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  • An HPV test may be more effective at detecting precancer than a Pap smear, study finds
  • Experts remain torn on whether screening practices should change

Cervical cancer is among the easiest gynecologic cancers to prevent, and two screening tests can help detect the disease early: the routine Pap smear and testing for human papillomavirus, or HPV.

The cytology-based Pap smear involves looking for cancer or precancer cells by testing cells taken from the lower end of a woman’s uterus, called the cervix. Diagnosing diseases by looking at single cells and small clusters of cells is called cytology or cytopathology.
On the other hand, a woman’s cervix also can be tested for the presence of certain high-risk types of HPV that can cause cancers, including cervical cancer.
Now, a study published in the journal JAMA on Tuesday suggests that cervical HPV testing may be able to detect signs of cancer earlier and more effectively than Pap smear over a 48-month period.
The findings are part of the Human Papillomavirus For Cervical Cancer screening trial, a publicly funded Canadian study.
“There has been a significant body of evidence that shows that by including HPV testing — as co-testing with cytology — we could improve detection of precancerous lesions of the cervix,” said Dr. Gina Ogilvie, professor and Tier 1 Canada Research Chair in Global Control of HPV-related diseases and prevention at the University of British Columbia, who was lead author of the study.
“So this study is the next step, showing that by using only HPV testing in a screening scenario, four years later, women who received HPV testing were less likely to develop precancerous lesions,” she said. “The HPV virus is the cause of 99% of cervical cancers. By focusing on detecting the virus, we are then better able to determine which women have developed precancerous lesions and treat those earlier.”
In 2017, the US Preventive Services Task Force put forth draft recommendations to explore the idea of recommending screening every three years with cervical cytology alone in women ages 21 to 29 and then either continuing that testing or screening with HPV testing alone every five years, up to age 65. A final recommendation has yet to be published.
In 2012, the task force recommended screening for cervical cancer with Pap smear in women 21 to 65 every three years. Women 30 to 65 can screen with a combination of cytology and HPV testing every five years.
Cervical cancer is the fourth most frequent cancer in women globally, according to the World Health Organization. There were an estimated 530,000 new cases in 2012, representing 7.9% of all female cancers.
In the United States this year, the American Cancer Society estimates that there will be 13,240 new cases of invasive cervical cancer diagnosed, and 4,170 women will die from cervical cancer.

Weighing screening options

The new study involved 19,009 women across British Columbia who had no history of invasive cervical cancer. The women, ages 25 to 65, were randomly assigned to one of two groups between 2008 and 2012.
In one group, the women underwent HPV testing alone. In the other group, the women underwent routine cytology-based Pap smear testing. Lastly, if women in the HPV testing group received positive results for HPV, it was followed by cytology, whereas HPV-negative women underwent cytology screening at 24 months after their results.
All participants were invited to complete a demographic and behavioral questionnaire, which included questions related to their HPV vaccination status, sexual health and sociodemographic status, among other factors.
The researchers found that significantly more women showed signs of precancer cells in the first round of HPV testing compared with the Pap test group, despite the groups having similar questionnaire responses.
Referral rates for followup appointments related to concerning test results were significantly higher in the HPV testing group, at 57%, compared with the Pap test group, at 30.8%. By 48 months, those referral rates were lower in the HPV testing group, at 49.2%, compared with the Pap test group, at 70.5%.
“What this study could offer is confidence that the most important part of screening in co-testing is HPV, and health agencies can now consider whether offering Pap tests is good use of limited and scarce health dollars,” Ogilvie said.
“Offering women HPV [testing] for cervical cancer screening detects more precancerous lesions earlier, and also a negative HPV test offers more assurance that women will not develop precancer in the next four years,” she said. “This can mean that women may need to be screened less frequently but have more accurate results.”
Limitations of the study included that the women were mostly highly educated and primarily from two specific regions in British Columbia. More research is needed to determine whether similar results would emerge among a more diverse group of women.
The study was funded by Canada’s public research agency, the Canadian Institutes of Health Research.
A few authors of the study reported conflict of interest disclosures with ties to Siemens, a company behind an array of HPV tests, and Merck, maker of the HPV vaccine Gardasil.
Though the findings turn a new spotlight on cervical cancer screening approaches, they should not change current screening guidelines, said Dr. Mark Spitzer, medical director of The Center for Colposcopy in Long Island, New York, and past president of the American Society for Colposcopy and Cervical Pathology. Spitzer was not involved in the study.
“In the US, co-testing is currently the recommended gold standard, and neither doctors nor their patients should be willing to give up the added benefit you get from screening with a Pap test and HPV test together,” said Spitzer, a professor of obstetrics and gynecology at the Zucker School of Medicine at Hofstra/Northwell.
“We have known from years of clinical research that primary HPV testing is more sensitive than cytology testing, a fact that was confirmed by this study. However, the study only compared primary HPV testing to liquid-based cytology,” he said. “There was no co-testing comparison group in the study.”

