Kevin Hart GOES ALL in on FITNESS—AND TAKES HIS FANS with HIM PAGE 32 WEBMD MAGAZINE Contents JUNE 2017

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TRY A SUMMER SQUASH DISH TONIGHT THE PUBERTY PAGE 48 TALK YOU NEED TO HAVE WITH YOUR DAUGHTER PAGE 28

FIT & FUNNY Kevin Hart GOES ALL IN ON FITNESS—AND TAKES HIS FANS WITH HIM PAGE 32 WEBMD MAGAZINE Contents JUNE 2017

FEATURES

32 Big Hart Actor and comedian Kevin Hart gets his fans pumped up for healthy living

39 Rewriting Our DNA CRISPR, a new gene-editing technique, may one day offer a cure for a host of diseases

42 The Race for an Anti-aging Pill Can a pill slow the effects of aging? Scientists explore the possibilities. PHOTOGRAPHY: ERIC RAY DAVIDSON / TRUNK ARCHIVE TRUNK / DAVIDSON RAY ERIC PHOTOGRAPHY:

1 WEBMD.COM WEBMD MAGAZINE Contents JUNE 2017

FITNESS

11 Move More Counter the adverse health effects of sitting with some exercise 13 Fitness Smarts How does your community rank for opportunities for activity? 23 Health Boost Exercise is good for kids’ bodies and minds GETTY IMAGES

2 WEBMD.COM WEBMD MAGAZINE Contents JUNE 2017

30 HELP FOR MIGRAINE PAIN PG 53

CHECKUP 27 53 Cutting Edge | Innovative treatments ahead for migraine relief

54 Expert Q&A | How to keep your 15 medications effective—and safe 55 Health Highlights | Ease 18 backache pain with these 10 tips

56 Quiz: Incontinence | Bladder leakage affects 25 million people

57 Sleep Matters | How does your sleep position affect your health? 58 Doctor’s Office | What you should 47 know about melanoma 59 By the Numbers: Osteoarthritis | Facts and stats LIVING FOOD about this joint disorder 12 Work Wise 15 Mind Matters 47 Summer Treat 60 My Story | One woman learns to Sexual harassment can take How to deal with Cherries are chock-full of manage hypothyroidism a toll on your health. Find cyberbullying vitamins and antioxidants out what you can do. 61 Your Smile | Brushing tips 17 Mind Matters 48 3 Ways: 14 Men’s Health Find out what happens in Summer Squash Questions for your doctor if your brain when you talk Grill, bake, and serve this versatile veggie you’re thinking of reversing on the phone while driving your vasectomy 50 Build a Better Burger In every issue Master the art of burger- BEAUTY making 4 EDITOR’S NOTE 18 Slip of the Lip 21 Expert Picks 51 1 Day, 5 Dinners 104 6 UPFRONT Keep lips soft and supple Top products for Tasty meals from a crop of Quick fitness facts, during the hot summer battling breakouts summer veggies plus health news months you can use 22 Anatomy of… 52 Salad Greens 101 19 Beauty Smarts Dry Shampoo Try these alternatives 62 TAKE 10 Get the scoop on sunscreen What’s in it and how to iceberg Top questions for does it work? Orange Is the New FAMILY Black’s Selenis Leyva

24 Pregnancy 26 Baby 28 Parenting Could morning sickness The ins and outs of How you can prepare offer clues to your baby’s newborn hearing your daughter for health? Plus, nausea tests puberty relief tips. 27 Kids' Health 30 Pets On the Cover What your dog or cat 25 Pregnancy Tips for disciplining children PHOTOGRAPHY: ERIC RAY DAVIDSON / Learn about pain relief with ADHD wants to say to you TRUNK ARCHIVE choices during labor GETTY IMAGES

3 WEBMD.COM EDITOR'S NOTE

Exercise Doesn’t Have to be Hard

Actor and comedian Kevin Hart is about 30 minutes per day five days very funny, but one thing he takes a week. You might be relieved seriously is fitness. He not only works to learn that you don’t need to out every day, including on set, but do all 30 minutes at once—three he also shares his enthusiasm with 10-minute sessions, for example, is his fans. He tells us in this issue how just fine. Keeping a fitness journal he uses his substantial celebrity or tracking your progress on an platform to inspire others to get app can help. So can enlisting a moving, such as by inviting them to friend to join you, even if he or she run with him. isn’t quite as funny as Kevin Hart. But if you’re more likely to be on a couch watching a Kevin Hart movie than working out, you’re not alone. The truth is, most people Kristy Hammam don’t get the recommended amount Editor in Chief of exercise, which is generally [email protected]

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THE FUTURE OF ANTI-AGING Check out WebMD’s new Special Report: Can Science Outsmart Aging? From the secrets of “super-agers” to the role of DNA in aging, you’ll find articles and a video detailing research efforts to help us live better, healthier, and longer lives. And for more on aging in this issue of WebMD Magazine, check out “The Race for an Anti-aging Pill” on page 42.

To see the full special report, search “anti-aging” at WebMD.com.

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FACTS & STATS Fit for Life Your mirror reveals the visible results of exercise: more muscle tone, a leaner body. Under the surface, good fitness habits help your body operate at maximum capacity and resist conditions like heart disease, diabetes, and cancer.

Tone Up Cardio and strength training can help maintain muscle mass as you age.

The amount of time you’d need to walk off the calories in an hour, iced cinnamon roll. 650+ 1% to 2% 1 Polish off two slices 5 p.m. The number of muscles in your body— The rate at which you lose muscle mass of pizza, and you’ll The optimum time of day to strength train. including your heart. Strengthen it with each year starting at age 50. To preserve need to pound the Late afternoon is peak performance time at least 30 minutes of aerobic exercise at your muscles, strength train twice a week, pavement for an hour for your muscles. Lung capacity also

GETTY IMAGES least five days a week. working all major muscle groups. 17 and 23 minutes. improves around dinnertime. minutes

6 WEBMD.COM UPFRONT

IN THE NEWS Facing the Future This issue, we take you on a journey into the future of health with two stories that explore how science aims to potentially eliminate disease and improve the inevitable process of aging that we all face. First, we dive into a very cool gene-editing technique called CRISPR that allows researchers to “snip” off sections of a cell’s DNA that could otherwise cause disease. Sound like science fiction? It’s happening in petri dishes in labs around the globe, with early clinical trials in humans in the U.S. and elsewhere just taking off. Turn to

COLLEEN PARETTY “Rewriting Our DNA” on page 39 to find out how CRISPR works and which diseases Editorial Director may be first up to be eradicated. colleen@ webmd.com Next, “The Race for an Anti-aging Pill” on page 42 asks whether a drug could potentially treat the aging process and perhaps prevent age-related illnesses altogether. Two drugs currently in use point to some intriguing health-enhancing effects on the body’s cells. Harnessing these benefits may one day change how—and how well— we age. Both stories are still in the realm of “maybe someday”—but they’re no less intriguing for all that. Enjoy. —

DIET DETECTION CHECKUPS MIGHT ONE DAY include a urine test that shows doctors how healthy your diet is. Researchers in the U.K. have developed a test that screens for byproducts of fruits, vegetables, chicken, fish, red meat, and other foods, and can rank your eating habits on a four-point scale from very healthy to very unhealthy. Doctors could use these test results to better predict your risk for heart disease and diabetes and counsel you on how to prevent them.

SOURCE: The Lancet Find Your Zen Take a deep breath and say “om.” The secret to a fast-working 1 in 3 brain might be to slow down the mind. In an eight-week study, RATIO OF U.S. ADULTS people ages 55 and older meditated five times a week for about who have high blood pressure. Only half know it. 10 minutes at a time. After two months, their reaction times in SOURCE: CDC a test of cognitive skills had improved.

SOURCE: Mindfulness GETTY IMAGES SAAD; MINDY STYLING: SUH; SHARON PHOTOGRAPHY:

7 WEBMD.COM UPFRONT

DIABETES' TOLL Some 12% of Americans ages 30 to 84 die of diabetes—much more than the 3% researchers estimated previously. They investigated the cause of death of more than 300,000 people and found that diabetes was widely underreported on death certificates.

SOURCE: PLOS One False Alarm A false-positive result on a mammogram can be upsetting. But don’t let it scare you off getting your next one on time. A recent study found that women who get false positives are more likely than others to put off their next screening. In the same study, researchers found that delaying mammograms VAPING RISKS The jury is still increases the risk of being diagnosed with late-stage breast out on whether e-cigarettes are cancer later on. The American Cancer Society recommends as harmful as tobacco cigarettes, women at average risk of breast cancer get annual but they aren’t risk-free. A recent mammograms starting at age 45. You can get them every study that compared healthy, young habitual e-cigarette users other year after age 55. to their cigarette-free peers found SOURCE: Cancer Epidemiology, Biomarkers and Prevention that the e-cig users had increased risk factors for heart disease, including more oxidative stress. That’s when the body takes in more free radicals or toxins than it clears out. It’s a consequence of cigarette smoking, too.

SOURCE: JAMA Cardiology

1 SHEEP, 2 SHEEP … Online sleep therapy might soon help people who have trouble sleeping catch some zzz’s. Researchers at the University of Virginia designed an online program that delivers components of cognitive behavior therapy 70NUMBER OF for insomnia. After 150 adults with chronic insomnia completed the six- extra calories you may take in each day if you add milk and sugar week program, they reported less severe insomnia and were able to fall to your coffee. asleep faster and stay asleep through the night. In the program, sleep- SOURCE: Public Health seekers learned about limiting nighttime stimuli, setting a sleep schedule,

and other good sleep habits. GETTY IMAGES

SOURCE: JAMA Psychiatry 8 WEBMD.COM UPFRONT

POSTURE POWER “WAS THAT MY PHONE?” Do you hear your phone when it’s not ringing? If so, you might be an addict. Researchers asked about Sit up straight! In a small study 800 young adults whether they ever heard phantom rings, felt vibrations, or saw phantom notifications. of adults with mild to moderate Those who did were more likely to report symptoms of cell phone dependency such as using the devices to relieve sadness or anger, depression, upright posture improved feeling bad when they couldn’t get to their phones, and having obsessive thoughts NUMBER about their phones. Sound familiar? Schedule some phone-free time each day, use 46 apps to help control your usage, and set goals to socialize regularly in real life. of calories in 1 cup of mood and decreased fatigue. diced watermelon. SOURCE: Journal of Behavior Therapy and Experimental Psychiatry SOURCE: Computers in Human Behavior SOURCE: USDA AGE ADVANTAGE Lather It On HEART HEALTHY Children born to moms older Only 16% of heart attack survivors get the recommended amount of physical activity five than age 35 had better thinking weeks after they leave the hospital. Thirty minutes of exercise, such as brisk walking, five days per week will greatly reduce your risk of a second heart attack. skills than kids of younger SOURCE: Journal of the American College of Cardiology mothers in a study of 11,600 kids. The older moms were better educated, made more money, and were less likely to DAILY USE OF SUNSCREEN with SPF 15 or higher reduces smoke during pregnancy. your risk for melanoma by 50% SOURCE: International Journal of Epidemiology and risk of squamous cell carcinoma by 40%. More is GROW KIDS' better—the American Academy of Dermatologists recommends using sunscreen with an SPF of at least 30. BRAINS SOURCE: Skin Cancer Foundation Children who believe that intelligence grows—compared to those who believe it is fixed— are better at learning from their mistakes. Researchers surveyed kids on their thoughts about intelligence. Then they monitored the kids’ brain activity while they played a fast-moving BRING ON THE HEAT video game that tested reaction time. Kids with the “growing Chili peppers may be the spice of a longer life. In a study of 16,000 Detergent Pod Dangers intelligence” mindset paid more adults, those who ate chili peppers at least once a month were 13% less attention to their mistakes and likely to die during the 12-year study period than those who avoided SOME 480 PRESCHOOL-AGE KIDS got chemical burns in their eyes from laundry did better in the next round than the spicy fruit (yes, the chili is a fruit). Capsaicin, which puts the fire in detergent pods in 2015. That’s up from 12 cases in 2012. It happens when kids touch kids with the “fixed” mindset. The their eyes after holding the pods. chilies, might protect against obesity and thus lower risk for heart and take-home message: Teach kids SOURCE: JAMA Ophthalmology lung disease and diabetes. It might also help maintain proper blood to learn from their mistakes. Don’t sweep them under the rug. flow, which can prevent heart disease and stroke.

SOURCE: Developmental Cognitive Neuroscience GETTY IMAGES SOURCE: PLOS One

9 WEBMD.COM HEALTHY HABITS Living MEANINGFUL CHANGE

MOVE MORE Get Going Between work, sleep, TV time, and meals, most people spend the majority of their day in a seated position. Get up and move more—and you just might live longer.

Keep It Up MOST OF US SPEND UPWARD OF EIGHT Daily workouts and hours a day—more than half our walking breaks can help waking hours—sitting. Too much stave off the effects of a sedentary time leads to weight gain sendentary lifestyle. and the host of health issues that come with it: high blood pressure, diabetes, heart disease, and cancer. Moving too little might even age your cells faster, research shows. The antidote to sitting is exercise. Take hourly breaks and walk laps around the office. Get in an hour- long daily workout. Schedule plenty of moving time on weekends and days off. —STEPHANIE WATSON GETTY IMAGES

11 WEBMD.COM BY Lisa Marshall LIVING Sign up for the Living Better Newsletter REVIEWED BY Patricia A. Farrell, PhD at WebMD.com. WebMD Medical Reviewer

WORK WISE The Toll of Harassment Unwanted come-ons and gender-based put-downs persist in the workplace, fueling health problems from anxiety disorders to chronic pain a host of other high-profile cases have rekindled discussion of an issue researchers say is still vastly underreported. Ninety percent of people who are harassed never take formal action against their harasser. And many mistakenly assume that if it’s not a “sleep with me or lose your job” scenario, it’s not truly harassment, says University of Illinois psychology professor emerita Louise Fitzgerald, PhD, who has studied the issue since 1983. The truth, notes Fitzgerald, is that sexual harassment comes in many forms and even at relatively low intensities can have lasting emotional and physical side effects: “It is like any stressor. It leads to a physiological stress reaction, and that reaction can over time have a real impact on health.” More than 200 studies have documented health consequences. People who are harassed are more likely to have anxiety disorders or post-traumatic stress disorder, abuse alcohol, or develop eating disorders later in life. They may also have chronic headaches, sleep and gastric problems, nausea, respiratory complaints, neck pain, and high blood pressure. The more frequent the harassment, even if subtle, the more severe the emotional impact, Fitzgerald’s research shows. What to do? Consider a lawsuit your last resort, not your first, stresses Florida-based employment lawyer Donna Ballman, author of Stand Up For Yourself Without Getting Fired. Take notes documenting the dates and times the harassment takes place. Familiarize yourself with your company’s sexual harassment policy. THIRTY YEARS AFTER THE U.S. SUPREME COURT DESIGNATED IT A FORM And once you feel the time is right, speak up, of unlawful discrimination under the Civil Rights Act, sexual harassment either to your supervisor, human resource direc- remains endemic in the American workplace, impacting one in two women tor, or in cases where you have been financially and one in six men, according to a recent report by the Equal Employment harmed by the harassment, the EEOC. Opportunity Commission (EEOC). “We have come a far way,” it concluded. “The best outcome is that the system works. You “But sadly and too often we still have far to go.” report it, they stop it, and you can work in peace The June 2016 report, along with newscaster Gretchen Carlson’s recent and they don’t hold it against you,” says Ballman. sexual harassment lawsuit against former Fox News Chairman Roger Ailes, and “There are a lot of situations where that happens.”

