Why Is My Skin Always Oily Halfway Through the Day No Matter What?

Welcome to Ask A Beauty Editor, our new column in which Sarah Jacoby, SELF’s senior health and beauty editor, goes on the hunt to find the science-backed answers to all of your skin-care questions. You can ask Sarah a question at askabeautyeditor@self.com.

Hey, Sarah!

OK so I don’t consider myself to have super oily skin, but I’ve noticed that no matter what foundation/primer/setting powder I use, it ends up breaking up around my nose by the end of the day. In high school, I swore by those little blue blotting papers, and I’m sure they would still be helpful, but I figure there must be a better way to deal with this.

I’m assuming this means that I have a good amount of oil production around my nose, so are there any ingredients I should look for in a skin-care product or makeup product to help makeup in this area stay put throughout the day? I don’t want to use anything too harsh all over my face since I do have sensitive skin and rosacea. Is there anything I could use to combat oil specifically in this area?

—Casey G.

Ah yes, the nearly universal scourge of nose oil. Even when everything else is perfectly matte—or, at most, delightfully dewy—that little area around the nose glistens with defiance. It’s annoying, to say the absolute least.

First off, know that you are not imagining things—the area around your nose is home to a high concentration of sebaceous glands, Shari Lipner, M.D., Ph.D., dermatologist at Weill Cornell Medicine and NewYork-Presbyterian Hospital, tells SELF. These are responsible for secreting sebum (oil) and the area is prime real estate for a buildup of sweat. So, it’s not uncommon for your nose to be an oil hot spot, even on an otherwise non-oily face.

So, what’s the best way to combat that stuff? It starts with the way you wash your face and how often you do it. “A common misconception is that, by washing the face more often or with harsher soaps, we will decrease oil at that time or later in the day,” Dr. Lipner says. But overwashing your face (especially with harsh acne cleansers) strips the skin of natural oils, which it then replaces with even more oil and sweat later on.

Basically, the body will always want to have a (thin, not visible) film of oil on the skin, Dr. Lipner says, and it will do whatever it takes to keep that there. That’s why Dr. Lipner recommends sticking with very gentle cleansers and only washing your face once or twice a day, depending on sweating and how much makeup you’re wearing.

The next factor is the amount of moisturizer you’re using. People with oily skin may not think they need to use moisturizer, but the opposite is true: “As long as you use a light moisturizer, it will hydrate and actually decrease oil production,” Dr. Lipner says. So, if you’re not already using a moisturizer every morning (ideally with at least 30 SPF), now is the time to start.

That said, those who are struggling with excess oil should not be using toner, which will only further dry out your skin leading to more oiliness, Dr. Lipner says.

Then, of course there’s the makeup you’re wearing. If you have oily skin, you should be paying special attention to only using oil-free or non-comedogenic products, which won’t clog your pores and will be less likely to contribute to oil, Dr. Lipner says.

And yes, in a pinch, those blotting papers are totally fine to use every so often, she says.

If you try and stick with all of this for a few weeks and still find that your skin always feels oily midday, that’s when it’s time to call in a board-certified dermatologist. They may prescribe you medication that can exfoliate and reduce the oil, like a retinoid, Dr. Lipner says. (And yes, you might be able to use them even if you have sensitive skin!).

Although there are a million over-the-counter exfoliating products, Dr. Lipner doesn’t suggest trying to go the DIY route on this one. At the point where you’re considering that, it’s time to see a derm instead.

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Good leadership and values key to staff satisfaction

Tourism and hospitality firms that score highly for leadership and cultural values see higher staff satisfaction, according to a new study by the University of East Anglia (UEA).

Researchers analysed almost 298,000 online review ratings by employees for 11,975 firms in the US to find the key elements of job satisfaction and employee turnover in high-contact services. The reviews were posted over a 10-year period on Glassdoor, one of the world’s largest job and recruiting sites.

The results, published in the journal Tourism Management, also show that career progression is a critical factor in staff turnover, with a unit increase in the career opportunities rating reducing the likelihood of an employee leaving a company by 14.87%.

Significantly, the study quantifies the effect of job satisfaction on firm profitability. In particular, an increase in job satisfaction by one unit is associated with an increase in ‘Return on Assets’ — a measure of profitability — of between 1.2% and 1.4%. The authors say this finding is important because they do not find evidence supporting the reverse relationship — that profitable firms increase employee’s satisfaction.

