Monthly Archives: March 2013

Cancer clusters

Cancer clusters

March 14, 2013
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Amy Corderoy

Amy Corderoy

Health Editor, Sydney Morning Herald

Spikes in illness rates are clear. But finding a cause is never easy.

Cancer cell PULSE 7 March 2013. Digital medical illustration.<br /><br />
Cancer cell. iStock Photo    File #18235009Cancer clusters can strike fear in modern homes or workplaces, but is the panic misplaced?

They were being knocked down, one at a time. Like bowling pins, was how one described it.

When woman after woman working at the ABC’s Toowong studios in Brisbane started developing breast cancer, they knew something had to be wrong.

”It was just getting too many,” producer’s assistant Deb Ormerod told Australian Story. ”It was like six or seven cases by then, then all of a sudden, there was, like, four girls in a 12-month period, and that’s when the warning bells just went right through the roof.”

Investigators eventually found women working at the studios were six times more likely to develop breast cancer. It also seemed that the longer they worked there, the more likely they were to get sick.


The studios were abandoned in December, 2006. Many other women working at the ABC feared they, too, could fall victim to the mysterious carcinogen wrecking the lives of so many. But a strange thing happened. No amount of scanning, prodding or swabbing could find a cause; relentless testing of the studio revealed no substance to blame.

”We have to conclude that looking back on it, like most cases of cancer clusters, it was by chance,” says Professor Bruce Armstrong, who led the investigation.

Cancer clusters can strike fear in modern homes and workplaces. But is this simply misplaced panic in the face of what is eventually found to be coincidence?

Often something that seems like a cancer cluster may not even involve an increased rate of disease, says Bernard Stewart, a professor at the University of NSW and the head of the cancer control program at the South Eastern Sydney Local Health District.

”It is not possible to recognise causation of cancer in the way it was portrayed in the film Erin Brockovich, where just seeing it is the sole evidence,” he says.

”The travesty in Erin Brockovich is not that ingested chromium VI causes breast and other tumour types; the travesty is the suggestion that the impact of any environmental carcinogen could be so marked as to be self evident,” he wrote in a stinging editorial in the Internal Medicine Journal.

”Should long-held views prejudice the investigation of newly reported cancer clusters? The answer is ‘yes’,” he says.

Stewart was responding to a study that examined cancer cluster investigations for 567 sites or categories of cancer over the past 20 years. It found that in 87 per cent of cases, authorities could not even find a true increase in cancer rates, let alone a cause.

”Considered against the thousands of cancer clusters reported to authorities each year in the United States, the new data indicate that the probability of establishing causation in relation to a community-reported cancer cluster is negligible, mesothelioma clusters exempted,” Stewart says.

The problem, then, is what to do. Despite the cost and difficulty of investigating clusters, Stewart says they cannot be ignored.

”Investigations are often put in place not because the medical science says they are worthy of further scrutiny but because the people have exercised their democratic right to go to their local MP and say ‘we want this investigation’,” he says. ”What we need to do is lift the level of understanding in the whole community.”

Being told the statistics don’t support your fear can only inflame the situation.

In Toowong, many of the women were disturbed by what they saw as a lack of support and rigorous investigation.

They rejected early attempts by epidemiologists who did not actually go into the site and look for causes.

Armstrong says the women also initially rejected tests done by his investigation because some were not totally complete. Armstrong is often called on to investigate cancer clusters. He says Toowong was one of the most difficult, extensive investigations he has undertaken. It was also one of the most likely to produce a positive finding because of the real increased rate of cancers that was found.

”It was certainly one of the most thorough investigations we did,” he says. ”But the reality with cancer clusters is that the balance of them occur by chance”.

Armstrong says other medical conditions, such as heart attacks, will cluster just as frequently as cancer – it’s just that people take those conditions for granted.

Phyllis Butow, professor of psychology at the University of Sydney, is an expert in the psychological impact of disease. She says cancer brings with it a special fear. ”Data suggests people catastrophise about risks they see as life-threatening; they search for the threat, in fact, and are more likely to see it,” she says.

”There is a lot of evidence that people find cancer more scary than other diseases [with] just as high mortality rates.”.

Chance findings

There is a 95 per cent chance that one of the hundreds of suburbs in NSW will have a statistically significantly increased rate of a cancer at any given time, NSW Health says. Recent investigations, such as those into the Kooragang coal plant last year, have found the events were likely due to chance. An investigation into an apparent cluster in Helensburgh last year found no local factor that could be responsible. In 2010, an investigation into five Singleton residents who developed brain tumours also found no potential cause.

In Victoria, revelations the Country Fire Authority knew of water contamination at its training college for at least 12 years prompted the reopening of an investigation into the Fiskville cancer clusters.

In 2008, an investigation ruled out a cancer cluster at the National Gallery of Australia in Canberra.

What the US study found

+567 suspected cancer cluster sites were studied over the past 20 years.

+In 87 per cent of cases, a true increase in cancer rates could not be established, let alone a cause.

+In only 0.5 per cent of the cancer types was there some evidence of a link between the cancers of concern and the suspected carcinogen.

Source: Critical Reviews in Toxicology: Cancer clusters in the USA. What do the last 20 years of state and federal investigations tell us?

Does aluminium cause Alzheimer’s and breast cancer?

I often get asked this question, so it is interesting to see the evidence about this issue.
25 March 2013, 6.04am AEST

Does aluminium cause Alzheimer’s and breast cancer?

Silvery, ductile, malleable and so very, very useful, aluminium is the most common metal in the Earth’s crust. But despite its importance (or perhaps because of it), there are fears that this metal causes everything from cancer to Alzheimer’s disease. From aircraft to tableware, aluminium forms an important…

The vast majority of us will never be exposed to calcium in high enough concentrations to do damage. ezioman/Flickr

Silvery, ductile, malleable and so very, very useful, aluminium is the most common metal in the Earth’s crust. But despite its importance (or perhaps because of it), there are fears that this metal causes everything from cancer to Alzheimer’s disease.

From aircraft to tableware, aluminium forms an important and ubiquitous part of our lives. It’s so common now, in fact, that it’s difficult to believe that, at one stage, metallic aluminium was so hard to make that having aluminium plates was a symbol of wealth.

But as it has become more commonplace, aluminium’s safety profile has come into question, with particular emphasis on aluminium in antiperspirants. The evidence for its supposed harms is weak, if not non-existent.

Yes, aluminium can be toxic, but in the spirit of my blog’s patron, remember it’s the dose that makes the poison.

The metal’s toxic effects can be seen in people working at aluminium smelters or those who have had similar industrial exposures with inadequate workplace safety measures. People on dialysis who have been exposed to higher than normal aluminium levels in their dialysis fluid also show a range of adverse effects, including damage to the brain and the nervous system.

And you can show neurotoxic effects in animals at lower (but still substantial) concentrations, if you inject aluminium directly into the brain. But the vast majority of us will never be exposed to such high concentrations of aluminium as in these cases. Our exposures will come from drinking water, food, antacid tablets and rubbing antiperspirant with aluminium on our skin.

