“The 4 Elements of a Good Night’s Sleep” plus 8 more Health

“The 4 Elements of a Good Night’s Sleep” plus 8 more Health – TIME

The 4 Elements of a Good Night’s Sleep
4 Quick Ways To Eat Healthier
The Story Behind the Viral Photo of an Opioid Overdose
Here’s What the Mexico City Policy Means for Women
How Your Partner Can Help You Sleep Better
Why Your Salmon Is About to Get Very Expensive
Scientists Warn, Again: French Fries May Increase Risk of Cancer
6 Foods to Avoid if You Have a Nut Allergy
Cervical Cancer Deaths Rates Are Much Higher Than Previously Thought, Study Says

Posted: 24 Jan 2017 06:53 AM PST

Some sleep problems are obvious: When you’re tossing and turning all night, or waking up every hour, it’s clear that something’s wrong. But sometimes, sleep quality can be more ambiguous. And until now, there weren’t any real guidelines to define what, exactly, good sleep really is.

That changed last month when the National Sleep Foundation published a first-of-its-kind set of sleep-quality recommendations in the journal Sleep Health. These guidelines, established by a panel of medical experts and based on a review of 277 previous studies, include several measures people can use to determine how well they’re really sleeping at night.

Sleep-medicine specialist Philip Gehrman, PhD, an assistant professor of psychiatry at the University of Pennsylvania, says these new guidelines can be helpful for anyone who’s wondered if their terrible night’s sleep was as bad as it seemed. “Not only will it help people know when their sleep is poor,” he says, “but sometimes people think they are bad sleepers when really they’re in the normal range.” (Gehrman was not involved in crafting the new guidelines.)

The recommendations determined “appropriate” and “inappropriate” ranges for several indicators of good sleep quality, including the time spent drifting off, number of times you wake up at night, time it takes for you to fall back asleep, and percentage of total time in bed spent snoozing. Based on those findings, here are the goals adults should aim for—plus advice from Gehrman on how achieve them.

You fall asleep in 30 minutes or less

If it takes you longer than half an hour to fall asleep at night, it’s likely for one of two reasons: “Either you’re going to bed too early for your internal clock, when you’re not physically and mentally ready for sleep,” says Gehrman, “or you’re engaging in activities that are too stimulating before bed.”

Lying awake is frustrating, he adds, and can lead to anxiety and continued sleep problems. To avoid it, reserve the hour before bed for relaxing activities—that means no work emails or computer time. If that doesn’t do the trick, try changing up your sleep schedule so you go to bed later, when you actually feel tired.

Health.com: What to Do If You Can’t Fall Asleep

You wake up—for five minutes or longer—no more than once a night

(For adults 65 and older, twice a night is appropriate, as well.) “If you wake up a few times and roll over and go right back to sleep, that’s no big deal,” says Gehrman. But if you suspect you’re waking up often because of a health issue, it’s worth talking to your doctor.

“It could be a sign of acid reflux, or eating too close to bedtime,” he says, “or it could be due to sleep apnea, or pain or discomfort.” If you can’t pinpoint an obvious cause—like your dog kicking while he’s dreaming, for example—mention it at your next checkup.

You fall back asleep within 20 minutes

(Older adults may take a little longer, up to 30 minutes.) “We usually have 10 or 15 minutes after waking up when our body is calm and relaxed,” says Gehrman. “But once you hit the point where you realize you’re not getting back to sleep, it can trigger a cascade of feeling more and more alert.”

When you hit the 20-minute mark, he says, get out of bed and do something relaxing—and preferably not TV- or computer-related—like reading a book, listening to a podcast, or coloring. It may seem counterintuitive, but the distraction could be what your brain needs to finally fall back asleep.

You’re asleep 85% of the time you spend in bed

If you follow the first three guidelines, this last one will likely take care of itself. But it’s a good overall reminder, says Gehrman, that the bedroom should be for two things only: sleep and sex. “Try to minimize the use of the bed for other activities,” he says, especially watching television, scrolling through your phone, or doing anything work-related.

The new guidelines have been endorsed by the American Association of Anatomists, American Academy of Neurology, American Physiological Society, Gerontological Society of America, Human Anatomy and Physiology Society, Society for Research on Biological Rhythms, Society for Research of Human Development, and Society for Women’s Health Research.

The authors say the recommendations can help both doctors and patients better define sleep health, and can also provide valuable context for the millions of consumers using commercial sleep trackers, as well.