Co-author Dr Nikolaos Korfiatis, of UEA’s Norwich Business School, said: “Skill shortages and high employee turnover are key challenges in the tourism and hospitality sector, and the problem is of high economic significance for firms due to the costs associated with severance, training and replacement. Job satisfaction is a critical factor in attracting and retaining a skilled workforce, but also plays a vital role in the customer experience.

“This study provides new evidence about the facets and dynamics of job satisfaction and their link to corporate profitability. Our analysis indicates that the feedback to management provided through online employee reviews holds important information with specific managerial implications.

“Tourism and hospitality firms should consider the factors revealed in these reviews if they want to increase the job satisfaction of their employees and reduce employee turnover, which eventually leads to a better customer experience and higher financial performance. This ‘wisdom of employees’, expressed through the feedback to management, would suggest that there are specific HR policies that firms should follow.”

The authors suggest that firms could set up anonymous hotlines for staff to report negative treatment towards them or other employees, should hold multi-source performance reviews, for example where staff can give feedback on their bosses anonymously, and post-exit interviews.

There should be open communication between staff and managers, while support for employee development could be through paid or subsidised courses, job shadowing and mentoring. Firms should enable staff to express their opinions, consider involving them in the design and implementation of policies or product offerings, and reward good ideas.

Although online reviews have been extensively studied in existing tourism and hospitality research, this has mainly focused on consumer evaluation, rather than other information such as employees’ ‘word of mouth’ views about their current and previous employers. This is collected and shared via online platforms such as Glassdoor that rate thousands of companies.

Lead author Panagiotis Stamolampros, formerly at UEA and now a lecturer at Leeds University Business School, said: “These platforms offer unprecedented opportunities to extend our understanding about the factors that increase job satisfaction and dissatisfaction, and employee turnover and attrition.

“Our results show that satisfied employees cite work environment, culture, leadership, and career opportunities as key things their companies offer, and that these factors reduce employee turnover.

“The discussion about career opportunities as a positive aspect increases significantly when the overall satisfaction increases. On the other hand, low ratings are connected with more discussion about leadership, communication with management, and managerial behaviour in the negative text of the reviews.”

Analysis of demographics and firm characteristics show that when it comes to gender, in all job satisfaction aspects, except career opportunities, male employees appear to be more satisfied than their female colleagues.

Companies with higher revenue also tend to achieve higher employee satisfaction. Similarly, publicly listed companies also appear to have higher employee satisfaction than private companies. However, although companies with many employees may offer better compensation — such as better pay or reward for effort — benefits and career opportunities compared to smaller ones, they seem to lack in terms of cultural values, senior leadership, and work-life balance, which eventually leads to lower employee satisfaction.

A higher level of employee education is linked to higher satisfaction, although this could be also the result of different job roles. Finally, employee age is linked to lower satisfaction except for the satisfaction with compensation and benefits.

Nearly 1 in 5 parents say their child never wears a helmet while riding a bike

Despite evidence that helmets are critical to preventing head injuries, not all children wear them while biking, skateboarding and riding scooters, a new national poll finds.

Eighteen percent of parents say their child never wears a helmet on a bike ride, and even more say their kids skip helmets on a skateboard (58 percent) and scooter (61 percent), suggests the C.S. Mott Children’s Hospital National Poll on Children’s Health at the University of Michigan.

The risks are significant. More than 426,000 children — nearly 50 every hour — visited an emergency department in 2015 due to a wheeled sports-related injury, according to a 2017 report from the Safe Kids Worldwide and Nationwide’s Make Safe Happen program.

“Helmets are vital to preventing head injuries in case a child falls or is struck by a car,” says poll co-director and Mott pediatrician Gary Freed, M.D., MPH.

“It is very concerning that so many children ride bikes and other non-motorized wheeled vehicles without ever using helmets.”

The nationally-representative poll was based on responses to questions about non-motorized vehicles from 1,330 parents of at least one child aged 4-13.

Results indicate a wide range in the use of safety strategies when children are playing with wheeled-toys outside. Most parents said their child gives cars the right of way (93 percent) and stops their bike at stop signs (82 percent.) However, the majority of parents also acknowledged their child does not use hand signals or walk their bike across crosswalks.

“Unfortunately, a substantial number of parents polled reported that their children do not consistently follow basic safety strategies on wheels, “Freed says. “Our report suggests that families should take more precautions to ensure children are safe, including wearing helmets and understanding safety in the streets.”

