6 Ways To Tone Your Entire Bod Using Just A Resistance Band

Not only are resistance bands a great toning tool, but you can take them anywhere because they're light and super compact. They're also a smart transition to using weights.

For this workout, try to do 10-12 repetitions of each move using a band that challenges you. (Try this Adjustable Resistance Tube, $8, ) Bands usually come with a light, medium, and heavy option, so choose the best match for your fitness level (and switch to a heavier one as you get stronger). Try to flow from one exercise to the next without taking a break.

(The Slim, Sexy, Strong Workout DVD is the fast, flexible workout you've been waiting for!)​

To start, step on the center of the band with one leg and then step forward with your other leg. Lean your torso forward and keep reaching out through the top of your head all the way down to your tailbone. Try not to hunch over, and make sure to keep tension on your band the whole time. This will be your base posture throughout all six of these moves:

The 1-Hour Workout That Gets Ciara THIS Bod

The singer — who gave birth to a son in May — recently appeared on MTV’s House of Style and continues to work with Degree Women for the brand’s Do More campaign. Users can search for fitness classes and view behind-the-scenes rehearsal footage on Degree’s web site

“As a hardworking woman, I’m always trying to figure out how I can get better and improve at everything I do," explains Ciara. "I really love being able to share this message with other women and encourage them to keep pursuing their dreams.”

 

 

 

 

At a Degree Women press event, Ciara gave Everyday Health the scoop on how she stays fit, healthy, and gorgeous while trying to juggle a packed schedule. 

On her fitness regimen: “I work out an hour a day. That’s all you need — the rest of it’s all about how you eat,” says Ciara. “When I train with Gunnar [Peterson], we do a mix of plyometric moving and weight training because you want a good balance of cardio, while still maintaining your muscle.”

 

 

 

On eating right: “For breakfast, I love an egg white omelet with spinach and turkey. I’ll also have a side of fruit and wheat toast,” she says. If she gets a late-night craving, Ciara satiates herself with chocolate Ensure protein shakes. “Sometimes I get hungry before I go to bed — I’ll drink one of these and it holds me over until the morning.” 

On how she motivates herself before a performance: “I think about what it is that I want to do onstage and how great I want the show to be,” she says. “I pray, stretch, jump, and move around to get my body warmed up.”

On maintaining her glow: “When I wake up, I wash my face with my dermatologist’s [Dr. Sabena Toor] foaming cleanser, which is made with organic ingredients,” says Ciara. “Then I put vitamin C and Revisions tinted moisturizer all over my face. I do that twice a day.”

When’s The Best Time to Exercise?

Ask the Fitness Expert,  Jennifer Bayliss

Q: What’s the best time of day to exercise?

A: The best time of day to exercise is the time that works best for you. Studies go back and forth on this topic and there are benefits in exercising in the morning and later in the day. Ultimately, it comes down to personal preference and lifestyle. Choose a time that helps you make exercise a regular and consistent part of your routine. Here’s why:

It’s all about finding your rhythm.
Ever wonder why some of us are morning people while others are not? This has quite a bit to do with your body’s internal clock, or your circadian rhythms. Circadian rhythms are a daily cycle of sleep and wake cycles. It’s this cycle that regulates physical, mental, and behavioral changes within a 24-hour period. Body temperature, blood pressure, and metabolism are some of the physiological processes that can be affected by your body’s internal clock. These rhythms respond to changes in the environment and can be set and reset. The changes in the environment that can have an effect on circadian rhythms include lightness and darkness, temperatures within the environment, artificial light, the use of an alarm clock to wake, timing of meals, and time of day you exercise. Your personal clock can affect what time of day you prefer to exercise. So, are you a morning person or a night owl?

If you’re a morning person…
It’s a no brainer: You should workout in the AM. Research suggests that those who exercise in the morning tend to be more consistent with their exercise routine. The idea is you’ll get your workout in before any other events or distractions of the day interfere, thus setting yourself up for success. People who exercise earlier in the day generally find they can manage their time better and they feel more energized throughout the day. If you do exercise in the morning, make sure to give yourself a little extra warm-up time to get your body temperature elevated and your muscles warm. Some people have trouble exercising in the morning because of dizziness, fatigue, or lightheadedness experienced when working out on an empty stomach. If that happens to you, try having a small snack, such as a banana or a serving of low-fat yogurt, prior to exercise.

If you’re a night owl…
Afternoon or evening exercise can be the perfect way to unwind. Some people find that afternoon or evening workouts are more productive and help relieve some of the stresses of the day. For others, exercise in the morning doesn’t feel good because, when you wake up, your muscles may feel tight and your blood sugars may be low. Afternoon or evening workouts may just seem that much better because you are more alert, your body temperature is naturally elevated, and your muscles are warm and flexible. You also have the added benefit of having had the opportunity to get some food in your system which can help you feel more energized during your workout.

Whether you exercise for weight loss, stress relief, or one of the many other health benefits, it is important to be consistent. Schedule that time for exercise based on what works best for you — morning, noon, or afternoon. Your body’s internal clock will reset itself and your sleep habits and changes to meal times will either fall into place or can be adjusted based on when you decide to work up a sweat!

Do you have a fitness question for us? Leave a comment below!

Jennifer Bayliss is a fitness expert and coach at Everyday Health. She is a certified strength and conditioning specialist through the National Strength and Conditioning Association, a AFAAcertified personal trainer, and holds both an undergraduate and a graduate degree in exercise science.

potting Between Periods: Should You Worry?

leeding between your periods, or “spotting,” can occur for many reasons.

The cause is usually benign; for example, hormonal fluctuations that occur at the very beginning of your reproductive life cycle (menarche, the onset of periods) or toward the end (menopause, when periods stop) are often likely culprits.

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But “spotting is never normal," says Joyce Gottesfeld, MD, an ob/gyn at Kaiser Permanente Colorado in Denver. "It doesn't necessarily mean that something bad is going on, but it's not normal.” So if you do notice spotting, it's worth a call to your physician to get it checked out.

When investigating why you’re spotting, healthcare providers consider your age and whether you’re pregnant, have been having unprotected sex, or recently started using a hormonal contraceptive.

 

 

If you’ve started taking the birth control pill or gotten a progesterone implant, it’s not unusual to experience irregular bleeding. If spotting doesn't taper off, talk to your doctor. “You're probably going to want to change birth control pills, because nobody wants to deal with that all the time,” Dr. Gottesfeld says.

Skipping a pill or two may also bring on spotting. “If you're on birth control pills and you missed a pill, that can also make you have bleeding between your cycles, and I wouldn't be so worried,” says Anne C. Ford, MD, associate professor of obstetrics and gynecology at the Duke University School of Medicine in Durham, North Carolina.

Spotting in the Early Years

Spotting can mean different things at early versus later stages of your reproductive cycle.

When you first start having your period, it may be quite irregular for months or even years. This is because your brain, ovaries, and uterus are still working on getting in sync hormonally. Unless your bleeding is excessively heavy or prolonged, it's usually not a problem, according to Dr. Ford.

Once you become sexually active, spotting after intercourse raises a red flag. This is especially true if you’re having unprotected sex or have just started having sex with a new partner.

Bleeding can signal a sexually transmitted infection (STI), such as chlamydia orgonorrhea, that should be treated promptly, Ford says. “Often, the cervix can be very friable [eroded] or just bleed very easily from the infection,” she explains.

Another condition that can lead to post-sex bleeding is cervical entropion, in which the fragile glandular cells lining the cervical opening grow on the surface of the uterus.

Much more rarely, post-sex spotting can be a sign of cervical cancer. Your doctor can take a Pap smear, a sample of cells from your cervix — the opening of the uterus at the top of the vagina — to test for STIs and abnormal precancerous or cancerous cells.

Mid-cycle bleeding could also mean that you’re pregnant and could be miscarrying, although spotting during pregnancy doesn't always mean the pregnancy will be lost. Ectopic pregnancy, in which a fertilized egg grows outside of the uterus (usually within the fallopian tubes), can also cause bleeding, according to the American Congress of Obstetricians and Gynecologists (ACOG). 

Spotting may also be due to vaginal trauma. “The vagina and the cervix are very vascular [they have a lot blood vessels], so they bleed very easily,” says Lisa Dabney, MD, an ob/gyn in the division of urogynecology at Mount Sinai West in New York City. “A scratch in the vagina will always bleed more than a scratch in your regular skin would.”

Bleeding Between Periods in the Middle Years

Once you reach your thirties, the chance that spotting could indicate endometrial cancer, a type of cancer of the uterus, increases. Obesity also boosts your risk of endometrial cancer, even if you’re a younger woman. “We're seeing more and more endometrial pathology like that because of the obesity epidemic. We have to worry about that in very obese women, even if they're younger,” Ford says.

Spotting “definitely becomes more worrisome after the age of 35, because it could be an early sign of endometrial cancer,” Dr. Dabney says. “Hormonal changes, fibroids, and polyps are far more common than endometrial cancer. It's probably one of those things, but unless you have it evaluated, you don't know if you're that one in 1,000 people who has the cancer.”

Fibroids, benign growths that can form in your uterus, are more likely to cause irregular bleeding if they grow into the uterine lining. Polyps, another type of benign growth, can also grow in the uterus or on the cervix and may cause bleeding. Bothfibroids and polyps can be removed surgically.

Endometrial hyperplasia, in which the lining of the uterus grows too thick, can also cause abnormal bleeding. While this condition is benign, it can be a precursor to cancer in some cases, according to ACOG.

If your doctor suspects you may have endometrial cancer, he or she will take a sample of tissue from the endometrium so that the cells can be examined under a microscope. Other tests, such as an ultrasound, may be used to determine if bleeding is related to polyps or fibroids.

The long march toward menopause — which officially occurs when a woman has not menstruated for a full year — begins for most women during their fourth decade. As your ovaries begin winding down egg production, your period is likely to become irregular. You may skip a cycle here or there, have your periods unusually close together, or experience heavy bleeding.

 

 

“As people's ovaries start to age, you can see mid-cycle spotting,” Ford says. “That's very normal and it comes from fluctuating hormone levels.” It can be hard to tell what's normal and what's not during this tricky time of life, according to Ford. “If your normal period was 3 to 5 days and now you're bleeding 7 to 10 days and it's heavy, then it's probably not a normal period.”

10 Ways to Live Better With Psoriasis

The keys to successful psoriasis management are working with your doctor to find a treatment plan that’s right for you and then sticking to that plan. But your role in treatment doesn’t stop with medication. Making certain lifestyle changes is important, too.

From the foods you eat to the support you seek, making healthy choices every day can help you ease the discomfort of flaky, red itchy skin, avoid flares, and start living life to the fullest. Follow these 10 steps.  

1. Eat an anti-inflammatory diet. Despite extensive research, there’s no evidence supporting a specific “psoriasis diet,” says Caitríona Ryan, MD, a dermatologist at Texas Dermatology Associates in Dallas and vice chair of the dermatology residency program at Baylor University Medical Center. However, many people with psoriasis report feeling better when they avoid foods that have been shown to cause or increase inflammation (such as fatty red meats, processed foods, refined sugar, and nightshade vegetables) and embrace foods that are known to reduce inflammation. Inflammation-fighting foods include those rich in omega-3s, such as salmon, albacore tuna, flaxseeds, and walnuts, and colorful fruits and vegetables, such as spinach, carrots, and blueberries, according to the National Psoriasis Foundation (NPF). 

2. Maintain a healthy weight. People who are overweight tend to have more severe psoriasis, according to a study published in November 2012 in Clinical & Experimental Dermatology Research. “We know that adipose tissue (fat) produces inflammatory cytokines like tumor necrosis factor (TNF),” Dr. Ryan says. Overproduction of TNF, a cell signaling protein, can trigger psoriasis. In addition, systemic and biologic agents for treating psoriasis tend to work better in patients who aren’t overweight, she says.

3. Aim for 30 minutes of exercise most days. Physical activity goes along when it comes to maintaining a healthy weight and lowering your risk for comorbid conditions — such as your risk for heart disease and type 2 diabetes, which increase when you have psoriasis. Try to get at least 30 minutes of aerobic exercise five times a week, and add in some strength training. Although a study published in 2012 in the Archives of Dermatology showed that women who exercised vigorously lowered their risk of developing psoriasis, any level of exercise is better than none, says the NPF. That may mean simply taking the stairs at work instead of the elevator or parking farther away in parking lots.

4. Quit smoking and drinking too much. Neither of these habits is good for anyone, says Mark Lebwohl, MD, a professor and chairman of the department of dermatology at Icahn School of Medicine at Mount Sinai in New York. But they may be even worse for people with psoriasis, he says. The chemicals in tobacco may trigger inflammation that can both cause psoriasis and make flares more severe, according to the NPF. In addition, excessive alcohol consumption may interfere with your response to psoriasis treatment and make it less effective. If you need help quitting smoking or drinking excessively, talk to your doctor.

5. Arm yourself with moisturizer to fight dry skin. “The skin of people with psoriasis is very dry,” Dr. Lebwohl says. “Moisturizing makes it feel better.” Apply moisturizer after showering and after washing your hands. The thicker the moisturizer the better — creams and ointments lock more moisture in your skin.

6. Avoid illness. “Infections worsen psoriasis — even mild colds or urinary tract infections,” Ryan says. “So keeping healthy is rather important.” To stay healthy, eat well, wash your hands frequently, get quality sleep, and be sure your immunizations are up to date. Also be sure to get a flu shot before the start of the flu season.

7. Avoid injuries, too. Some people can develop lesions in new areas if their skin is cut, bruised, or burned, according to The Psoriasis and Psoriatic Arthritis Alliance (PAPAA). Try not to scratch, Ryan says. Be sure to protect your hands and skin when doing activities that could lead to injury such as household chores in the kitchen or pruning bushes in the garden.

8. Cut back on stress. Stressed out? Like most inflammatory conditions, too much tension can cause psoriasis to flare or can exacerbate lesions, according to the NPF. If you’re feeling overextended, look for ways to reduce stress in your life — be it meditation, exercise, or talking to a therapist.

9. Reach out for support. “There are a lot of benefits to support groups,” Lebwohl says. Whether the groups meet online or in person, people with psoriasis often share tips that work well for them and that can help others in their group, Lebwohl says. And sometimes, it helps just having someone listen to you who understands what you’re going through.

10. Stick to your treatment plan—even when you feel good. “Many patients think they’re better off minimizing treatment,” Lebwohl says. They stop taking their medication or go longer than they should between injections. But if you want to avoid flares, you need to stick to the plan. Says the NPF: Using your treatments as prescribed makes a big difference in how well they work.

11 Struggles Every New Runner Understands

I've never been one of those people. You know the kind, the ones who wake up in the morning or lace up in the evening and "go for a run."

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I've always been envious of my roommates, who can sneak in a jog with ease and carry on with their day, as if they had done something casually simple like taking the trash out. So, I made a vow to give running another chance. After all, the exercise has been shown to make you happier, reduce your risk for disease and even increase longevity.

While group classes and long walks will probably always be more my speed, I did find that I was enjoying running more than I ever did in the past. However, that doesn't come without a few hiccups. Below are a handful of struggles all new runners can probably relate to.

Getting winded in the first few minutes.

Probably one of the most discouraging elements of getting into a running routine is realizing that you're not as in shape as you thought you were. I continuously find myself doing more walking or jogging than actual running. But just because you need those intermittent breaks doesn't mean you aren't a runner. In fact, research shows that walking intervals during your run can help you maintain your overall pace.

Two words: Sore. Muscles.

The second-day pain is real. If you're experiencing those achy muscles, try one of these post-run remedies. Just make sure you're checking in with your body as you establish your routine. A little soreness is OK, but if the pain is more intense you may have sustained a running-related injury.

 

 

Feeling overwhelmed by the copious amount of races.

Color runs, beer runs, zombie runs, princess half marathons... the list is seriously endless. However, there are some perks to picking a race. Signing up for one helps you set a goal as you get into a routine, plus there's an opportunity to turn it into a social event by participating with your friends.

If your goal is to become a marathon runner (and props to you!), there are also some benefits there: Research shows consistent long-distance running can improve cardiovascular health and lower the risk for other organ disorders, the Wall Street Journal reported.

The jolting agony of waking up at 6 a.m.