The aluminium we’re exposed to in these ways is in the form of aluminium salts. These salts are surprisingly hard to get into the body; only 0.1% of ingested aluminium is absorbed into the body.

Skin absorption is also quite weak and skin absorption of aluminium from antiperspirants contributes to less than 3% of blood levels of aluminium (the rest comes from gut absorption). So you need to go to some effort to get toxic levels of aluminium from these sources.

Indeed, according to the results of long-term animal studies you need to consume around 10,000 times the amount of aluminium in our water supplies to see the beginnings of neurotoxicity. Even if you were chewing antacids every day while rubbing antiperspirants all over yourself, you would still not have enough aluminium in your system to suffer from neurotoxicity.

So, while animal studies are all very well, is there any evidence from humans that our modest consumption of aluminium over long periods of time is toxic?

Alzheimer’s disease

Beta amyloid Ian Musgrave via Jmol

A common misconception about aluminium is that it causes Alzheimer’s disease. And since a large chunk of my research is on finding treatments for Alzheimer’s disease, I have a bit of insight into such claims.

Some very early studies suggested that there was more aluminium in the brains of people with Alzheimer’s disease than those without. Almost immediately, people selling stainless steel cookware seized on this result to promote their pots over aluminium ones (we were buying new cookware at this time, and I had some interesting discussions with these people).

Aluminium is rather hard to measure at the low levels that are in the brain, and later studies with better methods failed to find elevated aluminium levels in the brains of people with Alzheimer’s. Actually, there’s good evidence the positive results were due to contamination.

Personally, I wouldn’t have been surprised to find increased aluminium in the brains of Alzheimer’s sufferers. There’s an accumulation of a toxic protein called beta amyloid in the brains of people with Alzheimer’s disease. This protein binds metals including aluminium, but it binds copper, zinc and iron more strongly. In part, this binding of copper and zinc contributes to the protein’s toxicity. Despite significant amounts of copper in the accumulated amyloid in the brains of people with Alzheimer’s however, there’s no evidence that high levels of copper exposure increase the disease’s incidence.

What’s more, people on dialysis who are exposed to much higher concentrations of aluminium than most people for long periods of time don’t have a higher incidence of Alzheimer’s disease than people not on dialysis.

So, aluminium and Alzheimer’s disease, no.

Breast cancer

In breast cancer, the upper outer quadrant of the breast is more likely to be the site where tumours first appear than anywhere else. Since this quadrant is closest to the lymphatic drainage from the armpit, people have leapt to the conclusion that aluminium from application of antiperspirants is the culprit.

But the incidence of tumours is directly related to the amount of breast tissue, and that quadrant happens to have the most breast tissue.

Epidemiological data is rather sparse, but what little there is makes the aluminium-breast cancer link unlikely. A 2002 study found no correlation between aluminium containing antiperspirant use and breast cancer. A more recent meta-analysis found few high-quality studies, but those they found showed no evidence of an antiperspirant link to breast cancer.

So, aluminium and breast cancer, highly unlikely.

Alzheimer’s disease and breast cancer are devastating to both those who develop the diseases and their families. Everyone involved wants to know why these diseases strike. These are complex diseases, with complex and still poorly understood causes, but we can be pretty certain that the aluminium in antiperspirants is not one of those causes


I have patients who have benefitted from chiropractic treatment, and agree they have a place in treating some joint and back problems. Where I disagree is when chiropractors make outrageous claims, not based on the evidence, for treating babies, some pregnant women and for medical conditions like immunisation.
12 March 2013, 4.35pm AEST

Concerns about chiros are about quality and safety, not some phoney turf war

This weekend saw another exchange of views between chiropractors, the AMA and the Friends of Science in Medicine. It was set off by a number of stories by Amy Corderoy, the Health Editor at the Sydney Morning Herald, here and here and here.

In a nutshell, the issue was that government funding of chiropractic care for children under 14 was reported to have risen by 185% in four years. This prompted the AMA and others to question the advisability of this spending given the poor scientific evidence base for such care, as well as the potential for harm to children given that no clear benefit has been established. A particularly worrying point was the apparent tacit support of the Chiropractic Board of Australia for professional development courses run by opponents of mass immunisation.

The response from the Chiropractors’ Association of Australia (CAA) can be found here. Predictably enough, the CAA has chosen to cast chiropractors as the hapless victims of a league of overpaid bullies representing unnamed but powerful medical interests.

What concerns me? The back story…

What particularly concerns me is the near-complete avoidance of any plausible effort to address the concerns raised by the AMA and FSM. The CAA release simply dismisses them as “purported concerns” and claims there is no evidence presented to back them up. According to one of the SMH articles,

National director of the Chiropractors Association of Australia Tony Croke said in the past 40 years no serious adverse health consequences of chiropractic had been recorded in a child.

Well, I have some news for CAA. It took me about a minute to find it on PubMed.

Here is one case. And here is another. Here is a whole systematic review of serious adverse events in children receiving chiropractic care, including some fatalities.

How about some more evidence to support the concerns raised in the SMH that chiropractic continuing professional development (professional education or CPD) actively supports presenters with an anti-vaccination agenda?

Here is a flyer for Tim O’Shea, a well-known antivax chiropractor. As you can see, it was advertised as “CAA Accredited”. Nimrod Weiner, the CAA’s current NSW Branch Secretary has regularly presented a “vaccination information” seminar that is packed with misleading inaccuracies. Chiropractors remain by far the largest professional group supporting the Australian Vaccination Network.

A paper presented at a major international chiropractic conference gives more cause for concern about the teaching of attitudes to immunisation in chiropractic training. (the abstract concerned is on page 63). This Canadian study demonstrated that positive attitudes to vaccination declined from 60% among first-year students (which is worrying enough you might think) to under 40% by fourth year and graduation. What is it about going to train as a chiropractor that could convince a third of those with pro-vaccination attitudes to drop their support?

Denial of public health responsibilities is unacceptable

If the CAA figure of 215,000 weekly visits to chiropractors is to be believed, the antivax activities of chiropractors may be creating a huge reservoir of underimmunised Australians. Preventable diseases spread quickly where such reservoir populations exist. For an AHPRA Board to tolerate the creation of such a massive threat to public health is frankly alarming. It’s not that hard to join these dots, yet the Chiropractic Board of Australia (CBA) seems unable to understand or accept that as a regulated profession, chiropractic shares the responsibility for maintaining public health.

Resorting to the PR technique of pretending to know nothing about immunisation isn’t good enough. The CBA has released a position statement advising that,

Patients have the right to make their own health decisions, but they need to be appropriately informed about the benefits and the risks to both the individual and the broader community associated with their health decisions.

Practitioners may often be asked to provide information not directly relevant to their competency or the scope of their practice; in such cases patients should be referred to someone with sufficient expertise in that field to have their questions or concerns addressed.

Advice about vaccination is not typically within the usual area of practice for a chiropractor. Current evidence indicates that preventative measures such as vaccination are a cost and clinically effective public health procedure for certain viral and microbial diseases.

The Board would clearly seem to have a direct and insoluble conflict of opinion with the likes of Tim O’Shea and the (soon to be renamed) Australian Vaccination Network, who both provide CPD resources to chiropractors.

