The Surprising Nutrient You Need While Pregnant

From fighting caffeine cravings to stomaching prenatal vitamins, moms-to-be take great care to make sure everything they put in their mouths helps to keep their growing babies healthy. Unfortunately, despite their efforts, most expectant mothers aren’t getting enough iodine, a mineral that impacts neurological development, according to new research.

The study, conducted by researchers from The University of Adelaide, followed nearly 200 Australian women throughout their pregnancy and six months after giving birth. Although eating bread fortified with iodized salt (a common practice in both the U.S. and Australia) increased levels of the nutrient, most women still had a mild deficiency, says lead study author Vicki Clifton, PhD, a professor of obstetrics and gynecology at The University of Adelaide’s Robinson Institute. Only women who also took a supplement throughout their pregnancy met the World Health Organization’s recommended intake of 220 micrograms of iodine.

Why is the nutrient so important? Iodine deficiency during pregnancy can lead to high blood pressure for mom and can also negatively impact baby’s physical and mental development. While eating iodine-rich foods (like seafood, yogurt, and fortified bread) can boost your intake, the easiest way to get the right amount is by taking an iodine supplement for expectant mothers, says Clifton.

That said, getting too much iodine is also dangerous; it can lead to hypothyroidism in both mom and the little one she’s expecting. So before popping any pills, ask your gyno for a urine test to see if you’re deficient. If your levels are good, there’s no need for a supplement—just keep your diet consistent throughout your pregnancy to ensure you continue getting enough of the nutrient.

photo: iStockphoto/Thinkstock

More from Women’s Health:
What You Need to Know About Home Births
How Your Second Pregnancy Is Different from Your First
3 Steps to Have a Healthy Pregnancy

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Do You Know What Vaccines You Need?

Chances are that you got a handful of vaccinations as a kid and haven’t thought much about it since then. But there are a few shots that you still need to stay on top of as an adult—like the pertussis vaccine, which protects against whooping cough. Unfortunately, according to a recent report by the University of Michigan C.S. Mott Children’s Hospital, 61 percent of adults don’t know when they were last vaccinated against pertussis. And only 20 percent of adults said they received the vaccine within the last 10 years, which is the recommended time frame to stay protected.

Here’s why it’s essential to stay up-to-date on this vaccine: Rates of whooping cough cases are at their highest level in 50 years, according to the CDC. And since newborns can’t be vaccinated until they’re at least 2 months old, the best way to prevent infection is by vaccinating all adults, teens, and children who will come into contact with them.

If you got the pertussis vaccine as a child or teen, it’s recommended that you get the booster as an adult, says Matthew M. Davis, MD, director of the C.S. Mott Children’s Hospital National Poll on Children’s Health. The simple way to remember: You should be getting a tetanus shot booster (td booster) every 10 years, so the CDC recommends replacing your next td booster with the tdap booster, which is the same shot combined with the pertussis vaccine. This is especially important for women who are pregnant or anyone who plans to be around a newborn or infant, says Carolyn Bridges, MD, associate director for adult immunizations at the CDC.

Not sure when you were last vaccinated? Talk to your doctor to find out if you need the booster or the primary dose. If you’re pregnant or plan to be around a newborn, they might suggest that you get the tdap booster regardless of when your last vaccine may have been, says Davis.

And while you’re at it, use this cheat sheet to stay on top of your shots:

Flu shot:
Put this on your calendar every single year. It’s recommended that all adults get the flu shot annually since the flu can change from year to year, says Davis. This is also recommended for women who are pregnant since studies show that it may reduce the risk of miscarriage and other complications.

HPV vaccine:
This vaccine, which protects against the most common strains of the human papilloma virus (HPV), is recommended for all women and men through age 26—though ideally, you would have gotten it during adolescence, before any sexual contact, says Bridges. The shot includes three doses, and it’s important that you finish the series to reap the full benefits. After you’ve had all three doses, no booster shot is necessary, says Bridges.

