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  • Dozens of Zoo Tigers Die After Contracting Bird Flu in Vietnam

    Dozens of Zoo Tigers Die After Contracting Bird Flu in Vietnam

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    HANOI, Vietnam — More than a dozen tigers were incinerated after the animals contracted bird flu at a zoo in southern Vietnam, officials said.

    State media VNExpress cited a caretaker at Vuon Xoai zoo in Bien Hoa city saying the animals were fed with raw chicken bought from nearby farms. The panther and 20 tigers, including several cubs, weighed between 10 and 120 kilograms (20 and 265 pounds) when they died. The bodies were incinerated and buried on the premises.

    “The tigers died so fast. They looked weak, refused to eat and died after two days of falling sick,” said zoo manager Nguyen Ba Phuc.

    Samples taken from the tigers tested positive for H5N1, the virus that causes bird flu.

    The virus was first identified in 1959 and grew into a widespread and highly lethal menace to migratory birds and domesticated poultry. It has since evolved, and in recent years H5N1 was detected in a growing number of animals ranging from dogs and cats to sea lions and polar bears.

    In cats, scientists have found the virus attacking the brain, damaging and clotting blood vessels and causing seizures and death.

    More than 20 other tigers were isolated for monitoring. The zoo houses some 3,000 other animals including lions, bears, rhinos, hippos, and giraffes.

    Read More: A New Bird Flu Death Is Making Experts Uneasy

    The 30 staff members who were taking care of the tigers tested negative for bird flu and were in normal health condition, VNExpress reported. Another outbreak also occurred at a zoo in nearby Long An province, where 27 tigers and 3 lions died within a week in September, the newspaper said.

    Unusual flu strains that come from animals are occasionally found in people. Health officials in the United States said Thursday that two dairy workers in California were infected—making 16 total cases detected in the country in 2024.

    “The deaths of 47 tigers, three lions, and a panther at My Quynh Safari and Vuon Xoai Zoo amid Vietnam’s bird flu outbreak are tragic and highlight the risks of keeping wild animals in captivity,” PETA Senior Vice President Jason Baker said in a statement sent to The Associated Press.

    “The exploitation of wild animals also puts global human health at risk by increasing the likelihood of another pandemic,” Baker said.

    Bird flu has caused hundreds of deaths around the world, the vast majority of them involving direct contact between people and infected birds.

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    HAU DINH/AP

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  • Are Mushroom Edibles Safe and Legal?

    Are Mushroom Edibles Safe and Legal?

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    Edibles aren’t just for weed anymore. There’s a growing market for gummies, chocolates, and other products that claim to contain psychedelic mushrooms and promise consumers a new—and legal—way to get high.

    Psilocybin, the best-known psychedelic substance derived from “magic” mushrooms, is a Schedule I substance: an illegal drug considered to have no medical use and high potential for abuse. So what’s in mushroom edibles that are openly sold in gas stations, smoke shops, and online marketplaces? And are the ingredients really legal?

    Here’s what to know.

    What’s in mushroom edibles?

    “It could be anything,” says Dr. Avery Michienzi, a medical toxicologist at the University of Virginia School of Medicine who has studied mushroom gummies.

    Many brands say their products are made from Amanita muscaria, a mushroom that contains the psychoactive but non-scheduled compounds muscimol and ibotenic acid. (Michienzi calls Amanita muscaria the “Mario mushroom,” given its resemblance to the red-and-white spotted fungi in the classic video game.) Other brands claim to use only non-psychoactive mushrooms, like reishi, lion’s mane, and chaga, but still say their products will result in psychedelic experiences—a red flag that the label isn’t telling the whole story, Michienzi says. Inaccurate labeling, she says, is rampant throughout the mushroom edibles market.

    Read More: Safer Psychedelic Drugs May Be Coming

    Testing by Michienzi’s team, as well as additional analysis by federal regulators, has shown that these products may contain a wide range of undisclosed—and potentially dangerous or illegal—ingredients, including psilocybin, psilocin (a similar compound that’s also a Schedule I drug), kratom (an herb that can cause opioid-like effects), and even prescription medications, including stimulants.

    And those are just the substances that turned up in the specific batches that were tested, Michienzi notes. There’s no telling what’s in other batches, or if additional substances that the researchers didn’t have the capacity to test for may have been included as well.

    Some brands claim that their products have been lab-tested for safety and provide “certificates of analysis” that allegedly prove what’s inside, but Michienzi says they’re often bogus. “I don’t trust them at all,” she says.

    Are mushroom edibles safe?

    Without knowing exactly what’s in mushroom edibles, “I can’t say with any confidence that there’s any product that’s safe,” says Eric Leas, an assistant professor at the University of California, San Diego’s Herbert Wertheim School of Public Health who has studied mushroom edibles.

    The U.S. Food and Drug Administration (FDA) has recently told consumers not to use any products made by the brand Diamond Shruumz, as they have been linked to seizures, blackouts, heart problems, nausea, vomiting, agitation, and other side effects. As of late September, 70 people across the country had been hospitalized after using Diamond Shruumz products, and at least three deaths have been potentially linked to the investigation. FDA testing revealed a range of ingredients in Diamond Shruumz products, including a synthetic psychedelic similar to psilocybin, psilocin, a prescription anticonvulsant medication, muscimol, and ibotenic acid.

    “The FDA is concerned about any products that contain potentially harmful ingredients, including undisclosed ingredients and illegal substances,” an agency spokesperson said in a statement to TIME. “Consumers should use extra caution when deciding to purchase or consume such products that claim to produce a feeling of euphoria, hallucinations, or psychedelic effects.”

    Read More: How COVID-19 Messes Up Your Gut Health

    Even setting aside the possibility of undisclosed ingredients, it’s important for consumers to know about the effects of Amanita muscaria, which can be toxic. When muscimol and ibotenic acid, the mushroom’s psychoactive components, are used in edibles, they can affect people very differently than psilocybin, Leas says.

    As with psilocybin, consuming components of Amanita muscaria can lead to psychedelic effects including hallucinations and altered perceptions of sight, sound, time, and space. But muscimol is a sedative, so its effects can feel more similar to intoxication from alcohol—including potential blackouts at high doses, Leas says. Part of the reason Amanita muscaria’s psychoactive elements are not scheduled substances, he believes, is that people tend to find their effects unpleasant, so there’s low potential for abuse.

    Are mushroom edibles legal?

    Even if mushroom gummies truly contain only components of Amanita muscaria, they still fall into a legal and regulatory gray area. Amanita muscaria and its constituents are not scheduled substances, so they are legal for U.S. consumers to possess (except in Louisiana, which has banned the mushroom as part of a longstanding law limiting use of hallucinogenic plants). But existing laws do not definitively address whether it can be produced and distributed commercially, according to a recent journal article that Leas co-authored.

    The regulatory requirements for mushroom edibles are similarly murky, says Ikhlas Khan, director of the National Center for Natural Products Research at the University of Mississippi. “Nothing is defined,” he says, since the FDA has not clearly specified whether mushroom edibles must be regulated as dietary supplements, foods, or drugs, essentially creating a free-for-all for manufacturers.

    Read More: What to Expect at a Mammogram

    “‘Mushroom edibles’ is not a defined term in the Federal Food, Drug, and Cosmetic Act,” an FDA spokesperson wrote in a statement to TIME, adding that the agency needs to make a “case-by-case evaluation to determine product jurisdiction.” Depending on a particular product’s ingredients and the way it is being marketed—if its label makes claims about treating a specific health condition, for example—it could be considered a drug, dietary supplement, or food. 

    With so much uncertainty, brands are slipping through the cracks and effectively skirting regulation altogether, Leas says. He thinks the FDA should establish a new division—something like a Center for Psychoactive Products—to patrol this gray zone, which could also include herbal products like kratom, kava, and salvia.

    Right now, the safest choice for people curious about consciousness-altering drugs is to visit a state-regulated facility, where products must meet certain standards around safety, dosing, and ingredient disclosures, Leas says. There are licensed psilocybin administration centers in Oregon (and, soon, Colorado), and recreational marijuana is now legal for more than half of adults in the U.S.

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    Jamie Ducharme

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  • What to Expect at a Pap Smear

    What to Expect at a Pap Smear

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    Maybe you had a bad experience with your last Pap smear and you’re wary of going back to the ob-gyn. Or maybe you’ve never had one before and are scared to make the appointment. It’s understandable to feel anxiety about women’s health care, but a Pap smear is an important screening tool for cervical cancer.

    “A lot of people feel really nervous or anxious to get a Pap smear, and some people aren’t quite sure of exactly what we’re testing for,” says Dr. Jayme Trevino, an ob-gyn and fellow with the American College of Obstetricians and Gynecologists (ACOG). “One of my goals when a patient is coming to me for a Pap test is to thoroughly explain exactly what we’re looking for and the steps of the process.”

    Here, two ob-gyns explain what a Pap smear entails and dispel some common misconceptions about the potentially life-saving test.

    What is a Pap smear?

    A Pap smear involves collecting a sample from the cervix to test for abnormal cells that are cancerous or could lead to cervical cancer. The procedure typically only lasts for a minute, if that. Your medical provider will insert a speculum into your vagina, and then swab a sample from your cervix.

    Cervical cancer grows slowly, says Dr. Jennifer Lincoln, an ob-gyn in Portland, Ore. The earlier you can catch precancerous cells, the faster you and your medical provider can come up with a plan to treat them and prevent them from turning into cancer.

    Read More: What to Expect at a Mammogram

    People often confuse the procedure with a human papillomavirus (HPV) test or a pelvic exam. While an HPV test involves the same steps as a Pap smear—a speculum and a swab of the cervix—the lab tests specifically for strains of HPV, which can also lead to cervical cancer. A pelvic exam, meanwhile, is when a medical provider checks the uterus, cervix, and other parts of the reproductive system by using their fingers and hands or a speculum.

    “The biggest misconception is that people think any time they’re having a speculum placed in their vagina, that that is a Pap smear,” says Lincoln, who previously made a YouTube video demonstrating the different procedures. “It’s really important for people to know that a Pap smear is a procedure where we are getting a little brushing or a sample of cervical cells in order to see if they look abnormal—either that they are cervical cancer or they could potentially become cervical cancer. It’s a very specific test.”

    How often should you get one?

    Generally speaking, you should start getting regular Pap smears at age 21, according to ACOG’s guidelines. That’s a better guideline to follow than when you first become sexually active, experts say, even though the latter date might be sooner, because the chances of someone under the age of 21 getting cervical cancer is so small. 

    How frequently you should go for a Pap smear after that depends on your age and risk factors. But typically, you should get the screening done every three years between ages 21 and 29, according to ACOG’s guidelines. Between the ages of 30 and 65, you can choose one of three options: get a Pap smear and an HPV test every five years, get a Pap test alone every three years, or get an HPV test alone every five years.

    Read More: What to Expect at a Colonoscopy

    If you’re 65 or older, you may not need to get regular Pap smears anymore if you have no history of cervical changes and have tested negative on three Pap smears in a row, two HPV tests in a row, or two HPV and Pap tests in a row within the past 10 years, according to ACOG.

    Does it hurt?

    While a Pap smear can be uncomfortable, it should not hurt.

    “If a Pap smear is hurting, that’s a sign that something is not right,” Lincoln says. It could be how the test is being performed—for instance, if it’s not being done in a gentle manner or if you’re clenching because you’re not sure what to expect from the test—or it could be a sign of an underlying condition, such as a pelvic floor dysfunction issue or vaginal dryness, according to Lincoln.

    “It should feel like pressure; it can feel uncomfortable for a couple of minutes, but if it’s causing acute pain, it is absolutely okay to say, ‘Stop, this hurts.’ And they should absolutely stop and then try to figure out what’s going on,” Lincoln says. “You’re not supposed to be crying or in pain.”

    What happens afterward?

    It’s possible that you may experience cramping or some spotting after the procedure, according to Lincoln. But heavy bleeding is not normal, she says.

    The test results typically take a couple of days. Lincoln recommends asking your provider how you’ll be getting the results back—if your provider will call you to walk you through the results or if you’ll be getting them electronically, for instance—because it can vary depending on your provider and their office.

    Read More: IVF Changed America. But Its Future Is Under Threat

    If the results come back normal, all is well. If they come back unsatisfactory, it may mean you need to come back in for another Pap smear because the sample didn’t provide enough cells for the test. If the results are abnormal, don’t panic—most of the time that doesn’t mean you have cervical cancer. Talk to your provider about what the results mean for you. Depending on your risk factors and the types of cells detected—minor or serious ones—your provider might recommend coming in for additional tests, like a colposcopy, which is when a medical provider inserts a speculum into your vagina and uses a magnifying instrument to get a better look at your cervix.

    Talk to your doctor in advance

    While Lincoln and Trevino understand why people may feel anxious or wary of getting a Pap smear—“It’s not super fun,” Lincoln acknowledges—they both emphasize the importance of the test.

    “I always encourage my patients to feel really empowered, especially during the exam, to let me know what’s going on and if they need me to stop,” Trevino says.

    Both doctors say there are ways to make yourself feel at ease during a Pap smear—whether that’s bringing someone to the appointment with you for support, listening to music, or taking ibuprofen an hour or so before the exam to help avoid cramps.

    Lincoln and Trevino also encourage people to talk to their provider about what the test entails so they can be informed before getting the procedure done.

    “I just wish more people knew that for the vast majority of people, getting a Pap smear is not painful,” Lincoln says. “We fear the unknown. So being informed about what to expect, I think, is huge.”

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    Chantelle Lee

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  • Does Face Yoga Really Work? 

    Does Face Yoga Really Work? 

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    Yoga practitioners know that poses like downward-facing dog, warrior, bridge, and others can improve flexibility, reduce stress, and build strength in your body. Face yoga can offer similar benefits for your complexion.

    Face yoga—including moves like the eyebrow lifter, happy cheeks sculpting, and temple developer—refers to stretching, massaging, and exercising the face, says Dr. Joshua Zeichner, an associate professor of dermatology at the Icahn School of Medicine at Mount Sinai. “The goal is to enhance facial muscle tone to minimize signs of skin aging.” 

    The technique involves repeatedly moving facial muscles in certain ways. By practicing making these expressions, face yoga claims to improve how well those muscles function and boost your appearance, says Dr. Murad Alam, vice-chair of the dermatology department at Northwestern University’s Feinberg School of Medicine, who’s conducted research on face yoga. 

    So, if you’ve seen people making funny faces on TikTok, where there are more than 77,000 videos tagged #faceyoga, that’s why. If you’re considering trying it yourself, here’s how to do it and the benefits face yoga might offer. 

    Does face yoga really make you look younger? 

    Aging drives a number of changes that affect your complexion. You can lose muscle tone, which may make the skin on your face appear loose and saggy, Zeichner says. 

    As you age, the fat pads under your skin thin out, and you lose collagen, Alam adds. This typically makes your skin less elastic and gives it a less-full appearance.

    “With facial yoga, you’re trying to grow your muscles, which are underneath the fat pads,” he says. “Kind of like bodybuilding, you exercise the same muscles over and over again, and they become bigger.”

    Read More: Why You Should Change Your Exercise Routine—and How to Do It

    The bulked-up facial muscles can fill in some of the volume that’s been depleted by age-related fat, muscle, and collagen loss, Alam says.

    As you might imagine, there is very limited research on face yoga. But in a small study led by Alam and published in JAMA Dermatology in 2018, women ages 40 to 65 performed facial exercises for 30 minutes daily or every other day for 20 weeks. After comparing before-and-after photos, researchers noted that the people had fuller upper and lower cheeks and appeared younger after doing face yoga.

