Our twins were born two years apart

Although my children were conceived through IVF at the same time, the embryo that became my son was frozen for two years before being implanted. How will their birth order affect them?

Our son and daughter were conceived at the same time, while we were in the cafe at Ikea Croydon (a convenient place for brunch after an early-morning egg-retrieval operation). But while our fertility clinic implanted our little girl into my womb three days later, our little boy went into their freezer for two years. Now, she is five and he is three, but technically they are fraternal twins.

Felix first started to become aware of his unusual origins when he was about two, when we found some home video footage of his big sister at her first family Christmas. Watching her chuckling in glee while bouncing on Grannys knee, he pointed out our familiar red sofa and his older cousins laughing in the background, then asked: Where was I?

Well, that was before you were born.

But where was I?

Weve always been open about the medical intervention we needed to have our children. So we told him the truth, something along the lines of: When the doctors put tiny Miranda into Mummys tummy to grow into a baby, they put tiny Felix into a special freezer to wait until it was your turn. When that video was taken, you were waiting in the freezer.

We told him how special and amazing that was. And, in the usual way of toddlers presented with special and amazing things, he simply accepted it and asked to watch more videos.

Since that conversation, though, the realisation that he existed in suspended animation for two years while his sister was having fun, with Mum and Dad all to herself, has been a big thing for our little boy to get his head around. Some days, he is full of questions. Was it our freezer? he wants to know. What else was in the freezer with me? We have to explain that, no, he wasnt tucked away among the fertility doctors fish fingers and frozen peas. What did I look like? he asks. I suspect he is imagining some sort of miniature baby-shaped ice cube.

You were just a blob, his dad explains. We find some pictures online to show him. He was frozen five days after conception, as a blastocyst, a ball of 200 or so cells, the inner mass of which would become the embryonic Felix, the outer shell his placenta.

I was a blob! he repeats, sounding excited and reassured. Did I feel cold? Did I have eyes?

Recently, he has wanted to know: How did I get into your tummy? and: How did I get out again? His solemn assessment of the answers to these questions has been priceless. But there is one question he hasnt yet asked: Why me?

Surely, one day he will wonder why his sister was born first and he had to wait. When the question comes, will we tell him the truth? That his irregular and fragmented cells meant he was classified as an inferior-quality pre-embryo? That the pair given the top two gradings (out of the four used in IVF treatment) were placed together in my body first? That if they had grown into twins, instead of one disappearing as the other developed into our daughter, his fate might have been very different?

Cuddling his robust little body, admiring his ceaseless curiosity, helping him enrol Darth Vader into his sisters make-believe school of cuddly cats, it is difficult to imagine the alternatives.

Practically and financially, a third baby wasnt on the cards. Would we have offered him to medical researchers? Donated him to an infertile couple? Would anyone have wanted the runt of our pre-embryonic litter? Would he still be there, frozen expensively in time, like an estimated two million other frosties worldwide?

As much as I am thankful to medical science for enabling us to have our family, I am relieved we didnt have to make such an agonising decision. The alternatives are all the more heart-rending now we know that minuscule ball of cells, just 0.2mm in diameter, as a bouncy, impossibly stubborn, brown-eyed boy who adores superheroes, trumpets and all things yellow.

Every day, I watch him copying his sisters drawings and dancing, joining in her games of princesses and picnics, and wonder how their characters have been shaped by a very 21st-century twist of fate. How different would our children be if he had been born first and she had spent two years in the freezer or if they had been identical twins? How will their beginnings affect them as they grow up?

The differences arent just environmental, but biological, too. While IVF babies are generally a little smaller than average at birth, those frozen as pre-embryos tend to be heavier. Our family bears this out.

Despite being classed as inferior on day five of their existence, our son weighed 2lb (0.9kg) more than our daughter at birth she was just under 7lb, he was just under 9lb. His delivery was easier and he fed better, grew faster and slept for longer. While he was a bump, I worried constantly that this low-grade creature from the freezer couldnt possibly be normal. In fact, he couldnt have been more perfect.

Surprisingly, freezing is associated with better outcomes for babies and their mums than IVF with freshly fertilised eggs. Defrosted embryos have a lower risk of premature birth and perinatal death, as well as the all-important heavier birthweight associated with better academic performance and protection from conditions such as coronary heart disease, diabetes and stroke.

Perhaps it was Miranda, transplanted into a body battered by the surgeries, stresses and hormonal excesses of fertility treatment, who had a tougher time post-conception. But then, as our eldest child, she benefited from our undivided attention for the first two years of her life. Firstborn girls tend to do better educationally and have higher aspirations than their siblings.

It seems the hand that reproductive science has dealt our children may have slight benefits for both of them. (Note to self: remember these for when the Why me? question crops up.)

As for personality, our kids place in the family might not be as character-forming as we might think. In 2015, a major multinational study found no birth-order effects on extraversion, emotional stability, agreeableness, conscientiousness or imagination. Meanwhile, researchers studying 377,000 US teenagers concluded that birth order has an infinitesimally small effect on personality.

I am sure there will be times when they envy one anothers position in the family (is there anyone with a sibling who hasnt occasionally wished they could swap places?), but for now Miranda and Felix seem content in their roles as big sister and little brother. And, if resentment rears its ugly head, I will tell them that the important thing is not who was born first, but that they were born at all.

We chose the name Felix because it means lucky: lucky to have been our sole pre-embryo to make it to the blastocyst stage in vitro; lucky to have survived freezing to -196C and thawing without being damaged by intracellular ice crystals; lucky to have implanted successfully and grown healthily in the womb.

Some evenings, after I kiss him goodnight, he snuggles up to me and says: Tell me the story of how I came in our family. Every time I do, I remind myself that, after so many years of thinking we would never have children, to be wondering about the impact of their birth order is a wonder in itself.

@ElyssaCB

Choosing Childcare by Elyssa Campbell-Barr is published by Cross Publishing, 9.99. To order a copy for 8.49, go to bookshop.theguardian.com or call the Guardian Bookshop on 0330 333 6846

Read more: https://www.theguardian.com/lifeandstyle/2017/apr/29/our-twins-were-born-two-years-apart

Simple steps to help people with dementia lead better lives

Alzheimer’s disease has an unusual distinction: It’s the illness that Americans fear most — more than cancer, stroke or heart disease.

The rhetoric surrounding Alzheimer’s reflects this. People “fade away” and are tragically “robbed of their identities” as this incurable condition progresses, we’re told time and again.
Yet, a sizable body of research suggests this Alzheimer’s narrative is mistaken. It finds that people with Alzheimer’s and other types of dementia retain a sense of self and have a positive quality of life, overall, until the illness’s final stages.
    They appreciate relationships. They’re energized by meaningful activities and value opportunities to express themselves. And they enjoy feeling at home in their surroundings.
    “Do our abilities change? Yes. But inside we’re the same people,” said John Sandblom, 57, of Ankeny, Iowa, who was diagnosed with Alzheimer’s seven years ago.
    Dr. Peter Rabins, a psychiatrist and co-author of “The 36-Hour Day,” a guide for Alzheimer patients’ families, summarized research findings this way: “Overall, about one-quarter of people with dementia report a negative quality of life, although that number is higher in people with severe disease.”
    “I’ve learned something from this,” admitted Rabins, a professor at the University of Maryland. “I’m among the people who would have thought, ‘If anything happens to my memory, my ability to think, I can’t imagine anything worse.’
    “But I’ve seen that you can be a wonderful grandparent and not remember the name of the grandchild you adore. You can be with people you love and enjoy them, even if you’re not following the whole conversation.”
    The implication: Promoting well-being is both possible and desirable in people with dementia, even as people struggle with memory loss, slower cognitive processing, distractibility and other symptoms.
    “There are many things that caregivers, families and friends can do — right now — to improve people’s lives,” said Dr. Allen Power, author of “Dementia Beyond Disease: Enhancing Well-Being” and chair for aging and dementia innovation at the Schlegel-University of Waterloo Research Institute for Aging in Canada.
    Of course, the final stages of Alzheimer’s disease and other types of dementia are enormously difficult, and resources to help caregivers are scarce — problems that shouldn’t be underestimated.
    Still, up to 80 percent of people with dementia are in the mild and moderate stages. Here are some elements of their quality of life that should be attended to:

    Focus On Health

    One notable study analyzed lengthy discussions between people with dementia, caregivers and professionals at six meetings of Alzheimer’s Disease International, an association of Alzheimer’s societies across the world.
    Those discussions emphasized the importance of physical health: being free from pain, well-fed, physically active and well-groomed, having continence needs met, being equipped with glasses and hearing aids and not being overmedicated. Cognitive health was also a priority. People wanted “cognitive rehabilitation” to help them learn practical techniques for promoting memory or compensating for memory loss.
    Up to 40 percent of people with Alzheimer’s disease suffer from significant depression, and research by Rabins and colleagues underscores the importance of evaluating and offering treatment to someone who appears sad, apathetic and altogether disinterested in life.

