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CIRCADIAN RHYTHM KEEPING YOU SANE AND RESILIENT AGAINST INFECTION

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MICROBIOMES AND THE

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A HEALTHY CIRCADIAN RHYTHM KEEPING YOU SANE AND RESILIENT AGAINST INFECTION Te x t b y S a t c h i n P a n d a

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ocial distancing and washing hands have become the frontline in the fight against COVID-19, but there is another powerfully protective resource immediately available to all: your circadian rhythm.

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Try to get outside during daylight to set your circadian rhythms. Photo by Caleb Jones.

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Every cell in your body has a sense of time. Photo by Erik Witsoe.

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While isolation and hygiene are effective in reducing the chance of infection, they do little to increase our resilience to the virus so that we suffer less and recover faster. In addition, the stress and worry caused by current trends – school and business closures, self-quarantines, and mandates to stay at home – don’t help. The strains on our physical and psychological health can leave us even more vulnerable to viruses and other health issues. The answer to boosting your immunity may lie in simple steps you can take to maintain a robust circadian rhythm by developing and following a daily routine. I head a lab that researches circadian rhythms, the daily cycles of bodily functions that form the foundation of good health. These body clocks, found in nearly every organ of the body and part of the brain, are central and vital to a properly functioning immune system. A synchronized circadian rhythm in the lungs, heart, kidney, and brain ensures that the processes in our body go as planned while the immune system can effectively fight and defeat a virus. When the timing systems in the human body are desynchronized, essential organs are compromised, reducing the potency of your immune system. Circadian disruption dampens your immune system and makes a virus harder to defeat. HOW DO WE MAINTAIN A ROBUST CIRCADIAN RHYTHM? The answer is as simple as developing a daily routine and sticking to it consistently. Circadian rhythm in the brain is synchronized to the outside world by light and darkness. Circadian rhythms in the rest of the body are synchronized by when we eat. We can maintain a healthy circadian rhythm by the following simple practices: sleep, eating time, daylight exposure, exercise, and stress management. Sleep is the most profound predictor of a healthy circadian rhythm. When we disturb our sleep, it has effects beyond our brain. Studies have shown that chronically sleep-

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deprived animals and humans have weaker immune systems, making it easier for even mild infections and viruses to gain entry to the body and cause more damage or even death. Therefore, maintaining a consistent sleep schedule is a powerful strategy to maintain better immunity. Sleep researchers suggest babies and toddlers may sleep as much as 12 hours each day, children and teenagers should spend nine hours in bed, and adults should try to be in bed for eight hours. Dimming light for two to three hours before bedtime and taking a bath before bed will help you to get a good night’s sleep. A bedtime bath also cleanses our body and may wash off any virus that might have stuck to our skin. WHEN WE EAT CAN NURTURE OR TORTURE OUR RHYTHMS When we are not asleep, we tend to snack or eat. Studies show that nearly 50% of adults are likely to eat over a 15-hour window or longer. Shift workers who work early morning, evening, or overnight, sleep and try to catch up with regular life during offdays. This erratic scheduling may lead to an even worse eating schedule because of the nature of their work. However, you don’t have to be a shift worker to live like one. Such large eating windows disrupt the body’s circadian rhythm and weaken organs, including the gut, liver, muscle, heart, kidney, and lungs, making it harder to fight infection. Conversely, animal and human studies are increasingly showing that eating food and beverages within an 8- to 12-hour window reduces disease and infection risk and improves brain and body health. This style of eating is referred to as timerestricted eating or intermittent fasting. LIGHT UP YOUR MOOD AND DIM DOWN BEFORE SLEEP Finally, light and darkness play a crucial role in the brain’s circadian rhythm and brain health. Being outdoors and in daylight for at least 30 minutes each day is a great way to synchronize your brain clock with the outside world. It also reduces depression and

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Sleep is the most critical factor for maintaining circadian rhythms. Photos by Peter Oslanec (top) and Damir Spanic (bottom).

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Top: Try to avoid those midnight snacks. Photo by Charlotte Noelle. Bottom: Keep in touch with friends and family to prevent isolation and depression. Photo by Alexander Dummer.