    Other benefits of face yoga

    Exercise of any kind can improve circulation, so strengthening face muscles likely has the same effect, explains Dr. Anetta Reszko, a dermatologist in New York City.

    “Increased facial muscle strength results in a more natural ‘face-lift’ effect by creating a lifted and toned look, while improved blood circulation adds to a naturally radiant and healthy complexion,” she says. 

    Enhanced blood flow to the skin and better circulation are essential for cell turnover, the natural process where dead skin cells are replaced with new ones, Zeichner says. Improved cell turnover ensures the skin has a smooth texture and even tone and encourages collagen production.

    Read More: How to Stop Checking Your Phone Every 10 Seconds

    Face yoga can also tap into the parasympathetic nervous system, which is responsible for promoting relaxation and reducing stress, Reszko adds. This helps lower your heart rate and blood pressure and contributes to your overall well-being. 

    A small 2018 study found that facial exercises improved mental health for older people. The exercises also enhanced facial expressions and tongue muscle power, which the researchers concluded could be a useful therapy for this age group. Movement, in general, has been shown to release endorphins and decrease stress, improving mood. 

    “Any activity that helps improve relaxation and reduce stress can be of benefit to the body in general as well as the skin specifically,” Zeichner says. “We know that emotional stress has a negative impact on the skin, impairing wound healing and leading to worsening of conditions like eczema or rosacea.” 

    Are there any risks? 

    Face yoga is safe for most people who are looking for a non-invasive way to improve skin firmness, reduce wrinkles, and relieve facial tension, Reszko says. It could be uncomfortable if you have sensitive skin, though. 

    If you have facial injuries, like bruises or cuts, she recommends not trying the technique until these heal. You could inadvertently put extra strain on the skin if you don’t do the moves correctly, which could also worsen conditions such as acne, as the movements could irritate the skin.

    Read More: 8 Signs You’re in Perimenopause

    Talk to your dermatologist before trying face yoga if you’ve had dermal fillers or other cosmetic procedures to make sure you’re not interfering with the results, she adds. 

    Another issue is that continuous facial movements might end up causing more wrinkles if you do them too much, Reszko says. Repeating certain facial expressions could overwork some muscles and lead to skin folding and worsen the appearance of wrinkles in between the eyebrows, horizontal forehead lines, and crow’s feet, Zeichner says.  

    How to get started with face yoga

    Just like regular yoga, a face yoga practice consists of many different moves. Research showing the anti-aging benefits of face yoga featured some Happy Face Yoga exercises, developed by Gary Sikorski, who co-authored the study. These include: 

    • The Cheek Lifter: Shape your mouth into an “O” and drape your upper lip over your teeth. Then, smile, lifting your cheek muscles up; place your fingers on the top of your cheeks and release your lips to a neutral posture. Repeat the lowering and lifting 10 times. 
    • Happy Cheeks Sculpting: Smile with your lips pursed together without showing your teeth. Smile again, focusing on the corners of your mouth, which forces your cheeks up. Place your index fingers on the corners of your mouth and apply mild pressure as you push your fingers up to your cheekbones. Hold each rep for 20 seconds. 
    • The Eyebrow Lifter: Place three fingers from each hand just underneath each eyebrow, then force your eyes to open. Smile and try to push your eyebrows down like you’re furrowing your brow. Close your eyes and roll your eyeballs up toward the top of your head. Hold each rep for 20 seconds. 

    Research suggests that practicing face yoga for 30 minutes several times a week can offer anti-aging results, Alam says. That’s a lot of fake smiling and funny faces. “At least in our study, it required a fair amount of commitment.” 

    When to see a dermatologist 

    If you’re not getting the results you’re looking for with face yoga, see a dermatologist. They can recommend treatments like Botox, fillers, retinol, or other therapies, to help smooth wrinkles and stimulate collagen production, Zeichner says.

    A dermatologist can also identify any underlying skin issues that you might have and offer the best remedy, Reszko adds. 

    “Face yoga can be a good recommendation for those looking for natural, non-invasive methods to improve facial tone and reduce stress,” she says. “However, it’s important to emphasize proper technique and manage expectations regarding gradual results.” 

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    Erica Sweeney

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  • Therapists Share the 1 Tip That’s Changed Their Lives

    Therapists Share the 1 Tip That’s Changed Their Lives

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    Being a therapist means listening to a lot of clients’ problems. Between their schooling, reading, continuing-education requirements, workplace mentors, general curiosity, and learnings from patients, therapists are full of practical advice to improve mental health and well-being.

    But what’s the one mighty mental-health tip that stands out above all others? We tapped psychotherapists and psychologists for the single piece of advice that has changed their own lives for the better.

    You have more time than you think before you react

    Remembering to take the time to think things through, formulate a response, and decide on a course of action has positively affected New York City-based psychotherapist Lauren Tinaglia’s mental health, relationships, and work. “You always have at least a few seconds to take a breath and check in with yourself,” Tinaglia says. (She also recommends slowly counting to 10, taking a walk around the block, or journaling for a few minutes if that’s more your style.)

    “I often put pressure on myself to have the right answer or response right away,” which ratchets up anxiety, Tinaglia says. After taking a few slow, deep breaths, acknowledging her feelings (or asking herself how she’s feeling if she’s unsure), and reminding herself that her feelings are valid, she can decide with a level head how she wants to respond. Doing so helps her “access the calmer, kinder, wiser, more thoughtful, more empathic, less impulsive, and more grounded parts of me that I want to lead with,” says Tinaglia.

    Imagine troublesome people in your life as preschoolers

    Brooke Bardin, director of clinical operations at Victory Starts Now, a nonprofit providing comprehensive support to people affected by the justice system in Los Angeles, has taken to picturing frustrating and annoying people she has to deal with regularly as young, innocent children around age four. “When you’re talking to them and start to feel annoyed, bring up that mental image,” she says: how they were, basically, “before they developed behaviors that now make you want to pull your hair out.”

    Read More: Does Text Therapy Really Work?

    “This technique has really helped me handle difficult people with more patience and empathy, as it reminds me that everyone has that little child within them,” Bardin says.

    She used it recently at work, in fact: when dealing with someone who wasn’t being empathetic, “I pictured her as a five-year-old with pigtails, smiling and boisterous but not yet verbally aggressive,” says Bardin. “Almost immediately, my anger faded, and I was able to talk to her more patiently.”

    More From TIME

    You’re not that special

    Jonathan Levine, a therapy lead at Equip Health in Philadelphia, knows that it may sound rude: You’re not that special, so don’t take yourself that seriously. “But if you can lean into it, it will take you far,” he says.

    Levine used to have severe social anxiety and felt insecure that people wouldn’t like him, but that changed after his therapist reminded him that he wasn’t that special—people weren’t always paying attention to everything he did. “I found that freeing,” he says. As a therapist, Levine frequently reminds his patients of the same fact, especially when they’re frustrated or overcome by big emotions.

    “As a human, this helps me stay calm when I make mistakes or get caught up in thinking about what my life ‘should’ be like,” he explains. “It takes away the ego of it all.”

    Do a brief energy check before committing to an activity 

    “I gauge the emotional energy I have for an activity or interaction before committing to it,” says Patty Johnson, a clinical psychologist at Nia Integrative Healing in Oak Park, Ill. That helps her decide how much time to spend on it. “If I don’t take that pause, I may not do it at all because it feels too big, or I may overcommit and eventually feel exhausted and resentful,” she says.

    Stop asking questions that start with “why”

    Milissa Aronson, owner of Magnolia Psychotherapy in Summit, N.J., says this communication style has helped her to avoid unnecessary conflict over the years. “Whenever possible, I avoid asking questions that start with the word ‘why,’” she says of this “popular therapist technique.” While “why?” may seem like a benign question to the asker, it can put the responder in a defensive mindset. The answer generally starts with “because”—putting them in a guarding stance.

    Read More: How to Know if Your Friendship Is Toxic—and What to Do About It

    Aronson recommends reframing such questions with phrases like “What happened?” or “How come?” to spare you potential squabbles or hurt feelings. 

    If your child is driving you crazy, remind yourself it won’t always be this way 

    Katherine Mahan, a private practice mental-health counselor in Richmond, Va., remembers one evening when both of her sons were under age four, and she felt overwhelmed because she wasn’t able to meet both of their needs at once. Caught in the middle of breastfeeding and boiling water for pasta for her hungry older child, Mahan felt “on the verge of tears.”

    Everyone got fed, nobody was burned, and she “thankfully never had to perform that particular feat again.” Still, Mahan couldn’t knock the feeling of overwhelm. Some time later, she read a bit of wisdom that she has found helpful to this day: “In the times when you are feeling completely drained or dysregulated by your children, imagine that you have come back in time from the future to spend one more day with them at these very ages,” she says. “This resonated with me and allowed me to get some healthy distance from my own emotions and refocus my attention on my children.”

    Feel the water on your hands as you wash the dishes

    Or the texture of a cozy throw pillow. Or the heat from fresh laundry out of the dryer. “Connecting with the senses, like touch—especially during tedious, frustrating, or stressful tasks—brings us out of worry about the future and regret about the past, and simply to what is in the present,” says Aaron Gilbert, founder of Boston Evening Therapy Associates.

    Read More: Should You Work Out if Your Muscles Are Sore?

    In fact, “focusing on the senses reminds us that pleasure and peace and enjoyment are not on the other side of tedious tasks, or that next job promotion, or ‘once I finally figure my life out,’” he says. “Rather, pleasure and peace and enjoyment are only truly available in the present moment.”

    Some meditation apps like Headspace and Calm have guided tracks designed to be listened to while walking, cleaning, or doing chores. You may find these helpful in encouraging you to tap into your senses and tune into nature or your surroundings. 

    Don’t care about someone’s problem more than they do

    Kiki Ramsey, CEO of Positive Psychology Coaching and Diversity Institute in Atlanta, says that this mental-health insight has affected her life more than anything else. “This wisdom has helped me manage my anxiety, control stress levels, and navigate my relationships more effectively,” she says.

    Early in her coaching career, Ramsey says she often felt more committed to her clients’ success and goals than they were, and that this extended into her personal relationships.

    “There was a particular moment when a family member was contemplating a career change. Despite their lack of enthusiasm, I found myself obsessively invested in their journey, pushing harder than they were,” she recalls. Then Ramsey had a revelation: “As much as I wanted to support and guide others, they needed to own their own problems and solutions.”

    By stepping back and allowing others the autonomy to tackle their own issues, Ramsey has found immense relief. “It was liberating to realize that I could offer support without feeling responsible for the outcomes. This shift has been instrumental in reducing my stress and allowing me to focus on areas where I can make a meaningful impact.”

    There’s a difference between a thought and thinking

    Joanna Hardis, an anxiety and OCD therapist in Cleveland Heights, Ohio, and author of Just Do Nothing: A Paradoxical Guide to Getting Out of Your Way, learned this idea decades ago in a meditation class. “Having spent most of my life worrying until that point, I had never imagined that worrying (and ruminating) might be something in my control,” she says. “If it was in my control, that meant I might not have to do it all the time.”

    Having been a therapist for more than five years at the time, she wondered how she had never heard that the presence of a thought is largely a spontaneous event out of our control. “Thinking, on the other hand, is a behavior—it’s our involvement or engagement with the thought,” says Hardis. “The more we engage, the deeper we can get. Unlearning this loop was the key for me to stop worrying.”

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    Perri Ormont Blumberg

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  • How 5 Influencers With IBD Are Fighting Stigma

    How 5 Influencers With IBD Are Fighting Stigma

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    Although some health conditions are spoken about with more nuance and understanding than in the past, inflammatory bowel disease (IBD) hasn’t seemed to make that list yet, even though the condition affects between 2.4 and 3.1 million people in the United States, according to the U.S. Centers for Disease Control and Prevention.

    Because flare-ups can involve frequent diarrhea, and severe cases may require surgical placement of an ostomy bag, IBD (which is the umbrella term for two conditions: Crohn’s disease and ulcerative colitis) can often feel embarrassing and isolating, particularly if flares happen often or if others around you—from family members to coworkers—don’t understand the extent of the disease. That’s why social media can be a boon for those with IBD, helping them connect with others and share insights, as well as offer support. Here are five influencers who are leading the way in fighting the kind of stigma associated with IBD, and creating a robust community in the process.

    Addressing cultural stigma

    Although getting an official diagnosis of IBD can take time as symptoms worsen, New Jersey-based Tina Aswani-Omprakash, 41, encountered an additional delay, and it wasn’t because of her gastrointestinal issues.

    “My doctor said people like me, of South Asian descent, didn’t get IBD so that couldn’t be what I have,” she recalls. “Even when I told him that my dad died of colorectal cancer related to having Crohn’s, he still was unwilling to believe me or put me on medication.” 

    After changing her provider and finally getting the treatment she needed for her Crohn’s, Aswani-Omprakash continued to hear misperceptions, but this time they were within her own family. Several of her relatives were unhappy that she was taking medications, since there can be distrust of Western medicine within the South Asian community, she says, and they believed she could “cure” herself through diet. 

    “Also, I felt judged by many for having this disease,” she says. “Having UC is bad enough, but then to be blamed for it really takes a toll. Even when I needed emergency surgery, they were against it, telling me that ‘No one will marry you if you have an ostomy,’ and that this would be the end of my life.”

    Read More: How to Navigate Dating When You Have IBD

    She turned to social media to find others with the condition, but quickly discovered that not many people were talking about the type of cultural challenges she was facing. Because she knew other South Asian people must feel the same way, she got involved with the Crohn’s & Colitis Foundation to help manage online groups, and that led to starting to share her story on social media.

    “That was so hard because a lot of my family and friends said I was bringing shame onto my family, that talking about this was inappropriate,” she says. “In some ways, that drove me even more to address this stigma.” In 2021, Aswani-Omprakash also co-founded a nonprofit organization, the South Asian IBD Alliance, and it’s continuing to scale up and expand its reach. Her personal blog, OwnYourCrohns.com, has won several awards, and she speaks at numerous conferences every year about her experience as a way to inform not just those with the condition, but also health providers who might inadvertently hold biases like the first doctor she saw.

    “It’s really all about knowledge, because people tend to have bias and stigma around what they don’t understand,” she says. “That means the more awareness we can spread about what it’s like to have these conditions, the better.”

    Read More: Why Bathroom Access Is a Public Health Issue

    Navigating through emotional challenges

    When Natalie Hayden, 41, graduated from college in 2005, she was eager to start her career as a broadcaster, kicking off with an internship at CBS Chicago. Then, her occasional gastrointestinal issues intensified to the point that she sought help, and was shocked to be diagnosed with Crohn’s. Even worse, her sickness became so overwhelming that she could barely walk up a flight of stairs, much less be on camera every day.

    “When I left the hospital after an acute flare, I was put on 22 pills a day,” she says. “Plus, the prednisone I was taking changed my appearance. I didn’t even want anyone taking my photo, so it felt like my lifelong dream of being on the news was gone.”

    Added to that challenge, she felt utterly alone. At the time, few people on social media were talking about chronic illness, and all her friends were healthy and pursuing their careers without interruption. Hayden says it all added up to mental health challenges as well as physical issues. Then, in 2014, after stints in public relations and TV news, she realized that her love for storytelling and the lack of representation for those with IBD could drive a whole new effort. She started writing for blogs and sharing her story on social media and her own blog, LightsCameraCrohns.com, particularly her journey through motherhood. Because those with IBD often have to switch medications or even discontinue them during pregnancy, flares become such a significant concern that even those in remission will be considered to be having a high-risk pregnancy, she says.

