You can get sick with diarrhea if you swallow contaminated recreational water—water in pools, hot tubs, water playgrounds, or oceans, lakes, and rivers. In fact, diarrhea is the most common illness reported for outbreaks linked to recreational water.
These germs can survive in properly chlorinated water for minutes to days, depending on the germ.
How do germs that cause diarrhea spread in recreational water?
If someone is sick and has diarrhea in the water, millions of germs can contaminate the water. These germs can make other people sick if they swallow even a small amount of contaminated water. Swallowing 10 or fewer germs can make people sick. Germs can also get in the water if swimmers have poop, even tiny amounts, on their bottoms.
Pool chemicals and filters help kill germs
Filters and disinfectants (chemicals that disinfect the water, such as chlorine or bromine) work together to help kill germs in pools, hot tubs, and water playgrounds. Filters remove debris (such as leaves), which use up the disinfectant in the water. Pool staff make sure chlorine or bromine is at the level needed to kill most germs in the water within minutes. You can still be exposed to germs during the time it takes for the water to go through filters and for the disinfectant to kill germs. You can also get diarrhea from germs that are hard to kill, such as Crypto. Crypto stays alive for more than 7 days, even if water is properly filtered and disinfected.
Many places with pools use one filtration system for more than one pool, which causes water from multiple pools to mix. This means germs from one person’s body could contaminate the water in more than one pool.
How do I protect myself and those I care about?
We all share the water we swim, play, or relax in. Each of us can help protect ourselves, our families, and our friends from germs that can cause diarrhea.
Take the following steps when swimming in any type of water:
Stay out of the water if you are sick with diarrhea.
If you have Crypto, don’t go in the water until 2 weeks after diarrhea has completely stopped.
Don’t poop in the water.
Don’t swallow the water.
Take kids on bathroom breaks and check diapers every hour.
Change diapers away from the water’s edge to keep germs from getting in the water. Wash your hands after.
Before going in pools, water playgrounds, and hot tubs, also take these steps:
Use test strips to make sure the water has proper free chlorine (amount of chlorine available to kill germs) or bromine level and pH.
Free chlorine level: at least 1 part per million (ppm) in pools and water playgrounds and at least 3 ppm in hot tubs
Bromine level: at least 3 ppm in pools and water playgrounds and at least 4 ppm in hot tubs
pH (affects how well chlorine and bromine can kill germs): 7.2–7.8
Most superstores, hardware stores, and pool supply stores sell test strips. Follow the directions on the test strip package.
Shower before you get in the water.
A 1-minute shower removes most of the dirt, sweat, and oils on your body that use up chlorine or bromine needed to kill germs.
Follow these and other healthy swimming steps to help protect you and those you care about from getting sick.
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Social isolation was associated with about a 50% increased risk of dementia and other serious medical conditions.
Loneliness and social isolation in older adults are serious public health risks affecting a significant number of people in the United States and putting them at risk for dementia and other serious medical conditions.
A report from the National Academies of Sciences, Engineering, and Medicine (NASEM) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated.1 Older adults are at increased risk for loneliness and social isolation because they are more likely to face factors such as living alone, the loss of family or friends, chronic illness, and hearing loss.
Loneliness is the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.
Health Risks of Loneliness
Although it’s hard to measure social isolation and loneliness precisely, there is strong evidence that many adults aged 50 and older are socially isolated or lonely in ways that put their health at risk. Recent studies found that:
Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.1
Social isolation was associated with about a 50% percent increased risk of dementia.1
Poor social relationships (characterized by social isolation or loneliness) was associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.1
Loneliness was associated with higher rates of depression, anxiety, and suicide.
Loneliness among heart failure patients was associated with a nearly 4 times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.
Immigrant, LGBT People Are at Higher Risk
The report highlights loneliness among vulnerable older adults, including immigrants; lesbian, gay, bisexual, and transgender (LGBT) populations; minorities; and victims of elder abuse. It also points out that the literature base for these populations is sparse and more research is needed to determine risks, impacts, and appropriate actions needed.
Current research suggests that immigrant, and lesbian, gay, bisexual populations experience loneliness more often than other groups. Latino immigrants, for example, “have fewer social ties and lower levels of social integration than US-born Latinos.” First-generation immigrants experience stressors that can increase their social isolation, such as language barriers, differences in community, family dynamics, and new relationships that lack depth or history, the report states. Similarly, gay, lesbian, and bisexual populations tend to have more loneliness than their heterosexual peers because of stigma, discrimination, and barriers to care.
What Can You Do If You Are Experiencing Loneliness?
Your doctor can assess your risk for loneliness and social isolation and get you connected to community resources for help, if needed. The following national organizations also offer helpful resources:
AARP—Provides helpful information to seniors to help improve quality of life and provides access to Community Connection Tools.
Area Agencies on Aging (AAA)—A network of over 620 organizations across America that provides information and assistance with programs including nutrition and meal programs (counseling and home-delivered or group meals), caregiver support, and more. The website can help you find your local AAA, which may provide classes in Tai Chi and diabetes self-management.
Eldercare Locator—A free national service that helps find local resources for seniors such as financial support, caregiving services, and transportation. It includes a brochure that shows how volunteering can help keep you socially connected.
