What is deep sleep?

In order to understand deep sleep, you must first acknowledge the phases of the sleep cycle, as well as the stages of sleep. According to Sleepless in NOLA sleep consultant Nilong Vyas, MD, medical review expert at Sleep Foundation, the sleep cycle consists of two phases: REM (rapid eye movement) and NREM (non-rapid eye movement). “The NREM phase is further divided into three stages of sleep,” she explains. The three sleep stages are N1 (light sleep), N2 (medium sleep), and N3 (deep sleep). “The human body cycles through four to five stages of sleep every 90 minutes overnight,” Dr. Vyas says. “N1 is the lightest sleep, N2 is deeper and plays the most significant role in memory consolidation, and N3 is the deepest of the NREM phase.”

Why is deep sleep so important?

While every stage of sleep plays a role in overall health and wellness, deep sleep is the most important because it’s responsible for strengthening the immune system, repairing tissue, and releasing growth hormone. All in all, it’s when the body heals itself, Dr. Vyas says.

So perhaps you’ve been feeling under the weather and can’t seem to muster up any energy—deep sleep will help; maybe you had a super long day that started with a killer workout and felt absolutely wiped by the end of it—deep sleep will help; perhaps you’re navigating a breakup or other stressful life event—deep sleep will help.

But here’s the thing: It doesn’t only have an immediate impact on a person’s well-being—it’s cumulative, meaning that it can offer benefits that last a lifetime, or at the very least, extend your lifetime.

“During deep sleep, the brain’s ‘waste management system’ comes in and removes certain proteins that if not removed are thought to lead to Alzheimer’s and cognitive decline,” says sleep expert and clinical psychologist Michael Breus, PhD, aka The Sleep Doctor.

Which is better: REM or deep sleep?

While REM sleep is a different phase of the sleep cycle, it’s considered the fourth and final stage of it. Since rapid eye movement is tied to dreaming, many people mistakenly assume that it must be a very deep form of sleep in which the subconscious has the uninterrupted ability to soar. In reality, Dr. Vyas says that REM sleep is actually considered to be less restful.

That doesn’t mean that REM sleep isn’t important, though. “REM and deep sleep are completely different and both necessary for different reasons,” Dr. Breus says. “As an example, during REM sleep is when you move information from your short term memory to your long term memory, and when you process emotions; deep sleep is needed for more physical areas.” Though, it plays a role in long term memory, too.

How much deep sleep do you need each night?

TL;DR: It depends. How much sleep you need depends on your age, gender, medical condition, fitness level, and environment, Dr. Breus says. “As a general guideline, we recommend seven to nine hours of good quality sleep, but this can vary widely,” he adds. (Not sure where you stand? Check out our story on sleep calculators.)

If you’re over the age of 65, Abhinav Singh, MD, FAASM, medical director of the Indiana Sleep Center and a medical review expert at Sleep Foundation, says that seven to eight hours will typically suffice.

No matter your age, if we’re breaking it down by stage, Dr. Singh says that 20 to 25 percent of your total sleep should be deep sleep, while another 20 to 25 percent should be REM.

What happens if you don’t get enough deep sleep?

Considering the vital role it plays in our overall well-being, Dr. Breus reveals that not getting enough deep sleep is what’s officially considered sleep deprivation. “Sleep deprivation affects every organ system and every disease state—literally everything you do, you do better with a good night’s sleep,” he says.

More specifically, Dr. Breus points out that a lack of deep sleep can lend to a notable physical and cognitive decline, including slower reaction time, lower testosterone, memory issues, riskier decisions, trouble focusing, and more. And then there’s the emotional impact of sleep deprivation. When you don’t get enough of it, you’ll become more anxious and could experience deeper depression. Together, all of these side effects make one thing very clear: Deep sleep should be your priority—each and every night.

When does deep sleep take place?

While a full sleep cycle is roughly 90 minutes long and is comprised of all four sleep stages (N1, N2, deep sleep, and REM sleep), the amount of time you spend in each stage changes throughout the night. According to The Sleep Foundation, you typically get the most deep sleep during the first half of the night. Then, by the later sleep cycles, you spend less time in the N1, N2, and N3 stages, and more time in REM sleep.

What happens if you wake up during deep sleep?

Since the N3 stage is the deepest sleep stage, it makes sense that it’s the hardest to snap out of. According to Dr. Breus, the deep sleep stage is the hardest to awaken from. If someone does wake up during this stage, he says it’s not uncommon to feel especially groggy. “This experience is what’s known as sleep inertia,” he reveals on his website. He compares it to Isaac Newton’s Law of Inertia and points out that unless a pressing force is at play to entice someone to wake up, it’s totally normal to wish you were still asleep—or even fall back asleep in the process. This is a sign that you’re within a deep sleep stage and need it to feel rested.

If you continually wake up each morning wishing you could just sleep a little longer, however, it might be time to re-evaluate your sleep hygiene and routine, as certain habits can make falling and staying asleep much easier. For example, eating a snack comprised of foods that help sleep, taking OTC sleep aids (like the Olly Sleep Gummies, $13), wearing breathable cotton PJs (like the Printfresh Bagheera Sleep Shirt, $118), sleeping on soft, moisture-wicking sheets (like the Purple SoftStretch Sheet Set, $189), and waking up with a sunrise alarm clock (like the Hatch Restore 2, $200) can all make a big difference in the quality of your sleep.

If after adjusting your sleep routine you still find that falling and staying asleep is a challenge, or that you’re experiencing poor sleep quality overall, you may want to consult a doctor to discuss the possibility of prescription sleeping pills and best next steps overall.

With all of this news, you may be worrying about your own brain health, or that of your loved ones. After all, given over six million Americans have Alzheimer’s, it’s more common than any of us would like to imagine.

I mean, struggling to remember words and details can be scary. When is it normal for your age versus a sign of Alzheimer’s? Knowing where the line is between the two is tricky, and it’s a question no one wants to ask themselves.

Only an expert like a neurologist or geriatrician can make a diagnosis, but there are red flags that might signal that it’s time to book an appointment for some testing. To help you know what you’re working with, a neurologist shares how some early signs of the disease differ from the normal effects of aging.

1. Forgetting recently learned information

Forgetting about an appointment or what a person’s name is—and being able to recall it later—is a typical change you’ll see in older folks, according to Anjali N. Patel, DO, a memory and cognitive neurologist of the Atlantic Neuroscience Institute and Overlook Medical Center. An early sign of Alzheimer’s, on the other hand, is “forgetting recently learned information [or] repeating the same question,” she explains. In fact, according to the Alzheimer’s Association, that’s the most common sign in the early stages.

Dr. Patel gives an example. “If someone has a doctor’s appointment coming up, they may ask multiple times regarding the date and time of the appointment,” she says. “The person may repeat the question right away, after a few minutes, or the following day. This can vary.”

2. Feeling confused, suspicious, anxious/fearful, or depressed

Some emotional ups and downs are normal for all of us. Particularly once our days start to follow a predictable pattern, we “can become irritated when the routine is changed or disrupted,” Dr. Patel says. That’s typical with age (and is pretty understandable across the board!).

However, if you notice someone lose control over how they express their emotions, overreact, or have rapid mood changes due to not understanding a situation, it’s more likely an early sign of Alzheimer’s, she continues. One example of a confusing event is traveling to a new location, which can lead to intense reactions in an Alzheimer’s patient.

3. Consistently making poor judgments

Many of us have made mistakes here and there by falling for spam or struggling with a budget. But a red flag is if it’s consistent. Dr. Patel says, “Individuals might miss a payment once, make a mistake once in a while,” and that’s typical. It could signal Alzheimer’s, though, if “patients cannot manage a budget [or have] poor judgment, [such as] giving away personal information to strangers.”

4. Hiding items and/or accusing others of stealing items they can’t find

Being unable to find something—whether it’s the remote or a nice pair of earrings—can be stressful and confusing. Even the most organized people probably know the struggle. According to Dr. Patel, it’s a-okay if the person is able to retrace their steps to find the item.

But when “patients place objects in unusual places, cannot find the object again, and may accuse others of taking items,” she says, it’s possibly an early sign of Alzheimer’s. She explains how this happens, saying patients often lose or misplace items, assume someone must be taking their things, then hide those items in unexpected places for “safekeeping.”

5. Struggling to keep up in conversation

Having trouble thinking of the right word (and it eventually coming to mind) is a typical age-related change people may experience, Dr. Patel says. However, when patients have trouble following a conversation, consistently call things by the wrong name, or regularly lose their train of thought, you might be seeing early signs of Alzheimer’s.

6. Noticing a significantly decreased understanding of visual images

As we age, our vision may change due to cataracts. Buying a new pair of glasses can be a normal item on the to-do list. However, Alzheimer’s may be a concern if safety issues are popping up, like “having difficulty judging distance, leading to car accidents, [or] episodes of getting lost,” she says.

7. Losing track of time and events

If your loved one isn’t sure about the exact date or day of the week, there’s no need to be concerned, according to Dr. Patel. She warns more about patients “having difficulty understanding when events took place [and] losing track of the month/year/season” since that could be a potential sign of Alzheimer’s.

This could look several different ways. “They may forget recent events, such as visiting family or going on a trip,” she adds. “The person may recall events from the past in greater detail, and may believe those prior events took place more recently.”

What to do next

If you think you or a loved one might be exhibiting possible early signs of Alzheimer’s, book an appointment with a neurologist. They will be able to use imaging, cognitive or blood tests, and other neurological exams and assessments to figure out if that’s what’s going on.

And if it is, know that all hope is not lost. An Alzheimer’s medication was approved by the FDA in 2021, and prevention research is underway, from AI technology to a study about the benefits of folate to predictive blood tests. You aren’t alone in this.

Below, we’ll cover the basics of fortifying your gut while you’re on antibiotics. Plus: what you can do to promote gut restoration even further in the weeks and months thereafter.

How to protect your gut while you’re on antibiotics

Prioritize probiotics

Since antibiotics wipe out both good and bad gut bacteria, it’s common to experience digestive distress as you take them. “Studies show that taking a probiotic supplement can prevent upset stomach and diarrhea caused by antibiotic use,” says Bianca Tamburello, RDN, a dietitian on behalf of FRESH Communications. However, she and Greenfield both advise taking your antibiotic and probiotic at least a few hours apart so the latter has a better chance to survive.

Prioritizing foods with probiotics also get the green light. “While taking an antibiotic, eating probiotic-rich fermented foods like kraut, kimchi, and yogurt can help preserve gut health,” Tamburello says.

…And prebiotics

While you’re at it, Greenfield also suggests consuming prebiotics, which feed friendly bacteria. “If you take probiotics and prebiotics while you take antibiotics, you can prevent some of the damage being done by the antibiotic, which can help with gut recovery time,” Greenfield explains. Fortunately, there are plenty of healthy prebiotic foods to choose from—including but not limited to garlic, onions, and asparagus.

Be careful with high-fiber foods

It’s important to not only add things into your routine as you take antibiotics—but also consume a few others on moderation. For instance, while fiber is beneficial for your digestion and gut health at large, you’ll be better off saving fiber-rich foods for once you complete your Rx. “It’s recommended to avoid high-fiber foods while taking antibiotics because fiber may interfere with how quickly the antibiotic is absorbed,” Tamburello says. (This may be a bit confusing as many—though not all—fibrous foods are also prebiotic. Some high-fiber foods worth saving for your post-antibiotic regimen include beans and legumes.)

Make sure to chill out

Last but not least, lifestyle factors will also play a role in your recovery. “Decreasing stress and prioritizing rest while you are on antibiotics will help your gut be more resilient,” Greenfield adds.

Decreasing stress and prioritizing rest while you are on antibiotics will help your gut be more resilient,” Greenfield adds.

Tips to restore your gut after antibiotics

Once you finish your round of antibiotics, the standard tips and tricks for gut health apply. “After an antibiotic regimen is complete, eat foods high in probiotics, prebiotics, and fiber to restore the number and diversity of good gut bacteria and feed a healthy gut,” Tamburello says. “Probiotics increase the number of gut bacteria and promote gut balance,” while the last two “are especially beneficial when rebounding your gut health after a course of antibiotics.”

In fact, a 2019 study found that low-fiber diets exacerbated microbiota collapse and delayed recovery following antibiotic treatment, so be sure to rev up your fiber intake via veggies and pantry staples alike. “Most high-fiber foods have prebiotic benefits,” Tamburello reiterates, so they’ll typically offer two-for-one perks.

Further, Greenfield recommends eating a colorful diet rich in whole foods to promote the health of your microbiome. “Sunlight exposure helps balance circadian rhythm, which helps improve gut function,” she adds. “Since vitamin D can decrease gut permeability, adequate levels of vitamin D are important—ideally through sun exposure or supplementation.”

How long will it take to restore your gut after antibiotics?

Greenfield says that the answer to this question isn’t so simple to answer, as the research isn’t so clear-cut. Results will also vary based on which antibiotics you take, the specific bacteria strains measured, and similar considerations. That said, recent studies and reviews offer optimistic findings. Per a 2020 meta-analysis of 31 articles on gut microbiota and antibiotic use, “After cessation of treatment, gut bacteria recover, in most individuals, to their baseline state within a few weeks. Some studies suggested longer term effects from two to six months.”

“After cessation of treatment, gut bacteria recover, in most individuals, to their baseline state within a few weeks. Some studies suggested longer term effects from two to six months.”

In general, Greenfield says that the state of your gut and overall health before taking antibiotics will be highly influential in how quickly you’re able to restore your microbiome afterwards. “If you already had good gut diversity, the chances are the first round of antibiotics are not going to eradicate whole species of bacteria,” says Greenfield. “But if you already had weakened gut function, or have taken many rounds of antibiotics, the effects can be more damaging.”

Plus, additional factors that influence gut diversity—i.e., everything from your regular dietary and lifestyle habits, pre-existing conditions, medications, and stress levels—will inform your timeline for microbiome restoration.

To gain clarity and ensure that your gut health is trending in the right direction, Greenfield recommends getting a stool test done with a functional health expert. “I like to wait 14 days after taking antibiotics to test microbiome diversity. This gives us enough time to see what the bacteria look like after the antibiotic has been taken,” she says. From there, personalized protocols can lead the way and promote a greater abundance of the friendly bacteria your gut and greater health need to thrive.

So much of that is missing from adult working life. We get up, go to work, fit in some exercise, scrounge up dinner. But maybe, for that time we’re devoting to fitness, if we approach it like a form of adult summer camp, we can bring some of that exploration, socializing, and joy to our lives.

That was one of the guiding impulses behind the creation of Tampa and Los Angeles-based community fitness space CAMP, says CAMP co-founder and yoga teacher Jamie Lanza. She wanted to create a place where adults could connect with each other while exploring different forms of movement in an intentionally playful environment.

“My business partner and I both grew up in summer camps to varying degrees,” Lanza says. “It was like liberation. It was like freedom. It was like walking into a space where you’re like, I’m gonna be whatever I wanna be, and there’s all these activities for people like us who like to do all the things.”

“I’m gonna be whatever I wanna be, and there’s all these activities for people like us who like to do all the things.” CAMP co-founder Jamie Lanza

While the original location is in Tampa, Florida, I got to explore the newly expanded CAMP Los Angeles in Santa Monica. The space feels like more of a campus than a gym. There are five fitness studios that all face inward toward a large central courtyard and lounging space. Each studio serves a different modality, one each for yoga, a HIIT circuit, a cardio-strength stations class, sculpt, and Pilates.

“The campus itself is a big part of our ethos,” Lanza says. “There is this crossing paths and you’re getting to see a little bit of everything all the time and decide what else you want to be a part of in the campus space. A big part of it is we have outdoor lobbies, we have places to hang out and enjoy space together, rather than getting out as fast as possible.”

To make the space even more inviting, Lanza and team painted the buildings bright colors, with playful signage and paraphernalia like tire swings on the property. Driving down busy Lincoln Boulevard, CAMP stands out and definitely caught my eye and curiosity for months before I actually made it in.

Equally important to the environment is the variety. Getting to tap into what you’re feeling for the day and select what excites you—whether that’s a bootcamp or breath work—is all part of the summer camp spirit, says Lanza. A campus has allowed CAMP to bring the open-minded exploratory ethos of intuitive movement to the fitness studio. Incidentally, reigniting a sense of play and connecting with movement in the way you did when you were a child is one of the guiding ideas behind intuitive movement.

A community environment is what undergirds it all. CAMP hosts pop-up markets and food trucks in the courtyard, and classes encourage you to meet your fellow students, and include things like group sprints to build team spirit. It seems to be working—I ran into a friend who had only been going for about a month, and teachers and fellow students were greeting him right and left.

“There’s this feeling in LA that everybody kind of keeps to themselves or it’s a little bit cliquey or like you only speak when spoken to,” Lanza says. “Here we lean in, we lean in hard so that people feel like, come on, let’s go do this together. Let’s drop whatever title we walk in here with and let’s be human beings and get together like summer camp when we were kids.”

While not everyone has access to a studio like CAMP, reframing fitness as a way to physically go somewhere that’s inviting and fun, tap into how you want to move, explore your own interests, and make friends at the same time, might help bring a spark of joy to your routine. So try something new, reach out to a fellow camper, and consider pursuing a summer of movement like you did when you were a kid.

While there are many types of antioxidants, which Mary Purdy, MS, RD, nutrition and sustainability advisor at Big Bold Health, calls a family of protective plant chemicals, an important group to know is carotenoids.

The Linus Pauling Institute at Oregon State University describes carotenoids as a group of more than 750 naturally occurring pigments (in red, yellow, and orange) that can be synthesized by plants and algae. Fruits and vegetables contribute the most carotenoids to human diets and one of the key players in offering us some serious antioxidant power.

Health benefits of zeaxanthin

Purdy says that one of the most important things to know about zeaxanthin is that, like other members of the carotenoid family, it gets converted to vitamin A in our bodies. While we often associate vitamin A with eye health—Purdy says research shows that carotenoids’ antioxidant properties can protect against visual fatigue, macular degeneration, and cataracts—it serves many other important purposes throughout the body. “Vitamin A is also essential for supporting immunity and preserving the integrity of our gut lining,” she says.

