TIME Healthcare

10 Products You Think Are Healthy (But Aren’t)

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Some products meant to improve your health and well-being can actually have the opposite effect if used incorrectly

You buy these products with the best intentions: antibacterial soap to kill germs, toothpaste to prevent cavities, a humidifier to relieve sinus congestion. But everyday items like these can trigger your allergies, leave you with a skin infection, or cause other problems if used incorrectly. The good news: the fixes are resoundingly simple, super quick, and keep you safe.

Your loofah

It might make your shower nice and sudsy, but you wouldn’t believe what’s hiding in the nooks and crannies of your loofah. “These act as a perfect environment for growth of bacteria, fungi, and mold,” says Jessica Weiser, MD, of the New York Dermatology Group. Any small open wounds (even microscopic ones from shaving or dry skin) are at risk for infections, from impetigo to folliculitis, she says.

Stay safe: Loofah lovers, don’t worry—you can still use one. Choose one made with natural fibers—they have enzymes to control bacteria, mold, and mildew growth—and replace it every month. Rinse thoroughly and wring out all the water after each use, and store the loofah in a cool, dry environment.

The humidifier

Hooking up a humidifier can bring you much-needed relief from cold-weather ailments like stuffy nose and dry skin. The downside: if not cleaned properly or often enough, humidifiers can grow mold and pathogens, spewing plumes of the stuff into the air, says Miguel Wolbert, MD, medical director of West Texas Allergy in Midland, Texas. Plus, having too much moisture in the air can turn your home into a breeding ground for dust mites, a problem if you suffer from indoor allergies.

Stay safe: After running the humidifier at night, don’t just turn it off and let it sit. Freestanding water left in the bowl is what will accumulate mold. Empty and dry it out completely. The Environmental Protection Agency also recommends cleaning portable humidifiers every third day by using a brush or scrubber on the tank to remove deposits and film.

Cotton swabs

Even though it’s gunky, wax exists to protect your delicate inner ear structures from dust and debris. So it’s healthy, but if it builds up, it can cause an ache or annoying feeling of fullness. That’s why you might routinely dig out whatever’s in there with Q-tips, something doctors don’t recommend: “If you accidentally place the Q-tip anywhere past the ear canal, you can push wax further in and even perforate the ear drum,” says Sujana Chandrasekhar, MD, director of New York Otology in Manhattan.

Stay safe: Forget the cotton swab. “There’s no reason to clean out any of the gunk from your ears except the part that can be removed by sweeping the pad of your index finger in the opening of the canal,” Dr. Chandrasekhar says. “Any wax deeper than that is actually doing a nice job of protecting your ears already.” If you do have an earache, see your doctor for any remedies.

Antibacterial soap

For so long we’d scrub up, aiming to kill germs at every turn. But as it turns out, antibacterial soaps are ineffective at best, says Elaine Larson, PhD, a professor of epidemiology at Columbia University. A decade ago she authored a double-blind randomized clinical trial (the gold standard of study methods) comparing households that used antibacterial products to those without them. The result? There was no difference in the rates people got sick. “It was clear that in a healthy home, antibacterial soap doesn’t really help that much,” she says. At worse, antibacterial ingredients like triclosan may spur antibacterial resistance, says the FDA.

Stay safe: Wash up with plain soap and water, period. And scrub well—it’s the friction between your two hands that physically removes germs and sends the buggers down the drain, says Larson.

Your chair

The risks of sitting keep piling up: an increased risk of heart disease, obesity, and mortality (and the list goes on). Unfortunately, research also shows that even if you’re a regular exerciser, it’s not enough to offset sitting all day during your commute, at work, and then at night in front of the TV.

Stay safe: Unless you get a stand-up desk, you probably can’t change the fact you sit at your desk job. But you can move just a bit more. Get up and walk to refill your glass of water or chat with a colleague. Light walking for two minutes out of every hour reduced mortality risk by 23% compared to spending the full time on your duff, according to a 2015 study published in the Clinical Journal of the American Society of Nephrology.

The blender

You know to wash your blender every time you make one of your yummy spinach smoothies, but you’re probably skipping one of the most important parts: the blender gasket (the rubber ring that helps hold the blade in place). In a 2013 report by NSF International, an independent organization that tests the health and safety of consumer products, the blender gasket was found to be the third germiest item in the kitchen, harboring Salmonella, E. coli, yeast, and mold. When researchers asked people what they thought were the top sources of grime in their kitchen, the blender didn’t even make their list.

Stay safe: After sucking down the smoothie, the NSF recommends disassembling the blender and pulling the blade and gasket out for a thorough washing. Yes, every time.

Nail tools

At-home manis and pedis keep your hands and feet summer-ready, but the tools you use could be harboring a dirty secret. It’s normal for bacteria to live on your skin, so when you use a cuticle clipper or pumice stone, you’re transferring those bacteria to the tools. Skip cleaning them properly and the bacteria can grow and potentially lead to skin infections, notes Dr. Weiser.

Stay safe: Wash pumice stones with soap and water every time you use it and get a new one every three to four weeks. As for nail and cuticle clippers, clean those with soap and water after using, too. More importantly, don’t share. “Normal flora differ from person to person, so bacteria harmless to you could cause infection in your friend, sibling, or partner,” she says.

Rubber spatula

Sure, you clean it every time you use it, but you should consider adding an important step: pulling the spatula head off the handle before you wash. Forgetting to do so is one of the reasons the NSF declared the rubber spatula the number-two dirtiest kitchen item. It was found to contain E. coli, yeast, and mold—not things you want to mix into your batter.

Stay safe: If your spatula is detachable, wash both pieces separately. If it’s a one-piece, you still need to take precautions because yeast can hide and grow in the joint. Make sure to give extra TLC to that section when washing.

