Prevention Everyday ae Fixes 25 Feel-Good Remedies “i Mood _ », Boosting Bs Foods Crunch-Free Ab Workout36 46 Fast Health Fixes | How Health Care The absolute best Fails Women remedies for all of your The disturbing truth about everyday ait gender bias in medicine— By = MecCoffery, and how to get the first-rate Erica Sloan, and the eau dese Editors of Prevention By Kenneth Miller What Is That?! earn how to recognize and treat 10 of the most common, usually harmless skin conditions. By Jessica Brown CON PoUuLos- Power Up 3 a == That Taco! = Fold in plenty of fresh produce fora truly balanced and delicious meal, p. 84. 60 68 cg “TWalked Across | Want Better Abs? | Recharge America” Just Breathe! Your Life Lindsay Monroe traversed The secret to a stronger, Small tweaks to your routine the country for 9 months—_| leaner core: Make every that keep your energy going and rejuvenated her health inhale and exhale count. all day long along the way. By Evelyn Spence By Evelyn Spence As told to Tracy Ross JUNE 2018 - PREVENTION.COM ILContents 28 Pulse HEALTH 6 Cosmic Promise 9 Get the Right Result 10 New Human Organ 14 Mind Your Meds MIND + BODY 43 Build a Better Skeleton 14 Probiotics for Your Skin NUTRITION 16 15-Minute Meat 17 Fresh, Frozen, or Canned? FITNESS 18 Ease Into Exercise 49 Stretching 104 Everyday Health 20 Natural Remedies 3 new uses for lavender 24 The Holistic MD Natural ways to lower your blood pressure 26 Healing Movement Bear crawl 30 Does It Work? Can a home test tell you if your water is safe? 32 Reality Check 5 myths about hair In Every Issue 3 Breathe 4 Letters to the Editor 22 Problem Solved How to handle atoothache 28 Good Food What to eat to boost your mood 96 Brain Games Challenge yourself with these fun puzzles. On the Cover: 5 myths About Hair 32, Everyday Health Fixes 36, Mood Boosting Foods 28, 4 Woys to Beat Fatigue Fast 78, Crunch-Free Ab Workout 68. Cover credit: Getty Images 2 PREVENTION.COM - JUNE 2018 FROM LEFT: ANGELA LUMSDEN/STOCKSY; JASON VARNEY; VESNA JOVANOVICIGETTY IMAGES.\ Pe 3 sj : S$ iS s F =) = a 7FROM OUR READERS ourE Preprew?revendi Disa, opts p Pit wah soci Letters to the E ditor Your comments on the April issue PREVENTION'S GUIDE TO PREVENTING DISEASE In your article about colon cancer, the writer recommends colonos- copies once a decade starting at age 50. My cancerous polyp was detected 5% years after my previous colonos- copy. My gastroenterol- ogist informed me that a polyp takes 5 years to become cancerous. So, 10 years is too long to wait. Helen van Hell / Montreal, Quebec Af PREVENTION.COM - JUNE 2018 When | read “Guide to Preventing Disease” in the Aprilissue, it really gave me the motivation | needed to enjoy my weight-training sessions, seeing all the benefits they give me. Thank you for the boost! Elza Roussel / North Miami Beach, FL WOMEN'S HEALTH Thank you for the Women's Health column by Dr. Lau- ren Streicher. I'm happy to read frank and informative answers about women— especially the sexuality issues we have kept to ourselves for so long. Keep up the great work on Prevention. It is my “go-to” for scientific data. Rose Lynch / Quincy, MA PULSE Iread [in the April issue] that people who make their beds sleep well. We have not made our bed for years. leave the covers pulled back for the bed to air out. It always seems fresher when we go to sleep. Beryl Andrews / Myrtle Beach, SC GARDEN IN GOOD HEALTH This story was helpful in pointing out incorrect movements while CONNECT WITH US send your comments to letters@prevention.com. You may send your comments, eters, stories, phatos, images, text, content, information, and any other material (the “work” to usin connection with Prevention. Please Include your fullname, address, e-mail address, and phone number with all work yousend us, folowing the instructions (any) we provide. We reget that we cannot acknowledge or return any work. You must be a US resident and at least IB to send ‘us work. By submitting your work, you grant permission to Hearst Communications, Inc. and its licensees ("Hearst) to edt and use the work worldwide for any purpose, Including promotional purposes, in any form of mea, GETTY IMAGES: ANNA 1311; MANGPOR.2004gardening. But it did not is 1,000 total and then with obesity and diabetes include recommendations 10,000—it’s fun! in our world. for spinalalignment. Esther Natalie Cornell / ‘Sean Baltz / Gokhale’s work provides Frankford, Ontario Anderson, IN information that helps me maintain correct postures. Since September 1, READER REQUESTS | would think other readers —_| have lost 21 lb. Not Cholesterol in women is a would value her work. going crazy ona dict; strange phenomenon be- Judy Yesso / just investing extra cause, after menopause, Columbus, OH time in processing your cholesterol changes occur information. Thanks in spite of daily exercise FITNESS & WEIGHTLOSS _ for keeping it real. and fairly healthy diets. Seven years ago | lost Kurt Svoboda / Please run an article on 60 lb and started to Brookfield, IL both drug and nondrug exercise, which left me treatments for cholesterol. with aches and pains. So | lost 300 lb and cured Laurette M. Ellis, MD / | backed off on exercise. myself of diabetes. | had via e-mail But in the past 2 years, no surgery for weight | gained 5 lb and don't feel —_ loss and did not take any I love the changes made to as fit. One day | dropped medication to cure the Prevention, but | would like to the ground and grunted _ diabetes. | want to share to see effective and af- through five push-ups. | my story with more people _ fordable beauty products. am now finishing the week _to help them. There are so Jackie Mancini / with 17 push-ups. My goal many people struggling Staten Island, NY TONE AT HOME WITH OUR NEW DVD! Sculpt a strong, healthy body in just 20 minutes a day with Prevention's Toning Transformation DVD program. Trainer Sarah Kusch makes it fun and easy to get in shape in just 8 weeks with gentle, effective moves that target every zone. Asmart-eating guide and a daily workout schedule will speed your results. Go to PREVENTION.COM/TONINGTRANSFORMATION to pick up your copy today. ot Moc} JUNE 2018 - PREVENTION.COM &sem SSP AAU RANE NEA Rd BREAKTHROUGHSbate ba edn) (=) a ‘ : ee 2 Meee rs Ch ees th Oe 7 ¥ : Ty aaa See ose ea Runa ; Rene eee easy 2 . every part of astronauts’ bodies. NA ela TRC : Ue eet hrs ee - Bierman Poteet ti Cea) Porta nuke acts ete ae ca Z cea es eee ad oe See hae csc fo ae rat au ace Coat : Die ste OR rae Tne Meubles ate p emcee ks) : ee eur eat crac occurs, but the findings could lead Red sercoa te cteatea cee tt crc aa sce AN eo eRe Aas XN Your Health Coverage Did you know that your health insurance may fully cover (meaning no out-of-pocket costs) several preventive services that are critical to women’s health and well-being? We've listed just a handful of services below, but you can finda full roster (including ones for men and children) at healthcare.gov/ preventive-care-women. Check with your insur- ance company to see if your plan covers them. ‘WELL-WOMAN VISIT (annual physical) MAMMOGRAPHY CERVICAL CANCER screening INTERPERSONAL AND DOMESTIC VIOLENCE screening BREASTFEEDING counseling and services TESTING FOR INFECTIONS urinary tract infection, sexually transmitted infections, HIV, and more OSTEOPOROSIS screeningGet the Right Result Different ways of interpreting genetic mutations in BRCA genes—associated with a higher risk of breast and ovarian cancers—make some labs’ analyses incomplete or unreliable, says researcher Amanda Ewart Toland of Ohio State University. The inconsistencies among labs are cause for concern because women base major medical decisions, including whether to undergo a preven- tive mastectomy, on these test results. Toland and a team of scientists sent questionnaires to labs around the country. The results showed that while the labs were generally able to identify the gene mutations accurately, their methods of interpreting those mutations differed. For instance, one lab might label a specific mutation as pathogenic, or disease-causing, while another interpreted the same mutation as a variable of uncertain significance (meaning they are unsure whether it increases cancer risk). Toland says she's seen cases where a woman requests a BRCA gene test because her sister was found to have a mutation associated with cancer. But when another lab finds the same mutation, it reports that the change may or may not lead to higher cancer risk. “It can add a lot of uncertainty and conflict within a family, says Toland. HEATHER STEN/OFFSET PULSE How can women be sure they're getting the most reliable results? Toland recommends the following: Consider seeing a genetic coun- selor and having her send your sample to a lab. These profession- als tend to use labs that are very experienced. If your internist or ob-gyn sends the blood sample, ask how long the lab has been doing BRCA gene testing. More-experienced lab staff will be better at interpret- ing the findings. If you get the result “vari- able of uncertain significance,” know that that interpretation may change over time, so consider checking back in with your health care provider periodically to get updated information. JUNE 2018 - PREVENTION.coM @MUCOSA FLUID-FILLED SPACE CD34-POSITIVE LINING CELLS COLLAGEN BUNDLES FOUND! HUMAN ORGAN #79 Researchers from NYU's School of Medicine and the Feinstein Institute for Medical Research have discovered a brand-new organ called the interstitium, a network of interconnected, fluid-filled compartments that lies beneath the skin and within the tissue of your gut, lungs, and urinary system. It also surrounds most organs, muscles, and major blood vessels. While scientists are still determining the exact role of the interstitium, the newfound organ seems to act as an important conduit of immune cells as well as a channel that allows cancer to spread. Future research will investigate how the cells of the interstitium change over time to contribute to skin wrinkling, limb stiffening, and a host of other inflammatory diseases, say the NYU researchers. THE PERCENTAGE OF GYNECOLOGISTS WHO ARE WOMEN. IN THE’70S, JUST 7% WERE FEMALE. 10 prevention.com - JUNE 2018 FERENCE IMAGE BY JILL GREGORY/@MOUNT SINAI. VICISTOCKSY 22 a3THE BREAKDOWN Mind Your Meds Forget to take your pills? “Me compliance is a huge issue in this country,” says Norman Tomaka, a clinical consultant pharmacist in Melbourne, FL. To stem the trend, here are a variety of ways to help you stay on track—including some high-tech options that advance the old pill-organizer trays marked with the days of the week. Countertop devices I Smart caps Il Phone apps WHAT “Smart” pill dispensers Inexpensive, easy-to-use Special software that THEYARE that canbe programmed medicine bottle caps that sends pop-up alerts to. to sound alarmsorflash canbe set to indicate your cell phone when lights when it's time for the time ofthe next dose you're due to take your, adose and digitally keep track medication of when the bottle was last opened CAVEAT — You typically have to Hfyouare taking several The alerts can become have a smartphone or different medicines, annoying and are be home to see or hear most of these caps indiscreet. the alert. And some can't help you devices may be com- coordinate them. plicated to program. EXAMPLES — MedMinder, Med- Pillsy, Remind-A-Cap, Dosecast, Mango Memo Box TimerCap Health, Medisafe JUNE 2018 - PREVENTION.coM MLLPULSE BONING UP ON BONES The Blood Sugar Link Bones don’t just keep us mobile; they also influence blood sugar levels. Scientists have discovered that the human skeleton has a “me- tabolism” of its own—some bone cells form new bone, while others reabsorb it. This leads to a new skeleton about every 10 years—though it can also cause diseases like osteoporosis when the reabsorption is too aggressive. Bone cells use sugar as part of this process, and Belgian and French researchers conducting an animal study found that when bone cells “consumed” too much sugar, glucose levels in the blood dropped. Low blood sugar can lead to fatigue and be dangerous for people with type 1 diabetes. Researchers hope these findings contribute to future therapies for conditions such as osteoporosis and diabetes. ANOTHER REASON TO LOVE YOUR BONES l—fe Your bones might help you lose weight. That’s a new discovery by researchers from Sweden's Sahlgrenska Academy who conducted a al mC fe series of tests focusing on skeletons and obesity. They found what they're calling a gravitostat, a mechanism through which our bodies track and moderate weight. They linked this system to a type of cell A == jt in bone tissue that activates when it detects additional pressure on weight-bearing bones; then it sends signals to the brain to eat less. The researchers may next attempt to exploit this system in combination with leptin, a hormone that regulates body fat, to help treat obesity. PAPER BOAT CREATIVEIGETTY IMAGES. 