TIME Obesity

This Place Just Became the First Part of the U.S. to Impose a Tax On Junk Food

It also eliminated a 5% sales tax on healthy produce

The Navajo Nation, which suffers from a 10% obesity rate, is imposing a 2% junk food tax on its reservation beginning April 1.

Navajo President Ben Shelly approved the Healthy Dine Nation Act last November, which from this week will also eliminate a 5% sales tax on healthy fare including fresh fruits and vegetables.

Revenues from the sin tax will reportedly be channeled towards community wellness projects like farmer’s markets, vegetable gardens and greenhouses in the 27,000 sq. mi. of Navajo reservation spanning from Arizona and New Mexico to Utah.

Approximately 24,600 Navajo tribe members face obesity, according to the Navajo Area Indian Health Service. Type 2 diabetes has emerged as a growing public health concern afflicting up to 60% of reservation residents in some areas.

With nearly half of the Navajo youth population facing unemployment and 38% of the Navajo reservation at the poverty level, supporters say the act may serve as a prototype for sin taxes to curb obesity in low-income communities across the U.S.

By comparison, around one-third of Americans nationwide are classified as obese, the highest rate in the world.

TIME Research

Pediatrics Group Says Schools Shouldn’t Drug Test

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Random drug testing doesn't have enough evidence to support it, the AAP says

A leading U.S. pediatrics group is recommending against in-school drug testing as a way to prevent young people from experimenting with illegal substances.

The American Academy of Pediatrics (AAP) released a policy statement on Monday saying it opposes randomly drug testing students because there’s not enough evidence to show it’s effective, and because random testing can damage relationships between students and their schools. It’s also a possible infringement on privacy, the group says.

Fifteen years ago, the Supreme Court established the legality for school-based drug testing for students. Proponents of the practice say that random testing at schools deters students from using drugs.

But the AAP says they don’t believe it’s worth the costs to schools. “We want to be really clear about this—this is not pushing schools to the side or saying they have no role,” says report author Dr. Sharon Levy, the director of the Adolescent Substance Abuse Program at Boston Children’s Hospital. “It’s a question of what’s the best way for schools to be involved.”

According to the AAP policy statement, there’s limited evidence to suggest that drug testing programs in schools prevent kids from trying drugs. “We reviewed the studies done to take a look at this question, and while there’s evidence, there are a lot of caveats around that,” says Levy, who adds that many studies rely on self-reports and show inconsistent data.

The tests are imperfect, sometimes showing anxiety-inducing false negatives and false positives, the AAP says. While drug tests should be used to find students who may need intervention, the AAP believes, studies have shown that students are often given severe consequences like suspensions or expulsions that are not followed up by treatment. The tests can also detect substances used by young people for medical reasons, which could result in breaches of their privacy and damage the relationship between schools and their students, the AAP says.

“Random drug testing, particularly on the scale of these drug-testing programs which are typically once or twice a year, is not very likely to pick up sporadic use, which is the majority of use by high school kids,” says Levy. “It depends how important you think it is to pick up sporadic use, but I think it’s very important.”

The researchers also add that drug tests don’t typically pick up on alcohol, which is the illegal substance most commonly used by adolescents and teens.

Levy says that the goal of the new policy statement is not to stop schools from actively seeking out students who are at risk for drug use, but to weigh the best strategies. Instead, the AAP recommends school-based prevention and intervention programs, education, other screening methods like confidential self-reports, counseling and referrals.

Levy says she recognizes that not all experts may agree, but that she and her panel crafted their statement based on the most recent evidence available. She hopes that pediatricians and schools can collaborate to find the most effective ways to help students resist drugs.

TIME Exercise/Fitness

10 Habits of People Who Love to Work Out

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Experts say you can teach yourself to love exercise

You know these people: they bound out of bed in the morning ready to tackle their sunrise bike rides. They leave the office during lunch to sneak in a quick run. Or they head out of work, gym bag in hand—and they’re going to use it (not just bring it back home). They’re the ones who look like they’re actually enjoying themselves as they pedal furiously at Spin. Can you be more like these fitness fanatics? Experts say yes, you can teach yourself to love exercise. Get into the workout groove by mimicking their habits.

They only do workouts they enjoy

People who love to exercise don’t waste time with activities they despise. “Too often I see people who sign up to do something like running, even though they know they hate running,” says Shavise Glascoe, exercise physiologist at the Johns Hopkins Weight Management Center. Start with an activity that you’re interested in or already enjoy—it doesn’t have to be what your neighbor said helped her lose weight or what the group-class trend of the moment is. What matters is that you like it. If you don’t want to do it, you will make an excuse to skip it tonight (and tomorrow, and the next day).

Read more: 4 Fat-Blasting Jumping Exercises

They look for feedback

Fitness fanatics often thrive on instant feedback, says Jimmy Minardi, a former professional cyclist and personal trainer in New York City and Santa Barbara, Calif. He suggests trying out a fitness tracker that measures heart rate or calories burned. That real-time feedback will help you push yourself further—you’ll always feel motivated to match or exceed your personal best—and take your workouts to the next level. Plus, Minardi says, you’ll be more connected to your training.

