31 Things You Should Do Right Now to Avoid High Blood Pressure

Know where you stand

know whereSyda Productions/ShutterstockBe aware of the things that can elevate your blood pressure reading before you go in—but definitely get your BP tested regularly. “High blood pressure is silent so you don’t know if yours is elevated unless you get tested during your annual physical,” says Ali Rahimi, MD, a cardiologist at Kaiser Permanente in Atlanta. Don’t miss these surprising things you didn’t know were affecting your blood pressure.


Understand the numbers

numbersSeasontime/ShutterstockNormal blood pressure is defined as a systolic pressure (the top number in a blood pressure reading that measures heart beats while pumping blood) below 120 mm/Hg and a diastolic pressure (the lower number that reflects the pressure in the arteries between heartbeats) below 80 mm/Hg. “Know your numbers and what they mean so you can prevent heart attacks and strokes by taking action to lower your blood pressure if it is elevated,” says Dr. Rahimi. Anything above this may indicate a problem or the early stages of one.

Slash your salt intake

salttaa22/ShutterstockSalt gets a bad rap when it comes to high blood pressure. While salt is likely not public enemy No. 1, it can cause trouble for certain salt-sensitive individuals. Sodium can lure water into the bloodstream, which can increase the volume of blood and blood pressure. “Most of the salt in our diets comes from processed foods—not the salt shaker,” Dr. Rahimi says. These 13 foods have way more salt than you realized.

Read food labels

labelBenoit Daoust/ShutterstockThe American Heart Association recommends no more than 2,300 milligrams (mgs) of sodium a day with an ideal limit of no more than 1,500 mg. “Read labels and look for wording like ‘low-sodium’ (140 mg of sodium or less per serving), ‘sodium free’ (less than 5 mg of sodium per serving) or ‘no salt added’ (just what it says) when grocery shopping,” Dr. Rahimi says. Even a small reduction in the sodium in your diet can reduce blood pressure by 2 to 8 mm Hg, according to doctors at the Mayo Clinic in Rochester.

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Snack smart

snackBrent Hofacker/ShutterstockPeople on a low-salt diet can struggle to find low-sodium, healthy snacks that will help them control HBP. These 9 healthy snacks can curb your cravings for salty food.

Give canned veggies a bath

cannedSteve Cukrov/ShutterstockMost of us don’t get enough vegetables and for some the high cost associated with fresh ones is prohibitive. “Canned veggies do contain sodium, but rinsing them off before eating them can dial sodium back and for a more affordable alternative,” says Boston-based nutritionist Dana Greene, RD.

Go bananas

bananasHanna_photo/ShutterstockAn apple a day may keep the doctor away, but a banana a day may keep HBP at bay. “We know that potassium lessens the harmful effects of sodium,” says Greene. “The more potassium you take in, the more sodium you excrete through urine.” That’s not all this super important mineral does to help lower blood pressure either. “Potassium eases tension in your blood vessel walls, which helps reduce blood pressure,” she says. A medium banana has about 420 mg of potassium and is easy to include in your breakfast or as a mid-afternoon snack. The recommended potassium intake for an average adult is 4,700 milligrams (mg) per day, according to the American Heart Association. Sweet potatoes, chicken, broccoli, peas, Lima beans, tomatoes, potatoes and citrus fruits are excellent sources of potassium, Greene says.

Spice things up

spiceAtiwan Janprom/ShutterstockJust because you need to shake our salt habit doesn’t mean that flavor of your favorite foods should suffer. “Choose fresh herbs and spices such as garlic, pepper and lemon juice to add flavor to your food without raising your blood pressure,” Dr. Rahimi says. Here are some things doctors don’t tell you about healthy blood pressure.

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Lose weight, if you need to

weightgeorge cristi/ShutterstockBeing overweight or obese ups our risk of a host of illnesses including heart disease. And in case you haven’t heard, you can be “overfat” without being overweight. “Overweight also increases the chances that you will develop high blood pressure, and this can be a double whammy to your heart health,” says Arthur Heller, MD, a primary care doctor in New York City. But “losing as little as five to 10 pounds may help lower your blood pressure and improve heart health.”

Get moving

movingKamil Macniak/ShutterstockRegular exercise helps us maintain a normal weight and reduces blood pressure levels, packing a one-two punch against heart disease, and numerous other health issues. The current recommendations call for moderate-intensity aerobic exercise (think brisk walking) at least 2 hours and 30 minutes each week or vigorous-intensity aerobic exercise for 1 hour and 15 minutes per week (think indoor cycling or running). Check in with your doctor before making any major changes to your workout schedule. Here are some other things that are affecting your blood pressure reading.

Fill up on fiber

fiberLesiChkalll27/Shutterstock“Fiber makes us feel full for longer so we eat less and can maintain our weight,” Dr. Rahimi says. Aim for 21 to 38 grams of fiber each day. Great sources include dried beans, peas, fruits (with the skin on), vegetables and whole grains, according to the U.S. National Library of Medicine. Four slices of fiber-rich GG Scandinavian Bran Crispbread provides a whopping 80 percent of the recommended intake of fiber.

Indulge your sweet tooth

sweetiravgustin/ShutterstockChocoholics rejoice: Wondering how to lower high blood pressure? Dark chocolate—when eaten in moderation—may help keep blood pressure levels in check. Research suggests that the blood pressure-lowering properties come from antioxidant-rich compounds called flavonoids found in cocoa and dark chocolate. Most studies suggest 1 oz to 3.5 oz (roughly one chocolate bar) a day to reap the benefits. “Dark chocolate still has calories so it’s important not to over do it,” Dr. Heller warns. Here’s how dark chocolate is good for your heart, too.

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Choose healthier fats

fatsMaria Uspenskaya/ShutterstockIt turns out that coconut oil is not a superfood after all, but there are a plethora of other healthy fats out there that can help keep your heart in prime shape. “Use olive oil or vegetable oil for cooking, and stay away from margarine and hydrogenated cooking oils,” Dr. Rahimi says. These 12 foods help lower blood pressure naturally.

Cool it on the caffeine

coffeeYAKOBCHUK VIACHESLAV/ShutterstockThe caffeine that gives coffee, energy drinks, tea, and other foods and drinks their kick can raise blood pressure levels for a brief period of time, Dr. Heller says. “There have also been studies showing these products can improve blood pressure in some people,” he says. If you have high blood pressure or are concerned about how caffeine affects you, ask your doctor how much you can safely consume each day. (And remember, a cup is just 8 oz—far less than the supersized servings we get at Starbucks and other coffee shops.) Here’s what happens to your body when you drink coffee every day.

Chill out

chillDitty_about_summer/ShutterstockStress—and our inability to cope with it—makes everything worse, and high blood pressure is no exception. Carving out some “you time” can help boost mental and physical health. “In mindfulness meditation, you put your focus and awareness on your breath, and become the observer of your thoughts rather than a reactor,” explains Venice, CA-based Mindfulness Meditation teacher Ora Nadrich.”By doing this, you allow for your thoughts to come in and out of your mind with acceptance and non-reactivity. This lowers your stress levels, which has a direct effect on lowering your blood pressure.” Free Apps like Insight Timer and Aura can help you get into the mindfulness groove. You’ll want to take a look at these 37 stress management tips to find some calm in your life.

Say ohm

ohm Eugenio Marongiu/ShutterstockTranscendental mediation (TM for short) is a form of meditation reportedly practiced by Jennifer Aniston, Ellen DeGeneres, Howard Stern among other A-list celebs. TM may do more than improve mental clarity, this age-old practice may also confer a reduction in blood pressure levels. One study found that meditators showed a significant drop in blood pressure and had nearly 50 percent lower rates of heart attack, stroke and dying than their counterparts who did not meditate. This method requires training by a certified teacher, which can cost up to $1,500, although sliding scales are available.

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Eat like a Greek

green beansleonori/ShutterstockRich in olive oil, whole grains, vegetables, fruits, legumes, nuts and fish, the Mediterranean diet has been shown time and time again to lower blood pressure and heart disease risks. “This is not a diet as much as it is a lifestyle and these foods really work together to improve our overall health,” Greene says. Other blood-pressure lowering diets such as the DASH diet can also keep blood pressure in the normal range, she says.