    Foster Social Connections

    Being connected with and involved with other people is a high priority for people with dementia. Based on research conducted over several decades, Rabins listed social interaction as one of the five essential elements of a positive quality of life.
    But fear, discomfort and misunderstanding routinely disrupt relationships once a diagnosis is revealed.
    “The saddest thing that I hear, almost without exception, from people all over the world is that family, friends and acquaintances desert them,” said Sandblom, who runs a weekly online support group for Dementia Alliance International, an organization for people with dementia that he co-founded in January 2014.

    Adapt Communication

    Not knowing how to communicate with someone with dementia is a common problem.
    Laura Gitlin, a dementia researcher and director of The Center for Innovative Care in Aging at Johns Hopkins School of Nursing, offered these suggestions in an article in the International Encyclopedia of Rehabilitation: Speak slowly, simply and calmly, make one or two points at a time, allow someone sufficient time to respond, avoid the use of negative words, don’t argue, eliminate noise and distraction, make eye contact but don’t stare, and express affection by smiling, holding hands or giving a hug.
    Also, understand that people with dementia perceive things differently.
    “You have to understand that when you have dementia you lose a lot of your natural perceptions of what others are doing,” Sandblom said. “So, a lot of us get a little nervous or suspicious. I think that’s a natural human reaction to knowing that you’re not picking up on things very well.”

    Address Unmet Needs

    Needs that aren’t recognized or addressed can cause significant distress and a lower quality of life. Rather than treat the distress, Power suggested, try to understand the underlying cause and do something about it.
    Which needs are commonly unmet? In a study published in 2013, Rabins and colleagues identified several: managing patients’ risk of falling (unmet almost 75 percent of the time); addressing health and medical concerns (unmet, 63 percent); engaging people in meaningful activities (53 percent); and evaluating homes so that they’re safe and made easier to navigate (45 percent).

    Respect Autonomy And Individuality

    Rabins called this “awareness of self” and listed it among the essential components of a positive quality of life. Sandblom called this “being seen as a whole person, not as my disease.”

    See the latest news and share your comments with CNN Health on Facebook and Twitter.

    At the Alzheimer’s Disease International meetings, people spoke of being listened to, valued and given choices that allowed them to express themselves. They said they wanted to be respected and have their spirituality recognized, not patronized, demeaned or infantilized.
    In a review of 11 studies that asked people with dementia what was important to them, they said they wanted to experience autonomy and independence, feel accepted and understood, and not be overly identified with their illness.
    None of this is easy. But strategies for understanding what people with dementia experience and addressing their needs can be taught. This should become a priority, Rabins said, adding that “improved quality of life should be a primary outcome of all dementia treatments.”

    Read more: http://www.cnn.com/2017/04/28/health/dementia-alzheimers-patients-enjoy-life-partner/index.html

    5 surprising foods to help you sleep better

    Have trouble getting to bed or staying asleep? Youre not alone. The Centers for Disease Control and Prevention (CDC) estimates one in four American adults get less than the daily recommended seven to eight hours of sleep. That insufficient shuteye is leaving them more at risk of diabetes, heart disease, depression and obesity.

    THE BIGGEST SLEEP MYTHS, DEBUNKED

    But dont reach for that bottle of NyQuil. Luckily, you can improve your sleep by simply changing up your diet. When you cant snooze, reach for these eats:

    1. Meat
    When it comes to sleep-inducing fare, people often think of the Thanksgiving favorite turkey. But gamier meat like elk, goose, goat and rabbit are your best bet for promoting zzzs, as these options contain even more of turkeys key sleep ingredient, the essential amino acid tryptophan. Tryptophan can help you catch more shuteye because it contains the calming hormone serotonin, but elk, for example, contains three times as much of the ingredient as turkey.

    How to enjoy: Try mixing your favorite gamey meat with a complex carb like brown rice to help better ferry tryptophan to the brain.

    2. Garbanzo beans
    Not into gamey meat? Garbanzo beans are also a great source of tryptophan. As a plus, theyre easier to find in your local grocery store just head to the canned foods aisle.

    How to enjoy: For a bedtime snack, dig into some homemade or store-bought hummus with crudité or whole-wheat crackers.

    AGING ISN’T KILLING US, LACK OF SLEEP IS

    3. Tart cherries
    Tart cherries offer a natural source of melatonin, a hormone responsible for the sleep-wake cycle in humans. An easy way to get them year-round is by picking up a bottle of tart cherry juice, as research shows the benefits are the same as eating the whole fruit. A study published in the European Journal of Nutrition showed that subjects who drank tart cherry juice for seven days slept longer and better compared to those who didnt.

    How to enjoy: Aim for an 8-ounce glass daily, and steer clear of varieties with added sugar.

    4. Pumpkin seeds
    Next Halloween, salvage those seeds from your jack o lantern, as theyre proven to help you clock more snooze time. Pumpkin seeds contain the vital mineral magnesium, which promotes muscle relaxation and lowers levels of the stress hormone cortisol, among other benefits.

    How to enjoy: Whip up a salad with arugula, low-fat goat cheese and salt-free pumpkin seeds for a sleep-friendly dinner.

    5. Tuna
    One of the least expensive and most accessible types of fish can also help you snooze more soundly. A 100-gram portion of tuna contains 1 milligram of vitamin B6, which helps convert tryptophan into serotonin that aforementioned calming hormone that can aid sleep regulation.

    How to enjoy: Combine chopped celery and carrot sticks with low-fat mayonnaise, lemon juice and canned tuna in water. Spread the mixture onto whole-wheat crackers, and voila, you have an afternoon or midnight snack that can help you wake up feeling more refreshed.

    Tanya Zuckerbrot MS, RD, is a Registered Dietitian in New York City and the author of two bestselling diet books: The F-Factor Diet and The Miracle Carb Diet: Make Calories and Fat Disappear with Fiber.

    Subscribe to Tanyas FREE Weekly Newsletter and follow her on Instagram, Facebook, Twitter and Pinterest. To learn more about Tanyas private nutrition counseling services visit www.ffactor.com.

    Read more: http://www.foxnews.com/lifestyle/2017/04/28/5-surprising-foods-to-help-sleep-better.html

    Does saturated fat clog your arteries? Controversial paper says ‘no’

    (CNN)It is common knowledge supported by health experts, the American Heart Association and the World Heart Federation: Eating saturated fats will cause plaque to build up in the arteries, which then harden, and ultimately leads to coronary heart disease. To prevent heart disease, the association and federation both recommend a diet low in saturated fats, the animal-based fats found in beef, pork, chicken, butter and cheese, among other foods.

