity than they themselves are; four friends are significantly better. When I infiltrated the writers’ room at The Daily Show, the host, Trevor Noah, told me he makes up 90 percent of his stand-up comedy on stage. He just starts riffing on topics and gets instant input on what’s funny from a whole crowd. And at Bridgewater, the ratings are weighted by how believable your colleagues have proven themselves to be in each domain. When five of your close colleagues have a track record of being highly organized and they all say you’re not, it’s tough to argue that you’re right and they’re wrong.

Imagine if the White House were organized this way. Presidents are rated all the time in public-opinion polls, but they’d learn a lot more if their own teams evaluated them. Since stability is an internal state, as long as he’s not clinically unstable, President Trump might be able to weigh in on it accurately. But he—like everyone—probably can’t see himself clearly when it comes to traits that are clearly desirable or undesirable, like intelligence.

The first rule of intelligence: Don’t talk about your intelligence. It’s something you prove, not something you claim. As comedian Patton Oswalt quipped about humor, the only person who goes around saying “I’m funny” is a not-funny person. If you were really funny, you’d just make people laugh.

So if I wanted to know how smart political candidates were, I wouldn’t bother with an IQ test. I’d just ask one question: How intelligent do you think you are?

The real geniuses will know it’s not their place to judge.

Why Do Miscarriages Happen? 5 Miscarriage Myths We Need to Stop Believing


Straight from a gynecologist.
Miscarriages

“I am so sorry,” I say. Then I wait.

“You did nothing that caused this miscarriage and there is absolutely nothing you could have done differently.” I make sure that my patient not only hears me, but acknowledges what I’m telling her.

As an ob/gyn, most days I’m certain I have the best job in the world. I spend my days (and nights…and weekends) with women, bringing life into the world—and helping others avoid pregnancy when they’re not ready, thanks to the remarkable birth control options on the market. But there are also days when my job is to counsel patients about issues when it comes to getting—or staying—pregnant. And, unfortunately, one part of that discussion includes miscarriage. Miscarriages are extremely common, rarely talked about, and wrought with misinformation. Here are some of the most common and persistent myths I encounter as an ob/gyn.

But first, what exactly is a miscarriage?

A miscarriage is a non-viable pregnancy in the uterus, or an embryo or fetus without a heartbeat, up to 20 weeks along. Early pregnancy (or first trimester) losses account for 80 percent of all miscarriages. The American College of Obstetricians and Gynecologists (ACOG) estimates that 10 percent of known pregnancies end in miscarriage, and this doesn’t account for the miscarriages that occur when a women doesn’t even realize she is pregnant, which makes the real rate closer to 20-25 percent.

But despite how common they are, many people aren’t aware of the facts. A survey published in 2015 found that public awareness of miscarriages is fraught with misconceptions. A whopping 55 percent of survey respondents across 49 states believed that miscarriages are uncommon, defined as less than 5 percent of pregnancies. More so, a significant percentage of survey respondents believed that lifestyle choices caused miscarriage. (If you take one thing home from this piece: they do not.)

About half of miscarriages are directly related to fetal chromosomal abnormalities. Chromosomes are the structures inside cells that contain genetic material. So, biology has a way of identifying cells that are abnormal and will not go on to be viable—a built-in “quality control” of sorts.

Age can also play a role. According to ACOG, 10 percent of women have a miscarriage when they are younger than 30 years old, and this rate doubles to 20 percent between 35 and 39 years old. It goes up to 40 percent at age 40, and 80 percent at age 45. Reassuringly, most chromosomal problems are not inherited, so at baseline, one miscarriage does not mean that another one is around the corner. Other common causes are poorly controlled medical problems like diabetes, thyroid issues, and uncontrolled hypertension, as well as abnormalities of the uterus. So reproductive health planning and pre-conception health care are really important.

Now that we’ve gone over what a miscarriage is and what can cause them, let’s go over some common misconceptions:

Myth 1: I must have done something, like exercising too much or drinking coffee, to cause the miscarriage.

Here are a few things that are not causally related to miscarriages: exercising, using tampons, lifting heavy things, feeling anxious, morning sickness, drinking a cup of a coffee a day, and working.

