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If you’re going through menopause or perimenopause, you may be experiencing symptoms such as hot flashes, sleep problems, vaginal dryness, or changes in your menstrual cycles. These are all normal side effects of the “Big M,” but they can still be uncomfortable.

You don’t have to suffer in silence, says Erin Mateer, MD, an attending physician at Oak Hill Hospital in Brooksville, Florida. There are a number of options available, including hormone replacement therapy (HRT)—sometimes called hormone therapy (HT) and technically known as menopausal hormone therapy (MHT).

Whether you call it HRT, HT, or MHT, the formula generally consists of two hormones, estrogen and progestin. Estrogen is the hormone that relieves menopausal symptoms, explains Dr. Mateer. But it can also cause cells in your uterine lining to overgrow (a condition known as endometrial hyperplasia), which may lead to cancer. So, if you have a uterus, you’ll also need to take progestin to counteract that uterine overgrowth. If you don’t have a uterus because you’ve had a hysterectomy, you’re typically just given estrogen.

Is hormone therapy safe?
You may have heard about how HRT fell out of favor in years past, when the Women’s Health Initiative (WHI)—a trial funded by the National Institutes of Health—found in 2002 that women who took HRT had an increased risk of heart attack, breast cancer, blood clots, and stroke. But the thinking on therapy has changed since then.

This change was partly due to a reconsideration of the WHI’s limitations. For example, the study looked only at orally administered HRT and included only a limited number of women younger than 60 years old, the population best-suited to receive and benefit from HRT. Considering all the available research together—including newer studies, re-analyses of the WHI’s results, and reviews of other research—experts and authorities, such as the North American Menopause Society, now recommend short-term use of HRT for certain groups of women.

“The pendulum has swung back in the opposite direction,” notes Mateer. “We’re now advising it for younger women because they may actually get some protective side benefits when it comes to their heart and bone health,” in addition to symptom relief.

The primary recommended uses for HRT are to address:

HRT may also offer relief for achy joints and—when used alone or in tandem with an antidepressant—low mood or depression during menopause.

If you’re considering HRT, here’s what you need to know.

It’s only recommended for women under 60
“The perfect candidate is a woman younger than age 50 who is either going through perimenopause or actual menopause, who has no cardiovascular risk factors, and is a non-smoker,” says Mateer.

More broadly, HRT is considered a safe option for anyone who is within ten years of menopause or younger than 60 and doesn’t have a history of breast cancer, heart disease, previous blood clots or stroke, or liver disease.

Take it for the shortest time possible
If you do decide to take HRT, it should involve the lowest effective dose for the shortest time needed to provide relief from symptoms. How long is “shortest time”? Talk to your doctor about the dose and duration that makes the most sense for your health profile, but experts generally recommend taking it for no longer than five years or beyond the age of 60.

Most women don’t have any trouble stopping HRT once they’ve started. Studies show that 40 to 50 percent stop within a year of starting therapy, and up to 75 percent stop within two years. When you do end HRT, some experts recommending tapering off your dose rather than stopping cold turkey.

There are different forms of HRT
The most common form is an oral pill, but there are also skin patches, rings, and tablets that are placed in your vagina, and even creams and sprays you apply to the skin. If a woman is an iffy candidate because of concerns about blood clots, she’s probably better off using the patch rather than taking a pill. That’s because the hormones in the patch are absorbed directly into the blood through the skin—bypassing the digestive system and the liver where clotting factors can be affected, which may reduce the risk for blood clots.

If you have only vaginal symptoms, such as dryness, the ring or tablet may be a good option. “It’s broken down by the vaginal cells and stimulates receptors to help relieve dryness and pain,” Mateer adds. There are also vaginal creams that you insert via an applicator.

Non-hormonal methods may also offer relief
If you and your doctor decide that hormone therapy—in any form—just isn’t right for you, there are other options, stresses Mateer. While they generally aren’t as effective as HRT, anti-depressants including paroxetine (Brisdelle), venlafaxine (Effexor), desvenlafaxine (Pristiq), citalopram (Celexa), and escitalopram (Lexapro) have all been shown to improve hot flashes. An anti-seizure medication, gabapentin (Neurontin), usually given at bedtime, could offer relief as well.

Research also shows that regular exercise can also help reduce and relieve the frequency and severity of hot flashes.

Black cohosh, an herbal product, is often touted to help with hot flashes, as are plant-derived estrogens called phytoestrogens. But studies haven’t consistently shown that these so-called natural treatments help. It’s best to steer clear of over-the-counter remedies unless you’ve gotten the green light from your doctor.

Stay away from bioidentical hormones
Some women turn to “bioidentical” hormonal replacement products compounded in pharmacies because they believe they’re safer than conventional hormones, says Mateer. But these treatments are not regulated by the U.S. Food and Drug Administration (FDA), so there’s no guarantee of quality control. They may also contain hormones such as testosterone and dehydroepiandrosterone (DHEA).

In short, Mateer stresses, there’s no good evidence that bioidenticals either work or are safe for long-term use. The American College of Obstetricians and Gynecologists recommends FDA-approved hormone therapy instead.

Sourcing: Cleveland Clinic, The North American Menopause Society, Women’s Health Initiative, UptoDate, The American College of Gynecologists

Back to Women’s Health

Heart disease is the number one killer of women in the United States—killing one woman every 76 seconds—yet only one out of five American women actually believe it’s a threat.

Heart disease is a catch-all term that includes a variety of conditions and events—such as heart attacks, strokes and heart failure—and is often related to atherosclerosis, the formation of plaque buildup in the arteries. Warning signs of heart disease are not always the same for women and men, so understanding the symptoms and risk factors is important.

Women can actually respond to heart events differently than men. “Men are more likely to survive a heart attack than women,” says cardiologist Ramavathi Nandyala, MD of Methodist Hospital in San Antonio, Texas. And while both men and women usually experience chest pain and pressure during a heart attack, women can have a heart attack even without that common symptom. Women are in fact more likely than men to have nausea, vomiting and shortness of breath during a heart attack.

Smoking and a strong family history put you at risk for heart disease, but what about your eating habits and stress levels? Here are six things that can increase your heart disease risk—and easy ways to keep your ticker strong.

Stress or trauma

Stress—whether it be related to work, relationships or parenting—is the number one risk factor Dr. Nandyala sees in her female patients. “We keep adding more and more responsibility and stress on women,” she says. And traumatic events can also contribute to heart problems.

Stress causes the body to release adrenaline, which can cause arteries to go into spasms and your blood pressure to increase, Nandyala notes. Broken heart syndrome from an event like a death in the family can also cause the heart to “go into shock,” leading to a temporary type of heart failure. In fact, researchers from the University of Pittsburgh School of Medicine collected data from 272 postmenopausal and perimenopausal women to learn more about how traumatic events can impact heart health.

The study findings, presented at the North American Menopause Society’s annual conference in 2017, showed that women who were involved in at least three traumatic events during their lifetime—such as sexual harassment, a car accident or the death of a child—had poorer endothelial function than those women who had not experienced trauma. The endothelium is the inner lining of the heart and blood vessels, and poor functioning may increase the risk of heart disease.