    But in an editorial published Tuesday in the British Journal of Sports Medicine, three cardiologists say saturated fats do not clog arteries and the “clogged pipe” model of heart disease is “plain wrong.”
    The authors write that eating saturated fats is not associated with either coronary heart disease, ischemic stroke, type 2 diabetes, death from heart disease or early death in healthy adults, referencing a meta-analysis, or review of previous studies, to support their claims. Critics of the editorial noted that the meta-analysis is based on observational data and is not considered conclusive by general scientific standards.
      “This idea that dietary saturated fats build up in the coronary arteries is complete unscientific nonsense,” said Dr. Aseem Malhotra, first author of the new controversial editorial and a consultant cardiologist at London’s Lister Hospital, in an email to CNN.
      According to Malhotra and his co-authors, Dr. Rita Redberg, a cardiologist at UCSF School of Medicine in San Francisco, and Dr. Pascal Meier, a cardiologist at University Hospital Geneva, healthy people can effectively reduce risk of coronary disease by walking 22 minutes a day, minimizing stress and eating “real food.”
      Saturated fat in itself is not a problem, they say.
      Critics question the merits of the editorial, noting that it is not based on any new research. Among them, Dr. Mike Knapton, associate medical director at the British Heart Foundation, referred to it as an opinion piece, calling it “unhelpful and misleading.” He said in a statement, “decades of research have proved that a diet rich in saturated fat increases ‘bad’ LDL cholesterol in your blood, which puts you at greater risk of a heart attack or stroke.”

      Hard arteries

      As described by the American Heart Association, a heart attack or a stroke can begin when plaque — cholesterol, fat, cellular waste and other substances — accumulates in the arteries, effectively “hardening” them, a condition known as atherosclerosis. Wherever plaque builds, two things can occur: a blood clot can form, or a piece of the plaque can break off and block the artery.
      Whilemany of us believe that cardiac events occur wherever the biggest deposits of plaque are, the truth is that most events occur where there’s less than 70% coronary artery obstruction, the editorial authors said.
      “Coronary artery disease is a chronic inflammatory condition,” Malhotra said. It is inflammatory processes that contribute to deposits of cholesterol within the artery wall and formation of plaque, he and his co-authors say. Plaques rupture in the manner of a pimple, and this is what can cause a heart attack or stroke.
      Coronary disease does not resemble a “clogged pipe,” they say. Evidence of this, they say, is contained in a series of studies that found that using stents to open arteries narrowed by plaque fails to prevent heart attack or reduce mortality.
      Plus, higher-fat diets do not show saturated fats to be detrimental to coronary artery health.
      For example, a Mediterranean diet supplemented with at least 4 tablespoons of extra virgin olive oil — which contains 14% saturated fat — or a handful of nutseach day achieved a significant 30% reduction in cardiovascular events in over 7,500 high-risk patients, noted Malhotra and his colleagues, referencingthe Primary Prevention of Cardiovascular Disease with a Mediterranean Diet study, known as the PREDIMED study. And the Lyon Heart study showed that adopting a Mediterranean diet improved outcomes for both recurrent myocardial infarction and all-cause mortality, noted the authors.
      Not everyone agrees with this interpretation of the two studies.
      “The evidence cited to support that saturated fat does not increase the risk of CVD does not really support the claim: the PREDIMED study did not investigate differences in fat or saturated fat intake, the Lyon Heart study actually showed a beneficial effect,” Dr. Gunter Kuhnle, an associate professor in nutrition and health at University of Reading, wrote in a published commentary.
      Others believe that evidence to support the authors’ claims is generally lacking.

      Critics raise questions

      Dr. David Nunan, senior researcher at the Centre for Evidence Based Medicine at the University of Oxford, wrote in a published comment that one of the studies cited as evidence in the editorial actually supports the “current consensus.” Instead of disproving the benefits of reducing saturated fats, the cited study shows the beneficial effects of reducing saturated fats and replacing them with unsaturated fats for the general population.
      According to Dr. Frank Sacks, former chairman of the American Heart Association’s nutrition committee, “the editorial is misleading, ignoring a large database of highest quality evidence that saturated fat does cause atherosclerosis, and does so in large part because it increases LDL-cholesterol.” LDL cholesterol is “bad” cholesterol, responsible for plaque buildup in the arteries, while HDL cholesterol is “good,” because it is able to clear away some of the buildup, according to the American Heart Association.
      In an email, Sacks wrote that the authors used an “obsolete methodology” in their analysis. Studies that use a more sophisticated method of analysis consistently show lower cardiovascular disease rates when unsaturated fats replace saturated fats, he said.
      The US Department of Agriculture’s food guide explicitly recommends that you eat more unsaturated fat than both saturated and trans fats to reduce your risk of heart disease.
      Unsaturated fats are the plant-based fats found in nuts, seeds or olives and in fish. At room temperature, unsaturated fats are oils. Trans fats, which were once commonly found in snack foods, cakes, cookies, icings and margarines, are synthesized by adding hydrogen to vegetable oils. They were added to prevent spoilage and to create better texture, yet the Food and Drug Administration ruled artificial trans fat to be unsafe in 2015 and gave food manufacturers three years to remove them from their products.
      Malhotra nevertheless maintains his position, noting, “it’s not the saturated fat that’s the problem.”
      “On a biological level, different saturated fatty acids have different effects on LDL cholesterol but they also raise HDL cholesterol,” Malhotra said. Overall, this push me-pull you opposition neutralizes the effect of saturated fats on cardiovascular risk.
      There’sno association between eating saturated fats and heart disease among healthy people and no benefit found when fat and saturated fat are reduced in people with heart disease or people who have had a heart attack, he added.
      For people over the age of 60, Malhotra said, “LDL cholesterol is not associated with cardiovascular disease and is inversely associated with all cause mortality.” He added that the No. 1 risk factor for heart attacks is “insulin resistance, driven by a number of dietary factors especially increased sugar and other refined carbohydrates.”
      In other words, it’s not the meat, which contains less than 10% saturated fat, in your burger that’s the problem, noted Malhotra. It’s the bun, the French fries and the sugary drink that washes it all down, he said.
      Not that he condones eating excessive amounts of red meat, which may be a separate issue, he said. The main culprit, though, is industrial processing of food.
      “The processed foods that people perceive to be high in saturated fats are in fact loaded with sugar, other refined carbohydrates and industrial seed oils (commonly known as vegetable oils) which are also now implicated in being pro-inflammatory and linked to heart disease, cancer and dementia,” Malhotra said. And so, he recommends eating real food as opposed to processed.
      Sacks remains unconvinced. “This ‘real food’ recommendation is not a scientific approach,” he said.

      See the latest news and share your comments with CNN Health on Facebook and Twitter.

      Malhotra said that “you don’t need to worry about eating foods high in saturated fat” if you follow the recommendation put forth in the editorial: exercise, minimize stress and eat healthy foods.
      “I follow my own advice ,which is to base your meals on the most beneficial components of the Mediterranean diet, with a base fat of extra virgin olive oil, lots of fibrous vegetables, nuts and oily fish, eat very little refined carbs and sugar,” Malhotra said.
      Moderation may be warranted here, as suggested by Dr. Gavin Sandercock, director of research at the University of Essex and a reader in clinical physiology. He said, “In moderation as part of a mixed diet, there is no single food item that is bad for you, and no single nutrient should be thought of as ‘healthy or unhealthy.’ This is true for fat, protein and carbohydrates.”

      Read more: http://www.cnn.com/2017/04/25/health/saturated-fat-arteries-study/index.html

      Lose weight with these 8 little changes

      Losing weight shouldn’t mean giving up all the foods you love. Try these small changes, and you may notice big results.

      1. Spice up your coffee.
      With cinnamon, that is. Sweetening your drink with a dash of cinnamon instead of sugar and sugary creamer can save upward of 80 calories per drink.

      2. Have egg-y French toast (or pancakes).
      Order your eggs over-easy, and use that delicious egg yolk to add moisture to your breakfast no butter or syrup needed! Youll get a bonus boost of protein, too. Need some recipe inspo? Try this egg-topped Protein-Rich Cherry French Toast, with no added sugar.

