Fitness instructors’ comments shape women’s body satisfaction

Exercise has been called a double-edged sword for women when it comes to body image as some types of exercise seem to improve body esteem, whereas others have the potential to lower it.

In other words, from a psychological perspective, not all fitness approaches are created equal.

A new Northwestern University study found that while exercise, in this case, a 16-minute conditioning class, generally improved women’s mood and body satisfaction, women felt even better if the instructor made motivational comments that focused on strength and health instead of on losing weight or changing the appearance of one’s body.

“Our goal was to determine whether the psychological outcomes of a fitness class might vary based on whether the instructor made motivational comments based on health verses appearance,” said Renee Engeln, lead author of the study and professor of instruction in psychology in the Weinberg College of Arts and Sciences at Northwestern.

After taking the class, women reported more positive emotions and felt more satisfied with the shape of their body if the instructor said things like, “This exercise is crucial to developing strength in the legs; these are the muscles that truly help you run, jump, sprint like a super hero!” Those randomly assigned to the class in which the instructor made appearance-focused comments like, “This exercise blasts fat in the legs, no more thunder thighs for us! Get rid of that cellulite!” didn’t show those same improvements.

“We also asked the women to list three words that described how they felt at the end of class,” said Engeln, author of “Beauty Sick” (HarperCollins, 2017). “Those who heard appearance-focused comments were much more likely to write things like ‘ashamed’ and ‘disgusted with myself.’ Those in the health-focused classes were more likely to write things like ‘accomplished’ and ‘strong.'”

Engeln said the study is one more reminder that words really matter.

“The women in this study all did the same exercises, in the same room, with the same music playing,” Engeln added. “Yet just modifying the script the fitness instructor used had a meaningful impact on the way they felt about themselves afterward.

“If we want people to stick with exercise, we need to remove shame from the equation. This study points to an easy and cost-free step that fitness instructors can take to make their classrooms healthier, more inclusive and more inspiring.”

“Tone it Down: How Fitness Instructors’ Motivational Comments Shape Women’s Body Satisfaction” published online and will be in the December print issue of the Journal of Clinical Sport Psychology. In addition to Engeln, co-authors include Margaret Shavlik of Vanderbilt University and Colleen Daly of Northwestern.

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Materials provided by Northwestern University. Original written by Hilary Hurd Anyaso. Note: Content may be edited for style and length.

Antihistamines and Sleep: Can You Take an Antihistamine Every Night?

Getting a good night’s sleep is paramount to your health. So, when you’re lying awake at 1 A.M. for the third night in a row, you might be tempted to get some rest in any way possible—with whatever’s in your medicine cabinet. Most often, that means an antihistamine that either warns of drowsiness on the box or you anecdotally know makes you conk out. So, how bad is this really? Here’s what you need to know about taking an antihistamine to fall asleep.

The main ingredient in that fast-acting antihistamine is diphenhydramine hydrochloride (DPH).

It’s the active ingredient in Benadryl, an antihistamine meant to treat symptoms of an allergic reaction like itchiness, watery eyes, and sneezing. The sleepy part is really just a side effect listed on the box.

Histamine is a chemical that produces the inflammatory response behind allergy symptoms, but it also plays a key role in promoting wakefulness. (The nature of this relationship is not well understood.) So, along with soothing allergy symptoms, when antihistamines counteract the histamine in your body, they have the side effect of making you feel tired, Rafael Pelayo, M.D., a sleep specialist with the Stanford Sleep Medicine Center, tells SELF.

But this ingredient won’t necessarily knock everyone out. David Rapoport, M.D., director of the Sleep Medicine Research Program and professor of pulmonary and sleep medicine at the Icahn School of Medicine at Mount Sinai, tells SELF that these drugs aren’t very powerful as sleep aids. A 2017 review of the research in the Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults examined 46 studies in an attempt to recommend clinical guidelines for treating insomnia. The researchers determined that the evidence behind DPH-based drugs leading to better sleep were “clinically insignificant,” suggesting that people shouldn’t try to use these medications to fall asleep more quickly or stay asleep longer.

However, as Dr. Pelayo points out, how you react to a certain drug is pretty individual, and it’s possible that you might react more strongly due to the placebo effect of taking something you believe will make you sleepy.

Here’s how doctors feel about using DPH to help you fall asleep.

“It’s very attractive to people because it’s an over-the-counter medication,” says Dr. Rapoport. “It’s [seen as] a quick and dirty way to fix your insomnia.”

But, OK, how bad is it in a pinch? DPH is generally very safe and carries a low risk of serious side effects, so it’s not that big a deal if you turn to it to help you drift off every now and then, Dr. Rapoport says. But there are a couple things doctors want you to be aware of first.

“The big problem with this kind of medication is that it lasts a fairly long time in your system,” Dr. Pelayo says. The lingering effect of a standard adult dose (25 to 50 milligrams, i.e., one to two pills or liquid doses) will likely not be incredibly strong, Dr. Rapoport says, but it may be enough to make you feel sleepy or foggy-headed the next morning. Other side effects are mild and can include dry mouth, nose, and throat; dizziness, constipation; headache; and nausea, according to the National Institutes of Health (NIH).

