Shared lifetime of grandmothers and grandchildren significantly increased since 1800s

A great change began in the era of industrialisation, as better hygiene and development in medicine increased grandmothers’ life expectancy and also decreased infant mortality.

“The influence of grandmothers in terms of child survival has been particularly substantial once the child has grown past early infancy, and is between the ages of 2-5. Today, grandmothers are not a key factor in terms of young children’s survival, but several studies have indicated that grandmothers do influence the well-being of their grandchildren. Grandmothers can also lend support to their daughters by granting them opportunities to have more children and at a more rapid pace than they could without the support of their mother,” says Simon Chapman.

The study conducted by Doctoral Candidate Simon Chapman, Postdoctoral Researchers Jenni Pettay and Mirkka Lahdenperä, and Academy Professor Virpi Lummaa from the Department of Biology at the University of Turku utilised Finnish parish registers, which offer a globally remarkable, extensive set of data for researching genealogical tables.

The researchers studied eight parishes for information on children born between 1790-1959 and their grandmothers. The data described how many grandchildren a grandmother received during her lifetime and how that figure changed over the decades, the age at which a grandmother had her grandchildren, how long she lived alongside each child, and whether or not the grandchild lived in the same or neighbouring parish as their paternal and maternal grandmother.

  • Over the course of the time period covered in the study, more than a third of the children could never meet their grandmother: over 36% were born after the death of their maternal grandmother, and nearly 44% after the death of the paternal grandmother. Over the decades, the percentages changed considerably. 80% of children born in the 1950s had a living maternal grandmother and approximately 70% had a living paternal grandmother, says Simon Chapman.

Pre-industrially, even the children who were born while their grandmother was alive lost her relatively early. For children born prior to the 1870s, the shared lifetime with their grandmothers averaged 0-2 years. Along with industrialisation, the shared time started to increase, reaching 14 years for maternal grandmothers and 11 years for paternal grandmothers of children born in the 1950s.

Age of new grandmothers has not changed

The researchers discovered that the age of mothers at the time of childbirth has remained virtually constant over the time period covered in the research. The same discovery applied to grandmothers as well. On average, women have become grandmothers between the ages of 50 and 56. However, there has been a dramatic change in the number of grandchildren each grandmother has.

  • In the 1790s, grandmothers had an average 12-13 grandchildren, of whom 3-5 were born while their grandmother was still alive. Grandmothers in the 1950s got an average of 7-8 grandchildren, all born in the grandmother’s lifetime, says Chapman.

In the entire time period covered in the study, 80% of grandchildren lived longer than their grandmother, while in the 1950s the number was 96%.

The researchers also aimed to assess how many grandchildren have had an actual opportunity to be in contact with their grandmother. This was accomplished by studying the places of residence in the parish records. In the 1790s, over 73% of grandchildren lived in the same parish region as their paternal grandmother, and 68% in the same region as their maternal grandmother. In the 1950s, approximately 57% of grandchildren lived in the same parish region as one of their grandmothers.

Results underline importance of grandmothers

According to the study, the importance of shared time between grandmothers and their grandchildren had already been recognised earlier, but the factors determining the length of that time period had not been studied extensively. The recent study helps researchers to better understand menopausal influence over the centuries, the increase of the post-menopausal lifespan, and changes in family life.

The results can also be used to assess grandparents’ role in supporting their grandchild in times of crisis, such as parental divorce.

  • Historically and still today, grandmothers are considered an important partner in raising grandchildren, the researchers state.

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This is how the brain forgets on purpose

Researchers from Ruhr-Universität Bochum and the University Hospital of Gießen and Marburg, in collaboration with colleagues from Bonn, the Netherlands, and the UK, have analysed what happens in the brain when humans want to voluntarily forget something. They identified two areas of the brain — the prefrontal cortex and the hippocampus — whose activity patterns are characteristic for the process of forgetting. They measured the brain activity in epilepsy patients who had electrodes implanted in the brain for the purpose of surgical planning. The team headed by Carina Oehrn and Professor Nikolai Axmacher outlines the results in the journal Current Biology, published online on 6 September 2018.

“In the past century, memory research focused primarily on understanding how information can be successfully remembered,” says Nikolai Axmacher, Head of the Neuropsychology Department in Bochum. “However, forgetting is crucial for emotional wellbeing, and it enables humans to focus on a task.”

Rhythmic brain activity and word test

The researchers recorded the brain activity of 22 patients, who had electrodes implanted either in the prefrontal cortex or in a deeper structure, the hippocampus. They presented the participants with a number of words, asking them either to remember or to forget them. A test showed that the participants did indeed remember the words that they were supposed to forget less well than the words they were supposed to remember.

As they conducted the analysis, the researchers payed close attention to the synchronous rhythmic activity in the hippocampus and the prefrontal cortex. During active forgetting, oscillations in both areas of the brain showed characteristic changes in specific frequency bands. In the prefrontal cortex, oscillations between three and five Hertz were more pronounced, i.e. in the so-called theta range. They were coupled with increased oscillations at higher frequencies, namely between 6 and 18 Hertz, in the hippocampus.

The forgetting frequency

“The data showed us that during active forgetting, the activity in the hippocampus, an important region for memory, is regulated by the prefrontal cortex,” explains Carina Oehrn, who was initially involved in the research project in Bochum and now works at the University Hospital in Marburg. “The activity in the hippocampus is not just suppressed; rather, it is switched to a different frequency, in which currently processed information is no longer encoded,” continues the neuroscientist.