      THE 14 HEALTHIEST ITEMS AT YOUR FAVORITE FAST FOOD RESTAURANTS

      3. Make hummus your new favorite condiment.
      Next time you have a baked potato, top it with hummus instead of butter. Dont dismiss this until you have tried it, Keri Gans, RDN, author of The Small Change Diet, told Fox News. Creamy hummus adds a lot of flavor to a baked potato, with a lot less calories than butter. Thats 77 calories less per Tablespoon, to be exact. The bonus is you also get fiber and protein from the chickpeas, Gans added.

      4. Turn on slow jams during dinner.
      The speed of music influences how fast we eat, Christy Brissette, MS, RD, owner of 80 Twenty Nutrition in Toronto, told Fox News. Quick-serve restaurants sometimes use this trick to get people in and out of their seats faster. Playing slow music could have the opposite effect helping you eat more slowly and realize youre full faster.

      WHAT TO ORDER AT OLIVE GARDEN IF YOU’RE ON A DIET

      5. Vinegar down your salad dressing.
      Dilute your favorite salad dressing with balsamic vinegar. Youll pucker up for the intense flavor, while practically slashing your calories in half, Bonnie Taub-Dix, RDN, author of Read It Before You Eat It told Fox News.

      6. Eat fragrant cheese.
      Yes, this means you can eat cheese and lose weight! But choose the super flavorful varieties so a little goes a long way, Brissette advised. Try Manchego or Parmesan, so just a sprinkle adds tons of flavor to your salad or pasta. You wont need those big chunks of cheese you might be tempted to add when using less flavorful versions.

      7. Add beans to Bolognese.
      I am a die-hard meat lover, but I love to add black beans to a Bolognese so I can reduce the amount of chopped sirloin used, Gans said. This not only cuts calories it also adds health benefits from the beans, like helping to decrease your risk of heart disease.

      8. Mix your drink differently.
      In lieu of tonic water, use club soda as a mixer for your next drink. It contains zero calories, whereas tonic water has 124 calories per 12 ounces. This is nearly as much as cola, Ginger Hultin, MS, RDN, owner of Champagne Nutrition in Seattle, told Fox News.

      Amy Gorin is freelance writer and owner of Amy Gorin Nutrition in Jersey City, NJ. Connect with her on Facebook, Instagram, Twitter, and Pinterest.

      Read more: http://www.foxnews.com/lifestyle/2017/04/27/lose-weight-with-these-8-little-changes.html

      The Cheap Energy Revolution Is Here, and Coal Wont Cut It

      Wind and solar are about to become unstoppable, natural gas and oil production are approaching their peak, and electric cars and batteries for the grid are waiting to take over. This is the world Donald Trump inherited as U.S. president. And yet his energy plan is to cut regulations to resuscitate the one sector that’s never coming back: coal. 

      Clean energy installations broke new records worldwide in 2016, and wind and solar are seeing twice as much funding as fossil fuels, according to new data released Tuesday by Bloomberg New Energy Finance (BNEF). That’s largely because prices continue to fall. Solar power, for the first time, is becoming the cheapest form of new electricity in the world.

      But with Trump’s deregulations plans, what “we're going to see is the age of plenty—on steroids,” BNEF founder Michael Liebreich said during a presentation in New York. “That’s good news economically, except there’s one fly in the ointment, and that’s climate.”

      Here’s what’s shaping the future of power markets, in 15 charts from BNEF:

      Government subsidies have helped wind and solar get a foothold in global power markets, but economies of scale are the true driver of falling prices. Unsubsidized wind and solar are beginning to outcompete coal and natural gas in an ever-widening circle of countries.

      The U.S. may not be leading the world in renewables as a percentage of grid output, but a number of states are exceeding expectations. 

      Wind and solar have taken off—so much so that grid operators in California are facing some of the same challenges of regulating the peaks and valleys of high-density renewables that have plagued Germany’s energy revolution. The U.S. boom, while not the first, has been remarkable. 

      Electricity demand in the U.S. has been declining, largely due to increased energy efficiency in everything from light bulbs and TVs to heavy manufacturing. In such an environment, the most expensive fuel loses, and increasingly that’s coal. 

      With renewables entering the mix, even the fossil-fuel plants still in operation are being used less often. When the wind is blowing and the sun is shining, the marginal cost of that electricity is essentially free, and free energy wins every time. That also means declining profits for fuel-burning power plants.  

      The bad news for coal miners gets even worse. U.S. mining equipment has gotten bigger, badder, and way more efficient. Perhaps the biggest killer of coal jobs is improved mining equipment. The state of California now employs more people in the solar industry than the entire country employs for coal. 

      Historically, economic growth has gone hand-in-hand with increased energy consumption. Advances in efficiency are changing that, too. Call it the Great Decoupling. 

      The sharpest change in U.S. energy has been driven by advances in oil and gas drilling through shale rock. This type of horizontal drilling has also seen enormous improvements in efficiency, deploying fewer workers, fewer rigs, and drilling fewer wells to produce ever-more fossil fuels. The natural gas that comes out of these wells is practically free. 

      But demand for that oil and gas may not be long for this world. The world’s cars are getting wildly more efficient. 

      And the biggest threat to oil markets—electric cars—is just getting started. Joel Couse, the chief economist for Total SA, told the BNEF conference that EVs will make up 15 percent to 30 percent of new vehicles by 2030, after which fuel “demand will flatten out,” Couse said. “Maybe even decline.” 

      Couse’s projection for electric cars is the highest yet by a major oil company and exceeds BNEF’s own forecast.

      The outlook for electric cars—and for battery-backed wind and solar—is improving because the price of lithium-ion packs continues to tumble.  

      The shift to cleaner energy is ridding the air of local pollutants that cause heart disease, asthma, and cancer, as well as the greenhouse gas emissions responsible for climate change. Trump’s Energy Secretary, Rick Perry, told the BNEF Summit that the U.S. should remain in the Paris climate accord, but should renegotiate it to draw out stronger pledges from European countries. 

      Meeting U.S. commitments made under President Barack Obama shouldn’t be too difficult. America is already half way to meeting its 2025 goal. 

      And cleaning up emissions hasn’t exactly burdened consumers. Personal expenditures on electricity and fuels is down significantly. 

      Just meeting the Paris goals for emissions reductions doesn’t go far enough to fend off the catastrophe scientists anticipate from climate change. Eventually the economy will need to decarbonize completely—in energy, agriculture, construction, manufacturing, and land use. And solutions for some of the trickiest and most expensive parts of that equation are still decades away. 

      Fortunately, global energy markets at least seem headed in a cleaner direction. 

      Read more: http://www.bloomberg.com/news/articles/2017-04-26/the-cheap-energy-revolution-is-here-and-coal-won-t-cut-it

      Does saturated fats clog your arteries? Controversial paper says ‘no’

      (CNN)It is common knowledge supported by health experts, the American Heart Association and the World Heart Federation: Eating saturated fats will cause plaque to build up in the arteries, which then harden, and ultimately leads to coronary heart disease. To prevent heart disease, the association and federation both recommend a diet low in saturated fats, the animal-based fats found in beef, pork, chicken, butter and cheese, among other foods.

      But in an editorial published Tuesday in the British Journal of Sports Medicine, three cardiologists say saturated fats do not clog arteries and the “clogged pipe” model of heart disease is “plain wrong.”
      The authors write that eating saturated fats is not associated with either coronary heart disease, ischemic stroke, type 2 diabetes, death from heart disease or early death in healthy adults, referencing a meta-analysis, or review of previous studies, to support their claims. Critics of the editorial noted that the meta-analysis is based on observational data and is not considered conclusive by general scientific standards.
        “This idea that dietary saturated fats build up in the coronary arteries is complete unscientific nonsense,” said Dr. Aseem Malhotra, first author of the new controversial editorial and a consultant cardiologist at London’s Lister Hospital, in an email to CNN.
        According to Malhotra and his co-authors, Dr. Rita Redberg, a cardiologist at UCSF School of Medicine in San Francisco, and Dr. Pascal Meier, a cardiologist at University Hospital Geneva, healthy people can effectively reduce risk of coronary disease by walking 22 minutes a day, minimizing stress and eating “real food.”
        Saturated fat in itself is not a problem, they say.
        Critics question the merits of the editorial, noting that it is not based on any new research. Among them, Dr. Mike Knapton, associate medical director at the British Heart Foundation, referred to it as an opinion piece, calling it “unhelpful and misleading.” He said in a statement, “decades of research have proved that a diet rich in saturated fat increases ‘bad’ LDL cholesterol in your blood, which puts you at greater risk of a heart attack or stroke.”

