I’m a Big Girl. I Run. So What?

Image: Courtesy of Cooking Light/Manopjk

 

I don’t know when it happened. I woke up one day, and I said, “I’m going to try to run.”

At that point, I should have curled back into bed and forgiven myself for my insane idea. Instead, I got up, laced up, and went for a walk. As I was walking, I downloaded the always-popular Couch to 5K app, and I ran. (Read about my 50-pound weight loss and the journey I’m on to lose even more.)

It was exhausting. I had been walking 1 to 2 hours a day five times a week, and here I was: I couldn’t jog for 1 minute with a minute and a half of rest in between each jog without stopping and almost choking for air. It was embarrassing. And, it was exhilarating.

That first run this past spring has set me on a path toward trying to build greater momentum as a runner. I am not a runner. Let me please stress that again. I am not a runner. But I am a person who wants to run. I need the greater calorie burn, and despite my love for settling into a marathon of “Law & Order: SVU” or “Modern Family” while torching rubber on the treadmill, I need more efficient calorie-burning exercises. Running fills that void.

Plus, I need the satisfaction that comes after the final C25K ding. (But really, that voice needs to be a little more exhilarating. I just ran, damnit! I need a cheerleader!)

Running is not natural to me. I have joked, on many occasions, that I’d only run if I was being chased by a wild animal. And then, I’d stop to consider how quickly they’d kill me and if it would be more or less painful than running. Needless to say, running is taking me some time to love, but I’m committed. I’m determined to find my way and develop a passion for this form of exercise. In this journey, I’ve learned a few things, and I’m passing them along in case you’re a big girl (or boy) and you’d like to run, too.

1) Forget the haters. The first time I ran, I ran in the middle of the night—11 p.m. Most of my neighbors were asleep, and for that I was grateful. The first time I ran on a treadmill in the gym, I hid in a corner and prayed no cute guys needed to lift weights that day. Then one day, something clicked. Who cares?! You’re running for you, not them. If you pay any mind to what others think, you’ll never leave the house.

2) You need to invest in the right equipment. Who knew running was going to be so expensive?! Now I understand why entire companies exist for the sole purpose of outfitting runners. When you run in yoga pants, you may not have an enjoyable experience. Or in my case, you may find yourself trying to hold your pants with one hand while you jog. It’s not as easy as you might think. Better running shorts/capris make a huge difference!

3) Be fitted by a professional. The first shoes I ran in were not meant for running. Not even a little bit. A friend recommended me to a great local running store, Fleet Feet, and my world hasn’t been the same. The folks at Fleet Feet took the time to watch me walk and run so they could find the right shoes for my style. Now that I have proper running shoes, everything is different. My recovery time is faster, my form is better, and I’m not struggling with the aches and pains I first felt. I’m picking up momentum and stamina.

4) Don’t give up. It’s not easy, and some times, it’s not even fun. But don’t stop. You’re not here to impress anyone but yourself. Trust me, when you complete a really hard run, you’re going to be so proud of yourself. You’ve worked hard to get where you are. You should be proud! Keep going!

More from Cooking Light:

This Plus-Size Model’s Magazine Cover Shows There Are All Kinds of Runner’s Bodies

How I Plan to Fail at My Diet

Whose Fault Is It That I’m Overweight?

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Not Losing Weight? 4 Breakfast Mistakes You Might Be Making

Photo: Romula Yanes

Breakfast kick starts your metabolism for the day, so you don’t want to mess that up. Here are the top four breakfast mistakes I see, plus how to fix each one.

The mistake: you skip it to save calories
Forgoing breakfast may seem like a calorie-saver, but it can actually be a fat trap. Researchers at Imperial College London found that when people went without an a.m. meal, their brain reward centers lit up when they were shown images of high-calorie foods. That means turning down treats becomes harder, and you’re likely to make up for the missed calories (and then some) with junkier choices later in the day, when it’s tougher to burn them off.

The makeover
Commit to eating something every morning. If time is an issue, stash a healthy energy bar containing fruit in your bag.

The mistake: you turn to high-carb foods for energy
Grabbing a blueberry muffin with your coffee may not seem so bad, but a typical bakery muffin packs more added sugar than you should have for the entire day—a staggering 44 grams. According to the American Heart Association, women should top out at about 24 grams of added sugar daily (that’s 6 teaspoons’ worth).