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anxiety and increases alertness. In the current climate of hunkering down, staying home, and rarely venturing out, not having access to daylight may increase the risk of depression and other mood disorders. Also of note: The UV portion of sunlight is a disinfectant. Just 30 minutes of UV light on clothing may kill bacteria and viruses that may be attached to the exterior of our clothes. When it becomes dark outside, reducing exposure to bright indoor light for two to three hours before bed will help you sleep. AN IDEAL ROUTINE We can incorporate these insights into our daily routine to maintain sleep, eating time, light schedule, exercise, and strategies to stay positive to profoundly help millions of people who are now stuck at home or have minimal incentive to go out. My lab has developed a research app, myCircadianClock, to guide people on how to monitor and optimize their own circadian rhythms. A simple plan for adults would include the following: Sleep: Aim to spend eight hours in bed each night to allow at least seven hours of sleep. This allows the brain to rest, detoxify, and rejuvenate. Teenagers and children older than the age of 10 should try to be in bed for nine to 12 hours each night. Diet: Eat within an 8- to 10-hour window of time each day. Note the time you ingest your first calories of the day (beverage or food) and plan on taking your last calories of that day 10 hours later. Make sure that the last calories are consumed two to three hours before bedtime. Such time-restricted eating can be enhanced by being combined with home-cooked healthy food to sustain healthy gut, liver, heart, lung, kidney, and immune function. Time-restricted eating may also help shed some extra weight and manage blood pressure, blood glucose, and cholesterol.

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Light: Spend at least 30 minutes outdoors during daylight hours to reduce depression, increase alertness, and improve mood. Stress management: Social distancing can be social isolation, which can lead to increased stress, depression, and difficulty in falling asleep. Spend more time with the people you live with and get in touch with your faraway family and friends over video chat. Keep your mind busy with positive thoughts, read some books you wanted to read for a long time, make new music playlists, play some board games, or do puzzles. Avoid too much TV and depressing news. Exercise: Don’t forget to get some exercise. For those of you who feel you are physically less active, try to get in some steps. Walk around the neighborhood, do some simple strength exercise at home. Turn on some music and dance. If you can, get outside for a walk or hike. Try to do your intense exercise in the afternoon when the muscle clock can give you the most benefit of exercise. The exact time when each family goes to bed, eats, exercises, explores the outdoors, or socializes depends on where they live and what other constraints they may have. But it takes only a week to develop and follow such a plan. By the second week, you may begin to see the benefits of healthy circadian rhythms.

aM T M T H E M I L L M AG A Z I N E

Satchin Panda, a professor in the Regulatory Biology Laboratory at the Salk Institute for Biological Studies, Adjunct Professor of Cell and Developmental Biology at the University of California San Diego, is interested in understanding the molecular mechanism of the biological clock in a mouse model system. The biological clock or circadian oscillator in most organisms coordinates behavior and physiology with the natural light-dark cycle. His laboratory uses genetic, genomics and biochemical approaches to identify genes under circadian regulation in different organs and to understand the mechanism of such regulation. His lab also tries to characterize the mechanism by which the circadian oscillator is synchronized to the natural light-dark condition. Both classical rod/cone photoreceptors and a newly identified ocular photopigment melanopsin participate in photoentrainment of the clock. Research in his lab is geared towards identifying molecular components and events critical for transmitting light information from the eye to the master oscillator in the brain. This article was originally published on The Conversation.

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Empty theaters, cafes, and gyms are a common sight worldwide during the coronavirus pandemic. Photo by Edwin Hooper.

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THIRD

PLACES CREATE OUR SOCIAL FABRIC Te x t b y S e t h a L o w

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ocial distancing during the COVID-19 pandemic implies many painful losses. Among them are so-called “third places” – the restaurants, bars, gyms, houses of worship, barbershops, and other places we frequent that are neither work nor home. HEALTHY HOME•EDITION 11 NO. 3•THEMILLMAGAZINE.COM

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The third place is a concept in sociology and urban planning that recognizes the role these semi-public, semi-private places play in fostering social association, community identity, and civic engagement. In giving people a familiar setting for social interaction among regulars, they encourage “place attachment” – that is, the bond between a person and a place. Experiencing the coronavirus from the fortress of our living spaces, we may enjoy the feeling of being in a haven that protects against this invisible new enemy, but we’ve lost the social and psychological intimacy of third places. It is a significant loss. My three decades of research on urban spaces finds that both public spaces and third places contribute to a healthy and flourishing society. PLACES TO ‘FEEL AT HOME’ Third spaces have probably always existed. From attending social clubs and religious gatherings to neighborhood festivals and burial societies, people have long formed associations that bring groups together. Most of these associations reflected genealogical, religious, gender, cultural, or class homogeneity. Often, they were formed to fulfill a social function like raising funds or completing a group task. They were not necessarily geographically located in a particular place. Contemporary third places, in contrast, are always space-based. When urbanists use the term, they’re referring to a physical setting with a boundary or entrance designed to allow, even encourage, access to a variety of people –

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Third places, like this barbershop, anchor us to the community. Photo by Jason Leung.

