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MONDAY, Sept. 12, 2022 (HealthDay News) — Gum disease has far-reaching effects and may increase your odds of developing dementia, a new study suggests.
In a review of 47 previously published studies, researchers in Finland found that tooth loss, deep pockets around teeth in the gums, or bone loss in the tooth sockets was tied to a 21% higher risk of dementia and a 23% higher risk of milder cognitive decline.
Tooth loss itself — an indicator of gum, or periodontal, disease — was linked to a 23% higher risk of cognitive (mental) decline and a 13% higher risk of dementia, according to the study.
“Maintaining adequate periodontal health, including retention of healthy natural teeth, seems to be important also in the context of preventing cognitive decline and dementia,” said lead researcher Sam Asher, from the Institute of Dentistry at the University of Eastern Finland in Kuopio.
Asher noted that the study can’t prove that gum problems actually cause dementia. Still, prevention and treatment of periodontal conditions are particularly important in older adults who are at increased risk for dementia, he said.
“Our results also emphasize the importance of oral health care in people who already have some degree of cognitive decline or dementia. These individuals often develop difficulties with maintaining oral hygiene and using professional oral health services,” Asher said.
Dentists should take note, he added. “Oral health professionals need to be particularly aware of early changes in periodontal health and oral self-care that often occur at older ages due to cognitive decline,” Asher said.
About 10% to 15% of the global adult population has gum inflammation known as periodontitis, the researchers pointed out in background notes. In severe cases, it leads to tooth loss, and prior research has linked it to heart disease and diabetes.
“Future research needs to focus on providing higher-quality evidence to help both the general public and dental health care professionals with more specific oral health care strategies to prevent dementia,” Asher added.
Dr. Sam Gandy, director of the Mount Sinai Center for Cognitive Health in New York City, said, “There is growing evidence that somehow systemic inflammation and brain inflammation are linked.”
Periodontal disease, systemic viral illnesses, including herpes, COVID-19 and inflammatory bowel syndrome, among others, are capable of triggering brain inflammation, said Gandy, who was not involved in the study.
“These associations do not necessarily involve direct invasion of the brain by microbes, but we still understand relatively little about the molecular basis for how systemic inflammation aggravates brain inflammation,” he added.
Research in this field is still murky. According to a recent trial, treating gum disease in Alzheimer’s patients did not affect their condition, although it did affect markers linked to Alzheimer’s, Gandy said.
“This sort of result, taken together, raises the possibility that biomarkers may, at least under some circumstances, be misleading. There is still no acceptable substitute for the large, long, expensive, randomized clinical trials in which meaningful clinical benefit can be established,” he said.
This study can’t prove that the inflammation caused by dental disease causes dementia, agreed Dr. Jeremy Koppel, a geriatric psychiatrist and co–director of the Northwell Health Litwin-Zucker Alzheimer’s Disease Research Center in Manhasset, N.Y.
“You don’t know if they got the periodontal disease because they have Alzheimer’s or they got Alzheimer’s because of the gum disease,” said Koppel, who played no role in the research.
He noted that in this study, the risk for dementia linked with periodontal disease was very low. “The risk may be pretty much neutral when compared with known risks for the disease,” Koppel said. Those risks include smoking and unhealthy diet, according to the study.
Koppel doesn’t discount the importance of what’s happening in the mouth as it relates to Alzheimer’s disease. He said that research is being done on saliva to see what it has to tell about conditions in the brain.
“People are interested in looking at the saliva for biomarkers of the proteins in the brain that are related to Alzheimer’s,” Koppel said.
And anti-inflammatory therapies are already a treatment target for Alzheimer’s, he said.
“But whether the mouth may have other secrets hasn’t really been explored,” he added.
The report was published online Sept. 8 in the Journal of the American Geriatrics Society .
More information
For more on dementia, head to the U.S. National Institute on Aging.
SOURCES: Sam Asher, MPH, Institute of Dentistry, University of Eastern Finland, Kuopio; Jeremy Koppel, MD, geriatric psychiatrist, co–director, Northwell Health Litwin-Zucker Alzheimer’s Disease Research Center, Manhasset, N.Y.; Sam Gandy, MD, PhD, director, Mount Sinai Center for Cognitive Health, New York City; Journal of the American Geriatrics Society, Sept. 8, 2022, online
Well-designed gym machines enhance the effectiveness of your strength and hypertrophy training. They can minimize instability, allowing you to target and overload specific muscles. They can apply variable resistance and resistance to patterns of motion that free weights simply cannot. Good machines can also enhance safety when working with heavy loads or training to failure.
Credit: Prostock-studio / Shutterstock
The problem is that not all machines in the gym are good, useful, or worthwhile. To preface, this review isn’t the biased opinion of a fragile physio or some two-bit trainer who labels random machines as “injurious” or “non-functional.”
This is an objective, biomechanics-based, physiologically-informed discussion from a strength coach and physical therapist who uses certain machines just as often as free weights. With that said, not all machines are created equal. Here are five machines to avoid and five machine problems to avoid.
The Five Worst Exercise Machines
The Five Worst Machine Problems
The Five Worst Exercise Machines
Some machines should be avoided because they “take” more stress and effort than they “give” results. If you’re focused on training efficiently and effectively, double-check your training program to see if any of this avoidable equipment is in your plan.
Squat Machines That Bottom-Out Before You Do
Many lifters may struggle with achieving full depth in a free weight squat. This may occur for a number of reasons — poor coordination, limited ankle flexibility, or a lack of confidence in their ability to stand up after hitting depth.
Hack squats, leg presses, and other lower-body machines that enhance a lifter’s ability to achieve full range of motion in the “squat” movement pattern are worth their weight in gold (or, more specifically, iron).
For lifters with stiff ankles, placing your feet higher or further forward on the platform decreases the amount of ankle dorsiflexion (raising your toes towards your shin) required to hit depth. The upper-body support and guidance afforded by the machine assists lifters deficient in trunk control.
Built-in safety features may empower even the most apprehensive lifters to achieve significant depth. But these built-in safety “stops” can backfire if they end the squat movement too early.
Why Avoid Them
Maybe you’ve experienced this scenario: You hop on a shiny new hack squat or leg press. Everything feels great until midway through the rep…clunk… you’ve hit the machine’s safety stop before reaching the coveted “ass-to-grass” position of full hip and knee flexion.
The machine may have been working smoothly otherwise, but its design may be shorting more than your depth. It’s likely robbing you of potential gains.
Full range of motion squatting has been associated with superior strength and power outcomes compared to partial depth squatting. (1) Although other research showed no difference in strength improvement between those squatting to full depth and those training with partials, it did report significantly greater thigh hypertrophyin the full depth group. (2)
Altogether, it seems that most lifters would benefit from squatting deep. Squat machines should facilitate, not limit, full range of motion training. If the squat machine in your gym hits bottom before you do, it’s probably not worth your time.
The “High Five” Pec-Deck
Quite a while ago, many pec-deck or chest flye machines seemed to share a common ill-conceived design — the “high five” arm position. The machine requires users to sit and reach their arms slightly behind their body at shoulder-height, and then externally rotate their shoulders to place their forearms in contact with vertical pads.
To perform the exercise, the user pulls the pads toward each other in front of their chest. These machines train the pectoralis major, anterior deltoid, subscapularis, and few helper muscles. (3) They can still be found in commercial and home gyms.
Why Avoid Them
To be clear, there is nothing inherently “wrong” with this machine. It undeniably hits the pecs. (3) In fact, the total contribution of pectoralis major is likely underestimated because the muscle is put under substantial passive tension during full shoulder external rotation.
The issue with the “high five” pec-deck is not it’s lack of effectiveness, but that it’s unlikely to be universally tolerated by lifters who have existing shoulder issues. For example, when a team of physicians examined 20 weightlifters with painful shoulders, every single weightlifter reported reproduction of shoulder pain in the “high five” position. (4)
Interestingly, half of these weightlifters improved and ultimately avoided surgery with rehab and avoidance of the “high five” position. Heavy strength training in the “high five” shoulder position is thought to be associated with anterior instability. (5)(6) It undoubtedly stresses the front of the shoulder joint, including the rotator cuff.