Say yes to yogurt

yogurtGooDween123/ShutterstockYogurt has been shown to have many important health benefits, and now research adds lower blood pressure to the mix. Women who consumed five or more servings of yogurt a week had a 20 percent lower risk of developing high blood pressure than women who hardly ever ate yogurt, according to research presented at the American Heart Association’s Epidemiology/Lifestyle 2016 Scientific Sessions.

Strike a pose

Poprotskiy Alexey/ShutterstockYogis may be on to something. The mind-body practice touted by millions may be able to prevent high blood pressure along with its many other health benefits. “Yoga is great exercise and it also has a stress reduction aspect to it so it makes sense that doing yoga would improve blood pressure,” Dr. Heller says. Check out these natural remedies for high blood pressure.

Unplug

Surawut/ShutterstockTechnology can make you sick, and chatting it up on your mobile phone has been shown to increase blood pressure, according to a study our of Italy’s Guglielmo da Saliceto Hospital. It turns out that blood pressure readings of men and women who had mild to moderate high blood pressure jumped to 129/82 from 121/77 while they chatted on a mobile phone.

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Get your zzz’s

Rachata Teyparsit/Shutterstock“When you get poor sleep, your heart does not get the ‘rest’ it needs, and over time, a lack of sleep could hurt your body’s ability to regulate stress hormones, leading to high blood pressure,” says Los Angeles sleep expert Michael J. Breus, PhD, author of several books on sleep including the latest The Power of When. If you need an alarm clock to wake up, you are sleep deprived, he says. “Improve sleep hygiene by going to bed and waking at the same time every day (including weekends), keeping the bedroom cool and dark and avoiding stressful activities right before bed such as paying bills.”

Talk to your parents

pixelheadphoto digitalskillet/ShutterstockHBP runs in families. “If you have a first-degree relative who developed high blood pressure before the age of 50, you may be at risk,” Dr. Rahimi says. “It is silent so you don’t always know you have it until it starts causing problems.” Get ahead of HBP by talking to your parents about your family history and acting on it.

Beet it

Africa Studio/ShutterstockDrinking beet juice may help to lower blood pressure in just a few hours.  One study showed that guzzling one glass of beet juice lowered systolic blood pressure by an average of 4-5 points. “There are nitrates in beets, which are converted into nitric oxide,” Greene says. Nitric oxide relaxes and dilates blood vessels, to improve blood flow and lower pressure. “There is no miracle food or diet that can lower blood pressure, but there is nothing wrong with eating more beets as they are really good for you.” Don’t miss these ways to lower the top blood pressure number. 

Floss

ADragan/ShutterstockFlossing is a drag, but there are really good reasons why you should do it. Gum disease has been linked to an increased risk for many diseases and conditions including heart disease and preterm birth, and now Korean researchers show that poor oral hygiene may lead to high blood pressure. The study appears in the July 2015 issue of the Journal of Periodontology. “Keeping plaque to a minimum with regular flossing and visits to your dentist will help keep gum inflammation under better control and sometimes reduce cardiac risk factors,” says Saul Pressner, DMD, a dentist in New York City.

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Take your medications

Kristen Prahl/ShutterstockWe are fortunate to have a wealth of drugs that can help lower high blood pressure as well as its potentially dire consequences, Dr. Heller says. “Medications only work if you take them as directed for as long as directed.” Discuss any issues you have with your blood pressure meds with your doctor to see if there is a work around.

Don’t overdo it at happy hour

Arina P Habich/ShutterstockDrinking too much alcohol can raise your blood pressure, but moderate alcohol consumption may help protect the heart. “Moderation is the key word here,” Dr. Heller says. “I would never tell anyone to start drinking to improve their health, but some research does suggest that moderate alcohol intake of no more than two drinks per day for men and no more than one drink per day for women may have some benefits.” (Remember that a drink equals 12 oz. beer, 4 oz. of wine, and 1.5 oz. of 80-proof spirits or 1 oz. of 100-proof spirits.)

Don’t smoke

Bildagentur Zoonar GmbH/Shutterstock“We know that smokers are more likely to develop high blood pressure than non smokers,” Dr. Heller says. Smoking is also a major risk factor for heart disease, stroke and cancer. “If you do smoke, quit and if you don’t smoke, never start.” Get schooled on quitting methods at the CDC’s Smoking and Tobacco Use website. Here’s what you need to know about the new blood pressure guidelines.

Keep off the grass

ShutterstockProfessional/ShutterstockSmoking marijuana—legal or not—may increase your risk of dying from high blood pressure, according to a study out of Georgia State University in Atlanta that appears in the European Journal of Preventive Cardiology. The study found that the risk of dying from hypertension grew with each year of smoking marijuana. “Marijuana stimulates the sympathetic nervous system, leading to increases in heart rate, blood pressure and oxygen demand,” Barbara Yankey, who co-led the research told Newsmax. More studies will be needed to confirm these findings and draw any firm conclusions.

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Check your BP at home

Bacho/ShutterstockIf you do have HBP or are at risk of developing it, checking it at home can help make sure your treatment is working, Dr. Rahimi says. The American Heart Association recommends an automatic, cuff-style, and upper-arm monitor. “Sit with your back straight against a wall and your feet flat on the floor when taking your blood pressure at home,” he says. For accuracy, place your arm on a flat surface and take it at the same time every day, he says. “Keep a record and make sure to share your findings with your doctor.”

Get more D

Duangnapa Kanchanasakun/ShutterstockBy now you’ve probably heard about all the health benefits of vitamin D, which is why you should familiarize yourself with the signs that you might be low. Too low levels of vitamin D have been linked to high blood pressure, and a study in The Lancet Diabetes & Endocrinology found that for each 10 percent increase in vitamin D levels, there was an 8 percent decrease in the risk of developing high blood pressure. “It’s too soon to say that low vitamin D can cause high blood pressure, but getting tested to see where you stand and taking steps to increase your levels if they are low makes sense,” Dr. Heller says. Vitamin D is often called the sunshine vitamin because we produce it when exposed to sunlight. It is also found in eggs, milk, yogurt, tuna, salmon, cereal and orange juice. “Sometimes supplements may be necessary,” he says.

Invest in an activity monitor

g-stockstudio/ShutterstockBracelets, apps and the somewhat old-school pedometer can help us track activity and calories. Some even measure sleep, heart rate, and other health signs. “These can be really motivating for people,” Greene says. Next, don’t miss these foods that are bad for high blood pressure.

13 Natural Energy Drinks You Can Make at Home (That Really Work!)

Sweet potato breakfast smoothie

Courtesy Bonnie Taub-Dix

A leftover sweet potato from dinner gives you a head start for this natural energy drink that jump starts your day. “Sweet potatoes contain carbohydrates and fiber that provide long-lasting energy along with vitamins A and C,” says Bonnie Taub-Dix, RDN, creator of BetterThanDieting.com and author of Read it Before You Eat It – Taking You From Label To Table.

Ingredients:

1/2 medium baked sweet potato

1/2 cup plain 0% fat Greek yogurt

1/2 cup Blue Diamond Almond Breeze milk

1/2 banana

1 teaspoon ground sweetened cocoa powder

1 teaspoon chia seeds

3 ice cubes

Directions: Blend the above ingredients in a blender on a high speed. Makes 3 cups.

Dr. Green Detox Smoothie for Energy

Courtesy Get Off Your Acid

“When you need a real power punch of energy and cleansing vitality, you can’t do better than a straight-up green smoothie,” says Dr. Daryl Gioffre, (whose patients call him “Dr Green) and author of Get Off Your Acid. Be sure to check out these 31 energy boosters that aren’t coffee.

Ingredients:

1 handful of spinach

1/2 lemon, peeled

1-inch ginger, fresh

1/2 cucumber, peeled

1 small handful of cilantro

1 small handful of parsley

1 cup coconut water (or filtered water)

Optional: organic stevia or 1 date, handful of ice

Directions: Blend and enjoy.

Matcha Collagen Energy Booster

Natural Energy DrinksCourtesy Maggie Michalczyk

This natural energy drink provides a boost of energy and focus. “The matcha contains just about as much caffeine as a cup of coffee, but you’ll start to feel a relaxed yet focused state of mind,” says Maggie Michalczyk, RD in Chicago. “Matcha contains the amino acid called L-theanine, which produces an alert calmness.” This is processed slower in the body, so you’re not bouncing off the walls and crashing later. Check out these quick ways to boost energy if you’re feeling drained.