12 prevention.com- JUNE 2018CAMERON WHITMAN/STOCKSY Build a Stronger Skeleton Bones age as everything else does, but there’s an easy way to preserve and improve skeletal health— exercise and diet. “Women lose bone strength at the rate of 10% to 30% per decade, depending on their age and a variety of other factors,” says Wayne Westcott, an exercise physiologist and director of exercise science at Quincy College in Quincy, MA. Strength-training moves like leg presses, squats, bench presses, and pull-downs are the best way to rebuild bone, he says. Then make sure you include these nutrients in your diet. CALCIUM is the key to any bone-healthy diet, says Atlanta-based registered dietitian nutritionist Marisa Moore. In addition to dairy products, sources include canned sardines (with bones) and leafy greens like kale and turnip greens. VITAMIN D is also essential and can be obtained from fortified cereals, whole eggs, and fatty fish such as mackerel, salmon, and tuna. OTHER bone-building vitamins and minerals include magnesium (from black beans, nuts, and spinach), vitamin K (from grapes and leafy greens like collards, kale, parsley, and spinach), and vitamin C (from kiwi- fruit, red bell peppers, and citrus fruits like oranges). THE PERCENTAGE OF AMERICAN ADULTS WHO ARE AFRAID T0 VISIT A DENTIST Source: American Dental AssociationINGREDIENT SHELF BRORIOTICS Sah ls FORTHE SKIN WAS FOUND TO The bacteria The bacteria ae ae NIN eee MORE EFFECTIVE ae eae AT PROTECTING gut, When ap-_ AGAINST SUNBURN plied topically in skin care formu- THAN SPF 50. eee Sgt nen enc) SS ee) ieee tnt ttn may help reduce a aD inflammation, seiner which is linked to skin conditions — such as rosacea and acne. To get the skin- calming, purifying benefits, smooth on Pacifica Co- conut Probiotic Water Rehab Cream ($14.50, target.com) every morning and night. For a faster fix, apply H20 PREVENTION ae Seothingeroi- | PRODUCTS Essentials otic Bubble Mask Looking for more great Daily Clarifying ($6, ulta.com) picks? Try some of our favorite © Shampoo and leave on for affordable hair products, available ($1.50, 10 to 15 minutes. at drugstores nationwide. drugstores) 14 preveNTION.coM - JUNE 2018ANGELA LUMSDEN/STOCKSY PREVENTION PICK: Neutrogena Ultra Sheer Bodly Mist Broad Ermer it oaks Oise eco oni LOREAL PARIS Elvive Total Repair 5 Damage Erasing Balm ($7, drugstores) bee “TITT1 Y4IMOHS dO SIO IVILN4SS Just a few drops of an essential oil turn your bathroom into a spa. Before your next shower, sprinkle some on the floor—away from the drain and water stream—and let the warm steam circulate the scent. Try ArtNaturals Essential Oils (artnaturals.com) in eucalyptus ($15) to relax before bed, or grapefruit ($4) for an AM pick-me-up. A shower tab like Ulta Luxe Aromatherapy Shower Tablets in Eu- calyptus + Sage ($7.50 for four, ulta.com) is an easy premade option.PULSE 15-MINUTE MEAL UNDER $10 Tomato Tortellini Salad (serves 4) 1 2 3 4 5 6 Cook 9 oz Halve Thinly slice Combine Tosstortellini, Shave % oz tortellini Lpint cherry “medium — “cupchopped tomatoes, Parmesan over accordingto tomatoes. red onion. basil with onion, and olive tortellini. Drizzle package direc- $299 $0.34 2 Tbspchopped mixture in large with balsamic tions. Drain and black olives and bowl. Seasonto vinegar, if cool to room 2Tbspextra tastewithsalt _—_ desired. ‘temperature. virgin olive oil. and pepper. $0.17 $3.99 $1.45 $0.15 Cte r a Total: $9.09 NUTRITION (per serving): 298 cal, 11 g pro, 35 g carb, 3 g fiber, 5 g sugars (O g added sugars), 13 g fat, 3.5 g sat fat, 27 mg chol, 510 mg sodium Sip on This Drinking a variety of unsweetened teas adds antioxidants to your diet. Research suggests green tea may counteract oxidative stress in the brain and increase bone mineral density = to prevent fractures. Black tea has been linked to lower stroke risk. Antioxidants in oolong tea are associated with lower LDL (“bad”) cholesterol levels (in animal studies) and may help reg- ulate blood sugar. And studies show that white tea is high in polyphenols that can prevent DNA mutations linked to cancer. 16 prevention.com - JUNE 2018 MEAL, TORTELLINI, TOMATO, ONION, OLIVES: MITCH MANDEL. SALT, PEPPER, PARMESAN: GETTY IMAGESSTUDER-T. VERONIKA! GETTY IMAGES Fresh, Frozen, \ or Canned? These are the best ways to buy all your favorite produce year-round. [rev tHese WiatTo Loox For Fresh _ Berries, green Take advantage of freshly beans, melons _harvested produce in summer, you'll find it at your farmers’ market. Knowing what's in season will help you get the nutri- tional value that such crops are known for; the longer fresh produce sits in a warehouse or on grocery displays, the more nutrients it loses. Frozen Brussels For out-of-season favorites or sprouts, produce that may be harder to pineapples, find fresh at a farmers! market, turnips opt for frozen fruits and veggies. These are picked fully ripe and flash-frozen to preserve their nutrients. Check the label to make sure sodium hasn't been added in the form of sauces, seasonings, and cheese. Canned Corn, pumpkin, __Like the frozen variety, canned tomatoes produce is often blanched. Manufacturers typically add sodium as a preservative, but you can rinse some off with water (and look for low- or no-salt-added options). Canned food is often heated to kill germs—an approach that works well for corn and tomatoes, as they release more antioxidants when exposed to heat. JUNE 2018 - PREVENTION.COM AY”Exercise Newbies These tips from the National Institute on Aging will help you stay injury-free when beginning a new exercise program. START SLOWLY, especially if you haven't been active for a long time. Gradually build up your level of exertion. DON'T HOLD YOUR BREATH during strength exercises that use weights. That could cause changes in your blood pressure. GEAR UP PROPERLY. For ex- ample, wear a helmet for bike riding and the right shoes for walking or jogging. DRINK PLENTY OF FLUIDS, even if you don't feel thirsty. Staying hydrated gives you energy and keeps your body working as it should, ALWAYS BEND FORWARD FROM THE HIPS, not the waist, when doing moves that require bending. A straight back (not hunched) indicates proper form, preventing injury. WARMUP your muscles before you work out. Try walking and lightly pumping your arms.OPPOSITE PAGE: BONNINSTUDIOISTOCKSY. THIS PAGE: LAURA STOLFIISTOCKSY PULSE Step 4. Be sure that the area you're using is safe and free of anything that will interfere with your movements. Step 2. Slowly move into the required stretch position. Step 3. Check your form and alignment. Step 4. Gradually move deeper into the stretch position until you feel moderate to strong tension (but not pain) within the target muscle group. Step 5. Relax, breathe deeply, and hold the stretch for 30 to 60 seconds. Step 6. As they warm up, your muscles start to release and lengthen; now gently move deeply into position as you Follow these steps from Brad Walker, director of edu- exhale. cation at StretchLab in Los Angeles, to ensure that you Step 7. When finished, stay limber during your workout. “Identify and stretch slowly move out of the the parts of your body that are tight,” he says. And make stretch position. Repeat time to loosen up both before and after exercise. 2or3 times. THE PERCENTAGE OF PEOPLE WHO BELIEVE THAT EXERCISING REGULARLY IS PART OF AHEALTHY LIFESTYLE. ONLY 53% ACTUALLY EXERCISE REGULARLY. JUNE 2018 - PRevENTION.CoMHealth:NATURAL REMEDIES 3 New Uses for Lavender The purple flowers of this multipurpose herb have antibacterial and sedative properties, which make them useful for treating sinus headaches, dandruff, and other conditions. And the calming scent can help quell anxiety. eect TREAT DANDRUFF RELIEVE A SINUS * Lavender and HEADACHE mc Tree OilShampoo —_Daba few drops of c distilled water lavender essential oil 4c liquid castile soap ‘onto your temples. Thsp vitamin E oil eee ees EE: ential oil \drops tea tree oll EASE ANXIETY Brew some lavender tea. “The process of preparing and slowly savoring tea can create a temporary oasis of calm and focus that adds to the healing effects of the herb,” says Dorcia J. Tucker, a clinical psychologist and adjunct faculty member of the yoga therapy program at Maryland University of Integrative Health, in Laurel. Steep 1 tsp dried lavender ~ (ora mixture of lavender and chamomile, another calming herb) in 8 oz hot water for 5 to 7 minutes. Strain, sip, and de-stress. ombine the water, oap, vitamin E oil, jender essential oil, and tea tree oilina bottle. Use to wash your hair and scalp, then rinse.EVERYDAY HEALTH 92 Percentage of American adults who have had cavities in their permanent teeth eeth can hurt for a variety of reasons, Problem but the most likely causes are tooth decay that has penetrated deep enough S olved into the tooth to reach the nerves and gum disease, which can cause gums to recede and Toothache expose tooth roots. In other cases, the type of pain gives clues as to the cause. “If you have BY RICHARD LALIBERTE fleeting sensitivity to cold and/or intermittent pain when chewing, it’s likely due to a fracture ina tooth; says Gigi Meinecke, a spokesperson for the Academy of General Dentistry. “If it hurts at certain times when you chew, it may bea crack.” Less commonly, sinus infections \\ can put painful pressure on roots.oe gh OPPOSITE PAGE: AURORE MAXON PREVENT IT DENTAL HYGIENE Brush two or three times a day to remove plaque—a soft, sticky build- up that harbors tooth-eroding bacteria—and floss daily to dislodge it from between teeth. “Floss should wrap around the tooth like aC,” says Meinecke. MOUTHGUARD Tooth grinding (bruxism), which often happens during sleep, can cause cracks and damage teeth. A mouthguard separates upper and lower teeth, protecting against damage by distributing the force more evenly. GENTLE BRUSHING Research shows that aggressive tooth brushing can wear down enamel, so use a brush—manual or electric—with soft bristles and a light touch. Hold it at a 45-degree angle and brush in small circular motions for at least 2 minutes. REGULAR CHECKUPS Routine visits allow your dentist to detect problems before they become advanced and pain- ful. And professional cleanings can