Eczema Treatment

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Comment by Gary W. Cole, MD, FAAD

One of the problems in discussing the treatment of "eczema" is that this term inherently is nonspecific. For patients, any inflamed rash might be eczema, while for certain pediatricians and some dermatologists, eczema is synonymous with atopic dermatitis but can also refer to allergic contact dermatitis, seborrheic dermatitis, irritant dermatitis, or stasis dermatitis. In any case, there are certain basic approaches to treatment of these sorts of rashes.

Acute eczematous dermatitis is characterized by weeping, oozing, and vesicles (small fluid-filled blisters). Treatment involves the application of cool compresses for a short interval followed by evaporation. The compress could be a dilute vinegar solution or just tepid tap water. Evaporation can be enhanced by a fan blowing air onto the affected area. Repeated cycles of soaking and evaporation may be required to stop the weeping and oozing. Once this occurs, then the application of topical steroid creams, lotions, or ointments are likely to enhance the resolution of the problem. In chronic eczema, the weeping and oozing is not obvious and the vesicles are more difficult to appreciate (they may be microscopic). It may appear that the involved skin appears dry and scaling. In any case, the application of topical steroids to this sort of dermatitis is often very effective followed by the application an emollient (a substantial cream or ointment). This works best on moistened skin. Occasionally, severe, extensive cases may require the administration of systemic (oral or intramuscular) steroids. Ultimately, it is of utmost importance to determine the type of eczema in order to have any chance of permanently eliminating it. Occasionally it is necessary to treat certain cases of persistent eczematous dermatitis with ultraviolet light. This approach does have a biological rationale. The light is usually administered in a doctor's office under controlled conditions.

Learn how other people treat their eczema.

REFERENCE:

Coenraads, Pieter-Jan. "Hand Eczema." N Engl J Med 367.19 Nov. 8, 2012: 1829-1837. .

Last Editorial Review: 7/25/2013 6:15:20 PM

Tinea Versicolor Symptoms and Signs

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Comment by Gary W. Cole, MD, FAAD

Tinea versicolor is caused by a fungus, Malessezia, which produces very superficial scaling areas which can appear darker or lighter than the background skin color or any color in between. Involved areas are typically on the torso and upper arms. The lighter color, which is characteristic, is thought to be due to a fungal compound, azelaic acid. It is seen most commonly in the summer months when you try to tan. Although uncommon, involvement below the waist can occur. Because this infection is not inflammatory, most people do not report any symptoms associated with these lesions, but occasional itching can occur. Even after appropriate treatment, it takes months for your normal coloration to be reestablished, so patience and persistence is required for a successful outcome.

Read about other people's tinea versicolor symptoms and signs.

REFERENCE:

Bigby, Michael, and Hu, Stephanie W. "Pityriasis Versicolor: A Systemic Review of Interventions." Arch Dermatol 146.10 (2010): 1132-1140.

Last Editorial Review: 7/26/2013 7:05:43 PM

Cyst Treatment

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Comment by Melissa Conrad Stöppler, MD

Cyst treatment is highly dependent upon the type and location of your cyst. Management can range from simply watching and waiting for your cyst to drain to surgical removal of organs and surrounding tissues for cysts that are associated with a malignant tumor.

Cysts that are located in the skin or in tissues just below the skin surface can be related to acne or other skin conditions. Sebaceous cysts are a common type of cyst of the skin and underlying tissues. Antibiotic treatment can be helpful for those who suffer from severe acne. Other small, benign cysts can be surgically removed (taking out the entire cyst and its surrounding wall) or drained (inserting a needle to draw out cyst fluid or contents). Antibiotics or packing of the wound may be required following the procedure, depending on the size and location of the cyst.

Cysts within organs such as the kidneys, liver, or ovaries may be managed surgically or medically. Some conditions like polycystic ovary syndrome can be helped by medications. Isolated cysts of the ovary may be observed without treatment and some may resolve on their own. Other ovarian cysts may require biopsy and/or surgical removal to rule out a cancer.

Many simple benign cysts can be treated in the doctor's office with local anesthesia. Removal of larger cysts or cysts deep within the body may require general anesthesia in an operating room. Some types of cysts may resolve on their own over time, and small benign cysts that do not cause symptoms may not require treatment at all.

Learn how other people treat their cysts.

