Emma Thompson Reflects on Loss, Resilience, and Her FEELS VERY Idea of a “Perfect Day”

PAGE HOW TO LOWER YOUR RISK OF DEMENTIA 36

JUNE WEBMD.COM 2019

3 TAKES ON GRAIN BOWLS THE BEST NATURAL SKIN-CARE OPTIONS

FEARLESS & FABULOUS EMMA

THOMPSONPAGE 30 WEBMD MAGAZINE Contents JUNE 2019

FEATURES

30 REAL TALK Actor and screenwriter “MY EXISTENCE Emma Thompson reflects on loss, resilience, and her FEELS VERY idea of a “perfect day”

40 HARD-WON GOOD FOR YOU OR JUST FISHY? AND PRECIOUS What to consider before giving fish oil a try AT THE MOMENT.” JENNY GAGE AND TOM BETTERTON / TRUNK ARCHIVE ARCHIVE TRUNK / BETTERTON TOM AND GAGE JENNY

1 WEBMD.COM WEBMD MAGAZINE Contents JUNE 2019

THE MENTAL WELLNESS ISSUE 4 MEMORY LANE Try this long-term memory technique 15 MIND MATTERS The benefits of mindfulness apps 29 PETS Ways to keep your dog mentally stimulated 36 GUARDING THE MIND New research reveals dementia risk factors— and the possibilty of lowering your odds 56 QUIZ Test your mental health knowledge GETTY IMAGES

2 WEBMD.COM WEBMD MAGAZINE Contents JUNE 2019

18 50 28 26 CHECKUP 45 50 THE LATEST New research on hearing loss 51 EXPERT Q&A 48 The scoop on drug quality 52 WHO’S WHO What a pharmacist can do for you 53 INSIGHT 19 Four screenings to minimize risk 55 BY THE NUMBERS Facts and stats about 13 medical devices LIVING FAMILY FOOD

12 MEN’S HEALTH 23 RELATIONSHIPS 44 GOOD FOR YOU New research on How to strengthen your Make melon your next fatherhood after child’s sense of right summer snack 57 age 40 and wrong 45 3 WAYS: GRAIN BOWLS 13 WOMEN’S HEALTH 24 PREGNANCY Tasty takes on this light What to know Tips to relieve lower and healthy dinner about PCOS BEAUTY back pain 47 BUILD A BETTER 16 FITNESS 17 SKIN CARE 25 BABY Tips to make the A crash course in The scoop on charcoal The risks behind new perfect frittata gym etiquette baby monitors in the beauty aisle 48 FOOD 101 18 EXPERT PICKS 26 KIDS’ HEALTH Five essential fresh herbs IN EVERY ISSUE Five grooming gifts for The benefits of learning Father’s Day to play an instrument 4 EDITOR’S NOTE 19 DERM Q&A 27 TEEN HEALTH 6 UPFRONT Solutions for sun spots The epidemic of News about fatherhood, pain e-cigarette use relief, sleep, and more 20 BEAUTY SMARTS The seven best 28 PARENTING 57 TAKE 10 natural ingredients Ways play contributes Caterina Scorsone on raising to healthy development ON THE COVER a child with Down Syndrome, PHOTOGRAPHY BY: NICK HADDOW childbirth, and empathy

3 WEBMD.COM Editor’s Note

FROM THE WEBMD TEAM What healthy advice do you pass along to your kids?

I teach my kids that healthy stuff comes first. We need to take care of ourselves with exercise and healthy food, and if we do a good job of that, then we can sometimes JOHN CASSARAS TOM ROSEBERRY have treats and screens. WebMD Senior Video WebMD Senior Director, Producer But this can be a double- Audience Growth ealth advice comes from seem- edged sword. There are I try to pass along healthy ingly everywhere, whether times I just want to relax H we’re shopping, browsing our for a bit, and my daughter habits and routines: A social media feeds, using fitness tells me, “Get off your consistent bedtime helps trackers, listening to podcasts, or, phone, Daddy!” you recharge your battery; of course, talking to our health care eating fruits and veggies professionals. But perhaps the tips that make the biggest impression gives you energy to run and stick with us the longest are and play. My 4-year-old My sons, Max and Carter, those we get from our parents, both generally follows this are naturally good-hearted. in terms of words and actions. In our really well—but does like last issue, we asked moms for their I tell them: Honor yourself, to debate whether a fruit healthy advice to kids. This month, in not someone else’s idea of honor of Father’s Day, we turn to dads. you. You’re fantastic! Peer snack is a healthy snack. I We asked some of the fathers on our pressure is for the weak— say, you can have snacks staff to share the healthy guidance don’t accept it. People will AARON GOULD you like if you have them they pass on to their kids. respect you for it later. SHEININ with healthy snacks. It Happy Father’s Day to all of our Clean underwear, clean WebMD Senior News Editor leads to many interesting WebMD dads. teeth, clean nails. Kid, meet soap. Soap, meet kid. combinations like You two need get to know blueberry graham each other better. cracker sandwiches. Kristy Hammam Editor in Chief [email protected]

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WebMD Magazine is distributed to doctors’ offices throughout the U.S., online at WebMD.com, and by download from the App Store.WebMD Magazine is not responsible for advertising claims. WebMD Magazine (ISSN 1553-9946), Vol. 15, No. 4, is published by WebMD LLC and may not be reproduced in whole or in part without written permission of WebMD LLC. All editorial content is reviewed by our board-certified physicians, is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. WebMD does not endorse any specific product, service, or treatment. Always seek the advice of your health care provider with any questions regarding a medical condition and never disregard professional medical advice or delay seeking it because of something you have read in WebMD Magazine. If you think you have a medical emergency, call your doctor or 911 immediately. © 2019 WebMD LLC. All rights reserved. TIMELY TOPICS Upfront NEWS YOU CAN USE

Healthy Dads June marks Father’s Day, an ideal time for fathers, grandfathers, and all men FOR THE GUYS GUYS THE FOR to take stock of their health

Percentage by Percentage by which older men which a man’s with high blood pressure can risk of developing 1.07 reduce their risk of dying earlier by thinking problems is How much a man’s body mass index (BMI) getting fit (doing moderate aerobic 22% lowered if he eats at improves over a six-year period when he’s in a exercises at least 30 minutes a day, Percentage of 65-year- least six servings of healthy marriage. A good marriage is also linked three to six days a week), compared old men who can expect 34% vegetables a day. to lower LDL (unhealthy) cholesterol in men. 18% to those who exercise very little. to reach age 90. GETTY IMAGES

6 WEBMD.COM Upfront Upfront

IN THE NEWS THE PRIZE WOMEN IN CONTROL GOES TO ... Can You Ward off Dementia? Do you put off your annual mammogram? San Francisco is the Would you be more willing to go if you When it comes to dementia, none of us can escape one risk factor: getting older. But is there anything you can do to avoid this frightening decline in thinking skills healthiest U.S. city for could control that medieval torture device that flattens your breast into a pancake? that affects mood, memory, language, and other brain functions? The answer its health-care quality, is yes, according to some compelling recent research. “It’s not yet definitive, New research suggests there’s no reason you availability of healthy shouldn’t control it. In a study of 549 women, COLLEEN but in the past six years, we’ve made progress on identifying PARETTY modifiable risk factors for which the evidence is pretty strong,” foods, fitness of its half had a traditional mammogram and half Editorial Director, says one of the experts we consulted for our story, “Guarding residents, and available compressed their breasts themselves after the colleen@ the Mind” (page 36). Things like better sleep; controlling technician positioned them in the machine. webmd.com park space. Seattle blood pressure, diabetes, and high cholesterol; exercising When radiologists rated the quality of the regularly; and making strong social connections all seem to and San Diego follow images, they found no difference between the play a role in minimizing dementia risk. See what you can do close behind. patient-controlled scans and the regular ones. in your own life to beat the odds. — What’s more, the women in control of the SOURCE: Wallet Hub machine reported less pain than the others.

SOURCE: JAMA Internal Medicine PAINKILLER 4% NEW CONNECTION PREFERENCE 27% Percentage of Up to 72% of amputees have sometimes-debilitating phantom 1 IN 25 ALTERNATIVE PAIN RELIEF Percentage of adults Number of Only one in three parents people pain. It happens when severed nerves, once connected to the tissue cancers caused by Long-term, or chronic, pain can be difficult to treat. Opioid painkillers ages 50 to 64 who admitted to asks their pediatrician that was removed, form pinched nerves or nerve tumors called obesity worldwide. are addictive and not necessarily effective for pain that lasts longer than worry they won’t be ERs for neuromas. While this diminishes in most people, 25% end up with SOURCE: CA: A Cancer for alternatives to able to afford health e-scooter Journal of Clinicians a few days. A couple of non-drug alternatives could help. Among 21 chronic pain. Surgeons at The Ohio State University have found opioid painkillers when injuries who clinical trials that included more than 2,000 people, both mindfulness- insurance next year. they can re-route the severed nerve endings to other muscles and had been prescribed—even though SOURCE: National Poll on establish a new connection. The experimental procedure drastically based stress reduction—a form of meditation—and talk therapy were Healthy Aging wearing a PUSH-UP reduced or eliminated pain in the first 22 people to receive it. non-opioids are less effective treatments for long-term pain. People reported improved physical helmet. SOURCE: Plastic and Reconstructive Surgery POWER addictive and many are SOURCE: JAMA function, less pain, and less depression after receiving one of the two Active, middle-aged men equally effective. treatments. Most people in the study were women. Forty percent had ROCK-A- who can do 40 push-ups, SOURCE: American Society endured pain for more than 10 years. of Anesthesiologists BYE, BABY compared to those who SOURCE: BMJ can’t finish 10, are far less When 18 healthy likely to have heart disease young adults slept and other heart problems BRAIN in a lab for three 10 years from now. HEALTH nights, on the nights that their beds SOURCE: JAMA Four aerobic rocked them to workouts a week for sleep, they fell asleep six months improved faster, spent more brain function and time in memory- 80% increased brain consolidating deep Percentage of volume—that’s a Americans who rate sleep, and performed good thing—in their health-care quality better on a memory as excellent or good. adults of all ages. test the next day.

SOURCE: Gallup GETTY IMAGES GETTY IMAGES SOURCE: Neurology SOURCE: Current Biology

7 8 WEBMD.COM WEBMD.COM Upfront

READING SPEED AND DRY EYE Do you pass your vision test with flying colors but feel you read more slowly than most people? Do you struggle to spend more than 30 minutes at a time reading? It could be chronic dry eye. In a test of reading speed, people with dry eye syndrome read 32-words-per-minute less than those who do not have the condition. And, because long periods of visual concentration—as in reading, driving, or drawing —slow your blink rate, your eyes become dryer over the duration of the activity. Ophthalmologists and optometrists can recognize dry eye and refer you for the right care. POT AND DEATH RATES SOURCE: Optometry and Vision Science Live in a state where pot is legal? Be careful on the roads. In these states, traffic deaths increase by an additional one death per million THE TRUTH ABOUT AVOIDING COLDS residents in the year following legalization. The effect spills over into At least half of parents follow unproven “folk” neighboring states, too, as people cross state lines to buy marijuana advice to prevent kids’ colds: stay indoors, don’t then drive home under its influence. Traffic deaths don’t spike like go outside with wet hair, take vitamin C. But this in states that only authorize medical use of the plant. Deaths there’s no proof these methods work. Strategies drop. This may be because medical marijuana, once available, often that hold up are frequent handwashing and replaces more dangerous forms of self-medication, such as alcohol. avoiding people who are sick.

SOURCE: Addiction SOURCE: C.S. Mott Children’s Hospital National Poll on Children’s Health

ANXIETY MEDS PREGNANCY ON THE RISE RISKS Prescriptions Giving birth may raise women’s heart for anxiety disease and stroke risk by up to 14% over medications called those who’ve never had a baby, says a review benzodiazepines— of 10 studies that followed more than three think Xanax and million women for up to 52 years. While the Valium—have reason is unclear, the researchers speculate that pregnancy could trigger inflammation, doubled in the last 10 cause the heart to work harder, or lead to years. These drugs belly fat that lasts long after pregnancy. can be addictive, They suggest that women use pregnancy as and overdoses are an opportunity to adopt healthy habits and stick with them for life. on the rise.

GETTY IMAGES SOURCE: European Journal of Preventive Cardiology SOURCE: JAMA

9 WEBMD.COM Upfront

GUNS AND KIDS Gun-related injuries are the third-leading cause of death among U.S. children. While gun ownership has declined in the last decade, gun-related death rates among children have risen. The rise in deaths, new research finds, is linked to a shift in the types of guns people own. Three in four gun-owning families today own a small handgun, not a large hunting rifle. What’s SLEEP AS ALZHEIMER’S PREVENTION more, 5 million kids live in homes where a gun is kept loaded and unlocked. The Just one lost night of sleep causes a protein called tau in spinal cord fluid to spike. small curious hands of a child and an easily Too much tau is a marker of Alzheimer’s disease. Researchers took spinal cord fluid accessible, operable, and loaded handgun, samples from a group of adults at two different times: after a good night’s sleep and the researchers say, are an extremely after staying up all night. Tau levels after sleep deprivation were more than 50% higher than after a restful night. The findings help confirm that tau accumulates dangerous combination. during waking hours. Too many waking hours lead to too much tau. Sufficient sleep, SOURCE: Pediatrics

the researchers say, should be a part of Alzheimer’s prevention.

SOURCE: Science

LAUGHTER IS THE BEST MEDICINE As if the prospect of brain surgery weren’t nerve-racking enough, for some surgeries, the patient has to stay awake. Neurosurgeons at Emory University have discovered a way to relieve anxiety right at the source. When they stimulate a specific part of the brain during awake brain surgery, the person laughs spontaneously and then feels calm and happy. Stimulating other parts of the brain can trigger laughter but not the accompanying calm. The surgeons have successfully used the brain-tickling technique in at least three surgeries so far.

SOURCE: Journal of Clinical Investigation

LEARN WHILE YOU DREAM THE STATUS OF STATINS While a group of healthy young adults slept, researchers played Millions of people around the world take cholesterol-lowering drugs a recording of nonsense words followed by their supposed called statins to help prevent heart disease, heart attack, and stroke. But translations (e.g., tofer: house; arel: cork) four times, alternating doctors don’t know whether they are safe and effective for adults older the order of the words within each pair. They used made-up than age 75. New research suggests the pills do far more good than words rather than a foreign language to ensure that no one had harm. A review of numerous major clinical trials found that even patients ever learned the words before. A word-matching test after their who were age 75 and up when they started statins saw big reductions nap showed that the young people had learned many of the in heart attacks, strokes, and the need for bypass surgeries. Contrary words. A brain MRI confirmed that they had made associations to doctors’ previous concerns, the medication didn’t increase between the new words and their translations. the risk of non-heart-related death or cancer at any age.

SOURCE: Current Biology SOURCE: The Lancet GETTY IMAGES

10 WEBMD.COM HEALTHY HABITS Living MEANINGFUL CHANGE

DON’T JUST JOT DOWN YOUR SHOPPING LIST—READ IT ALOUD. According to researchers at the University of Waterloo in Ontario, when you Say It to say something aloud, it’s more likely to stick in your long-term memory. There’s something powerful about the one-two punch of Store It reading the words and hearing yourself say them at the same time. The researchers report that speaking aloud trumped reading silently, MEMORY LANE MEMORY NEXT TIME YOU HEAD TO THE hearing someone else say the words, or listening to a recording of STORE, A SIMPLE TECHNIQUE yourself. With this new trick, you’re sure to remember the cherry MAY HELP YOU REMEMBER WHAT tomatoes and—say it with us!—the red peppers, the barbecue sauce, TO TOSS INTO YOUR CART the plastic forks. ... —KARA MAYER ROBINSON GETTY IMAGES

11 WEBMD.COM Living Fatherhood After 40 NEW RESEARCH SUGGESTS THAT FATHERING A CHILD LATER IN LIFE MAY COME WITH RISKS Sign up for the Men’s Health Newsletter at

MEN’S HEALTH MEN’S BY Matt McMillen REVIEWED BY Michael W. Smith, MD, WebMD Chief Medical Editor WebMD.com.