reach areas inaccessible with a regular brush at home. TREAT IT NSAIDs Over-the-counter non- steroidal anti-inflammatory medications (ibuprofen, naproxen sodium) decrease inflammation and pain due to infection, injury, or sinusitis. “If you need them for more than 2 days, that indicates a more serious problem,” says Bradford Johnson, head of endo- dontics, University of Illinois at Chicago College of Dentistry. NUMBING AGENT Dabbing teeth or gums with an OTC topical anes- thetic such as benzocaine relieves pain by desensitizing nerve fibers (although it does not treat the underlying problem). In one study, applying 20% benzocaine on and around the aching tooth reduced the pain 87% of the time. DENTAL TREATMENT When they're caught early, cavities can be restored with fillings. More advanced infections that have reached the pulp require a root canal: The dentist removes the infected pulp, then fills and seals the space. Cracked or broken teeth are usually treated with acrown, a root canal, or—if needed—an extraction. JUNE 2018 - PREVENTION.COM BBEVERYDAY HEALTH The Holistic MD Lower Your Blood Pressure BY ANDREW WEIL, MD = Dr. Weil is founder and director of the Arizona Center for Integrative Medicine, LOOD PRESSURE is the force of your blood pushing against the walls of your arteries. When this force is persistently higher than what's considered healthy, it’s called hypertension, or high blood pressure. Hyper- tension is often considered a “silent killer” because it may have no obvious symptoms. Over time, it can damage arteries, impair blood flow to vital organs, and increase the risk of heart attack, kidney failure, and stroke. For the first time in more than a decade, the American Heart Association and the American College of Cardiology have revised their hyperten- sion guidelines, lowering the measurement that is defined as high blood pressure. Blood pressure readings are recorded as two numbers. The top number, or systolic pressure, is the reading when 24 PREVENTION.COM - JUNE 2018 the heart is fully contracted. The bottom number, diastolic pressure, is arterial pressure when the heart is fully re- laxed. Unless your blood pres- sure is extremely high—above 160/100—on multiple mea- surements or you are having symptoms such as chest pain or shortness of breath related to high blood pressure, your physician will probably ask you to return for a repeat set of blood pressure measure- ments before recommending treatment with medication. But that’s not always what happens, which is why I'm uncomfortable with the new guidelines. They still define healthy blood pressure as less than 120/80 mm Hg (millimeters of mercury). Before the guidelines were 3 TIPS FOR HOME MONITORINGrevised, though, a person whose blood pressure ran between 120/80 and 139/89 was characterized as having prehypertension, or border- line high blood pressure. Now the designation of prehyper- tension has been replaced with the term elevated blood pressure, in which the systolic blood pressure is between 120 and 129 and the diastolic pressure is less than 80. High blood pressure used to be defined as a persistent reading above 140/90, but now there are two stages of hypertension: stage 1, in which the reading is between 130 and 139 systolic or 80 and 89 diastolic, and stage 2, in which there is a consistent measurement of 140 or higher systolic or at least 90 diastolic. With these new categories, prescription antihyperten- sive drugs can be recommended for almost half of all Americans (up from about a third), often unnecessarily. In my view, these organizations have extended the diagnosis of a disease, which will lead to unnecessary pre- scribing of medications. It would be better for people whose numbers now fall in the lower end of the high blood pressure category to make healthy FOOD STYLING BY BARRETT WASHBURNE; PROP STYLING BY PAOLA ANDREA, OPPOSITE PAGE: ARTHUR MOUNT. THIS PAGE: MITCH MANDEL; Zl aa RTT Teay the Mediterranean Cece tee tia your blood pressure. lifestyle changes that will control blood pressure without medication. A doctor trained in integrative medicine can offer an effective program for managing high blood pressure. Smoking cessation, regular exercise, stress reduction, and healthy eating are practical steps to take before turning to drug therapy. (The exceptions are if. person’s blood pressure readings are consistently higher than 14.0/90 or the person is at increased risk of heart attack and stroke.) Finally, anyone diagnosed with hypertension should monitor their blood pressure at home, for consistent readings over time. For more information, go to heart.org. Choose an upper-arm —) monitor. Finger and wrist monitors may not provide accurate readings. Source: American Heart Association Ensure proper fit. Measure your upper arm to know your size before picking a cuff. Make sure the device has been validated. Ask your doctor or pharmacist for help if needed. JUNE 2018 - PREVENTION.COM 2BEVERYDAY HEALTH Healing Movement Bear Crawl BY KASEY BENJAMIN Keep back flat and core tight. Avoid placing ‘too much weight . ...> ‘on shoulders. Move as smoothly as possible. 26 preventioN.com - JUNE 2018The bear crawl enhances cardiovascular health and strengthens the entire body, especially the core and shoulders. You'll start on all fours, then lift your knees off the floor so you are supported only by your hands and toes. With your core braced, you'll walk your hands and feet forward. It’s not as easy as it seems—you'll feel your (Qe, heart rate increase—so keep your movements ety {\ small until you get stronger. The best part: You don’t need any equipment. By Startonall — @y Engagecore gy Move right PHOTOGRAPH BY MITCH MANDEL; HAIR AND MAKEUP BY ALEKSANDRA AMBROZY; WARDROBE BY AMANDA LIPTOCK. ILLUSTRATION BY T.M. DETWILER fours, wrists and press hand and under shoulders hands into floor left foot forward CGED andkneesunder to hover knees just afew inches, Sec hips with toes above floor. then left hand and Ofte tucked under. right foot forward. : Pxota Repeat. Continue for 30 seconds, Ser eventually working ba) up to 1 minute. Do 3sets. aa Sa urs Satay re hrc in Montclair, NJ. ee eer eee eek DreesEVERYDAY HEALTH Good Food Boost Your Mood BY JESSICA BROWN fyou go through the days ina fog or feeling irritable, tweaking your diet could help. Thanks to rapid ad- vances in the field of nutritional psychology, scientists now know far more about how diet affects mental health than they did just a decade ago. “Back then, I would have said that diet had some ef- fect on mood, but recent research has shown it actually plays a ma- jor role,’ says Lina Begdache, an assistant professor of health and wellness at Binghamton Uni- versity, State University of New York. Get a feel-good fix from these nutrient-packed foods. Increase motivation and concentration Mood booster: Black-eyed peas These legumes are loaded with folate, a B vitamin that is essen- tial for the production of neu- rotransmitters associated with motivation and pleasure, such as dopamine and serotonin. Low or 28 prevenTION.coM- JUNE 2018 imbalanced folate levels can lead to mood fluctuations, as well as poor memory and concentration. “Consuming folate regularly also assists with a process called methylation, which helps main- tain the structure and connectiv- ity of the circuits in your brain,” Begdache says. What’s more, black-eyed peas are a good source of iron. “If you have low iron stores or are anemic, your blood is less oxygenated, which makes you feel fatigued,” says Nancy Farrell, a registered dietitian based in Fredericksburg, VA. Tame anger Mood booster: Almonds These nuts are a good source of the amino acid tryptophan, which is one of the building blocks of serotonin, thought to play a role in regulating your emotional impulses. In a study published in the journal Biolog- ical Psychiatry, volunteers who consumed a drink with trypto- phan had better communication between brain regions that con- trol anger responses than when they had a drink without it. Banish brain fog Mood booster: Spinach Not only does this power green provide folate, but it also packs lutein and zeaxanthin, carot- enoids that may help reduce theVESNA JOVANOVICIGETTY IMAGES frustrating brain fog many people ex- perience as they age. “Lutein is a major carotenoid in the brain that helps with memory and cognition; says Joan Salge Blake, a clinical associate professor of nutrition at Boston University. Calm your mind Mood booster: Green tea This tea is high in antioxidants called polyphenols, which help prevent damage in the brain from free radicals. These harmful molecules build up as you grow older, a process that can be accelerated by smoking, alcohol, and pollution. “Your need for antioxidants increases as the brain starts accumulat- ing more free radicals,’ says Begdache. That accumulation puts you at greater WHEN COMFORT FOODS DON'T COMFORT YOU The treats we may turn to when anxious or sad—burgers, cookies, mac and cheese—ult { mately make us feel worse. “The pleasure that sweet and high-fat foods bring you is very fleeting,” says Lina Begdache of Bingham- ‘ton University. High-sugar, pro- cessed foods can trigger a surge of the feel-good neurotransmit- ters dopamine and serotonin, but when your blood sugar crashes a short time later, so does your mood. Plus, comfort foods like cookies often combine sugar with saturated fat, which can make you feel sluggish because your body has to expend a lot of energy to digest it. = risk of developing feelings of sadness, hopelessness, and tension. A bonus perk: Green tea also contains the amino acid L-theanine, which has a calming effect. Feel more rested Mood booster: Tart cherry juice If restless nights are making you cranky during the day, incorporate this drink into your diet. Tart cherry juice is a source of tryptophan (and compounds that increase its bioavailability) and the hormone melatonin, both of which help regulate sleep. A 2017 American Journal of Therapeutics study revealed that older adults with insomnia who drank tart cherry juice twice daily for 2 weeks increased their total sleep time by 84 minutes a night. JUNE 2018 - PREVENTION.COM @EVERYDAY HEALTH Does It Work? Water-Testing Kits BY ERICA SLOAN OCAL WATER utili- ties are required to ‘test their systems for contamination and to release annual reports demon- strating water safety (usually enclosed with a summer bill). But since the 2014 crisis in Flint, MI—when water laden with lead and other harmful substances flowed freely through the ci water supply—homeowners are turning to at-home testing kits to analyze the contents of their tap water (visit wqa.org for alist of common contaminants). The number of kits on the mar- ket is staggering, so we asked water-quality experts to distill the best options. TEST STRIPS THE CLAIM: Chemically treated strips or those made from mate- rials that react to contaminants show the presence or absence of substances according to the color 380 prevention.com - JUNE 2018 the strips turn when they are submerged in water. Users con- sult a corresponding color chart to discover what's in their water. THE EVIDENCE: Although many of these kits claim to test to Environmental Protection ‘Agency standards, the EPA neither evaluates nor recom- mends them. The strips don’t indicate the exact amounts of contaminants; moreover, the tests’ accuracy is uncertain be- cause people often judge shades of colors differently, says Lloyd Wilson, a research scientist and director of the New York Bureau of Water Supply Protection. “If you give a strip to five