Climate Change May Be Pushing ‘Brain-Eating’ Amoeba to Northern Lakes

By Steven Reinberg
HealthDay Reporter

FRIDAY, July 24, 2015 (HealthDay News) — A deadly “brain-eating” amoeba that lives in freshwater sources may be surviving in more northern areas of the United States thanks to climate change, health experts suggest.

Minnesota health officials are still trying to confirm if the death of a Minnesota teen this summer was caused by the single-celled organism Naegleria fowleri. If confirmed, it would be the northernmost infection of Naegleria fowleri ever reported, according to the Minneapolis Star-Tribune.

The amoeba normally lives in warmer waters in the southern United States. But since climate change is generally making summers hotter, the amoeba now seems to be in northern waters, said Dr. Bruce Hirsch, an infectious diseases specialist at North Shore University Hospital in Manhasset, N.Y. “Climate change may be playing a role,” he said.

The U.S. Centers for Disease Control and Prevention referred to the amoeba as “heat-loving.” In the United States, more than half of infections caused by the amoeba have occurred in Florida and Texas, the CDC reports. The first known case to occur in Minnesota didn’t happen until 2010.

Although Naegleria fowleri is endemic in many U.S. lakes and rivers, the odds of the bug getting into your brain are slight. In fact, between 2005 and 2014, only 35 people were infected in the United States, according to the CDC.

The infection caused by the amoeba is called primary amebic meningoencephalitis, which destroys brain tissue, the CDC says.

So how does someone get infected? When water containing the amoeba enters the nose, the CDC said. You cannot get this infection from drinking contaminated water, according to the agency.

Hirsch explained that the bug probably gets into the brain when water is forced into the nose as someone jumps into a lake, river or even a pool. The amoeba can then penetrate the lining of the nose and make its way through the porous bone between the nose and the brain, he explained.

Once in the brain, it can cause an infection that destroys brain cells and is almost always fatal. “There have been a few survivors, but it is a very dangerous infection,” Hirsch said.

The infection cannot be spread from one person to another, he added.

Treatment is available with several drugs, and sometimes it’s effective, Hirsch said.

“The mainstay of treatment is an antifungal, antimicrobial medicine called amphotericin,” he said. “Used in combination with other medicines given directly into the spinal fluid, if caught early, it has been able to help people survive this devastating infection,” he said.

Symptoms start about five days after infection, the CDC says. The first symptoms may include headache, fever, nausea or vomiting. Later symptoms can include stiff neck, confusion, seizures and hallucinations, the CDC says.

“The person would be totally out of it — confused — and then fall into a coma,” Hirsch said.

Most cases are from contaminated water in lakes or rivers, but some people were infected after nasal irrigation with contaminated tap water, and others have gotten infections from swimming pools, bathtubs and even a backyard Slip’N Slide using contaminated water, according to the CDC.

Among known cases, 97 percent of people infected have died. Only three out of 133 infected people in the United States from 1962 to 2014 have survived, the CDC noted.

Dr. Adriana Cadilla, a pediatric infectious disease specialist at Nicklaus Children’s Hospital in Miami, said there was a fatal case at her hospital several years ago.

Doctors are not usually looking for this infection, she said.

“Testing is not routine and that’s part of the reason that it’s difficult to diagnose, and it takes a couple of days to get results, which may be part of the reason why we don’t have as much of a success as we would like with the treatment,” she explained.

No real precautions exist beyond telling the public that a particular body of water has these amoeba, Cadilla said. The CDC cautions against getting water splashed up the nose.

“We don’t know why someone gets infected and others don’t,” Cadilla said. “We really can’t tell you what to do not to get infected.”

She stressed that this is a very rare infection and other hazards linked to water are much more common.

“There have been 35 cases, but from 2001 to 2010 there were 34,000 drownings,” Cadilla said. “There are other risks associated with water that have a higher priority.”

More information

For more information on Naegleria fowleri, visit the U.S. Centers for Disease Control and Prevention.

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1 in 3 Colon Cancers in Young People Has Genetic Link

FRIDAY, July 24, 2015 (HealthDay News) — More than a third of colon cancers diagnosed in younger patients are caused by inherited gene mutations, a new study finds.

These patients should undergo genetic counseling to determine if their families may be at increased risk, the researchers suggested.

Hereditary colon cancers are relatively rare overall, but tend to be more common if diagnosed before age 50, the researchers said. However, their prevalence among teens and young adults has not been well documented, according to the researchers.

This study included almost 200 patients, aged 35 and younger, who were diagnosed with colon cancer and underwent genetic testing between 2009 and 2013.