Nandyala says that some stress in our lives is inevitable, but that it’s important to learn to cope with it. She recommends relaxing for a few minutes each day with reading, music, yoga, prayer or any other activity that relaxes your mind. Exercise can also help you manage stress—a quick walk outside is a better move than stress eating, for example—and can even put you in a good mood.

If it’s trauma you’re working through, see your healthcare provider to learn about available resources and treatment options. According to the Centers for Disease Control and Prevention (CDC), common responses to trauma include fear, grief and depression. If symptoms worsen or last more than a month, you may have post-traumatic stress disorder.

Meat-based diets

A diet rich in saturated fat and sodium increases anyone’s risk of heart disease, but one study found that a high-protein diet—especially if the protein came from meat—is associated with a higher risk of heart failure among older women.

In one preliminary study presented at the American Heart Association’s Scientific Sessions in 2016, researchers reviewed the self-reported daily diets of 103,878 women ages 50 to 79 from 1993 to 1998. During the course of the study, 1,711 women developed heart failure, and the rates were higher among women who ate more protein compared to those who ate less protein or who ate veggie-based protein. Experts say more research is needed to understand the link between a high-protein diet and heart failure.

When it comes to eating habits, Nandyala says a balanced diet is best. “Strictly avoiding carbs or fats isn’t always the best option because our bodies are made of protein, carbohydrates and fat,” she explains. If you do eat meat, reach for lean meats like turkey and chicken rather than overly fatty, processed meats like sausage and bacon. Plant-based proteins like tofu, beans and nuts are good options, too.

Yo-yo dieting post-menopause

Repeatedly losing and gaining weight, known as yo-yo dieting or weight cycling, can hurt your heart down the road.

One observational study presented at the American Heart Association’s Scientific Sessions in 2016 looked at self-reported weight history for 158,063 post-menopausal women and grouped them into several categories: stable weight, steady gain, maintained weight loss or weight cycling. The findings were eye-opening. Those of normal weight who lost and regained weight during the study period had a 3.5 times higher risk of cardiac death than women whose weight remained the same.

The study also found that those women considered overweight or obese who reported weight cycling had no increase in cardiac death. For women who reported gaining weight but not losing it, or losing weight without gaining it back, there was also no increase in death risk.

Nandyala wants women to know that it’s more important to adopt and maintain a healthy lifestyle overall than to drop weight quickly by employing drastic dieting tactics.

Birth control pills

Research shows that there may be a link between birth control pills and high blood pressure in some women. And the link may be stronger for women who are overweight, have kidney disease, have a family history of high blood pressure or high blood pressure during a pregnancy.

Birth control pills are typically made up of estrogen and progesterone, and estrogen is thought to encourage blood clot formation in some women over the age of 35, says Nandyala. Blood clots can lead to heart attack and stroke, and women who smoke and take oral contraception are especially at risk.

The good news is that many of the newer birth control options pose less risk. Speak with your gynecologist and/or cardiologist about the best birth control for you, particularly if you have congenital heart disease.

Obesity

Nandyala says obesity is another huge risk factor for heart disease. In fact, two out of every three women in the United States are overweight or obese.

“Females are especially affected by hormones, which can sometimes make weight easy to gain and hard to lose,” notes Nandyala. “Testosterone is a fat-burning hormone, while estrogen tends to be a fat-preserving hormone.”

If you’re carrying around extra fat—a body mass index (BMI) over 30 is considered obese—you may be increasing your risk of high cholesterol, high blood pressure, diabetes and even osteoarthritis and breathing problems. Maintaining a healthy weight allows blood to circulate through the body more efficiently and lowers your risk of the health conditions above.

Make sure you measure your BMI at least once a year, and if you are obese, talk to your healthcare provider about weight loss programs that can help you focus on taking in fewer calories and developing exercise habits.

Skipping your workouts

Skimping on regular exercise is a no-no when it comes to keeping your ticker strong. Regular exercise not only reduces the risk of type 2 diabetes and certain cancers but aerobic exercise (think walking, jogging, biking and swimming) strengthens your muscles and bones and can also help strengthen the heart and lungs. And that’s not all. The American Heart Association says that getting just 30 minutes of exercise a day, whether aerobic or resistance training, can:

Despite all the benefits, many women are still skipping out on regular exercise—and it’s affecting their heart health. A study published in the Journal of the American Medical Association in April 2019 analyzed 10 years’ worth of self-reported data for 18,027 women with cardiovascular disease. Researchers found that more than half of these women didn’t meet the recommended physical activity levels, and women over 40 were much more likely to fall short than their younger counterparts. Study researchers suggest that more must be done to improve overall physical activity among women.

Talk to your doctor before you begin any new exercise routine. Once you get the green light, try a combination of both aerobic and resistance training. You can work in other heart-healthy moves like dancing, water aerobics, rowing, stair-climbing and even housework.

Neglecting regular screenings

So many female patients come in and say, “I’m totally fit, so I definitely don’t have heart disease,” says Nandyala. But unfortunately, that’s not always the case. People who have a family history of heart disease should be especially cautious.

If you do have a heart condition like high blood pressure or high cholesterol, the earlier you can get it under control, the less likely you are to have a serious heart event.

The American Heart Association recommends getting blood pressure screenings at least every two years if your levels are below 120/80 mm Hg. If your numbers are higher, you may need more frequent screenings. Every four to six years, you should also receive a fasting lipoprotein profile, a measurement of your cholesterol and triglyceride levels. And starting at age 45, be sure to have your blood glucose checked every three years, or more frequently if you’re at elevated risk.

Sourcing: American Heart Association, National Institutes of Health, Anxiety and Depression Association of America

Back to Women’s Health

For women in their 40s, the possibilities in life may still seem endless. But even though so many doors remain open, conventional wisdom suggests at least one is slamming shut: childbearing. While it’s true that the odds of getting pregnant and having a baby after 40 are slimmer and there are more risks involved, it’s certainly possible for many women.

The fact is, many people delay having children because they’re focused on their career or other priorities. Some may have needed more time to settle down, feel ready, or find the right partner. Whatever your reason, if you’re older than 40 and hoping to get pregnant, it’s important to not only understand some of the challenges that may be involved, but also learn what you can do to improve your chances of having a healthy pregnancy.

Fertility wanes over time

You may have heard the old adage: “You’re only as old as you feel.” That may well be true for many things. But when it comes to reproduction, your chronological age really does matter. That’s because as you age, so do your eggs.

A woman’s prime reproductive years are between her late teens and 20s. After that, fertility tends to decline. Generally speaking, about 1 in 4 women in their 20s or early 30s will become pregnant during any one menstrual cycle. By age 40, a woman’s chance drops to less than 5 percent per cycle, according to the American Society for Reproductive Medicine. After the age of 45, getting pregnant naturally (or without the help of fertility treatments) is unlikely for most women.

Much of the decline in a woman’s fertility over time is associated with changes in her ovarian reserve—the quantity and quality of her eggs. A woman begins life with a fixed number of eggs in her ovaries. Aside from their quantity, the quality of these eggs also declines with advancing age.

