Oldest Americans most focused on reducing food waste

The vast majority of Americans are paying attention to reducing food waste with the oldest being the most cognizant, according to the latest Michigan State University (MSU) Food Literacy and Engagement Poll.

The fourth wave of this poll, conducted Jan. 15-21, 2019, surveyed 2,090 Americans on their attitudes and knowledge of food issues. The results were released today at the American Association for the Advancement of Science Annual Meeting.

The majority of all Americans (88 percent) say they take steps to reduce food waste at home. This includes 94 percent of consumers age 55 and older and 81 percent of those under 30 years old.

Among respondents who make efforts to reduce food waste:

  • Seventy-one percent said they try not to purchase excess food.
  • Seventy-one percent said they often consume food before it spoils.
  • Thirty-four percent share excess food when possible.

Of the 12 percent of Americans who say they do not take steps to reduce food waste at home:

  • Thirty-one percent say they do not waste food.
  • Twenty-three percent are not familiar with the term “food waste.”
  • Twenty-one percent do not know how to reduce food waste.
  • Twenty percent are not concerned about it.
  • Eighteen percent do not have the time.

This fourth wave of the survey revealed that 41 percent of Americans correctly recognize that 31-50 percent of the food annually produced in the United States goes to waste, including 44 percent of those age 55 and older and 36 percent of those under 30 years old.

“Older Americans pay the closest attention to limiting food waste compared to their peers,” said Sheril Kirshenbaum, co-director of the MSU Food Literacy and Engagement Poll. “Previous waves of the survey have revealed this group also performs best on general food literacy questions.”

Additional survey highlights include:

  • Forty-eight percent of Americans say they never, rarely, or aren’t sure how often they consume genetically modified organisms, often called GMOs.
  • Forty-nine percent say they never or rarely seek information about where their food was grown or how it was produced, with an additional 15 percent responding once a month.
  • Forty-one percent would be willing to buy a GMO-derived fruit or vegetable that stayed fresh longer than currently available produce.

“These findings continue to expand our insights into the attitudes and behaviors of consumers,” said poll co-director Doug Buhler, director of MSU AgBioResearch. “Given the challenges ahead in feeding more people while preserving our natural resources and protecting our climate, getting a handle on the causes and remedies of food waste is key to meeting global food demand. It takes months to produce food, but we can waste it in an instant.”

Data from the MSU Food Literacy and Engagement Poll were weighted using U.S. Census Bureau figures, to ensure the sample’s composition reflects the actual U.S. population. Launched in 2017, the poll was developed by Food@MSU and is supported by MSU AgBioResearch. The survey, conducted twice per year, is intended to provide an objective, authoritative look at consumer attitudes and perspectives on key food issues, and is designed to help inform national discussion, business planning and policy development.

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Materials provided by Michigan State University College of Agriculture & Natural Resources. Note: Content may be edited for style and length.

Effective self-control strategies involve much more than willpower

It’s mid-February, around the time that most people waver in their commitment to the resolutions they’ve made for the new year. Many of these resolutions — whether it’s to spend less time looking at screens, eat more vegetables, or save money for retirement — require us to forego a behavior we want to engage in for the one we think we should engage in. In a new report, leading researchers in behavioral science propose a new framework that outlines different types of self-control strategies and emphasizes that self-control entails more than sheer willpower to be effective.

The report comes at a time when environmental pressures and societal problems are making strategies for boosting self-control more important than ever, says Angela Duckworth, a University of Pennsylvania psychology professor and one of report’s authors.

“Temptations are arguably more readily available, more creatively engineered, and cheaper than any time in history,” Duckworth says. “Junk food gets tastier and cheaper every year. And then there’s video games, social media, the list goes on. In parallel, there are public policy issues such as obesity, educational underachievement, and undersaving that result, in part, from failures of self-control.”

Duckworth’s coauthors on the report — published in Psychological Science in the Public Interest, a journal of the Association for Psychological Science — are Katherine L. Milkman (The Wharton School of the University of Pennsylvania) and David Laibson (Harvard University). George Loewenstein (Carnegie Mellon University), a leading researcher in the science of decision making, is author of an accompanying commentary.

Based on their comprehensive review of available research, Duckworth, Milkman, and Laibson propose a framework that organizes evidence-based self-control strategies along two dimensions based on how the strategies are implemented and who is initiating them.

They observe that in some cases the best self-control strategy involves us changing the situation to create incentives or obstacles that help us exercise self-control, such as using apps that restrict our phone usage or keeping junk food out of the house. In other cases it’s more effective to change how we think about the situation — for example, by making an if-then plan to anticipate how we’ll deal with treats in the office — so that exercising self-control becomes more appealing or easier to accomplish.

Other strategies work better when someone else implements them for us. For example, our electricity company might use social norms to prompt a change in our thinking, showing us how our energy usage compares with that of our neighbors. And policymakers often use situational constraints to prompt behavior focused on the long-term. Examples range from incentives (e.g., tax rebates for eco-friendly building materials) to penalties (e.g., raising taxes on cigarettes and alcohol). Employers are increasingly using another type of situational constraint, defaults, to encourage employees to save for retirement; many are requiring people to opt out of an employer-provided retirement plan if they don’t want to participate.

The strategies, drawing from insights in psychological science and economics, can inform the efforts of policymakers, employers, healthcare professionals, educators, and other practitioners to address pressing issues that stem, at least in part, from failures in self-control, the authors write.

