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Abortion in the US: Preparing for Life After Roe v. Wade

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In southern Texas, where the Rio Grande Valley hugs the Mexican border, people are already experiencing what it’s like to live in a post-Roe world.

In September 2021, Texas passed the SB8 law which banned abortions after 6 weeks of pregnancy and penalized anyone who helps a person get an abortion.

With a conservative majority on the U.S. Supreme Court, the court is expected to rule on Dobbs v. Jackson Women’s Health Organization this month, a decision that could end Americans’ constitutional right to get an abortion.

Abortion has been legal nationwide since 1973, due to the decision in the Roe v. Wade case. The U.S. Supreme Court decided that people had a constitutional right to an abortion before a fetus reached viability in that case. Further decisions said that the state could not put undue burdens on people seeking abortions.

But in May, a draft document published by Politico found that justices are likely to overrule Roe v. Wade which will lead to a near-total ban on abortion in numerous states including Texas.

As a result, abortion providers, people running abortion funds, and other reproductive rights groups have started to prepare for life after Roe v. Wade.

Life on the front lines of abortion care 

In the Texas Rio Grande Valley, the future of abortion care is in the hands of people like Zaena Zamora, the executive director of the Rio Grande-based abortion fund Frontera Fund.

The Frontera Fund, which is staffed by just two people and a small group of volunteers, has kept up with the post-SB8 demand.

Zamora said the abortion fund has seen a surge in pregnant Texans needing to travel out of state to get an abortion. For people traveling from southern Texas, that means money for ground travel, air travel, lodging, food vouchers, rideshare costs, and child care vouchers.

To reach another state from the Rio Grande Valley, the drive can easily take over 6 hours to get to Louisiana and up to 12 hours to get to New Mexico.

For the entire year of 2020, the Frontera Fund spent about $4,000 helping pregnant people get an abortion.

For just the month of February this year, the organization spent close to $13,000 helping people travel out of state for abortion care.

But Zamora and her team know things could get worse quickly if the Supreme Court overturns Roe v. Wade.

If it falls, 26 states — including Texas — are poised to pass bans and restrictions that will outlaw abortion in some way, shape, or form. This means pregnant people in Texas seeking an abortion will have to travel further and spend even more money on abortion care.

The rise of ‘destination states’

While a significant number of states plan on restricting or banning abortion access, multiple states are passing laws with the goal of protecting reproductive rights.

These states are likely to become destinations for people seeking abortions.

Already, the Frontera Fund has sent patients as far as Baltimore, Washington DC, and Virginia — anywhere they can get an appointment.

“The amount of funding that we are providing per person has skyrocketed astronomically because of the additional travel costs associated now with getting an abortion,” Zamora said.

If Roe v. Wade is overturned, the Frontera Fund expects to see a 20 percent increase in call volume and a 20 percent increase in their direct support budget to send people to states that reliably offer abortion care.

Some progressive states like California and New York are planning to set aside money to help out-of-state patients traveling for an abortion.

California has long been an abortion sanctuary for out-of-state people seeking an abortion.

The Guttmacher Institute estimates there will be a 3,000 percent increase in patients whose nearest clinic would be in California. This could result in an increase from 46,000 to 1.4 million people who wind up traveling to California for abortion care.

Jessica Pinckney, Access Reproductive Justice’s executive director, is working with the California Future of Abortion Council on multiple pieces of legislation that would help improve access to abortion in California in the event Roe is overturned.

One of California’s bills, SB 1142, is asking for a $20 million contribution from the state to provide practical support — like child care, lodging, travel, and food — to anyone getting an abortion in California.

“We hope that would really be able to shore up our ability to provide practical support to folks who are coming from other states, as well as those who are in California trying to access care,” Pinckney said.

Another bill, AB 2134, aims to fund abortion clinics that provide free care to low-income people whose insurance does not cover abortion and other reproductive health services.

Both of California’s bills, AB 2134 and SB 1142, are expected to move through the legislative process this summer and be voted on by the end of summer. 

The Hyde Amendment prohibits the use of federal funds for abortion care except in cases of rape, incest, or if the pregnant person’s life is endangered. But some states, like California, use their Medicaid funds to cover abortion care.

That said, even though California’s Medicaid program Medi-Cal covers abortion, the coverage does not apply to out-of-state callers.

And while some states require private insurers to cover abortion care, many states have some restrictions against abortion coverage in insurance. 