‘This could really potentially simplify how we screen women’

The study was “well-designed” and provides a much-needed comparison of Pap versus HPV testing, said Dr. Kathleen Schmeler, a gynecologic oncologist and co-leader of the HPV-Related Cancers Moon Shots Program at The University of Texas MD Anderson Cancer Center, who was not involved in the new research.
“The bottom line is that this could really potentially simplify how we screen women and have it be more effective and not quite as complicated and burdensome — and opens the door for doing just HPV testing, which is actually what’s currently recommended by the World Health Organization for countries that don’t have Pap testing capabilities,” Schmeler said.
“They say if you don’t have Pap testing right now, don’t start Pap testing; instead invest in doing primary HPV testing, because it is that much more effective if it’s the only option that you have,” she said. “So these implications are important for North America, but they’re really important for the whole world. Cervical cancer is more common in lower-resource settings where people don’t have access to screening.”
Dr. L. Stewart Massad Jr., a professor of obstetrics and gynecology in the division of gynecologic oncology at Washington University School of Medicine, wrote an editorial that accompanied the study in JAMA.
“What will replace the Pap test? In 2012, the American Cancer Society endorsed co-testing with cervical cytology testing and HPV testing at 5-year intervals as the preferred strategy for screening women 30 to 65 years of age because this approach combines the sensitivity of HPV testing with the familiarity of traditional Pap testing,” Massad wrote.
“However, the addition of cervical cytology testing adds little to the accuracy of HPV testing while increasing cost and false-positive results,” he wrote. “In 2018, organizations that develop cancer screening guidelines are wrestling with whether to recommend replacing co-testing with primary HPV testing as the optimal screening strategy.”
With this new study, that wrestling continues.
Source: https://edition.cnn.com/2018/07/03/health/cervical-cancer-hpv-testing-study/index.html

If you’ve ever suffered from dizziness or vertigo, you know that it’s not something you ever want to experience regularly (or at all). It can create uncomfortable, sometimes miserable feelings of panic, nausea, and weakness. It’s not only scary; dizziness can be a sign of more concerning problems, and understanding the underlying cause and any associated symptoms can help you feel better sooner rather than later.

The most prevalent cause of dizziness is vertigo, which accounts for 54 percent of dizziness reports in primary care offices. Vertigocreates a feeling of spinning within your body and also potentially within your environment. This feeling can last seconds or minutes (as in vestibular paroxysm) or hours (as in Menière’s disease or vestibular migraine). In the worst cases, vertigo can last days or even weeks.

The basics of vertigo: symptoms, severity, and root causes.

Interestingly, vertigo is not a disease but actually a symptom itself. Dizziness can be a sign of a wide range of disorders and often coincides with other uncomfortable symptoms. Depending on the cause, vertigo may also be accompanied by ear pressure, headaches, hearing loss, nausea, vomiting, loss of vision, slurred speech, or loss of consciousness. Identifying all of the associated symptoms is crucial because it can help determine the underlying problem, identify what type of vertigo is being experienced, and ensure appropriate care.

The most common type of vertigo is benign paroxysmal positional vertigo (BPPV). BPPV is caused by calcium carbonate crystals normally embedded in gel in the utricle (part of the inner ear) becoming dislodged. The crystals can then migrate into one or more of the three fluid-filled semicircular canals in the ear. When these crystals accumulate in one of the canals, they interfere with normal fluid movement, and the inner ear can send false signals to the brain.

