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Trump’s Promise To Rein In Drug Prices Could Open Dam To Importation Laws

With prescription drug prices soaring and President Donald Trump vowing to take action, an old idea is gaining fresh traction: allowing Americans to buy medicines from foreign pharmacies at far lower prices. A new bill in Congress to allow the practice would modify previous safety standards and remove a barrier that proved insurmountable in past attempts to enable progress.

Congress came close to allowing importation through the Medicare Modernization Act in 2003, but added one firm precondition that has proved a nonstarter. The secretary of Health and Human Services had to guarantee that imported medications posed no additional risk to public safety and would save money.

“That is a fairly absolute standard and a high bar to cross,” said Elizabeth Jungman, director of public health at the Pew Charitable Trusts. Such an exacting standard — guaranteeing that no imported prescriptions posed a threat — has kept any secretary of HHS from condoning it.

In an open letter to Congress, four former commissioners of the Food and Drug Administration argue consumer drug importation remains too risky to permit. “It could lead to a host of unintended consequences and undesirable effects, including serious harm stemming from the use of adulterated, substandard, or counterfeit drugs,” they said in the letter distributed to media organizations. It was signed by Robert Califf, Margaret Hamburg, Mark McClellan and Andrew von Eschenbach, who headed the FDA at various times between 2002 through 2016.

The recent proposal, from Sen. Bernie Sanders (I-Vt.) and such Democrats as Cory Booker from New Jersey and Bob Casey from Pennsylvania, drops that requirement. Instead, it sets up a regulatory system where Canadian pharmacies who purchase their supply from manufacturers inspected by the Food and Drug Administration would be licensed to sell to customers across the border. The bill allows not only individuals but drug wholesalers and pharmacies to buy from Canada.

After two years, HHS could allow importation from other countries that meet standards comparable to those of the U.S.

(Another bill in Congress, proposed in January by John McCain (R-Ariz.) and Amy Klobuchar (D-Minn.) focuses solely on allowing individuals to purchase from such pharmacies.)

Trump has promised that “pricing for the American people will come way down.” Last week, he had a high-profile meeting at the White House with Elijah Cummings, Peter Welch (D-Vt.) and the head of Johns Hopkins Hospital, Redonda Miller, to discuss allowing Medicare to negotiate prices on outpatient medicines. Cummings told reporters later that Trump said he supports Medicare price negotiation as well as the Sanders bill.

PhRMA, the drug industry’s trade group, has denounced Sanders’ proposal as it has others that enabled imports in the past.

“The bill lacks sufficient safety controls [and] would exacerbate threats to public health from counterfeit, adulterated or diverted medicines, and increase the burden on law enforcement to prevent unregulated medicines and other dangerous products from harming consumers,” said PhRMA spokeswoman Nicole Longo.

Surveys indicate that up to 8 percent of Americans have bought medicines outside the U.S. even though the practice is technically illegal and imported pills are subject to confiscation.

Around 45 million Americans — 18 percent of the adult population — said last year they did not fill a prescription due to cost, according to an analysis of data from the Commonwealth Fund by Gabe Levitt, president of PharmacyChecker.com, whose company helps Americans buy medications online by vetting overseas pharmacies and comparing prices for different drugs. Data compiled by the company comparing prices offered in Canada to those in New York, shows drugs are frequently three times or more as costly in the U.S. as over the border.

For example, a simple Proventil asthma inhaler costs $73.19 in the U.S. vs. $21.66 in Canada. Crestor, the cholesterol-lowering drug, is $6.82 per pill in the U.S. but $2.58 in Canada. Abilify, a psychiatric medicine, is $29.88 vs. $7.58, according to pharmacychecker.com.

Many previous bills to allow importation or to allow Medicare to negotiate prices for its beneficiaries have failed in the face of $1.9 billion in congressional lobbying by the pharmaceutical industry since 2003, according to Open Secrets. But Americans may be reaching a tipping point of intolerance. In polling just before the election by the Kaiser Family Foundation, 77 percent of Americans called drug prices “unreasonable” and well over half favored a variety of proposals to address them.

To address safety concerns, the Sanders bill institutes several new strategies. Canadian pharmacies that want to be registered to sell to Americans would have to pay a fee to pay for additional FDA monitoring. A General Accountability Office study would be required within 18 months of the final rule to address outcomes related to importation processes, drug safety, consumer savings and regulatory expenses.

Allowing people to legally import medications wouldn’t totally solve the problem of high prescription drugs, advocates say, but would be a step in the right direction. Said Levitt: “The best way for Americans to afford their meds is to enact polices here to bring the prices down here.”

KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Break Out of Your Food Rut!

What's for dinner? What are you eating for breakfast or lunch tomorrow? If you aren't feeling excited about your meals, or if your kids are complaining about eating chicken again, you may be in a food rut.   It happens easily; between work obligations, social plans, and kids' soccer practices, we tend to fall back on easy-to-prepare staple meals that don’t require much thought or effort. And for some of us, cooking doesn’t come easily or isn’t a pleasure, so we rely on a handful of recipes we can confidently prepare.   While it's wonderful to have a few go-to meals you can rely on in a pinch, it can get old when you rely on the same meals too often. And that lack of excitement about what's on your plate could lead you to reach for additional snacks or sweets to bring more pleasure back to your eating—which can be a problem if you're trying to manage your weight or eat healthier.   We recently asked SparkPeople members if they were stuck in a diet rut, and we were surprised by how many people replied. Member CHOUBROU summed it up this way: ''The food rut is my biggest problem! I fall into it because eating the same go-to meals is convenient and easy. But eventually I get tired of eating the same thing, and that leads me to the temptation of eating out more, eating more frozen/processed meals, etc.''   SparkPeople member KALENSMOMMY5 asked for help: ''One of the main reasons I fall off the healthy eating wagon is that I get caught in a major food rut! As I am a full-time working single mom to a toddler, I have very limited time to cook, so I end up buying the same grab-and-go foods week after week. The unhealthy choices start to look more and more attractive as I get more bored with my standard foods. Help would be much appreciated!''   Lots of folks told us they’ve hit the wall, cooking-wise. What’s more, they shared great advice on how you can break boring food habits, no matter what causes them.   5 Signs You're Stuck in a Food Rut (and What to Do about It)   Sign #1: You Don’t Enjoy Cooking For many folks, getting dinner on the table is a chore, not a pleasure. If you don’t love to cook, or you’re not confident in your culinary skills, then it's normal to feel like you're in a food rut for awhile—at least until you develop a few basic meals that you can prepare quickly and easily. Here’s how:

  • First, think about what you enjoy eating. Sandwiches? Burritos? Breakfast for dinner? Salads? Consider how you can make those into healthy dinner options.  
  • Settle on three to five things you like, and find simple recipes for those meals. SparkRecipes is a great resource for quick and healthy meal ideas.  
  • Get comfortable with the basics. Once you’ve mastered an essential technique like sautéing boneless chicken breasts, then you can move on to experiment with different sauces or add-ins to change things up over time and prevent yourself from getting bored.  
  • Accept that you don’t love to cook, but don’t let that be your excuse for not eating healthy. If you master a few basic recipes, you’ll gain confidence—and you’ll be making a commitment to yourself.
Sign #2: You’re On Auto-Pilot Even accomplished home cooks tend to get stuck in a rut preparing the same go-to dinners over and over. Katie, a mother of two, posted: ''[My son] calls me on my food ruts—I know I've got problems when my garbage disposal of a kid complains about what I'm cooking.''   Like many folks who commented on our question about food habits, Katie says she refers to cooking magazines (her favorite is Food and Wine) for inspiration when she’s stuck in a routine. Cooking Light magazine and the books ''Cook This, Not That'' by David Zinczenko and Matt Goulding, and ''Fast Food My Way'' by Chef Jacques Pepin were also recommended as great resources for quick and healthy meals.   David posted about different ways to find culinary inspiration: ''I realize [I’m in a food rut] when I’m on auto-pilot preparing a meal that usually gives me joy to cook. I break it up by shopping somewhere new for groceries, or getting a new cooking gadget, or sharpening my knives or getting a new spice.''   A simple strategy for busting out of the auto-pilot cooking rut is to find alternate ways to prepare those go-to meals—in particular, look to different ethnic cuisines for interesting takes on your standards. If spaghetti with meat sauce is in your repertoire, try linguine with spicy shrimp sauce instead. Not feeling that leftover chicken? Turn it into something new, like a tostada. Sometimes simply swapping a few ingredients within a go-to recipe can give you a whole new flavor and make your meals interesting again. Same with sides: If you're always steaming broccoli or brown rice, experiment with other healthy veggies or whole grains such as whole-wheat couscous, millet or quinoa instead.   Sign #3: You Always Eat the Same Meals This food rut often shows up at the start of the day, when we’re so busy getting out the door that we neglect a healthy breakfast, or we choose convenience foods over healthy ones. SparkPeople member LINDSAYHENNIGAN commented that she found herself eating high-fiber breakfast cereal every day: ''I got too focused on how much fiber they added, and failed to notice the 40 grams of sugar I was consuming each morning. My trainer caught it, and switched me over to bread with 2 or less grams of sugar with peanut butter, and I feel so much better.''   SparkPeople member FLUTTEROFSTARS, a vegetarian, shared a bunch of great ideas she enjoys to start her day: ''I’m fighting to get out of my food rut! I’ve been 'Sparking' for two months now, and have come up with several winning mini-meals.'' Some of her favorites include:
  • Salad with Morningstar veggie crumbles and low-fat cheddar cheese
  • Omelets with frozen vegetable blend
  • Greek yogurt with strawberries and flaxseed
  • The ''one-minute microwave muffin'' recipes for breakfast sandwiches from SparkRecipes
We all go through busy periods in our lives—a hectic few weeks at work, an extra-busy sports season—and getting a healthy dinner on the table every evening is even more challenging. Creating a weekly meal plan and then shopping for all the ingredients you’ll need helps avoid the food rut. When you know in the morning what you’re making for dinner that night, you can avoid grabbing quick and not-so-healthy items on that emergency trip to the grocery.  And planning dinners that can be repurposed into lunches avoids brown-bag boredom.   Sign #4: You’re Bored with Brown Bagging We’ll congratulate you for committing to bringing a healthy lunch instead of heading to the nearest fast food joint. But the contents of your brown bag need an overhaul if you’re stuck in the PB&J or turkey sandwich routine day in and day out.   Turning dinner into lunch is a great way to vary your midday meal, especially if you plan ahead and prepare extra food in the evening for the next day’s (or week’s) lunchbox. A dinner of grilled steak and veggies can become a lunchtime salad, and a pasta supper easily transforms into a chilled pasta salad a day later.   SparkPeople member FELIFISH26 posted: ''I usually eat the same boring thing for lunch (half a turkey sandwich on sandwich thin bread, cottage cheese, low-fat chips). BLAH, right?! After awhile your taste buds start to get used to it all, and I could probably be eating cardboard and not know the difference!'' She solved her lunch dilemma by combining some cooked chicken from dinner the night before with fresh pico de gallo that she made with chopped tomato, onion and cilantro. New lunch idea: chicken tacos.   Sign #5: You’re Stuck on ''Diet-Safe'' Foods Several SparkPeople members commented that their commitment to weight loss means they have a limited number of meal options that meet their calorie limits. Member STACYD16 wrote, ''I do believe that I'm in a food rut. I eat the same things daily because I know their caloric contents. I do have a cheat day about once a week that I really enjoy—and I thought that would throw me off, but it has really helped. I realized my issue is more portion control vs. the actual foods that I eat.''   While eating within a calorie range can be a challenge, portion control can help. You can also search for specific recipes within a certain calorie range by using the Advanced Search on SparkRecipes.com. So if you want slow-cooker dinners that contain fewer than 400 calories, simply edit your search options and voila! You'll be surprised just how many delicious and easy meals you can find within your calorie range for any meal.   When All Else Fails: Embrace the Rut Here’s one final strategy for breaking out of your food rut—know that you’ll get into one. Steve posted about exactly that: ''Another thing I'll do is the mid-week ‘king's food’ omelet—where, no matter what, I'll cook an omelet using the leftovers of previous meals. This does two things: It creates interesting flavors with combos I’d normally never think of, and it motivates me to cook good stuff early in the week because it's potential omelet fodder.''   Just as you can't expect perfection when it comes to eating within your calorie range, losing two pounds per week, or exercising as much as you'd like, you can't expect to be perfect in the kitchen, either—or to love every bite you eat. Accept that we all go through ruts with our food. But instead of allowing it to throw you off track, use it as a sign to change things up and find creative ways to make your food fun and delicious again. And remember, this (food rut) too, shall pass!   Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1759