Similarly, Vermont, New Jersey, New York, and Connecticut are approving legislation that will protect the right to abortion and provide support for out-of-state patients traveling for care. 

The cost of abortion care post-Roe v. Wade

Abortion funds have become a go-to way for people to afford and navigate travel to other states for abortion.

These nonprofit organizations are funded by individuals and organizations that are passionate about helping people that need to access abortion. They provide financial and logistical assistance to anyone who cannot afford an abortion and people from all over the globe can donate.

Zamora said that the Frontera Fund has seen bursts of what she calls “rage giving,” an uptick in funds whenever a new abortion restriction takes effect.

“People are just angry and they need to do something, right, so they give money to help with that and we’re very fortunate to be recipients of a lot of rage giving,” Zamora said.

According to the National Network of Abortion Funds, there are over 90 organizations scattered across the country. Most, if not all, are currently working to ensure they have the infrastructure in place to support the surge in callers that are expected if and when Roe v. Wade is overturned.

The Frontera Fund is hiring a third staff member, recruiting more volunteers, and ramping up its fundraising efforts in anticipation of the overruling.

“We’re a tiny organization and we have a lot of big things to do — and we get them done, but there’s a lot of growing pains right now,” Zamora said.

Access Reproductive Justice, the only statewide abortion fund in California operating outside of clinics, supported people who called in from 18 states in 2021. They expect to see a surge in out-of-state patients coming to California if Roe is gutted. 

Pinckney said Access Reproductive Justice has the infrastructure in place to support a surge in out-of-state patients — it’s something they’ve been working toward for decades. They anticipate that the number of out-of-state people calling for help will increase by 30 percent to 50 percent, if not more.

Last year, they supported 500 people calling for care, both in and out of state. And if Roe v. Wade is overturned, they expect that number to at least double to 1,000 people.

“We have been preparing for this moment and there are systems and structures already in place to support folks in getting from one state to another to get the support they need,” Pinckney said.

Pinckney added that abortion funds vary in how they financially support people who call in for help. Most funds have a monthly budget to support callers. Once that runs out, the helpline closes until the next month.

The group can make adjustments so people who call in can still get help.

“Abortion funding is an art, not a science, so we make a lot of adjustments and whatnot in real-time, as we cannot predict just how large or small an influx in callers might be, or when it might occur,” Pinckney said. 

If Access Reproductive Justice hits its limit, Pinckney and her team assess if funds can be pulled from other work. If for some reason that isn’t possible, they direct callers to other abortion funds across the country that can provide support — “although we’ve never found ourselves in a situation quite like that,” Pinckney said.

How clinics are preparing

There are over 700 clinics scattered across the country that provide a variety of care services, including abortion pills, abortion procedures, abortion referrals, ultrasounds, and post-abortion follow-up care.

For years, laws that restricted abortion rights have led to clinic closures nationwide. 

As of 2017, at least 89 percent of counties in the country do not offer abortion care services, and past restrictions have made it near impossible for many pregnant people to find care in their communities, according to the Guttmacher Institute.

In May 2017 there were 6 states that only had one remaining clinic. According to the American Civil Liberties Union (ACLU), if Roe v. Wade is overturned, more clinics will close, leaving some states with no clinics.

With abortion likely to be banned in many states, many of these clinics are working to figure out how to connect patients to services in other states.

Planned Parenthood, which operates over 600 health centers across the country, has been expanding its patient navigation efforts to help pregnant people in restrictive states figure out where and how they can get an abortion. 

When a patient calls a clinic in Texas, for instance, the health center will help the patient secure an out-of-state appointment along with transportation, lodging, child care, and funding for the abortion itself in a nearby state that permits the procedure.

“Texas presents a case study of what we’re going to see in these 26 other states,” Lauren Kokum, the director of affiliate communications at Planned Parenthood, told Healthline.

Moving patients and helping them navigate the healthcare and legal systems has always been a part of accessing abortion care.

According to Erin Grant, the deputy director at Abortion Care Network, clinics are all too familiar with working with very little to provide services.

“We are definitely seeing clinics be their resilient selves — find staff, train staff, and find really creative solutions to deliver the care that patients need,” said Grant.

According to Grant, the interworking of clinics, abortion funds, and patient support networks are there and may be key to providing abortion services for many.

Planned Parenthood says they are ramping up patient navigation services and working with abortion funds more closely to coordinate people’s abortion care journey every step of the way. 

