Bullying Can Turn Victims Into Bullies

SATURDAY, April 30, 2016 (HealthDay News) — A combination of face-to-face taunting and cyberbullying may greatly increase the risk that victims will become bullies themselves, a new study suggests.

“Students who are victimized are more likely to exhibit aggressive behaviors towards others,” said study principal investigator Alexandra Hua, from Cohen Children’s Medical Center of New York. “This phenomenon may lead to a vicious cycle whereby bullies create bullies out of those they victimize.”

In the study, researchers analyzed data from U.S. students aged 10 to 17. The investigators found that 43 percent of the children had experienced face-to-face bullying and 7 percent had been subjected to some form of cyberbullying through text messages, social media and other means.

Kids who experienced either in-person or online bullying were more likely to display aggressive behaviors, such as physical fighting, verbal hostility, property damage and peer coercion, the findings showed.

But the risk of those behaviors was more than twice as high among victims of both types of bullying, the study authors said.

Of the kids who experienced both forms of bullying, 38 percent showed aggressive behavior. This compared with 15 percent of those who were cyberbullied and 4 percent of those who were victims of face-to-face bullying alone.

The findings were scheduled for presentation Saturday at the Pediatric Academic Societies annual meeting, in Baltimore.

The results are concerning, but not surprising, study senior investigator Dr. Andrew Adesman said in an American Academy of Pediatrics news release.

“These behaviors may involve retaliatory measures against their aggressors, acting aggressive in order to fend off future bullying attempts, or worse, learning by example and engaging in bullying of previously uninvolved peers,” Adesman said. He is chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center of New York.

Hua also noted that with the high rates of mobile device use by young people, there should be greater focus on cyberbullying and its harm, especially when combined with face-to-face bullying.

Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Department of Health and Human Services has more on bullying.

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Kids With Two Dads as Well-Adjusted as Other Kids, Study Finds

SATURDAY, April 30, 2016 (HealthDay News) — Children of gay fathers are as well-adjusted as kids of heterosexual parents, a new survey finds.

Roughly 31,000 male couples are raising children in the United States, and little is known about the well-being of those kids, the researchers said.

“Because stigma continues to interfere with the efforts of gay men to become parents and with the lives of gay men and their children, our research underscores the need for social and legal protections for families headed by same-sex parents,” said principal investigator Dr. Ellen Perrin.

Perrin is director of research for the Center for Children With Special Needs at the Floating Hospital for Children at Tufts Medical Center, in Boston.

She and her colleagues analyzed responses from 732 gay fathers in 47 states who took part in an online survey. They were asked about their children’s well-being, including school performance, self-esteem and friendships.

The gay fathers’ responses were nearly identical to those of parents in a national general survey. For example, 88 percent of gay fathers and 87 percent of those in the general survey said their child was not unhappy or depressed. And, 72 percent of gay fathers and 75 percent of parents in the general survey said their child does not worry a lot.

Thirty-six percent of the children in gay families were born when the fathers were in a heterosexual relationship, 38 percent were adopted or fostered, and 14 percent were carried by a surrogate, the researchers found.

But many of the gay fathers said they faced barriers to sharing custody, adopting and using a surrogate carrier.

Twenty to 30 percent of gay fathers said they had faced stigma for being a gay father, mainly from family, friends and some people in religious settings. One-third of gay fathers said their children had experienced teasing, bullying or other stigma from friends.

“Our data add to those of other investigators showing that children of same-sex parents do as well in every way as children whose parents are heterosexual,” Perrin said in an American Academy of Pediatrics news release.

The study findings are to be presented Sunday at the annual meeting of the Pediatric Academic Societies, in Baltimore. Because the data and conclusions haven’t undergone peer review, they should be considered preliminary.

More information

The American Academy of Pediatrics offers advice for gay and lesbian parents.

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Autism Diagnosed at Younger Ages

SATURDAY, April 30, 2016 (HealthDay News) — Children are being diagnosed with autism at younger ages since the American Academy of Pediatrics (AAP) made changes to their diagnosis guidelines in 2007, a new study says.