You can also build up a tolerance to DPH fairly quickly. “[Antihistamines] tend to stop working,” Dr. Rapoport says. “The body adapts to them.” With daily use, you may build up a tolerance in about two weeks, he says, though the specific timeline here can vary from person to person. This means you will need to take an increasingly higher dose to achieve the same effect. Higher doses mean a greater risk of side effects, like next-morning sleepiness. If you take a medication with DPH for extended periods, you might get into a vicious cycle of needing more yet feeling even sleepier throughout the day.

Here’s something you may not know: DPH is the sole active ingredient in both Benadryl and ZzzQuil. But only one is indicated for helping you fall asleep.

Although Benadryl lists “marked drowsiness” as a potential side effect, it is not indicated for sleep on its packaging. In fact, Johnson & Johnson, the makers of Benadryl, declined to comment on this subject as it discusses an off-label use.

ZzzQuil products, on the other hand, have the exact same active ingredient. (Except for one that only has the active ingredient melatonin.) Therefore, these ZzzQuil products essentially work in the same way as Benadryl, but they’re marketed specifically to help you get sleep—in the short-term, that is. ZzzQuil is indicated for “the relief of occasional sleeplessness,” and the warning label advises consumers to stop use and consult a doctor if they’re still having trouble sleeping after two weeks. When reached for comment, Procter & Gamble, the makers of ZzzQuil, emphasized these instructions. Benadryl doesn’t contain any such warning, even though experts agree that it’s not good to take it over the long term.

But taking ZzzQuil to help you sleep could, theoretically, come with the same potential side effects of taking Benadryl, like next-day sleepiness. On the ZzzQuil site, the manufacturers note that there are “many factors” that could influence how well rested you feel the next morning, including the time you take ZzzQuil. They recommend you only take ZzzQuil if you know you’ll have enough time to get a full night’s rest, however much that usually is for you.

So, why is one drug marketed as an antihistamine and one marketed as a sleep aid? It really comes down to two companies deciding how they’d like to sell a product has two major effects: reducing allergy symptoms and inducing drowsiness. Benadryl is an allergy-relief brand; ZzzQuil is a sleep-aid line, so they’ve focused on marketing what is essentially the same product in different ways.
“Yes, it is the same compound [DPH], but … for a person to sleep well with any product, they have to have a certain amount of trust in the product,” Dr. Pelayo says. Some people may feel more confident that a medication marketed to help them fall asleep will do so than a medication used off-label. What’s more, “some people trust certain brands more or have preferences on how things taste or are formulated,” he says.

Also, as Dr. Pelayo points out, different drugs contain additional ingredients that are listed as inactive. It’s easy to think an inactive ingredient doesn’t do anything, but that’s not true. Inactive ingredients don’t bring about the indicated effects of a medicine, according to the Food and Drug Administration (FDA). But they may affect the taste, color, ease of active ingredient delivery, and other factors of a drug. This can lead to someone having a preference of Benadryl over ZzzQuil, or vice versa, even though they essentially work the same way.

In general, using a DPH product to help you fall asleep occasionally is fine, but it shouldn’t become a habit.

As long as you don’t mind the potential next-day drowsiness, then sporadic use of the recommended daily dose of these drugs typically won’t have serious medical repercussions for a healthy adult, Dr. Rapoport says. However, if you feel the need to turn to a sleep aid every night, you should seek treatment to address the underlying cause of your insomnia.

While it’s normal to have short periods of time where you can’t sleep well (during a hugely stressful week at work, for instance), regularly having trouble falling or staying asleep is a sign that something deeper is going on. “If you need to take something more than twice a week and the problem has gone on for more than three months, then you need to see someone,” Dr. Pelayo says. (Honestly, you should ask your doctor before even taking an antihistamine every so often to help with sleep, according to the Mayo Clinic. Drugs containing DPH can exacerbate certain underlying conditions you may have, like asthma and sleep apnea.)

A primary care doctor or sleep specialist can help you identify any underlying conditions causing your urge to reach for something in your medicine cabinet, such as anxiety. “There’s a pretty good chance that if you talk to somebody who knows what they’re talking about, we can find out what’s going on,” Dr. Rapoport says. Treating that condition can in turn help relieve the insomnia.

A doctor can also help you figure out if there are habits you may not realize are disturbing your sleep, like drinking tea late in the day, and help you work on establishing good sleep hygiene, like sticking to a consistent bedtime.

If your sleeplessness has no apparent cause, then it’s called primary or idiopathic insomnia. “The good news is that it’s very treatable,” Dr. Pelayo says. He and Dr. Rapoport both recommend cognitive behavioral therapy (CBT) to help you explore the stress or anxiety that’s come to surround sleep itself as a result of the insomnia. A therapist can help you identify and change thoughts and behaviors that may be affecting your sleep. There are even therapists who specialize in CBT for insomnia. And, while you’re figuring out treatment, your doctor may prescribe you a sedating anti-anxiety drug if they think that will help in the short term, Dr. Pelayo says.

The bottom line: Reaching for an antihistamine to help you sleep may not be harmful for most people, but it also won’t be the most helpful solution. Check in with your doctor for more suitable options.

