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Bottled water: WHO launches plastic health review

Media captionResearch led by journalism organisation Orb Media discovered an average of 10 plastic particles per litre

The World Health Organization is to launch a review into the potential risks of plastic in drinking water.

It will assess the latest research into the spread and impact of so-called microplastics – particles that are small enough to be ingested.

It comes after journalism organisation Orb Media found plastic particles in many major brands of bottled water.

There is no evidence that microplastics can undermine human health but the WHO wants to assess the state of knowledge.

  • Plastic particles found in bottled water

Bruce Gordon, coordinator of the WHO’s global work on water and sanitation, told BBC News that the key question was whether a lifetime of eating or drinking particles of plastic could have an effect.

“When we think about the composition of the plastic, whether there might be toxins in it, to what extent they might carry harmful constituents, what actually the particles might do in the body – there’s just not the research there to tell us.

“We normally have a ‘safe’ limit but to have a safe limit, to define that, we need to understand if these things are dangerous, and if they occur in water at concentrations that are dangerous.”

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Mr Gordon said that he did not want to alarm anyone, and also emphasised that a far greater waterborne threat comes in countries where supplies can be contaminated with sewage.

But he said he recognised that people hearing about the presence of microplastics in their drinking water would turn to the WHO for advice.

“The public are obviously going to be concerned about whether this is going to make them sick in the short term and the long term.”

The WHO initiative is partly in response to a study that screened more than 250 bottles of water from 11 different brands bought in nine countries – the largest investigation of its kind.

Image caption

A dye is used that binds to pieces of plastic

The tests were carried out at the State University of New York in Fredonia as part of a project involving original research and reporting by the US-based journalism organisation Orb Media.

Using a dye called Nile Red, which binds to free floating pieces of plastic, the university’s Prof Sherri Mason found an average of 10 plastic particles per litre of water, each larger than the size of a human hair.

Smaller particles assumed to be plastic but not positively identified were found as well – an average of 314 per litre.

Image copyright
Orb Media

Image caption

After filtration, the larger particles – yellow marks – are easy to see

Of all the bottles tested, 17 were found to have no particles at all while many had counts ranging into the hundreds or even thousands, with big differences within brands and even the same pack of bottles.

We contacted the companies behind the brands and most responded, standing by the quality and safety of their products.

A few questioned why the study’s results were so much higher than their own internal research or pointed out that there are no regulations on microplastics or agreed methods for testing for them.

The study comes on top of earlier investigations that have found microplastics in tap water, beer, sea salt and fish, and Prof Mason told me that researchers need to be able to answer the pressing question of whether microplastics can be harmful.

“What we do know is that some of these particles are big enough that, once ingested, they are probably excreted but along the way they can release chemicals that cause known human health impacts.

“Some of these particles are so incredibly small that they can actually make their way across the gastro-intestinal tract, across the lining and be carried throughout the body, and we don’t know the implications of what that means on our various organs and tissues.”

The UK’s Food Standards Agency said it was unlikely that the levels of microplastic reported in the bottles of water could cause harm but it added that, “it would assess any emerging information concerning microplastics in food and drink”.

For Dr Stephanie Wright of the King’s College Centre for Environment and Health, the priority is to understand how much microplastic we are exposed to, and exactly what happens to it inside us.

Researchers have established that tiny particles of titanium dioxide can pass through the lining of the gut so the same might be possible with plastic, raising the question of where it would then end up.

Dr Wright told me: “The particles could stay within an immune cell in the gut lining, or be passed into our lymphatic system ending up in the lymph nodes, or there is a small potential for them to enter the blood stream and possibly accumulate in the liver.

“These are foreign hard particles which our body will obviously want to get rid of but it can’t because plastic is not degradable so that will cause harm to the local tissue.

“But at the moment we don’t know.”

I suggested to Michael Walker, a consultant to the Office of the UK Government Chemist and founder board member of the Food Standards Agency, that the jury was out on whether microplastics could cause harm.

He replied: “The scientific literature says that not only is the jury not yet out on this question but the jury has not yet been convened on it.”