“We were very surprised to find that 35 percent of that population of patients had a genetic disease, although we hypothesized the proportion would be higher in this age group relative to the general population,” study leader Dr. Eduardo Vilar-Sanchez, an assistant professor in the department of clinical cancer prevention at the University of Texas M.D. Anderson Cancer Center, said in a cancer center news release.

The study was published July 20 in the Journal of Clinical Oncology.

“Based on our findings, patients under the age of 35 need to be evaluated by a genetic counselor. Period,” Vilar-Sanchez said. If they find they have a genetic disease, they can then share that information with their parents, siblings and other family members who could benefit from knowing about the genetic risk, he said.

Colorectal cancer is the third most common cancer in the United States, with more than 90,000 new diagnoses expected this year, the researchers said. People older than 50 will account for about 90 percent of those cases, they noted.

More information

The American Cancer Society has more about colorectal cancer.

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FDA OKs First of New Class of Cholesterol Drugs

By Amy Norton
HealthDay Reporter

FRIDAY, July 24, 2015 (HealthDay News) — The U.S. Food and Drug Administration on Friday approved Praluent, the first of a powerful new class of injected, cholesterol-lowering drugs that experts believe could change cardiovascular care.

Praluent (alirocumab) sharply cuts levels of LDL (“bad”) cholesterol, and is one of a group of newly developed drugs called PCSK9 inhibitors, the FDA explained in a news release.

The drug is only approved for patients with heart disease and a history of heart attack or stroke “who require additional lowering of LDL cholesterol” in addition to taking a statin drug and adopting a healthy diet, the agency said.

It is also for use by patients with a condition called heterozygous familial hypercholesterolemia (HeFH), an inherited illness that causes people to have high levels of LDL in the blood.

“Praluent provides another treatment option for patients with HeFH or with known cardiovascular disease who have not been able to lower their LDL cholesterol enough on statins,” Dr. John Jenkins, director of the FDA’s Office of New Drugs, Center for Drug Evaluation and Research, said in the news release.

Praluent may only be the first of two PCSK9 inhibitors to eventually hit the market: Earlier this month, an FDA panel also endorsed another such drug, called evolocumab (Repatha) for use in patients who are at very high risk for high cholesterol. According to the Associated Press, a decision on Repatha is due by Aug. 27.

Studies seem to back up the effectiveness of PCSK9 inhibitors in lowering artery-clogging cholesterol. One recent review of 24 clinical trials — published in the Annals of Internal Medicine — found that PCSK9 inhibitors lowered people’s LDL cholesterol by about 47 percent, on average.

More important, the drugs seemed to cut the risk of heart attack or death from heart disease, according to the researchers.

Experts did urge some caution, however: The trials so far have been short-term, and it’s not clear whether the new cholesterol drugs really do extend people’s lives, according to Dr. Seth Martin, a cardiologist at Johns Hopkins University in Baltimore.

“Still, the early data are exciting, and we’re cautiously optimistic,” Martin, who co-wrote an editorial published with the study, told HealthDay.

However, until large clinical trials are completed in 2017, experts won’t have definitive proof of whether the new drugs actually reduce the risk of heart attacks and death.

Statins have long been the go-to treatment for lowering LDL cholesterol. Studies have proven they can help prevent heart attacks, strokes and other cardiovascular complications.

But for some people, statins cause intolerable muscle pain. “Those people would be obvious candidates for PCSK9 inhibitors,” Martin said.

For others, statins just don’t do the job — including people with inherited conditions like HeFH, which causes very high LDL levels and heart attacks at an early age.

“Familial hypercholesterolemia is not rare,” Martin noted. “It affects about one in 300 to 500 people.”

Of the trials covered in the Annals review, half involved people with familial hypercholesterolemia. Some of the others focused on people who’d dropped statins because of side effects.

PCSK9 inhibitors work by blocking a protein in the liver that helps regulate LDL cholesterol, according to the study. The new drugs don’t seem to cause the muscle problems that statins can.

However, that doesn’t mean they’re completely safe. Martin said the main concern that has arisen in trials of the new drugs is the potential for “neurocognitive effects.” For example, some study patients have reported problems such as confusion and trouble paying attention. But, Martin said, it’s not clear yet whether the PCSK9 inhibitors are actually the cause.

And in the FDA news release, the agency said that side effects associated with Praluent include “itching, swelling, pain, or bruising where injection is given, [colds] and flu,” as well as allergic reactions at the injection site.

For the Annals review, researchers led by Dr. Eliano Navarese, of Heinrich Heine University in Dusseldorf, Germany, pooled the results of 24 clinical trials involving more than 10,000 patients. Some compared a PCSK9 inhibitor to a placebo (inactive treatment), while others used the cholesterol drug ezetimibe (Zetia) for comparison.

Overall, the researchers found, the new drugs cut LDL to a greater degree. They also lowered patients’ risk of heart attack or death by about half.