Potential therapy approach for posttraumatic stress disorder

The team believes that research into voluntary forgetting might constitute the basis of potential new therapies of posttraumatic stress disorder, which causes patients to relive negative emotional memories again and again.

“The prefrontal cortex, i.e. the brain region that exerts active control over memory processes, may be activated for therapy purposes through non-invasive magnetic or electrical stimulation,” as Oehrn outlines an initial idea. “Still, the benefits of this treatment will have to be tested in future studies.”

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Smiling doesn’t necessarily mean you’re happy

Smiling does not necessarily indicate that we are happy, according to new research at Brighton and Sussex Medical School (BSMS).

It is widely believed that smiling means a person is happy, and it usually occurs when they are engaging with another person or group of people. However, a new study led by body language expert Dr Harry Witchel, Discipline Leader in Physiology at BSMS, shows this is not always the case.

Dr Witchel claims that the way people often behave during one-to-one Human-Computer-Interaction (HCI) is as if they were socially engaged.

His research involved asking 44 participants aged 18-35 to play a geography quiz game consisting of nine difficult questions so that they often got the answer wrong.

Seated participants interacted with a computer alone in a room while their faces were video recorded.

After the quiz, the participants were asked to rate their subjective experience using a range of 12 emotions including ‘bored’, ‘interested’ and ‘frustrated’.

Meanwhile, their spontaneous facial expressions were then computer analysed frame by frame in order to judge how much they were smiling based on a scale of between 0 to 1.

Dr Witchel said: “According to some researchers, a genuine smile reflects the inner state of cheerfulness or amusement.

“However, Behavioural Ecology Theory suggests that all smiles are tools used in social interactions; that theory claims that cheerfulness is neither necessary nor sufficient for smiling.

“Our study showed that in these Human-Computer Interaction experiments, smiling is not driven by happiness; it is associated with subjective engagement, which acts like a social fuel for smiling, even when socialising with a computer on your own.”

Statistically, the emotion that was most associated with smiling was ‘engagement’ rather than ‘happiness’ or ‘frustration’.

The frame by frame smile analysis broke down each of the nine questions into a question and answer period.

Participants did not tend to smile during the period when they were trying to figure out the answers.

However, they did smile right after the computer game informed them if their answer was correct or wrong, and surprisingly, participants smiled more often when they got the answer wrong.

Dr Witchel added: “During these computerised quizzes, smiling was radically enhanced just after answering questions incorrectly. This behaviour could be explained by self-ratings of engagement, rather than by ratings of happiness or frustration.”

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National survey shows ocean and coastal recreation is big business

A new report by social scientists at NOAA Fisheries reveals that viewing or photographing the ocean was the top activity for ocean lovers in the U.S. in number of participants, days spent, and how much people paid to do it.

The recently released report provides results from the National Ocean Recreation Expenditure Survey, the first of its kind for NOAA. Responses to the survey indicate that in 2012, the baseline year chosen by researchers, nearly 49 million adults over 18 years of age nationwide participated in ocean and coastal recreation, spending more than 1.2 billion days along the coasts and spending over $141 billion in ocean recreation-related goods and services. That spending supported more than 3.1 million full and part-time jobs, $409 billion in income to businesses, and $135 billion to household incomes.

First NOAA Survey of its Kind

“This is the first national survey undertaken by NOAA Fisheries to estimate participation levels and the numbers of days people spent enjoying a broad range of ocean and coastal recreation activities,” said co-author Scott Steinback, an economist in the Social Sciences Branch at the Northeast Fisheries Science Center laboratory in Woods Hole, Mass. “Nothing of this magnitude had been attempted before, so it took a long time to collect the data, analyze it, and pull it together into a comprehensive report.”

The wide-ranging survey was conducted in 2012 and 2013. Focus groups, one-on-one interviews, and other techniques were used to test the survey design before the main survey period began in March 2012. Every two months for a year, survey respondents were asked details about their ocean-related activities in the previous two months to account for seasonal activities. That way data could be collected when changes in weather and temperatures influenced when people were most likely to be participating in various ocean and coastal recreation activities.

Includes Households in All 50 States, DC

Households in all fifty states and the District of Columbia were included in the online survey, which focused on eight categories of activities: recreational fishing; recreational shellfishing; hunting waterfowl or other animals; viewing or photographing the ocean; beachcombing, tidepooling or collecting items; water contact sports; boating and associated activities; and outdoor activities not involving water contact.

Six regions in the U.S. were defined for sampling: Pacific, New England, Mid-Atlantic, South Atlantic, Gulf of Mexico and Inland. Since the survey focused on ocean and coastal-recreation activities, any activities that occurred on the Great Lakes and other inland lakes, reservoirs, rivers and streams were excluded. The shoreline of the United States spans roughly 88,633 miles excluding the Great Lakes.

Pacific Largest Share, New England Smallest

The Pacific region, with 48 percent of the U.S. ocean shoreline, had the largest number of participants, days involved, and ocean recreation-related spending. Nearly 14 million participants spent 382 million days engaged in an ocean activity and spent over $39 billion on durable and trip-related goods and services. The Mid-Atlantic region, with 12 percent of the nation’s ocean coastline, was second in the number of ocean recreation participants, with over 10 million people enjoying the region’s coastline.