My sleepy brain is constantly telling me my bed feels better than running (and often, the bed wins). If you need a little extra motivation, try one of these hacks to help you jumpstart your morning workout.

The boredom.

Part of the reason I never got into a routine in the first place was because the exercise itself seemed extremely dull to me (the treadmill is my arch-nemesis). Once I discovered more running-path options, I started to have more fun. However, that's not to say that I don't get a little bored sometimes — and that's OK.

Note: If you still just can't get excited by the process most of the time, you may want to try a more entertaining workout option instead. Exercise should be engaging, not mind-numbing.

Trying to find your perfect route.

Finding your favorite place to run is like finding a good apartment: It feels elusive until one day you hit the lottery. Whether you're into lush scenery or a skyline, it's important to find the routes that work for you in order to make the exercise entertaining.

The joy of picking out new workout clothes.

Sleek tanks! Compression pants! Neon shoes!

Running toward (multiple) "finish lines."

If you've ever uttered to yourself just one more pole, you're not alone. In fact, picking out an arbitrary finish line on your run can improve your performance. Research shows those who stare at a target in the distance go faster and feel less exertion than those who don't concentrate on anything, The Atlantic reported.

 

 

Bargaining with yourself on your run.

If you run five more blocks, you can binge-watch Scandal when you get home, I tell myself. Chances are I'd probably do it anyway — but at least it encourages me in the moment.

Creating a playlist that will consistently keep you motivated.

No, a simple music-streaming app won't do when your lungs are on fire and your legs feel weak. You need that one specific song that will inspire you to keep going (shout out to all my Shake It Off comrades). If you're looking for a playlist to spice up your run, check out some of these.

Eating Well As You Age

Looking in the mirror for changes as you age? A healthy diet helps to ensure that you'll like the reflection you see. Good nutrition is linked to healthy aging on many levels: It can keep you energized and active as well as fight against slowing metabolism and digestion and the gradual loss of muscle mass and healthy bone as you age.

Making healthy diet choices can help you prevent or better manage chronic conditions such as high blood pressure, high cholesterol, and diabetes. It's never too late to adopt healthier eating habits.

Strategies for Healthy Eating as You Age

Replace old eating habits with these healthy approaches:

  • Eat every three or four hours. “This keeps energy levels high and keeps appetite hormones in check to avoid overeating,” says Kim Larson, RD, of Total Health in Seattle and a spokesperson for the Academy of Nutrition and Dietetics.
  • Eat protein at each meal. Aim for 20 to 30 grams to help maintain muscle mass. Choose fish at least twice a week as a source of high quality protein. Other good sources of protein include lean meat and poultry, eggs, beans, nuts, and seeds.
  • Choose whole grains. Replace refined flour products with whole grains for more nutrients and fiber.
  • Choose low-fat dairy. Cutting out the saturated fat may help lower your risk for heart disease.
  • Learn about portion sizes. You may need to scale back on the serving sizes of foods to control your weight.
  • Choose nutrient-rich whole foods over empty calories. Whole foods are those closest to their natural state. Empty calories are typically processed foods with added salt, sugar, and fat. For example, snack on whole fruit instead of cookies.
  • Eat a “rainbow” of foods. “Eat five to seven servings of fruits and veggies each day to keep antioxidants like vitamins A, C, and E high,” Larson says. Choosing fruits and vegetables of different colors provides your body with a wide range of nutrients. According to research published in the May 2012 issue of the Journal of the American Geriatric Societyexercise coupled with higher fruit and vegetable intake led to longer lives. Fruits and veggies also fill you up with fiber, which cuts down on snacking and helps control weight, Larson says.
  • Choose healthy cooking techniques. Try steaming, baking, roasting, or sautéing food rather than frying it to cut back on fat.
  • Cut down on salt. If you’re over 51, national recommendations are to eat less than 1,500 milligrams of salt per day. Look for low-sodium foods and season your meals with herbs and spices rather than salt.
  • Stay hydrated. “Dehydration can cause irritability, fatigue, confusion, and urinary tract infections,” Larson says. Be sure to drink plenty of water and other non-caffeinated liquids throughout the day.
  • Ask about supplements. You may have changing nutrient needs as you get older and might benefit from vitamins B12 and D, calcium, and omega-3 fatty acid supplements, Larson says. Ask your doctor or a dietitian for guidance.

Overcoming Challenges to Healthy Eating

Eating a healthy diet can be complicated by changes you may face as you age, such as difficulty eating or a limited budget. There are strategies you can try to solve these common challenges:

  • If you've lost your appetite or sense of taste: Try new recipes and flavors — adding spices, herbs, and lemon juice can make foods more appealing. If you take medication, ask your doctor if appetite or taste changes are side effects and if switching to another drug might help.
  • If you have a hard time swallowing or chewing: Choose foods that are moist and easy to eat, such as nutritious soups made with beans and vegetables, Larson says.
  • If affording groceries is difficult: Shop from a list — careful planning can help you make the healthiest and most cost-effective food choices. Use coupons or shop on days when discounts are offered. Buying fruits and veggies when they’re in season and frozen produce in bulk can also help control expenses.
  • If you have trouble preparing meals: Consider buying healthy prepared or semi-prepared meals or at least pre-cut ingredients to cut down on energy-draining prep time.

Larson believes in the importance of enjoying your food. Make healthy-diet changes step by step and have fun experimenting to find new tastes and cooking styles. Eat slowly and pay attention to the experience. “Create a pleasant eatingenvironment," she says. "Sit by a window and enjoy every bite.”

What You Need to Know About Hyperpigmentation

Even small skin traumas like a pimple or bug bite can leave you with complexion-busting dark spots. “This is one of the most common ailments that patients come to see me about,” explains Jeanine Downie, MD, director of Image Dermatology in Montclair, New Jersey. “It’s an annoying condition that affects all skin types, but the good news is that it’s fairly easy to treat.”

Find out how Dr. Downie helps patients treat and avoid marks on their complexions.

Everyday Health: What causes hyperpigmentation?

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Jeanine Downie: Any trauma or inflammation to the skin — either from acne, pimples, bug bites, or simply a bump, cut, or scratch — disrupts the surface layers where you have melanin, responsible for skin’s color. As the skin heals, it leaves behind residual pigmentation and dark spots.

 

 

 

EH: Is there anything you can do to prevent it?

JD: Unfortunately, if you’re prone to these dark spots, it’s tough to prevent them. Still, picking or scratching at an irritation will further traumatize the area, so hands off! You’ll also want to be vigilant about wearing sunscreen. As your skin gets darker, so will those hyperpigmented areas — it’s not like a tan is going to even out the color. Obviously, daily sunscreen wear is a must anyway, but this is just one more reason to protect your skin from UV rays.

EH: What steps can you take to treat it?

JD: The sooner you start taking care of your wound, the better it’ll look once healed. I recommend keeping the wound covered, especially if the skin is broken, and applying a topical healing ointment.

 

 

For large cysts or cuts, you may even want to see your dermatologist for a treatment plan. Once the pimple or cut has healed, apply 2% hydroquinone cream, which is available over-the-counter, or 4% hydroquinone, available by prescription from your doctor.

If the topical creams don’t quite do the trick, talk to your dermatologist about chemical peels or laser treatments to completely eliminate more stubborn discoloration.

EH: Is hyperpigmentation more common in people with darker complexions?

JD: No matter your skin color, everyone is susceptible to hyperpigmentation. Still, those with darker complexions seem to hold on to those spots for much longer because they have more melanin in their skin. It also means those hyperpigmented areas are going to be darker and more visible as well. Pregnancy and certain medications can increase your body’s production of melanin, and lead to hyperpigmentation as well.

6 Ways to Prep Your Skin for Summer

Scheduling vacation plans and buying a new swimsuit will mentally prepare you for summer, but your skin may need some help getting ready, too. For gorgeous, smooth skin you'll feel ready to bare, you need to take a few simple steps. Try this head-to-toe refresher to take your skin out of hibernation.

1. Reveal Glowing Skin

Regular exfoliation can be a part of a healthy skin regimen no matter the season; as long as your skin is not sensitive, exfoliation can help you achieve smooth, healthy-looking skin that makes you look more glowing and youthful. “But it must be done with care,” says Doris Day, MD, a dermatologist in New York City. “The goal is to lift off the outer layer of skin cells that are ready to be sloughed off without stripping the skin.”

 

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Brushes, polishing cloths, and scrubs offer easy ways to smooth away rough spots. Rotating cleansing brushes work by physically buffing off the dead skin cells. Exfoliating cloths, microdermabrasion kits, and scrubs with granular ingredients also operate the same way. “For the body, look for a scrub that contains coarse particles that dissolve over time, like sugar, so you don’t irritate the skin,” says Dr. Day.

Products that chemically exfoliate the skin contain ingredients such as glycolic, salicylic, or polyhydroxy acids that cause the skin to shed its outer layer and reveal the newer layer.

2. Remove Hair Without Irritation

If your summer forecast calls for sunny days at the beach or poolside, you may be putting some effort into removing unwanted hair. But once you rip off the wax strip, it’s also important to care for the skin that’s newly exposed to the elements.

Give your skin some time to recover before rolling out your beach towel or getting active outdoors. “I advise clients to stay out of the sun or heat for at least 48 hours after any hair-removal process,” says Cindy Barshop, owner of Completely Bare spas. “Follicles are vulnerable to irritation, and skin may be sensitive due to any heat or friction from lasers, waxing, or shaving.”

Since most of us don’t plan our hair removal that far in advance, buffer your tender skin with an oil-free sunscreen, wait for it to dry (about 5 minutes), and dust on some talc-free baby powder, says Barshop. To prevent ingrown hairs, it’s helpful to wear loose-fitting clothing and use an after-waxing product that contains glycolic and salicylic acids, which team up to prevent dead skin cells from causing bothersome bumps.

 

 

3. Fight UV Rays With Food

All the work you put into making your skin look good won’t be worth it unless you guard it from the sun’s damaging rays, which are strongest during the summer. Surprisingly, you can protect yourself from the inside, too. “In addition to usingsunscreen, eat cooked tomatoes every day if you know you’re going to be in the sun,” says Jessica Wu, MD, assistant clinical professor of dermatology at USC Medical School. According to research, cooked tomatoes are rich in lycopene, an antioxidant that helps fight the effects of UV rays such as redness, swelling, and blistering from sunburn. If you plan to spend a lot of time outdoors, you may benefit from consuming tomato sauce, grilled tomatoes, or even Bloody Marys. “This doesn’t replace sunscreen, but the habit could give you additional protection if you can’t reach your back and miss a spot,” Dr. Wu adds.

4. Clear Up Body Breakouts

It’s no better to have acne on your body than on the face, especially in the heat, when hiding and covering up isn’t an option. The approach to treating acne on the back, chest, and elsewhere on the body is the same as treating facial acne: “Exfoliate regularly, don’t pick, and treat with effective ingredients,” says Day.

Washing with products that contain salicylic acid helps slough off the dead skin cells; a treatment product with micronized benzoyl peroxide can also help by penetrating the skin and killing off the bacteria that cause acne.

If your skin is sensitive, investing in an acne-treating blue light tool may be worth the cost. “You simply wave the light wand over skin for five minutes daily and it helps kill bacteria,” says Leslie Baumann, MD, a dermatologist in Miami. If you have severe body acne, see a dermatologist.

5. Erase Cellulite

First, the good news: Some products may be able to smooth out the undesirable dimples and unevenness of cellulite. The bad news: They won’t get rid of cellulite forever. The smoothing and toning effect, like many good things in life, is fleeting. Still, it may be worth slathering on a toning body lotion to make your skin look and feel tighter for a day at the beach or a special event.

“Products that contain caffeine and theophylline temporarily dehydrate fat cells,” says Dr. Baumann. “However, it’s the massage and the application of the cream that does the work.” The best course of action long-term is to exercise regularly, coupled with targeted massage, suggests Baumann.

Another way to hide cellulite is to apply a fake tan. Take advantage of the newest self-tanners, which have come a long way from the strong-smelling streaky creams or sprays of yesteryear. “There has been so much progress in the formulations — the colors are natural, there’s no streaking, and the scent is so much better,” says Day.

6. Treat Your Feet

If you’ve stuffed your feet inside boots all winter, they probably could use a little TLC for sandal weather. Jump-start your program with a salon pedicure, or if you’re short on time, you can heed Day’s DIY tip, which will help soften feet while you sleep. First, remove thicker skin with a foot file. Apply a rich emollient cream or ointment, then cover the feet in plastic wrap and cotton socks. Leave on overnight. Repeat every day until you achieve smooth skin, then once a week to maintain soft skin.

7 Healthy Habits of the 2016 Presidential Candidates

The New Hampshire primary's in full swing, and if there’s one thing all the presidential hopefuls can agree on, it’s that running for office is the ultimate endurance challenge. They’re canvassing across the country with little time to exercise or sleep, and it doesn’t help that at every stop they’re tempted by unhealthy foods like pizza, pork chops, and pies. So how do the presidential candidates stay healthy and keep their energy levels up during the grueling primary season? Read on to find out!

What Is Guillain-Barré Syndrome?

Guillain-Barré syndrome (GBS) is an illness that can result in muscle weakness or loss of muscle function in parts of the body.

In people with Guillain-Barré syndrome (pronounced GHEE-yan ba-RAY), the body's own immune system attacks the peripheral nervous system.

The peripheral nervous system includes the nerves that connect the brain and spinal cord to the limbs. These nerves help control muscle movement.

GBS Prevalence

Guillain-Barré syndrome is a rare disease.

The Centers for Disease Control and Prevention (CDC) estimates that about 1 or 2 out of every 100,000 people develop GBS each year in the United States.

Anyone can get GBS, but the condition is more common in adults than in children, and more men than women are diagnosed with GBS each year.

Causes and Risk Factors

Doctors don't know what causes Guillain-Barré syndrome.

Many people with GBS report a bacterial or viral infection (such as the flu) days or weeks before GBS symptoms start.

Less common triggers for GBS may include:

  • Immunizations
  • Surgery
  • Trauma

Guillain-Barré syndrome is not contagious — it cannot spread from one person to another.

Types of GBS

There are several types of Guillain-Barré syndrome, which are characterized by what part of the nerve cell is damaged.

The most common type of GBS is called acute inflammatory demyelinating polyradiculoneuropathy (AIDP).

In AIDP, the immune system mistakenly attacks the protective nerve covering that helps transmit nerve signals from the brain to other parts of the body.

Guillain-Barré Syndrome Symptoms

The first symptoms of Guillain-Barré syndrome often include feelings of tingling or weakness in the feet and legs. These feelings may spread to the arms and face.

The chest muscles can also be affected. Up to a quarter of people with GBS experience problems breathing.

In very severe cases, people with GBS may lose all muscle function and movement, becoming temporarily paralyzed.

Signs and symptoms of Guillain-Barré syndrome may include:

  • Pricking or tingling "pins and needles" sensations in the fingers, toes, ankles, or wrists
  • Muscle weakness that starts in the legs and spreads to the upper body
  • Unsteady walking
  • Difficulty with eye or facial movements (blinking, chewing, speaking)
  • Difficulty controlling the bowels or bladder
  • Rapid heart rate
  • Difficulty breathing

What Is Binge Eating Disorder?

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It's unclear what causes binge eating disorder.

Like other eating disorders, BED is probably caused by a combination of genetic, psychological, and social factors.

Some risk factors for binge eating disorder include:

  • A history of anxiety or depression
  • A history of dieting (especially in unhealthy ways, such as skipping meals or not eating enough food each day)
  • Painful childhood experiences, such as family problems

Symptoms of Binge Eating Disorder

People with binge eating disorder have frequent bingeing episodes, typically at least once a week over the course of three months or more.

Binge eating episodes are associated with three or more of the following:

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when you're not feeling hungry
  • Eating alone, because you feel embarrassed about how much you're eating
  • Feeling extremely disgusted, depressed, or guilty after eating

Some people also display behavioral, emotional, or physical characteristics, such as:

  • Secretive food behaviors, including hoarding, hiding, or stealing food
  • Feelings of anger, anxiety, worthlessness, or shame preceding a binge
  • Feeling disgusted with your body size
  • A strong need to be in control, or perfectionist tendencies

Binge Eating Disorder Treatment

If you have binge eating disorder, you should seek help from a specialist in eating disorders, such as a psychiatrist or psychologist.