The full Orb Media report can be found at

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How Stephen Hawking Was Able to Live for So Long With ALS

Physicist, professor, and author Stephen Hawking died Wednesday at age 76, some five decades after being diagnosed at age 21 with amyotrophic lateral sclerosis, or ALS.

“ALS is a subset of a group of diseases called motor neuron diseases,” explains neurologist Heather A. Lau, MD, assistant professor in the department of neurology and director of the Lysosomal Storage Disease Program at NYU Langone Health. “ALS is typically a rapidly progressive neurologic disorder, progressing to death within a few years. Over time, you have progressive muscle weakness, which can include the muscles for swallowing and breathing.” 

RELATED: 5 Things You May Not Know About ALS

At the time he was diagnosed, Hawking was told he probably had about two years to live. As his condition worsened, he became confined to a wheelchair and was only able to communicate by using a single cheek muscle to control a computer system that facilitated his speech.

But rather than dying, he continued his world-renowned work for decades. That’s highly uncommon. Typically, people with ALS live just two to five years after they’re diagnosed, according to the ALS Association. Recent medical advances have extended that rate, with about 20% of patients now living five years or more and 10% living more than 10 years. 

But Hawking survived an extraordinary 55 years after his diagnosis and is thought to be the longest-living person with ALS. How did he do it?

A number of factors contribute to how long a person with ALS stays alive, Dr. Lau says. For starters, there are different forms of ALS, some of which progress more rapidly than others. While Dr. Lau has never treated Hawking, she hypothesizes that he could have had a form of ALS or another motor neuron disease that simply didn’t progress as quickly as a more typical presentation of ALS would.

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His lifespan could also be attributed to genetic factors that slowed the disease. In addition, ALS survival can depend on how the patient is cared for. “In this day and age, we are able to provide such wonderful support for breathing, for feeding, and physical therapy and rehab to maintain muscle strength,” says Dr. Lau.

While there is no cure for ALS, clinical trials suggest newer medications may further slow the disease. And because experts still don’t entirely understand what causes ALS, there may be other unknown factors that affect how long a person survives, Dr. Lau adds.

It’s easy to believe that Hawking’s impressive mind had something to do with his survival, but there’s no evidence that intellect plays any role in how ALS progresses, Dr. Lau says. Still, his genius may have helped him develop strong coping mechanisms, which enabled him to stay alive.

RELATED: 20 Celebrities Who Battled Depression

“He adapted, in a way, by harnessing or developing the aspect of him that was not degenerating,” she says. “He adapted to having what was initially a terminal diagnosis and was able to continue to contribute to his field, and that’s amazing. That speaks to his resilience.”

Hawking himself acknowledged the gravity of his diagnosis—and how he had pushed beyond it. “I have lived with the prospect of an early death for the last 49 years,” Hawking said in an interview with The Guardian in May 2011. “I’m not afraid of death, but I’m in no hurry to die. I have so much I want to do first.”

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This health start-up was throwing away employees’ candy — but says that was a step too far

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Child tantrum

Imagine bringing sodas or chocolate bars to work, only to have a fellow employee toss your junk food in the trash after spotting it in the kitchen.

That’s what was happening at a venture-backed start-up called Health IQ, and it was a policy that its workers wanted, according to CEO Munjal Shah. Health IQ’s careers page promoted an office with no sugar, candy bars or soda and said, “If you bring some it will get thrown away.”

But now the company is lightening up a bit, and this week toned down the rhetoric on its website. The change of heart came after a developer named David Heinemeier Hansson, who is the creator of Ruby on Rails, tweeted to his 280,000 followers over the weekend that he couldn’t work at Health IQ due to his candy bar habit.

“I did work out this morning,” he tweeted. “But I’m also going to eat a f—ing Twix today. I know, I know, not HealthIQ employee material.”

Commenters to the tweet responded by describing the culture as “cultish” and “fit supremacist.”

Health IQ, which sells life insurance to what it describes as “health conscious people,” was started by Shah after a health scare he experienced while at Google. The company wanted to create a culture with deeply ingrained health habits, including promoting regular use of the gym, which it said was “right in the middle of the office.”