The caveat, Martin stressed, is that the studies were short, and few people suffered complications. He said longer-term studies are needed to prove that the drugs prevent heart attacks and extend people’s lives — without serious side effects.

Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City, agreed that the results so far are encouraging.

“For all those patients unable to take statins, finally there might be an option that can change (their) outcomes,” said Steinbaum, who was not involved in the recent review.

But, she added, “we need to patiently wait for the next phase of trials to see whether the clinical outcomes are as promising as the initial studies suggest.”

And drugs like Praluent are not without their downsides, experts said.

For one, the drugs have to be self-injected, which might put some people off. On the other hand, Martin said, the injections are done only once a month or every couple of weeks.

“Some people may prefer that to taking a pill every day,” he said.

And then there’s the cost. PCSK9 inhibitors are specialty drugs known as monoclonal antibodies, which are lab-altered versions of human antibodies. And they are not cheap.

The cholesterol drugs could cost up to $12,000 a year per patient, according to a recent estimate by CVS Health, one of nation’s largest pharmacy benefit managers.

Since so many Americans take cholesterol drugs — for years or even decades — CVS warned that the cost to the health care system could be sky-high.

More information

The American Heart Association has more on treating high cholesterol.

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Here’s How to Stop Work Stress From Turning Into Burnout

Photo: Getty Images

Have you ever been so emotionally exhausted at work that the mere thought of typing up one more report or sending one more e-mail makes you want to scream? Yes, we’ve all been there every now and again. But if that “can’t go on” feeling becomes more of an everyday thing, that’s probably work burnout—a chronic state of job stress that can tank your performance at work as well as your emotional wellbeing.

According to the latest Gallup survey on the topic, full-time American workers are at their posts 47 hours a week, on average, with 18 percent of respondents saying they work at least 60 hours per week. Many of us are under a lot of pressure, in other words.

RELATED: 13 Ways to Beat Stress in 15 Minutes or Less

But burnout, which is defined by the feeling that you can’t cope with your workload and the frustration that comes with that, doesn’t have to be just something you put up with. (Or quit your job over—because who can do that?) A recent Australian study found that it might be avoidable or reversible with exercise (which definitely explains why going for a run or taking a CrossFit class feels so darn good after a terrible day at the office.)

In the study, inactive men and women either participated in a four-week cardio or weight-training exercise plan (with a minimum of three 30 min sessions per week), or continued to not work out, like normal.

Before and after those four weeks, researchers used three different tests, including the Perceived Stress Scale, to figure out whether the participants’ moods shifted.

RELATED: 17 Natural Remedies for Anxiety

The results? Not only did those on the fitness plan feel more accomplished about what they had gotten done after those four weeks, but they also had less mental distress, emotional exhaustion, and perceived stress. (In the control group, not much changed.)

“Exercise has potential to be an effective burnout intervention,” researchers from the University of New England in Australia wrote in the paper. “Organizations wishing to proactively reduce burnout can do so by encouraging their employees to access regular exercise programs,” they concluded. (So bosses, take note: Researchers even suggest that knowing this information could help save companies money, as they say the global burnout costs over $300 billion each year.)

And if you’re feeling down about your job or are in a constant state of tension every time you move your mouse, consider incorporating more cardio or weights into your fitness routine. Although the study was small—only 49 volunteers participated—the benefits to your work could be real (not to mention, you’ll also reap all the other health benefits you get when breaking a sweat).

RELATED: 10 Habits of People Who Love to Work Out

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What You Must Know About the Chemicals in Your Sunscreen

Photo: Getty Images

You probably don’t need to be told (again) how important wearing sunscreen is for reducing your risk of skin cancer, not to mention sunburns and signs of premature aging (think wrinkles). But go ahead and Google “best sunscreens” or even “sunscreen,” and plenty of articles pop up suggesting that the ingredients in many of these products could be harmful or even toxic, leaving you to worry about what’s really going on your skin. And maybe even wonder whether it’s actually safer to go outside without a protective spray or lotion?

The answer: No. In fact, the skin experts Health talked to were adamant that we should be more worried about shielding our skin from the sun’s harmful UV rays than about the chemical makeup of the products we’re using to do that.

“Five million Americans are treated for skin cancer each year, and an estimated 9,940 people will die of melanoma”—the deadliest type of skin cancer—”in 2015,” Steven Wang, MD, head of dermatological surgery at Memorial Sloan Kettering Basking Ridge in Basking Ridge, New Jersey, told Health. “The biggest precaution that you should be taking is using sunscreen. There is enough research at this point from various credible bodies that say sunscreens are safe and, when used appropriately, will reduce skin cancer.”

