We’re talking 60-plus — women and men. And we’re talking about hitting the gym and weight training. Don’t be put off, Bamman says.

“Resistance training is in many ways the true fountain of youth,” Bamman said in an interview with The Associated Press. “I like to say the fountain of youth is the water cooler in the gym.”

Of course, there are biological limits. But Bamman says the bulk of age-related decline in strength, flexibility and endurance is behavioral — putting too few demands on the body, not too many.

“When I tell somebody that in four to six months your strength and muscle mass and overall muscle function is going to elevate to the levels of people 30 to 35 years younger, that hits home,” he said.

So you know you’re too sedentary and the birthdays keep piling up. You suspect resistance training would be beneficial. But perhaps you’re intimidated. Don’t be.

Getting started

Check with medical professionals to make sure there are no health problems that stand in your way.

Then find a gym. Larger gyms offer a social component with things to do on a day off from weight training. And Bamman suggests getting a trainer.

“It’s actually quite safe, but it does require proper progression,” Bamman said. “You have to have a good instructor who can teach the movements properly.”

Bamman, a research scientist at the Florida Institute for Human & Machine Cognition, said finding a fully qualified trainer can be tricky.

“We need more rigorous certification of trainers,” he said. “The problem is that you can go online tonight and pay $50 and get some certification as a trainer.”

Done and dusted in an hour

Bamman suggests resistance training twice a week. Three times is even better, and he recommends non-weight-training days in between. For instance, work out on Monday, Wednesday and Friday, and let Tuesday and Thursday be days of rest.

He suggests 10 different exercise movements — eight is sufficient. Do 10 repetitions of each movement. Do this three times, described as three sets. Then move on to the next movement.

When you reach the 10th repetition, you should feel you can’t do many more. If you could have done 10 more reps, you might want to increase the resistance.

Bamman says machines are better for beginners, but free weights — barbells or dumbbells — may be more effective as you gain confidence.

Before the weights, start with a 5-10 minute warmup — on the treadmill, stationary bike or elliptical machine — to get the blood flowing. You can add a few minutes on the mat for stretching and abdominal work.

Then come the weights.

“Sometimes you see people who sit on the machine, do a set and then play with their phone for three or four minutes. We like to keep them moving.”

Women may benefit even more than men

Women may benefit from resistance training even more than men because it’s a way to fight osteoporosis, the loss of bone density.

“Women are on a disadvantaged trajectory for bone loss, particularly in susceptible areas such as the hips and lower back,” said Bamman, who completed his doctorate at the University of Florida College of Medicine.

“But the strength-training benefits for both sexes are really important. There are no sex differences in the ability to respond. In gaining muscle mass and strength in untrained people, men and women track the same.

Yasuko Kuroi is 72 and started resistance training about 20 years ago.

“I saw the men in the gym and thought I could do that, too,” she said, speaking at a municipal recreation center in Tokyo.

The body demands work

In a few words: Use it or lose it.

Bamman cautions against pampering yourself and criticized even health care professionals “who baby seniors.” Of course, common sense is required.

“Our human body is a demand-based system,” he explained. “If you chronically impart a low demand on the body, we have adaptations to low demand. That’s why we lose muscle mass, that’s why we get weaker. We’re not demanding much.”

“But if you put high demands on the system — like resistance training — now the body has to adapt to these higher demands. The body says: ‘To adapt to these new demands I’ve got to make my bones stronger. I’ve got to make my muscles bigger.”

Bamman used the example of space flight, or extended bed rest, where people rapidly lose strength.

“Bed rest or space flight is essentially expedited aging,” he said. “All of our systems as we age are capable of responding and adapting. They just need the stimulus.” He said he’s seen positive effects for people in their 70s and 80s, and even for some in their 90s.

Bamman is 57 and joked he’s getting “closer in age to the people I study.” He also emphasized there are no shortcuts.

“These programs that roll out for older adults — seated exercises and the like. This is gimmicky and they don’t impart enough demands on the body,” he said.

An analysis of data from more than 500 children and teens with hypertension revealed an association between shorter-than-recommended sleep times and high blood pressure, according to the study, published in Pediatrics.

While hypertension in kids has been declining, the Centers for Disease Control and Prevention estimates that 1 in 7 young people ages 12 to 19 have hypertension.

The study doesn’t prove that shortened sleep times cause hypertension, but doctors don’t typically think of sleep when they counsel parents about high blood pressure, said the study’s lead author, Dr. Amy Kogon, an assistant professor at the University of Pennsylvania Perelman School of Medicine.

Data for the study came from children and teens seen at a clinic at the Children’s Hospital of Philadelphia, where Kogon is a pediatric kidney specialist.

“We usually target things like diet and exercise,” Kogon said. “This is another thing parents might want to think about, particularly if the child has high blood pressure.”

Major risk factors for hypertension in children and teens include being overweight, not getting enough physical activity and a poor diet, according to the American Heart Association.

The majority of middle and high school kids in the U.S. are sleep-deprived. In fact, according to the CDC, nearly 60% of middle school kids and more than 70% of high schoolers aren’t getting enough sleep.

As many as a third of elementary school kids get less than the recommended amount of sleep, Kogon said.

The number of hours of sleep children and teens should get depends on age. The American Academy of Sleep Medicine recommends:

• 10 to 13 hours per night for children under age 6.
• 9 to 12 hours per night for children ages 6-12.
• 8 to 10 hours per night for ages 13 to 18.
•  7 to 9 hours per night for ages 18 and older.

It’s important to control blood pressure early in life because the longer someone has hypertension, the higher the risk of developing heart disease, said Dr. Barry Love, director of the congenital cardiac catheterization program at Mount Sinai Kravis Children’s Heart Center.

“We know that high blood pressure is associated with the early onset of coronary disease and stroke,” said Love, who wasn’t involved in the new study. “We think that the damage to blood vessels happens over time.”

For the new study, researchers at Children’s Hospital of Philadelphia examined the medical records of 539 kids, average age 14.6 years, who were referred to pediatric kidney clinics because of high blood pressure readings. The kids were asked when they went to bed and when they got up in the morning. They were also asked to wear ambulatory blood pressure measuring devices, which took readings every 20 minutes while they were awake and every 30 minutes during sleep.

The further sleep duration was from recommended levels, the more likely it was for kids to experience high blood pressure during the day. Kids who went to bed late were also more likely to have hypertension. The findings were consistent regardless of the kids’ ages, sexes and BMI categories.

Too much sleep was also linked to blood pressure issues. Normally, blood pressure drops by around 10% during sleep, but that was less likely when kids slept longer than the recommended amount.  

Why can’t kids sleep?

Anxiety causes sleep problems for about 25% of children ages 1 to 6, according to a University of Michigan C.S. Mott Children’s Hospital National Poll. Those kids were less likely to have bedtime routines and more likely to leave on videos or TV shows, their parents reported in the poll, which was released Monday.

Another possible cause of sleep problems: An estimated 59% of kids weren’t turning off their electronic devices at night, the poll found.

It’s not so much the light from the devices that causes problems but rather what the kids are viewing on such devices. Apps like TikTok and Instagram can spoil sleep because they are “difficult to put down and are also stimulating,” Kogon said.

Reading a book on a device, for example, “is probably not the same as flipping through social media,” Kogon said.

Parents shouldn’t allow cellphones in kids’ bedrooms at night, Kogon said. She also suggests kids not have any kind of electronics or TVs in bedrooms.

Dr. Mariana Bedoya, an assistant professor of allergy, immunology, pulmonology and sleep medicine at Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Nashville, Tennessee, said other ways to help improve sleep include:

• Quitting caffeine at least six hours before bed.
• Keeping to regular sleep schedules.
• Avoiding naps for older kids.

“I tell patients not to change their sleep schedule by more than an hour and a half to two hours over the weekend,” said Bedoya, who wasn’t involved in the new study.

Love said it’s tough for kids to get enough sleep these days. “Is it that kids are worrying or eating bad things?” he asked. “There are so many things distracting them from sleep.”

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Choose the right type of chocolate and you also get a rare dessert that gets approval from dietitians.

June is National Candy Month, though chocolate really rules in October for Halloween, December for the holiday season, February for Valentine’s Day and spring for Easter.

But people love it year-round: the average American eats almost 10 pounds of chocolate per year, according to Forbes.

Many might not know chocolate comes from a fruit tree and is made from a seed — the cocoa bean, the National Confectioners Association notes.

What is the healthiest chocolate?

Of the three types of chocolate — dark, milk and white — dark chocolate is the healthiest, nutrition experts say.

“The health benefits of chocolate products are all thanks to the cocoa bean, which contains numerous phytochemicals shown to have anti-inflammatory, anticancer, and antihypertensive properties,” Whitney English, a registered dietitian at Whitney E. RD in Palo Alto, California, tells TODAY.com.

“The more cocoa solids a product contains, the more nutritious it is. Dark chocolate contains the most cocoa bean solids and therefore is the most nutrient-dense.”

Dark chocolate also has a higher content of flavonoids than milk or white chocolate, says Elisabetta Politi, a registered dietitian at the Duke Lifestyle and Weight Management Center in Durham, North Carolina.

Flavonoids function as antioxidants to block the damaging effects of free radicals, which have been linked to increased risk of heart disease and cancer, she notes.

“Additionally, flavonols, a type of flavonoids in dark chocolate, may affect the function of the immune system by reducing inflammation,” Politi tells TODAY.com.

Is 70% dark chocolate healthy?

Both experts recommend choosing chocolate with at least 70% cocoa content because it will have less added sugar and more phytochemicals than chocolate with less cocoa.

A 70% chocolate bar will list cocoa beans or one of its derivatives — cocoa solids or cocoa liquor — as the first ingredient, Politi says. If sugar is listed first, it means cocoa makes up less than 50% of the bar, she adds.

Dark chocolate benefits

Cocoa beans contain protein and are a great source of minerals like iron and magnesium, plus manganese, copper, zinc and phosphorus, TODAY.com previously reported. You get a bit of fiber, too — about 3 grams per 1 ounce of dark chocolate, according to the U.S. Department of Agriculture.

Chocolate is rich in polyphenols, beneficial compounds produced by plants.

Higher chocolate intake is associated with a lower risk of future heart problems, researchers reported in the journal Heart.

Reviews of studies have found chocolate consumption “significantly reduced” triglycerides — a type of fat in the blood — and can modestly lower blood pressure.

Cocoa flavanols protect against vascular disease and appear to improve blood flow to the brain, a study published in Scientific Reports noted.

Chocolate also has benefits for the mind.

Dark chocolate “contributes to producing the feel-good hormone serotonin and contains magnesium, which is linked to reducing anxiety” and relieving stress, Keri Glassman, a registered dietitian in New York, notes.

Eating 85% cocoa dark chocolate may also boost mood via the gut-brain connection, with dark chocolate having a prebiotic effect on healthy bacteria in the gut and possibly improving negative emotions that way, a study found.

Could it make you smarter? There’s a “surprisingly powerful” correlation between chocolate intake and the number of Nobel laureates in various countries — perhaps because chocolate “enhances cognitive function,” a study published in The New England Journal of Medicine found.

For example, Switzerland was the top performer when it came to both the number of Nobel laureates and the amount of chocolate its residents eat, the authors noted. (Other experts were very skeptical of the correlation.)

Dark chocolate side effects

When Consumer Reports tested 28 dark chocolate bars from a variety of brands in 2022, it found cadmium and lead in all of them — two heavy metals harmful to health. The levels weren’t extremely high, but they were detectable, the organization said when it released its test results.

The National Confectioners Association countered that chocolate is safe to eat and all the products tested were “in compliance with strict quality and safety requirements.”

Any harms from heavy metals seem to be outweighed by other positive compounds in dark chocolate, English notes.

If heavy metals are a concern, Politi suggests choosing milk chocolate, or varying both milk and dark.

Dark chocolate contains caffeine — about 23 milligrams in a 1-ounce square, according to the U.S. Department of Agriculture. If you eat four squares, that’s about the same amount of caffeine as drinking a cup of coffee.

And it’s still candy — it has fat and sugar, with 170 calories per ounce, so eating too much can lead to weight gain.

How much chocolate per day is OK to eat?

Politi recommends sticking to 1 ounce per day, or the size of a dental floss case.

English says a few squares of chocolate a day is a reasonable amount for most people.

How do you eat dark chocolate if you don’t like it?

If it’s too bitter, try putting two small pieces in your mouth and let them melt over your tongue, which helps discover the complexity of the dark chocolate flavor, Politi advises.

A dark chocolate bar that contains sea salt or dried fruit may also taste less bitter than plain dark chocolate, even if they contain the same amount of cocoa, she adds. Politi personally loves chocolate with orange flavor added.

Yogurt with fresh berries and some dark chocolate chips sprinkled on top is another option, English notes.

Both dietitians are fans of dipping fruit in melted chocolate.

Is chocolate unhealthy or healthy?

Dark chocolate contains nutritious components and its benefits likely outweigh any potential drawbacks as long as it’s consumed in moderation, English says.

If a person enjoys a sweet treat at night, choosing a few squares of dark chocolate over a bowl of ice cream is more beneficial, but it’s likely less healthful than a bowl of blueberries, she explains.

“If someone loves a treat at the end of a meal, I think a small amount of dark chocolate is a guiltless choice, which has been shown to provide health benefits,” Politi adds.

“(But) I wouldn’t say chocolate is a health food.”

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“I didn’t think much of it,” Salvador, now 21 of New Orleans, tells TODAY.com. “It was just getting bigger.”

As it grew, he worried that the mass was a sign something was seriously wrong. In the fall, he asked his mom about it, and she examined it. Concerned, she took Salvador to a hospital, and he eventually learned that he had stage 1 testicular cancer. He’s sharing his story so other young people with cancer feel less alone.

“Maybe someone will relate to it,” Salvador says. “Maybe somebody will find hope in my story.” 

A lump that keeps growing

Over the summer of 2020, Salvador noticed the bump but thought his body had just changed.

“I thought it was normal,” he says. Then it began growing, and he became worried. In October, he mentioned it to his mom, who believed they should visit the hospital.

“They did some scans. They did some checks,” Salvador recalls. “They said, ‘Yes, this is cancerous.’”

The doctors recommended removing both testicles, but Salvador’s mother balked at this. She hoped to someday have grandchildren and thought that this plan was too aggressive for her teen son. The two visited a doctor at Children’s Hospital of New Orleans for a second opinion. Doctors there shared some welcome news.

“They were like, ‘OK, we’re going to do the best to save one (testicle),’” Salvador recalls. “But the other one definitely has to come out.”

The doctor removed the testicle and several lymph nodes during surgery and diagnosed Salvador with stage 1 rhabdomyosarcoma, a type of soft tissue cancer that can occur in connective tissue or muscle, according to the National Cancer Institute.

“The biggest surgery was the one where they took out my lymph nodes,” he says. “They opened up the whole chest area, stomach area.”

Following that surgery, Salvador underwent radiation for a month and then eight months of chemotherapy with infusions once a week. Treatment felt tough at times.

“I lost my hair. I was nauseous,” he says. “I was pretty weak.”

Following the completion of chemotherapy, Salvador was cancer free. He had another surgery where they gave him a prosthetic testicle. While going through cancer treatment as a teen felt difficult, he was able to enjoy his final year in high school.

“(My) hair grew back,” he says. “My late senior year, everything went back to normal.” 

Testicular cancer

While Salvador’s cancer grew in his testicle, it’s not the same type of cancer often associated with testicular cancer diagnosis, such as the type that Lance Armstrong had, Dr. Pinki Prasad, oncologist and hematologist at Children’s Hospital New Orleans and one of Salvador’s doctors, tells TODAY.com.

“Ronal actually had a type of sarcoma, rhabdomyosarcoma, that can be found very often in the … testicular region,” she explains, adding that it’s more common in children than adults.

This type of cancer doesn’t have many noticeable symptoms other than a lump on the testicles — “usually painless, but it’s a bump that gets bigger with time and doesn’t get better,” Prasad says. “Sometimes it will be painful, and that’s what brings this to (their) attention.”

She estimates that, in 90% of cases of testicular rhabdomyosarcoma, a lump is the only sign. Prasad adds that “very rarely do we see pain with urination, blood in the urine.”

While Prasad says all pediatric cancers are considered rare, including testicular rhabdomyosarcoma, she urges boys to be aware of their bodies and say something if they notice any changes.

“Once they hit puberty, they should be checking their testicles at least once a month,” she says. “No one is going to know outside of them if there’s any changes, and so it’s really important for them to get used to knowing what’s normal for them.”

Treatment for testicular rhabdomyosarcoma includes surgery to remove the testicle with the cancer and lymph nodes, which can be followed by radiation and chemotherapy.

Like any cancer, patients diagnosed with rhabdomyosarcoma in early stages have good outcomes with lower risk of recurrence. Still, Prasad says doctors closely monitor people for several years.

“They resume their normal lives pretty quickly. They go back to school. They do all the things they want to do,” she says. “We do follow them for a very indefinite amount of time, and most of these patients are survivors.”  

With testicular cancer, people often feel hesitant to share symptoms with their family or doctor.

“There is a stigma,” Prasad says. “Most of these patients who have some sort of a testicular tumor do end up having a testicle removed, which can lead to some body issues.”

Prasad notes that prosthetic testicles are available, and more than half of her patients opt to have one. 

College and beyond

For years, Salvador hoped to become a doctor. After graduating from high school, he started college and is studying pre-med.

“I want to be a cardiologist,” he says. “When I was younger, I used to have a lot of heart issues, and I used to always see cardiologists. They always looked so happy.”

This summer, Salvador plans to work at his family’s business and read for fun. He hopes his story encourages others to be aware of their health.

“It’s important for everybody to learn about their bodies, how to examine it on their own,” he says. “It’s important to know how to take care of yourself.” 

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The workout is simple: Set the treadmill to an incline of 12 (or lower — choose a challenging incline for your fitness level!) at a speed of 3 miles per hour and walk for 30 minutes.

The routine doesn’t require a lot of time, but if done consistently it can improve endurance and aid in weight loss. One of the reasons why it is so popular is that it can deliver these results with absolutely no running required!

Walking is lower-impact and less likely to cause injury than running, and has many important benefits, such as lowering blood pressure and cholesterol, boosting metabolism, improving mental health by reducing anxiety and depression, and even lowering the risk of some cancers.

The 12-3-30 trend took off when health and beauty influencer Lauren Giraldo posted about it on YouTube in 2019 and then again on Tiktok in 2020, sharing that the workout helped her lose 30 pounds and keep it off.

“I used to be so intimidated by the gym. It wasn’t motivating, but now I go do this one thing and I can feel good about myself,” she said on TikTok. “I look forward to it. It’s my me-time.”

Giraldo’s emphasis on self-care and attainable fitness goals has resonated with a wide audience. Her initial post has over 2.8 million likes.

The influencer, who is not a fitness expert, chose the numbers 12, 3 and 30 because the highest incline on the treadmill at her gym was 12, she didn’t enjoy running and three miles per hour felt like a good, brisk walking pace to her, and her grandmother always advised to exercise at least 30 minutes each day.

Clearly, the incline and intensity in the workout are personal to her, so people should consider their own fitness level and goals when trying it, and make adjustments as needed.

Physical therapist Vijay A. Daryanani, a certified personal trainer at Spaulding Outpatient Center, a hospital that partners with Harvard Medical School, says the simplicity of walking for 30 minutes is an attainable goal that’s appropriate for most people.

“I think the 3 mph for speed is good for most people, but the incline is a critical piece,” Daryanani tells TODAY.com.

He recommends that people pay close attention to their posture while walking on an incline.

“When I’m training someone, I will adjust the incline safely and with guidance to maintain posture, balance and stride. Inclining a treadmill is similar to walking up hills, which places different stresses on the musculoskeletal system,” he says.

Here’s what to know about preventing injury and walking for weight loss if you’re ready to try the 12-3-30 workout yourself.

What is the “12-3-30” workout?

Giraldo’s workout is guided by three settings on the treadmill:

• Incline: 12
• Speed: 3 mph
• Time: 30 minutes

According to Giraldo’s TikTok video, she does the workout approximately five times per week and it helped her drop 30 pounds. “I obviously noticed the changes in my body, but I was most happy with the changes that I felt mentally,” she said. “I was proud of myself every day for getting on the treadmill and having my ‘me time’ for 30 minutes. I feel accomplished every time I do it.”

For Giraldo it served another important purpose: getting her comfortable stepping foot in the gym. “The thing about 12-3-30 is it made the gym so much less of a scary place. I feel confident in the gym now, and I sometimes incorporate weights and other exercises into my workout,” she said.

Benefits of the “12-3-30” workout

As previously reported by TODAY.com, walking comes with a myriad of health benefits including: Improving cardiovascular health and blood pressure, controlling blood sugar and reduce your risk of diabetes, increasing your metabolism, aiding in weight loss and maintenance and increasing your aerobic capacity.

The U.S. Department of Health and Human Services recommends moderate-intensity aerobic exercise for 150 to 300 minutes a week. Doing the 12-3-30 workout five times a week will get you into the low end of that range.

Walking is also a low-impact alternative to running, which is good for people with joint issues, but adding the incline to your walks increases the intensity and makes it a more challenging workout. It also has toning benefits for the lower body. “Walking on an incline will engage your leg muscles more than walking on level ground,” TODAY fitness contributor Stephanie Mansour previously wrote on TODAY.com. “This will make for a more intense workout for your glutes, hamstrings and quads, while also increasing your heart rate.”

Is the “12-3-30” workout safe?

At first, Giraldo couldn’t make it the full 30 minutes. “I definitely had to work up to the 30 minutes. I couldn’t get through it without losing my breath and started out by taking a break after the 10 or 15-minute mark,” she said.

Although 12-3-30 is a relatively straightforward treadmill workout, it isn’t something you should just jump right into, Dr. Dennis Cardone, osteopathic sports medicine specialist and chief of primary care sports medicine at NYU Langone Health, tells TODAY.com.

“If someone is working that hard with this workout and they are a 20-something, young and healthy, and they are struggling, you see it was a pretty significant workout,” Cardone says. “It’s just too much too soon and it should really have a recovery day as well.”

That’s not to say that there can’t be benefits to adding an incline to your workout. “It certainly adds more stress to a workout in the sense that people are getting more of a workout in a shorter period of time; the muscles are working harder,” says Cardone.

But, he adds, the risks may outweigh the benefit when it comes to adding a significant incline to your workout.

“The problem is people don’t think that walking is a stressor. They think ‘what’s the big deal using an incline? I’m only walking.’ But it really is a big stressor: low back, hamstring, Achilles tendon, knee, plantar fascia … these are the areas where we see some significant injury related to inclining a treadmill,” he says. “As a general observation, anytime anybody begins or changes a workout or adds something like an incline, they have to follow the rule to do it slowly, otherwise they are certainly at significant risk for an overuse injury.”

Can you lose weight with the “12-3-30” workout?

Giraldo says that she lost 30 pounds with the 12-3-30 workout and has kept it off for years.

Gradual, steady weight loss of about 1 to 2 pounds per week is optimal for keeping the weight off, according to the Centers for Disease Control and Prevention. “Generally to lose 1 to 2 pounds a week, you need to burn 500 to 1,000 calories more than you consume each day, through a lower calorie diet and regular physical activity,” the Mayo Clinic explains.

Walking for 30 minutes burns about 125 calories for a 150-pound person — and adding an incline will increase that calorie burn. So with healthy diet changes, the 12-3-30 workout has the potential to burn the calories needed for steady, gradual weight loss.

Want to give it a try? Follow these guidelines for a safe and effective workout

“(Giraldo) did well, but most people never make it there because they will get an overuse injury and will be taken out of the game. It’s a great goal, but it’s just not realistic for most of the population,” says Cardone. “If you just do one activity — we don’t have to bash just this one — but whatever activity, if you keep doing it day in and day out, it’s just a setup for injury.”