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6 Products Dermatologists Recommend for Body Acne

As someone with acne, I’m used to dealing with the more-than-occasional flare up on my face. When it comes to zits and oil on my shoulders or back, I’m at a total loss. Should I treat body acne the same way that I treat acne on my face? Or would other products work better on different parts of my body?

To put my body acne in its place once and for all, I consulted a few dermatologists for the 411 on products they recommend to their patients with bacne. According to experts, the back is very hard to treat, and needs stronger washes than the face. Two of the key ingredients to look for when targeting bacne are benzoyl peroxide, which reduces the amount of bacteria on the skin, and retinoids, which stop dead skin cells from clogging up pores. Read on for some derm-approved picks that will have you sporting off-the-shoulder looks in no time.

Ask a Swole Woman: What Are the Best Pants for Lifting Weights?

Dear Swole Woman,

This may not give you enough meat to really sink your Swole Woman patriarchy-busting chops into (and the answer could just be on IG and not in your real column) but: What are good pants for working out that are not leggings or the lil booty shorts? Like, track pants? Joggers? Any recommendations or links to stylish lifting women’s IG accounts welcome. Thank you for your column, you are the reason I can nearly deadlift my body weight!

—Karen

It’s hard to overstate how self-conscious I felt about the way I looked when I first started lifting. I wore literal layers to the gym, shorts on top of leggings, in the hope of drawing as little attention to myself as possible. After a while I came to realize no one really cared what I was wearing, and as we know, no amount of clothing will deter people who have a will to harass you (also, harassment happened almost never, and it turns out I was basically invisible to other people at the gym, which was all I could have ever dreamed of!). Now I am one of the monsters going around in leggings and a sports bra.

BUT. But. I want to just quickly point out some of the practical reasons people who lift do commonly wear these garments that just so happen to also make butts look great—not to argue with you, but just to illustrate some of what I have learned in my years of iterating on gymwear.

While loose clothing is comfy, it’s easier to get it caught or tangled in barbells, pulleys, plates, clips, and so forth that you find in a weight room. Loose clothing conceals your body, which makes it harder to see if your form is correct. In the case of, say, a baggy shirt, it is hard to look down and see what your lower body is doing during a deadlift. The fact that you can see sort of everything in more form-fitting, stretchy clothes actually has a functional payoff there. Second, even if clothing is loose, it has the potential to bunch and restrict in all the wrong places during certain movements. Squatting in loose sweatpants that can’t move with you and bind up in your hip creases or restrict your butt can actually be more uncomfortable than squatting in a pair of stretchy leggings. On the same note, if the clothing is fairly fitted but not stretchy, like a pair of cotton joggers, lifting may tend to stretch it out in weird ways.

Lastly, wearing stretchy, close-fitting clothing means there is no chance of a leg hole hanging open while you’re, say, lying down on a bench, so you end up accidentally flashing someone. This isn’t even about being in somewhat compromising positions; in many gyms there are mirrors everywhere, and people can end up seeing weird visual angles they aren’t even looking for (this happened to me once wearing loose Sofi-style shorts on a leg press. Never again!).

Further, thanks to all those points above, there are always a fair number of dudes at my own gym (which is, to be fair, more sport- than aesthetics-oriented) who are working out in compression pants and shorts with no other coverage right alongside me. I do not think they are trying to show off their dickprints (necessarily); stretchy fitted pieces just do truly make a lot of the practical elements of lifting easier for everyone, regardless of your biology or geometry, and I do think many people end up making this transition not out of narcissism, but rather out of a kind of necessity. We are a stretchy-garment-loving people, and we come in peace.

Now, back to your actual question: There for sure are alternatives! For the reasons stated above, I would advocate against non-stretchy track pants and joggers, at least if you’re doing anything with your legs. Stereotypically “men’s” gym wear is a good place to start for inspiration; no reason to restrict ourselves to women’s wear. To the relative modesty point above, if you want to wear loose shorts, I’d suggest looking for mid-length ones that are stretchy, preferably with one of those underwear-like net linings. Honestly I would cop some of these from Nike, or these from Mizuno. It’s a bit trickier to find lined or dual-layer short shorts but they are out there; I would suggest something like these cute ones from Lululemon.

You could also put this together yourself and do a loose short on top of a fitted booty short, but then you’re paying for two of your own shorts. One way around this would be to actually invest in mostly booty shorts, since they are closest to your body and thus probably in the need of more frequent washing, and one loose short to throw over them when you go to work out. You may prefer longer-inseam fitted workout shorts that will never do the sausage-leg effect that comes from short shorts rolling up into your crotch; these or these look comfy. Always be careful to look for a gusset in any fitted bottom garment and buy in the right size to avoid camel toe discomfort. See-through fabric in the butt area can be a problem with training shorts and leggings, but if you’re wearing a covering garment, you shouldn’t have to worry about this. There are a handful of options that should fit your needs here and a bunch more fitted shorts here.

In the same vein, if you’re going with pants, even loose ones, look for fabric that stretches; here is such a pair from A7, and another option from Target. You can throw a rock on fitness Instagram and hit like 10 athleisure brands; being a staunch leggings person, I haven’t tried any of these particular kinds of products personally. I would caution that many of them tend to run small/lack extended sizing, disappointingly, and also to just be careful to look for stretchy, ideally four-way-stretch fabric, and a bit of length in loose shorts and/or inside lining so it’s harder for them to hang open to all the world.

