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5 Myths About Skin p. 32

April 2018

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Our Essential Guide to

Preventing Disease 12 Ways to Stop Back Pain! p. 22

Double Your Fiber Naturally Surprising Stress Busters p. 72

Contents

36 What Fitness

42 Prevention’s

64 Bake It Better

Pros Want You to Know

Guide to Preventing Disease

Get the benefits of a personal trainer without hiring one!

Experts share their secrets.

By Michelle Crouch

Essential steps you can take now to stay healthy for life

By Rochelle Sharpe

Boost the nutrition of your favorite desserts by adding surprise ingredients.

Recipes by the Prevention Test Kitchen

ARMANDO RAFAEL

APRIL 2018

HEALTHIER SWEETS Our Lemon & Coconut Bars have 50% less sugar and saturated fat, p. 71

72 1-Minute Meditations You can take control of your emotions with these easy mindfulness techniques.

By Carolyn Gregoire

78 88 Feel-Good Fitness Into the Woods Make daily tasks easier with simple toning moves for every level.

By Jeff Csatari

Betsy Andrews was looking for health and well-being.

She found it in a Colorado forest, clearing trails and protecting trees.

APRIL 2018 ¡ PREVENTION.COM

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15 Pulse HEALTH

6 Garden in Good Health 8 Best Time for Surgery 12 Is Your Salon Safe?

13 Detecting Melanoma MIND + BODY

10 Sleep Easier 11 The Power of Scent NUTRITION

14 15-Minute Meal 15 Know Your Grains FITNESS

16 Make Over Your Heart 17 Exercising With Cancer

On the Cover:

26

24

Everyday Health

In Every Issue

18 Natural Remedies

3 Editor’s Letter 4 Letters to the Editor 22 Problem Solved

Kitchen cures for common ailments

26 The Holistic MD Dr. Andrew Weil shares insights on asthma.

28 Healing Movement Counteract sitting all day with the figure 4 hip stretch.

30 Women’s Health Dr. Lauren Streicher on pelvic exams

Prevent and treat lower-back pain.

24 Good Food 6 swaps for more fiber

32 Beauty 5 myths about skin

96 Brain Games Stay sharp with these fun workouts for your mind.

5 Myths About Skin 32, Our Essential Guide to Preventing Disease 42, 12 Ways to Stop Back Pain 22, Double Your Fiber Naturally 24, Surprising Stress Busters 72, New Asthma Treatments 26, Secrets of Fitness Pros 36, Easy Everyday Exercises 78, 5 Healthy Treats to Bake 64. Cover credits: Anna 1311/Getty Images; Mangpor_2004/Getty Images. Back cover: Corinna Gissemann/Stocksy

2 PREVENTION.COM · APRIL 2018

FROM LEFT: EMILY KATE ROEMER. CARLES RODRIGO MONZO/STOCKSY. CORINNA GISSEMANN/STOCKSY

Contents

FROM OUR EDITOR

IT’S OUR NAME

FROM TOP: PHOTOGRAPH BY SHANNON GREER; WARDROBE STYLING BY JASMINE CHANG; HAIR AND MAKEUP BY RICHARD COOLEY. COURTESY OF PICNIC AT ASCOT. COURTESY OF ZAPPOS

I

F YOU’RE PLANNING to add 15 minutes to your workout or cut down on sugar but haven’t quite gotten there yet, take heart. We can help. I, for one, have a goal to get 1 more hour of sleep every night, and I’m working on it. This magazine is my inspiration.

At Prevention, it’s our mission to motivate you. We do that by arming you with the best health information available and advice on how to use it.

In this issue’s “Prevention’s Guide to Preventing Disease” (p. 42), we’re fulilling the promise of our name.

A new movement in medicine that emphasizes preventive care over disease management reinforces our focus. In this roundup, we’ve condensed a wealth of cutting-edge health research into essential and concrete steps you can take to help prevent 10 serious illnesses, including Alzheimer’s, cancer, and heart disease. The science-based strategies we specify create a road map to wellness that will help you protect yourself and your family for the rest of your lives.

We’ve created this guide for you because we want you to be well and stay well. There’s reason to be optimistic. While genetics and environment certainly play their roles, studies show that, with the right information, you can greatly inluence your odds of avoiding disease. We own the ability to shape our health history. That’s empowering. Please share your stories with me at barbara@prevention.com.

prevention.com/garden

Earthy Delights I tiptoe around the mud in my garden in ratty sneakers every year, lugging my tools in an old shopping bag. So indulge me: I’ve got my eye on Orange Hunter Original Short Gloss Rain Boots ($140) to do double duty in the dirt, paired with a stylish bag of stainless steel garden tools ($38). The worms will be impressed. Go to prevention .com/garden to purchase. (Prevention receives a share of the sales.)

APRIL 2018 · PREVENTION.COM

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FROM OUR READERS

MEDITATE FOR YOUR HEART I started meditating during a period of high stress and within a few weeks was much calmer—even right before I had surgery! It’s been an amazing tool for my health and mind-set.

Laura Chute / Rancho Santa Margarita, CA

Your comments on the February issue SHOCK TO THE SYSTEM Paige Henry’s heart attack story reminds me of my sister’s health scare.

She took sumatriptan for a migraine 2 days before getting arm and back pain. She went to the doctor, who immediately sent her to the ER. It turned out that she was having a coronary artery spasm. Until I read your article, we had no idea what had caused it. Thank you for a magazine that can save lives.

Elaine Cadiente / Kailua Kona, HI

4 PREVENTION.COM · APRIL 2018

START THE DISCUSSION Thank you for adding Lauren Streicher’s Women’s Health column. Her knowledgeable perspective and insights are absolutely needed and add another dimension of expert advice to Prevention.

Sharon Swan / Alexandria, VA

THE BEST NATURAL STOMACH SOOTHERS I’d like to add a stomach soother to your list. For occasional heartburn, I drink a cup of hot water with a good helping of powdered ginger in it. It works great!

It’s also a wonderful cure for hiccups.

E. Ann Witherspoon / Salem, OR RETHINKING “UNHEALTHY” Anyone reading this article and thinking that iceberg

CONNECT WITH US Send your comments to letters@prevention.com. You may send your comments, letters, stories, photos, images, text, content, information, and any other material (the “work”) to us in connection with Prevention. Please include your full name, address, e-mail address, and phone number with all work you send us, following the instructions (if any) we provide. We regret that we cannot acknowledge or return any work. You must be a US resident and at least 18 to send us work. By submitting your work, you grant permission to Hearst Communications, Inc. and its licensees (“Hearst”) to edit and use the work worldwide for any purpose, including promotional purposes, in any form of media.

WESTEND61/GETTY IMAGES

Leters to the Editor

lettuce is a “healthy” food choice is not well served by your publication.

T. R. H. / Woodbury, CT AGE DOESN’T MATTER I agree with your contention that age doesn’t matter. I believe weight doesn’t matter, either.

My advice to women is to ditch the scales, stop counting calories, keep moving, and don’t be afraid to try new things.

Kelly Hale / Tampa LIFELONG LEARNING My mind functions well because of a never-ending

desire to learn more. I can say “thank you” in 40 languages. I write a monthly column for a local newspaper and am finishing my seventh novel. I can recite the prologue to The Canterbury Tales in archaic English. Constant learning is vital.

Bill York / via e-mail

FROM LONGTIME READERS I read Prevention cover to cover, and it just keeps getting better.

Beryl Andrews / Myrtle Beach, SC I’ve subscribed to your magazine for years.

In my opinion, this was your best issue yet.

Debra Crenshaw / Friendswood, TX

MORE FOR MEN I’m a man in my mid-50s.

Some, but not all, of your information applies to men. Would you consider adding more advice we can use?

Don Warner / Brewerton, NY

I have a huge collection of Prevention issues. My husband wants me to get rid of them to declutter, but I don’t want to!

Verónica Millán / Carmel, IN

FITNESS—FASTER! Women ages 30 to 60+ have lost up to 30 lb with Prevention’s Fit in 10: Slim & Strong— For Life! program, now available in paperback ($19). The book includes everything you need to get in shape at home: a 10-day clean-eating jump start, 85 delicious recipes you can make in 10 minutes, and 10-minute workouts that tone every zone.

Get your copy wherever books are sold.

APRIL 2018 · PREVENTION.COM

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Pulse YASU + JUNKO/TRUNK ARCHIVE

HEALTH NEWS • BREAKTHROUGHS • QUICK TIPS

GARDEN IN GOOD HEALTH The right posture could protect gardeners from chronic injury and slash their risk of joint disease, according to new British research. Scientists used 3-D optical tracking equipment—the kind of technology used to create animated ilms—to map the motions of gardeners in action, then measured the amount of pressure on their bones and joints in various positions. It turns out that poor technique (a deep forward bend at the waist and fully extended limbs) increases the load on the lower back by 50% and doubles shoulder pressure, compared with bending at the knees. Over time, pressure on these regions contributes to chronic pain and raises the risk of injury and osteoarthritis, a degenerative joint disease that develops when the cartilage between joints breaks down.

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THE BEST TIME FOR HEART SURGERY

It may be safer to have it in the afternoon than in the morning. Of 600 cardiac patients in a French study, those who had afternoon operations had half the risk of heart attack or heart failure during recovery, compared with the morning patients.

Why? Genes tied to heart muscle repair are more active later in the day, as they’re triggered by the body’s circadian rhythm.

Cutting-Edge Curatives New technology is helping doctors diagnose health conditions and improve patient outcomes. Three of the latest developments:

Swallowable Gut Sensor WHAT’S NEW? Clinicians typically rely on imprecise measures such as fecal samples to gauge what’s going on inside the gut. Now scientists have developed pill-size, swallowable sensors that transmit real-time data about a patient’s microbiome to a doctor’s cell phone.

BENEFIT: Currently in human trials, the capsules could someday help diagnose digestive disorders like irritable bowel syndrome or reduce the need for colonoscopies.

WHAT’S NEW? A study found that kyphoplasty, one of the surgical procedures used to repair spinal compression fractures caused by osteoporosis, also helps alleviate the lasting back pain that can result from the fractures.

BENEFIT: Back pain can be tricky to treat, and this procedure is minimally invasive.

Surgeons make small incisions in the back, insert a balloon to reposition fractured vertebrae, and ill the cavity with a cement-like substance to stabilize the spine.

VICTOR ALBROW/ GETTY IMAGES

Cancer Detector WHAT’S NEW? Scientists in Texas developed a new way to analyze kidney tumors to determine whether they’re cancerous or benign. Using multiparametric MRI (mpMRI)—an extensive MRI now used most often to identify prostate cancer— they were able to detect the most common and aggressive type of kidney cancer with an 80% accuracy rate.

BENEFIT: It’s less invasive than the current method, which is to conduct a biopsy that is often painful and poses the risk of ongoing bleeding or infection.

camelina oil

Back-Pain Reliever

Derived from the Camelina sativa plant in the mustard family, it’s high in omega-3 fatty acids.

When used in cooking, it may lower LDL (“bad”) cholesterol and support heart and brain health.

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BUILD MUSCLE OVERNIGHT Postmenopausal women trying to maintain muscle mass might consider asking their doctor about casein, a slow-digesting protein. Men (with an average age of 72) who ingested 40 g of casein at bedtime showed 33% more protein synthesis (which fuels muscle growth) overnight than those who took less or a placebo, according to a study in the Journal of Nutrition.

19 PEOPLE WHO MAKE THEIR BED ARE 19% MORE LIKELY TO SLEEP WELL, COMPARED WITH THOSE WHO DON’T.

MORE SLEEP FOR A CALM MIND If you’re plagued by persistent negative thoughts that may be triggering anxiety and depression, your sleep schedule may be to blame.

Binghamton University researchers found that sleep-deprived people who were shown upsetting images had trouble getting them out of their head for hours after the viewing.

More research is planned on the link between sleep disruption and the development of psychological disorders.

FROM LEFT GETTY IMAGES: OLEKSIY MAKSYMENKO. BRIGITTE SPORRER

THE POWER OF SCENT

Skin Sense California dermatologist Christine Choi Kim recommends face-mask ingredients for four skin types.

DRY OR SENSITIVE Both hyaluronic acid and glycerin attract water to the skin and help it maintain moisture. Aloe vera soothes the skin, and oils such as coconut moisturize it.

ACNE-PRONE Salicylic acid reduces inflammation and redness, while benzoyl peroxide kills bacteria. Raw honey has antibacterial properties that may help prevent breakouts.

OILY Charcoal and clays such as kaolin and bentonite draw out excess oil and remove dead skin cells that can clog pores.

MATURE Vitamin C brightens and protects skin from damaging free radicals. Resveratrol fights inflammation and may reduce the appearance of wrinkles.

Feeling anxious?

Bury your face in the shirt of a loved one and inhale. In a study at the University of British Columbia, women completed a mock job interview and a challenging math test. Those who sniffed a shirt worn by their significant other had lower levels of the stress hormone cortisol and reported feeling less anxiety than those who smelled new shirts.

APRIL 2018 ¡ PREVENTION.COM

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33 NUMBER OF COMMON NAIL SALON CHEMICALS THAT CAN HAVE NEGATIVE HEALTH EFFECTS 12 PREVENTION.COM · APRIL 2018

The price of a pedicure or nail color might be higher than you think.

Two recent Rutgers University studies show that many salon-goers and employees experience adverse health efects. In addition, most hair and nail technicians are not properly trained in hygiene and chemical use, which can increase the risk of problems—including exposure to bacteria from improperly cleaned tools, respiratory irritation from poor air quality, and allergic reactions to chemicals in products— for both clients and workers.