Gehrman cautions against reading too much into sleep-tracker data, however. Sleep-tracking technology has been studied for years, and many research-grade devices are quite good, he says. But commercial products have little to no evidence to validate their accuracy, and several studies have shown they don’t work nearly as well as those used by scientists and sleep doctors.

“They can provide useful information, but they should always be taken with a grain of salt,” says Gehrman. When it comes to really understanding how well you’re sleeping, he says, how you feel—both while you’re in bed and during the day—should still be your most important indicator.

This article originally appeared on Health.com

4 Quick Ways To Eat Healthier

Posted: 24 Jan 2017 05:00 AM PST

In January many of my clients are focused on shedding holiday pounds. But others see the new year as a chance to establish healthy (and sustainable) eating habits for reasons other than weight loss. These folks are driven by goals like more energy, stronger immunity, improved strength and endurance, and better digestive health, sleep, or mood. Some are even driven by the beauty benefits of a clean diet, such as smoother skin and glossy hair.

I’ve found that people with these types of quality-of-life motivations are more likely to stay on track throughout the year, even if they don’t see a steady drop on the scale. If you are in a similar boat, I recommend the four simple resolutions below, to help making eating healthy your new normal in the months ahead.

Stock up on ingredients for quick, balanced meals

When hunger strikes, if you don’t have a healthy option on hand, it’s all too easy to gorge on anything that’s readily available. Many clients tell me they wind up eating things like their kids’ mac and cheese or pizza, when they haven’t planned their meals in advance.

While prepping healthy options may seem like a pain, you can actually make the process pretty simple by choosing a few go-to meals, and stocking up on their ingredients. For example, always keep a container of leafy greens in the fridge as the base of a meal. You can top it with canned wild salmon (seasoned with Dijon, balsamic vinegar, and Italian seasoning), a few hard-boiled eggs, a scoop of lentils, or a handful of pre-cooked frozen shrimp (thawed by rinsing under cold water).

Add a healthy fat, like avocado, or a jarred option, like olive tapenade or an EVOO-based pesto. For a good carb, toss in fruit (like a sliced apple, pear, or thawed frozen berries), a small scoop of pulses (canned chickpeas or lentils), or a whole grain like pre-cooked quinoa. You can also leave the starch out of the dish and munch on popcorn afterward instead.

These meals made from clever shortcuts can be prepared in minutes. And when you have the components on hand, it’s much easier to resist a less healthy option.

Health.com: How to Build a Healthy Meal That Actually Keeps You Full

Identify healthy take-out options

We all have days when we just cannot carve out time to put together even a quick meal. But if you’re going to order in, it doesn’t have to be pad Thai or a mega burrito. Instead, choose three solid options in advance, and alternate.

One good choice is a taco salad (without the fried shell) topped with grilled veggies, and either chicken, seafood, or black beans for protein; plus salsa or pico de gallo and guacamole as your dressing.

Another healthy choice is sashimi, paired with seaweed salad or a side salad with ginger dressing, and sides of brown rice and avocado. And you can’t go wrong with a Mediterranean platter (skip the free pita) of salad dressed with tahini or EVOO vinaigrette, lentil soup or kabobs of chicken or seafood, and a side of hummus. Scope out where you can find these meals in your delivery zone now, so you’ll know who to call on your next crazy-busy day.

Adopt a strategy for sweets and booze

The two things that most often derail my clients from a healthy eating routine are drinking alcohol and unplanned sweet or savory splurges (like a cupcake or potato chips). I don’t believe it’s realistic to never have these extras. However, I think the best approach is to determine how and when you’ll include them in your diet in advance.

For example, some of my clients eat clean, healthy meals Monday through Friday, then indulge on weekends. Others choose two days during the week when they’re going to indulge, based on their social plans.

Regardless of which approach works for you, having a concrete plan makes it a lot easier to pass up temptations. In other words, if you know you’re going to dinner Thursday night and will be splitting molten lava cake with a friend, you’ll be less tempted by M&Ms at the office.

Health.com: We Did Gwyneth Paltrow’s 2017 Goop Detox and Now We Are Very Hungry

Take five minutes a day to meditate

Now, you may be wondering what meditation has to do with healthy eating. The answer is everything.

When I take many of my clients through guided mediation, followed by instruction on mindful eating, the impact is immediate. When you clear your head, and stay present in the here and now, eating becomes a much different experience.