There are several treatments available for BED. Treatment options may include:

 

10 Varicose Veins Myths

If you have ropy, blue blood vessels in your legs, you may think that they’re unsightly but don't cause any overt symptoms. Yet for some people, varicose veins can cause skin damage and, even worse, lead to dangerous blood clots.

They’re incredibly common: Varicose veins affect about one in four U.S. adults, or about 22 million women and 11 million men between ages 40 and 80.

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Your leg veins face an uphill battle as they carry blood from your toes to your heart. Small flaps, or valves, within these vessels prevent blood from getting backed up on this journey, and the pumping action of your leg muscles helps push the blood along. 

But if these valves weaken, blood can pool — primarily in the veins of your legs — increasing pressure in the veins. As a result of this increased pressure, your body tries to widen the veins to compensate, causing them to bulge and thicken, and leading to the characteristic twisted appearance of varicose veins.

 

 

To help you learn the facts about these enlarged veins, we've set the record straight on 10 sometimes confusing pieces of information, including who gets varicose veins and why, health problems they can cause, and treatment options.

Myth 1: Varicose Veins Are Only a Cosmetic Issue

“A lot of people are told by primary care doctors or others that varicose veins are a cosmetic issue only, when oftentimes they can be much more than that,” saysKathleen D. Gibson, MD, a vascular surgeon practicing in Bellevue, Washington.

“A significant percentage of patients with varicose veins will eventually develop symptoms,” says Pablo Sung Yup Kim, MD, assistant professor of surgery at Mount Sinai's Icahn School of Medicine in New York City. “The most common include dull achiness, heaviness, throbbing, cramping, and swelling of the legs.” Other symptoms include severe dryness and itchiness of the skin near varicose veins. People with varicose veins are also at an increased risk for a dangerous type of blood clot known as deep vein thrombosis.

Other not-so-common signs and symptoms, found in less than 10 percent of patients, include bleeding, skin discoloration, skin thickening, and ulcer formation — all due to varicose veins, says Kim. Unfortunately, once you have skin damage, it’s usually permanent.

“It’s very important to seek medical advice if you have varicose veins and experience symptoms — before changes in the skin are irreversible,” he says.

Myth 2: Varicose Veins Are an Inevitable Sign of Aging

Aging definitely worsens varicose veins, though not everyone gets them. “It's a degenerative process that gets worse and more prominent as we age,” says Dr. Gibson. But young people can get varicose veins, too. While the average age of patients treated in Gibson’s practice is 52, she and her colleagues have treated patients as young as 13.

If you've got varicose veins, it may run in your family. “The cause of varicose veins is primarily genetic,” Gibson explains.

Changes in hormone levels also come into play as a risk factor for varicose veins. “Your risk can be made worse, especially by pregnancy,” she adds.

Myth 3: Varicose Veins Are Strictly a Women’s Issue

While varicose veins are more common in women, men get them, too. About one-quarter of adult women have some visible varicose veins, compared to 10 to 15 percent of men.

Steve Hahn, 51, of Kirkland, Washington, first noticed in his twenties that he had varicose veins in his left leg after he sprained his ankle playing basketball. When he injured his knee about 10 years ago, he noticed that the varicose veins had become more extensive.

“After about five years of thinking about it, I finally had them treated,” he says. “Both of my legs felt very heavy all of the time at this point, as opposed to just after walking a golf course or playing tennis or basketball.”

After treatment, Hahn says, “I feel like I have new legs.” The heaviness is gone, as is the ankle swelling, which he didn't know was related to the varicose veins. And as a side benefit, he adds, he looks better in shorts.

Myth 4: Running Can Cause Varicose Veins

Exercise — including running — is usually a good thing for your veins. “Exercise is always good for the circulation,” Kim says. “Walking or running can lead to more calf-muscle pumping and more blood returning to the heart.”

“Being a runner doesn’t cause varicose veins,” adds Gibson, though there's controversy about whether exercise makes them worse or not.” Compression stockings can help prevent blood from pooling in your lower legs during exercise. “For patients who haven't had their varicose veins treated and are running, I recommend compression. When you’re done running and are cooling off, elevate your legs,” she says.

Myth 5: Varicose Veins Are Always Visible

While the varicose veins you notice are right at the surface of the skin, they occur deeper in the body, too, where you can't see them. “It really depends on the makeup of the leg,” Gibson says. “If you've got a lot of fatty tissue between the muscle and the skin, you may not see them. Sometimes surface veins are the tip of the iceberg and there's a lot going on underneath.”

Myth 6: Standing on the Job Causes Varicose Veins

If you have a job that requires you to be on your feet a lot — as a teacher or flight attendant, for example — you may be more bothered by varicose veins. But the jury's still out on whether prolonged standing actually causes varicose veins. “People tend to notice their varicose vein symptoms more when they’re standing or sitting,” Gibson explains.

RELATED: Steer Clear of These 9 Artery and Vein Diseases

Myth 7: Making Lifestyle Changes Won't Help

Your lifestyle does matter, because obesity can worsen varicose veins, and getting down to a healthy weight can help ease symptoms. Becoming more physically active is also helpful. “Wearing compression stockings, doing calf-strengthening exercises, and elevating your legs can all improve or prevent varicose veins,” saysAndrew F. Alexis, MD, MPH, chairman of the dermatology department at Mount Sinai St. Luke's and Mount Sinai Roosevelt in New York City.

Myth 8: Surgery Is Your Only Treatment Option

The only treatment available for varicose veins used to be a type of surgery called stripping, in which the vein is surgically removed from the body. That’s no longer the case. While this procedure is still the most commonly used varicose vein treatment worldwide, according to Gibson, minimally invasive procedures that don't leave scars have become much more popular in the United States.

Endothermal ablation, for example, involves using a needle to deliver heat to your vein, causing it to close and no longer function. While the procedure doesn't leave a scar, it can be painful, and you may have to undergo sedation before being treated. “You have to have a series of injections along the vein to numb it up; otherwise, you wouldn't be able to tolerate the heat,” Gibson explains. You may need to take a day off from work to recover, as well as a few days off from the gym.

Some medications, called sclerosing agents, close a vein by causing irritation. Others are adhesives that seal a vein shut and don’t require the area to be numbed. Gibson and her colleagues have helped develop some of the new technologies and products used in treating varicose veins, including adhesives.

Milder varicose veins can be treated by dermatologists with non-invasive approaches, such as laser therapy and sclerotherapy, says Dr. Alexis. “For more severe cases where symptoms may be involved, seeing a vascular surgeon for surgical treatment options is advised.”

Although treatment for varicose veins means losing some veins, you have plenty of others in your body that can take up the slack, explains Gibson. “The majority of the blood flow in veins in the leg is not on the surface at all; it's in the deep veins within the muscle,” she says. “Those deep veins … are easily able to take over for any veins that we remove on the surface.”

Myth 9: Recovery After Varicose Vein Treatments Is Difficult

 

 

Newer treatments have quicker recovery times. “These procedures can be performed in an office within 20 to 30 minutes with no recovery time. Patients can usually return to work or daily activities on the same day,” Kim says.

Myth 10: Varicose Veins Can Be Cured

Treatments are effective, but they aren't a cure, Gibson says. Sometimes, varicose veins can make a repeat appearance after treatment. “What I tell my patients is it's kind of like weeding a garden,” she says. “We clear them all out, but that doesn't mean there's never going to be another dandelion popping out.”

10 Essential Facts About Ovarian Cancer

Statistically speaking, ovarian cancer is relatively rare: It represents just 1.3 percent of all new cancer cases in the United States each year, according to the National Cancer Institute (NCI). But although its numbers are small, the fear factor for many women may be disproportionately large.

We spoke to two leading ovarian cancer experts: Robert J. Morgan, Jr., MD, professor, and Mihaela C. Cristea, MD, associate clinical professor, of the medical oncology and therapeutics research department at City of Hope, an NCI-Designated Comprehensive Cancer Center in Duarte, California.

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Here are 10 essential facts about ovarian cancer that you should know:

1. About 20,000 women in the United States are diagnosed with ovarian cancer each year. As a comparison, nearly 250,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society. Of the women diagnosed with ovarian cancer, 90 percent will be older than 40; most ovarian cancers occur in women 60 or older, according to the CDC.

2. You should see your doctor if you experience any of these ovarian cancer symptoms:

  • Vaginal bleeding (especially if you’re past menopause)
  • Abnormal vaginal discharge
  • Pain or pressure in the area below your stomach and between your hip bones
  • Back pain
  • A change in bathroom habits, such as urgently needing to urinate, urinating frequently, or having constipation or diarrhea

It’s important to pay attention to your body and know what’s normal for you. If you have abnormal vaginal bleeding or have any of the other symptoms for two weeks or longer, see your doctor right away.

 

 

These symptoms can be caused by many different problems, but it’s best to have them evaluated, suggests the University of Texas MD Anderson Cancer Center.

3. It’s tricky to pinpoint early, milder symptoms of ovarian cancer. However, the findings of a study published in Cancer in 2007 point to a cluster of vague symptoms that may suggest the need for ovarian cancer testing, says Dr. Morgan. In the study, researchers linked these symptoms to the possibility of ovarian cancer:

  • Pelvic or abdominal pain
  • Strong urge to urinate or frequent urination
  • Bloating or increased abdominal size
  • Difficulty eating or feeling full early

If a woman experiences these symptoms on more than 12 days a month for less than one year, she should insist that her doctor perform a thorough ovarian evaluation, says Morgan. This might include the CA-125 blood test or atransvaginal ultrasound exam.

4. Early detection can mean a better prognosis. When detected early enough, ovarian cancer can be cured. “Stage 1 and stage 2 ovarian cancer is curable about 75 to 95 percent of the time, depending on the tumor grade and cell type,” says Morgan. But because this cancer occurs deep inside the body’s pelvic region, it is often diagnosed in later stages, he says. The cure rate for stage 3 ovarian cancer is about 25 to 30 percent, and for stage 4 it's less than 5 percent, he adds.

RELATED: Overcoming Ovarian Cancer, Twice

5. Ovarian cancer has several key risk factorsThese include:

  • Women with a family history of ovarian cancer may be at higher risk.
  • Women who have never been pregnant and women who have uninterrupted ovulation due to infertility treatments seem to be at higher risk.
  • Early onset of your period, or having a late menopause, seems to increase risk.
  • Using talcum powder in the genital area may increase risk.
  • Smoking is a risk factor for a type of ovarian cancer known as mucinous ovarian cancer. Quitting smoking seems to reverse the risk back to normal, says Morgan.

6. Ovarian cancer is not a single disease. In reality, it’s a diverse group of cancers that respond to different treatments based on their molecular characteristics, says Dr. Cristea. Treatment will also depend on other health conditions, such as diabetes or heart problems, that a woman might have.

7. Ovarian cancer treatments are evolving and improving all the time.Immunotherapy is emerging as a new treatment option for many malignancies, including ovarian cancer,” says Cristea. In another recent development, the firstPARP inhibitor, a DNA-repair drug, has been approved for women with BRCA-mutated ovarian cancer when chemotherapy hasn’t worked. “Women should also ask their doctors about clinical trials that are evaluating immunotherapy as well as other new treatments,” she adds.

 

 

8. Surgery may prevent ovarian cancer in women at very high risk. For women who carry the BRCA or other genes that predispose them to ovarian cancer, doctors often recommend surgery to remove the ovaries and fallopian tubes.Angelina Jolie, the actor and human rights activist, decided to have this surgery in March 2015. “Removing the ovaries can decrease the risk of developing the disease by 98 percent, and can substantially decrease the risk of developing breast cancer,” notes Morgan. Women in this very high-risk group should opt for this surgery after they’ve completed childbearing at around age 35, he notes.

9. Even after remission, ovarian cancer can still respond to treatment. “About 80 to 90 percent of ovarian cancer patients will achieve remission after chemotherapy treatment,” says Morgan. However, many of those women will later experience a recurrence of the cancer. The longer the remission, notes Morgan, the better the chances are for achieving a second remission.

10. It’s best to see an ovarian cancer specialist. When you’ve been diagnosed with ovarian cancer, getting a referral to an ovarian cancer specialist is a wise move, says Cristea. If you’re having surgery, it’s best to have a gynecologic oncologist perform the operation instead of a gynecologist, she adds. And to make sure you’re getting state-of-the-art treatment, consider seeking a second opinion at a NCI-Designated Cancer Center.

How to Prevent Hearing Loss

Do you have trouble following a conversation in a noisy room? Do other people complain that you have the television turned up too loud? If the answer to either of those questions is yes, you may already have some degree of hearing loss.

Hearing loss can start at any age. According to the National Academy on Aging and Society, the number of affected Americans between the ages of 45 and 64 has increased significantly since 1971. But it’s much more common in seniors: Some 40 percent of the 20 million Americans who have hearing loss are 65 or older.

Contrary to popular belief, however, hearing loss is not an inevitable part of aging. Some causes of hearing loss can be prevented, and most types of hearing loss can be helped.

Types and Causes of Hearing Loss

There are three basic types of hearing loss:

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  • Sensorineural hearing loss is caused by damage to the inner ear nerves or the nerves that carry sound to the hearing area of the brain. Once you have this type of nerve damage, the only treatment is a hearing aid. Causes of sensorineural hearing loss include injuries, tumors, infection, certain medications, and excessive noise exposure.
  • Conductive hearing loss is caused by a condition that blocks sound waves from being transferred to the nerves involved in the hearing process. Whereas sensorineural hearing loss usually affects both ears, conductive hearing loss may only affect one ear. Common causes include ear infections, ear wax, ear trauma such as a punctured eardrum, and other diseases that affect the ear canal, the eardrum, or the tiny bones in the middle ear. Unlike sensorineural hearing loss, this type of hearing loss can often be corrected and restored.
  • Mixed hearing loss occurs when someone who has nerve type hearing loss from aging or noise trauma then gets an ear infection or develops a wax impaction, causing their hearing to suddenly get much worse. It’s a combination of sensorineural hearing loss and conductive hearing loss.

Hearing Loss Evaluation

If you are having trouble hearing or develop sudden deafness, you need to get your hearing checked as soon as possible. Sudden deafness is a serious symptom and should be treated as a medical emergency. For many people, though, hearing loss may be gradual and not obvious. Here are seven warning signs to watch out for:

  • You have trouble hearing while on the telephone.
  • You can’t seem to follow a conversation if there is background noise.
  • You struggle to understand women’s or children's voices.
  • People complain that you turn up the TV volume too high.
  • You constantly ask people to repeat themselves.
  • You have a long history of working around loud noises.
  • You notice a ringing, hissing, or roaring sound in your ears.

 

 

If you think you have any kind of hearing loss, the place to start is with your doctor. Whether your hearing loss is gradual or sudden, your doctor may refer you to an audiologist (a medical specialist in hearing loss) or an otolaryngologist (a medical doctor specializing in disorders of the ear).

 

 

Depending on the cause and type of your hearing loss, treatment may be as simple as removing ear wax or as complicated as reconstructive ear surgery. Sensorineural hearing loss can't be corrected or reversed, but hearing aids and assistive devices can enhance most people’s hearing. For those with profound hearing loss approaching deafness, an electronic hearing device, called a cochlear implant, can even be implanted in the ear.

Tips for Hearing Loss Prevention

One type of hearing loss is 100 percent preventable: that due to noise exposure. Noise is measured in units called decibels: Normal conversation is about 45 decibels, heavy traffic may be about 85 decibels, and a firecracker may be about 120 decibels. Loud noise — anything at or above 85 decibels — can cause damage to the cells in the inner ear that convert sound into signals to the brain. Here are some tips for avoiding noise-induced hearing loss:

  • Minimize your exposure to loud noises that are persistent.
  • Never listen to music through headphones or ear buds with the volume all the way up.
  • Wear ear plugs or protective earmuffs during any activity that exposes you to noise at or above 85 decibels.
  • See your doctor about a baseline hearing test, called an audiogram, to find out if you already have some early hearing loss.

You should also see your doctor if you have any symptoms of ear pain, fullness, or ringing, or if you experience any sudden change in your hearing. These symptoms could be early warnings of preventable hearing loss.

Hearing loss or deafness can have a serious effect on social well-being. It can cut you off from the world around you. Know the causes of hearing loss, and practice hearing loss prevention to preserve the hearing you still have.