Of the 4 in 5 parents polled whose child rides a bicycle, most said their child uses sidewalks (73 percent) or parks or trails (59 percent). More children also ride on streets without bike lanes (42 percent) than streets with bike lanes (11 percent).

Parents were also more likely to say that younger children always wear a helmet compared to older children but not all families enforced a strict helmet rule.

Older children (ages 11-13) are more likely to ride in a street (with or without bike lanes) compared with younger children (ages 4-10). Just wearing a helmet is not enough, Freed notes. To get the most protection, helmets should fit snugly on the head, and be used correctly.

Freed says that in areas that allow it, children should also ride non-motorized vehicles on the sidewalk. Parents should accompany younger children and teach them top safety lessons, such as slowing down, using a bell, or calling out to alert pedestrians that they are approaching. Children biking on the sidewalk should also stop at intersections and walk their bike across the crosswalk, as passing cars may not be looking for a bike to emerge from the sidewalk.

Children also need to be on the lookout for people getting in or out of parked cars, experts say. Many children are injured each year when a driver opens their car door onto the street and strikes an oncoming bicycle.

“With summer around the corner, bikes, skateboards, and scooters will be a fun way for kids to play outside and get exercise,” Freed says.

“We encourage parents to talk to their children about safety rules and expectations ahead of time to make sure these outdoor activities are both fun and safe.”

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Materials provided by Michigan Medicine – University of Michigan. Original written by Helen Korneffel. Note: Content may be edited for style and length.

Driverless cars working together can speed up traffic by 35%

A fleet of driverless cars working together to keep traffic moving smoothly can improve overall traffic flow by at least 35 percent, researchers have shown.

The researchers, from the University of Cambridge, programmed a small fleet of miniature robotic cars to drive on a multi-lane track and observed how the traffic flow changed when one of the cars stopped.

When the cars were not driving cooperatively, any cars behind the stopped car had to stop or slow down and wait for a gap in the traffic, as would typically happen on a real road. A queue quickly formed behind the stopped car and overall traffic flow was slowed.

However, when the cars were communicating with each other and driving cooperatively, as soon as one car stopped in the inner lane, it sent a signal to all the other cars. Cars in the outer lane that were in immediate proximity of the stopped car slowed down slightly so that cars in the inner lane were able to quickly pass the stopped car without having to stop or slow down significantly.

Additionally, when a human-controlled driver was put on the ‘road’ with the autonomous cars and moved around the track in an aggressive manner, the other cars were able to give way to avoid the aggressive driver, improving safety.

The results, to be presented today at the International Conference on Robotics and Automation (ICRA) in Montréal, will be useful for studying how autonomous cars can communicate with each other, and with cars controlled by human drivers, on real roads in the future.

“Autonomous cars could fix a lot of different problems associated with driving in cities, but there needs to be a way for them to work together,” said co-author Michael He, an undergraduate student at St John’s College, who designed the algorithms for the experiment.

“If different automotive manufacturers are all developing their own autonomous cars with their own software, those cars all need to communicate with each other effectively,” said co-author Nicholas Hyldmar, an undergraduate student at Downing College, who designed much of the hardware for the experiment.

The two students completed the work as part of an undergraduate research project in summer 2018, in the lab of Dr Amanda Prorok from Cambridge’s Department of Computer Science and Technology.

Many existing tests for multiple autonomous driverless cars are done digitally, or with scale models that are either too large or too expensive to carry out indoor experiments with fleets of cars.

Starting with inexpensive scale models of commercially-available vehicles with realistic steering systems, the Cambridge researchers adapted the cars with motion capture sensors and a Raspberry Pi, so that the cars could communicate via wifi.

They then adapted a lane-changing algorithm for autonomous cars to work with a fleet of cars. The original algorithm decides when a car should change lanes, based on whether it is safe to do so and whether changing lanes would help the car move through traffic more quickly. The adapted algorithm allows for cars to be packed more closely when changing lanes and adds a safety constraint to prevent crashes when speeds are low. A second algorithm allowed the cars to detect a projected car in front of it and make space.

They then tested the fleet in ‘egocentric’ and ‘cooperative’ driving modes, using both normal and aggressive driving behaviours, and observed how the fleet reacted to a stopped car. In the normal mode, cooperative driving improved traffic flow by 35% over egocentric driving, while for aggressive driving, the improvement was 45%. The researchers then tested how the fleet reacted to a single car controlled by a human via a joystick.