different people, he says, “you might get five different results.” THE UPSHOT: Test strips can serve as an initial screening tool, providing info on water pH and hardness, but they don’t offer a clear picture of the level of con- tamination. (Prices range from $10 to $30, on average.) DIGITAL TESTERS THE CLAIM: Most digital tes- ters use an electronic probe to measure water properties that change according to the presence and quantity of different con- taminants. For example, testers will track hydrogen-ion activity to determine a sample’s pH levelPAPER BOAT CREATIVEIGETTY IMAGES. or measure total dissolved solids such as calcium, magnesium, chlorides, and sulfates. ‘THE EVIDENCE: Results are quantified and displayed as numbers, eliminating the subjectivity of the test strips’ color chart. However, “consumers should be careful that they are actually using the tester for its intended purpose, says Erie Yeggy, director of technical affairs at the Water Quality Association. “For example, a TDS [total dissolved solids] tester is no substitute for a lead or microbial test.” THE UPSHOT: These types of testers reliably detect water-quality indicators that affect taste but can be less accurate on other measures, experts say. (Prices range from $10 to several hundred dollars, depending on what they test for.) SEND-TO-LAB TESTS THE CLAIM: These tests provide instructions, vials, and packaging for a consumer to mail water samples toa lab for testing. Results indicate the presence of many types of chemicals, bacteria, and parasites. THE EVIDENCE: This ap- proach doesn’t provide instant results. It can ensure that the sample is accurately tested, but only if you choose a water-testing kit that uses a state-certified lab, which follows EPA-approved methods of separating, identifying, and measuring water contaminants. ‘THE UPSHOT: Water-quality experts agree: Send-to-lab tests are the most trust- worthy. “Using a certified lab ensures that tests are done with appropriate detection limits,’ says Roger Sokol, director of the division of environmental health protection at the New York State Department of Health. “This means they'll measure harmful contaminants at the levels of concern.” Find a certified lab via epa.gou/waterlabnetwork. (Test kits cost $25 to several hundred dollars, depending on what you'd like tested.) JUNE 2018 - PREVENTION.coM BLREALITY CHECK BY ASHLEY BREEDING ILLUSTRATIONS BY MICHAEL PARKIN any hair care tips are nothing but harmless make-believe. The trick is being able to tell the _\ myths from the science. Here, trichol- « ogists, dermatologists, and celebrity stylists separate the bogus from the Nw = best remedies for common hair woes.MYTH #1 You can grow your hair to any length. MYTHBUSTER: Nope, the maximum length of a person's hair is genetically predetermined. “Some people can grow hair down to their feet, while others cannot grow it beyond their shoulders,” says David Kingsley, president of the World Trichology Society. It's dependent on the anagen, or growing phase, of an individual's hair cycle. Hair grows about a half inch per month, and the average phase lasts 3 to 6 years. “So, a person with a 3-year cycle will grow their hair to 18 inches, while one with 6-year cycle can grow hair to 3 feet,” Kingsley explains. The hormonal changes of pregnancy and menopause can change the hair cycle, as cana poor diet. To encourage growth, Jordi Martinez, a stylist at Frédéric Fekkai’s SoHo Salon, advises keeping your scalp healthy with cool-water rinses and head massages to increase blood flow. MYTH #2 Cutting hair will make it grow faster. MYTHBUSTER: If only. “Trimming. hair doesn't make it grow, but it does prevent breakage,” says celebrity stylist Sally Hershberger. “Shorter hair often looks and feels thicker,” adds Kiki Cavie, a Paul Mitchell art team member, “but cutting your hair won't alter its normal, biologically determined growth rate or overall texture.” The best way to grow or maintain long hair is to keep it healthy. Hershberger recommends trimming ends every 6 to 10 weeks. If you want to encourage hair growth, what you eat will have more of an effect than how often you cut it. Get plenty of protein so your strands don't get weak, which will slow down growth, says Vandana Sheth, a Los Angeles-based registered dietitian nutritionist. o JUNE 2018 - PREVENTION.COM BB.Litt 6" MYTH #3 Hair loss is inherited from the mother’s side. MYTHBUSTER: Not nec- essarily. Genetic hair loss is polygenic, meaning that many genes are involved, Kingsley explains. “These genes can be inherited from either the mother’s or father’s side, or from both sides equally.” In fact, many studies indicate that a man's hair will more likely follow the pattern on his father's side, while a woman's hair more typically emulates the pattern on her mother's side. A person is also likely to inherit hair- loss tendencies similar to those of the family member whose hair characteristics— color, coarseness, distribu- tion—hers most resembles. Besides heredity, additional factors determining hair loss include general health, nutrition, stress, and hor- mones; the right treatment depends on the cause. BA pREVENTION.COM - JUNE 2018MYTH #4 Your hair grows back thicker after you shave it off. MYTHBUSTER: Nah. Shaving your legs doesn't change how fast or thick the hair grows. Using a razor can leave body hair with blunt tips that might feel coarse when it grows back, leading to the illu- sion that there's more of it, according to the Mayo Clinic. The hair might be more noticeable or appear thicker or darker, but it’s not. MYTH #5 If you use the same shampoo every day, it will eventually stop working. MYTHBUSTER: This notion is all wet. “Shampoo doesn't stop working on your hair—it’s just that we tend to get used to the benefit, the feeling, and even the smell that the prod- uct provides,” Martinez says. He recommends shampooing no more than every other day, unless you have an oily scalp. If it seems like your hair isn't responding to your usual shampoo in the same way, product buildup might be to blame. Lathering locks with a clarifying shampoo once aweek, Martinez says, will remove residue and leave strands looking clean and shiny. JUNE 2018 « PREVENTION.COMHEALTH THE ABSOLUTE BEST REMEDIES FOR ALL OF YOUR EVERYDAY AILMENTS BY JEN McCAFFERY AND ERICA SLOAN ADAPTED FROM THE DOCTORS BOOK OF NATURAL HEALING REMEDIES, WITH ADDITIONAL REPORTING BY THE EDITORS OF PREVENTION 36 prevention.com - JUNE 2018 JAMIE CHUNG/TRUNK1lcouGH FIXES A spoonful of honey. “The sugar molecules help soothe the throat,” says Chandra Ivey, an otolaryngologist based in New York City, Shower. The steam will help lubricate your throat. Turmeric. Add a pinch of the anti-inflammatory spices turmeric and ground ginger to water, then gargle. CHAPPED LIPS FIXES Coconut oil. Apply it often to make your lips soft and smooth. Paraffin wax. Wet lips with warm water, then immediately apply a pro- tective layer of wax from atin or Chapstick. Humidifier. Breathing through your mouth while you sleep parches your lips, says Adam Friedman, an associate professor of dermatology at George Washington University.HEALTH 83ICARPAL TUNNEL SYNDROME Stretching. Carve out a 5-minute break every hour to stretch your hands, says Leon Benson, an orthopedic surgeon at the Illinois Bone and Joint Institute. Wrist splint. “Wearing a wrist splint while you sleep will make your median nerve happy at night, and this relief frequently lasts throughout the day as well,” Benson says. MUSCLE CRAMPS Balanced electrolytes. ‘Try a hydration drink with electrolytes to replenish potassium and magnesium. Foam roller. Roll it up and down the muscles, says NYC sports doctor Jordan Metzl. 38 prevention.com- JUNE 2018 LOW IRON Cast-iron cookware. Cooking meals in it can help boost your iron levels, says Roxanne B. Sukol, a preventive medicine specialist at Cleveland Clinic’s Wellness Institute.THIS SPREAD, FROM LEFT: JAKOBISTOCKSY. Iron-rich foods. Beans, dark choco- late, lentils, oatmeal, poultry, pumpkin seeds, quinoa, red meat, shellfish, spin- ach, and tofu are all good sources of the mineral. Vitamin C. The pow- erhouse vitamin also | HADDON/GETTY IMAGES, NY FOGGIOFFSET helps your body ab- sorb iron. Get it from foods like oranges, peppers, strawberries, and tomatoes. Blackstrap molas- ses. The sweetener is high in iron and B vitamins. Swirl a teaspoon of it into hot water, tea, or coffee. SORE THROAT FIXES Ginger tea. Ease the pain with some anti-inflammatory action from ginger. Infuse 1 whole clove, % tsp ginger, and % tsp cinnamon in 2 cups boiling water. Strain, add 4 tsp honey, and drink as needed. Anti-inflammatory medications. Over-the-counter remedies like ibu- profen can help reduce the swelling of tissue and soreness in the throat, Ivey says. Ice pops. Make them from low-sugar fruit juice to provide cool relief.TENSION HEADACHES FIXES Hot or cold therapy. Both work, so take a hot shower, use a warm compress, or, if you prefer cold, wrap an ice pack in a towel and place it on your forehead, temples, or neck. Coffee. Research has shown that, for some people, drinking one cup can be as effective as. taking an over-the-counter painkiller. Relaxation. Tense and then completely relax one muscle group, starting with your toes. Progres- sively work your way up to your neck and head. 40 prevention.com- JUNE 2018 SIYEAST INFECTIONS FIXES Bacteria. Studies have shown that taking one or two capsules of Lactobacillus acidophi- lus, a common bacteria found in the vulva, helps keep yeast levels healthy and balanced. Or eat two or three servings per day of yo- gurt with live cultures. Garlic. A trial showed that women who took 1,500 még garlic tablets daily showed a signifi- cant reduction in yeast and symptoms like itching and discharge. f. CONSTIPATION FIXES Magnesium. Take 500 mg a day of this mineral to alleviate constipation, says David Borenstein, founder of Manhattan Integrative Medicine. Blueberries. The fiber in the berries will help get your digestive tract moving; a half cup is a good start. FROM LEFT: TRINETTE REED/STOCKSY. GETTY IMAGESOmega-3 fatty acids. Eggs and fatty fish like salmon and sardines will help replen- ish your skin’s natural oils. Humectants. Look for moisturizers with glycerin, hyaluronic acid, or sorbitol. joaking. Combine 2 cups dry oatmeal, und with a mortar and pestle or food processor; 1 cup honey; and 3% cup olive ‘or coconut oil. Add to your bath to restore the oils in your ski TIITOENAIL 12|WaRTS 13/GoUT 14|coRNS FUNGUS FIXES FIXES FIXES FIXES Duct tape. Cover Tart cherry juice. Aspirin paste. Jublia or Kerydin. the wart withduct —_ Drinking 2 oz Aspirin is a type of These prescription _ tape and leave it tart cherry juice salicylic acid that topical medications inplacefor6days. concentrate with can wear down were specifically Then soak the area 3% 0zwaterdaily —_corns. Crush five designed asanti- withwateranduse canreduce uricacid aspirin tablets and fungals for nails, apumice stone to _ levels. mix with % tsp wa- Friedman says. remove the skin. Cortisone. An in- ter and ¥tsp lemon Lamisil. This over- Garlic. Crusha gar- jection or oraldose _ juice. Apply to corm the-counter antifun- licclove, applyitto _can help relieve and leave on for galtopical spray is the wart,cover,and joint pain, says 10 minutes. Scrub also effective andis leave overnight.Re- JonathanGreer,a witha pumice stone. less expensive than move the bandage rheumatologist in Lemon compress. Jublia. and clean the area, Palm Beach, FL. Soak washeloth in Repeat until the warm lemon water wart goes away. and apply to corn. sTocKsy15|VARICOSE VEINS FIXES Elevating your feet. Lift them a few inches above your knees to increase blood flow while you're sitting. Compression stockings. “The stockings reduce swelling,” says Grand Rapids, Ml, vascular surgeon Jennifer Watson. Pine bark extract. An Italian study found that people who took 150 mg of Pycnogenol (pine bark extract) each day developed more elasticity in their veins. KNEE PAIN FIXES Foam roller. Using one on the surrounding muscles can relieve pressure on your knee, suggests Pitts- burgh-based orthopedic surgeon Vonda Wright. Tape. Kinesiology tape, or athletic tape, can support the muscles around the knees, says Holley J. DeShaw, and Capzi compound in chile peppers, can reduce knee pain. ICOWDEIGETTY IMAGES7 : 17|HEARTBURN FIXES Betaine. Take this over-the-counter remedy with meals to prevent acid reflux if you get no relief from antacids, says Borenstein. Baking soda. Mix 4 tsp baking soda with warm water and drink. Herbal tea. Tea made with chamomile, dan- delion, goldenseal, or licorice can help coun- teract stomach acids, says Elizabeth Pimentel, a naturopathic doctor and dean of the School of Naturopathic Med- icine at the Maryland University of Integrative Health, in Laurel. 