The makeover
You don’t have to completely avoid sugar if you need a jolt to get going. Chop up one tasting square of dark chocolate and mix it into your oatmeal. (I use this trick in my overnight oats recipe, at right.) Also, make fruit your friend: Blend up a smoothie or fold fruit into yogurt or oatmeal. You can also top toast with mashed avocado or almond butter, then slices of fresh figs or pears.

RELATED: The Best Fat-Burning Breakfasts

The mistake: you’re eating healthy but missing produce
Only 8 percent of Americans eat the recommended amount of fruit each day (2 cups, for a moderately active woman) and just 6 percent hit the mark for veggies (3 cups), according to a report from Produce for Better Health Foundation. So even if you have a nutritious egg-on whole-wheat sandwich in the morning, not fitting in some produce may keep you from reaching the daily goal.

The makeover
Get at least one serving at breakfast by grabbing a piece of fruit before you head out the door. For more, add vegetables to an omelet or put greens in a smoothie.

RELATED: 27 Mistakes Healthy People Make

The mistake: your breakfast is too skimpy
Being pressed for time is one of the main reasons women don’t eat enough in the morning. But the expression “Eat breakfast like a king, lunch like a prince and dinner like a pauper” holds up. Researchers in Israel found that overweight women who ate more calories at breakfast and fewer at dinner lost more weight and had greater waistline reductions than those who flipped the numbers, even when total daily calories were the same.

The makeover
Aim for a combo of lean protein, healthy fat and good carbs in every breakfast. Instead of just yogurt, add in nuts and fruit. Bottom line: If you work normal hours, your dinner should never pack twice as many calories as breakfast.

RELATED: The 20 Best Foods to Eat for Breakfast

Cynthia Sass is a nutritionist and registered dietitian with master’s degrees in both nutrition science and public health. Frequently seen on national TV, she’s Health’s contributing nutrition editor, and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Rangers NHL team and the New York Yankees MLB team, and is board certified as a specialist in sports dietetics. Cynthia is a three-time New York Times best-selling author, and her brand new book is Slim Down Now: Shed Pounds and Inches with Real Food, Real Fast. Connect with her on Facebook, Twitter and Pinterest.

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7 Questions To Ask Your Employer About Wellness Privacy

Photo: Bloomberg via Getty Images

If your company hasn’t launched a wellness program, this might be the year.

As benefits enrollment for 2016 approaches, more employers than ever are expected to nudge workers toward plans that screen them for risks, monitor their activity and encourage them to take the right pills, food and exercise.

This involves a huge collection of health data outside the established medical system, not only by wellness vendors such as Redbrick, Audax and Vitality but also by companies offering gym services, smartphone apps and devices that track steps and heartbeats. Such partners pass worker results to the wellness providers.

Standards to keep such information confidential have developed more slowly than the industry. That raises risks it could be abused for workplace discrimination, credit screening or marketing, consumer advocates say.

Here’s what to ask about your company’s plan.

Q. What information will my employer see?

Many employers get only anonymous, group data. The vendor reports how many workers are overweight or have high blood pressure, for example.

But sometimes employers can see individual results, setting the stage for potential discrimination against those with disabilities or chronic illness. Or they can guess them. Discrimination based on disability and illness is illegal but hard to prove.

Workers should ask exactly what information will get back to their company and whether it will identify them.

Q. Is the program covered under the HIPAA privacy law?

The Health Insurance Portability and Accountability Act restricts sharing of certain medical information to doctors, health insurers and other authorized users. Asking whether a wellness plan is covered by HIPAA is a good, first attempt at judging confidentiality.

Workplace wellness programs offered separately from an employer’s group health insurance plan are not protected by HIPAA. Other privacy laws might apply. But often it’s often impossible for employees to tell without asking.

Even in HIPAA-covered programs, a few, designated managers at your workplace can see health reports including identities, although they’re supposed to keep them confidential.

Q. I don’t understand the privacy policy. Did I give up my HIPAA rights when I filled out my health assessment on the wellness site?

Use of a wellness portal often gives the vendor permission to share personal data with unidentified “third parties.” Those would be insurers, data-storage firms and other partners necessary to the program, vendors say. They’ll protect the information as well as anybody, they say.

But the open-ended nature of the permission gives consumer advocates the creeps. Read the privacy and terms-of-use disclosures. Ask questions if you’re uncomfortable.