Shah admits that Health IQ might have taken it too far, and acknowledged that the company did a poor job in communicating itself to the outside world. Health IQ’s “Join the Movement” page now says the following:

“We’ve received some feedback recently on our Careers page and how we describe our culture and workplace, and we realize we may have missed the mark.”

But Health IQ is far from alone among technology companies in pushing healthy behaviors to its employees.

Wellness is a growing trend in Silicon Valley and beyond, with many employers dangling financial rewards in exchange for employee participation in so-called “biometric screenings” or Fitbit challenges that encourage internal competition.

Workplace wellness: A way to save costs

Some employers are going even further and designing their offices with walking paths and additional stairs, said Jennifer Benz, founder of Benz Communications, a San Francisco-based firm that advises companies like Nvidia and Adobe on their benefits strategy. That’s in addition to subsidized gym memberships and organic, healthy food options.

For many employers, it’s worth the investment.

Health and wellness perks help with recruitment and retention, and there’s some evidence to suggest that they can lower costs for employers. When workers indulge in unhealthy habits and get chronically sick, lost productivity and expensive medical bills can quickly add up.

The flipside, particularly at companies that stress diversity, is that employees are in very different situations. Think about a new mother who’s juggling sleepless nights compared to a single developer just out of college. People also have varying dietary needs.

The Health IQ team.

Shah, who spoke with CNBC on Monday, said that his employees had input into the company’s policies and tested them for more than a year. The ban on sugar, he said, was suggested by one employee who had trouble resisting leftover birthday cake on the kitchen table. As an alternative, the company provides things like nuts, fruit and popcorn. Anyone can keep chocolate or other sweets at their desk.

The fundamental motivation is not to discriminate but to provide a more unified workplace, he said, by encouraging employees to take time during the day to meditate or take a walk. He said he would pay them for that time off for hourly and salaried employees.

Shah also said he’s putting more thought into the nuances and the potential unintended consequences of this type of culture. For example, studies have found that there’s a huge stigma at American workplaces against people who are overweight or obese and that companies with a significant focus on being healthy may be further alienating them.

For Shah, the company’s next chapter will involve a lot more inclusion.

Not that he’s getting rid of all the health hoopla. On its careers page, Health IQ still promotes mid-day yoga and fitness classes, healthy snacks and “weekly office-wide standups where each person spends ten seconds on what they’ve accomplished that week.”

Three Views of the Crisis in Women’s Health

Taken together, these three books tell an alarming story about how difficult it is for women to access quality care; particularly those women suffering from poorly understood autoimmune disorders.

This is hardly breaking news. One member of the feminist collective that produced the 1971 women’s health manual “Our Bodies, Ourselves” said that “everyone had a ‘doctor story’—that is, a tale about male physicians who were sexist, paternalistic, judgmental or simply unable to provide the information women needed.”


Abby Norman, author of “Ask Me About My Uterus.”

Tim Sullivan

These new “doctor stories” cut deep, especially in a moment when “believe women” has become a rallying cry. They feel linked to other instances of women’s voices being suppressed and belittled — in the accounts of assault and harassment emerging in the #MeToo moment, for example, or in the recent studies showing how frequently men interrupt women in meetings and how rarely women are quoted as experts. This is a crisis of authority, Dusenbery argues. Women are regarded as unreliable narrators who can’t even be trusted to speak for themselves or to testify to their own pain.

In “Doing Harm,” this cultural distrust of women — ancient and ingrained — is shown to govern quality of care at every stage of treatment. Women with abdominal pain wait in emergency rooms for 65 minutes compared with 49 minutes for men , and young women are seven times more likely to be sent home from a hospital while in the middle of a heart attack. Doctors rarely communicate (or understand) how drugs from aspirin to antidepressants affect women and men differently. Autoimmune disorders have been understudied because, as Hirsch points out, three-fourths of the patients are women and it is considered a woman’s ailment, never mind that 37 million people are afflicted, as estimated by the American Autoimmune Related Diseases Association. (In comparison, 15 million Americans have cancer.)