BY THE NUMBERS

Percentage 13,000 of sexual Number of sex-based harassment harassment 90% charges filed with Equal Employment charges filed Percentage of people who have been sexually ILLUSTRATION: JAMES STEINBERG JAMES ILLUSTRATION: Opportunity Commission in 2015. 17% by males. harassed who never file a complaint. 12 WEBMD.COM BY Kara Mayer Robinson LIVING Search Walking at WebMD.com for REVIEWED BY Michael Smith, MD, CPT walking workouts. WebMD Chief Medical Editor

FITNESS SMARTS Community Action A new report ranks 50 metropolitan areas in the U.S. on their fitness prowess. How does yours stack up?

Paving the Way You’re more likely to biking and walking zones, and lots of keep moving if your recreation centers. Residents of the community makes it easy to do physical area smoke less and have lower rates of activity. diabetes and heart disease. If your community has these assets, take full advantage. Run errands on foot. Bike to work. Take a dunk in the public pool. Bring your dog to the bark park. If it doesn’t, not to worry. While living in a healthy community is a plus, that doesn’t mean you’re out of luck. Ainsworth suggests four ways to stay fit:

Think outside the blocks. Take a short drive to places you can walk safely—like a stretch of sidewalks, walking trails, or the mall. Or join a gym.

Try manual labor. Mow the lawn. Haul clippings to the trash. Rake the leaves. DOES YOUR COMMUNITY HAVE WHAT IT TAKES TO KEEP YOU FIT? Sweep your porch and driveway. According to the American College of Sports Medicine American Fitness Index, a yearly report that ranks the health and fitness of the 50 biggest U.S. Join a fitness group. Organized clubs metropolitan areas, certain factors are key. often have access to facilities. Try a club “The top 10 have many recreational opportunities for residents to engage in for biking, swimming, or tennis. physical activity,” says Barbara E. Ainsworth, PhD, a professor at Arizona State University’s School of Nutrition and Health Promotion. So if your community Be a weekend warrior. Too busy to drive is loaded with parks, playgrounds, ball fields, and swimming pools, you’re in to nearby recreation areas? “Studies good shape. If it has roads, trails, and sidewalks that make walking and biking show you can meet U.S. physical activity a breeze, even better. guidelines by engaging in activity on the This year’s winner is the Washington, DC, metro area, which includes weekends only—and also gain health Arlington and Alexandria, Virginia. The area has easy access to parks, benefits,” Ainsworth says.

Make REACH OUT MAKE REQUESTS ENGAGE GOVERNMENT GO LOCAL

Improvements Contact your parks Call your city and Write to your state Create a community WANT TO HELP YOUR CITY CLIMB and recreation county transportation policymakers. Ask them to action group. Encourage THE FITNESS LADDER? TRY THESE department. Ask them department. Ask for promote recreation and neighbors to trim over- TIPS FROM PUBLIC HEALTH EXPERT to repair streetlights, solutions for high- physical activity in your grown bushes that spill BARBARA E. AINSWORTH, PhD. broken sidewalks, and traffic areas and more community and in schools. onto sidewalks. Form a park equipment. bike lanes. group and help plant trees. GETTY IMAGES

13 WEBMD.COM BY Matt McMillen LIVING Search for the article Vasectomy Reversal: REVIEWED BY Michael Smith, MD Why You Need the Right Surgeon WebMD Chief Medical Editor at WebMD.com.

MEN’S HEALTH Reversing Course Each year, one in every 20 men who have had a vasectomy changes his mind and wants a reversal to restore his fertility. Our expert answers the questions you need to ask a urologist before undergoing this complex surgery.

How long will the If you see no sperm, do On Second Thought surgery take? you perform an Sometimes life changes affect the A correctly performed epididymal bypass? need for fertility after reversal takes about two Many men have a a vasectomy. and a half hours. Watch deeper obstruction in out for doctors who do their vas, and that quickie reversals in 45 to makes a traditional 60 minutes. Just as bad vas-to-vas procedure are the doctors who take ineffective. In such four to six hours or more. cases, your urologist should be able to Do you use a surgical perform vas-to- microscope? epididymal bypasses “Watch out A reversal requires (which connects the vas for doctors extreme precision because to the tube that carries who do your vas deferens—the sperm to the testicle) tube through which your when needed. quickie sperm flows during ejacu- reversals lation and which is the tar- Do you perform redo in 45 to 65 get of the reversal—is no reversals? thicker than a strand of On rare occasions, minutes.” spaghetti. True experts will reversals can scar up. —SHELDON only use a high-powered This usually occurs with MARKS, MD DIRECTOR, microscope—not magnify- less experienced INTERNATIONAL ing glasses—when per- surgeons—either CENTER FOR How frequently do you perform the procedure? forming the procedure. because they don’t have VASECTOMY Look for a urologist who does several each year. Some the skills required or REVERSAL, TUCSON, top experts perform two to five reversals every week, Do you look at the vasal they didn’t examine the ARIZONA which enables them to achieve higher success rates. But fluid under a microscope? vas fluid and so ended be sure they only do one reversal a day. This allows them This is essential to make up performing the to focus all their energy and concentration on your sure that the vas defer- wrong procedure. Top reversal without being rushed to finish in time for their ens, or vas for short, is experts often have a next surgery. It will also ensure that they won’t go into open or if there is deeper busy practice fixing your surgery fatigued from earlier operations. blockage. other doctors’ failures.

4 Tips WHY IT’S DONE WILL IT WORK? CHOOSE A UROLOGIST FIND AN EXPERT SOME BASIC FACTS TO KNOW ABOUT VASECTOMY “Sometimes a man “Top specialists in “Unlike other doctors, “Don’t settle on a REVERSAL PROCEDURES, who’s had a vasectomy the procedure have only urologists train in surgeon who happens ACCORDING TO UROLOGIST remarries, or he and his extremely high success male fertility surgery. to practice nearby. If SHELDON MARKS, MD. partner decide that they rates, even in men who Limit your search for a you can’t find an expert want more children.” had a vasectomy more surgeon to urologists.” you’re comfortable with than 20 years prior.” in your area, plan to trav-

el for the procedure.” KNORZER ULI ILLUSTRATION: GETTY IMAGES;

14 WEBMD.COM BY Locke Hughes LIVING REVIEWED BY Hansa Bhargava, MD WedMD Medical Editor

steps MIND MATTERS to stop 1 online Cyberbullying 101 bullying As online harassment becomes more prevalent, we all need some strategies to Do not respond to cope—and prevent it from affecting our health 7 the cyberbully. This can escalate the situation. If you feel damaging forms include physical threats, On WebMD’s Mental Health message damage, and even drive people to suicidal you must, calmly tell sexual harassment, and stalking. About one in boards, an anonymous user reported thoughts or actions. While most targets the person to stop. four women ages 18 to 24 report being stalked her own disturbing experience with of cyberbullying do not become suicidal, or sexually harassed on the Internet. cyberbullying and how it made her feel. research suggests they are more likely 2 3 Researchers believe cyberbullying can be even “He keeps writing things about me on to have symptoms of depression than more hurtful, psychologically, than physical Facebook and even is threatening to those who have been physically bullied. bullying. One reason: “Targets write blogs about me on the internet with People who deal with online harassment Don’t Do It Alone often do not know who the embarrassing photos,” she wrote. “Other may also feel sad, irritable, anxious, Save all Report the Cyberbullying can bully is, or why they are people are joining in. It really makes me and hopeless. They may lose interest evidence. abuse. be isolating—talk to 2 Take screen shots, Visit the safety or someone you trust. being targeted,” says Sameer feel like there is no point in even trying in activities they used to enjoy, start Hinduja, PhD, co-director at life. ... I just feel depressed all the time to sleep more or sleep less, and change keep voicemails, privacy control centers and print copies of of social media sites of the Cyberbullying Research Center. “The from when I wake up until I go to sleep, their eating patterns. Studies also suggest emails and texts. and internet service aggressor can cloak his or her identity behind and I can’t sleep because I don’t know that the psychological distress can lead to providers to learn a computer or cellphone using an anonymous what they are going to write next.” physical symptoms, such as stomach pain more about their email address or pseudonymous screen names.” Several other women we spoke with and headaches. policies. Plus, online harassment incidents can were among the 25% of women who It’s easy to feel alone when you’re quickly go viral, Hinduja says. With just a few have been stalked online. After meeting harassed online. But don’t isolate yourself; 4 5 keystrokes or clicks of a mouse, many people— an older man at an alumni event for her seek support instead. Talk about it with in a school, in a town, in the world—can get university, one young woman in New York a friend you trust, your partner, a mental involved or at least find out about the attack. City started receiving five to seven emails health professional, or your company Finally, “the fact that there is a measure of per day from him, until she finally blocked human resources department if you Contact law Block the bully’s anonymity, and that it is easier to be cruel his email. After that, he sent a threatening believe a co-worker may be involved. enforcement. social media profiles, email address, and using typed words rather than spoken words Facebook message, warning her that she Also, keep in mind why the person Tell them if threats include physical harm, phone number. face-to-face, also contributes to the problem,” “didn’t want to make” him angry, “or there is bullying others to begin with. sexual harassment, Hinduja says. would be consequences.” He also told her “Cyberbullying is related to low self-esteem, or stalking. he knew exactly where she lived. Once she suicidal ideation, anger, frustration, FIRSTHAND EXPERIENCES blocked him on Facebook, the messages and a variety of other emotional and 6 7 One writer, age 28, was harassed online after ended, but that didn’t stop her from psychological problems,” Hinduja says. penning a story on the potential drawbacks of feeling scared, even unable to eat or sleep. Reducing your stress can help you see a vegetarian diet in a popular publication. A She later found out he was a known “troll” these difficult situations more clearly _ YouTube vlogger who is vegan responded with a with many complaints from others about and make them easier to deal with. You Safeguard your Check your video in which he mocked the article, called the his online actions. can learn how to handle the stress of passwords. privacy controls. writer derogatory names, and even included cyberbullying in constructive ways, such If anyone else Make sure only people death threats. He encouraged his followers HEALTHY RESPONSES as eating healthy foods, working out, or knows them, change you know and trust to send her hate mail with more threats and Cyberbullying isn’t easy to shrug off. It trying yoga or meditation. them now. can see your social IN TODAY’S SOCIAL MEDIA-CENTRIC WORLD, BULLYING HAS MOVED disparaging statements. can cause long-lasting psychological media posts. from the playground into cyberspace—and not only between kids. Unsurprisingly, this kind of harassment Whether it’s a political argument between Facebook “friends” or in the took its toll. “I cried. I felt really anxious. I was comments section of a controversial article, adults increasingly find definitely scared,” the writer recalls. She felt themselves targets of online harassment. distracted when she would go out with friends, BY THE NUMBERS Studies suggest that about 40% of adults have been bullied or and whenever she had a lull at work, thoughts harassed online. The most common forms of cyberbullying (technically about the online vitriol cropped up. Eventually, called cyber harassment when between adults) include offensive name- the hateful comments and emails subsided, but Percentage of IN calling or purposeful embarrassment. More intense and emotionally she still revisits the trauma to this day. students ages Percentage of 12 to 18 in the US 1 4 adults who have who have been Number of women ages 18 to 24 who have been bullied or GETTY IMAGES 21% bullied online. been stalked or sexually harassed online. 40% harassed online. 15 16 WEBMD.COM WEBMD.COM BY Sonya Collins LIVING Search for the video The Basics: Text REVIEWED BY Arefa Cassoobhoy, MD, MPH Neck at WebMD.com. WedMD Medical Editor

Distraction Alert Even if your hands are on the wheel, phone conversations siphon your focus from dirving.

“The main problem is not the physical act of holding the phone, but your cognitive condition,” says Tobias Egner, PhD, associate professor of psychology and neuroscience at Duke University. “It takes time to switch your focus back and forth between driving and the conversation.” Brain scans show that when you concentrate on a task, such as a math equation, and then a distraction like background noise competes for your attention, a group of brain regions spring into action to help hold your focus on the primary task. But when you get engrossed in a phone conversation while you drive, your brain doesn’t necessarily recognize driving as the more important primary task. The brain recruits those attention-holding regions to help you focus on the phone conversation and lets the activity slow down MIND MATTERS in regions that ought to help with driving. Then the brain must quickly redirect the focus toward the road, reactivating driving- Drive, Already specific brain regions when you suddenly need to brake or swerve. Hands-free or handheld, phone calls drastically slow your “By introducing the second task, the phone reaction time behind the wheel. Think twice before you take conversation, which is the type of task that that call. Is it worth your—or someone else’s—life? requires you to think about what you’re hearing and what your response is going to A HEADSET OR IN-CAR SPEAKERPHONE KEEPS YOUR HANDS ON THE WHEEL, be, you create competition in your brain for but it doesn’t keep your mind on the road. Talking on the phone while a limited attentional resource,” says Egner. driving, whether on a handheld phone or hands-free, can slow your That doesn’t mean you have to drive in silence, reaction time by up to 40%, a new study finds. The consequences of Egner says. Radio and even conversations with distracted driving are the greatest for the least experienced drivers who people in the car don’t seem to win over your have a higher crash risk. attention the way phone calls do.

BY THE NUMBERS Percentage of Average number drivers using IN of seconds your % cell phones eyes are off 97.5Percentage of drivers who don’t drive well during fatal 1 3 the road while when they’re on the phone. (The others are a crashes who Number of drivers who admit to texting 5 texting. scientific anomaly called “super-taskers.”) 38% are in their 20s. while driving. GETTY IMAGES 17 WEBMD.COM BEHIND THE SCIENCE Beauty INSIDE OUT

SKIN CARE Slip of the Lip Think lip moisturizing is just for winter? Think again. Here’s how dermatologists keep lips soft and supple during hot summer months.

CHAPPED LIPS OCCUR YEAR- round, says Jessie Cheung, MD, a dermatologist in Chicago. “It’s because the humidity from outdoors to indoors is drastically different with air conditioning.” The solution? You can use a soft toothbrush or a damp washcloth to gently exfoliate your lips. Then apply a moisturizing lip balm afterward with softening ingredients like beeswax or coconut oil. Also, a balm infused with mineral sunblockers like zinc or titanium dioxide is critical in the summer. Lips can burn, and accumulated sun damage can lead to wrinkles as well as herpes outbreaks on the lips. —AYREN JACKSON-CANNADY Protect Your Pout Apply a balm with SPF to shield your lips from harmful UV rays. GETTY IMAGES

18 WEBMD.COM BY Liesa Goins BEAUTY Search for The Basics: How to REVIEWED BY Mohiba Tareen, MD Apply Sunscreen, a video at WebMD Medical Reviewer WebMD.com.

THE SCOOP The She Shave IT’S PERFECTLY FINE TO SHAVE THE PEACH FUZZ FROM YOUR FACE AS LONG AS YOU FOLLOW THESE SKIN SAFETY GUIDELINES, SAYS MIAMI BEAUTY SMARTS DERMATOLOGIST JILL WAIBEL, MD.

Keep Rays at Bay Spray or Spread Which SPF? Spray or lotion? Physical or Lotion chemical? Before you head outside, ensure you usually provides don’t see red this summer with a few important better sun-protection strategies. coverage than spray.