The AAP guidelines now advise doctors to screen all children for autism during well-child visits when children are 18 months and 24 months old. By screening all children, those who have the condition can receive early treatment, researchers said.

To see if that change made a difference, researchers compared children diagnosed with autism between 2003 and 2012 at a center in New York City. Among children born before 2005, the average age of diagnosis was just under 4 years. The average age at diagnosis for kids born after 2005 was about 2.5 years, the study found.

“Our research shows that children evaluated before the AAP recommended universal pediatric screening were more likely to be diagnosed at an older age and with more severe autistic symptoms and more impaired adaptive functioning,” lead author Dr. Maria Valicenti-McDermott said in an AAP news release. She’s an attending physician at the Children’s Evaluation and Rehabilitation Center at Montefiore Health System, in New York City.

The researchers noted that it’s not clear if the increase in younger children being diagnosed is a direct result of the AAP guideline change. It’s also possible that an increase in general autism awareness may have played a significant role.

The findings are scheduled to be presented Sunday at the Pediatric Academic Societies meeting, in Baltimore. Studies presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.

Children in all racial and ethnic groups are being diagnosed at earlier ages, the research showed. Valicenti-McDermott said this is important because black and Hispanic children have often been diagnosed with autism later, which can lead to worse outcomes.

Not everyone agrees with the new guidelines. Earlier this year, the U.S. Preventive Services Task Force said there wasn’t enough evidence to recommend universal autism screening of young children when no concerns of autism have been raised by their parents or health care provider.

More research is needed to confirm the effectiveness of universal autism screening, Valicenti-McDermott said.

“But given the undisputed benefit of early identification of autism, sorting out the contribution of universal screening to this pattern will be an important next step to address the concerns of the U.S. Preventive Services Task Force regarding the benefits of early screening,” she said.

More information

The National Alliance on Mental Illness has more about autism.

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‘Wandering’ a Hazard for More Than a Third of Kids With Autism

SATURDAY, April 30, 2016 (HealthDay News) — Discovering that a child with autism has wandered away from the safety of home would be a terrifying moment for any parent.

Now, a new study reports that one-third of children on the autism spectrum engage in wandering behaviors.

“Wandering places children with autism spectrum disorders at risk of serious injury or even death once they are away from adult supervision,” study senior investigator Dr. Andrew Adesman said in a Northwell Health news release. Adesman is chief of developmental pediatrics at Cohen Children’s Medical Center (CCMC) of New York.

His team tracked the histories of more than 1,400 children, aged 6 to 17, with autism. The researchers found that more than one-third had wandered from a safe setting within the past 12 months.

Kids who wandered were more likely to be unaware of when they are in danger, and to have trouble distinguishing between strangers and familiar people, the study found. In addition, these kids were also more prone to sudden mood changes, to over-react to situations and people, to get angry quickly, and to panic in new situations or if faced with change, the researchers said.

Wandering was twice as likely to occur when the children were in a public place — for example a mall or street — than from home or school, Adesman’s team found.

Principal investigator Bridget Kiely said in the news release, “As the prevalence of autism spectrum disorders in the United States continues to rise, there is a need to better understand the behaviors that may compromise the safety and well-being of these children.” Kiely is a research assistant in the division of developmental and behavioral pediatrics at CCMC.

There is also an urgent need to find more effective ways to prevent children with autism from wandering, the researchers said.

The study findings were scheduled to be presented Saturday at the Pediatric Academic Societies annual meeting, in Baltimore.

More information

The National Alliance on Mental Illness has more about autism.

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More U.S. Kids Have Chronic Health Problems: Study

By Steven Reinberg
HealthDay Reporter

SATURDAY, April 30, 2016 (HealthDay News) — The number of American kids suffering from asthma and attention deficit hyperactivity disorder (ADHD) is on the increase, with poor children being hit the hardest, researchers report.

Children living in extreme poverty who had asthma and ADHD were nearly twice as likely to have at least one other chronic medical condition. These conditions included developmental delays, autism, depression, anxiety, behavioral or conduct issues, speech and language problems, epilepsy and other seizure disorders, and learning disabilities.