Essential Facts About Antidepressants

Newer antidepressants target brain chemicals involved in regulating mood, but they're not magic bullets. Here are the risks and benefits of these commonly prescribed drugs.

Although mild forms of depression are often treated without medication, those with more severe symptoms may benefit from taking antidepressant drugs. These medications, which target brain chemicals involved in mood, may help people with severe depression who do not respond to talk therapy or healthy lifestyle changes alone, according to the National Alliance on Mental Illness (NAMI).

The Use of Antidepressants Is on the Rise

Roughly 67 percent of people living with depression use medication as their primary form of treatment, NAMI reports. Antidepressants are the second most commonly prescribed drugs in the United States, according to a study published in 2013 in the American Journal of Clinical Hypnosis. Overall, use of antidepressants increased from 6.5 percent in 2000 to 10.4 percent by 2010, a study published in 2014 in the Journal of Clinical Psychiatry reveals.

How Antidepressants May Help

There are many theories about what causes depression, according to the National Institute of Mental Health (NIMH). Brain imaging technology shows that parts of the brain involved in mood, thinking, sleep, and behavior look different in people with depression than in those who are not depressed. Genetics, stress, and grief could also trigger depression, according to NIMH.

RELATED: 6 Need-to-Know Antidepressant Facts

Because specific chemicals called neurotransmitters, particularly serotonin and norepinephrine, are involved in regulating mood, medications that target these chemicals are often used to treat depression. Antidepressants work by increasing concentrations of these chemicals. These drugs include:

Selective serotonin reuptake inhibitors (SSRIs): SSRIs work by making more of the neurotransmitter serotonin available to your brain. Some of the drug names you may be familiar with are Prozac (fluoxetine), Paxil (paroxetine), and Celexa (citalopram).

The most common side effects associated with these medications include sexual problems, headache, nausea, dry mouth, and difficulty sleeping. These symptoms often fade over time, NAMI notes.

Atypical antidepressants: This class of drugs includes serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Effexor (venlafaxine) and Cymbalta (duloxetine). In addition to serotonin, these antidepressants may target other brain chemicals such as dopamine or norepinephrine.

Side effects of SNRIs are similar to those associated with SSRI drugs. You may also experience, fatigue, weight gain, or blurred vision.

The antidepressant Wellbutrin (bupropion) affects only the levels of norepinephrine and dopamine. This drug, known as a norepinephrine and dopamine reuptake inhibitor (NDRI), has similar side effects as SSRIs and SNRIs, but it is less likely to cause sexual problems. Rarely, seizures may occur.

Tricyclic antidepressants: Tricyclics also affect levels of brain chemicals, but they are no longer commonly used because they have more side effects, including fatigue, dry mouth, blurred vision, urination difficulties, and constipation. If you have glaucoma, you should not take any tricyclic antidepressant. Some tricyclics antidepressants include amitriptyline, amoxapine, and Norpramin (desipramine).

Monoamine oxidase inhibitors (MAOIs): Like tricyclics, MAOIs are now prescribed less often because of their risk for serious side effects. These drugs work by blocking an enzyme called monoamine oxidase, which breaks down the brain chemicals serotonin and norepinephrine. People taking MAOIs can experience dangerous reactions if they eat certain foods, drink alcohol, or take over-the-counter cold medicines.

In 2006, the U.S. Food and Drug Administration (FDA) approved Emsam (selegiline), the first skin patch for treating major depression. At its lowest dose, this once-a-day patch can be used without the dietary restrictions associated with oral MAOIs. Some other MAOIs include Marplan (isocarboxazid) and Nardil (phenelzine).

Depression Medications and Government Warnings

In 2005, the FDA warned that the risk of suicidal thoughts or behavior could be higher in children and adolescents taking depression drugs. In 2007, the warning was expanded to include anyone under age 25 taking antidepressants.

However, to balance the risks and benefits of antidepressants, the FDA’s so-called black box warning also states that depression itself is associated with a greater risk for suicide, notes a 2014 study published in the New England Journal of Medicine. Nevertheless, if you are taking an antidepressant, especially if you are under 25, let your doctor know if your depression seems to be getting worse or if you have any thoughts of hurting yourself.

Antidepressants Are Not Magic Bullets

It's important to remember that simply taking a pill will not cure depression. It may take up to 12 weeks before these drugs have their full effect. Some people need to take various doses or combinations of different medications before they find the treatment strategy that works best for them, according to NAMI.

It’s also important to take antidepressants as prescribed and to follow up with your mental health professional on a regular basis. Some depression drugs must be stopped gradually — if you suddenly stop taking your medication, you could experience withdrawal symptoms or a relapse of your depression.

Often the most effective treatment for depression involves some form of talk therapy, notes NAMI. Discuss with your doctor how exercise and limiting alcohol can also help ease your symptoms.

Conquering Depression and Obesity

By the time David Clark was in his early thirties, he owned a chain of 13 retail stores that reported $8 million a year in sales, and he was married with three children. “I should be happy,” he recalls thinking. But he wasn’t.

He was depressed. “I couldn’t find simple joy in anything, and had thoughts of stepping in front of a bus to end it,” he says. The depression caused him to eat massive amounts of fast food and drink recklessly, he says, and that led to obesity. At his heaviest, the nearly 6-foot-tall Clark, from Lafayette, Colorado, weighed 320 pounds.

Clark was not alone in suffering from depression and obesity. Nearly half of all adults who live with depression — 43 percent — are obese, and adults with depression are more likely to be obese than adults who aren’t depressed, according to the Centers for Disease Control and Prevention.

Whether depression or obesity comes first can vary from person to person, says Kim Gudzune, MD, MPH, assistant professor of medicine at Johns Hopkins Medicine in Baltimore. “But if you have one condition, you’re more likely to have the other,” she says.

Depression and obesity are often linked because of the stigma of obesity. Some who are obese have a poor body image and can become depressed as a result, Dr. Gudzune says, and others eat to drown their sorrows.

In addition, “there may be shared neural pathways between obesity and depression that may place individuals at risk for both,” says Leslie Heinberg, PhD, director of behavioral services for the Bariatric and Metabolic Institute at the Cleveland Clinic in Ohio.

How Clark Turned His Life Around

After his weight gain, Clark was at risk for high blood pressure and was borderline diabetic.

He says he overcame both of his health conditions essentially on his own. One morning, when he was 34, Clark says he woke up and realized how close to death he was. He knew that if he didn’t change, his children would be fatherless.

“I didn’t want my kids to see their father drink himself to death,” he says, so he joined Alcoholics Anonymous and followed the group's 12 steps to stop drinking. “I went on a spiritual journey to make peace with my path,” says Clark, who grew up poor and homeless. As a kid, he and his dad had roamed the country in the back of a pickup truck, he says.

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He also began running. And running. Some years earlier, he'd seen the New York City Marathon on television and always had it in the back of his mind that that was something he might do. Eventually, Clark became an ultra-marathon runner. Now 44, he runs at least 80 to 100 miles a week and competes in some of the most challenging endurance races on the planet, including across Death Valley in California.

At first, it was painful to run, but he says the pain was also motivating. “I knew the stakes had to be pretty high to make such a dramatic change in my life," he says.

Running: A Low Cost Mood Booster

After Clark revamped his diet to be plant-based, stopped drinking alcohol, and began running regularly, his weight began to drop. It took him 18 months, but he got down to a healthy 180 pounds. When he switched to competitive running, he lost another 20 pounds and has stayed at 160 for years now, he says.

The running also improved his mood, says Clark, who chronicles his journey in the book Out There: A Story of Ultra Recovery. Exercise releases endorphins — hormones that reduce your perception of pain and improve your mood, according to Harvard Medical School in Boston.

Clark advises others who struggle with obesity and depression to do like he did and “draw a line in the sand” to say, “I’m not going to live this way anymore — I’m going to move on to a better place.”

What You Can Do

Though Clark lost weight on his own, not everyone can. So if you're struggling, consider working with a nutritionist or your doctor to find a weight-loss program. The key is to make low-calorie, healthy choices and exercise more so that you burn more calories than you consume, according to the National Institutes of Health. If you're extremely overweight, your doctor might suggest medication to curb your appetite, or weight-loss surgery.

Exercise and eating well may also help treat your depression. You can work with a therapist who can help you find the right treatment plan. That could include individual or group therapy, stress-reduction techniques, medication, or some combination of these.

Treatment can be difficult, because a side effect of some depression medications is weight gain, Gudzune says. But treating depression and weight issues simultaneously, Heinberg says, can be beneficial because if people who are depressed are able to lose weight, that could benefit their depression.

Plastics Chemical Tied to Changes in Boys' Reproductive Development

When expectant mothers are exposed to plastics chemicals called phthalatesduring the first trimester, their male offspring may have a greater risk of infertility later in life, a new study suggests.

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Boys exposed to the chemical diethylhexyl phthalate (DEHP) may be born with a significantly shorter anogenital distance than those not exposed to these chemicals. Anogenital distance is the distance between the anus and the genitals. A shorter anogenital distance has been linked to infertility and low sperm count, the researchers explained.

"We saw these changes even though moms' exposure to DEHP has dropped 50 percent in the past 10 years," said lead researcher Shanna Swan, a professor of preventive medicine and obstetrics, gynecology and reproductive medicine at the Icahn School of Medicine at Mount Sinai in New York City.

"Therefore, we have not found a safe level of phthalate exposure for pregnant women," she contended.

Swan said that this study cannot prove that these boys will have fertility problems as adults or that DEHP causes these problems. However, animal studies have implicated the chemical in male reproductive problems. Based on the data from this study, Swan believes there is a strong association between exposure to DEHP and fertility in human males.

DEHP is used to soften plastics. Most exposure results from eating foods that pick up the chemical during processing, Swan said.

RELATED: 10 Toxic Household Items You Should Throw Away Now

 

 

"Since food is the largest source of DEHP for consumers, it is difficult for pregnant women to minimize exposure," she said. "Eating unprocessed food will likely help. However, eliminating DEHP from food really has to be done by food producers."

The chemical is also found in medical tubing and in a variety of products, including flooring, wallpaper, lacquers and personal care products, Swan said.

The report was published Feb. 19 in the journal Human Reproduction.

For the study, Swan's team collected data on almost 800 pregnant women and their infants.

Specifically, the researchers found that exposure in the womb to three types of DEHP was associated with a significantly shorter anogenital distance in boys, but not in girls.

A group representing the chemical industry took issue with the study, however.

In a statement, the American Chemistry Council (ACC) stressed that the study only examined one type of phthalate, not all versions of the chemical. And it said that phthalates are "one of the most widely studied family of chemicals in use today."

The ACC added that DEHP "is known to break down into its metabolites within minutes after it enters the body. Information collected by the Centers for Disease Control and Prevention over the last 10 years indicates that, despite the fact that phthalates are used in many products, exposure from all sources combined is extremely low -- much lower than the levels established as safe by scientists at regulatory agencies."

 

 

But another expert says phthalate exposure may not be benign. Dr. Kenneth Spaeth, director of the Occupational and Environmental Medicine Center at North Shore University Hospital in Manhasset, N.Y., said, "virtually everyone in the U.S. experiences continual exposure to phthalates."

And, a number of studies have tied the chemicals with changes in developing fetuses. "Phthalates, in particular, have been shown in both human and animal studies to interfere with normal fetal development," he said.

This study supports what has been demonstrated before, that phthalate exposure in the first trimester is linked to male reproductive development, Spaeth said. "This study is an important step forward in establishing this effect because the study included a much larger number of individuals than prior studies and helps identify one particular agent, DEHP, as an important contributor to this effect," he said.

Additionally, this study shows the importance of exposure in the first trimester as a critical window for the effect of phthalates on the male reproductive system. "On the whole, given these features, the authors have contributed important information about the public health risk posed by phthalates," Spaeth suggested.

Electric Brain Stimulation No Better Than Meds For Depression: Study

For people who battle depression and can't find relief, stimulating the brain with electric impulses may help. But a new study by Brazilian researchers says it's still no better than antidepressant medication.

In a trial that pitted transcranial, direct-current stimulation (tDCS) against the antidepressant escitalopram (Lexapro), researchers found that lessening of depression was about the same for either treatment.

"We found that antidepressants are better than tDCS and should be the treatment of choice," said lead researcher Dr. Andre Brunoni. He's director of the Service of Interdisciplinary Neuromodulation at the University of Sao Paulo.

"In circumstances that antidepressant drugs cannot be used, tDCS can be considered, as it was more effective than placebo," he said.

The researchers used the Hamilton Depression Rating Scale. This test has a score range of zero to 52, with higher scores indicating more depression.

People who received brain stimulation lowered their depression score by 9 points. Those taking Lexapro had depression scores drop by 11 points. Patients receiving placebo experienced a drop of 6 points in their depression score, the researchers found.

RELATED: Depression May Hasten Death in Years After Heart Diagnosis

"tDCS has been increasingly used as an off-label treatment by physicians," Brunoni said. "Our study revealed that it cannot be recommended as a first-line therapy yet and should be investigated further."

The report was published June 29 in the New England Journal of Medicine.

Dr. Sarah Lisanby is director of the Division of Translational Research at the U.S. National Institute of Mental Health. "When you consider if this treatment adds anything to the ways we have to treat depression, you want to know that a new treatment is better than or at least as good as what's available today," she said.

"But this study failed to show that tDCS was better than medication," said Lisanby, who wrote an accompanying journal editorial.

Lisanby pointed out that unapproved tDCS units are being sold on the internet. She cautioned that trying brain stimulation at home to relieve depression or enhance brain function is risky business, because side effects can include mania.

"There are people who are doing do-it-yourself tDCS," she said. "People are trying to find ways to treat depression, but it's important for them to know that tDCS is experimental and not proven to be as effective or more effective than antidepressant medications."

To get a better idea of how well brain stimulation worked for depression, Brunoni and colleagues randomly assigned 245 patients suffering from depression to one of four groups. One group had brain stimulation plus a placebo pill, another had fake brain stimulation plus Lexapro. The third group had brain stimulation plus Lexapro, and the final group had fake brain stimulation plus a placebo.

Brain stimulation involved wearing sponge-covered electrodes on the head. The treatment was given for 15 consecutive days at 30 minutes each, then once a week for seven weeks.

Lexapro was taken daily for three weeks, after which the daily dose was increased from 10 milligrams (mg) to 20 mg for the next seven weeks.

After 10 weeks, patients receiving brain stimulation fared no better than those taking Lexapro. Patients receiving brain stimulation, however, suffered from more side effects, the researchers found.

Specifically, patients receiving brain stimulation had higher rates of skin redness, ringing in the ears and nervousness than those receiving fake brain stimulation.

In addition, two patients receiving brain stimulation developed new cases of mania. That condition can include elevated mood, inflated self-esteem, decreased need for sleep, racing thoughts, difficulty maintaining attention and excessive involvement in pleasurable activities.

Patients taking Lexapro reported more frequent sleepiness and constipation.

Brunoni, however, is not ready to write off brain stimulation as a treatment for depression based on this study.

"We did not test, in this study, the combined effects of tDCS with other techniques, such as cognitive behavior therapy and other antidepressant drugs," he said.

"Previous findings from our group showed that tDCS increases the efficacy of antidepressant drugs, however, it should not be used alone, and its use must be supervised by physicians due to the side effects," Brunoni said.

Lisanby said the tDCS dose in the study may be in question. She said it may have to be adjusted to each individual patient in terms of how strong the electrical stimulation should be. The treatment length also needs to be individualized, as does what part of the brain it should be directed toward.

Also, "we need larger studies to give us the definitive answer about whether tDCS is better than the treatments we have today," Lisanby said.

10 Ways to Fight Chronic RA Pain

The aches and pains of rheumatoid arthritis can be hard to overcome, but these strategies may help in treating chronic pain.

From fatigue to loss of appetite, rheumatoid arthritis (RA) can impact your life in a number of ways, but the most limiting symptom for many people is pain. Because that pain comes in different forms, you may need more than one strategy to relieve it.

“The primary cause of rheumatoid arthritis pain is inflammation that swells joint capsules," says Yousaf Ali, bachelor of medicine and bachelor of surgery, an associate professor of medicine at the Icahn School of Medicine and chief of the division of rheumatology at Mount Sinai West Hospital in New York City. Joint capsules are thin sacs of fluid that surround a joint, providing lubrication for bone movement. In RA, the body's immune system attacks those capsules.