Spending just five short minutes a day meditating can help you better tune in to your body’s hunger and fullness signals; eat with more awareness, at a slower pace; and lead you to make more thoughtful decisions about food. This change alone has the power to end patterns of under or overeating, and help you naturally eat in a way that optimizes wellness.

Cynthia Sass is Health’s contributing nutrition editor, a New York Times best-selling author, and consultant for the New York Yankees. See her full bio here.

This article originally appeared on Health.com

The Story Behind the Viral Photo of an Opioid Overdose

Posted: 24 Jan 2017 04:00 AM PST

Located in a red brick building on Jackson Street, the city of East Liverpool’s latest addition couldn’t be more urgently needed. The clinic, housed inside the Family Recovery Center, will soon dispense medication that can help people recover from opioid addiction, saving them a 45 minute drive to the next-nearest clinic.

This kind of resource is critical in East Liverpool, which drew nationwide attention when the police department decided to share on social media a picture of a couple overdosed and passed out in a car with a young boy in the backseat. Publishing the photo, say local law enforcement, was the city’s cry for help.

Overdoses from heroin and opiate abuse are common in this Ohio city of 11,000, as they are in other cities like it throughout the state. In 2014, Ohio earned the dubious distinction of leading the country in opioid overdose deaths; its more than 2100 deaths account for over 7% of the national total that year. The bulk of those deaths were traced to opiates or heroin, and law enforcement and emergency room doctors are frustrated with the growing problem. “When I started here in 2011, I don’t recall having any heroin or opiate overdoses at that time,” says Dr. Charles Payne, medical director of the emergency room at East Liverpool City Hospital. “There was a case here and there. Then it was once a week, then all of a sudden today I literally don’t work a shift without having at least one overdose.”

Many people who OD don’t even know what they took. Fentanyl, a synthetic analgesic that is up to 100 times more powerful than morphine, its more dangerous cousin carfentanil, which is up to 10,000 time more potent than morphine, as well as heroin and prescription painkillers like opiates are all common causes of overdose. The emergency room staff here is so accustomed to having people leave passed out addicts in their parking lot that they have a special alarm set up to alert doctors and nurses of a new case, and a dedicated gurney by the door for bringing the overdosed people in.

And it’s not just East Liverpool that is seeing this alarming rise in heroin and opioid abuse. More people died of drug overdoses in the U.S. in 2014 than in any other year, and 60% of them were because of painkillers. Over the last seven years, rates of opioid overdose deaths have quadrupled. Fueling the problem are a number of medical and cultural trends that make both legal (prescription painkillers like oxycodone and hydrocodone) and illegal opiates (such as heroin) more common. Prescriptions for opiate analgesics surged from 76 million at the beginning of the 1990s to over 200 million in 2013, as doctors attempted to better manage their patients’ pain. At the same time, man-made versions of opioids joined heroin in the illegal market, giving people more — and more dangerous — opiate drugs from which to choose.

The Controversial Way Forward

The photo of the boy has sparked debate over what created the problem in the first place, and what’s making it worse. Some public health experts argue that apart from the influx of drugs into economically struggling cities like East Liverpool, current policies for treating drug addiction have fueled the epidemic. Medications like suboxone mimic the narcotic effects of heroin and painkilling opiates without the addictive high. The medication can lower addicts’ risk of overdose death by more than 50% and their risk of relapse by more than 50% as well. After four years on the medication, a third were not abusing opioids and no longer needed suboxone to maintain their sobriety.

But its opponents, including those from national drug-rehabilitation programs, maintain that suboxone and its predecessor, methadone, are also habit-forming and therefor not appropriate for treating addiction. There are strict regulations requiring prescribing doctors to get certified to dispense the drugs, and rules limiting how many people they can treat at any one time.

Still, July 2016 the Obama Administration unveiled a $1.1 billion proposal that would encourage the use of medicine like suboxone to treat people with addictions and allow nurse practitioners and physician assistants, as well as doctors, to receive the proper training to prescribe the drug.

The proposal helped bring the drug-treatment clinic to East Liverpool; it’s the only one in the county that can dispense medications to treat opiate addiction. “We’re opening the new clinic in East Liverpool due to the need in the community to give the treatment that the community and the clients need,” says Jessica O’Dea, clinical director of the Family Recovery Center.

