A study has lodged a new kink in the breastfeeding dilemma that adds to the angst of exhausted new parents: While most newborns lose weight in the first days of life, do you or don’t you offer a little formula after breastfeeding if the weight loss is more than usual?

EASAC is the voice of independent science advice, mobilising Europe’s leading scientists from 27 national science academies to guide EU policy for the benefit of society. By considering a large body of independent studies on the effects of climate change on health, and on strategies to address the risks to health, EASAC has identified key messages and drawn important new conclusions. The evidence shows that climate change is adversely affecting human health and that health risks are projected to increase. Solutions are within reach and much can be done by acting on present knowledge, but this requires political will. With current trends in greenhouse gas emissions, a global average temperature increase of over 3°C above pre-industrial levels is projected by the end of the century. The increase will be higher over land than the oceans, exposing the world population to unprecedented rates of climate change and contributing to the burden of disease and premature mortality. Health risks will increase as climate change intensifies through a range of pathways including:

It’s a logical conclusion: If it hurts when a partner tries to put their penis or a toy inside of you, or if they can’t get all the way inside, then it must be a problem of tightness, right? Ehhh, not exactly.

There are several reasons for why you might feel like you’re too tight for vaginal penetration, and it’s actually a pretty common problem that gynaecologists hear about. But it’s a misconception that feeling a sensation of tightness means you actually have less elasticity down there—and thinking this may prevent you from finding a real (and, in many cases, easy!) solution.

The truth is, vaginas are ridiculously stretchy, says ob-gyn Dr Susan Khalil, director of sexual health for the Mount Sinai Health System. Think about it: Lots of people push babies out of that tiny hole, so it’s gotta give.

So if it’s not a problem of stretch, what’s the issue? Well, there are a variety of factors that might be at play. For instance, “Certain medical conditions can mimic the feeling of tightness,” Dr. Khalil says.

Here are a few common reasons why it may feel as if your vagina is too tight for sex, plus how to find relief.

You went through a hormonal shift.

During menopause, your body experiences a drop in estrogen, which can lead to dryness and the thinning of vaginal tissues, the Mayo Clinic explains. As a result, you may feel a sensation of tightness or irritation during sex. This is something you should bring up with your doctor, who can recommend an over-the-counter vaginal lubricant, or possibly a prescription estrogen cream or hormone replacement therapy.

For some people, menopause messes with more than just lubrication. Sometimes a postmenopausal vagina also atrophies a little bit, Dr. Khalil says, meaning it literally gets more narrow. “And if they don’t have intercourse at all, it can become very uncomfortable,” she says.

Her recommendation? Masturbation. This way, you’re in total control and can gradually help stretch your vagina and make penetration feel more comfortable for you. If a larger toy is uncomfortable at first, you can practice with a series of vaginal dilators that will help your vagina stretch slowly over time.

Birth control, too, can sometimes cause a bit of hormonal upheaval for some people and cause dryness (and, in turn, painful sex). If you just switched your BC and noticed feeling dry or “tight,” or if you have this issue at a particular time during the month, talk to your doctor about it so they can help you determine whether your birth control might be to blame.

You recently had a baby.

Pregnancy and childbirth also involve hormonal changes that can lead to vaginal dryness and issues with painful sex. This is especially the case if you are breastfeeding, according to the American College of Obstetrics and Gynecologists (ACOG).

Or, if you’re seriously convinced your vagina is tighter after childbirth, it may not be in your head. Though this isn’t super common, Dr. Khalil says that some women who tear during childbirth get stitched up too tightly—meaning that in this one case, their vagina truly is too tight for sex. “Sometimes sutures are done too tightly [and] they’ll need a surgical procedure to fix it,” Dr. Khalil notes.

The same thing can happen if you’ve had a surgery in your genital area (with or without a baby involved), Dr. Khalil notes. But once your doctor goes back in and loosens the stitch, you should be good to go.

Your vagina is too dry.