“Our design allows for a wide range of practical, low-cost experiments to be carried out on autonomous cars,” said Prorok. “For autonomous cars to be safely used on real roads, we need to know how they will interact with each other to improve safety and traffic flow.”

In future work, the researchers plan to use the fleet to test multi-car systems in more complex scenarios including roads with more lanes, intersections and a wider range of vehicle types.

I’m a Sex Coach, and I Swear By Scheduling Sex in Relationships

If you’ve ever been in a long-term relationship, this might sound familiar: You and your partner tumble into bed at the end of each day completely exhausted, promising yourselves you’ll have sex tomorrow. Then that tomorrow-sex rarely comes, pun fully intended.

As a certified sex coach and sexologist, I often hear about how difficult it is to make time for intimacy while leading hectic lives. It’s why I swear by scheduling sex in relationships. This is exactly what it sounds like: sitting down with your partner and marking sex dates into your calendar.

Many of my colleagues in the sexual health space and I call this “maintenance sex,” which…doesn’t sound sexy, I know. But for some people, scheduling sex is critical for maintaining a healthy relationship, hence the moniker.

“It definitely feels like we’re closer now than when we’d wait for ‘the mood’ to just hit us. Without it being scheduled, we were like two ships passing in the dead of night,” Melissa B., 28, who’s been with her husband for eight years and scheduling sex for just over a year, tells SELF. “Either I wasn’t feeling it, he was working late, or we honestly [were] just too exhausted.”

Why I’m a fan of scheduling sex

Even though sex is typically so, so vital for relationship happiness, people often let it fall by the wayside in long-term couplehood. Scheduling sex is an amazing way for partners to keep intimacy and satisfaction alive.

If sex feeds your bond, it isn’t just some extra fluff you should try to work into your day if you have time. When it’s part of the glue holding you together, it deserves some respect and dedication. But there’s this very pervasive and annoying myth that sex should just happen. For a lot of people, sex in long-term relationships generally doesn’t work that way. And that’s fine!

“[Scheduling sex] has helped our sex life. Having to plan it into our lives gave us both a bit of a reality check that we need to make the time,” Brook W., 24, who’s been with her partner for eight years and scheduling sex for the last nine months, tells SELF.

How to actually schedule sex

1. Figure out a day and time that works for both of you.

It sounds obvious, but you can’t schedule sex without this bit. I recommend that couples sit down together and carve out a time that works, whether it’s a standing sex date or something you need to decide anew each week. It feels like a more intentional step towards intimacy than scheduling via text and the like. Technology is great, but there’s really nothing like IRL face time.

Don’t just think about when logistically makes sense; also think about when you might feel most emotionally and mentally engaged or turned on.

“I suggested scheduling sex because my partner preferred late night sex and I’m such an early bird, and both our lives were pretty packed. We started scheduling late-afternoon and early-evening sex when we both had good energy,” August M., 40, who’s in a four-year relationship and has been scheduling sex for three years, tells SELF.

2. Actually put it in your calendar.

When you write your scheduled sex down, you’re granting it the same weight you’d give any other important appointment. So, be sure it’s on both of your calendars. Give it a designated color, even. I suggest hot pink or red. You can guess why.

“We noticed that the only day of the week that seemed to allow us to both have free time was Tuesday afternoons. We both [take] late and long lunches that day, allowing us to slip back to our apartment for one-on-one time,” Melissa says. “It’s something in my schedule that I protect at all costs. I mean, even my admin at the office knows not to schedule any meetings on Tuesday afternoons. I just always have a block on my schedule for that chunk of time.”

3. Be flexible about what kinds of intimacy are involved.

Having a sex schedule does not mean you need to have intercourse every time (or ever). This isn’t really about sex. It’s about intimacy. Many—but not all—couples often do experience this through sex, while others don’t.

The point is scheduling time to engage in whatever activities make you feel more closely connected. Perhaps it’s a make-out session. Maybe one week it’s oral sex and the next you spend time playing with your partner’s hair and talking about your fantasies.

This level of flexibility respects the fact that life happens. For example, I don’t expect you to toss aside a fight simply because sex is on the schedule. This flexibility also acknowledges that some people experience a more responsive form of desire and really only become aroused after seduction and sexual touching have begun. Scheduled sex is not about mandating a specific command performance, but creating a space where sex can happen if it’s right for you both at that time.

So, talk about what scheduling sex really encompasses. Be willing to compromise so both of you are satisfied. What’s most important is setting aside time for you two to be together and focus on your relationship.

