Immunity Debt: Does It Really Exist?

Illustration by Klawe Rzeczy.

The deaths of at least 190 people, including 30 children, from the invasive bacterial infection group A streptococcus, or strep A, are the most extreme consequences of a wave of winter infections that have seemingly left most of the country coughing and sneezing. The parlous state of the nation’s health has prompted suggestions that we are now paying an “immunity debt” incurred by the reduction of common infections during the Covid-19 lockdowns of 2020 and 2021.

But experts seem divided about whether the debt concept is genuine, let alone whether it explains the prevalence of non-Covid afflictions. As with so many of the debates about the outcomes of the pandemic, there do not appear to be simple answers – but no shortage of self-proclaimed “experts” ready to give them anyway.

While there are good reasons to believe that the measures taken to reduce the spread of the coronavirus have broader implications for common infectious diseases, there is no one-case-fits-all explanation for the spate of winter bugs, much less any obvious conclusions to be drawn about pandemic management.

Are the infection rates really so unusual anyway? Cases of strep A and associated scarlet fever certainly seem unusually high, with 37,068 recorded cases of the latter up to 8 January, compared to 4,490 at the same point in the earlier high season of 2017-18. But whether there is an anomalous prevalence of common infections across the board is less clear. “For some of the infections, we don’t really know,” says Petter Brodin, professor of paediatric immunology at Imperial College London.

Every winter, there is an upsurge in common infections such as flu, colds (caused by various viruses) and respiratory syncytial virus (RSV), which produces cold-like symptoms. Bacterial infections follow a similar seasonality, according to Michael Levin, professor of paediatrics and international child health at Imperial because they tend to take opportunistic advantage of an immune system weakened by a virus. RSV in infants and young children, for example, sometimes leads to bronchiolitis, an infection of the respiratory tract that can be serious.

At this time of year, “having hospital beds filled with children and adults with viral disease and pneumonia is not unusual”, says Levin. But although there is as yet little hard data, he adds that “there is an impression that we are having an unusually severe winter with RSV, flu and adenovirus”, the last of which causes cold-like symptoms. He adds: “We’re seeing increased numbers of children with severe bacterial infections – there is definitely more streptococcal infection around.”

There are similar reports across North America, while unusually high levels of RSV in children reported in Australia and New Zealand in mid-2021 provoked the first mentions of Covid immunity debt. Brodin agrees that something seems unusual both in the timing and the numbers of infections. In Sweden, where he was working until moving to Imperial in October 2021, the incidence of RSV was markedly unusual last year too.

If that is the case, what is the cause? “Here we enter the realm of guessing and speculation,” says Levin. It’s not clear that there is a general answer. “Every bug has a different dynamic,” concurs Brodin. Flu surges across the globe, driven largely by temperature changes and people’s travel behaviour, whereas RSV is present all the time in the population and usually peaks about November to December in the UK. The incidence of such infections also depends on how many children are born each year, since newborns have essentially no immunity.

Our immune systems need exposure to pathogens to maintain a good level of resistance. Many common infections such as colds are caused by endemic viruses and bacteria that people often carry asymptomatically because their immune systems keep the pathogen in check. For example, many people carry the meningococcal bacteria that cause meningitis, but only about one in 50,000 were, before vaccines, at risk of getting ill from them. “The normal state for most of these things is asymptomatic carriage,” says Levin.

Such symptom-free, low-level infection can prime the immune system to ward off another infection months or even years later. “Children and adults do build up a repertoire of immunity from exposure,” Levin says – as every parent knows, young children in particular are constantly exchanging common pathogens. But such immunity generally wanes, so if you haven’t been exposed for some time, for example, because of social distancing and lockdowns during 2020 and 2021, you will be more susceptible.

“It’s plausible that we may now have a population that has met fewer common viruses and is therefore more susceptible,” says Levin. Moreover, if fewer people have such immunity, there will be more transmission in the population. “Children normally catch scarlet fever in their first year at school, if at all,” says Shiranee Sriskandan, professor of infectious diseases at Imperial. “Scarlet fever rates plummeted during 2020-2021.

Therefore, school-age children may not have built up immunity to strep A, so we now have a much larger cohort of non-immune children.” A study last June reported that, because of reduced transmission of common respiratory viruses during the pandemic, breastfeeding infants were being passed fewer protective antibodies from the mother.

But whether there is a generalised immunity debt is less clear. How long post-infection immunity lasts varies from one virus to another. And for flu viruses, infection in one season may or may not offer protection in the next, depending on how closely related the two strains are. Levin says that in many cases we don’t really know how much repeated exposure is needed to sustain immunity – for some diseases, such as smallpox and measles, just one infection generally gives lifelong protection.

Another reason that has been proposed for enhanced infections this season is that Covid-19, which most of the population has now experienced at least once, has itself weakened some people’s immune systems. But this will probably not be widespread, if it happens at all. While there is evidence of immune dysfunction persisting for many months in some people who catch Covid, this is not so much a weakening of immunity as a problematic overactivation.

A study published last January by Prof Gail Matthews, an infectious diseases physician at the University of New South Wales in Australia, and her colleagues showed overactive immune function up to eight months after Covid infection in some people. “The most likely reason for this is some level of viral persistence that the immune system is recognising as foreign and still reacting to,” Matthews says. But she doubts that there is any evidence of widespread Covid-induced immune impairment.

