But a more luminous appearance during pregnancy can be as real as that inevitable baby bump — and there are clear medical reasons as to why.

Let’s turn to Ob/Gyn Catherine Caponero, DO, to enlighten us.

What is pregnancy glow?

During pregnancy, some women may find that their cheeks grow rosier and their skin looks more vibrant. Those physical changes can result in what many describe as a “glowing” appearance.  

Women typically find that this happens in the second trimester. However, some women report it throughout their pregnancy. 

What causes pregnancy glow?

Explanations for gestational glow typically focus on two physiological responses to pregnancy.

• Boosted hormone production. A surge in hormones during pregnancy may cause your skin to produce more oils, making it look shinier. Reviews on this side effect aren’t all glowing, however: That extra oil also can trigger acne breakouts.
• Increased blood flow. Blood volume typically increases almost 50% during pregnancy to meet the needs of your body and fetus. This rise dilates (or expands) blood vessels, which can lead to rosy-looking cheeks.

There’s also a long-held belief that happiness about being pregnant may add a certain luster to your appearance. There may be some validity to that theory, but it’s not always true.

“There are people who ‘glow’ who truly love being pregnant,” says Dr. Caponeo. “But not everyone enjoys pregnancy.”(Morning sickness, anyone?)

Can pregnancy glow indicate the sex of your baby?

Everyone loves to guess whether you’re having a boy or girl, right? Well, it’s been said that a person’s glow status during pregnancy can be a telling sign.

According to legend, a pregnancy glow means that you’ll have a boy. A face filled with acne, on the other hand, hints at a girl being born. (The theory there was that a baby girl “stole” her mother’s beauty.)

As you might expect, this is not a foolproof method. “There are no physical changes during pregnancy that will indicate the sex of the baby,” says Dr. Caponero.

Does everyone get a pregnancy glow?

While pregnancy glow is a completely natural bodily reaction, there’s no guarantee you’ll get it.

“Bodies respond differently to pregnancy,” emphasizes Dr. Caponero. “So just as it’s completely normal to experience pregnancy glow, it’s completely normal to NOT see it, too.”

Other ‘beauty’ perks of pregnancy

Radiant skin is just one example of a “beauty” perk connected to pregnancy. Others include:

• Stronger nails. The increased hormones that up your skin’s oil production also may make your nails grow faster and stronger. (Some people, however, see the opposite effect as their nails get softer and more brittle.)
• Thicker hair. Your hair may grow longer and stronger during pregnancy — and once again, the reason involves hormone production. These more luxurious locks often hang around for a few months after delivery.

How long does pregnancy glow last?

The name gives it away. If you get a pregnancy glow, expect it to disappear soon after your pregnancy ends. “After giving birth, your skin will typically change back to its pre-pregnancy state as your hormones return to previous levels,” says Dr. Caponero.

Tulsi, also known as holy basil, gets its name because of its classification as a sacred herb for Hindus and its long-term association as a medicinal herb.

So, how exactly does Tulsi differ from its more commonly known cousin? And what sort of benefits can you expect by ingesting it daily? Registered dietitian Devon Peart, RD, MHSc, BASc, breaks down this special herb below, along with ways you can work it into your nutritional plan.

What is holy basil or tulsi?

Holy basil or tulsi (scientific name: Ocimum tenuiflorum) is a medicinal herb that originates from India and has since been cultivated across East Asia, Australia and the surrounding tropics. The term “holy basil” gets its name because of its sacred classification among those who belong to the Vaishnavite sect of Hinduism.

Unlike traditional basil, which is often used in culinary cooking and has its own set of benefits, tulsi has a rich history as a core component in the medicinal practices of Ayurveda.

“Tulsi has been used for thousands of years in India and Nepal for its medicinal properties,” says Peart. “It’s been called ‘The Elixir of Life,’ ‘Liquid Yoga’ and ‘Queen of the Herbs,’ and it’s listed in the Journal of Ayurveda and Integrative Medicine for its many benefits.”

Is it healthy?

All parts of the plant — and particularly its leaves and purple flowers — are considered beneficial by people who sanctify the herb and by Ayurvedic practitioners.

Those who practice Ayurveda often use holy basil to create tea.

“You can pour boiling water over the leaves or the flowers and brew it for up to 10 minutes, similar to how you would make other teas,” says Peart. “After soaking them in boiling water, you strain off the solids and drink the leftover liquid.”

Tulsi can also be eaten raw if you can handle its bitter, spicy flavor. Or you can find it in other forms like extracts, essential oils or supplements — although Peart cautions using these forms.

“Supplements are notoriously not well-regulated,” she says. “From a safety perspective, if you have a particular health condition or you’re on medication, you should always check with a healthcare provider or pharmacist to see whether there could be any interaction between your medications and the supplements you’re thinking about taking.”

When looking at scientific research to determine whether or not holy basil is safe, studies are a bit varied and more research is needed.

Most of the studies on tulsi so far have been conducted in a laboratory setting. But in a 2017 systematic review of 24 clinical studies, researchers identified several positive benefits of tulsi in humans and found no negative downsides to using the herb for medicinal purposes. But only seven of those studies were classified as high-quality research, of which only three incorporated the preferred double-blind approach to clinical trials.

In addition, the long-term effects of using tulsi on a daily basis is relatively unknown. And to date, there isn’t a scientifically proven recommended dosage or daily limit for holy basil. Because of this, more research is needed to determine how much tulsi is needed to receive its intended benefits, how much is safe at any one time, and the exact mechanisms at play that inform the benefits people have experienced when taking this herb in its various forms.

“For a lot of the research, there’s a possibility that not every study is a great quality study. Sometimes, the benefits may be over-reported. And there’s always the possibility that there’s some negative evidence that hasn’t turned up through usual search engines,” explains Peart. “We don’t have long-term scientific evidence, but there have been thousands of years of traditional use — and that’s not nothing.”

The potential benefits discovered so far can be broken out into three areas:

• Metabolic benefits.
• Neurocognitive and mood conditions.
• Immunity and infections.

Metabolic benefits

Because of its properties as an antioxidant, research has shown that tulsi could have a positive effect on several metabolic processes, including:

• Lowering blood sugar.
• Improving LDL cholesterol.
• Improving blood pressure.
• Decreasing inflammation.

In particular, holy basil could be beneficial for anyone who has:

• Diabetes.
• High cholesterol.
• Obesity.
• Arthritis.
• Fibromyalgia.

Neurocognitive and mood conditions

Adaptogens, in particular, support your body’s ability to respond effectively to:

• Stress.
• Anxiety.
• Fatigue.

Some of the studies in the 2017 systematic review showed tulsi could increase someone’s energy and help manage physical and emotional stress. One example of a two-week controlled, randomized study from 2014 showed young adults who consumed nutrition bars fortified with eugenol tulsi leaf extract had significant improvement in levels of fatigue, immune response to viral infections and VO₂ max — a scientific measure of lung capacity.

Immunity and infections

Researchers believe many of these benefits may be caused by one of the plant’s core chemical components known as eugenol.

A polyphenol, eugenol has also been found to provide additional or similar benefits in cloves because of its anti-inflammatory properties. A 2021 study even suggests eugenol may also inhibit some of the spike proteins found in the SARS-CoV-2 virus from taking root and causing a COVID-19 infection.

Another small, randomized, double-blind, placebo-controlled trial in 2011 also showed an increased immune response in adults after four weeks of using a tulsi leaf extract daily.

For safe use

As you can see from the various trials and studies, much of what we know about tulsi seems promising, but we don’t completely understand yet just how we should use tulsi as part of our daily routines and for whom it’s most beneficial. We also don’t quite know whether or not there are any negative side effects. More research needs to be done, specifically in regard to human clinical trials.

“There isn’t any evidence at this point that says what’s a safe dose to use or how much you need to take for a specific health issue,” reiterates Peart. “We don’t have that level of specificity yet, but generally, daily use of tulsi has been found to be safe so far.”

If you decide to incorporate tulsi into your nutritional plan, Peart recommends sticking with holy basil tea or growing the raw herb organically on your own. If you’re considering using other forms like tulsi supplements, talk to your healthcare provider first, and avoid tulsi supplements completely if you’re pregnant or breastfeeding.

“You can use too much of any supplement, and if you do, there can always be some risk for side effects,” stresses Peart.

So, let’s get right to the point: Eating soy does NOT increase your risk for breast cancer. In fact, there’s plenty of research that suggests soy may offer some protection against getting the disease.

But rumors about soy and breast cancer continue to linger — and in truth, there are study-based explanations behind the misinformation.

Confused? Well, we don’t want that. So, let’s break down what the research shows and means to you with the help of two breast cancer specialists, oncologists Erin Roesch, MD, and Tiffany Onger, MD.

Why is soy linked to breast cancer?

Soy products contain isoflavones, molecules similar to the hormone estrogen. That has led to theoretical concerns that soy could increase the risk of estrogen-sensitive cancers, including breast cancer.

Receptors (protein molecules) on breast cancer cells can attach to estrogen in your system and fuel the growth of cancer. That’s one reason higher levels of estrogen increase breast cancer risk.

But while isoflavones resemble estrogen, they don’t make the same bond with those receptors to serve as a catalyst for cancer cell growth. “That’s a big distinction,” says Dr. Roesch.

Clinical trials consistently show that the intake of isoflavone​ does not adversely affect the risk of breast cancer. These studies haven’t confirmed a link between eating natural soy and developing breast cancer.

Some research even goes a step further by suggesting soy provides a protective effect.

There’s no shortage of studies either: Soy-related research generates about 2,000 papers a year on PubMed, a database of biomedical and life sciences literature maintained through the National Institutes of Health.

So, what causes concerns about soy?

Research looking at soy and cancer risk shows little reason for concern when it comes to studies involving people. But when the research involves small animals, the findings are a little bit different.

Rodents exposed to high doses of isoflavones can show an increased risk of breast cancer, according to studies. “Issues have come up in animal models,” says Dr. Onger.

It’s important to note the same results haven’t come up in human studies. But when studies suggest any possible correlation between food and cancer, misinformation and worry can spread quickly.

High soy diets and cancer rates

While soy-based foods may be trending in the United States, the plant has long served as a dietary staple in other areas of the world (particularly in Asia).

So, why bring that up? Breast cancer rates have historically been much lower in Asian countries than in the U.S., which suggests there isn’t a high correlation between consumption of soy and the disease.

Those countries also typically feature an overall lower-fat diet and differences in birthrates, both of which affect cancer rates.

So, is it safe to eat soy?

There’s no need to clear soy milk, tofu, edamame or other soy-based items out of your kitchen. The food is safe. If you enjoy it, keep eating it.

But it’s best to eat soy in moderation within a balanced diet, agree Dr. Roesch and Dr. Onger. Federal recommendations show health benefits when eating 25 grams of soy protein per day. (That’s equal to about 1 1/4 cups of tofu or 1 to 2 cups of soymilk.)

Look for more natural options as opposed to highly processed foods, too. (That’s a guideline that applies to pretty much every food.)

What about soy supplements?

As a general rule, you’re better off getting your nutrition through food sources rather than through soy supplements or isoflavone extracts.

“Doses of isoflavones from a vitamin store can be several hundred times higher than what you would ingest from eating tofu or drinking soy milk — and that could be a potential problem,” warns Dr. Roesch.

It’s always best to talk to your healthcare provider before beginning a supplement.

Bottom line on breast cancer risk

Known breast cancer risk factors such as having obesity, smoking at an early age, a sedentary lifestyle or high saturated fat intake all qualify as much bigger concerns than consuming soy-based foods.

“Removing attention from those factors is a much greater risk,” states Dr. Roesch.

Sommer explains the differences between manganese and magnesium, what foods contain them, how much of each you need — and what happens if you get too much or too little.

What’s the difference between manganese and magnesium?

Manganese and magnesium are both minerals that appear on the periodic table of elements. (Remember that poster from high school chemistry?) They’re also both essential minerals, which means you must get them from food, and it’s important to get enough every day.

“These nutrients play different roles in your body,” says Sommer. “And you need different amounts of them. Your daily magnesium requirements are quite a bit higher than your daily manganese requirements.”

What is manganese?

Manganese is a trace mineral or micromineral, meaning you don’t need a lot of it. Still, it’s vital to get enough because your body requires it for many different processes.

“You may not need much manganese compared to other nutrients, but its impact is mighty,” says Sommer. “It plays a role in nearly every type of chemical process in your body that you can think of.”

For example, you need manganese for:

• Blood clotting and wound repair.
• Bone tissue formation.
• Helping your reproductive system work well.
• Immune system function.
• Metabolizing (processing) amino acids, carbohydrates, cholesterol and glucose (sugar).

Research shows a link between diabetes and manganese levels in your blood. Interestingly, the study suggests there may be a “sweet spot” for manganese levels. People with Type 2 diabetes are more likely to have manganese levels that are too low or too high — a great example of how more isn’t always better.

Foods rich in manganese

You can find manganese in several healthy foods. Good sources include:

• Beverages like black tea and coffee.
• Fruits and vegetables, including blueberries, pineapple, spinach and squash.
• Legumes, which include chickpeas, lentils, peanuts and soybeans.
• Nuts and seeds like hazelnuts, pecans and sesame seeds.
• Shellfish, including clams, Pacific oysters and mussels.
• Whole-grain foods such as brown rice, oatmeal and whole-wheat bread.

How much manganese do you need?

The National Institutes of Health (NIH) advises 1.8 to 2.3 milligrams (mg) of manganese daily for adults.

“Manganese deficiency is uncommon,” notes Sommer. “Most people get enough through food. For example, if you ate a half-cup of oatmeal, one slice of whole-wheat bread and a half-cup of brown rice, you’d meet your manganese requirement for the day.”

“But in the rare event you don’t get enough,” she continues, “you have a higher risk of health issues such as metabolism problems, PMS and weak bones. Manganese deficiency can also affect children’s growth.” If you’re concerned about your manganese levels, talk to your healthcare provider.

Can you get too much manganese?

“If you’re only getting manganese through your food, you don’t have to worry about getting too much,” says Sommer. But if you take supplements with manganese, there’s a chance you could end up consuming toxic (highly dangerous) amounts.

“If you take multiple supplements, check the labels to see which ones contain manganese and how much,” she advises. “While manganese isn’t as common in supplements as some other vitamins and minerals, you should still be aware of your total amounts. It’s easy to overload yourself with certain nutrients through supplementation.”

What is magnesium?

Magnesium is also a mineral but not a trace mineral like manganese. You need quite a bit more magnesium. It’s considered a micronutrient. But, like manganese, your body uses magnesium in hundreds of different processes.

You need magnesium for functions such as:

• Blood pressure control.
• Blood sugar control.
• Bone health.
• Energy creation.
• Heart rhythm regulation.
• Muscle and nerve function.
• Protein synthesis (cells making proteins).

Most people get enough manganese, but magnesium is a different story. According to the NIH, many people in the U.S. don’t get enough magnesium through their food. Older people assigned male at birth and teenagers are most likely to have a deficiency. However, people who get magnesium through supplements usually have plenty of this nutrient.

What happens if you’re not getting enough magnesium? “You may not have any signs of low magnesium, especially at first,” says Sommer. “But over time, you can develop some serious health problems, including heart problems and seizures.” Talk to your healthcare provider about getting a blood test to check your magnesium levels — especially if you’re over 60 or have symptoms like heart rhythm issues or fatigue.

Foods rich in magnesium

You can find magnesium in many different foods. Examples of the best sources include:

• Dark leafy greens like collard greens, spinach and Swiss chard.
• Dairy and dairy alternatives, including milk, soymilk and yogurt.
• Fish, meat and poultry, which includes chicken breast, halibut, ground beef and salmon.
• Fruits and vegetables like apples, avocados, bananas, broccoli and potatoes.
• Legumes, including black beans, edamame (soybeans), kidney beans and lima beans.
• Nuts and seeds such as almonds, cashews, chia seeds, flaxseeds and pumpkin seeds.

Can you get too much magnesium?

“As with manganese, you’re unlikely to go too far with magnesium if you’re only getting it through food,” says Sommer. Your kidneys typically get rid of extra dietary magnesium.

But an overload of magnesium from supplements can send you running for the toilet. That’s because magnesium is a natural laxative. It’s the main ingredient in some laxative products. “If you take too much magnesium (more than around 350 mg in a supplement), you’ll have cramping, diarrhea and possibly nausea.”

And a very large dose (more than 5,000 mg in a day) has a toxic effect. Magnesium toxicity is rare, but it can cause:

• Breathing problems.
• Cardiac arrest.
• Irregular heartbeat.
• Low blood pressure.

People with kidney disease or health issues that affect kidney function are at higher risk of magnesium toxicity.

How much magnesium do you need?

Depending on your age and sex assigned at birth, adults need between 310 and 420 mg of magnesium a day. “Many people don’t get enough,” notes Sommer. “But if you decide to supplement, it’s best to start slowly with a lower dose. If it gives you a loose stool, that’s a sign to take a bit less.”

There are several different types of magnesium supplements, so it’s important you talk to a healthcare provider to help figure out the right supplement and dosage for you.

If you prefer to get your magnesium through food rather than a pill, there’s no shortage of magnesium-rich foods. Use our list above next time you go grocery shopping to make sure your meal plan contains enough foods with magnesium.

Ingredients

• 3 cups baby spinach
• 1 cup frozen mango
• 1 cup strawberries
• 3/4 cup unsweetened coconut almond milk
• A squeeze of lime juice

Directions

1. Add spinach, mango, strawberries, coconut almond milk and lime juice to food processor.
2. Blend until smooth.

Ingredient health benefits

• Spinach: This leafy green probably wasn’t on your radar as a smoothie ingredient, but adding spinach is a great way to get some iron and beta-carotene, an antioxidant that fights inflammation and helps protect your vision.
• Mango: A delicious tropical treat, mangoes are a good source of vitamins and minerals, like potassium and vitamin C. And did you know that two kinds of fiber contribute to a happy, healthy gut? Well, mangoes have both!  
• Strawberries: The compound that gives strawberries their luscious red color, anthocyanin, doubles as a powerful antioxidant with a lot of perks. Incorporating these little fruits into your diet can also support your heart health and help regulate your blood sugar levels.
• Coconut milk: As a low-calorie, no-carb, nondairy alternative, coconut milk is an excellent way to add some plant-based creaminess to any recipe.
• Almond milk: This popular nut milk is rich in vitamin E, which boosts your immune system, and has fewer calories than cow’s milk.

Nutrition information (per serving)

Makes 2 servings

Calories: 110
Total fat: 1 g
Total saturated fat: 0.5 g
Trans fat: 0 g
Cholesterol: 0 mg
Sodium: 155 mg
Fiber: 4 g
Carbohydrate: 23 g
Sugar: 17 g
Protein: 1 g

This kind of morning anxiety is an all-too-common feeling for many of us. Whether it happens due to situational stress or because of an underlying anxiety disorder, morning anxiety can stop your day in its tracks before it even begins.

But there’s a way to tackle this, and you may have guessed it — it has a lot to do with your sleep patterns. Psychiatrist Joseph Austerman, DO, goes over what morning anxiety is, why it happens and how to manage it. 

What is morning anxiety?

Morning anxiety is pretty much what it sounds like: It’s that feeling of dread that puts your body into fight-or-flight mode, even when there’s no danger around you. But this kind of anxiety pounces right when you wake up.

“Anxiety is a persistent worry,” says Dr. Austerman. “What makes morning anxiety really problematic is that it’s usually related to the night before. It may be related to something you went to bed thinking about, and then you wake up still affected by it.” He also notes that it’s common for these persistent anxieties to infect your dreams, too. This leads to feeling more wound up in the morning — and sometimes, you don’t even know why.

Overall, there’s nothing biologically different between morning anxiety and social anxiety or generalized anxiety. “Sometimes, it just hits people harder in the morning, and it’s associated with anxiety before bed as well,” clarifies Dr. Austerman.

Morning anxiety symptoms

Morning anxiety symptoms are similar to general anxiety you feel throughout the day, but as Dr. Austerman explains, you may feel more physical sensations rather than just a feeling of worry.

Morning anxiety includes symptoms like: 

• Stomach pain. 
• Heaviness or tightness in your chest.
• Headaches.
• Heart palpitations.
• Experiencing mind-racing thoughts.

“What is happening biologically is that your body is going into a fight or flight response,” he says. “So, because of that, you start breathing really fast and your heart rate jumps up.” 

In addition to the physical symptoms of morning anxiety, the specific worry we feel in the daybreak hours is usually about the day looming ahead of us. And these worries get magnified because you just woke up, the day hasn’t started and, as Dr. Austerman notes, you have nothing to distract yourself from this laundry list of worries. 

“What ends up happening is that you get paralyzed,” he explains. “It can lead to someone not getting out of bed or calling into work sick more often.”

Why do I get morning anxiety?

Our bodies work best when we keep them on a consistent sleep and wake schedule, so it’s no surprise that how we sleep can affect how we wake up — and vice versa. If you’ve been feeling a lot of morning anxiety, Dr. Austerman says it’s very likely you need to re-examine your sleep habits.

“What I often tell people is that we have to fix sleep first because we’re not going to be able to get at the underlying disorder if you’re not sleeping well,” he says. 

Tips for coping with morning anxiety

Tackling morning anxiety can be a little tricky. How do you calm yourself down even before you wake up? It’s all about starting with an ounce of prevention the night before.

Here are some ways you can prevent and relieve morning anxiety: 

Add calming rituals to your bedtime routine

To ensure that your mind isn’t waking you up with alarm bells the next morning, it’s important to have the best sleep routine possible.

Along with making sure you get about eight hours of sleep every night, it can be beneficial to try some specific relaxation techniques, like: 

• Sleep meditation.
• Guided imagery exercises.
• Yoga and light exercise. 
• Breathwork.

Play around with a few of these simple techniques to find out what works best for you, recommends Dr. Austerman. That way, you’ll be able to establish a consistent, relaxing routine to wind down at the end of your day — and alleviate, or lessen, morning anxiety.

“Being less anxious going to bed is going to help you be less anxious in the morning,” he reassures. 

Avoid screens before bed

It’s important to avoid too much stimulation right before bed. Your brain is like a sponge, and if you give it too much information to hold onto, that will keep spiraling into the night and morning. This is why Dr. Austerman stresses the importance of avoiding screen time for at least a full hour before hitting the hay. 

“Social media, and a lot of media in general, is geared toward keeping us emotionally keyed up and engaged,” he says. ”Scrolling the news on your phone or even watching an engaging TV show can keep your mind racing into the wee hours of the night.” 

Cut back on caffeine

Another stimulant can come in the form of what you put in your body. “It’s good to stay away from caffeine at least a good three hours from bedtime, preferably a little bit longer,” he continues, adding that if you experience a lot of anxiety during the day, it may be a good idea to switch to lighter caffeinated drinks in the morning as well.

“If your anxiety is based in your stomach and you’re already having a rumbling stomach, caffeine is going to increase your motility and it’s going to make things biologically worse,” he points out.

Use positive affirmations in the morning

You meditated before bed. You went to bed on time. But alas, you’re still anxious in the morning. What now? Thankfully, there are ways you can face any looming worries and get your day started easier. Dr. Austerman recommends using mental exercises that bring you back to the present, instead of letting your anxiety fast forward into the future. 

This can include the same meditative techniques you might be using at night, but instead of focusing on putting you to sleep, you’ll want to find a guided meditation that helps you feel calm and inspired for the day ahead. 

Dr. Austerman suggests saying some calming positive affirmations out loud, like: 

• I can do this.
• I’m calm right now.
• I’m physically OK. 
• There is nothing dangerous happening to me.

All of this ties in with that reassurance that helps pull back the dread that your anxiety may be causing. “Once you’re able to arrest these worries about the future, then you say, ‘OK, all I need to do is get out of bed,’” he says.

Try breathing exercises to ground yourself

If you’re feeling stuck in bed because of your anxiety in the morning, it may not be the best thing to shoot yourself out of bed as fast as possible. Instead, try approaching this feeling with a gentle nudge rather than a push.

Breathwork exercises can help with grounding yourself to the present moment. Some exercises to try include: 

• Box breathing. 
• Five-finger breathing.
• 4-7-8 breathing.
• Alternate nostril breathing.

“What you’re doing with these techniques is slowing down your breath rate and allowing your heart rate to calm down,” Dr. Austerman explains. “Once you get the breathing going, then you can try focusing on your heart rate and even trying to slow it down.” 

Take on your morning one step at a time

One of the toughest parts about morning anxiety is when it stops you from getting up. This is because morning anxiety throws a to-do list at us immediately, and we start to worry about all the things we need to do, but also that we need to do them right now.

Maybe your mind is immediately going to a meeting you have at work in the afternoon, or you start worrying about what you’re having for dinner. All these thoughts can begin to compound into a tornado in your mind, causing you to feel stuck.

To get unstuck, focus on each individual step of your morning routine. Don’t jump ahead to everything that needs to get done throughout the day. 

“Once you’re out of bed, all you need to do is start your morning routine,” states Dr. Austerman. “Try to keep it as present-centered as possible, and just focus on taking that next step.

“That stuff you’re thinking about is always going to be there. Thinking about it is not going to make it any better. But if you just think about what you have to do, right now, and focus that energy on right now, you’re just taking one little thing off the plate every time.” 

When to seek help 

While morning anxiety can be something you tackle on your own through meditation and better sleep hygiene, there’s no shame in seeking help if you feel like it’s affecting your health. Persistent morning anxiety can be a sign of sleep problems like insomnia or some kind of unchecked stress in your life that you may need help with. No one deserves to start their day feeling anxious, so if it’s starting to weigh on you more than usual, be sure to talk to a healthcare provider or therapist to see what other options are available. 

For people whose eczema (the most common form of which is called atopic dermatitis) isn’t well-managed, the impact can truly be all-consuming. But there’s good news: Your skin condition might not be curable, but it can be improved.

We talked with dermatologist Anthony Fernandez, MD, PhD, to learn how lifestyle changes and self-care practices can impact eczema. He shares some strategies for calming your skin and improving your daily lives.

How self-care can help with severe atopic dermatitis

Self-care means different things to different people, but when we’re talking about self-care for eczema management, the definition’s a bit easier to wrap your arms around.

“It’s all about prioritizing your physical and emotional well-being,” Dr. Fernandez says. In this context, that means intentionally taking time out of your day to care of yourself in ways that support your skin’s health.

For people living with eczema, the standard self-care bubble bath is a bad idea. But there are plenty of activities you can do that aren’t just OK for your skin, but good for it. It could be anything from taking a short nap or a walk to devoting five minutes to mindfulness every morning.

Right about now, you might be wondering, “How are naps, walks and mindfulness good for your skin?” The answer might surprise you.

Mindfulness

When you’re living with eczema, stress shows up on your skin. That, itself, can be pretty stressful. But that vicious cycle isn’t the only reason you need to attend to your insides as much as your outsides.

Dr. Fernandez explains that people with atopic dermatitis actually perceive itchiness differently than typical people do because their neural pathways are overreactive. Put another way, people living with eczema don’t just have sensitive skin; they also have sensitive nervous systems. When you take care of your mental and emotional well-being, you are treating your skin condition.

But let’s, for a moment, pretend there wasn’t a neuro or psychological component to eczema. It’s still a chronic illness. While some people are lucky enough to outgrow it, many individuals have work to manage the symptoms for the rest of their lives. As is true for most chronic illnesses — the mental and emotional health impact of dealing with eczema can be just as difficult to handle as the physical symptoms. That’s one reason Dr. Fernandez is a strong believer in the importance of mindfulness practices for atopic dermatitis treatment.

“Your eczema probably won’t cause you to develop a mental or emotional health issue, but it can definitely make one worse — and vice versa,” he explains. “Mindfulness can help everybody, but especially people who are experiencing severe symptoms.”

The research backs Dr. Fernandez up. A 2023 study found that adults with eczema who did online mindfulness and self-compassion training for 13 weeks saw a decline in the severity of their symptoms and an overall improvement in their quality of life. When we say, “quality of life,” we mean that they were in less discomfort, reported being in a better state of mind and were able to do their day-to-day tasks more effectively.

Here are a few ways you can work (preferably with the help of a trained mental health professional) to harness the power of the brain-body connection:

• Therapy. Maybe living with a skin condition has got you struggling with body image issues. Maybe all that itching makes you irritable or keeps you from getting anything done. These are just a few great reasons to consider seeing a mental health professional for eczema-related concerns. They can help you understand what’s happening in your brain and body when your symptoms are acting up. And the coping skills they teach you may help reduce the frequency or severity of your flares.
• Support groups. You don’t have to have a life-threatening illness to benefit from support groups. For conditions like atopic dermatitis, these in-person and online meetings aren’t just spaces to vent, but they’re also great places to stay updated on current research, get product recommendations and learn life hacks that you may have never thought of on your own. In addition to organizations like the National Eczema Association (NEA) and the Asthma & Allergy Foundation of America (AAFA), you can find eczema support groups through social media.
• Mindfulness. We mentioned earlier that mindfulness has been shown to improve eczema symptoms, but what exactly is mindfulness? It’s an activity — or several — that helps us get tuned into the present moment. It helps us connect more deeply to our body, our environment and our thoughts. Examples include:
  • Meditation.
  • Journaling (especially gratitude journaling).
  • Intentional movement practices like yoga, tai chi or qigong.
  • Breathwork.
• Self-soothing. If you have eczema, you know that there are moments when the itch becomes unbearable. But scratching is never a good call. It’s a gateway to further irritation and, potentially, infection. Self-soothing is sort of like hitting ctrl + alt + del on your brain. There are lots of different ways to self-soothe. Here are a few techniques Dr. Fernandez likes:
  • Get up and move. Even a little light stretching can do wonders.
  • Change your scenery. Go sit in the backyard for a moment, take the dog on a walk or grab a coffee across the street. A new environment means new things to see, hear, touch, smell and taste.
  • Activate your other senses. It’s all about making the itching sensation compete for your attention. Hold an ice cube in the palm of your hand. Take a few big whiffs of a scented candle, or — your skin permitting — dab a bit of essential oil on your wrist. Listen to some music you really love or turn on a guided meditation. Pop a hard candy in your mouth. Squeeze a stress ball or pet your furry friend. There’s lots of ways to engage your senses: Find the method that works best for you!
  • Rocking. There’s a reason we instinctively rock our children when they cry: It’s soothing! If you’re comfortable rocking yourself back and forth, go for it. Alternatively, consider getting yourself a rocking chair, glider or hammock that you can retreat to when you need a little extra comfort.

Lifestyle changes for dealing with severe eczema

Making time for mindfulness is just one lifestyle change that can positively impact your day-to-day symptoms. If you feel less like you’re managing your eczema and more like it’s managing you, Dr. Fernandez suggests considering changes in these five areas:

1. Your medications.
2. Your exercise regimen.
3. Your eating habits and nutrition.
4. Your bathing and skin care routine.
5. Your environment.

Medications

Atopic dermatitis treatment has come a long way in a short time, so if you haven’t seen a dermatologist recently, Dr. Fernandez suggests making an appointment.

“There are new prescription medications — some pills, some injections and some creams — that are making a big difference for people with eczema,” he says.

Also keep in mind that if you have other allergic conditions like a histamine intolerance, certain kinds of asthma, or mast cell activation syndrome (MCAS), treating those conditions might also improve your skin. Finally, a positive side effect!

Exercise

Dr. Fernandez has seen it happen far too often: People with severe eczema stop being physically active. Why? Because raising the surface temperature of your skin and sweating can make eczema itch worse.

“The benefits of exercise far outweigh the impact on your skin,” he says. “Instead of giving up on your fitness routine, choose activities that are less likely irritate your eczema and take precautions before, during and after your workout.”

Here are a few recommendations:

• Stay hydrated. Everybody should make sure to drink plenty of water while they’re working out, but that goes double for people with dry skin.
• Focus on activities that won’t make you sweat as much. You don’t have to complete an Iron Man to feel the burn and reap the benefits of exercise. Activities like Pilates can get your blood pumping and burn calories without leaving you drenched.
• Wear loose cotton clothes. Tight, moisture-wicking fabrics can be irritating for sensitive skin.
• Exercise indoors. If your eczema is flaring up, ditch the trail and run on a treadmill instead. You’ll still work up a sweat, but the climate control will help cool you down faster.
• Get the sweat off your body fast. According to Dr. Fernandez, all that salt sitting on your skin can dry it out. Have a towel handy to (gently) dab sweat away while you exercise. If you feel like your skin is overheating or your eczema’s getting angry, take a break and use a cold compress to cool down the affected skin.
• Consider swimming. For some people living with atopic dermatitis, chlorine does more harm than good. But for others, a swim in the pool can be like soaking in a really, really big bleach bath. And bonus: You don’t have to worry about being sweaty at the end of your workout!
• Moisturize before and after your workout. Put your moisturizer or eczema cream on an hour before being physically active and immediately after getting out of the shower. Just be sure to use something lightweight, Dr. Fernandez urges, so you aren’t trapping any extra heat on your skin.
• Avoid hot showers and skip the sauna. You don’t have to take a polar plunge or anything, but you also don’t want your post-workout routine to make your skin hotter. It feels great, but the warm water will dry your skin. Shower in lukewarm or cool water and, if you’re at a fancy gym, resist the temptation to sit in a steam bath. PS: If you plan on showering at a gym, be sure to bring your own soap, shampoo and lotion to avoid allergic reactions.

Diet

There’s no one way people who have eczema should eat because everybody has different triggers. That’s why it’s important to take the time — and it does take time — to figure out if anything you’re eating is making your eczema worse.

One way to do that is to go on an elimination diet. An elimination diet is exactly what it sounds like: An experiment to see what happens if you completely stop eating a certain type of food like gluten, dairy, or red meat for an extended period of time, usually about a month.  

It’s important to do elimination diets under medical supervision. Your provider can help you ensure your nutritional needs are being met. They can also they monitor your symptoms and give you advice on what to cut out of your diet and when.

If you find your symptoms improve while you’re on an elimination diet, that’s valuable information that can help you decide what an eczema-friendly diet looks like for you.

Bathing and skin care routine

People living with eczema have to be very intentional about their personal hygiene. It’s important to keep showers short and temperatures lukewarm to cool. You also need to use bath products that are mild and, where possible, fragrance-free. Gently pat yourself dry with your towel to avoid irritating your skin and slather on the lotion afterward to lock in the moisture. And If you tend to scratch in your sleep, it’s time to embrace the short-nail lifestyle (or sleep with gloves on). 

Environmental changes

Like any other allergic condition, the severity of your eczema has a lot to do with your surroundings. If your symptoms are giving you trouble, Dr. Fernandez says you may want to evaluate your space. You might need to put an air purifier in your bedroom or switch your cleaning products and laundry detergents. It could be time to swap out your yoga pants for something that’s less restrictive. If your furry friends shed a lot, you may need to vacuum several times a week to keep the dander levels in check. It may even be necessary to limit your time outside— or, if that’s a no-go, take steps to reduce your sun exposure. Small changes like these can make a big difference to your quality of life.

Final thoughts

There’s no cure for eczema, but that doesn’t mean you need to resign yourself to a lifetime of itching and discomfort. Instead, look at your lifestyle and see what changes you can make. From managing stress to making different fashion choices, there are lots of ways to reduce the frequency and severity of your flare-ups. Take what works, leave the rest — and when in doubt, talk to your dermatologist.

This winter season could be another doozy, as numerous respiratory viruses like the respiratory syncytial virus (RSV) surge alongside the flu and COVID-19 (what medical experts have dubbed “flurona”). Can you dodge all these infections? And if you get sick, how long should you expect to be sidelined before you return to regularly scheduled programming?

Family physician Matthew Goldman, MD, explains how to stay safe this winter season, along with how to handle 10 of the most common winter illnesses.

Why you might get sick this winter

“Illnesses are more common in the winter because contaminated respiratory droplets travel more easily in dry air when an ill person coughs or sneezes,” explains Dr. Goldman. “Plus, people tend to gather indoors when it’s cold outside (and for the holidays), making it easier for germs to spread from person to person.”

We also know that when you catch an illness, symptoms don’t always pop up right away. It could take up to a few days or a week for symptoms of a winter illness to appear depending on which virus you catch or germs you come into contact with and the strength of your immune system. Even though you might not feel sick, you’re still infected during this early incubation period — and you’re likely contagious and able to pass your infection on to others.

“You’re usually most contagious two to three days after you’re infected, but you can infect others for two weeks or longer while recovering from an illness,” reinforces Dr. Goldman.

How to stop the spread of common winter illnesses

If you or your child are sick with any illness, you can avoid spreading viruses to others by following these steps: 

• Cough and sneeze into the crook of your elbow, not your hands.
• Disinfect high-touch areas like countertops, doorknobs and remotes.
• Don’t share utensils, cups, food, toothbrushes, clothing, towels or other personal items.
• Stay home until symptoms improve and you’re no longer contagious.
• Wash your hands often with warm water and soap and use hand sanitizers intermittently.
• Wear a mask in public and consider wearing a mask at home around family members to protect other people, particularly those who are immunocompromised.

10 common winter illnesses

So, what’s circulating right now? And what should you know if you get sick? Dr. Goldman breaks down the top 10 winter illnesses you can catch during respiratory season:

1. Common cold (rhinovirus)

With more than 200 different cold viruses (rhinoviruses) in circulation, it’s no wonder that most adults catch colds two or three times a year. Kids — with their germy hands, phlegmy coughs and (lack of) sneeze-covering skills — get sick even more frequently.

Cold viruses linger, and you can pass the virus to others for up to two weeks. You and your child are contagious during the symptom-free incubation period. But you’re most likely to infect others when cold symptoms are at their worst — usually around day three of feeling lousy.

“For relief from a cold, staying hydrated is key. Drinking warm liquids like tea can be soothing for a sore throat and congestion, and small changes can make a big difference when you have a cold,” says Dr. Goldman. “Consider using a humidifier in your room to add moisture to the air to help loosen congestion or gargle with warm salt water to relieve a sore throat.”

2. Flu (influenza)

Flu season runs from October to May, but it’s possible to get sick with an influenza virus any time of the year. The flu sickens millions in the U.S. every year and could lead to potential hospitalization or death. The flu vaccine is the best way to protect yourself and your family from this highly contagious virus. Each year, a new vaccine is rolled out to protect you against current variants of the flu.

By the time you start showing flu symptoms, you’ve probably already given the virus to at least one other person. That’s because you’re contagious before you know you’re sick. The flu is contagious for a week or longer after you first have symptoms.

3. COVID-19

COVID-19 spreads easily and peaks during respiratory season just like the flu and RSV. Because of this, we now have an annual updated COVID-19 vaccine that functions just like the annual flu vaccine: It protects you and your loved ones from the most dangerous circulating variants of COVID-19.

While you can still get COVID-19 even after you’ve been vaccinated, you’re likely to experience less severe symptoms and you’re less at-risk of hospitalization.

If you get infected with COVID-19, you’re more likely to infect others with the virus one to two days before symptoms appear and two to three days after you start feeling unwell. How long you’re contagious can also depend on the severity of your illness. If you have:

• Mild or no symptoms (asymptomatic): You’re contagious for about five days.
• Moderate to severe symptoms: You may be contagious for up to 20 days.

“Once your symptoms have significantly improved or resolved, and it’s been at least five days since the onset of symptoms, you can generally be around others,” says Dr. Goldman.

“However, it’s prudent to wear a mask in public spaces or when close to vulnerable individuals for at least 10 days, to minimize the risk of transmitting the infection. If you’re symptom-free and it’s been more than 10 days since your symptoms first appeared, it’s typically safe to resume normal activities without a mask.”

4. Respiratory syncytial virus (RSV)

In adults and children who are otherwise healthy, RSV typically causes mild symptoms similar to the common cold. But this respiratory infection can cause potentially life threatening bronchiolitis and pneumonia in infants, adults who are older and people with weakened immune systems.

Every year, RSV infections in children lead to 58,000 to 85,000 hospitalizations, and now, we’re seeing around 177,000 adults 60 and older be hospitalized with this virus, too. To help protect these populations, we’re now rolling out an RSV vaccine for children and older adults.

If you or your child get infected with RSV, you can be contagious for a couple of days before symptoms appear and up to eight days afterward. But infants who are infected and people with weak immune systems may be contagious for up to four weeks, even when they no longer have symptoms.

5. Chest cold (bronchitis)

The viruses that cause colds, flu and COVID-19 can all lead to bronchitis if they’re left untreated or if their symptoms are severe enough. Also known as a chest cold, bronchitis causes the airways to your lungs to swell and fill with mucus. The most common symptom is a chronic cough that lasts three weeks or longer. Bronchitis isn’t contagious. But the cold, flu or other virus that led to bronchitis is, so you still need to take precautions to prevent infecting others.

6. Pneumonia

Bacteria — as well as the viruses that cause COVID-19 and RSV — can cause pneumonia. Both viral and bacterial pneumonia are contagious, but not everyone who’s exposed gets sick.

Children younger than 2, adults over 65 and people with weakened immune systems should get the pneumococcal (pneumonia) vaccine to prevent severe complications. These populations specifically are at increased risk for severe symptoms, and even death, as a result of pneumonia.

If you have viral pneumonia, you’re contagious until your fever breaks and when you’re fever-free for several days.

If you have bacterial pneumonia, you’re contagious until you’ve taken at least two days of antibiotics and no longer have a fever.

7. Pink eye (conjunctivitis)

Bacteria, as well as viruses that cause colds and COVID-19, can cause pink eye. This eye infection swells your blood vessels in the tissues (conjunctiva) that line your eyelids and outer eye. Your swollen blood vessels make the white part of your infected eye look pink.

You can spread viral pink eye very easily during the incubation period and while you have symptoms. Bacterial pink eye is contagious until you’ve taken antibiotics for at least 24 hours — or until the symptoms go away. For this reason, it’s important that if you have pink eye you avoid touching your face, your eyes and other surfaces as much as possible before washing your hands.

8. Sinus infection (sinusitis)

Colds and seasonal allergies can cause sinus infections. Also known as acute sinusitis, this infection occurs when your sinuses, which make mucus, fill with fluids. Bacteria sometimes grow in this mucus, causing bacterial sinusitis. A bacterial sinus infection isn’t contagious, but you can spread the cold that caused the sinus infection to others.

“To alleviate the discomfort of sinus pressure from an infection, I recommend regular saline nasal irrigation. This simple technique helps clear nasal passages, reduce congestion, and ease pressure. It’s a safe and effective way to lessen the symptoms and promote sinus drainage,” advises Dr. Goldman.

“Applying a warm, moist cloth over your sinuses several times a day can also be beneficial. The warmth helps open the nasal passages, reduces the pressure, and provides relief from pain.”

9. Strep throat

Colds and other viruses tend to cause sore throats. But it’s highly contagious group A streptococcus (strep) bacteria that causes strep throat.

This bacterial infection inflames the throat and tonsils, making it painful to swallow. You or your child may also have a fever and swollen lymph nodes. Left untreated, some children with strep throat will develop a bumpy red rash known as scarlet fever. If you or your child get strep throat, you’re contagious until the fever is gone and you’ve taken antibiotics for at least 12 hours.

10. Stomach bug (norovirus)

Norovirus is a stomach bug that causes diarrhea, vomiting and stomach cramps. Some people call it a “stomach flu”— but a flu strain doesn’t actually cause this illness. Still, noroviruses (there are many types) are highly contagious and difficult to kill. Noroviruses can linger for weeks on surfaces like countertops and doorknobs, too.

You’re most contagious when you’re throwing up, experiencing diarrhea or in the few days after symptoms ease. Unfortunately, you can infect others for two weeks or longer, even when you feel better.

When to see a provider about common winter illnesses

Depending on the illness, you or your child may need treatments like antibiotics or antivirals. If any of the following symptoms occur, you should make an appointment with a healthcare provider:

• Any fever in infants younger than 3 months or a fever between 99 degrees Fahrenheit (37.22 degrees Celsius) and 100.4 F (38 C) in a child older than 3 months.
• High fever above 102 F (38.88 C) in an adult that lasts more than four days.
• Difficulty breathing, wheezing or chest pain.
• Extreme fatigue or lethargy.
• Signs of dehydration like dark-colored urine, confusion, dizziness or a sunken soft spot (fontanelle) in infants.

With some preventive measures (vaccinate!), plenty of soap and water, and lots of common sense (don’t be the sneezy colleague!), we can all work together to weather the sick season better.

Wouldn’t it be great if you didn’t have to take these pain medications so often, or at all? It’s possible that modifying your eating habits could help you do just that.

Have you ever heard the phrase “food is medicine”? Well, there’s an abundance of scientific evidence to suggest that — when it comes to joint issues — it is! Adding certain foods, spices and supplements to your diet (and cutting back on foods that feed inflammation) can make a big difference in your quality of life. 

Registered dietitian Maxine Smith, RD, LD, shares six healthy foods that may help ease your joint pain, highlights those foods that need to be avoided and recommends a joint-friendly eating plan. 

How what you eat affects joint health 

Now, Smith isn’t claiming that food can reverse the effects of osteoarthritis, or that a change of diet can eliminate your pain completely. Most joint pain requires a combination of different treatment approaches, including medications, exercise, physical therapy and other lifestyle changes.  

But Smith is saying that a carefully curated diet is an important — and often overlooked — piece in the complex puzzle that is joint care. An eating plan centered on inflammation reduction can lessen pain in much the same way over-the-counter NSAIDs do.  

Side note: If you aren’t yet experiencing joint pain, Smith says that making good food choices now may help you keep it that way.  

What is inflammation? 

Inflammation is what happens when your body’s immune system gets … overexcited. If you cut yourself, your body responds by sending a horde of white blood cells to the wound to protect against infection. That’s a good thing: It’s a crucial part of the healing process.  

Inflammation becomes a problem when it’s chronic — when it decides to stick around long after it’s needed. It doesn’t have enough work to do, so it keeps itself busy by bothering healthy parts of your body. If you have a joint condition like arthritis, it’s not just the result of the wear and tear that comes from getting older. Inflammation is also in the picture.

“Our goal isn’t to eliminate inflammation,” Smith explains. “Inflammation serves an important purpose. We just want to reduce it, to make it more manageable and less widespread throughout the body.” 

Foods to eat that help with joint pain 

There are a lot of foods out there that have anti-inflammatory or pain-relieving properties. Smith selects six to start: 

1. Fish. 
2. Cruciferous vegetables. 
3. Turmeric. 
4. Yogurt.
5. Ginger. 
6. Green tea. 

You could combine all six of these foods and make quite a tasty meal for yourself! But for now, let’s break down each ingredient to find out how it can help you manage your joint pain. 

1. Fish  

Fish are rich in omega-3 fatty acids, which have anti-inflammatory properties. Ideally, you want to eat fish that’s both high in omega-3 and low in mercury. A few fish that meet that criteria are: 

• Salmon. 
• Trout.
• Mackerel. 
• Herring.
• Whitefish. 
• European anchovies. 

Fish isn’t typically an everyday food outside of coastal communities, so you might be wondering if you could just take a fish oil supplement instead. It might be an option, but you should definitely discuss it with a healthcare provider first. Smith also notes that you may be robbing yourself of other important nutrients that fish offers. Instead of popping a pill, consider going for frozen or canned fish. It’s convenient, healthy and tasty and can help keep inflammation in check!

2. Cruciferous vegetables 

“In addition to other vegetables, be sure to enjoy a host of cruciferous vegetables such as broccoli, cauliflower, Brussels sprouts or kale,” Smith recommends. “These are all nutritional powerhouses, chock full of phytochemicals like sulforaphane, which has potent anti-inflammatory properties.”

Dark green leafy vegetables and orange vegetables are other important vegetable groups to work into your daily menus. Salads, soups, bowls and stir-fries are an excellent way to get all these in a single dish.

3. Turmeric 

Turmeric — the bright yellow spice that you’ll find in many of your favorite curry dishes and that makes mustard yellow — has been used to calm painful, swollen joints for millennia. The pain-relieving ability can be credited to the curcumin in turmeric. Unfortunately, curcumin isn’t well used by the body, although consuming it with black pepper, healthy fats such as olive oil and in a heated dish can improve the absorption. A concentrated supplement can be the way to go if targeting pain relief. The types and dosages vary, so be sure to discuss any supplements with a physician before taking them.

4. Yogurt 

A healthy gut is of prime importance when it comes to managing inflammation. According to Smith, regularly eating fermented foods — like yogurt — provides bacteria that help create a healthy gut microbiome.

When you shop for yogurt, she recommends reviewing the nutrition facts label on the container to be sure it contains live and active yogurt cultures. Plain and unsweetened yogurts are the healthiest option, but don’t worry about being bored. “You can always enhance the flavor with an array of fruit, adding to the yogurt’s anti-inflammatory benefits!” she suggests.

5. Ginger 

At some point in your life, somebody’s probably given you something with ginger in it to settle an upset stomach. But did you know that ginger’s also great for more than just a crummy tummy? 

“Ginger has antioxidant properties and reduces inflammatory enzymes,” Smith explains. “That’s, in part, thanks to a compound in ginger called gingerol.” The name sounds made up, but there’s nothing fake about gingerol’s impact. Clinical trials have shown that ginger is helpful for dealing with a wide range of inflammatory conditions, from osteoarthritis to lupus. 

With ginger, Smith notes that preparation is important. “When ginger is heated, such as in curries and soups, gingerol gets converted into shogaols, which have more powerful anti-inflammatory potential.”

6. Green tea 

Green tea is one of the most popular beverages in the world. It’s also a nutritional powerhouse. It’s rich in polyphenolic compounds that help reduce inflammation across the board, not just in your joints.  

Quality matters with tea — and not just because it impacts the taste. In order to minimize the potential for consuming pesticides and herbicides, Smith recommends buying loose-leaf tea and rinsing it in water before steeping. Alternatively, consider purchasing a USDA- or Euro-leaf organic-certified tea. 

The Mediterranean diet and joint pain 

Having a few foods on hand to help when you’re feeling stiffer and more swollen than usual is great. But what if you want to create lasting change?  

The health benefits of the Mediterranean diet have been well established at this point. You may think of it as a go-to eating plan for heart health — and it is. But that’s just one of a long, long list of reasons to give it a try. The Mediterranean diet’s also great at combatting inflammation. So great, in fact, that some people find they no longer need NSAIDs to treat their pain after a short time following the eating plan. 

Eating a Mediterranean diet means eating:   

• Lots of fruits, vegetables and legumes. 
• Plant-based unsaturated fats (as opposed to animal-based saturated fat).
• Whole grains, nuts and seeds. 
• Fish and seafood. 
• Herbs and spices.

Notice that you don’t see a lot of processed food, red meat, alcohol, refined grains, sugars or dairy in that list? There’s a good reason for that: Those categories of food are known for stimulating inflammation.  

Foods to avoid 

In addition to eating foods with anti-inflammatory properties, you can improve joint pain and stiffness by avoiding foods that kick swelling into high gear. 

“Sugars and refined grains, including white rice, pasta and white bread, are some of the worst culprits when it comes to inflammation,” Smith states. 

Try limiting daily added sugar to six teaspoons for women and people assigned female at birth. Men and people assigned male at birth should restrict their intake to no more than nine teaspoons. Sugar hides in many foods from ketchup to cereals, so remember to be a label detective!

Another area to avoid: Unhealthy fats. “Choose healthy plant-based fats such as olive oil, avocado, flaxseeds, chia seeds, walnuts and hempseeds,” Smith advises. “They offer nutrients such as vitamins and minerals, antioxidants and fiber. They also have anti-inflammatory potential.” She also encourages eating fatty fish like salmon, saying, “They are by far the best sources of omega-3 fats.”

Smith also recommends limiting omega-6 fatty acids, which are often found in processed foods. While omega-6 fatty acids are healthy, we tend to eat way more than we need. Sources include corn oil, safflower oil, sunflower oil, peanut oil, grapeseed oil and vegetable oil. It’s common to use these oils in mayonnaise and salad dressing, so, again, you’ll have to do some label reading.

The fat in certain dairy products, fatty meats and chicken skin can also contribute to joint pain and swelling — another reason why plant-centric eating plans like the Mediterranean diet tend to reduce inflammation levels.  

Next steps 

It’s true that “food is medicine.” But if you feel like you’ve cleaned up your diet and are still experiencing joint inflammation and pain, it’s time to seek additional health support. 

First things first: Talk to your primary care provider or — if you have one — your rheumatologist. They’ll check to see if your joint issues are a sign of an underlying medical condition. If you already have a diagnosis, increased pain and inflammation may be a sign that your treatment plan needs to change.  

If you’re not already working with a pain management specialist, a provider may consider referring you to one for additional support. 

Once you’ve ruled out any issues with the joints themselves, get connected with a registered dietitian. They can help you determine if you have any food sensitivities or intolerances that might be impacting your inflammation levels. They can also personalize your eating plan so that it better fits your needs. 

As a supplement, some scientific evidence shows that it can help reduce your risk for high blood pressure. It also may help manage blood sugar levels for people with Type 2 diabetes. And there have been studies looking into the benefits of magnesium for everything from migraine treatment to COVID-19, which have shown to be helpful in some cases.

But when it comes to mental health, could magnesium really help reduce anxiety? From a neurological standpoint, there’s some evidence to suggest magnesium can be beneficial for managing anxiety and stress — though more research is needed. 

Before you consider taking it, here’s what you should know when it comes to magnesium and anxiety. 

How is magnesium good for anxiety?

Among other things, magnesium has been shown to help with anxiety in various ways. But before we get into the details, it’s important to remember that supplements like magnesium aren’t suitable replacement for professional medical care. That’s why it’s important to talk to your doctor about your anxiety and what other steps you should be taking to manage your symptoms, as other therapies can be more effective than magnesium.

Here’s what we know so far about magnesium and how it may help with anxiety: 

Regulates cortisol levels

First, magnesium has been shown to help with leveling out your cortisol — one of the stress hormones in your body. “Cortisol is very important for acute stress, but in times of chronic stress, it can actually worsen depression and anxiety,” warns Dr. Austerman. 

In other words, too much stress, and therefore, cortisol, can magnify your anxiety. Many studies have explored the effect that magnesium has on reducing cortisol levels. Magnesium can tackle this excessive anxiety by diminishing or blocking the neuroendocrine pathways that send cortisol to your brain. 

Balances out neurotransmitters

In addition, magnesium can help with regulating overwhelmed neurotransmitters in your brain. Neurotransmitters serve as the on and off switches of the brain — when you get stressed or anxious, they flip on, and when you calm back down, they turn off. 

“When too many of your switches are on, your nerves are hyper-excited, so you feel anxious and you can even feel depressed, especially in the emotional control centers of our brain,” Dr. Austerman explains. Your brain keeps these on-and-off switches balanced by having two types of neurotransmitters: the first excites the nerves (excitatory), while the other inhibits, or blocks them (inhibitory).

“The on switches are the neurochemical called glutamate,” he continues. “And the off switch — or the thing that turns some of these nerves off — is a neurochemical called gamma-aminobutyric acid (GABA), which is also the anxiety pathway.”

Magnesium can help with keeping our neurotransmitters from over-firing and making anxiety worse. According to Dr. Austerman, it does this by blunting the release of glutamate — the excitatory neurotransmitter — and helping release GABA, the inhibitory neurotransmitter.

“In some ways, magnesium can mimic what some of our anxiety medications do,” he says. 

What to know about magnesium deficiency

Finally, there’s also something to be said about magnesium deficiency and how, for some people, taking these supplements could fill in a nutritional gap.

“We know from studies done 10 to 15 years ago that about 70% of Americans are magnesium deficient,” says Dr. Austerman. “So, this is a pretty common thing that we see. And we’ve seen that when you give magnesium to people, especially with mild anxiety, they tend to get better.”

So, it may be possible that you could have a deficiency that’s contributing to your anxiety. It’s important to discuss this with your healthcare provider to know for sure.

Best forms of magnesium for anxiety

If you’ve ever browsed the rows and rows of shelves of supplements at the store, you’ve likely noticed that magnesium actually comes in a lot of different varieties. This is because some magnesium supplements are combined with other substances to either improve their efficiency or help the body absorb them better. Is there a specific formula you should look for?

Unfortunately, we just don’t know. Dr. Austerman notes that there hasn’t been any research yet looking at how well specific magnesium compounds work for treating anxiety.

“Currently, there is no uniform study where they use the same type of magnesium and replicate it in another study,” he says.

If you’re shopping around for magnesium, here are some common types that are usually recommended for anxiety:

Magnesium from food sources

Before trying a supplement, try to meet your daily magnesium needs naturally from foods. Your body is better able to absorb nutrients from food sources versus supplements, so aim to increase your intake of magnesium-rich foods such as nuts, legumes, whole grains, low-fat dairy and leafy greens.