Stuffed animals

What could go wrong with the impossibly cute and cuddly toys you use to comfort your little kids? “These are a magnet for dust mites,” says Dr. Wolbert. And dust mites are the biggest culprit in indoor dust allergens, setting off sneezing, runny nose, and red, itchy eyes. Dust mites living in your kids’ stuffed animals can prompt allergy attacks in anybody else in your household.

Stay safe: Keep one or two on your kid’s bed and keep the rest on a shelf. Trade them out every couple of weeks, he suggests. (It cuts down on exposure if you’re not surrounded by 10 at a time.) Or, wrap them in a plastic bag and stash in the freezer overnight—the cold kills mites.

Whitening toothpaste

Here’s the rub: you rely on toothpaste for fresh breath and fighting cavities, and many are designed to make your pearly whites white again. But just because whitening toothpastes are available over the counter doesn’t mean they’re completely harmless. Long-term use of some of these toothpastes—especially grittier ones designed to scrub off stains—can wear away your enamel and increase sensitivity, says Clifton M. Carey, PhD, professor in the school of dental medicine at the University of Colorado Anschutz Medical Campus.

Stay safe: Look for whitening toothpastes with the American Dental Association’s ADA Seal of Acceptance, which is an indication that they gently polish teeth to remove surface stains. If your teeth feel more sensitive after beginning a new whitening product, see your dentist.

This article originally appeared on Health.com

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TIME public health

The Downside to the FDA’s Trans Fat Ban

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The new law will make labeling more confusing and make way for more environmentally destructive palm oil

The U.S. Food and Drug Administration (FDA) recently told food manufacturers to stop using partially hydrogenated oils (PHOs), the major source of artificial trans fats in processed foods ranging from nondairy creamers, to baked goods, margarine, and microwave popcorn. The move, the FDA said, “is expected to reduce coronary heart disease and prevent thousands of fatal heart attacks every year.”

Use of these oils has already dropped by a dramatic 78 percent since the FDA required trans fats to be listed on nutrition labels in 2006. This next phase-out won’t happen overnight: Food companies will have until June 2018 to phase them out.

Before you reach for that donut labeled “trans fat 0 grams,” here’s what you need to know.

1. Trans fats will not disappear from processed food entirely

While the FDA has determined that PHOs will no longer be “generally recognized as safe,” or GRAS, processed food will not be entirely trans-fat-free. There are other sources of trans fats, including fully refined and hydrogenated oils. Some also occur naturally in dairy and meat products.

Food manufacturers have been lobbying to slow down the removal of trans fats since the 1970s, and they are still looking for loopholes. For instance, even with the new ban, companies can petition the FDA to approve specific uses of PHOs, and they will be doing just that. The Grocery Manufacturers Association (GMA) plans to file such a petition on behalf of the industry, “seeking limited and specific use levels to continue using PHOs in food,” said GMA spokesperson Roger Lowe in a recent phone interview. The petition, “will show that the presence of trans fats from the proposed low-level uses of partially hydrogenated oils is safe as the naturally occurring trans fat present in the normal diet,” the GMA explained further in a statement. Any outcome is likely to take several years.

2. “Zero grams” of trans fat per serving does not mean no trans fats

Under current regulations, companies can say “0 grams trans fat” on nutrition labels even if each serving contains up to 0.5 grams of these fats. As the FDA itself explains, “if there is partially hydrogenated oil listed among the ingredients, the product will contain a small amount of trans fat. Selecting foods with even small amounts of trans fat can add up to a significant intake.”

In a 2015 analysis, the Environmental Working Group (EWG) found that 27 percent of the 84,000 foods in its database contain artificial trans fat and another 10 percent were likely to. EWG also found that 87 percent of the more than 7,500 foods that contained partially hydrogenated oils didn’t disclose this on nutrition labels, but showed their trans fat content at 0 grams per serving. While this is not good news for anyone’s health, it’s particularly problematic for children, who tend to take in proportionally more of these fats, said EWG nutritionist and registered dietitian Dawn Underagga.

On a call with reporters, the FDA said it has plans to deal with this labeling issue separately. The agency is now considering a proposed update to nutrition labels, but whether it will change the amount of trans fat per serving allowed under the “0 grams per serving” listing, remains to be seen.

3. The replacement fats have their own problems

One of the attractions of PHOs is their long shelf-life, which is good for processed food manufacturers. It also allows fry oil to be used many times. “Regular soybean oil has a relatively short life before it goes rancid,” explained Center for Science in the Public Interest executive director Michael Jacobsen. But now, he added, “high oleic oils”–soy, canola, cottonseed, and palm–have been engineered to make them last.

According to Chemical and Engineering News, the oils created by Dow, DuPont, and Monsanto through breeding or genetic modification “are low in polyunsaturated fatty acids, which keeps them from going rancid, and enriched in monounsaturated oleic acid,” making them more healthful than trans fats. They are less beneficial than their natural counterparts, however, “because of their reduced levels of α-linolenic acid, a polyunsaturated omega-3 fatty acid, according to Harvard School of Public Health’s website.”

Palm oil, in particular, is likely to be a solution many companies turn to in the coming years. According to the Rainforest Action Network, use of palm oil has already increased by about 500 percent in the past 10 years as labeling rules took effect, and FDA indicated a phase-out might be coming.

This has been bad news in places like Indonesia and Malaysia, where rainforests are being cleared for palm oil plantations. Not only is this destroying habitat for orangutans, elephants, tigers, and other rare species, but it is also removing some of the world’s best natural sources for absorbing atmospheric carbon emissions, significantly contributing to climate change. Human and labor rights abuses are also an ongoing problem in this industry.

During the September 2014 U.N. Climate Summit, dozens of the world’s biggest food producers–including Cargill, General Mills, Kellogg, Mondelez, Mars, Nestlé, and Walmart–pledged to reduce the carbon impacts of their products, including by making a commitment to source only sustainably grown palm oil.