Altogether, if you have known shoulder problems, including but not limited to stiffness, rotator cuff pathology, biceps tendon issues, or a labrum injury (e.g. SLAP tear), steer clear of the “high five” pec-deck. But don’t despair. There are more forgiving options.
Improved pec-deck designs have multiple handle options. These machines allow the user to select a comfortable position for direct chest training. As a bonus, the improved machines often allow the lifter to spin around and train rear deltoids at the same station, enabling an efficient superset.
Crunch Machines
Abdominal machines will get you off the gym floor, but that’s pretty much the only good thing about most of them. Plate-loaded and stack-loaded crunch machines are generally designed to be used either seated or lying down.
While their designs tend to reduce a multi-joint spinal movement pattern to a single pivot point, this isn’t their main problem. Their range of motion is suboptimal for building a stronger, better looking set of abs.
Why Avoid Them
When you use a crunch machine, whether it’s a seated or supine (lying down) model, you only train through a small portion of your available trunk flexion range of motion. By the time you meet the resistance of the machine, many of your spinal joints are already flexed and the abdominals are only trained in their shortened length.
For the purpose of building muscle, mounting evidence suggests the superiority of training at long muscle lengths rather than short. (7)(8) So if you’re a healthy lifter who wants to build a more pronounced six-pack, a better option is to train through a full range of spinal flexion.
Start your crunch with an extended (arched) back. To accomplish this, you can perform crunches on top of a Swiss ball or lock into a glute-ham developer (GHD) machine for controlled, full range of motion sit-ups.
Standing Calf Raise Machines
Standing calf raise machines eliminate the need to hold heavy weights when performing calf raises. They also provide a stable environment to help the lifter focus on building big, strong gastrocnemius muscles — the superficial calf muscle trained during any straight-knee calf raise exercise. (9)
These machines typically load the calves through pads that rest atop the upper traps. Therefore, the standing calf raise is an axially-loaded exercise, which means the weight is supported through the trunk and spine like squats and deadlifts.
Why Avoid Them
Calf training is accessory work, which is typically programmed toward the end of the workout. By that time, most lifters have already performed at least one heavy axially-loaded lower body exercise. If they’ve trained with high effort and intensity, their core is likely exhausted. But unless their dress code always calls for pants or knee-high socks, calf training probably shouldn’t be skipped.
By avoiding standing machines in favor of machines that apply more direct loading to the target muscles, you can reduce the likelihood that trunk fatigue interferes with building the getaway sticks you’ve always wanted.
While standing calf raise machines have been around for decades, Golden Era bodybuilders had alternatives. They used donkey calf machines, which required the lifter to bend forward to load the calves from atop the pelvis instead of the spine.
There’s photographic evidence of Arnold performing this exercise without the machine, instead recruiting a training partner or the occasional beautiful woman (or two) to sit atop his hips while he performed calf raises.
Can’t find an old-school donkey calf machine? Asking others to climb onto your hips too risqué for your globo gym? There are plenty of alternatives to standing calf raise machines.
Purpose-built 45- or 60-degree calf raise machines load the calves through the hips. They look like mini hack squats. Rotary calf machines allow training to be performed seated with legs straight out in front of the body. If none of these options are available, a basic leg press usually works fine for calf raises while sparing you the axial-loading.
Combo Machines That Botch Both Movements
When limited floor space or budget is a concern, gym owners may be tempted by multi-function machines. Machines like functional trainers and cable columns serve as the gym’s “jack-of-all-trades, master of none.” These machines are mainstays, and there are usually no problems with them. But some multifunction machines are pretty lackluster.
The plate-loaded leg extension/leg curl combo is a multi-function machine that is universally rubbish, regardless of make or manufacturer. These machines combine a seated leg extension with a prone hamstring curl. In theory, these machines are a wonderful, space-efficient station to train two important muscle groups. In reality, you’ll realize after your first set why they are on this list.
Why Avoid Them
The plate-loaded leg extension/leg curl combo only has two jobs — train the quads and train the hamstrings — and it does neither particularly well. For quad training, the resistance peaks near the top position when knees are extended.
However, knee extension torque is highest near the middle of the range of motion, not in full extension. (10) Therefore, the resistance offered by the machine does not match the strength profile of the joint being trained. Many other machines may also fall short of providing ideal resistance through a full range of motion, which is discussed in more detail in the next section.
The prone hamstring curl half of this machine, in particular, is worthless at end-range knee flexion (the contracted position). Past a certain angle of knee flexion, the resistance cuts out because the plates are pulled above the machine’s axis of rotation as you complete the curl.
If you need to use one of these machines because, say, you already have one and aren’t shelling out for two separate machines, you might be able to work around this problem by creatively rigging resistance bands.
Credit: Dr. Merrick Lincoln, DPT, CSCS
Ultimately, there are better machines available for your quad and hamstring training — one dedicated to quads and a separate one for hamstrings.
The Five Worst Machine Problems
Some machines aren’t inherently “bad,” they just suffer from problems that can potentially be addressed with sufficient maintenance, proper setup, or an adjustment to overall program design. Here’s what to watch out for.
Machines Full of Friction
Have you ever felt a mid-rep grinding or jerking sensation when lifting on a machine? Or, maybe you’ve felt that you have to push or pull through lots of “slop” or play in the cables and pulleys of a machine before the weight stack begins to move? If so, you’ve got a friction issue.
Common sources of friction in gym machines can be bent, rusted, or poorly lubricated guide rods; worn or cracked cable sheathing; or worn bearings. Some machines, particularly those with multiple pulleys and long belts or cables have lots of friction when factory-new. By using high-friction machines, you could be sacrificing more than a smooth lifting experience.
Why Avoid Them
The same friction that makes the repetition feel “grindy” during the positive (concentric or lifting) portion of the repetition also robs you of resistance during the negative (eccentric or lowering) portion.
What’s the harm of losing a little resistance during the eccentric phase? It could be limiting the overall effectiveness of the exercise. Our muscles are physiologically stronger during eccentric contraction than concentric contraction. In any given movement, you can lower more weight than you can lift. Therefore, the concentric phase of a typical exercise will always be the limiting factor.
When using high-friction machines, your muscles get short-changed twice-over. First, you’ll need to use less weight than you would otherwise to allow you to overcome the weight and the friction during the concentric part of the lift.
The kicker is that your muscles don’t even get to experience full resistance during the eccentric. The effective resistance during the eccentric is the weight you’ve selected minus the resistance lost to friction.
Avoid the machine “wear” sources of friction by using well-maintained machines. To avoid machines with lots of friction intrinsic in their design, look for plate-loaded machines with high quality bearings.
Machines with Insufficient Support
Well-designed machinesshould help you to lock-in good form and allow you to effectively load the trained movement pattern. Good machines are incredibly effective. For example, research showed that 10 weeks of training on an isolated lumbar extension machine was superior to Romanian deadlift training for improving lumbar extension strength. (11)
However, unlike the highly desirable MedX lumbar extension machine, many other lumbar extension machines lack a seat belt to secure hips during the exercise. These machines can be safely presumed to be only marginally effective.
Speaking of seat belts, if you’ve ever tried a seated dip machine without a belt or pads that lock you in the seat, you’ve experienced this phenomenon: attempt to push down more than a certain percentage of your bodyweight and you rise out of the seat. A lack of support represents a design flaw that somehow made it to market.
Receiving honorable mention in this category are cable hip extension machines and rotary hip extension machines (e.g. 4-way hip). These machines are used standing on one leg while the opposite leg is extended against resistance from a cable or pad.
Although these machines typically offer handles to assist with balance, most users struggle to stabilize their trunk and pelvis. Strong contraction of the working-side glute typically causes anterior tilt of the pelvis along with rotation. These machines ultimately limit the amount of resistance that can be used to train hip extension, and your gluteus maximus is left with minimal gains.
Why Avoid Them
Machines lacking enough support can be less effective because they limit the potential use of higher resistance loads. They can also be downright frustrating. Think about the triceps extension machine with handles above a pad that resembles a preacher curl bench. It’s basically a reverse arm curl machine.