OVER THE LAST FOUR DECADES, THE NUMBER OF a pregnancy at risk,” says Eisenberg, “but we ASK YOUR MEN OLDER THAN 40 WHO FATHER A CHILD HAS don’t know for certain at this point.” DOCTOR MORE THAN DOUBLED. But only recently have Eisenberg doesn’t want his research to researchers begun to explore what impact a scare men over 40 away from having children. Q Do I have health risks dad’s age may have on his unborn children. He points out that although the risk of that could affect a child A study published in BMJ in October 2018 complications does appear to rise with age, I want to father? found that children of men ages 45 to 54 have the overall risk of birth problems remains a 14% higher risk of premature birth and low low. Still, age and health do influence your In addition to age, your birth weight compared with those fathered chances of conceiving a child in the first place. weight, diet, and physical by men between the ages of 25 and 34. Early It often takes older men longer to impregnate activity level may contribute births increase a child’s vulnerability to long- a woman, for example, while obesity and to your child’s health, so get term physical and mental health problems, physical inactivity appear to degrade semen a thorough checkup that will while low birth weight may require a stay in quality, says Eisenberg. identify any concerns. the hospital’s newborn intensive care unit. While you can’t stop time, you can—and Previous research has suggested that a dad’s should—take good care of yourself. Your health Q How can I improve older age boosts the risk of miscarriage as well will benefit, and so may the health of your my ability to father as his child’s chances of developing autism future children. “I talk to fathers-to-be about children? and schizophrenia. exercising as well as maintaining a good diet Be upfront about smoking, What explains the link between a man’s and a healthy bodyweight,” Eisenberg says. alcohol, and illicit drugs, age and the health of his children? Michael “Anything that affects your heart will affect which can harm your fertil- Eisenberg, MD, the BMJ study’s lead author your fertility.” ity. Also, have your doctor and an associate professor of urology at the Most attention has been focused on the review your medications. Stanford University School of Medicine, offers risks associated with mom’s age and health, Some drugs affect fertility. two possibilities: DNA mutations that accumu- but Eisenberg emphasizes that men need to late as men age and harms that may result from better understand their own role in repro- obesity, poor diet, lack of exercise, and other duction. “Keep in mind that fertility is a team Q Should I have a lifestyle factors. “Those could potentially put sport,” he says. semen analysis? It’s worth considering, to make sure everything’s normal. For example, if you learn that you have a low sperm count, you could consider fertility assistance sooner than you otherwise might.

Q Am I too old? While certain risks may rise with age, men continue to produce sperm throughout their lives and can father healthy children into old age. GETTY IMAGES GETTY IMAGES 12 WEBMD.COM12 WEBMD.COM Living

• Irregular periods the tendency to gain weight • Hair growth on the face or chin 4 MYTHS and develop diabetes, sleep ANUJA DOKRAS, MD, apnea, and high cholesterol. • Hair loss similar to a man’s PhD, DISPELS SOME The main goal of PCOS • Acne on the face, chest, and back that continues past the PCOS MISINFORMATION. treatments is to correct hor- teenage years mone imbalance. Common • Weight gain treatments include: • Trouble getting pregnant without help from a doctor IT CAUSES PAIN • Birth control pills or 1. Follicles on the ovaries progestin therapy to in PCOS measure only regulate your cycle, Diagnosing PCOS about 2 to 10 millimeters. Doctors don’t have a diagnostic test for PCOS because it’s a syndrome They don’t rupture, and reduce hair growth, —a collection of certain signs and symptoms. “It’s not like diabe- they don’t cause pain like improve acne, and ovarian cysts can. tes, where you can use a blood test to read a hemoglobin A1c,” says lower your endome- Dokras. A blood test is just one piece of the puzzle. trial cancer risk Your doctor will take a medical history, check your hormone levels, • Metformin (a dia- do a physical exam—including a pelvic exam—and may also do an IT MEANS betes medication) ultrasound. They will have to be able to check off at least two of three 2.YOU’RE INFERTILE to help regulate The number and quality symptom boxes to diagnose you with PCOS: irregular periods, extra periods—but only in of your eggs isn’t affected about half of women androgen hormone, and follicles on the ovaries. This clue-finding by PCOS, but you may aspect is part of what makes a PCOS diagnosis tricky, says Dokras: need medications to get who take it “It’s challenging, because if your physician doesn’t put all the pieces them to release regularly • Anti-androgens to so you know when your together, it may get missed for a little while.” block hormones that fertile window is. Losing cause some PCOS weight can also help PCOS and pregnancy fertility issues. symptoms such as Some women get their PCOS diagnosis in the process of trying to get acne and facial hair pregnant. Because one of the symptoms of PCOS is irregular periods, • Topical or oral acne it can be harder to predict when you’re ovulating, and therefore make medications to con- IT GIVES YOU LEVELS trol skin breakouts it harder to get pregnant. But it doesn’t mean you can’t get pregnant 3.OF TESTOSTERONE —you may just need some medical help. LIKE A MAN • Laser hair removal or “These are actually easier patients for infertility specialists like PCOS does mean slightly electrolysis for getting result, your hormone levels can get myself to treat because there are healthy eggs there, it’s just a matter higher levels of testosterone, rid of excess hair out of balance, throwing off your ovu- but they’re nowhere near of getting them to release,” says Dokras. In fact, she says, one-third the range for men, which is lation and causing irregular periods. As with most health PCOS Primer of women with PCOS get pregnant on their own without issues. The typically 10 times a woman’s Doctors don’t know why this happens issues, a focus on a healthy POLYCYSTIC OVARY SYNDROME IS TRICKY TO DIAGNOSE, OFTEN MISUNDERSTOOD, other two-thirds usually respond well to fertility medications. Losing normal range. for some women. lifestyle—regular exercise, AND MORE COMMON THAN YOU MIGHT THINK weight can also help improve fertility. In addition to its complicated stress reduction, and a name, PCOS also has a complex Living with PCOS nutritious diet—can reduce BY Rachel Reiff Ellis REVIEWED BY Arefa Cassoobhoy, MD, MPH, WebMD Senior Medical Editor IT ONLY NEEDS WOMEN’S HEALTH WOMEN’S cause. “We know it’s inherited, PCOS doesn’t have a cure, but it’s possible—and important—to treat its 4. TREATMENT IF your symptoms and make because we find that there are family symptoms, not only for short-term relief but for long-term health. “When YOU’RE TRYING TO you feel better in general. GET PREGNANT members who have it, but we don’t you have irregular periods, it means you’re not shedding the lining of Last but not least, be know the exact mutation or change,” The hormone imbalance sure you don’t ignore your the uterus every month,” says Dokras. Over time, this can thicken your caused by PCOS raises your EVEN IF YOU’VE NEVER HEARD OF POLYCYSTIC OVARY SYNDROME (PCOS), CHANCES ARE YOU Dokras says. Environmental and emotional well-being. Out- uterine lining and raise your risk of cancer. PCOS is also associated with risk of diabetes, cancer, and PROBABLY KNOW SOMEONE WITH IT. “In a room of 10 women of childbearing age, one is lifestyle factors can also increase the high cholesterol. Treating it ward symptoms like acne likely to have it—that’s a high percentage,” says Anuja Dokras, MD, PhD, professor of number of PCOS features you have helps improve your overall and excessive hair growth obstetrics and gynecology at the Hospital of the University of Pennsylvania and director of and how severe they are. For exam- health in important ways. can affect mental health, the Penn PCOS Center in Philadelphia. ple, she says, weight gain can be what says Dokras. “It’s important In fact, it’s the most common endocrine condition (which affects the system of glands makes your PCOS show up for the that we don’t ignore these that release hormones in the body) in women ages 15 to 44, affecting about 5% to 10%. But first time or make it worse. features,” she says. “Women despite how frequently it happens, PCOS can still be overlooked and misunderstood. This combination of genetic and with PCOS have an increase environmental causes creates a hormone in depressive and anxiety Breaking it down imbalance in your body and gives you symptoms that stem from The word “polycystic” means “many cysts,” but surprisingly, PCOS often doesn’t involve cysts. higher than usual levels of certain hor- body image issues and dis- “The name was coined 70 years ago when gynecologists didn’t understand as much mones such as insulin and androgen, the Search for the tress. It’s not just cosmetic. about what was happening in the body,” says Dokras. Doctors now know there is growth “male hormone.” Even though women slideshow A Visual Women need treatment as of an unusual number of structures called “follicles.” In the normal ovulation process, secrete androgen hormones normally, Guide to PCOS at well as education and coun- WebMD.com. ovaries make one follicle that produces hormones as it grows. Then it releases an egg. having higher levels than usual causes seling about the long-term

When you have PCOS, the ovary makes many small follicles instead of one big one. As a the symptoms of PCOS, including: GETTY IMAGES impact of the syndrome.”

13 14 WEBMD.COM WEBMD.COM Search for the video The Truth About Mindfulness and Living Mediation at WebMD.com.

CALM YOURSELF

STRESS AND ANXIETY CAN WREAK HAVOC ON THE HUMAN BODY. LEARNING TO BETTER HANDLE LIFE’S TENSE MOMENTS AND BOUTS OF WORRY CAN the past,” she says. “Meditation LEAD TO A HEALTHIER, brings us back to the moment HAPPIER YOU. Mind the App we’re in.” SMARTPHONE APPS THAT TEACH MINDFULNESS AND HEART TROUBLE Focusing on breathing In a Nurses’ Health Study, MEDITATION TECHNIQUES ARE ALL THE RAGE. BUT DO THEY techniques, Levitt says, is women with the highest TRULY BENEFIT YOUR HEALTH? fundamental because the

MIND MATTERS MIND levels of phobic anxiety breath anchors our attention. were 59% more likely to BY Lauren Paige Kennedy have a heart attack and “We battle anxiety because our REVIEWED BY Patricia A. Farrell, PhD, WebMD Medical Reviewer 31% more likely to die from minds are filled with fearful one than women with the thoughts. Mindfulness keeps lowest anxiety levels. us in the present, where we can ARE YOU ONE OF MILLIONS OF AMERICANS WHO USE A SMARTPHONE calm ourselves down,” she says. APP TO EASE STRESS AND ANXIETY? Popular choices include Calm, INSOMNIA But do users of these apps Headspace, Breathe2Relax, and Happify. More than 40 million truly reap health benefits? Americans suffer from While different forms of These apps give instruction on relaxation techniques that aim to chronic, long-term sleep decrease symptoms of anxiety and related health conditions, including disorders, with stress meditation have been practiced depression, sleep and digestive disorders, and substance use. They and anxiety causing or across cultures for thousand deliver daily, weekly, and/or monthly programs that users listen to like making them worse, of years, Harvard physician a podcast—and rely on like a personal life coach in their pockets. according to the National Herbert Benson first intro- Institutes of Health. Interestingly, their popularity parallels an upward tick in anxiety: duced “the relaxation response” The American Psychiatric Association’s annual poll on U.S. anxiety in the 1970s. This technique has levels shows a five-point jump between 2017 and 2018, from 46 ABDOMINAL PAIN gained widespread acceptance While stress doesn’t to 51 on a zero to 100 scale. Research published last year in the cause irritable bowel by therapists and doctors as a Journal of Developmental and Behavioral Pediatrics revealed a syndrome, it can make way of relieving symptoms from 20% increase in diagnoses of anxiety among children ages 6 to 17 symptoms—including stress and anxiety disorders. between 2007 and 2012. Another recent study connects smart- excessive cramping, While such smart apps vary, phone usage to peoples’ collectively anxious state. bloating, and diarrhea— and the American Psychiatric worse, according to the Technology, thus, can be a double-edged sword with its non-stop, Mayo Clinic. Association counsels caution alarmist news alerts, online arguments, and “fear of missing out.” when choosing one, many Can it also help address—and even correct—the problem? incorporate deep breathing PANIC ATTACKS Author and mindfulness instructor Tamara Levitt, who writes and Panic disorder affects 6 and relaxation techniques. records guided meditations for the Calm app (and who has studied million American adults, According to a 2018 study and practiced the art for three decades), believes meditation, no or 2.7% of the American published in the journal matter how it’s delivered, can yield powerful results. “Mindfulness is population, according mHealth, they can serve as the act of paying attention to the present moment,” she says. People to the Anxiety and helpful and accessible supple- Depression Association get in trouble with stress and anxiety, she adds, because staying of America. Women ments to in-person therapy, present can be difficult. “Our minds are often in the future, worrying are twice as likely to be which can be costly, for better

GETTY IMAGES about something that’s going to happen, or we’re ruminating about affected as men. mental health.

15 WEBMD.COM Living Mind Your Manners FITNESS FOLLOW OUR ETIQUETTE GUIDE TO KEEP THE GYM CONSIDERATE AND SAFE FOR ALL Search for the article Good Hygiene BY Kara Mayer Robinson REVIEWED BY Michael W. Smith, MD, CPT, WebMD Chief Medical Editor Habits at the Gym at WebMD.com.

SURE, YOU’RE AT THE GYM TO BETTER YOURSELF. disposable wipes. Take advantage. Drop them in the But if you aren’t aware of the people around you, used-towel bin or trash bin as you leave. EXTRA you may be committing a fitness no-no or two. CREDIT Next time you work out at your fitness facility, Watch the clock keep a few good habits in mind. “Be conscientious of how long you’re on a WANT TO GO ABOVE AND machine or bench if others are waiting,” says BEYOND? AVOID THESE OTHER GYM BLUNDERS. Mind your weights DiPaolo. “Everyone’s time is valuable. Being “One of the most annoying things gym members considerate goes a long way.” DON’T APPROACH do is not put their weights back,” says Christa Limit your cardio machine time to intervals 1. If you spot a friend or DiPaolo, a group fitness instructor at Equinox. “It suggested by your gym. When you’re strength acquaintance at the gym, don’t make a beeline to say can be a real pain scouring the gym floor to find training, it’s OK to take breaks between sets. But be hi and catch up. Give them the weights you want.” mindful and allow others to work in between sets. space and approach only Leaving equipment around isn’t just rude—it’s an when they’re on a break. accident waiting to happen. Someone can trip and Stay clean DON’T BANG injure themselves on a misplaced dumbbell or plate. Avoid wearing the same (unclean) gym clothes 2.Some people like Always re-rack your weights and tidy up your space. over and over to avoid potential skin infections to bang their weights from bacteria. Have three to four clean sets avail- together after a repetition. Pipe down able. Wash them regularly. Keep fresh clothes Don’t let that be you. It’s “Talking on the phone or texting on the gym and deodorant in your locker or gym bag. loud and distracting—and it can damage the weights. floor is a big no-no,” says DiPaolo. Ditto for loud conversations with workout buddies, grunting for Space it out DON’T GYM-SPREAD the entire gym to hear, and singing loudly with your Try not to crowd or get in the way of others. 3.Ever see someone headphones on. Loud noises are concentration- Instead of standing in front of the weight rack, take over an extra bench or killers. If you need to express yourself, take it into take your dumbbells and step back, clearing the machine just for their water bottle, towel, or book? It’s the hallway, locker room, or—better yet—outside. way for others. The same goes for mirrors—leave a no-no. Keep your stuff at space for others to look at their form. And your side or leave it in the Wipe it down remember: Mirrors can help you check your locker room. Sweating is good. But leaving it around isn’t. Not form; they are not there for an impromptu photo DON’T BE only is it gross, it can spread infections and illnesses shoot. Keep the selfies to yourself. 4. CLUELESS like MRSA and ringworm. Always wipe down your Finally, when in doubt, says DiPaolo, follow It’s easy to get used to bench, cardio machine, or other equipment after the golden rule: “Treat others how you want to paying more attention you use it. Many gyms provide clean towels or be treated.” to your phone than your surroundings, but at the gym, put it away so you can focus on people in your vicinity. GETTY IMAGES GETTY IMAGES 16 WEBMD.COM16 WEBMD.COM BEHIND THE SCIENCE Beauty INSIDE OUT

CHARCOAL HAS MADE ITS WAY FROM THE BACKYARD BARBECUE TO THE BEAUTY AISLE. You can now find activated charcoal—coal that has been heated up with steam—in Coal everything from cleansers to face masks. But does it work? “Unlike regular charcoal, activated charcoal is porous, filled with many tiny sponge-like spaces or pores,” says Fayne Frey, MD,

SKIN CARE SKIN a dermatologist in West Nyack, New York. “All these little spaces within activated charcoal Rush create a large surface area that is helpful for soaking up substances.” The idea is that a product made with activated charcoal is able to mimic a magnet to attract and absorb dirt, oil, toxins, DIG INTO THE DETAILS and pollutants. But don’t go out and switch all of your products for charcoal-based versions, OF CHARCOAL, A NEW Frey says. “Although there is no scientific evidence proving the benefits of topically applied INGREDIENT IN SKIN-CARE activated charcoal, there is also no evidence finding it harmful, either.” Bottom line: Have fun AND BEAUTY PRODUCTS with the trendy skin-care ingredient—in moderation. —AYREN JACKSON-CANNADY GETTY IMAGES

17 WEBMD.COM Beauty

1. BUMP BLOCKER St. Ives Blackhead Clearing Guy Buys Face Scrub, $5 “The beta hydroxy acid in this FROM SKIN-CARE SUPPLIES TO SHAVING GEAR, scrub helps remove excess THESE EXPERT-APPROVED GROOMING PRODUCTS FOR oil and enhances shedding of THE MAN IN YOUR LIFE ARE RECOMMENDED BY EXPERT PICKS EXPERT dead cells from the surface JOSHUA ZEICHNER, MD, DIRECTOR OF COSMETIC of the skin to keep the pores AND CLINICAL RESEARCH AT THE DEPARTMENT OF clear. It’s particularly useful on the nose, chin, and forehead.” DERMATOLOGY AT THE MOUNT SINAI HOSPITAL 3 BY Ayren Jackson-Cannady 2. SCREEN STAR Aveeno Positively REVIEWED BY Karyn Grossman, MD, Radiant SPF 30, $14 WebMD Medical Reviewer “Double up this moisturizer as both an aftershave lotion and a daily sunscreen. It hydrates the skin to prevent razor burn after shaving, gives broad-spectrum UV light protection, and contains a skin-brightening soy complex.”