In the irst study, lead researcher Lindsey Milich and her colleagues asked 90 regular and occasional New Jersey salon customers to identify problems they’d had after hair and nail treatments. Fifty-nine percent had experienced one or more adverse dermal symptoms, including minor skin irritations and fungal issues like warts and athlete’s foot, while 12% reported

279PHOTO/GETTY IMAGES

Is Your Salon Making You Sick?

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respiratory problems. Morefrequent salon visitors cited more symptoms, with one exception: Those who said they’d had respiratory problems were infrequent visitors. Milich speculates that people who experienced those symptoms reduced their visits or stopped going.

The second study surveyed nail technicians in 40 salons to better understand the efects of exposure to hazardous chemicals. The majority of respondents said they had work-related eye, nose, throat, and skin problems—and fewer than half reported using protective equipment (such as gloves and masks) during manicures, believing they were essential only when applying artiicial nails. Almost all technicians had received safety training—but in English, which was not the primary language for most of the salon employees in the participating clinics, who were of Vietnamese or Korean descent.

Milich suggests avoiding drinking from open containers (“particles from nail ilings can end up in your cup”) and making sure footbaths and tools are clean by requesting they be swapped for new ones or asking if you can bring your own supplies. Also, ask technicians how they disinfect their tools and look for salons with tabletop ventilation systems that pull odors and tiny nail particles away from clients and workstations.

YOUR STYLIST MIGHT SAVE YOUR LIFE A recent study published in JAMA Dermatology found that, with training, hairdressers can detect melanoma— the deadly skin cancer that kills nearly 10,000 Americans a year—in hardto-see places like the neck and scalp.

After watching a 5-minute educational video designed

by University of Colorado and University

of Southern California researchers, 71% of stylists were able to accurately identify abnormal skin lesions. The researchers see this training as a promising path for initial detection of skin irregularities that are hard to self-detect.

But clients should remember that a visit to the salon doesn’t take the place of a check by a dermatologist.

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15-MINUTE MEAL UNDER $10 Tuscan Burrito (serves 4) 2 Spread mixture over 4 warmed whole wheat tortillas (8" diameter).

$1.62

$1.33

3

4

5

Sprinkle Slice 1⁄2 lb Top each each with grilled chicken with ¼ cup breast (hot or baby kale and 1½ tsp grated Parmesan. cold). Divide 1 Tbsp oilamong tortillas. packed sun$0.31 dried tomatoes, $2.18 drained and chopped.

6 Roll up from bottom, tucking in sides. Cut in half on the diagonal and serve.

$1.85

Total: $7.29 NUTRITION (per serving) 326 cal, 23 g pro, 34 g carb, 7 g fiber, 2 g sugars (0 g added sugars), 11.5 g fat, 3 g sat fat, 42 mg chol, 418 mg sodium

Can Coffee Predict Parkinson’s?

There’s no way to diagnose early-stage Parkinson’s disease, but a Japanese study may change that. Subjects drank two cups of cofee daily; those with the disease had one-third as much cafeine in their blood as those without it. Scientists suspect Parkinson’s patients don’t absorb cafeine well and plan to explore whether this could help detect the disease before symptoms appear.

FROM TOP: PHOTOGRAPHS BY MONICA BUCK; FOOD STYLING BY JENN FRIBERG. COFFEE: AKIRASTOCK/GETTY IMAGES

1 Mix 1 can (15.5 oz) no-salt-added cannellini beans, rinsed, drained, and mashed, with 2 Tbsp pesto.

Know Your Grains HEALTH PERKS

TRY IT

Barley

Rich in the minerals copper and selenium, it’s also packed with fiber.

Swedish researchers found its high fiber content may stimulate gut hormones that help balance blood sugar and control metabolism.

Replace rice with barley in risotto or pilaf.

Farro

This hearty, chewy grain is a good source of iron, which enables red blood cells to carry oxygen throughout the body, and magnesium, which helps the body metabolize carbohydrates and fat.

Toss farro with vegetable noodles or stuff it into bell peppers and bake.

Kamut

Kamut, the trademarked name of Khorasan wheat, provides 5 g of protein per ½ cup cooked, up to 40% more than regular wheat.

It’s also a good source of fatty acids and zinc.

Use Kamut as the base for a grain bowl, topped with protein and veggies.

Spelt

One of the first grains used to make bread, spelt is particularly high in bone-building manganese and hearthealthy niacin.

Stir spelt into soups, or use spelt flour as a replacement for regular flour in baking.

Teff

EMILY KATE ROEMER

“Ancient grains” are nutrient-dense whole grains that haven’t been modified through the centuries. Our favorite types:

This sweet, tiny, gluten-free grain delivers healthy fatty acids, calcium, and iron. It’s also high in the essential amino acid lysine, which helps the body absorb calcium and plays a role in collagen production.

Replace cornmeal with teff in polenta, or use the flour version in pancakes.

Farro

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MAKE OVER YOUR HEART Just 2 years of regular aerobic exercise can counteract the harmful effects that decades of sitting have on the heart, according to new research from University of Texas Southwestern Medical Center. When sedentary adults ages 45 to 64 engaged in moderate- to highintensity exercise for 2 years, they reversed signs of heart aging such as cardiac stiffness and pumping inefficiencies.

In particular, they showed a 25% improvement in heart elasticity, which helps reduce blood pressure and the risk of heart failure.

prevention.com/primer

Light Up Your Face Show off your glow with Clarins SOS Primers ($39) made to address specific complexion issues: Lavender neutralizes yellow undertones, green combats redness, and coral minimizes dark spots. (Prevention receives a share of the sales.)

16 PREVENTION.COM ¡ APRIL 2018

THIS PAGE, FROM TOP: MIKOLETTE/GETTY IMAGES. COURTESY OF CLARINS. OPPOSITE PAGE: PEATHEGEE INC./GETTY IMAGES

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23 ADULTS AGES 45 TO 64 WHO EXERCISE REGULARLY ARE 23% MORE LIKELY TO REPORT FEELING OPTIMISTIC ABOUT LIFE. BEST TUNES FOR RECOVERY A recent study in the journal Medicine & Science in Sports & Exercise found that when women listened to slow, soothing tunes for 30 minutes after a strenuous workout, their heart rates dropped 6% more (from 172 beats per minute to 84) than when they heard fast, stimulating music. The mellower vibe also sped up muscle recovery.

Exercise to Beat Cancer In the past, doctors often encouraged people with cancer and other chronic illnesses to rest while undergoing treatment. Now research shows that inactivity may increase recovery time and tiredness and that exercise can, in fact, help patients get better, says Kathryn Schmitz, a professor of epidemiology at Penn State College of Medicine.

Walking, in particular, can be helpful for cancer patients undergoing chemotherapy or radiation.

Recent studies suggest that as little as 20 minutes of moderately paced walking 5 days a week is

enough to ight fatigue, the treatments’ most common and debilitating side efect.

Several organizations, such as Sunlower Wellness in San Francisco, provide free exercise counseling for cancer patients. Those looking for ongoing instruction can consult the American College of Sports Medicine, which trains and certiies health and itness experts to work with cancer patients, tailoring exercise routines to speciic diagnoses. (Find a trainer at certiication .acsm.org/pro-inder.)

“Any amount of activity is valuable,” says Schmitz.

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EVERYDAY

Health PREVENTION • TREATMENT • EXPERT ADVICE

Cayenne

Honey

Lavender

Apple cider vinegar

Baking soda

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NATURAL REMEDIES

Kitchen Cures Remedies made with everyday ingredients can relieve many of life’s minor aches, scrapes, and symptoms. Assemble your own first-aid kit with the following multitasking ingredients you probably already have in your pantry.

Coconut oil

APPLE CIDER VINEGAR Drink 1 tsp vinegar diluted in 8 oz water to calm an upset stomach, or make a solution of equal parts vinegar and water to spray on sunburned skin. Dab vinegar onto skin with a cotton ball to clear up acne, or mix 1 Tbsp with 32 oz water to eliminate dandruf; the vinegar’s acidic pH can help dry up the oil that causes both problems.

Black tea

Continued Tea tree essential oil

Salt

EVERYDAY HEALTH

BAKING SODA Combine baking soda with water to make a paste that helps relieve the pain and itch from a bee sting or poison ivy. Create a healing soak by tossing some baking soda into your bath. You can also mix ¼ tsp into 4 oz water and drink to relieve heartburn, but avoid prolonged use, especially if you’re on a lowsodium diet.

Coconut oil can soothe dry skin and blisters.

CLOVES

GINGER

CAYENNE

This spice has an analgesic efect and works like aspirin to relieve the pain of a toothache. Chew a clove bud using the sore tooth, or use your tongue to position the clove close to the tooth, where it can temporarily ease the pain.

Capsaicin—the component that makes cayenne hot—opens up nasal passages, making it an efective cold remedy. Try mixing ¼ tsp cayenne with 1 oz fresh sage and 3 cups water. Boil 5 minutes, then add raw local honey and lemon juice to taste.

Refrigerate and sip 1 Tbsp every hour as symptoms develop or as needed.

This root calms nausea and reduces diarrhea and cramping.

It can also decrease bronchial inlammation, dilute mucus, and reduce coughing.

To make tea, peel and slice 2 to 3 oz fresh ginger (a 3" piece of root or 3 Tbsp sliced), steep 5 minutes in 3 cups boiling water, strain, and pour.

This inlammation ighter and antimicrobial healer can soothe dry skin, blisters, burns, and canker sores.

Unlike most oils, it’s nearly solid at room temperature and can be slathered straight from the jar wherever and whenever you need it.

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COCONUT OIL

HONEY Raw honey’s antibacterial qualities make it an excellent healer.

Apply it directly to minor burns to keep the wound moist and prevent gauze from sticking. Use raw honey—preferably local, to avoid an allergic reaction.

LAVENDER ESSENTIAL OIL To relax jangled nerves, sprinkle several drops of oil on a handkerchief and inhale. The scent helps relieve muscle tension and stress. For a sinus headache, massage a couple of drops onto each temple.

PHOT PHOTOGRAPHS

BY JASON VARNEY; PROP STYLING BY KRISTINE TREVIÑO

SALT Dissolved in warm water, salt can help treat skin infections, such as those that can occur with ingrown toenails, by dehydrating bacteria so they can’t reproduce.

ALOE Gel from this plant soothes minor burns, sunburns, cuts, and irritations and helps skin heal. Grow aloe vera on a sunny windowsill, snap off a bit of stalk, use a butter knife to scrape out the gel, and gently apply to the injured area.

TEA The tannins in black tea are astringents that help reduce swelling and relieve pain; dampen a black tea bag and place it over a bruised, swollen,

or sunburned area.

Sip a cup of peppermint tea to ease a headache, settle your stomach, or lessen stress-induced tension.

TEA TREE ESSENTIAL OIL This oil has antiviral, antibacterial, and antifungal properties.

Dab it on minor cuts.

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EVERYDAY HEALTH

84 Percentage of the world population that experiences lower-back pain at some point in life

Problem Solved LowerBack Pain

BY RICHARD LALIBERTE

T

he lower back, or lumbar region, is vulnerable to injury because of its complex mix of vertebrae, muscles, ligaments, and nerves that engage when you squat, twist, lift, sit, or stand. Overstretching muscle ibers can cause pain, as can nerve compression due to soft material bulging from inside disks separating vertebrae (herniated disk), degeneration of those disks (osteoarthritis), or narrowing of space around the spinal cord (spinal stenosis). “Back pain can be frightening but in most cases isn’t serious,” says Raj Rao, an orthopedic surgeon in Washington, DC. Up to 90% of cases resolve within 6 weeks.

PREVENT IT

TREAT IT

GOOD POSTURE “A straight back helps prevent problems with muscles and vertebrae,” says Jack Ende, an internist in Philadelphia.

Sit in a chair that has an inwardcurving back, which provides lumbar support, or place a pillow in the small of your back; remember to stand every 30 minutes.

ICE Cold reduces inflammation and pain. Wrap a bag of ice cubes or frozen vegetables in a cloth to protect skin, then apply to the area for 15 minutes two or three times a day during the first 48 hours after injury. Move as much as possible between icing sessions.

EXERCISE Studies suggest that ex-

OPPOSITE PAGE: AURORE MAXON

ercise cuts the risk of lower-back pain; one found it does so by more than a third. Low-intensity activities like walking, swimming, and yoga and exercises like planks stabilize the spine and keep muscles and ligaments supple so they’re less likely to overstretch.

HEALTHY WEIGHT Excess weight puts more stress on the lower back’s muscles, ligaments, nerves, and vertebrae. “Keeping an eye on weight is one of the best ways to prevent the back’s mechanical structure from wearing out too quickly,” Rao says.

SUPPORTIVE SLEEP POSITION Sleeping on your back distributes weight evenly and aligns the spine in the position least likely to cause pain.

You can also sleep on your side, but avoid lying facedown, which exerts the most spinal pressure.

NSAIDS OTC anti-inflammatories like ibuprofen (Advil, Motrin) and naproxen (Aleve) can ease pain and improve movement. Start with one pill and increase to a full dose if you’re still in pain.

HANDS-ON THERAPIES Physical therapists use specific stretches to improve joint and spinal mobility. Chiropractors manipulate the spine to decrease pain and improve function. If those options fail, alternative therapies like massage or acupuncture may ease discomfort.

MEDICAL TREATMENTS If pain radiates down your leg due to sciatica (caused by injured or irritated nerves), an injection of anti-inflammatory corticosteroids may help. For pain due to problems with spinal vertebrae or disks, surgical procedures such as a spinal fusion, diskectomy, or laminectomy may provide relief by correcting the structural problems.