BPPV creates brief dizziness episodes often triggered by specific changes, like moving your head up or down, lying down, turning over, or sitting up. Symptoms of BPPV besides dizziness include nausea, vomiting, and unsteadiness that can increase your risk for falls. Fortunately, BPPV is the easiest type of vertigo to treat. If you suspect you have BPPV, consult with your doctor to discuss effective strategies to reduce or eliminate symptoms.

Photo: @skyNext

Treating vertigo: what to expect.

Treating vertigo typically includes some combination of medication, physical therapy, and psychotherapy. In extreme cases, it may require surgery, but this is rare. The treatment method and medications used depend on the type of vertigo and any underlying conditions. In the case of BPPV, a doctor may be able to help move the calcium crystals that cause the problem out of the ear canal, providing relief. Additionally, a doctor might prescribe medication including diuretics, anti-dizziness medications, anti-nausea medications, anti-anxiety medications, and migraine remedies. However, vertigo often demands a multifactorial approach beyond medication. One option is seeing a chiropractor. Vertigo centers on the nervous system and the structures that surround it, including the spine and its structure, so chiropractic treatments can be a perfect complement to care.

Manage vertigo naturally with these five strategies.

With the right approach, you can effectively manage vertigo. Research has found that combined therapy—including regular exercise and balance training—leads to marked improvement in more than 70 percent of patients, even those who’ve had vertigo for years.

1. Balance your blood sugar.

Processed, sugary foods can trigger blood sugar fluctuations, and so do things like alcohol, which can worsen symptoms like dizziness. Studies have found that reducing unhealthy fats and carbohydrates while increasing fiber-rich foods can stabilize triglycerides and minimize harm to the inner ear. Eating a whole foods, unprocessed diet with plenty of high-fiber plant foods including leafy and cruciferous vegetables as well as berries and legumes is a great way to stabilize your blood sugar and provide the nutrients your body needs to thrive.

2. Eat anti-inflammatory, antioxidant-rich foods.

Oxidative stress and inflammatory mediators may contribute to vertigo. One study found people with BPPV had low levels of antioxidants. Load up on antioxidant-rich foods like berries and nonstarchy vegetables along with anti-inflammatory omega-3 fatty-acid-rich foods including wild-caught seafood, flaxseed, chia seeds, and walnuts.

3. Control stress.

Studies show stress and vertigo go hand in hand and often feed off each other. When you’re stressed out, you’re more likely to experience an episode of vertigo, and worrying about vertigo, in turn, increases stress and anxiety. You can learn to manage those emotions with calming practices like meditation, deep breathing, or yoga.

4. Try herbal remedies.

A number of herbs can provide antioxidant, anti-inflammatory, and other benefits that can ameliorate the symptoms of vertigo. Among them include turmeric, cayenne, Ginkgo biloba, and ginger root. Just remember to always talk to your health care practitioner before incorporating new supplements or herbs into your routine.

5. Exercise consistently.

Researchers found a home-based exercise program was more effective than medication for some patients with persistent or chronic vertigo. The type and level of exercise recommended depends on several factors including how fit you are, what you’ll stick with consistently, and what you can do to safely minimize dizziness and other potential symptoms. That might mean an elliptical machine, brisk walking, or weight resistance. Yoga makes a great exercise to strengthen balance, improve blood flow, and positively affect your sympathetic nervous system. Some poses can be problematic for people with vertigo, so inform your yoga instructor if you have vertigo or other medical conditions.

Source: https://www.mindbodygreen.com/articles/dizziness-isnt-all-in-your-head-a-doctor-explains-vertigo-ways-to-treat-it

Kids exposed to tobacco smoke in the womb and early in infancy could have double the odds of developing hearing loss compared with children who were not exposed to tobacco at all, a Japanese study suggests.

While previous research suggests that adult smokers are at greater risk of hearing loss than nonsmokers, less is known about how much smoke exposure during infancy or pregnancy might impact hearing.

For the current study, researchers examined data on 50,734 children born between 2004 and 2010 in Kobe City, Japan. Overall, about 4 percent of these kids were exposed to smoking during pregnancy or infancy, and roughly 1 percent had tobacco exposure during both periods.

Hearing tests done when kids were 3 years old found that 4.6 percent of the children had hearing loss.

They were 68 percent more likely to have hearing loss if they were exposed to tobacco during pregnancy, and 30 percent more likely if they inhaled second-hand smoke during infancy, the study found.

