Prevention

GETTY IMAGES. says Peter Muennig, M.D., a professor women seeking the of health policy and management at procedure that they Columbia University and the coauthor might develop a of the infant mortality study. (Women condition similar to with money generally find ways to get post-traumatic stress an abortion, he speculates.) Babies disorder (PTSD) born to low-income moms are also afterward, accord- more likely to suffer from poor nutrition ing to the nonprofit and reduced medical care, and infants Guttmacher Institute, born to teen girls fare especially poorly, which tracks these the study found. laws. Research does not support this. In Abortion doesn’t cause the National Acade- depression or other illnesses. mies report, an exam- ination of numerous Some states require providers to tell studies found that having an abortion does not increase risk of depression, anxiety, or PTSD. Some states also require that women be told there’s a link between abor- tion and breast cancer or infertility, even though the American College of Obstetricians and Gynecolo- gists says that neither is true. Being denied an abortion can impact health for a lifetime. Women who can’t get an abortion are more likely to be impoverished four years later than those who can, and fewer of them eventually get a college degree, according to University of Cal- ifornia researchers. This has long-term health effects: A Yale study reported that people with higher levels of educa- tion are more likely to live longer. 49A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

HEALTH THE DOCTOR IS IN Weight Gain: Is It Midlife or Menopause? If your body has started to pack on pounds, you may wonder why it’s happening. Here are some answers. BY LAUREN STREICHER, M.D. Dr. Streicher is Besides hot flashes, one been that metabolism slows ILLUSTRATION BY KATHRYN RATHKE. of the main things with age, but a study released a clinical professor that gets women in the in 2021 suggests that it doesn’t of obstetrics door of our clinic, the slow down until age 60, and and gynecology Northwestern Medicine Center then only by about 1% a year. at Northwestern for Menopause, is weight gain University’s that feels out of control. And One reason for midlife Feinberg School guess what? I’ve observed weight gain is lifestyle of Medicine. that among our patients, the changes: more dining out This is adapted women having that symptom and less physical activity. But from her book tend to be the same ones who that said, it’s twice as likely Hot Flash Hell: are having hot flashes. for a woman in midlife to be A Gynecologist’s severely obese as for a man. Guide toTurning In fairness, it’s not just Men have the same lifestyle Down the Heat. menopause that brings on shifts women do—so what’s the extra pounds. I’ve always told difference? Men don’t have hot my patients that even if they flashes and the accompanying eat and exercise the same way insomnia. And that’s where the as they did in their 30s, they’ll menopause factor comes in. see the number on the scale start to climb. In fact, both THE HOT FLASH men and women gain weight IMPACT during midlife until it stabi- lizes around age 60. Every time you flash, there’s a surge of cortisol in your body. Metabolism shifts contrib- Cortisol, also known as a ute, but not to the degree that stress hormone, has several you might think. The belief has functions, but one is that 50 P R EVEN T ION.COM • AU G U S T 2 0 2 2

DAN SAELINGER/TRUNK ARCHIVE. levels of it rise to reduce inflammation increases it; however, when you’re stressed. A small, tran- ghrelin plays a role sient rise doesn’t cause problems, but in regulating short- if it’s chronically, consistently elevated, term feeding as there’s an increase in blood sugar well as in regulating levels and appetite, among other things. body weight over The result: Losing weight becomes the long term. much tougher. Not getting Another factor is inadequate sleep enough sleep trans- due to hot flashes. Seven to eight hours lates to low leptin appears to be the magic amount of shut- levels and high eye to ensure that the hunger-controlling ghrelin levels—the hormones, leptin and ghrelin, are at exact combo that optimal appetite-control levels. Leptin increases appe- decreases your appetite and ghrelin tite and sabotages weight-loss efforts. It also seems that inadequate sleep is tied to lower levels of thyroid-stimulating hormone, further slowing metabolism. Given the above, it’s not surprising that the women who gain weight during menopause also have more hot flashes. And when it comes to a new belly pooch, you can probably blame menopause too, because low estrogen impacts the distribution of weight even if you haven’t gained a pound. If you’re unhappy about weight gain, talk to your doctor about what’s a healthy weight for you and the best eating and workout plans for achieving that. This is also another reason to prioritize sleep and to talk to your health care practitioner about ways to ease and control hot flashes. 51A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

HEALTH FOR A LET’S GO DANIELLE DALY. RIDE Yes, B I K I N G as an adult can provide the same J OY A N D F R E E DOM it brought you as a kid. (The F I T N E S S B E N E F I T S are just a bonus.) This little G U I D E will get you up to speed in no time. BY JENNA DEDIC

They say “It’s like riding a bike!” for a skidding, which can feel reason: Whether you’re a semi-regular scary. Since your momen- rider or it’s been a while since you touched that tum takes you forward, dusty cruiser in the garage, you can probably shifting your weight hop on and get moving pretty quickly. But half a centimeter toward there are a few things about the bike itself the back of the seat that you can adjust to get an even better ride. can keep you from losing Here’s what to know, from Stephanie Kaplan, your balance. hardware group product manager for Peloton. TIRES SADDLE easy to hard—and a right shifter you can If tires are pumped up When your seat is use for fine-tuning. too much, you’ll feel at the right height, you every bump in the road; should be able to touch the BRAKES too little, and you’ll risk lowest pedal with only a getting a flat. So use a slight bend in your knee. Remember this: R is for pump with a gauge to Ask someone to hold right brake and rear wheel check your tire pressure your bike for you while (leaving left for the front before you ride. The ideal you check and adjust it. wheel). Gently squeeze level—for example, 90 to both when 120 PSI—is imprinted on HANDLEBARS you want to the tire’s sidewall. slow down. It’s normal to lean If you clamp forward to hold the too hard, handlebars, but you you risk shouldn’t be seated so far back that you have to lock your arms to reach them. Bend your elbows and keep your back straight to maintain the most control. GETTY IMAGES. GEAR SHIFTERS Changing gears makes it easier or harder to pedal. Most bikes have a left shifter that helps you set your bike to the range you want to ride in—from 53A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

