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  • Is Bed Rotting Bad for You? 

    Is Bed Rotting Bad for You? 

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    Burnout is steadily rising worldwide—and people are coping in very different ways. Some deal with their stress and exhaustion by binge-watching Netflix shows, hitting the gym, meditating, or crafting. As for others? They try bed rotting.

    The Tiktok trend is (usually) less repulsive than it sounds; it simply involves spending the entire day in bed relaxing, or “rotting away,” as a way to decompress from life’s stressors.

    “In our society, there’s an emphasis on being productive,” says Laurence Chan, instructor of medical psychology at Columbia University. “And bed rotting might be one socially acceptable way to say that you need a time-out and you’re looking to recharge.”

    Resting regularly is good for you, but bed rotting for too long or too often can indicate a deeper mental-health issue. “It can be difficult to disentangle what is a self-care day from what is a low or major depression, and when should you seek help?” says Stephanie Preston, a professor of psychology at the University of Michigan.

    Moderation is key 

    If you’re only bed rotting once or twice a month to cope with stress, it’s likely an acceptable form of self-care that isn’t damaging your mental health, Preston says. 

    But if you find yourself lying in bed multiple days a week, she says, there could be a deeper mental-health issue at play, like anxiety or depression. 

    Notice whether the activity is impacting your ability to keep up with work, family, or school obligations, as well as whether you’re struggling with basic hygiene. “You’re not showering, you’re not brushing your teeth, you’re not putting on clean clothes—that’s when you might suspect depression,” Preston says.

    Bed rotting could also be a coping mechanism for an anxiety disorder, Chan says. Someone with problematic anxiety could be using the self-care trend as a way to avoid certain things in their life. This could “reinforce that it’s safer to avoid the things that we’re avoiding, and then we might believe that we’re not able or capable of handling them,” he says.

    Read More: How to Be More Spontaneous As a Busy Adult

    That’s the tricky thing about bed rotting: While it might seem like an effective way to decompress, doing it too often or for too long will only worsen depression or anxiety. “While avoiding stress may feel good in the moment, prolonged avoidance is actually linked with long-term distress and greater dysfunction,” Chan says. This is partially because we’re sedentary when we bed rot, and moving our bodies is essential for both our physical and mental health.

    The anxious generation 

    Many of the bed-rotting TikTok videos are from users in Gen Z, a group that was born between 1997 and 2012. Research has shown that Gen Z is, generally speaking, more anxious than other generations. Countless factors contribute to this increased anxiety, from the years-long COVID-19 pandemic to increasing worry about cost of living and climate change.

    “I think that in today’s world, what Gen Z and later generations are facing is very different from their grandparents and parents,” says Dr. Justin Kei, a psychiatrist and medical director for the outpatient behavioral health clinic at Hackensack University Medical Center. “So we should be mindful that there’s probably a reason for [bed rotting].”

    The sleep connection

    Spending an entire day resting can be restorative. But even if you feel relaxed during a lazy day, you could be setting yourself up for sleep issues that night—and for many nights to come.

    “Our nighttime sleep is heavily influenced by our daytime behaviors,” says Joe Dzierzewski, vice president of research and scientific affairs at the National Sleep Foundation. If we spend too much time in bed during the day—even if we’re not strictly sleeping—we’re likely not getting enough bright light, exercise, and nutritious meals at the appropriate time. All of these are “important daytime contributors to healthy sleep,” he says.

    Read More: 8 Eating Habits That Actually Improve Your Sleep

    Bed rotting can also have a long-term effect on sleep. When you spend time in bed not sleeping, “the brain makes an association that bed is a place where you stress and worry and watch TV and study and do everything else except sleep,” Kei says. This behavior over extended periods of time, he says, can lead to insomnia. 

    Some TikTokers who engage in bed rotting record themselves napping throughout the day. Dzierzewski notes that research has shown weekend “catch-up” sleep can actually help us recover from a sleep deficit from the previous week. But it’s important “to limit the extra sleep to one or two hours on non-workdays,” he says.

    How to bed rot the right way

    Some TikTokers tout the benefits of bed rotting, mentioning how refreshed and recharged they feel afterward. Others say they feel guilty or gross after spending a day or weekend cooped up under the covers. To be clear, there are far healthier ways to spend a day than curled up in bed. But if you’re headed under the covers anyway, consider these tips. 

    • Get up and stretch every few hours. Sitting still for extended periods of time can impact mood, slow digestion, and strain the muscles. Chan recommends setting timers to get up and stretch throughout the day.
    • Opt for the couch instead. Spending the day in bed can confuse your brain and interfere with nighttime sleep. Because of this, Chan recommends bed rotting on the couch, on a comfy chair, or in a hammock instead. 
    • Call or text a friend. Many bed rotting videos on TikTok show people surfing their phones all day. While social media has its place in our lives, Kei says, “real human connection in day-to-day life is extremely important for maintaining a sense of wellness.” Chat with a friend, or even consider bed rotting with them: Some TikTokers document themselves bed rotting together.
    • Set limits for yourself. Chan recommends people limit their bed rotting to one or two days in a row while also taking breaks and, if possible, engaging in physical activity throughout the day.
    • Be mindful of your social-media use. Countless research studies have shown a correlation between social-media use and mental-health issues, Chan says. If social media tends to stress you out, avoid it. But in some cases, surfing Instagram or Reddit could be OK. “While it sounds terrible to stare at your phone for nine hours, I think if your brain is fried, it’s a mindless activity that doesn’t challenge your brain and keeps you entertained,” Preston says. “So it’s not necessarily problematic.”

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    Jamie Friedlander Serrano

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  • How to Be More Spontaneous As a Busy Adult

    How to Be More Spontaneous As a Busy Adult

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    My nine-year-old skips, jumps, flails his arms, jumps some more, kicks, skip-jumps, stops by to punch me in the leg, and continues. He drifts through the house to the energetic pop rock of his favorite band, Imagine Dragons.

    He’s mouthing the words, but his “dancing” takes no cues from the music’s rhythm. He prefers to romp spontaneously.

    Many people enjoy life with some dashes of spontaneity, and this freedom is often associated with being young. Meanwhile, rigid thinking is linked to worse mental health (and humans tend to get more mentally inflexible after childhood). You’re not doomed to a grown-up life of no surprises, though. Researchers have recently identified ways to increase spontaneity for well-being—and perhaps even longevity.

    Here’s what they’ve learned about spontaneity and how to cultivate it.

    What is spontaneity?

    Spontaneity is about loosening your mind and actions. It’s voluntary and off-task, serving no particular purpose—like an out-of-the-blue road trip this summer.

    We’re spontaneous when thoughts are free to move about, flexibly shifting across ideas and topics, often wandering to external matters that go beyond self-directed, personal concerns. This type of unconstrained thought is linked to specific neural action at the front of the brain, found Julia Kam, a psychology professor at the University of Calgary in Canada. “It’s a marker of letting your mind go,” Kam says.

    Read More: How to Start—And Stick to—A Breathwork Practice

    Thoughts that are automatic and stuck, like repetitive worries, compete with spontaneity, says Jessica Andrews-Hanna, a neuroscientist at the University of Arizona. “Habitual thoughts are ingrained in our psyches,” she explains, when brain regions related to emotion and self-focus interact repeatedly. If these constraints can be relaxed, “spontaneity is free to emerge” for a wide range of thoughts and behaviors. 

    Creativity is related but different. It’s the ability to choose among many spontaneously generated options for some useful purpose, whereas spontaneity “doesn’t need an end-game,” says Tali Marron, a clinical psychologist at Israel’s Shalvata Mental Health Center. It can be its own reward, like an amateur artist throwing paint at a canvas for fun, regardless of what’s produced.

    Why are kids little spontaneity machines?

    Young people enjoy these intrinsic pursuits naturally. As Picasso said, we are all born artists. The problem is, we grow up. 

    “Kids are little spontaneity machines,” says Edward Slingerland, a philosophy professor at the University of British Columbia in Canada and author of Trying Not to Try: The Art and Science of Spontaneity. He recalls his daughter at an age when she couldn’t walk a line from points A to B without zig-zagging jumps and somersaults. Kids are also known for experimenting with new personality traits, outfits, and passions that arise seemingly out of nowhere.

    Few adults seek a return to this behavior. Walking in a straight line is mostly very useful. So is a stable identity that doesn’t change with the weather. But adults can benefit from understanding why and how the young are so spontaneous.

    Read More: What’s the Best Skincare Routine?

    One factor is dopamine, a chemical in the brain related to motivation and reward. Sandeep Robert Datta, a neurobiologist at Harvard, monitors the brains of mice while they explore unfamiliar territory. He’s found that dopamine inspires their spontaneous movement just like more predictable movement rewarded by food, and this random behavior is far more common in younger mice. “They generate lots of spontaneous exploratory movements that peak just before adulthood, when mice begin to settle down and act their age,” Datta says.

    Dopamine drives human movement, too. “Your behavior any moment is the sum of actions that make you feel good” and more unusual ones that help you “better understand and interact with the world around you,” Datta says. The more we explore an environment, like a city, the better we grasp what’s possible, increasing resourcefulness. In humans as in mice, though, dopamine levels drop as we age—10% each decade. 

    Another explanation for youthful spontaneity is neuroplasticity. The period of “juvenile exuberance” coincides with the brain being “massively flexible and engaged in ongoing learning,” Datta says. Like dopamine, neuroplasticity declines after a certain point in life. “With the juvenile-to-adult transition, neural circuits get locked to some extent into adult configurations,” says Datta. “Spontaneity can be viewed as a measure of biological aging.”

    These changes affect more than movement. Spontaneous thoughts also seem to peak when we’re younger. Studies show that college students and young adults engage in mind wandering up to 50% of the day, Kam says. In older age, it typically declines to about 30%.

    That is, unless adults actively strengthen their spontaneity muscles. “Things that keep your brain plastic are probably very important to maintaining spontaneous behavior,” Datta says. The connection between spontaneity and longevity still needs to be tested. But Kam and Andrews-Hanna have found links between freely-moving spontaneous thoughts and having more life satisfaction. And a positive mindset is associated with slower aging.

    Follow these steps to enhance spontaneity regardless of age.

    Take free-moving, free-thinking breaks

    Make time to roam freely. Fantasize and daydream while strolling, losing track of where you’re going. Use GPS to find your way back.

    Andrews-Hanna takes such walks, letting her thoughts flow. Kam exercises while avoiding mental to-do lists, television, or anything else productive or distracting. “You can’t focus your mind 24/7,” she says. “I carve out time to let my thoughts wander wherever they want.” 

    Peter Felsman, assistant professor of social work at Oakland University in Rochester, Mich., introduces people to “sense and savor” walks, guiding them to spontaneously engage in whatever provides pleasure, like watching a bee go from flower to flower. For these walks, psychologists recommend giving “yourself over to the experience as if it were the only thing that existed in the world. When you lose interest…discover something else that is attractive.”

    Put yourself in a surprising situation

    “You can force neuroplasticity and spontaneity to remain part of your life by getting yourself to do new things,” Slingerland says. “Embrace surprise,” Felsman adds. “Pleasant breaking of routine wakes people up to life.”

    Recently, Felsman joined a friend for a sailing outing. He thought it’d be relaxing but, once on the water, they were invited to compete in several hours of competitive racing. The idea made Felsman nervous because this was his first time sailing. But he embraced the novelty of getting to learn how to participate in a sailing crew. “It just sort of happened,” he says. “It was extraordinary.”

    Read More: 8 Eating Habits That Actually Improve Your Sleep

    Datta, too, values spontaneous, new experiences. His father has Parkinson’s disease, which is associated with low dopamine levels. “The one thing that makes him better is novelty,” he says. “If I surprise him with a trip to the mall, the beach, or anywhere else, he perks up in a way that I’m not used to.”

    Free associate

    If you feel stuck with an unsatisfying routine, it may help to try a certain form of free association, in which you describe your inner train of thought out loud, one word at a time, each word associating with the previous one. You might go from cloud to mother to kitchen, depending on your associations. This aids creativity and, just as importantly, it practices silencing our internal critics while boosting spontaneity, says Marron, the Israeli psychologist. 

    When people’s thoughts move freely, the executive parts of their brain—controlling functions like planning and decision-making, also known as convergent thinking—aren’t as activated, Marron has found. “Their associations are more flexible with less inhibition.” They improve at watching their thoughts diverge, like zigzagging children, without “feeling like half their ideas are spam,” she says. 

    Asking people to read positive, creative stories could make these associations more original and lively. Free-writing is another activity that encourages “free, flowing forms of thinking,” Andrews-Hanna says. 

    Some people enjoy being alone with their divergent thoughts more than others. Andrews-Hanna has developed an app called MindWindow that lets users gain insight into their own thinking patterns, including spontaneity. 

    Take an improv class 

    Studies in adults show that taking improv classes, another free-association activity, reduces symptoms of depression and anxiety. It also boosts creativity, which is linked to well-being. Felsman’s research in Detroit schools found that kids who participated in an improv class became better at tolerating uncertainty—key to mental health—and less socially anxious.

    Read More: 8 Ways to Find Humor in Your Everyday Life

    The executive parts of the brain are important. Without their control functions, associations would loosen too much, Marron says. But free association can help ensure that top-down, executive forces don’t dominate one’s mental landscape. “The ideal is to find a balance between divergent and convergent thinking, so you can flexibly act in line with your values,” Felsman adds.

    Reduce stress

    Anxiety is linked to narrower, more ritualized thoughts and behavior. Practicing mindfulness can “break your attachment” to repetitive, negative thinking, Andrews-Hanna says, freeing up mental bandwidth for spontaneity. New research shows that psilocybin can weaken psychological constraints, perhaps by reducing stress and shifting the brain temporarily to a childlike state of neuroplasticity. Ignoring the stressful, digital constraints of smartphones can help, too.

    Try not to try

    Spontaneity as a virtue has ancient roots. It was seen as essential to enjoying life in 5th century BCE China through the concept of wu-wei, which translates as “no trying,” Slingerman writes in his book. People with wu-wei are successful without striving; they know when to trust their unconscious mind and do what comes naturally. Cultivate it by engaging in something awe-inspiring that syncs you up with the larger, natural order, Slingerman says—in his case, it’s ocean kayaking.

    Play without structure

    Part of Andrews-Hanna’s regimen for spontaneity involves playing with her kids. “I try to get into their mode of thinking, rather than directing their play,” she says. “It’s very difficult, more natural for a four-year-old. But it helps me connect with them and become more flexible in my thinking.”

    Read More: How Much Do You Actually Need to Shower?

    Recently, I started joining my son’s dancing. I imitate him with my own jumping and flailing. When he’s really feeling the music, he shakes his head vigorously, appearing to have, as Wordsworth said of poetry, “a spontaneous overflow of powerful feelings.” I shake my head, too, thinking about him sharing his gift of spontaneity. 

    At first, we collided a few times, but now we expertly dodge each other. Maybe it’s reopening my neural connections—or maybe not. But it’s certainly a welcome divergence from my sedentary routine. The rinse-repeat of daily life is like “hitting the same gumball machine all day,” Datta says. “If that’s all you do, when the machine runs out, you’re screwed.” There’s a fundamental need to continuously try random things. “These movements might seem meaningless, but who knows in the future whether a move you made while dancing will be useful to you.” Even if there’s no point, though, the true benefit may be simply enjoying the spontaneity for its own sake.

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    Matt Fuchs

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  • Five Takeaways From Haniyeh’s Killing

    Five Takeaways From Haniyeh’s Killing

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    Ismail Haniyeh was killed in a predawn airstrike in Tehran last night. The 62-year-old was not just another senior member of Hamas. He was the head of its political wing since 2017, a key member who initiated and orchestrated most of its strategic moves, and its worldwide representative. If Hamas’ leadership were a deck of cards, Haniyeh was the ace of spades. Iran and Hamas have blamed Tel Aviv and the U.S. for the killing, despite silence from the former and denial from the latter.

    There are a number of implications that can already be gleaned from Haniyeh’s death. Here are the top five.

    1. This is a message to the Iranian leadership. The targeted killing of Haniyeh serves as a demonstration of capabilities and power in the heart of Tehran as a new President began his tenure there. The message is clear: continuing to fund, sponsor, and support proxies such as Hamas, Hezbollah, or Yemen’s Houthis could lead to a direct response to the head of the octopus itself. If Haniyeh was eliminated in Tehran, anybody could be eliminated in Tehran.

    2. A full-scale war with Lebanon is less likely, not more. Haniyeh’s death occurred only hours after Israel carried out a strike in the Dahieh quarter in Beirut and killed Fuad Shukr, who was directly responsible for the death of 12 Druze children on Saturday in Majdal Shams. Their death did not happen in a vacuum. Since joining the war in October, Hezbollah has fired at Israel thousands of times, and Israel has returned fire. The deaths of Haniyeh and Shukr, in the span of a few hours, send a sharp message to Hezbollah leader Hassan Nasrallah that enough is enough. While no one can fully predict how Nasrallah may respond—he promptly declared that Haniyeh’s death would “increase the resistance”—Nasrallah is known for being highly calculated. This new equation may not ultimately prevent a full-scale war, but it could make Nasrallah more cautious about Hezbollah’s military posture.