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Third places, like this church, rely on a certain amount of heterogeneity to convey social importance. Photo by Chuttersnap.

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like a coffee shop with a bright sign and an open door. Staff and regulars are part of the scene here. But so are strangers. While not as diverse or accessible as public spaces, third places rely on a certain amount of heterogeneity to convey social importance and bring vitality. In this way, third places complement public spaces like parks, plazas, playgrounds, streets, and sidewalks – free and open places that offer contact, cooperation, and even conflict with a range of mostly unknown people. If public spaces expand our social relationships and liberalize our world view, third places anchor us to a community where we are recognized and our needs accommodated. Third places are predictable and comfortable – a setting where we feel “at home.” ‘IT IS NOT THE SAME’ Those sheltering in place are now missing their third places acutely. Recently, I spoke with some young men who are still gathering in a local state park near my home. They were sharing a pizza, hidden from view. They told me how hard it is not to be able to hang out at the pizza shop itself. It was their third place. Grace, an older friend of mine from Manhattan, told me she feels “cut off ” because she can’t go to the neighborhood restaurant where she knows the chef by name and enjoys sitting at the bar after work.

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I still get coffee every morning at the Golden Pear on the east end of Long Island, where I live, wearing a mask and gloves. Normally, I’d eat breakfast there while exchanging greetings and conversing in English and Spanish with friends and staff. Now I take my coffee to an empty beach to drink. It is not the same. As my colleague Judy Ling Wong observes, from London, where she lives alone, this lockdown is a time of “severe disorientation.” Phoning friends has almost a “ritualistic feel to it,” she writes. It is “done to maintain our hold on social connections.” GATED AGAINST CORONAVIRUS Our collective loneliness during the pandemic exposes how dependent we are on one another for happiness – and how interconnected we really are. Healthy societies depend on continuing interaction among people who are different in a multiplicity of ways. Third places are prime venues for such interactions because our shared enjoyment of its services – a love of coffee, music, or for working out – assures that even strangers have at least one thing in common. I have studied people who live in gated communities – places bereft of such diverse interactions. I found that even in a supposedly secured space, they worry about crime and feel anxiety when they walk outside the gates of their neighborhood. Children who grow up in such places learn, implicitly

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People miss the social aspects of sitting at the bar enjoying a pint. Photo by Florencia Viadana.

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Gyms are a third place between work and home for many people. Photo by Risen Wang.

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or intentionally, to fear those who are outside the walls, including their own families’ workers, nannies, or delivery people. Because of the potential of contagious strangers, the coronavirus creates a similar us-versus-them mentality. Without third places and public spaces where people come into regular contact with others outside their circle, such thinking can become ingrained. It can metastasize from prudent public health advice to paranoia and prejudice. The coronavirus, in other words, challenges not only our physical, mental, and economic health but also our social health. Third places provide the daily glue that binds us to a particular location and to the people who frequent it. With them, we construct a chosen community, a broader public realm. Without them, I worry, the associations that weave a complex society together will fray.

aM T M T H E M I L L M AG A Z I N E

Setha Low, distinguished Professor of Anthropology, Geography and Psychology and Director of the Public Space Research Group at the CUNY Graduate Center, is an interdisciplinary scholar who has also taught planning and design at the University of Pennsylvania and Pratt Institute. She holds honors from the Guggenheim Fellowship, NEH Fellowship, Getty Center Fellowship, Fulbright Fellowship, President of the American Association of Anthropology, SUNTA Senior Career Award, Anthony Leed’s Prize, and the Distinguished Career Award from SANA. This article was originally published on The Conversation.

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MICROBIOMES AND THE

healthhome Text by Kevin Van den Wymelenberg, Leslie Dietz, and Mark Fretz

A

rchitects and building engineers strive to

create safe, productive places where humans can live and work. We have developed complex codes, regulations, and guidelines to achieve goals such as structural safety, fire safety, adequate ventilation, and energy efficiency, and to anticipate extreme scenarios such as 100-year floods. The question for our profession now is whether and how the 100year viral pandemic will change architectural design and building operations.