“A woman’s ovarian reserve in her 40s is just not as hearty as it is when she is in her 20s or 30s,” explains Daren Watts, MD, an OBGYN at St. Mark’s Hospital in Salt Lake City, Utah. “This is the number one issue for women trying to get pregnant after age 40.”

This is why some younger women are choosing to freeze, or cryopreserve, their eggs—a minimally invasive procedure that involves harvesting unfertilized eggs from the ovaries and then freezing them for later use. This essentially halts the aging process for these eggs so they will have a lower risk for abnormalities later on when a woman decides she’s ready to conceive.

Low ovarian reserve, however, could also be related to other factors, including certain medical treatments, such as chemotherapy, or injuries. Women in their 40s may also be at higher risk for uterine fibroids, endometriosis and other health issues, which can affect their fertility.

A woman’s ability to get pregnant could also be affected by a man’s sperm quality. Men’s fertility also declines with age, though not as predictably as women’s ability to conceive.

More risks during pregnancy

Getting pregnant is just one hurdle, Dr. Watts points out. Once women are in their 40s, other risks associated with pregnancy also rise. Older mothers face greater odds of stillbirth, miscarriage, and other complications such as ectopic pregnancy (when an embryo implants somewhere other than the uterus) and placenta previa (when the placenta that feeds the fetus lies low in the uterus).

Additionally, women in their 40s are at higher risk for gestational diabetes and preeclampsia, or dangerous high blood pressure during pregnancy. They are also more likely to have babies with chromosomal abnormalities. Down syndrome, for example, is one of the most common genetic disorders associated with delayed childbearing.

Older moms are also more likely to have multiples, such as twins or triplets, since they are more likely to release more than one egg from their ovaries each month. Women in this age group may also be more likely to use fertility drugs, which increases the overall likelihood of having multiples.

Preparing for a healthy pregnancy

It may be harder to conceive once you’re in your 40s but you can increase your odds of success by taking certain steps, even before you start trying.

If you’re hoping to conceive later in life, schedule a “preconception” appointment with an OBGYN, particularly one that specializes in high-risk pregnancies. During this visit, your doctor will discuss genetic screening for you and your partner. You may also be advised to start taking prenatal vitamins, which have been shown to reduce the risk for certain birth defects when taken correctly both before and during pregnancy.

If you’re gearing up to get pregnant, it’s also important to shed excess weight and adopt healthy habits to prepare your body.

“It’s really important to lead a healthy lifestyle and be as fit as possible, as pregnancy does put strain on your body, and your body is capable of handling more strain when you are 20 than when you are 40,” Watts advises. If you smoke, quit, he adds. Getting a handle on any stress can also make a difference in your overall health.

Trying to conceive

Once your OBGYN gives you a “green light,” you may begin attempting to conceive naturally by making sure to schedule sex with ovulation. If you don’t get pregnant within a certain period of time, it may be time to consider an infertility evaluation.

Younger women often try to get pregnant for up to a year before considering fertility treatments, but women in their 40s may be offered these options sooner. “If you are over 40, we recommend six months of attempting to get pregnant naturally,” Watts says. “If you don’t succeed, we will do a full fertility workup.”

This workup may include a variety of tests, including an X-ray with dye or hysterosalpingography to confirm that your fallopian tubes (through which an egg travels from the ovaries to the uterus) are open. Your OB/GYN will also measure certain hormone levels and order tests that assess your ovarian reserve. In some cases, imaging tests can also give your doctor a better idea of the health of your reproductive organs. The quality of your partner’s sperm will also be evaluated during this process.

Based on the results of these tests, your doctor will develop a plan to help you achieve pregnancy, Watts says. Medications, or fertility drugs, may be used to help stimulate ovulation. “Advanced reproductive techniques and technologies may be necessary,” he says. For example, in vitro fertilization (IVF) involves combining sperm with a woman’s eggs in a laboratory and implanting the embryo in her uterus. If you chose to freeze your eggs, IVF is the technique that will be used to help you become pregnant.

If your ovarian reserve or your partner’s sperm quality is affecting your ability to conceive, you may also consider using a donor egg or sperm to improve your odds of becoming pregnant.

Ensuring a healthy pregnancy

All pregnant women should receive good prenatal care. This is especially true if you’re in your 40s. In fact, depending on your age, other health issues and medical history, you may need to undergo additional tests and have more frequent checkups throughout your pregnancy.

Early and routine monitoring by your OBGYN will help ensure that you have the best possible outcome. During each visit, your health and the health of your baby will be assessed.

Your doctor may recommend screening tests to make sure that your baby is developing properly. This includes a blood test in the first trimester plus an ultrasound of the fetus to assess risk for specific chromosomal abnormalities. This test, which is typically performed between the 11th and 13th week of pregnancy, could indicate the need for further testing.

Other diagnostic tests such as amniocentesis, which tests amniotic fluid, or chorionic villus sampling (CVS), which tests tissue from the placenta, can provide more definitive results. These tests do confer a higher risk of miscarriage, which is already higher in women older than 40.

“A newer blood test that analyzes bits of fetal DNA that leaked in the mother’s bloodstream is less risky,” Watts says. “This is much less invasive and can be done as early as nine weeks.” Together with your OBGYN, you should determine the most appropriate screening plan for your pregnancy.

It’s important to remember that pregnancy after 40 is less likely—but it is increasingly possible thanks to advancements in fertility and reproductive medicine. If you are expecting later in life, you can improve your chances of having a healthy pregnancy by establishing a game plan early on. That means getting regular prenatal care, adopting a healthy lifestyle—including stress reduction, regular physical activity, a nutritious diet, and adequate sleep—and having open communication with your healthcare team.

Sourcing: The American College of Gynecologists, National Institutes of Health, Rogel Cancer Center, The American Cancer Society

Back to Women’s Health

For many people, eating a healthy, balanced diet is the best way to get the vitamins and minerals your body needs. But even a very healthy diet might miss out on some key nutrients.

The stakes are even higher when you’re pregnant or trying to become pregnant. At that point, it’s vital to fill those gaps with a prenatal vitamin. Nutrients found in prenatal vitamins—like folic acid, iron, calcium and vitamin D, among others—are necessary for the growth and development of a fetus, and many studies have linked them to reduced risk of birth defects.

Of course, it’s important to talk to your healthcare provider before starting any new vitamin or supplement, particularly when you’re pregnant, breastfeeding or trying to conceive. Your doctor will be able to recommend the best prenatal based on your pregnancy and health history. Read on to learn more about how prenatal vitamins can contribute to a healthy pregnancy.

What essential ingredients do prenatal vitamins have?

Like a daily multivitamin, a good prenatal can provide nutrients your everyday diet might be lacking. The major difference? Prenatal vitamins typically contain higher amounts of the vitamins and minerals essential to a growing baby—specifically, folic acid and iron.