REFERENCE:

Fauci, Anthony S., et al. Harrison's Principles of Internal Medicine. 17th ed. United States: McGraw-Hill Professional, 2008.

Last Editorial Review: 7/26/2013 7:26:15 PM

Researchers Focus on Eczema-Food Allergy Link

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FRIDAY, July 19 (HealthDay News) -- The skin disease eczema may be an important factor in the development of food allergies in infants, a new British study suggests.

The breakdown in the skin barrier that occurs in eczema could play a key role in triggering food sensitivity in babies, the researchers from King's College London and the University of Dundee said.

"This is a very exciting study, providing further evidence that an impaired skin barrier and eczema could play a key role in triggering food sensitivity in babies, which could ultimately lead to the development of food allergies," Dr. Carsten Flohr, of King's College London, said in a college news release.

The researchers said the discovery suggests that food allergies may develop via immune cells in the skin rather than in the gut and that the findings indicate that eczema may be a potential target for preventing food allergies in children.

A link between eczema and food allergies has been known for some time, but this study -- published July 18 in the Journal of Investigative Dermatology -- adds to growing evidence of the skin barrier's role in the process, according to the researchers.

The study included more than 600 infants who were 3 months old and exclusively breast-fed from birth. They were tested for eczema and checked to see if they were sensitized to the six most common allergenic foods.

Egg white was the most common allergen, followed by cow's milk and peanuts. The more severe the eczema, the stronger the link to food sensitivity, independent of genetic factors.

It's believed that the breakdown of the skin barrier in infants with eczema leaves active immune cells found in skin exposed to environmental allergens -- in this case food proteins -- which then triggers an allergic immune response, the researchers explained.

They also noted that food sensitivity does not always lead to food allergy and they're conducting a follow-up of the infants in this study.

"This work takes what we thought we knew about eczema and food allergy and flips it on its head. We thought that food allergies are triggered from the inside out, but our work shows that in some children it could be from the outside in, via the skin," Flohr explained. "The skin barrier plays a crucial role in protecting us from allergens in our environment, and we can see here that when that barrier is compromised, especially in eczema, it seems to leave the skin's immune cells exposed to these allergens."

This finding opens up the possibility that by repairing the skin barrier and preventing eczema, it might be possible to reduce the risk of food allergies, Flohr added.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: King's College London, news release, July 18, 2013

Advice on calorie menu can help people eat better

By Alan Mozes
HealthDay Reporter

THURSDAY, July 18 (HealthDay News)--What general guidelines for consumption of calories available to patrons of the restaurant where the calories count labels are already in the menu do not lead to better food choices, the new study cautions.

"The general inability of calorie labelling will reduce the total number of calories has been quite widely demonstrated," said lead study author Julie Downs. "So it's nothing new. But in the light of this, there was a growing thought that maybe the problem is that people don't know how to use information without some framework, some guidance, "she said.

"So what we tested whether we can improve food purchasing behavior by offering people the General daily or for a meal next to the food labelling guidelines for calories in restaurants."But it turned out that it does not help at all, "she said.

Downs, associate research professor of social and decision sciences in the College of Humanities and social sciences Dietrich at Carnegie Mellon University, and colleagues present their results in the July 18 online edition of the American Journal of Public Health.

In recent years, various cities and counties, including New York, Philadelphia, San Francisco and King County in Washington state-mandated calorie posting in chain restaurant menus, as they have throughout the Member States, such as California and Oregon, according to a study. Going forward, some form of national marking calories is to dig under the federal health care reform unfurling already passed by Congress.

On this background for four months in 2008, the authors set out the standard recommendations of more than 1100 calories information to consumers under the age of 18 and right in front of the food bought in one of the two restaurants based on N.Y.C. McDonald's in Manhattan and one in Brooklyn.

The information provided was taken from a policy by the u.s. Department of agriculture and the calorie lunch Act national school. Half of the test took place just before the implemented standard calories labelling, half of the restaurant menu.

Participating consumers were randomly given: recommending the total daily intake of 2000 calories for women and 2400 calories for men; apprising material that one meal should contain between 650 and 800 calories; or no information at all.

The result: analysis of the influence of food and after studies showed that the calorie guideline does not seem to help clients better understand or generally better use calories labelling, when he was present. In addition, the guidelines were able to induce a decline in the total number of calories informed patrons purchased.