18|SINUSITIS FINES Saltwater rinse. Its pH is more like that of blood than straight water’s pH is, making it less irritating to sinus tissues. Use non-iodized salt in distilled water or buy a prepared version over the counter. Eucalyptus oil. Add a few drops of this essential oil toa bowl of hot water. Drape a towel over your head and inhale the steam to fight inflammation. HEALTH FACIAL ACNE FIXES Strawberries. The fruit contains sali- cylic acid, which helps turn over dead skin cells. Mash three strawberries, apply the paste to your face, leave on for 20 minutes, and rinse. Steroid shot. To clear up a pimple overnight, Friedman recommends a dermatologist-administered injection of the steroid Kenalog into the lesion. Differin gel. This retinoid-based medication penetrates skin to help cells turn over. Aloe vera. Squeeze the gel from a leaf and apply it to blemishes. The gel is a natural antibacterial and moisturizer. JUNE 2018 - PREVENTION.CoM 4BHEALTH 20|cOLD SORES FIXES Topical antiviral medica- tions. As soon as you feel the pre-cold sore tingling, ask your doctor to prescribe Valtrex or Zovirax, or try over- the-counter Abreva. These medications can help prevent the cold sore from emerging if used early enough—or will at least shorten the duration of the sore. Vanilla. Pure vanilla is a nat- ural antiviral. Dab on a cold sore three or four times a day until the sore is gone. 21|INDIGESTION FIXES Sweet basil tea. Add 1 Tbsp dried basil to a cup of boiling water, strain, and sip to aid digestion after a meal. Ginger. Try candied ginger, ginger tea, or one or two 250 mg ginger supplements at mealtimes to counteract an upset system. Peppermint oil. The supplement can aid digestion, Borenstein says. 22 CANKER SORES FIXES Vitamin E. Cut open a capsule and squeeze a bit of the liquid onto the sore several times a day, says Mitch Marder, a holistic integrative dentist in Seattle. Lysine. Take 500 mg of this amino acid in sup- plement form three times a day. Hydrogen peroxide. Mix equal parts hydrogen peroxide and water and apply to the sore. FROM LEFT: STOCKSY. OFFSET24:| STIFF NECK FIXES Looking sky- ward. Extend your neck with your face turned up and hold for 5 to 10 seconds, Wright suggests. Warm wash- cloth. Dampen acloth, heat it in the microwave, wrap it ina towel, and apply it to the back of your neck. BACK PAIN FIXES Yoga. Take 5 minutes to do a Child's Pose (shown below), which stretches the muscles in your lower back, and a Superman for core strengthening, Wright recommends. Mattress check. Studies show that. people who sleep on medium-firm mattresses feel less pain than those with firmer mattresses. White willow. The herbal supple- ment contains salicin, the natural form of the pain-relieving agent in aspirin, which can reduce soreness. BRUISES FIXES Arnika Forte. This supplement, made from the herb Arnica montana and the enzyme bromelain, can help relieve bruising, Friedman say: DerMend. This line of lotions can reduce the appearance of bruises, according to Friedman. Ice, then heat. Apply an ice pack (or a bag of frozen vegetables) after you've bumped yourself and leave on for 30 minutes. After 24 hours, switch to heat (a heating pad or hot water bottle) to increase circulation for healing. JUNE 2018 - PREVENTION.COM 4SPECIAL REPORT Dismissed symptoms, misdiagnoses, and exclusion from clinical trials put female patients at risk. Here, the disturbing truth about gender bias in medicine— and how to get the first-rate care you deserve. How Health Care aiken ys ReU Ce On acon CRU oriing began having rashes, joint pain, acetate neta eat with occasional heart palpit and fainting spells. Lab tests for autoimmune and cardiac diseases contd ern ree etn mencea ents BER yar eM lord come tacome Colurey amc) Cel ese eae eictmee t Rermetitces ing from panic attacks, though she FO MmeMTLEOTE a ter Nas Oe PETS OMe OE RECA eMeghan Cleary searched for decades before getting proper treatment for endometriosis.mae Poet ese in Norristown, PA. “Being told that I was malingering was incredibly frustrating.” After she got married, she began taking her husband toappointments forsupport. Finally, the couplefound aphysician who agreed to run more tests, which showed that Ernst had lupus (an inflammatory disease in immune system nd organs “It wasa good ideato bring your hus- bandalong,’ the doctor said. “I have another patient with similar symp- toms, and I've always assumed hers. were psychosomatic.” Just how hard is it for women to 48 prevention.com- JUNE 2018 eases SNe Ee ee eas tosutfer.as she did. get past doctors’ biases and get effective treat- ments? Women havinga stroke are 33% more likely than men to be misdiagnosed in the ER, with potentially devastating consequences, researchers at Johns Hopkins recently report- ed. Studies show that women experiencing a heartattack arealsolikelier to bemisdiagnosed. Women haveaneven hardertime getting acor- rect diagnosis forailments that solely or mostly affect women. For instance, about 75% of pa- tients with autoimmune disorders are female; onaverage, they see five physicians over 4years before their illness is identified, according toa survey by the American Autoimmune Related Diseases Association. In addition, more than 45% have been labeled chronic complainers. As documented in thenew book, Ask Me About'S MAKE CLEAR My Uterus: A Quest to Make Doctors Believe in Women's Pain, by Abby Norman, women with disorders of the female reproductive system, such as endometriosis and polycystic ovary syndrome, face similar obstacles to getting a correct diagnosis and treatment. The genderdivideis especially glaring when it comes to pain. According toa study published inthe journal Academic Emergency Medicine, female ER patients wait longer than males to receive painkillers—a median time of 65 min- utes, versus 49 formen—andarelesslikelytore- ceive those drugsatall. Inher newbook, Doing Harm: The Truth About How Bad Medicineand Lazy Science Leave Women Dismissed, Misa agnosed and Sick, journalist Maya Dusenbery describes a “trust gap”: the fact that women’s accounts of their symptoms are too often not believed. A 2014 online survey by the Nation- al Pain Report found that 65% of women felt doctors took their pain less seriously because of their sex. “There seems to bean ‘Oh, she’s so neurotic’ attitude toward female chronic pain patients,’ one respondent wrote. AllyNiemiee, 27,a digital marketingmanager in Atlanta, grew familiar with that experiencein herearly 20s, when she began suffering from fre- quentkidneystones. Every fewweeks, shewould limpintoherlocal hospitalemergencyroom with stabbing pain in her abdomen or lower back. Doctors there, she says, grew wary of her visits; though she'd been diagnosed with ahereditary condition known as medullary sponge kidney, which commonly causes such symptoms, they accused her of exaggerating her agony to get SPECIALREPORT ee SO SCRE tag docu than ey Bee Te nee ts le eel eee aro cea Pee ea earn a says Noel Bairey Merz, direc- Rem me c cee] Mma easecusagts eee ees er lee ecu is eee BREN Ca Nor a Perea a ee tte pee eke ri Cee ees eas) Pea en race Eire heer ken Rectal ene Teak Rute hu te says Janine Austin Clayton, director of the NIH’s Office eee saa Dem heck cid eee ee aaa Bra Rrra econ peony Penn eres PUM ce uy Pe ces Re ane Man et rn DN cclg See aCe acd Perea canara including the medications Make vceur raat consumption,” says Daniel J. cocoa e eld Bio ceagat nw JUNE 2018 - PREVENTION.cCoM 4)SPECIAL REPORT attention orscore painkillers. Finally, they told her not to return. Niemiecthen sought helpat other ERsaround Atlanta but was turned away again and again. Once, she drove for hours before finding a hos- pital where doctors identified the source of her pain: an obstructed kidney stone that they were able to remove surgically. “Otherwise, she says, “I would have lost the kidney.” Eventually a cocktail of medi- cations reduced the frequency of Niemiec’s attacks and her need for painkillers. Shealsojoinedasupport group formen and women suffering from thesame condition, where she learned she was not alone in being denied desperately needed care. Her fellow ER outcasts had one thing in common: their gender. “Many of the other women in the group had been accused of drug seeking when they wentto the hospital,’ says Niemiec. “But the men were quickly given pain meds and admitted. It’s 2014 online survey by the National Pain are doubted ortaken less seriously than men’s— there's a knowledge gap that may be even more dangerous: Far less is known medically about women’s bodies and the ailments that afflict them than about men’s. “It’s really a vicious cir- cle? says Dusenbery, who interviewed dozens of patients, doctors, and researchers and dove deep into medical history for her book. “Be- cause medicine has traditionally been a male- dominated field, ithas invested relatively little in research to explain women’s symptoms sci- entifically. Then when women have symptoms that health care providers can’t explain, those symptomsare dismissed as made up, exagger- ated, or psychogenic—all in the patient's head.” Research on women’s health issues is chron- ically underfunded. For example, over the past decade, the National Institutes of Health (NIH) hasspentabout $883 million annuallyonstudy- ing autoimmune diseases like lupus, which af- fect an estimated 23 million Americans—one- sixth the expenditure for cancer, which affects about 14.million. Whilecancerisobviouslymore deadly, thespending discrepancyisstill striking considering how many more people are affected by lupus and how much ofan impact it has on their quality of infuriating” Reportfoundthat _life. Similarly, chronic pain affects 65%ofwomen = 100 million Americans, and women TheKnowledgeGap _—eltdoctorstook a. at preaterriskofdevelopingcondi- Dusenbery blames the geri gender inequities in the pain less sly because of their sex. “There tionsthatcauseit. Though that'smore than the patient population for dia- healthcaresystemontwo —seemstobean'Oh, _etes, heartdisease, and cancercom- interlocking problems. In shes se neurotic bined, pain research gets only 5% of addition tothe trust gap— fecal chronic thefunding devoted to those diseases. in which women’s ac- pain patients?’ one What's more, women werelargely countsoftheirsymptoms respondent wrote. _ eft outofclinical studies fordecades, 5O prevention.com- JUNE 2018Many women Shed Peters Beer 4 in partbecause researchers worried thatwom- en's fluctuating hormones might skew results. Forsimilarreasons, scientists relied mostly on malelabanimals. These practiceshave proved to be misguided. “We now know that sex is an essential biological variable,” says Janine Austin Clayton, director of the NIH’s Office of Research on Women’s Health. Oneexampleiscardiovascular disease; while men typically suffer from obstructive coronary disease, in which clumps of plaque block ma- jor arteries in the heart, women often have more evenly spread plaques, which prevent small arteries from dilating properly. Women are also likelier than men to develop multiple sclerosis and Alzheimer's disease, to get lung cancer as nonsmokers, and to suffer from still- enigmatic disorders like fibromyalgia and chronic fatigue syndrome. To better un- derstand such tendencies, Clayton says, it’s “crucially important” to include both sexes in studies involving conditions that aren't gender-specific. In 1993, after prolonged pres- sure from activists, Congress man- dated that women be included in NIH-funded clinical research; to- day, about half of participants in such studies are female. Yet many currently used therapies were devel- opedusingdatacompiled before that shift occurred. It wasn’t until 2016, moreover, thatthe NIH implement- ed rules requiring grant applicants. todescribe their plans to study both males and females in animal stud- ies—andstill the vast majority oflab rats studied today are male. The longtime lack of women in clinical trials continues to do dam- age. Over the past 2 decades, forin- stance, numerous drugsand medical devices have been pulled from the market because they turned out to have greateradverse effects on wom- en than on men. One study found that 8 of the 10 treatments with- drawn between 1997 and 2000 fit that description. Examplesinclude fen-phen, a weight loss drug that was prescribed primarily for wom- en and caused heart problems in many patients, and troglitazone, a diabetes drug also prescribed more frequently for women that could cause liver failure. In 2013, the Food and Drug Administration lowered women's recommended dosages of JUNE 2018 - PREVENTION.COM &LSPECIAL REPORT thesleep medication zolpidem, mar- keted as Ambien, after a spate of auto“mishaps”among drivers who'd taken it the night before; women were more likely to have these ac- cidents because the drug is cleared more slowly from their bodies. Yet the FDA still doesn’t require most medications to be tested in ways that take gender into account. When fli- banserin, the “female Viagra,” was approved in 2015, its interactions with alcohol had been tested on 23 men and only 2 women. Gender disparities in health care also reflect stubborn inequalitiesin medical education. Although nearly LEARN MORE Boca Sra aS Paceline ey Cea) Parcs} Cru cea roca Cee) Etter! Sree ctd eons Cree eo Uso PA Cle oe reer SZ PREVENTION.COM - JUNE 2018 Cre ta erecta eet eT Cees Lune eee het Peace BOE or nad halfofall US medical students are women, they make up only 38% of full-time medical school faculty—and just 21% of full profe 8, 15% of department chairs, and 16% of deans. A re- cent survey of medical schools in the US and Canada showed that only 30% integrated sex and gender topics into their general curri lum. “There'sstill alot ofresearch to be done on the differences between men and women and howthat affects disease. And therefore, there’s not a lot of education,” says Rebecca Nebel, director of scientific programs at the Society for Women’s Health Research (SWHR). All these factors help explain why patients suffer- ing from “women’s diseases” often have trou- ble finding doctors who can properly diagnose and treat them. Meghan Cleary, a 45-year-old writer in Los ‘Angeles, had suffered from crippling menstrual crampsandpelvicpainsinceherteens.“The first Dean) ea eect iad .org) offers list- ete ed Pec iy ere ag Perce tana etd Eee nt PEC Mier Related Disease Association (aarda.org) is Piece Pets patients and their eshte Pein Seen primarily affect Suge) Oa?doctor I went to told me I needed to ‘Women having get proper medical care,” getintouchwithmybody,’sherecalls. astrokeare she says. Organizations Otherhealth professionalsprescribed 33%morelikely ie SWHR, the American than men tobe exercise or laxatives, or suggested she just accept her suffering. She was fi- nally diagnosed with endometriosis misdiagnosed in the ER, with poten- tially devastating Medical Women's Associ- ation, the National Wom- en’s Health Network, and (adisorder in which tissue similar to Gren daeen theSexand Gender Wom- fe fi /omen experienc- ; e thelining ofthe uterus grows outside ing.a heart attack en’s Health Collaborative ofthe organ)in 2016, whenasurgeon told her he'd burned away some en- dometriosis lesions while removing auterine fibroid. But that treatment onlymadehersymptomsworse. After learning, through onlineresearch, about widesurgical ex- cision—considered the gold standard therapy for endometriosis—she decided to have a top specialist in Northern California do the proce- dure, even though he didn’t accept her insur- ance plan. (She petitioned her insurer, which did eventually pay for the surgery—an unusual outcome, she says.) The operation was a success—“I’m not in chronic pain with my period anymore’—and Cleary says it was worth seeking out a spe- cialist trained in performing that procedure. She later launched an informational website, bad-periods.com, for women with menstrual disorders. “This whole experience has trans- formed my life,’ she says. But it angers her that the procedure isn’t more widely available. “You've got millions of women who've had mul- tipleinstances of these burning surgeries with norelief. Yet ob-gyns don'tlearn about the latest techniques for treating this disease in medical school. It’s really heartbreaking.” Maya Dusenbery agrees. “You shouldn’t have to be asuperinformed patient in orderto are also likelier to be misdiagnosed. are working to make that unnecessaryby promoting gender equity in medical research, education, and practice. Butaslongasthetrustand knowledge gaps persist, Dusenbery advises, women need to navigate carefully when they step into a doc- tors office. “The important thing is to trust yourself. Don’t let anyone dismiss you, because you're the ex- pert onyourbody. Instead ofsecond- guessing yourself, get a second opinion” Katie Emst, nowinremission from lupus, offers similar counsel on her blog, Miss-Treated (misstreated.org), where women who've encountered gender bias in health care can share their stories and find resources. “I havetwo daughters, and oneofthem may end up having the same prob- lems I do,” Ernst says. “I'm arealist. Idon'texpectthat medicine willever haveallthe answers. What's crucial is thatdoctors learn tolisten towomen and respect their lived experience. Morethan anything else, I pray that my daughters will be believed” © JUNE 2018 - PREVENTION.COM BBWhat Is That?’ Learn how to recognize e treat 10 of the most common, usually harmless skin conditions. BY JESSICA BROWN e expect to see our skin change as we age, but that can mean more than wrinkles and dryness. “It’s important to see a dermatologist who will explain what you can expect to see and what might be of concern,” says Joseph Jorizzo, a professor of dermatology at Wake Forest Univer- sity and Weill Cornell Medical College. Many are cosmetic annoyances, but others can indicate a risk of skin cancer and other conditions. To help you determine what warrants a trip to the derm, we've listed the most common skin problems that can arise over time. ILLUSTRATIONS BY GABY D'ALESSANDRO- 5A prevention.com- JUNE 2018 LE ededlainiaiiiaadaiuiaauuiuiiuuuuuiuuuuuuuuuuuuttyiyg) VIM‘WHAT THEY LOOK LIKE: Flat tan, brown, or black spots that appear on areas commonly exposed to the sun, such as the face, chest, shoulders, arms, and backs of the hands. WHO GETS THEM: Anyone can get them, but people who spend a lot of time in the sun or those with a hi tory of frequent or intense sunburns are more likely to develop age spots by age 50. Individuals with pale skin and red hair are particularly prone to them. The spots are benign, but because they often occur in areas of sun-damaged skin, they can be confused with skin cancers that develop in the same areas. If an individual spot gets larger or changes color, see your dermatologist right away. TREATMENT: Topical prescription medications such as hydroquinone and retinoids can help reduce the frequency of the spots if their appearance bothers you. There are also over-the-counter topicals that may be less effective. Dermatologists can treat them with lasers or intense pulsed light therapy.hypomelanoses WHAT THEY LOOK LIKE: Small, smooth, white lesions on the shins and forearms. WHO GETS THEM: These benign spots are caused by a decrease in melanin in the skin. They generally emerge in mid- life but tend to manifest earlier in women than in men. ‘TREATMENT: These spots typically don't require or respond well to treatment, but topical prescription medications such as retinoids may help im- prove their appearance; chemi- cal peels and laser therapy may also be helpful. = WHAT THEY LOOK LIKE: Waxy, scaly growths that are flat or slightly elevated. They're usually tan, brown, or black and arise on the face, chest, shoulders, or back. | Seborrheic keratoses | 5G prevention.com - JUNE 2018 WHO GETS THEM: Seborrheic keratoses (SKs) can appear at any time, but you're more likely to develop them after age 50 unless they run in your family. The lesions are noncan- cerous, but since they sometimes resemble skin cancer, it's a good idea to have a dermatol- ogist evaluate them to make sure nothing more serious is going on, says Alok Vij, a dermatologist at Cleveland Clinic, in Ohio. In very rare cases, a sudden eruption of Sk lesions may indicate the presence of an internal cancer such as stomach, colon, liver, or pancre- atic; scientists don't yet understand the link. TREATMENT: SKs are mainly a cosmetic issue and don't need to be removed, but if you pre- fer, your dermatologist can get rid of them with liquid nitrogen, cauterize them, or scrape them off with a curette.