Identifying four types of self-control strategies that go beyond willpower sends an important message, Loewenstein writes in his commentary, given that people often believe willpower is sufficient despite its high failure rate. One of the reasons people tend to fail in their New Year’s resolutions is “naivety about the limitations of the brute-force approach and ignorance of the far more effective strategies enumerated in the review,” he writes.

But Loewsenstein notes some important caveats to keep in mind when interpreting the research, which the researchers also acknowledge in the report. Many studies have examined self-control strategies in small groups of participants over brief periods of time, which raises questions about whether they will remain effective if implemented at a broader scale and how long the effects will last.

Duckworth, Milkman, and Laibson hope that their review helps to integrate existing research on self-control from several disciplines into a comprehensive whole.

“There is an urgent need for a cumulative and applied science of self-control — one that incorporates insights from theoretical traditions in both psychological science and economics,” the resesarchers write. “We hope this review is a step in that direction.”

Seasonale: Is Breakthrough Bleeding More Common?

Is breakthrough bleeding more common with extended-cycle birth control pills, such as Seasonale and others?

Answer From Shannon K. Laughlin-Tommaso, M.D.

Breakthrough bleeding—meaning spotting or bleeding between periods—can occur with any birth control pill, especially during the first few months of use. However, breakthrough bleeding is more likely with continuous and extended-cycle regimens—such as Seasonale, Seasonique, and Quartette—than with the traditional 28-day schedule. Breakthrough bleeding can also occur when taking normal 28-day birth control pills in a continuous manner.

What causes breakthrough bleeding with oral contraceptives isn’t always clear. It may simply take time for your body to adjust to the hormones in the pill or for your uterus to transition to a thinner lining (endometrium). In addition, you’re more likely to experience breakthrough bleeding if you:

  • Miss a pill
  • Start a new medication, such as certain antibiotics, or take supplements, such as St. John’s wort, that may interfere with the contraceptive
  • Become ill with vomiting or diarrhea, which may impair absorption of the medication

Unpredictable bleeding resulting from the use of continuous or extended-cycle birth control pills usually decreases with time. In the meantime:

  • Continue taking the medication as directed. Breakthrough bleeding isn’t a sign that the pill isn’t working. If you stop taking it, you risk unplanned pregnancy.
  • Track breakthrough bleeding in a calendar or diary. Typically, careful tracking offers reassurance that breakthrough bleeding is decreasing.
  • Ask your doctor about taking a short pill-free break. If you’ve taken active pills for at least 21 days, your doctor may suggest that you stop for three days to allow bleeding that resembles a period and then take the pill again for at least 21 days.
  • If you smoke, ask your doctor to help you quit. Women who smoke are more likely to experience breakthrough bleeding than are women who don’t smoke.

If breakthrough bleeding becomes heavy or lasts more than seven days in a row, contact your doctor. He or she will consider other possible causes of breakthrough bleeding, such as an infection. Depending on the circumstances, your doctor may recommend an alternative method of contraception.

Updated: 2014-11-27

Publication Date: 2014-11-27

The Best Presidents’ Day 2019 Sales

Some typical long-weekend activities can be expected this Presidents’ Day 2019—sleeping in, binge-watching Netflix, ordering takeout. But one activity in particular is my absolute favorite: shopping. With the celebration of George Washington and Abraham Lincoln’s birthdays also comes major discounts offered by top brands and retailers like Stila, Sugarfina, and more. To help you get the most bang for your buck this holiday, we’ve combed through the best holiday markdowns that will leave your shopping bags full, and your wallet, too. Just when you thought a three-day weekend couldn’t get any better than an extra day off work.


Algenist: From February 15 through February 18, buy $100 worth of products on Algenist.com and receive free shipping, three complimentary samples, and $25 off on your next purchase.

Inked by Dani: From February 16 through February 18, get 25 percent off sitewide with the code “INKED25.”

Stila: From February 15 through February 18, take an extra 25 percent off sale items.

The Art of Shaving: From now through February 18, get $20 off when you spend $100 or more, and get $50 off when you spend $200 or more.

Virtue: From now through February 21, take 20 percent off sitewide, plus get free shipping with the code “BDAY20.”


Adrianna Papell: From February 16 through February 18, get 20 percent off sitewide.

Lilly Pulitzer: From February 15 through February 18, get an exclusive Lilly Pulitzer golf ball set with a purchase of $75 or more, a Lilly Pulitzer Seaspray Wrap with a purchase of $200 or more, or an exclusive set of Lilly Pulitzer towels with a purchase of $500 or more.

Old Navy: From now through February 18, score up to 50 percent off storewide and online.

Rachel Rachel Roy: From February 15 through February 18, get 40 to 60 percent off sale items.

True Religion: From now through February 20, enjoy $50 off select denim styles.

Universal Standard: From now through February 19, get a limited edition Foundation Mystery Box, comprised of three items, starting at $50.


Allswell: From now through February 20, get 15 percent off sitewide with the code “15FORALL.”

Coddle: From February 15 through midnight on February 18, get 20 percent off sitewide.

Design Within Reach: From February 15 through February 26, get 15 percent off all Knoll products and select seating and dining.

Dormify: From February 17 through February 18, score 25 percent off sitewide with the code “LONGWEEKEND.”

Lamps Plus: From now through February 25, get select items 50 percent off.

Lowe’s: From now through February 20, score up to 40 percent off select home improvement items in kitchen, bathroom, appliances, and more.

Minted: From now through February 18, enjoy 30 percent off “save the date” invites and a $50 credit towards a future wedding thank you card order with the code “ENGAGEDTY.”