HEALTH GEAR UP ON YOUR FACE running shoes, which are GETTY IMAGES. so flexible that your foot A helmet isn’t the Along with sunscreen, may arch over the pedal, only cycling essential. wear sunglasses. “They’ll weakening your stroke. Here’s what you need keep your eyes clear of to protect your body debris and keep them EVERYWHERE ELSE from head to toe. from tearing because of the wind,” says pro cyclist There’s a reason ON YOUR HEAD Laura Van Gilder, a World cyclists wear spandex: It Championship rider.Your wicks away sweat, which You should be able shades should feel snug can cause chafing, says to fit only two fingers so they won’t slide down Rachel Vaziralli, director between your eyebrows or fog up. of fitness design and and your helmet’s brim, education at Orangetheory and between the strap ON YOUR FEET Fitness. “Tight-fitting and your chin. “It should clothes also won’t flutter be so snug that it may Reach for sneakers in the wind, which can leave an imprint on your with stiffer soles (like slow you down.” Look for forehead,” Kaplan says. cross-trainers) rather than 54 P R EVEN T ION.COM • AU G U S T 2 0 2 2

bottoms with a built-in seamless pad Lyles says. When you reach the top, (called a chamois) to prevent a sore move shifters back to a middle, rump. Liz Lyles, a former pro triathlete, moderate setting. recommends long shirts to shield your STAND UP lower back from the sun. CONQUER ANY HILL Standing while you pedal increases the amount of power you’re able to It’s one of the most intimidating parts generate so you can get up a hill faster. of cycling, we know. But with these It also gives your usual biking muscles strategies, you can stop staring at that a much-needed break. Before standing, incline and just get over it already. shift into a slightly more challenging gear. “You need a lot of resistance on PREP WITH THE RIGHT EXERCISES the pedal so the added force of your weight doesn’t cause you to ‘spin out’ You need to build strength to climb and perhaps lose control of the bike,” hills, so do jump lunges, says SoulCycle Lyles says. Standing’s tough, though, master instructor Rique Uresti: Step so alternate between that and sitting, back with your left leg and bend both and practice it on a flat road first. knees 90 degrees, then jump. Switch up your legs in midair, so your left leg is forward when you land and your right is in the back. Continue alternating A 155-lb sides for 12 to 20 reps. If that’s too person can BURN tough, start with alternating lunges and MORE THAN slowly build up to getting some air. 250 CALORIES in just 30 minutes UTILIZE YOUR GEARS of cycling at 12 mph. Before you hit the incline, shift your right (rear) shifter to a lower Use an app gear so it’s easier to like Strava pedal. Shift down on or MapMyRide to Tired of the left too.The ease TRACK YOUR riding solo? Ask your of pedaling might feel PROGRESS local bike shop if there silly, but you’ll be glad and plan new are any nearby when you can climb routes. CYCLING GROUPS the hill without needing you can join. It’s a great to stop. “As you go up, your way to MEET NEW effort level should feel more challenging than you’re used to, but PE O P L E and learn from not so difficult to maintain that you others who love the same activity. feel like you’re going to fall off the bike,” 55A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

HEALTH A health reporter journeys into Defying the world of off-label cancer treatment— the for herself. BY TERI CETTINA PHOTOGRAPHS BY BEN GOLDSTEIN nodearly four years ago, I had two encoun- ters with health professionals that sent chills down my entire body. The first dswas with a physical therapist, whom I’d gone to see for pain in my back and ribs. Within 10 minutes, a shadow came over From my experience as a health her face. “I don’t want to alarm writer, I knew that pancreatic can- you, but this pain is not muscular- cer was one of the deadliest types. skeletal,” she told me. “You need My brain switched to reporter to get a CT scan. Today.” mode, and I took meticulous notes. But when I look back at them now, Later that day, the ER doctor I barely recognize my own writing. came to my room with test results. “We found something we didn’t The doctors initially told me I expect,” she said. “There is a suspi- had about 18 months to live. Since cious mass on your pancreas that then, I’ve learned more than I ever looks like cancer. I’m so, so sorry.” expected about cancer treatment and how critical it is for us patients to take active roles in our healing. 56 P R EVEN T ION.COM • AU G U S T 2 0 2 2

PROP STYLING: MIAKO KATOH.

HEALTH WHAT IS I padded quietly downstairs to our dining PA N C R E AT I C room and set the table for dinner with CANCER? our extended family. I folded napkins and laid out silverware and plates. Pancreatic cancer is the third I set out bowls for mashed potatoes, deadliest cancer in the United States: stuffing, gravy, and vegetables and tucked Around three in four patients die within tiny yellow sticky notes into the dishes a year of being diagnosed. And it’s so I’d remember which was which. especially sneaky because its early symptoms are so vague—abdominal Then I gave up and dissolved onto the aches or backaches, a little stomach cool hardwood floor. I lay down flat, my discomfort, some bloating. Nothing you face touching the wood, and began to would take seriously at all. pray: “Please, God, give me time. Give me time to be with my daughters and In addition, most common blood Greg. Please give me more time.” tests don’t detect pancreatic cancer. By the time it is discovered, the tumor COPING WITH has usually grown quite large. It may MY TREATMENT also have spread outside the pancreas, to the liver or lungs. The most effective chemother- apy regimen for pancreatic cancer is a In my case, the pancreatic tumor was rigorous one called Folfirinox. It required about the size of a golf ball but had not me to sit in a cancer center infusion yet spread. However, it was wrapped so room for eight hours, then go home with tightly around several aortic and liver- a chemo pump attached to a vein in my related blood vessels that they were chest for 46 more hours. I repeated that almost completely blocked. Removing cycle every two weeks. the tumor surgically was next to impos- sible. My only option was aggressive I experienced all the classic chemo chemotherapy. It might extend my life, symptoms: fatigue, unrelenting nausea but it was not expected to cure me. and diarrhea, loss of appetite, and a metallic taste in my mouth that made I understood none of this on that first even plain water taste horrible. One night. All I knew was that my life was of the chemo drugs caused my hands forever changed. I felt that our daugh- and feet to go numb, a condition called ters, ages 17 and 21, were too young to neuropathy. I couldn’t close clasps on lose their mother without its leaving a necklaces or type accurately on my permanent scar. My husband and I had laptop. The numbness in my feet made been married 29 years and were as close me trip constantly when I walked. as we’d ever been. Our shared future was dissolving in front of my eyes. When I wasn’t leaning over the toilet retching, I was researching pancreatic The next day was Thanksgiving, cancer to see if I could improve my odds and at 3 a.m., I got up, unable to sleep. 58 P R EVEN T ION.COM • AU G U S T 2 0 2 2

of living. My research led Clockwise from top left: me to make a bunch of Teri with her oncologist, lifestyle changes: I adopted Rui Li, M.D., Ph.D.; with a ketogenic diet, which some best friend and husband health researchers believe of 33 years Greg; at may help stop certain types the Mayo Clinic; during of cancer from growing. what she calls the I completely stopped eating “Chia Pet” phase of hair sugar too, to give my body every health regrowth; and in her benefit I could. first wig with daughters Sophie and Flora. I read research by Valter Longo, Ph.D., of the University of Southern California, I specifically asked. I also found pancre- who discovered that fasting might atic cancer survivors and began emailing make chemotherapy more effective and with them. I joined a number of patient- help reduce chemo-related side effects led cancer Facebook groups too. such as nausea and mouth sores. For 48 hours before and 24 hours during In addition, I meditated, prayed, each of my biweekly chemo sessions, underwent Reiki healing sessions, and I stopped eating and drank only water used guided visualization to imagine and herbal tea. my tumor being dissolved by a healing white light. Friends and family set up Maintaining hope also became a a GoFundMe account to help Greg and key part of my treatment. I asked my me with our ongoing expenses. oncologist to stop talking to me about survival statistics or time frames unless After several months, new scans showed that not only had the cancer stopped growing, but also the tumor was actually shrinking. My pain disap- peared as well. It looked as if tumor- removal surgery might be a possibility. 59A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