So instead of jacking that incline way up, here is the safe way to try Giraldo’s workout:

• Don’t be fooled by the treadmill: “People think the treadmill is so safe; it’s not outdoors, it’s a soft, forgiving surface. But it’s not that different from walking up a hill; you’re not protecting yourself that much more by being on a treadmill as opposed to being out on a road,” warns Cardone. “Thirty minutes walking up a mountain, it’s pretty tough when you think about it. People feel a little overconfident about the treadmill.”
• Adjust the numbers to meet you where you’re at. “Don’t incline so rapidly, maybe don’t even start at 30 minutes; 3 mph is reasonable, but maybe slow down your duration of workout and incline to work up to that,” suggests Cardone. “Start flat on a treadmill, and do 0-3-30. Once that is comfortable for you, then start inclining, don’t go to 12 right away. Over 3 weeks start slowly progressing your incline, maybe 10-20 percent per week.”
• If you’re new to fitness, start on flat ground. “If someone is outdoors and starting their workout program, whether it’s walking, jogging, interval training, don’t look for a hill,” says Cardone. “First, tolerate flat. Once you’re doing that, then if you want to add some hills into your workout, fine. But don’t go looking for hills at the start of a program.”
• Gradually increase incline: “Slowly progress your incline, start at the lowest setting and it’s a gradual increase, like any other workout in terms of increasing mileage or intensity,” says Cardone. “This workout starts at a 12-degree incline, so I’d say go at 4-degree intervals. So gradually increase it over a 3-week period to get to that 12 degrees.”
• Don’t do it every day. “Almost whatever the routine is, the general rule is there should be a recovery day or at least alternating with some other activity in order to try to avoid overuse injuries,” says Cardone. “I wouldn’t discourage people from doing some sort of activity most days of the week, just not the same activity. Have a recovery day where you are doing some sort of alternate activity, maybe that might be the elliptical trainer, a bicycle or in the swimming pool, whatever you have available.”
• Supplement with strength and stretching. The bent posture of walking uphill places stress on your low back, Achilles tendon, calf muscles, plantar fascia and hamstring muscles, says Cardone. “Those are stubborn problems and people don’t want those kind of injuries, once they kick in, they are tough to treat,” he says. He suggests doing core-strengthening exercises as well as stretching those areas specifically to help reduce your risk of injury while walking or running.
• Consider something lower impact. If you are just getting into fitness, Cardone advises starting with lower-impact workouts. “Bicycling, elliptical trainer, swimming, cross-training type activities, are even safer. Those are great activities to start a workout routine and build up your cardiovascular endurance; you’re not doing a lot of impact, it’s a little more forgiving on the joints and also on muscle tendons,” he says. “So maybe do the treadmill 2 or 3 days a week and the other days these other activities; that is going to keep people out of trouble.”

How many times a week should I do the “12-3-30” workout?

Even if you’re following these guidelines, the workout should still be done at most, every other day, alternating with other lower-impact activities.

In order to get the benefits you seek from any exercise — whether that be weight loss, toning or overall health — the key is to find a program you can stick with, said Cardone. That means the fitness routine you choose not only needs to be safe, so you’re not sidelined by an injury, but “it has to be something they enjoy, and if they are only doing one activity they are going to burn out, not just physically, but mentally,” he says.

More viral workout trends:

• The Taylor Swift treadmill strut
• The ab dance
• The stomach vacuum
• Cozy cardio

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Following years of public outcry about the high cost of inhalers, the two drugmakers — along with a third, GlaxoSmithKline —  have committed to capping the out-of-pocket cost at $35 a month. GSK’s cap is expected to take effect by Jan. 1.

The moves mirror similar steps taken by insulin manufacturers last year following the passage of the Inflation Reduction Act.

Like insulin, the cost of inhalers in the U.S. is significantly higher than in other wealthy countries. An investigation by the Democratic-led Senate Committee on Health, Education, Labor and Pensions noted AstraZeneca charges $645 in the U.S. for the same inhaler it charges $49 for in the U.K. Teva Pharmaceuticals, another major inhaler manufacturer, charges $286 in the U.S. for an inhaler that costs $9 in Germany.

Caycee Shapland, 29, from Omaha, Nebraska, spends at least $80 each month on her 4-year-old son Jackson’s Symbicort, an inhaler from AstraZeneca, to manage his asthma. He also takes albuterol, also from AstraZeneca, for his asthma.

Despite having health insurance, Shapland said the cost can balloon to $350 a month — a significant financial burden — depending on the severity of Jackson’s asthma.

“Going down from at least $80 a month to $35 a month is astronomical,” Shapland said. “I mean, feeding three young boys 5 and under is $300 a week on our groceries alone. So, it’s a lot of money.”

Dr. Alan Baptist, the division chief of allergy and immunology in the department of internal medicine at Henry Ford Health in Detroit, said the price caps for inhalers should provide significant financial relief for the 30% of his patients who can’t afford their medication.

“I applaud the companies for putting that out and I was surprised by it,” Baptist said.

High prices and lack of access to inhalers, he said, play a role in the racial disparities seen in asthma care, both in Detroit and nationwide.

While asthma rates are slightly higher in Black Americans than in white Americans, “when you look at the outcomes, the adverse events, it’s so much worse,” he said. Black children were 4.5 times more likely to be hospitalized for asthma than white children, and 7.6 times more likely to die from asthma, according to the federal Office of Minority Health.

‘Chaos for patients’

More than 27 million people in the U.S. have asthma, including 5 million children, according to the Asthma and Allergy Foundation of America.

Dr. Steven Stryk, an allergist-immunologist and associate professor of internal medicine at Oakland University William Beaumont School of Medicine, said that while the price caps are a big deal, he remains skeptical until he sees how they’re implemented.

“I think what you’ll find is most doctors saying I’ll believe it when it happens,” he said.

According to a spokesperson for AstraZeneca, both privately insured and uninsured patients will be eligible for the $35 price cap, which will apply to all of the inhalers the drugmaker sells in the U.S.

A spokesperson for Boehringer Ingelheim said the $35 cap will be automatically applied at the pharmacy counter for the majority of eligible patients with commercial insurance. For those without insurance or whose pharmacies aren’t participating, they’ll be able to visit the company’s website starting Saturday, where they can enroll in a copay card that will reduce the out-of-pocket cost to $35.

GSK’s price cap will go into effect later this year, a spokesperson said, and will be available to all patients, regardless of income.

People enrolled in government insurance programs, such as Medicare and Medicaid, won’t be eligible for any of the price caps due to federal restrictions.

Out-of-pocket costs for inhalers can vary widely, depending on the medication and insurance coverage, said Dr. Megan Conroy, a pulmonologist and critical care specialist at Ohio State University’s Wexner Medical Center. “It really creates a lot of chaos for patients.”

Kiowa Rix, 27, of Warren, Michigan, found herself with a $500 out-of-pocket price tag for her son Lucas’ inhaler — Flovent, from GSK — in February, when her insurance stopped covering the medication. The 6-year-old has severe asthma and needs to use an inhaler twice a day.

Lucas’ doctor switched him to a different inhaler, from Merck, which cost $80 a month. Rix is now switching him to Symbicort, which will be capped at $35.

“It makes me feel a little better that they’re realizing they’re overcharging,” Rix said of the price caps going into effect. “You shouldn’t have to go through all these hoops just to get something lowered that you or your child needs.”

While the price caps are significant, it’s unclear whether they’ll apply to the cost of all of a patient’s asthma drugs, or $35 per inhaler.

Patients, said Conroy of Ohio State, often require a rescue inhaler for quick relief, as well as a long-acting or maintenance inhaler to prevent symptoms.

“Patients have multiple medical comorbidities that they’re treating, and a longer list of medications beyond just inhalers for their respiratory disease, some of which carry similar stories of high copays,” she said.

Devastating consequences

The price caps should at least provide a sense of relief to families that qualify, said Dr. Ixsy Abigail Ramirez, a pediatric pulmonologist at University of Michigan Health. Some families, she said, have been forced to consider skipping, delaying or going without the medication because of the high cost, which can add up to thousands of dollars a month.

“Am I going to pay for food and the roof over my head this month? Or am I going to pay for an inhaler that my child requires to breathe so that we don’t end up in the hospital incurring other costs?” she said.

Cole Schmidtknecht typically spent around $5 for his inhaler. According to his father, Bil, one day when he tried to refill his prescription, he was told it would cost more than $500, which he couldn’t afford. Cole suffered a severe asthma attack days later, leading to a fatal cardiac arrest. He was 22.

“Had he had an affordable option in front of him, he’d have probably been here today,” said Bil.

Baptist, of Henry Ford Health, said that while the price caps are a step in the right direction, they don’t go far enough.

“In some ways, it’s just a Band-Aid on the bigger problem that we have,” Baptist said. “The real problem is the outrageous cost of pharmaceutical and drug prices in the United States.”

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The most common type of dementia, Alzheimer’s disease, affects nearly 6 million Americans and is expected to rise to 14 million by 2060 due to our aging population. Cognitive decline — an impairment of memory, decision-making and ability to learn — develops due to aging neurons and the slowing down of the speed at which the brain functions. It’s directly linked to the aging process and leads to worsening memory, attention and brain processing. 

Beyond the calories that are burned by running all the many functions of the brain, there are specific foods that help support our brain’s activity. Here’s what to know about so-called brain foods.

New research on foods and brain aging

A new study published in the journal Nature Aging points to specific nutrients that can contribute to slower aging in the brain. The 100 participants between 65 and 75 years old completed questionnaires, underwent various physical and cognitive tests, MRI scans and had their blood plasma drawn after fasting.

Researchers found that one group had signs of slower aging and also ate a specific nutrient profile. The nutrients in the blood that were prevalent in participants with slower aging were:

• Fatty acids, found in seafood and some healthy cooking oils
• Antioxidants, found in berries, garlic, tomatoes, nuts and plenty of other fruits and vegetables
• Carotenoids, found in spinach, kale, carrots, broccoli and some fruits
• Vitamin E, found in fruits, vegetables, seafood, seeds and nuts and more
• Choline, found in egg yolks, beef, dairy and some veggies

Many foods that make up the Mediterranean diet are high in these nutrients, the researchers noted. While most previous research on foods and brain health have relied on food questionnaires, this research is one of the first to use blood biomarkers, brain scans and cognitive testing.

What is the No. 1 best food for brain health?

As a registered dietitian, I would say this is the best food to boost your brain health:

Fatty fish

Studies have shown that eating just one seafood meal per week has been linked with a lowered risk of both Alzheimer’s and dementia. Our brains are mostly made up of omega-3 fatty acids called EPA and DHA, so it makes sense that foods that contain these fats would help support brain health.

Omega-3 has been shown to help protect the brain with its anti-inflammatory effects, ability to help create new neurons, and power to help clear the brain of plaques, one of the signs of Alzheimer’s. The best-known sources of EPA and DHA on the planet are high-quality seafood, like wild Alaskan salmon, sablefish and halibut. Sardines are another source of omega-3s. Wild-caught seafood is sustainably caught and also has lower contaminants than farm-raised seafood.

What foods help with brain health?

Eggs

The micronutrient choline is finally getting the attention it deserves for its role in brain health, including memory, thinking, mood and more. Higher levels of choline intake are thought to support brain function, which may decrease the risk of some types of dementia, including Alzheimer’s. One of the best dietary sources of choline is the egg. One large egg provides 150 milligrams, about 25% of the daily requirement for men and 35% for women.

You’ll find choline (plus nearly half of an egg’s protein and many other vitamins and minerals) in the yolk, so be sure to eat the whole egg. According to the American Heart Association, eggs can be included as part of a heart-smart diet for healthy adults. 

Walnuts

Research has found that eating walnuts may be linked with improved cognitive function and memory in groups at high risk for age-related cognitive impairment, and reduced risk of Alzheimer’s disease. The nut is also linked with a reduced risk of other diseases, such as cardiovascular disease or Type 2 diabetes, which are both risk factors for developing dementia. Whether you’re munching on walnuts for heart or brain health, you can feel good knowing that you’re covering both bases. 

Berries

Known for being rich in antioxidants and polyphenols, berries contain several disease-fighting compounds. Research has found that eating berries has a protective effect against cardiovascular disease, cancer and Alzheimer’s. A major contributor to Alzheimer’s and other chronic diseases is inflammation. Both strawberries and blueberries have anti-inflammatory benefits.

A study on strawberries found that when older adults, ages 60 to 75, were given the equivalent of 2 cups of strawberries daily for 90 days, they showed improvement in memory and learning tests. In a similar study, participants who ate the equivalent of 1 cup of blueberries daily were tested on verbal learning and task switching and had significantly fewer errors on both tests at 45 and 90 days. 

Prunes

Known for their gut health and bone benefits, prunes are also great for your brain. Prunes are high in potassium and a source of vitamin B6 and copper, all micronutrients that contribute to normal functioning of the nervous system. What’s more, studies on prunes show that the dried fruit has anti-inflammatory, antioxidant and memory-improving characteristics. The benefits are likely due to the high content of anthocyanin, a blue plant pigment. 

Citrus fruits

One of the markers of Alzheimer’sdDisease is neurodegeneration. The peel of a small citrus fruit from Okinawa, Japan called shikuwasa lime (also called citrus depressa) is rich in a plant compound called nobiletin. Nobiletin has been found to protect nerve cells and provide anti-inflammatory benefits and is looking promising as a potential treatment for Alzheimer’s. The good news is that this important compound can also be found in mandarins, oranges, tangerines and grapefruits. 

Cocoa powder and dark chocolate

Cocoa beans are rich in flavanols, which help fight inflammation in our body and can increase blood flow to the brain. Choosing dark chocolate over milk chocolate helps you get more of the protective polyphenols.

Extra virgin olive oil

As the staple of the Mediterranean diet, extra virgin olive oil is rich in polyphenols and vitamin E. A 2023 study done at the Harvard T.H. Chan School of Public Health found that daily consumption of more than half a tablespoon of EVOO had a 28% lower risk of dying from dementia compared to never or rarely consuming olive oil. The study also found that replacing just one teaspoon of margarine or mayo with the same amount of EVOO daily was associated with an 8 to 14% lower risk of dying from dementia. 

Tips to sharpen your memory 

In addition to what we eat, there are other habits to work on to support brain health, Dr. Andrew Budson, author of “Why We Forget and How to Remember Better,” tells TODAY.com.

Here are some strategies to remember things better:

• Focus your attention on whatever it is that you want to remember.
• Organize whatever it is that you want to remember, whether it is by reviewing the sights, sounds, smells, thoughts, and feelings of an experience or the material you need to memorize for a presentation or exam.
• Understand what you want to remember, such as the deeper meaning or implications of an episode of your life or the individual elements of your presentation or exam
• Relate what you are learning to things you already know or have experienced

In addition to the tips above, you may want to ditch some habits that can hinder memory over time, Budson says. These include:

• Not correcting bad habits immediately. Break bad habits right away or they will become part of your routine. For example, don’t leave your keys, wallet, cell phone where they are difficult to find— even once —or you may find yourself frequently hunting around the house looking for them.
• Not paying attention to where you are or what you are doing. This is the No. 1 reason people have trouble finding their car, keys, phone, etc. Stop and pay attention to where you parked and where you put down your keys, for example.
• Not engaging in aerobic exercise regularly. Aerobic exercise releases growth factors from the brain that help to grow new brain cells in the hippocampus, the part of the brain that forms new memories.
• Being sedentary and watching too much television. There are new studies that suggest that even when controlling for vigorous exercise, it is still important to not be sedentary and not to watch more than one hour of television per day.
• Eating too much unhealthy food. Everyone can get away with eating dessert, red meat, butter, soda, refined sugar and flour once in a while, but it is important that the majority of one’s diet be from the Mediterranean menu, including fish, olive oil, fruits, and vegetables, nuts and beans, and whole grains.
• While Budson doesn’t recommend any particular supplements for brain health, he does encourage people to have their vitamin D and B12 levels checked by your physician at least once every decade after age 40. Both vitamin D and B-12 are necessary for proper memory function.

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Americans under the age of 30 reported lower levels of happiness from 2021 to 2023 than those over the age of 60, according to this year’s World Happiness Report.

Jonathan Haidt, a social psychologist at New York University’s Stern School of Business, lays the blame squarely on our devices.

His new book, “The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness,” argues that the constant access to social media that phones have given us has led to social comparison, sleep deprivation and loneliness in Gen Z.

And it’s touched a nerve: his book is currently No. 3 on the New York Times nonfiction bestseller list.

Of course, as high-profile as the book has become, not everyone agrees with its thesis. Some critics argue blaming smartphones is an oversimplification and not fully supported by evidence

Zach Rausch, lead researcher to Haidt and an associate research scientist at NYU-Stern School of Business, says kids who had access to social media and iPhones in elementary and middle school are more anxious and less productive.

“The goal of technology is that it’s a tool that we use to meet our goals,” he says. “If it’s not doing that, it ends up using us at the cost of our goals.”

But, there are ways to curb these negative effects. Here are three things you can do today to increase your happiness and stay focused.

1. Buy an alarm clock.

Your phone being the last thing you interact with before bed and the first when you wake up can adversely affect your sleep and add to stress levels.

Purchasing an alarm clock and keeping your device outside your bedroom can create some physical and mental distance from social media.

2. Use your phone to meet with people in person.

Oftentimes, conversations on Instagram or text don’t cross over from digital to physical.

“We used flip phones to connect with each other in order to eventually meet in person,” Rausch says. “The online world is kind of the opposite. We connect in order to stay there. And our argument is that that’s not sufficient.”

Yale University happiness professor Laurie Santos echoes this sentiment.

“Every available study of happy people suggests that happy people are more social, they spend more time physically around other people, and they invest time in their friends and family members,” Santos, who teaches “The Science of Wellbeing” course at Yale told CNBC Make It.

3. Silence notifications.

Adolescents get 237 smartphone notifications a day, according to a 2023 study which surveyed 203 teens and tween between ages 11 and 17. Almost a quarter, 23%, arrived during school.

Silencing your notifications can help you stay present and productive during the hours it matters most.

Rausch emphasizes that getting rid of smartphones is not a panacea for depression. But, using your phone in a more thoughtful way can help you pursue activities that are proven to increase your happiness, like in-person social connection, and get more done.

“It’s not that we need to reject technology outright,” he says. “It’s that as technology is rapidly changing the way that we live our lives we need to press pause and think about how we want this to be in our lives. Is it fulfilling us? Is it helping us flourish? Is it helping us meet our goals? And, if not, what can we do to change it?”

Want to be a successful, confident communicator? Take CNBC’s new online course Become an Effective Communicator: Master Public Speaking. We’ll teach you how to speak clearly and confidently, calm your nerves, what to say and not say, and body language techniques to make a great first impression. Sign up today and use code EARLYBIRD for an introductory discount of 30% off through July 10, 2024.

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According to NBC News report published this week by the Centers for Disease Control and Prevention revealed new details of the outbreak, which occurred in July 2022 at a nine-person family reunion in South Dakota.

One family member brought meat to the reunion from a black bear hunted in northern Canada. The meat had been frozen in a household freezer for 45 days. Hunting black bears is legal in Canada and many U.S. states.

The family made kebabs with the thawed meat, alongside grilled vegetables. According to the CDC, the family had a hard time determining whether the kebabs were fully cooked, because the meat was dark in color. So it was unintentionally served and eaten rare.

A week later, one family member — a 29-year-old man in Minnesota — developed a fever, severe muscle pain and swelling around the eyes. He was hospitalized twice for his symptoms.

The man tested positive for antibodies to Trichinella, a type of roundworm. Five other family members also developed symptoms such as fevers, headache, stomach pain, diarrhea, muscle pain and swelling around the eyes.

Two others who’d been exposed did not develop symptoms, and the CDC could not confirm whether the ninth person had been exposed to Trichinella.

The CDC tested the remaining frozen meat and detected larvae from the same roundworm species.

The agency presumed that all six family members had trichinellosis, a disease caused by eating undercooked meat contaminated with Trichinella larvae.

Such infections are rare. From January 2016 to December 2022, the CDC identified seven trichinellosis outbreaks in the U.S. involving 35 probable or confirmed cases. Most were linked to bear meat.

Trichinellosis is not the same parasitic infection that presidential candidate Robert F. Kennedy Jr. recently revealed he once suffered from. Kennedy said the brain infection he got comes from pork tapeworm larvae.

Two of the infected people at the family reunion ate the vegetables without the meat, the CDC said. Trichinella-infected meat can result in cross-contamination, so meat and its juices should be separated from other foods during cooking.

Three of the family members were hospitalized, each of whom had consumed the bear meat. They received a treatment called albendazole, which kills parasitic worms and their larvae.

All six people recovered from the disease.

The CDC report warns that freezing meat won’t kill all species of Trichinella. The bear meat at the family reunion, for instance, was contaminated with a species found in Arctic bears that’s resistant to freezing.

“Persons who consume meat from wild game animals should be aware that that adequate cooking is the only reliable way to kill Trichinella parasites,” the report’s authors wrote.

The CDC recommends cooking wild game meat to an internal temperature of at least 165 degrees Fahrenheit, which should be verified with a meat thermometer — not by looking at the color of the meat.

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Nutritionists highly recommend starting your morning with foods that will keep you energized throughout the day like protein shakes and whole grain oats, experts told CNBC Make It last January. And cereal doesn’t fit that category.

“I never recommend cereal to my patients to have for breakfast, simply because it’s processed. I don’t recommend anything that’s processed,” said Dr. Nancy Rahnama, an internist and clinical nutritionist.

But cereal is a convenient choice if you’re short on time, Rahnama acknowledged. If you have only enough time to grab a bowl of cereal, reach for ones that are high in fiber and low in sugar, she advised.

Here is a list of cereals that are high in nutrients like fiber and protein and low in added sugar, according to a recent report by Healthnews.com.

Cereals with the most nutrients, lowest added sugar

Healthnews.com worked with nutrition scientist Lauryna Nelkine to compare the ingredients of the 15 most popular cereals in America, “taking into account their sales volumes and ratings on major American retailing platforms,” the report states.

These are the cereals that had the most nutrients, vitamins and minerals to support health, and the lowest amounts of added sugar.

• Highest in dietary fiber: Post Raisin Bran — 9 grams of fiber per serving
• Highest in protein: Special K Protein — 7 grams of protein per serving
• Highest in calcium and vitamin D: Multi Grain Cheerios — 200 milligrams of calcium and 4 micrograms of vitamin D
• Lowest in added sugar: Corn Flakes, Corn Chex and Special K Protein — 4 grams of sugar per serving each

Cereals with high levels of added sugar

Here are the cereals that stood out as having the highest amounts of added sugar (with 12 grams of added sugar per serving each):

• Lucky Charms
• Frosted Flakes
• Cinnamon Toast Crunch
• Froot Loops
• Reese’s Puffs
• Fruity Pebbles

Want to be a successful, confident communicator? Take CNBC’s new online course Become an Effective Communicator: Master Public Speaking. We’ll teach you how to speak clearly and confidently, calm your nerves, what to say and not say, and body language techniques to make a great first impression. Sign up today and use code EARLYBIRD for an introductory discount of 30% off through July 10, 2024.

Plus, sign up for CNBC Make It’s newsletter to get tips and tricks for success at work, with money and in life.

“The last thing you want is for people to go home and remember the beach trip because they got sick,” Dr. John Torres, NBC News senior medical correspondent, said on TODAY.

Leaving food unrefrigerated for a prolonged period can cause certain bacteria, like E. coli and and salmonella, to grow and make those consuming the food sick with diarrhea and vomiting. Between 40 and 140 degrees Fahrenheit is known as the food “danger zone” for this reason, according to the U.S. Department of Agriculture.

Even if you use a cooler, you may not be able to completely prevent the temperature of your food from reaching above 40 degrees Fahrenheit. That’s why Torres recommends leaving certain items at home and choosing safer beach foods instead.

Foods not to bring to the beach

Cold cuts that require refrigeration

If you’re packing sandwiches made with deli meats or cold cuts — such as sliced turkey, ham, chicken, roast beef, salami, bacon or bologna — these need to be refrigerated until they are ready to eat, says Torres.

Although deli meats are often cured and processed to help prevent spoilage and contamination, they can still contain bacteria that can make you sick and multiple rapidly in warm temperatures, TODAY.com previously reported.

Keeping them in a cooler can make this food choice less risky, but once you take them out of the refrigerated environment, eat them right away.

Fresh salads

Fruits and vegetables contaminated with salmonella, E. coli, listeria and other bacteria are responsible for a large chunk of foodborne illness in the U.S., according to the U.S. Centers for Disease Control and Prevention.

Washing produce can reduce the amount but doesn’t entirely eliminate dangerous bacteria, which love to multiply in warm, most environments — like an airtight container holding salad on the beach.

Anything mayo-based

“Mayo-based potato salad is always one of those big things that cause a lot of issues,” says Torres.

Although it’s bought from a non-refrigerated shelf, mayonnaise does need to be refrigerated, and any salad or dish containing mayo can only be left out at temperatures above 40 degrees Fahrenheit for two hours before it should be discarded, according to the USDA.

Ideally, mayo-based foods should be refrigerated until they are served, says Torres. So it’s probably wise to avoid bringing these dishes to the beach entirely and enjoy them at home instead.

Raw meat

Grilling is a favorite beach activity for many. But bringing a bunch of raw hamburger meat or chicken that will sit around at various temperatures before it is barbecued is not the best idea due to the risk of bacteria growing. In general, Torres recommends against bringing raw or uncooked meats to the beach ever.

If you do decide to bring raw meat, store it properly in a cooler below 40 degrees Fahrenheit until it’s ready to be cooked, and keep it sealed and separate from any other foods that won’t get cooked in the cooler.