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EVERYDAY HEALTH

Good Food 6 Swaps for More Fiber

BY BLAKE MILLER

IBER—found in the highest quantities in fruits, vegetables, and whole grains— is a supernutrient in more ways than one. It not only slows digestion to keep you full but also reduces cholesterol absorption in your intestines, helping maintain heart and digestive health.

But most of us don’t get enough. “The average American consumes about 14 g of iber per day, but we should be consuming nearly double that,” says Elisabetta Politi, a registered dietitian at Duke University’s Diet and Fitness Center. Occasionally making these swaps will boost your iber intake and may even ofer bonus health perks.

F

sometimes trading them for raspberries is an easy way to it in extra iber, says Politi. Raspberries also contain more ellagic acid, which laboratory studies show may protect against some cancers. Mix raspberries with yogurt and a splash of fruit juice; spread in a parchmentlined pan and freeze for 4 hours to make yogurt bark.

Instead of: Brown rice (2 g iber per ½ cup serving, cooked)

Swap in: Bulgur (4 g iber per ½ cup serving, cooked) Brown rice is a more nutritious option than white, but bulgur is higher than both in iber and protein, keeping you full longer, says Tanya Zuckerbrot, a registered dietitian based in New York City. It also has nearly twice the folate of brown rice.

To make porridge, bring 1 cup milk, 1 cup water, and ½ cup bulgur to a boil, then reduce to a simmer and cook 15 minutes.

Instead of: Green juice (0 g iber per 8 oz serving)

Swap in: Leafy greens Instead of: Blueberries (2 g iber per ½ cup serving) Swap in: Raspberries (4 g iber per ½ cup serving) Although blueberries are packed with healthy nutrients,

24 PREVENTION.COM · APRIL 2018

(3 g iber per 3 cup serving) A study in the journal Appetite conirmed that fresh produce keeps you satiated longer than trendy juices do. “While you get some nutrients from the green

An antioxidant in raspberries may help ward off liver and colorectal cancers.

such as cumin; roast at 425°F for 15 minutes.

CORINNA GISSEMANN/STOCKSY

Instead of: Potato

juice, you’re stripping many of them away, especially iber, during juicing,” says Zuckerbrot. Make salads ahead in jars so they’re just as convenient.

chips (1 g iber per 1 oz serving) Swap in: Popcorn (4 g iber per 3 cup serving) “Potato chips are illed with empty calories and lack iber,” says Zuckerbrot. Popcorn ofers iber and healthy compounds. University of Scranton researchers found that it has 300 mg of polyphenols per serving, 15 times more than whole grain tortilla chips. Pop it on the stove with canola oil and season with cayenne or cinnamon.

Instead of: Pasta (1 g iber per

Instead of: Sour cream (0 g iber

½ cup serving, cooked) Swap in: Lentils (8 g iber per ½ cup serving, cooked) A 2017 review in the International Journal of Molecular Sciences found that lentils have the highest insoluble dietary iber content of any pulse and are high in prebiotics, which promote gut health.

“Lentils make a great booster for soup in place of pasta,” says Kathleen Johnson, a registered dietitian based in Baltimore.

You can also make a snack by tossing cooked lentils with olive oil and spices

per 2 Tbsp serving)

Swap in: Hummus (2 g iber per 2 Tbsp serving) This Mediterranean spread has more iber, vitamins, and minerals and less saturated fat than sour cream, says Johnson. A 2 Tbsp serving also provides bone-building phosphorus and magnesium. Blend 1 can (15 oz) chickpeas with ¼ cup olive oil, the juice of 1 lemon, and spices such as coriander and garlic in a food processor and use as a dip for crudités or to top a Greek salad.

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EVERYDAY HEALTH

The Holistic MD Treating Asthma

BY ANDREW WEIL, MD

STHMA is a chronic respiratory disorder that results in inlammation and narrowing of the airways, causing less air to low in and out of the lungs. Typical symptoms of an asthma attack include wheezing, coughing, and diiculty breathing. The number of Americans diagnosed with the disease increased from about 20 million in 2001 to almost 25 million in 2009, according to the CDC; many experts point to worsening indoor and outdoor air quality as a contributing factor.

People may be predisposed to develop asthma as a result of genetics, signiicant or recurrent viral infections (such as severe colds or sinusitis), or exposure to environmental toxins. For reasons that may be related to luctuating hormones, asthma is more common and more severe in women.

Asthma can be allergic or nonallergic, and either

A

Dr. Weil is founder and director of the Arizona Center for Integrative Medicine.

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form can be mild or severe, though the airway blockage is usually reversible with treatment. Attacks of allergic asthma are often triggered by exposure to pet dander, mold, or dust mites, while nonallergic asthma attacks can be precipitated by air pollution or even colds and other minor respiratory infections.

Frequent asthma attacks can result in permanent changes to the structure of the airways that can impair lung function over time.

Managing asthma requires a two-pronged approach.

The short-term strategy is to rapidly treat acute attacks, which can become medical emergencies if not handled quickly. To relieve airway obstruction and breathlessness, doctors typically

3 NATURAL WAYS TO MANAGE ASTHMA

doctor to use them in the lowest dose and for as short a period of time as possible. These drugs have serious side efects such as weight gain, bone thinning, and an increased risk of cataract formation.

I also recommend longterm asthma management that emphasizes lifestyle changes over drugs. You can control the underlying inlammation that contributes to asthma through diet and exercise and by reducing exposure to allergens and environmental toxins. People with asthma should eat a variety of fruits and vegetables (for their potent antioxidants), slowdigesting carbohydrates such as steelcut oats, and cold-water ish (for their anti-inlammatory omega-3 fatty acids). Avoid highly processed foods, which can increase inlammation.

Regular aerobic exercise can reduce inlammation and airway sensitivity.

(Exercise can also trigger an asthma attack, however, especially if a workout is long or done outside in cold weather.)

Some patients have also beneited from osteopathic manipulation that restores normal motion of the rib cage and diaphragm to make breathing easier.

OPPOSITE PAGE: ILLUSTRATION BY ARTHUR MOUNT. THIS PAGE: CARLES RODRIGO MONZO/STOCKSY

Vacuuming will help reduce pet dander.

prescribe fast-acting combinations of inhaled short-term beta-agonists (bronchodilators) and steroids.

The long-term goal of asthma treatment is to reduce underlying inlammation, which will decrease the frequency of acute attacks. Longer-lasting forms of inhaled drugs may be prescribed, in addition to oral leukotriene-modifying drugs such as zairlukast (Accolate) and theophylline (Theo-24). I often suggest the use of inhaled cromolyn sodium (Nasalcrom), one of the most efective medications. If oral steroids are recommended, work with your

Remove toxins from your home. Air filters can screen out smoke and chemicals. Regular cleaning will reduce dust and dander.

1

Limit nonorganic meat and dairy. They may contain small amounts of toxins that can irritate your immune system.

2

Practice mind-body techniques. Breathing exercises and clinical hypnosis can help lessen anxiety and reduce inflammation.

3

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EVERYDAY HEALTH

Healing Movement Figure 4 Hip Stretch

BY JEFF CSATARI

Keep thigh vertical.

Relax neck.

Avoid tilting or rotating pelvis.

28 PREVENTION.COM · APRIL 2018

PHOTOGRAPH BY MITCH MANDEL; HAIR AND MAKEUP BY ALEKSANDRA AMBROZY; WARDROBE BY AMANDA LIPTOCK. ILLUSTRATION BY T.M. DETWILER

WHY YOU NEED IT

Prolonged bouts of sitting or a tough workout can cause a muscle deep in your buttocks called the piriformis to spasm, leading to back and hip pain. The sciatic nerve, which runs underneath and sometimes through the piriformis, can also become irritated when the piriformis gets tight, causing pain, numbness, and tingling along the back of the leg. The figure 4 stretch reduces tension in the outer hip and butt so you can move more easily and with less pain.

HOW TO DO IT Lie on back,

1 raise feet, and straighten legs to lean them against wall. Keep feet hip-width apart.

(If you can’t get down on the floor, you can also do this move seated on the edge of a chair, starting with feet flat on floor.)

Keeping left

2 leg straight,

bend right knee and place right ankle across left knee. Now bend left leg to slide left foot down wall until left knee is bent 90 degrees and left calf is parallel to floor.

Using right

3 hand, gently push right knee toward wall. At the same time, press tailbone into floor to feel stretch in right buttock. Hold for 60 seconds.

Repeat stretch with left leg. Do 2 or 3 stretches on each side.

Fitness clothes available at prevention.com/April-gear (Prevention receives a share of the sales.)

WORKS THESE MUSCLES

• Piriformis • Deep hip rotators • Glutes • Adductors (inner thighs)

YOUR TRAINER Jennifer Friedin, who demonstrates the move at left, is a personal trainer in Montclair, NJ. Galina Denzel, author of Eat Well, Move Well, Live Well and an expert in restorative exercise at Movewell Studio in Rancho Santa Margarita, CA, provided the instructions.

EVERYDAY HEALTH

Women’s Health A Beter Pelvic Exam

BY LAUREN STREICHER, MD

Is it true that I don’t need an annual pelvic exam if I don’t have any specific problems?

Dr. Streicher is an associate clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine.

“No complaint” does not mean “no problem.” Many conditions don’t have symptoms in their early stages, and in other cases women disregard symptoms that are important. They may not recognize that vulvar discoloration can be a sign of vulvar cancer, for example, or may not mention they’re experiencing

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vaginal dryness because they think they need to tolerate it.

The American Congress of Obstetricians and Gynecologists and the North American Menopause Society recommend an annual pelvic exam.

Should it include a Pap test?

A Pap test is no longer required every year in low-risk women.

How often you should have it depends on your age and prior test results. The guidelines: • Women ages 21 to 29 should have a test every 3 years.

• Women over 30 should have a Pap test every 3 years or a Pap and HPV test every 5 years.

• Women 65 and older may stop having the tests if they have had three normal results in a row, never smoked, had only normal tests for 10 years, and do not have a new sex partner.

If I don’t need a Pap test, why do I need an annual pelvic exam?

A Pap test screens only for cervical cancer, not for other gynecologic cancers or conditions.

THIS PAGE: ARTHUR MOUNT. OPPOSITE PAGE: YULIA BRODSKAYA

M

OST WOMEN

count an annual pelvic exam as a routine part of their health care. In 2014, however, the American College of Physicians—a group of internists, not gynecologists—issued a statement saying there is no value in an annual pelvic exam unless a woman has a speciic concern, such as pain or bleeding. Ever since, women have been confused about why and how often they should have the exam. Read on for my answers to four common questions.

An annual pelvic exam includes a visual inspection of the external genitalia to check for growths or abnormal skin changes on the vulva; a speculum exam to look inside the vagina and look for abnormal discharge, abnormal growths on the cervix, and changes such as thinning or dryness of vaginal walls; and a bimanual exam in which the physician places one or two ingers into the vagina and a hand on the abdomen to evaluate the uterus and ovaries and check for pelvic masses.

The list of conditions that can be detected during this exam is long and includes vulvar disorders, uterine or bladder prolapse, cervical polyps, ovarian cysts, and ibroid tumors. Even nongynecologic conditions, such as colon cancer, can be detected. This is

also your chance to discuss issues such as sexual function or just be reassured that everything is normal.

I dread the speculum exam. Is there any way to make it more comfortable?

The modern speculum was invented (yes, by a man) in 1845. You would think someone would have come up with a better way to view the cervix by now!

Still, the exam shouldn’t be excruciating. If placement of the speculum goes beyond “a little pressure” and it pinches or hurts, be sure to speak up. Sometimes making a minor adjustment or switching to a diferent speculum (they’re not one size its all) can make a world of difference. And lubricant, which may alter the accuracy of a Pap test, can be used when you’re not having the test.

BEAUTY

5 Myths About Skin

BY KARYN REPINSKI ILLUSTRATIONS BY BEN WISEMAN

ealthy skin is important to all of us. For a majority of American women, it may be an obsession: A 2017 survey found that more than 85% of us apply an average of 16 skin care and cosmetic products each day in an efort to achieve that glow. Still, how much do we really know about the body’s largest organ? We asked top dermatologists to separate true science from false facts.

H

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MYTH #1 Drinking more water ights wrinkles.

MYTHBUSTER: A clinical review concluded there’s no solid evidence that drinking water will make your skin look younger. To combat dry skin and wrinkles, you need to trap water on the surface of your skin rather than ingest it, says Mona Gohara, an associate clinical professor of dermatology at Yale School of Medicine. Dry air, cold temperatures, and harsh soaps cause skin to lose the natural oils that seal in the skin’s moisture. You can lock those oils in by applying a moisturizing lotion to your face every morning, Gohara says. Try creams containing ceramides, glycerin, or hyaluronic acid.

MYTH #2 It’s possible to shrink the size of your pores.

MYTHBUSTER: Your natural pore size is genetic, and nothing will change it, says Gohara. Pores can, however, enlarge with age. And poor skin care habits, sun damage, and other factors can cause your pores to become clogged with dirt, dead cells, or bacteria and appear larger. But using a facial cleanser that contains charcoal can unclog pores and minimize their appearance, Gohara says. “Charcoal is like a Dyson vacuum—it’s able to absorb 1,000 times its particle size, so it literally sucks everything out of pores.”

MYTH #3 Your face should feel taut ater you wash it.

MYTHBUSTER:

“Facial skin should feel supple after you’ve cleansed,” says Gohara.

