Saturday, February 28, 2015

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Top-Line Questions From Moms About MMR

We all want our children to be safe and healthy. Measles is a serious and highly contagious disease, but, fortunately, we can prevent it with immunizations. The measles, mumps, and rubella (MMR) vaccine is safe and the best way to protect your child against measles and other diseases.

I understand that some parents are concerned about vaccines. The evidence about the vaccine's safety and benefits is strong and consistent. There is a lot of inaccurate information circulating about the measles vaccine, so let's make sure we separate the facts from the myths. If you have any concerns or questions, talk to your child's health care provider.

In the meantime, here are some answers to the most commonly asked questions I get:

How easy is it to get measles if you aren't vaccinated?

If you aren't vaccinated and you are exposed to measles, you have a 90 percent chance of getting measles.

We know that measles is extremely contagious. It spreads when an infected person breathes, coughs or sneezes. It spreads so easily that if one person has it, nine out of 10 of the people close to that person who are not immune will also become infected. You can get measles just by being in a room where a person with measles has been, even several hours after that person has left. A person is infectious from four days prior to rash onset through four days after rash onset.

Unvaccinated people put themselves and others at risk for measles and its complications.

If a person hasn't been vaccinated or isn't protected by virtue of having previously had a case of measles, they can get measles anywhere (school, work, gyms, etc.) and at any time of year because they can be exposed to the disease by unvaccinated and contagious people who may have entered or returned to the U.S. from another country. That's why vaccination is so important.

Should parents ever be worried about the vaccine? If so, which parents should be worried?

The measles-mumps-rubella (MMR) vaccine is very safe, and it is effective at preventing measles (as well as mumps and rubella). Vaccines, like any medicine, can have side effects. But most children who get the MMR shot have no side effects.

Many parents have some anxiety when it comes to health care visits, including those involving vaccines. However, parents can be reassured by the safety record of vaccines and the fact that they provide excellent protection. We take vaccine safety seriously. We have strong systems that monitor vaccines before they are licensed and after they go into widespread use.

In addition, it's important to remember that vaccines can provide parents with peace of mind when it comes to a number of diseases. Most parents choose the safe, proven protection of vaccines and are vaccinating their children according to the recommended immunization schedule. Thanks to vaccines, very few children now contract what used to be common diseases of childhood.

I encourage parents to talk to their health care professionals about their vaccine-related questions and concerns. There is a great deal of conflicting and often inaccurate information circulating about vaccines, so it is understandable that parents will have concerns. Parents may also have questions about which vaccines are being administered at a specific visit and how to recognize and manage any potential side effects. I always encourage parents to raise these kinds of questions with their children's health care providers.

What percentage of kids who get the MMR vaccine have a reaction?

Most children have no side effects from the MMR vaccine. The side effects that do occur are usually very mild and temporary, such as a fever or rash. More serious side effects are rare. These may include high fever that could cause a seizure (in about one person out of every 3,000 who get the shot) and temporary pain and stiffness in joints (mostly in teens and adults).

As America's doctor, I want our children to be safe and healthy. Nothing is more important than that. So I can understand why parents want to be sure that vaccines are safe for their kids. The evidence about the MMR vaccine's safety and benefits is strong and consistent. Many sources, like the independent Institute of Medicine report, have confirmed that the MMR vaccine is safe.

The measles vaccine has been used in the United States for more than 50 years and is 93-97 percent effective at preventing measles with long lasting protection. Because of measles vaccination, we have prevented more than 15.6 million deaths globally since 2000.

How would a parent know if they need to ask about their child getting a medical exemption?

I encourage all parents to talk to their doctor or health care provider about vaccinating their children for measles. There are cases in which some children should delay or should not get the MMR or MMRV (Measles, Mumps, Rubella and Varicella) vaccines and your doctor will be able to help guide you.

You should talk to your child's doctor if your child:

  • Has ever had a life-threatening allergic reaction to the antibiotic neomycin, or any other component of MMR vaccine

  • Has had a life-threatening allergic reaction to a previous dose of MMR or MMRV vaccine.

  • Has HIV/AIDS, or another disease that affects the immune system, or has a parent, brother or sister with a history of immune system problems

  • Is being treated with drugs that affect the immune system, such as steroids

  • Has cancer or is being treated for cancer with radiation or drugs

  • Has ever had a low platelet count, or another blood disorder, or has recently had a transfusion or received other blood products

  • Has a history of seizures, or has a parent, brother or sister with a history of seizures

  • Has received another vaccine within the past four weeks

The bottom line: talk to your child's health care provider if you have any questions or concerns about vaccinations for your child.

When are kids supposed to get their vaccines?

Different vaccines are recommended at different ages. The recommended immunization schedule is designed to protect infants and children early in life, when they are most vulnerable and before they are exposed to potentially life-threatening diseases. CDC recommends the first dose of the MMR vaccine at 12 through 15 months of age, and the second dose at 4 through 6 years of age.

Check schedules on when to get your child vaccinated. Talk with your health care provider about what is best for your child, including how to schedule any missed vaccinations.

My kids aren't vaccinated, and now I'm worried that they are at risk. What do I do if my kids are late on their vaccines?

If your child isn't vaccinated, work with your child's health care provider to determine vaccination dates for the missed or skipped vaccines. Although it is advised to follow the recommended vaccine schedule so that you don't leave your child vulnerable to disease, there are catch-up schedules for many vaccines, including MMR. School-aged children and adolescents are recommended to have had two doses of MMR vaccine, with at least 28 days between the two doses.

Does it make a difference, medically speaking, if the vaccines are all given on the same day or are spread out over time?

CDC recommends the first dose of the MMR vaccine at 12 through 15 months of age, and the second dose at 4 through 6 years of age, or at least 28 days following the first dose.

MMR vaccine combines protection against measles, mumps and rubella in one vaccine. However, your child may also need additional vaccines to protect against other diseases, such as Hepatitis A, on the same day that he/she receives the MMR vaccine. Your children can safely receive other recommended vaccines at the same visit that they receive the MMR vaccine. Giving a child several vaccinations during the same visit offers two practical advantages:
  • It provides protection as soon as possible to children during the vulnerable early period of their lives. It is important to help build and strengthen children's immune systems as early as possible because vaccine-preventable diseases can cause severe illness in infants and toddlers.

  • It reduces the number of office visits, saving parents both time and money, and may be less traumatic for the child.

If a child doesn't have health insurance, how do I get them the vaccine?

If you don't have insurance, the Vaccines for Children (VFC) program may be able to help. This program provides vaccines at no cost to doctors who serve eligible children. Children younger than 19 years of age are eligible for VFC vaccines if they are Medicaid-eligible, American Indian or Alaska Native or have no health insurance. "Underinsured" children who have health insurance that does not cover vaccination can receive VFC vaccines through Federally Qualified Health Centers or Rural Health Centers. Nationally, there are nearly 44,000 healthcare providers enrolled in the VFC Program.

There is no charge for any vaccines given by a VFC provider to eligible children, but there may be other costs such as a fee for the office visit or non-vaccine services (like a blood test). If your child is VFC-eligible, he or she cannot be refused a vaccination if you cannot pay the fee for administering the shot. For more information, visit this website.