Meningococcal vaccines:
If you lived in a college dorm, you’ve probably heard horror stories about meningitis, a serious infection of the brain and spinal cord that can be spread when you’re living in close quarters with others. While most people get this vaccine in their teens before they head off to college, it’s still possible that you might have missed it. In that case, talk to you doctor to find out if you should be vaccinated. If you got the shot in your teens, you only need to be revaccinated if you suffer from certain medical conditions (such as an immune system disorder or a removed or damaged spleen) or if you’ll be traveling to a high-risk area, such as parts of Africa, says Bridges.

MMR vaccine:
It’s recommended that all kids get the MMR (measles, mumps, and rubella) vaccine as children. If you missed it, you should be sure to get it as an adult, says Bridges. Not sure if you had the vaccine? Your doctor can give you a blood test to see if you’re protected. Once you’ve gotten this vaccination, no booster is necessary.

Varicella vaccine:
If you were lucky enough to escape chicken pox as a child, you can now get a vaccine to avoid it altogether. You may have gotten this vaccine as a child or teen, but if not, you can get the two-dose series at any time, says Davis. Not sure if you ever had chickenpox or the shot? Your doctor can do a blood test to determine if you still need to be protected, says Davis.

Hepatitis B vaccine:
Many people received the three-dose hepatitis B vaccine as a child. However, it’s recommended that all unvaccinated adults at risk for hepatitis B receive the shot. According to the CDC, the people who should get the vaccine includes: anyone with multiple sex partners, people with chronic liver or kidney disease, people under 60 with diabetes, healthcare workers, people with HIV, anyone traveling to countries where hepatitis B may be common, and more. If you haven’t been vaccinated, talk to your doctor to assess your risk, says Bridges.

Hepatitis A vaccine:
This is another shot that you probably got as a child, but if not, it’s never too late. According to Bridges, you may need to get vaccinated (if you haven’t already) if you have chronic liver disease, are being treated with clotting factor concentrates, or are planning to travel to a country where hepatitis A may be common. Once you receive both doses, you’re protected for life.


More from Women’s Health:
Should  You Get the HPV Shot? 
The New Flu Shot
HPV Vaccine: Have You Gotten All Three Shots? 

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Pregnant Women May Not Need Daily Iron Supplements

There are a ton of things to worry about when you’re expecting, but remembering to take an iron pill every single day doesn’t need to be one of them: Taking an iron-folic acid supplement just twice a week—instead of daily—leads to an equally healthy birth weight, growth rate, and possibly even improved cognitive development, suggests a new study published in the journal PLOS Medicine.

Researchers at the University of Melbourne in Australia asked more than 1,000 pregnant women in Vietnam to take either daily iron-folic acid supplements, twice-weekly iron-folic acid supplements, or twice-weekly iron-folic acid supplements plus micronutrients. They then measured the baby’s birth weight, how much he or she had grown at six months, and his or her cognitive development at the same time.

While birth weights and growth rates were similar across all groups, cognitive development scores were actually higher for the infants whose mothers took the supplements twice a week. Plus, the women who took the supplements twice a week were more likely to take them consistently than those who took them daily.

Iron is key for getting enough oxygen to both you and your baby, and this can affect fetal development, says Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at Yale University School of Medicine. Plus, not having enough iron in your blood can make you feel more fatigued, which is a big bummer since pregnancy is already pretty tiring.

That said, the supply of iron in your blood doesn’t fluctuate much from day to day, says Minkin, and the results of this study suggest that cutting back to twice-weekly supplements may not have much impact on your overall iron blood count—or, apparently, on the health of your child.

And as for folic acid?  While slashing your intake of the nutrient may not have had any impact on the outcomes measured in the study, Minkin strongly suggests continuing to take supplements for it daily since getting the recommended .4 milligrams each day helps protect your child against neural defects like spina bifida.

One important thing to remember: How much iron you need while you’re pregnant can vary from woman to woman, says Minkin, and can also depend on whether or not you were iron-deficient going into the pregnancy. So whether you’re already pregnant or trying to be, it’s best to talk to your doctor to find out just how much iron you need to be taking—whether it’s from daily supplements or a less frequent dosage.