How a 'Bad Food' Attitude Can Backfire

Do you struggle with cravings and wish you had the will power to cut out certain foods completely? When we work toward a healthy diet, so many of us think that making a list of food culprits and calling them off-limits will help us to succeed. However, if you take a deeper look at the psychology behind this flawed method, you’ll see so many reasons why adopting a ''good food'' or ''bad food'' attitude will never work.  Restricting certain foods won't just make dieting miserable--it can also ruin your good intentions of getting healthy and losing weight. Making arbitrary rules about good and bad food isn’t the answer to lasting lifestyle change. Instead, use the tips below to build a better relationship with food, learn to master cravings, build self-control and enjoy all foods in moderation.   Stop Labeling Foods as 'Good' and 'Bad' For decades, behavior analysts have studied the effects of deprivation on people’s preferences for food, tangible items and activities. The majority of literature on this topic says that, when we’re deprived of something, we’re more likely to select that particular item from an array of choices. In a recent study conducted at the University of Toronto at Mississauga, researchers found that participants who were asked to restrict either high-carb or high-protein foods for three days reported higher cravings for the banned foods. So, if you label chocolate as evil and forbid it from your menu, you’ll be more likely to want it in any form.   The good news is that some level of satiation (satisfying your craving for a particular food) can actually help you to avoid overindulging more often than not. If you can be conscious about your eating and have just enough of your favorite chocolate bar to satisfy that craving, you’ll be much less tempted to dip into the candy jar on your co-worker’s desk or buy a sweet snack from the vending machine.   This information about deprivation seems like common sense, but you’ve probably heard from friends or fellow dieters that the first step in avoiding high-calorie foods is putting them out of your mind altogether. Not true! Researchers are realizing that suppressing thoughts about a particular food can cause an increase in consumption of that food. In a 2010 study, 116 women were split into three groups. The first group was asked to suppress thoughts about chocolate, the second group was asked to actively think about chocolate, and the third group was instructed to think about anything they wished. Afterward, each of the participants was given a chocolate bar. The women who had suppressed their thoughts about chocolate ate significantly more chocolate than the others, despite identifying themselves as more ''restrained eaters'' in general. This just goes to show that ''out of mind'' doesn’t necessarily always mean ''out of mouth.''   Dump the Idea of 'Diet Foods' Often, when people are trying to eat better, they start to categorize foods into those that are on their diet plan and those that are not. However, banning specific foods from your weight-loss plan may just make you crave them more.  According to an article published this year in the journal Appetite, a UK study of 129 women measured the cravings of those who were ''dieting'' to lose weight, ''watching'' to maintain their weight, and not dieting at all. The researchers found that, compared with non-dieters, dieters experienced stronger, more irresistible cravings for the foods they were restricting.   Noticing the difference between healthy and unhealthy options is definitely key in establishing a pattern of better eating. And, when you’re starting a weight-loss program, it does help to read food labels and menus carefully so that you can choose wisely. However, when you start to categorize specific foods such as candy, baked goods, alcohol and fried chicken as foods you can’t have, you’re setting yourself up for a backfire. The issue with labeling a food as a forbidden substance is that your thoughts immediately center on that particular item... and then you inadvertently start bargaining and rationalizing to get more of it. (How many times have you broken your ''diet rules'' to reward a trip to the gym with chocolate or a long day at work with a cocktail or two?)   There are some diet plans out there that advocate choosing a particular day of the week as your ''cheat day''--a day when you can indulge in all the foods you’ve cut out during the week. But listing certain foods as ''cheats'' or ''treats'' can set up a scenario where you’re depriving yourself all week long and constantly looking to the future, waiting on the moment that you’ll be showered with your favorite forbidden goodies (like those commercials where fruit-flavored candies fall from a rainbow).   Besides causing you to crave, labeling certain foods as ''forbidden'' makes it really difficult to be mindful of and content with the healthy food you’re eating most of the time. Instead of worrying about restricting foods, try to redirect your focus on creating the most delicious salad, grilling a succulent chicken breast or munching a juicy piece of fruit. If you turn your attention to the abundance of healthy options in front of you instead of weighing the pros and cons of particular foods, you’ll be more likely to really relish and rejoice in your everyday choices.   Make Sense of 'Moderation' You’ve heard the line a thousand times: Everything in moderation. But what does this phrase really mean and how can you apply it to your healthy eating plan? Usually, people hand this advice out when they’re indulging in unhealthy food and drink and trying to get you to join in, say at a wedding or birthday party. So is it just peer pressure? Or is there something to this age-old saying?   Choosing to eat all foods in moderation works just fine for some people. If you have a healthy relationship with food (e.g., you have no trouble putting away the bag of chips after just one serving), then eating a little bit of your favorite food may satisfy your craving and leave you full until the next healthy meal.   However, for some people, it just doesn’t work that way. Sweets, salts and alcohol all cause biological reactions in the body that are hard to ignore. And, if you’re someone who responds strongly to these reactions, even one small bite can trigger you to continue sampling similar goodies. If you’re one of these folks, you’re definitely not alone, and it is important to know which foods affect you in these ways. Perhaps you’re a person who can have a bite of a sundae and pass the rest on to your spouse, but a fun-size candy bar can unravel your motivation and spark unhealthy choices for the rest of the day. Noting which tempting foods are your triggers can help you arrange your environment so that you don’t overindulge.   Rearranging your environment for success is the easiest way to change your behavior. If you do decide to indulge in a ''trigger food'' in moderation, opt to eat it in a place where there aren't any other snack options for you to munch on afterwards (a food-filled party would not be the best environment!). Choose snacks that you like, but don't love, so you're not tempted to eat too much but are still satisfied. Understanding which foods are likely to lead you down a slippery slope and preparing your environment and schedule for success will help you keep cravings at bay and keep your overeating under control.   Keep Cravings in Check Cravings are a good thing. On a basic, biological level, cravings tell us when we’re hungry, thirsty, sleepy and even when we need some human attention. The problem is that, because we’re so accustomed to having easy access to eat whenever we want and we’re able to choose from many unhealthy foods, the ratio of our wants and needs are all out of whack! It is time to step back and become aware of what we’re really craving and why. When we can look objectively at our yearnings for soda, chips, cake and cookies, we can make much better decisions about what we put in our mouths.   One of the best ways to get back in touch with your true cravings is to keep track of them.  For a few days, keep a journal of the time of day, what you’re craving, and whether you’re at work, at home, on the road, with your kids, etc. You can still give in to temptation—this exercise will simply give you a clearer picture of how often you crave, what you crave and in what settings those cravings occur.   In behavior science, before we try to change any habit, we do an assessment like this to look at the person’s current patterns so that we can set goals for small, stepwise changes. You’ll likely notice a pattern quickly (e.g., I always want something sweet with my 10 a.m. coffee). Then you can put some measures in place to deter this craving or make a healthy choice before it happens (e.g., I’ll start bringing a piece of fruit to eat with coffee so I don’t grab a muffin from the break room).   With a little mindfulness, you can ditch the ''good food, bad food'' attitude! Plan carefully and stay in tune with your body to make sensible decisions that will satisfy your cravings and promote weight loss.        References:   James A.K. Erskine & George J. Georgiou. 4 February 2010. Effects of thought suppression on eating behaviour in restrained and non-restrained eaters. Appetite 54, 3 (2010):499-503.   Jennifer S. Coelho, Janet Polivy, C. Peter Herman. 16 May 2006. Selective carbohydrate or protein restriction: Effects on subsequent food intake and cravings. Appetite 47, 3 (November 2006): 352-360.   David B. McAdam, Kevin P. Klatt, Mikhail Koffarnus, Anthony Dicesare, Katherine Solberg, Cassie Welch, & Sean Murphy. The effects of establishing operations on preferences for tangible items. Journal of Applied Behavior Analysis 38 (2005): 107-110.   Anna Massey & Andrew J. Hill. 18 January 2012. Dieting and food craving. A descriptive, quasi-prospective study. Appetite 58, 3 (June 2012): 781–785. Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1770

