There floats an enormous plastic garbage island in the North Pacific that is seven times the size of the Korean Peninsula. The island, called the Great Pacific Garbage Patch, is the result of 13 million tons of plastic that flow into the ocean annually from the 20,000 units of plastic consumed per second around the world. Plastic takes decades to hundreds of years to decompose naturally with plastic bags taking 10 to 20 years, nylon products or disposable straws 30 to 40 years, and plastic water bottles — commonly used once then thrown away -500 years to decompose. This problem of plastic, which has been labeled a human disaster, has been recently proven to be decomposable by beetles common in Korea.

• As men age, their testosterone levels naturally tend to drop
• Symptoms of low testosterone include lower energy levels, lower muscle mass and less vigour
• The benefits of off-label use of testosterone are doubtful and can cause harm  

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Testosterone therapy ads promise to help ageing men recapture their vitality, decrease body fat and enhance libido. But hormone treatments – while medically necessary for some men – aren’t meant to be a fountain of youth, and experts warn more research is needed to determine if such therapy could boost heart disease risks.

Testosterone levels naturally decline in most men as they age. This decline is generally mild, and symptoms often are non-specific, such as low energy, reduced muscle mass and reduced vigour. Roughly 20% of men over the age of 60 have experienced a drop in testosterone levels, though this gradual decline can begin as early as the mid-30s.

While that can be frustrating, experts say it’s not a clinical indication of a need for testosterone therapy, nor is there any evidence that therapy is effective for treating those symptoms. The Food and Drug Administration (FDA) has limited approval of testosterone therapy to the treatment of organic hypogonadism, a dramatic drop in testosterone caused by disease or injury of the hypothalamus, pituitary gland or the testes.

“If testosterone therapy is used appropriately in men with organic hypogonadism, then there is no controversy,” said Dr Shehzad Basaria, associate director of Men’s Health: Aging and Metabolism at Brigham and Women’s Hospital in Boston. The condition causes specific symptoms such as decreased sexual desire, breast enlargement, testicular atrophy and hot flashes.

Potentially harmful use

But “in middle-aged and ageing men who have a slightly lower testosterone level and non-specific symptoms due to ageing or obesity, testosterone therapy is not indicated. Similarly, testosterone is not a rejuvenation drug,” said Basaria, an associate professor of medicine at Harvard Medical School. “The majority of patients seen in our clinics have symptoms such as fatigue, weight gain, muscle loss or feeling sad. These symptoms are common and non-specific, and testosterone therapy is generally not indicated in such clinical scenarios.”

Over the past two decades, intense direct-to-consumer marketing of hormone therapy for ageing men, much of it via television ads, has more than doubled its off-label use. It’s a trend experts warn is medically unwarranted and potentially harmful.

The American College of Physicians, which issued new guidelines in January, recommends against prescribing testosterone therapy to boost energy, vitality or physical function, but supports its use for men experiencing sexual dysfunction. The recommendation calls for discussing potential benefits and risks with the patient and discontinuing treatment after one year if there is no improvement.

“I think one of the biggest concerns about testosterone therapy is whether it is really needed,” said Dr Robert Eckel, professor of medicine and an endocrinologist at the University of Colorado School of Medicine in Aurora, Colorado. “Erectile dysfunction is a common problem as men age, but there can be other reasons for this, such as vascular disease or nerve damage, which is more common in patients with diabetes. It is not necessarily an indication for treatment with testosterone therapy. The patient must be properly evaluated.”

Higher cardiovascular risk

The FDA warns against prescribing testosterone therapy for age-related hormonal decreases or anything other than a medical diagnosis of hypogonadism. Since 2015, it has required testosterone product labels to warn of a possible increased risk of heart attacks and stroke.

But research about that association so far is unclear, Basaria said.

“Some studies have reported higher cardiovascular risk with testosterone use but there are an equal number of studies showing that it does not increase cardiovascular risk,” he said. “This discrepancy exists because no study published to date has been powered to assess cardiovascular events as the primary outcome.”

Eckel, president of medicine and science for the American Diabetes Association and a past president of the American Heart Association, agreed. “The cardiovascular disease outcome story is not convincing one way or another. I think to make a strong statement here would be a mistake.”

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• Life expectancy in the US has remained on the same level for 30 years
• American researchers identified 10 social and behavioural factors most closely linked with dying
• Their approach to the problem focused on looking at potential long-term impacts of these factors

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Smoking, drinking too much and divorce are among the social and behavioural factors most strongly linked to dying early, a new study says.