Research shows that carotenoids can help our bodies fight infections, in addition to improving gene regulation and angiogenesis—a process that helps us best deliver oxygen and nutrients to various tissues to promote healing and prevent illnesses of all kinds. A comprehensive review of research conducted in 2021 found that zeaxanthin also appears to help protect against neurological disorders due to its ability to fight off inflammation and oxidative stress, which can play a role in protecting against all sorts of other inflammatory conditions, from allergies to chronic health issues. More specifically, zeaxanthin has been found to protect against different types of cancer and osteoporosis, as well as other bone-related issues to keep us healthy and strong for years to come.

More specifically, zeaxanthin has been found to protect against different types of cancer and osteoporosis, as well as other bone-related issues to keep us healthy and strong for years to come.

Best food sources of zeaxanthin

All these impressive health benefits likely have you wondering what the best sources of the antioxidant zeaxanthin are. According to Purdy, zeaxanthin is found in several types of vegetables such as orange and red peppers, yellow corn, cooked scallions, and can also be found in certain fruits like mangos. Additionally, you can find it in eggs and algae like the ever-popular spirulina and chlorella.

Zeaxanthin is found in several types of vegetables such as orange and red peppers, yellow corn, cooked scallions, and can also be found in certain fruits like mangos. Additionally, you can find zeaxanthin in eggs and algae.

“Using chemicals to grow food may reduce carotenoid content, so purchasing ‘Certified Organic’ can be a good bet,” says Purdy.

While Purdy hasn’t seen an exact recommendation for zeaxanthin consumption as an isolated compound, she notes that most research related to the nutrient indicates that the highest benefits are found when it is consumed alongside other carotenoids, micronutrients, protein, and healthy fats. Purdy highlights that dietary fats are especially important for proper zeaxanthin absorption, as it a diverse diet filled with fiber, omega-3 fats, and other delicious foods that help support a healthy gut—which will help your body absorb the nutrient.

Purdy highlights that dietary fats are especially important for proper zeaxanthin absorption, as it a diverse diet filled with fiber, omega-3 fats, and other delicious foods that help support a healthy gut—which will help your body absorb the nutrient.

Interestingly, Purdy explains that the absorption of carotenoids can be impacted by temperature—both positively and negatively. She says that high-temperature processing methods could decrease zeaxanthin concentration in raw foods but could improve its bioavailability in others, so it’s a safe bet to stick with moderately heated food sources.

Some simple ways to up your zeaxanthin intake is by starting your morning with scrambled eggs cooked low and slow to perfection—bonus points if you also serve it with some sauteed peppers cooked in olive oil for a healthy fat pairing. You could also get double the antioxidant power by whipping up a batch of mango-corn salsa with avocado for a tasty and nutritious appetizer. You can always add a serving of chlorella or spirulina to your morning smoothie to give it a vibrant color and help you feel more vibrant, too.

As a reminder, dermatologists recommend wearing sunscreen each and every day of the year, regardless of cloud cover or temperature, to best protect skin and prevent sun damage. What’s more, as a blanket rule, they suggest using sunscreens with SPF 30 or higher and applying at least two fingers worth to your face (and a shot glass worth all over your body) for optimal protection.

But the question is: What sunscreen should you use if you have reactive skin? And while on the topic, are those with sensitive complexions the only ones susceptible to an allergic reaction to sunscreen? To answer these questions and more, we chatted with three board-certified dermatologists about everything there is to know about sunscreen rashes and how to avoid them. Keep reading to learn more.

What causes a sunscreen rash?

Sunscreen rashes are a form of contact allergy. According to NYC board-certified dermatologist Hadley King, MD-FAAD, two things can cause sunscreen-related breakouts: occlusion of the pores by comedogenic materials or a sensitivity reaction to chemical UV-blocking ingredients. “And keep in mind that breakouts can come from any of the ingredients in the product, not only from the active sunscreen ingredients,” she says. “Breakouts can commonly be caused by other emollients, fragrances, preservatives, or other ingredients.” Because of this, she says that the best way to avoid developing a breakout or rash from sunscreen is to look for formulas labeled as non-comedogenic. Generally speaking, she says that zinc oxide and titanium dioxide (both of which are mineral sunscreens) are both non-comedogenic.

The trouble with sunscreen rashes is that they don’t always present immediately, which can make it difficult to identify the true complexion culprit. “It’s a delayed skin reaction that typically develops 12 to 72 hours after exposure,” King says.

On this episode of The Well+Good Podcast, Adeline Kikam, DO, FAAD, a board-certified dermatologist based in Texas, gets real about the gaps in diverse skin care, SPF education, and why wearing sunscreen on *all* skin tones is so important.

What does a sunscreen rash look like?

Sunscreen rashes can take on a couple of forms. On one hand, they can appear as tiny white pustule breakouts as a result of pore-clogging ingredients in the SPF; on the other, they can look like traditional inflamed rashes. (FYI: If you develop full-on sun blisters, the sun itself is more likely to be the cause than your SPF.)

“Most of the time [true sunscreen rashes] will appear as a pink to red rash composed of small bumps coalescing into larger bumps,” says Schweiger Dermatology Group board-certified dermatologist Nava Greenfield, MD.

Most importantly, sunscreen rashes will only appear when sunscreen was actually applied. So if you only applied SPF on your body but your face is breaking out, the sunscreen isn’t to blame.

“As with most types of contact dermatitis, an allergy from sunscreen should have a sharp line of demarcation,” says board-certified dermatologist Dustin Portela, DO, FAAD. “This means it is often very clear where you applied it and where you missed applying it by the abrupt geographic pattern of the rash.”

What should you do if you get a rash from sunscreen?

If you determine that the breakout or rash you’re experiencing is from the sunscreen you used, stop using it immediately.

Before tossing the rash-causing formula, though, Portela suggests scouring the label. “It is important to check the label and determine what kind of sunscreen you are using,” he says. “Although sunscreens are safe, there are a small percentage of people who may have an allergic reaction to some of the ingredients.”

In general, he says that chemical sunscreens tend to be more triggering than physical ones. “The active ingredients in a chemical sunscreen are often things like octinoxate, homosalate, octocrylene, oxybenzone, and avobenzone,” he says. “If you are using a chemical sunscreen and develop a rash, I recommend switching to a physical sunscreen with active ingredients like zinc oxide and titanium dioxide.” These physical (and reef-friendly!) ingredients tend to be gentler, which is why they’re often found in baby sunscreens.

While sunscreen rashes are most often linked to the UV-protecting ingredients, King says that an adverse reaction to SPF can also occur if the product is expired. “If the sunscreen has expired or the ingredients have been exposed to direct sunlight and high temperatures, then the heat and sun can break down the chemicals and render them ineffective and potentially irritating to the skin,” she says. That’s why most sunscreen bottles and tubes explicitly say to keep them out of direct sunlight and stored in a cool, dry place.

How long does it take for a sunscreen rash to go away?

Sunscreen rashes can disappear within days to a couple of weeks. To offer your inflamed skin some relief in the interim, King says to wash your face and/or body and follow up with an emollient to help support the skin barrier. If your skin is particularly itchy, she says to reach for OTC hydrocortisone. (While you may feel inclined to try Benadryl to alleviate your symptoms, Portela says it won’t do much to address the underlying cause of the rash, though it could make falling asleep with an itchy skin concern a bit easier.)

If after two weeks you’re still experiencing redness and/or itchiness in areas where you had applied sunscreen, consult your doctor for best next steps.

How to avoid developing a rash from sunscreen

If you have particularly reactive skin, you may want to skip out on one category of SPF overall. As we mentioned above, chemical sunscreens tend to be more triggering than physical UV blockers. Here’s why: “Chemical sunscreen ingredients are absorbed into the skin while mineral physical blockers sit on top of the skin,” King says. “I think this is one reason the chemical ingredients are more likely to cause reactions.”

Of the various chemical sunscreen ingredients on the market, King says that oxybenzone is one of the most problematic. “It has been linked to irritation, sensitization, and allergies,” she reveals. (This is why many chemical sunscreens, like the Shiseido Clear Sunscreen Stick SPF 50+ ($30), specifically market themselves as “oxybenzone-free.”)

Specific chemical ingredients aside, Greenfield says that chemical SPF ingredients in general are typically paired with more preservatives to make the overall formula more stable. The downside is that these preservatives can cause adverse skin reactions, which can show up in the form of a rash from sunscreen.

Because of this, you may want to only opt for mineral sunscreens. However, according to Portela, that’s really not necessary—unless you can unequivocally determine that the chemical ingredients are the issue. It’s very possible that your skin simply doesn’t jive with the other ingredients in the overall formula. As such, your best bet is to look for top-rated SPFs and to always perform a swatch test on a small area of skin before applying the product to your face or all over your body.

The good news is that there are so many dermatologist-approved sunscreen formulas to choose from for face and body. You’ll even find SPF in makeup and skin-care products.

How long does sunscreen last, you might ask? The answer depends on the intent of your question. After all, sunscreen has an expiration date but it also has a set protection period, which is why dermatologists are so adamant about telling their patients—and anyone else who will listen—the importance of SPF reapplication.

All this to say, if you’ve been religiously applying sunscreen but still experience the tingling, tightness, and redness of over-exposure to harmful UV rays, it’s high time you learn the reality of some of your most burning questions surrounding SPF. How long does sunscreen last once applied? How long is sunscreen good for? And can you use expired sunscreen? Uncover the answers to all these questions and more, below.

How long does sunscreen last on skin?

The longevity of your SPF will depend on the specific product you’re using. That said, according to the American Academy of Dermatology (AAD), you should reapply sunscreen every two hours while spending time in direct sunlight for optimal protection. And that goes for all SPF levels, too. While experts at the AAD (and dermatologists in general) recommend using SPF 30 or higher for solid sun protection, whether you use SPF 30, SPF 15, or SPF 50, reapplying is key to keeping your skin safe. That’s because sun exposure breaks down the ingredients in the formula, so once it hits that two-hour mark, it won’t continue delivering optimal protection.

Even though the UV protection of sunscreen only lasts for a few hours on the surface of the skin, the product itself sinks into pores and can irritate your complexion if left on overnight. So if you’ve been pondering whether or not it’s okay to sleep with sunscreen on, do yourself a favor and treat it like makeup—wash it off already!

Does sunscreen expire?

Like all skin-care products, sunscreen does have an expiration date. According to board-certified dermatologist Christina Lee Chung, MD, FAAD, at Schweiger Dermatology Group in Philadelphia, PA, sunscreen typically goes bad in three years.

“So if you purchase a sunscreen and notice there isn’t an expiration date, the best practice is to mark the date of purchase [or when you first peel the seal off] and toss it before you reach the three-year mark—which hopefully you don’t reach before using it all,” she says.

If you’re someone who likes to stretch the rules a bit and use products beyond their marked expiration dates, Chung suggests always keeping the rule of three in mind. “If you purchase a sunscreen and the expiration date is at the two-year mark, chances are you’re good for another year after that,” she says.

Which sunscreens break down the fastest?

While sunscreens have a general lifespan of three years, they break down differently based on the formula. “Chemical sunscreens disintegrate faster due to their relatively unstable active ingredients, such as octinoxate and avobenzone,” says board-certified dermatologist Michelle Henry, MD, FAAD.

Research also shows that oxybenzone (another popular chemical sunscreen ingredient) oxidizes particularly quickly, rendering it less effective over time. So, not only is it incredibly important to reapply every two hours like clockwork, it’s also important to not accidentally leave in your car on a hot summer day, Chung says, as heat and sun exposure will degrade its ingredients.

Physical sunscreens (aka ocean-friendly sunscreens), like zinc oxide and titanium dioxide, on the other hand, don’t break down. “Rather the formulation that stabilizes the product and allows it to disperse evenly degrades which indirectly affects their sun protective properties,” Dr. Chung says.

Can sunscreen go bad before the expiration date?

It’s possible for sunscreen to lose its effectiveness before the expiration date. Like food and other sensitive skin-care products, sunscreen fares best “when stored properly—in cool, room-temperature environments, away from heat exposure,” Dr. Henry says.

Can you use expired sunscreen?

Can you? Yes. Should you? It’s not advisable. “There comes a time when the product changes and, if used, may have unintended negative effects,” Dr. Chung says. There are a few reasons for this. For starters, expired ingredients can trigger allergic and irritant reactions. This can show up in the form of general inflammation, rashes, or full-blown breakouts from the degraded ingredients, Dr. Henry says.

Another reason you could have an adverse reaction to expired sunscreen? It could have mold, which means your face would be covered in bacteria if you were to apply it. “Sunscreens contain preservatives to keep them sterile,” Dr. Chung says. “These preservatives will diminish over time, increasing the risk of bacterial overgrowth, which can lead to acne breakouts if applied to the skin.”

When sunscreen goes bad, the ingredients aren’t the only things affected—the very texture and consistency of the product can be, too. According to Chung, mineral sunscreens, in particular, get grittier with age. Because of this, they can be more difficult to apply, which can result in uneven coverage. “And no one wants to come back from having fun in the sun looking like a Jackson Pollock painting,” she says.

The biggest risk of all, though, is that once expired, your sunscreen may lose its very purpose. “The challenge with expired sunscreen, while it likely still retains some measure of sun protective capability, no one can know how much,” Dr. Chung says. “So you could get a good hour or two of protection or you could be applying a product with a SPF equivalent of plain moisturizer—zero. And without a general sense, the risk of excess sun exposure increases significantly.”

How to tell if sunscreen has expired

Not sure if your SPF is expired? A good way to tell is by examining its color, texture, and scent. “Expired sunscreens can become grainy or clumpy in texture and display a distinct change in smell or scent if contaminated with bacteria,” Henry says.

Another way to determine if your SPF has lost its luster? Consider the state of your skin after you use it. “With expired sunscreens, our skin becomes instantly vulnerable to UV ray damage,” Henry says. “With reduced SPF efficacy, we can experience sudden sunburn from the lack of essential UV ray protection.”

The takeaway

To avoid any unnecessary skin irritation, Henry says that it’s best to keep tabs on your sunscreen’s expiration date and to toss even your most beloved SPF if that date arrives.

If the idea of throwing out your favorite sunscreen is cringe-worthy, may we introduce you to the AAD’s recommended sunscreen dosage guideline? For optimal UV protection, dermatologists suggest using an ounce (aka a shot glass’s worth) of sunscreen to adequately cover bare skin from head to toe (more specifically, derms recommend two finger-lengths worth of SPF for your face). If done daily (or even just during summer), you should easily hit empty before the three year-mark is up.

If you do have to toss your SPF, though, don’t take that as a sign that it’s a wasteful investment. Instead, treat yourself to a formula you’ll be happy to apply again and again. For me, nothing compares to the Tatcha Silken Pore Perfecting Sunscreen ($70)—it goes on so smoothly, never irritates my sensitive skin, and wears well under makeup. For my body, I keep my beach/lake/pool bag (I’m no gatekeeper! The A New Day Seasonal Tote Bag, $30, is my current obsession, so much so that I bought it in two colors.) stocked with Supergoop! PLAY Everyday Lotion SPF 50 with Sunflower Extract ($34), PLAY Antioxidant Body Mist SPF 50 with Vitamin C ($21), and Unseen Sunscreen Body SPF 40 ($42)—which is one of Well + Good’s top-rated sunscreens—are my current go-tos.

While money has helped realign these incentives in the U.S.—intended parents can legally pay donors for their frozen eggs—cash compensation for DNA that could spawn a new human is an ethically questionable practice (hence its illegality in much of Europe). The financial incentive could exploit lower-income folks in difficult situations by convincing them to do something they’re otherwise not comfortable with; and variations in pricing for eggs from different donors implies that some eggs (and by proxy, some people) are more valuable than others.

And yet, it feels unrealistic and unfair to expect young people to go through a time-intensive, sometimes painful medical process and share their eggs out of sheer generosity, even if would-be parents covered their costs of doing so. But what if they could hold onto a few frozen ones themselves, free of charge, as a perk of donating the rest?

That’s the premise behind egg sharing, a hybrid model of egg freezing and egg donation that lies at the heart of new fertility platform Cofertility. Users who join Cofertility’s “Split” program can freeze their eggs and store them for free for up to 10 years, so long as they donate half to intended parents with whom they’re matched (who front the bill for all medical expenses associated with freezing plus the storage).

This kind of arrangement has gained traction in the United Kingdom, where it’s the legal alternative to buying eggs, but has, until now, only cropped up in a few fertility clinics stateside, including CNY Fertility, Oma Fertility, and Freeze and Share. Cofertility—which launched in October 2022 and officially began conducting egg sharing earlier this year—coordinates matches and facilitates the logistics with clinics nationwide.

How the Cofertility Split program solves for pain points in egg freezing and egg donation

By creating an incentive structure where saving some of your eggs for yourself is the “return” for donating eggs, Cofertility’s Split program aims to lower the financial burden of egg freezing and eliminate some of the ethical murkiness of cash-compensated egg donation. Together—as the “co” in the name implies—these changes may help more people have more autonomy over their reproductive choices, regardless of certain financial or biological realities.

On the egg freezing side, “we know that the younger you are when you do it, the more likely you are to be successful down the line,” says reproductive endocrinologist Meera Shah, MD, a Cofertility medical advisor. Yet young people are the least likely to be able to afford it, says Cofertility co-founder and CEO Lauren Makler. After all, it costs, on average, $11,000 for one egg freezing cycle, $5,000 for the medication involved, and $500 per year for storage, according to FertilityIQ. Can’t front those costs? You’d typically need to speed up your pregnancy timeline or wait until you could afford to freeze eggs, when it may be less effective.

With Cofertility’s Split program, “you can preserve your fertility now, for free, while also pursuing other goals, whether you have massive career ambitions, or maybe you want to have three kids but you’re not going to start until you’re in your mid-thirties,” says Makler.

It’s important to note, however, that egg freezing is not an insurance policy nor a guarantee of future fertility. Not everyone is considered a candidate for freezing, either (more on that below). The retrieval itself can also cause unpleasant side effects like bloating and cramping. And though it’s becoming increasingly common—the number of people who froze their eggs jumped by 31 percent from 2020 to 2021—there’s still not enough data to determine the potential risk for long-term complications from the egg retrieval process (which involves stimulating the ovaries with hormones to produce many mature eggs at once).