Lockdown was the right strategy for a new disease with a totally susceptible population and probably saved thousands of lives

Brodin has seen similar Covid-related immune dysfunction. He and his co-workers have studied children with multisystem inflammatory syndrome, a rare but serious condition in which an extreme response a few months after infection has to be treated with immunosuppressants. He says that for some people with long Covid too: “There is clearly something wrong with the way the immune system continues to be activated.”

But whether any such problems arise for the majority of people who have mild Covid symptoms is far less clear, he says. “There’s nothing that suggests that, although we can’t rule it out.” Lockdowns and social distancing do seem to have reduced infections such as flu and RSV during the pandemic. But if it turns out that those measures have contributed to higher rates of such infections now, what conclusions should we draw? Opponents of lockdowns say that it highlights another of their flaws, for which we are now paying a heavy price.

That position makes little sense. There is compelling evidence that lockdowns and social distancing saved lives, especially while vaccines were still not available. A day or two in bed with a bad cold seems a small price to pay for that. A small minority of researchers have, however, questioned whether lockdowns really made much difference to the spread of Covid.

Infectious-disease epidemiologist Sunetra Gupta of Oxford University asserted in the Daily Telegraph that lockdowns do little to slow the spread of an epidemic disease such as Covid-19 but have much more impact on endemic diseases such as colds and RSV. But Brodin is dismissive of such a crude division into epidemic versus endemic diseases. “It’s incredibly far-fetched to say that is the uniform solution,” he says.

Besides, he adds, how then to explain that RSV is also running riot now in Sweden, which famously eschewed lockdowns and kept schools open? Those who have noisily championed the Swedish approach to the pandemic can hardly argue that it would have made any difference to our alleged immunity debt now. In short, Brodin says, it is much too simplistic to say: “What we’re seeing in children’s hospitals is simply the result of lockdown.”

Besides, Levin adds: “Lockdown was an essential public health measure. It was the right strategy for a new disease with a totally susceptible population and probably saved thousands of lives.” A much more fruitful response to the surge in infections, says Brodin, is to “be thinking about how we develop better vaccines and get people to take them”. We should be developing and rolling out vaccines against flu (for which multistrain “universal” jabs are now being trialled) and RSV (for which a vaccine is on the near horizon) much faster, as well as thinking more seriously about non-pharmaceutical interventions such as wearing masks.

“It seems absolutely insane to me that we should get on a packed tube at rush hour and there will be people sneezing and coughing and not wearing a mask to protect others,” says Levin. “In Asian countries, you have always worn a mask if you have a cold.” He adds that we should also stop encouraging ill people to go to work and continue to advise hand washing and good hygiene. Flu, for instance, is spread mostly by people touching infected surfaces and then their eyes.

Such measures “could greatly reduce the burden of infection in the population”, he says. But vaccines are key. “Many of these severe diseases are vaccine-preventable and we should be ensuring that as many of the population as are susceptible are protected,” says Levin. If we rely on natural infection to build up immunity, though, isn’t that better than getting vaccinated? No, says Prof Peter Openshaw, who heads the infection programme of the Biomedical Research Centre at Imperial.

The immune response a vaccine awakens is “just as ‘natural’ as the response you get to the virus, sometimes even better, and certainly less dangerous”. “I can’t think of an example of a viral infection being better than getting vaccinated,” Openshaw adds. What’s more, the point of a vaccine is to protect those who would otherwise probably develop severe disease – and predicting who those people are is not always possible.

“We vaccinate all to protect the few, because we can’t identify the vulnerable,” says Levin. Covid should have taught us that. Casting this debate in terms of an immunity debt is therefore potentially misleading, as it implies that this is a zero-sum game: you have to keep paying with infections to stay in credit. Vaccines can simply cancel the “debt”. Who wouldn’t want that?

By:

Source: Immunity debt: does it really exist? | Science | The Guardian

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When A Mutual-Fund Converts To An ETF: How It Works

Asset managers continue to convert some of their mutual funds into exchange-traded funds. So what does that mean for investors? A 2019 change to the rules governing investment funds made it easier for managers to convert mutual funds to ETFs by removing the need for separate approval of each potential conversion by the Securities and Exchange Commission.

A handful of asset managers, including Dimensional Fund Advisors and JPMorgan Chase & Co.’s J.P. Morgan Asset Management, have recently converted actively managed mutual funds into actively managed ETFs. They say the change is in response to the preference of many investors for ETFs, which generally offer lower fees than mutual funds and provide a tax advantage.

Investors in the funds being converted might appreciate those benefits. But they need a brokerage account to keep the new ETF, and may have some tax consequences if they own fractional shares of the mutual fund.

Why convert?

The initial group of conversions has mostly been in actively managed stock or bond funds. For example, J.P. Morgan completed conversions of four funds in June, an actively managed fixed-income fund now called JPMorgan Inflation Managed Bond ETF (JCPI); an active equities fund, now JPMorgan Market Expansion Enhanced Equity ETF (JMEE); a real-estate income fund, now JPMorgan Realty Income ETF (JPRE); and a global equities fund, now JPMorgan International Research Enhanced Equity ETF (JIRE).