HEALTH THE LIFESAVING treatment includes using a cocktail SURGERY JUST of fairly well-known nontoxic generic OUT OF MY REACH drugs and natural supplements to block cancer from growing. It took months of vigorous appeals to my insurance company The FDA-approved drugs before I could see one of the country’s McLelland describes were developed top pancreatic surgeons at the Mayo for other medical conditions, including Clinic in Rochester, MN. We tentatively diabetes, high cholesterol, and ulcers. scheduled the pancreatic surgery, and In recent years, though, researchers Greg and I felt as if we had just won the have found that these drugs may have health care lottery! anti-cancer properties. Unfortunately, our celebration was I learned that many other medical short-lived. I had to have emergency professionals and researchers were gallbladder surgery, and during the enthusiastic about the possibility of operation, my surgeon noticed several using these “off-label” or repurposed tiny cancerous lesions on my liver. With drugs to fight cancer. Patients and that, I was considered a Stage IV, or medical professionals have developed “terminal,” cancer patient. Because of entire Facebook groups devoted to those tiny tumors, the Mayo Clinic helping one another understand how canceled my surgery. My family and to access and use these prescriptions. I were heartbroken. I felt a wave of newfound hope: For several weeks, I could barely Could patients like me actually beat function. It seemed that my only hope back a deadly disease with a handful had been ripped out from under me. of inexpensive prescription drugs? Then I ran across an intriguing book: I wasn’t sure, but I knew one thing: I How to Starve Cancer…and Then Kill had nothing to lose by trying. There was It With Ferroptosis by Jane McLelland. no cure waiting in the wings for me. It opened the door to an entirely new world of cancer treatment. I printed out medical research papers about a few of the drugs and their DISCOVERING AN potentially cancer-fighting properties UNCONVENTIONAL and excitedly took them to my next APPROACH chemotherapy appointment. When I showed them to my oncologist, How to Starve Cancer isn’t a Rui Li, M.D., Ph.D., her reaction was book about food or lack thereof. It’s swift and firm: She refused to prescribe actually part memoir, part geeky med- the drugs and scared me into thinking ical research by a woman who survived I might seriously harm myself. Stage IV cervical cancer. McLelland’s Now, I’m not normally a rule breaker. I was a teacher-pleasing 60 P R EVEN T ION.COM • AU G U S T 2 0 2 2

student in school. I wait for green lights two weeks, and then he’d review my at crosswalks. And I have no delusions blood work and check on side effects. that I, a layperson, understand cancer As each proved safe, we added another, better than someone who has graduated then another. I bought an acrylic jewelry from medical school. But I had a termi- sorter to store the dozens of pills I took nal cancer diagnosis. Greg and I agreed three times a day. that we didn’t want to look back later with regret. I consulted two other Some of my fellow patients accessed doctors, who both agreed that the off- these same off-label drugs in a different label drugs I was considering were safe. way: through a group of experts That was all the reassurance I needed. who have organized themselves through a group called the Care Oncology MY JOURNEY WITH Clinic (COC). These doctors meet OFF-LABEL DRUGS virtually with cancer patients who want to try this experimental approach. I felt really uncom- fortable about it, but Within a couple of months, I chose not to tell my oncol- Allderdice and I could see that my ogist what I had decided. body was tolerating the prescriptions Instead, I consulted well. My biweekly blood tests looked Dave Allderdice, N.D., good. My tumor continued to shrink. a naturopath in my hometown who special- A handful of fellow pancreatic cancer izes in working with patients I met on Facebook were also cancer patients. experimenting with off-label meds. They With his help, I added off-label drugs to my many daily supplements. I’d take one drug for

HEALTH were, and still are, intense researchers, test history on her computer, and unfailing optimists, and strong advo- I showed her how my key tests cates for their health. I had found my had remained steady or even improved. tribe. None of us wanted to belong to the After our discussion, Dr. Li seemed cancer club. But if we had to face this reassured that I wasn’t a crackpot. challenge, we were going to do it on However, that doesn’t mean she fully our own terms—and share our findings supports my regimen. “I don’t think the with one another along the way. many supplements are the key contribut- ing factors for Teri’s health,” she says. “It COMING CLEAN is impossible to identify which supple- WITH MY I NO LONGER ments really helped.” DOCTOR She adds, “From a scientific view, I do not After about encourage patients to a year of trying the BELIEVE [take non-prescribed off-label drugs, I felt supplements or medi- the need to be honest THAT BEING cine] without partici- with my doctor. It was A POLITE, pating in clinical trials.” a risky move. Several But here’s what patients I knew had R U L E - F O L L O W I N G I kept reminding been “fired” by their myself: Stage IV cancer oncologists for trying PATIENT IS typically is a death alternative treatments THE WAY sentence. There is no without their doctors’ such thing as Stage V. knowledge. TO LIVE. Ideally, patients would At a regular chemo- wait for drug or other therapy appointment, treatment regimens to I finally blurted go through exhaustive out to Dr. Li: “You know those off-label clinical trials and become part of the drugs we talked about? Well, I’ve standard treatment for their cancer. But actually been taking them for a while. pancreatic patients like me—and many I feel bad about not telling you sooner, others with fast-moving cancers—simply but this was something I had to do.” cannot wait a decade or more for clinical Her face immediately registered dis- trials to finish and report their results. pleasure. “What? Which drugs? What In addition, unusual approaches like dosages? Who prescribed these drugs?” using off-label drugs, cannabis, and she asked. I answered all her questions. natural supplements may never get I could see that her main concern was the attention they might deserve. for my safety. She pulled up my blood- Pharmaceutical companies can’t patent 62 P R EVEN T ION.COM • AU G U S T 2 0 2 2

or repackage them to sell at a profit. remnant of the cancer remains in my And if oncologists are suspicious of pancreas, and rogue tumor cells are anything besides chemotherapy or likely still circulating throughout radiation, how will patients learn about my bloodstream. But I have gotten other options? precious extra time on this earth with Two weeks after I revealed my drug my friends and family—which is what I prayed for during the predawn hours experiment to my oncologist, we met of Thanksgiving in 2018. again. I asked her point-blank: “Are you going to fire me as a patient?” I’ve also learned for myself—and Dr. Li laughed and shook her head. have shared with anyone who will To her great credit, she said she would listen—how important it is for patients never feel insulted if I got better using to research and work alongside their drugs someone else had prescribed. doctors to get the best possible care. “I still don’t completely agree with the I no longer believe that being a polite, idea of these drugs, but I cannot argue rule-following patient is the way to with how well you’re doing,” she said. live. That’s especially true if you “And I do believe that Stage IV cancer have a health condition that takes patients should have a right to experi- the lives of significantly more people ment with their own care.” than it spares. I believe that if just one patient can LIVING WITH survive this cancer or live a longer- CANCER—AND HOPE than-expected life—and I know several who have—another person can do the I’ve long since passed my same. Maybe that person can be me. original “expiration date” of 18 months. If I’m fortunate RESOURCES FOR PANCREATIC enough to live for one more year—to CANCER PATIENTS the five-year sur- PANCREATIC CANCER CANCER COMMONS vival mark—I’ll be ACTION NETWORK A network of patients and one of only 11% of Patient support, clinical experts for those with pancreatic cancer trial information, and metastatic cancer patients to survive more (pancan.org) (cancercommons.org) that long. PROJECT PURPLE Go to prevention.com I wish I could say that I’m miracu- A source for financial sup- /pancan-teri for more help lously cured, but port (projectpurple.org) and Facebook-group links. I’m not. A tiny 63A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