Photo: iStockphoto/Thinkstock

More from WH:
Foods to Avoid While Pregnant
How Your Second Pregnancy is Different from Your First
5 Ways Pregnancy Changes Your Body

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What You Need to Know About the New DSM

In huge mental health news, the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released this week at the American Psychiatric Association’s Annual Meeting. Known as the authoritative guide for clinicians, the DSM-5 is the latest edition that helps to define, diagnose, and treat mental health disorders.

So what does a new edition mean for you? As with previous versions, this newest guide takes into account new research to add to, remove from, and tweak the list of disorders and their criteria. The goal? To make it as useful as possible. “Starting [May 21], one can look at these criteria sets and be able to utilize them for more precise diagnoses than we’ve been able to do in the past,” says David Kupfer, MD, Task Force Chair for the DSM-5.

The hope is that this new edition will be even better at diagnosing and treating patients. “Determining an accurate diagnosis is the first step toward being able to appropriately treat any medical condition, and mental disorders are no exception,” says Kupfer.

Not everyone is so thrilled about this latest edition, though. Critics of the DSM-5 worry that the new criteria for disorders may lead to overdiagnosis since more disorders have been added and the requirements for some have been modified.

Thomas Insel, MD, director of the National Institute of Mental Health, recently announced that the NIMH plans to turn their research away from the DSM. As Insel noted in a recent blog post on the topic, “We need to begin collecting the genetic, imaging, physiologic, and cognitive data to see how all the data—not just the symptoms—cluster and how these clusters relate to treatment response.” Translation: the NIMH would rather diagnose people based on lab tests and science—rather than using a symptom-based approach like the DSM encourages.

It took researchers 19 years to finalize this revision, so it’s understandable if you’re a little confused about it. Here, a few major things you need to know about the DSM-5:

New disorders were added 
A few disorders, like Premenstrual Dysphoric Disorder (PMDD, a severe form of PMS that may be related to low levels of serotonin), Binge Eating Disorder, and Caffeine Withdrawal, have been moved from the appendix to the main text. A disorder is listed in the appendix when it requires a little bit more research and is moved into the main text when the researchers feel that it meets a certain criteria. Because they’re now listed in the main text of the DSM-5, treatment and services related to these illnesses will now be covered by health insurance, says Kupfer. Other additions include the diagnoses for Hoarding Disorder and Excoriation (Skin-Picking) Disorder, neither of which were even mentioned in previous editions.

Not all the rumors are true
There was a ton of speculation about what changes the DSM-5 would include, but not everything was accurate. You may have heard, for example, that the section on personality disorders was getting reorganized and that a few diagnoses would be thrown out. In the end, because of the strong feedback they received, the task force decided to keep the same categories from the DSM-IV, and all 10 personality disorders are intact. They did, however, decide to include the proposed revisions into the back of the book to encourage further research on them and keep them in consideration for a future edition.

Another rumor was that sexual addiction or hypersexuality would be added as a disorder, but Kupfer says that the task force didn’t have sufficient research to put it in the main text or even the appendix.

Your insurance may take a while to catch up
When a disorder is defined in the DSM, it helps insurance companies to know what services should be covered. Unfortunately, these changes won’t happen overnight. While doctors can start using the DSM-5 immediately, insurance companies may take a while to update their claims forms and procedures, says Kupfer. “The American Psychiatric Association (APA) is working with these groups with the expectation that a transition to DSM-5 by the insurance industry can be made by December 31, 2013,” says Kupfer.

It will be online soon
You may have noticed that the DSM-5 uses the Arabic numeral for five instead of roman numerals, which is how it was written in the past (like DSM-IV, DSM-III, etc.). This is because the task force is hoping to update this version more frequently and simply than before. “We see a 5.1 and a 5.2,” says Kupfer. “Since this will be online, we will be able to make changes when it’s appropriate.” They expect it to be on the web in June 2013 and available on a subscription basis, with fees varying depending on your use.

Your doctor might not be totally behind it
While the creators of the DSM-5 hope it will be the new gold standard in diagnosing mental illness, it may not be widely accepted right away. Many clinicians have criticized the new text for either being too broad in scope or trying too hard to fit patients into distinct categories. In a recent blog post for Psychology Today, for example, Allen Frances, MD, (former chair of the DSM-IV Task Force) advises clinicians not to use the new edition and suggests patients become informed consumers when it comes to a diagnosis—just as they would when buying a car.