Ingredients:

1 cup unsweetened almond milk

1 1/2 tsp matcha powder

1 scoop collagen peptides (Michalczyk recommends Vital Proteins)

Directions: Heat almond milk. Add matcha powder and collagen to an 8 oz. mug. Pour heated milk over powders, and stir. Mix in a blender for a frothier drink. For a touch of sweetness add 1/2 teaspoon honey.

 

 

Kombucha Energy Tea

Kombucha tea, the brew is ready to be placed in storage with the bacteria culture in place to ferment the brew.Daniel S Edwards/Shutterstock

“Kombucha is a refreshing and healthy drink that contains probiotics, vitamin B12, butyrate (a fatty acid), and vitamin K2. Vitamin B12 is known to increase energy levels and contributes to an overall mental well being,” says Rebecca Lee, RN and founder of Remedies for Me.

Ingredients:

2 gallons water

8 black tea bags

1 1/2 cups organic sugar

SCOBY (Symbiotic Culture of Yeast and Bacteria)

Directions: Heat 2 gallons of water in a big pot with 8 black tea bags. Add 1-1/2 cup of organic sugar to the tea and boil for about 15 minutes on low heat. Turn the heat off and let liquid cool completely. Once cooled, carefully pour the tea into a glass jar that contains the SCOBY. Place a coffee filter or paper towel over the top of the jar and keep closed with a rubber band. Let it sit in a warm place out of direct sunlight for about seven to ten days. Drink and enjoy.

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Apple-Banana Energy Shake

Courtesy Caleb Backe

If you’re feeling like a slug in the afternoon, pass on the soda and blend this natural energy drink instead. “Apples are a great source of both long-term and short-term energy. Besides for being rich in antioxidants, apples contain natural vitamins and sugars that are slowly released throughout the body,” says Caleb Backe, a Health and Wellness Expert for Maple Holistics. “Peanut butter is an excellent source of healthy fats and proteins which not only fight off hunger but also store energy and balance blood sugar levels. Here are some tips for energy after lunch.

Ingredients:

2 medium-sized apples of choice, peeled

2 frozen bananas

3-4 dates

1/4 cup milk

2 tablespoons of preferred nut butter

1/2 cup crushed ice

Directions: Combine all of the ingredients in a blender until smooth. Pour into glasses and serve chilled.

Berry Matcha Energy Drink

Courtesy Cassandra Suarez

“This drink is great for the mornings or for an afternoon pick-me-up,” says Cassandra Suarez, MS, RDN, LDN, ACE-cPT. “Berries contain natural sugars, which don’t spike your blood sugar and slowly release the energy throughout the whole day.”

Ingredients:

1 cup frozen berries

2 teaspoon matcha

Juice of 1 lime

1 cup filtered water

Directions: Blend and drink up.

 

Watermelon Smoothie

Courtesy PureLYFT

The secret of this energy drink is the green coffee bean extract. “Green coffee bean extract has been shown to exhibit incredible health benefits including rich antioxidants, specifically 100-percent pure Chlorogenic Acid (a substance in green coffee beans), which aids in the suppression of appetite, reduction of free radicals, improves cholesterol levels, and various other anti-aging properties associated with longevity,” says Melissa Rifkin MS RD CDN CSO who created this recipe for pureLYFT. Always hungry? Check out these natural appetite suppressants.

Ingredients:

1 1/2 cups lemonade

2 cups watermelon

1 cup frozen strawberries

1/2 lime squeezed

1 Mixed Berry pureLYFT (green coffee bean extract)

Directions: Blend and enjoy.

Berry-Cherry Energy Drink

Fruit cherry ice tea with slice of lemon in glass mug, red checkered tablecloth, fresh cherries and lemons in foregroundCobraCZ/Shutterstock

“The coconut water is a source of potassium and tart cherry juice not only adds an amazing flavor, it’s rich in compounds called polyphenols that act not only as antioxidants, but are anti-inflammatory as well,” says Susan Bowerman, MS, RD, CSSD, CSOWM, FAND, Sr. Director, Worldwide Nutrition Education and Training Herbalife Nutrition. Find out the daily habits of people who have a lot of energy.

Ingredients:

1/2 teaspoon Herbalife Pomegranate Green Tea

3/4 cup coconut water

1/4 cup tart cherry juice

1/4 teaspoon ground turmeric

Handful of fresh strawberries, raspberries

Lemon slices

Directions: Combine tea, coconut water, pineapple juice, cherry juice and turmeric in a shaker bottle and shake until well mixed. Add fruit, lemon slices.

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Chai Smoothie with Spirulina

Courtesy Julie Morris

“Spirulina boosts energy by way of its massive nutrient-density, which includes complete protein, full-spectrum B-vitamins, and detoxifying chlorophyll,” says Julie Morris, author of Superfood Smoothies and recipe developer at Nutrex Hawaii.

Ingredients:

3 tablespoons raw cashews

2 tablespoons hemp seeds

2 large Medjool dates, pitted

2 tablespoons cacao nibs

1 tablespoons chia seeds

2 teaspoons maca powder

1/4 teaspoons Hawaiian Spirulina powder

1 teaspoons cinnamon powder

1 teaspoons ginger powder

1/4 teaspoons cardamom powder

2 cups coconut water

1 frozen banana

1 1/2 cups ice

Sweetener to taste (optional)

Directions: Blend together all the ingredients, except the frozen banana and ice, until smooth. Add the remaining ingredients and blend again until frosty. Taste and sweeten as desired.

 

Moroccan Mint Tea Refresher

Courtesy Rachel Swanson

“You’ll feel refreshed and rejuvenated after drinking this invigorating mint, vitamin-C rich lemon, and antioxidant-packed tea,” says Rachel Swanson, MS, RD, LDN nutritionist at LifeSpan.

Ingredients:

1 cup brewed tea (cold) green tea, white tea, or mint tea

1 cup cold water 1 glass full of ice

1 whole lemon, freshly squeezed

Several springs of fresh mint

Directions: Place all ingredients in a cocktail shaker to combine. Shake well and pour into a glass.

 

Golden Milk Latte

Courtesy IU Health

It seems by the 3 p.m., our energy and brain fizzle out. Cozy up to this energy latte instead of another cup of java to get an energizing immunity boost without caffeine, says Katie Hake RDN, CD, Bariatric Dietitian at IU Health. “The combination of turmeric and ginger will provide a calm yet energizing boost.” Here are some more healthy eating habits for more energy.

Ingredients:

1 cup milk of choice

1/2 teaspoon turmeric

1/2 teaspoon cinnamon

Pinch of black pepper

1/8 teaspoon ginger powder (or tiny piece of fresh peeled ginger)

Pinch of cayenne pepper

1/2 teaspoon raw honey to taste.

Directions: Blend together in saucepan over heat (or in a microwave-safe bowl) until hot, but not boiling. Pour into mug and sip.

 

Coconut Matcha Energy Drink

Courtesy Grace Derocha

Dehydration can zap energy and make you feel tired. This natural energy drink is thirst quencher that is low in calories to boot. “It is slightly sweet and helps balance electrolytes with more potassium than four bananas,” notes Grace Derocha, RD, CDE, Blue Cross Blue Shield of Michigan.

Ingredients:

1 cup coconut water

2 teaspoons matcha powder

Garnish with slice of orange

Optional: serve on ice

Directions: Mix matcha powder into coconut water. Stir until fully combined. Garnish with orange slice and enjoy.

 

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Dirty Matcha

Courtesy Mona Dan

A shot of espresso and matcha aren’t the only players in this energy drink. “The added dates are rich in protein and B vitamins, which assist in boosting energy, while the cinnamon invigorates blood, which helps with energy and mood,” says Mona Dan, founder of Vie Healing acupuncture and newly launched herbal tea and supplement line. Just be sure to drink this before 2 p.m. to avoid being wide awake at bedtime. Don’t miss these natural energy boosters that might change your life.

Ingredients:

1 teaspoon powdered matcha

1/2 cup boiling water

1/2 cup cashew or almond milk

1 finely chopped date

1/4 teaspoon cinnamon

1/4 teaspoon honey (optional)

1 shot espresso

 Whisk matcha with enough boiling water to dissolve. Add remaining water. Boil date, honey, and cinnamon in milk, until frothy. Strain or blend milk mixture. Pour frothy milk on top of matcha in cup. Add a shot of espresso. Sprinkle with cinnamon and savor sipping this natural energy drink.

