Topic: BODY

Rethinking What it Means to Recover from Addiction


My addiction was so extreme that by the end, I was injecting dozens of times a day. So I grabbed the lifeline I was thrown and attended the traditional 12-step rehab program recommended by the hospital where I underwent withdrawal.

But once I began to study the scientific data on addiction, I learned that these claims were not accurate. In fact, research shows that most people who meet full diagnostic criteria for having an addiction to alcohol or other drugs recover without any treatment or self-help groups—and many do so not by quitting entirely, but by moderating their use so that it no longer interferes with their productivity or relationships.

There is no “one true way” to end addiction—and the idea that “one size fits all” can be harmful and even deadly in some cases. Until we recognize this and celebrate the variety of recovery experiences, September’s National Recovery Month and similar efforts to promote healing will fail to reach millions of people who could benefit. During an overdose crisis that killed more than 90,000 people in 2020 alone, a better understanding of how people really do overcome addiction is essential.

Unfortunately, rehab hasn’t improved much since I attended in the late 20th century. At least two-thirds of American addiction treatment programs still focus on teaching the 12 steps and promoting lifelong abstinence and meeting attendance as the only way to recover. (The steps themselves include admitting powerlessness over the problem, finding a higher power, making amends for wrongs done, trying to improve “character defects” and prayer—a moral program unlike anything else in medicine.)

Moreover, despite the fact that the only treatment that is proven to cut the death rate from opioid addiction by 50% or more is long-term use of either methadone or buprenorphine, only about one-third of residential programs even permit these effective medicines, and around half of outpatient facilities use them, typically short-term.

Worse: when they do allow medication, most treatment centers also push people with opioid use disorder to attend the 12-step program, Narcotics Anonymous. That creates what can be deadly pressure to stop the meds. The group’s official literature says that people on methadone or buprenorphine are not “clean” and have only substituted one addiction for another.

I have been contacted by more than one family who lost a loved one to overdose because their relative had rejected or prematurely ended medication based on this view. If we don’t start to view recovery more inclusively, we are denying hope and healing to those who benefit from approaches other than the steps.

So, what does a more accurate and expansive view of recovery look like? To me, one of the most helpful definitions was devised by a group known as the Chicago Recovery Alliance (CRA), which founded the Windy City’s first needle exchange. CRA was also the first organization in the world to widely distribute the overdose reversal drug naloxone—and train drug users to save each other’s lives by using it. Naloxone (also known as Narcan) is a pure antidote to opioids: it restores the drive to breathe in overdose victims but must be given rapidly to be effective. (If used in error, it is safe: it won’t hurt people with other medical problems and typically works even if opioids have been combined with other drugs.)

15 natural ways to lower your blood pressure

If left uncontrolled, high blood pressure raises your risk of heart disease and stroke.

But there’s good news. There are a number of things you can do to lower your blood pressure naturally, even without medication.

Here are 15 natural ways to combat high blood pressure.

1. Walk and exercise regularly

Exercise is one of the best things you can do to lower high blood pressure.

Regular exercise helps make your heart stronger and more efficient at pumping blood, which lowers the pressure in your arteries.

In fact, 150 minutes of moderate exercise, such as walking, or 75 minutes of vigorous exercise, such as running, per week, can help lower blood pressure and improve your heart health.

What’s more, doing even more exercise than this reduces your blood pressure even further, according to the National Walkers’ Health Study.

Bottom line: Walking just 30 minutes a day can help lower your blood pressure. More exercise helps reduce it even further.

2. Reduce your sodium intake

Salt intake is high around the world. In large part, this is due to processed and prepared foods.

For this reason, many public health efforts are aimed at lowering salt in the food industry.

Many studies have linked high salt intake with high blood pressure and heart events, including stroke.

However, more recent research indicates that the relationship between sodium and high blood pressure is less clear.

One reason for this may be genetic differences in how people process sodium. About half of people with high blood pressure and a quarter of people with normal levels seem to have a sensitivity to salt.

If you already have high blood pressure, it’s worth cutting back your sodium intake to see if it makes a difference. Swap out processed foods with fresh ones and try seasoning with herbs and spices rather than salt.

Bottom line: Most guidelines for lowering blood pressure recommend reducing sodium intake. However, that recommendation might make the most sense for people who are salt-sensitive.

3. Drink less alcohol

Drinking alcohol can raise blood pressure. In fact, alcohol is linked to 16% of high blood pressure cases around the world (12Trusted Source).

While some research has suggested that low-to-moderate amounts of alcohol may protect the heart, those benefits may be offset by adverse effects (12Trusted Source).

In the U.S., moderate alcohol consumption is defined as no more than one drink a day for women and two for men. If you drink more than that, cut back.

Bottom line: Drinking alcohol in any quantity may raise your blood pressure. Limit your drinking in line with the recommendations.

4. Eat more potassium-rich foods

Potassium is an important mineral.

It helps your body get rid of sodium and eases pressure on your blood vessels.

Modern diets have increased most people’s sodium intake while decreasing potassium intake.

To get a better balance of potassium to sodium in your diet, focus on eating fewer processed foods and more fresh, whole foods.

Foods that are particularly high in potassium include:

  • vegetables, especially leafy greens, tomatoes, potatoes, and sweet potatoes
  • fruit, including melons, bananas, avocados, oranges, and apricots
  • dairy, such as milk and yogurt
  • tuna and salmon
  • nuts and seeds
  • beans

Bottom line: Eating fresh fruits and vegetables, which are rich in potassium, can help lower blood pressure.

The FDA Authorized a Booster Shot

“After considering the totality of the available scientific evidence and the deliberations of our advisory committee of independent, external experts, the FDA amended the Emergency Use Authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine to allow for a booster dose in certain populations such as health care workers, teachers and day care staff, grocery workers and those in homeless shelters or prisons, among others,” said Dr. Janet Woodcock, acting FDA commissioner in a statement announcing the FDA’s decision. “As we learn more about the safety and effectiveness of COVID-19 vaccines, including the use of a booster dose, we will continue to evaluate the rapidly changing science and keep the public informed.”

The agency’s decision follows the advice of its advisory committee, which met on Sept. 17 to review data on Pfizer-BioNTech’s booster, and voted unanimously to authorize an additional dose for certain populations. The FDA’s decision now goes to the Centers for Disease Control’s (CDC) Advisory Committee on Immunization Practices to provide details on how long people who have already been vaccinated must wait before getting a booster, and whether the booster should only be given to people who were originally vaccinated with the Pfizer-BioNTech shot, which is likely.

The data that Pfizer-BioNTech presented to the FDA showed the booster dose was both safe and efficacious in increasing waning immune responses to the vaccine. In the companies’ studies involving several hundred people who received the recommended two doses of the vaccine, antibody levels against the COVID-19 virus started to fall after several months. But boosting with third dose of the vaccine about six months after the second shot brought antibody counts back up, in some cases to levels even higher than those generated after the second dose. The FDA also reviewed data from Israeli health agencies, which showed early evidence that booster doses reduced infection rates among people over 60 years by 10-fold compared to those who received only the two original doses, and that the additional dose brought antibody levels up to where they were just after the second dose.

There are less robust data on people in younger age groups, since anyone in that category who has been vaccinated received their shots more recently than the elderly, who the FDA prioritized to receive the Pfizer-BioNTech vaccine first, after the agency authorized the two-dose shot in Dec. 2020. That’s why the advisory committee voted against recommending a booster for all vaccinated people, as Pfizer-BioNTech originally requested, and limited its recommendation to high-risk populations.

Studies looking at people who were originally vaccinated with Moderna or Johnson&Johnson-Janssen’s shot and received a different booster dose are expected soon, but were not available for health officials at FDA or CDC to review yet.

“This first FDA authorization of a COVID-19 vaccine booster is a critical milestone in the ongoing fight against this disease,” said Albert Bourla, chairman and chief executive officer of Pfizer, in a statement. “Today’s FDA action is an important step in helping the most vulnerable among us remain protected from COVID-19.”

Recovering from sleep deprivation takes longer than expected

It is common knowledge that sleep is essential for health. This is true for virtually all living creatures. However, new research suggests that the ability to readily “catch up” on lost sleep later is more myth than fact. 

Investigators at Jagiellonian University in Kraków, Poland, carefully examined changes in functioning associated with sleep loss among adults. Their results appear in the journal PLOS ONE.

Participants spent 10 days experiencing partial sleep deprivation, getting about one-third less sleep than usual. This was followed by a full week of recovery. 

The researchers’ findings suggest that sleep deprivation takes a lingering toll on functionality. Deficits in people’s ability to think clearly tended to accumulate as “partial sleep restriction” progressed.

Catching up is hard to do

The participants did not easily recover from these sleep deficits — not even after extra “make-up” sleep on subsequent days. 

The amount of sleep that people need varies widely. On average, however, adults require at least 7 hours every day to maintain peak functionality.

Dr. Stephanie M. Stahl is an assistant professor of clinical medicine and clinical neurology at the Indiana University School of Medicine in Indianapolis. 

Dr. Stahl, who was not involved in the research, specializes in sleep medicine. In an interview with Medical News Today, she commented on the importance of this and similar studies.

“This study adds to a large body of evidence that insufficient sleep has detrimental effects on our daytime functioning,” she said. “This study in particular highlights that even a short duration of obtaining only 1–2 hours below our goal of 7-plus hours of sleep caused persistence of impairment, even after 1 week of obtaining sufficient sleep.”

A weary world

In today’s busy world, it is exceedingly common for adults to sacrifice sleep for work, entertainment, and other reasons. 

Many people underestimate the effects of this low-level, chronic sleep deprivation on their mental and physical health. A lot of people believe that they can “make up” for lost sleep by sleeping longer on the weekends, for example. However, the new research suggests that we may be greatly overestimating this ability.

In their paper, the researchers note that disrupted sleep has always been common in certain professions and industries, such as healthcare, entertainment, and transportation. However, many dayshift workers are now working from home, resulting in a “blurring of the boundaries between work and private life.”

Although the ability to work remotely has been a boon for many during the global pandemic, all is not well. “The disruption of the rest-activity rhythm is one of the common side effects of remote work,” the investigators note.

Obesity and weight loss

There is significant consensus in the scientific community that environmental factors, especially the easy availability of highly processed foods and sedentary lifestyles, have contributed to increasing obesity rates.

However, there is much disagreement about how these environmental factors contribute to weight gain.

According to the predominant energy balance model (EBM), consuming more calories than those burned results in a positive energy balance and weight gain.

The increased caloric intake due to the easy accessibility of highly palatable and inexpensive processed food and lower energy expenditure due to reduced physical activity levels have contributed to the global increase in obesity. 

In other words, the EBM suggests that successful weight loss requires reducing total calorie intake. This involves consuming fewer calories and increasing physical activity levels.

Unlike the EBM, the carbohydrate-insulin model (CIM) posits that the quality of food consumed plays a critical role in body weight management rather than total calorie intake. 

Specifically, consumption of processed and starchy carbohydrates that cause a rapid increase in blood glucose levels results in their storage as fat. Increased fat accumulation sets off a feedback loop resulting in increased hunger and possible consumption of calorie-rich foods.

The CIM states that it is the increase in fat storage due to the consumption of processed carbohydrates and not increased calorie intake that leads to weight gain and is primarily responsible for elevated obesity rates.

A recent article published in the American Journal of Clinical Nutrition provides a comprehensive description of the CIM, along with testable hypotheses that may help clarify the precise changes in nutrition necessary to lose weight or maintain a healthy weight. 

The article’s first author Dr. David Ludwig, told Medical News Today, “If the CIM is right, then the conventional approach to weight loss, the low-calorie diet, is likely to fail for most people over the long term. We argue that people have more control over what they eat than how much. A focus on reducing processed carbohydrates, rather than calorie restriction, may be more effective by lowering the biological drive to store excessive fat.”

Flaws of the EBM

According to the EBM, a positive energy balance where a person takes in more calories than they burn is primarily responsible for weight gain. In other words, the EBM regards all calories in the same way, regardless of their dietary source. 

The proponents of the CIM acknowledge that a positive energy balance is associated with weight gain, but this does not establish causation. 

They argue that metabolic and hormonal changes that occur in response to the consumption of specific foods are the root cause of weight gain, with excessive calorie intake being the outcome. 

Although calorie intake tends to increase during puberty, some experts think that it is the biological changes rather than positive energy balance that is responsible for the growth spurt. 

Therefore, while the EBM focuses on the overall consumption of calories, it ignores the role of food quality and the subsequent metabolic processes and hormonal changes in mediating weight gain. 

Moreover, reducing caloric intake tends to be successful as a weight-loss strategy only in the short term. This is due to the body adapting to the lower calorie intake, resulting in lower metabolic rate and increased hunger.

Sleep apnea may almost double the risk of sudden death

Obstructive sleep apnea has become a globally prevalent health concern. Recent literature estimates that more than 1 billion individuals experience this chronic sleep disorder.

A study by Penn State College of Medicine in Hershey, which appears in BMJ Open Respiratory Research, found that those who receive a diagnosis of obstructive sleep apnea are at a significantly greater risk of dying suddenly than those who do not have the condition.

The word apnea means “without breath.” During obstructive sleep apnea, there is a reduction or complete blockage of airflow during sleep. This sleep disturbance manifests itself in various ways, including excessive daytime sleepiness, fatigue, heavy snoring, and non-refreshing sleep.

Serious consequences of sleep apnea

While these symptoms can potentially affect a person’s quality of life, they can also have even more serious consequences.

Researchers at Penn State performed a systematic review of the literature and identified 22 studies focusing on obstructive sleep apnea, cardiac death, and sudden death. The team analyzed the combined data of these studies by meta-analysis. 

The quantitative analysis included a combined total of over 42,000 individuals across the world. The mean age of participants was 62 years old, and 64% were men.

The meta-analysis showed that individuals with obstructive sleep apnea were approximatelytwice as likely to experience sudden death than those who did not have the sleep condition. The study also identified that obstructive sleep apnea resulted in a nearly twofold risk of cardiovascular death that increased with age.

According to Dr. John S. Oh, assistant professor in the Department of Surgery at Penn State Health Milton S. Hershey Medical Center and one of the study authors, many patients do not realize the seriousness of an apnea diagnosis.

“Obstructive sleep apnea is a common condition that can have fatal consequences,” stresses Dr. Oh.

Timely diagnosis and treatment

In an interview with Medical News Today, Dr. Ryan Soose, director of the UPMC Sleep Division, said: “We’ve known for a long time that untreated sleep apnea patients are more likely to develop high blood pressure, heart disease, and a number of other health conditions. But the risk of sudden death reported in this study is eye-opening and makes a timely diagnosis and treatment even more pressing.”

The effects of the nervous system on the human sleep cycle may explain the association between sleep apnea and the increased rate of sudden death.

Because of the intermittent lack of oxygen that people with sleep apnea experience, the central nervous system may be over-aroused to increase airflow. In turn, this can cause increases in both the systolic and diastolic blood pressure of an individual.

In addition, someone with sleep apnea will experience oxidative stress, which can contribute to an imbalance of antioxidants in the body. This imbalance can damage cells and speed up the aging process, causing numerous health problems over time.

In a podcast, Dale Coller, DO, from Holland Hospital Pulmonary and Sleep Medicine in Michigan, OH, has commented on the serious stressors resulting from obstructive sleep apnea. 

“Every time [the throat] closes off, it’s very similar to if someone is being choked,” Coller explains. “This can happen hundreds of times in one night, causing the person stress and fragmentation of their sleep.”

How often to work out for health, strength, and weight loss

Exercise has a range of important benefits. It enhances overall health, helps a person maintain a moderate weight, relieves stress, and can promote restful sleep. 

Due to this, what people wish to achieve through exercise differs among individuals. Some people may use exercise as a weight loss technique, whereas others may want to build their strength.

This article addresses how often a person should work out based on their particular goals. 

It is advisable to consult a doctor before starting any workout or strength training program, as they can offer advice on how to work out safely and minimize the risk of injury.

How often to work out for weight loss

At its most basic level, weight loss is about solving a math problem. 

A person must burn off more calories than they take in on a daily basis. Some of the ways a person can accomplish this include:

  • eating fewer calories each day than they burn off 
  • increasing their physical activity to burn off more calories 
  • increasing their muscle mass so that they burn more calories at rest 

There is controversy surrounding whether exercise alone is enough to achieve weight loss. 

For example, some research suggests that exercise can cause the body to start to compensate by adjusting metabolism as a means to hold on to body fat. 

Exercise still has a role to play in weight loss, but for maximum benefits, a person should combine it with a healthful calorie-controlled diet that reduces their calorie intake. 

Researchers also note that continuing to exercise after weight loss can help stop people from regaining the weight. 

The American Heart Association (AHA) recommend a combination of cardiovascular training and strength training to boost health and burn calories. 

Cardiovascular training 

The AHA recommend getting at least 150 minutes of moderate intensity activity or 75 minutes of vigorous activity throughout the week. 

A person can also engage in a mix of moderate intensity and vigorous activities should they prefer.

Example of moderate intensity activities include:

  • brisk walking at a speed of at least 2.5 miles per hour (mph)
  • dancing 
  • gardening 
  • riding a bicycle slower than 10 mph 
  • tennis 
  • water aerobics 

Examples of vigorous activities include:

  • hiking, particularly uphill or while wearing a heavy pack 
  • jumping rope 
  • running 
  • swimming 
  • taking an aerobics class 
  • vigorous yard work, such as digging 

Ultimately, a person can gain the greatest health benefits by engaging in at least 5 hours of physical activity a week. 

Strength training

Strength training involves using resistance to build muscle. 

Muscle can help make the body more metabolically active, increasing the rate at which it burns calories.

Greater whole grain intake may reduce cardiovascular risk factors

Researchers have demonstrated an association between consuming more whole grains and improved measures of risk factors for CVD.

In the research, which appears in the Journal of Nutrition, the researchers also found an association between eating more refined grains and worse measures of some of these risk factors.

The findings provide further evidence that increased consumption of whole grains has health benefits.

Cardiovascular disease

According to the World Health Organization (WHO), CVDs “are the leading cause of death globally.” In 2019, almost 18 million people died due to CVDs — the vast majority by either stroke or heart attack.

The Centers for Disease Control and Prevention (CDC) note that in the United States, a person dies from CVD every 36 seconds, accounting for 1 death in every 4.

To prevent CVD, the CDC advises that a person avoids smoking, avoids overweight and obesity, and stays physically active. The CDC also suggests a person should eat as healthy a diet as possible.

A 2015 review indicated that eating a healthier diet — including more fruit, vegetables, whole grains, legumes, fish, vegetable oil, and poultry — could reduce a person’s risk of CVD by a third.

More specifically, researchers have found significant evidence for the beneficial effects of eating more whole grains. This reduces the risk of CVD and death due to cancer, respiratory disease, infectious disease, and all-cause mortality.

However, there has been less research looking at the relationship between whole grain consumption and the early warning signs of CVD.

These early signs include a person’s waist circumference, blood pressure, levels of fasting plasma high-density lipoprotein (HDL), or “good” cholesterol, plasma triglyceride, and blood glucose.

More evidence that a plant-based diet protects heart health

Incorporating more fresh whole foods into one’s diet is something medical professionals often promote. Eating natural foods rather than highly processed foods can have a plethora of health benefits.

Two new observational studies looked at the benefits of plant-centered diets. Both studies followed participants for more than a decade to track health and food choice trends.

USDA nutrition recommendations

The United States Department of Agriculture (USDA) has been setting forth dietary guidelines for more than 100 years. While the guidelines have changed over time, the USDA has long focused on eating foods that provide the nutrients needed to maintain good health.

The USDA presently recommends an individual’s diet consist of the following:

  • fruit
  • vegetables
  • grains
  • protein
  • dairy

Based on a 2,000-calorie daily diet, the USDA suggests people eat 2 cups of fruit, 2.5 cups of vegetables, 6 ounces (oz) of grains, 5.5 oz of protein foods, and 3 cups of dairy.

It also suggests that people vary their protein sources and explore eating meatless meals every so often.

Young adulthood diet study

The first new study, called “Plant-centered diet and risk of incident cardiovascular disease during young to middle adulthood,” appears in the Journal of the American Heart Association.

The researchers in this study tracked almost 5,000 young adults who were aged 18–30 years when the study began. The study lasted for 32 years.

None of the participants had heart problems when the study started. At checkups over the years, doctors evaluated the participants’ health, asked about the foods they ate, and assigned them a diet quality score.

By the end of the study, nearly 300 people developed cardiovascular disease. Moreover, after adjusting for various factor, including race, sex, and educational attainment, the researchers also found that people with the most plant-based diets and a higher diet quality score were 52% less likely to develop heart issues than those following the least plant-based diets.

“A nutritionally rich plant-centered diet is beneficial for cardiovascular health. A plant-centered diet is not necessarily vegetarian,” says Dr. Yuni Choi, one of the authors of the young adult study.

Dr. Choi is a postdoctoral researcher at the University of Minnesota School of Public Health in Minneapolis.

“People can choose among plant foods that are as close to natural as possible, not highly processed. We think that individuals can include animal products in moderation from time to time, such as non-fried poultry, non-fried fish, eggs, and low fat dairy,” Dr. Choi says.

Kristin Kirkpatrick, a nutritionist with a master’s degree in health management and the founder of KAK Consulting, spoke with Medical News Today about the study.

“The data presented in this study is consistent with previous studies on plant-based diets and longevity and metabolic health,” said Kirkpatrick.

“I’m not surprised at the findings,” she said, “and perhaps the takeaway here is it’s never too late or too early to start a plant-based diet.”

Sleep apnea: Exercise and cutting TV time reduce risk

OSA involves repeated, intermittent upper airway blockage during sleep. This blockage reduces or halts airflow to the lungs and may increase the risk of serious conditions, including cancer, cardiovascular disease, and type 2 diabetes, among others.

OSA occurs when the throat muscles temporarily relax during sleep, causing partial or complete blockage of the airway. 

Snoring is a common indicator of OSA. Interrupted sleep and inadequate nighttime oxygenation may result in daytime sleepiness, headaches, mood swings, and high blood pressure, among other adverse effects. 

The role of physical activity

Previous research has shown that low levels of physical activity during the day, or increased sedentary behavior, may be linked to a higher risk of experiencing OSA.

Mediators of these adverse effects may include excess body fat, chronic low level inflammation, insulin resistance, and fluid retention.

Investigators at Brigham and Women’s Hospital and Harvard Medical School in Boston, MA, Johns Hopkins Bloomberg School of Public Health in Baltimore, MA, and other institutions collaborated on a new study, which examined “the potential role of maintaining an active lifestyle in reducing [OSA] incidence.”

The results appear in the European Respiratory Journal

The authors concluded that being more active and spending less time sitting while watching television are behaviors linked to a lower risk of developing OSA. 

The study also attempted to tease out each factor’s influence on OSA risk.

The investigation

The investigators examined data from 137,917 participants enrolled in the Nurses’ Health Study (NHS), Nurses’ Health Study II (NHSII), and the Health Professionals Follow-up Study (HPFS).

Medical News Today spoke with Tianyi Huang, an assistant professor of medicine at Harvard Medical School and one of the authors of the study. 

According to Huang, these large, long-term, ongoing studies provide an especially reliable source of health-related information, as the participants are all healthcare professionals. 

Among the general public, “OSA is highly underdiagnosed,” Huang said. He noted that healthcare professionals are presumably more likely to recognize and report symptoms of OSA.

The results

For their analysis, the investigators accounted for the time that the participants spent sitting at work. Physical activity included all the time that they spent moving, including walking, running, lap swimming, and weightlifting. 

Overall, the team found that individuals who were less active were more likely to report OSA. For example, the participants with more sedentary jobs had a 49% higher risk of OSA than those with the least sedentary occupations. 

Also, those who watched more than 4 hours of TV each day had a 78% higher risk of OSA than the participants with the least sedentary lifestyles.