Kupfer says he thinks the DSM-5 will catch on in the medical community—eventually. “I think there’s going to be a transition,” he says. “I think some people will take a little longer than others.

If you are considering or currently seeking treatment for a disorder, Kupfer suggests having a conversation with your doctor about the new edition and asking about any effect it may have on your diagnosis or treatment.

photo: iStockphoto/Thinkstock

More from Women’s Health:
Hooked On a Feeling
Are You Addicted?
Feeling Blah? 

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The Annoying Habit You Need to Break

When a friend says she likes your outfit, how do you respond? A recent Inside Amy Schumer skit suggests that most of us self implode (heads up: Seriously NSFW):

Of course, this scene is a bit extreme—but it gets at a real issue that many women face with trash-talking themselves and their bodies. Unfortunately, dissing yourself doesn’t help you fit in—it actually makes you less likeable, according to a new study conducted by University of Notre Dame’s Body Image and Eating Disorder Lab.

In the study, 139 normal-weight undergraduate women ranked the likeability of noticeably thin or noticeably overweight women’s photos. Some were pictured next to statements researchers defined as “fat talk”—self-disparaging comments about food, weight, or other insecurities—while others were pictured next to positive statements about their body image. And while people who engaged in fat talk were the least likeable, regardless of their weight, women who spoke highly of themselves were rated as the most likable.

Why? It’s only natural to be drawn to people who are positive, confident, and comfortable with themselves—both psychologically and physically, says study co-author Michaela Bucchianeri, PhD, a postdoctoral fellow at the University of Minnesota. When you’re around someone who accepts her body, you’re encouraged to shed your insecurities and embrace your own shape. And as a result, your mood soars.

On the flip side, previous studies have shown that fat talk is contagious—just like in the Inside clip. And since fat chat is associated with—and can actually cause—body dissatisfaction, you’re much more likely to walk away feeling badly about yourself, says Bucchianeri. “Whether these comments are made out of a need for belonging, desire for reassurance from others, or simple habit, the evidence suggests it can only hurt us, not help us,” she says.

But because you likely hear people diss their bodies all the time, it can be especially tricky to cut it out of your conversations. Use Bucchianeri’s strategies to curb fat talk (and keep your friends):

Focus on your assets
So you hate your cankles. The key to feeling better about them—or at least not complaining about them all the time—lies in choosing to focus on the other things that more than make up for your slightly thicker-than-normal ankles, says Bucchianeri. Maybe you’re super-proud of your sharp wit, for example, or the fact that you can command a boardroom without breaking a sweat.

If you’re so stuck in a negative mindset that you’re struggling to come up with a reason you rock, phone a friend or parent and ask them for a refresher course on your strengths. Everyone has at least a few things they totally own—and hearing someone else articulate them may be just the kick in the pants you need to snap out of your funk.

Make compliments count
Often, well-intentioned compliments (i.e., “You look amazing in that dress! Did you lose weight?”) can trigger other people’s fat talk (i.e., “I got so fat that nothing else fits.”). And that leads you to chime in. So, instead of just commenting on a coworker’s appearance, praise the qualities you can’t see—like her awesome personality traits (“You give the world’s best advice!”).

When you hear fat talk, change the conversation
If your friend says she got so fat this winter and you chime in with “Ugh, me too!” your reaction doesn’t make her feel better; it just reinforces her negativity, says Bucchianeri. Instead, tell her you hate hearing her talk like that because she has so many positive qualities. Then name them to give your point more impact. And if her fat chat is incessant? Bucchianeri suggests saying, “I’m uncomfortable with all of the focus on weight when we get together. Can we talk about something else?”

If you’re genuinely dissatisfied with your body…
Take charge with a new workout or some simple diet tweaks. But first, make sure you’re taking on healthier habits for the right reason. “Consistent exercisers who see working out as part of their lifestyle, rather than as a way to change their appearance, have the most success keeping weight off,” says J. Graham Thomas, Ph.D., an assistant professor at the Weight Control and Diabetes Research Center at Brown Medical School.