P R E VE N T ION SCIENCE 5 Myths About Food Safety The nose knows what’s OK to eat, and other lies that’ll make you sick. BY KATE ROCKWOOD ILLUSTRATIONS BY ANDREA DE SANTIS 64 P R EVEN T ION.COM • AU G U S T 2 0 2 2

MYTH #1 MYTH #2 As long as it smells fine, It’s a good idea you can eat it. to wash chicken. MYTHBUSTER Nope. Even if you have MYTHBUSTER Washing chicken is the most sensitive sniffer in the a good call only if you want to world, smell alone isn’t enough to splash potentially harmful bacteria tell if a food is safe to eat. In fact, around your kitchen. Research “it’s the bacteria you can’t see, shows that when you wash raw smell, or taste that are the most meat, bacteria from it can land dangerous,” says Isabel Maples, on countertops, dishes, and other a registered dietitian nutritionist food, up to an estimated three and spokesperson for the Academy feet from your sink. A USDA of Nutrition and Dietetics. Some observational study found of the most common foodborne that after washing poultry, germs (salmonella, norovirus) and 14% of study participants still the most dangerous ones (E. coli, had bacteria in their sinks even listeria) don’t make food smell bad, after they cleaned them, and according to the Centers for Disease 26% transferred bacteria from the Control and Prevention (CDC). On poultry to salads they prepared the flip side, spoilage bacteria, the (this is also why you need to kind that make your food moldy, wash your hands and scrub any smelly, or slimy, won’t always make surface, such as a cutting board, you sick, Maples says—not that you that comes into contact with raw should test that out. Bottom line: If meat). The safest way to handle it smells or looks gross, toss it, but raw meat is to transfer it directly also factor in “use by” dates, how from package to pan, then cook long food has been sitting out, how poultry to 165ºF in the center to kill old it is, and how thoroughly it was bacteria like salmonella. “Always cooked. Temperature-sensitive food use a food thermometer. Place the shouldn’t sit out longer than two probe tip in the thickest portion hours; leftovers should be tossed of the chicken, but not touching after three or four days; and eggs, bone,” says Brian Nummer, Ph.D., meat, and seafood need to be cooked a microbiologist in the department to the temperatures recommended of Nutrition, Dietetics, and Food by the USDA, Maples says. Sciences at Utah State University. 65A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

SCI E NCE MYTH #3 Eating pink meat is unsafe. MYTHBUSTER Not necessarily. MYTH #4 “For meat, you really need It’s fine to buy dented to take the temperature,” cans of food. says Carolyn Williams, Ph.D., a registered dietitian and MYTHBUSTER A small dent is OK, a National Restaurant but if the dent is big—think large Association ServSafe enough to fit your finger into—or instructor. “Sometimes near where the side of the can you’ll see pink in the middle meets the lid, don’t buy it, Nummer of a patty and think it’s says. The seam might be damaged unsafe, but if you stick a and bacteria could have gotten into thermometer in it and it’s at the can. In rare cases, it could be a the right temperature, it’s dangerous kind like C. botulinum, safe to eat.” On the flip side, which causes botulism. More meat might look fully cooked, commonly, it could be spoilage but if it wasn’t cooked at a bacteria, Nummer says, which will high enough temperature make your food taste pretty nasty. throughout, it could still Also avoid leaky, swollen, bulging, contain bacteria. Poultry or rusty cans—all of which could should be cooked to 165°F be signs of damage or existing and ground beef, pork, lamb, bacteria. Because it can be tough and veal to 160°F, according to tell whether a dent is a sign to government guidelines. of a problem, your best bet is to It’s safe to cook whole or choose dent-free cans. “Some chopped cuts of veal, pork, people purposely buy dented cans, lamb, beef, and ham to but it’s not worth saving 50¢ and 145°F, says Williams, as the then spending several thousand bacteria you’re trying to dollars on foodborne illness–related kill are only on the surface, medical costs,” Nummer says. whereas ground meat needs to be cooked all the way through to 160°F. 66 P R EVEN T ION.COM • AU G U S T 2 0 2 2

MYTH #5 Concerns about food safety at picnics are overblown. MYTHBUSTER Picnics are ripe opportunities for food poisoning. Bacteria thrive between 40°F and 140°F, which is why the FDA recommends not letting any food stay in that range for more than two hours. (If it’s over 90°F out, slash that time in half.) This all means that if you’re not eating right away (which is the best plan), cold food should be kept at 40°F or below and hot food at 140°F or above, says Karen Blakeslee, coordinator of Kansas State University’s Rapid Response Center. Keep hot food in slow cookers, warming trays, or steam tables; cold food should sit on bowls of ice or in coolers (empty melted ice and replace it regularly). And wash your hands before you eat or handle food—if you won’t have access to soap and running water, Blakeslee says moist towelettes or hand sanitizer will do in a pinch. 67A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

SCI E NCE DOES IT WORK? Fertility Trackers Let’s zero in on what can actually help you ID your prime baby-making days. BY STEPHANIE ANDERSON WITMER For couples trying to the pituitary gland that tells get pregnant, finding the ovaries to release an egg the optimal time for WHAT WE KNOW: A surge in baby-making can be LH occurs 24 to 48 hours surprisingly tricky. “Your before ovulation. For women fertile window starts 24 to with regular cycles, LH kits 48 hours before ovulation and can be very accurate—up lasts 24 to 48 hours after,” to 97%, according to a 2017 explains Anate Brauer, M.D., review of multiple studies. the IVF director at Shady But they may not work well for Grove Fertility New York. women with irregular cycles, because that makes it hard Plenty of products promise to to know which days to test the pinpoint your peak fertile time urine, says Dr. Brauer. frame, but which ones truly SHOULD YOU TRY THEM? Yes, deliver? (Note: Don’t rely on if your periods are regular and these as birth control, and keep you have no other complica- in mind that they may not work tions. The kits are reliable well for women with irregular and easy to use. Most are cycles, such as those with inexpensive; the pricier ones polycystic ovary syndrome.) use a more advanced analyzer and send results to an app. OVULATION BRANDS TO TRY: Stix Ovula- PREDICTION KITS tion Test ($17 for seven tests, getstix.co); Natalist Ovulation WHAT THEY ARE: Sticks or Test Kit ($21 for 30 test strips, wands that are held in urine natalist.com); Mira Plus Starter for several seconds to pick up Kit ($199, miracare.com) increased luteinizing hormone (LH), a hormone produced in 68 P R EVEN T ION.COM • AU G U S T 2 0 2 2