If it feels tight, as if you’d applied an astringent, it means your cleanser has removed the top protective layer of natural oils that creates a barrier to keep water in and harmful microorganisms and irritants out. These lipids also act as “mortar” around skin cells, providing structural support. Stripping them away while cleansing makes skin drier and compromises its firmness. Instead, use a mild nonsoap cleanser labeled “gentle” or “pH neutral” and rinse with lukewarm water to avoid washing away the oils.

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BEAUTY

MYTH #4 You can get rid of cellulite.

MYTHBUSTER: Many products claim to smooth out these bumps that accumulate under the skin, but none of them work. “The fix for cellulite remains elusive because there’s no single reason for it—everything from hormones and heredity to sluggish circulation plays a role,” says David Bank, a dermatologist in Mount Kisco, NY, who evaluates cellulite product claims for the Federal Trade Commission. Skin architecture is another key factor: The telltale dimpling is fat trapped by a network of connective tissue; as these fibers weaken with age, cellulite becomes even more pronounced. “The sad reality is that all sorts of products and technologies have been tried, and eventually the skin will always revert to baseline,” says Bank. One of the more effective methods, Cellfina, uses a large needle to break up the fibrous bands that cause dimpling.

But the in-office procedure rarely eliminates all cellulite or produces permanent results.

MYTH #5 Regular facials are necessary for healthy skin.

MYTHBUSTER: Facials may feel relaxing, but they won’t help improve your complexion in a significant or lasting way. Simple cleansing and moisturizing at home will provide the same temporary glow, Bank says. So what can you do to protect your skin from time? Studies have shown that topical vitamin C, alpha hydroxy acids, resveratrol, retinol, and niacinamide (vitamin B3) can reduce the appearance of wrinkles.

INSIDER TIPS

WHAT

FITNESS PROS WANT YOU TO

KNOW Get the benefits of a personal trainer without hiring one! We asked experts to share their secrets.

BY MICHELLE CROUCH

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SECRETS FOR

STAYING MOTIVATED 1 The best trainer is inside your head.

“Positive self-talk can motivate you to stay active.

While you exercise, tell yourself you’re doing a good job. You’ll be more likely to exercise again the next day.”

—JAMES WHATMORE, owner of Whatmore Performance Training, Lakewood Ranch, FL

2 A little prep goes a long way.

“I always set out my exercise clothes the night before.

This helps me roll out of bed and get moving.”

—KINDAL BOYLE, certiied

personal trainer at Fit Women’s Weekly, Charleston, SC

3 Success requires some inner digging.

“My clients who have the best results know why they are there. So think about what’s inspiring you to stay active, and then ind a way to come back to it daily.

I write my goals on sticky notes and post them on my bathroom mirror.”

—TRACY YANCEY, personal

trainer at Prescriptive Fitness, Charlotte, NC

INSIDER TIPS

4 Being slower and weaker has its perks.

“Invite a friend or family member who’s in better shape than you are to go on a walk. I always push myself harder when I’m working out with someone who is stronger and faster than I am.”

—ASHLEY DRUMMONDS, certiied personal trainer,

Tampa

5 You’re more likely to stick with morning workouts.

“Of course, the best time to exercise is when you’re going to show up. But the further you get into the day, the more likely it is that something will get in the way. I’ve noticed that my evening clients tend to cancel more often than my morning people.”

—TRACY YANCEY

6 “Workout buddies don’t have to be close by, thanks to technology.

My friend lives across the country but still keeps me accountable.”

—ASHLEY DRUMMONDS

7 THE RIGHT OUTFIT CAN MAKE ALL THE DIFFERENCE. “When I slip into a cute ensemble, I look in the mirror and think, Game on!” —BROOK BENTEN JIMENEZ, ACSMcertiied exercise physiologist, Austin, TX

SECRETS FOR

BETTER WORKOUTS 12

8 Resistance training should be your top priority.

“To truly transform your body, you need to strength-train, whether that’s with body weight, free weights, resistance bands, or a combination. You’ll not only build muscle but also burn fat and reduce your risk of developing osteoporosis.”

—KINDAL BOYLE

INTERVAL TRAINING BURNS MEGA CALORIES. “Exercising at a challenging pace for 30 seconds, then slowing down to catch your breath for a minute, will give you a better metabolic boost than exercising at a steady pace.”

9 Squeezing in squats throughout your day is as good as going to the gym.

“Every time I bend down to pick something up—whether that’s a pair of shoes or a bag of groceries—I squat.

I end up doing dozens of squats per day, which strengthens my whole lower body.” —SUSIE

—JAMES WHATMORE

13

HATHAWAY, personal trainer, Fairield, IA

“Some clients work out with me for several months and wonder why they haven’t lost more weight. I’ll take a look at their diet, and it’s usually very easy to see why their bodies aren’t changing. Weight loss is 80% what you eat and 20% how much you work out.”

Crunches waste time.

“Planks and full-body exercises like squats, which also strengthen the core, are best.”

—LINDSAY WRIGHT, owner of MoveMore Fitness, Franklin, NC

—JAMES WHATMORE

10 There’s really no such thing as spot reduction.

“You can’t remove fat from one part of your body by performing exercises that target that area. If you’re concerned about a problem area, you need to drop fat from your entire body.” —RUI LI, owner of New York Personal Training, New York City

11 It’s easier to cut calories than to burn them off.

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14 Your body is a better detector of how hard you’re working than your fitness tracker is.

“The formulas devices use to measure exertion aren’t always accurate.

Instead, be mindful about how you feel during your workout. If your goal is to work out at high intensity, you should feel wiped out after about 30 seconds.”

—MIKE CLANCY, owner of MikeClancyTraining, New York City

15 Moving side to side will tone you faster.

“Most of the exercises we do, like walking and running, have a forward-backward motion. However, adding lateral motion—such as side-to-side shuffles or side lunges and leg lifts—will help strengthen your hip and thigh muscles while shaping your backside.”

—KATE WHEELER,

certiied personal trainer, Charlotte, NC

16 Ten minutes a day makes a difference.

“Researchers have found that people who exercise for 10 minutes every day are more likely to reach their itness goals than those who exercise for an hour once a week. Not only is breaking workouts into tiny chunks more doable, but the time really adds up. Plus, when you exercise a little every day, it becomes part of your lifestyle.”

—RAPHAEL KONFORTI, national director of itness for

Youit Health Clubs, Fort Lauderdale, FL

17

18 STEALTH STRENGTHENING REALLY WORKS. “You can exercise your lower body while sitting at work or standing in line at the grocery store by squeezing your glutes 10 seconds at a time.

No one will ever know you’re doing it!”

—RUI LI

19 Circuits do double duty.

“To age well, you need cardio for heart health and strength work for metabolism. I love circuits in which you alternate between cardio drills and toning exercises; you can combine all of it into one workout!”

—CHRIS FREYTAG,

itness expert, Minneapolis

“Your body is an amazing piece of equipment.

Even something as simple as a plank or wall push-up can tone your body.”

—KATE WHEELER

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INSIDER TIPS

SECRETS FOR

STAYING PAIN-FREE

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20 Variety is the spice of fitness.

“Even if it’s just 1 day a week, diversifying your workout will reduce your risk of an injury caused by repetitive motion. It will also keep you from getting bored.” —TRACY YANCEY

21 It’s not a good idea to do static stretches before you exercise.

“We now know it actually increases your chance of injury. Instead, do something to get your blood lowing, like jogging in place or walking and swinging your arms.”

—KATE WHEELER

22 FOAM ROLLING IS A GREAT WAY TO EASE PAIN AND TIGHTNESS. “It should be a part of everyone’s regular routine, no matter what type of activity they do.”

—RUI LI

23 There is healing power in a warm bath. “The hot water increases blood flow to your muscles and loosens your joints.”

—KATE WHEELER

HEALTH

TOP 10 Deadliest Diseases 1. HEART DISEASE 2. RESPIRATORY

ILLNESSES 3. LUNG CANCER 4. STROKE 5. ALZHEIMER’S DISEASE 6. DIABETES 7. COLON CANCER 8. KIDNEY DISEASE 9. BREAST CANCER 10. DEPRESSION According to data for the US from the Centers for Disease Control and Prevention

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GUIDE TO PREVENTING DISEASE ESSENTIAL STEPS YOU CAN TAKE NOW TO STAY HEALTHY FOR LIFE

BY ROCHELLE SHARPE ILLUSTRATIONS BY KAITLIN WALSH

H

eart disease, cancer, and stroke cause more than half of all deaths in the US each year, and many could have been prevented. Research shows that 45% of cancer deaths are linked to such factors as poor diet and lack of exercise, for example. The science of prevention is showing how many serious illnesses can be avoided by adopting a healthy lifestyle or by taking medications and having surgical interventions when necessary.

Of course, there are no guarantees. The road to good health is not completely predictable and involves a complex interplay among lifestyle, genetics, and the environment. But knowledge is power, and the health suggestions outlined on the following pages can help anyone lower the odds of serious illness, regardless of age, family health history, or personal risk factors. We pored over research and interviewed dozens of top medical experts to bring you this guide to reducing your risk of getting 10 of the deadliest diseases in America.

1 WHAT IT IS Heart disease is a general term that refers to conditions afecting the structure or function of the cardiovascular system, including heart rhythm problems, heart muscle damage, malfunctioning heart

valves, and poorly functioning or clogged blood vessels.

WHO IS MOST AT RISK Smokers, people with diabetes, and those

HEALTH

with high cholesterol, high blood pressure, or high blood sugar. Being overweight or physically inactive can increase risk, too. “We need to pay attention to how we live,” says Mary Ann Bauman, an internist and a spokesperson for the American Heart Association.

According to a study published in the New England Journal of Medicine, a man’s risk of dying of heart disease by age 80 plummets from 30% to 5% if he has no more than one of four major risk factors (smoking, diabetes, high cholesterol, high blood pressure) by age 55. A woman’s risk of dying by age 80 declines similarly if she has none or one of these risk factors by 55.

HOW TO PREVENT IT

increases hardening of the arteries, and causes blood vessels to constrict. Secondhand smoke is a danger, too. One study found that the number of heart attacks dropped by an average of 13% in communities that banned smoking in public places.

Keep blood pressure in check. Lifestyle

improvements are the irst course of action to lower blood pressure.

If it remains high in spite of the changes, prescription medication may help. Thiazide diuretics (sometimes known as water pills), calcium channel blockers, angiotensinconverting enzyme inhibitors, and angiotensin receptor blockers can help lower pressure and reduce heart disease risk.

Don’t smoke. Smoking

Minimize dietary salt. Experts recom-

has a huge impact on the heart, with more smokers dying of cardiovascular disease than of cancer every year. Tobacco smoke raises blood pressure,

mend consuming no more than 2,300 mg of sodium a day, with 1,500 per day considered ideal. Foods that seem healthy may contain surprisingly

high amounts of salt. A whole wheat bun could have 300 mg of sodium, for example.

Keep potassium levels high. Research

shows that sodium and potassium may work together to maintain healthy blood pressure.

Avocados, bananas, spinach, and sweet potatoes are all rich in potassium.

If you’re at high risk, talk to your doctor about taking aspirin or statin drugs. Aspirin can

prevent blood clots, Bauman says, while statins can block cholesterol from forming in the liver and reduce the amount of cholesterol that circulates in the blood. Statins can also help stabilize the plaques that adhere to blood vessel walls and can lead to heart attacks if they rupture.

If you do develop cardiovascular disease, you may eventually need bypass surgery, which improves the supply of blood and oxygen to the heart and can reduce the risk of a heart attack.

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patients with impaired lung function.

WHO IS MOST AT RISK

WHAT THEY ARE Respiratory illnesses include the serious lung conditions grouped together as chronic obstructive pulmonary disease: emphysema, chronic bronchitis, and some forms of asthma.

COPD inlames the airways and in some cases may lead to destruction of the lungs’ air sacs, causing air to become trapped. Severe cases may even require lung transplants. Lung infections, such as pneumonia and lu, can also be deadly in

46 PREVENTION.COM ¡ APRIL 2018

Smoking is a major risk factor, but 25% of COPD suferers have never used tobacco.

Having a job that causes you to breathe in large amounts of dust and smoke can increase risk, as can inhaling fumes from burning wood.

Other factors that likely contribute to the development of COPD include childhood exposure to secondhand smoke or polluted environments and having multiple respiratory infections, says MeiLan Han, an associate professor of pulmonary medicine at the University of Michigan and a spokesperson for the American Lung Association.

Pneumonia and lu are most serious in the elderly, young children, smokers, and those with impaired immune systems or poor lung function.

HEALTH

HOW TO PREVENT THEM Quit smoking and limit exposure to secondhand smoke. Decline in lung

function slows within 5 years of stopping, says Charles S. Dela Cruz, a professor and director of the Center for Pulmonary Infection Research and Treatment at Yale University.

Steer clear of air pollution. Heed local warn-

ings about air quality and try to stay indoors on days when the air is bad. To avoid the impact of smog in heavily polluted areas, Dela Cruz recommends wearing a iltered air mask.

The masks typically sold in grocery stores may help with large air particulates (such as dust or dirt) but are usually not efective at iltering out invisible pollution or smoke from wildires. Specialty N95 masks, if itted properly, are a better choice.

Breathing through these masks can be harder, though, especially for the elderly and those with lung diseases.

Pay attention to early symptoms of COPD,

including shortness of breath, chronic coughs, and recurrent respiratory infections. “Don’t assume shortness of breath is normal and you’re just getting older,” Han says, pointing out that roughly half of all those living with COPD are undiagnosed. A spirometry breathing test (in which you blow into a mouthpiece attached to a sensor) can identify the condition.