34 Ways to Survive Your Next Trip to the Hospital

Errors in the hospital

Patient in wardPressmaster/ShutterstockAs many as 440,000 Americans die every year from medical errors and infections contracted in the 
hospital. Combined, they are the third-
leading cause of death in the United States.

Your best defense? Take charge of your care as much as possible. Ask lots of questions, take tons of notes, and have a family member or friend there to advocate on your behalf.

“You are part of the care team,” 
says Peter Pronovost, MD, PhD, former senior vice president for patient safety and quality at Johns Hopkins Medicine in Baltimore. “This is your body, and you have wisdom.”

While some risks are beyond your control, these lifesaving tips will help protect against some of the biggest perils you face in the hospital. Make sure you never do these things when visiting someone in the hospital.

Don’t just pick the closest facility

surgery, medicine and people concept - group of surgeons at operation in operating room at hospitalSyda Productions/ShutterstockIn an emergency, of course, you want to get to the nearest hospital—fast. But if you’re scheduling a surgery or procedure, selecting the right hospital, medical center, or surgery center could save your life, even if it means paying more to go out of network. A 2016 study in the journal PLOS One found that patients at the worst American hospitals were three times more likely to die during their stay (and 13 times more likely to have complications) than patients with the same health problem at the best hospitals. Three key questions to ask:

  1. How many times last year did the hospital perform the surgery you’re getting? Multiple studies show that the more often a hospital does a procedure, the better the outcome will be. You are significantly more likely to have complications—sometimes fatal ones—in a facility that performs the surgery only once or twice a year, 
Dr. Pronovost says.
  2. Does the ICU have critical-care specialists? Called intensivists, these specialists are experts on caring for the sickest patients. Studies show they decrease medication errors by 22 to 70 percent and complications by 50 percent. More important, your risk of death drops 30 percent if an intensivist manages your care.
  3. What is the hospital’s rate of catheter infections in the ICU? Low numbers indicate that the hospital has good safety and quality management, says Dr. Pronovost. Choose a hospital that has fewer than two bloodstream infections for every 1,000 days someone in the hospital has a catheter.

Always ask, “Is there anything else it might be?”

Emergency in the operating roomgpointstudio/ShutterstockThis crucial question encourages your hospital health-care providers to think about other possibilities, helping to reduce the risk of a diagnostic mistake, says Hardeep Singh, MD, MPH, a patient-safety researcher at the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston. As many as 160,000 patients in the medical system die or suffer a significant permanent injury every year because a condition is misdiagnosed or missed, according to a report in BMJ Quality and Safety. Such mistakes are especially common in the fast-paced environment of the ER. A patient may come in with a headache, receive a migraine ­diagnosis—and suffer a stroke hours later. Watch out for these secrets hospitals don’t want to tell you (but every patient should know.)

Consider a second opinion

A patient at the doctor at the reception.David Tadevosian/ShutterstockIf you’ve been diagnosed with a serious, complex, or rare condition—or if you have any doubts about your diagnosis—seek out another doctor’s insights before starting treatment. Research shows there’s a 20 to 30 percent chance the second doctor’s opinion will be different from the first’s. Even if the diagnosis is the same, you may learn new information about your treatment options.

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Call a bedside huddle

Multiracial team of doctors discussing a patient standing grouped in the foyer looking at a tablet computer, close up viewUber Images/ShutterstockIf your case is complex, ask whether your doctor can get all your care providers together to brainstorm possible diagnoses and come up with a plan for care, suggests Dr. Pronovost. One study found that bringing providers from different specialties together to talk about specific patients cut the number of adverse events almost in half. Happily, this has become an increasingly common practice in many hospitals.

Take charge of your test results

Woman Undergoing CT Scan While Doctor's Using ComputersTyler Olson/ShutterstockIf you have a CT scan or a biopsy in the hospital, find out when the results will be in and how you will be informed—and make a note to follow up. Also, ask the imaging center or lab to send the results to any doctors working on your case. Dr. Singh’s research shows that about 7 percent of abnormal lab tests and 8 percent of abnormal scans get lost in follow-up. “Don’t assume no news is good news,” he says. This is why you should never have surgery in the evening.

Be smart about antibiotics

drug pill and capsule of antibiotics in blister packagingYoottana Tiyaworanan/ShutterstockAntibiotics fight infections, but they can cause them too. Because the drugs kill the protective bacteria in your gut, they increase your risk of picking up Clostridium difficile (C. diff), one of the deadliest hospital-acquired infections, says Arjun Srinivasan, MD, a medical epidemiologist at the CDC. That’s why the CDC no longer recommends anti­biotics after an operation if you have no signs of infection. A 2017 study found that when doctors in British hospitals cut back on prescribing Cipro, Levaquin, and other broad-spectrum antibiotics, the rate of infections from C. diff bacteria dropped a whopping 80 percent. “If your doctor prescribes you an anti­biotic in the hospital, ask what infection you have and how long you need to take the antibiotic,” Dr. Srinivasan says.

Clean your hospital room

Clean UpQuinn Martin/ShutterstockEven though hospitals disinfect rooms between patients, studies show that up to 60 percent of hospital rooms are not cleaned properly. For extra protection, ask a nurse for some bleach wipes or bring your own (bleach is necessary to kill C. diff). Wipe down the room or have a family member do it. Make sure you swipe in one direction only, and don’t turn the wipe over and use the other side or you’ll risk contaminating your hand.

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Limit IVs, tubes, and catheters as much as possible

Nurse Injecting Senior Male Patient In Hospital BedMonkey Business Images/ShutterstockThe longer you have one of these devices, the higher your risk of picking up a deadly infection, says Dr. Srinivasan. If you need a catheter, ask whether intermittent catheterization is an option; it can lower the risk of infection by 20 percent or more.

Tell your doctor about diarrhea

Toilet Flushing Water close upTortoon/ShutterstockLoose stools are the first symptom of C. diff, which attacks the intestines. “Sometimes patients don’t tell anyone, because it’s embarrassing,” Dr. Srinivasan says. “But it’s really important to tell us, especially if you’re getting or recently had an antibiotic.” These are the secrets to finding the best doctor, according to doctors.

Brush your teeth

Dental health care clinic. Close-up of young man's hands is holding a toothbrush and placing toothpaste on it.VGstockstudio/ShutterstockBacteria in your mouth can find their way into your lungs, causing a nasty case of hospital-acquired pneumonia. Studies have found that good oral care while in the hospital cuts your risk by more than a third. If you’re the family member of a patient who can’t take care of himself or herself, ask the nurse to show you how to use a toothbrush or foam swab sticks to clean the inside of your loved one’s mouth, and do it at least twice a day.

Get your flu and pneumonia shots

Hand holding syringe and vaccine.Billion Photos/ShutterstockIdeally, you should get these vaccinations before you land in the hospital, but you can also ask for them once you’ve been admitted. Most insurance plans will still pick up the cost. The CDC recommends getting two different pneumococcal shots at least one year apart if you are 65 or older, smoke, or have a chronic condition that weakens your immune system.

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Insist on handwashing

hygieneBelusevic Srdjan/ShutterstockGood hand hygiene is your best weapon against hospital-acquired infections such as C. diff, methicillin-­resistant Staphylococcus aureus (MRSA), and carbapenem-­resistant Entero­bacteriaceae, a family of germs that includes Escherichia coli (E. coli). Ask all care providers and visitors to wash their hands with soap and water every time they enter the room. Don’t forget to wash your own hands before you eat and after you go to the bathroom. These are the medical facts everyone should know.

Ask to be screened for MRSA

Closeup DNA test tube and cotton swab, wipe test in man hands. Men's hands in blue gloves.IvanRiver/ShutterstockMany people carry these super-­resistant staph germs on their skin, and they’re harmless as long as you’re healthy. “But if your immunity is compromised or they sneak in through an IV line or an incision, they can have a field day,” causing pneumonia, sepsis (a life-threatening condition caused by an overwhelming immune response to infection), or an invasive bloodstream infection, says health-care safety consultant Karen Curtiss, author of Safe and Sound in the Hospital. Your doctor can test you for MRSA with a simple nose swab. If the test is positive, he or she can give you an anti­biotic that targets the strain.