National Council on Aging—Works with nonprofit organizations, governments, and businesses to provide community programs and services. This is the place to find what senior programs are available to assist with healthy aging and financial security, including the Aging Mastery Program® that is shown to increase social connectedness and healthy eating habits.
National Institute on Aging (NIA)– Provides materials on social isolation and loneliness for older adults, caregivers, and health care providers. Materials include health information, a print publication available to view or order no-cost paper copies, a health care provider flyer, and social media graphics and posts.
Health Care System Interventions Are Key
People generally are social by nature, and high-quality social relationships can help them live longer, healthier lives. Health care systems are an important, yet underused, partner in identifying loneliness and preventing medical conditions associated with loneliness.
Nearly all adults aged 50 or older interact with the health care system in some way. For those without social connections, a doctor’s appointment or visit from a home health nurse may be one of the few face-to-face encounters they have. This represents a unique opportunity for clinicians to identify people at risk for loneliness or social isolation.
NASEM recommends that clinicians periodically assess patients who may be at risk and connect them to community resources for help. In clinical settings, NASEM recommends using the Berkman-Syme Social Network Index (for measuring social isolation) and the three-item UCLA Loneliness Scale (for measuring loneliness).
But patients must make their own decisions. Some people may like being alone. It is also important to note that social isolation and loneliness are two distinct aspects of social relationships, and they are not significantly linked. Both can put health at risk, however.
Old lonely woman sitting near the window in his house with flowers
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It’s important to keep your blood sugar levels in your target range as much as possible to help prevent or delay long-term, serious health problems, such as heart disease, vision loss, and kidney disease. Staying in your target range can also help improve your energy and mood. Find answers below to common questions about blood sugar for people with diabetes.
Use a blood sugar meter (also called a glucometer) or a continuous glucose monitor (CGM) to check your blood sugar. A blood sugar meter measures the amount of sugar in a small sample of blood, usually from your fingertip. A CGM uses a sensor inserted under the skin to measure your blood sugar every few minutes. If you use a CGM, you’ll still need to test daily with a blood sugar meter to make sure your CGM readings are accurate.
When should I check my blood sugar?
How often you check your blood sugar depends on the type of diabetes you have and if you take any diabetes medicines.
Typical times to check your blood sugar include:
When you first wake up, before you eat or drink anything.
Before a meal.
Two hours after a meal.
At bedtime.
If you have type 1 diabetes, have type 2 diabetes and take insulin, or often have low blood sugar, your doctor may want you to check your blood sugar more often, such as before and after you’re physically active.
What are blood sugar targets?
A blood sugar target is the range you try to reach as much as possible. These are typical targets:
Before a meal: 80 to 130 mg/dL.
Two hours after the start of a meal: Less than 180 mg/dL.
Your blood sugar targets may be different depending on your age, any additional health problems you have, and other factors. Be sure to talk to your health care team about which targets are best for you.
What causes low blood sugar?
Low blood sugar (also called hypoglycemia) has many causes, including missing a meal, taking too much insulin, taking other diabetes medicines, exercising more than normal, and drinking alcohol. Blood sugar below 70 mg/dL is considered low.
Signs of low blood sugar are different for everyone. Common symptoms include:
Shaking.
Sweating.
Nervousness or anxiety.
Irritability or confusion.
Dizziness.
Hunger.
Know what your individual symptoms are so you can catch low blood sugar early and treat it. If you think you may have low blood sugar, check it even if you don’t have symptoms. Low blood sugar can be dangerous and should be treated as soon as possible.
How can I treat low blood sugar?
If you’ve had low blood sugar without feeling or noticing symptoms (hypoglycemia unawareness), you may need to check your blood sugar more often to see if it’s low and treat it. Driving with low blood sugar can be dangerous, so be sure to check your blood sugar before you get behind the wheel.
Carry supplies for treating low blood sugar with you. If you feel shaky, sweaty, or very hungry or have other symptoms, check your blood sugar. Even if you don’t have symptoms but think you may have low blood sugar, check it. If your blood sugar is lower than 70 mg/dL, do one of the following immediately:
Take four glucose tablets.
Drink four ounces of fruit juice.
Drink four ounces of regular soda, not diet soda.
Eat four pieces of hard candy.
Wait for 15 minutes and then check your blood sugar again. Do one of the above treatments again until your blood sugar is 70 mg/dL or above and eat a snack if your next meal is an hour or more away. If you have problems with low blood sugar, ask your doctor if your treatment plan needs to be changed.
What causes blood sugar to be high?
Many things can cause high blood sugar (hyperglycemia), including being sick, being stressed, eating more than planned, and not giving yourself enough insulin. Over time, high blood sugar can lead to long-term, serious health problems. Symptoms of high blood sugar include:
Feeling very tired.
Feeing thirsty.
Having blurry vision.
Needing to urinate (pee) more often.
If you get sick, your blood sugar can be hard to manage. You may not be able to eat or drink as much as usual, which can affect blood sugar levels. If you’re ill and your blood sugar is 240 mg/dL or above, use an over-the-counter ketone test kit to check your urine for ketones and call your doctor if your ketones are high. High ketones can be an early sign of diabetic ketoacidosis, which is a medical emergency and needs to be treated immediately.
What are ketones?
Ketones are a kind of fuel produced when fat is broken down for energy. Your liver starts breaking down fat when there’s not enough insulin in your bloodstream to let blood sugar into your cells.