Maintaining an active lifestyle and avoiding excessive sedentary behavior are associated with a lower risk of developing OSA. This, in turn, may be linked to a reduced risk of developing various potentially serious conditions, including cardiovascular disease and obesity.

Will new guidelines for heart failure affect you?

In a normally functioning heart, the left ventricle sends over half the blood within it out to the body every time the heart beats. The percentage of blood the left ventricle can pump is known as the ejection fraction.

When the heart’s ejection fraction is reduced, people can develop symptoms of heart failure. Heart failure due to a reduced ejection fraction (HFrEF) can impinge on a person’s ability to carry out daily tasks, and affect their quality of life. It also can shorten lives. Now, recently updated expert consensus guidelines recommend new decision pathways designed to help clinicians treating people with HFrEF navigate increasingly complex therapies. If you have this type of heart failure, these changes may help you and your doctor steer a course through many important decision points. Keep in mind, of course, that treatments — and your own goals for treatment — are likely to evolve as time passes.

What are the symptoms of heart failure?

Generally, symptoms of heart failure include shortness of breath, difficulty breathing when lying flat, and swelling in the ankles. Very mild symptoms may not affect or limit activities, while people who have more advanced illness may experience symptoms with even minor activities, such as getting dressed.

How is heart failure treated?

Fortunately, a steadily increasing number of medicines, devices, and procedures help reduce heart failure symptoms and hospitalizations, and may prolong life. While these treatments offer enormous potential benefit, they can seem confusingly complex to people living with heart failure — and even to their doctors.

Good care for heart failure emphasizes choosing the right medications and taking the right doses of those medications. Identifying the best approach to help you achieve the goals you set can be a slow and complicated process, as your medical team weighs which medications to begin sooner versus later, and how and when to increase dosages, based on current evidence.

If you have HFrEF, how can the updated guidelines help you?

The recent update is aimed at guiding physicians through complex decisions on how to successfully start medicines, and choosing the right dosages for people with heart failure. This process varies depending on many factors. One piece is selecting goals, which may change over time. Goals can be big or little, short-term or long-term. For some people, it may be their ability to do a favorite activity, such as gardening. For others, minimizing the disruption that medications can cause in their lives is most important. For example, a person might want to avoid having to use the bathroom every hour in the middle of the day.

Further, the update notes that two groups of people — older adults and those who identify as African American — have been underrepresented in studies examining many treatments for heart failure. So, we don’t currently know if the optimal dose of a given medicine might differ for these groups. In some cases, very limited data is available to show whether a drug works for certain populations. While acknowledging limitations, the update shares specific guidance for people in these groups. It also identifies ways to monitor whether the treatments chosen are working well.

When should you see an expert in heart failure?

While you may receive much of your care for heart failure within a primary care practice, in some instances it’s wise to see an expert to decide on the best path to take. Ask your doctor whether a referral to a cardiologist experienced in heart failure could be helpful at specific points. For example, it can help to see a cardiologist

  • when you are first diagnosed, to ensure that appropriate diagnostic testing has been done, and to choose a treatment plan that will be best for you.
  • if you experience persistent symptoms that limit your ability to function, have repeated hospitalizations for heart failure, or develop related health issues, such as worsening kidney disease or heart rhythm disorders.

Do you find it hard to follow your treatment plan for HFrEF?

Often, even the best medical advice for managing heart failure is hard to maintain for many reasons. Medicines may have side effects, like fatigue. The cost and logistics of taking several medicines at different times may be challenging. Not surprisingly, as many as half of people following a treatment plan for HFrEF aren’t able to take medicines consistently as prescribed — so if you’re finding it hard, you’re not alone.

Unfortunately, not taking medicine as often as needed or at the dose needed can affect your health. So, talk to your doctor to see if there are ways to address the challenges that make it hard to follow your plan.

Options might include

  • getting larger quantities of each prescription to minimize trips to the pharmacy
  • simplifying the regimen
  • using pill boxes and reminders
  • choosing generic medicines to lower cost, or getting assistance with copays.

Living well with heart failure depends not only on the available therapies, but on ongoing, open communication with your medical team about how you are feeling, what your goals are, and what challenges you’re facing, so that together you can determine the right path forward for you.

Physical activity may counter negative health effects of poor sleep

While the negative health effects of physical inactivity and poor sleep have been independently researched and documented numerous times, few studies have focused on the synergistic impact of these factors on mortality.

A study published in the British Journal of Sports Medicine investigates the joint association of physical activity and sleep with all-cause and cause-specific mortality risks.

Physical activity and healthy sleep

The long-term study followed over 380,000 middle-aged men and women who are part of the UK Biobank.

The participants completed questionnaires, interviews, and physical measurements to determine their baseline health condition along with their physical activity levels and sleep behaviors.

Individuals were excluded from participating in the study if their baseline assessments indicated a history of cardiovascular disease, cancer, sleep apnea, or class 3 obesity.

The researchers assessed and summarized physical activity data using metabolic equivalent task minutes. These minutes are roughly equivalent to the number of calories expended per minute of physical activity.

Individual physical activity was categorized based on the World Health Organization (WHO) guidelines. Categories included:

  • high (1200 or more minutes per week)
  • medium (600 to less than 1200 minutes per week)
  • low (0 to less than 600 minutes per week)

The researchers defined another category to include no moderate-to-vigorous activity per week so that they could also assess the effects of insufficient physical activity.

The negative health effects of poor sleep encompass more than just sleep quality or duration, and therefore the researchers applied a novel healthy sleep score.

They used five sleep characteristics — chronotype (night owl vs. morning lark tendencies), sleep duration, the presence of insomnia, daytime sleepiness, and snoring — to score participants on a scale from 0 to 5. Sleep score categories included: healthy (4 or higher), intermediate (2–3), and poor (0–1).

Using both these scoring methods along with other information supplied by the participants, the researchers derived a dozen physical activity/sleep combinations.

The participants’ health was then tracked until May 2020 or their death, depending on which came first, to assess their risk of dying from any cause, and specifically from cardiovascular disease, coronary heart disease, stroke, and all types of cancer. These are the common issues independently associated with poor sleep and minimal physical activity.

Fried foods, sugary drinks linked to sudden cardiac death

In a new study, researchers have found a positive association between the Southern diet — which involves more fried food and sugary drinks — and sudden cardiac death. They also linked the Mediterranean diet to a reduced risk of sudden cardiac death.

The research, which appears in the Journal of the American Heart Association, offers further evidence of the importance of diet to cardiovascular health.

Heart health and diet

Death certificates show that sudden cardiac death is a factor in 1 in 7.5 deaths in the United States. A key underlying cause is coronary heart disease.

According to the Office of Disease Prevention and Health Promotion (ODPHP)Trusted Source, a person can improve their heart health by changing their diet. The ODPHP suggests that people eat a variety of fruit and vegetables, low fat dairy, whole grains, a variety of proteins, and unsaturated fats.

Research has shown that the Mediterranean diet, which focuses on legumes, vegetables, fruits, fish, and grains, can be protective against cardiovascular disease.

Researchers have also identified an inverse link between the Mediterranean diet and sudden cardiac death. However, the study had significant limitations, as it included a hugely disproportionate number of white participants and focused primarily on women.

More than 20,000 participants

In the present study, the researchers drew on data from the Reasons for Geographic and Racial Differences in Stroke Study cohort in the U.S. This cohort consists of 30,239 African American and white adults aged 45 years or older, who all joined the study between 2003 and 2007.

The researchers excluded participants who were missing appropriate recorded information or were unavailable at follow-up. This left them with a sample size of 21,069 for the current analysis. Of these participants, 33% were Black, and 56% were women. 

A total of 56% of the participants lived in the Southeastern United States. This area is known as the Stroke Belt because it has had a higher-than-normal rate of death due to stroke since the 1940s.

The researchers took background health and demographic information from the participants at baseline and asked them to complete a food frequency questionnaire each year to show how many of 110 different food items they had eaten during the previous 12 months.

Looking at this data, the researchers were able to give each participant a Mediterranean diet score, reflecting their adherence to the Mediterranean diet.

The researchers were also able to identify five dietary patterns:

  1. The convenience pattern: This dietary pattern primarily consisted of pasta, pizza, and Mexican and Chinese food.
  2. The plant-based pattern: People following this pattern ate lots of vegetables, fruits, cereals, legumes, yogurt, chicken, and fish.
  3. The sweets pattern: This pattern included high amounts of dessert, candy, chocolate, and sugary cereal.
  4. The Southern pattern: The Southern diet is high in fried foods, sweetened drinks, processed and organ meats, and eggs.
  5. The alcohol and salad pattern: People following this pattern consumed lots of leafy greens, dressings, tomatoes, and alcoholic drinks.

According to lead author Prof. James M. Shikany, who is a professor of medicine and associate director for research in the Division of Preventive Medicine at the University of Alabama at Birmingham, “All participants had some level of adherence to each pattern but usually adhered more to some patterns and less to others.”

“For example, it would not be unusual for an individual who adheres highly to the Southern pattern to also adhere to the plant-based pattern but to a much lower degree.”

The researchers attempted to contact the participants approximately every 6 months over a 10-year period, which enabled them to record any cardiovascular events, including sudden cardiac death. During this period, there were 401 recorded instances of sudden cardiac death.

Is food addiction real?

Food addiction is a concept that researchers use to describe compulsive eating habits in humans, which may resemble addiction-like behaviors.

Research indicates that some individuals may be more likely than others to experience addiction to palatable foods — meaning foods that are high in fat and sugar.

Other studies suggest that those who may experience food addiction exhibit “seeking” behaviors, as well as other symptoms and cravings similar to those that people typically experience as part of a substance use disorder.

There is no universally accepted clinical definition of “food addiction,” and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not list it as a condition. However, researchers have identified some behaviors associated with this concept. These include:

  • compulsive overeating, even in the absence of hunger
  • cravings for high fat and sugary foods
  • difficulty in controlling food intake
  • binge eating and disordered eating patterns

What do we know about food addiction?

Publications from 2009, 2011, 2016, 2018, and 2019, among others, have highlighted that palatable foods — or even foods in general — stimulate the same parts of the brain and share the same neuronal activities as illicit substances.

The hippocampus, caudate, and insula are three brain regions that researchers have pinpointed as being implicated in this relationship. 

For instance, foods and illicit substances both result in the release of the hormones, such as dopamine, and endogenous opioids that the body naturally produces.

These hormones are a part of the “reward system” — or the mesolimbic circuit — in the brain, which is responsible for motivation, want, desire, and cravings.

Some studies even suggest that it is the anticipation of food rather than the consumption itself that may trigger food addiction — a “seeking” behavior that people with substance use disorder often display. 

In theory, it is possible to explain this behavior by the phenomenon of incentive sensitization, which posits that it is possible for a person to want something even if they do not like it, as long as it stimulates the pleasure centers in their brain.

For example, people may crave a sugary beverage because it makes them feel good due to the release of dopamine rather than because they genuinely enjoy drinking that beverage.

Even though the DSM-5 does not list food addiction as a condition, researchers have referred to both the DSM-4 and DSM-5, as well as the Yale Food Addiction Scale (YFAS), when studying this phenomenon.

In fact, researchers developed the YFAS based on information in the DSM-4 about the symptoms and associated behaviors of substance use disorders. The YFAS contains 25 self-reported questions that may help identify food addiction.

The concept of food addiction has drawn a lot of interest in the scientific community, with some proposing it as a potential underlying contributor to obesity and others seeing it as a symptom of having excess body weight.

Whichever way this association may lie, a 2017 review cites evidence that behaviors linked with food addiction occur at notably higher levels in people seeking bariatric or weight loss surgeries.

Even Vaccinated People Are Nervous About Going Back to ‘Normal.’

Claudia Campos, 34, wanted there to be no doubt about why she continues to wear a face mask at the Florida car rental company where she works. She decided to screen-print a mask that telegraphs her thoughts. “I’m vaccinated,” it reads, “but I’m not ready to trust you!”

Campos’ slogan distills the complicated emotions many people are feeling as the summer of vaccination commences. The U.S. Centers for Disease Control and Prevention (CDC) has said the roughly 43% of people in the U.S. who are fully vaccinated can mostly ditch masks, travel safely and gather indoors with others. But many of those 43% are finding that they’re not ready to live like it’s the Before Times.

In a March 2021 American Psychological Association poll, about half of respondents said they were “uneasy” about resuming in-person social interactions, regardless of vaccination status. And in a May 25 Axios/Ipsos poll, about half of vaccinated respondents said they still wear a mask at all times outside the house, even after the CDC’s announcement that doing so is no longer necessary.

Lauren, a 38-year-old from New York City who asked to be identified by first name to preserve her privacy, says she and her wife are living essentially as they did in 2020, even though they’re both fully vaccinated. They’ve dined inside once (an experience simultaneously refreshing and stressful, Lauren says), but otherwise have stayed mostly outside and mostly masked. That’s in large part because the couple has a 2-year-old daughter who isn’t eligible for vaccination, and they want to keep her safe. But Lauren admits there’s also “some lingering anxiety from having followed all of these protocols for so long. It’s hard to believe that certain things are actually safe, even though we know they should be.”

Rob Danzman, an Indiana-based licensed clinical mental health counselor, says that’s a normal response to a year marked by confusion. “Humans are terrible when it comes to not knowing the rules of the game,” Danzman says. “We had mixed messages, we had inconsistent science, inconsistent testimony, inconsistent mandates from different states. From my vantage point, if people were not experiencing some fear and trepidation, that would be weird.”

The confusion is also not over. On one hand, the data around COVID-19 vaccination is outstandingly and consistently good. People fully vaccinated with the mRNA-based shots made by Pfizer-BioNTech and Moderna are 91% less likely to be infected by the virus than unvaccinated people, according to recent CDC data. (Janssen/Johnson & Johnson’s single-dose shot is around 66% effective at preventing disease.) And even when fully vaccinated people do get infected, according to the CDC’s recent study, they are less likely to spread COVID-19 to others than an infected, unvaccinated person. Both of those findings support a return to normal life after vaccination.

But with thousands of people in the U.S. continuing to test positive for the virus every day, it is understandable that even vaccinated people remain skittish around others, particularly if they live with unvaccinated or immune-compromised people who are still at risk. The emergence of highly transmissible variants is also reason for concern. Throw in the psychological challenge of reentering the outside world after a year of being told other people could be deadly, and it’s little wonder that not everyone is eager to squeeze into a restaurant booth or crowded flight.

How to readjust

It’s natural that people respond differently to re-opening. Some individuals are at higher risk for severe COVID-19 than others, and personality, environment and experience all dictate how someone will rebound from the pandemic. But while it’s one thing to decide to take re-opening slowly, it’s another to feel so anxious about re-entering the world post-vaccination that it affects your mental health.

Conflicting feelings after vaccination are totally normal, Danzman says. “I can acknowledge, ‘I believe the science…and I also feel afraid,’” he says. “Both of those can co-exist.” Adjusting to post-vaccination life isn’t necessarily about suppressing one of those feelings, he says; it’s about learning to balance both.

People should “slow down and observe their thoughts, their feelings and the choices in front of them,” Danzman says. “Most of us smush all those things together.”

Ask yourself questions. Does a plan simply feel unfamiliar, or do you actually think it’s unsafe? Are there adjustments that would make an outing feel more comfortable? Danzman adds that it may feel less overwhelming to think about one decision at a time—like whether to go out to dinner or remove your mask in a certain setting—rather than trying to make big, sweeping statements about whether you’re ready to go “back to normal.”

Campos says she’d feel safer if around 70% of people in Florida were vaccinated. (As it stands, about 42% of people there have had both shots.) Making calculations like that can be useful, says Dr. Ryan Sultan, an assistant professor of clinical psychiatry at Columbia University Irvine Medical Center/New York State Psychiatric Institute. “Think about it as a long-term issue,” he says. “What’s your endpoint?” Waiting until every American is vaccinated may not be realistic, but you might decide you’ll only feel comfortable attending mask-free gatherings when your whole family is vaccinated, for example. That can help guide your actions in the interim.

A little bit of exposure therapy may help, too. For people who devoutly wore masks throughout the pandemic, shedding them may feel uncomfortable—even in a situation, like walking in a park, where the science strongly supports doing so. To practice, Sultan recommends starting small. You could try taking your mask off for a few minutes, he suggests, or when you’re alone and away from any crowds. Slowly but surely, that will begin to feel normal again.

Diabetes: Diet and weight loss may reduce need for blood pressure drugs

Diabetes is a common and serious medical condition, affecting approximately 463 million people worldwide in 2019. People with a condition called metabolic syndrome are about five times more likely to develop type 2 diabetes. 

Metabolic syndromeTrusted Source consists of a constellation of clinical findings defined by the presence of at least three of the following:

  • elevated blood pressure (hypertension)
  • abdominal obesity
  • impaired glucose tolerance
  • insulin resistance,
  • increased triglycerides
  • low high-density lipoprotein cholesterol (“good cholesterol”)

People who develop type 2 diabetes have a greater chance of having a heart attack, stroke, chronic kidney disease, nerve damage (neuropathy), and eye disease (retinopathy). 

Approximately 85% of patients with type 2 diabetes will require treatment for high blood pressure. Although antihypertensive medication medications effectively decrease blood pressure, some medications, such as β-blockers and thiazide diuretics, may have side effects or aggravate blood glucose control. 

The American Diabetes Association estimates that 33–49% of people with diabetes fail to achieve blood glycemic, blood pressure, and blood lipid goals. Lifestyle modifications, such as weight loss, can help.

Weight loss can effectively reduce blood pressure by about 1 millimeter of mercury (mmHg) for each kilogram (kg) of weight lost. However, current clinical practice guidelines do not recommend a trial withdrawal of antihypertensive medication during a medically managed weight loss program for people with diabetes who have overweight. 

In the Diabetes Remission Clinical Trial (DiRECT)Trusted Source, researchers at the Universities of Glasgow and Newcastle in the United Kingdom demonstrated that the primary-care-driven intensive weight management program Counterweight-Plus resulted in remission of type 2 diabetes in 46% of participants at 12 months. 

During the initial total diet replacement phase, participants underwent a planned withdrawal of all blood pressure medication to prevent low blood pressure when standing up from sitting or lying down.

Researchers re-examined data from this study to determine the safety of stopping blood pressure medications and the extent of the decrease in blood pressure levels in participants with and without hypertension. The scientists recently published the results from this post-hoc analysis in the journal Diabetologia.

Significant blood pressure decrease

The study used a low energy (825–853 kilocalories per day) formula diet for 12–20 weeks in the intervention part of the study, followed by a step-wise reintroduction of food over 2–8 weeks, as well as a structured weight-loss maintenance program with monthly visits.

Participants receiving the intervention discontinued all diabetes and antihypertensive medications when starting the initial total diet replacement phase unless they needed them for conditions other than diabetes or hypertension. 

Researchers monitored blood pressure and glycemic levels throughout the study and reintroduced medication to those participants whose levels increased.

78 of the 143 participants receiving total diet replacement had hypertension at baseline, with 44% of participants receiving one antihypertensive drug and approximately 56% receiving two or more. Around 36% of participants reported dizziness during the total diet replacement phase.

The study demonstrated significant decreases in average blood pressure levels during total diet replacement therapy at 20 weeks and 1 and 2 years. In those participants with no history of hypertension, the decreases were immediate. In contrast, significant reductions in blood pressure did not occur for those previously treated for hypertension until about week 9.

During the total diet replacement phase, 27.5% of participants (26% on one medication and 74% on two or more medications had to restart taking antihypertensive medications. However, at 2 years, 28% of the participants who stopped antihypertensive drugs did not need to take them again.

According to the study, 53 people saw remission in their type 2 diabetes with an average weight loss of 11.4 kg at 2 years. Of this group, 27 participants had high blood pressure and stopped all blood pressure medication at baseline, with 12 remaining off all antihypertensive medication at 2 years.

Paying the Price for Sun Damage

Pick your favorite cliché: Do as I say, not as I do; an ounce of prevention is worth a pound of cure; better safe than sorry; forewarned is forearmed.

Mea culpa. All the above relate to my failure to follow the well-established health advice about sun exposure that I’ve offered repeatedly to my readers: Routinely protect your skin from the cancer-causing and aging effects of the sun’s ultraviolet rays.

For decades I’ve failed to practice what I preached (OK to wince) and am now paying for my negligence with unsightly splotches, bumps and bruises and at least one cancerous lesion on my sun-damaged skin. My litany of excuses has included: hats mess up my hair, long sleeves and pants are too hot in summer and exercising while coated with sunscreen is suffocating.

Annually vowing to do better, every summer I dutifully purchase the latest dermatology-recommended sunscreen that, alas, spends the summer unopened on a bathroom shelf. I hereby pledge to do better this yearalbeit late in the game.

A new report from a dermatology team at Kaiser Permanente health care centers in California has prompted me to reform. The team, headed by the epidemiologist Lisa Herrinton in Oakland, followed nearly half a million patients seen at the centers for up to 10 years. Half had already developed one or more actinic keratosis, a precancerous rough, scaly skin lesion caused by years of unprotected sun exposure.

As you might expect, these lesions most often form on the face, ears, back of the hands, forearms, scalp and neck and are — or should be — routinely removed when found by dermatologists to prevent progression to cancer. The lesions are markers of sun damage and can serve as an early warning system for people at risk of developing cancer somewhere on sun-exposed skin.

The Link Between Insomnia and Mental Illness

Insomnia rates have continued to rise throughout the pandemic, contributing to increasing rates of depression and anxiety, as well as worsening symptoms of other severe mental illnesses. Defined as chronic sleep onset and/or sleep continuity problems associated with impaired daytime functioning, insomnia has a bidirectional relationship with mental health issues. 

Mental Illness and Insomnia: How Do They Interact?

The incidence of psychiatric illness in patients with insomnia is estimated to be near 50 percent. The highest comorbidity rates have been noted in mood disorders, including depression and bipolar disorder, as well as anxiety disorders. In patients with diagnosed major depressive disorder, as many as 90 percent struggle with insomnia. 

Insomnia has also been identified as a risk factor for the development of a mental illness. In a meta-analysis of patients with insomnia published in 2011, the authors concluded that persistent insomnia can more than double the risk of major depression. 

Another 2019 meta-analysis of more than 130,000 participants assessed the effects of baseline insomnia on the development of a psychiatric illness over a five-year period. Individuals with insomnia demonstrated a significantly higher risk of alcohol abuse and psychosis. Additionally, insomnia tripled the likelihood of being diagnosed with a depressive or anxiety disorder.

Sleep disturbances can also worsen symptoms of diagnosed mental illness, including substance abuse, mood, and psychotic disorders. Laskemoen and colleagues found that a startling 74 percent of participants with diagnoses of schizophrenia or bipolar spectrum had at least one type of sleep disturbance (insomnia, hypersomnia, or delayed sleep phase)—nearly twice the rates in healthy controls. Importantly, compared to those with mental illness not suffering from sleep disturbances, sleep-disordered participants had more severe negative and depressive symptoms on the positive and negative syndrome scale (PANSS), as well as significantly lower function as measured by global assessment of functioning (GAF).

How Can Insomnia Be Treated?

Although insomnia symptoms can resolve after relief from a particular life stressor, as many as 50 percent of patients with more severe symptoms will have a chronic course. Many of the sedative-hypnotics are designed for short-term use, though are frequently continued beyond the recommended time frame. In a survey reviewing the national use of prescription drugs for insomnia, as many as 20 percent of individuals use a medication to target insomnia in a given month. 

The benefits of cognitive-behavioral therapy for insomnia (CBT-I) have been demonstrated repeatedly, and it is recommended as the first-line treatment for insomnia by the Clinical Guidelines of the American Academy of Sleep Medicine, Center for Disease Control , and the National Institute of Health . Studies suggest benefits persist long-term, even after completing the therapy sessions have ended.

Packed on the Pandemic Pounds?

And according to a JAMA study, adults in lockdown gained more than half a pound every 10 days, which is about two pounds a month.