Don’t shave in the area of your surgery (and don’t let the nurse do it either)

Women's Shaving RazorMichelle Lee Photography/ShutterstockShaving leaves microscopic cuts and nicks that can become bacterial breeding grounds. The CDC now recommends that hair near your surgery site not be removed unless it will interfere with the operation. “If surgeons need to do it, they should use clippers and not a razor,” Dr. Srinivasan adds.

Shower with a disinfectant before you go to the hospital

Beautiful girl washing her body shower gelSahacha Nilkumhang/ShutterstockPick up some Hibiclens, a powerful antiseptic soap that will kill germs on your skin, at your local pharmacy, and shower with it at home the night before and the morning of your surgery. Use it instead of your regular soap or shower gel. “What you’re hoping to do is leave a little residue on your skin,” says Dale Bratzler, DO, MPH, medical director at the Oklahoma Foundation for Medical Quality in Oklahoma City.

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Tell your doctor if you have an infection

Senior doctor consults young patientuzhursky/ShutterstockEven a minor one, such as a sinus infection, can weaken your immune system and increase your risk of complications, Dr. Srinivasan says. The bacteria from something as simple as a tooth abscess can get into your bloodstream and cause a potentially life-threatening situation. You and your doctor can weigh the risks and discuss whether to delay your operation. Follow these secrets to make the most of your next doctor appointment.

Be the first surgical patient of the day

equipment and medical devices in modern operating room take with selective color technique and art lightingnimon/ShutterstockThe room is cleaner, your surgery is less likely to be delayed, and your surgeon won’t be as tired, says Jeanne Dockins, RN, a surgical care nurse in Tucson, Arizona. If you’re wheeled in around 4 p.m., you’re four times more likely to have anesthesia-related problems such as nausea and pain as patients who have surgery before noon, according to a Duke University analysis published in Quality and Safety in Health Care. The authors speculated that the discrepancy might be related to the doctors’ or nurses’ fatigue, swings in their circadian rhythms, and/or the fact that late-in-the-day surgical patients go all day without eating.

Get screened for blood-clot risk

hand with probe in medical laboratoryStudioLaMagica/ShutterstockYour risk of developing deep vein thrombosis­—a condition in which a dangerous blood clot forms in a deep vein in the leg or another part of the body—is ten times higher when you’re in the hospital because surgery can release tissue debris or other substances that don’t belong in your veins. Being confined to bed also raises your risk. Before your surgery, your doctor should take your medical history and give you a physical to determine your level of risk. If the screening shows you’re at high risk, your doctor can start you on blood-thinning medication, recommend compression stockings, or use a mechanical device to prevent blood from pooling in your legs, Dr. Pronovost says. Getting up and walking as soon as you can also reduces your risk.

Ask for extra blankets

Soft Neutral Fabric Blanket Pile BackgroundAnya Hess/ShutterstockSurgeons often like to keep the operating room cold so they won’t get overheated in their gowns, masks, and hats while working under the warm surgical lights. But research shows the chill and the effects of anesthesia may give you mild hypothermia, which can cause cardiac arrest and increase your risk of infection. For that reason, many anesthesiologists now use warming devices on patients during surgical procedures. And you should pile on the sweaters and blankets to stay warm before and after surgery.

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If you’re at all unsteady, get help to go to the bathroom

Portrait of happy female caregiver and senior woman walking together at home. Professional caregiver taking care of elderly woman.Jacob Lund/ShutterstockEvery year, 700,000 to one million patients fall in the hospital, and 30 to 50 percent end up with a serious injury such as a broken bone or a concussion. Wear skidproof slippers, and call the nurse before you try to get out of bed on your own, says critical-care nurse Kati Kleber, RN, author of Admit One. “People don’t want to bother us when they have to go to the bathroom, so they wait until it’s an emergency. Then they’re in a hurry, which puts them at risk,” she says.

Use a clean washcloth on incisions

Stack of colorful towels on whitemrsmint/Shutterstock“I’ve seen patients wash everything else, then use that same washcloth on their incision,” Kleber says. “Um, yuck!” Follow your doctor’s instructions on changing the dressing and caring for your wound, and always wash your hands before touching it. Find out what your doctor is really thinking, but won’t say to your face.

Request a physical therapist right away

TENS electrodes positioned for knee pain treatment in physical therapyMicrogen/ShutterstockYour condition and muscle tone start to deteriorate after just a few days of bed rest, says Bobbi Kolonay, RN, an aging life care manager in Pittsburgh. “Even in intensive care, you can do bedside exercises,” she says. This service is typically covered by insurance as long as your doctor deems it medically necessary.

Ask your nurses to “cluster” your overnight care

Asian woman sleeping In hospital bed, Morning sun shines into the room, AF point selection and blur.feelartfeelant/ShutterstockEven though sleep is important for healing, most hospitals disturb patients multiple times during the night. “If you ask, we can often cluster things together so you’re not woken up so much,” says Brittney Wilson, RN, a nurse in Nashville, Tennessee. It’s best to communicate this request as soon as you meet your night shift nurse, Wilson says, so he or she can plan ahead.

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Bring an up-to-date medication list

Woman's hand using a pencil noting on notepadRasstock/ShutterstockInclude all your prescriptions and dosages, along with any over-the-counter medicines and supplements you take. Many agencies, including the FDA and AARP, offer a medication list template you can download from the Web. If you’re tech-savvy, you can create an electronic record on your smartphone through a free app such as CareZone or Medisafe; just make sure family members know how to access it.

Don’t distract your nurse when he or she is programming your IV

Close-up Of Doctor's Hand With Iv Drip Inserted In Patient's HandAndrey_Popov/Shutterstock“I’m dealing with a lot of numbers—your weight, how much is left in the bag, and the rate the doctors want it to go in—and messing it up can be catastrophic,” Kleber says. “I often have to say to patients, ‘Hold that thought. Let me focus here for a minute.’”

Post a list of your medical allergies

Female doctor talking to male patient in hospital bed. Smiling doctor with clipboard attending sick man in hospital ward.Jacob Lund/ShutterstockThe hospital may already list them on a whiteboard, but nurses could forget to check it, says Dockins. “Sometimes your nurse’s mind might be wandering,” she says. “If you tape a sign over your bed that reads, ‘Allergic to XYZ,’ he or she won’t miss it.” These are common lies people tell their doctors, and why they need to stop.

Keep track of everything

Business woman taking notes at office workplace with colleague on the background. Business job offer, financial success, certified public accountant concept.Vitali Michkou/ShutterstockIt’s easy to get confused and overwhelmed in the hospital. “Often I have patients who have no idea who was in their room,” says Kevin D’Mello, MD, director of quality improvement and patient safety in internal medicine at Drexel University College of Medicine in Philadelphia. Write down your questions, the name of anyone who comes into your room, and a record of your conversation with him or her. Or have a loved one fill that note-taking role.

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Repeat back what you heard

Male nurse pushing stretcher gurney bed in hospital corridor with doctor & senior female patientSpotmatik Ltd/ShutterstockStudies show that patients immediately forget 40 to 80 percent of the medical information they receive, and nearly half of what they do remember is incorrect. So when the medical staff shares an explanation or instructions, repeat what they said back in your own words to make sure you understood correctly.

Ask for a bedside shift change

Doctor and nurse talking to a patient in hospital wardwavebreakmedia/ShutterstockMany errors occur when care transitions from one nurse to the next. If nurses do the handoff in your presence, you can catch slipups and ask questions. 

Read behind your doctor

medicine, healthcare and people concept - smiling doctor with clipboard and young man patient meeting at hospitalSyda Productions/ShutterstockStudies show that mistakes in patient files often contribute to errors­—your chart lists an incorrect body weight, for example, leading your doctor to prescribe a too-high dose of your medication. Under the law, you have a right to see your medical record. A growing number of medical systems make it easy to access through an online patient portal you can log in to right from your smartphone in your hospital room. Check your record for accuracy and point out any errors.

Get out of bed

Senior female patient being assisted by female asian nurse in using walker.GagliardiImages/ShutterstockYou’re inevitably going to spend a lot of time lying down, but try to get up as soon as you can. Being active helps prevent bed sores, blood clots, and pneumonia, and research shows you’ll get out of the hospital sooner, says Dr. Bratzler. Ask a nurse or a family member to help you take a short stroll a few times a day.