Purple: Now through February 18, buy one Purple Plush Pillow and get a second one free, plus pick a free gift with the purchase of any mattress.

Sugarfina: Buy one, get one free on all Valentine’s Day cubes in-store. Plus, buy two cubes, get one free online (select items only) from February 15 through February 25.

7 Important Tips for Traveling While Sober and Having an Even Better Time

When I first quit drinking I thought I was inadvertently signing up for a death sentence to everything I loved. I thought my social life would tank, my ability to have fun would be ruined, that I would always have an intense case of FOMO, and everything from that point forward would be utterly boring—including me.

I was the quintessential party girl from the moment I began drinking in high school all the way to my mid-twenties. By that point, alcohol was no longer my solo substance of choice and was almost always accompanied by cocaine or some other kind of upper.

My life consisted of VIP at the hot spots, free drinks from the bartenders, drug dealers on speed dial, and an all-access pass to the after parties.

Life was one big adrenaline rush fueled by booze-filled all-nighters. I was known to be the last woman standing—and was rather proud of it. There was no gathering, wedding, destination, or setting that didn’t revolve around binge drinking and powder up my nose.

Until one day when that lifestyle caught up with me, leaving me riddled with anxiety, shame, and total exhaustion. What was once fun turned into more of a nightmarish Groundhog Day. I couldn’t go out without drinking, couldn’t drink without using drugs, and couldn’t get through the day without a looming sense of anxiety under every inch of my skin.

After trying to fight the whisper that had now become a scream for well over a year, I finally came to the conclusion that alcohol was the culprit of so much of my misery. Yet another happy hour turned into a bender, and I finally reached my own personal breaking point, causing me to do something I had never done before.

I dropped to my knees in prayer. I wasn’t even sure if I was even doing it right, but I just knew I needed help after all my failed attempts to moderate or quit. Something in that moment sparked a change in me, and from that day forward I never drank or used cocaine again.

That fateful day was over ten years ago. As you can imagine, life as I knew it drastically changed. It had to. And eventually, things I never thought I’d be able to do suddenly became not only possible, but also much more enjoyable.

Out of all the changes that happened as I went alcohol-free, one of the most notable has been learning how to travel while staying sober.

I live in Las Vegas, one of the most infamous party destinations in the world. A common question I get from my clients and people who follow my adventures around the globe on Instagram is: How do I travel while sober and still have fun?

The short answer: It’s daunting, for sure, but it’s also been one of the most treasured parts of this path.

When people ask me about living in Vegas or traveling the world as a person who doesn’t drink, what I always tell them is: What you seek is what you will find.

If you’re seeking the party, you’ll surely find it. If you’re seeking wellness and conscious experiences, then that’s also what you’ll find. It’s simply a matter of shifting your attention and being better prepared, especially when you’re taking your first few booze-free trips.

Maybe you’re newly sober and worried about taking your first trip without alcohol. Or maybe you’ve been sober for some time but have a big trip coming up—a bachelorette party in Vegas or a wedding in Mexico—that’s making you anxious just thinking about doing it without drinking. Or maybe you’re simply trying to cut back on your drinking and don’t want to slip back into old habits the second you step off a plane.

Whatever your situation might be, you can become a person who travels sans alcohol and still has the time of your life. Here’s what I’ve learned in my 10 years of living—and traveling—while sober:

1. Set your intention before you even get your boarding pass.

Sometimes the hardest part of traveling is the anticipation in our minds of what it will be like. Because of that, you’ll want to decide on your intentions as they relate to alcohol well before you go. If you want to make sure that this trip or vacation is not going to be a pass to drink, it’s best to make that commitment as early on in the planning process as possible.

Before traveling, begin visualizing how you want the trip to go and see yourself at your destination experiencing joy instead of worrying about not drinking or what could go wrong. Focus on what you want and hope to happen—not what you’re worried about happening—in order to create the experience you really want.

If you catch yourself starting to experience FOMO, which seems to always happen before we even get where we are going, or if you start romanticizing drinking on patios in Italy or Paris or wherever you’re headed, try to bring focus back to your original intention. If it helps, remember that FOMO is much easier to deal with than a hangover from hell.

2. Be over-prepared for a triggering airport experience.

Next up on the possible obstacles for sober vacations is of course, the airport (insert JAWS music for full effect). For most people, the airport is full of triggers from the security lines that push all your buttons, to the bars that line the terminals, to the mini-nips of alcohol on the plane that you swear might have actually called your name out loud.

First thing’s first, don’t sit at the bar at the airport, even if you are alone. Get a table and order water or a seltzer straightaway. Tell the hostess or waiter you don’t want the drink menu, so you’re not tempted during one of the most vulnerable parts of the trip.

Once you board the plane, give yourself a silent round of applause because you’re halfway there. Put music on in your headphones on the plane immediately to help with any anxiety before take off, and close your eyes to breathe. Be prepared with tons of games, books, podcasts, movies, or anything else that will keep you occupied for the duration of the flight.

I always travel with a water bottle and my own snacks so I have something to sip on and don’t have to order anything if I don’t want to. This also prevents dehydration and hunger, which can both send cravings into your body that mimic wanting a drink.

3. Plan morning activities that will make you question what you do the night before.

If you have a fun activity already booked (and better yet, already paid for) in the morning, it’s going to be much easier to call it an early night. Hikes and excursions that have earlier start times are a great way to help you and the people you’re traveling with stay on track.

