Health headlines seemed extra polarized this year, veering from really good news—the arrival of long-awaited calorie labels on restaurant menus and the approval of the first cannabis-derived drug to treat debilitating seizures in children—to really bad news, including declining U.S. life expectancy, rising STD rates, and dire warnings about climate change (delivered amid the most destructive and deadly California wildfire season in history). Here, in chronological order, is our rundown of what we deemed the year’s most important health stories.
Low-fat vs. low-carb: new and encouraging findings
A major new clinical trial from Stanford University, published in February 2018, pitted a low-fat diet against a low-carb diet for the umpteenth time, but with a twist: The trial focused on sensible “healthy low-fat” and “healthy low-carb” diets, rather than on more restrictive versions of the diets, and it did not explicitly encourage participants to cut calories or limit portion sizes. Not only was there no clear winner, but contrary to the researchers’ expectations, genetics and insulin sensitivity didn’t predict who would fare best on each diet. Both plans produced similar moderate weight loss that was sustained for a year, and both were designed so that people could follow them for the rest of their lives. Good news all around. Get the details here.
Calorie labeling rules take effect...
In May, menu labeling regulations, developed under the Obama administration as part of the Affordable Care Act, finally went into effect nationally after multiple extensions of the original compliance date of December 2015—in large part due to heavy lobbying by the food industry from the start and then a last-minute delay under the Trump administration. The regulations require that calories be posted on menus, menu boards, or other signage, and they apply to restaurants (both fast-food and sit-down) and other food outlets offering prepared foods (including beverages) that have 20 or more locations. That includes supermarkets, convenience stores, movie theaters, ballparks, amusement parks, take-out restaurants, and even ice cream trucks.
...And so does trans fat ban
This past June marked the passing of the deadline that the FDA gave manufacturers and restaurants tostop using partially hydrogenated oils—the source of dangerous artificial trans fats—in their products. That follows the FDA’s decision in 2015 to remove these oils from its list of food ingredients that are “generally recognized as safe”(GRAS). The new ban is expected to prevent thousands of heart attacks and deaths in the U.S., and there’s already evidence of benefits from New York state, where many counties enacted trans fat bans up to a decade ago. Foods produced before the June 2018 compliance date that are still working their way through distribution are permitted to stay on shelves until January 1, 2020—so it’s a good idea to keep checking labels for partially hydrogenated oils until then.
CBD, CBD everywhere
In oils, in vaping liquids, in pills, even in dog treats, the hot new cannabis compound on the block exploded in popularity, with 13 percent of Americans now saying they’ve tried it for health reasons, according to a Consumer Reports survey released in July, and with sales predicted to increase sevenfold by 2021. Cannabidiol (known as CBD) is derived from marijuana or hemp, but unlike its psychoactive cousin tetrahydrocannabinol (THC), CBD does not get users high. Forty-seven states have now legalized CBD for some uses, and it’s broadly available online and in stores. Researchers are studying the chemical for a range of uses, from pain relief to reducing anxiety to slowing cancer progression. But with the exception of treating two rare but devastating forms of childhood epilepsy—for which a marijuana-derived CBD drug, Epidiolex, received FDA approval this summer—the research is largely still preliminary, though promising. And much remains unknown about CBD’s optimal dosing range and the best route of administration.
New cervical cancer screening guidelines (goodbye, Pap?)
In August, the influential U.S. Preventive Services Task Force (USPSTF) released updated guidelines about screening for cervical cancer. The main change: The USPSTF now says that women can safely opt to skip the Pap test and instead get an HPV test, which detects “high-risk” types of the human papillomavirus that cause most cases of cervical cancer (as well as some other cancers). Several other developed countries have already seen a shift to HPV testing as the primary screening tool for cervical cancer. But’s it’s probably not curtains for the Pap yet: The use of HPV testing as a stand-alone screening option remains controversial in the U.S., and several other expert groups, including the American Cancer Society, are still recommending it only in combination with a Pap test, called “co-testing.” The USPSTF also includes co-testing as an option. Whichever option they choose, most women—but not all—can safely stop cervical cancer screening at age 65.