The New England region had the smallest regional share with 5.6 million ocean recreation participants spending 135 million days and $11 billion along New England’s coast, which is about 7 percent of the U.S. ocean shoreline.

Survey Based on Experience

A link to the questionnaire was sent to a sample of households who participated on a web-enabled research panel maintained by GfK Group, formerly Knowledge Networks. This panel is designed to be statistically representative of the U.S. population and panel members are recruited through probability-based sampling methods (i.e., address-based sampling). To ensure the participation of households of varying income and technology fluency, GfK Group provided internet and computer equipment, as well as technical support as needed. Spanish-speaking households are also included on this panel and were sampled for this study.

“NOAA Fisheries has been doing surveys since 1994 with recreational anglers, so we built upon the experience gained from those, plus other recreational fishing expenditure studies that NOAA Fisheries continues to conduct,” Steinback said. “In addition to baseline information on participation and effort, or the time spent in that activity, we collected data on spending related to each category. That included the cost of boats and their maintenance, insurance, fishing rods, binoculars, and other items to purchases of food, beverages, lodging, paying visitor fees, and other costs of ocean recreation trips.”

Contributions to National, Regional Economies

Steinback and coauthor Rosemary Kosaka from the NOAA Fisheries Southwest Fisheries Science Center laboratory in Santa Cruz, CA used models to estimate the total economic contributions of a person’s expenditures.

“This study is an important contribution to our understanding of how a wide range of ocean and coastal activities contributes to our national and regional economies,” said Kosaka. “It is the first study to estimate participation and effort levels, and the economic contribution of these activities, using data collected from ocean recreation participants from all 50 states and the District of Columbia — not just coastal states. If someone in Ohio made a trip to the Jersey shore to hang out at the beach and they participated in our survey, their activities would be included in our estimates. We can now start to put that activity in context with other ocean and coastal activities.”

Bravery cells found in the hippocampus

Why do some people comfortably walk between skyscrapers on a high-wire or raft the Niagara Falls in a wooden barrel whereas others freeze on the mere thought of climbing off escalators in a shopping mall? In a new study, scientists have found that a certain type of cells in the hippocampus play a key role.

People are very different when it comes to trying dangerous or exhilarating things. Even siblings can show dramatic differences in risk-taking behaviour. The neural mechanisms that drive risk-taking behaviour are largely unknown. However, scientists from the Department of Neuroscience of Uppsala University in Sweden and the Brain Institute of the Federal University of Rio Grande do Norte in Brazil have found that some cells in the hippocampus play a key role in risk taking behaviour and anxiety.

In an article published in the journal Nature Communications the authors show that neurons known as OLM cells, when stimulated, produce a brain rhythm that is present when animals feel safe in a threatening environment (for example, when they are hiding from a predator but aware of the predator’s proximity). The study, produced by Drs. Sanja Mikulovic, Ernesto Restrepo, Klas Kullander and Richardson Leao among others, showed that anxiety and risk-taking behaviour can be controlled by the manipulation of OLM cells. To find a pathway that quickly and robustly modulates risk-taking behaviour is very important for treatment of pathological anxiety since reduced risk-taking behaviour is a trait in people with high anxiety levels.

Adaptive (or normal) anxiety is essential for survival because it protects us from harm. Unfortunately, in a large number of people, anxiety can be dysfunctional and severely interfere with daily life. In these cases, doctors often rely on antidepressants to help patients recover from the dysfunctional state. However, these drugs act in the entire brain and not only in the areas where it is needed and may therefore have severe side-effects. Thus, to act in a single brain region and in a very specific group of cells to control anxiety may be a major breakthrough in treating anxiety and associated disorders like depression. Another interesting finding in the study is that OLM cells can also be controlled by pharmacological agents. In the past, the same group of scientists have found that OLM cells were the ‘gatekeepers’ of memories in the hippocampus and that these cells were very sensitive to nicotine.

‘This finding may explain why people binge-smoke when they are anxious’, says Dr. Richardson Leao, researcher at the Brain Institute of the Federal University of Rio Grande do Norte.

The participation of the hippocampus in emotions is much less studied than its role in memory and cognition. In 2014, for example, the Nobel prize was awarded for the discovery of “place cells” that represent a biological GPS and underlie the memories of where we are located in our surroundings. In the past decade, scientists have started to appreciate the role of the hippocampus also in regulating emotions.

‘It is fascinating how different regions of the same brain structure control distinct behaviours and how they interact with each other. Identifying specific circuits that underlie either cognitive or emotional processes is crucial for the general understanding of brain function and for more specific drug development to treat disorders’, says Dr. Sanja Mikulovic, Uppsala University.

The discovery of these neurons and their role in anxiety and risk-taking may open a path for the development of highly efficient anxiolytics and antidepressants without common side-effects, such as apathy.

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Pregnant women can safely control weight gain through diet and lifestyle changes

Many overweight and obese women gain too much weight during pregnancy, further ratcheting up their already-increased risk of serious complications for themselves and their babies.

A new group of trials funded by the National Institutes of Health (NIH) showed that pregnant women can safely limit their weight gain with diet and exercise interventions. It is the largest set of trials in the U.S. to target pregnancy weight gain of overweight and obese women. The trials included diverse socioeconomic groups, which means the findings are generalizable to a large population.