    “It takes a lot to fight through the pain and to constantly be readjusting your life,” she says. “Becoming an advocate and sharing information, especially for those going through pregnancy, has become a source of transformation for me. I know many women with IBD who are worried that they can’t have children, but that’s simply not true.”

    Hayden says she’s very vocal about all her ups and downs, because she wants others who may be going through similar circumstances to feel seen. She gets many DMs from followers who are struggling with the emotional aspect of IBD, and says she tries to be a “safe space” where they can be heard. 

    “I know what it’s like to have dark thoughts with this disease and its treatment,” she says. “By sharing my own difficulties, I hope other people can feel lighter, and not alone.”

    Modeling body acceptance

    One of the most difficult aspects of IBD is accepting the kind of physical changes that come with treatment—for example, corticosteroids are commonly used to control inflammation but can result in a rounded face that might make people taking them feel self-conscious. For those who need a procedure such as placement of an ostomy bag, that awareness can be even more acute, says Gaylyn Henderson, 40, of Atlanta.

    She started experiencing symptoms of Crohn’s as a teenager in 1998, and needed an ostomy a few years later. But rather than trying to hide the bag under loose clothing, she embraced the opportunity to share her experience, and launched an Instagram account, known as GutlessAndGlamorous, in 2012. Not only does she talk about her experiences with IBD, but Henderson shares modeling photos of herself in bikinis and crop tops, which feature her ostomy bag prominently.

    Read More: Why Gut Health Issues Are More Common in Women

    “I wanted to address all the stigma around having an ostomy, because people have misconceptions like they’re nasty or stinky,” she says. “That can make people with an ostomy feel like they need to hide it, but I’m trying to show that it shouldn’t be a source of shame.”

    After gaining traction and followers on social media, she’s been asked to speak to groups, including a local children’s hospital where teenagers might be struggling with IBD treatment. She’s working to found a nonprofit, also called Gutless and Glamorous, focused on providing more patient education and resources about ostomies. 

    “When I was younger, I don’t think I would have felt so overwhelmed and on my own if I’d seen someone who looked like me modeling on the beach with an ostomy,” she says. “Now, I have the opportunity to be that person for a young girl who needs to see that and know it’s okay—that you can have a positive, beautiful life and a body that you celebrate, wherever you are in your IBD journey.”

    Creating an IBD network

    Like many with IBD, Kimberly Hooks spent years in and out of the hospital trying to manage the type of intense pain that can come with having ulcerative colitis. Then, she ended up having her colon removed in 2020, when COVID restrictions barred any hospital visitors during her recovery. To cope, she started both an Instagram account and a blog, KimberlyMHooks.com, and shared videos and photos from her bed.

    “At first, it was just a way to deal with the emotional effects of having a chronic illness,” she says. “I was used to isolation after dealing with ulcerative colitis for 10 years. Even working in a big corporation, it just seemed like no one there could relate, so I kept it to myself. But being in the hospital alone made me want to reach out and connect.”

    That was especially the case since she rarely saw Black women like herself represented in articles, patient information, or photos related to IBD. When she began using social media more often, she started building a patient community that reflected the diversity of people affected by the disease.

    “Representation matters,” says Hooks. “If you don’t see other people who look like you, it’s easy to feel isolated, and that affects your mental health and outlook. I knew that if I shared my story, another person of color might feel less alone. Social media is so powerful for connecting people and creating community, and this is a great example of that.”

    Fighting IBD stigma from the gym

    When Robert Frank, 46, of Sarasota, Florida, started having intense stomach pain in early 2021, he suspected it was food poisoning since it came on so suddenly. A colonoscopy done at the ER led to a diagnosis of ulcerative colitis, which came as a shock to him, he says. Unlike many people with IBD, who tend to have symptoms for years, Frank had no idea—and that also meant he didn’t know what might come next. 

    An avid bodybuilder, he started losing weight rapidly as a result of having the condition and going through treatment for it. He struggled to keep food down, and the physical changes and mental adjustment threw him into a dark place, he recalls. 

    “I kept thinking they must be misdiagnosing me, that I probably had cancer and it was spreading,” says Frank. “I didn’t feel in control of my body at all, which was new for me after decades of building my body in meaningful ways.”

    Because he already had a TikTok following from his bodybuilding videos, he began sharing his IBD story in a series of emotional videos that included him in a hospital bed, crying and detailing his worry over what might happen next. After he got home and began going back to the gym to rebuild his health, he kept sharing videos that were honest and vulnerable, and the response was stunning, he said. At this point, he has 1.7 million followers, and many of them come for the IBD insights.

    Read More: 8 Apps That Can Help You Manage IBD

    “I’ve gotten so many emails and DMs from people who have ulcerative colitis or Crohn’s, and they found me because they were looking for support or to feel less alone,” he says. “Once I started hearing from them, I realized how much stigma there is about IBD, so I encourage them to share their story, too. This disease can be hard, I’ve definitely felt that, and it’s even tougher when you feel alone.”

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    Elizabeth Millard

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  • Safer Psychedelic Drugs May Be Coming

    Safer Psychedelic Drugs May Be Coming

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    Psychedelics have shown great promise in treating a range of mental-health conditions, from PTSD to depression—but they’re not without significant downsides. People who take psychedelics can experience bad trips and unpleasant or dangerous side effects, and the drugs can be time-intensive and arduous to administer.

    These drugs are “very effective, but they’re scary and they’re chaotic and they’re unpredictable,” says Dillan DiNardo, CEO of psychedelic drug development company Mindstate Design Labs. 

    Mindstate, and plenty of companies like it, think they’ve found a workaround: what if psychedelics could be tamed and toned down, tweaked to keep their psychological benefits while reducing many of their risks? This approach could, in theory, improve patients’ experiences, boost the drugs’ efficacy, and make psychedelics more palatable to regulators at the U.S. Food and Drug Administration (FDA)—who earlier this year dealt a blow to the legal psychedelics movement by saying they would not approve MDMA to treat PTSD without additional safety and efficacy data.

    Classic psychedelics, some advocates argue, come with too much baggage. But these altered, “next generation” medications may be the future, says Cosmo Feilding Mellen, CEO of Beckley Psytech, a company working on one such drug.

    The pitfalls of psychedelics

    Psychedelics are thought to improve mental health by boosting neuroplasticity, helping the brain grow and form new connections. MDMA, known for promoting empathy and open-mindedness, seems to put people in a headspace where they can reprocess traumatic experiences. Some research suggests psilocybin, a psychoactive compound in magic mushrooms, eases depression by rewiring the brain, altering its landscape to disrupt toxic thought patterns. Other psychedelics and hallucinogens, including LSD, DMT, and ibogaine, also appear to promote psychologically beneficial changes in the brain, making them promising treatments for conditions including anxiety, depression, and substance-abuse disorder.

    But these drugs are messy. All of them, to varying degrees, come with side effects, ranging from relatively benign (nausea, tooth-grinding, sweating) to more concerning (cardiovascular risks, seizures, impaired judgment that can lead to dangerous situations). And using psychedelics to treat mental-health conditions isn’t as simple as prescribing a pill. Under current research protocols, patients often need to be monitored by multiple mental-health professionals during trips that last six hours or longer, which are sometimes augmented by additional psychotherapy sessions. That’s logistically difficult in a resource-strapped mental-health system, but also potentially intimidating for patients. If they get caught in a bad trip, feeling anxious and scared, they may be in it for hours on end.

    Read More: How to Stop Checking Your Phone Every 10 Seconds

    When an expert panel that advises the FDA met in June to discuss MDMA’s potential use as a PTSD treatment (when coupled with psychotherapy), its members had numerous concerns—including, among others, MDMA’s potential to cause heart problems and the need to carefully monitor patients in an altered state of consciousness. The agency’s advisors ultimately voted against approving the drug, and the FDA followed their advice.

    That decision “certainly rattled some cages” for others working in psychedelic development, and “understandably so,” says Dr. Srinivas Rao, co-CEO of Atai Life Sciences, a biopharmaceutical company that researches and invests in psychedelic drug development.

    One way companies are charting another path forward in the wake of that decision? New—and theoretically improved—drugs.

    How psychedelics 2.0 would work 

    Atai, for one, is experimenting with an alternative form of MDMA called R-MDMA. The drug is still in early-stage safety testing, so it’s too soon to say how well it will work against its intended target, social anxiety disorder. But early data suggest that, compared to typical MDMA, Atai’s version causes fewer side effects and a more introspective experience, Rao says.

    The latter could be beneficial for a couple reasons, Rao says. It could make MDMA treatment less reliant on psychotherapy—a major sticking point in the FDA’s recent review of the drug, since the agency doesn’t regulate therapy—and eliminate some of the risks that come with using a drug that makes people feel “amorous” in a clinical environment, Rao says. (A widely publicized ethical breach in a previous MDMA trial involved sexual contact between a therapist and a patient.)

    Read More: Why You Should Change Your Exercise Routine—and How to Do It

    Atai isn’t alone in researching R-MDMA. The psychedelics company MindMed is studying whether it can improve social functioning among people with autism spectrum disorder. “It is our intention with this new program to offer patients new hope for meaningful connection,” MindMed Chief Medical Officer Dr. Daniel Karlin said in a company statement.

    Meanwhile, other companies are trying to improve upon other psychedelics and hallucinogens. Researchers from Duke University, Yale University, and the University of California, San Francisco, are working on a drug modeled off ibogaine that, at least in animal trials, seems able to mimic its impact on the brain with fewer unwanted side effects.

    And Beckley Psytech is developing a synthetic form of a drug similar to DMT, a compound in ayahuasca that results in short-lived but intense hallucinations and can lead to cardiovascular side effects, seizures, and other risks. In a small, preliminary company trial, Beckley Psytech’s drug brought long-lasting relief for treatment-resistant depression in about half of people who took just one dose.

    In addition to its potential one-and-done dosing system, Mellen, Beckley Psytech’s CEO, says the compound has a major upside compared to traditional psychedelics: patients start to feel its effects in minutes and come down after about an hour. This not only frees up clinician resources, he says, but can also be a comfort to patients. “We can reassure a patient,” he says. “If you’re having a bad time, it should be over within an hour.”

    Some companies are going even further, trying to remove the trippy effects of psychedelics altogether. Pharmaceutical company AbbVie is working with Gilgamesh Pharmaceuticals on such an approach, trying to develop “neuroplastogens” that can change the brain without causing intense psychoactive effects. Similarly, Enveric Biosciences is preparing to begin human trials of a molecule that has structural similarities to psilocybin but—in theory—causes minimal psychedelic effects when it binds to receptors in the brain.

    The idea, says Enveric CEO Joseph Tucker, is to stoke neuroplasticity without getting people high. If it works, he says, such an approach would result in an effective drug that could be taken every day at home, just like an antidepressant—a model with which regulators and clinicians are already familiar, and one that removes the logistical burden of lengthy in-clinic sessions.

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

    Still, Enveric’s approach is controversial. Some researchers argue that psychedelic experiences are the whole point, and that drugs won’t improve mental health without them. Studies have suggested that certain transcendent effects of psychedelics—like feeling one with the world—are linked to improvements in psychological symptoms.

    To that end, Mindstate Design Labs is working to build drugs that cause psychedelic trips, but selectively. “Psychedelics are very promiscuous molecules,” Mindstate CEO DiNardo explains. “They interact with sites all over the brain.” Mindstate’s goal is to tailor them to cause more targeted effects.

    Aided by artificial intelligence, the company analyzed troves of data on how different psychedelics affect the brain, including tens of thousands of “trip reports” from drug users. The idea, DiNardo says, is to get granular enough to design medications that alter consciousness in seemingly beneficial ways (like through mystical experiences, altered perceptions of time and space, and feelings of “sacredness”) while avoiding effects that don’t seem useful (like auditory distortions and loss of control).

    Through its analysis, Mindstate identified a drug that DiNardo calls “psychedelic tofu”—that is, one that’s relatively bland and basic as psychedelics go, but that can be spiced up when paired with compounds that trigger desired effects in the brain. The FDA in early September gave Mindstate the green light to start testing its “tofu” drug; if that proves safe, the company will then begin testing it in combination with other compounds, DiNardo says.

    All of these approaches are in early phases of research, meaning companies have to get through years of clinical trials—which may or may not turn out to be successful—before they can even think about applying for FDA approval. There are no guarantees, and early hype often doesn’t translate to scientific or regulatory success.

    But DiNardo says he’s confident that psychedelics’ future is brighter than this year’s MDMA denial might suggest. “If we can selectively choose the effects” of these drugs, he says, “it just makes the regulatory path so much easier.”

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    Jamie Ducharme

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  • Women Can Now Order a Blood Test That Can Predict Preterm Birth

    Women Can Now Order a Blood Test That Can Predict Preterm Birth

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    In 2017, Dr. Barbi Phelps-Sandall, an obstetrician who has been practicing in the San Francisco Bay area for more than two decades, had just learned about a new blood test only available at select labs for predicting premature birth when the perfect case walked into her office.

    At 40, she was pregnant with her third child. Her first was born full term, but during her second pregnancy, she went into labor at 32 weeks.

    Because she had a history of premature labor, she was at higher risk of delivering her third baby early as well. But as the primary earner for her family, she could not afford to take time off on bed rest like she had for her second. Phelps-Sandall decided to give her the blood test to help inform any decision they made about her options.

    The test, called PreTRM, tracks levels of two proteins in the blood that tend to rise during the second trimester in women who are at risk of delivering early. This patient’s test was negative. That helped Phelps-Sandall and her patient decide to schedule more regular vaginal exams and get more frequent fetal monitoring, but gave them a little more reassurance that she wouldn’t need bed rest.

    The baby ended up sticking to its due date. “The blood test made life so much easier because it made us feel more secure,” says Phelps-Sandall.

    She now offers the test to every patient she sees, regardless of their risk of delivering prematurely. “It gives us information we never really had before.” Now, women can order it whether or not their ob-gyn knows about it or offers it.

    Who can get the test?

    Developed by Sera Prognostics, the test is not yet approved by the U.S. Food and Drug Administration but is available for doctors to order as a laboratory-developed test, which means that doctors in any state can order the test but only designated certified labs can perform the analysis. (New York state requires its department of health to certify any laboratory-developed tests for any of its residents, and this approval happened in 2018.)

    Doctors can order the prescription test and take a few drops of blood from a fingerprick. They then send the sample to the company’s labs in Salt Lake City for analysis. However, not many doctors are even aware of the relatively simple test for identifying women at highest risk of delivering early.

    Read More: What to Expect at a Mammogram

    Beginning Oct. 1, any woman can also order the test from the company’s website, either by getting a prescription from her physician or connecting with one of Sera’s telehealth providers. The test kit and instructions are sent to expectant mothers’ homes, where they can collect the blood sample and send it to Sera’s lab. Either their doctor or the telehealth doctor will receive and discuss the results with them.

    Why is preterm birth dangerous?

    Doctors consider any birth before 37 weeks gestation to be preterm, and it can lead to both short- and long-term health complications for newborns—including breathing and feeding problems, weaker immune systems, and lengthy stays in the neonatal intensive care unit. About one in 10 babies born in the U.S. is premature, according to the U.S. Centers for Disease Control and Prevention.

    “This is a paradigm change,” says Dr. Matthew Hoffman, vice chairman of obstetrics and gynecology at Christiana Care Health System who was involved in the studies of PreTRM. “In obstetrics we are faced with two questions: when and how to deliver the baby. This [test] lets us have insights into who is at risk, and put in preventive services [to prevent preterm birth].”