Planned Parenthood clinics in critical access points — such as those along the border of New Mexico and Colorado — are also bolstering their patient navigation efforts to coordinate care, travel, and lodging for the influx of patients, according to Kokum. They’re expanding their health centers, extending clinic hours, and training more providers.

Telemedicine abortion providers prepare 

Abortion provided via telemedicine has become more popular in recent years. Medication abortion now accounts for half of all abortions in the United States — a jump from 39 percent in 2017. 

Research has shown that abortion pills are effective and can be safely taken at home in the first 10 weeks of pregnancy.

Online abortion pill providers are planning to work within state restrictions and bans to get pills to people who need them. 

Honeybee Health, an online pharmacy that ships the pills, says that they will only ship to patients in states where the medications are legal. But they’re doing all they can to ensure access — where it’s legal — remains fast and accessible to support the influx of patients traveling for care. 

They’ve also teamed up with abortion funds to help people who can’t afford the medication.

Choix, which provides telehealth abortion medication to people in Colorado, California, and Illinois, is prepared to scale up its services to meet the increased demand they expect to see from out-of-state patients seeking telehealth care from the states it serves.

AidAccess, an organization based in the Netherlands that sends abortion pills to patients regardless of state law, has started prescribing abortion pills to people who would like to have the medications on hand just in case they eventually have an unintended pregnancy.

In addition to helping people get access to pills to end a pregnancy, telehealth medication can also help people cut down on the amount of time they would need to spend with a healthcare professional in person. 

Planned Parenthood’s sites and other clinics say they are ramping up telehealth services to reduce the amount of time patients need to spend at a clinic along with the amount of in-person appointments they have to go to. 

So instead of traveling to three in-person appointments, for example, patients will only need to travel for one or two, said Kokum. 

“We’re doing whatever we can in order to meet the patient demand [in access points],” Kokum said.

Restrictions may limit the effect of telehealth providers

Telemedicine abortions are restricted in 13 states and banned in 6.

At least 20 states are expected to pass stricter restrictions on medication abortion via telehealth.

Proposed bills in 10 states would require patients to pick up the pills from a healthcare facility, rather than receiving them by mail. Proposed bills in four other states would ban telehealth consultations and require patients to take the pills under a provider’s watch.

However, if Roe v. Wade is overturned and these states ban abortion fully, then telehealth appointments for abortion in those states will be illegal.

Providers can only consult with a patient in the state where they, the provider, are licensed and the patient is based. The pharmacies can only ship to patients where the pills are legal, according to Kristen Moore, director of the EMAA Project, an organization that works to expand access to medication abortion. 

Patients in states that ban abortion could potentially travel to a nearby state that permits medication abortion via telehealth, do a telehealth appointment from there, and have them shipped to a mailing address in that state (or look into mail forwarding). 

But people may still face legal risks if they have a complication.

While people are legally allowed to take the pills at home, no matter where they live, if they have some type of medical complication and need to go to the emergency room, a healthcare professional in a state like Ohio or Texas that bans the pills could turn them in, if the patient tells them that they took the pills.

Bleeding due to a miscarriage versus bleeding due to abortion via medication may appear similar or indistinguishable in a medical setting.

“To be clear, that healthcare provider will have no evidence that [an abortion] is what happened. They can just make that person’s life a living hell,” Moore said.

Who loses access to reproductive care? 

If Roe vs. Wade is overruled, an estimated 36 million people will be at risk of losing access to reproductive care, according to Planned Parenthood.

Even with all the work being done by clinics, abortion funds, and patient support networks, getting an abortion is about to get a lot more difficult for millions of people in the United States.

That means many people will opt for the other two options: self-managing an abortion or carrying the pregnancy to term.

“No state can absorb the amount of people experiencing pregnancy that may be looking for care,” Grant said.

And just because a government bans abortion does not mean that people are not going to try to get one. 

Data from the Guttmacher Institute shows that abortion rates are similar in countries where the procedure is restricted and where it is legal.

“While states may make abortions illegal or criminalize abortion providers or patients, they have done nothing to the human right and need for abortion,” Grant said.

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Health

5 Best Sunscreens for People with Psoriasis

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For many people, warm weather means outdoor activities like swimming and backyard barbecues.

But sunlight can be a friend — or foe — for those living with psoriasis. Making sure you choose the right sunblock for your sensitive skin can mean the difference between an amazing day outside, and one that’s worthy of nightmares.

Proper sun protection during outdoor activities is important for everyone. But people with psoriasis need to be particularly careful.