Dimensional Fund Advisors converted a $30 billion suite of actively managed systematic funds last year. Systematic funds’ investment decisions are largely guided by models based on extensive market data, rather than left purely to the fund managers’ discretion.

Analysts say actively managed funds are likely to be where most conversions happen. That’s because active funds have higher fees than passive ones and tend to generate more taxable gains through trading, which makes them more vulnerable to investors’ preference for lower fees and taxes.

There is a recognition among asset managers that there is a better way to offer certain strategies, and that’s coming alongside investor demand for ETFs,” says Daniel Sotiroff, a Morningstar analyst. Even mutual funds that already have some of the qualities of an ETF can benefit from conversion, he says. “If you look at what Dimensional converted, those funds were already tax managed as mutual funds,” meaning they were designed to minimize investors’ tax burden. “The ETF structure makes that process easier to do and comes with lower fees.”

He notes that ETFs typically don’t charge the so-called 12b-1 fees that mutual funds do. These fees, which are named after the SEC rule that allows them to be charged, cover the marketing and distribution of a mutual fund or ETF. ETFs also tend to have fewer trading transactions than mutual funds, which means they have lower transaction costs, because trades aren’t triggered by asset inflows and outflows in ETFs as they are in mutual funds.

ETFs offer a tax advantage because, since they can make fewer trades, they distribute fewer, if any, capital gains to investors. Some mutual funds are designed to distribute fewer gains, but investors are still likely to see taxable distributions over the course of their investment in a mutual fund.

The higher fees of actively managed funds and the taxes on capital gains from distributions have led to outflows in favor of actively managed ETFs with similar strategies for a number of years. The SEC rule change for conversions gives investors the option to stick with the same strategy and managers at a lower cost.

For fund managers, a conversion allows them to keep the performance record of the mutual fund as well as any investor assets in the fund that stay through the conversion. That can give the new ETF a leg up over a newly launched ETF, as many investors and financial advisers want to see a substantial record and enough assets to support the long-term viability of a fund before investing.

What to watch for

For investors in a mutual fund that is up for conversion, there are a few things to keep in mind. Those who invested in a mutual fund through a transfer agent instead of a broker, which is common, will need a brokerage account to be able to hold and trade the ETF. If they don’t have a brokerage account, there are many low-cost brokers, with some offering low or no minimums to open an account, but it may be a bit of a learning curve for those who haven’t used a brokerage account before.

ETFs also don’t offer fractional shares. Any fractional shares of the mutual fund held at the point of conversion will be redeemed and could result in a taxable gain.

A conversion may also require approval from shareholders, and if enough shareholders don’t want to convert, fund managers may opt to offer a separate ETF that runs the same strategy. Individual investors can then decide to move into the ETF on their own, but that could result in tax consequences when they sell out of the mutual fund if they end up with capital gains.

By:

Source: When a mutual-fund converts to an ETF: How it works | Mint

Critics by By Matthew Romano

Mutual fund” is the common term for an investment vehicle that pools money from multiple investors and invests in various assets such as stocks and bonds. Most traditional mutual funds, commonly referred to as “open ended” funds, issue shares directly to shareholders and redeem them at the demand of the shareholder at the fund’s net asset value (NAV). Mutual funds register with the SEC under the Investment Company Act of 1940 (the Act).

While an exchange-traded fund (ETF) is similar to a traditional mutual fund in that it pools money into a fund to invest in various assets and can register with the SEC under the Act, it differs in that its shares are traded on a secondary market as opposed to directly between the shareholders and the fund. One or more intermediaries, referred to as authorized participants, seed the fund with cash and/or stocks in exchange for the fund shares and then list those shares on a secondary market to be bought and sold by the prospective fund shareholders.

A traditional mutual fund can be converted to an ETF. The present discussion focuses on the tax implications of doing so. A conversion may be appealing because of the greater tax efficiency of ETFs (discussed below), lower expense ratios, and the fact that a conversion utilizes the scale and performance of an existing fund. Mutual funds’ appetite for converting was further enhanced by the SEC’s approving Rule 6c-11 in 2019, which reduced the time and cost of launching an ETF.

Tax efficiency of ETFs

Both traditional mutual funds and ETFs that are domestic corporations — if they are registered with the SEC under the Act and meet certain diversification, income, and distribution requirements — are taxed as regulated investment companies (RICs) under Subchapter M of the Internal Revenue Code. Under these rules, they are not subject to entity-level tax if they distribute their net income and capital gains via dividends to their shareholders. Shareholders with nonqualified taxable accounts ultimately bear the tax burden.

ETFs are often more tax-efficient than traditional mutual funds, however. In the case of a mutual fund, besides the trading that occurs in the normal course of business, other transactions at the fund level can result in an increased tax burden for the shareholders. For instance, a portfolio rebalance and/or change in investment strategy can result in the fund’s recognizing substantial gains. Large redemptions can also cause a mutual fund to recognize gains because it may need to sell securities to raise the cash to meet the redemption request.

The ETF structure can mitigate or even eliminate this tax burden. With respect to redemptions, Sec. 852(b)(6) provides that a RIC that redeems shareholders with “property” instead of cash will not recognize any gain from the disposition of that property. While this provision applies to both traditional mutual funds and ETFs, mutual fund shareholders will almost always prefer a cash redemption, while authorized participants are usually indifferent.