    How the test works

    The blood test measures levels of two proteins: the sex-hormone binding globulin, or SHBG, and the insulin-like growth factor binding protein (IBP4). It’s not the absolute levels of each that’s important, says Zhenya Lindgardt, CEO of Sera Prognostics, but the ratio of the two between 18 and 21 weeks gestation. Women with higher ratios—as determined by the company’s studies looking at the levels of women giving birth at term and those giving birth prematurely—are at higher risk of going into labor early compared to those with lower ratios.

    Because hormone and protein levels fluctuate constantly during pregnancy, the two proteins PreTRM tracks are carefully chosen and measured only when women are between 18 and 21 weeks of pregnancy. Any earlier or later might yield inaccurate results.

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

    If PreTRM indicates a higher risk of preterm delivery, then doctors can prescribe aspirin, vaginal progesterone, and more frequent vaginal and fetal checks to ensure the cervix remains closed. Currently about half of preterm births in the U.S. occur in women with known risk factors for early delivery, including a history of previous preterm birth or a shortened cervix. But the rest don’t expect, and their doctors can’t predict, that they will deliver early. “In the study, we identified about a third of women who were at higher risk. We were able to identify a much larger group of women, let them understand their risk, and give them tools to manage that risk,” says Hoffman. “This allows us to approach women who didn’t have a history of prior preterm birth, or didn’t have a shortened cervix.”

    The promise of preventing more preterm births

    With more widespread use of the test, doctors may gain better knowledge about the myriad factors that can contribute to early labor, and ultimately intervene much earlier than 18 weeks if they better understand other factors that are involved. “We should be thinking of this [test] as a population health component to improve the outcomes for both moms and babies long term,” Hoffman says.

    The company is completing another study looking at health outcomes for babies whose mothers used PreTRM; the trial was stopped early last December because the initial results also showed benefit.

    “PreTRM allows me to get ahead of things,” says Phelps-Sandall. “We don’t have good predictors for this condition. We know of a conglomerate of things that can explain why 50% of babies are born prematurely, but the other 50% are total surprises. This test allows you to catch a lot of those.”

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    Alice Park

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  • The Presidential Election Will Shape the Future of Human Health 

    The Presidential Election Will Shape the Future of Human Health 

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    As diplomats and officials from around the world gathered in New York last week for the annual United Nations General Assembly, one question dominated the attention of global leaders: who will lead the U.S. in 2025? The stakes of this election go far beyond America’s borders. The next president will play a critical role in addressing the world’s most pressing challenges: climate change, global health, and international cooperation. And the choice between Kamala Harris and Donald Trump could not be clearer.

    Vice President Kamala Harris and former President Donald Trump offer two starkly different visions of how the U.S. should engage on global challenges ranging from economic inequality to global health. Their opposing views on climate action, pandemic preparedness, and infectious disease prevention, among other challenges, will significantly influence not just the daily lives of Americans but the trajectory of millions of lives around the world.

    Global cooperation vs. a retreat from global responsibility

    Vice President Harris has consistently demonstrated her commitment to addressing the world’s most pressing challenges through multilateralism and global cooperation. Her approach embraces the notion that U.S. leadership is indispensable to tackling global issues. She recognizes that challenges like the spread of epidemics and pandemics and the emergence of bugs resistant to antimicrobial medicines are not isolated to individual nations—they are inherently global, demanding collective action.

    In stark contrast, isolationism, skepticism toward international organizations, and a retreat from global responsibility characterized former President Trump’s approach during his administration. In 2018, he disbanded a pandemic unit that President Obama had established that was tasked with preparing for the next pandemic. He recently told TIME that if re-elected, he will disband the Office of Pandemic Preparedness and Response Policy, which the Biden Administration created. Trump’s foreign policy when in office often undermined global cooperation when it was most needed, notably pulling the U.S. out of the Paris Climate Agreement and initiating the U.S.’s withdrawal from the World Health Organization (WHO) in the middle of the COVID-19 pandemic, a once-in-a-century global health crisis. (Biden’s administration later reversed course on both withdrawals.) Trump’s congressional ally Rep Marjorie Taylor Greene says that if Trump wins a second term in office next year, it is “very likely” that he would withdraw the U.S from the WHO again.

    Read More: The Global System for Distributing Mpox Shots Is Broken. Here’s How to Fix It

    It is hard to think of an action more destructive to public health at home and abroad than the U.S. severing ties with the WHO. There is no other organization that has the same legitimacy, the same power to convene the world’s health experts, and the same global reach. U.S. health agencies like the U.S. Centers for Disease Control and Prevention and the National Institutes for Health work closely with the WHO on a wide range of health challenges, including cancer prevention and polio eradication—work that would be greatly harmed if Trump were to pull the U.S. out of the WHO.

    If Trump is elected again, we can expect less engagement with global health institutions and more emphasis on going it alone: a strategy that leaves America and the world more vulnerable to future health crises. The COVID-19 pandemic taught us that we live in an interconnected world—no country can face pandemics alone. An outbreak anywhere can become an outbreak everywhere unless countries work together. In contrast to Trump, Harris supports strengthening global institutions like the WHO and fostering partnerships to improve global health security, recognizing that infectious diseases know no borders.

    A critical moment for climate leadership

    The recent devastation caused by Hurricane Helene highlights the urgency of addressing climate change, as increasingly severe weather patterns threaten communities, infrastructure, and livelihoods. Harris has championed the need for swift action to curb greenhouse gas emissions, transition to renewable energy, and support vulnerable nations in their adaptation efforts. These priorities are more than just environmental stewardship; they represent an investment in the health, security, and economic stability of our children. She also sees robust climate action not only as a way to protect the planet but also as an economic opportunity for American workers. Clean energy could be the next great job creator, with millions of green jobs emerging as we invest in wind, solar, and other renewable technologies.

    Read More: Products Can Harm People for Decades Before Companies Change. Here’s How to Stop Them

    In contrast, Trump has repeatedly downplayed the urgency of climate change and promoted fossil fuels over clean energy. He has repeatedly questioned the scientific consensus on climate change, rolled back environmental regulations, and promoted fossil fuel development. These policies, if reinstated, would not only exacerbate the climate crisis but also alienate the U.S. from key international partners who are pushing forward on climate action. A second Trump term would likely see more environmental rollbacks and less global cooperation on one of the most critical issues of our time.

    Reaching global development goals

    The differences between Harris and Trump are also evident when it comes to broader global development goals. The Sustainable Development Goals are a set of global targets agreed upon by 193 U.N. member states, including the U.S, with a target date of 2030. They aim to end poverty, protect the planet, and ensure prosperity for all. The U.S. is the largest financier of this agenda, and its leadership is crucial. Harris has made it clear that she will keep the U.S. engaged in this effort, understanding that global development directly affects our national security and economic prosperity. Trump’s past actions, however, show a clear disregard for these international commitments, and a second term would likely see further disengagement from global development efforts.

    Read More: The Far Right and Far Left Meet Over Wellness Conspiracy Theories

    For middle-class families in America, these conversations are not just about abstract foreign policy. They are about the jobs that can come from leading the world in clean energy. They are about staying safe from global health threats by working with other nations to prepare for and respond to pandemics. And they are about ensuring a stable global economy that benefits American workers and businesses.

    All told, Harris’s vision of global cooperation aligns with the urgency of transnational threats. She understands that if the U.S. retreats from its commitments, it will not just be the millions of American middle-class families who will suffer: global health security will be weakened, the risk of pandemics will increase, and climate disasters will worsen.

    Diplomats and officials from around the world are nervously watching the U.S. presidential election, as they know that the stakes are high. In the next five years, the decisions made in the White House will determine the fate of our collective human health. The next U.S. president will not just be making decisions for America—they’ll be setting the tone for the world. Will we work together with our allies and international partners, or will we step back and let others lead? The consequences of that choice will reverberate far beyond our borders.

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    Jirair Ratevosian and Gavin Yamey

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  • What to Expect at a Mammogram

    What to Expect at a Mammogram

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    Maybe you’ve been putting off a mammogram because you’re anxious about what it might find. But experts encourage women to reframe having a mammogram as empowering. “You can’t prevent breast cancer, but mammograms help you take some control,” says Dr. Nina S. Vincoff, chief of breast imaging at Northwell Health in New York. “Mammograms find cancers when they are smallest and easiest to treat. Women who have mammograms are less likely to die from breast cancer and less likely to need aggressive treatments like mastectomy and chemotherapy.”

    Dr. Laurie Margolies, professor and vice-chair for breast imaging at the Icahn School of Medicine at Mount Sinai, puts it even more succinctly: “Just come!  Don’t be afraid!”

    But many women don’t. That’s true even if there are symptoms, Margolies says. Some “pretend nothing is happening and allow a breast mass to grow and grow until it erodes through the skin, and they find themselves bleeding and come to the emergency room,” she says.

    The screening isn’t remotely as scary as you think. Ahead, Vincoff and Margolies walk you through what to know about mammograms and what the potentially life-saving exam entails.

    What is a mammogram?

    Breast cancer is relatively common. In the U.S., one in eight women will develop the disease sometime in her life. A mammogram is an X-ray examination of the breast used to detect breast cancer and other breast diseases.

    “Some mammograms are performed on people who are having breast problems such as lumps or nipple discharge,” says Margolies, and others—known as screening mammograms—are performed as part of well care in people who have no known breast problems.

    Who should be tested?

    Knowing your risk is important. “The American College of Radiology suggests that all women have a risk assessment by age 30,” Margolies says. You can have this done by your physician or use a free online calculator that asks questions about family history, prior breast biopsies, and more.

    Women of average risk should have yearly mammograms starting at age 40, says Vincoff. “Those are the guidelines that save the most lives.”

    If you have a family history of breast cancer or personal medical history that could put you at increased risk for breast cancer, talk to your doctor about earlier screening. In these high-risk cases, it may be recommended you start mammograms before the age of 40 and/or to supplement mammograms with other tests like ultrasound or MRI, says Vincoff. Mammograms use a very small amount of radiation and are safe during pregnancy and breastfeeding, she adds.

    Read More: Olivia Munn Shares Breast Cancer Diagnosis and Reveals She Had a Double Mastectomy

    “It is very important for women to know that young women can get breast cancer even when pregnant, so if something does not seem right, speak up,” Margolies says. “The saddest perhaps are the very young women, often young mothers, who have breast cancer. There are unfortunately too many.”

    When should women stop getting this annual test? “There is no absolute age cut-off for mammography” as long as you’re healthy, says Margolies. One of her patients in her late seventies asked if she could stop mammography given her age. “I quietly asked if she thought she was healthy and [would] live for at least five years,” Margolies says. “She replied, ‘Of course.’” Her next mammogram revealed bilateral breast cancer. “The great news is she is alive and well” eight years later, says Margolies. That may not have been the case had she skipped the test.

    The bottom line: Continue getting mammograms every year—well into your 80s, even—if you’re in good health.

    Men and transgender people have different considerations to keep in mind. Occasionally, men get mammograms either because they feel something abnormal or because they have a gene that puts them at higher risk for breast cancer, says Margolies. For transgender people, follow the “screen what you have” ethos, she says, with the timing of screening depending on multiple factors including how breasts were created and any hormonal treatments. Work with your doctor to figure out a plan.

    How should you prepare for a mammogram?

    The best preparation for a mammogram is the hardest: “Relax!” Margolies says.

    If you are relaxed, she says, it will make the technologist’s job easier and your mammogram better. This is because when the pectoralis (or chest wall muscle) is relaxed, the technologist can image more of your breast tissue optimally, making the mammogram image clearer for the radiologist.

    Here are some other guidelines to follow before going to your mammogram, according to Margolies and Vincoff:

    • Don’t put any deodorant, cream or powder on the skin on or around your breast. These products can look like calcifications and may require extra imaging to be sure that it is innocuous.
    • If you are getting a mammogram at a different facility or health care system than one you have previously been to, bring at least three years of previous mammograms (if applicable) on a CD as well as the mammogram reports, so the radiologist can compare your previous studies. This also lessens the chance that you will have to return for more imaging.
    • Consider scheduling your mammograms with a female friend or group of friends, and make lunch plans or do something festive after your mammograms together. “Having a friend can make the entire mammography experience more pleasant: a nice outing rather than just a medical event,” says Margolies.

    What should you expect during a mammogram?

    You’ll likely spend more time checking in and getting undressed and dressed for the exam than that actual mammogram. The mammogram itself, start to finish, should take less than 10 minutes.

    The typical mammogram consists of two X-ray images of each breast: one taken from the top and one taken from the side. To perform a mammogram, one breast is placed on a hard surface, and a plastic compression paddle then holds the breast in place with pressure before automatically lifting up and away from the breast. This is repeated on the other breast. While the mammogram takes a few minutes to perform, the compression that is needed to get the lowest radiation dose and clearest image lasts only a few seconds, says Margolies.

    Read More: 9 Weird Symptoms Cardiologists Say You Should Never Ignore

    Will it be painful? It shouldn’t be. While your breast is being held in place and compressed with a clear plastic plate, Vincoff says the exam may be “slightly uncomfortable, but it shouldn’t be painful.”

    Are there alternatives to mammograms?

    The short and sweet answer is that there is no substitute for a mammogram. 

    “It is the only breast cancer screening tool that has been shown to save lives over and over again—in old studies using old equipment. The results are even better now,” says Margolies.

    Breast ultrasound and breast MRI are the most common supplementary tests to mammograms. “These are often recommended if one has dense breasts,” says Margolies. “Dense breasts are normal, and about half of women have dense breasts.”

    The reason why women with dense breasts sometimes need these additional tests is because dense breast tissue looks white on a mammogram and can hide cancer even on a 3D mammogram. “Ultrasound can find some of these hidden cancers, and breast MRI can find even more,” says Margolies.

    What followups may be required?

    Research indicates that about 10% of screening mammograms find something that requires additional evaluation. (Advances in technology such as 3D mammography and artificial intelligence are reducing the number of women who get recalled even more.)

    Most patients who are recalled have the area of concern cleared up by additional mammogram images with different compression paddles or an ultrasound, says Margolies. Occasionally, you may be asked to obtain additional imaging in six months to ensure nothing is growing or changing, adds Vincoff.

    Although it can be scary to learn that you need further testing, Vincoff says that women should know that only about 20 out of 1,000 mammograms find something that needs a needle biopsy. “And only about 5 of every 1,000 mammograms find a cancer,” she says, so try not to assume the worst if they find out they need more testing.

    Read More: How to Prevent and Treat Hemorrhoids, According to Doctors

    Unfortunately, following a mammogram and follow-up tests, some women will need a biopsy, and some of those biopsies will result in cancer diagnoses, says Margolies. “That is why it is so very important to follow up if you are asked to return after a screening mammogram.”

    You’ve likely heard this many times regarding mammograms, but it bears repeating: mammograms save lives. In fact, since mammogram screening started in the 1980s, the mortality rate from breast cancer has decreased by 40% in the U.S. “That’s partially due to better treatment, but early detection is playing a big role,” says Vincoff. “Mammograms find cancers when they are small and easiest to treat,” she adds, noting that women who have mammograms every year starting at age 40 have a 40% lower risk of dying from breast cancer than women who don’t.

    Plus, women who have breast cancer detected on a mammogram—instead of waiting until the cancer becomes big enough to feel—are less likely to need aggressive treatments like mastectomy, chemotherapy, or a complete axillary dissection (removal of all the lymph nodes under the arm.)

    A mammogram is only the beginning 

    Though mammograms are an essential part of many women’s annual health care appointments, this test is only one part of preventive health for women. As a practicing radiologist, Vincoff says she sees a lot of women who have their mammogram every year but are neglecting other parts of their health. “Heart disease is still the biggest killer of women in the U.S., and it’s important for women to have regular checkups to test for things like high blood pressure and diabetes, to have colonoscopy and to have lung-cancer screening if they are at risk,” she says.