Q. My employer says it sees only group results. Does that guarantee privacy?

At smaller firms it’s sometimes easy for managers to match worker identities with results from group reports. The same goes for large companies when wellness data is disclosed by team or division.

Ask how far the results will be broken down.

Q. How many other companies see my wellness data?

Workplace wellness often involves multiple firms gathering or sharing your information. The main wellness provider might work with labs, app publishers, fitness device makers, gyms, rewards fulfillment companies and others — each with its own confusing privacy policy.

Employees deserve a clear explanation of which companies get their data, what form it takes, how recipients will use it and how it is protected, privacy advocates say.

Q. What privacy policies do subcontractors and other third parties have to follow?

One privacy standard for wellness contractors, set by the National Committee for Quality Assurance, requires the primary wellness vendor as well as third-party partners to conform to HIPAA.

But that kind of policy is not universal. NCQA recognizes only a few dozen out of hundreds of wellness companies. And NCQA standards are voluntary and don’t confer consumer rights.

Q. Could somebody try to identify individuals in the group results shared by my wellness plan?

Wellness privacy policies often give vendors broad room to share data stripped of names, addresses and other identifying features. Such information is not protected under HIPAA.

Experts have shown that such results can be re-identified by combining them with public databases. As an extra protection, wellness vendor Limeade and wearable device maker Fitbit prohibit third-party partners from attempting to re-identify the information they share.

But not all vendors do the same.

Kaiser Health News is a nonprofit national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.

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Face-to-Face Contact May Beat Email, Phone for Staving Off Depression

By Randy Dotinga
HealthDay Reporter

TUESDAY, Oct. 6, 2015 (HealthDay News) — While your days may be filled with electronic communications, a new study suggests that face-to-face contact may have more power to keep depression at bay, at least if you are older.

The research doesn’t prove that personal conversations are more valuable than email and phone calls. Still, study author Dr. Alan Teo, a staff psychiatrist at VA Portland Health Care System, is convinced there’s a connection.

“Meeting friends and family face-to-face is strong preventive medicine for depression,” said Teo, who’s also an assistant professor of psychiatry at Oregon Health & Science University. “Think of it like taking your vitamins, and make sure you get a regular dose of it,” he said.

It may seem obvious that interacting with other people — in a positive way — is good for your health. Indeed, “from prior studies we know that having social support and staying connected with people is good for your physical and mental health. It even helps you live longer,” Teo said.

“What we didn’t know is whether it matters how you stay connected with friends and family,” he added.

The investigators examined the results of a 2004-2010 survey including about 11,000 people aged 50 and older. After adjusting the statistics so they wouldn’t be thrown off by factors such as high or low numbers of certain kinds of people, the researchers found an association between the types of interactions people had with others and their likelihood of depression symptoms two years later.

Rates of depression didn’t seem to be affected by the level of communication by phone, letters and email. But those who communicated the least with friends and family via in-person meetings — every few months or less often — had a higher rate of signs of depression.

Two years later, 12 percent of those people showed signs of depression, the study found. By comparison, 8 percent of those who had in-person contact once or twice a month and 7 percent of those who met others once or twice a week showed signs of depression.

But the study only showed an association between more personal time spent with family and friends and lower chances of depression, and not a cause-and-effect relationship.

The study was published in the Oct. 5 issue of the Journal of the American Geriatrics Society.

It’s possible that some factor other than in-person contact is causing the differences in depression levels. Caitlin Coyle, a postdoctoral fellow at Yale School of Public Health in New Haven, Conn., said it’s also possible that depression could be the driver: “Adults experiencing depressive symptoms may be less likely to engage socially,” she suggested.

How is the research useful?

“Everyone can relate to the question of whether to call a friend on your smartphone, text them or arrange to meet up,” Teo said. “This study is perhaps the first to be able to offer some really concrete evidence that you are probably better off if you make sure to regularly spend quality time together with people.”

The study, which doesn’t track people past 2010, doesn’t account for the rapid rise of Facebook over the past few years and its ability to draw people together. But Teo wants to understand more about it.

“In one of my next studies,” he said, “I am now trying to measure all different types of social media use to see how that plays out with mental health outcomes, particularly in younger adults.”

Coyle cautioned that the rapid evolution of technology will make it tough to study how older people communicate.