“These findings emphasize the importance of studying poverty and its impact on child health, as well as confirm the need for increased awareness to inform child health policy,” said lead researcher Dr. Christian Pulcini, a resident at Children’s Hospital of Pittsburgh.

The reasons for the increase in chronic conditions aren’t clear, but access to health care and health literacy may be playing a part, he said. Increases in these conditions also were seen among children who rely on public assistance for their health care, Pulcini added.

“I like to think we are doing a better job with access to care and diagnosis, but I don’t know of any data that states that definitively,” he said.

“I also think the health literacy of the population is slowly improving, and programs such as Early Intervention and school-based services in individual states are working with parents to ensure they are aware of health concerns such as learning disabilities, speech and language disorders, ADHD, etcetera,” Pulcini said.

“This is all speculation, however, as our data only identifies the trends and not any causal factors,” he added.

The findings were to be presented Sunday at the Pediatric Academic Societies annual meeting, in Baltimore. Research presented at meetings should be viewed as preliminary because it has not undergone the rigorous process of peer review that most medical journals require.

For the study, Pulcini and his colleagues analyzed data from the National Survey of Children’s Health for 2003, 2007, 2011 and 2012, looking for trends in asthma, ADHD and economic status.

They found more significant increases in asthma and ADHD cases among children living in poverty, compared with their wealthier counterparts. Poor children with these conditions also were more likely to suffer from two or more additional conditions.

“I would like to think it could all be attributed to better identification and diagnosis, but, at least in my experience, there are still many children of families with limited means who have poor access to regular care who may not have their primary or additional health conditions identified correctly,” Pulcini said.

Dr. Jefry Biehler, chairman of pediatrics at Nicklaus Children’s Hospital in Miami, said he wasn’t surprised by the findings.

“We continue to see that chronic conditions unevenly affect the poor and the underserved more than the those who are not poor and receive more frequent health care,” he said.

Expanded Medicaid services under the Affordable Care Act should help by providing better access to care for thousands of children, Biehler added.

“We need to face these issues head on and try to prevent or manage these chronic conditions early on so that outcomes will be much better, both for the individuals and society,” he said.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on health care for children.

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Study Suggests Aerial Pesticide Spraying Tied to Higher Autism Rates

By Amy Norton
HealthDay Reporter

SATURDAY, April 30, 2016 (HealthDay News) — Children living in an area of New York state that uses aerial pesticides to control mosquitoes have a higher rate of autism than children in neighboring areas, a new study finds.

Researchers found that children living in a swampy region in central New York were 25 percent more likely to have been diagnosed with autism or general developmental delay, compared to children in other parts of the state.

However, the findings do not prove that aerial pesticides raise the risk of autism, stressed lead researcher Dr. Steven Hicks, a pediatrician at Penn State Milton S. Hershey Medical Center, in Hershey, Pa.

“This study really brings up more questions than answers,” he said. “We need more research before taking any public action on pesticide use.”

One reason for restraint, Hicks noted, is that communities spray for mosquitoes to help prevent potentially severe mosquito-borne diseases, such as West Nile virus.

Still, the study isn’t the first to find a possible link between pesticides and autism rates, Hicks said.

He pointed to a study that made the news two years ago. California researchers found that pregnant women who lived within a mile of pesticide-treated crops were slightly more likely to have a child with autism, compared to women who lived farther from the treated fields.

The implicated chemicals in the California study belonged to a group known as pyrethroid pesticides, Hicks noted.

Hicks is scheduled to present findings from the new study Saturday at the annual meeting of the Pediatric Academic Societies, in Baltimore. Findings from meetings are generally viewed as preliminary until published in a peer-reviewed journal.

An estimated one in 68 U.S. children has been diagnosed with an autism spectrum disorder (ASD), according to the U.S. Centers for Disease Control and Prevention.

ASD refers a group of developmental brain disorders that affect children’s behavior and the ability to communicate and socialize. Symptoms range widely in severity: Some kids have relatively mild problems with social interactions. Others are unable to speak and focus on a limited number of repetitive behaviors, the CDC says.

Hicks said he and his colleagues were interested in whether the method of applying pyrethroid pesticides might be related to autism rates.