But now, with the light at the end of the tunnel, summer on the way, and pants with actual waistbands making a reappearance, you may be ready to take control of the bad habits that cropped up over quarantine.

While experts have different theories about the best way to lose weight, celebrity nutritionist Haylie Pomroy believes it’s all about keeping your metabolism fired up. Here are her tips.

Give yourself grace

The stress and fear of the past year — worry about the virus, remote learning, job loss, ill loved ones — made it hard to stay fit. “We had hormonal shifts in our bodies that we didn’t have control over,” Pomroy tells PEOPLE. “Stress and fear create a spike in hormones that slow your metabolism.” Add to that disrupted routines, closed gyms, less movement and more takeout, and it’s no wonder people gained weight.

But don’t feel bad about it. “Guilt and shame are fattening,” says Pomroy, adding that our bodies did what they were supposed to do. “Let everything go that was in the past — start fresh from today.”

Eat breakfast

Pomroy’s approach is to eat within 30 minutes of waking up. The author of the bestselling The Fast Metabolism Diet says a good meal includes 10 to 15 grams of protein, a vegetable, a whole fruit and some sort of healthy fat such as organic eggs, coconut, avocado or a tablespoon of olive oil over a sweet potato. “You want to turn on your digestion and support proper blood-sugar based hormones.”

Sleep well — and reduce your risk of dementia and death

n a recent blog post I discussed how beneficial sleep is for memory function. But sleep isn’t just good for your memory; it can actually reduce your risk of dementia — and death. Although it has been known for some time that individuals with dementia frequently have poor, fragmented sleep, two new studies suggest that if you don’t get enough sleep, you are at increased risk for dementia.

Sleep six to eight hours each night

In the first study, researchers at Harvard Medical School studied more than 2,800 individuals ages 65 and older participating in the National Health and Aging Trends Study to examine the relationship between their self-report of sleep characteristics in 2013 or 2014, and their development of dementia and/or death five years later. Researchers found that individuals who slept fewer than five hours per night were twice as likely to develop dementia, and twice as likely to die, compared to those who slept six to eight hours per night. This study controlled for demographic characteristics including age, marital status, race, education, health conditions, and body weight.

In the second study, researchers in Europe (including France, the United Kingdom, the Netherlands, and Finland) examined data from almost 8,000 participants from a different study and found that consistently sleeping six hours or less at age 50, 60, and 70 was associated with a 30% increase in dementia risk compared to a normal sleep duration of seven hours. The mean age of dementia diagnosis was 77 years. This study controlled for sociodemographic, behavioral, cardiometabolic, and mental health factors, although most participants were white, better educated, and healthier than the general population. In addition, approximately half of the participants had their sleep duration measured objectively using a wearable accelerometer — a device that tracked their sleep using body movements — which confirmed the questionnaire data.

Inadequate sleep in midlife may lead to dementia

What’s new here is that inadequate sleep in midlife raises one’s risk of dementia. There are many reasons for poor sleep in middle age: shift work, insomnia, caretaking responsibilities, anxiety, and pressing deadlines, just to name a few. Although not all of these are controllable, some are. For example, if you’re currently only sleeping four to five hours because you’re up late working every night, you might want to change your habits, otherwise you risk developing dementia by the time you retire!

This relationship between sleep in midlife and dementia in late life is important not only from a clinical perspective, but also from a scientific one. It had always been a bit of a chicken-and-egg problem when trying to interpret the relationship between poor sleep and dementia. Was it really poor sleep that caused dementia, or just early dementia symptoms causing poor sleep? By looking at individuals who were initially studied in midlife — some as young as age 50 — we now have greater certainty that poor sleep can increase one’s risk of developing dementia 25 years or more in the future.

Flush your brain while you sleep

Although it is not totally understood why inadequate sleep increases your dementia risk, one possible reason relates to the deposition of the Alzheimer’s protein, beta amyloid. Beta amyloid is the protein that clusters and clumps together to form Alzheimer’s plaques. No one is completely certain what its normal function is, although there is increasing evidence it is involved in the brain’s defense against invading microorganisms.

During the day, we all make some of this beta amyloid protein in the brain. When we sleep, however, brain cells and their connections actually shrink. This shrinking allows more space between the brain cells, so that beta amyloid and other substances that accumulate during the day can be flushed away.

How to Ease Back into Exercise Safely After a Long Break

f you took a long break from exercise during the COVID-19 pandemic, you’re not alone. 

The stress and uncertainty of the past year, along with the closure of many gyms and need for physical distancing, have thrown off many people’s workout routines. 

Getting sick from COVID-19, a debilitating disease with weeks or sometimes months of symptoms, has also greatly limited the ability to engage in physical activity for many people.

As vaccines continue to roll out throughout the United States and restrictions begin to ease, it’s natural that many people are eager to get active again. 

However, there are some things people should be mindful of while restarting their fitness routines to avoid injury and get the most out of returning to exercise.

Manage your expectations 

People who have taken a long break from exercise are likely to find that they may not be able to do the things they once could. 

Whether this is running a 5K or holding a yoga pose, experts say not being able to perform at the same level is to be expected.

Still, this may be difficult for some to accept. 

Will You Need a Booster Shot of the COVID-19 Vaccine?

When the first COVID-19 vaccines from Pfizer-BioNTech and Moderna were authorized by the U.S. Food and Drug Administration in December 2020, most people breathed a sigh of relief since both shots were shown to be between 94% and 95% effective in protecting from COVID-19 symptoms. But public health experts warned that nobody really knew how long the protection would last, since the longest clinical trials in people only went to a few months. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and the chief medical advisor to President Joe Biden, suggested that additional booster doses—and perhaps even yearly shots, similar to the annual flu shot—might be necessary to keep the public safe.

That’s because SARS-CoV-2, like many other viruses we know about—from influenza to HIV—doesn’t sit still. It constantly mutates, and a handful of these mutations are now circulating around the world and keeping public health experts on the alert, since these variant viruses are better at evading immune cells, including those elicited by the vaccines.

So far, experts say that the vaccines continue to provide good protection against all forms of SARS-CoV-2. But the immune response against some of the variants, specifically against one called B.1.351 that was first identified in South Africa, may be slightly lower than immune responses against the original strain that the vaccines were designed to fight. An additional dose, scientists believe, may boost that response back up to where it should be.

The other open question about vaccines is how long the immunity they confer actually lasts. In data released in April, both Pfizer-BioNTech and Moderna reported that their current two-dose vaccines contribute to strong antibodies that can neutralize the COVID-19 virus for up to six months. Fauci has said that the protection may last even longer than that if other immune protection, involving immune cells such as T cells, are activated by the vaccines. Some early studies suggest that they are.

But only continued studies involving people in the early trials, who are supposed to be followed for up to two years, will answer the question of how long people can expect the vaccine protection to last. That said, both companies seem to believe a booster might be necessary: On April 14, Moderna’s CEO, Stephane Bancel said on CNBC that the company planned to have a booster shot ready by fall. And on April 15, CNBC aired a video segment, taped previously, in which Pfizer CEO Albert Bourla said that it might be “likely” that people would need a third dose of their COVID-19 vaccine within a year after getting the first two doses, referencing human clinical trials the company began in February to test a third dose.

It’s been a year since the first studies of the Pfizer and Moderna vaccines began last March. A small number of the participants of the initial trials of these two-dose vaccines have also volunteered to get a third, booster dose, so scientists can see if the additional dose improves immunity or makes it more durable. In February, Pfizer-BioNTech began studying a third dose of its existing vaccine among people enrolled in the early phase of the vaccine; the company’s scientists are also developing a new version of the vaccine directed specifically against the aforementioned B.1.351 variant.

Try these stretches before you get out of bed

“Stretching before getting out of bed can help wake up the body and improve the circulation. It can also turn on the parasympathetic system – the ‘rest and digest’ system — which puts us in a more relaxed state right when we get out of bed, helping set the tone for a calm morning and day,” says Dr. Beth Frates, who directs wellness programming for the Stroke Research and Recovery Institute at Harvard-affiliated Spaulding Rehabilitation Hospital.

Theoretically, stretching before getting out of bed may also help prevent falls. “By focusing on your legs and arms, you may be more careful and mindful when you put your feet on the ground,” Dr. Frates says.

How should you start?

Normally before you stretch, you should warm up your muscles; that gets blood flowing to them so they’re more pliable. But Dr. Frates says the muscles are already on the warmer side when you’ve been in bed all night. All it takes to prepare for stretches in bed, then, is a few minutes of flexing the joints before you stretch. (Tip: Remove your blanket and sheets before stretching, to give yourself a little more room.)

While you’re still lying down, flex your lower limbs: put your knees and feet in the air; with your knees in the air, raise and lower your feet; roll your ankles and move them back and forth.

Next, sit up in bed. Slowly look left and then right. Roll your shoulders a few times; work your elbows by holding both arms in front of you and doing biceps curls; flex your wrists up and down; open and close your hands several times.

Now you’re ready to start stretching. Try the stretches we’ve laid out for you on these pages (in any order you like). Some require a towel or resistance band, which you can keep next to your bed.

“Hold each stretch for 30 to 60 seconds if possible,” Dr. Frates advises. “And don’t bounce, which can damage the muscles.”

When you finish stretching, you’ll probably feel better. “Stretching can release the body’s ‘feel good’ chemicals, lubricate the joints, and help you maintain your range of motion,” Dr. Frates says. And that makes the wake-up stretching routine a prescription for a full day of better functioning.

For more stretching, including additional exercises, check out the Harvard Special Health Report Stretching (www.health.harvard.edu/str).

Full-body stretch with resistance band

Lie on your back with both legs extended. Hold the band shoulder-distance apart with both hands by your hips. Lift the strap up toward the ceiling, over your head and down toward the bed behind you.

Single knee pull

Lie on your back with your legs extended. Bend your left knee. Grasp the back of your left thigh and pull your knee toward your chest. Flex your right foot and press the thigh and calf of that leg down toward the bed to feel a stretch in the front of your right hip and top of your right thigh. Return to the starting position and repeat with the other leg.

Side-lying quadriceps stretch

Lie on your right side with your legs stacked and extended. Rest your right arm under your head. Bend your left knee and bring your heel toward your left buttock, reaching back with your left hand to grasp your foot. Feel the stretch in the front of your thigh and hip. Turn onto your left side and repeat the exercise.

Hamstring stretch with resistance band

2020: A Year in Fitness Like No Other

This year, the novel coronavirus crept into and transformed every aspect of our lives, including our fitness. In countless ways — some surprising, and a few beneficial and potentially lasting — it altered how, why and what we need from exercise.

At the start of the year, few of us expected a virus to upend our world and workouts. In January and February, I was writing about topics that seemed pressing at the time, such as whether low-carbohydrate, ketogenic diets endanger athletes’ skeletal health; if fat-soled, maximalist running shoes might alter our strides; and how completing a marathon — remember those? — remodels first-time racers’ arteries.

The answers, by the way, according to the research, are that avoiding carbs for several weeks may produce early signs of declining bone health in endurance athletes; runners donning super-cushioned, marshmallowy shoes often strike the ground with greater force than if they wear skinnier pairs; and a single marathon renders new runners’ arteries more pliable and biologically youthful.

But concerns about shoe cushioning and racing tended to fade in March, when the World Health Organization declared Covid-19 a pandemic and we suddenly had new, top-of-the-mind worries, including social distancing, masks, aerosol spread and lockdowns.

The effects on our exercise routines seemed to be both immediate and stuttering. At that time, none of us knew quite how and whether to work out in these new circumstances. Should we still run, ride and stroll outside if our community had instituted stay-at-home restrictions? Did we need to wear a mask during exercise — and could we do so without feeling as if we were suffocating? Were communal drinking fountains safe?

My first column grappling with these and related topics appeared on March 19. The experts I spoke with then were adamant that we should aim to remain physically active during the pandemic — but avoid shared drinking fountains. They also pointed out, though, that many questions about the virus, including how to exercise safely, remained unresolved.

After that, our experience with — and the research about — Covid and exercise snowballed. A much-discussed April study, for instance, showed that brisk walking and running could alter and accelerate the flow of air around us, sending expired respiratory particles farther than if we stayed still. Consequently, the study concluded, runners and walkers should maintain 15 feet or more of social distance between themselves and others, more than double the standard six feet of separation then recommended. (Subsequent research found that outdoor activities were generally safe, though experts still suggest staying as far apart as is practical, and to wear a mask.)

Another cautionary study I wrote about in June tracked 112 Covid infections in South Korea that spring to Zumba classes. A few infected instructors introduced the virus to their students during close-quarter, indoor, exuberant classes. Some students carried it home, infecting dozens of their family members and friends. Most rapidly recovered. But the study’s story was disquieting. “Exercising in a gym will make you vulnerable to infectious disease,” one of its disease-detective authors told me.

Thankfully, other science about exercising in the time of Covid was more encouraging. In two recent experiments involving masked exercisers, researchers found that face coverings barely budged people’s heart rates, respirations or, after some initial getting used to, subjective sense of the workouts’ difficulty. Moving felt the same, whether participants wore masks or not. (I use a cloth mask or neck gaiter on all my hikes and runs now.)

More surprising, the pandemic seems to have nudged some people to start moving more, additional research found. An online survey of runners and other athletes in June reported that most of these already active people said they were training more frequently now.

A separate British study, however, produced more-nuanced results. Using objective data from an activity-tracking phone app, its authors found that many of the older app users were up and walking more regularly after the pandemic began. But a majority of the younger, working-age adults, even if they had been active in the before times, sat almost all day now.

The long-range impacts of Covid on how often and in what ways we move are unsettled, of course, and I suspect will be the subject of considerable research in the years ahead. But, as someone who writes about, enjoys and procrastinates with exercise, the primary lesson of this year in exercise for me has been that fitness, in all its practical and evocative meanings, has never been so important.

In a useful study I wrote about in August, for instance, young, college athletes — all supremely fit — produced more antibodies to a flu vaccine than other healthy but untrained young people, a result that will keep me working out in anticipation of the Covid vaccine.

More poetically, in a mouse study I covered in September, animals that ran became much better able to cope later with unfamiliar trouble and stress than animals that had sat quietly in their cages.

And in perhaps my favorite study of the year, people who undertook “awe walks,” during which they deliberately sought out and focused on the small beauties and unexpected wonders along their way, felt more rejuvenated and happier afterward than walkers who did not cultivate awe.

In other words, we can dependably find solace and emotional — and physical — strength in moving through a world that remains lovely and beckoning. Happy, healthy holidays, everyone.

Feeling Tired in Social Situations?

Feeling tired after a physically or mentally straining day is normal. But if you are feeling more tired than usual after a typical day of interacting with family, friends and colleagues, it could be a sign of hearing loss. 

Hearing loss is incredibly common, affecting over 48 million Americans to some degree. It’s not just something that happens to the elderly—it can happen at any age and any stage in life. You may think you will know right away if you have hearing loss, but it typically occurs gradually over the course of a few years. In fact, it is often family members and friends who catch the early signs. They tend to notice the TV volume getting too loud and the frequent interjections of “Huh?” and “What?” before the person with hearing loss notices. 

So why does hearing loss make us feel so fatigued? 

When you have normal hearing, understanding your friends or loved ones doesn’t require significant thought or effort. It just comes naturally, allowing you to focus your attention on other details of everyday life. When you can’t hear well due to hearing loss, your brain has to work overtime to understand the people around you.  

Right now, we are all learning how it feels to have a conversation over video call. Missed connections, distracting noises, and poor sound quality make conversations more difficult and can leave us feeling exhausted and even frustrated afterwards. Know the feeling? 

Having a conversation with hearing loss is similar. You have to exert more focus and ask more clarifying questions. You may be mistaking words or feel like everyone is mumbling. Meanwhile, your brain is trying to process and interpret these sounds, as well as distinguish between important sounds and background noise. Some people with hearing loss even begin to rely on lip reading without noticing. With all this extra work, it’s no wonder those with hearing loss may feel tired or mentally drained after social interactions.

The good news is that hearing aids can help the majority of hearing loss cases. Even if you have a minor hearing loss, hearing aids can help you regain important sounds and take the fatigue out of everyday conversations. 

While some are resistant to trying hearing aids, patients who try them out find that the positive effects of feeling more connected to your friends and loved ones causes them to quickly forget about their hesitations. Treating hearing loss not only helps you have better conversations, but it will also leave you with more energy for other activities, like taking your children out to dinner or going on a bike ride after work.

As a member of the NFLPA, you have access to an exclusive program offered by EarQ and the PAF. Come in to any participating EarQ office to have a hearing test completed at no cost to you. If you show a significant need for hearing aids, you may be eligible for a Gene Upshaw PAT Grant to assist with the payment.   

If you are ready to get your energy back and take the next step to better hearing, please call us at 888-840-1292 to get set up with an EarQ provider today!

*Access to the Gene Upshaw PAT Grant is at the sole discretion of the Professional Athletes Foundation.  Please contact the Professional Athletes Foundation at 800.372.2000 with any questions about applying for the grant. 

4 ways to stay fit and stress less during the holidays

As the holiday season ramps up, daily schedules can easily fill with the demands of the season, like shopping, cooking, wrapping and planning. To avoid overload, it’s all too easy to shift self-care priorities — like regular exercise — to the bottom of the list. Skipping workouts, however, can actually make it more difficult for our bodies and minds to deal with added holiday stressors. 

Instead of letting exercise slide, taking a less-is-more approach to working out will enable you to avoid schedule overload without sacrificing your health. By training smarter, not longer, you can increase time available for holiday to-dos while still decreasing the impact of seasonal treats on the waistline. This plan will also help reduce stress and safeguard your overall well-being. 

Below, I outline four strategies to help you stay fit during the holiday season.

Use habit stacking to add more daily exercise 

One of the best ways to train smarter, not harder, in this busy time of year is to ensure you’re exercising consistently at least a few minutes every day by making it a habit. And one of the most effective ways to create a daily habit that sticks is to stack it on an existing one.

Consider some of common everyday habits that are so ingrained in your routine, you automatically do them, such as brushing your teeth, showering and making your bed. By adding an exercise right before, during or directly after one of those habits, it’s easier to make it stick in your daily routine. For example, for nearly eight years now, I’ve been doing 50 body-weight squats or two-minute wall sits while I brush my teeth.

It wasn’t until a couple years ago when I read James Clear’s book “Atomic Habits” that I realized what I’d been doing was called “habit stacking.”

In a blog post on Clear’s website, he explains why “synaptic pruning” in our brains supports habit stacking. Connections (synapses) between neurons in our brains, he wrote, decrease when not used and strengthen when used frequently. Consequently, existing habits have stronger synaptic connections that we can leverage through habit stacking to create new habits.

That’s why my squat habit while toothbrushing was so easy to start and maintain. After reading Clear’s blog, I also added 10 push-ups before showering to my daily routine — and I formed that habit easily as well!

What daily habits could you stack with different forms of exercise?

Feel free to use mine or come up with your own. Maybe 30 jumping jacks before morning coffee? Or 20 alternating step-back lunges right after putting on your shoes? Choose what feels right for you to slot into your routine.

Multitask your mobile screen time

Although spending time on your smartphone might seem like a habit, it’s usually more of a time waster that happens sporadically throughout the day rather than a natural part of a daily routine. And leading up to the holidays, many people experience an increase in mobile screen time. Whether people are online shopping, answering texts or scrolling social media to keep up with friends’ holiday plans, many folks inevitably spend a significant chunk of the day looking down at their phones.

What if you could make even a fraction of that time better for your health? And maybe even dissuade yourself from spending so much time looking at your phone? You can — by incorporating posture-improving, core and leg-strengthening wall sits in your smartphone time. 

By design, wall sits are challenging. So, even though they’re good for you, you aren’t going to want to hold them for very long or do very many sets. So if you pair them with your smartphone time, you’ll likely reduce your scrolling minutes just to avoid them — which isn’t a bad thing for your mental health.

High blood pressure before and after exercise linked to health issues in later life

Blood pressure and disease

Cardiovascular illnesses relate to issues with a person’s heart or blood vessels. According to the American Heart Association (AHA), these can include heart disease, heart attacks, stroke, arrhythmia, and heart valve problems.

A key issue driving cardiovascular diseases is high blood pressure, also known as hypertension. According to the Centers for Disease Control and Prevention (CDC), high blood pressure is a risk factor for heart disease and stroke, two of the leading causes of death in the United States.

High blood pressure occurs when a person’s blood vessels become stiff and narrow. This may be due to lifestyle factors, such as too little physical activity or consuming too much salt, or health issues, such as diabetes or obesity. Sometimes, hypertension may be a combination of lifestyle factors and disease.

The relationship between blood pressure and cardiovascular disease is well known, and the relationship between blood pressure and exercise has been explored before.

However, fewer studies have explored the relationship between blood pressure following exercise in middle age and cardiovascular disease in later life.

The authors of the present study set out to fill this gap in the literature.

Increased risk of illness and death

After adjusting for other risk factors of cardiovascular disease, the authors found that both systolic and diastolic measures of exercise blood pressure were risk factors for developing hypertension 12 years later. 

They also found that better levels of blood pressure recovery were protective against hypertension.

In contrast, the authors found that neither systolic nor diastolic blood pressure during exercise predicted cardiovascular disease at 12 years, after adjusting for other risk factors for cardiovascular disease and excluding participants not receiving treatment for hypertension. 

However, they found that good recovery of systolic blood pressure after exercise was protective, reducing risk of cardiovascular disease by 17%.

According to Dr. Vanessa Xanthakis, the corresponding author of the article and an investigator for the Framingham Heart Study: 

“The way our blood pressure changes during and after exercise provides important information on whether we will develop disease in the future; this may help investigators evaluate whether this information can be used to better identify people who are at higher risk of developing hypertension and CVD [cardiovascular diseases], or dying later in life.”

— Dr. Vanessa Xanthakis

As well as helping clinicians develop new prognostic tools for cardiovascular illnesses, Dr. Xanthakis says the study’s findings suggest that a person should keep track of their blood pressure numbers during and after exercise, reporting any changes to their doctor.

Up to 80% of COVID-19 Infections Are Asymptomatic

n one cruise-ship coronavirus outbreak, more than 80% of people who tested positive for COVID-19 did not show any symptoms of the disease, according to a new paper published in the journal Thorax.

The research shows just how prevalent asymptomatic transmission of COVID-19 may be—a reality that both suggests official case counts are drastic underestimates, and emphasizes the importance of practicing social distancing even if you feel healthy.

Researchers have known for months that asymptomatic transmission of COVID-19 is possible and common, but without population-wide testing, it’s been difficult to estimate how many people get infected without showing symptoms. The new paper provides an example of how widespread asymptomatic transmission can be, at least in a contained environment.

The (unnamed) cruise ship in the new paper left Argentina in mid-March, with plans to travel around the Antarctic Peninsula and over to South Georgia Island in the south Atlantic ocean. All passengers were checked for coronavirus symptoms before departure, and people who had traveled through COVID-19 hotspots were not allowed on board.

Even still, a passenger developed a fever eight days into the trip, triggering a ship-wide lockdown. Crew members and additional passengers began to develop coronavirus symptoms over the next few days.

The ship was not allowed to re-dock in Argentina after the country closed its borders, so it continued on to Uruguay, where eight people were evacuated to a hospital. Uruguayan officials eventually arranged for everyone remaining on board to get tested before the boat docked.

Out of 217 people on board, 128 tested positive for COVID-19—but only 24 of those people showed symptoms prior to testing. The remaining 104 people—81% of those who tested positive—had not experienced any symptoms, the researchers report.

Sedentary? Feel happier with sleep or light activity instead

There is plenty of evidence that a sedentary lifestyle is less conducive to good health than a physically active one. 

Meanwhile, SARS-CoV-2 and lockdowns have made it more difficult for many people to stay active or take up exercise. 

Some of the current situation has to do with many of us working at home. Some of it, however, is optional, such as the hours we willingly allocate to TV binge-watching. 

