‘Disease X’: What it is (and isn’t)
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What you need to know
- In January 2024, the World Economic Forum hosted an event called Preparing for Disease X to discuss strategies to improve international pandemic response.
- Disease X is a term used in epidemiology to refer to potential disease threats. It is not a real disease or a global conspiracy.
- Preparation to prevent and respond to future pandemics is a necessary part of global health to keep us all safer.
During the World Economic Forum’s 54th annual meeting in Davos, Switzerland, global health experts discussed ways to strengthen health care systems in preparation for future pandemics. Conspiracy theories quickly began circulating posts about the event and the fictional disease at its center, so-called Disease X.
What is Disease X?
In 2018, the World Health Organization added Disease X to its list of Blueprint Priority Diseases that are public health risks. But, unlike the other diseases on the list, Disease X doesn’t exist. The term represents a hypothetical human disease capable of causing a pandemic. Although experts don’t know what the next Disease X will be, they can make educated guesses about where and how it may emerge—and how we can prepare for it.
Why are we hearing about Disease X now?
COVID-19 has been the deadliest infectious disease outbreak of the 21st century. It’s also an example of a Disease X: a previously unknown pathogen that spreads rapidly around the world, claiming millions of lives.
When the WEF hosted a panel of experts to discuss Disease X, it was the first exposure that many people had to a concept that global health experts have been discussing since 2018.
Even before the routine pandemic preparedness event took place, online conspiracy theorists began circulating false claims that those discussing and preparing for Disease X had sinister motives, underscoring how widespread distrust of global health entities has become in the wake of the COVID-19 pandemic.
Why does Disease X matter?
Epidemiologists use concepts like Disease X to plan for future outbreaks and avoid the mistakes of past outbreaks. The COVID-19 pandemic and the recent non-endemic outbreak of mpox highlight the importance of global coordination to efficiently prevent and respond to disease outbreaks.
Pandemics are inevitable, but the scale of their destruction doesn’t have to be. Major disease outbreaks are likely to become more frequent due to the impacts of climate change. Preparing for a pandemic now helps ensure that the world is better equipped to handle the next one.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Which Sugars Are Healthier, And Which Are Just The Same?
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From Apples to Bees, and High-Fructose Cs
We asked you for your (health-related) policy on sugar. The trends were as follows:
- About half of all respondents voted for “I try to limit sugar intake, but struggle because it’s in everything”
- About a quarter of all respondents voted for “Refined sugar is terrible; natural sugars (e.g. honey, agave) are fine”
- About a quarter of all respondents voted for “Sugar is sugar and sugar is bad; I avoid it entirely”
- One (1) respondent voted for “Sugar is an important source of energy, so I consume plenty”
Writer’s note: I always forget to vote in these, but I’d have voted for “I try to limit sugar intake, but struggle because it’s in everything”.
Sometimes I would like to make my own [whatever] to not have the sugar, but it takes so much more time, and often money too.
So while I make most things from scratch (and typically spend about an hour cooking each day), sometimes store-bought is the regretfully practical timesaver/moneysaver (especially when it comes to condiments).
So, where does the science stand?
There has, of course, been a lot of research into the health impact of sugar.
Unfortunately, a lot of it has been funded by sugar companies, which has not helped. Conversely, there are also studies funded by other institutions with other agendas to push, and some of them will seek to make sugar out to be worse than it is.
So for today’s mythbusting overview, we’ve done our best to quality-control studies for not having financial conflicts of interest. And of course, the usual considerations of favoring high quality studies where possible Large sample sizes, good method, human subjects, that sort of thing.
Sugar is sugar and sugar is bad: True or False?
False and True, respectively.
- Sucrose is sucrose, and is generally bad.
- Fructose is fructose, and is worse.
Both ultimately get converted into glycogen (if not used immediately for energy), but for fructose, this happens mostly* in the liver, which a) taxes it b) goes very unregulated by the pancreas, causing potentially dangerous blood sugar spikes.
This has several interesting effects:
- Because fructose doesn’t directly affect insulin levels, it doesn’t cause insulin insensitivity (yay)
- Because fructose doesn’t directly affect insulin levels, this leaves hyperglycemia untreated (oh dear)
- Because fructose is metabolized by the liver and converted to glycogen which is stored there, it’s one of the main contributors to non-alcoholic fatty liver disease (at this point, we’re retracting our “yay”)
Read more: Fructose and sugar: a major mediator of non-alcoholic fatty liver disease
*”Mostly” in the liver being about 80% in the liver. The remaining 20%ish is processed by the kidneys, where it contributes to kidney stones instead. So, still not fabulous.
Fructose is very bad, so we shouldn’t eat too much fruit: True or False?
False! Fruit is really not the bad guy here. Fruit is good for you!
