Frontlines – Fall 2016

Survivors of Childhood Cancer May Face Accelerated Aging

Young adult survivors of childhood cancer experience “accelerated aging,” according to new research from the School and Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. The study, published in the Journal of the National Cancer Institute, found that overall health- related quality of life in survivors of child- hood cancer ages 18 to 29 was similar to that reported by adults in the general population who are in their 40s. Whether or not young survivors developed chronic conditions after their treatment was a key factor in their sense of well-being, the study found. Lead author Jennifer Yeh, a research scientist in the Center for Health Decision Science at Harvard Chan, and colleagues called for more research into ways to reduce the toxicity of childhood cancer treatments to improve long-term health and quality of life for survivors.

Green surroundings
Photo: Guille Faingold / Stocksy

Green Surroundings Linked to Lower Mortality Rates in Women

Women in the U.S. who live in homes surrounded by more vegetation appear to have significantly lower mortality rates than those who live in areas with less vegetation, according to a new study from the School and Brigham and Women’s Hospital. During an eight-year study period, the mortality rate of women who lived in the greenest surroundings was 12 percent lower than that of those living in homes in the least green areas. The study, published online in Environmental Health Perspectives, suggests several mechanisms that might be at play in green neighborhoods: lower levels of depression, increased opportunities for social engagement, more physical activity, and lower exposure to air pollution.

Botswana Study Shows Dramatic Viral Suppression for Patients on HIV Drugs

Botswana appears to have achieved very high rates of HIV diagnosis, treatment, and viral suppression—far better than most Western nations, including the United States—according to a new study from Harvard Chan researchers and colleagues in Botswana. The scientists assessed 12,610 people from 30 communities across the country between October 2013 and November 2015. The results were “remarkable,” according to the authors: More than 80 percent of infected individuals already knew their status, and among those individuals, 87 percent were receiving antiretroviral therapy (ART). Of those receiving ART who had their viral load checked, 96 percent had viral suppression—the highest rate ever shown in such a study. The findings, published online in The Lancet HIV, suggest that even in countries with limited resources where a large percentage of the population is infected with HIV, strong treatment programs can make significant headway against the HIV/AIDS epidemic.

Longevity Gap Between Rich and Poor Widening

Photo: David Ryder / REUTERS
Photo: David Ryder / REUTERS

Despite medical, technological, and educational advances in the U.S. over the last 50 years, the longevity gap between rich and poor continues to grow, said Lisa Berkman in an interview on PBS NewsHour Weekend. Berkman is Thomas D. Cabot Professor of Public Policy and of Epidemiology at Harvard Chan and director of the Harvard Center for Population and Development Studies. The discussion revolved around a report from the Brookings Institution, which found that a wealthy American man born in 1920 lived about six years longer than a poor man born the same year; but for a man born in 1950, that difference has more than doubled, to 14 years. For women, the rich-poor gap increased from 4.7 to 13 years. Among the reasons, Berkman said, could be job-related strains and unhealthy neighborhoods.

U.S. Seafood Guidelines: Too Much Mercury for Pregnant Women?

Pregnant women who follow U.S. government seafood recommendations may be exposing their babies to too much toxic mercury, according to a report released by the Environmental Working Group (EWG). The study also found that women may not be getting enough healthy omega-3 fatty acids from the fish they choose. EWG tested hair samples from 254 women who eat two or more seafood meals per week, which is in line with federal recommendations. Analysis of the samples—overseen by Philippe Grandjean, adjunct professor of environmental health—showed that nearly 30 percent of the women exceeded safety guidelines for mercury exposure during pregnancy, and 60 percent were not getting enough of the healthy fats essential for fetal development. Salmon, sardines, and rainbow trout are among the fish considered healthy choices according to EWG recommendations, because they are high in omega-3 and low in mercury.

Making Biking Easier and Safer

Solar-powered bike paths that can melt snow and ice; pollution-eating vacuum towers near bicycle paths; bicycle parking stations with lockers, restrooms, and showers; and bicycle wheels with rechargeable batteries that help propel riders up hills are just a few of the 70 innovations—some already in place in locations around the world, others still on the drawing board—outlined in a compilation of ideas aimed at encouraging people to bike. The report, released in June, was written by Anne Lusk, research scientist in the Department of Nutrition, in partnership with the U.S. Environmental Protection Agency and the League of American Bicyclists, with support from the Helen & William Mazer Foundation. Although some of the ideas would be hard to accomplish in the U.S., Lusk hopes to see in this country “an environment [that] would make it clear to everyone where to drive and bike and be safe.”

Eating More Homemade Meals May Help Reduce Type 2 Diabetes Risk

Photo: Bonnin Studio / Stocksy
Photo: Bonnin Studio / Stocksy

Research that followed nearly 100,000 people for over a decade revealed that those who ate homemade lunches and dinners more often were less likely to develop type 2 diabetes than those who got most of their meals from restaurants and other outside sources, according to a new study in PLOS Medicine by Harvard Chan researchers. During the study period, people who ate more homemade meals also put on less weight—and consumed more fruits, vegetables, and whole grains and fewer sugary drinks—than those who dined out frequently, which could in part explain the association. While researchers did not look at whether home cooks were eating meals made from scratch or from processed ingredients, these findings raise the possibility that preparing more meals at home—ideally with fewer processed ingredients—may reduce the risk of diabetes and obesity over the long term.

Cells “Taste”—Then Fight—Gut Parasites

What spurs the human immune system into action when there’s a parasitic infection in the gut? A new study finds that special cells called tuft cells play a big role—by “tasting” the presence of intestinal parasites, using taste chemosensory signaling pathways, and setting the immune system into motion against them. The finding, outlined in a paper published in Science, is important, said senior author Wendy Garrett, Melvin J. and Geraldine L. Glimcher Associate Professor of Immunology and Infectious Diseases at Harvard Chan. Knowing more about the interplay between tuft cells—which have stiff bristles and protrude from the intestinal wall in clumps—and the immune system could help scientists develop new ways to treat parasitic diseases that afflict millions around the world, particularly children.

Fluoridation Article: Debate and Corrections

Harvard Public Health received a number of letters from major dental organizations and others critical of the article “Is Fluoridated Drinking Water Safe?,” which appeared in the Spring 2016 issue of the magazine. To read those letters as part of the fluoride discussion, go to letters-in-response-to-is-fluoridated-drinking-water-safe.

In addition, because of an editing error, the print version of the article did not adequately characterize the findings of the 2015 Cochrane Collaboration report on fluoridation. The sentences describing those findings have been updated in the website version of the piece to include the following: “They found that while water fluoridation is effective at reducing tooth decay among children, ‘no studies that aimed to determine the effectiveness of water fluoridation for preventing caries [cavities] in adults met the review’s inclusion criteria.’” An accompanying chart in the print version also stated incorrectly that Australia and Chile do not have widespread water fluoridation, when in fact they do. This chart has also been updated in the digital version of the piece at is-fluoridated-water-safe.