“This is an important study because it affirms that women can change behaviors to control the amount of weight gained in pregnancy,” said lead author Dr. Alan Peaceman, chief of maternal fetal medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine high-risk obstetrician.

However, the reduced weight gain — about four pounds per woman — did not result in fewer obstetrical complications, including cesarean sections, diabetes, hypertension, and preeclampsia, or change the average birth weight of the baby.

“We think that by the time these women are already in the second trimester, it may already be late to change important outcomes,” Peaceman said. “To lower the risk of obstetrical complications, they may have to start changing their lifestyle before or immediately after they conceive.”

Investigators are hopeful that there will be longer-term benefits of the interventions in the infants, such as less childhood obesity or fewer metabolic abnormalities such as childhood diabetes.

The study was published Sept. 6 in the journal Obesity.

Seven teams of investigators recruited 1,150 participants for the LIFE-Mom trials (579 women had the lifestyle intervention, 571 had standard care), which ran from the second trimester to birth. Each trial offered a varied lifestyle intervention, but all aimed to improve diet quality and reduce calories, increase physical activity and incorporate behavior strategies such as self-monitoring.

Overweight and obese women are “hard nut to crack”

Overweight and obese women are a critical group to target, because they have higher rates of excess pregnancy weight gain and of retaining that weight postpartum. They also are more likely to have children who are obese. The majority of U.S. women of reproductive age are overweight or obese.

About 62 percent of the women in the intervention groups, versus 75 percent in the control groups, exceeded the National Academy of Medicine recommendations for pregnancy weight gain. The recommendation is overweight women limit their pregnancy weight gain to 15 to 25 pounds and obese women to 11 to 20 pounds, compared to 25 to 35 pounds for non-overweight women.

The fact that so many women in the intervention groups still exceeded the recommended weight gain shows the challenges of encouraging pregnant women to adhere to recommended diet and activity levels at a time when overeating and reluctance to exercise tend to increase, Peaceman said.

“It’s a very hard nut to crack,” he said.

A seesaw history of pregnancy weight gain

The advice doctors gave women about pregnancy weight gain has varied widely from decade to decade. In the 1950s, doctors often instructed their patients not to gain more than 15 pounds, Peaceman said.

By the late 1970s and early 1980s, mothers weren’t gaining enough weight and were having small babies, which could lead to developmental problems in childhood. Then doctors started encouraging women to gain more weight.

“Doctors essentially told them that they could eat for two,” Peaceman said.

“Then women started gaining excessively, but it wasn’t thought to be a medical issue, just a cosmetic one,” Peaceman said. “The attitude was, ‘there’s more weight for you to lose when you’re done, but that is not a major medical concern’.”

In the early 2000s, physicians started noticing that excessive pregnancy weight gain was associated with certain pregnancy complications: higher incidence of high blood pressure, gestational diabetes and cesarean sections.

“Then we started seeing more worrisome things,” Peaceman said. “Excess maternal weight gain was not just associated with bigger babies, but those babies ended up with an increased risk of obesity and childhood diabetes.”

A few researchers began investigating whether they could help women avoid excess weight gain during pregnancy. Trials testing different strategies for limiting pregnancy weight gain in overweight and obese women had mixed results, in part due to different populations studied and the lack of standardized clinical outcome measures.

“That’s why NIH recognized the need to do this study in diverse populations and with standardized clinical outcome measures,” Peaceman said. “It provides more reliable evidence.”

The clinical trials were conducted at Northwestern Medicine, California Polytechnic State University and Brown University, St. Luke’s-Roosevelt Hospital and Columbia University, University of Puerto Rico, Washington University in St. Louis, Louisiana State University-Pennington Biomedical Research Center and the Phoenix Indian Medical Center/National Institute of Diabetes and Digestive and Kidney Diseases-Phoenix.

Linda Van Horn, a professor of preventive medicine at Feinberg, was a coauthor on the study.

The LIFE-Moms study was funded by the National Institutes of Health through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK; U01 DK094418, U01 DK094463, U01 DK094416, 5U01 DK094466 [RCU]); the National Heart, Lung, and Blood Institute (NHLBI; U01 HL114344, U01 HL114377); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (U01 HD072834). Additional support was received from the NIDDK Obesity Nutrition Research Centers (P30 DK026687, P30 DK072476, P30 DK56341), the National Center for Advancing Translational Sciences Clinical and Translational Science Awards (U54 GM104940, U54 MD007587, UL1 RR024992), the National Institute on Minority Health and Health Disparities (S21MD001830) and EXODIAB-Excellence in Diabetes Research in Sweden.

‘Good Bones’ Star Mina Starsiak Says Breastfeeding Directly Was ‘Not in the Cards’

Breastfeeding is one of those weird things that’s easy for some people and incredibly difficult for others. For Mina Starsiak, star of HGTV’s Good Bones, it’s been far from simple, as she recently revealed on Instagram.

“My mornings…. and afternoons and evenings,” she captioned a shot of herself pumping while feeding her son Jack with a bottle. “There are sooo many ways I’m figuring out to take care of your babe the best way you can for yourself and them, and although I wanted to exclusively breastfeed directly, that’s not in the cards for us. So, this is how we roll.”

Starsiak doesn’t mention having any specific issues that led to her indirect breastfeeding, but there are a few reasons why moms might do this.