Women are consistently undertreated for pain, as one influential paper showed: Male patients are given pain relief while women, who are more likely to have their pain rated as “emotional,” are given sedatives. This also extends to children; a study of postoperative pain management found that boys were more likely to receive codeine and girls the gentler acetaminophen.

For women of color, especially black women, the situation is even more parlous. Black patients are 22 times less likely to get any kind of pain relief in emergency rooms. And Dusenbery reports on a disturbing 2016 study of more than 200 medical students who were presented absurd, made-up statements on race and medicine. Half gave credence to statements like: Black people have less sensitive nerve endings than white people.


Michele Lent Hirsch, author of “Invisible.”

Willy Somma

Addressing such entrenched inequities requires more than bringing more women doctors into the fold. As Norman learns the hard way in “Ask Me About My Uterus,” women doctors are not immune from implicit bias. Nor will a greater number of women doctors make up for the fact that, to this day, men are the default objects of study for research. A 2005 study found that almost 80 percent of animal pain studies used only males. A 1986 study on the influence of obesity on breast and uterine cancer infamously failed to enroll any women in the study.


Continue reading the main story

According to Virginia Woolf, writing about the sick body (“this monster,” “this miracle”) requires the courage of a lion tamer and the spirit of a philosopher.

Not all these books meet that exalted standard. But all three, despite their grim stories and projections, leave the reader galvanized, not despairing. Each of them ends on a similar note — calling for women to keep sharing their “doctor stories,” keep putting pressure on medical professionals to study women’s health and, in the meantime, for women themselves to learn how to advocate for their own care. Even as they recognize the burden that sick women must carry (Dusenbery: “Women should not be required to be more knowledgeable about women’s health than their doctors are”), they are each, in their own flawed, complicated way, the very intervention they seek.

Follow Parul Sehgal on Twitter: @parul_sehgal.

Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick
By Maya Dusenbery
390 pages. HarperOne/HarperCollins Publishers. $27.99.

Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain
By Abby Norman
272 pages. Nation Books. $27.

Invisible: How Young Women With Serious Health Issues Navigate Work, Relationships, and the Pressure to Seem Just Fine
By Michele Lent Hirsch
230 pages. Beacon Press. $26.95.

Continue reading the main story

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These antibiotics may endanger vascular health

A type of antibiotic used in treating bacterial infections has been tied to many adverse health events, leading specialists to advise caution in the prescription of these drugs. Recent evidence now confirms that they increase the risk of aortic disease, which is a condition that damages the main artery of the human body.

Fluoroquinolones, a type of antibiotic, could endanger vascular health.

Fluoroquinolones are a type of antibiotic sometimes prescribed in the treatment of various bacterial infections, from bacterial sinusitis to urinary tract infections.

Howevery, they have been flagged as bringing potentially dangerous side effects.

So, in 2016, the Food and Drug Administration (FDA) “approved safety labeling changes [...] to enhance warnings about their association with disabling and potentially permanent side effects and to limit their use.”

Recent longitudinal studies linked the use of these antibiotics with a significantly increased risk of aortic disease, which is a vascular condition wherein the aorta — the body’s main blood-carrying vessel — is affected.

Aortic disease is characterized either by aneurism (when the artery dilates) or dissection (when it ruptures), and both of these events can be life-threatening.

A new study — led by researchers from the Karolinska Institutet in Stockholm, Lund University (both of which are in Sweden), and the Statens Serum Institut in Copenhagen, Denmark — has now confirmed some of these worrying associations.

However, lead researcher Björn Pasternak — from the Department of Medicine at the Karolinska Institutet — says that there’s a ray of hope amid the general doom and gloom.

Our results confirm the findings in the previous studies but suggest that the increased risk is not as pronounced as indicated by those studies.”

Björn Pasternak

The findings have been published in The BMJ.

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Fluoroquinolones more than double risk

The researchers worked with data sourced from national health registers — the National Prescribed Drug Register, National Patient Register, Statistics Sweden, and Swedish Cause of Death Register — submitted between July 2006 and December 2013.

