Often dry or itchy patches of skin can be confused for eczema — also known as dermatitis — if you don’t know how to tell the two conditions apart. So, what’s the one way to tell the difference between dry skin and eczema? It all comes down to one thing — genetics. The main difference is that eczema is a genetic condition that manifests itself in many different forms with differing symptoms, while dry skin is just, well, skin that is depleted of moisture and that needs to be rehydrated.
According to the National Eczema Association, there are nine different known types of dermatitis, though the symptoms presented vary from person to person. The National Eczema Association also states that if you have eczema, your skin is usually less able to retain moisture and may have a more difficult time producing fats and oils. Generally, in mild cases, the skin is dry, scaly, red, and itchy. It’s important to figure out if you have dry skin verses eczema so that you can go about treating your symptoms the right way.
Dr. Jessica Weiser of the NY Dermatology group explains to me over email that, “There is typically a genetic predisposition to developing atopic dermatitis and is often associated with asthma and allergies. It is possible to develop eczema-like skin rashes as a result of irritation or contact allergies to a variety of chemicals and other substances.” She further notes that “Dry skin, however, is an acquired condition where moisture in the skin surface is depleted as a result of cold weather, dry indoor heat, poor hydration” et cetera. There is quite a difference between the two.” If you’re wondering whether you have eczema, look into your family history.
As far as treatment goes, the NEA recommends taking warm baths and using moisturizer to sooth eczema. However, make sure not to agitate the skin or you could worsen your condition.
First Aid Beauty Ultra Repair Cream, $30, ulta.com
Whether you have eczema or just plain old dry skin, a super hydrating moisturizer like this one from First Aid Beauty is a must-have. Just remember that it’s important to get a formal diagnosis if you suspect you have eczema so you can go about treating it the proper way with the help of a dermatologist.
While it’s become a central plot point on the latest season of The Real Housewives of Beverly Hills, it’s important to remember that Yolanda Foster is still dealing with her Lyme disease diagnosis, searching tirelessly for a cure to end her pain and suffering. Much has been made of her illness on this season, with several cast members calling into doubt not only that she has Lyme disease, but that she’s as sick as she says, and whether her two children Anwar and Bella Hadid also actually have it. Despite the doubts cast by her fellow Housewives, Foster has made it her mission to speak on behalf of other Lyme sufferers, so how did she actually get Lyme disease in the first place?
While the most commonly known (and widely accepted) medical view is that Lyme disease is contracted via deer tick bite, that’s where the simplicity with this disease ends. For starters, early symptoms of Lyme disease are not absolute. Some people remember being bitten by a tick because they removed the tick themselves, or receive the telltale “bull’s-eye” rash at the site of the bite. Others simply don’t get the rash or never realize they were bitten by a tiny tick. Things only get more complex from there for many Lyme sufferers.
Foster has been an advocate for those struggling with the same disease for nearly three years, as evidenced by her social media accounts.
?Lyme awareness Day in LA with my fellow Lymies #wemustfindacure
A photo posted by YOLANDA (@yolandahfoster) on May 10, 2013 at 2:01pm PDT
Of course, this photo featuring a lime green-clad, beaming Foster surrounded by fellow advocates is a stark reality to the Foster we see today, often bedridden and appearing less-than-healthy:
❤️Just because some ppl are done with your journey, doesn’t mean your journey is done…….. #AnotherWastedSaturday #LifeFromTheSideLines #Spoonie #LymeDiseaseAwereness #DeterminedToFindACure #AffordableForAll PS: Bad Selfie Day
A photo posted by YOLANDA (@yolandahfoster) on Jan 16, 2016 at 9:11pm PST
As time has gone on from her initial diagnosis in late 2012, Foster has opened up a flood of conversation surrounding Lyme disease: how it’s contracted, how it’s often misdiagnosed, and how complicated treating it can be. It’s unclear if Foster was actually bitten by a tick, but she told Andy Cohen on Watch What Happens Live! in early 2013 that she realized she was ill when shooting RHOBH and her brain functioning was impaired.
She has since publicly chronicled her efforts to find the best treatment for her, all the while sharing her ups and downs on her journey for a cure. Though people question exactly how Foster and her children could contract the disease, Foster explains on her Bravo blog: “The children and I lived on a horse ranch in Santa Barbara for 10 years and spent the majority of our time outside in nature.” Fans will remember that Foster, in healthier days, spent a lot of time gardening, and the family has always loved to ride horses. This time spent outside naturally ups the chances for getting a hard-to-notice tick bite, thus furthering the chances for the Lyme disease she’s still struggling with all these years later.
As someone who watched my mom struggle with the exact same search for a diagnosis and a cure for Lyme disease that Foster and her family are still dealing with, I especially wish them all the best. It goes to show that money and fame don’t make someone immune to serious illness, and that there is a long way to go for Foster and others struggling with the painful reality of Lyme disease.
Crohn’s disease is a type of inflammatory bowel disease (IBD) in which an abnormal immune system response causes chronic inflammation in the digestive tract. Crohn’s is often confused with ulcerative colitis, a similar IBD that only affects the large intestine.