The first goal of pain relief is the control of inflammation, Dr. Ali explains. “Inflammation can cause acute (short-term) pain or longer-lasting smoldering pain," he says. "Chronic erosion of joint tissues over time is another cause of chronic pain. But there are many options for pain relief.”

Getting RA pain under control may take some work. You may find that you'll need to take several drugs — some to slow the joint damage and some to alleviate joint pain. Alternative therapies, like acupuncture, combined with drugs may help you to feel stronger. It may take some time, too. Try the following strategies — with your doctor's supervision — to discover which are most effective for you:

Treatments and Strategies to Help Relieve Chronic RA Pain

1. Inflammation Medication "In the case of RA, all other pain-relief strategies are secondary to controlling inflammation," Ali says. The No. 1 option in the pain relief arsenal is to control inflammation with disease-modifying anti-rheumatic drugs, called DMARDs. These drugs, which work to suppress the body's overactive immune system response, are also used to prevent joint damage and slow the progression of the disease. DMARDs are often prescribed shortly after a diagnosis in order to prevent as much joint damage as possible.

"The most commonly used is the drug methotrexate," he says. It's administered both orally and through injections. Digestive issues, such as nausea and diarrhea, are the most common side effect of DMARDs, and of methotrexate in particular, if taken by mouth. Hair loss, mouth sores, and drowsiness are other potential side effects. Methotrexate, which is taken once a week, can take about five or six weeks to start working, and it may be three to six months before the full effects of the drug are felt; doctors may also combine it with other drugs, including other DMARDs.

"Steroids may be used to bridge the gap during an acute flare," adds Ali. "If flares continue, we can go to triple-drug therapy, or use newer biologic drugs that are more expensive but also effective.” The most common side effect of biologics are infections that may result from their effect on the immune system.

The next tier of pain relief includes these additional approaches:

2. Pain Medication The best drugs for acute pain, Ali says, are nonsteroidal anti-inflammatory drugs, called NSAIDs. Aspirin and ibuprofen belong to this class of drugs, as does a newer type of NSAID called celecoxib. While NSAIDs treat joint pain, research has shown that they don't prevent joint damage. In addition, NSAIDs may irritate the stomach lining and cause kidney damage when used over a long period of time.

"Stronger pain relievers, calledopioids, may be used for severe pain, but we try to avoid them if possible," says Ali. "These drugs must be used cautiously because of the potential to build up tolerance, which can lead to abuse."

3. Diet Although some diets may be touted to help RA symptoms, they aren’t backed by the medical community. “There is no evidence that any special diet will reduce RA pain," Ali says. But there is some evidence that omega-3 fatty acids can help reduce inflammation — and the joint pain that results from it. Omega-3s can be found in cold-water fish and in fish oil supplements. A study published in November 2015 in the Global Journal of Health Sciences found that people who took fish oil supplements were able to reduce the amount of pain medication they needed.

4. Weight Management Maintaining a healthy weight may help you better manage joint pain. A study published in November 2015 in the journal Arthritis Care & Research suggested that significant weight loss can lower the need for medication in people with RA. Among the study participants, 93 percent were using DMARDs before they underwent bariatric surgery, but that dropped to 59 percent a year after surgery.

5. Massage A massage from a therapist (or even one you give yourself) can be a soothing complementary treatment to help reduce muscle and joint pain. A study published in May 2013 in the journal Complementary Therapies in Clinical Practice involved 42 people with RA in their arms who received either light massage or medium massage from a massage therapist once a week for a month. The participants were also taught to do self-massage at home. After a month of treatment, the moderate-pressure massage group had less pain and greater range of motion than the others.

6. Exercise Although you may not feel like being active when you have RA, and it might seem that being active could put stress on your body, gentle exercises can actually help reduce muscle and joint pain, too. “Non-impact or low-impact exercise is a proven way to reduce pain," Ali says. "We recommend walking, swimming, and cycling.” In fact, one of the best exercises you can do for RA is water aerobics in a warm pool because the water buoys your body.

The Arthritis Foundation also notes that yoga is another option to help reduce RA pain, and traditional yoga poses can be modified to your abilities. Yoga may also help improve the coordination and balance that is sometimes impaired when you have the disease. When it comes to exercise, though, it’s also wise to use caution. Talk with your doctor if any workouts are making your pain worse, and, in general, put any exercise plan on hold during an acute flare.

7. Orthoses These are mechanical aids that can help support and protect your joints. Examples include padded insoles for your shoes and splints or braces that keep your joints in proper alignment. You can even get special gloves for hand and finger RA. A physical therapist can help you determine the best orthoses options for you.

8. Heat and Cold Heat helps to relax muscles, while cold helps to dull the sensation of pain. You might find that applying hot packs or ice packs, or alternating between hot and cold, helps reduce your joint pain. Relaxing in a hot bath can also bring relief, as can exercising in a warm pool.

9. Acupuncture This Eastern medicine practice, which has been around for centuries, is thought to work by stimulating the body's natural painkillers through the use of fine needles gently placed near nerve endings. “I have found acupuncture to be helpful for some patients, but the pain relief is usually not long-lasting,” says Ali.

10. Transcutaneous Electrical Nerve Stimulation (TENS) TENS is a form of therapy that uses low-voltage electric currents to stimulate nerves and interfere with pain pathways. “TENS is usually used for stubborn, chronic pain and not as a first-line treatment for RA,” Ali says. One of the benefits of this treatment is the low occurrence of side effects. If you're interested in trying it for pain relief, talk with your physical therapist.

Remember, you’re not alone — your doctor and specialists can help you find relief from chronic pain. If you’re experiencing more pain than before, or if pain is interfering with your ability to get things done, don’t hesitate to talk to your doctor. Ask your rheumatologist about pain relief options, like exercise, massage, yoga, and acupuncture, but remember that the first priority on your pain relief list should be to get RA inflammation under control.

Model for a Hepatitis C Cure: Success in the Cherokee Nation

For 9 out of 10 American Indians, treatment led to a hepatitis C cure.

For most of the 3.5 million Americans living with a hepatitis C infection today, the promise of a cure is an empty one unless patients can get proper care. And deaths from hepatitis C keep rising, surpassing deaths from HIV.

Now, in a successful pilot program by the Cherokee Nation Health Services of northeastern Oklahoma, a May 2016 Centers for Disease Control and Prevention (CDC) report shows that curing hepatitis C is possible not only in clinical trials, but also in the larger population — even in remote and impoverished areas.

 

Local Hepatitis C Screening Success

American Indians and Alaska Natives have the highest rates of death from hepatitis C of any group in the United States, and also the highest number of new hepatitis C infections, according to the CDC, says Jorge Mera, MD, lead study author and director of infectious diseases at Cherokee Nation Health Services, though he says it’s not known why. “We made a great effort to detect hepatitis C virus-positive patients," he says. "Hepatitis C virus is known as the invisible epidemic — we tried to make it visible.”

To get more people screened, the health services implemented an electronic health record reminder to target everyone born between 1945 and 1965. The automatic alert prompted medical providers if the patient they were seeing that day was due for a hepatitis C screening test based on the patient's birthdate. This pilot program resulted in a fivefold increase in first-time hepatitis C testing between 2012 and 2015, from 3,337 people to 16,772 and included 131,000 American Indian people, mostly from rural northeastern Oklahoma.

The program educated healthcare providers on how important it is to identify these patients as early as possible, and to offer them treatment. It also informed them about the many ways people are exposed to hepatitis C, including by using or having used IV or intranasal drugs, having been incarcerated, or having received a blood transfusion before 1992. The CDC recommends testing for all people with such histories.

 

Progress in National Hepatitis C Screening

A report on a second, national initiative by the Indian Health Service (IHS) that ramped up hepatitis C testing in a similar way was also published in May 2016 in the CDC's Morbidity and Mortality Weekly Report (MMWR). As of June 2015, the number of people they had screened overall increased from 14,402 to 68,514 over three years, varying by region from 31 to 41 percent of people in the high-risk age group.

“The Indian Health Service’s screening rates for American Indian and Alaska Native patients in the [1945 to 1965] birth cohort have more than tripled since the national recommendations were released, greatly increasing the potential for early detection and follow-up for our patients living with hepatitis C infection,” says Susan Karol, MD, Indian Health Service chief medical officer and member of the Tuscarora Indian Nation in Niagara Falls, New York. The Indian Health Service provides healthcare for 1.9 million American Indian and Alaska Native people, including 566 different recognized tribes.
A Second Test for Active Hepatitis C

“Once patients were detected as HCV-positive, a confirmatory viral blood test was performed to make sure they had an active infection,” says Mera about his hepatitis C program. This test looks for RNA that’s proof of ongoing hepatitis C virus replication in the patient’s blood.

Of the 715 people who tested positive on the first screening test, 68 percent had an active infection. They were referred to one of five hepatitis C virus clinics set up by Cherokee Nation Health Systems, which had primary care providers who were specifically trained through the Extension for Community Healthcare Outcomes (ECHO) program. Outreach also included home visits to people who had hepatitis.
Access to Hepatitis C Drugs That Can Cure

A high proportion of the people who had an active infection — 57 percent — received antiviral drug treatment in this pilot program. Ninety percent were cured of hepatitis C.

“We don’t deny treatment to anybody because they’re depressed or have an alcohol dependence medical problem,” says Mera, though this is often a barrier to getting approvals for antiviral treatment. “We do offer and encourage them to be enrolled in a behavioral health program to address the other medical conditions. As long as they’re following up with the medical appointments and interested in HCV treatment, we will treat their hepatitis C virus.”

David Rein, PhD, program area director of the public health analytics division of NORC, an independent research institution at the University of Chicago, says access to hepatitis C care is improving for some. “In March, the U.S. Veterans Administration dropped all restrictions on treatment and began to provide treatment to any veteran in its system who is infected with the virus, regardless of how far the disease has progressed. Unfortunately, the VA is the exception and not the rule. Many state Medicaid programs and private insurance plans still place unnecessary barriers on treatment access.”   

Coverage to pay for medications is a barrier for many people with hepatitis C, notes a May 2016 editorial in The Journal of the American Medical Association.

The key to success, Mera says, is being relentless. “We have a wonderful group of case managers dedicated to hepatitis C treatment procurement,” he says. “They will work with the third party payers such as Medicaid, Medicare, and private insurance, and also with the patient assistance programs. Our case managers will not take no for an answer very easily, and will exhaust all the possibilities they have to obtain the medications.”
How to Cure Hepatitis C Across the United States

The three steps to a hepatitis C cure are to:

    Get screened to see if you’ve ever been exposed to the hepatitis C virus
    Get tested for active viral infection
    Get effective drug treatment

Yet half of Americans infected with hepatitis C don’t know they have it, while many of those who do know can’t get access to care or can’t pay for the antiviral medication they need.

A plan to cure hepatitis C is important because cases of infection have increased more than 2.5 times from 2010 to 2014, and deaths from hepatitis C are on the rise, exceeding 19,000 per year, according to the CDC's U.S. viral hepatitis surveillance report, published in May 2016.  

“Acute cases, which occur when a patient is first infected with hepatitis C, are increasing at an alarming rate, likely due to higher rates of injection drug use,” says Dr. Rein. But this group of people is not likely to develop symptoms of liver dysfunction for several decades.

“The record number of hepatitis C deaths that the CDC reported for 2014 is almost exclusively related to people who were initially infected with the disease in the 1960s, ‘70s, and ‘80s who developed chronic infections which gradually destroyed their livers over the course of decades,” he explains.

Rein and his colleagues had predicted in 2010 that deaths from hepatitis C would increase to 18,200 annually by the year 2020, peak at 36,000 in 2033, and kill more than one million Americans by the year 2060 if we didn't take action to prevent it. But the sobering reality is that the U.S. case numbers have already exceeded that prediction, with more than 19,000 cases in 2014.

“I still believe that is what will happen if nothing is done to address the epidemic,“ Rein says. “However, I’m both hopeful and confident in our healthcare system, and I believe that we’ll see vastly expanded testing and treatment, which will lead to dramatic reductions in deaths from hepatitis C in the years to come.”

More people, especially those born between 1945 and 1965, need to be tested for the hepatitis C antibody, he says. “Simply disseminating guidelines and providing reimbursement for testing is insufficient to assure that doctors test their patients. Interventions are needed to prioritize testing for hepatitis C.”

The Cherokee Nation group is now working with the CDC on a model that experts hope can be expanded throughout the country to lead people effectively from screening through to a hepatitis C cure.

What can help the model succeed? According to Mera, support, commitment, and trust:

    Political support (in the Cherokee Nation program, from the tribe’s chief and council)
    Commitment and trust from the administration to do the right thing to eliminate hepatitis C
    Dedicated and motivated team members who include primary care providers (nurse practitioners, physicians, pharmacists), lab technicians, nurses, administrators, behavioral health personnel, case managers, and clerks who understand the importance and urgency of hepatitis C screening and a cure

“My wish would be that patients would ask their medical providers to test them for HCV if they think they could have been exposed. This would increase screening, the first step in visualizing the invisible epidemic,” says Mera.

 

Overly Controlling Moms Lose Out, Study Says

Helicopter parents, take note: A mother has a better relationship with her child if she respects the youngster's need for independence at a young age, a new study suggests.

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Mothers who allowed children more freedom at age 2 were viewed more positively by their children later in childhood, according to the University of Missouri study.

The study included more than 2,000 mothers and their children. The researchers observed how much the mothers controlled the children's play at age 2 and then interviewed the children at fifth grade to assess how they felt about their mothers.

"When mothers are highly controlling of small children's play, those children are less likely to want to engage with them," Jean Ispa, co-chair of the department of human development and family studies, said in a university news release.

 

 

Respect for independence is important both for children's growth and for creating positive parent-child relationships, she said. "We found that mothers who supported their children's autonomy were regarded more positively by their children than mothers who were highly directive," she said.

RELATED: Being a Good Parent Without Judging Other Parents

"Mothers who are very directive when their children are toddlers often tend to still be controlling when their children enter adolescence," Ispa noted.

Mothers with small children mostly use physical controls, she said, but when children are older these directives become more verbal and psychological -- not allowing kids to speak their mind, for instance. "It's not surprising that their children begin to view them in a negative light," Ispa said.

The findings, published online recently in the journal Social Development, don't mean that parents should not establish and enforce rules or offer advice, Ispa said. She noted that behavioral rules -- such as teaching children to check for cars before crossing the street -- did not have a negative impact on mother-child relationships.

It was psychological control -- such as inducing guilt or telling children what to think and feel, or to play in certain ways -- that damaged mother-child relationships, the study found.

 

 

"Many times, parents think that employing these controlling behaviors is the 'right way' to raise children, but our research shows that really does not work," Ispa said.

"Allowing children age-appropriate levels of autonomy to make safe decisions is very good for kids, and they usually will make wise decisions when they have been taught about safe choices as well as consequences," she added.

"A good place for parents to start would be to have open discussions and allow their children to express their own points of view," she suggested. "When giving children instructions, explain reasons for decisions rather than simply saying, 'Because I said so.' "

DIY Beauty Treatments for Every Skin Problem

Strawberries, lemons, blueberries, and onions – sounds like your average grocery list, right? Just as they are nutritious and important for a well-balanced diet, these ingredients can give your skin and hair a major boost, too.

Read on to learn these six expert-recommended at-home treatments that can help combat your biggest beauty woes.

5 Cooking Tips to Spice Up Your Heart-Healthy Diet

Add Flavor, Texture, and Zest with Heart-Healthy Ingredients

If you have high cholesterol and blood pressure, your doctor has probably advised you to start following a healthy diet as part of your treatment plan. The good news is that delighting your taste buds while sticking to a heart-healthy meal plan is easy — and many of the foods you enjoy most likely aren’t off limits. Healthy herbs and spices lend robust and savory flavor, hearty nuts add texture and a buttery taste, and teas infuse a bright flavor and antioxidants. Michael Fenster, MD (also known as Dr. Mike), a board-certified interventional cardiologist and gourmet chef, shares his cooking tips for preparing delicious meals that will boost your heart health. These choices are part of a healthy lifestyle that may reduce your risk for heart conditions like high blood pressure, heart attack, or stroke down the road.