If you have psoriasis, you may have heard that exposure to ultraviolet B (UVB) rays has actually been shown to help with the autoimmune skin condition.

“UVB rays are actually good for people with psoriasis,” says Jacqueline Schaffer, MD, founder of Schique Skincare. UVB rays help slow the skin growth and shedding that happens with psoriasis.

But too much sun exposure — of both UVA and UVB rays — can be a problem. “If people with psoriasis are overexposed, it can actually worsen the skin,” Schaffer says. “They’re extra sensitive versus someone who doesn’t have psoriasis.”

Psoriasis also mostly affects people with lighter skin tones who are already more prone to sunburn.

Plus, certain medications used to treat psoriasis can cause increased photosensitivity. This makes a person sunburn more easily.

For all these reasons, wearing sunblock when you have psoriasis is crucial. It’s important to choose wisely since skin may already be irritated and sensitive.

Make sure there are no parabens, no formaldehyde, and no other really strong preservatives.
— Jacqueline Schaffer, MD

Follow these expert tips next time you’re shopping for sunblock.

1. Make sure you’re buying sunblock, not sunscreen

“Sunscreen is known to be absorbed into your skin, whereas sunblock actually sits on top of your skin and reflects the UV rays,” Schaffer says.

Many products are a mixture of both, so a product labeled “sunscreen” can still have enough protection if it also contains sunblock. Common sunblock ingredients include zinc oxide and titanium dioxide.

2. Avoid preservatives and chemicals

“Make sure there are no parabens, no formaldehyde, and no other really strong preservatives that can be damaging to the skin,” Schaffer says. These ingredients can irritate psoriasis patches.

3. If you’re shopping for a child, don’t buy sunblock with added color

Some companies now offer colored or “disappearing color” sunblocks. Parents should avoid buying these for children with psoriasis, Schaffer says, as they can irritate skin.

4. Don’t buy sunblocks with added scents

Added fragrances can aggravate the skin in people with psoriasis.

5. Buy SPF 30 or above

People with psoriasis need just as much sun protection as everybody else. This is especially true if they’re on medications that can increase their sensitivity to the sun.

SPF 15 doesn’t provide enough protection throughout the day. “A lot of studies from the American Academy of Dermatology have shown that SPF 30 is more effective for longer use as a sunblock,” Schaffer notes.

6. Look for the label ‘broad spectrum’

This meansthe product will protect against both UVA and UVB rays. Even though UVB rays can be beneficial in treating psoriasis, people with the condition should still have sunblock on to protect against too much exposure to both types of rays.

The sunblocks on our list were carefully chosen and vetted. Following the advice from our expert, Schaffer, we looked for:

  • sunblocks that don’t include potential irritants like parabens, formaldehyde, potent preservatives, added color, or fragrances
  • sunblocks that include the mineral ingredients zinc oxide and titanium dioxide
  • sunblocks that are broad spectrum and provide SPF 30 or higher protection

We also carefully considered customer reviews, the prices of products, and selected products only from trusted brands.

Price guide

Sunscreen can become costly, as it’s something you regularly use that sometimes comes in small bottles. We considered options from different brands at a range of prices, to bring the best possible selection.

Sunscreens in this article are broken down on a price per ounce basis according to the following key:

  • $ = under $6 per ounce
  • $$ = $7-12 per ounce
  • $$$ = more than $12 per ounce

If you have psoriasis, try one of the following products that made it through the above checklist and past the experts.

Best sunblock for psoriasis for the face and body

Badger Sunscreen Cream

  • Price: $
  • Size: 2.9-ounce (oz.) bottle

Schaffer recommends this SPF 40 mineral-based cream because it’s unscented and doesn’t have dyes or chemicals. It uses four ingredients, and 98 percent of them are organic. You can use this sunscreen on both your face and body.

The certified non-GMO formula includes uncoated zinc oxide at 22.5 percent, and it adds organic sunflower oil, organic beeswax, and sunflower vitamin E for a moisturizing boost. The brand also says it’s hypoallergenic and gluten-free.

The product is designed to resist water for 80 minutes, but you’ll want to be mindful and reapply every 2 hours.

Coral reef safety is a big concern for many sunblock users. The company says this product is reef-safe. Even the manufacturing is eco-friendly — the company says it’s made with 100 percent solar power.

Amazon reviewers are impressed with the quality, especially given its reasonable price. A number mentioned that the formula is thick, so it may take some elbow grease to squeeze the product out of the tube. You may also need some extra time to rub it into your skin completely.