Additionally, your child or teen may qualify for free or low-cost health insurance coverage through Medicaid and the Children's Health Insurance Program (CHIP). Many parents may be eligible for Medicaid, too. If you or someone in your family needs health coverage, you should apply. Enrollment is open year-round. Visit here or call toll-free: 1-877-KIDS-NOW (877-543-7669). Under the Affordable Care Act, all children and adults enrolled in new group or individual private health plans will be eligible to receive the MMR vaccine without any cost-sharing requirements when provided by an in-network provider.

How long does the immunity from the mom last in an infant?

Most infants born in the United States will receive passive protection against measles, mumps, and rubella in the form of antibodies from their mothers if their mother has had measles or the MMR vaccine. By 12 months of age, almost all infants have lost this passive protection. While immunity from the mom can last for up to 12 months, this varies from child to child. All infants (of any age) are considered to be at risk for getting measles if they are exposed to the virus.

Should I be worried about measles when I bring my infant out in public, to events or to day care?

It depends.

Most infants born in the United States will receive passive protection against measles, mumps and rubella in the form of antibodies from their mothers - though by age 12 months almost all infants will have lost this passive protection.

Overall the U.S. has high national vaccination coverage of roughly 92%, meaning that the risk of measles transmission is low. However, there are pockets of people within communities where vaccination rates are lower than the national average, making the risk of measles spreading in these communities higher.

Because risk of exposure to measles depends on whether it is circulating in your community, in places where measles is not currently circulating and vaccination rates are high, we'd generally state that it is safe for your child to go to day care. Day care facilities are required to report vaccination records to the state health department each year. Talk with your child's day care provider, or check with your state health department, to obtain these records. I also encourage you to consult with your doctor or local health department to get their advice on the risk of measles in your community.

The best way to protect infants before they are able to get the vaccine is to make sure people around them are vaccinated. The bottom line: talk to your doctor, talk to your day care, and make sure your kids get vaccinated on time.

What percentage of the population needs the measles vaccine in order to make everyone safe?

Preventing measles cases and outbreaks requires having as many people vaccinated as possible. Generally, about 92 percent to 94 percent of people need to be immune to measles to protect others who cannot get vaccinated. In 2013, the overall national coverage for measles-mumps-rubella (MMR) vaccine among children aged 19--35 months was 91.9 percent. However, even with very high national vaccination coverage, there can be subsets of the population that have much lower rates of vaccination. Rapid and early public heath responses to limit transmission, particularly in communities that may have groups of people who are not vaccinated, are equally critical to maintaining measles elimination.

The more people who are vaccinated or otherwise immune to measles, the more we decrease everyone's risk for getting measles. However, this "community immunity" cannot provide 100 percent protection, so we recommend that everyone who can, get vaccinated.

If a child is medically at risk and has been advised by their health care provider not to get the vaccine, then how many people around them need to be vaccinated in order to keep them safe?

Generally, about 92 percent to 94 percent of people need to be immune to measles to protect others who cannot get vaccinated. However, the concern is that some individuals in the community are opting out of vaccination, and these individuals tend to cluster in groups. These groups of susceptible individuals then accumulate and age over time. This, in turn, makes them susceptible to outbreaks when someone brings the virus into the group from abroad.

In 2013, the overall national coverage for measles-mumps-rubella (MMR) vaccine among children aged 19--35 months was 91.9 percent. But pockets of unvaccinated people can exist in states with high vaccination coverage, underscoring considerable measles susceptibility at some local levels.

The best thing families can do to protect children who can't get vaccinated because they are too young or have a medical condition is to make sure their own vaccines are up to date.

"What's the contagion level from kids who have recently been vaccinated? I heard they shed the live virus for a while after receiving the vaccine."

People who receive an MMR vaccine do not shed the live measles virus. Measles, mumps and rubella vaccine viruses are not transmitted from a vaccinated person.

It takes about 10-14 days for your immune system to fully respond to the MMR vaccine and protect you against measles.

As an adult, should I get another MMR vaccine?

People who received two doses of measles vaccine as children according to the U.S. vaccination schedule, have had measles, or are born before 1957 are considered protected for life and do not need a booster dose. If you're not sure whether you were vaccinated, talk with your health care provider.

When my child goes on a playdate, how should I ask the parents about whether their kids are vaccinated?

Parents generally understand and empathize with each other's concern for the safety and well-being of their children. However, we must also respect people's privacy when it comes to health issues.

Vaccinating your child is the best way to ensure that your own child does not get the measles. After receiving the recommended two-doses of the MMR vaccine, it is 97 percent effective at preventing measles. Your child is also at lower risk if there are no active measles cases in the community and vaccination rates are higher than 90 percent.

If your child cannot get vaccinated for medical reasons, you may consider sharing that information with the parents of your child's playdate. You can let them know that you are concerned about the risk of your child getting measles.

If I know parents who are not vaccinating their kids, what should I say to them?

Parents have an important role in making decisions about their children's health. You can help provide accurate scientific and public health information by referring peers to sources such as this or Additionally, the CDC has an excellent brief video of mothers talking with a pediatrician about vaccinations here. You should also encourage them to talk to their own pediatrician or health care provider to answer questions they may have about vaccines.

How can I help increase the vaccination rates in my community?

The best way to help increase vaccinations rates in your community is to ensure that you and your family are vaccinated. You can also support activities, such as National Infant Immunization Week (NIIW), to help recognize the critical role vaccination plays in protecting our children, communities, and public health. To learn more about NIIW, which is being held this year April 18-25, 2015, visit here.

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The Science Behind Anti-Depressants May Be Completely 'Backwards'

Anti-depressants are the most commonly-prescribed medication in the U.S., with one in 10 Americans currently taking pills like Zoloft and Lexapro to treat depression. But these pharmaceuticals are only effective less than 30 percent of the time, and often come with troublesome side effects.

In a controversial new paper published in the journal Neuroscience & Biobehavioral Reviews, psychologist Paul Andrews of McMaster University in Ontario argues that this failure of medication may be based in a misunderstanding of the underlying chemistry related to depression.

Andrews surveyed 50 years' worth of research supporting the serotonin theory of depression, which suggests that the disease is caused by low levels of the "happiness" neurotransmitter, serotonin.

But Andrews argues that depression may actually be caused by elevated levels of serotonin. And this fundamental misunderstanding may be responsible for inappropriate treatment: The most common form of antidepressants are selective serotonin re-uptake inhibitors (SSRIs), which operate by targeting serotonin receptors in the brain in an effort to amplify serotonin production.

Currently, scientists are unable to measure precisely how the brain releases and uses serotonin, because it can't be safely observed in a human brain. But Andrews points to research on animals which suggests that serotonin might work just the opposite from what we've assumed.

In this scenario, elevated serotonin levels that are released and used by the brain during depressive episodes trigger processes that promote rumination -- the obsessive negative thinking that is the hallmark of depression. Then, because they facilitate the production of serotonin, SSRI treatments exacerbate rumination and actually worsen symptoms of depression, especially at first, Andrews explained. Over time, in come cases, the SSRIs can reverse ruminative processes and reduce symptoms -- but this is in spite of the medication, not because of it.