Surprising Physical Signs of Heart Disease

Many people associate heart disease with obvious symptoms, like chest pain. But there are some not-so-obvious connections, like swollen feet or bleeding gums, that should also merit a heart check from your doctor.

The classic red flags for a heart attack are familiar to anyone who has watched medical dramas on television. The patient, usually an older man, starts wheezing and gasping for breath. Then he clutches his chest, staggers, and eventually falls over. In real life, the signs and symptoms of heart disease are much more varied and subtle.

Signs Versus Symptoms of Heart Disease
First, some definitions. Heart disease symptoms are indications that you feel or experience, while a sign of heart disease is something your doctor can see or find. Obvious heart disease symptoms include shortness of breath and chest pain. But your doctor will also look for common heart disease signs during an examination or in a patient interview.

Knowing the signs of heart disease is important because you may have them before you have any of the common heart disease symptoms. Letting your doctor know about these warning signs could help you get early treatment for heart disease.

"Signs like ankle swelling or weight gain do not necessarily mean you have heart disease, but taken together with other symptoms of heart disease, laboratory studies, and family history, they are an important part of making a diagnosis of heart disease or heart failure," says Carl E. Orringer, MD, associate professor of medicine and director of the Preventive Cardiovascular Medicine and LDL Apheresis Programs at the University of Miami Miller School of Medicine.

Swelling of the Feet and Lower Legs
Retention of fluid in the feet and legs is known as peripheral edema. Edema may appear as "sock marks" on your legs and ankles at the end of the day, especially if you wear tight socks or hose. Mild peripheral edema is common. Your doctor may check for this sign by pressing a finger against your ankle or shin bone to see if a depression or dent is left behind. This is called "pitting edema” and it could indicate congestive heart failure.

Edema may be a sign of heart failure because when your heart is not pumping well, fluid from inside your blood vessels tends to leak out into surrounding tissues. The legs and ankles are common areas for edema because of the effects of gravity.

"Peripheral edema may be caused by a host of issues,” says Dr. Orringer. “The bottom line is that most people with peripheral edema do not have heart disease, but it could be an important sign if there are other signs and symptoms of heart failure."

Male Pattern Baldness
"If you watched any of the royal wedding, you might have noticed that Prince William is balding on the top of his head. This type of balding of the crown of the head in young men may be a sign of an increased risk for heart disease," says Orringer.

Several large studies have confirmed the link between baldness and heart disease. Compared with men with a full head of hair, men with crown loss have an increased risk of heart disease of about 23 percent. Men with complete loss of hair on the top of their head have an increased risk of 36 percent.

The combination of hair loss, high blood pressure, and high cholesterol pushes the risk even higher. This link may be due to too much of the male hormone testosterone, which interferes with hair growth on the head and causes hardening of the arteries. That doesn't mean you are doomed to heart disease if you are bald, but it does suggest you should be screened more carefully for other signs and symptoms of heart disease.

Yellow Bumps on the Skin
Xanthomas are deposits of fat that build up under the skin. They may appear as small yellow bumps or as flat, wide plaques on your elbows, knees, hands, feet, or buttocks. A type of xanthoma called xanthelasma palpebrarum appears on the eyelids. These yellow, fat deposits can potentially be signs of heart disease because they may indicate high levels of fats in the blood.

"Xanthomas may be a sign of a rare, inherited type of blood disorder in which high levels of triglycerides accumulate in the blood. Xanthomas may also be a sign of increased cholesterol, and they may disappear once cholesterol levels are under control," says Orringer.

Gum Disease
Swollen, sore, or bleeding gums are usually a sign of poor oral hygiene, but may also be an important sign of heart disease. "The association between gum disease and heart disease is the real deal," says Orringer. "There is plenty of research available now that backs up this connection."

Gum disease and heart disease may be linked because they are both signs of poor circulation, or there could be common bacteria that are involved in both gum disease and plaque buildup inside coronary arteries. The link may also have something to do with the body's response to prolonged inflammation. In any case, taking better care of your teeth and gums may be a good way to cut down your risk for heart disease.

Emotional Stress
Weakening of the heart muscle accompanied by extreme emotional stress, grief, or loss, especially in women, is called takotsubo cardiomyopathy, or broken heart syndrome. When this occurs, surging stress hormones, especially adrenaline, trigger cardiac pain that feels a lot like a heart attack, often with heart palpitations, shortness of breath, and flushing. But unlike during a real heart attack, the arteries are not blocked. This potentially serious and often overlooked condition is more common in women than in men; in fact, men make up for only 10 percent of diagnosed cases.

Signs of Heart Failure
Heart failure means the heart is not functioning as well as it should. It doesn't mean the heart has failed. Another term for heart failure is congestive heart failure, or CHF. Heart failure gradually gets worse over time. Some early warning signs may include:

Weight Gain If your heart starts to fail and fluid starts to build up in your tissue, causing edema, you might see a sudden weight gain.

Frequent Urination Heart failure may cause decreased blood flow to the kidneys, which causes you to retain more fluid. One of the signs of this fluid may be frequent urination.

Cataracts Although the exact cause of the relationship between cataracts and heart disease is not known, studies show that people who have cataracts are at higher risk for heart disease, high blood pressure, and high cholesterol. "This link is probably more of an association than a sign of heart disease," says Orringer.

Nighttime Cough "One of the signs of heart failure may be the buildup of fluid in the chest and heart when lying flat at night. This increased fluid can cause a nighttime cough," explains Orringer.

Remember that all these heart disease signs may have many different causes. They do not mean you have or will get heart disease. But combined with other heart disease signs and symptoms, your blood tests, and your family history, they give your doctor the best chance to find heart disease early and keep you in good health.

6 Things I Didn't Know About Depression Until It Happened to Me

If you or a loved one has been diagnosed with depression, these insights from people who are successfully managing their own depression may help you.

Depression can make you feel alone and isolated, but in reality you aren't. Many other people live with depression every day, and you can learn a lot from them. Here, three people diagnosed with depression share insights they’ve gained along the way.

1. It's Not Your Fault

For the longest time, "I felt like something was wrong with me," says Marisa McPeck-Stringham, 37, a social worker in Ogden, Utah, who blogs about her life, including her depression, as Iron Daisy. She first noticed as a teen that she was sometimes down in the dumps, but she wasn't diagnosed until age 20, she says. Before the diagnosis, she would ask herself: What's wrong with me? She knew she had a good family, a good home, and great parents. "I didn't know it was a mental illness," she says. "I didn't know it was a problem with my brain chemistry."

That reaction is a common one, says Michelle B. Riba, MD, associate director of the University of Michigan Comprehensive Depression Center in Ann Arbor and past president of the American Psychiatric Association. Patients often tell her they think they did something to bring on the depression, and that they could have been stronger.

Dr. Riba tells her patients, "It's a medical condition and has to be treated like a medical condition." Anyone diagnosed with depression must be evaluated to see which treatment or combination might work for them, Riba says.

2. Being Depressed Takes a Lot of Energy

Elizabeth Moon, 70, of Austin, who wrote Crown of Renewal and other books, was diagnosed in the early 1980s. She didn't understand until after she got a diagnosis and was treated how exhausted she had been from trying to keep up with her life. "I didn't realize how long I had been depressed," she says.

"I was active, very physically active," says Moon. "I didn't think of myself as depressed; I didn't realize I was sliding into depression."

RELATED: 5 Things Psychologists Wish Their Patients Would Do

“Not everyone fits the stereotype of sitting on the couch," unable to do anything, she says. "If you’re feeling worthless, like you have no future — even if you appear to be healthy and holding down a full-time job, get checked out.”

"People may not pinpoint [depression symptoms] right away," Riba says of those who get depressed. They may think they’re sleep deprived, for instance, or just have some temporary issues balancing responsibilities.

3. Exercise Has Been Proven to Help With Symptoms

Often, the last thing you want to do if you’re depressed is go out and get some exercise. But those who’ve been there understand the value of exercise, and say it often helps. "If I don't get out and exercise, I have to really watch myself and make sure I’m not sliding," Moon says. "I do much better if I’m active. I have much less chance of sliding into another episode."

RELATED: The Real Monthly Cost of Depression

Exercise ''readjusts our brain chemistry," says McPeck-Stringham. She includes exercise as part of her "self-care" routine. Her workouts also become valuable "me" time, she finds.

And there is good evidence that exercise improves your mental health. A study published in 2014 in JAMA Psychiatry found that exercise does lower your chance of becoming depressed. And in people who already have depression, exercise helps lift depressive symptoms.

4. Writing Helps You Sort Out Your Emotions

Keola Birano, 33, of Hilo, Hawaii, is a full-time writer who also works for his wife's clothing business. Diagnosed at age 19, he soon learned the power of writing — not for his livelihood, but for his depression. First, he wrote a letter to his father and ''without giving it to him," burned it. "It released whatever [negative] feeling I may have held onto," he says.

He has continued writing, both for his blog, Keola Birano Reimagined, and for personal growth. "When you write, it opens up parts of your brain you didn't know were there,'' he says. "I try to do 10 minutes a day on autopilot, to let the feelings out."

5. Managing Depression Is an Ongoing Effort

"It takes a lot of significant work to keep yourself strong," Birano says. "You have to keep working on it. Once you start thinking you have it beat, you set yourself up for failure."

Moon agrees. "I can go downhill in 30 seconds,'' she says. "I've learned to have a plan in place when that happens," she says. Part of her plan is to keep tabs on her mental health before that slide downhill. "At least five times a year, I take the Beck Depression Inventory [a tool used by mental health experts] and see where I am. If I’m coming up [on the score], I need to be very careful. If the score doesn't go back down, I may need meds."

RELATED: 10 Foods I Eat Every Day to Beat Depression

For her, the best approach has been to take medications when needed and then taper off them, she says, but she doesn’t claim this is best for everyone. It’s important to remember that decisions to stop or start medications should always be done in conjunction with your physician.

6. Having a Depression Relapse Doesn’t Mean You Failed

"Right now, I’m in between episodes," Moon says. "I know another one may come and it isn't a disaster when it does come. It doesn't mean you’ll end up committing suicide either."

Figuring out what works for you to stay on an even keel is critical, Moon says. The most important thing for anyone who's depressed? "Recognize when you’re falling off the cliff," she says. Then go get the help you need and deserve.

Maria Sharapova’s 5 Best Tips for Glowing Skin and Killer Confidence

Maria Sharapova isn’t just a talented athlete. With supermodel looks, it’s no surprise that the Russian-born blonde has endorsement deals with a slew of beauty and fashion brands and has been photographed for the “Sports Illustrated” Swimsuit Issue. (She even edged out rival Serena Williams to be named the highest paid female athlete in 2014 by “Forbes” magazine.) 

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The five-time Grand Slam winner, who is currently gearing up for this year’s US Open, took time out of her busy schedule to chat with Everyday Health at a recent Supergoop! press event. She reveals her healthy skin habits, how she stays energized during a tough match, and more. 

 

 

1. The most important step in her beauty routine: As one of the best tennis players in the world, Sharapova spends plenty of time out in the sun practicing and playing grueling matches. To ensure her fair skin stays protected, she reaches for SPF almost as soon as she wakes up. And in fact, she says she’s been an avid sunscreen user since her teenage years. 

“It’s important for me to think about sunscreen early in the day, because as you go about your day, you’re thinking about the challenges ahead and the activities you’re doing and [sunscreen] is almost not on your mind anymore,” she says. “I have a bottle of sunscreen next to my shower, so I wake up, take a shower, towel off, and apply.” When she’s playing tennis, Sharapova relies on Supergoop! Everyday Sunscreen Broad Spectrum SPF 50, which she says has a lightweight texture and doesn’t sting her eyes as she sweats. 

RELATED: 10 Best SPFs for Every Skin Concern

2. Her glow-boosting secret: In addition to slathering on SPF in the morning, Sharapova starts her day with a whole lot of water to stay hydrated and keep her skin fresh. “I usually wake up and drink more than a half liter of water, just to get my mind ready and aware that I need to drink [water],” she explains. 

 

 

3. How she relaxes before a big match: For Sharapova, getting enough sleep is one of the keys to her success. “I love to sleep. I love taking naps,” she says. “That’s been part of my regimen since I was a young girl. I used to have a morning and afternoon practice, and I’d come home and have lunch and then take a 45 minute nap. To this day, I enjoy doing that if I have the opportunity.” 

4. Her favorite pre-game meal: When it comes to food, Sharapova keeps it simple. “I’ve learned a lot over the years about how I react to foods and how much energy I have,” she says. “Usually, I eat a little bit of chicken and a lot of green vegetables [before a match].” Sharapova also likes to whip up her own green juices, visiting local stores to pick up veggies and adding lemon and kiwi for sweetness. 

5. How she stays confident: One of the easiest ways Sharapova gives herself a boost is by spritzing on her favorite perfume before walking out the door. And before she steps onto the court, she reminds herself of how lucky she is to be following her dream. 

“I’ve played this sport for a long time and put in a lot of work and effort,” she says. “And that moment when you’re about to go on the court — that’s what you work for, that’s the goal — it’s a privilege. No matter if you win or lose, the opportunity to go out there is pretty special. It’s very powerful.”

Does being short help you live longer?

Researchers believe so.

Guys who are 5'3" and under have a lower risk of developing blood clots, and smaller odds of heart attack and cancer.

6 Detoxifying Vegetable Soup Recipes for the New Year

Bone broth was the hipster darling of 2015 food trends, but if healthy eating is one of your resolutions, just sipping on broth isn’t going to cut it. It’s a new year, and 2016 is all about doubling down on fruits and veggies in the most delicious way possible. Sure, salads pack in a lot of produce, but broth-based soups may be the most satisfying — and warming! — route to healthy eating this winter. If you’ve been mainlining gingerbread and peppermint bark for the past two weeks, a detoxifying veggie soup is the perfect way to usher in a healthier new year, one satisfying slurp at a time. Here are five recipes that’ll give your resolutions staying power all month long:

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Depression and Substance Abuse

Depression often feeds a substance abuse problem, but the opposite may also be true. Find out just how intertwined these two conditions are.

Mood disorders, like depression, and substance abuse go together so frequently that doctors have coined a term for it: dual diagnosis. The link between these conditions is a two-way street. They feed each other. One problem will often make the other worse, according to the Anxiety and Depression Association of America (ADAA).

About 20 percent of Americans with an anxiety or mood disorder, such as depression, also have a substance abuse disorder, and about 20 percent of those with a substance abuse problem also have an anxiety or mood disorder, the ADAA reports.

Compared with the general population, people addicted to drugs are roughly twice as likely to have mood and anxiety disorders, and vice versa, according to the National Institute on Drug Abuse (NIDA).

The Shared Triggers of Depression and Substance Abuse

When it comes to substance abuse and depression, it isn't always clear which one came first, although depression may help predict first-time alcohol dependence, according to a study published in 2013 in the Journal of Clinical Psychiatry.

The conditions share certain triggers. Possible connections between depression and substance abuse include:

The brain. Similar parts of the brain are affected by both substance abuse and depression. For example, substance abuse affects brain areas that handle stress responses, and those same areas are affected by some mental disorders.
Genetics. Your DNA can make you more likely to develop a mental disorder or addiction, according to research published in 2012 in Disease Markers. Genetic factors also make it more likely that one condition will occur once the other has appeared, NIDA reports.
Developmental problems. Early drug use is known to harm brain development and make later mental illness more likely. The reverse also is true: Early mental health problems can increase the chances of later drug or alcohol abuse.
The Role of Environment

Environmental factors such as stress or trauma are known to prompt both depression and substance abuse.

Family history is another factor. A study published in the Journal of Affective Disorders in 2014 found that a family history of substance abuse is a significant risk factor for attempted suicide among people with depression and substance abuse.

These types of dual diagnosis may also be traced back to a time in early life when children are in a constant process of discovery and in search of gratification, according to David MacIsaac, PhD, a licensed psychologist in New York and New Jersey and president of the New York Institute for Psychoanalytic Self Psychology.

RELATED: 6 Depression Symptoms You Shouldn’t Ignore

Any interruption or denial of this natural discovery process can manifest clinically and lead people to believe that everything they feel and think is wrong, he explains.