Magnesium citrate

This form of magnesium supplement is bound to citric acid and is often used as a laxative. According to Dr. Austerman, it’s the most commonly available type of magnesium you can find over the counter.

Magnesium glycinate

This is a form of magnesium that’s bound to the amino acid glycine, which is found naturally in protein-rich foods like fish, dairy and meat. A 2017 review found that glycine can improve sleep, reduce inflammation and help manage metabolic disorders such as diabetes. Along with those reasons, this type of magnesium is often recommended for anxiety because it’s well-absorbed and may help reduce stress levels.

Magnesium l-threonate

This form of magnesium is relatively new. According to a 2013 review, it can be easily absorbed and does a good job of increasing magnesium levels in the brain. A 2022 study also found that a magnesium l-threonate-based formula helped improve cognitive function and mental clarity.                

Side effects of too much magnesium in the body

Especially with supplements, it’s important to understand the amounts you’re taking and how much is too much. It’s possible to experience symptoms of too much magnesium in the body from supplementation.

Some of these symptoms can include:

• Muscle weakness.
• Nausea.
• Vomiting.
• Low blood pressure.
• Feelings of fatigue.

How much magnesium should I take?

So, your next question may be: How much magnesium should I take?

First things first, if you’re considering trying out this supplement for your anxiety, you should talk to your healthcare provider to make sure it’s right for you and to make sure you’re taking the right amount. 

For normal intake, the National Institute of Health generally recommends: 

When to seek help

If you’ve been living with anxiety, one of the first steps is to talk to your healthcare provider to figure out a care plan that fits you best. Treating different types of anxiety can involve everything from talk therapy to prescription medications. 

“If you’ve been supplementing for about a month, and you’re not seeing any difference, then it’s time to look at something different,” says Dr. Austerman. 

While magnesium supplements may be helpful for some people with anxiety, they aren’t a substitute for professional medical care. If you’re experiencing symptoms of anxiety, it’s important to speak with your healthcare provider to determine the best course of treatment for your individual needs.

For instance: COVID toes. Are they really a thing? What about COVID rashes? And do these terms actually describe symptoms of COVID-19? We asked pediatric infectious disease specialist Frank Esper, MD. 

If they’re COVID-19-related, they’re uncommon 

By now, we’re all familiar with the telltale signs of a COVID-19 infection. But what about the disarming outliers? Should we be concerned?  

Dr. Esper says while they’re attention-grabbing and unusual, COVID toes and COVID rashes are quite rare and aren’t signs of life-threatening complications. And while these symptoms have been associated with the coronavirus more than other viral infections, neither of them became widespread during the pandemic. 

“These symptoms may be more common in COVID-19 compared with other viral infections,” Dr. Esper continues. “But they don’t affect a majority of people by any means.”  

But what if it happens to you? Should you be worried? 

Instead of seeing COVID toes or COVID rashes as a sign of danger, Dr. Esper says that we should see them as evidence that our bodies can react to infections in different ways. They may be interesting manifestations of our body’s response to the virus, but they’re nothing to worry about. 

Side effects of viral infections 

In the early days of the pandemic before home testing was possible, everybody was looking for new signs and symptoms to figure out if they were positive for COVID-19. In that context, COVID toes and COVID rashes seemed novel. But in reality, skin involvement isn’t unusual in the realm of viral infections.  

Dr. Esper says it’s actually quite common for people to get rashes when they’re battling infections, especially viral respiratory ones.  

“It’s not uncommon for someone to have a viral infection and have a rash or blotchy areas on their body,” he says. “This can happen with measles, for example. And medications sometimes cause skin rashes, too. So, there are a lot of reasons you may get a rash while battling a virus.”  

The same goes for the reddish spots or lesions on the feet that we took to calling “COVID toes” in the early days of the pandemic. They aren’t new symptoms. And they can occur for a number of reasons. 

“It’s possible that COVID toe is a skin reaction. It could also be caused by a small clog or micro clots in the blood vessels in the toes,” Dr. Esper explains. He’s seen something similar happen with ICU patients with sepsis and people on life support.  

It’s a possibility, but it’s not the only explanation out there. In fact, many researchers now think COVID toes have nothing to do with COVID-19.  

Could COVID toes actually be chilblains? 

There’s a growing body of evidence to suggest that “COVID toe” was never really a thing.  

That’s not to say that people’s toes weren’t inflamed or discolored. They were. But many doctors now believe they were just episodes of chilblains — painful patches of skin that occur in response to cold air exposure.  

Researchers found a weak correlation between chilblain-style lesions and COVID-19 infection. While they didn’t rule out the possibility of a relationship between chilblains and COVID-19, they offered a few theories as to why incidences of chilblains might have gone up during the early days of the pandemic: 

1. People were hyperaware of their bodies because of the pandemic. As a result, they noticed and sought treatment for a condition they might not have noticed otherwise. 
2. A lot of people don’t wear shoes and socks when they’re at home … and many of us spent a lot more time at home, thanks to shelter-in-place orders. That could have led to increased cold exposure — and a resulting increase in chilblains. 

An article in Nature notes that — as COVID-19 has shifted from an acute crisis into a feature of our daily lives — rates of chilblains have pretty much gone back to normal.

The debate is still alive and well in scientific circles, but for everyday people, it doesn’t especially matter if COVID toes are real. Mercifully, we’re past the stage of the pandemic where we can’t be sure whether or not we’re infected.

When to see a doctor 

If you’re concerned that you have COVID toes or a COVID rash, the first thing to do is to see if you have the virus. In countries where they’re available and affordable, most people use home tests to check for COVID-19. And those of us who are vaccinated (and boosted!) are unlikely to experience complications.  

If you test positive for the virus, you should isolate at home. If you notice a rash or COVID toes in addition to the more common symptoms of the coronavirus, Dr. Esper says it’s best to contact your healthcare provider. They may prescribe medication to treat your skin and toes. And if your age or health status raises your risk for more severe complications, they may also decide to put you on an anti-viral medication like Paxlovid®. 

Toes and rashes aside, you should call 911 or go to the nearest hospital if you have COVID-19 and: 

• Are experiencing chest pain, tightness or pressure. 
• Are dizzy, lightheaded or experienced a fainting episode (syncope). 
• Are struggling to breathe. 
• Are exhausted to the point of being unable to stay awake.  
• Are experiencing confusion or a sudden change in your mental state. 

COVID toe or no, all the basic rules of respiratory virus prevention still apply. If you’re sick, stay home. Wear a mask. When you are out, practice social distancing. And always, always, always wash your hands. Your skin will thank you! 

And if you were assigned female at birth (AFAB), you’re more likely to find yourself in this situation.

“Females are hospitalized for asthma twice as frequently as males, and their mortality is twice as high,” says pulmonologist Neha Solanki, MD.

Could sex hormones, which rise and fall throughout our lives, be the reason?

Research shows that lung function is affected when:

• Estrogen levels are higher, which happens after puberty for females.
• Testosterone levels are lower, which happens before puberty for males.

“The evidence linking the sex hormones to asthma continues to grow,” Dr. Solanki states. She breaks down the research we have to date on this topic — and what it could mean for your treatment options.  

Asthma through the years

Asthma is a curious illness. The statistics around prevalence, severity and hospitalizations jump back and forth based on age.

“Up to age 14, males are more likely to need office and ER visits, as well as hospitalization, for asthma,” Dr. Solanki notes. “But asthma prevalence, severity and hospitalizations are greater for older females, especially those 40 to 60 years of age.”

Estrogen levels start falling after menopause. “The research suggests menopause may actually protect against severe asthma,” she adds.

Cue another role reversal. Males tend to bear the brunt of their asthma later in life, probably because their testosterone levels decline with age.

Can hormones affect your breathing?

“The current research strongly suggests that sex hormones affect asthma,” Dr. Solanki reiterates. “But how exactly they affect the lungs is still poorly understood.”

One theory is that sex hormones affect the pace at which hair-like cilia clear mucus out of the airways.

Dr. Solanki underscores that, “Until the exact mechanism is identified, the research suggests that doctors should consider factors that impact the sex hormones — like age and personal medical history — when treating people for asthma.”

The power of sex hormones

Up to this point, we’ve been talking about symptom severity in general terms. But it’s important to realize just how significantly sex hormones may impact people living with severe asthma. So, let’s put a number to it: One-third of females of reproductive age find that their asthma symptoms get worse immediately before getting their period.

One-third is a lot of people, and the result — more visits to the ER — is no small thing. The physical and emotional resources (not to mention the time and money) poured into managing severe asthma can be draining.

And there’s more. Asthma prevalence is also higher in people who get their period early in life, have multiple pregnancies and/or have hormonal conditions like polycystic ovary syndrome.

Asthma and oral contraceptives

If hormone levels can impact your asthma symptoms, you may be wondering: What happens to people who take hormonal birth control?

In a study, researchers found that people who took oral contraceptives had a 14.3% risk of developing asthma in their lifetime. Females who didn’t take birth control had a lifetime risk of 8.8%.

But wait! It gets more complicated.

“We think birth control pills may actually benefit some people who get premenstrual asthma,” Dr. Solanki adds. “If they take it because their period is irregular, it may reduce their hormonal peaks. But studies have been inconclusive, and more research is needed.”

Endometriosis and asthma

Endometriosis is a painful condition in which tissue that’s similar to the tissue lining the uterus during the menstrual cycle grows outside of it.

“Both asthma and endometriosis are related to an imbalance of the sex hormones — and estrogen, in particular,” Dr. Solanki explains. In fact, there’s growing evidence to suggest that people who are transmasculine (and take testosterone as part of their transition process) experience endometriosis at higher rates than cisgender (people whose gender identity corresponds with what they were assigned at birth) women do.

Research suggests that there’s an association between asthma and endometriosis. While research is ongoing, there’s early evidence to suggest the two conditions may be genetically linked.

Can hormonal imbalances trigger asthma?

You may be noticing a pattern here. The available research tells us that if your body grows and develops in a typical way, changing levels of sex hormones may impact your experience of asthma over the course of your life. And if your hormones are imbalanced — when, for whatever reason, they aren’t behaving as expected for a person your age — you may be even more likely to experience severe asthma symptoms.

If you’re living with severe asthma, that might be a scary thought. So, what can you do about it?

How does this information impact you?

If you were assigned female at birth, you might be wondering: Should I stop taking birth control pills?

“We don’t want patients to just stop taking oral contraceptives,” Dr. Solanki stresses. “They’re effective for preventing pregnancy and managing certain chronic conditions, and most people tolerate them well.”

In fact, oral contraceptives may keep premenstrual asthma symptoms from worsening at the end of your menstrual cycle.

“We’re simply asking patients to be vigilant,” she says. “Tell your doctor if you notice more asthma attacks while on birth control pills. If you feel like your contraception method is having a negative impact on your health, your provider can help you decide what alternative is right for you and your situation.”

After menopause, your asthma will likely improve. But if hot flashes or other symptoms become unbearable during the transition, will it be safe to take hormone replacement therapy (HRT)?

Because HRT contains estrogen, Dr. Solanki notes that it may temporarily worsen your asthma. But don’t take that as a sign that you shouldn’t take a prescribed medication. Instead, watch your symptoms, and alert your provider if you have any concerns.

“Hopefully, randomized, controlled trials will lead to better recommendations soon,” she says.

Ingredients

• 4 cups cooked 100% whole-wheat, extra-wide noodles
• 8 ounces ground white meat turkey breast, extra lean and skinless
• 1 cup sliced fresh mushrooms
• 1/2 cup diced onions
• 2 packets mushroom gravy mix
• 1/2 cup light sour cream
• 1 cup frozen peas, thawed

Directions

1. Bring a large pot of water to a boil. Add noodles and follow cooking directions. When fully cooked, drain pasta.
2. In a large non-stick pan or a pan coated with non-stick cooking spray, sauté the ground turkey breast, mushrooms and onions. Cook thoroughly over medium heat. Drain any liquid remaining.
3. Microwave peas or steam them on stove.
4. In a saucepan, cook mushroom mix as directed. Whisk in light sour cream when finished to avoid curdling.
5. In a serving bowl, combine drained noodles, ground turkey mixture and thawed peas. Pour mushroom and sour cream mix over noodles, and mix gently. Serve with a side dish of steamed vegetables or a tossed salad.

Ingredient health benefits

• Whole-wheat pasta: Always a nutritious choice, whole-wheat pasta is full of whole grains, which support your health in many ways. For starters, they’re rich in fiber, which keeps you fuller for longer, and are even good for your brain.
• Mushrooms: In popular culture, these fungi are famous for helping out a beloved, mustachioed plumber — but he’s not the only one who benefits from eating them! Mushrooms have many important vitamins and minerals, like potassium, which helps your body regulate blood pressure, and zinc, which boosts your immune system.
• Onions: The perks of these edible bulbs aren’t often talked about, but onions are high in antioxidants like immunity-boosting vitamin C. They also have prebiotics and fiber, which your gut will thank you for.
• Peas: A perfect example of how good things come in small packages, green peas are a great source of vitamin B6 and butyrate. These essential nutrients support many body systems, from your brain down to your gut.

Nutrition information (per serving)

Makes 4 servings
Serving = 1/2 cup

Calories: 310
Carbohydrate: 44 g
Protein: 21 g
Total fat: 6 g
Saturated fat: 2.5 g
Cholesterol: 34 mg
Sodium: 641 mg
Potassium: 179 mg
Fiber: 6 g
Sugar:  5 g

Sports medicine physician Dominic King, DO, explains how to safely take an ice bath and what benefits it can provide your body after a big workout.

What is a cold plunge?

A cold plunge is exactly what it sounds like: A brief dip into an ice bath. And an ice bath is exactly what it sounds like: A very, very cold bath.

But unlike the long, relaxing baths you take for self-care purposes, cold plunges are quick, therapeutic dips in ice water. Brrr!

“You can create an ice bath by filling a bathtub halfway with cold water and then adding three large bags of commercial ice,” Dr. King says. “Or use a smaller container to focus on a smaller part of the body, such as the elbow.” Collapsible cold plunge tubs are sold online, as well.

Fill your bath with water that is no colder than about 53 degrees Fahrenheit (11.6 degrees Celsius). But if you’re new to ice baths, Dr. King recommends starting much warmer, at about 68 F (20 C). Don’t be fooled, though — that’s still pretty darn cold for a bath!

Cold plunge benefits

As long as you’re in good health and don’t have any underlying conditions mentioned below, cold plunges may bring some relief to your sore muscles.

“There’s no doubt that some people get great relief from using ice baths,” Dr. King notes. “Patients can get physical, mental and functional benefits from this kind of cold therapy.”

A small 2017 study showed that ice baths may not be as beneficial as once thought, but many medical professionals — especially those who work with serious athletes — still consider them useful. And a 2021 study of college soccer players showed that cold water immersion therapy promotes basic post-sport recovery.

Benefits include:

1. Eases sore muscles

This one is pretty simple: After a hard workout, ice baths feel good. The cold water constricts your blood vessels, which slows blood flow and relieves some of that swelling and soreness you feel in your muscles after a long run or a hard-fought game.

Again, though, be sure you’re only easing post-workout aches and not actual pain. If you have to push through pain during exercise, there may be an underlying injury. Don’t cover up that pain with cold. “You may be delaying appropriate healing,” Dr. King warns.

2. Reduces your core body temp

If you’ve just worked yourself into a sweat, it follows that an icy dip is a quick way to cool down. When your body is all fired up from a workout, that cold water brings your core temperature back down in a flash.

But be careful: Staying in an ice bath too long can lower your core body temp too much, which is also risky.

“In sports medicine, ice baths are used for marathon runners and others who are experiencing heat injuries,” Dr. King explains. “We use it as an emergency treatment in the field to bring down their core temperature.”

3. May help you focus

Honestly, you may just like a cold plunge now and then, especially if you find that the jolt of cold helps snap your brain into focus. “Some people feel that it’s a very helpful mental meditation for them,” Dr. King says.

4. May help you sleep better

This benefit is mostly anecdotal and not well-proven by research, but Dr. King says he’s heard it from some people.

“Some people say it helps them sleep much better and that they feel less fatigue overall,” he reports.

5. Decreases inflammation

Cold water constricts your blood vessels, which can help with the swelling related to inflammation.

“Some patients who have swelling and inflammation find great relief from soaking in an ice bath,” Dr. King says.

He notes, though, that other people find that heat works better at reducing their inflammation — so it’s really a matter of figuring out what feels best for your body.

How long should you spend in a cold plunge tub?

It’s best to keep it quick, starting with five minutes and maxing out at 10.

“Start low and go slow,” Dr. King advises. “Don’t go too cold and don’t go for more than five minutes, just to make sure you can tolerate it.”

Studies show that after a few minutes, an ice bath doesn’t do much for you anyway.

“There is some research that shows that after two to three minutes, additional benefits taper off,” he adds. 

Side effects, risks and who shouldn’t take ice baths

Before you take an ice bath, it’s important to know whether it’s safe for you. Check with your doctor beforehand, as cold plunges can have negative and potentially dangerous effects on people who have medical conditions like:

• Heart disease. 
• High blood pressure. 
• Diabetes. 
• Peripheral neuropathy. 
• Poor circulation. 
• Venous stasis. 
• Cold agglutinin disease. 

Your healthcare provider can also help assess whether you’re dealing with an underlying condition. While ice baths can ease your aches and pains, they aren’t the right choice if you’re dealing with something more pressing, like a fracture, a ​tendon or ligament tear, or another injury.

“You have to make sure there’s no underlying problem that you’re icing through,” Dr. King emphasizes. “You don’t want to use cold therapy to simply numb pain coming from a more serious injury, like a fractured bone or torn tendon.” 

So, when you hear popular folklore and read online headlines that claim certain foods will increase your milk supply, of course, you listen. And you’re tempted to take those recommendations seriously. 

“People who are breastfeeding want to be sure they’re doing everything possible for the health of their baby, and that’s admirable,” says lactation specialist Marie Lattarulo, RN. “If there’s a tip to crank up milk production, they’re looking for it.” 

The truth, though? There’s no solid scientific evidence that proves any particular foods will increase your milk supply.  

Let’s say it again: No. Eating more apricots, fennel seeds, oatmeal, salmon or any other certain foods won’t ensure you’ll make more milk.   

Disappointing? Perhaps.  

But there’s good news, too. It’s this: Everything you eat makes a difference in your milk supply.  

Lattarulo explains why people who are breastfeeding should stick to a well-rounded diet to keep their supply up, and why no particular foods are best for milk production. 

What to understand about galactagogues 

Galactagogues are foods some people claim help you make more milk when you’re breastfeeding. They include things like: 

• Whole grains and oats. 
• Nuts. 
• Legumes. 
• Brewer’s yeast. 
• Fenugreek.  
• Lactation cookies. 
• Milk thistle. 

But the problem is that none of these foods have been proven in scientific research to have any effect on milk supply. For that reason and others, the American College of Obstetricians and Gynecologists (ACOG) warns against relying on particular foods to improve milk supply. 

They say, “Galactagogues should not be considered as first-line therapy because current research on the effectiveness of pharmaceutical and herbal galactagogues is relatively inconclusive and all substances have potential adverse effects.” 

In other words, eating (or overeating) galactagogues isn’t likely to help you make more milk. And they could even be risky.  

How food affects your milk supply  

Lactation works primarily on the supply-and-demand principle. The more milk you put out, the more you’ll make. Your body naturally regulates your milk supply based on the demands of your baby. 

In addition to feeding your baby regularly using proper breastfeeding positioning, eating an overall healthy diet can also help to encourage a healthy milk supply. 

“When you’re breastfeeding, it’s important to maintain a balanced and nutritious diet to meet the demands placed on your body. Your plate should feature all five food groups — fruits, vegetables, grains, dairy and protein,” Lattarulo advises. 

Of course, you can include your favorite galactagogues in your diet. Things like whole grains, nuts and legumes can certainly play a role in your healthy eating. But think of them as a part of your overall healthy diet. Not as the primary food you need to stock up on to make more milk.  

What to eat when you’re breastfeeding 

Rule number one in your breastfeeding diet is to make sure you’re eating enough of a variety of healthy foods. Breastfeeding isn’t the time to consider cutting back on calories. Your body actually needs extra calories to produce milk.  

“We encourage people who are breastfeeding to take in about 300 to 500 calories more than they needed pre-pregnancy,” Lattarulo says. “That’s about how many calories you use to make milk and feed your baby each day.” 

Rather than worrying about choosing certain foods to increase your milk supply, aim to get plenty of nutrients in your diet to keep you and your baby healthy.  

Lattarulo suggests these nutritional guidelines for breastfeeding: 

• Fill half of your plate with fruits and vegetables. 
• Choose whole-grain products for at least half of your grains. 
• Select low-fat or fat-free milk, yogurt or cheese. 
• Pick from a variety of different proteins. 
• Limit your caffeine and alcohol intake. 

Stay hydrated, too. Most providers recommend you drink at least 16 cups of water per day when breastfeeding.  

“Most of us aren’t actively keeping track of how many ounces of water we drink every day, though, especially when you’re busy with a new baby,” Lattarulo notes. “So, listen to your body. Drink some water whenever you feel thirsty, and follow your body’s guidance.” 

How to know if your milk supply is enough 

Now, there’s a reason you went searching down a rabbit hole searching for superfoods to ramp up your milk production. Breastfeeding can seem a bit like a mystery at times. Particularly because when you’re nursing your baby, there isn’t a way to know for sure how much your baby is getting. 

We get it. 

Healthcare providers recommend breastfeeding exclusively for the first six months of your baby’s life. But research from the U.S. Centers for Disease Control and Prevention (CDC) suggests that only about 25% of babies drink only human milk by the six-month mark. 

Researchers also note that one of the major reasons for that is parents’ worries about baby not getting enough breastmilk. So, they wind up supplementing with formula. Or switching to formula altogether. 

But take a deep breath. Odds are you’re doing just fine. 

“It’s very typical and normal to worry about whether you’re making enough milk,” Lattarulo reassures. “But by and far, most people create plenty of milk to keep their babies healthy and growing.”  

How do you know if your baby is getting enough breastmilk? Check for these signs that your milk supply is doing its job: 

• Your baby makes six or more wet diapers per day. 
• Your baby is gaining weight. 
• Your baby sticks to a (mostly) regular feeding schedule with at least eight or more feedings each 24 hours.  
• You can hear and see your baby swallowing milk. 
• Your breasts feel softer and emptier after feeding your baby. 

If you have concerns about your milk production, raise them as soon as possible with your healthcare provider, your child’s healthcare provider or a lactation consultant. They can help make sure you’re on track.  

One thing is for certain, though: Any issues you encounter breastfeeding won’t be because you’re not eating specific foods. 

Want beef in your chili to add heartiness and protein? Toss it in the pot. Prefer chicken or turkey? That’ll work, too. Not a meat person? No problem! Tofu can hold a starring role in chili.

Your choices don’t end there, either. A variety of different beans can add flavor and health benefits to chili. Ditto for any number of veggies in your fridge or freezer.

And when it comes to spices … well, how hot do you want your chili to get?

Making a batch of chili is basically a culinary version of a choose-your-own-adventure book. The good news? No matter what decisions you make, odds are you’ll have a tasty meal to serve after a bit of simmering.

But if you’re looking for ideas to add a little extra zing or healthy goodness to your chili, try one (or two or three) of the ingredient ideas on this list from registered dietitian Julia Zumpano, RD, LD.

Picking a protein

Beef chili is king in many circles — but it’s not exactly the most gentle protein option when it comes to your cardiovascular health. That’s because beef, and red meat in general, is higher in artery-clogging saturated fats.

So, if you’re open to trying something different, Zumpano suggests using one of these proteins in your chili. (Plus, feel good about adding these nutritional benefits.)

• Turkey. (Niacin, selenium.)
• Chicken. (Niacin, vitamin B6, phosphorous, potassium.)
• Pork. (Thiamin, niacin, riboflavin, vitamin B6, phosphorous, zinc, selenium.)
• Venison. (Niacin, vitamins B6 and B12, thiamin, riboflavin, phosphorous, zinc.)
• Buffalo. (Niacin, vitamin B12, zinc, selenium.)
• Soy crumbles. (Thiamin, niacin, iron, vitamins B6 and B12.)
• Tofu (fortified). (Calcium, copper, iron, manganese, omega-3 fats, phosphorus, selenium.)

Now, if you just can’t imagine making chili without beef, make sure to grab a leaner cut. Zumpano recommends beef between 85% to 90% lean.

Another option? Mix and match proteins in your chili to cut down on the amount of beef in the pot. A chili with half beef and half chicken, for instance, will have less saturated fat and added taste interest.

Picking a bean

There’s a somewhat heated debate in chili circles about whether beans belong in the recipe. Most of the opposition comes from those who prefer Texas chili, which typically DOES NOT include beans.

Zumpano’s advice? Don’t skip the beans. (Sorry, Texas.)

Beans are chock full of soluble fiber, which offers benefits such as improved heart health, lower cancer risk and better digestion. Fiber also makes you feel fuller, which can keep you from going back for seconds (and help with weight management).

The Mediterranean diet — which many consider the gold standard of eating plans — recommends eating at least three servings of beans or legumes every week.

So, what kind of beans work nicely in chili? Here’s a short (but by no means complete) list:

• Kidney beans. (Fiber, protein, folate, iron, phosphorous, copper, manganese.)
• Black beans. (Fiber, protein, folate, iron, riboflavin, phosphorous, thiamin, manganese.)
• Chickpeas. (Fiber, protein, iron, phosphorous, vitamin B6, folate, manganese.)
• Navy or great northern beans. (Fiber, protein, iron, potassium, folate, magnesium, phosphorous, manganese, thiamin.)
• Pinto beans. (Fiber, protein, folate, thiamin, iron, phosphorous, manganese, selenium.)
• Soy or edamame (green soy) beans. (Calcium, copper, iron, magnesium, manganese, omega-3 fats, phosphorus, potassium, Vitamin K, folate.)

Adding in veggies

Don’t be shy about adding vegetables to your chili. In fact, Zumpano recommends doubling the veggies in your recipe. (And if your recipe doesn’t include veggies, add them to the ingredient list!)

Veggies add texture and bulk to your dish without bringing extra fat or a ton of calories. Try veggies such as:

• Red or green bell peppers. (Vitamins C, E, B1, B2 and B6, folate.)
• Onions. (Vitamin C and K, fiber, folate, potassium, manganese, iron.)
• Diced tomatoes. (Vitamins C and K, potassium, manganese, iron.)
• Celery. (Fiber, vitamins A, C and K, folate, potassium, manganese.)
• Diced carrots. (Fiber, vitamins A, C and K, potassium.)
• Cubed butternut squash. (Fiber, vitamins A and C, potassium, manganese, magnesium.)
• Diced zucchini. (Fiber, vitamins C, K and B6, riboflavin, folate, magnesium, potassium, manganese.)

Spicing it up

A store-bought packet of chili powder is often a go-to for many chili chefs. If you go that route, check labels to avoid added fillers (especially if you’re gluten- or dairy-free) or chemical anti-caking agents.

But don’t be afraid to use dried guajillo, chipotle and ancho chilis to make your own chili powder. Hit your spice rack for some extra zing, too. Options include:

• Cumin. (Iron, magnesium, copper, manganese, calcium).
• Oregano. (Vitamin K, anti-inflammatory, anti-bacterial, antiviral).
• Coriander. (Copper, manganese, iron, magnesium, anti-inflammatory, phytonutrients, antibacterial.)
• Garlic. (Vitamins C and B6, manganese, immune-boosting, anti-inflammatory, antibacterial.)
• Turmeric. (Iron, manganese, anti-inflammatory.)

Kicking up the heat

Dried, fresh or pickled peppers can differentiate your chili from the pack and bring some serious heat. But while peppers may make your belly feel like it’s on fire, they are actually “firefighters” that can help extinguish inflammation in your body.

Here are a few to try:

• Dried cayenne pepper. (Vitamins A, C, E, K and B6, manganese.)
• Jalapenos/Mexican dried chiles. (Vitamins A, C, K and B6, folate, potassium, manganese, iron, magnesium.)
• Canned chipotle chiles in adobo sauce. (Vitamin A, fiber, iron.)

Tantalizing toppings

A good bowl of chili speaks for itself. Why destroy it — and your waistline — by drowning it in high-fat, high-calorie toppings? Avoid processed oyster crackers or saltines and use a light hand when selecting fresh, color-adding finishes.

Any (or all) of these toppings are worth your consideration:

• Red onion. (Fiber, folate, vitamins B6 and C, manganese, potassium, phosphorous.)
• Avocado. (Vitamins C, E, K, B1, B2 and B6, folate, potassium, magnesium, fiber, heart-healthy unsaturated fat.)
• Chopped scallions. (Fiber, vitamins A, C and K, folate, calcium, iron, potassium, manganese.)
• Cilantro. (Vitamins C and K, choline).
• 2% shredded cheese. (Calcium, vitamin D.)
• Sour cream (low-fat or fat-free). (Calcium, vitamin D.)
• Plain Greek yogurt or dairy alternative yogurt (to replace sour cream). (Calcium, vitamin D, protein).

Chili recipes

Not interested in making so many choices just to get a dinner on the table? Don’t worry! We’ve got you covered. At least one of these six chili recipes should fit your taste.

• Spicy beef chili with butternut squash.
• White chicken chili.
• Buffalo chicken chili.
• Black bean chili with corn and cilantro.
• Vegetarian red bean chili.
• Meatless black bean chili.

From strains and sprains to tendonitis and carpal tunnel syndrome, wrist pain is all too common. But relief is possible by doing wrist pain exercises and stretches, says occupational therapist and certified hand therapist Jesse DeFilippo, OTR/L, CHT.

Why exercises and stretches help wrist pain

“Overuse causes inflammation in the tendons of your wrist, and eventually, pain and inflammation limit your range of motion,” DeFilippo says. “But certain movements and stretches help lengthen and strengthen your wrist muscles, restoring your full range of motion. Wrist exercises can also help ease your pain.”

Only do these stretches and exercises if you can move your wrist without significant pain. On a scale of 1 to 10, DeFilippo says that your pain should be at a three or four or lower — any higher and you should see a healthcare provider instead of trying to go it alone.

Best stretches for wrist pain

There are two holy grails of wrist pain stretches: The wrist flexor stretch and the wrist extensor stretch. Good for most wrist pain causes, both of these movements start with you holding your arm out straight in front of you.

To do the wrist flexor stretch:

1. Face your palm up.
2. With your fingers straight, bend your wrist down toward the floor.
3. Use your other hand to deepen the stretch by gently pushing your fingers downward. You should feel a mild to moderate stretch in your forearm.
4. Hold the stretch for 10 to 20 seconds and then release.

To do a wrist extensor stretch:

1. Face your palm down toward the floor.
2. Keeping your fingers straight, bend your wrist down.
3. Use your other hand to deepen the stretch by gently pushing against the back of your hand. You should feel a mild to moderate stretch in your forearm.
4. Hold the stretch for 10 to 20 seconds and then release.

Do three to five sets of each stretch, up to three times a day.

“But don’t force it,” DeFilippo advises. “Do it until you feel a stretch you can tolerate, and then gradually increase the stretch over time. It shouldn’t hurt, so pull back if you feel any pain.”

Wrist range of motion exercises

These exercises involve going through the different ways your wrist can move:

• Flexion: Bend your wrist forward and hold this position five seconds.
• Extension: Bend your wrist backward and hold for five seconds.
• Side to side: Moving only from your wrist joint, slowly move your hand side to side. This movement is similar to the wrist motion you’d do if you were, say, wiping down a table. Pause on each side rather than moving vigorously.

Do three sets of 10 repetitions for each exercise. “Start off doing each motion on its own to see if you can tolerate it,” DeFilippo recommends. “You can build up to holding a light weight while doing these exercises to further strengthen your wrist.”

Weighted wrist extension

To do a weighted wrist extension:

1. Hold a can or a weighted handle in your affected hand.
2. Position your hand palm down while holding the object.
3. Slowly bend your wrist, lifting your hand up and then back to its starting position.
4. Do three sets of 10 reps.

Over time, you can try using objects that are a little bit heavier.

Tendon glides

Tendon glides also help with your range of motion. To do them:

1. Hold your hand up in a high-five position.
2. Bend your fingers down toward your palm at your middle joints (proximal interphalangeal joints) and top joints (distal interphalangeal joints).
3. Hold this bent position for five seconds.
4. Return your fingers to their starting position.
5. Do three sets of 10 reps.

Scapular squeeze

“This stretch is mainly for carpal tunnel and other nerve-related conditions,” DeFilippo says. “It engages nerves that run all the way from your neck to your hand.”

To do a scapular squeeze:

1. Squeeze your shoulder blades together, opening up your chest.
2. Hold this position for five seconds.
3. Complete three sets of 10 reps.

Grip strengthening

If de Quervain’s tenosynovitis (aka de Quervain’s tendinosis) is your issue, DeFilippo says both grip strengthening and wrist range of motion exercises can help.

To do grip strengthening exercises, you need a rubber ball that you can hold in your hand. Squeeze and hold the ball for five seconds. Do three sets of 10.

“For each, do two sets of 15 reps. Stick to three times per week to ensure adequate rest and prevent overtraining,” he says. “But feel free to do wrist stretches and movements like flexion and extension every day up to three times daily without weight.”

Opposition stretch

To do an opposition stretch:

1. Place your hand on a flat surface with your palm facing up.
2. Touch the tip of your thumb to the tip of your pinkie finger. Keep your other three fingers as flat as possible against the surface.
3. Hold this stretch for six seconds.
4. Return your fingers to their original position.
5. Repeat this movement 10 times.

Weighted wrist flexion

Before you start, know that this exercise isn’t for everyone.

“You should typically avoid weighted wrist flexion if you have carpal tunnel syndrome,” DeFilippo states. “The excessive compression during wrist flexion can aggravate the median nerve.”

If you’re not dealing with carpal tunnel, here’s how to do a weighted wrist flexion:

1. Hold a can or a long handle in your hand with your palm facing up.
2. Bend your wrist upward and then slowly return it to its original position.
3. Do two sets of 15 repetitions on your affected wrist.
4. Gradually increase the weight of the object you hold.

Wrist radial deviation strengthening

To do this exercise:

1. Hold your affected wrist out as if you were about to shake someone’s hand. For example, if you’re exercising your right hand, your right palm should be facing left.
2. Support your hand on a hard surface or by putting your other hand under your wrist.
3. Holding a can or light weight, tilt your wrist up toward the ceiling and back down again.
4. Do two sets of 15 repetitions on your affected wrist.

Finger spring

To do a finger spring:

1. Put a rubber band around the outside of your fingers and thumb.
2. Stretch the rubber band by pushing your fingers and thumb outward against it.
3. Do two sets of 10 reps.

Other tips for wrist pain

To help relieve wrist pain, DeFilippo also recommends:

• Use ergonomic computer accessories such as an ergonomic keyboard or mouse.
• Take frequent breaks to stretch your wrist while working.
• Cut back on activities that aggravate your wrist while it heals, like texting or grasping things.
• Wear a wrist splint at night.

When to see a healthcare provider about wrist pain

Because wrist pain can have so many causes, it’s important to listen to your body. DeFilippo advises seeking medical attention if:

• There’s any indication of a fracture or dislocation.
• The pain impacts your ability to move the affected area.
• The pain gets in the way of your ability to do regular daily activities.
• Your wrist is swollen or bruised.
• You do wrist pain exercises for two to three weeks but your symptoms don’t get better.

And if you have a lactose intolerance or follow a dairy-free or vegan diet, you may need to avoid dairy products. But the list of foods that are dairy may be longer than you think.

Registered dietitian Anna Taylor, RD, LD, points out certain foods with dairy and what words to look for on your food labels if you’re living dairy-free.

What’s considered dairy?

The United States Department of Agriculture (USDA) defines dairy as milk, yogurt, cheese, lactose-free milk and fortified soy milk and yogurt.

But “nondairy” on a label doesn’t mean the product doesn’t contain milk derivatives. For example, a nondairy food may contain casein, one of the major milk allergens.

Foods that have dairy

Looking for a list of dairy products to avoid? Here are some common foods that you may not think contain dairy but do.

Margarine and butter

Is butter a dairy product? Yes, says Taylor. Butter is typically made by churning cream that comes from a cow’s milk. And even margarine, which you may think is a dairy-free alternative, may contain dairy ingredients like whey or lactose.

“There are plenty of vegan margarines on the market now,” she says. “An easy way to double-check is a quick glance at the package. If a product contains milk, it must disclose this by saying ‘contains milk’ or similar wording at the end of the ingredients list.”

Chocolate

Does chocolate have dairy? Say it ain’t so! Unfortunately, lots of chocolate contains milk — milk chocolate, white chocolate and even some dark chocolate.

“There are plenty of dark chocolates that don’t contain milk as an ingredient, but they may still be cross-contaminated with milk if they are made on the same equipment as other types of chocolate,” clarifies Taylor.

Bread

Think twice before you reach for that dinner roll. You need to check the label to see if the bread you’re about to eat contains lactose (which is used sometimes as a sweetener) or whey (which is used in some cases as a preservative). You also need to watch out for crackers, which may also contain lactose and whey. Check the label for any dairy ingredients or milk derivatives (more on those in a moment).

Baked goods

Chocolate chip cookies, vanilla cake, bread pudding — the list can go on and on with baked goods that contain some form of dairy. Just think about all that butter in your go-to recipe for sugar cookies. And even if a recipe doesn’t call for butter, you need to watch out for those that use yogurt or milk.

“Of course, not all baked goods contain dairy. Grocery stores often carry specialty products that are dairy-free or even vegan, and the internet is swarming with dairy-free recipe alternatives for a variety of baked goods,” notes Taylor. “And if it’s a sweet tooth you’re coddling, there are also plenty of tasty plant-based ice creams on the market today that use an alternative like coconut milk or soy milk — so these would be dairy-free as well.”

Frosting

The icing on the cake? It’s probably made with milk or even cream.

“Luckily, your holiday cookies can be decorated with a simple mixture of water and powdered sugar (food coloring and your favorite extract flavoring optional!),” suggests Taylor. “Let’s just not fool ourselves into thinking it’s any healthier just because it’s dairy-free!”

Hot dogs

While you may not think of the ballpark staple containing any dairy, you need to be careful. Even sausages and deli meat may contain forms of dairy.

Instant mashed potatoes

You know that homemade mashed potatoes are often made with milk and butter. But what about instant mashed potatoes? Sorry to burst your bubble, but the mixture often contains powdered milk or butter to add flavor.

Salad dressings

Skip pre-made options, which tend to use lactose for a creamy consistency and to add flavor. Instead, opt to make your own salad dressing at home.

“Try mixing 1 part vinegar (such as apple cider vinegar, red wine vinegar or balsamic vinegar) or lemon juice to 3 parts olive oil,” shares Taylor. “Feel free to add some seasonings (like pepper or Italian seasoning) and a dollop of your favorite grainy mustard to flavor. It’s easy, fast and delicious — without all the unnecessary additives.”

Flavored potato chips

It can be easy to chomp your way through a whole bag of barbecue or salt-and-vinegar potato chips, but any kind of chip that comes in a flavor like dill pickle or sour cream-and-onion often contain dairy in their seasoning.

Canned tuna

Think you’re just getting tuna packed in water or oil? Think again, there may be hidden dairy ingredients. Many varieties turn to casein as a filler.

Canned or boxed soup and broth

Sure, it makes sense that cream of chicken and cream of broccoli soups to have dairy (typically milk solids). But don’t forget to check other options, even chicken, vegetable and beef broth.

Gum

You just had a very garlicky lunch and need to freshen up your breath before your afternoon meeting. But did you know that some brands of gum use dairy in the form of casein? Make sure you read the label before you chew.

Medicines and vitamins

Taylor says to remember to check your medications, too. About 20% of prescription medications and 6% of over-the-counter drugs contain lactose. Talk to your doctor about your options.

“Or chat with your pharmacist about it,” she recommends. “They often have access to ingredient information for many medications and supplements.”

Other ingredients to watch out for

In addition to milk listed on a product’s label, you may be wondering: What is a milk derivative and what has dairy in it? If you’re avoiding dairy for any reason, it’s important to check your food labels for the following ingredients, many which are considered a milk derivative:

• Butter.
• Casein.
• Caseinates.
• Curds.
• Dry milk solids.
• Lactalbumin.
• Lactalbumin phosphate.
• Lactoglobulin.
• Lactose.
• Milk.
• Milk by-products.
• Nonfat dry milk.
• Whey.

“Since milk is one of the top allergens in the U.S., it has to be listed directly under the ingredients list if a product contains any dairy,” emphasizes Taylor. “So, don’t forget to check that label!”

What if you could get multiple vaccines in one visit — the old one-and-done approach? It’d be more convenient, but is it safe? 

Primary care specialist Daniel Sullivan, MD, answers that question and explains what you need to know about getting more than one vaccine at a time. 

Can you get multiple vaccines at once as an adult? 

The short answer is yes. “It’s been shown both in studies and in general use that getting more than one vaccine in a day is completely safe,” says Dr. Sullivan.

Getting more than one vaccine doesn’t mean mixing all the vaccines in a single syringe and getting only one shot, though. It means you can safely get multiple, separate vaccines during one appointment.  

Mixing or combining vaccines into one shot is only OK for certain formulations approved by the U.S. Food and Drug Administration (FDA). One approved combo is HepA-HepB — a single vaccination that guards adults against both hepatitis A and hepatitis B. 

While it’s safe, there are still some pros and cons to weigh about getting multiple, separate shots in one visit. Let’s take a look. 

Benefits of getting multiple vaccines at one time 

Overall, doubling or even tripling up on vaccines offers more benefits than downsides.  

“If you don’t mind getting multiple shots, you’ll be better off stacking multiple vaccines into one appointment when you can,” Dr. Sullivan says. 

Check out these potential benefits of getting multiple vaccinations at once.  

Increases effectiveness 

Vaccines trigger your immune system to produce antibodies — proteins that recognize and attack a disease or virus.  

You may wonder if your body can mount an immune response to more than one vaccine at a time. Dr. Sullivan explains that getting vaccines simultaneously is not only safe, but it also may actually make each of those vaccines even more effective. 

“Getting a vaccine improves your body’s immune response,” Dr. Sullivan explains. “The second vaccine enhances that response and intensifies your ability to react to the vaccine trigger.”  

He also recommends getting multiple vaccines in the same arm whenever possible. Research suggests it may encourage a stronger immune response than vaccines given in different limbs. 

“When multiple vaccines target the same local lymph nodes, those lymph nodes produce more antibodies and help your body build a stronger response to the vaccine,” he adds. 

So convenient 

Whether you’re due for routine vaccinations or simply want to stay healthy this winter, getting the vaccines you need can be challenging if you need multiple appointments. 

“Most routine vaccines for adults can be given at the same time,” Dr. Sullivan notes. “For instance, we offer the flu shot and COVID-19 vaccine together so it’s easier for patients to protect themselves without the hassle of coming back.” 

Wondering how many routine vaccines you can get at once? It’s a matter of preference. 

“Our nurses have given people four or more vaccines in one appointment if it’s what the patient wants and needs,” he says. “Not everyone wants that many pokes in one sitting, but it’s safe and saves your multiple trips to the office.” 

Downsides to getting two vaccines in the same arm 

Getting more than one shot in the same arm is safe, but it may not be ideal for everyone. 

 Your healthcare provider may want to give the shots in separate limbs if you are: 

• Getting painful shots: TDaP (tetanus, diphtheria and pertussis) and PCV (pneumococcal conjugate, a pneumonia vaccine) commonly cause muscle soreness and some tenderness at the injection site. Getting these shots in separate arms can decrease your post-vaccine pain. 
• Concerned about a bad reaction: If you’re worried about a severe reaction or have reacted badly to a previous vaccine, it may be wise to get vaccines in separate arms. If you have a reaction, you’ll know which vaccine caused it. 

Which vaccines can’t be given together? 

Dr. Sullivan acknowledges that there are urban legends about vaccines that you can’t get together. But most people can get most routine vaccines at the same time unless you prefer to space them out.  

That is most people and most vaccines can be given in combo.  

There are some circumstances that will require you to space things out.  

Dr. Sullivan explains those situations. 

People who are high-risk  

People age 65 and older and those who are at high-risk for certain complications shouldn’t get some vaccines at the same time.  

For example, people age 65 and older need two pneumococcal vaccines, PCV and PPSV23 (23-valent pneumococcal polysaccharide). But you can’t get both vaccines on the same day. 

Plan to get PCV first. Then, after eight weeks, you can get PPSV23. If you mistakenly get PPSV23 before PCV, that’s OK. But you’ll have to wait a year before getting PCV. 

People with certain spleen issues or HIV also have limits on how many vaccines they can get at once. If you have these conditions, plan to get pneumococcal conjugate and meningococcal vaccines at separate times.  

In general, if you have health conditions or any concerns, talk to your healthcare provider about the most appropriate vaccination schedule for you. 

People getting travel vaccines 

Traveling abroad often requires vaccinations that aren’t routine in the United States. Certain travel vaccines can’t be given at the same time.  

For example, if you need vaccines for both cholera and typhoid fever, you need to get the cholera vaccine first. You’ll then need to wait at least eight hours to get the typhoid vaccine. 

People getting live vaccines 

Vaccines use either a weakened (live) form of a disease or an inactivated one. Both trigger your immune system to fight off infection.  

Live vaccines tend to create a stronger immune response, so you don’t want to get more than two live vaccines at the same time. Some examples of live vaccines include:  

• Influenza (nasal spray). 
• Measles, mumps and rubella (MMR vaccine). 
• Smallpox. 
• Typhoid fever (oral vaccine). 
• Varicella (chickenpox). 
• Yellow fever. 

“You can get two live vaccines on the same day,” Dr. Sullivan says. “After that, you’ll need to wait four weeks to get another live vaccine. The spacing helps achieve the appropriate immune response.” 

If you’re due for multiple vaccines and want to get them over with at once, know that in most cases you can. Talk with your healthcare provider about any risks and the most appropriate vaccine schedule for you.  

That’s where you come to the rescue with a baby nose sucker, otherwise known as a nasal aspirator. Pediatrician Noah Schwartz, MD, explains what causes phlegm in babies, the nasal aspirators available and how to use them.

What causes throat phlegm in babies?

Phlegm is kind of icky, but it does serve a purpose. In normal amounts, it keeps tissues from drying out and helps get rid of dust and other particles your baby inhales. But when there’s too much phlegm in their nasal passages, it can make it difficult for them to breathe, as babies almost exclusively breathe from their nose. The phlegm can also drain down into their throat (postnasal drip) interfering with their ability to eat and making breathing even more difficult.

Several things can trigger extra mucus production in your infant.

“We most often think of things like upper respiratory infections causing phlegm,” says Dr. Schwartz. But a cold isn’t the only cause of excess mucus.

Common causes of throat phlegm in babies include:

• Acid reflux. If your baby has acid reflux, stomach acid irritates their throat and nasal passages. Your baby‘s body responds by making extra mucus.
• Allergies. Older babies and children may have allergies, but newborns typically don’t have the types of allergies that cause excess phlegm.
• Colds, viruses and upper respiratory infections. Catching a cold can stimulate more phlegm in babies just like in adults. An infection in the lungs can also cause phlegm that your baby has to cough up.

“In addition, babies just have really small nasal passages and nostrils,” explains Dr. Schwartz. So, it doesn’t take much for your baby’s nose to get stuffy.

Why is it important to clear phlegm from your baby’s nose and throat?

Keeping your baby’s airways clear of mucus helps with breathing and feeding.

“But babies have a hard time clearing their nose and throat on their own,” says Dr. Schwartz. “They can’t clear their throats or blow their noses like toddlers can.”

You can provide relief from nasal congestion with a nasal aspirator. This device helps prevent mucus from getting into your baby’s throat. But once the mucus is already there, they have to cough it up.

“You may get concerned when your baby coughs,” says Dr. Schwartz. “But don’t stop them from coughing. It’s a reflex and the only way for them to clear throat phlegm. That’s one of the reasons we don’t recommend cough medicine for children younger than 5.”

If you’re concerned about your infant’s cough or breathing, you should make an appointment with their pediatrician.

What is a nasal aspirator (baby nose sucker)?

Also known as a baby snot sucker, a nasal aspirator is a simple device for removing mucus from your baby’s nose. You can’t use a nasal aspirator in your baby’s mouth or throat. But clearing mucus from their nose keeps it from running down their throat.

Steps to remove phlegm from your baby’s nose

There are a few types of nasal aspirators. Each has its own instructions.

Before reaching for a nasal aspirator, Dr. Schwartz advises using saline nasal drops or spray in your baby’s nose. The saline loosens the mucus, making it easier to get out. You can get saline nasal drops or spray in drugstores without a prescription. Be sure to get one that says it’s safe for infants and doesn’t contain any medication.

How to use a suctioning bulb nasal aspirator

A suctioning bulb nasal aspirator is a rubber device with a round bulb and a tapered stem.

“This is the most common type of nasal aspirator,” says Dr. Schwartz. “New parents usually get one in the hospital to take home.”

Suctioning bulbs are inexpensive, readily available and can work well enough to give your baby relief. But they have a couple of drawbacks:

• They’re difficult to clean out. “It’s pretty much impossible to clean the inside of a suctioning bulb unless you find one that unscrews,” states Dr Schwartz.
• It’s easy to put the tip in too far. Babies have very short nostrils, and sticking the tip of the bulb in too far can damage nasal tissues.
• You can’t see what’s coming out. Suctioning bulbs are typically not see-through, so you can’t tell how much mucus you remove.

To use a suctioning bulb:

1. Follow the instructions for using saline nasal drops or spray.
2. Squeeze the bulb, then gently insert only the very tip into your baby’s nostril.
3. Slowly release the bulb to create suction that pulls out the mucus.
4. Using a tissue, squeeze the bulb into the tissue several times to get rid of the removed mucus.
5. Repeat with the other nostril.
6. Wash the entire suctioning bulb with soap, rinse it well and let it air dry.

How to use an oral suction nasal aspirator

Oral suction nasal aspirators require you to use your mouth. You suck on the end of a tube to remove mucus from your baby’s nose.

“This makes some parents a little squeamish, but there is a filter between your mouth and your baby’s nose,” explains Dr. Schwartz. So, there’s no risk of ending up with a mouth full of baby boogers.

Ick factor aside, research shows that parents generally like oral nasal aspirators better than suction bulbs. Dr. Schwartz prefers oral suction nasal aspirators because they’re:

• Cleanable. You can take them apart and clean them. (And change that very important filter, if needed!)
• Clear. The parts are clear plastic, so you can see how much mucus comes out.
• Easy to control. You use your mouth to control the level of suction.
• Safe. There’s a guard that keeps you from pushing the tip too far into your baby’s nostril.

To use an oral suction nasal aspirator:

1. Follow the instructions for using saline nasal drops or spray.
2. Insert the aspirator tip into your baby’s nostril.
3. Place the mouthpiece in your mouth and suck in slowly to create suction.
4. Repeat with the other nostril.
5. Clean the nasal aspirator according to the manufacturer’s instructions.

How to use an electric nasal aspirator

Electric suction nasal aspirators work the same way as oral suction nasal aspirators. The difference is that instead of using your mouth to create suction, you simply turn on the device.

“Electric nasal aspirators are the most expensive,” says Dr. Schwartz. “But they work well for parents who don’t want to use the oral suction type.”

To use an electric nasal aspirator:

1. Follow the instructions for using saline nasal drops or spray.
2. Insert the aspirator tip into your baby’s nostril.
3. Switch the device on. It may switch off automatically after several seconds.
4. Repeat with the other nostril.
5. Clean the device according to the manufacturer’s instructions.

“Unfortunately, there’s no magic trick to keeping your baby well and free of mucus all the time, and daycare can make this even more challenging,” says Dr. Schwartz.

In general, he recommends avoiding people who are sick if you can and washing your hands often. If you’re concerned that allergies or acid reflux might be causing throat phlegm in your baby, an appointment with your pediatrician is always the best course of action.

But when choosing tea, there’s more to consider than just flavor. Different teas offer distinct health benefits — and spearmint tea brings a lot to the table.

“The best thing about tea is that it’s affordable, readily available and easy to make,” says registered dietitian Natalie Romito, RDN, LD. “That means anyone can enjoy the benefits of spearmint tea.”

Spearmint (Mentha spicata), like peppermint, is a type of mint. The concentrated forms of different kinds of mint may offer similar health benefits. But spearmint leaves have unique health benefits that make its tea stand out.

Romito shares what you need to know about your soothing cup of spearmint tea.

Is spearmint tea good for you?

Spearmint tea is naturally sugar-free and doesn’t contain caffeine. It can help you stay hydrated and provides a healthy, flavorful alternative to water.

Fresh spearmint contains vitamins and vital nutrients but only in small amounts — it would be hard to get the recommended daily amount from spearmint tea alone. But spearmint tea contains antioxidants, which protect the cells from damage due to free radicals.

Spearmint tea is an excellent source of:

• Flavonoids, such as flavanones and flavones, which boast antioxidant properties.
• Rosmarinic acid, a compound that provides powerful antioxidant and anti-inflammatory benefits.

“Black tea is known to be high in antioxidants. But if you don’t like the taste of black tea, spearmint tea is a great alternative and has a comparable number of antioxidants,” Romito says. “And all teas help lower inflammation and reduce the risk of numerous diseases, including cancer, diabetes and heart disease.”

How spearmint tea can boost your health

Experts haven’t studied the benefits of spearmint tea as widely as the health benefits of other types of tea. But research related to a few specific health conditions is promising.

To gain the benefits of spearmint tea, Romito says it’s important to pay attention to the amount of tea needed to get that benefit.

“A lot of the studies for spearmint tea used 5 grams of tea a day, equivalent to three or four standard tea bags,” she says. “Measure loose-leaf tea in grams using a food scale.”

What can spearmint tea help with?

1. Improves hormonal imbalance associated with PCOS

As many as 5 million women and people assigned female at birth (AFAB) in the United States live with polycystic ovary syndrome (PCOS) — a condition marked by severe hormonal imbalance. People with PCOS typically have:

• High levels of androgens, a group of male sex hormones that includes testosterone.
• Low levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), the hormones responsible for sexual function.

“Multiple studies have shown that spearmint tea can benefit people AFAB who have a hormonal imbalance due to PCOS,” Romito says. “It helps bring testosterone levels back into the normal range, which may improve some of the symptoms associated with high testosterone.”

In one study, people with PCOS drank spearmint tea twice a day. After a month, they had lower levels of testosterone and higher levels of LH and FSH compared with participants who drank placebo tea.

But you may see results sooner than that. In another study, people with hormonal imbalances saw improvement after just five days of drinking spearmint tea.

“The benefit likely depends on how far out of normal range your numbers are,” Romito says. “If your testosterone levels are a little high, the tea may be enough. If they are very high, you may need additional medication to see improvement.”

2. Helps with excessive hair growth

Some people AFAB experience excessive hair growth (hirsutism). The dark, coarse hair typically grows on their face, breasts and stomach.

Approximately 5% to 10% of people AFAB of reproductive age experience hirsutism. It can be a side effect of some medications and a symptom of other conditions. But half of those who have it also have excess male hormones. The extra hormones overstimulate hair follicles.

“One of the symptoms of PCOS and hormonal imbalance can be excessive hair growth,” Romito shares. “But that symptom decreases and even goes away when you lower the testosterone level.”

Spearmint tea can help. In the same study that found drinking spearmint tea lowers testosterone, participants also reported reduced hirsutism.

3. Improves joint stiffness

One of the antioxidants in spearmint tea, rosmarinic acid, provides powerful benefits for joint pain and stiffness. Research shows that people with osteoarthritis who drank spearmint tea containing a high level of rosmarinic acid significantly reduced their joint pain and stiffness.

But your joints will benefit even if you don’t have access to tea high in rosmarinic acid. Study participants who drank generic spearmint tea purchased at their local supermarket found that their joint stiffness greatly improved.

Other possible benefits of spearmint

While there’s limited research on spearmint tea, experts have found other possible health benefits associated with spearmint extract and essential oils.

“Essential oils and extracts can be more concentrated, which can change the impact on your body,” Romito notes. “With humans specifically, studies looking at essential oils are very different from studies focusing on teas.”

The research on spearmint extract and essential oils — which includes both human and animal studies — finds that those substances may help:

• Fight bacterial infection.
• Improve nausea and stomach upset.
• Improve memory.
• Lower blood pressure.
• Lower blood sugar.

Additionally, spearmint may provide some of the same benefits as mint — both part of the Mentha plant family. But at this point, there isn’t enough research to be sure.

Is it good to drink spearmint tea every day?