How to Grow Your Own Herbs for Cooking

The next time a recipe calls for fresh basil, skip the poor substitute of dried basil, forgo the last-minute dash to the supermarket for some overpriced wilted basil, and just pluck a few tender leaves off of the basil plant you have growing in your very own herb garden.  What? You don't have fresh basil growing in your garden? Well consider this your invitation to start. Growing your own herbs is a simple and inexpensive undertaking that pays off big for your taste buds and your budget.  If you can keep a houseplant alive, you can sustain an herb garden.  Here’s how. Decide what you want to grow.  Some popular choices from home cooks are listed here along with their care instructions.  Start with just a few that you know you’ll use regularly, and then branch out from there. Herb Special Care How to Harvest How to Use Basil Pinch off any flowers that appear. This preserves the plant’s flavor, and will also help increase the leaf density of each stem. Harvest the upper leaves first, taking just a few leaves from each stem at a time. Add raw to salads, sandwiches and wraps, cook into soups and sauces, chop and sprinkle on pizza, make pesto. Parsley Parsley has a longer than average germination period of three to four weeks, so extra patience is required. Cut the outermost stalks just above ground level, which will encourage further growth. Both the leaves and stalks can be eaten in salads, soups, and Mediterranean dishes like Tabouli. Chives If you don’t intend on eating the flowers, pinch them off as soon as they begin to appear. Cut the leaves with scissors, starting with the outside leaves first, allowing about 2 inches of the leaves to remain. This entire plant can be eaten from top to bottom— the bulbs taste like mild onions, the leaves can be used in salads and other dishes, and even the flower heads can be tossed into salads. Cilantro Cilantro does not like hot weather. If the soil temperature reaches 75 degrees, the plant will bolt and go to seed, making this a short-lived herb. Aggressive pruning will extend its life, so be ready to use or store it. Save the seeds to use in cooking (the seeds are called coriander) or to plant. There are two methods of harvesting cilantro. When the plant reaches about 6" in height, you can remove the outer leaves with a scissors, leaving the growing point intact for new growth. Or you can wait until the plant is almost completely grown and pull it from the soil by its roots to use the whole bunch at once. Salads, wraps, dips, and many Mexican recipes. Rosemary This plant can be difficult to start from seed, so you may wish to buy a mature plant. And be careful not to overwater—rosemary likes its soil on the dry side. Simply cut off pieces of the stem as you need it. Many culinary and even medicinal uses. Thyme This plant can take awhile to start from seed, so you may wish to buy a mature plant. Drought-tolerant thyme is extremely easy to care for, and prefers drier soils. Simply cut off pieces of the stem as you need it. Often used to flavor meats, soups, and stews. Dill Drought-tolerant dill is extremely easy to care for, and prefers drier soils. Don't start harvesting dill until it's at least 12 inches tall, and never take more than one-third of the leaves at any one time. Great flavoring for fish, lamb, potatoes, and peas. Mint Mint is an invasive plant so stick to container gardening with this one. Pinch off sprigs as you need them. Mint is extremely versatile, and can be used in salads, desserts, drinks, and many other recipes. You can even chew it by itself for a pleasant, refreshing flavor.   Decide where to plant your herbs. Many herbs grow well indoors and outdoors in the ground or in containers.  If you have a little space with at least 5 hours of direct sunlight a day, you may prefer to grow them indoors, as the herbs will be much more accessible for cooking and watering, and not subject to threats of pests, weeds, or variations in temperature. Decide whether you’ll start from seeds or seedlings.  Seedlings are very young plants that you can transplant into your own garden. They are typically only available in the spring and summer from gardening centers and farmers markets.  Seeds cost less, but take more time and resources to grow from scratch (here's how). Gather your materials.  You’ll need a few gardening tools, like a small shovel or spade, some gardening gloves and pots or containers (optional since herbs can also be planted directly into the soil). You’ll also need some fertilized soil.  If you have a compost pile, you can use some fully decomposed compost to fertilize the soil.  Otherwise, you can use a general purpose compost solution, available in any gardening store.   If you’re container gardening, use a packaged potting soil mix, which will be free of pests. Start planting.  If you’re starting from seeds, sow into moist soil and cover with 1/2 inch of soil on top.  The seeds should germinate in about one week.  If you’re using a pot or container for seedlings, follow these steps.