Now, as a sidebar footnote for my fellow leggings/spandex shorts fans: some of my favorite inexpensive training wear finds have been from just Old Navy and Target, with a smattering of random Amazon finds. Target’s Joylab has a plus-size line, and Old Navy carries plus sizes as well. Having now had pieces from both for years I find them to be pretty high quality for the price: gusseted, and no show-through in the butt during squats. While I do have some fancier gym wear and lifting isn’t quite a contact sport, all the metal bits you might be around can pose a threat to your Lulus or Alos. So particularly when you are planning to do something like deadlifts, which involves literally running a knurled barbell against your (covered, not bare) shins, I would use caution when bringing your nice-ish stuff into the gym; at minimum, wear some knee socks or something over any nicer leggings in order to avoid dragging the fabric.


Casey Johnston is the editor of the Future section at The Outline and a competitive powerlifter with a degree in applied physics. She writes the column Ask a Swole Woman for SELF. You can find her on Twitter: @caseyjohnston.


Letters to AASW are edited for length and context, and the content of each AASW column is the opinion of the writer and does not necessarily reflect the views of SELF or SELF editors.

How the brain tells you to scratch that itch

It’s a maddening cycle that has affected us all: it starts with an itch that triggers scratching, but scratching only makes the itchiness worse. Now, researchers have revealed the brain mechanism driving this uncontrollable itch-scratching feedback loop. In a study publishing on December 13 in the journal Neuron, the researchers showed that the activity of a small subset of neurons, located in a deep brain region called the periaqueductal gray, tracks itch-evoked scratching behavior in mice.

“Effective treatment for chronic itch is still lacking, which is largely due to our limited knowledge about the neural mechanism of itch,” says senior study author Yan-Gang Sun of the Chinese Academy of Sciences. “Our study provides the starting point to further decipher how itch is processed and modulated in the brain. Eventually this might lead to the identification of new therapeutic targets.”

Itching can be triggered by a wide range of causes, including allergic reactions, skin conditions, irritating chemicals, parasites, diseases, pregnancy, and cancer treatments. The itch-scratching cycle can significantly impair quality of life and lead to serious skin and tissue damage. Recent studies have identified specific subtypes of neurons in the spinal itch circuit, including cells that express the gastrin-releasing peptide receptor (GRPR). But relatively little is known about the brain regions involved in itch processing. Sun and his team suspected that the periaqueductal gray could be involved, in part due to its critical and well-known role in processing related sensory information such as pain.

In the new study, the researchers first recorded from periaqueductal gray neurons in freely moving mice that were induced to scratch through injections with either histamine or an antimalarial drug called chloroquine. Itch-induced scratching behavior tracked the activity of a specific set of neurons that produce a neurotransmitter called glutamate and a neuropeptide called tachykinin 1 (Tac1). When the researchers ablated the Tac1-expressing neurons, itch-induced scratching decreased significantly. By contrast, stimulation of these neurons triggered spontaneous scratching behavior, even without histamine or chloroquine, by activating GRPR-expressing neurons in the spinal itch circuit.

Sun says little is known about how the itch circuit evolved, despite its importance for the survival of animals. “Itch sensation plays a key role in detecting harmful substances, especially those that have attached to the skin,” Sun says. “As itch leads to scratching behavior, this allows the animal to get rid of the harmful substances. In some cases, the lesion caused by scratching can evoke strong immune responses, which might help to combat the invaded substances.”

In future studies, Sun and his team plan to investigate which molecules in the Tac1-expressing periaqueductal gray neurons can be targeted by drugs. They will also search for other nodes in the brain’s itch network. “These studies will help us design new approaches or develop new drugs for the treatment of patients with chronic itch,” Sun says.

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Materials provided by Cell Press. Note: Content may be edited for style and length.

8 of the Best Weed Vaporizers for the Total Beginner

SELF would like to remind our readers that, although it may be legal to purchase vaporizers where you are, the legality of cannabis is subject to both state and federal laws.

At this point, 33 states have legalized medical cannabis (e.g. weed or marijuana) and 10 plus the District of Columbia have legalized recreational use. So if you’re a fairly new and inexperienced cannabis consumer, it’s understandable that all of the options and information out there is a little confusing. One thing you’ve probably heard about or seen before is a weed vaporizer (often referred to as a vape or vape pen). So how do you know if a vaporizer is right for you? We’ve got you covered.

But, before we start, there are a few things to keep in mind. The fact that we can even have this conversation is a result of the vast strides cannabis legalization and normalization have made in the past several years. And it’s important to remember that some communities—especially communities of color—have been and still are being affected by prohibitive laws more so than others. The same culture of prohibition that leads to and perpetuates these disparities also makes it incredibly difficult to study cannabis, including the effects of smoking and vaping.

With all of that said, here’s what we do and don’t know about the potential benefits of using a vape—plus, how to find one that’s right for you.

First off, just how risky is exposure to cannabis smoke?