According to the Crohn’s & Colitis Foundation of America, about 1.4 million Americans have Crohn’s disease or ulcerative colitis. Of those, about 700,000 have Crohn’s. In the years between 1992 and 2004, there was a 74 percent increase in doctor’s office visits due to Crohn’s disease. In 2004, Crohn’s disease was the cause of 57,000 hospitalizations.
Who Gets Crohn’s Disease
Anyone can develop Crohn’s disease or ulcerative colitis. However, IBDs are usually diagnosed in young adults between the ages of 15 and 30. Children are twice as likely to be diagnosed with Crohn’s as ulcerative colitis. Boys develop IBDs at a slightly higher rate than girls.
In the United States, males and females get Crohn’s at about the same rate. Caucasians and Ashkenazi Jews develop Crohn’s at a higher rate than other ethnicities. The highest rates occur in Canada. In general, people who live in higher latitudes are more likely to develop Crohn’s than those in lower latitudes. When relocating from a low-latitude to a high-latitude region, the risk of developing Crohn’s matches that of the high-latitude region within a single generation.
In Crohn’s disease, the immune system mistakenly attacks healthy bacteria in the GI tract. Chronic inflammation causes thickening of the intestinal wall, which triggers the symptoms. The exact reason this occurs is not clear, but there is a hereditary factor. According to the Crohn’s & Colitis Foundation of America, between 5 and 20 percent of people who have an IBD have a first-degree relative with one. The risk is higher in Crohn’s than ulcerative colitis, and higher when both parents are affected.
There may also be an environmental element. Rates of Crohn’s are higher in developed countries, urban areas, and northern climates. Stress and diet may worsen Crohn’s, but neither is thought to cause the disease. It’s likely that Crohn’s is caused by a combination of factors.
Symptoms of the disease vary from person to person, depending on the type of Crohn’s. The most widespread form is called ileocolitis, which affects the end of the small intestine (ileum) and the large intestine. Symptoms include pain in the lower or middle part of the abdomen. Diarrhea and weight loss are common. Ileitis affects only the ileum, but causes the same symptoms.
Gastroduodenal Crohn’s disease manifests in the beginning of the small intestine (duodenum) and the stomach. The main symptoms are loss of appetite, nausea, and vomiting, which can result in loss of weight. Jejunoileitis causes areas of inflammation in the upper part of the small intestine (jejunum). It can cause severe abdominal pain and cramping, especially after eating. Another symptom is diarrhea.
When Crohn’s affects only the colon, it is called Crohn’s granulomatous colitis. This type of Crohn’s causes diarrhea and rectal bleeding. Patients may develop abscesses and ulcers in the area of the anus. Other symptoms include joint pain and skin lesions.
Other general symptoms of Crohn’s include fatigue, fever, and night sweats. Some patients experience an urgent need to move their bowels. Constipation can also be a problem. Women may have an interruption in their menstrual cycle. Young children may have delayed development.
Most Crohn’s patients have episodes of disease activity followed by remissions. The stress of a flare-up can lead to anxiety and social withdrawal.
Diagnosis and Treatment
There’s no single test that can positively diagnose Crohn’s disease. If you have symptoms, your doctor will probably run a series of tests to rule out other conditions. Diagnostic testing may include:
blood tests to look for infection or anemia (not enough red blood cells)
fecal tests to see if there is blood in your stool
capsule endoscopy or double-balloon endoscopy, two procedures that allow a better view of the small bowel
flexible sigmoidoscopy, a procedure that helps your doctor view the last section of colon
colonoscopy to enable doctors to get a good look at the entire length of your colon and to remove samples for analysis (biopsy). The presence of inflammatory cells can help diagnose Crohn’s.
imaging tests such as computerized tomography (CT) or magnetic resonance imaging (MRI) to get detailed pictures of the abdominal area and intestinal tract
There’s no cure for Crohn’s. Treatment usually involves a combination approach. Immune suppressants can help control your immune system’s inflammatory response. Various medications can be used to treat individual symptoms. The Crohn’s & Colitis Foundation of America estimates that about 70 percent of Crohn’s patients eventually need surgery to repair damage or remove an obstruction. Sometimes, a portion of the bowel must be removed. About 30 percent of surgical patients will have a flare-up within three years, and 60 percent will have one within 10 years.
Good nutritional decisions are crucial for people with Crohn’s. A well-chosen diet can help reduce symptoms and help you heal. You may find that certain foods trigger symptoms, but it may take some trial and error to isolate which ones. Loss of appetite and diarrhea can make it hard to absorb the nutrients you need. Ask your doctor or nutritionist to advise you about dietary supplements.
Crohn’s can lead to fissures, or tears, in the lining of the anus. This can cause bleeding and pain. A common and serious complication is when inflammation and scar tissue block the intestines. Crohn’s can cause ulcers within the intestines. Another serious complication is the formation of fistulas, abnormal spaces that connect organs within the body. Crohn’s disease may also increase the risk of colorectal cancer.