RELATED: 6 Things Your Dermatologist Wants You to Know About Skin Cancer

Why you might have heard that sunscreen could be dangerous

So, where are people getting the idea that the chemicals in certain sunscreens are potentially hazardous?

For starters, there has been much concern about chemicals thought to be endocrine discruptors in our everyday environment in recent years. Proven endocrine disruptors, which include bisphenol-A and pesticides like DDT, can mimic the hormone estrogen in the body, which may increase risk in humans for low fertility, endometriosis, and certain cancers.

Most recently in regards to sunscreen, a report this year from the Environmental Working Group (a non-profit advocacy organization) once again made reference to “worrisome ingredients like oxybenzone and Vitamin A” commonly found in these protective products.

But the thing is, the actual research on the effects of these “worrisome” ingredients in sunscreen may have been blown out of proportion.

Take this 2008 study in the journal Environmental Health Perspectives, for example, which examined concentrations of benzophenonone-3 (a.k.a. BP-3, or oxybenzone) in residents of the United States. The researchers concluded that while exposure to the chemical was prevalent in the population studied, “human exposure to BP-3 has not been associated with adverse health effects.”

RELATED: How to Buy the Best Sunscreen for You

Some studies do suggest that the chemical could potentially have effects on the endocrine system, but, the scientists explain, that research was conducted on animals—including some in which mice and rats were fed oxybenzone orally—and animal tissue isolated in labs.

In 2011, Dr. Wang and colleagues published a research letter in JAMA Dermatology titled: “Safety of Oxybenzone: Putting Number into Perspective.” For that paper, the researchers, took the dose used in one of the most worrisome studies on oxybenzone in rats and determined that an equivalent dose in humans would amount to almost 35 years of daily, full-body application.

And even though there is evidence that oxybenzone does get absorbed by your skin and excreted via urine, the authors of another 2004 paper concluded that despite the presence of the chemical in participants’ urine, they observed no hormonal changes that could be traced back to the sunscreen exposure.

As for vitamin A, commonly found in products like sunscreen in the form of retinyl palmitate, the backlash stems from findings from the National Toxicology Program (NTP), which is a U.S. government program that tests and evaluates chemicals in our environments. One of the NTP’s oft-cited experiments found that retinyl palmitate cream applied to hairless mice exposed to UV radiation in a lab increased the incidence of skin tumors as well as the speed at which the tumors developed, compared to control groups of mice that weren’t covered in the cream.

RELATED: Are You Getting a Good Skin Cancer Check?

But again, this isn’t comparable to the effects of this additive in human skin because, for one thing, the researchers looked at retinyl palmitate “in isolation,” according to a 2010 critical analysis in the Journal of the American Academy of Dermatology. Retinyl palmitate is an antioxidant naturally found in human skin, along with vitamins C and E. And these three actually work together in a way that neutralizes any negative effects, the researchers report.

On top of that, as the researchers write in response: “It is important to mention that the mice in the above NTP study are highly susceptible to develop skin cancer after UV exposure… mouse epidermis is significantly thinner than that of human beings, hence resulting in higher percutaneous absorption. Therefore, extreme caution is needed when extrapolating these animal study results to human beings.”

The bottom line from the Skin Cancer Foundation: “[C]onsumers should rest assured that sunscreen products including the ingredients oxybenzone and retinyl palmitate are safe and effective when used as directed. Both oxybenzone and retinyl palmitate”—which is a form of vitamin A—”are approved for use in sunscreens by the U.S. Food and Drug Administration (FDA). The Skin Cancer Foundation’s position is based on years of clinical data.”

RELATED: 5 Best Ways to Protect Against Skin Cancer

How to choose the right sunscreen for you

First, a little skepticism can be helpful. “A lot of these articles [about sunscreen] are A+B = Z. There’s so many steps in between the science that they don’t discuss,” Ellen Marmur, MD, a New York City-based dermatologist, explained to Health. “You have to look at your sources, you have to trust that they are referencing their articles correctly. If it seems really radical, it’s probably not the whole truth.”

The very best sunscreen to use is simply the one you like and will actually reapply, often. So if that means you’d rather not use chemical sunscreens for whatever reason, that’s your call. There are plenty of sunscreens that rely on zinc oxide and other physical blocks that work just as well to protect your skin.

Dr. Wang encourages the use of a water-resistant broad-spectrum sunscreen with an SPF of 30 or higher and reapplying every two hours or after swimming or sweating excessively. Be sure to apply two ounces of sunscreen—to help you visualize, that’s the amount that would completely fill two shot glasses—to your entire body 30 minutes before heading outside, coating every part of your skin. When you reapply, use one ounce (so, one shot glass full) each time.