According to USDA guidelines, beef should be cooked to a minimum internal temperature of 145 degrees Fahrenheit, poultry to 165 degrees Fahrenheit and fish to 145 degrees Fahrenheit.

Precut fruits

Precut fruit is notorious for containing foodborne pathogens, such as salmonella. These include include papayas, peaches, and a major culprit, melon — including honeydew, cantaloupe and an all-time beach favorite, watermelon.

Cutting the fruit can transfer bacteria on the surface of the fruit into the flesh, where it can grow and multiply, especially in hot beach weather, TODAY.com previously reported.

Sliced fruit can also get warm faster and draw insects, says Torres. Instead of buying presliced fruit for your next beach trip, bring the whole thing and cut it up at the beach instead — just make sure you have clean hands and use a clean knife and cutting board.

Food safety tips for the beach

Many foods can be totally safe for the beach as long as you practice certain food safety precautions. Here’s some advice to keep in mind from Torres and the USDA:

• Perishable foods should never sit out of refrigeration for more than two hours, and if temperatures are 90 degrees are higher, no more than one hour.
• When packing, take food out of the fridge or freezer and put it immediately into the cooler. Aim to keep food refrigerated right up until you eat it.
• Try to avoid leftovers by only packing the amount you plan to consume.
• If you do choose to bring raw meat, season it at home, and keep it tightly wrapped in a place where any juices that may drip cannot get on to other foods, such as the bottom of the cooler.
• Pack drinks in a separate cooler from food so the food is exposed to warm temperatures less often.
• Try to fill your cooler all the way, packing extra ice if necessary, as this will keep its contents cool for longer.
• Bring a food thermometer if you are cooking at the beach.

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The male worker had been in contact with cows at a farm with infected animals. He experienced mild eye symptoms and has recovered, U.S. and Michigan health officials said in announcing the case Wednesday.

A nasal swab from the person tested negative for the virus, but an eye swab tested Tuesday was positive for bird flu, “indicating an eye infection,” U.S. Centers for Disease Control and Prevention officials said.

The worker developed a “gritty feeling” in his eye earlier this month but it was a “very mild case,” said Dr. Natasha Bagdasarian, Michigan’s chief medical executive. He was not treated with oseltamivir, a medication advised for treating bird flu, she said.

The risk to the public remains low, but farmworkers exposed to infected animals are at higher risk, health officials said. They said those workers should be offered protective equipment, especially for their eyes.

Health officials say they do not know if the Michigan farmworker was wearing protective eyewear, but an investigation is continuing.

The first case happened in late March, when a farmworker in Texas was diagnosed in what officials called the first known instance globally of a person catching this version of bird flu from a mammal. That patient also reported only eye inflammation and recovered.

Since 2020, a bird flu virus has been spreading among more animal species — including dogs, cats, skunks, bears and even seals and porpoises — in scores of countries.

The detection in U.S. livestock earlier this year was an unexpected twist that sparked questions about food safety and whether it would start spreading among humans.

That hasn’t happened, although there’s been a steady increase of reported infections in cows. As of Wednesday, the virus had been confirmed in 51 dairy herds in nine states, according to the U.S. Agriculture Department. Fifteen of the herds were in Michigan.

The CDC’s Dr. Nirav Shah said the case was “not unexpected” and it’s possible more infections could be diagnosed in people who work around infected cows.

U.S. officials said they had tested 40 people since the first cow cases were discovered in late March. Michigan has tested 35 of them, Bagdasarian told The Associated Press in an interview.

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Shah praised Michigan officials for actively monitoring farmworkers. He said health officials there have been sending daily text messages to workers exposed to infected cows asking about possible symptoms, and that the effort helped officials catch this infection. He said no other workers had reported symptoms.

That’s encouraging news, said Michael Osterholm, a University of Minnesota epidemiologist who has studied bird flu for decades. There’s no sign to date that the virus is causing flu-like illness or that it is spreading among people.

“If we had four or five people seriously ill with respiratory illness, we would be picking that up,” he said.

The virus has been found in high levels in the raw milk of infected cows, but government officials say pasteurized products sold in grocery stores are safe because heat treatment has been confirmed to kill the virus.

The new case marks the third time a person in the United States has been diagnosed with what’s known as Type A H5N1 virus. In 2022, a prison inmate in a work program picked it up while killing infected birds at a poultry farm in Montrose County, Colorado. His only symptom was fatigue, and he recovered. That predated the virus’s appearance in cows.

More severe symptoms of seasonal allergies this spring are likely due to a warmer winter and an earlier start of allergy season, says Dr. Purvi Parikh, an allergist and immunologist with the Allergy & Asthma Network.

And the cause of this longer, more intense allergy season? Climate change.

“There’s higher amounts of pollen due to rising greenhouse gasses and more CO2 in the air, which plants thrive off of,” Parikh tells CNBC Make It.

Allergens like pollen, dust and mold can cause swelling in your nasal passages, Shelby Harris, a licensed clinical psychologist and director of sleep health at Sleepopolis, told CNBC Make It in April of 2023.

“Your body mistakes allergens as a threat to the body, so then you have histamine that is released and that essentially can make you have the nasal swelling, the congestion and the scratchy throat,” Harris said.

Here are some effective ways to alleviate your allergy symptoms and still enjoy the spring.

1. Optimize your home to reduce pollen spread

Peak pollen times are in the early morning, so it’s best to keep your windows closed during those hours. Having your windows shut can prevent allergens from entering and circulating in your living space.

“When coming home, change clothes, take off shoes and shower to avoid bringing pollen into [the] house with you,” Parikh says.

Harris also provided seven tips for keeping your home as pollen-free as possible:

• Avoid using ceiling fans in your bedroom to reduce dust circulation
• Vacuum often
• Change your sheets once a week
• Use an air purifier
• Keep your hamper with your clothes you’ve worn outside out of your bedroom
• Use hypoallergenic bedding
• Try not to dry clothes outdoors if you can

2. Use these recommended medications

If you’re experiencing allergy symptoms, Parikh suggests grabbing medications from your local pharmacy, noting that even generic brands can work if well-known brands are sold out.

Here are a few of the allergy medications that she recommends:

• Claritin
• Zyrtec
• Xyzal
• Allegra
• Flonase
• Astepro
• Alaway
• Pataday

“Any cough, wheezing, chest pain [or] shortness of breath should not be treated with over-the-counter medications and [you] should see a physician,” Parikh says.

“This could be asthma which is deadly, and allergies are the most common cause.”

3. Try local honey

There are only a small number of studies that have tested the effectiveness of local honey on alleviating allergy symptoms, and lack of funding may be the reason, Dr. Timothy Wong, board-certified family medicine doctor and medical expert for JustAnswer, told Make It last April.

“Unfortunately when you’re not using medications that have billions of dollars of funding for research and development, you don’t get as many clinical trials,” Wong said.

A small study with 40 participants in 2013 found that eating honey each day, in combination with allergy medication as needed, was associated with less allergy symptoms after eight weeks, compared to taking just allergy medication on its own.

The logic behind using local honey specifically for allergy symptoms is that “if you ingest the pollens that bring you discomfort, you build up an immunity against them,” Andew Cote, head beekeeper at Andrew’s Honey, told CNBC Make It.

“One spoon a day every morning is the recommended dosage,” Cote added.

It’s better to start eating local honey a few weeks before you began experiencing allergy symptoms the previous year, Wong said.

Children under the age of one should not be given honey, the American Academy of Pediatrics strongly warns. And people who are allergic to bees and wasps should also avoid trying local honey for their allergies, Wong said, because “there are some cases where people who have bee allergies can also get allergies from honey.”

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“I had a deadline, and I thought, ’I don’t know if I can sit still this long,’” said Hutchins, who was working as a radio journalist.

At the urging of her father, a longtime practitioner, she tried again and managed to finish a 10-minute video on her third attempt. “I remember feeling this sense of joy and relaxation,” she said. “I used to be that person who said, ‘I can’t meditate.’”

Hutchins has since become a certified meditation teacher — and serves as an example that busy, restless people who try once should try again. Research shows a daily meditation practice can reduce anxiety, improve overall health and increase social connections, among other benefits.

The trick is to get over that initial barrier. Experts say it’s more achievable when you throw common misconceptions out the window. For instance, many people try meditation only once because they feel they’re doing it wrong or that they can’t turn off their brain.

That’s not the point, says Tara Brach, who holds a doctorate in psychology and has trained more than 7,000 people to be meditation teachers.

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“It’s not about stopping thoughts. The mind generates thoughts the way body creates enzymes,” she said. “It’s about being able to get larger than the thoughts and witness them.”

Start Simple

There is no right way to meditate, Brach stressed.

The key is to relax and focus on something in the present moment. Feel your breath pass through your nostrils, listen to a guided recording, mentally scan your body from head to toe, repeat a loving phrase to yourself or try countless other techniques.

You can sit on the floor, in a chair or on a cushion. If you can’t get comfortable, lie down. You don’t even need to close your eyes, though it’s recommended to try.

There is no standard amount of time to begin with, but set an achievable goal.

“You can customize it to who you are,” said Brach, author of several books, including “Radical Acceptance: Embracing Your Life With the Heart of a Buddha.”

“Start with the most you can comfortably do without having to feel like you want to quit,” she said

That could mean starting with as little as a few minutes, said John Mitchell, an associate professor in psychiatry and behavioral sciences at Duke University who uses meditation to treat patients with ADHD. The goal should be working meditation into a routine and focusing on the quality of the practice, not the quantity.

“Then the question is, what do we do to create success so we can have momentum and start off without feeling like you’re failing right way?” he said.

When you can’t sit still

When you inevitably get distracted — everyone does — notice the thought or urge to move, acknowledge it and bring your attention back to where you are.

Instead of judging yourself, get curious for a minute about the nature of restlessness, Brach said. Ask yourself, “What does it really feel like if I want to jump out of my skin?”

Then take a long, deep breath, and sit for one more minute. If you still want to move, then move. But Brach recommended doing so mindfully. Stand up, do a light stretch, take a deep breath and sit again. You will be surprised at how that sense of restlessness will change over time, she said. “It will evolve.”

If the restlessness builds to a point where you are uncomfortable, consider taking a slow, meditative walk, Mitchell said. Stay alert but calm, focusing on the sounds, sights and smells around you, or maybe on the sensation of the wind and sun on your face.

“You’re not restricted,” he said. “You don’t have to sit there in silence and be still all the time.”

Tomorrow, and the next day, try again

After sticking through the first session, you will almost certainly feel calmer, no matter the length. But to get the full benefits, as with exercise, research shows you need to practice consistently.

For people having trouble starting, that can be daunting, but Brach suggested trying a few techniques to find the right fit.

“It takes a bit of experimentation to find the style of meditation that works for your particular body, mind and personality,” she said.

Luckily, there’s a universe of free meditation resources online.

“Nobody reading this needs to go buy anything,” she said.

The oldest living person of Japanese descent in the United States, according to the Gerontology Research Group, Miwa prefers to focus on the times when she was happiest. She’s lived through the Spanish flu, prohibition, Black Tuesday, World War II, and the losses of her parents, siblings and friends, and still the supercentenarian’s go-to piece of longevity advice is: Don’t dwell.

Miwa is part of the nisei — the second-generation Japanese Americans sent to internment camps during World War II — who often say “gaman,” which translates to “enduring the seemingly unbearable with patience and dignity,” Alan Miwa, her son, tells TODAY.com. It’s often loosely translated to “perseverance,” “patience,” or “tolerance.”

These feelings, Alan Miwa suspects, are born from the resilience of many from his mother’s generation — who had much to endure. Shikata ga nai (仕方がない), a Japanese phrase meaning, “It cannot be helped,” or, “Nothing can be done about it,” is a common saying among them, too, he adds.

Yoshiko Miwa was born Yoshiko Tanaka on Feb. 28, 1914, in Guadalupe, California, to Japanese immigrants. She was the fifth of seven children. When her mother and infant brother died in 1919, her father struggled to care for his family and tend to the farm he owned. So Yoshiko Miwa and her siblings were sent to live at the children’s home founded by their parish, Guadalupe Buddhist Church.

She went on to graduate from Santa Maria High School in 1932, and she studied business at the University of California, Berkeley, graduating in 1936. She married Henry Miwa in 1939.

During the Second World War, the pair and their families were sent to Poston Internment Camp in Arizona before relocating to Hawthorne, California, after the war. When they, along with many other Japanese people, had difficulty finding work upon their release in 1945, her husband founded a plant nursery business, and in 1963, Yoshiko Miwa got her nursing license.

Yoshiko Miwa has three sons, 10 grandchildren, 20 great-grand children and one great-great-grandchild.

These days, Alan Miwa says she’s in good health and lives in a care facility, where she gets her hair done weekly and attends church services on Sundays.

In addition to a positive spirit, keeping your mind and body active is the key to a long life, Yoshiko Miwa has said in the past. Ahead she shares a few other aspects of her life that she believes have led to her longevity.

She keeps an ever-expanding roster of hobbies

When Yoshiko Miwa retired, she’d walk 4 miles each morning. In 1990, at 76, she walked a 20K as part of the March of Dimes Walkathon. She’s an avid reader, she practices ikebana (flower arranging), sumi-e (Japanese ink art), sashiko (Japanese stitching), sewing, furniture refinishing and reupholstery.

These days, though, her favorite activity is sleeping, she tells TODAY.com via email.

She wrote an autobiography

After taking a writing course, Yoshiko Miwa penned an autobiography. In it, she recalls her travels to Rome, Japan, Paris and Niagara Falls. She describes life in the children’s home and the long walks to school, her siblings and her childhood with her parents.

“We had a big pasture for the horses and cows to graze on,” she wrote of her family’s farm her in autobiography. “Some days, my sister and I would wander around the pasture to pick wild violets that grew there.”

She loves to eat noodles

Yoshiko Miwa’s a fan of any kind of noodles, eating them every day. “When I was in the children’s home, the cook used to make noodles and I used to love them,” she says. “Today, I like spaghetti, udon, ramen, soba and any other kind of noodles.”

Her faith energizes her

Yoshiko Miwa is grateful to Rev. and Mrs. Issei Matsuura of the Guadalupe Buddhist Church, who took her in when her mother died of the Spanish flu.

Yoshiko Miwa was 4 years old when her father turned to the church for help. “The church then started a children’s home and taught us Buddhism, Japanese language, Japanese culture and responsibility,” she recalls. “I’ve always been indebted to Rev. and Mrs. Matsuura.”  

… And her family does, too

The Miwa family travels together and hosts reunions. “I’ve been fortunate that my sons, my grandchildren, my great grandchildren and relatives have always been there for me,” says Yoshiko Miwa.

“Because my mother died so young, I have never enjoyed the warmth and love of a family unit,” she wrote in her autobiography. “Later, when I had my children, I keenly felt the wholesomeness of a complete family.”

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Since March 25, when the bird flu virus was confirmed in U.S. cattle for the first time, weekly sales of raw cow’s milk have ticked up 21% to as much as 65% compared with the same periods a year ago, according to the market research firm NielsenIQ.

That runs counter to advice from the Food and Drug Administration and the Centers for Disease Control and Prevention, which calls raw milk one of the “riskiest” foods people can consume.

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“Raw milk can be contaminated with harmful germs that can make you very sick,” the CDC says on its website.

As of Monday, at least 42 herds in nine states are known to have cows infected with the virus known as type A H5N1, federal officials said.

The virus has been found in high levels in the raw milk of infected cows. Viral remnants have been found in samples of milk sold in grocery stores, but the FDA said those products are safe to consume because pasteurization has been confirmed to kill the virus.

It’s not yet known whether live virus can be transmitted to people who consume milk that hasn’t been heat-treated.

But CDC officials warned last week that people who drink raw milk could theoretically become infected if the bird flu virus comes in contact with receptors in the nose, mouth and throat or by inhaling virus into the lungs. There’s also concern that if more people are exposed to the virus, it could mutate to spread more easily in people.

States have widely varying regulations regarding raw milk, with some allowing retail sales in stores and others allowing sale only at farms. Some states allow so-called cowshares, where people pay for milk from designated animals, and some allow consumption only by farm owners, employees or “non-paying guests.”

The NielsenIQ figures include grocery stores and other retail outlets. They show that raw milk products account for a small fraction of overall dairy sales. About 4,100 units of raw cow’s milk and about 43,000 units of raw milk cheese were sold the week of May 5, for instance, according to NielsenIQ. That compares with about 66.5 million units of pasteurized cow’s milk and about 62 million units of pasteurized cheese.

Still, testimonies to raw milk are trending on social media sites. And Mark McAfee, owner of Raw Farm USA in Fresno, California, says he can’t keep his unpasteurized products in stock.

“People are seeking raw milk like crazy,” he said, noting that no bird flu has been detected in his herds or in California. “Anything that the FDA tells our customers to do, they do the opposite.”

The surge surprises Donald Schaffner, a Rutgers University food science professor who called the trend “absolutely stunning.”

“Food safety experts like me are just simply left shaking their heads,” he said.

From 1998 to 2018, the CDC documented more than 200 illness outbreaks traced to raw milk, which sickened more than 2,600 people and hospitalized more than 225.

Raw milk is far more likely than pasteurized milk to cause illnesses and hospitalizations linked to dangerous bacteria such as campylobacter, listeria, salmonella and E. coli, research shows.

Before milk standards were adopted in 1924, about 25% of foodborne illnesses in the U.S. were related to dairy consumption, said Alex O’Brien, safety and quality coordinator for the Center for Dairy Research. Now, dairy products account for about 1% of such illnesses, he said.

“I liken drinking raw milk to playing Russian roulette,” O’Brien said. The more times people consume it, the greater the chance they’ll get sick, he added.

Despite the risks, about 4.4% of U.S. adults — nearly 11 million people — report that they drink raw milk at least once each year, and about 1% say they consume it each week, according to a 2022 FDA study.

Bonni Gilley, 75, of Fresno, said she has raised generations of her family on raw milk and unpasteurized cream and butter because she believes “it’s so healthy” and lacks additives.

Reports of bird flu in dairy cattle have not made her think twice about drinking raw milk, Gilley said.

“If anything, it is accelerating my thoughts about raw milk,” she said, partly because she doesn’t trust government officials.

Such views are part of a larger problem of government mistrust and a rejection of expertise, said Matthew Motta, who studies health misinformation at Boston University.

“It not that people are stupid or ignorant or that they don’t know what the science is,” he said. “They’re motivated to reject it on the basis of partisanship, their political ideology, their religion, their cultural values.”

CDC and FDA officials didn’t respond to questions about the rising popularity of raw milk.

Motta suggested that the agencies should push back with social media posts extolling the health effects of pasteurized milk.

“Communicators need to make an effort to understand why people consume raw milk and try to meet them where they are,” he said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The money is also intended to encourage testing of both dairy cows and the people who work closely with them — a key step, experts said, in understanding the true scope of bird flu, also known as H5N1, across the U.S.

“Incentives work very well to get a better understanding of epidemiology,” said Katelyn Jetelina, who tracks illnesses for a website called “Your Local Epidemiologist.”

Right now, there is no requirement for dairy cows to be tested unless they’re being moved across state lines, according to a recent federal order. Otherwise, the decision is left to farmers.

So far, only about 80 cows among the 26,000 dairy herds in the U.S. have been tested under the federal order, which went into effect at the end of April, Department of Agriculture Secretary Tom Vilsack said Friday in a media briefing. It was unclear how many of those 80 had tested positive.

As of Friday, 42 herds in nine states — Colorado, Idaho, Kansas, Michigan, New Mexico, North Carolina, South Dakota, Ohio and Texas — had been affected by the outbreak.

“Those 42 family farm operations are suffering, and we want to make sure we’re there to provide help and assistance,” Vilsack said.

The USDA will offer $98 million to affected farms over the next four months, which could equate to as much as $28,000 per farm, Vilsack said.

Jetelina called the program “a fantastic step” but “way overdue.” The outbreak among dairy cattle was first announced at the end of March.

“The incentive program is a huge leap forward,” especially for smaller farms, said Dr. Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory. It’s likely not enough, however, for larger farms that could lose upward of $3 million with a bird flu outbreak, he said.

“This is not going to get fixed tomorrow,” he said. But incentives “like this lay the groundwork for it to be better, and it also gives us precedent if and when we deal with the next large outbreak.”

The Department of Health and Human Services will put in an additional $101 million to ramp up monitoring of people who have been exposed to sick animals, contact tracing and genetic testing of the virus to watch for mutations.

Part of those funds will also go toward wastewater surveillance of the virus. The Centers for Disease Control and Prevention is expected to start posting that data publicly as early as Monday, a CDC spokesperson told NBC News.

A separate monitoring system called WastewaterSCAN, which tracks 191 sites in 41 states, is showing high levels of influenza A in the Midwest and Northeast. That’s unusual for mid-May, well past the typical flu season. The bird flu is a type of influenza A virus.

Those findings prompted the WastewaterSCAN researchers to look more closely at wastewater sites in Texas, where it’s believed the bird flu outbreak began.

Further testing indicated that, at the sites in Texas, “what we were seeing was most likely attributable to an H5 influenza virus,” said Marlene Wolfe, an assistant professor of environmental health at Emory University and program director for WastewaterSCAN.

While wastewater testing can detect influenza A, it can’t distinguish whether the virus came from a human or an animal, according to the CDC.

The findings, coupled with recent announcements that fragments of the bird flu virus had been detected in 1 in 5 samples of pasteurized milk, indicate that bird flu may be spreading undetected. Further testing confirmed that the milk, along with other pasteurized dairy products including sour cream and cottage cheese, were safe to eat or drink.

Just one person, a dairy worker in Texas, has tested positive for the virus during the current outbreak. His illness was mild, and his only symptom was pinkeye.

But experts have suggested that other cases could be going undetected. Friday’s incentives announcement included a $75 payment to any farm worker who agrees to give blood and nasal swab samples to the CDC.

Meanwhile, experts said the risk of bird flu spreading among the general public remains low.

“Stay aware, but only let it take up a small part of your brain,” Jetelina said. “There is a good probability that this will fizzle away.”

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After being diagnosed with stage 4 cancer, the high school football coach and counselor started chemotherapy in 2023, but he had to stop abruptly when the drug he received, cisplatin, became harder to find as part of a nationwide shortage of chemotherapy drugs.

“I just keep wondering, ‘What if we had gotten the cisplatin? Could it have slowed his cancer down? she tells TODAY.com. “Would he have been able to coach even more? Would he have been stronger? Would he have felt better? … It’s always a second guess.” 

In 2022, Jeff Bolle, of Milwaukee, learned he had bile duct cancer, which has a dismal long-term survival rate. At the time, doctors hoped that surgery and chemotherapy could prolong his life. He was in good health prior to his diagnosis, which made everyone feel optimistic.

He underwent surgery and four rounds of chemotherapy before the chemotherapy shortage stopped his treatment in May 2023 — two rounds short.

As the months passed and his cancer progressed unchecked, Jeff Bolle became sicker. In late September 2023, doctors realized “there was really nothing else they could do, which was hard to hear,” Connie Bolle recalls. There was no immunotherapy. There was no other chemotherapy.”

Jeff Bolle died on Dec. 29, 2023, seven months after losing access to his chemo drugs.

Last summer, Jeff Bolle shared his story with TODAY.com to raise awareness of the chemotherapy shortage. He also shared his desire to coach at least one more football season. He achieved that — and it was even sweeter than he could have imagined.

“The Marquette University High School ended up winning the division one state championship football title, and they were not predicted to be the one (to win),” Connie Bolle says. “Jeff made it to every single one of the games.”

Stage 4 cancer diagnosis

When Jeff Bolle felt the twinge of back pain in October 2022, he thought he pulled a muscle while exercising. But later that year, he was diagnosed with stage 4 bile duct cancer.

He underwent surgery, where doctors removed most of the tumor, and then started immunotherapy and chemotherapy, even though he knew he would likely never be cured.

“My doctor said it was the type of cancerous growth you’ll never really get into remission,” Jeff Bolle told TODAY in 2023. “Their thoughts were that they could get most of the tumor out and they could use chemo … to hold it off.”

The Bolles understood this. Still, it felt devastating when Jeff Bolle stopped treatment because of the chemotherapy shortage.

“He was never able to get on cisplatin (again),” Connie Bolle says. “His cancer was just continuing to grow, and his bile ducts were getting compromised because the cancer was pushing on them even more. He was really getting so very sick. It was horrible.”

Although he felt too weak to work as a counselor, Jeff Bolle continued coaching football. Prior to becoming sick, he’d ride to practice on his motorcycle, wearing sleeveless shirts to show off his biceps. He often hit the weight room with the players and challenge them to bench presses. Even when sick, Jeff Bolle continued to show up for his players at least several times a week and at games.