HuffPost Science spoke to Andrews about why we've gotten anti-depressants "backwards" -- and what the future of depression treatment might hold.

HuffPost: Where did the low-serotonin hypothesis originate?

Andrews: The hypothesis didn't originate because anybody measured serotonin in depression or in any depressed-like state in an animal. It's really based on circumstantial evidence. Researchers back in the '40s and '50s happened to find that certain drugs that were trying to treat tuberculosis and schizophrenia had depression-relieving properties, and they wondered, why were they relieving depressive symptoms? They eventually figured out that the drugs increased serotonin in rodent models.... They reasoned that if these drugs relieved depressive symptoms in humans -- and, as best as we can tell, they increased serotonin -- then depression must be a state of low or reduced serotonin transmission.

There have been problems with the low-serotonin hypothesis for a while. If you look to any serious neuroscientist, they'll all acknowledge that there are serious problems with it. It still is, nevertheless, the backbone of research on depression in neuroscience.

What evidence is there to suggest that the low-serotonin hypothesis of depression may not be accurate?

There is no way to be absolutely certain for two reasons. First, we cannot directly measure how fast serotonin is released, or transmitted. You can't do that even in a rat. You can measure the concentration of serotonin in a particular brain region, but you can't measure the transmission of it. The transmission would be to measure the release of the serotonin into the synapse.

The only thing we can measure is a marker of transmission, which reflects what happens to serotonin after it is released into the synapse and metabolized. Second, it is currently impossible to study this issue in humans without cutting holes in their skulls. But these studies can be done in animals. In these studies, there is abundant evidence that this marker of transmission is elevated.

We reviewed 15 different models of depression that are used in neuroscience research that had measured this particular marker that we're concerned with. Of those 15 studies, 13 were consistent with the high-serotonin hypothesis, and the other two were not inconsistent with it. If you extrapolate to humans... that would strongly suggest that the evidence is in favor of the high-serotonin hypothesis of depression.

OK, so how do anti-depressants work then?

Another problem with the low serotonin hypothesis is that these drugs increase serotonin pretty rapidly, within minutes to hours. You'd think that if the low serotonin hypothesis was true, the anti-depressant drugs would work rapidly too. But they don't -- it takes three to four weeks for their symptom-reducing effects to kick on. So there's always been this disconnect between the onset of the pharmacological effects of the anti-depressants and their therapeutic effects.

So what's actually happening to depressive symptoms when you first start taking these drugs? Well, it's extremely common for people to start saying "I feel worse" rather than getting better. That's theoretically important because these drugs are working very quickly in terms of increasing serotonin. So what's happening to serotonin in the brain as those three or four weeks pass? It's falling.... As time goes on [after the initial peak], serotonin dips below the baseline and that's when you actually start feeling better.

But things will eventually smooth out again and the brain will return to its steady state. That's what happens over prolonged anti-depressant use. Even when taking the drugs, people experience relapses. They might have that initial worsening of symptoms, then they'll feel better, and over prolonged period of use, they'll tell the doctor that the drugs aren't working anymore... And commonly the doctor will increase the dose or add on another drug.

But the brain is always fighting these drugs and trying to bring itself back to its homeostatic equilibrium.

Antidepressants are known to cause many side effects. What are some of the most common?

Limited efficacy at reducing depressive symptoms, sexual difficulties, difficulty concentrating, and problems with the digestive system are the most common. But many other types of problems can occur, including increased risk of relapse, a decrease in bone mineral density, abnormal bleeding, stroke, suicidal behaviour. Some of these problems can cause death -- several studies have shown that anti-depressants, especially in older people, are associated with an increased risk of death.

You all them all up, and they all can be potentially serious things.

What do you think is the future of depression treatment?

As people and physicians become more aware that antidepressants only work for a limited period of time, and are less safe than they have been supposed, the use of antidepressant medications will decline and the use of psychotherapies will increase.

I would suggest that the attempt to pharmacologically reduce depressive symptoms is not likely to produce lasting effects. You can get these temporary effects, but they're not likely to be lasting effects, and they can cause a whole lot of problems.

Psychotherapy is more likely to produce lasting effects, and can help people cope with the things that actually triggered their depressive episodes, and that's why these therapies are more productive in the long run.

This interview has been edited for clarity and length.

How To Beat A Bad Mood

By Jancee Dunn

Sigh if this has happened to you: You're heading out the door, feeling reasonably upbeat -- your outfit is cute, the weather is sunny. And then, wham! Your husband asks, "Why do you look so tired?" You forgot your phone. Oops, it's dead. And now you're late. A rotten mood builds. Though you're aware of what's happening, you can't stop it.

It's probably not much comfort to know that bad moods are having a moment: Americans reported record high levels of negativity about the future in an NBC-Wall Street Journal poll. "If things look uncertain, there's no question that people will be crankier than normal," says Jair C. Soares, M.D., director of the University of Texas Center of Excellence on Mood Disorders. Kicking it up another notch is the amplification of social media (ISIS! Ebola!): "The 24/7 media frenzy of contemporary life makes people even more apprehensive," Soares notes.

Meanwhile, we're in one of the least perky times of year, which wears on some of us more than others. A study published in the journal Emotion found that inclement weather can make a person's foul mood even worse. It sure doesn't help when someone tells you to cheer up. "You're not getting any empathy," points out psychologist Guy Winch, Ph.D., author of Emotional First Aid, "and that only makes you feel annoyed."

If reading this has upset you, take heart: "It's important to have emodiversity -- a variety of negative and positive feelings," says June Gruber, Ph.D., assistant professor of psychology at the University of Colorado, Boulder. If we're never out of sorts, we can't fully appreciate the sweetness of happiness. That said, nobody wants a terrible, horrible, no good, very bad day. The key to keeping it cheerful: Squash that snit before it starts.

Here's how to tame your bad-mood triggers:

Soothe your grumpy mind-set.

Psychologists believe that we're wired to react more strongly to crummy happenings than pleasant ones -- that on-the-edge feeling lingers as a primitive form of self-protection. And a combination of nature and nurture makes some of us moodier types. "Think of emotional resilience like an immune system," Winch says. "There are people who tend to have a stronger one than others." We're also likely to model our parents' reactions, so if Dad flipped out about small stuff like misplaced keys, you may have the same tendency.

Once you're sulky, that state spirals; grouchy people view events through tunnel vision, finds research in The Journal of Neuroscience. Subjects were hooked up to an MRI and shown pictures of faces superimposed over images of houses. Those in meh moods only took in information about the face; happier folks could also remember the surroundings. Per the lead study author, good moods "enhance the literal size of the window through which we see the world."

When certain irritations are repeated enough, they turn into triggers that set us off even when things aren't so bad, Winch says, "because they create a kind of emotional wound." If you've dealt with a lot of computer crashes, for example, then even just Chrome quitting on you could be maddening. And watch out if the colleague in the next cubicle is a grump; a University of Notre Dame study showed that negative thinking can be passed along from one person to another, like the flu. We copy one another's nonverbal cues, including frowns and grimaces, then internalize them.