They compared the risk of aortic disease in 360,088 people treated with fluoroquinolones with the risk of developing this condition among an equal number of participants treated with a different type of antibiotic: amoxicillin.

The researchers’ analysis revealed a 66 percent higher risk of developing aortic aneurism or dissection among people who had been administered fluoroquinolone antibiotics.

“This increase,” the authors write, “corresponded to an absolute difference of 82 [...] cases of aortic aneurysm or dissection per 1 million treatment episodes [over a] 60-day risk period.”

They admit that — similarly to previous studies — the new research was of an observational nature, and therefore it was unable to establish that fluoroquinolones caused aortic disease.

Yet Pasternak argues that the study’s size and strong methodology mean that its results provide the most credible evidence unearthed to this point.

“Although the absolute risk increase was relatively small,” the researchers explain, “the study’s findings should be interpreted in the context of the widespread use of fluoroquinolones.”

Thank you for supporting Medical News Today

An underlying mechanism behind the link between fluoroquinolone use and aortic disease may be that these antibiotics “turn on” the activity of certain enzymes that can harm the integrity of internal tissue.

“One of the factors involved in the development of aortic disease is increased activity in tissue-degrading enzymes known as matrix metalloproteinases,” explains Pasternak.

“We know that fluoroquinolones induce the activity of these enzymes,” he adds, “which is also thought to underlie the more well-known adverse effect of tendon pain and rupture.”

Further studies should aim to clarify whether particular types of fluoroquinolone antibiotic are more harmful to vascular health than others. Also, more focus should be placed on understanding the biological mechanisms at play, the researchers conclude.

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Vulva health guide released to discourage ‘designer vaginas’

A new health guide has been released in an attempt to deter girls from undergoing cosmetic genital surgery.

In recent years, the amount of girls and young women opting to have labiaplasty operations in an effort to obtain “designer vaginas” has risen drastically.

In 2017, it was stated that the number of procedures had increased by 45 per cent from 2015 to 2016, with girls as young as nine reportedly going under the knife.

The new health guide, titled “So What Is A Vulva Anyway?”, has been commissioned by the British Society for Paediatric and Adolescent Gynaecology (BritSPAG)  in an attempt to educate girls and young women about the varying nature of the female anatomy and the risks involved with labiaplasties.

“We see many patients in our paediatric and adolescent gynaecology clinic who have a poor understanding of the function of parts of the anatomy and also of normal genital variation,” said Louise Williams, clinical nurse specialist at University College Hospital and co-lead of the project. 

“This educational resource will help young people to understand their vulva and how it develops during puberty, particularly if they are worried about how they look or feel. 

“We hope it will reassure young people that vulvas come in a variety of shapes and sizes, and if they need advice and support, they can know where to go.”

The health guide includes illustrations of a variety of vulvas, highlighting the fact that there is no normal way for a vulva to look.

It also provides detailed explanations for several anatomical terms, including the vulva, clitoris and labia.

Dr Naomi Crouch, chair of the BritSPAG, has said that during her work for the NHS, she has never come across a girl who has undergone the operation who actually needed it.

“There is absolutely no scientific evidence to support the practice of labiaplasty and the risk of harm is significant, particularly for teenagers who are still in stages of development both physically and psychologically,” she said.

“We hope this resource will provide information for girls and young women that their vulva is unique and will change throughout their life, and that this is entirely normal.”

The guide was launched at the Annual Update in Paediatric and Adolescent Gynaecology, a joint event by the Royal College of Obstetricians and Gynaecologists (RCOG) and BritSPAG.

According to the NHS, a labiaplasty in the UK can cost between £1,000 and £3,000, excluding the additional costs of consultations and follow-up care.

The potential risks involved with having a labiaplasty include bleeding, infection, scarring of tissue and reduced sensitivity in the genital area.