Restoring credibility

In the interest of being seen as constructive, I’ll give some free advice to the CBA and CAA. Following these suggestions would go some way towards restoring some badly needed credibility for both organisations.

  1. CAA should stop pretending that children have never been harmed by chiropractors, and should publicly retract their assurances to the contrary. After all, I’ve already pointed them towards some published evidence with a brief online search. I’m sure there’s probably more to find.
  2. CBA should decline to acknowledge the CPD hours of those who have attended events which have a clear antivax agenda. It’s the least they could do now it is clear that CPD credit shouldn’t have been given to events which conflict with the Board’s clear directives.
  3. Both CAA and CBA should acknowledge that chiropractors have a public health duty to participate in immunisation and recommend it to the general public. They should do this to prevent the creation of a large community who all are in contact with each other and have inadequate herd immunity.
  4. CAA and CBA should encourage chiropractors to be educated about immunisation if they are of the opinion that it is not a particular area of expertise. Instead of giving their imprimatur to vaccine deniers, they could award CPD hours for undertaking online courses such as this one from the University of Pennsylvania.
  5. Both organisations should acknowledge that the scientific rationale for treating children with chiropractic methods is substandard. The usual course for a responsible profession is that such treatments should be considered experimental, and not offered widely until compelling evidence of their safety and effectiveness exists. Neither should endorse treatment for children with the current state of the literature, since harm can exist, and benefits are not established.

This isn’t a turf war

It is quite clear that this is not a turf war. It never was. With just over 4300 registered chiropractors compared to over 91,000 registered doctors I don’t think we’ll be seeing doctors lining up at Centrelink due to chiropractors taking over any time soon.

Despite the protestations of CAA, this is very much a quality and safety issue. In large part it has been brought about by the ongoing denial of chiropractors that they have such responsibilities.

People like myself, the AMA, FSM and many others expect a lot of an AHPRA-regulated profession. We are not picking on chiros as much as we are holding them to the same standards we would expect of any health profession. I’m sure many rank-and-file chiropractors would welcome decisive leadership from the largest of their professional bodies to put these issues to rest.

Exercise! One more reason to do it.

This sounds like a record stuck in a groove – activity is good for you. We underestimate how any form of movement does us good – even getting up from our chair to get a drink (of water of course :))
I had my flu shot yesterday and recommend all of you do the same. If you are over 65 or have a chronic illness, then it is free.
15 March 2013, 4.12pm AEST

Even a little exercise preserves sanity

Life-long exercise, even in low frequency and intensity, helps to preserve cognitive function in later life, a study has found.

The study used data from a prospective cohort study, a study that follows a group of people over time.

Those who reported at least a little exercise over their life had better cognitive functioning at age 50 than those who reported none.

Original Articles

Leisure-time physical activity over the life course and cognitive functioning in late mid-adult years: a cohort-based investigation

A. Dregana1 c1 and M. C. Gulliforda1

a1 King’s College London, NIHR Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, Department of Primary Care and Public Health Sciences, London, UK

Background The objective of the present study was to estimate the association between different leisure-time physical activity (LTPA) parameters from 11 to 50 years and cognitive functioning in late mid-adulthood.

Method The study used a prospective birth cohort study including participants in the UK National Child Development Study (NCDS) from age 11 to 50 years. Standardized z scores for cognitive, memory and executive functioning at age 50 represented the primary outcome measures. Exposures included self-reported LTPA at ages 11, 16, 33, 42, 46 and 50 years. Analyses were adjusted for important confounders including educational attainment and long-standing illness.

Results The adjusted difference in cognition score between women who reported LTPA for at least 4 days/week in five surveys or more and those who never reported LTPA for at least 4 days/week was 0.28 [95% confidence interval (CI) 0.20–0.35], 0.10 (95% CI 0.01–0.19) for memory score and 0.30 (95% CI 0.23–0.38) for executive functioning score. For men, the equivalent differences were: cognition 0.12 (95% CI 0.05–0.18), memory 0.06 (95% CI − 0.02 to 0.14) and executive functioning 0.16 (95% CI 0.10–0.23).

Conclusions This study provides novel evidence about the lifelong association between LTPA and memory and executive functioning in mid-adult years. Participation in low-frequency and low-intensity LTPA was positively associated with cognitive functioning in late mid-adult years for men and women. The greatest benefit emerged from participating in lifelong intensive LTP

The Secrets of Breast Milk.

Another amazing article on how wonderful the body is, and the intricacies of humans. As my web site as about hormones, we now learn of the effect of a mother’s hormones on her baby, and vice versa. Incredible.

The Secrets of Breast Milk



Posted Wednesday, March 20, 2013, at 4:46 AM

Mother breastfeeding her child.

The more we learn about breast milk, the more we learn how much more we have to learn.
Photo by Endopack/iStockphoto

When we come out of the womb, we make our way to the breast. We enter the world knowing we’re mammals, with milk on our minds.

But even as grown-ups, we have never known exactly what’s in that milk—or, as strange as it may sound, what the point of it is. For decades, milk was thought of strictly in terms of nutrients, which makes sense—milk is how a mother feeds her baby, after all. But providing nutrients turns out to be only part of what milk does. And it might not even be the most important part.

“Mother’s milk is food; mother’s milk is medicine; and mother’s milk is signal,” says Katie Hinde, an assistant professor of human evolutionary biology at Harvard. (She also writes the fascinating blog Mammals Suck, which I suspect is the only place on the Internet where you can fill out a Mammal Madness bracket.) “When people find out I study milk, they automatically think we already know about it, or it’s not important. And I’m like, ‘No, we don’t know about it, and it’s super important.’”

But first, a disclaimer—because conversations about lactation always seem to require disclaimers, especially if you happen to be someone who will never ever lactate. (I’m pretty sure.) In my new book Baby Meets World, I write about how, contrary to myth, not nursing has never been a death sentence. Hundreds of years before halfway-decent formula, infants were fed gruesome substitutes for breast milk (mushed bread and beer, say)—and although many more died than those who were nursed, many also survived. So the lesson of the new science of milk isn’t that formula is some sort of modern evil. (It isn’t modern or evil.) It’s that milk is really complicated—and evolutionarily amazing.

Here’s how complicated: Some human milk oligosaccharides—simple sugar carbohydrates—were recently discovered to be indigestible by infants. When my son was nursing, those oligosaccharides weren’t meant for him. They were meant for bacteria in his gut, which thought they were delicious. My wife was, in a sense, nursing another species altogether, a species that had been evolutionarily selected to protect her child. (A relationship immortalized in the paper titled “Human Milk Oligosaccharides: Every Baby Needs a Sugar Mama.”) In effect, as Hinde and UC-Davis chemist Bruce German have written, “mothers are not just eating for two, they are actually eating for 2 × 1011 (their own intestinal microbiome as well as their infant’s)!” That’s what’s meant by milk serving as medicine, and that’s only scratching the surface.

But Hinde primarily studies the food and the signal elements of milk. “The signal is in the form of hormones that are exerting physiological effects in the infant,” she explains. “Infants have their own internal hormones, but they’re also getting hormones from their mother. They’re binding to receptors in the babies, and we’re just starting to understand what those effects are.”