Researchers analysed data from more than 13 600 US adults between 1992 and 2008, and examined 57 social and behavioural factors among those who died between 2008 and 2014.

The 10 factors most closely linked with dying were: being a current smoker; history of divorce; history of alcohol abuse; recent financial difficulties; history of unemployment; past smoking; lower life satisfaction; never being married; history of food stamps, and negative affectivity.

“It shows that a life span approach is needed to really understand health and mortality,” said lead author Eli Puterman, an assistant professor of kinesiology at the University of British Columbia (UBC) in Vancouver. He co-authored the study with researchers from Johns Hopkins University, the University of Pennsylvania, the University of California, San Francisco, and Stanford University.

Negative affectivity

Puterman noted, for example, that he and his colleagues looked at a 16-year history of unemployment, not just whether people were currently out of work.

“It’s more than just a one-time snapshot in people’s lives, where something might be missed because it did not occur,” Puterman explained in a UBC news release. “Our approach provides a look at potential long-term impacts through a life span lens.”

Life expectancy in the United States has stagnated for three decades compared with other industrialised countries, but the reasons aren’t clear.

Biological factors and medical conditions are known to be major contributors to death risk, so the authors focused instead on social, psychological, economic, and behavioural factors.

“If we’re going to put money and effort into interventions or policy changes, these areas could potentially provide the greatest return on that investment,” Puterman said.

Identifying a factor such as negative affectivity – the idea that you tend to see and feel more negative things in life – suggests that new and targeted interventions may be needed, he said.

The findings were published in June in the Proceedings of the National Academy of Sciences.

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Cases doubled in the last week, prompting fears of tighter restrictions in the Lancashire borough.

Synairgen says preliminary results suggest its nebuliser treatment can lower the risk of disease.

The human body is teeming with bacteria, and a new study finds the same is true of many cancers – raising questions about what role microbes might play in the diseases.

Researchers have already known that tumours in certain areas of the body – like the gut – harbour bacteria of their own. But the new research reveals that a range of cancers, including those of the breast, lungs, bones and brain, have their own bacterial communities within tumour cells.

And the makeup of those communities seems to be unique to each cancer type, the researchers report in the 29 May issue of Science.

Exactly what it all means is unclear at this point. But the study also found that the same bacteria within tumour cells were present in patients’ immune system cells. Among other things, that brings up the possibility that tumour bacteria could have an effect on patients’ responses to certain cancer therapies.

Role of gut bacteria

“The fact that bacteria are frequently present in human tumours raises many intriguing questions regarding their local effects on tumour cells, as well as on tumour immunity and response to immunotherapy,” said senior researcher Dr Ravid Straussman, of the Weizmann Institute of Science in Rehovot, Israel.

Past research has already turned up hints that bacteria may influence cancer patients’ response to treatment. A 2017 study of patients with advanced melanoma suggested that people’s own gut bacteria might play a role: Patients who responded well to immunotherapy drugs generally had a gut “microbiome” that was distinct from that of patients who did not respond.

The new findings point to a similar connection between tumour bacteria and treatment response: Among melanoma patients, there was an association between the amount of certain bacteria in their tumours and the likelihood of responding to immunotherapy.

It is too soon, though, to draw any conclusions, according to Peter Turnbaugh, an associate professor of microbiology and immunology at the University of California, San Francisco. He co-authored an editorial published with the findings.

“The current study reports an association with immunotherapy response,” Turnbaugh said. “But the causal role of bacteria within tumours, or in other body sites, remains unclear – as do the potential mechanisms that might be at play.”

The results are based on more than 1 500 tumour samples, plus samples of nearby tissue, from patients at medical centres in four countries. Straussman and his colleagues analysed the samples for bacterial proteins and genetic material, taking measures to ensure they would not simply detect microbes that got there by contamination.

Bacteria may ‘translocate’

It turned out that all seven cancer types they studied harboured bacterial communities within their cells. And the composition of those communities varied by cancer type. Breast cancers, for example, had the most diverse collection of bacteria.

One of the key questions, Turnbaugh said, is where are those tumour bacteria coming from?

One possibility, he speculated, is that bacteria are able to “translocate” out of a person’s gut or other tissue and find their way into tumour cells. Other recent research has suggested bacteria can travel from the gut to tumours, Turnbaugh said.

Why would different cancer types have distinctive bacterial communities? The “microenvironment” within different body tissues and cancer types is known to vary, Turnbaugh explained. So it’s possible those conditions favour the growth of certain bacteria over others.