4. Do your best to stick with the schedule.

One of the biggest issues couples have with this process is not following through. It’s really up to the two of you to decide how committed you are to this schedule based on everything else going on in your lives.

I often have clients who note there is a sense of “pressure” when they first start a sex schedule, which can scare them away. For some people, that drops off once they get used to it. But it may also take some playing around to land on a version of scheduling sex that works for you.

“We tried putting sex on the calendar for Saturday mornings, and it was so exhausting,” Britt K., 28, who’s been with her partner for four years, tells SELF. “I would feel so needy and terrible because Saturday would come and she wasn’t into it. That isn’t fun.” Instead, Britt and her partner decided to designate Saturday as their standing weekly date, which is a more natural way for them to have opportunities to connect physically. “It’s just us, but no one feels pressure,” she says. “So far, it’s been good.”

5. Lean into the anticipation.

Look, I get that “scheduled” can sound synonymous with “so dull I want to cry.” It’s not. While this tactic won’t work in every relationship, scheduled sex creates anticipatory excitement for some people. It sets the sex date into your routine along with the opportunity to explore new sexual terrain.

“[Scheduling sex] might seem boring, but scheduling a date, party, or vacation doesn’t make it less fun,” August says. “Doing so can add to the enjoyment because you can put more thought into it and benefit from that spicy anticipation. On top of all of that, occasional spontaneous sex when you typically schedule it becomes even more exciting because it’s so novel.”

Long-lasting sexual excitement is built on the unknown, the new, and the exploration of fantasy. Capitalize on that here. You might think of a new intriguing sex position or pick up some cute new underwear for the occasion. You can even text your partner something like, “I can’t wait for our Monday night date. I bought something for us to try.” Then, when your partner gets home, they get to meet your new vibrator, set of anal beads, or whatever else has piqued your interest.

With all of the above said, if scheduling sex doesn’t work for you, don’t get down on yourself. It doesn’t automatically mean your relationship is over or in trouble. It might just not be your jam. This advice can still serve as a blueprint for becoming closer: Sit down. Communicate. And draw up a plan for quality time that might work better for you both.

Gigi Engle is a certified sex coach, sexologist, educator, and writer living in Chicago. Follow her on Twitter and Instagram @GigiEngle.

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Researchers document impact of coffee on bowels

Coffee drinkers know that coffee helps keep the bowels moving, but researchers in Texas are trying to find out exactly why this is true, and it doesn’t seem to be about the caffeine, according to a study presented at Digestive Disease Week® (DDW) 2019. Researchers, feeding rats coffee and also mixing it with gut bacteria in petri dishes, found that coffee suppressed bacteria and increased muscle motility, regardless of caffeine content.

“When rats were treated with coffee for three days, the ability of the muscles in the small intestine to contract appeared to increase,” said Xuan-Zheng Shi, PhD, lead author of the study and associate professor in internal medicine at the University of Texas Medical Branch, Galveston. “Interestingly, these effects are caffeine-independent, because caffeine-free coffee had similar effects as regular coffee.”

Coffee has long been known to increase bowel movement, but researchers have not pinpointed the specific reason or mechanism. Researchers examined changes to bacteria when fecal matter was exposed to coffee in a petri dish, and by studying the composition of feces after rats ingested differing concentrations of coffee over three days. The study also documented changes to smooth muscles in the intestine and colon, and the response of those muscles when exposed directly to coffee.

The study found that growth of bacteria and other microbes in fecal matter in a petri dish was suppressed with a solution of 1.5 percent coffee, and growth of microbes was even lower with a 3 percent solution of coffee. Decaffeinated coffee had a similar effect on the microbiome.

After the rats were fed coffee for three days, the overall bacteria counts in their feces were decreased, but researchers said more research is needed to determine whether these changes favor firmicutes, considered “good” bacteria, or enterobacteria, which are regarded as negative.

Muscles in the lower intestines and colons of the rats showed increased ability to contract after a period of coffee ingestion, and coffee stimulated contractions of the small intestine and colon when muscle tissues were exposed to coffee directly in the lab.

The results support the need for additional clinical research to determine whether coffee drinking might be an effective treatment for post-operative constipation, or ileus, in which the intestines quit working after abdominal surgery, the authors said.

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Materials provided by Digestive Disease Week. Note: Content may be edited for style and length.