Hinde works with rhesus macaques, and she’s tracked the effects of the hormone cortisol in their milk. Cortisol is often thought of as the stress hormone, but its function is far more varied, and Hinde has found that the amount and especially the variation of cortisol successfully predicts how the infant macaques go on to behave. It’s a stunning finding: The composition of early milk seems to mold infant temperament. But—and here’s the twist—the males were much more sensitive than the females. Roughly, the more cortisol, the more bold and exploratory the male rhesus macaques were.

Such sex-specific variations in milk, possibly “programmed” by the placenta during gestation, may be common. In humans, there’s early data suggesting that mothers produce fattier milk for boys than girls. But that may be only part of the story, as Hinde has found with rhesus macaques. “Just because sons are getting better milk doesn’t mean they’re getting more. It looks like they’re getting very similar total calories.” So why do sons get fattier milk? “In rhesus macaques, daughters stay in their social groups their whole lives,” Hinde notes. “They form a bond with their mother that only ends when one of them dies. So it might be that mothers are nursing their daughters more frequently and that helps establish this bond.” In contrast, the sons end up leaving the group—and fattier milk means they nurse less often, which means they can spend more time playing with strangers, developing skills they’ll need later in life. The milk, in other words, reflects and cements the social structure of rhesus macaques.

We think of milk as a static commodity, maybe because the milk we buy in the grocery store always looks the same. But scientists now believe that milk varies tremendously. It varies from mother to mother, and it varies within the milk of the same mother. That’s partly because the infants themselves can affect what’s in the milk. “Milk is this phenomenally difficult thing to study because mothers are not passive producers and babies are not passive consumers,” Hinde says. Instead, the composition of milk is a constant negotiation, subject to tiny variables.

For example, she notes, in humans skin-to-skin contact appears to trigger signals that are sent through the milk. “If the infant is showing signs of infection, somehow that’s being signaled back to the mother and she up-regulates the immune factors that are in her milk. Now is that her body’s responding to a need of the baby? Maybe. Is it that she also has a low-grade infection that she’s just not symptomatic for and so her body’s doing that? Maybe. Is it partially both? Maybe. We don’t know. It’s brand-new stuff.”

The new awareness of this sort of signaling is why there’s been a paradigm shift in the study of milk. Scientists have gone from seeing it only as food to seeing it far more expansively—as a highly sensitive variable that plays a wide range of developmental roles.

This new perspective should change how we look at formula, too, Hinde says. Instead of comparing breast milk and formula, we should accept how little we actually know about breast milk. “We need to go back to square one and look at all the variation in breast milk and where it’s coming from and what it does,” she says. “Because how could we possibly know what the difference between breast milk and formula is if we aren’t even keeping track of what the variation in breast milk is doing? And so the more that we understand about what is in milk, and what predicts how it varies, the more opportunity there is for formula to better emulate what breast milk is.”

Almost 150 years after the first infant formula, the splendidly named Liebig’s Soluble Food for Babies, was proclaimed to be “virtually identical” to human milk, we now know how much we don’t know about milk. It’s a deeply intimate mystery. And the scientists who study it are a lot like almost any parent gazing down at their sucking child: They too are full of wonder.

Children and alcohol

1 March 2013, 11.30am AEST

Forbidden fruit: are children tricked into wanting alcohol?

Over the years, we have become accustomed to alcohol companies and their allies seeking to convince us of their concern about alcohol problems and responsible use of alcohol. Their efforts range from desperately inept advertisements to labels on some products that provide (in small print) advice that…

Portraying alcohol as ‘forbidden fruit’ makes it more attractive to young people. Chris Goldberg

Over the years, we have become accustomed to alcohol companies and their allies seeking to convince us of their concern about alcohol problems and responsible use of alcohol. Their efforts range from desperately inept advertisements to labels on some products that provide (in small print) advice that is less than compelling (e.g. “Is your drinking harming yourself or others? Get the facts –”), or admonitions such as “drink responsibly” in barely visible fonts.

A large hoarding for Miller beer (see below) recently placed approximately 800 metres from a large school in Perth alongside a subway through which many children pass every day, eschewed the small print in favour of a very visible message that the product is “18+” and “for people over the age of 18 only”.

Miller billboard advertisement at the corner of Nicholson Road and Railway Parade in Shenton Park, Western Australia. McCusker Centre, Curtin University

Miller beer has had an association of more than 30 years with the Philip Morris/Altria tobacco group, which currently owns approximately 27% of SAB Miller. The SAB Miller board includes four current or former Philip Morris/Altria leaders, including long-time chairman and CEO, Geoffrey Bible.

The tobacco industry has known for decades about the value of promoting smoking as an adult habit – as forbidden fruit for young people.

Tobacco industry documents show that presenting smoking as an “adult choice”, a “forbidden fruit” and an “act of rebellion” have been “common industry marketing themes”.

An Imperial Tobacco marketing research report from 1977 noted:

Of course, one of the very things that are attractive is [the] mere fact that cigarettes are forbidden fruit…when the adolescent is looking for something that at the same time makes them feel different and also makes them feel that they are old enough to ignore this weight of authority so as to feel that they have made their own choice, what better could be found than a cigarette? It is not just a smoke. It is a statement, a naughty adventure, a milestone episode.

The Philip Morris company even ran literal “forbidden fruit” messages in full page advertisements in news magazines aimed at parents. And there is also research showing that the perception of smoking as “forbidden fruit” significantly predicted smoking intentions. Indeed, the authors of a major study in this area recommend that education programs “should incorporate strategies/messages counteracting the FF perspectives…”.

We know that over the years tobacco companies used “smoking prevention” programs to head off further constraints, as well as to legitimise research on and access to young people. There is also good evidence that tobacco company educational programs brought no benefits, but were indeed likely to be counter-productive.

Once-confidential industry documents show that these programs were intended to serve the industry’s interests and political needs, not least by preventing more effective action. They were also for:

preserving the industry’s access to youths, creating allies within policymaking and regulatory bodies, defusing opposition from parents and educators, bolstering industry credibility, and preserving the industry’s influence with policymakers.

A recently published paper shows that industry “education” advertisements even appear to have a priming effect on smokers.

One might argue that the alcohol industry has derived similar benefits from the education programs it has supported over the years, notwithstanding the ringingly sincere position drafted for the Philip Morris CEO in an internal briefing book in 1996, when Philip Morris owned the Miller Brewing company:

it’s good business for the industry to promote responsible drinking. These promotions are not ploys. They are sincere comprehensive programs implemented by brewers and distributors.

This is some way from the conclusions of an American study that “the evidence indicates that beer companies achieved advantageous outcomes to a large extent with these ‘drink responsibly’ campaigns and the interpretations tended to be mostly prodrinking”. They add “seemingly prohealth messages can serve to subtly advance both industry sales and public relations interests” and “the appearance of addressing the problem may preempt more persuasive campaign efforts from government agencies and prevention organizations.”

Corona billboard at the corner of Nicholson Road and Railway Parade at Shenton Park, Western Australia. McCusker Centre, Curtin University

Alongside the Miller Beer advertisement, on the other side of the subway, was another, equally large advertisement for Corona beer (see above). No warnings, just glamorous young people drinking on a beach.