Eventually, he needed a wheelchair to attend the games and sat on the sidelines, but he coached the defensive backs for as long as he could. No matter what, he always rated the game film after. In fact, Connie Bolls recalls that during one stay in the intensive care unit, he brought his laptop to grade a football game.

Connie Bolle says she believes he lived to finish this season.  

“He knew how important it was for these high school kids,” she says. “Some of the seniors had journeyed with Jeff for four years.”  

The team kept winning, ending up at the state championship in November.

“I don’t know how Jeff did it because he could barely stand honestly. At that point, he was probably down to about 140 pounds,” Connie Bolle says. “The cold was just intense, and he went up and down the sideline with his walker.”  

Chemotherapy shortage

Last year, cancer patients, like Jeff Bolle, and oncologists faced some grim news: Many chemotherapy drugs and agents used in oncological imaging had become increasingly difficult to find.

The most impactful shortages were of chemotherapeutic agents carboplatin and cisplatin, often used in cancers that can’t be cured, Dr. William Dahut, chief scientific officer of the American Cancer Society, told TODAY.com in 2023.

But shortages of cancer therapeutics are not new.

“What we’re experiencing right now is really the latest of multiple waves of shortages that have really gone back a decade,” Mark Fleury, Ph.D., who works in policy development and emerging science at the American Cancer Society Cancer Action Network, tells TODAY.com.

“We have many drugs that have never really left shortage and some that cycle in and cycle back out (of shortages).”

Last summer, NBC News reported that 14 drugs used in cancer treatment were hard to come by. In April 2024, the U.S. Food and Drug Administration website indicates that 15 oncology agents are currently in shortage.

Asked about the status of the chemo shortage, FDA spokesperson Chanapa Tantibanchachai shared an email statement with TODAY.com that says:

“The FDA recognizes the potential impact that lack of availability of certain products may have on health care providers and patients. While the agency does not manufacture drugs, and cannot require a pharmaceutical company to make a drug, make more of a drug, or mandate who a pharmaceutical company chooses to sell its product to (among lawful purchasers), the public should rest assured the FDA is working closely with numerous manufacturers and others in the supply chain to understand, mitigate and prevent or reduce the impact of intermittent or reduced availability of certain products.”

FDA Commissioner Dr. Robert Califf told NBC News in May 2023 that the main reason for the chemo shortage is there’s not enough profit in producing these drugs, many of which are generic and do not have a patent. “A number of firms are going either out of business, or they’re having quality problems because of difficulty investing in their technology,” Califf said.

While carboplatin and cisplatin are “still listed in shortage,” Fleury says last year the FDA allowed imports of cisplatin that helped assuage that shortfall, and the drugs are now being produced more widely in the U.S.

“We’re not seeing the type of shortage that we did,” Fleury says. “We qualify it as in shortage, but … patients are getting their drugs.”

How chemo drug shortages affect cancer patients

Cancer patients felt the shortages. A survey by the American Cancer Society Cancer Action Network published in December found that 10% of all cancer patients were impacted, but the “shortages were not felt equally,” Fleury says.

For example, people on Medicaid experienced a tougher time, with 22% reporting a cancer drug shortfall affected their treatment. Some reported struggling to find pain medications or other therapies not directly used to treat their cancer but still important, he notes.

“Folks just had no idea whether they were going to get their next treatment or not, whether the dose was going to be cut in half,” Fleury says. “These are drugs … have really formed the backbone (of cancer care) and in some case have pretty high efficacy. And if they’re not available, you’re entering uncharted territory.”

While patients grappled with a high “mental toll,” they also faced “logistical tolls,” too, with some patients driving around to find treatment, he says.

“There are patients today who need help,” Fleury adds. “We need to figure out how to better manage the crisis that we’re in, but we also need to address some of the underlying causes, which keep us in this constant state of crisis.”

Lawmakers have taken some steps to address this issue. While many bills often provide short-term solutions, the Senate Finance Committee has been “doing a deeper dive” to address constant shortages, Fleury explains.

“The government has an important role to solve this,” Fleury says. “(But) that’s not to say that the private sector can’t.”

A lasting impact

By Dec. 14, 2023, Jeff Bolle was in hospice at home. Connie Bolle knew he was nearing the end on Dec. 28, when he agreed to stay in a hospital bed on the first floor because he was too weak to get to their bedroom on the second floor. He died the next day.

“He only spent one night in it,” she says. “That was the sign of defeat.”

At his funeral, his players shared what Jeff Bolle meant to them.

“They said such amazing things about the strength and determination and perseverance (they learned) from Jeff and kindness and love and compassion,” she says.

Connie Bolle believes that her husband would be humbled hearing about the impact he had on his students. She also believes he would be proud that his story raised awareness of the shortage of cancer therapeutics.

“He really cared about other people not getting these chemotherapy drugs,” she says. “He would still be sad today that people are still dealing with this.”

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The proposal had come after wide-ranging studies found an association between some of the ingredients in hair-smoothing and hair-straightening products, which are used mostly by Black women, and cancer. 

It is unclear why the FDA has not released its proposed ban. The agency did not respond to requests for comment by NBC News. 

The FDA has previously told NBC News, “the Unified Agenda estimates the action date for the NPRM as April 2024. We are still developing the proposed rule and cannot comment further about questions of timing or content at this time.”

In 2022, a decadeslong study by the National Institutes of Health of more than 33,000 Black women showed an increase in uterine cancer among those who regularly used hair relaxers. 

Several women who had uterine cancer or other severe illnesses joined class-action lawsuits against major beauty product manufacturers, including L’Oreal and Revlon. Thousands of women allege that the hair products’ ingredients caused them to develop uterine cancer or other severe health problems. 

Revlon did not comment on this article. Previously, Revlon told Reuters that the company does not “believe the science supports a link between chemical hair straighteners or relaxers and cancer.”

A L’Oreal spokesperson told NBC News on Wednesday it doesn’t have formaldehyde in its products and that it would welcome the FDA ban.

“Our highest priority is the health and wellbeing of all our consumers,” the company said in a statement. “Our products are subject to a rigorous scientific evaluation of their safety by experts who also ensure that we strictly follow all regulations in every market in which we operate.”

Formaldehyde is used in many household products, including some topical medicines and cosmetics such as some nail polishes, hair gels, baby shampoos and others. Not all chemical hair-straighteners include it, but many do include components that, once heated, can release formaldehyde. It is highly toxic and linked to certain cancers, according to the National Cancer Institute.

“About 50% of products advertised to Black women contain these types of chemicals, compared to maybe only 7% that are advertised to white women,” Harvard T.H. Chan School of Public Health’s Tamarra James-Todd said in a radio interview in 2020. 

According to the FDA’s comments on the proposal, the use of products containing formaldehyde and other formaldehyde-releasing chemicals “is linked to short-term adverse health effects, such as sensitization reactions and breathing problems, and long-term adverse health effects, including an increased risk of certain cancers.”

Last year, Democratic Reps. Ayanna Pressley of Massachusetts and Shontel Brown of Ohio sent a joint letter to the FDA commissioner urging more regulation over hair relaxers marketed toward Black women. 

“As a result of anti-Black hair sentiment, Black women have been unfairly subjected to scrutiny and forced to navigate the extreme politicization of hair,” Brown and Pressley wrote. “Hence, generations of Black women have adapted by straightening hair in an attempt to achieve social and economic advancement.”

In an exclusive statement to NBC News, Pressley urged the FDA to finalize the ban. 

“The FDA’s proposal to ban harmful chemicals in hair relaxers is a win for public health — especially for the Black women whose health has been disproportionately put at risk due to systemic racism and anti-Black hair sentiment,” she said. “We have been pressing for this and the Administration should finalize this rule without delay.”

Melanie Benesh, the vice president of government affairs for the Environmental Working Group, a consumer product advocacy group, described the field of cosmetics as the “Wild, Wild West of regulation” since the FDA has historically had more limited authority over them, “compared to other items under their jurisdiction, like food and drugs,” Benesh said.

Her organization petitioned the FDA in 2011 and in 2021 to ban hair products with formaldehyde. Because the FDA has been long aware of the issue, she added, “this is one thing that they have clear authority to do. They can ban ingredients that are clearly adulterating products, that are clearly making that product unsafe for use.”

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The agency has been conducting tests on 297 pasteurized retail dairy products after findings last week showed that fragments of the virus had gotten into the commercial milk supply.

The tests showed that the products didn’t contain live virus that could make people sick, the FDA said Wednesday.

The new results, though still preliminary, “affirm the safety of the U.S. commercial milk supply,” Don Prater, acting director of the FDA’s Center for Food Safety and Applied Nutrition, said during the briefing. The samples come from 38 states.

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In addition, the FDA has tested powdered infant and toddler formulas and found no evidence of bird flu virus. It was unclear how many formula samples were tested.

Prater said the latest findings confirm that the pasteurization process inactivates the virus, making it unable to infect people. The FDA is also testing raw milk for live virus, though it strongly advises against drinking raw, unpasteurized milk.

Bird flu has now been detected in 36 dairy herds in nine states: Colorado, Idaho, Kansas, Michigan, New Mexico, North Carolina, South Dakota, Ohio and Texas.

Those cases appear to have all originated among herds in Texas, then spread as cattle were moved across state lines to other farms.

In affected herds, about 10% of the cows show symptoms, Dr. Rosemary Sifford, chief veterinary officer at the U.S. Department of Agriculture, said during the call. Most recover on their own within about two weeks, she said.

Sifford said that it appears the virus spreads between cows through affected raw milk, which contains high levels of the virus.

There is no evidence yet that this strain of the bird flu, called H5N1, spreads easily from person to person. But the concern is that the longer the virus spends in mammals, it could mutate into a form that does.

For now, Sifford said, that doesn’t seem to be happening.

“We are not seeing any changes in the virus that would indicate it is in a position to be more easily spread between people,” Sifford said.

The risk to the general public remains low, said Dr. Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases.

One person, a dairy worker in Texas, has been diagnosed with the virus since the outbreak was detected in dairy cows. The person’s case was mild and the only symptom was conjunctivitis, or pink eye.

The Centers for Disease Control and Prevention said Wednesday that more than 100 people have been asked to monitor themselves for symptoms for 10 days after coming into contact with an infected animal.

Around 25 have been tested for the virus, Daskalakis said.

He said there is no indication of “unusual flu activity in people, and that includes avian influenza.”

But there have been reports that other cases may have gone undetected.

Multiple dairy workers in Texas were sick with fevers, body aches, upset stomach and eye infections at the same time the bird flu was working its way through cows in Amarillo, Dr. Barb Petersen, the veterinarian who discovered what was making the animals sick, previously told NBC News.

No hospitalizations or deaths have been reported.

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Bird flu has been found in nearly three-dozen dairy herds across nine states. The new testing is the latest effort by the USDA to track and understand how the virus is spreading among livestock.

Two studies will test if particles of the bird flu virus, called Type A H5N1, is found in beef for sale in the states where dairy cows have tested positive or in the muscles of dairy cows sent to slaughter. A third will test how cooking meat at different temperatures affects the virus using a bird flu surrogate.

A week ago, the U.S. Food and Drug Administration confirmed it found non-infectious remnants of the bird flu virus in pasteurized milk. The particles are inactive and pose no threat to consumers, experts said.

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Scientists say there’s no evidence to suggest people can get bird flu by consuming food that’s been pasteurized or properly cooked.

The virus was first found in dairy cows this spring, and since then, H5N1 was detected in the lung tissue of a dairy cow culled and sent to slaughter.

So far, officials with the U.S. Centers for Disease Control and Prevention have not seen signs that the virus is changing to be more transmissible to people. Two farmworkers have been infected with bird flu since the outbreak began.

AP Health Writer JoNel Aleccia contributed to this report.

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Previously, the task force had said women could choose to start breast cancer screening as young as 40, with a stronger recommendation that they get the exams every two years from age 50 through 74.

The announcement Tuesday from the U.S. Preventive Services Task Force makes official a draft recommendation announced last year. The recommendations were published in the Journal of the American Medical Association.

“It’s a win that they are now recognizing the benefits of screening women in their 40s,” said Dr. Therese Bevers of MD Anderson Cancer Center in Houston. She was not involved in the guidance.

Other medical groups, including the American College of Radiology and the American Cancer Society, suggest mammograms every year — instead of every other year — starting at age 40 or 45, which may cause confusion, Bevers said, but “now the starting age will align with what many other organizations are saying.”

Breast cancer death rates have fallen as treatment continues to improve. But breast cancer is still the second-most common cause of cancer death for U.S. women. About 240,000 cases are diagnosed annually and nearly 43,000 women die from breast cancer.

The nudge toward earlier screening is meant to address two vexing issues: the increasing incidence of breast cancer among women in their 40s — it’s risen 2% annually since 2015 — and the higher breast cancer death rate among Black women compared to white women, said task force vice chair Dr. John Wong of Tufts Medical Center in Boston.

“Sadly, we know all too well that Black women are 40% more likely to die from breast cancer than white women,” Wong said. Modeling studies predict that earlier screening may help all women, and have “even more benefit for women who are Black,” he said.

Here are more details on what’s changed, why it’s important and who should pay attention.

When should I get my first mammogram?

Age 40 is when mammograms should start for women, transgender men and nonbinary people at average risk. They should have the X-ray exam every other year, according to the new guidance. Other groups recommend annual mammograms, starting at 40 or 45.

The advice does not apply to women who’ve had breast cancer or those at very high risk of breast cancer because of genetic markers. It also does not apply to women who had high-dose radiation therapy to the chest when they were young, or to women who’ve had a lesion on previous biopsies.

What about women 75 and older?

It’s not clear whether older women should continue getting regular mammograms. Studies rarely include women 75 and older, so the task force is calling for more research.

Bevers suggests that older women talk with their doctors about the benefits of screening, as well as harms like false alarms and unnecessary biopsies.

What about women with dense breasts?

Mammograms don’t work as well for women with dense breasts, but they should still get the exams.

The task force would like to see more evidence about additional tests such as ultrasounds or MRIs for women with dense breasts. It’s not yet clear whether those types of tests would help detect cancer at an earlier, more treatable stage, Wong said.

Does this affect insurance coverage?

Congress already passed legislation requiring insurers to pay for mammograms for women 40 and older without copays or deductibles. In addition, the Affordable Care Act requires insurers to cover task force recommendations with an “A” or “B” letter grade. The mammography recommendation has a “B” grade, meaning it has moderate net benefit.

So far, the risk to humans remains low, officials said, but scientists are wary that the virus could change to spread more easily among people.

The virus, known as Type A H5N1, has been detected in nearly three dozen dairy herds in eight states. Inactive viral remnants have been found in grocery store milk. Tests also show the virus is spreading between cows, including those that don’t show symptoms, and between cows and birds, according to the U.S. Department of Agriculture.

Starting Monday, hundreds of thousands of lactating dairy cows in the U.S. will have to be tested — with negative results — before they can be moved between states, under terms of a new federal order.

Here’s what you need to know about the ongoing bird flu investigation:

Why is this outbreak so unusual?

This strain of what’s known as highly pathogenic avian influenza has been circulating in wild birds for decades. In recent years, it has been detected in scores of mammals around the world. Most have been wild animals, such as foxes and bears, that ate sick or dying birds. But it’s also appeared in farmed minks. It’s shown up in aquatic mammals, such as harbor seals and porpoises, too. The virus was even found in a polar bear in northern Alaska.

The virus was discovered in ruminants — goats and then dairy cows — in the U.S. this spring, surprising many scientists who have studied it for years.

“When we think of influenza A, cows are not typically in that conversation,” said Richard Webby, an influenza expert at St. Jude Children’s Research Hospital.

How long has bird flu been spreading in cows?

Flu viruses are notorious for adapting to spread among new species, so detection in dairy cows raises concerns it could spread to people, Webby said.

Scientists confirmed the virus in cows in March after weeks of reports from dairy farms that the animals were falling ill. Symptoms included lethargy, sharply reduced milk supply and changes to the milk, which became thick and yellow.

Finding remnants of the virus in milk on the market “suggests that this has been going on longer, and is more widespread, than we have previously recognized,” said Matthew Aliota, a veterinary medicine researcher at the University of Minnesota.

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Under pressure from scientists, USDA officials released new genetic data about the outbreak this week.

The data omitted some information about when and where samples were collected, but showed that the virus likely was spread by birds to cattle late last year, said Michael Worobey, an evolutionary biologist with the University of Arizona.

Since then, it has spread among cattle and among farms, likely through contact with physical objects such as workers' shoes, trucks or milking machines, Worobey said.

And then the cows spread the virus back to birds, he said.

“The genetic evidence is as clear as could be,” Worobey said. "Birds that are sampled on these farms have viruses with clear mammalian adaptations."

What do scientists say about efforts to track the outbreak?

Several experts said the USDA's plans to require testing in cows are a good start.

“We need to be able to do greater surveillance so that we know what's going on,” said Thomas Friedrich, a virology professor at the University of Wisconsin's veterinary school.

Worobey said the ideal would be to screen every herd. Besides looking for active infections, agriculture officials also should be looking at whether cows have antibodies to the virus, indicating past infections, he said.

"That is a really accessible and quick way to find out how widespread this is,” he said.

More testing of workers exposed to infected animals is also crucial, experts said. Some farm owners and some individual workers have been reluctant to work with public health officials during the outbreak, experts have said.

“Increased surveillance is essentially an early warning system,” Aliota said. “It helps to characterize the scope of the problem, but also to head off potentially adverse consequences."

How big a risk does bird flu pose for people?

Scientists are working to analyze more samples of retail milk to confirm that pasteurization, or heat-treating, kills the H5N1 virus, said Dr. Don Prater, acting director of the FDA's food safety center. Those results are expected soon.

While the general public doesn't need to worry about drinking pasteurized milk, experts said they should avoid raw or unpasteurized milk.

Also, dairy farm workers should consider extra precautions, such as masking, hand washing and changing work clothes, Aliota said.

So far, 23 people have been tested for the virus during the outbreak in dairy cows, with one person testing positive for a mild eye infection, CDC officials said. At least 44 people who were exposed to infected animals in the current outbreak are being monitored for symptoms.

What are scientists' concerns for the future?

David O’Connor, a virology expert at the University of Wisconsin-Madison, likened recent bird flu developments to a tornado watch versus a warning.

“There are some of the ingredients that would be necessary for there to be a threat, but we’re not there,” he said. As with a tornado watch, "you wouldn’t change anything about how you live your daily life, but you would maybe just have a bit of increased awareness that something is happening.”

Worobey said this is the kind of outbreak “that we were hoping, after COVID, would not go unnoticed. But it has."

He said ambitious screening is needed "to detect things like this very quickly, and potentially nip them in the bud.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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A London-based dentist has sparked an online debate after advising against three situations that many regard as good times to brush your teeth.

The video, posted by Dr. Shaadi Manouchehri, clinical director at Smart Dental and Aesthetics Clinic in the U.K., has garnered more than 12 million views on TikTok, leaving many incredulous that they were brushing wrong all this time.

She recommends not brushing your teeth directly after vomiting and eating breakfast or sweets.

“I’ve ALWAYS brushed after vomiting,” one shocked TikTok user exclaimed.

“So then why have we ALWAYS been taught to brush out teeth after meals?” one quipped.

“Ah, yes, the three times I want to brush my teeth more than any other time,” another lamented.

So, do other dentists agree with Manouchehri’s assessment? TODAY.com spoke with a few experts to find out.

Acid and brushing your teeth

The argument against not brushing your teeth in certain scenarios is “all about the acid,” Dr. Tien Jiang, assistant professor of oral health policy and epidemiology at Harvard School of Dental Medicine, tells TODAY.com via email.

Many people think cavities come from sugar, but it’s not the direct cause, she says. It’s acid, which can remove the minerals, a process called demineralization, from the tooth’s outer layer, also known as enamel.

“Acid can come from many places — vomit … carbonated drinks, sucking on lemons, etc.,” Jiang explains.

The bacteria that break down the food you eat also release acid. As a result, “it’s natural for the pH of our mouths to drop when we eat, while the bacteria get to work to break down our food.”

Brushing while there’s too much acid in the mouth can damage your teeth.

“People should never brush when your mouth has a very low pH because you don’t want to then scrub that acid into your teeth,” Dr. Beth Caunitz, a dentist in New York City, New York, tells TODAY.com.

Should you brush directly after vomiting?

Many of the experts TODAY.com interviewed recommend waiting to brush your teeth after vomiting.

“Vomit contains stomach acids, which can soften and dissolve the outer layer of your teeth,” says Dr. Diana Nguyen, chief of clinical general dentistry at UCSF School of Dentistry.

“If you brush after vomiting, you’d actually be spreading the acid around to more of your enamel and risk stripping layers of enamel off your teeth with your toothbrush, which can cause the teeth to appear more yellow over time.”

One easy hack that she recommends is a simple homemade rinse.

Add a teaspoon of baking soda to a cup of water, swish it around in the mouth and then spit it out, she says. “This can help buffer the acids and protect your teeth.”

Rinsing after vomiting also reduces how long your teeth will be exposed to acid. A fluoride mouthwash in particular can help re-mineralize the enamel, and then you can brush your teeth sooner, adds Dr. Carlos González-Cabezas, professor and associate dean for academic affairs at the University of Michigan School of Dentistry.

Should you brush after you eat breakfast?

“When we eat, the mouth becomes acidic, as the bacteria in our mouth also feed on the food we eat and metabolize this to an acid, therefore dropping the pH of the mouth,” Manouchehri tells TODAY.com.

“If we brush straight away, we are rubbing this acid onto the teeth, which … can be damaged,” she says.

Our saliva naturally buffers this acidic state over approximately 30 to 60 minutes, so she recommends waiting at least that long to brush.

Jiang agrees: “Waiting 30 (minutes) after eating anything (not just breakfast or sweets) to brush is a normal instruction.”

“In these conditions, tooth enamel is softened, so you could actually damage your teeth by brushing them right after eating,” she explains. “In the meantime, you can drink water and rinse with mouthwash to help clear food particles away from your teeth and gums.”

However, Gonzalez-Cabezas says the impact on the enamel of brushing right after eating is likely minimal. The most important thing is that you brush your teeth at some point every morning.

Should you brush immediately after eating sweets?

Some experts recommend waiting at least an hour after eating sweets to brush your teeth to give your mouth time to wash away the acid, according Mayo Clinic.

Anything with sugar can increase the amount of acid in your mouth, but examples include soft drinks, sports drinks, sour candies, and citrus juices and fruits.

People should also avoid brushing right after having carbonated beverages, as they’re acidic, Caunitz warns.

Instead of brushing your teeth after eating sweets, Caunitz recommends drinking a glass of water because the water will rinse off all the unwanted acid.

However, Gonzalez-Cabezas says that brushing your teeth after eating sweets helps remove potentially harmful sugars that can damage the enamel sooner. Thanks to the toothpaste, brushing right after will also provide fluoride to your teeth, which promotes remineralization.

For those who enjoy sweets or snacking on sugary foods, Nguyen recommends the following:

• Drinking plenty of water
• Using a toothpaste that contains a remineralizing agent like fluoride
• Visiting your dentist regularly to monitor for tooth decay and other dental conditions

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Ana Estrada fought for years in Peruvian courts for the right to die with dignity, and became a celebrity in the conservative country where euthanasia and assisted suicide are illegal.

In 2022 Estrada was granted an exception by the nation’s Supreme Court, which upheld a ruling by a lower court that gave Estrada the right to decide when to end her life, and said that those who helped her would not be punished. Estrada became the first person to obtain the right to die with medical assistance in Peru.

“Ana’s struggle for her right to die with dignity has helped to educate thousands of Peruvians about this right and the importance of defending it,” her lawyer, Josefina Miró Quesada, said in a statement. “Her struggle transcended our nation’s borders.”

Estrada, 47, suffered from polymyositis, a disease that wastes away muscles and has no cure.

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She began to present the first symptoms as a teenager and started to use a wheelchair at the age of 20 because she had lost the strength to walk.

Despite these obstacles Estrada obtained a psychology degree and became a therapist. She earned enough money to buy her own apartment and became independent from her parents.

By 2017 however, Estrada’s condition worsened and she could no longer get up from her bed.

She had difficulty breathing and survived pneumonia. And even though she could not type, Estrada used transcription software to produce a blog called “Ana for a death with dignity,” where she discussed her struggles and her decision to seek euthanasia.

“I am no longer free,” she said in an interview with the Associated Press in 2018. “I am not the same person I was before.”

With the help of Peru’s Human Rights Ombudsman, Estrada won a lawsuit that gave her the right to die with euthanasia. From her bed, she participated in court sessions through video conferences.