Additionally, it’s possible that some young people may not see the benefit of going through with it—that is, self-administering hormone shots, attending several doctor’s appointments, and doing the retrieval procedure—even for free, particularly when they have plenty of fertile years ahead of them to conceive naturally.

But for people who plan to wait until later in life to have kids or who have reason to suspect fertility issues down the line, the opportunity to freeze now at no cost (to them) may feel entirely worth it. That was the case for Cofertility member Sara A., who’s 26 and planning to delay pregnancy, and whose mom experienced early menopause at 42. “It provides some comfort and mental space knowing that my young, hopefully healthy eggs are safely stored for later,” she says.

“So much of [cash-compensated egg donation] is rooted in someone selling their eggs for a particular price versus doing something nice for someone else.” —Lauren Makler, co-founder and CEO, Cofertility

That motivation also helps broaden the pool of potential egg donors for Cofertility’s intended parents, as it could appeal to those who might’ve felt skeeved out by the typical cash incentive—much like Makler once was herself. She initially looked into getting eggs from a donor after learning that she had a rare abdominal disease at age 28 that could affect her fertility. “I couldn’t believe how icky and transactional and outdated it all felt,” she says. “So much of it is rooted in someone selling their eggs for a particular price versus doing something nice for someone else.”

To her point, egg-donation advertisements have traditionally touted high-value paychecks and all-expenses-paid vacations as the perks of donating. Rarely do these advertisements reference the medical process of egg retrieval itself or the significant commitment of sharing your DNA with strangers. Not only do these kinds of misleading ads pose the ethical problem of potentially persuading those who aren’t comfortable with donating to do so for the money, but also, according to Makler, they may even dissuade those who might otherwise be keen to donate from doing so.

“One of the biggest problems in egg donation is a major lack of diversity among donors,” says Makler, which disadvantages plenty of intended parents by limiting the options they have to build their family. “We believe that’s because payment can be off-putting for a lot of women, making them feel like they’re selling their eggs,” she says, rather than getting compensated for their time and effort. There’s a fear that they’ll be judged by loved ones, she adds, who might wrongly assume that they’re exchanging a part of their body for money, presumably out of greed or financial desperation.

Reinforcing that narrative is the fact that traditional egg donation places a monetary premium on eggs from certain kinds of donors. Typically, that’s been people of a specific heritage or education level (e.g., “smart Asian women“), or even with particular talents or high SAT scores, adds Makler. “The fact that one woman could essentially cost more—rather, her eggs could cost more—feels super unethical,” she says.

In erasing cash compensation from the equation and providing the same benefit to all donors, the Cofertility model avoids commodifying the eggs of donors and gives intended parents the comfort of knowing that the eggs they’re receiving are from someone who genuinely would’ve wanted to freeze their eggs for themselves (and who isn’t just agreeing for the money).

Admittedly, the chance to freeze your own eggs at no cost can also reflect a major economic savings—and it’s possible that some donors may still be persuaded to donate for that reason. After all, there’s no incentive structure that doesn’t place some value on the eggs donated. But still, the setup of the Cofertility Split program ostensibly precludes any decision based solely on the monetary upside, says co-founder Halle Tecco, with its purposefully thorough process for onboarding, screening, and connecting donors with the intended parents they stand to help.

Cracking the medical and ethical logistics of egg sharing

Though people often address egg freezing rather flippantly (“Just freeze your eggs!”) and ads for egg donation would have you think it’s quick and easy, both processes involve a substantial investment of time and energy and carry significant future implications. Particularly with egg donation and sharing, you’re giving your genetic material to a stranger, which can have a life-altering impact on you, them, and (naturally) the potential future child. In order to ensure an ethical result, the process for egg sharing with Cofertility Split involves a good deal of screening.

As a baseline, only uterus-having folks who meet all the recommendations from the American Society of Reproductive Medicine (ASRM) for egg donation will qualify for Split to both ensure the safety of all people involved (including a potential future child) and help avoid the scenario where someone freezes their eggs with the intention of donating half of them and only winds up with, say, one or two eggs getting successfully retrieved.

For the sake of the former, every Split member has to complete a medical history and genetic screening to show that they have no markers of hereditary disease (which could make their way to a child) and have a psychological evaluation to demonstrate that they fully understand the gravity of the decision they’re making, says Tecco.

And in terms of the latter, hopeful Split members need to be under 34 years old and undergo a test for anti-müllerian hormone, (AMH), “which helps us understand a person’s egg supply or ovarian reserve, and whether they’re likely to get enough eggs that they can split and have a meaningful outcome,” says Dr. Shah. While you can’t guarantee good egg yield (even a healthy, young person might have low-quality eggs or not respond well to hormones), she adds, “I think we’ll find that the vast majority of women have outcomes that correlate well with what we’ve predicted.” Those who don’t qualify can still participate in Cofertility’s “Keep” program and freeze eggs just for themselves—but they’ll have to pay for it in this case (though the company has partnerships with clinics and storage facilities to lessen that price).

“So many intended parents today are really focused on finding a connection with a donor rather than just buying eggs.” —Makler

When a person does qualify and is accepted onto the platform for Cofertility Split, they’ll fill out a profile with all sorts of intel about who they are, what they do and like, and their personality—purposefully detailed to humanize the process of matching. This way, intended parents can “see more than a potential donor’s physical attributes,” says Makler. “They can learn about their values and their motivations and what their ambitions may be, and whether they’re an introvert, an extrovert, or an ambivert, and so on,” she adds. “It’s about getting to the core of who these women are because so many intended parents today are really focused on finding a connection with a donor rather than just buying eggs.”

Naturally, some intended parents might care less about personality and be more interested in connecting with a donor who looks like them, comes from their same ethnic or religious background, or has particular physical traits—which is why Cofertility Split members also share these details in their profiles.

The idea behind the platform’s universal exchange is to generate a highly diverse group of donors in order to serve the interests of as many different intended parents as possible. “Choosing a donor is a deeply personal decision,” says Makler, who says she’s seen the full gamut, from folks eager to choose someone based on the way they write their profile answers or because they share the same favorite movie to those who make a decision based on an uncanny physical similarity. “By the time you’re even coming to that decision, you’ve often been through so much—whether it’s multiple rounds of failed IVF or pregnancy losses or illness,” says Makler, “so we really try to hold space for whatever feels right.”

That experience is mirrored on the donor side, too, as any donor selected by intended parents will get information about that family and can choose whether to opt into the match. “That double opt-in is pretty unique,” says Tecco, “and gives the donor the chance to consider, ‘Who is this family that I’m going to donate to, and could I envision sharing my DNA with them?’”

This matching process opens the door for some version of a relationship between donor and intended parents (and perhaps, eventually, between donor and donor-conceived child), which is quite a departure from the norm. Traditional cash-compensated egg donations function more like a one-and-done transaction, with the egg donor typically remaining anonymous—which recent research suggests isn’t in the best interest of the donor-conceived child (and eventual adult).

“A lot of donor-conceived people may have questions when they grow up about where they came from, or their medical history, or their biological relatives.” —Halle Tecco, co-founder, Cofertility

“What we’ve learned is that a lot of donor-conceived people may have questions when they grow up about where they came from, or their medical history, or their biological relatives,” says Tecco. Knowing the nature of their conception before those questions arise is a good thing. “That doesn’t necessarily mean that all donor-conceived people will want to have a relationship with their donor, but it means having access to that information can feel a lot less troubling or traumatic down the line,” says Tecco.

For that reason, Cofertility encourages donors and intended parents to have a disclosed relationship (aka non-anonymous), and can even set up a virtual meeting for matches to get face time before deciding whether to formally pair. “I’m grateful that I moved forward with a direct connection [with my donor],” says Lisa F., 44, a cancer survivor who began her search for an egg donor after multiple unsuccessful rounds of IVF. “A total stranger just felt familiar to me, and our connection was magical.”

Sara was a bit more apprehensive going into her own match meeting with the intended parents to which she’ll be donating, but “the more I thought about adding a layer of transparency to the process and for the potential future kid, the more I liked the idea,” she says.

Certainly, not every donor or intended parent will want to meet either the family to which their eggs will go or the person supplying them, respectively—and that’s okay. The goal is just that all parties involved can have a say in the relationship or lack thereof, says Tecco. “When we set out to build this, we really just wanted to honor the donors, the parents, and ultimately, the children that we’re helping bring into this world.”

I have a tattoo on my inner wrist that reads “I am greater than my highs and lows.” All my life (well, since I was 7 at least), I’ve been focused on a number. A perfect blood sugar, a perfect A1C reading. I’ve wanted to be perfect to the point where it stresses me out to the extreme.

I was diagnosed with type 1 diabetes when I was 7 years old. My cousin, who was 2 at the time, was diagnosed about six months before me. Reading about Tzield makes me think I could have potentially been a candidate because I had a known family connection at the time. If I could have delayed my diabetes diagnosis by a minute, an hour, anything, I definitely would have.

Balancing hope and skepticism

Growing up, I was told so many times that we are right around the corner from a cure. I don’t think anyone is wrong for being optimistic, but I have become highly skeptical because it helps keep me from disappointment.

That’s not to say things haven’t really changed since I was diagnosed. I’ve gone from pricking my finger up to six times a day to staring at my phone to find out what my blood sugar is. Closed-loop insulin pumps have made such a difference for me to know exactly what my blood sugar is at any time. The funny thing is that I was initially reluctant to get one—I didn’t want another hip attachment. Now, it’s really made me freer more than tied me down.

When I think about being younger and living with diabetes, there was so much uncertainty and fear for me. And not only for me, but also my family who worried about my blood sugar on trips, when I would go to sleep, and probably many more times I don’t even know about.

I have struggled with all the things you read about with diabetics. Anxiety, depression, PTSD. I’ve even had “diabulimia,” where I figured out if my blood sugars were high, I’d be thinner. It took focusing on having a family and wanting to have a baby to make diabetes management look very different for me.

Hope for my son’s future

There have been times when I’ve been super active and engaged in the diabetes community, from mentoring younger children with the condition to running social media and in-person support groups for those living with type 1. Other times, for my own mental health, I’ve had to take a step back and focus on myself and my own medical management.

My family and I have been invited to participate in a lot of research studies over the years. One of them was about genetic testing for my brother to determine if he was at risk for type 1 diabetes. He had always said no, that he didn’t want to know because at the time, it wouldn’t really make any difference to how he lives his life.

Now, knowing that if there are genetic markers that could indicate type 1, this drug could possibly delay that onset, that might change things for him. It changes things for me. I had always wanted a child, and I struggled with whether the decision was selfish because I was afraid of passing on my condition. I did have a son, and it was an exciting but scary time for me because I had new worries in managing my condition and growing a baby!

The idea that this drug is out there and could potentially benefit my son in any way provides a lot of peace of mind for me.

When I reflect on this new opportunity for younger people, I feel a lot of excitement. I am thankful for what modern medicine has done for me and that there are researchers out there who are trying to help people like me. I watch every new thing that comes out with a little bit of reflection about how my life with type 1 has changed.

Every step that we take, we are getting closer to a cure. That brings me hope.

“Mobility versus stability is an old trope. What you really should ask yourself is ‘Do I have access to my native, natural range of motion, and can I control my movement through those ranges?’” says Starrett, co-author (with Juliet) of Built To Move: The Ten Essential Habits to Help You Move Freely and Live Fully.

Starrett explains that range of motion, or ROM, is how your joints and limbs move through their available  space, while mobility is being able to express those ranges with control to accomplish tasks. Starrett likens native ROM (the ROM we’re born with) to a wide, spacious hallway that begins to shrink in size if we don’t maintain it.

“Most of us in our 20s have a big movement hallway,” he says. “As we age, our hallway gets narrower and narrower due to things like injury and disease, until it gets to the point where some people can barely move around. If you keep access to your native ROM, your movement hallway tends to stay open.”

We use ROM in our daily lives for everything from squatting and sitting to lifting items and walking up stairs. But ROM and mobility are “use it or lose it,” and most of our lifestyles don’t require us to continually move like our ancestors did.

“What we often see is that if we don’t expose our tissues and joints to their ranges of motion, our brain takes away the ability to access that ROM,” he says. “Our bodies constantly adapt and may adapt in ways that are limiting until you can’t get off the couch or out of the car.”

When ROM is restricted, it affects mobility, stability, and ease of movement, which, in turn, can lead to pain and injury. Starrett cites the example of a runner whose restrictions mean they can no longer maintain proper form in their stride.

“Imagine I’m missing the ability to move the leg behind the body [properly]. If I’m missing that shape, when the leg is behind, the foot externally rotates,” he says. “That position is me solving a movement restriction because I don’t have access to my native range of motion. Then the hip is not in a stable position. The body’s workaround strategy is to create a range of motion considered less effective and where the movement is not as stable.”

With age, our joints tend to become stiffer which can also lead to compensating with positions that have less stability and force. “That’s when you see people struggle to do simple tasks,” says Starrett. “The number-one reason people end up in nursing homes is because they can’t get up off the ground. That’s usually a knee or hip problem, not a strength problem.”

How to maintain your range of motion over time

Starrett’s book contains 10 tests to assess ROM, including the couch test and the sit-and-rise test: Stand up, cross one foot in front of the other, lower yourself to sit cross-legged on the ground, then stand up, without using your hands for assistance. A recent study found that participants who did best on the sit-and-rise test had a greater likelihood of survival six years later, while those who struggled most were more likely to have died.

To keep and restore ROM and mobility, you don’t need to go to a gym or class—although yoga and Pilates are beneficial—but instead to focus on targeted movements that train your joints, muscles, tendons, ligaments, nerves, and brain to work together in harmony, so you move freely and effortlessly throughout life, says Starrett. His book contains 10 simple, at-home mobilization “physical practices”—there are also Mobility Workouts of the Day on his YouTube channel—and though you don’t need to go through the list daily, Starrett says it’s best to do some mobilization work every day.

For example, one of the most effective things you can do is sit on the ground for 30 minutes a day when watching TV. “You’re going to have to change position a lot to get comfortable. This creates an opportunity to spend time in ranges of motion you’re not used to,” says Starrett, who also recommends walking at least 8,000 steps a day.

While you may not be thinking about falling and not being able to get back up in your 20s or 30s, our bodies are our homes and working to maintain a spacious “movement hallway” throughout life is really about “playing the long game” to live well as we age, says Starrett.

“Your range of motion doesn’t need to change,” he says. “It’s one thing we can control at any age. If we think of body movement as a language, we are capable of Shakespeare, but most of us are using language like Dr. Seuss.”

Now that my favorite hobby is running, I’ll often see in race photos (especially during the later miles) that it looks like I’m leaving my butt half a foot behind the rest of my body—not the most efficient form, nor the most comfortable. My husband knows that if there’s anywhere I’m going to ask for a massage, it’s my low back. All that arching leaves it constantly aching.

Physical therapists, trainers, and coaches have all prescribed the same fix over and over: lower ab work to strengthen that section of my body so I can hold my spine in a better position. But no matter how many core strengthening exercises for lower back pain I add to my routine, I’ve never really been able to solve the problem.

When I told all this to movement coach and postural alignment specialist Emily DePauw, she wasn’t the least bit surprised.

“People think, okay, well if I strengthen my abs, then I can provide a structure of support that will reduce the instability in my spine. It makes a lot of sense because opposite your spine is your abs,” she says. “It’s not an entirely uninformed thought; it’s just an incomplete thought.”

That’s because, she says, core work itself won’t fix imbalances or asymmetries in your torso. For instance, when assessing my posture, she noticed that one of my hips is tilted further than the other, and that leg naturally rotates out further, twisting my spine off-balance, and causing me to arch my lower back to compensate. “When you resolve the rotation in the body, then you can recruit your obliques and your transverse abs [deep core stabilizers] much more symmetrically from right to left. And then you really are strengthening [to support] your spine better, but you wanna resolve these imbalances first,” she says.

She adds that even if lower ab weakness is the reason for your lower back pain, it’s worth doing some Sherlock Holmes work to figure out why they’re weak. “It’s not like these muscles just decided one day to be non-participatory and just be weak for an arbitrary reason,” says DePauw. “This is because they’re not in a position of leverage that they should be in to be used. Weakness in the core is because of a misalignment, and you wanna address the misalignment first.”

“Weakness in the core is because of a misalignment, and you wanna address the misalignment first.” —Emily DePauw

If you think a misalignment may be behind your own back pain, you’re likely right. “Pretty much everyone is dealing with some sort of imbalance just as a result of our lifestyles and our habits,” DePauw says. That could be anything from consistently sitting cross-legged, to a habit of leaning more into one hip than the other when you’re just standing around, or even a hobby like surfing or snowboarding that forces you to favor one side.

You can quickly tell if you may have an imbalance if, for instance, you find you always get injured on the same side of your body, if the bottoms of your shoes wear down unevenly between your left and right feet, or if you notice more strength or flexibility on one side of your body. Or you can do a simple test: Stand up, close your eyes, and see if it feels like you have more weight in one foot than the other. A postural alignment specialist like DePauw or even a physical therapist could also help point out asymmetries, and give you some ways to fix them.

It’s not that we need to be perfectly symmetrical. Just ask any pro tennis or golf player—they’ll probably never have equal strength on both sides, and that’s fine. “You just need to be functional,” DePauw says. That means balancing out any misalignments before working on things like core strength.

For my tilted pelvis and uneven leg rotation, DePauw gave me three short exercises I could do lying on the floor to retrain the alignment in my hips. After just a few days of regular practice, I noticed my lower back lying flatter against the ground.

“You’re gonna get so much more out of your core work because you actually have access to your abs in a better way,” she told me. “I definitely am not villainizing abdominal work because it’s super helpful, super important. You just wanna position yourself for success first. Do this first, and then you’re gonna get so much more juice from the squeeze.”

Ahead, see what two gut health dietitians recommend—and practice themselves—to support gut health and digestion upon rising.

5 RD-approved gut-healthy habits to try in the morning

“There are so many simple options for how you can boost your gut health first thing in the morning,” says Kara Landau, RD, of Gut Feeling Consultancy and nutrition advisor to the Global Prebiotic Association. “You just have to pick the one, or the few, that will blend most seamlessly into your routine.”

Here are some of the top morning lifestyle and dietary habits that can lead to major gut health gains.