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Sunlight, ventilation and relative humidity all affect the microbiome of indoor spaces.. Photo by Brina Blum.

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Some microbes help keep us healthy. Photo by Tracey Hocking.

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How can societies safeguard buildings or homes from a viral pathogen during an epidemic? What would it take to redesign public and institutional buildings so they could help “flatten the curve,” instead of simply evacuating occupants? What if people could shape and modify the microbial communities present inside buildings to minimize exposure to harmful pathogens? At the University of Oregon’s Biology and the Built Environment (BioBE) Center, we study interactions between humans, buildings, and microorganisms. We believe that architecture needs to adapt and evolve in ways that help people manage indoor microbiomes to support health. In a new paper, we combine research on how microbes function indoors with knowledge about the novel coronavirus to outline ways of minimizing COVID-19 transmission in buildings. CULTIVATING OR MURDERING MICROBES Even in good times, and certainly during pandemics, the main thing people typically want to know about microbes is how to kill them. But in fact, the vast majority of microbes help humans more than they hurt us. The idea that microbes around us play an important role in our lives is known as the Old Friends Hypothesis or the Hygiene Hypothesis. Each of us has our own microbiome, a collection of bacteria, fungi, viruses, and protozoa that inhabit our skin and body, which may be as unique as our fingerprints. Some of these microbes help keep us healthy, while others may cause us to become ill. These organisms help regulate our digestion and impact our mood and

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our weight. Skin microbes can have immunoprotective effects. There are also surprisingly complex microbial ecosystems within indoor spaces. Removing all microbial life from these settings can create problems. For example, irritable bowel disease, asthma, and some mood disorders have been linked to overall decreases in our microbial exposure. Lack of exposure during childhood is thought to spark overreactive immune function later in life, potentially leading to increased inflammation and contributing to these afflictions. Focusing solely on murdering microbes can have unintended consequences. For example, our lab recently discovered a correlation between concentrations of antimicrobial compounds and an abundance of antibiotic-resistant bacteria indoors. This finding has led our team to reexamine indoor cleaning practices more broadly. DESIGNING INDOOR MICROBIOMES Architects can use many design features to shape and modify microbial communities within homes and office buildings. They include space configuration and occupant density; interior material selection; window location, size, and glass type; electric lighting spectrum and intensity; and air movement and ventilation strategies. Building managers also play a role. They can adjust the amount of outside air that is admitted and the frequency at which it is exchanged with indoor air. Other levers include humidification and dehumidification, and of course, cleaning products and practices.

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A healthy home is important to everyone in the family. Photo by Brina Blum.

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Natural unfinished wood surfaces have been shown to reduce the abundance of some viruses. Photo by Andy Fitzsimon.

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Our recent research suggests that many natural systems, such as daylight and natural ventilation, don’t just reduce energy consumption and support human health – they also support more diverse indoor microbial ecosystems and reduce the abundance of potential pathogens. Similarly, natural unfinished wood surfaces have been shown to reduce the abundance of some viruses more quickly than other common indoor surfaces, such as stainless steel or plastic. Humidification is an important influence in indoor settings. Most indoor environments are very dry in the heating season. Dampness can produce mold, but very dry air is also a problem. It dehydrates our mucus membranes and skin and carries particles deeper into our respiratory tract, leaving us more susceptible to infection. Dry air also decreases particle deposition, allowing ultra-fine particles to remain aerosolized longer. This increases the risk of airborne transmission of microbes. Indoor air with a relative humidity of 40%-60% avoids these harmful impacts. It has also been shown to decrease viral infectivity, likely by disrupting viruses’ outer membranes. Based on our past research, we have developed some basic guidelines for enhanced building operations during the COVID-19 pandemic. They aim to reduce the risk of indoor viral transmission in settings including homes, medical buildings, and other critical infrastructure These strategies can be applied to nearly every building. Examples include