And don’t forget: sunscreen is just one part of a complete sun-protection regimen, our experts add. Don’t be shy about seeking shade between the hours of 10 am and 4 pm, wearing a wide-brimmed hat, and UV-blocking sunglasses in addition to using sunscreen, all in the service of lessening your exposure to UV radiation. Says Dr. Wang: “That is the real threat, not whether or not sunscreen is safe.”

RELATED: 15 Biggest Sunscreen Mistakes

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New Skin Cancer Drug Approved by FDA

FRIDAY, July 24, 2015 (HealthDay News) — A new drug to treat the most common form of skin cancer has been approved by the U.S. Food and Drug Administration.

Odomzo (sonidegib) was cleared to treat locally advanced basal cell carcinoma in patients who cannot undergo surgery or radiation therapy, or whose skin cancer has returned after surgery or radiation therapy.

Skin cancer is the most common type of cancer, and basal cell carcinoma accounts for about 80 percent of non-melanoma skin cancers. Locally advanced basal cell skin cancer has not spread to other parts of the body, but cannot be cured with surgery or radiation.

Odomzo is a once-a-day pill designed to suppress a molecular pathway that is active in basal cell cancers, according to the FDA.

The drug’s approval was based on a clinical trial that included 66 patients who took 200 milligrams (mg) of Odomzo a day and 128 patients who took 800 mg a day. Tumors shrank or disappeared in 58 percent of patients in the 200-mg group. This benefit lasted from nearly two months to almost 19 months, and six months or longer in about half of the cases.

Response rates were similar among patients in the 800-mg group, but they had a higher rate of side effects, the FDA said.

At the lower dose, the most common side effects were muscle spasms, hair loss, taste problems, fatigue, nausea, musculoskeletal pain, diarrhea, decreased weight and decreased appetite. Some people also reported muscle pain, abdominal pain, headache, vomiting and itching.

Odomzo also poses a risk for serious musculoskeletal problems, including rare reports of muscle tissue breakdown.

The drug carries a Boxed Warning about the risk for fetal death or severe birth defects when taken by pregnant women. Doctors should check women for pregnancy before prescribing Odomzo, and both men and women should be warned about these risks and told to use birth control, the FDA said.

Odomzo is marketed by Novartis Pharmaceuticals of East Hanover, N.J. In 2012, Genentech’s Erivedge (vismodegib) became the first FDA-approved drug to treat locally advanced and metastatic basal cell carcinoma, meaning cancer that has spread to other parts of the body.

Basal cell skin cancers usually result from regular exposure to the sun and other forms of ultraviolet radiation, the FDA says.

More information

The U.S. National Cancer Institute has more about skin cancer.

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Transgender Youth Don’t Have Hormone Abnormalities

FRIDAY, July 24, 2015 (HealthDay News) — Sex hormone levels in transgender youth are consistent with the gender they were assigned at birth, a new study finds.

“We’ve now put to rest the residual belief that transgender experience is a result of a hormone imbalance. It’s not,” Dr. Johanna Olson, who practices adolescent medicine at Children’s Hospital Los Angeles, said in a hospital news release.

At birth, babies are typically assigned a gender based on their external genitalia. Transgender people have a different gender identity than the one they were given at birth, the researchers said.

The study included 101 transgender youth. They were between the ages of 12 and 24. There was nearly an equal number who had been assigned “male” at birth but identify as female, and who were assigned “female” at birth but identify as male.

On average, the participants realized they were transgender at about age 8 but waited until age 17 to tell their families. Keeping this knowledge secret can harm a person’s mental health. Thirty-five percent of the participants had suffered depression, more than half said they thought about suicide and 30 percent made at least one suicide attempt, the researchers said.

The study was published July 21 in the Journal of Adolescent Health.

“My goal is to move kids who are having a gender atypical experience from survive to thrive,” said Olson. “With this study, we hope to identify the best way to accomplish that.”

The ongoing study of transgender youth will track the safety and effectiveness of medical intervention, along with how intervention affects quality of life and mental health.

More information

The American Academy of Pediatrics has more about gender identity.

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How the Mattress You Sleep on Actually Affects Your Beauty

Photo: Courtesy of MIMI/ Getty Images

A good night’s sleep is one of the most important things to do for health. Whether weight loss, mental health or beauty is the goal, catching ZZZs is key. In fact, anyone who’s beauty obsessed already knows sleep is a critical time for refreshing and renewing. But what *actually* factors into a good night’s sleep? What you eat, when you hit the sack and physical activity can all play a part in securing beauty sleep, but so can your mattress. In fact, you might not always think of it, but the quality of your bed itself can impact the quality of your sleep. We’re taking a look at what happens when you get beauty sleep and how you can change your environment to make the most out of your night.