3. PROTECT AND SERVE Vaseline Clinical Care Extremely Dry Skin Rescue Lotion, $6 4 “This light lotion delivers a heavy punch with a special 2 lipid complex that softens the outer skin layer and helps repair a damaged barrier. It’s great for hair-bearing areas like the legs, and I have even used it for extra help for 1 shaving irritation.”

4. RAZOR SHARP Gillette Fusion Proshield, $20 “This razor has five individually spring-mounted blades to adjust to contours of the skin. It also has lubricating strips before and after shaving and technology to help lift the hair from the skin for easy shaving.”

5. NIGHT SHIFT Neutrogena Rapid Wrinkle Repair Serum, $24 “What’s better than the gift of a youthful glow? Retinol Search for the slideshow is the best-studied ingredi- Easy Skincare Tips for Men ent we have over the counter at WebMD.com. to rev up collagen production, which strengthens the THE OPINIONS EXPRESSED IN THIS SECTION ARE OF THE EXPERTS AND ARE NOT THE OPINIONS OF skin’s foundation and fights GETTY IMAGES WEBMD. WEBMD DOES NOT ENDORSE ANY off the appearances of lines

PHOTOGRAPHY: RICK LOZIER RICK PHOTOGRAPHY: SPECIFIC PRODUCT, SERVICE, OR TREATMENT. and wrinkles.” 18 WEBMD.COM18 WEBMD.COM GETTY IMAGES DERM Q&A Spotting Your Age OVER TIME COULD BE CALLED SUN SPOTS. WHAT CAN YOU DO ABOUT THEM? ABOUT WHAT DO YOU CAN SPOTS. SUN CALLED BE COULD TIME OVER SKIN YOUR ON THAT DOTS DEVELOP BROWN THE BUT SPOTS, AGE CALLED OFTEN THEY’RE serious type ofpigmentedspot. be evaluated byadermatologist toruleoutamore people may toasage refer spots.Alloftheseshould asweage, which of spotsandgrowthsalsooccur as tanningbeds,canalsobeasource.Sometypes tothesun.OthersourcesofUVlight,such exposure usually formdueto areas.They sun-exposed with clearlydefined edges onyourfaceorother University Medical School,explains. at Northwestern professor ofclinicaldermatology term isasolarlentigo. Jerome Garden,MD , technical theresultofsun.The they’re often a misnomer. overtime, dodevelop Whilethey onyourskin asyouage,that areabitof develop effects onyour skin. such destructive months—may result indarkening oftheskin,and afew But long-termhydroquinone use—beyond which canbemildlyeffective insomepatients. orhydroquinone ingredient, contain aretinoid and dothey work? cause them? GARDEN GARDEN WARMTH, AND VITAMIN D. AH, THE SUN—OUR BELOVED SOURCE OF LIGHT, Q Q BY What are age spots and does the sun alone What are thesunalone anddoes agespots Age spots,orthebenign,light-brownflat spots What at-hometreatments are available— Kara Mayer Robinson at WebMD.com. at You Age as Skin Your to Happen That Weird Things slideshow the for Search

Most over-the-counter skinlighteners Age spots are common benign skin spots Age spotsarecommon benignskinspots

If onlyitdidn’t have REVIEWED BY

Mohiba K. Tareen,Mohiba K. MD, WebMD MedicalReviewer can prescribeaprescription-strength cream. you don’t seetheresultsyouwant,adermatologist shouldbemonitoredbyadermatologist. If they may retinoids beirritating tosensitiveskin,so approach or something moreaggressive. approach orsomething touseanover-the-counter can decidewhether gerous skincancer. Onceadiagnosis ismade,you spot. Brownspotscanalsopotentially beadan- dermatologist diagnose abrown toaccurately regardless ofwhichtherapeutic approachyouuse. spots, youmay needtouch-uptherapy astimepasses, byyourdermatologist. performed skin lighteningordarkening, butthey’re lowwhen quick.Risksincludescarringand painful, butvery gen toinjurethe cellsintheage spot. It canbeabit procedure iscryotherapy, whichusesliquidnitro- should onlybeusedbyatrained physician. Another including burns,scars,andcolorchange, sothey remove brownspots. But lasers have potential risks, treatments, itcansignificantly lightenandeven that specifically oneortwo pigment.After targets GARDEN GARDEN GARDEN Q Q Q What in-officetreatments canItry? When shouldIseeadoctor? Are results permanent? It’s agood idea toseeaboard-certified therapies Sincemost willonlyfadethe effective most treatment The isalaser

3. 4. 1. 1. 4 TIPS 2. wide-brimmed hat. skin. Top itoffwitha cover-up to shieldyour warm, wear alightweight clothing. Even ifit’s Wear sun-protective skin now,” Garden. says skin your protecting start you if you thank will self older “ to prevent arepeat. Protect themfrom thesun exposure,” says Garden. darker withongoingsun residual spotswillbecome fade withtreatment, the

three hours. to two every it Reapply higher. preferably 30, least at of SPF an with day every sunscreen Apply HERE’S WHAT TO DO. JEROME GARDEN, MD. DERMATOLOGIST FROM THE SUN, SAYS SPOTS IS PROTECTION THAT PREVENTS AGE THE NUMBER-ONE THING No matter your age, your your age, your matter No WAIT DON’T UP COVER “Even ifyour spots PREVENT A REPEAT SUNSCREEN SUNSCREEN WEAR

Beauty

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19 Beauty Sign up for the Skin & Beauty Newsletter at WebMD.com.

INGREDIENT: GREEN TEA size and quality of oats is what makes the showed improvement in two weeks. Benefits: Photoprotection, antiaging ingredient so therapeutic and able to blend Geraghty points out another plus of the The connection between drinking green tea with water to form the soothing paste when natural moisturizer—shea butter doesn’t and improved health has been suggested mixed with water. seem to cause skin allergies often, which for years, but there is also a potential bene- “I like colloidal oatmeal products makes it appropriate even for the most fit to topical use of the plant. “Green tea has because they’re gentle and safe and studies sensitive skin types. LEAFY BENEFITS good results in terms of photoprotection show they don’t tend to cause allergies or Gotu kola (also known as and anti-aging benefits,” says Jeanine irritation,” Geraghty says. “I’ve found that FIND IT IN: Geraghty likes Dove Cream centella asiatica) contains chemicals that Downie, a dermatologist in Montclair, New if my eczema patients develop gentle skin- Oil Shea Butter Body Lotion ($6) and promote skin healing. Jersey. The polyphenols in green tea have care habits and regularly slather on a thick L’Occitane Pure Shea Butter ($38). antioxidant properties as well as soothing moisturizer containing colloidal oatmeal, abilities that help treat sun-damaged skin they don’t need topical steroids as much or INGREDIENT: SOY and offer a way to address the signs of sun as often.” Benefits: Inhibit pigmentation, improve damage, says Downie. collagen production FIND IT IN: Wong likes Aveeno colloidal Soybeans contain a variety of plant-based FIND IT IN: Downie likes sunscreen con- oatmeal products like their Soothing Bath chemicals that impact the skin. Among them taining green tea, such as Paula’s Choice Treatment, ($10). are antioxidants, fatty acids, and isoflavones. Skin Balancing Ultra-Sheer Daily Defense The legume also produces plant-derived Broad Spectrum SPF 30 ($23). INGREDIENT: SHEA BUTTER estrogens or phytoestrogens that address skin Benefits: Anti-inflammatory, itch relief conditions related to menopause. INGREDIENT: OATMEAL Derived from the nut of a shea tree, “One of the reasons we believe that Benefits: Anti-inflammatory, eczema relief shea butter is an ingredient in many a woman’s skin turgor and brightness “Oatmeal contains anti-inflammatory and moisturizers. “It seems to hydrate skin decreases after menopause is because of anti-irritant chemicals called avenanthr- effectively because it’s loaded with fatty decreased estrogen,” she says. “Topical amides,” Wong says. “It also has moistur- acids,” Geraghty says. These nutrients have estrogens have been shown to help izing beta glucans and starches. It’s the a calming and anti-inflammatory effect decrease UV-induced pigmentation and reason why oatmeal baths are so effective on the skin. But Geraghty says shea butter can improve collagen synthesis.” Sarkar for conditions like eczema and rashes.” But might be the most useful for treating and explains that soy won’t offer as robust 7 Best Natural Ingredients not all oatmeal is created equal, Geraghty soothing eczema. Clinical studies using results as retinoids, but they offer another says. “Colloidal oatmeal is powder that’s shea butter as a treatment for eczema in option to patients looking to address these IF YOU’RE LOOKING FOR NATURAL OPTIONS TO COMPLEMENT YOUR SKIN-CARE REGIMEN, derived from grinding and preparing oats children showed reduced itch within four conditions. The isoflavones in soy also offer TRY THESE TOP PICKS FROM THE PROS into very tiny, specific sizes,” she says. This weeks, and another study with adults photoprotective benefits that can help

BEAUTY SMARTS BEAUTY Continued on page 22 BY Liesa Goins REVIEWED BY Mohiba K. Tareen, MD, WebMD Medical Reviewer THE SCOOP THE BEAUTY WORLD IS BRIMMING We asked the experts to share the ingredients INGREDIENT: GOTU KOLA (ALSO KNOWN WITH HIGH-TECH DEVICES AND that are the best of both worlds—naturally based AS CENTELLA ASIATICA) SPLIT UP WITH SPLIT ENDS CUTTING-EDGE INGREDIENTS, and science-backed. Benefits: Wound-healing FIGHT YOUR HAIR’S NUMBER-ONE ENEMY WITH THESE PRO TIPS FROM SHAUN SURETHING, but when it comes to handling This ancient herb often used in Asian cuisine LEAD STYLIST AND CO-OWNER OF SEAGULL SALON IN NEW YORK CITY. some of the most common INGREDIENT: COCONUT OIL has become integrated into modern skin skin-care problems, newer isn’t Benefits: Hydration, anti-inflammatory care due to its wound-healing benefits, says FINE HAIR WAVY HAIR CURLY HAIR COARSE HAIR always better. In some cases, There’s growing science supporting the use of this Michelle Wong, PhD, a cosmetics chemist and For all hair types, Swap your cotton As fun as it is to On coarse, kinky hair, change the look of it’s more difficult to simple natural options might plant fat as a topical skin soother. Recent research creator of the Lab Muffin Beauty Science blog. but especially fine pillowcase for satin, hair, sleeping with which allows waves your hair, remember maintain levels of be as effective as scientifically shows that extra virgin coconut oil suppresses The plant contains chemicals that increase a humidifier is an to glide freely over that excessive use of moisture, so weekly engineered solutions. some of the body’s natural inflammatory agents blood supply to injury sites and strengthen absolute must. Hair the pillow rather hot tools and styling masks and hydrating “Many of my patients practice while enhancing the skin’s barrier function. “Many the skin. Researchers have found that when splits because it is than snag on cotton tools can cause ends conditioners are ‘clean’ eating and want to people love coconut oil products to help fight dry, skin injuries in rats are treated with centella dry, and fine hair fibers. If you prefer to split. Surething paramount. “These extend that philosophy to their itchy skin and skin diseases such as eczema and asiatica, the sites showed significantly higher splits the easiest. cotton pillowcases, says to always products lock in “If you can take consider wrapping start gently, from moisture and keep a psoriasis,” says Laurel Naversen Geraghty, MD, skin-care routine,” says Papri healing. The combination of amino acids, beta the financial leap, your hair in a satin the bottom, when barrier between your Sarkar, MD, a dermatologist a dermatologist in Medford, Oregon. “Some of carotene, fatty acids, and phytochemicals help a good humidifier scarf before you combing or brushing. hair’s cuticle and the in Brookline, Massachusetts. my psoriasis patients swear by overnight coconut support the skin’s regenerative properties to with a digital display drift to sleep, Never yank at tangles elements, including “Finding effective clean beauty oil scalp treatments worn under a plastic shower speed healing time, making it a helpful way to is great,” says Surething suggests. because it can cause rain, snow, and sun,” products isn’t as simple as cap.” However, Geraghty warns against applying treat injury sites. Surething. “Keeping tearing and splitting says Surething. the humidity level of the strand. Shield finding organic produce at the coconut oil on blemish-prone areas because it is higher will help keep ends from heat grocery store, but it’s easier than naturally comedogenic and may worsen acne. FIND IT IN: Wong likes La Roche-Posay Cicaplast moisture in the hair with a thermal- ever before to find something Baume B5 Soothing Repairing Balm ($15) and and prevent it protecting spray.

that will fit your needs.” FIND IT IN: Jars in the cooking aisle. Dr. Jart+ Cicapair Tiger Grass Cream ($48). GETTY IMAGES GETTY IMAGES from splitting.”

20 21 WEBMD.COM WEBMD.COM Beauty

Continued from page 21 “TEA TREE OIL ... MAY HELP REDUCE THE INFLAMMATORY TYPE OF BLEMISHES.” address pigmentation to keep skin even, effect against deep cystic acne or comedo- according to research. nes. Geraghty also warns about the potential for irritation when using tea tree oil as a FIND IT IN: Sarkar likes Aveeno Positively topical treatment. She suggests monitoring Radiant Daily Moisturizer ($13). areas for signs of redness or signs of a rash.