Additional reporting by PA

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  • Labiaplasty
  • Vaginal surgery
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NASA Twins Study Verifies Long-Term Health Effects of Space Travel

NASA’s Twins Study just hit another major milestone. The long-term investigation of Scott Kelly’s health after nearly a year in space shows that the early findings from 2017 were valid — with some new insights into possible health issues for future Mars travelers.

The astronaut spent 340 days on the International Space Station in 2015 to 2016, along with Russian crewmate Mikhail Kornienko. The milestone flight was the longest single flight of any American, providing investigators an opportunity to see how human health changes in nearly a year. 

But there was another advantage to using Scott as a test subject; he has a twin brother, Mark, who flew as an astronaut during the space shuttle program. So while Scott flew on the International Space Station, investigators collected data from him and from Mark, who remained on the ground. [Twins In Space: Astronauts Mark and Scott Kelly in Photos]

“The perfect nature versus nurture study was born,” NASA officials said in a statement.


A year in space is a long time by today’s standards, but investigators are preparing for future flights to Mars. That journey would likely take an astronaut close to three years. Seeing how Scott’s body reacted will provide one data point, but more information on the long-term health effects of space is needed before the journey can be made. So far, investigators know that bones and muscles weaken, fluids shift and in some cases, astronauts return with permanent eyesight changes. Countermeasures are being investigated.

The Twins Study went a step further, including surveying the brothers’ genomes and collecting data on Scott and Mark’s physical and psychological health. In the case of Scott, some of the changes to his body disappeared only a few hours or days after landing, while some remained after six months. Here are some of the major new findings:

  • Scott’s telomeres — or the ends of chromosomes that shorten as people get older — got a lot longer in space. This finding was known in 2017, but investigators confirmed it and also discovered that most of the telomeres got shorter again within two days of Scott’s landing.
  • About 7 percent of Scott’s genes may have longer-term changes after spaceflight, in areas such as DNA repair, the immune system, how bones are formed, hypoxia (an oxygen deficiency in the tissues) and hypercapnia (excessive carbon dioxide in the bloodstream). The other 93 percent of his genes quickly returned to normal.
  • Scott had no significant cognitive performance decline in space after one year, compared with Mark or with typical astronauts who fly a six-month mission. Investigators did, however, see pronounced decreases in Scott’s cognitive speed and accuracy after he landed. This might have happened because of “re-exposure and adjustment to Earth’s gravity, and the busy schedule that enveloped Scott after his mission,” NASA officials said.
  • The researchers also saw that spaceflight is linked with nutrient shifts, oxygen deprivation stress and more inflammation. They gathered the evidence after looking at “large numbers” of proteins (chains of amino acids), cytokines (substances secreted by cells in the immune system) and metabolites (substances related to metabolism) in Scott’s body.

“All of these findings are being integrated and summarized by the research teams; researchers are also evaluating the possible impact that these findings will have on future space travel beyond low Earth orbit,” NASA officials said.

More details will be released in an integrated summary paper that will be published later this year. NASA stated that “a series of smaller papers grouped by related research areas” will also be disclosed at a later time.

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Inside Tim McGraw’s Health Journey 10 Years After Going Sober—Including His Twice-Daily Workouts

In the 10 years since Tim McGraw decided to cut out alcohol, the country singer has completely revamped his life to focus on fitness.

McGraw — who had to cut his set short at the Country to Country festival in Dublin on Sunday after collapsing due to dehydration — went sober in 2008 after friends started to worry.

The country superstar, now 50, used to drink before every show to calm his nerves.

“It was exactly my process,” McGraw told PEOPLE in 2013. “Basically, I am an unsure, self-conscious, shy person. That is how I started — even when I was in college, before I would get on stage, I would start drinking. I would start drinking to stop shaking.”

And he would never have just one drink — it would always be in multiples. “It was a pattern for me, for sure,” he added.

RELATED: Thumbs Up! Tim McGraw Steps Out Smiling After Onstage Collapse During Ireland Show

Tim McGraw

Getting Help

His friends became the impetus for eliminating alcohol, but McGraw said he did it for Gracie, Maggie and Audrey, his daughters with wife of 21 years, fellow country star Faith Hill.