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    Perri Ormont Blumberg

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  • How COVID-19 Messes Up Your Gut Health

    How COVID-19 Messes Up Your Gut Health

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    When you reach for a COVID-19 test, it’s probably because you’ve got a scratchy throat, runny nose, or cough. But those are far from the only symptoms that make Dr. Rohit Jain, an internal medicine doctor at PennState Health, suspect the virus.

    These days, when someone complains of nausea, diarrhea, or vomiting, “I always get a COVID test on that patient,” Jain says.

    Why? Despite its reputation as a respiratory virus, SARS-CoV-2 can also have a profound impact on the gut. Although most people don’t realize it, “COVID-19 really is a GI-tract disease” as well as a respiratory illness, says Dr. Mark Rupp, chief of infectious diseases at the University of Nebraska Medical Center.

    Here’s what to know about the gastrointestinal symptoms of COVID-19.

    What are the GI symptoms of COVID-19?

    While some people experience no gastrointestinal symptoms or mild ones, a subset of COVID-19 patients have experienced significant digestive symptoms since the early days of the pandemic.

    Loss of appetite, nausea, vomiting, diarrhea, and stomach pain are common GI symptoms of COVID-19, according to Jain’s research. Some people experience these issues as their first signs of infection, he says, while others initially experience cold-like symptoms and develop gastrointestinal issues as their illness progresses.

    Read More: Why You Should Change Your Exercise Routine—and How to Do It

    It’s not entirely clear why the same virus can affect people so differently, but it’s good to be aware that SARS-CoV-2 can result in a wide range of symptoms, Rupp says.

    How long do GI symptoms of COVID-19 last?

    Some patients recover in a matter of days, Jain says, while others may suffer from diarrhea and other symptoms for weeks. 

    Still others may be sick for even longer. Gastrointestinal problems are a common manifestation of Long COVID, the name for chronic symptoms that follow a case of COVID-19 and can last indefinitely.

    One recent study in Clinical Gastroenterology and Hepatology found that, among a small group of adults who were hospitalized when they had acute COVID-19, more than 40% who originally experienced GI problems such as stomach pain, nausea, vomiting, or diarrhea still had at least one a year or more later. Overall, whether they were hospitalized or not, adults who have had COVID-19 are about 36% more likely than uninfected people to develop gastrointestinal disorders including ulcers, pancreatitis, IBS, and acid reflux, according to a 2023 study published in Nature Communications.

    GI problems are also common among kids with Long COVID. Stomach pain, nausea, and vomiting are telltale signs of the condition among children younger than 12, according to 2024 research published in JAMA.

    Why a respiratory virus affects the gut

    How can the same virus cause both a runny nose and the runs? 

    Once SARS-CoV-2 gets into your body, it infects cells by binding to a protein called ACE2, which is found throughout the body. ACE2 is prevalent in the lungs, which helps explain COVID-19’s respiratory symptoms—but it’s also found in high concentrations in the gastrointestinal tract, “so it makes sense that the GI tract would be a target for the virus,” Rupp says. It’s in part because SARS-CoV-2 collects in the gut that wastewater surveillance is a useful tool for tracking the virus’ spread, Rupp adds.

    Read More: Green Tea Is Even Better For You Than You Think

    Studies have shown that the virus can hide out in the “nooks and crannies” of the digestive system for months or even years, says Ziyad Al-Aly, a clinical epidemiologist at the Washington University School of Medicine in St. Louis who co-authored the Nature Communications study on chronic post-COVID GI symptoms. This may explain why gut-related symptoms can long outlast an acute infection, Al-Aly says—but there are many potential hypotheses in play, and researchers don’t know for sure which one or ones are correct.

    For example, many researchers also think the virus is capable of causing widespread and sometimes long-lasting inflammation, potentially affecting organs throughout the body. This inflammatory response may have trickle-down effects on the gut microbiome, the colony of bacteria and other microbes that live in the GI tract, Rupp says. “We’re just scratching the surface as to what happens there,” Rupp says, but studies have already shown that SARS-CoV-2 can change the composition of the gut microbiome both during an acute infection and chronically.

    There’s also a complex relationship between the gut and the brain, adds Dr. Badih Joseph Elmunzer, a gastroenterologist at the Medical University of South Carolina and co-author of the Clinical Gastroenterology and Hepatology study on prolonged post-COVID GI symptoms. His research suggests people are particularly likely to suffer long-term GI problems if they also have signs of PTSD from their acute illness or hospitalization.

    That’s not to say GI symptoms are all in patients’ heads; on the contrary, Elmunzer says, they are very real. But, he says, there’s a lot left to learn about the microbiome, the gut, and the myriad ways they interact with other bodily systems.

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    Jamie Ducharme

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  • Why You Should Change Your Exercise Routine—And How to Do It

    Why You Should Change Your Exercise Routine—And How to Do It

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    The alarm clock blares, and you reach for your running shoes without thinking about it. Next thing you know, you’re jogging through your neighborhood on the same route as every other morning.

    You are a creature of exercise habit. And there’s nothing wrong with that—in fact, you’re much healthier because of it. “The best exercise is the one you will do,” says Stella Volpe, a professor of exercise and nutrition at Virginia Tech.

    At some point, though, there’s a decent chance you’ll stop doing it. What was once a fun challenge may lose its luster. Repeated hundreds of times, your rock-steady workout may start feeling like a Sisyphean rock, an obligation lingering in your life like a former crush who can’t take the hint that it’s over.

    Science points to the best reasons to break up with a dissatisfying routine and how to switch to a new one.

    Break the plateau

    It could be time to change if you perform the same workout daily and you’re no longer increasing your strength, speed, or endurance. This plateau means the body has adapted to the challenge, possibly spelling boredom and less vigorous exercise. Yet we often continue grinding the same stone, day-in, day-out, simply out of habit.

    Health is boosted with practically any exercise, even if you’ve plateaued. But revamping your routine could “perturb the body, stopping it from getting overly comfortable,” spurring cellular changes for greater health, says Shane Shapiro, a professor of orthopedics at Mayo Clinic in Florida and fellow of the American Medical Society for Sports Medicine.

    “Variety is the spice of an active life, and the data seem to support that,” says Mark Beauchamp, a health and exercise psychology professor at the University of British Columbia. With his colleagues, Beauchamp found routines that mix several workouts lead to more physical activity and feelings of well-being, compared to just one type of workout. 

    Change is hard. It takes time and entails risk that the new workout won’t work out, possibly turning a bored exerciser into a non-exerciser.

    Read More: How to Stop Checking Your Phone Every 10 Seconds

    But people can reduce the risk by keeping their go-to workout, while connecting it to a new one. For example, someone who uses an elliptical for 40 minutes every day could stay with that machine, but stop at 20 minutes to bike around town (or on a stationary one at the gym) for the remaining minutes. This “chunking” strategy is effective at making your new workout as automatic to perform as the older one, because the mind unconsciously links the two activities, says Phillippa Lally, a senior lecturer at the University of Surrey in England, who has written about this phenomenon.

    People do better with making these changes when they maintain their “instigation habit”—whatever they always do right before working out that helps them transition from non-exercise activities. If you always pick your workout clothes the night before or create an exercise playlist, for example, keep it up.

    Add balance

    Exercise benefits health in multiple ways, but it helps more if you’re actually exercising in multiple ways, especially by doing cardio, strength conditioning, and balance training. “If people stick to just one of the three, often cardio, they miss out on physical and mental-health benefits” of more diverse routines, says Jen Carter, a sport psychologist at Ohio State University Wexner Medical Center Sports Medicine.

    Even within these three domains, it’s good to be well-rounded to get the full benefits. For instance, cardio at only low or moderate intensity won’t provide the additional health benefits of higher intensity—and vice-versa

    Volpe, who is also president of the American College of Sports Medicine, recommends the acronym FIT when tweaking exercise routines for cardio, weights, and balance: try switching the frequency of these workouts, their intensity, and the amount of time you perform them. Carter, a dedicated swimmer, alternates long-distance swims with intense sprints.

    Read More: Do You Need to Take Electrolytes to Stay Hydrated?

    One activity won’t deliver the full range of benefits, Volpe notes. Take swimming: great for cardio and strength, but less so for improving balance and getting the bone health benefits of higher impact workouts.

    Some exercise regimens call for diverse activities that support several fitness domains. Volpe has done CrossFit for 16 years, combining various movements that target different aspects of physical performance. Carter notes other examples of all-in-one workout protocols: TRX, Zumba, and bootcamp classes. 

    An annual blood workup might signal that your routine is too focused on one domain. If you’re working out but still falling short on metrics that exercise should improve—like fasting blood glucose or fats in the blood linked to heart disease—maybe it’s time to balance out your routine.

    Find a new sauce 

    Instead of supplementing your current routine with other activities, consider dipping it into a new “sauce”: accompany your exercise with a tempting new podcast, TV show, or community of exercisers. A spicy dip could help make a stale routine more palatable.

    Katy Milkman, an economist at the Wharton School of the University of Pennsylvania, studies these types of changes, called temptation bundling. The added pieces “complement your workout in ways that make the activity more enjoyable,” she says, boosting average weekly workouts by 10-12%. When you tire of a podcast, picking a new one is easier than upsetting the whole exercise apple cart. “Variety is created through shifting the bundle,” says Milkman, author of the book How to Change

    Temptation bundling does not mean donut parties on the treadmill, Milkman adds. Healthier bundles can lean on personal quirks. Love cleaning? Wear a weighted vest while washing your car. Or try working out in an unfamiliar location. “Instead of walking in the city, try the same walk in a country environment,” suggests Ben Singh, a research fellow in health and human performance at the University of South Australia. 

    Try something totally new

    Rather than including variety or sauces, the brave exerciser could start a completely new chapter of their workout playbook. If you’re an explorer at heart, novelty may be what you crave most. 

    Novel activities may increase enjoyment, life satisfaction, and the experience of flow. With repetition, novelty wears off, but with a little strategy, it can be extended. One approach is to choose a new training regimen every few weeks or with each new season, pairing it with a specific goal, says Dr. Matthew Kraeutler, an assistant professor of orthopaedic surgery and rehabilitation at Texas Tech University Health Sciences Center.

    Read More: Green Tea Is Even Better For You Than You Think

    Studies show that this method, called periodization, prevents boredom and improves health outcomes. Kraeutler swears by it. “By focusing on something in a short timeframe, I reach levels that would be impossible if I just did it occasionally,” he says. During a recent “period,” he set a personal record for squat clean. “I used to get on the same machines every time at the gym. Now I have something to work toward.” Other goals include training for a 10K, executing a sun salutation on a paddleboard, or improving important health metrics like your VO2 max.

    Before attempting unfamiliar workouts, develop a base level of fitness by meeting the minimum guidelines. Then “you can go to the next level,” Shapiro says, “and start doing goal-specific periodization to make additional gains” with less injury risk. Even so, train-up gradually. “Start low, go slow” with any novel workout, Shapiro advises, increasing exercise duration and intensity by no more than about 10% each week.

    Beware of novelty exhaustion. Research shows that well-being is eroded by introducing too many new activities at once—plus, you’ll soon run out of innovative ideas.

    Adapt to life’s surprises  

    Sometimes novelty is freely chosen. Other times, life disrupts a routine, requiring change. A new job might require an earlier arrival, sabotaging your morning trampoline workout. Instead of stopping exercise altogether, view it as a cosmic intervention to try a new routine. 

    “Often life forces us to make changes,” Singh says. “Being adaptable to changing the program is extremely important.” 

    With life’s curveballs, “there’s opportunity,” says Milkman, “but also risk.” In Milkman’s research on college students, exercise routines go well until they’re disrupted by school breaks. When the kids return, maybe especially after going to Thanksgiving or Cancun, “it’s back to square one,” she says. Or a workout partner who motivates you to exercise could disappear. “What if your friend Bonnie moves to Japan?” Milkman says.

    Maintaining flexibility is key, Milkman has found. To roll with the punches, it’s important to cultivate substitutes for your main workouts and exercise buddies. “The concept of backup habits is a really good idea,” Lally says. She prefers to exercise before work, but knowing that some mornings may be too busy, she takes her exercise gear to the office for lunchtime sessions.

    Sidestep pain

    Another factor is whether a one-dimensional routine is causing pain. “If you’re doing the same thing every day, you’re at much higher risk of developing overuse injuries,” Kraeutler says.

    This is especially true for activities with prolonged, repetitive impact to the same joints. Kraeutler has compared the rates at which runners and non-runners go on to develop knee osteoarthritis. Runners were less likely to get osteoarthritis than non-runners, but that was only for “mild to moderate” running, under 200 minutes per week. (Some of the non-runners didn’t exercise at all, which can contribute to obesity, an independent risk factor for joint pain.) If you’re staying under this threshold, you may be “in the safe zone,” Kraeutler says.

    Read More: Here’s How Much Sleep You Need According to Your Age

    If you’re over this mark with running—or overdoing anything else—it’s worth considering a change. “Taking at least one day off per week from exercise will reset the mind and prevent compulsive exercise,” Carter says. South American hunter-gatherers have alternated rest days with days full of movement for eons. They’re probably onto something.

    Note the difference between problematic pain and just being sore. The latter is the inevitable side effect of a new exercise program, not a reason to shut it down. “You’ll have some discomfort when using muscles in novel ways, but it should dissipate within a day or two,” Shapiro says.

    If you’re already injured, view it as another opportunity to change your routine. Instead of being sidelined by a lower-body injury, opt for upper-body workouts, Volpe says.

    Let your mental health guide you

    If your mental health is suffering, think about changing your routine to better meet your mood. When going through periods of anxiety, try more yoga. In a research review, Singh found that mind-body exercises like yoga were associated with lower anxiety. Aerobic exercise and strength training were linked to less depression.

    Increasingly, fitness apps can assess whether we’re underperforming, perhaps due to boredom, or stressed. “If you don’t feel like doing your typical workout, a fitness app might suggest alternatives,” says Singh, who studies these technologies. Just don’t follow exercise apps blindly. Carter recommends “intuitive exercise”: listening to your body to find routines that suit you best.

    Remember what you liked in high school

    Part of building up your exercise intuition is recognizing activities that intrigue you. When starting a routine, initial enthusiasm goes a long way. “Positive expectations shape positive outcomes,” Milkman says. 

    So does having some degree of competence in the activity, Beauchamp says. Lack of improvement is a main reason people quit new activities in the first six months. Maybe you were decent at a sport in high school and daydream of playing again. Or maybe something at the Paris Olympics caught your eye. Handball or badminton, anyone? “Many more sports are available than people think,” Volpe says.

    Don’t underestimate the power of play; mammals like us have enjoyed it for 80 million years. Volpe played field hockey in high school. Decades later, she’s on the masters national team. Recently, she’s gotten into curling. 

    “It’s never too late to add a sport,” she says. “People might not realize how fun it can be to make the change.” 

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    Matt Fuchs

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  • When Is the Best Time to Get a Flu Shot?

    When Is the Best Time to Get a Flu Shot?

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    Ask a doctor when the best time is to get your annual flu shot, and they’re likely to tell you that it doesn’t matter when it you get it—just that you get vaccinated.

    But there is a sweet spot to optimize your immunity.

    When is the optimal time to get the flu shot?

    Flu season lasts from October to May, and cases in the U.S. peak from December to February. That’s why the U.S. Centers for Disease Control and Prevention recommends that people get their flu vaccine by the end of October, since it takes the immune system about two weeks to rev up its maximum response to the vaccine. This means generating sufficient immune cells—including antibodies—against the virus. “The perfect time to get vaccinated against flu is right before cases start to take off,” says Dr. Kawsar Talaat, associate professor in international health at the Johns Hopkins Bloomberg School of Public Health.