5 Exercises to Try If You Hate Burpees

If you were to tell me you know someone who genuinely likes doing burpees, I’d have a hard time believing you. The burpee is one of the most vilified exercises out there (if not the most), and honestly, there are good reasons.

Burpees are hard. They’re meant to be. The goal is to do them as quickly as possible, so that your heart rate skyrockets. Some trainers like them because of this—a burpee really is a challenging, efficient, total-body cardio exercise. But other trainers hate them. Most famously, celebrity trainer Ben Bruno is quite vocal about how awful he thinks burpees are. The biggest criticisms: Many people can’t do them right, which increases the risk of injury, and more simply, a lot of people dread them. And being forced to do something you hate isn’t the best way to fall in love with exercise and get motivated to do it long term.

I, personally, feel pretty neutral about burpees. I don’t despise them (I actually dislike mountain climbers more), but I don’t particularly like them. I’m fine with doing them for 30 seconds here and there as part of a larger workout. But a burpee is not an exercise I’d ever do while working out on my own—I’m only doing them in a class when an instructor is telling me to do so.

“Burpees hurt no matter who you are, from the most regressed version to the hardest variation of a burpee,” says Morit Summers, certified personal trainer and owner of FORM Fitness Brooklyn. “They are hard and no one truly enjoys pain.” But just like any other exercise move, practicing burpees can make you better at them and hopefully hate them less. “They can become easier to swallow with practice. Your body will get used to doing them and you will be more prepared, so it won’t be as mentally challenging as it was before,” says Summers.

But also, if you don’t want to do burpees, take this as your permission to give them up forever. There are plenty of other exercises you can do instead to reap the same benefits—ones that you might actually enjoy.

Here, Summers shares a few great burpee substitutes that you can do in place of, or to work up to, a burpee, depending on where you stand on the issue. Feel free to share this with all the fellow burpee-haters you know out there. We know you’re not the only one.

Demoing the move below are Cookie Janee, a background investigator and security forces specialist in the Air Force Reserve; Rachel Denis, a powerlifter who competes with USA Powerlifting and holds multiple New York state powerlifting records; and Kira Stokes, celebrity trainer, group fitness instructor, and creator of the Kira Stokes Fit app.

All products featured on SELF are independently selected by our editors. If you buy something through our retail links, we may earn an affiliate commission.

This Setting Powder is Amazing and I’m Totally Obsessed With it

You know that feeling when you run something incredibly soft over your face? Maybe a fluffy towel straight out of the shower, or the feel of a satin pillowcase against your cheek? That’s exactly what Onomie’s AHA! Perfecting Setting Powder feels like on my skin—completely amazing. In fact, I’ve never liked a makeup product right off the bat because of the way it feels on my face until using this product for the first time.

It’s extremely lightweight, and after applying my foundation and concealer, I add some powder, and later wipe it away to nothing. It comes with a handy makeup puff that makes for an even application of powder, and is a perfect fit for my index and middle finger. The powder itself is made with ingredients like lactic acid and vitamin C, which makes me feel like I’m taking care of my skin while wearing makeup.

Since the powder is small and travel-friendly, it’s easy for me to throw it in my bag to take with me for quick touch-ups on the go. It’s the perfect size for me to set my makeup during my commute to work without making a total mess. There’s even a mirror and a compartment for the powder puff built into the compact which makes application a breeze. Did I mention its packaging is an adorable shade of millennial pink?

Buy it: Onomie AHA! Perfecting Setting Powder, $30, onomie.com

All products featured on SELF are independently selected by our editors. If you buy something through our retail links, we may earn an affiliate commission.

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Button batteries can rapidly damage stomach lining before symptoms appear

Damage to the lining of the stomach can occur quickly when children swallow button batteries; therefore, clinicians should consider prompt endoscopic removal, even when the child is symptom free and the battery has passed safely through the narrow esophagus, according to research presented at Digestive Disease Week® (DDW) 2019. The recommendations represent a change from current practice of watching and waiting.

“We know there can be injury even when there are no symptoms,” said Racha Khalaf, MD, lead researcher and pediatric gastroenterology, hepatology and nutrition fellow at the Digestive Health Institute at Children’s Hospital Colorado, Aurora. “Batteries in the stomach cause damage, including perforation of the gastric wall, so physicians should consider removing the batteries as soon as possible and not let them pass through the digestive tract.”

Researchers from pediatric hospitals in Colorado, Florida, Texas and Ohio collected data regarding 68 button battery ingestions from January 2014 to May 2018. Previous research has been conducted on button batteries lodged in the esophagus, but little is known about the effect in the stomach.