Experts find minimal risks associated with drinking spearmint tea. For most people, it’s OK to have multiple cups daily.

But some people should be careful about how much spearmint tea they drink. Children and people who are pregnant should consult their healthcare provider, as there’s no conclusive evidence that spearmint tea is safe for them. Romito also suggests limiting or avoiding spearmint tea if you have:

• Gastroesophageal reflux disease (GERD).
• Kidney function issues.
• Liver function issues.

“Spearmint tea can worsen these conditions if you have too much or drink it too often,” Romito cautions. “But if you like spearmint tea, ask your healthcare provider if it’s safe to have it occasionally in small amounts. It’s often all about the dose.”

There are proactive steps you should be taking to keep yourself from getting sick in the first place. That’s the offense. And it includes things like getting vaccinated and keeping up with booster shots. And, of course, good hand hygiene and staying away from people who are sick. 

And then, there’s the other side of it. The defense. The treatments that can help keep your illness more manageable if your best attempts at keeping the virus at bay don’t work out.  

Because it happens.  

Despite our best efforts, COVID-19 is a tough competitor. Even after taking precautions, you can still get infected with COVID-19 and be forced to go on the defense.  

Getting vaccinated can reduce your risk for becoming infected with COVID-19 or from becoming seriously ill. But if you do still become infected, layering on certain medications can also help limit the severity of your illness. 

“COVID-19 medications shouldn’t be looked at as alternatives to vaccination,” clarifies critical care physician Abhijit Duggal, MD. “But they can be effective as adjuncts to vaccination if you do become ill.” 

So, if you do get COVID-19, what pills may be prescribed to you? And how do they work? Dr. Duggal explains. 

What pills are used to treat COVID-19 infections?  

If you become infected with COVID-19, your healthcare provider may recommend specific medications that can help.   

Some COVID-19 medications can be used for people who have severe infections and are being treated in the hospital. That includes things like IV medications to decrease inflammation and immunomodulators, which work to change your body’s immune response. 

But for people whose symptoms are on the mild-to-moderate side, two prescription medications are being used these days. They are the antiviral pills Paxlovid™ and Lagevrio™. 

“Both of these medications are antivirals and are being used to prevent the severity of disease,” Dr. Duggal explains. “They’ve been associated with decreasing the symptoms of COVID-19 and decreasing the risk of being hospitalized as a result of COVID-19.” 

How do antiviral COVID-19 pills work? 

A virus consists of genetic material surrounded by a capsid, or a protective covering made of proteins.  

To reproduce, viruses worm their way into your body’s cells, and use them as incubators to make copies of themselves. The more they copy, the more likely they are to cause severe infection. 

But if that copy-and-paste process gets interrupted, the virus will stop replicating. And you won’t get as sick. 

That’s the goal of antiviral pills. To stop the copy machine. 

How? 

“Antiviral pills act directly on the virus itself, and either disrupt the reproduction cycle of the virus — meaning the virus can’t replicate — or cause direct damage to the virus, so you decrease how dangerous it is,” Dr. Duggal further explains. “When we can stop the virus from replicating, the virus can’t sustain itself. When its replication stops, you basically drop the overall number of virus cells in your body.” 

Antiviral pills aren’t new and aren’t limited to COVID-19 treatment. Antivirals are also used to treat infectious diseases like HIV, hepatitis B and hepatitis C. Tamiflu®, which you may have taken after catching the flu, is also an antiviral.  

And they’re not one-size-fits-all medications.  

“You need to figure out which chemical is going to disrupt the exact protein associated with the specific virus itself,” notes Dr. Duggal. For example, drugs used to treat HIV are calibrated specifically for those virus proteins. Similarly, Paxlovid and Lagevrio are used exclusively to treat COVID-19. 

Who should take COVID-19 antiviral pills?  

Some COVID-19 infections may be quite mild and managed well with over-the-counter medication or simple home remedies, like using a humidifier, getting lots of rest and drinking plenty of fluids. 

For people whose symptoms don’t improve on their own, COVID-19 antiviral medications may be a consideration. But they’re not for everyone. 

The U.S. Department of Health and Human Services says Paxlovid is approved for use in adults ages 18 and older “with a current diagnosis of mild to moderate COVID-19 and who are at high risk for progression to severe COVID-19.” Paxlovid also has received Emergency Use Authorization (EUA) for treating children who are at least 12 and weigh 40 kilograms (88 pounds) who are at high risk for severe COVID-19 infection. 

Lagevrio has only been approved for adults and for use in cases where alternative COVID-19 treatment (that is, Paxlovid) isn’t accessible or appropriate for them. Like Paxlovid, it’s approved for people who are at higher risk for severe infection.  

“The way to think about these medications is that if you have tested positive for COVID-19 and are at risk for developing complications from the infection, they significantly decrease your risk for becoming seriously ill,” says Dr. Duggal.  

Both Paxlovid and Lagevrio are best when started as soon as possible after you start developing symptoms — best when started within five days. They’re available only by prescription. 

Should you take COVID-19 pills proactively? 

It’s important to recognize that Paxlovid and Lagevrio should only be used in people who have tested positive for COVID-19. Not as a “just in case” measure to try to prevent illness.  

That’s because overuse of these medications can cause the virus to become drug resistant. 

“Resistance against medications is always a problem,” Dr. Duggal emphasizes. “Even in other diseases, when you’re using antivirals, you want to be very mindful of how you use them so you don’t develop resistance against those medications. You want to save these medications for people who really need them. If people just start taking pills in hopes it’ll decrease their risk, the risk of the virus developing resistance against the pill is going to go up very, very quickly, which would be a big problem.” 

COVID-19 pills don’t replace the vaccine 

Dr. Duggal reiterates that antiviral pills to treat COVID-19 aren’t a substitute for vaccination.  

“Antiviral medications are post-exposure medications to make sure that you don’t develop viral concentration levels high enough to cause you to have a very bad infection,” he stresses. “Your primary prevention is vaccination because your risk for severe disease is going to definitely be much, much lower if you are vaccinated.” 

Getting vaccinated against COVID-19 is the most crucial step you can take to keep yourself safe and healthy. But rest assured that if you do catch COVID-19, vaccination coupled with antiviral medication may help keep you from becoming seriously ill. Talk with your healthcare provider about your risk and your options. 

But it’s not that simple, says registered dietitian Anna Taylor, RD, LD. “Not all carbs are created equal.”

Carbs can provide energy, protect against disease and actually help control your body weight. It’s all about the types of carbs you choose. And there’s two different types of carbs:

• Simple carbs. Your body digests simple carbs easily. And this leads to your blood sugar to spike. Simple carbs include items made with white sugar and added sugars like a can of soda, baked goods, cereal and candy.
• Complex carbs. Your body digests complex carbs more slowly. By doing so, it provides your body with a steady stream of sugar and can help you feel fuller for longer, as well as provide energy.

And if you eat the right mix of healthy carbs while following a high-carb diet, you may reap some benefits like weight loss and a decrease in inflammation.

Taylor breaks down the pros and cons of eating a high-carb diet.

What is a high-carb diet?

Taylor says there’s no official definition of a high-carb diet, but offers this guidance:

“In general, in the United States, we recommend that about 45% to 65% of your total calories come from carbohydrates,” she explains. “So, a high-carb diet would be at the upper end of that range or may include more than two-thirds of your total calories coming from carbs.”

And you may have heard that the Mediterranean diet or the DASH diet may be considered a high-carb way of eating.

“The Mediterranean diet and the DASH diet are styles or patterns of eating that focus on foods that you eat more often and less frequently — not necessarily the exact proportions or ratios of these foods,” clarifies Taylor. “But many people who follow the Mediterranean diet or the DASH diet may end up with a higher amount of carbohydrate intake. And that’s because you’re eating healthy fiber-rich plant foods that are mostly carbohydrates, like whole grains, fruits, vegetables and legumes.”

Can you lose weight on a high-carb diet?

The answer isn’t so simple, reiterates Taylor. But what does the research say?

A 2015 study shows that a high-carbohydrate diet affected the body composition in young men and resulted in a significant increase in total body weight and BMI (body mass index).

But a 2018 study of people considered having overweight shows that a plant-based high-carb, low-fat diet has beneficial effects on weight and body composition.

“And a 2018 systematic review and meta-analysis, which looks at all available information, says that it cannot conclude that a high-carb diet increases the odds of obesity,” adds Taylor. “That’s because not all carbs are created equal. In other words, it’s not necessarily about the percentage of carbs that we’re eating, it’s about what kind of foods we’re choosing.”

Think about it:

• Person A may consume a lot of carbs that can come from drinking a bunch of soda, while eating cereal for breakfast, having granola bars or sweetened yogurt as a snack and eating white rice for dinner. These types of high-carb items contain added sugar and lack fiber. Person A doesn’t feel full and isn’t getting the nutrients they need.
• Person B focuses on a plant-based diet that includes a lot of carbs like whole grains, beans, fruits and vegetables. These types of foods are fiber-rich.

“Since these higher fiber foods are more filling, Person B may lose some weight over time,” notes Taylor. “So, although on paper, these people both are on high-carb diets, the application is completely different and you get different results. That’s the crux of the issue with carbs.”

High-carb diet benefits

Eating a minimally processed high-carb diet does have some benefits — but remember, it’s all about the types of carbs you choose.

Benefits may include:

• Decreases risk of heart disease.
• Decreases risk of several types of cancer.
• Improves insulin sensitivity.
• Decreases inflammation.

“Fiber-rich carbohydrates can also support a healthy digestive system,” says Taylor.

Healthy carbohydrate-rich foods

The key is eating the right kind of carbohydrates. Taylor says these are the types of healthy carbs you want to work into your meals:

• Whole grains. This includes farro, quinoa, brown or wild rice and whole-grain breads and pastas.
• Beans and legumes. Options include black beans, lima beans, chickpeas, split peas and lentils.
• Fruits and vegetables. It’s all fair game — try to eat the colors of rainbow. And yes, this includes starchy vegetables like potatoes, corn and winter squash.

“Fiber is only found naturally in plant foods, so the less processed these plant foods are, the more fiber they typically contain,” explains Taylor. “So, eating lots of food that grow out of the ground and haven’t spent too much time in a factory since then is key to following a high-carb diet with these types of health benefits.”

High-carb diet cons

If you’re not choosing the right kind of carbs, a high-carb diet full of processed refined grains and simple sugars can wreak havoc on your diet.

“Those types of foods — though high-carb — aren’t going to be satisfying and you’re going to constantly be craving sugar. And the reason is because every time you eat fast-acting carbs, your insulin response promotes hunger and your blood sugar skyrockets,” stresses Taylor.

“And you’re missing out on all the foods that help protect you from disease, while eating foods that can contribute to risk for diseases or worsen preexisting conditions.”

To carb or not to carb?

Taylor understands that carbs have a bad reputation, but clarifies that if you choose smartly, the carbs you eat — again, think whole grains, fruits and vegetables — can be a vital part of your health and wellness goals.

“What we want to focus on is how can we make the foundation of your diet foods that matter and foods that you can live with,” she says. “I think that people get so caught up in counting carbs or counting calories that they’re missing the forest of the trees. They’re not filling up on foods that enhance their health and make them feel good.”

And — because shopping for your children isn’t complicated enough — the language we use to define these toddler drinks is … well, a little on the slippery side.

We spoke to pediatric dietitian Jennifer Hyland, RD, CSP, LD, to get clarity about what these beverages are, what they aren’t and whether or not they’re worth pouring your savings into.

What are toddler drinks?

Toddler drinks — also referred to as toddler milks or toddler nutrition drinks — are powdered products that are usually sold by baby formula companies. Toddler milks are marketed specifically for children ages 12 to 36 months who are transitioning from breast/chest or formula feeding to solid foods.

Like the baby formula they’re supposed to help children transition away from, toddler milks tend to be quite pricey.

If that’s what toddler drinks are, what aren’t they?

Toddler drinks are not the same as the supplemental nutrition drinks for children that may be prescribed by your doctor to help with growth. These products usually come pre-mixed in a variety of flavors and are used as medically necessary for children with specific medical needs. Supplemental nutrition drinks should only be used if your doctor or dietitian recommends them. These drinks are higher in calories than powdered toddler drinks and regular milk.

Now that we have a working definition of toddler drinks, it’s time to talk about the claims their manufacturers make. Are these “transitional drinks” actually necessary for your little one? Or are we reinventing the wheel, when we could just give our kids good old-fashioned whole milk? 

Is there any evidence that toddler drinks help children transition from breast milk or infant formula to solid foods?

Hyland doesn’t pull any punches when it comes to the science around toddler nutrition drinks. “There is no literature to support the claim that toddler milks are necessary or warranted for a developmentally neurotypical child,” she states.

In other words, if your child is eating a regular diet and consuming age-appropriate solid foods, there’s no reason they should need a toddler drink.

“After age 1, most children can meet all of their nutrient needs with a balanced mix of whole milk, fruits, vegetables, protein, grains and healthy fats,” Hyland says. “If you’re concerned that your child isn’t eating with enough variety, you can use a standard multivitamin to cover most of what the toddler drinks aim to accomplish. Even in the pickiest eaters, I don’t usually recommend these powdered toddler drinks.”

Parents are often surprised to learn that toddler drinks actually have the same protein and calories as whole milk! That being the case, Hyland notes that “If you feel like your child needs extra calories, there are other ways to do so, and a toddler drink would not be the answer.”

Hyland isn’t the only expert who doesn’t see the value in toddler drinks. In 2023, the American Academy of Pediatrics (AAP) released a report stating that toddler drinks — which they refer to as Older Infant-Young Child “Formulas,” or OIYCFs — have no nutritional value.

Like Hyland, the AAP concluded that toddler drinks are safe to incorporate into a varied, healthy diet, but don’t provide “a nutritional advantage in most children over a well-balanced diet that includes human milk (preferred) and/or cow milk.” The report goes on to say that this family of products, which are more expensive than cow milk, have “no specific role in the routine care of healthy children.”

But what if your child isn’t developmentally neurotypical or “healthy”? What if your child was a preemie or has a chronic illness like Crohn’s disease?

“Discuss that with your physician or dietitian,” Hyland advises. “Whether or not they need additional supplementation or toddler milks could be very specific to that individual child, but I still rarely recommend them.” 

Does drinking toddler drinks increase the risk of obesity in young children?

Toddler milks aren’t beneficial to the majority of children, but the only damage they’re likely to do is to your wallet.

Hyland notes that there are some occasions — like when a child is underweight — when a supplemental drink may be just what the doctor ordered. But remember: Toddler milks or drinks aren’t the same thing as supplemental nutrition drinks. And, importantly, toddler milks don’t stimulate healthy weight gain. In fact, they don’t provide any more calories than whole milk! 

“Sometimes, parents think, ‘Oh, toddler milks will give them an extra boost,’” Hyland says. “It does give them some extra vitamins, minerals and essential fatty acids. But it doesn’t give them extra calories, so I would not say that a toddler drink is going to lead to or encourage obesity, necessarily.”

Hyland encourages you to speak to your pediatrician or registered dietitian. They can give recommendations for an appropriate oral supplement to promote growth.

Should you be worried about the ingredients in toddler drinks?

At this point you may be asking yourself: “If toddler drinks don’t aid the transition to solid foods and don’t facilitate weight gain, what’s in that powder, exactly?”

It’s a good question.

Hyland doesn’t see toddler nutrition drinks as necessary for the majority of children, but she’s not poo-pooing their ingredients either. They do provide more nutrients than whole milk alone, and most don’t have added sugar.

“There are a lot of vitamins, minerals and essential fatty acids in toddler nutrition drinks,” she says. “So, there’s nothing in them that I’m concerned with.” However, she’s quick to note that context matters.

“It could be risky to give fortified toddler drinks to a kid who’s eating a regular diet and taking a multivitamin. In that case, they could be overdosing on certain vitamins and minerals.”

Supplement nutrition drinks are a different story

We talked earlier about the difference between toddler milks and supplemental nutrition drinks. As a reminder, supplemental nutrition drinks are typically premixed and flavored. Most of them are manufactured by companies that make nutritional drinks for adults, too.

Unless specifically recommended for your child by their doctor or a pediatric dietitian, Hyland advocates skipping them.

“The pre-mixed drinks are higher calorie than milk and they contain added sugar, which, while indicated for some, aren’t necessary for most kids. If your child does need a supplement drink, a dietitian will help you work out how to optimize them in your day so your child still learns to eat solid foods.”

Are toddler drinks worth the money?

Toddler drinks might not encourage obesity or contain any dangerous ingredients. But does that make them a good buy?

Frankly, it depends why you’re buying them.

If you’re buying them with the expectation that they’ll have a significant impact on your child’s health, it isn’t worth the money.

If you would sleep a little easier knowing that your picky child is getting full nutrition, it may be worth the extra cost.

Ultimately, Hyland considers this less a question of health and more a question of personal preference.

“If a parent feels inclined to give their child toddler milks, I wouldn’t advise against it,” Hyland clarifies. “They certainly will not harm the child, but you can find the same thing in a multivitamin if nutrient variety is your main concern.”

Do toddler drinks re-invent the wheel that is whole milk and food? Sort of, yeah. Does that wheel still turn? Yeah, it does. As long as your child is eating a varied diet, you can’t go wrong.

If only all parenting decisions were that simple. 

Ingredients

• 1 tablespoon extra virgin olive oil
• 1 medium head cauliflower, cut into large florets, stem sliced in half
• 1 medium apple, peeled, cored and chopped
• 1 medium yellow onion, chopped
• 2 teaspoons curry powder
• 1 pinch sea salt
• 1 pinch freshly ground black pepper
• 1 cup water

Directions

1. Heat the oil in a large cast-iron pan over medium heat. When the oil is shimmering, add the cauliflower, apple, onion and curry powder. Season to taste with salt and black pepper and mix well until the cauliflower is coated in the oil and spices. Cook, stirring frequently, for 8 minutes.
2. Turn the heat down to low and add the water. Cover and cook until the cauliflower is completely tender, 10 to 15 minutes.
3. Transfer the contents of the pan to a food processor and pulse the cauliflower mixture until it is creamy but thick, similar to the consistency of mashed potatoes. Add a little more water if necessary, but be careful or you’ll wind up with cauliflower soup.
4. Check for seasoning and add more salt or pepper if necessary. Any leftover mashed cauliflower can be stored in the refrigerator for up to four days.

Ingredient health benefits

• Extra virgin olive oil: Did you know the Romans used to wash themselves with olive oil? Today’s average olive oil enjoyer probably wouldn’t go that far. But as a cooking oil, it’s full of vitamins — like vitamin A and vitamin E — and plenty of other nutrients.
• Cauliflower: A perfect swap for your traditional mashed potatoes, cauliflower is rich vitamin K, which supports your heart and bones, and compounds that may fight cancer called phytochemicals.
• Apples: Delicious and nutritious! Apples have an antioxidant called quercetin that can combat chronic inflammation in your body. And as they’re mostly made of water and fiber, apples tend to keep you fuller longer.
• Onions: These alliums are a great source of vitamin C, which keeps your immune system healthy. They also have quercetin, just like apples, which (in addition to fighting inflammation) fight bad bacteria and may protect against heart disease.
• Black pepper: Even this common table seasoning has benefits to offer. With its ability to help your body absorb other nutrients, and its knack for reducing the craving for more salt, black pepper truly is the spice of life.

Nutrition information (per serving)

Makes 3 servings
Serving = 1 cup

Calories: 215
Fat: 11 g
Saturated fat: 2 g
Cholesterol: 147 mg
Fiber: 7 g
Protein: 20 g
Carbohydrate: 13 g
Sodium: 226 mg

— DrHyman.com and Cleveland Clinic’s Center for Functional Medicine.

But gratitude isn’t an act or a feeling that should be reserved for just a few special days out of the year. In fact, psychologist Lauren Alexander, PhD, says it’s something we should strive to include in our day-to-day lives year-round — whether that be in our friendships, our relationships, our physical activities or even during the quiet moments we have time to ourselves.

“When I talk about gratitude with patients, I talk about actively and intentionally recognizing those things that make our lives better in some way,” says Dr. Alexander.

Here, we share the many ways that gratitude can make a big difference in your physical and mental health, as well as small things you can do every day to practice gratitude.

Health benefits of gratitude

There’s no downside when it comes to gratitude. That’s because we know there’s a strong connection between our minds and our bodies.

Generally speaking, when we maintain a positive mindset, we can rely more intentionally on embracing healthy coping strategies, building healthier habits and feeling better about ourselves. And all of these mental health benefits have a direct effect on our physical health.

“There is research out there that practicing gratitude can help lower blood pressure, help build a stronger immune system and even help with certain treatment outcomes,” adds Dr. Alexander.

Indeed, when we have positive perceptions about our medical care, we’re more likely to achieve our desired outcomes and recover more efficiently.

An example of that can be found in a systematic review of 19 studies involving nearly 3,000 participants from 2005 to 2023. In that review, researchers identified that gratitude not only promotes mental health and more sustainable healthy habits, but it also improves cardiovascular outcomes. So, what does that mean? Well, a kinder heart is a healthier heart.

“I talk about being intentional with people all the time because we sometimes live very mindlessly and we’re not always intentional about what we’re doing,” notes Dr. Alexander. “But if we can get in the habit of being grateful every day, even about the small things that make us feel good about ourselves and the world around us, we can create better lives for ourselves.”

Small ways to practice gratitude every day

Practicing gratitude doesn’t come easily to everyone — especially if you’ve been down on your luck or you’re going through a hard time. No matter who you are and what stage of life you’re in, you might want to focus on doing these small things every day to build your sense of gratefulness:

1. Boost your self-esteem by switching your perspective

If you’ve ever been on a plane, you’re probably familiar with the advice that in case of emergencies, you should put on your oxygen mask first before helping others. Well, the same idea applies when it comes to your mental health: You have to take care of yourself before you can effectively take care of others.

The journey of self-care often begins with boosting your self-esteem, and you can do that by shifting your perspective. Whenever you’re confronted with a negative situation, or whenever you just have a bad day, boost your self-esteem by refocusing your perspective on one good thing that’s happened to you or even the smallest things you’re grateful for. That can be your health, your job, a nice conversation you had with your children or the simple fact that you’re alive.

“Processing information differently is very hard for people to do because we get into habits and keep going down the path that’s most well-traveled. And if you compare it to walking on a path through your front yard, If you keep walking on that same path over and over again, your grass is eventually going to die,” says Dr. Alexander.

“So going down a different path, mentally, really requires a lot of intentional effort to shift to a direction where the grass is still growing. It may not be as easy to get through. But if you keep walking on it, you’ll start creating new paths and new ways of thinking.”

2. Strengthen your relationships

There’s a reason we gather around the table with people we love a couple times a year. It makes us feel good about our places in other people’s lives, but it also strengthens our relationships when we practice gratitude with each other.

You can do this with your romantic partner, your siblings, your best friends and even your coworkers. Whether it’s a quick note letting someone know you appreciate them, or it’s a more intentional, sit-down moment shared between a couple people, letting others know how much they mean to you really shapes the way your relationships are maintained. And asking what others are grateful for is a good opportunity to see things from a new perspective.

“If you’re someone who really struggles with being grateful or finding things to be grateful for, you might want to use this as an opportunity to connect with other people,” suggests Dr. Alexander. “Maybe enlist a friend or spouse to help you see some of the things to be grateful for, and that experience can be mutually beneficial.”

3. Foster healthy habits

“A big part of what stops people from having better habits is that people develop ideas about how they should feel when they’re doing things like exercising or eating healthy, and if they don’t feel that way, then they don’t do it,” says Dr. Alexander.

“So much of healthy habits involves the acceptance that you might not have a feeling that matches what the intended action should be.”

That means the next time you feel like giving up on starting a new exercise routine, maybe take a step back. Take a deep breath, and recognize that you’re in a position to make a choice about what you want to do and how you want to do it.

Taking even that small moment to be grateful for being able to make choices about your health and infusing that gratitude into your daily activities like eating healthy or working out can make all the difference when it comes to finding motivation to be healthier.

4. Remain intentional

Start or end your day by writing down three things you’re grateful for.

“Maybe you find joy in going on a walk during your lunch break, or it’s that you can hear your child laughing. Or maybe you are just thankful for a good night of sleep,” says Dr. Alexander.

Whatever the reason, write it down in a gratitude journal and use that as a reference that you come back to whenever you’re struggling or you just need a reminder about what inspires you.

“When you think to yourself, My life hasn’t been very good, you can look back and see objectively that there’s actually been a lot of good things in your life and there’s a lot to be grateful for,” she adds.

5. Get active in the issues you care about the most

Ever find yourself scrolling through all the negativity on your social media newsfeed and then find it hard to resurface from the latest disaster making headlines? What do you do with all the heavy feelings you’re having about important issues like climate change or food insecurity?

If you’re looking for a way out of those ruminating thoughts, you can practice gratitude by volunteering to help others who are directly affected by the issues you care about the most.

“By being actively involved, you’re going to feel far better about your concerns and it’s going to feel far more gratifying to connect with others who are making a difference,” says Dr. Alexander.

6. Model good behavior

For parents looking to instill gratitude in your children, perhaps the best way is to model that behavior during conversations at the dinner table, during prayer before bedtime or even during mundane activities that pop up throughout the day.

“Bring it up in everyday conversation — talk about how thankful you are that there’s a refrigerator full of food or that you’re thankful for the raise at work or how you’re thankful for the way your child helped out a friend in class,” recommends Dr. Alexander. “It’s important for us to be thankful for these things and the best way to cultivate that attitude is to say these things out loud to each other.”

7. Enhance your appreciation for your lived experiences

So much of gratitude is rooted in mindfulness. At the end of the day, if there’s anything you do, try to be present in every situation and do your best to keep yourself grounded. That’s certainly not always easy to do in a busy world. But when we set out to be intentional about everything we do, even the simplest act of having a meal can be an experience full of gratitude.

“Our experience with food is a good example because it’s often something that we just inhale and we don’t spend a whole lot of time thinking about it,” says Dr. Alexander. “But mindful eating can be a way to cultivate gratitude by paying more attention to the smell, taste and texture. By cultivating a more mindful attitude, we can start to be grateful for the food we have in front of us.”

Have you ever wondered: Why am I craving sweets? Why do I crave sugar?

The reasons are partly physiological, partly psychological and partly because of the environment in which we live.

“The human body functions a bit like a car — you put fuel in the tank, and then you drive,” explains dietitian Anna Taylor, RD, LD. “If the body doesn’t get the fuel it needs, then strong physical cravings can manifest.”

What kind of fuel does your body need? A balanced intake throughout the day of high-fiber carbohydrates, lean protein and heart-healthy fats

So, before we talk about how to manage your sugar cravings, Taylor explains what may cause them.  

Common causes of sugar cravings

Are you guilty of these factors that can contribute to your sugar cravings?

You don’t realize how addictive sugar can be

Why do we crave sugar?

For one thing, it tastes good. Many food companies conduct research to determine which food components will tempt consumers’ taste buds the most.

“Our brains are wired to enjoy things which make us happy,” says Taylor. “Sugar, in particular, releases brain chemicals, like serotonin, that make us feel good.”

This leaves us wanting to experience that good feeling over and over again, day after day.

“Many people say they’re ‘sugar addicts,’ consuming real sugar and artificial sweeteners in various forms,” she adds.

And some sweet foods and drinks are incredibly addictive. That’s why many processed foods are loaded with them. They trigger the release of dopamine, a brain chemical that motivates us to engage in rewarding behaviors.

Over time, our tolerance for sweet foods builds up, and we need more to reward ourselves.

“We’re basically feeding our taste buds,” explains Taylor. “This creates a vicious cycle because your taste buds typically crave what you feed them.”

You’re not eating enough

Think you’re being “good” by having coffee for breakfast and a garden salad for lunch?

“Truly, you’re setting yourself up for failure in the afternoon and evening,” warns Taylor. “If you go too long without eating, your body will crave the fastest fuel it can think of — refined grains and simple sugars.”

These are also known as empty carbs such as chips, as well as candy and cookies. Cramming them into your body late in the day means the calories will get stored as fat. Another popular trap you may be guilty of is meal-skipping or waiting too long between meals to eat.

“This leads to significant hunger, which makes you crave anything sweet you can get your hands on,” says Taylor.

Having an all-or-nothing mentality — forbidding all foods with sugar — can backfire, too.

“Some research suggests that eliminating sweet foods makes you crave them less,” notes Taylor. “But eventually, most people tend to give in and resume eating the foods they’ve restricted. That often leads to bingeing.”

You’re stressed

Perhaps you often find yourself bingeing on sweet snacks. The next time it happens, pay attention to your stress level. Have you been anxious about a big work presentation? Are you dealing with family drama?

We bet you’re not surprised if during stressful situations, all you want is a pint of ice cream and other sugary treats.

That’s because your stress hormones contribute to your sugar cravings, raising your ghrelin levels. Ghrelin, known as the hunger hormone, stimulates your appetite. And research shows that an increase in ghrelin levels may contribute to your sugar cravings.

“Low serotonin levels can also trigger cravings for sugar,” explains Taylor. “So, if you’re feeling down or stressed, sugar can be especially appealing.”

You’re not getting enough sleep

Sure, we all know by now that we need at least seven to nine hours of sleep each night. And that our body and mind functions differently without sleep.

For example, a lack of ZZZs can contribute to your sugar cravings. You may tend to overeat when you’re tired and not make the healthiest choices when it comes to food.

Research shows that sleep deprivation plays a significant role in how your brain thinks about food and manages cravings.

Raise your hand if this has happened to you: You’re too tired to even think about making a home-cooked meal and instead opt for fast-food or packaged meals that may be high in added sugar.

“When people feel tired, they crave a pick-me-up, so what’s more tempting that the fast fuel source of sugar?” asks Taylor. “The problem is the energy doesn’t last. It peaks, then plummets and then the fuel is gone, leaving you tired again and seeking — you guessed it — another sugary treat.”

When you feel a craving for sweets during the afternoon, going for a walk around your building instead, suggests Taylor.

“And make sure you are sleeping seven to nine hours each night,” reiterates Taylor. “Practicing good sleep hygiene is essential when someone’s sleep schedule is off.”

How to manage sugar cravings

There’s a good chance you’re eating too much sugar each day. In fact, the American Heart Association says that an average adult in the U.S. eats between 22 to 30 teaspoons of added sugar each day. Yikes! Taylor offers up these tips on how to stop craving sugar.

Assess your energy level

Jonesing for a sweet or salty treat? Before you indulge, check your fatigue level.

“Research shows that when you’re tired, you’re more likely to turn to whatever you crave to get more energy or to wake up,” Taylor says.

So, instead giving into your sugar craving, she recommends taking a short walk or doing something that gets you moving to help curb your craving.

Drink water

Before you reach for a cookie (or two), take your thirst into account. And there’s a good chance you’re not drinking enough water.

Basic guidelines state that women should drink 91 ounces (2.7 liters) of water each day, while men should drink 125 ounces (3.7 liters) of water daily. But other factors like your metabolism, diet, physical activity and health all contribute to how much water you need.

Research suggests that mistaking dehydration for hunger may trigger cravings as well.

Opt for a healthy snack

It’s the middle of the day and you’ve been busy at work when you realize you want a snack.

But instead of eating a piece of candy, choose a healthier snack like an apple with peanut butter or Greek yogurt and cinnamon or carrots and hummus.

By doing so, you’re eating fiber-rich carbs with either a lean protein or a healthy fat. And that combination will set you up to fuel your body better than a sugary doughnut would.

“Unlike sugary treats, which provide only short-term fuel for the body and can make you crave more sugary treats, a healthy snack that pairs a protein with a high-fiber carb will provide a longer lasting fuel source, satisfying your hunger,” clarifies Taylor.

“If an apple doesn’t appeal and the only thing that sounds good in that moment is the sugary treat, you probably aren’t hungry, just bored. If that is the case, maybe it isn’t time for a snack after all.”

Bottom line?

Feel like you can’t break the sugar cycle? It may be time to talk to a healthcare provider about how much you’re craving sugar.

Certain medications like those used to treat depression and other mental health issues may affect your blood sugar levels. Others can affect your appetite.

And your healthcare provider, a dietitian or a mental health professional can help you identify strategies that can help you manage your sugar cravings.

“Overcoming your sugar cravings is likely not a willpower issue,” says Taylor. “Instead, you need to set up your environment differently so those cravings stay tame, allowing you to fuel your body with food not just sugar.”

Ingredients

• 1 (15-ounce) can solid pack pumpkin
• 1 (14-ounce) can fat-free sweetened condensed milk     
• 1/2 cup egg substitute
• 1/2 teaspoon salt
• 1/2 teaspoon ground cinnamon
• 1/2 teaspoon ground nutmeg
• 1/2 teaspoon ground ginger
• 1 (9-inch) unbaked pastry shell

Directions

1. In a large mixing bowl, combine the first seven ingredients; beat just until smooth. Pour into pastry shell.
2. Bake at 425 F for 15 minutes.
3. Reduce heat to 350 F and bake 25 to 30 minutes longer or until knife inserted near the center comes out clean. Cool on a wire rack.
4. Store in the refrigerator.

Ingredient health benefits

• Pumpkin: There’s a lot to say about this seasonal gourd, but here are some highlights. Pumpkin is full of potassium, which helps keep your heart pumping, and vitamin C, which supports your immunity. It’s so nutritious that even its seeds might lower your risk of cancer and help you catch some ZZZs while they’re at it!
• Cinnamon: This flavor enhancer does more than make your food taste delicious. Cinnamon may lower your blood sugar and cholesterol, as well as fight inflammation.
• Nutmeg: Researchers are still uncovering the secrets of this time-honored spice, but we know that nutmeg has antioxidants, which protect your cells from damage by free radicals, and anti-inflammatory compounds.
• Ginger: You’re probably well aware of ginger’s ability to calm stomach sickness. But did you know that it can also help relieve pain and lower cholesterol? If not, you’re welcome.

Nutrition information (per serving)

Makes 8 servings

Calories: 270
Total fat: 7 g
Saturated fat: 3 g
Cholesterol: 10 mg
Sodium: 360 mg
Carbohydrate: 46 g
Fiber: 2 g
Protein: 7 g

But too often, we approach our fitness goals and plans a bit haphazardly. We know we should exercise, so we just … go for it.  

But starting an exercise program without a solid plan doesn’t set you up for success. 

“Exercise is medicine,” says sports medicine physician Michael Dakkak, DO. “And in order for medicine to be effective, you need to consider what you are taking, when, how much and for how long. The same thing goes for exercise. You need a plan.” 

Enter, the FITT principle — a structure for helping you (and your healthcare team) devise an exercise routine tailored to your goals.  

What is FITT and how do you get started? Dr. Dakkak explains. 

What is the FITT principle? 

You can think of the FITT principle as a prescription for exercise. FITT stands for frequency, intensity, time and type. That means considering: 

• How often you’ll work out (frequency). 
• How hard you’ll push yourself (intensity). 
• How much exercise you’ll do (time). 
• What kind of exercise you’ll do (type). 

“FITT is a way to design an exercise program that works for you,” Dr. Dakkak says. “If you don’t have a plan or don’t have a plan that works well for you, it’s easy to get off track. Having a solid plan is the first step to success.” 

Consider this: If you have heart disease, a healthcare provider may recommend certain medications. But they don’t just say, “Take medicine.” They prescribe a specific medication. And then, they give you instructions on how much to take, when to take it and how long you should take it for. 

Similarly, a provider may recommend exercise to help strengthen your heart. But, as with medication, you’ll benefit from guidance that’s more concrete than just, “Exercise more.”  

Following the FITT principles to create a routine can ensure the exercise you’re doing will work for you. You can take into account how much time you can dedicate to exercise and what you enjoy doing.  

FITT allows you to have a set plan to hold yourself accountable to. And it’ll ensure you don’t overdo things and leave yourself prone to injury.  

“FITT principles help you to lay it all out in black and white so you know what you should be doing, when to do it, for how long and how hard to push yourself,” Dr. Dakkak explains. “Everybody’s goals and experience levels are different, but the nice thing about these principles is that they can be used by anybody, whether they’re beginner, intermediate or experienced.” 

Let’s take a look at each of the elements of FITT and how they work together to create a prescription to fuel your fitness program. 

Frequency 

Determining the frequency of your fitness routine is about solidifying a plan for how often you’ll exercise. 

“The frequency of your exercise depends a lot on how much time you have to dedicate to exercise, what your goals are and what your fitness level is like currently,” Dr. Dakkak clarifies. 

For example, if your workouts hinge mostly on lower-intensity activities like walking or swimming, you may consider doing those activities four to five times per week or even daily.  

If you’re going to embark on more vigorous activities, like Zumba or HIIT (high-intensity interval training), you may consider taking the frequency down to something more like two or three sessions per week.  

Intensity 

The intensity of your exercise program is a question of how much you’re getting your blood pumping. It’s essentially how hard your body is working to keep up. 

“We measure the intensity of a workout based on heart rate zones,” Dr. Dakkak explains. “Your heart rate zone is a measure of how quickly your heart is beating. A higher heart rate during exercise means your heart is working harder.” 

Knowing your exact heart rate zone takes a bit of math and a heart rate monitor. (You can learn how to calculate your heart rate zone here.) But you can also estimate what heart rate zone you’re in by gauging how you feel during your workout. Consider these signals: 

• Zone 1: You can easily hold a conversation with someone at the rate you’re going. 
• Zone 2: You can still hold a light conversation, but you have to push yourself a bit and may need to stop for a beat occasionally to take a breath. 
• Zone 3: You could talk if you needed to, but it would take some effort. You could sustain this pace for about 20 to 40 minutes. 
•  Zone 4: You’re not talking unless you have to and can’t keep up at the rate you’re going for more than about 15 minutes. 
•  Zone 5: Talking is out of the question. You can keep up your efforts here for maybe five minutes. 

During your workouts, your goal doesn’t have to be to push yourself to your zone 5-sweaty-panting-breaking-point. In fact, that shouldn’t be most people’s goal. Because the benefits of exercise start far below that threshold. 

“For most people, we look to aim for their workouts to be in zones 2 or 3 for most of their exercise program,” Dr. Dakkak advises. “It’s not just about sweating, it’s about increasing VO2 max, which improves oxygenation and your cardiopulmonary system. You’re going to get benefits of that starting in zone two.” 

What your intensity level should look like again depends on your goals and your other FITT principles.  

If you’re working out regularly and for longer stretches, zone 2 may be perfect for you. But if you’re trying to squeeze in your exercise in shorter bursts (a la exercise snacks), you’ll want to ratchet up the intensity to reach your goals. 

Time 

The American College of Cardiology (ACC) recommends that adults get at least 150 minutes per week of moderate-intensity exercise. Or at least 75 minutes a week of vigorous exercise. Or some combination of the two.  

Additionally, the ACC recommends that adults do muscle-strengthening activities at least twice a week.  

What exactly constitutes moderate versus vigorous exercise goes back to understanding your heart rate zone. Zones 2 and 3 are typically considered to be moderate exercise. Zones 4 and 5 are considered vigorous intensity. 

Depending on your health goals, you may choose to meet those thresholds by taking a 30-minute walk five days a week. That comes out to 150 minutes of moderate intensity exercise.  

Or maybe you’ll swim laps for 20 minutes a day for three days and do two (rather challenging) half-hour spin classes a week. That would equate to 60 minutes of moderate intensity exercise and 60 minutes of vigorous exercise. A good balance. 

Or you could pack it all in with quick 15-minute sessions of HIIT five times a week for a total of 75 minutes of vigorous exercise. 

The trick is knowing at least approximately where your heart rate is at and sustaining or increasing that rate in order to get full cardio benefits without risking injury. 

“When you think about time, it’s also important to look at making sure that you have safe recovery periods, too,” Dr. Dakkak emphasizes. “If your plan is to allot your exercise time mostly to vigorous intensity exercise, that’s OK for some people. But you always want to make sure you’re taking enough time off to let your body rest. So, you’ll want to stick to shorter durations and be mindful of frequency.” 

Type 

The type of exercise you do matters. A lot. It matters for your health goals and your level of fitness, of course. But Dr. Dakkak reminds us that it also matters because the type of exercises you choose will make a big difference in your success in maintaining your exercise program. 

“It has to be fun,” he stresses. “I think fun is like a hidden ‘F’ in FITT. Because if you don’t enjoy it, it’s going to be next to impossible to keep up. If you’re miserable, you’re not going to keep doing it.” 

When you consider the types of exercise to include in your exercise program, consider your goals, what’s accessible and feasible in your life, and what you actually like to do.  

Here are some ideas: 

Lower-intensity cardio exercise 

• Ellipticals with little or no resistance. 
• Walking on a flat surface. 
• Swimming. 
• Biking. 

Higher-intensity cardio exercise 

• Ellipticals with more resistance. 
• Walking on an incline. 
• Running or jogging. 
• Spin classes. 
• Sports activities, like pickleball, basketball or tennis. 

Strengthening activities 

• Yoga. 
• Pilates. 
• Lifting weights. 

“There are tons of activities that involve aerobic activity and strengthen your body,” Dr. Dakkak says. “The best type of exercise for you is whatever gets you moving and that you’ll be consistent doing. You have to be consistent with it, have fun with it and do it in a safe matter. That’s what we’re looking for.” 

And make sure to get a mix of activity in whenever possible. 

“If you’re just doing one thing, your body is going to be conditioned to that one thing,” he adds. “But your whole body needs your attention.” 

Tips for FITT success 

Over time, your exercise program will need to undergo some maintenance. 

Check in with how you’re doing at sticking to the plan. Keep a log of your exercise activities so you can be more mindful if you’re slipping off track. (And to congratulate yourself for a job well done!) 

And be ready to adjust the plan as your body becomes more conditioned. Perhaps that walk around the block used to get your heart rate up. But after a few months, you may need to push a little more to get that same benefit.  

“As your health improves, you’ll need to work harder to push your heart rate into higher zones, and that’s a good thing. It means your plan is working,” Dr. Dakkak says.  

If your daily walk isn’t putting you into zone 2 anymore, you may need to calibrate one of your other FITT elements. Maybe it’s a question of time and you walk longer to get that heart rate up. Or you change up the type of exercise and turn that walk into a light jog. 

When you go to tweak your plan, though, resist the temptation to make wholesale changes. 

“I like to always say to only increase one thing at a time — whether that’s frequency, intensity or time,” Dr. Dakkak advises. “That’s really how we’re going to grow through the program and in our cardiovascular fitness and make sure that we’re not pushing our bodies too far too fast.” 

Not sure where to start your FITT journey? Talk with a healthcare provider, like a sports medicine physician. They can help you develop a personalized plan tailored to your goals, your health and, perhaps most importantly, your life. 

Wouldn’t it be nice if something as simple as a short walk could help keep blood sugar in line? And, in fact, research suggests walking after eating can do just that. Nurse and diabetes care and education specialist Shannon Knapp, MEd, BSN, RN, CDCES, discusses the benefits of a post-meal walk and what else to consider when managing your blood sugar levels.

What causes high blood sugar?

Your body turns the carbohydrates you eat into sugar (glucose). When things are working well, your pancreas releases insulin. This hormone transports glucose into your cells, so your body can use it for energy. But when things aren’t working as they should, you can end up with high blood sugar.

Knapp says two things typically cause problematic hyperglycemia (high blood sugar), and insulin is at the root of both of them. You may have high blood sugar because your:

• Pancreas doesn’t make enough insulin. Without enough insulin, glucose stays in your bloodstream and raises your blood glucose level. This is the hallmark of Type 1 diabetes, but is often seen in Type 2 diabetes as well.
• Body makes insulin but doesn’t use it correctly. This is called insulin resistance and can also cause high levels of glucose in your blood. It typically plays a role in Type 2 diabetes, but occurs in Type 1 diabetes as well.

Why does high blood sugar matter? “Over time, elevated blood sugar causes blood vessel damage,” says Knapp. Damaged blood vessels lead to serious complications, such as:

• Diabetes-related retinopathy, which can cause blindness.
• Diabetes-related nephropathy, which can lead to kidney failure.
• Heart attack.
• Nerve damage (neuropathy).
• Stroke.

“It’s so important to keep your blood sugar in your target range if you have diabetes,” she continues. There are many ways to nudge your blood sugar into a healthy range — including a short walk after eating.

Benefits of walking after eating

There are many health benefits of walking, and walking after you eat can specifically benefit your blood sugar.

After meals, your blood glucose goes up (even if you don’t have diabetes). “Your blood sugar level is highest about 30 to 90 minutes after your meal,” shares Knapp. This rise is a natural response to eating, and it isn’t a concern unless your glucose spikes too high or remains at an unhealthy level.

But research shows that a short walk after eating a meal:

• Prevents your blood glucose from spiking as high as it would if you ate and then stayed sitting.
• Keeps your insulin levels stable.

Any activity is helpful for your blood glucose. “Exercise impacts your blood sugar quickly, often within a few minutes,” says Knapp. “And over time, physical activity helps your body use insulin more effectively, decreasing the insulin resistance we often see in diabetes.”

The study indicates that walking just two to five minutes can bump your blood sugar down a bit. “But this isn’t a magical solution for diabetes,” states Knapp. “A post-meal walk is a great habit that benefits blood sugar, but managing diabetes never comes down to just one thing.”

Watch out for low blood sugar if you have diabetes

Knapp also cautions that you can take exercise too far. If you’re on medication to lower your blood glucose, exercising can make it dip too low. Low blood sugar — hypoglycemia — can be dangerous.

A short walk is unlikely to cause hypoglycemia, but a hard workout could. “Always know your blood glucose levels,” Knapp advises. Timing your exercise is key. Whenever you exercise, check your glucose levels before and after activity. A blood glucose reading of less than 70 mg/dL (milligrams per deciliter) typically is in the hypoglycemic range. But before and during exercise, aiming for a blood glucose level closer to 100 mg/dL may be a safer option.

If you have a low reading, consume some fast-acting carbs to raise your glucose level. For example, drink a small cup of juice, take a spoonful of honey or use glucose tablets or gel. Your healthcare provider or diabetes care and education specialist can help you create a plan for treating hypoglycemia. And no matter what you choose to use for treating hypoglycemia, be sure to have it on hand during activity.

Other ways to manage blood sugar

“If you have diabetes, healthy habits are part of keeping your blood glucose in your target range. This is true even if you’re taking medication to manage your blood sugar,” says Knapp.

Good habits for natural blood sugar management include:

• Eating healthy.
• Getting regular exercise.
• Managing stress.

If you have diabetes, the other vital part of blood glucose management is knowing your levels. That’s why frequent blood sugar checks are so important.

Your target blood glucose range depends on when you last ate. For adults with diabetes, typical target blood glucose levels are:

• 80 to 130 mg/dL before you eat a meal.
• Less than 180 mg/dL one to two hours after the start of your meal.

Walking after meals can help stabilize your blood sugar and insulin, which may make it easier to hit your target range. If you don’t have diabetes, you can still benefit from post-meal strolls that reduce your blood sugar spikes.

“People worldwide enjoy their morning coffee,” says registered dietitian Anthony DiMarino, RD, LD. “It’s a common habit, and you may feel unsettled if something disrupts your morning ritual.”

But should you push back the timing of your coffee breaks? Scientifically speaking, that’s still up for debate. Some experts believe it’s better to wait until mid-morning or afternoon to enjoy that first (or second) cup.

But don’t panic! DiMarino says there isn’t necessarily a “best time” to drink coffee.

Drinking coffee in the morning

An 8-ounce cup of coffee contains close to 100 milligrams of caffeine, though that amount varies depending on the type of coffee grounds and how you brew them.

“Because caffeine is a stimulant, drinking coffee first thing in the morning helps you wake up,” DiMarino says. One way caffeine does this is by increasing the amount of cortisol in your body. Let’s dig in.

Coffee, caffeine and cortisol

Cortisol, which is sometimes known as the stress hormone, is the chemical your body releases in response to danger — those fight-or-flight situations. Now, your average morning isn’t typically a dangerous one (even if you’re not a morning person!), but your body still releases cortisol after waking up.

“You naturally release cortisol in the morning to help you become more alert and aware of your surroundings as you wake from your slumber,” DiMarino explains.

Your cortisol levels typically peak between 7 a.m. and 8 a.m. and gradually drop throughout the day, reaching their lowest point in the middle of the night while you sleep. In this way, cortisol helps your body maintain its sleep-wake cycle, known as the circadian rhythm.

But the stimulating effects of caffeinated coffee first thing in the morning can rev up your cortisol production. Some people may welcome this extra jolt to their systems, while others may feel more anxious, jittery or irritable.

“Everyone’s sensitivity, or internal response, to caffeine is different,” DiMarino says.

Chronically high cortisol levels — brought on by stress, too much caffeine or other factors — can lead to inflammation that causes cell damage.

“When your cortisol levels stay elevated, you’re at an increased risk for weight gain, diabetes, heart problems and other health concerns,” he adds.

Drinking coffee at night

Drinking coffee late at night may be unwise, unless you’re working a late shift.

“Caffeine has a half-life of two to 10 hours, depending on your metabolism,” DiMarino says. In other words, it could take as little as two hours or as long as 10 hours for your body to eliminate half the caffeine from one cup of coffee.

For people with a certain “coffee gene,” a late-night cup of coffee isn’t a problem. The CYP1A2 gene helps your body break down and get rid of caffeine — and some people actually have two copies of this gene, which helps them break down caffeine faster than those who have one copy.

If you can down a double shot of espresso at 10 p.m. and sleep soundly afterward, you probably metabolize caffeine quickly.

Determining the best time to drink coffee

Here’s what experts know about the timing of drinking coffee:

• Coffee first thing in the morning increases cortisol levels, potentially making you feel more wired.
• Coffee at night may (or may not, depending on your genes and metabolism) affect your slumber.

So, when’s the best time to have that cuppa?

There’s no scientific evidence that supports a “best time.” But a mid- to late-morning cup between 9:30 a.m. and 11 a.m. may help you reap the most coffee benefits. That’s when cortisol levels start to dip, and you’ll get the biggest bang from the effect of caffeine.

On the other hand, you may want a cup of joe at 2 p.m. to boost you through the afternoon slump. “Many of us feel sluggish or less productive after lunch,” DiMarino notes. If a power nap isn’t in the cards, a cup of coffee may get you through the rest of your day.

Is there a best time to drink coffee for weight loss?

No, there isn’t — because coffee doesn’t help with weight loss. Despite what you might have seen on TikTok or elsewhere on social media, coffee doesn’t have magical calorie- or fat-burning properties. And the scale won’t budge faster if you add lemon to your coffee.

But coffee can be a good swap for higher-calorie beverages.

“Specialty flavored coffee drinks can have more than 500 calories, depending on the cup size,” DiMarino warns. You can cut those empty calories by switching to reduced- or fat-free milk alternatives or sugar substitutes.

Drinking proffee (coffee mixed with protein powder) may also have some benefits. Because protein takes longer to digest, it can aid weight loss by helping you feel full longer.

How much coffee is too much?

The U.S. Food and Drug Administration (FDA) recommends no more than 400 milligrams of caffeine per day for adults and less than 200 milligrams of caffeine per day during pregnancy. This includes the caffeine you get in chocolate, tea, sodas, energy drinks and other products.

While Americans are known for overdoing it on sugar and salt, we tend to stay below the recommended caffeine amount. Many of us consume around 135 milligrams of caffeine each day. That’s about 1 1/2 cups of coffee. The time of day you decide to drink those invigorating brews is entirely up to you!

When you start limiting your activities and movement due to arthritis pain, your tendons can shorten over time, leading to the telltale signs of advanced hand arthritis (think: knotted joints and bent, curled fingers).

Why exercise helps arthritis in the hands and wrist

Eventually, everything gets so tight that it makes it that much harder — and more painful — to recover your range of motion. That’s why it’s critical to prevent worsening symptoms now rather than try to restore function later. And exercise is a natural antidote.

“Hand strengthening exercises for arthritis help you protect your range of motion and function so you’re able to grasp objects and perform fine motor tasks like buttoning or zippering,” explains occupational therapist and certified hand therapist Jesse DeFilippo, OTR/L, CHT. “More motion equals more mobility, and that usually leads to less pain and better functioning.”

Hand and wrist exercises for arthritis

When you’re doing exercises for hand arthritis, it’s important to let pain be your guide, DeFilippo says.

“If they hurt, stop doing them. Do everything to your tolerance,” he advises. “The point is not to force anything. It’s to gradually build your tolerance to motion and light strengthening.”

You should also avoid these movements if you’re experiencing an arthritis flare-up, which involves a sudden increase in joint pain and inflammation.

So, how often should you do your hand and wrist exercises? It depends on the exercises themselves. “Stretches and non-resistive movements are OK to do every day,” DeFilippo says, “but weighted and resistance-based exercises should only be done three times a week.”

These 16 movements can get you on the road to arthritis symptom relief.

Warm-up ball

Rolling a ball along your hand is a great way to warm it up before you exercise. “It’s a nice massage and stretch for your muscles and tendons,” says DeFilippo.

To do it:

1. Grab a tennis ball or another firm ball of a similar size.
2. Put it on a flat surface (like a table) and place your hand on top of it, with your palm facing down.
3. Roll the ball back and forth, up your fingers and down your palm.

Therapy putty exercises

Using therapy putty provides a warm-up effect, too. It’s a type of modeling putty that has different levels of pliability and resistance.

“I have patients roll it out to loosen and warm things up, but there are therapy putty exercises that help strengthen arthritic hands, too,” DeFilippo says. “Spending 10 to 15 minutes three times each week working on some of these therapy putty exercises can be beneficial.”

Here are a few (dare we say a handful?) to try:

• Finger scissors: Squeeze the putty between two of your fingers as if your fingers are cutting it like a pair of scissors.
• Finger extension: Shape the putty into a long rope. Make a hook shape with one of your fingers, and loop the putty around your fingernail. Hold the two ends of the putty with your other hand against the bottom of your palm so it forms a kind of resistance band as you try to straighten your hooked finger.
• Finger spread: Form the putty into a donut, then put it around two of your fingers and spread them apart. You can also put the donut around all your fingers and thumb and spread them outward to stretch the putty.
• Fingertip pinch: Shape the putty into a ball and grip it between your thumb and fingertips.
• Flat pinch: Put the putty between your thumb and straightened fingers (sort of like your hand is inside a puppet), and pinch.
• Power grip: Place the putty in the palm of your hand. Make a fist and squeeze the putty.

Tendon glides

Tendon glides are great exercises to maintain range of motion in your fingers. They involve a series of four hand movements.

“These movements isolate each motion that your fingers can do,” DeFilippo explains.

To do tendon glides:

1. Hold your hand up with your fingers straight like you’re about to high-five someone.
2. Keeping your fingers straight, bend your fingers down at your knuckles (metacarpophalangeal or MCP joints) so they’re perpendicular to your palm. Return them to their starting position.
3. Bend your fingers down at their top two joints towards the bottom of your fingers. Return them to their starting position.
4. Bend your fingers at your MCP joints and the joints in the middle of your fingers (proximal interphalangeal joints or PIP joints), trying to touch your palm. Return them to their starting position.
5. Make a fist with your thumb out to the side. Return your hand to its starting high-five position.

“Do them as many as 10 times in a sitting, three to five times each day, to help keep everything moving smoothly,” DeFillippo recommends. “Treat it like your meals. Do it first thing in the morning, at midday and then toward the end of the day around dinnertime.”

Wrist flexion

Wrist flexion and other wrist movements can help arthritis in your wrist joint.

“Just the process of actively moving your wrist to the best of its ability leads to an increase in range of motion and tolerance to that activity over time,” DeFilippo says.

To do wrist flexions:

1. Hold a can or a weighted handle in your hand.
2. Position your hand palm up while holding the object.
3. Bend your wrist upward and then slowly lower it back to its starting position. Think of it like a bicep curl for your wrists.
4. Over time, you can increase the weight of the object.
5. Do two sets of 15 reps on each wrist.

Wrist extension

Like wrist flexion, wrist extension can help ease arthritis in your wrist. It’s a similar motion, but in the opposite direction.

To do wrist extension:

1. Sit in a chair next to a flat surface, like a desk or table.
2. Place your forearm on the surface, with your wrist and hand hanging off the edge (so that you have room to move it).
3. Palm down, hold a can or a weighted handle in your hand.
4. Without moving your forearm, bend your wrist upward and then slowly lower it back to its starting position.
5. Do two sets of 15 reps on each wrist.

Finger blocking and reverse blocking

Finger blocking isolates and moves your finger joints. With the thumb or index finger from your opposite hand, you’re blocking a finger from moving down to your palm as you bend it.

To do finger blocking:

1. Place your left thumb or index finger against your right index finger’s proximal interphalangeal joint (joint in the middle of your finger).
2. Bend your right finger down along that joint as far as you can.
3. Do 10 reps on each finger.