Fruit does contain fructose yes, but not actually that much in the grand scheme of things, and moreover, fruit contains (unless you have done something unnatural to it) plenty of fiber, which mitigates the impact of the fructose.
- A medium-sized apple (one of the most sugary fruits there is) might contain around 11g of fructose
- A tablespoon of high-fructose corn syrup can have about 27g of fructose (plus about 3g glucose)
Read more about it: Effects of high-fructose (90%) corn syrup on plasma glucose, insulin, and C-peptide in non-insulin-dependent diabetes mellitus and normal subjects
However! The fiber content (in fruit) mitigates the impact of the fructose almost entirely anyway.
And if you take fruits that are high in sugar and/but high in polyphenols, like berries, they now have a considerable net positive impact on glycemic health:
- Polyphenols and Glycemic Control
- Polyphenols and their effects on diabetes management: A review
- Dietary polyphenols as antidiabetic agents: Advances and opportunities
You may be wondering: what was that about “unless you have done something unnatural to it”?
That’s mostly about juicing. Juicing removes much (or all) of the fiber, and if you do that, you’re basically back to shooting fructose into your veins:
- Effect of Fruit Juice on Glucose Control and Insulin Sensitivity in Adults: A Meta-Analysis of 12 Randomized Controlled Trials
- Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women
Natural sugars like honey, agave, and maple syrup, are healthier than refined sugars: True or False?
True… Sometimes, and sometimes marginally.
This is partly because of the glycemic index and glycemic load. The glycemic index scores tail off thus:
- table sugar = 65
- maple syrup = 54
- honey = 46
- agave syrup = 15
So, that’s a big difference there between agave syrup and maple syrup, for example… But it might not matter if you’re using a very small amount, which means it may have a high glycemic index but a low glycemic load.
Note, incidentally, that table sugar, sucrose, is a disaccharide, and is 50% glucose and 50% fructose.
The other more marginal health benefits come from that fact that natural sugars are usually found in foods high in other nutrients. Maple syrup is very high in manganese, for example, and also a fair source of other minerals.
But… Because of its GI, you really don’t want to be relying on it for your nutrients.
Wait, why is sugar bad again?
We’ve been covering mostly the more “mythbusting” aspects of different forms of sugar, rather than the less controversial harms it does, but let’s give at least a cursory nod to the health risks of sugar overall:
- Obesity and associated metabolic risk
- Main contributor to non-alcoholic fatty liver disease
- Increased risk of heart disease
- Insulin resistance and diabetes risk
- Cellular aging (shortened telomeres)
- 95% increased cancer risk
That last one, by the way, was a huge systematic review of 37 large longitudinal cohort studies. Results varied depending on what, specifically, was being examined (e.g. total sugar, fructose content, sugary beverages, etc), and gave up to 200% increased cancer risk in some studies on sugary beverages, but 95% increased risk is a respectable example figure to cite here, pertaining to added sugars in foods.
And finally…
The 56 Most Common Names for Sugar (Some Are Tricky)
How many did you know?
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Blueberries vs Elderberries – Which is Healthier?
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Our Verdict
When comparing blueberries to elderberries, we picked the elderberries.
Why?
Both are certainly top-tier fruits! But…
In terms of macros, elderberries have more than 2x the fiber, while the two berries are approximately equal on other macros. An easy win for elderberries in this category.
In the category of vitamins, blueberries have more of vitamins E, K, and choline, while elderberries have more of vitamins A, B1, B2, B3, B5, B6, B7, B9, and C, scoring another win for elderberries here.
When it comes to minerals, blueberries have more magnesium, manganese, and zinc, while elderberries have more calcium, copper, iron, phosphorus, potassium, and selenium—one more win for elderberries.
In terms of phytochemicals, both berries are (like most berries) an abundant source of polyphenols, but elderberries have more, including more quercetin, too.
Adding up the sections makes for a convincing win for elderberries, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like:
Herbs For Evidence-Based Health & Healing ← elderberry significantly hastens recovery from upper respiratory viral infections 😎
Enjoy!
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Knit for Health & Wellness – by Betsan Corkhill
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Betsan Corkhill, a physiotherapist, has more than just physiotherapy in mind when it comes to the therapeutic potential of knitting (although yes, also physiotherapy!), and much of this book is about the more psychological benefits that go way beyond “it’s a relaxing pastime”.
She makes the case for how knitting (much like good mental health) requires planning, action, organization, persistence, focus, problem-solving, and flexibility—and thus the hobby develops and maintains all the appropriate faculties for those things, which will then be things you get to keep in the rest of your life, too.
Fun fact: knitting, along with other similar needlecrafts, was the forerunner technology for modern computer programming! And indeed, early computers, the kind with hole-punch data streams, used very similar pattern-storing methods to knitting patterns.