With respect to a rebalancing of the portfolio, ETFs can utilize either a redemption basket (of securities) or a creation basket (of securities) between the ETF and the authorized participants. This allows the ETF to avoid recognizing and distributing taxable gains to the shareholders.

The conversion transaction itself

While the conversion of a traditional mutual fund to an ETF has numerous legal and operational hurdles, the details of which are outside the scope of this discussion, the tax structuring is fairly simple. Typically, the fund sponsor will create a shell ETF for purposes of the conversion. This ETF will likely have the same investment objectives, board of directors, and management as the original mutual fund. After the shell ETF is created, the original mutual fund merges into the shell ETF.

If structured properly, the merger will qualify as a tax-free reorganization under Sec. 368(a)(1)(F) (F reorganization). The requirements of an F reorganization, detailed in Regs. Sec. 1.368-2(m), are listed below:

  • Immediately after the F reorganization, all the stock of the resulting corporation, including any stock issued before the potential F reorganization, must have been distributed in exchange for the stock of the transferor corporation.
  • The same person or persons must own all the stock of the transferor corporation and of the resulting corporation in identical proportions.
  • The resulting corporation may not hold any property or have any tax attributes immediately before the F reorganization.
  • The transferor corporation must completely liquidate as part of the transaction.
  • Immediately following the potential F reorganization, no corporation other than the resulting corporation may hold property that was held by the transferor corporation immediately before the reorganization.
  • Immediately following the potential F reorganization, the resulting corporation may not hold property acquired from a corporation other than the transferor corporation.

Given the nature of the conversion of a traditional mutual fund to an ETF, it is likely that the transaction will meet the above requirements. Assuming it does, an F reorganization is considered a “mere change of form” for tax purposes. As such, the fund tax year end, employer identification number, and all tax attributes from the original mutual fund remain.

There are some other ancillary tax implications of the conversion. The mutual fund may want to sell some assets prior to the conversion; this could result in some taxable distributions to shareholders. Also, unlike traditional mutual funds, ETFs generally do not issue fractional shares, so these will be redeemed with cash prior to the conversion and could result in a nominal amount of tax.

Other items to consider

While this item focuses primarily on the tax impact, some nontax aspects of converting a traditional mutual fund to an ETF should also be considered:

  • Shareholders may need to set up a brokerage account to hold the ETF shares.
  • Unlike traditional mutual funds, ETFs can trade at a premium or discount to NAV, which can create some level of risk to the shareholder. However, the create/redeem process between the ETF and the authorized participants can operate to reduce any premium or discount spreads.
  • Approval by the mutual fund’s board of directors may be required to complete this transaction.

Potentially significant benefits

While substantial operational and legal obstacles need to be considered and addressed, the conversion of a traditional mutual fund to an ETF can have significant tax benefits, depending on the nature of the fund’s activities and the makeup of the fund shareholder base.

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The Effects of Self-Centered Parenting on Children

Many children suffer grave emotional problems from living with a self-absorbed parent. The child is disregarded and used as an extension of the parent. Often, this means the child’s physical wants and needs, points of view, and emotional needs go unmet.

The Role-Reversal Relationship

Everything revolves around the self-absorbed parent. The relationship is one-sided and directed by the parent. Such a parent enlists the child in caring for and catering to him or her. This creates a role-reversal relationship that is inappropriate for the child’s growth, development, and welfare.

Self-absorbed parents have many characteristics in the ways they relate with their children These relationship traits are well summarized by both Nina W. Brown, EdD, LPC, in Children of the Self-Absorbed and by Lindsay C. Gibson, PsyD. in Adult Children of Emotionally Immature Parents. Such parents manipulate the child to ensure the spotlight of admiration stays on the parent. They lack empathy for the child’s emotional needs. They may show jealousy with any steps the child takes toward individuation––being his or her own person.

Children’s Emotional Responses

Children are affected by growing up with a self-focused parent. When a child is not related to as an individual, a separate person from a parent, there are many emotional and psychological consequences for the child. When a child’s individuality is disregarded, it affects self-esteem and confidence. Low self-esteem in turn can create anxieties and depressions, suicidal thoughts, substance abuse, and runaway behaviors.

There are a wide variety of consequences children suffer in growing up with a selfish parent. Are there discernible patterns to their suffering? Homer B. Martin. M.D., and I found that there are. Children respond to self-centered parents differently based on the child’s personality style. This style is created by how a child is emotionally conditioned within the family. We discovered personality styles form into two types––omnipotent and impotent.

Effects on Omnipotent Children

Omnipotent children try hard to satisfy selfish parents. The omnipotent label comes from the child’s unconscious belief that he or she is psychologically strong and able to fulfill the parent’s needs and requests, no matter how inappropriate. Such children are trained to be emotionally attuned to what the parent needs and wants. It’s a tall order and an impossible job for adults, much less a small child.

A child with an omnipotent personality acts as a complement to a self-focused parent. The omnipotent child will attempt to care for and meet a selfish parent’s needs and desires. Since omnipotent children strive to do what Dad wants or be what Mom demands, they fall short. Selfish parents ask too much and are capricious, readily changing their demands. When these children fail to please selfish parents, they feel guilty, berate themselves, and lose self-esteem and confidence.