Despite what he calls “tremendous changes” in palm oil supply chains, Friends of the Earth international forest campaigner Jeff Conant says the FDA’s trans fat phase-out could lead to more rain forest destruction. The U.S., said Conant, should “create and enforce mandatory environmental and social standards on palm oil investment and palm oil purchasing.” And Rainforest Action Network, which continues to watchdog the companies who’ve pledged to improve their palm oil sourcing, found that many big brands, including Sara Lee, Pepperidge Farm, Top Ramen, Cup Noodles, and Weight Watchers are still using what the group calls “conflict palm oil.”

4. This change probably won’t make Americans healthy on its own

General Mills told Civil Eats that “more than 95 percent of its U.S. retail products are already labeled zero grams trans fat, and work on the rest of the portfolio is already underway.” Kraft and Kellogg’s report similar progress. But the FDA says to truly avoid PHOs, shoppers should read ingredient lists rather than rely only on labels.

Restaurant food is trickier, since it isn’t labeled, but a number of restaurant chains–including McDonald’s–have already moved away from trans fats, partly in response to restrictions imposed by local governments, such as those in New York City, Boston, Philadelphia, Baltimore, California, and King County, in Washington’s Seattle area. But it’s still not clear whether these changes will make a significant enough impact on customers’ health.

Meanwhile, environmental health advocates are calling on FDA to act further. “This is a public health victory, but there are thousands of chemicals in the food supply the FDA should also be reviewing,” said Natural Resources Defense Council health and environment program director Erik Olson. EWG research director Renee Sharp agreed, adding, “there’s so much more that needs to be done.”

As Harvard T.H. Chan School of Public Health professor of epidemiology and nutrition Walter Willett noted in a blog on the Harvard website, while, “elimination of trans fat is an important step forward, much additional effort is needed to improve the quality of the U.S. food supply, which is far too high in refined starch, sugar, salt, and red meat, and far too low in fruits, vegetables, and whole grains.”

Elizabeth Grossman is a Portland, Oregon-based journalist specializing in environmental and science issues. She is the author of Chasing Molecules, High Tech Trash, Watershed and other books. Her work has appeared in a variety of publications, including Scientific American, Environmental Health Perspectives, Yale e360, Ensia, High Country News, The Pump Handle, Chemical Watch, Washington Post, TheAtlantic.com, Salon, The Nation, and Mother Jones.

This article originally appeared on Civil Eats

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TIME Exercise/Fitness

14 Ways You Lie to Yourself About Your Weight

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Time to face the truth

Your bathroom scale doesn’t lie about your weight—but you might be fibbing to yourself. People tend to subtract a few pounds from their weight and add an inch or two of height in self-reported surveys, according to a 2013 Irish study from University College of Cork. It doesn’t end there. We also lie to ourselves about what it takes to drop pounds and keep them off. Being truthful to yourself can help you recognize the challenges you need to overcome in order to make real progress. Here are common weight loss lies you may be telling yourself—and how to face the facts.

I can’t afford to buy healthy food.

In reality, people prioritize and spend money on what’s important to them, says Amy Goodson, RD, co-author of Swim, Bike, Run—Eat ($17; amazon.com). “You may pay more for some healthy and organic food, but you are getting more nutrient quality for your dollar,” she says. Plus, there are plenty of ways to save. Seasonal, local produce costs less than fruits and veggies shipped from afar—and the more-frugal frozen stuff is just as nutritious as fresh. You can also buy lean meats in bulk when they’re on sale and freeze what you don’t use for later.

I just don’t like the taste of healthy food.

Many people claim they don’t like “healthy food,” when the truth is they reject nutritious eats without even trying them, says Goodson. “It’s recommended you eat a food 10 times before you can determine if you really dislike it or not,” she says. To acquire a taste for healthy food, Goodson suggests you try mixing the food you don’t like with foods you do like. For instance, if you hate broccoli but like rice and cheese, trying making broccoli rice casserole with brown rice and 2% cheese. Gradually increase the amount of broccoli in the dish each time you make it.

My jeans don’t fit because they shrunk in the wash.

Sure, this might be true with some of your clothing, says Brian Quebbemann, MD, a bariatric surgeon in Newport Beach, Calif. “All my patients know, however, that normally clothes don’t tell lies. If you ask, ‘Have I gained weight?’ just put on that sleek dress, or Speedo from your swim team days, and you’ll have the honest answer.”

I worked out today, so I can have this bowl of ice cream.

No amount of exercise will overcome a high-calorie diet, says Dr. Quebbemann. Consider that walking for an hour at 4 mph (a very brisk pace) burns approximately 360 calories. A mere half-cup of Ben & Jerry’s vanilla ice cream contains 230 calories. A real-life serving of ice cream is typically double that, clocking in at 460 calories. That means you’d take in 100 calories more than you burned.

I eat healthy all week so I can indulge on the weekend.

No, you can’t follow a healthy diet during the workweek and then go hogwild on Saturday and Sunday without gaining weight. “Eating 2,000 extra calories over a weekend will increase your daily average by close to 300 calories, causing a gain of 20 pounds within a year,” says Dr. Quebbemann. If you do indulge during your downtime, then be sure to make up for it in the following days. A 2014 Cornell University study found that thin people are better at adjusting their calorie intake after a calorie-packed weekend than those who are overweight.

My mom’s fat, so no matter what I do, I’m always going to be overweight too.

Some research does show a genetic link to obesity, but in most cases, lifestyle trumps genetics. “The most common reason some families are overweight and some are not is because some parents have poor eating habits and teach their kids the same,” says Dr. Quebbemann. “It’s often a cultural inheritance more than a physical one.”

I can have another glass of wine—it’s healthy!

Moderate wine consumption has proven heart-health benefits, but the keyword here is “moderate,” says Lori Zanini, RD, a spokesperson for the Academy of Nutrition and Dietetics. Having more than the recommended one-a-day for women or two-a-day for men cancels out the health benefits—and adds extra calories to your day to boot.

