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	Ask the doc Dr. Pierre-Paul Tellier is associate professor of family medicine and director of student health services at McGill University in Quebec.

“Some of my friends have developed fatty liver disease and they are so young. Why is this happening to them? ”
—Luc G., Cambrian College, Ontario

When “fatty liver” is translated literally into French it becomes foie gras. Do you know how foie gras is made? Farmers force-feed ducks or geese until eventually their liver becomes very full of fat. While we do not know the exact mechanism that leads to the development of this abnormality in humans, we do know it has some relationship with poor nutritional habits.  

What is non-alcoholic fatty liver disease?
When people talk about fatty liver, they are usually referring to non-alcoholic fatty liver disease (NAFLD). With NAFLD, the liver cells get infiltrated with fat. (We all know that drinking alcohol regularly can lead to liver disease. In its milder form, this may simply appear like a fatty liver, but as it becomes more serious it may present as cirrhosis. Cirrhosis is the destruction of liver cells caused by alcohol.)

Between 1988 and 2008, NAFLD doubled in prevalence and became the most common cause of chronic liver disease, according to a 2011 study by the Center for Liver Disease in Virginia. During the same time we have also observed an increase in obesity, high cholesterol levels, high blood pressure, and diabetes. This is called the “metabolic syndrome”. This does not mean that the metabolic syndrome causes NAFLD, but there is a relationship between the two and it can occur at any age.

How do you know you have it and what does it mean?
Most people have no symptoms. Fatty liver can be diagnosed when a blood test for the liver is done and found to be abnormal. However, this does not mean that abnormal liver test results are all related to fatty liver, so further tests are required. The most useful test is an ultrasound or MRI.  

Most people have no long-term consequences except for those that have the inflammatory type, which may lead to cirrhosis. However, getting to that diagnosis is not simple, and even if the diagnosis of an inflammatory condition is made, we do not know who will progress to severe disease.

What can you do if you have it?
We don’t really know. However, as previously mentioned, fatty liver is often linked to other conditions that are concerning for long-term health. And, interestingly enough, by managing these conditions—e.g., losing weight or controlling blood sugar or cholesterol—you can also improve fatty liver disease.

The lesson to be learnt: Don’t be a goose. Eat well and don’t force-feed yourself, and you may avoid this problem. However, stay tuned: it may not be this simple. There’s a lot still to be learned about this condition.

	Ask the counselor Sharon Sevier, PhD, LPC, is chair of the board of directors of the American School Counselor Association.

“Is it better to sleep it off when you’re going through a tough time?”
—Mark S.*, University of Alaska, Anchorage (*name changed)

Sleep can be a great way to help yourself if you’re sick, but it’s not the best way to cope with tough times. When you’re asleep you’re avoiding your problems, but when you’re awake you can get the support you need from yourself and others. So, how can you take care of yourself in tough times?

Think about possible solutions
You don’t need to act on it right away, but start thinking about what you can do to make the situation better. How can you solve or alleviate the issue? What are the first steps needed to find a solution?

For example, are you having a hard time at school because you are overwhelmed with homework? If so, what are some ways to lighten up your workload? Could you reserve some extra time during the day to catch up? Are there people who could help you? Could you talk to your teachers? Or get a tutor?

Distract yourself 
Instead of retreating into bed and under the covers, try to do something else. This may be the perfect time to try something new. Have you been meaning to be physically active again? Go for a walk outside. Being active outdoors can have dramatic positive effects, reducing our stress and increasing our coping ability.

Hang out with your friends
Friends can be the support you need in tough times. You can talk with them openly, and they’ll listen and may have ideas for how to help. Sometimes when we are dealing with tough stuff, it’s a relief to just hang out with our friends and get our minds off it. Those relationships build our resilience.

Take care of yourself 
When you’re dealing with a stressful situation, you need to take extra care of yourself. Remember to eat regularly, stay physically active, get enough sleep, and really listen to what your body is telling you. You may need some alone time, and that’s OK—just don’t habitually withdraw. 

Stay positive 
When you are feeling down, try to remember that this is only temporary. You won’t always feel this way. Take it one hour at a time so that you aren’t overwhelmed. One hour you might be upbeat, the next hour you may feel more discouraged. It’s OK to take the good with the bad—after all, that’s what developing coping skills is all about.

	Ask the trainer Frankie Romeo is a certified personal trainer, small group training coach, and graduate student at Lipscomb University in Nashville, Tennessee.