“Folic acid is important in the nerve development of the fetus, protecting against neural tube defects, like spina bifida,” explains Meghan J. Freund, MD, an OBGYN with Mercy Health Physician Partners OB/GYN, East Beltline in Grand Rapids, Michigan. “Iron helps with growth and development of the fetus, and also helps mom. Because blood volume expands during pregnancy, a lot of pregnant patients become anemic. You need a prenatal because a lot of over-the-counter multivitamins don’t even contain iron.”

Adequate intake of folic acid has been linked to reduced risk of spina bifida, a birth defect affecting the spine and spinal cord, and anencephaly, the underdevelopment of the brain and skull.

According to the Centers for Disease Control and Prevention (CDC), all women of reproductive age should obtain at least 400 mcg of folic acid every day—whether they’re planning to get pregnant or not. Birth defects affecting the spine and brain usually occur three to four weeks following conception—often before a woman even knows she’s pregnant.

In addition to taking a prenatal vitamin, you can boost your daily intake of folic acid by eating foods such as:

Iron, a mineral that helps red blood cells transport oxygen to the rest of the body, is another key nutrient in prenatal vitamins.

Not only has inadequate iron intake during pregnancy been linked to low birth weight, premature birth and maternal and infant mortality, but it can lead to anemia in the mother, too. Anemia occurs when there aren’t enough red blood cells to carry oxygen to the body’s tissues, often causing symptoms like fatigue, weakness, shortness of breath, dizziness, headaches and chest pain. Although anemia is highly treatable when caught early, it may become dangerous if left untreated.

Because blood volume increases by a whopping 30 to 50 percent during pregnancy, pregnant and nursing women should aim for 27 milligrams of iron per day. In addition to taking a prenatal vitamin, you can enjoy iron-rich foods like:

Although those who eat a plant-based diet can still choose from a variety of foods with iron, the body absorbs two to three times more iron from animal sources than from plants.

Foods that contain vitamin C can help the body absorb iron more efficiently. Pair foods containing iron with fruits and veggies like strawberries, oranges, bell peppers and tomatoes.

Who should take prenatal vitamins?

Prenatal vitamins are recommended for all pregnant, as well as women of reproductive age. They may also be valuable for women who are nursing.

Groups who may need to take higher than usual amounts of prenatal vitamins are:

Speak with your doctor if you fall into any of these categories.

Additionally, women with special diets, such as vegetarian or gluten-free, should talk with a doctor or dietitian to ensure their dietary needs are being met during their pregnancy.

When should I start taking prenatal vitamins—and for how long?

“Any patient who is not on birth control and could potentially get pregnant, or someone who is trying to conceive should start taking prenatal vitamins at least a few months before conception,” says Dr. Freund.

Prenatal vitamins can also be important post-pregnancy. Women with restrictive diets or those who are breastfeeding may not get adequate nutrients through diet alone. A prenatal or multivitamin may help breastfeeding mothers meet their daily nutritional needs.

What should I look for when shopping for a prenatal vitamin?

Over-the-counter prenatal vitamins are widely available in pharmacies, drugstores, grocery stores and through online retailers. Your healthcare provider can also provide a prescription. If you have a family history of neural tube defects, have given birth to a child with neural tube defect or have a medical condition like anemia, you may be advised to take additional supplements to help support your pregnancy.

In addition to folic acid and iron, look for prenatal vitamins that are high in calcium and vitamin D. These nutrients play a vital role in the development of your baby’s skeletal system and are especially important during the second and third trimesters, says Freund.

Some prenatal vitamins also have DHA, a type of omega-3 fatty acid. DHA is thought to help fetal brain and eye development. Not all prenatal vitamins have DHA, but it may be beneficial to seek one, especially if you do not eat fish or other foods high in omega-3 fatty acids.

When paired with a prenatal, you can also up your intake with foods that are high in calcium and vitamin D, like fortified dairy products, fortified orange juice, fatty fish, egg yolks, kale and broccoli.

Not all prenatal supplements are created equal though. The amount of each nutrient contained in a prenatal vitamin can vary widely by brand. A June 2019 study published by the Journal of the American Medical Association JAMA Network Open found that while prenatal supplements do help reduce inadequate intakes of important nutrients—particularly folate and iron—they can also lead to women consuming too much. However, without the use of supplements, pregnant women would likely not take in the recommended amount of either nutrient. Researchers suggest that guidance should be provided to pregnant women about selecting a supplement with a responsible formulation, along with nutritional and dietary recommendations.

Are there side effects to prenatal vitamins?

According to Freund, most women don’t experience serious side effects from prenatal vitamins. “Sometimes people have trouble swallowing pills,” she says. “Or, if they have bad nausea, especially in the first trimester, they may have an aversion to their prenatal vitamins.”

Other women may experience constipation, often due to the high amount of iron in prenatal vitamins. Drinking plenty of fluids, exercising, taking your vitamin at night and adding fiber to your diet can provide relief for some women.

However, some women may still experience discomfort. “For those patients, we recommend prenatal gummy vitamins,” she says. Since gummy vitamins often lack calcium and iron, women may need to take in additional amounts of those nutrients within their diet or through other supplements.

It is possible to take too many vitamins, which could result in vitamin toxicity. If you’re planning to conceive or already pregnant, be sure to talk to your healthcare provider before starting any vitamins, as well as mentioning any other supplements you already take. Use prenatal vitamins only as directed, typically once daily.

Remember: If you’re pregnant or trying to become pregnant, a prenatal vitamin should be a part of your daily routine. If you’re not sure which prenatal is right for you or have any questions about your diet, talk to your healthcare provider. But remember, a vitamin or supplement is never substitution for a complete and healthy diet.

“Having a healthy, balanced diet and staying adequately hydrated will lay the groundwork for a healthy, happy baby,” says Freund.

Sourcing: U.S. National Library of Medicine, CDC, American Pregnancy Association, National Institutes of Health, The American Red Cross, The Cleveland Clinic, The American College of Gynecologists

Back to Women’s Health

Losing weight can be tough, but keeping the pounds off can be even harder. Some research suggests dieters who have successfully lost weight are likely to pack the pounds back on in the months and years that follow. Some may even gain more than they lost.

Weight regain can be caused by an unhealthy diet, lack of physical activity and even your hormones. Despite the difficulty of weight loss maintenance, there are some proven ways to keep the pounds at bay, and some of these tricks require almost no effort.

Charan Donkor, MD, a bariatric surgeon with Westside Regional Medical Center in Plantation, Florida, reveals some of his top tips for maintaining a steady weight.

WEIGH YOURSELF REGULARLY

According to the National Weight Control Registry (NWCR), a group that studies the behaviors of people who’ve lost weight and kept it off, weighing yourself on a regular basis can help stave off pounds. In fact, 75 percent of the more than 10,000 people on the registry—those who’ve lost weight and kept it off—weigh themselves at least once a week.

“Weight can be very dynamic, and it can fluctuate,” Dr. Donkor says. “Do whatever works for you, but weighing yourself once a week, or every two weeks, is very reasonable,” he adds.

Some research suggests once every seven days just isn’t enough to avoid weight gain. A small 2017 study of 294 college-aged women suggests those who stepped on the scale every day for a two-year period were more successful at avoiding weight gain than those who weighed in less frequently.