Daily aspirin takes a hit
An alliterative trio of large clinical trials published in August and September provided the most discouraging evidence to date about the ability of daily low-dose aspirin (typically 81 to 100 milligrams a day) to reduce the risk of cardiovascular disease (CVD). Known as ARRIVE, ASCEND, and ASPREE, the studies tested daily aspirin versus a placebo in three groups, respectively: people at moderate CVD risk, people with diabetes (which increases heart disease risk two- to three-fold), and people ages 65 and older. Collectively, the studies found that daily aspirin either did not reduce the rate of CVD events—such as heart attacks, strokes, and unstable angina—or that it reduced risk slightly but not enough to offset the increased risk of serious gastrointestinal bleeding. (Note that these findings apply to daily aspirin use in people who don’t already have CVD, known as primary prevention. For people already diagnosed with CVD, daily aspirin has clear benefits.) If you’re already taking low-dose aspirin for heart health, don’t stop without talking to your doctor first.
STDs continue to rise, even in babies
Nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the U.S. in 2017, according to data released in late September by the CDC. This surpassed the previous record high, set in 2016, and marked the fourth consecutive year of sharp increases in these sexually transmitted diseases (STDs). Among the hardest-hit groups are men who have sex with men, who accounted for almost 70 percent of syphilis cases, and females ages 15–24, who had more chlamydia diagnoses than any other group. Though the absolute numbers remain small, CDC also announced that congenital syphilis cases in newborn babies more than doubled in the last four years.
Devastating climate change news
A landmark report issued in October by the United Nations’ Intergovernmental Panel on Climate Change warned that the world could see catastrophic consequences from warming temperatures—including widespread food shortages, wildfires, and decimation of coral reefs—as early as 2040, unless major reductions in carbon emissions are achieved. Meanwhile, we reported in May about the rise in vector-borne illnesses in the U.S., which has been largely attributed to climate change, and in December on the effects climate change is already having on our national parks. In November, we reprinted this letter sent to the UC Berkeley School of Public Health community by three faculty members during the deadly Camp Fire in Northern California, which led to dangerously high levels of particulate pollution as far away as the San Francisco Bay Area. The experts provided advice for staying safe when local air becomes unsafe to breathe—a harbinger of what could become a new normal if climate change is not reversed.
U.S. life expectancy is declining, driven by overdoses and suicides
In a brief media statement released in late fall, CDC director Robert Redfield, MD, announced that “the latest CDC data show that the U.S. life expectancy has declined over the past few years.” He characterized this “troubling trend” as “tragically . . . largely driven by deaths from drug overdose and suicide.” Dr. Redfield called the data a wake-up call that the nation is losing “too many Americans, too early and too often, to conditions that are preventable,” and appealed to all Americans to work together to reverse this trend. See our articles on suicide warning signs, the U.S.’s declining life expectancy, and alternatives to highly addictive opioid drugs for treating chronic pain. If you or someone you know is in danger of attempting suicide, call the National Suicide Prevention Lifelineat 1-800-273-TALK (8255).
VITAL evidence on two top-selling supplements
After countless studies (mostly observational) on the potential benefits of omega-3 (fish oil) and vitamin D capsules for a wide array of diseases—the results of which have been largely confusing, conflicting, or inconclusive—the first results from the long-awaited “gold standard” clinical trial of the supplements, called VITAL, were finally published in November. These initial findings, which appeared in two studies in the New England Journal of Medicine, focused on the biggest questions about vitamin D and omega-3s, namely: Can they help prevent cardiovascular disease or cancer in healthy people? The answers overall were no, but not all the news is bad, especially for supplemental omega-3s. Read our take on the VITAL findings and what they may mean for you.
New cholesterol guidelines released
Updated cholesterol treatment guidelines from the American College of Cardiology and the American Heart Association (ACC/AHA), released in November (the last update was in 2013), emphasize aiming for lower levels of LDL (“bad”) cholesterol for many people—sometimes much lower—than earlier guidelines did. They also add steps to personalize cardiovascular risk assessment and the decision process about taking statins or possibly other drugs to lower LDL. Read our breakdown of the new guidelines.