“What exercises could the average student do to eliminate neck pain caused by spending too many hours sitting over a desk? ”
—Amber O., California State University, San Bernardino

Whether we are in class listening to a lecture or at home completing an online assignment, we often have no choice but to sit for long periods of time. In fact, there’s a good chance you’re seated right now. Without moving, analyze your posture: Is your head tilted downward? Are your shoulders slouched forward?

Even if we start from a healthy posture, we tend to relax when our attention is focused elsewhere. This makes it easy to place stress on the posterior muscles of the neck and upper back. I’ve provided four exercises you can perform two to three times each week that help strengthen the muscles linked to neck pain. These can be done inside or outside the gym. Two of the four exercises require an elastic band—an effective, cost-efficient tool for at-home training.

Resisted head extension

• Waffle your hands and place them behind your head toward the top.
• Look up toward the sky, then touch your chin to your chest. This will look like an exaggerated nod.
• The hands behind the head are constantly pulling the head down, forcing the chin towards the chest. Resistance is being applied during the entire movement when moving the head both up and down. This will strengthen the posterior neck muscles, which support your posture.
• Perform 20 slow repetitions.

Lying “T” raise
Perform this movement on a padded surface or carpet to help reduce any discomfort.

• Lie facedown on the floor with your arms straight out, forming a “T,” with your thumbs up.
• Lift your arms and head off the floor. Keep your neck neutral by facing the floor.
• Hold this position for 10–30 seconds. Repeat 3–5 times.

Low straight-arm pull

• Anchor an elastic band around a stable object (e.g., a railing, a piece of playground equipment or furniture, a tree branch). It should be around thigh-height, somewhere between your knee and your hip.
• Stand facing the band with one end in each hand at your sides. Your arms should be straight with no slack in the band. This is the starting position.
• Maintain straight arms and an upright posture as you pull the band slightly behind you. Initiate the movement by squeezing the back and shoulder blades together rather than pulling only at the hands. Step backward or forward as needed to adjust the resistance of the band.
• Perform up to 3 sets of 12–15 repetitions per set.

High elbow rows

• Anchor an elastic band around a stable object (e.g., a railing, a piece of playground equipment or furniture, or a tree branch). It should be around chest height.
• Stand facing it, holding the ends of the band in your hands, with staggered feet—one foot slightly in front of the other.
• Lift your elbows so that your arms form a 90-degree angle with your torso. Maintain this position and an upright posture as you pull with both hands. Make sure to squeeze your back and shoulder blades together.
• Perform up to 4 sets of 8–12 repetitions per set.

Mind your mind

Hope for the haters: How to do self-compassion

By Dr. Holly Rogers

Do you criticize yourself repeatedly? Are you hard on yourself for even small missteps, like leaving your apple core decomposing on the counter or reading the wrong chapter of social psych? If so, you might be a hater. In 2016, make self-compassion your priority.

People who cut themselves more slack are happier, less stressed, and more productive, studies show. Read on for students’ questions on self-compassion. No judgment here.

#JobProb

How (and why) to get that internship

In a crowd of applicants, how can you get noticed? How can students demonstrate hands-on, relevant experience? How much does an internship matter to your future employers? Is it possible to make your summer serving ice cream sound like a UN position? Experts reveal all.

Whichever year of college you’re in, it’s not too soon to be thinking about how to position yourself for the job market you’ll face after graduation. The Job Prob, our monthly series, shows you how to use your college years to build the skills, practical experience, and networks that will help you thrive professionally.

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Contributor spotlight

Noelle Vuong is a fourth-year nursing student at Humber College in Ontario.

For this issue, Noelle reviewed Fooducate, an app that gives us an insider’s look into the ways the food industry hooks us. It helps us eat healthier by offering an A–D rating for food items, debunking nutrition myths, and enabling users to share recipes.

Why did you join the SH101 Student Advisory Board? 
“I joined the SAB to gain a unique experience of working at a health magazine. Each month, I’m amazed at how students across the country keep healthy and active. My favorite part is always the cooking videos, because the recipes are usually right within my budget and time constraints.”

Best productivity tip?
“Take care of yourself. I keep an agenda of how my week is going to play out, and I always leave a big blank space on Saturdays to do literally nothing related to school—like going out with family or friends, seeing a movie, or sleeping in.”

Student reporter internship
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Student advisory board
Selected students from our diverse community of readers help shape SH101 content.
+ 2015 – 16 Student Advisory Board