What to do: To help prevent a dour mood from brewing into a storm, take a walk or try another change of environment to stop the cycle of rumination, Gruber suggests. Or focus on doing just one thing, like crafting or cooking; a recent Harvard University study found that bad moods were most apt to strike when the subject's mind was wandering. If you're in danger of being infected by a grouch, make like a public health expert and contain it. "When someone is complaining, you can say, 'It sounds like that was very hard for you,' and do not engage," says New York City psychologist Paulette Sherman. Instead, go find someone perky: A Harvard and University of California, San Diego study concluded that if a nearby friend is happy, you have a 25 percent higher chance of feeling brighter.

Deal with your no-sleep situation.
awake night

The number of Americans who get eight hours of shut-eye is at an all-time low, per a Gallup poll -- so it makes sense that crankiness may be at an all-time high. Our average is 6.8 hours a night, but it's not just quantity that's lacking -- quality is compromised by our inability to surrender our smartphones and tablets until our heads hit the pillow. A survey by the marketing agency Rosetta found that 68% of tablet owners use the device in the bedroom. Yet a growing pile of studies assert that the blue light from gadgets ramps up our alertness and disrupts our circadian rhythms.

Why does sleep deprivation make us snappish? The emotional part of the brain, the amygdala, is much more active when deprived of sleep, finds a study by Matthew P. Walker, PhD, director of the Sleep and Neuroimaging Laboratory at the University of California, Berkeley. Normally, the more rational prefrontal cortex would put everything into context -- but when the brain is sleep-addled, this relationship breaks down. Suddenly, your responses are less controlled—and you wig out when someone cuts in front of you in the ATM line.

Adding to the problem is our belief that we can power through fatigue, which only brings on more bad moods. Walker compares this mind-set to that of drunk drivers. "After five drinks, they may think they're fine to drive home, but they're markedly impaired in their brain function," he says. "The same is true of sleep: When people regularly get less than seven hours, we can measure significant cognitive impairment."

What to do: For sounder sleep, power down gadgets an hour before bed. If you keep your iDevice in your bedroom, apply a blue-light protector film over the screen. Mega-texters, take note: A new study from Washington and Lee University in Lexington, Virginia, found that higher levels of texting were directly associated with more sleep problems (likely from being too wired, literally and figuratively).

Swiss researchers have discovered this not-sexy-but-effective tip for better slumber: Wear socks to bed. When your body has to work to redistribute heat from your core to the extremities, the process upsets the natural release of the sleep-giving hormone melatonin. Or try the "quiet ears" technique from the University of Maryland's Sleep Disorders Center: Lie on your back with your eyes shut. Place your hands behind your head and put your thumbs in your ears so you close the ear canal. Listen to this soothing, rushing sound and off you go to dreamland. The morning after a night when you've skimped on rest, do a few minutes of meditation; it has been shown to boost energy and dampen the production of stress hormones.

Stop the stress tornado.

Anxiety has the unfortunate habit of also making you crotchety. It's similar to toddler behavior, Dr. Soares says: "Getting worked up overstimulates our minds, and it's hard to come down." One Swiss research team recently unearthed the key connection between frayed nerves and bad moods: When triggered by stress, an enzyme attacks a synaptic molecule in the brain that usually regulates mood.

What to do: Prevent that giant list of to-dos from freaking you out: "Research shows that just jotting down quick ideas for tackling things is enough to eliminate mental nagging and improve your mood," Winch says.

Of course, exercise is the magic bullet for stress reduction. Even moderate workouts help spur the release of brain-derived neurotrophic factor (BDNF), reversing the negative effects of stress. Hanging outdoors is another good idea: An analysis of 10 studies published in the journal Environmental Science & Technology found that people's stress levels dropped if they walked in a natural setting, like a park.

Also consider the tea cure; a study in Psychopharmacology found that downing a few cups of black tea daily lowered people's cortisol levels (a hormone tied to stress) by 47 percent. If nothing else, popping a piece of gum in your mouth may help, according to a recent study that found that keyed-up people had lower saliva levels of cortisol after chewing gum.

Head off hangry.

There's a reason you get prickly when your stomach has been empty for too long: Skipping meals causes fluctuations in serotonin, the brain chemical responsible for mood balance. When your blood sugar plummets, loved ones may suffer along with you (as your partner might well know): A new study of married couples from Ohio State University found that people with low blood sugar were much more likely to get angry at their spouse.

Refined sugar is another crabbiness culprit. That vending-machine candy bar will spike your blood sugar—then plunge both it and your mood lower. Down too much sugar and the brain's reward system goes through withdrawal if you don't give it a constant supply, says Nicole Avena, Ph.D., assistant professor at the Icahn School of Medicine at Mount Sinai in New York City. "The resulting 'sugar rage' looks like what you'd see if there was an addiction to something like nicotine," she says. "There have been lab studies on rats who eat sugar where the rats will actually bite investigators when they take it away because they're so angry."

What to do: Eat every three to four hours or so if you're prone to food mood swings, choosing unprocessed foods as much as possible. Regularly nosh on good-mood foods. Stick with your resolve to avoid trans fats; researchers at the University of California, San Diego have discovered a link between trans fats and irritability (it's been shown that they interfere with the production of mood-stabilizing omega-3s). Oh, and if you need to have a difficult conversation with your mate, it couldn't hurt to first have some protein. Major issue? Break out the porterhouse steaks.

Head over to to read more about how to prevent a bad mood.

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Troy Roness And Zach Stafford Discuss Eating Disorders With HuffPost Live

What's it like to identify as a male and struggle with an eating disorder?

While eating disorders are usually portrayed exclusively as issues that women struggle with in our culture, they also affect a significant number of men.

According to The National Eating Disorders Association (NEDA), the percentage of college-age men dealing with of eating disorders falls somewhere between 4-10 percent.

And while straight men certainly struggle with eating disorders as well, the gay community can especially place unrealistic expectations of how a man's body should look through body policing and shaming.

In this clip from HuffPost Live, Troy Roness and Zach Stafford share their own experiences with battling eating disorders.

"Even within the gay community, as I came out and I moved to Chicago and went to college, my eating disorder, while I can talk to other gay men about it, was sometimes really celebrated," Stafford told Huff Post Live. "And even now when I go to bars and talk to friends about it, it's joked about as a thing that we should all be doing -- we should all be obsessed with restricting calories, purging etc. So it's really complicated and I think the reason it's so accepted in the gay community, per se, is because so many of us are battling it."

Check out the video above to hear more about eating disorders among men or head here to watch the segment in full.

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What Nutrition Experts Eat On Vacation

If you're a healthy eater who practices portion control, you know a vacation can put a dent in your healthy lifestyle. Whether you're kicking back and relaxing for a week or getting to know a new city, counting calories doesn't exactly sound appealing when you're trying to have a great time.

So, how can you have a blast on vacation without packing on the pounds? We consulted a number of nutrition experts, and they let us know what they eat when they leave town -- and, truthfully, it sounds pretty awesome.