When kids had smoke exposure during both periods, they were 2.4 times more likely than unexposed kids to have hearing loss.

“Patients with the greatest risk of hearing impairment are those who are directly exposed to maternal smoking in the womb,” said Dr. Matteo Pezzoli, a hearing specialist at San Lazzaro Hospital in Alba, Italy.

“Interestingly, the exposure to tobacco in early life seems to further strengthen the prenatal toxic effect,” Pezzoli, who wasn’t involved in the study, said by email.

When pregnant women smoke, it may harm fetal brain development and lead to auditory cognitive dysfunction, Pezzoli added. Tobacco smoke may also damage sensory receptors in the ear that relay messages to the brain based on sound vibration.

Globally, about 68 million people have a hearing impairment that is thought to have originated in childhood, Koji Kawakami of Kyoto University in Japan and colleagues note in Paediatric and Perinatal Epidemiology. Kawakami didn’t respond to requests for comment.

Researchers assessed children’s hearing using what’s known as a whisper test. For these tests, mothers stood behind their kids to prevent lip reading, then whispered a word while kids’ had one ear covered.

While this test is simple and considered an accurate way to assess hearing in adults and older children, there’s some concern about how reliable the results may be in young kids.

It’s considered more reliable when it’s done by trained clinicians and specialists and less reliable when it’s done by primary care providers, researchers note. It’s unclear how accurate study results based on tests administered by the children’s parents would be, researchers acknowledge.

The study also wasn’t a controlled experiment designed to prove whether or how tobacco exposure during pregnancy or infancy might directly cause hearing loss in kids.

“There was no standardized medical evaluation of hearing or examination of the ears by ear specialists,” said Dr. Michael Weitzman, a pediatrician and hearing researcher at New York University who wasn’t involved in the study.

“Moreover, the severity of hearing loss could not be ascertained in this study, and it did not follow up the children throughout their childhood so we do not know if what they found attenuated or got worse over time,” Weitzman said by email.

Still, the results add to the evidence linking tobacco exposure to hearing problems in kids, Weitzman said.

To protect children against hearing problems caused by cigarette smoke, it’s important for women to quit before they become pregnant or as soon as they discover they’re pregnant, said Huanhuan Hu, a researcher at the National Center for Global Health and Medicine in Japan who wasn’t involved in the study.

“To minimize the chance that their baby will be exposed to tobacco smoke in the womb, other family members should also quit, or at least not smoke at home or nearby the pregnant women,” Hu said by email.

SOURCE: bit.ly/2IAPU2W Paediatric and Perinatal Epidemiology, online June 5, 2018.

Source: https://www.reuters.com/article/us-health-infancy-hearing-smoke/smoke-exposure-during-pregnancy-and-infancy-tied-to-hearing-loss-idUSKBN1JO341

Association is mediated by increased use of β-lactam alternative antibiotics

There is a correlation for documented penicillin allergy with increased risk of methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile, which is mediated by increased use of β-lactam alternative antibiotics, according to a study published online June 27 in the BMJ.

Kimberly G. Blumenthal, M.D., from Massachusetts General Hospital in Boston, and colleagues conducted a population-based matched cohort study to examine the correlation between penicillin allergy and development of MRSA and C. difficile. Data were included for 301,399 adults without previous MRSA or C. difficile: 64,141 with a penicillin allergy and 237,258 age-, sex-, and study-entry-time-matched comparators.

The researchers found that during a mean six years of follow-up, 1,365 adults developed MRSA (442 with penicillin allergy) and 1,688 developed C. difficile (442 with penicillin allergy). The adjusted hazard ratio for MRSA and for C. difficile was 1.69 and 1.26, respectively, among patients with penicillin allergy. Also among patients with penicillin allergy, the adjusted incidence rate ratios for antibiotic use were 4.15, 3.89, and 2.1 for macrolides, clindamycin, and fluoroquinolones, respectively. Increased use of β-lactam alternative antibiotics accounted for 55 and 35 percent of the increased risk of MRSA and C. difficile, respectively.

“Systematically addressing penicillin allergies may be an important public health strategy to reduce the incidence of MRSA and C. difficile among patients with a penicillin allergy label,” the authors write.