What is diabetic ketoacidosis?
If you think you may have low blood sugar, check it even if you don’t have symptoms.
When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:
Fast, deep breathing.
Dry skin and mouth.
Flushed face.
Frequent urination or thirst that lasts for a day or more.
Fruity-smelling breath.
Headache.
Muscle stiffness or aches.
Nausea and vomiting.
Stomach pain.
If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level. If your ketones are high, call your health care provider right away. DKA requires treatment in a hospital.
DKA happens most in people with type 1 diabetes and is sometimes the first sign of type 1 in people who haven’t yet been diagnosed. People with type 2 diabetes can also develop DKA, but it’s less common.
How can I treat high blood sugar?
Talk to your doctor about how to keep your blood sugar levels within your target range. Your doctor may suggest the following:
Be more active. Regular exercise can help keep your blood sugar levels on track. Important: don’t exercise if ketones are present in your urine. This can make your blood sugar go even higher.
Take medicine as instructed. If your blood sugar is often high, your doctor may change how much medicine you take or when you take it.
Follow your diabetes meal plan. Ask your doctor or dietitian for help if you’re having trouble sticking to it.
Check your blood sugar as directed by your doctor. Check more often if you’re sick or if you’re concerned about high or low blood sugar.
Talk to your doctor about adjusting how much insulin you take and what types of insulin (such as short-acting) to use.
How do carbs affect blood sugar?
Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors. Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you.
What is the A1C test?
The A1C test is a simple blood test that measures your average blood sugar levels over the past 2 or 3 months. The test is done at a lab or your doctor’s office in addition to—not instead of—regular blood sugar testing you do yourself.
A1C testing is part of the ABCs of diabetes—important steps you can take to prevent or delay health complications down the road:
A: Get a regular A1C test.
B: Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).
The A1C goal for most adults with diabetes is between 7% and 8%, but your goal may be different depending on your age, other health conditions, medicines you’re taking, and other factors. Work with your doctor to establish a personal A1C goal for you.
What else can I do to help manage my blood sugar levels?
Keep track of your blood sugar levels to see what makes them go up or down.
Eat at regular times, and don’t skip meals.
Choose foods lower in calories, saturated fat, trans fat, sugar, and salt.
Track your food, drink, and physical activity.
Drink water instead of juice or soda.
Limit alcoholic drinks.
For a sweet treat, choose fruit.
Control your food portions (for example, use the plate method: fill half your plate with non-starchy vegetables, a quarter with lean protein, and a quarter with a grain or starchy food).
How can I pay for tests and diabetes supplies?
Medicare, Medicaid, and most private insurance plans pay for the A1C test and fasting blood sugar test as well as some diabetes supplies. Check your plan or ask your health care team for help finding low-cost or free supplies, and see How to Save Money on Diabetes Care for more resources.
If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Preconception health and health care focus on things you can do before and between pregnancies to increase the chances of having a healthy baby. For some women, getting their body ready for pregnancy takes a few months. For other women, it might take longer. Whether this is your first, second, or sixth baby, the following are important steps to help you get ready for the healthiest pregnancy possible.
1. Make a Plan and Take Action
Whether or not you’ve written them down, you’ve probably thought about your goals for having or not having children, and how to achieve those goals. For example, when you didn’t want to have a baby, you used effective birth control methods to achieve your goals. Now that you’re thinking about getting pregnant, it’s really important to take steps to achieve your goal [PDF – 764 KB]—getting pregnant and having a healthy baby!
Preventive health care can help you stay healthier throughout your life.
Before getting pregnant, talk to your doctor about preconception health care. Your doctor will want to discuss your health history and any medical conditions you currently have that could affect a pregnancy. He or she also will discuss any previous pregnancy problems, medicines that you currently are taking, vaccinations that you might need, and steps you can take before pregnancy to prevent certain birth defects.
If your doctor has not talked with you about this type of care―ask about it! Take a list of talking points so you don’t forget anything!
Talk with your doctor or another health professional if you smoke, drink alcohol, or use certain drugs; live in a stressful or abusive environment; or work with or live around toxic substances. Health care professionals can help you with counseling, treatment, and other support services.
Medications
Taking certain medicines during pregnancy can cause serious birth defects. These include some prescription and over-the-counter medications and dietary or herbal supplements. If you are planning a pregnancy, you should discuss the need for any medication with your doctor before becoming pregnant and make sure you are taking only those medications that are necessary.
People may use opioids as prescribed, may misuse prescription opioids, may use illicit opioids such as heroin, or may use opioids as part of medication-assisted treatment for opioid use disorder. If a woman is pregnant or planning to become pregnant, the first thing she should do is talk to a healthcare provider. Some women need to take an opioid medication during pregnancy to manage pain or to treat opioid use disorder. Creating a treatment plan for opioid use disorder, as well as other co-occurring health conditions, before pregnancy can help a woman increase her chances of a healthy pregnancy. If you are struggling with an opioid use disorder, take a look at CDC’s and partner resources.
Vaccinations (shots)
Some vaccinations are recommended before you become pregnant, during pregnancy, or right after delivery. Having the right vaccinations at the right time can help keep you healthy and help keep your baby from getting very sick or having lifelong health problems.