To some, treating drug addiction with more drugs may be counterintuitive, but there is growing data to support it. Both in Switzerland and in England, health authorities actually dispense small amounts of heroin to addicts as a way to wean them off if they haven’t been successful using methadone or suboxone. “We tend to look at addiction treatment in a black-and-white way,” says Dr. Joji Suzuki, director of addiction psychiatry at Brigham and Women’s Hospital. “These drug-based treatments are effective, but overall the medical culture has not embraced them.”

The key is to think of these measures more as necessary medical treatments, similar to the way people take statins to lower cholesterol or insulin to keep their blood sugar in check. People with addiction may be dependent on the drugs to keep them clean, experts say, but they are not addicted to them, since addiction, as defined in the psychiatric manual, involves severe disruption of daily activities as the craving for the next high takes precedence over all else. Study after study supports the effectiveness of drug-based therapies for opiate addiction. People who take methadone and suboxone are better able to keep a job, avoid relapses and gradually reduce their need to continue using heroin or opioids.

What’s Next

With the new clinic, O’Dea is hoping that more people are educated about the dangers of prescription painkillers, and, just as importantly, about the best ways to treat addiction. But she is concerned that more publicity of overdoses may be a double-edge sword, especially if they depict people in compromising situations. There’s a difficult balance between raising awareness about a problem like addiction and turning that attention into something counter productive. “As a clinician, I feel that it’s my job to advocate for people struggling with addiction,” she says. “I think that posting photos of addicts does probably have them feel pretty shameful and embarrassed. These pictures might keep somebody from reaching out for help.”

Still, with an epidemic as powerful as opioid addiction, it’s important for recovery experts, law enforcement and the community to coordinate their efforts to educate and support people with addiction. And O’Dea admits that the photo of the boy did make the clinic possible. “That picture started getting agencies and policy makers, and law enforcement talking about the epidemic going on,” she says. “It drew attention to more resources, and access for people needing treatment.”

Alice Park is a writer at TIME. Follow her on Twitter.

Paul Moakley, who produced this video, is TIME’s deputy director of photography and visual enterprise.

Here’s What the Mexico City Policy Means for Women

Posted: 23 Jan 2017 02:49 PM PST

Two days after millions of women around the world marched on behalf of women’s rights, President Donald Trump reinstated the Mexico City Policy.

In an executive order, Trump reinstated the rule on Monday. The Mexico City Policy prohibits foreign aid from the U.S. to be given to any nongovernmental organization (NGO) abroad that discusses abortion as a family-planning option. Currently, taxpayer dollars cannot be used to fund abortion procedures in other countries, but the order expands that oversight and also prohibits organizations from receiving U.S. family planning funding if they offer abortion counseling or advocate for abortion rights in other countries — even if the medical procedure is legal in that country.

The rule has gone back and forth between Administrations since it was first introduced in 1984 at the U.N. International Conference on Population held in Mexico City. In 2009, former President Barack Obama revoked the ruling as one of his first executive actions. It had been reinstated by former President George W. Bush after Bill Clinton’s Administration and was first introduced by former President Ronald Reagan.

The policy forces health providers to decide whether to accept the ruling and no longer provide abortion-related counseling services, or reject it and lose U.S. funding that many rely on. Several health and development groups expressed concern about the possible implications on women’s health abroad. The U.S. Agency for International Development (USAID) is currently the largest bilateral donor of funding for family-planning services, and studies reveal that when the Global Gag Rule is implemented, the number of clinics and family services in a given country drop, sometimes spurring a rise in abortion rates.

A 2015 report from the reproductive health group Population Action International (PAI) showed that after the rule was reinstated in 2001 by former President George W. Bush, shipments of U.S.-donated contraceptives stopped in 16 developing countries. A 2011 report from the World Health Organization found that abortion rates actually increased in sub-Saharan Africa after the rule was reinstated in 2001, likely owing to the fact that women no longer had the same access to contraceptives.

Marie Stopes International, a nonprofit reproductive-health group, said on Monday that it will not agree to the conditions, and therefore will no longer receive USAID funding. Until Monday, the group said it partnered with USAID to provide voluntary contraceptive services to millions of women and girls across Africa and Asia. Without the funding, the group says the loss of its services during Trump’s first term could result in 6.5 million unintended pregnancies, 2.2 million abortions, 2.1 million unsafe abortions and 21,700 maternal deaths.