Well, it’s more complicated than you might imagine. Although we can estimate the risks of smoking cannabis relative to, say, smoking cigarettes, we haven’t been able to really quantify the absolute risks associated with smoking cannabis on its own, Mallory Loflin, Ph.D., a researcher at University of California San Diego whose work focuses on the potential uses for medical cannabis among veterans, tells SELF. (To be clear, we’re just talking health risks here.)

But we do know some things: As with basically anything that burns, the process of combustion creates compounds that can cause lung irritation resulting in coughing or wheezing in the short term, Loflin says. Some of the compounds created in that process are also associated with an increased risk for things like lung cancer. But whether or not exposure to those pyrolytic compounds (meaning they’re created when plant material is burned) in the amount that regular cannabis smokers experience could cause problems in the long term isn’t entirely clear.

One solid long-term study that examined long-term cannabis use was published in the journal Cancer Epidemiology, Biomarkers & Prevention in 2006, as Jordan Tishler, M.D., medical cannabis expert at InhaleMD in Boston, tells SELF.

For this study, researchers collected data for 1,210 people living in Los Angeles who had a history of lung or other upper aerodigestive cancers (such as oral or laryngeal cancers) and 1,040 control participants without a history of those cancers, but matched to the other participants based on age, gender, and their neighborhood.

The researchers then conducted interviews with all the participants about their use of cannabis, including the frequency, type, and duration of their use. They were also asked about their use of other substances, including tobacco and alcohol, as well as their other demographic information and their family history of cancer.

Results showed that, after statistically adjusting for tobacco use, there were no significant associations between cannabis use and the chances of developing cancer—people who reported using cannabis were not significantly more or less likely to be in the cancer or control group. The study authors do concede that their results may have been affected by selection bias and the difficulties inherent in asking people to recall their own drug use. Plus Loflin points out the fact that statistically disentangling the risks associated with smoking isn’t quite the same thing as using participants who only have long-term experience with smoking cannabis (which are, understandably, difficult to find).

But overall the authors conclude that their results suggest “the association of these cancers with marijuana, even long-term or heavy use, is not strong and may be below practically detectable limits.”

So, although there are still plenty of unanswered questions, any issues with smoking cannabis seem to be mostly confined to the time during which you’re actually smoking. “My takeaway is: Let’s avoid smoke if we can, because why not?” Dr. Tishler says. “That way we don’t get exposed to things that we might be afraid of even if they don’t seem to be causing a problem.”

Loflin, who recently co-authored a review of previous studies looking at the effects of smoking versus vaping, says that vaporization may be beneficial in avoiding those compounds and preventing those acute issues (e.g. lung irritation)—but only under certain circumstances.

When you take away the actual smoke associated with smoking cannabis, what other health risks should you keep in mind? Again, it’s complicated and hard to study under the current legislation, but we do know that cannabis can temporarily increase your heart rate, make you feel sleepy or drowsy, affect your short-term memory, and cause some transient anxiety. And, of course, using a vaporizer won’t eliminate those risks.

Vaporizers are everywhere, but are they actually any better for you than smoking?

Cannabis releases cannabinoids (the compounds that provide a “high” and some potential benefits) at a temperature lower than that at which it burns. So, the whole point of using a vaporizer is to heat the herb to a point at which it’s releasing the things you want it to without combusting, Dr. Tishler says.

Although there hasn’t been a well-controlled direct comparison of the effects of smoking versus vaping cannabis, the research we do have suggests using a vaporizer reduces your exposure to the worrying compounds associated with smoke. “We already know that there are significantly less pyrolytic compounds in smoked cannabis compared to smoked tobacco,” Loflin says. “And if you compare smoked cannabis to vaporized cannabis (using a specific type of vaporizer) there have been several studies that have shown that you really, really reduce the amount of pyrolytic carcinogenic compounds.”

For instance, a study published in 2004 in the Journal of Cannabis Therapeutics looked directly at the compounds found in cannabis smoke versus those created via vaporization. It found that by and large, cannabis vapor is made up of the things you’d expect (and want) to see: cannabinoids. Although there were some of the same pyrolytic compounds in vapor that were also seen in smoke, they appeared in vastly smaller amounts in vapor than smoke.

And when looking at how that translates to actual humans, research is promising so far. “Data from my lab reveal that cannabis users who report symptoms of bronchitis or respiratory irritation show significant improvements in lung function and symptoms of bronchitis after switching to the vaporizer for a month,” Mitch Earleywine, Ph.D., professor of psychology at the University at Albany, SUNY, tells SELF.

Indeed, in one of Earleywine’s studies, published in 2010 in the International Journal of Drug Policy, 20 participants who used cannabis frequently and reported symptoms of lung irritation all switched to using a vaporizer for one month. After that month, eight of the participants developed a respiratory infection. But the 12 who didn’t reported that their symptoms had significantly improved. Although this is a small preliminary study, it suggests that vaping does, in fact, cause fewer lung issues than smoking.

The quality of the vaporizer you’re using—and what you put in it—can vastly change your experience.

“It turns out that not all vaporizers do a particularly good job [of heating without combustion],” Dr. Tishler says. “The big divide seems to be the vape pens and the flower vaporizers.”

Nearly all of the studies that have been conducted about vaping were done using a type of flower vape, such as the Volcano or other tabletop vaporizers, Loflin says. The Volcano is a classic (and expensive) vape that uses both convection and conduction heating to create vapor from plant material that’s collected in a bag, which then inflates like a balloon. Devices like this are effective, but often unwieldy and tend to be difficult to dose.