Get vaccinated.

Everyone should get the lu vaccine each year. Those over age 65 should also have the pneumonia vaccine, which protects against the most common form of bacterial pneumonia.

People with diabetes, chronic heart disease, and chronic lung diseases such as asthma may need to have the pneumonia shot before age 65, Dela Cruz says.

Reduce your exposure to germs. Stay away

from sick people, wash your hands frequently, and keep your hands away from your face.

Understanding Inflammation The body’s inflammation response can be protective, helping to fight off infection and prevent illness.

But when inflammation becomes a chronic condition, it can contribute to the development of any of the deadliest diseases.

“Chronic inflammation is a silent killer,” says Rudolph Tanzi, director of Massachusetts General Hospital’s Genetics and Aging Research Unit. “It’s what leads to the deterioration of every organ of your body.”

Maintaining a healthy lifestyle—with proper diet, exercise, sleep, and stress management—will help keep the inflammatory response in check, according to Tanzi.

A blood test for C-reactive protein— a substance produced in the liver that is elevated in the presence of inflammation—can help detect chronic inflammation so steps can be taken to reduce it.

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HEALTH

3 48 PREVENTION.COM ¡ APRIL 2018

WHAT IT IS This form of cancer, which kills more people than breast and colon cancers combined, occurs when cells in the lung grow rapidly and out of control. The most aggressive type is smallcell lung cancer, while the most common kind

is non–small-cell cancer, which afects about 85% of patients and spreads more slowly.

WHO IS MOST AT RISK Smokers, those with a family history of the disease, and people exposed to air pollution, asbestos, radon, or secondhand smoke.

Although cigarette smoking accounts for more than 80% of lung cancer cases, many nonsmokers get the disease, too, and their numbers are on the rise.

“All you need to get lung cancer are lungs,” says David Cooke, head of general thoracic surgery at the University of California, Davis.

structures, says Cooke.

The more smoke you inhale, the greater your risk. Even nonsmokers are at signiicant risk from secondhand smoke, says Cooke, cautioning that air puriiers aren’t adequate protection.

Once smoke exposure stops, though, the lungs begin to recover and health risks begin to dissipate. When smokers quit and abstain from tobacco for 10 years, their risk of developing lung cancer can drop by as much as 50%, the US Surgeon General found.

Pay attention to air-quality alerts. Heed

HOW TO PREVENT IT

community warnings to stay inside on days when levels of pollutants such as ozone or wood smoke are high. Some California towns call these “Spare the Air” days.

If you smoke, quit.

And avoid exposure to secondhand smoke.

Check that radon levels in your home are low. Radon, an invisible

Cigarette smoke contains a toxic brew of such chemicals as arsenic and formaldehyde that lead to changes in the lungs’ cells and

radioactive gas, is the second-leading cause of lung cancer after smoking. Homeowners can get their houses tested for this gas, which can

seep into foundations from decaying rocks, soil, or water. If radon levels are high, ask a certiied radon mitigation contractor for help.

These contractors, who can be found through state oices of the Environmental Protection Agency, may seal cracks, use underground pipes, or install exhaust fans to get rid of the deadly gas.

The work typically costs about $1,200.

Eat plenty of produce.

Studies have linked 8% of lung cancers to low consumption of fruits and vegetables, says Otis Brawley, chief medical oicer of the American Cancer Society. The antioxidants in produce appear to help protect against cancer.

Request a low-dose CT scan if you’re a smoker or ex-smoker. While the

screening test doesn’t prevent cancer, it can detect the disease earlier, when it’s more treatable.

Studies show that the tests can reduce lung cancer deaths by 20%, compared with screening with a conventional chest x-ray.

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HEALTH

to die rapidly. In hemorrhagic strokes, brain cells die after vessels or arteries burst and blood leaks into the brain.

WHO IS MOST AT RISK Smokers and people with heart disease, diabetes, high blood pressure, blood vessel inlammation, or a family history of strokes. In addition, people who have atrial ibrillation, a type of racing, irregular heartbeat, are at especially high risk: They’re 500% more likely to have a stroke than the general population, according to the National Stroke Association.

HOW TO PREVENT IT WHAT IT IS Often called brain attacks, strokes occur when blood vessels to the brain either burst or get blocked. In ischemic strokes, the most common type, a clogged vessel or artery impedes blood low to the brain, causing brain cells

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Follow a heart-healthy lifestyle. Eating a healthy

diet, getting plenty of physical activity, and avoiding smoking can keep blood vessels open and reduce the risk of blood clots.

Get checked for A-fib.

Since the condition— which can cause blood

Eating a healthy diet, getting plenty of physical activity, and avoiding smoking can keep blood vessels open and reduce the risk of blood clots. clots to form in the heart and travel to the brain—often has no symptoms, an estimated one-third of Americans who have it aren’t aware that they do. People can check themselves using the FDA-approved Kardia smartphone app and phone clip, which capture a medical-grade electrocardiogram in 30 seconds. But the diagnosis then has to be conirmed with another EKG. Consider preventive medication. People

diagnosed with A-ib can have their condition treated—and stroke risk reduced— with prescription blood thinners. Aspirin also thins the blood and may be recommended for stroke prevention, but no one should start

an aspirin regimen before irst checking with their physician.

Keep your weight, blood pressure, blood sugar, and cholesterol in check. General guide-

lines recommend a BMI between 18.5 and 25, blood pressure no higher than 120/80, and total cholesterol at 200 or less.

Know the symptoms of a transient ischemic attack. While TIAs

generally don’t cause permanent damage, they temporarily block blood low to the brain and are a strong indicator of future stroke risk.

(About one-third of people with TIAs have a stroke within a year.)

The American Stroke Association’s BEFAST acronym can help you remember stroke symptoms: balance

problems, eye problems (speciically, not being able to see out of one eye), face drooping, arm weakness, slurred speech, and time— a reminder that time is of the essence. If you have any of these symptoms, call 911.

Get medical help fast.

Even if a stroke occurs, quick action can often prevent brain damage.

Treatment with intravenous drugs within the irst 4½ hours can dissolve the blood clot— and in some people with large blood clots, IV drugs can help up to 24 hours after the event, says Sanjeeva Reddy Onteddu, a vascular neurologist at the University of Arkansas medical school and director of the medical school’s stroke program.

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HEALTH

WHAT IT IS Alzheimer’s is a progressive disease of memory loss and thinking diiculties. It involves protein fragments called plaques and tangles, which are suspected of disrupting communication among nerve cells in the brain.

WHO IS MOST AT RISK People over age 65, those with a family history of the disease, and those with certain genetic mutations, including in a gene called APOE. Mild cognitive impairment, severe head trauma, and a lack of social and intellectual engagement appear to raise risk, too.

There’s also evidence that the odds of getting the disease increase with unhealthy behaviors such as smoking or being sedentary.

HOW TO PREVENT IT Maintain a healthy heart.

“A heart-healthy lifestyle is a brain-healthy

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lifestyle,” potentially reducing Alzheimer’s disease symptoms by as much as 40%, says Pierre Tariot, director of the Banner Alzheimer’s Institute in Phoenix and a professor at the University of Arizona medical school. The goal is to lower inlammation to keep blood vessels and brain cells healthy, since “the cardiovascular system provides the pipes that provide blood to our brain,” says Tariot.

Follow the MIND diet.

The MediterraneanDASH Intervention for Neurodegenerative Delay approach to eating focuses on 10 brainhealthy foods, including beans, berries, ish, nuts, vegetables, and whole grains. The diet—developed by Martha Clare Morris, a nutritional epidemiologist at Rush University’s medical school, along with several colleagues— emphasizes the importance of eating these foods while severely limiting consumption of butter, cheese, and fried and fast foods. One

Adopt a variety of preventive measures, rather than picking and choosing. When Finnish

researchers tested a wide-ranging program of preventive measures in a study of 1,260 people considered at risk of dementia, they found that a combination of measures improved overall mental functioning by 25% in 2 years.

Be on the lookout for new drug approvals.

study showed that this diet can lower the risk of developing Alzheimer’s by 53% if followed rigorously.

Exercise regularly and maintain normal blood pressure. Physical activ-

ity increases blood and oxygen low in the brain, while high blood pressure can damage small blood vessels there.

Get enough sleep. Aim for 7 to 8 hours a night.

Beta-amyloid, one of the proteins associated with Alzheimer’s, diminishes during sleep. Plus, “the brain literally clears itself out” during sleep,

says Rudolph Tanzi, a neurology professor at Harvard University and director of Massachusetts General Hospital’s Genetics and Aging Research Unit.

Try brain training exercises. The recent

Advanced Cognitive Training for Independent and Vital Elderly study, funded by the National Institute on Aging, found that cognitive activities that help enhance reasoning, memory, and speed of processing showed promise in keeping Alzheimer’s at bay.

Preventive drugs are currently being tested for high-risk patients with no symptoms, Tariot says. These include an active immunotherapy drug that works like a vaccine to neutralize amyloid protein fragments and brain plaques characteristic of Alzheimer’s disease. Passive immunotherapy drugs, also being studied, work a bit like a vacuum cleaner, removing various forms of amyloid proteins from the brain, Tariot says. There are also oral medications that block production of new amyloid proteins.

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6 WHAT IT IS This metabolic disorder disrupts the way the body produces or metabolizes the hormone insulin, which is necessary for maintaining blood sugar levels and processing food for energy.

In type 1 diabetes, the pancreas produces little to no insulin.

In the more common type 2, the body produces insulin but cannot use it properly.

In both types, high blood sugar—if the disease isn’t managed—makes people more susceptible to heart disease, nerve damage,

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blindness, kidney failure, and stroke.

WHO IS MOST AT RISK It’s not known why people develop type 1 diabetes, which accounts for about 5% of diabetes cases, although genetic susceptibility plays a role. But type 2 diabetes tends to strike people who are overweight, have high blood pressure, are physically inactive, or have a family history of the disease.

It’s estimated that 1 of every 3 American adults now has prediabetes, a precursor to type 2 diabetes (although most are unaware they have the condition).

HOW TO PREVENT IT Adopt a healthy lifestyle.

A Diabetes Prevention Program study, funded by the National Institutes of Health, has found that type 2 diabetes risk can be dramatically slashed with physical activity and moderate weight

HEALTH

loss. People diagnosed with prediabetes who lost 7% of their body weight lowered their risk of developing diabetes by up to 58%.

Join a prevention program. There are more

than 200 community prevention programs run

by YMCAs (ymca.net) across the United States.

The program, based on the study above, coaches participants to improve their diet and increase physical activity.

Consider medication.

Metformin is a popular drug that can prevent and manage diabetes.

The National Diabetes Prevention Program study found that people who took metformin lowered their disease risk by 31%.

The drugs liraglutide and pioglitazone also show potential for preventing the disease, though questions remain about possible side efects. “I would not recommend these new drugs for general use,” says William C. Knowler, a physician in Phoenix who conducts diabetes research for the National Institutes of Health.

Clinics for Health, Not Sickness The first large clinical and research prevention program—for cardiovascular disease—began almost 30 years ago at Johns Hopkins University. Since then, prevention clinics have sprung up across the country, aiming to provide the medical advice, lifestyle counseling, proactive tests, and preventive treatments that will help people recognize their risks and establish healthy habits. “If you can improve people’s lifestyle so they make sustained changes, that’s a good thing,” says Roger Blumenthal, a cardiologist at Johns Hopkins School of Medicine.

New York University, Emory University, Cedars-Sinai Medical Center, and Brigham and Women’s Hospital now have cardiovascular disease prevention centers. The Ornish Program for Reversing Heart Disease, a comprehensive lifestyle program, is available at centers in 16 states. Diabetes prevention programs also exist in almost every state, as well as prevention resorts, such as the Pritikin Longevity Center in Miami, which is devoted to establishing good health in general. The nonprofit Cooper Clinic in Dallas also participates in prevention research.

“There’s a limit to what a physician can say or do in a standard office visit of 15 to 30 minutes,” says Blumenthal. So, rather than simply tell a patient to lose weight or stop smoking, these clinics provide the programs and follow-up to help people adopt important lifestyle changes.

One caution: Not all have stellar medical credentials. Be wary of clinics that are not affiliated with a large organization or medical institution and those that seem to emphasize sales over results. “If you click on a clinic website and you see it’s selling lots of supplements or other products, that can indicate a problem,” says Ethan Weiss, an associate professor of medicine at the University of California’s San Francisco Cardiovascular Research Institute.

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inlammatory bowel disease, family members with the disease, or certain genetic mutations can also raise risk.

HOW TO PREVENT IT Get a colonoscopy if you’re age 50 or older.

WHAT IT IS The second-deadliest form of cancer develops slowly in the colon’s inner lining, almost always starting with a growth, called a polyp, that becomes malignant.

WHO IS MOST AT RISK People who are overweight, don’t get much exercise, eat a lot of red meat, drink alcohol heavily, or smoke. Having a history of colorectal polyps,

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This procedure is both a screening test and a preventive measure. In a colonoscopy, a slim tube with a camera is passed through the rectum into the colon to examine the walls for polyps, which may be benign but are at risk of turning malignant. Once detected, these suspicious polyps can be removed before they turn cancerous.

The general recommendation is for most men and women to start getting colonoscopies once a decade starting at age 50. But individuals at high risk may be advised to begin having colonoscopies earlier or to undergo the test more frequently.