I remember one of my first sober international trips was to Amsterdam and I knew I needed to have things planned out for my mornings so I wouldn’t be tempted to seek out the nightlife scene. So, I researched some yoga studios around the flat I was renting and picked out some classes to take. The best part was when I sat down on my mat and the teacher started to speak in Dutch, which as you can imagine made for an interesting adventure considering I don’t know a single word in that language.

Remember, you’re probably spending a good amount of money on any trip you take, so you owe it to yourself to make sure you create the experience you want. While it’s each person’s prerogative to spend the bulk of their vacation budget on drinks and rack up hours in a hotel room hungover, that’s certainly not the only way to spend a vacation. The more you prove that to yourself, the less you’ll worry about how to spend your travel time without booze.

4. Stay connected to your support system.

Just because you’ve (hopefully) turned on your out-of-office doesn’t mean you need to check out of all communications back home—especially if you have people you rely on to help you stay on track. This might be a friend or loved one or it could be a sponsor or therapist. When you are out of your normal routine and experiencing new elements while traveling, even if you are in a great place with your sobriety, it’s always a good idea to have some trusted advisors in place for you to call on.

Stay connected to your support group and use it as you’re traveling even if it’s just checking in with your digital tribe. Another way to stay connected is to get to a meeting in the city you’re visiting if that’s your jam. You can also set up alliances with other sober people you know in the city where you’ll be. Coffee dates with sober peeps are great opportunities to engage in conversations that usually go deeper than small talk and can help you connect with people you may have only known from the Internet. One of my favorite things to do in new places is reach out to people in my social media circles and bring online relationships to life.

Finally, don’t feel guilty for needing certain accommodations or wanting to make certain tweaks to the itinerary. If you’re traveling with someone, have a conversation before the trip to get on the same page about your mindset—like that you’re obviously going to want to plan some alcohol-free activities. It’s important to voice healthy boundaries to friends and family, and you shouldn’t feel like a burden for doing so.

5. Plan for a mix of structure and spontaneity.

It’s great to have some plans, especially if you need structure to keep you accountable, but it’s also helpful to be flexible to allow for things to flow. By doing this, you’re opening yourself up to more spontaneity, which is the real reason to get out of your normal routine anyway, right? Plus, this mindset could help protect you from disappointment if something comes up that you either can’t or don’t want to participate in while sober.

Be willing to sit some things out and break away to do things you want to do if the people you are traveling with have different ideas of how to spend their time. It’s OK, and in fact necessary, to do your own thing at times.

I used to seek parties over culture and alcohol over, well, everything when I traveled. I never thought the day would come when my trips wouldn’t revolve around the DJ that was playing or making sure I hit the best nightclubs or bars in each city I visited. That is, until I quit drinking and my priorities shifted.

When you change what you look for, the things you look for change. It’s funny how your priorities shift when catching a buzz isn’t at the top of your to-do list. Trips start to become much more focused on taking in the smells, food, character, and ambiance of our surroundings when our minds are less clouded.

6. View your trip as an opportunity for relaxing, recharging, and all of the self-care.

Consider this the antidote to that “I need a vacation from my vacation” feeling. So often our vacations revolve around partying, which tend to leave us feeling exhausted instead of refreshed. Traveling sober is a chance to redefine your vacation goals and rather than using it as an excuse to go wild, you can choose to use your time to recharge and spoil yourself.

Always remember to bask in your hangover-free mornings on vacation by doing a quick gratitude practice and meditation when you wake up to keep yourself in the right frame of mind. You can also check out where you’re staying ahead of time to see if they have a gym or place to exercise as another great way to start your day.

One of my favorite things to do now on trips is spend money on spa days instead of popping bottles. All that money saved can go towards a massage or facial. When you switch your mindset from partying to pampering, you’ll be more inclined to hit the spa instead of hitting the club. Spa-ing is a staple of sober vacations that can completely transform the focal point of your trip.

Another fun idea is to indulge in a gift for yourself with the money you save from not buying alcohol. I always find a piece of jewelry or locally made apparel to splurge on and take home with me as a memory—one that I’ll actually remember.

7. Research the local scene and culture ahead of time so you can make a list of your must-do activities.

It was a newsflash when I realized there were sights to see beyond the pool bar. The reality is that you’ll have a lot more free time on your hands when sipping margaritas by the pool doesn’t steal away your day, so make it a point to spend your time taking in the culture and landmarks your destination has to offer.

Look for shows, museums, national monuments or art exhibits you might like to see that are one-of-a-kind and will help you stay excited about your visit. Even when making dinner reservations, look for places with unique atmospheres that are easy on the eyes—and ideally have a cool mocktail menu. It’s mind-blowing to me how many places drunk me visited without even considering I could get a fix from the excitement the local culture and art had to offer.

Overall, remember to stay committed to giving yourself the perspective of seeing a new place with clear eyes. Let yourself have a great time knowing you don’t need alcohol to do it. By choosing to be a sober traveler you are also making the choice to not let alcohol (or any possible resulting shame or regret) take away from your memories. You don’t often get a re-do of experiences like this, so why not show up as your best, most authentic self?


The more the merrier? Children with multiple siblings more susceptible to bullying

A child with more than one brother or sister is more likely to be the victim of sibling bullying than those with only one sibling, and firstborn children and older brothers tend to be the perpetrators, according to research published by the American Psychological Association.