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    But the reality is that pharmacies, clinics, and doctors’ offices can’t accommodate everyone flooding in at the same time. So if you’re at the pharmacy and there’s no line in September, there’s no reason not to get vaccinated.

    “We have seen flu circulate as early as October, so it’s not too early to get vaccinated now,” says Talaat. And while protection from the vaccine starts to wane after three to four months, “it doesn’t go down to zero.” Even if your protection starts to fade, you will still be protected.

    There are some exceptions to that guidance, says Dr. Robert Jacobson, professor of pediatrics at Mayo Clinic. Children under nine years old who are getting vaccinated for flu for the first time need two doses, spaced a month apart. For them, starting in late July or August makes sense, especially if parents want their children to be vaccinated before the start of the school year. Anyone age 65 or older should also consider getting vaccinated in late summer as well, since influenza does start circulating then and older people are at higher risk of developing complications, being hospitalized, or dying from the flu. Finally, pregnant women in their third trimester should also consider getting vaccinated in July or August, so their bodies can pass on protective antibodies to the baby in utero. This protection is important since babies generally don’t get their first flu vaccine until they are about six months old. If they are born during the flu season, the protection they receive from their mothers serves as the strongest defense against influenza in their first few months of life.

    How effective is the annual flu shot?

    That depends on the year. Each spring, health experts predict which influenza strains will be circulating and causing disease, giving manufacturers enough time to include them in the vaccines. Generally, says Talaat, if the shot is a good match with circulating strains, then you can expect your shot to protect you from getting flu about half the time. And if you do get infected, you’re more likely to have a milder bout of disease than if you hadn’t been vaccinated. You’re also less likely to be hospitalized or die from influenza: risks that especially affect older people.

    Studies show that being vaccinated against the flu can protect you from other health issues as well, such as heart attacks and strokes. Flu infections can worsen inflammation, which can contribute to heart disease and other conditions.

    Read More: Do You Need to Take Electrolytes to Stay Hydrated?

    Even with waning, the vaccine continues to provide good protection, says Jacobson—enough that health officials do not recommend that older people who get vaccinated in late summer, for example, get boosted with another dose later in the season. “We consider them protected for the season,” he says. Plus, people age 65 and older generally receive one of several stronger flu vaccines to generate the most robust immune response; one of them includes four times the amount of immune-activating flu antigens. “They are safe and effective, and for people over 65, they are the way to go,” says Jacobson.

    Can I get the flu shot and COVID-19 vaccine at the same time?

    Yes, and you shouldn’t hesitate to do so. Talaat has conducted a study showing that people getting both shots did not report any more side effects—such as sore arms, muscle aches, or fevers—than people who got them at different times.

    And for people wondering if getting the two shots on the same day might somehow yield weaker immune responses to both COVID-19 and influenza, “we have not found any interference with flu and COVID-19 vaccines,” says Jacobson. By not getting the vaccines on the same day, “you aren’t doing your immune system any favors.”

    Even if you’ve already had the flu, or if it’s later in the season (say January or February), it’s not too late to get vaccinated. There are usually several strains of influenza causing-disease, and the shot would protect you against the strains you haven’t gotten yet. In fact, flu vaccines generate a more wide-ranging immune response against several influenza strains included in the shot than a natural infection would, since the infection is only a single strain of the virus. “This is a good example where natural infection is not as good as vaccination, and certainly not as safe,” says Jacobson. “Our vaccines these days are refined and designed to work with each other, and we have good evidence that they are safe and effective. Get all the vaccines you are due for.”

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    Alice Park

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  • FDA Approves the First New Schizophrenia Drug in Decades

    FDA Approves the First New Schizophrenia Drug in Decades

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    No new treatments for schizophrenia have been approved in nearly three decades, but that changed on Sept. 26, when the U.S. Food and Drug Administration (FDA) approved Cobenfy for the psychiatric disorder.

    Developed by Karuna Therapeutics, which was subsequently acquired by Bristol Myers Squibb, the drug works in an entirely different way from existing medications for schizophrenia, which is building excitement and enthusiasm among doctors and patients alike.

    How scientists developed the new drug

    While schizophrenia treatments primarily target the dopamine neurotransmitter system in the brain, Cobenfy goes after a different one, the cholinergic system, through muscarinic receptors. Decades ago, scientists at Eli Lilly had studied the muscarinic system as a possible treatment for Alzheimer’s disease, since manipulating it seemed to reduce some of the symptoms of Alzheimer’s-related psychosis that some patients develop. The company’s researchers also serendipitously learned that a compound they developed to activate the system also improved symptoms of schizophrenia. But cells in many parts of the body—the brain, but also the bladder, gut, salivary glands, eyes, and heart—contain receptors for the muscarinic system, which meant it was challenging to selectively target just those in the brain and not elsewhere. Because the compound, called xanomeline, caused wide-ranging side effects, Lilly’s researchers shelved further study on it.

    Read More: Why Gut Health Issues Are More Common in Women

    Andrew Miller, co-founder of Karuna, became intrigued by this research and tried to figure out how to activate the muscarinic system in the brain while tamping it down elsewhere in the body. He and his team tested 7,000 compounds and eventually combined xanomeline with a drug that had been approved by the FDA in the 1970s for treating overactive bladder, to suppress muscarinic activity elsewhere in the body. “It’s a pretty out-of-the-box approach,” says Miller. The overactive bladder drug “has nothing to do with psychiatry,” he said. Combining it with a serendipitous discovery of xanomeline “didn’t fit the traditional model of innovative drug discovery.” But it worked.

    What studies have found

    In a study the company published last December in the journal Lancet, the researchers reported that the combination—now called Cobenfy but then called KarXT—helped to significantly reduce symptoms of schizophrenia such as hallucinations, delusions, paranoia, social withdrawal, and a loss of motivation compared to a placebo. Those data were part of the application that the company submitted to the FDA for approval.

    Bristol Myers Squibb acquired Karuna in 2023 largely based on these encouraging results. “When we looked at the available neuroscience and neuropsychiatric assets out there, we didn’t want the next dopamine agonist or antagonist in the marketplace, which all of the physicians have [already] seen,” says Adam Lenkowsky, chief commercialization officer for Bristol Myers Squibb. “We wanted a truly revolutionary asset, one with a different mechanism: a first-in-class, best-in-category asset we think could transform the space.”

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    Samit Hirawat, chief medical officer at Bristol Myers Squibb, says that not only does Cobenfy address schizophrenia in an entirely new way, but its approach could be used for other neurological conditions as well. “The breadth of applicability of this medicine is what attracted us.”

    Dr. Rishi Kakar, chief scientific officer at Segal Trials who led several studies on Cobenfy, says that “the uniqueness of the mechanism of action differentiated this medication from everything else we had so far, and truly caught my eye right off the bat.” Kakar—a psychiatrist who treats patients as well as conducts research—says that historically, only about 40% of people with schizophrenia respond to dopamine-based treatments, and the other 60% who may respond often stop taking their medications because of intolerable side effects, which can include uncontrolled muscle movements, dizziness, fainting, and weight gain.

    The trials included patients who were hospitalized for acute schizophrenia and randomly assigned to receive Cobenfy—as a pill taken twice a day—or a placebo for five weeks. In order to reflect the real-world population of patients, some had been taking existing medications but stopped because of the side effects, or weren’t compliant. All patients went through a wash-out period of up to two weeks to ensure any measurements of their outcomes during the study were due solely to Cobenfy or placebo. Patients received escalating doses of the drug, and prescribing doctors were able to adjust dosages for their patients depending on their symptoms.

    The studies documented a significant reduction in overall symptoms of schizophrenia in the patients receiving Cobenfy compared to placebo. “My viewpoint is that [this difference] can mean someone can potentially carry on a better life by having symptom control,” says Kakar.

    What else to know about Cobenfy

    The FDA approved Cobenfy as a monotherapy—meaning it is meant to be taken alone, without other medications—but more studies will be needed to see how the medication works in combination with existing treatments, and what the benefits and risks are of combining them. “I think many clinicians are going to try this as a first-time pharmacological option, because they will find that the reduction in symptoms is fairly robust,” says Kakar. “From what I saw, it has true value for the unmet need we have.” Lenkowsky says Bristol Myers Squibb is conducting a trial studying Cobenfy in combination with dopamine-based medications that will yield results in about a year.

    Read More: The ‘Dopamine Detox’ Is Having a Moment

    In contrast to the existing dopamine-based treatments, the side effects of Cobenfy reported by the volunteers in the studies were mostly mild to moderate, involving nausea and gastrointestinal distress, and tended to lessen with time. The label also alerts patients that the drug is associated with urinary retention, increased heart rate and swelling in the face in rare cases; the medication is not recommended for people with a history of liver or kidney disorders.

    Bristol Myers Squibb is continuing to study the drug for its longer term effects, as well as to understand and potentially guide doctors on how to adjust doses for patients as their symptoms change over time. The success in schizophrenia patients may lead to other uses of the drug in other conditions as well. “Neuropsychiatry is at the cusp of bringing an explosion of new medicines, and Cobenfy is the start of a pipeline of potential products,” says Hirawat. The company is currently studying the drug in Alzheimer’s-related psychosis, and next year plans to start late-stage trials investigating whether it can improve bipolar mania, Alzheimer’s-associated agitation, and Alzheimer’s-associated cognitive impairment. In 2027, the company hopes to begin trials in people with autism.

    How much will Cobenfy cost?

    According to a Bristol Myers Squibb spokesperson, the wholesale cost for a month’s supply will be $1,850. Depending on people’s insurance coverage, that cost could be lower for individual patients. Bristol Myers Squibb estimates that 80% of people with schizophrenia in the U.S. have insurance coverage either through Medicare or Medicaid.

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    Alice Park

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  • How to Survive Election Season Without Losing Your Mind

    How to Survive Election Season Without Losing Your Mind

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    Political pundits would have a much easier job if they started predicting Americans’ stress levels instead of the outcome of the presidential election. No margin of error needed—it’s easy to see we’re all anxious. (Talk about unfavorable polling.)

    According to a recent American Psychiatric Association poll, 73% of adults in the U.S. are stressed about the race. A 2024 Pew Research Center survey concluded that 65% of Americans always or often feel exhausted when thinking about politics, while 55% report feeling angry. Politics triggers sleep loss, shortened tempers, and obsessive thoughts. 

    As researchers found last year, even election-related anticipatory stress—like ruminating over the social gathering you’re going to with people who support a different candidate—can adversely affect health. “It has immediate consequences,” says study author Shevaun Neupert, a professor in the department of psychology at NC State University. “It’s getting under our skin in ways that are affecting our health on a day-to-day basis.” Research has long suggested that stress can make people more susceptible to colds and the flu, as well as debilitating chronic illness. “If someone is having a strong reaction, and it’s impeding their day-to-day functioning, it’s important to talk to someone,” she says. “It’s a very common experience—but that doesn’t mean it’s a healthy one.”

    With that in mind, we asked experts to share strategies that can help us all survive election season, sanity intact.

    Do some problem-analysis

    While researching anticipatory election stress, Neupert landed on one particularly effective coping strategy: problem-analysis. “It’s when people think critically about what they think will happen, and why they think it might happen,” she says. “Like, why is it you think you’re going to have this argument about the election with an acquaintance tomorrow? And could you try to understand their perspective ahead of time?” As you reflect on those questions, brainstorm how you’ll respond to each point they bring up, she suggests, with the goal of preventing an argument and still engaging in a productive conversation.

    Read More: Do You Really Store Stress In Your Body?

    Problem-analysis helped Neupert’s study participants protect themselves from the damaging effects of stress during the event they were worried about. “There was no significant decrease in their physical health,” she says. “We’re aware the messaging could be, ‘Elections are stressful. People should just put their heads in the sand, and wait until it’s all over’—which isn’t great for democracy. So we’re trying to understand ways that people can stay engaged but still preserve their mental and physical health.”

    Put your thoughts on trial

    In addition to brainstorming how you might handle future election-related stress, it can be helpful to challenge the existential fears you have around the presidential election. Colleen Marshall, chief clinical officer at the mental-health clinic Two Chairs, calls this technique—which is common in cognitive behavioral therapy—putting your thoughts on trial. Let’s say you think life as you know it will go up in flames if the candidate you’re pulling for doesn’t win. First, ask yourself what evidence you have that that’s true: “You’ll have to hear their name for four years, and it’s true they’ll have an impact on policy, and some of those policies might impact your life,” she says. But what evidence do you have that your belief your life will be over is not true? “I’d be like, ‘Well, they probably won’t impact who I’m married to, where I live, or where I go to dinner on Friday night. They’re not going to impact what job I have, what I do for fun, or where I travel.’” Identifying “anxiety thoughts”—as opposed to factual thoughts—typically quells people’s nerves, Marshall says. She’s found it’s an effective antidote to catastrophizing and black-and-white thinking.

    Set boundaries around news consumption

    For some people, not tuning into the news causes anxiety to swell. Others benefit from setting firm boundaries around media intake. “You can control how much news you’re consuming, and how much you’re letting it intrude into your daily life,” Marshall says. For example, consider allowing yourself 30 minutes a day to catch up on the news, muting notifications from news apps, or turning off your phone one day a week.

    Read More: How to Stop Checking Your Phone Every 10 Seconds

    Marshall sometimes works with military families who have a loved one deployed, and she coaches them to designate a trusted person who funnels essential news to them. That way, they don’t have to be glued to their screens, anxiously refreshing their apps to see if anything has changed. Closer to home, Marshall’s husband is a history professor, so he likes to stay up-to-date on all things politics—but she doesn’t. “I check in with him, like, ‘Hey, anything going on?’” If there is, he lets her know: “Actually, you probably want to turn on the news because Biden stepped down and Harris is now running.” Enlist a trusted friend to help you stick to your news consumption boundaries, too, she advises, and have a conversation about what warrants an update.

    Prune your social accounts

    Social media has altered the way we get information during elections—for both better and worse, says Dr. Laura Erickson-Schroth, chief medical officer of The Jed Foundation, a mental-health nonprofit. While information on platforms like Instagram is often appealing because it feels digestible, the algorithms driving these sites “can push us toward the same kind of content and opinions over and over,” she points out. “It can be really stressful to see those same kinds of difficult issues raised repeatedly.” That’s especially true if you belong to a group of people worried about safety or rights, she adds—and you’re seeing, for example, frequent headlines about decreased support for LGBTQI people or immigrants.

    It’s important to acknowledge that “these apps are designed to deliver content that will get more likes and keep us on longer, and not necessarily provide useful information,” Erickson-Schroth says. From there, take steps to make your social-media experience as healthy as possible: Set daily time limits, change up the accounts you’re following, and search for particular topics you’d like to see more of—which will train the algorithm to send them your way. You can also log words and phrases that you don’t want to see on Instagram, and you won’t be shown any suggested posts in your feed that contain them.

    Make a plan for tricky conversations

    Spend time reflecting on what kind of personal boundaries you want to set around talking about politics. Inevitably, you’ll encounter differences of opinion—and things can get heated fast, Erickson-Schroth acknowledges. Before engaging in a conversation, she suggests asking yourself: “Am I in the emotional headspace to have this conversation? Am I already feeling stressed out, on edge, or angry?” If the answer is yes, change the subject.

    Read More: 8 Signs You’re in Perimenopause

    If you do choose to engage in a conversation with someone who has different political views, approach it with curiosity—and the understanding that you probably won’t change their mind, Erickson-Schroth says. If that’s your goal, you’re setting yourself up for disappointment. Instead, treat it as an opportunity to learn where they’re coming from. If things start to dissolve, she recommends interjecting: “This conversation is really challenging for me. Could we talk about something else?”