In the big picture, “things like Skype, email or Facebook are all wonderful resources to help older adults stay engaged,” she said.

“But by engaging in these types of social contact, older adults could be forgoing opportunities to engage socially in their communities. For example, you can’t go to the theater with someone via Skype. Although a variety in the type of social contact is great, there really is no replacement for engaging with others face-to-face,” Coyle added.

Dr. Carla Perissinotto, an assistant clinical professor in the division of geriatrics at the University of California, San Francisco, puts it this way: “This is a reminder that it is important for all of us to stay connected. The human touch and human contact cannot be replaced.”

More information

For more about depression in seniors, visit the National Alliance on Mental Illness.

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Grades May Sink for Girls Who Are Compulsive Texters

TUESDAY, Oct. 6, 2015 (HealthDay News) — Compulsive texting can lead to poor school performance for teenage girls, a new study suggests.

“It appears that it is the compulsive nature of texting, rather than sheer frequency, that is problematic,” said lead researcher Kelly Lister-Landman, who was at Chestnut Hill College in Pennsylvania when the study was conducted.

The study involved 211 girls and 192 boys in grades eight and 11 at schools in a semi-rural town in the Midwest.

Only girls showed a link between compulsive texting and lower school performance in areas such as grades, feeling able to do school work and school bonding.

The study was published online Oct. 5 in the journal Psychology of Popular Media Culture.

“Compulsive texting is more complex than frequency of texting. It involves trying and failing to cut back on texting, becoming defensive when challenged about the behavior and feeling frustrated when one can’t do it,” Lister-Landman explained in a journal news release.

Girls don’t text more often than boys, but they text for different reasons, the study authors noted.

“Borrowing from what we know about Internet communication, prior research has shown that boys use the Internet to convey information while girls use it for social interaction and to nurture relationships,” Lister-Landman said.

“Girls in this developmental stage also are more likely than boys to ruminate with others, or engage in obsessive, preoccupied thinking, across contexts. Therefore, it may be that the nature of the texts girls send and receive is more distracting, thus interfering with their academic adjustment,” she noted.

While the study shows an association between compulsive texting and poor school performance, it doesn’t establish a direct cause-and-effect relationship. And the authors acknowledge that texting can benefit teens in various ways.

U.S. teens send and receive an average of 167 texts a day, according to 2012 Pew Internet and American Life Project study.

More information

Common Sense Media has more about teens and social media.

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Concussion Recovery May Be Delayed in Older Adults

TUESDAY, Oct. 6, 2015 (HealthDay News) — Older adults recover more slowly from concussion than younger patients, a small new study finds.

“Old age has been recognized as an independent predictor of worse outcome from concussion, but most previous studies were performed on younger adults,” said lead author Dr. David Yen-Ting Chen, a radiologist at Shuang-Ho Hospital in New Taipei City, Taiwan.

This study — published online Oct. 6 in the journal Radiology — included 13 older adults, aged 51 to 68, and 13 young adults, aged 21 to 30. The participants were assessed four weeks and 10 weeks after suffering a concussion.

A significant decline in concussion symptoms — such as problems with working memory — was seen among young patients between the first and second assessment. However, no such decrease in symptoms was seen in older patients, Chen and colleagues said in a news release from the Radiological Society of North America.

“The results suggest that [concussion] might cause a more profound and lasting effect in older patients,” study co-author Dr. Ying-Chi Tseng, of Shuang-Ho Hospital, said in the news release.

The findings could lead to the development of targeted treatments for specific age groups of concussion patients, according to the researchers.

Concussion accounts for 75 percent of all traumatic brain injuries, the researchers pointed out in the news release.

More information

The American Academy of Family Physicians has more about concussion.

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Young Cancer Survivors Often Develop New Malignancies

TUESDAY, Oct. 6, 2015 (HealthDay News) — Teen and young adult cancer survivors are at increased risk for other cancers later in life, a new study reveals.

Researchers analyzed U.S. National Cancer Institute data on people who survived cancers before age 40. They had the most common types of cancers in that age group: leukemia, lymphoma, testicular, ovarian, thyroid, breast, soft tissue and bone cancers.

“This is a patient demographic that has been largely overlooked,” said senior study author Dr. Robert Goldsby, a professor of pediatrics at the University of California, San Francisco Benioff Children’s Hospital.