Source: http://www.physiciansbriefing.com/Article.asp?AID=735229

Three-quarters of Americans are falling far short when it comes to exercise, and the South and Midwest bear the dubious distinction of having the most couch potatoes, a new government report shows.

Only about one in four adults (23 percent) meets minimum federal guidelines for physical activity, according to researchers from the U.S. National Center for Health Statistics.

Dr. William Roberts, past president of the American College of Sports Medicine, said the only surprise is that the percentage of Americans meeting the exercise target “is as high as it is.”

But he suggested that it’s never too late for those who aren’t active.

“Regular exercise reduces the prevalence of heart disease, [high blood pressure], diabetes, obesity, depression and many other medical conditions,” he said. “It is dose-dependent, and basically free.”

In the study, investigators Debra Blackwell and Tainya Clarke surveyed exercise habits among more than 155,000 American men and women, aged 18 to 64, between 2010 and 2015.

The goal was to see whether Americans were meeting the most recent recommendations issued by the U.S. Department of Health and Human Services (HHS) back in 2008. Activities performed during work or while commuting were not included.

The 2008 guidelines advocate muscle training at least twice weekly, alongside either 150 minutes per week of moderate-intensity aerobic exercise or 75 minutes of high-intensity aerobics (or a mix of both).

The 23 percent figure shifted little throughout the five-year study, the investigators found. And the good news is that while three-quarters of Americans didn’t meet the thresholds, the 23 percent who did exceeded the federal goal of getting 20 percent adherence by 2020.

The bad news, however, is that the report also found huge geographical disparities, with activity levels in some states dipping far below or far above the national average.

“Fourteen states and the District of Columbia had significantly higher percentages of adults meeting the guidelines than the national average, while 13 states had percentages that were significantly below the national average,” Blackwell said.

Among men, Washington, D.C., topped the rankings, with just over 40 percent of residents meeting the guidelines. But in South Dakota, less than 18 percent of male residents made the exercise grade.

Colorado came out on top among women, said Blackwell, with nearly one-third meeting the guidelines. By contrast, Mississippi came in dead last, with only about one in 10 women achieving minimum standards.

As to what might explain regional differences, Blackwell said “there are likely many factors that play a role,” including social and cultural backgrounds, economic status and job status.

Blackwell and Clarke found that states that were home to more professional or managerial workers met higher exercise thresholds. Similarly, states that had fewer unemployed adults encumbered by fair-to-poor health or disabilities also registered higher exercise rates.

Gender also mattered, as less than 19 percent of all women met HHS exercise goals.

But sedentary people who get off the couch and start moving actually have “the most gain in health benefit for any group of people,” noted Roberts, a professor in the department of family medicine and community health at the University of Minnesota.

“Or put another way,” he said, “the same increase in activity benefits a sedentary person by a far greater amount than a similar increase in an already moderately active person, and even more so than a vigorously active person.”

So what’s an aspiring exerciser to do?

“‘Well’ people can start with a five-minute walk, and add a minute a day — more or less — to gradually increase activity over a period of weeks to months,” Roberts said. “Once at 30 to 60 minutes nearly every day of the week, picking up the pace is OK. Any physical activity from walking to running to dancing to biking is OK. The goal is to move.”

The findings were reported in the June 28 issue of the National Health Statistics Reports.

More information

The U.S. Department of Health and Human Services has more about the exercise guidelines.

SOURCES: Debra Blackwell, Ph.D., statistician/demographer, U.S. National Center for Health Statistics, Hyattsville, Md.; William Roberts, M.D., professor, department of family medicine and community health, University of Minnesota, Minneapolis, and past president, American College of Sports Medicine; June 28, 2018, National Health Statistics Reports

Source: https://consumer.healthday.com/fitness-information-14/misc-health-news-265/just-1-in-4-americans-gets-enough-exercise-735267.html

Meat and fish aren’t the only sources of protein. Veggies, legumes, and other vegetarian foods can also load you up with this power nutrient.

BRIAN YARVIN/GETTY IMAGES

There lots of good reasons to go vegetarian. For one, there are major health benefits: People who eat more plant-based protein tend to weigh less and have a lower risk of cardiovascular disease and diabetes than people who eat a lot of meat, and some research shows a meatless diet reduces your risk of death from any cause. Even if you’re not interested in going fully meatless, simply cutting back on animal protein could have a positive impact on your health.