Best tinted sunblock for psoriasis

La Roche-Posay Anthelios 50 Mineral Ultra-Light Sunscreen Fluid

  • Price: $$$
  • Size: 1.7-oz. bottle

This water-resistant product, which is free of dyes, fragrances, oil, and chemicals, is one of Schaffer’s go-to recommendations. It’s a 100 percent mineral sunscreen that’s safe for sensitive skin, and it’s noncomedogenic, so it won’t clog your pores.

This sunscreen is tinted with a matte finish, which some may prefer. For those who’d rather skip the tinted glow, there’s an untinted version available on the company’s website.

The sunscreen is lightweight, nonwhitening, and nongreasy, according to the company. The majority of Amazon reviewers seem to agree it checks those boxes.

One complaint from Amazon reviewers about the tinted version is that there’s only one shade available. The tinted version doesn’t include zinc oxide, using instead titanium dioxide, which may be a drawback for some.

Best sunblock for psoriasis with vitamin C

Derma E Sun Defense Clear Zinc Mineral Oil-Free Sunscreen SPF 30

  • Price: $$
  • Size: 2-oz. bottle

This broad spectrum, oil-free sunblock is chemical-free and contains vitamin C and green tea, which can help skin recover after sun exposure. It also contains soothing aloe vera. To protect you from UVA and UVB rays, this sunblock uses non-nano mineral zinc oxide.

The brand says this pick checks a number of other boxes, as it’s:

  • vegan
  • reef-safe
  • cruelty-free
  • non-GMO
  • gluten-free

Keep in mind that some reviewers mention pilling or peeling and a white cast — a common, but still bothersome, factor in mineral sunscreens.

Best sheer sunblock for psoriasis

Drunk Elephant Umbra SheerPhysical Daily Defense SPF 30

  • Price: $$
  • Size: 3-oz. bottle

This SPF 30 broad spectrum sunscreen contains 20 percent zinc oxide, as well as algae and sunflower sprout extracts for additional antioxidant protection. Aloe vera is tossed in to soothe and moisturize.

It doesn’t use sunblocking chemicals (it’s mineral-based), essential oils, silicones, and fragrances. Plus it’s cruelty-free.

The brand suggests applying this sunscreen to the face, neck, chest, and backs of hands. So, it’s not considered an all-over sunscreen, but it works for more than just your face. The company also says it’s safe for daily use and sensitive skin types.

Reviews in Google are split. Some users call it their favorite, noting how effective it is for sensitive and acne-prone skin. Others were underwhelmed — one said they wished it felt more moisturizing, while another pointed out a white cast (but again, it’s tough to find mineral sunscreens that completely leave out a white cast).

Best value sunblock for psoriasis

All Good SPF 30 Sport Mineral Sunscreen Lotion

  • Price: $
  • Size: 3-oz. bottle

This certified organic sunscreen is made with sensitive skin in mind, leaving out harsh chemicals.

The non-GMO formula uses 16 percent non-nano particle zinc oxide to block UVA and UVB rays (as well as blue light from screens). The exclusion of chemical sunscreen ingredients also makes this sunscreen coral reef-friendly.

The sunblock is also:

  • biodegradable
  • gluten-free
  • paraben-free
  • cruelty-free

This pick gets high marks among Google reviewers, who mention it’s kind to their sensitive skin and doesn’t leave them feeling sticky or greasy.

It’s intended for use on the face and body, which makes it a pretty convenient go-to for all uses. Plus, there’s a 16-oz. family-size version with a pump top available.

The only complaints we found on this one say that it has a thick consistency, and may leave a white cast behind if it’s not fully rubbed in.

What type of sunscreen is best for psoriasis?

People with psoriasis should look for mineral (physical) sunscreens that include zinc oxide and titanium dioxide. The sunscreens they use should have an SPF of 30 or higher.

Should people with psoriasis wear sunscreen every day?

Most people — those with psoriasis and those without — should wear SPF daily. If you believe your symptoms improve with some sun exposure, limit your time in the sun without sunblock to just about 5- or 10-minute periods. Keep in mind that too much exposure could potentially worsen your symptoms.

What ingredients should I avoid when selecting a sunscreen?

It’s a good idea to avoid potentially irritating ingredients like intense preservatives, parabens, formaldehyde, and added color or fragrances.