Over 30 years, nearly 14 percent of the survivors were diagnosed with another, different type of cancer. On average, the second cancer occurred within 15 years.

Compared to people in the general population, patients successfully treated for cancer between ages 15 and 39 were nearly 60 percent more likely to develop cancer. In contrast, people successfully treated for cancer after age 40 were 10 percent more likely to develop another cancer.

The most common second cancers were breast, gastrointestinal and genital cancers, and melanoma skin cancer, the study found. Over 30 years, those who received radiation therapy for their first cancer were more likely to have a second cancer than those who did not have radiation therapy — about 17 percent compared to 12 percent.

Of the 7,384 patients who developed second cancers, 1,195 also developed a third cancer, according to the study published Oct. 6 in the journal Cancer.

Cancer patients used to be told that after five years of remission, they no longer had special health care needs, Goldsby said in a university news release. “But our study demonstrates that adolescent and younger adult survivors require lifelong follow-up with regular medical screening,” he added.

In older adults, cancer frequently stems from age and the cumulative effects of long-term exposures or habits, such as smoking or unhealthy diet, he said. “But younger patients may harbor genetic changes that influence the risk of cancer. They may need counseling if their lifestyle choices increase their existing risk,” he explained.

More information

The American Cancer Society has more about cancer survivorship.

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Doctors Use 3D Printing to Safeguard Baby Before Birth

By Tara Haelle
HealthDay Reporter

TUESDAY, Oct. 6, 2015 (HealthDay News) — When Michigan doctors saw a large mass on the face of a fetus late in pregnancy, they feared it might block the baby’s airway at birth.

The doctors didn’t know what the abnormality was, or if the infant would need lifesaving care in order to breathe.

Use of 3D printing technology removed the guesswork, the team reported in the Oct. 5 online edition of the journal Pediatrics.

It’s the first time 3D printing technology has been used in utero “to diagnose facial deformity and severity of airway risk with a newborn,” said Dr. Albert Woo, a pediatric plastic surgeon at St. Louis Children’s Hospital.

The problem surfaced when the mother-to-be, age 22, was 30 weeks into pregnancy.

The mother underwent an ultrasound, but the imaging did not provide enough information because of the way the fetus was positioned. She then underwent an MRI, but again the doctors couldn’t be sure if the airways would be clear after birth.

If the airways were blocked, the newborn would need an intubation — placement of a plastic tube into the windpipe — at birth to help with breathing, doctors feared.

A subsequent, specialized MRI captured more data that the University of Michigan doctors could use to build a 3D model. Then they printed a model of the fetal face with a 3D printer.

The model predicted a cleft lip and palate deformity — without airway obstruction. The baby’s delivery and discharge proceeded uneventfully, the report said.

In 3D printing, a special “printing” machine heats up plastic and follows a computer program’s instructions to layer the plastic into a three-dimensional shape. Medical applications so far have included printing prosthetic limbs, medical supplies, models of jaws to use in reconstruction and other feats.

“In this specific instance where airway distress is a major possible issue, I think it potentially can help to revolutionize that field,” said Woo, director of the 3D printing lab at Washington University School of Medicine in St. Louis.

“It really provides a new tool so that doctors are much better prepared to deal with airway problems or other congenital anomalies that they need to diagnose critically right when babies are born,” he said.

Woo, who was not involved with the study, said it’s possible that looking at the 3D image on the screen might have been sufficient, but it is more difficult to grasp aspects of the physiology, such as scale.

“I would suggest that there’s no replacement for being able to hold an object in your hand and have this tactile three-dimensional ability to assess something,” Woo said. “When you’re actually holding a model of a skull, for example, in your hand, it’s a whole different experience.”

The use of 3D printing itself should not present any risks to patients, Woo said, but two potential downsides of the technology are its high cost and the potential for overuse.

Woo estimated that the software used to create the model costs $10,000 to $20,000 annually.

Medical-grade printers can range from several thousand dollars on the low end to hundreds of thousands of dollars for extremely precise high-end printers, said Dr. Oren Tepper, director of craniofacial surgery at Montefiore Health System in New York City.

As for the case involving the Michigan doctors, the serious nature of the possible emergency justified the use of a 3D-printed model, Tepper said.

“What really made it appropriate was the severity of the disease and the danger of not having an open airway after birth,” said Tepper, who also played no role in this study.