I’ve witnessed lifters try with all their might to lean into this style of seated triceps extension machine only to push themselves away from the machine with heavy loads on the weight stack. A simple fix, such as an adjustable seat back, could greatly enhance the ability to use heavy loads and enhance the user-experience (and results).
If you’re a strong lifter who is struggling to maintain body position while using a gym machine, it’s not you, it’s the machine. Spare yourself the frustration and find a better option.
Machines That Don’t Fit Your Body
Encountering machines that don’t match your body is common, even for a decidedly average-sized lifter. If your anthropometry, or body proportion, is further from the population mean, expect to run into this issue even more often.
Watch out for machines whose axis of movement doesn’t alignwithyour primary working joint. Single-joint machines like arm curl machines, triceps extensions, prone hamstring curls, and leg extension machines seem to be the common culprits.
Also, be aware of machines that are too tall or too short for your stature. For example, if a machine is intended to be used with feet on the floor, your feet should not be dangling. Or maybe you’re long-limbed and a particular gym machine does not allow you to press or row through your full range of motion.
Why Avoid Them
It should be obvious that a gym machine with poor ergonomics will deliver a less-than-stellar user experience. Beyond that, questions arise regarding the effectiveness of exercises performed on misfit machines.
Are muscles and joints being trained through their intended ranges of motion? Are fit issues precluding the use of effective resistance loads? Are misalignments between the machine’s geometry and your body creating abnormal joint stresses?
If a machine doesn’t feel right, it is unlikely to help you accomplish your training objectives. When you encounter a machine that doesn’t fit, despite the use of all available adjustments, it’s time to move on.
Machines with a Poor Resistance Curve
A machine’s resistance curve describes the pattern of variable resistance the user experiences throughout the range of motion of the exercise. Machines can be designed to apply variable resistance to the lifter via the use of levers and irregularly shaped cams.
The classic example of variable resistance is the Nautilus shell-shaped cam. The cam was intended to apply more resistance during the part of the exercise where the lifter is stronger and less resistance where the lifter is weaker.
While no machine matches each individual lifter’s strength curve, or capacity to demonstrate strength throughout the range of motion, the resistance curve should correspond with the generalized strength curve of the movement pattern. (12)(13)
In theory, machines engineered to accommodate the general human strength curves should be superior to free weights, which exert a constant resistance relying on gravity. It should also be noted there is certainly no consensus regarding the superiority of variable resistance training or free weight training for increasing strength. (12)(14)(15)
Why Avoid Them
For the moment, let’s limit our scope to single-joint training for simplicity’s sake. When variable resistance, cam-based arm curl machines were compared to circular, cam-based arm curl machines, the variable resistance version was superior for strength gains and slightly better hypertrophy gains have been reported. (16)(17)
These results make sense, as circular cams generally do not match the generalized strength curve of the movement being trained. In general, you should choose the oblong-shaped cam machine over the circle-shaped cam machine for single-joint training. But what about other machine designs for other body parts? You’re going to have to feel them out.
You might encounter a machine that applies variable resistance in conflict with the movement pattern’s strength curve. For example, a lever-based pressing machine with a low pivot point may apply heavier resistance at the bottom position.
This design would conflict with the pressing movement pattern’s ascending strength curve (where you’re typically stronger at the top). (13) This type of machine is likely to limit the overall weight used for the exercise and may ultimately reduce its effectiveness for building muscle and strength.
You don’t have to be a biomechanist to qualitatively determine if a machine’s resistance curve is good or poor for yourself. A good resistance curve will just… feel right. With heavy loads, you will feel that you can exert maximum effort into the machine throughout the full range of motion without losing connection with the resistance, creating excessive momentum, or grinding into a pronounced sticking point. High-quality machines are “buttery” through the full range of motion.
If a machine feels extremely difficult during a one portion of the range of motion and allows for rapid acceleration elsewhere, it may have a poor resistance curve. If this is the case, you’re better off finding a different machine or switching to free weights for a comparable exercise.
Machines Redundant to Effective Free Weight Options
Some free weight exercises are simply damn good and deserve to be in your program. The trap bar isn’t beaten by a shrug machine. If you want to do seated shrugs, sit on a bench and use heavy dumbbells.
For rack pulls, it’s perfectly fine to get in the squat rack. The Smith machine might’ve became the go-to for this exercise in recent years, but a good old barbell lifted from the safety catches works just fine, arguably with superior carryover to your conventional deadlift due the specificity principle.
The point is, there’s no need to re-invent the wheel. And gym equipment manufacturers and gym owners need to receive that message.
Why Avoid Them
The decision to avoid a machine in favor of an equally-effective free weight variation is an “exercise” in restraint. Just because a machine is available doesn’t mean it needs to be used.
If you and others at your gym exercise this restraint, the gym’s management will likely take notice. A machine that doesn’t get used in a public gym doesn’t stick around. With any luck, the valuable gym real estate occupied by the redundant machine might soon be filled with a new machine.
Hopefully it will be something unique and effective, such as a good plate-loaded pullover, standing lateral raise, or pendulum squat. Or maybe management will swap out the redundant machine with another squat rack or whatever popular piece you’re constantly waiting for at your gym.
References
Pallarés, J. G., Cava, A. M., Courel-Ibáñez, et al. (2020). Full squat produces greater neuromuscular and functional adaptations and lower pain than partial squats after prolonged resistance training. European Journal of Sport Science, 20(1), 115-124.
Bloomquist, K., Langberg, H., Karlsen, S., Madsgaard, S., Boesen, M., & Raastad, T. (2013). Effect of range of motion in heavy load squatting on muscle and tendon adaptations. European Journal of Applied Physiology, 113(8), 2133-2142.
Kuechle, D. K., Newman, S. R., Itoi, E., et al. (1997). Shoulder muscle moment arms during horizontal flexion and elevation. Journal of Shoulder and Elbow Surgery, 6(5), 429-439.
Gross, M. L., Brenner, S. L., Esformes, I., & Sonzogni, J. J. (1993). Anterior shoulder instability in weight lifters. The American Journal of Sports Medicine, 21(4), 599-603.
Escalante, G. (2017). Exercise modification strategies to prevent and train around shoulder pain. Strength & Conditioning Journal, 39(3), 74-86.
Kolber, M. J., Beekhuizen, K. S., Cheng, M. S. S., & Hellman, M. A. (2010). Shoulder injuries attributed to resistance training: a brief review. The Journal of Strength & Conditioning Research, 24(6), 1696-1704.
Maeo, S., Huang, M., Wu, Y., et al. (2021). Greater hamstrings muscle hypertrophy but similar damage protection after training at long versus short muscle lengths. Medicine and Science in Sports and Exercise, 53(4), 825.
Sato, S., Yoshida, R., Kiyono, R., et al. (2021). Elbow joint angles in elbow flexor unilateral resistance exercise training determine its effects on muscle strength and thickness of trained and non-trained arms. Frontiers in Physiology, 12.
Landin, D., Thompson, M., & Reid, M. (2015). Knee and ankle joint angles influence the plantarflexion torque of the gastrocnemius. Journal of Clinical Medicine Research, 7(8), 602-606.
Guenzkofer, F., Engstler, F., Bubb, H., & Bengler, K. (2011, July). Joint torque modeling of knee extension and flexion. In International Conference on Digital Human Modeling (pp. 79-88). Springer, Berlin, Heidelberg.
Fisher, J., Bruce-Low, S., & Smith, D. (2013). A randomized trial to consider the effect of Romanian deadlift exercise on the development of lumbar extension strength. Physical Therapy in Sport, 14(3), 139-145.
Carpinelli, R. (2017). A critical analysis of the national strength and conditioning association’s opinion that free weights are superior to machines for increasing muscular strength and power. Medicina Sportiva Practica, 18(2), 21-39.
Wallace, B. J., Bergstrom, H. C., & Butterfield, T. A. (2018). Muscular bases and mechanisms of variable resistance training efficacy. International Journal of Sports Science & Coaching, 13(6), 1177-1188.