Living with Crohn’s disease also takes an emotional toll. Embarrassment over bathroom issues can interfere with your social life and your career. You may find it helpful to seek counseling or join a support group for people with IBD.
Crohn’s is an expensive disease. In a 2008 study, direct medical costs were $18,022 to $18,932 per patient per year in the United States. About 53 to 67 percent of those costs were from hospitalizations. Costs were higher for patients with more severe disease activity. Patients in the top 25 percent averaged $60,582 per year. Those in the top two percent averaged more than $300,000 per year.
Professor Carol Ryff studied well-being before it was cool. Twenty years before we all start talking about well-being and thriving, Ryff was already quietly working on the problem at the University of Wisconsin-Madison.
She ended up creating one of the first systematic models of psychological well-being, and her model remain one of the most scientifically verified and empirically rigorous today. 1
Carol Ryff was motivated by two things: Firstly,well-being should not be restricted to medical or biological descriptions — instead it is a philosophical question about the meaning of a good life. 2Secondly, current psychological theories of well-being at that time lacked empirical rigor — they had not been and could not be tested.
To construct a theory that joins philosophical questions with scientific empiricism, Ryff mined for building blocks in a diverse selection of well-being theories and research, from Aristotle to John Stuart Mill, from Abraham Maslow to Carl Jung. She identified the recurrence and convergence across these diverse theories, and these intersections gave her the foundation for her new model of well-being.
Carol Ryff’s model of psychological well-being differs from past models in one important way: Well-being is multidimensional and not merely about happiness or positive emotions. A good life is balanced and whole, engaging each of the different aspects of well-being, instead of being narrowly focused. Ryff roots this principle in Aristotle’s Nichomachean Ethics, where the goal of life isn’t feeling good but is instead about living virtuously.
Carol Ryff’s six categories of well-being are: 2
High Self Acceptance: You possess a positive attitude toward yourself; acknowledge and accept multiple aspects of yourself including both good and bad qualities; and feel positive about your past life.
Low Self Acceptance: You feel dissatisfied with yourself; are disappointed with what has occurred in your past life; are troubled about certain personal qualities; and wish to be different than what you are.
2) Personal Growth
Strong Personal Growth: You have a feeling of continued development; see yourself as growing and expanding; are open to new experiences; have the sense of realizing your potential; see improvement in yourself and behavior over time; are changing in ways that reflect more self-knowledge and effectiveness.
Weak Personal Growth: You have a sense of personal stagnation; lack the sense of improvement or expansion over time; feel bored and uninterested with life; and feel unable to develop new attitudes or behaviors.
3) Purpose in Life
Strong Purpose in Life: You have goals in life and a sense of directedness; feel there is meaning to your present and past life; hold beliefs that give life purpose; and have aims and objectives for living.
Weak Purpose in Life: You lack a sense of meaning in life; have few goals or aims, lack a sense of direction; do not see purpose of your past life; and have no outlook or beliefs that give life meaning.
4) Positive Relations With Others
Strong Positive Relations: You have warm, satisfying, trusting relationships with others; are concerned about the welfare of others; are capable of strong empathy, affection, and intimacy; and understand the give and take of human relationships.
Weak Relations: You have few close, trusting relationships with others; find it difficult to be warm, open, and concerned about others; are isolated and frustrated in interpersonal relationships; and are not willing to make compromises to sustain important ties with others.
5) Environmental Mastery
High Environmental Mastery: You have a sense of mastery and competence in managing the environment; control complex array of external activities; make effective use of surrounding opportunities; and are able to choose or create contexts suitable to your personal needs and values.
Low Environmental Mastery: You have difficulty managing everyday affairs; feel unable to change or improve surrounding contexts; are unaware of surrounding opportunities; and lack a sense of control over the external world.
High Autonomy: You are self-determining and independent; are able to resist social pressures to think and act in certain ways; regulate behavior from within; and evaluate yourself by personal standards.
Low Autonomy: You are concerned about the expectations and evaluations of others; rely on judgments of others to make important decisions; and conform to social pressures to think and act in certain ways.
Next time chronic pain is dragging you down, consider trying a more natural route to relief. And, because pain is individual, ask your doctor for specifics about these treatments, such as doses and time to continue trying them.
1. Exercise. “People who exercise and maintain a good aerobic condition will improve most pain conditions,” says Charles Kim, MD, assistant professor of rehabilitation medicine and anesthesiology and a certified medical acupuncturist at Rusk Rehabilitation at NYU Langone Medical Center.
When we work out, he says, the body produces its own version of painkillers, such as endorphins, hormones that actually increase your pain threshold. Endorphins interact with brain receptors and can change our perception of pain.
When patients tell Dr. Kim they are in too much pain to exercise, he suggests they start slowly, and do even a little burst of walking or other activity — then build up.
In one review of non-pharmacologic treatments for chronic pain, researchers concluded that exercise was moderately effective.