They eat dessert!
Think nutritionists are skimping on fun foods, even on vacation? Joy Bauer, nutritionist for "The Today Show," certainly isn't. "I generally go out of my way to eat as healthfully as possible when I'm away from home -- but I allow myself something fun and indulgent each day," she said. "I try to make it indigenous of the area, so it's special and memorable, like key lime pie in Florida, a piña colada when I'm in a tropical setting, or clam chowder in the northeast."

They don't skimp on produce.
fruits and vegetables

Regardless of anything else she's eating on vacation, Katherine Brooking, MS, RD, makes sure her diet is full of fruits of vegetables. "Even when vacationing, I don't skimp on produce. I just buy more pre-washed, ready-to-eat options like ... pre-cut fruit cups sold in most supermarkets," she said.

They eat one big a meal a day.
plate of food

Easing up on portion control on vacation isn't a bad idea at all -- just make sure every meal isn't a huge one. "I either have a big lunch or big dinner, not both, and will snack on a granola bar or nuts," Elisa Zied, MS, RDN, CDN, and author of Younger Next Week said. "I usually bring mixed nuts with us on vacation-cashews, pistachios, almonds, pecans."

They try healthy new things.
healthy food

Why not take advantage of being in a new place to get to know the local healthy cuisine? That's what Susan Mitchell, Ph.D., RDN, does. "Before I go, I ask around to find out about the best restaurants, local fare, farmers markets or fun places that give me a feel for the food in the area that I'm going to," she told HuffPost. "I always want to try local specialties. At the same time, I look for venues that give healthier options too such as salads, locally grown vegetables and fruits, or fish so that I continue to make smart choices and eat healthy and well for my body."

They make smart alcohol choices.

It's no secret that a vacation spent sipping sugary drinks can tack on a lot of extra calories. So Dawn Jackson Blatner, RD, and author of The Flexitarian Diet says she doesn't budge on her alcohol choice. "Instead of high-sugar topical drinks, I lean toward light beer with lime or club soda with a shot of fun-flavored vodka," she said.

They don't eat every meal out.

Julie Upton, MS, RD, doesn't avoid restaurants on vacations, but she does only eat at them once a day. "Research consistently shows that the more you eat out, the harder it is to maintain a healthy weight. That means I make my own breakfast every day," she explained. "I find starting your day out right is really important to keep your overall diet on track. I will eat a bowl of instant oatmeal with Greek yogurt and fruit or some type of whole-grain, fiber-rich cereal with soy milk and fruit or Greek yogurt with fresh fruit. I like to pick up lunches at a salad bar or piece that meal together from yogurt, cheese, hard-boiled eggs, deli meat. These are items you can pretty much find anywhere so you can avoid eating lunch out."

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Why I Thought My Eating Disorder Was The Answer

As a woman who threw up for more than four decades to control my weight, even as I needed the comfort and "cure" that overeating provided, I have some insights on what the "over love of food" is all about. It wasn't the problem. It was the answer. The cure for food disorders is not just intervention to change the behavior. It is intervention with a soul that is lost and knows no other way to fill the hurt and the despair.

By age 12, my inner self was very confused and terribly hurt. I had no understanding as to what life was about -- and there was no one coming up with answers for me that made any sense. My body was changing and driving me into emotions and urges that I had no guideposts for. All I had was a cultural model that told me that "Twiggy" was cool, I needed to be sexy-thin and that being who I was wasn't important or valid. I was a young girl morphing into womanhood who knew that a "kiss on a boo-boo" from one of my parents was no longer going to heal my wounds.

I was in a place of serious growing pain. My mind was firing on all cylinders with questions and my soul was blossoming into a knowing that the answers coming at me were somehow flawed and not what I needed. I was floundering and trying to find a place of balance for my feet and my heart. No one was talking about the things that were aching me: Why am I here? What is the purpose of existence? Why does it hurt so much?

I began to find comfort in food. I began to overeat. I used food to fill a gaping hole in my soul where a self-loving and self-knowing me belonged. The food also occupied my mind and distracted me from the pain. My mother was delighted as I showed great interest in food preparation and taking over some of her mealtime chores. There were seven children in my family to feed, so this was no light task. Add two parents to that number, and you have nine mouths to feed at every sitting. I became a constant in the kitchen. This also meant that I could eat with mind-numbing abandon, as I moved from refrigerator to stove.

I had a sister who was 17 months older, and she had found the comforts of food as well -- pushing her weight to well over 180 lbs. My mother began terrorizing her about her weight, even going so far as to call her, "disgusting." I realized my own body was beginning to tip that same scale and I didn't want to suffer this abuse myself. So, what did I do? I started to throw up. I would overeat to get the "high" and pain-killing comfort of the food. Then I would stick my finger down my throat and get rid of it. I was in control! I had found the perfect answer. I could eat with impunity and stay thin.

What I didn't know was that I had started on a cycle that would hold my body, my soul and my heart for 42 years -- anorexia/bulimia. Soon "being skinny" became my single goal, even as eating became my god. My feelings and fears disappeared as every thought and passion I had was now centered on food. I was starving to death -- at age 32 I was very proud of being 5'9" and weighing only 102 pounds -- and stuffing myself with food at the same time. Food made it so I didn't have to hurt. I didn't have to mature, think or feel when I was in the kitchen creating gourmet meals and gorging on the "fine art of cooking." I would binge and vomit sometimes as much as 20 times a day. Behaving this way didn't even seem strange to me -- nor apparently to those around me. It was simply what I did. What a great way to hide from my pain and avoid living courageously within my own life.

I finally just walked away from my eating disorder on a cruise ship in 2009 at the age of 54. I consider this event a gift of "divine grace." A large cruise ship, with food in every corner, is a "Puker's Paradise." My body decided -- or better yet, my soul decided -- I no longer needed this survival technique. It was time for me to put my knife and fork down. I had started doing the work of finding my soul about three years earlier in the rooms of a 12-step program for alcoholism. I no longer needed the mindless comfort and pain-distraction that my eating disorder had graced me with. Why? Because I was finally and fully on my way to learning and loving who I am.

So, when we talk about eating disorders -- when we talk about any addiction -- we are not looking at the problem. We are looking at the answer that one of our brothers or sisters is using to fill a horrendous hole. This hole is where a conscious and loving sense of ourselves belongs. Healing this hole starts when we admit to ourselves that we are scared, lost and lonely and that we are using food -- or some other substance or behavior -- to fill this emptiness within us.

I found the beginnings of my self-love in the powerfully honest and accepting rooms of a 12-step program. Perhaps you will find yours there, as well. If you have an eating disorder or any other addiction, please, please know that you are not alone; also that you are not "bad" and that nothing is "wrong" with you. Here's the link for Over-Eaters Anonymous:

Robin Korth enjoys interactions with her readers. Feel free to contact her at or on Facebook.

To learn about her new book, "Soul on the Run," go to:

You can also download her "Robin In Your Face" free daily motivational app by going to

Earlier on Huff/Post50:

8 Soul-Satisfying Comfort Foods To Chase Away The Chill

Lift your family's spirit on a cold winter day with one of these delicious and satisfying comfort foods.