INGREDIENT: TEA TREE OIL FIND IT IN: Geraghty likes Biossance Benefits: Anti-microbial, blemish-fighting Squalane + Tea Tree Detox Mask ($39). The herbal remedy derived from tea tree leaves has antimicrobial and anti- A FINAL NOTE inflammatory effects that help combat a As is the case when trying any new range of pathogenic germs, fungus, and treatment, it’s always a good idea to run bacteria, Geraghty says. “The fact that tea something by your dermatologist to make tree oil helps combat bacteria-driven acne sure a natural therapy is being used appro- means it may help reduce the inflammatory priately, Geraghty says. “Coconut oil can type of blemishes—the tender pustules or worsen breakouts, for example, and some inflamed pink papules,” she says. However, treatments are completely unproven—they

the topical treatment doesn’t have much wouldn’t be worth it.” GETTY IMAGES HEALTHY TOGETHER Family SMARTER LIVING

NEARLY 30% OF KIDS IN GRADES SIX TO 12 HAVE BEEN BULLIED. When someone steps in, that bullying quickly stops more than half the time. Now, a new Moral study suggests that children of parents who foster positive relationships with them will be more likely to intervene. Researchers surveyed nearly 900 sixth and ninth graders about their home lives. Those most willing to stand up to Support bullies had parents who set clear rules. When the kids broke those rules, their

RELATIONSHIPS parents calmly talked with them and helped them understand what they’d RAISE KIDS WHO ARE MORE LIKELY done wrong. They also said their parents knew what they were up to when they TO DO THE RIGHT THING were not at home, and they received praise from their parents when they did well in school and elsewhere. Such nurturing, the researchers speculate, helps strengthen kids’ sense of right and wrong as well as their sense of responsibility

GETTY IMAGES to intervene when bullies threaten others. —MATT McMILLEN

23 WEBMD.COM Family Back on Track IF YOUR PREGNANCY IS A PAIN IN THE BACK, TRY THESE DOCTOR-APPROVED TIPS Search for the article Back Pain in Pregnancy at

PREGNANCY TO GET SOME RELIEF WebMD.com. BY Colleen Oakley REVIEWED BY Nivin C.S. Todd, MD, WebMD Medical Reviewer

YOUR BABY BUMP IS GROWING BY THE DAY, BUT way,” says Anand. Walking, swimming, or riding YOUR NEW BODY SHAPE OFTEN BRINGS NEW a stationary bike are all great, low-impact options 3 ACHES AND PAINS—ESPECIALLY IN YOUR BACK. “A when you have a baby on board. woman’s body is in a constant state of change during STRETCHES PRENATAL YOGA IS pregnancy, and the spine is no exception,” says Neel Kick off your heels. Improper shoes—whether A GREAT WAY TO Anand, MD, professor of orthopaedic surgery and unsupportive or too high—alter the alignment PREVENT AND RELIEVE director of spine trauma at Cedars-Sinai Spine of your pelvis, which can cause back pain even PREGNANCY BACK PAIN. Center in Los Angeles. when you’re not pregnant, says Anand. Instead, CAN’T GET TO A CLASS? TRY THESE SIMPLE As your center of gravity shifts, your body opt for comfy flats or tennis shoes that have STRETCHES, ADVISES compensates by leaning backwards, increasing the adequate cushioning and a supportive arch—at NEEL ANAND, MD. natural curve of your lower spine, which can lead least until the baby comes. to back pain. While it’s extremely common—50% CAT STRETCH to 70% of all women encounter back pain at some Perfect your pillow placement. The best position 1. Get on your hands point during their pregnancy—you don’t have to for sleeping while pregnant is on your side, with and knees and gently suffer. Ease the ache with these simple tips. a pillow between your knees. This takes pressure round out your back as off your lower back. But you can experiment with you pull in your stomach. Stand up straight. This sounds like a simple different pillow placements to see what works Do 10 reps holding this and obvious solution, but it can become more position for at least 10 best for you—like one between your arms if you to 20 seconds each, difficult as pregnancy progresses, says Anand. have upper back pain, or as pregnancy progresses depending on your To train your back muscles, sit up straight in a one under your abdomen for even more back comfort level. chair with your hands on your thighs and your support. “And, of course,” says Anand, “some shoulders down. Pull your shoulders back and pregnant women prefer a full body pillow to help STANDING 2.PELVIC TILT squeeze the shoulder blades together and hold support all these key areas of the body.” While standing straight for 5 seconds. Repeat this three or four times up against a wall with daily to perfect your posture and help relieve Talk to your doctor. For many women, back your feet shoulder-width pressure on your lower back. pain during pregnancy is bound to happen, apart, push the small of your back against and not all cases require a visit to the OB/GYN. the wall. Do 10 reps at a Jump in the pool. Or lake. Or go for a walk. “But, as always, listen to your body and don’t time to help stretch and “Exercise can be one of the best ways to be afraid to seek help if you feel you need it,” strengthen your lower relieve back pain during pregnancy because it says Anand. “Your physician can help evaluate back muscles. strengthens muscles and increases flexibility, your pain and make the best recommendations FITNESS BALL so your spinal muscles will be more ready and for treatment—giving you the best chance for 3. STRETCH willing to take on whatever changes come their bouncing back after childbirth.” Sit on the floor with a fitness ball at your back in front of a wall. Lean your back against the ball, until it supports your weight, keeping your knees bent, feet flat on the floor, and your hands on your hips with your elbows out. Push the small of your back upward into the fitness ball and hold for 10 to 20 seconds before going back into the starting position. Do 10 reps. GETTY IMAGES

24 WEBMD.COM Family

BABY Sensors for Sleep? NEW MONITORS CAN KEEP WATCH ON AN INFANT’S BREATHING DURING SLEEP, Search for the slideshow BUT RESEARCH SUGGESTS THAT THEY COULD PUT BABY AT RISK Baby Gear Essentials at WebMD.com. BY Erin O’Donnell REVIEWED BY Hansa Bhargava, MD, WebMD Senior Medical Editor

ASK YOUR DOCTOR

Q What do you think of wearable baby monitors? Despite the advice against these monitors, neonatologist Liz Foglia, MD, MSCE, acknowledges that they remain popular among new parents. If you decide to use a wearable monitor on your baby, have an honest conversation with your pediatrician. Have they had any experience with them? Have other families in their IF YOU HAVE A NEWBORN IN THE FAMILY, you Hospital of the University of Pennsylvania, who practice used them? may be tempted by a new type of baby monitor coauthored the study. designed to check vital signs while the child She hopes companies keep working to Q If I use one of these sleeps. Some of these devices are worn on develop new types of reliable home devices; monitors, how should I the infant’s foot or ankle and feature a pulse some babies with health problems do need respond to an alarm? oximeter that monitors heart rate and oxygen monitoring. “I would love to see manufacturers level, sending the information to the parent’s get to a point that they get FDA approval so we Ask your pediatrician what smartphone. An alarm sounds if the readings have confidence that their device works,” you should do if the alarm are abnormal. she says. sounds. What signs or As good as this may sound to anxious parents She worries that the current wearable symptoms should you look hoping to reduce the risk of sudden infant death monitors give parents a false sense of security, for? In what situations would syndrome (SIDS), the American Academy of making them too relaxed about proven safe they want you to seek medical Pediatrics (AAP) warns against using these sleep habits. The AAP’s recommendations attention for your baby? devices. The AAP has reviewed the existing include always putting your baby to sleep on research on apnea monitors and found no evi- their back on a firm surface with a tight sheet Q How should the wear- dence that they impact the prevention of SIDS and no excess bedding. able monitor affect the in healthy babies. And a recent study found the Babies should sleep in the same room with way I put my baby down new wearable monitors are often inaccurate, their parents, but not on the same bed, and to sleep? sending panicked parents and their babies to the parents should keep their baby away from Foglia is concerned parents hospital for unnecessary procedures. smokers and people using alcohol or drugs. will think they can use a The study suggests that the technology in A mom herself, Foglia understands the worry monitor and then place baby these monitors isn’t reliable. One of the brands that leads some parents to use sleep monitors. on her stomach to sleep, or tested detected low oxygen levels sometimes, The newborn period can be overwhelming, co-sleep. It’s essential to but not consistently, while another brand given all the responsibility of keeping your stick with safe sleep prac- missed all instances of low oxygen. False baby safe and healthy, she says. But Foglia’s tices proven to reduce SIDS alarms about pulse rate were common. “These work as a physician and researcher gives her an risk. “These monitors should consumer devices aren’t held to the same additional perspective: “I think parents can feel not change your behavior at regulatory standard as medical care devices,” empowered by the fact that there are proven all,” Foglia says. says Liz Foglia, MD, MSCE, a neonatologist at practices that put your baby at the lowest possi-

GETTY IMAGES the Children’s Hospital of Philadelphia and the ble risk for SIDS,” she says.

25 WEBMD.COM Family

4 TIPS ARTUR JASCHKE, PhD, SUGGESTS WAYS TO TURN YOUR CHILD ON TO MUSIC. some with structured music START WHEN lessons that included learning 1. THEY’RE BABIES Your Child’s One recent study found an instrument in school or at that 9-month-old babies home, some with visual arts taught to tap out rhythms classes, and some with no arts in time with music showed schooling. Then they followed KIDS’ HEALTH KIDS’ Brain on Music improvements in brain regions associated with them for two and a half years, LEARNING TO PLAY AN INSTRUMENT CAN BOOST BRAIN detecting patterns and giving them a battery of tests CONNECTIONS AND IMPROVE ACADEMIC TEST SCORES processing language. every six months. Notably, there was little BY Lisa Marshall INTRODUCE INSTRUMENT difference between groups after REVIEWED BY Arefa Cassoobhoy, MD, MPH, WebMD Senior Medical Editor 2. LESSONS BY one year. GRADE SCHOOL After 18 months, however, the While listening to music music groups started to score has its benefits, playing WANT TO GIVE YOUR CHILD AN EDGE IN MATH AND ENGLISH? higher than the other children Enroll an instrument produces them in music lessons. more cognitive rewards, on cognitive tasks such as That’s the takeaway of a recent study finding that elementary- studies show. Starting planning, memory, and problem schoolers who studied an instrument for at least 18 months not only did between ages 5 and 12, solving. After two-and-a-half better on tests of memory, planning, reasoning, focus, and self-control, when the brain is rapidly years, the differences became changing, can have the they also vastly outperformed non-musical peers on arithmetic, most impact. pronounced, with those in the language, and IQ tests. music groups also scoring 14% “Learning an instrument provides a full-brain workout, stimulating STICK WITH IT to 18% higher on arithmetic growth and building connections in various regions throughout the 3. Some benefits, and language tests and about 15 including heightened points higher on IQ tests than brain,” says lead author Artur Jaschke, PhD, a clinical neuropsychologist academic test scores, at the University of Amsterdam. “Our study provides some of the stron- don’t kick in until after the no-arts group. gest evidence yet that the cognitive skills developed during music lessons a child has played for Jaschke hopes such can influence children’s abilities in completely unrelated subjects, too.” a year. research will help demon- Parents and educators have long assumed that exposure to music strate the broader value of DON’T music education. is good for a child’s brain, but research on its impact on academic 4. DISCRIMINATE performance has been mixed and controversial. Ask your child what “To play an instrument, In 2007, a comprehensive review firmly debunked the “Mozart effect,” instrument and what you need to plan, have motor concluding that merely listening to music cannot, as some had pro- genre they are most control, remember, exercise interested in. Whether patience, and understand the fessed, make you smarter. While some research has shown that students they play violin, piano, or who play an instrument do better on standardized tests, some studies guitar or choose classical, emotions behind the music,” have shown no link at all or have been criticized for being too short or jazz, or punk, the benefits he says. “In passively training too small. are similar, says Jaschke. all those brain areas, which can With funding for arts education dwindling in the United States and be really enjoyable, you build Europe, Jaschke and his colleagues set out to “close the gap” with a Search for the connections that can improve quiz The Health larger, longer study. Benefits of Music performance in many areas

GETTY IMAGES They divided 150 children, ages 5 to 10, into four groups, providing at WebMD.com. of life.”

26 WEBMD.COM Family

Search for the article How Do E-cigarettes Affect Your Body? Vaping Risks at WebMD.com. WITH E-CIGARETTE USE AMONG ADOLESCENTS SOARING, OFFICIALS ARE WARNING OF A “PUBLIC HEALTH CRISIS” AND CALLING ON PARENTS TO HELP PREVENT A NEW GENERATION OF NICOTINE ADDICTS TEEN HEALTH TEEN BY Lisa Marshall REVIEWED BY Neha Pathak, MD, WebMD Medical Editor

BY THE NUMBERS 38% Percentage of high school seniors who say they vaped in the past year (up from 28% in 2017). 32% of 10th graders and 18% of 6th graders also say they vaped.

THINK SMOKING ISN’T COOL ANYMORE? THINK AGAIN. the developing brain. The most popular device, the A decade after the electronic cigarette was sleek black flash-drive-shaped Juul, doesn’t come in 30% introduced in the United States as a potentially a nicotine-free variety and can contain 20 times the Percentage of high- less-harmful, more-discrete alternative for adult nicotine that a combustible cigarette does. school seniors who smokers, public health experts are warning that They taste better, don’t smell like cigarettes, and vape and believe they use among youth has reached “epidemic pro- are easier to conceal from parents, making them are inhaling nicotine. portions” and could ignite a new generation of even more appealing to teens, says Prochaska. Even 26% say they’re inhaling “just flavoring.” 13% nicotine addicts. nicotine-free vaping devices have raised some con- say they’re inhaling “We are actually getting more young peo- cerns. The vapor often contains propylene glycol, a marijuana. ple’s brains exposed to nicotine today than we lung irritant that can impact behavior and the central have in years,” says Stanford University tobacco nervous system, and diacetyl, a chemical linked to a researcher Judith Prochaska, noting that use of debilitating respiratory disease known as “popcorn combustible cigarettes had been rapidly declin- lung.” With more than 7,000 largely unregulated ing in the early 2000s. “This is an unusual shift varieties—from cotton candy to Katy Perry cherry— 1,300 and very concerning.” it’s impossible to know what’s safe, she says. Number of warning In 2011, just 2% of high-schoolers said they had Even more concerning, studies show teens who letters issued by the tried e-cigarettes, or vaping (using a battery pow- vape are three times as likely to take up smoking FDA to retailers last ered device that heats up often-nicotine-infused real cigarettes. September for selling liquid and turns it into a vapor). Today, two in five Prochaska notes that because they don’t emit e-cigarettes to minors. high-school seniors say they have vaped. the carbon monoxide that comes with combustion, The meteoric rise prompted the U.S. Surgeon e-cigarettes may be less hazardous than conven- General in December to issue a rare advisory warn- tional cigarettes—and could be a good option for an ing of the “epidemic.” “We have never seen the use adult trying to wean off the real thing. “But you are of any substance by America’s young people rise as getting young people who would never have picked 1.3 rapidly as e-cigarette use is rising,” said Health and up cigarettes exposing their developing brain to this Human Services Secretary Alex Azar in a statement. addictive drug; that’s a real concern,” Prochaska says. MILLION While many teens believe they are just inhaling She encourages parents to talk to their kids Increase in the number of flavored vapor, they’re often really inhaling nicotine, about vaping, make sure they know the risk, and teens who vaped in 2018

GETTY IMAGES an addictive drug that can be uniquely harmful to set a good example by not smoking around them. compared to 2017.