As researchers and doctors discover more uses for 3D technology and costs drop, Tepper expects to see its acceptance spread.

“For myself, I learn a new thing each week and I learn a new application outside my specialty each week,” said Tepper, who has used 3D-printed models to guide him in facial reconstruction.

“It’s still finding its way into other industries and hasn’t really figured out which way it will go, but one area I’m confident it’s going to be routine in is medicine,” he added.

Woo agreed that people are only just beginning to realize the potential of 3D printing technology.

“It’s surprising how quickly this technology has evolved and it’s going to continue to evolve very rapidly,” Woo said. “There’s a lot more that 3D printing can provide, not just for the medical industry but for our daily lives.”

More information

For more on 3D printing in medicine, visit the U.S. National Institutes of Health.

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California Gov. Jerry Brown Signs Right-to-Die Bill Into Law

By Dennis Thompson
HealthDay Reporter

MONDAY, Oct. 5, 2015 (HealthDay News) — California Gov. Jerry Brown on Monday signed “right-to-die” legislation that would allow the terminally ill to legally end their lives.

A lifelong Catholic and former Jesuit seminarian, Brown’s decision to support the bill passed by state legislators last month could have a significant impact on the right-to-die debate in the United States. Given the size of its population — nearly 40 million people — and its influence, California often sets the tone for potentially groundbreaking issues.

“I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill,” the governor wrote in a signing statement that accompanied his signature, the Associated Press reported.

In September, state senators voted 23-14 to let doctors prescribe life-ending medications to patients expected to die within six months. The California Assembly approved the bill earlier in a 43-34 vote.

Supporters believe that California’s approval of the measure could add momentum to the adoption of right-to-die laws across the country.

Opponents of the bill include religious groups such as the Catholic Church and advocates for the disabled.

California becomes the fifth state in which people are allowed to legally end their lives. Oregon, Vermont and Washington already have passed laws allowing the practice, and Montana’s courts have authorized it.

“I think lawmakers will be more comfortable voting for aid-in-dying, knowing that a big jurisdiction like California has already done so,” said Barbara Coombs Lee, president of Compassion & Choices, a national organization that supports the practice. “It’s hard for lawmakers sometimes to think about being the pioneers in a social change movement. It will be easier for them to feel that they are one more state coming along in the assimilation of a new medical practice.”

The California legislation is modeled after the Death With Dignity law passed by Oregon voters in 1994, which made that state the first in the nation to allow some terminally ill patients to choose the time of their own death.

The effort to pass the legislation in California was prompted, in part, by the death last year of Brittany Maynard, a 29-year-old California woman diagnosed with terminal brain cancer. Maynard moved to Oregon so she could end her own life when the time was right, and became a prominent activist in the “death with dignity” movement through online videos and well-read news articles about her choice.

Under both the Oregon law and the California law, two physicians must see the patient, review the prognosis and agree that the person has an illness that will be fatal in six months, Coombs Lee said.

The doctors also must attest that the patient has no mental illness or mood disorder that impairs judgment, and that the person is not being coerced or forced into the decision, she said. The person must receive counseling about hospice and palliative care, and be told that they are under no obligation to either fill the prescription for the life-ending drugs or to take them.

“The control resides with the patient, from beginning to end,” Coombs Lee said.

The California law places additional safeguards on the Oregon model, including a statement that the patient must sign within 48 hours of their self-inflicted death indicating that they are still of sound mind and remain capable of taking the medication on their own, Coombs Lee said.

However, opponents believe the Oregon law is flawed and allows abuses that will also occur in California.

Marilyn Golden, a senior policy analyst with the Disability Rights Education and Defense Fund, said that assisted suicide laws could potentially let insurance companies coerce vulnerable people into a cheap and quick death.

“If insurers deny or even delay a person’s life-sustaining treatment, they are being steered toward hastening their death,” she said. “Do we really think insurers will do the right thing or the cheapest thing?”

Golden also questioned whether the safeguards cited by Coombs Lee are truly effective, noting that people who are depressed or being pressured to take their own lives can “doctor shop” until they find a physician willing to sign off on their lethal prescription.

“It’s common knowledge in Oregon that if your doctor says no, you can call Compassion & Choices to find a doctor who says yes,” Golden said.

These are troubling concerns that have kept legislators in other states from acting on assisted suicide legislation, she said.