        Hard arteries

        As described by the American Heart Association, a heart attack or a stroke can begin when plaque — cholesterol, fat, cellular waste and other substances — accumulates in the arteries, effectively “hardening” them, a condition known as atherosclerosis. Wherever plaque builds, two things can occur: a blood clot can form, or a piece of the plaque can break off and block the artery.
        Whilemany of us believe that cardiac events occur wherever the biggest deposits of plaque are, the truth is that most events occur where there’s less than 70% coronary artery obstruction, the editorial authors said.
        “Coronary artery disease is a chronic inflammatory condition,” Malhotra said. It is inflammatory processes that contribute to deposits of cholesterol within the artery wall and formation of plaque, he and his co-authors say. Plaques rupture in the manner of a pimple, and this is what can cause a heart attack or stroke.
        Coronary disease does not resemble a “clogged pipe,” they say. Evidence of this, they say, is contained in a series of studies that found that using stents to open arteries narrowed by plaque fails to prevent heart attack or reduce mortality.
        Plus, higher-fat diets do not show saturated fats to be detrimental to coronary artery health.
        For example, a Mediterranean diet supplemented with at least 4 tablespoons of extra virgin olive oil — which contains 14% saturated fat — or a handful of nutseach day achieved a significant 30% reduction in cardiovascular events in over 7,500 high-risk patients, noted Malhotra and his colleagues, referencingthe Primary Prevention of Cardiovascular Disease with a Mediterranean Diet study, known as the PREDIMED study. And the Lyon Heart study showed that adopting a Mediterranean diet improved outcomes for both recurrent myocardial infarction and all-cause mortality, noted the authors.
        Not everyone agrees with this interpretation of the two studies.
        “The evidence cited to support that saturated fat does not increase the risk of CVD does not really support the claim: the PREDIMED study did not investigate differences in fat or saturated fat intake, the Lyon Heart study actually showed a beneficial effect,” Dr. Gunter Kuhnle, an associate professor in nutrition and health at University of Reading, wrote in a published commentary.
        Others believe that evidence to support the authors’ claims is generally lacking.

        Critics raise questions

        Dr. David Nunan, senior researcher at the Centre for Evidence Based Medicine at the University of Oxford, wrote in a published comment that one of the studies cited as evidence in the editorial actually supports the “current consensus.” Instead of disproving the benefits of reducing saturated fats, the cited study shows the beneficial effects of reducing saturated fats and replacing them with unsaturated fats for the general population.
        According to Dr. Frank Sacks, former chairman of the American Heart Association’s nutrition committee, “the editorial is misleading, ignoring a large database of highest quality evidence that saturated fat does cause atherosclerosis, and does so in large part because it increases LDL-cholesterol.” LDL cholesterol is “bad” cholesterol, responsible for plaque buildup in the arteries, while HDL cholesterol is “good,” because it is able to clear away some of the buildup, according to the American Heart Association.
        In an email, Sacks wrote that the authors used an “obsolete methodology” in their analysis. Studies that use a more sophisticated method of analysis consistently show lower cardiovascular disease rates when unsaturated fats replace saturated fats, he said.
        The US Department of Agriculture’s food guide explicitly recommends that you eat more unsaturated fat than both saturated and trans fats to reduce your risk of heart disease.
        Unsaturated fats are the plant-based fats found in nuts, seeds or olives and in fish. At room temperature, unsaturated fats are oils. Trans fats, which were once commonly found in snack foods, cakes, cookies, icings and margarines, are synthesized by adding hydrogen to vegetable oils. They were added to prevent spoilage and to create better texture, yet the Food and Drug Administration ruled artificial trans fat to be unsafe in 2015 and gave food manufacturers three years to remove them from their products.
        Malhotra nevertheless maintains his position, noting, “it’s not the saturated fat that’s the problem.”
        “On a biological level, different saturated fatty acids have different effects on LDL cholesterol but they also raise HDL cholesterol,” Malhotra said. Overall, this push me-pull you opposition neutralizes the effect of saturated fats on cardiovascular risk.
        There’sno association between eating saturated fats and heart disease among healthy people and no benefit found when fat and saturated fat are reduced in people with heart disease or people who have had a heart attack, he added.
        For people over the age of 60, Malhotra said, “LDL cholesterol is not associated with cardiovascular disease and is inversely associated with all cause mortality.” He added that the No. 1 risk factor for heart attacks is “insulin resistance, driven by a number of dietary factors especially increased sugar and other refined carbohydrates.”
        In other words, it’s not the meat, which contains less than 10% saturated fat, in your burger that’s the problem, noted Malhotra. It’s the bun, the French fries and the sugary drink that washes it all down, he said.
        Not that he condones eating excessive amounts of red meat, which may be a separate issue, he said. The main culprit, though, is industrial processing of food.
        “The processed foods that people perceive to be high in saturated fats are in fact loaded with sugar, other refined carbohydrates and industrial seed oils (commonly known as vegetable oils) which are also now implicated in being pro-inflammatory and linked to heart disease, cancer and dementia,” Malhotra said. And so, he recommends eating real food as opposed to processed.
        Sacks remains unconvinced. “This ‘real food’ recommendation is not a scientific approach,” he said.

        See the latest news and share your comments with CNN Health on Facebook and Twitter.

        Malhotra said that “you don’t need to worry about eating foods high in saturated fat” if you follow the recommendation put forth in the editorial: exercise, minimize stress and eat healthy foods.
        “I follow my own advice ,which is to base your meals on the most beneficial components of the Mediterranean diet, with a base fat of extra virgin olive oil, lots of fibrous vegetables, nuts and oily fish, eat very little refined carbs and sugar,” Malhotra said.
        Moderation may be warranted here, as suggested by Dr. Gavin Sandercock, director of research at the University of Essex and a reader in clinical physiology. He said, “In moderation as part of a mixed diet, there is no single food item that is bad for you, and no single nutrient should be thought of as ‘healthy or unhealthy.’ This is true for fat, protein and carbohydrates.”

        Read more: http://www.cnn.com/2017/04/25/health/saturated-fat-arteries-study/index.html

        Two-thirds of people in Mexico, Chile and Ecuador are obese, UN finds

        Study calls epidemic frightening and finds that overnutrition and sedentary lifestyles are costing countries tens of billions of dollars every year

        More than two-thirds of people living in Mexico, Chile and Ecuador are overweight or obese, costing their economies tens of billions of dollars every year, driving rates of disease and straining health services, according to a new UN report.

        While the number of hungry people in Latin America and the Caribbean has halved in the past 25 years, the region is now struggling to combat an obesity epidemic.

        Changing diets, including more processed food that are high in salt, sugar and fat, along with more sedentary lifestyles have triggered a rising tide of obesity, experts say.

        The implications for the future of countries are frightening … undernutrition is declining, but overnutrition is expected to become the largest social and economic burden in the region, the UN World Food Programme (WFP) said in a statement.

        The report by the WFP and the UNs Economic Commission for Latin America and the Caribbean (ECLAC), said over the next six decades people being overweight and obese would cost Mexico an estimated $13bn a year, Ecuador $3bn and Chile $1bn.

        Undernutrition, when people do not get enough food, and obesity itself a form of malnutrition are two sides of the same coin, and together they inflict a so-called double burden of disease on people and economies, the report said.

        Undernutrition impairs child growth and brain development, while obesity can led to type 2 diabetes, cancer and heart disease.

        We now witness a worrying trend among vulnerable communities with cases of undernourishment and overweight simultaneously within the same families, said Miguel Barreto, WFPs regional director said in a statement.