This idea, which Dr. MacIsaac says is based on the work of Crayton Rowe, author of the book Empathic Attunement: The 'Technique' of Psychoanalytic Self Psychology, challenges the idea that people dealing with depression try to self-medicate using drugs or alcohol. In fact, people with a dual diagnosis may be doing just the opposite, MacIsaac suggests.

"Individuals who are severely depressed drink to feed this negativity," he explains. "Initially it's soothing, but only for about 15 minutes. After that individuals sink deeper and deeper and feel worse than they did before."

For these people, MacIsaac points out, negativity is "where they get their oxygen." Any inclination that treatment is working will trigger a need to go back into the black hole of negative discovery, and alcohol will intensify their depression, he adds.

Why Simultaneous Treatment Is Important

Successful recovery involves treatment for both depression and substance abuse. If people are treated for only one condition, they are less likely to get well until they follow up with treatment for the other.

If they are told they need to abruptly stop drinking, however, depressed people with a substance abuse problem may be reluctant to undergo treatment, MacIsaac cautions. "They cling to drinking because they are terrified of losing that negativity," he says.

People with dual diagnoses must understand the root of their issues on a profound level, MacIsaac says. Once they understand, he says, they may have the ability to change. Treatment for depression and substance abuse could involve therapy, antidepressants, and interaction with a support group.

If you think you need treatment but are unsure where to start, the American Psychological Association provides the following suggestions:

Ask close friends and relatives whether they have recommendations for qualified psychologists, psychiatrists, or other mental health counselors.
Find out whether your state psychological association has a referral service for licensed mental health professionals.

9 Allergy Safe Beauty Products

For a hypoallergenic beauty product to plump up your lashes, Van Dyke suggests Almay Thickening Mascara. It's affordable, available at mass-market stores, and a great beauty product to avoid skin allergy reactions. Almay products go through rigorous testing to avoid allergens and irritants and maintain the brand's reputation for hypoallergenic beauty products, says Van Dyke. "It is hard to beat Almay for dermatologist-approved makeup, particularly around the eye," she adds.

Mindfulness Therapy May Help Ease Recurrent Depression

Review of 9 studies suggests it helps patients better cope with troubling thoughts and emotions.

Mindfulness therapy may help reduce the risk of repeated bouts of depression, researchers report.

One expert not connected to the study explained the mindfulness approach.

"Mindfulness-based cognitive therapy enhances awareness of thoughts and emotions being experienced, and enables development of skills to better cope with them," said Dr. Ami Baxi, a psychiatrist who directs adult inpatient services at Lenox Hill Hospital in New York City.

In the new study, a team led by Willem Kuyken, of the University of Oxford in England, analyzed the findings of nine published studies. The research included a total of almost 1,300 patients with a history of depression. The studies compared the effectiveness of mindfulness therapy against usual depression care and other active treatments, including antidepressants.

After 60 weeks of follow-up, those who received mindfulness therapy were less likely to have undergone a relapse of depression than those who received usual care, and had about the same risk of those who received other active treatments, the team reported.

The study authors also believe that mindfulness therapy may provide greater benefits than other treatments for patients with more severe depression.

The study was published online April 27 in the journal JAMA Psychiatry.

"Mindfulness practices were not originally developed as therapeutic treatments," Richard Davidson, of the University of Wisconsin-Madison, wrote in an accompanying editorial. "They emerged originally in contemplative traditions for the purposes of cultivating well-being and virtue," he explained.

RELATED: 6 Depression Symptoms You Shouldn’t Ignore

"The questions of whether and how they might be helpful in alleviating symptoms of depression and other related psychopathologies are quite new, and the evidence base is in its embryonic stage," according to Davidson.

While this review is the most comprehensive analysis of data to date, it "also raises many questions, and the limited nature of the extant evidence underscores the critical need for additional research," Davidson concluded.

However, another psychologist said she is already using mindfulness therapy in her practice.

"I have increasingly incorporated mindfulness based-interventions into my work with children, adolescents and adults, and I've seen how it has improved treatment outcome and overall well-being in my clients," said Jill Emanuele. She is senior clinical psychologist at the Child Mind Institute in New York City.

Emanuele said there is growing evidence that the approach brings patients "increased awareness of emotions and thoughts, and the ability to more effectively regulate and cope with them."

Light Box Might Help Nonseasonal Depression, Too

Light therapy, a treatment for a kind of depression known as seasonal affective disorder (SAD), may also benefit nonseasonal depression, a new study indicates.

"The combination of light and an antidepressant seems to work very well for treating nonseasonal depression," said study leader Dr. Raymond Lam, a professor and head of the Mood and Anxiety Disorders Program at the University of British Columbia in Canada.

Depression, a leading cause of disability worldwide, affects one in 20 people, according to background information with the study. Current treatments include psychotherapy and antidepressant medication, but recurrent episodes are common.

Since bright light treatment is used for people whose seasonal depression occurs in the darker months, the researchers hypothesized it might also lift depression that isn't brought on by light deprivation.

Lam and his team randomly assigned 122 adults with major depression not related to seasonal affective disorder to one of four groups. One group got 30 minutes of bright light treatment a day and took a placebo pill, while another used a device that was not light therapy and took the antidepressant fluoxetine (Prozac). A third group took a placebo pill and used a placebo device, while a fourth took Prozac and got light therapy.

The researchers followed the men and women for eight weeks, looking to see how many went into remission -- defined as having normal scores on a widely used depression scale.

"About 60 percent of the patients who got the combination [Prozac plus light] treatment went into remission with their symptoms compared to about 40 percent on light therapy alone," Lam said.

RESEARCH: 12 Ways to Treat Seasonal Depression

The antidepressant alone was not superior to placebo medication. Only about 30 percent of those on placebo medication and sham light treatment had remission, as did just 20 percent of those on Prozac with sham light treatment.

Light therapy alone was better than placebo, but not from a statistically significant point of view, Lam said.

Experts can't say for sure why light therapy works, but for seasonal affective disorder they think it may help correct disturbances in the body's circadian rhythms, or internal clock.

The same may be true for nonseasonal depression, Lam said. "Another theory is that light affects neurotransmitters in the brain such as serotonin [which affects mood]," he said. Or both could play a role, he added.

One limitation of the study, published online Nov. 18 in JAMA Psychiatry, is that patients' natural light exposure was not measured, the researchers said.

Simon Rego is director of psychology training at Montefiore Medical Center and an associate professor at Albert Einstein College of Medicine in New York City. He said the study is the first well-designed comparison of light therapy and the combination of light therapy and antidepressant medications in adults with nonseasonal major depressive disorder.

"In this case, the authors found that the light treatment, whether delivered alone or particularly when delivered in combination with an antidepressant medication, was efficacious in the treatment of nonseasonal [depression] and, just as important, the treatments were well-tolerated by the subjects," Rego said.

"It appears that light therapy, which is already seen as an effective treatment for seasonal affective disorder, may also be appropriate for nonseasonal [depression]," he added.

However, questions remain, Lam said, such as how long the combination treatment should continue.

Light boxes are sold at drugstores and other locations, Lam said, for less than $100 to $300. Some insurance plans cover them, he said.

Recommended treatment involves sitting in front of the fluorescent light box for a half hour daily as soon as possible after waking up. Lam said this can be done while eating breakfast or working on the computer.

The Canadian Institutes of Health Research funded the study. Lam reports serving as a consultant to or receiving honoraria for speaking from various pharmaceutical companies, including Eli Lilly and Co., which makes Prozac.

Why Some Seniors Lose Their Hearing

Do you have difficulty hearing conversations held in a noisy room? Do you have a harder time picking up women’s voices than men’s? Do you constantly ask others to repeat what they just said? If you answered ‘yes’ to these questions, you may be experiencing hearing loss — especially if you are 65 or older.

About 8.5 percent of adults between the ages of 55 and 64 suffer from hearing loss, according to the National Institute on Deafness and Other Communication Disorders. That number jumps to 25 percent for those 65 to 74, and it doubles to 50 percent for ages 75 and older. After high blood pressure and arthritis, hearing loss is the most common chronic condition affecting senior health.

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What Causes Hearing Loss?

As you age, you are at risk for two types of hearing loss. The most common type of hearing loss in seniors is presbycusis, or age-related hearing loss. A gradual loss of hearing that affects both ears, presbycusis occurs when tiny hairs in the ear, which are necessary for converting sound waves to sound, become damaged or die. Hearing loss from presbycusis is permanent because once these hairs are damaged or die, they are not replaced with new growth.

Related: 11 Early Signs of Dementia

The other type of hearing loss that seniors experience is tinnitus, or ringing in the ears. Tinnitus can be either permanent or temporary.

Risk Factors Related to Hearing Loss

A lifetime of exposure to loud noises such as music, motorcycles, or firecrackers can cause hearing loss in seniors. Noise-related hearing loss often results in tinnitus. Other causes of and risk factors for hearing loss experienced by seniors include:

  • Smoking
  • Allergies, high blood pressure, tumors, or stroke
  • Medications
  • A punctured eardrum
  • Viruses or bacteria
  • Earwax buildup

Your genes may also play a role in presbycusis, as it tends to run in families. Environmental factors like loud music and smoking make it difficult to determine the effect of genetics on age-related hearing loss; however, according to American Family Physician, an estimated 50 percent of age-related hearing loss is inherited.

Men are also more likely than women to develop hearing loss, and they’re more likely to develop it at an earlier age, says American Family Physician.

The Consequences of Hearing Loss

Losing hearing can have a significant effect on other aspects of your wellbeing. Researchers in a 2014 survey of 18,300 adults found that about 12 percent of participants with hearing loss had moderate to severe depression compared with about 5 percent of those with excellent hearing. The survey, which was published in JAMA Otolaryngology Head and Neck Surgery, also noted that women were particularly susceptible to depression related to hearing loss.

Hearing loss also appears to worsen cognitive functioning, according to a study published in the February 2013 issue of JAMA Internal Medicine. Among the nearly 2,000 seniors studied, hearing loss lowered cognitive functioning on some assessments as much as 41 percent more than it did among those without hearing loss.

Hearing Aids and Other Treatment Options

Though you can’t always fully prevent hearing loss, you can take steps to minimize or overcome it. Age-related hearing loss may be prevented or at least lessened by avoiding loud noises.

Because there is no known cure for age-related hearing loss, treatment is generally focused on improving your ability to function day to day. Your doctor may treat you or refer you to a hearing specialist such an otolaryngologist (or ENT, a medical doctor who specializes in the ear, nose, and throat) or an audiologist (a licensed professional who diagnoses and helps manage hearing problems). The cause and extent of your hearing loss will determine the course of treatment.

hearing aid may be one recommendation from your doctor or audiologist. Hearing aids can be beneficial for many, but according to the National Institute on Deafness and Other Communication Disorders, fewer than 30 percent of adults older than 70 who could benefit from a hearing aid have one. Hearing aids have come a long way over the years and are available in a variety of styles. A hearing aid and its battery will either fit behind the ear, on the ear, just inside the ear, or in the ear canal.

Types of hearing aids include:

  • Analog hearing aids that increase the volume of some sounds while lowering the volume of others
  • Digital hearing aids that allow you to determine which sounds to make louder or lower

Using assistive listening devices also can help compensate for hearing loss. These products either amplify sound, such as sound from telephones, televisions, and radio listening systems, or alert the user visually, such as with smoke detectors or alarm clocks.

 

 

Surgery may be another consideration. Cochlear implants are electronic devices with one part surgically implanted in the skin and the other part worn behind or in the ear. Used only for severe hearing loss, implants will not restore normal hearing, but they can make sounds louder. Because of the nature of the implants, they are not without risks — they pose the potential for infection, damage to the facial nerve, and tinnitus.

Speech or lip reading and sign language may be an answer for some seniors with hearing loss. Both of these techniques require training and practice and are generally recommended for those with severe hearing loss.

See your doctor as soon as you think you have a hearing problem. The loss of hearing could be a symptom of another medical condition. Seniors with untreated hearing loss are also more likely to suffer emotionally and socially when they areunable to interact with friends and family members. Left untreated, hearing loss could lead to deafness, and seniors who do not address their hearing loss put their lives at risk if they are unable to hear emergency warnings such as car horns or smoke alarms.

Resting Heart Rate for MEN Or WOMEN

Resting Heart Rate for MEN

Age 18-25 26-35 36-45 46-55 56-65 65+
Athlete 49-55 49-54 50-56 50-57 51-56 50-55
Excellent 56-61 55-61 57-62 58-63 57-61 56-61
Good 62-65 62-65 63-66 64-67 62-67 62-65
Above Average 66-69 66-70 67-70 68-71 68-71 66-69
Average 70-73 71-74 71-75 72-76 72-75 70-73
Below Average 74-81 75-81 76-82 77-83 76-81 74-79
Poor 82+ 82+ 83+ 84+ 82+ 80+

Resting Heart Rate for WOMEN

Age 18-25 26-35 36-45 46-55 56-65 65+
Athlete 54-60 54-59 54-59 54-60 54-59 54-59
Excellent 61-65 60-64 60-64 61-65 60-64 60-64
Good 66-69 65-68 65-69 66-69 65-68 65-68
Above Average 70-73 69-72 70-73 70-73 69-73 69-72
Average 74-78 73-76 74-78 74-77 74-77 73-76
Below Average 79-84 77-82 79-84 78-83 78-83 77-84
Poor 85+ 83+ 85+ 84+ 84+ 84+

The Link Between Depression and Debt

Too often, depression and debt are connected — and together, they can spiral out of control. Try these strategies to regain your footing.

Mental problems and money problems often go hand in hand. For one, debt is an increasingly common stressor that can trigger depression. Indeed, people who live with debt are more likely than their peers to be depressed and even contemplate suicide, according to a report on the health effects of debt published in 2014 in BMC Public Health. They're also less likely to take good care of their health. On the other hand, the researchers found that debt management programs can help stave off depression. Here's what else you need to know.

How Debt Leads to Emotional Distress

Debt can make you feel helpless, hopeless, and low on self-esteem — and these are all symptoms and risk factors for depression, says Nadine Kaslow, PhD, professor in the department of psychiatry and behavioral sciences at Emory University School of Medicine in Atlanta.

Credit card debt, mortgage foreclosure, student loan debt, medical debt, and job loss can all contribute to depression, agree the authors of the BMC Public Health article, adding that you might also experience anger and anxiety. Other factors, such as being the sole breadwinner with dependent children, being elderly and not having much saved for retirement, or having very high interest debts, seem to increase depression risk.

When Depression Leads to Debt

It’s easy to understand how the stress of debt can trigger or worsen depression, but you may not realize that depression can also lead to debt problems.

Symptoms of depression can lead some people to accumulate growing piles of debt, Dr. Kaslow says. "Someone with depression may exhibit behaviors that can lead them into a debt crisis."

"Some people may try to relieve feelings of depression by compulsive shopping. Depression is often associated with destructive and addictive behaviors that can result in overwhelming debt. This type of debt can lead to extreme despair and even to suicide," Kaslow warns.

RELATED: 5 Ways to Ease Unemployment Blues

Compulsive buying, which can lead to debt, is indeed linked to depression, anxiety, and other mood disorders, researchers reported in the American Journal of Addiction in 2013. The researchers note that in addition to depression treatment, support groups using cognitive behavioral strategies can help control compulsive buying.

How to Find Debt and Depression Help

If you find you are dealing with debt and depression, it is important to address both, Kaslow says. Many types of help are available. "If a person is feeling trapped, desperate, and hopeless, they may need help for depression and help getting out of debt," she adds.

Depression is a very treatable disorder. The first step is to recognize the problem and ask your doctor for depression help. Once depression is diagnosed, your doctor might recommend a range of treatment strategies, including talk therapy, medications, and support groups.

For someone with addictive spending behaviors, Debtors Anonymous (DA) is an organization that can be very helpful, says Kaslow. DA has meetings all over the country where people share their experiences with compulsive debt and debt management. There are also online meetings. For help with compulsive debt, check out DA's website.

A good source of advice for getting help with a debt problem can be found via the Federal Trade Commission, which recommends the following strategies:

Develop and closely follow a budget.
Contact your creditors instead of avoiding them.
Know your rights when dealing with debt collectors.
Use a credit counseling or debt management agency.
Seek protection through bankruptcy laws.
Learn about the steps you need to take to repair your credit.
Beware of debt management scams promising an easy fix.