1. 3. IF YOU’RE LIKE 70% OF WOMEN (AND 85% OF MEN), CHANCES ARE YOU SPEND BUT SPF 50 IS BETTER need to reapply.” When in doubt, go ahead it in before it evaporates—most people WASH THE AREA SHAVE IN ONE most of the summer way too exposed. That’s how many of us fail to regularly If you plan to spend any significant time and reapply to be on the safe side. aren’t doing that.” He suggests starting CLEAN DIRECTION use sun protection on faces and bare skin, according to the CDC. outdoors, you need to upgrade to SPF 50. with a lotion, then using a spray for This softens Use a sharp razor Because melanoma rates doubled between 1982 and 2011 and skin cancer “The chemical ingredients that absorb and PHYSICAL OR CHEMICAL? reapplication or additional coverage. the skin while and go over each getting rid of any section only is the most common cancer in the U.S., we could all use a little more coverage. diffuse UV rays lose their effectiveness Sunscreen falls into two categories: bacteria already once to reduce (Doctors also believe UV-ray damage is responsible for 80% of the signs of after two hours, and mineral block can be physical and chemical. They both START NOW on the skin. the risk of skin premature aging.) rubbed off,” says Jennifer Linder, MD, a effectively block UV rays, just in different “It’s never too late to start using UV trauma that can But you’re not doomed to a life indoors. The thinking has changed on dermatologist in Scottsdale, Arizona, and ways, Linder says. Physical works just like protection,” Linder says. “It’s a common lead to bacterial infections. sun-protection strategies in recent years, and new insights should make it founder of Linder Dermatology and Skin it sounds—mineral particles of zinc oxide misperception that we’ve done all 2. easier for you to avoid the rays and protect your skin. Cancer Center. But if you can add SPF 50 and titanium dioxide deflect rays before the damage before the age of 18—but USE SHAVING to your regular routine, that would be ideal. they penetrate the skin. Chemical options damage is cumulative, so you’re adding CREAM

SPF 30 IS THE NEW RULE The “reapply every two hours” mandate use a variety of ingredients to absorb UV The formulas 4. on every day.” Simple changes like MOISTURIZE Conventional wisdom once dictated that SPF 15 was enough—but now the is still solid advice, according to the radiation before it can penetrate your skin. seeking shade and wearing a wide-brim are designed to deflect friction Calm your skin standard is to apply an absolute minimum of SPF 30, says Brian Zelickson, American Academy of Dermatology, “The most effective sunscreens hat can make a difference. and help prevent after shaving although Linder says it depends on your MD, a dermatologist in Minneapolis and founder of ZelSkin dermatology. incorporate a combination of the two,” “Limiting exposure to UV rays at any skin irritation. with a non- SPF 30 offers 97% protection against UV rays while SPF 15 only offers daily activities. “An application in the she explains. But people with extremely age is important because the tipping comedogenic 93%. That 4% difference may not sound like much, but since most of us morning is probably enough for most sensitive skin will do better with physical point at which a damaged skin cell (meaning one that won’t don’t apply enough sunscreen for adequate coverage, that extra percentage people, as long as you’re just going from formulas, she says. “In general, I advise becomes cancer can happen at any time,” clog pores) can have a significant impact, Zelickson explains. The Skin Cancer your home to your car,” she says. “But if looking for fragrance-free options to avoid says Linder. face cream Foundation suggests you use at least a nickel-size drop for your face alone. you’re going to a kid’s soccer game, you irritation.” or soothing When in doubt, opt for a physical hydrocortisone sunscreen, says Matthew Mahlberg, MD, cream. medical director of Colorado Center for Dermatology & Skin Surgery in Denver. “New formulas avoid the chalky look of Dirty Secret Aisle Do earlier versions, so they’re feasible for a “I’VE NEVER CLEANED MY HAIRBRUSH—HOW BAD IS THAT?” range of skin types and tones.” He adds FEET ARE MORE EXPOSED YOUR PRODUCTS CAN BE YOUR BRISTLES NEED YOU’LL HAVE MORE DURING THE SUMMER that people who are prone to eczema or A PROBLEM SOME TLC GOOD HAIR DAYS MONTHS, BUT THEY DON’T PRODUCT PICK PRODUCT PICK PRODUCT PICK very dry skin may find physical sunscreens All the styling products you use Without regular cleaning, If you’re not sharing your brush HAVE TO LOOK LIKE IT. AQUAPHOR Healing Ointment ISDIN Foot Care Uradin Podos AmLACTIN Moisturizing Body to be drying. build up on the bristles and settle alcohol from aerosol sprays with anyone else and use SMOOTH AND SOFTEN ($14.99) Hydrating Gel Oil ($30) Lotion ($18) on the base. That goop attracts and silicone from styling very few styling products, you YOUR SOLES WITH THESE “I call this ‘dermatologist duct tape’ “This is amazing! It starts to eliminate “This body moisturizer contains 12% dirt, which ends up on your products can break down and can get away without regular LOTION OR SPRAY? PEDI PICKS FROM LEADING because it has so many uses. But for roughness and mild thickening lactic acid, which is one of the best hair—leaving it dull and weighed weaken bristles, decreasing cleaning. Once a month, take DERMATOLOGISTS. feet, it heals cracks in dry skin. It’s a on the heel and sole of the foot in alpha-hydroxy-acids and a great Essentially pick the option you’ll most down. It’s also possible to devel- their lifespan. If you’ve a comb and scrape the bristles little slippery, so don’t walk around three days. Plus, the gel-oil texture exfoliant. Exfoliation is needed to get likely use. That being said, you tend to op scalp problems because the invested in a high-quality to remove hair. Squirt shampoo barefoot after putting it on.” absorbs fast, so it’s not messy.” rid of dead, dry, and often cracked have better coverage with a lotion rather buildup breeds bacteria that can natural bristle brush, you on the brush, rinse in lukewarm THE OPINIONS EXPRESSED IN THIS SECTION ARE Eric Bernstein, MD Fran Cook-Bolden, MD skin. Hydration is needed to bring lead to irritation. should do a little maintenance. water, and let it air dry. OF THE EXPERTS AND ARE NOT THE OPINIONS OF than a spray, Mahlberg says. “You need WEBMD. WEBMD DOES NOT ENDORSE ANY SPECIFIC dermatologist, Ardmore, Pennsylvania assistant professor of dermatology, back supple, healthy-looking skin.”

PRODUCT, SERVICE, OR TREATMENT. Columbia University, New York City Eliot Battle, Jr., MD GETTY IMAGES to spray a liberal amount and then rub —Gwynne Mims, owner of Gwynne Mims Salon, Jacksonville, Florida dermatologist, Washington, D.C. 19 20 WEBMD.COM WEBMD.COM BY Ayren Jackson-Cannady BEAUTY REVIEWED BY Karyn Grossman, MD WebMD Medical Reviewer

EXPERT PICKS

1. SPOT LESS Neutrogena On-the-Spot JILL WAIBEL, MD, Breakouts, Begone Acne Treatment OWNER, MIAMI Acne isn’t just for teenagers. If you fight fine ($6.84) DERMATOLOGY AND “This over-the-counter cream LASER INSTITUTE, lines alongside breakouts, add these expert helps spot-treat small breakouts MIAMI, FLORIDA product picks to your beauty arsenal. without drying out your face. It goes into the pores to kill the acne-causing bacteria and helps with the prevention of new pimples.”

2. SCREEN TIME EltaMD UV Clear Broad-Spectrum SPF 46 Sunscreen Search for the slideshow Adult ($18.62) Acne: Popular Questions and Answers at WebMD.com. “This is an oil-free, lightweight sunscreen that calms and protects sensitive skin from 2 UV rays. It is recommended for patients who are prone to acne breakouts, rosacea, and discoloration. It contains a variety of vitamins and antioxidants that help give skin a healthy-looking glow.”

3. DOUBLE DUTY ROC Retinol ($19.99) “This retinol is naturally 1 derived from vitamin A, a key component in helping 3 rid skin of acne breakouts. It works by slowing down oil production in your skin, which can prevent future breakouts. Bonus: Retinols help reduce the appearance of fine lines by rejuvenating the collagen in your skin.”

4. POWDER PLAY Bare Escentuals bareMinerals Matte Foundation ($28.50) 4 “It is common for acne-prone women to apply liquid foundation or thick makeup to cover up their skin. But doing that is counterproductive—it further clogs pores, causing additional breakouts. These powders are applied with a brush and can help absorb acne-causing excess oil from your face.” PHOTOGRAPHY: RICK LOZIER; ILLUSTRATION: ULI KNORZER ULI ILLUSTRATION: LOZIER; RICK PHOTOGRAPHY:

21 WEBMD.COM BY Liesa Goins BEAUTY REVIEWED BY Mohiba Tareen, MD WebMD Medical Reviewer

ANATOMY OF… Dry Shampoo You don’t have to get into a lather to keep your hair fresh. Here’s how dry shampoo can save your strands.

SOAK IT UP It’s not really a shampoo, per se. Consider it a styling product that helps absorb dirt, oil, and product residue to refresh hair without water. Usually in aerosol form, dry SHAMPOO IN A CAN shampoo also can be dusted on like Liquefied petroleum gas a powder. (an alternative to outlawed chlorofluorocarbons) acts as HAIR HISTORY a propellant that launches the Dry shampoos usually contain a powders out of the can. Just don’t form of starch or clay that absorbs spray it near an open flame—it’s residue. The concept is similar to highly flammable. powdering wigs during the 18th century. The National Museum of SPRAY ON American History even has a dry Hold the can 6 inches away from shampoo in its collection. your head, aim at your roots, then brush through. If you’re too close, the HOW IT WORKS product can feel waxy and heavy. Denatured alcohol acts as a carrying agent that holds the ingredients in GIVE YOUR HAIR A LIFT suspension so the formula is spray- Spray on roots before going to bed able. It evaporates quickly, leaving to help fight oil. It’s also a shortcut the starches in place. for restyling hair after a workout. Those with fine hair can use dry shampoo to add volume or provide grip to keep an updo in place.

COLOR CONSCIOUS Skipping a wash can help extend the life of hair color. So swapping a traditional shampoo with a dry option can slow the fading process. GETTY IMAGES

22 WEBMD.COM HEALTHY TOGETHER Family SMARTER LIVING

HEALTH BOOST Fit Kids

Kids who exercise their body Do the Math also exercise their mind Research says that at least 20 minutes of exercise WANT TO GIVE YOUR a day can improve kids a boost for their math ability. physical health and their school skills? A recent study suggests that regular physical activity—at least 20 minutes a day—for kids who are overweight improves their math abilities without any extra studying. Even better, the more exercise your child gets, the more he might improve in math. Kids who exercised 40 minutes a day saw their math scores go up even higher. One- third of kids in the U.S. are overweight, and this is just one more reason to encourage your kids to get exercise every day. —HEATHER HATFIELD GETTY IMAGES

23 WEBMD.COM BY Stephanie Watson FAMILY Get the WebMD Pregnancy App REVIEWED BY Nivin C. S. Todd, MD and keep track every day until that WedMD Medical Reviewer special day.

PREGNANCY Do women with end of the first morning sickness trimester. But in have healthier some women it Easy Queasy pregnancies? stops sooner, and in The healthier a others it continues KRISTEN SHARP, MD Could morning sickness offer clues pregnancy is, the throughout the ASSISTANT PROFESSOR, OBSTETRICS AND GYNECOLOGY, to your baby’s health? Our expert more likely a woman’s entire pregnancy. UNIVERSITY OF WISCONSIN explains the connection and offers body is to produce SCHOOL OF MEDICINE AND some nausea relief tips. normal amounts of What can women do PUBLIC HEALTH beta hCG. So we for relief? expect those levels to Eating small, rise if a pregnancy is frequent meals can developing normally. be helpful. Settle Down Ginger tea and And with rising hCG Sometimes the ginger ale help levels comes more nausea gets worse alleviate nausea. So nausea. So in a sense, when you have does vitamin B-6. it can give clues about nothing in your the health of the stomach. Keep a box pregnancy. of crackers by your bedside so you can Could a lack of eat something when morning sickness you first get up. If signal a problem? certain foods or That depends on smells—like coffee— when it happens. set off your nausea, Morning sickness is try to avoid them. so variable from woman to woman. To calm the nausea, Some women don’t take ginger—such have it at all. Others as ginger ale and have such severe ginger tea. Vitamin morning sickness that B-6 and the sleep it’s debilitating. If the aid doxylamine nausea abruptly stops, (Unisom) can also sometimes that can help. Because this be a warning sign, but can make you it isn’t a diagnostic drowsy, you might indicator that some- want to take it at thing is wrong with night. Some studies the pregnancy. show that acupunc- What causes morning sickness? ture and acupres- The exact cause isn’t completely understood. We do know that morning sick- When does morning sure help with ness can be tied to the pregnancy hormone beta hCG. Women who have sickness ease up? morning sickness, increased amounts of beta hCG—for example, if they’re pregnant with twins— Usually it will start so they’re also tend to have more severe nausea and vomiting. to taper off by the worth trying.

4 Warning VAGINAL BLEEDING MENSTRUAL-LIKE CRAMPS DEHYDRATION SEVERE VOMITING Signs “Intense morning sickness CALL YOUR DOCTOR “Spotting or bleeding, “Early in your pregnancy, “If you’re so nauseated that severe cramps could warn can prevent you from IF YOU NOTICE ANY especially in your first you can’t keep down fluids, trimester, could be a of a miscarriage. Later on, you’re at risk for dehydration. eating. It becomes a OF THESE MORE problem when you can’t sign of a miscarriage or abdominal pain could mean Look for signs like decreased PROBLEMATIC you’re in early labor.” take in enough calories to SYMPTOMS, SAYS ectopic pregnancy.” urine, headaches, dizziness, support your growing baby.” KRISTEN SHARP, MD and severe fatigue.” GETTY IMAGES; ILLUSTRATION: ULI KNORZER ULI ILLUSTRATION: GETTY IMAGES;

24 WEBMD.COM BY Michele Cohen Marill FAMILY Search for Checklist: Get Prepared to REVIEWED BY Nivin C. S. Todd, MD Go into Labor at WebMD.com. WedMD Medical Reviewer

Q If I choose nitrous oxide, Labor Options can I also have Birth balls and a different kind warm baths can help you stay ASK YOUR of pain relief if I mobile—and more DOCTOR need it? comfortable— When you stop during early labor. Q I’m nervous breathing in nitrous about the pain. oxide, the effects How can I subside within five minutes. You can then reduce my fear? switch to a different Childbirth education may method. help. Or try enlisting a doula, or trained childbirth aide, to provide emotional Q What effect support and comfort will my pain techniques during labor. relief choice have on my Q What pain baby? relief do you All methods are safe and recommend for none should have early labor? significant effects on You may want to use a your infant, but always technique or medication ask your doctor to that allows you to walk clarify and confirm. and stay mobile.