PRACTICE MINDFUL EATING

Work, smartphones and our favorite television shows can all be unhealthy distractions. When we take our focus off what we’re eating, we’re more likely to overindulge—many times, without even realizing it. Practicing mindfulness can help.

Mindful eating is a concept that comes from the Buddhist practice of mindfulness, which encourages you to be totally aware of what is happening. When applied to eating, mindfulness involves paying attention the colors, textures, smells and flavors of the food in front of you.

Results of a 2012 study of participants with type 2 diabetes suggest mindful eating was helpful for weight maintenance over a three-month period. The next time you’re ready to eat, leave diversions off the table, sit quietly and savor your food.

EAT A WELL-BALANCED BREAKFAST

About 78 percent of people on the weight control registry eat breakfast every day. A 2016 study of 354 men and women who lost at least 10 percent of their initial body weight suggests a morning meal is associated with low rates of weight regain. The study also suggests men were most successful, especially when the first meal of the day was eaten at home.

Breakfast has also been associated with more stable blood sugar levels, increased productivity and consumption of less fat and cholesterol throughout the day. But, what you eat matters. A healthy breakfast should consist of whole grains, lean protein, low-fat dairy and plenty of produce.

No time to cook in the morning? Overnight oatmeal makes a great grab-and-go breakfast option. In a mason jar, combine equal parts rolled oats and low-fat or non-dairy milk, a tablespoon of almond butter and a serving of your favorite berries. Place in your fridge overnight, and enjoy in the morning.

KEEP A FOOD DIARY

Donkor recommends keeping to a regular schedule that includes healthy eating and regular exercise whenever possible. Logging your calories is one way to help you stick to your eating plan, and keep the unwanted pounds at bay.

“You want to track the calories that you take in, and see how much you burn on a daily basis,” he says. If you’re looking to slim down before maintaining a steady weight, tracking your caloric intake can also help, suggest the results from one systemic review of 22 studies.

You can keep track of your meals with phone applications, like Sharecare, available for Android and iOS. Simply log the size and quality of your meals, and the app will keep track of your daily intake.

You can track your physical activity, too. Once you activate the tracker, steps are automatically tracked, so grab your phone whenever you get up and more.

GET DAILY PHYSICAL ACTIVITY

About 90 percent of members on the NWCR who’ve successful maintained weight loss get about 60 minutes of physical activity each day. This is more than the recommended 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity weekly aerobic activity, but you have to start somewhere!

“You want to have a time set out for your physical activity,” Donkor says. “I always recommend my patients dedicate 30 or 45 minutes to exercise about four times a week.”

In addition to aiding in weight loss maintenance, regular physical activity can help reduce the risk of diabetes, high blood pressure and symptoms of anxiety and depression. To reap the benefits, choose an activity you enjoy and get moving.

Not sure where to start?

CUT DOWN YOUR SCREEN TIME

A 2017 survey suggests the average American spends between two and three hours watching television each day. Some research suggests watching TV, an activity that’s often done in a seated position, can up your risk of weight gain and obesity.

There is also some evidence that slashing the amount of time you spend perched in front of the tube is associated with better maintenance of weight loss. In fact, 62 percent of successful NWCR members spend fewer than 10 hours a week watching television.

If you turn to the big screen as a way to unwind after a long day, you’re not alone. Instead, try focusing your energy on other relaxing activities, like walking, meditation or yoga.

Sourcing: National Institutes of Health, Harvard Medical School, National Weight Control Registry, CDC, United States Department of Labor

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If you’re struggling with a chronic illness, chances are you have regular appointments with your oncologist, cardiologist or gastroenterologist. If you’re an aspiring—but injury-prone—marathoner, you probably see an orthopedist or sports medicine doctor. And if you’re trying to conceive or are already pregnant, it’s likely you’ve got a great OB/GYN on call. But whether you’re a marathoning mom of three or a high-powered attorney with high cholesterol, you may benefit from an appointment with a registered dietitian.

What does a dietitian do?

While the most common reasons people see a registered dietitian (RD) are to lose weight or make lifestyle changes, RDs are educated and trained to advise patients and clients in many additional areas. “A dietitian can work clinically, usually in a hospital or medical setting,” explains New York City-based dietitian Kelly Hogan, MS, RD. “Many dietitians have private practices with various specialties, or they can work in corporate wellness, communications, food service, grocery stores or as consultants for food companies.”

An RD is also trained to help navigate the ever-changing landscape of nutrition guidelines, as well as interpret specific literature and the latest research to help inform recommendations for patients and clients.

An RD typically has the equivalent of a bachelor’s degree in nutrition and dietetics. Prospective RDs must complete a yearlong accredited dietetic internship, pass a national examination and complete continuing education credits. They must also abide by a code of ethics. Comparatively, similar-seeming nutrition advocates—like nutritionists or health coaches—may not require any formal education or training requirements.

How an RD fits in with other treatments?

Despite the growing public interest in health, wellness and nutrition, many of the aforementioned doctors—the oncologists, gastroenterologists and urologists of the world—receive little education when it comes to nutrition. According to a 2015 survey of 121 four-year medical schools, 71 percent didn’t require students to complete at least 25 hours of nutrition education. Plus, the survey found fewer than 20 percent of those schools required a single nutrition course. Where nutrition education is lacking in the mainstream medical system, RDs fill a crucial gap in helping patients achieve well-rounded health.

Of course, an RD doesn’t take the place of those specialists. An RD shouldn’t tell you to ignore your medical treatments, nor will they use anecdotal stories to inform recommendations. “We only use evidence from scientific literature and peer-reviewed journals,” Hogan explains. “Dietitians aren’t the food police and we’re not all in bed with big food companies or government organizations.” Plus, Hogan explains, even though diet is indeed part of their title, RDs do not exist solely to put people on diets.

Why should I see a dietitian?

If your goal is to lose weight—whether for health, vanity or doctor-mandated reasons—an RD can absolutely help with that. But Hogan shares ten more reasons why seeing an RD could be beneficial. Consider speaking with your doctor about getting a referral for an appointment if you feel an RD can help with one of these conditions.

If you have diabetes. An RD can help guide your blood sugar management through diet.

If you have digestive issues. From common gastrointestinal-related ailments like constipation, diarrhea, bloating, gas and heartburn, to more serious issues like celiac disease or Crohn’s disease, an RD can suggest dietary changes that can help to pinpoint triggering foods and manage symptoms of your condition.

If you have heart problems, hypertension or high cholesterol. A healthy diet is important in managing blood pressure and cholesterol and to treating heart problems. A dietitian can educate clients about best nutrition choices to reduce the risk of heart disease. They may also factor into a cardiac rehabilitation plan for patients who have experienced heart attack or failure.

If you’re pregnant or thinking about getting pregnant. Proper nutrition is key when you’re growing a human. If you’re unsure about what you should or should not eat during pregnancy, an RD can help make sure both mom and baby are properly nourished. An RD can also help manage gestational diabetes through dietary changes and keep an eye out for other common pregnancy-related issues like heartburn and nausea. Dietitians can also be helpful post-partum to ensure the mother is staying well-nourished if breastfeeding.