2. Fish Oil. Fish oil is known for its anti-inflammatory properties, and inflammation plays a large role in pain, says Michael Cronin, ND, a naturopathic physician in Scottsdale, Az., and immediate past president of the American Association of Naturopathic Physicians.
In one study, researchers instructed patients with neck or back pain to take 1200 milligrams a day of fish oil supplements with eicosapentaenoic and decosahexanoic acid. After 75 days on fish oil, more than half of the 125 patients who reported back said they had stopped their prescription painkillers.
3. Turmeric. Also called Curcuma longa, turmeric is basically a root, Kim says. “It’s often found in spicy foods, very much in Indian cooking. Studies have shown it has definite anti-inflammatory properties.”
Researchers who tested a combination of turmeric with two other substances, Devil’s claw and bromelain, on patients with pain from osteoarthritis found the mixture gave noticeable pain relief. Patients took two 650-milligram capsules either two or three times a day.
4. Resveratrol. Found in red wine, grapes and berries, resveratrol is known to have many beneficial effects, including anti-cancer, brain protective and even life-prolonging benefits.
Recently, researchers reported that the substance works on a cellular level for pain regulation.
5. Heat Therapy. Using heat as well as cold therapy are time-honored ways to quell pain, Dr. Cronin and Kim agree.
“Hot Epsom salt baths relax the mind and change the nervous input from the body to the brain,” Cronin says. “Using ice is a well-accepted modality that decreases inflammation locally.”
The key is to know when to use which.
“When you have an acute injury, put ice on it right away,” Kim says. For instance, you twist your ankle and it’s painful and swollen. Using heat in this situation will increase blood flow and increase the swelling, he says.
“If you have lingering back spasms, heat would be the best for that,” Kim says. He suggests taking a warm shower and massaging your neck or back (or whatever body part hurts) under the warm water.
6. Meditation. Meditation can quell pain, Kim says. While some people get anxious, thinking they have to do meditation a certain way, Kim tells them it’s just not true.
“Meditation is not scripted,” he says. While you can get instruction, you can also look up approaches and follow instructions, such as this information on the approach known as mindfulness meditation.
Researchers who assigned 109 patients with chronic pain to either a mindfulness meditation program or a wait list found that those who did the meditation reported more pain relief, as well as lower anxiety and depression and a better mental quality of life, than those who did not.
Researchers have discovered a new bacteria that causes Lyme disease in humans, a U.S. health agency said Monday.
The Centers for Disease Control and Prevention, working with the Mayo Clinic and health officials from Minnesota, Wisconsin and North Dakota, discovered the new bacteria, called Borrelia mayonii, the CDC said in a statement.
Previously, only one bacteria, Borrelia burgdorferi, was believed to cause human Lyme disease, which is transmitted through bites from by the blacklegged “deer” tick, the CDC statement said.
The new bacteria has so far only been detected in the upper Midwest region of the United States, the CDC said.
Researchers discovered Borrelia mayonii after studying blood samples of patients in Minnesota, Wisconsin, and North Dakota who were suspected of having Lyme disease from 2012-2014, the CDC said. Samples from six out of 9,000 patients showed “unusual results” and prompted further study, the health agency said.
The newly discovered bacteria is similar to Borrelia burgdorferi in that it initially causes fever, headache, rash, and neck pain and later arthritis associated with Lyme disease, according to the CDC.
But Borrelia mayonii adds nausea, vomiting and widespread rash, and causes a higher concentration of bacteria in the blood, the CDC said.
There are an estimated 300,000 cases of Lyme disease in the U.S. annually, according to the CDC. The disease is rarely fatal, and most patients recover after a few weeks of oral antibiotics, the agency said.
The patients infected with the new bacteria were treated successfully with the same antibiotics used for those with Borrelia burgdorferi, the CDC said.
It is too early to say whether the newly discovered bacteria will be more or less dangerous than Borrelia burgdorferi, said Jeannine Petersen, a CDC microbiologist.
“We have fairly limited information in that our study described six patients,” she told Reuters. “We need more patients in order to capture the full spectrum of those who might have less severe symptoms and those who might have more severe ones.”
It is likely that the bacteria is a “recently emerged” organism since it did not appear in previous, extensive testing of blood samples of patients suspected of having Lyme disease, Peterson added.
For centuries people have decided to embrace vegetarianism for several different reasons. Some people decide to become vegetarians because they feel it is more ethical, some do it in accordance with their religion, and others do it for health reasons. Even though a person decides to not include animal protein in their diet, it would not create any health issues with the right vitamins and minerals supplementing their daily intake.
You may have heard some people consider themselves “vegan.” While there are similarities, difference between vegan and vegetarian also exist. A vegetarian lifestyle could include a few different diets but being a vegan could exclude any type of animal products of any kind in their lives.
One of the main differences between a vegan and a vegetarian is in not only what they eat but in what they will not eat. A vegan will not eat anything to do with animals, which includes meat, poultry, fish, dairy, eggs, honey or gelatin. Their diet consists solely of beans, grains, fruits, nuts, seeds and vegetables. It may appear that this style of eating is a far cry from a standard American diet, or SAD, but it is much more than just eating a salad. There are many delicious gourmet meals that a vegan can enjoy.