“People said things,” McGraw admitted. “People were worried about me … It wasn’t something that I didn’t know as well. But ultimately, it is really about how I want to be around for my kids. I want to be around to see how they grow up. I want to see what their lives become. I want to see what their kids look like.”

He added: “I felt like I had to change it. I felt like I had to change my life. And it wasn’t like I was out doing crazy things, it was just that I was drinking too much. You know, some people might look at it and say — hey, I drank twice as much as that. But for me, it adversely affected my life and it was time to change it.”

Working Out

McGraw cut out alcohol entirely, and focused on exercise, which he had been neglecting.

“That’s where my workout program came into play,” he said. “It took the place of alcohol and it is really important.”

An ideal day for McGraw is filled with two workouts a day, for up to two hours at a time.

“I do [the] elliptical. Or a treadmill. I will go back and forth between those two. On tour, I do that routine in the morning and in the afternoon, I do a CrossFit routine and all the guys in the band do it with me,” he told PEOPLE in 2013. “It is two hours in the morning and two hours in the afternoon. Sometimes it gets into three hours because we are loving what we are doing.”

And when he knows a busy couple of days are coming where he’ll have to go without a workout, McGraw will do a little extra.

“I try to work out every day,” he said. “Days like today — today I won’t have the chance to work out … But I know days are coming where I will have a chance to work out. Or I will go hard for hours knowing there will be days I don’t have a chance to work out. I try to keep it very constant.”

Tim McGraw

And now, instead of soothing his nerves with a drink before he goes on stage, McGraw will head out with his bandmates for a run.

“The ritual now is to run,” he said. “Me and a few of the guys in the band — I do my meet and greet and right after the meet and greet — we take off and run for 4 or 5 miles. It is literally timed so I run straight into the dressing room, get ready and hit the stage.”

“By the end of it, you are done,” he added. “You are exhausted. We work out in the morning, have a whole day, then we run and do the show. Our show is pretty high energy. Now at the end of the show, I have worn myself out.”

RELATED: What to Know About Dehydration, the Condition that Caused Tim McGraw to Collapse on Stage

McGraw said that feeling of exhaustion keeps him from drinking after the show.

“For so many years, I would go do the show and right before you finish the show, you would feel like you were just getting warmed up and you were just getting in gear and you wanted to go and do it another hour,” he said. “And I ran into a lot of problems after a show where you wanted to keep drinking and keep the party going after a show for a while.”

McGraw told PEOPLE in 2015 that his workouts are generally the same as they were two years prior, but he’s in the gym for a little less time.

“I’ll do a 30 minute walk on the treadmill to warm up,” he said. “[And] swimming, that’s my go-to workout. I mix it up. On the road, it’s more strict, we do CrossFit every afternoon and weights in the morning. But at home, I’ll mix it up, I’ll swim or I’ll lift one day or I’ll run.”

For more coverage, follow our country magazine on Flipboard.

Feeling Good

Between ditching alcohol and ramping up his exercise routine, McGraw unintentionally lost 40 lbs. in about two years.

Tim McGraw in 2008 (L) and 2018

“It wasn’t like I was trying to lose 40 pounds, I was just wanting to get healthy,” he said. “For me, it is more about feeling good and being where I want to be physically and on stage. When I am on stage in 98 degrees out there, you want to feel good. And my show isn’t stand out there and not move around.”

He wasn’t following any strict diet, however.

“I am going to eat a cheeseburger today. I love Coke. Not as much as I used to. I like to eat, I like food. That is one of the reasons that I throw that extra hour [of exercise] in,” McGraw said. “Sometimes you watch it, sometimes you don’t.”

RELATED: Tim McGraw Collapses During Ireland Concert Due to Dehydration

And he had no interest in cleansing.

“I don’t know if I could do the cleanse,” he said, laughing. “You don’t want to go for that last note of ‘Live Like You Were Dying’ and have something bad happening… like ‘Whoaaa… look out for the front row.’ ”

Overall, McGraw said he was in the best shape of his life.