A new study suggests better and perhaps surprising ways to spend our spare time — that might benefit our health, as well.

The research appears now in the American Journal of Preventive Medicine.

Moving from the couch to the bed, and to sleep, is more refreshing than spending hours sitting in front of a screen — and the same is true of doing light housework, the study suggests.

The findings arrive at a useful time for those struggling to feel good during the COVID-19 pandemic and lockdowns. 

Lead author Jacob Meyer of Ohio State University (OSU) in Columbus, Ohio, says, “With everything happening right now, this is one thing we can control or manage, and it has the potential to help our mental health.”

Escaping the couch

According to the study’s authors, previous research has shown that adults in the United States typically spend 75% of their waking hours being sedentary, including 90% of their leisure time. 

Even active adults have seen their activity levels drop by 32% in lockdown, according to preliminary data the researchers released in May.

During quarantine, and after a day’s work, we may find ourselves in search of restorative activity within our four walls, and immersion in online entertainment may seem a reasonable form of escape.

The new OSU study proposes, however, that there are better options that people can easily work into their quarantine schedules. 

“It may be easier for people to change their behavior if they feel it’s doable and doesn’t require a major change,” according to Meyer.

The first of the study’s conclusions is that people might do themselves a favor to turn off the TV and simply go to bed for the night.

The researchers correlated getting more sleep with feeling less stressed, being in a better mood, and even having a lower body mass index (BMI).

They also associate a lasting reduction in BMI, as well as improved mood, with some light activity performed around the home.

While previous studies — and this one — document the value of moderate-to-high levels of activity, Meyer and his colleagues see real benefits even from less demanding activities, such as walking around as people talk on their phones, or standing as they prepare dinner.

“People may not even think about some of these activities as physical activity,” Meyer says. 

However, they do more for you than merely being sedentary, the researcher maintains. 

“Light activity is much lower intensity than going to the gym or walking to work,” he argues, “but taking these steps to break up long periods of sitting may have an impact.”

Tips for Wearing a Mask to the Gym

There’s a massive amount of information available from sources like the Centers for Disease Control and the World Health Organization about whether wearing a mask is right for you, so we’re going to leave that advice to the pros. Today, we’re assuming that you have chosen to wear a mask to the gym. Many gyms are requiring that their members wear some sort of face covering, so here are some helpful tips to know before you mask up!

What Is The Best Kind Of Mask?

There has been an incredible amount of creativity when it comes to homemade masks. Some people are using bandanas, folded T-shirts, and even custom-sewn masks. The finer the fabric—that is, the smaller the gaps in the threading—the better the mask will be for capturing any moisture from your breath. You can also get this effect by folding fabric over itself multiple times. Masks made by folding fabric may also be useful for gym-goers because if you get too sweaty, you can quickly remove your mask, refold it, wash your hands, and get back to your workout feeling fresh.

For now, it seems that homemade masks are the best bet considering that true surgical masks are at a premium for those who need them most: frontline medical workers. Since doctors and nurses require these masks to provide care safely for people who are actively sick, do your part and leave the medical-grade masks for the professionals and home caretakers.

Reasons For Wearing A Mask

Based on our initial understanding of COVID-19, wearing a mask may potentially reduce the spread of any moisture exhaled from your mouth via breathing. If you are sneezing or coughing, it’s probably not the time to be going to the gym anyway. Since your breath is projected outward with less force thanks to the mask, there’s a decreased likelihood of spreading any pathogens outside of your small bubble. This is potentially a way to help protect those around you, should you be sick without knowing it. Everyone at the gym is going to be working hard and breathing heavy, so keeping all that breath from moving around may be helpful.

Reasons Against Wearing A Mask

We’re still learning more about COVID-19 every day. The unique nature of this virus means that plans will change, policies will evolve, and we’ll have to be flexible. One thing we have learned is that wearing a mask may not be an end-all solution. First, the moisture from your breath can move in particle sizes smaller than the weave of many fabrics. So you could still get sick and cause others to get sick while wearing a mask. Keeping a safe distance from others and being smart about social interaction are still important things to remember.

Second, human behavior is a funny thing. Experts studying people wearing masks found that they seemed to feel almost too safe. When wearing a mask, users would resume touching their face more often, neglect washing their hands as often, and more. Having a strong but false sense of security could be dangerous. It’s important that wearing a mask is only your first step in staying safe.

Finally—and this is for all you high-intensity exercisers out there—wearing a mask may decrease your ability to work out at your peak. Your muscles’ ability to function is directly tied to how much oxygen they can get to make energy. If you’re wearing a face covering, you’re decreasing the amount of air you can pull in with each breath and increasing the amount of work it takes to get each breath due to resistance. Without even knowing it, you may be simulating high-altitude training (but that’s a conversation for another day).

For now, life is going to be a bit different. Going to the gym with your face covered will feel odd, but don’t feel ashamed. We’re all in this together, and if by wearing a mask you have the chance to help others, we say it’s worth it. Just make sure to continue keeping your distance from others, clean your bench when you’re done lifting, and wash your hands regularly.

How the COVID-19 Pandemic Could Be Messing With Your Sleep

COVID-19 and its associated quarantine have messed with pretty much every aspect of our lives. Work time, meal time, family time, play time; our moods, our stress level, our tolerance; our ability to spend so much as one more minutestaring at the same four walls of the same den or living room or home office in which we spend most of our days.

And if you’re like plenty of people, the quarantine has also completely bollixed up your sleep cycle, wrecking what might have been the most predictable and peaceful eight hours of your day. Unless, that is, you’re like plenty of other people—and the quarantine has led to some of the best and most consistently restful sleep you’ve ever had. If the pandemic itself has been an unalloyed bad, its impact on sleep has been much more ambiguous.

“There are both upsides and downsides,” says Dr. Cathy Goldstein, associate professor of neurology at the University of Michigan Sleep Disorders Center. “We have more time in general so we’re devoting more of it to sleeping. When people run out of discretionary time, the first thing they do is condense their sleep. Now we can get that full eight hours—but we can also get too much.” At the same time, she points out, the pandemic might be causing other people to get too little sleep, or at times none at all.

Broadly, Goldstein explains, sleep is governed by two systems: the homeostatic and the circadian. The homeostatic system is more internal and is simply a function of how much sleep you’ve had and when you need more. The circadian system is pegged more to the external—the 24-hour clock and the daylight-nighttime cycle. “The two systems are independent but interlocking,” Goldstein says.

Left to ourselves, with no external clock but the rising and setting of the sun—humans in the state of nature in other words—we would all fall naturally into an approximate midnight to 8:00 AM sleep cycle, with 4:00 AM the peak and midpoint of rest. Those times are not fixed, of course, with the entire eight-hour cycle shifting earlier during the summer, when the sun might rise before 6:00 AM. Ten to midnight seems like a relatively late bedtime, but in that same state of nature there were also evening matters to tend to: getting children fed and put to sleep, tending the fires, watching out for predators. Indeed, Goldstein says, it’s normal for all of us to have a burst of evening alertness from 7:00 to 9:00 PM, which is more or less when our long-ago ancestors would have been performing these chores.

During quarantine, it appears that a lot of people are finding their way back to that primordial sleep state. In two papers currently in pre-publication for the journal Current Biology—one a study of 435 European respondents, and the other of 139 students at the University of Colorado, Boulder—researchers had only good news to report.

“They found the subjects were sleeping slightly longer and at more consistent times across the course of the week,” Goldstein says. “They found a reduction in ‘social jet lag,’ which is the deviation from the midnight to 8:00 AM natural cycle. The discrepancy is much reduced—with subjects sleeping more consistently across seven days.”

But things are also more complicated—and less rosy—than that. People with jobs that allow them to work from home may be less physically active than they normally would be, which can disrupt the homeostatic system; they may have less exposure to outdoor light and dark, which can disrupt the circadian system. They may be eating more or at irregular times, which can put the digestive and sleep cycles in opposition to each other.

9 Fitness Trends to Look for in 2021

As former Congressman and Mayor of Chicago Rahm Emanuel once said, “Never let a serious crisis go to waste. And what I mean by that is that it’s an opportunity to do things you think you could not do before.”

Health and exercise professionals have applied this mindset and responded to mandated facility closures by finding new ways to deliver workout solutions via video streaming services as well as making use of outdoor spaces that allow for proper social distancing. The question becomes: Are these adaptations merely a stopgap solution for dealing with the pandemic or will they become a part of the fitness landscape for the foreseeable future? And importantly: How will these changes affect the ability of health and exercise professionals to earn a living in the coming year?

While it is not possible to predict the future with any certainty, this attempt to see how we’ll be doing fitness in the coming year is based on conversations with colleagues who work for equipment manufacturers, have positions in health club operations or own fitness studios, both in the United States and all over the world. To help you plan for your business in the coming year, each prediction is also accompanied by what it means for health and exercise professionals and how it might affect your ability to conduct your business in the coming year.

  1. Streaming services that deliver workouts to any screen connected to the internet have become extremely popular and will remain so for the foreseeable future. The variety of workouts combined with the chat features that allow participants to engage with the instructors and each other really does create the studio experience from the comfort of home. According to Jessica Pohl Sinnarajah, a cycling instructor in Buffalo, N.Y., “The social online presence created by the streaming platforms help create a feeling of community, even while you’re working out alone. There is a sense of accomplishment when posting about workout achieving that also helps to build accountability to others who work out on the platform.” In 2021, class size restrictions will lead many facilities to offer hybrid services of streaming workouts directly from their studios. Thanks to technology, many facilities will create their own streaming services that will allow some members to participate live in the studio while others will be sweating from home. Fitness facilities that have not already done so will need to identify virtual solutions to deliver group workouts, which can help ensure retention of existing members while providing new opportunities to engage with coaches from the facility.
  1. Group fitness classes are going green. Governments have attempted to limit the spread of the virus through shelter-in-place orders and by restricting business operations; in many locations, fitness facilities are allowed to operate but only by offering outdoor workouts. Health clubs and studios in warm-weather locations such as Southern California, Arizona and Florida have responded by moving equipment and classes outdoors. Partly in response to the business closures that restrict popular leisure activities such as going to the movies or watching professional sports, many people are rediscovering the benefits of accessible activities such as walking and are making use of outdoor recreation spaces such as parks and hiking trails. In addition, activities such as cycling, roller skating and inline skating are seeing a resurgence in popularity. “Outdoor classes that include the whole family have become a popular option in for our members, says Christy Giroux, a personal trainer in Gaithersburg, Md., and co-owner of Prime Fitness. “In addition, we have seen many of our neighbors at our local parks because you can be active while remaining socially distant.” People seeking new ways to be active outdoors creates new opportunities for health and exercise professionals to help clients get in shape so they can enjoy those activities to the fullest extent possible.
  1. In response to business closures and restrictions on large groups, many consumers have been buying up all available fitness equipment to stock up their garage gyms. It’s one thing to buy exercise equipment for the home, it’s another to learn how to use it correctly. The explosive popularity of garage gyms should create a number of new opportunities for health and exercise professionals who specialize in in-home workouts to deliver their services to a whole new clientele.
  1. As mentioned above, due to a variety of reasons, including evidence suggesting a link between obesity and COVID-19 complications, it appears as if many individuals have become more physically active and have started to exercise for the purpose of improving health. According to the results of a United Kingdom-based study, the pandemic may be initiating a new interest in physical activity and exercise among older adults who are at greater risk of complications from the virus. As this recent CERTIFIED article on exercise and the immune system points out, it’s well established that regular exercise combined with other healthy lifestyle habits can strengthen the immune system. As new fitness consumers enter the market, it will create new opportunities for health and exercise professionals to design exercise programs to reduce risk factors and improve overall health.
  1. On that note, in 2021 social media will continue to be the primary way that many individuals search for and consume fitness information. As more consumers enter the fitness market, many turn to popular social media platforms to look for guidance on how to start an exercise program. Health and exercise professionals that have a strong social media presence and know how to leverage platforms such as Facebook, Instagram, YouTube or TikTok to engage potential clients will have a distinct advantage for attracting this new business. If you’re a health and exercise professional who wants to develop a business that can deliver online workouts, now is the time to master the power of social media.

COVID-19 May Lead to a Heart-Disease Surge

Take a nation that already eats too much, drinks too much, exercises too little and fails too often to show up for regular checkups, put them in lockdown for a year or more, and those behaviors–all of which are drivers of cardiovascular disease–will only get worse.

In a recent survey in the journal Circulation, the American Heart Association (AHA) predicted a surge of cardiovascular death and disease in the months and years to come as a lagging indicator of the lifestyle changes forced upon the world by the pandemic. “We don’t have a lot of well-vetted data up to the minute on the cardiovascular impact of COVID because we are living through the pandemic now,” says Dr. Mitch Elkind, president of the AHA and a professor of neurology and epidemiology at Columbia University. “That new data will come in the next year or two, but we are anticipating that the pandemic will have a significant impact.”

SARS-COV-2, the virus that causes COVID-19, does on occasion infect and damage heart tissue directly. One study published over the summer in JAMA Cardiology, for example, found that of a sample group of 100 people who had recovered from COVID-19, 78 had some inflammation of myocardial tissue or other damage such as scarring. In another JAMA Cardiology study, researchers reported finding SARS-CoV-2 in the heart tissue of 61.5% of 39 patients who had died due to COVID-19. The sample groups in both studies were small, and in the overwhelming number of cases of coronavirus death, heart failure is not the proximate cause. But there’s a related truth: the pandemic seems to be leading people into developing the very lifestyle factors that cause heart disease over the long term.

Consider a September 2020 study in JAMA that showed that alcohol consumption had increased 14% in a sample group of 1,540 adults during the pandemic. Or the study (from the same month) in Psychiatry of 3,052 adults showing a decrease in physical activity in 32.3% of adults who were previously physically active. Or the survey conducted by the COVID Symptom Study (again, from September 2020) showing that 31% of adults had reported snacking more during lockdowns.

It’s not just eating, drinking and sitting still that can be killers. Elkind and the AHA also cite emotional stress caused by economic hardship, and depression as the isolation of quarantining drags on. When hospitals and doctors’ offices are seen as viral hot zones, people are less likely to show up for routine monitoring of hypertension, cholesterol levels and other chronic conditions that can have a cardiovascular impact. Acute cardiac events too are being ignored. “We know people have delayed getting care for heart attacks and strokes, which can lead to poorer outcomes,” said Dr. Salim Virani, who chaired the committee that wrote up the AHA’s statistical update, in a statement.

In the U.S., about 655,000 people die of heart disease each year, according to the U.S. Centers for Disease Control and Prevention, a figure that outpaces the 360,000 reported to have died of COVID-19 in 2020. But those statistics don’t tell the whole story. Elkind estimates as many as 500,000 additional U.S. deaths in the past year due to people not getting prompt medical help for severe or emergency medical conditions, many of which were cardiovascular in nature.

The Essential Role of Sleep in Immunity

Want to ensure your vaccination offers the greatest protection against COVID-19? Sleep—and sleep well—before and after your vaccine appointment, because natural sleep boosts the immune system significantly.

The authors of a January 2021 article in Sleep Diagnosis and Therapy are even more specific. They suggest at least two nights of full sleep before receiving the COVID vaccine, followed by several more nights of sufficient sleep to minimize, or avoid, any side effects of the vaccination. Their comments follow the publication of a study in a 2020 issue of theInternational Journal of Behavioral Medicine, in which scientists report an association between sleep duration and the effectiveness of influenza vaccine.  Sleep, the study authors say, seems to increase the body’s “immunological memory,” meaning the immune system is more likely to recognize—“remember”—invading viruses and other pathogens and develop a quicker and more potent antibody response against them once a vaccine is injected.

Sleep and “Immunological Memory”

The link between sleep and the immune system is central to a study appearing in a 2019 edition of the Journal of Experimental Medicine. In the article, researchers describe a “potential mechanism” by which sleep advances the response of the body’s T-cells, lymphocytes that can differentiate between “good” and “bad” cells and kill those that are cancerous or infected with viruses like COVID. Other studies have shown that the quantity of T-cells in the bloodstream decreases in people who are sleep-deprived—getting less than five or six hours of sleep a night—and that insufficient sleep cripples T-cells’ ability to recognize and fight incoming pathogens.

Such findings should not be surprising. In fact, nearly 20 years ago, scientists from the University of Chicago and Ohio State University, writing in the Journal of the American Medical Association, were already warning that “response to influenza vaccination may be impaired in individuals with chronic partial sleep restriction.” They advised that their study results “support the concept that adequate amounts of sleep are needed for optimal resistance to infectious challenge.”

But COVID Vaccines Are 95 Percent Effective, Right?

News sources are reporting that the various COVID vaccines currently in circulation are as much as 90 percent or 95 percent effective. But these numbers are based on controlled clinical trials. The precise extent of the vaccines’ infection-fighting capabilities over time among the general public is not yet fully known. Many variables—one of them being sleep—modulate the effects of a vaccine in any given individual.   

Ohio State University scientists undertook a review of nearly 50 vaccine studies, some published as far back as 30 years. They found evidence that unhealthy lifestyle habits, lack of exercise, anxiety, stress, mental health disorders like depression, and, yes, sleep deprivation could significantly decrease the benefits of vaccination. Negative health factors prevented sufficient antibody production, reduced the time period of immunity protection, or enhanced or prolonged the vaccine’s unwanted side effects, they concluded. Their report is published in the January 2021 Perspectives on Psychological Science.

Long-term, heavy coffee consumption and CVD risk

In a world first genetic study, researchers from the Australian Centre for Precision Health at the University of South Australia found that that long-term, heavy coffee consumption — six or more cups a day — can increase the amount of lipids (fats) in your blood to significantly heighten your risk of cardiovascular disease (CVD).

Importantly, this correlation is both positive and dose-dependent, meaning that the more coffee you drink, the greater the risk of CVD.

It’s a bitter pill, especially for lovers of coffee, but according to UniSA researcher, Professor Elina Hyppönen, it’s one we must swallow if we want keep our hearts healthy.

“There’s certainly a lot of scientific debate about the pros and cons of coffee, but while it may seem like we’re going over old ground, it’s essential to fully understand how one of the world’s most widely consumed drinks can impact our health,” Prof Hyppönen says.

“In this study we looked at genetic and phenotypic associations between coffee intake and plasma lipid profiles — the cholesterols and fats in your blood — finding causal evidence that habitual coffee consumption contributes to an adverse lipid profile which can increase your risk of heart disease.

“High levels of blood lipids are a known risk factor for heart disease, and interestingly, as coffee beans contain a very potent cholesterol-elevating compound (cafestol), it was valuable to examine them together.

“Cafestol is mainly present in unfiltered brews, such as French press, Turkish and Greek coffees, but it’s also in espressos, which is the base for most barista-made coffees, including lattes and cappuccinos.

“There is no, or very little cafestol in filtered and instant coffee, so with respect to effects on lipids, those are good coffee choices.

“The implications of this study are potentially broad-reaching. In my opinion it is especially important for people with high cholesterol or who are worried about getting heart disease to carefully choose what type of coffee they drink.

“Importantly, the coffee-lipid association is dose-dependent — the more you drink unfiltered coffee the more it raises your blood lipids, putting you at greater risk of heart disease.”

Plant-based diets reduce risk of heart disease, dementia, study finds

The study, published Wednesday in the Journal of the American Heart Association (JAHA), studied more than 100,000 post-menopausal women for nearly 20 years.

The women in the study who ate more protein from plant-based sources had an associated lower risk of deaths related to heart disease and dementia and a lower risk of all-cause mortality, or death from all causes, in comparison to women who ate more red meat, dairy and eggs.

Why a plant-based diet could impact health factors like dementia and heart disease is the subject of two working theories in medical and nutritional science literature, according to Dr. Jennifer Ashton, ABC News chief medical correspondent and a board-certified OB-GYN.

“One of them has to do with inflammatory metabolites, so these are by-products of animal protein that can then affect the heart and the brain and our blood vessels,” said Ashton, who also has a master’s degree in human nutrition. “Another [theory] has to do with the gut microbiome, that good bacteria, and obviously what we eat is related to that.

Ashton said on “Good Morning America” Thursday that she has followed a plant-based diet for the past three weeks and has seen her bad cholesterol level, or LDL, and her body fat decrease.

My weight stayed the same and I lost one point off that dangerous internal visceral fat, so even someone doing this just one or two days a week could potentially have some health benefits,” she said. “My advice is dip your toe in the water.”

“It doesn’t have to be all or none,” she said. “You could start with just one day of plant-based eating then maybe that will lead to two but, listen, if I can do it, anyone can do it.”

What is a plant-based diet?

A plant-based diet is a way of eating that consists mostly or entirely of foods derived from plants, including vegetables, grains, nuts, seeds, legumes and fruits.

How much will fried foods harm your heart?

Not many, suggests a large analysis published online Jan. 18, 2021, by the journal Heart. Scientists pooled the findings of 17 studies on fried foods and problems like heart attacks, clogged coronary arteries, heart failure, and stroke. The studies included more than half a million people. Researchers also looked at the data from another six studies assessing the association of eating fried food and dying prematurely. Those studies involved more than 750,000 people. People who ate the most fried foods each week were 28% more likely to have heart problems, compared with people who ate the least. Each additional 114-gram (4-ounce) serving of fried foods per week bumped up overall risk by 3%. But the analysis failed to show that people who ate lots of fried foods were more likely to die prematurely. Besides provoking inflammation, fried foods are often also high in sodium as well as harmful saturated fats. If you choose to indulge in them, do it sparingly. And avoid foods fried in animal fats; instead, choose foods fried in vegetable oils.

I’m Vaccinated Against COVID-19 But My Kids Aren’t. What’s Safe for Us?

Those lucky enough to have received both vaccine doses (or one dose of Janssen/Johnson & Johnson’s single-dose vaccine) can now hang out in a private home, blissfully mask-free, with other fully vaccinated folks, according to the guidelines.

But what about families with kids?

As of now, kids younger than 16 are not authorized to get a COVID-19 vaccine in the U.S., so there’s no way they can be fully protected. Does that mean parents and their children are staring down another year of isolation? Here’s what to know.

Kids get seriously ill far less often than adults

First, the good news: It’s pretty rare for kids to get a severe case of COVID-19. According to CDC estimates, COVID-19 hospitalization rates are 80 times higher among adults older than 85 than they are among children of ages five to 17. Death rates for adults older than 85 are a staggering 7,900 times higher than they are for children.

There are always unfortunate exceptions, of course. Kids certainly have been hospitalized and died from the virus, and some have developed an inflammatory condition known as MIS-C. Some evidence also suggests kids, like adults, can develop long-term symptoms after an infection. But, in general, a child who gets sick with COVID-19 is likely to have a fairly mild case and make a full recovery.

So, what’s safe for my family?

Even though children are at lower risk, families with unvaccinated kids shouldn’t rush straight back into pre-pandemic life, even if both parents are fully immunized, says Dr. David Kimberlin, co-director of the pediatric division of infectious diseases at Children’s of Alabama. “We are beginning to loosen up and emerge from this darkness,” Kimberlin says, but “it’s not full sunlight” yet.

Your family can, however, take small steps. Under CDC guidelines, fully vaccinated people can visit with one household of unvaccinated people, provided none of the unvaccinated individuals has an underlying condition that puts them at risk of complications. That means, for example, that your children’s vaccinated grandparents could come to your house for an indoor, unmasked visit, even if the kids aren’t yet protected.

Such a visit isn’t entirely risk-free, says Dr. Richard Malley, a senior physician in Boston Children’s Hospital’s division of infectious diseases. Malley says he is confident that a fully vaccinated person is less likely to spread the virus than an unvaccinated person, but exactly how much less likely they are remains unclear. Without that information—and with new variants complicating our knowledge of the virus and how it spreads—it’s impossible to say exactly how risky it would be for an unvaccinated child to spend time unmasked around other people, even if those other people have had their shots.

Can the kids have a playdate?

Until your kids are vaccinated, Kimberlin says he wouldn’t invite anyone unvaccinated into the house without a mask—even another child. The kids could potentially infect each other, and then pass on the virus to someone else, he says.