Instead, those who received the overall caloric information decided to eat a bit more calories, not less.

"It's just speculation," Downs said, "but I think that what happens is that people see the calories on a daily basis or for a meal." She gave an example of a Big Mac, listed in 550 calories. "What is not actually unreasonable. So [customers] might feel OK to go ahead and get a slightly larger main dish, but at the same time still the same appetizer and drink, which usually gets. And then all of a sudden they more than 1,100 calories a meal. Any one item may seem OK, but it adds, "she noted.

"In the end, what is more problematic is that asking people to do math three times a day every day of life is a lot," added Downs. "Because that's not how we decide what they eat only once. There are a lot of decisions. "And if you add the cognitive load on the mount, the [mental] is that there is a lot to ask."

For its part, Lona Sandon, a dietitian and Assistant Professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas, suggested that informing the calories should be seen as an important step towards building awareness, even if not immediately leads to better food choices.

"It continues To prove what those of us who work in the field of promoting healthy eating and lifestyle have known for years," Sandon said. "This means that knowledge does not equal to or guarantee a change in behavior. Knowledge is only one piece of the puzzle. We need to consider people attitudes, beliefs and values of the surrounding healthier eating and body weight, "she said.

"The pros choose fewer calories must outweigh the cons," added Sandon. "In other words, they must see the benefits, that is strong enough to offset the disadvantages of high-calorie meals, which will be immediately satisfying and tasty," considering, she said that the number one reason people say they eat for taste, not health.

Study author, which Downs said: "now there is a reasonable argument that we should have those calories the label and access to information. Of course, for someone who is already aware of health, provision of information and transparency is helpful. But the problem is, when we consider that this is the solution to the obesity epidemic among the population at risk, which we are trying to address. "

Copyright © 2013 HealthDay. All rights reserved. Source: Julie Downs, Ph.d., Associate Professor, Department of social and decision sciences, humanities and Social Sciences College, Dietrich, Carnegie Mellon University, Pittsburgh; Lona Sandon, R.D., Assistant Professor of clinical nutrition, the University of Texas Southwestern Medical Center in Dallas; 18 July 2013, the American Journal of Public Health, online

Health Tip: Choose healthier Chinese food

(HealthDay News)--some Chinese dishes are full of fat and salt, but others can be just as delicious and much healthier.

Nutrition and dietetics Academy offers these examples of healthier and not-so-healthy Chinese fare:

Skip the fried wontons and opt for the hot and sour soup or wonton soup.Instead of fried egg rolls opt for steamed spring rolls.Skip the Peking duck and fried rice and instead ordered chicken, scallops or shrimp with vegetables, tofu or steamed fish.Skip the fried dim sum for the steamed dumplings.Avoid foods that are breaded and deep-fried to steamed dishes and simmer.

-Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

Tinea Versicolor Treatment

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Comment by Gary W. Cole, MD, FAAD

Tinea versicolor is a common skin infection of adults and teenagers (less common in children) caused by a fungus of the genus Malessezia. Since this fungus is a normal inhabitant of the skin of most adults, it is unclear as to the factors that induce the disease. It commonly involves the torso, sparing the head and legs. Though tinea versicolor usually doesn't cause symptoms, it occasionally can itch. The lesions appear as flat, slightly scaly areas of discolored skin, hence the term versicolor. Involved areas can be any color but frequently appear lighter than adjacent normal skin if you have been tanning. It is a chronic condition unless treated. Even with treatment, the disease is predisposed to recur.

Topical creams, sprays, shampoos, and foams that contain an azole (clotrimazole, miconazole, ketoconazole, and econazole are some examples) antifungal as the active ingredient are very effective in eliminating this condition. Lotions and shampoos that contain selenium sulfide or zinc pyrithione (for example, Selsun Blue) are also effective. Many of these chemicals are available in over-the-counter products. The only difficulty is applying the medication to the affected areas. For example, if the disease is on your back, you may require some aid with applying the antifungal medicine. Extensive disease obviously makes it harder to apply medication directly to every affected location. Occasionally, if topical therapy fails or if you are unable to apply medication, it may be necessary to add an oral medication (an azole drug). The most efficacious dosage and duration of therapy has not been determined. Since this disease is generally considered more of a cosmetic difficulty, it is prudent to use very small amounts of systemic medication to enhance the topical treatment. After the tinea versicolor seemingly disappears, it would be wise to continue topical treatments less frequently to maintain clearance.