To do so, they looked at autism diagnoses among children at pediatric clinics in two New York state areas: eight zip codes within a swampy area where officials used aerial spraying of pyrethroid pesticides to control mosquitoes, and 16 zip codes that used different methods to apply pesticides, such as using hoses or manually spreading granules.

In the area with aerial spraying, Hicks said, one in 120 children was diagnosed with an autism spectrum disorder or developmental delay. The prevalence in areas without aerial spraying was one in 172, he said.

After the researchers accounted for factors such as local poverty levels and preterm birth rates, children in the zip codes with aerial spraying were still one-quarter more likely to have been diagnosed with an ASD, the study revealed.

“That suggests it’s not just the type of pesticide or the timing of exposure, but the mode of application that matters,” Hicks said.

However, he stressed, there could be other explanations for the link. And it’s not clear whether the children’s mothers lived in those zip codes during pregnancy — a “big limitation” of the study, Hicks said.

Dr. Paul Wang is head of medical research for the nonprofit Autism Speaks. If pesticide exposure contributes to autism risk, it would most likely be during fetal development — not childhood, he said.

And while a few studies have now found correlations between pesticides and autism risk, that doesn’t prove cause-and-effect, Wang said.

It’s also unclear whether there is anything special about aerial spraying, Wang pointed out. In this study, zip codes with aerial spraying also had higher levels of total pesticide exposure.

In general, Wang said, experts believe autism arises from an “interplay of genes and environment.” Researchers have found a number of genes associated with autism risk, and children with an affected older sibling are at higher-than-average risk.

Hicks made the same point. It’s thought that genes make some kids more vulnerable to autism, but they also need to be exposed to certain environmental factors during critical windows of early brain development for the disorder to emerge.

It’s not clear what those factors are, but some suspects include prenatal exposure to poor nutrition, certain infections and heavy air pollution, according to Autism Speaks.

For now, Wang suggested that expectant moms focus on good nutrition, regular prenatal care and other steps to help ensure they have as healthy a pregnancy as possible.

More information

Autism Speaks has advice on avoiding toxic exposures during pregnancy.

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Seniors’ Worsening Depression May Sometimes Predict Dementia

FRIDAY, April 29, 2016 (HealthDay News) — In some cases, worsening symptoms of depression in seniors might point to early dementia, a new study suggests.

The Dutch study can’t prove cause-and-effect, and certainly not every depressed senior is headed for dementia. But experts said the findings are intriguing.

“More research is needed, but the study raises the possibility of an overlap between the pathology of dementia and depression,” said Dr. Gisele Wolf-Klein, who reviewed the findings. She directs geriatric education at Northwell Health in New Hyde Park, N.Y.

The study was led by Dr. M Arfan Ikram, an epidemiologist at Erasmus University Medical Center in Rotterdam. His team tracked depression symptoms in more than 3,300 adults, aged 55 and older, in the Netherlands for 11 years. The patients were then monitored for signs of dementia for another 10 years.

During that follow-up, 434 of the participants developed dementia, including 348 cases of Alzheimer’s disease. Only those whose symptoms of depression increased over time were at increased risk for dementia, Ikram’s team found.

And not everyone in that group developed dementia: Only about 22 percent did so, the researchers said.

Still, that number was higher than for people who had a low level of symptoms of depression — only 10 percent in that group went on to develop dementia, the study found. That rate was similar for those with remitting (coming and going) symptoms of depression.

According to the research team, the findings suggest that having temporary depression — even if severe — does not have a lasting effect on the risk of dementia.

However, Ikram’s group believes that increasing symptoms of depression in older adults could be reflective of an early stage of dementia in some cases. They say the finding supports prior research suggesting that dementia and certain types of depression may have a common cause.

Wolf-Klein agreed. “Different courses of depression may reflect different underlying causes, and might be linked to different risks of dementia,” she theorized.

Dr. Aaron Pinkhasov is chair of behavioral health at Winthrop-University Hospital in Mineola, N.Y. He called the research “the first robust study looking into the very important association between depression and dementia.”