When the lights go out

When our bodies hit the sack, a lot happens. “It’s important that people get a good night’s sleep because that’s when skin is best able to repair itself and oxygenate itself from the day,” explains Dr. Rebecca Kazin, Medical Director of the Johns Hopkins Dermatology and Cosmetic Center. In essence, sleep isn’t just a time for dreams. It’s the time in which our skin, which also follows a circadian rhythm similar to our sleep pattern, can rehydrate and refresh.

This is also when our bodies produce growth hormones. Dr. William Christopher Winter, a board-certified and nationally recognized sleep medicine doctor as well as a board-certified neurologist, explains growth hormones are only produced during deep sleep for adults and are critical for the body’s daily recovery, injury recovery, immune system functioning and overall vitality.

During this stage of delta sleep, true physical restoration occurs, says Dr. Michael Breus, clinical psychologist and author of Beauty Sleep: Look Younger, Lose Weight, and Feel Great Through Better Sleep, through not only growth hormone secretion but cellular repair as well. Cellular repair is responsible for repairing all the minor damage the skin and body have received throughout the day.

But if you’re sleep deprived, less growth hormone is produced, cellular repair and metabolism slows down and blood circulation even decreases, causing pooled blood a.k.a. dark circles and high blood pressure, which leads to puffiness. Not to mention skin’s overall rosy appearance disappears.

“When you have lowered circulation, nutrients are not going to you hair, skin, nails,” explains Dr. Breus. Basically, your body is not making those necessary maintenance repairs.

The wrong side of the bed

There is a wrong side of the bed, as anyone who missed a few hours of shut eye will attest. When we get a bad night’s sleep, it shows—and we don’t just mean with dark circles.

“If you’re sleep deprived, you’re not fooling anyone,” says Dr. Breus.

In fact, in a Swedish study, 23 adults were photographed on a full night’s sleep (eight hours) and again after only five hours. Observers were asked to look at the two photos and rate in which photo the subject looked more healthy and more attractive. The majority of the observers rated the photo taken after eight hours of sleep as more attractive and lively than the more sleep deprived one.

But beauty isn’t just physical; it’s emotional. And to no surprise, there’s an emotional side of sleeping.

“If you’re sleep deprived, there’s a greater likelihood any emotional scenario you have is going to be worse,” explains Dr. Breus. “So if you’re a normal healthy person, the more sleep deprived you are the more likely you are to add valence to emotions. Jokes might seem funnier, but you might be more offended by things.”

So in theory, getting a good night’s sleep can have an effect on our general mood, thus possibly making us more enthusiastic about our physical appearance. Ever wake up inspired to attempt that fabulous smoky eye? Guess there’s a reason behind that saying “bright-eyed and bushy tailed.”

Creating the ideal bedtime

If there’s ever one time it’s okay to play Goldilocks, it’s when you sleep. Sleeping in a room that’s too hot or too cold is like showing up to a marathon without training — it just doesn’t work. To get the most comfortable sleeping environment, Dr. Winter says opt for a room temperature of the mid 60s to help lower the body temperature.

But besides setting the thermostat, giving yourself enough time for sleep is key to the body’s repair cycle. We’ve all heard that eight is a magic number, but really, there’s no set number of hours we’re required to get each night. According to Dr. Winter, much like caloric need, the amount of sleep needed is really dependent on each individual person.

“The idea of saying a number [of hours of sleep you should get] is difficult because you’ll have people who will really do best with seven hours of sleep,” says Dr. Winter. “But if you tell them eight hours is better, it can really backfire if they’re trying to get eight, and they can’t. Then they’ll start to struggle with what they would consider to be insomnia.”

Similar to the time spent asleep, the position in which you sleep can also effect your appearance. Constantly sleeping in the same position on your side or your stomach can cause permanent creases in the skin, says Dr. Kazin. She also explains side or belly sleepers who drool when they sleep can breakout or get heat rash in that area.

So what is the ideal sleeping position for all-around health?

“The best position for sleep is actually on your back,” says Dr. Breus, “Because the weight is displaced across the skeletal plane with the largest amount of surface area that way. When you sleep on your side, everything kind of falls to the side that you’re sleeping on. So from a gravitational perspective, you’re crushing all the capillaries of the side that you’re sleeping on.”

Although we have little control on how we end up sleeping throughout the night—some of us twist and turn and end up at the foot of the bed even — those who sleep on their backs benefit the most when it comes to beauty as there’s no pressure on the face, breasts or other parts of the body. So if you can help it, back sleeping à la Sleeping Beauty is key. Gown and crown optional.

What about the mattress?

Now that you know why a good night’s sleep is essential for all things beauty related, how does one get a truly restful night? Besides turning off technology at night — yes, step away from Snapchat — finding a bed that will actually create a sanctuary is equally important.