® ° E Skin tags j) WHAT THEY LOOK LIKE: Fleshy growths, usually the same color as your skin or slightly darker. Most are small (1 to Heer but some can become the size of a pencil eraser or larger. They grow in areas that are frequently rubbed, such as the neck, armpits, and groin and under the breasts. WHO GETS THEM: Upto half Siena these benign skin tumors. For most . Che: hhemangionsse people, they're simply WHAT THEY but some believe | They can also ie occu! LOOK LIKE genetics plays bleed if injured by be associated with ‘Small, bright-red | a role. “Most scratching, pick- health conditions like spots that may people have one ing, or shaving. prediabetes, so your be flatorraised. or two cherry TREATMENT: dermatologist may They can develop | hemangiomas, Light cauteriza- recommendithatyou \ anywhere but but those who tion, laser therapy get screened if you ~ typically appear are genetically and freezing with evela lot of.them. on the torso. Spredisposedto liquid nitrogen eaiyaeitea ta WHo Gers them mayhave (cryotherapy) are ‘ones with OTC skin ‘THEM: Experts 10 or more,” says —_ options. However, tag removal products, aren't sure why Jorizzo. They're there's a chance including gadgets, people develop mostlyacosmetic _that removal may sprays, and liquids. these harmless issue but maybe-_leaveamark, so For larger skin tags, growths, which comeswollenand _ it's often best to. His best to have voir: contain aprolif- _feeluncomfort- _—_leave them alone dermatologist snip, eration of small —ableifiirritatedby _if they're not cutee OLE ee blood vessels, clothing or jewelry. _ bothering you. them off. JUNE 2018 - PREVENTION.COM &@ ULLAL LLPERSONAL SERVICE Actinic become hard and wart- 1 a like over time. They ap- pear on the face, scalp, of @. % 2 WHAT THEY LOOK LIKE: Crusty, scaly growths that may be gray, pink, red, or the color of your skin. They're usually flat or slightly raised but can “atti Feaeeeeael | Stucco keratoses backs of hands, and other exposed areas. WHO GETS THEM: Anyone can develop actinic keratoses (AKs), but people with fair skin, freckles, blond or red hair, and light eyes are more prone to them. The lesions may seem like random patches of dry skin at first, but they're actually a sign of DNA damage caused by years of sun exposure and are considered pre- cancers that should be @ 2 a WHAT THEY LOOK LIKE: Dry, rough, grayish-white lesions, mainly on the lower legs and feet. WHO GETS THEM: Experts don’t know much about who is most likely to develop these lesions. They don’t appear related to sun damage, usually arise in midlife, and may be caused by avirus. “Dermatologists often think of stucco keratosis as a variant of seborrheic keratosis,” says Vij. The main difference is that stucco lesions occur in far greater numbers than seborrheic ones. ‘TREATMENT: They can be removed with liquid nitrogen or scraped off with a curette, but Vij says chemical peels may be a better option. “The shins and feet take a long time to heal from freezing and scraping, and you could end up with scars,” he says. 38S prevention.com- JUNE 2018 While most are benign, up to 10% of AKs devel- op into skin cancer— typically squamous cell carcinoma, the second-most-common form of the disease. ‘TREATMENT: There's no way to determine which lesions may become cancerous, s0 your doctor will always treat them. If you have just one or two, they can be frozen off with liquid nitrogen. Larger clusters are treated with a chem- ical peel, light therapy, shaving with a curette, or topical chemotherapy evaluated byadoctor. or immunotherapy. MULL/ Lipomas | WHAT THEY LOOK LIKE: Soft, rubbery lumps on the neck, shoul- ders, back, abdomen, arms, or thighs. They're usually small (less than 2 inches in diameter) but occasionally grow to be the size of a baseball or even larger. Never try to pop them— they're filled with fatty tissue, not liquid or pus. WHO GET'S THEM: The tendency to develop multiple lipomas is often inherited. Otherwise, experts don't know why they form. They can appear at any time but are most common at ages 40 to 60. They usually aren't painful, but ones larger than 2 inches in diameter may become uncomfortable if they start pressing on nerves. ‘TREATMENT: While they can be surgically removed or liposuctioned, there isa risk they will recur, Jorizzo says. Investigations are under way to see if injectable products that dissolve the fatty tissue are more effective. ahistory of extensive sun exposure are most at risk. Allatypical moles should be examined by a doctor, as they can be melanoma, a potentially deadly form of skin cancer that's more [ Atypical moles | likely to occur in older (dysplastic nevi) people, those with a family history of the disease, and WHAT THEY LOOK people with pale skin and LIKE: Unlike ordinary a history of sunburns, moles, atypical moles are _ particularly severe ones. asymmetrical, with irreg- ‘TREATMENT: Your der- ular borders. They're also matologist may use special multicolored and may have techniques to examine the patches of tan, brown, red, mole more closely, and if blue, or black, They can it's suspicious, will biopsy appear anywhere. it. Many moles can be left WHO GETS THEM: Any- alone, Jorizzo says, but one can develop them, but very abnormal ones should people with fairskinand always be removed. ALULLALOLLL ALLL [ Xantholasmas | WHAT THEY LOOK LIKE: Soft, yellow patches that are flat or slightly elevated. They typically appear on the eyelids, often near the inner corner. WHO GETS THEM: The condition is not common and usually arises during midlife or later. The patches themselves aren't harmful, but it's likely your dermatologist will refer you to your primary care physician ora cardiologist for a cholesterol check, says Jorizzo. That's because ‘the bumps are filled with cholesterol, which may signal that your blood levels are abnormal (a risk factor for cardiac disease). TREATMENT: There's no medical need to treat, but many people do so for cosmetic reasons. The patches can be removed surgically, with lasers, or with a chemical peel. ©hree years ago, I saw America in a way that made me want to know it better. My family and I were flying from our home in Marlboro, MA, to the mountain resort town of Steamboat Springs, CO. Peering out the window at the mountain peaks of the Rockies, I thought to myself, I need to see this country up close. | turned to my mom and said, “I think I should ride my bike across America” “You haven't ridden a bike since you were a child,’ she said with a laugh. “You don’t even own a bike.” “Fine,” I said, “Ill walk.” Tadmit my proclamation was sudden. But at the time, I needed a life change. I was 34, and between my full-time job bartending and my part-time gig as a wedding photog- rapher, the long hours were taking atoll on my health. I had gained 20 Ib, was taking medication for high blood pressure, and felt a sense of aimlessness and depres- sion. I longed to slim down, breathe fresh air, and once again feel that endorphin high I used to get from running track and playing soccer in high school and college. More As told to Tracy Ross Photos by Lindsay Monroe One foot in front of the other, Lindsay Monroe traversed the country for iaeyat eke leek rejuvenated her health along the wa:TeNoota |PERSONAL JOURNEY than anything, I wanted an adventure. After that vacation, I couldn't shake the idea that I needed to quit my jobs and travel the country. Tread Peter Jenkins’s book A Walk Across America, which details his on-foot journey across the US over the course of 7 years, and became even more inspired to do something similar. Td saved up enough money to take some time off, so I decided to quit my job in August 2016 and take the next year to explore. Thadn't hit the gym with any regularity for months, so I started by walking short distances. Over the next 3 months, I built up to 5 miles a day. I also began plotting my route across the US and bought the necessary gear: camping and trekking equipment and a jogging stroller that Td use to push my gear (which turned out to weigh more than 100 Ib). When my brother realized I was actually going to walk across the US, he asked if he could help me make a podcast about my journey. I said yes immediately; even if only a few people listened to it, it would be a great verbal diary for me. We named it Lindsay Walks and decided that I would call him from the road every Sunday. We'd chat about my experiences, and he would post the recording online so that G2 prevention.com - JUNE 2018 people could hear about my trip as close to real time as possible. Finally, after a year of prepping—and convincing friends and family that I wasn't crazy—it was time to get started. I put my bills on autopay and showed my family how to track my location via cell phone. Then, on Nov. 13, 2016, Tim, my boyfriend of 8 years, drove me to my jumping-off point: balmy Myrtle Beach, SC. I planned to spend the next 9 months walking from the Atlantic through the Bible Belt and into Texas, New Mexico, and Nevada. At Las Vegas, I'd turn north and go through Death Valley and into California. 'd finish my walk on the shores of thePacific. Some nights I'd stay in a hotel or hostel, but the rest of the time I would pitch my tent wherever I ended up and sleep under the star: The first week was surprisingly easy. It felt amazing to stretch my legs in the sunny coastal weather, and the miles flew by. I was giddy with excitement. Twas doing what I'd set out to do. I was taking a risk, exploring the world! You doef baste Te by fs Talso had a fail-safe in place those first few days in case I changed my mind: Tim stayed nearby in his car and spent the first couple of nights with me so I wasn’t alone. On day 3, the weather turned cold and drizzly, and a driver pulled up alongside me and asked if I needed aride. Even though I was wet and tired—my body was struggling to get ee T happens. JUNE 2018 - PREVENTIONCOM 6Bused to walking 15-plus miles a day— Iwas happy. I smiled and said, “No, thank you. I’m walking to California. On purpose!” ‘Two weeks later, after Tim had gone back home, my real challenges began. My first evening on my own, as the sky darkened, there wasn’t a hotel in sight, and I knew I'd have to camp alone. I stopped at the first place I could find, which happened to be someone's private farmland. I set up my tent but couldn't manage to spark a fire, which meant I couldn't eat. I went to bed G4 prevention.com - JUNE 2018 cold, hungry, and frightened. It was the worst night I’d ever had, and when daylight finally broke, I was ready to call Tim and quit. But I realized that if Tcould survive a night like that, I was strong enough to keep going. By January, I'd been walking for 2 months, and I'd gotten into a rhythm. I walked an average of 18 to 20 miles per day through Georgia, Alabama, and Mississippi. When I was tired or hungry or needed to charge my phone, Td find a gas station, café, or RV park sst. Often, curious onlookers% would see my rig and strike up a con- versation. Many times, I'd end up with an offer of a hot meal, a bathroom, and sometimes even a bed. Unless I got a weird vibe from them, I said yes. Part of the reason I took this trip was to make authentic connections with people I met along the way, as Peter Jenkins had done on his trip. And I took pre- cautions. I carried pepper spray and a knife, and I'd text my family or Tim about who I was with or where I would be staying. There was a ripple effect, too. Once I'd stayed with one person, he or she often called friends and family down the road to let them know I was headed their way. My walk was full of this “trail magic.” It seemed whenever Thad a need, a stranger would fill it. Tran out of water? A fam- ily in a car would come by with an ice-cold cooler full of water bottles. My hands were cold? A trucker would pull up and produce a pair of gloves. These chance meetings and conversations restored my belief that people are inherently good and kept me from getting lonely. It wasn’t until 3 months into my journey, however, that my walk turned up its greatest gift. I was walking through rural Arkansas when a scruffy black pup started to follow me. After 2 days of her being my shadow and disappearing at night, she spent the en- tire night camped outside my tent door. In the morning, she let me pet her. I had a feeling she was adopting me. Inamed her Cynthiana—Thina, for short—bought a leash, got her shots, and had her spayed. Over the next 6 months, Thina showed me how to live deeply in the moment. In places where she could run free, I'd watch how truly alive and happy she was just play- ing in a pond, leaping through a field, running among cows. Little by little, that happiness began to rub off on me. I was changing with every step, and it showed in many ways. When you walk 15 to 20 miles a day while pushing a buggy weighing 100-plus pounds, you easily burn 5,000 calories. Even though my diet wasn’t as clean as 'd prefer—T ate a lot of gas station hot dogs and snacks—my clothes were getting looser, and my legs were becoming stronger. I was also sleeping better than ever. (You'd be amazed how walking 60,000 steps a day makes falling asleep easy—even in the picnic area at a truck stop!) Of course, not every mile was en- joyable. Thina and I hit Texas in April, and the high temperatures and strong winds were brutal. During a stop for water, I was so exhausted that I stepped on a rattlesnake sunning itself on the shoulder of the road. I screamed and JUNE 2018 - PREVENTION.COM GBPERSONAL JOURNEY sprinted off, then crept back slowly to retrieve Thina and my cart. At this point, I was receiving a dozen e-mails a week from my podcast listen- ers telling me they were inspired by my story. Knowing that my experience was helping others kept me going. By late April, the weather had turned blisteringly hot. We made it through New Mexico and to Arizona, where the winding roads of the South turned into four-lane interstates with cars screaming by at 80 miles an hour. It was so hot at times that Thina’s feet would crack or she'd simply stop walking. I'd put her in the cart, which added another 50 |b to the load. Friends, family, and a fellow walker Td met all recommended that we swap our current route for one that took us north, through Utah, rather than through Death Valley as I'd originally intended. 