    Read More: The Coming Israel-Hezbollah War

    More from TIME

    3. This is part of the Israeli healing process. The Israeli sentiment regards Hamas’ leadership just like it did with the Black September militants who carried out the Munich massacre in the 1972 Olympic games. Back then, killing Ali Hassan Salameh—the organization’s operations chief, known as the “Red Prince”—was essential for retaliatory purposes. Even more so, it was necessary for social healing. Similarly, here, Haniyeh is one of the symbols behind the biggest tragedy for Jews since the Holocaust. His death is a message for the victims and fallen soldiers’ families that the killing of innocent Jews, like in the 1930s and 1940s Europe, won’t go without punishment.

    4. Yahya Sinwar is isolated. It’s been barely three weeks, and the world has forgotten the attempt on the airstrike targeting Mohammed Deif, the head of Hamas’ military wing, in Khan Yunis. In the event Deif did not survive, Sinwar, the architect of Oct. 7, would be the only senior Hamas leader standing (alongside Khaled Mashal). On the one hand, this means more power and responsibilities to the man who is already Hamas’ most influential person. Conversely, one man can handle only so much alone, especially while hiding underground. The direct implication here is that Hamas’ “management” will be harmed, both inside (militarily) and outside (politically) the Gaza Strip.

    5. More uncertainty over a hostage deal. If there’s one topic Sinwar’s isolation could affect the most, it’s this. And it’s not just another topic. The 115 remaining hostages represent a national trauma in Israel. Their release isn’t vital just for their own sake but for the continuation of the Israeli ethos, according to which no one is left behind. In the short run, Sinwar will likely refuse to engage in any deal to avoid “rewarding” Israel following Haniyeh’s death. Such a decision will also grant him a time window for a potential response from Iran or its proxies, which aligns with Sinwar’s aspiration for a full-scale regional war. In the longer run, however, this may increase the likelihood of a hostage deal, as Sinwar might seek to avoid a fate similar to Haniyeh’s. The problem is the hostages don’t have time. Conditions in captivity are horrendous and former hostages have recounted physical and sexual abuse. Finding the right formula to engage in a deal without altogether forfeiting its military interests will be an Israeli challenge.

    Like every significant targeted killing in the Middle East, the implications go far beyond the specific target. Haniyeh’s case provides a profound example. This doesn’t mean the war ended—far from it. But it means new conditions have been set that will impact us all.

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    Gadi Ezra

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  • Do Americans Need Prescriptions for Healthy Food?

    Do Americans Need Prescriptions for Healthy Food?

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    As an internist in the public primary care clinic at Zuckerberg San Francisco General Hospital, Dr. Hilary Seligman often asked her patients about their diets. One conversation that stands out involved a man in his 50s, a longtime patient she had just diagnosed with prediabetes. Asked to describe his meals, he revealed that his daily lunch was a sandwich of Spam between two cinnamon rolls.

    “It really shocked me,” says Seligman. She couldn’t fathom why someone would even put those two foods together until she realized he did it because it was affordable and kept him full until he had enough money to eat again. “Healthier food just costs more,” she adds.

    That pivotal conversation shed light on the harsh realities of food insecurity, fueling Seligman’s passion for health equity and the growing movement known as Food Is Medicine (FIM). The philosophy of FIM is simple: Nutritious food is as critical to health as other medical treatments like prescription drugs and should be included in health care coverage.

    As the director of UC San Francisco’s Food Policy, Health, and Hunger Research Program and the Nutrition and Obesity Policy, Research and Evaluation Network of the U.S. Centers for Disease Control and Prevention, Seligman has played a key role in spearheading policy changes aimed at treating and preventing diet-related chronic illness by improving what people eat. Her initiatives, EatSF and Vouchers 4 Veggies, provide low-income residents who can’t afford nutritious food with “produce prescriptions” to redeem for fruits and vegetables at various outlets in California and outside the state. 

    “From the perspective of the patient, it makes a difference when your doctor prescribes something,” says Seligman, a professor of medicine, and of epidemiology and biostatistics at UCSF. People take it more seriously. In this case, instead of “take this antibiotic for your ear infection,” it’s “take this healthy food to prevent your diabetes.”

    The statistics clearly illustrate the need for this approach. One in eight U.S. households lacks access to affordable and nutritious food, while half of all American adults suffer from chronic diseases linked to their diets such as cardiovascular disease, high blood pressure, or Type 2 diabetes. Each year, these diet-related conditions lead to more than a million deaths in the U.S., exceeding those caused by smoking. These illnesses are also among the country’s largest health care costs, with a price tag of $1.1 trillion annually, which matches what the entire country spends on food itself.

    Read More: Why Your Breakfast Should Start with a Vegetable

    Given the profound health and economic impact of poor nutrition, it’s no surprise that the FIM concept is gaining traction. That’s due to a few key turning points, says Dr. Dariush Mozaffarian, a cardiologist and director of the Food Is Medicine Institute at Tufts University. 

    First, the COVID-19 pandemic drove home the crucial link between diet-related diseases and severe health outcomes, as people with obesity and other nutritional issues often had much tougher battles with the virus. Second, heightened national attention to health disparities, particularly influenced by movements like Black Lives Matter and economic pressures like rising food prices, has further pushed the issue to the forefront. The conversation has also been propelled by the high costs of popular injectable weight loss medications like Ozempic and Wegovy, driving the search for more sustainable health solutions. This collective awareness culminated in the Biden Administration’s 2022 White House Conference on Hunger, Nutrition, and Health, which pledged $8 billion in public and private funds to these causes. In government funding alone, 2023 data from the U.S. Department of Agriculture’s Gus Schumacher Nutrition Incentive Program (GusNIP), administered by the U.S. Department of Agriculture, shows a near seven-fold increase in the number of FIM sites and a near twelve-fold increase in participation of these programs.

    One of the movement’s biggest wins came in recent years when FIM programs, including produce prescriptions, were integrated into Medicaid through Section 1115 waivers in 11 states. Additionally, Medicare Advantage has broadly adopted similar coverage, while the departments of Veterans Affairs and the U.S. Indian Health Service are exploring these initiatives through pilot programs.

    How do produce prescriptions work?

    To improve patient health, many organizations are addressing the lack of access and affordability of nutritious foods through innovative collaborations. For example, Brighter Bites, a national nonprofit based in Houston, serves thousands of children and their families across the country through school systems and health care organizations, delivering each of them 20 pounds of fresh fruits and vegetables per week, along with nutrition education. It’s funded by government agencies and partnerships with produce companies, other nonprofits, and philanthropic organizations.

    Among providers, a big player is Kaiser Permanente, which recently committed $50 million to further integrate FIM into its care model. Part of this work includes launching its Food Is Medicine Center of Excellence. The center combines clinical services—from produce prescriptions and medically tailored meals to culinary medicine and nutrition counseling—with new research and partnerships. In one trial in collaboration with Instacart, Kaiser is studying the outcomes of giving Medi-Cal members in Northern and Southern California more choices with grocery stipends that can be used to purchase fresh and frozen produce, legumes, plant-based oils, spices, and other foods from a curated virtual storefront.

    “By building the evidence for how to not only treat but also to prevent these very common conditions, our hope is to improve health—including for our most vulnerable populations—and to lower the cost of care,” says Pamela Schwartz, Kaiser Permanente’s executive director of community health.

    Read More: Why Your Diet Needs More Fermented Pickles

    These initiatives align with findings from a 2022 survey that revealed a high level of food and nutrition insecurity among Kaiser Permanente members: A quarter of all members, and nearly half of those on Medicaid, reported struggling to have enough to eat or access to nutritious food. As a result, Kaiser has also been helping members access food assistance through federal programs like SNAP (Supplemental Nutrition Assistance Program), and WIC (Women, Infants and Children).

    Trinadad Cuevas Garcia, a 53-year-old nursery worker in Forest Grove, Ore., knows this firsthand. She faced an ironic twist of fate when she moved to the U.S. from Oaxaca, Mexico, where she once grew her own tomatoes, corn, potatoes, and green beans on her family farm. Despite her farming skills and work in the agriculture industry, she could no longer afford fresh produce and had to subsist on a diet of mostly tortillas, rice, and beans. 

    However, a diagnosis of diabetes in 2021 and a doctor’s referral led Garcia to a produce prescription program at Adelante Mujeres, an Oregon-based nonprofit that supports marginalized Latina women and their families. The program provided her with a monthly budget of $300 to buy fresh produce for her family and to gain access to cooking workshops to learn how to prepare unfamiliar vegetables. Since joining the program, Garcia has embraced a healthier lifestyle, incorporating vegetables like kale, broccoli, and cauliflower into her diet. “I’m so grateful for this program,” says Garcia through a translator, “and I no longer need to restrict myself when buying fresh produce at the market.” Her health has significantly improved as a result; her A1C levels dropped from 7.6 to 6.4, moving her out of the high-risk diabetic category. 

    While access to these life-changing programs is still limited, it is possible thanks to partnerships with organizations like the Rockefeller Foundation, which supports the produce prescription programs at Adelante Mujeres, Brighter Bites, and others as part of the $100 million it earmarked to FIM programs nationally since 2019. “It’s a little bit crazy when you realize that what we eat is the number one driver of poor health in the country, and yet the health care system has so few tools to actually help patients eat better,” says Devon Klatell, vice president of Rockefeller’s food initiatives. 

    The research on FIM programs is also starting to build. In a 2024 review of dozens of studies published in the Journal of the American College of Cardiology, Mozzafarian at Tufts and his co-authors found that these interventions have shown the ability to significantly improve diet, manage chronic diseases like Type 2 diabetes and hypertension, and enhance overall physical and mental health, while also being cost-effective. However, larger, more rigorous studies are still needed, and several such robust experiments are currently underway, including a trial involving high-risk pregnancies in Georgia. 

    What challenges and opportunities lie ahead?

    If food is truly medicine, say experts, interventions like produce prescriptions should become as routine as taking a pill—and become fully integrated into the health care system. That includes better screening for food and nutrition insecurity, expanded public and private coverage, and more providers. It will also require more nutrition education for patients, and training in the field. Currently, U.S. medical schools offer less than 20 hours of nutrition education across four years, which is less than 1% of the total estimated lecture hours.

    It will also require better screening for food insecurity and more innovation to bridge the gap between health care professionals and grocers, some of which is already happening—such as patients getting produce benefits deposited straight onto debit cards to swipe at the grocery store. “We have a system that connects the health care system to the pharmacy in the back of the grocery store, but we don’t have a system to connect the health care system to the healthy foods at the front of the grocery store,” says Seligman.

    In order for healthy eating to be the norm, there also has to be a shift beyond underserved communities, says Shreela Sharma, a professor of epidemiology at the University of Texas’ UTHealth Houston School of Public Health and co-founder of Brighter Bites. “Historically—with smoking, seatbelts—when you shift the social norms, that’s where the sweet spot is.”

    Read More: How to Lower Your Cholesterol Naturally

    In Congress, there’s a significant push to expand federal support for these initiatives, says UCSF’s Seligman. This expansion isn’t just about encouraging healthier eating; it’s also about bolstering farmers and local food systems. “One of the challenges of these programs is that there isn’t a long term, sustainable funding stream outside of health insurance,” she says. “That’s really the cutting edge. Will health insurance pay for this? Because when people don’t eat healthy food, it’s the health system that’s bearing the downstream costs.”

    Food not only underpins our health, but also plays a vital role in our social fabric. Seligman shares a story about a group of socially isolated older adults from the same housing site in San Francisco who decided to spend their EatSF produce vouchers together at a farmers market. They pooled their resources to buy ingredients for a communal meal, which they then cooked and shared. “That’s really important,” says Seligman. “It starts with food, but hopefully food is also an avenue towards better physical and mental health and more connection with one another.”

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    Claire Sibonney

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  • Pokémon TCG legend Mitsuhiro Arita on illustrating his first card for Magic: The Gathering

    Pokémon TCG legend Mitsuhiro Arita on illustrating his first card for Magic: The Gathering

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    It’s hard to overstate the impact artist Mitsuhiro Arita has had on trading card games. Nearly 30 years ago, as a member of the original design team on the Pokémon Trading Card Game, Arita contributed to the look and feel of the franchise’s original 150 monsters. He also authored the art for some of the most iconic Pokémon cards, images that have global recognition — including some of the first interpretations of Pikachu and Charizard.

    Image: The Pokémon Company

    A Japanese language version of Charizard, featuring a chromatic background.

    Image: The Pokémon Company

    The full-frame version of Lumra, Bellow of the Woods with art by Mitsuhiro Arita.

    Image: Wizards of the Coast

    Since then, Arita has remained one of the Pokémon TCG’s most prolific illustrators, while occasionally contributing art for other card games such as the Shin Megami Tensei Trading Card Game, the Monster Hunter Hunting Card Game, and even the Power Rangers Collectible Card Game.

    And now, for the first time, Arita’s work will appear on a Magic: The Gathering card as part of its latest expansion, in a world of anthropomorphic animals known as Bloomburrow. Although his art will only feature on one card in the set, a special, full-art treatment for a new creature called Lumra, Bellow of the Woods, the massive elemental bear highlights the detailed approach that makes Arita one of the most cherished TCG artists in the world.

    Polygon was able to share questions with Arita ahead of Bloomburrow’s official tabletop release on Aug. 2. What follows are his professionally translated answers, which have been lightly edited for clarity and concision.

    Polygon: Was working on a Magic card different from your typical process with the other card games you have contributed to?

    Mitsuhiro Arita: In Japan, it’s very common to have detailed checks at every stage of the drawing process. Character consistency in particular is strictly controlled. I’m used to making changes all the way through the process. Usually you present the piece for detailed feedback around 60-70% of the way through, so you can make adjustments before starting on the final details. With Magic, the most thorough checks were at the conceptualization stage. After that, there weren’t any further corrections, so I realized I had to make sure things were spot-on from the beginning.

    Can you describe your process in creating the art for this Magic card?

    I was asked to create the piece using sketches by Matt Stewart as a reference. After that, the process was like any other job — I’d draw the rough, and once that had been approved, I’d draw the pencil sketch, scan it, and paint the final image using software [such as Photoshop and Painter].

    Lumra, Bellow of the Woods as portrayed by Matt Stewart. The 6-mana legendary creature, an elemental bear, has vigilence and reach as well as other powers.

    Like many rare and mythic Magic cards these days, Lumra, Bellow of the Woods will have several versions, featuring different artists or card templates. While Arita drew one of the full-art variants of the card, the equally prolific Magic artist Matt Stewart handled the standard variant that will appear with Magic’s traditional card frame.
    Image: Wizards of the Coast

    What was your opinion of Magic: The Gathering’s art style before you were asked to illustrate a card for the game?

    I’ve always liked the feel of high fantasy, and have wanted an opportunity of drawing in that style.

    Can you describe Magic’s reputation in Japan, compared to other trading card games?

    In Japan, TCGs based on existing manga, anime, and video game franchises, which are aimed primarily at the collectors’ market, are very prominent. On the other hand, card products like Magic, which has a solid card game at its core, can feel a bit overshadowed. Of course, it’s not just card games but all games played face-to-face which are losing ground. I think a lot of it stems from how smartphones are eating up any bits of free time in which you’d otherwise have played a game like that.

    For Magic or in general, is it hard transitioning your art style to other card games?

    When I’m drawing, I usually like to put myself in the shoes of the fans. I think to myself “What kind of Arita artwork would I want to see?” Of course, each job provides its own challenges and you need to adapt your vision, but I didn’t go out of my way to do anything specifically different. If you look at my website’s blog, I think you can see how varied my style has been over the years.

    Looking through Arita’s body of work, his art from the original Pokémon TCG base set feels noticeably simpler, minimalistic, and two-dimensional compared to his current style. For instance, the evolution line he did for Charmander, Charmeleon, and Charizard mostly feature the Pokémon in profile, and there’s no mistaking them as cartoons.

    A Pokémon card depicting Charmander looking over his shoulder to admire his lightly burning tail.

    Image: The Pokémon Company

    A Pokémon card depicting Charmeleon taking a swipe in attack while his tail smolders.

    Image: The Pokémon Company

    This approach is not at all indicative of who Arita is, as an artist, today. The art he did for the Power Rangers CCG could be mistaken for stills from the television show. Lumra, like many of the Pokémon he now draws, exists in a highly detailed and lived-in environment.

    A card from the Power Rangers CCG depicting the Yellow Ranger making a call on a flip phone.

    Image: Bandai

    A card from the Power Rangers CCG depicting the Blue Ranger, with a double-barreled weapon of some kind, taking cover.

    Image: Bandai

    His takes on Pokémon and Magic almost could be mistaken for photorealism, if the subject matter of both games weren’t so steeped in fiction and fantasy. He creates action that jumps off the page, or the card in this case, giving his illustrations a practically tangible weight that in turn makes the cards themselves feel unique.

    Lumra explodes from the woods, scattering rabbitfolk in his wake.

    Image: Matsuhiro Arita/Wizards of the Coast

    Your work has appeared across so many card games over the years, it’s a wonder you haven’t worked on Magic until now. Are there any other games, or brands that you still hope to work on for the first time?

    Magic has always been high on my list of card games which I’d like to do work for, so I was extremely happy to get the opportunity to be involved on this project. I’d done work for Culdcept before, and I’m very keen to do so again, if there’s ever a sequel. It was the first job in my career when I got to go all-out on a series of high-fantasy artworks.

    How important is understanding a new game before designing art for it?