  1. Ensure proper drainage by filling the pot with a shallow layer of course gravel.  
  2. Fill the pot about 1/2 of the way full, and place the plant, still in its original container, into the new pot.  Add dirt around the plant, gently packing it into place, so that the top of the new soil is at the same level as the top of the plant’s original soil.   
  3. Remove the plastic pot, tap it so you can easily slide the plant and all of its soil out, and place the plant and all of its soil into the hole in the soil of the new pot.
Care for your plants. Water at the base of the plant when the soil begins to feel dry, at least once per week.  Pull weeds that appear near the plant, because they will steal the nutrients from the soil.  If growing outdoors, bring them in before the first frost. Harvest the herbs.  Most plants will grow new leaves if you don’t pick the stems bare. You can pick the leaves with your fingers or snip them with kitchen shears. Use or store the herbs.  Many recipes call for fresh herbs, so simply pick your herbs, wash them and pat them dry before using in your favorite recipes. To store, you can preserve your herbs for future use by freezing them or drying them.  In either case, you must first prep them.  First, remove any soil or bugs by rinsing in cold water.  Then, remove flowering stems and flowers and gently remove excess water by patting with a paper towel.  Once your herbs are prepped, you can choose your method of storage:
  • Air drying:  Cut the stems at soil level and hang upside down in bunches (so that the flavorful oil travels into the leaves) to dry for one to two weeks.  Once dry, remove the leaves from the stems and store in a dry, airtight container for up to a year.  
  • Freezing:  The benefit of freezing, as opposed to drying, is that the herbs retain more of their just-picked flavor.  Place clean herbs directly into freezer bags, or try the cube method: Place a few teaspoons of chopped, fresh herbs into each cell of an ice cube tray.  Fill the trays with water, and freeze.  When cooking, just pop out a cube and add it to the pot like you would fresh herbs!
Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1739

8 Tips for Deciphering Diet Claims

Though food is supposed to be one of life's simple pleasures, few things cause more angst and confusion. It's no wonder why. We're constantly being told which foods we should eat to be healthy, which diets we should follow to be skinny, which preparation methods we should use to be safe, and which chemicals and contaminants in food we should shun to avoid illness. It's enough to give anyone indigestion. If you're confused about what to believe, you've come to the right place. In "Coffee Is Good for You," I'll give you the bottom line on an array of popular diet and nutrition claims in a quick, easily digestible way. Research about diet and health rarely yields the equivalent of DNA evidence, which provides incontrovertible proof. All types of studies come with caveats. However, if interpreted properly, a body of research can allow us to make sound judgments about how believable a claim is. Trying to make sense of the seemingly endless stream of food and nutrition claims can be overwhelming. Remembering the following 8 rules will make the task easier and allow you to stay focused on what’s really important:

  1. Don’t fixate on particular foods. Be wary of lists of miraculous “superfoods” you must eat or “toxic” foods you should never touch. Rather than worrying about squeezing one food or another into your diet, focus on your overall eating patterns, which should include plenty of vegetables, fruits, whole grains, fish, legumes, and good fats, and limited amounts of refined carbohydrates, junk food, red meat, and trans fats.  
  2. Look beyond narrow categories like carbs and calories. Many diet books and seals of approval on foods emphasize one or two factors, such as the calorie or carbohydrate count, while giving short shrift to other important things, like fiber, sodium, or trans fat. The fact that a hamburger is lower in calories than a salad doesn’t necessarily make it a better option. Likewise, just because fruit punch or cereal has added vitamins doesn’t mean it’s healthful. What’s important is the overall nutritional profile. You can get this from comprehensive food- scoring systems such as NuVal, which ranks the healthfulness of foods based on more than 30 factors.  
  3. Forget about fad diets. A plethora of weight- loss plans promise to melt away pounds quickly and easily. But in the long run, they rarely work. About 95 percent of dieters eventually regain lost weight. Instead of searching for the secret to skinniness, which doesn’t exist, try to eat more healthfully and be mindful of how much you’re consuming. Combined with exercise, this approach can prevent weight gain and, over time, lead to weight loss. And unlike dieting, it’s something you can stick with long term.  
  4. Recognize the limits of vitamin pills. While vitamin and mineral supplements can help make up for deficiencies of nutrients, they generally don’t live up to their billing when it comes to preventing disease, boosting energy, or improving your overall health. Supplements pack far less nutritional punch than food, which contains multiple nutrients that interact with one another and with other foods in a variety of complex ways. As a result, vitamin pills can’t compensate for an unhealthful diet. And they can cause harm if you take too much of certain nutrients.  
  5. Ignore health claims on food packages and in ads. A few such claims, such as those related to sodium and high blood pressure, are officially approved by the FDA, but most aren’t. They fall under a loophole that allows companies to use sneaky language like “helps maintain healthy cholesterol levels” or “helps support a healthy immune system.” Because these phrases don’t explicitly say that the food prevents or treats disease— even though that’s what any normal person would infer—manufacturers don’t have to provide any evidence. What’s more, there are no strict definitions for frequently used terms such as all natural, low sugar, and made with whole grains or real fruit. Because it’s virtually impossible to distinguish between legitimate and misleading claims by manufacturers, the best approach is to disregard them all and get your information from the Nutrition Facts panel on the package.  
  6. Verify emails before forwarding them. The vast majority of emails about food and nutrition are half truths or outright hoaxes. If someone forwards you an email claiming, for example, that canola oil is toxic or that asparagus cures cancer, assume it’s not true, no matter how scientific it sounds. Check it out with a reputable source like Snopes. com or Urbanlegends. about. com. Forwarding unconfirmed claims only adds to the hype, misinformation, and confusion.  
  7. Don’t be influenced by just one study. When you encounter news reports about the latest study, don’t jump to conclusions based on that alone. Remember that it’s just one piece of a puzzle. What matters is the big picture— what scientists call the totality of the evidence. For a credible overview of the science, check out online sources such as the Nutrition Source from Harvard School of Public Health, or newsletters such as Nutrition Action Healthletter, the Tufts Health & Nutrition Letter, and the Berkeley Wellness Letter. Or go to www. pubmed. gov and look up the research yourself.  
  8. Enjoy eating! As I said at the beginning of this book, all the admonitions about which foods we should and shouldn’t consume can make eating a stressful chore. But it doesn’t have to be that way. Using science as your guide, focus on the claims with the greatest credibility and relevance, and tune out the rest. That way, you’ll feel less overwhelmed. While following sound nutrition advice is important for good health, it need not spoil your dinner. Bon appétit!
   Adapted with permission from "Coffee is Good for You" by Robert J. Davis, PhD, by arrangement with Perigee, a member of Penguin Group (USA) Inc., Copyright (c) 2012 by Robert J. Davis, PhD, MPH. Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1725

GAO To Launch Investigation Of FDA’s Orphan Drug Program

Acting on a request from three influential U.S. senators, the government’s accountability arm confirmed that it will investigate potential abuses of the Orphan Drug Act.

The Government Accountability Office still must determine the full scope of what it will look into and the methodology to be used. Determining the scope will take some months, said Chuck Young, GAO’s managing director for public affairs.