3. Take 400 Micrograms of Folic Acid Every Day
Folic acid is a B vitamin. If a woman has enough folic acid in her body at least 1 month before and during pregnancy, it can help prevent major birth defects of the baby’s brain and spine.
4. Stop Drinking Alcohol, Smoking, and Using Certain Drugs
Smoking, drinking alcohol, and using certain drugs can cause many problems during pregnancy for a woman and her baby, such as premature birth, birth defects, and infant death.
If you are trying to get pregnant and cannot stop drinking, smoking, or using drugs―get help! Contact your doctor or local treatment center.
Alcohol and Drug Resources
Substance Abuse Treatment Facility Locator The Substance Abuse and Mental Health Services Administration (SAMHSA) has a treatment facility locator. This locator helps people find drug and alcohol treatment programs in their area.
Alcoholics Anonymous (A.A.) Alcoholics Anonymous® is a fellowship of men and women who share their experiences, strengths, and hopes with each other so that they can solve their common problem and help others to recover from alcoholism. Locate an A.A. program near you.
5. Avoid Toxic Substances and Environmental Contaminants
Avoid harmful chemicals, environmental contaminants, and other toxic substances such as synthetic chemicals, metals, fertilizer, bug spray, and cat or rodent feces around the home and in the workplace. These substances can hurt the reproductive systems of men and women. They can make it more difficult to get pregnant. Exposure to even small amounts during pregnancy, infancy, childhood, or puberty can lead to diseases. Learn how to protect yourself and your loved ones from toxic substances at work and at home.
People who are overweight or obese have a higher risk for many serious conditions, including complications during pregnancy, heart disease, type 2 diabetes, and certain cancers (endometrial, breast, and colon).1 People who are underweight are also at risk for serious health problems.2
The key to achieving and maintaining a healthy weight isn’t about short-term dietary changes. It’s about a lifestyle that includes healthy eating and regular physical activity.
If you are underweight, overweight, or obese, talk with your doctor about ways to reach and maintain a healthy weight before you get pregnant.
Violence can lead to injury and death among women at any stage of life, including during pregnancy. The number of violent deaths experienced by women tells only part of the story. Many more survive violence and are left with lifelong physical and emotional scars.
If someone is violent toward you or you are violent toward your loved ones―get help. Violence destroys relationships and families.
Collecting your family’s health history can be important for your child’s health. You might not realize that your sister’s heart defect or your cousin’s sickle cell disease could affect your child, but sharing this family history information with your doctor can be important.
Other reasons people go for genetic counseling include having had several miscarriages, infant deaths, trouble getting pregnant (infertility), or a genetic condition or birth defect that occurred during a previous pregnancy.
Mental health is how we think, feel, and act as we cope with life. To be at your best, you need to feel good about your life and value yourself. Everyone feels worried, anxious, sad, or stressed sometimes. However, if these feelings do not go away and they interfere with your daily life, get help. Talk with your doctor or another health professional about your feelings and treatment options.
NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available online: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf (PDF-1.25Mb)
Moos, Merry-K, et al. Healthier women, healthier reproductive outcomes: recommendations for the routine care of all women of reproductive age. AJOG Volume 199, Issue 6, Supplement B , Pages S280-S289, December 2008.
Vector poster Planning pregnancy. 9 steps to prepare for conceiving a child. Illustration of a cute girl.
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Smokeless tobacco is associated with many health problems. Using smokeless tobacco:
Can lead to nicotine addiction1,2
Causes cancer of the mouth, esophagus (the passage that connects the throat to the stomach), and pancreas (a gland that helps with digestion and maintaining proper blood sugar levels)1,2
Is associated with diseases of the mouth1,3
Can increase risks for early delivery and stillbirth when used during pregnancy2
Can cause nicotine poisoning in children4
May increase the risk for death from heart disease and stroke1,3
Using smokeless products can cause serious health problems. Protect your health; don’t start. If you do use them, quit.
Addiction to Smokeless Tobacco
Smokeless tobacco contains nicotine, which is highly addictive.1,2
Because young people who use smokeless tobacco can become addicted to nicotine, they may be more likely to also become cigarette smokers.5
Smokeless Tobacco and Cancer
Many smokeless tobacco products contain cancer-causing chemicals.1,6
The most harmful chemicals are tobacco-specific nitrosamines, which form during the growing, curing, fermenting, and aging of tobacco. The amount of these chemicals varies by product.1
The higher the levels of these chemicals, the greater the risk for cancer.2
Other chemicals found in tobacco can also cause cancer. These include:6
A radioactive element (polonium-210) found in tobacco fertilizer
Chemicals formed when tobacco is cured with heat (polynuclear aromatic hydrocarbons—also known as polycyclic aromatic hydrocarbons)
Smokeless tobacco causes cancer of the mouth, esophagus, and pancreas.1
Smokeless Tobacco and Oral Disease
Smokeless tobacco can cause white or gray patches inside the mouth (leukoplakia) that can lead to cancer.1
Smokeless tobacco can cause gum disease, tooth decay, and tooth loss.1,3
Reproductive and Developmental Risks
Using smokeless tobacco during pregnancy can increase the risk for early delivery and stillbirth.2
Nicotine in smokeless tobacco products that are used during pregnancy can affect how a baby’s brain develops before birth.2,7
Other Risks
Using smokeless tobacco increases the risk for death from heart disease and stroke.1,3
Smokeless tobacco can cause nicotine poisoning in children.4
Additional research is needed to examine long-term effects of newer smokeless tobacco products, such as dissolvables and U.S. snus.