    It’s important to try and understand that the perspective of hardcore fans is not an entirely objective perspective. In fact, I think that introducing the perspective of an outsider can help bring about positive innovation. I’ve been involved with [Pokémon] for a long time, but [my work] still feels very fresh [to the fans]. I think that having multiple product lines which employ various styles has helped to change and progress it over time.

    When creating characters for a new client, such as Magic, how do you tailor your approach to fit the specific lore and themes in that game’s identity?


    When doing research for a creature, I think about it as if it really existed. If it had this set of characteristics, what would it look like? Where would it live? How would it behave? And I always keep in mind the visual impact while I think through these things.

    How much did you have to learn about Magic before working on your first Magic card?

    I like to keep my work feeling fresh and original, so I tend to avoid looking at other artists’ work. I prepared for this project just as I would for any other project — I didn’t really do anything differently.

    In some ways, Arita’s career in art was an unexpected one. Not only was Pokémon TCG his first professional job as an artist, prior to that assignment he had very little formal training in art or drawing.

    I read that your art is self-taught, following a natural talent from a young age. Is this true, and have you ever sought some formal training once your career in arts began to take shape?

    I did attend sumi-ink painting classes at a cultural center. Watching the instructor do live demonstrations, I came to understand how water and pigment behave inside the body of the brush, and the techniques used to control it. I also took all five of the workshops at the Liquitex School, which focuses on acrylic paint, where I learned about the history and special chemical properties of paint.

    That knowledge turned out to be a very useful foundation for when I started working in watercolor and other liquid-based media later on. As I didn’t have a comprehensive art education, I’d only had limited experience with [legacy] art materials. Every time I tried my hand at a new medium — watercolor, opaque watercolor, acrylic paint, oil paint — I was able to increase my understanding by paying close attention to the work of my predecessors.

    Apart from formal training, how do you continue learning at this stage in your career?

    When I’m grappling with new subject matter, I turn to YouTube and get studying.

    As Arita’s career expanded beyond his roots in Pokémon TCG, he eventually had to adjust his style to new stories, characters and worlds. These new projects also brought with them new audiences and expectations, and for a mostly self-taught artist like Arita, this came with the unique challenge of evolving and adapting beyond the potential comfort zone of his home within Pokémon.

    Lumra, Bellow of the Woods with gold filligree’d accents.

    A render of the gold raised foil version of Arita’s Lumra, Bellow of the Woods. The rare treatment is only available in Collector Boosters.
    Image: Wizards of the Coast

    Do you need to make an effort to evolve and explore new styles, or does it come naturally through the work you’re assigned across different games?

    I actually find it more natural and not at all laborious to continue to change and take on new challenges. I’m convinced that I won’t catch anyone’s interest unless I draw with an intense level of focus. One of the things that has contributed most to my changing creative style has been the fact that I’ve worked on so many different kinds of projects, in so many different domains over the years.

    How do you handle feedback and critique from fans and colleagues?

    You’d think that you needed a distinct and consistent style and set of themes, if you wanted to be an established artist but, for some reason, I haven’t really been criticized for not following that path. The fans are very much up for the adventure, and they enjoy following me on that journey, for which I’m very grateful. I find it slightly curious that fans will seek out some of my art pieces, even when they have no consistency with the rest of my work, just because it’s by me. I really appreciate the open-mindedness of my clients and my fans.

    Can you recall an instance where constructive criticism significantly influenced one of your pieces?

    The idea that you don’t have to draw things as they look in real life really freed me up as an artist. But, for a while, I just couldn’t get it!

    Mitsuhiro Arita’s first Magic card can be found in all Bloomburrow booster packs, including Play Boosters and Collector Boosters, when the set goes on sale Aug. 2. The most coveted version of the card, the raised foil borderless treatment with the first-of-its-kind gold accents, is exclusive to Collector Boosters.

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    Stan Golovchuk

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  • How to Start—And Stick to—A Breathwork Practice

    How to Start—And Stick to—A Breathwork Practice

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    Ilana Nankin loved being a pre-K teacher, but she and her colleagues often felt stressed by their jobs. So when Nankin noticed a fellow teacher “looking absolutely blissed-out,” she tagged along to the teacher’s new yoga and breathwork class. “I haven’t looked back since,” Nankin says.

    She felt so calmed by the mindful movement and breathing techniques she learned that Nankin brought them into her classroom—and marveled as her students calmed down after a round of “bear belly breathing.” Nankin went on to found a company, Breathe for Change, which brings mindfulness practices to teachers and students in public schools. If breathwork can work for a preschool teacher who was “overwhelmed and overworked, with little to no tools for self-care”—and her toddler students—it can help anyone, she believes. 

    “The most frequent question I’ll get is, ‘How do I start?’” says Nankin. And the answer is easier than you may think. If you can spare a few minutes each day, you have all the time you need to develop a fruitful breathwork routine.

    Ahead, Nankin and other experts share why breathwork matters, how to get started, and simple but effective exercises to try.

    What is breathwork?

    Dr. Sheila Patel, a family physician and chief medical officer of Chopra, defines breathwork as the conscious control of the breath. “When we change the depth and rate of breathing, we can create specific effects on the mind and body,” she says. “When we slow the breath rate, we directly inform the nervous system to shift toward the parasympathetic nervous system, which calms and relaxes us, and is the opposite of the stress response.” By manipulating your breath differently, you can also invigorate and energize yourself. This may sound similar to meditation, but “meditation focuses on cultivating present moment awareness, whereas breathwork focuses on consciously directing the breath to induce a specific outcome,” Nankin says.

    The health benefits of breathwork

    Patel didn’t practice breathwork until adulthood, but she was acquainted with it from a young age. Growing up, many relatives from India would visit her family’s home. “My first introduction to breathwork was hearing snorts and heavy breathing sounds coming from my uncle’s bedroom in the morning,” she says. This brought on fits of laughter for Patel and her sister, until one day they asked their parents what was happening. They explained he was practicing yoga postures and pranayama, which is yogic breathwork, to stay healthy.

    Read More: What’s the Best Skincare Routine?

    Now, Patel maintains a similar practice. “I experienced firsthand how calming the slow-breathing techniques could feel, and I really needed to relax and calm my mind, being a busy doctor, wife, and mother of two young kids,” she says. Given her demanding schedule, she often couldn’t find time to do yoga, but breathwork was more manageable. “Doing five minutes in the morning and five minutes at the end of my day had such profound benefits,” she says. “I was amazed to realize that the simple practice could be so transformational. “

    A large body of research confirms the benefits of slow rhythmic breathing: a lighter mood, reduced feelings of stress, and improved glucose and cortisol levels, says Patel. Some of these findings hold true even after just one session.

    What’s behind the impressive findings? Many of breathwork’s benefits seem to relate to its ability to tamp down your body’s “flight-or-fight” response. “When you are stressed, overwhelmed, or have experienced trauma, your nervous system is activated in the sympathetic state,” says Nankin.That’s when you enter fight-or-flight mode. “Engaging in breathing practices regulates your nervous system and enhances its flexibility, leading to increased comfort, relaxation, and alertness, and reduced symptoms of arousal, anxiety, depression, anger, and confusion,” she says.

    Even though we’re now able to describe the benefits in the language of science, Patel emphasizes that these practices have been done for thousands of years and the benefits have long been known through direct experience. “The practices aren’t new, but we’re learning about them and teaching them in a new way,” she says.

    How to start a breathwork practice, step-by-step

    If you’re an absolute beginner and don’t want to make this your whole identity, experts recommend trying a few easy breathing techniques. You don’t need a fancy meditation cushion or to download any apps. 

    First, note that there is no “right” way to practice breathwork. Kimberly Faith, a breathwork practitioner in Reno, Nev., tells clients who get overwhelmed by how many breathing techniques are available that as long as your exhales are equal to or longer than your inhales, you are calming your nervous system and are on the right track. 

    These three breathwork techniques work well for newbies.

    Box breathing

    Faith calls this popular technique one of the simplest breathwork exercises there is: “Inhale through the nose for a count of four, hold for four, exhale through the mouth for a count of four, hold for four,” she explains. “Doing this several times will relax the nervous system and restore homeostasis to the body.”

    Read More: How to Stop Clenching Your Jaw

    If even this seems like too much for you, Faith recommends trying to become more aware of your breath throughout the day. “Often, when people are stressed, or something triggers them, people stop breathing altogether. They do not even realize it, yet this triggers the sympathetic nervous system to go into overdrive,” she says. “The more we can become aware of our breath, the more we can do something about it.”

    5:2:5 rhythmic breathing

    This breathing technique is one of Patel’s favorites to teach her patients. This can be practiced sitting up or lying down. However, she recommends beginners start lying down, with one hand gently resting on the abdomen. 

    Here’s how it’s done: inhale through the nose for five seconds while feeling your abdomen rising up toward the ceiling. Pause for two seconds, and then exhale through the nose for five seconds while contracting your belly button toward the spine. Patel notes that this practice should be very comfortable, without causing any strain or lightheadedness.

    A 5-step breathwork practice

    Nankin developed this easy exercise in order for beginners to get comfortable with how it feels to pay attention to your breath. She says to approach this exercise (and all types of breathwork) with a non-judgmental attitude. “Start with curiosity, noticing your natural breath for five, 10, or 20 seconds, and the quality of each breath,” she says. “Simply observe without trying to change it.”

    1. Find a comfortable position. Be intentional about your posture and what your body needs. If you’re exhausted, lie down on the floor or couch. If you’re seated, relax your shoulders and lengthen your spine. To energize, stand up, aligning your head, shoulders, hips, and feet.
    2. Connect to your breath. Observe the natural flow of your breath. Focus on each inhale and exhale, allowing your awareness to orient towards your breath.
    3. Connect to your body. Notice sensations arising in your body as you breathe. It could be tingling toes, tension in your lower back or neck, a headache, or even feeling energized. Acknowledge and accept what’s happening in your body.
    4. Connect to your emotions. Notice how you feel as a result of this experience. You might feel calm, relaxed, content, overwhelmed, sad, or joyful.  Give yourself what you need in that moment, treating yourself as you would care for a loved one.
    5. Come back to your space. Begin to move your fingers and your toes. If your eyes are closed, gently open them. Make any final movements that feel good.

    How to commit to a regular breathwork practice

    Do you want to stick to a consistent breathwork practice but fear it will go, well, in one nostril and out the other? Here are five ways to stay the course.

    Pick a technique that feels right for you

    And it may change. Daily. Just because a friend swears by the box breath doesn’t mean that you will. “In this process, it is crucial to really find the right style that works for you,” says Pavel Stuchlik, a breathwork instructor and founder of NOA|AON, an online wellness platform which focuses on breathwork, meditation, and dance. Ask your body, “What is the right flow today?” he suggests. Stuchlik uses different techniques for different situations. “If you need breathwork for sleep, choose practices for sleep. If you need to do breathwork for energy, there’s breathwork for energy.”

    Read More: 8 Eating Habits That Actually Improve Your Sleep

    Set reminders 

    Since breathing is so automatic, Nina Kaiser, a clinical psychologist and founder of Practice San Francisco, says that it’s easy to forget to do these practices. “Setting reminders or habit-stacking with something you do consistently (e.g., picking up your phone, sitting down at your computer, etc.) can be helpful in establishing intentional breathwork as a new habit,” she says.

    Just like building any other habit, Kaiser stresses that it’s easiest to begin by making tiny changes to your routine. “People eager to achieve the benefits of breathwork may be tempted to dive in with complicated, time-consuming, or advanced practices,” she says. “Instead, it’s best to start with small shifts or additions to your current habits.”

    Practice it proactively

    A way to seamlessly wiggle breathwork into your daily life is to practice at the start of the day or as a way to decompress before sleep. You could also try incorporating a 30-second breathing practice throughout the day as a “brain break,” before a meal, or as a transition between activities, she says.

    And deep breathing isn’t only for the tranquil moments. Breathwork is especially vital when the going gets tough. Nankin recommends using it during heightened moments of stress, such as an argument, test, or accident. “Notice how you are feeling. Are you stressed, angry, sad? Pause and engage in a breathing technique to bring yourself back to a calm, regulated state,” she suggests. 

    Don’t breathe too hard 

    One of the most common breathwork mistakes Patel sees is when people strain or try to inhale or exhale to the maximum capacity. When done properly, your inhalations and exhalations should only be at about 75% capacity, says Patel, at a slow rate of about five to seven breaths per minute. “People think it’s about getting more oxygen in your lungs, but true breathwork is not about that. Creating this regular rhythmic and slow breathing synchronizes all the functions in the body regulation of the nervous system,” she says.

    Abandon expectations

    “I should feel calm” or “I should be less stressed” are common expectations Nankin hears from beginners—and when they don’t happen right away, they create anxiety. “The truth is, these practices won’t necessarily lead to immediate outcomes or to the same outcome every time,” says Nankin. “It can take weeks, months, or even years to feel the life-changing effects of breathwork. Be childlike in your experience, and the outcomes will follow. “

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    Perri Ormont Blumberg

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  • The Coming Battle Over the Arctic

    The Coming Battle Over the Arctic

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    Since the end of the Cold War, the High North has been defined by the idea of “Arctic exceptionalism,” the common understanding that the region had unwritten rules, beliefs, and history that protected it from great-power rivalry. Under this shield, China emerged in recent years as a new power in the European Arctic through increased trade, investments, and scientific cooperation. But Russia’s full-scale invasion of Ukraine has disrupted this delicate status quo in profound ways. The European Arctic is fast becoming an arena in which the U.S. and its allies must compete directly with its geopolitical foes.

    To be sure, the war in Ukraine is not the only driver of increasing tensions. Retreating sea ice has led to greater interest in the region’s economic value and geopolitical importance, fueling militarization among Arctic states and engagement from traditionally non-Arctic players such as China. These economic pressures have typically centered on three areas.

    Read More: An Arctic Border Town Feels a New Chill From Russia

    First, the Arctic contains vast fossil fuel reserves, the development of which is a key priority in Russia’s Arctic strategic vision for 2035. The Russian Arctic alone is estimated to contain more than 35,700 billion cubic meters of natural gas and more than 2,300 million metric tons of oil and condensate, mainly concentrated in the Yamal and Gydan peninsulas.  

    Second, changing ice conditions caused by climate change is reshaping potential Arctic shipping routes. Russia’s development of the Northern Sea Route along its Arctic coasts, which intends to connect the Atlantic and Pacific Oceans through the Russian Arctic, is particularly noteworthy. The route is ice-free during the summer and enables ships to reduce travel time by 40% with significant fuel savings compared to transit through the Suez Canal.

    Third, the successful co-management of fisheries in the North Atlantic and Barents Sea is at danger of collapsing under mounting climate pressures. As surface air temperatures continue to rise dramatically, warming waters are causing fish stocks with marine catch potential to extend further north. Some have speculated that Russia could use commercial activities in a broader challenge to NATO. Norwegian naval intelligence has already claimed that between 50 and 100 Russian fishing vessels operating in Norwegian waters may be linked to intelligence gathering activities. The blurring distinction between commercial and military activities in the region, coupled with more military exercises there, has resulted in a heightened danger of accidents involving fishers. Svalbard, a Norwegian archipelago located midway between the North Pole and Norway’s northern coast, is a particular source of tension, since Russia does not recognize Norway’s jurisdiction to inspect and arrest vessels in the island’s waters beyond 12 nautical miles.

    It’s in this context that growing Russia-China collaboration is a concern to the U.S. and its Arctic NATO allies. Even prior to the war in Ukraine, Moscow looked to its eastern neighbor to develop the Northern Sea Route, invest in Arctic energy projects and infrastructure, and enhance military cooperation. But Russia’s international isolation since Ukraine has made the Kremlin reliant on Beijing to finance its energy export infrastructure in the Arctic, where over 80% of Russia’s natural gas production and almost 20% percent of its oil production comes from.

    The West’s longstanding focus on engagement and cooperation in the European Arctic has also been instrumentalized by China to make inroads. China has pursued investments in Arctic energy and logistics infrastructure (in Greenland, Svalbard, Northern Sweden, and Northern Norway) in a long-term effort to consolidate Beijing’s energy security, sustain economic growth, and expand its global reach. But as the seven non-Russian Arctic states have grown wary of China’s strategic ambitions and coercive economic tactics, Beijing is increasingly relying on Moscow to act as a conduit to expand Chinese activities in the Arctic writ large.

    These factors could provide China with a pretense to consolidate a more substantive presence in the European Arctic, be it through joint military exercises, investments in Russian energy infrastructure, or a role in maritime law enforcement. A recent cooperation agreement between the Russian Federal Security Service and the Chinese Coast Guard may open the door for China in Arctic security affairs, since coast guard tasks entail protecting sovereign rights at sea, such as fishing resources and access to oil and gas infrastructure.

    That said, the short-term impact from increased geopolitical jostling over the Arctic should not be exaggerated. First, large-scale mineral resource extraction in the Arctic still requires significant new investments in mining infrastructure while the region remains an extremely expensive place to drill for oil. Second, overt military aggression will likely remain limited since Russia can scarcely afford to shift its attention to the High North with its objectives in Ukraine far from achieved and its ground forces depleting at an increasing rate. Likewise, a slumping domestic Chinese economy will likely keep Beijing focused on domestic policy issues and limit expansive engagement in the European Arctic in the coming years. Beijing has largely engaged selectively with Russia in the Arctic in areas that further China’s own interest, such as increased science diplomacy and purchasing heavily discounted Russian oil and gas, thus failing to meet Moscow’s lofty expectations for what its “limitless friendship” would entail.