Read how other people treat tinea versicolor.

REFERENCE:

Mendez-Tovar, L.J. "Pathogenesis of Dermatophytosis and Tinea Versicolor." Clinics in Dermatology 28 (2010): 185-189.

Last Editorial Review: 7/18/2013 7:19:03 PM

Why some like it hot: personality can sway dietary choices

Thursday, July 25 (HealthDay News)--If you prefer savory or sweet food can be a matter of personality, new research suggests.

The researchers gave personality tests 184 non-smokers aged 18-45, to see if you were looking for personality, sensation (someone who is open to new experiences and willing to take risks), or a more sedate personality and less open to things like that.

The participants were then given a small amount of capsaicin, a component of hot chili peppers and asked to rate how much they liked the spicy meal as smoke from capsaicin increased intensity.

Those seeking personality experience still liked spicy meal, even as smoke from the capsaicin has increased, while those with more sedate personality didn't like the meal how to burn increased, according to a study. The results were presented recently at the annual meeting of the Institute of food technologists in Chicago.

"In theory, we know that the intensity of combustion and the needs are linear," study author Nadia Byrnes, of Pennsylvania State University, said in a press statement of the Institute. "More annoying relationship or food gets, the less people should like it."But this is not always the case. "

The data and conclusions presented in the meetings are usually considered tentative until published in a peer-reviewed journal.

--Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. Source: Institute of food technologists, press release, 17 July 2013

Don't Let Hair Care Lead to Hair Damage

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SATURDAY, July 20 (HealthDay News) -- Improper use of styling tools and hair care techniques can cause hair damage and loss, according to experts.

"Hair myths, such as brushing your hair 100 strokes each day, can cause split ends," Dr. Paradi Mirmirani, an assistant clinical professor of dermatology at the University of California, San Francisco, said in an American Academy of Dermatology news release.

"Having healthy hair is possible if you know how to care for your hair before and after styling," she said.

Mirmirani offered the following tips:

Dry your hair by wrapping it in a towel after a shower or bath or let your hair air dry.In general, people should handle their wet hair as little as possible, as wet hair breaks more easily when combed or brushed. However, people with tightly curled or textured hair should brush their hair when wet to decrease breakage.Give your hair time to partially air dry before you style or comb. Decreasing how often you blow-dry each week also helps limit damage.Keep brushing to minimum. Split ends can occur from brushing your hair 100 strokes daily.Reduce your use of "long-lasting hold" styling products. Combing your hair after you apply the product can cause the hair to break and can lead to hair loss over time.Flat irons should only be used on dry hair on a low or medium heat setting, and no more than every other day. If you use a curling iron, leave it in place for no more than two seconds. Excessive heat can damage all types of hair.Braids, cornrows, ponytails and hair extensions should not be worn continuously. These styles pull on the hair and can cause tension that leads to hair breakage. Long-term tension can lead to permanent hair loss.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Academy of Dermatology, news release, July 9, 2013

Health Tip: Keep Bed Bugs at Bay

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(HealthDay News) -- People who travel or buy used furniture should make sure they haven't brought home any unwanted guests: bed bugs.

The U.S. Environmental Protection Agency offers this advice:

Carefully inspect any second-hand mattress, couch or other furniture for signs of bed bug infestation before bringing it home.Place a protective cover over your mattress and box spring. Check the cover often for any tears.Keep your home clean and clutter-free.At a hotel or lodge, place luggage on a rack, rather than on the floor or bed.Inspect the mattress and headboard at a hotel before using the bed.Once home, carefully inspect luggage. Unpack directly into the washing machine.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

Hair-Straightening Product May Endanger Stylists, Clients

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THURSDAY, July 25 (HealthDay News) -- A popular hair-straightening product can pose a health threat to hairstylists and their customers, researchers say.

The Brazilian Blowout Acai Professional Smoothing Hair Solution could expose people to potentially dangerous levels of the cancer-causing chemical formaldehyde, according to the study in the August issue of the Journal of Occupational and Environmental Hygiene.

"Our study found that using Brazilian Blowout, without proper engineering controls like local exhaust ventilation, could expose hairdressers and their clients to formaldehyde at levels above the short-term occupational exposure limits," study author Michelle Stewart said in a University of California, Berkeley, news release.