Instead of dwelling on the svelte figure you want, focus on the awesome benefits of treating your body well—like having more energy, more strength, and maintaining a better mood. And when someone compliments you about how awesome you look as a result? Just say “thank you!”

Additional reporting by Araina Bond
photo: iStockphoto/Thinkstock

More from WH:
Too Legit To Quit: Workout Motivation
Bikini Confidence Boosters
Bust Through Body Confidence Barriers

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What You Need to Know About Alzheimer’s

Alzheimer’s disease is disproportionately affecting ladies—and not just the older female population. WomenAgainstAlzheimers, a new network that’s part of USAgainstAlzheimer’s, is currently holding a summit in Washington, D.C. with activists, researchers, and policymakers to raise awareness and encourage more research. Here’s how the disease affects you—and what you can do about it:

What is Alzheimer’s disease?
Alzheimer’s disease is the most common form of dementia; it affects memory function and gradually gets worse over time, eventually impeding day-to-day functioning, says Sarah K. Tighe, MD, a clinical and research fellow in the Johns Hopkins University School of Medicine department of psychiatry and behavioral sciences, who sees patients in the Memory and Alzheimer’s Treatment Center. More than five million Americans have the disease, according to the Alzheimer’s Association. Unfortunately there’s no cure at this time.

What are the symptoms?
“Alzheimer’s affects people in different ways, so not everyone has the same presentation,” says Tighe. One of the earliest symptoms of an Alzheimer’s patient, though, is having trouble remembering new information—forgetting a recent conversation or current events—and having that difficulty get progressively worse.

Other symptoms include trouble remembering a name they should know or a word they want to use—the “tip-of-the-tongue phenomenon,” as Tighe refers to it—and problems with tasks, like following a recipe. People with Alzheimer’s may also not recognize people they should know (such as a grandchild), or be able to navigate areas they should be familiar with.

If you’re seeing these symptoms in, say, a grandparent, how do you know when it’s just forgetfulness versus when it’s a real concern worthy of a doctor’s visit?

“We all have times where we might misplace our keys, we might forget where we parked our car,” says Tighe. “But if it’s happening consistently or to the point where the person cannot problem-solve and deal with that situation, then that would be very concerning to me that there could be something like Alzheimer’s or another dementia occurring.”

What are the risk factors?
Age is the biggest, says Tighe. While you can develop Alzheimer’s earlier, most people with the disease are 65 and older. Genetics can also play a part, and some research says you’re more likely to get Alzheimer’s if it runs on your mom’s side.

Some common chronic medical conditions—uncontrolled diabetes, high blood pressure, and high cholesterol—are risk factors, too. And no surprise here: Smoking also makes you more likely to get Alzheimer’s (in addition to a whole host of other well-known health problems, of course).

Is there anything you can do to prevent it?
“Age and genetics are not modifiable: We are our age and we have the genes that we were given,” says Tighe. There are other things that you can change, though. Do your best to keep those medical conditions mentioned above at bay, she says. Staying away from cigarettes goes without saying. You should also eat healthfully and exercise—both your body and your brain. That might mean taking an online course or embracing your puzzle hobby, says Tighe, as well as staying socially engaged (even more reason to hang with the fam and your girlfriends!). Yes, your 60s are a long ways away, but: “We think trying to stay healthy and maintain your health as you approach middle age is important in terms of reducing your risk of developing Alzheimer’s,” says Tighe.

So how does this affect you now?
Get this: Women make up almost two out of three Americans with Alzheimer’s and the majority of unpaid caregivers for Alzheimer’s patients, according to the recently released Alzheimer’s Association 2013 Alzheimer’s Disease Facts and Figures report.

So as a woman, you have a higher chance of developing the disease later on in life and potentially caring for an Alzheimer’s patient much sooner.

Taking care of someone with Alzheimer’s is a full-time job, says Trish Vradenburg, co-founder of USAgainstAlzheimer’s and co-founder of WomenAgainstAlzheimer’s.  “This is an intergenerational issue,” says co-founder Meryl Comer, who also takes care of a mother and husband with Alzheimer’s. “Young women are now watching their mothers take care of their mothers, seeing it wear them out.”