Other facts about Smoking
Smoking leads to disease and disability and harms nearly every organ of the body.
Cigarette smoking remains the leading cause of preventable disease, disability, and death in the United States.
The tobacco industry spends billions of dollars each year on marketing cigarettes.
Smoking costs the United States hundreds of billions of dollars each year.
States do not spend much of the money they get from tobacco taxes and lawsuits to prevent smoking and help smokers quit. CDC recommends that states spend 12% of those funds on tobacco control.
In 2020, 12.5% of U.S. adults (an estimated 30.8 million people) currently smoked cigarettes: 14.1% of men, 11% of women.
Each day, about 1,600 youth try their first cigarette.
Many adult cigarette smokers want to quit smoking.
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About 1 in 5 American children has obesity. Compared to children with healthy weight, children with overweight or obesity are at a higher risk for asthma, sleep apnea, bone and joint problems, type 2 diabetes, and heart disease. Children with obesity are also more likely to experience bullying, social isolation, depression, and lower self-esteem. While there is no simple solution, there are many ways parents and caregivers can help children reach a healthy weight.
Eat the Rainbow
Having a healthy diet can help children get the nutrients they need for healthy growth and development, and help them reach a healthy weight. A healthy diet is rich in fruits, vegetables, whole grains, lean proteins, and low-fat or fat-free dairy.
Unfortunately, very few people get enough fruits and vegetables. In 2017, just 2% of high school students ate enough vegetables, and 7% ate enough fruit. Help your kids eat the rainbow: make half of their plate fruits and vegetables for optimal health.
Move More
Compared to those who are inactive, physically active youth have stronger muscles and better cardiovascular fitness. They also typically have lower body fat and stronger bones. Regular physical activity in childhood also reduces the risk of depression. Children need at least 60 minutes of physical activity every day – try these tips to help your kids move more.
Slow Down on Sugar
Most of us eat and drink too many added sugars, which can lead to health problems such as weight gain and obesity, type 2 diabetes, and heart disease. Children under age 2 should have no added sugar in their diet at all, and children over age 2 should keep sugars to less than 10% of their daily calories.
A good way to slow down on sugar is by avoiding sugary drinks like soda, juice drinks, and flavored milk. Help your kids rethink their drink by offering water, plain low-fat milk, or 100% juice instead.
Reduce Screen Time
Adults and children spend over 7 hours a day being sedentary – and that doesn’t include time spent sleeping! Many of these sedentary hours are spent sitting or laying down with a phone, tablet, or computer; watching TV; or playing video games (also known as screen time).
Too much screen time has health consequences: it’s associated with poor sleep, weight gain, lower grades in school, and poor mental health in youth. When you reduce screen time, you free up time for family activities. The American Academy of Pediatrics recommends creating a family media plan, and has examples such as keeping meal times tech-free, charging devices at night outside the bedroom, turning screens off an hour before bed, and many more.
Sleep Well
Good sleep is critical to prevent type 2 diabetes, obesity, injuries, poor mental health, and problems with attention and behavior. Did you know that children 6-12 years old need 9-12 hours of uninterrupted sleep a night and youth 13-18 need 8-10 hours? Too little sleep is associated with obesity partly because inadequate sleep can make us eat more and be less physically active. Help your children sleep better by making sure they’re active during the day, removing screens from their bedrooms, and setting a consistent sleep schedule, even on weekends.
Kids imitate the adults in their lives. Be a role model for them by adopting these healthy habits, and they will too! Finally, remember that obesity is a complex disease with many contributing factors. Learn more about what states and communities can do to make healthy and active living accessible for everyone.
Obesity
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A person with borderline diabetes, or prediabetes, has blood sugar levels that are higher than normal but not yet high enough for a diagnosis of type 2 diabetes.
Borderline diabetes is a condition that may lead to type 2 diabetes. According to the American Diabetes Association, an estimated 10 to 23 percent of people with borderline diabetes will go on to develop type 2 diabetes within 5 years.
If a person’s blood sugar level remains high, they may begin to develop some symptoms of type 2 diabetes. Symptoms include frequent urination and increased thirst.
Most people will not know they have prediabetes until they receive testing.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a range of other conditions can increase the risk of prediabetes, including:
Regularly consuming high-sugar drinks may also increase the risk.
One 2017 review found that people who regularly drink sugary beverages face an increased risk of metabolic diseases, such as high blood pressure and high levels of blood glucose and fats.
These metabolic conditions can lead to prediabetes and diabetes.
People who lead an inactive lifestyle are at higher risk of taking in too many calories without burning them through exercise.
Other people who may be at risk of developing prediabetes include those with polycystic ovary syndrome (PCOS) and those who have experienced instances of high blood sugar levels in the past.
Anyone with any of these risk factors may benefit from a prediabetes screening to identify whether they have the condition.
A doctor typically diagnoses prediabetes with a blood test, particularly a glucose tolerance test. A glucose tolerance test measures how quickly the body can process the sugar in the blood in a 2-hour period.
Other tests include measuring blood sugar levels after a person has not eaten for a specific period. This is called a fasting blood test.
