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The Strength of the Placebo Effect May Hinge on Your DNA

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Whenever medical researchers conduct clinical trials of a new drug, they have to account for the placebo effectthe fact that if you give people a treatment, even if it’s sugar pills, some of them will feel better. Though the treatment might be inactive, patients (and sometimes even the investigators in charge of the study) have an implicit bias toward believing that it works. Whether or not you’re the kind of person who feels better after taking a placebo may have something to do with your genes, though, as a new study from Trends in Molecular Medicine argues. 

Recent research has shown that the placebo effect isn’t just psychological—it’s physiological. Several things happen when you take a placebo, including anxiety reduction, pain suppression, or the activation of reward centers in the brain, which might make you feel better. When you think about it, a placebo can be a beautiful thing. Why wouldn’t you want to feel better without having to pay for real medicine (which might also come with annoying side effects)? 

Hence, it would be nice to be able to figure out who, exactly, is most susceptible to the placebo effect, since not everyone feels great after a course of sugar pills. Led by Kathryn Hall of Harvard Medical School, a group of scientists reviewed previous research for evidence of a genetic variation in the placebo effect by looking for correlations between certain genetic mutations and the strength of a person’s placebo response. Common genetic mutations called Single nucleotide polymorphisms, or SNPs, have been implicated in changing the placebo response in clinical trials. Hall and her team found 11 of these SNPs to be associated with the placebo response in previous research, including those in the dopamine system (the brain’s reward system), the serotonin system (which deals with mood), and the opioid and cannabinoid systems (which both deal with pain). 

With this evidence, it’s looking like the placebo response is even more complicated than we thought. “Given the complex interplay of behavior, expectation, neurotransmitter signaling, disease, and the context of the medical treatment ritual, the molecular pathways and genes involved in contributing to placebo responses is unfolding as a potentially complex network,” the researchers write. 

This study is just a preliminary look into the genetics of placebo responses, but if your response to placebos is coded into your genes, that could affect the reliability of studies that measure a drug’s efficacy against the efficacy of the placebo treatment. If a trial featured all people who respond strongly to placebos in the control group, for instance, the results would skew toward indicating that the drug treatment was completely ineffective. Furthermore, it could lead to honest placebo treatments, where patients knowingly receive placebo treatments (as has been suggested for certain conditions, like Irritable Bowel Syndrome). Because in some cases, feeling better is more important than which medicine you take.  

[h/t: The Economist]

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Medicine
Why Haven't We Cured Cancer Yet?
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Walkathons, fundraisers, and ribbon-shaped bumper stickers raise research dollars and boost spirits, but cancer—the dreaded disease that affects more than 14 million people and their families at any given time—still remains bereft of a cure.

Why? For starters, cancer isn't just one disease—it's more than 100 of them, with different causes. This makes it impossible to treat each one using a one-size-fits-all method. Secondly, scientists use lab-grown cell lines cultivated from human tumors to develop cancer therapies. Living masses are far more complex, so potential treatments that show promise in lab experiments often don't work on cancer patients. As for the tumors themselves, they're prone to tiny genetic mutations, so just one growth might contain multiple types of cancer cells, and even unique sub-clones of tumors. These distinct entities might not respond the same way, or at all, to the same drug.

These are just a few of the challenges that cancer researchers face—but the good news is that they're working to beat all of them, as this TED-Ed video explains below.

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Health
Skipping Breakfast Could Be Bad for Your Heart
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There are mountains of evidence supporting the claim that breakfast really is the most important meal of the day. Getting something in your stomach in the first hours of the morning can regulate your glucose levels, improve your cognition, and keep your hunger in check. Now new research published in the Journal of the American College of Cardiology points to another reason not to wait until lunchtime to break last night’s fast. As TIME reports, people who skip breakfast are at an increased risk for atherosclerosis, a disease caused by plaque buildup in the arteries.

Researchers surveyed over 4000 men and women between the ages of 40 and 54 living in Spain. After looking at the dietary habits of each participant, they broke them into three groups: people who consumed more than 20 percent of their daily calories in the morning; those who got 5 to 20 percent; and those who ate less than 5 percent.

The subjects who ate very little in the a.m. hours or skipped breakfast all together were 2.5 more likely to have generalized atherosclerosis. This meant that plaque was starting to collect on the walls of their arteries, hardening and narrowing them and increasing the risk for heart attack or stroke. People who fell into the 5 to 20 percent calorie category were also more likely to show early signs of the disease, while those who ate the most calories in the morning were the healthiest.

These results aren’t entirely surprising. Previous studies have shown a connection between skipping breakfast and health problems like high blood pressure, high cholesterol, diabetes, and unwanted weight gain. A possible explanation for this trend could be that waiting several hours after waking up to eat your first meal of the day could trigger hormonal imbalances. The time between getting into and out of bed is the longest most of us go without eating, and our bodies expect us to consume some calories to help kickstart our energy for the day (drinking straight coffee doesn’t cut it). Another theory is that people who don’t eat in the morning are so hungry by the time lunch rolls around that they overcompensate for those missing calories, which is why skipping breakfast doesn’t make sense as a diet strategy.

But of course there are many breakfast skippers who aren’t motivated by health reasons either way: They just don’t think they have the time or energy to feed themselves in the morning before walking out the door. If this describes you, here are some simple, protein-packed meals you can prepare the night before.

[h/t TIME]

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