“Sibling bullying is the most frequent form of family violence and it is often seen as a normal part of growing up by parents and health professionals, but there is increasing evidence that it can have long-term consequences, like increased loneliness, delinquency and mental health problems,” said Dieter Wolke, PhD, of the University of Warwick and lead author of the study. It was published in the journal Developmental Psychology.

Wolke and his co-author, Slava Dantchev, B.Sc., also of the University of Warwick, wanted to understand the underlying causes of sibling bullying and examined the possible impact of family structure, parenting behaviors, early social experiences and a child’s temperament.

The researchers analyzed data from a longitudinal study of 6,838 British children born in either 1991 or 1992 and their mothers. They defined sibling bullying as psychological abuse (e.g., saying nasty or hurtful things), physical abuse (e.g., hitting, kicking or pushing) or emotional abuse (e.g., ignoring one’s sibling, telling lies or spreading false rumors). The kids were put into four categories: victims, bully victims (defined as being both a perpetrator and victim of bullying), bullies or uninvolved.

When the children were 5 years old, their mothers reported how often the children were victims or perpetrators of bullying in the household. Sibling relations were analyzed two years later when the mothers were asked how much time the children spent engaging with their siblings on various activities, such as crafts or drawing. Several years later, at age 12, the children reported if they had been bullied by a sibling or if they had bullied a sibling within the previous six months. The boys and girls were also asked their ages when they first experienced sibling bullying and when they first bullied a sibling.

Researchers also collected family statistics from the mothers, including the number of children living in the household, the mother’s marital status, the family’s socioeconomic background, maternal mental health during and after pregnancy, parental conflicts, domestic violence and child abuse and the mother-child relations. They also assessed each child’s temperament, mental health, IQ and social/emotional intelligence at various points during their early years.

Approximately 28 percent of the children in the study were involved in sibling bullying and psychological abuse was the most common form. The majority of those children were found to be bully victims, meaning they bullied and were bullied, according to the study.

“Bullying occurs in situations where we cannot choose our peers, like in families,” said Wolke. “Siblings live in close quarters and the familiarity allows them to know what buttons to press to upset their brothers or sisters. This can go both ways and allows a child to be both a victim and a perpetrator of bullying.”

Family structure and gender were the strongest predictors of sibling bullying by middle childhood, according to the authors.

“Bullying was more likely to occur in families with three or more children and the eldest child or older brothers were more often the bullies,” said Dantchev. “Female children and younger children were more often targeted.”

Wolke and Dantchev believe bullying can happen in larger families because resources such as parental affection or attention and material goods are more limited.

“Despite our cultural differences, humans are still very biologically driven. A firstborn child will have their resources halved with the birth of a sibling, and even more so as more siblings are added to the family,” said Wolke. “This causes siblings to fight for those limited resources through dominance.”

Although the researchers investigated whether marital and socioeconomic status would be associated with more or less bullying, they did not find any evidence.

“Sibling bullying does not discriminate. It occurs in wealthy families just as much as lower-income families and it occurs in single-parent households just as much as two-parent households,” said Wolke.

These findings may be helpful to parents as they welcome new additions to their families, Wolke said.

“It will be important for parents to realize and understand that resource loss can affect an older child,” he said. “It is a good idea for parents to manage this from the beginning by spending quality time with their firstborn or older children and by involving them in caring for younger siblings.”

What’s age got to do with it?

It’s often said: It’s not how old you are, it’s how old you feel. New research shows that physiological age is a better predictor of survival than chronological age. The study is published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

“Age is one of the most reliable risk factors for death: the older you are, the greater your risk of dying,” said study author Dr Serge Harb, cardiologist at the Cleveland Clinic in the United States. “But we found that physiological health is an even better predictor. If you want to live longer then exercise more. It should improve your health and your length of life.”

Based on exercise stress testing performance, the researchers developed a formula to calculate how well people exercise — their “physiological age” — which they call A-BEST (Age Based on Exercise Stress Testing). The equation uses exercise capacity, how the heart responds to exercise (chronotropic competence), and how the heart rate recovers after exercise.

“Knowing your physiological age is good motivation to increase your exercise performance, which could translate into improved survival,” said Dr Harb. “Telling a 45-year-old that their physiological age is 55 should be a wake-up call that they are losing years of life by being unfit. On the other hand, a 65-year-old with an A-BEST of 50 is likely to live longer than their peers.”

The study included 126,356 patients referred to the Cleveland Clinic between 1991 and 2015 for their first exercise stress test, a common examination for diagnosing heart problems. It involves walking on a treadmill, which gets progressively more difficult. During the test, exercise capacity, heart rate response to exercise, and heart rate recovery are all routinely measured. The data were used to calculate A-BEST, taking into account gender and use of medications that affect heart rate.

The average age of study participants was 53.5 years and 59% were men. More than half of patients aged 50-60 years — 55% of men and 57% of women — were physiologically younger according to A-BEST. After an average follow-up of 8.7 years, 9,929 (8%) participants had died. As expected, the individual components of A-BEST were each associated with mortality.

Patients who died were ten years older than those who survived. But A-BEST was a significantly better predictor of survival than chronological age, even after adjusting for sex, smoking, body mass index, statin use, diabetes, hypertension, coronary artery disease, and end-stage kidney disease. This was true for the overall cohort and for both men and women when they were analysed separately.

Dr Harb said doctors could use A-BEST to report results of exercise testing to patients “Telling patients their estimated age based on exercise performance is a powerful estimate of longevity and easier to understand than providing results for the individual components of the examination.”