        Both undernourishment and overweight represent a serious burden for the health of those families, that eventually translates into losses in productivity, and in pressure on the health and education systems in the country where they live.

        According to the World Health Organisation, obesity is an epidemic worldwide, killing 2.8 million adults every year, and obesity-related conditions now cause more deaths than hunger.

        In Latin America, obesity is increasingly affecting the regions poor, particularly women.

        In Mexico, a country that faces one of the worlds most acute obesity crisis, 74% of women are obese or overweight compared with 70% of men, the report said.

        The report urged food companies to play a greater role in combating obesity.

        The food industry has the opportunity to ensure the production, availability and accessibility of healthier food products, it said.

        Governments should also do more to promote exercise and health eating and place greater controls on food labelling.

        The report noted Chiles efforts to combat obesity, including an 18% tax on sugary drinks introduced in 2014 one of the worlds highest along with laws that restrict the advertising of unhealthy foods targeting children.

        In 2014, Mexico also introduced a 10% tax on fizzy drinks, and 2016 research by the British Medical Journal found that the sugar tax led to as much as a 12% reduction in sales during the first year it was implemented.

        Read more: https://www.theguardian.com/society/2017/apr/25/obesity-epidemic-latin-america-mexico-chile-ecuador-un-report

        Single, childless and nearing 40, I saw one real option

        Denver (CNN)It was a year ago when a young woman stopped me in a neighborhood shop. She gazed at my stroller and started crying. She told me how lucky I was to be married with kids.

        My heart dropped. She didn’t know me at all.
        I am a single mother by choice. Yet I was raised in a Christian, conservative home, where I grew up believing in the traditional family unit. And I was taught that there was an order to achieving it. First, fall in love. Second, marry a man. Third, start a family.
        Now in my fifth decade, only one has proven true for me — and it isn’t the first.
        On the day that I turned 30, I journaled that I would think about becoming a mother should I still be single at 38. What that looked like, I didn’t exactly know. It was a promise to myself, maybe to God.
        At the time, I was in a terrible relationship with a man who told me he wanted to be with me, but he could never love me. It was because of those words that I first clung to the idea of motherhood. Maybe a man could deny me love, but he would never deny me a child.
        Fast forward to my 38th birthday. I was still single, and the world of dating had changed significantly in the last eight years. Tinder and Bumble, the dominant dating apps, offered countless options for single men and women, but made the experience of dating entirely impersonal.
        Every family is different: Share your story of how IVF, adoption or your unique family structure has shaped your life with #ToBeMe or text/WhatsApp us on +1-347-322-0415
        Dating amounted to small talk with a stranger, who you had briefly interfaced with online because you each thought the other attractive. The small talk was a prelude to hooking up, and there were no expectations even of a text the next day.
        It was brutal. And after trying my hand at it, I was no closer to finding the love of my life or starting a family.
        If I needed statistics to back me up, I had them. In 2014, marriage was on the decline, as was the fertility rate in the United States.
        I had one real option left — and that was to attempt to get pregnant alone.
        Maybe I didn’t deserve a family, or so many of the subscribers to my conservative Christian values might say. And maybe the men with whom I had been involved didn’t view me as acceptable wife/mother material.
          But deep down I felt differently and decided to give myself one shot.
          And so I started the process of in vitro fertilization (IVF). I was mentally prepared for the physical havoc that would ensue, and I had saved every penny for it — to the tune of $30,000.
          But why didn’t I adopt? After all, even if I were fortunate enough to have a child, the child would be fatherless. And many, myself included, believe this places the child in a precarious situation.
          That said, at least with IVF my potential child would be biologically related to me, his or her grandparents and cousins. The child might not have a father, but he or she would have a strong bloodline. I hoped this would help ease any future struggle for my child.

          The IVF experience

          The very decade I was born into — the glorious 70’s — ushered in the science and technology that might allow me to conceive. Alone.
          More specifically, 1978 was the year that the first human being was born through the process of embryo creation outside of the womb, then implantation inside of the womb, pregnancy and successful birth. Since that time, IVF has produced approximately 5 million babies, with nearly 1 million of those being born in the United States.
          The IVF pool is quite minuscule compared to total US births — for example, in 2011, only 0.7% of all US births were attributed to IVF. That said, and barely optimistic, I was committed to the process, or so I thought.
          And yet there I was at a bar in Los Angeles, a month out from IVF, crying in front of two people I barely knew, but knew well enough to unload to.
          My life was great on paper. I had done all the right things. I went to Stanford for graduate school. I worked at the White House under Condoleezza Rice. I had the opportunity to travel the world. I had loving parents and two wonderful sisters.
          And yet I felt unloved — even unlovable. And also greatly conflicted.
          On the one hand, I was ecstatic — I was weeks away from my shot at becoming a biological mom. I started thinking about this potential path nine years ago and had been setting aside money for five years. I was in love with idea of having a family and giddy at the thought of the unknown.
            But there was doubt. Goodness, there was doubt. There was that little voice inside my head — the voice of my parents and others — that was very much alive in me. “Why would you purposely bring a child into the world without a father? Are you really that lonely? How would that child feel one day?”
            Throughout my upbringing, I was told that it’s wrong to play God. And, as recently as the previous Christmas Eve, I was told that bringing a child into the world without a father was selfish.
            My heart and my brain had to fight back.
            No, I was not that lonely. No, I was not that selfish. Actually, it was waking up single, every single day of my life — only to be greeted by my career — that felt selfish. And while I could never speak for the feelings that my future child might have, I took solace in the belief that any child would be happy to be alive if he or she were sincerely loved.
            As I drew nearer to the implantation date, the prospect of creating a tiny human grew more real and began to override any lingering doubt.
            And so, on August 29, 2014, I asked my doctor to implant two embryos. He wisely asked me to justify two. I was quick to answer. If I were lucky enough to get pregnant with twins — what a gift for them. They may not have a father, but they would always have each other.
            I knew the statistics and did not expect to get pregnant. Given my age and the means of conception, I was praying for the long shot of one, knowing two would be a miracle.
            The 2014 Assisted Reproductive Technology National Summary Report, as published by the US Department of Health and Human Services, is a humbling reminder of just how small the odds were during the year that I attempted to conceive. In 2014, a woman of my age, using fresh non-donor eggs with no previous pregnancies, had an 18.8% chance of pregnancy resulting in a live birth. When it came to percentages of cycles resulting in twin lives births, the success rate plummeted to 3.7%.
            Yes, I had a 3.7% chance of success.

            Choosing a donor

            Of course, before the IVF process could begin, I had to choose a donor — and let’s just say I took a less than conventional approach.
            Given my professional background as a conservative politico, I think people expect me to say that IQ, number of educational degrees and political association were at the top of my donor qualifications list. Not the case.
            I was looking for someone who I would be attracted to if we were procreating in the traditional way.
              I know this must sound incredibly superficial. But, let’s be frank, it’s impossible to gauge true intellect or a kind heart by virtue of an online donor search.
              And so I began my search with a focus on the physical attributes that I have always been attracted to — namely height and athleticism. Six-foot-2 and toned was my baseline.
              The donor was a collegiate lacrosse athlete. I was able to see three pictures, from tot to teen, of an adorable boy with an incredible smile, unruly hair and a twinkle in his eyes. (This particular bank did not allow adult pictures of the donor for legal reasons. So, at the end of the day, the attraction part of my search was also a gamble.)
              I finished my search on the scientific side of things. The donor bank I chose provided a full medical history and genetic testing results. Honestly, why wouldn’t you opt for a donor with no heart disease, cancer, mental illness or any other serious genetic conditions in his family history?
              This is the one distinct advantage of going the donor route as opposed to the good old-fashioned route when conceiving. While I haven’t polled my married or attached friends, I am 99.9% certain that not a single one queried their partner about the specifics of their family’s medical history prior to sleeping with them or accepting a marriage proposal.
              I was searching for my version of good genes, who also looks good in jeans — at least on paper.