27 WEBMD.COM Family

Sign up for the Parenting & Children’s Health The Power of Play Newsletter at WebMD.com. TO BUILD THE SKILLS THEY NEED TO THRIVE, KIDS REQUIRE AMPLE TIME TO 4 GAME PARENTING EXPLORE THE WORLD CHANGERS BY Lauren Paige Kennedy REVIEWED BY Roy Benaroch, MD, WebMD Medical Reviewer IMPLEMENT THESE PLAY TIPS FROM CHILD PSYCHOLOGIST EILEEN FOR MILLENNIA, PARENTS HAVE INSTRUCTED THEIR is rough-and-tumble, with kids running and KENNEDY-MOORE, ROWDY KIDS TO “GO OUT AND PLAY!” In doing so, moving their bodies. Social play may involve a PhD, INTO YOUR KIDS’ most hadn’t a clue they were actively nurturing child watching another kid, playing alongside DOWNTIME FOR OPTIMAL the emotional, cognitive, language, and self- him, which becomes cooperative play with SOCIAL, EMOTIONAL, AND MENTAL DEVELOPMENT. regulation skills that build executive function and shared goals as they interact. Pretend play is social aptitude in children, all while enhancing when children take on adult roles. Interestingly, DITCH THE DEVICE critical brain structures that support pursuing this happens cross-culturally at specific 1. There’s no “right” goals and ignoring distractions. developmental times, primarily during the number of hours for kids In other words, play is imperative for healthy preschool years.” to play—but do monitor development. So says a recent clinical report Free play enables children to understand their screen time, Kennedy- Moore says: “Playing a published in the journal Pediatrics, which own preferences and interests, the report states. video game virtually with outlines how play advances such skills even as But play guided by an adult, where the child a friend is not the same it manages toxic stress. What’s more, playing is retains his or her own agency, better promotes as a game of tag, where shown to support the formation of stable and learning with a specific goal in mind. kids negotiate the rules, cooperate, and compete nurturing relationships with caregivers that kids Kennedy-Moore agrees: “Adult-guided play is to catch each other.” need to thrive. not about an adult lecturing, but rather modeling While the definition of play is not clear-cut, for children by asking questions. For example, SOLO PLAY IS the researchers agree that play is intrinsically if a parent and a child are doing a puzzle, the 2.GOOD—TO A POINT motivated, entails active engagement, and results adult might say, ‘I notice the color yellow is “Alone play can be wonderful, and it builds imagina- in joyful discovery. It’s also voluntary, fun, and running through here. Do you see a yellow tion,” Kennedy-Moore says. spontaneous, with no extrinsic goals. piece?’ Asking questions instead of giving the “For instance, kids love There are different types of play, says Eileen answers.” This allows a child to figure it out—and playing alone with Legos.” Kennedy-Moore, PhD, a child psychologist and succeed—independently. But if your child always plays solo, it can be a red the author of Growing Friendships: A Kid’s Play and stress are closely linked, with flag for social isolation. Guide to Making and Keeping Friends. “Some high levels of play associated with low levels play is child-directed; it’s about exploring,” she of cortisol. Play may be especially important EMBRACE says. “A toddler puts everything in her mouth— for children in high-stress familial situations, 3. UNSTRUCTURED she’s curious about the world. Physical play according to the report. PLAY TIME “Kids say, ‘I’m bored!’ and parents leap to the rescue,” Kennedy- Moore says. “If they can resist, the child moans and groans—and, then, something wonderful happens: kids think of something to do. It’s a life skill to follow their own curiosity, entertain themselves, and manage their emotions.”

THE PLAY’S 4.THE THING “Play is important and valuable, in and of itself,” Kennedy-Moore says, “even if it doesn’t always encourage development every time. Play is like art— to be appreciated.” GETTY IMAGES

28 WEBMD.COM Search for the Pets Message Family Board at WebMD.com.

4 QUESTIONS WORRIED ABOUT YOUR OLDER DOG’S BRAIN HEALTH? “TELL YOUR VET ABOUT RECENT CHANGES IN YOUR DOG’S BEHAVIOR,” SAYS LETICIA FANUCCHI, DVM, AND CONSIDER THESE QUESTIONS.

DOES YOUR DOG 1. SHOW SIGNS OF COGNITIVE DECLINE? Don’t assume that ignoring commands connections between different and having accidents in parts of the brain. The tasty PETS Brain Games the house are signs of a defiant dog. reward motivated the dogs to MENTAL STIMULATION HELPS PREVENT CANINE stick with the activity. COGNITIVE DECLINE COULD OTHER While the touchscreen 2.HEALTH ISSUES games used in lab research BY Jodi Helmer BE CAUSING THESE aren’t sold in stores (yet), REVIEWED BY Will Draper, DVM, WebMD Medical Reviewer SYMPTOMS? Before diagnosing cog- Fanucchi suggests creating nitive decline, Fanucchi your own brain games says your vet will want at home. Offer your dog to rule out endocrine LONG WALKS AND ROMPS AT THE DOG PARK KEEP YOUR DOG IN TOP interactive toys that require issues, heart disease, PHYSICAL SHAPE, BUT WHAT ABOUT HER MENTAL HEALTH? Like and other medical condi- her to move a puzzle piece their owners, dogs are susceptible to cognitive decline, according tions that could cause or roll a cube to release to Leticia Fanucchi, DVM, veterinarian and clinical instructor similar symptoms. a treat. And get your pet at Washington State University in Pullman, Washington. “Dogs outside. Regular walks allow IS MEDICATION shouldn’t stop being mentally and physically active just because her to explore new sights, 3. AVAILABLE? they get older,” she says. There is a medication sounds, and smells, which Specifically, degenerative brain changes often affect dogs approved to treat cognitive can be mentally stimulating, older than 8 years. Signs of canine cognitive dysfunction include decline in dogs. Fanucchi and keeping her active disorientation, changes in sleep/wake cycles, housetraining suggests talking to your during daylight hours can veterinarian about whether accidents, increased anxiety, and less desire for physical activity and it’s right for your pet. also help reset a confused social interaction. Dogs that have memory loss may have forgotten sleep/wake cycle. routine commands such as “sit” and “stay.” WILL DIETARY Don’t wait until your Medications can help slow this cognitive decline, but a 2018 4. CHANGES HELP? pet starts showing signs of Research shows that study found that mental stimulation could also improve brain kibble formulated for doggie dementia to introduce health. Researchers at Messerli Research Institution in Vienna senior dogs could help brain-training activities. used a touchscreen to teach dogs simple computer games; the dogs improve cognitive function Fanucchi advocates a received treats for getting the answers correct. and slow cognitive decline. preventive approach: “Mental “These kinds of mental games help wake up areas of the brain that Ask about brain-protection stimulation benefits dogs blends that contain have been inactive,” Fanucchi says. The combination of sight, scent, triglycerides, B vitamins, of all ages and is especially

GETTY IMAGES and spatial orientation required to solve the puzzle helped make and antioxidants. important for older dogs.”

29 WEBMD.COM EMMA THOMPSON Thompson’s life recently REFLECTS ON THE LARGER has been “dotted with loss,” she says. Her beloved sister- in-law, Clare (who lived ISSUES OF LIFE, LOSS, just down the road from Thompson and her husband, Greg Wise, in London’s West AND RESILIENCE Hampstead neighborhood), died of cancer in 2017, just Emma Thompson is thinking about death. a year after the death of Having just turned 60 in April, the two-time Academy Award-winning Thompson’s close friend actor and screenwriter is used to the typical media questions about and Love, Actually co-star “growing old gracefully” in the film and television world. But she’s more Alan Rickman, also from interested in talking about bigger questions. cancer. “My mate Jeremy “With this watershed birthday, I will contemplate what I really want Hardy, a comedian, died just to do next,” she says during an interview from her offices in London, two weeks ago, and my best where she’s just wrapped up filming for Last Christmas—a romantic mate’s husband died last comedy inspired by the George Michael song—which she co-wrote with year. It seems like people performance artist Bryony Kimmings. “Time is precious, and it is not are dying all the time in my unlimited. One feels immortal, I think, until one is about 40. Then life. My existence feels very intimations of mortality come. My big conversation with myself, which hard-won and precious at has already started, but will go on this year is, ‘How do I feel about the moment. I’m addicted dying? Am I ready to look at that?’ We are in such denial about it, and it’s to doing and action and very strange because it’s the one thing we know absolutely will happen.” activity, but this year I’m going to look at how it feels to be less addicted to that and more able to sit.” Emma Thompson? Sit? Probably not for very long, she acknowledges: “That’s the point of this patch of time. Sixty isn’t 50. Sixty is well into ‘How many more years have I got when I can be active and useful and produce good and worthwhile work?’ Maybe 10 or 15? Going longer, I think maybe you should let everyone else have a go.” She pauses. “But if I’m lucky enough to reach that age and no one’s able to shut me up, you can remind me of this interview.”

BY GINA SHAW REVIEWED BY NEHA PATHAK, MD REWEBMD MEDICAL EDITOR HADDOW NICK BY: PHOTOGRAPHY AL Top right Late Night Top left Nanny McPhee Middle Sense and Sensibility Bottom left Men in Black: International Bottom right Saving Mr. Banks

A LIFETIME OF ROLES a way, now. It’s so interesting It’s hard to imagine the peripatetic Thompson “just sitting.” to be allowed to live long Since rising to fame with her role as Princess Catherine enough to survive things like of Valois opposite her then-husband Kenneth Branagh in depression. I’ve got an awful Henry V in 1989, Thompson has appeared in at least one lot of mechanisms that I can major movie virtually every year—sometimes several. In use now to cope with it, so I’m 1993, for example, she starred as Beatrice in Much Ado much more resilient, I think, About Nothing, as Gareth Peirce in In the Name of the than I was before.” Father, and as Miss Kenton opposite Anthony Hopkins Some of her resilience may in Merchant Ivory’s The Remains of the Day. Thompson’s also come from her passion also a screenwriter: She wrote and starred in both for activism and focus on the Nanny McPhee movies and won an Academy Award for needs of others. Thompson screenwriting for 1995’s Sense and Sensibility, in which is a longtime supporter of she played Elinor Dashwood. This summer, she reprises Greenpeace UK and the Food her role as Agent O in Men in Black: International, and Foundation, which focuses on her new film with Mindy Kaling, Late Night, which earned making a healthy diet more praise at the Sundance Film Festival in February, debuts as affordable for families. And an Amazon Original Movie. she’s the president of the Thompson’s “good and worthwhile work” has defied Helen Bamber Foundation, genre and categorization. For every restrained, enigmatic, which provides specialized emotions-bubbling-under-the-surface character like care for refugees and asylum Miss Kenton or judge Fiona Maye in 2017’s The Children seekers who have experienced Act, there’s a kooky Sybill Trelawney, the divination extreme cruelty, such as teacher in Harry Potter and The Prisoner of Azkaban or a passionate, fiery Beatrice in Much Ado About Nothing. She loves comedy—she began her career in standup with the Cambridge Footlights, alongside Stephen Fry and Hugh Laurie. And in 2003, she took on the complex dual roles of nurse practitioner Emily and the fantastical Angel in HBO’s Angels in America. “I’ve enjoyed the really out-there characters more than anything,” she says. “I played a 77-year-old I’VE ENJOYED. serial killer in The Legend of Barney Thomson. That was something special. And maybe the most remarkable .THE REALLY. experience I’ve had in the last 10 years was playing Mrs. Lovett on Broadway in the concert version of Sweeney Todd. I suppose I’m probably not very good at repeating .OUT-THERE. stuff. I think I would be bored if I had to do things again and again. It’s like going on a different walk, and the landscape is different, so you’re unlikely not .CHARACTERS. to notice what’s going on. And it’s vital that you know what’s going on when you’re creating.” .MORE THAN. “ RESILIENCE Thompson has spoken candidly about plunging into work to help her cope with depression in the 1990s, when she .ANYTHING.. was going through her divorce from Branagh, but says she hasn’t had any serious bouts with it recently. “My brain might be changing,” she says. “Your brain does change as you get older. And life is kind of settled, in TOP RIGHT: COURTESY AMAZON STUDIOS; TOP LEFT: PHOTO 12/ALAMY STOCK PHOTO; MIDDLE: COLUMBIA PICTURES/RONALD GRANT ARCHIVE/ALAMY STOCK PHOTO; PHOTO; STOCK ARCHIVE/ALAMY GRANT PICTURES/RONALD COLUMBIA MIDDLE: PHOTO; STOCK 12/ALAMY PHOTO LEFT: TOP STUDIOS; AMAZON COURTESY RIGHT: TOP PHOTO STOCK LTD/ALAMY COLLECTION MOVIESTORE RIGHT: BOTTOM ENTERTAINMENT; PICTURES SONY COURTESY LEFT: BOTTOM

32 WEBMD.COM torture and human trafficking. She has also spent many overnight. Or in a year,” she years campaigning for immigrants’ rights—her son, wrote. “But I am also aware that Tindyebwa Agaba, now 30, escaped life as a child soldier if people who have spoken out— in Rwanda. like me—do not take this sort Always politically outspoken, Thompson says that as of a stand then things are very time has passed she’s become more willing to see things unlikely to change at anything from other people’s point of view. “That’s a great, great like the pace required to protect gift, and only time gives you that,” she says. But she’s still my daughter’s generation.” more than willing to put values ahead of career: In late For young women like her February, she released a powerful letter explaining why daughter—Gaia, who’s now she was dropping out of the animated film Luck after 18—as well as women of her the producers hired a former Pixar executive accused of own age, Thompson has a inappropriate conduct with women. message: “Summon your I’M MUCH “I am well aware that centuries of entitlement to women’s powers,” she says. “You’ll find bodies, whether they like it or not, is not going to change they are great.” MORE RESILIENT, I THINK,

THAN I WAS King suggests seeking your own DEATH, MEANING, meaning in a similar way: BEFORE. Don’t aim for the gigantic achievement. Seek meaning in everyday, trivial AND YOUR moments—like Thompson’s cup of tea. “We’ve found that just being in a good mood, playing with the dog, having an enjoyable meal with friends, MORNING COFFEE can promote the sense that life is meaningful,” she says. Spending time contemplating death, as Emma Thompson plans to do in her That regular morning 60th year, may not sound appealing. But in her research, social psychologist Love your routine. coffee, the after-work walk with your Laura King, PhD, has found the opposite: After reminders of death, people dog, the glass of wine after dinner? value life more highly and find more meaning in it. “When we remind people They’re more than just mundane. of the idea of death, it makes life seem more wonderful, more precious,” “Everyday habits bring a structure and says King, curators’ professor of psychological sciences at the University of rhythm to your life that has meaning. Missouri, Columbia. They’re about the stamp that you put on To find meaning in life in the face of the fact that it’s inevitably going to stop your day,” says King. one day, you might imagine the need to achieve something great—a lasting contribution to the world. “But 1,000 years from now, all our lives will be as if Take time to notice. When you’re doing they never happened,” says King. “So our meaning has to be located in our your spring cleaning or watching snow present circumstances.” fall from your front porch or talking Indeed, Emma Thompson’s description of a recent “perfect day” has noth- to a friend in the carpool line after ing to do with receiving her damehood from the Queen of England or getting school, take a minute now and then to an Academy Award. “I got up and pootled in my kitchen, and then I went for be present. “You don’t have to hire a a long walk and had a coffee in a glass in one of my favorite food shops. I life coach or find that perfect self-help bought my mother some biscuits and then walked home and had a cup of tea book,” King says. “Your life is already with my mum and my sister.”

PHOTOGRAPHY BY: NICK HADDOW NICK BY: PHOTOGRAPHY meaningful—you just have to see it.”