“I believe sleep is a performance activity,” says Dr. Breus. “If you have the right equipment, it’s going to be helpful in the level of performance.” He explains the biggest function of a mattress is supporting the spine, the head and the neck in a way shape and form that’s comfortable, neutral and allows the body to regenerate in the evening. The problem is there’s no one mattress that can do this for everyone.

“The ideal mattress is the mattress that you sleep best on,” says Neil Parikh, Co-Founder & Chief Operating Officer of Casper. [Ed note: Several MIMI editors have the Casper mattress and are ob-sessed with it.] Because there’s not one bed to suit everyone, it’s important to take into consideration what your sleeping needs are.

Parikh says a top complaint from consumers when it comes to mattresses is heat retention — a factor the Casper brand took into account when creating their mattresses. “There are two main reasons why people sleep hot,” says Parikh of current memory foam options. “Most memory foam isn’t very breathable, and the material tightly conforms to your body, so there isn’t enough air space around your skin. When your body is enveloped in a non-breathable memory foam, the material gets toasty, and you get sweaty.” Bottom line: if you’re prone to getting hot, perhaps memory foam isn’t for you.

Another factor to consider is your partner. If you share your bed, consider a latex mattress. As Dr. Winter points out, latex is a natural material, which is hypoallergenic, resistant to bacteria, mildew, mold and dust mites. But it’s also highly customizable on each side thanks to its pliable nature. Most importantly, it’s very easy to replace if you decide you want a different firmness over time. Or if your bed partner changes.

Whether you’re looking for a spring, air, water or foam mattress, “to each his or her own” is a good rule of thumb. Just make sure to fully test the bed before buying. Dr. Breus suggests going mattress shopping at the end of the day when your body is most tired, wearing lose clothing, taking off your shoes, bringing your own pillow and making sure to lie on each side you sleep on for at least 15 minutes to get the most out of your shopping experience.

At the end of the day, our experts all agree there was no hard and fast rule to sleeping. Just make sure you equip yourself with the gear you find the comfiest and let your body to the rest.

This story originally appeared on MIMIChatter.com

More from MIMIChatter.com:

7 Secrets to Get More Beauty from Your Beauty Sleep

This Is Why You Can’t Fall Asleep in the Summer

8 Ways to Wake Up Prettier

MIMI Chatter is an endless stream of beauty content. We bring together the must-knows and the how-tos from your favorite sites, beauty influencers, our editors, and YOU.

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When Chemotherapy Does More Harm than Good

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A cancer diagnosis is a life-altering event, and the news—let alone making decisions about how to manage treatment—is already challenging enough. But with a terminal diagnosis, those choices become even more fraught. At some point, say ethicists, doctors and patient advocates, enough is enough. Meaning the potential for benefit has to be weighed against the quality of what life is likely to be left. But where is that line? And how does each patient find it?

A study published in JAMA Oncology highlights just how agonizing those choices can get. Holly Prigerson, director of the Center for Research on End of Life Care at Weill Cornell Medical College and her colleagues studied the use of chemotherapy among a group of 312 terminal cancer patients. All had been given no more than six months by their doctors, and had failed at least one if not multiple rounds of chemotherapy, seeing their tumors spread to other parts of their body. About half were on chemotherapy, regardless of its ineffectiveness, at the time of the study.

Despite the intuitive sense that any treatment is better than none, there is not much evidence that chemotherapy is the right choice in these cases—and it may very well be the wrong one. Prigerson’s analysis showed that these patients experience a drop in their quality of life if they get chemo, and that they are therefore worse off than if they hadn’t opted for the treatment. On measures of things like whether they could continue to walk on their own and take care of themselves and keep up with their daily activities, those on chemotherapy reported marked declines compared to patients who opted not to receive more chemo.

“The results were counterintuitive to some extent,” says Prigerson. “The finding that the quality of life was impaired with receipt of the toxic chemotherapy was not surprising. The surprising part was that people who were feeling the best at the start of the therapy ended up feeling the worst. They are the ones most harmed and who had the most to lose.”

In other words, the chemo made the patients feel worse without providing any significant benefit for their cancer.

Previous studies have showed that chemotherapy in terminal patients is essentially ineffective; among those with non-small cell lung cancer, for example, third rounds of chemo were associated with a 2% response rate in tumor shrinkage, while fourth rounds showed 0% response. And whatever tumor shrinkage occurred wasn’t linked to a longer life.

Groups like the American Society of Clinical Oncologists (ASCO) recently advised doctors to be more judicious with their chemotherapy use in terminal patients. The group’s guidelines recommend limiting it to relatively healthy patients who can withstand the toxic treatment and potentially overcome side effects.

The decision about how long to continue care, including chemotherapy, is up to each cancer patient, but Prigerson hopes that her results help to better inform those choices in coming years. Recent studies showed, for example, that despite explanations from their doctors, many cancer patients still believe that more rounds of chemo will provide some benefit to them, and are therefore—and understandably—reluctant to stop receiving therapy. But at some point, the data shows, more treatment is not better.