If you have kids. Many dietitians specialize in pediatric nutrition, from infancy through puberty. Your pediatrician may suggest nutritional counseling if a child is underweight or overweight. RDs can also help parents navigate through difficult medical diagnoses, like various genetic conditions, autoimmune disorders or signs of an eating disorder.

If you’re going through cancer treatment. Eating well during cancer treatments can help with retaining strength, maintaining a healthy body weight, recovering faster, lowering risk of infection and feeling better. But when you’re sick and spending most of your time going to and from treatments, eating a healthy diet can feel daunting. Chemotherapy can also cause side effects that affect eating, like nausea, taste changes, mouth sores, vomiting, diarrhea, constipation and loss of appetite. Many cancer treatment plans include an appointment with a dietitian, who will help you to find exactly what to eat.

You want to run faster, lift more or be more centered on your yoga mat. Nutrition is so important for sports performance. It can make or break a game, match or race. Specialized sports dietitians can help make sure you’re fueled adequately for performance and recovery.

You have a history of following various diets and want to free yourself from the notion that dieting is necessary. Many dietitians today specialize in a non-diet approach. They believe in intuitive eating and health at every size, which can help clients understand why diets don’t work for them. They can help people become more in tune with hunger and fullness cues.

You have a history of disordered eating. If you’ve ever been diagnosed with an eating disorder, a dietitian is a crucial part of your recovery and treatment team, in addition to doctors and therapists.

You just want to learn how best to fuel your body. There’s a lot of nutrition-related noise and quick-fix diet trends without much evidence to back them up. An RD can help you figure out how best to eat for your body, your health and your goals.

If you’re interested in making an appointment with an RD but aren’t sure where to start, the first step is to consider your own goals and the type of people you trust. Many private practice RDs offer free, short introductory phone calls, which is a great way to get to know what they do and see if they’re a good fit. Do some research to make sure they have the knowledge to treat your condition and help you reach your goals. “You’ll want an RD whose specialties and philosophies resonate with yours,” Hogan says.

Sourcing: Academy of Nutrition and Dietetics, NutritionED.org, American Diabetes Association, Celiac Disease Foundation, American Heart Association, UpToDate, American Cancer Society, National Eating Disorders Association

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Adults are supposed to get between seven and nine hours of quality sleep each night, but the number of people getting by on six hours—or fewer—is on the rise. With so many of us short-changing our sleep, it may not seem surprising that the number of Americans who rely on a daily jolt of coffee is also climbing. In fact, 63 percent of U.S. adults reported a daily java fix in 2019, according to a survey commissioned by the National Coffee Association USA (NCA).

If your days are hectic and you’re short on time, you might think sacrificing a few hours of shut-eye isn’t a big deal. After all, you can offset your resulting mental grogginess with a dose of caffeine.

But poor sleep affects more than your alertness and energy level. It also affects your metabolism and may contribute to weight gain as well as obesity-related conditions, such as type 2 diabetes, according to Ismary De Castro, MD, an endocrinologist affiliated with Memorial Health University Medical Center in Savannah, Georgia.

“Sleep is very important for general health and metabolism because we have changes in our hormones that are influenced by how well and how long we sleep,” explains Dr. De Castro. “Sleep is a time for healing and communication within the brain that the body needs in order to maintain metabolic health. We’re in a ‘go, go, go’ type of society with more and more expectations to be met and a lot of times, we forget about the importance of sleep.”

Metabolic consequences of poor sleep

Inadequate sleep has been linked to overeating and trouble losing excess weight. Adults who sleep less than seven hours per night are more likely to report being obese than those who sleep seven or more hours, according to the Centers for Disease Control and Prevention.

You might assume this association is simply due to the fact that people who stay up late or don’t have a well-established sleep-wake routine are just too tired to be active or to work out. But the sleep-metabolism connection is more complicated than that.

Your circadian rhythms, or “body clock,” govern many biological systems, including appetite and metabolism. These internal clockworks are established mainly by genetics, but external factors, such as exercise, light exposure, meal times and sleep deprivation, can influence them.

In short, going to bed at different times and getting irregular amounts of sleep can have metabolic consequences. A May 2019 study involving 2,003 men and women between the ages of 45 and 84-years old found that inconsistent sleeping patterns are linked to a higher risk for obesity, high cholesterol, high blood pressure, high blood sugar and other metabolic problems. The findings, published in Diabetes Care, suggest that for every hour that bedtimes and sleep durations shift, people’s odds for a metabolic disorder may increase by up to 27 percent.

Sleep loss affects hormone levels

So, how does inconsistent, poor-quality sleep affect your metabolic health? Research suggests that sleep loss affects hormone levels tied to hunger, satiety, stress and even insulin sensitivity. The more sleep deprived you are, the more profound these effects, De Castro points out.

The cascade of metabolic changes that may result from poor sleep include a drop in blood levels of leptin (a “satiety” hormone that triggers feelings of fullness after eating) and a rise in blood levels of ghrelin (a “hunger” hormone that stimulates appetite and helps regulate body weight over time).

Normally, higher ghrelin levels are associated with exercise and calorie restriction, while excess weight is linked with lower levels of this hormone. But when related to sleep deprivation, these changes can trigger cravings for calorie-dense, carbohydrate-rich foods, which can lead to weight gain, De Castro adds.

Poor sleep—or more specifically fewer hours of deep, rapid eye movement (REM) sleep—may also increase levels of the stress hormone cortisol, according to De Castro. As bedtime approaches, cortisol levels typically drop—but research shows that levels remain elevated in those who are sleep deprived. Over time, higher than normal cortisol levels due to poor sleep can lead to insulin resistance, increasing your risk for obesity and type 2 diabetes.

People who are sleep deprived and have changes in their cortisol levels also tend to use another hormone, called Glucagon-like peptide-1 (GLP-1), ineffectively, De Castro points out. Since GLP-1 also promotes satiety and helps control appetite, this disruption can lead to higher caloric intake or overeating in order to feel full, she explains.

Moreover, if you’re routinely skimping on sleep, your levels of human growth hormone (HGH) may drop. In addition to your sleeping habits, the secretion of HGH is influenced by your age, gender, diet, level of physical activity and weight. It works in combination with another hormone, known as Insulin-like Growth Factor-1, to build muscle and burn body fat. Low levels of growth hormone are typically associated with obesity.

“There are so many different things going on at the same time, and these changes can be slightly different from one person to the next,” De Castro says. She notes that your genetics, family history and lifestyle will also dictate how your sleeping habits affect your metabolism and your ability to maintain a healthy weight.

Protecting your metabolic health

Aside from adopting good sleep hygiene habits that help ensure you get consistent, quality shut-eye, exercising regularly is one of the best ways to improve your sleep and protect your metabolic health, according to De Castro.

“I can’t emphasize exercise enough,” she says. “There are so many endorphins and hormones released during physical activity that help improve your mood and so many other aspects of your health.”

Over time, regular exercise promotes better sleep. “Your body will want to go to sleep,” De Castro says. “And with better sleep, you’re more likely to achieve those stages of sleep that are so important to helping you maintain appropriate metabolism.”

