Munn's the Word

WEBMDMAGAZINE The Comeback A SERIES FROM THE EDITORS OF

SEE PAGE 17

Jan/Feb 2016 / $4.95 FAMILY & PARENTING WEIGHT- Rewards-Based LOSS MEN’S Pet Training MYSTERIES HEALTH pg. 29 EXPLAINED Vasectomies: PG. 40 What to Know HEALTHY pg. 21 BEAUTY

Scrubs for a LIVING Fresh Start HEALTHY pg. 23

Mindfulness & Your Health pg. 20

MUNN’S

THE WORDOlivia Munn on FOOD & J

ANUARY/FEBRUARY 2016 self-acceptance FITNESS and success PG. 34 Workout Motivation HEALTH pg. 49 HIGHLIGHTS

Cold & Flu Season Tips pg. 51 *

WEBMD.COM JAN/FEB 2016 Contents FEATURES

Pg. 34

Pg. Download WebMD Magazine for FREE 40 on the App Store and Google Play.

Munn

Rising I LIVE WITH Known for roles in HBO’s ANXIETY

The Newsroom and action A LOT. THE flick X-Men: Apocalypse, “MORE I actor Olivia Munn CAN TALK shines brighter than ever. “ She’s learned to focus on TO PEOPLE herself—and her health. ABOUT IT, She opens up about her THE LESS stuggles with anxiety ALONE attacks and exercise, and I FEEL. how she ultimately has accepted herself.

Straight Talk IN EVERY ISSUE Weight-loss mysteries baffle many on their quest to shed extra pounds. Pg. 4 Now, recent research EDITOR’S NOTE helps to answer some of the most common Pg. 56 questions about how TAKE 10 calories, genes, and more Harry Connick Jr. is play a role in determining an American music that number on the scale. idol in his own right. The talent show’s judge talks about his new album, his long- lasting relationship, 40 56 and his health habits.

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HEALTHY START HOT TOPICS: Why outdoor-playing kids might have better eyesight, how fidgeting may lead to a longer life, which diets may help prevent Pg. depression, and more news you can use.

7 LIVING HEALTHY WEBMD ON THE STREET: Our experts help a personal trainer take steps toward her goals in the gym—and in life. • THE COMEBACK: As part of Pg. our series with Sports Illustrated, WebMD takes an in-depth look at a pro basketball player’s injury, treatment, and recovery. • WOMEN’S HEALTH: Are you present in this very moment? Learn how mindfulness 13 can improve your life—and health. • MEN’S HEALTH: Our experts weigh in on the latest research about vasectomies.

Pg. HEALTHY BEAUTY YOU ASKED: Want a fresh start? Our expert sheds some light on 22 exfoliation tips and product picks. • BEAUTY SMARTS: Do you see spots? Learn what hyperpigmentation is and what you can do about it. Plus: Beauty 411 and Aisle Do. • YOUR SMILE: Do you really need wisdom teeth? Get smart about your options. Pg. FAMILY & PARENTING 27 PET HEALTH: Beth Stern is the cat’s meow. This year’s Hallmark Channel Kitten Bowl host opens up about how she’s saving one feline at a time. Plus: Teach your pup new tricks with rewards-based training. • BABY TALK: Becoming a parent is huge. Ask yourself these Pg. questions before you start trying. • PREGNANCY: Are antidepressants during pregnancy safe? • KIDS’ HEALTH: What you need to know about 44 taking your child’s temperature.

FOOD & FITNESS IN SEASON: Get the year off to a sunny start with our juicy and nutritious citrus recipes. • OFF THE MENU: Washington, D.C., chef Jeff Tunks shares his fish story. • FITNESS CHALLENGE: Calorie-burning cardio moves that will have you jumping up and down. • WORK IT OUT: Need some motivation? Fitness experts share their secrets to keep your routine on track.

WEBMD CHECKUP January is Glaucoma Awareness Month. • HEALTH HIGHLIGHTS: How to stay Pg. healthy during cold and flu season. • BY THE NUMBERS: A closer look at eye health. • LIVING WELL: Tips to manage hypothyroidism. • MY STORY: A reader 50 shares how he kicked smoking once and for all. • TEST YOUR SMARTS: What’s your heart health IQ? Take the quiz to find out.

W ebMD.COM 3 JAN/FEB 2016 EDITOR’S NOTE SECOND ANNUAL WEBMD HEALTH HEROES GALA

On November 5, WebMD celebrated its second Health Hero Awards Gala at the Times Center in New York. Hosted by Good Morning America co-anchor Robin Roberts, the star-studded event paid tribute to an advocate, a scientist, From left to right: Advocate winner Ronald “Jake” Clark, Scientist winner Bennet I. Omalu, MD, a prodigy, and our People’s presenter Fran Drescher, People’s Choice winner Choice winner, actor Glenn Glenn Close, WebMD CEO David J. Schlanger, Close. Each took action to Prodigy winner Kenneth Shinozuka, presenter Jessie solve a health challenge, give Close, and host Robin Roberts. back to others, and inspire people to live healthier lives. Celebrities, including actors Seth Rogen and Fran Drescher, presented the winners with the night’s awards. Musical guests The Broadway Boys, Mary McBride, and singer-songwriter Amos Lee entertained the crowd. I love a new year. There’s something about it that makes me feel like THANK YOU TO OUR SPONSORS anything is possible—even if I end up attaining only a fraction of my goals once reality sets in. Our theme for this issue is “Fresh Start,” which of course you can have any time, but it’s worth highlighting now as you think about your resolutions Access Now! and what you hope to accomplish in the Download the free Digimarc Discover year ahead. 1 app, available at iTunes and Google Our cover celebrity, Olivia Munn, Play. is a black belt in karate, but she’s also mastered the art of the fresh start. She Open the app. Hold your device 4 Look for this tells us how she’s tackled both emotional 2 to 7 inches away from the activated icon on pages throughout and physical challenges in her personal icon (shown at right) to scan it. Your phone will alert you when Digimarc the magazine. and professional life. From dealing with Discover recognizes the image. fluctuating weight and anxiety attacks to harsh words from entertainment critics, Your browser will open to display Munn shares how she channels her inner 3 a Web page where you can access resilience to keep pushing forward. Turn WebMD articles, videos, slideshows, and to page 34 for her story. more content or download WebMD apps. No matter what your goals are for the New Year, we’ve got the weight-loss know-how, recipes, fitness tips, and stress CONNECT WITH US! reducers to keep you on track. We’ve also Subscribe to a newsletter! got pointers for jump-starting motivation webmd.com/newsletters for your workout routine and some simple Like WebMD! ways to try mindfulness and meditation. Download WebMD facebook.com/webmd Here’s to a happy new year full of Magazine fresh starts, for FREE Tweet us! on the twitter.com/webmd App Store and Google Pin with us! Play. pinterest.com/webmd/ webmd-magazine

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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 or Google Play. WebMD Magazine is not responsible for advertising claims. WebMD Magazine (ISSN 1553-9946), Vol. 12, No. 1, 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. © 2016 WebMD, LLC. All rights reserved. HEALTHY START HOTTOPICS! FACTS AND NEWS YOU CAN USE

Caramels are the most popular flavor in a box of 20 Number of teeth humans chocolates. are born with. Usually at Source: National Confectioners Association about 6 months, the initial “baby” teeth begin to emerge.

1/3 of women of Source: American Dental Association childbearing age in the U.S. get the TOP 2016 Eating disorders recommended FITNESS usually start amount of folic acid TREND: in the teens but (400 micrograms) WEARABLE may begin as TECHNOLOGY early as age 8. from their diets. Source: American College of Source: National Birth Defects Prevention Network Sports Medicine Source: National Association of Anorexia Nervosa and Associated Disorders

AN ADULT’S NORMAL AND HEALTHY 23,000 HEART IS emergency ABOUT THE room visits each SIZE OF A year are due to CLENCHED Chefs say locally sourced people suffering FIST. meats and seafood will be this year’s adverse Source: National Heart, Lung, and hottest food trend. health effects Blood Institute Source: National Restaurant Association of dietary supplements. Source: New England Journal 54.4 42.9 of Medicine million million households households own a dog. own a cat. CLOCKWISE FROM TOP LEFT: DARIO EGIDI/GETTY IMAGES; BLUE JEAN IMAGES/ALAMY; SABINE SCHECKEL/GETTY IMAGES; MA-K/GETTY IMAGES; UPPERCUT IMAGES/GLOW IMAGES; JANE BURTON/GETTY IMAGES; STOCKBYTE/GLOW IMAGES; ROOM THE AGENCY/ALAMY THE ROOM IMAGES; STOCKBYTE/GLOW IMAGES; BURTON/GETTY JANE IMAGES; IMAGES/GLOW UPPERCUT IMAGES; MA-K/GETTY IMAGES; SCHECKEL/GETTY SABINE IMAGES/ALAMY; JEAN BLUE IMAGES; EGIDI/GETTY DARIO LEFT: TOP FROM CLOCKWISE Source: American Pet Products Association

JAN/FEB 2016 7 W ebMD.COM HEALTHY START

See the Light Here’s another reason to pry the kids from their screens and send them outside to play: It could save their eyesight. In an experiment in China, 900 elementary school students got 40 minutes of additional outdoor play each school day for three years. Another 900 continued normal activities. The kids in the outdoor playgroup were 23% less likely than their peers to develop nearsightedness during that time. About 30% of Americans are nearsighted, : and the condition usually starts in school-age 13% kids. Sunlight stimulates the release of the brain Americans chemical dopamine in the retina. Researchers who don’t believe this helps prevent nearsightedness. have health Source: JAMA insurance. That’s down of Americans exercise from more three or more days per than 16% week. That’s the highest in 2014. number in seven years. Source: CDC 55.5% Source: Gallup VEG OUT .com Have you ever tried to make broccoli Hot Hits What’s trending on seem more appealing by serving it WebMD.com right now* alongside a slice of pizza? That might Why is turmeric backfire. In a study of kids who get good for me? school lunches, researchers found that Symptoms of they were less likely to eat their least postpartum depression favorite vegetables when the veggies Benefits of acupuncture came with their favorite entrées, like 100-calorie snacks chicken nuggets or cheeseburgers. Kids Best birth control ate more green beans, for example, Famous schizophrenics when paired with a not-so-seductive deli sandwich. Try serving your kids’ Cold feet favorite main dishes with veggies you Cancer-fighting foods know they’ll eat, and use the harder- Yoga for beginners to-swallow ones to accompany less Teen beauty tips distracting entrées. *as of Nov. 1, 2015

Source: Food and Nutrition Sciences IMAGES SOURCE/GLOW IMAGE IMAGES; PASSIONATES/GLOW FOOD THE RIGHT: IMAGES; COMET/GETTY RENEE IMAGES; WWING/GETTY IMAGES; PEOPLEIMAGES/GETTY LEFT: TOP FROM

W ebMD.COM 8 JAN/FEB 2016 BUSY BODY Stop fidgeting! That’s one piece of motherly advice you might want to ignore. Among more than 12,000 women, those who CLUB MED sat for seven hours a day were 30% more likely to die during The heart-healthy Mediterranean diet a three-year period than those who sat for less than five hours could also help prevent breast cancer. a day. But women who fidgeted during those seven hours More than 1,000 women ages 60 to were exempt from this risk. All that toe-tapping and finger- 80 followed the diet—lean protein, lots drumming counteracted the sitting. Source: American Journal of Preventive Medicine of fruits and veggies, nuts, legumes, whole grains, and healthy fats like those in olive oil and salmon—for five years. They got 20% of their daily calories from extra virgin olive oil. Another group of nearly 1,000 women were told to eat a reduced-fat diet. Those in the Mediterranean group were 62% less likely to develop breast cancer than those in the other group. Source: JAMA

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Whether you have five pounds to lose or north of 50 or more, weight loss may very well top your New Year’s resolutions list. So far, so good. But the “how” to dropping pounds consistently 1 in 3 and effectively can be mysterious. Number of U.S. Do your genes and Context Clues family history mat- kids ages ter? What about your Text messages may one day send more gender—do men 2 to 19 who meaningful information than “I’m on my have an advantage, eat fast way,” according to a study of 700 people with losing weight more easily than women? food daily heart disease. For six months, half the study What about diet—are Source: CDC participants received four text messages all calories equal? per week tailored to their needs, such as None of this is an exact science—even encouragement to quit smoking or get out for for science. “Amaz- a daily walk. The others got normal care. At ingly, in this era of the end of the experiment, the text group had obesity, there are still many things that we lowered their cholesterol and blood pressure really don’t know,” levels more than the other group. They also admits one expert did better at losing weight, exercising, and we talked to. Nevertheless, our quitting smoking. story on page 40 Source: JAMA zeroes in on what researchers do know, such as how many calories you really need per day to lose pounds, where those calories should come from, how genes play a role, and the truth about weight loss for men versus women. Find more information and support online at webmd. com/weight-loss- mysteries. CONNECT THE DOTS We shed light, you shed pounds. Your skills and experiences leave their mark on your brain. Researchers analyzed brain Good deal. MRIs and personal information on 461 people. They found 200 brain regions associated Healthy, happy with classically “positive” traits, such as strong memory, large vocabulary, high income, new year, and education. In the MRIs of people who had the positive traits, many of those brain regions activated simultaneously, suggesting strong connections between the varied regions. The people who ranked high in negative traits—anger, rule-breaking, substance abuse, poor sleep quality—didn’t have these connections. But that doesn’t mean brains Colleen Paretty are hard-wired, the researchers say. Brains change. For example, improving skills like Editorial Director vocabulary can strengthen connections between related brain regions. [email protected]

Source: Nature Neuroscience IMAGES SORENSEN/GETTY HENRIK IMAGES; PHOTOS/GLOW DEPOSIT IMAGES; OKADA/GLOW KUNIAKI TOP: FROM