1. Start your morning with a calming regimen

Many of us jump out of bed with a go-go-go routine, whether that entails scrolling through your inbox while you’re half asleep or rushing to get ready to head to work. However, these are less than ideal ways to kick off your morning on a relaxing note, and they can have negative repercussions for your mind and gut alike.

“The gut and the brain are connected through hundreds of millions of nerves, known as the enteric nervous system. This often means that what’s going on in our brain can influence what’s going on in our gut and vice versa,” explains Megan Rossi, PhD, RD, founder of The Gut Health Doctor. Rather than kicking off your morning in a rush or with stimulating activities, Dr. Rossi suggests replacing it with an activity that will prioritize the gut-brain axis. Think: journaling, meditating, or even taking a few deep breaths before climbing out of bed.

2. Move your body

Gentle forms of movement in the morning can also promote gut health. “Various activities have been seen to positively impact the diversity of gut bacteria, ranging from aerobic activities all the way to yoga,” Landau shares. Again, these benefits may be attributed to the gut-brain axis. “The calming and mental health benefits that come from these activities could be behind why the gut bacteria respond favorably to movement and mindfulness activity, resulting in increased probiotic abundance in the gut,” she continues.

P.S. She adds that mindful morning movements may be particularly beneficial for people struggling with IBS.

3. Get some sunlight

Taking a stroll may very well be one of the best morning habits for gut health, as you can reap countless benefits with each step. It’s calming while gently waking your body up for the day to come. All the while, you’ll enjoy gut-friendly perks from the sunshine vitamin.

“Many people think of getting morning sunlight as important only in relation to their circadian rhythm and assisting with hormones to keep them alert throughout the day,” Landau begins. “However, an interesting study in healthy female subjects showed that exposure to UVB rays—which boosted their serum vitamin D levels—was able to lead to significant positive changes in the abundance of a number of probiotic strains in their gut.” Plus, these results were more pronounced in the sunlight group than another group in which participants took a vitamin D supplement.

Since bacterial diversity is a key marker of gut health, Landau champions spending at least a few minutes outdoors each morning. Whether you take a short walk around the block or sit on your balcony, “Getting outside for a few minutes appears to be a fantastic option within people’s reach to support their gut health,” she explains.

4. Sip on coffee or tea

Now, for my favorite gut-friendly morning tip: enjoy a delicious cup of coffee. While Dr. Rossi emphasizes the importance of staying hydrated with H2O—for both digestion and overall health—she also advocates for caffeinating (so long as you can tolerate the stimulant). “Enjoy a cup of filtered coffee or tea in the morning, or decaf after noon,” she suggests. “They’re rich in phytochemicals, which your gut microbes love.” Even better, Dr. Rossi clarifies that moderate caffeine intake actually offers similar hydrating qualities to water.

If caffeine’s not your thing or if your gut is very sensitive, she advises opting for decaf coffee or tea, both of which will still provide good-for-you phytochemicals.

5. Build a breakfast with prebiotics and probiotics

Although probiotics tend to hog the spotlight in the gut health conversation, prebiotics are just as important since they feed beneficial gut bacteria. According to Landau, a sample menu for a prebiotic-rich breakfast could look like:

• Overnight oats with crushed cashews
• Sliced kiwi (hot tip: Dr. Rossi advises keeping the fuzzy peels on to triple the fiber content)
• A teaspoon of green banana powder resistant starch

“This mix offers a blend of prebiotics in the form of resistant starch, soluble prebiotic fiber, and even polyphenols,” she explains. “All work together to feed a greater variety of the probiotics in your gut, enhance digestion and motility, and help balance your blood glucose levels.” Essentially, this plant-powered prebiotic brekkie is a veritable MVP for gut health… but you shouldn’t skimp on probiotics, either.

By eating probiotic foods for breakfast, you’ll “naturally add to the variety of gut bacteria that are present in your body, further enhancing your gut health from the moment you wake up,” Landau says. She then calls out kefir as her chief recommendation. “Kefir probiotics are particularly valuable in their ability to stick in your gut to grow and multiply, compared to many other probiotic-rich foods that are known to be more transient and only remain for a few hours. This may be due to the greater diversity in strains present, as well as the abundance of bacteria due to kefir being fermented for a longer period of time.”

Fortunately, there’s a variety of ways in which you can enjoy your kefir—with my own recent favorites being Buchi Kefir Soda and Lifeway Oat Kefir. Both are dairy-free, so they’re great options especially for those who have trouble digesting the animal byproduct.

Previously, endorphins have been the star of the show for the connection between exercise and mood: A good sweat session will cause a release of endorphins, which are neurochemicals produced in the pituitary gland that react with opiate receptors, meaning they make you feel really good. Working out also stimulates the production of serotonin and norphenylephrine, which are other happiness, wellbeing, and pleasure-inducing neurotransmitters.

These mood-boosting stimulations would probably be enough to give you that post-yoga glow. But there’s something even more going on.

Researchers have come to understand that when our muscles contract, they produce substances that get dispersed throughout the body. Some of these are chains of amino acids called myokines, and they are able to cross the blood-brain barrier—which means they can act on your brain. And when they get there, they improve brain function.

“Several myokines—irisin, hydroxybutyrate, etc.—have been shown to stimulate neuronal function and facilitate synapses, which are the way neurons communicate with each other,” Mychael Vinicius Lourenco, PhD, an assistant professor of neuroscience at the Federal University of Rio de Janeiro, who co-authored a recent review of research around myokines and brain function, previously told Well+Good.

That includes potentially “mediating the beneficial actions of physical exercise in the brain,” Lourenco and his co-authors write in the review. As a potential example, assisting with neuron communication could mean that myokines are helping those feel-good messages being sent by endorphins, serotonin, and norphenylephrine be heard.

Beyond just helping your brain do its job better, researchers also think that myokines could actually be a bulwark against depression. This has led to the substances garnering the name “hope molecules.”

In 2016, physical therapy and psychiatry researchers writing in the journal Physical Therapy were reviewing research on the connection between exercise and depression. They referenced a 2014 study on mice in which mice with lower levels of a certain type of myokine exhibit less resilience under stress than those mice with higher levels of the myokine.

“After a significant amount of stress, the mice appeared to ‘lose hope,’ as evidenced by their decreased survival efforts during forced swimming (an indicator of depression),” the authors write. “Altogether, these results suggest that the release of ‘hope molecules’ from the skeletal muscles of rodents influence mood disorder symptoms.”

While we can’t necessarily extrapolate the findings from studies on mice to humans, both species share some underlying biology that might cause myokines to work in a similar way. Namely, these myokines could inhibit a neurotransmitter pathway that, when it’s overactive, is linked with depression.

This was compelling enough for Stanford University psychologist Kelly McGonigal, the author of The Joy of Movement, to take notice of the study, and popularize the term. “Hope molecules,” McGonigal previously said on the Rich Roll podcast, could be like “an intravenous dose of hope.”

“It’s not just an endorphin rush,” McGonigal says on the podcast. “You go for a walk or a run or you lift weights and your muscles contract and they secrete these proteins into your bloodstream. They travel to your brain, they cross the blood-brain barrier. And in your brain, they can act as an antidepressant. Like irisin [a myokine] can make your brain more resilient to stress. They increase motivation. They help you learn from experience. And the only way you get these chemicals is by using your muscles.”

Even if research is still developing for how exactly exercise boosts mood and mental health, the link between exercise and wellbeing has never been clearer. Two recent meta-analyses on the effects of exercise in adults and exercise in kids have found it to be an effective bulwark against depression.

What with our emerging understanding of myokines, and the undeniable benefits of exercise, there’s never been a more compelling reason to take your medicine: A dose of movement.

But that doesn’t necessarily mean putting your body through grueling workout after grueling workout—in fact, it’s much simpler and less brutal than that.

How to exercise for healthy aging

When thinking holistically about exercise for longevity, there are some common themes to keep in mind.

Think about function first

Different workouts can address different facets of aging, like how high-impact workouts benefit bone strength, for instance. But nothing is quite as useful to healthy aging as functional fitness. This fitness buzzword essentially means training in a way that offers strength you can use in the movements you do in everyday life. And it doesn’t matter whether that’s cardio or lifting weights.

“If an exercise yields an adaptation that helps someone become better able to do what they need to do, then it’s functional,” explains Ryan Chow, DPT, founder of Reload, a physical therapy and fitness practice, where he frequently works with aging and elderly populations.

“Function is defined as ‘useful, ‘purposeful’—stuff like bending, twisting, lifting, loading, pushing, pulling, squatting, and hauling,” adds Ingrid Clay, CPT, a trainer on Centr, a personalized coaching app. Functional fitness often works on flexibility and balance, which are key components of healthy aging, as they help prevent falls and injuries, adds Clay. Functional exercises are designed to help you, say, get up out of a car, or safely walk down stairs—real-life movements we need to do to stay independent as we age.

Do it often enough

It’s not just about how you move, but how much time you spend moving. Dr. Chow recommends following the physical activity guidelines set by the World Health Organization or American Heart Association: 150 to 300 minutes of moderate to vigorous aerobic exercise throughout the week and progressive resistance training (aka strength training) targeting all major muscle groups twice a week.

“The mounting evidence suggests that this can reduce all causes of mortality by 40 percent,” says Dr. Chow. “Maybe more importantly, reaching these guidelines is also giving you [greater] quality of life.”

Vary your workouts

For best results as you age, avoid doing the same type of exercise again and again. Instead, mix things up. Even if what you love most is walking, push yourself to try a yoga class or hop on a bicycle every so often. This ensures you’re moving your body in all planes of motion and maintaining a strong heart, lungs, and muscles. “Doing both resistance training and cardiovascular training can keep your metabolic and cardiovascular systems healthy, while maintaining the health and function of your muscles and joints so that you can be able-bodied as you get older,” says Dr. Chow.

Five strength exercises you can do at home for healthy aging

Whether you’re 25 or 75, these functional exercises recommended by Dr. Chow will help set you up for safe, comfortable movement for life. Add them to your weekly routine, along with regular bouts of aerobic exercise for a longevity-focused regimen.

Isometric split squat

“This exercise is related to balance, and getting up and down from the ground,” says Dr. Chow.

1. With one foot in front and the other behind you, bend both knees coming into a 90-degree bend with both legs.
2. Hold for as long as you can, with the goal of working up to two minutes.

Modification: If 90-degrees is too deep to bend and hold comfortability, hold the position a bit higher or use a sturdy object to touch lightly for support.

Supported deep squat

“This exercise trains both strength and mobility in the hips and knees,” says Dr. Chow. Clay adds that the lower body strength you build with squats “is important for maintaining balance and mobility as we age.”

1. Stand in front of a closed door that does not swing toward you. Feet should be slightly wider than hip-distance apart and toes slightly turned out.
2. Grab the door handle for leverage to pull against as you bend both knees to slowly come into a squat, taking five seconds to get there.
3. Pause at the bottom for one second.
4. Slowly push through soles of the feet to return to standing, taking five seconds to get there.

Form note: Keep tension on the door handle to engage the upper body, which helps maintain a straight back throughout the movement.

Wall sit with heel raise

“This exercise trains the soleus and the Achilles tendon to maintain the ability to be springy and absorb impact in the hips, knees, and ankles,” says Dr. Chow.

1. Stand with your back toward a wall. Press your head, upper back, and butt against the wall, as you walk your feet away from it and begin to slide into a sitting position, with knees and hips bent at 90 degrees.
2. Raise your heels up without moving anything else. Aim to hold for 60 seconds.

Progression: Once you’re able to hold the heel-elevated wall sit for a minute, try holding for as long as possible on one leg, then the next.

Bat wing

“This exercise trains the muscles of the upper back to maintain the ability to stay upright,” says Dr. Chow. “These are your antigravity muscles to limit the negative effects of slouching and slumping.”

1. Begin standing with hands behind your ears, palms facing forward, and elbows out wide.
2. Engage your lats (the large muscles on the sides and upper back) to pull your elbows down and in toward your sides, squeezing your shoulder blades together.
3. Squeeze and hold for five seconds.

Form tip: Don’t crunch inward when bringing elbows down to sides. Keep your chest lifted. Arms will mimic the letter W.

Beast crawl

“This move trains your shoulders, trunk, thighs, and most importantly, the toes,” says Dr. Chow. “It’s important to maintain the ability to land on the toes to allow for push-off during quick activities like running or walking fast, plus it controls stress to the big toe joint, which can prevent bunion development.”

1. Start in a tabletop position on hands and knees, with your toes tucked under.
2. Engage the core to lift knees off the ground in a hover.
3. From here, crawl slowly forward, back, and side to side with the goal of staying moving and knees elevated for 30 seconds.

Form tip: Try to keep your back flat and hips parallel to the ground.

First, a recap on probiotics

New to the world of probiotics or need a quick refresher? “Probiotics are live microorganisms that provide health benefits when consumed,” begins Erin Kenney, MS, RD, LDN, CPT, of Nutrition Rewired. “The primary benefits of probiotics include improved digestion, immune system and mental health support, reduced inflammation, and lowered risk of certain diseases.” Not only can you find them in the likes of dietary supplements, but also in certain fermented foods and drinks.

The consumption of probiotics helps to support greater gut diversity. And when it comes to getting your fix of different strains, the more is (often) the merrier since various kinds can yield different beneficial effects on the body. “Consuming a variety of probiotics can help ensure that the gut microbiome is populated with a diverse range of beneficial bacteria, which has been shown to be important for maintaining a healthy gut and overall health,” Kenny explains. Conversely, she notes that a lack of microbial diversity in the gut is associated with health concerns including but not limited to IBD and allergies.

How often should you be rotating probiotics?

Since we know that a diverse gut is a healthy gut, it seems as though introducing new strains by rotating your probiotics would be a smart idea. But is there a specific timeline or schedule you should keep in mind?

“If you want to get a continuous beneficial effect from your probiotics, you should change probiotics every three months or with the seasons,” says Paulina Lee, RD, LD of Savvy Stummy. “If you were to take the same probiotic all year round, it may lose its effectiveness and even lend itself to gut dysbiosis by creating an imbalance of the very diversity you were trying to create.” By heeding her three-month rotating schedule, Lee says you’ll have a better chance to maintain heightened defenses in the gut as well as potentially avoid resistance of the probiotic.

Is it *always* necessary to rotate probiotics?

While it could very well be beneficial to diversify the types of probiotic strains you ingest, Kenney notes that research on the necessity of doing so is limited. That said, certain individuals—such as those with chronic digestive issues—may be better off than others by rotating their probiotic supplements.

With that, she notes that there are different types of probiotic classes themselves, including yeast-based, spore-based, and lactobacillus/bifidobacterium (i.e., broad-spectrum) blends. “There may be benefits to using certain types of probiotics for short periods of time when healing an underlying gut imbalance, and then switching to another kind during the repopulation stage,” Kenney explains. “For example, if someone has small intestinal bacterial overgrowth (SIBO), they may not tolerate a broad-spectrum probiotic during treatment and instead use a spore-based or yeast-based probiotic to support symptom management.” In addition, she says that short-term use of lactobacillus probiotics can assist those who have trouble digesting lactose in dairy products.

“There may be benefits to using certain types of probiotics for short periods of time when healing an underlying gut imbalance, and then switching to another kind during the repopulation stage.”

Kenney adds that it could also be beneficial to integrate a new probiotic into your regimen if you’re making a major dietary change. “If someone is switching to a lower carbohydrate diet, a lactobacillus/bifidobacterium blend may be beneficial since they are not consuming fruits and whole grains, which feed the healthy bacteria in the gut to support regularity,” she shares. However, unless her clients fall under these examples, Kenney doesn’t typically call for rotating probiotics.

Next, despite Lee’s suggested probiotic rotation schedule shared above, she notes that supplementation isn’t an exact science. “We have lots of research to support the benefits of probiotics, but application of different strains on different disease states are still being evaluated,” Lee explains. For instance, while research shows that some strains colonize the gut post-administration, “the amount of viable bacteria that can colonize will depend on many factors—like dosage and probiotic formulation—and the individual’s gastric pH, intestinal motility and prior gut microbiota composition.” Moreover, Lee cites research showing that long-term use of the same probiotics can still yield beneficial effects (including one study in patients post-colectomy, who experienced reduced inflammation by supplementing with the same blend over nine months).

“We have lots of research to support the benefits of probiotics, but application of different strains on different disease states are still being evaluated.”

All things considered, the best probiotic routine will likely vary based on the individual at hand. “The type of probiotic and length of time may vary depending on the individual, their lifestyle, medical history, and other factors that impact health,” Lee shares. She advises working with a healthcare provider to find the best individualized protocol for your needs.

3 tips to promote gut diversity

It’ll ultimately be up to you (and your healthcare team) to see if it makes sense to switch up your probiotics every 90 days, seasonally, or based on changes in your diet and/or health status. That said, there are other tried-and-true ways to support gut diversity that don’t involve supplementation.

1. Eat more fermented and probiotic foods

“A daily intake of fermented foods—like kefir, miso, sauerkraut, and kimchi that contain live microbes—can provide a wide variety of probiotic strains that bring diverse, beneficial bacteria into the gut,” Lee shares. Kenney suggests adding kimchi to scrambled eggs or kefir to a fruit smoothie to easily boost your go-to meals with fermented fare.

2. Stick to a diverse plant-forward diet

“Eating colorful fruits and veggies that contain polyphenols—like flavonoids and carotenoids—can feed healthy gut bacteria, especially Bifidobacterium and Akkermansia muciniphila,” the latter of which is inversely associated with inflammation and metabolic disorders, Lee says.

She also suggests prioritizing prebiotic foods, saying it’s one of the best ways to maintain gut diversity. “Prebiotic foods feed our healthy gut bacteria so that they can produce metabolites, like short-chain fatty acids, that can reduce inflammation and oxidative stress,” says Lee. Her go-tos include garlic, dandelion greens, onions, bananas, barley, and flax seeds.

However, a higher intake of plant-based foods at large is always a good idea for your gut and greater health. “Eating a diet that includes a variety of fruits, vegetables, whole grains, legumes, nuts, and seeds can help provide the gut with the nutrients and fiber needed to support the growth of beneficial bacteria,” Kenney adds.