Breastfeeding indirectly means that, rather than feeding your baby directly from your breast, you pump milk from your breasts and feed it to your baby using a bottle, Gina Posner, M.D., a pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., tells SELF. (It’s also referred to as using expressed breast milk or EBM, DeeAnne Jackson, M.D., a pediatrician at The University of Alabama at Birmingham, tells SELF.)

There are a few reasons why people may need to do this. For instance, you might have inverted nipples, which is when your nipples are pulled in toward the breast. That can make it hard for a baby to latch onto the breast and nurse, Dr. Posner says. “Sometimes using a nipple shield, which rests over the mom’s breast, can help,” she says. “But sometimes moms will pump instead.”

Indirect breastfeeding may also come in handy if a baby is in the neonatal intensive care unit (NICU) after birth or requires hospitalization, Diane L. Spatz, Ph.D., a professor of perinatal nursing at the University of Pennsylvania and nurse researcher at the Children’s Hospital of Philadelphia, tells SELF. Some of those babies need to be fed through a feeding tube that goes into their stomach, so their parent may need to pump in advance, she explains. Babies who are born premature are more likely to have an insufficient sucking reflex so they may not be able to nurse directly as well, Katie Reel, certified lactation consultant, Northwestern Medicine Delnor Hospital, tells SELF.

Some babies just have a hard time latching onto the breast, Spatz says. “If this is the case, the most important thing is making milk.” And, in other cases, some moms simply choose to do this, Dr. Jackson says.

The first few hours and days after a baby is born are critical to establishing your milk supply. So if your baby can’t nurse directly within the first hour after being born, you should pump—and keep doing it often if direct nursing continues to be a problem, Spatz says. You’ll need to pump “early and often,” Spatz says, with a goal of pumping every two to three hours, amounting to at least eight pumping sessions every 24 hours.

Indirect breastfeeding is a perfectly fine option if you can’t nurse your baby directly.

Of course, the most important thing is that your baby is fed, whether that’s via direct breastfeeding, indirect breastfeeding, or formula. If possible, experts generally recommend breastfeeding as the first choice. And, technically, indirect breastfeeding is still breastfeeding—and your baby should still get the benefits, Dr. Posner says.

Still, if you can nurse your baby directly, that’s still the best route because it’ll make your life easier, too, Dr. Jackson says. “Babies feed on demand and imitating that with a pump is a little more difficult,” she says.

If you’re having trouble nursing your baby, it’s important to flag the issue immediately, Dr. Posner says. That may mean talking to the nurses at the hospital, your child’s pediatrician, or a lactation consultant. “The first day, the first hour, the first four days, and first one to two weeks are critical [when it comes to establishing your] milk supply,” Spatz says. “Moms should have a sense of urgency about getting help right away.”

If you plan or need to go this route, there are a few things to keep in mind.

First off, you’ll want a good pump—preferably something “hospital grade,” Spatz says. And, again, you should pump every two to three hours around the clock to establish and maintain your milk supply. “Always pump both breasts at the same time,” Spatz recommends, adding that it’s a good idea to get a hands-free bra so you can multitask while you pump.

But know that if you try this out and it’s stressing you out or just not working for whatever reason, it’s perfectly OK to go the formula route. “The best thing is a fed baby,” Dr. Posner says. “If you have to choose between pumping and formula, definitely choose the breast milk. But formula is also a great alternative.”

If you’re pregnant and concerned about your ability to nurse or feel like you just don’t really know what you’re doing (understandable), you can actually set up a prenatal visit with a lactation consultant who can run over the basics with you, as well as do an assessment, Reel says. So, if you have inverted nipples, for example, they may be able to flag it and help come up with a game plan early on.


What Even is Alkaline Water and Is It Really Better Than Regular Water?

Every week in my work as a dietitian I hear about a new diet, product (like alkaline water), or supplement from my patients that has sent me to PubMed to fact-check the details. Combing through this information can be difficult for me as a health professional, not to mention overwhelming for someone who doesn’t have a background in health or nutrition. We live in a time when we have more access to health and nutrition information than ever before. Yet, paradoxically, there seems to be even more confusion about health and nutrition than there has been in the past. Having spent a good portion of my career working with cancer patients, I have been asked about cancer cure alls and products that make flashy claims. My goal is to sort through the information to provide others with evidence based information that may be useful for others.

You probably already know this, but water is good for you. Like, really good for you. Like there’s-no-substance-more-important-to-our-bodies good for you. But did you also know that there’s a drink on the market that proponents say is even better for you than water? A drink that (allegedly) will make you healthier and more hydrated and comes with a host of other health benefits? This supposed miracle liquid is alkaline water.

You can get bottles of it at the grocery store or you can buy an ionizing device (for anywhere from a few hundred to a couple thousand dollars) to alkanize tap water from the comfort of your own home. So, what’s the deal—is there really a water out there even better for us than, well, water?

So, what even is alkaline water?

For starters, let’s talk about pH. A substance’s pH (potential hydrogen) is the measure of the hydrogen ion concentration within it. The pH scale ranges from 0 to 14, and is based around the hydrogen ion concentration of pure water, which is neutral—a pH of 7. A pH below 7 is considered acidic and above a 7 pH is referred to as basic. The more hydrogen ions present, the more acidic the solution will be, and the lower the pH. Conversely, lower hydrogen concentration means a solution is more basic and therefore it has a higher pH.