GETTY IMAGES. WEARABLES SHOULD YOU TRY THEM? Probably not— more research is needed on them. WHAT THEY ARE: App-connected arm- bands or bracelets that measure fertility INSERTABLE DEVICES signals like basal body temperature (BBT) and heart rate, which fluctuate WHAT THEY ARE: Products placed during a menstrual cycle in the mouth or the vagina to measure WHAT WE KNOW: These are designed to markers of fertility, including BBT predict fertile windows after gathering and electrolyte levels data for weeks or months. “Over time, WHAT WE KNOW: Hormonal shifts cause wearables can detect bodily trends to BBT and potassium and magnesium pinpoint ovulation,” says Kecia Gaither, levels to rise and fall throughout the M.D., the director of perinatal services cycle, which these devices detect. Some and maternal fetal medicine at NYC are worn like a tampon overnight. Oth- Health + Hospitals/Lincoln. “Small ers track fertility through saliva during studies demonstrate some benefit, but certain days of the cycle and through high-quality studies are still needed cervical mucus in the vagina on other to recommend them,” says Julie Rios, days. Because they’re so new, they M.D., the division director of reproduc- haven’t had a lot of scientific study yet. tive endocrinology and infertility at the SHOULD YOU TRY THEM? Skip these. University of Pittsburgh Medical Center They are expensive and more invasive Magee-Womens Hospital. and may feel uncomfortable to use. 69A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

SCI E NCE GETTY IMAGES.

WoWmhyen Need to CoCanrecAubosust ions The female brain is more susceptible to lasting damage from a head injury. The science explains why—and we’ve got the latest info on how to protect yourself. BY MEGHAN RABBITT 71A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

SCI E NCE t was the middle of crash.” Yet when she went to the the night when Karen hospital, the ER doc ordered a Murray’s 10-year-old CT scan, and sure enough, Karen was daughter called out for her and she diagnosed with a mild concussion. jumped out of bed to see if everything was OK. The next thing she remem- Abigail Bretzin, Ph.D., ATC, a post- bers, her legs gave out from under her doctoral research fellow in the Penn and she fell, hitting her head on the Injury Science Center at the University nightstand on her way down. “I blacked of Pennsylvania, isn’t surprised that out,” says the 45-year-old from Phila- Karen didn’t initially realize her head delphia. “A few seconds later, I came injury might be as serious as it was. to and got up, but I felt wobbly and “It really hasn’t been recognized that nauseous.” Her husband went to check concussion and traumatic brain injury on their daughter, and Karen spent the happen as often as they do in women,” next 20 minutes feeling as if she was says Bretzin, who researches sex differ- going to throw up. When the nausea ences in outcomes of concussion. “In passed, she drifted back to sleep. general, the focus has been on men. But the next morning, the mom of And while men do have higher rates two woke up with a pounding headache. of concussion than women overall, we Throughout the rest of that day and the also know that women’s brains may be next, she had bouts of nausea and dizzi- more vulnerable.” Understanding the ness. While waiting for her son’s soccer reasons for this—as well as the signs practice to finish, Karen called her and symptoms of a brain injury— mom, a nurse, explaining what had can help you keep your brain protected happened the night before and how she for years to come. still felt “off.” Her mother urged her to go to the emergency room, worried that An INSIDE her daughter had suffered a concussion. LOOK at concussions “I wasn’t thinking I had a concus- sion,” says Karen. “I’d always thought The word “concussion” comes from that happened only to football players or after a serious accident like a car a Latin word that means “to shake violently,” explains Bretzin. “When you hit your head, the impact imparts forces to your brain, and those forces lead to a cascade of events that can cause a range of symptoms.” Douglas H. Smith, M.D., director of the Penn Center for Brain Injury and Repair, studies the mechanics of concussion. “You can think of your 72 P R EVEN T ION.COM • AU G U S T 2 0 2 2

GETTY IMAGES. brain as being like an electric grid, with from neuron to neuron so we can do a network of fibers coursing throughout everything from breathe and talk to this crucial organ,” says Dr. Smith. “The read and move our muscles. impulse starts in the gray matter on the outside of the brain and moves through The axons are able to do this thanks to the white matter on the inside, which to sodium channels that run through is filled with axons—little fibers so small them, which work a little like what’s in and delicate that you’d need to put a toilet tank: A flapper valve lets just 100 of them side by side to be as thick the right amount of sodium into the as one human hair.” The axons are like axon to generate a spark that creates the brain’s wires in this electrical grid, electricity, which then gets passed down he explains, transporting information the axon. When the axon has enough sodium for that spark, the valve shuts. 73A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

SCI E NCE But let’s say you bang your head consciousness. Since it takes a while for like Karen did. The impact can stretch your brain to pump out all that excess those axons so abruptly that parts of sodium, those quintessential symptoms them break, explains Dr. Smith, which of head injury—headache, confusion, in turn disrupts the valve. The result: dizziness, trouble focusing, and more— Too much sodium rushes into the persist. As your brain tries to regulate axons (like pouring salt water on live itself and get back to normal, you circuits), thereby prompting an electri- are even more susceptible to another cal “brownout” that may cause you to injury, adds Bretzin, which is why it’s feel dazed and confused, have a important not to reinjure the brain in slower reaction time, and even lose the weeks after a blow to the head. GETTY IMAGES. 74 P R EVEN T ION.COM • AU G U S T 2 0 2 2

The AFTERMATH looking at her computer screen or watching TV for more than an hour of a head injury at a time led to intense head pain. The good news is that most people who These continued symptoms may have experience a concussion recover fully— something to do with biological differ- about 80% do fine, says Dr. Smith. ences between males and females, which Researchers are working on understand- can cause women to have more severe ing why the other 20% don’t fare as well. symptoms than men and take a longer Still, seeking medical attention after time to recover after a concussion, says a head injury is crucial—even if you’re Angela Colantonio, Ph.D., a professor starting to feel a bit better, warns at the Rehabilitation Sciences Institute at Dr. Smith: “The reason we take head the University of Toronto who researches injuries so seriously and almost always traumatic brain injuries. For starters, order a CT scan is so we can check women tend to have smaller and weaker for bleeding in the brain, which, if not necks than men do, which makes them addressed, can cause death in rare cases.” more vulnerable to the rotational forces that can injure the brain. In one study Early care also helps target treatment of soccer players, females were nearly approaches, says Bretzin. “Not every- twice as likely to suffer concussions as one with a concussion presents with their male counterparts, and researchers the same symptoms, which can make it found that women had a significantly tricky to diagnose and treat,” she says. greater head and neck “angular acceler- “But if we can monitor your symptoms, ation,” a measure of head impact that’s we can better direct you to treatments thought to be a cause of brain injury. to help prevent a long-term effect.” For example, if your balance is off, you Anatomical differences also may may need to see a physical therapist; play a role in making the female brain cognitive impairments, like brain fog more vulnerable, adds Dr. Smith. or a shorter attention span, might Women’s axons tend to be finer than require a visit to a neuropsychologist. men’s, with narrower diameters. “When we use in vitro models— Why WOMEN’S where we take human neurons and BRAINS are at risk micropattern them into a human ‘mini-brain’—and induce the same kind Luckily, a CT scan of Karen’s brain the of rapid stretching of those axons that day after her fall showed no internal happens in concussion, we find that bleeding. But her symptoms persisted there’s far less swelling and sodium for about three months. She got influx in males’ axons compared with frequent headaches and found that females’, ” he says. Researchers think its larger axon size makes the male 75A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