Earlier this month, Sens. Orrin Hatch (R-Utah), Chuck Grassley (R-Iowa) and Tom Cotton (R-Ark.) sent a letter to the GAO and raised the possibility that regulatory or legislative changes might be needed “to preserve the intent of this vital law” that gives drugmakers lucrative incentives to develop drugs for rare diseases.

Grassley’s office said Tuesday they expected the GAO to begin its work in about nine months. The delay is typical as the agency has a queue of requests it is pursuing.

The senators have asked the GAO to “investigate whether the ODA is still incentivizing product development for diseases with fewer than 200,000 affected individuals, as intended.”

Congress overwhelmingly passed the 1983 Orphan Drug Act to motivate pharmaceutical companies to develop drugs for people whose rare diseases had been ignored. Drugs approved as orphans are granted tax incentives and seven years of exclusive rights to market drugs that are needed by fewer than 200,000 patients in the U.S.

In recent months, reports of five- and six-figure annual price tags for orphan drugs have amplified long-simmering concerns about abuse of the law. The senators’ call for a GAO investigation reflects that sentiment.

“While few will argue against the importance of the development of these drugs, several recent press reports suggest that some pharmaceutical manufacturers might be taking advantage of the multiple designation allowance in the orphan drug approval process,” the letter states.

In January, Kaiser Health News published an investigation that found the orphan drug program is being manipulated by drugmakers to maximize profits and to protect niche markets for medicines being taken by millions.

That investigation, which also was published and aired by NPR, found that many drugs that now have orphan status aren’t entirely new. More than 70 were drugs first approved by the Food and Drug Administration for mass-market use. Those include cholesterol blockbuster Crestor, Abilify for psychiatric disorders and the rheumatoid arthritis drug Humira, the world’s best-selling drug.

Others are drugs that have received multiple exclusivity periods for two or more rare conditions.

The senators asked the GAO for a list of drugs approved or denied orphan status by the FDA. It also asked if resources at the FDA, which oversees the law, have “kept up with the number of requests” from drugmakers and whether there is consistency in the department’s reviews.

And they said it would be important to include patient experiences in the GAO review. The GAO does not provide updates on ongoing work but rather reports its findings once they complete an assignment.

The rare-disease drugs have become increasingly popular with pharmaceutical and biotech companies and are expected to comprise 21.4 percent of worldwide prescription sales by 2022, not including generics, according to consulting firm EvaluatePharma’s 2017 orphan drug report.

That’s in part because of the exorbitant prices that can be charged. Of the top 100 drugs in the U.S., the average cost per patient per year for an orphan drug was $140,443 in 2016, compared with $27,756 for a non-orphan, EvaluatePharma said.

KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

¿Habla el idioma de la ley de salud? Haga click en los globos para aprenderlo

[caption id="" align="alignnone" width="770"] ¿Tiene preguntas sobre los términos que se están usando en el debate sobre el rechazo y reemplazo del Obacamare? Haga click en los globos para aprender más. (Ilustración: Lynne Shallcross; foto: Mandel Ngan/AFP/Getty Images)[/caption]

El presidente Donald Trump y varios de los líderes republicanos del Congreso están haciendo campaña para rechazar la Ley de Cuidado de Salud Asequible (ACA) y reemplazarla por su propio plan para revisar y modificar el sistema nacional de atención de salud. A medida que los republicanos desarrollan su oferta, sus representantes utilizan complejas palabras de la jerga de la política de salud para describir sus principales estrategias.

Abajo encontrará algunas definiciones breves. Haga click en la palabra o frase dentro de los globos en la foto para leer el significado completo, y entender un poco más sobre el sistema de salud del país y los esfuerzos en marcha para reemplazar ACA.

SUBVENCIONES EN BLOQUE AL MEDICAID Y LIMITES PER CAPITA: cuando el gobierno federal da a los estados una suma fija de dinero para pagar por la cobertura de los beneficiarios del Medicaid. Este sería un cambio con respecto a como funciona ahora el programa, en el cual el gobierno federal iguala el gasto estatal en el Medicaid, en base a un porcentaje. Aprenda más.

CUENTAS DE AHORRO DE SALUD: también conocidas como HSAs, estas cuentas permiten a los consumidores ahorrar dinero libre de impuestos siempre y cuando se utilice para gastos médicos. Aprenda más.

RECONCILIACION PRESUPUESTARIA: Proceso legislativo que permite que se aprueben medidas con una simple mayoría en el Congreso. Los proyectos de reconciliación presupuestaria no pueden ser cabildeados pero se deben enfocar en provisiones que tengan un impacto presupuestario. Aprenda más.

BENEFICIOS ESENCIALES DE SALUD: categorías de beneficios que son mandatorios bajo ACA, y que los planes de salud deben cubrir. Incluyen servicios de emergencia, internación y cuidado materno. Aprenda más.

MERCADO INDIVIDUAL: lugar en donde las personas que no tienen cobertura de salud a través del gobierno o de su empleador compran un plan directamente a una aseguradora. Aprenda más.

CREDITOS IMPOSITIVOS/SUBSIDIOS: asistencia financiera para ayudar a los consumidores a comprar un seguro de salud. Aprenda más.

FONDOS COMUNES DE ALTO RIESGO: grupos de aseguradoras que cubren a individuos con costos altos de salud, como personas con enfermedades graves o condiciones crónicas. Aprenda más.

Visite Repeal & Replace Watch para más cobertura de Kaiser Health News sobre el debate de la ley de salud.

GOP Scraps Individual Mandate But Sets Up New Penalty For Those Skipping Coverage

The Affordable Care Act’s tax penalty for people who opt out of health insurance is one of the most loathed parts of the law, so it is no surprise that Republicans are keen to abolish it. But the penalty, called the individual mandate, plays a vital function: nudging healthy people into the insurance markets where their premiums help pay for the cost of care for the sick. That has required Republican lawmakers to come up with an alternative.

The GOP approach is called a “continuous coverage” penalty. It increases premiums for people who buy insurance if they have gone 63 consecutive days without a policy during the past 12 months. Their premiums would rise by 30 percent and that surcharge would last for a year. While the ACA assesses a fine for each year people don’t buy insurance, the GOP plan would punish those who decide to purchase it after not being in the market.

Much is at stake. If this approach fails to prod enough healthy people into buying insurance, rates for everyone else in the insurance pool will rise, destabilizing promises by President Donald Trump and GOP leaders to make their Obamacare replacement more affordable. The nonpartisan Congressional Budget Office projects that millions fewer people will buy insurance if the individual mandate is repealed and replaced with a continuous coverage surcharge.