Dos Santos, W. D. N., Gentil, P., de Araújo Ribeiro, A. L., et al. (2018). Effects of Variable Resistance Training on Maximal Strength: A Meta-analysis. The Journal of Strength & Conditioning Research, 32(11), e52-e55. doi: 10.1519/JSC.0000000000002836.
Andersen, V., Prieske, O., Stien, N., et al. (2022). Comparing the effects of variable and traditional resistance training on maximal strength and muscle power in healthy adults: a systematic review and meta-analysis. Journal of Science and Medicine in Sport.
Urbanik, C., Staniszewski, M., Mastalerz, A., et al. (2013). Evaluation of the effectiveness of training on a machine with a variable-cam. Acta of Bioengineering and Biomechanics, 15(4).
Staniszewski, M., Mastalerz, A., & Urbanik, C. (2020). Effect of a strength or hypertrophy training protocol, each performed using two different modes of resistance, on biomechanical, biochemical and anthropometric parameters. Biology of Sport, 37(1), 85-91.
Kim Uccellini, 42, manager, policy and community relations, UNOS; 33-year kidney transplant recipient, Atlanta.
Brian Shepard, CEO, UNOS, Richmond, VA.
Deepali Kumar, MD, president, American Society of Transplantation; transplant infectious diseases physician, Ajmera Transplant Centre; professor of medicine, University of Toronto.
News release, UNOS.
National Academies of Sciences, Engineering and Medicine: “Realizing the Promises of Equity in the Organ Transplant System.”
Health Resources & Services Administration: “Organ Donation Statistics.”
Organ Procurement and Transplantation Network (OPTN): “Data.”
News release, Unites States Sente Committee on Finance.
Journal of Clinical Medicine: “Progress and Recent Advances in Solid Organ Transplantation.”
Yuri S. Genyk, MD, transplant surgeon, co-director, USC Transplant Institute, Keck School of Medicine, University of Southern California.
Timucin Taner, MD, PhD, transplant surgeon, division chair of transplant surgery, Mayo Clinic, Rochester, MN.
Kim Lute, 48, two-time liver transplant recipient; regional communications manager, Morehouse School of Medicine, Atlanta.
Journal of Medical Economics: “Mean lifetime survival estimates following solid organ transplantation in the U.S. and UK.”
The 2022 Yamamoto Pro took place on September 10, 2022, in Padua, Italy. With the 2022 Olympia inching ever closer, this year’s International Federation of Bodybuilding and Fitness (IFBB) Pro League contest in Italy held a lot of weight as another step in the qualification process. As the respective competitors showed off their immense mass, it was another opportunity for some to make a name for themselves.
The 2022 edition of the Yamamoto Pro featured four divisions, with Vladyslav Suhoruchkoas one of the headline victors. The respective winners of each category earned an automatic place in the Olympia on December 16-18, 2022. Meanwhile, with the Yamamoto Pro being an IFBB Tier 4 contest, the second to fifth place finishers earned points ranging from four to one in their overall bid for the prestigious bodybuilding competition.
The final point standings for athletes who haven’t won an IFBB Pro League contest this season will be finalized on November 20, 2022. Here’s a rundown of the results from the Men’s Open division at the 2022 Yamamoto Pro:
2022 Yamamoto Pro Results | Men’s Open
Vladyslav Suhoruchko
Mohamed El Eman
Andrea Muzi
Jamie Christian-Johal
Roman Fritz
Pasquale D’Angelo
Harry Harris
Anton Bippus
Mustafa Yildiz
Fabio Romagnolo
With his win, Suhoruchko continues a quality spate of performances in recent years. The Ukrainian athlete finished in fifth place at the 2022 Big Man Evolution Pro. Plus, according to NPC News Online, he took home a second-place result at the 2020 Romania Muscle Fest Pro. As a result of his victory, Suhoruchko will now compete in his first career Olympia contest. He follows in a recent line of athletes who will make their Olympia debut this late fall.
Here’s an overview of the other Men’s divisions featured at the 2022 Yamamoto Pro.
According to the IFBB Pro League calendar, the next contest on the docket for some of these competitors is the 2022 Arnold Classic UK Pro, set to occur on September 24-25, 2022, in Birmingham, England.
The Arnold Classic UK Pro is Tier 2 under the IFBB’s umbrella, meaning the second through fifth place finishers can earn qualifying points ranging from eight to five. It’ll assuredly be another significant rung on the ladder to the 2022 Olympia.
I’ve always been curious about different family styles. So, I asked 10 single mothers by choice to share their experiences. They talked about making the decision, the highs and lows of solo parenting, discussing donor conception with kids, and the joys of going it alone…
On Making the Decision
“I knew I wanted to have kids, preferably through pregnancy, and that time was a factor. As I got closer to 35 and found myself still single, I decided that I didn’t want to lose my chance at being a mom. I could find a husband at any age, but that wasn’t true for getting pregnant.” — Sharon, 42, who has five-year-old twin daughters
“After a miscarriage and then a sudden divorce, I longed for the weight of my baby in my arms. I dated for a few years post-divorce and had a relationship that ended because he was on the fence about having kids. My route to parenthood wasn’t the most typical, but my family and friends knew how badly I wanted to be a mom. My boomer parents were confused at first, but then were just like, ‘Give us a grandchild!’” — Tara, 35, who has a five-month-old son
“I approached it like a research project and read every article I could about being a single mom. I googled things like ‘I regret having kids.’ I talked to friends who had kids and friends who didn’t. I mapped out what my days would look like with kids versus without, and that still didn’t come close to reality, but it was a start.” — Millicent, 42, who has a two-and-a-half-year-old son
“By the time I was 30, I knew certain things about myself. I had no desire for a husband but lots of desire for a child. And I lived in a time and place where I could make that happen. Because I didn’t care about having a partner, I didn’t go through the mourning period that some other single moms by choice seem to go through. I wasn’t giving up one dream in favor of another. I was pursuing my exact dream.” — Melissa, 62, who has a 26-year-old daughter
On Choosing a Sperm Donor
“Genetic testing allowed me to pick donors who weren’t carriers for the same things as I was. I also tried to pick donors that looked similar to my family, mainly because it felt weird to try to choose what my child might look like. I had to go through several donors before I got pregnant, so I was definitely pickier on the first few. But because of the pandemic, there were fewer and fewer options as I went through the process.” — Jessica, 40, who has a seven-month-old daughter
“Choosing the donor felt like a very big decision at the time, but that’s something I rarely think of now.” — Sharon, 42, who has five-year-old twin daughters
On Not Having a Partner
“The best and hardest parts are actually the same: I get to make all the decisions. I choose where they go to school, what pediatrician they see, what religion and traditions they’ll be raised with. But sometimes you want to run things by someone who is just as invested as you are. There is a weight to making all the decisions, and you don’t have anyone to assure you that you’re making the right ones. You don’t have someone else’s strengths to complement your weaknesses.” — Sharon, 42, who has five-year-old twin daughters
“When I hear mothers complaining about how their partners don’t help out, that feels like one place where it’s easier for me. I don’t have the added stress of either disagreeing on how to do things with the baby or the unmet expectations of how someone else is going to help out.” — Jessica, 40, who has a seven-month-old daughter
“A few weeks ago, there was a tornado warning. As I ran into the bathroom with my little guy and my dog, I felt the weight of being solely responsible. That feels heavy some days.” — Tara, 35, who has a five-month-old son
“I try to be the best mom I can be, but it’s difficult that there isn’t an in-house witness to that. On Mother’s Day, seeing all of the posts from spouses about how their partner is the ‘best mom’ is hard.” — Meredith, 40, who has a four-year-old daughter and a one-year-old son
On Preparing for an Empty Nest
“My son starts college in the fall, and I expect that becoming an empty nester as a single mother by choice might be tougher than if I had a partner (or if I had other kids at home).” — Marsha, 60, who has an 18-year-old son