Now, the term “alkaline” gets used interchangeably with “basic” but they’re not exactly the same. Alkaline compounds are things—salts, metals—that, when added to water, make it more basic. That’s what people are talking about when they talk about “alkaline water.”

Water always contains some amount of dissolved solids (inorganic salts like calcium, magnesium, potassium, and sodium, for example), which influences its pH. According to Nicole M. Hancock, executive director of the Safe Drinking Water Foundation, the higher the total dissolved solids, the more alkaline the water tends to be. The pH of tap water is close to 7, while water with more alkaline compounds in it typically has a pH of 8 or 9.

The idea that alkaline water is medicinal, curative, and able to bring about optimal health seems to be based on the belief that acidic properties in the body and blood are the cause of ill health and disease, and need to be neutralized. Therefore, a more alkaline body will lead to better health.

Is it even possible to “optimize” the body’s alkalinity?

According to Stephen Lower, Ph.D. professor emeritus of chemistry at Simon Fraser University in Vancouver, Canada, there’s really no such thing as “the body’s pH” in the first place. “A wide range of pH values, from highly acidic to moderately alkaline, can be found in different parts of the body, and even in different regions of a single cell,” he says.

Every organ in the body has a different pH range needed for the organ to function, so pH values vary greatly within the body. For example, gastric fluids as well as vaginal fluids are highly acidic because they break down proteins and limit growth of microbes respectively.

Our blood on the other hand has a specific and stable pH that is always between 7.35 and 7.45, explains Charles Mueller, Ph.D., R.D.N., C.D.N., C.N.S.C., clinical assistant professor of clinical nutrition at New York University. If that number gets too low, the risk of coma, heart failure, multi-system organ failure, and death increase. Because of this, our bodies are specifically designed to make it so that, if everything is functioning as it should be, our blood pH can’t fluctuate too much. In fact, thanks to the body’s various buffering systems, what we consume “by and large has nothing to do with” our blood’s pH, says Mueller.

According to Adam Ramin, M.D., urologist and medical director of Urology Cancer Specialists in Los Angeles, agrees. “There is absolutely no need to tamper with this well functioning system in our bodies by drinking water that is alkaline,” he writes to SELF. Dr. Ramin explains that the kidneys are primarily responsible for maintaining proper levels of acidity in the bloodstream. And that as long as we have healthy kidneys, “the delicate balance of pH in our blood stream is kept intact.” David Gorski, M.D., Ph.D., F.A.C.S., a cancer surgeon and researcher, professor of surgery at Wayne State University School of Medicine, and managing editor of the website Science-Based Medicine agrees, saying that when it comes to changing the pH of the blood, “it’s difficult because the body’s buffering mechanisms through the kidneys and lungs are very good at maintaining the blood pH within a narrow range.”

That said, there are certain conditions that can lead to a rapid, dangerous rise in acidity in the bloodstream. “Severe infection known as sepsis, laxative abuse, uncontrolled diabetes, physical muscle trauma, kidney failure, massive blood loss, and respiratory failure are some conditions that lead to pathologically high levels of acidity in the blood stream…,” he says. Of course, in patients with kidney failure or other life-threatening conditions that cause high acidity in the blood, “drinking alkaline water amounts to trying to fight a forest fire with a garden hose.” While these patients need urgent medical attention to reduce the acidity of their bloodstream, alkaline water is not nearly strong enough to do the job. “These patients will need to undergo intravenous infusion of alkaline solutions directly into their bloodstream, undergo dialysis, and [receive] treatment of the underlying cause.“

So, then what does happen if you drink alkaline water?

Besides the fact that our bodies have various systems that keep our blood pH regulated, our gastrointestinal tract in particular was basically made to cope with foods and liquids that run the gamut of the pH scale. In fact, by the time something we’ve consumed hits our bloodstream or exits our body, its pH has already been altered several times.

For example, Dr. Ramin explains that the pH of fluids in our stomach is very low—between 1.5 and 3.5. This fluid is highly acidic so that it can dissolve the toughest foods we eat. “Therefore, when one ingests alkaline water, this water mixes with the highly acidic gastric juice.” The result? Most, if not all of the alkalinity of alkaline water will be neutralized in the stomach. What’s more, explains Mueller, is that food and liquid we consume moves very quickly from the stomach to the duodenum (the part of the small intestine that immediately follows the stomach), which squirts bicarbonate, neutralizing the acidic contents. This is one of the body’s built-in acid buffering systems. So, by the time the water is absorbed from the GI tract into the bloodstream, it has become neutralized as normal pH water, and is no longer alkaline or acidic. And beyond that, “Even if the extra alkaline found in ‘alkaline water’ was to make it into our bloodstream, it will simply be filtered by our kidneys and excreted in the urine,” he says. As you can tell, even if we wanted to influence our blood pH, we really can’t. Our body is doing that for us.

What does the research say about alkaline water?

The most common claims about alkaline water are that it can reduce acid reflux, improve hydration, and prevent cancer. Looking at the literature on reflux, you’ll find a handful of studies. In 2012, a lab study showed that water with a pH of 8.8 neutralized pepsin, the enzyme that causes damage to the esophagus in people with acid reflux. The study authors said that while their findings suggested that alkaline water could have therapeutic effects for acid reflux, more systematic studies with actual heartburn patients are needed. When asked about this study, Gorski said, “It is lab work that might suggest benefit, but without showing an actual benefit in humans it’s hard to get too excited.” Two other studies have since followed and both recommend further scientific study.