1. Broccoli & Gruyère Soup with Homemade Croutons


Topped with crisp homemade croutons, this rich and creamy broccoli soup is a hearty meal unto itself. It's perfect to ward off winter's chill, and ready in under an hour. GET THE RECIPE

2. Roast Chicken with Herb Butter


What better than a succulent roast chicken to create cozy moments around the dinner table with your family? This delicious recipe is adapted from The Family Dinner: Great Ways to Connect with Your Kids, One Meal at a Time by Laurie David and Kirsten Uhrenholdt. GET THE RECIPE

3. Potatoes Au Gratin


The ultimate French comfort food, this simple yet indulgent dish involves layering thinly sliced potatoes with heavy cream and grated cheese. The calories are worth every delicious bite. GET THE RECIPE

4. Chicken Soup with Matzo Balls


Is there anything more comforting than homemade chicken matzo ball soup? It's not hard -- just throw everything into a pot and forget it, and the matzo balls are made from a mix. GET THE RECIPE

5. BBQ Turkey Meatloaf


Comfort food doesn't have to be unhealthy. This BBQ turkey meatloaf is hearty, flavorful and -- bonus -- low in fat. GET THE RECIPE

6. Cauliflower Purée with Fresh Thyme


This cauliflower purée is creamy and comforting, and just happens to taste remarkably like mashed potatoes. It also has the benefit of being easier to make, healthier and lower in carbs. But don't make it just for that reason -- it's delicious in its own right. GET THE RECIPE

7. Buttermilk Fried Chicken Tenders


Comfort food is often the food of our childhood -- but these chicken tenders, marinated in seasoned buttermilk and pan-fried to crispy perfection, aren't just for kids. Dip them, put them on a salad, or eat them on their own. GET THE RECIPE

8. Texas Beef Chili


With meltingly tender chunks of beef enveloped in a deep, spicy and smoky sauce, Texas beef chili (or Chili con Carne) is essentially a chili-flavored beef stew. Try it, and you may never go back to that ground beef and bean chili again. GET THE RECIPE

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Avocado Veggie Pita Pizza


We are rebooting our metabolism with this avocado veggie pita pizza. We cleared out what was left in our veggie drawer and created a nutritious energizing meal. The colorful array of veggies add fiber, vitamins A, C, and E; the mashed avocado is also a great source of monounsaturated fat. This "healthy fat" can help reduce bad cholesterol and lower our risk of stroke and heart disease. We love using natural herbs and spices for added flavor. Sprinkling a spice like chili powder can help kick our metabolism into high gear. So, don't be shy-spice it up!

(serves 1)

  • 1 whole grain pita pocket

  • ½ avocado, mashed and lightly seasoned with sea salt

  • ¼ c vine ripe tomato, diced

  • ¼ c cucumber, diced

  • ¼ c yellow bell pepper, diced

  • 2 teaspoons crumbled feta

  • chili powder


1. Spread the mashed avocado on an opened pita pocket.

2. Layer the diced vegetables, top with the crumbled feta, and sprinkle with chili powder.

~Healthy Happy Eating!

For more healthy recipes and nutrition advice visit and "Like" Professional Nutrition Consulting, LLC on Facebook.

New Nanoparticle Gene Therapy Strategy Effectively Treats Deadly Brain Cancer in Rats

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Will Carolinas HealthCare, UnitedHealthcare strike last-minute contract deal?

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Overwhelmed By Your Life? Perhaps It Is Time to Simplify

If you had millions of dollars, what would you do? Buy an expensive house and car? How about a used van and park it by the ocean? That is exactly what Major League pitcher Daniel Norris did. Instead of spending his multimillion dollar contract to live up to the appearance of a celebrity ball player, this 21-year-old pitcher chose a simpler life. In a segment on the Today Show Daniel Norris said, "When I can simplify outside of the fair and foul lines, that's so much less to think about off the field and all my focus is put onto the baseball field."

Ideal Work LifeAs you go through your day, what is causing your stress, worry, and distraction? Is it a desire for a new car? Is it ensuring your dinner party is as good as your neighbor's was? Are you concerned about people stealing what you own? Are you having difficulty paying your mortgage but worry you have failed if you downsize? Are you stressed because you can't seem to achieve the American dream? Perhaps your unique dream life is different from the one society has dictated for us all.

Are the issues causing stress in your life providing you with any value? Start cataloging everything in your life. What brings you joy? What makes you feel whole? What helps to make you your best? Now, what is causing you to feel overwhelmed? What is a distraction? What is more hassle than it is worth? Next explore what is keeping you from removing things from your life that are affecting you negatively. Do you keep them around for your values or someone else's? Are you living your unique Type Me life or are you unhappily living someone else's life? Your ideal life might not to be living in a van, but is it the way you are living now?

Look around you. Did you create your life or are you living the life your parents, society, or your peers instilled in you? Are you trying to win at a game you don't want to play? If you had the courage and the means, what life would you create? What would be included? What would you remove?

Henry David Thoreau wrote in the book Walden, "Simplify, simplify, simplify." Simplifying your life is not just about downsizing your house or selling your possessions. At its heart, simplifying means living by your values. What do you personally value? When you choose to add something in your life, do you first gauge it against what you values? If you lived by your values, what would you experience? Make a list of all of the adjectives that would describe your life if you lived by your values. Perhaps it would be calm, peaceful, and content. Perhaps it would be exciting, adventurous, and joyful. What makes your heart sing? What truly makes you happy? Are you actively bringing into your life those things that make you happy?

Can you be as brave as Daniel Norris and remove yourself from the expectations of your role and status to remain true to your Type Me? Are you willing to stand up to ridicule and live the life that brings you joy? Are you ready to choose your version of living no matter what society expects? It is time to simplify your life by removing everything that is not you?

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6 Months Into My Anorexia Recovery, I Finally Smashed My Scale

By Annie Zomaya

On the 18th of this month, I will be a solid six months into recovery from anorexia nervosa. That is such a huge milestone! By no means has this journey been easy. A lot of people think that recovery from a restrictive eating disorder is as easy as "sit down and eat," but we know that there is so much more to it than that. Within the past six months, I have had my share of ups and downs. There have been days where I barely pay any mind to the ED, and other days where it's a struggle just to eat breakfast. There have even been days when I just sat in my room and cried, asking myself, "What's wrong with me?" But looking back from where I am now, I'm proud of myself for always getting back up and moving forward.

One pivotal day in this process was the day I smashed my scale.

I was only a couple months into recovery and I was about to have a serious relapse. I would just stand in the mirror and cry, and then stand on the scale and cry some more. The reason I still had a scale in my room was because I wanted to track my progress in weight restoration. I even drew the ED recovery symbol on it for motivation. That only worked for a little while. Soon the process began to reverse and I wanted to make sure I didn't gain too much weight. My mother finally hid my scale from me, but one day in a fit of anger I searched the house and found it.

I stood on it one last time. I became angry with myself. Part of me was angry for putting on weight, but the better part of me was even angrier that I had come so far and allowed myself to fall back into old habits that kept me in bondage to this monstrous eating disorder. That was it. I knew that the only way to stop this relapse was to give up the things that were holding me back from a full recovery. When my mom got home later that day, I confessed to her what I had done and told her what I thought I needed to do. It was time to break up with my scale. I had to completely give up any excuse I had for keeping it. This was really hard and scary, but also extremely liberating. I thought of my scale as a security blanket -- as long as I had it, I felt like I had some sort of control. In reality, the scale controlled me. It wasn't a security blanket; it was a ball and chain.