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Have someone by your side

medicine, support, family health care and people concept - happy senior man and young woman visiting and cheering her grandmother lying in bed at hospital wardSyda Productions/ShutterstockNurses can’t always get to a room right away when the call bell or the monitoring alarm goes off. A friend or family member can help make sure medical staff respond quickly if there’s an urgent need. “I had a friend who went in for a routine hernia operation,” Curtiss says. “The nurses told his wife that he was going to sleep for a few hours, so she went out to run errands. When she came back, he was brain-dead. He had a bad reaction to anesthesia, vomited, and choked to death before the nurses got there.” This might be a rare occurrence, but you don’t want to be the one it happens to.

Trust your gut

Medical specialist discussing with female patient in his clinic. Doctor with patient during consultation in medical office.Jacob Lund/ShutterstockIf something doesn’t seem right, speak up. Tell the doctor if the drug he or she is prescribing didn’t work the last time you tried it or if you notice changes in a loved one’s condition. “Sometimes the family will say, ‘I know he doesn’t look different, but he seems confused,’” says Dr. Pronovost, “and sure enough, he’s developing an infection.” When Dr. Pronovost’s team examined adverse events at hospitals, they found that in an astonishing 90 percent of cases, someone knew things were going wrong but the person didn’t speak up or wasn’t heard.

Ask to record discharge instructions

Doctor pushing and assisting patient in the hospitalXiXinXing/ShutterstockStudy after study has documented that many patients don’t remember or understand what to do after they leave the hospital, meaning they’re vulnerable to complications. One Alabama hospital recorded the instructions so patients could play them back later; this reduced the number of patients who had to be readmitted within 30 days. Steal that strategy by asking the nurse at discharge whether you can tape him or her with your smartphone. Also, make sure you have these four things before you leave the hospital:

  1. A follow-up appointment. Your doctor or nurse may tell you to see your primary care doctor in seven days, but when you call, he or she can’t see you for a month. Before you leave the hospital, ask someone there to call and make the appointment for you.
  2. An updated list of medications, with instructions on when and how to take them. Make sure you know which prescriptions you’re supposed to continue and which ones you already took the day you are discharged. If you need new medications, ask the hospital to call them in to your pharmacy.
  3. The number to call if you have a question. Ask how to get in touch with your specific doctor if you have questions after discharge. If you leave the hospital on a Thursday or Friday, get the number for the doctor who will be on call over the weekend.
  4. A list of red flags to watch for. Don’t rely on the general handout the hospital gives you. Find out which specific symptoms may indicate your condition is getting worse and what you should do if they occur.

Next, read about these secrets nurses wish they could tell you.

13 Dangerous Myths About Food Allergies

Myth: You either have a mild or severe food allergy

Young child having an allergic reactionYAKOBCHUK VIACHESLAV/ShutterstockThe truth: There are no mild or severe allergies, only mild or severe reactions. “Reactions are somewhat unpredictable,” explains Joshua Dorn, MD, allergy/immunology fellow at the Mayo Clinic in Rochester, MN. That means you can eat a food a few times and have nothing more than a couple of hives, then boom, you might have anaphylaxis—a severe systemic reaction that requires immediate medical treatment. “There have been many reports of people having severe reactions after mild ones,” Dr. Dorn confirms. And anaphylaxis is on the rise: Visits to the ER for a severe allergic reaction shot up a staggering 124 percent from 2005 to 2014, according to a 2017 study published in the Journal of Allergy and Clinical Immunology: In Practice.

Reactions are tricky to predict because other variables can be in play. Are you sick? Were you exercising? Overheated? Drinking alcohol? Do you have active asthma? Other allergies? They’re all considered “co-factors” that can contribute to a more extreme immune response.

The bottom line: “Any reaction can range from mild to severe so it’s best to be prepared for a severe one,” says Dr. Dorn. And when allergists say “be prepared,” they mean carry two EpiPens or other epinephrine auto-injectors.

Myth: You don’t need epinephrine if you’re not going to be eating

Woman injecting emergency medicine into her legRob Byron/ShutterstockThis is one of the most common mistakes allergists see.  You think, “My child is just going to lacrosse practice. She won’t be eating—no need to bother with the EpiPen.”

You’re taking a serious risk, warns Dr. Dorn. What happens if your child’s coach hands out surprise snacks on the sidelines? Research shows that about half of fatal food allergy reactions happen away from home. Perhaps the bigger worry, though, is that reactions sometimes strike an hour or more after eating. If you don’t have epinephrine on hand, it could set in motion a terrible turn of events. “Most severe reactions happen when people don’t have their EpiPen with them,” notes Dr. Dorn. Deaths from food allergy often involve delayed epinephrine or not getting it at all, according to a 2017 review of research. “If you always carry it, it becomes a habit,” he says. This is some of the worst advice allergy doctors have heard.

Myth: Adults can’t develop new food allergies

Healthy Food. Hands Holding Bowl With Nutspuhhha/ShutterstockWhile kids are more prone to food allergies, you can absolutely develop them at any age. One surprising study presented at the American Academy of Allergy, Asthma and Immunology Conference in 2017 found that 45 percent of adults with food allergy got them after age 18.

The most common adult food allergy, according to this research, is shellfish allergy: 3.6 percent of adults have one, which is up 44 percent from 2014. Next up: tree nut allergies. If you’re seeing hives or noticing other allergic symptoms after eating, be sure to see an allergist, who can test you and prescribe an EpiPen. Then bring it everywhere.

Does your mouth feel itchy when you bite into an apple or other fruit or veggie? You may have a common condition called oral allergy syndrome—OAS.  Related to pollen allergy, OAS is an immune response to certain fruits or vegetables, but it almost never leads to anaphylaxis, explains Dr. Dorn. “About 90 percent of the time, symptoms are just in the mouth.” The other good news about OAS: People can generally tolerate the food cooked (which means apple pie is back on the menu!). Find out more about OAS.

Myth: Nobody outgrows nut allergies

Toast with peanut butter and chocolateRachata Teyparsit/ShutterstockOK, there is a kernel of truth here: A child is less likely to outgrow a peanut or tree nut allergy than an allergy to, say, milk or eggs. But they definitely can shed nut allergies. Experts believe that roughly one in five kids will lose their peanut allergies, Dr. Dorn reports, and about the same amount or slightly less will one day be able to safely enjoy tree nuts.

Most allergists test patients yearly and, if there is evidence that the food allergy is waning, they may propose you try a food challenge. Conducted in the allergist’s office or at a hospital, a food challenge means you’ll keep eating the problem food in increasing amounts while a medical team monitors you. If you pass, you can safely reintroduce the food at home—after a 24-hour waiting period to make sure there’s no delayed reaction.

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Myth: Blood tests reveal how bad your reactions will be

Medical equipment. Blood testRomaset/ShutterstockAbout that bloodwork at the allergist’s office: The IgE test shows the levels of immunoglobulin E antibodies circulating in your blood in response to an allergen. Keep in mind that it’s a probability test, Dr. Dorn stresses. “People think higher results mean severe, lower mean less severe,” he says. “All it does is provide one piece of information to help decide whether or not someone is allergic to food.” A person with an 80 result to cashews, say, is more prone to be allergic to them than someone with a 5, but it doesn’t necessarily mean that they’ll have more severe reactions.

These tests are often used in tandem with skin prick tests: An allergist uses a needle with a diluted allergen to prick your skin and see if you develop a weal (a hive).

Since both blood and skin prick tests can have false positives, the new thinking on testing is that allergist should only use them to confirm suspected allergies, not to search for possible sensitivities. Don’t miss these weird things you can be allergic to.

Myth: Feeling tired or weird after eating means you’re allergic

Tired young woman sitting on sofa at homewavebreakmedia/ShutterstockNope, and here’s why: A food allergy is a reproducible immune response to proteins in food. Food allergy symptoms may include some or all of the following: hives, a rash, itching or swelling of the mouth, vomiting, diarrhea, stomach cramps, breathing difficulty, or low blood pressure. “When it comes to non-specific symptoms like fatigue or symptoms that occur daily, food allergy is unlikely,” Dr. Dorn says.