Dr Harb noted that this type of approach has shown merit in specific disease areas. For example, ESC guidelines advocate using “cardiovascular risk age” — based on risk factors including smoking, blood cholesterol and blood pressure — to communicate with patients.2

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Materials provided by European Society of Cardiology. Note: Content may be edited for style and length.

Why Are Heart Attacks Becoming More Common in Women Under Age 54?

Heart disease is the most common cause of death in men and women, according to the Centers for Disease Control and Prevention (CDC). But some people still think of cardiac issues—particularly heart attacks—as a male problem. Unfortunately, a recent study suggests that, not only are heart attacks a concern for women, they’re becoming more common among women of younger ages.

The study, which published this past November in the journal Circulation, analyzed data from hospital surveillance of heart attacks in people between the ages of 35 and 74 in four communities in Maryland, Minnesota, Mississippi, and North Carolina. The researchers looked at the records of more than 28,000 people hospitalized for heart attacks between 1995 and 2014. Of those, a whopping 30 percent (8,737 patients) were under the age of 54.

The results showed that the annual number of hospitalizations for young people (meaning from the ages of 35 to 54) overall went up from 27 percent between 1995 and 1999 to 32 percent between 2010 and 2014. But the increase was even more notable for young women in particular: Specifically, young women accounted for 21 percent of reported heart attacks among women between 1995 and 1999, but they accounted for 31 percent of reported heart attacks among women between 2010 and 2014—a 10 percent jump. In comparison, young men accounted for 30 percent of heart attacks in men between 1995 and 1999 and 33 percent between 2010 and 2014.

“This is a really provocative study and it highlights some of the biggest issues we see in the world of preventative health, which is identifying people with an increased risk of cardiovascular disease,” Nicole Weinberg, M.D., a cardiologist at Providence Saint John’s Health Center in Santa Monica, Calif., tells SELF.

There are a few possible reasons behind this trend.

The study authors note that two major risk factors for heart diseasehigh blood pressure and diabetes—were increasingly common in young patients who had heart attacks. Specifically, 71 percent of young women with heart attacks in the study had a history of high blood pressure and 39 percent had a history of diabetes. For young men who had heart attacks, the numbers were 64 percent and 26 percent, respectively.

Both high blood pressure and diabetes have been linked to obesity, which could be another factor in the increase in heart attacks in young people, study co-author Melissa Caughey, Ph.D., a cardiovascular epidemiologist at the University of North Carolina School of Medicine, tells SELF. “Women under 54 have a higher prevalence of obesity and diabetes than men of the same age group, and the trend continues to rise,” she points out.

Obviously, not everyone with diabetes or high blood pressure also has obesity—and patients with those risk factors aren’t necessarily being identified and treated ahead of time, Dr. Weinberg says. “Even when women with these conditions are identified, they’re not being aggressively treated or having interventional therapy,” she says. “As a result, their prognosis isn’t as good as those of men.”

Stress—which can directly and indirectly raise your blood pressure—may also play a role, Johanna Contreras, M.D., a cardiologist and director of heart failure at Mount Sinai St. Luke’s, tells SELF. That kind of stress might come from a traumatic or abusive situation, but your job, pressures at home, and other life stressors can build up without healthy coping mechanisms in place.

There are some things you can do to reduce your risk for a heart attack.

For starters, it’s crucial that you regularly see your doctor, even if you feel fine, Jennifer Haythe, M.D., co-director of the Women’s Center for Cardiovascular Health at Columbia University Irving Medical Center and cardiologist at NewYork-Presbyterian/Columbia, tells SELF. “Women should see their doctors at least annually and ask for cardiac risk assessment to be done,” she says. This can include taking account of your age, weight, smoking habits, blood pressure, diet and exercise habits, as well as your lipid profile (which measures the levels of cholesterol and fat in your blood) and possibly even an electrocardiogram (which measures your heart’s electrical activity).

If you do have any modifiable risk factors for heart disease, it’s important to act on them, David Goff, M.D., Ph.D., director of the Division of Cardiovascular Sciences at the National Institutes of Health, tells SELF. That might mean making changes to what you eat, prioritizing quality sleep and stress management, or increasing physical activity. “By diagnosing and treating risk factors earlier, heart disease can be minimized in this population,” Dr. Haythe adds.

Finally, if you have a family history of heart disease, tell your doctor about it so they can monitor your risk. “Having a family risk of heart disease makes all of this advice even more important,” Dr. Goff says.

Still, don’t assume that you’re doomed to have a heart attack if it seems to run in your family. “Genetics and family history doesn’t determine everything,” Caughey says. “There are many steps you can take, such as adopting a healthy lifestyle, that can lower your risk even if you have a family history of heart disease.”

There are a few classic signs of a heart attack. The American Heart Association recommends calling 911 and getting to a hospital right away if you experience any of these:

  • Uncomfortable pressure, squeezing, fullness, or pain in the center of your chest (this might last more than a few minutes or goes away and come back)
  • Pain or discomfort in one or both arms, your back, neck, jaw, or stomach
  • Shortness of breath with or without chest discomfort
  • Breaking out in a cold sweat
  • Nausea
  • Lightheadedness
  • A feeling of fatigue that is new or unusual for you

But symptoms may present differently in women than in men. Women are more likely to have the less obvious symptoms—like nausea and a vague chest discomfort or tightness—rather than the stereotypical crushing chest pain. So it’s important to seek medical attention if you’re experiencing any new or distressing symptoms like these, even if you’re unsure whether it’s serious or not.