Some companies will advertise that their sunblock doesn’t contain these ingredients. But it’s always good to double-check the label on products that say they’re good for sensitive skin, and don’t call out certain ingredients their formula excludes.

Can sunshine help with psoriasis?

Some sun exposure can benefit people with psoriasis. But when people with psoriasis are overexposed to the sun, they may see worsened symptoms.

People with psoriasis should wear sunblock in the sun, even when using the sun as treatment for their condition. Look for broad spectrum, fragrance- and preservative-free sunblocks that are at least SPF 30.

If you have psoriasis and are planning on being in the sun, experts recommend starting with 10 minutes of exposure at noon, then increasing exposure by 30 seconds to 1 minute each day.

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8 Healthy Ways to Use White Rice, According to a Dietitian

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Rice is a staple food in many cultures.

It’s predominantly produced in the Asian-Pacific region, where it serves as an important economic crop. More than 60% of the world’s population eats rice every day.

Compared to brown rice, white rice offers fewer nutrients, including minerals, vitamins, and dietary fiber. This disparity has led many in the West to vilify white rice, and there are claims that it can’t fit into a balanced diet.

However, white rice remains more widely consumed than brown rice, potentially due to cultural practices, its faster cooking time, and its softer texture, which many people find more favorable.

Plus, it is more cost-effective and can be purchased in bulk.

For example, a bag containing 320 ounces of white rice (more than 200 standard servings) costs less than $9 USD at Walmart. A similarly-sized bag of brown rice is not available at the retailer. Instead, a 32-ounce bag (about 20 servings) costs $1.37 USD.

To buy the same amount of brown rice as offered in the bulk bag of white rice, you’d need to purchase 10 32-ounce bags for more than $13, plus tax.

Therefore, it’s important that we acknowledge the roles and benefits of white rice as a cultural staple in several dietary patterns and as an affordable alternative to other grains.

We need to develop a deeper understanding of ways to use this staple food as part of a healthy diet and lifestyle.

This article explains the benefits of white rice and ways to enjoy it through balanced nutrition.

The scientific research on white rice’s association with various health outcomes has been inconsistent.

For instance, some research suggests that white rice is associated with the development of type 2 diabetes among Asian women when consumed in “extreme” amounts — but “extreme” is not well-defined with respect to the amount of white rice consumed each day.

In other research, white rice that has been cooked and cooled before consumption in a human clinical study lowered blood sugar spikes after a meal.

This occurred because cooking the white rice then refrigerating it for 24 hours before reheating activated its resistant starch — a type of non-digestible carbohydrate that confers benefits for gut health and blood sugar management.

Here is how 1 cup (158 grams) of cooked parboiled white rice compares to 1 cup (155 grams) cooked parboiled brown rice:

White rice offers fewer calories, fewer grams of carbs, fat, and dietary fiber, and less of the mineral phosphorus, but comparable protein and selenium compared with brown rice.

However, it is richer in the B vitamin niacin than brown rice.

This data shows that white rice offers some nutritional benefits. Consider pairing it with foods rich in dietary fiber and minerals to boost the nutritional profile of your meal.

Learn more about the differences between white and brown rice here.

Summary

White rice is not inherently inferior to brown rice, despite myths. It offers nutritional benefits, including some minerals. It’s low in fiber, fat, and calories, and can be paired with fiber-rich foods to boost a meal’s nutritional profile.

Here are 8 healthy ways to enjoy white rice.

1. With peas and beans

Peas and beans are rich in dietary fiber, antioxidants, and other health-promoting compounds shown to improve blood sugar, cholesterol levels, and blood pressure.

Furthermore, when peas and beans are paired with rice — including white rice — a complete protein is formed. A complete protein is one that provides all nine essential amino acids in sufficient amounts.

This is an especially important food combination for people who follow a vegetarian or vegan dietary pattern, since most complete proteins are animal-based foods.

Enjoy white rice with stewed lentil peas, dhal (split peas), or a black bean chili.

Learn more about complete protein sources for people who eat plant-based here.

2. Vegetable rice

Like peas and beans, non-starchy vegetables are rich in dietary fiber. When included in a vegetable rice dish, they can help make up for the lower fiber content of white rice.

Vegetables also contain nutrients like calcium, vitamin C, iron, and folate that support lower cholesterol and blood sugar levels and may reduce the risk of some types of cancers.

Examples include carrot rice, spinach rice, and pumpkin rice.

3. Balanced with veggies and meat

A great way to build a meal using white rice is following the balanced MyPlate method recommended by the United States Department of Agriculture (USDA).