W ebMD.COM 10 JAN/FEB 2016 FROM TOP LEFT: LAWRENCE MANNING/CORBIS; SPRINT/GLOW IMAGES; SCIENCE PHOTO LIBRARY/ALAMY 30% lenses, too.lenses, Eachof these indiscretionsthese CASE STUDY replacing it.About contact lenscase?contact Some 82% oflens that many people of lensuse. More 99% are guiltyof three months.In the cardinal sins than completely wearers clingto than halftopoff quintuples yourquintuples fact, more than the caserather How longhave recommended the solutionin their cases fortheir cases at least oneofat least more thanthe risk ofaneye sleep intheir you hadthat infection. Source: CDC

Strict followers didn’t ofthese regimes vegetarians were 25% about likely less than their to develop peers depression the Mediterranean dietand part-time help prevent Researchers depression. during the study Want period. to try 10 years. Bothmoderate followers of and amostly vegetarian diet,could followed 15,000 inSpainfor people enjoy any more benefits than their it? No need toit? No take need itto extremes. Predominantly diets, plant-based cigarettes withinsixmonths. That’s including the Mediterranean diet teens who haven’t triede-cigs. more moderate peers. more moderate peers. Happy Meal four asmany times asamong who willmove ontotobacco Source: BMCMedicine Teen e-cigarette users Source: JAMA

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Friend Request As an adult, developing friendships can be challenging. But difficult as it may be, you can find and nurture the friendships that make life a happier, more meaningful journey. Here’s how. Be a good friend. Trite as it may sound, to have a good friend, you must be a good friend. Truly listen and be respectful, supportive, and caring. In your interactions, be reliable and trustworthy. Commit to regular activities. Forming friendships takes time and exposure. If you do something on a regular basis with others, you create an opportunity for friendships to develop. Walk after work weekly with an acquaintance, for example, or go to a monthly book club. Be persistent. If you’ve been hurt by a friend in the past, consider whether you’ve learned something about how you might approach friendships differently. Allow yourself to mourn, but don’t shut down enjoying the closeness of people in your life. Adjust your expectations. You may want friendship to provide support, connect around deep issues, and help you out in practical ways. Keep in mind that you are unlikely to find one person to fill all those roles.—Leslie Becker-Phelps, PhD, WebMD’s Relationships blog

Photograph by Grady Reese/Getty Images JAN/FEB 2016 13 W ebMD.COM LIVING Weight HEALTHY GOOD NIGHT

“Sleep is about consistency. If you go to bed and wake up at the same time every day, including the weekends, you’ll win half the battle. Next, avoid caffeine after Watcher 2 p.m. and stop drinking alcohol We pound the pavement to get within three hours of lights out, because they can affect sleep expert answers to your pressing quality. Finally, get 15 minutes of sunlight each morning to help health questions reset the circadian clock—your Photograph by Chuk Nowak body’s natural sleep-wake cycle.”

FIRM UP Michael Breus, PhD diplomate of the American Board of “Retinol is a good ingredient to Sleep Medicine and author of The Sleep look for because it stimulates Doctor’s Diet Plan: Lose Weight collagen production, giving skin Through Better Sleep a firmer appearance. You can find a lot of great retinol products at the drugstore. Look for one that is moisture-based so you don’t dry SUPPORT SYSTEM out your skin. Amino acids called peptides also stimulate collagen “A bra that offers encapsulation production. Pentapeptides, which supports each breast individually. are made up of five peptides This, combined with a snug-fitting strung together, band and adjustable shoulder are especially effective.” straps, will give you a customized fit. A well-padded underwire can boost support even further. Be sure to buy the right band and cup size. When you try on the bra, run in place or do jumping jacks to make sure the bra is Debra Jaliman, MD comfortable and offers firm assistant professor of dermatology, Icahn enough support.” School of Medicine at Mount Sinai and author of Skin Rules: Trade Secrets From a Top New York Dermatologist

Janet Hamilton, MA, RCEP, CSCS registered clinical exercise physiologist and running coach with Running Strong

ABOVE WATER WEBMD ON THE STREET “Drinking plenty of water keeps you hydrated, which is key for Sherlonda Tyrus workouts. If you’re not sure you’re getting enough water, check Personal trainer and that your urine is fairly clear. The nail technician, 40 general guideline for women your size is to take in about half your Southfield, Mich. body weight in ounces or, for you, 70 ounces of fluid daily. Eating Seat belts were the last straw for foods rich in water, like fruits, Sherlonda Tyrus. She wanted a vegetables, and soups, counts toward meeting your fluid needs.” ride in her dad’s new Corvette but couldn’t get the belt fastened; on a flight to visit colleges with her daughter, she almost had to ask for an extender. At 325 pounds, she’d reached her limit. “Both events really crushed me because Kathleen Zelman, MPH, RD, LD WebMD director of nutrition I realized I was too big,” she says. In 2011, Tyrus committed to losing weight. She enrolled in boot camp, cut out junk food, and dropped 145 pounds. “I started seeing the weight come off and the clothes sizes come down, and I was super excited.” One downside to losing so much weight is the loose skin left behind. She asks, BODY CHECK “Which products can help my skin “Muscle doesn’t weigh more than look tighter and firmer?” Though fat, but a pound of muscle takes she dropped a few bra sizes, at 34DD up less space than a pound of fat. she still needs extra support. “I get So when you build muscle, your uncomfortable sometimes when I weight may stay the same but you Want to be the next exercise, especially when I do a lot appear smaller. Even with muscle WebMD on the Street of jumping.” As part of her healthier star? Tweet us your development, keep your weight in lifestyle, Tyrus drinks more water the healthy range. If you need to health issues at @WebMD. We might but she’s not sure it’s enough. Jug- slim down a bit more, come to your city! tweak your diet and keep up the gling four children and two jobs great workouts.” keeps her busy from 4 a.m. to 9 p.m. “How can I make sure I rest enough when I have such a busy schedule?” Despite five years of consistent training, Tyrus hasn’t hit her goal weight, and wonders if muscle has Michael W. Smith, MD tipped the scales against her. “I’ve WebMD chief medical editor heard muscle weighs more than fat. Is that true?”—Stephanie Watson

THE OPINIONS EXPRESSED IN THIS SECTION ARE OF THE EXPERTS AND ARE NOT THE OPINIONS OF WEBMD. WEBMD DOES NOT ENDORSE ANY SPECIFIC PRODUCT, SERVICE, OR TREATMENT. LIVING HEALTHY

AND Cold Shoulder In this installment of The Comeback series, WebMD takes a look at a professional athlete’s shoulder dislocation, treatment, and recovery BY MATT McMILLEN

On April 26, 2015, the Cleveland Grizzlies and immediate past president Cavaliers advanced to the second of the American Academy of Orthopae- round of the NBA playoffs, but the dic Surgeons. team would finish the season without Azar compares the shoulder joint star forward Kevin Love. In the first to a golf ball on a tee—the ball’s big- quarter of the game, Love and Boston ger than the socket. While its form Celtics center Kelly Olynyk became allows for significant range of motion, entangled as they fought over a that range does have limits. A rim of rebound. The struggle wrenched Love’s cartilage, called the labrum, holds left shoulder from its socket. A few days the ball in place. Ligaments attached later, he underwent surgery to repair to the labrum keep the ball (the ANATOMY OF A SHOULDER the injury and began a six-month humerus, part of the upper arm bone) recuperation. in the socket (the glenoid fossa of the Three bones make up the shoulder: the shoulder blade (scapula), the collar bone (clavicle), and the arm bone The younger and more active the player, (humerus). the more likely he or she will suffer another The major joint of dislocation. the shoulder is the glenohumeral joint. It includes the humeral head, which sits in the socket (the NBA players do not often dislocate scapula), while muscles like the rotator glenoid of the scapula) like a their shoulders. During the past 20 cuff surround the joint. golf ball on a tee. Dislocation years, only two professional basketball “When the shoulder dislocates, occurs when the ball is players per season underwent surgery the ball slips out of the socket,” Azar wrenched from the socket. to repair them. explains. “When it does so, it can tear The labrum, a layer of “They’re not nearly as common as we the labrum and/or the ligaments.” cartilage that holds the ball see in a contact sport like football, but Azar estimates that 90% of disloca- in place, often tears when a we do see them,” says Frederick Azar, tions are anterior, meaning the joint has dislocation occurs.

MD, team physician for the Memphis slipped forward. When that happens, IMAGES DINEEN/GETTY GARY RIGHT: SOURCE; SCIENCE

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they very frequently tear the anterior inferior labrum. That’s just what happened to Love, now 27. “If you think of it like a clock, Love looks like he tore it from 6 o’clock to 9 o’clock,” Azar says.

Game Changer Once the shoulder undergoes such an agonizing injury, it becomes less stable and more prone to future dislocations. And the younger and more active the player, the more likely he or she will suffer another dislocation. Only surgery lessens the likelihood of future injury for athletes at Love’s level. “If you don’t fix it right away, you may be able to get back in the game in about 14 days, but there’s a risk of recurrence,” says Chicago Bulls team physician Brian Cole, MD. “In collision sports, some studies cite recurrence rates of 90%.” Before they evaluate the injury, doctors must put the shoulder back in the socket, a painful procedure that often requires sedation. Once done, they’ll image the shoulder. “We do an X-ray to make sure the shoulder is back in the socket and an MRI to get a road map of the particular pathology, the damage done,” says Azar, who adds that a CT scan also may be needed for pre-op planning. “Then we counsel the patient on what the next wait. He did it at an interesting time— in the socket. The minimally invasive steps might be.” during the playoffs.” procedure allows surgeons to repair the Cole says the decision to have surgery The surgery, say both Azar and joint without having to cut through the most often comes down to when, not Cole, is most often a straightforward rotator cuff muscle. if, and many factors will contribute to procedure. Patients undergo a general that decision: the extent and type of the anesthetic, after which the surgeon Back to the Court injury, as well as where the player is in drills 1-centimeter holes into the joint, Azar says 90% of the pro basketball the season and in his contract. one for a camera to guide the proce- players who have undergone this sur- “It’s a very personal, very individual- dure and the others through which to gery in the past 20 years have returned ized decision,” Cole says. “Kevin had thread the permanent sutures that will to the game at their pre-injury level of to decide to get it fixed in-season or to hold the labrum and capsule in place play or better. However, surgeons can’t

W ebMD.COM 18 JAN/FEB 2016 Explore this series further with videos and articles at webmd. com/getbackinthegame. LEARN HOW ON PAGE 4

Exactly six months after his injury, Love was back in the game on opening night of the season, as the Cavs met the Chicago Bulls.

TIME TO OPERATE? Surgery takes about 30 to 90 minutes, and most patients go home the When professional athletes such as basketball or football same day. The road to recovery begins players suffer a dislocation, right away. surgeons need to operate to “The art of getting an athlete back to restore them to their previous play involves a lot of different factors, level of play. For the rest of us, and there’s no cookbook approach,” surgery may not be necessary. Cole says. “They start rehab immedi- You may need surgery if you ately, but avoid the things that could are age 25 or younger and quite re-injure them.” active in sports and/or other For the first six to eight weeks—the physical activities; both your time it takes for the tissue to heal— age and your activity level put you at risk of recurring injuries athletes wear a sling to immobilize the without surgery; you have shoulder and focus on exercises that tried rehab and strengthening won’t interfere with the healing process: exercises but continue to leg extensions, stationary bike rid- have shoulder instability that ing, safe range of motion movements, prevents the joint from holding the shoulder in place; or you and some core work. By the eight- to have tissue damage, caused 12-week mark, they can usually begin when the ball of your shoulder light dribbling exercises and running. violently separated from your Within four to six months, after a socket, severe enough to program of gradual strength building, require repair. recovering players graduate to making You may not need surgery if shots, noncontact basketball moves, guarantee success, and complications, you have a partial dislocation— and, finally, five-on-five contact drills. while rare, may occur. a stretch injury that most often Love, exactly six months after his “The most common complication is heals on its own with activity injury, was back in the game on opening modification, physical therapy, recurrence, and that’s what we all worry and time; or you are older than night of the season, October 27, as the about, especially in collision athletes,” age 25 and not an athlete who Cavs met the Chicago Bulls. His experi- Cole says. plays contact or collision sports, ence with the surgery and rehab, Cole The surgery may also result in a loss such as basketball, football, says, was typical. of some rotation, or the ability to move or hockey. “Success rates are high. In the the arm away from the body. “If that scheme of things, it’s one of the more happens,” Cole says, “it can compro- Reviewed by Michael W. Smith, MD, CPT predictable things we do in terms of WebMD Chief Medical Editor

JIM ROGASH/GETTY IMAGES ROGASH/GETTY JIM mise certain athletes, especially pros.” getting an athlete back to play.”

JAN/FEB 2016 19 W ebMD.COM Read How to Be Present, LIVING an article at WebMD.com.