Isn’t it good to know that, as the Corona website assures us, “We at Corona work to model responsible drinking throughout our advertising and actions as a company” and that the Corona Grupo Modelo education program (of which this author has never seen any traces in Australia) claims to “spread the message of responsible drinking among students, authorities, teachers and parents through a variety of practices.”

Those accessing the Corona website are told, “You have to be old enough to enter this site”. Given that there are no further constraints or checks, a cynic might see this as something of a dare or encouragement to teens to enter an earlier birth date. More forbidden fruit.

Alcohol advertising is expensively and meticulously researched. Alcohol companies are not likely to receive plaudits from their shareholders for reducing their present or future markets. Indeed, in September 2012, the marketing director of SAB Miller’s Australian Carlton United Brewers was quoted as saying:

I think the first thing is we need to find ways to work harder to make people drink more and drink at higher value…

These billboard advertisements, like other alcohol ads in locations passed by children, come and go. Miller Beer is not alone in emphasising that alcohol products are for adults. Is it too cynical to suggest that advertisements such as this, from a company so closely associated with the tobacco industry, may be helping to portray alcohol as “forbidden fruit” to which children and young people might aspire?

It is hard to credit that anybody other than the alcohol industry and its supporters takes seriously the self-regulatory codes that are supposed to protect children from alcohol advertising. Hence the current increasing pressure for regulation.

Surely, it is also time to ensure that any warning messages, whether about health or directed to children and young people, are developed by our health authorities, rather than by alcohol industry organisations, and global companies whose purpose is to sell as much of their product as possible.

Another benefit from Aspirin

There is a chapter in my book “Live Well Over 100” devoted to the benefits of aspirin. It is inexpensive, reduces the risk of breast cancer, bowel cancer, heart disease and now we find it also reduces the risk of skin cancer. It has a small downside in that it can increase the risk of bleeding.
11 March 2013, 3.26pm AEST

Aspirin linked to lower skin cancer risk in women

Women who use aspirin for five or more years have a 30% lower risk of developing melanoma skin cancer than women who don’t take aspirin, a new study has found. Previous studies have linked aspirin with a reduced risk of gastric, colorectal and breast cancer but the new study suggests its anti-inflammatory…

The study found that the longer women take aspirin, the lower the risk of melanoma skin cancer.

Women who use aspirin for five or more years have a 30% lower risk of developing melanoma skin cancer than women who don’t take aspirin, a new study has found.

Previous studies have linked aspirin with a reduced risk of gastric, colorectal and breast cancer but the new study suggests its anti-inflammatory properties may play a role in skin cancer risk too.

The study, published in Cancer, the journal of the American Cancer Society, examined data on 59,806 Caucasian women in the US aged between 50 and 79 years over an average period of 12 years.

The results were adjusted for age, education, body mass index, smoking status, vitamin D intake, physical activity, history of non-melanoma skin cancer, history of melanoma, skin reaction to the sun, regional solar radiation, childhood and current summer sun exposure, sunscreen use, time since last medical visit and other factors.

Women who took aspirin had a 21% lower risk of developing melanoma than women who did not take aspirin, the study found, and longer term use was linked with a further reduction in risk.

Study co-author, Jean Tang, of Stanford University School of Medicine in Palo Alto, said other pain relief drugs like acetaminophen did not reduce melanoma risk in women.

“Aspirin works by reducing inflammation and this may be why using aspirin may lower your risk of developing melanoma,” said Dr. Tang.

In comments released by the Australian Science Media Centre, Associate Professor Steven Stacker said the findings were important.

“For many years, doctors have observed the beneficial impact of non-steroidal anti-inflammatory drugs, such as aspirin, in cancer, without fully comprehending the biological processes involved,” he said.

“Today, many research groups are pulling apart this link to understand these anti-cancer effects, in the hope they can be boosted and replicated through the development of new treatments.”

Prof Mark Wahlqvist, Emeritus Professor of Medicine at Monash University and Visiting Professor at the National Health Research Institute in Taiwan, said “more work needs to be done to extrapolate from the US population studied to Australians in general.”

“This would be of great importance as melanoma incidence continues to rise. The authors have access to similar data sets for men and it will be important to know if the findings are gender-specific,” he said.

“Aspirin-like activity is also found in food (after all, aspirin is a salicylate which comes from plants) and again, the study reported has a vast food data base which should be reconciled with the current findings,” he said.

“The authors note a possible protective role for vitamin D and control for it, but no less important is it to know whether Vitamin D interacts with aspirin to allow its apparent effect on melanoma – this is a difficult public health issue given the importance of sun-light in ensuring vitamin D status.”

What is cancer

15 March 2013, 6.33am AEST

Explainer: what is cancer?

Few things strike fear into people more than the word cancer, and with good reason. While improvements in cancer therapy and advances in palliative care mean that the illness does not always lead to inevitable and painful death as it once did, approximately one in three of us will get some form of cancer…

Cancer is a disease in which abnormal cells divide without control and are able to invade other tissues. Tips Times

Few things strike fear into people more than the word cancer, and with good reason. While improvements in cancer therapy and advances in palliative care mean that the illness does not always lead to inevitable and painful death as it once did, approximately one in three of us will get some form of cancer in our lifetime.

Cancer accounted for about three in ten deaths (over 42,000) in Australia last year. It was the second most common cause of death after cardiovascular disease. Aside from the obvious personal cost, cancer is expensive, with direct costs to our national health system running at $3.8 billion a year.

The US National Cancer Institute defines cancer as a disease in which abnormal cells divide without control and are able to invade other tissues.

Our bodies contain over 200 different types of cell, the basic units of life. Each of these has specific functions and is organised into the various organs such as the lungs, liver, skin, and brain. To keep these organs functioning, cells grow and divide to replace other cells as they age and die.

The exquisite balance between cell growth and death is normally kept under tight control by an incredibly complex genetic network. Mutations in the DNA of genes controlling the network can disrupt this balance, causing an accumulation of excess cells, which forms a tumour.

Chemotherapy works by targeting rapidly dividing cancer cells with toxic chemicals. Tips Times

If a tumour forms in an essential organ, such as the liver or lungs, it may eventually grow large enough to compromise organ function and kill us. But some of the most common cancers occur in organs that aren’t necessary to keep us alive, such as breasts and prostate. Here, the real problems usually arise when cells from the primary tumour spread (metastasise) to form secondary tumours in essential organs.

It’s staggering to think that a mutation in any one of the 100 trillion or so cells in our body is all it takes to initiate a tumour. Cancer-causing mutations can be inherited, or induced by infection with bacteria or viruses (HPV and HIV), or environmental factors, such as smoking, asbestos and radiation.

But most mutations probably occur as the result of unrepaired DNA damage that is a consequence of normal cell metabolism.

Complexity is one of the most challenging aspects of understanding cancer and developing therapies. At the molecular level, this complexity can be reduced to a relatively small number of underlying principles known as the hallmarks of cancer. But the more we learn about cancer at the genetic level, the more we understand that each person’s disease is unique.