A 2017 study looking at alternative methods for treating acid reflux symptoms found a correlation between the methods tested (alkaline water and the Mediterranean diet) and reducing symptoms, but the authors report that the clinical significance in differences requires further study. Another 2018 retrospective study investigated those who drank alkaline water, consumed a low-acid, low-fat diet, and made behavioral changes, versus another group who took medication and made behavioral modifications. The researchers concluded that the anti-reflux protocol that included alkaline water (along with the dietary and behavioral changes) “compared favorably with medication and behavioral modification alone” and that while this protocol had potential to be “powerful” in the effort to reduce longterm, widespread use of certain anti-reflux medications, further study is required.

When it comes to hydration, the evidence is limited. A small 2016 study looked at alkaline water compared to regular water to see if one improved hydration better or more than the other. Hydration was measured using four biomarkers in 100 adults who exercised until they were dehydrated. The researchers found that those who drank the alkaline water had reduced systolic blood viscosity, which indicates better hydration, but, as Mueller points out, there was no significant difference demonstrated between alkaline and regular water when it came to other biomarkers that indicate hydration status. A 2017 study that had 36 participants concluded that “preliminary data demonstrated that consumption of alkaline water can improve anaerobic performance and post-exercise recovery.”

Mueller is skeptical about the possibility that alkaline water is exceptionally hydrating. For one thing, he explains (and most experts agree) that drinking regular old water when thirsty will keep healthy adults sufficiently hydrated. If the chances for become dehydrated increase because, for example, you’re working out in the extreme heat and humidity, or are a heavy sweater, a fluid that contains electrolytes might be necessary. In this case, a drink like Pedialyte or a homemade oral rehydration solution (ORS) made of water, salt, and sugar would do the trick. As the CDC explains, when dehydration becomes severe (from diarrhea, for example), the appropriate protocol is to administer ORS using the formula they provide. So far, neither research nor recommendations indicate alkaline water over regular water.

And finally, looking at the cancer research, the only systematic review of alkaline water for cancer treatment found there is almost no actual research to either support or disprove its use. No randomized trials exist and promotion of it is not justified for prevention to the public. According to Lower, “The statement made by many promoters of alkaline water that cancer cells thrive under acidic conditions is extremely misleading. It’s really the other way around: cancer cells tend to produce acidity because their more primitive nature causes them to metabolize anaerobically, and often because they typically have an inadequate blood supply.”

Basically, alkaline water has yet to be shown to benefit general health.

The evidence to disprove alkaline water claims are sparse, but evidence to strongly support claims are also greatly lacking in scientific evidence. This leaves us with bottled water whose benefits are not backed with enough evidence to justify their cost. It’s possible there may be hints of some benefits for some people under certain circumstances, but nothing is conclusive.

When you hear many wellness claims it can be quite frustrating to feel like you have to spend more money to stay healthy. Often good nutrition isn’t as complicated as many people may make you feel. When it comes to hydration and well-being, experts agree that plain old tap water is just fine. We also know that eating enough fruits and veggies will have a major impact on overall health. But eating fruits, veggies, and drinking tap water just often seems too simple. If you drink alkaline water because it makes you feel good or you like the taste of it, then it may make you drink more water and stay better hydrated. If this is the case then it could have a major impact on your well-being. But the same could be true for any form of water you choose.

Danielle Penick, M.S., R.D., C.N.S.C., L.D.N., is a registered dietitian in the Phoenix Valley in Arizona and writes for the cancer nutrition blog Survivors’ Table. You can follow her page on Facebook for regular updates.

Kate Hudson Shows Off Her ‘Outie’ Pregnancy Belly Button

Kate Hudson is currently pregnant with her third baby and has been sharing photos of her growing belly on Instagram since announcing her pregnancy earlier this year. The latest addition is a post debuting the new shape of her belly button. Yes, her belly button.

In the cute pic, Hudson is draped in an orange robe with her very pregnant tummy front and center. Her formerly innie belly button is popped out. “#Outie,” she captioned the photo, followed by an emoji of a pregnant lady and a smiley face.

While Hudson’s Hollywood status does set her apart from some moms-to-be, her suddenly outie belly button isn’t so rare.

“It’s very common and completely normal” for a woman’s belly button to become an outie during pregnancy, Christine Greves, M.D., a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies, previously told SELF.

“When a woman is pregnant, the uterus gets bigger, and it has to go somewhere, so the fascia in our abdomen stretches,” Dr. Greves says. And because the belly button tissue is already a little weaker, “it’s going to stretch out even more so.” The pressure of the expanding uterus can push the belly button outward. “It’s like if you have a pair of jeans with a hole on them and you patch it up,” Dr. Greves explains. “Then if you put tons of weight or force there, that patch is more likely to open up [than another place].”

According to Dr. Greves, it usually happens in the second or third trimester—which is right where Hudson appears to be. The actor announced that she was expecting a child with boyfriend Danny Fujikawa this past April with a sweet video on Instagram.