Omnipotent-role children feel anxious, get depressed, and believe they are of little value for failing the selfish parent’s demands. This puts them at risk for emotional illnesses of depression, academic failure, social withdrawal from friends, suicidal thoughts, substance abuse, and eating disorders.

Effects on Impotent Children

The other emotionally conditioned role for children in families is the impotent role. These children are raised differently from omnipotent children. Impotent refers to their unaware belief and actions of helplessness in their relationships. They are raised to be self-absorbed, like the self-centered parent. In this situation there are two peas in a pod. Parent and child are alike in personality.

An impotent parent and impotent child robustly compete with one another. Each wants to be the top dog in the relationship. Each wants his or her way. Young impotent children are often bullied by their selfish parent with put-downs and name-calling. At other times they may be favored children, regarded by selfish parents as special. This happens because the parents project their own specialness and self-centered view onto the child. It is like looking in a mirror.

Older impotent children and teenagers bully and fight back with their impotent parent. This can create verbal and even physical conflict, as they both erupt with demands to gain their way in the relationship. Impotent personality teens may run away from home, self-mutilate, abuse substances, or become involved in legal troubles. They are more likely to be outwardly volatile in their reactions to a self-absorbed parent than are omnipotent personality children, who curtail their emotional reactions.

Difficulties Follow into Adult Life

Unfortunately, the effects of living with a self-absorbed parent do not vanish at the end of childhood. As children grow to adulthood, they continue to relate to other selfish people the same way they were emotionally conditioned to do as a child. We discovered that omnipotent personality children often marry self-focused mates. They focus on pleasing and caring for their partner. They neglect themselves in the relationship. Often, they walk on emotional eggshells, striving to never upset their mates.

Impotent children may form the same high-conflict relationships with other selfish people. They will always be in a contest to get their way in the relationship. They may have frequent emotional blowups and even physical altercations.

A Way Out

Hopefully, self-absorbed people will want to improve themselves before they become parents. They can do this by taking honest stock of their own emotional conditioning style.How were you raised? Were you indulged and allowed to have your way a great deal? Did other family members give in to your requests, demands, or tantrums, no matter how unreasonable they were? Do you expect others to meet your desires and never thwart you?

If answers to these questions are positive for you, then you were likely raised in an impotent role. Your job before becoming a parent is to undo some of your emotional conditioning. Seek out psychotherapy and work with a therapist. By so doing you can be prepared to raise your children in a reasonable way, listening to their needs and viewpoints and imposing judicious guidance and discipline. By undertaking the job of changing yourself, their childhoods will not be all about you.

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Weight Loss: Why We Should Stop Complimenting It

(CNN)If your friend has recently lost weight, you might want to tell her how great she looks. Maybe you also say that you wish you had her body or self-control or you ask her how she did it. Perhaps you’ve been on the receiving end of such a “compliment” in the past. Such comments are well meaning but can have unintended negative consequences.

“In that case, we are unintentionally exacerbating or affirming the thin ideal that our society tends to emphasize and idolize,” said Alvin Tran, an assistant professor of public health at the University of New Haven in Connecticut, who does research on eating disorders and body image. “We need to be very cautious when we do approach conversations around someone’s physical appearance, especially their weight.”

This is especially important when talking to people with eating disorders or serious body image issues, since such remarks can worsen their situation. Compliments about someone’s weight loss or thinner body perpetuate society’s deep-seated diet culture, Tran said, and the idea that thinness is inherently good.

“We do tend to operate (as if) we can somehow look at people and, based on body size, determine whether they’re healthy,” said Tamara Pryor, a senior fellow and director of research at ED Care, an eating disorder treatment center based in Denver.

“We have people in large bodies that are in a state of malnourishment as well as people in extremely low size that are malnourished, and people that are standard size but still very severely compromised by an eating disorder. People can’t look at them and tell that.”

But if you’re pleased or wowed by how someone looks, should you not compliment them at all? What is and isn’t OK to say? CNN asked for advice from Pryor and Joann Hendelman, the clinical director of the National Alliance for Eating Disorders.

The following conversation has been lightly edited for length and clarity

CNN: Why else is complimenting someone’s weight loss or thinness problematic?

Tamara Pryor: It’s intrusive. Whose business is it for us to be passing judgment, particularly expressing it verbally? We might look at people and make judgment calls, but we need to keep it to ourselves. I come from the second wave of the feminist movement, where it was “my body, my business.” That still stands to be the case.

CNN: How might people on the receiving end feel?

Pryor: If somebody said to me, “Oh my gosh, you look great. You’ve lost some weight,” I would find myself thinking, “What did you think of me beforehand? Was I not acceptable?” I could imagine the pressure the receiver would then feel to maintain the lower weight or lose more weight to receive more praise or be accepted.

They might think, “What about me and the essence of who I am as a human being?” There are both physical consequences and significant psychological consequences that get perpetuated.

Joann Hendelman: If you don’t get that compliment, then it becomes, “There’s something wrong with me. I’m not good enough.”

CNN: What should people consider when they want to praise someone’s thinner appearance?

Pryor: Any questions regarding appearance tend to be triggering, and they’re more triggering for people with eating disorders, because they have such a heightened sensitivity about how they’re being judged based on body shape and size.