That’s not to say your symptoms aren’t real. If you suspect your diet is making you feel blah, bloated, or otherwise off, keep a food diary and check in with your doc. Developing headaches after eating foods like red wine, aged cheese, and deli meats can signal you’re susceptible to migraines. If you have the autoimmune disorder celiac disease, simply eating gluten (a protein found in wheat, barley, and rye) triggers the body to attack the lining of the small intestines. Many people have an intolerance to gluten, lactose, or other foods. So if food is making you feel bad, Dr. Dorn says it’s normal to ask yourself, “What am I eating and can I change it to feel better?”

Myth: Kids who are allergic to peanuts just need to start eating them

Cute funny little girl eating nuts and watching TV at home.EKirillova/ShutterstockNot on your—or their—life. Feeding an allergic child a peanut could be deadly. Why do some people believe this myth? In 2015 the LEAP study grabbed headlines with its findings that peanut exposure decreased rates of peanut allergy by more than 70 percent. However, some people mixed up the takeaway of the study. “LEAP is about prevention, not treatment,” Dr. Dorn says. “Kids who are allergic to peanuts should never be fed a peanut at home.”

The real message of the LEAP findings is that we’ve been introducing foods like peanuts to babies all wrong. “What the study showed is that consuming peanuts earlier seems to prevent the development of peanut allergy in those at high risk of peanut allergy—which the guidelines define as having an egg allergy or moderate to severe eczema.” Infants who are in that high-risk group should be tested by an allergist to make sure they’re not already allergic, then introduced to peanuts at four to six months.

Myth: But doctors are giving peanuts to kids with allergies

african american doctor and little boy using tablet together in hospitalLightField Studios/ShutterstockActually, they’re not, but it is easy to confuse LEAP with something called “peanut oral immunotherapy.” Oral immunotherapy research tests whether allergists can treat food allergies by exposing kids to incredibly tiny amounts of the allergen—peanut proteins. The researchers gradually increase exposure over a period of years until they reach a maintenance dose. The goal is to see if it’s possible to retrain the immune system so it won’t react to peanuts as a dangerous substance and trigger a severe reaction. “The peanut trials are farther along than tree nut, eggs, and milk, and have had some success,” says Dr. Dorn. Find out more about peanut immunotherapy for peanut allergies.

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Myth: Epinephrine is a dangerous drug, try an antihistamine first

Woman injecting emergency medicine into her legRob Byron/ShutterstockThis can have devastating consequences. “Epinephrine is the only treatment for anaphylaxis and it works better when it’s given earlier in a reaction,” Dr. Dorn says. Plus: “It’s very safe.”

How do you know when to use it? That’s a great question to talk through with an allergy doctor, who will take your past reactions and test results into account. The standard advice is to use the EpiPen or Auvi-Q if two of your body systems—skin, gastrointestinal, respiratory, cardiovascular—are reacting. One example could be that you break out in hives and then vomit. But some allergists will recommend using it as soon as you have any symptoms at all, or even as soon as you know you’ve been exposed.

Every year, the news reports tragic stories about people who waited too long to use their epinephrine. Remember: You’re safer using an EpiPen when you didn’t need it, as opposed to waiting too long.

Myth: Airborne reactions are a huge problem

Children eating at the canteen at schoolwavebreakmedia/ShutterstockGrowing up allergic to tree nuts and peanuts, Dr. Dorn felt anxiety about having a bad reaction because someone was eating nuts near him. He now knows better: “You’re very unlikely to have anaphylaxis from casual contact or inhalation,” he says. Since peanut protein isn’t airborne, a child sitting across the room from a friend who is eating peanut butter should be fine (as long as the pal washes their hands with soap and water after). But if you are sitting right next to a guy shucking peanuts, you could have a mild reaction such as “hay-fever type symptoms like itchy eyes and a stuffy nose,” Dr. Dorn says.

Myth: An allergy always happens within minutes of eating something

Group of Kindergarten Students Eating Food Lunch Break TogetherRawpixel.com/ShutterstockIt may—or it may not. So just because a food doesn’t give you immediate hives doesn’t mean you’re in the clear. The typical window is minutes to two hours—and symptoms can progress fast. (The timeframe is longer—six to eight hours—with Alpha-Gal allergy, a sensitivity to meat that is spread by the Lone Star Tick.)

You should also watch out for a bi-phasic reaction, a second wave of anaphylaxis after the initial round seems to clear up. This dangerous recurrence can come hours or days later. It’s more likely to happen to children, people who needed more than one dose of epinephrine, and folks who didn’t get epinephrine promptly. These reactions are prone to getting life-and-death serious, fast, so if you notice a flare after you’re home from the ER, use another EpiPen and call 911. Here are some signs your child may be developing a food sensitivity.

Myth: Companies have to list every single ingredient in foods

Elderly man shopping in local supermarket. He is holding box and reading nutrition label.Goksi/ShutterstockYou would think so, but no. In fact, the only rule that food manufacturers have to follow—as a result of the Food Allergen and Consumer Protection Law, passed in 2004—is listing on the label if a food contains any of the top eight allergens: peanuts, tree nuts, soy, milk, eggs, shellfish, fish, and wheat. They have to use plain English and tell the consumer exactly which type of tree nut, shellfish, or fish is present (meaning a label would state “shrimp” rather than using a generic term like “shellfish”).

These foods are responsible for 90 percent of food allergies, according to the FDA, but plenty of people are allergic to other foods. And if you are and want to make sure your food is safe? You’re on your own, as crazy as that seems. Your allergen might be listed, or it might not. Terms like “spices” and “natural flavorings” are particularly vexing to people trying to manage food allergies. What do they even mean? Your only recourse is to call each company and try to get that essential information from them.

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Myth: Food companies must reveal if their products are made on the same lines as top allergens

Woman shopping at the supermarket and reading nutrition facts and ingredients on a boxStokkete/ShutterstockYou’ve probably seen warning words on labels: “made in a factory with…, may contain…., made on shared equipment with… If you believe this means manufacturers will always warn you about the potential for cross-contamination, you’re mistaken. This precautionary labeling is completely voluntary, which means it’s completely unreliable.

Dr. Dorn’s advice: You can always contact the manufacturer to see if they will share specifics about their manufacturing process. Next, find out about these medical conditions that could be mistaken for allergies.

12 Small Habits That Actually Reveal a Lot About Your Personality

The way you roll toilet paper

Toilet-paperLukassek/Shutterstock The debate about the “right way” to hang your TP has raged nearly since the roller’s invention. However, therapist Gilda Carle, PhD, claims that she can learn about your personality through your preference on this matter. She surveyed 2,000 men and women about whether they hang their toilet paper in the overhand or underhand position. She also asked her volunteers to fill out questionnaires that would probe how assertive they were—on a scale of 1 to 10—in their relationships. Dr. Carle’s results suggest that those who prefer the overhand method are more dominant, while the underhanders tend to be more submissive. (Some extremely dominant types even admitted to switching the paper direction in other bathrooms they visited.) “What first began as a fun exercise actually turned into an accurate assessment tool. While it adds humor to the conversation, it also provides insight on your compatibility with a prospective partner, Carle tells the Independent. (Find out the right way to hang your toilet paper.)

Your shoe choices

ShoesPavel_D/Shutterstock

A study published in Journal of Research in Personality suggests that you can read someone’s personality through their choice in footwear. Volunteers submitted photos of their shoes and then completed a questionnaire on their personality traits. Another group gazed upon the photos and then described the personality of the wearer—and they were remarkably accurate. They gauged the age, income, and attachment anxiety of someone based solely on the shoes. Their results indicate that people who wear comfortable shoes tend to be relatively agreeable. Ankle boots are generally worn by those who are more aggressive. Wearing uncomfortable shoes implies that you’re more of a calm person, while those with new and well-maintained footwear have a more anxious or clingy persona. (Here’s what your favorite pair of shoes says about your personality.)

The way you walk

WalkingErlo Brown/Shutterstock

Body language expert Patti Wood tells Men’s Health that your stroll reveals your personality. If your weight is usually forward and your stride is quick, you are extremely productive and highly logical. People admire you for that, but you may come off a bit cold and competitive. If you walk with your chest forward, shoulders back, and your head held high (common in a lot of politicians and celebrities), you are fun, charismatic, and socially adept, though you may tend to hog the spotlight. If your weight is over your legs, not forward or back, you’re more interested in people than in tasks, and more focused on your personal life than your career. You’re great when part of a group, but tend to get distracted. Lastly, if you’re light on your toes when you walk and your eyes are glued to the floor, you’re most likely introverted and polite. A study published in the Journal of Interpersonal Violence suggests that jail inmates with psychopathic tendencies were able to judge vulnerability and pick potential victims simply by viewing the way people walk; you might want to adopt some of those more assertive styles. Here are ways introverts can develop leadership qualities.