This situation will improve with time, Malley says. As more adults get vaccinated, case counts, test positivity rates and hospitalizations should continue to fall. As they do, you may feel more confident about expanding your social bubble, since it will be increasingly unlikely that anyone in your circle was exposed to the virus. “That risk declines as the intensity of the virus in that community drops,” Malley says.

But for now, it’s still safest to arrange playdates for the kids outside, or inside wearing masks, Kimberlin suggests. And if your child has a health condition that puts them at higher risk of severe disease, you may want to continue taking precautions until he or she can get vaccinated.

Black people in rural areas continue to experience health disparities

Numerous healthcare-related inequities persist among different racial groups. For example, research has shown that Black people experience lower life expectancy, have higher rates of high blood pressure, and receive fewer flu vaccinations than white people.

Structural inequities in healthcare may have a more significant effect on Black people living in rural locations than those living in urban areas, where healthcare may be more accessible.

Health inequities affect all of us differently. Visit our dedicated hub for an in-depth look at social disparities in health and what we can do to correct them.

To investigate rural and urban trends in health disparities and determine whether the gaps between racial groups are closing, researchers from Beth Israel Deaconess Medical Center (BIDMC) used data from the Centers for Disease Control and Prevention (CDC). Specifically, they used the CDC WONDER databases to compare annual mortality rates between Black adults and white adults.

Their research letter appears in the Journal of the American College of Cardiology.

Mortality rates show ongoing inequities

The investigators looked at age-adjusted mortality rates between 1999 and 2018 in rural and urban areas for both Black and white people aged 25 years and older. They examined the death rates associated with four health conditions: heart disease, diabetes, high blood pressure, and stroke.

Over the 20-year timeframe, the researchers found:

  • Black adults had consistently higher death rates from all four conditions in both rural and urban areas than white adults.
  • The highest mortality rates from each health condition occurred in Black adults residing in rural areas.
  • Mortality rates from diabetes and high blood pressure complications were nearly two and three times higher, respectively, in Black adults than in white adults.
  • For diabetes and high blood pressure, the mortality rate gap between white adults and Black adults narrowed over the past 2 decades in urban areas. This also occurred in rural locations but to a lesser extent.
  • For heart disease, the mortality rate gap between the two racial groups narrowed at a similar rate in rural and urban areas, whereas for deaths due to stroke, the gap narrowed more rapidly in rural areas. 

“The persistent racial disparities for diabetes and high blood pressure-related mortality in rural areas may reflect structural inequities that impede access to primary, preventive, and specialist care for rural Black adults.”

– Rahul Aggarwal, M.D., a clinical fellow in the Department of Medicine at BIDMC

Aggarwal also says that the heart disease and stroke mortality gap between Black and white adults may have narrowed in rural areas because of several factors.

These include improvements in emergency services, expansion of referral networks, and the creation of more healthcare facilities specific to stroke and heart care in rural locations.

The reduced length in time from diagnosis to treatment is another factor that the researcher mentions.

THE FITNESS NOT TO DO LIST

Health can feel like an overwhelming checklist of foods to eat, exercises to perform, and habits to follow. And, that’s before you have to deal with flip-flopping opinions that tell you to do something one day and avoid it the next.

But, there’s a much shorter checklist that might be more helpful and cause a lot fewer headaches.

Instead of worrying about what you need to add to your life, it might be easier to think about addition by subtraction.

Avoiding the bad means you’re more likely to be doing something good — and isn’t that the point?

Many years ago, Tim Ferriss created a “not-to-list” that applied to getting through life with less stress and frustration. It’s such a brilliant idea that I thought it should be applied to fitness.

In many ways, a not-to-do list is much more powerful than any version of “The 11 Best Foods You Should Eat,” the “20 Best Diets” or the “15 Most Effective Exercises.” What do all of these articles have in common?

They make it very clear that many things work with fitness and nutrition. So, picking the right plan is less about finding “the one approach that works” and more about finding “the right approach for you.” It’s a lot easier to accomplish if you avoid all of the garbage information that will lead you farther from your goals.

As with Tim’s original post, I highly recommend not trying to avoid all of these at once. Start with 1-3, master them (or, more accurately, just limit), and then add other items from the list as they apply to your health and lifestyle.

1. Don’t eat while working or watching TV.

You might believe that hunger alone is what drives you towards food. But, what you might not realize is that attention and memory also play a big role in how much you eat and whether you feel full.

Distracted eating — or having a meal (or snacks) while watching TV or working — is a sure-fire way to ensure that you don’t pay as much attention or remember what you ate. And that means you’ll be eating more during your meal or eat more later. The less you are distracted, the less you eat, according to The American Journal of Clinical Nutrition.

2. Avoid workouts that
require time you don’t have.

If you’re going to be healthy, you need to make time for exercise. However, prioritizing movement does not mean you need to spend hours lifting weights or on the treadmill or bike. When you select plans, a primary consideration needs to be the total number of hours required and the amount of time you can realistically commit.

Don’t get it twisted: you might need to adjust your schedule to create time to prioritize your health. But, however much time you create should be something you can realistically accomplish.

If you pick a plan that demands too much of your schedule, you’re more likely to fall off the plan and become sedentary. That’s the opposite of what you want. (Research goes as far as providing data that a 60-minute workout doesn’t necessarily lead to more results than a 30-minute workout.)

Where to start? As a good rule of thumb, aim for, at least, 20-30 minutes of movement per day. This can be as simple as a walk at a brisk pace.

And, 2-3 times per week, try to include 10-20 minutes of intense exercise. In fact, if you have the right program, research suggests that just 1-minute of high-intensity exercise (along with a 10-minute warmup of moderate intensity) might improve your heart health and metabolic factors.

3. Do not buy over-the-counter fat burners.

American’s spend anywhere from 2 to 5 billion on fat-loss pills every year. That’s a mind-numbing amount of wasted money. While some supplements — such as caffeine — work to help your body’s thermogenic process (it increases heat production), the actual impact on the scale is minimal at best.

Simply put: fat burners might have a tiny boost on your exercise and diet plan, but it’s not likely anything you’ll notice. And, for the amount of money you pay, you might as well just drink coffee or black tea.

Better yet, stop depending on over-the-counter weight loss supplements altogether. They are fool’s gold.

4. Do not argue with people
about which diet is best.

Many diets work. If someone is married to an idea, you’re unlikely to convince them otherwise. There are many ways to reduce calories, and infinite ways to get the nutrients your body needs. Some diets are more likely to work for many people, but the “best diet” is the one that works for you.

5. Do not ignore off days.

Your body needs rest. Your muscles need to recover. Your mind enjoys breaks. If you want better results, more effective workouts, and a body that won’t break down, then make sure — at a minimum — you have 1-2 off days per week.

6. Do not downplay sleep.

It might seem similar to prioritizing off days, but sleep and rest two sides of the same coin. Sleep abuse is an equal problem for people who exercise and those who don’t. But, it very well might be the healthiest habit you can master every day.

Nine Tools for Better, Longer Sleep

For many of us, a restful night of sleep is hard to come by under the best of circumstances. But against the backdrop of a long, cold winter and the ongoing pandemic, it can feel almost impossible. While there will always be newfangled gadgets that claim to solve your sleep problems with advanced technology — yes, there are such things as sleep robots and sleep-tracking rings — newer doesn’t always mean better. Wirecutter, the New York Times Company that reviews and recommends products, has tested countless items to find real, proven solutions, from blackout curtains and sleep masks to better pillows and white-noise machines.

In addition to the products they test for work, Wirecutter writers and editors have found their own sleep solutions for these overworked, overstressed times. These aren’t necessarily products we’ve rigorously tested (unless we’re talking about meditation apps), but they are the things Wirecutter staffers are finding useful at home for falling, and staying, asleep.

  • Soulage Body Wrap

It’s very hard to fall asleep when you’re cold. Heated blankets are nice, but I often wake up sweating later in the evening. The Soulage Body Wrap heating pads (about $52) are the perfect solution. After a few minutes in the microwave, they retain heat for around 30 minutes, gradually and safely cooling down as you nod off. They’re well-made and smell yummy — filled with natural ingredients such as rice, cloves and orange peel. The filling gives the pads some heft, so you get that comforting weighted-blanket feel. Great for warming sheets, soothing muscle aches and even easing menstrual cramps, these wraps are made to last.

I just replaced my old wrap with a new one because it finally started getting too worn — after 18 years of use. Laying the pad across my belly or on my back feels like a cozy hug — and all but guarantees I’ll start to drift off in no time. — Lauren Dragan, senior staff writer

  • Google Nest Hub

Some people are bothered by light interrupting their sleep, but at night I am sensitive to sound. The sudden creaking of the wood frame as the house cools or a squirrel running across the roof can snap me out of a deep slumber. Although any white-noise machine can do the trick, I have found that a smart display, like the Google Nest Hub (about $90), combines several useful bedside gadgets in one box: an alarm clock, a digital picture frame and — above all, for me — a white-noise machine. The constant background sound will put me right to sleep and keep me asleep, with no interruptions. The Nest Hub also can play relaxing sounds, like a babbling brook or steady rain, as well as a voluminous playlist of YouTube videos or Spotify songs. Plus, it’s the only smart display without a camera, preserving that aspect of my privacy. — Joel Santo Domingo, senior staff writer

  • 69 Herbs Coat My Nerves Herbal Drops

I’m convinced this lovely herbal blend — which includes valerian, passionflower and other calming botanicals — helps relax me before sleep. It could just be the ritual aspect: Taking it with a bath or before some yin yoga, I’m far more likely to ease into bed than to continue doom-scrolling well into the night. The tincture is packaged in a frosted bottle with a pastel, vaporwave-y label, and the blend is also sweetened to be more palatable (unlike some more medicinal drops I’ve tried). Coat My Nerves ($22 for an ounce) tastes like an earthy honey, and it immediately dissolves on the tongue without leaving a bitter aftertaste. The company, New York-based 69 Herbs, offers sliding-scale payments for customers who need it. (As with any herbal formula, check with your doctor before taking this blend if you have any medical issues or concerns). — Anna Perling, staff writer

15 natural ways to lower your blood pressure

If left uncontrolled, high blood pressure raises your risk of heart disease and stroke.

But there’s good news. There are a number of things you can do to lower your blood pressure naturally, even without medication.

Here are 15 natural ways to combat high blood pressure.

1. Walk and exercise regularly

Exercise is one of the best things you can do to lower high blood pressure.

Regular exercise helps make your heart stronger and more efficient at pumping blood, which lowers the pressure in your arteries.

In fact, 150 minutes of moderate exercise, such as walking, or 75 minutes of vigorous exercise, such as running, per week, can help lower blood pressure and improve your heart health.

What’s more, doing even more exercise than this reduces your blood pressure even further, according to the National Walkers’ Health Study.

Bottom line: Walking just 30 minutes a day can help lower your blood pressure. More exercise helps reduce it even further.

2. Reduce your sodium intake

Salt intake is high around the world. In large part, this is due to processed and prepared foods.

For this reason, many public health efforts are aimed at lowering salt in the food industry.

Many studies have linked high salt intake with high blood pressure and heart events, including stroke.

However, more recent research indicates that the relationship between sodium and high blood pressure is less clear.

One reason for this may be genetic differences in how people process sodium. About half of people with high blood pressure and a quarter of people with normal levels seem to have a sensitivity to salt.

If you already have high blood pressure, it’s worth cutting back your sodium intake to see if it makes a difference. Swap out processed foods with fresh ones and try seasoning with herbs and spices rather than salt.

Bottom line: Most guidelines for lowering blood pressure recommend reducing sodium intake. However, that recommendation might make the most sense for people who are salt-sensitive.

3. Drink less alcohol

Drinking alcohol can raise blood pressure. In fact, alcohol is linked to 16% of high blood pressure cases around the world.

While some research has suggested that low-to-moderate amounts of alcohol may protect the heart, those benefits may be offset by adverse effects.

In the U.S., moderate alcohol consumption is defined as no more than one drink a day for women and two for men. If you drink more than that, cut back.

Bottom line: Drinking alcohol in any quantity may raise your blood pressure. Limit your drinking in line with the recommendations.

4. Eat more potassium-rich foods

Potassium is an important mineral.

It helps your body get rid of sodium and eases pressure on your blood vessels.

Modern diets have increased most people’s sodium intake while decreasing potassium intake.

To get a better balance of potassium to sodium in your diet, focus on eating fewer processed foods and more fresh, whole foods.

Foods that are particularly high in potassium include:

  • vegetables, especially leafy greens, tomatoes, potatoes, and sweet potatoes
  • fruit, including melons, bananas, avocados, oranges, and apricots
  • dairy, such as milk and yogurt
  • tuna and salmon
  • nuts and seeds
  • beans

Bottom line: Eating fresh fruits and vegetables, which are rich in potassium, can help lower blood pressure.

The connection between post-traumatic stress disorder and nutrition

A new analysis of data from the Canadian Longitudinal Study on Aging (CLSA) finds statistical associations between various health factors and PTSD.

According to the authors of the new study, which appears in Social Psychiatry and Psychiatric Epidemiology, the research does not establish that these factors actually cause PTSD, and the reverse may be true. However, their identification may nonetheless inform further research.

In some cases, the authors posit that underlying physiological mechanisms may be at play.

Nutritional health and PTSD

The CLSA is a large, long-term study of the Canadian population that has been ongoing for more than 20 years. The researchers behind the new study examined the data for 27,211 individuals aged 45–85 years. Of these people, 1,323 had PTSD.

The study found that people who eat two or three sources of fiber per day are less likely to experience episodes of PTSD than those eating less fiber.

Lead author Karen Davison, director of the Nutrition Informatics Research Group and health science program faculty member at Kwantlen Polytechnic University in Surrey, British Columbia, suggests a reason for this finding: “It is possible that optimal levels of dietary fiber have some type of mental health-related protective effect.”

Davison says that this may have to do with short chain fatty acids (SCFAs), which originate in the gut. “SCFA molecules can communicate with cells and may affect brain function,” she explains.

The researchers also linked the consumption of other foods to a higher incidence of PTSD. These foods included chocolate, pastries, nuts, and pulses.

Co-author Christina Hyland, a doctoral student at the University of Toronto (U of T), calls the finding unexpected.

She cautions, however, that the inclusion of nuts on the list may reflect the inclusion of peanut butter, but not more healthful nut options, among the food choices in the CLSA.

Poverty and PTSD

When they looked at nondietary factors, the researchers found a strong association between poverty and PTSD. Of the individuals with an annual household income below $20,000 Canadian, 1 in 7 experienced the disorder.

Senior author Prof. Esme Fuller-Thomson, director of the Institute for Life Course & Aging and professor at the U of T, says that this is one of those links in which the cause and effect are unclear.

“Unfortunately, we do not know whether PTSD symptoms undermined an individual’s ability to work, which resulted in poverty, or whether the stress associated with poverty exacerbated PTSD symptoms in respondents,” Prof. Fuller-Thomson notes.

PTSD, women, and age

The results showed that 6.9% of women and 3.9% of men had PTSD, meaning that it affected women nearly twice as often as men.

Among the women, 8.8% of those who were divorced or widowed had PTSD compared with 4.4% of currently married women or women with a common-law partner.

The study’s analysis supports previous research showing that men and women are more likely to experience PTSD at certain times in their life.

Men are most likely to have PTSD in their early 40s, while women most often experience it in their early 50s.

Chronic health conditions and PTSD

The analysis revealed links between PTSD and both chronic pain and smoking. Meghan West, a master of social work student at the U of T, notes, “This is consistent with results from other studies, which found increased risks of cardiovascular, metabolic, and musculoskeletal conditions among individuals with PTSD.” 

“These links may be due to alterations in the hypothalamic-pituitary-adrenal axis (HPA axis), sympathetic nervous system inflammation, or health behaviors that increase the risk of poor physical health,” she adds.

What do we really know about antioxidants?

According to an article in biomolecules, the word antioxidant is one of the most confusing scientific terms that scientific literature does not clearly define.

This article takes an in-depth look at antioxidants, explaining what they are and how they affect health.

What are antioxidants?

Antioxidants are compounds that reduce or inhibit cellular damage through their ability to neutralize molecules called free radicals.

Free radicals are molecules that have one or more unpaired electrons in their outer orbit, making them unstable and highly reactive. The body creates them through normal endogenous metabolic processes, including energy production. 

The body also produces them in response to environmental and lifestyle factors, such as sun exposure, smoking, alcohol consumption, and more. 

Antioxidants inhibit a process called oxidation, which generates free radicals that leads to cellular damage. Antioxidants safely interact with free radicals, neutralizing them before they can cause damage to proteins, lipids, and DNA. 

Oxidative stress occurs when there are too many free radicals in the body. This imbalance can occur due to increased production of free radicals or decreased antioxidant defenses. 

Free radicals play an important role in the normal physiological functioning of the body and contribute to a person’s health. However, when the body produces an excess of free radicals, it can increase a person’s disease risk.

For example, many chronic diseases, including heart disease and cancer, have links to progressive damage from free radicals.

Antioxidant defense systems

Cells have antioxidant defense systems that help keep free radical production in check.

For example, cells contain antioxidant enzymes that help reduce free radical levels. The primary antioxidant enzymes in the cells include superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and glutathione reductase (GRx).

These antioxidant enzymes are known as first-line defense antioxidants. They help regulate free radical levels by neutralizing both free radicals and other molecules that have the potential to become free radicals.

The body also produces metabolic antioxidants through metabolism. These include lipoic acid, glutathione, coenzyme Q10, melatonin, uric acid, L-arginine, metal-chelating proteins, bilirubin, and transferrin.

However, there are some antioxidants that the body cannot produce, which means a person must consume them through food or by taking dietary supplements. These nutrient antioxidants include carotenoids, antioxidant vitamins, including vitamins C and E, selenium, manganese, zinc, flavonoids, and omega-3 and omega-6 fats. 

Dietary and supplemental antioxidants tend to receive the most attention within the nutrition world because consuming a diet rich in antioxidants can help boost the body’s antioxidant defenses.

Antioxidants in food vs. supplements

Unraveling the intricacies of dietary antioxidants can be challenging and confusing. Many antioxidants occur naturally in food, and countless other compounds that claim to boost the body’s antioxidant defenses are available as dietary supplements. 

Foods such as fruits, vegetables, spices, and nuts contain thousands of different compounds that act as antioxidants. 

For example, grapes, apples, pears, cherries, and berries contain a group of plant chemicals called polyphenol antioxidants. There are over 8,000 different polyphenol antioxidants in nature.

Brightly colored fruits and vegetables also contain high concentrations of carotenoids, another class of antioxidants. 

However, these natural food-derived antioxidants are very different from those found in dietary supplements.

For example, there are many forms of vitamin E, including synthetic vitamin E and natural vitamin E, such as alpha-tocopherol esters. All these forms of vitamin E may have different effects on the body. 

This may be why studies investigating the potential health benefits of vitamin E supplements have produced conflicting results. 

Additionally, supplements typically contain concentrated doses of isolated antioxidant compounds that can impact health differently than antioxidant-rich foods.

Although antioxidant-rich foods are extremely nutritious and important for health, taking a very high-dose antioxidant supplement may not suit everyone and may even be harmful to some people.

3 easy ways to eat a healthier diet

But this motivation is often focused on a diet that’s too ambitious, or too restrictive. Without a solid plan, you may fail quickly. So consider a compromise: start with these three easy ways to eat a healthier diet.

Aim for real food only

Look at your plate and note what’s processed and what isn’t. Maybe it’s the whole thing (like a frozen dinner), or maybe it’s just part of your meal (like the bottled dressing on your salad). Think of where you can swap processed foods for healthier versions. Ideas include

  • eating whole-grain pasta instead of enriched white-flour spaghetti
  • having quinoa instead of white rice
  • making your own snacks like baked chickpeas, instead of opening a bag of potato chips.

Processed foods are linked with chronic inflammation and other health conditions such as heart disease, diabetes, and cancer. One of the healthiest diets you can eat is a Mediterranean-style eating plan rich in vegetables, legumes, fruits, whole grains, nuts and seeds, fish, poultry, and low-fat dairy products (milk, yogurt, small amounts of cheese).

Schedule your meals and snacks

Set timers on your phone for three different meals and two snacks (if you need them), and don’t eat in between these scheduled times. This might curb your cravings, reduce stress about when you’ll eat next, and cut down on the extra calories of unnecessary snacking — a real challenge if you’re close to a refrigerator all day while at home or work.

Avoid scheduling late-night meals or snacks, when your body’s internal clock (circadian rhythm) senses that you’re supposed to be sleeping. “During the circadian sleep period our metabolism slows, our digestive system turns down, and brain temperature drops, part of the process of clearing toxins during sleep. Eating at different times than our typical circadian awake phase leads to weight gain,” says Dr. Lawrence Epstein, associate physician with the Division of Sleep and Circadian Disorders at Harvard-affiliated Brigham and Women’s Hospital.

Reduce your portion sizes

If you’re like most Americans, you’re eating too much food. An easy way to implement portion control: load your plate as you normally would, then put back a third or half of the food. Other ideas:

  • Use a salad plate instead of a dinner plate, to fool yourself into taking less food.
  • Keep serving bowls off the table, so you won’t be tempted to eat extra helpings.
  • Don’t linger at the table and keep eating when you’re already full.

It will also help to know how many calories you should consume in a day. For example, if you’re supposed to eat 2,000 calories per day but you’re scarfing down 3,000, it’s probably time to cut all of your usual portions by a third. How can you figure out your calorie needs? For healthy people who exercise 30 minutes per day, multiply your weight (in pounds) by 15 for an estimate.

A final thought: Take just one step a week

You don’t need to incorporate all of these steps at one time; try one step per week. Write down what you’re eating and any thoughts or questions you have about the process. After a week, assess what worked and what didn’t. Before long, you’ll have the confidence to attempt new steps.

The best exercises for better sleep (that aren’t yoga)

So if yoga isn’t your jam or you just want some variety in your bedtime routine, give these other types of exercise a go for better sleep.

Does exercise really help you sleep? 

It sure does. Exercise helps you sleep in a few ways. First, it reduces stress levels, which can quiet your mind before bed so you don’t hit the pillow with thoughts racing 100 miles per hour. Second, exercise requires you to burn more energy during the day, so you’ll naturally feel more tired at night.

Physiologically, exercise works wonders inside your body, and many of these benefits may translate to improved sleep. Scientists haven’t pinpointed the exact mechanisms behind the effect of exercise on sleep, but they do know the relationship exists. Some potential connections include the endorphin rush from exercise and, when done consistently, exercise can help your body settle into a healthy circadian rhythm. 

It’s true that exercise also instigates reactions in your body that would, in theory, ruin sleep. Exercise temporarily increases cortisol levels and raises your core body temperature, two things that tell your body not to hit the hay. However, the majority of observational studies suggest that exercise — no matter what time of day you do it — promotes restful sleep.

Walking

Who it’s for: The person who needs to destress.

A nice walk outside might be the antidote to your sleep struggle. Walking at any pace is a relaxing way to wind down from the day. The combined benefits of exercise and nature exposure work together to promote restfulness. 

Try it out: Sometime in the evening, head out for a 30-minute walk (or however long you have time for). Choose your pace based on what feels good that day. Listening to calm music may enhance the effects of your walk on your sleep.

Strength training

Who it’s for: The person who needs to burn off extra energy.

Some people argue that doing intense workouts, such as weightlifting, at night disrupts sleep, but studies say otherwise. Remember, you don’t have to go all out during a nighttime strength training workout. Stick to a shorter or less-intense strength training session before bed if you’re worried you might have trouble sleeping.

Try it out: A kettlebell or a pair of dumbbells will provide a more intense burn, while bodyweight strength training makes for a lighter pre-bed workout. Pick two to three exercises and do three sets of 10 of each. Or, try a circuit. 

Jumping rope

Who it’s for: The person who needs a productive distraction. 