Narcotics: If the pain becomes too great, an injection of a narcotic can take the edge off. (You won’t be pain-free.) Often it is mixed with PREGNANCY another medicine that reduces the side effects of nausea and vomiting. Narcotics can make you drowsy. But they are short-acting so the effect Pain Points wears off quickly. Your doctor will not likely give If you’re expecting, you may be worried about how you’ll you a narcotic close to the delivery time, due to make it through labor. Fortunately, moms-to-be have access potential risk to the baby. to many pain-relief methods. Epidural or spinal block: An anesthesiologist injects medicine through a narrow tube in your IN NEW RECOMMENDATIONS, THE AMERICAN CONGRESS OF OBSTETRICIANS lower back to block pain signals. Pain subsides and Gynecologists now says that women with low-risk pregnancies can safely within 10 or 20 minutes. Some women have a choose to have less medical intervention during labor. But that doesn’t mean no single spinal injection, which isn’t as long-lasting pain relief. About 60% of women have an epidural, but that’s just one possible (about two and a half hours) but does provide path. “An epidural is not a medical must,” says Jeffrey Ecker, MD, chief of immediate relief. You will remain alert but might obstetrics and gynecology at Massachusetts General Hospital in Boston. feel some numbness. Sometimes women have Women often develop a labor plan with advice from their doctor. Each headaches or backache after an epidural but the delivery is different, so be open to changing your mind. Pain varies based on technique is safe for the baby. the size and position of the baby and the strength of the contractions. Your Nitrous oxide: You control how often you choices for relief include: breathe a mixture of nitrous oxide and oxygen Comfort and support: Rhythmic breathing and relaxation techniques help you through a mask. It may ease but not eliminate cope with contractions. In early labor, a warm bath (close to body temperature) the pain, and possible side effects include can be soothing. Sitting on a “birth ball”—which resembles an exercise ball—can sleepiness, nausea, or dizziness. Your baby’s

GETTY IMAGES curtail the intensity of the pain. alertness won’t be affected.

25 WEBMD.COM BY Michele Cohen Marill FAMILY Get the WebMD Baby App to track REVIEWED BY Arefa Cassoobhoy, MD, MPH growth and capture your baby’s WedMD Medical Editor special moments.

Q If my baby can’t hear me, can I use sign ASK YOUR language? DOCTOR Babies can learn American Sign Language Q No one in my as their first language. family has a You can teach your baby hearing while you and your family problem. What are learning it. caused this? Low birthweight, Q My newborn premature birth, and some infections during passed the test. pregnancy can put Does that mean your baby at risk for he will have hearing loss. normal hearing? Older babies and children Young Ears can develop hearing loss In-hospital Q Is the hearing hearing tests from ear infections, injury, happen while loss part of or other causes. Ask for a your baby another screening if your child sleeps. problem? isn’t hearing well. Some babies with hearing loss have a genetic syndrome, such as Down syndrome. BABY The first, in-hospital hearing test isn’t loud or uncomfortable. Your baby will be tested while Hear This Out sleeping. (At the 3-month follow up, your baby Did your newborn fail his hearing screen? Here’s why the may receive sedation.) Tests take 10 minutes or result might not be as bad as you think. less and measure either sound waves or nerve response in the ear to a click or tone. JUST BEFORE LEAVING THE HOSPITAL, NEWBORN BABIES TYPICALLY You can’t always tell if your baby has a receive a hearing test. For most, the result adds to an overall report of good hearing problem. Your baby may have hearing health. But what if your baby fails? loss even if she is cooing, babbling, or seems “The first message is ‘Don’t panic,’” says Charles Bower, MD, chief of to respond to sound. Even mild or moderate pediatric otolaryngology at Arkansas Children’s Hospital in Little Rock. “Not hearing loss needs attention, Bower says. passing the screen does not mean your child has permanent hearing loss.” The test is set to detect as many cases of hearing loss at birth as possible, Babies can have hearing aids. They are usually which means some babies fail even though their hearing is fine. Other babies placed behind both ears to amplify sound. have temporary issues, such as fluid in the middle ear that hasn’t yet fully Hearing aid technology has improved greatly, and drained, left over from their time in a watery womb. they can be set to minimize background noise. Between 2% and 10% of newborns fail their first hearing screen, but fewer Babies can have implants when they are 1 than 1% have hearing loss. Still, that adds up to about 12,000 newborns each year. year old. Cochlear implants are an option if Finding those babies is important because language and speech development hearing aids don’t work and the hearing loss is begins at birth. Early intervention helps babies with hearing loss build normal profound. Placed under the skin behind the ear language skills. and in the cochlea in the inner ear, the devices If your baby failed, follow up with your pediatrician and arrange another convert sound into electrical impulses that the test with an audiologist by 3 months of age. Other things to know about auditory nerve transmits to the brain. Children

GETTY IMAGES babies and hearing: need therapy to adjust to the implants.

26 WEBMD.COM BY Heather Hatfield FAMILY REVIEWED BY Hansa Bhargava, MD WedMD Medical Editor

KIDS’ HEALTH Be Consistent How can you discipline a child with attention deficit hyperactive disorder in a way that helps teach better behavior? Strike the right balance between praise and privileges and use the rules consistently.

What strategies work being calm. How can I best when disciplining help you now?” A good Rule Breakers kids with ADHD? rule of thumb: If the At times, you might Setting clear expectations behavior isn’t bothering need to take away is an important part of you or creating problems a fun activity, like parenting kids with for your family, think playtime. ADHD—use the rules about letting it slide. consistently, and remind your child frequently so he What types of discipline understands and learns should I avoid? them. Then, praise your Only parenting your child child and let him earn with ADHD when he privileges for following the misbehaves will probably rules. When the rules not work. This creates a “Don’t are broken, the result is cycle in which the child simple—no privileges. knows he’ll get attention give up. When behavior really if he misbehaves. Yelling, Discplining requires a clear conse- lecturing, and spanking a child with quence, you might need to are probably not going to take away everyday activi- work either—these put ADHD isn’t ties as well, for instance, stress on both the parent easy, and reducing access to phones, and the child, which could results take TVs, or playtime. make the symptoms of

ADHD worse. time.” What behaviors can I let —JULIE S. OWENS, slide with kids with What can I do if disci- PHD, PROFESSOR OF PSYCHOLOGY, Why is discipline important for children with attention ADHD? pline just doesn’t work? CO-DIRECTOR, deficit hyperactive disorder (ADHD)? Ignore the little things Don’t give up. Disciplin- CENTER FOR Kids with ADHD have difficulty with instructions, that all kids do—with or ing a child with ADHD INTERVENTION maintaining focus, regulating their behavior, and RESEARCH IN without ADHD. Whining isn’t easy, and results take SCHOOLS, OHIO organization. Getting things done on time for kids with is a good example. time. Try a balance of UNIVERSITY ADHD isn’t easy either. So parents play an important role Annoying? Yes, but it’s praise and privileges, in creating structure: clear rules, feedback—both positive not a punishable along with consequences, and negative—and consequences to help kids with ADHD behavior. Instead, wait every day for two weeks, understand limits and learn how choices bring either for the child to stop, and and you should start to privileges or discipline. then say, “Thanks for see some benefit.

4 Tips BALANCE SMALL DOSES EMPOWER GET HELP HERE’S HOW JULIE OWENS, PhD, SUGGESTS TURNING “Strike the right balance “Don’t pile on the discipline. “After your child is disci- “Talk to others, attend a par- BAD BEHAVIOR INTO A between praise and disci- Take away TV for 10 plined, talk to him about ent group for kids with ADHD, LEARNING OPPORTUNITY pline in kids with ADHD— minutes—this gives you what went wrong. Help or talk to a behavior support they need both to learn room to add on more time him understand that if specialist—all will give you and understand limits.” if the behavior continues.” he doesn’t like losing a new ideas for parenting your privilege, then he should child and remind you that

GETTY IMAGES; ILLUSTRATION: ULI KNORZER ULI ILLUSTRATION: GETTY IMAGES; choose better behavior.” you’re not alone.”

27 WEBMD.COM BY Lisa Marshall FAMILY Search for the slideshow Girl to Woman: REVIEWED BY Arefa Cassoobhoy, MD, MPH Your Changing Body at WebMD.com. WedMD Medical Reviewer

Start Talking Information and support during puberty can help build self-confidence in girls.

PARENTING The Puberty Talk New research suggests mothers provide too little information too late, leaving girls feeling scared and unprepared. Here’s TALKING TIPS PUBERTY RESEARCHER MARNIE SOMMER what you can do. AND PSYCHOLOGIST JOHN CHIRBAN OFFER THESE TIPS FOR NAVIGATING DISCUSSIONS ABOUT PUBERTY WITH YOUR DAUGHTER.

EASE IN DON’T LEAVE IT Don’t feel like you TO OTHERS have to cover School sex everything at once. education WHY IS MY BODY CHANGING? WHEN WILL I GET MY FIRST PERIOD? I’M SO EARLY PUBERTY CAN MEAN HIGHER RISK If you notice body classes often moody; what’s wrong with me? Such questions are par for the course for girls The first signs of puberty now arrive earlier “Starting off with a sense of insecurity during odor, start talking don’t start until approaching puberty. But many girls aren’t getting the answers they need to than a generation ago. The average age of about hygiene. If fifth grade, after you notice breast- some girls have answer these basic questions. breast development among U.S. girls is this time can have a domino effect.” buds, go bra already started A sweeping review of 20 studies of lower-income U.S. girls, published in younger than 10, while the average age of shopping. Save talk developing. January in the Journal of Adolescent Health, found that the majority felt the a girl’s first menstrual period is 12.5 (that’s of menstruation While books can information they got about puberty was inaccurate, incomplete, or too late. 3.5 years younger than it was in 1860). “unwanted attention, touching or teasing” often as early as age 7 or 8, it’s time to get and sex for later. be helpful, “just The less prepared girls felt, the more likely they were to describe puberty Some 49% of African American girls and from male peers, wore baggy clothes to specific. Start talking not only about the throwing a book at your child can as “embarrassing,” “scary,” and “confusing.” The study (which focused on 15% of Caucasian girls show some sign of avoid it, and often felt shame and fear when physical changes in store, including skin BE SPECIFIC make them feel mothers specifically) also found that a mom’s approach to addressing pubertal development by age 8. Rising they got their period. changes, hair growth, and body odor, but ABOUT even more alone. MENSTRUATION puberty with her daughter mirrored her experience with her own mom, obesity rates, psychological stressors, and “Starting off with a sense of insecurity also the emotional ups and down that can They need your When preparing and that most mothers today feel unsure about when and how to bring the endocrine-disrupting chemicals are all during this fragile time can have a come with fluctuating hormones. “It’s help unpacking her for her first subject up. likely at play, research suggests. domino effect” later in life, says clinical normal to feel exuberant and excited it,” says Chirban. The results are troublesome, says lead author Marni Sommer, RN, an period, let her Girls who enter puberty early are more psychologist John Chirban, PhD, author one day and sad the next,” says Sommer. know it might start associate professor at Columbia University, because a girl’s experience with likely to have poorer body image and of How to Talk with Your Kids About Sex. Chirban recommends discussing why with spotting, be KNOW WHAT’S the onset of puberty can have a lasting impact on her social and sexual lower self-esteem and are at greater risk of In contrast, research shows that girls who menstruation happens and what to brown rather than GOING ON IN development and her attitude toward menstruation. depression and substance abuse later in life, feel prepared and supported are more expect from it during a separate, later red, and she may SCHOOL “Puberty is the cornerstone of reproductive development. If a child has an studies show. Sommer’s review collected buffered from such negative consequences, conversation (ages 9 to 11 on average but have cramping. Ask your child informed, supported, healthy transition that helps her build self-confidence dozens of girls’ comments and found that even if they get their period early. for some it could be earlier). Send her to what they talk school with pads instead of being ashamed, that can set her on a really good path,” she says. early-maturing girls in particular recalled Moms uncomfortable with the topic about in health or tampons, so class and what TALK EARLY AND OFTEN of puberty can get help from peers and she isn’t caught is going on with The takeaway: Don’t wait for your daughter books. (Chirban’s offers scripts for parents off guard. friends. These to come to you. of children age 8 and younger, 9 to 11, can all be great Chirban stresses that the earlier in life and 12 and older.) If Dad is charged with BE SPECIFIC springboards for you start subtly broaching the subject of handling the task, consider enlisting an ABOUT SEX conversations MENSTRUATION 101 sexual development, the less awkward it older sister, aunt, or other female role Don’t just explain about puberty. The age by which Average length will be to talk about when puberty arrives. model to help get the conversation started. that your daughter 98% of girls have of the menstrual As early as toddlerhood, bath-time Then be ready to listen. is physically able gotten their first cycle in the first to get pregnant conversations about hygiene can serve as “Let her know that you understand it can 2 to 3 period. If your child year. The first 3 to 6 now. Explain The average number of years between is 16 or older and 32 period typically The number of pads or tampons a a springboard to answer questions and be uncomfortable, but that it’s a natural physiologically the first sign of breast development hasn’t had one yet, lasts two to girl can expect to use in the course talk about how bodies develop over time. part of growing up and you’re available,” why. Illustrations and a girl’s first period. 15 consult your doctor. days seven days. of one day. GETTY IMAGES At the first signs puberty is coming on, says Sommer. can help. 28 29 WEBMD.COM WEBMD.COM BY Jodi Helmer FAMILY Search for the slideshow Risky Mistakes REVIEWED BY Will Draper, DVM Pet Owners Make at WebMD.com. WedMD Medical Reviewer

PETS ket, a spot on the sofa, Q Is this normal? or a hideout beneath Whether the dog eats the bed will all work. grass or the cat hides Say What? Since some cats like to under the couch, your be up high and others Have you ever wondered what your dog or cat would tell you if they could talk? Chances are vet will know if the prefer to be down low, ASK they’d ask for love, consideration, and plenty of healthy habits for a happy life. YOUR VET behavior is normal or a offer spots at a number sign something is wrong. of different heights. FOR YOUR NEXT “Pay attention when DOGS APPOINTMENT, Q Will training I tell you something.” VETERINARY MEDICINE “I need you to be a loving parent.” Your dog help? Your cat knows what EXPERT SHARON Share the Love relies on you for more than food, water, and CROWELL-DAVIS “If a pet is doing shelter. “Dogs have been bred to crave attention she wants—and she’ll Talk to your dog in an upbeat “Provide a scratching post—or else.” Scratching DVM, SUGGESTS something wrong, tone instead of yelling to help and affection from humans,” says Sharon Crowell- hiss, claw, or run off THREE QUESTIONS. helps cats trim their claws, mark their territories, don’t abandon them at her feel loved. Davis DVM, PhD, DACVB, veterinary behaviorist if she is forced into a and get a good stretch. To protect your furniture and a shelter,” Crowell- and professor at the University of Georgia. situation she doesn’t curtains, provide an appropriate place for cats to put Q Is my pet Davis says. “Most Speaking to your dog in an upbeat tone of like. Understanding their claws. overweight? behaviors can be voice and offering lots of belly rubs will help and respecting a cat’s “Cats don’t want to scratch on the couch but they Your vet will tell you if changed with training.” your dog feel loved. Avoid yelling, which can signals is important, will if nothing else is available,” says Corsun. your pet needs to shed a make your dog feel afraid. notes Corsun. “I need my space.” Cats are independent and need a “If she hides when few pounds and offer “I crave mental and physical exercise.” Dogs warm, safe place to call their own where they can retreat people come to vis- tips for healthy, love to play. Games of fetch, long walks, and if they need time alone, according to Corsun. it, don’t drag her out,” sustained weight loss. romps at the dog park are perfect activities Their needs are simple: A cardboard box with a blan- she says. for burning energy. But dogs also need mental exercise. Crowell-Davis suggests teaching dogs new tricks or using puzzle feeders to give their brains a workout, too. “My diet matters.” Dogs need a balanced diet and portion control. “Being overweight makes a dog’s joints hurt and can lead to diseases like diabetes,” Crowell-Davis explains. Your vet can recommend the right food (and serving size) based on your dog’s age, breed, and current weight. Offer treats sparingly. “Please take me to the vet.” Your dog might prefer going to the dog park or pet store over the vet, but Crowell-Davis believes dogs appreciate the health benefits of being up-to- date on vaccines (or at least—maybe—they enjoy the ride there and back). Your dog should have annual wellness checks.