Pinkhasov believes the findings point to a possible common cause between the underpinnings of some cases of depression and dementia.

The study “raises extremely important questions about the role of depression screening and treatment in mitigating the risk of dementia development,” he said.

The study was published April 29 in The Lancet Psychiatry.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on dementia.

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If You’re Craving Cookies, You Might Just Be Bored

FRIDAY, April 29, 2016 (HealthDay News) — If you find yourself reaching into a bag of chips and you know you’re not hungry, maybe you’re just bored instead, new research suggests.

British researchers conducted two experiments to see how boredom affects people’s food choices.

In one trial, the researchers asked 52 participants to fill out a questionnaire about their food preferences before and after repeatedly copying the same group of letters. After completing that boring task, the participants were more likely to say they preferred unhealthy fare such as chips, sweets and fast food.

In a second experiment, 45 people were offered a number of healthy and unhealthy snacks while watching either a boring or funny video. Those who watched the boring video ate much more of the unhealthy snacks.

The findings were presented at the British Psychological Society’s annual meeting this week.

“These results are in line with previous research suggesting that we crave fatty and sugary foods when we are bored. This strengthens the theory that boredom is related to low levels of the stimulating brain chemical dopamine and that people try to boost this by eating fat and sugar if they cannot alleviate their boredom in some other way,” said lead investigator Sandi Mann, a senior psychology lecturer at the University of Central Lancashire.

Mann said this information could be helpful for people designing public health campaigns. If they want to encourage healthier food choices, they need “to take boredom, including boredom in the workplace, into account. Bored people do not eat nuts,” she said in a society news release.

Research presented at meetings is generally viewed as preliminary until published in a peer-reviewed journal.

More information

The American Heart Association has more on healthy snacking.

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Jello Shots While Underage, Bigger Booze Problems Later?

FRIDAY, April 29, 2016 (HealthDay News) — Many underage Americans down jello shots, and these young drinkers are more likely to binge drink, drink heavily and get into alcohol-fueled fights, researchers say.

The Boston University researchers surveyed more than 1,000 alcohol users, aged 13 to 20, and found that just over 20 percent had consumed jello shots in the past 30 days. Rates were slightly higher among females than males, and higher among those from homes with lower incomes and those without internet access.

Compared to those who did not consume jello shots, users consumed alcohol an average of slightly more than two more days per week and had more drinks per month (31 versus 19). In addition, jello shot users got into more fights after consuming alcohol (close to 19 percent versus 9.5 percent), the study found.

But the study did not prove that consuming these alcohol-laced concoctions caused young people to engage in heavy drinking.

Still, the findings suggest that jello shot consumption should be included in data collected about youth alcohol use, according to study leader Dr. Michael Siegel. He is a professor of community health sciences at Boston University.

“Specific interventions to address this consumption may be warranted as part of the effort to reduce risky alcohol use among youths,” Siegel said in a university news release.

Further research is needed to learn more about the link between jello shots and risky drinking, he and his colleagues added.

The study was published online recently in the Journal of Child and Adolescent Substance Abuse.

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism has more about underage drinking.

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Officials Report First Zika Death in Puerto Rico

FRIDAY, April 29, 2016 (HealthDay News) — The first known Zika virus-linked death in Puerto Rico was announced Friday by officials of the U.S. territory.

A 70-year-old man with Zika died in February from severe thrombocytopenia, which causes a low blood platelet count that can lead to internal bleeding. The death was announced by Puerto Rico’s health secretary, Ana Rius.

So far, Puerto Rico has had more than 600 Zika cases, including 73 involving pregnant women. All 14 women who have given birth so far have had healthy babies, the Associated Press reported. Zika can cause severe birth defects.

Sixteen of the Zika patients in Puerto Rico have been hospitalized and four are believed to have developed temporary paralysis due to the mosquito-borne virus, according to the U.S. Centers for Disease Control and Prevention.

The CDC is urging all residents of and travelers to Puerto Rico to continue to protect themselves from mosquito bites, take precautions to reduce the risk of sexual transmission of the virus, and seek medical care for any acute illness with rash or fever.