Why do people allow their insurance to lapse?

Some simply can’t afford the premiums, like Sheila Swartz. She and her husband, Don, who has a heart condition, dropped their policy in December after learning monthly premiums were going to increase by about $140 to $530. “You can’t get blood out of a turnip,” said Swartz, who lives outside Nashville, Tenn., and works as a house cleaner. “If you can’t afford that premium, you can’t afford that premium.”

Others stop paying premiums when they lose a job or are hit with unexpected costs in other areas, such as major home or car repairs. “If you have to pay rent or health insurance, you are probably not going to choose health insurance,” said Bruce Jugan, a health insurance broker in Montebello, Calif.

Some people try to game the system, taking the calculated risk of going without insurance until they get sick or know they need expensive medical care, such as for maternity or an elective surgery.

Both the Affordable Care Act and the GOP proposal include a deterrent by limiting people from enrolling anytime they want. People must wait for annual enrollment periods, usually in the final weeks of the year, meaning that some people might have to wait months before getting coverage. (People still can get insurance during special enrollment periods if they lose a job, get divorced or have another specified major life change.)

How tough is the GOP penalty compared with the individual mandate?

Under the ACA, the average individual mandate penalty in 2015 was $442, according to the Internal Revenue Service.  The GOP penalty would vary based on cost of premiums but generally would be more expensive than paying the mandate’s penalty. A 40-year-old with annual premiums of $4,328 would pay an extra $1,298 because of the GOP surcharge.

“It’s got teeth,” said Cheryl Damberg, a Rand Corp. economist. “In some ways, it’s a more punishing penalty, and it’s going to hit people who are least capable of financially affording it.”

Seth Chandler, a law professor at the University of Houston Law Center who has been critical of the Affordable Care Act’s insurance markets, said he is skeptical the GOP surcharge is high enough to make people enroll. “I am concerned that the Republicans are succumbing to the same softness of heart as the Democrats succumbed too when they set the individual mandate [fine],” he said. “If you start to see insurance companies object or drop out of the markets, that’s a sign this thing is miscalculated.”

Two conservative economists at the American Enterprise Institute, Joseph Antos and James Capretta, argue the penalty is “far too small” to be effective. “Healthy consumers are likely to take their chances,” they wrote. “With the repeal of the individual mandate, and the retention of the ACA’s insurance rules, the overall effect would be significant market turbulence, starting immediately in 2017.”

The CBO predicts that there would be a brief increase in the number of people holding insurance in 2018, as roughly 1 million people buy coverage to avoid the surcharge. In most years afterward, however, about 2 million fewer people would buy policies, either because of the surcharge or because of the requirement they provide documentation proving they had been insured. The CBO said healthy people in particular would be more likely to avoid buying policies.

The plan has some parallels to Medicare’s late enrollment penalty, which is applied to premiums for people who did not sign up upon turning 65. But Christopher Koller, a former Rhode Island health insurance commissioner, doubts the GOP penalty would be as effective. “Medicare is an entitlement with the force of government behind it,” said Koller, now president of the Milbank Memorial Fund, a foundation in New York that focuses on healthy populations. “You get lots of notices about what your obligations are as you approach that age.”

What about people who can’t afford premiums?

The GOP surcharge contains no hardship exemptions, unlike the individual mandate, which allowed people to escape paying a penalty if premiums would have eaten up too much of their income (8.16 percent in 2017).

In 2015, 5.6 million people paid the individual mandate penalty, but another 11 million claimed a hardship exemption, according to the IRS.

Lower-income people are going to have even more trouble buying — and keeping — coverage under the GOP plan, experts said. The ACA’s premium subsidies are based on income, and millions of people on the poorer end of the spectrum do not have to pay anything for premiums if they choose the cheapest plan. The GOP plan would offer a flat tax credit that adjusts only for age. The penalties would make some even more reluctant to buy insurance — especially if they are relatively healthy.

“I think we would just end up with a lot more uninsured people, and they would clearly be the type of people who are less able to navigate and less able to afford insurance,” said Geoffrey Joyce, director of health policy for the University of Southern California Schaeffer Center for Health Policy & Economics.

Republican lawmakers say their plan rightly places the responsibility on individuals. It is a view shared by some health insurance brokers like Helena Ruffin, a broker in Playa Vista, Calif. She said that a continuous coverage requirement would “limit those people who are not playing by the rules.”

“I am favor of the penalties,” she said. “Whether or not people are going to pay attention is another story.”

KHN’s coverage in California is funded in part by Blue Shield of California Foundation.

A Science-Backed 7-Minute Workout That Hits All the Muscles You Forget About

Don't get us wrong—we're all about bodyweight exercises. And quick, high-intensity routines like the scientific 7-minute workout (plus the research that inspired it) prove you can get in a great workout with very little time and equipment. 

But one issue with relying on body weight as resistance is that it can get a little tricky to work the muscles of your back body—you know, your upper and lower back, glutes, and hamstrings.

"It's easier to find bodyweight exercises that include squatting and pushing than pulling and hanging," says Noam Tamir, certified personal trainer and owner of TS Fitness. "These exercises are great; however, they mainly strengthen areas that are already dominant and promote short, tight muscles in the front of the body, leading to poor posture, possible injury, and aesthetic imbalances." (That's no bueno.)

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Not to worry. We've teamed up with Tamir to create a sister workout for the original 7-minute circuit. This routine is the perfect companion, because each exercise works the opposite muscle groups of the original. "These moves are efficient at keeping the body fit and functioning optimally," Tamir says. And since you shouldn't perform HIIT every single day, it's easy to alternate between the two workouts once or twice a week.  

How to use this list: Perform each exercise in order below at a high-intensity effort for 30 seconds. For single-sided exercises, such as Lateral Squat and Single-Leg Romanian Deadlift, perform the exercise for 15 seconds before switching to the other side. (If you have extra time, perform 30 seconds on each side.) Rest for 5 seconds between each exercise to reset. This circuit can be repeated 2-3 times if desired. All you need is an exercise mat. 