Prescription Drugs That Cause Depression

Some prescription drugs can cause or contribute to the development of depression and other mood disorders.

What do certain asthma, acne, malaria, and smoking-cessation prescription drugs have in common? Answer: Their possible side effects include depression or other mood disorders.

Depression as a side effect of prescription drugs is widespread and increasingly gaining attention. The medications that contribute to drug-induced depression might surprise you. For example, an asthma medication, Singulair (montelukast), is prescribed to help people breathe more easily, but its side effects may include depression, anxiety, and suicidal thinking, according to a research review published in Pharmacology in 2014.

“In 2009, Merck added psychiatric side effects as possible outcomes with Singulair, including tremor, depression, suicidality — suicidal thinking and behavior — and anxiousness,” says J. Douglas Bremner, MD, researcher and professor of psychiatry and radiology at Emory University School of Medicine in Atlanta.

Drugs With Depression as a Side Effect

Dr. Bremner has published studies on the possible relationship between the use of retinoic acid acne treatments and the development of depression. One of the drugs within this category is Accutane (isotretinoin), the oral treatment for severe acne that has been associated with psychiatric problems, including depression.

“The original brand-name version of isotretinoin, Accutane, was taken off the market in 2009, although it continues to be marketed as Roaccutane in the U.K., Australia, and other countries," Bremner notes. "In the U.S. there are three generic versions available that have also been associated with reports of depression and suicide, Sotret, Claravis, and Amnesteem."

RELATED: Are You Getting Hooked on Anxiety Medications?

The full list of drugs that could cause depression is a long one. British researchers found 110 different medications between 1998 and 2011 that were associated with increased depression risk, according to a report published in BMC Pharmacology and Toxicology in September 2014.

Besides isotretinoin and montelukast, drugs that can cause or contribute to the development of depression or other mood symptoms include:

Lariam (mefloquine), used to treat malaria. Depression, anxiety, and psychosis are among the side effects of this medication, according to an article in Medical Science Monitor in 2013 that explored the chemical cascade behind mood changes.
Chantix (varenicline), used to stop smoking. The Food and Drug Administration (FDA) lists hostility, anxiety, depression, and suicidal thoughts as possible side effects of this medication.
Inderal (propranolol hydrochloride) and other drugs in the beta-blocker class, used to treat high blood pressure. Research on beta-blockers and depression suggests that some, but not all, of the medications in this class can contribute to depression, according to a report in the February 2011 issue of the Journal of Clinical Psychopharmacology.
Contraceptives. Contraceptives including those delivered by vaginal ring or patch could lead to depression in some people, according to research published in the Cochrane Database of Systematic Reviews in 2010.
Corticosteroids. Some people who take corticosteroids experience side effects such as depression, anxiety, and panic attacks, among other symptoms, according to a review of research published in Rheumatology International in 2013.
Interferon-alpha. As many as 40 percent of people using this immunologic medication may experience depression, according to a 2009 report in Dialogues in Clinical Neuroscience.
Interferon-beta. The link between this immunologic medication and depression is debated, but researchers reporting in Therapeutic Advances in Neurologic Disorders in 2011 note that depression is a concern for those who take it, in part because of their underlying conditions.
Nonnucleoside reverse transcriptase inhibitors. These HIV medications may increase the risk for depression, according to research published in the September 2014 issue of HIV Medicine. Arimidex (anastrozole) and aromasin (exemestane). Both of these long-term breast cancer therapies may contribute to depression, according to the FDA.
Vigabatrin. This anticonvulsant may cause depression, irritability, and psychosis, notes a review of studies in Acta Neurologica Scandinavica in 2011.
The FDA investigates drugs that have many reports of depression symptoms as a side effect. It requires what are called black-box warnings to be clearly printed on medications, like isotretinoin, that have been linked to depression and suicidal behavior, among other serious health threats. Make sure you read the information pamphlets that come with your prescription medications (and ask your pharmacist if you don’t understand what they say). You can stay on top of any news about their side effects by setting up a news alert on Google.

You can get the latest drug safety information on the FDA website.

Also, pay attention to how you feel. Though you may be taking medications that seem unrelated to mood, let your doctor know if you have symptoms such as sadness, difficulty sleeping, hopelessness, sleep changes, or thoughts of suicide.

“If you suspect your medication may be causing depression or similar problems, talk with your doctor and, if necessary, consult with a psychiatrist,” Bremner advises. The good news is that drug-induced depression usually clears up once you stop taking the medication.

Are Your Drugs Causing Depression?

It can be challenging to figure out whether your depression is related to taking a prescription drug, but here are some indicators:

Timeline. Drug-induced depression is defined as depression that appears within a month of starting or stopping a medication, according to the American Society of Health-System Pharmacists (ASHP). The society also advises that other conditions that might cause depression have to be considered in figuring out whether medication is the contributing factor. Bremner found in his research that the timeline varies from weeks to a month or two.
Dose-response relationship. With some drugs, depression symptoms may get better as the dose is reduced or worse as it is increased. This is usually a clear indicator of a relationship.
If you are uncertain about whether your changes in mood or energy are drug symptoms, talk with your doctor. Screening tools and questionnaires can reliably identify depression. You can also send information about your experiences to the FDA.

Prescription Drug-Induced Depression Treatment

In severe cases, people taking prescription drugs have developed depression leading to suicidal behavior. Because of this risk, don’t ignore or try to wait out feelings of depression, even if you believe they are only a prescription drug side effect. Talk with your doctor about these options to correct the situation:

Switching to an alternative treatment. If an equally effective medication that does not have depression as a side effect exists, the easiest option is to switch prescription drugs.
Getting a psychiatric evaluation. This may be recommended in any case to make sure you do not have an underlying psychiatric condition that has gone undiagnosed. People with a history of depression may have a worse response to some medications. An antidepressant might be prescribed in order to help manage depression symptoms.
Talk therapy will not work in this case, says Bremner, because the problem is chemically based. You will need prescription medication to address the depression if you cannot stop taking the drugs that are causing it.

If you think your depression symptoms are linked to a prescription drug you’re taking, talk with your doctor right away, get screened for depression, and find a better way to manage both your health issues and your mood.

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10 Ways to Make Your Treadmill Workout Safer

With the news of SurveyMonkey CEO David Goldberg's accidental death on a treadmill, we are reminded that there are risks to exercise, particularly when using gym equipment. Because a treadmill is powered by a motor, rather than self-propelled, accidents can happen, especially when people lose their balance. Injuries can include bruises, sprains, broken bones, concussions, and sometimes, even death. 

While the Consumer Products Safety Commission reported over 24,000 emergency room visits associated with treadmills in the United States in 2014, deaths are rare. That said, it's important for people to know their physical limits and keep safety in mind when using a treadmill.

A Diet for Better Energy

Complex carbs are key for sustained energy throughout the day, while too many sugary snacks can lead to energy crashes. Find out which foods you need for round-the-clock energy.

 

Juggling the responsibilities of work, life, and family can cause too little sleep, too much stress, and too little time.

Yet even when you're at your busiest, you should never cut corners when it comes to maintaining a healthy diet. Your body needs food to function at its best and to fight the daily stress and fatigue of life.

Energy and Diet: How The Body Turns Food Into Fuel

Our energy comes from the foods we eat and the liquids we drink. The three main nutrients used for energy are carbohydrates, protein, and fats, with carbohydrates being the most important source.

Your body can also use protein and fats for energy when carbs have been depleted. When you eat, your body breaks down nutrients into smaller components and absorbs them to use as fuel. This process is known as metabolism.

Carbohydrates come in two types, simple and complex, and both are converted to sugar (glucose). “The body breaks the sugar down in the blood and the blood cells use the glucose to provide energy,” says Melissa Rifkin, RD, a registered dietitian at the Montefiore Medical Center in the Bronx, N.Y.

Energy and Diet: Best Foods for Sustained Energy

Complex carbohydrates such as high-fiber cereals, whole-grain breads and pastas, dried beans, and starchy vegetables are the best type of foods for prolonged energy because they are digested at a slow, consistent rate. “Complex carbohydrates contain fiber, which takes a longer time to digest in the body as it is absorbed slowly," says Rifkin. Complex carbs also stabilize your body’s sugar level, which in turn causes the pancreas to produce less insulin. This gives you a feeling of satiety and you are less hungry.”

Also important in a healthy, energy-producing diet is protein (preferably chicken, turkey, pork tenderloin, and fish), legumes (lentils and beans), and a moderate amount of healthy monounsaturated and polyunsaturated fats (avocados, seeds, nuts, and certain oils).

“Adequate fluids are also essential for sustaining energy,” says Suzanne Lugerner, RN, director of clinical nutrition at the Washington Hospital Center in Washington, D.C. “Water is necessary for digestion, absorption, and the transport of nutrients for energy. Dehydration can cause a lack of energy. The average person needs to drink six to eight 8-ounce glasses of water each day.”

Energy and Diet: Foods to Avoid

 

Simple carbohydrates, on the other hand, should be limited. Ranging from candy and cookies to sugary beverages and juices, simple carbs are broken down and absorbed quickly by the body. They provide an initial burst of energy for 30 to 60 minutes, but are digested so quickly they can result in a slump afterward.

You should also avoid alcohol and caffeine. Alcohol is a depressant and can reduce your energy levels, while caffeine usually provides an initial two-hour energy burst, followed by a crash.

Energy and Diet: Scheduling Meals for Sustained Energy

 

“I always recommend three meals and three snacks a day and to never go over three to four hours without eating something,” says Tara Harwood, RD, a registered dietitian at the Cleveland Clinic in Ohio. “If you become too hungry, this can cause you to overeat.”

Also, try to include something from each food group at every meal, remembering that foods high in fiber, protein, and fat take a longer time to digest.

Even if life is hectic, it’s important to make wise food choices that provide energy throughout the day. Your body will thank you.

 

Influenza, a viral infection, illness that can range from mild to life-threatening

Influenza, commonly known as "the flu," is a viral infection of the respiratory tract that affects the nose, throat, and sometimes lungs.

 tend to happen annually, at about the same time every year. This period is commonly referred .

However, each outbreak may be caused by a different subtype or strain of the virus, so a different flu vaccine is needed to prevent the flu each year.

For most people, a bout of flu is an unpleasant but short-lived illness.

For others, however, flu can pose serious health risks, particularly if complications such as pneumonia develop.

Every year, thousands of Americans die from the flu. According to the Centers for Disease Control and Prevention (CDC), the number of deaths caused annually by flu in the United States ranged from 3,000 to 49,000 between 1976 and 2006, with an annual average of 23,607 flu-related deaths.

The best way to avoid getting the flu is to get an annual flu vaccination, encourage the people you live and work with to do likewise, stay away from people who are sick, and wash your hands frequently.

7 Detox Tips From Scientists Who Actually Tried Them

One of the realities of 2014 is that when a baby is born, he or she has already been exposed to toxic chemicals. The evidence is in umbilical cords, which research has confirmed contain pesticides, waste from burning coal and gasoline, and garbage. Even if you try to do everything right (eat organic, buy natural products, live in a cabin in the middle of the woods, etc.), you can’t avoid all of the chemicals that have become pervasive.

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Bruce Lourie and Rick Smith researched the dominance of these chemicals while writing their first book, Slow Death by Rubber Duck: How the Toxic Chemistry of Everyday Life Affects Our Health (2009), which took a look at everyday items, including canned food, pajamas, Tupperware, and rubber ducks, that put toxins into our bodies. Their readers bombarded them with a simple question: If all this stuff is inside us, how do we get it out?

So the two authors, armed with Smith’s PhD in biology and collective decades working in the environmental field (Smith's the executive director of the Broadbent Institute and Lourie is the president of the Ivey Foundation), went out again to determine what actually worked to get toxins out of the body. Through a series of self-designed experiments on themselves and others, they take readers through their journey in Toxin Toxout: Getting Harmful Chemicals Out of Our Bodies and Our World.

Here are some key facts they learned about what actually matters when it comes to detoxing:

1. Chemicals are everywhere, but you don’t have to worry about all of them.Not all chemicals are actually going to damage us, Laurie said, and people have different tolerance to chemicals (though you may find that out the hard way). Some chemicals are disappearing from our lives (DDT, dioxin, lead) because of awareness of their dangers. “I joke sometimes that I’m a worrier, and I carry around a worry list with me,” Smith said. “In the book, we tried to come up with a short worry list.” The list included phthalates, BPA, pesticides, methyl paraben, triclosan, sodium lauryl sulphatel, and metals that can be harmful when they accumulate, such as aluminum, tin, and mercury. Yes, that’s still a long (and confusing) list, but there are some simple ways to avoid or eliminate them.

 

 

2. Avoid some toxins by shopping natural. Chemicals don’t just get into our bodies through what we eat — they come in through what we slather on our skin, what furniture we sit on, and what we breathe. While reporting for the book, Smith measured his urine before and after simply sitting and breathing in a new Chevy Tahoe for eight hours, and found that doing so had elevated his body's levels of four chemicals from the worry list. So shop smart (and roll down the windows when driving). “When you’re making a purchase, be it a cosmetic, a shampoo, or a new sofa, ask ‘Is this the most natural thing I could buy?’” Lourie said. Read ingredient labels and look up the ones you can’t pronounce. Do your research and check out eco-certifications before making big purchases like sofas or cars to see which, like the Tahoe, are made with dangerous chemicals. 

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3. Organic is actually better, if you want to avoid pesticides. Recent research — particularly one study from Stanford that concluded organic produce doesn’t have more nutrients — has ignored the intended benefit of going organic, Smith and Lourie argue. Organic farming isn’t necessarily meant to yield more nutrient-dense food. It’s meant to make food that won’t contain excessive pesticides. (Yes, it may have traces of pesticides, because almost everything does. Remember the umbilical cords?) Smith and Laurie asked nine kids who hadn’t eaten organic before to eat an all-organic diet for five days while giving urine samples. The urine samples showed the switch yielded a big drop in pesticide levels. “Once people start eating organic food, pesticide reduction occurs in a matter of hours,” Smith said.

 

 

4. It’s better to adjust your habits than to go through a cleanse.  One of the most basic things you can do to get toxins out of your body is to drink more water. Another is to eat less animal fat and more (preferably organic) fruits and vegetables. But is the best way to do that a four-day juice cleanse? Probably not, say Smith and Laurie. "'Cleanse' makes it sound like it’s a special thing,” Lourie said. “If you’re eating more vegetables and drinking plenty of water, and you want to put the vegetables in the water, that’s a good thing to do. Just don’t be mistaken that if you do that for four days out of the year, you’re going to be detoxing your body — it doesn’t work that way.” It’s much better to incorporate fruits, veggies, and water into your daily diet.

5. Embrace sweat — and saunas. Toxins enter your body through what you eat, breathe and touch, and they go out the same way, through breath, digested food and drink, and sweat. While exhaling and urinating are pretty non-negotiable, a lot of us are engaged in a war against sweat. “We’re really confused as to what clean smells like,” Jessa Blades, an eco-blogger, tells the authors in the book.Antiperspirants and some deodorants prevent us from sweating out toxins while using toxic metals to keep the sweat in, a “double toxic whammy” Smith said. Lourie even admitted that he’s stopped using deodorant. Even if you change or quit your antiperspirant, you should try to sweat more, too. You can do this by exercising more or by using saunas to “detox through heavy sweating,” Lourie said. You’ll also end up drinking more water, which is good for eliminating toxins.

6. Be wary of fat. Fat holds on to toxins, which is part of the reason chemicals like DDT still hang around our systems. So if you’re eating lots of animal fat, you’re also eating the chemicals that the animal fat is holding. Then, you’re probably also putting on weight and thus adding fat to your body, which will hold on to those chemicals. “It’s a positive feedback loop,” Lourie said. In fact, if you’re worried about toxins and you’re overweight, losing that extra body fat should be the first step toward reducing the toxins in your body.

7. Push companies to do the right thing, and support regulation of toxins.“Only part of the solution to this problem is being a more careful consumer,” Smith said. ‘The other part is to be a more engaged citizen.” Remember when people learned that Subway bread contained a yoga mat chemical, and took to social media to demand that change? “Never has a company capitulated so quickly,” Smith said. It’s easier than ever to make your voice heard.