Take Your Kettlebell Squats to the Next Level With This Small Tweak From Blake Lively’s Trainer

Squats are hard. Weighted squats are harder. And weighted squats with a kettlebell in the rack position—which means resting the weight in front of your body at shoulder-level versus holding it down at your side—can be an even greater challenge.

This was the subject of an Instagram video posted on Tuesday by Don Saladino, celebrity trainer and co-founder of NYC-based Drive495 gym whose clients have included Blake Lively, Ryan Reynolds, and Hugh Jackman, among others. In the video, Saladino demos a move he dubs “single-arm rack squats” with an explanation of why the rack positioning, which in general mimics how you’d position yourself if you were holding an actual barbell in front of you, can seriously up your squat game.

“I love squatting in the rack position because it allows you to squat with much more ease,” Saladino writes in the caption. “It also destroys the abs and core.”

You can check out the video, via @donsaladino, here:

As Saladino mentioned, there are several reasons that this specific body positioning can be beneficial.

For starters, the rack position can make squatting with kettlebells easier.

If you have mobility issues when squatting, adding weight in front of your body can displace some of your own bodyweight and allow you to squat with more ease, Mark DiSalvo, NYC-based certified strength and conditioning specialist, tells SELF.

What’s more, the ideal body positioning for a rack squat involves a wider-than-normal stance and your toes angled slightly outward, rather than pointing them straight forward, as you would in a traditional squat, Stephanie Mansour, Chicago-based certified personal trainer, tells SELF. Positioning your body in this way, which helps protect your knees and back as you add weight onto your squat, can help you squat to greater depth than you would reach in a standard squat position.

It also targets your core in a different and more intense way than the standard squat.

The placement of the kettlebell—in front of your body, versus in line with or behind it—acts as a force pulling you forward, says DiSalvo. To prevent this force from “pulling you forward onto your face,” you need to engage your core muscles even more, he explains. “It’s a little bit like a reverse crunch.”

On top of that, because Saladino’s move is performed with a weight in just one hand (versus both), it’s an asymmetrical movement that requires strength in your obliques (the muscles on the sides of your stomach), as well as your transverse abdominis (the deepest ab muscle that wraps around your sides and spine) and rectus abdominis (what you think of when you think abs), to keep you upright, says Mansour. For that reason, “it’s a complete exercise for your core,” says DiSalvo.

Lastly, the move can help promote good posture.

As mentioned, holding the weight in the rack position will naturally pull your body forward. In addition to the core strength required to stay upright, you’ll also need to retract your shoulders to keep your upper body in the correct position, explains DiSalvo. This type of shoulder retraction is an important component of good posture, so doing single-arm rack squats can improve your ability to achieve and maintain good posture.

Here’s how to do Saladino’s single-arm rack squats:

  • Grab a light kettlebell (3 to 5 pounds in a good place to start, says Mansour) and place it on the ground in front of you. Stand with your feet wider than hip-width apart with your toes pointed out about 30 degrees.
  • Bend your knees and grab the kettlebell with both hands. Press through your heels and squeeze your glutes to stand up.
  • Grip the kettlebell handle with your right hand to free up your left hand. Put your left hand in a “high five” position with your thumb sticking out.
  • Next, hook your left thumb around the middle of the handle and curl your fingers over the top. Use your right hand to support the base of the kettlebell and flip it so that the handle is facing into your chest and the base is pointing out to the left. When you feel comfortable in this position, remove your right hand so that the kettlebell is supported by just your left hand. The base of the kettlebell will rest on the front of your left shoulder. (Saladino performs a more advanced movement known as the “kettlebell swing clean” to get to this positioning. If you’re not yet versed in this technique, follow the cues above.)
  • When gripping the kettlebell, make sure your elbow is under the kettlebell (not flared out to the side) and your wrist is straight (not bent backward), says DiSalvo. Engage your upper back muscles and retract your shoulder blades. This is the starting position.
  • Bend your knees and hinge forward at the waist as you press your glutes and hips back to lower yourself down into a squat, keeping the kettlebell fixed in position, your chest up, and your spine straight.
  • Go as low as you can (stopping when your quads are parallel to the floor) while still following all the cues above.
  • Once you’ve reached the bottom of the movement, drive down through your heels to push yourself back up to standing.
  • Squeeze your glutes at the top of the movement. This is 1 rep.
  • Do 10 reps. Switch the weight to your other side and do another 10 reps.

As you move through the reps, pay attention to your knees and don’t let them cave in. If your lower back starts to hurt, think about squeezing your core to redirect the force, says Mansour. Keep your gaze fixed a few feet in front of you.

Also know this: While Saladino makes the move appear easy, “it’s more challenging than it looks to stay balanced with an offset load,” says Mansour. If you’re struggling to stay balanced, lighten up your weight—or grab another weight and perform the squats with a weight in each hand. Though you’re technically working with more total weight now, the exercise will actually feel easier when you eliminate the asymmetrical element. You may also want to regress to a bodyweight version of the move, says Mansour. It’s a good idea to master the standard squat before loading it up with any of these weighted progressions, adds DiSalvo. (And as always, it’s always smart to check with your doctor before trying a new exercise, especially if you’re concerned about whether it’s safe for you to do.)

Lastly, no matter what version of the move you attempt, keep in mind that “slow, quality reps” are more important than number of reps, says Mansour. “It’s not cardio,” she explains, but rather total-body strengthening. Take your time.