In other words, cancer is not a single disease. Over 100 different types of cancer have been described using anatomical classifications – that is, by the organ or cell type in which they originate (such as prostate cancer, bowel cancer, breast cancer, skin cancer and lung cancer). But common molecular features (such as a particular genetic signature) are emerging as a much more powerful way to determine appropriate treatment.

This paradigm shift in treatment is being driven by large-scale gene sequencing and functional genomics projects, which are giving us unprecedented insight into cancer at the genetic and molecular level. Australia is at the forefront of this effort, particularly in pancreatic and ovarian cancer genomics.

Radiotherapy works by targeting rapidly dividing cancer cells with radiation. Tips Times

By far the strongest risk factor for cancer is age. Put simply, the older you get, the better your odds of getting cancer. A long list of genetic and environmental risk factors have been identified for various cancer types, but many of these have relatively moderate effects. Family history is also a predictor of cancer risk but discrete inherited mutations (such as BRCA1) have only been linked to a relatively small number of cancers. Obesity is emerging as a common risk factor for several cancers.

Cancer prevention efforts have largely been elusive, with the notable exceptions of the HPV vaccine (for cervical cancer), and reduced smoking rates (for lung cancer).

Until recently, the three pillars of cancer treatment have been surgery, radiation and chemotherapy. The simple aim of all three is to reduce tumour mass.

The first report of cancer being cured by surgery appeared in 1809, and it remained the only effective tool available through the first half of the 20th century. Radical mastectomy for breast cancer – still one of the most profound influences on cancer surgery – was first performed in 1894. Radiation treatment was first shown to cure head and neck cancer in 1928.

Radiotherapy and chemotherapy both work by targeting rapidly dividing cancer cells with radiation or toxic chemicals, respectively. But side effects arise when normal, healthy cells are inadvertently targeted. The cells lining the gut, for instance, and hair follicles are also rapidly dividing and often the victim of collateral damage.

Newer therapies for cancer are designed to specifically target molecular abnormalities related to the hallmarks of cancer. Radiotherapy

More recent developments in therapy have come in the form of immunotherapy, which uses antibodies or stimulates parts of the immune system to help fight the growth of tumours, and newer therapies designed to specifically target molecular abnormalities related to the hallmarks of cancer. Notable examples of these include Herceptin for the treatment of breast cancer, and Gleevec (Imatinib) for the treatment of some types of leukemia.

There are myriad misconceptions about the risk factors for cancer, and no shortage of snake-oil salesman flogging unproven cures to desperate patients. Everything from coffee enemas to an alkaline diet has been touted as a cure. Cancer Council Australia has a great website that uses hard evidence to dispel many of the myths and misconceptions about cancer.

The best news is that we’re starting to beat this disease. And for some cancer types, such as testicular cancer and specific kinds of leukemia, we can effectively treat most cases.

Five-year survival across all types of the disease has increased markedly in the last 20 years (from 47% in 1982-87 to 66% in 2006-10) but these gains have not been consistent across all cancers. Australians generally have better cancer survival prospects compared with people living in other countries. But unfortunately, there are still inequalities for Aboriginals, people living in remote areas and people of lower socioeconomic status.

Further advances in screening, diagnostics, and targeted therapeutics are likely to continue pushing cancer survival rates even higher. The emergence of personalised medicine has the potential to completely change the way cancer is treated, and there is a rapid push towards this approach, even in the face of the very expensive price tag.

But what of the elusive cure? It’s likely that we’ll turn cancer into a disease that is managed and treated as a chronic disease, so that people will die with, rather than from, cancer.

Disturbing story about oral health.

I have been on about our poor eating habits for some time, and discussed this at length in my book, “Live Well Over 100”  We have to get back to eating like “cave-men (or women)” with ancient, more natural diets. Modern processed foods are killing us.  As well, excessive cleanliness with our children does them no favours.  Let toddlers eat sand(and other nasties) as it helps with their inner bacterial environment, and builds immunity.  This article confirms what I have known for ages, but is scary all the same.
18 February 2013, 6.30am AEST

Degraded microcosms: loss of oral biodiversity will kill you

The more we look, the more we realise just how important intact ecosystems are for our own well-being – and it really doesn’t matter at which scale we are looking. When Alan Cooper, Director of the Australian Centre for Ancient DNA, asked me (Corey) for a bit of help with a cool paper he and some of…

Biodiversity matters, even in your mouth. Mandy Jouan

The more we look, the more we realise just how important intact ecosystems are for our own well-being – and it really doesn’t matter at which scale we are looking.

When Alan Cooper, Director of the Australian Centre for Ancient DNA, asked me (Corey) for a bit of help with a cool paper he and some of his colleagues were working on, I was initially sceptical. Why would an ecologist be even remotely interested in dentistry? I mean seriously – oral hygiene? Then he went into detail, and I couldn’t refuse.

Before we get into that detail, we have to tell a story about a colleague of ours (name withheld, but true story) who recently went to the dentist to have some routine cleaning done. There was nothing particularly special about his visit – no local anaesthetic, no extractions, no caps, and certainly no surgery. Two weeks later he was in the hospital getting his chest cracked open for open-heart surgery.

What happened was a microscopic bit of his dental plaque had dislodged during the cleaning and entered his bloodstream through a small wound in his mouth. The tiny bacterial plaque fragment raced around his circulatory system until it became unfortunately lodged in a tiny eddy that had developed behind one of his (slightly faulty – but he didn’t know it at the time) ventricular valves. The fragment started to grow and threaten the working of his entire heart, such that had he not had the surgery to repair the valve, he would have been dead in weeks to months. Who knew that going to the bleeding dentist (pun intended) was so dangerous? We certainly didn’t.

As it turns out, our mouths are really disgusting places. I mean really, really disgusting, pathogen-ridden cesspits of filth. You might think you have a clean mouth, but ironically, all that modern oral hygiene combined with our spectacularly unhealthy diets dominated by refined foods mean that we have rapidly destroyed the once-healthy bacterial ecosystem of our mouths. And most of that ecosystem degradation has come about in the last 150 years.

Our paper just published online in Nature Genetics is a weird and eclectic mix of ancient-DNA genetics, dentistry, ecology and nutrition. Christina Adler (lead author), Alan and others hooked up with an archaeologist, Keith Dobney, to identify what was in the hard dental plaque found on the teeth of ancient human skulls. Of course, ancient DNA techniques were really the only tools at their disposal for determining the composition of those bacteria, but it wasn’t until 2007 that the methods had become refined enough and the facilities isolated enough to amplify the very delicate strands of degraded bacterial DNA.

After isolating samples from Mesolithic (7550-5450 years before present), Neolithic (7400-4000 years BP), Bronze Age (4200-3000 years BP), Medieval (1100-400 years BP) and modern (today) human remains (well, the modern samples were taken from live humans – we didn’t kill them – and many of them were from Alan’s lab), we found a marked decline in bacterial diversity over time.

The first change we noted was a decrease in diversity and an increase in prevalence of specific bacterial pathogens after farming became widespread in the Neolithic. A second but much more acute drop in diversity occurred again after the Industrial Revolution about 150 years ago when refined sugars and flour became widely available.