Jumping rope might’ve never crossed your mind as a pro-sleep workout. Due to its rhythmic nature, jumping rope can soothe anxious, racing minds before bed. The key is to count your reps. You can go as fast or as slow as you want, but either way, counting your jumps gives your mind something to focus on — something other than all of the day’s stressors. It’s kind of like counting sheep, except you reap all the benefits of exercise at the same time. 

Try it out: Do four sets of 50 jumps, resting 1 minute in between sets. 

Flexibility training

Who it’s for: The person who tosses and turns from achiness.

Aches and pains really ruin a good night’s sleep. If you struggle to get good sleep because your body hurts, try incorporating flexibility training into your bedtime routine. Stretching at night will mobilize any tight joints and loosen up stiff muscles. Using a foam roller can help, too. 

Try it out: Choose two deep stretches for each body part that hurts. Accumulate 2 minutes in each stretch, breaking the time up as needed. 

COVID-19 Vaccines Are Coming

Public-health officials and governments now have the dual challenge of convincing the public that the vaccines are both safe and scientifically sound, as well as figuring out how to distribute billions of doses. Here’s what we know so far about how that’s going.

When can I get vaccinated?

That depends.

Manufacturers have already begun producing vaccines, betting that they will be effective, so they can be ready to ship if the FDA authorizes them, possibly as soon as December. Still, doses will be limited this year and will be reserved for those at highest risk of infection, such as health care workers as well as those with essential jobs, like first responders and law-enforcement personnel. As vaccine manufacturers fire up production, more people, including those with chronic health conditions, and the elderly, will be able to get immunized. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, says it may not be until spring that most Americans can start to get vaccinated.

Who approves the vaccines?

The Food and Drug Administration must approve any vaccine. But most COVID-19 vaccine makers won’t initially apply for normal approval, which typically requires six or more months of follow-up study. Instead, they will likely ask for emergency-use authorization (EUA), which makes it possible to release new drugs and vaccines during a health emergency. For an EUA, the FDA has said companies should monitor trial participants for two months to make sure the vaccines are safe and don’t lead to serious side effects. All of the testing and other requirements for evaluating safety and effectiveness remain the same for an EUA as for full approval. Many vaccine makers plan to apply for full approval of their shots once they accumulate the appropriate amount of follow-up data.

Were shortcuts taken to develop these vaccines?

According to leading public-health experts and the vaccine makers, the same rigorous scientific process that goes into developing any vaccine was used to create the COVID-19 shots. But in some cases, new technology like the mRNA-based technique used by Moderna and Pfizer—the first two companies to finish human testing—have sped up the development process. The mRNA method doesn’t require researchers to grow or manipulate SARS-CoV-2, the virus responsible for COVID-19; all they need is its genetic sequence, which Chinese scientists released in January. The technology is both fast and flexible, and allowed vaccine makers to develop and start testing their vaccines in a matter of months.

If I get vaccinated, does that mean that I can’t get infected?

Not necessarily.

But it means you are less likely to get sick. When Pfizer announced that its vaccine was more than 95% effective and Moderna said its shot was 94.5% effective, that was how well they kept people from getting sick. In the studies, people were randomly assigned to get the vaccine or a placebo. If anyone in either group felt symptoms of COVID-19 (including fever, cough, headache and difficulty breathing), they reported it to the researchers, who then decided whether to test for COVID-19. So the studies did not test everyone to see how many people in the vaccinated group got infected compared with the placebo group. Instead, the scientists took those participants who tested positive for COVID-19 and compared how many in the vaccinated group went on to develop disease and how many in the placebo group did. The companies will continue to test people in the studies for antibodies to the COVID-19 virus, which would include people who did not show any symptoms of their infection, so they can get a better sense of whether or not the vaccines protect against not only getting sick but also against infection.

How to Cook the Ultimate Healthy Thanksgiving Dinner

Planning a healthy Thanksgiving menu doesn’t mean the food has to be bland and boring. In fact, think of Thanksgiving as the perfect excuse to pile your plate high with your favorite nutritious vegetables—Brussels sprouts, green beans, sweet potatoes, and more.

To keep your waistline in check over the holidays, we’ve created a stunning Thanksgiving feast that’s perfect for both large crowds and smaller groups. These easy and healthy recipes are inspired by all of your favorite Thanksgiving dishes—like stuffing, sweet potato casserole, and pumpkin pie—but they’re lighter, more nutritious, and (much) more delicious.  

How to Eat Healthy on Thanksgiving

Thanksgiving tends to evoke the “feast” mentality, and it’s far too easy to overload on your favorite comfort foods like macaroni and cheese, mashed potatoes and gravy, and pumpkin pie. While we urge you to avoid holiday food guilt, try to balance your plate as much as possible without depriving yourself. So help yourself to that creamy macaroni and cheese—but don’t forget about the green bean salad.

In fact, the Academy of Nutrition and Dietetics recommends filling up your plate with salad and vegetables before heartier dishes to help you consume less calories during the meal. The organization also notes a common Thanksgiving mistake that even the healthiest eaters make: assuming that nutrient-rich foods are fair game for massive portion sizes. Even though a Thanksgiving meal is inevitably going to be higher in fat, calories, and sodium, you can minimize the damage by mixing in some healthier items.

Click Read More for all of the recipes!

All you need to know about flu

Influenza A and influenza B cause seasonal epidemics in the United States and elsewhere every winter. Type C usually causes mild respiratory illness.

Some strains of influenza A, such as the H5N1 “bird flu” virus, occasionally infect humans, causing serious illness. Experts track these strains carefully, as they try to predict how they will change, and how they might affect people.

In this article, we explain the symptoms of flu, the treatment options, how it differs from a cold, and how to prevent the flu.

Symptoms

According to the Centers for Disease Control and Prevention (CDC), a person with flu may experience:

  • a high temperature that lasts 3–4 days
  • a stuffy or runny nose
  • cold sweats and shivers
  • aches that may be severe
  • a headache
  • fatigue

Not everyone with flu will have all of these symptoms. For instance, it is possible to have flu without a fever.

The symptoms of influenza typically come on suddenly. Initially, a person with flu may experience:

  • a high temperature
  • a stuffy or runny nose
  • a dry cough
  • cold sweats and shivers
  • aches that may be severe
  • a headache
  • fatigue, and a feeling of being unwell
  • a low appetite

Flu symptoms in adults

Adults with the following symptoms should seek medical help urgently:

  • breathing difficulties
  • pain or pressure in the chest or abdomen
  • dizziness, confusion, or loss of alertness
  • seizures
  • not urinating, which may indicate dehydration
  • severe pain, weakness, and unsteadiness
  • a fever or cough that goes away and then comes back
  • a worsening of other existing health conditions

Flu symptoms in children

Children often have similar symptoms to adults but can also have gastrointestinal symptoms, such as nausea, vomiting, and diarrhea.

If a child has the following symptoms, they need emergency medical care:

  • breathing difficulties
  • rapid breathing
  • bluish face or lips
  • chest pain or ribs pulling inward as they breathe
  • severe aches
  • dehydration, for example, not urinating for 8 hours and crying dry tears
  • lack of alertness or interaction with others
  • a fever above 104°F or any fever in a child under 12 weeks of age
  • a fever or cough that goes away but then comes back
  • a worsening of any other medical conditions

Flu symptoms in babies

Flu can be dangerous for babies. If symptoms appear, a parent or caregiver should seek medical help.

A baby with flu may:

  • be very tired
  • have a cough and sore throat
  • have a stuffy or runny nose
  • have a fever of 100°F or more
  • have vomiting or diarrhea

The baby needs emergency medical attention if they:

  • do not want anyone to hold them
  • have a blue or gray skin color
  • are breathing fast or have difficulty breathing
  • have a fever with a rash
  • have symptoms that go away but come back again
  • show signs of dehydration, for example, not urinating
  • do not wake up or interact
  • have severe and persistent vomiting

Flu type A symptoms

If a person has the following symptoms, they may have influenza type A:

  • fever and chills
  • headache
  • muscle aches
  • fatigue
  • weakness
  • a stuffy or runny nose
  • a sore throat and cough

Learn more here about influenza A.

Flu type B symptoms

Influenza B symptoms are similar to those of influenza A.

Learn more here about influenza B.

For more information and resources to help keep you and your loved ones healt

Study hints that early morning exercise may reduce cancer risk

New research has suggested that people who exercise in the early morning may have a reduced risk of developing cancer than those who exercise later in the day.

The research, appearing in the International Journal of Cancer, may help inform future research into the timing of exercise as a potential way of reducing cancer risk.

Cancer, sleep, and exercise

Research has shown that doing recreational exercise can reduce a person’s risk of developing many different cancers.

This information is important because of the high numbers of people who develop cancer and the significant number who die of the disease. For example, in the United States, scientists estimate that by the end of 2020, 1,806,590 people will receive a diagnosis of cancer, while 606,520 people will die from the disease.

Given the large numbers of people who develop cancer, even a change as small as changing the time a person exercises could make a significant contribution to reducing the impact of cancer across a whole population. 

As of 2018, 46.7% of adults in the U.S. did not meet the minimum aerobic physical activity guidelines. Increasing physical activity and optimizing when it is most effective might be a possible way of reducing the prevalence of cancer in society.

There is also evidence that a person’s circadian rhythm may have links to their chance of developing cancer. The phrase circadian rhythm refers to the biological processes that affect a person’s sleep-wake cycle.

The International Agency for Research on Cancer have classified the level of evidence linking night shift work that disrupts a person’s circadian rhythm as “probably” carcinogenic to humans.

In particular, researchers have linked night shift work to an increased risk of breast cancer. The evidence for prostate cancer remains unclear.

Scientists have shown that exercise also has a relationship with a person’s circadian rhythm. According to 2019 research, exercising during the day may help improve a person’s circadian rhythm and lessen the adverse effects of disrupted sleep patterns.

Given that exercise can potentially reduce the risks of cancer and improve circadian rhythms and disrupted circadian rhythms can increase cancer risk, the authors of the new research hypothesized that the timing of physical activity might affect cancer risk.

How the Pandemic Is Changing Our Exercise Habits

Are you exercising more or less since the coronavirus pandemic began?

According to a new study that focused on physical activity in the United Kingdom, most of us — not surprisingly — have been less physically active since the pandemic and its waves of lockdowns and quarantines began. Some people, however, seem to be exercising as much or more than before, and surprisingly, a hefty percentage of those extra-active people are older than 65. The findings have not yet been peer reviewed, but they add to a mounting body of evidence from around the globe that the coronavirus is remaking how we move, although not necessarily in the ways we may have anticipated.

The pandemic lockdowns and other containment measures during the past six months and counting have altered almost every aspect of our lives, affecting our work, family, education, moods, expectations, social interactions and health.

None of us should be surprised, then, to learn that the pandemic seems also to be transforming whether, when and how we exercise. The nature of those changes, though, remains rather muddled and mutable, according to a number of recent studies. In one, researchers report that during the first few weeks after pandemic-related lockdowns began in the United States and other nations, Google searches related to the word “exercise” spiked and remained elevated for months.

And many people seem to have been using the information they gleaned from those searches by actually exercising more. An online survey conducted in 139 countries by RunRepeat, a company that reviews running shoes, found that a majority of people who had been exercising before the health crisis began reported exercising more often in the early weeks after. A separate survey of almost 1,500 older Japanese adults found that most said they had been quite inactive in the early weeks of lockdowns, but by June, they were walking and exercising as much as ever.

A gloomier June study, however, using anonymized data from more than 450,000 users of a smartphone step-counting app, concluded that, around the world, steps declined substantially after lockdowns began. Average daily steps declined by about 5.5 percent during the first 10 days of a nation’s pandemic lockdowns and by about 27 percent by the end of the first month.

But most of these studies and surveys relied on people recalling their exercise habits, which can be unreliable, or looked at aggregate results, without digging into differences by age, socioeconomic group, gender and other factors, which might turn up telling variations in how people’s exercise habits might have changed during the pandemic.

Regular tea drinking linked to better heart health

Sipping a cup of tea at least every other day or so may be good for your heart, according to a study published online January 9 by the European Journal of Preventive Cardiology.

The study included data from more than 100,000 Chinese adults who were part of a long-term health study. The participants provided health and behavioral information, including how much tea they drank. The follow-up lasted an average of seven years.

Compared with people who drank fewer than three cups of tea a week, those who drank more had a 20% lower risk of a heart attack or related problem and a 22% lower risk for dying of heart disease.

The findings don’t prove that tea drinking was responsible for those benefits. But both green and black tea are rich in compounds called flavonoids that help dampen inflammation, a culprit in heart disease. Tea drinking has also been linked to lower cholesterol and improved blood vessel function.

US election 2020

Voting is a democratic right and duty: it helps decide the direction that a country or a region’s economic, healthcare, and domestic and international policies take.

In the U.S., the upcoming presidential election — scheduled for November 3 — has been a top concern in the media.

While elections always offer fertile ground for debates and discussions, this year’s event has created even more of a buzz because it will take place during a world pandemic. 

Scientists and medical doctors have not yet found a vaccine for SARS-CoV-2, the new coronavirus that has caused the pandemic. Also, there is no targeted treatment for COVID-19, the respiratory disease that the virus causes, which has claimed hundreds of thousands of lives to date. 

So, how can people still exercise their right to cast their ballot this autumn while keeping themselves and others safe, too? Read on for our top tips and advice.

If you would like to check your registration status or register to vote, we have added some useful links at the bottom of this article.

How to vote safely

The Centers for Disease Control and Prevention (CDC) have drawn up an extensive guide informing polling stations and voters how to adhere to the best health and safety practices during this year’s presidential elections.

While many of the prevention strategies — such as frequently cleaning polling station surfaces — are in the hands of election officials and poll workers, there is a lot that voters themselves can do to stay safe.

In-person voting

The first consideration for voters is to determine whether or not they feel well physically. If a person feels well and has no symptoms of a potential viral infection, they may choose to vote in person at the polling station.

To ensure that their voting experience goes smoothly, a person might want to check that they have all the documentation they need to vote in their jurisdiction before heading to the polling station. 

Fill in any necessary forms in advance, if possible. All of this can help avoid unnecessary delays and standing in line.

To avoid long lines on election day, people could also choose to vote early, if that option is available in their jurisdiction. 

For those who want to vote on the day, reporting to the polling station at off-peak times, such as mid-morning, might reduce waiting time.

Information on what voting entails, and what documents and ID a person needs to vote in the U.S. presidential election is available here.

Other safety measures are the same as the CDC advice in any other context. These include maintaining a physical distance of at least 6 feet from others if standing in line and keeping hand sanitizer with at least 60% alcohol content handy.

Individuals should wash their hands before and after entering the polling station, if possible, and use hand sanitizer before and after touching objects or surfaces.

Good hand washing practices and the use of hand sanitizer can help kill viruses and any potentially harmful bacteria.

Wearing a face mask or other face covering in public settings is also an important step in preventing the spread of the new coronavirus, as CDC guidelines explain. This applies to polling station settings as well.

Children younger than 2 and people who have difficulty breathing should not wear a mask or face covering.

Finally, people may also want to bring their own black ink pen and electronic stylus to the polling station instead of using one provided at the venue. However, not all polling stations allow this, so individuals should check in advance.

When asked about best voting practices, Healthline adviser Dr. Angela Bell said that one of her “top tips” is voting early. She also said to “wear your mask, stay at least 6 feet away from people when possible, avoid contact with people not wearing masks, bring hand sanitizer with you, [and] consider eye protection like goggles if you live in an area where there are high amounts of daily cases or if there is no mask mandate in your area.”

She also advised readers to “wear comfortable shoes, bring a portable chair to sit in if you are concerned about long lines, [and] try to get familiar with who and what is on your ballot prior to getting into the building so you spend less time making choices in the booth.”

Regular tea drinking linked to better heart health

The study included data from more than 100,000 Chinese adults who were part of a long-term health study. The participants provided health and behavioral information, including how much tea they drank. The follow-up lasted an average of seven years.

Compared with people who drank fewer than three cups of tea a week, those who drank more had a 20% lower risk of a heart attack or related problem and a 22% lower risk for dying of heart disease.

The findings don’t prove that tea drinking was responsible for those benefits. But both green and black tea are rich in compounds called flavonoids that help dampen inflammation, a culprit in heart disease. Tea drinking has also been linked to lower cholesterol and improved blood vessel function.

Scientists discover COVID-19 symptoms appear in a specific order

The study findings reveal individuals infected with COVID-19 will likely experience symptoms in the following order:

  1. fever
  2. coughing and muscle pain
  3. nausea, vomiting, or both
  4. diarrhea

The research appears in the journal Frontiers in Public Health. Doctoral candidate Joseph Larsen and his colleagues conducted the study in collaboration with faculty advisers Peter Kuhn and James Hicks, at the USC Michelson Center for Convergent Bioscience’s Convergent Science Institute in Cancer.

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a catastrophic global impact.

According to current data from Johns Hopkins University, there are now more than 23.9 million confirmed cases of COVID-19 globally and more than 820,000 recorded deaths.

Individuals infected with COVID-19 are highly infectious, demonstrating a rate two to three times more contagious than influenza. Also, as outbreaks of COVID-19 occur in clusters, early identification of the disease may reduce their number and size. However, experts are unable to define the initial symptoms accurately.

Improving treatment strategy for COVID-19

The researchers note that an improved understanding of how COVID-19 symptoms appear helps patients promptly seek care or decide to self-isolate.

This information may also help medical professionals identify patients with the disease, rule out other illnesses, and design appropriate treatments more quickly.

“Given that there are now better approaches to treatments for COVID-19, identifying patients earlier could reduce hospitalization time,” says Prof. Larsen, the study’s lead author, and a USC Dornsife professor.

Good Fats vs. Bad Fats for Healthy Heart

NOT SO LONG AGO, FAT was the mortal enemy in the fight for good health. All fat was considered bad, especially for cardiovascular health. Today, the situation is more nuanced. Science has determined that all fats are not created equal.

In fact, some types of fat actually promote better health – even heart health. “There are good fats and bad fats,” says Sandra Arévalo, the director of community and patient education at Montefiore Nyack Hospital and a certified diabetes educator. Good fats help keep blood vessels and arteries smooth and flexible, she says. Bad fats stick to the walls of arteries and veins, causing clots that narrow the pathways blood follows in the circulatory system, a condition known as atherosclerosis.

It’s important to know the difference between good and bad fats, in large part because cardiovascular disease is the leading global cause of death, accounting for 17.3 million deaths per year. The American Heart Association presidential advisory on dietary fats and cardiovascular disease recommends lowering the intake of dietary saturated fat – one of the bad kinds – and replacing it with polyunsaturated vegetable oil – a good kind. According to the AHA, this substitution can reduce cardiovascular disease risk by about 30%, similar to the reduction achieved by statin treatment.

Good Fat vs. Bad Fat

There are many different types of fat. Your body makes its own fat from extra calories, and fat comes in foods you eat. Fat is essential to your health. It is “a major source of energy,” Arévalo says. “Fats help you absorb some vitamins and minerals, and they help build cell membranes and the sheaths surrounding nerves. They are essential for blood clotting and muscle movement.”

But some types of dietary fat play a role in cardiovascular disease, and all fats are high in calories and can contribute to weight gain. They also are a source of inflammation.

The evidence suggests it is smart to select healthier fats and avoid the less healthy ones. But how do you choose?

“An easy way to separate good from bad fats is looking at their consistency. Bad fats like lard are solid at room temperature, while good fats like olive oil are liquid,” Arévalo says. The solid, bad fats come in two main types:

  • Saturated fat. This comes mainly from animal sources of food, such as red meat, poultry and full-fat dairy products like butter. Saturated fats raise total cholesterol and low-density lipoprotein cholesterol levels, which may increase your risk of cardiovascular disease. (LDL cholesterol is often called “bad” cholesterol.)
  • Trans fat. Most trans fats are man-made from oils in a process called partial hydrogenation. Partially hydrogenated trans fats can boost total blood cholesterol, LDL cholesterol and triglyceride levels while also lowering high-density lipoprotein cholesterol, all of which can increase your risk of cardiovascular disease. (HDL cholesterol is sometimes called “good” cholesterol.)

Good types of dietary fat are primarily unsaturated fats:

  • Monounsaturated fatty acids. These are found in many types of foods and oils. Eating foods rich in monounsaturated fatty acids instead of saturated fats has been shown to improve cholesterol levels, which can decrease your risk of heart disease and also of type 2 diabetes.
  • Polyunsaturated fatty acids. Found mostly in plant-based foods and oils, these fats also improves blood cholesterol levels.
  • Omega-3 fatty acids. Omega-3 is a type of polyunsaturated fat that appears to be especially beneficial for heart health. These fats help reduce chronic inflammation, which can lead to or progressively worsen heart disease, says Wesley McWhorter, a registered dietician, doctor of public health and director of culinary nutrition for the Nourish Program at the University of Texas School of Public Health. Omega-3, found in abundance in fatty fish like salmon, tuna, trout, mackerel, sardines and herring, and also in some plant sources like flaxseed, vegetable oils (canola, flaxseed, soybean) and nuts and other seeds, may decrease the risk of coronary artery disease.

What Is the Real Future of Work?

One of the growing trends that the world has seen over the past year is the rise of remote work. As working from home is continuing to gain some serious steam around the world, more and more predictions have been taking place as to whether or not these trends will proceed into the future. With the rise of modern technology and the introduction of new careers that didn’t exist 100 years ago, the future of work will be much different than what we witnessed in the previous century. 

As we progress, the present of the workforce is remote, but the real future of work will be much more flexible. It is also likely to be one where workers are more focused on accomplishing goals to a high level of quality as opposed to filling out a timesheet and working exactly 40 hours a week.  

Remote work is the present 

Right now, remote work is not just a trend of the future. It is the present. As reported by CNBC, 70% of the global workforce already are working remotely at least once a week. This sort of data should be inspiring for anybody who is looking for a reason to start working remotely as opposed to their desk job. 

The remote work industry has propelled itself further throughout the past year. According to a survey conducted by popular remote work platform Slack, 16 million skilled US workers switched to working online in the month of May 2020 alone. If this trend continues, the majority of the world’s workforce could feasibly soon be permanent remote workers. 

The future is flexible 

Flexible working is not a new concept, but there will soon be mass adoption while the remote workforce continues to progress. Henry Ford helped standardized for the 40-hour workweek back in 1920, but this was initially created for factory workers. A lot has changed since then and the modern workforce needs to adapt and progress. In the future of work, hours will be more flexible and the future will be one where companies are more concerned about the results of their employees. 

All of us live personal lives and professional lives. When the two start to intermix together to a high extent, it is easy for workers to get burnt out on their jobs, ask for time off, a raise on pay, and so on. In the future of remote work, we anticipate that jobs will be more respectful and flexible when it comes to your personal life. Work will start to focus more on wrapping around your personal schedule and needs, and not the other way around. 

Output vs. Input

A worker’s key performance indicators (or KPIs) are likely to be more important than the number of hours that they put in each week. Employers of the future are likely to focus more on how well the workers accomplish particular goals instead of focusing solely upon the hours they are working each day. The old-school office attitude of working yourself to the bone as a means to rise up the corporate ranks might not be as relevant of a theme for the future.  

How to Recover From Sleep Disruptions During the Pandemic

It would be difficult to find someone whose life has not been disrupted by the pandemic. Nowhere is that more evident than in our routines, including work and sleep schedules. Beyond schedule disruptions, the stress of coping with so many changes may have provided an additional sleep disruption for some.

Our sleep is guided by our circadian rhythm, a biological clock that is influenced by the environment around us. The amount of sunlight we are exposed to, physical activity, social interaction, occupational demands, and timing of meals—collectively referred to as “zeitgebers” or “time-givers” in German—provide cues to our body about when we should be sleeping or awake. In other words, with the factors that anchor our sleep disrupted, sleep patterns can and will shift over time.