              The longest days of my life

              In early September, my blood work came back with hormone levels signaling pregnancy. I was in shock, but I had eight long weeks to go until seeing if there was a heartbeat or two. I started to take a pregnancy test every evening. It was the longest 56 days of my life.
              D-Day finally arrived. And, there on the sonogram screen right in front of me, was the most beautiful thing: my child’s heartbeat, strong and steady.
              I had a million immediate questions for the sonographer and started right in. She stopped me, because there was heartbeat number two. Wait, what? I was laughing and crying at the same time. This must be what joy feels like, I thought.
              The clich that I despise most is: It will happen when you least expect it. Nonsense. I had gone almost 40 years expecting nothing in terms of dating, love and, God forbid, a husband — and I received exactly that in return.
              But suddenly the least expected had happened. I was pregnant with twins.
              My journal entry from the evening read as follows:
              Week 8, Day 1: October 6th D Day
              Dear God: Thank you.
              Baby A: your heartbeat was 159 today.
                Baby B: your heartbeat was 168.
                I love you A & B. Please keep growing. You’re looking great.
                Thank you, God. I pray for their development — from their fingers to their toes. From brain to nose. I am so grateful for these precious beings. Prepare me to be the strong parent — fiscally and spiritually — that they will need me to be.
                Love you.

                The Friday of truth

                On a Friday morning roughly 30 weeks after implantation, something seemed wrong. I had such severe leg cramps that I was crawling around the apartment on my hands and knees. I called an Uber at 8:30 am. Never having taken any birthing classes, I had no idea what the onset of labor looked like.
                By the time I got to the hospital the pain was so intense that I could barely make it to the door. The Uber driver offered to help me up. I was immediately checked in and within minutes was told that I was 7 cm dilated and would be headed into an emergency C-section.
                My heart stopped. I was petrified that those little heartbeats were going to stop and that my sons — my sons — were not going to make it. I was alone in the pre-delivery room just long enough to run through every awful scenario in my head.
                And then it was time. Seventy minutes after arrival, I was wheeled into a room with a team of 16 doctors and nurses waiting for me. The sight of this army, the two waiting incubators and all the other metal contraptions made me well up. I had no idea what was going to happen next, but I had never expected it to happen quite like this — not this early, not with these many medical professionals and not entirely on my own.
                Doctors and nurses were working quickly all around me. Epidural, check. Babies’ heart rates, check. Slicing me open, check. Ripping two crimson-colored sons out of me at 10:40 am and 10:43 am, check and check.
                I saw Eli and Abel for a nanosecond before the nurses cut the cords and rushed them to their incubator stations to begin inserting the breathing tubes. They were 10 weeks premature and neither could suck, swallow or breathe on their own.
                The two teams whisked my babies to the Level 4 NICU (neonatal intensive care unit) without me getting to touch their skin or ask if their vital signs were stable. I did hear them cry, which was a relief. I just wish my sisters had been there to take a picture and help recount what happened. I can’t ever get that moment back.
                Little did I know when I moved to Denver that I would be delivering twins two years later at Denver’s premier NICU hospital — The Rocky Mountain Hospital for Children at Presbyterian St. Luke’s
                I was not able to see my sons until nine very long hours after delivery. I walked into a room with two incubators housing my baby boys, who looked more like starved squirrels than the roly-poly infants that I had envisioned. All wired up, with IVs jutting out of the top of their skulls, they were absolutely perfect. Complete miracles from inception to emergency birth.
                And, of course, they chose Friday the 13th of March to scare the living hell out of me and fight their way onto this Earth.

                The next 60 days

                Two weeks after I was released from the hospital, I found myself sleeping in my Denver home of almost two years, as my boys lived and slept inside NICU — for 60 days straight.
                And though I could easily have felt alone — so removed from my two miracles — I didn’t.
                Friends and family from across the country constantly checked in on me, calling, texting, writing me words of encouragement.
                And even once Eli and Abel were out of NICU, loving and supporting friends — and sometimes even strangers –continued to shower us with kindness and affection.
                Initially, the NICU team was our rock. These complete strangers became the most significant and consequential people in the lives of my sons during their first two months. I will never be able to appropriately express my gratitude to the nurses and doctors who safeguarded their lives. Several are friends to this day.
                Then my personal trainer and his wife, the first people to visit me in the hospital, became the most trusted and consistent presence in our lives. From celebrating our birthdays, to helping with our apartment move, to Fourth of July and Super Bowl celebrations, to just being those adult ears that I need — Adam and Teri have been there for all of it.
                The mother of twin boys, who lived steps away from me, became my sanity check. We were pregnant at the same time and delivered within weeks of each other. We met by fluke, thanks to a double stroller sighting in the alley.
                And the parents of my first employee proved invaluable, babysitting the boys on weekends so I could nap.
                I can’t forget the British transplant, who regularly delivered homemade quiche on weeknights just because.
                More recently, though, the manager at the Palm (steakhouse) took care of my family. It was Thanksgiving night, and I took the twins for our first holiday fte as a family of three. In one of the most random acts of kindness, the manager worked her way to our table, poured me a glass of wine, helped feed the boys, shared a bit of her life story with me and then bought our meal. She did not know me.
                Most importantly, since the birth of Eli and Abel, my parents have fallen so completely in love with their grandsons that it’s hard to fully put into words the intensity of their connection. What was at first an idea hard for my traditional parents to grasp, is now two, tiny human beings, who have my parents tightly wrapped around their little fingers. Though thousands of miles away, my parents — and my sisters — express their love and support constantly and in innumerable ways.
                There are incredible people in this world. My sons’ existences have made that real to me.

                The lessons learned

                Eli and Abel have proven to be the embodiment of that saying you always hear — the hardest, yet best thing I’ve ever done.
                My sons are my family and my future. They represent everything good, hopeful and hilarious about life. They smile and cheer when I walk into their room. They blow kisses and sneak hugs. They belly laugh when we dance. They cuddle up at night and put their heads in the crook of my neck.
                They also scream, bite and bang their heads on the floor when they’re upset. They chuck their food when they don’t like it. They act like the world is coming to an end at bath time. And they are a constant financial stress. Being a single parent is hard as hell.
                But from my two little men, I quickly internalized that love is a verb. Love is an action and something you work at every single day. You wake up every morning with a mandate and desire to be a better parent to your children than you were the day before.
                Speaking of love, friends like to tell me that there is a man out there — some wonderful man who will sweep me off my feet and be an excellent father. To that I say, please stop. Do I want to date? Of course. But I can honestly write that I have no expectations for love, and I certainly do not believe that there is a father out there for my sons. I am not waiting and hoping, because I have lost that hope.
                Why have I lost that hope? Truth be told, I have been vulnerable with a few men pre- and post-pregnancy. But rejection upon rejection by man after man will do it to you. Even when you are that aloof gal, who doesn’t ask questions or have expectations of something real or long-term, it still ends. I guess you just lose your luster after awhile. It’s my reality, and it never changes.
                And while we are on the topic of relationships, I would note that I will forever be perplexed by the rate of unsolicited and unexpected congratulatory communications from ex-boyfriends after years of no contact. These were the men who rejected me. These were the men who left after months or years of pretending and/or cheating.
                After the birth of my sons, these same men suddenly thought they had a green card to strike up conversation and ask for pictures of the twins. One suggested grabbing dinner in DC. One kindly offered to come to Colorado to help run errands, cook dinner or do whatever I needed.
                The attention was hard to digest. I once cried over these men. Perhaps this was a way of absolving their guilt for being dishonest or wasting my time? Perhaps they were sincerely happy for me, which would suggest that they did respect me after all? Perhaps they were feeling slighted or envious that I went it alone, without them? I’ll never know.
                And, most importantly, I finally no longer care.
                Though I may never have a significant other, I do have my sons, who’ve taken me from unloved to loved and from unlovable to lovable. They’ve done this all on their own. They are my miracles, which I almost didn’t allow to happen because of heartbreak, self-doubt and maybe even self-loathing.
                Prior to Eli and Abel, I wasted at least half of my adult life obsessing about things I had lost — men who broke my heart, clients who weren’t a good fit, friendships that had faded.
                My sons taught me to focus on the miracles that are right in front of my eyes every single day, beginning with my 3.7%.
                Every family is different: Share your story of how IVF, adoption or your unique family structure has shaped your life with #ToBeMe or text/WhatsApp us on +1-347-322-0415
                Correction: This piece initially stated Lenti is in her fourth decade and has been amended to reflect that she is in her fifth decade.