Consider a biannual stool test. A colonoscopy

is the most widely used

HEALTH

A colonoscopy is both a screening test and a preventive measure. If suspicious polyps are found during the exam, they can be removed before they turn cancerous. tool for colon cancer screening and prevention, but more than 40% of people who should be getting them avoid them. For those people, stool tests— which check for tiny amounts of blood in the stool that can indicate cancer—can be a good alternative, says Otis Brawley, an oncologist and chief medical oicer for the American Cancer Society. Having a stool test every year, he says, can be just as efective at detecting cancer as a colonoscopy.

Tests for stool DNA are also efective at inding colon cancer. If this test indicates the possibility of cancer, patients will need a colonoscopy to remove polyps or a biopsy to conirm the disease.

Consider moredetailed stool tests.

Some patients should get their stool screened with a quantitative fecal immunochemical test, which not only can detect blood that may indicate the disease but also can help predict when polyps are likely to recur, says Joel Levine, a gastroenterologist and cofounder of the Colon Cancer Prevention Program at UConn Health. These tests may be recommended even for people who have regular colonoscopies, since a substantial number of colon cancer cases develop in the years between once-a-decade colonoscopies.

Rethink your diet.

Foods that help move stool through the colon more quickly help reduce the risk of cancer, Brawley says, because some of the

substances the body produces to help with digestion are actually carcinogenic. Bile, which is produced by the liver to help digest fats, for example, can mutate the DNA of colon cells it comes in contact with, he says.

High-iber foods and grains can decrease bowel transit times, he says, as can exercise.

Also helpful: foods high in resistant starch, such as lentils, green bananas, and cold potatoes, which ferment slowly in the intestine, improving the bacterial composition of the microbiome and reducing inlammation that causes DNA mutations.

These foods also reduce insulin resistance, a medical condition that can lead to diabetes and raise the risk of some cancers.

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HEALTH

WHAT IT IS

8

The kidneys ilter blood to produce urine, regulate blood pressure, and help make red blood cells. Disease in these organs afects the body’s ability to ilter impurities and excess water from the blood. Uncontrolled kidney disease can lead to heart problems, anemia, and bone weakness—and ultimately to kidney failure.

WHO IS MOST AT RISK People with diabetes, high blood pressure, and a family history of the disease. Being over 60 is also a risk factor, as kidney function naturally declines with age.

poultry. Studies show that the similar Mediterranean diet can also keep kidneys healthy and prevent or postpone kidney disease.

Monitor salt intake.

Limiting sodium can lower blood pressure, a key cause of kidney disease. Nearly 20% of people with high blood pressure eventually develop the illness.

Since salt is hidden in so many foods, it’s important to be aware of what you’re eating, says Joseph Vassalotti, chief medical ofer of the National Kidney Foundation. He’s a fan of Healthwatch 360, a research-based app that tracks food composition and customizes eating plans for speciic medical conditions.

HOW TO PREVENT IT

If you have diabetes, keep blood sugar levels in check. Nearly 40%

Follow a kidney-friendly diet. The National

of people with type 2 diabetes develop kidney disease.

Stop smoking. The National Kidney Foundation warns that smoking reduces blood low to the kidneys and can worsen kidney

Kidney Foundation recommends the DASH (Dietary Approaches to Stop Hypertension) diet, which is rich in fruits, vegetables, beans, whole grains, ish, and

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Limit nonsteroidal anti-inflammatory drugs.

to the kidneys. While sporadic use may be safe, patients should talk to their doctors about alternatives if they need to take these drugs for more than 4 days in a row, Vassalotti says.

These painkillers, which include ibuprofen (Advil) and naproxen (Aleve), can reduce blood low

A National Health and Nutrition Examination Survey study found that

disease. It may also impair the efectiveness of medications used to treat high blood pressure, a leading cause of the disease.

Give up soft drinks.

consumption of more than two sodas per day was linked to kidney damage. And the Nurses’ Health Study found that consuming two or more diet sodas per day was linked to a drop in the glomerular iltration rate, an important measure of kidney function.

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HEALTH

9

WHAT IT IS The disease occurs when cells in the breast ducts start to grow out of control, eventually forming a tumor. Most breast cancers are estrogendriven and begin in the lining of the milk ducts.

WHO IS MOST AT RISK Women get most breast cancers, though men can get them, too. Because estrogen and progesterone play a role in both normal breast tissue development and breast cancer development, women who began menstruating relatively young (before age 12) and/or go through menopause relatively late (after 55) are at increased risk because they’re exposed to high levels of estrogen for a longer time.

Women who never had children, never breastfed, drink a lot of alcohol, are overweight, or take hormone therapy after menopause are also at higher risk. Family history is also a factor.

Women who have the

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BRCA1 genetic mutation, for instance, have a 55 to 65% chance of developing breast cancer, compared with 12% for women who don’t.

HOW TO PREVENT IT Keep your BMI between 18.5 and 25. Excess

weight may be a problem because fat produces estrogen, especially after menopause.

Evaluate your risk. An online breast cancer risk calculator (cancer.gov/ bcrisktool) developed by the National Cancer Institute can help.

Consult a genetic counselor if you have a family history of the disease.

These specialists can provide advice about testing and help interpret genetic test results.

With only about 5 to 10% of breast cancers thought to be genetic, testing doesn’t make sense without a strong family history, says Susan Love, a patient advocate and chief visionary oicer of the Dr. Susan Love Research Foundation.

Think twice about prophylactic mastectomies. Even women who

carry dangerous genetic mutations may not need these procedures, Love says. “Having a mastectomy does not always give you a guarantee, as breast tissue doesn’t come in a nice package.

It’s hard to know if you’ve removed it all.”

Consider preventive medication. If you’re at

high risk, talk to your

doctor about taking tamoxifen or raloxifene, which have been shown to reduce breast cancer risk, Love says. These drugs block estrogen in the breast tissue, helping to prevent or reduce tumor growth.

Side efects can include menopausal symptoms such as hot lashes.

Participate in research.

Most breast cancer research is conducted on rats and mice, which

don’t get the disease naturally. Love’s foundation sponsors the Army of Women initiative (armyofwomen .org), which informs people about studies that are looking for female participants.

The more research that’s conducted on breast cancer in women, the more scientists will learn about how to prevent and treat the disease.

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HEALTH

10 WHAT IT IS A common mood disorder, depression causes persistent sadness, feelings of worthlessness, and a loss of interest in regular activities. Some people with depression have trouble concentrating or making decisions.

They may overeat or lose their appetite, sufer from insomnia or sleep too much. Two-thirds of people with depression also report physical symptoms, such as increased aches and pains. Many may contemplate suicide.

Symptoms need to last for at least 2 weeks before the negative moods are diagnosed as depression.

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WHO IS MOST AT RISK People who are experiencing major stress or life changes or who have a family history of depression, as well as people who have been repeatedly exposed to abuse, neglect, or violence. People who have had previous bouts of depression also have a much higher risk of future episodes, says Philip R. Muskin, a psychiatry professor at Columbia University Medical Center. Scientists still don’t know exactly what’s happening in the brain during a depressive episode.

HOW TO PREVENT IT Consider psychotherapy. “Speaking with a

mental health professional can change how someone interacts in personal or professional relationships that may be problematic and can help reduce the factors that precipitate depression,” says Muskin. Psychotherapy

can also help people who have experienced depression in the past to recognize and deal with triggers that may cause another episode.

Research shows that cognitive-behavioral therapy can reduce the risk of depression by as much as 50%.

Learn cognitivebehavioral skills on your own. Mind Over Mood,

a popular book and website (mindovermood .com), contains worksheets that teach ways of thinking that ight depression, says Steven D. Hollon, a psychology professor at Vanderbilt University.

Try meditation and mindfulness. These

techniques can help with letting go of negative thoughts, Hollon

says. They also help people manage their stress levels, which is an important skill, given that stress can trigger depression.

Exercise regularly.

Physical activity can cut the risk of depression by 12%, Muskin says. Studies show that as little as an hour of moderate exercise a week can be helpful.

Adopt a depressionfighting diet. Healthy

food is crucial for preventing depression, says Drew Ramsey, a psychiatrist with the Columbia University College of Physicians and Surgeons and founder of the Brain Food Clinic. Ramsey recommends eating lots of leafy greens and seafood, especially

clams, mussels, and oysters, which are high in iron, selenium, zinc, vitamin B12, and antiinlammatory omega-3 fatty acids. Following the Mediterranean diet can also be beneicial, as studies have linked this way of eating to a 30 to 50% reduced risk of depression.

Ask your doctor about the Fisher Wallace Stimulator. This headband

device (isherwallace .com) uses electrical pulses to stimulate the brain to produce serotonin and other neurochemicals that help improve mood.

Because the device treats anxiety, a risk factor for depression, Muskin says it may help prevent depressive episodes.

Medical Sources for Prevention’s Guide to Preventing Disease Mary Ann Bauman, American Heart Association; Roger Blumenthal, Johns Hopkins School of Medicine; Otis Brawley, American Cancer Society; David Cooke, University of California, Davis; Charles S. Dela Cruz, Yale University; MeiLan Han, University of Michigan Health System; Steven D. Hollon, Vanderbilt University; William C. Knowler, National Institute of Diabetes and Digestive and Kidney Diseases; Joel Levine, UConn Health; Susan Love, David Geffen School of Medicine at UCLA; Philip R. Muskin, Columbia University Medical Center; Sanjeeva Reddy Onteddu, University of Arkansas College of Medicine; Drew Ramsey, Columbia University College of Physicians and Surgeons; Rudolph Tanzi, Harvard Medical School; Pierre Tariot, University of Arizona College of Medicine; Joseph Vassalotti, National Kidney Foundation; Ethan Weiss, University of California, San Francisco’s Cardiovascular Research Institute

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Bake It Vanilla-Applesauce Cupcakes Using unsweetened applesauce in baked goods reduces the amount of butter or oil you need. Our cream cheese frosting gets its color from fruit juice or avocado instead of artificial dyes.

FIND ALL RECIPES ON PAGES 70 AND 71.

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Better

FOOD

Boot the nutrition f your favorite desserts by adding surprise ingredients.

RECIPES BY THE PREVENTION TEST KITCHEN PHOTOGRAPHS BY ARMANDO RAFAEL

Almond & Chickpea Cookies Chickpeas give these treats extra protein, fiber, and anti-inflammatory selenium. The legumes’ subtle flavor easily blends into the recipe.

FOOD

ChocolateBeet Cake Rich and delicious cake becomes extra sweet and moist with beets, which provide betaine, an amino acid that helps support heart, liver, and digestive health.

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Lemon & Coconut Bars Featuring a coconut-flake crust, these bars have 50% less sugar and saturated fat than the traditional shortbread variety.

The curd uses extra lemon juice, rather than butter, for flavor.

FOOD

Vegetable Quick Bread Using a single recipe, you can create multiple variations on our healthy quick bread. Try carrots, parsnips, or zucchini and mix in berries, raisins, or nuts for extra vitamins and minerals.

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VANILLAAPPLESAUCE CUPCAKES PREP TIME: 10 MINUTES TOTAL TIME: 45 MINUTES + cooling/chilling time MAKES 12 CUPCAKES 1½ c self-rising flour ½ tsp salt ½ c sugar 3 Tbsp unsalted butter, softened 2 lg eggs 2⁄3 c unsweetened applesauce ½ c 2% milk ½ tsp vanilla extract FROSTING 6 oz reduced-fat cream cheese (Neufchâtel) ¾ c confectioners’ sugar 2 Tbsp unsweetened beet, blueberry, carrot, cherry, or raspberry juice or ½ avocado, mashed MAKE CUPCAKES 1. HEAT oven to 350°F. Line

12-cup muffin pan with paper liners. Sift flour and salt.

2. BEAT sugar and butter in large bowl until fluffy using an electric mixer on medium speed. Add eggs one at a time and beat until incorporated. Mix in applesauce. Add half of flour mixture and beat, then half of milk and beat; repeat.

Stir in vanilla.

3. DIVIDE batter among 12 cups. Bake until wooden pick inserted comes out clean, 22 minutes. Let cool.

MAKE FROSTING 1. BEAT cream cheese and

sugar in medium bowl until

creamy using an electric mixer on medium speed.

Add fruit juice or avocado and beat until smooth. Chill until easily spreadable, then frost cooled cupcakes.

NUTRITION (per cupcake with juice frosting) 198 cal, 4 g pro, 30 g carb, 1 g fiber, 18 g sugars (16 g added sugars), 7 g fat, 4 g sat fat, 50 mg chol, 362 mg sodium NUTRITION (per cupcake with avocado frosting) 206 cal, 4 g pro, 30 g carb, 1 g fiber, 18 g sugars (16 g added sugars), 8 g fat, 4 g sat fat, 50 mg chol, 362 mg sodium

ALMOND & CHICKPEA COOKIES PREP TIME: 5 MINUTES TOTAL TIME: 20 MINUTES + cooling time MAKES 18 1 can (15 oz) chickpeas, rinsed and drained ¼ c light brown sugar 2 Tbsp unsalted butter, melted 1 tsp almond extract 1 lg egg 1 c almond flour ½ tsp baking soda ¼ tsp salt ¼ c unsweetened shredded coconut ½ c dark chocolate chips 1. HEAT oven to 350°F. Line baking sheet with parchment.

2. BLEND chickpeas, sugar, butter, almond extract, and egg in food processor until smooth. Mix in almond flour, baking soda, and salt

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until smooth batter forms.

Add coconut and ¼ cup of the chocolate chips, pulsing to mix.

3. SCOOP dough onto baking sheet in 2 Tbsp balls.

Gently flatten cookies with moistened fingers. Bake until brown around edges, 12 to 14 minutes. Cool on sheet 2 minutes; transfer to rack to cool completely.