She conducted the study as a graduate student in the university's school of public health. Stewart and her colleagues found that formaldehyde concentrations in the air around hairstylists and customers exceeded limits set by the U.S. Occupational Safety and Health Administration, the U.S. National Institute for Occupational Safety and Health, and the California Division of Occupational Safety and Health.

The findings appear in the August issue of the Journal of Occupational and Environmental Hygiene.

"While installing local exhaust ventilation is a traditional exposure control, that solution may not be feasible in small salons due to the cost of ventilation systems, permits, installations, ongoing maintenance and efficacy checks," Stewart noted.

"The recommendation is that salons use products containing no more than 0.1 percent formaldehyde, but the product we investigated contained 12 percent formaldehyde," she added.

Symptoms that have been reported by hairstylists when using hair-straightening treatments such as Brazilian Blowout include watery eyes, runny nose, upper respiratory tract irritation and nosebleeds. The product is available in more than 6,000 salons within the United States, according to the news release.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Journal of Occupational and Environmental Hygiene, news release, July 23, 2013

Best Hospitals 2013-14: Overview and Honor Roll

Some hospitals have more expertise than others when it comes to caring for patients with life-threatening or rare conditions. And people facing such health challenges need every bit of help they can get. That's why U.S. News & World Report publishes annual rankings of the nation's Best Hospitals.

[See the Complete Rankings: Best Hospitals 2013-14]

The rankings, now in their 24th year, cover nearly 5,000 medical centers across the country and span 16 medical specialties, from cancer to neurology & neurosurgery. Hospitals that rank near the top of at least six specialties earn a spot on the Honor Roll. Just 18 distinguished hospitals made this year's list.

[See Pictures of the 18 Honor Roll Hospitals]

Baltimore's Johns Hopkins Hospital reclaimed the No. 1 spot after last year losing a 21-year reign to Boston's Massachusetts General Hospital. In order of rank, the Honor Roll hospitals are:

In most specialties, U.S. News ranks the top 50 hospitals nationwide. This year, 147 different hospitals earned a ranking in at least one specialty. The University of Texas MD Anderson Cancer Center in Houston, for example, ranked first in Cancer. The Cleveland Clinic topped the Cardiology & Heart Surgery rankings. And the Hospital for Special Surgery in New York, N.Y., snagged No. 1 in Orthopedics. Hospitals that ranked nationally in any specialty have the skill and experience to treat the most complex and demanding cases that can arise in that area of medicine.

Some patients might be unable to travel far for care -- or may not need to because their condition is more straight-forward. To help them find care close to home, U.S. News ranks more than 700 hospitals by state, region and metro area. These Best Regional Hospitals are highly proficient in serving the needs of the majority of patients in at least one specialty.

[See Best Regional Hospitals by Metro Area and State]

Just five metropolitan areas have more than one Honor Roll hospital. New York City and Boston achieved this feat last year as well, and were joined this year by Los Angeles, Philadelphia and Cleveland, due to the additions of Cedars-Sinai Medical Center, Thomas Jefferson University Hospital (which landed on the coveted list for the first time), and University Hospitals Case Medical Center respectively.

[Read 5 Cities with Tons of Top Hospitals]

Chicago's Northwestern Memorial Hospital jumped the highest in Honor Roll rankings from last year, from 12th to sixth place, while Barnes-Jewish Hospital/Washington University in St. Louis dropped the furthest down the list, from sixth place to 15th place. Mount Sinai Medical Center in New York, N.Y., and University of Michigan Hospitals and Health Centers in Ann Arbor fell off the Honor Roll but remain nationally ranked in multiple specialties.

To make the Honor Roll, a hospital had to score near the top in at least six out of 16 medical specialties.

U.S. News bases the rankings mostly on objective data on hospital performance, such as patient survival rates, and structural resources, such as nurse staffing levels. Each hospital's reputation, as determined by a survey of physician specialists, is also a factor determining each hospital's rankings.

[Read How We Ranked the Best Hospitals 2013-14: An FAQ] 

For patients under 18 and their caregivers, U.S. News in June published a separate Best Children's Hospitals Honor Roll and rankings in 10 pediatric specialties.