CATS “Please clean my litter box.” If you want your cat to do her business in the litter box, keep it clean. Scoop the litter at least once, preferably twice, per day. Jen Corsun, manager of Cat World at Best Friends Animal Society, recommends one THERE’S NO SHORTAGE OF VIDEOS, CARTOON STRIPS, AND MEMES “TRANSLATING” litter box for each cat plus one extra. So, one what pets think. But our experts make some educated guesses about what the cat should have access to two litter boxes, and dog or cat in your life would like you to know. three cats need four litter boxes. GETTY IMAGES

30 WEBMD.COM Actor and comedian KEVIN HART goes all in on his work, fitness regimen, and life. He wants you to do the same.

BY Kara Mayer Robinson REVIEWED BY Michael W. Smith, MD, CPT, WebMD Chief Medical Editor

COMIC POWERHOUSE KEVIN HART IS BIG. REALLY, REALLY BIG. OK, sure, at around 5'4", he comes in a compact package. But his personality and following are huge. The megawatt comedian consistently sells out football stadiums and arenas. He’s a box-office smash, with films like Get Hard, Ride Along, and The Secret Lives of Pets grossing more than $3.5

PHOTOGRAPHY: ART STREIBER/AUGUST ART PHOTOGRAPHY: billion. He has 105.9 million—million!—

32 WEBMD.COM “THIS IS MY HOW LIFESTYLE HEALTHY ARE social media followers. His new memoir, I —ALWAYS WANTING TO Can’t Make This Up: Life Lessons, climbed AMERICANS? IMPROVE, ALWAYS to the top of Barnes & Noble’s bestseller list four months ahead of its June 6 release. For most of us, 30 minutes most days One in three Americans This is no accident. When Hart takes of the week is a good target, says Aparna gets enough exercise. WANTING TO on a challenge, he goes full throttle. With Asher, MD, a family physician with Davita That’s 150 minutes of mottos like “The sky’s the limit” and “No Medical Group in St. Petersburg, Florida. moderate activity or 75 minutes of intense activity DO MORE AND GET days off,” no one should be surprised he’s But if you’re super-active like Hart, factor every week. BETTER.” skyrocketed into the stratosphere. in time for recovery. “You need a break,” “Always putting forth the best effort Asher says. For every six days of high- possible is what my life is about,” says Hart, octane exercise, take one to two days off.” Most adults don’t eat 37. “I’m pure proof that quitting is not a Hart is committed to eating well, too. A enough fruits, vegetables, choice. This is my lifestyle—always wanting typical meal includes chicken, brown rice, and whole grains. That’s about 2 cups of fruit, 2 to to improve, always wanting to do more and and asparagus. “It’s always chicken. Maybe 3 cups of vegetables, and get better.” turkey burgers or turkey meatballs every 3 to 4 ounces of whole once in a while,” he says. grains a day. About 58% of MOVING “At this point, I’m a machine. I put a adults say they should eat NONSTOP heavy demand on my body,” Hart explains. healthier than they do. Hart employs this philosophy in just about “We’re talking about a guy who does any-

every corner of his life, including his health. where from 12- to 13-hour days. You can’t Heart disease is the His fitness regimen is serious business. ask your body to constantly give you results No. 1 cause of death in the Whether it’s running, boxing, CrossFit, if you’re not putting good things into it. It’s United States, affecting core work, or weight lifting, he’s all in— not something I hop in and hop out of. It’s 27.6 million people. typically seven days a week, with only one a way of life.”

to two days off per month. Asher gives this a thumbs-up. For About 12.6% of When he’s shooting a movie—like starters, a diet high in fruits, vegetables, American adults have Captain Underpants: The First Epic Movie, whole grains, and lean protein is linked diabetes. One-quarter of out this month, or Untouchable, which to a longer, healthier life. Hart’s lifestyle people living with diabetes he recently filmed with actor Bryan approach is equally stellar. “Healthy living don’t know they have it. Cranston—he doesn’t let up. “I treat it like is not a fad. It’s a mindset. It’s what you do

boot camp,” he says. “I work out in the every single day,” Asher says. One-third of adults morning, and I’ll work out on my lunch Hart does fess up to one guilty pleasure: have an annual checkup. break in my gym trailer.” That’s right—his fried chicken. “That’s the one thing,” he It’s the top reason they visit gym trailer. Most Hollywood A-listers have says. “Oh, man, Popeyes, KFC, home- a doctor. a mobile dressing room, or trailer. But Hart made—it doesn’t matter. Anyone who eats also sets up a temporary gym. it around me is in trouble!” Fewer than two in three “I’m pretty much nonstop,” he admits. adults get enough sleep “But my days don’t feel right if I don’t feel PASS IT ON on most nights. That’s like I’ve put the most into it, into building With so many fans watching his every seven hours or more. Lack me and working on me as much as possible.” move, Hart wants his “all in” attitude to rub of sleep is linked to obesity, Hart puts more time in than most. Fewer off—and he’s making it happen. diabetes, high blood than 5% of Americans get 30 minutes of Hart recently signed with Nike to create pressure, heart disease, stroke, and mental distress. exercise five days a week, the official recom- Move With Hart, a program that inspires mendation. Exercise is key for warding off people to be active with training apps, conditions like heart disease, diabetes, and clubs, events, and podcasts. Nike also Seven in 10 adults stroke; recent studies suggest it may also designed a shoe embellished with Hart’s brush their teeth at least

PHOTOGRAPHY: JEFF LIPSKY/CPI SYNDICATION LIPSKY/CPI JEFF PHOTOGRAPHY: improve memory and slow cognitive decline. twice a day. About 23% of Americans say they’ve skipped brushing their teeth two or more days in the past year.

34 35 WEBMD.COM WEBMD.COM “I ENGAGE WITH “There’s impromptu runs as well as MY FANS. I’M PUTTING workouts. I’ve done beach workouts where I’ve just popped up, me and my trainer. It PEOPLE IN THE could be any afternoon to say, ‘I’m about BEST POSITION TO WANT to hit Central Park to do a quick five miles. Come join me,’” he says. “You’d be surprised Hart’s harmonious home life lies in TO BE BETTER. ” favorite motivating phrases, called the Nike at the turnout. stark contrast to his childhood. His family Free Train Instinct Hart. “I consider myself an entertainer who’s lived in a rough neighborhood in North In 2015, Hart partnered with Rally approachable,” he adds. “I engage with my Philadelphia. His father struggled with Health, a digital platform to help people be fans. I’m putting people in the best position drug addiction and was in and out of jail. active, improve their diet, find doctors, and to want to be better. It’s just something I His mother worked hard to keep him off shop for health benefits. As an ambassador, love to do.” the streets. he appears in health tip videos and hosts Life wasn’t easy. “But at the same time,” he RallyFest, a live event with free boot camp TURN UP THE says, “it’s what develops character. It’s what classes, yoga, massages, and kids’ attrac- LAUGHS made me the man I am today. I don’t believe tions. A whopping 10,000 people showed Lately, Hart also has comedy on the brain in crying over things that can’t be changed. I up at last year’s festival in New York, where —in a big way. just believe in evolving and developing.” Hart’s personal trainer led workouts and He’s building up to an hour-long comedy Taking a positive approach is his default, Hart sweated it out alongside everyone else. special, so in his spare time he often hits Hart says. His work ethic and will, howev- “Kevin has a real gift for inspiring people random comedy clubs—unannounced—to er, are gifts from his mother. “Nancy Hart and bringing everyone to their feet,” says perfect his act. “I love doing the unexpect- put 100% into making me the man that I Grant Verstandig, Rally Health founder ed,” he says. “Giving people that surprise am today. Without her I wouldn’t be where and CEO. “Changing a diet or adopting a and doing a good 30 or 40 minutes? It’s a I am in life,” he says. healthy behavior can be hard, but when you different ballgame. People love it.” Hart is determined to pay it forward. have someone who can connect with people While Hart loves to get out and make Whether it’s to inspire others that persever- the way Kevin can and is offering encour- people laugh, he’s equally happy staying in. ance pays off, the sky’s the limit, or better agement, all of sudden taking that first step “I’m a homebody,” he says. “I’m a married health is within reach, Hart intends to put feels easier.” man. I love to be with my wife. I love to be his big voice to good use. Sometimes Hart gets people off their with my kids.” “I know the platform that I’m on. I know couches on the fly—like when he tweeted Last year Hart, who lives in Los Angeles, the eyeballs that are watching. So it’s not to his millions of followers that he’d be tied the knot with longtime girlfriend just for myself, but to act as a constant running an informal 5K the next morn- Eniko Parrish. His daughter, Heaven, is 12, example for other people,” he says. “I want ing, and anyone in Boston who’d like to and son, Hendrix, is 9. Rounding out the to know that I’m doing a lot more than just join him could meet him at the Chestnut family are Roxie, a Doberman pinscher, making people laugh.” Hill Reservoir at 8:45 a.m. Hundreds and Riggs, a miniature pinscher. Together Search for the slideshow The Best Flat-Abs happily complied. time often involves tacos, Jenga, and the Moves for Men at WebMD.com. whole gang piling into one bed to watch TV. “Less is more,” he says. “It’s just about being with each other.”

Top left: Speaking at KEVIN HART’S Nickelodeon’s 2017 Kids’ Choice Awards. HEALTHY LIVING TIPS Middle left: Attending Just For Laughs Comedy PRO last year. Middle right: Joining his LIVE LAUGH LOVE personal trainer, Ron “Boss” “Live life to the fullest by “Don’t take anything too “Love is simple and self- Everline (left), at a “Move with giving yourself all chances to serious, to the point where you explanatory. You’ve got a heart Hart” session in March. succeed—at the highest level— can’t smile. No matter how for a reason. Go hug somebody. Bottom: Being honored with a star on the Hollywood Walk at what you do. You can’t do angry you are, life is going to Go tell somebody you love of Fame as Director Tim Story, that without an effort. Put that go on. It’s not going to stop for them. It’s contagious.” rapper/actor Ice Cube and effort in.” you. Take a chance. Show your producer Will Packer look on. teeth and smile.” GETTY IMAGES

36 37 WEBMD.COM WEBMD.COM BY SONYA COLLINS SONYA BY EDITOR MD, MPH, WEBMD MEDICAL CASSOOBHOY, AREFA REVIEWED BY DNA

CAN YOU ROLL YOUR TONGUE? Do you have a widow’s peak? Does peppermint OUR make you sneeze? The answers are written in your DNA—along with a host of other A NEW GENE- assembly instructions that give you certain traits, skills, and susceptibilities. Your DNA also contains EDITING information about your health—both your current status and your risk of developing certain diseases TECHNIQUE in the future. Genetic testing can tell you whether you have KNOWN AS certain genes related to increased disease risk. In CRISPR MAY some cases, that knowledge can help you make decisions about prevention. But what good is ONE DAY ALLOW knowing your risk for diseases such as macular degeneration, Huntington’s disease, Parkinson’s, SCIENTISTS T0 or Alzheimer’s if you can’t (at least currently) definitively prevent them? DELETE DISEASES Now consider this: What if a procedure could rewrite the DNA that says you’re likely to develop a FROM OUR particular disease? Or rewrite the DNA that caused the disease you’re living with right now? Scientists GENETIC CODE are doing exactly that in labs around the world. They’re using a new gene-editing technique called CRISPR/Cas9—or simply CRISPR—to revise the DNA of animals and plants and even human cells in

38 REWRITING 39 WEBMD.COM WEBMD.COM petri dishes. Now in early clinical trials of DNA in plant, animal, and human don’t have the disease,” says Charis Eng, genes puts the pressure on bioethicists in humans in the United States and cells to edit away parts that could MD, PhD, who is chair and founding and regulators to address a bevy of OTHER DISEASE IMPLICATIONS abroad, CRISPR could one day offer a cause disease or other problems. director of the Genomic Medicine concerns about the technology in a hurry. CRISPR gene-editing has the potential to help people living with any gene-driven cure for a host of diseases. This DNA-cutting process includes Institute at Cleveland Clinic. First, the technology may run the risk disease. These conditions may be among the first in line. “Whether it relates to treating disease, two main steps. A messenger molecule Researchers are trying out CRISPR of “over-editing” the genes, says Eng. editing crops, or doing basic genetics attaches itself to the DNA of a cell in many diseases. The first attempt to “While we are editing the gene that we experiments, CRISPR is broadly useful and highlights the exact spot on the use the technique in humans began want to, there could be off-target effects, DISEASES OF THE EYES lifelong condition that causes chronic in many different platforms,” says Sam genome that needs to be cut. Then last October in a clinical trial in China. so you might be editing another [very Researchers have edited the genes of pain, fatigue, inflammation, and other Sternberg, PhD, a biochemist and another enzyme comes to that spot and Scientists injected CRISPR cells intended similar] gene and not even know it, CRISPR expert who completed his cuts the strands of DNA. to destroy non-small cell lung cancer into introducing a second or third mutation diseased eye cells in animals. They have also health problems. doctorate in the lab of Jennifer Doudna at After the DNA is cut, the cell realizes a patient with an aggressive form of the into the gene.” successfully edited human stem cells that University of California, Berkeley, where its DNA is damaged and tries to disease. They don’t have results yet; the It would be difficult to predict the could be transplanted into diseased eyes. BETA THALASSEMIA CRISPR technology was developed. He repair it. Scientists can use the cell’s study is still recruiting participants and consequences of that inadvertent editing. Researchers have corrected the is now a scientist at Caribou Biosciences, built-in DNA repair machinery to then will be complete in April 2018. Before CRISPR can be ready for use in VARIOUS CANCERS gene mutation for beta thalassemia Inc. “I’m excited about the ways in which introduce the changes they want to In the first CRISPR trial to get the green humans, “We have to be certain that the Phase I clinical trials already underway in human cells in petri dishes. This CRISPR could directly improve human make to that genome. light in the U.S., doctors at the University benefits outweigh any risks,” says Eng. in China and slated to start recruiting blood disorder leads to lack of oxygen health for individuals who are currently This type of gene editing, like using of Pennsylvania will test the safety of Researchers at several institutions living with disease.” word-processing software to delete or CRISPR therapy in 18 people with various patients in the U.S. will test CRISPR- in many parts of the body. are exploring techniques to ensure that based treatments in various cancers. correct a typo, can shut off a gene or cancers; the trial has not yet started. CRISPR cells edit only their specific targets. CYSTIC FIBROSIS HOW DOES CRISPR WORK? change the order of its genome letters. Elsewhere, scientists are searching With a single treatment, researchers for a CRISPR-based cure for HIV. SICKLE CELL ANEMIA Researchers have used CRISPR to edit Almost every cell in your body has a recently cured a rare liver disorder Attempts so far have failed. Still, ETHICAL CONCERNS In experiments with human cells in petri cells in petri dishes containing the gene genome. Your genome is your complete in mice by editing the mutated gene scientists are pressing on. Technical glitches aside, CRISPR gives dishes, researchers have used CRISPR to defect that causes cystic fibrosis, an set of DNA—all 6 billion letters. The that caused the disease. CRISPR Cancer and HIV are just the tip of the humans a power to manipulate life that letters A, G, C, T stand for the chemical successfully correct the gene mutation inherited life-threatening disease of the might also help researchers make proverbial iceberg. “The research is so they have never had before. Whether it’s bases that make up DNA. They are that results in sickle cell anemia, a lungs and digestive system. more specific antibiotics that can widespread,” says Eng. “You name it.” for use in people, crops, or entire insect arranged in pairs that form the rungs Scientists are studying the potential of kill disease-causing bacteria without populations, CRISPR raises countless of the ladder you may recognize as CRISPR to combat countless problems eliminating good bacteria. ethical questions. DNA’s double helix formation. The in plants, animals, and cell cultures down to offspring for all generations to scientists to hold off on gene editing While the researchers who developed unique order of these letters makes (cells living in petri dishes). come. Some argue that humans should intended to enhance an otherwise this method of gene editing are interested each person unique. Think of it as your TREATMENT FOR DISEASES not have this level of control over human healthy genome. That is, don’t create in advancing science and potentially cur- very long, personal barcode. If successful, CRISPR could one day RISKS VERSUS BENEFITS reproduction under any circumstances. designer babies just yet—a concept To edit your DNA, scientists use a edit away virtually any illness driven by ing human disease, the same technology Even those who would support editing that’s still very far away from becoming process they observed in e. coli bacteria. a genetic mutation—be it in the DNA in CRISPR isn’t science’s first method of would theoretically allow specialists to DNA in the name of disease prevention a realistic possibility. E. coli has a built-in immune system your own cells or in the cells of a virus gene-editing. But it is the easiest, most edit DNA in eggs and sperm and create might ask where to draw the line. Given the potential benefits, CRISPR- that enables it to destroy viruses that has invaded your body. The BRCA1 precise, and most broadly applicable. “designer” babies in vitro. The National Academies of Science based cancer treatments might be among the that may try to attack it. CRISPR gene that substantially increases risk “It makes what was once an arduous, According to Eng, there may be some and Medicine acknowledged this least controversial and perhaps the first that refers to the DNA for breast cancer? The genes that cause time-consuming, and costly process things in an egg’s or sperm’s DNA that it question in a recent report. The doctors may be able to offer their patients. sequences in the cystic fibrosis? Muscular dystrophy? into something that is very fast and would be unethical not to change. “If you Academies support continued research “I suspect that any concerns may IF THIS WORKS, IMAGINE CORRECTING GENE MUTATIONS SO THAT YOU CAN TURN AN INHERITED DISEASE INTO… SUDDENLY YOU DON’T HAVE THE DISEASE.