They exercise with a friend

Exercise addicts get by with a little help from their friends, says Glascoe. They’re sure not to ditch their yoga buddy for an om-session even when they’d rather beeline straight home, and are excited to get out of bed for a morning run because they’ll have the chance to chit-chat with their pals. Case in point: in a University of Southern California study, people said they had more fun and enjoyed working out more when they did it with a friend. Don’t assume that none of your friends want to work out—you may find one who wants to get in shape alongside you. But you could also find a workout buddy by joining a local running or biking club, or signing up for a recreational sports league.

Read more: 11 Reasons Why You’re Not Losing Belly Fat

They get back to nature

When the weather outside is nasty, it’s natural to want to take exercise inside. But if it’s nice and bright out, bike along that lakefront path, run through your neighborhood early in the morning, or find an outdoor yoga class. “Nature makes you feel alive—and when you feel great, you are more likely to want to do the workout again,” says Minardi. Besides, in one 2011 study in Environmental Science & Technology, sweating outdoors was associated with a boost of energy, more engagement in the activity, and better mental wellbeing. Go ahead—sweat, and say ahhh.

They let setbacks slide

Sometimes life gets in the way of exercise, and that’s okay, says Glascoe: “Studies show that people who have wiggle room in their mindset are more likely to maintain a regular exercise routine,” she says. “Prepare yourself for potential barriers and come up with a backup plan.” Glascoe has her clients plan the maximum and minimum number of days they want to exercise in a week. That way, if they miss one, there’s no “I’ve blown it” mentality. If you have to work late and can’t hit Spin, tell yourself that tomorrow you’ll get back on track.

Read more: 5 Ways to Work Your Abs Without Crunches

They don’t think about how much weight they’re losing

“We seem to be more powerfully motivated when we look at the short-term, immediate benefits of exercise,” says Gregory Chertok, a sport psychology consultant. Rather than focusing on the 20 pounds you want to lose (which, turns out, doesn’t help us get off our butts and get moving, he says), think about the almost instantaneous extra energy you’ll get with your kids, at work, or in the bedroom. And anyway, when you stop thinking about how your workouts are affecting your weight, you may actually start seeing the pounds melt away: Cornell University research suggests that framing your exercise as something other than calorie burning (like a break or “me time”) can help you eat less after.

They don’t care if it’s ‘traditional’

Exercise is exercise—doesn’t matter if it’s at the gym or not. All types of activity count, so try baking your playtime into your workout time by becoming a member of the company kickball team, joining a beach volleyball league, or trying something you’re curious about, like martial arts. “You’re creating a lasting relationship with the activity, rather than simply showing up for classes,” Minardi says. Other activities that count? Gardening, running in the backyard with your kids, and dancing (even if it’s a dance party for one in your living room), adds Chertok.

Read more: 10 Fun Ways to Get Fit Without a Gym

They crank up the tunes

There’s a reason why you see so many people wearing earbuds at the gym: Music is a huge motivator, reveals research in the International Review of Sport and Exercise Psychology. “Use music to improve your results. People exercise longer and more vigorously to music, and it distracts them from fatigue,” says Chertok. He recommends compiling a playlist of your favorite music. When you need motivation to get out the door, put your headphones on and get inspired to sweat.

They reward themselves

Your goal is to make exercise an automatic habit that you don’t have to agonize over. (Do I really have to go to the gym after work today? Am I actually going to get up early for that run?) A way to reinforce the routine is to reward yourself for a job well done, says Chertok. One of his clients set up a checking account that he uses to deposit a set amount of money each week he successfully sticks to his fitness goals. And every time he misses them? He withdraws money. At the end of the month, he takes the money he saved and does something fun, like signing up for a cooking class or buying tickets for a show. You can also plan mini rewards, like stopping by your favorite coffee shop or juice bar post-workout. (Just don’t go overboard on treats.) It’s something to get you up and moving when you’d rather not.

They dress the part

Truth: you don’t need expensive workout gear to have a great workout. But, buying new athletic apparel may be a good motivator. “We feel better about ourselves doing something athletic when we perceive ourselves as looking more athletic,” says Chertok. So switch out your old, rundown pair of shoes in favor of new kicks, pick up a new sporty headband to accessorize, or spring for a pair of running shorts if you’re starting to train for your first 10K.

This article originally appeared on Health.com.

TIME Diet/Nutrition

17 Ways to Lose Weight When You Have No Time

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Trust us, you're not too busy for these easy tips

If packing your lunch, cooking dinner every night, and getting to the gym regularly sound like things you’ll be able to do half past never, you may think that real weight loss just isn’t in the cards for you right now. It’s true: healthy weight loss can be a time commitment, especially if you’re overweight thanks to a job that keeps you sedentary for much of the day or a schedule that lends itself to fast food and unhealthy snacking.