I skip breakfast, so I’m already cutting enough calories.

Skipping meals as a way to save calories won’t help you drop pounds, says Zanini, because you’ll make up for it—and then some—later in the day when you’re starving. A 2012 study published in the Journal of the Academy of Nutrition and Dietetics found that women who reported missing meals lost 8 fewer pounds than those who ate breakfast, lunch, and dinner every day.

I can’t lose weight because I have kids.

We get it—it can be tough to plan kid-friendly meals that are compatible with your diet goals, and you probably feel too busy carting the kiddos to and from school, soccer practice, and piano lessons to give your diet goals much thought. But the truth is, you can overcome these obstacles. If you find yourself eating your child’s leftovers or sharing a few licks of an ice cream several times a day, for example, then try to stop—this can easily add up to 300-plus extra calories, says Goodson.

Losing weight is impossible because I’m hungry all the time.

Your own poor eating choices are likely the reason you’re always hungry, says Dr. Quebbemann. High-carb, low-protein meals spike your blood sugar, which leaves your belly rumbling after it plummets back to earth. “This is the carb-hunger roller coaster many of my patients ride every day,” says Dr. Quebbemann. “When they tell me, ‘I’m hungry all the time,’ I respond, ‘I would be too, if I ate that way.'” Dehydration, stress, and certain meds may also cause an insatiable appetite.

I’m not eating that much and the scale’s not budging.

Chances are, you’re overestimating how hard you’re working out and underestimating how much food you’re taking in, says Jonathan Ross, senior advisor for the American Council on Exercise (ACE). In fact, a study published in the British Medical Journal showed that 23% of adults underestimated the number of calories in their fast food meal and, as a result are making uninformed choices.

I’m doing everything I can to lose weight and nothing’s working.

“This typically translates to, ‘I’m doing everything I’m willing to do,'” says Ross. “You need to ask yourself, ‘Is there anything I can do that I’m currently not willing to do?'” Take a look at your day-to-day habits for ways to add in more activity (get up from your desk more often, walk the stairs) or eat healthier (bring a lunch versus relying on last-minute choices from the vending machine). Track your food and exercise to pinpoint trouble spots.

I deserve a treat once in a while.

Many people “compartmentalize” what they eat, says Ross. “They’ll have a doughnut at a meeting, pizza for lunch, and go out with friends and have chicken wings and then say, ‘I only ate chicken wings twice this month,’ forgetting all the other treats they didn’t count.” These treats are the foods that take you further away from your goals, he says. Keep an accurate food journal to pinpoint all these treats you may otherwise forget.

I look better when I have more meat on my bones.

It’s important to accept yourself, love your shape, and feel comfortable in your own skin. But if your body mass index (BMI) indicates that you’re overweight or obese, think about whether you need to lose weight or at least eat healthier and exercise more. Of course, some people have more muscle than others (BMI is not a perfect measure), but the truth is, research shows that if you are obese, your risk rises for serious health problems such as type 2 diabetes, heart disease, and cancer. Maintaining a BMI over 30 or a having a waist circumference larger than 35 inches for women and 40 inches for men puts you at a higher risk for cardiovascular disease, type 2 diabetes, and other illnesses, says Goodson. “Losing just 10% of your body weight can help lower cholesterol and blood pressure,” she says. And even if you don’t lose weight, exercise and healthy eating will help lower your risks for those conditions.

This article originally appeared on Health.com

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MONEY Finding a job

Need a Job? These 5 Fields Are Hiring Like Crazy

Companies are desperate for qualified candidates.

The unemployment rate in America keeps inching downward, measuring 5.3% in July, compared with 5.7% in January 2015 and roughly half the level it was during the worst of the Great Recession circa 2009.

The fact that life has gotten better (or at least more stable) for employees in a wide range of careers means that businesses have a harder time finding eager, aspiring job candidates—especially the kind of experienced, well-qualified ones that are most in demand. Here are a handful of fields facing big worker shortages right now.

Read next: How Do You Actually Land Your Dream Job?

  • Teachers

    High school precalculus teacher
    RJ Sangosti—Denver Post via Getty Images

    According to Education Week, there are now 100,000 fewer public school teachers than there were in 2008, before the Great Recession caused budget cutbacks and broad layoffs. State budgets have since rallied, and school districts all over the country have gotten the green light to hire many of those teachers back. But because the number of students training to be teachers declined significantly during the recession years, it’s been very difficult to find qualified candidates for the large number of openings.

    The New York Times is reporting that cities like Charlotte, Louisville, Nashville, and Oklahoma City—as well as pretty much everywhere in California—need new teachers so badly that they are “hiring novices still studying for their teaching credentials, with little, if any, classroom experience.” Aspiring teachers who are bilingual, and/or who are capable of handling math, science, and special education are particularly desirable candidates.


  • Chefs

    Chef in kitchen
    Cyrus McCrimmon—Denver Post via Getty Images

    Not long ago, restaurant owners had it pretty easy when they needed to hire a new chef. There was an abundance of qualified candidates for almost any opening, and restaurants could give a few aspiring employees a test-run in the kitchen before hiring anyone. Lately, however, the tables have turned. According to one restaurant owner who recently spoke to Fortune, it’s more typical nowadays for a dozen different restaurants to be fighting over the same single qualified chef to hire.

    The reasons for a shortage of quality chefs mostly boil down to two factors: 1) there have been a flood of new restaurant openings (perhaps 50 in a city like Denver, whereas 10 openings per year is more typical); and 2) the impatience of younger, debt-ridden culinary employees, who aren’t as game as those in the past to learn the craft as low-wage kitchen staff and work their way up the rungs.

  • Construction

    A carpenter carries lumber inside a house under construction.
    Daniel Acker—Bloomberg via Getty Images

    The housing bust took a huge toll on construction workers, to the tune of two million lost jobs, according to the Wall Street Journal. Now that the construction business has picked up again substantially, large building companies are struggling to find all of the experienced, qualified carpenters, plumbers, and electricians they need to keep up with the pace of the work.