“We have been seeing more injuries from button batteries,” Dr. Khalaf said. “The batteries come in toys, remote controls, key fobs, singing greeting cards and watches. They are everywhere.”

Erosive injuries to the mucous lining of the stomach were found in 60 percent of cases reviewed, with no apparent relationship between damage and symptoms, or with the amount of time passed since ingestion. This suggests that clinicians and parents should not wait for symptoms or passage of time to act, Dr. Khalaf said, adding that removing the battery earlier avoids repeated trips to the emergency room or pediatrician’s office and reduces repetitive x-rays or other imaging.

The authors’ recommendations are more aggressive than those of two national organizations that have issued recommendations about button battery ingestion. The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition recommends observation when it’s been less than two hours since ingestion, the battery is 20 mm or smaller, and the child is at least 5 years old. The National Capital Poison Center, which runs the National Battery Ingestion Hotline, currently recommends observation alone for asymptomatic gastric button batteries to allow them to pass through the digestive system.

This work is partly supported by a Cystic Fibrosis Foundational Grant Award #Khalaf17B0 to Racha Khalaf, National Institutes of Health Training Grant 5T32-DK067009-12 to Keith Hazleton and Racha Khalaf, and National Institutes of Health Training Grant 5T32-DK7664-28 to Wenly Ruan.

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Materials provided by Digestive Disease Week. Note: Content may be edited for style and length.

Refined Carbs—What Exactly Are They?

The phrase “refined carbs” pops up in a lot of conversations about food and nutrition, generally in a negative way. You may have been advised to stay far away from them—by your doctor, a friend, the internet—but you’re still a little fuzzy on what they are, actually.

What technically makes something a refined carb? And do they really deserve their bad rap? We asked nutrition experts these questions and more.

What “refined carbs” actually means

The loose label is an umbrella term generally used to describe carbohydrates that have had the bulk of their nutritional value removed during the manufacturing process, Lisa Young, R.D.N., C.D.N., Ph.D., adjunct professor in the department of nutrition and food studies at New York University and author of Finally Full, Finally Slim, tells SELF. It’s often used interchangeably with its equally nebulous cousin, “processed carbs.”

To be more specific, “refined carbs” and “processed carbs” are generally used in reference to grains and grain products in particular, Young adds. Some people would also consider any products containing large amounts of added sugars to be “refined carbs.” But if you look at the technical meaning of the word “refined” and the foods that most nutrition pros agree belong in that category, refined grains and grain products are the clearest fit. So that’s what we’re going to focus on here.

“Refined grains” does have a precise definition: It describes any grain (like white rice) or grain product (like bread) that is not made of whole grains, according to the 2015–2020 Dietary Guidelines for Americans.

In their whole, natural form, grain seeds, or kernels, consist of three parts: the bran (the tough outer layer), the germ (the tiny, nutrient-dense core), and the endosperm (the largest, starchy part) the Food and Drug Administration (FDA) explains. In whole grains, like brown rice, the entire kernel has been left intact; in products made from whole grain flours, like whole wheat flour, the flour is ground from these intact grains, so it contains the contents of the bran, the germ, and the endosperm.

Refined grains, on the other hand, have had the bran and germ removed during processing, according to the FDA, leaving only the starchy endosperm. This process yields a finer texture and lighter color—resulting in delightfully fluffy carbs that also have a prolonged shelf life.

The most common example of a refined grain as a single food item is white rice—brown rice that’s had the bran and germ removed. Most of the refined grains we consume, though, are in the form of flours milled from refined grains. The most ubiquitous example is wheat flour, which is ground from wheat that has had the bran and germ removed, and used as a main ingredient in a number of baked goods and packaged foods like bread, muffins, crackers, pretzels, and cookies. (This is the same thing as good ol’ white flour, or all-purpose flour, which is just wheat flour that has been bleached.)

How refining a grain alters its nutritional value

When you consume a whole grain or whole grain flour, you’re getting all of the fiber, protein, vitamins, minerals, and nutritious fats that they have to offer, per the FDA. In refined grains, the bran and germ have been removed—along with all of their nutritional value. That’s the main beef that nutrition experts have with refined grains. “You are missing out on the many nutrients provided by the whole grain,” board-certified health and wellness coach Kim Larson, R.D.N., tells SELF.