Don’t throw in the towel just yet. You don’t need extra minutes in your day to eat less or to move more, the two basic pillars of weight loss. Here’s how to reevaluate the time you do have, and smart strategies to make dropping pounds easier, no matter how swamped you are.

Ditch the all-or-nothing mentality

Every small step you take toward a healthier lifestyle matters, says Jeff Katula, PhD, associate professor of health and exercise science at Wake Forest University. “People often think they have to spend an hour at the gym or eat a diet full of hummus and superfoods, and when they can’t attain that level they just give up and don’t even try,” he says. Instead of looking at your whole day as a success or failure, says Katula, consider every decision you make a chance to do something healthy. Just because you skipped the gym doesn’t mean you shouldn’t watch your calorie intake for the rest of the day, for example. (In fact, it means the exact opposite!)

Eat smaller portions

“You don’t need to cook your own food or even eat different food to lose weight,” says Katula. “You just need to eat less, and eating less doesn’t take more time or cost more money.” Most people need to consume between 1,200 and 1,500 calories a day if they want to drop pounds in a healthy and sustainable way—and for a lot of people, eating appropriate portion sizes, skipping dessert, or not going back for seconds is one of the easiest ways to reduce their total calorie intake.

Watch: 5 Easy Ways to Measure Portion Sizes

Don’t skip meals

This may seem counterintuitive after advice to eat less overall, but busy people especially may need to space out their calories more throughout the day, says Jessica Bartfield, MD, clinical assistant professor at Loyola University’s Center for Metabolic Surgery and Bariatric Care. That’s because going more than four or five hours without refueling can slow metabolism, affect hormones and insulin levels, and contribute to unhealthy food choices when you do finally sit down to eat. “A lot of our overweight patients aren’t necessarily overeating, but their eating patterns have become so erratic—they have a cup of coffee in the morning and then no real food until late afternoon,” she says. “They key is to avoid that and keep a consistent schedule, whether that’s three meals a day and a couple of snacks, or five mini meals.”

Squeeze in more movement

Setting aside time for a 30- or 60-minute workout is ideal, “but you can burn a lot of calories in not-so-ideal workout situations, too,” says Katula. In fact, there’s nothing wrong with breaking up your 150 recommended minutes of weekly moderate exercise into short bursts throughout your day. “If you can fit in 10 minutes in the morning, 10 minutes at lunch, and 10 minutes at night, and you can do that five days a week, you’re there,” he says.

Katula tells his patients to think of burning calories they way they think of saving money. “We do so many little things—clip coupons, buy store brands—to save a dime here or a quarter there, because we know it adds up,” he says. “Exercise is the same way: A few push-ups here and a few extra steps there can add up, too, if you do it regularly.”

Practice simple food swaps

Just like Katula tells his patients to think of exercise like they do clipping coupons, he tells them to think of their food choices the same way. “Whether it’s leaving the cheese off a hamburger or switching from mayo to honey mustard, there are so many little things you can do and so many little swaps you can make over the course of a day that can add up and save you calories without costing you any extra time.” Think about your daily beverages too, not just your solid foods. Switching from soda to seltzer water with lemon (or even to diet soda), or using less sugar in your coffee, for example, can save you several pounds a year.

Read more: 24 Food Swaps That Slash Calories

Don’t sit when you can stand

You’ve heard it before: Too much sedentary behavior is bad for your heart, your brain, and yes, your waistline. Turning some of that sitting time into standing time (or, better yet, fidgeting, walking, or working-out time) will help you burn more calories. “It may not add up to much weight loss on its own, but it certainly comes into play if you’re looking to maintain any weight you’re already losing,” says Dr. Bartfield.

Standing while you work may not be an option, especially if you use a computer and your office doesn’t offer a standing-desk setup. Instead, consider other times during your day you might be able to get up off your butt: your morning train ride, staff meetings, an evening phone call with your sister, or while you unwind after dinner in front of the TV.

Make sure you’re sleeping enough

When it feels like there aren’t enough hours in the day, it may be tempting to stay up late or wake up super early just to get everything done—especially if you’re trying to squeeze in regular exercise in addition to everything else you have to do. That strategy can backfire if you’re not getting enough quality shuteye for your body to function properly, says Katula. “If you’re trying to change your behavior and lose weight by eating less and moving more, you will be more likely to achieve that if you are getting the proper amount of sleep,” he says. Sell yourself short and you may lack the energy needed to complete your workouts; even worse, you’ll crave sugary and fatty foods that will help you stay awake, but will wreak havoc on your waistline.

Use your weekends wisely

Even if your job requires long and grueling hours, hopefully you have at least a couple of days off every week to regroup—and plan ahead. “Even though we’re pressed for time, most of us have pretty predictable schedules,” says Dr. Bartfield. “So it can help to spend some time on Saturday and Sunday shopping for healthy food, preparing some lunch and dinner items for the week, and deciding which days you’re going to eat what.”