Under this guideline, about half your plate should be filled with non-starchy vegetables and fruit, a quarter of your plate with protein like meat, fish or poultry, and a quarter with grains like white rice.

This method encourages flexibility and a diversity of nutrients to be enjoyed while also helping you eat mindful servings of white rice.

Serve a quarter-plate of white rice with a half-plate of cooked spinach and a quarter-plate of grilled fish for a quick, balanced dinner meal.

4. In a one-pot dish

It is impractical to enjoy all meals in the MyPlate method recommended above, as is the case with one-pot meals.

However, these can still be a nutritious and healthy way to eat white rice.

Pair one-pot dishes like pelau — a Caribbean dish made with caramelized chicken, rice, pigeon peas, herbs, spices, and vegetables — with an additional side of non-starchy vegetables like carrot coleslaw or tossed salad.

Other rice-based one-pot dishes, such as casseroles or South Indian recipes like sambar rice, can also be accompanied with a side of non-starchy vegetables for a boost of filling dietary fiber.

5. Vegetarian rice bowls

Rice bowls are quite popular in Asian, Persian, and Spanish cultures.

The rice may be topped with beans, vegetables like lettuce, onions, and olives, avocados for healthy fats, and sauces or gravies for flavor.

Because rice bowls use so many ingredients, that often means you’ll use smaller portions of each food, including rice, to create room for a variety of other food groups.

The inclusion of fats like avocado or olive oil-based dressings encourage the absorption of fat-soluble vitamins like vitamins A, D, E and K, and may support heart health by lowering low density lipoprotein (LDL or “bad”) cholesterol.

6. Lean meat burrito bowl

In some cultures, rice bowls are also called burrito bowls.

Popular burrito toppings include lettuce, red onions, celery, or a combination of other non-starchy vegetables, corn, black beans, and cooked chicken, beef, pork, or plant-based proteins like tofu and tempeh.

If you’re making a burrito bowl that uses meat, choose lean cuts to reduce saturated fat intake. Research shows that a moderate intake of lean, fresh red meats is associated with lower blood pressure compared with high-fat meats.

Try topping your rice bowl with a Mongolian beef or smoked pork recipe for a burst of flavor.

7. With fish

Consuming fish at least twice per week is associated with benefits for heart, nerve, and liver health.

In addition, fish is an important source of protein, antioxidants, and anti-inflammatory nutrients, including the heart-friendly omega-3 fatty acids.

Try curry fish, blackened creole fish with white rice, or a tuna fish and rice casserole. Don’t forget to include a fresh or cooked non-starchy vegetable side dish for fiber and health-promoting added nutrients.

8. Stuffed in bell peppers

A clever way to enjoy white rice and vegetables in a nutritious and filling yet simple dish is by making stuffed bell peppers.

Bell peppers contain capsaicin, which is a phytochemical compound with potential benefits against cancer development.

This active compound in bell peppers has also demonstrated anti-inflammatory, blood sugar-lowering, anti-fungal, antioxidant, and other beneficial properties for human health.

Summary

Pair white rice with peas and beans, lean cuts of meat, fish, and vegetables to make balanced and nutritious dishes. White rice can also be enjoyed in one-pot meals like pelau and sambar rice or in rice bowls and stuffed bell peppers.

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Depression May Not Be Linked to Low Serotonin, New Analysis Finds

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  • A new analysis finds that depression may not be caused by lower levels of serotinin in the brain.
  • Researchers say the chemical and neurological underpinnings of depression are complex.
  • Additionally, researchers say this does not mean that anti-depressants don’t work, only that they may not understand why they work.

There is no evidence that depression is caused by lower levels or reduced activity of serotonin in the brain, according to a recent analysis of 17 previous studies.

This suggests that depression is not caused by a chemical imbalance of this brain-signaling molecule, say the authors of the review. It also raises questions about how antidepressants that supposedly target serotonin work, they add.

However, other researchers say the chemical and neurological underpinnings of depression are complex, so to completely rule out serotonin is an oversimplification of the research.

They also caution against making decisions about how to treat depression based on this review, saying antidepressants have been shown to be moderately effective for certain people.

The serotonin hypothesis, proposed decades ago, says that a chemical imbalance in the brain — including a deficiency of serotonin — causes depression.

The most common antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), are thought to make serotonin more available in the brain by blocking the reabsorption of serotonin into neurons.