The particular nutrients that are lost during the refining process depend on what whole grain you start with. In general, though, much of the grain’s fiber and key vitamins and minerals, like iron and the B vitamins niacin, riboflavin, and thiamin, per the FDA, and sometimes some protein, are removed during processing. Refined flours are then usually “enriched,” meaning some of those key nutrients lost during processing have been added back in, the FDA explains. But fiber isn’t typically added back in, meaning most refined grains are low or devoid of it.

Take a grain that’s common in both whole and refined iterations: wheat. According to the USDA nutrient database, 100 grams of whole wheat flour contains about 71.4 grams of carbs and 10.7 grams of fiber. Refined and enriched wheat flour, on the other hand, contains a similar amount of carbs (76.3 grams), but considerably less fiber (2.7 grams) per 100 grams, according to the USDA. It also contains less protein—only 10.3 grams per 100 grams versus whole wheat flour’s 14.3.

For an example of how that translates into packaged foods, consider a slice of 100 percent whole wheat bread vs a slice of white bread (of the same size and from the same manufacturer). The whole wheat slice has 12 carbs, 2 grams of fiber, and 3 grams of protein, while a slice of the white bread has 13 carbs, 0 grams of fiber, and 2 grams of protein. Of course, differences of one or two grams of fiber and protein seems small, and they are in the grand scheme of your overall food intake. But if you’re consistently choosing refined grains over whole ones, you’ll miss out on some pretty good chances to consume these good-for-you nutrients.

Fiber is probably the most concerning nutrient loss, Larson says, given that most Americans aren’t getting enough of it, according to the U.S. National Library of Medicine. Fiber has a slew of health benefits—helping to regulate digestion, bowel movements, blood sugar levels, LDL cholesterol, and more—that you don’t really get from refined grains.

How to distinguish between whole and refined grains on nutrition labels

When you’re just talking grains by themselves, it’s pretty simple. If you’re buying a whole grain to cook with, for instance—like oats, bulgur, or rice—then the only ingredient on the package should be that whole grain. (Or, it should at least be first in the case of something like microwave popcorn that also contains oil and salt.) Where it gets tricky is on the ingredients lists of the countless packaged foods made with grains at the grocery store.

According to the American Heart Association (AHA), most whole grain products will contain the word “whole” or “whole grain” first in the ingredient list—like whole wheat flour or whole rye flour. If it just says “wheat flour” or “rye flour,” that means it’s probably been refined, Young explains. Sometimes, foods like whole wheat bread or whole wheat pasta will indicate “100 percent whole grain” on the label.

Of course, lots of products will contain both whole grains and refined grains, Larson says. In these cases, the placement of the whole grain or whole grain flour on the ingredients list indicates the relative amount in the product. If you’re looking for a mostly whole grain product, the whole grain or whole grain flour should be either first on the ingredients list or high up, according to the Dietary Guidelines (and certainly before any refined grain flours). Foods made from at least 50 percent whole grain ingredients by weight may have a “whole grains” claim on the label, per the Dietary Guidelines. It’s a good idea to also peek at the nutrition facts to see how much fiber and protein is in the product, if you want to make sure you’re getting some nutrients even though a product contains both whole and refined grains.

So, do you actually need to worry about refined carbs?

At the end of the day, most of us could probably stand to eat fewer refined grains and more whole grains, Larson adds. As a baseline, the Dietary Guidelines recommend getting at least half of your grains from whole grains. The average refined grain intake, though, is “well above” recommended limits among men and women in most age groups while the average whole grain intake is “far below” the recommended amount, according to the Dietary Guidelines.

So, if you notice that your own diet leans pretty heavy towards refined carbs and you want to incorporate more whole grains into your diet, Larson suggests swapping out refined grains for whole grain versions where you can—such as brown rice instead of white rice and 100 percent whole wheat bread instead of wheat bread or white bread.

But there’s nothing wrong with eating refined carbs. “Sometimes refined carbs are demonized in diet culture,” Larson says. But they’re not gonna kill you. Assigning a moral value to grains (like considering white pasta as “bad” and whole grain pasta as “good”) isn’t productive and could contribute to an unhealthy relationship to eating something that gives your body fuel and pleasure.

“Certainly eating a few refined grains every day, along with a healthy diet and at least half of your grain intake as whole grains, is fine,” Larson says. “Everyone needs treats and sweets in their life to enjoy and enhance eating pleasure, for celebration, and for many other reasons.” Just make sure whole grains get invited to the party, too.

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