3. Abide by healthy lifestyle basics

Dietary considerations aside, following the basics of healthy living can also allow your gut to thrive. “Moderate levels of physical activity can boost beneficial bacteria in the gut,” Kenney shares. You’ll also want to find healthy ways to manage stress—such as by practicing yoga or meditation—as well as get a solid amount of shut-eye per night. “Stress can reduce gut diversity, [as can] sleep deprivation,” she concludes.

“Your hair color comes from melanocytes in the hair follicle. And once you lose those melanocytes, you usually don’t get them back,” says Dr. Shah. “Theoretically, if you stimulate them, you could produce more pigment.”

For years, researchers have been working to figure out how to do just that. A potential treatment is alpha-melanocyte-stimulating hormone (α-MSH). It’s a peptide and the main ingredient in Scenesse, a prescription implant that increases eumelanin in the skin and thus tolerance to the sun and light in adults with a diagnosed sunlight sensitivity. It’s also the main ingredient in Greyverse, a topical treatment that has not yet been commercialized nor approved by the Food and Drug Administration. A 2022 study of one 25-year-old woman experiencing premature gray hair found that after five months of applying an α-MSH solution to her scalp, 90 percent of her grays returned to black.

Researchers are able to purchase this peptide for research use, and Dr. Shah adds that some doctors may even prescribe it off-label. But the commercialization of α-MSH won’t happen anytime soon. “It is interesting, but there is not enough evidence yet to support the use,” says Marisa Garshick, MD, a board-certified dermatologist in New York City. First and foremost, researchers have to establish whether or not it is safe.

“Do we want to be stimulating our melanocytes? Because melanocytes also contribute to melanoma” (AKA skin cancer), says Dr. Shah. “Some of the studies are showing that it works. And so the next stage would be safety. I don’t know necessarily where or when that will be commercialized, but the fact that those studies are coming out is exciting.”

If a prescription to reverse gray hair does come to fruition, it could save people time and money spent on dyeing their grays.

“A lot of people right now, when they go gray, they just dye their hair,” says Dr. Shah. “But there are a lot of problems with the hair dyes out there because a lot of them irritate the skin or cause allergies, especially the permanent hair dyes.”

Beyond dye, you can try antioxidant hair products, like Arey, which are designed to delay graying by reducing oxidative stress on the hair that can contribute to premature graying. “Theoretically, that would be the equivalent of using vitamin C on your face as an antioxidant to protect against the aging effects of the sun,” says Dr. Shah. “Sure, it does a good job [of that], but it’s not going to prevent natural aging.”

Although the science of gray hair reversal is still up in the air, Mona Gohara, MD, a board-certified dermatologist in Hamden, Connecticut, says it’s very possible that we’ll eventually see it in action.

“Twenty-five years ago, when everyone was getting facelifts, we would never have thought that you could stick a needle in somebody’s face and make wrinkles go away,” says Dr. Gohara, in reference to Botox and other neuromodulators. “Now you just go in on your lunch hour and get a little teeny injection and boom, it’s like magic. So I’m not saying that the science for gray hair reversal doesn’t exist, I just think that it needs to be perfected a little bit.”

“Until then, I’ll be dyeing my hair every three weeks,” says Dr. Gohara.

Black and brown birthing people face the brunt of these risks. Statistics show that in 2021 (the latest year for which data is available), the Black maternal death rate was 2.6 times higher than that of white people. This racial disparity has long been the case—even among patients with similar education and socioeconomic factors—and when the maternal mortality rate rose sharply in 2021 (partially due to COVID and its ripple effects on hospitals), the increases were especially prevalent among Black birthing people.

This begs the question: How do we fix this tragic trajectory?

There are several channels working in parallel path to strike positive, life-saving change. From maternal care in and out of the hospital, to research and better diversity education within medical schools, multiple channels are trying to improve the dire and completely lacking state of healthcare for Black birthing parents.

Midwives and doulas can bring a more holistic approach to maternal care

It is well-documented that doulas and midwives can positively impact birth outcomes for many, especially people of color who need advocates in the delivery room. While doulas can provide emotional support and assistance before, during, and after labor, midwives combine medical expertise with a patient-centered approach.

According to Saonjie Hamilton, CNM, the lead midwife for Oula Health, a New York City-based midwifery clinic, “Midwives are licensed medical professionals who take a more holistic approach to pregnancy, childbirth, and postpartum care.” Midwives don’t just focus on the labor, but the birthing person as a whole. Their work goes beyond test results: Midwifery often takes into account social determinants of health—like family support, access to nutrition, the stability of a patient’s housing situation, implicit bias, and partner violence (homicide is the leading cause of death for pregnant people)—and they build relationships that aren’t often forged in a typical seven-minute obstetrics visit.

Midwifery can be a standalone practice, or part of interprofessional collaboration with physicians, nurses, dietitians, and even social workers. Though they can’t perform C-sections, midwives can collaborate with other physicians in hospital settings if complications arise.

Particularly in parts of the country that are considered “maternal-care deserts,” midwifery has been called the answer to offering more care for low-risk pregnancies. Counties classified as deserts are those that have zero birthing centers, obstetricians, or nurse midwife access. And they are unfortunately quite common. A 2022 March of Dimes report shows that 1,119 counties in the US are considered deserts, affecting 6.9 million women. These areas overlap with ones that are known for poor outcomes for birthing people and their babies.

For a little history: Prior to the 1920s, Black midwives were the standard for prenatal care throughout the South for Black pregnant people. When laws were enacted that prevented them from practicing without a license or medical education, obstetrics—mostly led by white men—became the norm. Today, only eight percent of births are overseen by midwives.

Medical schools are training providers more intentionally

According to 2018 data, 68 percent of OB/GYNs are white, and 43 percent are men. Even leadership roles in universities are more likely to be held by white physicians. This is why some universities are actively encouraging and fostering the careers of future doctors from diverse backgrounds.

Patients of color often feel better having practitioners who look like them, but studies also show that there are merits to racial concordance that extend to infant survival. Racism has been built into medical care, and many doctors still believe in biological differences between Black and white bodies. For instance, one 2016 study even showed that some doctors believe that Black people have thicker skin and feel less pain.

Of course, doctors don’t necessarily need to be the same race as their patient to provide them with quality treatment. But more equitable care does require providers of all backgrounds to be aware of how implicit bias can show up in a doctor’s notes, tests ordered, and patient communication. This is why public health expert Tiffany Green, PhD, is launching a class at the University of Wisconsin-Madison that teaches medical school students about racial disparities in healthcare. “I can’t tell you how many doctors, including obstetricians, are just now learning about reproductive health disparities,” she says. “So I’ll be teaching what is probably one of the first, if not the first, medical school classes on race and obstetrics in American obstetrics and gynecology.”

Dr. Green emphasizes that surviving pregnancy and childbirth shouldn’t just be the responsibility of the pregnant person, and that often the disparities begin before conception. She explains that history is rife with examples of Black and brown, and even Irish, bodies being used solely for the advancement of gynecology: They were treated as test subjects instead of people, and often without anesthesia. “When we’re talking about the solutions to this problem, and asking universities to be a part of promoting evidence-based solutions to this problem, start with a true acknowledgment of why this problem exists,” she says. Med students in her class will gain an understanding of this long history of doctors ignoring Black women’s pain.

University-led research can highlight where interventions are needed

Last year, Tufts University launched The Center for Black Maternal Health and Reproductive Justice. This center is a part of its medical school, and as one of a handful of universities looking to close the maternal health gap, is focused on researching the racial disparities that continue to feed it. Similarly, health equity researcher Rachel Hardeman, PhD, founded the Center for Antiracism Research for Health Equity at the University of Minnesota. She has conducted extensive research on birth outcomes in heavily policed areas, and on racial concordance of doctors and birth outcomes for Black babies.

“By establishing and prioritizing centers for maternal and infant health research, policy, and birth equity, dedicated funding can help close the maternal and infant health mortality gap through targeted, evidence-based interventions,” says Quantrilla Ard, PhD, PMH, a maternal and infant health advocate, who adds that from education comes quality, empathetic care.

Government is aware, but legislation takes time

With a problem of this magnitude, you’d expect the government to get involved as well. And there are some strides being made. The Black Maternal Health Caucus in Congress is bringing the concerns of Black parents to the forefront and inspiring legislative action, like the recently reintroduced Momnibus Act, made up of 12 individual bills that target Black maternal health equity through efforts around affordable housing and transportation, mental health care, nutrition, and support for women in prison.

“Other proposed legislation such as the Build Back Better bill and Maternal Care Act all work together to build the infrastructure necessary to reduce and eliminate maternal and infant morbidity and mortality,” Dr. Ard says. She believes these strides will start to change the systems that put Black birthing people and their babies at risk.

Yet it’s anyone’s guess when this legislation might kick in, if it ever does. So in the meantime, nonprofit organizations like the Black Mamas Matter Alliance are shifting cultural understanding of the issue so that more Americans are aware of the problem and can start making noise about its dire consequences.

Altering the trajectory of the birthing experience will require changes in all areas of healthcare. Working together is imperative. Fixing health and, specifically, birth disparities, must touch every level of our society, from the government to the very classrooms where future frontline medical staff are trained.

The main lifestyle difference the researchers were interested in was the fact that these monks meditated for over two hours a day. They wondered if meditation might have an impact on the microbiome (which is the types and amounts of bacteria found in the gut, as analyzed from a person’s stool).

The resulting study, published in the British Medical Journal’s General Psychiatry, found that the monks had higher quantities of certain bacteria that are associated with lower levels of depression, anxiety, and cardiovascular disease. The exciting findings caught the attention of outlets like The Guardian, Healthline, and others. So, does the study show that meditation is good for the gut, and subsequently good for your overall health?

Unfortunately, it’s not so clear cut.

“I’m not sure how much I would really take home from that study,” Emeran Mayer, MD, a gastroenterologist, UCLA medical school professor, Seed Health board member, and the author of the book The Mind-Gut Connection, says. “There’s more limitations than positives.”

Dr. Mayer says the technical methods the researchers used to analyze the samples were outdated. The study size as a whole was small, and the control group (just 19 people) was not robust enough to draw conclusions of difference from. He’s skeptical that samples could maintain their integrity even in a refrigerated box for a trip down a mountain and on a plane; most studies, he says, require very controlled sample collection that happens in a lab. And he also points out that diet and the sedentary lifestyle of monks was not taken into account.

Speaking with Prevention, Martin J. Blaser, MD, professor and Henry Rutgers chair of the human microbiome at Rutgers Robert Wood Johnson Medical School, thought the study was “well conducted,” but didn’t think meditation could be pinpointed as the defining factor that accounted for potential differences in the microbiomes of the monks versus the control group.

So, essentially, even if the findings sound exciting, experts aren’t confident that this is the study for meditation x gut health enthusiasts to hang their hats on.

What’s the big deal with “gut health” anyway?

“Gut health” has been an exciting concept (and buzzword) for years, with proponents claiming that the population of diverse, robust bacteria inside of us can influence everything from chronic disease to mental health. Our stomachs produce a lot of the substances we need to fight disease, manage inflammation, and regulate our mood (for example, most of the body’s serotonin comes from the gut). So the “mind-gut axis” is an exploding field for research.

“It turns out that microorganisms can actually counteract the harmful effects of food, drugs, hormones in our bodies, either introduced from the outside or produced inside our bodies,” Ian Smith, MD, best-selling author and chief medical advisor for the probiotics brand Jetson, previously told Well+Good. “The sheer number of conditions that have been found to link back to gut health is in itself an exciting advancement: things like obesity, diabetes, liver diseases, cancer, and even neurodegenerative diseases.”

Still, some researchers caution that many of the claims are overblown, and Dr. Mayer gives the caveat that “the majority of really revolutionary findings in the brain-gut microbiome space has come from animal models,” which he says can’t necessarily be extrapolated to humans. Furthermore, what constitutes a “healthy gut” isn’t so clearly defined, and could vary from person to person.

“We don’t know what a ‘normal’ microbiome looks like,” Ali Rezaie, MD, a gastroenterologist and co-author of The Microbiome Connection, previously told Well+Good. “Your microbiome is unique to you, and there’s no known magic mix of bacteria.”

Okay, but could meditation positively impact your gut microbiome?

Dr. Mayer’s skepticism for the Tibetan monk study in particular does not mean he thinks the theory itself doesn’t hold water. A long-time meditation practitioner (Dr. Mayer and his wife even got married at a Tibetan monastery in Kathmandu), and an expert in studying the connection between the gut, body, and brain, Dr. Mayer says it makes sense that meditation could impact the microbiome in a positive way. That’s all down to the growing (but still not-definitive) body of research showing that meditation can possibly reduce stress, and evidence is amassing that stress can wreak havoc on the gut.

When we’re stressed, our sympathetic nervous system gets activated. That activation “changes the environment in which the microbes live, their habitat,” Dr. Mayer says, including blood flow, contractions, mucus production, and more. Certain neurotransmitters, like norepinephrine, can make their way into the gut, which “modifies gene expression of the microbes,” he says. A meta-analysis of studies found that more research is needed to further understand how stress affects the gut (much of the research has been done on mice), “but emerging human evidence has begun to corroborate preclinical findings” that stress can impact gut health.

“If relaxation and stress reduction and meditation decrease sympathetic nervous system tone and reactivity, then I think that will be the most possible explanation for changes in microbiome,” Dr. Mayer says.

Other studies have shown some promise for this hypothesis. One small study that looked at meditation practitioners who ate a vegan diet found a higher prevalence of beneficial bacteria versus a control group. A meta-analysis of studies that looked at topics including stress, the microbiome, epigenetics, and meditation concluded that “during stress, an altered gut microbial population affects the regulation of neurotransmitters mediated by the microbiome and gut barrier function. Meditation helps regulate the stress response, thereby suppressing chronic inflammation states and maintaining a healthy gut-barrier function.” While other papers suggest that these statements are not so clearly established as scientific fact, the stress-gut connection—and meditation’s ability to modulate it—are not so theoretically far-fetched.

So should you be making like a Buddhist monk and meditating for two hours every day for the sake of your microbiome? There’s probably no need to divest of all your worldly belongings just yet—but don’t ignore the potential power of a meditation practice to contribute to your overall health and wellbeing (and subsequently, your gut).

“The ultimate thing is really to have a microbiome-friendly diet, plus the contemplative component, you know, the half hour meditation,” Dr. Mayer says. “A healthy lifestyle should have both.”

Let’s learn why detox diets are diet culture at its worst—and tactics to resist their toxic lure.

4 detox diet myths to cut back on, stat

Myth: There are special foods that magically detox your body

The truth is, detoxing is an incredibly complex system of physiological processes that our body utilizes to remove harmful substances. According to Deepti Agarwal, MD, director of interventional and integrative pain management, longevity medicine at Case Integrative Health, “there is no single food that will detoxify an individual’s body. Detoxification can be seen as a ‘package’ of physiological and psychological processes through which the body eliminates toxic substances.”

Caroline Young, MS, RD, RYT of Whole Self Nutrition confirms that detox diets are neither healthy for our bodies nor our mental health. “Detox diets typically require some level of restriction and a high level of rigidity—both of which stress the body and the mind by increasing cortisol, our stress hormone, and causing food preoccupation. Detoxes can cause other mental and physical issues, like isolation, fatigue, and brain fog,” Young says.

“Detox diets typically require some level of restriction and a high level of rigidity—both of which stress the body and the mind by increasing cortisol, our stress hormone, and causing food preoccupation. Detoxes can cause other mental and physical issues, like isolation, fatigue, and brain fog,”—Caroline Young, MS, RD, RYT

The verdict is in: Detox diets are just not worth the physical or mental stress.

Myth: Detoxing jumpstarts weight loss

Detox diets are often promoted as a fast track to weight loss; an “overnight” fix. It makes sense: When you eat very little, drink a lot of water, and take pills and potions that may make you go to the bathroom, you will end up a few pounds lighter.

However, this weight loss is often short-lived. As soon as you begin eating again, you’ll find that you regain any weight that you initially lost. Sheri Berger, RDN, CDCES helps us clear up this myth. “The myth that detox diets jump-start weight loss needs to go. You may feel super psyched when you are a few pounds down after days of drinking only liquids, but that is all water weight and not fat loss. The moment you start eating food again, the water weight will come back. Our bodies naturally store a couple of grams of water with every gram of carbohydrates we eat. Carbohydrates are in pretty much everything we eat as they are our main fuel source,” Berger says.

According to Kim Yawitz, RD, a dietitian based in St. Louis, “Cutting back on sugar, alcohol, and other foods commonly eliminated on detox diets will certainly help you lose weight, but enjoying these foods in moderation can help you achieve results that last.”

Myth: Detox plans are scientifically proven to work

Dr. Agarwal fact-checked this one for us: “Many detox products we see online, or even pushed by our favorite influencers, are not regulated by the FDA and may not be properly tested for what they are claiming to do for your body.”

Much of the research around detox supplements is lacking. Instead, the research supports living a healthy lifestyle to reduce your overall toxic load and improve your body‘s natural ability to detox itself. Focusing on consuming a variety of high fiber foods, lots of colorful fruit and vegetables, regular exercise, and getting good sleep are all the building blocks of living a healthy lifestyle. Before we focus on the minutia, let’s make sure that you are consistently taking care of yourself with these habits first.

Myth: Your body isn’t capable of detoxing on its own

In fact, you already have a built-in detoxification organ: your liver! “Our bodies do not need a detox program, because it is naturally taking place. We have an entire system in place to fight off the endotoxins—the toxins we produce—and the exotoxins, or toxins from the environment, that we are exposed to throughout our life,” explains Molly Snyder, RDN a Pittsburgh, PA based dietitian.

“Our bodies are well-equipped to detox on their own via the liver and kidneys. Plus the digestive system, skin, and lymphatic system. Supporting these systems is far more beneficial than any detoxification program, pill, or supplement,’ says Taylor Grasso, MPPD, RD.

“Our bodies are well-equipped to detox on their own via the liver and kidneys. Plus the digestive system, skin, and lymphatic system. Supporting these systems is far more beneficial than any detoxification program, pill, or supplement.”
—Taylor Grasso, MPPD, RD

With this said, Casey Kelley, MD, founder and medical director of Case Integrative Health suggests that there is more nuance to this discussion. “While it is true that our body has a natural detoxification system, the influx of toxins to our system can overload the detox pathways, and we aren’t able to detox as optimally. We are dealing with more toxins in our life than our forefathers. Think of it as a sink that is overflowing—the more we can help widen the outgoing pipe, the better,” says Dr. Kelley.