“I was a bit of an island before I had a child, but I think it is the job of a parent to raise a child who can leave them, and I did not want to raise one who felt like she could not leave her ‘poor lonely’ mother behind. When she was young, I worked and parented, and there was not much time for anything else. As she got older, I tried to expand my social network and engage in community activities, so that I would have an active life when she left.” — Allison, 55, who has a 22-year-old daughter
On Male Role Models
“Raising boys, I consciously tried to keep a supply of male role models around (uncles, neighbors, friends, teachers, older neighborhood kids) and encouraged those relationships. I did wonder how they would learn to shave and tie a tie, but it turned out my kids figured that stuff out with YouTube! And, later, Reddit.” — Robin, “sixty something,” who has a 26-year-old son and 23-year-old son
“Since I had pretty much always been single, other than a few short-term relationships, I wondered, How could I help my daughter navigate that part of her life? How could I model a good relationship for her when I wasn’t in one and didn’t plan to be in one? But she looked at my parents, at her friends’ parents, and at my brother and his wife. We talked a lot about relationships, especially those we saw in TV shows, movies and books. We talked about sex and sexual relationships. And we talked about who she was dating or spending time with. At 26, she’s already had some long-term relationships, so I’m no longer worried on that front.” — Melissa, 62, who has a 26-year-old daughter
“I was concerned that my daughter would grow up to either be intimidated by men or seek out their attention inappropriately. Neither of those things happened. I made sure she spent time with great men like my father, my brother and brother in law. I asked for her to be assigned to male teachers in school. I will say she has very little tolerance for men who do not respect her, largely because she has no sense that she ‘needs’ to have a man in her life.” — Allison, 55, who has a 22-year-old daughter
On Finances and Work
“My insurance did not cover fertility treatments that weren’t between a man and a woman. All of the fertility visits, drugs, and procedures cost about $50,000. I was lucky that I had a well-paying job at that point and that I had saved up a lot. ” — Sharon, 42, who has five-year-old twin daughters
“Finances were the primary reason I stopped with one child. I would always tell my son we had enough money for all we needed and some of what we wanted, and that was plenty. Flexibility at work is the most important element [in terms of making single motherhood feel easier]. I’ve had some great bosses and some horrible ones, and I was only ever anything close to being a great mom when I’ve had a great boss.” — Marsha, 60, who has an 18-year-old son
“My job was a huge reason I was able to become a single mom of choice. I work at a hospital, and after two years, you are eligible for half off fertility benefits and IVF medications through the hospital pharmacy. Still, IVF was expensive and I ended up putting some on a credit card, which I will be paying off for the next year. I upped my life insurance while I was pregnant and created a will shortly after he was born. The financial burden is something I think about a lot. ” — Tara, 35, who has a five-month-old son
On Getting Help
“One thing I realized within my online community is that many of us single mothers by choice have a personality where we like or are used to doing everything ourselves, so we have a hard time asking for help. But, as a single mom, you need to learn to ask for help. It’s easier with family, but I am always mentally trying to figure out how to do the impossible before finally realizing I can just ask someone to pick the girls up from an after-school activity. As they get older and form real friendships, I in turn become friendlier with the moms of their friends which makes it easier to ask if one of my daughters can go home with them after school or something like that.” — Sharon, 42, who has five-year-old twin daughters
“My friends have lifted us up time and again. One of my closest friends attended prenatal classes with me and kept me company while I was in labor. Later, she started hosting Sunday night dinners for us, which we’ve attended almost every week since lockdown. My childhood best friend came to stay with me the week before my due date and was with me during my unplanned C-section. Because of Covid, my daughter and I spent most of her first year in isolation, but we were supported (from six feet away) by a network that just kept showing up, even though they didn’t get to cash in on the baby snuggles I promised them while I was pregnant. They brought us groceries, flowers, fresh bread, burritos, and that all-important baby Tylenol for baby’s first teething experience.” — Austen, 44, who has a two-year-old daughter
“I remember driving my son eight hours to Santa Fe when he was seven months old. I had an arsenal of toys in the passenger seat to hand back to him. We also stopped a lot. I was so stressed but so proud that I did that all on my own. That said, one of the best things anyone can do to help a single mom friend is just show up and get to work, especially right after she has the baby. Let her sleep or shower. Do the dishes and laundry. Bring food; for god’s sake, bring food.” — Millicent, 42, who has a two-and-a-half-year-old son
“It’s incredibly helpful when someone assumes responsibility for one complete task. My dad walks my daughter to school every morning. My best friend always babysits on the night of my book club. Knowing those things are entirely off my plate is a huge lift.” — Meredith, 40, who has a four-year-old daughter and a one-year-old son
“I asked for help all the time and paid for help when I could. I took short vacations away from the kids — and always came back a better mom.” — Robin, “sixty something,” who has a 26-year-old son and 23-year-old son
On Dating
“Between working and parenting, 100% of my bandwidth is used. I fantasize about having a torrid romance in my fifties when I’m near retirement and no longer have small kids at home. Who knows what will happen?” — Meredith, 40, who has a four-year-old daughter and a one-year-old son
“I do want a long-term partnership, but the thought of paying a sitter while I go on a bad first date seems terrible right now. Once my son starts daycare, I’m thinking of starting dating during my lunch hour. Choosing to become a single mom doesn’t mean that I gave up on romantic relationships. I enjoy being single, but if someone could add to my life and my son’s life, I would be thrilled.” — Tara, 35, who has a five-month-old son
On Public Response
“I live in Oklahoma, a very conservative state, but I’ve been surprised with how many people say they know someone who is a single mom by choice or are just generally happy for me.” — Millicent, 42, who has a two-and-a-half-year-old son
“Around the 12-week mark, when my OB confirmed the pregnancy, I told my coworker (who was pleased), my brother (who was startled but accepting), and then my parents. My parents were very surprised. We had never talked about plans for my future, I’d never introduced them to any boyfriends, so this felt out of the blue for them. My mother had to sit down! Of course they had questions: Could I afford it? What was I going to do about childcare? My father was very concerned about the financials, but I knew that that was his way of expressing worry for me. Once they saw that I had a handle on everything, they relaxed and were very excited about becoming grandparents.
“My paternal grandmother was really shocked when I told her I was pregnant, but it was clear that her primary concern was, ‘How am I going to explain this to the people at synagogue?’ which obviously was about her rather than me, and was pretty much the reaction I’d expected from her. I told her to tell them she was going to become a great-grandmother (she did that, later, and her friends were happy for her), and after that she sort of threw me out of her apartment. We weren’t close, so her response made no difference to me. My maternal grandmother’s love and enthusiasm more than made up for my paternal grandmother’s reaction.
“I was working in commercial publishing, which is generally a liberal field, so I expected my being pregnant wouldn’t be a big deal, and it wasn’t. I was very open about how I’d conceived. My becoming a single mom by choice was completely uncontroversial in my social circle and my work life.