    But that does not mean that Western governments can afford to be complacent on the Arctic. To its credit, Washington is increasingly recognizing the nuances of the Arctic’s growing geopolitical salience. The Department of Defense’s recently released Arctic strategy reflects the need to rethink U.S. engagement by emphasizing enhanced domain awareness and Arctic capabilities, closer engagement with regional allies and partners, and exercising tailored presence. 

    Increasing Russian military and grey zone activities has already illustrated the implications of a changing Arctic threat environment. Several incidents of interference with critical undersea infrastructure have highlighted the pressing threat that Russian hybrid tactics present to Northern Europe. Cooperation on undersea mapping and maritime domain awareness is thus a promising area to pursue in the short-term, and one NATO is paying attention to. Another area of emphasis should be to enhance coordination of investment screenings and the use of international scientific research and science diplomacy as a guise for China to establish a foothold in the European Arctic.

    The era of “Arctic exceptionalism” may be coming to a close. But a sensible Western approach can at least mitigate its worst impacts.

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    Max Bergmann and Otto Svendsen

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  • Isles of Sea and Sky taught me it’s okay to move on

    Isles of Sea and Sky taught me it’s okay to move on

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    Sometimes, turning a linear game into an open world just makes sense. Whether it’s Elden Ring or Breath of the Wild, plenty of franchises have found that their core gameplay loops map well to an open world iteration. With Elden Ring, you can disperse the intense FromSoft difficulty across a map that invites players to “git gud” at their own pace. With Breath of the Wild, the entire world is now a dungeon, every hill and valley a puzzle. Playing both, it almost feels as though each franchise and its mechanics were just waiting to be spread across a sprawling map. They just feel right.

    By contrast, Isles of Sea and Sky, an open-world Sokoban game, isn’t quite as obvious a fit. But just because something isn’t immediately obvious doesn’t mean it won’t work.

    Released in late May, Cicada Games’s Isles of Sea and Sky employs Game Boy Color-era Zelda aesthetics in pursuit of a genre mashup that produces harmony and dissonance in equal parts. The game makes a great first impression. It evokes that feeling of playing Link’s Awakening DX (pre-remake), to the point where you’d be forgiven for mistaking one of Isles’ beaches for Awakening’s. Moving from screen to screen is a nostalgic joy, with a Vocaloid-infused soundtrack that imbues the game with even more personality, which is good, because at its core, open world or no, this is a Sokoban-ass Sokoban game.

    You will push blocks in Isles of Sea and Sky. You will push many, many standard-issue blocks into standard-issue holes, allowing you to cross over those holes in order to push more blocks. You will also push things that aren’t blocks, like little boulder dudes (definitely not Gorons) who roll as far as they can in the direction you push them, crushing any boxes they encounter. Or little water guys, who can extend riverways if you push them downstream. The puzzles start simply, easing you into the game’s increasing difficulty one screen at a time, until eventually you find yourself stumped. And, in being stumped, you will find yourself pushing up against the contradictions inherent to Isles’ mixture of freedom and linearity.

    Image: Cicada Games

    One of the pleasures of Sokoban games is the underlying conceit that, though you may feel frustrated by an individual puzzle, you always have the necessary abilities to get through the level. Each stage is then simply a matter of thinking and working through what things you have tried and not yet tried. You’re stuck, sure, but you’re not lacking anything you need to achieve the solution.

    Not so in Isles of Sea and Sky. Early on, you will be presented with puzzles you are not yet able to complete until you unlock a new ability. While plenty of games include this kind of lock-and-key design, where you must first unlock an ability before you can access certain areas, this runs contrary to genre expectations for Sokoban titles. Going into Isles, the player might reasonably expect that, if they’re stuck, they just need to keep trying different solutions. Such a mentality will get you through similar games like Baba Is You or A Monster’s Expedition. The solution is there. You just need to keep at it. By contrast, in Isles, you are often meant to move on, to travel elsewhere in the game’s map and overworld. In short, you are meant to give up when you get frustrated.

    At first, I found myself stymied by this dynamic. How am I meant to know when I am failing to understand a puzzle versus lacking the ability to solve it? When is my frustration an intended element of the solution and when is it futile? To its immense credit, Isles goes out of its way to reduce some of this frustration by allowing the player, at any point, to rewind their actions step-by-step, or to reset the entire puzzle, each with the press of a button. But you cannot rewind the real-life time you are putting into the game. You cannot undo the minutes spent bashing your head against the wall, stubbornly trying to solve something you are simply unable to solve. Encountering this, I found myself asking why anyone would design a game in this way, when they must know that players will get stuck like this.

    That’s when it hit me. They know players will get stuck like this.

    Full disclosure: I can be a bit stubborn. I like to think of myself as a creative problem-solver, but my general approach is to stick to something until it’s done. This can be a good trait (sticktoitiveness and all that), but it can also be a problem (see: my description above of bashing my head against the wall). Traditional Sokoban titles are designed with this kind of player in mind — someone like myself, who will spend hours trying out different things until finally they figure something out. The folks at Cicada Games clearly love this genre, as is evident by the sheer number and variety of puzzles they’ve crammed into Isles, but what they clearly don’t love is that feeling of being stuck without any recourse, of being unable to move on.

    Not to quote a meme, but to quote a meme: Isles of Sea and Sky is here to say “Just Walk Out. You Can Leave!!!” What began for me as a frustration with the game turned into a bit of self-reflection when I stopped to consider why, exactly, I felt the need to stay frustrated, when, at any point, I could simply leave, or, to quote our generation’s preeminent philosopher dasharez0ne, “hit da bricks!!!” Sure, there are some areas you cannot access before completing at least a certain number of puzzles, but in general, you can well and truly leave behind most anything that’s too frustrating in Isles and find something you’d rather be doing. The challenge, at least in my case, was in allowing myself to do so.

    As I’ve argued, Sokoban games are not an obvious fit for an open world iteration. Their inherent linearity rubs up against a style of game best known for its variety and, well, openness. The focus required of the player feels categorically different than the desirable distraction of asking, “What’s over that hill?” With Isles of Sea and Sky, specifically, there’s an immediate dissonance between how you expect to play a block-pushing puzzle game and how you’re meant to play this block-pushing puzzle game. But dissonance can resolve into consonance, to harmony and stability, and in Isles’ case, you’re pushed not only toward accepting limitation, but toward the inclination to free yourself.

    For me, it was difficult, at first, to see moving on as a valid strategy, having become so accustomed to the habit of pushing through mental blocks, both in Sokoban titles and in life. But once I did, I found that mentality extending beyond the game. Is stubbornness helping or hurting here? Do I have to sit in this feeling? Why do I think of moving on as giving up?

    In the end, I was happy to play a game that inspired this kind of self-reflection. Isles of Sea and Sky challenged me to take a step back, to reassess, and to move on. Maybe it’ll do the same for you.

    Isles of Sea and Sky was released May 22 on Windows PC. The game was reviewed with code provided by Cicada Games. Vox Media has affiliate partnerships. These do not influence editorial content, though Vox Media may earn commissions for products purchased via affiliate links. You can find additional information about Polygon’s ethics policy here.

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    Grayson Morley

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  • The Link Between a Mother’s Lupus and a Child’s Autism

    The Link Between a Mother’s Lupus and a Child’s Autism

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    At the turn of the 21st century, the prevalence of autism spectrum disorder among American children was roughly 1 in 150. That’s according to data collected by the Autism and Developmental Disabilities Monitoring Network of the U.S. Centers for Disease Control and Prevention. A decade later, in 2010, the prevalence had risen to 1 in 68 children. By 2020, it had climbed again—to 1 in 36 children. “The prevalence of Autism Spectrum Disorder (ASD) has increased dramatically in recent decades, supporting the claim of an autism epidemic,” wrote the authors of a 2020 study in the journal Brain Sciences.

    The precise cause and extent of that epidemic are contested. Some researchers have observed that the diagnostic criteria for ASD have evolved during that time—stretching and broadening to include a wider array of conditions. And so part of the rise in diagnoses, they argue, is likely attributable to dilating conceptions and a deeper understanding of autism. Still, the increasing prevalence of ASD diagnoses has spurred greater scientific interest in the underlying causes of the disorder. That work has revealed a possible connection between ASD and autoimmune conditions, including systemic lupus erythematosus (SLE).

    “For quite a while, there’s been a link between maternal autoimmune diseases and risk for having a child with autism,” says Paul Ashwood, a professor of medical microbiology and immunology at the University of California, Davis and the MIND Institute, which focuses on autism and other neurodevelopmental conditions. He mentions work based on nationwide data collected over a period of many years from mothers and their offspring in Denmark. That research found that prenatal exposure to a number of different maternal autoimmune diseases, including both lupus and rheumatoid arthritis, was associated with an increased risk for an eventual autism diagnosis.

    Since then, more research has firmed up the apparent association, and also found evidence of a broader connection between a pregnant woman’s immune system and the risk of an offspring with autism. “What we’ve been looking at a lot more recently is how anything that generates a maternal immune response could be linked to autism risk,” Ashwood says.

    Read More: The Most Exciting New Advancements in Managing and Treating Lupus

    Antibodies and the developing brain

    In response to a threat, such as a virus or other pathogen, the immune system produces protein antibodies that are intended to neutralize or eliminate the danger. But among people with autoimmune conditions such as systemic lupus erythematosus, the immune system produces antibodies that attack the body’s own healthy proteins or tissues. These are called autoantibodies.

    In a 2015 study in the journal Arthritis and Rheumatology, a group of Canadian researchers found that children born to women with systemic lupus erythematosus were nearly twice as likely to develop autism as children of women who did not have SLE. Furthermore, the children of mothers with SLE tended to be diagnosed with autism at a younger age than those of mothers without SLE. 

    “In-utero exposures to maternal antibodies and cytokines [proteins that regulate the growth of immune system cells] are important risk factors for ASD,” the authors of that study wrote. Women with SLE “display high levels of autoantibodies and cytokines,” which have been shown in animal models to alter fetal brain development and induce behavioral anomalies in offspring, they added.

    “Maternal antibodies, including autoantibodies, start crossing the placenta barrier around day 100 of gestation, and we know that this can affect the developing fetus,” says Judy Van de Water, professor of medicine and associate director of biological sciences at the University of California, Davis and the MIND Institute. “One of the things we’re looking at is how these autoantibodies or other aspects of the mother’s immune response could affect neurodevelopment.”

    Some research has already found that maternal autoantibodies related to SLE may lead to the development of heart conditions and also blood and liver abnormalities in a developing fetus. Van de Water and her colleagues are examining whether and how other autoantibodies may similarly affect fetal brain development. “Several of the proteins that these autoantibodies target are really highly expressed in the developing brain, and not the mature brain,” she says. This may create unique exposure risks for a developing fetus.

    Read More: How Changing Your Diet Could Have a Major Impact on Managing Lupus Symptoms

    The immune-autism link

    Apart from lupus, several other maternal autoimmune disorders, including rheumatoid arthritis, have been tied to an increased risk for having children with autism. The same is true of immune-related conditions such as asthma and allergies. Van de Water and other researchers are now taking a broad look at how a pregnant woman’s immune system activity may affect the fetal brain. “Anything that impacts maternal immune homeostasis or the balance of the immune response in the mother could impact neurodevelopment in the child,” she says. “So we’re looking at different immune systems responses—what the response is, how intense the response is, the makeup of inflammatory markers—and their relationships to autism.” 

    An autoimmune condition like lupus is one source of a heightened maternal immune response, but Van de Water says that, under the right conditions, just about anything that triggers an immune reaction could potentially affect neurodevelopment in ways that contribute to autism. “We’re looking at a lot of different maternal immune activations or perturbations—whether from an existing condition or illness, or something that happens during pregnancy,” she says. 

    In particular, experts highlight the role that inflammatory cytokines may play in autism risk. “The way to think about cytokines in the fetal environment is that they can potentially act in a dose response manner—just as too much is bad, then too little is also bad, but there is this goldilocks level that you need to have for appropriate growth,” Ashwood says. “If there’s some kind of immune condition or inflammatory response that leads to the constant production and release of these cytokines, those could cross the placental barrier and affect fetal development.” 

    In the brain, for example, the presence of cytokines “could affect neuron growth, neuron proliferation, the connection of neurons to other neurons, synapse formation, neuronal migration, and all sorts of processes that are necessary to build an interconnected network as the brain grows,” he explains. “Having those systems slightly off-kilter can potentially affect the trajectory of neurodevelopment.”

    Lupus and other autoimmune disorders are one potential source of cytokine imbalance. But Van de Water says that obesity is another inflammation-related condition—and a far more common one than lupus—that could produce the sort of immune activity that contributes to autism. “Obesity has a major inflammatory component attached to it,” she says. “We just published a paper looking at this, and it turns out that the biggest maternal risk factor for autism was not any autoimmune disease, but asthma and allergies coupled with obesity. You put these two together with obesity and he risk was significantly greater.”

    Another potential connection between a mother’s immune activity and her offspring’s autism risk is the microbiome—the community of bacteria that inhabit the gut. Some research has found that the metabolites produced by a mother’s gut bacteria can affect the neurodevelopment of the fetus. Furthermore, there’s evidence that infections, metabolic stress (such as obesity), and other immune-related events can lead to maternal microbiome imbalances that, potentially, could raise her offspring’s risk for autism. 

    On top of this, there’s evidence that people with autism share some distinct microbiome characteristics, and that gut-related symptoms—diarrhea, constipation, and abdominal pain in particular—are common comorbidities among people with autism. “There’s a lot of interest right now in the microbiome —how it’s formed, the way it nourishes the body, and how it shapes the activity of the immune system,” Ashwood says. There’s also been much recent interest in the so-called “gut-brain connection,” and science has established that the gut’s microbiota influence brain connectivity and functioning.

    It’s not certain yet, but it’s possible that maternal autoimmune disorders and other immune-related perturbations could directly or indirectly affect the microbiome of the fetus in ways that contribute to the development of autism.

    Read More: What to Know About Complementary Treatments for Lupus

    A multifaceted disease

    While there are several plausible mechanisms that could tie autoimmune disorders to autism, experts say this is likely only one small part of the autism equation. “It’s worth remembering that autoimmunity in the general populace is pretty low,” Ashwood says. Also, research on the link between maternal lupus and autism has found that while the risks are elevated, women with the autoimmune condition were still at low overall risk for having a child with autism.

    Apart from maternal immune conditions, there’s growing evidence of the role that genetics play in a person’s risk for autism. “More than 100 genes are known to confer risk, and 1,000 or more may ultimately be identified,” wrote David Amaral, a distinguished professor at the University of California, Davis and the MIND Institute, in a 2017 paper on the causes of autism. He goes on to explain that, most likely, a mix of genetic and environmental factors contribute to the development of autism. “It seems clear at this point,” he writes, “that when all is said and done, we will find that autism has multiple causes that occur in diverse combinations.”

    Van de Water likewise emphasizes this point. Autism spectrum disorder is a diverse and multifaceted condition, and its underlying causes are likely equally complex. Lupus and other immune-related conditions may be a piece of the puzzle, but they’re just one of many. “Anyone who tells you they know the cause of autism doesn’t know autism very well. There are many layers to it,” Van de Water says. “There seems to be a relationship between the mother’s immune activity and autism, but we don’t have all the answers yet.” 

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    Markham Heid

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  • Can Food Really Change Your Hormones?

    Can Food Really Change Your Hormones?

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    Dr. Taraneh Nazem, a reproductive endocrinologist and infertility specialist for RMA of New York, recently watched a TikTok video claiming that eating raw cacao daily could completely balance your hormones and cure PMS. “The creator made sweeping statements without any scientific backing, and the comment section was filled with people eager to try it—despite cacao’s known potential to cause insomnia and anxiety if consumed in large quantities,” says Nazem.

    Social-media is rife with posts like this, pushing superfoods and supplements to boost your hormonal health and improve your low energy, poor sleep, bad acne, and so many other ills in the process. “Every day, another influencer on TikTok claims that superfoods can change our hormonal balance,” says Dr. Caroline Messer, an endocrinologist with Northwell Health at Lenox Hill Hospital in New York City. The myths that especially irk Messer: apple cider vinegar helps women with PCOS, green tea is the secret to better insulin sensitivity, and butter supports healthy estrogen levels.

    Do you even need to “balance your hormones,” as many on social-media tout in their hashtags? Experts share what foods can—and can’t—do for your hormonal health.

    The connection between diet and your hormones

    The foods you eat can affect your hormone production and secretion by creating small changes throughout your gut, says Perri Halperin, a registered dietitian who is a clinical nutrition coordinator at Mount Sinai Hospital. Some foods also contain hormones or compounds that are similar to or imitate them. (For example, soy contains phytoestrogen, which mimics estrogen.)

    But a person’s big-picture way of eating—not any single food included in their diet—is what can truly affect hormonal health, experts agree. “An unhealthy diet high in processed foods and saturated fats can lead to conditions like metabolic syndrome, diabetes, and polycystic ovary syndrome [PCOS],” says Messer. That’s because a diet high in sweets, dairy, refined grains, red meat, and processed foods can raise estrogen levels and promote insulin resistance due to higher body fat, she explains. Research has linked a Western diet with high estrogen in women, low testosterone in men, insulin abnormalities, and imbalanced cortisol levels.