The doctor may also use an A1C test. This involves measuring the average blood sugar levels over 2–3 months. People do not need to fast or take any special liquids or medications for this test, and it gives reliable results.
According to the American Diabetes Association, a doctor will diagnose prediabetes when test results show the following measurements:
fasting blood sugar levels of 100–125 milligrams per deciliter (mg/dl)
glucose tolerance levels of 140–199 mg/dl
an A1C test result of 5.7–6.4 percent
A doctor will often re-test these levels to confirm that the readings are not due to one-off spikes in blood sugar.
a waist circumference larger than 40 inches in males or over 35 inches in females
a close relative with diabetes
a condition that increases insulin resistance, including PCOS, acanthosis nigricans, and nonalcoholic steatohepatitis
an ethnic background that places an individual at high risk of diabetes, including people who are African-American, Asian-American, Latino, Native American, or a Pacific Islander
a history of gestational diabetes, or diabetes as a result of pregnancy
having given birth to an infant weighing over 9 pounds
having a disease that harden the arteries
recent treatment with glucocorticoids or atypical antipsychotic medications
If a doctor identifies any of these risk factors, they may recommend that the person has a screening for blood glucose levels.
Medical professionals advise repeating screening tests every 1 to 3 years if a person has these risk factors.
The NIDDK has an official resource to check diabetes risk. Click here to take the test.
However, anyone who is concerned that they may have borderline diabetes should visit the doctor for testing and a proper diagnosis.
Prediabetes is reversible, but it is often easier to prevent than treat. Lifestyle factors are the primary causes of prediabetes, and making changes in some aspects of life can significantly reduce risk factors.
A balanced, nutritious diet that moderates sugar intake and regular exercise can help reverse borderline diabetes.
According to the American Diabetes Association, diet and nutrition changes should include the following:
improving intake of unprocessed high-fiber carbohydrates
Exercise is also important. According to a report in Diabetes Care, exercise can help prevent or delay diabetes from developing.
Current guidelines for Americans recommend that adults should:
have at least 150–300 minutes of moderate-intensity aerobic activity each week
do muscle-strengthening exercises at least twice a week, such as lifting weights or doing push-ups
Examples of moderate exercise are fast dancing and brisk walking.
Regular exercise and a healthful diet not only help reduce the risk of developing diabetes but also protect the heart against future diseases.
Diabetes Prevention Program
The Diabetes Prevention Program (DPP) was a long-term study that aimed to identify practical steps for reducing diabetes risk and reversing prediabetes.
The people who took part in the DPP Lifestyle Change Program aimed to lose 7 percent of their body weight and maintain this loss through dietary changes and activity. After 3 years, the results of the program showed:
a 58-percent drop in the risk of developing diabetes regardless of sex or ethnicity, compared with those who took a placebo
a 71-percent drop in risk people of developing type 2 diabetes among people aged over 60 years
All the people in the program received motivational support on effective diet and exercise and attended “lifestyle change classes,” for the duration of the study.
Follow-ups took place regularly. After 15 years, people in the DPP Lifestyle Change Program continued to see a delay in the onset of diabetes compared to people who took a medication called metformin or a placebo.
Anyone who developed diabetes during the study received extra medical care. However, diet and exercise remained important in managing symptoms and reducing the risk of complications.
Monitoring borderline diabetes
In addition to lifestyle changes, doctors may recommend other steps for managing the risk of diabetes.
Medical management may include treating related conditions, such as obesity and heart disease.
Managing prediabetes also involves continued monitoring of the risk factors and regular testing of blood sugar levels.
A person can reverse borderline diabetes if they can make and maintain the necessary lifestyle changes.
Borderline diabetes is the stage before type 2 diabetes develops. By this stage, blood sugar, blood pressure, and insulin resistance may start reaching harmful levels.
Prediabetes does not usually cause active symptoms, and most people will not be aware they have the condition until it becomes diabetes and starts causing severe health problems.
It is therefore essential for anyone who is at risk of developing diabetes to receive regular screening. Risk factors include high BMI and waist circumference, an age of more than 45 years, or other cardiovascular diseases.
Prediabetes is often reversible with a sustained exercise program and a balanced, low-sugar diet.
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Babies are unpredictable. Knowing your rights can help you better prepare for the unpredictable.
After 9 months of nausea, weight gain, back pain, and general discomfort, the day is finally here: delivery day. And, if you’re anything like me, you are more than ready.
I was trying to evict my daughter as soon as she turned 37 weeks.
But before you head to labor and delivery, you should know what your rights are (and aren’t). Because while you may have a well-written birth plan, things change, and it’s important that you know how to advocate for yourself and your baby.
The basics
You have the right to receive full and clear information about the benefits and risks of any medication, treatment, test, or procedure you may receive
Things move quickly in labor and delivery wards, and for good reason. Childbirth can be unpredictable, and most medical professionals act abruptly out of necessity. They simply want to ensure a safe and healthy delivery.
But before receiving any treatment, you can (and should) ask about the risks and results of procedures. It’s your legal right and duty to give permission for care.
You have the right to receive full and clear information about your healthcare professional’s background and qualifications
When it comes to your OB-GYN, transparency isn’t just important, it’s your right.
Ask about their medical training and degree. Inquire how many years of experience they have (and how many babies they’ve delivered), and request any other information which you deem necessary. For example, you can ask how many vaginal and Cesarean births they’ve attended.