SCI E NCE brain better able to sustain impact. who runs one of the few programs Hormones may also play a role in how focused on treating traumatic brain injury in survivors of domestic violence. women fare after a brain injury, adds Colantonio. Some research has shown A 2017 retrospective study by Barrow a clear correlation between a woman’s stated that traumatic brain injury is menstrual cycle phase at the time of a frequent consequence of domestic injury and her recovery. One 2014 violence. “Our main finding was the study found that women who suffered sheer number of injuries and also the a concussion during the two weeks after frequency,” says Dr. Zieman. “Victims ovulation, when progesterone levels are hit in the head many times over are highest, had worse outcomes a many years—so many times that they’ve month later than those whose injuries lost count—and their symptoms persist happened during the two weeks and are often quite severe.” In the study, following menstruation, when levels of 81% of subjects reported that they had this hormone are low. Women taking lost consciousness at least once because oral contraceptives also fared better. of their injuries. Victims often don’t A blow to the head may suppress the seek treatment, she adds, and even pituitary gland, the brain’s hormone when they do, if they’re there for, say, control center. If the pituitary gland slows a broken arm, the ER doctor may not down when progesterone is high, a rapid bring up brain injury. “We’re often the decline in this hormone leads to worse first to ask them about head injuries,” symptoms that stick around longer. she says. And unlike athletes, who might take a break to recover after The DOMESTIC a head injury, these victims often don’t VIOLENCE factor have that luxury. Then there are circumstances related to Dr. Zieman adds, “The most pro- the fact that one in three women falls found thing they endure is cognitive victim to intimate partner violence at problems—particularly related to some point in her life. According to the memory, attention, organization, and Brain Injury Association of America, planning—that often prevent them a victim of intimate partner abuse will from holding down a job or performing often be hit in the head area. “We’ve everyday tasks.” And cognitive problems had countless victims tell us that their are more impactful in this population, abuser hit them on the head because she points out: “If they can’t process their hair would hide their bruises,” information, it makes it harder to plan says Glynnis Zieman, M.D., a neurolo- a way to leave their abuser.” gist at the Concussion and Brain Injury Center at Barrow Neurological Institute, It’s certainly time for these women— and other women with head injuries— to have their brains taken seriously. 76 P R EVEN T ION.COM • AU G U S T 2 0 2 2

HOW TO PROTECT YOUR BRAIN FROM CONCUSSION While you can’t isolate yourself from everything that poses a risk of a head injury, experts agree there are a few smart steps you can take.  1 MINIMIZE YOUR way toward keeping concussion expert, who RISK OF FALLING you safe.” She recom- will have more training The answer to prevent- mends getting a home and can point you to ing concussions, says safety assessment from specific rehabilitation Bretzin, could be as an occupational ther- treatments and possi- simple as eliminating apist to check for trip bly even clinical trials.” some risky behaviors or hazards and suggest using protective equip- safer design tweaks.  3 SOFTEN THE ment, like a properly POTENTIAL fitting helmet when you  2 SEE A DOCTOR LASTING EFFECTS ride a bike. Colantonio STAT AFTER A If you experience adds that older adults BUMP TO THE HEAD long-term effects, it’s are one of the biggest Detecting and treating important to pipe up segments of the a head injury as soon about your pain, says population who get as possible is one of Bretzin. “Talk to your concussions, which the most important health care provider means it’s especially things you can do, about your under- important to assess says Bretzin. “This can standing that women your risk of falls as you really help prevent or are at greater risk of age. “It’s easy to think mitigate lasting effects persistent symptoms of falls as accidents, but of the injury,” she says. after concussion,” she there’s a lot you can do Dr. Smith agrees, adding advises. “Ask about to prevent them,” she that seeing a specialist rehab programs and says. “Things like exer- is especially important if support groups for cising to build balance you’ve been diagnosed concussion survivors. and strength, getting with a concussion. “If Your symptoms may enough sleep, not you hit your head and require continued care rushing when you stand go to your primary care and management, up, and even wearing doctor, they may not and there are special- sturdy, well-fitting know who to refer you ists who can help shoes can go a long to,” he says. “Ask for a you along this path.” 77A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

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P R E VE N T ION FOOD Flex Those Muscles The right mix of nutrients helps with strength and function. BY ARIELLE WEG COWBOY CAVIAR Y our muscles need ACTIVE 15 MIN. fuel to stay limber TOTAL 15 MIN. and strong—good SERVES 4 TO 6 muscle tone is crucial for bone health and In large bowl, whisk together 6 Tbsp lime everyday mobility. “Nutrition is important juice, 3 Tbsp olive oil, and 1 tsp each honey for muscle building and repair, and to provide and kosher salt. Toss with two 15-oz cans the energy required to take a walk, work out, black-eyed peas (rinsed), 2 plum tomatoes or complete chores,” says Jim White, R.D., (cut into ½-in. pieces), 1 small poblano an American College of Sports Medicine pepper (cut into ¼-in. exercise physiologist and the owner of BLACK-EYED pieces), 1 cup each Jim White Fitness & corn kernels (from Nutrition Studios. Post-workout pro tip: PEAS 1 ear, or thawed from Eat protein to rebuild tissue and carbs for Iron-rich foods frozen) and cilantro the glucose needed for provide the (chopped), and muscle function. Try nutrients necessary to ½ medium red onion these tasty muscle- build red blood cells, (finely chopped). Fold supporting snacks: which carry oxygen in 1 large avocado to your muscles and (diced) just before throughout the body; serving. Serve as this encourages healthy a side or scoop onto muscle function. Pulses tortilla chips. like black-eyed peas PER SERVING 274 cal, are a great plant- 9 g pro, 32 g carb, based option to boost 9 g fiber, 4 g sugars (1 g your iron intake. added sugars), 14 g fat (2 g sat fat), 0 mg chol, 585 mg sodium 80 P R EVEN T ION.COM • AU G U S T 2 0 2 2