Diet and hygiene issues aside, what is the ecology behind these changes? Our interpretation was that a change to a simplified diet first dominated by basic carbohydrates, and subsequently purified sugars, has essentially led to widespread ecosystem degradation in the mouth’s bacterial community.

We know at least that in a macro-ecological context (what we traditionally define as “ecosystems”), higher species diversity (more species) generally means greater ecosystem resilience to disturbance and greater productivity. We’ve observed this pattern in forests, grasslands and coral reefs – the more species there are, greater is the long-term stability (resilience) of the ecosystem, and the productivity of the species of which they are comprised.

In other words, the amount of sugar and carbohydrate in our modern diet strongly favours bacteria that can use it effectively, and has resulted in the loss of much of the mouth’s natural microbiome, leaving the path open for invasion and dominance by disease-causing bacteria. We have systematically simplified our natural mouth ecosystem to the point where the pathogens are winning – and they’re killing us in response.

Indeed, dental caries is now a major endemic disease that affects 60–90% of school-aged children in industrialised countries, and periodontal disease occurs in 5–20% of the adult population worldwide. But it’s not just rotten mouth diseases – nasty oral bacteria are also associated with arthritis, cardiovascular disease and diabetes and other systemic diseases. The permanent state of inflammation permitted by our weakened bacterial ecosystems stimulates a constant immune response, as well as allowing bacteria to leak into the blood stream and do all sorts of damage to our bodies.

Convincing people that biodiversity is important for human well-being is a fairly difficult ask because most people do not understand the complexities of ecosystem services such as carbon sequestration, pollination of our crops, flood control and fresh water provision. But this particular “ecosystem service” – your health – is vastly more digestible; more species are better, even in your mouth.

Living a meaningful Life

The past year’s top 10 scientific insights about living a meaningful life

Jeremy Adam Smith, Web Editor & Producer, Greater Good Science Center | 1/3/13 | 8 comments | Leave a comment
Jeremy Adam Smith

The science we cover on the UC Berkeley Greater Good Science Center website — aka, “the science of a meaningful life” — has exploded over the past 10 years, with many more studies published each year on gratitude, mindfulness, and our other core themes than we saw a decade ago.

2012 was no exception. In fact, in the year just past, new findings added nuance, depth, and even some caveats to our understanding of the science of a meaningful life. Here are 10 of the scientific insights that made the biggest impression on us in 2012–the findings most likely to resonate in scientific journals and the public consciousness in the years to come, listed in roughly the order in which they were published.

There’s a Personal Cost to Callousness. In March, researchers at the University of North Carolina, Chapel Hill, published a study in Psychological Science that should make anyone think twice before ignoring a homeless person or declining an appeal from a charity.

Daryl Cameron and Keith Payne found that after people were instructed to restrain feelings of compassion in the face of heart-wrenching images, those people later reported feeling less committed to moral principles. It was as if, by regulating compassion, the study participants sensed an inner conflict between valuing morality and living by their moral rules; to resolve that conflict, they seemed to tell themselves that those moral principles must not have been so important. Making that choice, argue Cameron and Payne, may encourage immoral behavior and even undermine our moral identity, inducing personal distress.

“Regulating compassion is often seen as motivated by self-interest, as when people keep money for themselves rather than donate it,” write the researchers. “Yet our research suggests that regulating compassion might actually work against self-interest by forcing trade-offs within the individual’s moral self-concept.”

High Status Brings Low Ethics. They may have more money, but it seems that the upper class are poorer in morality. In a series of seven studies, published in March in PNAS, researchers found that upper-class people are more likely than the lower class to break all kinds of rules—to cut off cars and pedestrians while driving, to help themselves to candy they know is meant for children, to report an impossible score in a game of chance to win cash they don’t rightfully deserve.

While the results surprised some, they didn’t come out of nowhere: They were the latest, if perhaps the most damning, in a series of studies in which researchers, including Greater Good Science Center Faculty Director Dacher Keltner, have looked at the effects of status on morality and kind, helpful (or “pro-social”) behavior.

Previously, as we’ve reported, they’ve found that upper class people are less generous, less compassionate, and less empathic. (Many of these findings were summarized in a Greater Good article by Editor-in-Chief Jason Marsh, “Why Inequality is Bad for the One Percent,” published in September.) Considered together, this line of research suggests not that the rich are inherently more unethical but that experiencing high status makes people more focused on themselves and feel less connected to others—an important lesson in this age of growing inequality.

“The rich aren’t bad people, they just live in insular worlds,” study co-author Paul Piff told Greater Good earlier this year. “But if you’re able to reduce the extremes that exist between the haves and the have-nots, you’re going to go a long way toward closing the compassion and empathy gap.”

Happiness is about Respect, Not Riches. And there was other discouraging news for the wealthy this year. Research has long suggested that money doesn’t buy happiness; a study published in Psychological Science in July confirms that finding and goes a step further, changing the stakes of what we think of as high status: It turns out that if we’re looking to money, we’re looking in the wrong place.

Instead, the study found that happiness is more strongly associated with the level of respect and admiration we receive from peers. The study’s researchers, led by UC Berkeley’s Cameron Anderson (and again including Keltner), refer to this level of respect and admiration as our “sociometric status,” as opposed to socioeconomic status.

In one experiment, college students high in sociometric status in their group—their sorority, for example, or their ROTC group—were happier than their peers, whereas socioeconomic status didn’t predict happiness. Similarly, a broader, nationwide survey, which boasted people from a variety of backgrounds, income, and education levels, found that those who felt accepted, liked, included, and welcomed in their local hierarchy were happier than those who were simply wealthier.

“You don’t have to be rich to be happy,” Anderson told Greater Good, “but instead be a valuable contributing member to your groups.”

Kindness Is Its Own Reward—Even to Toddlers. Several studies over the past six years have found that kids as young as 18 months old will spontaneously help people in need. But do they do so just to please adults? Apparently not: In July, researchers published evidence that their kindness is motivated by deep, perhaps innate, feelings of compassion for others.

The researchers found that toddlers’ pupil sizes increased—a sign of concern—when they saw someone in need of help; their pupil size decreased when that person received helped. The kids’ pupils got smaller when they were the ones who helped—but also when they watched someone else help. These results, published in Psychological Science, suggest that toddlers’ kindness springs from genuine feelings of concern, not simply a concern for their own reputation.

This argument gains support from a study published around the same time in PLOS ONE. In that study, children just shy of their second birthday appeared happier when they gave away a treat than when they received a treat. What’s more, they seemed even happier when they gave away one of their own treats than when they were allowed to give away a treat that didn’t belong to them. In other words, performing truly altruistic acts—acts that involve some kind of personal sacrifice—made the kids happier than helping others at no cost to themselves.

“While other studies have suggested adults are happier giving to others than to themselves and that kids are motivated to help others spontaneously,” Delia Fuhrmann, a Greater Good research assistant, wrote in August, “this is the first study to suggest that altruism is intrinsically rewarding even to very young kids, and that it makes them happier to give than to receive.”

When a behavior is intrinsically rewarding like this, especially at the earliest stages of life, it suggests to scientists that it has deep evolutionary roots. Watch the video below to see one toddler going through the experiment.