You have the right to receive treatment that’s appropriate for your cultural and religious background
This includes refusing certain medical procedures and receiving written correspondence in a language of your choosing.
You have the right to accept or refuse any unnecessary medical test, intervention, or procedure, including continuous fetal monitoring or an episiotomy
While certain birthing situations require intervention — sometimes it’s medically necessary to perform a C-section or monitor your unborn babe — if you’re laboring naturally and there is no fetal or maternal distress, you have the right to accept or refuse any test or procedure.
You have the right to change your mind
If something doesn’t feel right or if you’re having second thoughts, speak up. Period.
The birth process
You have the right to know if you will be induced (and why)
Some pregnancy complications may require you to be induced. In fact, in certain cases, it may be the best way to keep you and your baby healthy.
However, many inductions are unnecessary, and in some cases, can increase your risk of complications.
You have the right to labor in whatever position you choose
Barring any unforeseen problems or medically restrictive devices (such as a catheter), you can — and should — be able to labor in any position.
Some hospitals have various policies in place when it comes to delivery. If you’re planning a hospital delivery, ask about their policies ahead of time.
Newborn care
You have the right to uninterrupted contact with your newborn
There are numerous benefits of skin-to-skin contact, both immediately following birth and in the days and weeks after. As long as you and your baby are healthy, you should be given (and are entitled to) relatively uninterrupted time to bond with your child.
You have the right to breastfeed or bottle feed
While the benefits of breast milk are well-researched and well-known, not everyone can or wants to. (I stopped breastfeeding to resume my regular mental health care regimen.)
Do what is best and right for you.
You have the right to deny unnecessary medical tests or procedures
After your child is born, medical professionals will likely perform a series of tests on your wee one. For example, your newborn will be measured, weighed, given an APGAR test, and blood will be drawn.
However, not all procedures need to be done immediately after birth (or in the hospital). Speak to your OB-GYN or pediatrician in advance to better understand what they recommend doing and when.
You are your own best advocate
You should speak up, ask questions, and remember this is your birth experience and your child.
If something doesn’t seem or feel right, or if you have questions, it’s your right to ask questions and receive answers.
Kimberly Zapata is a mother, writer, and mental health advocate. Her work has appeared on several sites, including the Washington Post, HuffPost, Oprah, Vice, Parents, Health, and Scary Mommy — to name a few. When her nose isn’t buried in work (or a good book), Kimberly spends her free time running Greater Than: Illness, a nonprofit organization that aims to empower children and young adults struggling with mental health conditions.
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Researchers examined the relationship between avocado consumption and cardiovascular events.
They found that eating 2 or more servings of avocado per week is linked to 16% fewer cardiovascular events over a 30-year period. One serving is half an avocado, or 80 grams (g).
The researchers conclude that replacing certain fat-containing foods with avocado could lower cardiovascular disease risk.
The note however that replacing plant oils with avocado is linked to a 45% higher stroke risk.
Cardiovascular disease (CVD) is the leading cause of death worldwide. However, it can be prevented through lifestyle factors like diet.
The American Heart Association (AHA) recommends limiting 5 to 6% of calories intake from saturated fatty acid (SFA), and replacing SFA and trans-fats with monounsaturated fats (MUFA) and polyunsaturated fats for better heart health.
Avocados are rich in MUFAs and polyunsaturated fats. Studies have found that their regular consumption reduces triglycerides, low-density lipoprotein (LDL) cholesterol, and total cholesterol level.
Most studies on avocado consumption have focused on cardiovascular risk factors. Studies investigating the link between avocado consumption and cardiovascular events could improve understanding of the fruit’s health benefits.
Recently, researchers have investigated the link between avocado consumption and cardiovascular events.
They found that higher consumption of avocados was linked to a lower risk of CVD and coronary heart disease (CHD).
“The […] results are significant and strengthen previous findings of avocados’ association with a lower risk of cardiovascular disease [as well as] reducing heart outcomes such as fatal and nonfatal myocardial infarction,” Bhanu Gupta, MD, cardiologist at The University of Kansas Health System, not involved in the study, told Medical News Today.
“Point to be noted: avocado consumption does not lower the risk of stroke in the study. Another point to be noted: avocado is not a replacement for healthy dietary fats such as olive oils, nuts, and other plant oils.”
For the study, the researchers used data from the Health Professionals Follow-Up Study (HPFS) and the Nurses’ Health Studies (NHS). Both studies are ongoing and began in 1986 and 1976 to examine the effects of health and lifestyle on the incidence of serious illness in male and female healthcare professionals.
For the present study, the researchers included 62,225 females and 41,701 males who did not have a history of heart disease, stroke, or cancer.
The researchers examined their medical records for incidence of myocardial infarction and stroke, dietary surveys taken once every 4 years, and risk factors such as hypertension and type 2 diabetes from self-reports and physician diagnoses. Participants were tracked for 30 years.
By the end of the study period, the researchers noted 14,274 incident cases of CVD including 9,185 CHD events and 5,290 strokes.
The researchers noted that males and females with higher avocado intake tended to have higher total energy intake and a healthier diet with more fruits, vegetables, whole grains, nuts, and dairy products such as yogurt and cheese.