    Read More: You Don’t Need to Balance Your Hormones

    It’s also possible to have hormone-based medical issues that can be helped by a dietary overhaul. Kaytee Hadley, a functional dietitian in Richmond, Va., recently worked with a young woman experiencing unpleasant gut symptoms along with irregular cycles, PMS, and ovarian cysts, which would rupture regularly and cause excruciating pain. “It was clear she had hormonal imbalances,” says Hadley. After running a few tests, it was also determined that she had nutritional deficiencies and poor gut health exacerbating these issues.

    Hadley had the client focus on a “food-first approach” by adding more nourishment and gut-friendly foods, addressing her vitamin deficiencies, and developing a consistent eating schedule with foods she enjoyed. “In less than six months, she had no more symptoms of PMS or cysts, her acne cleared up, her cycles became more regular, she had more energy, and her bloating and gas were completely gone,” says Hadley.

    But this success story doesn’t apply to the average person—and no “magic” superfood touted on TikTok can have these effects. It wasn’t, say, the beans or tofu she started eating more regularly that “cured” her sex hormone imbalances, but sweeping lifestyle changes that focused on a healthy diet, exercise, stress-reduction techniques, and improving her sleep, Hadley says.

    Read More: 8 Eating Habits That Actually Improve Your Sleep

    “While a single food won’t address the underlying cause of hormonal imbalances, nutrients are important building blocks for hormones and affect their production, transportation and elimination,” says Hadley. “If you aren’t getting the necessary vitamins, minerals and macronutrients, making positive long-term changes to your diet can help to optimize thyroid, stress and sex hormones.”

    Others echo that outlook. Making lifestyle changes for the long haul can significantly improve hormonal issues. “But a teaspoon of apple cider vinegar or a cup of green tea won’t fix everything,” Messer says.

    “This kind of misinformation can lead to unmet expectations and potential health issues,” says Nazem.

    Hormonal health is often more about what you don’t eat

    Consider testosterone, a sex hormone made from cholesterol. Some studies suggest that healthy sources of cholesterol such as eggs and avocados can support testosterone production, says Dr. Alex Robles, a reproductive endocrinologist at Columbia University Fertility Center. Other nutrients important for testosterone production include zinc, magnesium, and vitamin D.

    But eating foods rich in these nutrients “likely won’t cause a massive boost to your testosterone levels,” says Robles. “Rather, the lack of these nutrients (or being deficient in them) can negatively affect your body’s ability to produce certain hormones.” (You may see on social media that zinc deficiencies are linked to low testosterone, but such deficiencies are uncommon in the U.S., where people regularly consume zinc from sources like poultry, beans, oats, eggs, and nuts.)

    Read More: What Alcohol Does to the Gut

    With testosterone and many other hormones, maintaining the right levels is more about what you don’t eat—too many processed foods, refined carbohydrates, and saturated fats, and alcohol—rather than putting a health halo on any one food.

    What foods can help your hormones?

    Most people do not need to stress about “balancing” their hormones through food or supplements. Your body does that complicated task for you, says Halperin.  “The truth is, [hormones] are incredibly complex, individualized, and they fluctuate,” she says. There’s no “magic bullet” that will create optimal hormonal health.

    Messer agrees. While it’s true that foods can impact our metabolic health, our bodies are “pretty resilient,” says Messer, and individual food choices don’t usually create drastic hormonal changes. Eating a well-rounded diet rich in whole foods will cover your bases. 

    However, certain foods can sometimes slightly influence your hormones. Here’s how.

    Thyroid hormones

    Thyroid hormones regulate energy levels, temperature, weight, and metabolism. Called triiodothyronine (T3) and thyroxine (T4), they are also involved in skin, hair, and nail growth.

    “Chances are your thyroid and its hormones are working just fine, unless you have a diagnosed thyroid condition like hypo- or hyperthyroidism, for which you should consult a doctor for medication managed treatment,” says Halperin.

    Foods that may help thyroid health

    Including foods rich in minerals such as iron, selenium, zinc, and iodine in your diet may be beneficial for thyroid health. These include shellfish such as shrimp and oysters, seaweed, Brazil nuts (which are particularly rich in selenium), and fortified foods like iodized salt, cereals, and dairy products. 

    Cortisol

    The body releases cortisol when it’s physically or emotionally stressed (earning its reputation as the “stress hormone.”) Cortisol normally peaks in the morning to help you wake up and declines throughout the day so you can fall asleep at night. When this natural rhythm is disrupted, people tend to become fatigued, gain weight, and get sick more often. 

    As with most hormones, to optimize cortisol levels, dietitians recommend eating a balanced diet and not restricting food intake, as severe calorie restriction may increase cortisol levels. (This is because not getting adequate energy from food and calories is stressful for your body.)

    Read More: Should I Take Supplements to Sleep? What Experts Think

    Another thing to note: When we’re stressed, our bodies use up certain vitamins and minerals faster. “Focusing on magnesium and B vitamins during these times is especially important for helping your body combat stress and rebalance cortisol,” says Hadley. As long as your doctor or dietitian isn’t recommending you take these supplements, the best way to get those is through a balanced diet.

    Foods that may lower cortisol levels

    Oily fish rich in omega-3 fatty acids, such as mackerel, may help lower cortisol levels. That in turn can decrease cortisol-sensitive symptoms like fatigue.  

    Some studies have also shown that other omega-3 rich foods like avocado oil and dark chocolate may support healthy cortisol levels. Decreasing added sugar—by cutting out soda, for example—is also key for healthy cortisol levels.

    Read More: For Better Well-Being, Just Breathe

    Recently, a study showed that following a Mediterranean style diet lowers cortisol levels. In general, adhering to a plant-filled, nutrient-rich diet may keep cortisol in check. An ultra-processed diet composed of refined carbohydrates and sugary beverages can lead to a constant release of insulin, which can result in insulin resistance, weight gain, and inflammation. Because of this blood-sugar roller coaster, you can end up boosting cortisol, which Dr. Simran Malhotra, an internal medicine and lifestyle medicine physician in Bethesda, Md., says may worsen the vicious cycle of eating highly palatable but nutrient-depleted foods.

    Melatonin

    Often called the “sleep hormone,” melatonin promotes a proper sleep-wake cycle. “Healthy habits, like giving yourself time to wind down and not drinking caffeine or alcohol before bed, can increase melatonin production,” says Halperin. As with other hormones, what you avoid may impact levels as much as what you consume.

    Foods that may help produce melatonin

    Some studies suggest that tart cherry juice may increase melatonin levels, beneficially impacting both sleep duration and quality. And tryptophan is an amino acid that supports the production of melatonin. Tryptophan-rich foods include turkey, tuna, and quinoa. 

    Serotonin

    Scientists have discovered a close link between the stomach and the mind known as the gut-brain axis, a two-way communication system between the central nervous system and the enteric nervous system in our gut. Research indicates that 95% of the body’s serotonin—the so-called “happy” hormone that plays a key role in mood—is produced in the gut. 

    Foods that may boost serotonin levels

    Tryptophan is a key protein building block used to make serotonin. “Meats such as turkey are rich in tryptophan, but our bodies struggle to convert it to serotonin due to competing amino acids,” says Malhotra. Scientists have found that high-carbohydrate meals help by triggering insulin, which aids your muscles absorbing the competing amino acids; this makes it easier for the tryptophan to cross into the brain and boost serotonin levels, she explains. “That’s why a high animal-protein diet can limit serotonin production, whereas tryptophan-rich whole-plant foods such as oats, walnuts, pumpkin seeds, tofu, spinach, and dark chocolate (more than 70% cacao) can boost serotonin levels and promote feelings of calm,” explains Malhotra.

    What about “fertility” diets for women?

    Sex hormones like estrogen, progesterone, and testosterone impact fertility for men and women in different amounts. On social media, the so-called “fertility diet” is presented as a way for couples (especially women) who are trying to conceive to improve their chances. Experts like Nazem believe that while some aspects of these diets are rooted in scientific evidence, others are exaggerated or lack sufficient scientific evidence. “It’s essential to approach such diets with a critical mindset and understand that individual health and fertility depend on a complex interplay of various factors,” she says.

    While there’s no one-size-fits-all approach to eating to optimize fertility, reproductive endocrinologists—doctors who specialize in hormonal health as it relates to fertility—tend to endorse eating a fiber-rich, whole foods diet. Sound familiar? That’s because it’s the same research-backed eating approach science says is best to promote overall health, such as through a Mediterranean or plant-based diet.

    Read More: The Silent Shame of Male Infertility

    One key reason these diets are so healthy is because they emphasize fiber. “Fiber from fruits, vegetables, beans, and whole grains not only helps to keep you regular, but it is also important for maintaining healthy estrogen levels,” says Hadley—a sex hormone that can negatively affect fertility if it’s too high. The nutrient acts like a broom to sweep excess estrogen out of the body through bowel movements. Large-scale, longitudinal studies have also shown that women who eat more fiber have a reduced risk of breast cancer. 

    Nazem counsels female patients to focus on foods rich in antioxidants, healthy fats and folate to support hormone balance and improve egg quality. “Avocados, nuts, seeds, leafy greens and whole grains are excellent choices,” she says. She’s also a fan of flax seeds and cruciferous vegetables such as broccoli, cabbage, and cauliflower; they all contain phytoestrogen, which can improve estrogen metabolism.

    The bottom line 

    For Hadley, the key takeaway is that making nutrition changes for the sake of your hormones should only be done based on your body’s unique needs. “While there are foundational strategies that anyone can implement, knowing what’s going on with your hormones will allow you to take a more individualized approach and address those imbalances specifically,” she says.

    The body is incredibly smart and likes to maintain equilibrium, so unless you have a diagnosed hormone condition, Halperin says there is a good chance your hormone levels are where they need to be. “Small dips or spikes in hormone levels can cause unpleasant symptoms like difficulty losing weight or sleeping, but can generally be managed through a balanced diet, regularly scheduled meals and snacks, weight maintenance, adequate sleep, and stress management,” she says. “If you’re living your best life, but still not feeling your best, your actual best bet is to get checked out by your doctor or RD, versus believing what you see and hear on social media.”

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    Perri Ormont Blumberg

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  • 8 Eating Habits That Actually Improve Your Sleep

    8 Eating Habits That Actually Improve Your Sleep

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    About 1 in 3 Americans say they’re sleep deprived, and these deficits are linked to serious illnesses like heart disease, stroke, diabetes, cancer, and depression. Certain patterns of eating could lead to more nightly rest, translating into healthier, more satisfying lives.

    Good sleep also stabilizes the body’s hunger hormones for less impulsive snacking the next day. “It’s a cycle,” says Marie-Pierre St-Onge, an associate professor of nutrition and director of Columbia University’s Irving Medical Center of Excellence for Sleep and Circadian Research. “If you eat better, you’ll sleep better and be more refreshed. And that helps you make better decisions for your diet.”

    Here’s what to eat for better sleep.

    Have tryptophan the right way

    Key to improving nighttime rest is picking an eating regimen with plenty of compounds that promote sleep. This doesn’t come down to any one food or ingredient. “It’s more of a holistic profile with various helpful components,” St-Onge says.

    One of those is tryptophan, a building block of protein. The body doesn’t make any of it. Rather, we get tryptophan from food: yes, turkey, but also fish, eggs, yogurt, and nuts like walnuts, among other examples. Once eaten, tryptophan passes from the blood into the brain and becomes melatonin, the hormone that triggers sleepiness for nighttime shuteye.

    There’s a hiccup, though: not much tryptophan enters the brain if other substances are competing to get in. But when we pair foods that have tryptophan with healthy carbohydrates, such as lentils or fruits, the cells throughout our bodies gobble up the competitors, clearing tryptophan’s path.

    “We need tryptophan in combination with carbohydrate-rich foods,” says Arman Arab, a postdoctoral fellow at Harvard Medical School who specializes in nutrition.

    The Mediterranean diet is one regimen loaded with both tryptophan and healthy carbs—those with plenty of fiber. Like carbs, nutrients such as zinc, B vitamins, and magnesium play key roles in converting tryptophan into melatonin for better sleep, and the Mediterranean diet delivers each of these components. Spinach, barley, and whole wheat are great mates for tryptophan-rich foods. Arab recently found that people who follow the Mediterranean diet have better sleep quality and less insomnia. St-Onge has researched similar associations.

    Avoid foods that cause inflammation

    An ideal diet leaves out foods with substances that could spoil your slumber. They include less healthy carbs like low-fiber, high-sugar cereals, bagels, and fruit juices. People who eat unhealthy carbs tend to wake up more frequently overnight, according to St-Onge’s research. 

    When frequently consumed, foods high in saturated fats (for instance, beef and chicken with the skin) also contribute to sleep problems. 

    A common denominator between unhealthy carbs and saturated fats is that they both produce inflammation across the body, an issue linked to lower sleep quality and duration, Arab says. A diet packed with these foods may also lead to excess weight gain, which can cause sleep apnea and pressure on the diaphragm, further disrupting sleep.

    Read More: Should I Take Supplements to Sleep? What Experts Think

    People can use the Dietary Inflammatory Index to score their daily consumption of inflammatory foods. Scores improve with plenty of healthy, unsaturated fats, like the ones in salmon, nuts, and seeds. These foods are anti-inflammatory and prevalent in the Mediterranean diet—another reason this diet promotes sleep. 

    Having a wide variety of fruits and vegetables is optimal, says Erica Jansen, an assistant professor of nutritional epidemiology at the University of Michigan. The diversity can “spread out exposure to any one toxicant” such as pesticides or heavy metals—which may disrupt sleep—and it ensures plenty of polyphenols and micronutrients that support sleep partly by lowering inflammation. Jansen found that when women increased their daily fruit and vegetable consumption by three servings, they dramatically improved their sleep quality and insomnia symptoms.

    Try other approaches with sleep “superfoods”

    Although the Mediterranean regimen is backed by the most research, other approaches could be just as beneficial if they offer the same sleep-promoting nutrients and compounds. Aim for diets with many vegetables, lower-sugar fruits, plant-based proteins, and unsaturated fats. “Such patterns probably influence sleep in the same way” as the Mediterranean approach, St-Onge says.

    These strategies include the USDA’s Healthy Eating Index and the Dietary Approaches to Stop Hypertension diet, or DASH. Arab didn’t find a strong link between DASH and having fewer insomnia symptoms, but some other research suggests it’s helpful. The Chinese Healthy Eating Index, another eating pattern with many sleep-supportive ingredients, is also associated with good sleep.

    Some effects differ across individuals, so plug-and-play items to find what boosts your sleep, even if they’re not staples of a particular diet. A line of research points to Montmorency tart cherry juice, for example. It’s full of melatonin, as are kiwis, nutritional yeast, pumpkin seeds, edamame, tofu, and dairy products. 

    Many ingredients high in fiber can also be found beyond the Mediterranean diet. These sleep-promoting foods include black beans, split peas, sweet potatoes, chia seeds, and flaxseeds.

    Start eating early, stop eating early

    Like most things in life, timing matters. Research shows that having meals too close to bedtime can hinder sleep. It’s important to wrap up eating for the day a few hours before turning in for the night. 

    This final meal could feature a plant-based protein such as tofu—which is filling, contains tryptophan, and keeps inflammation low—and a healthy carb like chickpeas to support tryptophan’s passage into the brain. Time it 2-4 hours before bed; that’s how long it takes for tryptophan levels in the body to peak. 

    Foods that are heavy or have too much sugar or spice, when eaten before bed, are especially likely to cause bloating, blood sugar spikes, and a night of tossing and turning, Jansen says.

    Sleep is also disturbed at the other extreme: being really hungry at bedtime. To avoid this scenario, get a headstart on nutrition in the morning. “Wherever we look, individuals who have breakfast, sleep better,” St-Onge says. Keep the same timing each day as much as possible, Jansen adds. “Maintaining a consistent pattern is really important for sleep.”

    Try the liquid loophole

    There is an exception to the rule about wrapping up nutrition several hours before bed. Pouring through this loophole could be some of your favorite liquids. The research isn’t conclusive, but a variety of teas, such as chamomile and lemon balm, have relaxing compounds that seem to improve sleep, at least for some “super responders,” St-Onge says. Low-fat milk, rich in tryptophan, may help as well. “There’s no harm in trying them” about an hour before bedtime; they’re absorbed faster than food.

    Melatonin supplements are another matter. While these pills may help with occasional bouts of insomnia or jet lag, even small doses “go beyond what’s needed for sleep,” an excess that may cause health problems with regular use, Jansen explains.  

    Feed your gut bugs

    Food affects the bacteria in the digestive tract, known as the microbiome, and the right bacteria may help reduce inflammation. In theory, “If we can improve our microbiota, it could reduce inflammation in the body and lead to better sleep,” Arab says. 

    Some early research suggests that certain gut bacteria play a role in converting tryptophan into sleep hormones. A study in 2022 found that mice given prebiotics had more rapid-eye movement and other relaxing forms of sleep. According to a recent research review, consuming prebiotics and probiotics improves sleep quality in humans. 

    Instead of probiotic supplements, though, eating yogurt, kimchi, and other fermented foods will support the microbiome as part of a natural, healthy diet. More research is needed on “sleepbiotics,” whether pills or food, to know their effect on slumber, Jansen says.