So, for something often thought of as a fairly mindless activity for those not in the know, knitting has a lot to offer for what’s between your ears, as well as potentially something for keeping your ears warm later.
One thing this book’s not, by the way: a “how to” guide for learning to knit. It assumes you either have that knowledge already, or will gain it elsewhere (there are many tutorials online).
Bottom line: if you’re in the market for a new hobby that’s good for your brain, this book will give you great motivation to give knitting a go!
Click here to check out Knit For Health & Wellness, and get knitting!
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How to Think More Effectively – by Alain de Botton
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Our brain is our most powerful organ, and our mind is an astonishing thing. So why do we sometimes go off-piste?
The School of Life‘s Alain de Botton lays out for us a framework of cumulative thinking, directions for effort, and unlikely tools for cognitive improvement.
The book especially highlights the importance of such things as…
- making time for cumulative thinking
- not, however, trying to force it
- working with, rather than in spite of, distractions
- noting and making use of our irrationalities
- taking what we think/do both seriously and lightly, at once
- practising constructive self-doubt
The style is as clear and easy as you may have come to expect from Alain de Botton / The School of Life, and yet, its ideas are still likely to challenge every reader in some (good!) way.
Bottom line: if you would like what you think, say, do to be more meaningful, this book will help you to make the most of your abilities!
Click here to check out How To Think More Effectively, and upgrade your thought processes!
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What’s Keeping the US From Allowing Better Sunscreens?
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When dermatologist Adewole “Ade” Adamson sees people spritzing sunscreen as if it’s cologne at the pool where he lives in Austin, Texas, he wants to intervene. “My wife says I shouldn’t,” he said, “even though most people rarely use enough sunscreen.”
At issue is not just whether people are using enough sunscreen, but what ingredients are in it.
The Food and Drug Administration’s ability to approve the chemical filters in sunscreens that are sold in countries such as Japan, South Korea, and France is hamstrung by a 1938 U.S. law that has required sunscreens to be tested on animals and classified as drugs, rather than as cosmetics as they are in much of the world. So Americans are not likely to get those better sunscreens — which block the ultraviolet rays that can cause skin cancer and lead to wrinkles — in time for this summer, or even the next.
Sunscreen makers say that requirement is unfair because companies including BASF Corp. and L’Oréal, which make the newer sunscreen chemicals, submitted safety data on sunscreen chemicals to the European Union authorities some 20 years ago.
Steven Goldberg, a retired vice president of BASF, said companies are wary of the FDA process because of the cost and their fear that additional animal testing could ignite a consumer backlash in the European Union, which bans animal testing of cosmetics, including sunscreen. The companies are asking Congress to change the testing requirements before they take steps to enter the U.S. marketplace.
In a rare example of bipartisanship last summer, Sen. Mike Lee (R-Utah) thanked Rep. Alexandria Ocasio-Cortez (D-N.Y.) for urging the FDA to speed up approvals of new, more effective sunscreen ingredients. Now a bipartisan bill is pending in the House that would require the FDA to allow non-animal testing.
“It goes back to sunscreens being classified as over-the-counter drugs,” said Carl D’Ruiz, a senior manager at DSM-Firmenich, a Switzerland-based maker of sunscreen chemicals. “It’s really about giving the U.S. consumer something that the rest of the world has. People aren’t dying from using sunscreen. They’re dying from melanoma.”
Every hour, at least two people die of skin cancer in the United States. Skin cancer is the most common cancer in America, and 6.1 million adults are treated each year for basal cell and squamous cell carcinomas, according to the Centers for Disease Control and Prevention. The nation’s second-most-common cancer, breast cancer, is diagnosed about 300,000 times annually, though it is far more deadly.
Dermatologists Offer Tips on Keeping Skin Safe and Healthy
– Stay in the shade during peak sunlight hours, 10 a.m. to 4 p.m. daylight time.– Wear hats and sunglasses.– Use UV-blocking sun umbrellas and clothing.– Reapply sunscreen every two hours.You can order overseas versions of sunscreens from online pharmacies such as Cocooncenter in France. Keep in mind that the same brands may have different ingredients if sold in U.S. stores. But importing your sunscreen may not be affordable or practical. “The best sunscreen is the one that you will use over and over again,” said Jane Yoo, a New York City dermatologist.
Though skin cancer treatment success rates are excellent, 1 in 5 Americans will develop skin cancer by age 70. The disease costs the health care system $8.9 billion a year, according to CDC researchers. One study found that the annual cost of treating skin cancer in the United States more than doubled from 2002 to 2011, while the average annual cost for all other cancers increased by just 25%. And unlike many other cancers, most forms of skin cancer can largely be prevented — by using sunscreens and taking other precautions.