While the Zika virus poses little health risk to most people, it poses a significant threat to pregnant women because it can cause a birth defect called microcephaly, which results in babies born with abnormally small heads and brains.

To control the threat posed by Zika, officials in Puerto Rico are pursuing “vector control activities” that include indoor and outdoor spraying of insecticides and reducing mosquito breeding grounds, especially around pregnant women’s homes, the CDC said.

As of April 27, there were 1,025 confirmed cases of Zika in U.S. states and territories, according to the CDC. Nearly all of these infections were acquired by people who had traveled outside the United States.

As mosquito season approaches, U.S. health experts expect to see more infections in Gulf Coast states such as Florida and Texas, as well as Hawaii.

Meanwhile, new research suggests the Zika virus was circulating in Haiti months before the first cases in Brazil — the epicenter of the outbreak — were reported last spring.

“We know that the virus was present in Haiti in December of 2014,” said Dr. Glenn Morris, director of University of Florida’s Emerging Pathogens Institute. “And, based on molecular studies, it may have been present in Haiti even before that date.”

What remains unclear is exactly why there was such a widespread outbreak in Brazil, the study authors said, and more research is needed to reveal why the same did not happen in Haiti.

In Brazil, Zika infections have been linked to more than 5,000 cases of the birth defect microcephaly.

To uncover Zika’s presence in Haiti, the team of researchers analyzed three “mystery” infections reported in that country in 2014.

The cases involved school-aged children in Haiti’s Gressier/Leogane region who developed a fever. The students were taken to a free clinic where samples of their blood were screened for dengue, chikungunya and malaria.

The blood tests ruled out these three well-known viruses but little thought was given to the Zika virus, which was not known to be present in the region at the time.

Using an advanced testing method, the University of Florida researchers went back and analyzed the children’s blood samples. They found the samples tested positive for the Zika virus.

Their findings, published April 26 in the journal PLOS Neglected Tropical Diseases, suggest the virus was circulating in the Americas long before it swept through Brazil.

The earliest known outbreak of the Zika virus occurred in 2007 in a small group of islands in French Polynesia, known as the Yap Islands. That outbreak affected an estimated 73 percent of people aged 3 and older, the researchers said.

After comparing the viruses, the researchers found the genetic sequences of the slightly older Haitian strains of the virus were more similar to the French Polynesian strains than many of the Brazilian strains.

“There is a possibility that this virus had been moving around the Caribbean before it hit the right combination of conditions in Brazil and took off,” Morris said in a university news release.

“By using the sophisticated culturing and sequencing capabilities that we have here at the Emerging Pathogens Institute, we were able to begin to fill in some of the unknown areas in the history of the Zika virus, leading us toward a better understanding of what caused this outbreak to suddenly occur at the magnitude that it did in Brazil,” Morris said.

More information

The U.S. Centers for Disease Control and Prevention provides more information on the Zika virus.

To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

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These Adorable Sweet Potato ‘Nests’ are Perfect for Brunch

Photo: Beth Lipton

You have friends coming over for Sunday brunch. What to make that will look impressive, taste good, and also leave everyone feeling energized?

These little nests fit the bill in every way. They’ve got vitamin-rich sweet potatoes (also a great source of fiber, potassium, and other minerals), satiating eggs, and metabolism-boosting chili powder. Plus, look how cute they are! Serve a salad or some fruit on the side, and you’re good to go.

Sweet Potato Egg Nests

Yield: 12

1 lb. sweet potatoes, ends trimmed, potatoes scrubbed and thoroughly patted dry

3 Tbsp. neutral oil, like grapeseed

3/4 tsp. chili powder, optional

Salt and pepper

12 large eggs

Chopped parsley, for garnish, optional

1. Preheat oven to 350ºF. Using a food processor with a shredding attachment or the large grates on a box grater, shred sweet potatoes (you’ll have about 4 2/3 cups). Warm oil in a large skillet over medium heat. Add sweet potatoes and chili powder, if using. Season with salt and pepper. Cook, stirring often, until just tender, about 4 to 5 minutes. Transfer to a bowl and let cool.
2. Mist a 12-cup muffin tin with olive oil cooking spray. Place about 1/3 cup potatoes in each muffin cup. Press potatoes firmly into bottom and sides of each cup. Bake for 5 minutes.
3. Crack an egg carefully into each cup. Sprinkle with salt and pepper. Bake until eggs reach desired firmness, 20 to 25 minutes. Let cool for 5 minutes in pan before carefully removing. (Run a knife or offset spatula around edges before carefully lifting out.) Sprinkle with parsley just before serving, if desired.