    Be consistent

    People who follow these dietary patterns regularly have better sleep outcomes than those who merely dabble in them, several studies show. Whichever sleep-promoting diet you choose, stick with it. For the biggest improvements in sleep, “make sure you have a healthy diet day in, day out,” St-Onge says. “Give it a week or two” before expecting to see benefits.

    Have a vegetable before breakfast

    The relationship between food and sleep goes both ways. Just as a healthy diet with sleep-promoting compounds leads to better sleep, better sleep leads to healthier food choices. By the same token, less sleep changes hunger hormones for worse decisions. “After sleeping poorly, you should be extra vigilant about a healthy diet to get back on track,” St-Onge says.

    Jansen is a good example. With her one-year-old interrupting sleep, “I keep in mind that, because I was up all night, I’ll crave more energy-dense foods,” she says. “So I try not to give in to that.”

    She also has a healthy breakfast to “get off on a good nutritional foot.” A related strategy when sleep-deprived is to begin the day with a veggie starter. When people have a salad or other vegetable before a carb-heavy breakfast, their appetites and blood sugar tend to be more stable the rest of the day. This could prevent a cycle of several nights of bad sleep and poor nutrition. “You can break the cycle,” St-Onge says.

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    Matt Fuchs

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  • Ser Criston Cole could rule the world if it wasn’t for all these dragons

    Ser Criston Cole could rule the world if it wasn’t for all these dragons

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    Criston Cole (Fabien Frankel) should be the kind of man who has songs written in his honor. A low-born knight, elevated to the Kingsguard, then made Lord Commander, before finally rising to the position of Hand of the King. Our handsome knight has some … anger issues, yes (who doesn’t in this world?), but he appears to be an honorable and gallant knight — and really that’s all that matters as far as the histories are concerned. He does have one fatal flaw though, something entirely outside of his control: he was born in the age of dragons.

    Episode 4 saw Criston rise to his highest yet. His successive military victories earn him the acclaim of the masses. For a low-born knight to be named “kingmaker” is the stuff of legend, but here we saw just how far he can fall. As dragons clash in the sky over Rook’s Rest, Criston is thrown from his horse and spends most of the battle unconscious. While there is no shortage of sweeping dragon-on-dragon action, the focus of this sequence is remarkably human. This climactic battle represents one of the most important days of Criston’s career, the moment this entire campaign has been leading to, but he spends it face down in the mud. It doesn’t matter what someone’s status is, when faced with a dragon they are little more than a sack of meat and bone.

    But this is just one setback in what has been a long line. He was elevated to the Kingsguard, only to discover the limits of his station. He is constantly beneath royalty (and you can take that in any way you will), which means he rarely has leave to act of his own accord. He has had two royal flings so far, and neither have gone particularly well. Even when things go his way, he is uncomfortably aware of his own fragility. No matter what he does, how hard he tries, he just isn’t enough. His military is larger and better equipped than that of team Black, but they are little more than specks when viewed from dragonback. He has seen men tossed aside like dolls, and burned in dragonfire. He knows that his little battle of men and land is a farce — there are greater powers in the sky. But Criston rails against these limits. Faced with his own powerlessness, we see him declare this a war of dragons, not men. He is restless in his position, and it’s easy to see why.

    Criston is entirely convinced of his own self-importance. To be fair, he has a good deal of evidence to support that perspective, even beyond what’s outlined above. He unseated Daemon at the tourney and quickly won his position on the Kingsguard, and his military victories are all his own. Aegon looks pathetic when placed next to Criston (though this is true of most people, to be fair), but even the more formidable Prince Aemond was his pupil. He has done the impossible already, so it is no wonder that he is so confident in his own abilities; he can already hear the songs that will be sung in his honor.

    Photo: Theo Whiteman/HBO

    But that honor is fragile. He tries to bury any and all evidence that suggests he is not suited to his position, first by murdering Joffrey back in season 1, and more recently by deflecting blame for Jaehaerys’ murder onto Ser Arryk and sending him to his death. Criston is skilled, yes, but he is also recklessly prideful. He is locked in a constant battle to prove to himself and others that he deserves his position, but he constantly falls short. Episode by episode we can see his frustration mounting, Frankel deftly portraying the rising anger of a man who can’t quite get it right. We can all sense the danger here: We have a man who wants to prove his own greatness, who blinds himself to his shortcomings, yet is cursed to spend his life in the shadow of dragons.

    In most cases, this kind of self belief would serve one well. Criston is ruthless and bold, and while that aids him on the battlefield, it presents a problem when the conflict begins to escalate. The battle at Rook’s Rest has clearly shaken him, but where some would reconsider, he doubles down. He endorses Aemond as regent, knowing that he will escalate the war. Criston has seen a fight between dragons firsthand, he knows the chaos it will bring to the Seven Kingdoms, yet he still leads team Green down the path of war. He’s not pure evil, but he is delightfully hateable in this moment. Alicent pushes for him to side with her, but he knows he can’t. It’s the dilemma at the core of the series, and Criston would rather see the Seven Kingdoms fall to ruin than be on the losing side. He’s just as doomed as anyone else in King’s Landing, no matter how high he climbs.

    Criston’s attempts to rise above the dragons ultimately ensure that he will always be under them. Desperate to prove himself, he will lead this war of dragons to its bloody end. His legacy is set in stone, at least as far as his brief mention in A Feast for Crows is concerned. Of all the tragic and thoughtless mistakes characters in House of the Dragon have made so far, pitting the dragons against one another might just be the most significant.

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    Duncan Butcher

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  • Stop Feeling Bad About Sweating

    Stop Feeling Bad About Sweating

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    If you trust advertisements, the only way to survive this summer is with whole-body deodorant. Commercials for the product typically feature a hyper-earnest person confessing that they solved their odor problem by putting whole-body deodorant everywhere—and, yes they mean everywhere.

    At first glance, the whole-body deodorant phenomenon is a comical cash grab. If you can convince folks to apply deodorant beyond the confines of the armpit, so much more product will be sold, it would seem. But beyond the greed and absurdity, these products and their marketing both exemplify—and unfortunately exacerbate—our culture’s fear of sweat.

    Although I think we all need a perspiration peptalk, I’ll absolutely concede that sweat is an objectively weird and flamboyant way to control body temperature: It’s a coordinated breach of the skin by the salty ocean inside. One minute you’re cool as a cucumber; the next you’re leaking liquid from inside your body. And yet, it is the most efficient strategy in the animal kingdom for staying cool when temperatures rise. The evaporation of these cooling floods dispatch our body heat into the atmosphere with stellar efficiency and sweep us back from the brink of heatstroke or death.

    In fact, evolutionary biologists count sweat as one of the curious advantages that makes us human, a human superpower you might say. Sweat is much more efficient than, say, panting because we have oodles more naked skin (than tongue), millions of specialized glands, and a fluid entirely devoted to cooling us down. Other animals dispatch arguably grosser bodily fluids to evaporate away their body heat, including urine (seals), liquid poop (vultures) and vomit (bumblebees). In comparison to what evolution might have bequeathed humans, sweating is a gift.

    Even still, many of us side-eye sweat because of the stink. The majority of humanity’s dubious aroma emerges from our armpits at puberty, thanks to the activation of a unique sweat gland that is much different than the ones releasing the cooling, salty floods. This second sweat gland (called an apocrine gland) produces a waxy and mostly odorless sweat. Specific kinds of bacteria living in your armpits find this waxy sweat delicious, and when they eat it, their metabolic byproducts—a scientific euphemism for “bacterial farts”—is what makes that area aromatically raunchy.

    Most deodorants work by being antiseptics: You put it on, the deodorant kills all the bacteria that eat apocrine sweat, and their death keeps stink at bay. But here’s the rub: putting deodorants over your whole body, as some advertisements advise, would likely spread antiseptic everywhere and have the potential to disrupt your skin’s microbiome. These symbionts help fight off pathogenic bacteria and fungi. Annihilation of these populations in your armpits, a contained area specifically responsible for an exceptionally noxious stink, seems comparatively moderate. (And if a brand of whole-body deodorant contains no antiseptic then it’s just perfume by another name, and mediocre perfume at that. )

    The truth is that humans don’t just smell “good” or “bad.” We also just smell like ourselves. There’s a subtle symphony of aroma that distinguishes you from me, beyond the strong odor of our armpits. Our body odor print is often recognized and appreciated by those closest to us. Many cherish the scent of their partner, their baby, their parents, their best friends. This aroma can evoke feelings of attachment, nostalgia, desire.

    Read More: What Your Body Odor Says About You

    A successful whole-body deodorant wouldn’t just dampen the unpleasantly ripe aroma of our armpits, it would interrupt the subtle symphony of smell that distinguishes your aroma from everybody else’s and provides subtle clues about yourself to your nearest and dearest. Why would you mess with that?

    Much of the reason is shame marketing.

    In the early 1900s, advertisers developed a strategy called whisper copy to rescue the then fledgling deodorant and antiperspirant industry. Whisper copy, launched first in 1919 for a product amusingly called Odorono, equated body odor with social exclusion. In short: You stink, people are gossiping about it, and you’ll consequently never find love or a successful career.

    One example of the strategy from 1937, borrowed by Odorono’s competitor Mum deodorant read, “In this smart modern age, it’s against the code for a girl (or a man, either) to carry a repellent odor of underarm perspiration on clothing or person.” This “straight talk” whisper copy strategy is still used by traditional advertising and social media influencers when marketing deodorant (and other personal care products) today.

    And it’s not just the odor of sweat that can feel shameful. The mere appearance of the bodily fluid can also betray social anxiety and stress—a moist handshake at a job interview, soggy armpits when you’re chatting up your crush. That’s because temperature isn’t the only sweat trigger; the stress hormone adrenaline can also open the floodgates.

    We can often suppress other socially embarrassing bodily functions—a fart or a burp—for a second or two, enough time to relocate somewhere more socially secluded. But when sweat glands get marching orders, whether it’s from our internal thermometers or our emotional centers, the tides of sweat (and shame) wait for no one. The biological realities of sweat collide with our unreasonable (but perpetually sought out) desire to perfectly curate our external appearance.

    Our control freakish behavior is even more amplified because of social media and the rise of video conference call applications, where we can carefully tweak our brand identity to the people in our social circles. Yet those filtered digital personas go rogue in real life, especially when a heat wave, hot flash, or moment of anxiety soaks a tidy outfit.

    But here’s the thing: We’re all nervous on dates or job interviews. We’ve all had a body odor malfunction. It’s part of being human. Let’s reinforce empathy rather than shame when our bodies go off-message.

    Completely controlling our sweat is a faulty quest so let’s opt for moderation. Especially given that staying cool will be a key to surviving increasingly warmer temperatures. How unfairly lucky that humans are both the perpetrators of climate change and have a biological advantage for surviving it.

    So instead of being ashamed of sweat this summer, let’s include it in the body positivity movement. And let’s appreciate that our sweat is not only keeping us alive, but also more connected.

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    Sarah Everts

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  • How Much Hair Loss Is Normal for Women?

    How Much Hair Loss Is Normal for Women?

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    When your brush quickly becomes clogged with hair or you start finding increasing numbers of stray strands on your clothes, it’s enough to make any woman feel uneasy—especially if you’re also getting older. But in most cases, it’s an ordinary part of aging. Research has found that more than 50% of women over age 50 experience female pattern hair loss (on the crown of the head), which is the most common form of hair loss in women.

    The simple truth is: Time isn’t on your side when it comes to holding onto the hair on your head. “You probably have the thickest and most luxurious head of hair between the ages of 15 and 30,” says Dr. Mary Lupo, a dermatologist based in New Orleans. “After that, there’s a gradual decline, followed by precipitous changes after menopause. Estrogen is very good for the hair. After menopause, women lose estrogen and hair.”

    It’s normal to lose 50 to 150 hairs per day. That may seem like a lot, but most people have about 100,000 hairs on their heads at any given time. A strand of human hair has its own life cycle with four phases: anagen (the growth phase), which lasts several years; the transitional “catagen” period, which lasts a few weeks; telogen (the resting phase), which lasts three to four months; and exogen (shedding). At that point, the follicle from which a hair sprouted begins to grow a new one. Fortunately, different hairs are in different phases of the growth cycle at any given time, which is why you don’t go bald every few years. 

    The trouble is: “Once you decide you have hair loss, all you see is hair falling out,” says Dr. Doris Day, a clinical associate professor of dermatology at NYU Langone Health and author of Beyond Beautiful: Using the Power of Your Mind and Aesthetic Breakthroughs to Look Naturally Young and Radiant.

    But there are objective signs that the loss may be excessive. If you suddenly notice a widening of your part, or you can see your scalp through your hair in the front, these are signs that you may be losing too much. Other women notice their ponytails are thinner than they used to be, or they discover clumps of hair in the shower drain or on their pillows.

    The roots of the problem

    Genetic factors often contribute to hair loss in women, and they can be passed down from either side of the family. In addition, emotional stress (like the kind caused by the death of a loved one or a challenging relocation) or physiological strain (such as major surgery, rapid weight loss, or a bad case of COVID-19) can lead to significant hair loss. It may not happen right away. “There’s a lag with stress—when stress happens, you don’t see the change in hair loss for three to four months because of the natural hair cycle,” Day says.

    What’s more, the presence of certain medical conditions (such as thyroid disorders, anemia, or polycystic ovary syndrome, known as PCOS for short) or the use of some medications (including certain antidepressants and hypertension drugs) can contribute to excessive hair loss in women. And nutrient deficiencies—particularly in vitamin D, iron, and protein—can play a role in hair loss.

    Read More: Multivitamins Are Linked to Slower Brain Aging

    Sometimes, intense hair-styling practices can cause strands to fall out before they’re ready to be shed naturally. “About 40% of women lose extra hair every day due to the way they style their hair—[with] tight buns, high pulled-back ponytails, and hair extensions,” says Dr. Elizabeth Bahar Houshmand, a dermatologist based in Dallas.

    On top of all this are the effects of getting older. As the decades pass, women often lose more strands and hair growth slows down. Plus, the texture and fiber density of hair changes so that “the new strands are thinner than when you were younger,” Day says. Research has found that the hair shaft diameter increases among women until age 45 and decreases after that; this change, combined with a sparser density in hair, can make hair thinning increasingly visible as women get older. 

    “It’s important to understand that hair loss and shedding can be multifactorial—you can have multiple causes,” Houshmand says.

    Hair loss solutions

    If noticeable hair loss is upsetting you, schedule a visit to a dermatologist, who can examine your scalp and order blood work to check for possible underlying causes for the hair loss, Houshmand says. 

    If a medical condition is to blame, addressing it directly, perhaps with medication, may help restore growth. For example, if an excess of male hormones (androgens such as testosterone) is responsible for the hair loss, as it is with PCOS, a diuretic called spironolactone, which has anti-androgen effects, can be used in an off-label capacity to increase hair growth in women, says Dr. Valerie D. Callender, founder and medical director of the Callender Dermatology & Cosmetic Center in Glenn Dale, Maryland, and a professor of dermatology at Howard University.

    If a nutrient deficiency—involving iron, vitamin D, or protein—is at the root of hair loss, taking specific supplements may remedy the situation. “If you have low levels and you get them back to normal, you’ll get a greater volume of hair, and you won’t shed as much,” Lupo says.

    You’ve probably seen or heard commercials for a hair-growth-promoting nutritional supplement called Nutrafol—a blend of vitamins, minerals, and botanical ingredients—and one study funded by the company found that taking it regularly enhances hair growth and decreases shedding in perimenopausal, menopausal, and postmenopausal women with thinning hair. Research has found similar benefits with regular use of another supplement called Viviscal.

    Read More: Is It Really That Bad to Pop a Pimple?

    If scalp conditions such as seborrheic dermatitis—which can involve dandruff, scaling, or inflammation of the hair follicles—are the source of the problem, treating them with a shampoo that contains zinc pyrithione (like Head and Shoulders) or ketoconazole (such as Nizoral) may help with hair loss. “Lather the scalp more than the hair, and give yourself a vigorous scalp massage to increase blood circulation to the area,”  Lupo advises. “Let the shampoo sit for a couple of minutes before rinsing.”

    For female pattern hair loss, minoxidil, a 5% over-the-counter foam preparation that’s applied directly to the scalp once a day, can be helpful with continuous use, says Callender. “If you stop using it, the benefits stop within three months, and you’ll go back to baseline.”

    If you’re prone to hair loss, you may need to modify the way you take care of your hair. Avoid pulling on your hair with tight buns or ponytails or over-processing your hair (with coloring, straightening, or other treatments). It also means treating your tresses with TLC, including using a leave-in conditioner to moisturize hair and a satin pillowcase to prevent stress to hair while you sleep, Callender says.

    None of these are quick fixes. “With any hair-loss remedy, it will take a minimum of six months before you see a positive effect,” says Lupo. And most women use more than one approach to manage hair loss, experts say.

    If these approaches don’t sufficiently address hair loss, dermatologists have stronger weapons in their arsenals. These include laser and light therapy treatments, PRP (platelet-rich plasma) injections to the scalp, and hair transplantation procedures. “There are a lot of treatments,” says Callender, “and more are coming out.”  

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    Stacey Colino

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  • Should You Try to Raise Your ‘Good’ Cholesterol? You Might Not Need To

    Should You Try to Raise Your ‘Good’ Cholesterol? You Might Not Need To

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    Most of the time, you want your cholesterol to be low—ideally less than 150 milligrams per deciliter (mg/dL). But as you likely know if you’ve had your levels tested, the results aren’t quite that simple.