Reverse blocking is similar, except you bend your fingers at your MCP joints (knuckle joints). You can do four fingers at the same time by using the entire length of your opposite finger to block them.

Finger lift

Finger lifts are a great way to increase the range of motion in your fingers and prevent pain.

To do finger lifts:

1. Lay your palm flat on a table.
2. Lift one finger, leaving the rest flat on the table.
3. Do 10 reps.
4. Repeat with your remaining fingers.

Hand exercises for thumb arthritis

Starting a thumb exercise regimen is more complicated.

“I don’t recommend that people start one unless they see a therapist who can give them an outline of specific exercises to do,” says DeFilippo. “Splinting is often needed for thumb arthritis to protect the joint while you use your hand. And it’s crucial to avoid pinching activities and movements that will hyperextend your thumb and put more stress on the joint.”

Because thumb arthritis affects your carpometacarpal (CMC) joint at the base of your thumb, the most effective exercises strengthen the muscles supporting it. Try these three exercises to help thumb arthritis symptoms:

• Isometric “C” exercise: Make a C-shape with your hand. Touch your fingertips to your thumb to turn the C into an O.
• First dorsal interossei strengthening isolated abduction: Put a rubber band around your four fingers. Using the rubber band as resistance, separate your index finger from your other three fingers.
• Thumb extension: Hold your hand up like you are showing the number five. Move your thumb toward your palm like you’re showing the number four and back again. “Make sure tip your thumb and the joint below are flexed during the whole movement,” DeFilippo says. “This ensures that there isn’t excessive strain on your CMC joint.”

When to see your healthcare provider about hand arthritis

DeFilippo recommends seeing a physical or occupational therapist if the pain gets in the way of any of your daily activities.

“On a scale of 1 to 10, if your pain is at a 2 or 3, that’s probably manageable,” he says. “But if you’re at a 6 to 8 every day, get help right away — especially if the pain has increased over time or your personal pain management techniques aren’t working.”

Remember that, when it comes to hand exercises for arthritis, consistency is key.

“In my experience, it takes about three to four weeks for patients who consistently do their exercises at home and in combination with therapy appointments to experience noticeable relief,” DeFilippo says. “Often, they feel like they’re able to increase their range of motion, and if they were sore, it reduces their pain.”

Luckily, there are more than enough recipes to go around, each of them more flavorful than the last.

Here are some dietitian-approved recipes that will let you cruise through the holidays feeling great.

Easy Artichoke Dip and Crudites

Invited to a party (or hosting) and stumped for a tasty yet healthy appetizer? Try this easy artichoke dip and crudites recipe. It’s super simple — though it doesn’t taste like it! But that can be our little secret!

Sweet Potato Hummus

Yes, a sweet potato really can do it all! Even turn into a delicious, fall-inspired hummus dip by mixing it with garlic, cumin, lemon juice and cayenne pepper. 

Roast Chicken Raspberry and Walnut Salad

Here’s a festive, healthy twist on classic chicken salad. Roast the chicken a few days ahead to make assembly faster, or use leftover roast chicken or rotisserie chicken from the store.

Braised Chicken With Cashew Gravy

Cashew butter gives this gravy an amazingly smooth richness. It’s a delicious accompaniment to the crisp-skinned chicken breast. Save the extra gravy for another chicken dish!

Turkey Meatloaf With Baked Root Vegetables

A colorful dish is a favorite at Thanksgiving, but simple enough to try any time of year! It takes just 15 minutes to prep for the oven and can serve four people. 

Slow-Cooked Brisket With Fennel and Onions

Start preparing this zero-fuss meal Sunday night. Then, before you leave for work on Monday, turn on your slow cooker, and let the aroma of herbs, spices and savory meat permeate your home!

Spicy Lamb and Veggie Shepherd’s Pie

This easy casserole features spiced ground lamb, but works with beef and bison, too. The top may look like high-carb mashed potatoes, but we use pureed cauliflower instead. You’ll love the switch!

Herb-Roasted Butternut Squash With Shallots and Garlic

This easy, tasty side is great with turkey, braised chicken or baked fish. The squash cooks soft in the center and slightly crispy on the outside, creating an earthy, satisfying dish. The sweet roasted garlic pairs well with the squash and shallots, too.

Rosemary Garlic Mashed Sweet Potatoes

When you’re incorporating starchy vegetables into your diet, try this sweet and tasty side dish. It’s a great addition to any holiday meal.

Baked Cinnamon Apples

Especially if it’s apple-picking season, this cozy, autumnal recipe is a great way to make use of a healthy and delicious fruit. With only 100 calories in each serving, this is a simple dish to serve as a dessert or evening snack.

Pomegranate Citrus Cranberry Sauce

Ready to kick that jellied cranberry sauce to the curb? Here’s a perfect substitute that’s bursting with flavor, but won’t keep you in the kitchen long.

Pumpkin Spice Muffins

Don’t reserve pumpkin just for your pumpkin spice lattes and pie! These easy and delicious muffins are a great way to spread the pumpkin love throughout the season. Plus, these treats have all of the flavor, with less of the saturated fat. 

Pumpkin Pie

Staying healthy doesn’t necessarily mean you have to sacrifice the signature desert of the Thanksgiving season: pumpkin pie! Try this healthy version on for size by using fat-free condensed milk, flavorful spices like cinnamon and, of course, plenty of pumpkin that’s full of antioxidants. 

Ginger Spice Smoothie

This creamy, low-carb smoothie is a fabulous way to start your day and get into fat-burning mode! As an added benefit, ginger is great for your digestion.

Now imagine those same physical changes happening when you aren’t in a potentially dangerous situation. Imagine it happening every time you leave the house. Every time you introduce yourself at a work function. Every time your partner is 15 minutes late coming home. Your brain and body race far ahead of the facts, so you feel as if there’s danger around every corner.

If that sounds like you, you may be experiencing hypervigilance.

We talked to psychologist Susan Albers, PsyD, about hypervigilance: What it is, what causes it and what to do if it’s negatively impacting your life.

What is hypervigilance?

Dr. Albers describes hypervigilance as a heightened state of awareness. “It’s your brain’s way of protecting you by scanning the environment for signs of danger and being extremely aware of your surroundings” she says.

To be clear, hypervigilance isn’t a diagnosis. It’s a symptom that occurs with a wide range of different conditions — both mental and physical. It’s perhaps easiest to think about hypervigilance as a natural instinct gone awry.

“Hypervigilance is a basic human survival mechanism,” Dr. Albers explains. “It allows us to sense predators and threats to our safety. But with hypervigilance, you’re feel like you’re constantly under threat.” Put differently, the amygdala — the part of your brain that’s responsible for managing emotions — is on overdrive.

Perpetual fight-or-flight

You’ve probably heard of the fight-or-flight instinct. It’s a mental and physical response to perceived danger. In an attempt to survive, our bodies undergo big physiological changes when we’re threatened. Certain processes — like digestion — slow down. Meanwhile, Dr. Albers says, our bodies get flooded by adrenaline.

“You have higher blood pressure, your heart rate increases, your pupils dilate and your body prepares itself to respond to the threat,” she explains.

All of these changes — and others — serve an evolutionary purpose. You may become pale or flushed, for example, because your body is diverting blood to your brain and limbs. Your muscles may tense up or tremble, primed to react quickly if needed.

When our frontal cortex — the part of our brain that makes decisions — gets flooded with hormones, Dr. Albers says it produces emotions that “are so intense that they knock out any logic or reason.”

These automatic responses are beneficial when we find ourselves in genuine danger. But for people who are hypervigilant, fight-or-flight is the default mode. The result is physical, mental and emotional discomfort.

Hypervigilance causes

There’s a long list of medical and mental health conditions that can trigger hypervigilance. That list includes:

• Post-traumatic stress disorder (PTSD) or complex post-traumatic stress disorder (CPTSD).
• Anxiety and panic disorders.
• Depression.
• Personality disorders.
• Neurodegenerative conditions like dementia.
• Adrenal disorders.
• Fibromyalgia.

Dr. Albers says that hypervigilance is sometimes just a personality trait. “Sometimes, a person is just more aware and mindful of their environment or other people’s feelings, but if hypervigilance is chronic or severe, it’s usually a symptom of a mental health disorder.”

Hypervigilance is also strongly linked to childhood trauma. According to Dr. Albers, that has a lot to do with the fact that, as we grow up, our brain develops in a way that’s responsive to our environment.

She gives the example of a child growing up in an abusive home. “The child is immersed in an unpredictable environment,” she illustrates. “Maybe their parent is sometimes in a good mood and then — out of the blue — becomes enraged or violent. That child will learn how to pick up on very subtle clues because knowing what state their parent is in helps keep them safe.”

When it comes to person with a history of trauma, hypervigilance is about self-protection, about preventing a traumatic situation from happening again.

Examples of hypervigilance

Hypervigilant behavior looks different depending on who you are and its underlying cause. All of the following are potential examples of hypervigilant behavior:

Hyper-fixation on your surroundings

This kind of hypervigilance is especially common for people who’ve experienced violence — especially if they’re living with post-traumatic stress disorder (PTSD).

Perhaps they have to sit with their backs against the wall to ensure nobody can sneak up behind them. Maybe they have to sleep with the lights on. Perhaps they feel it necessary to have a weapon on hand at all times. They may also have a particularly strong startle reflex, jumping at the slightest noise or motion.

Hyper-fixation on the thoughts and feelings of the people around you

Dr. Albers says it’s common for a person who’s hypervigilant to watch the people around them diligently for slight changes in behavior, tone, cadence, body language, written communication or even sentence structure.

“These individuals tend to do a lot of overanalyzing of people’s moods and their expression — even things like text messages,” she explains. These traits are especially common in people who’ve endured abuse or been exposed to violence.

Hyper-fixation on your own body or mind

It doesn’t get as much attention as some other forms of trauma, but medical trauma is very real. Dr. Albers sees it frequently: People who’ve experienced severe illness (their own or a family member’s), major medical procedures, mental health crises or an extended hospitalization or disability can become aware of their own bodies to a degree that’s detrimental. It can cause hypervigilance-related health anxiety.

A minor ache or pain may get them concerned that their cancer is out of remission. A bad day could be misinterpreted as a sign that their depression’s returned. The result can be a vicious cycle: All that worrying causes physical symptoms that are, well, worrying.

Catastrophizing

“When a person catastrophizes,” Dr. Albers says, “they’re creating a narrative in their head in an attempt to understand a situation. But that narrative gets spun in a negative way.”

A hypervigilant mind tends to be preoccupied by worst-case scenarios. Not getting a call back within a couple of hours may get read as a sign that a loved one has died and a slow response to a message signals the end of a years-long friendship.

The tendency to catastrophize may make it hard to let one’s guard down and enjoy happy moments. When life is going really well, a person living with hypervigilance may find themselves anxious, waiting for the next shoe to drop.

Avoidant behavior

It’s normal to change your behavior in response to a traumatic experience, but a person who’s hypervigilant takes that natural response too far.

If, for example, a person’s in a bad car accident, it’s understandable that they’d want to buy a car with a top safety rating. Never driving again — even if it means losing out on job opportunities, missing family vacations and relying on others for transportation — is an overreaction. In extreme cases, a hypervigilant individual may go on to develop full-fledged agoraphobia — a fear of places, people or situations that they see as threatening.

Hypervigilance can also impact your education, career and other areas of your life. “Some people have difficulty trying new activities or even learning new things because they’re afraid of not being good at it,” Dr. Albers notes. “They might worry that other people will judge or not like them if they aren’t perfect.”

Insecurity

Hypervigilance is all about identifying, responding to or preventing threats as soon as possible — whether those threats are real or perceived. For people with a history of trauma that can happen in many different ways.

Hypervigilant people may struggle with clinginess, people-pleasing, emotional regulation problems and trust issues. They often neglect their own needs (or even suppress elements of their identity) to avoid conflict. The concepts of relationship OCD and good girl syndrome tend to fit neatly under this umbrella.

“Hypervigilance makes it hard for people to relax at all. They always feel awkward or worried that they’re doing or saying something wrong,” Dr. Albers says.

How hypervigilance can impact your life

One of the things that makes hypervigilance difficult to deal with is the fact that it’s a legitimately helpful instinct. We should all be hypervigilant in certain situations. But when we’re in nonstop fight-or-flight mode, it can wreak havoc on our bodies, our minds and our relationships.

The physical, mental and behavioral impact of hypervigilance

The impact of one’s body being constantly flooded with adrenaline and cortisol is no small thing.

“Over time, you become exhausted,” Dr. Albers says. “You may experience frequent physical illness, you may have difficulty sleeping, you might find yourself eating too much or not enough. You can even experience gastrointestinal problems from your body being in constant fight-or-flight mode.”

The result of all that pressure? Your mental state — and even your behavior — may change. You could find you struggle to pay attention when that’s not been an issue in the past. You might be more irritable, more inclined to fight with others or more likely to have emotional outbursts. You could isolate yourself from others or experience mood issues like depression.

All too often, people struggling to sleep, regulate their emotions or endure chronic stress turn to substances to cope. While it may seem to help in the moment, self-medicating ultimately makes things worse — especially if there’s an underlying mental health issue involved.

Hypervigilance’s impact on relationships

When it comes to relationships of all kinds, hypervigilance is a double-edged sword.

Dr. Albers concedes that an individual with hypervigilant tendencies may notice negative behavior, lying or red flags more quickly than the average person. “Hypervigilance can prevent a lot of conflict,” she says. “An individual who’s hypervigilant might hear a slight shift in someone’s tone and know not to go there.” It may also help you to spot someone whose behavior doesn’t add up, preventing you from getting into a relationship that could be dangerous or hurtful.

While hypervigilance can protect you from conflict or danger, it can also hurt your relationships. In some cases, Dr. Albers adds that hypervigilance prevents people from getting close to or trusting others. It can also have the opposite effect: It can promote an anxious attachment style. “Needing constant reassurance can drive other people away because they know everything’s fine, but the other person keeps reading into the situation and making assumptions.”

To make things more complicated, hypervigilance may cause somebody person to be overly sensitive to feedback, or to be emotionally volatile. Needing to provide constant reassurance can be frustrating, exhausting and — in some cases, for some people — insulting. 

Hypervigilance can be self-perpetuating

Another thing that makes hypervigilance difficult to deal with is the fact that those gut feelings sometimes end up being valid.

“People with extreme hypervigilance can be so tuned in to what is happening that their feelings end up being spot on,” Dr. Albers recognizes. That kind of positive reinforcement can be damaging because it can lead a person who’s hypervigilant to accept their understanding of the world around them.

“If a person who’s hypervigilant has enough experiences where they’re spot on, it can almost start to feel like that they can predict the future,” she continues. “That becomes problematic because it leads to over-analyzing, making assumptions and anticipating the worst. Nobody’s gut instinct is always 100% right and we can’t know or control the future.”

Coping with hypervigilance

If hypervigilance is negatively impacting your life, there are lots of ways to address it. Dr. Albers suggests the following:

• Therapy. If you think you’re experiencing hypervigilance, Dr. Albers recommends working with a mental health professional to address it. “Working with a counselor can help you identify your triggers and better understand how and why those triggers create a sense of panic and hyper awareness,” she says. Therapy is also a great place to work on distinguishing between feelings and facts, as well as unravelling any past trauma that might be influencing you in the present.
• Self-soothing and grounding exercises. If you’re struggling with hypervigilance at a specific moment, Dr. Albers suggests calming yourself with deep breathing, counting, self-talk or whatever self-soothing or grounding activities you find helpful. “Calming down the fight-or-flight response’s going to help you stop catastrophizing, think more rationally and be present in the moment,” she explains.
• Mindfulness. Self-soothing and grounding are great coping mechanisms for the times when you find yourself on high alert, but it’s just as important to reduce your overall stress and anxiety level. Mindfulness is a great way to do just that. “When engaged in mindfulness,” Dr. Albers says, “you focus on what’s happening on the inside instead of on the outside.” Instead of closely watching someone’s else behavior to decode what they’re thinking or feeling, mindfulness redirects you to your own thoughts and emotions. When practicing mindfulness, you try to look at situations neutrally without judgment. There are many different ways to be do that, so choose an activity that resonates for you.
• Medication. Some people need extra help calming down their nervous system — especially people experiencing hypervigilance as a side effect of a physical condition like thyroiditis.
• Limiting alcohol and caffeine consumption. Have you ever noticed a jittery feeling after overdoing it on the coffee-front? Dr. Albers says caffeine can increase anxiety which, in turn, can feed hypervigilance. Alcohol doesn’t mix with most mental health issues, including anxiety, so it’s best to steer clear of it when you’re struggling with hypervigilance. 

The bottom line

Hypervigilance is what happens when our natural flight-or-flight instinct goes into overdrive. People who are hypervigilant are in a constant state of anxiety. It isn’t a diagnosable mental health condition, but it’s a common feature of a wide range of physical, psychological and thought disorders. Causes range from childhood trauma and personality disorders to physical conditions like hypothyroidism. Hypervigilance can be physically, mentally and emotionally exhausting. It can make daily life and relationships difficult.

If you’re experiencing hypervigilance, consider reaching out to your primary care provider or a mental health professional for help. You may also benefit from limiting your caffeine and alcohol intake, starting a mindfulness practice and learning self-soothing techniques you can use to ground yourself in the present moment.

Registered dietitian Devon Peart, RD, MHSc, BASc, explains what nitrates and nitrites are, including which foods they’re found in and how they affect your health, for good and for bad.

What are nitrates and nitrites?

Nitrates and nitrites are naturally occurring chemicals that are similar in structure. They’re both made of nitrogen and oxygen, but nitrates contain three oxygen atoms and nitrites only two oxygen atoms. But for your purposes, what does that mean?

“Nitrates and nitrites are natural chemicals that are found in soil and water as part of the earth’s nitrogen cycle,” Peart explains. “They’re naturally present in the human body and in some foods, and nitrates are also added to some foods.”

The nitrates and nitrites that occur naturally in our bodies and in whole foods (like plants, which we’ll talk about momentarily) aren’t concerning. They’re normal and healthy.

But if you’ve heard that you should avoid foods that contain nitrates and nitrites, there’s some truth to that advice: When they’re added to certain foods, that’s when they start causing trouble — namely, by raising your risk of cancer.

Foods high in nitrates

Nitrates and nitrites occur naturally in leafy green vegetables like spinach, romaine and kale, as well as in root vegetables like beets, celery and carrots.

“Most of the nitrates and nitrites we consume come from plant foods we eat,” Peart says. But plants aren’t the only purveyors of nitrates and nitrites, which is where the problems start to occur.

“We also add nitrates and nitrites to meat products (and to some cheeses) as a preservative, to prevent the growth of harmful bacteria, and sometimes to boost the color and palatability of food,” she continues. “They can even add extra umami flavor.”  

Yum! Sounds great, right? Not so fast.

The issue, Peart says, isn’t with the nitrates themselves but with their potential to form nitrosamines, carcinogenic compounds that can increase your risk of various cancers

“Research shows that the source of the nitrates matters,” Peart says. “Eating too many processed meats containing added nitrates and nitrites is associated with an increased risk of cancer, but eating plants that have nitrites or nitrates in them has not been associated with increased cancer risk.”  

Let’s break down the differences between nitrates and nitrates found in plants and the kind added to meats and cheeses.

The downside: nitrosamines

On ingredient labels, you might also see added nitrates and nitrites listed as “sodium nitrite” or “potassium nitrate.” Some common foods that include them are:

• Deli-style meats.
• Bacon.
• Hot dogs.
• Salami.
• Sausages.
• Some cheeses, including gruyere, edam, gouda, processed cheese and cheese spreads.

But what makes the nitrates and nitrites in some foods problematic and not in others? Several factors may be involved, including food prep methods.

“When meat is cooked at high heat, like during frying or grilling, nitrates and nitrites can react with the amino acids in the meat protein to form nitrosamines,” Peart explains. “Most nitrosamines are known carcinogens, which means they’re associated with an increased risk of cancer.”

Vitamin C can stop nitrates from turning into nitrosamines, she says: “One reason we don’t see increased cancer risk with leafy greens, for example, could be due the vitamin C in plant foods.” Vitamin C is sometimes added to processed meats to try to prevent cancer-causing compounds from forming.

What about meats that are labeled “organic,” “natural” or “preservative-free”? This usually means they contain nitrates or nitrates that occur naturally in plants, which have been processed into powders or juices and added to the food as a preservative.

“This is somewhat misleading, though, because the nitrates can still be converted to nitrosamines,” Peart warns, “so they’re not necessarily healthier.”

The upside: nitric oxide

Remember: Not all nitrates and nitrites are bad news — in fact, quite the opposite. “Naturally occurring nitrates and nitrites help our digestive system by protecting against certain bacteria,” Peart states.

They can also transform into nitric oxide, which has known health benefits. In-depth research from the last 15 years shows that nitrate from vegetables might have heart health benefits like:

• Lower blood pressure.
• Reduced risk of cardiovascular disease.
• Improved energy, sports performance and recovery.

Research is ongoing, but nitric oxide may have a positive impact on or improve outcomes for conditions like:

• Diabetes.
• Inflammation.
• Eye disease.
• Age-related poor muscle function.
• Cognitive function.
• Dementia.

If you’re an athlete, the energy/performance/recovery benefit might sound familiar. “Many athletes drink beetroot juice to harness the potential performance-enhancing effect of the naturally occurring nitrates in beets,” Peart says.

To get the potential benefits of nitric oxide from food, eat leafy greens like spinach and kale, as well as root vegetables like celery, carrots and beets.

“Include plenty of vitamin C-rich foods in your diet, too, like citrus fruits,” Peart advises, “because vitamin C helps your body absorb and use nitric oxide.”

Should you limit your nitrates and nitrites?

It depends on which foods you’re getting them in.

“The nitrates and nitrites in processed meat are chemically identical to naturally occurring nitrates in plant foods, but eating those plant foods is not associated with increased cancer risk,” Peart clarifies. “There is, however, an increased risk associated with eating processed meats, if you have them often.”

And then, there’s the simple fact that vegetables are just really healthy, generally, providing other health benefits like antioxidants, fiber and micronutrients. Processed meats, on the other hand, are ultra-processed foods that are also high in saturated fat and sodium, which are known to negatively impact your health (and especially your heart).

As with so much of the guidance around nutrition, Peart emphasizes that moderation is key.

“Having an occasional slice of bacon (or two!) doesn’t pose an increased health risk,” she says. “But we should limit the amount of processed meat in our diets and aim to enjoy a wide variety of health-enhancing plant foods.”

Think boxing might be right for you? Physical therapist James Edwards, DPT, discusses why fitness boxing is good for you and how to steer clear of injuries.

Is boxing good exercise?

Traditional boxing prepares fighters to spar in a ring, while fitness boxing is a form of high-intensity interval training (HIIT) that challenges your body and mind.

“Boxing combines punching drills and conditioning exercises that can improve your heart health, strength, endurance, balance and coordination,” Dr. Edwards says. “It can also reduce stress, anxiety and depression and improve your confidence and overall well-being.”

A typical fitness boxing class includes a series of drills to keep you moving. Your class may include a mix of:

• Punching rounds, into bags, mitts or the air (known as shadowboxing).
• Footwork drills, like jumping rope and using an agility ladder.
• Jump training, like squat jumps, lateral bounds or burpees.
• Strength exercises, like crunches, planks or pushups.

Both traditional and fitness boxing are great workouts, but fitness boxing is certainly safer. You’re not taking any punches to the face or body — just getting in a great sweat sesh.

6 benefits of boxing

Both traditional boxing and fitness boxing bring a number of health benefits, both physical and emotional — and the more you box, the bigger the benefits!

Dr. Edwards breaks them down for you.

1. Improves heart health

Regular physical activity, including boxing, can lower your blood pressure, your cholesterol and your risk of heart disease.

To achieve these benefits, the U.S. Department of Health and Human Services’ Physical Activity Guidelines recommend one of these activity levels for adults:

• 150 to 300 minutes of moderate-intensity exercise per week.
• 75 to 150 minutes of vigorous-intensity exercise per week.
• A combination of moderate- and vigorous-intensity exercise.

When you’re boxing, you’re likely to exert moderate- to vigorous-intensity effort. Moderate intensity means you’re at about 50% of your maximum level of exertion. With vigorous exercise, your intensity is 70% to 80%. Want to track your activity levels? Consider purchasing a heart rate monitor.

“A monitor can help you maintain your heart rate during exercise and make sure you’re not overexerting yourself,” Dr. Edwards says.

2. Boosts endurance

Traditional boxing prepares fighters for four to 12 rounds in the ring. Each round is three minutes with a one-minute rest.

“The drills in fitness boxing provide a similar level of conditioning that translates to better stamina,” Dr. Edwards explains.

3. Provides full-body strength

“Throwing a punch works your entire body, from your arms and shoulders all the way to your core and legs,” Dr. Edwards says.

The conditioning exercises in fitness boxing classes also use a whole-body approach. You’ll tone muscles you never knew you had!

4. Helps with weight management

The calories you burn during boxing can help you maintain or achieve a healthy weight.

One study compared boxing training versus moderate-intensity walking in people with a body mass index (BMI) of greater than 25 (which is considered having overweight/obesity). The researchers noted reductions in BMI, waist circumference and body fat percentage in the boxing group, while the walking group showed no changes.

5. Improves balance

Exercise is key to good balance, especially as you age.

“Boxing can give you better agility and hand-eye coordination,” Dr. Edwards notes. “It also helps build a strong core, which is essential for maintaining your equilibrium.”

Boxing training may be an effective therapy to improve balance and reduce falls in people with brain disorders. One early study found that twice-weekly virtual boxing training reduced falls in people with Parkinson’s disease, while another study showed that boxing training improved balance in people who had a stroke.

6. Enhances mental health

Boxing drills can be a form of moving meditation.

“Punching requires intense focus,” Dr. Edwards states, “and the constant movement and HIIT exercises during class leave little time for deep thought.”

Individually, meditation and HIIT offer a range of mental health benefits. Together, they deliver a double punch of rewards. According to a review of 16 studies, the mental health benefits of boxing include:

• A healthy outlet for anger and aggression.
• Improved self-esteem and quality of life.
• Less stress.
• Reduced symptoms of conditions like anxiety and depression.

How to prevent boxing injuries

The saying “An ounce of prevention is worth a pound of cure” holds true for all sports, including boxing: Taking preventive steps can help you avoid injuries.

Dr. Edwards shares tips for staying injury-free:

• Ease into it: You may be tempted to push beyond your limits at first, especially if your classmates are more advanced, but take it slow. “Over time, your endurance and strength will increase,” Dr. Edwards encourages.
• Wear the right gear: Wrapping your hands and wrists and donning the right gloves and mitts will help keep you protected. Ask your instructor for recommendations based on your skill level. 
• Use good form: Going rogue can lead to injuries. “Your instructor will teach you the different types of punches and how to throw them properly,” Dr. Edwards says.
• Listen to your body: Pain and swelling are signs you need rest. For sore muscles or joints, 20 minutes of ice can reduce inflammation. Talk to a healthcare provider or physical therapist if the pain continues.
• Make time for recovery: You need time to recover from a high-intensity boxing workout, so plan for two to three HIIT classes per week. On off days, stay active and promote recovery with resistance training, light cardio, yoga and stretching.

And do your due diligence ahead of time.

“If you aren’t used to high-intensity exercise, be sure to check with your healthcare provider to make sure it’s safe for you,” Dr Edwards advises.

What to know before you take a fitness boxing class

If you’ve never thrown a punch, a boxing class may seem intimidating. But many gyms welcome beginners and go out of their way to help new students learn the ropes.

“It can be helpful to have a basic level of fitness, but you don’t need any previous boxing experience to get started,” Dr. Edwards says.

To get off on the right foot:

• Choose a class that allows you to go at your own pace. Many fitness boxing classes offer modifications to help ease newbies into the sport.
• Reach out to the instructor ahead of time to raise any questions or concerns.
• Ask whether your gym has hand wraps and gloves you can borrow, to start.
• To make class more fun and less intimidating, bring a friend!

Anyone who’s taken a boxing class knows it’s great exercise. But that’s only one reason to choose boxing. Learning to punch — even if it’s only for fitness — can be empowering. You may even find that it gives you the strength and confidence to better navigate life’s challenges.

Ingredients

• 1 8-ounce package dry bread stuffing mix (whole grain if available)
• 2 cups apple juice, or as needed
• 2 tablespoons trans fat-free tub margarine
• 2 red delicious apples — peeled, cored and diced

Directions

1. Prepare the stuffing mix according to package directions, but substitute apple juice for water.
2. When bringing the juice and margarine to a boil, add the diced apple to the pan.
3. Stir in the stuffing mix until the liquid is absorbed.
4. Transfer the stuffing to a baking dish sprayed with non-stick cooking spray and top with remaining apples.
5. Bake for 25 to 30 minutes at 350 F or until stuffing is heated through.

Ingredient health benefits

• Apples: What’s not to love about apples? In addition to tasting great on a crisp fall day, apples can help regulate blood sugar, lower cholesterol and give the microbes in your gut the fuel they need to keep you healthy.
• Margarine: This well-known spread has less saturated fat and fewer calories than butter. And the trans fat-free version doesn’t have trans fats, which raise your risk of heart disease.
• Whole-grain bread: Whole grains support your heart health, lower your blood pressure and can help you manage your weight. That being said, be choosy when selecting a whole-grain bread. Opt for breads that say “100% whole-grain” or “100% whole-wheat” on the labels and avoid brands that claim to be “enriched.”

Nutrition information (per serving)

Makes 8 servings

Calories: 180
Total Fat: 3 g
Sodium: 530 mg
Carb: 34 g
Fiber: 2 g
Protein: 3 g

But is it bad to drink coffee late at night?

“It depends on how sensitive you are to caffeine,” says registered dietitian Anthony DiMarino, RD, LD. “Some people can enjoy a late-night brew and sleep soundly a few hours later. People more sensitive to caffeine may toss and turn all night and be unable to sleep.”

Here’s how that evening coffee may affect you — and when it might actually help.

How late is too late for coffee?

To figure out how late you can drink coffee and still get a good night’s rest, consider how long it takes your body to clear out or eliminate caffeine.

“It can take two to 10 hours for just half of caffeine’s effects to wear off,” DiMarino explains. “This ‘half-life,’ as it’s known, varies from person to person.”

Research shows that your genes may affect how quickly you metabolize caffeine. Specifically, some people are blessed with two CYP1A2 genes — the “coffee gene” that helps your body break down and eliminate caffeine faster than those who have one copy.

“Someone who metabolizes caffeine slowly should probably avoid evening caffeine if they want a good night’s rest,” DiMarino advises.

The lowdown on coffee and caffeine

An 8-ounce cup of coffee has close to 100 milligrams of caffeine. But DiMarino cautions that the amount of caffeine per cup can vary depending on the type of coffee grounds and the brew. For example, instant coffee typically has about half the caffeine that brewed coffee has. And coffee shop brews often come in larger sizes, which means more caffeine.

The U.S. Food and Drug Administration (FDA) recommends that adults limit caffeine to 400 milligrams per day. That’s the equivalent of four to five cups of coffee a day, depending on the coffee type and cup size. Of course, you also need to consider the caffeine you get from chocolate, tea, sodas, energy drinks and other products.

Other factors affect how well you tolerate caffeine, too, including your biological sex and medications you take. People who smoke or use nicotine a lot tend to metabolize caffeine faster, cutting its half-life by up to 50%. Pregnancy, on the other hand, slows your ability to eliminate caffeine, which is why experts recommend no more than 200 milligrams of caffeine per day during pregnancy.

What are the risks of drinking coffee late at night?

A bad night’s sleep is perhaps the No. 1 risk of drinking coffee late at night. Insomnia (the inability to fall asleep or stay asleep most nights of the week) affects as many as 1 in 3 adults worldwide. Too much caffeine throughout the day or late at night can make insomnia worse.

One study found that consuming caffeine within four hours of bedtime didn’t affect sleep, but using alcohol and nicotine did. But DiMarino notes that researchers relied on sleep journals and smart watches worn only by a specific demographic.

“Among other concerns, this observational study didn’t track how much or what type of coffee people drank,” he says, “so take these findings lightly.”  

In general, he says, a late-night cup of java can affect your sleep in several ways.

1. It messes with your sleep signals

Caffeine is a biochemical that blocks your brain’s production of adenosine, a chemical that induces sleep. Adenosine acts as a nervous system depressant, slowing your brain activity to promote sleep and keep you from waking up at night.

“Adenosine gradually builds in your body throughout the day,” DiMarino explains, “but caffeine blocks adenosine receptors, making you feel more alert and less tired at the end of the day.

2. It changes your body’s internal clock

Drinking coffee late at night when your body is preparing to wind down can also affect your circadian rhythm. This 24-hour internal body clock controls your sleep-wake cycles.

One study found that drinking a double espresso (about 120 milligrams of caffeine) three hours before bedtime throws off your circadian rhythm by at least 40 minutes. That’s like being exposed to 90 minutes of bright light just before turning in for the night. Yikes!

3. It makes you more anxious

Caffeine is a stimulant that affects your brain and nerves — and your nervous system controls your thoughts and feelings (not to mention your heart rate and breathing).

“For someone prone to anxiety, caffeine can make symptoms worse,” DiMarino says. “Drinking coffee late in the evening may contribute to racing thoughts, making it more difficult to shut off worries and relax.”

Nighttime panic attacks may also become more of a concern after a late-night cup of coffee. One study found that consuming five or more cups of caffeinated coffee per day may lead to more panic attacks in people who are already prone to them.

Even if you don’t have a history of anxiety, a late-day coffee can have unwelcome effects like making you feel more jittery or irritable as the evening winds down.

What are the benefits of drinking coffee late at night?

Drinking coffee late at night can help those working late or overnight shifts and college students cramming for exams. The beverage gives you energy, boosts your mood and helps you think more clearly.

Coffee has surprising health benefits, too, regardless of when you drink it, such as:

• Antioxidants that protect against cell damage.
• B vitamins like riboflavin, which lower the risk of migraines, vision problems and certain cancers.
• Potassium to lower blood pressure.

If you need to make it through a late night, just know that coffee isn’t your only option. There are also other ways to stay awake without caffeine!

Is decaffeinated coffee a better late-night choice?

Maybe. Despite its name, decaffeinated coffee still has small amounts of caffeine. An 8-ounce cup of decaffeinated coffee may have up to 15 milligrams of caffeine.

“If you’re sensitive to caffeine, a cup of decaf late at night may still interfere with your sleep,” DiMarino cautions.

Because everyone’s caffeine tolerance is different, only you can decide when it’s too late for you to drink coffee. You may love your late afternoon or evening coffee and have no problems dashing off to dreamland. But if you’re having sleeping troubles, try getting rid of your nighttime coffee — or having it earlier in the day.

Now, your goal is to shed that extra weight as quickly as possible. But as many people learn, it’s a lot tougher to drop pounds than it is to pack them on. But don’t let these 10 common mistakes sabotage your success.

1. Setting unrealistic goals

Vowing to lose 10 pounds within a week may sound like a good idea, but it’s not the sort of goal that sets you up for success, says psychologist Susan Albers, PsyD. It’s simply too much to lose so quickly. It’s not realistic.

Research indicates that losing 1 to 2 pounds a week is a reasonable goal, depending on your body type. This gradual approach is more likely to result in sustainable behaviors that help keep lost weight from returning.

Setting more achievable short-term goals also lets you build on accomplishments. Every pound lost becomes a reason to celebrate your effort and commitment.

“Don’t underestimate the power of positive reinforcement,” says Dr. Albers. “When you do actions that make you feel good, you want to keep doing them.”

Another option? Instead of focusing on the numbers on your scale, aim to establish healthier eating patterns and lifestyle changes. That typically leads to weight loss and your body feeling better.

2. Relying on fad diets

If a sketchy diet program promising to melt away pounds sounds too good to be true … well, it’s probably not true or worth your time and effort.

Fad diets offer many breathless promises (MELT AWAY BELLY FAT!) but deliver few, if any, long-term results, says registered dietitian Beth Czerwony, RD, LD. Basically, these plans offer hope and hype but little else.

So, how do you spot a fad diet? Many focus on eating one specific food or type of food. The “grapefruit diet” is a good example. Ditto for eating programs that focus largely on just proteins or fats.

But by cutting groups of foods, many fad diets exclude major nutrients your body needs, which can lead to health issues.

Plus, fad diets often set up a dysfunctional relationship with food that can be hard to undo.

“A healthy and sustainable diet is typically one that is well-rounded,” states Czerwony. “That means eating fruit, vegetables, whole grains, protein and dairy in serving sizes that make sense.”

If you’re looking for a healthy, long-term diet plan, many healthcare providers recommend the Mediterranean diet.

3. Using guilt as a motivator

Mentally beating yourself up about your weight won’t help lower numbers on your scale. In fact, it may have the opposite effect.

Research shows that feelings of guilt about your weight can lead to weight gain and trigger an unhealthy relationship with food. “It’s not a path to success,” cautions Dr. Albers. “When you feel like you’re doing things ‘wrong’ or ‘bad,’ you’re more likely to just give up completely.”

In other words, dropping “negative” thoughts may help you drop pounds.

4. Skipping meals

If cutting calories equals weight loss, then skipping meals should work wonders, right? Not exactly, says Czerwony. Food is fuel for your body, after all. You can’t just let your tank go empty.

“Skipping meal after meal can keep your body from getting the nutrients it needs,” she explains.

It also may slow down your metabolism, which means your body burns less calories — a physiological adjustment that can lead to weight gain. (And that’s not exactly your goal with avoiding meals.)

Now, there are intermittent fasting programs that limit your “eating hours” and can be effective for weight loss and management. But these plans maintain nutrition intake and aren’t based on skipping meals.

On a related note, be cautious of low-calorie diets that fall below 1,000 calories a day. Eating such a minimal amount of food often requires extra nutritional support through vitamins and supplements. Talk to your healthcare provider to make sure you avoid any deficiencies.

5. Obsessing over the scale

Weight is easily measurable — and that’s not always a good thing. “Too often, people use the scale as a weapon — not as a tool,” emphasizes Dr. Albers. “They become obsessed with one number.”

So, don’t focus solely on that number that pops up between your feet as you try to adopt a healthier lifestyle. Oftentimes, how you feel and fit into your clothes may be better measures of your efforts.

But if you simply can’t resist the urge to weigh yourself, use a range rather than focusing on a single number. “Be flexible,” advises Dr. Albers. “Expect to see some ups and downs. It’s natural.”

6. Overdoing high-intensity exercise

Working out is good for you and can certainly help you achieve and maintain a healthy weight. But overdoing it on the treadmill or weight-lifting in an attempt to shed pounds quickly is NOT recommended.

Excessive high-intensity exercise can suppress your immune system and make you more susceptible to injury, says exercise physiologist Katie Lawton, MEd, ATC.

Combining tough workouts with a low-calorie diet may bring unwanted results, too.

“If your body doesn’t get enough fuel for the workout, it can actually store fat and burn muscle,” she explains. “Your metabolism slows down as you deplete muscle, which can lead to weight gain.”

Bottom line? Limit high-intensity training to two to three days per week.

7. Sweating off weight

More than half of your body weight is water. That fact explains the temptation to simply “sweat out” a few pounds by exercising in a heavy sweatshirt or camping out in a sauna for extended periods.

But what amounts to intentional dehydration is never a good idea. “It’s not just water that you’re losing with sweat,” notes Lawton. “You’re depleting electrolytes and losing key vitamins and minerals.”

Plus, any weight loss will be short-lived as those pounds will return once you rehydrate.

8. Overlooking hydration

Want to crave food less? Try drinking more water.

A glass of H2O before meals or when you feel like snacking works to fill your stomach before you eat, says Czerwony. That’ll help satisfy your hunger, which may prevent you from going back for seconds at dinner or grabbing a midday snack.

But numerous studies connect other benefits to drinking more water, too, including:

• Increased calorie burn.
• Better digestion to remove waste from your body more quickly.
• Improved blood flow, which can supply an energy boost for activity.
• Less reliance on sugary, high-calorie drinks such as soda or juice to quench your thirst.

So, how much water should you drink a day? Hydration needs vary from person to person, but a good target is 64 ounces a day, Czerwony says.

One warning, though: Don’t overdo it. Consuming vast amounts of water can cause a rare yet dangerous condition known as hyponatremia, which dilutes the sodium levels in your body.

9. Purging

Emptying out by vomiting or taking laxatives isn’t a healthy choice to lose weight, stresses Czerwony. They qualify as eating disorder behaviors and can be extremely damaging to your body.

Complications could include:

• Arrhythmia, heart failure and other heart problems.
• Acid reflux (gastroesophageal reflux disease or GERD).
• Gastrointestinal issues.
• Low blood pressure (hypotension).
• Organ failure and brain damage.
• Osteoporosis and tooth damage.
• Severe dehydration and constipation.
• Stopped menstrual cycles (amenorrhea) and infertility.
• Stroke.

“Purging is never the right choice for weight loss,” she emphasizes.

10. Focusing solely on food and exercise

Limiting calories and increasing activity are typically the go-to moves for anyone looking to pounds. But other lifestyle habits shouldn’t be ignored as you work toward your goal weight.

“How’s your stress level? How’s your sleep?” asks Dr. Albers. “The answers to both are important. High stress and little sleep can affect hormones that control appetite and lead to overeating.”

Final thoughts

Losing weight isn’t easy. There aren’t any shortcuts. (Sorry!) But there are ways to safely lose pounds and improve your overall health. Give yourself time and flexibility to work toward the body you want.

Sleep apnea is a “grossly under-recognized” breathing condition that increases the risk of heart attack, stroke and other serious health consequences. It’s estimated that 85% to 90% of people with sleep apnea don’t know that they have it.

Meanwhile, research shows that the number of people with diagnosed sleep apnea continues to grow, affecting:

• 10% of men aged 30 to 49 and 17% of men aged 50 to 70.
• 3% of women aged 30 to 49 and 9% of women aged 50 to 70.

That’s a worrisome trend that can keep you up at night. To help you sleep easier, let’s learn more about the condition and talk about solutions with sleep medicine specialist Nancy Foldvary-Schaefer, DO, MS.

What happens during sleep apnea?

In the simplest of explanations, you stop breathing.

Obstructive sleep apnea (the most common type of sleep apnea) occurs when your upper airway narrows or becomes blocked at the back of your throat, which reduces or even stops airflow to your lungs.

Thankfully, your body’s on-duty survival reflex is trained to kick in when your oxygen dwindles. That save-the-day response results in you waking up just enough to resume breathing, explains Dr. Foldvary-Schaefer.

People with moderate to severe sleep apnea may have 15 or more of these episodes per hour. Briefly waking up is better than not breathing, of course … but it’s also not great for restful and restorative sleep.

Signs you might have sleep apnea

If your sleep apnea is severe, you might wake up at night gasping for air and feeling like you’re choking. (If you share a bed with someone, they may tell you that it’s pretty scary watching you sleep.)

Snoring is often a telltale sign of sleep apnea. “Not all snorers have sleep apnea, but snoring is usually the first noticeable symptom,” shares Dr. Foldvary-Schaefer.

But signs of sleep apnea aren’t just evident during sleep. Fatigue, declining performance at work or school and mood changes are all associated with sleep apnea. Morning headaches are common, too. You also may experience problems with sex.

Women and people assigned female at birth (AFAB) often have more subtle symptoms, typically involving fatigue and often attributed to depression. “It can take women up to a decade longer than men to receive a diagnosis of sleep apnea,” says Dr. Foldvary-Schaefer.

Who typically gets sleep apnea?

Anyone at any age can experience sleep apnea, but some groups or circumstances make the condition more likely. The list includes:

• Age. Constricted airways during sleep become more common as throat muscles naturally weaken over time. Increases in sleep apnea cases since 1990 have been connected to aging Baby Boomers.
• Excess weight. Extra fat around your neck can compress your airway as you sleep. The “obesity epidemic” has also contributed to the rise in sleep apnea diagnoses, says Dr. Foldvary-Schaefer.
• Sex. Before age 50, sleep apnea is more common in men and people assigned male at birth (AMAB). The gap between men and women (people AMAB or AFAB) narrows later in life.
• Ethnicity. Sleep apnea is more common among Asian, Black and Hispanic populations.
• Large tonsils that obstruct your airway.
• Genetics. A family history of sleep apnea is present in about 25% to 30% of cases.

Drinking alcohol and sleeping on your back also can aggravate the condition, notes Dr. Foldvary-Schaefer.

Risks of sleep apnea

Ignoring sleep apnea can come with consequences.

“Untreated apnea increases your risk of stroke, heart attack and high blood pressure,” states Dr. Foldvary-Schaefer. “If you have atrial fibrillation, sleep apnea doubles your odds of having a recurrence. If you have heart failure, it increases your risk of hospital admission.”

Sleep apnea can leave you fatigued and irritable, too, raising your risk of motor vehicle crashes, work-related injuries and accidents. Children with sleep apnea may have difficulty focusing on school.

Worldwide, people with obstructive apnea rate their quality of life worse in every measurable way.

Finding solutions for sleep apnea

Sleep apnea is very treatable once it’s identified. That’s where you come in.

“It’s easy to forget to bring up sleep apnea symptoms at your annual checkup, but it’s best to tell your doctor about them,” advises Dr. Foldvary-Schaefer. “Otherwise, sleep apnea can be missed for many, many years.”

To see if you have sleep apnea, your healthcare provider will likely take a sleep history and order a sleep study. In some cases, you may be referred to a sleep medicine specialist or sleep center.

The gold standard for sleep apnea treatment is positive airway pressure (PAP). This method uses specialized devices to increase air pressure in your airway, which keeps it open so you can breathe.

Odds are you’ve heard of a continuous positive airway pressure (CPAP) machine, one of many devices used for treatment.

“But there are multiple forms of PAP therapy and a wide range of masks,” clarifies Dr. Foldvary-Schaefer. “Patients with difficulty tolerating the constant flow of air pressure often prefer auto- or bi-level PAP therapy and need help with mask options.”

Other treatment routes include:

• Weight loss.
• Use of a body pillow or positional device to promote sleeping on your side.
• Oral appliances that advance your lower jaw forward.
• Tonsil removal surgery.
• Hypoglossal nerve stimulation.

The bottom line

Most people spend one-third of their day sleeping. Don’t underestimate how vital that time is for your overall well-being.

“Sleep is as important to good health as diet and exercise,” says Dr. Foldvary-Schaefer. “We need sleep to restore every cell in our bodies. If we neglect it, some aspect of our health will suffer.”

But if you can, avoid high-speed jet air dryers in public restrooms. Research shows that they spread — rather than remove — germs. The same is true to a lesser extent for warm air dryers.

The clear winner: Good old-fashioned paper towels.

“We often say handwashing is the key to preventing the spread of illness,” says family medicine physician Daniel Allan, MD. “But wet hands increase the risk of transmitting bacteria, so drying is an equally important step in prevention.”

Importance of handwashing and hand drying 

The healthcare and food industries are obsessed with hand hygiene. That’s because in a hospital, transmitting viruses and bacteria can mean life or death. And in a restaurant or on a cruise ship, foodborne illnesses like E. coli and coronavirus can make people severely and even critically ill.

Lots of research has focused on handwashing — and hand drying — techniques as a result.

Let’s separate fact from fiction when it comes to hand drying. 

Myth: Hand dryers help kill germs

Fact: Hand dryers can spread viruses and bacteria 

The airport. The mall. Your beauty salon. You may have noticed how many public buildings have switched to hand dryers in recent years. Yet researchers have found that mechanical hand dryers may essentially “undo” what handwashing does in the first place — get rid of germs.

In a small 2021 study, volunteers wore aprons while washing and drying their hands. Half of the participants used paper towels to dry their hands while the other half used a jet air dryer. The researchers then analyzed the aprons, the participants’ hands and the surfaces they touched afterward to see how viruses spread. 

The results showed that the people who used hand dryers had more viruses on their hands and aprons than those who used paper towels. But it’s important to keep in mind that the experiment used high amounts of microbes that may not be found in an average environment and that the sample size was very small. 

Still, these findings were similar to results from other studies, including a 2018 study that found that hand dryers can blow bacteria present in public bathrooms onto your hands. 

While this doesn’t confirm that hand dryers can spread certain viruses, the World Health Organization (WHO) did make it clear that hand dryers can’t protect against the COVID-19 virus. 

Myth: Jet air dryers are better than traditional warm air dryers

Fact: Jet air dryers spread more microbes than warm air dryers

Could certain air dryers be worse than others? In a 2015 study, microbiologists aimed to find out by comparing jet air dryers to warm air dryers and paper towels. 

Here’s what they found: 

• The jet air dryer dispersed an average of 60 times more viruses than the warm air dryer and 1,300 times more than paper towels, at six different heights.
• The impact of the viral spread was greatest at 2.5 feet to 4.1 feet — which is about face-level for a small child.
• The jet air dryer dispersed 20 times more viruses than the warm air dryer and 190 times more virus than paper towels, at nine different distances.

The way each method works helps to explain the results. Jet air dryers force air out sideways at ultrahigh speeds, while warm air dryers work by evaporation. Paper towels absorb water. Essentially, both types of hand dryers spread microbes, but jet air dryers have been found to do it more aggressively.

Myth: Hand dryers are more sanitary than paper towels

Fact: Paper towels are the most hygienic

When you’re in a public restroom, remember that low-tech is sometimes better than high-tech and stick with paper towels. As the above studies have noted, opting for paper towels will keep more germs off your freshly cleaned hands than air dryers. 

“Drying your hands with paper towels not only dries them faster, but the friction also dislodges bacteria to leave them cleaner,” notes Dr. Allan.

And those cloth towel dispensers? It’s best to avoid them. The patch of cloth at the end of the roll tends to get used over and over again. This transmits germs from hand to hand to hand.

The best way to get your hands really clean

Handwashing is still one of the best ways to protect yourself against bacteria and disease. 

The U.S. Centers for Disease Control and Prevention (CDC) recommends the following:

• Use warm or cold water. Wet your hands, then turn off the tap, then apply soap.
• Lather well, washing the backs of your hands, between your fingers and beneath your nails.
• Wash for at least 20 seconds — about as long as it takes to sing “Happy Birthday.”
• Rinse well under clean, running water.
• Dry hands with a clean towel or air dry.

A last resort: hand sanitizers

No matter where you go, it’s probably a good idea to carry around some hand sanitizer. If you’re in a public restroom that only has air dryers, you can try and cover your bases by sanitizing your hands after drying them. 

Hand sanitizers are better than nothing, according to the CDC. But they won’t clean visible dirt or grease, they can’t kill all germs and they can’t remove all harmful chemicals. If hand sanitizers are your only option, make sure they are at least 60% alcohol.

Keeping your hands germ-free is an important part of staying healthy. Wash your hands before and after preparing and eating food, after blowing your nose or sneezing, and after using the bathroom. If you’re using a public restroom, your best bet is to skip the hand dryer as well.

So, we get our vaccines. We wash our hands. We (try to) stay away from sick people and stay home when we’re feeling ill.

And we clean and sanitize what we can — like countertops, doorknobs and other pesky places where germs can hide. Or maybe you’ve taken to protecting yourself by covering your hands with a tissue or towel when you open the bathroom door or press the buttons on the elevator. Because we’ve heard COVID-19 can live on the things we touch every day. 

But what’s the timeline here? How long can COVID-19 last on surfaces?   

We asked infectious disease specialist Frank Esper, MD, to weigh in. 

What happens when COVID-19 lands on surfaces 

The whole point of a virus is to invade a living host, hijack it, produce more virus babies and get out to infect more people; thus, starting the process over again. So, viruses like COVID-19 don’t survive well on their own. 

When an infected person coughs or sneezes, they send out millions of viral droplets. If those droplets land on the person sitting next to them, the virus has won the jackpot. (Yay! We’ve found a shiny new home. Let’s set up camp immediately!)  

But when those virus particles land on non-living things like tables, chairs, papers or counters, it’s something of a disappointment to the virus. Because surfaces don’t provide the kind of homey vibe it needs to replicate and grow.

“If a virus lands on something like a chair or table, it starts dying pretty quickly,” Dr. Esper states. 

The virus may get lucky, though. Maybe someone will soon come along and touch the part of the surface where the virus landed. That person then touches their eyes, nose, mouth. And voila, the virus has a new home base.  

But if no one comes by and picks them up in time, the virus starts to die off. Because without access to human cells to absorb the virus, the outer shell of the virus (called the capsid) starts to lose its integrity. And from there, the virus loses its illness-inducing potential.  

It’s like a fish out of water. Sure, your goldfish might be OK to flop around for a few seconds while you’re transporting them into a new bowl, but you better act fast. Viruses need humans like fish need water. 

COVID-19 survival times by surface 

So, for those COVID-19 viruses that land on a surface instead of a human … how long can they last without a new person to call home?

Research demonstrates that the virus’s survival depends, in part, on the type of surface it lands on. The live virus can survive anywhere from a couple of hours to a couple of days.

Hard, non-porous surfaces, like windows, railings, doorknobs and the like are likely to keep the virus living longer. On the other hand, COVID-19 and other viruses are less likely to last on softer materials that have teeny holes, like paper, cardboard or fabric. 

“The COVID-19 virus typically doesn’t like to live on surfaces that have a lot of holes or microscopic little grooves, nooks or crannies,” Dr. Esper explains. “It likes surfaces that are very smooth, like doorknobs.” 

What’s more, how long COVID-19 and other viruses last on surfaces can change depending on factors like the cleanliness of the surface, temperature, humidity and sunlight. Viruses tend to live longer in warm, moist environments and die off quicker when it’s cool and dry.  

Here’s how long the virus typically lasts on some common surfaces: 

• Glass: 5 days. 
• Wood: 4 days. 
• Plastic: 3 days. 
• Stainless-steel: 3 days. 
• Cardboard: 1 day. 
• Copper surfaces: 4 hours. 

It’s important to know, though that there’s a difference between a virus “lasting” on a surface and a virus “lasting-to-the-point-that-they-can-make-you-sick.”  

“We may be able to find some viable virus after a few days, but it’s thousands of times less than what was originally deposited,” Dr. Esper points out. “As soon as the virus hits something that’s not alive and certainly not a human, it’s not going to do very well.” 

So, just because the virus is detectable on a surface doesn’t necessarily mean that there’s enough there to infect you. Remember that viruses start to die when they’re not in the body, so the amount of live virus decreases over time on surfaces.  

Even if COVID-19 may be seen under a microscope on something like glass for five days, the risk of getting infected from touching that glass after a few days (or even a few hours) would be lower. 

Should you worry about COVID-19 on surfaces? 

The short shelf-life of COVID-19 on surfaces doesn’t mean you’re entirely in the clear.  

Think about those buttons on the elevator. Maybe you don’t have to worry about catching germs from the person who rode in it three days ago. But you don’t know who was on that elevator just before you or where they may have sneezed. Their germs can still infect you. 

And if you live with other people, you know you share a lot of surfaces in your home with them. If one person coughs in the bathroom and then opens the door, you know it won’t be long before you need to touch that same doorknob and could potentially catch their germs.  

So, yes, cleaning, sanitizing and taking care not to needlessly touch public surfaces is still important to staying healthy. So is keeping up with your COVID-19 vaccines, washing your hands properly and following other steps to stop virus transmission.  

If this sounds like you, you might be considering having your achy joint or joints replaced.

Joint replacements are generally very successful, allowing most people who have them to return to active lives free of chronic pain.

But while artificial joints are designed to last a long time, they won’t last forever. This means that if you’re a young, active person considering a hip or knee replacement, there’s a possibility that you’ll need to have the same joint replaced more than once.

Just how long does a knee replacement last? And how many knee replacements can you have in a lifetime?

Orthopaedic surgeon Nicolas Piuzzi, MD, explains what may affect the longevity of your hip or knee replacement and what you can do to maintain it.

What factors affect the lifespan of a knee replacement?

Based on many large studies of different joint implants, it’s generally thought that around 90% of modern total knee replacements still function well 10 or 15 years later. That number might be slightly higher for total hip replacements.

But today’s replacements might last longer than those numbers suggest, as the world of orthopaedic implants is evolving at a quick pace.

“Even though we have 15 or 20 years of data on implants, many of those implants that have been studied are no longer even in the market,” Dr. Piuzzi concedes. “We’ve come a long way with more durable and newer materials that are allowing the newer generation of hip and knee replacements to last longer than previous designs.”

One good example of a newer technology is a plastic called “highly cross-linked polyethylene,” which has very low-wear properties. There’s good reason to feel that implants made from this material will last longer than plastics that were previously used, but only time can tell.