4. MICROWAVE remaining chocolate chips in 15second increments, stirring regularly, until melted, 1 to 2 minutes. Drizzle on cookies.

NUTRITION (per cookie) 117 cal, 3 g pro, 10 g carb, 2 g fiber, 6 g sugars (5 g added sugars), 8 g fat, 3 g sat fat, 14 mg chol, 118 mg sodium

CHOCOLATEBEET CAKE PREP TIME: 10 MINUTES TOTAL TIME: 1 HOUR 5 MINUTES + cooling time SERVES 12 1 c self-rising flour ½ c unsweetened cocoa powder ¾ c sugar 4 Tbsp unsalted butter, softened 1 lg egg 1 cooked beet, grated (about 1 c) 1 tsp vanilla extract ¼ c heavy cream 2 oz dark chocolate, chopped 1. HEAT oven to 350°F. Line bottom of 8" cake pan with parchment and lightly coat with cooking spray.

FOOD STYLING BY HEATHER MELDROM; PROP STYLING BY PAIGE HICKS

FOOD

2. SIFT flour and cocoa powder. Beat sugar and butter in large bowl until fluffy using an electric mixer on medium speed.

Add egg and mix until incorporated. Mix in beet and vanilla.

3. ADD half of the flour mixture until completely incorporated with mixer on low speed. Add ½ cup hot water and remaining flour mixture, mixing until smooth. Pour into cake pan and smooth top.

4. BAKE until wooden pick inserted in center comes out clean, 30 minutes. Cool on rack 10 minutes. Remove from pan; cool completely.

5. BRING cream to a boil.

Remove from heat, add chocolate, and let sit 5 minutes. Stir until smooth and allow to thicken, 5 minutes.

Pour over cooled cake and refrigerate to set, if desired.

NUTRITION (per serving) 179 cal, 3 g pro, 25 g carb, 1 g fiber, 15 g sugars (14 g added sugars), 8.5 g fat, 4.5 g sat fat, 33 mg chol, 145 mg sodium

LEMON & COCONUT BARS PREP TIME: 5 MINUTES TOTAL TIME: 1 HOUR + cooling/setting time MAKES 16 CURD ⅔ c lemon juice ½ c sugar 2 tsp lemon zest 1 Tbsp cornstarch 2 lg eggs

CRUST 2 Tbsp sugar ¼ tsp vanilla extract Pinch of salt 1 lg egg white 1½ c unsweetened shredded coconut MAKE CURD 1. COOK lemon juice and

sugar, stirring until sugar dissolves, in small saucepan over medium heat.

Stir in zest.

2. WHISK cornstarch and eggs to combine.

Whisking constantly, slowly pour in lemon syrup until combined, then transfer back to saucepan.

Heat over low, stirring constantly, until bubbles form at edges. Transfer to bowl, cover surface directly with plastic wrap, and refrigerate until cold.

MAKE CRUST 1. HEAT oven to 325°F.

Whisk sugar, vanilla, salt, and egg white in large bowl until combined. Fold in coconut.

2. LINE 8" x 8" baking pan with parchment and coat with cooking spray. Press in crust mixture and bake until toasted and brown, 15 minutes. Cool completely before spreading cold curd on top. Refrigerate until set, 2 hours.

NUTRITION (per bar) 103 cal, 2 g pro, 11 g carb, 1 g fiber, 8 g sugars (8 g added sugars), 6 g fat, 5 g sat fat, 23 mg chol, 24 mg sodium

VEGETABLE QUICK BREAD PREP TIME: 10 MINUTES TOTAL TIME: 1 HOUR 15 MINUTES + cooling time SERVES 16 1½ c self-rising flour 1 c whole wheat flour 1 tsp cinnamon ½ tsp nutmeg 2⁄3 c canola oil ½ c light brown sugar 2 tsp vanilla extract 2 lg eggs 3 c freshly grated carrot, parsnip, or zucchini 1 c mix-ins: blueberries, chopped nuts, dried cranberries, raisins (optional) 1. HEAT oven to 350°F.

Generously grease 9" x 5" loaf pan.

2. WHISK flours, cinnamon, and nutmeg in medium bowl. In separate bowl, whisk oil, sugar, vanilla, and eggs. Mix in carrot, parsnip, or zucchini.

3. ADD dry ingredients to wet and stir until flour is moistened. Stir in fruit or nut mix-ins, if using.

4. TRANSFER to loaf pan, smooth top, and bake until wooden pick inserted in center comes out clean, 45 to 55 minutes. Cool in pan 20 minutes, then transfer to rack to cool completely.

NUTRITION (per serving, with carrots) 197 cal, 3 g protein, 24 g carb, 2 g fiber, 9 g sugars, (8 g added sugars), 10 g fat, 1 g sat fat, 23 mg chol, 175 mg sodium

MIND + BODY

1-Minute Meditations YOU CAN TAKE CONTROL OF YOUR EMOTIONS WITH THESE EASY MINDFULNESS TECHNIQUES.

BY CAROLYN GREGOIRE ILLUSTRATIONS BY SILJA GOETZ

e often refer to certain emotions— anger, sadness—as “diicult.”

The problem, though, isn’t the feelings themselves. Rather, it’s the way we react to them, which is typically through resistance. But many psychologists agree: The harder we try not to feel the diicult emotions that are an inevitable part of our lives, the more intensely we do.

Swiss psychiatrist Carl Jung wrote: “We cannot change anything unless we accept it.” To acknowledge and even welcome unpleasant emotions is ultimately a more useful approach than pushing them away. Mindfulness can help.

This meditative practice, which focuses awareness on the

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MIND + BODY

HOW TO MANAGE YOUR THOUGHTS Mindfulness helps us pause the brain’s constant reminders (“I have to finish my to-do list!”), commentary (“Why must it rain today?”), and judgment (“That driver was rude.”).

Reducing the volume of your thoughts can be as simple as going through a checklist of your senses: What do you see, smell, hear, taste, and feel right now? Make a mental list: I see chicken cooking on the stove, I smell that chicken, I hear the oil sizzling, I can taste the lemon water I’m sipping, and I can feel its cool glass. “That brings you back into your current experience and stimulates positive thinking instead,” says psychologist Kristen Race.

present moment, has been shown to increase activity in brain regions associated with emotion regulation— sometimes quickly. A Michigan State University study found that participants who had never practiced mindfulness were better able to control diicult emotions after a single session.

Mindfulness provides other beneits as well. It’s been shown to reduce the body’s stress response, which in turn may help lower blood pressure, ease chronic pain, and regulate the immune system. “When we address stress, many other health concerns are addressed, too,” says Kristen Race, a Colorado-based psychologist and mindfulness expert.

By practicing little moments of mindfulness meditation in your daily life, you can not only reduce stress and improve your handling of negative emotions but be more present for the good feelings as well. “Happiness, wonder, joy, and love will be much more vivid if you’re present and aware,” says Vidyamala Burch, a meditation expert and instructor based in the UK. “Quite often we talk about how mindfulness can help with diicult things, but it also helps you to have a more joyful life.” Try these mini-meditations whenever you need them.

When You’re Angry If you’re confronted with a negative event that causes you to bubble with anger, take a moment to sit quietly before reacting outwardly. Simply focus on the sensations of anger in your body. Once you’ve taken a few seconds to cool down, go a step further with a mindfulness exercise from meditation teacher Sharon Salzburg.

Imagine you’re a Martian who’s new to Earth. You’re experiencing anger for the irst time. Ask yourself, What is this thing that’s happening? Where do

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I feel it in my body? What am I thinking about?

“This mindfulness gives us perspective,” says Christopher Germer, a clinical psychologist at Harvard Medical School.

“It helps us to disentangle and step back to see what we’re feeling and then work with it.” Considering this external point of view helps you bring objectivity and calm to the situation and prevents outbursts you might regret later.

When You’re Feeling Insecure If you’re stuck in self-doubt, Ronald Siegel, a clinical psychologist at Harvard Medical School, recommends a simple writing exercise to boost feelings of positivity.

Think of a loving and wise friend or family member.

Next, write a letter to yourself from that person’s perspective. What would the person say? What kind of advice would he or she give? Write it down, then read the letter to yourself. Chances are, it’s diferent from the negative self-talk you’re using. “Invariably, the friend is saying, ‘It’s OK, we all make mistakes, and I’ve done things like that, too,’ says Siegel. “It teaches us to be compassionate to ourselves.”

When You’re Lonely The traditional Tibetan practice of tonglen is based on the idea that we can combat feelings of disconnection or separateness by practicing compassion. This

reminds us that others experience the same emotions and sufer in the same ways we do, reinforcing the belief that we are never truly alone.

To ease feelings of loneliness, ind a quiet place and sit silently.

Call to mind an image of someone who is sufering. It could be a family member, friend, or stranger (such as a victim of war or natural disaster). Each time you inhale, breathe in this person’s pain; when you APRIL 2018 · PREVENTION.COM

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exhale, send peace, joy, hope, and love. “The idea is to fully take in the pain of the other person and practice being with it, while sending out a loving intention toward him or her,” says Siegel.

When You’re Impatient

3 QUICK MEDITATIONS TO HELP YOU SLEEP A growing body of research shows that mindfulness meditation is an effective way to improve sleep quality. Try one of these practices from psychologist Kristen Race to prime yourself for sleep.

Scan your body “Imagine yourself from your head to your toes, bringing awareness to the different parts of your body,” says Race.

This takes the attention away from your busy brain.

Time your breaths Focus on your breath as you inhale for four counts and exhale for six counts. “By increasing exhalation, we trigger a relaxation response in the body,” explains Race.

Reflect on your day Think about a good thing that happened during the day.

Taking a moment to feel thankful can help you relax, ward off worries, and get you in the right mind-set for sleep.

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You’re sitting in traic or waiting in line at the bank. Instead of focusing on getting out of the frustrating or boring situation, try being curious about it. “By doing so, you give the mind something to occupy itself with that’s satisfying and attainable,” says Burch.

Ask yourself: What’s it like to be stuck here in traic? How does impatience affect my breath and the rest of my body?

Am I tapping my foot or biting my nails?

You can even consider the colors of cars around you or the feeling of sunlight shining down on you through the window. When you spend a minute taking

MIND + BODY

they experienced less stress and anxiety.

an active interest in what’s happening this very moment, the impatience will dissolve as curiosity takes over, says Burch.

When You’re Cranky

When You’re Envious Use this simple practice to turn envy into joyful connection: Call to mind the person you feel envious of and wish him or her well. Think of this person warmly and say to yourself, I’m happy for you.

Repeat it a few times if you need to. You might even allow a little smile for the person you’re thinking about. This helps you feel closer to the individual, which is important because envy thrives on separation, explains Germer. “When we wish somebody well, it closes that emotional distance,” he says.

When You’re Worried As uncomfortable as it may be, confronting your fearful thoughts can be the best way to ease their impact. When your mind starts running through the things that might go wrong in your life, notice how the sensations in your body—a racing heart, quicker breathing—feel similar to those of excitement. Then acknowledge the fear kindly by using your name: Sarah, you’re feeling fear.

Using your name is a powerful way to create distance between yourself and the fear, halting your worried inner monologue and helping you put the situation in perspective. “It’s like a splash of cold water on your face,” says Germer. “You’re more likely to motivate yourself that way because using your name facilitates instant mindfulness.” In fact, a Journal of Personality and Social Psychology study found that when participants used their own name instead of “I” when approaching nerve-racking situations such as speaking in public,

It can feel like everything is going wrong when you’re stuck in a bad mood. When that happens, take a moment to appreciate what’s going right.

To start, Burch suggests bringing to mind something you’re thankful for and thinking of the person who made it possible as you inhale and exhale. That person could be a friend or family member or a stranger who played a small role in your day.

“If you’re grateful for your cup of cofee in the morning, think about the one person or the many people who made it possible,” she says.

Practicing gratitude has been shown to not only increase feelings of happiness but also potentially boost immunity and reduce symptoms of depression and anxiety.

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EXERCISE

Feel-Good

FITNESS Make daily tasks easier with simple toning moves for every level.

BY JEFF CSATARI PHOTOGRAPHS BY CHRIS FANNING

W

orkout fads come and go, but there’s a reason functional itness landed in the American College of Sports Medicine’s top 10 exercise trends of 2018. “It’s realworld itness,” says LA-based trainer Sarah Kusch. “It helps you build strength, balance, power, and mobility so you can tackle whatever life throws at you, whether that’s carrying groceries, jogging upstairs, lifting kids, or righting yourself before a fall.”

The best part: You can develop a leaner, more capable body with the ive key functional movements on the following pages.

Each type of exercise will make daily tasks easier while simultaneously toning trouble spots. “Anyone can do this,” says Kusch, who created this routine. Begin with Level I and work your way up to more challenging modiications as you get stronger. Aim to do 2 sets of 10 reps of each movement 3 times a week.

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1. BEND AND LIFT These moves develop core stability, lower-body strength, and flexibility in the knees and ankles.

You need them for: squatting down to lift heavy items like bags of groceries, gardening tools, or kids

LEVEL I

GOOD-MORNING BEND Stand with feet shoulderwidth apart, hands resting on hips. Keeping knees slightly bent and torso straight, slowly bend from hips until upper body is nearly parallel to floor, keeping back flat. Pause, then return to standing position. That’s 1 rep.

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EXERCISE

Challenge Yourself Add some weight! Perform Level II, but place an object, such as a dumbbell or water bottle, on floor between feet. When squatting, pick up object with both hands and stand up.

LEVEL II

WIDE SQUAT WITH TAP Stand with feet slightly wider than hip-width apart, hands in front of chest, palms touching.