My patient and her mother went to a clothing store. She’s extremely low weight and anorexic, and had just started treatment. As she’s in the dressing room, her mom gasps, because when she saw her daughter trying on clothes, she realized how extreme the weight loss was. In comes the clerk, who hears the mom say, “Oh, honey, I’m so sorry. I had no idea that your weight had gotten so low. I’m so grateful that you’re in treatment now.”

The clerk said, “Are you kidding? I would die to be that thin. How did you do it?” So, then the patient has this mixed and conflicted response: She can feel her mother’s very real concern, but on the other hand, she’s getting complimented.

Hendelman: I have known and worked with people who had cancer or another reason why their bodies were small. For them, compliments are very uncomfortable because they know they have this horrible illness, and yet people are complimenting them on this weight loss that they would give everything not to have.

CNN: What can people say instead?

Pryor: Find ways to engage that don’t include commentary on their bodies.

Eating disorder resources

US: National Eating Disorder Association

The NEDA has a confidential, toll free helpline at 800-931-2237 as well as an online click-to-chat service. For 24/7 crisis support, text “NEDA” to 741-741.

The NEDA also has a list of recommended websites and free or low-cost resources.

US: National Association of Anorexia Nervosa and Associated Disorders

ANAD runs a helpline at 888-375-7767 from 9 a.m. to 9 p.m. CT and provides links to support groups and treatment providers.

Australia: National Eating Disorders Collaboration

A call center at 800-334-673 and online chat run by the Butterfly Foundation is open 8 a.m. to midnight AET every day except public holidays.

UK: Beat Eating Disorders

Helplines for England, Scotland, Wales and Northern Ireland are open 9 a.m. to midnight weekdays and 4 p.m. to midnight weekends, every day of the year.If someone needed to lose weight for health reasons, complimenting them on their tenacity in achieving that goal isn’t best. Because then it’s like, “Oh, boy, what if I fail or gain some weight back?” That feels like a lot of pressure. Instead, if someone brings up recent weight loss, ask how they feel about the weight they’ve lost or what made them do it, rather than making a judgment yourself.

Hendelman: Compliment them on what they’re wearing, or say something like, “Your eyes are so bright today” — those kinds of things. If a friend is still so tied to being skinny in order to get compliments, and I say how fantastic that is, I am supporting their focus on their body size and doing them a disservice.

CNN: How can people stop perceiving weight loss or thinness as ideal and inherently good?

Pryor: Think about what being healthy means and what your body can do for you — such as taking in the nutrients you need or gaining strength.

Hendelman: If we could all accept that our bodies get us from this position to the next position, and that it’s not about the way our bodies look, but what’s inside — it’s amazing how much our bodies can give us back.

It’s important to accept who we are and our uniqueness. We have to accept our genetics. The more we can accept our bodies, the healthier we are likely to be. Believe that our bodies know best.

Source: Weight loss: Why we should stop complimenting it – CNN

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Beauty Products are Full of Risky Chemicals

Six years ago, I felt a lump in my breast and felt utterly betrayed by my body. Three exams, two ultrasounds, and one biopsy later, doctors discovered multiple benign breast tumors that will require a lifetime of monitoring. Lumps like mine seem to show up in people whose breast tissue is sensitive to the hormone estrogen.

I was 21 and still in college, but the seeming invincibility of youth quickly fell away; I felt anxious and vulnerable like never before. But I was inspired to learn more about my body and the chemicals I was in contact with every day, in everything from hair relaxers to styling creams.

About 10 percent of women will experience the same diagnosis, fibroadenoma, in their lifetime. While fibroadenoma hasn’t been linked to an increased risk of breast cancer, all I could think about was how I’d spend years living with the consequences of something I couldn’t see or feel: hormones.

Hormones affect all of us, as they carry messages between different parts of the body. We’re talking estrogens, androgens, progesterones, testosterone, and everything in between. Together, they make up the endocrine system, which impacts our reproductive health, metabolism, and a range of biological processes.

Over the years, I tried to limit my exposure to synthetic hormones, including hormonal birth control. But our society doesn’t make it easy, even when it comes to potentially harmful chemicals. For years, scientists have been studying potential links between human cancers and the growth hormones that farmers feed to livestock, to take just one example. An even more pervasive threat lurks in everything from cleaning products to cookware to fragrances: endocrine-disrupting chemicals (EDCs), which I’d never even heard of until I studied environmental policy in graduate school.

“It’s pretty safe to say that everyone likely has some level of EDCs in their system,” says Heather Patisaul, associate dean for research at North Carolina State University. “There are hundreds if not thousands of EDCs in the marketplace, so it’s just a question of what your personal exposure profile looks like.”

EDCs are a class of chemicals that interfere with normal hormone function. They include “forever chemicals,” also known as PFAS (per- and polyfluorinated substances), which are found in adhesives, nonstick cookware, food packaging, and even waterproof mascara. The CDC writes that PFAS are found everywhere from the soil to our bloodstream, and that in studies that fed large amounts of them to animals, they affected reproduction, immunity, and the thyroid and liver. (The CDC also notes, “Human health effects from exposure to low environmental levels of PFAS are uncertain.”)

Other EDCs like bisphenol A (BPA) and alkylphenols target estrogen receptors. And phthalates — a chemical used to make plastic soft and flexible — can be found in a slew of cosmetics, and targets both estrogen and testosterone receptors. Even low-level exposure to EDCs can result in minute changes to the body’s natural hormonal activity.