After adjusting for major dietary and lifestyle factors, the researchers found that having two or more servings of avocado per week was linked to a 16% lower CVD risk and 21% lower CHD risk compared to those who did not eat avocados.
They further found that replacing half a serving per day of mayonnaise, margarine, butter, egg, yogurt, cheese, or processed meats with the same amount of avocado was linked to a 19–31% lower risk of coronary heart disease.
They reported no significant association between stroke risk and avocado consumption. However, they noted that replacing half a serving per day of plant oils with an equivalent amount of avocado was linked to a 45% higher stroke risk.
When asked to explain what might account for the positive effects of avocado on CVD risk, study first author Lorena Pacheco, Ph.D., MPH, RDN, postdoctoral research fellow at Harvard T.H. Chan School of Public Health, told MNT:
“Avocados are a nutrient-rich food item with favorable food compounds including monounsaturated and polyunsaturated fats (healthy fats), vitamins, minerals, soluble fiber, vegetable proteins, phytosterols, and polyphenols. There are potential biological mechanisms by which avocados offer cardioprotective benefits.”
“The primary monounsaturated fatty acid present in avocados is oleic acid – healthy fat – and it is suggested that it helps in reducing hypertension, inflammation, and insulin sensitivity.”
“Additionally, they contain plant sterols that could have favorable effects on lipid profiles. [Also], the soluble fiber intake in avocados can also lead to a better lipid profile, meaning lower ‘bad cholesterol’ levels,” she explained.
“They also are a source of vegetable protein,” added Penny M. Kris-Etherton Ph.D., professor of nutritional science at Penn State College of Health and Human Development, not involved in the study. “Collectively, it is very likely that this ‘package’ of heart-health compounds accounts for the findings,” said Dr. Kris-Etherton.
The researchers concluded that replacing certain fat-containing foods with avocado could lower CVD risk.
The authors noted some limitations to their findings. As their study was observational, they could not establish causation.
Shannon Hoos-Thompson, MD, a cardiologist at The University of Kansas Health System, not involved in the study, explained for MNT:
“To put the findings in perspective, eating less cardiovascular unhealthy food may be the explanation [rather] than the result being specific to avocado consumption.”
The authors also noted that their study population was primarily non-Hispanic white nurses and health professionals, so their results may not be generalized to wider demographics.
“The dietary data were self-reported and have some measurement error,” added Dr. Kris-Etherton. “However, the authors used a repeated measurements dietary assessment method and collected intake data over time, which reduces random measurement error.”
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Sadness, fear, worry, or other emotions can affect us during or after tough situations, like dealing with the COVID-19 pandemic, the loss of a family member or friend, or experiences related to racism. Dealing with these challenges can weigh heavily on your mental health, and recent data suggest this is the case for many who have sought professional help with their mental health since the pandemic started.
Increases in mental health-related ED visits
Recent research suggests that some racial and ethnic minority groups have been more affected by mental health challenges related to the pandemic. According to a new study published in JAMA Psychiatry, these groups had significant increases in emergency department (ED) visits for new and existing mental disorders during and after a COVID-19 case surge.
Asian adults had increases in the number of visits for most of the mental disorders that the study looked at, including a 21% increase in ED visits with depression during a COVID-19 surge.
American Indian and Alaska Native adults had increases in the number of ED visits for multiple mental disorders after a COVID-19 surge, including a 42% increase in trauma and stressor-related visits.
There was a 24% increase in ED visits for bipolar disorder among Hispanic adults and a 14% increase in trauma and stressor disorder-related visits among Black adults after a surge.
Mental Health Impact of Stress
It’s natural to feel stress, anxiety, grief, and worry during challenging times. Feeling strong emotions or being stressed can have negative effects on your health. Stress can cause the following:
Feelings of fear, anger, sadness, worry, numbness, or frustration.
Changes in appetite, energy, desires, or interests.
Problems concentrating or making decisions.
Nightmares or problems sleeping.
Physical reactions, such as headaches, body pains, stomach problems, or skin rashes.
Worsening of chronic diseases and mental health conditions.
Learning to cope with stress in a healthy way will help you, the people you care about, and those around you become more resilient. You can help yourself, others, and your community manage stress in the following ways.
Take breaks from news stories, including those on social media. It’s good to be informed, but constant discouraging information can be upsetting. Consider limiting news to just a couple of times a day and disconnecting from your phone, TV, and computer screens for a while.
Take care of your body:
Get vaccinated and stay up to date on your COVID-19 vaccines.
Eat plenty of fruits and vegetables, lean protein, whole grains, and fat-free or low-fat milk and dairy products. Eating well also means limiting saturated fats, cholesterol, salt, and added sugars.
Going to bed at the same time each night and getting up at the same time each morning, including on the weekends, can help you sleep better (adults need 7 or more hours per night).
Move more and sit less. Every little bit of physical activity helps. You can start small and build up to 150 minutes a week that can be broken down to smaller amounts such as 20 to 30 minutes a day.
Limit alcohol intake. Choose not to drink, or drink in moderation (one drink a day for women, two for men) on days that alcohol is consumed.
Avoid using prescription drugs in ways other than prescribed, taking someone else’s prescription, or using illegal drugs. Treatment is available and recovery starts with asking for help.
Continue with regular health appointments, testing, and screening, especially those for cancer.
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