“Attempts to stop abortion through restrictive laws — or by withholding family planning aid — will never work, because they do not eliminate women’s need for abortion,” Marjorie Newman-Williams, vice president and director of Marie Stopes International’s international operations, said in a statement. “This policy only exacerbates the already significant challenge of ensuring that people in the developing world who want to time and space their children can obtain the contraception they need to do so.”

How Your Partner Can Help You Sleep Better

Posted: 23 Jan 2017 01:12 PM PST

Sharing everyday good news with your S.O.—like the personal record you broke at the gym, or the compliment you got from a colleague—won’t just strengthen your bond. It may help you sleep better, too, according to researchers. That is, as long as your partner celebrates the happy news along with you, and doesn’t just brush it off.

The new study builds on previous research that shows how being in a supportive relationship can improve psychological health, partner intimacy, and overall sleep patterns. But this is the first to show how sharing and responding to good news on a daily basis seems to directly affect how well couples sleep each night.

“For a long time, researchers only focused on what happens when we share bad news, when we’re stressed out and we go home and vent to our partners,” says lead author Sarah Arpin, PhD, assistant professor of psychology at Gonzaga University. “But now we know that it’s equally important, if not more important, to share the good stuff—that people can really benefit from such a simple act.”

Arpin presented the findings over the weekend at the Society for Personality and Social Psychology Annual Convention in San Antonio. For the study, which has not yet been published in a peer-reviewed journal, Arpin and her colleagues followed 162 married or co-habitating couples, asking them to complete daily online surveys for 32 days.

Health.com: 20 Ways to Fall in Love All Over Again

Individually, each participant answered questions about the best things that happened to them each day, whether they shared that information with anyone, and how that information was received when shared with their romantic partner. The participants also reported how they felt about these interactions, their current levels of loneliness and intimacy with their partner, and how well they’d slept the night before. The researchers analyzed those responses, comparing each day’s answers to that subsequent night’s sleep quality.

And they noticed a definite pattern: On days when people shared good news and felt it was received in a supportive manner, they fell asleep faster and slept better than on days when they didn’t feel their partners cared. A more supportive response was also associated with less loneliness and more intimacy, which in turn predicted better sleep that night.

Health.com: 11 Signs You’re Sleep Deprived

In other words, the benefits of sharing good news are contingent on how your partner reacts. “If I go home and tell my husband I had a great day and I got a raise, and he says, ‘Hey what’s for dinner,’ that would be awful—it would undermine my well being,” Aprin says. “It’s an important reminder that when your partner is sharing something, you really need to be listening and open and actively engaging.”

The study participants were all heterosexual military couples, with one partner having served in active duty, the National Guard, or the Army reserves. The research is part of a larger study aimed at improving service members’ experiences reentering the workforce after deployment, and the authors say that veterans face unique challenges when it comes to loneliness, relationships, and sleep problems.

But all couples can benefit from the study’s findings, says Arpin, because all couples can struggle with intimacy and communication problems—and the physiological consequences those problems can have on sleep and mental health.

In their presentation, the researchers conclude that celebrating good news together is an “important relationship-maintenance and health-enhancing process.” They say that future research should study the impact of sharing good news on specific behaviors, such as diet or alcohol use, to learn about other ways it may affect well being.

“It may be common sense that we all want to share with our partners when good things happen,” Arpin says, “but the real lesson here is that doing so can have a stronger impact on your health than you might realize.”

This article originally appeared on Health.com

Why Your Salmon Is About to Get Very Expensive

Posted: 23 Jan 2017 11:32 AM PST

The price of salmon across the globe has surged following widespread contamination by a tiny pest known as sea lice that eat salmon’s blood and skin.

The price of salmon has climbed more than 15% in the last three months, according to data from the NASDAQ Salmon Index. Norwegian salmon prices jumped 40% in 2016 from the previous year. Unusually high salmon prices are likely to remain throughout this year given the time it takes for fish to grow to an appropriate size, according to a Financial Times report.

Sea lice are nothing new, but their effect has grown more widespread alongside the rise of large salmon farms. The farms—essentially large-scaled netted areas in the ocean—act as a fertile breeding ground for sea lice because the closely confined space allows the parasite to spread quickly. The problem has also affected wild salmon as they move nearby the farms. Researchers also found that high water temperatures—largely due to man-made climate change—likely contributed to the problem.

Experts say that an algal bloom off the coast of Chile last year that killed more than 135,000 tons of salmon has also contributed to the price spike.