However, because similar studies haven’t been conducted with every weed vaporizer on the market, we don’t know if the results would generalize to them, including “the ubiquitous vape pens that heat oil,” Earleywine says.

The vape pens work similarly to e-cigarettes, meaning they are essentially a battery attached to a heating coil that holds a cartridge. The cartridge contains cannabis extracts suspended in some sort of liquid filler, which could be propylene or polyethelene glycol (often found in e-cigs) or it could be MCT oil or, more recently, liquid terpenes. We don’t know much about the effects of inhaling these ingredients when heated at high temperatures in these amounts, but we do know they can cause lung irritation even when vaped. So, in general, Dr. Tishler advises his patients to stick with vaporizers that work with plant material rather than oil cartridges.

But whatever you choose, the quality of the stuff you’re putting in the vaporizer matters just as much as the device itself, Loflin says. Both pesticide residue and mold have been found on herb, for instance. And when it comes to vape pens (especially CBD varieties), they may not always contain what they say. So, as always, it pays to get your stuff from a trustworthy source.

If you’re going with herb (the actual plant material), then you’ll want to decide whether you want a vaporizer that uses conductive heating, convective heating, or a combination of the two. A vape that uses a conductive heating method places the plant material right in contact with the heating element, which means there’s still a chance that it will burn unless the temperature is well controlled. With convective heating, on the other hand, the heating element doesn’t come in direct contact with the herb, but rather heats up the air around it. (Vape pens work entirely differently because they’re heating oil, not plant material.)

There are pros and cons to both—vapes that use conductive heating tend to be cheaper while those that use convective heating may have less stable temperatures because the air may cool as you draw in, for instance—which is why Dr. Tishler prefers vapes that combine the two.

The most important component, though, is that you have some method of monitoring the temperature of the vape. That might be done directly on the device with a digital thermometer or lights that change color or through the use of a bluetooth-connected app, for instance.

With so many unknowns, this is something you definitely want to discuss with your doctor or a knowledgeable budtender before spending your money.

In addition to the way your vape works and the quality of the cannabis you’re using, your own physiology—including any conditions you might have—could also affect your experience. And if, after everything, you decide that vaping isn’t right for you, that’s totally OK.

Plus, as we’ve seen, questions about cannabis rarely have an easy answer. For instance, “It would certainly make sense that vaporizing would be better that smoking, especially for folks with asthma, but data are not available,” Earleywine says. Curiously, there is even scattered evidence that cannabis can ease the symptoms of asthma in some cases.

So, if you do have a chronic condition that could interfere with your cannabis consumption, and with so many other ways to consume cannabis (without smoking), you can work with a medical professional to figure out what makes the most sense for you.

If you do want to try vaping your cannabis, here are a few options that we’d suggest looking into. Based on our experts’ advice, we looked for devices that offer some method of monitoring their heat level (via a digital display, app, or light color), work with plant material (some will also take concentrates), are relatively portable, and come with great reviews. And all the devices on this list meet at least a few of those criteria.

‘RHOA’ Star Kenya Moore Says Her Uterine Fibroids Led to Her 3-Hour C-Section

Real Housewives of Atlanta star Kenya Moore shared with fans in late October that her daughter Brooklyn would have to be delivered early due to preeclampsia, a condition that causes high blood pressure in pregnancy. Now, Moore revealed in a new interview that her delivery wasn’t easy either.

Moore, 47, told People that she had to have a three-hour emergency C-section and, because she had uterine fibroids, her doctors had to create incisions both horizontally and vertically.

“They couldn’t get the baby out,” she shared. “There were all these complications and they knew if they cut into a fibroid, I could potentially bleed out and die. So they ended up cutting me vertically too, to just get the baby out and make sure I survived the surgery. They were so scared they were going to lose me.”

Moore also said that her epidural ran out at one point and she needed anesthesia to put her out entirely. “When it was all over, my doctor said, ‘This was one for the books,’” Moore said. While Brooklyn was born six weeks premature, she’s a healthy baby, Moore added.

Unfortunately, people who have fibroids are more likely to have problems during their pregnancy and delivery.

Uterine fibroids are muscular tumors that grow in the wall of your uterus. They’re almost always benign (meaning not cancerous), according to the American College of Obstetricians and Gynecologists (ACOG). It’s possible to have fibroids and not know it, but those who do have symptoms may deal with pain, heavy periods, vaginal bleeding when you’re not on your period, a feeling of pressure during sex, infertility, and miscarriages, ACOG says.

That doesn’t mean you’re guaranteed to have issues—most women with fibroids have normal pregnancies, Brett Worly, M.D., an ob/gyn at The Ohio State University Wexner Medical Center tells SELF. Fibroids can be “small and inconsequential,” he says. But bigger fibroids, which are less common, are more likely to cause issues during pregnancy, he notes.

Compared to those who don’t have fibroids, women who do have them are more likely to need a C-section, to have a breech baby (meaning the baby is not positioned well for a vaginal delivery), to have a labor that doesn’t progress, to experience placental abruption (a condition in which the placenta breaks away from the wall of the uterus before delivery), or to have a preterm delivery, according to the U.S. Department of Health and Human Services’ Office on Women’s Health.