Estrada told judges in 2022 that she valued life, and did not want to die immediately, but wanted to have the freedom to decide when to end her life.

“I want to accede to euthanasia when I can no longer sustain suffering in life,” she said. “And when I decide to bid farewell to my loved ones in peace and with tranquility.”

Only a handful of countries have legalized euthanasia, including Canada, Belgium and Spain. Some U.S. states including Maine and Oregon allow physician-assisted suicide, where a doctor provides a terminally ill patient with the means to end life.

Euthanasia is illegal in most Latin American countries, except for Colombia, which legalized it in 2015 and Ecuador, which decriminalized the practice in February.

According to NBC News, in the study of people ages 65 and older, 8.15% of women treated by female physicians died within 30 days, compared with 8.38% of women treated by male physicians. 

Although the difference between the two groups seems small, the researchers say erasing the gap could save 5,000 women’s lives each year. 

The study included nearly 800,000 male and female patients hospitalized from 2016 through 2019. All patients were covered by Medicare. For male hospitalized patients, the gender of the doctor didn’t appear to have an effect on risk of death or hospital readmission.

The data alone doesn’t explain why women fare better when treated by other women. But other studies suggest that women are less likely to experience “miscommunication, misunderstanding and bias” when treated by female doctors, said lead study author Dr. Atsushi Miyawaki, a senior assistant professor of health services research at the University of Tokyo Graduate School of Medicine.

The new research is part of a growing field of study examining why women and minorities tend to receive worse medical care than men and white patients. For example, women and minority patients are up to 30% more likely to be misdiagnosed than white men.

“Our pain and our symptoms are often dismissed,” said Dr. Megan Ranney, dean of the Yale School of Public Health. “It may be that women physicians are more aware of that and are more empathetic.”

Research shows that women are less likely than men to receive intensive care but more likely to report having negative experiences with health care, having their concerns dismissed, and having their heart or pain symptoms ignored, the authors wrote in the new study. Male physicians are also more likely than female doctors to underestimate women’s risk of stroke.

Part of the problem, Miyawaki said, is that medical students get “limited training in women’s health issues.”

Dr. Ronald Wyatt, who is Black, said his 27-year-old daughter recently had trouble getting an accurate diagnosis for her shortness of breath. An emergency room physician told her the problem was caused by asthma. It took two more trips to the emergency room for his daughter to learn that she actually had a blood clot in her lungs, a potentially life-threatening situation.

“There is a tendency for doctors to harbor sexist stereotypes about women, regardless of age, such as the notion that women’s symptoms are more emotional or their pain is less severe or more psychological in origin,” said Wyatt, former chief science and chief medical officer at the Society to Improve Diagnosis in Medicine, a nonprofit research and advocacy group.

Women seem to experience fewer of these problems when treated by other women.

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For example, a study published JAMA Surgery in 2021 found that women patients developed fewer complications if their surgeon was female. Another JAMA Surgery study published in 2023 found all patients had fewer complications and shorter hospital stays if they were operated on by female surgeons, who worked more slowly than their male counterparts.

Women primary care doctors also tend to spend more time with their patients, Ranney said. Although that extra attention is great for patients, it also means that women see fewer patients per day and earn less, on average, than male doctors.

Dr. Ashish Jha, dean of the Brown University School of Public Health, said several studies suggest that female doctors follow medical evidence and guidelines, and that their patients have better outcomes. 

“There’s lots of variation between women and men physicians,” said Jha, who was not involved in the new study. Women “tend to be better at communication, listening to patients, speaking openly. Patients report that communication is better. You put these things together, and you can understand why there are small but important differences.”

The authors of the study said it’s also possible that women are more forthcoming about sensitive issues with female physicians, allowing them to make more informed diagnoses.

That doesn’t mean that women should switch doctors, said Dr. Preeti Malani, a professor of medicine at the University of Michigan. For an individual patient, the differences in mortality and readmission rates seen in the new study are tiny.

“It would be a mistake to suggest that people need to find physicians of the same gender or race as themselves,” Jha said. “The bigger issue is that we need to understand why these differences exist.”

Malani said she’s curious about what women doctors are doing to prevent patients from needing to be readmitted soon after discharge. “How much care and thought is going into that discharge plan?” Malani asked. “Is that where women are succeeding? What can we learn about cultural humility and asking the right questions?”

Others aren’t convinced that the new study proves a physician’s gender makes a big difference.

Few hospitalized patients are treated by a single doctor, said Dr. Hardeep Singh, a professor at Baylor College of Medicine in Houston and a patient safety researcher at the Michael E. DeBakey VA Medical Center.

Hospital patients are treated by teams of physicians, especially if they need specialist care, in addition to nurses and other professionals, Singh said.

“How often do you see the same doc every day in the hospital?” Singh asked. “The point is that it’s not a one-man or one-woman show. Outcomes are unlikely to depend on one individual, but rather on a clinical team and the local context of care. … One name may appear on your bill, but the care is team-based.”

However, Singh said his research on misdiagnoses shows that doctors in general need to do a better job listening to patients.

Jha said he’d like the health system to learn what women doctors are doing right when they treat other women, then teach all physicians to practice that way.

“We should train everyone to be better at generating trust and being worthy of trust,” Jha said.

Wyatt said the country needs to take several steps to better care for women patients, including “de-biasing training” to teach doctors to overcome stereotypes. The health care system also needs to increase the number of women physicians in leadership, recruit more female doctors and do a better job at retaining them. All physicians also need more understanding of how adverse childhood experiences affect patient health, particularly for women, he said.

“More than once I’ve had white female patients tell me they came to be because I listened and they trusted me,” Wyatt said.

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“He was telling me, ‘Oh my neck is really hurting me,’” wife Lauren Barchanowicz, 38, of Finleyville, Pennsylvania, tells TODAY.com. “I’m like, ‘I think you should probably get it checked out.’”

The couple visited the emergency room where doctors found an orange-sized mass in his chest. Len Barchanowicz had a thymoma, a type of cancer of the thymus.  

“I thought I was a dead guy, honestly. Even how she presented it to me because she said she couldn’t tell if it was attached to my aorta,” Len Barchanowicz tells TODAY.com. “I thought honestly I was going in for an emergency surgery.”

Neck pain reveals underlying problem

As a mailman in the Pittsburgh area, Len Barchanowicz spends a lot of his time walking. When he began experienced stinging pain in his neck he wondered if he somehow pinched a nerve. Then on a humid August day, he felt like he couldn’t breathe easily.   

“I started having almost like chest pains, but not heart related but above where your heart would be,” Len Barchanowicz says.

At first, he attributed that to the weather, but Lauren Barchanowicz, a nurse, worried something more serious was occurring. She examined him and didn’t think he was having a heart attack. Still, it felt concerning.

“He’s like, ‘Oh it’s getting better,’” Lauren Barchanowicz says. “I’m like, ‘I don’t know. I think you should probably get checked out.’”

At the emergency room, it soon became clear something serious was occurring as doctors ran a slew of tests on him.

“I thought maybe they found like a clog or something was going on heart related,” he says.

While an X-ray didn’t show anything, a doctor had a hunch that something else was occurring and ordered a CT scan with contrast. That test revealed an orange-sized mass nestled in his chest above the heart.

“It was a shock,” Lauren Barchanowicz says.

At first, the oncologists thought he had Hodgkin’s Lymphoma, a type of cancer that begins in the lymphatic system which works to protect the body from infection.

“(When) you read the report on the CT, it is very unclear,” Lauren Barchanowicz says. “The only thing that they could say is there is a big mass.”

The surgical team mentioned something called a thymoma, too, but the diagnosis remained mysterious. His blood test had markers for Hodgkin’s Lymphoma and he no other symptoms consistent with cancer.

“They give you the cancer checklist,” Len Barchanowicz says. “Like, is there is a sudden weight loss? Do you have night sweats? Do you feel nauseated? I wouldn’t be able to check any of them.”

Len Barchanowicz eventually underwent a PET scan, which can determine where cancer is in the body.

“The only thing that lit up with him was literally the little circle right around … the mass,” Lauren Barchanowicz. “We were like, ‘Oh thank God. It’s localized. It’s not spread throughout his body.’”

Soon after, he underwent a video-assisted thoracoscopic surgery (VATS) for doctors to obtain a sample of the tumor to better understand what he had. It was still unclear but doctors had a better idea.

“They said probable thymoma,” Lauren Barchanowicz says.

Thymoma

Cancer of the thymus gland remains “very rare,” Dr. Ranjita Pallavi, a medical oncologist and Len Barchanowicz’s doctor at Allegheny Health Network in Pittsburgh, tells TODAY.com.

“He turned out to have something called a thymoma, which is a tumor that arises from the front of the chest,” says Pallavi. “When we see a mass in that area we’re thinking of something arising from the thymus gland.”

Everyone has a thymus gland, which is part of the immune system, but it works the most during infancy and childhood before becoming dormant, according to past TODAY.com reporting.

Pallavi says these types of tumors tend to be encapsulated, meaning they do not easily spread, and don’t have many symptoms associated with them. Doctors tend to find them incidentally when someone come in with an other unrelated problem. And in some rare cases, there can be symptoms, Pallavi says.

“There’s a proportion of patients where the mass can really get big in size when it starts compressing on the surrounding organs,” she explains. “That’s the time when people actually present with chest pains or shortness of breath.”

In Len Barchanowicz’s case, his tumor remained mostly encapsulated but did spread a little bit, deeming it a stage 2 cancer.

“It was also invading into the surrounding fat,” Pallavi says.

A surgeon removed the 8.7 centimeter mass and 14 lymph nodes leaving clean margins on October 3, 2023.

“He was not given any radiation after surgery,” she says. “For the same reason, because of the very low risk of these tumors coming back, he did not get chemotherapy.”

Len Barchanowicz will need to undergo a chest CT scan every six months for the first two years then yearly for up to eight more years.

“Sometimes the tumors can come back seven, eight years down the line,” Pallavi says. “The surveillance does extend up to 10 years.”

Recovery

Recovering from surgery, which required doctors to crack open his sternum, felt difficult. Len Barchanowicz experienced intense pain.  

“It was a nightmare,” he says. “I was hitting that (pain medicine) button pretty regularly on the hour.”

After two days in the hospital, Len Barchanowicz went home.

“Having good lung capacity and having a good heart, I think that probably helped in my recovery early, too,” he says.

Good news came shortly after, he says. His tumor had not become attached to his aorta or his phrenic nerve, where the cancer sometimes grows, Lauren Barchanowicz notes.

“There was no involvement with the major arteries and he did not have any major bleeding because that was a big concern as well,” she says. “The (surgeon) said … ‘The tumor came out easily and beautifully.”

Len Barchanowicz is struck by how quickly neck pain turned into a serious diagnosis that he luckily overcame. 

“It’s so weird that one day everything’s going great and then you get hit with this,” he says. “I almost have survivor’s guilt.”

By January 2024, Len Barchanowicz was able to return to work and feels grateful for the great care he received from his doctors at Allegheny Health Network and the support of loved ones.

“When something like that happens it hits you like a ton of bricks,” he says. “I was always very blessed with my kids and my wife and I really do live this great life.”

The Barchanowicz family wanted to share his story to help others who might also experience a thymoma because they often felt alone in the experience.

“We just can’t believe that this happened and I don’t want anyone else to feel this way,” Lauren Barchanowicz says.

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“Our water has been cloudy and bubbly and looks milky,” said Barrett, who blames fluoride, a mineral that communities across the nation have for decades added to the water supply to help prevent cavities and improve dental health.

“I don’t want fluoride in my nothing!” said Barrett, echoing a growing number of people who not only doubt the mineral’s effectiveness but also believe it may be harmful despite decades of data pointing to public health and economic benefits.

In February, the Board of County Commissioners in Union County, whose seat is Monroe, voted 3-2 to stop adding fluoride to drinking water at the Yadkin River Water Treatment Plant, the only water source wholly owned and operated by the county. But the decision came after heated discussions among residents and county officials.

“My children had the blessing of growing up with fluoride in their water and … they have very little dental issues,” said Commissioner Richard Helms ahead of the vote. A fellow commissioner saw it differently: “Let’s stop putting something in the water that’s meant to treat us, and give people the freedom to choose,” said David Williams.

Barrett’s water comes from the city of Monroe, not the Yadkin facility. So, for now, she will continue to drink water enhanced with fluoride. “I’m suspicious as to why they add that to our water,” she told KFF Health News.

It is a scenario playing out nationwide. From Oregon to Pennsylvania, hundreds of communities have in recent years either stopped adding fluoride to their water supplies or voted to prevent its addition. Supporters of such bans argue that people should be given the freedom of choice. The broad availability of over-the-counter dental products containing the mineral makes it no longer necessary to add to public water supplies, they say. The Centers for Disease Control and Prevention says that while store-bought products reduce tooth decay, the greatest protection comes when they are used in combination with water fluoridation.

The outcome of an ongoing federal case in California could force the Environmental Protection Agency to create a rule regulating or banning the use of fluoride in drinking water nationwide. In the meantime, the trend is raising alarm bells for public health researchers who worry that, much like vaccines, fluoride may have become a victim of its own success.

The CDC maintains that community water fluoridation is not only safe and effective but also yields significant cost savings in dental treatment. Public health officials say removing fluoride could be particularly harmful to low-income families — for whom drinking water may be the only source of preventive dental care.

“If you have to go out and get care on your own, it’s a whole different ballgame,” said Myron Allukian Jr., a dentist and past president of the American Public Health Association. Millions of people have lived with fluoridated water for years, “and we’ve had no major health problems,” he said. “It’s much easier to prevent a disease than to treat it.”

According to the anti-fluoride group Fluoride Action Network, since 2010, over 240 communities around the world have removed fluoride from their drinking water or decided not to add it.

One needs only to look to Union County to see just how intense discussions can be. Usually when the commissioners meet on the first floor of the Government Center in downtown Monroe, there are more vacant seats than attendees. But sessions about the prohibition of fluoride in public water supplies were packed, and residents who signed up to speak were divided.

One person who came to the microphone on Feb. 5 compared water fluoridation to a seat belt. It does not “prevent the car crash, but it limits the harm done,” he said. Another argued that there is no proof fluoride is safe or effective. “It’s a significant potential milestone to reverse 60-plus years of poisoning the public,” he said, using an unproven claim often made by opponents of fluoridation.

Fluoride opponents claim the mineral is responsible for everything from acne to high blood pressure and thyroid dysfunction to bone cancer.

The National Institutes of Health acknowledges that, when ingested in extremely large amounts, fluoride from dental products or dietary supplements can cause nausea, vomiting, abdominal pain, diarrhea, bone pain, and even death in extremely rare cases.

Infants and children who receive too much fluoride can develop discoloration or small dents in their teeth. In adults, consumption of excessive fluoride for extended periods can lead to skeletal fluorosis, a very rare condition that causes joint pain and stiffness, weak bones, muscle loss, and nerve problems.

However, the recommended dosage in drinking water has always been small. In 2015, the Department of Health and Human Services lowered the optimal fluoride concentration from 1.2 milligrams per liter to 0.7 mg/L.

Juneau, Alaska, voted to remove fluoride from its drinking water in 2007. A study published in the journal BMC Oral Health in 2018 compared the dental records of children and adolescents who received dental care for decaying teeth four years before and five years after the city stopped adding fluoride to the water. Cavity-related procedures and treatment costs were significantly higher in the latter group, the study found.

Portland, Oregon, is the largest city in the nation that has consistently refused to fluoridate its drinking water. Voters have repeatedly rejected measures to add it, first in 1956 and the latest time in 2013.

Despite the strong recommendation of local doctors and dentists, voters in Wichita, Kansas, have rejected adding fluoride to the water several times, most recently in 2012.

The Brushy Creek Municipal Utility District in Williamson County, Texas, had been adding fluoride to its water system since 2007 but ended the practice in December.

In 2016, Collier County, Florida, commissioners opted not to remove fluoride from the water system. But they unanimously reversed that decision following a 2023 Health Freedom Bill of Rights county ordinance in response to covid-19 “to safeguard the healthcare rights and freedoms of Collier County residents.”

The State College Borough Water Authority in Pennsylvania stopped adding fluoride to the water of its 75,000 customers in March 2023. Officials used claims often cited by fluoride opponents, such as potential environmental contamination, concerns about medical freedom, and possible adverse health effects, like the potential for the appearance of faint white lines on the teeth and lowered IQ for babies.

A study published in JAMA Pediatrics in 2019, conducted in six Canadian cities, associated fluoride exposure during pregnancy with lower IQ scores in children. But the study was based on self-reporting and has been criticized for its perceived methodological shortcomings.

In 2016, several consumer advocacy groups, including the Fluoride Action Network, Food & Water Watch, and Moms Against Fluoridation, petitioned the EPA to end water fluoridation under the Toxic Substances Control Act, alleging that significant research showed fluoride was neurotoxic at the doses now used. The same group filed a federal lawsuit against the EPA the following year, after the agency denied their citizen petition.

During a 10-day bench trial in San Francisco that concluded in mid-February, the two sides debated the risks and areas of uncertainty. If Senior U.S. District Judge Edward Chen determines water fluoridation presents an “unreasonable risk” to human health, the EPA will be forced to create a rule regulating or banning water fluoridation in the U.S. A decision is expected soon.

For the time being, decisions about whether to fluoridate community water systems are still made primarily at the local level, which Barrett hopes will change.

“Of all things, they want our teeth healthy when basic needs of housing and food are lacking.”

The number of confirmed measles cases across the U.S. nearly doubled in the last two weeks, dwarfing the total for all of last year, according to new CDC data released Thursday.

Cases have been reported in New York City, New Jersey and on Long Island, though exact numbers remain under investigation. Nationwide, the CDC reports 113 measles cases as of April 4. Two weeks ago, the total was 64, which surpassed the 2023 total of 58 confirmed cases.

Measles is a highly contagious, viral respiratory disease — and a CDC report out Thursday says cases in the first three months of 2024 were 17 times higher than the average number seen in the first three months of the last three years.

The alarming rise prompted a CDC warning last month as well as an alert from the New York State Department of Health, regarding a Nassau County case. Reports of cases continue to climb.

While health officials seem to be doing a good job detecting and responding to outbreaks, “the rapid increase in the number of reported measles cases during the first quarter of 2024 represents a renewed threat to elimination,” the report’s authors said.

The single best way to prevent measles is to be vaccinated. Individuals should receive two doses of MMR vaccine to be fully protected. In New York State, measles immunization is required of children enrolled in schools, daycare, and pre-kindergarten. Since August 1990, college students have also been required to demonstrate immunity against measles.

People are considered protected or immune to measles if they were born before 1957, have received two doses of measles, mumps, rubella (MMR) vaccine, have had measles disease, or have a lab test confirming immunity.

Unvaccinated people have a 90% chance of becoming infected if exposed. Measles is spread by direct contact with nasal or throat secretions of infected people.

Anyone concerned they may have been exposed is advised to contact their healthcare provider, a local emergency department or a local clinic before going for care to reduce further exposure risk.

People first develop a fever, then may have a cough, runny nose and watery eyes, followed by a rash. They are considered infectious from four days before the rash appears to four days after it appears. Symptoms usually appear 10 to 12 days after exposure, but may appear as early as seven days and as late as 21 days after exposure.

Preventive treatment for measles is recommended for those without evidence of immunity as follows: MMR vaccine can be given to eligible exposed individuals within 72 hours of exposure or immune globulin can be administered within six days of exposure.

For additional information about measles, visit the New York Department of Health website here. Learn more about the vaccine here.

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But besides adding flavor, condiments can also add salt, fat and sugar to healthy food if people pour or spread them on too enthusiastically, dietitians say.

There are countless condiments, classic and new, and the list keeps growing. Some Americans now use a half-dozen sauces at a meal, amounting to a “condiment invasion,” The Wall Street Journal recently reported.

“In general, I’m pro-condiment if it helps you eat healthier foods,” says registered dietitian Natalie Rizzo, nutrition editor for TODAY.

“For example, if you only like tofu with soy sauce on it, then add the condiment to entice you to eat more of this healthy plant-based protein. Or if you like to make spicy cauliflower with hot sauce, go ahead and use it to eat more of this cruciferous veggie.”

But if you love mayonnaise and add a few tablespoons of it to a meal, it can drastically increase the calories and saturated fat, she warns.

“Condiments change the nutrition equation. Of course, how much you use is going to be the biggest game changer,” Lisa Young, a registered dietitian in New York and author of “Finally Full, Finally Slim,” tells TODAY.com.

“A little bit goes a long way.”

What are basic condiments?

A condiment is “something used to enhance the flavor of food,” especially a pungent seasoning, according to Merriam-Webster’s definition.

Popular choices in the U.S. include:

• Mustard
• Ketchup
• Mayonnaise
• Relish
• Barbecue sauce
• Salsa
• Hot sauce
• Soy sauce
• Vinegar
• Wasabi or horseradish

Some people consider guacamole and hummus condiments, but foods that can be eaten on their own generally don’t count as a condiment, chefs told The Kitchn.

Condiment nutrition

Every condiment is different, so it’s important to read the label to check the serving size and nutrition facts, both dietitians advise.

Soy sauce and salsa are higher in salt, while mayonnaise is higher in calories, Rizzo says. Ketchup, barbecue sauce and relish all have added sugar.

You can taste the sweetness, but people don’t realize one tablespoon of ketchup has a teaspoon of sugar, Young notes. “Ketchup is something we put on so many foods. It becomes a quantity thing that you want to make sure that you watch,” she adds.

What are the benefits of condiments?

Besides being an easy way to boost taste, condiments can also make a meal more satisfying — potentially helping people to make better choices and eat less in the long run, Young notes.

“If you eat something you like, you’re satisfied and you stop. The thought is psychologically, you’re satisfied,” she says.

Steamed chicken is healthy but bland, so a bit of barbecue sauce will give it that flavor someone might need to choose it over a less nutritious option, Young points out.

Some condiments can add a little bit of nutrition: Salsa, for example, is made with tomatoes and onions — two vegetables that are beneficial to health, Rizzo points out.

What is the healthiest condiment?

Vinegar was the top pick of both dietitians. Drizzling it over beef, poultry or vegetables can boost taste without adding many calories.

“It doesn’t have any added salt, sugar or fat, and you don’t need a lot of it to get a really strong flavor,” Rizzo says.

Vinegar is fermented, good for the gut and adds a pungent taste, Young adds. Fruit vinegars made from wine or apple cider are rich in polyphenols — beneficial compounds found in plants — and organic acids, and can be a good source of antioxidants, studies have found.

Salsa was another top choice since it’s made from mostly tomatoes and plant-based ingredients, which means it has lycopene — a powerful antioxidant — and other health benefits, the dietitians say.

Mustard can also be a healthy pick, adding lots of flavor without many calories or sugar, Young says. But it can be salty, so people with high blood pressure should be careful about eating too much.

What is the least healthy condiment?

Mayonnaise, because it has a good amount of saturated fat, Rizzo says.

Since it’s high in fat and calories, mayonnaise would be the least healthy condiment to choose if you’re watching weight, Young adds. But if you’re a mayo fan, it’s OK to have it; just watch how much you eat.

“If you love mayo, have mayo, but then limit your guacamole” and other high-fat additions to a meal, she advises. “It’s not in the category of butter or cream.”

If sugar is a concern, ketchup and barbecue sauce are the worst condiments, both dietitians say. “The first ingredient on a lot of BBQ sauces is sugar,” Rizzo notes.

The main message is to use condiments wisely: Pick the one you like the best, add a bit to your meal and don’t go overboard. If you’re drowning your roasted veggies in condiments, you’re probably going way over the daily recommendation for salt, sugar and saturated fat, Rizzo cautions.

“It’s always best to look at the recommended serving size on the label. Sometimes you may want a little bit more than the recommendation and that’s fine, but don’t do it every time,” she says.

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CVS Health on Thursday said its drug plans will cover the first over-the-counter birth control pill in the U.S. at no cost for many health plan sponsors, a decision that could open the door for more people to prevent unintended pregnancies without a prescription. 

The company’s pharmacy benefit manager, CVS Caremark, said the pill will be added to its preventive services oral contraceptives list and will be covered at zero cost for many sponsors. The drug, known as Opill from Perrigo, was available at pharmacies starting April 1, according to a pharmacy update from CVS Caremark dated last week and viewed by CNBC.

Pharmacy benefit managers, or PBMs, maintain lists of drugs covered by health insurance plans and negotiate drug discounts with manufacturers. At most stores, Opill has a retail price of $19.99 for a one-month supply and $49.99 for a three-month supply. 

The Food and Drug Administration approved Perrigo’s medication in July. It marks the first time that many U.S. residents are able to buy birth control pills over the counter, the same way they would purchase common pills like Tylenol or Advil. 