However, in their recent analysis, Joanna Moncrieff, MD, a professor of psychiatry at University College London, and her colleagues found that there is no “consistent evidence” that serotonin is involved in depression.

Their findings, which were published July 20 in Molecular Psychiatry, included:

  • Research on serotonin and its breakdown products in the blood and brain fluids found that the level of these chemicals was similar in people with and without depression.
  • Research on serotonin receptors and the serotonin transporter, a protein targeted by many antidepressants, offered “weak and inconsistent” evidence that people with depression had higher levels of serotonin activity.
  • Studies in which healthy people’s serotonin levels were artificially lowered through a special diet found that this did not increase their risk of developing depression.
  • Genetic studies found no difference in serotonin-related genes between people with depression and healthy participants.

“After a vast amount of research conducted over several decades, there is no convincing evidence that depression is caused by serotonin abnormalities, particularly by lower levels or reduced activity of serotonin,” Moncrieff said in a news release.

Anthony King, PhD, a neuroscientist and licensed psychologist and psychotherapist at The Ohio State University’s College of Medicine, who was not involved in the new review, agrees that the role of serotonin in depression has been overblown.

“The idea that depression is a chemical imbalance characterized by a deficit or a lower level of serotonin in the synapses is just not correct,” he said. “It never was, and it’s not now.”

However, “I’m not saying serotonin is not involved and I’m not saying SSRIs don’t help,” he added.

Serotonin is likely involved in some way, he said, but the relationship between depression and other brain chemicals is complex. Likewise, he said SSRIs can help some people — just not everyone.

King also noted that stress can play a role in the development of depression

Dr. Srijan Sen, a professor of depression and neurosciences and director of the Frances and Kenneth Eisenberg and Family Depression Center at the University of Michigan, said he doesn’t think the new review entirely eliminates serotonin from the picture.

“Whether serotonin plays a role in depression in some way is an open question,” he said. “The brain is so complicated and complex, it would be surprising if serotonin wasn’t involved at all.”

He pointed to a recent meta-analysis of studies looking at the link between serotonin-related gene variants, stress, and depression as evidence that the case for serotonin is far from closed.

In that study, researchers found that people who carry a certain serotonin-related gene variant are at higher risk of developing depression in response to a stressful life event. However, this was only true for chronic stress and for depression assessed within a year of the stressor.

This meta-analysis was published this month, so it was not included in the review by Moncrieff and her colleagues.

There is, however, one thing that Sen agrees with Moncrieff and her colleagues on: “[Chemical imbalance] is not an accurate representation of our understanding of what happens in the brain,” he said.

“It’s probably more likely that there are certain circuits and loops of connections in the brain that are changed that are important,” he said. “But we don’t know exactly what is happening.”

King said there are other ways to think about depression that can help people break free of the downward spiral that often accompanies this condition.

“[Stressful life events] can lead to emotional upset and a big change,” he said. “That can be accompanied by a sort of pessimism and a certain habit of behavior and thinking.”

Basically, “people get into a rut — they get into a rut mentally and behaviorally,” he said. “And a sense of inertia sets in.”

While this may sound like a hard cycle to get out of, King said several types of treatment can help people get moving again, including cognitive behavioral therapy, behavioral activation, and mindfulness.

The new review also challenged whether it’s helpful to talk about SSRIs as fixing a chemical imbalance.

“Many people take antidepressants because they have been led to believe their depression has a biochemical cause, but this new research suggests this belief is not grounded in evidence,” said Moncrieff.

Sen, though, cautioned against making decisions about depression treatments based on this review.

“We generally don’t make clinical decisions about treatments based on the molecular and biological understanding of what the treatments do,” said Sen. “It’s much more based on the results of clinical trials.”

Scientists use rigorous clinical trials to see if a treatment works, as well as under what conditions and for which people. These trials can produce useful results even without a good understanding of how a treatment works, said Sen.

That said, “understanding the biology in the long term, I hope, will help us develop better medications and advancements in personalized treatments,” he added.

To date, clinical trials of SSRIs have shown that “they are moderately effective and help some people,” said Sen. “But we definitely do need better drugs.”

For people who don’t benefit from SSRIs, he said there are other potential treatments for depression, such as improved sleep routines, regular exercise, and stronger social connections. Recently using psychedelic drugs like ketamine has become more common as a potential option for people with depression.

“With all these things, there is observational and clinical trial evidence showing that they really help with depression,” he said.

Read the full article here

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