Note: Be sure to use large eggs, not extra large, because extra large will overflow the muffin cups.

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21 Signs You’ve Found Your Fitness Swole Mate

Image: Pond5

There’s strength in numbers—literally. While a solo sweat session can be therapeutic and confidence-boosting, we can all get by with a little help from our friends. Whether you thrive in spin class, at CrossFit, on group runs or at the yoga studio, it’s easier to feel motivated when you can look to your side and see a fitness buddy who can’t stop, won’t stop. (It’s no secret that working out with a partner or group of like-minded people has numerous benefits!) And if exercising at home is more your speed, commiserating over burpees with your online BFFs can motivate you to push your limits.

But what separates the good workout partners from the ride-or-die fitness besties that have your back, 100 percent of the time? Here are 21 signs you’ve found your fitness soul mate—er, swolemate.

RELATED: 20 Partner Exercises from the Fittest Couples on Instagram

21 Signs You’ve Found a True Fitness Buddy

1. The time flies when you’re sweating together.
Want to know how to make that HIIT workout easier? You’ll get a dose of healthy distraction when you’ve got a buddy. Robyn Broker, blogger at Run Birdie Run, forgoes her running playlists when she’s got a friend to entertain her. “A long run with a running BFF is a multi-hour conversation… Sometimes there’s constant chatter and sometimes there’s silence, but running completely transforms when it’s in a shared space.”

2. You don’t give in to each other’s excuses.
It’s easy to tell yourself you can’t do another rep. It’s harder to tell that to a friend. “When I work out with my boyfriend, we push each other way out of our respective comfort zones,” says Lauren Wolman, blogger at Peanut Butter Is My Boyfriend. “Whether he’s encouraging me to lift those 10 extra pounds or I’m convincing him that doing seven minutes of planks is a great idea, it’s not about competition or proving anything to each other. We’re working together to push ourselves further.”

RELATED: The 25 Craziest Workout Excuses Trainers Have Ever Heard

3. You’ll exercise together, even if you’re at different fitness levels.
Think having different fitness levels is a swolemate deal breaker? Think again. NYC-based runner and physical therapist Abby Bales is 30 minutes slower than her 3:04 marathon running buddy, but that doesn’t stop them. “My friend has worked out with me through everything—when I had a colostomy bag, after surgeries, when I was pregnant and barely moving, post-partum, and with my son in a stroller,” says Bales. “She never makes me feel like I’m not worthy of her fitness company.”

4. You’ll sacrifice sleep to meet up.
It’s tempting to hit the snooze button when you’ve got a solo workout on tap. But if you know your friend is waiting for you, you’re far less likely to bail. “My friend Nina is my accountabilibuddy,” says blogger Tracy Davis, who uses the term coined by her November Project workout group. Nina and Tracy made a pact to touch base at 5:45 a.m. to make sure they’re both out of bed and ready to go for a run or to the gym.

5. You’ll help each other recover properly.
Davis’s accountabilibuddy gives her the push she needs to keep her lower body foam rolled and feeling good, too. “She stays on top of me to make sure I’m doing my IT-band recovery work,” says Davis of her fitness bestie. We all strive to #NeverMissaMonday, but hey, sustainable workouts are the end goal, right?

RELATED: 7 Reasons to Never Miss a Monday Workout

6. You high five or fist bump on the reg.
You don’t have to pat your own back when you’re done sweating—your friend can do it for you. Even if it’s a shaky-armed high-five between push-up sets or a quick fist bump after Tabata, sometimes that classic, old-school form of encouragement is totally more validating than a push notification from your fitness tracker.