But a heavy dose of misinformation has permeated the sunscreen debate, and some people question the safety of sunscreens sold in the United States, which they deride as “chemical” sunscreens. These sunscreen opponents prefer “physical” or “mineral” sunscreens, such as zinc oxide, even though all sunscreen ingredients are chemicals.
“It’s an artificial categorization,” said E. Dennis Bashaw, a retired FDA official who ran the agency’s clinical pharmacology division that studies sunscreens.
Still, such concerns were partly fed by the FDA itself after it published a study that said some sunscreen ingredients had been found in trace amounts in human bloodstreams. When the FDA said in 2019, and then again two years later, that older sunscreen ingredients needed to be studied more to see if they were safe, sunscreen opponents saw an opening, said Nadim Shaath, president of Alpha Research & Development, which imports chemicals used in cosmetics.
“That’s why we have extreme groups and people who aren’t well informed thinking that something penetrating the skin is the end of the world,” Shaath said. “Anything you put on your skin or eat is absorbed.”
Adamson, the Austin dermatologist, said some sunscreen ingredients have been used for 30 years without any population-level evidence that they have harmed anyone. “The issue for me isn’t the safety of the sunscreens we have,” he said. “It’s that some of the chemical sunscreens aren’t as broad spectrum as they could be, meaning they do not block UVA as well. This could be alleviated by the FDA allowing new ingredients.”
Ultraviolet radiation falls between X-rays and visible light on the electromagnetic spectrum. Most of the UV rays that people come in contact with are UVA rays that can penetrate the middle layer of the skin and that cause up to 90% of skin aging, along with a smaller amount of UVB rays that are responsible for sunburns.
The sun protection factor, or SPF, rating on American sunscreen bottles denotes only a sunscreen’s ability to block UVB rays. Although American sunscreens labeled “broad spectrum” should, in theory, block UVA light, some studies have shown they fail to meet the European Union’s higher UVA-blocking standards.
“It looks like a number of these newer chemicals have a better safety profile in addition to better UVA protection,” said David Andrews, deputy director of Environmental Working Group, a nonprofit that researches the ingredients in consumer products. “We have asked the FDA to consider allowing market access.”
The FDA defends its review process and its call for tests of the sunscreens sold in American stores as a way to ensure the safety of products that many people use daily, rather than just a few times a year at the beach.
“Many Americans today rely on sunscreens as a key part of their skin cancer prevention strategy, which makes satisfactory evidence of both safety and effectiveness of these products critical for public health,” Cherie Duvall-Jones, an FDA spokesperson, wrote in an email.
D’Ruiz’s company, DSM-Firmenich, is the only one currently seeking to have a new over-the-counter sunscreen ingredient approved in the United States. The company has spent the past 20 years trying to gain approval for bemotrizinol, a process D’Ruiz said has cost $18 million and has advanced fitfully, despite attempts by Congress in 2014 and 2020 to speed along applications for new UV filters.
Bemotrizinol is the bedrock ingredient in nearly all European and Asian sunscreens, including those by the South Korean brand Beauty of Joseon and Bioré, a Japanese brand.
D’Ruiz said bemotrizinol could secure FDA approval by the end of 2025. If it does, he said, bemotrizinol would be the most vetted and safest sunscreen ingredient on the market, outperforming even the safety profiles of zinc oxide and titanium dioxide.
As Congress and the FDA debate, many Americans have taken to importing their own sunscreens from Asia or Europe, despite the risk of fake products.
“The sunscreen issue has gotten people to see that you can be unsafe if you’re too slow,” said Alex Tabarrok, a professor of economics at George Mason University. “The FDA is just incredibly slow. They’ve been looking at this now literally for 40 years. Congress has ordered them to do it, and they still haven’t done it.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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The Skincare Bible − by Dr. Anjali Mahto
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The subtitle claims this to be a “no-nonsense guide to great skin”, and while subtitle claims can often wildly overstate what’s being delivered, in this case, the book really is a no-nonsense guide to great skin.
The author is a dermatologist, and as such she speaks from her professional knowledge and experience, which is a lot more reliable than someone’s latest hack on TikTok.
She gives a quick crash course on what skin actually is and how it works, giving time to genetic considerations, cellular matters, and the grander-scale physical issues at hand, as well as what things affect it and how, ranging from diet to UV light to hormones and more.
We also get a clear explanation of regular skincare as well as specific skin concerns, ranging from minor inconveniences to skin cancer.
You may wonder if she covers anti-aging treatments, and yes, she does.
The style is (as indeed promised by the subtitle) no-nonsense, insofar as it’s straight to the point, no hype, and no padding, just plenty of information-dense content while still being very readable.
Bottom line: if you’d like to seriously look after your skin but aren’t a fan of every latest trend, this book will be a welcome guide.
Click here to check out The Skincare Bible, and enjoy great skin!
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