Your handshake

HandshakeMangostar/ShutterstockA study published in the Journal of Personality and Social Psychology found your handshake can alter people’s impressions of you. In the experiment, judges were trained to assess eight characteristics of a handshake: completeness of grip, temperature, dryness, strength, duration, vigor, texture, and eye contact. The results indicate that participants with firmer handshakes described themselves as more emotionally expressive, extroverted, and positive than others. Those with looser grips were more shy and neurotic. The judges’ first impressions correlated with this—they agreed that the participants with firmer handshakes were more confident and less socially anxious. Check out the different types of handshakes—and what they say about your personality.

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Your email etiquette

EmailRawpixel.com/Shutterstock

If you’re trying to pick up cues from your coworker, the answer may lie in your inbox. Psychologist Tomas Chamorro-Premuzic, PhD, writes in Fast Company that there is a strong connection between our email persona and our real-life character. Text mining studies have found associations between certain keywords and major traits. Narcissists will generally use words such as “I,” “me,” and “mine” frequently. Extroverts tend to be more casual and talk about fun-related things, like music and parties. And it’s not only what you say—it’s how you say it. An absence of typos is a sign of someone’s conscientiousness, perfectionism, and potential obsessions, whereas poor grammar indicates lower levels of IQ and academic intelligence. Interestingly, long emails reflect energy and thoroughness, but also some degree of neediness. Find out about the most annoying e-mail habits, according to science.

Nervous ticks

Biting-NailsFotyma/Shutterstock

Are you a nail biter or skin picker? Scientists call these “body-focused repetitive behaviors” (BFRB). In a 2015 study published in the Journal of Behavior Therapy and Experimental Psychiatry, researchers analyzed people’s personalities and then filmed while they were in a situation that was extremely frustrating, relaxing, or boring, looking for ticks that might emerge. People who compulsively tugged on their hair or bit their nails tended toward perfectionism, and their actions are a result of trying to soothe boredom, irritation, and dissatisfaction. Because it feels better to do something instead of nothing, repetitive behavior proves comforting. These are the clear sings that you’re a perfectionist.

Your punctuality

WatchMaurice Volmeyer/Shutterstock

study published in the Journal of Research in Personality suggests that timeliness is an accurate assessment of positive character traits. In the study, researchers asked participants to complete a personality assessment at home and come to the laboratory for a group experiment. By analyzing the participants time of arrival, they found punctual people were more conscientious and agreeable; being early was connected to neuroticism. And those who are chronically late tended to be more laid-back. Are you often tardy? Try the 13 must-steal habits of people who are always on time.

Your eating habits

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You are what you eat—but science suggests you also are how you eat. Julia Hormes, PhD, a psychologist specializing in food behavior, and Juliet Boghossian, a Los Angeles-based behavioral food expert, told the huffingtonpost.com that food-related behaviors can tells us a lot about personality. Slow eaters are usually people who like to be in control and know how to appreciate life, but fast eaters tend to be ambitious and impatient. The adventurous eater is a thrill-seeker and risk-taker, while picky eaters are likely to exhibit anxiety and neuroticism. Lastly, if you’re someone who likes to separate different foods on their plate, you’re very cautious and detail-oriented in your everyday life. What if you want to live to 100? Here are six eating habits you should adopt—today.

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Your shopping habits

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Want to get to know someone better? Take them to the mall. A series of experiments, published in the Journal of Consumer Research, found that there are two types of consumers: the explanation fiend and the explanation foe. A fiend is the type to meticulously scrutinize every single shampoo bottle in the aisle before settling for something. On the other hand, a foe will quickly decide and be done. According to the researchers, the fiends score high on measures of cognitive reflection, meaning they analyze information to death and are detail-oriented. Explanation foes don’t do well with details and prefer more general information. If you happen to be the type that spends too much at the mall, try these psychologist-approved tricks to spend less.

Your selfie style

Selfiessantypan/Shutterstock Your Instagram or Facebook feed may reveal more about your personality than you realize. In a 2015 study from Nanyang Technological University in Singapore, researchers analyzed 123 selfies taken from a popular Chinese social media site. Each person then completed a personality questionnaire. The researchers found that more agreeable people tended to take pictures from below; conscientious types were less likely to reveal a private space in the background. People who displayed positive expressions (smiling, laughing) were more open to new experiences, while the duck face revealed a more neurotic personality. Find out what else science has to say about your selfies.

Your handwriting

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Graphology is the analysis of handwriting and how it relates to personality, and it has been a science since the days of Aristotle. Master graphologist Kathi McKnight tells businessinsider.com that handwriting experts can detect more than 5,000 personality traits from your scrawl. People who write large, for example, are people-oriented and attention-seeking, whereas those with small handwriting are introverted and are capable of acute concentration. Writing with a slight right slant means you’re friendly and impulsive; a left slant means you’re reserved and individualistic. No slant suggests you’re logical and pragmatic. Lastly, handwriting with heavy pressure indicates you have strong emotions and are quick to react, but a light pressure implies an easiness and ability to move from place to place. Learn more about what your handwriting reveals.

The way you carry a bag

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You might spend days or weeks picking out a handbag, but how much thought do you give to how you carry it? Here’s what that mindless choice reveals, according to body language expert Patti Wood: Wearing a purse in the crook of your arm shows you are high-maintenance and place a lot of emphasis on social status. Wearing the strap across your body with the bag in front means you prioritize protection and accessibility; toting your bag behind you demonstrates a cool, calm, and collected personality. People who sport a backpack are more independent and want to take care of themselves and the people around them, while those who carry their bag in their hands tend to be assertive, well-organized, and efficient. Find out what your handbag style says about your personality.

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WAY Too Many People Don’t Wash Their Underwear—and Other Gross Things People Don’t Clean

Avoiding germs doesn’t begin or end at toilet seats and doorknobs. Turns out, you can’t even imagine the unlikely things that people don’t clean. (You aren’t exempt, either. These are the everyday items you don’t wash nearly enough.)

In an online survey conducted by a team at Mulberrys Garment Care, about 1,000 respondents revealed some of their grossest laundry habits. Most appallingly, the study reports that 18 percent of men and 10.5 percent of women say they don’t wash their underwear… ever. Yuck!

Eighteen to 24-year-olds are the most hygienic undergarment cleaners, the Mulberry’s team reports. Most (around 85 percent) said they toss their underwear in the laundry after one or two wears. Only 10.3 percent said they never wash them, the lowest percentage of any demographic. On the other hand, 16 percent of middle-aged people reported never washing their underwear, the highest of all age groups.

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Feeling grossed out? We’re just getting started. Bedding is another unclean culprit, the survey found. (By the way, here’s why you should be washing your pillows WAY more often.) Seventeen percent of men and seven percent of women report that they do not wash their guest bed sheets before or after having a guest over. We’ll be sleeping on top of the comforter from now on.

There also appears to be an gender gap when it comes to laundry habits; women tended to be more reliable about washing their own bedding. Seven percent of men reported washing their bedding only once in the last six months, as compared to just three percent of women. Forty-three percent of women said they wash it every week, while only 31.6 percent of men did. In fact, 12 percent of men say they can’t even recall the last time they washed their bedding.

Granted, laundry can be confusing—even for the careful germophobe. To make sure your own stuff is tip-top shape, check out this definitive guide to how often you should clean everything.

TOC Supports New H-2C Visa Program







At the request of the NTRA, TOC has added its name to the growing list of industry organizations supporting the Agricultural Guest Worker Act of 2018, which would streamline the current visa program for temporary agricultural workers. The legislation is sponsored by longtime friend of horseracing and breeding Rep. Bob Goodlatte.

Importantly, the proposed legislation also will provide an expanded definition of the type of workers who can be included in this H-2C visa to include Thoroughbred horse trainers, thus circumventing the existing H-2B mess that has many horse trainers scrambling for workers.

Also, this legislation moves the entire agriculture visa system out from under the Department of Labor and under the Department of Agriculture where there is greater sensitivity to the issues facing ag interests like horse breeding and racing.

For more detailed information, click here.