    Carve out time for whatever de-stresses you

    Prioritize relaxation—whatever that might mean for you—during the tumultuous months leading up to the election. “We need to do things we call wellness, like practicing mindfulness or being out in nature, and making sure to get enough sleep and exercise,” Marshall says. “All the things that keep you balanced overall.”

    It can be helpful to reflect on how you successfully coped with tough times in the past, says Kristin Papa, a psychotherapist in San Jose, Calif. If you were waiting for your doctor to call with nerve-wracking test results, did you journal? Seek out social support? Take a long bath? “Maybe you did physical activity to get the energy out,” she says. “Making connections to past experiences can help you deal with this one—I tell clients, ‘Let’s just turn the volume down.’ It’s finding a way to get to the point where you can live your life and do what you need to do,” rather than becoming stuck in an election-related frenzy.

    Focus on what you can control

    Many people struggle with a lack of agency—or feeling powerless, like you’re “just one vote”—during election season. Reclaim a sense of control by getting involved, Erickson-Schroth suggests. Civic engagement promotes positive mental-health outcomes as well as a sense of social connectedness, including among young people, she says.

    Read More: 11 Things to Say to Persuade Someone to Vote

    What might that look like? Whatever speaks to you: You could write postcards encouraging people to vote, Papa says, or connect with local organizations about volunteer opportunities. Or, consider attending rallies, canvassing on behalf of your favorite candidate, or making a donation to an important cause. What matters most “is realizing that you can’t change everything, but you can do what you can within your own emotional capacity and time,” she says.

    Make a plan for election night

    We might not know who the next president of the United States is by midnight on Nov. 5—but we’ll likely be in for a tense evening as preliminary results are broadcast. If you know the stress will get to you, plan accordingly: Marshall, for instance, has a friend who goes on vacation every four years during election week. “She’s already taken time off work, because in her mind, it’s done; she voted. Like, ‘Why am I here, just living through the anxiety?’” Marshall’s friend knows herself well enough to understand she won’t enjoy election night, so disconnecting from the news cycle suits her well.

    You don’t have to book a plane ticket to make election night more palatable. Marshall suggests thinking through who you want around you—or whether you’d rather be alone to process the news—and how you want to manage your nerves. (“I probably would not recommend drinking,” she clarifies. “It does relieve anxiety, but it’s not the healthiest choice.”) Consider planning activities you enjoy, like getting takeout from a favorite restaurant, doing a hot yoga class or pickleball session, or even buying some new candles to light around your living room.

    Practice radical acceptance

    No matter how the election turns out, some segment of the population will be disappointed. If that’s you, consider practicing radical acceptance, Marshall urges—which means removing emotion from the situation, and accepting it for what it is. “Part of our suffering is trying to argue away reality,” she says. “What’s nice about the election results is once they’re in and clear, you can just sort of accept reality: Factually, where are we? And then make your decision from that point of view.” That might mean increasing your political activism, or on the flipside, tuning out politics altogether. But until then, do your best to keep your anxiety in check. “We don’t actually know yet what the outcome is going to be,” Marshall says. “Why are you planning for it today? It’s not going to help.”

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    Angela Haupt

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  • How to Stop Checking Your Phone Every 10 Seconds

    How to Stop Checking Your Phone Every 10 Seconds

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    You’re standing in line at the grocery store or waiting for an elevator. You have no more than a minute to kill. And yet, before you’ve even processed what you’re doing, you’ve pulled out your phone and have begun to mindlessly scroll through TikTok or Instagram.

    Sound familiar? It does to Adrian Ward, an associate professor at the McCombs School of Business at the University of Texas at Austin who studies people’s relationships to technology. “It’s not even an urge,” he says. “There’s no intention.” In his experience, checking your phone is often automatic.

    Research suggests plenty of people do the same thing. Maxi Heitmayer, a teaching fellow who studies human-computer interaction at the London School of Economics and Political Science, found in a small 2022 experiment that only 11% of people’s smartphone checks were in response to a notification. The other 89% of the time, they checked their phones totally unprompted, often without thinking through why they were doing it.

    The call of your phone

    Why? Heitmayer thinks that, in our ultra plugged-in world, we’re so used to constant stimulation that we feel uncomfortable when we’re not doing anything, even for just a few seconds. 

    Phones are so good at relieving such discomfort that Shiri Melumad, an associate professor at the University of Pennsylvania’s Wharton School, calls them “adult pacifiers.” Much as a child totes around a toy or blanket to feel safe, adults draw comfort from the constant, familiar presence of their phones, Melumad says. You may lean on your digital pacifier deliberately—when you’re alone at a party and feeling awkward, say—or simply because you’ve become accustomed to always having something to occupy your brain.

    Read More: 8 Signs You’re in Perimenopause

    Ward, meanwhile, calls smartphones a “supernormal stimulus,” or something “beyond anything [we] evolved to deal with or make decisions about.” Our brains are hardwired to seek out rewards like knowledge, entertainment, and social connection, all of which were much harder to find before we had tiny computers at our fingertips, Ward says. Now that we do, our phones are basically 24/7 all-you-can-eat buffets for our brains, endlessly and easily serving up the things they want. Of course our minds can’t help but gorge themselves.

    Never mind that some studies suggest mindless scrolling, and smartphone use in general, can actually increase boredom; reaching for the phone gives us something to do, and a feeling that that “something” is more rewarding than whatever is happening to us in the real world. “Unless what you’re doing right here, right now, is the most interesting thing you could possibly be doing, your phone at some level”—perhaps not even a conscious one—”represents a better alternative,” Ward says.

    Is that a bad thing? 

    The answer is complex, Melumad says.

    “It’s a little bit alarmist to say that smartphones are addictive and they’re [all] bad,” she says. Smartphones can certainly connect us to troubling content, whether we seek it out or not, and there are valid arguments about the downsides of losing the ability to do nothing, Melumad says. But some aspects of smartphone use can also be beneficial. It’s not necessarily problematic to self-soothe by texting a friend or watching a funny TikTok video after a stressful work day, for instance.

    A quick phone check probably isn’t doing your brain any real harm, Heitmayer agrees. But to Ward, it’s also worth considering how all those little checks add up.

    Read More: 15 Things to Say When Someone Comments on Your Weight

    Over time, constant scrolling could have a negative effect on your job performance, relationships, sleep, and possibly even physical safety, if you’re doing things like checking your phone while you walk or drive. There’s also a mental-health element to consider. Although not all researchers agree, many believe that heavy smartphone and social-media use harms psychological well-being. Even beyond that, Heitmayer says, people tend to beat themselves up about their screen time. As of 2022, about 60% of U.S. adults, and 80% of those under 30, said they were on their phones “too much.”

    When you give into your urges and check your phone, then feel guilty about it, “the feeling of failure adds insult to injury,” Heitmayer says. 

    How to keep your phone-checking habit in check

    If you want to break the habit of constant checking, you’ll have to work at it. The more you’ve trained your brain to expect constant diversion, the harder it will be to kick the compulsion. But it is possible.

    Part of that process—as you can probably guess—is getting used to being without your phone. Many studies, including Ward’s, have found that simply having your phone near you, even if it’s not buzzing or lighting up with a notification, is enough to distract you and give you the itch to check.

    You don’t have to quit cold turkey, Ward says. (In fact, some research suggests this kind of abrupt digital detox can trigger anxiety.) To ease in, start going without your phone for set periods of time, like when you’re working on an important project or want to give all of your attention to your friend or partner. Over time, as you get used to being without your device, it may get easier to resist that constant pull to check. You may even find that you want to leave your phone behind more and more often, Ward says.

    Read More: How to Know if Your Friendship Is Toxic—and What to Do About It

    Building awareness is also helpful. Melumad recommends paying attention to how different kinds of smartphone use make you feel. Reading a news article on your phone, for example, may bring up different feelings than doomscrolling.

    If you catch yourself swiping through TikTok videos without even absorbing the content, take a moment to ask yourself what’s driving your behavior, suggests Katy Tam, a postdoctoral fellow at the University of Toronto Scarborough who researches boredom and digital media. Do you actually want to be on TikTok, or are you just putting off a less-fun task?

    Tam is one of the researchers who has found that smartphone usage can increase boredom—which may be handy to remember if you’re trying to cut back on your screen time. Shifting your mindset to think of phone usage not as a salve, but as a crutch, may make it easier to cut back.

    Sometimes, Tam says, “it’s our behavior that makes us feel bored.”

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    Jamie Ducharme

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  • Former NFL Star Brett Favre Reveals He Has Parkinson’s. Here’s What to Know

    Former NFL Star Brett Favre Reveals He Has Parkinson’s. Here’s What to Know

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    Former Green Bay Packers quarterback Brett Favre said that he has been recently diagnosed with Parkinson’s disease.

    The three-time NFL MVP made the revelation during his testimony before a House committee on federal welfare reform. Favre had previously been implicated for his connections to Mississippi’s welfare abuse scandal involving the Temporary Assistance for Needy Families (TANF) program and investments he made in a company that was researching treatments for concussions. The founder of that company pleaded guilty to wire fraud charges and was accused of misappropriating funds received through TANF for personal use. Favre allegedly received TANF money via Mississippi non profit groups for public appearances he did not make, but was not criminally charged. He has paid back some of the money he received, but state auditors say he still owes additional funds to the program.

    “I lost an investment in a company that I believed was developing a breakthrough concussion drug I thought would help others, and I’m sure you’ll understand why it’s too late for me, because I’ve recently been diagnosed with Parkinson’s,” he said in his testimony.

    Here’s what to know about the disease.

    What is Parkinson’s disease?

    Parkinson’s is a brain disorder that results in uncontrolled muscle movements and tremors that can affect everything from the extremities to more core body functions such as swallowing and speaking. It generally occurs with age, but can also result from certain genetic changes that are passed down in families, as well as medications, exposure to toxins, and traumatic injuries to the brain. In an interview on Today in 2018, Favre estimated that he suffered from “hundreds, maybe thousands” of concussions during his decades-long NFL career, in which he once played nearly 300 consecutive games. Favre did not indicate whether his history of concussions was directly related to his condition, or provide any additional details about his diagnosis. But since his retirement from the NFL, he has spoken about his concerns about concussions and the dangers of chronic traumatic encephalopathy among football players, and his own experiences with worsening short term memory.

    Are there treatments?

    Currently, there is no effective treatment that reverses or slows down the progression of Parkinson’s—only medications or surgical interventions that can alleviate some of the motor symptoms by addressing changes in the brain chemical dopamine that contribute to the condition. Patients generally cycle through different medications, which often work for a while, but when the tremors or unpredictable muscle movements return or worsen, doctors can combine or add other medications. For those who no longer respond to available drugs, deep brain stimulation, in which surgeons implant an electrode in the brain to help control tremors, can help. But the implants only address tremors and involuntary muscles movements; they can’t slow other Parkinson’s symptoms, such as cognitive changes or balance issues.

    The future of diagnosis and treatment

    Researchers are working on novel treatment strategies and are developing new ways to detect Parkinson’s earlier. Most of these target alpha synuclein, a protein that accumulates in patients with the disease. Doctors currently rely primarily on clinical symptoms—like tremors, slow movements, or muscle rigidity—to diagnose the condition. But researchers are developing a new test that looks for alpha synuclein in the spinal fluid, which could be a sign of early Parkinson’s.

    Until better treatments become available to address the root cause of Parkinson’s, however, even such tests might not be so useful. “The problem is that at this point, we don’t have any treatment to potentially slow the disease down,” says Dr. Rocco DiPaola, a neurologist at Hackensack Meridian Neuroscience Institute. “But down the road, should those treatments become available, then identifying people who are at risk earlier would be good to know, so we could potentially give them a medication that could either prevent or slow progression of the disease.”

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    Alice Park

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  • Is the Novavax COVID-19 Vaccine Better?

    Is the Novavax COVID-19 Vaccine Better?

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    It’s fall, which means it’s time to get updated on the winter season shots. That includes vaccines for flu, RSV (for babies and the elderly) and, for anyone six months or older, COVID-19.

    While the new mRNA vaccines from Moderna and Pfizer-BioNTech have dominated the COVID-19 vaccine story, there is another type of shot that uses a more traditional vaccine-making technology, used by Novavax. The vaccine is generating interest among some people online who prefer the more tried and true approach behind the company’s shot, so here’s what you need to know.

    How is Novavax’s vaccine different from mRNA vaccines?

    Novavax uses a protein-based vaccine strategy, which means people getting the vaccine receive a protein made by the virus that their body’s immune systems then see as foreign and mount responses against. mRNA vaccines, by contrast, include snippets of mRNA genetic material from the COVID-19 virus’ spike protein.

    Novavax makes its vaccine by first inserting the gene for a SARS-CoV-2 viral protein into an insect virus, then using this loaded virus to infect an armyworm, or larva, of a moth that infects cabbages. Using the larva, the virus then produces more copies of itself, and by default, more copies of the SARS-CoV-2 protein as well, and it is this COVID-19 protein that is then used in the vaccine.

    Bob Walker, chief medical officer at Novavax, says this method does a good job of mimicking the way the SARS-CoV-2 virus naturally infects the body, which could theoretically lead to some benefits in terms of the immune response the vaccine generates, although the company and others are still conducting deeper studies to find out whether that’s the case. “The construct resembles the virus in terms of how the [body’s] immune cells might see it—the full length of the spike protein that represents the natural configuration of the viral protein,” he says. “And that has certain potential advantages.”

    The protein is coupled with what vaccine makers call an adjuvant, or additional compound that further activates the immune system to enhance the body’s response to the virus. “One major advantage of the adjuvant is that it works not only on the antibody side in terms of the immune response, but it also activates the T cells,” says Walker. “And T cells have many functions in the body—one is to fight viruses, and the other is to help antibody-producing cells to make more antibodies.”

    Is Novavax’s vaccine approved by the U.S. Food and Drug Administration (FDA)?

    Novavax’s COVID-19 vaccine is not approved by the FDA yet, but it is available in the U.S. under emergency use authorization, which the FDA issued to the company in July 2022, and allows companies to make and distribute a product during a public health emergency while the FDA continues to review a broader set of data concerning its safety and efficacy. Novavax’s vaccine is safe and effective, but the agency is reviewing more robust and longer term data. Novavax has filed for full approval of its COVID-19 vaccine and expects a decision from the FDA by April 2025.

    Both Pfizer-BioNTech and Moderna have received approval for adults for their COVID-19 vaccines, in 2021 and 2022, respectively, after first receiving emergency use authorization in 2020. Their shorter timeline was due mainly to the fact that the mRNA technology streamlines the development and manufacturing time for the shots. Because Novavax’s vaccine-making process requires more time, and different types of testing, Walker says it’s taken longer to complete the regulatory requirements for approval. But “with each successive season, we are getting faster and more efficient in manufacturing our vaccines, and we think we will be able to shorten that difference in time,” he says. “But I don’t know that we will ever surpass mRNA [technology’s timeline] just because of the technological and testing requirement differences.”

    Which vaccine provides better protection against COVID-19?

    Studies conducted by academic researchers over the past few years consistently show that there are few major differences between the mRNA and Novavax vaccines in terms of the immune responses they generate. Researchers generally measure this by looking at levels of neutralizing antibodies that the body makes against SARS-CoV-2, which were comparable across all three manufacturers’ vaccines. Some studies have also looked at T cell responses which also appear to be similar among the three shots so far.

    Is one vaccine better at protecting against the new COVID-19 variants?