“I think that I am firing pretty much on all cylinders,” he said. “I’m in a good place all the way around … I feel like I’m better than ever, better than I’ve ever been. I don’t feel like this is as good as it’s going to get … but I am better than ever.”

Faith Hill and Tim McGraw

He also recognized that his wife Hill saved his life. McGraw said that without her, “I’d be dead.”

“I would have partied too hard,” he said. “Faith saved my life in a lot of ways — from myself more than anything. I can go down a dark road sometimes, when you’re not feeling good about yourself, and she pulls me out. My wife makes me a better man.”

And in 2015, McGraw reiterated that he stays healthy for his kids.

“I just want to be around. I want to be around for my kids, I want to be around to see their kids, I want to be around to watch them grow up and do things,” he told PEOPLE. “And I feel like the best years I have are ahead of me. I want to be ready for them. I want to be ready for whatever life comes at me later on down the road.” 


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Legalize cannabis and other drugs to reduce crime and improve health

It is time to end the war on drugs and the social ailments that comes with it: crime, health issues, homelessness and premature deaths. We have the means to accomplish this, just legalize drugs and treat it as the health issue it is, which addiction is.

In 2001, Portugal decriminalized drugs much to the consternation of its critics and the warnings of chaos and ruin. However, in the 17 years since, Portugal has seen a drop in first-time users, especially in the 15- to 24-year age group, a decline in overall usage, a sharp decline in drug-related deaths and HIV infections, and a decline in imprisonment. Portugal also moved its drug control from law enforcement and the Justice Department to its Ministry of Health and created a public health model for treating drug addiction.

We have alcohol, gambling and other addictions, which are treated as health problems. This is where our money should be spent, which would create jobs and stop most drug-related crimes, and result in saving money by not tying up the court system, reduce overcrowding in jails, and reduce the workload of law enforcement while saving lives.

A couple of years ago, the Lancet and Johns Hopkins University reported that when Portugal and the Czech Republic decriminalized non-violent drug offenses, the results showed compelling health benefits, saved money and did not promote drug use. In another article, the former presidents of Mexico, Brazil and Colombia all said the war on drugs was “an unmitigated disaster.” The only thing the prohibition did was to make organized crime families and private prison industries wealthier, but did not help the afflicted.

The prohibition of alcohol did not stop the consumption of alcohol, but drove the production of it underground. Today, while legal, it still kills both the drinker and those unfortunate enough to be in their driven path.

The most recent reports show that Australia, Canada, Chile, Colombia, Costa Rica, India, Israel, Jamaica, Mexico, the Netherlands, South Africa, Spain, Uruguay, and the Czech Republic are following the trail led by Portugal.

If we were to legalize cannabis/drugs, where would the push back come from? Follow the money and it will lead you to drug cartels, the private prison industry, most law enforcement agencies that benefit from asset forfeiture laws, drug companies, religious and rehab organizations, and politicians who worry about their next election. A platform of crippling the drug cartels, saving lives, stopping most related crimes and a lot of homelessness looks like a candidate I would vote for.

The modern-day policing was founded in 1829 by Sir Robert Peel, whose policing principles included preventing crime, not catching criminals. “If the police stop crime before it happens, we don’t have to punish citizens or suppress their rights. An effective police department doesn’t have high arrests stats; its community has low crime rates.”

There is a large and growing coalition among law enforcement who organized to bring about a change in our drug laws. Law Enforcement Action Partnership (L.E.A.P.) is a group of more than 5,000 former police, judges, prosecutors, and other criminal justice professionals and more than 100,000 supporters as of 2017 using their expertise to find solutions to our country’s drug problem while enhancing public safety.

L.E.A.P.’s initial focus was on ending the war on drugs, but has expanded to include improving police-community relations, reducing crime and violence associated with the war on drugs, reducing and finding alternatives to incarceration, improving public health policies to lessen the negative social and physical consequences associated with drug abuse.

We have the answer to this problem, but do we have the public and political will to do so? It is time for a change. What we are doing is not working and is, instead, promoting a killing field of our young.

Larry Russell lives in Round Mountain.

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Lots of talk, little action on curbing health care costs

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