However, that’s not to say that all patients with a particular cancer have exactly the same bacterial makeup in their tumours. The study also found differences among individuals with the same cancer. In melanoma patients, certain differences in tumour bacterial makeup were associated with treatment response.

Straussman said it all raises many “intriguing” questions about how bacteria might interact with a patient’s cancer and own immune cells. Some bacteria, he noted, might have “anti-tumour” effects, while others could be “pro-tumour”.

Changing the gut’s bacterial environment

If tumour bacteria do influence treatment outcomes – an area Straussman said his team is actively studying – that would lead to an obvious next step: figuring out what, if anything, can be done about it.

Straussman said ongoing research might lead to new ways of “manipulating” tumour bacteria, to improve cancer treatment.

Right now, it’s not clear how bacteria within tumour cells could be targeted. But, Turnbaugh said, if it turns out that gut bacteria do migrate to tumours, it might be possible to alter tumour bacteria by changing the gut’s bacterial environment.

In one instance of how such research is bearing fruit, a study presented this week at the annual meeting of the American Society of Clinical Oncologists found that bacteria in or around colon tumours may be tied to patient survival.

Researchers at Ohio State University Comprehensive Cancer Center found that “the presence of bacteria was mostly, but not always, associated with worse overall survival”. They believe that testing for bacterial types might help guide treatment, as might the use of antibiotics against certain species.

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• ‘Empty calories’ make up more than a quarter of American kids’ total calories

• Kids are urged to consume less sugar by avoiding sugar-laden drinks

• Getting kids to eat their vegetables would help a lot

US children and teenagers are still downing too many “empty calories” – primarily from sugary beverages, sweets and pizza, a new government study finds.

The study, based on a long-running federal health survey, did turn up some good news: In recent years, kids have been eating fewer empty calories, versus a decade before.

The bad news is, by 2016, those sources still accounted for more than one-quarter of kids’ total calories.

The term “empty” generally refers to food and drinks that provide a lot of calories but little to no nutrition. In this study, empty calories were defined as those coming from added sugars or “solid” fats (like butter and shortening).

Limiting sweetened drinks

Sugary drinks, the study found, have consistently been a top source of US kids’ empty-calorie intake. That’s not surprising, since added sugar lurks not only in sodas, but also sweetened juices, sports drinks, teas and milk, said lead researcher Edwina Wambogo, of the US National Cancer Institute.

And that, said Wambogo, points to a straightforward way to cut down on empty calories: Watch the liquid sugar.

When it comes to preschoolers, in particular, she said, simply limiting sweetened juices and milks would go a long way.

As kids get a little older, the study found, soda becomes a prime sugar source, while foods like cookies, brownies and pizza provide a large share of total sugar, as well as solid fats.

That’s not to say there’s no value in any of those foods, Wambogo pointed out. Even sweetened milk contains nutrients like protein and calcium. And pizza provides protein, dairy and vegetables.

So context matters, Wambogo said. If parents make a pizza topped with vegetables – and get their kids to actually eat vegetables – that’s different from feeding the family a diet full of take-out.

Pizza not the problem

Wambogo was scheduled to present the findings at the annual meeting of the American Society for Nutrition, being held online. Data and conclusions presented at meetings are usually considered preliminary because they haven’t yet been peer-reviewed for journal publication.

Connie Diekman, a registered dietitian who was not involved in the study, agreed that kids’ overall diet is what’s critical. And there can be room for pizza and chocolate milk.

“Pizza is not the problem,” said Diekman, a former president of the Academy of Nutrition and Dietetics. “The issue is – what is on it, and what does the rest of your family’s eating plan look like?”

She suggested that parents focus on offering kids plenty of vegetables and fruits, whole grains, lean meats and low-fat dairy. “Find foods within those groups that your kids enjoy and then build meals around those options,” Diekman said.

“If your kids love pizza,” she added, “then try either making it at home with all the veggies they love, a leaner meat and a bit less cheese – or ordering a cheese pizza and adding steamed veggies.”

Nutritious whole foods

Of course, Wambogo noted, kids eat outside of the home, too. “There’s a lot that policymakers can do, too,” she said.

In fact, Wambogo added, the recent decline in empty calories may be partly related to school policies that removed sugary drinks from cafeterias and vending machines.

Diekman agreed, saying the general advice to parents applies to schools as well: Offer kids nutritious whole foods and limit the added sugar.

No one is saying, however, that parents should deny their kids all sweet treats. “You can reduce the amount of sugar without eliminating it,” Wambogo said.

Everyone, she noted, likes a brownie now and then.

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