7. Their accomplishments are just as exciting as your own.
Whether it’s a race, a CrossFit competition, or holding a five-minute plank, training for your own goals is exciting, satisfying and empowering. Watching your fitness friend hit his or her goals, though? Equally if not more awesome. Runner Meggie Smith, blogger at The Thinks I Can Think, was psyched to watch her friend Jocelyn get a marathon PR, and the support is always mutual. “When I saw Jocelyn after I ran a Boston-Qualifying race, the first thing she said to me was, ‘Of course you did! I knew you would!’”

8. Things seem less scary when you’re together.
While Meghan Conroy’s workout bestie liked the front-row-center spot during spin class, 32-year-old Conroy, a senior research analyst in Los Angeles, preferred a less conspicuous seat. But Conroy eventually made her way to the front row. “I became more brave and finally tried the front row because there were two of us, and there was safety in numbers,” Conroy says. “That made it less scary.”

9. You look forward to your sweat dates, even after a long day.
“By the end of the workday, I’m typically dragging and have zero motivation,” says Conroy. But she can’t turn down the opportunity to meet up with her fitness buddy. “If I made plans to meet my friend at the gym for a boxing class, I’m going to show up. It gives me something to look forward to all day at the office.”

10. You share stuff that would be TMI to anybody else.
Bruised toes, chafing disasters, bathroom breaks gone wrong… you share it all and then some with your partner in crime. True sign of a swole mate? You’re not above swapping blister photos to get advice on popping technique.

Read the rest on Life by Daily Burn

More from Daily Burn:

Need Running Motivation? 20 Epic Runspo Instagrams
The 20 Worst People at the Gym, According to Trainers
What Happens to Your Body When You Skip the Gym

Life by Daily Burn is dedicated to helping you live a healthier, happier and more active lifestyle. Whether your goal is to lose weight, gain strength or de-stress, a better you is well within reach. Get more health and fitness tips at Life by Daily Burn.

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Link Between Money Woes, Domestic Abuse Tough to Untangle

FRIDAY, April 29, 2016 (HealthDay News) — Money problems and domestic violence appear to be linked, but it’s not clear whether one leads to the other, researchers report.

“What we don’t know yet is whether financial stress makes a violent couple more violent, or is financial stress enough of a disruption in a relationship that violence begins? Both are plausible,” said study corresponding author Corinne Peek-Asa. She is the director of the Injury Prevention Research Center at the University of Iowa.

Peek-Asa and her colleagues analyzed data collected from nearly 11,500 Americans, aged 24 to 32, in 2008 — the middle of the Great Recession. They then examined the association between financial issues and three levels of domestic violence: making threats/minor physical abuse; severe physical abuse; and physical abuse causing injury.

More women (about 28 percent) than men (almost 23 percent) reported money problems in the prior 12 months, the study found. And more women than men said they were unable to pay for utilities or housing; concerned about being unable to afford food; and worried about having utilities shut off or being evicted.

Women were also more likely to say they had resorted to threats and minor abuse, and more than twice as likely to have perpetrated severe physical abuse (11 percent versus 7 percent). But men were more likely than women to have committed physical abuse causing injury (32 percent versus 21 percent), the researchers reported.

Among all the study participants, about nine out of 10 women and men said they hadn’t committed any form of domestic violence to their partner in the previous year.

While the findings are helpful, they aren’t conclusive enough to develop ways of helping, said study author Laura Schwab-Reese, who earned her Ph.D. from the university’s College of Public Health.

“So, we know violence happened in the last year, and we know that financial stressors happened in the last year,” Schwab-Reese said in a university news release. “But what we haven’t been able to tease apart with this data is whether the financial stressor happened immediately before a violent episode, or did it exacerbate an already violent relationship? That is a really important point in terms of developing interventions.”

Identifying the central issue is crucial for providing effective help, Peek-Asa agreed.

“When we are developing interventions, do we need to focus on reducing the event, such as reducing the financial stressor, or do we need to help people manage the stress that happens as a result of the financial stressor?” she said.

The study was published online recently in the journal Injury Epidemiology.

More information

The U.S. Department of Justice has more on domestic violence.

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