Salmon producers have largely used pesticides to try to eliminate the problem, but some strands of sea lice have grown immune to the problem. Salmons farmers, who have lost millions thanks to sea lice, have invested heavily in developing farms where the pest cannot thrive. One $71 million project from the Norwegian company Nordlaks aims to help fish avoid tight confines at a length of nearly five football fields.

Scientists Warn, Again: French Fries May Increase Risk of Cancer

Posted: 23 Jan 2017 11:28 AM PST

New evidence in animal studies suggests that regularly eating fried, browned or burnt foods—such as French fries or toast—may increase the risk of cancer, a British government agency said today.

The link between fries and disease isn’t new, but the U.K. Food Standards Agency (FSA) has found that acrylamide, a substance produced when starchy foods are heated at high temperatures, has been linked to cancer in animals. The FSA suggest people cook foods at lower temperatures and aim for a more golden color, rather than crispy brown, Reuters reports.

“The scientific consensus is that acrylamide has the potential to cause cancer in humans,” the FSA warned. “As a general rule of thumb, aim for a golden yellow color or lighter when frying, baking, toasting or roasting starchy foods like potatoes, root vegetables and bread.”

The FSA also recommends other ways to reduce excessive acrylamide consumption, including not overloading on starches through a balanced diet and not storing raw potatoes in the fridge.

The agency is launching a “Go for Gold” campaign to publicize the recommendations, but some experts said people would be better off monitoring behaviors with stronger links to cancer, such as smoking, according to Reuters.

[Reuters]

6 Foods to Avoid if You Have a Nut Allergy

Posted: 23 Jan 2017 10:56 AM PST

My younger son has food allergies and I’m absolutely obsessive about helping him steer clear of peanuts and tree nuts. Yet somehow, last month, I brought him home a pistachio sandwich.

Let me explain: I ran to the deli to buy chicken salad, but it was next to a salad with nuts. Trying to avoid that cross-contamination risk, I pivoted and grabbed Gus, who is 10, a slice of an Italian Combo hero, stupidly without asking what was in it. One bite in he said, “My mouth feels itchy and numb.” I ripped apart his sandwich and found a meat dotted with green flecks…oh no, pistachio? A quick call to the deli revealed he had eaten mortadella—an Italian pork studded with one of his worst allergens.

Thankfully, after an injection of epinephrine and a few hours in the ER, Gus was fine. But my husband and I were traumatized. Where else were there nuts lurking? Raising a child with a food allergy sometimes feels like being a hockey goalie, to use an analogy from Gus’s favorite sport: You’re always guarding against not only the obvious threats (that Thai takeout) but also the surprise wraparound ones you never see coming (nut meat, I’m talking to you).

And, in a way, having a food allergy is a paradoxical health problem: You are perfectly healthy. And yet the wrong food, in the wrong amount, without prompt administration of the right amount of epinephrine, can kill you. To make sure that we know all the wild cards out there, I consulted Sujan Patel, MD, an allergist/immunologist at New York University Langone Medical Center in New York, and David Stukus, MD, a Columbus-based spokesperson for the American College of Allergy, Asthma, and Immunology.

Chili

In 1986, a freshman at Brown University tragically died after she ate restaurant chili thickened with peanut butter. More recently, a 28-year-old dad in England reportedly died from anaphylaxsis after having a chili burger that likely contained peanuts. PB may not be a classic ingredient in this comfort food, says Dr. Patel, “but with chili cook offs and all kinds of ways to prepare things, you shouldn’t assume it is safe.”

Health.com: 31 Everyday Things You Can Be Allergic to

Still, the even more common danger in Mexican joints is the mole sauce. While mole’s most famous ingredient is chocolate (itself a potential disaster for the nut-allergic), peanuts or peanut butter may also be in the mix. “Sauces in general are dicey,” warns Dr. Patel, adding that Indian and Thai cuisines are particularly tricky. “Indian cooking uses cashews and almonds made into a paste and then used as a thickener.”

French fries

Most frites are a-ok, but when grabbing them out, do ask about the oil. Peanut oil is the go-to at some chains such as Five Guys, as well as smaller restaurants. “The interesting thing about peanut oil,” says Dr. Patel, “is that when it’s made in the U.S. it is so refined that almost nobody with a peanut allergy would react to it. But the problem is we don’t know if it is one from China, which are much less refined. We don’t tell people this because we don’t want them to take a chance.”