It’s also important to be aware of the signs of an underlying heart issue, Laxmi Mehta, M.D., director of the Women’s Cardiovascular Health Program and an associate professor of medicine at The Ohio State University Wexner Medical Center, tells SELF—even if you’re not necessarily dealing with a medical emergency like a heart attack. Many people have heart disease without knowing it, and it develops slowly over time and may not be obvious, the U.S. National Library of Medicine says.

Symptoms of heart disease include chest pain, ankle swelling, and shortness of breath, and they should be a tip-off that something requires your doctor’s attention, according to the U.S. National Library of Medicine. Addressing symptoms like these early on with your doctor may even help prevent a heart attack or stroke down the line.

Above all, pay attention to your body and don’t be afraid to speak up to your doctor if you think something is off.


Cannabis use in teens linked to risk of depression in young adults

While there has been a lot of focus on the role of cannabis use in psychosis, there has been less attention on whether cannabis use is associated with an increased risk of common mental health disorders, such as depression and anxiety.

Researchers from McGill University and the University of Oxford carried out a systematic review and meta-analysis of the best existing evidence and analysed 23,317 individuals (from 11 international studies) to see whether use of cannabis in young people is associated with depression, anxiety and suicidality in early adulthood.

They found that cannabis use among adolescents is associated with a significant increased risk of depression and suicidality in adulthood (not anxiety). While the individual-level risk was found to be modest, the widespread use of the drug by young people makes the scale of the risk much more serious.

The population attributable risk was found to be around 7%, which translates to more than 400,000 adolescent cases of depression potentially attributable to cannabis exposure in the US, 25,000 in Canada and about 60,000 in the UK.

Dr. Gabriella Gobbi, Professor, Department of Psychiatry, McGill University and a scientist at the Research Institute of the McGill University Health Centre, states: “While the link between cannabis and mood regulation has been largely studied in preclinical studies, there was still a gap in clinical studies regarding the systematic evaluation of the link between adolescent cannabis consumption and the risk of depression and suicidal behaviour in young adulthood. This study aimed to fill this gap, helping mental health professionals and parents to better address this problem.”

Professor Andrea Cipriani, NIHR Research Professor of Psychiatry at the University of Oxford, said: ‘We looked at the effects of cannabis because its use among young people is so common, but the long-term effects are still poorly understood. We carefully selected the best studies carried out since 1993 and included only the methodologically sound ones to rule out important confounding factors, such us premorbid depression.’

‘Our findings about depression and suicidality are very relevant for clinical practice and public health. Although the size of the negative effects of cannabis can vary between individual adolescents and it is not possible to predict the exact risk for each teenager, the widespread use of cannabis among the young generations makes it an important public health issue.

‘Regular use during adolescence is associated with lower achievement at school, addiction, psychosis and neuropsychological decline, increased risk of motor vehicle crashes, as well as the respiratory problems that are associated with smoking.’

The active ingredient in cannabis,THC, mediates most of psychoactive and mood-related effects of cannabis and also has addictive properties. Preclinical studies in laboratory animals reported an association between pubertal exposure to cannabinoids and adult-onset depressive symptoms. It is thought that cannabis may alter the physiological neurodevelopment (frontal cortex and limbic system) of adolescent brains.

While the review of observational studies was the first to look at the effects of cannabis use in adolescents only, it was not possible to predict the risk at the individual level, nor was it possible to discern information about the dose-dependent risk of cannabis use.

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Materials provided by University of Oxford. Note: Content may be edited for style and length.

Sneezing and Coughing: Here’s How Far Germs Spread

There are plenty of times when you might wonder how far germs spread through sneezing and coughing. Maybe you’re sitting in a meeting when the person across from you sneezes so hard they may have shifted a few tectonic plates, spraying you with a fine mist in the process. Or perhaps the person next to you on a flight spends the entire trip coughing so intensely you worry they’re going to hack up a lung.

In a weird way, it can feel even worse when you’re the culprit. You can’t always control when your body decides to let ‘er rip. If a sneeze or cough sneaks up on you when you’re sick and you can’t cover your mouth and nose, are you going to infect everyone around you?

Here, doctors explain what you should know about how far germs spread when people sneeze and cough, how to keep yourself as healthy as possible, and how to protect others when you’re the sick one.

Infectious diseases have a few modes of transmission.

One of these is large droplet transmission, Alexander L. Greninger M.D., assistant director of the University of Washington Medicine Clinical Virology Laboratory, tells SELF. This refers to the droplets sick people expel when they cough, sneeze, or talk. If someone else inhales those secretions, they can get sick, too. Illnesses like the flu, the common cold, and pertussis (whooping cough) are thought to mainly spread this way.

Then there are infections that fall into the airborne transmission category, like measles, tuberculosis, and chickenpox. Unlike large droplets, which need to quickly come into contact with someone’s mucous membranes in order to cause an infection, airborne transmission allows potential pathogens to remain suspended in the air for some time after someone coughs, sneezes, or talks. (Remember, not all germs are actual pathogens that can make you ill.) Then someone else can breathe in those particles and get sick.

Some illnesses can infect people via both forms of transmission. For instance, the flu mainly spreads through large droplets, but the CDC notes that it can be airborne as well.

Infectious diseases can spread in other ways, such as through direct contact (like if you kiss someone who’s sick). But since we’re talking about how far germs spread through the air, we’re going to focus on large droplet and airborne transmission.

So, how far can germs actually make it through the air?