There’s a laundry list of reasons for why your vagina may be producing less natural lubrication than it usually does: Maybe you’re going through menopause, you’re breastfeeding, your vagina is naturally dry, or you’re on medication (yup, like birth control) that messes with your lubrication.

Regardless of the reason, though, not having enough lubrication can make sex feel more painful and might make you think your vagina seems tighter, Dr. Khalil says. “I’ll have patients come in and they’ll say it really hurts to have sex,” she says.

Luckily, the immediate solution is pretty easy most of the time: Use a lubricant. Tbh, lubricant makes sex feel better for most people, but it’s especially helpful for people who are dealing with vaginal dryness. Keep in mind, using lube doesn’t actually fix the underlying issue at hand (say, finding a birth control that vibes better with your body), so you should still *always* bring it up with your doc if dryness is a problem for you.

You have vaginismus.

Some people have a condition called vaginismus, which is when the muscles inside their vagina contract involuntarily. The muscle contraction makes it painful anytime something is inserted into the vagina; sometimes even tampon insertion is too much, according to the Merck Manuals.

Most of the time, someone who has vaginismus has it from the very first time they attempt to have penetrative sex. But in other cases it can develop later in life. For some, the cause behind vaginismus may be psychological or a result of an emotional trauma, the Merck Manual says.

While it may take some time to treat vaginismus, working with a pelvic floor physical therapist or gradually using larger and larger vaginal dilators can help, Dr. Khalil says. Working with a mental health professional may also help some individuals.

No matter what, Dr. Khalil encourages talking openly about any vaginal discomfort that you’re unsure about.

Whether you feel “tight” or something else, know that you deserve to feel pain-free down below during sex and everything else in life. So be your own health advocate and speak up—to both your partner(s) and your gynaecologist.

“Your annual exam is more than a Pap smear,” Dr. Khalil says. “It’s also an opportunity to get to the bottom of any sexual health concerns.”

^{This article was originally published on www.womenshealthsa.co.za}

^{Image credit: iStock}

Kasandra Brabaw

All you really need to now about the keto diet is fat equals good, carbs equals bad… right?

If only. While, yes, the keto diet focuses on keeping your daily carb intake low and boosting the good fats in your diet, it can get a little more complicated than that—especially if you’re following the keto diet to a T and, you know, actually counting your keto macros—a.k.a. how many grams of carbs, fats, and protein you get each day.

TBH, counting your macros is hard regardless of the eating plan (math, amiright??), but it gets even more complicated when your entire diet depends on it (too many carbs and not enough fat means no ketosis—and less weight loss).

Here’s how to break down your keto macros, so you have the best chance of seeing those sweet, sweet keto diet results.

So what do macros on the keto diet look like?

Real talk: Hard numbers or percentages on the keto diet are tricky because there are so many differing opinions about the “right way” to do keto, and little research to back up the varying methods, says J. Wesley McWhorter, a registered dietitian at UTHealth School of Public Health in Houston. “Keto diets have morphed into a variety of macro levels with ranges of up to 20 percent carbohydrates, 10 to 30 percent protein, and 50 to 90 percent fat.”

READ MORE: “I Did The Vegan Keto Diet And This Is What Happened”

Okay, but how does that break down in grams of protein, fat, and carbs?

There’s a simple equation to help you figure out how many grams of carbs you should be eating on, say, a 1,600-calorie-a-day keto diet, but first you need to know that:

• Carbs have four calories per gram.
• Fat has nine calories per gram
• Protein has four calories per gram.

Let’s also say you’re aiming for a standard keto diet of 10 percent carbs—”which is low enough for most people to get into nutritional ketosis,” says Amanda Maucere, a registered dietitian nutritionist at Lung Health Institute in Tampa, Florida—20 percent protein, and 70 percent fat.