You can also use your day or days off to get in longer workouts than you’d have time for during the week, says Katula. “If you can get in 120 minutes of exercise over the weekend, you really only need to dedicate small amounts of time throughout the week to reach your 150-minute goal.”

Read more: Skinny Up Your Weekend

Be active with friends and family

You may argue that weekends are for family time, or that you’d rather spend your precious free time with friends. Why not turn that social time into fitness time? “You don’t need to go to the gym for it to count as exercise,” says Katula. “You can play with your kids for a few hours and still get your heart rate up and see beneficial results.”

Join a pick-up sports league or a running group with friends, or swap your typical happy-hour date for a Spin class together. Or, start a weekly walking or hiking tradition with your family. Either way, being active with others can help you stick with it. “Social support is a key ingredient to any sort of behavior change,” says Katula.

Switch to a high-intensity workout

The best workout for fat loss doesn’t require hours upon hours in the gym. In fact, multiple studies show that a 20-minute high-intensity interval workout (HIIT) may burn more calories than 45 minutes chugging away on the elliptical. Try this workout, which you can do running, walking, biking, or with any type of cardio equipment: Warm up at a moderate pace for 5 to 10 minutes. Go all-out for 30 seconds, then switch to an easier pace for 45 seconds. Repeat the 30- and 45-second intervals five more times. Then cool off at an easy pace for 5 to 10 minutes.

Use healthy-meal shortcuts

We’re often told to steer clear of packaged foods for better health, but some frozen and pre-made goods can truly help you whip up a healthy meal in minutes, says Bartfield. “There are tons of good options in the freezer aisle, either for individuals or even family-size meals, that can be prepared quickly,” she says. “Or you could buy a rotisserie chicken—take the skin off and slice it on top of a salad, or buy frozen vegetables to serve with it.” (Keep in mind that rotisserie chickens can be high in sodium, so cut back your intake from other sources.) On nights when even that’s not an option, you still have choices about where you eat out or what prepared foods you bring home; the key is knowing ahead of time which restaurant you’ll choose and which items are healthiest, so you’re not stuck making a last-minute (bad) decision.

Set up a home gym

If you can’t devote time to driving to the gym or you’re stuck at home with kids, working out in your own home may be your best option for fitting in quick calorie-burning session. You don’t necessarily need to invest in a cardio machine—you can still get a great workout using nothing but your own body weight, or with a few simple tools (like hand weights and resistance bands) that take up next to no room in your home. Just roll out your yoga mat, set up a mirror, and you’re ready to go.

Watch: How to Set Up a Home Gym for Less Than $50

Use high-tech solutions

Few of us have the time (or patience) to keep track of all the numbers involved in weight loss—calories eaten, calories burned, steps taken, and so on. That’s why fitness trackers were invented. “These apps and devices can save an extraordinary amount of time and make it much easier to follow a specific plan or reach daily step goals or calorie goals,” says Katula. The type of tracker you wear on your wrist—think Fitbit, Jawbone, and Garmin Vivofit—typically log steps taken and calories burned, and pricier models may track your heart rate in real time. Plus, seeing the tracker on your wrist may serve as a constant reminder to get moving. You can also log your meals with an app like MyFitnessPal, which automatically calculates calorie totals and nutrition content for you.

Use social media

Put all that time you waste scrolling through Facebook or Twitter to good use. A 2014 Imperial College London study found that social networks can be affordable and practical alternatives to real-life weight-loss support groups like Weight Watchers. Talking about your weight loss journey with your virtual social circle can help you feel like part of a community. So join an Instagram fitness challenge, Tweet about your Pilates class, or start a Facebook group—all on your own time.

Read more: 30-Day Weight Loss Challenge

Eat more fiber

Here’s one weight-loss trick that requires zero extra time: Eat at least 30 grams of fiber a day (from food, not supplements). People who did that for a year lost almost as much weight as those who followed a complicated diet plan with 13 components in a recent University of Massachusetts study. “For people who find it difficult to follow complex dietary recommendations, a simple-to-follow diet with just one message—increase your fiber intake—may be the way to go,” said study author Yunsheng Ma, MD. The logic is simple: eating foods rich in fiber, like whole grains, beans, fruits, and vegetables, makes you feel full, so you have less room less room high-calorie junk food.

Get a handle on stress

The way you deal with that stress can mean a lot to your waistline. “I tell my patients the three areas affecting their weight they have the greatest control over is what they eat, how they move, and how they handle stress,” says Bartfield. “Stress has a big influence on appetite, food intake, and how the body processes calories, and I think people underestimate that.” And no, confronting your anxiety won’t add a ton of extra time to your day. Unwind with 13 ways to beat stress in 15 minutes or less.

Reflect on your priorities

Take a long, hard look at what’s eating up your time. “When my patients tell me they don’t have time to lose weight, I ask them to really think about what they do have time for,” says Katula. You may be able to pinpoint time sucks you weren’t conscious of before, or decide that certain commitments aren’t as important to you as they once were. (You may also want to talk with your boss or your partner about ways you might make your schedule more flexible.)