    Cholesterol tests will tell you not just your total cholesterol, but also your low-density lipoprotein, triglycerides, and high-density lipoprotein. And you actually want your high-density lipoprotein, or HDL, to be high.

    HDL cholesterol is considered “good” cholesterol. While still a type of fat in your bloodstream, it doesn’t clog arteries, and higher levels are linked to lower chances of heart problems. Low-density lipoprotein, or LDL, is considered “bad” cholesterol because it’s the type that builds up in your arteries and can contribute to your risk for heart disease and stroke. Triglycerides, another type of fat in the blood, are tied to higher risks of heart attack and stroke if you also have low HDL or high LDL.

    It would make sense, then, that in order to protect your heart, you’d want to boost your good cholesterol, or HDL. But research examining increases in HDL so far hasn’t shown any subsequent reduction in heart problems, and medications that raise your good cholesterol don’t stave off those risks, either.

    Read More: How Stress Affects Your Heart Health

    “Starting from the 1970s, large population studies…showed that people who had very low levels of HDL cholesterol…had a higher risk of heart attacks,” says Dr. Anand Rohatgi, an academic cardiologist and professor of medicine in cardiology at UT Southwestern Medical Center. It’s a “powerful risk predictor,” he says, which is why low HDL made it into the heart disease risk calculators doctors still use today—but it doesn’t necessarily translate to a treatment tactic. Experts agree that the relationship between higher HDL levels and better heart health is correlational—not causative. “The challenge has been that when drugs have been studied that raise HDL cholesterol…that has never translated into a reduced risk for heart disease. So from a pharmaceutical standpoint, it’s not a treatment target—it’s a risk marker.” Instead of fixating on any one aspect of cholesterol, he says, you have to think of the numbers in concert, alongside other risk markers for heart problems like age, sex, blood pressure, and diabetes.

    That said, certain lifestyle habits do increase HDL, Rohatgi says; we just don’t necessarily know what effect raising your HDL cholesterol actually has on your heart. The numbers alone “are not a crystal ball.”

    The habits below are all associated with higher HDL levels—as well as other benefits for your heart and overall health.

    Exercise more

    A sedentary lifestyle is linked to a host of health problems, including a greater likelihood of heart disease. Moving more has routinely been shown to increase HDL levels, and it’s also linked to living longer and lower rates of heart disease.

    Aim for about 30 minutes a day, five days a week, says Dr. Melissa Tracy, cardiologist and medical director of cardiac rehabilitation at Rush University Medical Center. It can be any form of cardio exercise—brisk walking, pickleball, dancing, swimming, cycling, or anything else you enjoy and will stick with—as long as it gets your heart rate up. You can even do a few 10- or 15-minute sessions each day if that fits into your schedule better, she says.

    Eat heart-healthy unsaturated fats

    “Eating foods that are high in polyunsaturated and monounsaturated fats and antioxidants may improve the HDL to LDL ratio,” says Dr. Joy M. Gelbman, a cardiologist at Weill Cornell Medicine.

    Choose options like olive oil and fatty fish over foods higher in saturated fats like red meat, full-fat dairy, fried foods, and baked goods.

    Read More: Why Your Diet Needs More Fermented Pickles

    Making healthier diet choices overall means your body won’t store as much fat. You’ll be using your fat stores for some of your energy, which in turn helps your body metabolize cholesterol better, Tracy says. That may result in lower LDL and higher HDL, as HDL helps transport LDL to the liver where it’s processed and excreted, Rohatgi says.

    Quit smoking

    Smoking not only lowers your HDL; it also makes the HDL you do have worse at its protective job. Quitting smoking can increase your HDL in a matter of weeks, according to a meta-analysis in Biomarker Research.

    Experts don’t know exactly why this happens, but it might have to do with the way smoking stresses the body, Gelbman says.

    Shed excess weight

    “Exercise, weight loss in people [who are overweight], and smoking cessation are the key means for optimizing HDL,” Gelbman says. If you have obesity or are overweight, getting to a healthier weight may lower your triglycerides and LDL and lift your HDL.

    And the weight loss doesn’t have to be dramatic: People who lost just 1 to 3 percent of their body weight displayed better improvements in HDL than people who lost just 1% of their body weight in an Obesity Research & Clinical Practice study.

    Read More: No One Knows How to Talk About Weight Loss Anymore

    While finding a sustainable diet plan that helps you lose weight and keep it off is most important, research suggests eating more protein and fat and fewer carbs may have the biggest effect on HDL.

    Experts still don’t completely understand the concrete heart benefits of higher HDL levels. “It’s complex and dynamic, and that’s what makes it hard to study and hard to pin down,” Rohatgi says. But heart-healthy habits have additional benefits regardless of their effect on your cholesterol, such as greater longevity, improved cardiovascular fitness, and lower risk of heart disease. The fact that they also increase your HDL in the process is an added perk.

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    Sarah Klein

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  • How AI Can Help Alleviate the Stress of a Cancer Diagnosis

    How AI Can Help Alleviate the Stress of a Cancer Diagnosis

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    In an era where cancer rates continue to rise, the emotional toll a cancer diagnosis and the subsequent treatment journey has on a patient is becoming a critical concern. A 2021 study found that, globally, 27% of cancer patients have depression. The same study notes that this rate is rising by 0.6% every year.

    Most patients and loved ones confronting cancer can be faced with a flood of emotions, grappling with feelings of fear, confusion, and uncertainty. Not to mention, both patients and clinicians are faced with the daunting task of navigating complex treatment decisions, as well as the ins and outs of a complicated healthcare system, amidst this emotional turbulence. Today more treatment options are available than ever before, and most patients will be on a combination of treatments. While the increased options offer more hope, they also offer more roads to take to arrive at the optimal treatment path. Determining the course for each patient based on their unique clinical characteristics and needs can be an uphill battle without the right tools to guide the way.

    In the cancer journey, clinicians are forced to strike a balance in matching the aggressiveness of treatment to the aggressiveness of the tumor. Without the foresight of how cancer will progress, and how quickly, both clinicians and patients may find themselves navigating the path forward without clarity or confidence.

    But what if technology could help us simplify the problem? With the rapid advancements in AI, we are witnessing a shift in how we deliver healthcare. AI-enabled cancer tests, in particular, have the potential to provide personalized insights, empowering both patients and clinicians to make more informed treatment decisions and ultimately improving patient outcomes, both mentally and physically.

    Read More: The Unique Hell of Getting Cancer as a Young Adult

    One of the highest contributing factors to the mental anguish of cancer patients is the overwhelming uncertainty associated with treatment decisions. Patients are afraid of what they are signing up for, often asking “Will this therapy make a difference for me” or “Is it worth the adverse effects?” These concerns are especially valid as cancer treatments are known to have potential life-altering side effects such as loss of sexual function, bone density loss, decreased muscle mass, and even increased risk of death. When these questions go unanswered, they can hugely impact a patient’s psychosocial adjustment, health behaviors, and quality of life.

    A patient’s mental health can also prevent them from seeking out treatment or consistently following their treatment plan. A 2024 study in Cureus found that patients who do not follow their treatment plan are more likely to have worse outcomes including increased physician visits, higher hospitalization rates, longer stays, disease progression, and elevated mortality rates.

    AI can serve as an aid. Today there are AI-enabled tests that can swiftly analyze real-world data and translate it into digestible and personalized insights, allowing for a more personalized approach to cancer therapy. For example, there are tests for localized prostate cancer that use enormous amounts of data from digitized pathology slides to extract hidden patterns and corresponding knowledge about an individual patient’s disease. These are data that clinicians are not capable of interpreting as the human eye cannot uncover the patterns within these large datasets without technological support. The current standard of care is to rely on a pathologist, who will review pathology slides, determine if cancer is present, and grade the cancer risk, e.g. Gleason grading for prostate cancer. While these general categories are effective, the reality is that digitizing the pathology slide can identify between 10-40k image patterns of data from just one patient alone. With the power of AI, the test can analyze the digitized slide to determine with far greater detail the specific risks of the individual patient, and provide detailed insights into prognosis and treatment benefit. This benefits the clinician by not only saving time and alleviating the cognitive burden but also by creating confidence when it comes to determining whether or not to advise a patient to undergo a specific course of treatment.

    Integrating AI into the decision-making process not only places the patient at the center but also provides more clarity throughout the cancer treatment journey. How does it achieve this? By equipping patients with precise information derived from their unique data and potential outcomes. For instance, in prostate cancer, AI tests now have the capability to analyze digital biopsy images and patient clinical data to identify those who would benefit from hormone therapy. A 2023 study validating this test showed that only a third of the patient population receiving the therapy demonstrated benefits, meaning two-thirds of patients were overtreated and could’ve safely avoided the therapy.

    Read More: AI-Driven Behavior Change Could Transform Health Care

    Aside from the toll cancer therapy takes on the body, there’s also the physical strain and apprehension regarding the potential necessity for multiple biopsies to procure tissue samples.

    For example, genomic tests can offer the potential for personalized care, however, they often require the consumption of tissue samples. As new tests emerge, a portion of the tissue sample is needed for re-analysis. Tissue is finite, which poses a significant challenge as each genomic test diminishes the available tissue for future testing or procedures. However, the rise of digital pathology allows the opportunity to forgo additional tissue consumption, and instead, AI tests can tap into the same digitized samples as many times as needed, yielding fresh insights without the need for further invasive procedures. This approach not only preserves patient tissue but also streamlines prognostic procedures, potentially obviating the necessity for subsequent biopsies.

    It is also important to recognize the challenges of implementing AI into clinical care. One of the reasons racial bias exists in AI, for instance, is because there is a lack of racially diverse clinical data, leaving algorithms to be trained from a patient population that is primarily white. This is why researchers must properly train algorithms on racially diverse data that represent the patient population. The technology is only as great as the data that it receives.

    There is no argument that AI will have a significant impact on the healthcare industry. While the technology can aid in alleviating administrative burdens and streamline workflows, its more powerful potential can be found in its ability to simplify complex problems and signal solutions. Harnessing this capability will be what paves the way for patients and clinicians to find hope, confidence, and comfort amid a cancer journey.

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    Andre Esteva

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  • How Much Water Should You Drink When It’s Hot Outside?

    How Much Water Should You Drink When It’s Hot Outside?

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    Record-setting high temperatures are dangerous not only for the planet, but also for human health. Whether you’re situated in the middle of a heat wave or you’re just trying to survive a scorching day, you’ll need strategies to cool off and stay well.

    One of the most crucial is to stay hydrated. But do eight eight-ounce glasses really cut it amid skyrocketing temps?

    What you need on a normal day—and a scorcher

    Most adults should drink somewhere between 68 and 100 ounces of water each day, says Dr. Ashley Karpinos, associate professor of medicine, pediatrics, and sports medicine at Vanderbilt University Medical Center. Another way to keep track of your water intake is to halve your weight in pounds—then drink that number of ounces each day, says Dr. Dana Cohen, an integrative medicine practitioner in New York City and co-author of Quench, a book about the science behind hydration.

    But “in the heat, everyone needs more water,” Karpinos says. If you’re working, exercising, or are otherwise active in hot weather, a good rule of thumb is to drink eight ounces of water every 15 to 20 minutes during the physical parts of your day, Karpinos says. 

    Seems simple, right? Not so much. Hydration is complex. Not only do some people need more water than others, but sometimes, a glass of H20 isn’t even the best solution. The following tips from experts can help ensure you’re properly hydrated when it’s hot outside. 

    Monitor your bathroom breaks

    The best way to keep track of how hydrated you are in hot weather isn’t through the total ounces of water you drink, but rather how often you’re urinating, Cohen says. “If you’re not getting up and going to the bathroom every two or three hours, you’re not well-hydrated,” she says. “That is truly the best way to do it—not looking at your urine color, not pinching your skin.” (The skin-pinch test is often used to assess skin turgor, or how elastic your skin is. If you’re dehydrated, your skin might not bounce back as quickly after a gentle pinch.)

    Read More: 8 Ways to Stay Hydrated If You Hate Drinking Water

    Dr. Seth Feltheimer, a primary care physician and associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons, agrees. “It’s not [about] how much you’re drinking, it’s what your urine output is,” he says. “If you’re not urinating, you’re not drinking enough.”

    Think beyond water

    Water is typically the best thing you can drink when it’s hot outside, Karpinos says. But other beverages can also do an excellent job keeping you hydrated. She recommends drinking something with electrolytes after about an hour in the heat. Sports drinks like Gatorade will do the trick, but Cohen recommends coconut water, as it contains natural electrolytes. 

    Some research suggests a surprising drink might be hydrating as well: milk. One small 2016 study published in the American Journal of Clinical Nutrition gave people 13 beverages and tested their urine output over the next four hours. All of the beverages tested (including still and sparkling water, soda, diet soda, hot and iced tea, beer, orange juice, coffee, a sports drink, skim and full-fat milk, and an oral rehydration solution) had more or less the same hydrating effect except for three standouts: the oral rehydration solution, full-fat milk, and skim milk. Cow’s milk has sodium and electrolytes, which could potentially stave off dehydration. 

    Skip the Aperol spritz and iced coffee

    Generally speaking, any fluid is good for hydration except for drinks with caffeine and alcohol since both are diuretics, says Lina Begdache, a registered dietitian and associate professor at Binghamton University’s Decker College of Nursing and Health Sciences. It’s also important to avoid alcohol in the heat because it can interfere with the body’s ability to regulate its core temperature, Feltheimer says.

    Read More: What’s the Most Refreshing Drink That’s Not Water?

    Cohen notes that coffee is only problematic in excess. “Anything over four cups of coffee, and it starts to become a diuretic,” she says. 

    Add water-rich foods to your diet 

    Eating foods with a high water content is a great way to stay hydrated in the heat, Karpinos says. She recommends fruits and vegetables like watermelon, cantaloupe, berries, peppers, lettuce, and cucumbers. “You can also add mint leaves or fresh orange slices to flavor your water, which can make it easier to drink enough.”

    Cohen also recommends smoothies, as well as chia seeds and flax seeds because of their high fiber content. “Chia seeds are sort of the star of the show,” she says. “They plump up to three times their amount with water, so they really hold onto that hydration well.” 

    Hydrate before you feel thirsty

    One of the biggest mistakes people make is waiting until they feel thirsty to drink water, Karpinos says. This is because by the time you feel thirsty, you’ve already lost fluid and you’re on the way to dehydration. 

    Begdache adds that it’s also good to drink water before bed and first thing in the morning since you lose water while you sleep to respiration and sweating. 

    Pay special attention to children and the elderly 

    Since children are smaller than adults, their stores of water are also smaller and they’re more likely to get dehydrated in hot weather, Feltheimer says. The amount of water children need varies—toddlers need about 32 ounces a day, while pre-teens need about 60 ounces, Karpinos says. “Watch children closely for facial flushing, fussiness, or less urination, which can be signs of dehydration,” she says.

    Read More: What to Wear When It’s Really Hot Outside

    Elderly people are more likely to become dehydrated as well. This is because the body’s water content decreases with age. One 2023 study published in the International Journal of Clinical and Laboratory Medicine looked at hydration status in nearly 1,000 elderly adults. Researchers found that 31% of participants were dehydrated. Diabetes and chronic renal failure were more common in the dehydrated group, as was their likelihood of experiencing a fall. 

    Athletes should exercise extra caution 

    It’s particularly important for athletes to have a hydration plan in the heat, says Karpinos, who is the team physician for Vanderbilt University athletics. “The goal is to start an exercise session well-hydrated, maintain hydration during exercise, and then correct excessive losses afterward,” she says. 

    The amount of water to add will vary depending on the athlete’s sex, weight, and how much they sweat, as well as the intensity of the workout and the temperature outside, she says. But in general, athletes should drink an additional 12 ounces of water two hours before exercise and about eight ounces of water every 15 to 20 minutes during the workout, Karpinos says. 

    Athletes should also check for signs of dehydration when they’re done exercising. “If athletes lose weight quickly during an exercise session, that can be a sign of dehydration,” Karpinos says. “In this case, we recommend drinking about 20 ounces of fluids for every one pound lost during the exercise session to correct the dehydration.”

    Be on the lookout for dehydration

    Early signs of dehydration include feeling thirsty, having dry lips and mouth, not sweating enough, and dark urine, Karpinos says. Feltheimer adds that body cramps, lethargy, and an inability to urinate “are all signs that your body is trying to conserve whatever fluid it has.” 

    Being dehydrated can have a greater impact than many people realize. Even just a 2% drop in hydration can lead to brain fog, headaches, and dizziness, Cohen says. One 2019 study found dehydration can also have a negative effect on short-term memory, attention, energy, and mood.

    Read More: How to Cool Your Body Down Fast

    Drinking enough water is also important long-term. One 2023 study published in the Lancet found chronic dehydration can lead to premature aging, chronic disease (including heart failure, diabetes, and dementia), and premature death. 

    “There’s nothing that can function in the body without hydration, down to the cellular level,” Cohen says. “The single most important thing we can do to treat and prevent chronic disease is learn how to hydrate properly.”

    Don’t overhydrate

    Some people—in an attempt to stay hydrated on hot summer days—overdo it. Cohen says she regularly sees patients with lab results that are too low in sodium and chloride because they’re drinking too much water. “I see this more often than [you’d] think,” she says. Overhydration, she says, can lead to many of the same symptoms as dehydration, like muscle cramps and fatigue.