Ice Skater Start standing with feet hip-width apart. Hop right leg to the right and swing left leg behind as left arm crosses front of body and right arms swings back. Repeat on other side by reversing the movement with left leg. Continue to hop back and forth (like you're gliding on ice skates) for 30 seconds.  Back Push-Up Lie faceup on mat with knees bent, feet on floor. Bend elbows to 90 degrees with fists toward ceiling (as if you're holding an imaginary pull-up bar above chest). On the exhale, engage core and press elbows into floor as you squeeze shoulder blades together to lift upper back off the mat. Lead with chest (like a crunch) and keep neck in a neutral position. This should feel like a row, just using body weight (as opposed to cables or weights) for resistance. Inhale and lower back down to starting position.  Hamstring Curl Lie facedown on mat. Bend arms and stack hands on top of one another below head to support upper body and maintain a neutral neck. Engage quads and glutes so that lower legs hover above mat. Keeping hips glued down, use backs of legs to slowly bring heels to butt. Resist as you straighten legs back to starting position.   Shoulder Tap Start in high plank position, wrists under shoulders, feet slightly wider than hip-width apart. Engage core and butt for stability. Tap left hand to right shoulder, then place back on mat. Resist the urge to let hips twist or dip; keep them square to mat. Repeat by tapping right hand to left shoulder and continue to alternate.  Mountain Climber Start in high plank position, wrists under shoulders, core engaged. Maintaining a straight back, draw right knee to chest, then return to starting position. Repeat with other knee. Continue to alternate legs as fast as possible as if you're running in place. Keep core tight the entire time to prevent hips dipping or piking. Superman Lie facedown on mat with arms at sides. Inhale, then on the exhale, engage core, back, and glutes to lift upper body and legs up off mat as far as possible. Draw shoulder blades together to engage the upper back muscles and keep neck relaxed by keeping your gaze down. Hold for full exhale, then lower back down on the inhale and repeat.   Lateral Squat Stand with feet just wider than hip-width apart. Take a big step to the left with left foot as you hinge at hips to send butt back (like a squat). Bend left knee and keep right leg straight. Shift all body weight to the left side as you squat back while keeping chest lifted. Push off with left leg to return to standing, then repeat.  Bicycle Crunch Lie faceup on mat with core engaged so that lower back presses into mat. Lift legs to a tabletop position and lightly touch fingertips to back of ears (this will help you avoid pulling on your neck). Use core to rotate at waist, bringing right elbow to left knee as right leg straightens. Then twist to bring left elbow to right knee as left leg straightens, and continue to alternate.  Butt Kicker Stand with knees slightly bent. Bring right heel to butt then quickly switch legs to bring left heel to butt. Continue alternating legs while you pump arms (like you're running in place). Remain on your toes the entire time, landing softly rather than stomping feet to protect your knees.  Press-Up Lie facedown on mat with neck neutral, elbows bent to 90 degrees, and hands placed next to ribs. Press through palms to lift upper body up off mat (even hips will come up, but only go as far as lower back will allow). Engage upper back muscles to prevent collapsing into your shoulders. Slowly lower back down and repeat.  Single Leg Romanian Deadlift Stand with feet together and shift weight to right side to balance on right leg. With a slight bend in standing leg, inhale, then bend at hips to bring upper body and arms forward while left leg shoots back. Keep toes of back leg foot facing the floor and exhale as you return to starting position.  Downward Dog to Plank Start in high plank position. Press floor away as you shift hips back and straight up into downward dog position—you'll feel a stretch along the backs of your legs and through your upper back. Hold for one count then shift forward back into high plank position and repeat. 

7 Struggles Every Extrovert Understands

In our hyper-social culture, which tends to favor outgoing personalities (not to mention nonstop connectivity and networking), there's an unfortunate stigma that surrounds introverts; it’s generally perceived as less advantageous to be one. But as it turns out, extroverts (myself included) face an entirely different set of social struggles and judgments:

1. You’re apparently not allowed to be sad.    

“What’s wrong with Susie/Clare/Marianne?” people ask if ever we’re not our talkative selves for any reason. The truth is, extroverts need a little down time too. I purposefully choose the end of a table at a dinner party on nights when I feel less chatty or a bit tired. That’s OK! It does not mean we're unhappy or upset.

2. You’re expected to be the entertainment, everywhere, every time.

It's an incredibly helpful skill to have a knack for talking, laughing, and engaging with others, especially strangers. So, naturally, extroverts receive a lot of social invitations. But oftentimes extroverts are expected to bring the party wherever they go. We like to do that a lot—just not 100 percent of the time.

3. You’re perceived as superficial and/or insincere.

Vivaciousness has become a synonym for shallow. Extroverts are just as capable of intellectual discussion and complex thinking as introverts are of talking to people. Two extroverted friends of mine are some of the brightest people I know, but sadly, not everyone perceives them that way. In fact, they feel they have to prove themselves or highlight their education or career accolades to dispel negative presumptions. But it’s so important for everyone not make these assumptions. Communication styles are all unique!

4. You’re expected to carry the conversation.

 Just because you are gifted at something doesn't mean you have to put that talent on display constantly. Introverts are not always expected to just listen to everyone, all the time. Women, in particular, have expressed to me in coaching sessions the pressure they feel to be social lubricants at work and with family. It’s no one’s job to keep an environment light and chatty. Plus, you'd be surprised how often discussions can stay on track without you directing them. So give your vocal chords a break! 

5. You worry you’re a little intense.

A common fear that extroverts have is that they are “too much” for some people. That might be true. But not all people are your people. That’s true (and fine!) too. Extroverts don’t conceal their passion, and it shows. Some perceive this trait as a flaw, as it can appear a little forceful. But we can’t help it.

6. Your friendliness gets mistaken for flirting.

Just because someone smiles, engages, and talks with zest does not mean they’re romantically interested in their conversational partner. My friend Sarah once said to me, “Just because I’m friendly doesn't mean a man can make a pass at me! Nor should I have to tone down my personality, right?” It feels like a bit of a tricky balance. All that’s important is that you feel comfortable. And remember: You don’t owe anyone a thing! 

7. You’re high-maintenance.

Extroverts love to share a crisis, a win, and everything in-between (with a lot of people). That means we actually need you to pick up your phone! And no, it cannot wait. Sorry. But does being high-maintenance have to be a bad thing? What if it were re-framed as making your needs a priority? That’s a very healthy thing to do.

Making the world a colorful and balanced place requires both extroverts and introverts. No one personality type “has it all” or should be celebrated over another. In the end, we all just want to feel heard, seen, and accepted. We may express this in diverse ways and require different forms of support, but at our core, we’re more alike than not. And that simple truth is worth celebrating.

Susie Moore is Greatist's life coach columnist and a confidence coach in New York City. Sign up for free weekly wellness tips on her website and check back every Tuesday for her latest No Regrets column!

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