Surgeons also have new tools that they think could improve the longevity of a joint replacement surgery, such as robotic surgery.

“We’ve seen that the partial knee replacement surgeries that we’ve been doing robotically seem to be doing better than the manually performed ones,” Dr. Piuzzi says.

That doesn’t mean that every surgery should or will be done robotically. But in certain cases, it’s showing potential to improve outcomes for people.

With all that information, it’s still important to understand that a joint replacement may need to be replaced early on or after a long period of time. The following factors can affect the lifespan of your knee replacement:

• An infection in the joint after surgery. Early failure isn’t common, but when it does occur, it’s usually because an infection develops in the joint after surgery. One of the best things people can do to set themselves up for a successful procedure is to minimize their risk factors beforehand, Dr. Piuzzi says. Risk factors include things like uncontrolled diabetes, increased BMI or poor nutrition, which increase chances of an infection.
• The bond between the bone and the implant loosens. Long-term failure is most likely to occur because the bond between the bone and the implant loosens over time, bone fracture or, more rarely, a component of the implant wears down.
• Your age. While doctors are performing joint replacement on patients at younger ages, if pain and function is severely affected, the joint replacements used are set to last much longer than earlier designs.

How do you know when your knee replacement is wearing out?

Once you’re fully recovered from your knee replacement surgery — which can take up to year — you shouldn’t feel pain or discomfort.

So, how do you know if your knee replacement is wearing out? You may start to feel:

• Pain.
• Swelling.
• Stiffness.
• Limited joint function and stability.

“The main symptoms to be on the lookout for are if you’re doing well and something changes, especially if pain limits activities or wakes you up at night,” clarifies Dr. Piuzzi.

Can knee replacement be done twice?

When a failure occurs, a revision surgery is needed to replace the original implant.

That’s a pretty big deal because revision surgery is a longer and more complex procedure. It requires specialized tools and implants, as well as a surgeon with advanced technical skills.

“The good news is that we now have improved tools, techniques and care pathways to revise failed total joint replacements and outcomes have improved,” says Dr. Piuzzi.

Tips to maintaining your knee replacement

So, how can you reduce your chances of needing a second knee replacement? Dr. Piuzzi says you can maintain your knee replacement by doing the following:

• Stay active. But there’s a caveat. You want to avoid high-impact activities like football, skiing or gymnastics, as there isn’t strong data to ensure it doesn’t affect long-term survivorship. And can walking too much damage your knee replacement? No, walking is encouraged to help you stay healthy and active.
• Maintain a healthy weight. This is important to avoid excessive stress on your knee replacement.
• Check in with your orthopaedic specialist every few years. Overall, don’t hesitate in reaching out and managing the status of your joint replacement, especially if something doesn’t feel right.

Bottom line?

If you’re having difficulty with your knees or hips, it may be time to consider a knee or hip replacement. The technology and materials used for hip and knee replacements have evolved. Your healthcare provider can answer any questions you have and help you make the best decision for your body and lifestyle.

“The newer materials, the novel technical procedures such as robotics, and the new knowledge that we’re applying to today’s surgery should impact how long they last,” Dr. Piuzzi reassures. “Hopefully, 20 years from now, the numbers that we’re going to be seeing will be even better.”

Things like so-called hangover cures, effects of different types of alcohol and even how much alcohol we can handle.

And while it may seem harmless to live by some of these “tips,” some of these alcohol myths can put your health at risk.

Chemical dependency specialist Joseph Janesz, PhD, LICDC, helps clear up the confusion around alcohol so you can drink smarter and more responsibly. 

Myth 1: Drinking perks you up at parties

One of the biggest misconceptions around alcohol is that it gives you energy, which may motivate you to drink more, especially during social situations. 

“Especially throughout the holiday season, many of us struggle with fatigue and excess stress,” Dr. Janesz notes. “We may look to alcohol at a holiday party to dissipate that fatigue, enhance our energy level and relieve stress.”

But alcohol is a brain-depressant. It first acts by shutting off executive functions like judgment, mood control and natural inhibitions. Some people experience this as a sense of thrill and excitement. But others experience the opposite: sleepiness, lethargy and even a depressed feeling.

The bottom line? Alcohol interferes with normal brain activity, no matter how you feel when you drink.

Myth 2: A beer before bed helps you sleep

Using any kind of alcoholic beverage to help you sleep is always going to backfire, even if in the moment it feels like it’s helping.

“Drinking a beer before bed may get you to fall asleep more quickly,” says Dr. Janesz. “However, it interrupts your deep sleep, and you’ll wake later on feeling not rested and hungover.”

Normally, your body cycles through light and deep phases of sleep. Alcohol inhibits refreshing REM (rapid eye movement) sleep and later on causes “REM rebound,” with nightmares and trouble sleeping.

Repeated alcohol use seriously disturbs sleep and makes it difficult to re-establish a normal sleep pattern. Often, this leads to more drinking or to sedative abuse in the quest for sleep.

Myth 3: An Irish coffee will keep you warm on the slopes

You may have heard that an alcoholic drink — especially something like an Irish coffee or hot toddy — can warm your body up when it’s cold. But that’s just a temporary sensation you’re feeling. 

“Alcohol intake may make your skin feel warm,” acknowledges Dr. Janesz. “Yet it deceptively lowers the core temperature of your body.”

Your body normally stores warm blood in its core to preserve important organ functions. Alcohol artificially dilates blood vessels in your extremities, allowing warm blood to escape from your core into your peripheral circulation, where it cools. The result: Your body can no longer keep vital organs warm as your overall temperature drops.

In other words, when you’re dealing with harsh conditions, don’t depend on a drink to keep you toasty. 

Myth 4: A beer is less potent than a cocktail

There’s also a lot of myths around the different types of alcohol and how they affect you. And while drinking a casual beer with friends may feel less intense than a spirited cocktail, they’re more similar than you might think. 

According to Dr. Janesz, whether you’re drinking a pale ale or a Moscow Mule, you’re typically consuming a similar amount of alcohol. But regardless, “Any alcohol beverage you consume will have a similar effect on your body and on your ability to function.”

This myth can especially be harmful if it causes you to drink more than you can handle — so always pay attention to the alcohol content in your drinks and be honest with what your body can manage.

Myth 5: Coffee can sober you up when you’ve had a few too many

While it may feel like coffee is bringing you back to life in many ways, you shouldn’t depend on it to get alcohol out of your system. In truth, coffee has no real effect on your blood alcohol level, which is the major factor in determining your level of intoxication.

“Drinking coffee or other caffeine products after having one too many drinks can trick your brain into making you feel energized and more awake or alert,” warns Dr. Janesz. 

In other words, coffee may just mask the feeling of being drunk, which is still not good. In reality, you need to know if you’ve had too many or not. “The alertness can create the perception that you aren’t as drunk or intoxicated as you actually are, and you may decide to have another drink or to drive home,” he adds.

Instead, you should keep track of how long alcohol can stay in your system, drink lots of water and wait for your body to clear it all out. Unfortunately, there aren’t any shortcuts.

Myth 6: All sexes react to alcohol in the same way

Drinking tends to produce higher blood alcohol concentrations in women than men because of a difference in body weight and composition. This leads to a greater degree of intoxication for women.

“Alcohol disperses in water, and women have less water in their bodies than men,” explains Dr. Janesz. “So, if a woman and man of the same weight consume the same amount of alcohol, her blood alcohol concentration will usually rise more rapidly than his.”

But while women may reach the “drunk driving” limit — 0.08 percent blood alcohol — sooner, alcohol can impair driving at much lower blood alcohol levels. So “don’t drink and drive” remains sound advice for everyone.

Myth 7: Drinking reduces stress and anxiety

If you’ve ever heard the phrase that a couple of cocktails can “take the edge off” after a long week at work, you may believe the myth that alcohol can calm you down. And while alcohol can initially make you feel looser and at ease (again, because it’s a depressant), the effects don’t last long. In fact, alcohol may actually cause more anxiety the day after.

So, while you may temporarily feel at ease in the moment, you can feel more stressed the day after.

If you use alcohol as a way to numb your symptoms of anxiety, this can also make the symptoms worse down the line — due to the fact that you’re not learning how to cope with your emotions properly. 

“Many of us look for a quick fix to resolve our pain. We all have developed habits of reinforcing immediate gratification and needing instant results,” explains Dr. Janesz. “Another issue with numbing your symptoms of anxiety is that over time, we develop a tolerance to alcohol and we are required to drink more alcohol for us to have the same numbing effect.” 

Myth 8: Alcohol only hurts your liver

If a recent doctor’s appointment told you that your liver is in good shape, don’t think that’s a free excuse to drink heavily. In fact, drinking can affect other parts of your body as well. This includes your heart, blood pressure, kidneys and mental health.

As Dr. Janesz explains, when you ingest alcohol, most of the alcohol is absorbed through the mucous membrane of your throat and esophagus, where it enters your bloodstream and compromises all parts of your body. 

“Alcohol is also inflammatory and increases your risk of cancer and other diseases,” he says.

Myth 9: Mixing energy drinks and alcohol is OK

You may think that mixing an energy drink with your cocktail will help combat alcohol’s drowsiness effects. But this isn’t a good idea.

For the same reasons why you shouldn’t mix alcohol with caffeine, this energy-drink combo can also cause masked intoxication — which can lead to consumption of more alcohol than your body can handle. It can also cause increased dehydration, sleep disruption and even heart issues.  

Myth 10: Drinking more alcohol can cure a hangover

Last but not least, the “hair of the dog” method is another alcohol myth that gets repeated one too many times. Essentially, this “trick” claims that you can kill your hangover with more alcohol. Of all the shady hangover cures out there, this one may be the most harmful.

This is because while it may feel like you’re taking the edge off your hangover and nausea by downing more drinks, doing this will only prolong your recovery process. All you’re doing is adding more toxins to your body that’s already working overtime to clean out the alcohol you’ve already consumed. 

The bottom line

Drinking responsibly doesn’t just come down to the amount you consume, but also how you consume it. You may hear a lot of tales around how to make drinking “easier” or “healthier,” but in reality, there aren’t any shortcuts or magic tricks out there. That’s why it’s best to consume alcohol safely and in moderation — without buying into any myths.

Ingredients

• 12-ounce bag of fresh cranberries
• 1/2 cup orange juice
• 1/2 cup water
• 3/4 cup brown sugar
• 1/4 teaspoon cinnamon
• Optional: 1/4 cup chopped walnuts or pecans

Directions

1. Combine orange juice, water and brown sugar in a medium pot on your stove. Bring to a boil over medium heat.
2. Add the bag of cranberries. Reduce heat to simmer and cook until the cranberries begin to pop and split open — about 10 to 15 minutes.
3. Remove from heat. Cool to room temperature. Stir in option nuts and then refrigerate until ready to serve.

Ingredient health benefits

• Cranberries: These little bog berries pack a powerful punch in flavor and nutrition. Among their many perks, cranberries are rich in antioxidants, which help reduce inflammation, as well as have certain compounds that promote a healthy gut.
• Cinnamon: You may be surprised to see a spice on this list, but cinnamon has some of its own benefits to bring to the table. It may help lower your cholesterol and blood sugar levels. And, like cranberries, its high antioxidant content also fights — you guessed it — inflammation!
• Orange juice: A popular breakfast beverage (and a delicious cranberry sauce recipe ingredient), orange juice is rich in vitamin B9, which is also called folate. Folate is a vital nutrient for supporting many aspects of your health, such as your brain and heart function.

Nutrition information (per serving)

Makes 8 servings

Calories: 130
Total fat: 2.5 mg
Saturated fat: 0 g
Cholesterol: 0 mg
Sodium: 5 mg
Carbohydrates: 28 g
Dietary fiber: 2 g
Sugar: 26 g
Protein: 1 g
Vitamin C: 15%

The question on your mind (after “How do I make it stop?”) is probably along the lines of “Should I be worried about a nosebleed?” 

Otolaryngologist Brandon Hopkins, MD, says most nosebleeds aren’t reason to worry, but there are times when it’s a good idea to seek help from a healthcare provider.

How do you know if a nosebleed is serious? 

It’s understandable to be worried when your nose starts bleeding. Blood coming out of your nose just seems unnatural at best and downright horror-movie-esque at worst.  

But be rest assured that most nosebleeds look more dramatic than they really are. 

“Think about if you put just a drop of blood in a toilet bowl — the whole bowl goes red,” Dr. Hopkins illustrates. “It doesn’t take a lot of blood to look like something extreme. We usually vastly overestimate the volume of blood that’s present.”

So, no, you’re probably not in danger of “bleeding out” (and if you were, there’d be no doubt that you’d need medical attention.) But still, your typical nosebleed may be an indication that something isn’t quite right. 

It may just be that your nose is irritated by things like allergies, dry air or your nose spray. But it could be something more.  

Dr. Hopkins lists three times when nosebleeds deserve medical attention: 

1. It’s long-lasting. 
2. You get frequent nosebleeds.  
3. You have a bleeding condition. 

Let’s take a closer look at worrisome nosebleeds and what may be happening. 

A nosebleed that won’t stop 

How long a nosebleed lasts is one of top considerations when determining whether it’s something to worry about. Nosebleeds that last longer than 20 minutes can be cause for concern. 

But what you do to attempt to curb the bleeding in those 20 minutes matters.  

Here’s how to know if your nosebleed is lasting too long. 

When your nose starts bleeding, your first order of business is to encourage a clot to form. That’s done by holding pressure on your nostrils. 

“If you’re holding enough pressure in the right spot, it won’t be able to bleed anymore,” Dr. Hopkins explains. “You want to compress the site of bleeding.” 

Dr. Hopkins suggests these steps to encourage the bleeding to stop. 

1. Stay calm and breathe through your mouth. 
2. Sit down and lean your body and your head just slightly forward. (Note, that’s slightly forward, don’t look down at your shoes or put your head in your lap.) 
3. Place a basin or damp washcloth on your lap to catch any dripping blood. 
4. Use your thumb and index finger to pinch together the soft part of your nose. (Not the bony part.) 
5. Keep pinching your nose for at least 10 minutes (watch the clock or set a timer).  
6. If it hasn’t stopped, repeat for another 10 minutes. 
7. If it’s still bleeding, it’s time to seek emergency medical care. 

Now, time can feel a little different when you’re worrying about the blood streaming from your nose, so use a timer. What may feel like an eternity might actually only be a few minutes.  

It’s important to avoid the temptation to release pressure before those 10 minutes are up. Because every time you peek to see if it’s stopped, you need to restart the clock.  

“It’s going to feel weird and uncomfortable to hold your nose for a full 10 minutes. It’s not an easy task,” Dr. Hopkins acknowledges. “But it takes eight to 10 minutes for fibrin proteins in your blood to start to form a clot to stop the bleeding. If you let go, it just washes out that developing clot and your body has to start all over again.” 

If after two rounds of holding your nose for 10 minutes, the blood is still flowing, it’s time to get prompt attention at an emergency room or urgent care.  

Once there, healthcare providers may treat your nosebleed by packing it with something like gauze or special nasal sponges. (Note that while some people might tell you to put something like tissues or tampons in your nose to absorb the blood, Dr. Hopkins advises against that. You’re more likely to irritate the lining of your nose and cause even more bleeding. Leave that to the pros.)

In some cases, providers may recommend cauterization to seal off the bleeding blood vessel. 

Nosebleeds that happen again and again 

Wondering how many nosebleeds is too many? It’s a judgement call, really — one that may vary from person to person. But if frequent nosebleeds are affecting your life, a visit to an otolaryngologist (a specialist in conditions of the ears, nose and throat) is in order.  

“For example, if your child is having nosebleeds twice a week and has to leave their classroom for a half hour to address them, they’re missing out on school time. That’s a reasonable cause to get checked out,” Dr. Hopkins says. “Or if you’re waking up in the middle of the night with bloody sheets for some time, that’s going to be enough for some people to say that’s past the threshold of what’s acceptable for them.” 

Potential causes of frequent nosebleeds 

Recurring nosebleeds in kids could be from something like your child could be picking their nose (gross by true). That’s particularly common in cold weather when their nose is more likely to feel dry. 

Kids and adults with frequent nosebleeds may be from nothing more than dry air irritating their nose. In those cases, you might benefit from some simple changes to moisturize your nasal passages, like a saline spray or a lubricating nasal cream.   

If those measures don’t do the trick, talk with a healthcare provider. They may look for things like a deviated septum or less-common causes for frequent nosebleeds, like nasal tumors, bleeding disorders or a condition called hereditary hemorrhagic telangiectasia, a genetic disorder that affects blood vessel formation. Frequent nosebleeds in adolescent males may, rarely, be associated with a benign tumor called juvenile nasopharyngeal angiofibroma.  

Nosebleeds when you have a bleeding disorder 

For people with certain conditions, your threshold for seeing a provider should be lower than most. That includes people who’ve been diagnosed with a bleeding disorder (also called a bleeding diathesis), like hemophilia or Von Willebrand disease. Or if you have a bloody nose and take blood-thinning medication.  

“If you have a bleeding condition or if you take blood-thinners or aspirin regularly, it’s harder to stop bleeding once it starts,” Dr. Hopkins explains. “Working with an otolaryngologist can help you figure out appropriate mitigation strategies for you, like steps to keep your nose very moisturized to try to prevent them and then having a plan and action plan for when nosebleeds happen.” 

Most nosebleeds clear up on their own with a few minutes of pinching (without peeking). But if the bleeding doesn’t clear up or nosebleeds are impacting your life, a trip to a provider can make a big difference.

Dermatologist Melissa Piliang, MD, breaks down why your hands might get dry, what happens when you wash them and what you can do to keep your hands soft and healthy. 

Why do my hands get dry after washing them?

If you feel your hands getting irritated after washing, you’re not alone. Dry hands after washing can be a common issue, and it’s usually caused by the removal of natural oils and moisture from your skin during the washing process.

Here are some factors that contribute to dry hands after washing:

1. Soap: Most soaps and hand washes are designed to remove dirt, bacteria and oils from your skin. While this is important for cleanliness, it can also strip your skin of its natural oils, leaving it dry and less supple. Certain soaps or hand washes are harsher than others. For example, some contain harsh chemicals like sodium lauryl sulfate that can be particularly drying to your skin. 
2. Water temperature: Using very hot water can be hard on your skin. Hot water can cause your skin to lose moisture more rapidly, leading to dryness. This is because the lipid barrier — also known as the moisture barrier and located on the outermost layer of your skin — melts away under hot water. (This doesn’t happen with cold and lukewarm water.)
3. Overwashing: Is it true that you can wash your hands too much? Frequent handwashing, especially if done without moisturizing afterward, can lead to dryness. Healthcare workers and people in certain professions, for example, may be more prone to this issue. 
4. Skin conditions: Your hands may also be more prone to drying out due to a skin condition like psoriasis or eczema. If you have a history of skin conditions, take note if you’re experiencing flare ups after washing your hands with certain soaps or at hotter temperatures. You should also consider using specially prescribed lotions or extra gentle remedies after handwashing to avoid making your condition worse. 

Is hand sanitizer less harsh on your hands?

You may have heard that opting for hand sanitizer may be a less irritating way to keep your hands clean. But that’s not exactly the case. While using hand sanitizer doesn’t involve hot water or soap, it’s not a proper swap-out for handwashing. Plus, hand sanitizer can also cause irritation on your skin. 

To minimize the potential drawbacks of hand sanitizer and protect your skin:

• Moisturize your hands after hand sanitizer has dried.
• Limit the use of hand sanitizer to situations where soap and water aren’t available.
• Wash your hands with soap and water when they’re visibly dirty.

Treating and preventing dry hands from washing

If you struggle with dry skin, it can be frustrating every time you go to the sink to wash your hands. But there are ways to avoid irritated skin and find relief from dryness. 

Remember: Washing your hands consistently and thoroughly protects you against germs and bacteria, so here are a couple ways to make it less of a hassle: 

1. Avoid hot water

You don’t have to switch to completely cold water, but scalding hot water during a handwash isn’t doing you any favors either. Try to turn down the temperature while washing your hands and even showering to avoid your hands feeling dry or irritated. “Hot water can wash away healthy skin oils,” Dr Piliang reiterates. 

Remember to do this when you’re doing other hygiene-related chores like washing the dishes. Lukewarm as opposed to hot water can be just the difference your skin needs to avoid dryness. 

2. Opt for a moisturizing soap

Certain soaps have a moisturizing agent in them that can be gentler on your skin and prevent dryness. “Your best bet is to use a moisturizing soap and rinse well afterwards,” Dr. Piliang advises. 

When shopping around for gentle soap, try looking for moisturizing ingredients like: 

• Shea butter.
• Jojoba.
• Ceramides.
• Hyaluronic acid.

3. Moisturize after washing

Using a moisturizer after washing is one of the best ways to keep your hands feeling smooth and nourished. “After washing, apply a lotion to help seal in the moisture,” Dr. Piliang recommends. Opt for a lotion or hand cream that’s fragrance-free to avoid any further irritation on your skin. 

4. Use a balm treatment

If you’re prone to very dry skin, you can skip the lotion and go straight to a good, thick moisturizer. You want to look for a cream, balm or ointment — something that’s thick and a little bit hard to spread that will provide more moisture to your skin.

5. Gently dry your hands

You can also avoid dry hands after washing by the way you dry them. Your first instinct after washing is probably to dry your hands until not even a drop of water is left. But it’s actually better to leave your hands a bit damp after drying. If you can get away with air drying your hands sometimes, even better!  Also, don’t rub, just dab, so you’re not irritating your skin.

6. Consider using gloves for cleaning

Finally, make sure you’re avoiding any unnecessary interactions with your hands. “Especially if you have really dry hands, it’s wise to consider wearing gloves when you do dishes or cleaning,” suggests Dr. Piliang. 

“Also, running a humidifier in the bedroom at night can help moisten the air and your skin while you sleep,” she adds. This way, you’re keeping your hands healthy throughout the day, so that hopefully, they’re less sensitive to handwashing. 

The bottom line

Washing your hands is an important way to stay healthy. Consistent handwashing can help kill bacteria and prevent spreadable diseases. But if you’re frustrated with your hands getting dry after each wash, try turning down the temperature, swapping out your soap and consistently reaching for a good moisturizer.

If you feel like you’re experiencing extreme dryness after handwashing that’s leading to cracking or pain, be sure to talk to a dermatologist or healthcare provider.

But could that hot brew on an empty stomach be bad for your health? Probably not, says registered dietitian Anthony DiMarino, RD, LD.

“Your digestive system is incredibly complex and efficient,” he says. “Most people don’t have any problem drinking coffee on an empty stomach.”

What are the health risks of drinking coffee on an empty stomach?

Social media platforms like TikTok have contributed to the spread of questionable health trends and misinformation. Among them is the idea that drinking coffee on an empty stomach is bad for you.

DiMarino debunks two common myths and shares why it’s OK to enjoy that cuppa without any food.

Myth #1: Coffee gives you bad reflux and heartburn

Gastroesophageal reflux disease (GERD) happens when a valve between your stomach and esophagus (food pipe) doesn’t close properly. When this happens, the contents of your stomach — including food, drinks and stomach acid — flow back into your esophagus. You may experience a burning sensation in your chest known as heartburn.

Research into whether coffee causes reflux or worsens symptoms isn’t definitive. One study that examined coffee’s effects on the digestive system found that factors like obesity and other chronic health conditions cause reflux — not the beverage itself. But a different study found increased reflux symptoms after participants drank caffeinated coffee, tea or soda.

“Coffee and caffeine can increase the production of stomach acid,” DiMarino shares. “Coffee also relaxes the valve, allowing excess acid to enter your esophagus.” Both reactions can cause more severe and frequent reflux symptoms.

If you’re prone to reflux or heartburn but don’t want to give up your morning coffee fix, DiMarino recommends adding a low-fat or nonfat dairy creamer or milk alternative to your brew.

“Fat in milk sometimes aggravates reflux symptoms,” he says. “But low-fat dairy can act as a buffer between stomach acid and your stomach lining, which helps prevent heartburn.”

Myth #2: Coffee gives you ulcers

Ulcers are sores that form in your stomach or small intestine. They cause burning stomach pain, bloating and heartburn. While you might have heard that stress and diet (including coffee) cause peptic ulcer disease, research shows that’s not true.

The main cause of ulcers is Helicobacter pylori (H. pylori) infections, bacteria that eat away at your stomach’s protective lining and allow stomach acid to damage the tissue. The other top cause of ulcers is overusing nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and aspirin.

But coffee doesn’t appear to play a role. One study examined coffee consumption and ulcer formation in more than 8,000 people living in Japan. The study found no significant link, even among people who drank three or more cups each day.

Important to note, again, though: Although coffee may not cause stomach ulcers, it can increase how much stomach acid you make. If you already have an ulcer, higher amounts of stomach acid can make your symptoms worse.

Are there side effects to drinking coffee on an empty stomach?

Having coffee before you’ve eaten may not be bad for your health. But it could lead to a few unwanted side effects.

Increased jitters or anxiety

Your body absorbs coffee (and, therefore, caffeine) faster when there’s nothing else in your belly. This rapid absorption can intensify caffeine’s effects, making you feel anxious, jittery or irritable.

Caffeine can also raise blood pressure and cause your heart to feel like it’s beating too fast or skipping beats (heart palpitations). You may start experiencing these side effects within 10 minutes of having your first cup, although it typically takes up to an hour for caffeine’s full effects to kick in.

If you find yourself experiencing these effects after your morning cup, the fix is simple: Eat something along with your brew.

“Having food in your stomach slows the absorption of caffeine into your bloodstream,” DiMarino says.

He also recommends not adding sugar to your morning cup.

“Sugar causes a spike in blood sugar,” he says. The combination of sugar and caffeine can give you a quick burst of energy, followed by a crash that leaves you more tired than before. You might find yourself in a cycle of reaching for yet another cup of coffee with more sugar.

A quick trip to the bathroom

As many as 1 in 3 coffee drinkers report an urge to poop after enjoying a hot brew. This need to go number two can happen anywhere from four to 30 minutes after you set down your cup.

Research suggests that it’s the acids in coffee that make you poop. These acids stimulate hormone production — specifically, gastrin and cholecystokinin, which cause involuntary muscle contractions in your digestive system. That gets your bowels moving.

It’s not clear whether drinking coffee on an empty stomach will wake up your bowels faster. But findings suggest that caffeinated coffee is as effective as food, and 23% more effective than decaf coffee, at creating a laxative-type effect.

When should you drink coffee?

There really isn’t a “best time” to drink coffee, DiMarino says: “Everyone reacts to caffeine and coffee differently, so listen to your body.”

Some people have no issues drinking coffee on an empty stomach. But if you’re not one of them, DiMarino suggests making sure your breakfast has at least one of these:

• Fiber in whole-grain toast, cereal or steel-cut oatmeal absorbs the coffee in your stomach and helps neutralize stomach acids.
• Healthy fats, like those in avocados, nuts and nut butters, can reduce inflammation in your digestive tract brought on by increased stomach acid.
• Protein-rich foods, including eggs, yogurt and cottage cheese, can slow digestion and caffeine absorption.

The 75 Hard Challenge, for example, puts a lot of pressure on overhauling different areas of your life by demanding that you follow these five strict rules daily for 75 days straight without stopping:

• Stick to a nutrition plan of your choice while avoiding alcohol and cheat meals.
• Exercise for 45 minutes twice a day, including one workout routine outside.
• Drink 1 gallon of water.
• Read 10 pages of a nonfiction, personal development-focused book.
• Take a progress picture.

What makes following this list increasingly difficult is that if you miss just one activity or don’t follow these rules 100% of the time, you have to start over and try to maintain these rules for another 75 days.

“If you’re already in a high-level fitness area of your life, the 75 Hard Challenge likely aligns very much with some of the things you’re already doing,” says health and sports/performance psychologist Matthew Sacco, PhD.

“But for many people, especially beginners who are trying to start new healthy habits, if you have to start over anytime you take a break or don’t follow the rules, it’s going to be very difficult to find the motivation to keep going.”

Rather than rely on such a rigid routine, Dr. Sacco suggests participating in the watered-down version known as 75 Soft instead. Here, he covers how the rules are different from 75 Hard, and what benefits you’ll find when you start taking on this routine one day at a time.

75 Soft Challenge rules

75 Soft takes the same concepts from 75 Hard but makes them more accessible and less rigid. The emphasis in 75 Soft is to make sure you’re attempting to do your best to follow these rules every day:

1. Eat well in general and avoid alcohol except for social occasions.
2. Exercise once for 45 minutes each day, with one day of active recovery each week.
3. Drink 3 liters of water daily.
4. Read 10 pages of any book each day.

If you miss one of these steps, take a break or try out an alternative approach — you’re not penalized and you don’t have to start the 75 days over again. Instead, you’re trusted to hold yourself accountable and focus more on the small things you’re doing to improve yourself and build a healthier life.

“When you’re trying to make improvements, it’s better and more helpful if you try to tackle one small thing at a time until you start to feel comfortable and get better over time,” notes Dr. Sacco. “The goal is not to push yourself so hard that you think of failing. The goal is to help yourself feel confident enough to keep going. And it feels really good when you accomplish a goal.”

1. Eat well and only drink on social occasions

If you’re not beholden to any one specific nutritional plan, what does “eating well” mean?

For starters, it comes down to being intentional about what you’re eating, how much you’re eating and how often you’re eating. And you can start by setting some goals, creating a food journal and figuring out what you want to get out of a nutritional plan.

“You want to create goals that are action-oriented or attainable, and you always want to apply the dead person rule: If a dead person can do it, it’s not a good goal,” says Dr. Sacco.

“For example, if you say, ‘I’m just not going to eat chips anymore,’ one way you can make that goal smarter is by asking yourself what are you going to do instead,” he continues. “If you’re just going to pull something out of your life, you’re going to leave a hole, and you still need to eat and be satisfied.”

A smarter goal, then, might be to replace potato chips with unsalted popcorn or nuts.

By creating goals for yourself, and then relying on a nutritional plan that fits within your goals, you’ll likely start to see small improvements in your overall health.

In general, healthcare providers recommend the Mediterranean diet as an entry point for anyone looking to eat healthier.

“There are 50,000 or more diets out there and all sorts of things you can try, but the easiest nutritional plan I always come back to is the Mediterranean diet because it’s the best thing for your heart health and it’s flexible,” says Dr. Sacco.

2. Work out 45 minutes per day, with one day of active recovery each week

The hardest part of working out is finding the motivation to get moving. The second hardest part of working out is sticking with it for the long term.

In general and at minimum, we should try to do 30 minutes of moderate-intensity aerobic exercises every day, five days a week. Although that minimum requirement offers less activity than 75 Soft suggests you should do, it does account for the need of rest by building in one day of active recovery.

Designed to stimulate the recovery process and increase blood flow to your muscles, active recovery is a crucial component of fitness. Instead of sitting down or avoiding exercises completely on your off days, you can do low-intensity exercises like stretching, swimming, walking and even yoga to keep your muscles active and your body prepped for more intense exercises on other days.

“The idea is just to try not to have high-intensity stuff on that day,” says Dr. Sacco. “You want to do something where you’re continuing to move in a healthy, sustainable way.”

3. Drink 3 liters of water daily

Much more achievable than drinking 1 gallon a day, this is an example of 75 Soft taking the concept of drinking water and making it smart. In general, the daily recommendation for water is 2.7 liters for women and 3.7 liters for men — and those amounts fluctuate based on factors like your activity level, metabolism and body type.

By drinking 3 liters of water a day, the intention is set on making sure the act of drinking water alone is incorporated into your daily life. In some way, it also gives you the freedom to replace some of the things you’re drinking (and some of the things you might be addicted to drinking) with water instead in order to achieve this goal.

“Staying hydrated is very important and it will likely reduce some of the cravings you have for other drinks over time,” notes Dr. Sacco.

4. Read 10 pages of any book daily

One of these rules is not like the other, but it still fits into the goal of improving your overall health by giving you the freedom to be intellectually or creatively stimulated. And as we know our mental health and moods have a direct impact on our physical health, taking any time to ground ourselves and read something we enjoy can be beneficial, if only to help us slow down just a little.

“Reading, in general, is incredibly intellectually stimulating,” encourages Dr. Sacco. “It gets your brain going. It slows us down and keeps our minds from racing. And it activates different parts of your brain and your imagination.”

75 Hard vs. 75 Soft

75 Soft is, for many people, much safer, more manageable and perhaps more helpful in the long-term. If and when you get to the end of your 75 days and you want to continue on the program, or start something else, you can! Or you can even level up and give 75 Hard a try, too, as long as you pace yourself and give yourself the grace you deserve when you inevitably have an off-day.

“When you’re starting a fitness routine or going through lifestyle changes, there will be some things that happen that you can’t account for that will get in the way — a flat tire, a sick day, a last-minute emergency,” acknowledges Dr. Sacco. “To have some flexibility, give ourselves some grace and the ability to be human can really be helpful.”

Other things to consider when starting 75 Soft (or any other fitness and lifestyle routine) is to do your homework. Talking to your healthcare provider, making an appointment with a physical therapist or exercise physiologist or even checking in with a personal trainer at your local gym can help shed some perspective on the smallest steps you can take to starting your new routine on the right foot.

“Extreme programs can have extreme results, but they can also have extreme consequences if you’re not prepared,” cautions Dr. Sacco. “By seeking advice from medically trained experts, you can get an idea of what activities and exercises can help you based on your unique experiences and personal health issues.”

“Cheat days,” as they’re commonly called, are a subject of considerable debate among dietitians, especially when it comes to eating to support weight loss. Some people say they can have a positive impact on your metabolism. Others say that needing a cheat day is probably a sign that your current eating plan — and possibly your relationship with food — needs rethinking.

We talked to registered dietitian Anna Taylor, RD, LD, about the arguments for and against cheat days. And she explains why, after reviewing the evidence, she’s concluded that “rewarding” yourself with a cheat day after sticking to your weight loss plan all week will backfire on you.

The argument for cheat days

While Taylor isn’t a fan of cheat days, there are some arguments that advocates make in their favor.

The most common reason people support cheat days is psychological. Some find that the prospect of indulging helps them stay disciplined the rest of the time — and there’s some research to suggest that “planned hedonic deviations” really can help us stay on track.

The best eating plan is the one that (1) you can stick to and (2) that doesn’t rob you of the joy of eating. For some people, cheat days do just that.

Setting motivation aside, there’s also a scientific case for cheat days — it just isn’t an especially rigorous one. Some researchers theorize that the occasional cheat day improves your metabolic rate.

The basic idea is that occasionally deviating from an eating plan helps temporarily raise your body’s levels of leptin. Leptin is a hormone that tells you when you’re full. When you’re on a restrictive diet, leptin levels go down to encourage you to eat. In theory, cheat days help override that survival mechanism and prevent you from feeling really hungry while dieting. 

There are some studies that suggest this theory’s valid … sort of. The thing is, most of studies that people point to as supporting the use of cheat days aren’t really studying cheat days at all. In some cases they’re focused on refeed days for athletes or intermittent energy balancing protocols — neither of which are really “cheat days.” In the case of the intermittent energy balancing study, the participants ate meals that were planned and prepared by a dietitian at all times. That’s hardly “cheating.”

The argument against cheat days

Taylor is of the opinion that any short-term benefits you might get from a cheat day are outweighed by the harm they cause.

There are two main reasons she — and plenty of other experts — advise against cheat days.

1. It’s easy to go overboard.
2. The idea of “cheat days” promotes an unhealthy attitude toward food.

Let’s start with the impact cheat days have on weight loss. While your metabolism may go up in the immediate aftermath of a splurge, it doesn’t stay that way for long enough to make a significant difference.

“Cheat day calories can add up fast and bring your weight loss progress to a screeching halt — or even reverse it,” Taylor warns. “What’s the point of working hard all week to create a calorie deficit, just to undo it completely with a calorie splurge on the weekend?”

To make matters worse, a quick tour of social media will tell you that a lot of people aren’t exactly clear on what a “cheat day” is supposed to be. They actually make a whole day of it, consuming thousands upon thousands of calories worth of fast food, sweets, sugary drinks or other calorie-dense foods.  

That’s not really cheating. It’s overeating. In some cases, its binge eating. And it can open the door — if it’s not already open — to a wide range of disordered eating behaviors.

A 2022 article in the Journal of Eating Disorders found that, among adolescents, eating cheat meals “is linked to greater eating disorder behaviors and psychopathology, including binge-eating episodes.“

The physical benefits of cheat days are questionable at best. And they clearly come with their own risks. But setting those issues aside, they also reinforce some outdated ways of thinking about food and weight loss.

“Having a cheat day implies that a healthy diet is all-or-nothing — that you’re either ‘off the plan’ or ‘on the plan,’” Taylor explains. “Nothing could be further from the truth.”

If sustainable weight loss is your goal, Taylor emphasizes that labeling certain foods “good” and others “bad” isn’t the way to go. It adds moral baggage to every decision you make about food and encourages a black-or-white, extreme approach to dieting. Unless it makes you physically ill, no food needs to be off limits all the time. A deprivation mindset doesn’t do you any good.

A balanced diet is the way to go

In a world without cheat days, every day is an opportunity to enjoy what you eat.

“A healthy diet is a balanced one,” Taylor encourages. “My mantra is 80/20 or 90/10.” She explains that if you want to stay healthy, healthful foods should make up about 80% of your total calories. If you want to better your health, they should make up about 90% of your total calories.

The remaining 20% or 10% represents wiggle room. Not everything you eat has to enhance your health, but you need to be mindful of portion size when enjoying those foods.

Instead of a cheat day, Taylor recommends spreading the extra calories throughout the week.

“Otherwise, you’ll start associating cheat days with ‘treating yourself’ or ‘being bad,’” she further explains. “Using food as a ‘tool’ at either extreme won’t sustain long-term weight loss.”

Other things to keep in mind

If you’re trying to decide whether or not to incorporate cheat days into your weight loss plan, there are a few things you need to remember:

• Your metabolic mileage may vary. There are a wide range of factors that influence your metabolism, including sex, medical conditions, hormones and the amount of exercise you get. While you and your dietitian can make an educated guess, it’s impossible to know for sure how your body is going to respond to a cheat meal. Any metabolic increase is unlikely to outweigh the excess calories consumed with a carte blanche all-you-can-eat buffet.
• Not all eating plans are cheat-friendly. Whether or not a cheat meal or cheat day is a good idea for you has a lot to do with the kind of eating plan you’re on and why you’re on it. If you’re on a ketogenic diet, for example, a cheat day could kick you out of ketosis, derailing your weight loss efforts for several days until you’re able to get back into ketosis.
• Mindful eating is a must. Whether you’re following a restrictive diet or just trying to stay healthy, incorporating a mindful approach to food and eating is key. If you do choose to incorporate cheat days, it’s even more important.
• Talk to your provider. It’s always best to speak to a healthcare provider before embarking on a diet of any kind — whether it’s for weight loss or to optimize your health. They can help you tailor an eating plan to fit your needs. The value of cheat days should be part of that discussion.

Whether you’re a “yes” or a “no” on cheat days, it’s important to remember that you have a right to enjoy and have a healthy relationship with food. Any eating plan that leaves you feeling hungry and deprived isn’t going to be sustainable in the long term, so if that’s where you’re finding yourself, talk to your healthcare provider. They’ll help you figure out what about your approach needs adjusting.

If the best part of waking up is all that caffeine in your cup, it may be time to scale back.

Caffeine is considered a stimulant. The white bitter substance, which is found naturally in more than 60 plants, passes into your bloodstream from your stomach and small intestine. Once in your bloodstream, caffeine stimulates your central nervous system — your nerves, brain and spinal cord — to make you feel more awake and alert.

If you’re wondering how to quit caffeine (or tried in the past), you know you may experience a headache. That’s because your body is used to having caffeine every day.

The key is to cut down slowly on the amount of caffeine in your diet. Don’t make the mistake of stopping totally abruptly. By doing so, you’ll likely experience withdrawal symptoms like headache, nausea, tiredness, muscle pain, irritability and difficulty concentrating.

And you may be tempted to go back to drinking coffee or soda or may think about taking a headache medication with caffeine in it to make your symptoms disappear. And if you do that, the dependency cycle all over again. Avoiding the withdrawal symptoms is one of the most common reasons why people continue their caffeine habit.

Registered dietitian Beth Czerwony, RD, LD, talks about safely scaling back your caffeine consumption and how to do so without getting a headache or other caffeine withdrawal symptoms.

Effects of caffeine on your body

We tend to turn to caffeine to keep us awake and help us concentrate. It can increase your energy and decrease your fatigue.

And although caffeine is generally considered safe, consuming as little as 300 milligrams per day can increase your risk of negative side effects, including:

• Nausea.
• Anxiety.
• Sleeplessness.
• Restlessness.

The more caffeine you consume, the more likely you are to experience negative side effects, including neurologic and cardiac issues and even death.

And even people who are drinking safe amounts of caffeine may be doing so for unhealthy reasons.

“Any time you’re trying to manage stress with a substance, that’s something to pause and think about,” states Czerwony.

Do I have a caffeine dependence?

The U.S. Food and Drug Administration (FDA) says healthy adults should have no more than 400 milligrams of caffeine per day, which amounts to four or five cups of coffee. But the American Medical Association Council on Scientific Affairs recommends no more than 250 milligrams (or about three cups of coffee) per day.

“If you’re doing a cup of coffee every morning, it’s not that big of a deal,” notes Czerwony. “But if you’re doing espressos every day throughout the day, that’s more of a problem.”

If you’re pregnant, you’ll want to be even more careful with your caffeine. The American Pregnancy Organization recommends you limit your caffeine intake to 200 milligrams a day (including food with caffeine). And children and adolescents should stay away from caffeine and other stimulants entirely.

So, how long is caffeine in your system? The effects of caffeine can be felt as soon as 15 minutes after it’s consumed. The level of caffeine in your blood peaks about one hour later and stays at this level for several hours for most people. Six hours after caffeine is consumed, half of it is still in your body. It can take up to 10 hours to completely clear caffeine from your bloodstream.

Is coffee addictive?

Your body can have a dependence on caffeine, but it’s not technically an addiction. It raises dopamine, but the level is small. Illegal stimulants like methamphetamine (“meth”) and MDMA (“ecstasy” or “molly”) cause a huge surge that messes with the reward circuits in your brain. You get “addicted” to ecstasy and “dependent” on caffeine.

How to quit caffeine without a headache

Caffeine withdrawal is exactly what it sounds like — withdrawal from a substance.

“Your body is literally going through withdrawal symptoms, as if you were coming off of any other substance,” Czerwony explains. “Because it affects the central nervous system, you’re going to get shaky, irritable and headachey.”

To avoid these undesirable side effects, including the agonizing headaches associated with withdrawal, go slowly and don’t expect to give up your caffeine habit overnight.

In fact, quitting caffeine cold turkey can actually further your reliance on it.

Caffeine is a vasodilator, which can help relieve headache pain, making it an ingredient in many over-the-counter pain relievers. So, taking a caffeine-laden painkiller for your caffeine withdrawal headache will help your pain but will only continue your caffeine dependence.

“You’re not really helping yourself — you’re just feeding your dependency in a different way,” clarifies Czerwony. “Instead, you want to start weaning yourself down.”

If you’re taking a prescription medication that includes caffeine, speak with your healthcare provider about the possibility of alternatives — but know that they may not be an option. If not, you’ll have to reduce your caffeine intake in other ways.

If you’re trying to quit your caffeine habit and want to avoid that dreaded headache, here’s where you can start.

Do a caffeine audit

Before you make moves to quit, assess your current caffeine intake: How much are you actually having each day? Figure out how much caffeine is in the beverages you drink, then think about where you can cut back.

“So many people tell me they can’t sleep at night if they drink coffee after 2 p.m.,” relates Czerwony. “So, this step is really about assessing how caffeine is affecting and interfering with your everyday activities.”

Although caffeine amounts depend on what you’re drinking — and not just what kind of drink but what brand — these estimates can guide you in your assessment:

• Mug of filtered coffee: 140 milligrams.
• Mug of instant coffee: 100 milligrams.
• Canned energy drink: 80 milligrams.
• Mug of black tea: 75 milligrams.
• Can of soda: 40 milligrams.
• Mug of decaffeinated coffee: 12 milligrams.
• Mug of hot chocolate: 9 milligrams.

But it’s not only about what you’re drinking. Caffeine also lurks in foods such as chocolate and coffee-flavored ice cream, as well as in many pre-workout powders, protein drinks, water flavor enhancers and even medications.

“It’s very important that you read the labels and be observant of what those labels are telling you,” Czerwony advises.

Drink more water

Another key to beating caffeine withdrawal symptoms is water, water, water. And staying hydrated will energize your body, which may negate the need for caffeine in the first place.

“People often drink caffeine because they can’t seem to stay awake, but dehydration is often the reason they don’t have energy to begin with,” Czerwony explains. “If you can get hydrated, you’re going to perk up and not need that caffeine as much.”

Set a time limit

Set a time by which you stop your caffeine intake each day. Medical professionals recommend 2 p.m., so as not to interfere with your sleep.

“Setting a time limit is helpful to allow adequate time for the caffeine level to decrease and allow your body to relax and allow you to get to sleep,” says Czerwony.

Substitute for a lower caffeine drink

Start with small changes. If you usually drink dark roast coffee, switch to a light roast, to start. If you usually drink black tea, try green or white tea instead.

According to Czerwony, “By decreasing lower caffeine drinks, you will be able to curb your caffeine intake by slowly weaning and allowing your body to get used to the lower levels over time without having the side effects previously mentioned,”

Lean on decaf

If you typically drink espressos, which have more caffeine than other caffeinated drinks, start by cutting it with half or even a quarter of decaf coffee. Then, every few days, cut it down further, slowly reducing your intake over time.

Studies have found that dark-roast coffee beans tend to contain slightly less caffeine than light roast coffee beans. “However, that’s mostly due to the volume of the beans. When the two roasts are compared by weight, the difference is negligible,” clarifies Czerwony.

Try other swaps

If you delve deeper into your own psychology to identify your consumption habits, you may find that the caffeine itself isn’t as important to you as the feeling of consuming it.

Consider how you can maintain your caffeine routines in caffeine-free ways:

• If you love sitting down in the morning with a warm, cozy cup of coffee, try replacing it with a warm, cozy mug of tea.
• If you crave the fizzy carbonation of a soda, see if a bubbly, sugar-free seltzer does the trick instead.
• If you want to join in the fun of getting Instagram-worthy drinks from the coffee shop with friends, go for brightly colored but unsweetened teas, such as dragon fruit and passionfruit.

“It’s important to look for caffeine-free options if you’re trying to decrease overall caffeine intake to allow yourself to stay hydrated and decrease the amount of stimulants you’re adding to your body,” encourages Czerwony.

Bottom line?

As with any substance, caffeine can be tough to quit — but maybe not as tough as you may think.

“If you’re trying to hit the reset button on your health,” Czerwony says, “cutting down on the caffeine while increasing water take is one of the simplest and most beneficial things you can do for yourself.”

Internal medicine physician Rafael Fernandez Bohorquez, MD, explains what causes cold sores and what to do when you feel one coming on.

Why do I get cold sores?

Cold sores are the result of a herpes simplex virus (HSV) infection, the same virus that causes genital herpes. HSV spreads from person to person through kissing or sharing items like drinks, utensils, towels and lip balm. There’s no cure for HSV, so once you catch the virus, it stays in your body forever.

But having an HSV infection doesn’t mean you always get cold sores. “HSV can remain in a latent, or resting, state in your body for months or years,” Dr. Fernandez Bohorquez explains. “You get a cold sore when something triggers the virus to become active.”

Common cold sore triggers

Cold sores can be triggered by many different things that put stress on your body, such as:

• The common cold, the flu and other illnesses.
• Damaged or cracked skin from eczema or sunburn.
• Extreme hot or cold weather.
• Hormonal changes, like the ones experienced as part of the menstrual cycle or pregnancy.
• Injury to your lips, including cosmetic treatments and lip fillers.
• Lack of sleep.
• Stress (both emotional and physical).

Cold sores aren’t usually a serious health problem, but they’re uncomfortable and downright annoying. Knowing your triggers can sometimes help you sidestep an outbreak.

“We can’t always avoid cold sore triggers,” says Dr. Fernandez Bohorquez. “But if you learn your triggers, you can counteract them or start treating a cold sore early so it goes away faster.”

For example, if you get cold sores after cold or wind exposure, wear a scarf or face covering to help prevent a flare-up. If sunburn is a trigger, be diligent about sunscreen. Wear a wide-brimmed hat and use lip balm with SPF. (Bonus: you’ll also help prevent skin cancer!)

Stress management techniques can help you feel better emotionally, which could ward off at least a few cold sores.

“Exercise can reduce stress, as well as getting enough sleep and eating a healthy diet,” says Dr. Fernandez Bohorquez. “These healthy habits also boost your immune system so it can fight cold sore outbreaks.”

Should I avoid certain foods when I have a cold sore?

Along with understanding your triggers, it’d be great if eating certain foods could put a stop to cold sores for good. Unfortunately, there isn’t solid evidence to suggest that’s the case. Still, making some healthy diet tweaks couldn’t hurt if you’re desperate to eliminate that cold sore.

“Many foods contain the amino acid L-arginine, which helps the herpes virus multiply,” explains Dr. Fernandez Bohorquez. “Some research suggests that avoiding high-arginine foods could prevent cold sores or clear them up faster.”

Most foods that contain protein also contain some L-arginine, from meats to whole grains. That makes L-arginine pretty tricky to avoid completely. The better solution may be to find foods that contain higher amounts of another amino acid, L-lysine.

Foods that could help fight cold sores

“Some research shows that L-lysine lowers the number of cold sore outbreaks for some people,” adds Dr. Fernandez Bohorquez. “We don’t have any large, controlled studies proving it can help, but it’s worth trying if you get frequent cold sores.”

So, when you feel that first tingle of a cold sore or know you were exposed to a trigger, try focusing on foods with more lysine, including:

• Cheese, especially Parmesan.
• Chicken.
• Eggs.
• Quinoa.
• Shrimp.
• Tofu.
• Tuna.

Likewise, avoid foods high in arginine and low in lysine, such as:

• Chocolate.
• Rice.
• Wheat and wheat products, like bread and pasta.

And if you’re thinking about lysine supplements, ask your provider first. “Supplements may not be safe for people who take medications or have certain health conditions,” says Dr. Fernandez Bohorquez. “We also don’t have large studies to prove that they help. If you get repeated cold sore outbreaks, your provider can help you find a safe and effective treatment.”

How to heal a cold sore fast

Cold compresses and numbing creams can make you feel better, but they won’t get rid of a cold sore any sooner. Antivirals are the only proven solution for getting a cold sore to go away ASAP.

“Over-the-counter antiviral creams can treat cold sores and help them clear up faster,” says Dr. Fernandez Bohorquez. “Start using the cream at the first sign of a sore. The sooner you start applying it, the more effective it will be.”

If you get frequent outbreaks, a preventive oral antiviral medication could be your BFF.

“Your provider can prescribe an oral antiviral medication if you get repeated cold sores,” Dr. Fernandez Bohorquez says. “These medications can stop cold sores from surfacing. In most cases, you try the medication for up to a year and then see your provider again to discuss how well it’s working.”

Knowledge (and regular healthcare) is power

Don’t assume you have to live with cold sores. Knowing your triggers and seeing your healthcare provider can help you handle outbreaks better.

“Antivirals can make a big difference for people who get cold sores regularly,” states Dr. Fernandez Bohorquez. “Your provider can help you find the best way to prevent outbreaks so they don’t interfere with your life.”

If you’re not sure what that means, there’s a good chance you’ve managed to keep your head above water as hallyu, “The Korean Wave,” has broken across the English-speaking world. Kpop, Kdramas, “Hallyuwood” and Kbeauty are increasingly ubiquitous — and it’s sending enrollment in Korean language classes through the roof across the U.S.

For dermatologist Alok Vij, MD, the arrival of Korean skin care is particularly welcome. We asked him to explain what distinguishes Korean skin care from its Western counterparts, what makes it so great and how to integrate Korean skin care products into your daily routine.   

What is the philosophy of Korean skin care?

People of a certain age remember a time when taking care of your skin wasn’t just a chore: It was often downright painful. Toners stung, abrasive exfoliants left our skin red and absolutely everything had an unavoidably strong scent. We knew our skin was “clean” when it was tight and dry. We avoided oils at all costs and — our greatest skin care sin of all — we turned to tanning beds for a not-so-healthy glow. It was a one-size-fits-all approach that didn’t work for the vast majority of us.

Today, Dr. Vij explains that Korean skin care products are helping us undo what he describes as the “years and years of damage” we’ve done to our skin. And as we undo that damage, we’re beginning to learn that taking care of our skin can be relaxing, luxurious and even fun. And the end result feels as good as it looks. Korean skin care is all about restoring (and respecting) your skin — not punishing it.

“These are elegant lotions and potions that feel good and rewarding to use,” he notes. “So, it builds a positive cycle of reinforcement.”

That’s not the only reason Korean skin care products and approaches are so popular. Here are a few others:

Designed for diverse skin types

“There’s been an overall trend toward inclusive skin care and inclusive beauty,” Dr. Vij says, “and Korean skin care offers a lot of solutions to common problems in a way that we hadn’t thought of before.”

U.S. beauty products are often marketed toward people with fair skin — and the skin care issues that come along with it.

“Dermatologists know that people with fair skin often have a certain subset of complaints, and people with darker skin tend to have slightly different concerns,” Dr. Vij says. There are plenty of exceptions to every skin care rule, but dermatologists more frequently treat people with pale skin for conditions like redness, rosacea and aging, while people with skin of color are more focused on issues like hyperpigmentation and uneven complexion.

“The beauty of Korean skin care is that it really hits the sweet spot, where it has active ingredients that work for everything,” Dr. Vij shares. “The products offer anti-aging benefits, but they’re also hydrating and promote an even skin tone.”

Korean skin care products are addressing needs that the U.S. skin care market hasn’t. And it definitely doesn’t hurt that Kbeauty brands tend to be much more affordable than their U.S., British and French counterparts.

A sunscreen standout

Korean skin care has popularized a lot of different ingredients (like ginseng and snail mucin) and preparations (like ampoules, serums and essences) that are new to Western audiences. They’re also putting new, innovative spins on old skin care standards — especially sunscreen. And U.S. skin care companies quite literally can’t compete.

“The FDA is notoriously slow when it comes to approving sunscreens,” Dr. Vij states. “In the U.S., we’re still living on products that have were approved 20 to 30 years ago. And we haven’t made a lot of progress in new approvals.”

While Asian countries are producing unscented, sting-free SPF++++ (yup, that’s a thing) sunscreens, U.S. manufacturers are stuck with the same old chemical sunscreens. And the longer they’re around, the more concerns they’re raising.

“There’s more and more data that these chemical sunscreens get absorbed into your bloodstream — and they stick around in your body for a long time,” Dr. Vij says. “And we don’t know if there are any real deleterious health effects that go along with it. Meanwhile, there are sunscreens in other countries that are much, much more effective for sun protection, potentially safer to use and are even better for the environment.”

Different ingredients

One of the things that makes South Korean skin care products so enticing is the way regulations and competition within the industry impact their formulation. The products:

• Are frequently (if not always) vegan and cruelty-free.
• Tend to have little to no fragrance added.
• Encourage gentler alternatives to active ingredients like acids and retinols.
• Use natural ingredients (like Centella Asiatica) that aren’t as common in Western products.

10-step Korean skin care routine

If you’re familiar with Korean skin care, you’ve probably heard of the “10-step” routine. It usually looks something like this:

1. Oil-based cleanser.
2. Water-based cleanser.
3. Exfoliant (one or two times a week).
4. Toner.
5. Essence.
6. Face oil, serum, or ampoule that targets your primary skin concern.
7. Sheet mask (not every day).
8. Eye cream.
9. Moisturizer.
10. Sunscreen.

Ten steps are a lot. A lot of time, a lot of money and a lot of new products to put on your face. That’s why Dr. Vij doesn’t recommend a 10-step routine to his patients.

“If you give someone a 10-step routine, they’re probably going to do two or three of those steps reliably,” he concedes. “And if you start adding a bunch of different products to your routine at once, you won’t know what’s effective or harmful.”

The concept of the 10-step routine is brilliant from a marketing standpoint, but Dr. Vij prefers to focus less on steps and products and more on principles:

• Be gentle. Gone are the days of harsh astringents, rough exfoliants and skin-peelingly intense retinols. Dr. Vij explains that a good Korean skin care routine focuses on water-based products, doesn’t strip away too much of the natural oil on your face and doesn’t overburden your skin with lots of different active ingredients.
• Hydrate with every step. “Pretty much every step of a Korean skin care routine is going to have some component of hydration,” he notes. If a product leaves your face feeling tight or dry, it’s not the right choice for you.
• Always finish with sunscreen. For better and for worse, pale skin is prized in many Asian cultures. As a result of those beauty standards, sun protection is indispensable to a Kbeauty routine. As Dr. Vij is quick to point out, all skin colors are beautiful in their own right. And we don’t have to buy into colorism to believe that we all deserve top-notch sun protection.