35 WEBMD.COM Search for the article Things That Raise Your Chances of Dementia at WebMD.com.

Guard ing he number of people around the world with dementia is T staggering—and growing. The mind-robbing disease has no cure, but recent research is beginning to show how you may best be able to lower your chances of getting it. “It’s not yet definitive, but in the past six years, we’ve made progress on identifying modifiable risk factors for which the evidence is pretty strong,” says Kristine Yaffe, MD, professor the of psychiatry, neurology, and epidemiology at the University of California, San Francisco. At least one risk factor, getting older, is unavoidable. But scien- tists say certain lifestyle choices may lower the odds in your favor. And while it’s never too late to benefit from healthy changes in your life, studies show that starting early may mean extra protec- Mind tion decades later. THE LATEST RESEARCH POINTS TO “Research from the past two to three years suggests that WAYS YOU CAN LOWER YOUR ODDS OF risk factors need to be focused on in midlife,” says Keith Fargo, PhD, director of scientific programs and outreach at the DEVELOPING DEMENTIA Alzheimer’s Association. Consider high blood pressure. In a study published in 2017, researchers followed nearly 16,000 adults ages 44 to 66 for 24 years. They found that people with high blood pressure in midlife had a nearly 40% higher risk of dementia. A 2014 review of previously published studies estimated that midlife high blood pressure leads to as many as 425,000 cases of Alzheimer’s disease BY MATT McMILLEN in the U.S. each year. Fortunately, according to a 2018 study pub- REVIEWED BY NEHA PATHAK, M D, lished in JAMA that included nearly 9,500 adults age 50 or older, WEBMD MEDICAL EDITOR some evidence shows that controlling blood pressure could reduce the risk of mild cognitive impairment, a precursor to dementia. “This is the first trial that has demonstrated an effec- ILLUSTRATIONS: PATRYCJA PODKOŚCIELNY tive strategy for prevention of age-related cognitive impairment,” Yaffe wrote researchers reported similar findings in 101 PROTECT YOUR HEAD in an editorial published adults whose average age was 63. “We don’t Head injuries also have been tied to dementia. In a study published alongside the study. know exactly what explains the link between Minimize in 2018, for example, researchers studied the health records of more .That said, you should sleep and dementia, but it does seem that than 164,000 people who’d had a traumatic brain injury (TBI). Serious pay attention to your there is something about sleep and the clear- Your injuries doubled the risk of dementia, while repeated injuries nearly health no matter ing of beta-amyloid,” Yaffe says. tripled it. Even after more than 30 years, the risk remained 25% higher how young or old you New research also shows such buildups in than normal. are, says neurologist Risks humans. Two small studies—one published in Recent research also suggests that even mild head injuries make Douglas Scharre, MD, 2017, the other in 2018—showed an increase To potentially reduce your risk of dementia more likely. Yaffe and her colleagues studied veterans who director of the division in beta-amyloid in people who got a single dementia, says Douglas Scharre, had had mild concussions but did not lose consciousness. Their of cognitive neurology night’s poor sleep. But, the author of one of MD, focus on three targets—exercise, findings, published in September 2018, reports that such injuries at Ohio State’s Wexner the studies points out, experts worry more mental stimulation, and diet: more than double the risk of dementia. More severe injuries boost Medical Center in Columbus, about chronic sleep problems than one night the risk even higher. Ohio: “If you have any dementia risk of tossing and turning. ++ Get your heart going with Pillai points out that we can’t say if Yaffe’s results would apply factor identified at any age, that is when you There likely are other explanations as well. frequent aerobic exercise like to others besides veterans, but, he says, “it opens up a new area of should be addressing or trying to control it.” For example, Pillai says uncontrolled sleep running, walking, or riding a concern.” The relationship between head injuries and dementia The World Health Organization estimates that 82 million people apnea may cause numerous small strokes bike. That may help protect the makes sense. As Scharre puts it, “Head injuries can’t possibly be worldwide will have dementia by 2030. In the United States, nearly that lead to memory and thinking problems aging brain. “If you can, you helpful for the brain.” Nevertheless, the link is complicated and not 14 million will have Alzheimer’s disease—a leading cause of dementia later in life. But recent research raises more want to get sweaty a few times well understood. “Injury takes its toll, but we don’t know all of the —by 2050, more than double the current number, according to the questions than it answers. “A lot of the details a week,” says Scharre. mechanisms,” says Yaffe. Alzheimer’s Association. are unclear regarding how sleep impacts ++ Eat right to protect your brain. Genetics may play a role, too. One gene known to increase the risk of Dementia causes a slow decline in thinking skills. It affects mem- Alzheimer’s disease and dementia in general,” Scharre recommends the MIND Alzheimer’s disease, APOE4, may also contribute to a heightened risk ory, mood, language, and other functions of the brain. People with Pillai says. And, says Yaffe, “We still don’t diet, which combines the heart- dementia eventually become unable to live independently and require of dementia following a traumatic brain injury, according to a study know whether treating your sleep problems healthy Mediterranean diet with around-the-clock care and attention. Alzheimer’s is the leading cause, published in September. “I truly believe that there’s a huge impact from would decrease your risk of dementia.” the blood pressure-lowering followed by stroke and other conditions that damage blood vessels and genetics,” Scharre says. “Certain genetics likely make you much more DASH diet. “Anything you can do can cause what’s known as vascular dementia. HEARING AND prone to the effects of concussion such that your brain is less able to to make better eating choices, In addition to maintaining a healthy blood pressure, evidence has SOCIAL STIMULATION heal or the inflammatory condition that arises maybe goes overboard you should do,” he says. been building that keeping other heart-health factors—such as choles- In 2017, a major report on dementia added and causes more damage.” terol and diabetes—in check may lower your risk. In a study released hearing loss to the list of significant modi- ++ Keep your brain active, especially Eventually, tests might be able to identify individuals whose genes last December, for example, researchers reported that type 2 diabetes fiable risk factors. (“That’s the most import- by involving others. Play strategy make it more dangerous for them to play football, a sport in which head appears to cause brain changes that could harm memory and other ant development of the last year,” Fargo games like mah-jongg, bridge, injuries commonly occur. Scharre says that by that point we may also brain functions. Another from May 2018 found that cholesterol seems says.) Right now, though, experts don’t and hearts; find volunteer know how to modify those genes to reduce risk before the first hit occurs. to encourage the buildup of proteins in the brain that are believed to know what links hearing loss to dementia. opportunities; or simply engage In the meantime, though, avoiding injury is your best protection. play a major role in the development of Alzheimer’s disease. The authors of the report suggest that hear- people in conversation. “Social “From a public health point of view, we need to prevent traumatic brain “Managing your blood pressure, your cholesterol, and, if you have it, ing problems force the brain to work harder interaction is huge,” says Scharre. injuries,” says Yaffe, who is now studying what factors make some people your diabetes, will likely lower your risk of dementia later in life,” says to understand what’s being said. Over time, ++ Don’t wait. It’s never too soon more susceptible to dementia than others after a brain injury. “And if Jagan Pillai, MD, PhD, a neurologist with the Cleveland Clinic Lou that extra burden may cause harm. Or, the to begin buttressing your brain you’ve had one, you don’t want to get another one. We think there’s a Ruvo Center for Brain Health in Cleveland, Ohio. dementia may come from social isolation. health, says Scharre: “Start cumulative risk.” Recent research also has pointed to other things that may contrib- If your poor hearing does not allow you to early and do it continuously to ute to brain health, including: participate fully in conversations, you may protect your brain.” MORE QUESTIONS TO ANSWER lose the brain benefits that come from that All of these dementia risk factors—and more—need to be better under- • Proper sleep type of mental stimulation. stood, and another question also must be answered: How do the risks • The use of hearing aids, if necessary Scharre agrees: “Most hearing loss relate to each other? And how might addressing those risks together • Prevention of head injuries occurs outside the brain and is not related influence the development of dementia? • Regular social interaction and other types to the brain, but if you’re not getting For example, Yaffe says, if you go to the gym, you may not only of mental stimulation input or socialization, that may affect the be more physically active but also more social, both of which are brain indirectly.” believed to help protect against dementia. That may also reduce your THE LINK TO SLEEP As with sleep, it’s not yet known whether likelihood of developing depression, which some research has linked During sleep, the brain cleans house, flushing out toxic buildups of correcting hearing loss—through the use of to dementia as well. beta-amyloid, a protein that has been linked to Alzheimer’s disease. hearing aids, for example—will reduce the “We’re starting now to do trials where we don’t look at just one Poor sleep hampers the brain’s ability to perform this janitorial work. risk of dementia. But Fargo says that men- factor—we try to look at risk factors together, because often they Over time, the buildup of toxins may lead to dementia. tal stimulation, which includes interacting go together,” says Yaffe, who just began a two-year study that will A study published in June 2018, which included 283 adults whose with others, appears to offer protection examine the impact of a combination of risk factors such as social average age was 77, revealed a link between daytime sleepiness and against dementia. “Social stimulation is isolation, sleep, and blood pressure, as well as diabetes, exercise, and higher amounts of beta-amyloid. And in a study published in 2017, huge,” he says. certain medications.

38 39 WEBMD.COM WEBMD.COM 40 WEBMD.COM GOOD FORGOOD YOU GET THE OR JUST OR FACTS

ABOUT

GETTY IMAGES healthy type offat. Two important ofthemost albacore tuna,containomega-3fatty acids—a mackerel, herring,lake trout,sardines,and 2022.) Many types of fish, including salmon, tosurpass$4billionby isexpected market globalvalue ofthefishease. (FYI:The oil dis- lowerratesfor example—had ofheart ate morefish—Scandinavians andInuits, that that cultures oil whenresearchrevealed first andscientists Doctors tooknoticeoffish joints, andyourbrain. Buttherearecaveats. may have somebenefits your foryourheart, a three-day oldfish, It considerthefacts. you know. If that allsoundstoogood tobetrue,well, gorgeousand may helpyouget hair. even depression,asthma, ADHD, disease, heart pain,highcholesterol,matoid arthritis I But before youthrowoutyourfishBut before oillike macular degeneration,macular rheu- can helpwithage-related saythem. Enthusiasts it chances arefish oilisamong morning,plements every f youtake ahandfulofsup- heart-related health problems. Their LDL, LDL, health problems.Their heart-related saw those benefits already had of a host during thatcardiac arrest time. pain,anddeathbypass, chest fromsudden attack,nificantly theriskforheart cut stroke, 4 grams of pure EPA per day for five years sig- the bloodstream. A recent showed study that triglycerides—a type offat in that circulates lems morelikely. Prescription fish oilslower have conditionsthat prob - make certain heart ofpeoplewho helpthehearts drugstore—can EPA—not thetype youbuyoff the shelfat the prescription-strengthLarge dosesofpure having one: at a high risk of you’vealready hadaheartIf attack orare supplement mightbehelpful. oil’s benefits? situations may a These suggest So what do researchers know so far about fish or heavier ononethantheother. EPA areequalparts they whether andDHA different fish oil doses and formulations— wouldn’t help.Plus,different alsouse studies heard it’s good for them, so a supplement fish today oncedidbecause they’ve thanthey in Boston. medicine at Brigham andWomen’s Hospital says JoAnn Manson, MD, ofpreventive chief supplementlike omega-3s,”role ofadietary ACE the inhibitors,andthismay obscure andare onaspirin,statins, beta-blockers, large percentagehigh-risk patients. Avery medications that arenowbeingusedtotreat thesameresults. didn’t get studies scratched theirheadswhenmorerecent in many ways,heart butresearchers have showed thatEarly tests fish oil helped the “Some showbenefits. Many donot.” Arkansas forMedical SciencesinLittle Rock. diologist and professor at the University of mixed,” says J.L. Mehta, MD, PhD, acar- help theheart. fish oilstraight—without eating fish—might taking Researchers wantedtoknowwhether (EPA) acid(DHA). anddocosahexaenoic omega-3s infish areeicosapentaenoicacid But it’s noting that the people who worth It may alsobethat Westerners eat more may be because there are so many “This “In clinicaltrials,theresultsarevery at WebMD.com. at Omega-3s About Know to Need What You slideshow the for Search

study of 25,871 adults older than 50 with an adultsolderthan50withan of25,871 study of people who are in pretty good health. In a In lower doses,fish oil may help the hearts your heart’sIf already pretty healthy: of aclinician,avoid mega-dosing.” Manson. “Unless you’re undertheguidance sules. Butwedon’t knowthat that’s safe,” says tion drugs. like FDA-approvedand safety-tested prescrip- arenotregulated ingredients, too,andthey Over-the-counter supplementshave other of EPA useprescription-grade pureEPA. that. Studiesthat showbenefits ofhighdoses about 22 capsules—and noonerecommends Want thefullfourgrams? You’d needtotake fish 1.8grams ofEPA. oilsupplementtoget an averageservings—of over-the-counter EPA? You’d have totake 10capsules—five thanWesternersdiet do. fromthefishoil directly intheirregular who wereJapanese, alreadygot morefish EPA than 4 grams, participants, the study pressure. Although1.8grams isalotless and/or disease,diabetes, heart highblood Manyhigh cholesterol. ofthemalsohad problemsinpeople whohadother heart theoddsofhaving attackscut heart and medication,tion toacholesterol-lowering form of1.8 grams ofEPA per day, in addi- at whichyou’d seeingbenefits.” stop would berecommended.There’s athreshold says Manson, “it’s unlikely that 4 grams a day havingand runanormalriskofever one, disease morelikely. that madeheartat oneotherfactor least and haddiabetes disease,orthey had heart alsoalreadylowering medications. They tookcholesterol- thoughthey high even or “bad,” andtriglycerides cholesterol were “Some peopletake multiple,multiplecap- howmuchis1.8grams ofSo, exactly foundthatA similarstudy aprescription For attack hadaheart never peoplewho’ve

GETTY IMAGES consume enoughfish,” says Duffy MacKay, forpeoplewho don’tnutrient shortfalls reason tosupplement,thenit’s tofulfill enoughfish.don’t get “Ifthere’s arock-solid eat plenty of fish—and more in people who benefits may in bepeople fewer who already benefits fromfish oilsupplements,those lead todementia. andthinking skillsthat can loss ofmemory shellfish theriskofstroke may andthe cut do.Eatingthose whorarely fish ornever and diseasethanare lesslikely todieofheart people whoeat fish onetofourtimesaweek showthat disease,studies the riskofheart ple, whilefish oilsupplements don’tlower strate thebenefits ofeating fish. For- exam benefits offish oilsupplementsdodemon- In that studies show no diet. several fact, nutrient, includingomega-3,isfromyour Absolutely. way any best almost toget The orunclear.oil areeithernonexistent less likely. disease arisemay make having thecondition symptomsofthe high dosesofDHAbefore Alzheimer’s),a higherriskofdeveloping APOE 4gene mutation (which indicates Alzheimer’s the carry diseasebecausethey have ahigher-than-average riskofgetting the researchshows.Andinpeoplewho for painmedications, butonlyalittle, andreducetheneedrheumatoid arthritis a few. symptomsof Fishoilmightrelieve benefitsconditions. The areclearforonly theeffectsstudied offish oilonmany other health,researchershave fromheart Aside worried about: it’sIf not your heart you’re disease havefor heart failedtodoso. fishprove ordinary oil supplements lower risk disease. In many that studies aimedto fact, have alowerriskofstroke ordeath fromheart attack duringthat time.However, didnot they for five yearshada28%lowerriskforheart day in adaily over-the-counter dose)—every alittle morethanyoumightfind DHA (just taining 460 mg EPA and 380 mg one gram of fish oil—con attack, the ones who took average riskforheart What’s that more,instudies doshow forotherconditions,thebenefitsAs offish -

before starting fish starting before oil. that couldbedangerousabout interactions Xenical), orvitaminE,talktoyourdoctor weight lossdrugorlistat (soldasAlliand lowering medications, contraceptives, the gas, acidreflux, andvomiting. bloating, belly pain, constipation, diarrhea, include belching,indigestion, nausea, effects, which1%to10% of peoplehave, commonside most you alreadytake. The itmight haveinteractions withmedications aboutto yourside effectsdoctor and any erably thefatty kindthat’s rich inomega-3s. that’s about7ounces—offish- aweek,pref recommendstwoAssociation servings— from yourplate first. AmericanHeart The There’s noproofthat’s safeorhelpful. take Butdon’t stop. any morethan that. doing wellonit,noresearchsays youshould mended over-the-counterdose,andyou’re says MacKay. nutrient,”areas showsitisanimportant issolid inacouple that theevidence fact but the“Fish oil isnotamagiccure-all, not have aclearbenefit,” Manson says. did aweek,they were above1.5servings they ments would have no additional benefit. If already at athresholdwherethesupple- have sufficient fish intake andweren’t already didn’t took thesupplement.“They attacka 40%dropinheart riskwhenthey attack, diseasedeath and stroke, andheart ate fish theleast hada19%dropinheart oneswhowho ate that muchormore.The andahalfoffish serving perweek,andthose into two groups—thosewhoate lessthana participantsresearchers dividedthestudy alreadyeatfor peoplewhodidn’t fish. The attacks.risk for heart was trueonly That that 1gram offish oil perday loweredthe andingredientsuppliers. facturers supplementmanu- that representsdietary Responsible Nutrition, atrade association affairs at the Council for entific andregulatory president forsci- ND, seniorvice If youtake bloodthinners,pressure- takingIf fish you want to start oil, talk If you’re it nottakingfish toget oil,try If youalreadytake fish oilat arecom- For take that example, thestudy showed

QUESTIONS WEBMD.COM 43 DELICIOUS BITES Food MEALS MADE EASY

IF SUMMER’S APPROACH HAS YOU FEELING PARCHED, reach for a cool wedge of melon. Cantaloupe, honeydew, and watermelon, all in season now, are Juicy Fruit loaded with water. (The aptly named watermelon, for example, is 92% water.) SATISFYINGLY SWEET BUT LOW- Melons also offer an impressive array of disease-fighting nutrients. One cup CALORIE, MELON IS A PERFECT of cubed cantaloupe provides 98% of an adult’s daily value of vitamin C and SUMMER SNACK—WITH THE ADDED 108% of vitamin A, both important for healthy skin and strong immunity.