“Most people still find time to go to the doctor when they’re sick or get their hair done when they need a cut, but they’re not able to find a few minutes to exercise or eat well, because it just doesn’t seem as urgent,” Katula continues. But it should be just as important, he says, in order to ward off health problems in the future. The bottom line? If you truly can’t find time to take care of yourself, it’s probably time for a change.

This article originally appeared on Health.com.

Read next: 7 Reasons Why You’re Working Out and Still Not Losing Weight

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TIME medicine

Who Should—And Who Shouldn’t—Take Vitamin D

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Here's what experts say, based on the latest evidence

Does your diet need a little extra D? For researchers, it’s one of nutrition’s most vexing questions. “It’s the wild, wild west,” says Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School. “The issue has become murkier over time rather than clearer.” Research is mixed about whether doctors should routinely test for vitamin D levels, like they do for cholesterol, and whether people should be supplementing their diets with vitamin D pills.

Case in point: a study just released in JAMA Internal Medicine showed that vitamin D did not lower the risk of falls among an elderly population in Finland. The study, which compared the effects of exercise against vitamin D supplements on falls and resulting injuries, did find, however, that exercise cut the chances of more severe injury from falls in half compared to those who didn’t exercise.

MORE Want to Stay Healthy? Don’t Rely on Vitamins

But that doesn’t mean that vitamin D isn’t worth taking at all. The Institute of Medicine (IOM), and the U.S. Preventive Services Task Force (USPSTF) both recently reviewed all of the evidence on vitamin D and its health effects and concluded that in many cases, D supplementation is beneficial—with some important caveats. The two groups say that 600 international units (IU) are generally enough for most healthy adults and that higher doses of vitamin D don’t necessarily produce more health benefits. They also stress that those benefits are limited to bone health; there isn’t enough evidence to support the idea that taking the vitamin can protect against heart disease, cancer, diabetes or cognitive decline, all benefits suggested by some smaller studies.

“More isn’t necessarily better,” says Manson, who served on the IOM committee. “In some cases, it can be worse.”

Overdoing vitamin D can lead to calcium in the urine, which can cause kidney stones. Extremely high doses—around 10,000 IU a day—can trigger calcium deposits in the blood vessels, which can lead to clots that cause heart attacks. The IOM panel recommended no more than 4,000 IU of vitamin D daily to avoid these potential problems.

MORE Want to Build Endurance? Cut Back on Vitamin C and E Supplements

When people are tested for vitamin D deficiency and come up short, some researchers caution against treatment. In addition to the dosage risks, there’s also evidence that the lab tests for the type of vitamin D circulating in the blood, 25-hydroxyvitamin D, may not be the most reliable measure of a person’s D levels. Plus, not all labs use the same standard test for picking up 25 hydroxy D, and they set different standards for what are considered normal levels. “Clinicians are often left chasing a number, and trying to get patients’ blood levels up to a certain point,” says Manson. “But when you think about how many people are screened for vitamin D, and the concerns about the reliability in how it’s measured, and the differences in what is considered normal ranges across laboratories, it’s really concerning.”

Better data may be coming soon, however. Several large trials are underway in which people are randomly assigned to take different levels of vitamin D supplements so researchers can study their health outcomes, from bone problems to heart disease, cancer, diabetes and more. Manson is overseeing the largest of these, called VITAL, which has 26,000 participants. The results from these studies, which are being conducted in the U.S., Europe, Australia and New Zealand, should be available in 2017. “We should have conclusive answers in about three years,” Manson says.

The studies will also look specifically at whether vitamin D levels and metabolism differ across racial and ethnic groups. Some studies have hinted that disparities by race in heart disease and certain cancer risks may be due to vitamin D, and the randomized trials will hopefully provide more information on whether that’s true.

In the meantime, Manson says doctors and patients should follow the IOM and USPSTF guidelines: doctors should not order vitamin D blood tests for all of their patients, and people shouldn’t take more than 600 IU of the vitamin if they are otherwise healthy. The only people who may need regular testing for vitamin D deficiency, and possible supplementation, are those with malabsorption problems like Celiac disease, those who have had bypass surgery, or people who have already had fractures and have been diagnosed with osteoporosis. People taking certain medications, including treatment for tuberculosis, may also need to consider vitamin D pills.

For everyone else, however, universal screening isn’t necessary—and there isn’t any reason to take more than the recommended daily allowance of vitamin D.

Read next: The 4 Most Confusing Things About Sugar

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TIME Infectious Disease

How an HIV Outbreak Hit the Heartland

TIME.com stock photos Health Syringe Needle
Elizabeth Renstrom—TIME

Drug abuse combined with a spotty public health system are to blame for Indiana's public health emergency

Indiana Governor Mike Pence on Thursday declared a public health emergency in a rural Indiana county after 79 cases of HIV were confirmed there in the last several months.

An outbreak of HIV may seem odd in such a remote part of the country. The dozens of confirmed cases, described as an epidemic, are centered in Scott County, about a half-hour north of Louisville with a population of about 25,000.