                Read more: http://www.cnn.com/2017/04/25/opinions/ivf-3-7-percent-opinion-lenti/index.html

                The next great medical innovations that could save children

                (CNN)What medical advancements could save the lives of our children in the future? That’s the question members of the American Academy of Pediatrics asked themselves. Their answers were published last week in the journal Pediatrics.

                “We thought about the next 40 years and what fields of study might lead to great medical achievements,” said co-author Dr. Tina Cheng, Director of the Department of Pediatrics at John Hopkins Hospital.
                “We wanted to identify areas that could have the greatest impact on improving children’s lives,” added co-author Dr. Clifford Bogue, a critical care pediatrician at Yale University School of Medicine. “Because we believe child research is a great investment, we thought it would be helpful for advocating for funding in the future.”

                  What has pediatric research accomplished?

                  Studies say research into diseases that disableand kill children falls far behind those done on adults in both scope and quality.
                  “The amount of research being done with children and infants has been declining,” said Cheng, “and funding for pediatric research has been flat or declining as well.”
                  To draw attention to the disparity, the American Academy of Pediatrics created a campaign: the “7 Great Achievements in Pediatric Research.” By canvassing board members and asking them to rank key advances in childhood health, the AAP created a list of seven of the greatest pediatric research achievements of the last 40 years.
                  Published in 2015, the historical advances included the famous “Back to Sleep” campaign to prevent sudden infant death syndrome, or SIDS; the all-out push for laws requiring car seats and seat belts for children of all ages; preventing disease with life-saving immunizations and finding a successful treatment for the most common childhood cancer, acute lymphocytic leukemia.
                  Other great achievements they highlighted were helping premature babies breathe with a surfactant therapy, reducing HIV transmission from mother to baby and increasing the life expectancy for children with sickle cell anemia and cystic fibrosis.
                  “We wanted to highlight to the public and to legislators just what the value was for the research dollars that were spent, most of which were funded by the National Institutes of Health,” said Bogue, “to show the huge impact the research had on saving and improving the lives of children and their families.”
                  More childhood immunizations
                  The AAP strongly advocates for routine vaccinations as one of the best ways to protect children from dangerous diseases. Two examples in the survey are rotavirus, a severe gastroenteritis, and Haemophilus influenzae type b (Hib), a leading cause of bacterial meningitis.
                  Before vaccines were developed, rotavirus killed about 450,000 children worldwide each year. In the United States Haemophilus influenzae type b took the lives of 1,200 children annually.
                  “We’d had incredible success,” said Cheng. “A lot of residents-in-training have never seen tetanus, influenza or polio. But there are always new and emerging diseases, and even some of the vaccines we have need to be better.”
                  Some of the vaccines the survey participants hope to see in the future include Zika, Ebola, certain cancers, and the flu.
                  “As we see from history, there are regular pandemics in our world and we are due for one,” said Cheng. “Many point to the flu as most likely culprit. It’s especially hard on the young and elderly and those with chronic illness.”
                  Cancer immunotherapy ‘moonshot’
                  “We need to find an innovation that can really make a difference with childhood cancer, and immunotherapy may be the next great thing, the sort of ‘moonshot’ we need,” said Cheng.
                  Using one’s own immune system to target cancer cells is cutting-edge research that is showing enormous potential. While most current research focuses on adults, it’s also expected to reap huge dividends in childhood cancer treatment, especially for cancers notoriously difficult to treat.
                  “Immunotherapy is booming right now and that’s why we picked it,” agreed Bogue. “But children are often left out of that research. One reason is safety issues, but they are also a very small market for pharmaceutical companies.
                  “Yet it’s very important to do the research in children,” added Bogue. “Because if you can cure a cancer with immunotherapy at age 10 or 15 instead of 65 you have greatly magnified the impact of that therapy.”
                  Genomic testing
                  As understanding of our human genome continues to grow, so will the ability of science to discover genetic mutations and test for them “prenatally, at birth, and throughout the life course”, says the committee, which will allow us to better predict, diagnose and prevent disease.
                  “Right now when you have a baby, she gets a heel stick for a few drops of blood and they test for a host of genetic conditions that if found early, can be much more treatable,” said Cheng.
                  “30% of disease in young infants and children is due to a genetic disorder and that’s just based on the small number of genes we have identified and confirmed to date,” added Bogue.
                  He points out that as science works on the human genome, it’s getting cheaper and easier to gather information, take it to the lab and do the work to figure out why a mutation causes a disease, the pathways involved and how science might intervene.
                  “That’s the big promise in genomic information,” Bogue said. “We can not only tell parents what their child has, but also why and even come up with new treatments.”
                  Early interventions
                  Wouldn’t you like to know as a child if you might get type 2 diabetes, heart disease or cancer later in life?
                  “Many adult diseases are present in childhood,” said Bogue, “and follow a pathway that may take years to develop.”
                  As research on the human genome progresses, it is beginning to pinpoint the environmental, behavioral and genetic triggers that might flip a disease switch into action.
                  “For example, science is beginning to show that young adults who develop schizophrenia may have had brain abnormalities as infants,” explained Bogue. “So we can now begin to predict and intervene before the disease becomes severe.
                  “In the future, if we knew someone was going to become a diabetic at 25, we could start intervening at age 5. Just think of the impact on that child’s life, as well as society.”
                  Impact of social, behavior and environmental factors
                  Exposure to toxic chemicals in our environment has long been known to impact a child’s development. For example, a mother or father’s exposure to heavy metals, such as arsenic, mercury and lead, can lead to lower IQ and other neurologic and psychological disorders in their children.
                  But according to the AAP committee, there are social and behavioral ways that can limit a child’s potential. They point to maternal malnutrition and other stresses, as well as childhood exposure to violence as stress factors that can “clearly re-program a variety of gene interactions.”
                  “Even interactions that parents have with their child, such as reading to them versus propping them in front of a TV,” said Bogue,” can have a huge impact on their child’s development. We need to focus on those factors as well.”
                  Improving our systems of care
                  What’s the third most common cause of death in the United States? It’s not a disease. According to researchers at Johns Hopkins, medical errors by health care providers lead to approximately 251,000 deaths each year. The AAP committee sees advances in service among health care providers to be a key area of growth that will have an impact on children’s health in the future.
                  “We’re not talking on the individual level, but improving health care itself,” explained Cheng. “If we decrease medical errors and provide the same highest quality of care every time we see a patient, we will save lives.”
                  “It’s about systems of care,” agreed Bogue. “How do we engineer the care we deliver so that it gives us better outcomes? And oddly it often ends up being cheaper.”
                  Increasing global access to care
                  Today, many children around the world are without access to even the basics of proper health care, such as sanitary water, medical supplies, and food. Nearly one in five children have not received routine immunizations, much less the many advances that have occurred in the last 40 years.
                  Knowing that intervention A reduces disease B by 90% is great medicine, said Bogue, but how do you actually implement that science so providers and even whole countries are doing it?
                  “It can take years for those breakthroughs to become standard practice,” he explained. “We need to markedly shorten time frame from knowing when it works to putting it into practice so that people can benefit from it.”

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                  Are these seven medical advancements a definite for the future? No, and they aren’t meant to be, said the authors.
                  “It’s true we can’t really predict what comes next, but we need to be thinking about it and where are we going,” said Cheng. “The take home message here is that pediatric research has led to improved life expectancy and there are emerging diseases and issues we need to combat. We just want to start the conversation.”

                  Read more: http://www.cnn.com/2017/04/24/health/childhood-medical-advances/index.html