GOOD FOR YOU FOR GOOD ADVANTAGE OF CONTAINING And watermelon is a top source of the antioxidant lycopene—diets high in DISEASE-FIGHTING ANTIOXIDANTS lycopene may reduce prostate cancer risk. Before slicing a ripe melon, wash the rind well and use a clean knife to prevent the spread of harmful bacteria. Once cut, store melon in the fridge. For a true summer treat, enjoy melon

GETTY IMAGES cubes tossed with chopped mint and fresh lime juice. —ERIN O’DONNELL

44 WEBMD.COM Food

LEMON-THYME VINAIGRETTE Grain Bowls Whisk together 3 tbsp extra-virgin olive oil; 2 tbsp white 3WAYS balsamic, cider, or sherry vinegar; 1 tbsp chopped GRAIN BOWLS MAKE SUPER-HEALTHY SUMMER SUPPERS. START WITH fresh thyme; 1 tbsp fresh lemon juice; ½ tsp prepared YOUR FAVORITE WHOLE GRAIN, ADD A LEAN PROTEIN AND CHOPPED VEGGIES, Dijon mustard; ¼ tsp salt; and fresh ground pepper. AND TOP IT OFF WITH A FLAVORFUL DRESSING. (Recommended for the California and Greek Bowls.)

BY Erin O’Donnell RECIPES BY Kathleen Zelman, MPH, RD, LD

Sign up for the Healthy Eating Newsletter at WebMD.com. 2 The Mediterranean 3 Asian-inspired Greek Tuna Grain Bowl Thai Salmon Grain Bowl 2 Grain bowls are fabulously flexible. You This bowl is a cool treat on a warm evening. 1 The Vegan Version can swap out ingredients depending on It combines sweet and sour flavors with what you have on hand. For example, this satisfying crunch. Some of the crunch California Veggie Bowl recipe calls for deliciously chewy wheat comes from bok choy, a mild relative of The combo of avocado, quinoa, berries, but you could use farro (another cabbage with wide celery-like stalks and chickpeas, and kale makes this type of wheat) if you prefer. We use bright green leaves. Find it in most large a filling meal. We recommend lightly cooked tuna steak here, but you grocery store produce sections. baby kale, which is more tender can make it with canned tuna, too. than the larger leaves. Try this THE MIX dish with different beans in 1 THE MIX place of the chickpeas; we like COOKED BROWN RICE + COOKED SALMON, white cannellini beans, too. COOKED WHEAT BERRIES + TUNA STEAMED SHELLED EDAMAME, RED SWEET STEAK, 2 HARD-BOILED EGGS, STEAMED PEPPER, BOK CHOY, MANGO, DRY-ROASTED THE MIX GREEN BEANS, GRAPE TOMATOES, UNSALTED PEANUTS, CILANTRO, LIME COOKED RED QUINOA + KALAMATA OLIVES, FETA CHEESE COOKED CHICKPEAS, BABY MAKE IT KALE, CUCUMBER, CARROTS, MAKE IT Make the dressing: Whisk together 1 tbsp AVOCADO, SUN-DRIED Spray a heavy-bottom skillet with cooking each of lime juice, soy sauce, and peanut TOMATOES, TOASTED WALNUTS spray and heat over medium-high heat. butter with 1 tsp rice vinegar. Set aside. In Season tuna steak with salt and pepper each of four bowls, arrange ½ cup brown MAKE IT and add to skillet. Cook, uncovered, for rice, 3 oz cooked salmon, edamame, thinly Prepare the Lemon-Thyme Vin- 6 to 9 minutes or until fish begins to flake sliced red pepper, chopped bok choy, and aigrette, above, in a large bowl. when tested with a fork but is still pink in cubed mango. Spoon dressing Add kale and toss to combine. the center, turning once halfway through over each bowl, and serve In each of four bowls, arrange through cooking. Remove from heat and topped with peanuts, chopped an equal amount of kale, chick- cut into 12 slices. Prepare the Lemon-Thyme cilantro, and a lime wedge. peas, thinly sliced cucumber, Vinaigrette, above. In each of four bowls, SERVES 4 shredded carrots, cubed arrange wheat berries, tuna slices, half an avocado, and quinoa. Serve egg, green beans, grape tomatoes, and topped with sliced sun-dried olives. Spoon dressing over each bowl, PER SERVING (1½ CUPS OF RICE, tomatoes and toasted walnuts. garnish with crumbled feta, and serve. VEGETABLES, AND FRUIT WITH 3 SERVES 4 SERVES 4 OUNCES SALMON) 536 calories, 29 g protein, 41 g carbohydrate, 29 g fat (5 g saturated fat), PER SERVING (½ CUP QUINOA WITH ABOUT PER SERVING (1 CUP WHEAT BERRIES AND VEGETABLE 53 mg cholesterol, 3 1½ CUPS BEANS AND VEGETABLES) WITH ½ EGG AND 3 OUNCES TUNA) 7 g fiber, 12 g sugar, 430 calories, 14 g protein, 50 g 399 calories, 28 g protein, 31 g 297 mg sodium. carbohydrate, 22 g fat (3 g carbohydrate, 18 g fat (4 g saturated fat), Calories saturated fat), 0 mg cholesterol, 152 mg cholesterol, 5 g fiber, 4 g sugar, from fat: 11 g fiber, 5 g sugar, 361 mg sodium. 400 mg sodium. Calories from fat: 33% 47% Calories from fat: 44% PHOTOGRAPHY: RICK LOZIER; FOOD STYLING: CHARLIE WORTHINGTON CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY: Food

MAKE IT • Use a non-stick 8- or 10-inch • Prep your fillings. Some sauté pan so that the frittata classic fillings—potatoes, easily slides out when done. mushrooms, and spinach, for Make sure it’s oven-safe (no example—need to be cooked plastic handles). in advance. Corn, however, can go in raw. Some Frittata • Keep it light. Plan for two vegetables, like broccoli, eggs per person and season become mushy and should AN ITALIAN VARIATION ON THE OMELET, THE FRITTATA CAN BE them with salt when you be left out. MADE IN COUNTLESS DELICIOUS WAYS whisk them. • Work in stages. Cook on the • Fresh eggs from a farmers stovetop until the edges BY Matt McMillen market or, even better, from begin to set, then slide the BUILD A BETTER A BUILD REVIEWED BY Hansa Bhargava, MD, WebMD Senior Medical Editor a friend who raises chickens pan into the oven. To test make the best frittatas. But doneness, give the pan a FOR MICHAEL RUHLMAN, THE JAMES BEARD AWARD-WINNING don’t worry if those aren’t quick shake. It’s ready once COOKBOOK WRITER and author of Egg: A Culinary Exploration options: You’ll do just fine with the center barely jiggles. generic supermarket eggs. of the World’s Most Versatile Ingredient, cooking began with • Serve it in wedges alongside the frittata. “It was the first meal I made as a child,” he says. • Personalize it. Let the cheese a salad. Having a party? you use match your taste Make it an hors d’oeuvre: He was in fifth grade, and he’s been making them ever since. and mood. Cheddar, Comté, Cut it into small squares and “They’re simple, anyone can make them, they’re nutritious, and Emmenthaler all shine serve at room temperature. they’re economical, they’re delicious, and they make a great in a frittata, but if you prefer smoked Gouda or crave a meal for breakfast, lunch, or dinner,” he says. Follow his tips for stinky cheese like Taleggio, a better frittata. toss those in.

SALAD KITS

THE EASIEST SALAD? ONE THAT’S ALREADY MADE, LIKE THESE SALAD KITS SELECTED BY REGISTERED DIETITIAN MELISSA TRADER JOE’S TAYLOR FARMS WHOLE FOODS TAYLOR FARMS TRADER JOE’S YELLOW CURRY SOUTHWEST 365 SWEET KALE ASIAGO KALE GOCHUJANG CHOP JOY DOBBINS, CHOPPED SALAD KIT CHOPPED SALAD KIT SALAD KIT CHOPPED KIT SALAD KIT MS, CDE, HOST “This delicious “Love cilantro? This is “Slightly sweet with “The Parmesan “This Korean-style kit OF THE “SOUND Indian-inspired kit, your salad. The creamy only a little added croutons and aged has a spicy yet sweet BITES” PODCAST. with red and green cilantro dressing—no sugar, this salad boasts Asiago cheese add vinaigrette to flavor its cabbage, carrots, added sugars—pairs more fiber than the hints of Italy to this nutritious blend of cab- THE OPINIONS EXPRESSED IN THIS naan chips, and more, perfectly with the others with broccoli, salad of shaved bage, lettuce, carrot, SECTION ARE OF THE EXPERTS AND ARE packs a lot of bold green cabbage, ro- Brussels sprouts, green Brussels sprouts, celery, and radishes, NOT THE OPINIONS OF WEBMD; WEBMD flavor in its ginger maine lettuce, carrots, cabbage, radicchio, tender kale, and while puffed brown DOES NOT ENDORSE ANY SPECIFIC radicchio dressed PHOTOGRAPHY: RICK LOZIER; FOOD STYLING: CHARLIE WORTHINGTON CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY: PRODUCT, SERVICE, OR TREATMENT. lime vinaigrette, so pepitas, green onion, dried cranberries, and rice and black sesame consider dressing it and tortilla strips.” pumpkin seeds and with lemon garlic seeds add crunch.” to taste.” a zesty poppy seed vinaigrette.” dressing.” 47 WEBMD.COM Food 3 FOOD 101

Look for the slideshow Spices and Herbs to Pump Up the Flavor Fresh at WebMD.com.

EGGS, SOUPS, PIZZA, PASTA, SALADS, STEWS—REALLY JUST ABOUT ANY DISH YOU PREPARE—TASTE BETTER AND BRIGHTER HerbsWITH FRESH HERBS 2

BY Matt McMillen REVIEWED BY Hansa Bhargava, MD, ~WebMD Senior Medical Editor

FOR NIK SHARMA, CREATOR 3. CILANTRO OF THE POPULAR FOOD “With faint hints of BLOG A Brown Table and citrus, this herb works 5 author of the cookbook wonderfully as a garnish Season: Big Flavors, Beautiful and in marinades and Food, fresh herbs add flavor dressings—both leaves and more. “The color contrast and chopped stems—and they add, those bright greens, it pairs perfectly with cooked spinach.” makes a dish seem lighter and much more appetizing,” he says. “And they’re such a cheap way to change the flavor profile 4. FLAT-LEAF PARSLEY of what you cook.” Here are his “Much more citrus- five essential herbs: forward than cilantro, this all-purpose herb should always be on hand. Scat- 1. CURRY LEAVES ter it on just about every- “Fragrant and unique, fresh thing, especially eggs. leaves can be ground for mar- Just a little bit amplifies inades, sauces, and, naturally, their flavor.” curries. Or, infuse their flavor into hot oil that can then be used to make a vinaigrette.” 5. CHIVES 1 “There are so many kinds 2. FENNEL FRONDS to choose from. Their “This is such an aromatic pretty, edible flowers herb, with its strong anise make an ideal garnish, scent. Add the delicate and you can liven up fronds to seafood dishes or ground beef or ground to yogurt and reserve the lamb with the potent

tough stalks to use in stocks.” flavor of garlic chives.” WORTHINGTON CHARLIE STYLING: FOOD LOZIER; RICK PHOTOGRAPHY: GETTY IMAGES GETTY IMAGES

48 49 WEBMD.COM WEBMD.COM EXPLORE HEALTH Checkup TAKE ACTION

Hearing Loss HEARING LOSS IS A FRUSTRATING BUT THE LATEST THE COMMON PART OF GROWING OLDER. ALMOST THREE-QUARTERS OF ADULTS OLDER THAN 70 HAVE SOME TROUBLE HEARING.

ALL TOLD, HEARING LOSS AFFECTS AN ESTIMATED 37.5 MILLION tests of their brain function. Those with severe hearing loss AMERICANS. Yet relatively few adults who could benefit since the start of the study got the lowest scores on the test, from hearing aids use them. Among those younger than and their thinking skills slipped fastest over the years to 70, fewer than one in five use hearing aids. Older than 70, come. Any hearing difficulty was linked to swifter decline just under one in three who are hard of hearing use the in thinking than those whose hearing held steady, but devices. But getting help can head off bigger problems education helped make up for mild impairment. In another down the road. study of older adults, those who had minor loss were twice When you can’t hear as well as you used to, needless to as likely as their fully hearing peers to have signs and say, you miss a lot. That drives many people to think they symptoms of depression. are losing their memory instead. New research shows that However, age-related hearing loss is not an irreversible more than half of the people who see their doctor about fate. Hearing aids help. Until recently, though, cost, lack of memory and thinking concerns have a hearing problem. insurance coverage for the devices, and a required medical Many don’t have memory loss at all. appointment have put them out of reach for many people. Trouble hearing, however, can be a precursor to a decline A new federal law is designed to bring lower-cost, over- in memory and thinking skills. In a study that followed the-counter hearing aids to the market by the end of 2020. 1,164 adults around age 73 for up to 24 years, about 70% Preliminary studies show that many of the devices that could had some degree of hearing impairment at the start of the be available under the new law work just as well as their study. During the years of follow-up, the older adults took more expensive, prescription counterparts. —SONYA COLLINS GETTY IMAGES

50 WEBMD.COM Checkup Quality News SOME IMPORTANT THINGS TO KNOW ABOUT YOUR MEDICATIONS EXPERT Q&A EXPERT

RECENT ARTICLES HAVE PROMPTED QUESTIONS Q Are drugs legally marketed in the U.S. but REGARDING THE QUALITY OF THE NATION’S made outside of the U.S. of lower quality than BY THE DRUG SUPPLY. Michael Kopcha, PhD, RPh, drugs made domestically? NUMBERS director of the Office of Pharmaceutical KOPCHA There is no difference in the quality of Quality at the FDA, answers some questions drugs legally marketed in the U.S. based only about drug quality. on their origin. The FDA has the same quality standards and conducts the same inspections of Q How does the FDA assure the quality of manufacturing facilities around the globe. We 252 drugs in the U.S.? also did a test. We bought 323 different drugs Number of drug KOPCHA All drugs must consistently and safely legally marketed in the U.S. but made around the manufacturing facility provide their intended benefit. To do this, world—including more than 100 from India. All inspections in India in drug manufacturers must meet quality samples met the tested quality standards regard- 2018, an all-time high. standards that ensure every dose of a drug less of the drug’s origin. is of the appropriate strength and free of around contamination and defects. The FDA assesses Q Are generic drugs of lower quality than a drug—and its manufacturing process— brand-name drugs? before approving it. KOPCHA Generic drugs have the same risks, bene- Surveillance programs continue after a drug fits, and quality as brand-name drugs. They use 80% is on the market so we can check that the same active ingredients and work the same Percentage of manufacturers correct any problems as way. Generic drugs go through a rigorous assess- manufacturing facilities soon as possible. The FDA also conducts ment prior to receiving FDA approval. We conduct for active ingredients in inspections of drug manufacturing facilities to inspections of generic drug manufacturing facili- drug products located ensure compliance with our requirements. We ties to ensure compliance with good manufactur- outside the U.S. prioritize these inspections based on facilities ing practices. The FDA monitors brand-name and and drugs that pose the greatest potential risk generic drugs to make sure manufacturers pro- around to patients. duce safe, effective, quality medicines for patients. 80% Percentage of respondents to a WebMD.com survey who felt generic drugs were of equal quality to the prescription brand- name version. around 80% How much lower the cost of a generic drug is, on average, compared to a brand- name drug. GETTY IMAGES

51 WEBMD.COM Checkup

Need a doctor? Use WebMD’s Physician Directory. Go to WebMD.com/findadoctor.