    Over the summer, the FDA recommended that vaccine makers target the KP.2 strain of SARS-CoV-2 for the upcoming fall and winter season, and studies from Moderna, PfizerBioNTech, and Novavax show that each of the company’s updated vaccines provide strong protection against this strain as well as some of the even newer ones that have emerged in recent months. That’s because all of the variants remain related and are part of the Omicron group.

    I’ve heard Novavax vaccine has fewer side effects. Is that true?

    There haven’t been enough rigorous side-by-side comparisons of side effects and adverse events between the mRNA vaccines and the Novavax shot; instead each manufacturer has provided the FDA with reports of side effects that each has seen in its respective studies. But it appears that so far, people receiving the Novavax vaccine may be reporting fewer events such as fever, muscle aches, and headaches compared to those receiving either mRNA vaccine. All COVID-19 vaccines from the three manufacturers have been linked to an increased risk of inflammation of heart muscle, or pericarditis or myocarditis—most of the studies involving the risk with Novavax’s vaccines have come from outside of the U.S.

    Which vaccine should I get this year?

    “The best vaccine is the one that is in your arm,” says Walker. “We are in the fortunate position that we have multiple options, and are not relying on one technology to achieve very high levels of protection and safety. The FDA has determined that all of these vaccines are safe and effective.”

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    Alice Park

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  • 8 Apps That Can Help You Manage IBD

    8 Apps That Can Help You Manage IBD

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    As the saying goes, there’s an app for that. And inflammatory bowel disease, or IBD, is no exception.

    IBD is an umbrella term for chronic inflammation-related conditions affecting the digestive system, most commonly Crohn’s disease and ulcerative colitis. Both can result in waves of symptoms, typically called flares or flare-ups, involving diarrhea, stomach pain, fatigue, and weight loss. In addition to medication, many treatment plans involve diet and lifestyle changes that require careful compliance and diligence. And that’s where apps come in.

    For example, as part of your IBD management, you might see your doctor every six months or so. They’ll likely ask you how you’re feeling, how your symptoms have changed over that time, how you’ve been sleeping, how stressed you’ve been—all challenging details to remember off the top of your head.

    But an app that offers symptom and lifestyle habit tracking lets you record all of that information and keep it in the palm of your hand. “Apps that help you track your symptoms, food intake, exercise, and general well-being could give you a better sense of how your disease has been,” says Dr. Victor Chedid, a gastroenterologist at the Mayo Clinic in Rochester, Minn.

    Having this data on hand might also help you recognize patterns in your symptoms more quickly. And that could lead to better care: If you notice your symptoms have been getting worse after logging them in an app, “it could help pick up flares at an earlier time potentially and [encourage you to] discuss health concerns at an earlier time with your doctor,” Chedid says.

    But with so many IBD and gut health apps available, how do you know what’s worth a download? Here, experts and people living with IBD weigh in on which ones to try and how to pick the perfect match for your needs.

    We Can’t Wait

    Type: Restroom finder

    Cost: Free

    Available for: iOs and Android

    It’s not uncommon for people with IBD to plan their social activities and travel around the closest public bathrooms, Chedid says. Not knowing where the nearest option is in a desperate moment causes a lot of anxiety and stress. So an app that provides that information brings comfort and reassurance, empowering people to live their lives.

    “I think it’s a really awesome idea,” says Molly Dunham-Friel, an IBD and IBS (irritable bowel syndrome) patient advocate and the founder of the website and social media accounts Better Bellies by Molly. She was diagnosed with ulcerative colitis in 2012 and IBS—which can cause similar symptoms to IBD such as abdominal pain and diarrhea or constipation but without visible signs of damage or disease to your digestive tract—in 2013. Adds Dr. Alan Moss, chief scientific officer of the Crohn’s & Colitis Foundation: “[The app] has been downloaded 35,000 times, showing you [there’s] definitely a need there.”

    Read More: Why Bathroom Access Is a Public Health Issue

    Ayble Health

    Type: Personalized management plan, symptom tracker, education

    Cost: $19.99 for the basic plan or $49.99/month with access to a health coach

    Available for: iOs and Android

    Dunham-Friel assisted in the development of this app and used it for some time herself. “The goal is to collect information about what you’re eating and how your bowel movements are, what your GI symptoms are, to help patients draw some conclusions or generalize a correlation, which is really valuable because of how complicated IBD is,” she says.

    The app gives users different levels of access to educational materials, a mobile chat feature that connects to digestive health coaches, and symptom and lifestyle habit tracking to help identify and eliminate trigger foods.

    Trellus Health

    Type: Symptom tracker, education, support

    Cost: Free

    Available for: iOs and Android

    This app was specifically designed for people with Crohn’s disease, ulcerative colitis, or irritable bowel syndrome, and it’s meant to provide support and education that complements your current treatment plan.

    “They have a lot of education, mindfulness tools, and social support,” Moss says. You can use it to track symptoms, medications, and lab results, while also connecting with a team of dietitians and resilience coaches for additional support.

    Bezzy IBD

    Type: Community forum

    Cost: Free

    Available for: iOs and Android

    Bezzy, from media company Healthline, offers a number of specialized online forums and apps for different health concerns and conditions, including one for IBD, allowing members to connect with other users with IBD and find educational articles on the condition.

    “You can find other people that share some of the same things you do with your disease, and get some support and information from people’s experiences,” says Lenette Sparacino, a Crohn’s disease patient and advocate who shares about her experience with IBD on Instagram and Tiktok @_lifewithcrohnsdisease.

    Bearable

    Type: Chronic illness symptom tracker

    Cost: Free; optional $34.99 subscription for premium features

    Available for: iOs and Android

    Bearable offers customizable tracking for mood, symptoms, sleep, energy, meals, medications, and more that can be useful for people with any chronic condition, including IBD.

    Sparacino appreciates its graphs and charts for highlighting patterns in symptoms and triggers. “I found that really helpful, because with Crohn’s, a lot of my triggers are from stress.” The visuals helped her better manage her symptoms, she says.

    Calm

    Type: Meditation and sleep app

    Cost: $14.99/month or $69.99/year

    Available for: iOs and Android

    There are many popular relaxation and meditation apps that aren’t specifically designed for people with IBD but could still be helpful. “If you really want to focus on ways to cope and manage stress, you could use any of those,” Moss says, such as Calm, which provides guided meditations, music for relaxation, and more. “There is some nice research showing if you can adequately manage stress, you reduce the triggers for flare ups, or help attenuate or minimize a given flare up,” he adds.

    “A lot of times people just need a guiding light to help them figure out how to get their stress under control,” Sparacino says. 

    Nerva

    Type: Gut-directed hypnotherapy program

    Cost: $43.99/month

    Available for: iOs and Android

    While this is technically an app for IBS rather than IBD, Dunham-Friel swears by this guided, gut-focused hypnotherapy system. It offers a six-week program that she followed leading up to her honeymoon. “I was really worried about my IBD getting in the way of my enjoyment of my honeymoon, and so I committed to that app, and I just had an amazing week with very little to no GI upset,” she recalls.

    It also helped her cope when she did notice a little pain or sense of urgency. “I didn’t let it mentally derail me into a spiral of worry and anxiety that essentially is a vicious cycle between symptoms and anxiety,” she says.

    Instagram

    Type: Social media

    Cost: Free

    Available for: iOs and Android

    While it’s certainly not unique to IBD, Instagram offers an opportunity for connection that Sparacino found to be life-changing after she was diagnosed with Crohn’s disease. “I was getting ready to have a bowel resection in 2016, and I didn’t know anyone in real life that had Crohn’s or had a bowel resection,” she says. She created an IBD-focused Instagram account and started searching for other people sharing about Crohn’s disease. Asking them questions and learning more about their experiences “was just super beneficial,” she says.

    She also likes that you can find people of all different backgrounds on Instagram sharing their IBD experiences, such as accounts specifically for LGBTQ+ people, South Asian people, or Black people with Crohn’s or ulcerative colitis. 

    Some of her go-to IBD accounts to follow on Instagram include @natalieannhayden, @betterbelliesbymolly (run by Dunham-Friel), @crohns_and_colitis_dietitian, and @crohnscolitisfoundation.

    Which App Is Right for You?

    When you’re deciding which app might help you the most, there are a few things to keep in mind.

    Your Budget

    If the app costs money, make sure it has a free trial period. “At least test drive it for a week to make sure, before you sign up, [and decide] if you like how it is and you’re willing to [follow] the prompts,” Moss says.

    Your Notification Preferences

    Think about whether or not you want more pings and dings in your life. Before recommending an app to a patient, Chedid asks himself: “Is it going to feed into making them more anxious with notifications, or is it going to actually help them become more capable of managing their disease?”

    Who’s Behind the App

    Chedid recommends making sure an appropriately credentialed health care provider was involved in the creation of the app you choose.

    Your Must-Have Features 

    Identify the aspects of your IBD management you want to track with an app, and look for an option that provides that functionality, Chedid says.

    For example, if tracking your food intake is most important, look for a diet-focused IBD app. If stress is a big trigger, look for an app that addresses mental health concerns. If you have trouble remembering to take your daily meds, you may be best off with a medication tracker or reminder app, he says.

    Then, make sure it delivers: If you’re mindlessly adding your food and symptoms but not getting any actionable takeaways or conclusions from all that data, the app might not be the best choice. “Something where you can look at the big picture as much as possible is really key,” Dunham-Friel says.

    Read More: Why Gut Health Issues Are More Common in Women

    Remember, an app shouldn’t replace your health care providers. “These tools are meant to be a supplement, to empower you, but they’re not meant to substitute your medical team,” Chedid says. And don’t feel like you have to use an app, either. If you’re not interested, can’t afford it, or don’t have access to a smartphone, you can track many of the same symptoms with pen and paper, he adds.

    For some people, using an app can be a little upsetting: You may be faced with discouraging trends in your symptoms or the reality of logging yet another day of sky-high stress levels. If that sounds familiar, remind yourself in those moments that everything changes. “It’s not always going to be like this,” Sparacino says. “There’ve been so many times I thought I’m never going to feel good ever again, but I do have periods where I feel good. There are times you’re going to feel better.”

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    Sarah Klein

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  • Why Does Everyone Seem to Have IBS Now?

    Why Does Everyone Seem to Have IBS Now?

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    We’re in the midst of a weird cultural moment involving people’s bowel habits. Irritable bowel syndrome (IBS) has been trending on social media, including TikTok videos and posts about the disorder on Instagram, X, and other platforms. Billboards proclaiming that Hot girls have IBS have popped up over the past few years in Los Angeles and other cities.

    As a result, a subject that was once unthinkable to discuss socially has been normalized. “It’s definitely a phenomenon,” says gastroenterologist Dr. Roshini Raj, an associate professor of medicine at the NYU Grossman School of Medicine and author of Gut Renovation. “It’s a topic more people are comfortable talking about, and people are paying more attention to how their guts are feeling.”

    What is IBS?

    A functional GI disorder, IBS is characterized by symptoms like bloating, gas, abdominal pain, cramping, constipation, and/or diarrhea. The syndrome is more common among women—affecting more than twice as many women as men—but men experience it, too.

    Thanks to the social-media trend, people may be diagnosing themselves with IBS based on their symptoms, or they may be bringing them to their doctors’ attention.

    Read More: Why Gut Health Issues Are More Common in Women

    “When people share their stories, awareness [of IBS] increases, and with that exposure, people realize their symptoms aren’t normal,” says Dr. Shabnam Sarker, an assistant professor of medicine in the gastroenterology and hepatology division at Vanderbilt University Medical Center. “And they’re realizing it doesn’t have to be that way.”

    Dr. Bryan Curtin, director of the Center for Neurogastroenterology and GI Motility at The Melissa L. Posner Institute for Digestive Health & Liver Disease at Mercy Medical Center in Baltimore, agrees. “The upside of this openness to discussing IBS is that it is less stigmatized and people suffering with these conditions feel less alone and isolated,” he says.

    How do you know if you have IBS? 

    While there’s no structural or biochemical test for IBS, there are specific criteria—called the ROME IV Criteria—that are essential for its diagnosis. These include recurrent abdominal pain at least one day per week in the last three months, along with changes in the frequency and appearance of stools (among other symptoms). Subtypes of IBS include constipation-predominant IBS, diarrhea-predominant IBS, mixed IBS, and unclassified IBS. 

    In other words, it’s a clinical diagnosis based on someone’s medical history, physical examination, and personal set of symptoms. But because other gastrointestinal disorders—such as celiac disease and inflammatory bowel diseases like Crohn’s disease—can have similar symptoms to IBS, doctors often order tests to rule those out before making an IBS diagnosis.

    Beyond the hashtags, the latest research does suggest that IBS is more prevalent—affecting 6.1% of people in the U.S.—than previously thought. Experts estimate that as many as 10-15%of people in the U.S. have IBS, and many of them may be undiagnosed, Raj says.

    Why is IBS on the rise?

    The digestive system is complicated, and the precise cause of IBS isn’t well understood. It may be related to gut motility or permeability problems, and many experts believe it has to do with the quality of a person’s diet and dysregulation of the gut microbiome: the community of microbes, including bacteria, that naturally live in the gastrointestinal tract.

    The uptick also could be related to stress. “IBS is a brain-gut axis disorder,” explains Sarker. “The gut has a lot of nerves, and the way the nerves are firing affects [gut] movement, pain, and bloating. Psychological stressors play a big role in IBS, and there’s been a lot more stress since the pandemic.”

    Read More: Green Tea Is Even Better For You Than You Think

    The increase in IBS prevalence also could be related to COVID-19 because “viral illnesses can induce disorders of the gastrointestinal system,” says Dr. Darren Brenner, a gastroenterologist and professor of medicine and surgery at the Northwestern University Feinberg School of Medicine. Indeed, a 2023 review of studies on the subject found that COVID-19 infection was associated with new IBS diagnoses; this was especially true among women and people with depression or anxiety.

    While IBS isn’t life-threatening, it can be a miserable experience and negatively affect someone’s quality of life. “With IBS, a lot of people change their behavior to work around their symptoms,” Sarker says. This may lead them to decline invitations to parties or other social events because they’re worried about having a flare-up. Or, it may spur them to avoid physical activity for the same reason.

    How to find relief

    One of the drawbacks to the IBS social-media sensation: Some of the information being shared isn’t correct, research has found. Another possible downside? If people with GI symptoms start doom-scrolling, their anxiety and hypervigilance can get ramped up, which could worsen their symptoms. They also might be seduced by online products that promise to eliminate bloating that may not actually work.

    Because the symptoms and severity of IBS can vary among people, there isn’t a one-size-fits-all approach to treating it. “The nice thing is because we have so many things in our armamentarium, people can choose their treatment,” says Brenner. “There is no cure for this disorder, and the symptoms wax and wane, but we have multiple modalities that can improve symptoms and quality of life.”

    Read More: What’s So Great About Cottage Cheese?

    These include dietary modifications such as increasing fiber and water intake and avoiding possible trigger foods like gluten and dairy. “Keeping a food diary can help people identify triggers for IBS,” says Sarker.

    Other treatments may include botanical preparations (like peppermint oil, which can reduce intestinal spasms), neuromodulators (such as some antidepressants), antibiotics, or medications that influence gut motility. Mind-body approaches—such as cognitive behavioral therapy, meditation, and gut-directed hypnosis—can also be beneficial because “the gut-mind condition is very real and even more pronounced in someone with irritable bowel syndrome,” says Raj.

    Getting plenty of sleep and regular exercise is also beneficial for managing IBS. Many people with IBS rely on a combination of therapeutic strategies to treat the condition.

    “There’s no definitive cure for IBS,” says Sarker. “But we can manage this and get you to where your quality of life is much better.”

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    Stacey Colino

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