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WOMEN’S HEALTH Magic Moment BEING PRESENT IS A GIFT IN ITSELF. LEARN HOW MINDFULNESS BRINGS MENTAL AND PHYSICAL BENEFITS

By Sonya Collins

You’re on a conference call while responding to an email and eating your lunch. Sound familiar? Most people divide their attention between several tasks at once without being truly engaged with any of them. But your health could suffer as a result. If you want to jump-start your health in the new year, then just be. Mindful- ness—the art of being fully present in the moment—may bring mental and physical health benefits. “There’s consistent evidence that mindfulness reduces stress, depression, and anxiety, and that flows into other things,” says Karen O’Leary, PhD, a researcher in applied psychology at Uni- versity College in Cork, Ireland. “It has associations with physical benefits, too.” O’Leary studies mindfulness as a way to improve women’s quality of life dur- GET STARTED anxiety, and sleep quality. Mindful ing pregnancy, reduce labor pain, and WANT TO TRY MINDFULNESS people might have lower blood pres- YOURSELF? RESEARCHER improve their babies’ birth weight. KAREN O’LEARY, PHD, SUGGESTS sure, lower blood sugar, and better heart The concept of mindfulness comes A 10- TO 20-MINUTE “BODY health. One study found that people from ancient Buddhist meditation, SCAN” MEDITATION. who got a flu vaccine after eight weeks but Westerners often practice a mod- Sit up straight in a chair with of mindfulness training developed more ern, secular form. Usually starting both feet on the floor and antibodies against the flu than those with deep focus on the breath, a mind- your hands on your thighs. who only got the vaccine. It may relieve ful person pays full attention to the Close your eyes. symptoms of irritable bowel syndrome present moment and all the thoughts, and cut down on migraines, too. Pay attention to your breath as feelings, and sensations associated you inhale and exhale. It could also reduce pain—or at least with that moment. “You don’t judge your perception of it. “Mindfulness the moment as good or bad,” O’Leary Focus on your forehead, then trains people not to dwell or ruminate says. “You just live it, with the knowl- the bridge of your nose, your on the pain,” O’Leary says. edge that it will soon pass.” During cheeks, and so on down the What do many of these conditions body till you reach your toes. that moment, she says, let go of any have in common? Stress. “Two main thoughts about the past, the future, or As you go, focus only on components of mindfulness are an open- anything other than now. the sensations in one part of ness to all experience and an acceptance What benefits does mindfulness offer? the body and let all other of all feelings and sensations, whether Plenty, according to recent research. It thoughts go. good or bad,” O’Leary says. “That prac- can better your test scores and working With practice, you can apply tice can help reduce stress.” memory—the type of memory you use to this level of awareness and do a math problem in your head. Mind- attention to any of the activities Reviewed by Patricia A. Farrell, PhD WebMD Mental Health Expert fulness may help improve depression, in your daily life. IMAGES PEOPLEIMAGES/GETTY

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MEN’S HEALTH Tied Up? VASECTOMIES GET A BAD RAP. OUR EXPERTS CLARIFY SOME COMMON MISPERCEPTIONS

By Lisa Marshall

Among the safest and Hills, Calif. “The pain during most foolproof forms and after tends to be exag- of birth control, a vasectomy gerated.” Also, contrary to takes about nine minutes to popular belief, a vasectomy complete, is often covered by doesn’t affect a man’s sexual insurance, and may be more performance, semen volume, reversible than once believed. or libido, says Tobias Köhler, ASK YOUR ample, mobile sperm again Yet, 70 years after its MD, associate professor DOCTOR afterward. Even among those introduction, the procedure of surgery in the urology who’d had their vasectomies How many vasectomies remains a hard sell, even division at Southern Illinois more than 15 years earlier, have you performed? among older men who are University School of Medi- If the answer is the rate exceeded 75%. sure they don’t want cine. Nor does it (as some fewer than 100, look The older the vasectomy, children, doctors say. debunked studies suggested) elsewhere, says the more complex the While female sterilization boost risk of prostate cancer Tobias Köhler, MD. surgery may be, Turek says. is far more costly and risky, or dementia, he says. Still, the “reversibility” of What do you do in case women are two to three In 1% to 2% of cases an of a complication? Look vasectomy has improved so times more likely to have infection, hematoma, or for a doctor who has much that Turek (and some their “tubes tied” than men lingering pain can occur, the expertise to handle other urologists) believe are to have a vasectomy. requiring antibiotics or a sec- an infection, hematoma, that in some cases, if he can or corrective surgery Even among people who say ond surgery. In about one in afford it, a younger man without referring they intend to have no more 2,000 cases, the vasectomy you elsewhere. might consider having one children, only 16% of men fails, resulting in pregnancy, now, then having it reversed have had a vasectomy, while either due to surgical error What method do you if and when he decides to 44% of women have under- or because the vas deferens use? Some doctors use have kids. a scalpel and needle. gone a tubal ligation. (the tube that carries sperm) But Köhler says this Some use a no-scalpel, Despite surgical advances spontaneously reconnects. no-needle method. Pick approach is “unwise.” He that reduced complica- By comparison, condoms fail the method you’re most cautions that just because tions and recovery times, 18 in 100 times. comfortable with and sperm is flowing, pregnancy U.S. vasectomy rates have Roughly 6% of vasec- a doctor with plenty isn’t a given. For men certain of experience. (Note: remained flat since the tomized men request a they’re done having kids, 75% of vasectomies 1990s. In some areas, like reversal, a complex, $10,000 are performed by a vasectomy can’t be beat, the United Kingdom, they’re to $15,000 surgery that urologists, according to Köhler says. His advice to declining sharply. involves reconnecting the the American Urological everyone else: Don’t rush “The problem with two ends of the vas deferens. Association.) into it. vasectomy is the fish stories One study of 1,300 reversals What insurance do you surrounding it,” says Paul found that among men who take? Your insurance Reviewed by Turek, MD, a reproductive had their vasectomies within Michael W. Smith, MD company may cover WebMD Chief Medical Editor

FUSE/GETTY IMAGES FUSE/GETTY health specialist in Beverly the past 15 years, 93% had the procedure.

JAN/FEB 2016 21 W ebMD.COM Helping Hands Whether you live in a cold, windy climate or plan a ski trip this winter, exposed skin on your hands becomes super sensitive to dryness and cracking in chilly temperatures. Joel Schlessinger, MD, a dermatologist in Omaha, Neb., has a few strategies to help prevent moisture loss and irritation. Stock up on shea butter, which contains fatty acids and vitamins that help moisturize and keep the skin resilient. Fight the urge to wash your hands with hot water, as it strips away the skin’s natural oils that are key for keeping hands healthy. Use lukewarm water instead. Apply lotion after washing your hands, and do it before you even reach for a paper towel—it’s the best way to lock in moisture. Even better? Use a moisturizer infused with lactic acid, which provides exfoliation benefits but is gentle enough to use in harsh, cold climates. Use a gentle cleanser when you wash your hands, avoiding fragrance and antibacterial soaps that dry out skin. Look for a cleanser that contains hydrating ingredients like ceramides, glycerin, and hyaluronic acid.—Ayren Jackson-Cannady

Photograph by Andrea Bricco/Corbis JAN/FEB 2016 22 W ebMD.COM HEALTHY BEAUTY

YOU ASKED Flake Out WHAT’S THE BEST WAY TO EXFOLIATE FROM HEAD TO TOE? AN EXPERT WEIGHS IN WITH PRODUCT PICKS AND TIPS

By Ayren Jackson-Cannady

FACE BODY 1 Smooth Move Star Wash 1 First Aid Beauty Facial 4 Glytone Exfoliating Radiance Polish ($24) Body Wash ($32) “Bathing “Exfoliating helps out with is routine, so by swapping multiple cosmetic goals: in a therapeutic wash like It removes ‘dead’ old skin this one that’s infused with cells. It smooths the tex- skin-polishing glycolic acid, ture of skin, which gives an you don’t have to add any overall glow to the skin. This extra steps to your regimen. paraben- and fragrance-free Bonus: Most people can face scrub is made out of safely use this on their face.” shea nut shell, yet it’s gentle enough to use regularly.” Brush Off 5 Clarisonic Brush ($99) In the Mix “Smooth out rough patches 3 2 Jan Marini Bioglycolic with this device, which you Bioclear Lotion ($60) “This can use on the entire body unique mixture of glycolic while showering along with a and salicylic acid also con- cleanser of your choice. This tains azelaic acid, known to handheld brush oscillates at have multiple therapeutic a very high frequency, equat- properties, such as decreasing to thousands of brush ing inflammation, lightening strokes on the skin.” 5 pigmented spots, and reducing acne-like eruptions.” Dry Spell 6 CeraVe Renewing All-In-One SA Cream ($16.25) “This 3 PCA Retinol Renewal skin-sloughing moisturizer ($88) “For those who have contains a time-tested and trouble tolerating a prescrip- true exfoliant: salicylic acid. tion retinoic acid, retinol But it also has ceramides, products can have similar proteins that repair a broken effects. This product is skin barrier and boost the especially good because it hydrating effects. This is also contains antioxidants to important for chronic skin protect against environmen- conditions driven by dry- tal and solar damage, as well ness, such as keratosis pilaris 4 as emollients to replenish and eczema.” 6 and moisturize the skin. It’s a great one-stop product for the face.”

THE OPINIONS EXPRESSED IN THIS Reviewed by Robert J. Casquejo, PA-C SECTION ARE OF THE EXPERTS AND ARE NOT THE OPINIONS OF WEBMD. WEBMD Karyn Grossman, MD owner, Skin and Cancer Center of Scottsdale, Arizona DOES NOT ENDORSE ANY SPECIFIC WebMD Skin Care Expert PRODUCT, SERVICE, OR TREATMENT.

W ebMD.COM 23 JAN/FEB 2016 Photograph by Ted Morrison What’s the Best Way to Brighten Your Skin? Take the quiz at HEALTHY WebMD.com. BEAUTY LEARN HOW ON PAGE 4

BEAUTY 411 What’s all the hype about coconut oil?

The organic movement has led many people to seek unprocessed, natural options. That’s what makes coconut oil so appealing: It contains a single BEAUTY SMARTS ingredient, is free of synthetic additives, and is readily available at grocery stores. Get Even People use coconut oil as shaving cream, a SEEING SPOTS? HYPERPIGMENTATION IS LIKELY TO BLAME. base to make a scrub, HERE’S WHAT YOU CAN DO TO CORRECT AND TREAT IT an eye cream, and a makeup remover. By Liesa Goins Other cultures have used coconut oil for No one likes marks on their record—or are so common—and the demand to correct centuries in skin and complexion. You’ve heard words like the condition are so high—many options hair care. melasma and liver spots. Both refer to the exist for treating brown spots and patches. Studies show that it reduces water loss and same condition: hyperpigmentation. But you can’t treat all spots equally. Before helps strengthen the “Uneven pigmentation is a response to cell you pick a course of action, see your derma skin’s barrier function, injury,” says Carl R. Thornfeldt, MD, a tologist, Tanzi advises. Ingredients can be which helps it retain dermatologist in Fruitland, Idaho. “Damage harsh and irritating, so seek advice about moisture. Plus, coconut due to inflammation, UV exposure, and which to use and how to use them safely oil contains lauric acid, a natural antibacterial other environmental insults causes the cells and effectively. agent. This makes it a to produce more pigment to protect them One option is hydroquinone, a prescrip great option for people selves.” Fluctuations in estrogen levels (due tion topical cream that slows down the with eczema or who are to birth control pills or pregnancy) can also pigment-making mechanisms in the skin, prone to skin infections. affect melanin production. Tanzi says. “Hydroquinone is one of the The downside is it penetrates skin so This results in uneven pigmentation, a strongest and most effective brightening effectively that it can common condition that can affect any skin agents we have,” she explains. But at high clog pores, which can tone, “but in different ways,” says Elizabeth concentrations it can be toxic to the skin, aggravate breakouts. Tanzi, MD, founder and director of Capital she adds. (Some countries have banned it; And it doesn’t have Laser & Skin Care and assistant clinical pro in the U.S., most doctors think a low dose is the staying power of heavier moisturizers, fessor of dermatology at George Washington safe but closely monitor patients.) so anyone with severely University in Washington, D.C. Lighter skin Doctors usually prescribe a 4% hydroqui dry skin will need tones tend to develop freckles and sun spots none cream, and a 2% version is available another option. while darker skin looks shadowed or patchy, over the counter. “Hydroquinone can be —Papri Sarkar, MD she says. irritating and can actually increase pig Brookline Dermatology

IMAGE SOURCE/GLOW IMAGES SOURCE/GLOW IMAGE Since the causes of uneven pigmentation mentation if used for too long, so I have Associates, Brookline, Mass.

JAN/FEB 2016 24 W ebMD.COM HEALTHY BEAUTY

UNDER COVER PIGMENTATION DOESN’T HAPPEN OVERNIGHT—IT’S THE RESULT OF Vitamin C is another CUMULATIVE SUN DAMAGE, popular treatment. Stud DERMATOLOGIST ies show vitamin C can ELIZABETH TANZI, MD, EXPLAINS. HERE’S help brighten skin and fade patients take a ‘holiday’ College in Valhalla, N.Y. HOW TANZI TELLS HER hyperpigmentation much PATIENTS TO PREVENT every three months and use That’s why he says he HYPERPIGMENTATION. like hydroquinone, but other lightening agents,” suggests his patients try without as much irritation. Tanzi says. Your doctor OTC options rather than Seek shade. “I always “Look for high levels of may suggest alternating hydroquinone. “The non- talk to my patients magnesium ascorbyl phos hydroquinone with over-the- prescription products about avoiding the phate in the ingredients sun,” Tanzi says. counter (OTC) treatments don’t have the same risk Whenever possible, of a brightening treatment,” to limit irritation and avoid of complications and are stand in a spot out of says Renée Rouleau, a an adverse reaction. still effective at reducing direct sunlight—even Dallas-based celebrity aes Retin-A (tretinoin) and pigmentation.” One of the little things, thetician who treats hyper steroids may be prescribed best is kojic acid, Rietkerk like crossing to a pigmentation. This form of shadier side of the in addition to or in place says. “It is a very effec street, matter. vitamin C stays stable, so it’s of hydroquinone, but they tive pigment reducer that more effective. might not work as well, says you can use continuously Never skip SPF. “You Other OTC options that William Rietkerk, MD, an without the risk of the side have to wear an SPF may improve hyperpigmen associate professor of derma effects that can come with 30 sunscreen every tation include soy, niacini day,” Tanzi advises. tology at New York Medical hydroquinone.” Every UV ray that mide, ellagic acid, arbutin, hits your skin causes and licorice, according to damage, she says. And some research results. Your the damaging rays can doctor may combine one penetrate clouds and of these treatments with glass, so you always need SPF protection. hydroquinone to minimize AISLE DO You have to use a reactions and irritation. moisturizer. Even Wear a hat. A wide- “Most people forget though it’s a lotion PRODUCT PICK brimmed hat will designed for keratosis that uneven pigmentation Avène Akérat shield your face, the pilaris, this cream contains doesn’t have a quick fix,” Smoothing Exfoliating area most prone to humectants that hydrate Cream ($31) hyperpigmentation, Thornfeldt says. “The dam and trap water in the skin, Tanzi says. You age occurs deep in the skin so it works very well on EXPERT need that physical and takes time to come to dry feet. For moisturizers Carolyn I. Jacob, MD protection from the to penetrate you need to the surface, which means founder and medical director, sun. And a hat is Chicago Cosmetic Surgery and exfoliate, and this one reversing the damage can a key accessory if Dermatology contains salicylic acid you’re undergoing also take time.” That’s why and lactic acid to exfoliate treatment for the most effective treatment “Here in Chicago, feet the skin as well as urea to hyperpigmentation. for uneven skin tone might become a mess in the soften thick skin. I suggest “You have to wear wintertime. The skin gets using a pumice stone in the be patience. a hat every day; dry and cracked due to shower first, then applying otherwise, a topical the lack of humidity—at this on top of damp skin cream won’t Reviewed by least we have boots on! for the best results.” do anything,” Mohiba K. Tareen, MD WebMD Skin Care Expert