Sourcing: CDC, National Sleep Foundation, National Coffee Association, UpToDate, Harvard Medical School, National Institutes of Health, American Diabetes Association, John Hopkins Medicine

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Want to slim down, firm flab and boost your body confidence? Regular workout sessions can help accomplish all of those things. But there are other reasons why exercise deserves a spot on your weekly schedule that have nothing to do with losing weight—and they could boost your quality of life. Learn about more major payoffs from your workouts.

IT MAKES SEX MORE FUN

Research has shown that exercise outside the bedroom can turn up the heat inside. In one study, 300 men self-reported their exercise habits and sex lives; researchers found a positive correlation between those who worked out and their sexual function. Another study found that women who participated in short bouts of vigorous exercise experienced increased blood flow to their genital area, enhancing sexual enjoyment. And if you like to swim, here’s another reason to jump in the pool: In a study of 160 male and female swimmers in their 40s and 60s, Harvard University researchers found that swimming was associated with more frequent, satisfying sex.

YOU MAY LIVE LONGER

According to the Centers for Disease Control and Prevention (CDC), people who are physically active for about seven hours per week have a 40 percent lower risk of premature death than those who clock less than 30 minutes of weekly activity. In fact, just 150 minutes a week of moderately intense cardio, such as brisk walking, or 75 minutes of vigorous cardio, such as running, can help prevent dying early. If you can get closer to 300 minutes of week of moderate exercise or 150 minutes of more strenuous activity, it’s even better. In fact, the more exercise you get, the greater the health benefits. But keep in mind that every minute of exercise counts towards this weekly goal. Even a short walk offers health benefits.

The CDC also reports that regular exercise decreases your risk of many conditions, including heart disease, type 2 diabetes, metabolic syndrome and certain cancers, such as colon and breast cancer. Gardening, taking your dog for a walk and other low-impact activities all count as exercise that will work toward reducing your risk for a slew of chronic health issues. If that’s not reason enough to get moving, we’re not sure what is!

Get motivated to get your daily activity by downloading the Sharecare app, available on both iOS and Android. Sharecare tracks your daily steps, so you can get a sense of how much you move—and you can try to go further each day.

YOU’LL SNOOZE BETTER

It seems that active days can bring restful nights. A 2013 National Sleep Foundation’s (NSF) 2013 poll found that exercisers reported higher sleep satisfaction than their more sedentary peers. Plus, those who don’t exercise are at higher risk for sleep issues such as insomnia and sleep apnea. One surprising finding: the NSF says that “normal” sleepers can work out at any time, even within a few hours of bedtime, unless it interferes with their ability to doze off.

IT CAN KEEP YOUR NOGGIN SHARP

There is some evidence that regular exercise throughout your lifetime is associated with better memory and cognitive skills. In one study led by researchers at the University of Illinois, 120 older adults underwent MRI brain scans. Half of the group then began a program of moderate aerobic exercise, such as walking, for 45 minutes, three days a week. When their brains were rescanned a year later researchers found that the exercisers’ brain volume had increased. Another small study published in the Journal of Clinical and Diagnostic Research found that just one 30-minute bout of moderate exercise could help improve memory, planning and reasoning.

IT MAY HELP YOU STOP SMOKING

An analysis of 20 studies with a total of 5,870 participants suggested that exercise may help people kick the habit for good. While more research is needed, one study showed evidence that people who received smoking cessation information along with an exercise program had higher rates of nonsmoking at a six-month follow-up than did those who only received smoking cessation advice. Research has also suggested that working out with a friend after quitting tobacco can increase the sense of support.

Sourcing: CDC, Electronic Journal of Human Sexuality, American College of Sports Medicine, National Institutes of Health, National Sleep Foundation, American Psychological Association

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Anyone who has tried to slim down can tell you: there’s no simple solution for shedding pounds. But drastic steps, like eliminating whole food groups, aren’t a healthy way to lose weight. They’re also not an effective long-term solution for keeping belly bulge at bay.

“These quick, instant gratification myths sometimes result in modest weight loss in the short term, but they’re not sustainable or effective in the long-term,” says Tammy Baranowski, MS, RDN, a Registered Dietitian with Orange Park Medical Center in Orange Park, Florida.

Meanwhile, these misconceptions, which can be harmful to your health, may fuel dieting frustration. It’s time to separate fact from fiction, debunk some common weight loss myths, and learn some proven ways to lose weight.

MYTH: YOU SHOULD AVOID FAT TO LOSE WEIGHT

Fats have gotten a bad reputation, but you don’t have to eliminate them from your diet to lose weight. In fact, a Harvard meta-analysis of 53 studies, involving more than 68,000 people, compared the effectiveness of various diets and resulting weight loss over the course of a year or more. Researchers found those on a low-fat eating plan weren’t particularly successful in shedding pounds and keeping them off.

What’s more, replacing your favorite foods with low-fat versions could introduce unhealthy additives into your diet. “When they remove the fat, they have to replace it with something else so low-fat products are often filled with a lot of sugar and sodium,” Baranowski explains.

Avoid these unwanted ingredients by opting for healthy fats, including olive oil, salmon, avocado and walnuts. These good-for-you fats can not only help improve heart health, but also help you maintain a healthy weight when eaten in moderation. Remember, don’t overdo it. Foods rich in healthy fats still tend to be higher in calories. Be sure to mind your portion size when slicing an avocado, or sprinkling nuts into your salad.

MYTH: LOW-CARB DIETS ARE BEST FOR WEIGHT LOSS

There’s no shortage of well-known low-carb eating plans on the market, such as the Atkins and South Beach diets.

Many people have a misguided fear of carbs, according to Baranowski. “I think that’s sad,” she says. “Because carbs are so important to our health, and they taste good, too.”

In fact, evidence suggests that whole grains as part of an overall healthy diet, rich in fruits and vegetables, can help you maintain a healthy weight. The fiber content of whole grains helps you feel satisfied with fewer calories. And despite the claims of low-carb diets, there is little evidence to suggest that a diet rich in healthy carbs contributes to weight gain or obesity.

That said, when it comes to carbs, you do need to consider quality as well as quantity. Some carbohydrates are simply better for our bodies than others. High-quality carbs contain more fiber, which helps slow your digestion and, in turn, keeps your blood sugar from spiking. Low-quality carbs, on the other hand, have usually been processed or refined in some way. This may strip away most of that helpful fiber.

Naturally occurring carbs, found in fruits, vegetables, whole grains, legumes and seeds, should be a part of a healthy diet. In fact, dietary guidelines suggest that between 45 and 65 percent of your daily calories should come from carbohydrates. But avoid refined grains like white rice and foods with added sugars, including baked desserts and candy, which are high in calorie but low in nutritional value.

MYTH: ALL CALORIES ARE CREATED EQUAL

Your diet affects your metabolism, so when it comes to shedding extra pounds, the source of your calories matters. Sugar-rich foods, like cakes and cookies, can cause a spike in your blood sugar—a signal to your body that it should hold onto more fat. This isn’t a good thing for those looking to slim down. Instead, fuel your body with lean protein, fresh produce, whole grains and a moderate amount of healthy fats.