Tips on Hydration from Sports Dietitians

This time of year, it can be tough to stay well hydrated, especially if you exercise. Imagine how much harder it is for those who make a living from physical activity – professional athletes! Compiled here are insider tips directly from top sports dietitians, which will help us stay hydrated during these dog days of summer:

Tips from Roberta Anding, dietitian for the Houston Texans:

Drink early and drink often. Anding works with football players in one of the more humid parts of our country and knows a thing or two about the difficulty of staying hydrated while fighting heat and humidity. She notes that our stomach can only empty so much fluid at one time, so it's better to keep smaller doses going throughout the day, rather than taking huge gulps once thirst strikes. 

High water foods should be part of your hydration plan. Foods like fruits, vegetables, dairy, yogurt and soups all contain significant amounts of water and will help keep you hydrated. 

If you're sweating, sports drinks play a role in rehydration. Sweat contains electrolytes, and sports drinks will help replace those, while also providing some carbohydrates to help fuel your activity. Anding notes that plain water as well as some other popular alternatives to sports drinks, such as coconut water and maple syrup water, do not contain electrolytes. 

[Read: Healthy Drinks for Summer.] 

Tips from Leslie Bonci, dietitian for numerous professional sports teams and author of "Sports Nutrition for Coaches:" 

Hydration should be proactive. Counseling professional athletes from football to hockey and baseball teams, Bonci advocates proactive hydration.That means drinking at least 20 ounces of fluid one to two hours before exercise, and possibly more if your urine is still dark. 

If you're drippin', you better be sippin'! Becoming dehydrated during exercise not only interferes with performance, it can also increase the chance for injury and heat illness. Bonci recommends athletes take gulps of water during activity, rather than sips (which helps to speed up stomach emptying). She also tells them that they shouldn't rely on pouring water on their heads to cool off. The fluid must go in, not just on. 

Replace what you lose. The best way to know how much fluid is lost during an exercise session is to weigh yourself before and after the session. Bonci recommends drinking 24 ounces of fluid for each pound lost over the rest of the day after activity. 

[Read: Foods that Beat the Heat: Part 1.] 

Tips from Chrissy Barth, dietitian for the Arizona Cardinals and Milwaukee Brewers: 

Hydrate for optimal performance. While dehydration can definitely be dangerous, Barth points out that it can also greatly impact how well a person functions at physical tasks. She points out that even a 2 percent dehydration level can decrease performance. That's just four pounds of fluid lost on a 200-pound frame. Barth echoes the importance of drinking fluid throughout the day, not just when you're exercising. 

Look at the color of your urine. The best way to tell if you're properly hydrated is to monitor your water output through urine. Barth says your urine should be lemonade in color – if it's closer to apple juice color, you need to drink up! 

Focus on fluid before, during and after exercise. One of her favorite post-exercise fluid replacers is low-fat chocolate milk, which provides fluid along with a good dose of refueling carbs and protein. To determine how much fluid you need in a day, Barth gives this rule of thumb: Drink half to all of your body weight in fluid ounces. For example, a 150-pound woman needs at least 75 ounces and up to 150 ounces of fluid each day. 

[Read: How to Exercise in the Heat and What to Do if You Get Sick.] 

Tips from Lisa Dorfman, dietitian for multiple collegiate, Olympian and professional athletes: 

Mind your electrolytes. Dorfman, a former pro triathlete herself, notes that some of the symptoms of dehydration (such as muscle cramps or side stitches) are actually due to loss of electrolytes. She suggests using a variety of beverages during the day to maintain fluid and electrolytes – low-sugar juices and drinks, tart cherry juice and nonfat milk all meet her stamp of approval. 

If in doubt, check yourself. Each person's fluid needs are different, depending on weather conditions, genetics and how much time is spent exercising. Dorfman recommends considering factors such as symptoms of headaches or lightheadedness during the day, as well as urine color, to adjust fluid intake to meet personal needs. 

[Read: Wondrous Ways That Water Can Improve Your Health.] 

Hungry for more? Write to eatandrun@usnews.com with your questions, concerns, and feedback. 

Melinda Johnson, MS, RD, is the Director of the Didactic Program in Dietetics and lecturer for the Nutrition Program at Arizona State University, and a Spokesperson for the Academy of Nutrition and Dietetics. Follow her on Twitter @MelindaRD.

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A $36,000 Birthday Gift (Plus: Free Roundtrip Anywhere in the World)

I’m turning 36 years young! Here in a village in the Tigray Region of Ethiopia.