“When my daughter was in elementary school, there was one mother who didn’t want our daughters to be friends because my daughter was conceived out of wedlock. The reason I remember this is because she was the only person who ever reacted like that. I found it more amusing than anything else. Our daughters weren’t close friends, just classmates. My daughter was nine or ten by then and aware that some people had different attitudes about single mothers, so I flat out told her that this mom disapproved of our family. My daughter’s reaction was basically a shrug. We ignored the mother’s disapproval and went on with our lives.” — Melissa, 62, who has a 26-year-old daughter
“I got nothing but support when I shared my plans. Some of my mom’s friends actually seemed a little bit envious that this choice was an option for me, because in order to become mothers, they didn’t see any other path besides marriage.” — Marsha, 60, who has an 18-year-old son
“I thought that my conservative community was not going to approve, but I was overwhelmed with support. People I barely know were talking about how brave I was! There are some who probably don’t agree with my choices but they thankfully stay quiet.” — Sharon, 42, who has five-year-old twin daughters
On the Power of Community
“I read a few books — Choosing Single Motherhood and Going Solo, plus Liv’s Alone which is hilarious — and listened to the great podcast Not By Accident. The world we live in is very couple focused and you get a lot of questions. When I was pregnant, my neighbor yelled across the street, ‘WHO IS THE DADDY?!?’ It was like Jerry Springer, but real life. Thankfully, I was in a weekly support group on Zoom, so I had a vibrant online community of other women who understood exactly what I was going through. In hearing the experiences of others, I felt seen and validated and knew this was the path for me. These days, I follow a lot of solo moms on Instagram and I’m in a WhatsApp group of single moms by choice all over the world whose babies were born around the same time. I have also met two local single moms by choice and that has been wonderful.” — Tara, 35, who has a five-month-old son
“It was really helpful to hear from members of Jane Mattes’s Single Mothers by Choice group who had been there before me. I knew I could succeed because I had those examples. Other members were also a great resource when I had specific questions.” — Marsha, 60, who has an 18-year-old son
On Talking to Kids
“I started telling my daughter our story when she was much too young to understand. That was partly because I wanted practice and partly because I did not ever want there to be a time she ‘found out.’ She just always knew.” — Allison, 55, who has a 22-year-old daughter
“My biggest fear was that my children would resent me for not having a father. My son is too young to know; my daughter has asked questions. My narrative is that I tried to find a man worthy of being a daddy, I couldn’t find one, and so I used a donor instead. We also talk a lot about different kinds of families and that it’s okay to want a daddy (or a sister, a cousin, etc.), but also that it’s important to remember all the people we have who love us (insert long list of people who love her).” — Meredith, 40, who has a four-year-old daughter and a one-year-old son
“What I have learned over the years is that the vast majority of donor-conceived people who are unhappy about it are people who didn’t know they were donor-conceived until their teens or adulthood. Learning the truth about their origins was wrenching because it revealed that there was a huge secret in their family, and because it’s hard, I think, not to feel some kind of shame or betrayal when you learn that your parents kept such an important thing from you. The few studies that have been done seem to indicate that donor-conceived people who have always known about their conception are generally okay with it, though of course some people are going to feel more stressed about it than others. At eight, my daughter explained to her friends that her mom went to ‘a bank, like a regular bank, but for sperm, not money,’ which was hilarious.” — Melissa, 62, who has a 26-year-old daughter
On Magic Moments
“When you’re a single mom who used a donor, there’s always an element of surprise: Did she get this trait from me? From her donor? Is it her own unique inborn nature? One of my favorite things has been watching my daughter’s sense of humor develop, and it’s been a delight to see that she loves wordplay and puns as much as I do. For example, one day she ran up to me shouting, ‘Mummy, I peed in the potty!’ She took me by the hand into the bathroom to show off…a wooden snap pea that she had carefully laid in the potty. She was beside herself with glee.” — Austen, 44, who has a two-year-old daughter
“When my son started smiling, that felt like the best thing. A little over a year ago, I was injecting myself with IVF meds and feeling quite hopeless. It took years to have this little guy, and I can’t believe I’m someone’s mom!” — Tara, 35, who has a five-month-old son
“My son and I were making different faces: a silly face, a sad face, a happy face. He said ‘make a mama face.’ I asked him what a mama face looks like and he answered ‘Happy!’ I’m so proud that he sees me that way.” — Millicent, 42, who has a two-and-a-half-year-old son
Thank you so much to everyone who shared their story! And, CoJ community, please share your stories and thoughts below, if you’d like…
Sept. 12, 2022 — New COVID boosters that target the fast-spreading Omicron strains of the virus are rolling out this week, with the CDC recommending these so-called bivalent mRNA shots for Americans 12 and older.
Here are answers to frequently asked questions about the shots produced by Moderna and Pfizer/BioNTech, based on information provided by the CDC and Keri Althoff, PhD, and virologist Andrew Pekosz, PhD, Johns Hopkins Bloomberg School of Public Health epidemiologists.
Q: Who is eligible for the new bivalent boosters?
A: The CDC greenlighted the upgraded Pfizer/BioNTech shots for Americans 12 and older and the Moderna booster for those 18 and over, if they have received a primary vaccine series or a booster at least 2 months before.
The boosters have been redesigned to protect against the predominant BA.4 and BA.5 strains of the virus. The Biden administration is making 160 million of the booster shots available free of charge through pharmacies, doctor’s offices, clinics, and state health departments.
Q: What about children under 12?
A: The new boosters are not approved for children under 12. Additional testing and trials need to be conducted for safety and effectiveness. But officials recommend that children 5 and above receive the primary vaccine series and be boosted with one shot. Children 6 months to under 5 years are not yet eligible for boosters.
Pfizer said it hopes to ask the FDA for authorization in 5- to 11-year-olds in October.
Q: How do the new bivalent boosters differ from previous shots?
A: The new shots use the same mRNA technology as the prior Moderna and Pfizer/BioNTech vaccines and boosters but have been upgraded to target the newer Omicron strains. The shots use mRNA created in a lab to teach our cells to produce a specific protein that triggers an immune-system response and make antibodies that help protect us from of SARS-CoV-2, the virus that causes COVID.
The recipe for the new shots incorporates the so-called “spike protein” of both the original (ancestral) strain of the virus and more highly transmissible Omicron strains (BA.4, BA.5). Once your body produces these proteins, your immune system kicks into gear to mount a response.
It’s also possible – but yet to be determined – that the new bivalent boosters will offer protection against newer but less common strains known as BA.4.6 and BA.2.75.
Q: Are there any new risks or side effects associated with these boosters?
A: Health experts don’t expect to see anything beyond what has already been noted with prior mRNA vaccines, with the vast majority of recipients experiencing only mild issues such as redness from the shot, soreness, and fatigue.
Q: Do I need one of the new shots if I’ve already had past boosters or had COVID?
Yes. Even if you’ve been infected with COVID in the past year and/or received the prior series of primary vaccines and boosters, you should get a bivalent Omicron shot.
Doing so will give you broader immunity against COVID and also help limit the emergence of other variants. The more Americans with high immunity, the better; it makes it less likely other variants will emerge that can escape the immunity provided by vaccines and COVID infections.
Q: How long should I wait, from the time of my last shot, before getting a new booster?
A: The bivalent boosters are most effective when given after a period of time has passed between your last shot and the new one. A 2-to-3-month waiting period is the minimum, but some evidence suggests extending it out to 4 to 6 months might be good timing.
A: There are no specific rules about a waiting period after COVID infection. But if you have been infected with the virus in the last 8 weeks, you may want to wait for 8 weeks to pass before receiving the bivalent booster to allow your immune system to get greater benefit from the shot.
Q: If I never got the original vaccines, do I need to get those shots first?
A: Yes. The bivalent vaccine has a lower dose of mRNA than the vaccines used in the primary series of vaccines, rolled out in late 2020. The bivalent vaccine is authorized for use as a booster dose and not a primary vaccine series dose.
Q: Do the Omicron-specific boosters entirely replace the other boosters?
A: Yes. The new booster shots, which target the original strain and the Omicron subvariants, are now the only available boosters for people ages 12 and older. The FDA no longer authorizes the previous booster doses for people in the approved age groups.
Q: What if I received a non-mRNA vaccine produced by Novavax or Johnson & Johnson? Should I still get an mRNA booster?
A: You can mix and match COVID vaccines, and you are eligible to get the bivalent booster 8 weeks after completing the primary COVID vaccination series – whether that was two doses of mRNA or Novavax, or one shot of J&J.
Q: How effective are the new boosters?
A: Scientists don’t have complete effectiveness data from the bivalent vaccines yet. But because the new boosters contain mRNA from the Omicron and the original strains, they are believed to offer greater protection against COVID overall.
Cellular-level data supports this, with studies showing the bivalent vaccines increase neutralizing antibodies to BA.4/BA.5 strains. Scientists regard these kinds of studies as surrogate stand-ins for clinical trials. But officials will be studying the effectiveness of the new boosters, examining to what degree they reduce hospitalizations and deaths.
Q: How long will the boosters’ protection last?
A: Research shows that vaccine effectiveness eventually wanes, which is why we have the boosters. Scientists will be monitoring to see how long the protection lasts from the bivalent boosters through studies of antibody levels as well as assessments of severe COVID illnesses over time, throughout the fall and winter.
Q: Is it OK to get a flu shot and a COVID booster at the same time?