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introducing more outside air, increasing air exchange, maintaining relative humidity of 40%-60%, opening windows to provide natural ventilation and flush out indoor spaces, increasing access to daylight, and implementing targeted disinfection techniques, such as UV-C light in health care settings. People can use similar strategies to reduce risks at home. If someone in the house has been infected or is symptomatic, we recommend having them self-isolate in a space next to a bathroom with an exhaust fan that can operate continuously. This will pull air from the rest of the home through the infected space and out the bathroom exhaust. BETTER LIVING THROUGH MICROBIOLOGY Our team’s next goal is to define what makes up a community of beneficial microbes. We are partnering with industry, institutions, and government organizations to develop real-time indoor microbial monitoring technologies that can support better-operating practices and improve contact tracing strategies. With this knowledge, we can monitor for pathogens and use data science to improve our understanding of healthy indoor microbiomes. How might people cultivate an indoor community of benign and favorable microbes? Several cleaning product manufacturers are already exploring the idea of adding specific microbes to indoor environments to outcompete or attack harmful microbes and curate others. These products avert many traditional cleaners’ “scorched earth” approach, which relies on caustic and volatile ingredients.

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Letting in sunlight and fresh air and maintaining healthy humidity levels can help create a healthy indoor environment at home during the COVID-19 pandemic. Photo by Brina Blum.

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We believe this concept is worth exploring but should be based on robust research with effective oversight. The key agency in this area is the Environmental Protection Agency, which regulates antimicrobial products designed as pesticides, including cleaning products. For several decades, the architectural design and construction industry has been developing standards to guide building performance, including aspects related to human health. In our view, it is time to focus on shaping healthy indoor microbiomes so that they can shape us.

aM T M T H E M I L L M AG A Z I N E

Dr. Kevin Van Den Wymelenberg is an Associate Professor at the University of Oregon, is the Director of the Energy Studies in Buildings Laboratory in Eugene and Portland, OR, and Co-Director of the Biology and the Built Environment Center. He has a PhD in the Built Environment from the University of Washington. He teaches classes in daylighting, integrated design principles, energy performance in buildings, and design. Van Den Wymelenberg has consulted on several hundred new construction and major renovation projects with architects and engineers regarding daylight, energy in buildings, and indoor environmental quality since 2000. Five of these projects have been recognized with AIA’s Committee on the Environment Top 10 Awards and many others are LEED certified. Leslie Dietz is a Wet Lab Manager at the University of Oregon and has a molecular biology and chemistry background. She’s done a lot of genetic sequencing work with soil and has researched bacteria, fungi, and hypertension. Not only is she a scientist, but she’s also a mom, weightlifter, wildland firefighter, and avid feminist who works to empower women in and out of the scientific field. Leslie is a Pod coordinator for Eugene’s 500 Women Scientists, and the Eugene chapter leader for the Bold Betties, a women’s outdoor pursuits group. She’s been fighting fires for 11 years and is currently thinking about going into competitive weightlifting. Mark Fretz is an Assistant Research Professor and Associate Director of Outreach at the University of Oregon’s Institute for Health in the Built Environment. A designer, researcher, and former Public Health Service clinician, Mark synthesizes diverse experience to facilitate knowledge exchange between the Institute’s Industry Consortium, research labs, collaborators, and stakeholders. His research interests are focused on exploring and designing synergies that optimize human occupant health while reducing energy use in buildings. An important theme in this exploration is understanding how human migration from outdoor to indoor dwelling has affected evolutionary mechanisms connected with health and how architectural design can restore these relationships. This article was originally published on The Conversation.

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Regular family meals together can have long-term benefits for children. Photo by August de Richelieu.

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5 ways

YOUR RELATIONSHIP WITH FOOD HAS IMPROVED SINCE THE PANDEMIC Te x t

by Stephanie.Me yers

I

t’s 5 p.m. on who can tell which day, and instead of rushing from work to kids’ activities, I’m unpacking a box of produce while my 7-year-old peels carrots beside me. Rather than grab what we can from the fridge on the way to soccer practice, my family is all sitting down together to a homemade vegetarian meal. On the menu tonight: cauliflower lentil tacos. HEALTHY HOME•EDITION 11 NO. 3•THEMILLMAGAZINE.COM