Tanzi warns. IMAGES KINDERSLEY/GETTY DORLING

W ebMD.COM 25 JAN/FEB 2016 Read Tips for Finding the Right Dentist, a HEALTHYresource at WebMD.com. BEAUTY LEARN HOW ON PAGE 4

YOUR SMILE Wise Words HOW KNOWLEDGEABLE ARE YOU ABOUT WISDOM TEETH? A GUIDE TO WHAT YOU NEED TO KNOW

By Kara Mayer Robinson

Wisdom teeth aren’t DID YOU very practical. You KNOW? don’t need them to chew. Wisdom teeth Because they’re so far back typically come in in your mouth, it’s hard to when you’re 17–21 keep them clean. Many years old. people have them pulled. They’re called “wisdom But should you? Gregory M. teeth” because Ness, DDS, professor of oral they come in after surgery at the Ohio State childhood, when you’re University College of older and wiser. Dentistry, shares the facts. They’re also called Wisdom teeth usually “third molars.” push through your gums during young adulthood. People used to think But it can happen earlier or wisdom teeth crowded your other teeth. later, Ness says. Or they may Research suggests become impacted, which that’s not true. means they get stuck in your jawbone and don’t pop through your gums at all. They don’t always develop that collects germs, which a bad taste that comes from minor procedure. Your doc perfectly—they may grow in can then spread to harm that area,” Ness says. See tor may give you local anes partially or at an angle. nearby teeth. your dentist regularly. Even thesia, moderate sedation, Some dentists advocate If you have signs of prob if you have no problems now, or general anesthesia. The taking wisdom teeth out lems, like pain, tooth decay, things can change. risks are low and similar to before they cause problems. gum disease, infections, Do your best to keep other minor surgeries. It’s Others think it’s OK to keep cysts, or damage to nearby them clean. Floss regularly, possible, but not common, them if they’ve grown in nor teeth, removing your wisdom including along the back of to have an infection or mally, they’re pain-free, and teeth might be prudent. If each wisdom tooth. Most bleeding after the surgery. they’re healthy—but only if not, “a lot of people look at it people don’t think to floss “Most people can expect they’re in a position where as a sleeping dog that should there, and that’s the most to be at home for a few you can clean them well. be left to lie. But we know it likely spot to cause trouble, days,” Ness says. You may That last caveat is the can get ugly later,” Ness says. Ness says. have some pain and swell tricky bit; they’re tough to Your dentist can take X-rays If you do have your wisdom ing. Your doctor might rec keep clean. That can lead to to detect problems and help teeth removed, Ness suggests ommend over-the-counter problems like infections and you decide what’s best. seeing a board-certified oral or prescription medication gum disease. You can get a “If you’re going to hang or maxillofacial surgeon. to ease any discomfort. cavity in your wisdom tooth on to your wisdom teeth, Your insurance plan may or an infection in the gums. particularly if they’re par cover some or all of the cost. Reviewed by You may develop a pocket tially exposed in your mouth, Having your wisdom Eric Yabu, DDS WebMD Oral Care Expert SUNG-IL KIM/CORBIS SUNG-IL around your wisdom tooth watch for pain, swelling, or teeth pulled is usually a

JAN/FEB 2016 26 W ebMD.COM FAMILY & PARENTING

PET HEALTH Cat Lady By Melanie D.G. Kaplan In February, television personality and animal activist Beth Stern will host the third annual Hallmark Channel Kitten Bowl, during which, she says, “macho men will cheer on ridiculously cute kittens.” When she’s not watching felines tackle each other in the end zone, Stern is the spokeswoman for North Shore Animal League America, the world’s largest no-kill animal shelter, and she and her husband, radio personality Howard Stern, are active cat and kitten foster care providers. She’s written two children’s books based on cats, the most recent of which, Yoda Gets a Buddy, was released in December 2015. “I don’t have human children,” she says, “so this is my purpose.”

Photograph by Howard Stern JAN/FEB 2016 27 W ebMD.COM FAMILY& PARENTING What are your next animal projects after the Kitten Bowl? Howard and I are working on a 14,000-square-foot expansion of North Shore’s existing shelter, called Bianca’s Furry Friends. The space will allow the cats to live cage-free until they’re adopted. Friends have been so supportive—Billy Joel donated over a million dollars, and Rachael Ray presented me with a $500,000 check on her show. We’ll break ground early this year.

Did you have animals growing up? My parents’ firstborn was a collie mix named Susie-Dog. She was our older sister and was treated like one. We also had guinea pigs and adopted cats. We’d transport hurt wildlife. I took a course on how to transport wounded wild animals a few years ago. When an animal’s hurt, we don’t ignore it.

Who are your rescues? Apple, Bella, Walter, Leon Bear, Charlie Chunk, and Yoda. Bella was a blind, pregnant cat found in a junkyard, and she was on the “to be destroyed” list at a shelter. North Shore goes to these municipal shelters, and if we have the room—which we did in this case—we rescue them.

How do they get their names? Whenever a foster comes into the house, Howard will name them. He’ll say, “You are Raisin!” “You are Pound- cake!” “You are Bagel!” Sometimes I think he’s hungry, because so many of them are food names.

Do you have rules about how many rescues you can have in the house? No. Whenever a cat or kitten needs us, we’re there. I think more than 165 cats and kittens have come through our home, and I personally deliver them to their forever home. At one point we had 15 in our foster room. I’ll hear about a cat in need, and Howard will say, “Go pick it up!” He’s so supportive. The Hallmark Channel’s He photographs them and has even Kitten Bowl III been known to clean out litter boxes. will air on Feb. 7. Reviewed by Will Draper, DVM WebMD Pet Health Expert HOWARD STERN HOWARD

W ebMD.COM 28 JAN/FEB 2016 all situations,Woodard says. Make sure in be offlimits to itneeds offlimits, is adults butnotchildren. Ifa behavior thatrecognize he’s allowed to jump on at strangers butnotthe or neighbors, understand that it’s allright to bark fear,” shesays. which breaks down trust and teaches behaviors. dog will feel “The threatened, ates confusion and canleadto negative using a harsh tone or spanking a dog cre right. Infact, Woodard believes that won’t introuble be ifhedoesn’t get it Your to understand that dog needs he therequest behavior voice. inanupbeat sit, off, come, ordown (for liedown). keep Use commands one word— short. will repeatthe behavior. the your odds increases or praise, dog A reward, whether a favorite toy, a treat, recting unwanted behaviors. Thereason: methods ofteaching commands orcor forcement, one of the is effective most rewards-based training orpositive rein- teach them.” Friends Animal Society. “We have to animal behavior consultant for Best Woodard, professional dog trainer and know these behaviors,” says Sherry After all, “your dog can’tbe expected to raising awell-behaved and safe dog. of part commands anessential basic is Consistency is key, is Consistency too. Your dog won’t understand tone, sureDogs be to so For positive training to successful, be Positive training, known also as W Sit. Stay. it. Leave Come. Teaching your four-legged family member eb PARENTING Reviewed by Will Draper, DVM MD.COM FAMILY& WebMD Pet Expert Health THE SCOOP ONTHE SCOOP REWARDS-BASED TRAINING Think Positive 29 JAN/FEB 2016 PET HEALTH By Jodi Helmer - - focus, it’s gone toofar,” Woodard says. excited;dog still is ifhe’s orlosing tired and fun. short oftheless venue, keep training sessions walkshood orthe dog park. Regard- neighbor such as activities and areas, commands, move to higher-distraction dog gets more adeptatresponding to teaching your the athomeand, as basics shesays.cuits,” dogs don’t want to work for bis dry toys that the dog really wants. “Most using treats likeorchicken, cheese or suggests skipping and boring kibble go” the to behavior. request same commands. Don’t say “come” and “let’s the words uses same sessions for basic everyone intraining who participates “End when atraining your session Finally, by Start essential. practice is When to itcomes rewards, Woodard - -

MATILDA DELVES/GETTY IMAGES Get the WebMD Baby App to track growth and capture your FAMILY& baby’s special moments. PARENTING LEARN HOW ON PAGE 4

BABY TALK Prep School ARE YOU READY TO HAVE A BABY? ASK THESE QUESTIONS BEFORE TRYING TO CONCEIVE

By Colleen Oakley

Some decisions in life are easy: Eat in or take out? Boxers or briefs? Beach or mountains? But some— like deciding when to start a family—are on a whole different level. “Becoming a parent is a wonderful and unpredictable life-changing responsibility to another human being,” says Claire Nicogossian, PsyD, a psychologist in Rhode Island and founder of momswellbeing.com. “I don’t know if a couple can ever know with 100% certainty, but my hope is for couples to feel they are mostly ready to become parents.” Being sure that you both want a child is just part of determining whether you’re into those practices after brought home and where it ASK YOUR ready. Ideally, you need baby,” she says. is spent during the month.” OB/GYN to consider a host of other Are we good at com- Lay out a financial plan— How and when factors, like your emotional municating? Couples need what you currently have and should I stop taking birth control? and physical health, your to feel they are on the same how you will afford future job stability, your finances, team when they’re parent- needs that come with having What will and the health of your rela- ing, O’Brien says. “I encour- a baby. Will you both con- increase my tionship. Experts suggest age them to share with each tinue to work? Will you have chances of fertility? discussing these questions other what their concerns a nanny or daycare? Can you with your partner. are, have their partner afford diapers? What type of Are you taking care acknowledge what their Whom do we have for prenatal vitamin should I take? of yourself? Having a concerns are, and validate support when baby comes baby can be taxing, says what their partner is feel- home? Caring for a baby all Can I Catherine O’Brien, LMFT, ing,” she says. on your own, especially in continue my a marriage and family ther- Do we know where our those early months, can be current over-the- apist and founder of happy money is? “I’ve worked difficult, O’Brien says. Do counter or prescription withbaby.com. “Getting in with many couples who do you have nearby relatives medicines while trying to conceive? the habit of taking care of not share bank accounts and friends you can call on yourself now—meditating, with their significant oth- for help? Or can you hire a

going to the gym, spend- ers,” O’Brien says. “A lot postpartum doula or night Reviewed by ing time with friends—will of assumptions arise about nurse? Most of all, “Don’t Hansa Bhargava, MD WebMD Medical Editor

make it easier to get back how much money is being ever hesitate to ask for help.” PHOTO/CORBIS ARTIGA

W ebMD.COM 30 JAN/FEB 2016 FAMILY& PARENTING

PREGNANCY Bottle Cap? ARE ANTIDEPRESSANTS SAFE TO TAKE WHEN YOU’RE EXPECTING?

By Kelli Miller

If you’re pregnant (or trying) and you have depres- ASK YOUR confusing. For example, sion, you might wonder if taking antidepressants OB/GYN doctors have long pre- could harm your baby. Spend a day surfing the Web, and Should I quit my scribed fluoxetine (Prozac) the conflicting reports could make your head spin. antidepressant to pregnant women, but Some studies suggest antidepressants are dangerous medication if I get that will now likely change pregnant? for babies in the womb. Others say the risks are extremely because the same CDC small, and that untreated depression poses a bigger threat report says this drug may What do studies say to both the baby and the mom. about this specific drug not be so safe for babies The health risks of untreated depression during and pregnancy? in the womb after all. pregnancy are real. Moms-to-be who are depressed are The CDC and FDA less likely to eat well and get proper prenatal care. Will I need special both warn that another They’re more likely to smoke and drink alcohol, and to care if I take an SSRI, paroxetine (Paxil), antidepressant while have pregnancy complications such as preeclampsia, increases the chances pregnant? gestational diabetes, premature birth, and low birth for birth defects. One of weight. Taking an antidepressant may help a woman have a What about alternatives the most publicized risks healthier pregnancy. to antidepressants? related to these two drugs is Still, “it can be very challenging for some pregnant a life-threatening condition women to admit feeling depressed,” says Jennifer Payne, Can I breastfeed called persistent pulmo- MD, co-founder and director of the Women’s Mood while taking an nary hypertension of the antidepressant? Disorders Center at The Johns Hopkins Hospital in newborn, which causes (Ask this before the Baltimore. “Also, there’s an idea that antidepressants are baby comes.) severe breathing problems. a luxury medicine, and women should be pulling up their Yet many review studies, including a 2015 report in socks and getting through JAMA, say the risk is “sta- their pregnancy without tistically insignificant.” taking them.” The bottom line: Tak- Which antidepressants ing any medicine while are safest during preg- you’re expecting can be nancy? No one has a clear- risky. If you have depres- cut answer. “We tend to use sion, talk to your doctor older antidepressants like if possible before you Zoloft (sertraline) because conceive. Together you they’ve been around for a can weigh the risks and long time, and if there’s benefits. Sometimes, you going to be an issue we may be able to stay on your would have seen it,” Payne current medicine. says. A recent CDC study “The best antidepressant confirms this thinking; it to use during pregnancy is found no link between birth the one that keeps mothers defects and this common well,” Payne says. selective serotonin reuptake inhibitor (SSRI). Reviewed by However, the safety of Arefa Cassoobhoy, MD, MPH WebMD Medical Editor

other SSRIs is certainly PELAEZ/CORBIS LUIS JOSE

W ebMD.COM 31 JAN/FEB 2016 Check out Treating Your Child’s Cold or Fever, a slideshow at WebMD.com. LEARN HOW ON PAGE 4