But the spike has been fueled by growing heroin and drug use in rural counties like this one. A number of Midwestern states have struggled with a recent uptick in drug and needle use, and Indiana specifically has seen an increase in the use of a powerful painkiller called Opana, which can be altered and injected. The number of deaths related to opioids like Opana rose from 200 a year in 2002 to 700 in 2012, according to the Indiana State Department of Health.

In this area of the state, there’s relatively weak public health infrastructure to prevent the infection from spreading. Scott County is just one of five counties serviced by a single HIV testing clinic, and the county’s relative isolation from a sufficient public health system can help explain the virus’s rapid growth, says Beth Meyerson, an Indiana University health professor and co-director of the Rural Center for AIDS/STD Prevention.

“The system isn’t working and isn’t strong enough from a public health perspective,” Meyerson says.

In a 2013 study by the non-partisan organization Trust for America’s Health, Indiana ranked last in federal funding per capita from the Centers for Disease Control. The national average spent per capita was $19.54. In Indiana, $13.72 was spent on each Hoosier.

Indiana has also seen an increase in Hepatitis C in many rural communities, says Meyerson, another warning sign that HIV may be spreading. According to the U.S. Department of Health & Human Services, about 25% of people who have HIV in the U.S. are co-infected with Hepatitis C.

On Thursday, state authorities stepped in. Gov. Pence allowed local officials to start a 30-day needle-exchange program in Scott County as a way to stop the outbreak. “I do not enter this lightly,” Pence said, according to the Indianapolis Star. “In response to a public health emergency, I’m prepared to make an exception to my long-standing opposition to needle exchange programs.”

MORE: This Contraceptive is Linked to a Higher Risk of HIV

While dozens of cases have been reported, it’s likely that there are many more still unconfirmed. “I don’t expect these counties will remain the center of the epidemic,” Meyerson says. “I’m sure it’s going to be in other parts of southern Indiana, wherever our system is the weakest. We don’t know what we don’t know right now.”

TIME health

What Experts Got Wrong About Viagra

Small blue Viagra pills, Pfizer's pharma
Suzanne Opton—The LIFE Images Collection/Getty Small blue Viagra pills, separated by machine, in 1998

March 27, 1998: Viagra is approved by the FDA

It was the miracle drug to beat all miracle drugs; an instant bestseller that topped the sales figures of Big Pharma’s other greatest hits: Prozac and Rogaine. After the FDA approved Viagra on this day, March 27, in 1998, sales of the drug rose quickly — pumped by an early rush that yielded at least 10,000 scripts a day, per a TIME cover story about the drug — and had staying power, as evidenced by Pfizer’s annual profit of about $1.8 billion as of 2013 and the fact that our email inboxes are still routinely barraged with spam offers for the drug.

It was a magic bullet for many men, but one that TIME initially feared would herald “the end of sex as we know it.”

“Could there be a product more tailored to the easy-solution-loving, sexually insecure American psyche than this one?” Bruce Handy wondered in the 1998 piece.

There were many who saw chemically-induced erection as a slippery slope to a Sleeper-style orgasmatron.

“People always want a quick fix,” one psychiatrist complained to TIME. “They think Viagra is magic, just like they thought the G spot worked like a garage-door opener.”

Seventeen years later, sex as we know it hasn’t ended — it’s still happening in more or less the usual ways, whether or not Viagra is a part of it. But what was a godsend for men hasn’t opened any doors for women with sexual dysfunction. That’s not for lack of trying: A drug hailed as “the female Viagra” has undergone extensive clinical trials and been submitted to the FDA three times so far, most recently last month, but has never been approved, as Cosmopolitan reports.

The two drugs operate differently, as one might expect: while Viagra stimulates blood flow to the genitals, it doesn’t act on the brain. The proposed drug for women, flibanserin, instead works on neurotransmitters to increase sexual desire.

The fact that there are now several drugs on the market for men’s sexual troubles and none for women constitutes sexism, some have argued, especially since an estimated 16 million women over the age of 50 suffer from some form of sexual dysfunction. A new campaign called “Even the Score” focuses on just this disparity, calling on the FDA to make “safe & effective treatments for low [female] desire” a priority.

In the meantime, a North Carolina doctor has patented a spinal implant that can produce orgasms at the push of a button, although he’s had trouble securing the funding to perfect the device. He calls it the Orgasmatron.

Read the 1998 cover story, here in the TIME Vault: The Potency Pill

TIME Diet/Nutrition

5 Habits of Vegetarians You Should Steal

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These habits can lead to weight loss, and lower risks of high blood pressure and diabetes

More and more of my clients consider themselves to be “part-time” vegetarians. While they may not want to give up meat altogether, they enjoy plenty of meatless meals or take part in ongoing movements, like Meatless Mondays. Today is another formal campaign focused on leaving meat off your plate: It’s the Great American Meat-Out, and getting on board can be a great opportunity to improve your health.