  • Skilled Manufacturing

    Automation machinist
    Michael Ciaglo—AP

    The shortage of skilled manufacturing workers has been growing for years. The number of American manufacturing jobs that remained vacant was reportedly 600,000 a couple of years ago, and a 2015 report estimates that a skills gap will result in two million jobs going unfilled over the next decade.

    Average manufacturing wages have crept up to just over $25 per hour, compared with $24 in 2013. But at least some of the reason manufacturing firms have a hard time finding good workers is that the majority of Americans rank manufacturing low as a career choice. It seems that many think of assembly line and production workers, who tend to make wages of sub-$20 per hour, when they imagine a career in manufacturing. Relatively few think of engineers and machinists—the higher-paid kinds of skilled workers manufacturing companies need so badly.

  • Health Care

    Circulating nurse
    Dina Rudick—Boston Globe/Getty Images Circulating nurse

    In Michigan, hospitals have created paid apprenticeships to help attract and train medical assistants. Montana recently hosted a series of summer camps to expose high school students to careers in health care and medicine. Colleges in Florida, Wyoming, Nebraska, and beyond are ramping up outreach and educational programs to entice workers to enter a career in health care. These are among the many strategies being employed to address the looming shortage of doctors, aides, nurses, and other health care workers—who are in demand more than ever as more Baby Boomers retire and more Americans get access to treatment via Obamacare.

TIME Healthcare

Uninsured Rates Are Plummeting in These 7 States

Affordable Care Act Fair Draws Floridians As Enrollmnent Deadline Looms
Joe Raedle—Getty Images A computer screen reads, "Enroll by Dec. 23 for coverage starting as soon as Jan 1." as agents from Sunshine Life and Health Advisors help people purchase health insurance under the Affordable Care Act at the kiosk setup at the Mall of Americas on December 22, 2013 in Miami, Florida.

Arkansas sees biggest drop in uninsured rate

The proportion of Americans without health insurance has plummeted in states choosing to expand Medicaid eligibility under the Affordable Care Act, according to results from a Gallup survey published Monday.

Uninsured rates fell below 5% in seven states in the first six months of 2015: Rhode Island, Massachusetts, Vermont, Minnesota, Iowa, Connecticut and Hawaii. Those seven states, all of which recently expanded Medicaid coverage, join Massachusetts as the only states to be at or below that rate, according to Gallup.

Arkansas and Kentucky saw the most significant drops in uninsured rates between between 2013 (before the Affordable Care Act’s core provisions took effect) and the first half of 2015. Uninsured rates in Arkansas fell from 22.5% to 9.1%, and in Kentucky fell from 20.4% to 9.0%, respectively. Those states’ drops coincided not only with their expansion of Medicaid but also the establishment of their own state health exchanges, the poll found.

The findings, arriving just weeks after a Supreme Court ruling upheld the Affordable Care Act’s subsidies, continue to challenge states like Florida and Texas, where political leaders are hesitant to expand Medicaid over cost concerns.

Read next: Birth Control Costs Nearly Halved After Obamacare, Study Finds

TIME Healthcare

Hospitals Have Reduced Deaths, Hospitalizations, and Costs Among Medicare Patients

"It's a jaw-dropping finding"

American hospitals have reduced deaths, hospitalizations, and costs among people over the age of 65 in the past couple of decades, according to a new report released Tuesday.

“We didn’t expect to see such a remarkable improvement over time,” said Harlan Krumholz, a cardiologist at the Yale School of Medicine and lead author of the study, which appeared in the Journal of the American Medical Association (JAMA).

Krumholz and his colleagues looked at over 68 million Medicare beneficiaries between 1999 and 2013. The group was chosen for their “fee-for-service” structure, where doctors and hospitals would be paid per procedure or visit.

They found that hospitalization rates for this group plummeted 24%, saving more than 3 million people unnecessary hospital visits. Their chance of survival and recovery had improved from less than two decades ago: patients were 45% less likely to die during their stay, 24% less likely to die within a month of being admitted, and 22% less likely to die within the year.

Deaths among the group fell 16%, meaning 300,000 lives were saved in the 14-year span, according to the report. Patients who visited the hospital also saw a 15% drop in their bills compared to 1999.

Krumholz said that better training for hospital staff led to many of the improvements.

“There has been tremendous focus on making sure that our hospitals are safer and that treatments are more timely and effective,” Krumholz told USA Today.

People are also living healthier, longer lives—smoking less, breathing cleaner air, and able to take advantage of scientific breakthroughs in medicine.

Despite doing so well, Krumholz doesn’t think it’s time for hospitals to get lax.

“The things we’re trying to do to make things better are working,” Krumholz noted. “Rather than wave the victory flag, we want to see that trend continue. There’s no reason to take our foot off the pedal.”


TIME Healthcare

15 Weird Risk Factors for Kidney Stones

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Your love for leafy greens may increase risk for kidney stones

Anyone who’s ever passed a kidney stone before has probably wondered how something so small (usually, anyway!) can cause so much pain. Unfair, we know. About 1 in 11 people will suffer from a kidney stone in their lifetime—and once you’ve already had one, you’re about 50% more likely to have another. More bad news: At one time, stones primarily affected men, but new research shows that this gender gap has almost closed, possibly due to the rise in obesity.

What are kidney stones, exactly?

Most kidney stones are a solid mass of minerals that have congealed and lodged itself somewhere in your urinary tract. The majority of them are made of calcium—usually a combination of calcium and oxalate, but, in rarer cases, calcium and phosphate—and, to a much lesser extent, uric acid.

Now for the good news: With a few dietary and lifestyle tweaks, you might be able to slash your odds of ever suffering from a kidney stone again—or, even better, prevent one entirely.