A vegetarian is a person who will not eat meat for whatever reasons he chooses – his health, animals protection, or for the environment. A lacto-ovo vegetarian is a vegetarian who does include eggs and dairy into their diet.
To be considered a vegetarian, you would not eat meat of any kind. The vegetarian way of eating is often called a meat-free or meatless diet. Anyone who does not eat meat but eats fish is considered a pesco-vegetarian; if they eat fish they are considered a pollo-vegetarian; and someone who eats a vegetarian diet sometimes is considered to be a flexitarian. None of these specialty groups are considered vegetarians.
Difference Between Vegan and Vegetarian
The main difference between being a vegan and being a vegetarian is that being vegetarian is mostly limited to what a person eats while being a vegan is a lifestyle. A vegan does not eat meal, they also do not have anything to do with animal products in their lives. A vegan does not have household items, clothing of any kind, or cosmetics that have anything to do with animals. Many vegans begin as vegetarians and slowly migrate to eliminating anything to do with animals.
Many people become vegans because of their health (dietary vegans) and others embrace it because of political or moral issues (ethical vegans). A vegan has very strong feelings that animals were not put here to be taken advantage of and commercialized for the good of man. They respect all aspects of life including those of animals.
People who become vegetarian may begin this type of diet because of health issues; some are concerned about the safety of the meats and poultry we get from the grocery stores. Religious reasons could also be the basis for someone becoming a vegetarian. Some Christian religions call for a period of a meatless diet during Lent; other religions like Jainism and Hinduism are geared towards a vegetarian diet.
Famous Vegetarians and Vegans
Talk show host and comedian Ellen DeGeneres has been a vegan since 2008. She has encouraged others to follow her lead through her website “Going Vegan with Ellen.” Ellen used to love cheeseburgers but was influenced by the book Skinny Bitch and a documentary called Earthlings.
Comedian Russell Brand has been a vegetarian since he was just 14. In 2011 he was named the “Sexiest Vegetarian Celebrity” by PETA (People for the Ethical Treatment of Animals). Brand feels that “You shouldn’t eat animals, it’s mean to them.”
Not only is Carrie Underwood a major country music entertainer, she is an affirmed vegetarian. She has eliminated all animal products from her regime and is a complete vegan. She became a vegetarian at 13 while on her family’s farm and found out what happened to the animals.
Actress Anne Hathaway has struggled with her commitment to vegetarianism. She began eliminating meat on and off since she was 12. After an epiphany while filming a movie in England, she committed to being a vegan swearing off fish as well as meat.
Even though she is known for her comedic talent, Applegate takes being a vegetarian seriously. It all began when she was eating her lunch while on the Married with Children sit-com. The plate she was served had blood on it. She has since gone on to encourage people to not buy fur coats through PETA.
Harper is the fitness trainer on the weight loss show The Biggest Loser. The 44-year old health fanatic started out as a vegetarian but has since turned vegan. He feels “clear headed and strong” since eliminating meat from his diet.
Once veganism was widely associated with animal rights activists, the health conscious and the religious. But now more and more people are dabbling with a vegan diet, albeit temporarily. Why?
To a committed carnivore, adopting a vegan diet – no meat, no fish, no dairy, no eggs – sounds like a dramatic step.
But a growing trend for giving up all animal products doesn’t involve going vegan forever. Nor does it even require being morally opposed to eating meat.
In fact, it might only last a matter of weeks.
More people are pledging to go vegan for seven or 30 days, according to the Vegan Society. There were 40% more people signing up to this temporary menu in the first two months of 2013 compared with the same period in 2012, it says.
Most famously singer Beyonce and her rapper husband Jay-Z went vegan for 22 days as part of a “spiritual and physical cleanse”.
And this year a new campaign – Veganuary – has already seen 3,200 people commit to go vegan for the first month of 2014, organisers say.
Many of these part-time vegans aren’t against eating animal products in principle. But they might have taken inspiration from well-known figures who have adopted the vegan lifestyle full-time, such as Oscar-winning film director James Cameron, former US president Bill Clinton and Microsoft founder Bill Gates.
There are also 150,000 full-time vegans in the UK – so about one in 400 – according to the Vegan Society. The ratio goes up to roughly one in 150 in the US, according to the Vegetarian Resource Group, which puts the total figure at two million. Like vegetarians, they don’t eat meat, poultry, fish or by-products of slaughter – vegans don’t eat eggs and dairy products either.
But it’s those who dabble in the diet rather than follow it full-time who are coming to prominence like never before.
Each temporary vegan might have very different motivations. Some might seek to shed the signs of Christmas indulgence, others might see it as a good way to detox.
According to Juliet Gellatley, director of the vegan and vegetarian group Viva, it mostly comes down to two main reasons – health concerns, and greater awareness about how animals are treated.