As stay-at-home restrictions relax for many communities and life returns to a new normal, our bodies will need to recalibrate and readjust. The following are some recommendations to adjust sleep back to normal.

Assessing the Damage

Everyone has a circadian rhythm that directs your body’s sleeping and waking, and this is often not aligned to society’s demands. Adolescents and young adults are often biologically predisposed to have a “night-owl” pattern of staying up late and sleeping in. Without the structure provided by school, a work commute, or the ability to exercise at a gym, our sleep will revert to a natural sleep window or even become irregular. Therefore, the first step is often to start tracking sleep through a sleep diary. Collecting a week’s worth of data (i.e., when you go to bed, how long it takes to fall asleep, how many awakenings each night, and when you got out of bed) will help you determine when your natural sleep window is, and how different it is from when you will need to sleep and wake up once life returns to normal.

An alternative to manually maintaining a sleep diary is to use a wearable device, such as a smart-watch or fitness watch, that tracks sleep through activity and heart rate. A recent study in the journal Sleep showed that consumer wearables are just as effective at determining when you are asleep and awake as existing, established research devices.

Creating the Right Conditions 

After reviewing your sleep schedule, you should have a better idea of whether you tend to be a night owl or an early bird. From there, making an adjustment is a slow, steady process. Start by practicing healthy sleep hygiene:

  1. Create a pleasant sleep environment that is cool, dark, and quiet.
  2. Develop a wind-down routine leading up to bed that signals to your body that it is time to sleep. This should involve relaxing, low-stimulation activities such as reading a book or meditation.
  3. To also help train your body’s sleep rhythm, maintain a consistent bedtime and waketime every day.
  4. Avoid meals and heavy exercise at least two hours before bedtime. Both are examples of zeitgebers or cues that activate the rest of your body, making sleep less likely.
  5. Limit or stop napping during the day.
  6. Minimize or eliminate caffeine, nicotine, and alcohol several hours before bed. These can cause more difficulty falling asleep or fragment your sleep more throughout the night.

Take Small, Progressive Steps 

Being too ambitious in adjusting your sleep can exacerbate insomnia or cause excessive sleepiness during the day. Building practices for good sleep is a methodical process and taking these steps can help.

  1. Shift your time in bed slowly. If you are currently going to sleep at 12 a.m. and waking up at 8 a.m., but normally go to sleep at 10 a.m. and wake up at 6 a.m. for work, jumping directly to that schedule may be too difficult and jarring to your body. You might have several nights of not being able to fall asleep and becoming frustrated and subsequently feel tired the following day. Instead, try adjusting your window of sleep by 15 minutes per day. This is a much more natural and tolerable change for your body and mind.
  2. Melatonin timing. Melatonin is a chemical that your brain produces to communicate to the rest of your body that it is time to sleep. Over-the-counter melatonin supplements can be taken to help guide your internal body clock as it adjusts to a new sleep schedule. However, appropriate dosing and timing of the melatonin is something you should discuss with a health care provider.
  3. Bright-Light Therapy. The strategic avoidance and exposure to light have been studied because light can suppress melatonin secretion and help shift the internal body clock timing. Consumer light therapy products are often advertised to help with mood or seasonal affective disorder. Exposure to light therapy in the morning after waking up may help activate your body and mind, reinforcing the shift of your sleep. Again, exact timing and duration of exposure should be discussed with a health care provider if you are still struggling.

As life returns, hopefully soon, to a sense of normalcy, having a sleep pattern back in line with societal demands will have you primed to hit the ground running again.

Naps and cardiovascular health: The pros and cons

Much controversy has surrounded the topic of the cardiovascular effects of napping, with various studies yielding mixed results. 

For instance, a case-control study of a Greek population found that those who took a nap were at a lower risk of developing coronary heart disease than those who did not. The study appeared in 1988, and it set the tone for much of the ensuing research on napping. 

Later, a large cohort study, also of a Greek population, confirmed the findings. It suggested that those who napped regularly had a 37% lower risk of death from coronary heart disease than those who did not nap.

However, studies in other parts of the world — such as Costa Rica, United States, Germany, and Japan — all found higher risks of cardiovascular disease and mortality. 

Frequency of naps may be key

Medical News Today reported how the authors of a 2019 paper appearing in the journal Heartset out to settle the controversy. They suggested that not accounting for the frequency of the naps may explain these mixed results. The frequency of napping has been insufficiently studied, the authors argued. 

So, they followed almost 3,500 people who had no history of cardiovascular disease over more than 5 years. 

The participants reported their napping patterns over the course of a week. 

After the follow-up period, 155 fatal and non-fatal cardiovascular events occurred. The analysis accounted for excessive daytime sleepiness (which may have been the result of a sleeping disorder) or obstructive sleep apnea. 

The researchers also accounted for age, hypertension, other heart disease risk factors, and the important variables of overall sleep length and physical activity levels (which were missing from the other studies).

The analysis revealed that people who napped 1–2 times a week were 48% less likely to have cardiovascular problems, such as heart attack, stroke, or heart failure, after an average of 5 years follow-up than those who did not nap at all. The benefits were no longer visible for those who napped 6–7 times a week, and the duration of the nap did not seem to make a difference. 

First author Nadine Häusler, Ph.D., from the department of internal medicine at Lausanne University Hospital, in Switzerland and her colleagues, concluded at the time:

“Nap frequency may help explain the discrepant findings regarding the association between napping and [cardiovascular disease] events.”

Study reveals how sleep boosts learning

Scientists have long known that a good night’s sleep works wonders for our ability to learn new skills.

What has been less clear is the role of different sleep stages. In particular, there has been controversy over the relative contributions of rapid eye movement (REM) sleep, which is when most dreaming occurs, and non-REM sleep, which is mostly dreamless.

Now, a study by psychologists of the Department of Cognitive, Linguistic, and Psychological Sciences at Brown University in Providence, RI, provides important clues that could help resolve the debate.

Their experiment — which focuses on visual learning — suggests that rather than one stage being more important than the other for learning new skills, both play essential and complementary neurochemical processing roles.

They found that while non-REM sleep enhances our performance of newly acquired skills by restoring flexibility, REM sleep stabilizes those improvements, and prevents them from being overwritten by subsequent learning.

“I hope this helps people realize that both non-REM sleep and REM sleep are important for learning,” says corresponding author Yuka Sasaki, a professor of Cognitive, Linguistic, and Psychological Sciences at Brown. 

Most REM sleep occurs in the final hours of sleep, so the finding reinforces the importance of not cutting short these later stages.

“When people sleep at night, there are many sleep cycles. REM sleep appears at least three, four, five times, and especially in the later part of the night. We want to have lots of REM sleep to help us remember more robustly, so we shouldn’t shorten our sleep.”

– Prof. Yuka Sasaki

The research is published in the journal Nature Neuroscience.

Twin benefits

Psychologists have previously identified two distinct benefits of sleep for learning.

The first benefit, which they call “offline performance gains,” means the learning acquired before sleep is enhanced after sleep, without any additional training.

The second benefit, called “resilience to interference,” protects the skills learned before sleep from being disrupted or overwritten by subsequent learning after awaking.

To reap both benefits, there is a trade-off between flexibility and stability.

Learning during the day involves forming new synapses, which are the electrical connections between nerve cells, and the strengthening of existing synapses through repeated use.

While we sleep, the brain appears to streamline its operations to work more efficiently. According to a leading hypothesis, it does this by reactivating synapses that have been strengthened during the day, and then indiscriminately ‘downscales’ or weakens them all.

This restores flexibility, or plasticity, to the brain’s local connections and wider networks, to improve overall performance.

At the same time, during sleep, the brain must also stabilize key synapses to prevent what was learned the previous day from being eliminated by new learning experiences.

Cardiovascular health may contribute to dementia risk

New research has found that cardiovascular health and genetics can jointly increase the risk of dementia.

The research, published in the journal Neurology, suggests that even if someone is genetically predisposed to develop dementia, maintaining good cardiovascular health can help reduce this risk.

According to the National Institute on Aging (NIA), dementia describes a person’s loss of cognitive functioning, which affects their ability to think, remember, and reason. Various issues can cause this, the most common of which is Alzheimer’s disease.

Mild dementia may present as increasing forgetfulness or momentary confusion, accompanied by at least one other area of poor functioning, such as losing your way home (visuospatial problems) or not knowing how to pay a bill (executive function).

As it becomes moderate or severe, it can result in changes in personality, a failure to recognize family or friends, and an almost complete dependence on others for basic life activities.

Dementia occurs when a significant number of neurons — key cells in the brain — no longer function properly and ultimately die.

According to the NIA, this can happen in Alzheimer’s disease due to a combination of genetic, environmental, and lifestyle factors.

There is currently no cure for dementia. So understanding how these factors interrelate is the best way to help clinicians advise patients on what they can do to minimize their chances of developing this condition.

Genetics vs. cardiovascular health

In the present research, the researchers drew on data from the Framingham Heart Study (FHS)— a long-term study organized by the National Heart, Lung, and Blood Institute — to look at the relationship between genetics, cardiovascular health, and dementia.

The investigators assessed the data of 1,211 participants from the FHS, analyzing their relative cardiovascular health and genetic risk score for dementia.

The researchers found that participants with high genetic risk scores were 2.6 times more likely to develop dementia than those with low-risk scores.

They also found that good cardiovascular health can reduce a person’s chances of developing dementia by 55% across the follow-up period, an average of 8.4 years. Having relatively poor cardiovascular health increased a person’s risk of developing dementia.

Finally, the study made it clear that genetic predisposition and poor cardiovascular health can jointly increase a person’s risk of developing dementia.

According to Dr. Sudha Seshadri, of The University of Texas Health Science Center at San Antonio and a co-author of the research, “[t]he connection between heart health and brain health becomes clearer with each finding.”

“We hope that the results of this study will send the public a message, and that message is to exercise, reduce stress, and eat a healthy diet. Then, regardless of your genes, you have the potential to lower your risk of dementia.”

– Dr. Sudha Seshadri

Adding to this, co-author Dr. Claudia Satizabal noted, “[i]t is imperative to start today. [F]rom our findings, having favorable cardiovascular health mitigates the risk of dementia in persons with high genetic risk.”

While there are many unknowns around dementia, the study contributes to a growing body of research demonstrating that staying physically active and eating well can make a meaningful difference to cognitive health issues.

How is red meat linked to cancer?

The authors of a recent study, which appears in BMC Medicine, argue that at least part of the answer might lie in an immune interaction.

Nutrition and dietary habits play pivotal roles in a wide range of health conditions, including type 2 diabetes, obesity, cancer, hypertension, and cardiovascular disease.

Red meats and processed meats have each received a fair amount of attention in this regard. Both have been implicated in cancer risk, but how they exert their influence is up for debate. As the authors of the latest study explain:

“Although various mechanistic explanations have been proposed, [such as a] high energy/fat diet, N-nitroso, nitrates, nitrites, heme iron, [and] compounds produced by gut microbiome or during cooking, none seems to be specific to red meat or dairy.”

A role for antibodies?

The authors point to tentative evidence that N-glycolylneuraminic acid (Neu5Gc) might be a risk factor for colorectal cancer. 

Neu5Gc is a carbohydrate, or sugar, present in foods derived from mammals, and it is abundant in red meat and dairy. It occurs at low levels in some fish but is absent from poultry.

Humans cannot synthesize Neu5Gc, but when we consume it, small amounts accumulate on cell surfaces. When immune cells encounter this nonhuman material, it triggers the production of anti-Neu5Gc antibodies. Studies have shown that humans have a wide range of these antibodies.

Scientists have also found evidence that long-term exposure to these antibodies promotes inflammation and cancer in animal models. However, they have yet to identify any clear effect of eating mammalian products on levels of these antibodies.

As these anti-Neu5Gc antibodies travel around the body, they bump into Neu5Gc on cell surfaces, sparking inflammation. Experts believe that this, in turn, exacerbates cancer, because cancer cells tend to have higher levels of Neu5Gc on their surfaces.

In one study, researchers demonstrated an association between levels of circulating Neu5Gc antibodies and colorectal cancer risk. However, the level of antibodies was not associated with red meat intake. 

Now, the latest study has set out to unpick the relationship between a person’s diet and their levels of Neu5Gc once and for all.

“We found a significant correlation between high consumption of Neu5Gc from red meat and cheeses and increased development of those antibodies that heighten the risk of cancer,” explains corresponding author Dr. Veder Padler-Karavani, of Tel Aviv University. 

“For years, there have been efforts to find such a connection, but no one did. Here, for the first time, we were able to find a molecular link thanks to the accuracy of the methods used to measure the antibodies in the blood and the detailed data from the French diet questionnaires.

Which homemade masks are most effective?

Due to the scarcity and cost of medical-grade face masks, many people are using homemade masks to avoid spreading or contracting SARS-CoV-2, the virus that causes COVID-19.

There has been relatively little official guidance about which mask designs provide the strongest barriers to infection, leading amateur mask-makers to improvise.

Now, a new study has used laser visualization experiments to demonstrate the effectiveness of homemade masks of various designs.

For the best protection against the new coronavirus, a mask should be well-fitting and contain multiple layers of quilted fabric.

These masks are roughly as good at preventing the spread of infection as commercially produced cone-shaped masks, researchers from Florida Atlantic University (FAU), in Boca Raton, report in a Physics of Fluids study paper.

Lead author Siddhartha Verma, an assistant professor at FAU, notes, “While there are a few prior studies on the effectiveness of medical-grade equipment, we don’t have a lot of information about the cloth-based coverings that are most accessible to us at present.”

What visualization revealed

At the outset, Prof. Verma says, it is “important to understand that face coverings are not 100% effective in blocking respiratory pathogens.”

“This is why it is imperative that we use a combination of social distancing, face coverings, hand washing, and other recommendations from healthcare officials until an effective vaccine is released.”

Nonetheless, the researchers established that:

  • Without face masks, droplets were projected up to 12 feet (ft) from their source, well beyond the often-employed 6-ft social distancing margin. The average distance was 8 ft. 
  • The droplets hung in the air for up to 3 minutes before falling.
  • Commercially produced, off-the-shelf cone masks reduced the average droplet projection to just 8 inches (in), though the researchers saw significant leakage of droplets from the tops and sides of these masks.
  • Simple homemade face masks somewhat reduced the forward projection of droplets. However, they also exhibited significant side and top leakage. 
  • When the team tested a bandana made from elastic T-shirt fabric, the average forward travel was 3 ft, 7 in. When they used a folded cotton handkerchief mask, it was 1 ft, 3 in.
  • The most effective homemade masks were constructed of stitched layers of cotton quilting. These reduced the forward travel of droplets to just 2.5 in, a shorter distance than the researchers observed with commercial face masks.
  • For anyone hoping that fabrics with higher thread counts produce more effective coverage, the visualizations suggested otherwise: The tested mask with the highest thread count was the bandana, which was the worst at impeding the travel of droplets.

Prof. Verma reports that his team is interested in continuing their study and incorporating factors that affect the real-world dissemination of respiratory droplets, such as evaporation, ambient airflow, and properties of respiratory fluids that may impact their behavior when airborne.

What is the impact of eating too much sugar?

According to the Centers for Disease Control and Prevention (CDC), people in the United States consume too much added sugar. Added sugars are sugars that manufacturers add to food to sweeten them.

In this article, we look at how much added sugar a person should consume, the symptoms and impact of eating too much sugar, and how someone can reduce their sugar intake.

How much sugar is too much? 

According to the Dietary Guidelines for Americans 2010-2015, on average, Americans consume 17 teaspoons (tsp) of added sugar each day. This adds up to 270 calories.

However, the guidelines advise that people limit added sugars to less than 10% of their daily calorie intake. For a daily intake of 2,000 calories, added sugar should account for fewer than 200 calories.

However, in 2015, the World Health Organization (WHO) advised that people eat half this amount, with no more than 5% of their daily calories coming from added sugar. For a diet of 2,000 calories per day, this would amount to 100 calories, or 6 tsp, at the most.

Symptoms of eating too much sugar

Some people experience the following symptoms after consuming sugar:

  • Low energy levels: A 2019 study found that 1 hour after sugar consumption, participants felt tired and less alert than a control group.
  • Low mood: A 2017 prospective study found that higher sugar intake increased rates of depression and mood disorder in males.
  • Bloating: According to Johns Hopkins Medicine, certain types of sugar may cause bloating and gas in people who have digestive conditions, such as irritable bowel syndrome (IBS) or small intestinal bacterial overgrowth (SIBO).

Risks of eating too much sugar 

Consuming too much sugar can also contribute to long-term health problems.

Tooth decay

Sugar feeds bacteria that live in the mouth. When bacteria digest the sugar, they create acid as a waste product. This acid can erode tooth enamel, leading to holes or cavities in the teeth.

People who frequently eat sugary foods, particularly in between mealtimes as snacks or in sweetened drinks, are more likely to develop tooth decay, according to Action on Sugar, part of the Wolfson Institute in Preventive Medicine in the United Kingdom.

Acne

A 2018 study of university students in China showed that those who drank sweetened drinks seven times per week or more were more likely to develop moderate or severe acne.

Additionally, a 2019 study suggests that lowering sugar consumption may decrease insulin-like growth factors, androgens, and sebum, all of which may contribute to acne.

Weight gain and obesity

Sugar can affect the hormones in the body that control a person’s weight. The hormone leptin tells the brain a person has had enough to eat. However, according to a 2008 animal study, a diet high in sugar may cause leptin resistance. 

This may mean, that over time, a high sugar diet prevents the brain from knowing when a person has eaten enough. However, researchers have yet to test this in humans.

Diabetes and insulin resistance

A 2013 article in PLOS ONE, indicated that high sugar levels in the diet might cause type 2 diabetes over time. 

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) add that other risk factors, such as obesity and insulin resistance, can also lead to type 2 diabetes.

Cardiovascular disease

A large prospective study in 2014 found that people who got 17–21% of their daily calories from added sugar had a 38% higher risk of dying from cardiovascular disease (CVD) than those who consumed 8% added sugars. For those who consumed 21% or more of their energy from added sugars, their risk for CVD doubled.

High blood pressure

In a 2011 study, researchers found a link between sugar-sweetened beverages and high blood pressure, or hypertension. A review in Pharmacological Research states that hypertension is a risk factor for CVD. This may mean that sugar exacerbates both conditions.

Cancer

Excess sugar consumption can cause inflammation, oxidative stress, and obesity. These factors influence a person’s risk of developing cancer.

A review of studies in the Annual Review of Nutrition found a 23–200% increased cancer risk with sugary drink consumption. Another study found a 59% increased risk of some cancers in people who consumed sugary drinks and carried weight around their abdomen.

Aging skin

Excess sugar in the diet leads to the formation of advanced glycation end products (AGEs), which play a role in diabetes. However, they also affect collagen formation in the skin. 

According to Skin Therapy Letter, there is some evidence to suggest that a high number of AGEs may lead to faster visible aging. However, scientists need to study this in humans more thoroughly to understand the impact of sugar in the aging process.

What are the nonmedical factors most closely linked to death risk?

Although there has been plenty of research linking mortality to various habits and lifestyle factors, scientists at the University of British Columbia (UBC) in Vancouver, Canada — in collaboration with colleagues from other institutions — have identified the 10 factors most likely to lead to death.

The new study appears in the journal PNAS. The research aimed to better understand the stagnation in life expectancy occurring in the United States over the past 3 decades compared with other industrialized countries.

According to the study, the top three factors most closely connected to death are smoking, experiencing divorce, and having engaged in alcohol misuse.

The full list of the top 10 factors that most strongly predict death is as follows:

  1. smoking (currently)
  2. history of divorce
  3. history of alcohol misuse
  4. recent financial difficulties
  5. history of unemployment
  6. smoking (previously)
  7. lower life satisfaction
  8. never having been married
  9. history of using food stamps
  10. negative affectivity

Analyzing the data

A recent estimate of U.S. life expectancy stood at 78.6 years, while 11 other industrialized nations averaged about 82.3 years. This represented a gain of just 4.9 years for the U.S. between 1980 and 2017, while other nations added an average of 7.8 years.

Biological and medical factors are likely part of the reason, and advances in medicine that aim to address these factors continue. The roles of social, psychological, economic, and behavioral factors in life expectancy are less well understood, and researchers often study them in isolation.

This means that it is unclear which of these nonmedical factors are the strongest predictors of mortality risk — a knowledge gap the new study hoped to fill.

The study, which Eli Puterman of UBC led, included the data of 13,611 adults who took part in the U.S. Health and Retirement Study. This was a nationally representative sample of U.S. adults aged 52–104. The average age was 69.3. Scientists collected these data between 1992 and 2008 and analyzed them in relation to deaths that occurred between 2008 and 2014.

The original data did not capture all potential psychosocial factors that might be linked to mortality. For example, the researchers tracked neither food insecurity nor domestic abuse.

Of the results, Puterman says, “It shows that a lifespan approach is needed to really understand health and mortality.”

We can only understand the long lasting effect of a life event or lifestyle choice by taking the sort of view Puterman and his co-authors embrace.

“For example,” says Puterman, “instead of just asking whether people are unemployed, we looked at their history of unemployment over 16 years. If they were unemployed at any time, was that a predictor of mortality?”

“It’s more than just a one-time snapshot in people’s lives, where something might be missed because it did not occur. Our approach provides a look at potential long-term impacts through a lifespan lens.”

– Eli Puterman

5 insanely cheap workout items

Dr. John-Paul Rue, an orthopedic surgeon and sports medicine doctor at Mercy Medical Center, says he considers it to be “generally safe” — provided that proper guidelines are followed.

But there are some key factors to consider. If you find it difficult to wear a mask while working out (which some gyms will require), for example, it’s probably best to hold off. 

“It may be harder for someone with an underlying medical condition, such as asthma, because wearing a mask restricts the movement of air in and out of our lungs,” Rue tells CNBC Make It.

Luckily, transforming a corner of your home into a gym can be incredibly simple and cheap. Below, fitness trainers share their favorite exercise equipment to use at home:

(Note: These workouts are not for everyone. If you have a physical condition, health concerns or are currently pregnant, consult with your doctor first.)

A yoga or exercise mat

A yoga or exercise mat is the most important item you need.

“It sets the stage for where you’ll be working out and makes moving on the ground easier,” Geoff Tripp, head of fitness science at Trainiac, a personal training app, tells CNBC Make It. 

If you prefer extra support and comfort, choose a mat that is thicker and has more cushion.

A foam roller

Price point$12.95 and up

This is a versatile and inexpensive piece of equipment that can be used to warm up your body before working out, or as a way to cool down tired muscles after a long session, Peter Athans, a trainer and director of coach development at Noom, a health app, tells CNBC Make It.

Studies have shown that foam-rolling after a high-intensity workout can help improve the range of motion and muscle performance.

“I love foam rollers because they increase circulation in my muscles and connective tissue, which helps reduce any soreness,” says Athans.

A kettlebell

Price point: $14.99 and up

Most people are more familiar with dumbbells, but kettlebells (which look like small cannonballs with triangular handles) can be used to mix up your strength-training sessions.

Athans uses a kettlebell for cardiovascular endurance. “It brings added weight plus dynamic function to any workout,” he says. “Kettlebells also target every muscle group, take up minimal space and are easy to store.”

Health and well-being improved by spending time in the garden

A study by a team of researchers from the University of Exeter in the United Kingdom and the Royal Horticultural Society, a U.K. charity, has found that having access to a private garden improves people’s health and well-being if they actively make use of it.

The research, which appears in the journal Landscape and Urban Planning, shines a light on the value of private green space, as well as public green space. It also raises questions about the equity of access to these spaces.

Green spaces

The association between green spaces — open areas of land that have vegetation growing in them — and health benefits is well-documented.

For example, a recent meta-analysis in the journal Environmental Research found that “[green space] exposure is associated with numerous health benefits in intervention and observational studies,” which suggests “a beneficial influence of [green space] on a wide range of health outcomes.”

However, less research has focused on the role of access to and use of gardens for people’s health and well-being.