“No one pays attention to the fact that 12 other states this year have rejected the Oregon model,” Golden said. “As the legislators became aware of these problems, they chose not to move forward.”

Coombs Lee believes many other states will come around, encouraged by Maynard’s story and the example set by California.

“It takes a long time for lawmakers to educate themselves, and to start to feel comfortable voting yes,” Coombs Lee said. “It’s very unlikely a bill would pass a legislature the first time. California has been considering this in one way or another since 1991, when the first ballot initiative occurred.”

More information

For more on Oregon’s Death With Dignity Act, visit the Oregon Health Authority.

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Is Butter Bad For You? What You Should Know

Photo: Getty Images

Is butter really artery-clogging enemy No. 1? For the past few years, a fierce debate has raged on among experts about saturated fat—is it bad or not? A new study from Journal of the American College of Cardiology offers some key insights.

After following close to 85,000 women and nearly 43,000 men, Harvard researchers found that what you eat instead of saturated fat, found in whole milk, cheese, and meat as well as butter, matters just as much for your heart as the total amount of saturated fat in your diet.

RELATED: 13 Best (and Worst) Ways to Measure Body Fat

To reach their findings, the researchers checked in with participants every four years over three decades to evaluate their diets and signs of disease. (Everyone was free of diabetes, heart disease, and cancer at the start of the study.) In the end, they found that when men and women replaced 5% of their saturated fat calories with polyunsaturated fats, like those in nuts, their risk for heart disease dropped by 25%. Replacing that same amount of saturated fat with monounsaturated fat (also found in nuts as well as olive oil) reduced participants’ heart risk by 15%. Meanwhile, trading “sat fat” for whole grain carbohydrates resulted in a 9% reduction in risk.

Finally, and this is the important part, the researchers found that swapping saturated fat for processed carbs, like white bread and white rice, had zero effect on heart disease risk.

In other words if you trade ice cream for cookies, or swap in white rice in lieu of extra cheese, you won’t do your heart any favors. But there might be some benefit to replacing a portion of the saturated fat in your diet with other plant-based fats and whole grains.

What about your beloved butter?

While I don’t think butter is your best fat option, I do think organic grass-fed butter is far better than margarine, which is processed and loaded with trans fats, which we know for sure are bad. Previous studies also seem to show that overall saturated fats may be neutral, and some, like those found in coconut and cocoa butter, are actually beneficial.

What this really shows, however, is that your health depends on your whole diet. So go ahead and eat a little saturated fat, but make sure you have it with lots of produce, as well as lean protein, whole grains, and other good fats, too.

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To simplify things further, check out these 5 simple swaps. Each is designed to keep your diet balanced and best protect your ticker.

Choose spreads and substitutes wisely

If you have to choose between organic, grass-fed butter on whole wheat toast versus a donut, I say pick the toast! But even better, try using ripe avocado or almond butter as spreads.

In a similar vein, instead of adding bacon and cheese to a burger, slather it with olive tapenade, guacamole, or tahini.

Eat meat with veggies

When using ground meat in loaves, meatballs, or casseroles, cut the portion in half, and fill it in with a combo of minced or shredded veggies, and either a whole grain, like quinoa or oats, or mashed beans. Sadly, the latest study didn’t look at replacing your saturated fat with veggies, but with everything we know about the health benefits of produce, I’m willing to bet this move can pay major health dividends.

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Think beyond cheese

In a burrito, tacos, or a taco salad, replace cheese and sour cream with veggies, like spinach, mushrooms, bell peppers, and onions, along with brown rice, beans, and guacamole.

Snack smart

In place of cheese and crackers as an appetizer or snack, reach for nuts, olives, and popcorn (it’s a whole grain).

Tweak your treats

Cut your ice cream portion in half and top it with toasted oats and chopped nuts.

What’s your take on this topic? Chat with us on Twitter by mentioning @goodhealth and @CynthiaSass.

Cynthia Sass is a nutritionist and registered dietitian with master’s degrees in both nutrition science and public health. Frequently seen on national TV, she’s Health’s contributing nutrition editor, and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Yankees, previously consulted for three other professional sports team, and is board certified as a specialist in sports dietetics. Cynthia is a three-time New York Times best-selling author, and her brand new book is Slim Down Now: Shed Pounds and Inches with Real Food, Real Fast. Connect with her on Facebook, Twitter and Pinterest.

 

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