ALMOST HALF OF AMERICANS TAKE AT LEAST ONE PRESCRIPTION DRUG, while more than 12% take five or more prescription drugs, putting pharmacists on the frontlines as health care providers.

EXPERT KNOWLEDGE, ACCESSIBLE ADVICE Pharmacists field requests about medications used to treat complex diseases and common conditions. You’ll find them in hospitals, medical clinics, and nursing homes, but 45% work in retail pharmacies, dispensing prescription drugs and helping customers find the right over-the- counter medications for ailments such as fevers, headaches, toothaches, and athlete’s foot. These medication specialists advise patients about correct dosing and possible drug interactions. Research shows that having a pharmacist on a health care team helps boost medication adher- ence (that is, patients taking their prescription drugs when they should in the correct dosage).

BEYOND MEDICATION Dispensing medication and advising on correct use is a big part of what pharmacists do, but many also perform blood pressure monitoring, cholesterol screening, and bone density scans; they are also licensed to give immunizations. Pharmacists help patients minimize the financial burdens of filling their prescriptions, offering information about generic alternatives and programs to help cover medication costs.

HIGH-TECH HEALTH CARE PROS Pharmacists, who must earn doctoral degrees and Pharmacist pass licensing exams, are passionate about patient care. New technologies tackle manual tasks like IF YOU’VE EVER FILLED A PRESCRIPTION OR ASKED FOR ADVICE counting, sorting, packaging, and dispensing WHO’S WHO WHO’S ON WHICH OVER-THE-COUNTER MEDICINE TO CHOOSE, YOU’VE medications to give pharmacists more time to BENEFITTED FROM A PHARMACIST’S EXPERT KNOWLEDGE devote to patient education. In fact, robots are BY Jodi Helmer becoming more common in hospital pharmacies REVIEWED BY Brunilda Nazario, MD, WebMD Senior Medical Editor and may debut in drug stores in the near future.

BY THE NUMBERS

Percentage Percentage of 4.7 billion 282,000 of female pharmacists who Projected number of prescriptions GETTY IMAGES Number of licensed pharmacists in the U.S. 57.5% pharmacists. 13% work in hospitals. that will be filled in 2021. 52 WEBMD.COM Checkup Test Time INSIGHT FIND OUT WHEN THESE FOUR SCREENINGS CAN BE BENEFICIAL TO YOUR HEALTH

IT’S OFTEN SAID OUR HEALTH CARE SYSTEM IS If you have a family history of an abdominal DESIGNED TO TREAT SICK PEOPLE, NOT PEOPLE aneurysm or if you are a man aged 65 to 75 WHO ARE DOING FINE. Sometimes that results in who has ever smoked cigarettes during your missed screening tests people need to have as lifetime, you should get an ultrasound of your they get older. Talk to your doctor about these abdomen at least once. four tests to help minimize your risk of certain health conditions. 3. LUNG CANCER SCREENING We have learned over the years that routine, BY John Whyte, MD, MPH, COLON CANCER SCREENING WebMD Chief Medical Officer 1. yearly chest X-rays are not cost-effective for I find this is the test that people often cancel diagnosing lung cancer. However, doctors do at the last minute or simply don’t show up recommend a low-dose CT scan for anyone to do. I recognize that many people find 55 to 80 who has a 30-pack-year smoking the thought of the procedure as just too history (that is, one pack of cigarettes per day unpleasant. But now we have less invasive for 30 years) and currently smokes or has quit tests available, and even the preps used to within the last 15 years. clean out the colon are easier to drink and more tolerable. Current recommendations COMPREHENSIVE EYE EXAMS by most insurers are that people of normal 4. Vision plays such an important role in risk get a colonoscopy every 10 years everyone’s life. Even an inability to read fine starting at age 50. Given some data that print that often occurs as you age can decrease shows colon cancer is increasing in people quality of life. Unfortunately, eye conditions younger than 50, the American Cancer such as glaucoma and macular degeneration Society recently recommended people of often have no symptoms until vision loss is average risk start at age 45. significant. That’s why it is so important to get comprehensive eye exams. The American 2. ULTRASOUND FOR ABDOMINAL Academy of Ophthalmology recommends AORTIC ANEURYSM that most adults have such an exam at age 40. We often hear about aneurysms in the For adults 40 to 54 with no risk factors, the brain, but they can also happen in the part screening recommendation is every two to four of the aorta (the main artery in the body) years. If you’re 55 to 64, you should be screened located in the abdomen. If an aneurysm every one to three years; if you’re older than 65, Search for the slideshow bursts, death is almost always certain. you should receive a comprehensive eye exam Over 50? These Problems every one to two years. Can Sneak Up on You at Luckily, we have tests than can help

GETTY IMAGES WebMD.com. diagnose an aneurysm before it bursts. Questions? Comments? Email me at [email protected].

53 WEBMD.COM Checkup This content is created and controlled by WebMD’s editorial staff and brought to you by the UPMC Living-Donor Liver Transplant Program. Living Liver Donors HELP FOR THOSE WAITING FOR TRANSPLANTS SPOTLIGHT SPOTLIGHT BY Matt McMillen REVIEWED BY Hansa Bhargava, MD, WebMD Senior Medical Editor

RIGHT NOW, NEARLY 14,000 PEOPLE ARE ON A dramatic discrepancy. Many people know that NATIONWIDE WAITING LIST FOR A LIVER TRANS- they have two kidneys and that, given the right QUESTIONS PLANT. While the number of liver transplants circumstances, they can spare one to save the life FOR YOUR performed annually has risen significantly during of someone in need. “But,” says DiNorcia, “people DOCTOR the past decade, the demand still far exceeds the often wonder, How can I be a living donor when I supply. In 2018, fewer than 60% of those on the only have one liver?” DO I QUALIFY TO BE waiting list received a transplant. It’s true that you can’t live without your liver. It A LIVING DONOR? Criteria vary, but, in “There are more patients than we have organs,” performs too many essential functions as part of general, you must be a says transplant surgeon Joseph DiNorcia III, MD. your digestive system. However, it has a remark- healthy adult, and some “In the U.S., we have a national, well-organized able ability to regenerate. While recovery times facilities require you to system to procure livers, but even with that there may vary, that means the portion of the donor’s have a blood type that are patients who die on the waiting list. Living liver that gets removed will grow back within a few matches the recipient's. You will undergo a donors can play a big role in filling the gap.” months. Meanwhile, the transplanted portion will thorough medical A living donor volunteers to have a portion of grow into a fully functioning liver in the recipient. evaluation before you her or his liver surgically removed for trans- When waiting for a liver from a deceased become a donor. plant. Most often, says DiNorcia, who directs donor, those most severely ill get highest pri- WHAT ARE THE RISKS? the Living Donor Transplant Program at UCLA, ority. Living donor programs work differently. As with any surgery, such a donor is a family member, close friend, They allow doctors to plan procedures when complications may occur, or loved one of the recipient, who has end-stage patients who need a transplant are still relatively including infections, liver disease. But some people offer to donate to healthy—compared to the sickest of the sick— bleeding, and blood clots. strangers, what’s called a non-directed donation. and when the benefits of the surgery are more While rare, it’s possible that you would not survive “We do see a fair number who just want to do likely to outweigh its risks, says DiNorcia. He the procedure. something good,” says DiNorcia. calls it “a paradigm shift.” Currently, though, only about 5% of liver trans- DiNorcia hopes that as awareness grows, so will WHO PAYS THE COSTS? plants come from living donors. Donors who have the ranks of volunteer donors. He finds them quite Most commonly, the recipient’s insurance will recently died account for the remaining 95%. inspirational. “You can tell them about all the poten- cover all medical fees, Compare those numbers to kidney transplant sta- tial risks of complications from surgery, but they but you should confirm tistics: 40% of kidney donors are living donors. don’t care,” says DiNorcia. “They just want to help.” that and understand DiNorcia says that lack of public awareness For more information, go to webmd.com/ any costs, such as about living liver donation explains much of that livingdonor. travel, that you might be required to pay.

HOW LONG WILL IT TAKE TO RECOVER? While it varies, you should expect to spend a week in the hospital, then up to two months recuperating at home before returning to work or regular activities. GETTY IMAGES

54 WEBMD.COM Checkup

Medical Devices BY Matt McMillen REVIEWED BY Brunilda Nazario, MD, WebMD Senior Medical Editor

Search for the article Obstructive Sleep Apnea:

BY THE NUMBERS THE BY Gadgets and Devices at WebMD.com. 1/4" Approximate length BILLION of the world’s Size of the U.S. medical device market smallest pacemaker

69% Percentage of home 400,000 blood pressure monitors Number of people with type 1 diabetes deemed inaccurate who use an insulin pump

28.8 #1Rank of wearable 1984 MILLION devices in 2019 Year the FDA approved Number of U.S. adults who could fitness trends the first cochlear implant benefit from hearing aids

1 IN 3 The number of 2 IN 3 artificial heart People with sleep CPAP users whose sleep apnea who don’t use improved while using models approved their CPAP device their device 1 by the FDA

ACSM’S HEALTH & FITNESS JOURNAL, AMERICAN JOURNAL OF HYPERTENSION, DIABETES CARE, THE GEORGE INSTITUTE, HAWAII JOURNAL OF MEDICINE & PUBLIC HEALTH, JOURNAL OF OTOLARYNGOLOGY—HEAD & NECK SURGERY, JOURNAL OF THORACIC DISEASE, NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISOR-

GETTY IMAGES DERS, NATIONAL INSTITUTES OF HEALTH, SELECTUSA.GOV

55 WEBMD.COM Checkup

QUIZ On Your Mind NEARLY ONE IN FIVE AMERICANS—ALMOST 45 MILLION PEOPLE—LIVE WITH A MENTAL ILLNESS. DO YOU KNOW THE DIFFERENCE BETWEEN DEPRESSION, BIPOLAR DISORDER, AND OTHER MENTAL HEALTH CONDITIONS? TAKE THIS QUIZ TO FIND OUT. ANSWERS BY Stephanie Watson REVIEWED BY Brunilda Nazario, MD, WebMD Senior Medical Editor 1. FALSE To qualify for a diagnosis of major depression (also called clinical depression), you need to have severe symptoms that interfere with your daily life for at 1 2 3 least two weeks. IF YOU’VE BEEN BACK PAIN, COLD SAD FOR A STOMACHACHES, TEMPERATURES TRUE WHOLE WEEKEND, AND HEADACHES CAUSE SEASONAL 2. Not all depression symptoms are mood-related. YOU COULD BE CAN BE SYMPTOMS AFFECTIVE You can also have physical symptoms such as DEPRESSED. OF DEPRESSION. DISORDER (SAD). headaches, stomachaches, or weight loss. TRUE TRUE TRUE

FALSE FALSE FALSE 3. FALSE The lack of sunlight throws off your body’s natural clock, which leads to depression in the winter months. Shorter days also cause you to 4 5 6 overproduce melatonin—a hormone that makes PERSISTENT PEOPLE WITH SCHIZOPHRENIA CAN you feel sleepy. DEPRESSIVE BIPOLAR DISORDER CAUSE A “FLATTENING” DISORDER CYCLE BETWEEN EFFECT THAT MAKES FALSE IS A SHORT- PERIODS OF ELATED, PEOPLE SEEM 4. People with persistent depressive disorder TERM FORM OF DEPRESSED, AND DISCONNECTED FROM (also called dysthymia) alternate between major DEPRESSION. NORMAL MOODS. THE WORLD AROUND THEM. depression and milder depressive symptoms, TRUE TRUE TRUE which last for at least two years.

FALSE FALSE FALSE 5. TRUE People with bipolar disorder have severe mood Search for the Mental Health swings. They go from periods of elation to Message Board at WebMD.com. severe depression, sometimes with normal moods in between.

6. TRUE Along with hearing and seeing things (hallucinations) and having false thoughts (delusions), people with schizophrenia can have a flattening of emotions that looks like depression. GETTY IMAGES

56 WEBMD.COM TEN QUESTIONS Take 10 REAL LIFE

YOUR YOUNGER DAUGHTER, so inspired that I decided to go to The 1. PALOMA (“PIPPA”), HAS DOWN Farm and train to be an assistant mid- SYNDROME (DS). INSTEAD OF TALKING ABOUT THE “RISK” OF HAVING A CHILD wife. Then I came back to Los Angeles WITH DOWN, YOU SAY THAT WE SHOULD to apprentice with some midwives here. TALK ABOUT THE “CHANCE” OF THAT HAPPENING—JUST LIKE THE “CHANCE” DID THAT AFFECT YOUR OWN OF HAVING A BOY OR A GIRL. WHY IS EXPERIENCE OF PREGNANCY? THAT IMPORTANT? 6. Oh, yes! It’s fundamentally redefined I want to help people expand their un- pregnancy and birth for me, to see it derstanding of what it is to love a person as an incredible, miraculous, powerful who isn’t “typical” or who is living with a thing that women have evolved over disability. Down Syndrome is a genetic millions of years to do really well. variation and there are lots of genetic variations. There isn’t one particular HOW ARE YOU MOST AND LEAST way that a person should be to have val- 7. LIKE YOUR GREY’S ANATOMY CHAR- ue. Life with Pippa is one of the richest ACTER, DR. AMELIA SHEPHERD? gifts our family has ever received. We’re alike in eye color, height, and

HOW DID YOU AND YOUR HUSBAND, facial structure—that’s about it! One 2.ROB GILES, REACT WHEN YOU of the things I really like about acting FOUND OUT THAT PIPPA HAD DS? is that it helps people develop their The truth is that having any child is capacity for empathy and compas- challenging! You get to know your sion. Her character began as someone baby and you figure out her needs just facing addiction and trauma, and over like you do with a typical kid. time we’ve taken her from being stuck in her trauma to someone who’s being WHAT IS THE RELATIONSHIP LIKE of service to others. I love portraying BETWEEN PIPPA AND YOUR OLDER 3. that journey of healing. DAUGHTER, ELIZA, 6? We wondered if Pippa having DS WHAT’S THE ONE THING THAT’S would affect things between them, 8.MOST IMPORTANT IN TAKING CARE but it has really unfolded just like any OF YOURSELF? other sibling relationship. I’ve been practicing yoga since I was 16 years old. WHAT HAVE YOU LEARNED FROM GETTING INVOLVED WITH A COM- 4. DOES YOGA HELP YOU AS MUNITY OF FAMILIES WHO HAVE KIDS WITH DOWN SYNDROME? Caterina 9. AN ACTOR? They helped me realize that parenting Definitely! Breath control and body a child with DS is just a learning curve Scorsone awareness can be a great way to con- as with any child. And they have so nect to a character and also to connect Actor, Los Angeles many helpful insights, like the best to yourself. places to get physical therapy. WHAT ARE YOUR GOALS FOR YOURSELF FOR THE NEXT YEAR? YOU HELPED OUT WITH YOUR “I WANT TO HELP 10. 5.NIECE’S BIRTH AND WORKED WITH I want to approach community-build- A MIDWIFE WHEN YOU FIRST CAME TO PEOPLE EXPAND THEIR ing in the present moment and doing LOS ANGELES. WHAT WAS THAT LIKE? small things with care and with love, as After I was the doula for my sister’s UNDERSTANDING OF WHAT opposed to setting my eyes on a later home birth, I read the famous guide date or a bigger role that might bring to natural childbirth by midwife Ina IT IS TO LOVE A PERSON community to me later. May Gaskin, who founded The Farm Midwifery Center in Tennessee. I was WITH A DISABILITY.” MAARTEN DE BOER/GETTY IMAGES BOER/GETTY DE MAARTEN —GINA SHAW

57 WEBMD.COM