We Can Train Ourselves to be More Compassionate. For decades, psychology was preoccupied with alleviating negative emotional states like depression, chronic anger, or anxiety. More recently, we’ve come to understand that we can also “treat” people to cultivate positive emotions and behaviors, and that traits like empathy and happiness are skills we can consciously develop over time.

But what about compassion? This has been less investigated, which is why a study published in the July issue of the Journal of Happiness Studies stands to be so influential.

Stanford researcher Hooria Jazaieri and colleagues (including GGSC Science Director Emiliana Simon-Thomas) randomly assigned 100 adults to a nine-week compassion cultivation training program or to a waitlist control condition. Before and after taking the compassion course, participants completed surveys that “measured compassion for others, receiving compassion from others, and self-compassion.”

The results have important implications: Across all three domains, participants showed big increases in compassion. More research needs to be done, but this paper clearly suggests that we can train people — in schools, workplaces, churches, and elsewhere — to ease suffering in themselves and other people.

Gratitude Sustains Relationships through Tough Times. Several studies have shown that feeling grateful for one’s romantic partner can improve one’s relationship. But this year, new research by Amie Gordon built on that research significantly, factoring in another critical dimension: the extent to which people feel appreciated by their partner.

Synthesizing the science of successful relationships with recent research on gratitude, Gordon and her colleagues developed a new model of what it takes to sustain a good relationship. They found that feeling appreciated by our partner gives us a sense of security that allows us to focus on what we appreciate about him or her–which, in turn, make us more responsive to his or her needs and more committed to the relationship in general … which then makes our partner feel more appreciated as well.

So when we hit a rocky patch, this research suggests, it’s the upward spiral of gratitude that encourages us to risk vulnerability, tune into our partner’s needs, and resolve the conflict, rather than turning away from him or her. “Feeling appreciated helps people with relationship maintenance by giving them the security they need to recognize they have a valuable relationship worth maintaining,” write Gordon and her co-authors in their study, published in August in the Journal of Personality and Social Psychology. “Cultivating appreciation may be just what we need to hold onto healthy, happy relationships that thrive.”

Humans Are Quicker to Cooperate than Compete. In a September paper published in Nature, a group of Harvard researchers took on an age-old question: Are humans instinctively selfish or cooperative?

To get at an answer, they had more than 1,000 people play a game that required them to decide how much money to contribute to a common pool. In a blow to conventional wisdom, the researchers found that people who made their decision quickly—in less than 10 seconds—gave roughly 15 percent more to the pool than people who deliberated for more time. In a second study, the researchers instructed some people to make their decision in less than 10 seconds and other people to think for longer than that; again, they found that quick decisions led to more generosity while deliberating bred selfishness.

“These studies provide strong evidence that people, on average, have an initial impulse to behave cooperatively—and with continued reasoning, become more likely to behave selfishly,” writes GGSC Science Director Emiliana Simon-Thomas. “The authors caution that their data do not prove that cooperation is more innate than selfishness at a genetic level—but they point out that life experience suggests that, in most cases, cooperation is advantageous, so that’s generally not a bad place to start by default.”

There’s a Dark Side to Pursuing Happiness. As we often report on Greater Good, happy people have it better: They’ve got more friends, they’re more successful, and they live longer and healthier lives. But in May, Yale psychologist June Gruber wrote a Greater Good essay outlining “Four Ways Happiness Can Hurt You.” Based on research Gruber and others have conducted over the past few years, she explained how feeling happy can actually make us less creative, less safe, and, in some cases, less able to connect with other people.

Then, in October, some of Gruber’s collaborators published a study deepening the dark side to happiness: It seems that wanting to be happy might make us feel lonely.

Led by UC Berkeley’s Iris Mauss, the study, published in the journal Emotion, found that the more people value happiness, the more likely they are to feel lonely during stressful events. What’s more, Mauss and her colleagues found that inducing people to value happiness increases feelings of loneliness and even causes a hormonal response associated with loneliness—troubling news given how much emphasis our culture places on happiness, particularly through the media.

Why this effect? The researchers argue that, at least in the West, the more people value happiness, the more likely they are to focus on the self—often at the expense of connecting with others, and those social connections are a key to happiness. “Therefore,” they write in their Emotion paper, “it may be that to reap the benefits of happiness people should want it less.”

Parenthood Actually Does Make Most — but Not All — People Happier. American parents tend to say that parenthood is stressful and hard on marriages, a feeling seemingly confirmed by many studies. One 2004 paper even found that moms prefer watching TV, shopping, and cooking to parenting their children. These findings led to a spate of media coverage claiming that parenthood will screw up your life.

But most of these studies have had a weakness: They didn’t directly compare the well-being of parents to that of non-parents. Moreover, they were contradicted by many other studies suggesting that men and women can find tremendous meaning and satisfaction in parenthood, even despite high stress levels.

To correct for these weaknesses, psychologist S. Katherine Nelson and colleagues (including GGSC friend Sonja Lyubomirsky) ran three studies. The first used the massive World Values Survey to compare the happiness of parents to non-parents; the second tested moment-to-moment happiness of both parents and non-parents; the third looked specifically at how parents felt about taking care of children, compared to other daily activities.

Taken together, these three studies found that, overall, parents seem to be happier and more satisfied with their lives—and that as a group they derived tremendous meaning and positive feelings from parenting.

However, these findings, published in November by Psychological Science, come with several rather important caveats.

First, parenthood makes men happier than women—quite a bit happier, though mothers still reported less depression and more positive emotion than did child-free women. And contrary to conventional wisdom, single parenthood does not automatically lead to unhappiness. Parents without a partner did tend to be less happy than child-free peers—but they also reported fewer depressive symptoms than non-parents without a partner, largely, it seems, because they derived more meaning from their lives.

Kindness Makes Kids Popular. In some ways, researcher Kristin Layous and her colleagues are like everyone in middle school: They pay attention to the popular kids. But their research stood out this year for how it explored what makes those kids popular in the first place.

The researchers gave more than 400 students one of two simple tasks: Every week for four weeks, they were either to perform three acts of kindness or visit three places. At the end of the four weeks, all the kids in the study, who ranged in age from 9 to 11, reported greater happiness than they had before, and more of their peers said they wanted to spend time with them. But the kind kids saw a much greater spike in their popularity, gaining an average of 1.5 friends—roughly twice as many as their counterparts.

In other words, the results, published in December by PLOS ONE, offer perhaps the most convincing argument you could make to a tween for why they should share their lunch with someone or give their mom a hug when she’s feeling stressed (two of the kind acts students said they performed): Kids who are kind to others are more well-liked, helping their own popularity even as they help other people.

What’s more, Layous and her colleagues point out that, according to prior research, kids who are well-liked are less likely to bully and more likely to do nice things for others, and classrooms with an even distribution of popularity have higher average mental health. So a lesson for teachers: For a classroom of happy kids, consider adding to your curriculum the purposeful practice of pro-social behavior.

This piece originally appeared on the website of the UC Berkeley Greater Good Science Center, and was co-authored by Jason Marsh and Lauren Klein.