bacteria’s genome that help it identify Their genetic codes, found in your very inexpensive. In addition, we now can turn a lethal disease or, even worse, into gene-editing aimed at treating and disappear when it threatening viruses. When the system genome, inside almost every cell in your know that these CRISPR components a disease that does not claim life quickly preventing disease in cells that are not comes to treating is triggered, the bacteria cut the DNA body, could be snipped out. work effectively in different cell types,” but rather leads to a life of misery, would passed onto offspring. They support living patients by editing their DNA,” says of the offending virus in half. Scientists “If this works, imagine correcting says Sternberg. it not be good to do something?” she asks. research into editing inherited genes Sternberg. “If CRISPR allows scientists are now learning to use that same gene mutations so that you can turn an The speed and ease with which But editing the genes of eggs and sperm only in the case of serious diseases and and doctors to prevent suffering, then DNA-cutting process to cut sections inherited disease into…suddenly you CRISPR allows researchers to edit changes the DNA that would be passed disabilities. But the report admonished why shouldn’t we support it?”

Search for the video What Is Precision Medicine? at WebMD.com.

40 41 WEBMD.COM WEBMD.COM BY MATT SMITH REVIEWED BY AREFA CASSOOBHOY, MD, MPH WEBMD MEDICAL EDITOR

CAN A PILL SLOW THE EFFECTS OF AGING? SOME DRUGS ALREADY SHOW PROMISE FOR IMPROVING THE HEALTH OF THE BODY’S CELLS.

FOR AN HE NO. 1 RISK FACTOR FOR all the big diseases—cancer, heart disease, Alzheimer’s—is aging. But instead of treating T the diseases, could a drug treat the aging process itself? That’s the idea behind a growing area of research drawing extensive support from both government and private donors, including millions from Silicon Valley executives like Microsoft co-founder Paul Allen and venture capitalist Peter Thiel. While federal science agency budgets have struggled in the past decade, funding at the National Institute on Aging has risen more than 50% since 2007. Researchers are seeking a drug to push back the most serious consequences of aging—and GETTY IMAGES

42 WEBMD.COM keep people healthy, active, and alert years smoking and [other factors], but who didn’t of a low-calorie diet, something researchers disorders like Alzheimer’s. longer, a notion they call health span. have diabetes,” says Steven Austad, PhD , say can extend lifespan in laboratory animals. But rapamycin has some powerful side “I’m not interested in creating a pop- chairman of the biology department at the effects. It can cause mouth sores, cataracts, ulation that lives to be 200, because that University of Alabama at Birmingham. “It Rapamycin and diabetes. It can also raise the risks of would be a problem for the world we live turned out the diabetics on metformin Biologist Ross is one of several scientists infection, bleeding, and some types of can- in,” says Corrina Ross, a biologist at Texas were living longer than the non-diabetics who has looked into the potential life- cers, such as skin cancer. It can cause high A&M University in San Antonio. “But if we who were not on metformin. ... It was very, extending effects of rapamycin. This blood pressure, fever, and anemia. can keep people out of nursing home care very intriguing.” potent drug, also known as sirolimus and Kennedy says much of the rapamycin and reduce the number of Alzheimer’s and Austad is a biogerontologist and scientific the brand name Rapamune, is most often research now underway aims at figuring Parkinson’s patients—that would be ideal.” director of the American Federation for used in chemotherapy and to keep the out how to reduce these side effects. What What scientists know about Aging Research. The organization is trying bodies of transplant patients from rejecting researchers know about the drug’s side effects Preventing mitochondria aging has advanced sharply in to raise about $65 million in federal and a new organ. Studies show that the drug comes from people who already have serious running wild and burn- the past two decades, as private funding for what Austad says would can extend lifespan in mice, roundworms, health problems and who usually take the they learn more about be the first human trial of an anti-aging drug. and marmosets, a drug in combination with other drugs. But ing out can head off species of monkey. they don’t know whether those same issues effects like inf lam- Like metformin, would happen in healthier people taking mation—a com- rapamycin works rapamycin on its own. on a cell’s mitochon- So while rapamycin appears to pro- mon contributor dria, where it may duce more dramatic results, metformin is to age-related change how cells likely to get a clinical trial in humans first, Other contenders diseases. burn glucose, Ross Kennedy says. says. Researchers “Metformin has been in millions of peo- suspect rapamycin Beyond metformin and ple. It’s pretty safe as drugs go,” he says. And rapamycin, research has looked can keep the mito- as doctors and scientists delve deeper into chondria running at the potential anti-aging role anti-aging research, “the last thing we want is of various drugs, hormones, and smoothly longer. a drug that’s going to cause toxicity and have “The image I food compounds, with mixed or something like that happen, because that’s teach to my stu- uncertain results: going to set the whole deal back.” dents is the idea of a Ross’ marmoset study, published in 2015, Reservatrol, a compound found in factory running out was the first to look at rapamycin’s side effects grapes and nuts, may reduce stress that of control, and it’s in healthy primates. Like humans, marmo- leads to cell aging. Research shows it just spewing stuff sets have a higher risk of heart problems and can extend lifespan in yeast, worms, out the windows, metabolic illnesses when they’re obese. The and fish, but researchers haven’t seen and you’ve got a study found no notable metabolic problems these effects in humans yet. negative cascade in a group of the monkeys who received rapa- effect,” Ross says. Acarbose, a diabetes drug that Researchers would give the drug to people mycin in human-equivalent doses for a year, what drives the aging process within cells. Preventing mitochondria running wild can block the body’s absorption of ages 65 to 80 with no chronic conditions, then and they lost significant amounts of body fat With the race on to find an anti-aging pill, two and burning out can head off effects like carbohydrates, shows promise in male wait to see how long it takes until their next in the early months. of the most promising candidates are drugs inflammation—a common contributor to mice but did little for females, says major health problem shows up, Austad says. As the search for an anti-aging drug goes that already exist: metformin and rapamycin. age-related diseases. biologist Brian Kennedy, PhD. Metformin Scientists believe the drug works in the Rapamycin “works in everything from yeast on, scientists keep their eye on the end goal. mitochondria, the powerhouses in the body’s to mice. It works in multiple mouse strains Kennedy says being able to prevent some of A hormone called 17-alpha Doctors have prescribed metformin, the cells that convert sugars like glucose into and backgrounds. It works in both sexes,” the most debilitating age-related illnesses estradiol—a type of the female most common drug to treat type 2 diabetes, energy. Austad says metformin makes those says biologist Brian Kennedy, PhD, former holds out the hope of a better life. hormone estrogen—shows promise for about 60 years. But it’s received new powerhouses run more efficiently, reducing the president of the Buck Institute on Aging in “We’re better at keeping people alive with for extending longevity in mice, says attention as a possible anti-aging drug after release of substances known as free radicals. Novato, California. “I think it’s really exciting.” various diseases of aging, but we rarely bring says Steven Austad, PhD. However, researchers in Britain found that people with Those compounds can damage cells, impairing For example, the drug has extended them back to full health,” he says. “I think the side effects haven’t been diabetes who took it outlived some of their their ability to reproduce or causing defects. lifespan in mice by 30% to 50%, Austad it’s going to be much better for the quality investigated enough to determine peers who did not have the disease by 15%. Metformin may also activate an enzyme says. And multiple animal studies show its of life of the individual, and much better what risks it may pose. “They compared them to a whole bunch that regulates the body’s demand for energy. promise for protecting against cancer and economically, if we can just keep them from of people who were matched for weight and Austad says that activation mimics the effect heart disease, as well as degenerative brain getting sick in the first place.” GETTY IMAGES

44 45 WEBMD.COM WEBMD.COM ADVERTISEMENT HEALTH HAPPENINGS Products, Ideas & Promotions for Healthy Living

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SUMMER TREAT Sweet Tart Thought to originate in Asia, these fab fruits were likely carried to Europe by birds and to America by English colonists. Chock-full of disease-quashing compounds, cherries make a succulent snack for hot summer days.

CHEER UP, FRUIT FANS: Cherries are back in season. These vibrant stone fruits not only taste delicious but also offer a decent amount of vitamin C (16% of an adult’s daily value per cup) and fiber (12% of an adult’s daily value per cup). Their deep red hue comes from disease-fighting antioxidants known as anthocyanins, potent plant chemicals that appear to slow cancer cell growth and quell inflammation. Some research suggests that the red pigments in tart cherries may also ease arthritis pain and headaches. All good reasons to start enjoying. —ERIN O’DONNELL

Fruit Fact Most Americans eat about two pounds of cherries annually. GETTY IMAGES

47 WEBMD.COM BY Erin O’Donnell FOOD Search for the video 7 Tasty Zucchini RECIPES BY Kathleen Zelman, MPH, RD, LD Recipe Ideas at WebMD.com.

3 WAYS Summer Squash 1A SUPER SOUP 2THE LIGHT LUNCH 3THE MAKE-AHEAD MEAL Get to know these delicious yellow and green Squash and Corn Chowder Grilled Squash Salad Summer Casserole squash varieties, such as crookneck and patty pan, In addition to squash, this flavorful soup features other summer It’s summer, which means it’s time to fire up the grill. Here tender Bake this one-dish recipe starring summer squash early in the favorites, such as corn and scallions. Serve the soup warm or cold with squash gets the chance to sizzle and top a light salad, offering a day while it’s cooler, then serve for lunch with a green salad on ripening now. They’re inexpensive, calorie-light, a crusty whole grain roll. tasty way to boost the veggies in your day. the side. and brimming with beneficial antioxidants.

THE MIX THE MIX THE MIX Summer squash + Summer squash + Summer squash + eggs, scallions, potatoes, arugula, grape mayonnaise, carrots, red corn, whole milk, tomatoes, lemon, pepper, cheddar cheese, fresh thyme olive oil, goat cheese cornflakes

MAKE IT Heat a large pot over chopped squash, and 2 cups each MAKE IT Slice 6 medium squash 2 tbsp each of lemon juice and MAKE IT Combine 2 eggs with egg mixture, and a sprinkle of medium heat. Chop 1 bunch of chopped yellow potatoes, corn, and lengthwise. Lightly brush squash olive oil with salt and pepper 1/2 cup mayonnaise. Add 1 cup sharp cheddar. Repeat. Over scallions, setting the green tops whole milk. Simmer, uncovered, slices with olive oil, and grill each and toss with arugula and halved grated carrot, 1 finely chopped the top layer, sprinkle 2 cups of aside for later. Add oil to the pot until potatoes are tender, about 15 piece until tender, 3 to 4 minutes grape tomatoes. Place salad on red pepper, 1 finely chopped crushed cornflakes tossed with 2 and sauté scallions with 2 stalks minutes. Add 1 tbsp fresh thyme. per side. Remove from heat. six plates. Top with grilled squash. onion, salt, and pepper. Thinly tbsp melted butter. Bake at 350°F chopped celery. Add 3 cups each Garnish with chopped scallion tops (Chop into bite-size pieces, if you Garnish with fresh mint and goat slice 2 lbs squash. In a sprayed for 45 minutes, until golden. low-sodium chicken stock and and crumbled bacon. SERVES 6 like.) Make dressing: Combine cheese crumbles. SERVES 6 2-quart baking dish, layer squash, SERVES 6

PER SERVING (1 ½ CUP) | 201 calories, 10 g protein, 27 g carbohydrate, 8 g fat (2 g satu- PER SERVING (1 ½ CUP) | 126 calories, 5 g protein, 8 g carbohydrate, 9 g fat (2 g satu- PER SERVING (1 CUP) | 228 calories, 8 g protein, 22 g carbohydrate, 13 g fat (6 g satu-

rated fat), 8mg cholesterol, 4 g fiber, 8 g sugar, 310 mg sodium. Calories from fat: 34% WORTHINGTON CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY: rated fat), 4 mg cholesterol, 3 g fiber, 4 g sugar, 252 mg sodium. Calories from fat: 66% rated fat), 94 mg cholesterol, 4 g fiber, 7 g sugar, 389 mg sodium. Calories from fat: 48%

48 49 WEBMD.COM WEBMD.COM BY Matt McMillen FOOD Sign up for the Daily Bites Newsletter REVIEWED BY Hansa Bhargava, MD at WebMD.com. WedMD Medical Editor

MAKE IT • Start with good quality 80/20 ground beef. The ideal size: 4- to 8-ounce patties per person, depending on the appetite of those you’re serving.

• When forming a patty, work with cool hands in a cool room; otherwise, the fat may melt and leave you with a grainy burger.

• Shape the patty so that it’s round and flat with straight sides so that it cooks evenly.

• Make a shallow dimple in the center of the patty to help it keep its shape as it cooks.

• Get the grill or cast iron pan really hot to get a good sear on each side. Use canola oil, which can handle higher heat than many other cooking oils, to grease the grill grates or pan. OFF THE MENU • Cook until you’ve seared each side a nice dark golden brown. If you have a good instant-read thermometer, Build a Better Burger check the temperature of the meat. An all-American food, hamburgers appear simple: A patty of Medium rare is about 160°. cooked ground beef slipped into a bun. But to master the art of • When done, let the burger rest on a rack (not in its juices) for two to three burger-making, you need to learn several essential lessons. minutes. That’s a good time to toast the bun—Husbands recommends ANDY HUSBANDS MADE HIS FIRST HAMBURGER 38 YEARS AGO, AT AGE seeded potato buns—and prep your toppings: ketchup, mustard, 10. A chef and author of Wicked Good Burgers and the just published ripe tomato slices, and crisp lettuce Pitmaster, Husbands takes the subject very seriously: “I think about burgers leaves. Want something a bit out of ANDY HUSBANDS, a lot,” he says. “The meat and how it’s cooked, the toppings, the bun—it’s the ordinary? Try sauerkraut, chopped CHEF, OWNER, olives and pickles, grilled romaine TREMONT 647, the whole package that makes a fine burger.” Incorporate his tips to build a lettuce, or salmon roe mixed with a BOSTON better burger in your own kitchen or on your outdoor grill. little bacon, shallots, and fresh dill.