Even semi-vegetarians weigh less, and have lower risks of high blood pressure and diabetes. Plus, taking the focus off meat can be a simple way to boost your intake of plant-based foods you may not be eating enough of.

Here are five healthy veg-based habits you can adopt, even if you aren’t interested in embracing a total vegetarian lifestyle.

Make veggies the main attraction

When I ask most of my omnivore clients what they had for dinner last night, they typically reply with meat first (e.g. “I had chicken with…”). Veggies are often an afterthought. Obviously my vegetarian and vegan clients don’t eat meat, but I advise everyone—including omnivores—to think about veggies first and build the rest of their meals around them. It’s key, because eating more veggies is one of the most impactful dietary changes you can make, but about 75% of adults fall short of the minimum recommended three daily servings.

Fitting in just one additional portion per day can slash your risk of heart disease by as much as 11%, and making veggies the star of your plate can lead to a myriad of benefits. From today on, when choosing what’s for lunch or dinner, select your veggies to start, then add lean protein, good fat, and healthy starch to round out your meal.

Read more: 13 Ways to Make Veggies Taste Better

Choose plant-based fats over animal fats

My hubby, who’s from Texas, grew up eating not just plenty of meat, but also meals made with other animal-based fats, like butter, and bacon grease, as well as lots of dairy-based sauces. While he still eats these foods once in a while, he now prefers veggies sautéed in olive oil or dressed with EVOO and balsamic vinegar, as well as guacamole instead of sour cream, and sauces made from tahini (sesame seed paste) or nut butter—all staples for many vegetarians.

The switch has helped him lose weight, up his energy, and improve his health, and I see the same with many of my clients. Plant-based fats have been shown to reduce inflammation, a known trigger of premature aging and diseases, including obesity, and even help boost weight control and whittle waistlines—even without cutting calories (check out my previous post 5 Amazing Powers of Avocado). Make the switch more often yourself and monitor how you feel, as well as how your jeans fit.

Read more: 14 Best Vegetarian Protein Sources

Make “pulses” your protein

Pulses are my current obsession. Eating at least one serving a day is the cornerstone of my latest book Slim Down Now, and I truly believe that pulses are the most underrated superfoods on the planet. Pulses include beans, peas (e.g. chickpeas, black eyed peas), and lentils, and in numerous studies, eating more of them has been tied to weight loss, less belly fat, appetite suppression, a better overall nutrient intake, and a lowered risk of diabetes and heart disease. Vegetarians often opt for pulses as their protein source and there are plenty of delicious ways to enjoy them, including lentil or split pea soup, black bean tacos, and hummus.

Pea protein powder, also a pulse, is also becoming a hot plant-based protein. I love to whip it into smoothies, and use it as a protein-booster in oatmeal. In addition to providing protein, pulses are rich in filling, blood-sugar regulating fiber, as well as resistant starch, a unique kind of carb that’s been shown to naturally up your body’s fat-burning furnace. Pulses also pack antioxidant levels that rival berries, and they’re satisfying without making you feel sluggish. This Friday or any day, trade the meat in a meal for a serving of pulse, like cannellini beans, lentils, or oven-roasted chickpeas—they’ll fill you up while helping you slim down and stay healthy.

Read more: 9 Reasons You Should Eat More Beans

Snack on plants

While there are “junk food vegetarians,” many veg-heads make whole, plant-based foods their focus, including at snack time. Great options anyone can reach for include raw veggies with hummus or guacamole, fresh fruit with nuts, seeds or nut/seed butter, or a smoothie made with a plant-based “milk” (like almond or coconut) with fruit, leafy greens, and a plant-derived protein powder, such as pea or hemp. Even choosing dark chocolate over milk chocolate ups your plant-based game and boosts your antioxidant intake!


Build plants into desserts

I love baking (check out this video for my 5 healthy baking swaps) and one of my favorite challenges is to find delicious ways to sneak more plants into my splurges. I’ve added puréed spinach to vegan brownies, and in Slim Down Now I incorporate pulses into several goodies, including whipping white beans into chocolate pudding, and using garbanzo bean flour to make pumpkin spice mini muffins. Nutritionists and chefs are incorporating produce into desserts in lots of interesting ways, from tomato sorbet and chocolate eggplant cake to mushroom meringue.

Cynthia Sass, MPH, RD, is Health’s contributing nutrition editor, and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Rangers NHL team and the Tampa Bay Rays MLB team, and is board certified as a specialist in sports dietetics.

This article originally appeared on Health.com.

Read next: How the Nation’s Nutrition Panel Thinks You Should Be Eating

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TIME Diet/Nutrition

12 Recalled Foods Not to Eat This Week

Frozen Vegetable Lasagna
FDA Frozen Vegetable Lasagna

There were 17 food recalls in total this week

Every week lots of foods are pulled from grocery shelves for contamination. There were over a dozen recalls just this week, but since not every recall reported by the Food and Drug Administration makes headlines, we’ve listed them for you.