Even if foods have the same number of calories, some may be more effective in helping people lose weight than others.

A candy bar and an ounce of raw almonds, for example, contain about the same number of calories. But the nuts, which are loaded with healthy fats, will likely keep you satisfied longer. If you’re feeling full, you’re less likely to graze and consume extra calories throughout the day, which can lead to weight gain.

Rather than making a trip to the vending machine, think ahead and prepare and pack healthy meals and snacks that you can have when hunger strikes in the afternoon.

“Planning ahead and setting yourself up for success is so important,” says Baranowski. “So, take a few minutes every weekend to think about and plan your meals for the week.”

MYTH: GO GLUTEN-FREE TO LOSE WEIGHT

Gluten, a protein found in grains like wheat, barley and rye, has received a lot of attention in recent years. Gluten-free diets were created as a way to manage the symptoms of those with celiac disease—a condition that causes inflammation of the small intestine and can lead to distressing symptoms, including diarrhea, constipation, gas, bloating, abdominal pain, fatigue, and sometimes nausea or vomiting. Those who have gluten sensitivity, which is a delayed adverse reaction to the protein, may have similar symptoms and also benefit from avoiding gluten. Keep in mind however, unlike celiac disease, gluten sensitivity doesn’t damage the intestines.

But gluten-free diets have been adopted by people without these conditions. Why? Some eliminated the protein from their diet because they believe they are intolerant to it, while others swear off gluten in an attempt to lose weight. But research suggests gluten is unlikely the cause of your bulging belly—and there’s no direct link between eliminating gluten and losing weight. In fact, gluten-free products are often high in calories and fat, which could lead to weight gain. Meanwhile, some healthy whole grains contain gluten, and avoiding them could deprive your body of valuable nutrients, like protein.

“I would just say, as a general takeaway, anything that eliminates an entire food group just won’t work,” Baranowski advises. “So, I would avoid eliminating entire food groups, and anything too restrictive; it’s not going to have long-term success.”

MYTH: YOU CAN’T EAT YOUR FAVORITE FOODS

As soon as we commit to a diet, many of us pledge to give up unhealthy foods—even the guilty pleasures we love most. Don’t be so quick to go cold turkey on your favorite takeout order or bakery staple, though.

“Anybody who feels deprived is not going to be successful in managing their weight or leading a healthy lifestyle,” Baranowski points out.

The key to losing weight is consuming fewer calories than you burn. It’s possible to fit well-planned snacks, and even the occasional unhealthy indulgence, into a healthy weight loss plan. The key however, is keeping track of your calories. Research suggests those who log their daily intake, are more successful at losing weight than those who don’t.

Work with your healthcare provider or a dietitian to determine how many calories you should be eating to slim down, and keep a log of the foods and drinks you consume. Food scales are an inexpensive way to measure portions before filling your plate. A handy notepad or even a kitchen napkin would suffice as a food journal.

You can also keep track of your meals with phone applications, like Sharecare, available for iOS and Android. Simply log your food and beverage choices, and the application will keep track of your daily intake. Here’s how it works.

For Android and iOS users:

For desktop users:

Sourcing: Harvard Medical School, American Heart Association, U.S. National Library of Medicine, The Cleveland Clinic, National Institute of Diabetes and Digestive and Kidney Diseases

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Christie Donnelly –

We all know smoking has countless negative effects on our health—from discolored teeth, to heart disease and heart failure, to the development of cancers—but quitting can be extremely difficult. Common misconceptions about quitting smoking, like fear of gaining weight, can make it even tougher.

According to the Centers for Disease Control and Prevention (CDC), the smoking rate among Americans is historically low, at only 15.5 percent (2016), down from almost 21 percent in 2005. If you’re part of that 15.5 percent, it’s prime time to kick the habit. Not sure where to begin? Start by forgetting these common myths about smoking cessation.

MYTH: YOU’LL GAIN SIGNIFICANT WEIGHT

About 80 percent of smokers who quit gain some weight, but the benefits of quitting far outweigh packing on a few pounds. In fact, one study by the National Institutes of Health found that former smokers without diabetes halved their risk of developing heart disease, despite gaining a moderate amount of weight. Plus, quitting improves lung and cardiovascular health, so following a regular exercise routine to stave off post-cessation weight gain may feel easier. Most weight gain occurs within three months of quitting, so that is a critical time to watch calories and eat healthy. Quit aids and medication may also help limit weight gain during this time.

MYTH: QUITTING IS EXPENSIVE

This myth is easy to debunk. Smoking cessation treatments, like patches or counseling, may be available at no or minimal cost. However, the average cost of a pack of cigarettes in 2016 in the United States was $6.43. That’s $2,346.95 per year for a pack-a-day smoker. Plus, smoking-related illnesses and loss of productivity chalk up an additional $316 billion in US spending each year. Many insurance companies offer incentives and discounts for smoking cessation, so check with your provider. You can also try using your state or sponsored telephone quitline or online services, dedicated to helping participants quit smoking. Many quit smoking aids are covered by insurance plans.

MYTH: YOU’RE ONLY HARMING YOURSELF

Your smoking habit doesn’t only affect your health; nonsmokers can be exposed to over 7,000 chemicals found in secondhand smoke. In fact, according to the CDC, secondhand smoke causes 41,000 deaths among nonsmoking adults and 400 infant deaths every year in the US; increases the risk of stroke and lung cancer by 20 to 30 percent; and increases the risk of asthma, respiratory and ear infections and even Sudden Infant Death Syndrome (SIDS) in children.

MYTH: THERE ARE SAFE ALTERNATIVES

If you’ve swapped cigarettes for cigars, snuff or chewing tobacco you’re still exposing yourself—and those around you—to toxic substances. Not only are they highly addictive tobacco products, but they’ve been linked to many cancers. Smokeless tobacco can cause cancers of the mouth, pharynx, larynx, esophagus and pancreas. It can also cause gum disease and tooth decay and can increase the risk of deadly heart attacks and strokes. Cigars can cause damage similar to cigarettes, including COPD. The bottom line? There’s no risk-free level of tobacco use.

MYTH: YOU’LL LOSE YOUR SOCIAL CIRCLE

Smoking is often considered a social activity, but quitting doesn’t mean you’ll lose your friends—especially if you take the time to explain why quitting is so important to you. You will likely find that your friends want to help you succeed. Tell them specifically how they can support you. You may simply ask smoking friends to avoid lighting up in your presence or ask them to join you in nonsmoking activities. You can request that they be available when you are struggling with cravings. Who knows—you may even inspire some fellow smokers to quit themselves.

MYTH: YOU CAN’T DO IT

It’s true that it can take several attempts to quit smoking, but don’t feel discouraged if you have a slip-up. Rather, take the time to assess the situation: What made you crave a cigarette? How can you overcome cravings in the future? Try to take control of those stressful situations, so you can finally kick the habit and addiction.

You can join the 59 percent of adult former smokers who have been able to quit!

Sourcing: National Institutes of Health, American Cancer Society, CDC

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