I thought of a song I had heard a few days before: "I Wanna Get Better" by Bleachers. When I heard it I thought to myself, "Hey, that's me... I want to get better!" So I blasted some music and took out all of my rage on the little twerp. This was really hard. And I don't just mean emotionally -- that thing was ridiculously durable. I mean, what are those things made of? Vibranium or something? We should make cars out of that stuff...

Anyway, so I didn't actually get to grind it to a pulp like I wanted to, but symbolically I had finally found the strength to destroy what had tried to destroy me. I also cut up the measuring tape I had hidden in my closet, and my mother took down the body-length mirror from the bathroom door and threw my scale in the trash where it belonged. This day was monumental.


My recovery quickly picked back up and has been on a mostly positive slope ever since. Of course I still have off days, but I am no longer a slave to a scale or mirror. The funny thing? I am more confident now than ever! I guess that's what happens when you force yourself to recognize your own inner beauty and give up the superficial.

The only thing a scale can tell us is about our relationship with gravity. Defy gravity. No scale can measure how much we are loved or how incredibly precious we are.

This was originally published on

About this blogger: Annie Zomaya is a college sophomore from Kentucky, currently debating what to major in. She also has her own blog, She is almost six months into recovery from anorexia nervosa.

Here's a How-To Guide on how to host your own scale smashing!

Are you struggling with an eating disorder or do you know someone who is? Call the National Eating Disorders Association's toll-free helpline for support: (800)-931-2237.

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Test predicts woman's chance of surviving breast cancer

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Test predicts woman's chance of surviving breast cancer

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How Much Coffee Do Americans Drink Every Day?

Coffee is one of life's greatest gifts. Not only does it help most people wake up in the morning, it also has a lot of health benefits. But how much do we know about coffee? How much should we be drinking, and how much are Americans actually drinking?

Luckily, the folks at Zagat have some of the answers. They just released the results from their third annual coffee study, which highlights consumers' coffee habits.

Check out more of the Zagat findings below and see how your coffee consumption compares:

How much coffee does the average American drink?
2.1 coffee drinks per day, and it increases with age.
two cups of coffee

How much do Americans pay, on average, for a coffee drink? $3.28, higher than 2013 and 2014.

What kind of drink does the average American woman order? Lattes (22 percent), followed by regular coffee (19 percent) and cappuccinos (12 percent).

What kind of drink does the average American man order?
Men go for regular coffee (30 percent) followed by espresso (14 percent).

What kind of sweeteners do Americans add to their coffee?
52 percent of people said they don't add sweeteners, 14 percent of people use Splenda, 7 percent of people use white sugar, 4 percent of people use Stevia and 3 percent of people use simple/flavored syrup.

Read the rest of the findings here to learn more about American coffee consumption patterns.

And if you're worried about how much coffee is okay to consume -- you might be surprised by how much is "allowed" in one day. The new 2015 dietary guidelines the government just released say 3 to 5 cups of coffee are okay, as long as you don't add cream, milk or sugar.

Want to read more from HuffPost Taste? Follow us on Twitter, Facebook, Pinterest and Tumblr.

Mystery of the reverse-wired eyeball solved

Counter-intuitively, in vertebrates photoreceptors are located behind the neurons in the back of the eye. Now physicists explain why the neural wiring seems to be backwards.

Child Poverty Would Be Almost Twice As High If Safety Net Programs Didn't Exist: Report

Child poverty in the U.S. would be significantly worse if government assistance programs weren't in place, a new report suggests.

A study released on Wednesday by the Annie E. Casey Foundation, an advocacy group for low-income kids, found that without government support programs -- like food assistance, housing subsidies and tax credits -- the child poverty rate would swell from 18 percent to 33 percent.

According to the foundation, the study, which used the Supplemental Poverty Measure (SPM) to track data, does a better job at gauging how government programs are benefiting low-income Americans than the federal government's official index -- a measure that was developed in the 1960s.

As the report explains, the government's index "falls short of accurately estimating the current need" by not considering certain factors, such as varying cost of living levels across individual states.

It also doesn't consider the impact of some of the government's biggest anti-poverty initiatives, like the Supplemental Nutrition Assistance Program (SNAP). Last November, SNAP enrollment stood at more than 46 million -- down slightly from the same month a year prior mainly due to an improving U.S. economy.

Because the government doesn't consider such factors, it can't monitor their success or failure, the foundation argues. If the government can't determine what investments are working, it can't accurately distinguish the needs of the most vulnerable Americans.

"Relying on [the federal government's official measure] alone prevents policymakers from gauging the effectiveness of government programs aimed at reducing child poverty," Patrick McCarthy, president and CEO of the Annie E. Casey Foundation, said in a statement on the organization's website. "Given that child poverty costs our society an estimated $500 billion a year in lost productivity and earnings as well as health- and crime-related costs, the SPM is an important tool that should be used to assess state-level progress in fighting poverty."

Although slightly lowered SNAP participation is a welcomed economic sign, overall many more American families still rely on food stamps now than before the Great Recession, The Guardian reported last month. About 15.9 million kids lived in food insecure homes in 2013, according to Feeding America, and for the first time, more than half of American public school children live in low-income households.

But the SPM model, which was first introduced by U.S. Census Bureau in 2011, provides a more optimistic look at child poverty in the U.S. The SPM model discovered child poverty has actually declined since 1990, while official measurements by the federal government has reflected no substantial change.

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Kaleida, unions renegotiate wages for 8,000 healthcare workers

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No, My Entire Party Hasn't Arrived Yet. Yes, I Still Think You Should Seat Me.

I don't think of myself as a punctual person -- I'm constantly pulling into movie theater parking garages just as they start to roll the trailers. So when I meet people at a restaurant for dinner, I'm rarely the first to arrive.

But a couple months ago, I was meeting my mom for dinner at a sushi bar called Hiko in LA's Sawtelle neighborhood, and I happened to beat her there. When I walked in, I found it deserted. Although it was 7 p.m., there were literally no diners in any of the seats. The only other souls in the restaurant were a waitress and a sushi chef. I walked up to the waitress and asked for a table for two. Her expression darkened.

"Has your dining partner arrived yet?" she asked.

"No," I responded warily, "But I was just texting with her and she's only a few minutes away."

"I'm sorry, but we only seat complete parties," she said.

"Even though there's literally no one else here?" I asked, confused.

"It's the policy," she said, clearly embarrassed. She gestured toward a row of stools in the hallway. "Would you mind sitting here while you wait for your companion?"

I did mind. The restaurant was empty! And I just wanted to relax, order a beer and peruse the menu while I waited. I didn't want to perch on some uncomfortable stool in a drafty hallway for who knows how long. But I'd heard that the owner of Hiko was known for strictly enforcing a host of specific rules in his restaurant; he's known for kicking diners out mid-meal. So instead of complaining, I sat down at a stool and waited five minutes, until my mom walked in and we were allowed to sit. Our food, for the record, ended up being superb -- but when I've thought about the meal since that night, I've found myself focusing more on the restaurant's lack of hospitality than its deft handling of blue crab.