“People might be prone to heart disease or want to get their cholesterol down,” she says. “Or it might be because they’ve seen something on factory farming. But once people turn to veganism, they usually open their minds to the other issue too.
“The third factor, which is more unusual, is environmental reasons such as global warning or deforestation,” she says.
It’s a tale that rings true with young professional Rachel Hollos, a global marketing director from London. She says her main motivation for going vegan for a month was the health benefits.
“I have read a lot of articles about how we don’t really need dairy products and how cow’s milk contains lots of hormones, which puts our own hormones out of sync,” she says.
Publicity surrounding a PETA investigation into angora farms also got her thinking.
Rachel says the vegan diet “differs substantially” to her normal diet, which typically includes lots of fish, eggs, goats milk and yogurt. The switch has been easy during the week – when she’s able to cook meals at home and prepare packed lunches – but difficult when eating out at weekends.
“I definitely feel like I’ve got more energy and feel less bloated, but I also feel very hungry most of the time.”
Advocates for the diet insist this latter sensation is not what veganism is about. Gellatley says hunger is easy to avoid if new vegans plan their meals carefully. Porridge, pulses, lentils and beans all help keep the stomach feeling full, she says.
Someone whose belly hasn’t been rumbling is 32-year-old Luke Graham from Cardiff, despite burning lots of energy in his job as a personal trainer. He says his motivation to sign up to Veganuary was “half ethics and health, and half experiment”.
A vegan diet is all about planning, he says. “I used to put a slab of meat and veg under the grill most nights. Now my cupboard is full of pulses, which has taken some adjustment,” he says.
So far Luke is finding his energy levels are fine, unlike when he tried going vegan about 10 years ago, which he says “made him look like a 12-year-old boy”.
“I need to be strong and in good shape for my job and I was worried going vegan was contrary to this. Last time I tried it, I didn’t really understand much about nutrition. Now writing nutrition plans are part of my job,” he says.
Viva’s Gellatley says there’s been a shift in attitude when it comes to men going vegan. “Before many would say there’s no way they’d give up meat. They were traditionalist, loved their steaks and roasts, (and were) macho about it. But now more moneyed, powerful men are coming out and saying vegan is the healthier way,” she says.
It’s not even always about cutting out meat and dairy for weeks at a time. The VB6 diet, which advocates eating a vegan diet before 18:00, became the fad diet to follow after New York Times food writer Mark Bittman published his book last year.
There are also any number of raw food, juice cleansing, soup slimming diets that involved cutting down on animal products.
But there is also some evidence to suggest that veganism isn’t just for January. The UK market for meat-free products such as tofu, burgers, and imitation chicken fillets was put at £625m in 2013, up 21% from five years earlier, according to Mintel.
The free-from market – which includes dairy free and wheat-and gluten-free products – went up by 72% between the same period.
And the first German all-vegan supermarket chain, Veganz – offering more than 6,000 vegan products – is due to open in London later this year.
There may be other reasons why people are moving towards plant-based diets. The horsemeat scandal led to more than half of UK consumers changing their shopping habits, according to consumer group Which?
Others argue celebrity-backed campaigns such as Meat Free Mondays – which Sir Paul McCartney helped launch in a bid to encourage people to reduce their carbon footprint by cutting out meat – have also contributed to a club of “meat reducers”.
But Gellatley believes there’s been a “seismic shift in attitude” towards going vegan, “which is no longer seen as alien”.
“People aren’t necessarily going vegan, but they seem to admire those cutting it out a bit more – they are more apologetic, saying, ‘I know it’s not good for my heart’,” she says.
And the 21-year veteran of veganism says she doesn’t take issue with the apparent disjunction between the principles of veganism adhered to by some devotees and the more casual attitude of the occasional dabbler.
“Any change is positive in my view. Anything that pushes that shift to eat less animals rather than more is good.
“Plus very few people go straight to a vegan diet. Some change overnight, but we get emails from people every day saying they gave up red meat, then white meat, then fish, then diary etc. Most people go vegetarian before vegan. It’s about opening hearts and minds,” she says.
For Rachel, the vegan diet is only for January. She says she will add fish back into her diet in February, and possibly add organic white meat later.
“The vegan diet has really made me think about what I put into my body and I’ve come across lots of nutritionally beneficial and tasty recipes which I’ll continue to cook.
“I think there is common sense in a lot of the theories and it’s a definitely a worthwhile challenge,” she says.
The part-time vegan might well become a permanent fixture.
Summer is both a blessing and curse for millions of people afflicted with a common chronic skin condition called eczema. The dry, red and usually intolerably itchy patches often recede when the air is warm and damp and skin is exposed more often to sunlight.
Yet, for many of the 15 million Americans with eczema, shedding the clothes may be embarrassing and, in the case of children, may result in teasing and exclusion. Even for those who are comfortable in a bathing suit, swimming in a pool can be problematic if sensitivity to chlorine worsens the condition.