The drug could significantly expand availability of contraception, especially for younger women and those in rural and underserved communities who often have trouble getting access to birth control methods. 

Medical organizations have estimated that 45% of the 6 million annual pregnancies in the U.S. are unintended.

The pill’s entrance into the market is a win for the Biden administration, which has tried to shore up reproductive rights as abortion restrictions rise in many states. 

The Supreme Court’s decision to overturn the landmark Roe v. Wade ruling more than a year ago, which ended 50 years of federal abortion rights, has led to shrinking availability of the procedure nationwide and renewed calls for expanded access to birth control.

In all, five women who lived in different parts of southwest Michigan suddenly sought help for serious eye problems within weeks of each other.

The medical mystery led to a startling diagnosis: All of the patients had ocular syphilis, a complication of the sexually transmitted disease.

The cluster of cases shared a common link. It turned out the five women had sex with the same man who had syphilis, according to a case report published by the Centers for Disease Control and Prevention in November 2023. His illness was mostly asymptomatic and never affected his eyes.

Few people know syphilis can endanger vision, doctors say.

“Patients are very surprised, and most of the lay public doesn’t think of syphilis involving the eye,” Dr. Rahul Khurana, a spokesperson for the American Academy of Ophthalmology, tells TODAY.com.

“Untreated syphilis in the eye is devastating because it can lead to blindness.”

‘Syphilis crisis’

It’s especially concerning as syphilis cases surge in the U.S.

More than 207,000 Americans were diagnosed with the disease in 2022, an 80% increase since 2018 and the highest levels since the 1950s, the CDC reported in January 2024.

Cases were up in most every region and demographic group, including older people.

The U.S. Department of Health and Human Services called it a “syphilis crisis” and an “epidemic.”

Possible reasons why it’s happening include a rise in substance use, with alcohol and marijuana linked to more risky sexual behavior, Dr. Akshay Syal, a medical fellow with the NBC News Health and Medical Unit, told NBC News Now.

There’s also been a decrease in condom use and less funding for clinics where people can get tested for STDs, he added.

As the crisis unfolds, doctors are seeing more people in the U.S. hospitalized for syphilitic uveitis, or inflammation inside the eye and the most common ocular manifestation of syphilis, according to an investigation published in JAMA Ophthalmology in November 2023.

What causes ocular syphilis?

Syphilis is a sexually transmitted disease caused by a bacterium that invades blood vessels and could involve the central nervous system — when that happens, it can go into the brain and the eye, Khurana says.

The illness can lie hidden in the body only to cause symptoms later in time, so it’s often not caught early and people don’t realize that they have it, he adds. Some of his patients had no idea they were infected until they sought help for eye problems.

“We often call syphilis the great imitator because it looks like many other things,” says Khurana, who is ophthalmologist at Northern California Retina Vitreous Associates.

“Because it’s non-specific, it’s often missed by many ophthalmologists, and many people don’t even think about it.”

Besides causing blindness, untreated syphilis can seriously damage the heart and brain, and cause deafness and paralysis, the CDC warns.

What are the symptoms of ocular syphilis?

When syphilis affects the eyes, it usually causes inflammation inside them known as uveitis, Khurana says.

Eyes may be red, light sensitive or painful, he notes.

“Whenever I have a patient with uveitis, I always rule out everybody for syphilis just because it can present in so many different ways that you don’t want to miss it,” Khurana notes.

Syphilis accounts for 1% to 5% of cases of eye inflammation, according to the American Academy of Ophthalmology notes.

Other possible symptoms of ocular syphilis include floaters, blurry vision or even blindness, the CDC warns.

A blood test can confirm if a patient has syphilis.

What is the treatment?

If there’s a positive test, it’s important for the patient to see an infectious disease doctor because when syphilis involves the eyes, it’s also potentially involved in the brain, Khurana says.

Patients are treated with an intravenous antibiotic for 10 to 14 days and usually respond well, he notes. They may also get anti-inflammatory medicine to take care of the eye inflammation.

“If these things are caught early and treated early, patients could do very well,” Khurana says. “The challenge with syphilis is that often (doctors) don’t think about it, and so the diagnosis is often delayed.”

He urges eye doctors to have a “high index of suspicion” and rule out syphilis when patients show up with eye inflammation.

Treatment may not undo any damage caused by the infection, the CDC warns.

Using condoms every time you have sex can reduce the risk of getting syphilis, the agency notes.

Always get checked for any vision problems to rule out eye syphilis or other sexually transmitted diseases. STDs such as herpes and gonorrhea can also harm the eyes, according to the American Academy of Ophthalmology.

“With the incidence of STDs and syphilis on the rise in the community, I think everyone should be aware of it,” Khurana says.

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Gutke, of Joliet, Illinois, has polycystic ovary syndrome, or PCOS, and the medications and supplements help the 45-year-old cope with migraines, high blood pressure, diabetes, high cholesterol, anxiety and depression that come with the complex hormonal condition. 

Not one of  Gutke’s medications are technically “PCOS drugs.” 

The Food and Drug Administration has not approved a medication specifically for PCOS, which is often linked to infertility, irregular or missed periods, weight problems, and other debilitating symptoms. Gutke’s array of medications is typical of how many of the estimated 5 million women in the U.S. diagnosed with PCOS deal with it.

“It’s such a vast syndrome that affects everything from your head to your toes,” she said. She was diagnosed with endometrial cancer — another risk linked to PCOS — at age 37. 

After nearly a century of disagreements over what, exactly, defines the condition, as well as a lack of research, PCOS is still poorly understood. The symptoms vary so widely that any single drug would be unlikely to help all patients, said Dr. Heather Huddleston, a reproductive endocrinologist at the University of California, San Francisco and director of UCSF’s PCOS Clinic. 

Women with PCOS and the doctors who care for them say they want better options — treatments for the condition’s root causes rather than bandages for individual symptoms. Even as calls for better treatments grow, the lack of investment in PCOS research has limited doctors’ ability to help their patients. 

“It gets very messy to try to identify one treatment that’s going to work for everybody,” Huddleston said. 

Many women with the condition end up taking off-label prescriptions — meaning drugs technically approved for other conditions, like diabetes or obesity — to help PCOS-related symptoms. Navigating insurance coverage for off-label prescriptions can be challenging.

“There’s no magic pill,” said Tallene Hacatoryan, 31, a registered dietician from Orange County, California. “There are too many components for there to be a one-size-fits-all treatment.”

Hacatoryan was diagnosed with PCOS at age 18 and now works as a diet and lifestyle coach for women with PCOS.  

Although research is murky when it comes to the best diet for women with PCOS, the most up-to-date international guidelines recommend exercise and a healthy diet. There’s no evidence that any particular diet improves symptoms, although some women have found lifestyle coaching helpful.

Insufficient funding for research

Among the reported 315 medical conditions that receive federal support from the National Institutes of Health, PCOS ranks near the bottom, with an estimated $10 million earmarked for research in 2024. Until 2022, PCOS was so underfunded that it wasn’t included as a line item in the NIH list.  And the condition is not explicitly included in the $100 million the Department of Health and Human Services announced recently to research neglected areas of women’s health. Neither is PCOS mentioned in President Joe Biden’s recent executive order to advance women’s health, which includes $200 million for NIH research grants, or the White House’s calls for Congress to allocate $12 billion to fund women’s health research.

A spokesperson at the NIH said that it’s too early to know which women’s health conditions will receive funding under the new initiative. 

“Given how common PCOS is, the amount of funding it’s gotten is proportionately extremely small,” Huddleston said. 

Government funding is just one part of the total research budget for a given disease. While it’s tough to pin down a dollar figure for private industry spending, experts say the lack of FDA-approved PCOS treatments reflects a lack of investment from drugmakers, too. 

Developing PCOS treatments requires a better understanding of the condition. This, in turn, requires far more research tracking thousands of women over many years, which can be extremely expensive, experts say. 

However, there are some promising signs.

Although research is early and only in a few dozen women, there are a handful of small drug companies studying possible PCOS treatments. A Menlo Park, California-based company called May Health, for instance, is developing a one-time surgical procedure it thinks could help with PCOS. Spruce Bio, a San Francisco biotech firm, is running a small clinical trial with a drug called tildacerfont for PCOS. It is not clear yet if the oral drug works. President and CFO Samir Gharib said larger clinical trials will depend on the company’s ability to “secure additional financing” or partner with another drug company. 

The FDA recently attended a meeting with advocacy group PCOS Challenge where women shared their experiences with the agency’s scientists and drug companies. No PCOS drug trials were announced after the meeting, but the FDA’s interest shows a growing push for improved treatment, said William Patterson, a spokesperson for PCOS Challenge.

No known cure for PCOS

Doctors recommend hormonal contraceptives — most commonly the birth control pill — to regulate heavy, irregular periods;, acne;, and unwanted hair growth. Others say taking the pill just masks, rather than treats, their PCOS symptoms and the symptoms return as soon as they stop taking it. 

“PCOS is unfortunately not curable, so treatment is about managing its symptoms,” said Dr. Jessica Chan, a reproductive endocrinologist at Cedars-Sinai. Chan said birth control can be a good option for some, but not all, of her PCOS patients. 

For women with PCOS whose main concerns are insulin resistance or stubborn weight gain, Chan often prescribes off-label diabetes medications like metformin. 

Some doctors who treat PCOS, including OB-GYNs or endocrinologists, have also begun prescribing GLP-1 agonists like Ozempic and Wegovy, which have shown promise for some women with PCOS,  although studies have been small and early -stage.

Novo Nordisk, the company that makes Ozempic and Wegovy, said it has no plans as of now to seek FDA approval for PCOS. Still, the company mentions PCOS on its Truth About Weight website, part of its marketing campaign for Wegovy

Causes and symptoms of PCOS

“We don’t know the initial spark leading to PCOS or where it arises from,” Chan said.

PCOS affects an estimated 6% to 12% of reproductive-age women in the U.S. The real prevalence is likely higher since an estimated 70% of cases go undetected. 

Experts generally agree that PCOS, at its core, is a hormone-related condition. Women with PCOS have higher levels of androgen hormones, which can cause a range of symptoms, including:

•  Missing, irregular, or heavy periods
• Acne
• Excess hair growth on the face or body
• Thinning or balding scalp hair

According to endocrinologist Dr. Andrea Dunaif, some doctors have been pushing to separate PCOS into two different diagnoses: one having more to do with the reproductive cycle and fertility issues and another having more to do with metabolism, high body weight, and diabetes. 

“PCOS looks to be at least two or three different conditions we’re lumping together, but they’re genetically distinct,” said Dunaif, the chief of the endocrinology, diabetes and bone disease division of Mount Sinai Health System and the Icahn School of Medicine.

The confusion surrounding PCOS diagnosis is partly why it’s been hard to get large pharmaceutical companies to invest in PCOS treatment, she said.

In Dunaif’s view, it’s not accurate to call the condition “PCOS” at all, because it has more to do with excess hormones than it does with actual cysts on the ovaries. PCOS got its name from the bumps on the ovaries appearing like cysts on an ultrasound image. These are not cysts, but instead egg follicles that are, as Dunaif described them, “arrested in development.” 

As it is, many doctors diagnose the condition based on two of three factors:

• Irregular periods
• High androgen levels
• Multiple follicles on the patient’s ovaries

But these three factors don’t account for some of the most challenging symptoms of PCOS: insulin resistance and stubborn weight gain. Excess androgen hormones can spike insulin levels, which interferes with how the body processes sugar. Doctors aren’t sure whether the hormonal dysregulation causes insulin resistance, or whether insulin resistance causes excess androgen hormones. 

Either way, women with PCOS have a higher risk of diabetes, excess weight gain, high cholesterol, and high blood pressure. Yet these metabolic conditions aren’t included in the criteria many doctors use to diagnose PCOS. The result? A missed diagnosis. 

This was initially the case for Candice Bolden, 35, who started noticing acne and excess facial and body hair several years before she was diagnosed with PCOS in 2021. Bolden, a lifelong dancer, also had unusually low energy.  

“The final straw was excess weight gain that I could not take off no matter what I did,” said Bolden, who lives in Los Angeles. “All the other things I had kind of just stuffed under the rug. I’d just chalked it up to being a hairy, Haitian woman.”

After gaining 35 pounds, the 5-foot-2-inch Bolden, who exercised twice a day and followed strict diets, saw multiple doctors who she said ignored her symptoms. 

“Doctors kept telling me I was fine, and to go home, work out, and eat clean,” she said. “It was the most frustrating thing ever.”

‘We don’t have to live underneath this dark cloud’

Women living with PCOS say the rise of online communities, including on social media apps like TikTok and Instagram, has given them a place to speak out, share the treatment approaches working for them, and meet other women with PCOS. 

When Bolden finally got a diagnosis, she wasn’t sure what to do next. Gutke and Hacatoryan had similar experiences. 

“I was like, ‘Wait, I have so many questions,’ and the doctor just told me, ‘It is what it is,’” Hacatoryan said. 

Hacatoryan calls women in her online community her “cysters.”

Bolden said she’s noticed more women turning to social media to learn how others manage their PCOS and share their own stories.

On her own social media accounts, she’s been trying to change the narrative about PCOS being primarily a fertility problem, which she sees as an outdated perception.

“When I was diagnosed, my doctor mentioned PCOS being the No. 1 reason for infertility, and that shattered me,” said Bolden, who was newly engaged at the time and eager to start a family. “I was happy I was diagnosed, because it showed me something was actually happening and I wasn’t just crazy. But I was heartbroken.”

Things changed after Bolden moved; found a new doctor; and worked closely with her husband and the  online PCOS community to find a system that worked to manage her PCOS symptoms.  

Bolden is now pregnant and expecting a baby girl. 

“I want people diagnosed with PCOS to know there’s hope, and we don’t have to live underneath this dark cloud all the time,” she said.

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The term “high-functioning” isn’t actually clinical, but, generally, it refers to those who perform well in work and in school. So if someone has high-functioning depression, it means they are excelling at their job, despite being in poor mental health.

After the pandemic, when levels of depression and anxiety both spiked, people became more aware of the fact that you can have depression or anxiety and still be excelling in certain parts of your life, says Irina Gorelik, a psychologist with Williamsburg Therapy Group.

“After Covid, the focus on mental health has been much more significant,” she says. “And people are much more aware of signs that might have been subtle in the past.”

While the idea of a high-functioning depressed or anxious person isn’t new, our recent obsession with the term is. And experts believe it might signal a shift in how we believe mental health presents.

You’re ‘masking’ your struggles with high performance

Gorelik likens high-functioning tendencies to masking. A person will work extra hard in the office in order to cover up their poor mental health.

“You’re masking something you’re struggling with with performance,” she says. “You’re able to maintain the basic aspects of your life without people noticing a significant change, but you’re using a lot more mental effort to sustain that high performance.”

Saying your “high-functioning” also signals that you have economic value to society, says John T. Maier, a psychotherapist in Cambridge Massachusetts,

“When people say ‘high-functioning,’ they aren’t saying, ‘I’m doing a great job at raising my family’ or ‘I’m doing a great job at going to church,'” he says. “It means ‘I’m doing a great job at work.'”

Historically, admitting you have mental health struggles might suggest you have trouble holding down a job or performing well in school. The spike in use of this term shows that people are rethinking what depression or anxiety look like.

“It’s implicating that you are somehow different from someone else with this label,” he says.

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The Centers for Disease Control and Prevention issued an alert to U.S. doctors on Thursday about an increase in cases of one type of invasive meningococcal disease, most of it due to a specific strain of bacteria.

Last year, 422 cases of it were reported in the U.S. — the most in a year since 2014. Already, 143 cases have been reported this year, meaning infections appear to be on track to surpass 2023, the CDC said. Most of the cases last year did not involve meningitis, though at least 17 died. The cases were disproportionately more common in adults ages 30 to 60, in Black people and in people who have HIV, the CDC said.

The bacteria can cause a dangerous brain and spinal cord inflammation called meningitis, with symptoms that may include fever, headache, stiff neck, nausea and vomiting. The bacteria also can cause a bloodstream infection with symptoms like chills, fatigue, cold hands and feet, rapid breathing, diarrhea, or, in later stages, a dark purple rash.

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The infection can be treated with antibiotics, but quick treatment is essential. An estimated 10% to 15% of infected people die, and survivors sometimes suffer deafness or amputations.

There also are vaccines against meningococcal disease.

Officials recommend that all children should get a meningococcal conjugate vaccine, which protects against the rising strain, at around the time they enter a middle school. Since vaccine protection fades, the CDC also recommends a booster dose at age 16. Shots also are recommended for people at higher risk, like those in a place where an outbreak is occurring or those with HIV infection or certain other health conditions.

Forty states reported an increase in TB, and rates were up among all age groups, the Centers for Disease Control and Prevention said Thursday. More than 9,600 cases were reported, a 16% increase from 2022 and the highest since 2013.

Cases declined sharply at the beginning of the COVID-19 pandemic, but have been rising since.

Most U.S. TB cases are diagnosed in people born in other countries. Experts say the 2023 number is in part a combination of a surge in TB cases internationally — the World Health Organization said TB was behind only COVID-19 in infectious fatal diseases worldwide in 2022. And there are also increases in migration and post-pandemic international travel.

But other factors are also at play, including other illnesses that weaken the immune system and allow latent TB infections to emerge.

CDC officials expected TB numbers would rise, but the 2023 count “was a little more than was expected,” said Dr. Philip LoBue, director of the agency’s Division of Tuberculosis Elimination.

Despite the jump, the number and rate of new TB cases each year remains smaller than it was in the past, and the U.S. has a lower rate of new TB cases than most countries.

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Tuberculosis is caused by bacteria that usually attack the lungs, and is spread through the air when an infectious person coughs or sneezes. If not treated properly, it can be fatal. In the late 1800s, TB killed one out of every seven people living in the United States and Europe. But the development of antibiotics and public health efforts succeeded in treating infections and tracking down those they infected, leading to cases falling for decades.

The new CDC statistics are not a count of how many people were newly infected in 2023, but rather of how many people developed a cough or other symptoms and were diagnosed.

An estimated 85% of the people counted in 2023 were infected at least a year or two earlier and had what’s called latent TB, when the bacteria enters the body and hibernates in the lungs or other parts of the body. Experts estimate as many as 13 million Americans have latent TB and are not contagious.

When the immune system is weakened — by certain medications or other illnesses like diabetes and HIV — the TB wakes up, so to speak. Nicole Skaggs said she was infected in 2020, but didn’t develop symptoms until 2022 — after she got sick from COVID-19.

“Anything that can take out or lower your immune system can put you at risk,” said Skaggs, 41, a property manager in Bothell, Washington.

CDC officials called the idea that COVID-19 has played a role in increased reactivation of TB “an important question.” Scientists are still learning what causes latent TB to reactivate and “I would consider it an unknown at this point,” LoBue said.

“It’s too early to tell” what will happen to TB trends in the next few years, he also said.

There are TB vaccines being developed, and public health workers that were focused on COVID are now back to trying new approaches to preventing TB. New York City, which saw cases jump 28% last year, is hiring TB case managers and community health workers and increasingly using video monitoring of patients taking medications to keep treatment rates high, said Dr. Ashwin Vasan, the city’s health commissioner.

On the other hand, federal TB funding for state and local health department efforts has been flat, and one of the key antibiotics used against TB has been in short supply in recent years. Plus, drug-resistant TB infections have popped up in a fraction of cases.

Rates of chlamydia, gonorrhea and syphilis in people ages 55 and up more than doubled in the U.S. over the 10-year period from 2012 to 2022, according to data from the Centers for Disease Control and Prevention.

The number of syphilis cases among people ages 55 and up increased seven-fold during those 10 years, while gonorrhea cases increased nearly five-fold and chlamydia cases more than tripled during that time. 

A presentation to be delivered Thursday — part of a lead-up event to the European Congress of Clinical Microbiology and Infectious Diseases next month — warns that both doctors and older adults are overlooking the risks of STIs in this age group. 

“We talk about smoking, we talk about diet, exercise, so many things, and not about sex at all,” said Justyna Kowalska, the author of the presentation and a professor of medicine at the Medical University of Warsaw. 

The issue is not limited to the U.S. In England, surveillance data published in 2022 suggested that STI diagnoses rose 22% from 2014 to 2019 among people ages 45 and up. Chlamydia was the most common, followed by gonorrhea. 

Kowalska pointed to a few factors that may be driving up STI rates among older adults.

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For one, people are living longer compared to past generations and enjoying more active lifestyles in their 60s, 70s and 80s. For many, that includes sex. A 2018 survey from AARP and the University of Michigan estimated that 40% of people ages 65 to 80 are sexually active, and nearly two-thirds are interested in sex. 

Hormone replacement therapy, which can treat symptoms of menopause, can prolong sexual desire in older women, while erectile dysfunction drugs like Viagra can help older men remain sexually active.

But older adults may not have gotten the type of sex education provided to teenagers today, according to Matthew Lee Smith, an associate professor at the Texas A&M School of Public Health.

“Back in the ’30s, the ’40s, the ’50s, traditional school wasn’t really doing sexual education very formally,” said Smith, who studies behavioral health risks in older adults.

Smith’s research has shown that older adults lack some knowledge about STI transmission, symptoms and prevention.

He said doctors can be sheepish about asking older patients about their sexual activity, and older people often aren’t inclined to discuss their sex lives with peers or family members.

“No one wants to think about grandma doing this,” Smith said. “You certainly aren’t going to ask grandma if she was wearing condoms — and that’s part of the problem, because every individual regardless of age has the right to intimacy.”

Some older men may struggle with condom use, Smith said, because of either a lack of dexterity or erectile dysfunction.

What’s more, he added, many older adults married at a younger age than is typical now and only had one sexual partner until they divorced or were widowed. So some might not think to use a condom, Smith said — especially since pregnancy isn’t a concern. 

Nursing homes also create opportunities for new sexual partners. The results of a U.S. survey of nursing home directors, published in 2016, found that sexual activity was common in these settings, which often have more female than male residents.

“In the heterosexual, older adult community, there’s a partner gap: Women live longer than men and there’s a larger proportion of females to men,” Smith said. “What it can lead to oftentimes is multiple partners and sharing of partners.”

Though STIs pose health risks to all age groups, older people may have a harder time clearing infections or be more susceptible to contracting them in the first place, medical experts said.

“The immune system is weaker, so you can get an infection easier, but there’s other physical things related to just sexual intimacy that make one more susceptible,” said Ethan Morgan, an assistant professor of epidemiology at The Ohio State University College of Nursing. Among women who are postmenopausal, for instance, the vaginal lining is more prone to tearing, which makes it easier for an infection to occur.

The experts stressed that doctors need to do a better job of discussing safe sex with older patients.

“We want them to have their best life,” Smith said, “but we want them to have it safely.” 

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If you miss a doctor’s appointment these days, you could get hit with a “no-show” fee of up to $100 — or more.

This happened to me recently for the first time, and the charge was a steep $150. When I complained to friends and family, I learned that my experience wasn’t unusual: Most had dealt with a similar fee.

I talked to experts and consumer advocates about why such fees are becoming common, if the charges are fair to patients and how to best avoid them.

Fees are a ‘disincentive’ for late cancellations, no-shows

“I very strongly support such fees,” said George Loewenstein, an economics and psychology professor at Carnegie Mellon University.

“Patients who don’t show up are taking up appointments which other patients could use,” saisd Loewenstein, adding that “without such a fee, patients have little if any disincentive for not bothering to cancel appointments well in advance.”

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Certified financial planner and physician Carolyn McClanahan said the fees are “totally fair.”

“If a patient doesn’t show up, that cost the practice money,” said McClanahan, a member of CNBC’s FA Council. “The doctor and their staff is left with nothing to do and everyone still needs to get paid. Also, that empty slot is a time that another patient can get the care they need.”

Penalties shouldn’t ‘become a profit center’

Caitlin Donovan, a spokesperson for the National Patient Advocate Foundation, said “no-shows” are a reoccurring dilemma for doctors.

But, she said, “to solve this problem is not to charge patients more fees, which many can’t afford.”

She’s heard of medical offices having success with call and texts reminders to patients about their appointments. Patients should always be given the opportunity to bow out, she said.

That doesn’t always happen.

Earlier this month, my sister, Janna, tried to call her doctor twice to cancel her appointment for the next day.

“I was in elevator music purgatory for over 20 minutes,” she said. Both times, she didn’t get through to anyone. Three weeks later, she got a bill for a $100 “no-show” fee.

For my appointment, I did get a call the day before from the doctor’s office. But when I told the woman I’d forgotten about the appointment and couldn’t make it, she said I’d still be charged a cancellation fee.

Adam Rust, the director of financial services at the Consumer Federation of America, said that using a fee to recover costs may be reasonable.

“But if penalty fees become a profit center, it may incentivize trickery and deception,” Rust said.