Just use these simple equations to figure out how many grams of carbs, protein, and fat you should be aiming for:

• Carbs: Calories per day (1,600) x percentage of calories from carbs (.10) / Number of calories per gram in carbohydrates (4) = 40 grams of carbs per day
• Protein: Calories per day (1,600) x percentage of calories from protein (.20) / Number of calories per gram in protein (4) = 80 grams of protein per day
• Fat: Calories per day (1,600) x percentage of calories from carbs (.70) / Number of calories per gram in fat (9) = 125 grams of fat per day

Tracking your carbs is likely the most important part of the keto diet—but you can have a little more flexibility when it comes to your protein and fat macros.

When it comes to your protein intake, in general, it’s a good rule to eat about half of your ideal body weight, says Maucere. “For example, if you feel your best at 68 kilos, you’d want to eat around 75 grams of protein a day,” she says (which, tbh, is very close to the 80 grams of protein you’d get from the equation above).

The rest of your diet should consist mainly of fats, but even that varies based on your energy needs, says Maucere. “I typically tell my patients to eat enough fat to feel satiated between meals,” she adds. For some, that might mean far less than the 125 grams of fat per day calculated above.

READ MORE: 10 Keto-Friendly Vegetables That Are Incredibly Low-Carb

That’s… a lot of math. Is there an easier way to keep track of this?

I get it; tallying all those grams and percentages can get a bit daunting (no one said there’d be math on this portion of the test!). You can try apps like Cron-o-meter (Maucere’s favourite), old school notebooks, etc. But remember: “The best method of tracking macros is always going to be the one you can commit to and stick to on a regular basis,” says Jen Oikarinen, a registered dietician and clinical dietitian at Banner University Medical Center in Phoenix.

If counting is really not your jam, you can also just eyeball your macros: “A typical keto plate would have a palm-sized portion of meat, one or two fistfuls of vegetables, and as much fat as you need to achieve satiety,” says Maucere. To figure out what satiety looks like for you, she suggests going with one or two thumb-sized portions of fat to start and building from there. “So, a meal may look like a small piece of steak with a good-sized portion of green beans and chopped walnuts.”

Of course, even more important than counting your keto macros, McWhorter says, is paying attention to the quality of food you put in your body. “Even if you hit your ‘macro goals,’ but you are not including fruits, vegetables, legumes, nuts, seeds, and whole grains, you could be in trouble.” Remember that all of these food groups are full of fibre and beneficial in fighting diabetes, cardiovascular disease, and promoting satiety and weight control.

^{This article was originally published on www.womenshealthsa.co.za}

^{Image credit: iStock}

Nicole Blades

Twin girls had their DNA altered to protect against HIV – but their mutation may increase the risk of an early death.

Simon Wright, of The Shrewsbury and Telford Hospital trust, says the decision was not easy.

Steering clear of people who are coughing and sneezing is one way to prevent catching the flu. Avoiding e-cigarettes may be another, new research suggests.

In a small study including smokers, e-cigarette users and non-smokers, researchers saw that both traditional cigarette smokers and “vapers” were more susceptible to flu.

Women have greater risk

But cigarettes and e-cigarettes appeared to boost flu risk through different pathways.

“E-cigarettes can alter your response to viral infections and may make you more susceptible to influenza,” said the study’s lead author, Meghan Rebuli. She’s a postdoctoral research associate at the University of North Carolina at Chapel Hill’s Center for Environmental Medicine, Asthma and Lung Biology.

Rebuli added that the researchers found that men and women responded differently to e-cigarettes, and women may have an even greater risk of infection with flu if they vape.

E-cigarettes are small electronic devices that heat a liquid to make an aerosol to be inhaled or “vaped”. The liquid may contain nicotine, flavouring and other chemicals, according to the US Centers for Disease Control and Prevention.

Because e-cigarettes contain fewer chemicals than tobacco cigarettes, they’re generally considered somewhat safer. E-cigarettes can be beneficial if they help people stop smoking tobacco cigarettes, the CDC says. But people who haven’t smoked shouldn’t start using e-cigarettes, they advise.

Disrupting immune response

More research needs to be done on any potential health effects from e-cigarettes, the CDC noted.

And that’s where this study comes in.

“We know that cigarette smoking increases your risk of infection with influenza, and we were curious whether e-cigarettes would also disrupt the normal immune response,” Rebuli said.