66 prevention.com- JUNE 2018 While in Utah, I took a break for a side trip to several national parks. I was hiking in a ravine when I lost my foot- ing. I wound up with a broken finger and bruises on my leg that made walk- ing uncomfortable. Still, I pressed on. Tleft Bryce Canyon National Park and continued walking through the state. Between the miles and the heat, however, my calf grew more swollen. Then in Ogden, UT, I slammed my injured shin into the cart when my wheels hit a curb, and I screamed in pain. I knew I needed to get medical attention soon. At an urgent care clinic in Pocatello, ID, I learned my leg was so bad that my trip might be over. At first, I cried thinking about the possibility of quitting after having come so far. But I was determined to reach the Pacific, even if I had to drag my leg across the finish line. After spending 5 days at a campground to let my body heal, I started slowly walking again. The first day I went 9 miles, the next 12. My leg wasn't in great shape, but it 4 was holding up. Thina and I continued walking northwest through the high desert, which was so hot that I could stay upright for only a few hours before needing to find shade and guzzle water. But I walked, and yet another—I don’t know, miracle?—happened. A woman driving past saw me limping. She pulled up and asked if I needed help. She and her roommate spent 3 days driving back and forth across Idaho picking me up, taking me to sleep at their house for the night, then dropping me off at my pickup spot again. She got eme through the most desolate part of Idaho and into my final state, Oregon. Nine months after I started, I pushed my cart to the edge of the water and jumped into the Pacific. A few days later, I arrived in Lincoln City during a total eclipse, just as the moon was pass- ing in front of the sun. I knew then that Ihad done something remarkable. These days, I still make it a point to explore outdoors with Thina at least 5 days a week. Now, though, walking is so much more than exercise: It’s about embracing my surroundings, living in the moment, and scheming about my next adventures. This summer I’m walking 300 miles through New En- gland. Next, I plan on hiking the 1,800- mile Te Araroa Trail in New Zealand. Thina, as always, will be by my side. ©FITNESS Want Better Abs? Just Breathe! The secret to a stronger, leaner core: Make every inhale and exhale count. BY EVELYN SPENCE PHOTOGRAPHS BY JESSE DEYOUNG 68 prevention.com- JUNE 2018Jill Miller, 46, mother of two, shares the method that helps her abs look this good.ake one look at Jill Miller's core, and you'd guess that the 46-year-old mom of two spends hours at the gym taming her abs into submis- sion. Her secret, however, has nothing to do with intense exercise and a lot to do with the way she breathes. “On average, we take 20,000 breaths a day, but most of us never pay attention to the muscles that make it happen,’ says Miller, who used her varied background as a yoga therapist and a trained singer to develop the Coregeous Method. ‘This breathing-based approach, which has improved the health and bellies. of thousands of women, marries deep abdominal breathing with gentle movements to train the core muscles from the inside out. “In order to have a healthy core that provides a slim silhouette, we need to stop focusing on the visible six-pack muscles and instead develop our innermost abs first,” says Miller. And the best way to do that is through your breath. We know what you're thinking: You breathe all day but don’t have toned abs to show for it, right? Shallow breath- ing doesn’t cut it. Miller is talking about intentional and deep abdominal breathing that engages a hidden muscle that we rarely think about: the respira- tory diaphragm. “The respiratory diaphragm lives inside the lower rib cage” says Miller. Using your breath to stretch it fully 20 prevention.com - JUNE 2018 causes all of the deep muscles in your trunk to fire up. Understanding why breathing this way can transform your core requires ashort anatomy lesson. Your torso is like an elastic, muscular cylinder, says Miller, and the inside is lined by the respiratory diaphragm at the top, the pelvic floor at the base, and your deep abdominal muscles wrapping around the back and sides. Breathing correctly with your diaphragm—so that your belly expands outward like a balloon filling with air—increases pressure in the cylinder, and your innermost ab muscles lengthen and shorten as the diaphragm contracts and relaxes; each breath thereby improves both strength and pliability throughout your inner trunk. “A strong and functional core is resilient like a rubber band,” says, Miller. “If your abs are always tense— say, from sucking in your belly to look thinner—you can lose your range of motion, and your muscles can’t be used to their full potential.” Plus, once you learn how to train the core through your breath, you can breathe your way to better abs anywhere, anytime. “When you turn on your abs through the breath, sitting and standing become toning moves,” says Miller. “And rather than holding your abs tight during exercise, breathing this way when you work out will power up your core while improving your health.”STYLING BY KEL FITNESS ‘Tone From \ Belly and Chest Breathing Usingarolled-up Step 1: Take towel, firm. 5 slow breaths pillow, orsmall over the course of exercise ball, about 4 minute. facedown and Concentrate place propunder —_oninflating abdomen. abdomen and feeling belly press into prop. “This routine will strengthen your innermost abdominals,” says Miller. First, you'll do breathing sequences to awaken your deep belly muscles (including the obliques, the transversus abdominis, and, of course, the diaphragm). Next, you'll incorporate the breath work into a few strengthening moves that will tone your core even faster. You'll need a yoga mat, a hand towel, and a few throw pillows or a small, cushy exercise ball. Do the routine 3 days a week, and your middle will become more defined— supple and sturdy, not just tight. Step2:Fornext Step 3:Finally, Move prop under Sbreaths, inhale breathingasin _—_ sternum and until full, then, Step 2,rollgently repeat the 3-step hold, stiffening fromsidetoside, sequence, this, all muscles of massaging abdo- time feeling abdomen at men.Continue _rib cage press ‘once, asifbrac- for 1 minute. into prop. ing against prop. Hold breath for 3seconds, then slowly exhale.FITNESS S ide Lie on side First place prop _Ineach position, : with knees under waist,then repeat breathing B reathing bent and arm directly under series from Steps under head. side ribs. Land 2onp.71. Pelle: This position increases rib cage movement so you breathe better. Bridge With Diaphragm Vacuum _ = = Lieonbackwith Whileinhaling, While exhal- and your core kneesbentand —slowlylifthips _ingfully, let hollowing). Then feet hip-width into bridgeand abdominal lowerhips to apart. extend arms muscles go slack, _floorand bring overhead. then broaden arms back to ribs (you'llfeel _ sides. Repeat diaphragm move 10 times. (e“ F PREVENTION.COM - JUNE 2018hands on knees, lower chin, and arms straight. spread ribs apart Diaphragm | tHissimpte move ‘Vacuum on Knees DB interal core muscles. ‘Gon! heels and ae ‘empty of air, lean forward with lean into hands, { so belly is sucked - inandup. Take 1 complete breath, then - emptylungsand Hold 40to 30 torso of air. seconds. Repeat Amore times. WE NEED TO STOP FOCUSING ON THE VISIBLE SIX-PACK ABS AND INSTEAD DEVELOP OUR INNERMOST ABS FIRST. AND THE BEST WAY TO DO THAT IS THROUGH YOUR BREATH. When your diaphragm is 7. FP stretched in this > movement, our . pelvic ftoor gets nel aworkout, too.Band Press — Attach 1 end of exercise band to at. doorknob or other immovable object. Hold other end of ¥ bandin front of chest with elbows bent and hands shoulder-width apart. ay Take 4 step away from doorknob toadd tension toband. Next, extend arms straight in front of chest, pulling hands slightly away from each other. Keeping body still and resisting tension from band, hold 10 to 20 seconds while breathing into belly and rib cage. Release band for 10 to 20 seconds. Do5to7 reps. This move works deep core stabiliz- ers like the trans- versus abdominis and inner obliques, as well as the pelvic floor. If you're not getting fatigued, stand farther from the doorknob or use a thicker band.Leg Lift - - - Lie on back on Stretchleftleg Concentrate on yogamat,extend straighttoward —_—keeping spine armsoverhead, _ceilingandhover__inits natural and hold on to right leg above shape. Relax, lesofmatas _ floor. Hold for then repeat on iftryingtopullit 30 seconds, other side. apart. breathing into belly and rib cage. a WHEN YOU TURN ON YOUR CORE THROUGH BREATH WORK, EVEN SITTING AND STANDING BECOME ABDOMINAL TONING MOVES. FITNESS ) Ifit’s too difficult, bend either or both knees, or place a folded towel or pillow under your pelvis. Twisted Cobra Place prop under sternum and lie facedown with legs hip-width apartand right arm under fore- head. Flexlegmuscles Pull shoulders untilknees come down your back upofffloorand and extend spine, push off right using right arm to arm, lifting help rotate torso leftarmstraight — toleft. alongside ear asif trying to - touch ceiling Brace and hold with thumb, 20 to 30 seconds perside, breath- inginto belly and rib cage. Repeat “© — 3timesoneach side. JUNE 2018 - PREVENTION.COM SE* This exercise attempts to “surprise” the Q core muscles, helping them grow stronger. ASTRONG, FUNCTIONAL COREIS RESILIENT LIKE A RUBBER BAND. r IF YOUR ABS ARE ALWAYS TENSE—SAY, FROM SUCKING IN YOUR BELLY— YOU LOSE Ab Free-for-All PENG AND RANGE OF _ - MOTION. Lie on back Your core will andplaceafew work to keep you pillows under from rolling off. pelvis—themore If you start to unstable, the tumble, place a better. foot back on floor for stability. - Bracingabdom- = inals,liftfeetoff Continue for floor and kick 30 seconds to legs around in minute, breath- whatever way ing into belly and J feels fun and rib cage. challenging. 7 > 96 pReveNTION.com - JUNE 2018