In addition to sufficient reminders and opportunities to cancel appointments for patients, there can be other creative alternatives to “no-show” fees, Donovan said.

She recently spoke to one medical group in Camden, New Jersey, that had a problem with patients standing them up. They started asking people why they hadn’t come. Many said they just didn’t have reliable transportation to get there.

“They implemented a ride share, which came at a cost to the office, but their attendance levels went right up and more than compensated for the cost of the rides,” Donovan said.

Fees shouldn’t hurt credit, still may be worth disputing

When you make a doctor’s appointment, ask about the office’s policy around late cancellations and missed appointments, Donovan said. If you’re told you’ll be charged for missing an appointment, ask if you can reschedule it instead.

You can also try asking the office if they can waive the charge if you find it unfair or if you can’t afford it, she said. They should work with you.

“Ultimately, these fees are discretionary and I would be reluctant to work with any office that inflexibly charged them,” Donovan said.

On a practical note, debt owed to a doctor’s or dentist’s office is considered medical debt, a spokesperson for the Consumer Financial Protection Bureau told CNBC. Such debts that are less than $500 are not reported to the credit bureaus, they added.

As a result, it seems unlikely that a no-show fee would harm your credit.

When my sister Janna got her no-show invoice, she simply called the number on the bill and explained that she’d tried without success to cancel her appointment. The customer service agent agreed to waive the fee immediately.

“I feel like they have a system where they send out the bill for a no-show and then if people make the effort of calling it to question it, they’ll get rid of it,” Janna said. “But there are some people who are just going to pay it, so they bank on those people.”

New York legislators and families are speaking at the state’s capital on Tuesday, in support of “baby bonds” for those children who lost a parent or caregiver during the COVID-19 pandemic, marking four years since it ravaged the country.

State Senator Jamaal Bailey (D-NY) and Assemblywoman Catalina Cruz (D-NY) introduced a bill in May 2023 called the New York Covid-19 Children’s Fund, a program that would establish savings accounts for those grieving children.

The proposed legislation, currently sitting in committee in both houses of the state legislature, would set trust funds starting with $1,000 deposits for New York children who lost a guardian to COVID. The account would gain an additional $1,000 per year until the child turns 18.

Bailey represents New York’s 36th district, which includes parts of the Bronx and Westchester. He says the grief these children face is everlasting, but if the bill passes, the assistance given will also act as a commitment from the state toward their well-being.

“Though nothing can fill the void left by a parent, grandparent, or caregiver during the pivotal moments of a child’s life, this legislation is a way to show our young people that despite their unimaginable loss, we stand by them, we believe in them, and we’re committed to investing in their future,” Bailey told NBC New York.

Once age 18, those eligible can access these publicly-funded savings accounts to afford qualified life expenses, such as college or starting a small business.

In New York State alone, nearly 18,000 children have lost a primary or secondary caregiver to COVID, and in the tri-state area, the estimate is over 28,000 impacted, according to data by the Global Reference Group on Children Affected by COVID-19.

Queens Assemblywoman Catalina Cruz represents one of the most diverse areas in the nation. She believes this potential financial investment would provide a safety net for an eligible child and plans to continue to push for the cause whether or not the bill passes this or next week given the upcoming state budget.

“When you’re looking at what investments to make in the state budget, I think you really have to look at what are the principles. What are our core beliefs as a state and as legislators? I can’t find a more noble reason to be in Albany than to support children who lost a parent or caregiver during this pandemic,” Cruz told News 4 before the rally.

Based on data from the National Institutes of Health, an estimated 216,000 children lost a co-residing caregiver to COVID-19 in the United States, while 77,000 lost a parent and 17,000 lost the only caregiver in the household.

Black and Latino children were more than twice as likely to lose a caregiver over white children. Based on the NIH data, 70% of caregivers lost were those children of color under 14 years old.

Veronica Fletcher, 49, is a Brooklyn widow whose husband, Joseph Trevor Fletcher, died from COVID-19 on the evening of April 11, 2020. Joseph Fletcher, an immigrant from Grenada, worked for the Metropolitan Transit Authority for over 17 years and left behind three children, Joshua, Zachary, and Madison.

In February, State Senator Steve Rhoads (R-NY) and Assemblyman Michael Durso (R-NY) announced a separate COVID-related bill named after the late Brooklyn father, the “Joseph Fletcher Act.” This proposed legislation would amend the workers’ compensation law for essential workers relating to certain claims for benefits based on death due to COVID-19.

“As we memorialize and heal, let us also take action and care for who remains, by supporting and passing ‘Baby Bonds,’ along with scholarships, a New York State memorial and the ‘Joseph Trevor Act’ for Workmans’ Compensation for our heroic fallen essential workers,” said Fletcher to News 4.

The day of advocacy is led by the community group COVID Survivors for Change, founded by Queens resident Christopher Kocher, who noted a full schedule of over a dozen meetings with legislators, including with the chair of Government Operations.

Other organizations like Elmhurst Hospital and the New York Immigration Coalition have supported the New York baby bonds for COVID orphans.

Kocher foresees some obstacles to the bill’s passage, including an “out of sight, out of mind” mentality now toward the pandemic and securing the necessary budget to implement plans. According to Kocher, the anticipated funding amount, which ranges from $50 million to $150 million, depends on the actual number of eligible families.

If the baby bonds are approved, New York would come second in the U.S. to California, which allocated $100 million in the state budget for the Hope, Opportunity, Perseverance, and Empowerment for Children Trust Account Fund.

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The New York State Department of Health is investigating a confirmed case of measles — a highly contagious, viral respiratory disease that prompted a CDC warning last week — on Long Island, Nassau County health officials said.

Health officials say the case involves an unvaccinated child who tested positive for measles at Cohen Children’s Medical Center last week. Anyone who was in the ER department’s waiting room and treatment area in New Hyde Park from 6:45 p.m. Wednesday, March 20, to 3:30 p.m. Thursday, March 21, may have been exposed, officials said.

Unvaccinated people have a 90% chance of becoming infected if exposed. Measles is spread by direct contact with nasal or throat secretions of infected people.

“Nassau County Department of Health is closely investigating potential exposures and taking the necessary proactive steps to prevent the spread of measles,” said Health Commissioner Dr. Irina Gelman. “We strongly encourage all residents to protect their health by ensuring they are up-to-date on important, lifesaving immunizations.”

Anyone concerned they may have been exposed is advised to contact their healthcare provider, a local emergency department or a local clinic before going for care to reduce further exposure risk.

People first develop a fever, then may have a cough, runny nose and watery eyes, followed by a rash. They are considered infectious from four days before the rash appears to four days after it appears. Symptoms usually appear 10 to 12 days after exposure, but may appear as early as seven days and as late as 21 days after exposure.

A total of 64 measles cases have been reported in the United States this year, according to the latest CDC numbers. Those include cases in New York City and New Jersey. There were 58 confirmed measles cases in the U.S. last year.

The CDC issued a warning last week about the increase: In three months, we’ve surpassed the total from 2023.

The single best way to prevent measles is to be vaccinated. Individuals should receive two doses of MMR vaccine to be fully protected. In New York State, measles immunization is required of children enrolled in schools, daycare, and pre-kindergarten. Since August 1990, college students have also been required to demonstrate immunity against measles.

People are considered protected or immune to measles if they were born before 1957, have received two doses of measles, mumps, rubella (MMR) vaccine, have had measles disease, or have a lab test confirming immunity.

Preventive treatment for measles is recommended for those without evidence of immunity as follows: MMR vaccine can be given to eligible exposed individuals within 72 hours of exposure or immune globulin can be administered within six days of exposure.

For additional information about measles, visit the New York Department of Health website here. Learn more about the vaccine here.

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Oscar experienced commotio cordis, the same rare condition that caused Buffalo Bills player Damar Hamlin to collapse on the football field in Jan. 2023.

After several days in the PICU, Oscar seems to be neurologically fine and is resting at home. “He’s back to his 6-year-old self,” says his mom. “We were told not to get his heart rate up — a little difficult with three other brothers at home,” Sarah jokes.

Though these parents of four boys are relieved that their crisis seems to have a happy ending, they are taking action to stop other families from experiencing the same trauma.

Playing centerfield

On Sunday, March 10, the Stuebe family attended a double-header for their 7-year-old son’s travel baseball team. Because there was a shortage of players, 6-year-old Oscar, who plays on a coach-pitch team, helped out by playing centerfield.

The first game went off without a hitch. During the second game, a player on the opposing team hit a pop fly. It was a “good hit” but it was “not hard,” Sarah says. Oscar rushed toward the ball with his mitt held up.

“It looked like he caught it and it dropped,” Sarah explains. “And then, he fell. To the ground.”

Oscar’s father, Riley Stuebe, rushed to his son. From the stands, Sarah initially assumed Oscar was “fine.”

But then Riley yelled Sarah’s name.

“I’ll never forget that. It was just the way he said it” that indicated that something was seriously wrong, she says.

Saving Oscar

When Riley reached Oscar, he saw that “everything was stiff. His fingers were stiff, his hands were stiff, his arms were stiff. You could tell he was not in control of his body.” Riley, a retired Marine Corps officer, explains, “I’ve seen trauma, and this was certainly in line with all of that. We couldn’t find a pulse.”

Sarah, who happens to be a nurse, grabbed her phone and ran to the field. Before she laid eyes on her son, she dialed 9-1-1 and handed the phone to her friend to relay details.

“He was having a seizure,” Sarah says. She asked someone to time the seizure and put Oscar on his side. “During that, he went lifeless. His eyes were rolling in the back of his head. He turned grey. He started gasping.”

Sarah, knowing that “gasping isn’t regular breathing,” again checked for a pulse and began CPR. She called out for an AED, a medical device to help in the case of cardiac arrest, but there was no AED at the field.

Even after Sarah began compressions, Oscar was unresponsive. After about two minutes, “it was hitting me that I’m doing CPR on my son.”

A parent of a child playing on a neighboring field relieved Sarah and continued compressions for an additional 2.5 minutes. Riley and Sarah held Oscar’s hand until the first responders arrived.

Hospital-bound

The West Palm Fire Station 2 happened to share the property with the baseball field, according to Fire Chief Diana Matty, so first responders were on the scene within minutes. “A lot of little pieces came together to give this little guy a great shot,” she says.

“The ambulance ride seemed like forever,” Sarah says. Along the way, the paramedics found Oscar’s pulse.

At the hospital, Oscar was rushed into the emergency room while his parents were ushered into a waiting room. St. Mary’s Medical Center happens to be a Level 1 trauma center. “There’s only a couple in the state, and the fact that we were so close to one is another miracle,” Sarah says.

Waiting for an update on her son’s condition was “excruciating,” Sarah says. “We prayed, we prayed, we prayed.” In addition to praying for Oscar, they also prayed for the 7-year-old who hit the fly ball “because it was traumatic for everybody on the field.”

Eventually they were able to see Oscar. He had been intubated and connected to a ventilator. The tube was removed Monday morning because Oscar was “fighting the vent” overnight, which seemed to be a positive sign. Oscar woke up on Monday, “delirious” and “hallucinating,” and he finally slept from 5 p.m. on Tuesday evening through 12:30 a.m. Wednesday.

“Sleep apparently was the best medicine,” Sarah says. “He woke up and was like, ‘Hi, Mom!’ And it was him.”

Riley and Sarah had not left Oscar’s bedside. In fact, they were still wearing the same clothes they had been wearing at Sunday’s baseball game. Sarah’s family traveled from Connecticut to Florida to take care of Oscar’s brothers.

Oscar needed physical therapy and occupational therapy to get back on his feet, “and by Friday, it was back to old Oscar.” He returned home that same day.

A message to parents

The Stuebes want to make sure parents have the knowledge, skills and equipment to keep their children safe.

Their sons will now wear specially designed chest protectors on the field, a measure required by USA Lacrosse but not by national youth baseball leagues. (Baseball and lacrosse players have the highest risk of commotio cordis.)

“We said, ‘Whether you’re in the backyard, at a friend’s house, on the field … you’re wearing the shirt,'” says Sarah firmly. “And they feel cool wearing it,” Riley adds. “Like they’re on the Yankees.”

They also urge everyone to learn CPR.

Sarah’s mother connected Sarah and Riley with her cardiologist at New York-Presbyterian, Dr. Holly S. Andersen, who started a Hands Only CPR initiative. The Stuebes are hoping to spread this message.

“You don’t need to be certified,” says Andersen. “All you need to do is put your arms out straight, interlock your fingers, lean over the victim and push hard and fast in the center of the chest.”

They also hope that more locations will have AEDs on hand. These machines are now fairly affordable and easy to use. They can greatly increase the chance for survival.

The Stuebes say they greatly appreciated the care they experienced through the paramedics and the hospital, as well as the outreach from the opposing team.

Sarah says, “I was talking to one of the other team’s moms and she said, ‘We wear different jerseys but we’re all on one team.'”

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“I started to have a flare up and it came out of the blue and hit me hard,” Sheridan, 36, of Lancaster, Ohio tells TODAY.com. “I was able to get it back under control relatively quickly within a few months.” Still, he contacted his gastroenterologist for a follow-up and they scheduled a colonoscopy, which was canceled when the COVID-19 pandemic started in 2020. In December 2020, he finally got an appointment where doctors discovered he had stage 3 colon cancer.

“The found a stricture, which was actually the tumor,” he says. “The stricture was big enough or tight enough that they had to use a pediatric scope. They were only able to scope about half of my colon.”

Colon cancer and ulcerative colitis

In 2019, Sheridan experienced the sudden onset of ulcerative colitis symptoms.

“It was weird that I had a flare up,” he says. “Even with the flare under control things weren’t quite where they should be.”

For about seven years prior, Sheridan’s ulcerative colitis was so well controlled that he hadn’t needed to visit his doctor. He reached out to his gastroenterologist and scheduled an appointment to make sure everything was OK.

“There were changes,” he says. “The caliber of my bowel movements had changed and gotten smaller.”

Otherwise, he felt healthy.

“I felt great. I was strong. I was starting to exercise,” Sheridan says. “We had a new daughter.”

When he finally had his colonoscopy in December 2020, being diagnosed with cancer “was really shocking.”

“The doctor he explained to me, ‘I think it’s just a normal stricture. This thing happens sometimes,’” Sheridan recalls. “But then he called me a week later, which ended up being Christmas Eve and told me it was a tumor.”

After the holidays, Sheridan sought out oncologists to come up with a treatment plan. Some wanted to remove his entire colon because it would lower his risk of recurrence. But the tumor only appeared to be in the sigmoid colon. It seemed the rest of his colon was healthy.

“There’s other downsides to taking the colon. It’s an organ in the body and if it works, it’s really helpful,” Sheridan says.  

He found a doctor who thought a sigmoidectomy, taking out the sigmoid colon, would be enough to remove the entire tumor and have clear margins without removing the entire colon.

“They did the sigmoidectomy,” Sheridan says. “Once the tumor was analyzed and they checked my lymph nodes, they came back with stage 3B. I had five of 51 lymph nodes positive (for cancer).”

Doctors gave him a temporary ostomy, a surgically-implanted pouch that collects bodily waste outside of the body, to help his colon recover. Healing felt tough at times especially because he had three children at the time, including a 6-month-old daughter.

“The hardest part was not being able to pick her up,” Sheridan says. “It was painful and moving around was difficult but mentally the hardest part was not picking up my daughter and getting to hold her for six weeks.”

Adjusting to having something attached to him felt tough, too.

“It’s not a whole lot of fun,” Sheridan says. “It’s definitely a lifesaver for a lot of folks. But I was glad, going through that experience, that I didn’t have to lose my colon.”

Sheridan underwent seven rounds of chemotherapy though he was originally scheduled for 12 rounds. To bolster his treatments, he received acupuncture and fasted before an infusion and then had a lymphatic massage following treatment.

“I would go in the next day for a lymphatic massage just to help move the chemo through my lymphatic system more effectively,” Sheridan explains.

He kept detailed records of how he felt after treatment and monitored symptoms, including neuropathy — nerve damage sometimes brought on by chemo. When the neuropathy began, he worried about how the changes would affect him in the long term and spoke to his doctors about what they could do to address it.

“We ended up deciding to cut the chemo short just because I started having some neuropathy that wasn’t going away, which is kind of the first sign of being permanent damage,” Sheridan says. “We did do that second colonoscopy, and the rest of my colon was clean. There were no other tumors, there was no other dysplasia or anything. Everything looked very healthy.”

Colon cancer and inflammatory bowel disease

Colon cancer has been increasing in young people, and it is the most common cause of cancer deaths in men under 50, according to a recent report from the American Cancer Society.

“The specific cause for early onset colorectal cancer is still unknown,” Dr. Ning Jin, a medical oncologist at the James The Ohio State University Comprehensive Cancer Center, and one of Sheridan’s doctor, tells TODAY.com. “However, epidemiology studies suggest that sporadic early onset colorectal cancer is likely to be associated with lifestyle changes, such as diet and sedentary lifestyle, smoking, alcohol and other food additives.”

People with inflammatory bowel disease have a slightly increased risk of developing the cancer.

“Inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, are characterized by chronic inflammation. It does carry the risk for developing colorectal cancer,” Jin explains. “The chronic inflammation can cause … abnormal cell growth and transform into a malignancy.”

While people with low risk of colorectal cancer should start colonoscopies at age 45, those with inflammatory bowel disease should begin screening earlier, generally eight years after they received their diagnosis, Jin explains.

“Colonoscopy is highly recommended because if there’s a cancer (in an IBD patient) their lesions are more flat and they’re very difficult to be detected by other methods, such as the so-called virtual colonoscopy,” she says. 

For a virtual colonoscopy, a less invasive way to examine the colon and rectum, a radiologist uses X-rays and a computer to find ulcers, polyps and cancer, according the National Institute of Diabetes and Digestive and Kidney Diseases. The organization notes they “may not be as effective as colonoscopy at finding certain polyps.”

There can be overlap in inflammatory bowel symptoms and colon cancer symptoms, such as having bloody stool. That’s why it is important for IBD patients to have regular colonoscopies and talk to the doctor when symptoms occur.

“Everybody needs to be aware,” Jin says. “For younger patients, if they have those symptoms and signs, please (ask) your physician and be aware of the risk of early onset colorectal cancer.”

Recovery

After chemotherapy finished, Sheridan had surgery to reverse his ostomy in June 2021. He has no evidence of disease. While the neuropathy went away and his hair started growing back, Sheridan has been grappling with the emotions of having cancer.

“You’re thinking about how you view yourself and even your trust in your own body,” he says.

Still, the experience revealed some positives, too. Because he was sick, he spent a lot of time watching his children grow, and he and his wife welcomed a fourth child.

“The whole process really showed me how much I love to be around my kids,” he says. “The whole process helped to reorient me in my mind and helped me become less afraid of change.”

Sheridan engaged in informed consent with his doctors, meaning there was an open dialogue about treatments and approaches. The mechanical engineer often brought research papers and detailed notes about how he was feeling to meetings with doctors. He believes that helped him receive the best care.

“You’re your own advocate,” he says. “There have been great strides in the last 10 years, five years with cancer research. … It’s really come a long way.” 

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Daniella Thackray’s funeral was held on Monday, March 18, her fiancé, Tom Calvert tells TODAY.com.

Her last letter, posted by her family to LinkedIn and Facebook on Feb. 23 upon her death, has received thousands of reactions and comments from people around the world.

“I LOVED my life. Everything I had achieved was what I wanted. I loved my job, my fiancé, my family, my friends and my dog, and the house we were going to buy and the future we were making for ourselves,” Thackray wrote.

“I chose not to mourn the life I was losing despite being so devastated, but to instead enjoy every moment I had left.”

She worked as a people administrator for an advertising agency in Leeds, England, describing herself as “very healthy and active” until she was diagnosed with cholangiocarcinoma, a cancer that forms in the bile ducts, in July 2023.

Even though her life was never the same again, she wrote, she chose to focus on everyone and everything she loved.

“We can’t control what happens to us, (but) we can control how we react,” Thackray added.

“You should enjoy the little things in life and cherish every moment! Romanticise your life! Do whatever makes you happy and don’t let anyone take the joy of life away from you.”

She finished the letter with a message to her fiancé: “Go enjoy your life now, you deserve it.”

The 25-year-old was the most enthusiastic and cheerful person, Liz Reynolds, her manager at 26 Agency wrote when announcing her death. The company is fundraising for St Gemma’s hospice in Leeds in her memory.

Bile duct cancer symptoms

Thackray called cholangiocarcinoma a “horrid cruel disease” that wasn’t caused by anything in her control and just happened.

It’s a rare and aggressive cancer that spreads fast and has usually metastasized by the time it’s diagnosed, according to the Cleveland Clinic.

Experts don’t know what causes it, but risk factors include having bile duct stones, cirrhosis of the liver or inflammatory bowel disease.

About 8,000 people are diagnosed with bile duct cancer each year in the U.S.

It starts in small tubes that carry bile — a fluid that helps the body digest fats — inside and outside the liver, the National Cancer Institute notes.

Symptoms include:

• Jaundice, or yellowing of the skin or whites of the eyes
• Dark urine
• Clay colored stool
• Abdominal pain
• Fever
• Itchy skin
• Nausea and vomiting
• Unexplained weight loss

Treatment is challenging because the cancer has usually already spread by the time it’s discovered. Options include surgery, chemotherapy, radiation and a liver transplant, according to the Cleveland Clinic.

The five-year survival rate for bile duct cancer that has spread to distant parts of the body is 2% to 3%, the American Cancer Society notes.

“I really really do hope that in the years to come more research is done about this horrid cruel disease so that more lives can be saved,” Thackray wrote in her final message.

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Aside from being grossed out, you may have concerns about the health effects: What happens if you eat mold? How much mold on food does it take to make you sick? And where do foods that are sold with mold, like blue cheese, stand in all of this?

Here’s why mold grows on food, what happens when you eat it, and tips to keep food mold-free.

What is mold?

Molds are microscopic fungi, Josephine Wee, Ph.D., an assistant professor of food science at Penn State University, tells TODAY.com. Other examples of fungi include mushrooms and yeast, the kind used to make bread. In other words, all molds are fungi, but not all fungi are molds.

Molds are a natural part of the environment and found almost everywhere moisture and oxygen are present, per the U.S. Environmental Protection Agency.

There are tens of thousands of species of mold, which spread by producing tiny cells called spores. “The spores are everywhere; they are on our skin, in the air that we breathe, on our foods,” says Wee.

Outdoors, molds play an important role in breaking down organic matter like decaying leaves, but inside, mold can spoil foods or grow on damp surfaces and should be avoided, according to the EPA.

“Molds grow in the right conditions. … They like higher humidity and warmer temperatures,” says Wee. This is why mold does not grow as quickly on food that’s refrigerated.

Molds, like other living microorganisms, also require oxygen to grow, Randy Worobo, Ph.D., professor of food microbiology at Cornell University, tells TODAY.com. Cheese and other foods with a higher moisture content often come vacuum-packed as mold can grow soon after products are exposed to air, he explains.

“One of the unique characteristics of molds is that they’re really good at growing on just about anything. … They’re scavengers,” says Worobo. Even at lower temperatures in the refrigerator, mold can eventually form on foods over time. If you’ve ever forgotten about leftovers, you’ve learned this the hard way.

Which types of mold are harmful?

When it comes to molds, some types are more harmful than others. “There’s the good, the bad and the ugly,” aka toxic, says Wee.

“Good” molds are used to produce certain cheeses, for example. A type called penicillium roqueforti is used to make blue cheeses like roquefort, gorgonzola and stilton, the experts note. Penicillium camemberti is used to make camembert and brie cheese, which have a white mold surface, Worobo explains.

The mold in and on these cheeses is safe to eat, according to the U.S. Department of Agriculture. “These are intentionally added to the milk cultures,” says Wee. So blue cheese lovers can rejoice.

“Bad” mold grows on foods due to spoilage, says Wee. Food mold comes in many different colors and textures. On bread, it may look like green or black spots, says Wee, whereas berries often grow a white cotton-like fuzz, and mold on citrus fruits will look like green or gray dust.

Mold can also look red, pink or orange, and the color can change over time depending on the mold’s life cycle, says Wee.

What happens if you eat mold?

In most cases, nothing happens if you accidentally eat food with mold on it, the experts note. “When you ingest the mold, the acids in your stomach, as well as the digestive enzymes, will break the cells down,” says Worobo. Healthy individuals generally won’t get sick from eating a few bites of moldy food.

“For the general population, it’s not a big deal,” Worobo adds.

However, in immunocompromised people, the mold can potentially colonize and result in fungal infections, so these individuals should be extra careful and avoid any mold.

And certain types of mold — aka the “ugly” — can produce toxic substances called mycotoxins under the right conditions, says Wee. These can make anyone sick and pose serious health risks.