LUCY SCHAEFFER. FOOD STYLING: CHRISTINE ALBANO. TURKISH EGGS warm. Remove from skillet with remaining PROP STYLING: CHRISTINA LANE. RECIPES: KRISTINA KUREK. WITH GREEK heat, stir in 1¼ tsp oil to medium heat and YOGURT Aleppo pepper and cook 2 large eggs to ¼ tsp cumin seeds, and desired doneness, ACTIVE 15 MIN. let sit 4 min. Spoon half about 2 min. for runny TOTAL 15 MIN. of oil into small bowl yolks. Spoon yogurt SERVES 2 and reserve. Return onto 2 plates, spread- ing out. Top with eggs, In bowl, combine reserved oil, and dill. ¾ cup Greek yogurt (at Sprinkle with additional room temp), ¼ cup dill Aleppo pepper and (chopped), ½ tsp grated flaked salt if desired garlic, and ¼ tsp kosher and serve with toast. salt. Heat 1 Tbsp olive oil in medium nonstick PER SERVING 230 cal, 15 g skillet on medium until pro, 5 g carb, 0 g fiber, 4 g sugars (0 g added sugars), GREEK YOGURT says. Dairy foods 16.5 g fat (5 g sat fat), contain all nine 198 mg chol, 346 mg sodium Strength training essential amino acids makes your needed for muscle muscle tissue break formation along down—but don’t with carbs, making worry: You actually get something like creamy stronger when it repairs Greek yogurt an ideal itself. To help with that, post-workout snack. you need protein, White

FOOD from heat and keep covered 3 min., then fluff with fork. In large bowl, ALMONDS whisk together 2 Tbsp olive oil, 1 Tbsp sherry Just an ounce of almonds vinegar, 1 tsp grated gives you protein, iron, garlic, 1 tsp kosher salt, and magnesium for some serious and 2 tsp smoked muscle-building power. “Magnesium paprika. Fluff quinoa, is important to help your muscles then add to dressing relax,” White says. This aids in and toss to combine. preventing muscle cramps and allows Add one 12-oz jar your muscles to work properly, roasted piquillo peppers as when gripping and extending. (drained and chopped), 1 cup almonds (well toasted and chopped), “ROMESCO” QUINOA ¾ cup flat-leaf parsley (chopped), and 2 oz manchego cheese ACTIVE 15 MIN. (grated) and toss well. Top TOTAL 25 MIN. with additional almonds and SERVES 4 cheese if desired. In medium saucepan, combine PER SERVING 566 cal, 19 g pro, 1⅓ cups quinoa and 2½ cups 50 g carb, 9 g fiber, 5.5 g sugars water and simmer until just (0 g added sugars), 33 g fat (6 g sat fat), tender, about 12 min. Remove 15 mg chol, 665 mg sodium

HALIBUT WITH lemon zest and 3 Tbsp flat-leaf parsley LEMON-ANCHOVY lemon juice, 8 anchovy (chopped). Heat 2 tsp SAUCE fillets (thinly sliced; olive oil in large about 2 Tbsp), ½ shallot cast-iron or nonstick ACTIVE 20 MIN. and ½ Fresno chile skillet on medium- TOTAL 20 MIN. (both finely chopped), high. Season four 6-oz SERVES 4 ½ small clove garlic halibut fillets with (grated), and a pinch of ½ tsp kosher salt and In small bowl, combine kosher salt; stir in ¼ cup cook, flesh side down, 3 Tbsp olive oil, 2 tsp until golden brown, 4 min. Flip and cook HALIBUT due to aging. Salmon until just opaque may get the spotlight in throughout, 2 to Research suggests terms of omega-3s, but 3 min. more. Transfer that omega-3s mix up the menu with to platter and spoon can help older adults halibut, which contains sauce over top. increase muscle size and half a day’s worth of Sprinkle with additional gain strength and may these fatty acids in one chiles and parsley also prevent muscle loss 5-oz serving. if desired. PER SERVING 284 cal, 33 g pro, 2 g carb, 0 g fiber, 0.5 g sugars (0 g added sugars), 15.5 g fat (2.5 g sat fat), 88 mg chol, 676 mg sodium 83A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

FOOD HYDRATE & SHINE BR E A K FAST This smoothie offers a Pineapple- Cucumber serious boost of H2O. Smoothie Cucumber, pineapple, Frozen fruit adds and spinach all consist just enough sweetness of more than 85% to this spinach- packed sipper. water by weight! TOTAL 5 MIN. MIKE GARTEN. SERVES 2 1 Persian cucumber, chopped, plus thin slices, for serving 1 banana, cut into pieces, then frozen 1 cup frozen pineapple chunks 1 cup baby spinach ½ cup Greek yogurt 1 Tbsp lemon juice ¼ cup unsweetened almond milk or water In blender, puree all ingredients until smooth. If desired, press thinly sliced cucumbers against sides of glass before pouring in smoothie. PER SERVING 178 cal, 8 g pro, 31 g carb, 4 g fiber, 12.5 g sugars (0 g added sugars), 4 g fat (1.5 g sat fat), 8 mg chol, 62 mg sodium 84 P R EVEN T ION.COM • AU G U S T 2 0 2 2

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FOOD You can get corn, blackberries, zucchini, and tomatoes all year round, but they’ll never taste sweeter than they do right now. Seize the moment with these fresh ways to serve them up today— and then freeze some of that goodness to enjoy in the fall too. s u mS A V O R I N G

CHELSEA KYLE. CHARRED CORN SALAD recipe, p. 92 CORN Summer’s golden child is chock-full of antioxidants that can help strengthen vision and may also help prevent hardening of the arteries. TO SAVE: Blanch ears (boil 2 min.; cool in ice water).Then cut kernels off the cobs and freeze on a parchment- lined sheet until firm; transfer to a container. Freeze for up to 4 months. mer 87A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

FOOD ZUCCHINI BREAD COOKIES recipe, p. 92 ZUCCHINI This hearty veg is packed with immune- boosting vitamins A and C as well as potassium to help regulate sodium levels. TO SAVE: The best way is to make a baked good (like these cookies), then freeze it. Or whip up a soup and store it, then pair with farro to serve. 88 P R EVEN T ION.COM • AU G U S T 2 0 2 2

BLACKBERRY JAM BLACKBERRIES + This juicy fruit gets its deep hue from anthocyanins, anti- BLACKBE RRY JAM oxidants that may help reduce the risk of some types of cancer. COCKTAIL TO SAVE: recipes, p. 93 Freeze in a single layer until firm before moving to a container. Store in the freezer for up to 4 months.

FOOD

SLOW-ROASTED TOMATOES recipe, p. 93 T O M ATO E S These gems are full of lycopene, which helps protect skin from sun damage and wrinkles. TO SAVE: When you slow-roast tomatoes, they become extra sweet and can last up to 3 months in the freezer. Thaw, then spread on toast, fold into eggs, or toss with pasta or shrimp. 91A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