MORE Organic Frozen Foods Recalled Over Listeria Scare

Spinach
Brands: Simply Balanced, La Terra Fina, Cadia, Meijer, Wild Harvest and Wegmans
Contaminated with: Listeria
Several companies had recalls related to listeria-contaminated spinach this week. Simply Balanced and Cadia, Meijer, Wild Harvest and Wegmans brands recalled organic spinach packages. Wegmans had to recall up to 12,540 packages. La Terra Fina recalled spinach artichoke & parmesan dips and organic spinach dip.

Frozen meals
Brands: Amy’s Kitchen
Contaminated with: Listeria
Amy’s Kitchen, the popular frozen organic dinner company, voluntarily recalled over 73,890 cases of products due to possible contamination with listeria. Foods ranged from tofu vegetable lasagna to spinach pizza.

Ice cream
Brands: Blue Bell
Contaminated with: Listeria
The company made headlines earlier in March when five people in a Kansas hospital became ill, and three people died, from consuming Blue Bell ice cream products contaminated with listeria. This week, three flavors of 3 oz. ice cream cups were also recalled for possible contamination with the same bacteria.

Chocolate covered raisins and almonds
Brands: Lindt, Essential Everyday
Contaminated with: Undeclared hazelnuts and undeclared peanut allergen
Lindt recalled some of its 6.4 oz chocolate covered raisin bags and 6.4 oz chocolate covered almond bags for having undeclared hazelnuts. The products were sold in nine Lindt Chocolate Shop locations in the U.S. In addition, Supervalu Inc. recalled Essential Everyday chocolate covered raisins due to the presence of undeclared peanuts. Having undeclared nut allergens in products can be a serious a risk for people with nuts allergies.

Cod filets
Brands: Giant Eagle
Contaminated with: Undeclared soy
Giant Eagle recalled all lots of its name-brand Japanese Breaded Cod Fillets due to having undeclared soy, which is a risk for people who have soy allergies.

Paninis
Brands: Giant Eagle
Contaminated with: Undeclared egg
Giant Eagle recalled all lots of its name-brand Little Italy Paninis sold in its supermarkets due to having undeclared egg allergen, which is a risk for people with egg allergies.

Frozen Ravioli
Brands: Rising Moon Organics
Contaminated with: Listeria
Carmel Food Group recalled some of its Rising Moon Organics frozen ravioli items after it was discovered spinach from its supplier was contaminated with the bacteria listeria.

Walnuts
Brands: Aurora, Martin Food Products, Stop&Shop, Giant Carlisle Food Store, Giant of Maryland, Whole Foods Market
Contaminated with: Salmonella
Aurora Products, Inc. recalled its Natural Walnuts and Trail Mixes Containing Walnuts sold through the above retailers due to possible contamination with the bacteria salmonella.

Macadamia nuts
Brands: Nature’s Eats
Contaminated with: Salmonella
Texas Star Nut and Food Co. Inc. recalled Nature’s Eats macadamia nuts due to the detection of salmonella.

Kale and quinoa salad
Brands: Wawa
Contaminated with: Undeclared soy
Taylor Farms Florida Inc. recalled some of its Wawa brand Kale and Quinoa Salad due to undeclared soy in the dressing packet in the salad which could put people with soy allergies at risk.

Cookies
Brands: Giant Eagle
Contaminated with: Undeclared milk
Giant Eagle is recalling its Raisin Filled and Apricot Filled cookies which are sold in its supermarkets due to having undisclosed milk allergen, a risk for people with milk allergies.

O’Coconut products
Brands: Nutiva
Contaminated with:
Salmonella
Organic company, Nutiva, recalled O’Coconut products after learning they may be contaminated with salmonella.

Read next: Here’s the Terrifying Truth About Metal Shards in Your Food

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TIME Diet/Nutrition

A High-Fat Diet Could Be Altering Your Behavior and Not Just Your Waistline

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Study finds that heart disease and obesity aren't the only effects of eating too many fatty foods

Obesity, heart disease and other physical afflictions may not be the only negative impacts of consuming fatty foods. According to a recent study on mice, high-fat foods could be affecting behavior, increasing the risk of depression and related psychological disorders.

The study, published in the journal Biological Psychiatry, suggests that a high-fat diet alters the mix of bacteria in the gut known as the gut microbiome. These changes, researchers from Louisiana State University believe, might be affecting one’s susceptibility to mental illness.

The researchers tested their hypothesis by taking organisms from the gut microbiome of mice that had been fed a high-fat diet and transplanting them into non-obese mice. They found that the microbiome associated with greater levels of fat led to problems such as increased anxiety and impaired memory.

“This paper suggests that high-fat diets impair brain health, in part, by disrupting the symbiotic relationship between humans and the microorganisms that occupy our gastrointestinal tracks,” Dr. John Krystal, Editor of Biological Psychiatry, told Science Daily.

Although there is still a lot of research to be done in this field, the study highlights mental issues associated with a high-fat diet regardless of obesity.

[Science Daily]

Read next: 10 Reasons Your Belly Fat Isn’t Going Away

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