But if you go vegetarian, how are you going to get enough protein? Protein is essential for building and maintaining muscle mass, keeping you full between meals, and ensuring every cell in your body is operating properly.

Don’t sweat it—we figured it out for you. There are plenty of other sources of protein besides meat, and they’re incredibly good for your body. Here, we’ve ranked 20 high-protein vegetables, legumes, and minimally processed meat alternatives.


Edamame

edamame
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Protein: 18 g per 1-cup serving (cooked)

Talk about healthiest appetizer ever—just a cup’s worth of edamame (or cooked soybeans) packs a huge protein punch. Be sure to pick an organic variety, though, as most soybeans in the US are genetically modified and heavily treated with pesticides.

Tempeh

tempeh
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Protein: 16 g per 3 oz serving

Tempeh is made by fermenting cooked soybeans and shaping it into a dense cake that can be sliced and pan-fried like tofu. It’s nutty, chewy, and packs significantly more protein and fiber than tofu—and because it’s fermented, it’s easier to digest for some.

Try this recipe: Tempeh Meatballs

Tofu

tofu
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Protein: 8 to 15 g per 3 oz serving

Ah, tofu, the classic vegetarian blank slate made from curdled soymilk that’s wonderful pan-fried, sautéed in a stir-fry, and even scrambled. Though it’s not quite as protein-packed as tempeh, its taste may be more tolerable. Opt for organic varieties to avoid genetically modified soy and funky pesticides. Then try the versatile protein in one of these 7 delicious recipes guaranteed to make you like tofu.

Lentils

lentils
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Protein: 9 g per ½-cup serving

Low-cal, high-fiber, and high-protein lentils can be morphed into a nutrient-dense side dish, veggie burger, or even whipped into a hummus-like dip. Bonus: They’ve been shown to lower cholesterol and reduce risk of heart disease.

Black Beans

black beans
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Protein: 7.6 g per ½-cup serving (cooked)

Black beans are also packed with heart-healthy fiber, potassium, folate, vitamin B6, and a range of phytonutrients.

Lima Beans

lima beans
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Protein: 7.3 g per ½-cup serving (cooked)

What, you haven’t had these since you were 10? Well, good news: In addition to filling protein, lima beans contain the amino acid leucine, which may play a big role in healthy muscle synthesis among older adults.

Peanuts or Peanut Butter

Peanut butter
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Protein: 7 g per ¼-cup serving (or 2 Tbsp peanut butter)

Not only are peanuts and peanut butter great for munching and whipping up classic childhood comfort food, they’re also super versatile—really, you can even use them in a pizza. They’ve also been shown to help you eat less at lunch if you consume them at breakfast—aka the second-meal effect. PB and banana, anyone? Just make sure to use a peanut butter that’s 100% nuts and doesn’t contain added sugars, like Smucker’s Natural Peanut Butter.

Wild Rice

wild rice
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Protein: 6.5 g per 1-cup serving (cooked)

Move over, quinoa. Wild rice is the protein-rich grain you should be gravitating toward. With a nutty taste and slightly chewy texture, it’s way more satisfying, too. Use this ultimate guide to cooking whole grains.

Chickpeas

chickpeas
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Protein: 6 g per ½-cup serving

Permission to eat all the hummus—well, maybe not all of it, but chickpeas’ combo of protein and fiber make for one healthy dip. Try it slathered on sandwich bread in place of mayo, or serve up one of these four ridiculously tasty hummus recipes with veggie slices. You can even use chickpeas to make these super-easy Flourless Banana Blender Muffins when you’re hankering for something sweet.

almonds
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Protein: 6 g per ¼-cup serving

Along with protein, almonds deliver some serious vitamin E, which is great for the health of your skin and hair. (These are the 25 best foods for your skin.) They also provide 61% of your daily recommended intake of magnesium, which can help curb sugar cravings, soothe PMS-related cramps, boost bone health, and ease muscle soreness and spasms.

Chia Seeds

chia seeds
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Protein: 6 g per 2 Tbsp

Chia seeds pack a ton of protein in those pint-sized orbs, which are also a great source of alpha-linolenic acid (ALA), a type of plant-based omega-3 fatty acid. Bonus: Omega-3s help stimulate the satiety hormone leptin, which signals your body to burn these fats instead of storing them.