While lifestyle choices like alcohol consumption and smoking have been investigated as a cause of miscarriage, the data is less clear that they are a direct cause. There is some data that points to smoking or alcohol increasing the risk of miscarriages, however, the interpretation of these studies is complicated by the difficulty of making accurate adjustments for the many confounding factors. Though the link to miscarriage directly is unclear, both smoking and alcohol should be avoided during pregnancy for their developmental risks and links to poor pregnancy outcomes.

Another concern many of my patients have is that a fall can cause a miscarriage. During the first trimester, the position of the uterus (the walls of which are strong, thick muscle designed to protect your growing baby), the cushion of the amniotic sac, and the small size of the fetus make it unlikely that a fall will do any harm. However, if you suffer a fall later in your pregnancy and you notice vaginal bleeding, severe pain in your abdomen, or your baby’s movements slow or stop, call your doctor right away.

Myth 2: My stress level caused the miscarriage.

In the same U.S. survey mentioned earlier, 76 percent of respondents believed that a stressful event could cause a miscarriage, while 74 percent believed a longstanding stressor could, and 21 percent believed an argument could lead to a miscarriage. Rest assured: There is absolutely no biological basis for any of these.

Myth 3: Having sex caused the miscarriage.

A normal pregnancy is implanted in the uterus on a supportive layer of cells called the endometrium. During intercourse, the uterus is never entered. Studies investigating the relationship of sexual intercourse and adverse pregnancy outcomes have not observed any association between pregnancy complications, including miscarriage.

Many women in the first trimester report that fear of injury to the fetus affects the freedom of their physical response (aka their enjoyment) during intercourse. It shouldn’t. So, unless you have a specific complication of pregnancy that your doctor has recommended pelvic rest for, enjoying sex while pregnant should be encouraged.

Myth 4: My prior birth control use caused the miscarriage.

Generally, birth control pills work by stopping ovulation, stopping the possibility of your egg meeting with sperm after sex, and stopping the fertilization that’s required before a pregnancy is implanted. When you stop using birth control pills, ovulation resumes. In some cases, like with IUDs (which generally work by stopping fertilization and implantation), it’s possible to get pregnant pretty much as soon as you stop using the method.

If there has been contraceptive failure leading to an unplanned pregnancy or you’ve recently stopped using contraception, you are at no increased risk of miscarriage or major birth defects as demonstrated by large registry studies. More so, women who have had prolonged use of contraceptives should be reassured that they have no delay in the resumption of ovulation and are at no increased risk of miscarriage.

Myth 5: Getting the flu shot caused a miscarriage.

Despite what you might have read in some corners of the internet, it is safe to receive the flu vaccine during pregnancy. This is particularly important because pregnant women are at a heightened risk of death from flu compared to non-pregnant women. Vaccination of the mother is the most effective way to protect the fetus and will not put the pregnancy at risk.

The ACOG recommendation that all pregnant women get the flu shot is based on a safety profile and data that is tracked by the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services (HHS). With the support of a large body of literature, they found the flu vaccine (at any point in pregnancy) to be a safe and effective way to reduce maternal morbidity and mortality, and to protect the fetus in-utero and after birth without risk of pregnancy loss.

So why is there so much misinformation out there about miscarriages?

We’re intelligent and curious creatures, and it’s natural to want an explanation for something out of our control. Even if nothing can be done to prevent a subsequent miscarriage, 78 percent of people in that previously-mentioned survey wanted to know the underlying cause of miscarriage.

The good news is that isolated pregnancy loss in the first trimester is usually a one-time event and, if desired, women go on to have a successful pregnancy. Recurrent pregnancy loss is rare—estimates show that fewer than 5 percent of women will have two consecutive miscarriages and just 1 percent will experience three or more.

If desired, there is no medical reason to wait before trying to conceive again after a miscarriage, and you often ovulate two to three weeks after a miscarriage. Though not medically necessary, some doctors recommend waiting until you have one regular period before trying again. This helps give you a more precise due date for a subsequent pregnancy, as this date is calculated by your period. And if you don’t want to become pregnant again, you can start using contraception immediately.

Miscarriages are very difficult and people often feel very alone after experiencing one. Talk to your gynecologist or health care team. Support groups and counselors can also provide resources, like SHARE: Pregnancy and Infant Loss Support, Inc., which provides a list of online resources and support groups.

And remember, it’s not you. You did nothing to cause the miscarriage. Repeat it again: You did nothing to cause the miscarriage.

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