This was an extreme example. Few restaurants would refuse to seat an incomplete table if there were literally no one else in the dining room. But it speaks to a troubling trend in the restaurant world: Maitre d's hatred of seating incomplete parties.

Intellectually, I understand why a restaurant wouldn't want to seat someone before the rest of their party arrives. Since a party is unlikely to order food until everyone arrives, seating an incomplete table wastes space that could otherwise go to people who are ready to order. It's an inefficient allocation of limited seating. That's why I'm fine with a very popular restaurant refusing to seat incomplete parties during prime times -- 8 o'clock on Friday night, say, or in the middle of the Sunday brunch rush.

But in my experience, this policy extends far beyond that. It's ubiquitous. Restaurants everywhere insist on only seating complete parties, at all times of day and on all the days of the week. And it's a major turnoff.

After all, the host is the first person you encounter when you walk through a restaurant's doors. When they tell you that you can't sit down, even though there are empty tables, it immediately signals that the restaurant's owners are more interested in maximizing profits than in making their guests feel welcome and comfortable. It can be hard for a restaurant to recover from that foul first impression. Especially since someone who arrives before their dining companions might already feel vulnerable and awkward. Who hasn't been the first one to show up for a date and worried that the other person will stand them up?

Plus, even if diners aren't likely to order their main courses before their companions arrive, they're very likely to start ordering little appetizers to share and, especially, drinks, which are the main profit centers for restaurants in any case. So it's not a total waste. At restaurants with bars, hosts will often encourage early arrivers to wait for the rest of their table at the bar and order a drink in the meantime -- and I'm generally A-OK with that.

But if the bar's full, or the restaurant has no bar, and there are open tables, I really wish hosts would seat incomplete tables. Not if it's just one person in a group of eight, I suppose, and not if the restaurant's slammed. I wouldn't want to replace one kind of rigidity with another. I'm just asking for hosts to be flexible and hospitable rather than blindly obeying ironclad policies.

I witnessed a stellar example of a smart attitude toward incomplete parties a few weeks after my meal at Hiko, when I was meeting a friend for dinner at Ludo Lefebvre's hotspot Petit Trois. I walked in at 7 p.m. on a Tuesday and found it just as empty as Hiko had been. This was more surprising, as it's a tiny restaurant that's attracted a ton of buzz. Most of the time, it's packed; it's the rare LA restaurant that regularly has a wait for a table. So even though I was the only diner there, I felt sure that I would be asked to hover outside until my friend arrived.

But much to my delight, the waitress who greeted me at the door encouraged me to sit right down. She poured me a glass of water and asked if I wanted a cocktail while I waited. My friend soon texted to say that he'd mixed up his schedule, and wouldn't get there for 20 minutes -- but at no point did anyone in the restaurant flinch. Indeed, they were friendly and solicitous even as the restaurant started to fill up a bit and my companion still hadn't arrived.

When he finally showed up, I had worked up an appetite while waiting and drinking, so we ordered a great deal of food and drink, racking up a larger bill than I had intended. But because the restaurant had welcomed me enthusiastically from the minute I walked in, I left eager to return. That's what a good restaurant meal should always do.

7 Ways to Your Dream Body Right Now

Why is it so easy to fall into the pattern of negative self-talk about our bodies? One look at the latest models on fashion show runways and some bad lighting in a fitting room and suddenly we have gone from walking tall to shrinking under our puffiest down coat. It happens to the best of us, even the women on the actual runway themselves. We are all susceptible to negative self-talk, but the quicker we can learn to shift those thoughts back to the positive track the more we will stay on course to truly show up shining for every moment in our lives. Here are seven ways to instantly show yourself some love and celebrate your shape.


1. Lift weights -- It is easy to get stuck in the rut of long, punishing sessions on the elliptical trainer or stair master. I've been there, trying to burn off last night's dinner or dessert or get in shape for swimsuit season. Cardio exercise is an important part of a workout regimen, but instead of focusing on shrinking yourself, think about how you can take up some space in the world with your strengths and start a weight training routine. The more you focus on what your body can do rather than what shape or size it is, the more you will appreciate it. The weight room at any gym can admittedly be intimidating, especially if you feel like you don't know what you are doing. If you are a weight training novice take a group class at your gym, try CrossFit or find a circuit training studio. You will find inner strength you never knew you had and you may be surprised at your extra superpowers that develop outside of the gym as well.

2. Phone a friend -- Or even better, get outside and go for a power walk together. Nothing lifts the spirit quite like spending time with someone who reminds you that you are not alone in this world. Female friends give the incredible gift of nurturing, supporting and uplifting one another. They remind us we are worthy, just because we are here.

3. Drop the guilt -- Often times we overindulge on food or drinks and immediately feel guilty, rather than truly enjoying the splurge. By pouring guilt all over our moment of decadence we don't even give ourselves a chance to savor it and are more likely to feel the urge to repeat it again the next day. The guilt won't erase what happened. If you eat some fries or choose to have dessert, truly taste and enjoy. Be grateful for the food you are so lucky to have access to. Forgive yourself for your judgments and get back on track.

4. Toss the scale -- Scales don't measure muscle or strength or endurance or flexibility. Who wants to attach their self-worth to a number anyway? As long as you are eating healthy foods, getting regular exercise and feeling good in your clothes there is no reason not to celebrate your body. Do your clothes fit? Are you getting enough sleep? How is your stress level? These are all more important questions to know the answers to then the number on the scale.

5. Practice yoga and meditation -- when we bring our body and mind to a state of peace, it is easier to be kind to ourselves and the world around us. It becomes easier to feed ourselves nourishing food and get the exercise our body craves. With a quiet mind we create the space for self-love. Often times women think they will love themselves once they get to their ultimate size or fitness goal, but one is not conditioned on the other. The more we love ourselves right now, the easier the journey is.

6. Choose your media -- Nobody looks like the girl in the magazine, even her. Photoshop is used in everything now, to erase anything from a pimple to several inches on a persons midsection or thigh. It is important to remember this when looking at any mainstream media. Find positive and healthy people to follow on Instagram like @mykindoflife_em, @aldawomen and @ _theshift_. Did you see the unretouched photo leaks of Cindy Crawford and Beyonce lately? This shouldn't be news, it's just what women really look like.

7. Accept yourself -- I know, easier said than done, however the faster we can learn and love the kind of body we have, the quicker we can be to take care of it for optimal health and wellbeing. Some things like cellulite and long second toes may not be ideal but everyone has something they are better off accepting then spending precious time trying to change. If we can focus on how to be the best version of the body we have we are able to enjoy the gifts we were given, like amazing hair and the ability to stand on our head. If you don't know what type of body you have been given naturally, spend a day eating only what would truly make you feel full and nourished and take note of what those foods are. Ask yourself what form of movement would actually be fun and make you laugh and want to do it again the next day? These are all clues to your lasting health, enjoyment and wellbeing.

Erin Henry is contributing on behalf of