    Although a little extra water is nothing to worry about, drinking way too much can lead to hyponatremia, a condition caused by not enough sodium in the blood that can lead to seizures. Cohen notes that overhydrating to this level is exceptionally rare, but it’s still something to be aware of.

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    Jamie Friedlander Serrano

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  • Do I need a GST or HST number? – MoneySense

    Do I need a GST or HST number? – MoneySense

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    Why registering for GST/HST pays off

    The other excellent reason to charge GST and HST is that it pays off in dollars and cents.

    One of the great advantages of being self-employed is that when you charge these taxes, you only give the government what you charged minus the GST or HST you pay on your deductible business expenses. 

    For freelance writers like us, this is the sales tax we pay on printer paper, internet service, professional development workshops and more. The government lets us in essence deduct the sales taxes we pay on deductible expenses from the sales taxes we charge our clients. We then pocket the difference. The amount we save each year is roughly enough to pay for a trip to Europe.

    HST quick method or detailed method?

    The good news is that we don’t have to add up every bit of GST and sales tax we pay on our expenses to take advantage of this. That’s because we use the “quick method” for our calculations. 

    The government gives you two choices for paying GST and PST/HST instalments: the “detailed method” and the “quick method.” With the quick method, you simply pay 3.6% of the 5% GST you collect. In the case of provinces with HST, it’s a percentage of the HST: so, in Ontario, you only pay 8.8% to the government from the 13% you collect. 

    Image by rawpixel.com on Freepik

    The advantage of the quick method is that it’s much less work. You must only add up how much sales tax you charge your clients or customers. My spouse and I use the quick method and find it easy to do our calculations with an Excel spreadsheet. There is no need to keep a detailed account of the sales tax you pay on all the pens, paper, printer cartridges and more you claim as deductible expenses. 

    There’s another bonus to using the quick method. Governments offer a credit of an additional 1% on the first $30,000 of gross revenue. So, for example, in Ontario you pay 7.8% (instead of 8.8%) of the 13% HST you collect for that amount and pocket the other 5.2%. However, if you use the quick method, you must add the credit to your total revenue when you file your income tax return.

    The detailed method involves more work, since you must add up the GST and PST/HST you paid on each of your expenses and subtract it from the taxes you collect to determine the amount you have to pay. But this calculation method is useful if your taxable expenses are proportionately high, amounting to roughly more than 50% of your income. The advantage of the detailed method is that you don’t have to add the amount you retain to your revenue when you file your income tax return. 

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    Julie Barlow

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  • What Competitive Eating Does To the Body

    What Competitive Eating Does To the Body

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    This Independence Day, competitors at Nathan’s Famous hot dog eating contest may gulp down as many as 76 wieners in about the time it takes to read this article. Like ultramarathoners hoofing 50 miles or football players shaking off big hits, “speed-eating” entails natural resilience, dedicated training, and serious risks to health.

    Some may see the annual Coney Island, N.Y., contest as an act of defiance, capturing the holiday spirit. When the British taxed our sugar, we fought for independence. When modern-day doctors tell us to eat fewer carbs that turn quickly into blood sugar, we devour as much as possible on ESPN—and walk away seemingly unscathed. 

    But this gastric rebellion could damage the body, during competition and over the long haul. 

    A dangerous trek through the body

    Mouth

    Competitors typically fast before the event, says Miki Sudo, the winningest female champion in the history of the sport with nine Nathan’s titles in the women’s division. “You want the stomach to be empty and hungry” on gameday, she says.

    After a rousing national anthem, a horn signals participants to eat as many hot dogs as possible in a breezy 10 minutes. Thus begins a blur of chewing and swallowing with a physicality that’s half-shark, half-snake. According to the ESPN documentary series 30 for 30, competitors train to strengthen their jaws so they can rip apart food with fang-like efficiency and desensitize their gag reflexes to gulp large pieces that would make the rest of humanity retch.

    Esophagus

    Just five seconds into this self-proclaimed “Super Bowl of competitive eating,” bits of hot dog arrive in the esophagus, the tube that goes to the stomach. Because they’re not chewed enough, though, chunks can slide into the airway, which can cause choking. Paramedics stand ready to assist, but across all speed-eating contests, choking is the biggest risk, and can result in death.

    Read More: Why Your Diet Needs More Fermented Pickles

    As hot dogs accumulate in the body, so do more risks. The stomach can’t accept the food as fast as it’s coming, so it piles up in the lower esophagus. This traffic jam could cause the food to come back up forcefully, which can lead to choking, rips in the esophagus, and surgery to fix them, says Dr. David Metz, a retired professor of gastroenterology at the University of Pennsylvania who has studied the effects of speed-eating.

    Stomach

    In just two minutes, some participants may have already packed ten hot dogs into their stomachs. To accommodate this barrage, the stomach begins to expand. Normally, our stomachs enlarge like a balloon, with greater pressure as the meal goes on—and this pressure triggers a newsflash to the brain that we’re full. But speed-eaters have trained with increasingly large food quantities to increase the elasticity of their stomach, so it stretches more like spider silk. Without the same pressure build-up, their brains receive no “drop your hot dog” message—only the crowd’s roar to keep gorging.    

    Small intestine

    Seven minutes into the contest, some pioneering pieces of hot dog have already raced through the stomach to explore the small intestine, an organ dedicated to further digesting food and absorbing nutrients. However, this important job may be sabotaged when dealing with as many as 22,800 calories in a single meal.

    One issue is that way too much glucose—the broken down form of all those hot dogs, especially their buns—could get dumped into the small intestine, Metz explains. The influx would send the body into panic mode as it seeks to avoid organ damage. This stress response, known as “dumping syndrome,” involves heavy sweating, rapid heartbeat, nausea, and diarrhea.

    More research on dumping syndrome is needed, Metz says. For his study, Metz took X-ray images of one speed-eater in action and found that rapid feasting was enabled by “remarkable” stomach expansion, not by food dropping quickly into the small intestine to make room for more. This suggests dumping syndrome may not be a risk, though some competitive eaters report symptoms of the syndrome, such as profuse sweating.

    Read More: Why You Sweat So Much at Night—And What to Do About It

    Another problem: many hot dog pieces stay mostly undigested even after making it through the stomach’s churn, says Kathleen Melanson, a professor of nutrition and director of the Energy Balance Laboratory at the University of Rhode Island. These chunks may be fermented by bacteria in the small intestine, which could cause bacterial overgrowth, Melanson says, leading to abdominal pain and diarrhea, among other symptoms.

    Examples of debilitating symptoms, such as severe pain requiring a five-day hospitalization, have been documented, albeit rarely. “That doesn’t mean more haven’t happened,” Metz says. Not helping matters: the feast can stay in the digestive tract for multiple days before it’s finally expelled.

    Destined to devour 

    Thinking you can eat scores of hot dogs because you saw it on TV is like trying to climb El Capitan without ropes because you saw Free Solo. “No one at home should try this,” Metz says.

    Professional gluttons gradually increase their intake of food over long periods of time. (They do not practice by chugging water, which can lead to brain swelling.) “There’s clearly a training effect,” says James Smoliga, a sports medicine researcher at Tufts University. He found that elite competitive eaters reliably enhance their performance with years of practice, such that their rate of scarfing resembles grizzly bears.

    The improvement likely builds on physiologies uniquely suited to speed-eating, Smoliga says. Sudo thinks she’s always had “natural stomach elasticity,” and Melanson notes that twin studies suggest some people are biologically faster eaters than others. This inborn “talent” could confer some protection from the harms. 

    Unknown long-term harms

    Far from being overweight, many speed-eaters appear healthy. “They’re physical specimens,” Metz says. “There are no physical side effects for me yet from doing this,” other than some discomfort and sweating right afterward, says Nick Wehry, who is a competitive eater ranked fourth worldwide (and Sudo’s husband). “Many of us have a love for fitness,” Sudo says—a passion reinforced by the desire to reduce the risks of competitive eating, she adds.

    Whether this strategy will result in healthy aging is yet to be seen, since the “sport” (and the study of it) is relatively new. (Major League Eating, the body that oversees pro contests, including Nathan’s, did not respond to a request for comment about whether they track the long-term effects of competitive eating.)

    One long-term concern is that their stomachs have permanently expanded, so they’ll never feel full again, no matter how much they consume. “We don’t know if or how you can train it back after you’re done competing,” Melanson says. To avoid obesity, former competitors could simply remind themselves to stop eating, without relying on their stomach’s signals. But this is “challenging and takes practice,” explains Melanson, who studies people trying to slow their rate of eating, which may help with weight loss and overall health. 

    Eating champ Takeru Kobayashi may have disabled his stomach’s signals after decades of competition, according to the recent documentary Hack Your Health. “I overeat because I’m a competitive eater,” he says in the film. “When you eat too much, you don’t savor the taste or fully enjoy the smell of the food. You ignore your body’s signals, like fullness.”

    However, Sudo and Wehry say that after many years of competing, they still have normal appetites. 

    Read More: What’s the Least Amount of Sleep You Need?

    A permanently stretched stomach could also result in gastroparesis, where the stomach takes too long to empty, resulting in chronic nausea, pain, and vomiting.

    Tim Janus, a 47-year old ex-competitive eater who Metz has studied in scientific research, quit the sport in 2016 after 11 years “out of an abundance of caution” partly based on Metz’s findings about the risks. He was also concerned about the harms of throwing up following competition, a practice that he describes as widespread. “When you’re eating that much food, you can’t digest it all,” he says. “Your stomach is too full to move things along. Throwing up after the contest is a necessary part of the sport.” 

    Janus tried to collaborate with other pro eaters to share and track their health to better understand the effects of competing, but he couldn’t rally their interest. He’s now a foreign service officer in Mexico City in good health. Most of his former competitors say they’re healthy, too, but he “didn’t want to continue and realize I made a mistake.”  

    Speed-eaters may develop other illnesses associated with unhealthy diets, such as heart disease and diabetes. The American Medical Association has recognized speed-eating as an unhealthy practice. But Sudo and Wehry are trim and muscular. Their weights spike during contests but, afterward, they eat less than normal to recover their health. (Another incentive for fasting beforehand or after: belly fat can block the stomach’s expansion, some competitive eaters have found.) Wehry says he drops about 20 pounds in just a few days after contests. They say they avoid regurgitating food following competition. So do many other pro competitors.

    Outside of competition, Sudo and Wehry exercise daily and eat nutritiously. Wehry estimates that 70% of his calories per year are highly nutritious; training and contests account for only 30%. His blood pressure is slightly elevated, but his cholesterol has actually improved since he started competing, he says. Sudo’s doctor has given her a clean bill of health. She gave birth without any complication at age 35. Even with the contests, “we still have a healthier lifestyle than 95% of the population,” says Wehry, a former competitive bodybuilder.

    Another speed-eating couple, Rich and Carlene LeFevre, are longevity role models. After competing since the mid-80s, the LeFevres have reached old age in good health, Sudo says. (Rich is 80 years old.)

    Can these speed demons eat their 9.25 cakes in eight minutes and have their health, too? Perhaps with the right genetics and behavior strategies, Melanson says. “You can’t assume it’s going to work for the general population.” Research suggests that other extreme competitors, ultramarathoners, are faring better than some scientists had expected, with many of them living into their mid-80s, Smoliga notes.

    In addition to training as a dental hygienist, Sudo enjoys speed-eating for the thrill of competition and “putting on a good show.” At the same time, she and Wehry want long lives to watch their son grow up and meet their grandkids. “I’m going to do everything I can to stick around for a while,” Sudo says. 

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    Matt Fuchs

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  • What’s the Least Amount of Sleep You Need to Get?

    What’s the Least Amount of Sleep You Need to Get?

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    Imagine what else you could do with the hours you spend unconscious each night. Oh, the things you could accomplish!

    But if you’re trying to claw back more of your personal time, sacrificing sleep is not where to start. The American Academy of Sleep Medicine and the Sleep Research Society both recommend a minimum of seven hours a night to maintain optimal health. If you regularly sleep less than that, “you’re going to experience physical, psychological, and social consequences,” says Joe Dzierzewski, vice president of research and scientific affairs at the National Sleep Foundation.

    There are two exceptions to this advice. Older adults typically need less sleep than people who are younger, says Lynelle Schneeberg, a sleep psychologist and assistant professor of psychiatry at Yale Medicine. For instance, someone who slept eight hours a night in their 40s might be able to function well with 6.5 hours a night in their 70s. Older people produce less of the sleep-promoting hormone melatonin, and they tend to have more medical conditions that can interfere with sleep.

    In addition, a very small number of people have a genetic mutation that allows them to function on less than 6.5 hours of sleep per night with no apparent consequences to their health. This genetic mutation is quite rare, with experts estimating that it only affects around one in 25,000 people. 

    But for everyone else, here’s the bottom line on how low you can go: seven hours is the minimum for your regular sleep schedule, anything between five and seven hours isn’t great but will do if it’s just a night or two, and anything less than five hours—for any length of time—can have serious consequences.

    Surviving versus thriving

    Most sleep experts recommend getting somewhere between seven and nine hours of sleep per night. But this isn’t always achievable. Perhaps you have a newborn who won’t sleep, you’re grieving the loss of a loved one, or you’re a medical resident working 80 hours a week. 

    If special circumstances aren’t allowing you to sleep as much as you need to, Schneeberg says, at least try to get 5.5 to six hours each night. “That’s not what I want people to strive for,” she says, but it will allow you to log some deep sleep.

    Read More: How to Take the Perfect Nap

    Although you might be able to survive with less than seven hours of sleep a night in the short-term, you definitely won’t be thriving, especially if you keep it up for a while. “Can you compensate on a short-term basis for an occasional night of poor sleep? Yes, you can,” Dzierzewski says. “But if you consistently neglect your sleep health, will it eventually catch up to you? More than likely.”

    A cascade of negative effects from too little sleep

    Many people don’t prioritize their sleep because a night or two of poor sleep doesn’t lead to any immediate or dire consequences, Dzierzewski says. But once people get less than about five hours of sleep per night, they start to experience clear detriments to their physical health, says Aric Prather, a​​ sleep scientist and professor in the department of psychiatry and behavioral sciences at the University of California, San Francisco. 

    A day of less-than-adequate rest can lead to poor mood, concentration, and attention, along with greater susceptibility to illness and riskier driving, Dzierzewski says. Short-term sleep loss can also lead you to crave foods that are higher in fat and sugar because your body produces extra cortisol, the stress hormone, when you’re sleep-deprived, says Michael Breus, a clinical psychologist and sleep medicine specialist in Hermosa Beach, Calif.

    Read More: You’re Vacationing All Wrong. Here’s How to Have a Truly Restful Break

    A prime example of the consequences of short-term sleep loss: Motor-vehicle fatalities rise by 6% in the workweek following Daylight Saving Time in the spring, according to a 2020 study published in the journal Current Biology. (The authors believe this is due to a combination of sleep loss and driving to work in the dark.) Another study found a 24% increase in heart attacks on the Monday after Daylight Saving Time, and a 21% decrease once the clocks turn back in the fall. 

    Chronic sleep deprivation over weeks, months, or years can lead to a host of problems, including increased insulin resistance, increased inflammation in the body, and high blood pressure, Prather says. Long-term sleep deprivation can also increase someone’s chances of having a heart attack or stroke. Early research has even begun looking at whether people who don’t get enough sleep for a long time are at a higher risk of developing neurodegenerative diseases like Alzheimer’s, says Prather, who wrote The Sleep Prescription. “There are some devastating things that can happen when people don’t get the sleep they need for a sustained period of time,” he says. 

    Quality counts, too

    When it comes to getting good shuteye, quality matters just as much as quantity. “Sleep health is multidimensional,” Dzierzewski says. “It’s made up of more than just duration.”

    How many times you hit the snooze button, how long it takes you to fall asleep, how often you wake up at night, and how rested you feel in the morning are all good indicators of whether or not you’re getting good quality sleep, Breus says. “You can get eight hours of really [poor] sleep, and it’s not going to do you a whole lot of good,” he says.

    Read More: 4 Signs Your Body Is Telling You It’s Time to Take a Break

    Sleep continuity, or sleeping most of the night without any wakeups, is of particular importance, Prather says. “If you got seven hours of sleep, but it took 10 hours to get it because there were all of these awakenings in the middle of the night, it just doesn’t feel as high quality, and it impacts how you feel during the day.”

    Figuring out your genetic chronotype can be a good way to ensure you’re getting high-quality sleep. Your chronotype is when you are biologically programmed to sleep, Breus says. (Think early birds and night owls.) Sleeping according to your chronotype can help you get more restorative sleep, Breus says. 

    Short sleep is nothing to brag about 

    We often hear stories of people—famous and otherwise—who function on very little sleep. Former president Barack Obama reportedly only slept about five hours per night during his presidency. Dwayne “The Rock” Johnson once said he only sleeps three to five hours per night. And we all know at least one family member or friend who swears they only need five or six hours of sleep a night. 

    Don’t believe them. “Functioning on less than seven hours of sleep on a routine basis is not a badge of honor,” Dzierzewski says. “I don’t think it’s anything that anyone should be proud of… It would be like someone saying, ‘I’m able to maintain a healthy weight when all I do is eat chocolate all day.’” If you’re looking for more hours in your day, start trimming something else besides your sleep.

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    Jamie Friedlander Serrano

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