If you’re looking for a Korean skin care routine that’s cheaper and involves fewer steps, Dr. Vij suggests following this basic plan:

If you have the interest, time and money for a 10-step skin care regimen, Dr. Vij recommends integrating products very slowly. Not only will this reduce the hit to your wallet, but it will also make it easier to see what products are proving worthwhile and — if you develop an allergy — what products your skin can and can’t tolerate.

“Anyone who has a history of sensitive or delicate skin needs to be careful about using new products — especially if it has a fragrance or preservatives in it,” he cautions. “The Korean skin care industry may have better technology than we have, but you can still have an allergic reaction or intolerance. That’s why slowly increasing the number of products you use and the steps in your skin care routine is always a great idea.”

Who should try a Korean skin care routine?

The sheer size of the Korean skin care industry means that there’s probably a product (or 20) out there that will work wonders for your skin. But with all the innovative ingredients and preparations available, you need to be comfortable that your skin can handle the trial and error.

“Acne, rosacea, eczema — those are common skin conditions where you really need to pick and choose what you use carefully,” Dr. Vij advises. But because Korean skin care tends to be fairly gentle, he finds that people with these conditions usually do OK with these products. Still, hypersensitive skin can be hard to calm down once it flares up, so it’s important to patch test products on your inner arm before putting them on your face.

Focus on the philosophy

There are many reasons to be excited about Korean skin care. But getting into it takes time — learning about the brands, about the different ingredients and preparations available, testing products … it can be overwhelming. And it’s OK if that isn’t your priority. There’s more than one way to do right by your skin.

“Some people have this stereotypical view of Korean skin care leading to endless beauty,” Dr. Vij muses. But that’s not reality — it’s just great marketing.

At the end of the day, he says what makes Korean skin care special is its foundational principles: It’s all about keeping your skin hydrated, happy and protected from the sun — and starting as early as possible.

“That’s the key,” he says, “and you can do those things with any good skin care routine.”

Maybe it’s actually a fructan intolerance.

Fructans are a type of carbohydrate, or sugar, that some people have a hard time digesting. But the symptoms of fructan intolerance often mimic those of gluten intolerance, and to make things even more complicated, some foods have both gluten and fructans — so it can be extra difficult to figure out what’s going on in your stomach and which foods you’re reacting negatively to.

Registered dietitian Beth Czerwony, RD, LD, explains what fructans are, where they’re found and what to do if you think you have a fructan intolerance.

What’s a fructan intolerance?

Fructans are a type of oligosaccharides, which are part of a class of small-chain carbohydrates or sugars known as FODMAPs. That acronym stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols” — but the much simpler FODMAPs will do just fine.

Not sure what, exactly, that means? Czerwony helps simplify: “There are naturally forming sugars in certain foods, and they all have their own unique sugar content and makeup.”

Importantly, FODMAPs are found across a wide spectrum of foods, and our bodies can’t digest them very well. But some people react worse to them than others do, experiencing symptoms like:

• Bloating.
• Diarrhea.
• Gas.
• Stomach pain and discomfort.

Foods high in fructans

OK, buckle up: A lot of foods have fructans in them. They can be broken down into two categories: Foods that have gluten in them and foods that don’t. In the typical American diet, the two biggest sources of fructans are wheat (which has gluten) and onions (which don’t). But there are lots of others that fall into these categories, too.

In the “has gluten” column are any typical bread products, including bread itself, along with pastries, pizza dough and so on. High-fructan foods that have gluten in them include:

• Wheat.
• Barley.
• Rye.
• Spelt.

On the other hand are high-fructan foods that don’t have gluten in them. That list is pretty long:

• Fruits: Bananas, dates, grapefruit, nectarines, persimmons, plums, pomegranate, watermelon and yacon.
• Legumes: Black beans, chickpeas, kidney beans, lima beans, mung beans, navy beans, split peas.
• Vegetables: Artichoke, asparagus, beets, Brussels sprouts, chicory root, fennel, garlic, leeks, onions, savoy cabbage, shallots and snow peas.
• Nuts: Almonds, cashews and pistachios.

“A lot of these foods are ones that we default to because they’re healthy options,” Czerwony notes. “Depending on how your body reacts to them, you may have to figure out what your personal limit is.”

Should you avoid eating fructans?

Foods that contain fructans are part of a healthy, balanced diet, so if you don’t have a fructan intolerance, there’s no reason to avoid them.

But what if you don’t yet know?

If you’re prone to gas, bloating and overall stomach issues without any clear cause, start paying attention to how certain foods make you feel.

“Keep a food log where you track what you eat and what’s going on in your body afterward,” Czerwony suggests. “You may start to see when your symptoms occur, which will help you figure out if you should be eliminating certain foods from your diet.”

What to do if you think you have a fructan intolerance 

So, you suspect that you have a fructan intolerance. Now what? The only way to nail down a fructan intolerance is to go through a very specific elimination diet known as the low-FODMAP diet.

“You actually have to go through the list of each type of FODMAP and start eliminating foods that include them,” Czerwony explains. “If you find that you’re particularly sensitive to something, you’ll begin to slowly add certain foods back in to see like what your tolerance is — or if you can’t tolerate them at all.”

Because that’s the other thing: You can be levels of fructan intolerant. You could discover that you’re able to eat a little bit of some foods that contain fructans but that a super-oniony meal is too much for you to handle. Or maybe it all upsets your stomach. But you can’t know for sure until you’ve done the low-FODMAP diet.

“There may be foods that you end up totally eliminating from your diet, or you may find that you have some threshold of tolerance,” Czerwony notes.

Ask for help with the low-FODMAP diet

Working your way through any elimination diet can be a fairly involved process, and the low-FODMAP diet is especially in-depth. You want to make sure you’re doing it properly and that you’re still getting enough nutrients, especially as you remove so many foods from your diet.

Working with a dietitian will help you navigate it much more easily. They can also make the whole process a little bit less grueling by helping you figure out what you can eat — which is just an important as knowing what to stay away from.

“There are definitely foods that we’ll tell you to avoid, but we can also tell you what to replace them with so that you don’t feel like you can’t eat anything,” Czerwony reassures. “A dietitian is able to give you appropriate recommendations and alternatives based on your food preferences, too so that you’re still getting a well-balanced intake.”

We often rely on mantras like these as a form of motivation. When faced with difficult challenges, we hold on to these ideologies in an effort to push ourselves beyond our current limitations. The goal? To strive for improvement and feel confident in our strengths as we push beyond our comfort zones.

When it comes to physical fitness and our overall well-being, affirmations like these can help when we’re attempting to tackle a new workout routine or a brand-new diet plan or even trying to do small everyday things.

But do we ever run the risk of pushing ourselves too far? And how do we know we’re actually doing enough? Should we, perhaps, in an effort to take better care of ourselves, know when to rest instead of charging forward?

A viral trend known as the 75 Hard Challenge has turned many of these questions on their heads by inspiring people to take part in a strict 75-day lifestyle program. For 75 days, participants must complete five critical daily tasks that double down on exercising twice a day, sticking to a rigid nutrition plan and strengthening your mental fortitude — all without rest, cheat days or substitutions. If even one task is overlooked or left partially completed, the clock restarts, and you’re forced to begin the 75-day program all over again starting with Day One.

Can a rigid program like this be healthy? Or could it actually cause more harm in the long run? Health and sports/performance psychologist Matthew Sacco, PhD, shares why the 75 Hard Challenge raises far more concerns than rewards for most people and how certain aspects of the program can actually be put to good use regardless of the state of your physical, mental and emotional health.

What is 75 Hard?

The 75 Hard Challenge was started in 2019 by Andy Frisella, podcaster, entrepreneur and CEO of the supplement company 1st Phorm. One part-fitness program, one-part-nutritional plan, the 75 Hard Challenge centers around the idea of “mental toughness”: That you have to push past your comfort zone and challenge yourself to the extreme in the effort to make long-term lasting improvement on your mind, body and overall outlook on life.

“This is another one of those fad lifestyle plans,” states Dr. Sacco. “On the surface, it’s very much about your willpower and your ability to push yourself and stick to something very rigidly.”

For anyone who has a tough time sticking to new routines and lifestyle changes (like eating healthier or exercising five days a week), change can be difficult. But the 75 Hard mentality has one overarching golden rule designed to get you to avoid cheat meals and quitting on your goals: You must participate and complete every aspect of the five-rule challenge every single day for 75 days; if you fail to deliver, you start all over, and attempt another shot at completing each daily task for another 75 days.

Although Frisella and 75 Hard fanatics swear by their own personal experiences that the program is life-changing, much of its promise is anecdotal. There’s little-to-no scientific evidence the program itself is beneficial, says Dr. Sacco, even when individual parts of the program stem from healthy ideas about forming healthy habits.

“To my knowledge, there’s no science behind it and no research behind it because it’s really kind of anecdotal,” he says. “These very rigid rules become problematic because they boil down this idea that any single person should simply be able to make these choices day-in and day-out without understanding the more interconnected parts to it.”

What are the rules?

The 75 Hard Challenge is designed to push you to improve in the areas of physical fitness, emotional resilience and mental insight — all within the context that you should press on when faced with indecision, pain or discomfort.

“It speaks to this idea that we’re supposed to be able to suck it up, pull ourselves up by our bootstraps and move on,” explains Dr. Sacco. “But that’s not a good long-term philosophy, especially if you have chronic, ongoing medical issues.”

The program’s five critical tasks, or core values, are meant to be completed daily for 75 days. And each of the following areas have varying benefits and risks associated with them:

1. Follow a nutrition plan of your choice — no alcohol or cheat meals

On the 75 Hard Challenge, you can start any diet or nutritional plan, but you’re expected to stick to that plan firmly for 75 days. That means, you can try any healthy or trendy diet or eating style, including:

• Mediterranean diet: A well-rounded, heart healthy diet recommended by many healthcare providers focused on plant-based foods and healthy fats (think lean meats like chicken and fish).
• Keto: A high-fat and low-carb diet designed to improve metabolism and muscle mass.
• Vegan: A diet that avoids anything that comes from animals (think meats, eggs, dairy and meat-based broths) and focuses solely on plant-based proteins, fruits and vegetables.
• Flexitarian: A mix of vegan and vegetarian diets but with the added flexibility of semi-occasional meats and animal products.
• Paleo: The Stone Age diet that focuses on fruits, vegetables, lean meats, fish, nuts, eggs and seeds while giving up grains, legumes, dairy, refined sugars, added salt and high-processed foods.
• Pegan: A dietary mix of paleo and vegan, with 75% of your diet focused on plants and 25% focused on meats, eggs and fish.
• DASH: A nutritional plan that helps lower the risk of high blood pressure by consuming higher amounts of potassium and less sodium.
• The Whole30 diet: An elimination diet that gives up dairy, grains and legumes but focuses on fresh fruits and vegetables, eggs and lean proteins, some fats and nuts.

Whichever plan you choose, you have to stick to it. There’s no room for error and it’s frowned upon to just one day decide you’re going to eat outside of the nutritional box you’ve put yourself in. That means you can’t have a cheat meal along the way or have any alcohol — not for nutritional reasons, but in the effort to drill down on discipline.

If you break away from your nutritional plan of choice, you have to start over. And that can be hard for anyone trying a diet for the first time or anyone with certain dietary restrictions.

“This can be very challenging for people because in our society, food is a very emotional thing, and sometimes, it’s hard to make abrupt changes and make sure you have everything you need and know how to pull it all together even once you’ve settled on a plan,” recognizes Dr. Sacco.

Still, focusing on nutritional value is a huge piece of the weight management and overall healthy pie. Dr. Sacco recommends talking to a healthcare provider before starting any diet plan to make sure it’s right for you. In most cases, the Mediterranean diet may be the best option because of its broad-based approach to nutrition and its accessibility.

“There are a lot of rules to the Mediterranean diet, but there is some softness to that, too, in that you’re open to having green, leafy vegetables, lean meats and other things,” he adds.

2. Two 45-minute workouts — one MUST be outside

In general, it’s good to participate in moderate-intensity aerobic exercises 30 minutes a day, five days a week. Doing so will likely increase your blood flow, improve your metabolism and provide substantial benefit to your heart and other areas of your body. Such physical activity can also help improve or prevent conditions like:

• Type 2 diabetes.
• Heart disease.
• Depression.

Sounds simple enough, and like a pretty important thing to do, right? Not to mention, you have a lot of choices when it comes to exercise, including:

• Cardiovascular exercises.
• Swimming.
• Cycling.
• Running.
• Yoga.
• Pilates.
• Strength training.
• High-intensity interval training (HIIT).

Now, imagine working out twice a day, every day, without a day of rest — and imagine ramping up from doing no exercises each week to doing them twice a day, every day, for 75 days in a row.

For those of us who are unfamiliar with exercising at such high frequency, or for those of us who have other disabilities and conditions that impact our level of mobility and flexibility, the 75 Hard Challenge can feel like an impossible task.

And even those who do workout on a regular basis still run a higher risk of injury if they over-exert parts of their body and/or never take a day to rest and recharge.

“Psychologically, it does reinforce your commitment to physical health when you exercise twice a day,” says Dr. Sacco. “But the mentality of pushing through, and that exercise is supposed to be hard and it’s supposed to hurt further increases that risk for somebody to push beyond just being sore and risk injuring themselves.”

Plus, if you’re new to physical fitness and you’re not sure what to do, or you’re just getting back into it after taking a long break from exercise, you’re more likely to over-extend your abilities, putting you at further risk for injury.

3. Drink 1 gallon of water

This one is pretty clear: We could always drink more water in an effort to hydrate our bodies. It’s also a good substitute if you’re trying to cut back on soda and other sugary concoctions. In general, the daily recommendation for water is 2.7 liters for women and 3.7 liters for men — and those amounts fluctuate based on factors like your activity level, metabolism and body type.

A gallon feels like a lot of water to have in one day, but if you’re actually spending a lot of time working out, your body might need it.

“There’s a behavioral component to consider when drinking that much water because for some people, you have to work to refocus your attention,” notes Dr. Sacco.

“It’s such a significant amount of water, you would have to be continually drinking water all day. So there is some benefit in that you’re more likely to replace some of those other drinks you’d be having if you weren’t drinking a gallon of water a day.”

4. Read 10 pages of a nonfiction, personal development-focused book

So, how does reading fit into this 75-day challenge? Well, we know that there’s a significant connection between our mental and physical health. Taking time out for self-care, and thinking of self-improvement from a mental standpoint, can all benefit your overall health.

While this challenge chooses to focus specifically on nonfiction and personal development reading, Dr. Sacco suggests that taking time out to read anything for any amount of time daily can help you slow down and keep you grounded — especially when you’re trying to do a bunch of new things all at once.

“Reading, in general, is incredibly intellectually stimulating,” he adds. “It gets your brain going. It slows us down and keeps our minds from racing. And it activates different parts of your brain and your imagination.

“Sometimes, you need something to keep you grounded when you’ve got so much else going on or some of these other new challenges you’re trying to tackle.”

5. Take a progress picture

Healthcare providers advise avoiding weighing yourself every day because numbers tend to fluctuate — and your progress on your journey to physical fitness is more than just counting numbers. Sometimes, it takes weeks or months to see real results, but even then, the goal should always be to improve in some small way every day.

The 75 Hard Challenge tackles this daily measurement of success by asking you to capture a progress photo every day. By doing this, in theory, you’re giving yourself the opportunity to zero in on your physical changes over time.

But like the scale, hyperfocusing on your body image has its own set of risks that include:

• Increased low self-esteem.
• Body dysmorphic disorder.
• Eating disorders.

“If you’re focusing on self-improvement and you’re noticing these changes, that visual cueing and feedback can be really reinforcing and rewarding,” acknowledges Dr. Sacco. “But these kinds of changes take far more than just simple willpower, and if you feel like you’re not getting enough of the results that you set out to achieve, it can affect you physically, mentally and emotionally.”

Does 75 Hard work and is it healthy?

It remains to be seen whether or not a program like this is safe and accessible for everyone. In fact, some of Dr. Sacco’s largest concerns are focused on whether the outcomes of completing the 75-day program override the potential health risks along the way, particularly for those who struggle with physical fitness and healthy nutrition.

“In order to make something like this work effectively, it would probably take a little bit more knowledge in terms of how to do two separate 45-minute workouts a day without compromising results or putting yourself in harm’s way,” he says.

“Something like this requires smart goal setting: Your goals have to be measurable, attainable, realistic and time-limited. And sometimes, that looks like walking around the block three times a week for two weeks, and then scaling that up when you’re comfortable, instead of pushing to run two miles every day without rest.”

Healthy alternatives, healthy goals

In general, if you’re interested in starting a lifestyle/fitness program like 75 Hard, it’s important that you weigh the risks and advantages and how they relate to your individual level of physical health and mental health. From there, you should try to check off your improvement list one small task at a time.

“There is sometimes this temptation to tackle everything and sometimes, that can feel like too much,” says Dr. Sacco. “For most people, making little changes and figuring out how you can get it to work in your life will help make lifestyle changes that can last for a long time.”

If you have trouble getting up early and feeling motivated to start the day, try to get up 30 minutes earlier than you normally would, for example, and then increase that by 30-minutes every week until you feel better about your start time.

If you want to cut back on sodas, maybe drink one a day instead of three. And if you’re trying to start a workout routine, maybe try to exercise once a week, then twice a week and so on.

And if there’s a day or a week you don’t meet your goals, it’s OK. Try again when you’re ready, or try a different approach. The key is to never push yourself so far that you feel uncomfortable, in pain or like you’re not doing enough.

“When we’re able to accommodate these changes in our life and make it a part of what we’re regularly doing, it comes a lot easier over time,” notes Dr. Sacco. “I think there’s a lot more to take out of the individual parts of the 75 Hard Challenge than keeping to its overall rigidity because there are some benefits to drinking water, pushing yourself with some exercise and trying to do better every day.”

If these are all things you care about, there are safer and healthier alternatives to 75 Hard, including a separate program Frisella created in 2021 called 75 Soft. Designed to be more flexible, 75 Soft inspires its participants to:

• Eat well in general.
• Exercise for 45 minutes each day, with one day of active recovery.
• Drink 3 liters of water daily instead of a gallon.
• Read 10 pages of any book each day.

Something like 75 Soft is perhaps more in line with general health guidelines and offers a much safer way to achieve your goals. But more importantly, it’s always better to be intentional about your choices. Give yourself some grace and flexibility to fail. Instead of taking an all-or-nothing approach to self-improvement, allowing yourself some wiggle room can positively impact your growth. And that’s true, whether you’re starting a new lifestyle program or focusing on one area of improvement at a time.

“None of us are perfect, and the idea of being perfect, even for something like 75 days, is very difficult,” says Dr. Sacco.

“Sticking with a strict approach to making changes for some people might work. But what actually builds resilience is having the ability to bounce back when something happens. That’s going to be more sustainable in the long haul.”

This erratic and irregular heartbeat is called atrial fibrillation, or AFib. It’s a common and frightening symptom affecting up to 55% of patients after cardiac surgery, according to some estimates.

So, is there a way to reduce your risk of developing AFib and the complications that can come with it? Let’s look at options with cardiothoracic surgeon Edward Soltesz, MD.

Why does AFib often follow heart surgery?

It’s believed that inflammation in the chest following heart surgery contributes to AFib within a week after the procedure, says Dr. Soltesz. But the exact trigger for AFib remains unclear.

AFib is basically a malfunction of your heart’s electrical system, which powers the steady contractions that pump blood through your body. Most people’s heart rates are between 60 and 100 beats per minute. But AFib brings a series of rapid, chaotic pulses that upset your heart’s rhythm and drive it higher or lower. When this happens, your heart doesn’t contract effectively — which means blood isn’t squeezed out properly.

Some cases of AFib can be mild enough to go unnoticed. More severe cases of AFib, however, can lead to fatigue, chest pains (angina) and what’s described as a “feeling of butterflies” in your chest.

How to lower your risk of AFib

“Prevent” may be too strong a word regarding your ability to ward off the development of AFib, but here are four steps you can take ahead of heart surgery to reduce your risk, according to Dr. Soltesz:

1. Focus on diet and exercise. A healthier heart going into surgery decreases your chance of experiencing AFib afterward. Work with your healthcare provider to create a “heart-healthy” eating and exercise plan to get you ready for the rigors ahead.
2. Address other health issues. Your risk of AFib increases if you go into surgery with anemia (low iron levels in the blood), an electrolyte imbalance or high blood sugar. Your doctor may perform tests before the procedure to check for these issues, which often can be addressed through a changed diet or by taking medication or vitamins.
3. Stop smoking and limit alcohol. Need another reason to stop smoking if you’re currently lighting up? Consider this: Smoking increases your risk of AFib by 32%, according to researchers. Quitting can improve your odds. Excessive alcohol intake also can increase the risk of AFib.
4. Limit stress. The relationship between stress and AFib is still being explored, but there appears to be a connection. Managing stress and anxiety can minimize your cardiovascular risk.

Is AFib treatable?

If you get AFib, various treatments and medications are available to help get your heart back into its proper rhythm.

Regaining control is important. Untreated AFib can increase your risk of blood clots and stroke. (Fast fact: AFib causes about 1 in 7 strokes, according to the U.S. Centers for Disease Control and Prevention.)

Over time, AFib can weaken your heart and open the door to heart failure.

“AFib can occur sporadically or persistently — and if it happens once, it’s more likely to happen again,” states Dr. Soltesz. “Talk to your physician before and after surgery about your potential risks and what you can do to decrease them.”

Ingredients

• 2 cans water-packed tuna, drained
• 1/2 cup panko (Japanese breadcrumbs)
• 1/4 cup carrots, diced
• 1/4 cup celery, diced
• 1/4 cup 2% (low-fat) cheddar cheese, shredded
• 3 tablespoons nonfat or light mayonnaise
• 2 tablespoons mustard (preferably Dijon)
• 3 tablespoons dried Italian seasoning

Directions

1. Combine all ingredients in a bowl.
2. Mix until all ingredients are evenly distributed.
3. Form 4 patties. Place them in a nonstick pan or a pan lightly
4. coated with cooking spray. Cook on medium heat until patties are slightly browned on both sides.
5. Place patty in a whole-wheat English muffin or serve by itself.
6. Garnish with tomato, spinach and onion, if desired.

Ingredient health benefits

• Tuna: While its strong flavor may be divisive, the wealth of vitamins found in this saltwater fish is something we can all get behind. Tuna is one of the richest food sources of vitamin B6, which supports brain and heart health, and vitamin B12, which (among other things) helps your body make DNA and happy, healthy red blood cells.
• Carrots: There’s more to these beloved taproots than meets the eye. Carotenoids, pigments that give many vegetables their delectable colors, are an important nutrient found in carrots — especially beta-carotene, which helps fight inflammation, preserve your vision and is chock full of antioxidants.
• Celery: This stalky vegetable is packed with vitamin C and vitamin K, which can help heal wounds and build strong bones. It also has folate, or vitamin B9, which wears a lot of hats when it comes to maintaining your health, from improving your thinking and memory to supporting a healthy pregnancy.
• Cheese: Dairy often gets a bad rap on the health foods scene, but things aren’t as black-and-white as they seem. Eating cheese is a good way to get some omega-3s and may help reduce your blood pressure, protect your teeth from cavities and keep your gut health in check.

Nutrition information (per serving)

Makes 4 servings

Calories: 171
Protein: 21 g
Carbohydrate: 6 g
Dietary fiber: 0 g
Sugar: 1 g
Total fat: 6 g
Saturated fat: 1 g
Cholesterol: 30 mg
Sodium: 304 mg
Potassium: 209 mg
Calcium: 62 mg
Iron: 1 mg

“Cancer is scary, and it’s scary to talk about bad things, especially when there are so many unknowns about it,” recognizes child psychologist Kate Eshleman, PsyD. “As an adult, you don’t always know what you’re dealing with, which can make it more difficult to speak to children about it.” 

Dr. Eshleman shares some strategies that can help you explain this tough topic — and keep the lines of communication open.  

Plan the first conversation 

First, it’s important to give yourself some time between learning the news yourself and sharing it with your kids. Allow yourself to process the news and get a handle on it before talking to your children.  

Other things to consider: 

• Seek moral and emotional support. Ask your spouse, partner or another trusted family member to be part of the first conversation. 
• Get on the same page as your partner, if you have one. Make sure you both agree about how much you’ll reveal in this first conversation. Go over the topics you’ll cover, like how treatment will affect you physically and how it may change what you’ll be able to do day-to-day. 
• Take your time. You might feel tempted to get the initial conversation out of the way quickly, but be sure to leave ample time for it — and for your kids’ questions. Don’t break the news right before rushing to another commitment or bedtime.  

How to break the news of your diagnosis 

There’s no definitively correct way to tell your children that you have cancer, but try to trust yourself. You know your kids best and what they can handle, so let your instincts be your main guide. 

So, where should you begin?

“In general, it’s always important to give information truthfully and in a developmentally appropriate way,” Dr. Eshleman says.  

1. Ask kids what they know about cancer. This will give you a baseline of their knowledge level and any misconceptions.  
2. Be honest. Kids can often tell when adults are lying or withholding, which can make their fears worse.
3. Give age-appropriate explanations. Use straightforward language that your kids can understand.
4. Consider your child’s personality. Tailor the discussion to their temperament and conversational style. 
5. Talk about expectations. Tell kids what may happen, like that Mommy will lose her hair or that they’ll start going to an afterschool program. 
6. Answer their questions. Give kids a chance to ask questions. If they ask something you’re not sure about, it’s OK to say that you don’t know — and that you’ll find out. 
7. Show that you’re coping. When you demonstrate your own coping skills, you reassure kids that they can cope, too. 
8. Share your own emotions. Don’t feel like you have to hide your own fear or sadness. This helps model healthy emotional regulation skills for kids. 

Dr. Eshleman delves deeper into each of these tips for talking to your kids about cancer.  

Ask them what they know

This might seem like an unexpected first step, but before you break the news about your cancer, ask kids what they know about cancer, in general — even if you expect them not to know anything about it. 

“As adults, a lot of times, we under-assume what children are aware of,” Dr. Eshleman says, “but kids often know more than we expect.” 

She suggests asking them what they know about cancer, which can help provide a starting point for the conversation and clues you in to any understanding and misconceptions they may have.  

Be honest

When you’re talking to your kids about anything, but especially something as weighty as a cancer diagnosis, one of your main goals should be to maintain their trust.  

“In order to do that, you have to be able to tell them the truth,” Dr. Eshleman states. “Kids are smarter and pick up on more than we sometimes assume.” 

No matter their age, kids can sense when something’s wrong and when you’re not telling them the truth, which can make their fears worse. So, when you tell your children that you have cancer, it’s important to be honest and direct — even when you wish you could shield them from the truth.

Give age-appropriate explanations

Children of different ages react differently to the news of a cancer diagnosis. And being honest with them doesn’t necessarily mean giving them every single painful detail.

“When you’re communicating with your kids, it’s important to be mindful of the language you use,” Dr. Eshleman encourages.  

• Keep your explanations simple, short and honest. “You want to give them the information they need to know in a way that they can understand, depending on their age and functioning,” she says.
• Use accurate words. Start incorporating words like “chemotherapy” and “surgery” into your kids’ understanding. 
• Don’t be afraid to use the word “cancer.” “We tend to describe illness as ‘being sick,’ but then kids worry that they could get sick, too,” Dr. Eshleman notes. “I encourage naming the illness, whether that’s a specific term like leukemia or osteosarcoma or more broadly just cancer. Then, provide reassurance that the child cannot catch it.” 

Consider your child’s personality

Age isn’t the only important factor in how you have this important discussion. Their temperament and general personality play a role, too.

“Some kids will want a lot of information, while other kids will be very uncomfortable and just need to know the basics,” Dr. Eshleman says. “Think about who your child is and how they typically cope best, then use that information to frame your conversation.” 

Different kids, of course, have very different personalities — and very different coping skills. You may need to have separate conversations with your kids, each targeted to individual needs and levels of understanding. 

Talk about expectations

As you share the news, begin to discuss the changes to come.  

“Start telling them what they can expect and what plans are in place for coping with that,” Dr. Eshleman advises. “Explain, for example, that Mommy is going to lose her hair, then problem-solve around that: She will start wearing a wig, or We’re going to go buy some new hats.”   

Talk, too, about some of the ways your cancer may impact their life. Kids thrive on routine, and nothing upends everyday routines like cancer can.

“It’s possible that each and every aspect of a child’s day-to-day life could shift,” Dr. Eshleman says. “Explain that there will be appointments that might affect them — that sometimes, Grandma will pick them up from school instead of Daddy, or that they might spend the night with their cousins more often.” 

Answer their questions, if you can

Not all kids will have questions, at least not right away. But depending on your child’s personality and coping style, they may want to know more about your illness and what comes next.  

“By answering their questions, you make them feel safe and comfortable to continue asking questions,” Dr. Eshleman explains. “This helps maintain open lines of communication.” 

Common questions include: 

• “Can I catch it?” Kids may need assurance that your illness isn’t contagious, as other illnesses are.
• “Did I cause it?” Young children may blur the boundary between imagination and reality, leading them to believe they’re somehow responsible for a loved one’s illness. Reassure them that nothing they did played a part. 
• “Who will take care of me?” Kids want to know that they’ll be safe. When one of their primary caregivers is sick, they may worry that no one will be available to care for them. “Provide reassurance that there are a lot of people here to help as your family goes through this process,” Dr. Eshleman suggests.  

If your child asks questions that you don’t have the answer to, it’s OK to say so.  

“You don’t have to have all the answers at the start of the conversation,” Dr. Eshleman says. “You can say that you’ll talk to your doctor and find out for both of you.” 

Show that you’re coping

Guide the conversation as much as you can. When you present the news in a calm, reassuring voice, you show your children that you’re coping — which helps them do the same.  

“What impacts you is going to impact your child,” Dr. Eshleman says. Try to be mindful of your own reactions to this new diagnosis and the stress it’s putting on you. You’re there to inform and support your children, so you want to do your best to stay in control. 

Share your own emotions

Staying in control doesn’t mean that you have to suppress all of your feelings. Dr. Eshleman encourages you to be yourself — and that may mean showing your emotions.  

“Show expressions of emotion and modeling how to cope with those emotions gives children permission and space to do the same,” she continues. “It tells them it’s OK to be angry, sad or worried, and it opens up conversations about how to deal with that.” 

Sharing your own feelings can reinforce that you’re all in this together. Plus, Dr. Eshleman says that trying to hide your emotions will only make you feel — and appear — more stressed, which can make the conversation more difficult. 

How to help your child cope

You’ve had the initial conversation. Now what? Dr. Eshleman shares additional tips about how to be there for your child afterward and in an ongoing way. 

Keep communicating about it

Kids might have a hard time processing or understanding the news the first time they hear it. They may also need to ask the same questions over and over again.  

“Think of your first conversation as one in a series,” Dr. Eshleman recommends. “Learning together as you go creates continued space for discussion.  

On the other hand, don’t force conversations that your child doesn’t seem to want to have. 

“It’s important to remember that each person, children and adults included, copes differently,” she adds. “Some people benefit from talking, but not everyone wants that. Look for other opportunities to promote that act of coping that don’t involve conversation.” 

Explain any changes in their routine

During your first conversation with your child, you set expectations about possible changes in their routine. But when their routines are actually about to change, be sure to discuss the details so kids know what to expect in real-time.

Explicitly explain, for example, “Starting next week, you’re going to take the bus home after school,” or “You and your sister are going to go to the neighbors’ house for a playdate tomorrow so your dad and I can go to his doctor’s appointment.”  

Try to maintain kids’ routines as much as possible, but also help your child develop flexibility and coping skills by communicating on an ongoing basis. 

Involve your child in the process

Kids don’t know what’s happening when you’re at appointments or in the hospital. All they know is that you’re not there to pick them up from school or tuck them into bed. 

“Helping them understand what’s going on during these periods of time can make it feel less mysterious to them,” Dr. Eshleman says.  

With your provider’s permission, she suggests considering sharing photos of clinic visits or doing a video chat from the waiting room. It may also be appropriate for your child to visit you in the hospital or be involved in other aspects of your treatment.  

“This helps them to better understand what’s going on when you’re not home,” Dr. Eshleman says.  

Provide opportunities for play

Just like adults, children need breaks from stress and other painful emotions. Play can be a wonderful opportunity for this type of pause. 

It can also be a chance to better understand how they’re coping. Many children express and work through their feelings while playing, which means that oftentimes, their play can reveal their fears or misconceptions about what’s going on. 

It’s important for caregivers to watch and listen for issues or feelings that appear during play so you can help address them. 

Seek support from others

Your family doesn’t have to go through this experience alone. Other adults who play important roles in your children’s lives can also help them cope.   

“Oftentimes, parents feel like this is a private issue that the family needs to address independently,” Dr. Eshleman understands, “but there are a lot of people who can help support your child through this experience.” 

She recommends communicating with teachers and other school personnel, like coaches or tutors. “When they know what’s going on, they can keep an eye on how your child is coping and continue to support them.” 

Consider sharing the news with the parents of your child’s friends, too. They may be willing to add your child to their afterschool pickup route, squeeze in an extra playdate or host an occasional sleepover to help give you time to manage your illness and treatment.  

You don’t have to be perfect

“There’s no handbook for how to communicate with your kids in this type of unknown situation,” Dr. Eshleman stresses, “so try to reduce the pressure to do it perfectly.” 

You’re going through something big and scary. It’s understandable that you don’t know exactly how to talk to your kids about it. But give yourself — and them — some credit.  

“Children tend to be very resilient, especially if we can support their coping along the way,” she encourages. “They may do much better with it than you think.” 

The medication, officially known as sildenafil, debuted in 1998. Today, it’s used by millions of people around the world when they want to … well, rise to the occasion during an amorous moment.

Yet myth-based questions continue to follow the little blue pill around. Can Viagra give you a never-ending erection? Is it dangerous? Will it turn you into a Casanova?

Let’s set the record straight with the help of urologist Drogo Montague, MD.

Myth #1: Viagra causes hours-long erections

Odds are you’ve seen a Viagra commercial and heard this warning: Seek immediate medical help for an erection lasting four or more hours.

It’s an attention-grabbing piece of cautionary advice. But the situation that it addresses — a condition known as priapism — is a relatively uncommon side effect of the medication, says Dr. Montague.

A study published in 2020 categorized long-lasting erections from Viagra and other ED medications as a “rare event.” Researchers found 411 cases of drug-induced priapism while reviewing more than two decades worth of data.

But your odds of problematic prolonged erections increase if you combine Viagra with certain penile injection therapies, notes Dr. Montague.

“Combining the treatments has a cumulative effect — penile injection therapy makes your erections hard, and adding Viagra makes them harder and even more long-lasting,” he continues. “So stay on the safe side and don’t pair them.”

Myth #2: Viagra is bad for your heart

Here’s a fun fact for you: Viagra was created to help your heart.

Researchers initially developed Viagra to treat angina, a type of chest pain. Angina occurs when your heart doesn’t get enough oxygen-rich blood and starts working harder to compensate.

Now, Viagra didn’t exactly shine as a treatment for angina … but the stiffer erections the little blue pill caused certainly stood out as a side benefit.

Which brings us back to the question regarding Viagra and your heart.

The erectile dysfunction medication isn’t harmful to your ticker when taken on its own. That’s an important caveat because Viagra should NOT be taken with heart medications that include nitrates.

The reason? Like nitrates, Viagra helps dilate (or expand) blood vessels constricted by coronary artery disease. Your blood pressure drops when this happens, as less force is needed to pump blood through your system.

The worry if you take both Viagra and nitrates is that your blood pressure could drop too low, a condition known as hypotension. Abnormally low blood pressure increases your risk of a heart attack or stroke.

Bottom line? Talk to your healthcare provider before taking Viagra with other medications.

Myth #3: Viagra damages your eyes

Taking Viagra to enhance your bedroom performance likely won’t make it more difficult for you to see your partner — unless you overdo it.

High doses of Viagra have been connected to temporary vision issues, reports the American Academy of Ophthalmology. But overall, the medication is considered low risk when it comes to eyesight.

There’s a slight chance, though, that the pill may color your world blue for a bit. Chemicals in Viagra can temporarily change how light hits your eyes, giving everything you see a short-lived blue tint. This reaction is more likely if you take a maximum dose of Viagra (100 milligrams).

“This side effect can happen with higher doses, but it’s uncommon,” says Dr. Montague.

Myth #4: Viagra improves sex drive

Viagra increases blood flow to your penis, which can help you get and maintain an erection for whatever activity you have in mind. But responsibility for the “in mind” part of the process is on you.

The little blue pill isn’t designed to increase libido or sex drive, clarifies Dr. Montague. Basically, think of Viagra as a performance enhancer as opposed to a mood setter.

Myth #5: Viagra is only for older adults

ED is more common with age, but that doesn’t mean it’s not an issue for the younger crowd. Studies show that nearly 40% of men and people assigned male at birth are affected by ED by age 40. It can happen much, much earlier, too.

Talking to your healthcare provider about ED and ED medications also may help you save your penis from injury. The reason? Having sex with an erection that’s barely “hard enough” can bend your penis and tear tissue that may scar while healing.

As scar tissue isn’t elastic like healthy penile tissue, it can force your penis to bend with future erections. That can lead to a condition known as Peyronie’s disease.

Taking Viagra or another ED medication can bring a firmness that prevents the issue.

“If you’re having erectile dysfunction problems, you should feel confident going to your doctor no matter your age,” reassures Dr. Montague. “Many men are embarrassed, but they shouldn’t be. It’s a common issue. Help is available, and it’s worth a try.”

Viagra is approved for use to treat ED after age 18.

Among those (many) common concerns are questions about your loved one’s weight. Specifically, weight loss. Because it’s very common for people with Alzheimer’s disease to shed pounds as their condition progresses. Some reports say up to 40% of people with dementia experience significant weight loss. 

“Alzheimer’s disease and weight loss are intricately linked,” confirms Alzheimer’s disease specialist Jagan Pillai, MD, PhD. “There are dozens of reasons why people living with dementia lose weight. But when we can pinpoint why it’s happening, we can often find strategies for treating it.” 

So, why exactly do people with Alzheimer’s disease lose weight? Dr. Pillai explains what’s happening and what can be done. 

Why people with Alzheimer’s disease lose weight 

Weight loss is most common in the intermediate and later stages of Alzheimer’s disease, but it can happen much earlier, too. It can even be an early sign of dementia before a person is diagnosed with the condition in some cases. 

Weight loss in older age can be cause for concern in anyone. That’s because weight loss often goes hand-in-hand with muscle loss, which can put you at risk for slips, falls, broken bones and a general decline in quality of life. And coupling those risks with a progressive brain disease like Alzheimer’s poses a real threat to your loved one’s well-being.

Dr. Pillai shares factors that can cause weight loss in people with Alzheimer’s.

Progression of Alzheimer’s disease 

As dementia progresses, it can change a person’s relationship with food and their ability to eat, which can lead to weight loss. 

Food preferences may change, and favorite foods may no longer hold interest.  

“As the disease progresses, people with Alzheimer’s may have completely different tastes for certain foods, or they may lose interest in food altogether,” Dr. Pillai explains. “For some people, their senses — like vision, smell and taste — can become impaired over time. That can make some foods seem less appetizing and makes stimulating their appetite difficult.”  

Some people with Alzheimer’s disease may not be able to communicate those changes to their preferences or ask for foods they’d like to eat. They also may not be able to explain physical symptoms that affect their appetite, like stomach pain or discomfort. 

What’s more is that people living with Alzheimer’s may also experience hallucinations or delusional thinking. That can lead to fear and distractions that get in the way of eating. 

In later stages of Alzheimer’s disease, people may no longer recognize foods. And they can forget how to use utensils to bring food to their mouth. They can also lose the ability to safely chew or swallow food, which makes getting nutrition very difficult. 

Other conditions and medications 

As we age, we tend to rack up a number of chronic health conditions and may rely on more medications to keep us healthy. And people with Alzheimer’s disease often live with other conditions that affect their health, in addition to living with Alzheimer’s. Those conditions are called comorbidities. Many comorbidities, and the medications used to treat them, can be associated with weight loss. 

Unintentional weight loss may be a side effect of medication used to treat Alzheimer’s disease. It can also be associated with many conditions and medications to treat other conditions, including: 

• Bone and joint conditions, like osteoporosis, arthritis, gout and lupus. 
• Heart conditions, like high cholesterol, heart failure, high blood pressure or chest pain. 
• Gastrointestinal disorders, like celiac disease, inflammatory bowel disease, or gastroesophageal reflux disease (GERD). 
• Mental health conditions, like anxiety or depression.  
• Emotional concerns, like grief and social isolation. 
• Fluid buildup (edema). 
• Kidney disease. 
• Cancer. 
• Thyroid disease.  
• Diabetes. 
• Pain. 
• Infections. 
• Allergies. 
• Colds and coughs. 
• Anemia. 
• Potassium deficiency. 
• Chronic obstructive pulmonary disease (COPD).  
• Liver failure. 
• Involuntary muscle movement. 

Physical activity 

People with Alzheimer’s disease may lose weight because they can burn more calories compared to many older people who don’t live with the disease. Part of that reason may be that people with dementia frequently pace or wander. They’re more likely to be in motion. Through those activities, they may rack up their step counts and burn more calories than they take in. 

Treating weight loss 

If your loved one with Alzheimer’s disease is losing weight, check with their healthcare provider to get to the bottom of it. 

“There are a lot of variables that can lead to weight loss, so the provider should be taking a very thorough look at what’s going on,” Dr. Pillai notes.  

That may mean things like: 

• Taking a thorough medical history. 
• Conducting a physical exam. 
• Reviewing all medications, including prescriptions, over-the-counter medications and supplements. 
• Consulting a speech pathologist to rule out any swallowing problems. 

By understanding what’s causing your loved one to lose weight, you can work on strategies to stop the decline.  

Their healthcare provider may suggest changing, starting or removing certain medications. For example, if a decreased appetite is the issue, some people may benefit from an appetite stimulant medication, which can work to increase feelings of hunger.  

Or if a medication a person is taking is suspected to be at the root of their appetite decline, they may benefit from a different medication. Or maybe new chronic conditions have been identified that are contributing to weight loss and can be managed with new approaches. 

For people who have trouble eating, a speech therapist may recommend a feeding strategy if there are reversible causes for the eating problems. That may include things like using different dishes or utensils to make it easier for the person to feed themselves. Or offering softer foods or foods that are cut into small pieces.  

Some people may need someone to feed them by hand. Or in some cases, they may require a feeding tube to ensure they get nutrition and prevent choking. 

The bottom line

Weight loss is common among people living with Alzheimer’s disease. But there are ways to help your loved one maintain their strength. Talk with their healthcare provider about your concerns — they’re valid and important. 

Too often, it’s shaky pseudo-science that winds up going viral, though (sorry, but rubbing banana peels on your face won’t give you wrinkle-free skin). But occasionally, there’s some scientific basis for their recommendations. And they may work — at least in theory. 

That’s the case for the so-called “sleepy girl mocktail” that’s making its rounds online. Proponents say the combination of tart cherry juice, magnesium powder and a fizzy mixer like sparkling water or prebiotic soda is “a match made in heaven for good sleep.” 

And it actually might help. 

“There’s sound science to back up the idea that a drink like this could help you relax and possibly fall asleep faster,” says registered dietitian Devon Peart, RD, MHSc, BASc. “But it’s not a cure for insomnia or a sure-fire antidote to poor sleep.” 

It’s also worth noting that the social media-fueled sleepy girl mocktail’s name is based on the influencers who started sharing it, who identify as the namesake “girl.” The mocktail will work the same, regardless of your gender or sex assigned at birth. 

So, what is the sleepy girl mocktail, and should it be part of your bedtime routine? Peart explains. 

What is the sleepy girl mocktail?  

The basic recipe for the sleepy girl mocktail is simple: 

• 1/2 cup pure tart cherry juice. 
• 1 tablespoon of magnesium powder. 
• A bit of fizzy drink to cut it, like a prebiotic soda or sparkling water. 

Simply stir, sip and sleep tight (or so the story goes). 

How the sleepy girl mocktail affects sleep 

The ratios and the fizzy stuff used in sleepy girl mocktail recipes can vary a bit, but the important parts — tart cherry juice and magnesium powder — are the stars. And both these ingredients have been shown in some limited research to support relaxation and promote sleep. 

Tart cherry juice: Melatonin and anti-inflammatory   

Both sweet cherries (the ones you’re most likely to snack on) and tart cherries (which you typically find in pies and other backed goods) are packed with vitamins, minerals, antioxidants and anti-inflammatory properties.  

But tart cherries, also called Montmorency cherries, come with some additional nutrients, which have given them a reputation for bringing on better sleep: 

1. Naturally high amounts of melatonin, the “sleepy hormone.” 
2. Tryptophan, an amino acid used in the production of serotonin and melatonin. (It’s also why you might associate your turkey dinner with sleepiness.) 

In small studies of older adults with insomnia, drinking tart cherry juice before bed resulted in longer and more restful sleep. 

And while tart cherries’ melatonin and tryptophan would seem the obvious reasons for promoting better sleep, Peart says the reason tart cherry juice may help you relax may also be due to its anti-inflammatory effects. 

“There is probably some benefit to the melatonin content in tart cherry juice, but some small studies suggest the main benefit is the anti-inflammatory properties of tart cherries,” she elaborates. “Anti-inflammatory foods like tart cherries can help lower our stress hormones and make us more able to relax and get into a sleep state.” 

Popping a few tart cherries before bedtime may also bring on some relaxation and help you get some ZZZs, but fresh tart cherries can be hard to come by. Tart cherry juice, on the other hand, is probably more easily available at your local grocery store. Peart suggests choosing juice that’s unsweetened (without added sugars).  

Magnesium: A natural muscle relaxer  

The other main ingredient in the sleepy girl mocktail is magnesium powder.  

“Magnesium is involved in hundreds of different reactions in your body. It’s used for lots of different things,” Peart shares. “It’s a fairly common supplement that a lot of people use. And one of its benefits is that it may promote physical and mental relaxation (a sense of calm), which could make magnesium a helpful sleep aid for some people.”  

There are several different kinds of magnesium supplements available, and recipes for sleepy girl mocktails that you find online don’t always indicate which kind to use. 

Peart suggests magnesium glycinate as a first choice for promoting relaxation. Others, like magnesium citrate, are more likely to have a laxative effect, which can derail your sleep goals.  

Researchers say about half the U.S. population doesn’t get enough magnesium in their diet.  

If you want to try some in your evening mocktail, Peart suggests starting with 100 to 200 milligrams (mg) of magnesium. You can also up your intake of magnesium-rich foods like nuts, seeds, legumes and whole grains. 

But remember, magnesium may act as a natural muscle relaxant, which could help you get some rest, but it’s not a cure-all. 

“Magnesium isn’t directly sleep-inducing,” Peart clarifies. “But it can help you relax so you can get into a sleep state. So, indirectly, it could be helpful.” 

Does the sleepy girl mocktail work? 

Combining tart cherry juice and magnesium powder into a sleek sleepy girl mocktail may help to bring about a better night’s sleep. But it’s not a magic bullet.

“I would put it in the category of ‘it’s worth a try,’ as long as you don’t have any medical conditions that make it risky for you to have tart cherries or magnesium,” Peart advises. “If your options are something like a sleepy girl mocktail versus a medication sleep aid, I’d say it’s OK to try something like this first before turning to medication.” 

She suggests trying the mocktail about an hour before bed. That will give it time to work through your system.  

But consider the sleepy girl mocktail as just one more avenue to help your body prepare for bed. To work effectively, it needs to be paired with other sleep-inducing activities, like turning off electronics an hour before sleep, engaging in calming activities before going to bed, and keeping regular sleep and wake times. 

“Perhaps even more powerful than the ingredients themselves is its role in the ritual of getting your body ready for sleep — what we call sleep hygiene,” Peart states. “So, if you incorporate a sleepy girl mocktail into a routine that promotes sleep, it’s more likely to be effective.” 

Sleep is a critical part of keeping your body and your mind healthy. So, it’s important to find ways to make sure you’re getting the rest you need. If you want to try adding the sleepy girl mocktail to your bedtime routine, talk with a healthcare provider about any chronic conditions or medication that may not react well with tart cherry juice or magnesium powder. 

Maybe not. A quick check online reveals hundreds of different models — and even a bunch of apps for your smartphone. How do you even start to sort through all that without, well, spiking your blood pressure?

Don’t worry, we’ve got you covered. Heart and hypertension specialist Luke Laffin, MD, has six tips on what you need — and what you don’t need — in a home blood pressure monitor.

How to monitor blood pressure at home

Before we dive into Dr. Laffin’s tips, let’s review how to take your blood pressure at home. The American Heart Association has a few suggestions to make sure your readings are accurate:

1. Avoid activities that raise blood pressure 30 minutes before testing. That means no caffeine, cigarettes or exercise.
2. Positioning matters. When you’re testing your blood pressure, you need to pay attention to your posture. Sit upright with your back supported, and make sure your arm is raised to heart level. Your arm should be supported by something like a cushion or armrest.
3. Chill out a bit. Try to relax for five minutes before turning the monitor on. Chatting with friends, checking your phone — anything that could stress you out or get you excited, really — can impact the accuracy of your reading.
4. Don’t hold it. Weird fact of the day: Needing to pee raises your blood pressure! That’s another reason (though, we hope you didn’t need one) to make time for a bio-break.
5. Have a routine. Blood pressure fluctuates a lot during the day, so you’re most likely to get useful data if you test at roughly the same times every day. Notice the “s” there: Testing once a day won’t give you or your doctor the same kind of insight that you’ll get from checking several times a day at consistent times.

Of course, you can do everything right and still get an inaccurate blood pressure reading if you’re working with a sub-par monitor.

What to consider when choosing a monitor

With so many blood pressure monitors on the market, how do you decide what to pick? And how do you know that your monitor’s working properly? Dr. Laffin says you need to keep six things in mind.

Choose arm cuffs over wrist cuffs

You can purchase a blood pressure monitor at any drugstore or online. No matter where you buy yours, Dr. Laffin recommends getting a monitor with an automatic cuff that wraps around your upper arm. It’s called a brachial blood pressure monitor.

“Don’t get one where you need a stethoscope,” he advises. “An automatic cuff is best.”

What about those monitors with wrist cuffs? Or finger cuffs? The American Heart Association recommends against both for people who are able to use an arm cuff. It’s the best option and tends to provide the most accurate readings.

Size matters

The size of the cuff is the most important feature to check when you’re selecting a blood pressure monitor, Dr. Laffin notes. In fact, a 2023 study found that “miscuffing” resulted in “strikingly inaccurate BP measurements.”

The size you need is determined by the circumference of your upper arm. A cuff that doesn’t fit properly may give you inaccurate readings, leading to a misdiagnosis.

Right about now you may be thinking, what about the one-size-fits-all options that many home monitors offer? They aren’t terrible, but they also aren’t as reliable as cuffs that are fitted to the size and shape of your arm. This is one of those situations where it’s worth it to pull out the tape measure. You need to measure the circumference of the middle of your arm — exactly halfway between your shoulder and elbow.

The different cuff sizes are:

• Adult small: Arm circumference of 22 to 26 centimeters (about 8.5 to 10 inches).
• Adult average: Arm circumference of 27 to 34 centimeters (about 10.5 to 13 inches).
• Adult large: Arm circumference of 35 to 44 centimeters (about 13.5 to 17 inches).
• Adult extra-large: Arm circumference of 45-52 centimeters (about 17.7 to 20.5 inches).

Keep it simple

Forget the bells and whistles. They boost the cost of the monitor and are often unnecessary.

Sure, Bluetooth connectivity and storing your readings in the cloud are cool features, but you don’t really need them.

“You shouldn’t have to pay more than $40 to $60 for an appropriate, physician-approved blood pressure monitor that will do the job just fine,” Dr. Laffin says.

Skip the apps

If you look at any app store, you’re likely to find dozens of blood pressure measurement apps for your smartphone.

Dr. Laffin is blunt: “These products don’t work and have not been rigorously tested.”

Certain apps claim to measure your blood pressure through pulse wave velocity, which essentially looks at the wave form in the artery of your finger.

“But those are often inaccurate,” he continues. The last thing you want is to obtain false information and be falsely scared — or falsely reassured — about your blood pressure numbers.

Check for validation and inspect for accuracy

By now, you might be feeling a bit overwhelmed by all the things you need to keep in mind when selecting a monitor. After all, there are so many brands out there.

Have no fear: There’s a website out there that can help cull that list for you!

It’s called the US Blood Pressure Validated Device Listing. This independent review committee tests blood pressure monitoring products for accuracy and gives specific models their stamp of approval. The committee reviews all blood pressure monitors, including the stations you see at grocery stores and pharmacies. So, while not everything you see on the site is going to fit your needs or budget, it’s a quick way to find a product you can trust.

Of course, even the best blood pressure monitors aren’t always going to be perfect. Manufacturing errors, wear and tear, battery depletion — there are plenty of issues that can cause inaccurate readings. That’s why it’s important to test your device against other monitors on a regular basis.

Most monitors you find in a drugstore or online are fine, Dr. Laffin says. But it doesn’t hurt to take it to your doctor’s office and check yours against the office monitor.

“If the systolic blood pressure (the top number) on your cuff is within 10 points of the monitor, then it’s generally accurate,” he says.

Most home blood pressure machines last for about two or three years. After that, check it at your healthcare provider’s office annually to make sure it’s still accurate.

Three is better than one

There’s one extra feature you might consider seeking out to help boost a monitor’s accuracy: Taking three measurements automatically.

Some monitors do this each time you check your blood pressure. They take a first reading; wait 30 to 60 seconds and take a second reading; then wait 30 to 60 more seconds and take a final measurement.

“This is helpful because it averages your three readings, which probably more closely reflects your actual blood pressure than the first number alone,” Dr. Laffin explains.

A no-pressure purchase

If you find yourself in a situation where you need to regularly monitor your blood pressure, the last thing you need is uncertainty — about the product you’re buying, your testing procedure or the readings you’re getting. You can now consider yourself armed (get it?) with all the basic information you need.

If any other questions come up, don’t be shy about checking in with your healthcare provider. If they’re asking you to check your blood pressure regularly, they’re going to be just as invested as you are in making sure it’s done right!

Ingredients

• 1 1/2 teaspoons oil-based butter spread
• 1/4 cup plus 1 teaspoon sugar
• 1 tablespoon ground toasted almonds
• 3 tablespoons plus 1 teaspoon good-quality cocoa
• 4 large egg whites, at room temperature
• 1 tablespoon Cognac
• 1/2 teaspoon ground cinnamon
• 1 teaspoon confectioners’ sugar
• 12 strawberries, thinly sliced

Directions

1. Preheat the oven to 375 F. Grease/flour 6-ounce soufflé cups with the butter spread.
2. Mix 1 teaspoon of the sugar with the almonds and 1 teaspoon of the cocoa. Coat the insides and bottom of the soufflé cups, tapping the sides to make sure they’re coated.
3. Heat 2 tablespoons water with the remaining sugar in a nonstick small pot. Bring to a simmer and cook until the mixture becomes thick, about 3 minutes. Don’t allow the syrup to color. Brush down the sugar crystals on the sides of the pot with a wet pastry brush as the syrup thickens. It will be quite hot so be careful.
4. While the sugar and water are simmering, beat the egg whites until stiff in the bowl of an electric mixer. While continuing to beat, slowly and carefully pour the hot sugar syrup into the egg whites. Add the 3 tablespoons cocoa, the Cognac and cinnamon.
5. Spoon the mixture into the soufflé cups, tapping each cup to make sure there aren’t any bubbles. Bake for 10 minutes, or until the soufflés are puffed and set. Immediately place the soufflés on dessert plates. Sift the confectioners’ sugar over the tops and decorate each plate with 3 strawberries. Serve immediately.

Nutrition information (per serving)

Makes 4 servings

Calories: 130
Total fat: 2.5g
Saturated fat: 0.5g
Protein: 5g
Carbohydrates: 24g
Dietary fiber: 3g
Cholesterol: 0mg
Sodium: 70mg
Potassium: 260mg

— Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook (© 2007 Broadway Books).