People who have large fibroids in particular can have trouble with vaginal deliveries because they can impact their ability to deliver the afterbirth or placenta, Dr. Worly says. “Sometimes fibroids can be removed at the time of C-section,” he says, but other times “fibroids cannot be removed based on their location or blood supply,” he says.

Their location can affect the delivery as well: “Sometimes if they grow in the lower part of the uterus, they can block the cervix—the ‘escape route’ for the baby—and you end up needing a C-section to get the baby out,” Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, tells SELF.

C-sections can be a little more complicated with fibroids.

“Fibroids can make it tough to enter the uterus [with a C-section], and they can grow during pregnancy,” Dr. Minkin says. “So if you have a big, bulky fibroid, it can be a problem getting around it to get to the baby.”

Fibroids also have a solid blood flow and that can get even more significant during pregnancy, when a woman’s blood supply is greater than normal, Jessica Shepherd, M.D., a minimally invasive gynecologic surgeon at Baylor University Medical Center at Dallas, tells SELF. “When you make an incision during pregnancy, the woman has the potential to lose a lot more blood than usual because of the fibroids,” she explains.

This isn’t always the case, though—Dr. Shepherd says that the location of a woman’s fibroids, how large they are, and whether she’s had previous surgeries (which can create adhesions that are difficult to navigate around) all factor in to how complicated and lengthy a C-section will ultimately be. For the record, though, a three-hour C-section is definitely on the extreme end and “very uncommon,” Dr. Worly notes.

That said, having fibroids obviously isn’t a guarantee that you’re in for a complicated delivery. The most important thing is that you work with your doctor to make sure things go as smoothly as possible.

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Regular trips out guard against depression in old age

Regular visits to the cinema, theatre or to museums could dramatically reduce the chances of becoming depressed in older age a new study has found.

Researchers at University College London found a clear link between the frequency of ‘cultural engagement’ and the chances of someone over 50 developing depression. It is the first such study to show that cultural activities not only help people manage and recover from depression but can actually help to prevent it.

Their study, published in the British Journal of Psychiatry, found people who attended films, plays or exhibitions every few months had a 32 per cent lower risk of developing depression, with those attending once a month or more having a 48 per cent lower risk.

Now its lead author, Dr Daisy Fancourt, wants to encourage greater awareness of the benefits so that people can take better control of their own mental health.

She said: ‘Generally speaking, people know the benefits of eating their five-a-day and of exercise for their physical and mental health, but there is very little awareness that cultural activities also have similar benefits. People engage with culture for the pure enjoyment of doing so, but we need to be raising awareness of their wider benefits too.’

The study looked at data on more than 2,000 people over the age of 50, who took part in the long-running English Longitudinal Study of Ageing (ELSA). This provides a rich source of information for researchers like Dr Fancourt and her colleagues, covering the health, social, wellbeing and economic circumstances of older people in England.

Along with her colleague, Urszula Tymoszuk, Dr Fancourt was able to look at data collected from people’s answers to questionnaires and in one-to-one interviews over the course of ten years. This included information about how often they visited the theatre, concerts or the opera, the cinema, art galleries, exhibitions or museums. Their answers also revealed when participants reported being diagnosed with depression, and when they experienced symptoms that the pair could then measure on a scale widely used to spot people at risk of depression.

Even when the results were adjusted to take account of differences in people’s age, gender, health and their levels of wealth, education and exercise, the benefits of cultural activities remained clear. Those benefits were also independent of whether or not people had contact with friends and family or took part in social activities like clubs and societies.

The researchers believe the power of these cultural activities lies in the combination of social interaction, creativity, mental stimulation and gentle physical activity they encourage.

Dr Fancourt said: ‘We were very pleasantly surprised by the results. Notably we find the same relationship between cultural engagement and depression amongst those of high and low wealth and of different levels of education — the only thing that differs is the frequency of participation.

‘Cultural engagement is what we call a “perishable commodity.” For it to have long-term benefits for mental health, we need to engage in activities regularly. This is similar to exercise: going for a run on the first of January won’t still have benefits in October unless we keep going for runs.’

She added: ‘Depression is a major issue affecting millions of people. If we are starting to feel low or isolated then cultural engagement is something simple that we can do to proactively help with our own mental health, before it gets to the point where we need professional medical help.’

Dr Amanda Thompsell, chair of the old age faculty at the Royal College of Psychiatrists, said: ‘This paper highlights the good news story that doing something enjoyable is not just for pleasure — it can be positively beneficial for older people’s mental health. The findings suggest that engaging in regular cultural activities such as visiting the theatre or cinema could be a way to reduce the risk of developing depression.

‘However, such activities on their own won’t treat depression. This requires an approach based on the use of talking therapies, complemented by the use of medication where an older person doesn’t respond or when they have more severe depression.

‘The College welcomes this paper and encourages further research into the important area of old age mental health.’

Widespread brain alterations in children with callousness

Children with elevated levels of callous traits — such as a lack of remorse and disregard for other people’s feelings — show widespread differences in brain structure compared with children with lower levels of the traits, according to a new study published in Biological Psychiatry. The differences, which included large- and small-scale structural alterations, support the idea of callous traits as a neurodevelopmental condition.