Too little calcium

Since calcium is present in most kidney stones, it makes sense to just cut the nutrient right out of your diet, right? Nope. That was the old thinking. Now experts know that people who consume more calcium are less likely to encounter a kidney stone than those on low-calcium diets, according to one 2013 study by researchers from Harvard Medical School. “It’s all about balance,” says Mantu Gupta, MD, the chair of urology at Mount Sinai Roosevelt and Mount Sinai St. Luke’s Hospital. Dr. Gupta goes on to explain that if your diet is deficient in calcium, chemicals called oxalates, which normally bind to calcium in the digestive tract, will instead bind with calcium in the urine and trigger the formation of stones.

Your salad obsession

You eat all the right things, only to end up in a urologist’s office. What gives? Oxalates, again. These substances are found in leafy greens like spinach, rhubarb, and beets. Ideally, those oxalates will bind with calcium in your intestine and be shuttled out of your body via your urinary tract, says Roger L. Sur, MD, director of the University of California San Diego’s Comprehensive Kidney Stone Center. But when the amount of oxalates is too high, these chemicals can concentrate in the urine and lead to a stone formation. That’s not to say you should give up veggies, of course. Talk to your doctor about possible food swaps for lower-oxalate foods—for example, kale instead of spinach or cauliflower in place of amaranth.

A salty diet

Out of all the potential problems caused by too much salt, kidney stones are probably last on the list. But when your sodium intake rises, that can also trigger an increase in the amount of calcium your kidneys excrete. Translation: A build-up of calcium in the urine, which increases the risk of kidney stone formation, says Brian Stork, MD, a urologist and spokesperson for the American Urological Association. Experts recommend that most people limit their sodium consumption to 2,300 milligrams per day, but other people, like those with high blood pressure, should lower that to less than 1,500 milligrams per day.

Not enough citrus fruits

If you can’t remember the last time you had a lemon or grapefruit, consider this a reason to up your intake: Citrus fruits contain a compound called citrate, which is thought to help lower the risk of some kidney stones, says Dr. Gupta. Plus, one study in the journal Nature found that when people who normally avoided produce added fruits and vegetables into their diet for one month, they decreased the amount of kidney-stone-causing chemicals that were present in their urine. Try adding a lemon or lime wedge to your water daily, says Dr. Gupta.

Too much meat

On the other hand, eating too much poultry and red meat can also put you at risk for stones: One 2014 study in the journal Nutritional Epidemiology found that vegetarians and fish-eaters were 30 to 50% less likely to have kidney stones than people who ate about 100 grams of meat per day (think: a steak and a half). People who load up on meat might be crowding out fruits and vegetables from their diets—a mistake, since produce contains magnesium, which can also prevent stones from forming.

Living in the South

The Southeastern United States might be known as the Bible Belt, but urologists have another name for it: the kidney stone belt. One oft-cited study published in the American Journal of Epidemiology in 1996 found that people living in this area had nearly double the risk of stones as people living in cooler regions of the United States. Blame the hot, arid climate: “Because the temperatures are higher, people in the South can lose more fluid through sweat and become dehydrated,” says Dr. Gupta. When you aren’t drinking enough water, there will be a higher percentage of minerals in a lower amount of urine, increasing the likelihood that those minerals will bind together to form a stone.

Too much iced tea

Another strike against the sweet-tea-loving South. A 2015 report in the New England Journal of Medicine about a 56-year-old man who was rushed to the hospital for kidney failure after drinking too much iced tea shocked the Internet. And as it turned out, black tea (one of the most popular kinds in the U.S.) is also a major source of oxalate, which can cluster in the urine to form kidney stones. This man was drinking about 16 8-ounce glasses of black tea daily, which is at least double the average person’s daily intake. If you’ve had a kidney stone before, ask your doctor about limiting your consumption to one 8-ounce serving a day, says Dr. Gupta, who also notes that people with super high levels may have to cut it out of their diet completely.

A can of soda

Normally, staying hydrated is one of the smartest ways to avoid kidney stones because it dilutes kidney-stone forming substances: (That’s why experts say that drinking about eight glasses of water a day is one way to prevent them from forming in the first place.) But not all beverages are created equal: One 2013 study found that downing even one sugary-sweet soda a day can increase your odds of developing kidney stones by 23%. Researchers think that the fructose (a sugar) in sweetened drinks causes an increase in kidney stone-causing chemicals. Stick to water, minus the sugar.

Your parents

Here’s something else to thank mom and dad for: If either parent has had a kidney stone, your risk increases as well. Sure, families have similar diets, but there’s a biological reason as well. “Like obesity or diabetes, there are multiple genes involved, and oftentimes, people inherit the inability to efficiently absorb oxalate from their parents,” says Dr. Gupta.

Having IBD

People with inflammatory bowel diseases tend to have a higher risk for stones than those without these serious conditions, and one 2013 study in the International Journal of Nephrology and Renovascular Disease found that those with Crohn’s disease and ulcerative colitis were especially at risk. One reason: These conditions are accompanied by diarrhea, which can increase a person’s risk of dehydration—and, in turn, up the percentage of kidney stone-causing chemicals in lower amounts of urine, says Dr. Stork.

Recurring urinary tract infections

In this case, frequent UTIs are a possible sign of a kidney stone. Some background: Not all stones cause pain—in fact, some can pass through your body unnoticed. But other times, kidney stones stay in your urinary tract and block the flow of urine, which could lead to a UTI. This infection is one possible sign that you may have a kidney stone that you don’t know about, explains Dr. Sur. “In some people, the only way we would have found their kidney stones is because they had recurrent urinary tract infections,” he says.