Summery Sorbets

REGISTERED DIETITIAN CAROLYN O’NEIL, MS, LD, AND AUTHOR OF CIAO BELLA WHOLE FRUIT TALENTI ROMAN GELATO FIASCO HAAGEN-DAZ ZESTY SLIM DOWN SOUTH, SORBETTO SICILIAN SORBET RASPBERRY SORBETTO RIPE LEMON PRESENTS HER FIVE BLOOD ORANGE STRAWBERRY MANGO FAVORITE SORBETS, REFRESHING, HOT “This sorbet sings with “Low in sugar for a sorbet, “This sorbet boasts true “Made from the sweetest ”Balanced with sweetness, WEATHER TREATS bright, citrusy notes of it’s loaded with whole raspberry flavor, fresh variety of vitamins A- the lemon’s lip-puckering WITH FEWER blood orange, which fruit, its flavor deepened and refreshing. And the and C-rich mango, this tartness will encourage CALORIES THAN packs a nutrition punch with ruby red strawberry delicious fruit adds a sorbet tastes intensely you to slow down and REGULAR ICE in the form of vitamin puree. Top with a healthy bonus: 3 grams of fresh tropical fruit. savor a small serving. CREAM. C. Pair with a square of spoonful of tangy vanilla of fiber per serving.” Garnish with pomegran- Sprinkle with a little lemon dark chocolate.” Greek yogurt.” ate seeds.” zest for a citrus boost.”

THE OPINIONS EXPRESSED IN THIS SECTION ARE OF THE EXPERTS AND ARE NOT THE OPINIONS OF WEBMD, WEBMD DOES NOT ENDORSE ANY SPECIFIC PRODUCT, SERVICE, OR TREATEMENT. KNORZER ULI ILLUSTRATION: WORTHINGTON; CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY:

50 WEBMD.COM BY Kerri-Ann Jennings FOOD Search for the quiz Grilling Test: Check REVIEWED BY Hansa Bhargava, MD Your Cooking Skills at WebMD.com. WedMD Medical Editor

FOR THE WEEK 1 Day, 5 Meals: Grilled Veggies FIRE UP THE GRILL AND COOK UP A WEEK’S WORTH OF VEGGIES. THINK BASKETS OF CHERRY BREAKFAST SMARTS TOMATOES AND BUTTON MUSHROOMS, SLICED EGGPLANT, STEMS OF ASPARAGUS, WEDGES OF BELL PEPPERS, PLANKS OF ZUCCHINI, AND WHOLE SCALLIONS. YOU CAN EVEN GRILL ROOT Make Ahead VEGETABLES LIKE POTATOES, CARROTS, AND RADISHES. COOL, CREAMY OVERNIGHT OATS TAKE A WINTER STAPLE TO THE SUMMER BREAKFAST TABLE. BONUS: IT’S LIKE DESSERT IN THE MORNING. MONDAY GET GRILLING. For the first night, prepare your grill and cook up your protein of choice (burgers, salmon, marinated tofu) and some veggies for a side. Grill more vegetables than you need and you’ll be set for a week of plant-powered meals.

TUESDAY FOR A FLAVORFUL FRITTATA, start Fiber-filled, make-ahead overnight of by heating a large ovenproof pan over oats will keep you running for hours. medium heat. Start with a drizzle of olive oil, Plus, they’re infinitely versatile. then add some grilled vegetables and slices 1 • For each serving, combine /3 of spicy Italian chicken sausage. Beat six 1 cup rolled oats, /3 cup plain eggs with a bit of water, salt, and pepper and 1 pour over the veggie mixture. Cook in a 450° Greek yogurt, and /3 cup liquid. oven until eggs are set, about 10 minutes. (Milk, orange juice or almond milk are all good choices.) • Then add extras: fruit, seeds, or WEDNESDAY chopped nuts for healthy fats THIS GRAIN SALAD is the perfect and extra protein, and any extra packable lunch. Whisk together these flavoring (powdered or ground ingredients to make a dressing: 1 lemon, cinnamon, toasted coconut squeezed; 2 tbsp of olive oil; 1 tbsp honey; a tsp of Dijon mustard; and salt and pepper. flakes, cocoa powder, a few In a large bowl, stir together a couple cups THURSDAY drops of vanilla or almond of cooked farro or barley with a rinsed can extract). FOR A QUICK PASTA DINNER, pulse of chickpeas, 1 ½ cups chopped roasted • Refrigerate overnight. When you 2 cups grilled vegetables in a food vegetables, a bag of washed arugula, and a wake up, breakfast is served. half cup of chopped toasted almonds. processor and swirl in a tablespoon of olive oil, a handful of fresh herbs, and a Then get creative with the add-ins. pinch of red chili flakes. Pair this quick Here are some stellar combos to get sauce with cooked tortellini. you started: • Sliced banana, maple syrup, toasted walnuts, and cinnamon FRIDAY • Cubes of mango and strawberries, FOR A MAKE-IN-MINUTES PIZZA, toasted coconut, and chopped brush a lavash with olive oil and broil for macadamia nuts a minute until crispy. Top with veggies, • Mixed berries, chia seeds, a few crumbled feta, a few sprigs of oregano, drops of vanilla, and crystallized and pitted kalamata olives. Bake at 400° ginger for about 10 minutes until heated through. PHOTOGRAPHY: RICK LOZIER; FOOD STYLING: CHARLIE WORTHINGTON; GETTY IMAGES WORTHINGTON; CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY:

51 WEBMD.COM BY Matt McMillen FOOD REVIEWED BY Hansa Bhargava, MD WedMD Medical Editor

1. ARUGULA Peppery and lively, it’s great on its own or mixed with other greens. Dress it lightly with lemon juice and olive oil and toss with Parmesan, walnuts, and currants.

2. RADICCHIO 1 This lettuce is pleasurably bitter, tender but very sturdy, with beautiful leaves. It’s awesome when grilled, and it pairs well with strong flavors like 2 blue cheese and anchovies.

3. BUTTER LETTUCES This variety is delicate and elegant, with a mildly sweet taste. Drizzle lightly with a creamy dressing and mix gently with other light vegetables such as cucumbers. 3 4. FRISEE Form its curled leaves into a little nest, which you can then fill with nuts, shaved cheeses, grains like farro, and even fried oysters. Finish with a tangy buttermilk and chive

5 dressing.

5. ROMAINE 4 A great salad green for the grill, crisp and crunchy romaine shines with thinly sliced lamb and creamy Middle Eastern- accented dressings like tahini or lemon.

LETTUCES 101 Salad Days The next time you make a salad, go beyond iceberg lettuce for an elevated taste treat SOME ARE BITTER, SOME ARE SWEET, SOME CRUNCH NOISILY, SOME ALMOST melt in your mouth. To craft beautiful and flavorful salads, get to know the textures and tastes

offered by each of the many varieties of salad greens, says Mindy Fox, the author of WORTHINGTON CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY: Salads: Beyond the Bowl. Here are her five favorites and how she likes to serve them. 52 WEBMD.COM EXPLORE HEALTH Checkup TAKE ACTION

Pain Relief CUTTING EDGE Potential new migraine treatments Migraines are extremely common include special light bulbs and —in fact, they are the third glasses. most common illness in the world. Researchers believe a combination of genetic and environmental factors cause these chronic, debilitating headaches.

EXPERTS DEBATE WHETHER A BLOOD- and procedures to treat and vessel or nerve-cell dysfunction prevent migraine headaches, but causes the condition. A recent study few are specific to migraines. More points to blood vessels. In the largest- methods are in development. ever genetic study on migraines, Several clinical trials are underway scientists uncovered 28 new locations around the country to study a new on the human genome—the sum of drug that could stop migraines your genetic material—that could before they start. The medication, predispose a person to the intense which would come in the form of headaches. The genomic regions were a monthly injection, could receive rich with genes related to blood vessels. FDA approval and become available But genes don’t tell the whole story. as early as 2018. Researchers in Another study found that people who Washington are testing an IV drug get migraines have more nitrate-mod- that could help prevent migraines. ifying microbes living in their mouths People would receive 30-minute than their peers. These bacteria help infusions of the drug four times break down nitrates, found in foods a year. Harvard scientists are such as cured meats and leafy greens, developing a bulb that emits low- substances known to cause headaches intensity green light—recently found in some people. to ease migraine pain—and glasses Doctors pull from a toolbox of that filter out all light except for low-

GETTY IMAGES hundreds of medications, devices, intensity green. —SONYA COLLINS

53 WEBMD.COM CHECKUP Search for the article OTC Medicines: What Parents Need to Know at WebMD.com.

EXPERT Q&A

Q Where should I containers, such as pill Safe Storage store medications? organizers and bag- Do you know how to properly store your A Put them in cool, gies, often lack child- JOHN WHYTE, MD, MPH dry places, such as a safety features. Using DIRECTOR OF PROFESSIONAL medications? high dresser drawer the original container AFFAIRS AND STAKEHOLDER ENGAGEMENT AT THE FDA or storage box in the also ensures you know closet. Be sure to what the medication read the label to see is for and when it if specific storage expires. instructions are indicated, such as Q Should I keep refrigeration. expired medicines? A Don’t be tempted to Q What can I do to keep or use expired keep children from medicines, which can accidentally taking be less effective or my medicine? risky due to changes A Keep your medi- in chemical composi- cation out of sight tion or a decrease in and out of reach. strength. Even worse, Children could eas- certain expired medi- ily mistake colorful cations have the pills and sweet potential risk of bac- smelling liquids terial growth that can with candy. Count lead to more serious the pills regularly to illnesses and antibi- make sure no one otic resistance. else is using them, and don’t share your Q How should I medicines. If you store medicines expect guests in while traveling? your home, make A Keep them their sure all medications original child- Keep It Bottled Up Keep medications in their are properly secured resistant containers. original child-resistant in a locked cabinet If you’re staying at a containers with the label. or drawer. hotel, secure them in Q Can I put my your room’s passcode- medication into protected safe. If another container? you’re a guest, ask the A No. Medicines host to put your WHERE YOU KEEP YOUR MEDICINES CAN AFFECT HOW WELL THEY WORK. FOR should be stored in medicines example, if you store them in a medicine cabinet in a hot and moist bathroom, their original child- somewhere out of you might want to reconsider. The FDA’s John Whyte explains why and offers resistant containers sight and reach of storage tips to keep you and your family safe. with the label. Other children.

BY THE NUMBERS Every Percentage of Percentage of grandparents who U.S. adults taking report storing 70,000 at least one 10 minutes medications in easy- Approximate number of children brought prescription or How often a child in the U.S. under age to-access places, to the emergency room annually because non-prescription 6 is taken to the emergency room after including daily-dose of accidental medication overdoses. 82% medication. swallowing medicine he shouldn’t have. 23% boxes. KNORZER ULI ILLUSTRATION: GETTY IMAGES; 54 WEBMD.COM BY Matt McMillen CHECKUP Search for the slideshow Good and Bad REVIEWED BY Arefa Cassoobhoy, MD, MPH Exercises for Low Back Pain WebMD Medical Editor at WebMD.com.

HEALTH HIGHLIGHTS 10 tips to prevent or ease back pain DEVELOP A HEALTHIER, STRONGER, AND LESS Back Pain Relief PAINFUL BACK At some point in their lives, four in five people will have back pain, the leading cause of disability among adults ages 45 1. GO HOT 6. LOSE WEIGHT and younger. More than 26 million American ages 20 to 64 Try heating pads, heat Shed extra pounds to packs, and warm baths take the pressure off report frequent back pain, which may lead to poor mental and for acute back pain. your back. physical health. 2. QUIT SMOKING 7. DO THE TWIST Nicotine impedes blood Practice yoga to stretch flow to the back, so drop and strengthen back the habit to prevent or muscles. Bath-Time Bliss Indulging in a warm relieve pain. bath can help ease 8. BE SUPPORTIVE back pain. 3. BE MINDFUL When seated or driving, Practice mindfulness place a lumbar roll or meditation to reduce rolled towel in the hollow stress and ease chronic of your back. back pain. 9. JOIN A GROUP 4. WALK IT OFF Don’t endure chronic Even when in pain, take back pain alone. Seek a short walk every hour out local or online to maintain your back support groups. muscles. 10. FIGHT BACK 5. CALL YOUR DOCTOR Eat foods that fight pain- Make an appointment causing inflammation, if you have numbness, like salmon, nuts, tingling, or pain that berries, and olive oil. persists despite rest.

EXPERT TIPS

“Exercise and strengthen “Be patient. Back pain is “Being active will help your core muscles. a very common problem, ward off chronic pain. Although back pain makes and the vast majority But as with anything in it difficult to exercise, of people get better with life, practice moderation. people with chronic back time. Stay as active as While too little activity pain will get worse if they your body will allow; can contribute to chronic gain weight or if their core bed rest is no longer the back pain, overdoing it muscles weaken, putting recommendation.” can cause your back pain additional pressure on Khoi D. Than, MD to flare.” the spine.” assistant professor, department Akhil Chhatre, MD A. Nick Shamie, MD of neurological surgery, Oregon director of spine rehabilitation, professor and chief of orthopedic Health and Science University, Johns Hopkins Medicine, spine surgery, UCLA Spine Center, Portland, Oregon Baltimore, Maryland Santa Monica, California GETTY IMAGES; ILLUSTRATIONS: ULI KNORZER ULI ILLUSTRATIONS: GETTY IMAGES;

55 WEBMD.COM BY Stephanie Watson CHECKUP REVIEWED BY Brunilda Nazario, MD WebMD Lead Medical Editor

QUIZ Q Which foods or drinks can make my Major Leaks incontinence Do you leak urine with every laugh or cough, or constantly run for ASK YOUR worse? the restroom? About 25 million Americans share this embarrassing DOCTOR Avoid soda and other dilemma. Take this quiz to see if you have incontinence. caffeinated drinks, alcohol, and acidic Q What can I do foods like citrus fruits, to relieve the which can irritate your urge to go? bladder and trigger the urge to go. Try bladder training, in which you gradually increase the amount of Q What lifestyle time between bathroom changes should visits. When you feel the I make? urge to go, tighten your Drink smaller amounts pelvic floor muscles to of fluid, especially close stop leaks. to bedtime. Lose weight if you’re overweight. Q Can Exercise more often but medicines help avoid weightlifting, control the urge which puts stress on to go? your bladder. If you have constipation, Medications that relax treating this condition the bladder muscles helps as well. help control the urge of overactive bladder.

Quiz 1 2 3 4 5 6

I leak urine whenever I feel a sudden urge I have both an urge I constantly leak I can’t get to the bath- I started to leak I cough or laugh. to go, and then I leak to go and urine leak- small amounts of room in time because during my pregnancy. urine. age when I laugh or urine. of a condition that cough. limits my movement.