Using brain imaging techniques to examine the structure of the brain, researchers from Erasmus University Medical Center, Rotterdam, the Netherlands, found lower overall brain volumes associated with callous traits in children. Childhood callous traits were also associated with differences in how the brain is wired together, referred to as connectivity.

“This is the first study to comprehensively examine the relationship between callous traits and brain structure in the general child population, based on data from over 2,000 10-year-old children,” said senior author Charlotte Cecil, PhD.

Understanding the development of childhood callous traits is an important but unanswered question, as they are an early risk factor for negative behaviors and health outcomes later in life, like criminality, psychiatric disorders and substance abuse. And callous traits aren’t something that you either have or don’t have, said Dr. Cecil, but rather they “exist as a continuum in the overall population (i.e., like height or weight), so that everyone scores somewhere along this spectrum.”

“How is it that some children are born with an indifference to the suffering of others? This is an important science question about the neural basis for empathy. It is also an important humanistic question as the lack of a capacity for empathy presents a fundamental challenge to living collaboratively within a community. This study highlights important deficits affecting higher brain centers that may contribute to callousness,” said John Krystal, MD, Editor of Biological Psychiatry.

The affected brain centers included those important for decision-making, emotion regulation, and behavior control. The researchers ruled out other emotional and behavior problems that often co-occur with callousness, indicating that the alterations are specific to callous traits — an important finding as the researchers hope that future research will investigate whether brain structure may be useful as a screening tool for these traits in children.

“In addition, our study was the first to examine neuroanatomical features of callous traits in a sample with an equal distribution of boys and girls, making it possible to test for sex differences,” said first author Koen Bolhuis, MD. The association between brain structures and callous traits was similar for boys and girls, but the association between brain connectivity and callous traits was only observed in girls. “This could mean that the brain development related to callous traits differs for girls and boys.”

Because the researchers examined each child only once, they were not able to determine cause and consequence, or if the callousness-related alterations predict how the children would turn out, like their school performance or later substance use. But the findings suggest that children with callous traits show differences in brain development, which provides a jumping off point for future research to understand how severe antisocial behavior develops later in life.

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Physical activity in the evening does not cause sleep problems

Even among sleep researchers, it is a widely held belief that sleep quality can be improved by avoiding exercise in the evening. However, as researchers from the Institute of Human Movement Sciences and Sport at ETH Zurich have demonstrated, it is not generally true.

The scientists combed through the literature on the subject and analysed all 23 studies that met their quality requirements. They concluded that doing exercise in the four hours before going to bed does not have a negative effect on sleep. “If doing sport in the evening has any effect on sleep quality at all, it’s rather a positive effect, albeit only a mild one,” says Christina Spengler, head of the Exercise Physiology Lab at ETH Zurich.

By combining the data from the different studies, the researchers showed that in the night after study participants had done some sport in the evening, they spent 21.2 percent of their sleeping time in deep sleep. Following an evening without exercise, the average figure was 19.9 percent. While the difference is small, it is statistically significant. Deep sleep phases are especially important for physical recovery.

Intensive training late in the evening: an exception to the rule

Vigorous training within an hour before bedtime is an exception to the rule. According to this analysis, it is the only type of evening exercise that may have a negative effect on sleep. “However, this preliminary observation is based on just one study,” Spengler says.

“As a rule of thumb, vigorous training is defined as training in which a person is unable to talk. Moderate training is physical activity of an intensity high enough that a person would no longer be able to sing, but they could speak,” Spengler says. One example of vigorous training is the kind of high-intensity interval training that competitive athletes often perform. In many cases, though, a longer endurance run or a longer ride on a racing bike would fall into the moderate training category.

As the analysis showed, it took study participants who completed an intensive training session shortly before bedtime longer to fall asleep. The study also provided insight into why this is the case: the test subjects were not able to recover sufficiently in the hour before they went to bed. Their hearts were still beating more than 20 beats per minute faster than their resting heart rate.

Possible sleep problems are no excuse

According to the official recommendations of sport physicians, people should do at least 150 minutes of moderate exercise each week. Many may ask themselves: should I exercise in the evening if I didn’t have time during the day, or will that have a negative effect on my sleep? “People can do exercise in the evening without hesitation. The data shows that moderate exercise in the evening is no problem at all,” says Jan Stutz, a doctoral student in Spengler’s research group and lead author of the analysis, which was published in the journal Sports Medicine. Moderate exercise did not cause sleep problems in any of the studies examined, not even when the training session ended just 30 minutes before bedtime. “However, vigorous training or competitions should be scheduled earlier in the day, if possible,” Stutz says.

Stutz and Spengler point out that they examined average values over the course of their analysis, which made only general statements possible. “Not everyone reacts to exercise in the same way, and people should keep listening to their bodies. If they notice they are having problems falling asleep after doing sport, they should try to work out a little earlier,” Stutz says.

“It is well known that doing exercise during the day improves sleep quality,” Spengler says, adding: “Now we have shown that, at the very least, exercising in the evening doesn’t have a negative effect.”

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Materials provided by ETH Zurich. Note: Content may be edited for style and length.