If someone you love has the disease, or if you want to learn more about it and join the fight against it, check out these resources:

Alzheimer’s Association. If you’re a caregiver, find support groups in your area, call their 24/7 helpline for caregivers at 1.800.272.3900, and/or visit their AlzNavigator, a free online tool to help you plan next steps if someone you love has the disease.

WomenAgainstAlzheimer’s and USAgainstAlzheimer’s (managed by the U.S. Department of Health & Human Services)

Alzheimer’s Foundation of America


photo: iStockphoto/Thinkstock

More from Women’s Health:
The Vitamin That Protects Against Alzheimer’s
Reduce Your Risk: Family History of Disease
The 101 Best Things to Do for Your Body Now!

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Report: Sodium Guidelines Need to be Reconsidered

Keeping your sodium intake as low as possible may not be so smart after all: Although the current Dietary Guidelines for Americans recommend limiting yourself to between 1,500 to 2,300 mg of sodium a day, there’s no proof that consuming less than 2,300 mg a day is actually beneficial—and in fact, it may even be harmful, according to a new report from the Institute of Medicine (IOM).

The federal guidelines were set back in 2005, after an earlier IOM report concluded that 1,500 mg of sodium was the lowest possible intake that allowed people to still get all of the other nutrients they needed—and that 2,300 mg of sodium was the maximum daily intake that didn’t negatively impact blood pressure. Based off of these findings, the federal guidelines suggested that those at risk for high blood pressure (people 51 or older, African Americans, and people with hypertension, diabetes, or chronic kidney disease—a group that, combined, makes up more than half the population) limit themselves to 1,500 mg of sodium a day. The guideline for everyone else was set at 2,300 mg. The American Heart Association actually took it a step further and recommended that everyone try to cap their daily sodium intake at 1,500 mg.

“Blood pressure is very important, but it’s important because it’s closely linked to heart attacks, to strokes, to heart disease, to kidney disease to lots of other problems—and to death,” says Brian Strom, MD, MPH professor of public health and preventive medicine and executive vice dean at the School of Medicine at the University of Pennsylvania. “In the interim years, new data have come out that studied those actual heart outcomes.”

So the CDC asked a committee from the IOM chaired by Strom to investigate how recent research has shown sodium intake to affect  health outcomes like heart disease and death—rather than hypertension, an intermediate marker.

What they found: While lowering excessive salt intake can improve health outcomes, the committee didn’t find any evidence that health benefits are associated with lowering consumption to below 2,300 mg a day. This suggests that, while blood pressure is important, it’s not the only factor that affects health outcomes. What’s more, the committee found evidence that indicates going under this level—whether you’re at risk for high blood pressure or not—might lead to problems. Why? Likely because it’s difficult to get all of the other nutrients you need if you’re not taking in that much sodium, says Strom.

“You can’t change just sodium without changing your entire diet,” says Strom, pointing out that it’s extremely difficult to take in less than 1,500 mg of sodium a day; less than 1 percent of the population successfully limits themselves to this level.

“There are two studies that show benefit of going down to 2,300 mg, but there’s not one showing benefit going below that,” says Strom.

That said, the committee didn’t make any specific guideline recommendations. A different committee will take this report into consideration when assessing whether the federal guidelines should be updated; the next time the committee is scheduled to meet is in 2015.

The American Heart Association, meanwhile, is sticking to its recommendation of 1,500 mg of sodium a day or less, even in light of this new report.

“While the American Heart Association commends the IOM for taking on the challenging topic of sodium consumption, we disagree with key conclusions,” the association’s CEO Nancy Brown said in a statement.

Strom says that the IOM generally agrees with the American Heart Association, but that he hopes its leaders will reconsider their stance.

“The central point here is that people who eat diets that are too high in salt should lower it,” he says. “We don’t disagree with that at all—our only disagreement is that the target of 1,500 isn’t founded in science.”

photo: CollectionNameTK/Thinkstock

More From Women’s Health:
Surprisingly Salty Foods
Don’t Pass the Salt
How Sweet Is Your Breakfast?

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