A: Yes. In fact, it’s important to get a flu shot this year because some experts believe we could see overlapping COVID-influenza surges this fall – a phenomenon some have fancifully called a “twindemic.” Getting a flu shot and COVID booster — simultaneously, if possible – is particularly important if you’re in a high-risk group.
People who are susceptible to severe complications from COVID — such as older people, people with weakened immune systems, and those will chronic health conditions — are also especially vulnerable to severe influenza complications.
Q: Will a new booster mean I can stop wearing a mask, social distancing, avoiding crowded indoor spaces, and taking other precautions to avoid COVID?
A: No. It’s still a good idea to mask up, keep your distance from others, avoid indoor spaces with people whose vaccine status is unknown, and take other precautions against COVID.
Although the new boosters are front of mind, it’s a good idea to also use other tools in the toolbox, as well, particularly if you have contact with someone who is older, immune-suppressed, has a chronic condition that puts them at higher risk from COVID.
Keep in mind: The community risk of infection nationwide is still high today, with about 67,400 new cases and nearly 320 deaths reported each day in the U.S., according to the latest CDC reports.
Tech-enabled maternity clinic Millie raised $4 million in a seed funding round led by TMV Ventures and BBG Ventures.
Others participating in the financing round include Venn Growth Partners; Looking Glass Capital; Learn Capital; Hustle Fund; Banana Capital’s Turner Novak; Michelle Kennedy of fertility and motherhood-focused social media platform Peanut; and Tristan Walker, founder and CEO of Walker & Company, a health and beauty brand.
WHAT THEY DO
The startup offers virtual maternity care services and plans to open an in-person clinic in Berkeley, Calif., at the end of the month.
Millie provides patients with a care team made up of an OB-GYN, a midwife and a doula. Patients receive three postpartum visits with a Millie clinician, including the first in-home appointment within a week after giving birth.
They can remotely monitor patients using devices like blood pressure cuffs, and patients can access mental health services, nutrition counseling and lactation support though Millie’s app.
“I had endured an induction, over two days of labor, and an unplanned C-section with near-hemorrhage and, while this was the definition of a high-risk delivery, I was sent home with ‘standard’ care instructions to see my OB in six weeks. That resulted in a near miss,” CEO Anu Sharma said in a statement. “I spoke with Talia, my midwife at the time, and asked her, ‘If you could provide care the way you know people need, what would that look like?’ Today, I’m proud to say that we’re providing that level of attentive care through Millie.”
MARKET SNAPSHOT
Pregnant patients in the U.S. face worse health outcomes compared with other wealthy nations. In 2020, the CDC reported the country’s maternal mortality rate was 23.8 deaths per 100,000 live births, rising from 20.1 in 2019. Black women’s maternal mortality rate reached 55.3 deaths per 100,000 live births, nearly three times the rate of non-Hispanic white women.
In April, virtual behavioral health company Brave Health partnered with the Doula Network, a service that pairs pregnant Medicaid patients with doulas, to add maternal mental healthcare services to its offerings.
Eggplant on the grill is such a simple and delicious side dish! In this recipe, we salt the eggplant to help remove some of the water and moisture from the slices so that you get a flavorful bite that’s crispy on the outside and tender on the inside. Enjoy the eggplant as is with a sprinkle of fresh herbs, or drizzle on balsamic vinegar, tahini sauce or Primal Kitchen Italian Dressing or Balsamic Vinaigrette.
We like using Italian, Graffiti, Chinese or Japanese eggplant for this recipe. They are meaty, firm, and hold up to grilling well. Feel free to adjust grill time depending on your grill and any parts of it that are hotter than others. The end result should be crispy on the outside and soft and flavorful on the inside without being chewy. If the flesh of your eggplant ends up chewy but the outside is already too browned, reduce the heat of your grill a little and cook the eggplant for longer – chewy eggplant usually means it’s undercooked.
How to Grill Eggplant
First, cut off the stem and end of each eggplant. Then slice the eggplants into rings about ½” thick. You can also slice them on an angle or into thick strips if you’d like. Place the sliced eggplant in a large bowl and add a generous pinch of salt. Toss the eggplant to distribute the salt. Place a large cloth or towel on top of a large sheet pan and lay the sliced eggplant out on top of it. Allow the eggplant to rest for 30 minutes or so. You can also place a towel on top of the eggplant and another sheet pan on top of that to push down on the eggplant and release more water.
Blot or wipe the eggplant slices with a towel to remove excess moisture. Then salt and place them into a bowl. Toss in another bowl with the olive oil until the oil coats and starts to get absorbed into the slices.
Heat your grill to medium-high heat and clean the grates well. Once hot, add the eggplant slices and grill for about 2 minutes, then turn them 90 degrees with tongs and grill for another minute or two to get nice grill marks on one side. Repeat on the other side until eggplant is crisp on the outside but soft on the inside. Adjust the time as needed depending on what part of your grill is hottest so the eggplant is cooked through but doesn’t burn. Repeat with the remaining eggplant.
Serve your eggplant with a sprinkle of fresh herbs, a drizzle of balsamic vinegar or tahini, or your favorite Primal Kitchen dressing such as Italian or Balsamic Vinaigrette!
Eggplant on the grill is such a simple and delicious side dish! In this recipe, we salt the eggplant to help remove some of the water and moisture from the slices so that you get a flavorful bite that’s crispy on the outside and tender on the inside.
Cut off the stem and end of each eggplant. Slice the eggplants into rings about ½” thick. You can also slice them on an angle or into thick strips if you’d like.
Place the sliced eggplant in a large bowl and add a generous pinch of salt. Toss the eggplant to distribute the salt.
Place a large cloth or towel on top of a large sheet pan and lay the sliced eggplant out on top of it. Allow the eggplant to rest for 30 minutes or so. You can also place a towel on top of the eggplant and another sheet pan on top of that to push down on the eggplant and release more water.
Blot or wipe the eggplant slices with a towel to remove excess moisture and salt and place them into a bowl. Toss in another bowl with the olive oil until the oil coats and starts to get absorbed into the slices.
Heat your grill to medium-high heat and clean the grates well. Once hot, add the eggplant slices and grill for about 2 minutes, then turn them 90 degrees with tongs and grill for another minute or two to get nice grill marks on one side. Repeat on the other side until eggplant is crisp on the outside but soft on the inside. Adjust the time as needed depending on what part of your grill is hottest so the eggplant is cooked through but doesn’t burn. Repeat with the remaining eggplant.
Serve your eggplant with a sprinkle of fresh herbs, a drizzle of balsamic vinegar or tahini, or your favorite Primal Kitchen dressing (we like Italian or Balsamic Vinaigrette!)
Prep Time:40 minutes
Cook Time:8-10 minutes
Nutrition
Serving Size:1/6 or recipe
Calories:153.3
Sugar:6.7g
Sodium:102.3mg
Fat:12.3g
Saturated Fat:1.7g
Trans Fat:0g
Carbohydrates:11.1g
Fiber:5.7g
Protein:1.9g
Cholesterol:0mg
Net Carbs:5.22g
Keywords: grilled eggplant
About the Author
A food blogger, recipe developer, and personal chef based in Missouri, Priscilla specializes in low-carb, Paleo, gluten-free, keto, vegetarian, and low FODMAP cooking. See what she’s cooking on Priscilla Cooks, and follow her food adventures on Instagram and Pinterest.
Karen Douthitt (left) and her two of her older sisters, Susie Gilliam (center), and June Ward (right) each took a test for the genetic mutation presenilin 1 after their mom got Alzheimer’s disease in her early 60s. Each child of a parent with this mutation has a 50% chance of inheriting it.
Juan Diego Reyes for NPR
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Juan Diego Reyes for NPR
Karen Douthitt (left) and her two of her older sisters, Susie Gilliam (center), and June Ward (right) each took a test for the genetic mutation presenilin 1 after their mom got Alzheimer’s disease in her early 60s. Each child of a parent with this mutation has a 50% chance of inheriting it.
Juan Diego Reyes for NPR
In some families, Alzheimer’s disease seems inevitable.