Steel-Cut Oatmeal

steel cut oats
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Protein: 5 g in ¼-cup serving (dry)

Steel-cut oats aren’t just a solid source of protein; they also have a lower glycemic index than rolled oats. This means they don’t spike blood sugar as much, so you’re likely to be more satisfied and experience fewer cravings after eating them.

Cashews

cashews
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Protein: 5 g per ¼-cup serving

In addition to a decent protein punch, cashews contain 20% of the recommended intake of magnesium, along with 12% of the recommended intake of vitamin K—two essential bone-building nutrients. (Here are 4 things that can happen if you don’t get enough magnesium.)

Pumpkin Seeds

pumpkin seeds
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Protein: 5 g per ¼-cup serving

Pumpkin seeds aren’t just a super convenient way to get a dose of satiating protein, they’re total nutrient powerhouses, packing about half the recommended daily intake of magnesium, along with immune-boosting zinc, plant-based omega-3s, and tryptophan—which can help ease you into a restful slumber.

Potatoes

potatoes
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Protein: 4 g in 1 medium white potato

Another stealth source of protein! Despite having a reputation for being pretty much devoid of all nutrition, a medium-sized spud actually contains 4 g of protein, along with about 20% of the recommended daily intake of heart-healthy potassium.

Spinach

spinach
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Protein: 3 g per ½-cup serving (cooked)

Sure, 3 g may not sound like a lot, but for a green veggie, it is. Still, don’t just make a salad and call it a day. Cooking this green is the secret to upping its protein content.

Corn

corn on the cob
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Protein: 2.5 g per ½-cup serving

Like potatoes, corn often gets put into the “plants with no redeeming qualities” category, but paired with protein-rich veggies and legumes, it can nicely round out a protein-packed plant-based dish. Pick organic or non-GMO fresh or frozen varieties, though, as most conventional corn has been genetically modified.

Avocado

avocado
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Protein: 2 g per ½ avocado

This fruit is creamy, dreamy, and super filling, thanks to its bend of monounsaturated fatty acids and a bit of protein.

Broccoli

broccoli
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Protein: 2 g per ½-cup serving (cooked)

Broccoli’s not only an awesome source of fiber, its protein content is surprising, too (for a veggie anyway). And you can’t go wrong with a vegetable that’s been proven to deliver cancer-preventing properties.

Brussels Sprouts

Brussels sprouts
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Protein: 2 g per ½-cup serving

These little green guys get a bad rap in the taste department—especially the frozen variety—but they’re actually nutritional superstars. In addition to protein, Brussels sprouts pack hefty doses of potassium and vitamin K.

Source: https://www.prevention.com/food-nutrition/healthy-eating/a20514733/high-protein-vegetables-and-plant-based-food/

Post traumatic stress disorder is more common than you think, and women are more than twice as likely to develop it than men.

Most people will experience a traumatic event at some point in their lives, whether they’ve lived it themselves, witnessed it, or heard about it happening to a friend or family member.

In fact, five out of 10 women in the United States—yes, half—will experience one of these events, like a tragic car accident or sexual assault. When this happens, it’s normal and expected for those affected to act differently afterward—nightmares, being hyper-alert, or avoiding the place where the trauma happened, for example.

But if those behavioral changes last longer than a month or two, it could signal something more lasting than that initial after-shock: post-traumatic stress disorder (PTSD).

“After a traumatic event, for a little while, anybody would experience some after-events like upsetting memories,” says Shannon Wiltsey Stirman, PhD, acting deputy director at the National Center for PTSD. “But as time passes, a lot of people notice that they start to feel better, and they notice that those difficulties start to decrease. But for a smaller subset of people, even after a couple of months, these types of problems remain, and that’s when we would think about diagnosing PTSD.”

While PTSD doesn’t discriminate, women are more than twice as likely as men to develop the condition at some point in their lives. It can happen at any time to any woman of any age. Here’s what you need to know.

How does PTSD develop?