KIDS’ HEALTH Fever Pitch HOW YOU TAKE YOUR CHILD’S TEMPERATURE MATTERS. GET THE FACTS

By Erin O’Donnell

Few things set off alarm bells for parents like a child with a high fever. Yet while a fever signals that the body is fighting an infection, it’s not an emergency in most instances, says Alex Okun, MD, a primary care pediatrician and medical director for New Alterna- tives for Children, a nonprofit child wel- fare agency in New York City. “A fever may matter less than some families think,” Okun says. “It’s really just part of the big picture. Other signs and symptoms, and how the child’s looking and doing, usually matter more.” For example, few pediatricians worry if a child has a fever but is running around playing as usual. And most pediatricians don’t even consider a child’s temperature a fever until it reaches 100.4°F, Okun adds. Still, if you suspect your child has a fever, some situations call for taking her temperature and tracking sides, with legs bent. Place the tip of the ASK YOUR it carefully: when a baby is younger thermometer about a half-inch inside PEDIATRICIAN than about 12 weeks, when a child has the rectum, and gently pinch the but- If I think my child has a fever, a suppressed immune system due to tocks to hold the thermometer in place should I take her temperature? cancer treatment or disease, if a child until the thermometer beeps. Label If so, how? has sickle cell disease, or when a child thermometers so a rectal thermometer Above what temperature uses a medical device known as a cen- is never used in someone’s mouth. should I consider my tral venous catheter. Axillary This method involves plac- child to have a fever? Here’s a rundown of common fever- ing a thermometer under a child’s arm checking methods. in the armpit. Studies show this tech- If my child has a fever, Oral Once a child is about 5 or 6 years nique is not useful if you need a precise what other signs should old, this is an easy, accurate option. “The reading, Okun says. I watch for? child needs to be old enough to hold the Ear The tympanic membrane ther- When should I give my thermometer under the tongue, and mometer, or ear thermometer, measures child fever-reducing close his mouth until the number stops the heat given off by a child’s eardrum. medication? Which can I give changing or the thermometer beeps,” These thermometers may not be accu- her, and how much? Okun says. rate if your child has a curved ear canal Rectal Pediatricians consider this or lots of earwax. When should I call you? the most accurate option in children too Temporal artery The temporal young for an oral thermometer. Infants artery thermometer uses an infrared and toddlers can lie on their backs, but scanner to measure the temperature of Reviewed by Hansa Bhargava, MD WebMD Medical Editor

MICHAEL H/GLOW IMAGES H/GLOW MICHAEL older children may prefer to lie on their the temporal artery in the forehead.

JAN/FEB 2016 32 W ebMD.COM Take Control of Your Allergies.

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From gamingR geek to serious newsie to action hero, Olivia Munn has a diverse career. And she has no problem being smart, beautiful, and funny. We talk to the actor about her versatility and how she learned self-acceptance

BY REBECCA ASCHER-WALSH PHOTOGRAPH BY WILLIAMS + HIRAKAWA/CORBIS OUTLINE Olivia Fresh MUNN STARTS OLIVIA MUNN KNOWS WHAT IT TAKES TO is an expert at fresh starts. START LEADING A member of a military family, she and her four siblings A HEALTHIER EMOTIONAL AND spent their childhoods moving between bases in Japan and PHYSICAL LIFE—AND Oklahoma. “I was perpetually the new kid,” she says, “and it’s TO KEEP IT UP. always hard to have to break through those barriers. But when PARTNER UP. Get motivated with I would come home sad about something like girls being mean a friend or family member. Munn says at school, my mother would just say, ‘Figure it out.’ We were she’s inspired by her pro-athlete boyfriend’s never allowed to feel sorry for ourselves. healthy habits.

LOVE IT OR LEAVE IT. Pick an exercise routine you enjoy. “Yoga and “My mom gave us the message that when something was happening to us, for me, but wanting to feel pretty was running for me are so we were smart enough to change it,” she continues. “Whether it changes for never a crime in my family.” tedious, but I love the better or even the worse, at least you’ve tried. And that gave me a strong Critics were less kind about Munn’s martial arts,” Munn says, sense of self-worth.” decisions to pose for Playboy and “so I’ll go do kicks in Not to mention flexibility, an attribute reflected in her diverse career. Munn, Maxim, railing against the actor when, the gym.” 35, has been a correspondent on Comedy Central’s The Daily Show With Jon in 2010, she got her first big break as KNOW YOURSELF. Stewart, played a financial news reporter on Aaron Sorkin’s HBO series The a correspondent on The Daily Show. In the past, Munn Newsroom, and held her own in film comedies like Steven Soderbergh’s Magic When they claimed Munn had been skipped working out if it Mike. Currently starring in the Kevin Hart romp Ride Along 2 and making a hired for her beauty rather than her was a solo activity. If you cameo appearance in Zoolander 2, she gets in on the blockbuster action this brains, she came out swinging and has need company to sweat, choose classes. summer with X-Men: Apocalypse, starring as the sword-swinging Psylocke. never looked back. A self-professed geek (she can turn any PC into a gaming rig) who has “I don’t want to apologize for any- SPEND FACE TIME. posed for the cover of Playboy (albeit in a bikini), Munn makes no apologies thing,” she says, “and I’m never going to Invest in the future by for being funny, smart, and beautiful. apologize for being a woman. Men use taking care of your face their physicality all the time. Channing in the present. For Munn, SELF EVOLVED Tatum”—with whom she co-starred that means cleansing properly and indulging That sense of acceptance was hard-earned. “I didn’t start out feeling comfort- in Magic Mike—“is super talented and in facials. able with how I looked,” Munn says. “I grew up with a sister who had this very super smart and looks great without a voluptuous body and other girls at school were tall and thin, and I wasn’t those shirt. But when women use everything TALK IT OUT. things,” she remembers. we have, we’re exploiting ourselves and To keep anxiety and “Then I moved from Oklahoma to Hollywood, and I was showing up at bringing other women down. What if we depression in check, “be open with your auditions in my Sunday best with high heels and a dress. I’d go in with these use everything we have, which puts us friends,” she says. really tall, thin girls with their jeans and ballet flats and tank tops and they on an even playing field with men, and made it look so effortless. So I had to figure it out because it wasn’t working we don’t put each other down for it?”

W ebMD.COM 36 JAN/FEB 2016 Photograph by Squire Fox/August JAN/FEB 2016 37 W ebMD.COM Read a blog post at WebMD.com, Is My Anxiety Normal? TAKING THE “I know LEARN HOW ON PAGE 4 Panic OUT what I’ve been through in my life, OF ANXIETY ATTACKS and I know who I am. Olivia Munn is one of about You have to just keep 6 million people with a panic disorder. Women are twice as likely to suffer as men. Panic pushing forward.” attacks—an errant fight-or-flight instinct marked by a pounding heart, sweating, weakness and dizziness, and chest or stomach pain—are terrifying, but they are also treatable. HEALTHY CHOICES This year, Munn is focused on her over- “Milder cases can be cured completely,” says psychiatrist all health. The first step is discipline O. Joseph Bienvenu III, MD, about exercise and accepting what PhD. People with severe cases, works for her. “I don’t understand how he says, “can feel normal and people run or do yoga,” she says. “I’m so function well in life.” The first not Zen.” And when she went on loca- step toward relief: “Talk to your doctor, and empower yourself tion to filmRide Along 2, “I didn’t know by looking at the NIH and Ameri- how to work out by myself,” she admits, can Psychiatric Association “so I put on weight.” websites, which have material But when she began stunt training on what we know and what you for X-Men, Munn—who earned a black should do next.” The most effective treatments include: belt in karate as a child—fell back in love with martial arts. She embraced Cognitive behavioral therapy the six-hour-a-day workouts, and, one This teaches a person how month into the training, got on the to react differently to panic scale to see she had lost 12 pounds. attacks, from practicing self- talk to deep breathing. “Even if What worked for her, she says, is “I you’re still having panic attacks, wasn’t thinking about getting more with this therapy you cannot Munn’s rebel yell is offset by the comedic human beings I have ever met. You don’t Asian, and for them anxiety, panic attacks, and chiropractors all fall into one cat- toned. I was thinking about getting fit- worry about them because chops she’s demonstrated professionally as always need to do Sorkin or Soderbergh egory of ‘You’re being lazy,’” she says with a laugh. “But the doctor explained to me ter and more capable.” you’ve taught yourself you’re well as in the Dubsmash videos she and her projects. Go do something fun.’ that life doesn’t have to be bad to have a panic attack. Your body is overstimulated, Now that filming is over, she practices going to be fine.” boyfriend, Green Bay Packers star quar- “I’m not trying to change the world with and your brain just can’t keep up with your body.” martial arts in her home gym. Dating Medications Selective sero- terback Aaron Rodgers, have posted of the my work,” she continues. “I don’t know if I In addition to working with a therapist, Munn began to see a hypnotist to help a pro-football superstar provides daily tonin reuptake inhibitors, a type two acting out scenes from Princess Bride have the energy to do that. What I want to her manage her anxiety and the resulting trichotillomania (the urge to pull out inspiration. “My boyfriend is so athletic of antidepressant, can help and channeling Mariah Carey. Then there do is entertain.” hair anywhere on the body, including the scalp or eyelashes; in Munn’s case, it was and good at everything, and it’s so much prevent anxiety attacks. “When is the way she approaches her failures, with eyelashes). The hypnotist suggested exercise as a natural way to help combat both fun to watch,” she says. “This past year someone is impaired by panic attacks in their everyday life, I a signature, sassy shrug. Of her role in the PANIC BUTTON anxiety and depression. Three days after a session when he hypnotized her to do he’s wanting to get really healthy, so think about antidepressants in Johnny Depp-starring flop Mortdecai she Munn’s confidence has been won despite just that, she began to work out regularly with a trainer. Her weight became more when organic is an option, we’ll both addition to cognitive therapy,” says, “My best work was in the poster. But many false starts, beginning with unhealthy consistent, and her anxiety level decreased. choose that.” Bienvenu says. Benzodiaz- you take the opportunities that come along, diet habits. “I was never the weight I wanted Still, “I live with anxiety a lot,” Munn says. “And I think when people have anxi- Above all, her focus is on finding joy. epines, or tranquilizers, are and you don’t know what that will give you to be,” she says. “In 2009, I lost 16 pounds ety attacks we don’t talk about it, because the people who don’t understand make That means not just time with family, “good for stopping the physical symptoms, reduce anxiety in the end.” because I came up with the rule of ‘If I don’t you feel like you’re going crazy, even when you know you’re not. But I’ve found that friends, and Rodgers, but time spent overall, and work as soon as What she’s chasing, she says, is not a con- see it, I don’t eat it,’ which meant I had to the more I can talk to people about it, the less alone I feel,” she continues, “and having honest conversations. “I know they are absorbed,” he says. ventional path of success but one of happi- actually see the ingredients. But my weight that people are more compassionate about it than you realize.” what I’ve been through in my life, and I Doctors often prescribe them in ness. “When I was coming off of Newsroom, has always fluctuated.” O. Joseph Bienvenu III, MD, PhD, an associate professor of psychiatry and know who I am,” she says. “You have to the short term before cognitive people would say, ‘You’re doing Ride Along Then, two years ago, Munn began to have behavioral sciences at Johns Hopkins University School of Medicine, applauds just keep taking the hits as they come, therapy and/or antidepressants have had time to be effective; 2, huh? That’s really different than work- panic attacks, which, with the resulting Munn’s speaking out. “A panic attack is a fight-or-flight bodily response at a time and keep pushing forward.” they discourage long-term use ing with Aaron Sorkin.’ But I talked to Jon shortness of breath, she blamed on seasonal when it’s not needed, and in addition to being terrifying, people can feel like they’re because of the risk Stewart, who is like a big brother to me, asthma—until she passed out and ended up losing their minds,” he says. “So social support is huge. And talking allows people Reviewed by Michael W. Smith, MD WebMD Chief Medical Editor of addiction. and he said, ‘Kevin Hart is one of the best in the emergency room. “Half my family is to process things and put anxiety in perspective.”

W ebMD.COM 38 JAN/FEB 2016 Photograph by Squire Fox/August JAN/FEB 2016 39 W ebMD.COM Ever wonder why the scale won’t budge? Is it your genes, your gender, or something else? We explore some weight- loss mysteries to help dieters shed some light—and weight—on their journey S TRAIGHT

TALK| | BY BRENDA GOODMAN | | PHOTOGRAPHY BY ANN CUTTING

So you’re finally ready to lose weight. Now the question is: How? The standard advice—eat less and move more—isn’t so helpful when it comes to the “how.” You know you need to cut calories, but how many? Are you better off getting those calories from low-fat or low-carb foods? And what’s going on with your metabolism—your personal energy-burning furnace? Is it programmed to keep you overweight? Can you fan the flames enough to dream of one day eating a slice of pie without gaining a pound?