My family got stumped by cottonseed oil on a trip to Florida. (“Siri, is cottonseed a nut? Help!”) Nope, cottonseed oil, I’ve since learned, is not a nut, though it’s pretty terrible for your health.

Deli meat

My son’s kryptonite—mortadella—is a fancy Italian bologna that was banned from import to America for years due to an Italian outbreak of African swine fever, according to the New York Times. More expensive than bologna and speckled with fat and pistachios, it isn’t a big seller in the U.S (which almost explains how I could be half Italian-American, raised on antipasto spreads, and never heard of it). “A real fluke,” is how Dr. Patel described my son’s close call. And yet in 2016, BJ’s Wholesale Club issued a recall of deli meats for undeclared pistachios; they had been sent Citterio’s Mortadella by mistake and sold it—along with other meats sliced on the same equipment—without listing pistachio on the labels.

So how do you make sure your cold cuts don’t come with an unwanted side of nut residue? “Ask the person at the counter about any potential source of cross contact,” advises Dr. Stukus, who is also an associate professor of pediatric allergy and immunology at the Ohio State College of Medicine. And if they’re unsure, steer clear and opt for a prepackaged lunch meat with a nut-safe label.

Cocktails

Better ask what’s in that signature cocktail before you knock it back. Major vodka makers now sell bottles infused with hazelnut, almond, and other tree nuts. Frangelico gets its flavor from hazelnuts and Nocello from walnuts. And here’s a who knew: Many gins, including Bombay Sapphire, are flavored with almonds. Not even beer is completely safe. Brown ales may contain peanuts and/or macadamia, walnut, or other tree nuts.

Pet food

Is your toddler at the stage where she puts everything in her mouth? If she’s allergic to peanuts or tree nuts, watch out for your dog food, warns Dr. Patel. Pet foods are not subject to The Food Allergen Labeling and Consumer Protection Act—a law mandating that food labels clearly list out in plain English if they contain any of the top eight most common allergens (peanuts, tree nuts, milk, eggs, wheat, soy, shellfish, fish). But a scan of that puppy chow label should alert you to peanuts, he adds. (When in doubt, call the manufacturer.) Bird food almost always contains nuts, or has a nut warning. Our family’s solution is to buy food-grade sunflower seeds (labeled as nut-safe) for our outdoor feeders.

Gluten-free treats

A gluten-free cupcake or bread may seem harmless for all, but don’t be fooled: It can pack lupin, “a legume frequently used as flour in gluten-free products that can cross react with a peanut,” says Dr. Stukus. He notes that there have been many reports of people with peanut allergies having reactions from lupin. Also watch out for almond flour, sometimes used to hold things together in G-free sweets.

Another 2017 concern? Nut butters popping up in unexpected places. “I had a mom whose child had a reaction to kale chips,” shares Dr. Patel. “Randomly, they were made with cashew butter.”

To stay one step ahead, read labels every time (ingredients on familiar products can change). And, as I learned the hard way, always ask, even when it seems unlikely that a dish would contain nuts. When it comes to managing food allergies, you can never be too careful. My son knows this well: Hand him a banana and he’ll ask you, “Are there nuts in it?”

This article originally appeared on Health.com

Cervical Cancer Deaths Rates Are Much Higher Than Previously Thought, Study Says

Posted: 23 Jan 2017 10:50 AM PST

Cervical cancer kills more women in the U.S. than health experts have previously believed, according to a new study.

Researchers have found that the rate of death from cervical cancer is much higher than what has been reported, particularly among black women.

The mortality rate for black women was 10.1 per 100,000, compared to 4.7 per 100,000 for white women, according to the study published Monday in the journal Cancer. The rate for black women who are 85 and over was even higher, at 37.2 deaths per 100,000, the study found. Previous estimates put the death rate of cervical cancer at 5.7 per 100,000 black women and 3.2 per 100,000 white women.

“This shows that our disparities are even worse than we feared,” Dr. Kathleen Schmeler, an associate professor of gynecologic oncology at the University of Texas M. D. Anderson Cancer Center, told the New York Times. “We have screenings that are great, but many women in America are not getting them.”

The corrected rates come after researchers reevaluated the figures, keeping in mind women involved who have had hysterectomies — operations to remove the cervix.

Cervical cancer is highly preventable with vaccinations to prevent the human papillomavirus (HPV), which is the most common cause of cervical cancer, according to the Centers for Disease Control and Prevention. Cervical cancer is also treatable when diagnosed early from screening tests.

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