Still, Dr. Kelley does not recommend falling prey to the detox diet you heard about on TikTok. Instead, she recommends focusing on specific habits that increase your body’s natural ability to detox. Follow these science-backed tips from Dr. Kelley that will support your body’s built-in detox pathway without harming your health.

• Eat foods that naturally support your body’s detoxification system, including cruciferous veggies, garlic, onions, eggs, and high-fiber foods
• Drink plenty of water throughout the day
• Exercise regularly, because sweat removes toxins through the skin
• Hold a regular sleep schedule by aiming for seven hours of sleep per night
• Reduce your toxic burden: Consider non-toxic beauty products and non-toxic cleaning products. Clean the air in your home: pollutants like mold can increase your toxic burden. If you are able, consider high-quality water or air filters

However, if you don’t feel favorably toward veggies due to the gastrointestinal problems they can cause, you’re not alone. As registered dietitian Elaina Efird, RD discusses in a TikTok, vegetables (and other high-fiber foods) can feel uncomfortable on the gut for some people. While this is especially a common struggle for people with irritable bowel syndrome (IBS), she says, people with a sensitive stomach often can’t digest vegetables as easily as others, too. It may even feel like the “bane of your existence,” as it has for many of Efird’s clients.

@elainaefird Try doing cooked veggies and avoid doing them in huge amounts at one time #dietitian #foryou #veggies #vegetables #fyp #ibstok #nutrition ♬ original sound – Elaina Efird RD, CEDRD, CSSD

But how do you know that side of broccoli, for example, is the reason behind uh, hours spent in the bathroom? And does that mean you can’t eat vegetables again?

Signs that you can’t digest vegetables easily (or that they’re hard on your gut)

According to Sarah Schlichter, MPH, RDN, the co-host of the Nail Your Nutrition podcast and CEO of Bucket List Tummy, the main symptom is gastrointestinal issues (which can show up in various ways). Some examples she lists include:

Stomach discomfort

In other words, if you feel bloated, gassy, or even nauseous after eating vegetables, it may be because your stomach is struggling to digest them. Be mindful of how you feel while and after eating to test this theory out.

Running to the bathroom (or not being able to go)

Interestingly, both constipation and diarrhea are additional signs to look out for. Schlichter says constipation is more likely “if one is not drinking enough water to counteract the fiber intake.”

Lastly, it’s important to note that symptoms like these—as well as fatty stools, stomach pain, and vomiting—are also signs of nutrient malabsorption, which Schlichter says can occur if the veggies you eat aren’t making your gut happy.

What to do if your stomach can’t digest vegetables easily

First, Efird shares that it’s totally fair to avoid vegetables if needed. (Seriously.) “If you’re someone who’s really struggling to eat vegetables because every time you do, you end up on the toilet, then maybe vegetables aren’t healthy for you,” Efird says. “It’s not worth it for you to try to force yourself to eat vegetables when you’re finding yourself on the toilet for an hour after just because vegetables are the stereotypically ‘healthy’ choice.”

“If you’re someone who’s really struggling to eat vegetables because every time you do, you end up on the toilet, then maybe vegetables aren’t healthy for you,” Efird says. “It’s not worth it for you to try to force yourself to eat vegetables when you’re finding yourself on the toilet for an hour after just because vegetables are the stereotypically ‘healthy’ choice.”

But as a lifelong fanatic of peas (it’s a hot take, I know!), I understand the desire to eat veggies or to want some of their nutrients. If this is how you feel, you can have them in a more comfortable way by:

Changing how you cook the vegetables

Cook the veggies longer or add specific ingredients to them. “Cooking the vegetables to a softer state and breaking down the plant fiber is one way to mitigate some of these symptoms,” Schlichter says. “Furthermore, consider adding butter or oil to the vegetables, as fats can increase fat-soluble vitamin absorption.”

Additionally, some people experience reduced symptoms by adding in bitters or digestive enzymes, Schlichter adds, which you can buy at vitamin shops and similar stores.

Drinking more water

Digestion is yet another situation in which hydration is key. “Fluids can help things pass through the digestive system quicker,” Schlichter explains. She advises drinking more water, especially if you already struggle to do that. (FYI, according to Harvard Medical School, an average of four to six cups a day is best.)

Paying attention to how much fiber you’re eating

Watching your fiber intake is another option Schlichter mentions. In other words, if you just ate a fiber bar, you may want to skip out on cauliflower that night.

On that note, consider looking at what else is in the veggie (or high-fiber food) you’re eating. “Beware of some of the additives in certain products, like inulin, sugar alcohols, and artificial sweeteners, which can also cause gastrointestinal upset and digestive difficulties in some people who are sensitive,” Schlichter says. (Side note: If you’re concerned that steps like these may trigger disordered eating for you, good for you for acknowledging that! Working with a dietitian who’s well-versed in eating disorders can help you navigate that in a less harmful way.)

Along this same vein, it can help to know which veggies are the worst for your gut. Schlichter says cruciferous vegetables (aka the leafy ones) as well as raw ones, like broccoli and cauliflower, are more likely to give you problems. On the other hand, some options that are lower in fiber include canned or well-cooked carrots, green beans, and vegetable juice.

If the tips above aren’t doing it for you, you may want to reach out to your doctor for more specialized care. “Give it a one to two week timespan to give your digestive system time to adjust, and then if symptoms have not improved, see a medical provider,” Schlichter adds.

While veggies are typically full of great vitamins, they can be hard on your stomach—which makes them not the healthiest choice for everyone. If popping a multivitamin ends up being the best choice for you, that’s okay! Health isn’t one-size-fits-all.

“You need to have a seat.”

A therapeutic assistant at the residential eating disorder treatment center where I was then a patient stood nearby, glaring at me.

I had been standing while talking on the phone with my mom, when the staff member interrupted. I was only allowed a few minutes for the call, so I decided it wasn’t worth the fight and sat down.

Standing wasn’t the only forbidden activity at the facility. Motion of any kind was so frowned upon that providers even coined a term for it: “excessive body movement.”

“Any kind of movement in [eating disorder] treatment—from fidgeting to formal exercise—is closely surveilled, monitored, structured, and overall limited,” says Stacie Fanelli, LCSW, of Revolutionary Eating Disorder Psychotherapy and Consulting.

As someone with anorexia recovery, I can attest to this: At all five treatment centers where I have been a patient, movement was forbidden.

During my first inpatient visit, an assistant sat in my room with me until I fell asleep, which I believe was meant to ensure that I didn’t exercise. At another treatment center, I once was sitting on the floor during a group therapy session, rocking back and forth. I didn’t even realize I was doing it; the motion just felt soothing. Almost immediately, a therapist rushed over, signaling for me to stop. It didn’t matter that I had been self-soothing—my coping skill wasn’t allowed.

“Even for those for whom over-exercise and under-fueling has been the primary behavior at play, how are they supposed to repair their relationship with [exercise] when we’re sending an abstinence-only message?” Fanelli says. “When my clients are told they have to drink a supplement when they’re ‘excessively standing’ or engaging in joyful movement like hanging upside down off a couch, they’re getting validation that movement is in fact a form of currency that you use to earn food, which is exactly what many eating disorders are telling them.”

For me, not being able to move during treatment only took away a key tool that I’ve used to heal.

Why eating disorder treatment centers restrict movement

What’s behind providers’ insistence on not allowing patients to move? Psychiatrist Wendy Oliver-Pyatt, MD, FAED, CEDS, founder of several eating disorder treatment centers, including Within Health, explains that for some patients, a period of rest may be needed if their body needs time to heal from disordered behaviors. Those with restrictive eating disorders may truly not be fueling their bodies enough to allow for anything strenuous. Some patients may also need time off from movement for psychological reasons, if they feel like they need to exercise to burn calories.

Fanelli adds that another major concern for centers is liability. Providers don’t want to be responsible for a patient passing out or injuring themselves, for instance, so they ban movement to reduce the chances of this happening.

But instead of being upfront about these fears, she says centers sometimes shift blame onto the patient. “Providers often couch their fears that come with the perceived physical fragility of all eating disorder clients in a catch-all ‘that’s your eating disorder talking’ accusation so that they don’t have to take accountability for what’s actually their own anxiety,” Fanelli says.

As a patient, I can’t help but feel like this kind of policy is created for providers’ own self-preservation. Rather than treating patients as individuals with different needs and choosing what’s best for each person at each step of their recovery, a blanket ban against movement seems to serve the center itself most of all.

The effects of not being allowed to move during recovery

Personally, having the choice to move my body completely removed from my coping skills toolbox left me feeling powerless. And it instilled an intense need to feel in control of my body—which ironically is the reason many patients wind up in treatment.

Compounding the frustration of not being able to move was a lack of any timeline for when I might be able to do so. “When the person has no indication of when they’re going to be able to move again or it’s contingent on their compliance with a protocol of some sort, that lack of agency can activate emotions that have nowhere to go,” Fanelli says.

I found that this rigidity around movement actually reinforced a harmful myth that many patients already believe: that food and exercise are directly correlated. Fanelli notes that patients who begin treatment with rigid rules about food can end up with a new set of rules, this time about movement. “It just becomes another control mechanism,” she says. “Is that really recovery?”

In contrast, when I’m not in treatment, joyful movement has been a key part of my recovery. Instead of restricting or purging away my anxious thoughts, I’ll go for a quick walk down the street, enjoying not only the benefits of stretching my legs, but also fresh air and nature.

A better way forward

It’s a natural human impulse to desire some kind of physical activity. And I honestly believe that not being allowed to move my body the way it craved removed my autonomy in a way that was not only not helpful, but actually harmful.

Fortunately, not all eating disorder treatment centers follow this policy. There are some centers that actively embrace the benefits of movement through dance or movement therapy to help patients reconnect with their bodies. “We can get back to the basics of feeling safe in moving our body,” says Erica Hornthal, a dance therapist in Chicago. Hornthal says this process isn’t about body positivity and how the body looks, but focuses on how it feels to be in the body, something eating disorder survivors often struggle with.

“Allowing ourselves to take up space and notice how our body moves helps us reclaim ourselves on the road to recovery,” says Hornthal, who helps clients do this through practices like guided imagery, movement meditation, and creative techniques like mirroring (where the therapist will mirror the client’s movements to externalize what they’re feeling in their body). “It’s like rebuilding a friendship with someone who has hurt us, and working to repair that connection.”

Fanelli adds that yoga can also be a helpful transition exercise. Not only does the practice encourage a mindful connection to the body, it takes the focus off reaching numerical goals, which patients often struggle with in more intense workouts, like running or high-intensity interval training.

Dr. Oliver-Pyatt says the key is to create a “paradigm shift” so that patients see exercise as self-care instead of something they have to do to burn calories. “You want to do it not out of fear, but because you want to move your body,” Dr. Oliver-Pyatt says.

At Within Health, Dr. Oliver-Pyatt says patients begin to move gradually and with support of a provider. And if they’re not quite ready yet, providers will determine when to incorporate it into a patient’s recovery plan and let clients know that even if they can’t exercise at the moment, they will be able to eventually.

With any steps in the recovery process, I strongly believe—and Dr. Oliver-Pyatt agrees—that the client should be included in the process. “If you don’t have that relationship, they won’t share with you what’s actually going on,” she says. When it comes to movement, having someone listen to my concerns around not being able to move while in treatment would have been instrumental in learning to trust not only my body, but also my voice.

“Patients may not have ever learned how to trust their body, and that you can eat without compensatory activity,” Dr. Oliver-Pyatt says. “But if people don’t learn that while in treatment, they may never learn it all their life.”

“Keloids are raised scars that are caused from an overgrowth of scar tissue and can be itchy, tender or painful,” says Dendy Engelman MD, FACMS, FAAD, a board-certified and award-winning dermatologist at Shafer Clinic in New York City. “They can be pink or red in color and are triggered by any type of skin injury that causes the body to overproduce collagen, which is the protein used in wound healing.”

So you can make an informed decision about getting your ears pierced, we spoke to three dermatologists to uncover everything you need to know about keloids.

What are keloids, and why do they occur after piercings?

You may already be familiar with the term keloid from the skin-care world, as these types of scars are often associated with acne. When the skin is injured (which happens when you pop a pimple, or, in this case, when you pierce your skin with a needle), collagen becomes damaged. Your skin cells and connective tissues start to multiply in an attempt to repair that damage, which leads to scarring.

“The body doesn’t know that a piercing is an intentional injury, so the wound healing process kicks into effect and can cause scar tissue to form and keep growing and developing, turning into a keloid,” says Dr. Engelman.

Who tends to develop keloids and why?

“Although it’s not completely known why, keloids are more likely to occur in those with darker skin, with studies showing that keloids are most commonly seen in individuals of African and Asian descent, as well as those of Hispanic and Mediterranean descent,” says Marisa Garshick, MD, FAAD, a leading board-certified dermatologist and assistant clinical professor of dermatology at Weill Cornell Medical Center. In other words, there’s a genetic component at play.

What are the treatment options for keloids?

Keloids are tricky to treat, but there are several treatment options available to get rid of them for good. The hardest part is ensuring that the vicious circle of removing them, causing injury to the skin, and keloid formation potentially re-occurring stops, once and for all.

So, what choices do you have for treatment?

“In general, keloids are most commonly treated with the use of intralesional injections, using intralesional triamcinolone, a type of steroid,” says Dr. Garshick. “Other treatment options include intralesional injections of a type of chemotherapy known as 5-fluorouracil, silicone gels such as Biocorneum or Silagen, or silicone sheets such as Scarguard.”

Radiation, cryotherapy, lasers, or surgical removal are also options, but Dr. Garshick is hesitant to recommend surgery. “Surgical removal is generally not recommended given the risk of the keloid coming back even larger than before, so if surgery is planned, it is important to treat with radiation or steroid injections immediately after surgery to prevent keloid recurrence,” she says.

If a keloid does start re-forming, it can be retreated with intralesional cortisone injections to reduce its size and symptoms, such as pain and itching.

How can I prevent keloids in the first place?

A good question that comes with a simple, if not so fun, answer.

“If someone is prone to keloids with a family history, it may be recommended to avoid any piercings, tattoos or elective procedures, especially in cosmetically sensitive areas. Common locations for keloids to develop include the ears, neck, arms, legs, upper back, shoulders and chest,” says Dr. Garshick.

Rebecca Marcus, MD, FAAD, a board-certified dermatologist and founder of skin-care brand Maei MD agrees, revealing that proper wound care is important if you do suffer a skin injury.

“Make sure you properly clean any wound, as infection could potentially raise the risk of developing a keloid,” she says. “Try to reduce any tension and stress on the wound as it heals too; as avoiding excessive stretching, movement, or pressure on the affected area can decrease risk of keloid scar formation. Protect any healing wounds from the sun as well.”

One last thing. All of the dermatologists we spoke to mention how important it is to seek treatment sooner rather than later if you notice a keloid forming, as they are much easier to treat in its initial early stages.

So if you notice anything that doesn’t look quite right after your piercing, don’t hold back from making a dermatologist appointment, but otherwise, enjoy your beautiful new piece of body art.

“I’m sorry,” I said sheepishly. “My calves and hamstrings are so, so tight.”

Lulu got down to business and did serious work on my body. My feet, calves, and hamstrings took a particularly intense kneading. It felt like she was disentangling the rigid strands of a thick rope in a way that was incredibly needed.

As we wrapped up and I was thanking her, she gave me some advice: “You need to soak your feet in warm water for 15 minutes every night,” Lulu said.

“For my calves?” I asked. “And legs,” Lulu replied.

“Okay, but…” I didn’t get to finish my question of, well, “why?” before Lulu whisked out of the room, off to her next lucky client.

My upper and lower leg muscles are tight because of the running, dead lifting, and non-ergonomic sitting I do on the regular. I also have pretty flat feet, which can pull on my calf muscles and tendons when I walk, further straining them and causing tension. However, tightness like mine is in fact very common.

“Muscles tighten up just from the repetitive stress of twisting and turning and bending day after day after day,” chiropractor Jeffrey Klein, DC, founder of Broadway Chiropractic & Wellness Center in New York City, previously told Well+Good.

Lower body tightness can start in your feet and work its way up from a myriad of sources, like “standing on your feet for many hours, the type of shoes you wear, sitting too long, flying, or strenuous workouts,” says massage therapist Gilma Linares, the assistant spa manager of Four Seasons Hotel Los Angeles.

I asked Linares if my massage therapist Lulu’s advice to soak my feet every night to reduce tightness held water. She was all for it.

“Soaking feet in hot water reduces inflammation and stimulates circulation,” Linares says. “Therefore, it will help reduce pain or discomfort to lower extremities such as lower back, hips, and legs.”

Sitting or standing for long periods of time causes blood to pool in the lower body, “which adds pressure to leg veins and compromises their structural integrity,” Kate Denniston, ND, a licensed naturopathic doctor at Los Angeles Integrative Health clinic, previously told Well+Good. That’s why Linares says paying attention to your feet can pay off in other parts of the body.

“Warm water will increase circulation, which helps with cell recovery,” Linares says. Those muscles that are knotty or inflamed from exercise or being stationary get some extra blood and oxygen sent their way, which helps them rebuild. “The feet carry all the weight, therefore it’s necessary to pamper your feet.”

And the snatched trend, in particular, is problematic for not only this reason, but because it also appropriates a term with roots in Black and LGBTQ+ communities and applies it to groups (or for purposes) outside of its original intent—often as a thinly veiled (pun intended) code word for “skinny.” This is something that delineates from its original definition, according to April Baker-Bell, PhD, an associate professor at Michigan State University who specializes in Black language education and linguistic justice.

Snatched has long been a term used to compliment an individual’s appearance. “When I think about what ‘snatched’ means, I think it could look very different—there’s no one image in my mind [embodying] what that means in the Black community,” says Dr. Baker-Bell. “I think snatched could be used for a full-figure woman, someone very thin, and someone who’s slim thick. It’s not limited within the Black community.” The term has also been used on shows like RuPaul’s Drag Race to express a look that blows people away.