Even science is still stumped on some YOU DON’T HAVE TO CUT 3,500 of the basic questions about weight loss. CALORIES TO LOSE A POUND “Amazingly, in this era of obesity, there The idea that dieters need to cut 3,500 are still many things that we really don’t calories to lose one pound of weight comes know,” says Robin Callister, PhD, professor from an influential scientific paper pub- of human physiology at The University of lished in 1958. Max Wishnofsky, a doctor Newcastle in New South Wales, Australia. who lived in Brooklyn, N.Y., tried to sum Here’s what researchers do know about up everything known about how calories some of the most persistent weight-loss are stored by the body. He concluded that mysteries. it would take a deficit of 3,500 calories to

W ebMD.COM 40 JAN/FEB 2016 JAN/FEB 2016 41 W ebMD.COM Check out videos and an infographic at webmd.com/ weight-loss-mysteries. LEARN HOW ON PAGE 4 GENES MAY lose a pound. For decades, the so-called EXPLAIN AS In the lab, researchers have shown that MEN AND WOMEN ARE NOT Wishnofsky Rule has been the formula higher-protein diets tend to increase the THE SAME by which determined dieters live. MUCH AS 80% number of calories a person burns, Hall When it comes to weight loss, gender The trouble is that it’s wrong. OF PEOPLE’S says. “So in that sense, a protein calorie makes a difference. The 3,500-calorie rule doesn’t work is not equivalent to a carbohydrate or a Pound for pound, a man on a diet SURPRISING because the body adjusts to weight loss, WEIGHT. fat calorie.” will drop 10 pounds faster than you can PROTEIN quickly decreasing the number of calo- Protein helps you burn more calo- say “please pass the celery.” Research- ries it needs to maintain a new, lighter BUT THE ries during the day and helps preserve ers think that’s probably more of a size POWERHOUSES weight, says Corby Martin, PhD, an POTENTIAL TO muscle. When people lose weight, they issue than a sex difference. Men are associate professor with the Ingestive lose muscle as well as fat. The more bigger than women and naturally carry Protein is key for dieters because Behavior Laboratory at Louisiana State muscle you lose, the more your metab- more muscle, the tissue that burns the it helps burn more calories during GAIN WEIGHT 5the day and keeps you feeling full University’s Pennington Biomedical olism slows. That can make it tough to greatest number of calories. So they longer. These five plant-based Research Center. AND BECOME keep the weight off down the road. Pro- have an easier time losing weight. foods have at least 5 grams of Let’s say a dieter knows she needs to OBESE IS IN tein also helps you feel satisfied longer But here’s the thing about men: protein per serving. eat 2,500 calories a day to maintain her after you eat. They start strong but often can’t sus- weight. When she wants to slim down, tain the effort. ASPARAGUS | | A cup and a half of EVERYBODY. cooked asparagus has more she decides to shave 500 calories off her WHEN IT COMES TO WEIGHT, “At three months, men are ahead— than 6 grams of protein—that’s daily intake. According to the Wishnof- YOU’RE JUST BORN A CERTAIN definitely ahead on absolute weight about the same as a large egg. sky Rule, after about a week of doing WAY—RIGHT? loss,” says Callister, who recently con- How to get more in your diet: that, she should lose a pound. “For the To a large extent, yes. Genes are “at ducted a study of studies, or meta- Grill or steam asparagus, then first week or two, the 3,500-calories-per- least 40% of the answer,” says Fujioka, analysis, to look at sex differences season and drizzle with olive oil for a side dish. pound rule kind of works, roughly, but and may explain as much as 80% of in weight loss. “But by six months, after the first couple of weeks it doesn’t,” people’s weight. there’s no difference.” OATS | | With 5 to 6 grams of Martin says. He says that’s especially likely to be But what about percent protein per cup, old-fashioned Here’s why: In three or four weeks, the true if a person is very overweight and weight loss? Do men really lose cooked oats pack a great protein dieter needs fewer calories to maintain has struggled with being heavy his or a bigger percentage of their punch. How to get more in your diet: Go beyond cereal. Use oats to her new shape. “Therefore, when you’re her whole life. “The potential to gain overall weight when they diet make muffins, cookies, following that 2,000 calories per day, weight and become obese is in every- than women do? Surprisingly, and even pancakes. your energy deficit is no longer 500 calo- body. But for some people, the poten- few studies have looked at ries. Now it’s 450, then it’s 425, then it’s tial is clearly genetically much, much that question. Callister says PISTACHIOS | | At 6 grams per 375, then it’s 200,” Martin says. you need? Will a drink torpedo your As for calories from fat, carbohy- higher,” he says. researchers don’t know the serving (about 49 nuts), pistachios have more protein than most “Over time, your weight loss will slow hard work? drates, and protein, this is where one So far, researchers have flagged more answer. other tree nuts. How to get more until you reach a new, lower weight pla- Let’s start with the alcohol. “There’s eating plan doesn’t fit all. than 30 genes associated with body One study, however, com- in your diet: Snack on a handful of teau,” he says. a big debate on whether alcohol calories Good science shows that people who mass index. The one most strongly pared the weight loss between pistachios, or chop and use to top Fortunately, researchers have been are even usable, whether you can even have high insulin levels—associated with tied to obesity is called the FTO gene. men and women who had fish, salads, or yogurt. working to update Wishnofsky’s for- turn them into fat,” says Ken Fujioka, conditions such as type 2 diabetes, pre- Researchers recently reported that peo- gastric bypass weight-loss CHIA SEEDS | | Just mula. The result: new calculators, such MD, a weight-loss expert at Scripps diabetes, gestational diabetes, polycys- ple who get a faulty copy of that gene surgery. The study found 2 tablespoons of dried chia as the Body Weight Planner from NIH Clinic in San Diego. “When you look at tic ovary syndrome, and fatty liver dis- are more likely to store calories as fat that after 24 months, no sig- seeds add about 3 grams of and the Weight Loss Predictor from various studies, you actually get mixed ease—benefit from diets that are lower instead of burn them for energy. The nificant difference showed up protein to any meal. How Pennington Biomedical Research Cen- results. Some studies say it’s not a prob- in carbohydrates (especially refined discovery, published in The New Eng- in the percentage of weight to get more in your diet: ter. Enter a few key details, such as your lem; don’t worry about it. Others say it’s ones) and higher in healthy fats and lean land Journal of Medicine, should pave the lost by men and women. Toss seeds into smoothies, salads, or yogurt. sex, age, weight, height, activity level, associated with weight gain.” proteins. Examples of this kind of diet way for better weight-loss treatments. On average, men lost and the date you want to hit your goal, Fujioka counsels his patients to pay are the South Beach diet, the Zone diet, Though FTO is the most powerful about 66% of their excess WHOLE GRAINS | | One cup of and each tool will give you a more real- attention to how alcohol affects their the Mediterranean diet, and the Low GI single gene identified to date, it doesn’t weight, while women lost cooked buckwheat has more than istic daily calorie count to get you there. eating. “Some folks, when they drink (glycemic index) diet. explain all obesity. Fujioka says obesity is about 73%. 5.5 grams of protein, and 1 cup alcohol, feel like they have license to If insulin levels aren’t a concern, probably the sum of many genes working Here’s more news: of cooked millet has more than 6 grams of protein. How to get CALORIES ARE NOT ALL EQUAL eat whatever they want to and they get there’s very little difference in how much together. “The more genetic flaws you While women may take more in your diet: Want a sandwich? So now you know how many calories into problems.” weight people lose, whether they cut get that lead you to obesity, you’re more a little longer than men Swap white bread for 100% whole you need to eat every day. But where If a glass of wine weakens your will to back on fat or carbs, says Kevin D. Hall, like a loaded gun. The environment will to shed the same amount wheat bread, and you’ll get nearly should they come from? Is it better to resist that plate of cheese and crackers, PhD, a senior investigator and expert in pull the trigger and you’ll just get heavy.” of weight, Callister says they 8 grams of protein in two slices. cut carbs or fat? How much protein do it’s not doing your waistline any favors. metabolism at the National Institute of On the other hand, people who don’t seem to do a better job keep- Or give beef a rest and try a buckwheat burger. But if alcohol doesn’t affect your eat- Diabetes and Digestive and Kidney Dis- inherit those risk genes will be protected, ing it off, perhaps because Reviewed by Brunilda Nazario, MD ing, one or two drinks is probably OK, eases in Bethesda, Md. But, he says, pro- to some extent, from major weight gain they lost it more gradually in —Katherine Brooking, MS, RD WebMD Lead Medical Editor he says. tein calories are a different story. no matter how badly they eat. the first place.

W ebMD.COM 42 JAN/FEB 2016 JAN/FEB 2016 43 W ebMD.COM FOOD & FITNESS IN SEASON Sun Burst By Erin O’Donnell

Recipes by Kathleen Zelman, MPH, RD, LD

Just at the moment you make a resolution to eat more healthy foods, nature hands you a simple, tasty way to do it. It’s citrus season, so supermarkets are stocked with oranges, grapefruits, tangerines, and their many cousins. Snacking on one medium orange provides more than 100% of an adult’s daily value of immune-boosting vitamin C and an impressive 12% of the daily value of fiber. That fiber includes pectin, “which seems to bind to cholesterol in the gut and remove it from the body,” says Bahram Arjmandi, PhD, RD, director of the Center for Advancing Exercise and Nutrition Research on Aging at Florida State University. Citrus fruits also contain plant chemicals including naringenin and hesperidin, anti-inflammatory compounds that preliminary research suggests could help reduce blood pressure and cancer risk. Pink and red grapefruit contain the antioxidant known as lycopene, which may play a role in preventing cancer. While a glass of your favorite sunshine-hued juice rocks as an occasional treat, “take the time to eat the whole fruit to get the fiber,” Arjmandi says. Our recipes on the next pages offer new ways to get the new year off to a sunny start. FOOD STYLIST DEBBIE WAHL DEBBIE STYLIST FOOD

Photograph by Dan Whipps JAN/FEB 2016 44 W ebMD.COM FOOD & FITNESS Grapefruits come in pink, red, white, and golden varieties. A New Leaf This salad boasts a host of disease-fighting antioxidants. The recipe calls for pomegranate arils, the juicy, edible part of the pomegranate. The produce aisles of many large grocery stores sell pomegranate arils removed from their skin and ready to eat.

Baby Kale, Grapefruit, and Avocado Salad Makes 6 servings Ingredients The bigger the “navel” on an 3 tbsp extra virgin olive oil orange, the sweeter 2 tbsp freshly squeezed it will be. grapefruit juice 2 tbsp freshly squeezed lime juice 1 shallot, finely minced ¼ tsp sea salt freshly ground pepper to taste 9 cups thinly sliced baby kale, ribs and stems Wrap Star removed This recipe involves parchment paper, sold next to the foil 1 pink grapefruit, and plastic wrap in supermarkets. The paper acts as a tent to sectioned steam the fish in the aromatic citrus juices. Serve the fish with 1 avocado, halved, pitted, asparagus and a whole-grain side dish such as brown rice. and sliced ½ cup pomegranate arils Citrus Salmon in Parchment ¼ cup toasted sunflower Makes 6 servings seeds black and red pepper. Top .com Ingredients Directions each piece of salmon with 6 (6-oz) skinless salmon 1. Make the dressing: In a fennel, citrus fruit, and fillets small bowl, whisk olive oil, What’s thyme. 6 (12–15-inch) squares of grapefruit juice, lime juice, 3. Bring the edges of the Cooking! parchment paper shallot, salt, and pepper. paper together and fold Thousands of people turn 1 tbsp olive or canola oil Place kale in a large bowl to seal, tucking the edges to WebMD.com for meal ¼ tsp sea salt and toss with dressing. inspiration every day. under the packet. Place freshly ground black 2. Place dressed kale on six Here are the most-clicked packets on a baking sheet. pepper to taste salad plates. Top leaves recipes.* 4. Bake 15 minutes, or until ¼ tsp ground red pepper with grapefruit, avocado, fish is flaky. (Carefully 1 medium fennel bulb, pomegranate arils, and Spicy Vegetable Soup open one packet to test.) thinly sliced sunflower seeds. Place packets on serv- Chicken Waldorf Salad 1 lemon, thinly sliced ing plates and cut an Per serving 1 blood orange, thinly X in the center of the Easy French Apple Tart sliced 215 calories, 5 g protein, 22 g paper on each one. Serve 12 sprigs fresh thyme carbohydrate, 14 g fat (2 g Lemon Dill Chicken immediately. saturated fat), 5 g fiber, 5 g Directions Per serving sugar, 143 mg sodium. Calories Autumn Chicken Stew from fat: 56% 1. Preheat oven to 450°F. 395 calories, 35 g protein, 6 g 2. Place each salmon fillet carbohydrate, 25 g fat (5 g *as of Nov. 1, 2015 Reviewed by on a piece of parchment saturated fat), 92 mg cholesterol, Hansa Bhargava, MD paper. Drizzle with oil and 2 g fiber, 2 g sugar, 216 mg WebMD Medical Editor

sprinkle with sea salt and sodium. Calories from fat: 57% WAHL DEBBIE STYLIST FOOD WHIPPS; DAN

W ebMD.COM 45 JAN/FEB 2016 FOOD & FITNESS The pomelo, the largest member of the citrus family, tastes like a sweeter, milder version of grapefruit.

Overnight Delight This simple dish looks, smells, and tastes delicious, but requires a little planning because the flavor is best when the chicken marinates overnight.

Citrus-Roasted Rosemary 12 skinless chicken thighs in juice mixture. Seal and 3. Bake uncovered 50–60 Chicken Thighs 1 lemon, sliced place bag in the refrig- minutes, or until the Makes 6 servings 1 orange, sliced erator overnight or for at chicken is golden brown 1 large onion, thinly least three hours. and an instant-read ther- Ingredients sliced 2. Preheat oven to 400°F. mometer registers 165°F. 2 tbsp olive oil 3 tbsp fresh rosemary, Remove chicken from Garnish with remaining 2–4 garlic cloves, minced divided marinade and place in rosemary and serve. 1 tbsp honey a 13-by-9 glass baking Directions Per serving ⅓ cup fresh orange juice dish sprayed with cook- ⅓ cup fresh lemon juice 1. In a small bowl, whisk ing spray. Pour remaining 257 calories, 28 g protein, 14 g 1 tsp paprika together olive oil, garlic, marinade into the bottom carbohydrate, 10 g fat (2 g satu- ½ tsp red pepper flakes honey, juices, paprika, of the dish. Arrange slices rated fat), 115 mg cholesterol, 2 g (optional) red pepper flakes, of lemon, orange, and fiber, 8 g sugar, 249 mg sodium. ¼ tsp sea salt salt, and pepper. Place onion on and around the Calories from fat: 35% freshly ground pepper to chicken thighs in a large chicken. Sprinkle 1 tbsp taste zip-top bag and pour rosemary on top.