“Your grandmother has it, your mom has it, your uncle has it, your aunts have it, your cousin has it. I always assumed that I would have it,” says Karen Douthitt, 57.
“It was always in our peripheral vision,” says Karen’s sister June Ward, 61.
“Our own mother started having symptoms at age 62, so it has been a part of our life.”
Nearly a decade ago, Karen, June, and an older sister, Susie Gilliam, 64, set out to learn why Alzheimer’s was affecting so many family members.
Since then, each sister has found out whether she carries a rare gene mutation that makes Alzheimer’s inescapable. And all three have found ways to help scientists trying to develop treatments for the disease.
Bad news on the golf course
I met Karen and June in 2015, at the first-ever conference for families with a particular type of genetic mutation in which Alzheimer’s often appears in middle age.
The annual conference is sponsored by the Alzheimer’s Association and the Dominantly Inherited Alzheimer’s Network Trials Unit, a research program run by Washington University School of Medicine in St. Louis.
Karen and June had come to Washington, D.C., for the family conference because of something they had just learned about a cousin on their mother’s side.
The cousin had developed Alzheimer’s in her 50s. And genetic tests showed that she carried a rare, inherited gene mutation called presenilin 1. It’s one of three mutations that typically cause Alzheimer’s to appear in middle age.
The three gene mutations responsible for early Alzheimer’s are unlike a better known gene called APOE4, which merely increases the likelihood somewhat that a person will develop Alzheimer’s – and usuallyat age 65 or older. In contrast, the early-onset mutations, including presenilin 1, make it almost certain an individual will develop the disease, andusually before age 60.
Each child of a parent who has the presenilin 1 mutation has a 50% chance of inheriting it.
The genetic finding in Karen’s cousin seemed to explain why the sisters’ mother had developed Alzheimer’s in her early 60s. And it meant that any of the sisters, or all three of them, might also carry the mutation.
Karen got the news in March of 2015, during a round of golf.
Her takeaway: “We now have a coin flip of whether we’ll develop Alzheimer’s by the time we’re 62.” That was “kind of a heavy load on the golf course,” Karen told me at our first meeting..
Karen Douthitt learned that a cousin on her mother’s side had undergone genetic testing and was found to be a carrier of presenilin 1, a rare genetic mutation for early-onset Alzheimer’s dementia. The cousin had developed the disease in her 50s.
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Karen Douthitt learned that a cousin on her mother’s side had undergone genetic testing and was found to be a carrier of presenilin 1, a rare genetic mutation for early-onset Alzheimer’s dementia. The cousin had developed the disease in her 50s.
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June had a different reaction: “It was shocking news, but yet there was this element of, ‘oh, so now we finally know what’s been going on.'”
Karen and June talked it over with their older sister Susie.
The sisters had grown up with three other siblings in Swannanoa, a town in the Blue Ridge Mountains of North Carolina. But the three younger girls always had a special bond, “like a three-legged stool,” June says.
So they made a decision together in the spring of 2015.
“We’re doing what we can do,” June told me at the 2015 conference, “which is to participate in the drug trials and try to take what action we can toward a better future.”
They began raising money for the Alzheimer’s Association. And they volunteered for Alzheimer’s drug studies led by researchers at Washington University School of Medicine in St. Louis.
High stakes gene testing
All that happened seven years ago.
This summer, I sat down with Karen and June again. They were attending the annual family conference, this time in San Diego. Susie, the eldest of the three, was there too.
By this time, all three sisters had learned whether they carried the gene mutation.
Karen, the youngest, found out just after the 2015 conference.
“I decided to do gene testing relatively early after that meeting,” she says, “and I’m negative.”
The middle sister, June, waited until March of 2016.
Ward (left) and Douthitt pick wildflowers down the road from their childhood home in Swannanoa, N.C.
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Ward (left) and Douthitt pick wildflowers down the road from their childhood home in Swannanoa, N.C.
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Ward says she and her sisters enjoyed picking honeysuckles on their walks home from school when they were kids.
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Ward says she and her sisters enjoyed picking honeysuckles on their walks home from school when they were kids.
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“I decided I was ready to do genetic testing, just cause I like to know things,” she says. “And I turned out to be genetically positive for Alzheimer’s disease, which means that if I live long enough I will get it, unless the [experimental] medicine works.”
For years, Susie had chosen not to find out whether she carried the gene.
“I asked my husband and my two children, and everybody said they’d just as soon not know,” she says.
Eventually, though, their views changed. And in March of this year, Susie discovered that she, like June, carries the gene mutation.
For years, partly at her kids’ and husband’s urging, Susie Gilliam chose not to get tested for the gene mutation for Alzheimer’s disease.
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For years, partly at her kids’ and husband’s urging, Susie Gilliam chose not to get tested for the gene mutation for Alzheimer’s disease.
Juan Diego Reyes for NPR
At first, she was devastated.
“The next morning I was wallowing in self pity, and what I’m going to miss,” Susie says. “I’m going to miss birthdays, and my grandchildren won’t know me as a healthy person.
“But then on the front porch, in the mountains of western North Carolina, I’m rocking and there’s this single cloud in a Carolina blue sky, and I was praying for Him to take my worries away. And I’m sitting there rocking and this single cloud thins and thins and thins, and then, poof, it’s gone – and with it my worries.”
Douthitt and her sisters grew up in the Blue Ridge Mountains in Swannanoa, N.C.
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Douthitt and her sisters grew up in the Blue Ridge Mountains in Swannanoa, N.C.
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The sisters affectionately call their childhood family compound “the holler.”
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The sisters affectionately call their childhood family compound “the holler.”
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A plan for the future
The situation still worries little sister Karen – even though she’s negative for the mutation.
Late last year, she got some alarming news about her own health. She had breast cancer. But Karen says cancer doesn’t make a person feel helpless the way Alzheimer’s does.
“You go see a surgeon. You go see an oncologist. And then you have surgery and then you have radiation or chemo. There’s a to-do list,” she says. “Susie had her diagnosis in March and her to-do list is: Go see an attorney, make a will.”
Karen knows that June and Susie could develop symptoms at any time. She says that will be devastating for her family, which dotes on them.
“We call ’em marshmallows, ’cause they’re so sweet,” she says.
June has found some measure of solace by participating in Alzheimer’s research studies.
She knows the experimental drugs she’s taking are unlikely to help her. But she hopes they’ll eventually lead to treatments that will make a difference to younger members of her family.
“If anything I do can have a positive effect for their lives and their future, I’m all in,” she says.
Even though the sisters hope a successful drug treatment for their family’s form of dementia will emerge, they’re now planning for a future without one. “There’s a kind of sorrow about Alzheimer’s disease that, as strange as it seems, there’s a comfort in being in the presence of people who understand it,” Ward says.
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Even though the sisters hope a successful drug treatment for their family’s form of dementia will emerge, they’re now planning for a future without one. “There’s a kind of sorrow about Alzheimer’s disease that, as strange as it seems, there’s a comfort in being in the presence of people who understand it,” Ward says.
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June also has become a regular at the annual conference for families affected by the early Alzheimer’s mutations. She says it’s a place to hear about scientific advances — and feel a sense of ease.
“There’s a kind of sorrow about Alzheimer’s disease that, as strange as it seems, there’s a comfort in being in the presence of people who understand it,” she says.
June says attending the conference also reminds her that some other families carry a more extreme version of the gene mutation.
“Sometimes I feel guilty because I’m a 61-year-old woman with the gene who can still have a conversation and not make too many faux-pas,” she says. “There are people in their 30s here that are struggling already.”
The three sisters are still hoping for a drug that can slow down Alzheimer’s. But they are also planning for a future without that drug.
Karen and her husband have moved back to her childhood home in the Blue Ridge mountains. They live in the same small house where she and her siblings were raised. It’s part of a family compound they call “the holler.”
“I say it’s like the Kennedy compound except redneck,” Karen says. “Some of the houses have wheels on them. But my dream is to have both of my sisters there.”
“The good thing is we would be surrounded by family and people that have known us since we were children,” June says. “So if we walked away, somebody would help us find our way back home.”
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