That may be especially true of patients with end-stage cancer who are still relatively healthy and not feeling sick. For them, additional chemotherapy will likely make them weaker, not to mention eat up more of the precious time they have left traveling to and from infusion centers. Prigerson plans to continue the study to better understand the dynamics of how decisions about treatments are made toward the end of life, but in the meantime hopes the latest findings at least convince doctors to reconsider how they advise their terminal patients about end-stage chemotherapy.

This article originally appeared on Time.com.

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5 Running Mistakes Beginners Always Make

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Summertime is the perfect season to start a running program. With the sun shining, there’s simply no reason to not lace up your sneaks and hit the road. But before you get started, learn the five mistakes every beginning runner makes. And skip them!

Starting too fast

The most common mistake new runners make: going too hard, too fast. By not easing into it, you end up exhausted much sooner than expected, and the tail end of your run becomes a wind-sucking session. This can make running seem too hard, which can lead you to quit your program all together.

Solution: The key is pacing yourself; running is a sport in which progress is especially slow and gradual. If you’re running outside, downloading a pacing app like RunKeeper (free, iTunes and Google Play) can help you keep track of your speed. Start off at a moderate pace, and gradually increase throughout your run. This will make for not only a more enjoyable run, but it’s also the key to building endurance.

RELATED: 15 Running Tips You Need to Know

Wearing the wrong shoes

Maybe you’ve heard this one before, but it’s worth repeating. You may think because your feet feel okay, and you’re not getting blisters, you’re in the clear. But poor-fitting shoes can cause all sorts of unexpected problems:  ankle pain, hip pain, even shoulder pain, and so on. This is why I think of the wrong shoes as the “silent killer” of running programs.

Solution: The best advice is to sidestep this from the get-go. Hit your local running store and have them fit you for the proper shoes. They will look at your gait and see what areas of your feet take on the most pressure while you walk and run. The right shoe will take your runs to a whole new level.

Setting unrealistic goals

It’s very easy to get caught up in what others are doing and try to match up with them, especially when it comes to running. But remember: the only person you should be competing against is yourself. If you’re a brand new runner, trying to run a 5k straight through right off the bat is likely going to leave you feeling discouraged. It’s okay—even recommended—to start with an even smaller goal, like running a mile. And then move forward from there.

RELATED: Just 5 Minutes of Running Per Day Could Add Years to Your Life

Solution: Start with a realistic program that will help you build the strength and endurance to reach your running goal. For example, start with a run/walk program that allows you to take rests in between each set of running. Over time, you’ll build the endurance to run all the way through with no breaks.

Fueling improperly

A car can’t run without gas, right? It also probably won’t run very well if you fill it with water. This is exactly the way you should be thinking about fueling yourself for a run. New runners often find that one day, they feel like a million bucks on their run, but then the next, it feels like all progress has gone out the window. Often the difference is proper food and water.

Solution: Everybody is different, so you’ll have to experiment a bit to find out what works best for you, but there are some tried and true solutions that work for most.

If you have 1 hour or less before your run, eat a small mixture of protein, carbohydrates and fats. This could be a slice of whole wheat bread with peanut or almond butter spread on top.

If you have 2 hours, eat a meal that includes larger portions of protein, carbohydrates and fats. This could be eggs, bacon, and a slice of whole wheat toast.

If you’re going on a longer run, you can bring some energy gels (GU Energy Gels are a popular option) for the road, but I find it easier and healthier to just snag a pack of your kid’s fruit snacks. My kids and I love Fruigees since they’re a natural, organic option and made with only fruits and veggies. This is a super efficient snack that will give you that quick punch of natural sugar to help you keep going, without upsetting your stomach.

RELATED: Food Rules for Beginning Runners

Heel Striking

You may have heard the term, but many people don’t know what this is or how to fix it. By overstriding (landing on your heel first), you are opening yourself up to injury, such as shin splints.
Solution: Aim to land mid-sole. Your stride may have to shorten up to achieve this, but you’ll be happy you did in the long run (pun intended)!

For more running tips like this, check out The Pros and Cons of Running On the Treadmill

Jennifer Cohen is a leading fitness authority, TV personality, entrepreneur, and best-selling author of the new book, Strong is the New Skinny. With her signature, straight-talking approach to wellness, Jennifer was the featured trainer on The CW’s Shedding for the Wedding, mentoring the contestants to lose hundreds of pounds before their big day, and she appears regularly on NBC’s Today Show, Extra, The Doctors, and Good Morning America. Connect with Jennifer on Facebook, Twitter, G+ and on Pinterest.

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