BREAKFAST 411

James Beard award-winning chef Ming Tsai scallions, garlic, and eggs—and sometimes knows the value of a good breakfast for kids. ground turkey or organic sliced sandwich The host of TV’s Simply Ming is the father meat. He’ll also top ramen with an egg for of two boys, David, 15, and Henry, 13, and another savory breakfast dish. president of the National Advisory Board of Family Reach, a nonprofit that provides a In the winter, he’ll often make his sons financial lifeline for families of children with oatmeal. Instead of using ready-made cancer. His advice? Start the day with a meal packets (which can have lots of added that’s low in sugar and high in protein, and sugar), Tsai cooks the oatmeal with diced that has some sort of fruit or vegetable. banana and rice milk. “My kids love tasty, bold-flavored breakfasts. For me, it's about For breakfast, his family leans toward savory, starting with wholesome ingredients, adding including his sons’ favorite: fried rice. some high-impact (low calorie, all natural) Using leftover rice he stores in the fridge flavor boosters, and keeping it simple.” or freezer, Tsai cooks it up with ginger, —Kerri-Ann Jennings LEFT: GEORGINA PALMER/GETTY IMAGES; DAN WHIPPS; FOOD STYLIST DEBBIE WAHL DEBBIE STYLIST FOOD WHIPPS; DAN IMAGES; PALMER/GETTY GEORGINA LEFT:

W ebMD.COM 46 JAN/FEB 2016 Craving more recipes? Sign up for The Daily Bite newsletter at WebMD.com. LEARN HOW ON PAGE 4 OFF THE MENU Jeff Tunks RESTAURATEUR, WASHINGTON, D.C.

By Matt McMillen

Chef Jeff Tunks has biking.” This past summer, always been a big guy, they two-wheeled through but he used to be a lot Provence in France. bigger. Several years ago, he His favorite comfort food weighed in at 375 pounds. is now a big salad, prefer- For someone who works 70 ably a Caesar. He no longer to 80 hours a week on his skips breakfast. His diet, feet, that burden eventually like his restaurant menus, became too great to bear focuses a lot on fish. and his body rebelled. PassionFish Bethesda, “I ruptured a disc in my just north of D.C., serves back while at work and sushi and features an abun- had to have surgery,” says dant raw bar and several Tunks, 54, who—together catches of the day. Tunks with his two partners in Pas- shares the recipe for the res- sion Food LLC—runs more taurant’s most popular dish, than seven restaurants in the grilled whole branzino. the Washington, D.C., area. “Any time you have a “That’s what triggered the wardrobe,” says Tunks, what the scale says but how whole fish, its flavor is just realization that I needed a single father with joint my clothes feel.” richer and deeper than a to do something to change custody of two teenage boys, Tunks mastered new piece of boneless, skin- my lifestyle and take some Jordan and Bradley, whom habits that help him control less fish,” Tunks says. “It’s pounds off, not only to pre- he cooks for—and some- his weight. He’s learned to really simple to do, and the serve my career but to be a times with—three evenings love exercise. It helps that skin keeps it moist, so it’s better father.” a week. his fiancée happens to be hard to overcook.” The 6-foot-3 Tunks “I bought all new clothes, a triathlete. “I’m not built

dropped about 130 pounds and all my old stuff went for running, but I do like Reviewed by and has since kept it off. to the Salvation Army and cycling,” Tunks says. “We Hansa Bhargava, MD WebMD Medical Editor “My motivation now is my Goodwill. For me, it’s not try to focus our vacations on

Grilled Whole Branzino Directions Makes 4 servings 1. Stuff the cavity of the clean fish with parsley, lemon, scallions, thyme, and Ingredients fennel. Add salt and pepper in the cav- 1½ lb branzino, scaled and gutted, ity and surrounding the fish. Drizzle the head on (if you can’t find branzino, fish lightly with the olive oil. look for a whole red snapper or 2. Preheat the oven to 400°F. Heat a small rockfish) grill pan on medium-high, lightly 1 tbsp chopped parsley spray the whole fish with nonstick 4 round lemon slices spray, then sear it on both sides. 1 tbsp sliced scallions Transfer fish to a baking sheet and and a sprinkling of coarse sea salt. 1 tbsp fresh chopped thyme cook in the oven 8–10 minutes. It’s Drizzle with extra virgin olive oil and ¼ cup julienned fennel bulb done when the thickest part of the serve. kosher salt and freshly ground black fillet around the head feels firm to pepper to taste the touch. Per serving 1 tsp extra virgin olive oil plus olive 3. After it has cooked through, remove 170 calories, 30 g protein, 2 g carbohydrate, oil to finish garnish: fennel fronds, fish from the oven and place on a 5 g fat (1 g saturated fat), 63 mg cholesterol, lemon wedge, coarse sea salt serving plate. Garnish with fennel 1 g fiber, 256 mg sodium. Calories from

FROM TOP: SCOTT SUCHMAN; CHRIS GRANGER CHRIS SUCHMAN; SCOTT TOP: FROM (preferably Maldon) to taste fronds, a big wedge of fresh lemon, fat: 25%

JAN/FEB 2016 47 W ebMD.COM FOOD & FITNESS

FITNESS CHALLENGE Fuel the Fire

RETHINK YOUR CARDIO ROUTINE WITH THESE Q CALORIE-TORCHING MOVES “What are some of the By Jodi Helmer biggest fitness trends of 2016, and which are Want to drop a few pounds in the new year? To turn your resolution into an accom- worth trying?” plishment, Ashley Borden, a Los Angeles–based personal trainer whose celebrity Molly Blake, 41, stay-at-home clients include Christina Aguilera, Mandy Moore, and Ryan Gosling, wants you to rethink mom, Palo Alto, Calif. your approach to cardio. “The idea that a cardio workout has to include the treadmill is very outdated,” she says. The moves in this circuit are designed to fire up your muscles and get your heart pumping to burn calories. Aim to do five rounds of the circuit (working through one set of the moves in order is one circuit) at least three times per week.

A “Fitness trends, like fashion trends, change over time, Single-Leg Modified Squat Jump so by all means experiment. Plyometric Jumps Burpees Touch This year, small-group Borden likes this move This popular move combines Perform these steps as personal training is a big because it works the glutes, cardio and strength training, one fluid movement and trend. It’s more affordable quads, and calves while working the arms, chest, you’ll work the muscles in engaging the core and core, and legs. Beginners your inner thighs, quads, than a one-on-one session improving balance. If you can modify the move to hamstrings, glutes, and with a trainer, and you still feel off balance, hold on to a walk, not jump, the legs core. “It’s a simple, explosive get personalized attention. chair for support. back and forth. For a more move that gets great Try it if you want a workout advanced burpee, trade the results,” Borden says. tailored to your needs. 1. Stand with feet hip-width plank position for a push-up. apart. 1. Stand with feet together. Restorative classes that 2. Bring your left leg back 1. Start with feet a little 2. Jump with feet apart hip- include stretching or foam and bend your left knee wider than hip-width width and, keeping your rollers are also really hot toward the floor (getting apart. chest raised, lower into for 2016. The classes are a it as close to the floor as 2. Bend your knees, lower a squat. Make sure your great addition to regular possible). Your right knee into a squat, and place knees don’t extend past will bend, too. both hands on the floor, your toes. workouts to help prevent 3. With your weight on your shoulder-width apart. 3. Keep your arms straight injuries. Online classes are right heel, push off the 3. Keeping your core and touch your fingertips a growing trend. Thanks to ground, straightening engaged and your weight to the floor. technology, you can work your right leg and driving on your arms, jump both 4. Push through your feet with a trainer via Skype and your left knee up toward feet back and lower into a and, squeezing your your belly button. plank position. glutes, jump up to the get a great workout without 4. Return to the starting 4. Jump your feet back to start position, raising your leaving home.” position. the start position. arms over your head. 5. Repeat five times. 5. Pushing through your 5. Repeat five times. 6. Repeat five times on the legs, jump up as you raise opposite leg. both hands above your head and clap. Reviewed by 6. Repeat five times. Michael W. Smith, MD, CPT WebMD Chief Medical Editor Joy Keller, CPT, executive editor,

IDEA Fitness Journal LEE JASON

W ebMD.COM 48 JAN/FEB 2016 Watch Motivation for Exercise, a video at WebMD.com. LEARN HOW ON PAGE 4

WORK IT OUT You Turn LACKING MOTIVATION? HERE’S HOW TO KEEP YOUR FITNESS ROUTINE ON TRACK

By Kara Mayer Robinson

We totally get it: One day you’re super enthused about exercising, the next day—not so much. But your routine doesn’t have to go off the rails every time your motivation flags. We called in fitness experts to keep you amped up and on track when you need it most. Swap intensity for great form. Can’t muster the energy for your usual workout? Scale back and focus on improving your form, says certified personal trainer Catherine Gordon, owner of Gordon Studio in Sonora, Calif. Use lighter weights, do fewer repeti- tions, or trim the length of Go rogue. Novelty goes Accept that you have no your workout. Don’t worry a long way in replenishing about intensity or duration. your oomph. Find an activ- motivation. Then get out and do For today, simply focus on ity that feels more like fun your workout anyway. form and technique. You can than exercise, says Joanna go back to your usual drill Chodorowska, a Philadelphia Crossfire high-intensity better health and weight tomorrow. sports nutrition coach. Do training clips on YouTube. loss, exercise less than Let others propel you. something you’ve never tried. What you see can be a pow- people who are in it for Try a group exercise class. Go with the flow of the erful source of adrenaline short-term rewards. Most instructors change seasons, says Larissa Hall and motivation, says Darin Stop worrying about up the routine regularly to Carlson, yoga instructor and Hulslander, certified per- motivation. When all else keep things interesting, says dean of the Kripalu School sonal trainer and owner of fails, accept that you have Traci Maughan, a group of Ayurveda in Stockbridge, Fitness by Darin in Chicago. no motivation. And accept fitness instructor. Bonus: Mass. “Try winter snowshoe- Go for the immediate that you don’t need it, says No self-motivation required. ing, spring dance classes, payoff. Sometimes it’s bet- Rachel DeBusk, MEd, a Just show up and follow your summer kayaking, or ter to forget your end goal. certified personal trainer instructor’s lead. autumn hiking. The variety The small rewards that and USA Triathlon coach. Or join a running group, will keep you physically and follow a workout—more “Then get out and do your swimming club, or local mentally invigorated.” energy, less stress, a better workout anyway.” sports team. Your team- Watch a clip. Use an mood—can be even more mates will keep you on your inspiring video to get you powerful. Research sug- Reviewed by game. And if you’re a no- fired up for your next gests people who aim for Michael W. Smith, MD, CPT WebMD Chief Medical Editor

JORDAN SIEMENS/GETTY IMAGES SIEMENS/GETTY JORDAN show, they’ll call you out. workout. Rent Rocky. Watch broad, long-term goals, like

JAN/FEB 2016 49 W ebMD.COM CheckupTAKING CARE, LIVING WELL

January is Glaucoma Awareness Month Glaucoma is one of the leading causes of blindness in the glaucoma in its early stages during comprehensive eye world, second only to cataracts. In the U.S., more than exams. They might prescribe eye drops or pills that can 2.7 million people older than age 40 have the condition, slow the progress of the disease and preserve eyesight. though as many as half of them may not know it. By Doctors can also recommend laser surgery or procedures 2030, the number of people in the U.S. with glaucoma to reduce fluid or pressure in the eyes. Stem cells taken could more than double. from bone marrow or fat may one day help grow new Glaucoma is most often the result of fluid buildup in healthy optic nerve cells to replace those damaged the eye, which can increase pressure and damage the by glaucoma. optic nerve. This is the nerve that sends images from the Not all rock stars have an excuse to wear dark glasses. eyes to the brain. But U2 rocker Bono has become very sensitive to bright The most common type of glaucoma—open-angle light in his 20 years living with glaucoma. Though studies glaucoma—develops slowly over time. The vision loss first don’t yet prove medical marijuana improves happens around the edges of what you see; eventually all eye pressure as well as prescription medi vision is lost. People with this condition might lose up to cations can, Whoopi Goldberg wrote in The 40% of their eyesight before they notice. Cannabist that it helps her “live comfortably” Ophthalmologists and optometrists can detect with the condition.—Sonya Collins COLOR RETINAL IMAGE OF PIGMENTARY RETINOPATHY: CHRIS BARRY/GETTY IMAGES; INSET: KEVIN MAZUR/GETTY IMAGES MAZUR/GETTY KEVIN INSET: IMAGES; BARRY/GETTY CHRIS RETINOPATHY: PIGMENTARY OF IMAGE RETINAL COLOR

JAN/FEB 2016 50 W ebMD.COM Checkup

Reviewed by Hansa Bhargava, MD, WebMD Medical Editor

HEALTH HIGHLIGHTS COLD & FLU HOW TO STAY HEALTHY ALL SEASON

By Matt McMillen

Flush it out Enhance immunity 1 Use a clean neti pot or 6 Eat well and exercise other nasal irrigation regularly to help prevent device to ease your stuffy, colds and flu. runny nose. Get help Sleep it off 7 Call a doctor if you have 2 Quality shut-eye gives trouble breathing or your body the opportunity you’ve been sick more to fight infection, so get than five days. plenty of rest. Act fast Get stuck 8 Take a prescription anti- 3 Guard against the flu viral within 48 hours of with an annual flu shot. getting the flu to ease some Get yours today. symptoms.