The study included nearly 50 people – 14 e-cigarette users, 13 tobacco cigarette smokers and 20 non-smokers. On average, participants were slightly overweight and in their mid to late 20s. But the e-cigarette vapers were slightly younger, with an average age of 23.

Rebuli noted that many of the e-cigarette users were former tobacco smokers, but they had to have been off of tobacco cigarettes for at least a year to be in the study. E-cigarette users had to have vaped for at least 30 days, though most had been doing so for a few years, according to Rebuli.

The researchers also required that e-cigarette users in the study had to puff on an e-cigarette at least 18 times daily. Many did more than that, with some puffing several hundred times a day, Rebuli said.

E-cigarettes do affect immune system

All of the volunteers were exposed to a “live attenuated influenza virus”. Rebuli said this particular virus only replicates in the nose.

When the investigators looked at how the immune system responded to the virus, they saw differences in e-cigarette and regular cigarette smokers compared to the non-smokers. But the changes differed depending on the method of smoking.

Rebuli said it’s not clear exactly how e-cigarettes led to the changes in the immune response, just that they did. And while the researchers didn’t look at whether or not a flu infection might be more severe in people who use e-cigarettes, “it’s a possibility,” she said.

Dr Richard Stumacher is chief of pulmonary and critical care medicine at Northern Westchester Hospital in Mount Kisco, New York. He said this study is an important step in better understanding the effects of e-cigarette research.

“What’s important to glean from this preliminary information is that there is evidence that e-cigarettes do affect the immune system in a way that’s directly related to a person’s ability to fight an infection,” Stumacher said.

Findings from the study are scheduled to be presented at the American Thoracic Society meeting in Dallas. Findings presented at meetings should be viewed as preliminary until they’ve been published in a peer-reviewed journal.

^{Image credit: iStock}

Partnership with online parenting chatroom is part of a package of measures to recruit 40,000 more nurses.

We all have days when we arrive at home late and feel too tired to prepare a meal. While ready-made food seems like the answer, we don’t always know how healthy these pre-prepared dishes are. 

We went shopping and evaluated the options on the shelves. For the purpose of this research and analysis we focused on meals found at Spar, Pick n Pay, Woolworths and Checkers. We focused on food options that can be considered a meal by offering a combination of protein, healthy fats, vegetables and wholegrains.   

Why our choices may not be as healthy as they seem

The key to deciding on a ready-made meal basically comes down to reading labels. Options that look healthy often prove to be quite the opposite. Some Indian style meals for example have double the energy value you would normally aim for.

Quiche portions turned out to be high in energy, carbohydrates and sugars. Some grain salads that seem suitable as ready-made meals were, however, high in energy and fat. And the sachets of dressing included with ready-made salads often alter the nutritional value of a seemingly healthy salad because of high sugar content. 

How do I read a label?

Look at the section on a food label where it gives nutritional information per serving size. This is useful because some ready-made food packages contain only one serving, while others contain two to six servings.

Energy: preferably ±1000–1300kJ (aim for a maximum of 1600kJ)

• Protein: ±14–35g
• Carbohydrates: ±15g (max 30g)
• Of which is sugar: ±<5–10g
• Total fat: <10–15g per 100g
• Saturated fat: <10g fat per 100g
• Fibre: >6g per 100g
• Total cholesterol per meal: <80mg
• Sodium: <900mg

Other helpful tips for label reading:

Ingredients are listed in order of weight, with the largest quantity first. Keep an eye out for red flag items such as fats, salt and sugar in all their different forms. They are normally listed by their scientific names:

• Sugar: cane sugar, honey, maltose, maltodextrin, glucose, corn syrup, fructose, dextrose, sucrose or high fructose corn syrup 
• Fats: vegetable fats, hydrogenated fats, lard, shortening, coconut oil or palm kernel oil
• Salt: sodium, a word which may appear in combination with other terms (e.g. monosodium glutamate or MSG)

You can also seek out key terms or icons on the packaging suggesting that it may be a healthier option:

• Low GI (glycaemic index), Low GI icon or Diabetes SA icon (This gives an idea on the balance of carbohydrates, sugar, protein and fibre in the food, allowing slow and steady release of glucose)
• Heart and Stroke Foundation icon (the red and white heart)
• Managed fat, fibre and salt contents to promote good cardiovascular health
• Reduced calories/energy (Be careful of a potentially high sugar content in these products.)
• High fibre content
• Low sugar
• Low salt

So, what’s on our shopping list?* 

 The top runners we found were the following:

Soups:

• Pick n Pay soups: Spicy Red Thai; Beetroot; Broccoli and Kale; Moroccan Lamb (R16.50–R27.50/serving)
• Spar Tomato Soup (R18.99/serving)
• Checkers soups: Veg; Veg and Split Pea; Sweetcorn Chowder; Beef and Barley (R12.5–R15.5/serving)

Meals:

• Checkers Asian Bowl (R35.99)
• Checkers Mediterranean Salad (R32.99)
• Woolworths Low Fat & KJ Controlled™ Beef & Pumpkin Mash 320g (R73.99)
• Woolworths Low Fat & KJ Controlled™ Teriyaki Chicken 300g (R73.99)
• Woolworths Carb Clever™ Sun-Dried Tomato Chicken with Pesto 320g (R75.99)
• Woolworths Carb Clever™ Beef Chilli 330g (R75.99)
• Woolworths Carb Clever™ Beef Bolognese 340g (R75.99)
• Woolworths Cottage Pie 235g (R46.99)
• Woolworths Roast Veg Couscous Salad (R46.99)
• Woolworths Chicken Biryani (R38.50)

Not wanting to be caught unawares, while staying within your budget? Our tips and go-to shopping list for eating health on a budget may help you. 

*Prices correct at the time of publishing, but could change at any time. 

^{Image credit: iStock}

Jessica Pieterse

A 13-year-old girl from Kentucky made the headlines earlier this year when she died suddenly during a school cheerleading competition. A coroner’s report later revealed that Lilliana Schaik died from a strep infection. According to reports, Schaik fell ill during a school ballet competition. After her hand went numb and she experienced pain in her pelvis, her father rushed her to the emergency room, but her condition quickly deteriorated…

Strep throat: viral or bacterial?

Sore throats can be caused by both viruses and bacteria, but the most common cause of a sore throat (pharyngitis) is a viral infection.

The common cold is a viral infection that usually resolves on its own. Strep throat (streptococcal infection), on the other hand, is a bacterial infection and usually requires antibiotic treatment.

In Schalck’s case, bacteria called Group A beta-haemolytic Streptococcus (GAS) are what led to her death. Her father told WLWT5 that she was healthy and had caught a cold about a week before the competition, which she had seemingly fought off. He added that the strep infection “overwhelmed her immune system with little or no warning, with catastrophic results”.

The Centers for Disease Control and Prevention notes that GAS can cause various infections ranging from minor illnesses, such as strep throat, to more deadly diseases like pneumonia and meningitis. If your immune system is strong, your body will fight back and you’ll recover after about a week. For the situation to result in serious complications or death, GAS would need to be very invasive, and even in such cases, around 90% of people recover with medical help. 

Oral antibiotics are effective for treating mild GAS infections, but more serious cases require multiple IV antibiotics, and even surgery to remove dead and dying tissue.     

In another 2017 case, a Michigan man needed a quadruple amputation after a near-death encounter due to strep-throat that had progressed. An 11-year-old Mississauga girl suffered the same fate after doctors had diagnosed her condition as flu.

According to MedicineNet, GAS is usually spread by direct human-to-human contact. Touching items recently handled by an infected individual also makes one susceptible to infection. While research into GAS is ongoing, there is as yet no commercially available vaccine to prevent infection. However, good hygiene helps to protect one against the disease, and early treatment of GAS infections can reduce or prevent progression to a more severe condition.

^{Image: iStock}

Zakiyah Ebrahim