Using too many laxatives

Laxatives have existed for over 2,000 years, and people have been abusing or misusing them that entire time, according to a 2010 study published in the journal Drugs. Older people dealing with constipation who believe they need to have a bowel movement daily for good health comprise a significant number of laxative abusers, but the largest group, by far, is made up of people suffering from anorexia or bulimia. Laxative overuse may interfere with your body’s ability to absorb nutrients and medications, and may also bring on an electrolyte imbalance—and it’s been linked to kidney stones, says Dr. Sur. Using too much of these meds may cause people to become dehydrated, which could trigger a stone.

A migraine medication

People who take topiramate (found in the prescription med called Topamax) can be more likely to have kidney stones than those who don’t take this drug, says Dr. Sur. One 2006 study in the American Journal of Kidney Diseases found that topiramate can increase the pH levels in the urinary tract, which may lead to an increased risk of kidney stone formation. (Talk to your doctor before making any changes to your medication regimen.)

Your weight

Obese women may be about 35% more likely to develop kidney stones than their leaner counterparts, according to a 2011 study in The Journal of Urology. Researchers aren’t quite sure why, but they suspect that the extra poundage changes the environment in your urinary tract, making it easier for kidney stones to form. “People who are obese have altered urinary pH levels, which can cause a buildup of uric acid-forming kidney stones,” says Dr. Sur.

Weight loss surgery

While it’s true that obesity increases your risk of stones, so can bariatric surgery, according to one 2009 study in The Journal of Urology. “It’s thought that after the procedure, people might not absorb as much calcium from their diets,” says Dr. Stork. “When that happens, the build-up of oxalate in the urinary tract could lead to a kidney stone.” If you’ve recently had surgery, talk to your doctor about how you can cut your risk, either by drinking more water, limiting meat and sodium, or consuming enough calcium.

This article originally appeared on Health.com

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6 Things Every Woman Should Know About Yeast Infections

So-called 'preventative' products may cause more harm than good

Sorry to be a downer, but if you haven’t had a yeast infection yet, you’ll probably get one eventually. Three out of four women will experience one sometime in her life—and half will have two or more. “These are so common because yeast normally lives on your skin and around your vagina,” says Melissa Goist, MD, an ob-gyn at The Ohio State University Wexner Medical Center. When something disrupts the vagina’s natural balance of healthy bacteria, yeast (aka the fungus Candida) can grow out of control. And then comes the telltale down-there itching and burning sensation that can drive you up a wall.

Whether you’ve been visited by a yeast problem once, a bunch of times, or not yet, you may be surprised by the truth about these frustrating infections. Here are the facts every woman should know.

The symptoms can mimic other problems

One study found that as few as 11% of women who have never had a yeast infection could identify the symptoms, while other research has found that only one-third of women who thought they had a yeast infection actually did. Why the confusion?

The signs are similar to other down-there problems. If you have a yeast infection, you might notice burning, itching, pain during sex, and a thick white odorless discharge.

But if it smells fishy, it may instead be bacterial vaginosis (BV), and if you have only burning and pain during urination, that suggests a urinary tract infection. Bottom line: It can be difficult to figure out.

First-timer? Go to the doctor if you think you have one

Now you know the signs, but remember: Just because you can buy over-the-counter treatment for a yeast infection doesn’t mean you always should. The first time you experience symptoms, it’s important to see your doctor (or hit up an urgent care center if you can’t score an appointment) because if it turns out you don’t have a yeast infection, at-home treatments can make inflammation worse or not provide any relief at all, Dr. Goist says.

A doctor will be able to correctly pinpoint the problem (yeast infection or something else) then give you personalized treatment, like an Rx for the oral antifungal fluconazole as well as a topical skin cream to reduce inflammation.

After that, you’ll know exactly what to watch out for, and your doc may give you the all clear to self-treat your next one with an over-the-counter antifungal, like Monistat or generic clotrimazole.

You don’t need products to prevent them

Gynecologists like to call the vagina a “self-cleaning oven.” That’s because it doesn’t need any help with douches, scented gels, perfumes, and other “feminine” products to stay clean. In fact, rather than helping prevent a yeast infection, these can cause an imbalance of the healthy bacteria in your vagina that makes you more susceptible to a yeast infection, explains Dr. Goist.

What to do if it happens after sex

A yeast infection is not technically a sexually transmitted infection (STI), but sex can throw off the bacterial balance in your vagina, upping your risk for a yeast overgrowth. That said, if you get what you think is a yeast infection after sex with a new partner, it’s a good idea to see your doctor, so you can rule out any potential new STIs, as well.

The truth about wet bathing suits

You’ve probably heard hanging out in wet clothes is a recipe for disaster. Doctors often say it’s a good idea to change out of a wet suit or sweaty exercise clothes because yeast thrives in warm, wet environments. And that’s true. But it’s mostly important for women who suffer from recurrent episodes rather than the general population. “Unless you know you’re prone to yeast infections, you won’t necessarily get one by hanging out in a wet suit,” Dr. Goist says. Make changing a priority if you get them frequently, otherwise, you’re probably fine.

Switching birth control pills may make you more susceptible

Anything that alters your hormone levels—like changing to a new hormonal birth control pill (that increases your estrogen levels) or too much stress (high cortisol) is a risk factor. Other things to watch out for: taking antibiotics, which kill healthy bacteria in the vagina, allowing yeast to thrive; or having uncontrolled blood sugar levels if you have type 2 diabetes (high blood sugar can feed yeast). If any of these sound like you and you get yeast infections, come up with a plan with your doc about how to control them.

This article originally appeared on Health.com

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Hillary Clinton Dined With John Kasich Over Healthcare Reform—In 1993

Republican U.S. presidential candidate and Ohio Governor John Kasich formally announces his campaign for the 2016 Republican presidential nomination during a kickoff rally in Columbus
Aaron Bernstein—Reuters Republican presidential candidate and Ohio Governor John Kasich formally announces his campaign for the 2016 Republican presidential nomination.

A decades old meeting between two 2016 rivals takes on new significance.