And although illnesses can come about from a combination of genetic, environmental, and behavioral factors, environmental health researchers continue to link EDC exposure as a possible risk factor in the development of immunity related diseases, neurological diseases, reproductive disorders, and breast and uterine cancer.

Our society makes potentially harmful chemicals hard to avoid

I wanted to learn how to lower my risks from personal care items with help from science, so I joined a consumer study led by the Silent Spring Institute, a research and advocacy organization that studies toxins in the environment. For three months, I meticulously tracked my personal care, right down to the brands I used and how often I used them.

It isn’t just that beauty products are full of hard-to-pronounce and potentially harmful chemicals. The study, a partnership with the Resilient Sisterhood Project and published as the POWER study, also validated previous findings that Black women like me purchase more hair products than other groups, and that these products are more likely to contain endocrine disruptors. The results rocked me to my core.

“There’s a disparity in exposure to chemicals that act like hormones,” says Robin Dodson, a chemical exposure researcher at the Silent Spring Institute. “When you look at general health trends, Black women have higher rates of hormone-mediated diseases like uterine fibroids, aggressive forms of breast cancer, fertility issues, and are more likely to have pre-term births.” As a Black woman with my own health condition related to hormones, I was starting to see connections between health issues in my community and the products we rely on.

How I purged worrisome chemicals from my beauty care

Cosmetics are a billion-dollar industry in the US, but remain woefully underregulated. Consumer protections against harmful chemicals hinge on product labels, but labels are hard to understand and aren’t always fully transparent. We’re all living with the consequences, and Black women in particular are paying a high price. Here’s how I’ve changed my beauty care with help from science and research, and how others can too.

Use a trusted source to compare products

For me, one of the most valuable parts of joining the POWER study was having a forum to navigate hair care questions with other Black women. When researchers asked participants how we discover new product recommendations, we pointed to social media, friends, and family. How many people cross-reference those word-of-mouth recommendations with a scientific database? That’s now a core step in my discovery process.

Screenshot 2022-01-04 at 21-44-09 Done For You Commission Machines

Some companies are better at avoiding chemicals of concern than others. When I’m in doubt, I look to the Environmental Working Group’s Skin Deep database, which gives a complete profile of chemical ingredients of concern in skin and hair products.

Reviewing the Toxic-Free Beauty pocket guide, tailored for products commonly used by Black women, helped me get familiar with the chemical names I might see on product labels. Keeping tabs on the FDA’s product safety alert page informs me of product recalls and FDA consumer warnings. Apps like Think Dirty will do the research for you; simply use your phone to scan a product’s barcode, and it displays a clear overview of health impacts associated with its ingredients.

Of course, these apps are only as good as the product label itself. Since new products enter the market constantly, Detox Me, developed by the Silent Spring Institute, shares practical tips for more conscious purchasing. Tools like these draw on years of scientific evidence to help you decode product labels and steer clear of potentially harmful chemicals.

Avoid unspecified fragrances

“Secret, unlabeled fragrance chemicals are hiding in personal care products, without the public’s knowledge or consent,” says Janet Nudelman, policy and program director at the advocacy group Breast Cancer Prevention Partners. “These chemicals are often linked to both environmental and public health harms, but people don’t know because companies don’t have to disclose them.”

While the FDA requires cosmetics to list other kinds of ingredients, many fragrance chemicals are protected as trade secrets and may appear as simply “perfume” or “aroma” on product labels. Fragrances are often mixed with aldehydes, which may increase cancer risks in some people, and benzophenone derivatives, which may be endocrine disruptors, according to the advocacy coalition Campaign for Safe Cosmetics.

When the campaign tested 17 of the most popular perfumes in 2010, in partnership with the Environmental Working Group, it found 14 undisclosed ingredients in the average product, among them chemicals associated with hormone disruption.

Even “unscented” products may contain fragrance ingredients to mask unpleasant smells without giving the product a notable odor.

States like California are starting to close this “fragrance loophole” with stricter product labeling laws. In the meantime, you can do your own research to avoid products with vague fragrance labeling and other undisclosed ingredients.

Understand your body and what it needs

After 10 years of relaxing my hair, I wanted to assert my newfound independence and went natural, but was soon overwhelmed by the array of creams, gels, lotions, and oils intended to smooth my curls. Trying a new hair product from the “ethnic” aisle of my local drug store became my weekend ritual. Black consumers spend nine times more on hair care than their white counterparts, and I was beginning to understand why.

Looking back, I tried too many products, including low-quality ones that actually damaged my hair, and potentially exposed myself to more harmful chemicals in the process.Instead, I wish I took the time upfront to understand what my hair needed.

Learn about your hair porosity, density, and texture (yes, even straight hair has a texture), and tailor solutions to your needs. As a type-four, low-porosity queen myself, what my hair really needed — more than it needed three different kinds of styling creams — was moisture. That’s right, plain water! Understanding your hair’s natural attributes will save you time and money on wasted products.

When researchers from the Battelle Memorial Institute tested the hair products that Black women use most frequently, a long list of chemicals turned up: cyclosiloxane, fragrances, diethyl phthalate (DEP), and parabens, all of which are known to affect the endocrine system. Chemical straighteners, also known as “relaxers,” sometimes contain carcinogens like formaldehyde and might even lead to an increased risk of breast cancer in Black women (there’s still no scientific consensus on this one). Relaxer usage among Black consumers has declined in recent years, but some women are returning to them out of convenience.