In industrialized countries, eczema has become two or three times more common in recent decades. Only part of this rise can be attributed to better diagnosis. Now between 15 and 30 percent of children and 2 percent to 10 percent of adults have eczema, which nearly always begins in the first five years of life. Fortunately, in more than two-thirds of children with eczema, the condition resolves on its own beforeadolescence.
The medical name for eczema is atopic dermatitis, which reflects the immunological nature of the condition. It is more common among children living in cities than those in rural areas. According to the so-called hygiene hypothesis, exposure to infectious agents early in life offers protection against allergic diseases. The more hygienic a child’s environment, the greater the risk.
Eczema is not contagious, but more than one member of a family may be afflicted. The condition seems to have a genetic component. In identical twins, 77 percent will both have eczema, but it occurs in both fraternal twins only 15 percent of the time. My sons, who are identical twins, had eczema as young children, and one still has it in his 40s.
Another indication is the fact that people with celiac disease (a gluten intolerance) are three times more likely to have eczema; relatives of celiac patients are twice as likely to have eczema.
Eczema is often called “the itch you can’t scratch,” though a wiser description would be “the itch you shouldn’t scratch.” Scratching can make the lesions worse and expose the skin to infection.
“Scratching the spot when it’s itchy brings relief only as long as you scratch it,” said my son, Lorin. “After scratching, the itch generally stays the same or worsens. It’s better not to scratch, though sometimes the itch is so intense that scratching feels compulsory.”
Although there is no known cure for eczema, flare-ups can nearly always be minimized and sometimes prevented, and recent research has identified factors involved in its development that may lead to new treatments to control it more effectively.
Normal skin provides a remarkably effective physical and chemical barrier to substances in the environment. It also prevents substances that should remain in the body from escaping.
As Dr. Thomas Bieber, a dermatologist at the University of Bonn in Germany, explained in The New England Journal of Medicine, the hallmark of eczema is an alteration in the skin that allows essential water to escape and environmental allergens (like those from pollen, dust mites and food) to enter. The result is dry, itchy, inflamed patches that are sometimes misdiagnosed as psoriasis.
Eczematous skin also lacks normal amounts of a natural antimicrobial agent called cathelicidin, leaving it susceptible to infections that can be hard to control. More than 90 percent of people with eczema have colonies of the bacterium Staphylococcus aureus growing on their skin and contributing to the skin’s allergic sensitivity and inflammation, Dr. Bieber reported. Scratching the lesions enhances the ability of these bacteria to further disrupt the skin’s barrier function.
While it has long been known that the skin’s outermost layer functions poorly in people with eczema, researchers at the University of Rochester have identified another reason eczematous skin is susceptible to invasion by allergens. Dr. Anna De Benedetto and co-authors showed that a protective protein called claudin-1 is significantly weakened in the skin of eczema patients but not in those with normal skin or other skin conditions.
When claudin-1 is reduced, the “tight junctions” between skin cells become leaky and permeable to environmental allergens and infectious agents. If future studies confirm these findings, developing treatments that strengthen this barrier should improve control of eczema.
Current treatment focuses on reducing inflammation, loss of moisture and colonization by bacteria. Doctors typically recommend a prescription steroid, used topically in tiny amounts, coupled with an over-the-counter moisturizer applied generously right after showering to hold water in the skin. Only mild, nondrying bath soaps should be used.
Overly expensive and exotic skin products are not necessary, according to Dr. Lisa A. Beck, a dermatologist at the University of Rochester. But finding the most helpful products may require trial and error.
For example, my son tried several steroids before finding that mometasone furoate, the generic version of Elocon, is most effective for him. He has also used coal tar-based shampoo, like Neutrogena T/Gel, for occasional eczema on his scalp.
In selecting a moisturizer (often called an emollient), choose a product that contains no scent, which itself can be a skin irritant.
An acquaintance who suffered for years with widespread eczema finally found relief last year when her doctor suggested she try taking a nonsedatingantihistamine, like loratadine (Claritin), fexofenadine (Allegra) or cetirizine (Zyrtec).
Sweat can trigger an outbreak, so it is best to shower as soon as possible after a sweat-inducing activity. Stress can provoke flare-ups in some people with eczema, so measures to reduce stress may be helpful.
Food allergies show up as eczema in some patients. Eliminating one potential culprit at a time, like dairy products, eggs or nuts, may reveal an eczema-inducer.
Some people develop a form of eczema that results from skin contact with an irritant, not unlike a reaction to poison ivy. Contact eczema is often an occupational disease stemming from exposure to detergents, for example, or various cleaning agents or wet cement. The condition may show up only after the skin is exposed to sunlight. People with eczema on their hands are usually advised to wear cotton-lined waterproof gloves when washing dishes or working with irritating substances.
The DSM-IV (the diagnostic Bible) divides bipolar disorder into two types, rather unimaginatively labeled bipolar I and bipolar II. “Raging” and “Swinging” are far more apt:
Raging bipolar (I) is characterized by at least one full-blown manic episode lasting at least one week or any duration if hospitalization is required. This may include inflated self-esteem or grandiosity, decreased need for sleep, being more talkative than usual, flight of ideas, distractibility, increase in goal-oriented activity and excessive involvement in risky activities.