The important thing to understand here is that scientists really only have estimates for how far coughing and sneezing can spread germs, not hard numbers. Some of this might even depend on how forcefully a person coughs or sneezes. (Scream sneezers, we’re looking at you. But we also know it’s not your fault.)

Large respiratory droplets containing pathogens like influenza can travel up to 6 feet when a sick person coughs or sneezes, according to the CDC. A 2014 study by MIT scientists published in the Journal of Fluid Mechanics suggests this number may be way higher for smaller airborne particles. Researchers used high-speed video upwards of 1,000 frames per second to record sprays of mist as well as human coughs and sneezes, finding that smaller droplet particles traveled as far as 2.5 meters horizontally through the air. That’s more than 8 feet.

The study also recorded smaller airborne droplets spraying 13 to 20 feet vertically in the air, which researchers noted was theoretically high enough to enter and travel through some ceiling ventilation systems in some buildings. The researchers posit that this impressive (and kind of nauseating) distance is because smaller pathogens can travel as part of a buoyant cloud that extends their reach.

The problem with airborne pathogens isn’t just how far they can spread, it’s also how long they can hang out in the air and on objects. A lot of this depends on the pathogen in question. Measles, for instance, can live for up to two hours in the air and on surfaces, according to the CDC. This illness is so contagious that 90 percent of people who are close to a person with measles but who aren’t immune (like through vaccinations) will catch the illness. That’s especially scary considering the recent measles resurgence happening in some parts of the United States.

You’re not guaranteed to get sick if someone sneezes or coughs on or near you.

It’s normal to feel completely grossed out by how far germs may be able to travel. That still doesn’t mean you’re doomed to get sick, even if someone sneezes in your face. (Anyone else just full-body shudder?)

Yes, someone who is ill sneezing or coughing on or near you can boost your chances of getting sick. This is true even if you hold your breath. “The particles will stay there for many minutes, and in some cases many hours, and you can’t hold your breath that long,” Keith Roach M.D., associate professor in clinical medicine at New York Presbyterian Hospital. Or you could rush away from the scene, but the particles may still be on your clothes, which you might touch later. You get the picture.

The good news is that even if someone sick sneezes or coughs around you, factors like your past exposure to viruses and your vaccination record could end up protecting you from that illness, depending on the strain in question. (Make sure you’re up to date on your flu vaccine every single year. Is it 100 percent effective? No. Does it still slash the death toll and number of hospital visits linked with the flu each year? Yes.)

If you have good hygiene habits, that’s another point in your corner.

Excellent hygiene practices may help you avoid getting sick.

Wash your hands, people! Soap and water are most effective at preventing transmission of illnesses like the cold and flu, but Dr. Roach recommends keeping alcohol-based hand sanitizer at the ready for the times you can’t wash your hands. Your sanitizer should be at least 60 percent alcohol in order to be as effective as possible. Even with great hand hygiene, you should try to avoid touching areas like your mouth, nose, and eyes, since those are possible portals for pathogens. That stands whether or not your entire office has come down with the flu.

If someone around you is obviously sick, the CDC advises avoiding close contact if at all possible. You should also disinfect common surfaces (like doorknobs) often.

Finally, Dr. Greninger recommends prioritizing lifestyle measures that can help your immune system work as well as possible, like getting adequate sleep. Eating in a way that fuels you and trying to manage stress are good ideas, too. (When possible, since we know it’s not always.)

If you’re sick, cover your face when you sneeze and cough.

This can definitely be helpful in sparing others from your illness, Dr. Greninger says. Just don’t cover your face with your hands, because that makes it all too easy to spread those germs around. Instead, the CDC recommends coughing or sneezing into a tissue and then throwing it away, or sneezing into your upper shirt sleeve or elbow, completely covering your nose and mouth.

Unfortunately, even the best cough and sneeze etiquette can’t fully stop the spread of disease, Dr. Roach explains. A small 2013 study of 31 people published in BMC Public Health found that some droplets—especially smaller ones—still spread when the participants were practicing good cough etiquette, including coughing into their shirt sleeve or elbow.

As the scientists explained, this is because some particles manage to find the path of least resistance around whatever is blocking them. But pure physics dictates that putting an obstacle in the way of any pathogens is preferable to just spewing them into the air without any barriers. Even though covering your nose and mouth isn’t foolproof, it’s definitely better than nothing—which is precisely why the CDC recommends it.

In addition to following proper sneeze and cough etiquette, you should wash your hands thoroughly and frequently when you’re sick. (Especially if you slip up and cough or sneeze into your hands.) It’s also kind to try to keep your distance from people when you’re ill, including staying home from work if you can when you’re really sick, and to frequently disinfect surfaces you’re always touching.

In situations involving compromised immunity, face-blocking devices may help.

If you’re sick and spending time with people who have compromised immune systems, or if you have a compromised immune system yourself, you may want to step your illness prevention up a notch. Depending on your specific scenario, it could make sense for you or the people around you to wear a device like a face mask or N95 respirator.

Face masks can block many large droplets, while N95 respirators are designed to obstruct the passage of those very small airborne particles that can lead to illness, according to the Food and Drug Administration (FDA). But a 2011 systematic review published in Influenza and Other Respiratory Viruses, which looked at 17 different studies, suggests that these devices are much more likely to help prevent illness if worn consistently and correctly. If you’re curious about these illness-preventing measures, talk to your doctor for advice and guidance on proper usage. And even if you do opt to use these, you should still practice the above measures to make sure you—and those around you—can remain as infection-free as possible.