Just months after her husband took office, First Lady Hillary Clinton attended an unusual backyard dinner in Northern Virginia on her quest to sell the healthcare reform plan known as Hillarycare.

The June 1993 gathering was at the home of then-House Budget Committee ranking member John Kasich, the same man who announced his campaign as a 2016 presidential candidate for a Republican Party still furious about a healthcare reform bill by President Obama that drew heavily on the work of Clinton from the early 1990s.

At the time, Kasich was developing his own national health insurance proposal, which offered a more marketplace-based solution than what emerged in Obamacare. The Kasich plan would have covered all Americans by 2005, using a form of an individual mandate that would have required employees to purchase insurance through their employers. (The mandate was an idea initially supported by conservative groups like the Heritage Foundation.)

In his announcement speech this week, Kasich referred to his work on health issues in the 1990s. “I went on to chair the Health Committee where I learned to work across the aisle because the House was run by Democrats,” Kasich said of his time working in the State Senate. “And that’s where I learned that policy is far more important than politics, ideology, or any of the other nonsense we see.”

In 1993, the bipartisan outreach included the dinner with Clinton and nine fellow Republicans. Afterwards, Kasich declared Clinton had been “a big hit,” with the crowd.

A contemporaneous memo released last year by the Clinton Library provides more insight into the meeting, and Kasich’s role in the healthcare reform effort.

After the dinner, “Congressman Kaslch, has been quite complimentary about you, personally, and the Administration’s consultative and outreach process for health reform,” Clinton aide Chris Jennings wrote to Hillary Clinton in a memo.

Before a follow-up meeting two weeks after the dinner, Jennings pegged Kasich as a strong target for administration outreach. “Kasich, given his reputation as a smart and serious legislator, can be very helpful With mainstream Republicans,” Jennings wrote. “In addition, he seems to have gained the respect of the media so his supportive comments about you and the process can have a positive impact externally on public perception, as well.”

“Even if he ultimately opposes the plan,” Jennings concluded, “his positive feeling toward you and the process may mute his criticism and moderate the Republican opposition effort.”

In 1993, before the Clinton meetings, Kasich released a report on healthcare that amounted to a “rather stereotypical conservative position on health reform,” in Jennings’ words, including means-testing Medicare, increasing co-payments, and using private healthcare savings accounts. But, he added, “it also includes a number of suggestions that are consistent with the direction the Administration has been heading including: Developing incentives for greater use of competition in the Medicare and Medicaid programs, providing flexibility/waiver authority to the states, reducing health care fraud, assuring Insurance portability, establishing purchasing groups, and addressing the medical liability problem.”

A year later, Kasich introduced a plan that would have provided health insurance to all Americans by 2005, requiring them to purchase insurance through their employers on the private market, with government subsidies helping those below or near the federal poverty line. Small businesses and individuals would have been able to join “voluntary alliances” to purchase insurance as a pool. It also ensured that those with pre-existing conditions could get coverage.

Kasich aides said the meeting with Clinton is an example of his willingness to create connections with all sides, including those he disagrees with. “They certainly didn’t agree, but that didn’t keep him from wanting them to engage in converation,” said Kasich spokesman Scott Milburn.

Ultimately, Hillary Clinton’s effort was doomed to failure—though some of its proposals found a home later in the Affordable Care Act.

Many of Kasich’s own ideas for the era were gathered into the Affordable Care Act as well, though Kasich takes issue with their implementation. He has long called for ensuring that all Americans have health care insurance, but, in line with his party’s thinking about the healthcare law, has said he would sign a repeal of the bill.

“He wants to see people cared for, and he wants a competitive free market approach to do it,” Milburn said.

Aides point to Kasich’s turn to expanding managed care healthcare plans in Ohio, which has halved the rate of cost growth, as an example of the types of reforms he is looking to expand nationally.

Kasich frequently defends his decision to expand Medicaid on the campaign trail, tying it to his broader message of compassionate conservatism, arguing that those facing drug addiction, mental illness, and other difficulties should be cared for.

“I’m not for Obamacare.” Kasich told Bloomberg in April. “I have expanded Medicaid, because I wanted to bring Ohio dollars back to Ohio. We’ve been able to apply it to bring significant change, and our ultimate goal is that so all of these people who have been hurt can be in a position to get on their feet and move forward.”

TIME Research

How Having Oily Skin Might Help Prevent Wrinkles

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And why wrinkles tend to be more noticeable around your eyes than on your forehead

Have you ever heard the old wives’ tale that people with oilier skin get fewer wrinkles? There may be some small grain of truth in that after all, according to a new study published in the journal Clinical Anatomy.

For the study, Japanese researchers analyzed the skin on the foreheads and around the eyes in cadavers aged 20 to 90 years old, looking at the wrinkles, the number of sebaceous glands (which are what secrete the skin’s oil), as well as the skin’s elasticity and density. In the end they found that the depth and length of wrinkles correlated to the amount of sebaceous glands in these areas, with areas with more glands tending to have wrinkles that weren’t as deep or long.

This may explain why wrinkles tend to be more noticeable around your eyes (hello, crow’s feet) than on your forehead, since there are more oil-secreting glands in the forehead than around your eyes.

While the authors say it’s possible that oilier skin (thanks to having more glands) prevents dry and deeper wrinkles from forming, the presence of the oil isn’t the only thing that seems to help keep skin smooth. It could also be that the skin on the areas with more glands tended to be thicker and have more elasticity. As the researchers put it: “Such properties will suppress the deformation of the skin.”

Another interesting finding: the density of oil glands was lower in women, than it was for the men, though they didn’t see a big difference in wrinkle depth between the sexes.

Ultimately, what matters more for your skin is the total picture: protecting yourself from the sun’s rays, exercise, eating a healthy diet with lots of foods that are good for your skin, and getting enough sleep.

But hey, if this makes you feel a little bit better about your oily skin, we won’t blame you.

This article originally appeared on Health.com

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