Don’t be afraid to DIY

The science of hair care may be simpler than you think. Shampoos contain surfactants that help wash away dirt, oil, and products that build up in our hair. They also balance pH and close the hair cuticle, the protective outer layer of your hair. Most hair creams and butters help to lock in moisture between washes and prevent split ends. Commercial conditioners work to seal moisture into the hair cuticle, but may rely on chemical preservatives.

If you’re only able to swap out one or two products in your rotation, consider the ones that are in contact with your body for long periods of time. “From an exposure point of view, you’ll want to reduce usage of commercial products that you leave on your hair for a longer period of time, like scalp treatments, leave-in conditioners, hair dyes, and chemical straighteners,” says Dodson.

Early on, I internalized the myth that my hair was too difficult for me to care for without the use of chemical straighteners. But I’ve realized that most of what my own hair needs — moisture retention — can be achieved with ingredients from my own kitchen.

I spent months recreating the best parts of my favorite storebought products: banana and avocado are now core ingredients in my DIY conditioner. You could consider using honey, which has emollient (hair smoothing) and humectant (water bonding) properties. Coconut oil is another great alternative, and its lauric acid delivers moisture deep into the hair shaft. Any of these natural conditioners can be used on their own or together in a hair mask, or a deep conditioning treatment for the hair.

The US needs stronger regulation of cosmetics and personal care products

In the early 1900s, cosmetics and drugs were dangerously unregulated: Lead and arsenic found their way into skin creams, and mercury brightened makeup products. As more women suffered scarring, poisonings, and in some cases death, scientists sounded the alarm about harsh chemicals in consumer goods. In 1937, elixir sulfanilamide — an untested, but heavily marketed antibiotic — killed more than 100 Americans.

But medicines are regulated more closely than cosmetics, and the FDA does not order companies to recall cosmetic products that may be unsafe. “Neither the law nor FDA regulations require specific tests to demonstrate the safety of individual [cosmetic] products or ingredients,” the FDA explains on its website. “The law also does not require cosmetic companies to share their safety information with the FDA.”Screenshot 2022-01-04 at 21-56-49 JV - PrimeStocks

While some chemicals have been outlawed (DDT, DES, lead acetate hair dyes, and BPA in baby products), the FDA has failed to prohibit many endocrine-disrupting chemicals that are still widely used in personal care products.

Politics and big business play a role in keeping regulations to a minimum, according to the experts I talked to. “The $100 billion-dollar US cosmetics industry is very invested in maintaining the status quo, and is powerfully incentivized to fight regulation,” Nudelman says. Major industry trade groups, like the Personal Care Products Council, representing 600 beauty companies, heavily promote self-regulation, through the Cosmetic Ingredient Review program (CIR).

“Industry self-regulation lacks the safeguards provided by FDA reviews. The Cosmetics Ingredient Review is financed by cosmetics manufacturers and housed inside the industry’s trade association. Many CIR findings are inconsistent with the findings by other regulatory authorities or experts,” Scott Faber, vice president of government affairs at the Environmental Working Group, testified to the House Committee on Oversight and Government Reform.

Opponents of stricter cosmetics regulation continue to muddy the link between hormone-driven disease rates and risky environmental chemicals. While some research gaps remain, an ever-growing body of evidence shows that the chemicals we absorb from our environments matter, and may be compounding existing racial disparities in health outcomes.

When Vox contacted the FDA’s Office of Cosmetics and Colors for comment, a spokesperson said that “a change in the FDA’s legal authority over cosmetics would require Congress to change the law.”

Congress has had some historical interest in better regulating cosmetics — Sens. Thomas Eagleton and Ted Kennedy tried to get traction on bills in the ’70s and ’90s, respectively, and current Rep. Ron Wyden (D-OR) has been an advocate, as well.

More recently, Rep. Jan Schakowsky (D-IL) introduced a package of four Safer Beauty bills this summer. One bill would ban 11 chemicals of concern currently outlawed for use in the EU, California, and Maryland. While Schakowsky has been trying to pass versions of the package since 2009, Nudelman of the Breast Cancer Prevention Partners believes they now have a fighting chance.

“We believe this bill package to be different from past legislative attempts,” she says. “It addresses four discrete issues that are already at the forefront of people’s minds: banning toxic chemicals, increased labeling transparency, protections for women of color, and closing the fragrance loophole.”

Occasionally, I’ll see “Just for Me” — a hair relaxer containing hormonally active ingredients and marketed specifically for children — at my local drugstore. It’s the same relaxer I used up until college and my eventual diagnosis with fibroadenoma. I’m hopeful that one day, consumers won’t have to wonder whether toxins are hiding in the products that are supposed to make us feel beautiful. But until then, research can help us look out for our own health.

Paige Curtis is a Boston-based writer covering the intersection of climate, arts, and culture in such publications as Yes! Magazine and Boston Art Review. Formally trained in environmental management from the Yale School of Environment, she’s most excited by community-based solutions to the climate crisis.

Source: Beauty products are full of risky chemicals. I tried to get rid of them. – Vox

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