When the roots of well-intentioned terms like snatched are ignored and their meanings are twisted, the original creators suffer, and it’s possible to end up with yet another unattainable body standard.

But that’s not the message you’d get by searching #snatched on social media. Instead, you’ll be met primarily with videos of women with tiny waists performing bodyweight abs exercises or showing off their flat stomachs post-cardio. You’ll also find clips of women trying to chisel their jawlines and cheekbones with microcurrent devices, contouring hacks, and filler. [Editor’s note: We’re opting not to link out this content here because we don’t want to give it a greater platform as it may be harmful to your mental and physical health.]

Snatched is far from the first expression from marginalized communities to migrate into popular culture—and have its meaning distorted along the way. Consider the term “squad goals,” which stems from Black culture. In the mid-2010s, the expression entered mainstream culture and was used by “everybody and their mama” to describe friend groups, says Dr. Baker-Bell. Exhibit A: In 2015, Taylor Swift’s crew of famous gal pals was quickly dubbed #SquadGoals. But as writer Judnick Mayard explained in the Guardian at the time, “[#SquadGoals] refer to the allies they’ve found in this life that is inundated by racism, sexism and elitism affecting those who look like them.” Ever since the original meaning was lost, the expression hasn’t been used as much within the Black community, says Dr. Baker-Bell.

“Black language, African American Vernacular English, or African American language is a coded language that’s used within our community to communicate certain ideas, but it’s also a language that is kind of protected from dominant culture,” says Dr. Baker-Bell. “Usually, when dominant culture starts using some of the terms that we develop in-house, so to speak, it loses its value within our own community.”

Essentially, it’s linguistic appropriation, says Dr. Baker-Bell. “The issue with this is that—especially in this current racial climate, which has always existed—Black people contribute so much to this country, to the culture, but less of it is attributed to Black people,” she explains.

There’s also a clear double standard: When Black individuals use their language in school or professional settings, it’s often not seen as valuable, and they may be corrected and told these expressions will prevent them from becoming successful, Dr. Baker-Bell explains. At the same time, white individuals on social media and in real life use these terms (often without the original meaning) to their gain, she notes. “We see people co-opting and using it and just simply playing in the language and not thinking about how this group is discriminated against,” she says.

While some may advocate for the appreciation of Black language, Dr. Baker-Bell argues that can’t be possible without first appreciating the people. “We have to make sure that we’re advocating and we’re standing up for these communities. When Black people are murdered in the streets, when Black trans people are killed, we don’t see as many people who want to use the language standing up to advocate for these specific communities.”

When the roots of well-intentioned terms like snatched are ignored and their meanings are twisted, the original creators suffer, and it’s possible to end up with yet another unattainable body standard, which in this case is the opposite intention of the term in question. Snatched is about celebrating diverse bodies and beauty, not making you feel bad if you don’t fit a certain mold.

The harm of the TikTok ‘snatched’ ideal

When tips to help you become snatched—or achieve any other body ideal—are promoted online or IRL, it perpetuates the myth that people can easily control their weight, body shape, or size, says Maddie Friedman, AM, LCSW, a clinician and therapist lead at Equip Health. “It overlooks the reality that everyone’s DNA is different, everyone’s gene pool is different, and certain body ideals cannot be obtained by manipulating food or [utilizing] other channels that could theoretically alter your shape or size,” she says.

The problem: 79 percent of Americans report feeling unhappy with how their body looks at times, according to an Ipsos survey of more than 1,000 people. And the ingrained need for acceptance, belonging, safety, and love can lead some folks to try their hardest to match their body to the new ideal, no matter how difficult or potentially dangerous it is, says Carise Rotach, MA, LMFT, an eating disorder therapist at Equip Health. Trans women and non-binary individuals may be particularly at risk, she notes; concerns of passing may influence trans folks’ body image, and genderqueer college students already have a heightened risk of eating disorders.

To conform to the “body type of the moment,” some folks may go so far as to modify their lifestyle, like exercising more or restricting their diet, the latter of which may increase the risk of an eating disorder, according to the National Eating Disorders Association. Or, they may use external measures such as drugs or cosmetic surgery, adds Friedman, which could also come with serious consequences. Research shows that depression and anxiety may develop after undergoing an aesthetic procedure, such as a face lift, particularly in people with depression-prone personality traits.

What’s more, the media perpetuating this snatched stereotype makes it seem attainable, when in actuality it’s not for the majority of people. This is especially harmful for impressionable audiences. “Young people [in particular] will see videos saying, ‘do these exercises’ or ‘eat these 10 things’ or ‘cut out this’—[essentially] a roadmap to achieving this beauty ideal that’s being lifted up on social media,” Friedman explains. “And innocently enough, they’re like, ‘Okay, let me find a way to fit this.’”

Engaging in these promoted behaviors can damage a person’s relationship with food, movement, and their body, Friedman says, adding that it can be like a match that ignites a flame in individuals who are already susceptible to an eating disorder. (For the record, eating disorders are often influenced by a combination of genetics, environment, and other factors, according to UNC Health.) “So it may not be until they dabble with [restrictive eating] or exercise that this cascade goes into effect where a snatched waist is not snatched enough and the line keeps moving,” she notes. “It’s a really slippery slope to illness.”

Though the current standards for “snatched” are often promoted by white women on the internet, they’re not necessarily the only ones dealing with the ideal’s potential ramifications. “People in all body shapes and sizes, from all walks of life, from all cultural and racial and ethnic backgrounds, can and do experience eating disorders,” says Friedman. Not to mention, “people of color are less likely to get appropriately assessed and diagnosed because of the stereotype that only thin, white women get eating disorders.”

To make matters worse, the beauty ideal is always in flux. So while the snatched look may be desirable in this very moment, the opposite could be true soon. “It leads generations and generations of people to be working toward an appearance ideal that they may or may not ever achieve because it keeps changing,” says Friedman. “What that leads to, I think, is just a vast majority of people who never feel that good in their bodies. It leads to people feeling like they can always be doing more or doing something different to achieve some type of end that really has very little to do with who they are as unique individuals.”

How to overcome the pressure to be snatched

To accept your body as it is, you first need to stop blaming yourself for feeling like you need to live up to a certain, often thin, appearance standard. Over your lifetime, you’ve likely been inundated with messages highlighting what bodies are supposed to look like in order to be loved and seen as attractive. (Exhibit A: the latest reality TV shows featuring slim, bikini-clad women finding their perfect romantic partner.) You’ve also been “indoctrinated with anti-fatness” and ideas of what is and isn’t an ideal body, says Friedman.

“When we feel pressured to fit into a norm,” she adds, “it’s important that we understand this happened to us. Generations before us have passed down messaging—without the intention necessarily of causing harm—that reinforced these ideas of the standard of beauty. Then every other outlet we’re exposed to just perpetuates them.”

To start minimizing the societal pressure you face, think critically about the media you consume. According to Rotach, when you see a new look or body type trending online, consider the content creator’s objective (is it to sell waist trainers or supplements, or is it to make you feel good about yourself?), who’s sponsoring the content, and, if it’s promoting a certain body descriptor, what the term’s origins and meaning actually are. Taking a few extra moments to unpack the videos or photos you’re viewing can help minimize your susceptibility to their toxic messaging.

Then, take charge of your feed. If you see a post encouraging the snatched look or another body standard that makes you uncomfortable, block it from your algorithm, suggests Rotach. (Instagram, for instance, has a “not interested” button on suggested posts that will hide related content from your feed. That said, don’t be afraid to report harmful content.) “When you say no to that enough, [the websites] kind of stop trying,” she says. You can’t necessarily stop seeing magazines at grocery story checkouts or driving by a billboard, Rotach adds, but in terms of social media, you can tell the algorithm, “This isn’t what I want to see.”

After blocking the posts that make you bad about your appearance, that things a step further in a positive direction by following the individuals who look like you and the communities that give you a sense of belonging and boost your self-confidence, says Rotach. “If you only ever see people with thin bodies as the object of desire and affection, it can be hard to imagine that anyone who doesn’t look like that could have those things,” adds Friedman. “And make sure that your social media feeds do not exclusively feature influencers who are talking about how little they eat and how much they exercise—that is often really, really harmful to people.”

While making these changes to your internet use can be valuable, they may not fully heal your relationship with your body. That’s why it’s important to chat with a mental health professional if you notice that what you eat, how you move, or what you look like are taking up a big chunk of your brain space, advises Friedman. “If these concerns are feeling overwhelming, then it’s important to make sure that you’re talking to someone about it because it can grow in the darkness,” she says. “We know eating disorders, in particular, thrive in secrecy. And so the more guilt and shame, or the more distance that a person feels from their life and their loved ones, the more that these mental health concerns can amplify.”

Everyone simply wants to feel as though they belong—but restricting eating habits, increasing physical activity, or having surgical intervention can be mentally and physically harmful paths to achieving that end. “If we offer people other ways to feel belonging, they won’t need those harmful or eating disorder-like behaviors,” says Rotach. “[Attaining] this snatched beauty standard, which very few of us were ever supposed to use to describe ourselves…that’s a never-ending pit.”

But what do they do, and are they actually effective? A new systematic review of the research on massage guns may hold some answers.

How massage guns work

“These ‘massage guns’ are a form of what’s called percussive treatment, which delivers mechanical vibration—in this case the head of the massage gun delivering repeated contacts—to muscles or tendons,” says physical therapist Andy Barr, DPT

If you’ve ever had a massage where the masseuse uses a cupped hand technique with quick, repeated contacts (this is called “tapotement massage”), it’s the same principle. You may be surprised to learn that percussive treatment delivered through an instrument was first invented in the 1950s!

Dr. Barr, who works with elite athletes and has been in the professional sports health and performance space for over 25 years, has recently seen a stark increase in the use of massage guns.

“Whether it’s for player recovery or if it’s for performance—to complement a warm-up prior to the game or keep players ‘warm’ while they’re resting—many teams and players use these massage guns constantly. The continued development and portability of the tool have made it even easier to use.”

The latter point has made the use of massage guns viable for large swaths of the population as well: The yearly revenue on massage guns is reportedly over 550 million dollars and growing.

Should you use one? It depends on your goals

The research on the effectiveness of massage guns up to this point had been relatively mixed, but that tends to be the case with any new device. However, there was a new high-quality systematic review released that reviewed multiple studies looking at the impact of massage guns on pain and athletic performance.

The results were quite interesting across multiple domains. The systematic review—which looked at 13 different papers—found that use of a massage gun resulted in improving multiple aspects of athletic performance along with recovery as well.

Specifically, a single use of a massage gun resulted in increasing muscle strength (particularly in the upper body) and increasing explosive muscle strength (think fast, powerful movements like sprinting). With multiple and consistent uses of a massage gun, the study found that muscular pain can be reduced as well, especially for decreasing delayed onset muscle soreness (DOMS) 48 hours after challenging workouts.

Interestingly, the study further found that the use of a massage gun had no overt change on flexibility. But the majority of studies that found a decrease in pain also found an improvement in flexibility, so there may be some nebulous connection there!

Based on this new, promising evidence, how should you be using a massage gun to optimize your recovery and athletic performance? For recovery and reducing pain, use the massage gun consistently after exercise and/or athletic competitions, up to 72 hours post activity. For athletic performance, use the massage gun immediately prior to the activity, whether it’s strength training or athletic activities.

Bear in mind: If flexibility is your main objective, a massage gun isn’t the best use of your time. The best research-driven method there continues to be dynamic stretching and eccentric strength training.

On the day of my appointment, I waddled into the maternity ward in no hurry and with no incident. I was given Misoprostol, to “ripen” my cervix. Later, I had a Foley balloon inserted to help dilation and I got an IV to administer Pitocin, a hormone that causes uterine contractions. After 12 hours, six loops of my labor playlist, one last-minute epidural, and maybe a little swearing, I was holding my happy, healthy baby girl. I gave the whole experience an A-plus.

So, when I was pregnant with my second, I started planning for another induction. But by then, I’d made a wealth of mom friends, and when I mentioned my plan, their reactions were mixed.

Some raved about their own elective inductions, saying it was a safe way to get peace of mind about where and when they delivered. Plus, they talked about how inductions helped avoid fetal risks that are more common later in pregnancy.

Others couldn’t believe I would sign up to be induced. One said that the process increased the chances of a caesarian section, while another said her induction was much more painful than her other births. “Why not just let the baby come when she’s ready?” my friend asked with a shrug. “She’ll know when it’s time.”

I wasn’t sure what to do. My first induction went smoothly, but after hearing horror stories from other moms, I wondered if I’d just been lucky.

Why inductions get a bad rap

The truth is, inductions have had a bad reputation for years. For one thing, my friend’s claim that induction caused higher rates of c-sections was a widely accepted theory for decades. Research from the 1970s, and even into 1999 and 2000, seemed to connect induction with the invasive surgery. However, a 2013 study found that the previous research failed to account for birth complications. Inductions, it turns out, actually help avoid c-sections.

Another long-standing concern is that induction could affect the health of the baby. While many people are pregnant for 40 or 41 weeks, elective inductions are widely available starting at 39 weeks gestation, which is considered full-term. However, some worry that not giving the fetus those extra days, or weeks, in the womb could be detrimental to its health.

But the often-cited ARRIVE trial, which was published by the New England Journal of Medicine in 2018, found that delivery at 39 weeks did not increase complications for babies. In fact, letting a pregnancy go into post-term (42 weeks or later) is associated with a number of risks for the fetus, including stillbirth, meconium aspiration (when the fetus has their first bowel movement while in the womb and ingests it), and decreased amniotic fluid (which can lead to a restricted flow of oxygen to the fetus).

Obstetrician Lauren Beaven, MD, FACOG, of Axia Women’s Health in Lexington, Kentucky, explains, “Fetuses at 39 weeks have reached maximum development of their lungs and brains, meaning that waiting until 40 weeks or after does not improve newborn respiratory capability, feeding, or temperature control. Babies born electively at 39 weeks have developed to their full potential and past 40 weeks this does not improve any further.”

She notes that risks increase for babies born before 39 weeks but explains that elective inductions shouldn’t be performed before that point anyway. Any induction performed before full term would only be done out of medical necessity. “We expect that respiratory temperature and feeding behaviors may be less developed in those [premature] babies, but the benefit of delivering them due to medical complications of the pregnancy outweighs those risks,” she says.

Another common worry is that inductions make labor more painful. However, in one study, parents who were induced reported less pain during labor and claimed they felt “more perceived control during childbirth.”

The real risks of inducing labor

There are some rare risks to induction. For one thing, it doesn’t always work, which could mean another induction or even a c-section. Some methods of induction can increase the risk of infection. Plus, induction increases the risk that the uterine muscles won’t properly contract after birth, which could lead to heavy bleeding after delivery.

Sometimes Pitocin, which is often given during induction, can cause the fetal heart rate to drop, though Dr. Beaven shares that this can also happen during spontaneous labor. “If this occurs with Pitocin, the medication can be turned off and there are methods that are used immediately to try to bring the baby’s heart rate back to normal,” she explains.

Figuring out what’s right for your birth plan

Even with these risks in mind, I felt sure that another induction would be safe, and even beneficial. But I wondered if it was truly my preference. Lots of parents talk about the convenience of going through the early stages of labor at home. And because I didn’t want to leave my clingy toddler with grandparents for days and days, I even considered a home birth.

Tara Kenny, a certified professional midwife, certified lactation counselor, and doula based in Boston, acknowledges that there are many benefits to inductions. However, she doesn’t want pregnant people to feel unnecessarily pressured to induce.

“The ARRIVE trial has kind of tipped a lot of providers into the camp of ‘let’s induce people earlier’ because they tend to have fewer complications,” she says. “But I don’t think it’s fair or appropriate to say that to every pregnant person. I think that it should be more of an informed choice.”

Kenny adds that while a medically-indicated induction can be life-saving for those who need it, she hopes pregnant people know that most people who wait for spontaneous labor have perfectly healthy births. “I think that we’re losing sight of the fact that, statistically speaking, it’s normal to be pregnant up until 41 weeks and a few days,” she says.

She adds that while studies show that induction can provide a safer birth experience for the parent and baby, the statistical differences are marginal. One study published in the New England Journal of Medicine in 2016 revealed that the women who were induced had 3 percent fewer c-sections than those who weren’t. So, while inducing may benefit some, it’s not a cure-all.

“I think as a midwife, it is our responsibility to present all the information and ultimately let the patients be the one to decide,” Kenny says.

“It is our responsibility to present all the information and ultimately let the patients be the one to decide.” —Midwife Tara Kenny

Physician William Grobman, MD, MBA, the lead researcher on the 2018 article “Labor Induction versus Expectant Management in Low-Risk Nulliparous Women,” echoes Kenny’s claim that, with the margin being so small, it should be about the pregnant person’s preference. “I feel very strongly that people should have the option to induce or not induce and that this should be a person-centered decision,” he states.

When it came to delivering my second daughter, I didn’t have a chance to decide on induction or not. At 37 weeks I was diagnosed with preeclampsia, a potentially life-threatening condition that causes high blood pressure during pregnancy and is remedied by giving birth. My induction was started within the hour. Once again, I was administered Misoprostol, I had a Foley balloon, and got Pitocin. The induction methods were the same, but this time, labor seemed much harder and lasted twice as long. My epidural fell out twice and I spent the whole time nervous about my blood pressure. But all turned out well, and in the end, I got to hold my new baby girl. I give it an A-plus.

“Gender-affirming care is the steps one takes in order to affirm who they are and feel a better sense of belonging in their bodies and in this world, and it can encompass a variety of things,” says transgender athlete and activist Chris Mosier. Exactly how gender-affirming care looks is different for everyone, but there are two main components: social transitioning and medical transitioning—and they’re under attack by lawmakers, particularly for minors, he says.

In just the last few years, 20 states have passed laws or policies banning or restricting access to gender-affirming care for youth. Montana, Idaho, Utah, North Dakota, South Dakota, Texas, Iowa, Missouri, Indiana, Kentucky, Tennessee, and Mississippi have passed full bans. West Virginia, Arizona, Nebraska, and Georgia have passed partial bans. And in Alabama, Arkansas, Oklahoma, and Florida, laws banning or restricting access to gender-affirming youth have passed but are being temporarily blocked (in some cases partially) by legal challenges. Seven other states—Oregon, Wisconsin, Michigan, Ohio, New Hampshire, North Carolina, and South Carolina—are considering or have considered similar laws banning access to gender-affirming care for youth. Some states, such as Florida and Missouri, are also introducing restrictions that would regulate access to gender-affirming care for adults.