Exposure to toxic molds can cause adverse health effects in the short- and long-term, per the World Health Organization. The most dangerous type are aflatoxins, which can be carcinogenic to humans, per the USDA.

It’s impossible to tell which type of mold is growing on food or whether it is toxic just by looking at it, which is why it’s important to avoid eating moldy foods when possible.

How much mold can make you sick?

The amount of mold you consume matters, too. The average person likely won’t get sick from ingesting small amounts of mold, the experts note. However, eating larger quantities of mold may result in some nausea or stomach upset.

Chances are you won’t be able to eat very much because people naturally tend to avoid food that’s spoiled, Wee explains.

“You’re not going to eat a slice of moldy bread because it does not taste good and it’s not appealing to the eye. It’s a sensory issue,” she says, adding that moldy food may smell bad or have an earthy flavor, like dirt.

You’ll likely spit the food out or throw it away before you can finish the entire thing, Wee notes.

Any amount or type of mold can cause issues for people with mold allergies, the experts note. This often occurs through inhalation, but eating mold can also cause a reaction. “Even though there are no toxins that are present, there are people who cannot eat even small amounts (of moldy food) because of the spores,” says Wee.

Symptoms of an allergic reaction to mold may include sneezing, a runny nose, or an itchy throat, according to Mayo Clinic.

Ingesting large doses of certain mycotoxins can cause acute poisoning or life-threatening liver damage, per the WHO. Fortunately, this is relatively rare.

Can you cut around moldy food?

The mold you can see growing on food may penetrate much deeper than surface-level, the experts note. Think of the roots of a tree growing underground, says Wee.

The body of mold consists of a thread-like root that invades the food, a stalk that rises above the food and may not be visible to the naked eye, and spores that form at the end of the stalks, according to the USDA. (The spores are what you see growing on the food.)

So cutting out or around mold on foods may not get rid of it, the experts warn. In fact, slicing a knife through a moldy spot can spread the spores to other parts of the food, says Worobo.

Moldy, spoiled foods may also contain bacteria that can make you sick — and are not visible. To be safe, toss any food that is growing mold or touching other moldy food, says Wee.

When to see a doctor if you’ve eaten mold

If you’ve eaten moldy food and it’s too late to spit it out, don’t panic. Unless you are immunocompromised or eat very large quantities of mold, you will probably be OK. But watch for any symptoms, the experts note. If you feel fine, you can proceed as normal.

If you develop severe gastrointestinal symptoms or signs of an allergic reaction, seek medical attention. These include but are not limited to: shortness of breath, an elevated temperature, vomiting or wheezing, per the Cleveland Clinic.

In any case, if you have concerns or questions about eating mold, always talk to your health care provider.

How to prevent mold on foods

There are steps you can take to reduce your risk of exposure to mold spores and prevent mold from growing on foods, according to the experts and the USDA:

• Discard all food growing mold
• Do not sniff moldy food (to avoid inhaling spores)
• Clean any surfaces and containers moldy food has touched
• Refrigerate all perishables at 40 degrees or lower
• Store and refrigerate cooked food within two hours of serving
• Cover foods while serving to prevent exposure to spores in the air
• Eat or discard leftovers after three to four days
• Examine all food for signs of mold before buying

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An analysis of data from more than 20,000 adults revealed that over several years participants who consumed all food in eight hours or less a day were almost twice as likely to die from cardiovascular disease compared to those who consumed food over the standard 12 to 16 hours a day, according to the report presented on Monday, March 18, at an American Heart Association conference in Chicago.

Time-restricted eating, aka intermittent fasting, has become increasingly popular, with mounting evidence from human and animal studies that associate the eating pattern with better health. Specifically, studies have associated intermittent fasting with weight loss and improved regulation of blood sugar along with decreased blood pressure, cholesterol, resting heart rate and inflammation.

There are a few different types of intermittent fasting with 16:8 — when you fast for 16 hours and eat over the course of eight — being one of the most popular. Another type is 5:2, when you eat only 500 calories two days a week and follow a normal diet the other days.

So what does the new study mean if you practice intermittent fasting or are interested in trying it out? Here’s what to know.

What did the study find?

To take a closer look at the long term health impacts of time-restricted eating, the researchers turned to data from the National Health and Nutrition Examination Survey (NHANES) and linked it with information from the National Death Index.

The researchers focused on NHANES participants who were at least 20 years old at enrollment. Between 2003 and 2018, the 20,078 men and women twice filled out a questionnaire that asked about what food they consumed and when during the previous 24 hours. They were followed for a median of eight years. During the course of the study, there were 2,797 deaths overall, 840 of which were due to heart disease and 643 to cancer.

When the researchers analyzed the data, they found that people who consumed all their food in eight hours or less a day were 91% more likely to die from heart disease than those who spread their eating out over 12 to 16 hours.

The findings — which are not peer-reviewed or published in an academic journal — came as a surprise to the researchers.

“We had expected that long-term adoption of eight-hour restricted eating would be associated with lower risk of cardiovascular death and even all-cause death, because short-term randomized controlled trials, generally conducted within a one-month to one-year period, have reported that time-restricted eating reduces weight and improves cardiometabolic health,” senior author of the study Victor Wenze Zhong, Ph.D., professor and chair of epidemiology and biostatistics at Shanghai Jiao Tong University School of Medicine, tells TODAY.com via email.

He says possible explanation for the finding is that the intermittent-fasting group had less lean muscle mass than the other, and low lean muscle mass has been associated with a higher risk of cardiovascular death in previous research.

But Zhong stresses it’s “too early to give a specific recommendation on time-restricted eating based on our study alone.”

In fact, “practicing intermittent fasting for a short period, such as three months or six months, may likely lead to benefits on reducing weight and improving cardiometabolic health based on what we know so far,” he says.

So, in light of the new research, he simply recommends caution for people who’ve been doing 16:8 intermittent fasting for years. 

What do experts say?

TODAY.com nutrition editor and registered dietitian Natalie Rizzo says the results seem to align with how intermittent fast can affect your cravings.

“Since intermittent fasting is based on eating in a certain window of time, there is no limit to the types of foods you can eat,” Rizzo explains. “Restricting eating to eight hours of the day can cause extreme hunger, which may result in binging on food or making unhealthy food choices. Plus, restricting food for 16 hours per day can increase cravings, which can also lead to unhealthy choices.”

Mark Mattson, Ph.D, a leading researcher on intermittent fasting and adjunct professor of neuroscience at Johns Hopkins University School of Medicine, says the study has “a number of problems.”

First, the findings are based on just two days of dietary recall, Mattson, author of “The Intermittent Fasting Revolution: The Science of Optimizing Health and Enhancing Performance,” tells TODAY.com. Moreover, the researchers don’t appear to have accounted for the number of calories participants consumed. It’s possible the people who ate only during eight hours were consuming high-calorie, less nutritious foods.

“If they binge eat during those eight hours, it’s not going to be good for their cardiovascular system,” agrees Dr. Deepak Bhatt, director of the Mount Sinai Fuster Heart Hospital in New York City.

But most importantly, the study doesn’t prove that the greater risk of death was due to people cramming all their eating into eight hours or less, Mattson explains. It’s possible that the 8-hour fasting group had something in common besides their pattern of eating.

While most clinical trials designed to look at the impact of restricted eating have lasted only several months to a year, “the changes in health indicators — insulin resistance, belly fat, blood lipid (fat) profiles, for example — are consistently going in the right direction,” Mattson says. 

Also, the data for the new study were collected at a time when many people weren’t purposely practicing restricted eating, says Dr. Sean P. Heffron, a preventive cardiologist and director of fitness-focused cardiology at the Center for the Prevention of Cardiovascular Disease at NYU Langone Heart. So, we don’t know why they were eating all their food in eight hours or less, Heffron tells TODAY.com.

“There is nothing here that would suggest I make any clinical recommendations one way or the other,” he says.

The new results are “surprising,” adds Bhatt. But the biggest problem with the study, he says, is that it depends upon dietary recall, “which is imperfect. … People often don’t recall what they had for breakfast. For this sort of research, you need detailed dietary information gathered in real time.”

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There were 58 confirmed cases of measles in the U.S. this year as of Thursday, the Centers for Disease Control and Prevention said, compared to 58 in all of 2023.

In the cases this year, 93% were linked to international travel, the agency said. Most of the cases involved children a year or older who haven’t yet gotten a measles-mumps-rubella vaccine, or MMR.

“Healthcare providers should ensure children are current on routine immunizations, including MMR,” the agency said in an advisory to medical providers.

Seventeen states have reported cases this year. In New York, the cases were reported in New York City, the CDC says on its website.

There are also outbreaks in other countries, including Austria and the United Kingdom, so anyone of any age traveling to any international destination should be current on their vaccinations, the agency said in the advisory.

Measles is highly contagious and unvaccinated people have a 90% chance of becoming infected if exposed.

Late last month there was a large outbreak in Florida, and in January there was one in Philadelphia.

It can also be fatal. In 2021, an estimated 128,000 people, most of whom were children, died from the disease, the World Health Organization organization says.

It estimates that 56 million deaths were averted by vaccination worldwide between 2000 and 2021.

Measles was declared eliminated in the U.S. in 2000, which means no continuous disease transmission for greater than 12 months, or not constantly present in the country, according to the agency.

The U.S. retains its eliminated status, but in 2019 there was a 27-year high with 1,274 cases. Those outbreaks were all travel-related cases that then infected people who are unvaccinated or under-vaccinated in the U.S., the CDC has said.

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Tallulah Willis is getting candid about her journey.

The 30-year-old shared her autism diagnosis March 16 with a heartwarming, throwback video of her and dad Bruce Willis.

In the video, Willis — whose mom is Demi Moore — is seen playing with the actor’s head and ear as he holds her. As she captioned the post, alongside the laughing crying emoji, “Tell me your autistic without telling me your autistic.” [sic]

And, when a user asked whether she’d been diagnosed as a child, she explained, “Actually this is the first time I’ve ever publicly shared my diagnosis. Found out this summer and it’s changed my life.”

Afterwards, older sister Scout Willis, 32, showed her love commenting, “She’s stimming.” (Stimming refers to self-stimulatory behaviors, like the repetitive movements Tallulah shows in the clip.)

To which Willis wrote back, “Dude the ear curl. I wish we had better audio.”

Mar 3

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The throwback video strikes an especially poignant chord amid her dad’s ongoing battle with frontotemporal dementia. Since announcing his diagnosis with aphasia in 2022, and then with the more specific diagnosis of frontotemporal dementia in Feb. 2023, the “Die Hard” actor has taken a step away from the spotlight.

Throughout it all, the actor’s family — which also includes Tallulah Willis’ older sister Rumer Willis, 35, as well the actor’s wife Emma Heming Willis and their daughters Mabel, 11, and Evelyn, 9 — have been open about his health journey.

“There is grief and sadness,” Emma Willis has previously shared. “There is all of that. But you start a new chapter and that chapter is filled. It’s filled with love. It’s filled with connection. It’s filled with joy. It’s filled with happiness. That’s where we are.”

And some of that joy and happiness involves celebrating as a family, which is exactly what they did for Tallulah’s 30^th birthday in February.

Moore shared a peek into the milestone celebration with a picture of herself and the actor posing with their daughter. The “Ghost” actress captioned the Feb. 3 post, alongside a heart, “Showering our @buuski with love today on her 30th birthday.”

By that age, she was already well-aware of the stigma surrounding body hair that it was masculine and unhygienic. And since she had no intention of becoming the subject of ridicule, she and her mom had it removed by an aesthetician.

By the time she was in high school, Calixte-Bea had adopted an involved beauty routine: She’d shave and epilate her chest, legs, armpits and sideburns, which grew in unevenly every two days.

“I started hating my body,” Calixte-Bea, 27, of Montreal, tells TODAY.com. And she began to resent the hair that seemed to taunt her every time it grew back, somehow appearing coarser than the time before.

Soon enough, the constant shaving and epilating made the soft skin on Calixte-Bea’s chest especially sensitive. She noticed a series of bumps that turned red whenever her clothing rubbed up against it. And when the level of friction was especially high depending on clothing material or how much she moved, she’d get pimple-like bumps, filled with puss.

She tried to cut back on shaving as much as she could and covered up instead. “I wouldn’t wear certain clothes,” Calixte-Bea recalls. “I wouldn’t even go swimming anymore because I was tired of removing (the hair).”

But a time would inevitably come when an outfit or occasion called for her to be hairless again, and the removal routine would resume.

This was women’s work, Calixte-Bea was taught. Being beautiful was laborious, but she was burning out and knew she couldn’t continue like this.

Reworking her mindset

In university, Calixte-Bea was determined to work on her self-esteem. The amount of body hair she had seemed to have multiplied just before school started, and she couldn’t keep up.

“I started to have a little crisis inside me,” she said. “That’s when I started really questioning why I was shaving and for who I was doing this,” she says.

Calixte-Bea came up with affirmations she’d repeat to herself daily about her worthiness. And she wrote lists of all the things she disliked about herself before rewriting the same list, this time labeling them as the things she loved most.

“How is it possible that in society they tell me that I shouldn’t have body hair, but I remove it and then it grows back? If women aren’t supposed to have it, why is it growing back?” Calixte-Bea remembers thinking at the time.

She told herself she’d be the authority on what made her beautiful moving forward. But living it out was another thing entirely.

To hold herself accountable, Calixte-Bea launched the Lavender Project in 2019. For it, she photographed herself showcasing her body hair and posted online. “(I was) finally embracing (my hair) and starting this conversation around body hair and femininity.”

Since posting the Lavender Project, Calixte-Bea hasn’t shaved or waxed.

Finding the root cause

Genetics always seemed the most probable reason for her body hair. And while Calixte-Bea’s mom didn’t have chest hair, she was always hairier than her sisters. Calixte-Bea’s dad was also covered in body hair, so for a while, she didn’t feel compelled to investigate further.

But in 2022, her aunt who lives in Côte d’Ivoire told her about the tribe Calixte-Bea’s paternal family descends from, called We. All the women, Calixte-Bea learned, had body hair that resembled hers.

“In my great-grandmother’s time, it was seen as beautiful,” she says.

“Increased hair growth can be hereditary,” Dr. Deena Gupta-Adimoolam, specialist in endocrinology, diabetes, metabolism and obesity medicine, tells TODAY.com. “There are certain ethnic populations more susceptible to increased hair growth than others, specifically those of Mediterranean, South Asian and Middle Eastern descent.”

Bloodwork confirmed this was likely the case in Calixte-Bea’s family.

Her endocrinologist ruled out PCOS and other illnesses typically associated with excess body hair but found Calixte-Bea had elevated levels of a hormone called DHEAS, which is typically harmless.

“There are some genetic mutations that can be associated with higher levels of hormones, like DHEAS.” Gupta-Adimoolam confirmed. So, the hormone may have been elevated in her family and ancestors, too.

Committed to leaving her hair untouched, Calixte-Bea declined the hair-thinning medication her doctor offered her.

Embracing the hair

Calixte-Bea is now 27 years old with an impressive social media presence dedicated to body hair activism. “By making content, I really tried to remove the shame,” Calixte-Bea says.

She recognizes that for some women, excess body hair comes with other health issues that she’s lucky not to have, so she reminds her followers that people’s relationships with their hair can be complicated and emotional.

Calixte-Bea’s not concerned with whether her followers choose to keep their body hair or remove it, but she aims to show how proud she is of hers. In fact, she knew she’d repaired her confidence when the thought of her chest being hairless made her shiver.

“It’s something that I’ve identified as a part of me,” she says.

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From melatonin gummies to bedtime snacks to the military sleep method, there’s no shortage of hacks out there that promise to help you fall asleep faster. One of the recent sleep hacks making the rounds on social media is the “sleepy girl mocktail.”

The sleepy girl mocktail was invented by TikToker Calee Shea in January 2023, but went viral again after it was posted by Gracie Norton in a TikTok video that has since garnered more than 1.5 million views.

Norton claimed the beverage was a game-changer for her bedtime routine and helped her fall asleep, saying “pure tart cherry juice and magnesium is a match made in heaven.”

Hundreds of people commented on the video that they found similar results from drinking the concoction before bedtime and a long feed of users have posted their own videos claiming it’s given them the best sleep of their lives.

Could the hype be true? Is there really a magic potion to help you fall asleep?

What’s in the sleepy girl mocktail from TikTok?

The main ingredients in the sleepy girl mocktail are tart cherry juice, magnesium powder and prebiotic soda or sparkling water.

Sleep girl mocktail recipe

The recipe for the sleepy girl mocktail is:

• ½ cup pure tart cherry juice
• 1 tablespoon of magnesium powder
• A splash of prebiotic soda (Shea and Norton used Olipop) or sparkling water

Does the sleepy girl mocktail help you sleep?

“People’s responses will vary, but the research supports these ingredients for better sleep,” Samantha Cassetty, a registered dietitian based in New York City and the co-author of “Sugar Shock,” tells TODAY.com. 

What is it about tart cherry juice and magnesium that can help you fall asleep?

“Tart cherry juice has a high concentration of melatonin — the hormone that induces drowsiness at bedtime,” says Cassetty. “And researchers are investigating other nutrients in tart cherry juice, such as tryptophan and polyphenol antioxidants, that might play a role in supporting sleep.”

So can consuming tart cherry juice actually have sleep-inducing properties? “There’s good evidence that drinking tart cherry juice can improve sleep duration and quality,” confirms Cassetty.  

Magnesium can also help prepare your body for sleep. “Magnesium (promotes) relaxation, and it’s also involved in regulating melatonin, which guides your sleep-wake cycle and kickstarts the feeling of sleepiness,” says Cassetty. “Plus, magnesium regulates the stress hormone cortisol, and when you’re under stress … you deplete magnesium. This means your magnesium needs go up, and it also means you may not sleep well. When you have adequate magnesium, you may feel calmer and have fewer physical symptoms of stress, making it easier to sleep.”

Prebiotic soda, like the Olipop used in the original recipe, is where the recipe falls short.

“The ingredients in prebiotic sodas can trigger digestive discomforts like bloating, gassiness and diarrhea, and they don’t come with the benefits that prebiotic-rich whole foods offer,” says Cassetty.

“While there is some evidence that prebiotics can support better sleep, prebiotic sodas are pricey, and it’s hard to say if they’d have any immediate impact,” she adds. To save money and (and potential gastrointestinal aggravation), she recommends getting prebiotics from food instead by eating fiber-rich plant foods and using seltzer water in the recipe instead.

What kind of magnesium powder works best in the sleepy girl mocktail?

All magnesium powders aren’t created equal, so it’s important to read the ingredients label closely. “The most popular magnesium powder contains magnesium citrate, which can cause diarrhea, gassiness and bloating,” says Cassetty. “Instead, I’d recommend a powder containing magnesium glycinate, which isn’t associated with these side effects, and it’s better for the calming properties that can help with sleep.”

Is it safe to drink the ‘sleepy girl mocktail’?

The mocktail can be a safe addition to your nightly routine, especially if it’s replacing other beverages that you’re currently using to wind down.

This drink is “definitely a safer choice than a cocktail or glass of wine,” says Cassetty. “While alcohol makes you drowsy, which may help you fall asleep, it leads to sleep disruptions, which impair your sleep quality.”

But people have also raised some red flags about the mocktail.

As a follow-up to her initial viral video, Sierra Cooley says that while the drink did help her fall asleep faster, the melatonin gave her extremely vivid dreams that triggered her anxiety. In addition to comments about the drink triggering anxiety, some users also reported gastrointestinal symptoms like acid reflux and upset stomach.

“Anyone who has a chronic medical condition — such as kidney disease, heart disease or a GI disorder — should steer clear of this drink,” says Cassetty. “Anyone who is being treated for a medical condition should talk with their health care team before trying a new supplement. Even though supplements are sold over the counter, they can interfere with certain medications.”

Drinking any beverage can increase the chances that you’ll wake up to pee, which might disrupt a good night’s sleep, she added. “This is especially true if you have difficulty falling asleep after waking in the middle of the night,” she says.

If you do want to try the ‘sleepy girl mocktail,’ sipping the drink with a small snack may be a smart move for blood-sugar control, TODAY.com previously reported. Registered dietitian Bonnie Taub-Dix recommends combining it with other foods that can induce sleep, such as cheese, high in tryptophan, or almonds, high in melatonin. This will help you avoid the rise in blood sugar that can happen when you drink tart cherry juice alone.

What to eat for better sleep

These other changes to your diet will also help promote healthy sleep, says Cassetty.

1. Limit caffeine starting midday. “It’s average half-life is about five hours, so a late afternoon latte could interfere with your ability to fall asleep,” she says.
2. Eat less added sugar and more fiber-rich plant foods. “A 2016 study found that a typical American diet, which is high in sugar and saturated fat (found in red meat and full-fat dairy foods), but low in fiber was associated with more sleep disturbances and less time in deep sleep,” she says.
3. Fill your plate with fruits, veggies and other plant foods. “A 2020 study found that people who ate more fruits, vegetables and legumes reported better sleep. The same study found that people who closely followed the Mediterranean diet fell asleep faster and experienced better sleep quality,” Cassetty says. “So there’s evidence that your diet plays a strong role in sleep, and the same diet that’s healthy for your body in mind may also help you enjoy better sleep.”

More healthy habits for better sleep

Besides making tweaks to your diet, Cassetty says there are some other lifestyle habits you can adopt to encourage better quality sleep:

• Avoid electronics one to two hours before bed.
• Get outside in the morning for early sunlight exposure. This will help you feel more awake during the day and more sleepy at night, thanks to sunlight’s role in regulating your body’s internal clock. 
• Reduce the stress in your life with activities like journaling or deep breathing.
• Exercise daily. Make it a goal to move your body most days in ways that you enjoy. Studies link exercise with better sleep, and that’s true whether you walk, ride a bike or do yoga.

This story first appeared on TODAY.com. More from TODAY:

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Munn said her score prompted further tests and the discovery of an aggressive form of the disease.

“I’m lucky. We caught it with enough time that I had options,” the 43-year-old actor posted on Instagram. “I want the same for any woman who might have to face this one day.”

A look at the calculator, the Breast Cancer Risk Assessment Tool:

What is the Breast Cancer Risk Assessment Tool?

It’s a questionnaire on the National Cancer Institute’s website that is designed for health care providers to use with patients. The tool received a “dramatic increase in visits” since Munn’s post, according to an NCI spokesperson.

First developed in 1989, it was originally based on data from only white women. Updates have made it more accurate for Black, Hispanic and Asian and Pacific Islander women.

It doesn’t take everything into account and can’t actually predict whether any one person will get breast cancer.

It asks about age, age at first menstrual period, age when the woman’s first child was born or if the woman has not given birth, family history of breast cancer, past breast biopsies, results of past biopsies, race and ethnicity.

The result is a lifetime risk and a five-year risk based on factors that have been tied to a higher risk of breast cancer. For comparison, it also gives an average risk for U.S. women of the same age, race and ethnicity.

Dr. Elizabeth Comen, who treats breast cancer at Memorial Sloan Kettering Cancer Center in New York, said women should do the assessment with their doctors, not by themselves.

“It’s very important to talk to your doctor about doing that together, and then making decisions about what imaging techniques are appropriate” based on the results, Comen said. Munn’s high score prompted additional imaging tests that aren’t recommended for women of average risk.

Should everyone use the tool?

It’s not the best risk calculator for some women. If you have a certain gene mutation or a previous history of breast cancer, it’s not for you. It also doesn’t take into account dense breast tissue, which can make cancer harder to spot.

The National Cancer Institute says the tool may underestimate risk in Black women with previous biopsies and Hispanic women born outside the U.S.

“The model needs further validation for Hispanic women and other subgroups,” the institute’s website says. “Researchers are conducting additional studies to gather more data to test and improve the model.”

There are dozens of similar tools, said Ashley Johnson, a nurse practitioner at Vanderbilt University Medical Center, who has studied them. Many health groups recommend that women over age 25 have such an assessment, she said, but there’s not enough evidence to say which tool is best.

What do the scores mean?

A five-year risk score of 2%, for example, means a woman’s estimated risk of developing breast cancer over the next five years is 2%.

A lifetime risk score of 7% means a woman’s estimated risk of developing breast cancer through age 90 is 7%.

Mammogram guidelines are for women at average risk, said Dr. Arif Kamal, chief patient officer at the American Cancer Society. Guidelines vary but the society says women can choose to start annual mammograms at age 40.

“Knowing your risk starts even before the age of 40,” Kamal said. That’s where a risk calculator can help.

How can I lower my risk of breast cancer?

Everyone has some risk of cancer, Comen said, but some lifestyle changes can reduce the chances.

She suggests avoiding processed foods, adding exercise and strength training to your routine, limiting alcohol and not smoking.

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