Avoid antibiotics Hands off 4 They can’t fight cold 9 Cough or sneeze into and flu viruses, so a tissue or your sleeve, not don’t take them. your hands.

Call in sick Keep it clean 5 Don’t share your illness 10 Clean and disinfect surfaces with others. Instead, stay you frequently touch to stop home and get better. the spread of germs.

EXPERT TIPS

Sharon E. Orrange, MD, MPH Paul Pottinger, MD Robert Graham, MD assistant professor of clinical medicine, associate professor of medicine, allergy director of integrative health, Lenox Hill Keck Medicine of USC, University and infectious diseases division, Hospital, New York City of Southern California University of Washington School of Medicine “Meditate or exercise now to reduce “Your best weapon against cold and colds. Some research suggests that flu viruses is washing your hands. “Need another reason to quit smoking? adults who practice mindful meditation Use soap and warm water and rub Tobacco smoke paralyzes your lungs’ or moderately intense exercise for eight hands together. The friction may be microscopic cilia, the tiny fingers that weeks suffer less from seasonal ailments the reason hand washing really works. move foreign material—including cold during the following winter than those Wash hands for 15 to 20 seconds or the and flu germs—up and out of your system. who do not.” length of ‘Happy Birthday’ twice or Remember: It’s never too late to quit.” your ABCs once.” PAUL BRADBURY/GLOW IMAGES BRADBURY/GLOW PAUL

W ebMD.COM 51 JAN/FEB 2016 Checkup

Reviewed by Arefa Cassoobhoy, MD, MPH, WebMD Medical Editor

BY THE NUMBERS EYE HEALTH FACTS AND STATS ABOUT TOP HEALTH ISSUES

By Heather Hatfield $3.84 BILLION 142,648,393 Annual cost of dry eye People in the U.S. with vision impairment and age-related eye disease in the U.S. 24.4 in MILLION People in the in U.S. ages 40 and older No.Ranking of macular 1 affected by degeneration as a cause of Women in the U.S. 110Men in the U.S. cataracts vision loss 15with dry eye with dry eye 10 million People in the U.S. with macular degeneration AND55 OLDER Age at which macular degeneration is most likely to occur 50% Percentage of people Increased2x risk of macular in the U.S. who have degeneration for smokers cataracts by age 75 40Age at which you should have a comprehensive Every 2 to 4 years Every 1 to 3 years Every 1 to 2 years eye exam, even if you are symptom-free Frequency of eye exams Frequency of eye exams Frequency of eye exams for symptom-free people for symptom-free people for symptom-free people ages 40–54 ages 55–64 older than 65

People in the U.S. No. 2 ages 40 and older Ranking of glaucoma as a 2.7 million affected by glaucoma cause of vision loss Sources: American Academy of Ophthalmology, American Journal of Ophthalmology, American Macular Degeneration Foundation, American Optometric Association, Cornea: The Journal of Cornea and External Disease, National Eye Institute ISTOCK

JAN/FEB 2016 52 W ebMD.COM Check out Thyroid Symptoms and Solutions, a slideshow at Checkup WebMD.com. LEARN HOW ON PAGE 4 Reviewed by Brunilda Nazario, MD, WebMD Lead Medical Editor

LIVING WELL HYPOTHYROIDISM TIPS TO MANAGE THE MOST COMMON THYROID DISORDER

By Christina Boufis

“I was exhausted,” enough? “Let your body be says Jane Johnson your guide, and always try Wall, 45, a therapist from to do more the next day,” Cranston, R.I. “I could Blevins says. “For some barely make it through the people that means going to day without taking a nap. I the gym and starting with fell asleep mid-conversation 10 minutes [of cardio] and at night. I was always cold. building up from there. For And I was gaining weight— others it may mean walking maybe 25 pounds—though I a mile and working up to 2 was going to the gym.” or 3 miles daily.” Turns out Wall’s thyroid, Watch your supple- a small gland in the neck, ments. “If you take iron wasn’t producing enough of or calcium [supplements], the hormone that regulates you have to take those sep- metabolism. arately” from your thyroid Thyroid diseases—either medication, Blevins says. hyperthyroidism, when That’s because calcium and the thyroid releases more iron can bind to the synthetic hormone and prevent Exercise can help you shed pounds requirements may change,” its absorption, he adds. he adds. That’s why you As for Wall, once she and boost energy once your thyroid should see your doctor was diagnosed with Hashi- hormone levels are regulated. regularly, particularly moto’s disease, the most if something about your common cause of hypo- hormone than you need, Take your meds. “The health changes. thyroidism, “getting the or hypothyroidism, when it most important thing is to Get moving. “Most peo- right thyroid medication makes less—are quite com- make sure you take your ple [with hypothyroidism] made a big difference” in mon, particularly in women, medication,” Blevins says. will have gained weight her energy levels, she says. says Lewis Blevins Jr., MD, Though hypothyroidism because their metabolism With her thyroid back on endocrinologist and medical can’t be cured, synthetic has slowed,” Blevins says. track, she lost 15 pounds director of the California hormones can control it. Exercise can help you shed and felt better. “I’m as Center for Pituitary Dis- You’ll likely take the drug pounds and boost energy exhausted as any other orders at the University of for life. once your thyroid hormone 45-year-old,” she says. “But California, San Francisco. “Follow up with your levels are regulated. it’s not sustained, continual In fact, 1 in 8 women will doctor to make sure your How much exercise is exhaustion.” develop a thyroid disorder in medication is right,” her lifetime, according to the Blevins says. “Thyroid American Thyroid Associa- hormone is like Goldilocks. ? ASK YOUR DOCTOR tion. What can you do if you Too little is not good. Too 1. How often should I have my thyroid hormone levels checked? 2. How will changes in my health affect my thyroid medication? have hypothyroidism, the much is not good. It has to 3. Should I avoid certain foods or supplements? most common type of thy- be just right.” Also, “if you 4. Can I take a natural thyroid hormone? roid disorders? Our expert have a new disease or start 5. Can natural treatments like iodine improve my thyroid offers his tips. new medications, your dose function? SAM EDWARDS/GLOW IMAGES EDWARDS/GLOW SAM

W ebMD.COM 53 JAN/FEB 2016 Make healthy habits stick. Get the WebMD app for on-demand healthy living tips. Checkup LEARN HOW ON PAGE 4 Reviewed by Michael W. Smith, MD, WebMD Chief Medical Editor

MY STORY BUTT OUT A READER SHARES HOW HE KICKED HIS SMOKING HABIT ONCE AND FOR ALL

By David Rachford WebMD.com community member

My parents were smoker, I realized I wasn’t smokers, and I said I in alignment with my would never smoke. Then values—a commitment to came high school and health and fitness. teenage rebellion, so I tried I started changing my smoking, but I was always habits. After work, I stopped athletic and it never really going to the gas station took root. where I bought beer and After high school, I cheap cigarettes. Instead, joined the military, which I went directly to a yoga had a strong smoking cul- class before heading home. ture at that time. It was a I stopped drinking because social thing—taking a break beer and cigarettes went with a friend and having a together for me. Instead smoke. I continued smok- of having a cigarette as a ing until my late 20s. When reward, I’d do something I quit, I got athletic again physical instead, like 20 and ran four marathons. push-ups. I collected my Then, in my mid-30s, life smoking money and put it got rough. In a period of six in a coffee can. At the end months, my mom died, I of the month, I’d reward went through a divorce, and myself with a gift like new I suffered a bad back injury. running shoes. I self-medicated with alcohol But I struggled with and fell into the habit of quitting and would relapse. smoking again. I smoked Then I started dating a in the morning after coffee, woman and hid my smok- after meals, and when I felt ing from her. I knew she stress, like after getting a bill wouldn’t date a smoker. in the mail. Before I knew it, DAVID’S DOS fatal condition where my Dating her was a catalyst my half pack a day turned “The biggest thing lungs filled with fluid and I to quit for good—I didn’t into a pack a day. for me was to install a was gasping for air. I don’t want to expose that part of For my 40th birthday, I positive habit in place know if it was smoking- myself to someone I cared convinced some friends to of the negative.” related, but I have a hard about and wanted to have a do something challenging: time believing it wasn’t. future with. “The last pack you buy Get in shape and climb could be your last pack After that trip, I contin- It’s been about a year now California’s Mount Whitney, if you want it to. You ued smoking, though I tried since I quit. I’ve dropped 40 which is 14,494 feet. I was don’t have to wait for a to quit. My mom had died pounds because I’m exercis- going to the gym but I still big event to quit.” from cancer, and my dad ing more. My blood pressure smoked. When we climbed had emphysema. I didn’t numbers dropped from “You can choose the Mount Whitney, I devel- habits you want and want to be like them. For borderline high to a healthy oped high-altitude pulmo- don’t want from me, an athlete caught in normal. I’m running again. I nary edema—a potentially your parents.” the body of a drinker and feel pretty darn good.

Photograph by Thomas Alleman JAN/FEB 2016 54 W ebMD.COM Checkup THIS CONTENT IS CREATED BY WEBMD’S EDITORIAL STAFF AND IS Reviewed by Arefa Cassoobhoy, MD, MPH, WebMD Medical Editor BROUGHT TO YOU BY WALGREENS.

TEST YOUR SMARTS HEART HEALTH HOW SMART ARE YOU WHEN IT COMES TO YOUR TICKER? TAKE THE QUIZ TO FIND OUT

How much do you know about your heart? Can you tell LDL from HDL cholesterol, and do you know which one you need to lower? Are you aware of which lifestyle habits raise your odds of a heart attack or stroke? Since heart disease tops the list of deadly diseases for both men and women, getting heart smart could save your life. Can you distinguish these common heart disease myths from facts?

1. To avoid heart 2. Women and men 3. If you stay at a 4. No matter when disease, cut the fat from have different heart normal weight, you’ll you quit smoking, your diet. risks. avoid heart disease. you’ll reduce your Yes Yes Yes heart disease risk. No No No Yes No

ANSWERS 1. False. A low-fat diet has 2. True. Heart disease risks 3. False. When it comes to heart 4. True. Smoking damages the long been touted for heart aren’t gender neutral. Women’s disease risk, the scale doesn’t heart and blood vessels. For- protection, but not all dietary body weight, blood pressure, tell the whole story. Being tunately, quitting will improve fat is the same. The mono- and and LDL or “bad” cholesterol overweight or obese does make your health regardless of when polyunsaturated fats in nuts, level rise more steeply than you more likely to develop heart you do it. vegetable oils, and fish are men’s with age, putting them disease, but people of normal best. A diet filled with these at greater risk for a heart attack weight can have heart attacks, foods can lower cholesterol or stroke. Women are also less too. More important is where and protect your heart. Trans likely than men to know their the fat is located, and other risks fats from baked and fried foods heart risks, and to get the right you may have. Research shows are the type to avoid—they’re care for them. a big belly can predict heart linked to a higher heart disease problems ahead. risk. Experts also recommend limiting saturated fats from foods like butter and meat.

SOURCES: American Heart Association; Columbia University; Harvard Medical School; National Heart, Lung, and Blood Institute; WebMD Heart Health Center KELLY BOWDEN/GETTY IMAGES BOWDEN/GETTY KELLY

W ebMD.COM 55 JAN/FEB 2016 TAKE 10 10 QUESTIONS Harry Connick Jr. Singer, Actor

Your latest Connick’s How do you album, That latest album, eat these That Would 1 Would Be Me, Be Me, is 7 days? I’ve includes a available tried every- mix of funk, pop, now. thing from a macrobi- country, and ballads. otic diet to the Atkins How did you come up diet. I’ve tried vegan- with the sound? ism and vegetarianism. I wasn’t trying to make But right now I’m a particular kind of eating clean. I find that record. This is just the out of all the things style it happened to I’ve done, this has got be. That was fun me feeling the best. because it was sort of unpredictable. What’s your biggest food The first 8 vice? I like single, “(I Do) bad carbs— 2 Like We Do,” awful things, like is about the candy and Slurpees. love between people So I just don’t go there who’ve been together at all. a long time. To what do you attribute the Which success of your disease has 21-year marriage? 9 affected your I think it’s the way I family the was brought up and most? There’s been a the way Jill [Goodacre] lot of cancer in my was brought up. We family. My mother died share the same types from ovarian cancer. of values, and we That’s a hell of a balance each other motivator. When you out. Even more than lose people you’re so that, we take marriage close to, you think, really seriously. I don’t “Well, if there are any want to get married variables I can change, more than once. I what would I change?” know that it happens Diet is the first and that way sometimes. How does it your critiques? There foods did you eat? We most important. I try to People die or drift feel to be have been plenty of ate anything and eat foods that will be apart. But the ultimate 4 working on pop singers who know everything that was medicinal. goal is to put that ring the final nothing about music. put in front of us. My on and keep it on. season of Fox’s You can turn on the dad would make When it long-running singing radio and hear that. gumbo. We’d eat a comes to How has competition American But I feel a responsibil- regular type of 10 your health, being a father Idol? We’ve seen some ity to let them know breakfast—eggs and who in your 3 changed you? great talent this year. that they can only bacon and grits. A life has most inspired I can’t imagine I’m excited going into improve and think clean meal would be you? My kids, because what my life would it. The ultimate goal is about things that boiled crawfish. A I want to be there for be like or who I would to discover the next they’ve never thought not-so-clean meal them. My dad is 89 be if I didn’t have our pop superstar. about if they have would be crawfish and he’s in great daughters. They’re some semblance of a étouffée. It’s almost health, and Jill’s dad is three amazing young Why has it knowledge base. like the food in France. 79. Having them in our women who have been impor- It’s made from good lives is absolutely the grown into these 5 tant for you to Growing up in ingredients, but it may greatest thing, and I passionate, driven stress music New Orleans, not be the best thing want my kids to have women. fundamentals during 6 what kind of for you. that.—Stephanie Watson

W ebMD.COM 56 JAN/FEB 2016 Photograph by Fox/Getty Images