Socially rooted gender-affirming care might include emotional or community support around non-medical transitions, like name or pronoun changes and non-permanent shifts in appearance, like haircuts or clothing style. And these are the forms of care that most trans young people seek, says Mosier of social gender-affirming care: “It’s about allowing people to dress how they want and to use the names and pronouns that affirm who they are.”

Access to gender-affirming care is an essential right that must be protected in order to ensure that trans and non-binary people are able to live healthy lives.

In other words, the bulk of care for young people involves non-permanent changes. And while current anti-trans legislation mostly takes aim at medical gender-affirming care, Mosier says such attacks can make social transitioning, or accessing care around social transitioning, feel less safe.

Gender-affirming care—medical and social—is safe and beneficial to the mental health of trans and non-binary individuals. Limiting or eliminating its availability jeopardizes the well-being of the person seeking it—not the person aiming to restrict it. Access to gender-affirming care must be protected in order to ensure that trans and non-binary people are able to live healthy lives.

The positive power of the gender-affirming care that’s under attack

Medical gender-affirming care mainly includes treatments such as puberty blockers and gender-affirming hormone therapies. Puberty blockers buy young people more time to decide how they want to proceed with their care by delaying the onset of puberty, says Kate Steinle, nurse practitioner and Chief Clinical Officer at FOLX Health—a digital health-care service for the LGBTQ+ community. Hormone treatments are then the next step, or potentially the first medical step for an individual who has already been through puberty, in transitioning.

“Someone who was assigned male at birth might take estrogen or a testosterone blocker for their care, and that would be for their lifetime,” says Steinle. “Those medications are going to help that person become less gender dysphoric, to be able to see their body or their voice or whatever parts they might have dysphoria about come into alignment with their gender identity.”

According to Steinle, puberty blockers and other hormone-based medications are prescribed in the same way any other medication is prescribed: following a clinical diagnosis, lab work, and all other standard protocols. (That said, the Food and Drug Administration (FDA) has only approved puberty blockers to treat precocious (or early) puberty, and its efficacy as gender-affirming care is an off-label use.)

There are also many steps in the transition process before such medications are even introduced. “Young people are working closely with parents and health-care providers and mental health-care providers to determine what sort of changes to make at any given time that are age appropriate and in the best interest of that young person,” says Mosier.

Treatment for minors only rarely involves surgery and that’s a step only taken after many years of professional medical evaluation, says Kate Steinle, nurse practitioner and Chief Clinical Officer at FOLX Health.

Despite disinformation to the contrary, treatment for minors only rarely involves surgery and, says Steinle, that’s a step only taken after many years of professional medical evaluation. (And certainly, no one is operating on very young children, as some would suggest.) An analysis of insurance claims in the United States conducted by Reuters and health technology company Komodo Health Inc last year found that just 56 individuals between the ages of 13 and 17 with a prior diagnosis of gender dysphoria underwent genital surgery between 2019 and 2021. Top surgery for teenagers is more common but still statistically rare, according to the analysis. (That said, the study authors acknowledge it may be an undercount because the number doesn’t include procedures paid for out of pocket). In that same three-year time span, 776 mastectomies were performed on individuals in the same demographic.

Many of the proposed bills banning gender-affirming surgery for trans youth include exemptions for intersex children, too, which is further evidence of a bias against transgender and non-binary individuals. Intersex surgeries are performed on infants and children, who have sex organs or characteristics that don’t neatly fit into a biological male or female binary in order to align the child’s genitalia more closely with one gender or the other. These children are often too young to consent, and by exempting intersex surgeries from these bills, lawmakers are further demonstrating that their stated intent—to protect children–is a bad-faith argument

And while it’s true that some percentage of those who receive gender-affirming surgery may eventually come to regret it, such regret is extremely rare. “This discourse is just a scare tactic,” says Steinle. “In any surgery, there’s going to be a small percentage of people with regrets.” And if this were truly the concern, Steinle says these bills would also be banning cosmetic surgery for cisgender minors.

What science says about the safety of medical gender-affirming care

Puberty blockers have been prescribed to cisgender children with precocious (early) puberty for decades. “These are medications that have been used over time and have been proven safe and effective,” says Mosier, who adds that numerous studies have examined the mental health impact of gender-affirming care on trans youth, and results have landed in overwhelming favor of the treatments.

Trans youth have high rates of depression, anxiety, and suicidality, and gender-affirming care has been shown to help. “Existing evidence suggests that gender-affirming medical care has favorable mental health outcomes for young people,” says Mosier.

“We can see through study after study that when people do not have access to gender-affirming hormones, mental health issues skyrocket.” —Steinle

And on the flip side, there’s significant evidence to support that harm is done by limiting access. “We can see through study after study that when people do not have access to gender-affirming hormones, mental health issues skyrocket,” says Steinle. “Depression and anxiety and suicidality are extremely high risks when people do not have access to care.”

Because of this evidence, an overwhelming number of major medical organizations—the American Academy of Pediatrics, the American Medical Association, the American Psychological Association, and more—support access to gender-affirming care. “It’s so clear to people who have worked in this field for a long time that this is a safe and effective treatment for people who are trans or non-binary,” says Steinle.

Where the legislation may be headed—and how to help

While the bulk of bans on gender-affirming care are, at this point, focused on access to gender-affirming care for minors, some are targeting access for adults as well. In fact, Steinle says the law that was just temporarily and narrowly blocked in Florida, SB 254, included regulations around gender-affirming care access for adults. “Specifically, [the law said] the only people who could prescribe gender-affirming care for adults were MDs or DOs, and so any of the nurse practitioners or physician’s assistants who were already caring for a lot of these patients could no longer care for them,” she says. The law also stipulated that patients see these doctors to sign informed consent forms in person, which Steinle says could be another barrier to care for those who live in care deserts or otherwise rely on telehealth services.

Mosier and Steinle see this law as a possible test case for many coming attempts to regulate access to gender-affirming care for adults. “The easiest idea to rally people around is, ‘Protect the children,’ but they won’t stop there,” says Steinle. “They want to politically and culturally eradicate trans people. It’s very clear in the language that they use that the only acceptable way to be is to be cis.”

“We are moving toward a reality where if you’re not a straight, white, cisgender person of a certain socio-economic bracket, your rights are at risk.” —Chris Mosier, transgender athlete and activist

These attempts at limiting freedoms should be troubling to everyone, says Mosier—not just members of and allies to the LGBGQIA+ community. “The attacks on the trans community are deeply related to the attacks on bodily autonomy for people who can become pregnant, and the attacks on Black and brown individuals in our country who, when we layer in the intersections of identity, are disproportionately impacted by these bills and laws,” says Mosier. “All the things we’re seeing happening in this country—abortion rights and voting rights and redistricting and voter suppression—are moving toward a reality where if you’re not a straight, white, cisgender person of a certain socio-economic bracket, your rights are at risk.”

The first thing you can do to help is educate yourself. “There’s a real lack of understanding around transgender and non-binary people in general, from basic terminology and concepts all the way up to what our care is, what being in sports is like for us, and so on,” Mosier says. “This is a much more nuanced conversation than can be conveyed in a headline or tweet, and it needs to be—because we’re talking about people’s humanity.”

With regard to that self-education, Mosier concedes that it can be hard to know where to turn for accurate intel. Steinle recommends the library at FOLX as a resource, and both she and Mosier say the best sources of information more generally are the people who work and live in this space—trans and non-binary people themselves, and the clinicians who provide them with care.

Once you’ve begun the ongoing process of educating yourself, Mosier says it’s important to speak up, whether that means helping to inform friends and family or publicly speaking out against disinformation, myths, and lies around gender-affirming care and other trans-rights issues.

Steinle says that those with financial resources can also donate to the FOLX HRT Care Fund, which gifts grants for free care—e.g. medications and clinical care—through FOLX for those in need.

If you don’t have financial resources to spare, Steinle points out that there is something far more simple, and equally impactful, to be done: Reach out to those in the LGBTQIA+ community to show your support. “This is a scary time for people, so it’s important for individuals to reach out to their friends or family members who are in the LGBTQ community to show them they’re loved, they’re important, they’re amazing and beautiful regardless of all the crazy loud political theater saying otherwise,” she says. “We have to remember to offset that language with language of acceptance and love.”

“Having good oral health is imperative for our physical and psychological well-being,” says Dani Benyaminy, DDS, a cosmetic dentist based in Los Angeles. “Nonetheless, most folks fail to realize how important oral health is until there is a major issue that forces them to rethink their routines.” Such issues include but aren’t limited to enamel erosion, tooth decay, gum disease, discoloration, and bad breath. Arguably, the lot of us wouldn’t prefer to wait to course-correct after any of these scenarios come into play, which is why Dr. Benyaminy encourages us to be more proactive to support oral health.

One simple tip we can enact from this day forward takes only a few seconds but can make a major difference in the long run: rinsing after drinking highly acidic beverages. Ahead, see how a quick post-sip swish can save your smile, plus which drinks have the potential to be the biggest offenders.

Why you should rinse your mouth after drinking acidic beverages

Dr. Benyaminy says that overexposure to highly acidic drinks increases the risk of enamel erosion. (As a friendly reminder, enamel is the outer protective layer of your teeth.) “Enamel erosion increases the risk for decay, sensitivity, staining, and in some cases increased tooth wear and/or fracture,” he explains. Again, not a single one of these scenarios is ideal to address after the fact, which is why taking greater care of our oral health via protective daily habits is crucial. “The truth is that you can have the dental health of your dreams if you are willing to do the work to make it happen,” Dr. Benyaminy says.

Enter: making it habitual to head to the sink for a quick swish-and-spit after sipping on acidic bevs. “This helps to neutralize the acid by bringing the pH levels inside your mouth up,” says Dr. Benyaminy. (Another friendly reminder for those of us, myself included, who weren’t the strongest students in high school chemistry: “A neutral pH is considered to be seven. Anything that lowers that value is considered to be acidic,” he explains.)

Acidity aside, some of these beverages contain added sugar, which amplifies the risk of damage to your teeth. “Bacteria in the mouth feed off the sugar and create an acidic byproduct that further increases the risk for erosion and decay,” Dr. Benyaminy shares.

4 highly acidic drinks that can lead to enamel erosion

1. Soda with added sugar

It’s no surprise that sugary sodas aren’t great for your health at large—and this fact extends to oral health, too. Dr. Benyaminy says that they’re amongst the most highly acidic beverages around, with a pH level around 2.5 to 3.5. When consumed regularly and consistently, these carbonated drinks “erode tooth enamel over time, increase the risk of cavities, and cause noticeable staining due to the combination of acids and sugars,” he says.

2. Fruit juices

Dr. Benyaminy notes that store-bought fruit juices also aren’t stellar for oral health, again due to their high acidity and sugar content. He calls out apple juice (with pH levels ranging from 3.0 to 4.0) and orange juice (with pH levels ranging from 3.3 to 4.2) in particular. Despite the nutritional benefits of each—such as their antioxidant content and ability to count towards your daily fruit intake, if they are, in fact, 100 percent fruit juice—you’ll still want to be mindful of your intake. “They can contribute to tooth erosion and enamel damage if consumed regularly and in large quantities,” the dentist notes.

3. Coffee

As *amazing* as coffee is (IMHO) for its taste, antioxidant profile, and of course the energetic boost it provides, it’s less of an all-star in the dental department. Yes, it has the ability to stain your teeth—and it’s also pretty acidic depending on which brew you choose. “Coffee generally has a pH of 5-5.5,” says Dr. Benyaminy. However, he continues to say that cold brew tends to be less acidic due to the extraction process. Whether oral health, digestive upset, or both concern you, you may want to opt for the cold stuff. You can also purchase low-acid coffee or rely on creamer, extra water, or even baking soda to tamper down acidity.

4. Sparkling water

While sparkling water has many merits—including but not limited its ability to hydrate you as much as plain H2O will—they, too, should be followed up with a quick rinse. “Sparkling water is a great alternative to regular sodas. However, it is still acidic,” Dr. Benyaminy explains. He also notes that those with added flavors tend to be more acidic than others.

Final tips

While you don’t need to restrict these acidic drinks completely, rinsing after consuming them can protect your enamel and teeth more efficiently in the long-term. In addition, Dr. Benyaminy suggests using a straw, when possible, to bypass the fluids’ direct exposure to your teeth.

He also advises against prolonged sipping. “The longer your teeth are exposed to the acidic drink, the more detrimental it is,” Dr. Benyaminy concludes.

What is teeth sensitivity?

A big player in tooth sensitivity is gum recession, which happens when your gums have pulled away from your tooth, exposing your root surface, explains Whitney DiFoggio, BS, RDH, better known as Teeth Talk Girl. “When your root surface is exposed, the dentin tubules on your tooth (similar to the pores on your face) are open, so they feel extra sensations when touched by a typically cold stimulus.”

Each of the tiny pore-like tubules house small nerve endings that run through the different layers of the tooth. When something stimulates them, it causes an uncomfortable sensation.

“Beyond gum recession, enamel erosion, orthodontics, large fillings, new crowns, and even teeth whitening, can also cause sensitivity,” adds the registered dental hygienist. Fortunately, it’s generally something that comes and goes, and rarely lingers or lasts a long time.

Why are our teeth more sensitive in summer?

Summer months can trigger sensitive teeth simply based on what we typically eat and drink— ice cream, popsicles, cold drinks, and all those delicious cool treats we don’t have as often when temps are lower.

“In addition, dehydration is more likely to occur in the summer, which means less saliva, leading to higher chances of bacteria overgrowth,” says DiFoggio.

And beyond our daily food and beverage consumption, many of us add routines like whitening our teeth for that “perfect summer smile,” particularly since it’s the season of weddings, graduations, and Instagram-worthy vacations. This can play a big role in sensitivity too.

Dealing with tooth sensitivity? Here are 3 ways to combat it

Scale back teeth whitening and cold food and drinks

37 million Americans used teeth whiteners in 2020, according to Statista. And the trend is set to continue with the cosmetic tooth bleaching market expected to increase by $941 million from 2021 to 2026.

Beyond limiting cold food and drink consumption, DiFoggio encourages teeth whitening fans to cut it down and perhaps even ask their dental provider for a different concentration of whitening products if they’re feeling increased sensitivity. “Whether you have gum recession or not, be sure to scale back or stop using any type of whitening products, including whitening toothpaste, as it only makes your teeth more sensitive,” she warns.

Use sensitivity-relief products

Saying no to that delicious gelato scoop on a hot summer’s day can be hard, so using sensitivity-relief toothpaste and products may help. “These toothpastes work by clogging the dentin tubules,” says DiFoggio.

How do you know if it will actually work? She suggests looking for the working ingredients of stannous fluoride and potassium nitrate when purchasing products that say they help with sensitivity. “I always tell my patients to make sure they have at least one of those ingredients, and that they don’t contain whitening additives like peroxide,” DiFoggio says.

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Request a flouride treatment

So you’ve cut out cold food and beverages, and switched from whitening to sensitivity-friendly products. If you’re still experiencing pain, it may be time to book an appointment with your dental office.

“Some dentists offer fluoride varnish treatments that can provide months of sensitivity relief, and they can also prescribe a prescription-strength toothpaste,” says DiFoggio.

But most importantly, booking that appointment will help rule out anything else that might be causing your pain. “Sensitivity is typically caused by gum recession,” she says, “but checking in with your dentist will is the best way to ensure it’s nothing more serious.”

I haven’t always been fat. Sure, I’ve always been a larger gal with bigger shoulders, wider hips, bigger boobs. But I entered my fat era maybe in my late 20s, and have only more fully engaged it as I’ve flown through my 30s.

My ex made me feel terrible about my body at every turn for almost a decade. My grandmother used to comment on things not fitting properly—including a prom dress that I was in love with. Trainers will often recommend “lifestyle changes” even though I’m working with them to get strong, not to lose weight.

No matter what they all might think, I am dedicated to taking care of my body. My mother taught me the importance of preventative care, annual physicals, and having a good relationship with your primary care physician (PCP). Yet my adult life has been a series of disappointing interactions with doctors and healthcare professionals who would suggest weight loss for an earache or sciatica, rather than observing my actual symptoms and treating them. Fat was the problem, and weight loss the answer—always. I’ve been on so many diets, from WW to FODMAP elimination, and even some weight loss meds back in the day. Many of these were doctor-recommended, either explicitly (with a prescription) or suggested as a way to lose pounds.

When my last PCP referred me to a gynecologist for polycystic ovary syndrome even though I had no symptoms besides some missed periods and being what the BMI deems “overweight,” I knew I had to find a new healthcare provider. So I asked a family friend who’s an amazing nurse practitioner if she could suggest someone who might be a better fit.

Even with her recommendation, entering your office was another exercise in anxiety—which was, thankfully, immediately put to rest.

Dinah, everything about my visits with you are based on how I feel, what my concerns are, and how to address them. There is no shame or blame. You treat my symptoms and look for underlying causes. Weight loss is not the cure-all. In fact, we don’t talk about weight unless I want to. You have made sure to refer me to specialists who will treat me similarly, or warn me if I should expect they aren’t weight-neutral.

It is hard for fat people to seek medical care because we know we often will be ridiculed or pathologized just for being in the bodies we have. But in your office we talk about my GI issues as a point of information, not an indicator of an unhealthy lifestyle. I told you about my love of running and you suggested podcasts to help merge my need for mindfulness with my training schedule. You have shown up for me as a healthcare provider in the way we all deserve, putting my needs and concerns at the center, with a laser focus on my health—not my weight.

I am so lucky to have found you (and my therapist Sarina, and psychiatric nurse Rebecca, and nutritionist Anita) to help me learn that I deserve and demand respect from my healthcare providers. I am so grateful for you. And Dinah/Sarina/Rebecca/Anita, I hope everyone in your profession looks to you as exemplars of what helping is. It is human-centered, it is compassionate, it is weight-neutral, it is full of joy and, most of all, care.

Love,
Emilia