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Before you get the wrong impression that everything’s going swimmingly at my house, it’s not. But as a registered dietitian and a mom, I’m noticing a few noteworthy patterns amid the pandemic, both in my own family and in what my clients report every day. Some of these food-related behavior changes have the potential to become new habits with long-term benefits. Here are five eatingrelated behaviors I hope endure beyond the pandemic. 1. EATING FAMILY MEALS TOGETHER For the first time, some kids now have two parents home for weeknight dinners. In stark contrast, kids of front-line workers may eat more meals away from their parents. Each of these scenarios highlight the importance of eating together when you can. Research has found that eating as a family helps kids have better self-esteem, more success in school, and lower risk of depression and substance use disorders. Finding time for family meals isn’t always possible or easy. But hopefully, people will continue to prioritize eating together whenever they’re able. And remember, it isn’t only dinner that counts. Even eating a quick snack together or family breakfast is valuable. 2. KIDS LEARNING TO COOK Some families are making time to get kids involved in the kitchen. That’s good news because research shows it leads to healthier eating

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In some households, children are learning to cook and bake while parents are home during the pandemic. Photo by August de Richelieu.

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More families are opting for plant-based meals as a healthier alternative. Photo by August de Richelieu.

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as an adult. A long-term study found that adolescents who learned to cook by age 18 to 23 were eating more vegetables, less fast food, and more family meals a decade later. Learning to cook can be fascinating for kids but exhausting for overworked parents. Don’t lose heart if it seems every kid but yours can whisk and sauté. Ignite the basics by letting your child arrange simple snacks on a plate. It’s never too little, too early or too late to start giving kids some autonomy in the kitchen. 3. EATING MORE PLANT-BASED PROTEINS Nutritionists have spent decades encouraging people to eat plantbased meals. Now suddenly everyone’s stocking up on all kinds of dried beans and lentils. They’re trying tofu and homemade veggie burgers and finding out that, with the right recipes, these foods can be delicious. Alternatives to animal protein benefit the health of individuals and our planet. This doesn’t mean you need to become vegetarian, but you can start thinking about meat differently. Make it less of a main dish and more like a condiment. For example, instead of grilling a whole pack of chicken breasts for dinner try making vegetable kebabs using smaller or fewer pieces of chicken on the skewers. Or make a colorful dinner salad with grilled salmon crumbled on top.

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4. BUYING FOOD LOCALLY AND LENDING A HAND IN THE HUNGER CRISIS In the early weeks of COVID-19, some grocery shelves went bare while farmers plowed ripe crops into fields and dumped fresh milk down drains. Problems in the food supply chain that have been magnified by the pandemic have prompted people to seek local sources of food. Sales of regionally milled flour, sustainably caught fish, and community-supported agriculture programs have skyrocketed. I hope this trend continues long after the pandemic ends and deepens our appreciation for who and what it takes to bring food to our table. Another crisis is that 42 million Americans are facing food insecurity, a number that has grown daily amid the coronavirus pandemic. With increasing awareness of the hunger problem, people are stepping forward to help. Like my friend who’s decided to donate the produce from her garden to help other families in need. One critical thing we can do is advocate for policies that expand access to quality food and health care. 5. CHANGING MINDSETS ABOUT WELLNESS TO INCLUDE SELF-COMPASSION Eating is one of the most basic ways we take care of ourselves, and disruptions in food and activity routines have people rethinking how they define wellness.

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Buying produce from a local farm or a community-supported agriculture program is a growing trend today. Photo by Lisa Fotios.

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Many of my clients are starting to gently investigate their relationships with food and their bodies. With proper support, they’re creating “new normal” plans for eating that include self-compassion as a daily practice. One example is short daily meditations, which research suggests improves many aspects of well-being, including self-worth and body appreciation. One of the most important things I hope people maintain after the pandemic is more friendliness toward themselves as eaters. People have come home to roost around food in these unprecedented times, discovering new habits and insights about what it means to truly nourish themselves.Take pride in both big and small changes you’ve recently put into practice. They might turn into brand new habits with benefits in the long run. I encourage everyone to hang on to a homemade version of at least one food they used to buy instead of going back, because cooking at home benefits health and personal relationships.

aM T M T H E M I L L M AG A Z I N E

Stephanie Meyers has 22 years of experience as a registered dietitian specializing in cancer care, family nutrition, and sustainable behavior change. She is an instructor in the graduate nutrition program at Boston University, The Nutrition Coordinator at Dana-Farber Cancer Institute’s Zakim Center for Integrative Therapies and Healthy Living and Founder of Families Eating Well, a private nutrition practice in Boston. This article was originally published on The Conversation.

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A local exchange inspiring vibrant, prosperous communities throughout the Carolina Piedmont. #charlottenc #fortmillsc #rockhillsc #waxhawnc...

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