___ YES ___ YES ___ YES ___ YES ___ YES ___ YES

___ NO ___ NO ___ NO ___ NO ___ NO ___ NO

Answers

1. You could have 2. Urge incontinence, 3. Mixed incontinence 4. You could have 5. With functional 6. The weight of your stress incontinence. also called overactive is a combination overflow incontinence. incontinence, a growing baby puts A cough, sneeze, bladder, is an of stress and urge Your bladder never fully problem with your pressure on your bladder laugh, or heavy lifting overwhelming and incontinence. You can empties, so it overflows nerves or a mobility and weakens the pelvic puts pressure on your urgent need to go to have symptoms of both and constantly leaks. issue makes it hard muscles that support bladder and makes the bathroom. It can conditions—leakage The urine comes out in to recognize the urge this organ. Incontinence you leak. wake you up at night and urgency. dribbles, or you might to go or get to the can continue after you

or cause leaks. wet the bed at night. bathroom in time. deliver. STEINBERG JAMES ILLUSTRATION:

56 WEBMD.COM BY Jodi Helmer CHECKUP Search for the article Why Can’t I Sleep? REVIEWED BY Arefa Cassoobhoy, MD, MPH at WebMD.com. WedMD Medical Editor

Lights Out Sleeping on your side can ease acid reflux symptoms. Back: Although just 8% of people sleep on their backs, this position is the gold standard, according to Salas. The prone position keeps the head, neck, and spine in a neutral position, easing back pain. Some research even suggests that back sleeping may reduce wrinkling of the skin. But, for the 18 million adults with obstructive sleep apnea, back sleeping may make the condition worse. “The position makes the tissues in your throat relax and causes the tongue to roll back, which can [obstruct] the airway,” Salas says.

Side: A whopping 41% of people sleep in the fetal position, and another 15% sleep on their sides. If you like to fall asleep in the fetal position, curling up on your left side can ease acid reflux. “When you sleep on the left side [where the stomach is located], it keeps the stomach lower than the esophagus and SLEEP MATTERS settles the gastric juices,” Salas says. Salas also recommends sleeping on your left side if you’re pregnant because it Does Sleep Position Matter? improves circulation to the fetus. When it comes to your health, research shows that your sleep position may be as important as sleep quality Stomach: Although stomach sleepers snore less, according to Salas, the position wreaks WHEN YOU CRAWL INTO BED, DO YOU LIE ON YOUR BACK? CURL UP IN THE FETAL havoc on the alignment of your neck and back. position? Sprawl on your stomach? “Sleeping on your stomach puts a lot of Your sleep position might provide important clues about your health, says stress on your spine and can cause back pain Rachel Salas, MD, associate professor of neurology at Johns Hopkins Medicine or make it worse,” she says. Center for Sleep. For the 7% of people who sleep on their Consider the health benefits—and drawbacks—of three popular sleep positions. stomach, Salas offers some advice: Roll over.

Q What is the best Q Will changing my Q How can I switch Q Should I try sleep position for sleep position allevi- positions? an adjustable me? ate my symptoms? Placing pillows in strategic mattress? No one-size-fits-all sleep For health complaints like acid positions—behind your back Adjustable mattresses allow position exists. Consult your reflux and back pain, changing while lying on your side, for you to raise the head of the ASK YOUR example—could keep you from DOCTOR doctor for recommendations sleep positions could provide bed, which could alleviate based on your health. relief. rolling over. chronic snoring, acid reflux,

GETTY IMAGES and obstructive sleep apnea.

57 WEBMD.COM BY Stephanie Watson CHECKUP Search for the video Melanoma Check REVIEWED BY Mohiba Tareen, MD at WebMD.com. WebMD Medical Reviewer

DOCTOR’S OFFICE MYTH: Melanoma MYTH: You can’t get isn’t serious. melanoma on areas FACT: Melanoma is of your body that Melanoma 101 more likely than squa- aren’t exposed to LAWRENCE MARK, MD, PHD A mole isn’t the only sign of melanoma, and mous cell or basal cell the sun. ASSOCIATE PROFESSOR OF you can get it in surprising places. We bust skin cancers to spread FACT: Not all skin CLINICAL DERMATOLOGY, to other parts of your cancers start from UV INDIANA UNIVERSITY five myths about this dangerous skin cancer. body. Once it spreads, damage. You can get it can be life melanoma in areas threatening. that haven’t been DESPITE BEING ONE OF THE MOST COMMON CANCERS IN THE U.S. AND exposed to the sun, the leading cause of skin cancer deaths, melanoma remains a mystery to MYTH: People with like underneath your many Americans. Our expert corrects some common mistruths. dark skin can’t get nails, in your eyes, on melanoma. the palms of your FACT: People with hands or soles of your darker skin are less feet, and inside your susceptible to the vulva. So don’t be shy kinds of melanoma about looking at your caused by ultraviolet own skin—including (UV) radiation your genitals. damage, because they have extra melanin—a MYTH: Indoor protective pigment in tanning doesn’t their skin. But they cause melanoma. can get melanoma, FACT: Theoretically, and they still need to your risk of protect their skin melanoma could be whenever they go even higher from outside. indoor tanning. Studies show that MYTH: A dark-colored even one tanning mole is the only sign bed exposure before of melanoma. the age of 30 can FACT: In many cases, increase your risk of melanoma doesn’t melanoma by 75%. look like the colored This increase is due mole with irregular to the young age Full-Body Check Melanoma isn’t always borders that we that people start to caused by UV rays. You expect. Instead, it’s a tan (while skin cells can get it on body parts pink spot or sore that are still maturing) not exposed to sun. doesn’t heal. Change as well as the is what’s most increased radiation important. If the given off by tanning spot is evolving, it booths compared to could be melanoma. natural sunlight.

Skin Guard CHANGE YOUR WEAR PROTECTIVE SEEK SHADE WEAR SHADES SUNSCREEN ISN’T AN ROUTINE CLOTHES IMPENETRABLE SHIELD AGAINST UV DAMAGE. APPLY “Go outside early in the “Be smarter about your “If you do have to be “Put on a pair of IT, BUT ALSO FOLLOW THESE day or later in the after- clothing choices. Wear a outside when the sun is sunglasses that block PROTECTIVE STRATEGIES TO noon, when the sun isn’t breezy long-sleeved shirt strongest, between 10 100% of UV light to REDUCE YOUR SKIN CANCER at its peak.” instead of short sleeves, a.m. and 4 p.m., sit in prevent melanoma in RISK, SAYS LAWRENCE and put on a wide- the shade.” your eyes, as well as

MARK, MD, PhD. brimmed hat.” cataracts.” KNORZER ULI ILLUSTRATION: GETTY IMAGES;

58 WEBMD.COM BY Heather Hatfield CHECKUP REVIEWED BY Arefa Cassoobhoy, MD, MPH WedMD Medical Editor

BY THE NUMBERS: Facts and Stats on Trending Health Topics

Osteoarthritis

# Increased 637 risk of OA in Number of 1 women who open clinical 11 are obese studies for MOST COMMON X Ranking of OA among types 4 OA POUNDS of arthritis in the U.S. Weight loss that reduces risk of developing OA by half 12.4 MILLION X Number of adults ages 65 and up 5 INCREASED RISK affected by OA of OA in men who , are obese 78 MILLION

Number of people expected to MEDICINE INTERNAL OF JOURNAL 10% 13% have OA by 2040

30 MINUTES, PERCENTAGE PERCENTAGE 5 DAYS A WEEK of men of women Recommended older than 60 older than 60 amount of who have OA who have OA moderate, low- in the knee in the knee impact exercise, More than such as swimming or biking, to help OA 30 MILLION Number of adults in the U.S. affected by OA SOURCES: ARTHRITIS FOUNDATION, CDC, JOHNS HOPKINS ARTHRITIS, ARTHRITIS, HOPKINS JOHNS CDC, FOUNDATION, ARTHRITIS SOURCES: HEALTH OF INSTITUTES NATIONAL

59 WEBMD.COM BY Stena Schmitt CHECKUP Search for the quiz Could You Have a REVIEWED BY Brunilda Nazario, MD Thyroid Problem? on WebMD.com WebMD Lead Medical Editor

MY STORY Changes for the Better A woman makes lifestyle and medication modifications to manage life with hypothyroidism I went on synthetic thyroid medication, started working out a lot, lost weight, and felt much better. But over time, the medication became less effective. And the more ineffective the medicine, the more tired I became. When you have hypothyroidism, you have to keep testing your blood to Ups and Downs make sure the medication is working. Water, daily walks, I’d go every few months for tests. Until and medication recently, the longest I’ve gone without have helped Stena Schmitt manage having a medication dosage change was hypothroidism. 18 months. One thing I’ve noticed with hypothyroidism is that stress affects it. Over the years, I’ve moved states, changed jobs, got married, and every time I had a lot of stress in my life, I noticed I had a lot more medication dosage changes. I’ve also learned that lifestyle changes can help hypothyroidism. For example, if I drink at least 2 liters of water per day, I feel much better. Before I was diagnosed, I used to drink soda all the time for the caffeine. Now I don’t. I also try to walk at least 40 minutes each day, which seems to help as well. Following a low-calorie diet, cutting back on carbs, and eating lots of veggies and TEN YEARS AGO, I WAS 26, IN THE MIDDLE OF MY FIRST YEAR OF protein helps with the energy. I’m not teaching special education, and felt like I was on the verge of getting “Every time I as consistent as I should be with these fired. I wasn’t productive and couldn’t focus, but I didn’t know why. I had a lot of lifestyle changes, but when I am it seems was tired and cold all the time. I had gained weight and was forgetful. stress in my to help. I’ve lost about 20 pounds (though I’d walk up to my principal or another teacher, and I’d forget the it’s still hard to keep that weight off). question I was about to ask. I felt like I was losing my mind. life, I noticed Last January, I started a new medi- I thought I might be depressed, so I went to my doctor, who a lot more cation. I’m working two jobs, including ordered a blood test to check my thyroid. While normal blood work medication running my own tutoring business, shows TSH (thyroid stimulating hormone) levels of .3 to 5, according dosage which is very stressful, but I feel much to my doctor, mine were over 100. I had severe hypothyroidism. My better on the new medication. I have thyroid was severely underactive. changes.” much more energy than I did before.

MY STORY DOs AND DON’Ts

research hypothyroidism, which can overdo it on the days be misdiagnosed as depression. I you have energy. I found talk to your doctor if learned it runs in families and can skip that if I did too much in your medication isn’t a generation. My maternal grandmother one day, the next day working. You’re in DO had it, but my mother did not. DON’T was harder. DO charge of your health. TOWE RYAN PHOTOGRAPHY: 60 WEBMD.COM BY Kara Mayer Robinson CHECKUP Search for the article Choosing a REVIEWED BY Eric Yabu, DDS Toothbrush at WebMD.com. WebMD Medical Reviewer

YOUR SMILE Brush Better Is your brushing technique up to par? Follow these expert tips.

of your teeth.” Swap your brush for a new one every three to four months or when the bristles are frayed, whichever comes first. Choose a toothpaste with fluoride, which helps tooth enamel resist decay and fend off cavities. Tartar-control Say “Cheese” Make brushing toothpaste helps prevent gingivitis, fun for kids—think which is swelling and bleeding of music, timer apps, your gums. or stickers. Then, brush. “Ideally, a vibrating, jiggling motion should be used,” says Furgeson. Try to keep your toothbrush at a 45-degree angle, except when you’re brushing the chewing surface of your teeth. You can also try the “roll method.” Place the bristles at a 45-degree angle, aiming toward your gum line. Then gently roll or sweep the brush toward the other end of the tooth. If you have a power toothbrush, don’t brush. Simply hold your brush in position and let it do its work. Think you should swish water IS THERE A PERFECT WAY TO BRUSH YOUR TEETH? ACCORDING around your mouth until every last “Don’t rinse to a study in the British Dental Journal, not all dentists are on bit of toothpaste is gone? Think the same page, and many people get conflicting advice. Danielle again. Don’t rinse after you brush after you Furgeson, DHSc, RDH, director of the dental hygiene graduate or you’ll lose the benefits of the brush or program at the University of Michigan, helps clear up the fluoride, Furgeson says. Instead, try you’ll lose the confusion and shares her strategies for brushing your way to a to spit out as much of the toothpaste healthy, beautiful smile. as you can. And remember to floss benefits of the First, choose the right tools. “You should always use either a at least once a day. Flossing between fluoride.” soft or extra-soft toothbrush,” Furgeson says. “The size of the your teeth will remove plaque and toothbrush should be what is comfortable for the size of your reach food particles that your brush mouth so that you are able to comfortably reach all the surfaces may have missed.

4 Tips PERFECT YOUR TAKE TIME DOUBLE UP BE GENTLE DENTAL HYGIENE EXPERT TECHNIQUE DANIELLE FURGESON As you brush, try to touch Try to brush your teeth for Brush at least twice a day— Many people brush too EXPLAINS HOW TO GET every part of each tooth two full minutes. Set your once in the morning and hard. “It is best to be slow THE MOST OUT OF TEETH- with toothpaste. Clean the smartphone or an egg timer once before bed. But don’t and gentle, with very light or flip over a sand timer to pressure,” Furgeson says. BRUSHING outer, inner, and chewing brush more than three times alert you when time is up. surfaces. And give your Some electronic brushes a day or you may damage tongue a brush, too. have built-in timers. your gums and root surfaces. GETTY IMAGES

61 WEBMD.COM TEN QUESTIONS Take 10 REAL LIFE

1 I’m going to step out of the house Season five of Orange Is the Selenis Leyva today as who I was born to be”— New Black premieres June 9. Actor, Los Angeles that to me was so courageous. Can you give us a preview? I think you’ll definitely see what happens when people feel injustice. 7 Do we stick together? Do we What kinds of advocacy continue fighting the powers-that- work have you done for the be segregated, or do we unite? transgender community? I work with the Stonewall Community Foundation. I’ve been 2 working with The Anti-Violence What has working on this show Project. I’m going to set up a tour been like for you? where I’m going to visit a lot of It really has been life changing. facilities that cater to the lesbian, I’ve been an actress for 20-plus gay, bisexual, transgender, and years and…I never in a million questioning youth community. years thought that I would be part of something like this. 8 You star in Spider-Man: 3 Homecoming, which comes out Has working in an image- this summer. What was it like to dominated industry ever act in a superhero movie? affected your self-esteem? To be part of the Marvel world is When I went to a performing arts incredible. I play Ms. Warren. She’s high school, I was made to feel the physics teacher. In the comic that there was something wrong books she’s Mr. Warren. I love the with me for having curves. That fact that they made her a woman brought up a lot of insecurities. and gave it to a Latina actress.

4 9 You have a 14-year-old for the next gig, being told you’re What is your personal health daughter. What kind of self- not good enough, being rejected. philosophy? image message do you try to So when you have a different Everything in moderation makes get across to her? outlet, for me it’s the best thing me happy. I make sure I exercise I try to make sure that my that could have happened. “Beauty just enough, I eat just enough, daughter gets that beauty is not and if I need to have a drink every just when you look at yourself comes from once in awhile, I do so. in the mirror and think, “Wow! 6 I have great cheekbones.” No, Your sister is transgender. within, and beauty comes from within and What was it like to watch her we should 10 we should nurture that. go through the transition? What makes you happiest? I saw her at such an early age— nurture When my daughter climbs into at 17, 18—begin her transition, that.” bed and the cat and the dog 5 when that was not something do the same. And they’re all just How has motherhood that was talked about. And when there. I look around and I think, changed you? I saw that she, even with all those “I’m really lucky.”

This industry is all about waiting obstacles, said, “I am who I am. —MATT McMILLEN GREGORY PAUL PHOTOGRAPHY:

62 WEBMD.COM