My 36th birthday is here!

It’s going to be a great natal year–I can already feel it. Perhaps it will be good luck for you, too. In this post, I’m giving away a round-trip ticket anywhere in the world.

But back to that strange birthday gift…

Much to the chagrin of my momma-san, I’ve become quite difficult to buy presents for. Some friends even think I’m impossible to find presents for. Not so. I love handwritten letters, homemade brownies, girlfriends in next-to-nothing, and–most of all–when people do something nice.

You, my dear readers, have an awesome track record of doing nice things.

For my b-day in 2010, you all raised more than $100,000 for high-need public school classrooms in the US.  In 2011, you helped build libraries overseas (Cambodia, Nepal, Sri Lanka, and Vietnam), and last year, you helped poor youth in developing nations finish school.

In lieu of gifts this year, my birthday wish is to provide clean water to the people who need it most. I’m doing it on this page. There are fun prizes involved, so keep reading.

I recently traveled to the Tigray Region in Ethiopia with the incredible Charity: Water team. I witnessed, first-hand, what life is like for people living without clean, safe water.

Nearly 1 billion people worldwide fall into this group. For me, it’s not just a health issue. That’s not the most interesting part. If you want to offer a hand up (education, work) and not a hand out, water is highly leveraged for breaking the cycle of poverty.

In fact, every $1 invested in improved water access and sanitation can yield an average of $12 in economic returns.

Here’s how:

In Africa alone, people spend 40 billion hours every year (e.g. the entire annual workforce of France!) walking for water. Women and children usually bear the burden of water collection, walking for miles to the nearest source. The solution? Installing simple water wells for clean water in strategically close locations.

Children can then spend more time in classrooms learning, and women can contribute to their communities with their minds instead of carrying jerry cans most of the day.

A jerry can, 40 pounds when full.

Clean water creates more capable problem solvers in places with persistent problems. If you want to empower people instead of doling out aid indefinitely, this is a powerful starting point.

Here’s what I’d love to ask, and where the free roundtrip ticket comes in:

1. Join my 36th birthday challenge by clicking here. It’s worth clicking through just to check out the site. Donations are tax-deductible.

2. To get your engines started, I’ve put in $3,600 of my own money.

3. If the spirit moves you, please make a $36 donation (or whatever you can: $1, $36, $1,000, etc.) to providing clean water to those who need it most. Even a $1 can make a big difference!

4. Charity: Water sends 100% of every donation directly to fund projects in the field. No “administrative fees” or anything–every penny of every dollar goes to the field. Cool, right? And because I was just in Ethiopia, they’ll be sending it there. The best part: Charity: Water will report back in 18 months with GPS coordinates, photos and information about the communities we’ve impacted.

- If you all help raise $36,000, I will personally add another $5,000.
- If you all help raise $100,000 (100% doable), I’ll add on a total of $10,000.
- The deadline is 5pm PST on Friday, August 2nd, 2013.

- I’m giving away a free round-trip ticket anywhere in the world that Star Alliance flies, which is just about everywhere. There is no expiration date on the trip, so no rush on deciding where or when to go. If you like, I’ll fly you to San Francisco to have dinner with me, but other places might be more interesting

Here’s how to get it:

- Spread the word however you can. Send people to this post or to my Charity: Water birthday page. Here’s the URL for copying and pasting: http://my.charitywater.org/timferriss

- Leave a comment below telling me what you did (Facebook, Twitter, blog post, e-mail blast, e-mail signature, encouraged employees/friends to do the same, company donation matching, etc.). Measurement of any type gets huge bonus points. This comment must be put up no later than 5pm PST on Friday, August 2nd, 2013.

- Lastly, answer one question at the very top of your comment: “What does education mean to you?” Begin your answer with “To me, education means…”

Based on comments, I’ll pick the top five promoters. Then, you’ll all vote on the winner of the round-trip.

Beyond the bribes, you’ll feel awesome about yourself for doing real good for people who have so little. People who, without water, might not have much of a future at all.

Trust me. It feels great.

Will you pause for a moment and step up, even if for $1? It would mean the world to me. I’ll share updates as I get them.

Again, here is where to go to donate $1, $36, $360, or whatever you can.

Thank you for reading this post. You are all rock stars, and I continue to write on this blog purely because of you.

Pura vida!

Tim

Posted on July 24th, 2013

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