The symptoms are severe enough to disrupt the patient’s ability to work and socialize, and may require hospitalization to prevent harm to themselves or others. The patient may lose touch with reality to the point of being psychotic.
The other option for raging bipolar is at least one “mixed” episode on the part of the patient. The DSM-IV is uncharacteristically vague as to what constitutes mixed, an accurate reflection of the confusion within the psychiatric profession. More tellingly, a mixed episode is almost impossible to explain to the public. One is literally “up” and “down” at the same time.
The pioneering German psychiatrist Emil Kraepelin around the turn of the twentieth century divided mania into four classes, including hypomania, acute mania, delusional or psychotic mania, and depressive or anxious mania (ie mixed). Researchers at Duke University, following a study of 327 bipolar inpatients, have refined this to five categories:
Pure Type 1 (20.5 percent of sample) resembles Kraepelin’s hypomania, with euphoric mood, humor, grandiosity, decreased sleep, psychomotor acceleration and hypersexuality. Absent was aggression and paranoia, with low irritability.
Pure Type 2 (24.5 of sample), by contrast, is a very severe form of classic mania, similar to Kraepelin’s acute mania with prominent euphoria, irritability, volatility, sexual drive, grandiosity and high levels of psychosis, paranoia, and aggression.
Group 3 (18 percent) had high ratings of psychosis, paranoia, delusional grandiosity and delusional lack of insight; but, lower levels of psychomotor and hedonic activation than the first two types. Resembling Kraepelin’s delusional mania, patients also had low ratings of dysphoria.
Group 4 (21.4 percent) had the highest ratings of dysphoria and the lowest of hedonic activation. Corresponding with Kraepelin’s depressive or anxious mania, these patients were marked by prominent depressed mood, anxiety, suicidal ideation and feelings of guilt, along with high levels of irritability, aggression, psychosis and paranoid thinking.
Group 5 patients (15.6 percent) also had notable dysphoric features (though not of suicidality or guilt) as well as Type 2 euphoria. Though this category was not formalized by Kraepelin, he acknowledged that “the doctrine of mixed states is … too incomplete for a more thorough characterization …”
The study notes that while Groups 4 and 5 comprised 37 percent of all manic episodes in their sample, only 13 percent of the subjects met DSM criteria for a mixed bipolar episode; and of these, 86 percent fell into Group 4, leading the authors to conclude that the DSM criteria for a mixed episode is too restrictive.
Different manias often demand different medications. Lithium, for example, is effective for classic mania while Depakote is the treatment of choice for mixed mania.
The next DSM is likely to expand on mania. In a grand rounds lecture delivered at UCLA in March 2003, Susan McElroy MD of the University of Cincinnati outlined her four “domains” of mania, namely:
As well as the “classic” DSM-IV symptoms (eg euphoria and grandiosity), there are also “psychotic” symptoms, with “all the psychotic symptoms in schizophrenia also in mania.” Then there is “negative mood and behavior,” including depression, anxiety, irritability, violence, or suicide. Finally, there are “cognitive symptoms,” such as racing thoughts, distractibility, disorganization, and inattentiveness. Unfortunately, “if you have thought disorder problems, you get all sorts of points for schizophrenia, but not for mania unless there are racing thoughts and distractibility.”
Kay Jamison in Touched with Fire writes:
“The illness encompasses the extremes of human experience. Thinking can range from florid psychosis, or ‘madness,’ to patterns of unusually clear, fast, and creative associations, to retardation so profound that no meaningful activity can occur.”
The DSM-IV has given delusional or psychotic mania its own separate diagnosis as schizoaffective disorder – a sort of hybrid between bipolar disorder and schizophrenia, but this may be a completely artificial distinction. These days, psychiatrists are acknowledging psychotic features as part of the illness, and are finding the newer generation of antipsychotics such as Zyprexa effective in treating mania. As Terrance Ketter MD of Yale told the 2001 National Depressive and Manic Depressive Association Conference, it may be inappropriate to have a discrete cut between the two disorders when both may represent part of a spectrum.
At the 2003 Fifth International Conference on Bipolar Disorder, Gary Sachs MD of Harvard and principal investigator of the NIMH-funded STEP-BD reported that of the first 500 patients in the study, 52.8 percent of bipolar I patients and 46.1 percent of bipolar II patients had a co-occurring (comorbid) anxiety disorder. Dr. Sachs suggested that in light of these numbers, comorbid may be a misnomer, that anxiety could actually be a manifestation of bipolar. About 60 percent of bipolar patients with a current anxiety disorder had attempted suicide as opposed to 30 percent with no anxiety. Among those withPTSD, more than 70 percent had attempted suicide.
Depression is not a necessary component of raging bipolar, though it is strongly implied that what goes up must come down. The DSM-IV subdivides bipolar I into those presenting with a single manic episode with no past major depression, and those who have had a past major depression (corresponding to the DSM -IV for unipolar depression).