“Pears are so healthy, and most people tolerate them very well,” says registered dietitian Beth Czerwony, RD, LD. “They’re terrific for your digestion and have other impressive health benefits. They’re a perfect snack if you’re craving something sweet.”

Types of pears

Pears are members of the Rosaceae plant family, along with apples, apricots, cherries, peaches and several other fruits and berries. Pears can range in texture, color, crispness, juiciness and sweetness. Common varieties you may find in the grocery store include:

• Anjou (green or red).
• Asian.
• Bartlett.
• Bosc.
• Comice.
• Concorde.
• Forelle.
• Seckel.
• Starkrimson.

Health benefits of pears

Are pears good for you? Absolutely. Pears are a great source of antioxidants, fiber, potassium and vitamin C. But they’re not just full of nutrients — they also may lower your risk of some diseases. Here are five ways pears boost your health.

1. A nutritious source of vitamins and minerals

Like most fruit, pears are a source of good nutrition. One medium pear has approximately:

• 102 calories.
• 27 grams of carbohydrates.
• 0 grams of cholesterol.
• 0.2 grams of fat.
• 6 grams of fiber.
• 0.6 grams of protein.
• 1 milligram of sodium.
• 17 grams of sugar.

A medium pear also gives you:

• 8 milligrams of vitamin C (9% daily value or DV).
• 8 micrograms of vitamin K (7% DV).
• 0.05 milligrams of vitamin B6 (5% DV).
• 206 milligrams of potassium (4% DV).

2. Helps manage your blood sugar

Nobody enjoys the dreaded crash that happens after sugary foods spike your blood glucose. Steady blood sugar means a steady supply of energy, which is healthier for your body. Blood sugar management is even more important if you have diabetes.

Czerwony says pears may help stabilize blood sugar and even reduce your risk of Type 2 diabetes. How? Fiber, for starters. A medium pear offers nearly one-quarter of the fiber you need in a day. Fiber helps keep blood sugar steadier by slowing your body’s absorption of sugar.

Pears also contain anthocyanin, an antioxidant. An observational study suggests a link between eating anthocyanin-rich foods and a lower risk of Type 2 diabetes.

Another study showed that eating pears could significantly lower your odds of developing Type 2 diabetes. For each serving of pears eaten per week, researchers found a 3% lower risk of Type 2 diabetes.

In addition, pears are a low-glycemic food, which means they won’t spike your blood sugar like sugary foods and some fruits can.

3. Relieves constipation and improves digestive health

Fiber adds bulk to and softens your stool, which helps things move along in your gut. Lots of foods contain fiber, but pears are a particularly excellent source.

A single pear contains 6 grams of fiber (more than 20% of what an adult needs in a day). And pectin, a type of fiber in pears, has some specific benefits. Pectin is a soluble fiber known to help:

• Constipation: In a study of 80 people with constipation, pectin significantly improved food movement through their digestive systems and reduced symptoms.
• Gut microbiome: Pectin promotes the growth of good bacteria in your colon, according to a review of several studies, helping your microbiome stay healthy.

To reap the fibrous benefit of pears, don’t skip the skin. “Pear skin contains a significant amount of the fruit’s total fiber content,” notes Czerwony.

4. Lowers inflammation

Inflammation happens when your immune system tries to protect you from something — an infection, a toxin or some other offender. Some temporary inflammation is actually a healthy response to these things. But when inflammation hangs around, it can contribute to diseases such as Alzheimer’s, asthma, cancer and Type 2 diabetes.

Antioxidants are nutrients that can prevent some of the cell damage that leads to inflammation. Pears are rich in powerful types of antioxidants called flavonoids.

Research shows that flavonoids can reduce inflammation and lower the risk of:

• Cancer.
• Heart disease.
• Infections from bacteria, fungi and viruses.
• Alzheimer’s disease, dementia and Parkinson’s disease.
• Stroke.
• Type 2 diabetes and the nerve damage it can cause.

5. Promotes heart health

Pears are an excellent part of a heart-healthy diet. Nutrients in pears that can benefit your heart include:

• Anthocyanins, an antioxidant and pigment that gives some pears their red color. According to a review of 44 studies, anthocyanins may protect against coronary artery disease.
• Fiber, which may play a role in lowering cholesterol, according to a meta-analysis of 15 clinical trials. High cholesterol may increase your risk of heart disease.
• Potassium, known to help reduce high blood pressure — another risk factor for heart disease.

In addition, a study examining the effects of fruit and vegetable consumption suggests eating pears lowers your risk of stroke. And one large clinical trial showed a link between eating pears and a lower risk of dying from heart disease.

Are fresh, canned or frozen pears better?

“In general, fresh fruits are best because they have the highest amount of nutrients,” explains Czerwony. “Frozen is usually a close second to fresh. The heat of canning, though, can break down certain nutrients.”

But don’t avoid canned pears completely. They’re still good for you. She advises looking for pears in water rather than syrup, which adds unneeded sugar.

“You might be surprised by what you can do with fresh pears,” she adds. “Think of how you use apples — sliced raw, in pies or baked — and you can do all those things with pears.”

Try making this poached pear dessert, include pears in your stuffing or make some interesting salads with pears.

It can be a lot to think about.  

Eat this. Avoid that.  

Don’t diet. But try to keep your weight gain managed.  

And all the while dealing with pregnancy’s various effects on your body. 

We get it. It’s not easy. 

Even still, a healthy pregnancy diet is important. Because it can keep you nourished and, again, promote healthy fetal development. So, knowing what healthy pregnancy nutrition looks like is important. 

“Certain nutrients are so essential during pregnancy that we recommend everyone take a daily prenatal vitamin to ensure you get some critical vitamins and minerals,” says nurse midwife Tamara Noy, MSN, CNM. “But prenatals alone aren’t enough. Just as important is following a healthy eating pattern during pregnancy to keep your body healthy and encourage proper fetal development.”  

We talked with Noy about what to eat and what to avoid when you’re pregnant.  

Daily guidelines: What pregnant people need to eat 

Noy explains some of the most important nutrients to support a healthy pregnancy and how to make sure you’re getting your fill. 

Calcium 

Recommended intake: 1,300 milligrams (mg) per day. 

Calcium helps your body build strong bones and teeth. Calcium also allows your blood to clot normally, your nerves to function as they should and your heart to beat properly. And those benefits are passed on to a growing fetus, too. 

“Dairy products are the best source of calcium, but even pregnant people who are dairy-free or who don’t eat a lot of dairy can still get enough calcium. It’s just a matter of choosing the right foods,” Noy says. 

Aim for eating or drinking four servings of dairy products or other foods rich in calcium, like:  

• Pasteurized cheese. 
• Milk (including non-dairy options, like almond milk). 
• Dark, leafy greens.  
• Fortified cereal. 
• Fish low in mercury. (Mercury levels are important when choosing fish during pregnancy. More on that in a bit.)
• Fortified orange juice.  
• Almonds.  
• Sesame seeds. 

Folic acid 

Recommended intake: 600 micrograms (mcg) per day or more. 

Folic acid is used to make the extra blood your body needs during pregnancy.  

Folic acid helps encourage healthy development of the fetus’ brain, spine and spinal cord. The March of Dimes suggests that 70% of neural tube defects during fetal development can be avoided with appropriate folic acid intake. That’s important because neural tube defects are associated with conditions like spina bifida and anencephaly. 

Folic acid is a major ingredient in prenatal vitamins, and yours should include the 400 mcg that are recommended for most healthy pregnancies. Your provider or a genetic counselor may recommend additional folic acid if you’re at an increased risk for neural tube defects. That includes pregnant people who have a family history of spina bifida or if you take antiseizure medicines during pregnancy.   

Folic acid is also added as a supplement to certain foods, such as fortified bread, cereal, pasta, rice and flour. And it’s found naturally in foods like: 

• Lentils.  
• Beans. 
• Green leafy vegetables (like spinach, romaine lettuce, kale and broccoli). 
• Citrus fruit. 
• Nuts.  
• Beans.  

Iron 

Recommended intake: 27 mg per day. 

Iron is an important part of the healthy development of red blood cells, which carry oxygen through your body, including to the developing fetus. Iron will help you build resistance to stress and disease, as well as help you avoid tiredness, weakness, irritability and depression.  

Good sources of iron during pregnancy include: 

• Whole-grain products. 
• Lean beef and pork. 
• Dried fruit. 
• Beans. 
• Sardines. 
• Green leafy vegetables. 

Noy notes that iron deficiency in pregnancy can lead to some unusual cravings. If you’re craving non-food items such as ice, laundry detergent, dirt, clay, ashes or paint chips, you may have a condition known as pica. Don’t eat non-food items, and discuss these cravings with your doctor immediately.  

Vitamin D   

Recommended intake: 600 international units per day. 

Vitamin D works with calcium to support healthy fetal growth — particularly for developing teeth, bones, healthy skin and eyesight.  

Good sources of vitamin D are milk fortified with vitamin D and fatty fish such as salmon. Exposure to sunlight also converts a chemical in your skin to vitamin D. (But, as always, make sure to wear your sunscreen!) 

DHA 

Recommended intake: 200 mg per day, plus prenatal vitamins. 

Docosahexaenoic acid (DHA) is a powerful omega-3 fatty acid that supports the development of healthy brains, eyes and nervous systems.  

Your provider will recommend taking a prenatal vitamin that contains DHA or a separate daily DHA supplement. And it’s recommended that you get an additional 200 mg of DHA each day from the foods you eat. Good sources of DHA in your diet include: 

• Fatty fish low in mercury, like salmon, herring and sardines. 
• Cooked shellfish. 
• Omega-3 enriched eggs. 
• Walnuts. 
• Chia seeds. 

Protein  

Recommended intake: Your pre-pregnancy weight divided by two, in grams. (For example, a person weighing 150 pounds before pregnancy should aim for 75 grams of protein per day.) 

Protein is an important nutrient needed for growth and development. It gives your body energy and works to build and repair your brain, muscle and blood.  

During pregnancy, getting additional protein will help support healthy fetal growth and development.  

Choose a variety of protein-rich foods, including:  

• Low-mercury, cooked seafood.  
• Lean meat and poultry.  
• Eggs.  
• Beans.  
• Peas.  
• Soy products.  
• Unsalted nuts and seeds.  

You can check the labels on packaged food to determine how many grams of protein each food provides. 

Foods to avoid 

While you’re working to increase some nutrients in your pregnancy diet, there are some things that can be especially harmful to you and the fetus during pregnancy. 

Noy explains a few that should be off the menu. 

Alcohol 

Let’s be very clear here. No amount of alcohol is safe during pregnancy. None. Zero. 

“Fetuses can’t break down alcohol in the way that adults do. Alcohol stays in their systems longer and dangerously interferes with fetal brain and nervous system development,” Noy explains.  

Alcohol use during pregnancy has been linked with preterm delivery, low birth weight and fetal alcohol syndrome spectrum disorders. Those are permanent conditions that cause mental and physical defects in children who were exposed to alcohol during pregnancy.  

If you’re pregnant and living with alcohol use disorder or find it difficult to stop drinking, talk with your provider for help. It’s vitally important to your health and to having a healthy pregnancy. 

Listeria risks 

During pregnancy, hormonal changes during can lower your immune system and put you at greater risk for contracting a foodborne illness (aka food poisoning). And while no one wants to deal with the effects of food poisoning, the risk can be much higher during pregnancy. 

In fact, during pregnancy, you’re 20 times more likely to contract the foodborne illness listeria, which has been shown to increase risk of premature delivery, miscarriage and even fetal death.  

“The most common causes of listeria in pregnancy are foods that contain raw eggs, uncooked proteins, processed meats and unpasteurized dairy products,” Noy explains. “So, we recommend avoiding those foods during pregnancy.” 

That includes:  

• Sushi.  
• Rare or undercooked meats and poultry and beef. 
• Undercooked and raw eggs.  
• Caesar dressing. 
• Mayonnaise.  
• Cold deli meats, like turkey, ham, bologna or salami.  
• Fermented or dried sausages. 
• Cold hot dogs. 
• Unpasteurized juice or cider — words like “natural” or “fresh-squeezed” are indications that they haven’t been pasteurized. 
• Soft cheeses, like feta, queso blanco, queso fresco, brie, Camembert, blue-veined or panela (queso panela). Only eat cheeses that are labeled as “made with pasteurized milk.” 
• Refrigerated pâté or meat spreads. Canned or shelf-stable pâté and meat spreads are safe to eat. But sure to refrigerate them after opening. 

Fish with high mercury content 

Fish is full of healthy fats and proteins, but some kinds should be avoided or eaten with caution during pregnancy. That’s because some fish have elevated levels of methyl mercury or polychlorinated biphenyls (PCBs), a pollutant in the environment. 

Consuming fish with high levels of methyl mercury during pregnancy has been associated with brain damage and developmental delays in the fetus. 

Fish to avoid include:  

• Any raw or seared fish, including sushi and sashimi. 
• Undercooked finfish and shellfish, such as undercooked oysters, clams, mussels and scallops. 
• Shark.  
• Swordfish.  
• King mackerel. 
• Tilefish even when cooked as they have higher levels of mercury. 
• Bluefish.  
• Bass. 
• Freshwater salmon. 
• Pike. 
• Trout. 
• Walleye. 

Foods to be cautious about  

Not all foods are black-or-white, eat-it-or-avoid-it during pregnancy. There are some gray areas. Some foods that are OK but need to be considered in moderation. Noy breaks it down. 

Caffeine 

It’s not that you can’t enjoy a cup of coffee during your pregnancy. But limiting your caffeine intake during pregnancy is a good idea.  

That’s because high levels of caffeine can cause constriction in the blood vessels that feed the fetus. That can lead to low blood flow and inhibit fetal growth.  

Noy recommends sticking to no more than 200 mg of caffeine a day during your pregnancy. That’s about two six-ounce cups of coffee or three six-ounce cups of tea. And avoid energy drinks during pregnancy. The additional additives in them may not be safe during pregnancy.  

“If you’re a coffee drinker before pregnancy, you’ll want to cut back slowly,” she advises. “Going cold-turkey can make you completely miserable.” 

Excess salt 

A moderate amount of salt in your diet is healthy for you. In fact, salt is important for maintaining proper electrolyte levels in your blood. 

But too much salt can cause your body to retain water and could lead to an elevation in your blood pressure. That can be particularly problematic during pregnancy and lead to conditions like preeclampsia. Eat salty foods in moderation.  

What to eat when pregnancy has you sick 

Pregnancy symptoms vary. Some people may have difficulty with morning sickness, diarrhea or constipation. What you eat can help you feel better.  

Noy offers these suggestions to deal with some common pregnancy symptoms.  

Foods for morning sickness 

Eating small meals frequently throughout the day can help keep pregnancy nausea symptoms at bay. Eating increased protein can help, too, as can eating foods rich in magnesium or taking a magnesium supplement. 

“Some people find that eating first thing in the morning, even before getting out of bed, can help,” Noy suggests. “And protein is super important. Protein changes everything.” 

But morning sickness (despite its name) can show up any time of day — or night. Keep healthy, eat-on-the-tummy snacks on hand to help with morning sickness symptoms. 

Avoid fatty, fried foods, and try:  

• Crackers. 
• Cereal.  
• Pretzels. 
• Unsalted nuts and seeds. 

Constipation  

When pregnancy has you all bound up, increasing your fiber intake can help get things moving again. Try these high-fiber foods:  

• High-fiber cereal. 
• Lentils. 
• Split peas. 
• Chickpeas. 
• Raspberries. 
• Blackberries. 
• Pears. 
• Whole-wheat pasta. 

Also, make sure you’re drinking plenty of water — at least 10 to 12 glasses per day. 

Diarrhea  

When you have the runs, staying hydrated is your first goal, so make sure you’re drinking enough. Electrolyte-enhanced sports drinks can help if water isn’t enough.  

Increase your intake of foods containing pectin and gum fiber to help absorb excess water. And keep your options bland. Good choices include:  

• Applesauce. 
• Bananas. 
• White rice. 
• Oatmeal. 
• Refined wheat bread. 

Heartburn  

Heartburn can be a common complaint during pregnancy. Especially at later stages, as your uterus pushes your stomach out of the way.  

Noy offers these suggestions for lessen the intensity of pregnancy heartburn:  

• Eat small, frequent meals throughout the day. 
• Eat slowly and chew thoroughly. 
• Avoid spicy or rich foods, and caffeine.  
• Drink fluids in between meals but not with your meal.  
• Try not to lie down after eating a meal. 
• Keep your head elevated when lying down. 

If you’re worried about getting proper nutrition during your pregnancy, talk with a healthcare provider like an Ob/Gyn or certified nurse midwife. You deserve a happy, healthy pregnancy. 

We asked family medicine physician Jeffrey Brown, DO, to explain the “varicella order of operations.” He shares what you have to do to protect yourself against chickenpox and shingles, depending on your personal medical history.

The relationship between chickenpox and shingles

Up until a couple of decades ago, before there was a vaccine, almost everybody contracted chickenpox at some point during their childhood. It was like a rite of passage — a thing that happened to all kids sooner or later. Some parents actually used to have “pox parties,” where they deliberately exposed their children to somebody with the virus. In the U.S., approximately 99% of people over the age of 40 have had the virus.

“Typically, when you’re a child and you get chickenpox, your body fights off the virus,” Dr. Brown explains, “But it doesn’t get rid of it. The virus, varicella-zoster, goes into hiding somewhere at the base of a nerve in your body for years and years and just stays there quietly. We call that latency.”

Most people who get chickenpox live out the rest of their lives without the virus ever rearing its ugly head again. But for a portion of that population — about 10% — the virus reactivates as shingles.

“I almost think of shingles as being chickenpox: the sequel,” Dr. Brown says. It’s the same virus, but the symptoms are slightly different — and, because it typically strikes people over the age of 50 — it can pack an even heavier punch.

In some cases, shingles causes serious side effects like post-herpetic neuralgia (PHN), inflammation of the brain (encephalitis) and bacterial infections. Those kinds of complications are most likely in people over 70 years of age and people with compromised immune systems.

Unlike chickenpox, which is a “one and done” thing, you actually can have shingles more than once — just like a movie can have multiple sequels.

How vaccines have changed things

Chickenpox and shingles used to be facts of life. Nearly everybody got chickenpox. And shingles was a roll of the dice everybody had to take.

Today, both conditions are largely preventable, thanks to the development of vaccines:

• ProQuad® and Varivax® both provide protection against chickenpox.
• Shingrix® is the newest vaccine against shingles and is recommended for all people over age 50 that have already had chickenpox. It’s also recommended for anybody who received a shingles vaccine before Shingrix came onto the market in 2020, because previous vaccines weren’t nearly as effective.

The advent of these vaccines means that there are a lot more people out there who have never had chickenpox. And that’s great news! But it can also make it hard to figure out which vaccines you need and which you don’t.

Dr. Brown explains that people who’ve been vaccinated against chickenpox (and never got sick) don’t have to worry about the shingles vaccine, saying, “If you’ve been vaccinated for chickenpox, you’re also protected from shingles as an adult.”

But that doesn’t mean you can throw caution entirely to the wind. You still need to protect yourself against breakthrough infection if somebody around you is sick. It’s not just important for your health: It’s also important for people who are unable to be vaccinated.

Protecting yourself against breakthrough infections

More than 90% of people who receive the chickenpox vaccine will avoid the virus. But — while the vaccine is highly effective — it’s not a 100% guarantee against infection.

That means it’s important to take protective measures if somebody close to you is sick with either chickenpox or shingles.

“If someone has chickenpox or shingles and they are at the blister stage where they are contagious, they could transmit the virus to you and you could potentially get chickenpox,” Dr. Brown states.

Specifically, he says that you need to avoid touching the blisters, as that’s the primary way varicella-zoster spreads. The U.S. Centers for Disease Control and Prevention (CDC) also notes that you can breathe in virus particles when a person with chickenpox or shingles scratches their blisters.

If you are unlucky enough to have a breakthrough chickenpox infection, take heart: Vaccinated people who experience breakthrough infections usually have milder symptoms than people who aren’t vaccinated. Just remember that you’ll need to be vaccinated for shingles when you reach age 50 or — if you’re already 50 or older — after your chickenpox infection has subsided.

The bottom line

• If you’ve had chickenpox, you’re at risk of getting shingles and should be vaccinated when you reach the age of eligibility.
• If you were vaccinated against chickenpox and haven’t had a breakthrough infection, you don’t need to be vaccinated for shingles.
• If you were vaccinated against chickenpox and did have a breakthrough infection, you should be vaccinated for shingles when you reach the age of eligibility.
• If you haven’t had chickenpox and haven’t had the chickenpox vaccine, you should get vaccinated as soon as possible. You won’t need the shingles vaccine unless you have a breakthrough chickenpox infection at some point.

Regardless of your vaccination status or immunity, you need to always take protective measures if somebody around you is sick with chickenpox or shingles. Doing so doesn’t just protect you: It also prevents the virus from spreading to people who aren’t vaccinated against it.

What is period flu?

But according to Ob/Gyn Sara Yuen, MD, “Period flu isn’t the flu or an official medical diagnosis. It’s a type of premenstrual syndrome (PMS), which can cause symptoms similar to the flu.”

Dr. Yuen shares what researchers know about period flu and how you can relieve your symptoms.

Who experiences period flu?

It’s not clear how many people get the specific symptoms of period flu, but PMS is very common. Up to 90% of women and people assigned female at birth (AFAB) get PMS at some point. Most people have manageable symptoms, says Dr. Yuen.

A debilitating form of PMS called premenstrual dysphoric disorder (PMDD) affects about 5% of women and people AFAB. Healthcare providers classify PMDD as a psychiatric disorder because it can cause significant mental health distress. Severe depression, anxiety, mood changes and even thoughts of suicide can occur with PMDD. If you’re experiencing these symptoms, it’s important to speak to a mental health provider or psychiatrist.

PMS and period flu symptoms

PMS symptoms can start any time after ovulation, although it’s unusual to have symptoms for the full two weeks between ovulation and your period starting. For most people, symptoms kick in a few days before their period and go away once it starts. It can be helpful to keep a menstrual diary to track your symptoms.

The symptoms of PMS can vary widely from person to person. People who experience period flu may notice:

• Body aches.
• Diarrhea.
• Fatigue.
• Fever.
• Headaches.
• Nausea and vomiting.

Why do some people get period flu?

Healthcare providers don’t know exactly what causes period flu and PMS. It’s most likely related to changes in hormones and chemicals during your menstrual cycle. A typical menstrual cycle is 28 days, but can range from 21 to 35 days. Day one is the first day of your period and cycle length is counted from day one of your last period to day one of your next. Ovulation usually occurs around day 14 in a 28-day cycle.

Estrogen and progesterone are hormones that help regulate your menstrual cycle. They surge before and after ovulation. If you don’t become pregnant, the levels drop just before your period. This decline in hormones can cause headaches, mood swings, fatigue and other PMS symptoms.

Chemicals called prostaglandins may also contribute to PMS. Before your period, cells in the lining of your uterus release prostaglandins. The prostaglandins help your uterus contract and shed its lining during menstruation.

“The contractions are the cramping pains you feel,” explains Dr. Yuen. “Prostaglandins produced by your uterus can also cause diarrhea, nausea and sometimes even a low-grade fever before your period.”

How to relieve period flu symptoms

There are many ways you can ease flu-like symptoms before your period. “Certain medications can help,” says Dr. Yuen. “Adopting healthy lifestyle habits can also make a big difference.”

These nine steps can help you reduce period flu and PMS symptoms:

1. Make a healthy meal plan

A healthy diet can improve PMS symptoms by stabilizing your blood sugar. Changes in blood sugar can cause food cravings, irritability and mood swings.

“Reduce refined sugars by substituting whole grains, such as whole-wheat bread and brown rice,” Dr. Yuen suggests. “Eating smaller meals throughout the day with healthy snacks in between can also help maintain your blood sugar.”

Certain foods can also decrease inflammation in your body and reduce PMS symptoms. Aim for an anti-inflammatory diet rich in:

• Fruits and vegetables.
• Lean proteins.
• Nuts and seeds.
• Omega-3 fatty acids.

And eat less:

• Animal proteins.
• Caffeine.
• Refined sugars.
• Salt.
• Saturated fats.

2. Get more calcium

Studies show that calcium can improve PMS symptoms, especially mood changes. The recommendation for premenopausal people is 1,000 milligrams of calcium per day and 800 international units of vitamin D. (Vitamin D helps you absorb calcium.)

Your best bet to increase calcium is by eating more calcium-rich foods, including low-fat dairy, calcium-fortified foods, and nuts and seeds. If needed, you can also get calcium through supplements. But getting too much calcium can also be a risk, so check with your provider before beginning a supplement.

3. Try nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are over-the-counter medications. They block your body’s production of prostaglandin, easing cramps, body aches and diarrhea.

4. Use a warm compress

A warm compress can help reduce the cramping and muscle pain of PMS. It’s also a great way to feel warm and cozy.

5. Talk with a provider about hormonal birth control

Hormonal birth control methods contain progestin (a compound similar to progesterone) or estrogen and progestin. The steady dose of hormones helps maintain hormone levels and reduce prostaglandin production.

Hormonal birth control comes in many forms, including short-acting options such as the pill, patch, shot and vaginal ring. Long-acting options include the implant and hormonal intrauterine devices (IUDs).

6. Exercise regularly

Regular aerobic exercise is good for your health — and helps reduce PMS symptoms. Aim for 30 minutes of moderate-intensity exercise per day, five days a week — or 150 minutes per week. Running, brisk walking and biking are great ways to get moving.

7. Stop smoking

Smoking is linked to a wide range of health conditions, including PMS. Quitting smoking can ease PMS symptoms. Trying to quit can be hard, but it’s one of the best steps you can take to help you live a longer, healthier life. Ask your healthcare provider for ways you can quit.

8. Get enough sleep

Getting plenty of sleep can help combat the fatigue, irritability and poor concentration symptoms of PMS. Dr. Yuen recommends at least seven hours of sleep a night.

9. Reduce stress

Reducing stress can help you manage the psychological aspects of PMS, such as depression, anxiety and mood swings. Ways to reduce stress include:

• Exercise.
• Getting enough sleep.
• Spending time outdoors.
• Mind-body practices, such as yoga and meditation.

The bottom line

If you get the period flu every month, you don’t have to push through the distressing symptoms until they pass. Talk to a healthcare provider to figure out the best plan to relieve your pain and discomfort. Whether it’s a prescription for birth control or discovering the right combo of food, sleep and exercise, you can work together to find a solution that helps you feel your best, every day of the month. 

Not exactly.

“Running is certainly a load-bearing sport that impacts your body. But it’s a bit of a myth that it’s bad for your joints. There’s little evidence that running causes knee arthritis,” says sports medicine physician Anne Rex, DO.

Dr. Rex says running isn’t inherently bad for your knees — but it does affect them. She explains and offers tips for protecting your joints.

How does running affect your knees?

“Running causes changes to the cartilage and fluids in your knees,” says Dr. Rex. “But these changes are temporary. Cartilage can recover from those changes in between runs, and your body adapts to running over time.”

Bottom line: Running does not cause arthritis, and when you rest, your body — and your knees — recover from the effects of running. A recent study backs this up. In a large survey of marathon runners, researchers found that running more did not raise their risk of arthritis.

Running may even lower your risk of arthritis. As your knees compress when you run, more fluid travels to your joints to keep them lubricated. That means running may benefit your joints (in addition to improving your health).

Dr. Rex emphasizes the many benefits of running. “Running is great cardiovascular exercise. It’s convenient because you don’t need any equipment except a good pair of running shoes. You can open your front door and just go.”

But where you run can make a difference in your joint health. Dr. Rex discusses the potential benefits and risks of different running terrains.

Does the running surface matter?

“The type of surface you run on does matter because it changes the impact on your body,” notes Dr. Rex.

Think about bouncing a golf ball on different surfaces. The ball bounces differently depending on how hard the surface is. The same is true for your joints. The harder the surface, the more impact on your joints. Softer terrain means less impact.

A cushy woodland trail might seem best but has potential problems. Although softer, cushioned terrain, like grass or dirt trails, offers a gentler run that reduces impact, you need to be careful of uneven ground, slippery spots and objects you could trip over.

“We know that running-related injuries increase the risk of arthritis and joint damage,” she adds.

Is running on a treadmill bad for your knees?

No, a treadmill isn’t bad for your knees. A treadmill is pretty easy on your joints because it’s flat, cushioned and free of obstacles.

“A treadmill can be great because you can run when the weather is bad or you don’t have access to a good outdoor route,” says Dr. Rex. “You can also control your pace and incline. But treadmills can be boring because there’s no change of scenery.”

She also cautions that if you’re training for a race, a treadmill isn’t a good choice. It’s best to train on the surface you’ll be racing on so your body can get used to it.

Is running on concrete bad for your knees?

“Asphalt and concrete are solid and predictable. And these surfaces are everywhere, so they’re convenient,” says Dr. Rex. “But they’re very hard, which means more impact on your joints and possible injury due to those forces.”

She advises building more rest time between runs on very hard surfaces, allowing your knee cartilage to recover. “Someone who’s younger may be able to run consecutive days on concrete and not feel pain,” she continues. “But someone who’s older or has arthritis may find they need more rest days.”

Is running every day bad for your knees?

“It really depends on you and the condition of your joints and body,” she clarifies. Running every day isn’t bad if your joints are healthy and you’re not trying to push through injuries. Always listen to your body rather than forcing yourself to stick to a strict running schedule.

How to protect your knees while running

Whether you’re training for a marathon or just getting started with running, take steps to give your knees some extra love.

Dr. Rex suggests six tips:

1. Wear the right shoes

Running shoes are the most important piece of equipment for protecting your bones and joints. Your shoes act as shock absorbers for your body, but they wear out over time and lose their ability to absorb the impact of running.

“I usually tell people to replace their running shoes every 300 to 500 miles,” she says. “It’s also important to pick the right type of shoe. I recommend going to a running specialty store to get expert help.”

2. Rest and recover between runs

“Runners with arthritis require a longer recovery time to allow for knee cartilage recovery,” Dr. Rex states. So, if you already have arthritis and you’re not taking enough rest time between runs, you could be setting yourself up for more joint pain and damage.

Even if you’re in great condition, uninjured and free of arthritis, rest days help prevent problems down the road. Also, make sure to get plenty of sleep — that’s when your body makes repairs.

3. Try knee braces

“For people with knee arthritis, I recommend trying some lightweight knee braces,” says Dr. Rex. “Braces may allow you to tolerate more running and even decrease the time needed to recover between runs.”

A sports medicine physician or physical therapist can help you find the right type of knee brace.

4. Don’t go too hard, too fast

To help avoid injuries, don’t increase your mileage or intensity too quickly. Dr. Rex recommends limiting distance and duration increases to no more than 10% per week.

She also cautions against transitioning from treadmill to outdoor running too quickly. Go slowly and give your body time to adjust to different surfaces.

5. Fuel your body well

“You need to give your body the right nutrition to perform exercise such as running,” emphasizes Dr. Rex. “If you’re a serious runner, I highly recommend working with a sports nutritionist to make sure you’re getting enough calories and nutrients to help your body and joints recover.”

6. Focus on flexibility and strength

Working on your flexibility and strength can help prevent injuries. But if you do get injured, don’t just rest.

“Ideally, you should be working with a sports medicine specialist to correct whatever caused the injury,” says Dr. Rex. “That may mean correcting a muscle weakness, reducing muscle tightness or working on your form.”

She also recommends cross-training to balance out your running routine. “Try strength training, yoga or other activities on your rest days.” These activities may also help you reduce your risk of arthritis. And try exercises and stretches to ease knee pain (runner’s knee).

Take steps to prevent injuries and avoid falls. And care for your body when you’re not running. This way, you’ll be able to keep logging miles for years to come.

You tuck into a full plate, excited and overwhelmed by all the wonderful food at your fingertips. Thank goodness you wore your stretchy pants — you’re going to need them.

Whether you clean your plate or leave a few forkfuls of Brussels sprouts behind, it doesn’t take long before you start to crash. You’re sleepy, sluggish, lethargic and feel like you can’t eat another bite (but wait, there’s three kinds of pumpkin pie, a pecan pie and Grandma’s cookies). Yikes.

Many of us attribute this sloth-like feeling to turkey (and more specifically, to tryptophan). But is that really true? Could other habits and behaviors also account for why we pass out on the couch after a big meal?

Registered dietitian Julia Zumpano, RD, LD, explains why turkey is just part of the recipe to feeling sleepy on Thanksgiving.

Does turkey make you sleepy?

Tryptophan is known to cause drowsiness — and it can be found in turkey.

A serving size of turkey, which is about 3 ounces, contains anywhere between 250 milligrams to 300 milligrams of tryptophan.

So, what is tryptophan exactly? It’s an essential amino acid that’s used to make proteins. And you can only get tryptophan from the foods you eat.

Turkey isn’t the only food with tryptophan. Other foods that contain it include:

• Milk.
• Eggs whites.
• Chicken.
• Fish.
• Canned tuna.
• Oats.
• Cheese.
• Sunflower seeds.
• Peanuts.
• Pumpkin seeds.
• Sesame seeds.
• Soybeans.

A key point of clarification, though? You’d have to eat a lot of these foods — including turkey — to feel drowsy.

So, why do you feel sleepy after Thanksgiving dinner or another big meal? You need to look at the whole picture.

“You might feel mildly tired after eating turkey,” says Zumpano. “But the tryptophan is not the only reason.”

Other reasons why you may feel sleepy after eating Thanksgiving dinner

Eating turkey is just one piece of the drowsiness puzzle when you eat a big meal like a turkey dinner. Here are some other reasons why you may feel sleepy after Thanksgiving dinner:

You eat too much

You probably tend to overeat during Thanksgiving dinner. And consider the types of foods you’re eating, says Zumpano.

“The meal typically contains large amounts of carbs (stuffing, potatoes, pie, desserts, rolls), which can spike your blood sugar initially,” she continues. “But then, your blood sugar levels crash or decrease, which leaves you feeling lethargic.”

Your body increases blood flow to your stomach

To handle the large amount of food in your stomach, there’s a change in your blood circulation.

“Your bowels need more blood to digest the large meal, which may lead to less blood to your brain causing you to feel less alert,” explains Zumpano.

You may have had a few alcoholic drinks

You don’t just have to contend with all the delicious food options. You may also feel like having a cocktail, glass of wine or beer with your meal.

“When you’re adding alcohol in the mix, that’s going to make you feel that more lethargic, more relaxed feeling on top of a big heavy meal,” Zumpano adds.

How to avoid drowsiness after eating a big meal

What can you do to combat that post-meal crash? Zumpano shares a few tips:

• Eat smaller portions. It’s OK to indulge in all your Turkey Day favorites, but eating a smaller amount of food can help you avoid feeling tired afterward.
• Limit alcohol. You’re in a celebratory mood — and that may mean you want to have an alcoholic drink (or two or three) with your friends and family. Zumpano says it’s a good idea to limit how much you drink and to make sure you’re drinking water throughout the meal (and day), too.
• Slow down. With all those yummy choices, you may tend to eat quickly. But Zumpano advises to slow down and enjoy the food you’re eating. Try eating with your nondominant hand, which can really help you slow down.
• Stop eating once full. Are your eyes bigger than your stomach? If so, that’s OK. You may feel like you need to eat every last morsel on your plate. But Zumpano says that you shouldn’t force it. In fact, pay attention to how long you’ve been eating and when you reach the 10- to 15-minute mark, take a moment to assess how you’re feeling. If you feel full, then stop eating. Try using a smaller plate or filling your plate with vegetables first, as those don’t tend to be as filling — that will leave less room for the meat and carbs.
• Talk a walk. It’s probably the last thing you feel like doing, but going for a walk around the neighborhood (or any form of exercise like a Turkey Trot race) can help your digestive system work through that heavy meal you just ate. Plus, activity will keep you alert and increase your energy.
• Get a good night’s sleep the night before. The holidays, while fun, can be stressful. You have to make dinner, clean the house, entertain out-of-town guests and deal with any family drama. Zumpano says all those factors can lead to a lack of sleep. “It’s important to get enough rest, because that’s also going to increase the effects of the meal if you’re already tired to begin with,” she explains. “And it may also lead to you making poor decisions when it comes to eating.”

Give thanks!

It can be tempting to load up your plate with all Thanksgiving dinner has to offer. But if you don’t like how you feel afterward, remember that you’re in control.

“If it’s a part of Thanksgiving that you don’t particularly enjoy, know that you can change the outcome,” encourages Zumpano. “You can take steps like watching how much you eat and drink exercising and getting enough sleep beforehand.”

Ob/Gyn and menopause specialist Stephen Livingston, MD, explains how HRT might improve your menopause experience and what current research says about its possible cancer risks.

How does HRT help menopause symptoms?

Women and people assigned female at birth (AFAB) have two main sex hormones — estrogen and progesterone. This duo makes ovulation and menstruation possible.

Your hormone levels start to change in perimenopause, about eight to 10 years before menopause. When your estrogen starts to drop, it throws off the balance of estrogen and progesterone in your body. That’s when you may start to experience symptoms, while still having menstrual cycles. Then, when you reach menopause (typically around age 52), your body makes such a small amount of estrogen that your ovaries stop releasing eggs — and you stop having periods entirely.

For some people, hormone fluctuations can feel like a rollercoaster. Menopause symptoms can include:

• Frequent urges to pee.
• Hot flashes.
• Insomnia.
• Mood swings.
• Night sweats.
• Pain during sex.
• Vaginal dryness.

“The goal of HRT is to replace estrogen lost in menopause,” Dr. Livingston explains. “While the goal isn’t necessarily to eliminate 100% of your symptoms, HRT can significantly help most people with the majority of their menopause symptoms.”

There are two main types of hormone replacement therapy. The type you use depends on whether you have a uterus:

1. If you have a uterus: Your provider will prescribe estrogen progesterone/progestin hormone therapy (EPT). This HRT contains both estrogen and progesterone or progestin (a manmade form of progesterone). It’s also called combination therapy.
2. If you no longer have a uterus: Your provider will prescribe therapy that contains only estrogen. It usually comes in a pill or patch but is also available as a cream, vaginal ring, gel or spray.

Can hormone replacement therapy cause cancer?

Any risk is thought to be minimal. So, why is this such a hot topic? The debate about hormone replacement therapy goes back to the Women’s Health Initiative, a large study released in the early 2000s.

“That seems to be where the identification of a risk first occurred,” Dr. Livingston says. “Since then, though, additional studies and analysis have shed more light on the real risks of HRT. Not only is the cancer risk associated with HRT minimal, but HRT can even help reduce the risk of certain cancers in some people.”

Dr. Livingston explains the latest research on HRT and the risk of certain types of cancer.

Breast cancer and HRT

“While there does appear to be a very small risk of breast cancer from taking estrogen and progesterone/progestin therapy, it’s about 1 in 1,000 cases,” he notes. While this slightly increased risk might sound worrisome, he says recent data suggests no increase in mortality, and this cancer is typically treatable.

There’s even some good news for women who’ve had a hysterectomy and are taking estrogen-only HRT. With this HRT regimen, the rate of breast cancer is actually less than for those not taking HRT.

The bottom line? “The risk is not zero, but the risk of developing breast cancer from HRT is very low,” Dr. Livingston says.

Colon cancer and HRT

No matter which type of HRT you’re on, recent studies show a nearly 40% reduction in cases of colon cancer in post-menopausal people who take hormone replacement therapy.

Ovarian cancer and HRT

“The jury is still out here,” Dr. Livingston says. “While some studies point to a minor increase in the risk of ovarian cancer with HRT, the evidence isn’t conclusive.”

There are also studies that suggest estrogen therapy might improve the survival of people who’ve already been diagnosed and treated for ovarian cancer.

“With ovarian cancer, overall I’d say that any pluses or minuses seem to balance out,” he adds.

Is HRT right for you?

If menopause symptoms are affecting your ability to enjoy life, HRT might be the answer you’ve been looking for.

“In our evolution as menopause practitioners since the Women’s Health Initiative, we have determined the safest types of HRT and the safest ways to administer them to you,” Dr. Livingston reassures.

But most importantly, HRT is about you.

“It’s not just about what the lab tests show us,” he continues. “We want to hear how you’re doing. When we prescribe hormone replacement therapy, our goal is to help you feel and function much like you did before menopause.”

“The most important thing is to stay calm,” says pediatrician Noah Schwartz, MD. “It’s OK to put your baby down in a safe place and take a few minutes to catch your breath. With a cooler head, you’ll be better able to figure out what they’re trying to tell you.”

Why do babies cry so much?

Crying is your little one’s main way of telling you they need something. But what they need isn’t always obvious.

As your baby grows, you’ll get to know their specific sounds and what they mean. But those first three to four months can be challenging.

Dr. Schwartz recommends parents of newborns use a checklist to help find out what’s wrong. That checklist includes these seven common scenarios:

1. Hunger

During the first few months, newborns eat every one to three hours. These feedings will space out as they get older and can take in larger amounts of food.

Besides crying, babies have other ways of showing hunger, too. They may:

• Chew on their hand.
• Smack their lips.
• Move their head toward a touch on their cheek (rooting).

These are all helpful behaviors to look out for as signs your baby could benefit from a feeding.

2. Dirty diaper

Life with a newborn is a constant cycle of feeding and changing diapers. A full diaper can irritate their skin and lead to crying, says Dr. Schwartz. Changing your baby’s diaper whenever it’s wet or soiled can keep your baby comfortable and prevent a painful diaper rash.

3. Too hot or too cold

Feeling hot or cold can be uncomfortable for anyone, including babies. If your newborn won’t stop crying, look for signs they’re cold or overheated:

• Check for warmer-than-normal skin on their chest or the back of their neck.
• Touch their nose or ears to feel if they’re cold.

Adding an extra layer or putting on a lighter outfit are easy fixes. For safe sleep, avoid loose blankets or sheets in their crib. The best sleeping temperature for babies is 65 to 70 degrees Fahrenheit (18 to 21 degrees Celsius).

If your baby’s temperature is greater than 100.4 F (38 C) or lower than 95 F (35 C), call your healthcare provider or seek medical care right away.

4. Fatigue

Babies are often fussy because they’re tired. Newborns sleep up to 20 hours a day, but they may need help falling asleep. During the first few months, it’s OK to soothe your baby to sleep whenever they need it. Try swaddling, rocking or holding them skin-to-skin to ease them into dreamland, then place them on their back in their crib.

As your baby adjusts to the world around them and the routine of day and night, their sleep will become more regular. At about four months, Dr. Schwartz recommends thinking about sleep training.

“Sleep training helps teach your baby to self-soothe and put themselves to sleep,” he explains. “It includes several different techniques, including the ‘cry it out’ approach or the preferred ‘check and console’ method. The result is a step toward independence for your baby and more sleep for you.”

5. Gas

Gas can build up in your baby’s tummy, causing pain, bloating and, you guessed it, crying. In addition to being extra fussy, gassy babies may:

• Make a face.
• Pull their legs to their chest.
• Squirm their body.
• Strain as though they’re having a bowel movement.

Some babies make more gas than others. If your baby is showing signs of discomfort, you can help them out. One of the best gas-relieving strategies is to place them on their back and bicycle their legs gently. You can also try a warm bath or over-the-counter simethicone gas drops, although the effectiveness of gas drops varies.

6. Food sensitivities

Food allergies are reactions of your immune system to certain foods. They’re rare in babies and typically don’t show up until they start eating solid food.

But food sensitivities or intolerance can happen in babies. A food intolerance is a digestive problem. It occurs when your baby can’t break down molecules that get into your breast milk from the food you eat. Symptoms of food intolerance in babies include:

• Bloody stools (poop).
• Diarrhea.
• Gas.
• Poor weight gain.

Cow’s milk and soy are the most common causes of food intolerance.

“If you suspect a food intolerance, talk to your baby’s provider before making any dietary changes,” advises Dr. Schwartz.

7. Colic

Colic causes excessive crying for no apparent reason. If your baby meets these three criteria, they may have colic:

• Crying more than three hours (nonstop) per day.
• Crying for at least three days per week.
• Crying for more than three weeks.

Colicky crying usually occurs in the late afternoon and evening and doesn’t respond to soothing. It often starts at about three weeks and usually stops by three months. This period of crying can be difficult for parents and increases the risk of shaken baby syndrome.

It’s normal to feel frustrated by your baby’s crying. If it becomes overwhelming:

• Put your baby in a safe place.
• Walk away and calm down.
• Remind yourself that this phase will end.
• Ask a family member or friend to give you a break.
• Talk to your healthcare provider.

How to get your baby to stop crying

Is there a surefire way to calm a crying baby? Unfortunately, no. Every baby is different, and what works for one may not work for another. But you can always try these strategies to see which ones are helpful in getting your baby to calm down:

• Check if they’re hungry, tired, hot, cold or need a diaper change.
• Give them a warm bath.
• Take them for a walk or ride in the car.
• Offer a pacifier (for breastfed or chestfed babies, wait until after breastfeeding is well established to introduce a pacifier).
• Reduce overstimulation by moving your baby to a quiet area, placing them in their crib or putting on white noise.
• Soothe them with skin-to-skin contact, swaddling, rocking, walking or singing.

My baby won’t stop crying, and I’ve tried everything

If you’ve tried everything and your baby is still fussy, Dr. Schwartz recommends a head-to-toe check. Look for areas of redness, irritation, injury or a piece of hair wrapped around a finger, toe or other appendage. When in doubt, call your healthcare provider.

“I always encourage families to make an appointment whenever something seems off,” says Dr. Schwartz. “Your provider can check your baby. If nothing is wrong, you can go home reassured that their crying is not due to a health concern.”

Other reasons to call your doctor right away include:

• Bloody stools or stool changes (diarrhea or constipation).
• Excessive spitting up or vomiting.
• Fever of 100.4 F or higher (38 C or higher).
• Not eating or drinking.

If your baby cries a lot, know that it will get better as they get older. And the reasons why your baby is crying will become clearer. So, try to take a breath, give yourself a break when you need to and rest assured that you can do this given a little time and familiarity.

In most cases, the spell or potion doesn’t last long, and these folktales leave us with a cautionary message: Love, in excess, can become harmful. Rather than be consumed, it’s better to strive for a healthy, balanced relationship where love is reciprocated.

In real life, we navigate love in different ways by going on dating apps, managing the odds of being ghosted or dodging love bombs. But can a passion for someone else actually become addictive? While there’s no definitive research on this topic, psychologists do point out that love — or the pursuit of it — can be the root of other issues like anxiety, depression and unhealthy relationship patterns.

In other words, if you feel like love can make you obsessive, you’re not alone. Real-life love can be complicated stuff — and it’s never as simple as waiting for the love potion to wear off.

Postdoctoral psychology fellow Gina Gerardo, PhD, talks us through “love addiction” and how you can strengthen your relationship with love.

What is love addiction?

There’s no precise definition for love addiction because it’s not an actual condition as much as it is an abstract concept. After all, you can’t really test love in a lab and see how someone reacts.

But as some research has explored, you can make note of how relationships affect our lives, both physically and mentally. A 2023 review described love addiction — sometimes called relationship addiction or obsessive love disorder — as an overwhelming and compulsive longing for love, attention and affection from others.

It can look like developing feelings toward specific people in an unhealthy or extreme way, or as constantly seeking out romantic partners. 

While love addiction isn’t an official diagnosis in the Diagnostic And Statistical Manual of Mental Disorders (DSM), Dr. Gerardo points out that the term can help define certain relationship problems or emotional issues you could experience.

“If someone finds that love is becoming particularly distressing or disruptive to their lives, it’s worth asking more about it and potentially treating,” she explains. That means while you might never get a diagnosis for love addiction, you can treat the associated behaviors.

In fact, love addiction may not always come across with the behaviors typically associated with addiction. It can also go hand-in-hand with a mood disorder, an obsessive-compulsive disorder or even an impulse-control disorder. 

Signs and symptoms of love addiction

If you’re a fan of love songs and romance novels, you may have an idea in your head of the symptoms of love addiction: Feeling empty when the person isn’t there, having to be in touch with the person constantly, having an overwhelming physical reaction when the person is in the room.

And, according to the current research, that’s not too far off.

“One distinction from other types of addictions is that there’s a love object,” clarifies Dr. Gerardo. “As opposed to a substance that people feel is addictive or find that they are dependent on, this would be an object, whether that’s a person or something else, they start to become obsessed with.”

For example, a 2023 study examined how love addiction and unhealthy attachments between adults can lead to intense negative emotions and feelings of low self-worth. 

Another study from 2010 study found similarities between extreme passion and substance dependence — from feelings of euphoria when near one’s love object to a negative mood and sleep disturbances when separated.

Symptoms of love addiction can include: 

• Obsessive thoughts. Feeling constantly preoccupied with thoughts of love and romance or the object of your affection. This becomes obsessive when it’s challenging to focus on other aspects of your life.
• Fear of abandonment. An intense fear of being alone or abandoned, leading to clinging behavior and a constant need for reassurance. You may also experience a sort of “withdrawal” or intrusive thoughts when the significant other isn’t around.
• Unhealthy relationship patterns. Repeating cycles of intense, short-lived relationships or staying in toxic relationships despite obvious red flags.
• Neglecting self-care. Prioritizing the needs and desires of the partner over personal well-being and neglecting your own goals, interests and needs. 
• Emotional turmoil. Experiencing highs and lows depending on the state of the current relationship. “You may feel a euphoric feeling that is more than what is normally experienced in romantic relationships,” says Dr. Gerardo. 

How love addiction impacts your well-being

When it comes to matters of the heart, it can be difficult to recognize when the love in your life is doing more harm than good. 

While symptoms of love addiction can weave into other mental health disorders, they can also magnify existing problems. Some mental health issues associated with love addiction include: 

• Anxiety. 
• Depression. 
• Low self-esteem.
• Sleep disturbances.
• Codependency. 
• Eating disorders. 
• Borderline personality disorder (BPD). 

Dr. Gerardo also warns of love addiction affecting your day-to-day life.

“If it’s harming your other relationships with friends and family or if it’s keeping you from other responsibilities like work, taking care of children, keeping up with bills or medical appointments, that’s a sign that there could be a problem,” she says.

How to get help

When dealing with love addiction, you might consider quitting cold turkey, swearing off love and moving to the woods alone. But just like other addictions, an obsessive need for love should be treated with care.

Plus, love is something that’s very important to make us feel fulfilled in our lives. Rather than trying to let it go completely, you can work to find a healthy balance.

Some coping strategies that Dr. Gerardo suggests include:

Open communication

As symptoms of love addiction will usually involve another person, communication is key when it comes to resolving any issues you may be having. You might realize that you’ve been avoiding communicating because of fear or anxiety — but having an open dialogue about your feelings can ultimately bring clarity to your relationship. 

“This includes communication with the partner, with yourself and even with friends and family before entering a relationship,” explains Dr. Gerardo. 

Specifically with a partner, it’s good to be honest with some of the complicated feelings you’ve been having. This can help you feel more open about what you’re feeling and can clue them into what you might be working through and why.

For example, maybe to deal with feelings of love addiction, you decide to spend more time alone. Communicating this change in your behavior with your partner so they know what your motivations are can help maintain a healthy bond. And if you’re having trouble putting your emotions into words, couples counseling can also be a good option. 

Seek other perspectives

One common red flag of any relationship — romantic or otherwise — is if it puts blinders on you from the rest of the world. When this happens, it can be hard to notice any problems or toxic behaviors. Dr. Gerardo recommends popping this “love bubble” by seeking out people in your life to get their points of view.

“If your friends and family notice that these problems are persisting for a long period of time and are getting in the way of all your normal responsibilities and behaviors, then that would be a cue to pump the brakes and communicate your needs with your partner,” she says. 

Therapy and counseling

Individual or group therapy can help address underlying issues and learn healthier relationship patterns.

If you feel like love addiction might be affecting your personal health or the health of your relationship, talking with a therapist can help you work through your concerns. A session with a couples counselor or some other kind of group therapy can also help get you and your partner to a healthier and more balanced place. 

The bottom line

An addiction to love can definitely have an effect on your well-being. If you find yourself completely engrossed by someone and something to the point that it’s affecting how you eat, sleep or react to stressful situations, it might be time to assess your relationship with love. With focus, outside perspectives and counseling, there are ways to find peace with feelings of love and turn them into a more positive force in your life.

You’ve upped your nutritional game! Soaking up your vitamins and minerals with every sip! 

Unfortunately, the celebration isn’t quite merited. 

Yes, juicing can up your intake of certain nutrients. And that’s something you can feel good about. But when you squeeze juice from produce, you leave behind some important stuff, too. And your sugar intake? Sky high. 

We talked with registered dietitian Natalie Romito, RD, LD, about what you’re getting (and missing) when you’re juicing.   

What is juicing? 

Turning fruits and vegetables into drinks isn’t a new idea. Some reports say people have been making and consuming juice for hundreds, if not thousands, of years. 

But it wasn’t until the 1990s that juice bars and home juicers started becoming more and more mainstream. Ill-advised juice cleanses started sprouting up. And around that same time, smoothies started taking off, too. 

And while both smoothies and juices remain popular today, nutritionally, there’s a difference.  

Smoothies are made in blenders, which break food down to the point where you can drink it through a straw. Juicers, on the other hand, extract liquid from fruits and vegetables. 

“When you make a smoothie, whatever goes into the blender comes out in your drink,” Romito explains. “But with juicing, the pulp gets removed.”  

And the pulp matters. Because what you wind up throwing away or composting contains important nutrients that your body could use. 

Is juicing healthy? 

Juice is, by some measures, a healthy choice in moderation. But it’s not the best choice you could make.  

“It’s a question of healthier than what?” Romito points out. “Juice is going to be a healthier choice than drinking, say, a soda. But it’s not as healthy as eating fruits and veggies in their natural form.” 

Romito explains why that is. 

Benefits of juicing 

Typically, what you get when juicing fruits and vegetables is a good amount of the food’s vitamins, minerals, antioxidants, polyphenols and other compounds that your body loves. Not all of them, but some at least. More on that in a bit.

So, depending on what foods you put in the juicer, you can increase your intake of things like vitamin C, vitamin K, folic acid, magnesium and other good-for-you stuff. 

“If the food’s color is translating into your juice, you can feel good that you’re getting some of the antioxidants and vitamins that your fruits and vegetables have naturally,” Romito notes. 

Some people will tell you, too, that drinking juice, rather than eating whole fruits and veggies, allows your body to better absorb those nutrients. That may be true of some foods, Romito acknowledges. When you break down the cell walls of certain plant-based foods — either from things like juicing or cooking them — you can absorb some nutrients a little better. 

But Romito says the potential benefit of better absorption doesn’t outweigh what you’re losing out on when you juice. 

Drawbacks of juicing 

Even though your juice may be high in vitamin content, that’s not the full story.  

Romito explains the downsides of juicing. 

Removes fiber 

Remember the pulpy leftovers that juicers make? It’s full of fiber. And fiber makes a big difference in the health content of your foods and drinks. 

Some of your food’s polyphenols and antioxidants are wrapped up in that fiber. So, when you remove the fiber, you lose out on some of those nutrients. 

Also, fiber is important for making you feel full. And it helps with digestion, lowering cholesterol and stabilizing your blood sugar.  

“Fiber is important for our bodies in a lot of ways. But when you’re juicing, you remove fiber from the food. That changes the way the natural sugars in that food work in your body. So, something like apple juice is much more likely to have a big effect on your blood sugar than eating a whole apple would,” Romito explains.  

Here’s why. 

In their natural form, fruits are chock full of natural sugars. And for most people, natural sugars from whole foods don’t cause spikes in your blood sugar in the way that refined sugars do.  

That’s because the sugar in fruit is all wrapped up in fiber. Your body doesn’t digest fiber, so the majority of those sugars don’t get absorbed in your bloodstream.

Strip out the fiber, though, and the sugar content from the fruit acts more like refined sugar in your body. You get sugar rushes. Sugar crashes. Sugar cravings. And for people with diabetes, the sugar overload can be dangerous. 

What’s more, fiber helps your body feel full. When you drink juice, it doesn’t help to fill your belly like eating whole food would. So, you risk overeating.

Serving size troubles 

The average person should aim for three to four servings of fruit and at least three servings of vegetables per day. One serving is typically considered to be: 

• A cup of fruit: One apple, one small banana, eight strawberries or 16 grapes. 
• A half cup of cooked vegetables: Half of a small sweet potato or a small ear of corn. 
• A cup of raw vegetables: Half of a bell pepper, six broccoli florets or six baby carrots. 

When you juice fruits and vegetables, you can easily wind up taking in a whole lot more.  