PTSD is a collection of symptoms that develop after an extremely traumatic experience that involves exposure to a stressor. In this case, there could have been a threat of potential death, serious injury, or sexual violence, says Gloria Kardong, MD, adjunct clinical associate professor at Stanford University Medical Center’s Department of Psychiatry & Behavioral Sciences.

That last stressor could be partially to blame for the huge disparity in PTSD between men and women. After all, 1 in every 6 American women will be the victim of sexual assault at some point during their lifetimes, according to RAINN.

Although the psychological and physiological causes of PTSD are still being researched, people who have already been exposed to trauma or who are already experiencing depression or anxiety are at higher risk, says Wiltsey Stirman. The same is true for those who experience ongoing trauma or were injured during the event.

But one important factor can also determine whether a person’s post-traumatic-event behaviors develop into PTSD: the support they get afterward. “If people have supportive people that they can talk with about what happened and how they’re feeling, they’re less likely to experience PTSD,” says Wiltsey Stirman.

Especially since there are often feelings of shame and guilt associated with a traumatic event, victims might be less apt to talk about it, and if it’s not well-received when they do, that could ultimately lead to them experiencing PTSD, says Wiltsey Stirman.

What are the symptoms of PTSD?


In order to receive a PTSD diagnosis, you must have symptoms that fall under four categories.

You relive your trauma

This means you can experience upsetting memories and thoughts, flashbacks, or nightmares, all of which cause you emotional distress, says Wiltsey Stirman. If you have PTSD, you will continue to relive your trauma a month or more after it occurred.

You avoid things that remind you of what happened

You might completely shy away from reminders of the trauma or the emotions associated with it. “That might mean that people aren’t going to places that remind them of what happened, or they might avoid crowds because crowds now feel dangerous,” says Wiltsey Stirman.

But it can also look like people staying busier than usual. “You might see someone who seems to be functioning at a really high level, but part of what they’re doing is trying to stay so busy that they don’t even actually have much time to think about what happened,” says Wiltsey Stirman.

Your way of thinking changes

PTSD can seriously mess with your head. You may have a hard time feeling positive emotions or view the world as being dangerous as a whole. “They may develop a sense of blame or responsibility for the trauma or results of the trauma and develop an altered worldview,” says Kardong.

Because of those changed perceptions, you might start to lose trust in other people, which can also affect their interpersonal relationships, says Wiltsey Stirman.

You’re constantly on alert

The final cluster of symptoms involves feeling on edge, easily startled, or irritable, which could cause you to have difficulty sleeping or concentrating. “People kind of stay in a state of what we call hyperarousal,” says Wiltsey Stirman. Because of that hyperarousal, you start feeling constantly unsafe, which results in more reactive behaviors, like not wanting to get in a car if the traumatic event you experienced was a car accident.

The important thing to recognize is that all of these signs can impact each person in a unique way. “Just from the variety of different ways they can manifest, it can look pretty different in different people,” says Wiltsey Stirman. So if you find yourself experiencing some mix or variation of these symptoms a month or more after the event, it’s worth scheduling an appointment with your therapist or health care provider.

How is PTSD treated?


Living with PTSD can be extremely debilitating for those affected. “PTSD can adversely affect every area of the person’s life and make daily living almost intolerable,” says Kardong. Because of the symptoms and effects, PTSD can kill your self-esteem and mood while boosting your anxiety, all of which can affect family, personal, and professional relationships.

But there are several treatment options available for PTSD that have been proven to work. “What we know is that certain forms of psychotherapy seem to work better than medications,” says Wiltsey Stirman.

The first line of therapy with PTSD is trauma-focused treatments like cognitive behavioral therapy, which aims to help you process the memories you’ve been avoiding. You also take a look at how you’ve been making sense of what happened. These treatments take about 8 to 16 sessions, says Wiltsey Stirman.

If the trauma-focused treatments don’t seem to work or aren’t available, there is also present-centered therapy, which focuses on how the trauma affects your day-to-day life and problem-solves for those effects. To figure out which treatment might be best for you, the National Center for PTSD offers a Treatment Comparison Chart that breaks the details down even further.

Plus, unlike other mental health conditions like depression, once PTSD is treated, it’s unlikely for someone to experience a relapse. “This is not something people have to live with their whole lives,” says Wiltsey Stirman.

Source: https://www.prevention.com/health/health-conditions/a21965989/ptsd-signs-symptoms/