FOOD CHARRED skillet on medium- ¼ cup all-purpose flour high. Add remaining ½ tsp baking soda CORN SALAD Tbsp oil, then corn; ½ tsp ground arrange in even layer; ACTIVE 20 MIN. and cook, without cinnamon TOTAL 20 MIN. stirring, until charred, ¼ tsp salt SERVES 4 2 min.Toss, rearrange 1 cup old-fashioned in even layer, and ½ small red onion, cook 2 min. more. rolled oats finely chopped Toss with onion 2 medium zucchini, mixture and fold in 1 red chile, cilantro and queso coarsely grated thinly sliced fresco if using. and squeezed of excess moisture 3 Tbsp fresh PER SERVING 130 cal, ½ cup bittersweet lime juice 3 g pro, 16 g carb, 2 g fiber, chocolate chips 5 g sugars (0 g added ¼ cup walnuts, 2 Tbsp olive oil, sugars), 8 g fat (1 g sat fat), chopped divided 0 mg chol, 252 mg sodium Kosher salt 1. Heat oven to 350°F. and pepper Z UCC H I N I Line large baking sheet BREAD COOKIES with parchment paper. 2 cups fresh In large bowl, mash corn kernels ACTIVE 15 MIN. bananas with coconut (from about 2 ears) TOTAL 30 MIN. oil, honey, and vanilla. MAKES 12 COOKIES 2. Add flours, baking ¼ cup cilantro, soda, cinnamon, and roughly chopped 2 ripe medium salt; mix to combine. Crumbled queso bananas Fold in oats, then fresco, for serving zucchini, chocolate (optional) ¼ cup coconut oil, chips, and walnuts. melted and cooled 3. Drop ¼-cupfuls of 1. In large bowl, toss batter onto prepared together red onion and 2 Tbsp honey sheet, spacing 2 in. chile with lime juice, 1½ tsp pure apart. Bake until golden 1Tbsp olive oil, ½ tsp brown, 14 to 18 min. salt, and ¼ tsp pepper. vanilla extract Let cool on sheet 3 min., 2. Heat large cast-iron ½ cup whole-wheat then transfer to wire rack to cool completely. flour Once cool, refrigerate up to 1 week or freeze up to 3 months. Warm at 350°F. PER COOKIE 195 cal, 3 g pro, 23 g carb, 2 g fiber, 9.5 g sugars (6 g added sugars), 10 g fat (6 g sat fat), 0 mg chol, 96 mg sodium 92 P R EVEN T ION.COM • AU G U S T 2 0 2 2

BLACKBERRY JAM and stir 3 min. BLACKB E R RY Transfer mixture to ACTIVE 15 MIN. 8-oz freezer-safe jars, JAM COCKTAIL TOTAL 30 MIN. leaving ½-in. space PLUS FREEZING at top of each. In shaker, shake MAKES 4½ CUPS 3. Refrigerate at least 2Tbsp fresh 3 days before serving lime juice, 1Tbsp 1 navel orange or freeze up to 1 year. blackberry jam, and 2 lbs blackberries If frozen, thaw in 2 oz gin to dissolve 2 tsp lime zest plus refrigerator overnight jam. Add 4 mint before using (once leaves, fill with ice, 2 Tbsp lime juice open, consume within and shake until cold. 1 cup superfine sugar, 1 week). Pour over ice and top with 1 to 2 oz club divided PER 2-TBSP SERVING soda. Serve with mint 3 Tbsp Ball RealFruit 33 cal, 0 g pro, 8 g carb, and a lime slice. 1 g fiber, 7 g sugars instant pectin (5.5 g added sugars), 0 g fat (0 g sat fat), 0 mg 1. Finely grate 1 tsp chol, 7 mg sodium orange zest into bowl, then cut away peel and SLOW-ROASTED 1. Heat oven pith. Cut orange into TOMATOES to 275°F. segments, then roughly 2. On large rimmed chop. Add to bowl ACTIVE 10 MIN. baking sheet, gently along with blackberries, TOTAL 2 HR. 15 MIN. toss tomatoes and lime zest and juice, MAKES ABOUT 4 CUPS garlic with oil, and ¼ cup sugar; thyme, ¾ tsp salt, use potato masher to 3 lbs mixed-color and ½ tsp pepper. lightly crush black- cherry and grape 3. Roast until berries; let sit 15 min. tomatoes, halved tomatoes have 2. In bowl, whisk reduced one- together pectin and 10 cloves garlic quarter in size and remaining ¾ cup sugar. ¼ cup olive oil are just beginning Sprinkle over fruit; fold 8 fresh thyme sprigs to dry around edges, 2 to 2½ hr. Kosher salt 4.Transfer to and pepper freezer-safe jars or containers and add more oil to cover. PER ¼-CUP SERVING 77 cal, 1 g pro, 5 g carb, 1 g fiber, 1 g sugars (0 g added sugars), 7 g fat (1 g sat fat), 0 mg chol, 103 mg sodium 93A U G U S T 2 0 2 2 • P R E V E N T I O N.C O M

EDITOR IN CHIEF PREVENTION ADVISORY BOARD Sarah Smith Richard Carmona, M.D. 17TH SURGEON GENERAL CREATI VE DI R ECTOR DIGITAL DI R ECTOR OF THE UNITED STATES; UNIVERSITY OF ARIZONA Jarred Ford Allie Early Sandra Bond Chapman, Ph.D. CENTER FOR EXECUTIVE DIRECTOR, HEALTH NEWSROOM CHIEF FOOD DIRECTOR BRAINHEALTH, THE UNIVERSITY OF TEXAS AT DALLAS Lisa Bain Kate Merker Raj Dasgupta, M.D. UNIVERSITY OF SOUTHERN EDITORIAL FOOD HEARST VISUAL GROUP CALIFORNIA (USC) KECK SCHOOL OF MEDICINE DEPUTY DIRECTOR, DEPUTY FOOD EDITOR CHIEF VISUAL CONTENT Elizabeth K. Hale, M.D. NEW YORK UNIVERSITY HEALTH NEWSROOM DIRECTOR Trish Clasen Marsanico LANGONE MEDICAL CENTER Stephanie Dolgoff Alix Campbell SENIOR FOOD EDITOR Rita Rastogi Kalyani, M.D. JOHNS HOPKINS SENIOR EDITORS EXECUTIVE VISUAL DIRECTOR Catherine Lo UNIVERSITY SCHOOL OF MEDICINE Emily Goldman, Alyssa Jung, Christina Weber Kaitlyn Pirie, Lizz Schumer ASSOCIATE EDITOR Rachel Lustgarten, R.D. 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BRAIN GAMES HISTORY QUIZ Stay Sharp Can you place these important health and wellness Fun ways to give your milestones in chronological order, brain a little workout beginning with the earliest event? A First National Park Established B First Earth Day C Discovery of Penicillin D Founding of The Red Cross E Founding of The American Cancer Society THE MISSING LETTER What is the correct letter to fill in this famous sequence? D R M F S L __ D 96 P R EVEN T ION.COM • AU G U S T 2 0 2 2

HIDDEN EQUATION USE EACH OF THE MATHEMATICAL SYMBOLS SHOWN HERE TO MAKE THE ANSWER CORRECT. (Don’t worry about order of operations— just go from left to right.) 10 8 6 4 2 = 5 CRYPTOGRAM Can you decipher this expression and the character who said it? ’N N A L’K F G M K W Y G A F Y YY T S U C L G QWK LWJ V S Q , TWUSMKW A O S K S N NN V A X XWJ WF L HWJ K G F L Z W F . ~S T AUW ANSWERS: History quiz: A (1872), D (1881), E (1913), C (1928), B (1970). The missing letter: T (do, re, mi…). Hidden equation: minus, times, divided by, plus. Cryptogram: It’s no use going back to yesterday, because I was a different person then. ~Alice (from Alice’s Adventures in Wonderland ).