Consider this: 12 ounces of apple juice or cider has about the same calories and sugar as eating three small apples. But the juice has virtually no fiber. So, your body will absorb the sugar from those apples much more quickly. The result? You’ll be hungrier faster than if you ate the apples themselves. 

“Juicing makes it a lot easier to overconsume,” Romito says. “Most people will naturally moderate their fruit intake when they eat whole foods because they get tired of chewing it and the fruit’s fiber fills them up.”  

Most people probably aren’t going to eat three or four apples in a row, too. Or munch their way through a whole bag of carrots in one sitting. Your jaw would be begging for a break by then. But it’s really easy to drink the equivalent amount — and more — in juice. And still be hungry after. 

“You wind up taking in more sugars and more calories when you’re having a juice form versus when you’re having the whole food form,” Romito emphasizes. “When you don’t have to chew food, you’re bypassing your body’s natural mechanisms that help regulate your eating.” 

Tips for healthier juicing 

If you want to include some juice here and there, that’s probably OK for most people. Just know that it shouldn’t be your primary method for including fruits and veggies in your diet.  

Romito offers these tips for healthier juicing: 

• Include fresh vegetables, not just fruit, in your juice. That will help cut down the sugar content. 
• Choose juice that doesn’t include added sugar and dilute your juice with water to help with portion control (aim for a 50-50 juice-to-water ratio).  
• If you’re making your own juice or drinking unpasteurized juice from the store, plan to drink it fast, as leftover juice can breed bacteria and lead to foodborne illness.  
• People who are at a higher risk for foodborne illness shouldn’t drink unpasteurized juice. That includes children, people who are pregnant and people who are immunocompromised. 
• Keep your servings small, closer to the serving size you’d have of the whole food, particularly for fruits. For example, the American Heart Association considers 1/4 cup of fruit juice as equivalent to one serving of fruit. And 1/2 cup of vegetable juice is considered one serving of vegetables. 

Fruits and vegetables that are as close to their natural form as possible are always going to be the healthier choice. And while sipping on some juice can be a yummy way to get in some vitamins and minerals, just remember that it shouldn’t be your primary source of fruits and veggies in your diet.  

But when most people think about wearing a bra, “comfort” is not the first thing that comes to mind — it may not even make the Top 10. So, why would someone consider sleeping in a bra?

Breast surgical oncologist Margaret Thompson, MD, explains the upsides and downsides of wearing a bra while you snooze.

Should you sleep in a bra?

Several factors may affect your decision to wear a bra to bed, but Dr. Thompson emphasizes that the risk of breast cancer is not one of them.

“There’s no evidence that wearing a bra — or not wearing a bra — while sleeping increases your risk for breast cancer,” she states. “It really comes down to comfort and personal preference.”

But there are other health issues to consider. Dr. Thompson lays out the pros and cons of sleeping in a bra:

Pros: Why sleeping in a bra might be good for you

There are some benefits to sleeping in a bra, especially if you’re recovering from surgery or breastfeeding (chestfeeding). Dr. Thompson lists six potential benefits of wearing a bra while you sleep:

1. Lessens breast pain

According to the Sleep Foundation, 1 in 3 people with breast pain (mastalgia) find that it interferes with sleep. Having the support of a bra may help.

In fact, up to 70% of women or people assigned female at birth (AFAB) in the United States experience breast pain at some point. Common causes of breast pain include:

• Hormonal changes, which often occur as part of your menstrual cycle.
• Locally advanced breast cancer, including inflammatory breast cancer, which accounts for 5% of all breast cancers.
• Lactation (producing milk), which may cause breasts to ache.
• Large breasts, which may strain breast ligaments and tissue.
• Recent surgery related to your heart or breasts.
• Underwire, especially if the bra is too tight.

“When somebody reports breast pain, one of the first things we ask is whether they wear an underwire bra,” says Dr. Thompson. “It can dig into your skin or breast tissue, leaving you sore and tender.”

But whether your tender breasts result from hormones or underwire — or you’re not sure what’s causing your breast pain — a soft sleep bra can keep your breasts from moving around and causing discomfort while you sleep.

2. Protects lactating breasts

Lactation can cause significant changes to your breasts. And let’s face it — your mammary glands don’t care if you’re trying to get some rest. Swollen or full breasts can be painful, especially as you move during sleep or change positions. Wearing a supportive bra while sleeping:

• Holds nursing pads in place.
• Keeps nipples clean and free from bacteria.
• Reduces nipple chafing.
• Supports the structure of your breasts.

Make sure your sleep bra is supportive but not too tight. Wearing a bra that’s too tight while breastfeeding can reduce your milk production and possibly lead to clogged milk ducts and mastitis — inflammation of the breast tissue.

3. Prevents fungal infections

Everyone loves to be warm and cozy in bed. But do you know what else loves a warm environment? Fungal infections.

“There’s a lot of skin-on-skin contact, especially underneath the breast,” notes Dr. Thompson. “When you’ve got that contact, particularly when you’re covered with blankets and possibly sweating, it’s the perfect environment for fungal or yeast infections.”

Wearing a bra to bed helps absorb moisture beneath your breasts and reduce friction. Dr. Thompson adds that even a camisole with a built-in shelf bra should do the trick.

4. Reduces nipple irritation

Friction is a common reason for nipple pain — ask any avid runner. While you may not be running a marathon as you sleep, your nipples can get sore by rubbing against:

• Tight shirts, especially if they’re textured or have a graphic design that can be felt inside the shirt.
• Fabric of your pajama top or sheets (if you prefer to sleep naked).
• Sleep bra that’s too loose and moves around.

“Some people wake up with sensitive or painful nipples and no obvious explanation,” says Dr. Thompson. “But you need to think about what’s touching your nipples while you sleep.”

She recommends wearing a fitted, but not tight, sleep bra constructed out of silky material.

5. Helps with recovery after surgery

It’s important to keep your breasts compressed after certain surgeries. Restricting their movement after cardiac surgery protects stitches and incisions. After any type of breast surgery (including breast reduction surgery), compression can help:

• Decrease fluid collection.
• Minimize pain.
• Hold gauze and drains in place.

“Most cardiac and breast surgeons want patients to wear a bra for some time after surgery, even while sleeping,” emphasizes Dr. Thompson. “Always follow your surgeon’s advice.”

6. Diminishes stretch marks

Stretch marks happen when your skin expands or shrinks quickly. When those sudden changes occur, your skin’s collagen and elastin (skin’s support system) may break. As your skin heals, those breaks can scar and become stretch marks.

Stretch marks on breasts are common — especially if your breasts change size during pregnancy. Bras support your skin’s structure, which helps prevent stretch marks.

“There’s no proof that wearing a bra during the day or at night will decrease breast sagginess,” Dr. Thompson says. “But it may help to decrease stretch marks.”

Cons: Why it’s bad to sleep with a bra on

Looking for a reason to sleep without strapping on a bra? Dr. Thompson points out a few potential disadvantages of sleeping in a bra:

1. Causes skin irritation and infection

A sleep bra can protect your skin from irritation and infection. But it can also lead to those issues if your sleep bra is:

• Dirty and possibly full of bacteria.
• Tight or contains underwire, which can cause ridges in your skin and chafing.
• Too big, causing it to rub against your breasts and nipples.

“Whenever there’s skin irritation, it causes tiny breaks in the skin’s surface,” explains Dr. Thompson. “If your bra is dirty, bacteria can enter through a break in your skin and lead to infection.”

2. Restricts circulation

Wearing a bra can feel restricting at any time of day. But wearing a poorly fitted bra that’s too snug or has wire may keep you from breathing easy while you sleep.

“Bras that are too tight or contain underwire may cause you to wake up with some discomfort,” reiterates Dr. Thompson. “Those bras can decrease some of your circulation for the entire time you’ve been sleeping. So, be careful when choosing your sleep bra.”

Tips for wearing a bra to bed

If you decide to sleep in a bra, choose one that’s comfortable and fits well — not too tight, not too loose. Purchase new bras whenever your breast size changes. Measure yourself to determine your bra size or ask the fitter at your lingerie store for help finding the right size.

For the best experience with your sleep bra, Dr. Thompson recommends:

• Choose a gentle fabric. Avoid lace or scratchy fabrics that may be rough on your nipples. Choose a natural material like cotton or something silky and soft.
• Consider a shelf bra. Some camisoles and tank tops have a built-in shelf bra that may help you feel supported while sleeping.
• Skip the underwire. Underwire can restrict circulation and cause pain while you sleep.
• Wear a clean bra. Don’t wear a bra you’ve worn all day, and wash your sleep bras regularly — after every two or three wears.

Your schedule is jam-packed with school drop-off, work meetings, after-school activities and everything in between, making it hard to sit down to a meal consistently day after day.

Does the time of day that you eat meals factor into your overall health and wellness? And if so, what’s the best time to eat dinner? What about breakfast and lunch?

“Our schedules make it challenging to eat dinner at a reasonable time,” recognizes registered dietitian Julia Zumpano, RD, LD. “And it’s leaving us scrambling for what to eat and what we can grab on the go. In some cases, it can lead to disordered eating patterns.”

Zumpano provides us with some guidance on the best time to eat dinner and other meals throughout your day.

What’s the best time to eat meals?

Zumpano says it’s a personal decision that depends on any medical conditions you might have, as well as your health and wellness goals.

A 2016 study shows that our eating patterns are varied and erratic. While you may like to have dinner on the table at 6 p.m., others may be eating a later supper or snack before bed.

Even if you have a habit of eating three square meals a day, a change can be enough to throw off your eating habits. For example, your kids could have a choir performance smack dab in the middle of dinner time or you’re behind at work and skip lunch, which may lead to you making unhealthy food choices later in the day (raise your hand if you’re guilty of a fast-food dinner run).

In fact, a 2022 study shows eating later in the day increases your risk for having obesity.

“The later we eat, the hungrier we get, which can often lead to quick and unhealthy meal options,” notes Zumpano. “If we plan ahead, we can have a healthy dinner ready or at least thought through an on-the-go meal, meaning that you made time to stop at the salad bar instead of the drive-thru.”

But if you’re looking for some guidance on when to eat throughout the day, Zumpano offers the following recommendations:

Breakfast

Not everyone is a breakfast person — and that’s OK. But if you do eat a morning meal, Zumpano suggests eating breakfast with the first hour to hour-and-a-half after you wake up.

And what type of breakfast should you eat? We think you know the answer (sorry, chocolate croissant). But it bears repeating.

“I recommend eating a protein-based breakfast. I’m a fan of egg whites with a turkey sausage or chicken sausage. I love cottage cheese or Greek yogurt for breakfast. I think they’re great sources of protein. Scrambled tofu is a great plant-based breakfast option,” advises Zumpano.

“Include fiber rich foods to your meal. So, if you’re going to have eggs, throw in some greens, sauteed veggies, black beans or salsa. If you’re going to have cottage cheese or Greek yogurt have some berries and nuts with it.”

She also stresses limiting or avoiding added sugars because they can lead to a spike in your blood sugar, then a drop, which causes you to search for more sugar for energy. Sugar is addictive for most people — if you start your day off with something sweet, you’ll fight that sugar craving all day long.

Lunch

A good rule of thumb that Zumpano likes to follow is to space your meals four to six hours apart.

And like breakfast, you want to focus on having a meal that mainly consists of fiber and protein. Think about a salad with grilled chicken and chickpeas or a hearty bowl of bean and vegetable soup with turkey meatballs. A whole-grain wrap, filled with cabbage slaw, avocado, edamame beans and tuna, is also a great option.

“A lunch filled with protein and fiber can help you over the 2 or 3 o’clock hump where energy levels tend to plummet,” says Zumpano. “If your meal is too high in carbohydrates, fat or sugar, that can leave you feeling sluggish.”

She adds that it’s more important to focus on what’s in your meal rather than when you’re eating your meal. In fact, she likes to have a larger lunch, rather than a bigger dinner.

“Some European countries focus on having a larger lunch and then a lighter dinner,” she shares. “European countries tend to have a lower incidence of disease and obesity when compared to Americans.”

Snacks in between

To snack or not to snack? You’re feeling hungry and all you want to eat are some potato chips or a candy bar to tide you over until your next meal. So, what do you do?

“Snacking is often unnecessary if you are eating enough at meals times,” says Zumpano. “But if you had a lighter meal, skipped a meal or didn’t have time to finish your meal, healthy snacks can help prevent overeating at the next meal for some people. Mindless snacking lead by cravings of salty or sweet often results in high amounts extra calories in the form of processed food.”

So, if you’re going to snack, snack smartly. Opt for a piece of fruit with a handful of nuts. And before you eat, Zumpano says to pay attention to your hunger cues. Are you snacking out of boredom? Or because you want a distraction from work?

If you determine you’re truly hungry, then have a healthy snack.

Dinner

While it can be hard to fit into your schedule, there’s something to be said about eating dinner earlier in the evening — at least three hours before your bedtime.

“An earlier dinner gives you a good amount of time to digest your food and allows your blood sugar to properly rise and fall after dinner,” Zumpano explains. “So, you’re not going to bed with a full belly or skyrocketing blood sugar. In fact, people who eat an earlier dinner often report better sleep.”

But she adds that if you must have a late dinner, there’s no need to stress.

“If you have to eat dinner later than you’d like, don’t be overly concerned with the timing,” she continues. “In that case, you want to make better choices on what you eat. And if you’re consistently going to eat late dinners, then consider making your lunch your largest meal that can carry you through to dinner. Then, choose a lighter dinner so you’re not overconsuming calories.”

Need a light dinner suggestion? Try a green salad with grilled fish, vegetable bean stew with lean meat, or a shrimp and veggie stir-fry. Pro tip? Stick to protein and vegetables, and keep it light in starch and fat especially when it’s getting close to bedtime.  

Another tip if you’re eating dinner later? Get moving to help speed up digestion.

“If you’re eating dinner and going straight to bed, that’s going to slow down the digestion process,” states Zumpano. “If you take a short 10- to 20-minute walk or do something active like clean the kitchen, vacuum or mop, or any moderate amount of movement is going to help with digestion.”

Should you try time-restricted eating?

You’ve probably heard of intermittent fasting or time-restricted eating. But how does it work?

“Time-restricted eating is when you shorten your eating window to anywhere between eight and 12 hours, meaning you’re only eating between eight and 12 hours for that day,” clarifies Zumpano. “And the rest of the time, you’re fasting from any food or beverage that has calories.”

So, should you try time-restricted eating? It depends on the person.

“If you’re interested in time-restricted eating, start with a 12-hour fast after dinner, so if you’re done with dinner by 7 p.m., avoid eating or drinking until 7 a.m. the next day. If that’s no big deal, begin to push breakfast an hour later until you find the eating window that works best for your body and schedule,” suggests Zumpano. “It’s important to give your body rest from eating but the food you choose to eat can play an even greater role in health.”

Bottom line?

When it comes to when and how you eat your meals throughout the day, there isn’t a one-size-fits-all approach.

“It really should be tailored and personalized to you,” Zumpano emphasizes. “The No. 1 thing you want to keep in mind is what you’re eating: Are you consuming enough protein and fiber at your meals? Are you snacking on whole foods? But the timing of those meals can vary based on you and your schedule.”

We talked to ophthalmologist Nicole Bajic, MD, about the kinds of lifestyle changes that make it easier — physically, mentally and emotionally — to live with diabetes-related macular degeneration. Changing longstanding habits isn’t easy, but if you’re experiencing vision loss, it’s totally worth it. In fact, some lucky people are even able regain some of their sight as a result of their efforts.

1. Get your health priorities in order

Vision loss is scary and — unlike some other diabetes complications — relatively easy to recognize. But if you’re experiencing DME, the chances are good it’s not the only thing that’s going on.

“It’s not just your eyes that are affected by diabetes,” Dr. Bajic says. “You may have trouble with your kidneys or your heart, or conditions like gum disease, erectile dysfunction or nerve damage.”

If you’re diagnosed with vision loss caused by DME, Dr. Bajic recommends immediately following up with your primary care provider.

“It’s important to make sure the most serious concerns are addressed first,” she continues. “After all, your eyes don’t work if your heart’s not beating.”

2. Connect with the right providers

Because diabetes can impact your body in so many different ways, it’s important that your health is monitored by a team of specialists.

Your primary care provider (PCP) is the team captain. Having a good relationship with them is key because they’ll make sure you’re getting your annual diabetes-related exams.

If you don’t have a PCP, you should get one as soon as possible.

“As an ophthalmologist, I often see patients who don’t have a primary care doctor. And they’re frequently kind of lost out at sea,” Dr. Bajic notes. If that’s your situation, let the ophthalmologist that diagnosed you with DME know. They may be able to recommend somebody.

In addition to PCPs and ophthalmologists, many people with diabetes see these specialists to prevent or treat complications:

• An endocrinologist.
• A Certified Diabetes Care and Education Specialist (CDCES).
• A low-vision specialist.
• A nutritionist or dietitian.
• A cardiologist.
• A podiatrist.
• A dentist.
• A urologist.

If you’re experiencing DME vision loss, Dr. Bajic strongly recommends working with a low-vision specialist or vision rehabilitation specialist.

“Low vision specialists don’t just help people who are legally blind,” she explains. “If you have significant (and chronic) vision loss that’s hindering your ability to do daily activities, that may warrant an evaluation, just to learn about all of your options. Researchers are always coming out with new ways to help people with vision problems. And if you’re having trouble, by all means use the resources that are there.”

3. Improve your blood sugar management

We know it can be easier said than done, but one of the single most effective ways to combat DME vision loss is to improve your blood sugar management. There are many different ways to do that, including:

• Making a habit of checking your blood sugar throughout the day to find patterns.
• Understanding how your medication works — and taking it as prescribed.
• Quitting smoking.
• Reducing your stress levels.

4. Eat right and exercise

Of course, no conversation about diabetes management would be complete without mentioning the importance of diet and exercise.

“It sounds cliche,” Dr. Bajic concedes, “but being active, moving your body more and clean eating can solve a multitude of ills.”

That’s probably not news to you. If it were easy, we’d all manage to eat a healthy diet and work out for at least 2.5 hours a week. They’re hard habits to get into for many of us — and can be harder still to maintain. But in the case of DME, there’s a very good incentive to try.

“If someone can really get their diet and exercise routine into a good place — and are able to manage their blood sugar and blood pressure effectively — they may be able to avoid getting started on the series of eye injections we use to treat DME,” Dr. Bajic says. “That can be highly motivating for some people. And understandably so!”

Here are some general guidelines to help you get started:

Diet

There isn’t a specific diet designed for people with DME. But there are some basic principles that are worth keeping in mind as you change your eating habits:

• Eat a plant-based (or mostly plant based) diet.
• Integrate foods that are high in vitamin A into your meals.
• Steer clear of highly processed foods.
• Avoid white breads, starches and sugars. Opt instead for whole-grain breads and complex carbs like quinoa, farro, freekeh and brown rice. 
• Choose heart-healthy options at the grocery store.

The closest you’re likely to get to a food plan for blood sugar management is the Mediterranean diet. If you need more individualized guidance, consider getting a referral to a nutritionist or dietitian. They’re trained to help people living with diabetes find the eating plan that works best for them.

Exercise

A strong exercise program can do wonders for diabetes management. Not only can a good workout impact your blood glucose levels for a full 24 hours after the fact, but it’s also a great way to relieve stress and lower your blood pressure. In fact, the American Diabetes Association recommends that you miss no more than two days of aerobic exercise in a row. 

Of course, exercise is only beneficial if it’s being done safely. Check with your PCP before beginning a new exercise routine. Once you have the all clear, remember to do the following:

• Check that your blood sugar is less than 250 mg/dl before starting any kind of physical activity. Check it again once you’re done so you can see how your workout’s impacting your glucose levels.
• Stay hydrated before, during and after your workout.
• Avoid exercising in extreme heat or cold.
• Wear a medical alert bracelet and keep a cell phone with you in the event of an emergency.
• Wear appropriate footwear and (to the extent that you can) check for injuries before and after exercising.

5. Make some home modifications

If you’re experiencing vision loss as a result of DME — be it mild, moderate or severe — it’s important to adjust your environment accordingly. From installing grab bars to removing tripping hazards to purchasing assistive devices, there are lots of ways you can modify your home to fit your needs.

6. Avoid ’quick fixes’

When a remedy sounds a bit too good to be true, it usually is. Managing DME vision loss requires making a lot of big changes. As a result, there are lots of quick fixes advertised to people with DME — especially on social media.

“You’ll see ads that say something like ‘For the low, low price of $59.99, you don’t have to do all of this work,’” Dr. Bajic shares. “Unfortunately, that’s not true. These products can be so tempting, but unfortunately, you actually do need to put in the work and the time to change your lifestyle.”

Dr. Bajic is unequivocal: When it comes to over-the-counter supplements, you need to follow your doctor’s advice. That’s because the research isn’t straightforward. For example, some people with age-related macular degeneration (AMD) benefit from taking a combo of certain vitamins and minerals, known as AREDS2 — but only some people. The effectiveness seems to depend on the type and stage of the condition.

The same goes for vitamins. Dr. Bajic notes that, while the literature is mixed, there’s compelling evidence to suggest people living with diabetic retinopathy have lower serum concentrations of several vitamins — particularly vitamin B, C and E. But before you start popping supplements, you should check with your primary care provider to see if you have a deficiency. It’s also important that they review your health history and the other medications you take to ensure adding vitamins is safe.

Herbal remedies are another story. Dr. Bajic recommends avoiding herbal supplements completely. The U.S. Food and Drug Administration (FDA) doesn’t regulate them, and they could potentially be harmful.

While there may be a place for a supplement in your DME regimen, Dr. Bajic recommends focusing your attention on eating healthy, moving more and taking your prescribed medications consistently and correctly. “There’s no substitute for a well-balanced, nutritious diet and exercise,” she says.

7. Prioritize your mental health

No two people with DME are the same, which means that no two people are going to react the exact same way to a diagnosis.

“It can vary widely based on a person’s situation, health status, background and personality,” Dr. Bajic clarifies. “I sometimes see people with objectively good vision who are very anxious about their condition. I also see people who are legally blind as a result of DME and aren’t bothered whatsoever. It’s important to meet a patient where they’re at, both physically and mentally, to ensure their needs are met.”

Losing your vision can be very scary — and so can getting eye injections. Denial is a common response. Sometimes, people stop going to their doctor appointments altogether.

“It’s really important for people with DME to address any mental health concerns they may have,” Dr. Bajic stresses. Getting into the right headspace makes it easier to understand your condition, get access to any resources you may need and build strong relationships with your healthcare team.

She adds that her patients have found vision support groups to be particularly helpful.

“They love it because they get to make friends with local people who are coping with similar challenges,” she explains. “The groups also get you connected to all the support services in your area. If your vision permits it, online support groups can be really helpful too.”

The bottom line

The experience of diabetes-related macular degeneration looks different for everyone. But one thing is true across the board: A DME diagnosis is a sign that something about your current lifestyle needs to change in order to prevent further diabetes complications and vision loss.

Changing habits and behaviors is hard, but you don’t have to do it alone. Reach out for help early and often, to healthcare providers, friends, family — and to the many, many people who are doing the same hard work you are. Together, you’ve got this.

But let the healing begin! This recipe transforms it from bland to bursting with flavor. Roasting at high heat brings out cauliflower’s natural sweetness and adds a crispy texture. Top with the savory roasted red pepper sauce, almonds and parsley. Talk about redemption!

Ingredients

• 1 head cauliflower, cut into small florets
• 2 tablespoons extra virgin olive oil
• 1/4 teaspoon plus 1/8 teaspoon kosher salt
• 1/4 teaspoon plus 1/8 teaspoon freshly ground black pepper
• 1/8 teaspoon crushed red pepper flakes
• 1 red bell pepper
• 1/4 cup sliced almonds
• 1 small clove garlic
• 2 tablespoons 0% Greek yogurt
• 1/4 cup fresh flat-leaf parsley leaves, torn

Directions

1. Heat oven to 425 F.
2. On a rimmed sheet pan, toss together the cauliflower, oil, 1/4 teaspoon of the salt, 1/4 teaspoon of the pepper and the red pepper flakes, then spread into a single layer. Cut the bell pepper in half and remove the seeds. Place on the pan, cut sides down. Roast until bell pepper is tender and cauliflower is tender and caramelized, 30 to 35 minutes.
3. Meanwhile, in a small skillet, toast the almonds until golden brown, 3 to 5 minutes.
4. Let bell pepper cool for a few minutes, then put it into a food processor along with the garlic. Puree. Add the yogurt, and remaining 1/8 teaspoon salt and 1/8 teaspoon pepper. Puree until creamy.
5. Serve the cauliflower topped with the red pepper sauce, almonds and parsley.

Ingredient health benefits

• Cauliflower: Broccoli’s lighter cousin has more to it than you’d expect. Cauliflower is a great way to get your vitamin C, which supports your immune system, and vitamin K, which keeps your heart and bones healthy.
• Extra virgin olive oil: This popular cooking oil comes with many perks. Among its selling points, extra virgin olive oil (or EVOO) can help fight inflammation, viruses, bacteria, fungi and tumor growth.
• Red bell peppers: A treasure trove of nutrients, red bell peppers are loaded with vitamins and minerals — like vitamins A and E, potassium and manganese. The pigments that give the peppers their bright red color also support brain health, and their high fiber content is good for your gut.
• Almonds: A little nut with a lot to give. In addition to being high in calcium and antioxidants, almonds are a great source of “healthy” fats that promote good cholesterol and lower bad cholesterol.
• Greek yogurt: With twice the amount of protein as traditional yogurts, Greek yogurt will help fuel your body while leaving your stomach more satisfied. It’s also full of calcium, which keeps your bones strong and your teeth smiling.
• Black pepper: Did you know this flavor enhancer is also a nutrition enhancer? Black pepper has a compound that helps your body more readily absorb essential nutrients, like iron. It can also lower inflammation.

Nutrition information (per serving)

Makes 4 servings

Calories: 163
Total fat: 10.4 g
Saturated fat: 1.3 g
Protein: 6.1 g
Carbohydrate: 14.8 g
Dietary fiber: 5 g
Sugar: 6.1 g
Added sugars: 0 g
Cholesterol: 0 mg
Sodium: 291.6 mg

— Recipe courtesy of Sara Quessenberry for Cleveland Clinic Wellness.

But each measures distinctly different factors related to your heart health. 

Cardiologist Luke Laffin, MD, explains some key differences — and busts some common myths along the way.

Heart rate vs. blood pressure: What’s the difference?

When you think about heart rate and blood pressure, your mind probably goes straight to your ticker in your chest. And while both measurements are related to your cardiovascular system, they play different roles.

Heart rate — sometimes called pulse — is the number of times your heart beats every minute. Changes in your heart rate can be influenced by factors like physical activity, emotions and medications.

Blood pressure is the force of blood flowing against the walls of your arteries. Your blood pressure values indicate the health of your cardiovascular system and can give insight into conditions like hypertension (high blood pressure) or hypotension (low blood pressure).

What’s the connection?

Your heart rate and blood pressure can impact each other in different ways. You can usually see this when your heart rate or blood pressure is experiencing extremes — either very high or low.

“It is true that blood pressure and heart rate often rise and fall together,” Dr. Laffin says. When you face danger, for example, your blood pressure and pulse may both jump upward at the same time. But Dr. Laffin also notes that if your heart rate rises, that doesn’t automatically mean your blood pressure will rise — or vice versa.

“When the two are disconnected, you may be looking at a specific problem,” he says. “For example, if you are dehydrated, bleeding or have a severe infection, blood pressure typically decreases and heart rate increases.”

How to measure both 

To measure your resting heart rate and blood pressure, pick a reliable and reproducible time, Dr. Laffin advises. Ideally, check in the morning before medications and occasionally in the evening, around dinner time. Don’t take your readings right after exercising — unless you’re trying to establish a baseline for what’s called active blood pressure and heart rate.

During readings, you want to be in a resting position with your legs uncrossed. Many people don’t realize that crossing your legs while taking a reading may cause an eight- to 10-point increase in systolic blood pressure.

Which measure is more important? This depends on your health, too. For people with atrial fibrillation, heart rate might be more important to watch, but many other heart diseases depend more on blood pressure. To be safe, measure both.

“Almost all automated kits you buy at a store provide blood pressure and pulse on one readout,” Dr. Laffin says. “It’s convenient — and knowing both numbers helps better understand how to make lifestyle and medication adjustments.”

Myths and truths about heart rate and blood pressure

Here are some other things you may not know about the relationship between heart rate and blood pressure.  

Myth or truth: Blood pressure and heart rate have ’normal’ target numbers

Myth: There are guidelines, but what’s normal varies from person to person. In general, a normal blood pressure ranges between less than 120 mm Hg systolic — which is the pressure as your heart beats — and less than 80 mm Hg diastolic — which is the pressure as your heart relaxes. For your resting heart rate, the target is between 60 and 100 beats per minute (BPM).

Keep in mind that heart rate and blood pressure are a customized fit. You need to work with your doctor to establish a baseline that’s normal for you.

Myth or truth: A low pulse or blood pressure always indicates a problem

Myth: What’s healthy for one person may indicate danger for another. For example, a fit person may have a resting heart rate in their 50s or, in some cases, even their 40s. “It can actually be a sign of being in really good shape,” Dr. Laffin says.

Low blood pressure can be a bit trickier, especially in older people and those with heart disease. If you’re in danger from low blood pressure, your body will tell you.

“It’s really about how you feel,” Dr. Laffin says. “Are you feeling weak? The numbers on their own don’t tell the story; it’s the numbers paired with the symptoms you may have.”

Myth or truth: High blood pressure is more dangerous than a high heart rate

Truth: Again, what’s considered normal varies. But Dr. Laffin says there’s enough clinical evidence to suggest that when blood pressure is even a little above your typical average over time, the risk for heart disease and stroke go up. The physical effects of high blood pressure take their toll on your blood vessels.

“Essentially, for each increment of 20 mmHg over 115 mmHg systolic, your risk of heart attack, stroke, heart failure or chronic kidney disease doubles,” Dr. Laffin states.

Elevated heart rate can be a sign of danger, too, but the cause-effect relationship isn’t so clear. “Studies show that people who have faster baseline heart rates are more likely to have cardiac problems and premature cardiac death,” he adds. 

“But we’re not sure whether that is the cause of the problem or just a sign of what’s going on. The most common cause of a high resting heart rate is being deconditioned (in other words, out of shape).”

Myth or truth: The faster the heart rate, the shorter the lifespan

Truth: In a large study of people going for a health checkup, those who had a high-normal resting heart rate of 80 bpm to 90 bpm had a 40% shorter lifespan than those with a lower heart rate of 60 bpm to 69 bpm.

But the good news is that 15 to 30 minutes of daily moderate exercise, such as brisk walking, could eliminate the increased mortality and reverse the life-span loss, according to the researchers.

The study underlines the important role that physical activity can play in keeping your heart healthy — and giving you a longer life.

“Even moderate activity has benefits,” Dr. Laffin emphasizes. “So, there is no longer any reason to stay on the couch.” 

The bottom line

Your heart rate and blood pressure are different, but both play important roles in your body’s health. It’s important to know how to read your heart rate and blood pressure and take note when either one is getting too high or too low.

Your healthcare provider will usually check both of these vitals during yearly appointments, but make sure to let them know if you notice any sudden changes in your heart rate or blood pressure. 

Men and people assigned male at birth (AMAB) who have testicular cancer may experience several different kinds of symptoms, says oncologist Shilpa Gupta, MD.

While testicular cancer is rare, it most frequently strikes people with testicles younger than age 44 and is the most commonly diagnosed cancer for men and people AMAB ages 15 to 34. It is almost always curable if found early, Dr. Gupta says, and is usually curable even when at a later stage. So, it’s important to know signs and symptoms.

Here are the possible signs of testicular cancer you might not know about.

What are the signs of testicular cancer?

Many of these symptoms typically occur with other conditions as well. If you have any of the following symptoms, you should schedule an appointment with a healthcare provider.

A painless lump

One of the early signs of testicular cancer is a lump or bump on your testicles. Most of the time, that lump won’t cause pain, but some people have reported feeling pain and discomfort.

“The correct way to do a testicular self-exam is to cup one testicle at a time using both hands performed during or after a warm bath or shower. You can examine the area by rolling the testicle between your thumb and fingers using slight pressure,” explains Dr. Gupta.

“Familiarize yourself with the spermatic cord and epididymis, which are tubelike strictures that connect on the back side of each testicle. Feel for lumps, change in size or irregularities. It’s normal for one testis be slightly larger than the other.”

A feeling of heaviness or pressure in your scrotum

You may start to notice that your testicles feel different or even heavier. One testicle may feel firmer than the other.

“It’s important to not ignore any of such symptoms,” she stresses.

Swelling or sudden fluid build-up in your scrotum

Your scrotum and testicles can become swollen. They may appear red and seem larger. And you may also have fluid backup in your scrotum.

“Always get checked out if you feel a sudden accumulation of fluid in scrotum,” advises Dr. Gupta.

Change in testicle size or firmness

Certain types of testicular tumors can reduce testosterone or increase estrogen in the body, which can result in a change in testicle size or firmness. This can include a shrinking testicle, known as testicular atrophy.

“It’s important to do a self-exam and get checked out by a physician if any changes are noted in consistency of testes,” says Dr. Gupta.

Swollen legs

When a tumor spreads to a lymph node, it can constrict blood flow in the veins and result in a blood clot. The clots often occur in your legs, which causes them to swell. You might even experience blood clot symptoms like pain and difficulty breathing.

“It’s important to watch out for sudden leg swelling,” reiterates Dr. Gupta.

Lower back pain and shortness of breath

These are symptoms of advanced testicular cancer, meaning the cancer has spread to lymph nodes behind your stomach. Shortness of breath also may signal that the cancer has spread to your lungs, which may make it harder for air to move in and out.

“More advanced disease can present with more generalized symptoms,” notes Dr. Gupta. “It’s important to not ignore these.”

Breast growth or tenderness

In rare cases, hormone changes also can cause breast tenderness or growth of breast tissue. Some tumors can secrete high levels of a hormone called human chorionic gonadotropin (HCG), which stimulates breast development.

“If men notice sudden breast tenderness or swelling, it’s recommended to get it checked out,” she says.

When to talk to a doctor

If you experience any of the signs and symptoms of testicular cancer, make an appointment with a healthcare provider right away, Dr. Gupta advises.

During your appointment, your healthcare provider may want to do a physical exam and will ask you about your medical history. Common tests include an ultrasound and biopsy. 

If your healthcare provider diagnoses you with epididymitis or orchitis and the symptoms don’t resolve quickly with antibiotics, request an ultrasound to evaluate for a testicular tumor.

It’s important to speak up if you’re not feeling better. Treatment options for testicular cancer include:

• Surgery, including radical inguinal orchiectomy.
• Radiation therapy.
• Chemotherapy.

“While up to 95% of people with testicular cancer are cured, it’s important to get care quickly if you’re experiencing symptoms because testicular cancers usually grow fast,” Dr. Gupta emphasizes. “If there is disease, the earlier it is treated, the greater than chance for success.”

Padel, a paddle sport similar to pickleball, is another activity becoming popular around the world, especially in Spanish-speaking countries. But padel and pickleball have some differences, including the type of court, equipment and scoring system.

What is pickleball?

Pickleball is similar to tennis but has its own court, paddle, ball and rules. Most people find it more forgiving than tennis and easier to play. But even though it can be less impactful on your joints, it’s still a great workout, says physical therapist Jim Edwards, DPT. You need to move quickly and make rapid decisions.

“Advanced picklers are taking their play to the next level with tournaments across the U.S. and world,” he adds.

Edwards shares more on how the sport of pickleball can boost your health and well-being.

Five health benefits of pickleball

“Pickleball appeals to people of all ages and experience levels,” says Edwards. “It’s a great sport for beginners who want to get more exercise.”

And the pickleball culture is welcoming, despite its competitiveness. The teams and leagues are a draw for those who want to meet new people.

These unique features can translate to a range of physical and mental health benefits for those who play regularly:

1. Improves heart health

Current physical activity guidelines for adults recommend at least 150 minutes of moderate-intensity exercise per week. Moderate intensity means you’re at about 50% of your maximum effort.

Pickleball can help you meet these guidelines. One study of adults over the age of 50 found that more than 70% of their playing time was in the moderate to vigorous heart rate zone.

“When you play pickleball, your heart rate and breathing rate are up and you’re burning calories,” notes Edwards. “That translates to better heart health, lung health and weight management.”

2. Enhances muscle and bone strength

Sports like pickleball stress your muscles and bones. Your body responds by making them stronger. Routine pickleball play can help you:

• Improve muscle strength.
• Prevent osteoporosis, a disease that weakens your bones and can lead to fractures.

3. Increases balance and coordination

Balance is a key measure of being physically fit. Good balance reduces your risk of falls, a serious health threat to older adults. Exercise is one of the best ways to improve your balance.

To succeed at pickleball, you need to:

• Move forward, backward and side-to-side around the court.
• Navigate your play around the “kitchen” (the no-volley zone on either side of the net).
• Place your shot strategically so your opponent can’t hit the ball.
• React quickly to balls coming at you.

“These movements sharpen the connections between your body, brain and eyes,” explains Edwards. “Over time, you develop better balance and coordination.”

4. Boosts brain health

Exercise is not only good for your body — it also boosts brain health. The benefits of routine physical activity on your brain include:

• Better sleep.
• Improved cognition (ability to think, remember and process information).
• Reduced risk of depression and anxiety.

“The social aspect of the game is also important,” says Edwards. “People interact with each other, enhancing their quality of life.”

According to a review of 13 studies on pickleball and mental health, players also report improvements in:

• Happiness.
• Life satisfaction.
• Well-being.

5. Lengthens lifespan

Research shows that exercise can help you live longer. One study of adults ages 40 to 85 found that a small increase in physical activity could reduce annual deaths. Adding just 10 more minutes of daily exercise could prevent 110,000 deaths each year.

Other studies link regular exercise to longer life expectancies. According to a recent report, the life expectancy of tennis players is nearly 10 years longer than people who don’t exercise. The researchers noted that activities involving more social interaction showed the greatest longevity effects.

Pickleball injuries

Pickleball injuries have increased as the sport’s popularity has risen.

“This increase isn’t because pickleball is more dangerous than other fast-moving sports,” clarifies Edwards. “Rather, it’s due to more people playing.”

The most common pickleball injuries Edwards treats include:

• Overuse syndrome, inflammatory injuries that occur over time due to repetitive movements. Examples include tendonitis and joint inflammation.
• Sprains, sudden injuries to your ligaments.
• Strains, stretched or torn muscles.

Because of the quick steps, lunges, twists and arm swings, injuries typically affect players’:

• Ankles.
• Back.
• Elbows.
• Knees.
• Shoulders.

How to prevent pickleball injuries

You can prevent many pickleball injuries by taking precautions before and during play. Edwards recommends:

• Don’t overdo it. You may be tempted to play pickleball every day, but your body needs rest. If you have sore muscles or joints, use ice to reduce inflammation. Rest until the pain is gone. Stretching on your rest days can also promote recovery and improve flexibility.
• Take care of your body. All athletes, including pickleball players, need to eat a healthy diet, drink enough water and get good sleep. If you’re healthy, you’ll perform better and recover faster. You’ll also have less fatigue, which can increase your risk of injury.
• Warm up and cool down. Get your blood flowing before you play with a three- to five-minute warmup. After, let your heart rate come down slowly. Stretching your major muscle groups before and after a match can also help prevent sprains and strains.
• Wear the right shoes. Court shoes are best for pickleball. They support your ankles and feet as you turn and pivot. Avoid running shoes, which are good for forward motion but not complex movements on the pickleball court.

Before you start pickleball

Are you ready to give pickleball a try? Check with your healthcare provider to make sure exercise is safe for you. If you’ve got the green light, look for a pickleball class for beginners, advises Edwards. A lesson before your first match can help you learn the game and proper form, which can help prevent injuries.

Pickleball can be competitive and intense. Start slowly and play with people at your skill level. Before you know it, you’ll be part of the pickleball wave that’s helping millions of people stay active and have fun.

That idea, however, may be as dated as that classic movie. Research shows that the Generation Z crowd now on campus seems to be knocking back far less beer and booze than previous generations.

And this isn’t just a random blip in the numbers: “Younger adults are drinking less alcohol — and it has been moving in that direction for two decades,” says addiction psychiatrist Akhil Anand, MD.

So, what’s behind the trend? And does this mean alcohol and drug use worries are disappearing for Gen Z, loosely defined as those born between 1997 and 2010? Let’s take a closer look with Dr. Anand.

Gen Z and alcohol consumption

Want a beer? The answer to that question is increasingly “no” for college students and young adults (age 18 to 22) not in school. A study published in 2020 found that alcohol abstinence is increasingly common among Gen Z.

Researchers found that:

• 28% of college students in 2018 reported that they abstained from alcohol. In 2002, the number was 20%.
• Young adults not in college were even more likely to avoid alcohol. Nearly 30% of this group in 2018 reported that they did not drink beer, wine or spirits. The number was about 24% in 2002.

How noticeable is the trend? Put it this way: Earlier this year, music venues holding concerts catering to Gen Z reported significant drops in alcohol sales during the events. (The bar tab is still strong at shows attended by older fans, by the way.)

Why is Gen Z drinking less?

Is there a definitive reason for Gen Z’s movement away from alcohol? “The answer is we don’t really know,” says Dr. Anand. “But there are a lot of theories.”

So, let’s look at a few of them. (SPOILER ALERT: They’re not all positive signs.)

Mental health awareness

Years ago, people routinely turned to alcohol instead of each other to cope with the stresses of life. It’s why “drowning one’s sorrows” became a well-known phrase.

But in today’s world, people talk far more openly about depression, anxiety and other mental health issues, explains Dr. Anand. There’s an understanding that these feelings are part of the human condition— and that alcohol isn’t a solution.

“Alcohol is a depressant and never the answer to a bad day,” says Dr. Anand. “Gen Z seems to understand that concept and they’ve moved in a different direction.”

Healthier lifestyles

The “clean living” lifestyle embraced by many in Gen Z means making healthier choices when it comes to eating and drinking. It’s one of the forces driving increases in organic food sales and products such as kombucha.

Alcohol is a toxin that doesn’t exactly fit within that care-for-your-body mindset, notes Dr. Anand. (The increased popularity of “Dry January” — where people commit to not drink for the month ­— is another example of thought process in action.)

Giving up alcohol also can lead to health benefits such as:

• Improved sleep.
• Lower cholesterol.
• Reduced blood pressure.
• Increased energy.
• Improved liver function.
• Weight loss.

“When people give up drinking, even for a month, they often notice that they feel better,” notes Dr. Anand. “That’s not by coincidence.

Education

Numerous programs aimed at school-aged children warn about the dangers of alcohol use. “The message may be getting through,” suggests Dr. Anand.

Increased cannabis use

In ditching alcohol, did members of Gen Z just replace one drug with another? The answer might be yes judging by the research.

Decreases in alcohol consumption by Gen Z coincide with an uptick in cannabis use, according to numerous reports. The rise coincides with increased legalization of cannabis and a lower feeling of risk, says Dr. Anand.

Is this a one-for-one trade in substances? Some signs point that way. “There are people using cannabis to cope with stress and depression, just like they were using alcohol,” he explains. “We see similar harmful use patterns.”

Binge drinking: Still a concern

While some Gen Zers have turned away from alcohol, many of their peers continue to binge drink beer, wine and liquor. (Binge drinking is defined as five or more drinks for men and four or more drinks for women on a single occasion.)

“Binge drinking is highest among younger adults — and it can be very harmful,” states Dr. Anand. “We’re even seeing a rise in severe liver disease in younger people from drinking too much alcohol.”

Addiction concerns remain

Are there positive signs involving trends with drinking and alcohol use disorder? Absolutely, says Dr. Anand. But that movement doesn’t erase the reality that addiction remains a significant health issue.

Increased use of cannabis and other drugs also deserves greater attention.

“There’s a new landscape of drug use with young adults,” he continues. “It’s nice to see that there is more awareness about alcohol use, but we’re still seeing extremes with alcohol and other substances.

“If you or someone you know is struggling with addiction, know that there is help available. Go to your healthcare provider, family or friends. Nobody needs to go at it alone.”

An estimated 15% to 30% of the U.S. population is thought to have allergic rhinitis. You’re more likely to have fall allergies if you have:

• Asthma.
• Eczema.
• Other seasonal or perennial allergies.

“All people are different, but often, people with allergies are sensitive to multiple allergens — spring, fall and perennial,” says allergist Mark Aronica, MD. “Sometimes, though, we do see patients with only a few sensitivities or with symptoms only in one of the seasons.”

Dr. Aronica talks fall allergies, including what causes them and how to handle them.

Common symptoms of fall allergies

A fall allergy goes under the category of allergic rhinitis, also called hay fever, which happens when your body’s immune system reacts to an inhaled pollen in the air. It can cause:

• Congestion.
• Itchy eyes.
• Runny nose.
• Sneezing.
• Post-nasal drip (that feeling of constantly needing to clear your throat of mucus).

Allergic rhinitis encompasses seasonal allergies — those that arrive with the onset of a particular season — as well as allergies you have all year round, known as perennial allergies.

“Perennial allergens are year-round and include people who are sensitive to animal danders (like cats and dogs), as well as dust mites, cockroaches and molds, which are also considered to be year-round allergens,” Dr. Aronica explains. “Seasonal allergens include the spring and fall pollens — and spring allergens also include trees and grasses.”

Allergy culprits

It’s such a pretty season, but it’s hard to enjoy when you can’t seem to stop sneezing. So, what causes fall allergies? What is it that you’re actually allergic to?

“Fall allergens are generally weeds,” Dr. Aronica says. He breaks down some of the most common allergens during this time of year:

• Ragweed.
• Cocklebur.
• Lamb’s quarter (pigweed).
• Mugwort.
• Nettle.
• Russian thistle.
• Sagebrush.
• Tumbleweed.

When do fall allergies start? The most common fall allergen is ragweed, a member of the daisy family that starts to bloom in North America in late August and lives through autumn.

Ragweed’s flowers produce significant amounts of pollen, which makes it an especially potent allergen. A single ragweed plant can release up to a billion grains of pollen.

How to relieve fall allergy symptoms

The best way to try to prevent allergy issues is to try to stay away from the things you’re allergic to. “The mainstay of therapy is avoidance,” Dr. Aronica says.

But that can be difficult when you’re allergic to pollen, which blows in the crisp autumn breeze and settles on everything in its path. He explains how you can fight allergies in fall:

• Close your windows. Open windows welcome pollen. In the fall, when your allergies are high, use your home’s air conditioner or heat instead, if possible (depending on the temperature outside).
• Wash your hands and face. Who doesn’t love autumnal activities like apple-picking, hiking or trick-or-treating? But as fun as they are, they all expose you to pollen. After you’ve spent time outdoors, take care to wash your hands and face when you return indoors, which will help get rid of lingering pollen.
• Change your clothes. It’s not just your skin: Pollen even settles on your clothes! In addition to washing yourself off, you may consider changing into an outfit untainted by pollen, which will keep the sneezy stuff further from you.
• Delegate yardwork. Somebody’s got to mow the lawn — but if at all possible, avoid outdoor chores that kick up allergens, like pulling up weeds and raking leaves.
• Wear a mask. The pandemic isn’t the only reason to wear a face mask. Covering your mouth and nose with a mask can also keep pollen from making contact.

Though these tips will help you come into contact with less pollen, it’s just about impossible to fully avoid pollen. If you’re still sneezy, get an assist from science and hit up a drugstore or pharmacy to try an over-the-counter medication designed to relieve your allergy symptoms.

“Many allergy medications are safe and now available over the counter, including nasal steroid sprays like fluticasone and triamcinolone, and the long-acting, nonsedating antihistamines such as loratadine and cetirizine,” Dr. Aronica notes. “These medications are generally very good at managing most allergies.”

Take your allergy medicine before your allergies get bad, especially on days predicted to have high pollen counts. Local news channels and online weather websites offer pollen forecasts that can help you stay up to date.

When to see an allergist

If you’re doing everything you can but still can’t kick the sniffles and sneezes, it may be time to see an allergy specialist for extra help.

“We can do a skin test to identify a patient’s specific allergens and to determine if there are additional pollens or if they have a perennial allergy,” Dr. Aronica says. “If you might be interested in allergy shots, that is only something an allergist can provide.”

Allergy shots — also called allergen immunotherapy or subcutaneous immunotherapy (SCIT) — are a way to slowly decrease your sensitivity to certain allergens, which can greatly reduce your symptoms. But they’re typically a long-term therapy used only after you’ve tried everything else.

And as Dr. Aronica points out, not all runny noses are due to allergies. A skin test will also show whether you’re indeed experiencing allergies. If not, you’ll know to seek continued medical input to figure out what’s causing your symptoms.

Allergy symptoms can vary during a person’s lifetime, depending on where they live and what they’re exposed to. If your primary issues are fall seasonal allergies and then you move someplace where pollen is less abundant, you’ll probably experience a drop in symptoms when autumn comes around.

Ultimately, there isn’t a cure for allergies. But by arming yourself with preventive measures, allergy medication and pollen forecasts, you can finally enjoy autumn, rather than sneeze your way through it.

Ingredients

• 2 pounds fresh whole beets
• 1 1/2 tablespoons balsamic vinegar
• 1 1/2 tablespoons extra virgin olive oil
• 2 tablespoons finely diced red onion
• 1 tablespoon chopped fresh chives
• 2 tablespoons chopped fresh parsley
• 1/2 teaspoon salt

Directions

1. Preheat oven to 350 F. Line a roasting pan with foil. Remove stems and place beets in pan. Cover with another piece of foil, and roast until easily pierced with a fork — about 1 hour for medium beets, longer if the beets are large.
2. Let beets cool slightly; while still warm, peel and cut into bite-sized chunks. Place beets in mixing bowl and lightly toss with balsamic vinegar, olive oil, red onion and salt. Place in shallow serving bowl. Top with chives and parsley.

Ingredient health benefits

• Beets: That trademark deep red isn’t just for show, you know! Beets get their color from betalains, pigments that fight inflammation and help keep your cells at peak performance. Beets are also rich in fiber and nitrates, which can lower your blood pressure and may even boost your athletic ability.

  Extra Virgin Olive Oil: There’s a lot to say about this cooking oil, but we’ll give you the TL;DR. Among many things, extra virgin olive oil (also called EVOO) is high in antioxidants, which help protect your cells from damage. And it has a polyphenol called hydroxytyrosol that fights inflammation, fungal and bacterial infections, and potentially even tumors.

  Onions: You don’t really hear influencers or food blogs touting the amazing benefits of onions, but rest assured, these alliums are loaded with nutrients. Onions have lots of antioxidants, and a flavonoid found in onions called quercetin may have anti-inflammatory and antibacterial properties.

  Parsley: This bitter herb is a natural diuretic, which helps your body shed extra water and salt (in other words, it makes you pee more). Under medical guidance, this can be beneficial in the long term for people with certain conditions that affect the lungs, kidneys and heart.

Nutrition information (per serving)

Make 6 servings
Serving = 3/4 cup

Calories: 100 (35 calories from fat)
Total fat: 4 g
Saturated fat: 0.5 g
Cholesterol: 0 mg
Sodium: 310 mg
Carbohydrate: 15 g
Dietary fiber: 4 g
Sugar: 11 g
Protein: 3 g

— Prevent & Reverse Heart Disease, by Caldwell B. Esselstyn Jr, MD.

The American Cancer Society, American Lung Association and the U.S. Preventive Services Task Force (USPSTF) say “yes” if you meet certain criteria tied to long-time cigarette use.

Let’s take a closer look at your options with pulmonologist Peter Mazzone, MD, MPH.

Who should get a lung cancer screening?

A lung cancer screening isn’t for everyone, states Dr. Mazzone. It’s recommended only for adults who are at high risk for the disease — which explains why screening guidelines are pretty specific.

The USPSTF suggests an annual lung cancer screening if all of the following apply:  

• You’re between age 50 and 80.
• You’ve smoked at least 20 “pack-years” of cigarettes. (To calculate pack-years, multiply the average number of packs smoked per day by the number of years you smoked. So, 20 pack-years is one pack a day for 20 years or two packs a day for 10 years).
• You currently smoke or have quit smoking within the past 15 years.

It’s also important that you’re healthy enough to benefit from finding and treating early-stage lung cancer. People who get tested don’t typically have symptoms of lung cancer.

“If someone comes to us in a wheelchair already wearing oxygen and couldn’t tolerate treatment, they typically aren’t eligible for screening,” clarifies Dr. Mazzone. “However, there are nearly 15 million Americans who are at high risk and should receive screening.”

It should be noted, too, that a lung cancer screening is a quick and painless imaging exam. It uses low-dose computed tomography, or low-dose CT, to capture very detailed pictures of your lungs.

Why is lung cancer screening important?

As noted, lung cancer often doesn’t announce itself with early symptoms. So, without an annual screening, lung cancer is often detected once the disease has progressed and spread — which makes successful treatment less likely.

People with lung cancer have about an 80% chance of being alive five years later if the cancer is diagnosed and treatment begins during Stage 1. The five-year survival rate is about 4% if tumors have spread.

That leads us to this alarming reality: Only about 1 in 4 people with lung cancer are diagnosed before the cancer spreads. “Early detection is key to changing that,” says Dr. Mazzone.

Are lung cancer screenings perfect? Of course not. Scans sometimes detect small spots called nodules that look concerning but are basically harmless little scars. Radiation exposure is a concern, too. Ditto for overdiagnosis of conditions and additional testing and stress.

“But the benefits of lung cancer screening still outweigh any potential harm for many people,” notes Dr. Mazzone.

How often is lung cancer found during a screening?

Lung cancer is found in about 1 in every 140 people who get screened. This may sound like a small number, but it’s about the same or better than the results for breast cancer and colon cancer screening.

How to decide whether to get a lung screening

A counseling session is often required before a lung cancer screening so you can discuss lung cancer risks, the screening process, benefits and potential harm. It can be a complex and difficult decision for people to make.

“Many people value the potential benefit of screening so much they’re happy to accept them,” explains Dr. Mazzone. “Others may have a different perspective. Talk to your doctor to help decide what’s best for you.”

And because the test is annual, the decision on whether to do it can be revisited every year.

Maybe you’re in recovery or you’re pregnant. Perhaps you’re sober-curious, starting a new medication that doesn’t mix with alcohol or finding that drinking is having a negative impact on your health. Whatever your motivation, you’re likely discovering that navigating a nonalcoholic lifestyle can sometimes be difficult in social situations.

Luckily, as more people are drinking less, there’s been an uptick in more drink companies creating nonalcoholic options. But it can still be tough to figure out which of these options are healthy. 

Registered dietitian Beth Czerwony, RD, LD, weighs in on the rise of nonalcoholic drink options and what to know before your next toast with friends.

The popularity of nonalcoholic drinks

In recent years, there have been some big shifts in the way people are engaging with alcohol in their lives. A recent Gallup poll found a decline in young adults’ drinking habits. Based on self-reported statistics, the average number of drinks young adults consumed dropped from 5.2 to 3.6 between 2001 and 2023. 

This shift comes at the same time as a 2023 World Health Organization (WHO) report noting that even the smallest amount of alcohol is still not safe for your health. So, the rise of mocktails and nonalcoholic drink alternatives is good timing.

But here are some things to consider as you navigate the options of nonalcoholic drinks. 

Nonalcoholic drink options

Nonalcoholic drink options can be as simple as ordering an ice water or as creative as a mocktail or lemonade mix. It all comes down to your preference, health history and motivation (AKA: Why do you want to cut down on drinking in the first place?).

“I always go back to the ‘why,’” says Czerwony. “Why do you want to stop or reduce your drinking? Is it because you’re having health concerns? Or is it because you feel like crud right after you drink? Then, you can look at the distinct options and decide which avenue to go down.” 

Here are some different nonalcoholic options to consider: 

’Virgin’ cocktails or mocktails

These are the drinks that have all the building blocks of well-known cocktails, minus the alcohol. If you’re comfortable with trying these, you can simply ask for a “virgin” or “nonalcoholic” version of your favorite cocktail. 

You can also directly ask for combinations that mimic cocktails like: 

• Soda water with lime or lemon. 
• Soda water with cranberry juice. 
• Faux margarita. 
• Basil lemonade.

“If you wanted to do a virgin version of something like a mojito or daiquiri, you’re still getting the feel of having a cocktail, but you’re not getting the alcohol,” Czerwony says. 

Nonalcoholic beers and wines 

If your go-to beverages are beers and wines, you’re in luck because there are nonalcoholic versions of these as well. These options can be especially helpful if you’re trying to slowly transition away from drinking and want to comfortably socialize (without anyone asking unwanted questions about your drink choice).