Hinge at hips and bend knees, reaching down to touch floor between legs with 1 hand. Press weight into heels and straighten legs to return to starting position. Alternate hands with each rep.

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2. SINGLE LEG These moves develop balance, core strength, and hip flexibility.

You need them for: climbing stairs, catching yourself before a fall, or balancing on one leg to reach down to the floor to grab a sock

LEVEL I

KNEE LIFT TO HIP EXTENSION Stand with right hand on back of sturdy chair.

Keeping torso upright, raise left knee until thigh is parallel to floor, knee bent 90 degrees, then extend left leg behind you. Complete set, then repeat on opposite side.

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EXERCISE

LEVEL II

SINGLE-LEG DEADLIFT Stand on right leg with right knee slightly bent. Without changing bend in knee, hinge at hips, and lower torso until it’s parallel to floor, extending left leg behind you at hip height. Pause, then return to starting position. Complete set, then repeat on opposite side.

Challenge Yourself Add a knee lift to Level II! Raise left thigh until parallel to floor, knee bent 90 degrees.

Extend left leg behind you and bring torso parallel to floor.

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3. ROTATIONAL These moves develop flexibility and core stability to support the spine.

You need them for: sweeping and raking leaves, looking over your shoulder when driving, or reaching across your body

LEVEL I

STANDING THORACIC ROTATION Stand with feet hipwidth apart, hands in front of chest with elbows bent, palms touching. Keeping hips still, rotate torso to left, extending left arm and directing gaze over left shoulder. Return to start and repeat on opposite side. That’s 1 rep.

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EXERCISE

LEVEL II

STATIC SUMO SQUAT WITH THORACIC ROTATION Stand with feet wider than hipwidth apart, toes pointed slightly outward, hands in front of chest with elbows bent, palms touching. Squat, bending at hips and knees and ensuring that knees point toward toes. Holding squat, keep hips still and rotate torso to left and reach left arm behind you at 45-degree angle, directing gaze over left shoulder. Return to starting position and repeat rotation on opposite side. That’s 1 rep. Continue holding squat until all reps are completed.

Challenge Yourself Add some resistance!

Perform Level II, but hold a pair of light dumbbells or water bottles. If you feel a pinch in your shoulder or lower back, use a lighter weight.

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EXERCISE

4. PULLING These moves strengthen the back and improve posture.

You need them for: pulling open a door or dragging a trash can to the curb

LEVEL I

STANDING T PULL Stand with feet hip-width apart, arms extended in front of chest with palms touching.

Slowly draw shoulder blades together, bringing arms out to sides so body forms T shape.

Return to starting position.

Challenge Yourself Do the Superwoman exercise! Lie on belly with arms stretched forward. Squeeze buttocks and engage abs to protect lower back. Slowly lift arms and legs off floor, drawing shoulder blades together.

Hold for 5 breaths; return to start.

LEVEL II

BIRD DOG

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Start on all fours, wrists under shoulders and knees under hips.

Reach left arm forward and right leg back, keeping core engaged and lengthening spine. Hold, then contract shoulder blades and return to starting position. Repeat with opposite arm and leg. That’s 1 rep.

5. PUSHING These moves work the chest, shoulders, and triceps.

You need them for: pushing a door open or putting a pot on a high shelf

LEVEL I

INCLINE SEATED CHEST PRESS Sit at angle on chair, upper back supported by backrest, abs contracted. Hold dumbbells (or water bottles) close to shoulders, palms facing forward. Press weights out in front of torso at 45-degree angle, then return to starting position.

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Challenge Yourself Do a push-up on your knees! Start on all fours, hands slightly more than shoulder-width apart, legs bent. Lower chest toward floor. Hold, then push back to start.

LEVEL II

WALL PUSH-UP

Place hands slightly more than shoulder-width apart on wall.

Walk feet back until upper body is at slight angle toward wall.

On toes, keeping back and hips straight, bend elbows until face nears wall. Press back up, focusing on trying to push wall away.

PERSONAL JOURNEY

JENNIFER MARTINEZ/EYEEM/GETTY IMAGES

BETSY ANDREWS WAS LOOKING FOR HEALTH AND WELL-BEING. SHE FOUND IT IN A COLORADO FOREST, CLEARING TRAILS AND PROTECTING TREES.

T

he tool feels heavy. That’s my immediate impression when Dan Leach hands me a Pulaski, an ax-type device used for chopping wood and clearing trail. The 14 other Sierra Club volunteers I’m working with in Hermit Park, an open space in the Colorado Rockies, are spread out along the ribbon of trail we’re building. Leach explains that I’m meant to swing the tool against the stump of a Ponderosa pine recently cut to make way for this new 6.8-mile path for hikers, mountain bikers, and

horses, providing greater access to 1,362 acres of mountain meadows and pine forests.

It may sound odd that Sierra Club volunteers would hack up trees, but there’s a method to the madness: The pine is a sacriice to the greater good of preserving wilderness by, paradoxically, allowing humans to use it. The new trails will potentially bring in new visitors, and the fees collected from those visitors will help maintain the park. I lift the Pulaski, gauging how it will feel to raise it overhead.

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PERSONAL JOURNEY

M

onths earlier, when I signed up for this experience, I’d wanted to help out in a way that felt meaningful. That made me part of a very large group. In 2015, the

JAMES FRANK

I’m here to reap the cognitive, social, and physical beneits that come from giving back—and the revitalizing efects of being in nature. I needed a jolt. Working long hours tied to a desk at home in New York, I’d let my itness slip, and my left leg had been throbbing below an arthritic hip. I’ve come to the Rockies to work, huing and puing in the high altitude. Now I wonder: Am I up for it?

OK, I think, raising the Pulaski over my head, I’m about to ind out.

most recent year for which statistics exist, nearly 63 million Americans volunteered—by distributing food to the needy, helping out in hospitals, and tutoring kids, among hundreds of other services.

There was more to my decision than that, though. Volunteer work is good for you, but donating time and sweat in the outdoors is particularly beneicial, says Karl Pillemer, a professor of gerontology in medicine at Weill Cornell Medical College. Using longitudinal data from nearly 7,000 adults, he and his colleagues conirmed that people who volunteer in nature, compared with those who volunteer in other ways, stay more physically active, feel healthier, and sufer less depression later in life (for more details, see “The Nature Fix,” at right).

The regulars on this kind of adventure intuitively know as much, I learned right away. “You will meet people who are living their best life—inspirational,

uplifting sorts,” group leader Linda Gerdenich had told me when I’d called about the trip. She wasn’t kidding.

As I discovered when we gathered in a ranch house at the YMCA of the Rockies, everyone was over 50—but the group included a woman who had just backpacked 186 miles across Wales, a retired doctor who had run four marathons, and a petite 70-year-old who raises grizzly bears with her wildlife biologist husband.

I wasn’t sure I’d it in with these rugged and proven adventurers. But I knew we’d be sleeping in a lodge—and with a comfortable bed to come back to each evening, I thought my joints could survive a few days of exertion. I’d also packed my yoga mat so I could do the routine my physical therapist had prescribed to help me endure whatever kind of work I would be doing.

We started the irst morning by stretching on the ranch house lawn. At Hermit Park, we met up with Leach and his crew, who led us as we wound a slow half mile up to the trail site. Steller’s jays zoomed through the ields squawking, and the mountains rose around us. The park was so pretty I forgot about my hip.

Leach explained how to use the various tools, then looked us over. “Pace yourselves,” he said. “Stay within your means. You guys look ready, but we don’t want you hurting yourselves.”

I took a shovel and fell in behind Barb Robbins, the grizzly bear expert, who was scratching up grass with a

THE NATURE FIX Projects like the Sierra Club’s offer a sense of purpose, among other benefits, says Karl Pillemer, a professor of gerontology in medicine at Weill Cornell Medical College. Clearing trails and cleaning streams can be motivating because “someone who may not be inclined to exercise may love the idea of maintaining an environmental area,” he says.

Another plus: Eco-volunteers are nearly three times as likely as nonvolunteers to meet the Centers for Disease Control and Prevention guidelines for physical activity. That bodes well for their long-term health; studies show that moderate to vigorous aerobic exercise helps to reduce the risk of heart ailments, obesity, and other chronic diseases.

Finally, conserving natural areas offers what Pillemer calls “generativity”—the chance to build a legacy, to “do something that will benefit generations beyond your lifetime.”

To find a trip, visit the websites of the Sierra Club (sierraclub.org; $400–$2,800), the American Hiking Society (americanhiking .org; $330), Biosphere Expeditions (biosphere-expeditions .org; $2,130–$3,100), or Earth Watch (earthwatch.org; $1,450–$3,900). Closer to home, check out your local Nature Conservancy preserve (nature.org) or Audubon chapter (audubon.org).

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trail-building device called a McLeod.

Mine wasn’t a glamorous job, but it was important: The scraped-up grass and dirt had to be removed before people could enjoy the trail. So I scooped and tossed, making sure to bend my knees to protect my back and hips.

“We’re the trailblazers!” somebody hollered. “Go, Team Sierra!” There was laughter amid the clanking and scraping.

At lunchtime, I sat with Barb beneath a limber pine. Though she spends the majority of her time in nature, she especially likes service trips. “When you’re sharing tools and moans and groans, you develop a closer bond than when you’re just hiking,” she said. “I worried in the beginning that I might not be strong enough to help much, but there’s always something to do within your ability that lets you feel that you’re contributing.”

I saw what she meant. Late that afternoon, as I surveyed our 350 feet of

new trail, I felt proud of our hardworking group. “I walked back down the trail we just created,” said volunteer Lucy Harmon, “and it was magical.”

The trip was illed with moments like that. Taking time from shoveling to look up at the majestic peaks around us, sitting under a blanket of stars after dinner, waking to a family of elk walking past the ranch house—I felt elated.

T

he next day, fellow volunteer Leo Mellon, 70, waits for me as I stand holding the Pulaski to cut the roots free so he can wind a winch to the stump and ratchet it out of the ground. I recall something he told me over dinner. “After I retired, I lost 30 pounds,” the former school principal had said.

“Work was really stressful, and I wasn’t exercising.” He’d committed to

JAMES FRANK

PERSONAL JOURNEY

environmental volunteerism, and with all the activity, his blood pressure and other key health markers improved.

If Leo can do it, I igure, so can I. I lift the Pulaski, raising it above my shoulder and sliding my right hand down its neck to meet my left so the tool drops with the force of its own weight. Thwack. A clean hit. A few more cracks at it and the thick root splits in two, leaving the stump one tentacle free of the earth.

I go at another root, working up a sweat as others cheer me on. And that’s it: I’m hooked.

On the inal day, we switch from trail work to building slash piles, arranging fallen and felled wood into teepee shapes that can be lit in controlled burns to minimize the risk of wildires.

Conident from my tussle with the tree stump, I join in with the strongest members of the group, who are hauling

and raising hefty logs to balance against one another so others can ill in the structures with smaller tinder. Each pile is a puzzle to igure out.

“Problem-solving together engages your brain in all kinds of ways that become part of your creativity,” says Bonnie Black, 81, another volunteer, her arms full of branches.

I’m fully focused, I’m sweating again, and I’m having a ball. With each big log I set in place, I feel more empowered.

Even my hip isn’t complaining. What a few days it’s been. I’ve learned how to build trails and slash piles. I’ve made new friends. And though I might have to reckon with my hip later, I’ve pushed my body—and taken care of it—in ways that have made me proud.

The hours pass quickly, and by the time we inish, we’ve built a dozen sturdy structures. They’re just piles of wood, but they sure look beautiful to me.

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Barbara O’Dair

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Get your doctor’s approval before beginning any exercise or dietary program.

PROMOTION

Transform Your Health With Yoga Lose weight, build strength, and feel calmer.

JASON VARNEY

Want to feel and look your best? Our simple videos with yoga teacher Amy Ippoliti make it easy to jump right in, even if you’ve never done yoga before.

START NOW! Go to prevention.com/ easyyoga to order your DVDs today.

BRAIN GAMES

Stay Sharp Try these fun workouts for your brain.

1 ZIGGURAT

2 MIND

TWISTER

Test your logic with this riddle.

ÎIt lies yet has no wings.

ÎIt can be long or short but is not a measuring stick.

Do not put this before the horse, as the expression goes.

ÎIt can be

associated with a capsule but is not a medicine.

(Add an E) A footprint or physical sign left behind

What is it? Î

(Add an S) What someone does when he or she responds impulsively

96 PREVENTION.COM · APRIL 2018

__ __ __ __

PUZZLES ADAPTED FROM THE TOTAL BRAIN WORKOUT BY MARCEL DANESI, PHD

Work on your vocabulary recall with this stacked puzzle. Begin by determining the top word according to the provided deinition. Then go down a level, add one letter to the word above, and rearrange the letters to form a new word.

Repeat and form the inal word.

3 BUILD A SQUARE To strengthen your visualization skills, determine how many circles you need to add to the rows and columns to ill in the square.

4 ODD ONE OUT Test your critical thinking skills by iguring out which word doesn’t belong in each group.

Check our answers below, and then see what other solutions you can ind.

A.

LIMP, DROP, PLAIN, LIKE, TRUE

B.

AVID, UNDERNEATH, ISLAND, TRY, ERA

C.

AWAY, DATA, EASY, AHA, MANNA

Answers: 1. Cart, trace, reacts. 2. Time. 3. 38. 4. A. All words except plain have four letters. B. All words except try start with a vowel. C. All words except easy have two As.

Also Inside New Asthma Secrets of Treatments Fitness Pros Easy Everyday Exercises

5 Healthy Treats to Bake