Dr. Siân de Bell, of the University of Exeter Medical School and lead author of the present study, says that “[a] growing body of evidence points to the health and well-being benefits of access to green or coastal spaces. Our study is one of the largest to date to look at the benefits of gardens and gardening specifically.”

“Our findings suggest that whilst being able to access an outdoor space, such as a garden or yard, is important, using that space is what really leads to benefits for health and well-being.”

Access to private gardens important

The team found that access to a private outdoor space — whether a garden, patio, or balcony — was associated with improved health and well-being.

However, a significant factor was whether and how people used their private garden. The researchers found that people who both relaxed in their garden and did some gardening had improved health and well-being compared with those who did not use the space.

Interestingly, the type of garden to which people had access played a significant role in the health and well-being benefits that they gained from their garden use. Having access to a private outdoor space improved health and well-being more than having access to a communal space.

The team speculates that this may be because, in a private space, there is less chance of conflict with people who may wish to use the area differently. Having access to a private space allows a person to craft it in the way that suits them.

Conversely, a communal garden that a management company runs for a block of flats, for example, may not give the users of the garden permission to make any changes.

As the authors note, the study was limited in this way, as the data it drew on were not detailed enough for the authors to understand fully why people gain health and well-being benefits from a private garden.

For example, it may be that communal gardens produce similar benefits if a person has more control over crafting a part of it, or if they can contribute to collective decisions about its management. These data were not available to the researchers, however.

How to Lift Heavy and Stay Healthy at 40, 50, and Beyond

As I’ve gotten older, I’ve become known by some people as “that skinny old guy who can do 10 reps with your deadlift max.” But while I chuckle at that characterization, what I’m most proud of (and grateful for) is what it means in action: I’m able to continue lifting pretty heavy weights as a soon-to-be 60-year-old lifter, without most of the aches and pains you might expect from that.

Sure, every so often my shoulders get cranky, and I’ve got a bit of calcium in my left elbow. But that’s pretty much it. My hips, knees, and back continue to play along. And part of that is what you may call “luck,” but a major part of it is making conscious choices to keep me out of pain.

These seven rules are how I got here—and how I plan to stay here as long as possible. No matter if you’re 40, 50, 60 or just a younger person who wants to keep lifting at those ages, pay attention.

1. Never Lift Through Pain. Ever.

This is rule number one for all older lifters dealing with chronic injury issues. Pain is your body telling you how to resolve whatever injuries you have.

Acclaimed strength coach Mike Boyle advises: “Pain that dissipates during or after your warm-up is still pain.” Now, I’m sure that on an intellectual level you already understand it, but perhaps you have a difficult time squelching your more primitive instincts to keep pushing despite the pain. Maybe you reason that you’re just being “weak minded” and can pop an Ibuprofen to help you sleep that night.

If so, let me introduce you to a revolutionary technique devised by lower back pain expert Dr. Stuart McGill, who has resolved many cases of severe back pain with it. It’s known as “virtual surgery”, and here’s how McGill performs it:

When a new patient comes in with lower back pain, McGill places his palm on top of the patient’s head for a moment and declares “OK you’ve just had virtual back surgery. So what are you going to do for the next 6-8 weeks?” Puzzled, the patient guesses hesitantly, “Rest?” “Exactly!” McGill replies. And sure enough, many lower back pain sufferers (not all, mind you) experience complete relief from their pain.

If something hurts regularly, rest it! If over a period of a week or so, you don’t see at least a gradual reduction of symptoms, get yourself checked out. But no, this doesn’t mean you need to simply hang out on the couch.

2. Train What’s Not Injured

Every injury is both a warning and a veiled opportunity. Here’s what I mean: Recently, I was experiencing some elbow pain that meant I wasn’t able to do any type of loaded elbow flexion without pain, including chin-ups or curls of any kind, for approximately 10 weeks. So, I rested my elbow.

However, I could work triceps with no issues at all. So that’s what I did. Sure, I temporarily lost some strength in my pulls, but it came back soon enough after my layoff. And meanwhile, my pressing exercises got stronger. Adding a little size to my triceps even meant that my arms appeared bigger.

This is the definition of a silver lining. Shed your ego, do what you can, and embrace the long road.

3. Train Your Most Problematic Exercises Last, Not First

This is a “hack” that has worked for countless lifters, but if you want to be one of them, your ego will have to take another temporary hit (sense a theme here?).

Here’s why: Most lifting-related orthopedic issues are related to the exercises you do first in your workout. The bench press is a common example of this. Guys will start their upper-body session with the bench, with the rationale that they “have the most energy” early in the workout. Then, after multiple sets of intense benching, they move on to lats, shoulders, arms, etc.

The predictable result is that they end up with a strong bench and chest, as well as cranky shoulders and elbows. Here’s what happens if you turn that workout around:

  • By doing back, shoulder, and/or arm work first, your shoulders and elbows will be more thoroughly warmed up from less-irritating exercises before you start benching.
  • At the end of your workout, you’ll be less likely to fall victim to “ego lifting” since your energy levels are lower at that point and your muscles are fatigue.

Will your bench press suffer when you do it last? Maybe for a while. But your newly strengthened delts and triceps will probably catch up and maintain (and sometimes improve) your bench, despite de-emphasizing it in your training. And benching is a lot more fun when it doesn’t hurt, even if your numbers take a temporary dip.

Are starchy snacks or sports supplements better for muscle recovery?

The manufacturers of sports energy bars and drinks market them as providing an “edge” for amateur and professional athletes.

The implicit claim is that their products are better than relatively cheap, ordinary snacks at restoring energy levels after exercise and maximizing athletic performance.

Now, however, research at the University of Montana (UM) in Missoula has cast doubt on this claim.

“Athletes are vulnerable to strategic marketing. We are easily swayed,” says Prof. Brent Ruby, a former endurance athlete and director of UM’s Montana Center for Work Physiology and Exercise Metabolism.

Prof. Ruby led the study, which features in the European Journal of Applied Physiology.

Potato-based snacks

In the lab, the researchers pitted sports energy bars and drinks against potato-based snacks. The latter were potato pancakes and syrup, gnocchi and pasta sauce, hash browns and apple sauce, and fries.

The scientists measured the ability of the two types of food to replenish energy stores in volunteers’ skeletal muscle and sustain their performance in a time trial.

Muscles use the polysaccharide glycogen to store energy. During periods of intense activity, the muscles break down this glycogen to make glucose, which they use as fuel.

Sports scientists have found that the amount of stored glycogen in muscle helps determine performance in aerobic exercise, which includes cycling, swimming, and running.

In the new study, the participants rode a cycle ergometer, which is a high-tech exercise bike that takes measurements, such as oxygen consumption and power output.

A total of 16 healthy, injury-free, active volunteers (eight females and eight males) each completed two sessions at the lab. These took place 1 week apart.

The participants fasted for 12 hours before each session and abstained from exercise, alcohol, and caffeine for the previous 24 hours. In each session, they completed a glycogen depletion ride and then, after a 4-hour recovery period, a 20-kilometer (km) time trial.

The experiment used a “crossover design,” whereby, during the recovery period, each participant ate only sports energy bars and drinks at one session and only potato-based foods at the other.

They ate one snack immediately after the glycogen depletion ride and another 2 hours later.

The two diets matched in terms of their nutrient and calorie content.

LET’S STAY STRONG AT HOME

We’re not taking this pandemic lying down, and neither should you. There’s never been a better time to get active, unwind, eat well, and have some fun with the people you live with.

Join other former players with EXOS, a partner of The Trust, as they offer daily programming to keep your health and nutrition on point.

Check out the EXOS at Home Schedule of Programs


Don’t forget to check out our 30 Days of Purpose and Productivity throughout April and our “Using Social Distancing to Grow” Bingo Card to track your progress.

Discovering And Exploring Emotional Triggers

Start your day with an excerpt from InsightTimer to help you get started today.

We all know the feeling.

A friend or family member says something offhand, maybe a bad joke or a random comment about an article of clothing. They probably said it without thinking about it, but something about it just stirs things up within us. We might see ourselves reacting negatively even though we know intellectually that our reaction is out of context or proportion.

This is an example of an emotional trigger.

If you don’t have the tools to manage these reactions you may find yourself spiraling into depression, anxiety or panic. One bad joke could ruin your whole day.

Identifying and learning to work with these triggers is a very important part of recovering from PTSD, or other trauma-related disorders. However, the truth is that everyone has emotional triggers and we can all benefit from learning to be less reactive.

Why Do We Get Triggered?

A trigger is an event or sense impression that sets off an emotionally upsetting memory of an event in someone’s past, usually some kind of trauma. This can result in a memory replay or flashback, but just as often the response is subconscious and a triggered person may find themselves reacting to a situation without really knowing why. The brain has created a link between the perception of a present situation or experience and that response, which might lead to automatic negative or even self-destructive behavior and habits. 

Techniques For Identifying Emotional Triggers

It stands to reason that unraveling these sensations and corresponding emotional states in our bodies will help us to identify and understand the situations that trigger them, possibly even allowing us to reprogram these responses. We can do this through a number of introspective techniques.

1. Keep A Journal

Psychiatrist Judith Orloff, the bestselling author of The Empaths Survival Guide, recommends journaling as a way to explore emotional triggers.

Make a list of the situations that commonly trigger negative reactions. Try to be as vivid as possible. Keep a regular account of real-world situations on a day to day basis that have stirred up your emotions. According to Orloff, writing these down will help “to clarify the aspects of yourself need to heal.”

The next step is to write about possible situations in your past that may explain where these triggers come from. These could include significant traumas but could also include simple acts of unkindness or neglect from parents, friends or authority figures.

2. Visualization Meditation

Once you have an idea of the situations that trigger you and the possible sources of those triggers, a simple meditation technique that employs visualization can help you become clear on the emotions that arise as a result of these triggers and the sensations in your body that these emotions correspond to.

Lie down on your back in a quiet place, try to get as comfortable as possible. Close your eyes, take a few deep breaths and allow the body to settle. In your mind try to recall some of the sensations that have triggered your emotions in recent days and explore the sensations that arise in the physical body as you do this. Try to become clear on how the emotions that arise actually feel.

It may also be beneficial to explore some of the situations in your past that you explored in your journal. Try to recall these situations in as much detail as possible and explore the emotions that arise. This technique may not be appropriate for people with serious PTSD. If you are in doubt, consult a mental health professional.

3. Mindfulness Meditation

A 2016 neurological study published in the Journal of Biological Psychology found that the practice of mindfulness meditation helps to lessen emotional reactivity.

The study required participants hooked up to an EEG to view a series of emotional stimulating images while at the same time attending non-judgmentally to their thoughts, feelings and physical sensations. They found a significant decrease in a neurological marker of emotional response called the “Late Positive Potential” while in this “mindful” state.

The American Mindfulness Research Association published a review of this study where they expressed the following:

“One advantage of being mindful is that it allows one to respond to situations with equanimity rather than reacting emotionally in a “knee-jerk” fashion. How does mindfulness help us to do this? According to one theory, mindfulness helps to extinguish our negative emotional reactions. It does this by increasing our exposure to the stimuli that provoke these reactions while helping us to maintain an open, nonjudgmental stance.”

Many different techniques are taught in both traditional and modern mindfulness training. However, one of the most effective for tracking down and exploring the effects of emotions in the physical body is the simple technique and practice of a body scan:

Sit comfortably in a quiet place with the eyes closed. Take a moment to slow the breathing down a bit and relax all the muscles of the body not necessary to maintain an upright posture. When you are ready simply begin to pass the awareness through the physical body from head to foot, noticing whatever sensations arise. Try not to label or judge these sensations. Simply observe them. If you become distracted by a thought or emotion, that’s OK. Simply observe the thought or emotion and allow it to pass before returning to the body scan.

Click here to Read More


Don’t forget to check out our 30 Days of Purpose and Productivity throughout April and our “Using Social Distancing to Grow” Bingo Card to track your progress.

How to Breathe Properly

Here is an excerpt from Patrik Edblad to help you get started today.

1. Breathe through the nose

Every breath you take should go in and out through the nose. You can think of your nose as a little factory that refines and prepares the air coming in to be used by the body as efficiently as possible.

When you breathe through your mouth, the lungs get a lot more “unfiltered” air that is raw, cold, dry and full of viruses and bacteria. So, be kind to your lungs and breathe through your nose, will ya?

If you feel like your nasal passages are too tight to breathe trough, that’s most likely because you’ve been breathing through your mouth for so long that your nose has adapted.

It usually won’t take more than a couple of days of nose breathing to open up your nostrils again.

2. Breathe with the diaphragm

The air you breathe in through your nose should go all the way down in your belly. 70–80% of the inhaling should be done by the diaphragm so that your breathing is nice and deep. That has a couple of advantages:

  • It helps your lungs with the gas exchange because it’s much more efficient in the lower parts of the lungs.
  • The diaphragm ”massages” your liver, stomach, and intestines, giving these organs a rhythmical balance.
  • The lymphatic system, which is important for your immune system, gets the help it needs to get rid of the waste products from the bowels.
  • The pressure in the chest and belly is decreased so that the heart won’t have to work as hard.
  • The chest becomes more relaxed, and so does the neck and shoulders. As a result, the likelihood of pain in these areas goes down.

3. Breathe relaxed

No matter what you want to do, you’ll do it better if you’re relaxed. Since your breathing reflects your thoughts and feelings, situations that make you feel tense also lead to tense and stressed breathing pattern. That way of breathing then leads to a lack of oxygen which, in turn, makes your body and brain even more stressed.

By taking control of your breathing and making it more relaxed, your body ”tunes in” and becomes relaxed as well, which leads to better functioning in general.

When your body is relaxed, your health is good, and your energy is high, it becomes easier to be happy and loving toward yourself and others.

4. Breathe rhythmically

Everything has a natural rhythm — the ocean waves, the seasons, the moon. Your body is no different. The rhythm of your heart is measured in EKG and the brain in EEG.

The hormones in the body follow our natural rhythm. One example is melatonin that is released when you’re going to sleep.

Optimal breathing is no different: When everything is in tune, your body functions at it’s very best.

5. Breathe silently

Coughing, snoring, sniffling and so on, are suboptimal breaths in disguise.

It’s easy to neglect all these sounds we make, but a breathing pattern that contains a lot of them puts a considerable strain on the body. The breath loses its rhythm, and we mess up principle number 4.

Before we sigh or cough we usually take a big breath which leads to irregular breathing. Snoring means we have to compensate through breathing faster.

A lot of us breathe quicker and louder when we talk. All these noises and talking lead to incorrect breathing.

To read more on how to breathe, click here.


Don’t forget to check out our 30 Days of Purpose and Productivity throughout April and our “Using Social Distancing to Grow” Bingo Card to track your progress.

5 Reasons Chronic Pain Interferes with Sleep

Does chronic pain prevent you from getting good sleep? No…it does not.

Yet, many (if not all) chronic pain sufferers believe that they must first rid themselves of their pain in order to sleep better. Unfortunately, this is a false belief. When it comes to getting quality sleep, identifying the roadblocks getting in the way of sleep is actually the first step. 

The body is designed for sleep. Therefore, what we must do to facilitate it, is to get out of our own way. This paves the way to achieve sleep naturally. Although pain-sufferers can get trapped in a cycle of sleeping poorly (increasing their perception of pain and further disrupting their sleep), this cycle can indeed be broken.

Let’s assume that you are a pain-sufferer, only getting two hours of sleep per night. Your sleep problem did not start suddenly—it developed gradually over months, or even years. The same timetable occurs for recovering a healthy sleep pattern; as you begin to make changes in your habits you will see improvements in your sleep quality, but it takes time for this to happen.

Here are five habits known to negatively affect restful sleep for chronic pain-sufferers: 

1. Eating at the wrong time of day. 

Many chronic pain sufferers have fallen out of the pattern of getting up early in the morning; consequently, they do not eat breakfast, lunch, and dinner in the first 2/3 of the day. Yet, our eating schedule sets our biological clock for many things, including our sleep cycle.

Eating your first meal of the day in the morning increases your metabolism. This in turn starts the digestive cycle; as a result, energy is made available to keep you alert and active during the day. A person who eats only in the evening or at night develops a biological clock that is off-balance. This can distort the sense of being awake, hungry, alert, and…sleepiness.

2. Taking medications and/or drugs that interfere with sleep.

Opioids—one of the more common medications used to treat chronic pain—interfere with the brain’s ability to enter both REM and the deeper, restorative stages of sleep.

Those who use marijuana in the evening or throughout the day to manage pain develop  less slow-wave sleep, worse sleep efficiency, and shorter periods of REM sleep than non-users. Alcohol has often been used as a sleep aid, but it too disrupts sleep. A well-known depressant, alcohol also decreases alertness and memory storage in the day following its consumption due to disrupted sleep patterns.  

3. Moving less to reduce pain levels.  

The pain cycle that interferes with quality sleep also serves as a trap for chronic pain patients. See if this scenario sounds familiar: a person begins to experience ongoing pain; as a result, they assume that moving less by not exercising, stretching, or walking will limit their pain.

However, moving less does not, in fact, limit pain. What it does do is lead to muscle and nervous system dysfunction, which then leads to muscle spasms and shooting pain. Shooting pain leads to guarding behavior, which results in even less movement. There’s no question that quality sleep requires a day full of activity, movement, and stress-reducing activities like exercise, walking, and stretching. The less you move, the more poorly you will sleep.

Coronavirus myths explored

The novel coronavirus, now known as SARS-CoV-2, has spread from Wuhan, China, to every continent on Earth except Antarctica.

The World Health Organization (WHO) officially changed their classification of the situation from a public health emergency of international concern to a pandemic on March 11. 

To date, the novel coronavirus — currently dubbed “severe acute respiratory syndrome coronavirus 2,” or SARS-CoV-2 for short — has been responsible for more than 245,000 infections globally, causing more than 10,000 deaths. In the U.S., the virus has affected 14,250 people and has so far caused 205 deaths.

As ever, when the word “pandemic” starts appearing in headlines, people become fearful, and with fear come misinformation and rumors.

Here, we will dissect some of the most common myths that are currently circulating on social media and beyond.

1. Spraying chlorine or alcohol on skin kills viruses in the body

Applying alcohol or chlorine to the body can cause harm, especially if it enters the eyes or mouth. Although people can use these chemicals to disinfect surfaces, they should not use them on skin.

These products cannot kill viruses within the body.

2. Only older adults and young people are at risk

SARS-CoV-2, like other coronaviruses, can infect people of any age. However, older adults or individuals with preexisting health conditions, such as diabetes or asthma, are more likely to become severely ill.

3. Children cannot catch COVID-19

All age groups can become infected. Most cases, so far, have been in adults, but children are not immune. In fact, preliminary evidence shows that children are just as likely to become infected, but their symptoms tend to be less severe.

4. COVID-19 is just like the flu

SARS-CoV-2 causes illness that does, indeed, have flu-like symptoms, such as aches, fever, and cough. Similarly, both COVID-19 and flu can be mild, severe, or, in rare cases, fatal. Both can also lead to pneumonia.

However, the overall profile of COVID-19 is more serious. Estimates vary, but its mortality rate seems to be between about 1% and 3%. 

Although scientists are working out the exact mortality rate, it is likely to be many times higher than that of seasonal flu.

5. Everyone with COVID-19 dies

This statement is untrue. As we have mentioned above, COVID-19 is only fatal for a small percentage of people.

In a recent report, the Chinese Center for Disease Control and Prevention concluded that 80.9% of COVID-19 cases were mild. 

The WHO also report that around 80% of people will experience a relatively mild form of the disease, which will not require specialist treatment in a hospital. 

Mild symptoms may include fever, cough, sore throat, tiredness, and shortness of breath.

6. Cats and dogs spread coronavirus

Currently, there is little evidence that SARS-CoV-2 can infect cats and dogs. However, in Hong Kong, a Pomeranian whose owner had COVID-19 became infected. The dog did not display any symptoms.

Scientists are debating the importance of this case to the epidemic. For instance, Prof. Jonathan Ball, Professor of Molecular Virology at the University of Nottingham in the United Kingdom, says:

“We have to differentiate between real infection and just detecting the presence of the virus. I still think it’s questionable how relevant it is to the human outbreak, as most of the global outbreak has been driven by human-to-human transmission.” 

He continues: “We need to find out more, but we don’t need to panic — I doubt it could spread to another dog or a human because of the low levels of the virus. The real driver of the outbreak is humans.”

7. Face masks protect against coronavirus

Healthcare workers use professional face masks, which fit tightly around the face, to protect them against infection. However, disposable face masks are unlikely to provide such protection.

As these masks do not fit neatly against the face, droplets can still enter the mouth and nose. Also, tiny viral particles can penetrate directly through the material.

However, if someone has a respiratory illness, wearing a mask can help protect others from becoming infected.

“There is very little evidence that wearing such masks protects the wearer from infection,” Dr. Ben Killingley, Consultant in Acute Medicine and Infectious Diseases at University College London Hospital in the U.K., explains. 

“Furthermore, wearing masks can give a false sense of reassurance and might lead to other infection control practices being ignored, e.g., hand hygiene.”

The WHO recommend that people who are caring for someone with suspected COVID-19 should wear a mask. In these cases, wearing a mask is only effective if the individual regularly washes their hands with alcohol-based hand rub or soap and water.

Also, when using a mask, it is important to use it and dispose of it properly.

8. Hand dryers kill coronavirus

Hand dryers do not kill coronavirus. The best way to protect yourself and others from the virus is to wash your hands with soap and water or an alcohol-based hand rub.

9. SARS-CoV-2 is just a mutated form of the common cold

Coronaviruses are a large family of viruses, all of which have spiky proteins on their surface. Some of these viruses use humans as their primary host and cause the common cold. Other coronaviruses, such as SARS-CoV-2, primarily infect animals.

Both Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) began in animals and passed into humans.

10. You have to be with someone for 10 minutes to catch the virus

The longer someone is with an infected person, the more likely they are to catch the virus, but it is still possible to catch it in less than 10 minutes.

Click Read More for the rest of the myths.

Can eating a vegetarian diet prevent a stroke?

The study, which appears in Neurology, the medical journal of the American Academy of Neurology, investigated the link between a person’s diet and the occurrence of two different types of stroke.

These were hemorrhagic stroke, in which blood from an artery bleeds into the brain, and ischemic stroke, which results from a blocked blood vessel.

In the United States, about 795,000 people experience a new or recurrent stroke each year, and it is the second leading cause of death globally. 

A stroke can result in disabilities, and affected individuals are more likely to develop dementia in the future. 

The American Heart Association (AHA) estimate that by 2030, almost 4% of adults in the U.S. will have had a stroke.

Is a vegetarian diet better or worse for health?

Vegetarianism and veganism have become increasingly popular in both the United Kingdom and the U.S. 

While many people opt for a plant-based diet for environmental and animal welfare reasons, they also often perceive these diets as being better for their health.

A study that the BMJ published last year investigated strokes in more than 48,000 meat eaters and vegetarians in the U.K. The study authors reported that although vegetarians had lower rates of ischemic heart disease than the meat eaters, they were more likely to have a stroke. 

They concluded that there could be some factors associated with animal food consumption that might prevent a stroke.

Sleep Should Be Another Measure of Heart Health

The preliminary findings, presented Thursday at the American Heart Association’s Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions in Phoenix, recommend changing the AHA’s Life’s Simple 7 measure of cardiovascular health to the “Simple 8 or Essential 8” to incorporate sleep metrics.

“Sleep, like diet and physical activity, is a health behavior we engage in every day,” said lead author Nour Makarem, an associate research scientist at Columbia University Irving Medical Center in New York. “Increasingly, it is linked to not only the risk of heart disease but also to the risk factors that lead to cardiovascular disease. Despite this importance, unlike diet and exercise, sleep has received less attention and is not currently included in guidelines for cardiovascular disease prevention or as a measure of cardiovascular health.”

About 4 in 10 people report consistently getting a good night’s sleep and more than 50 million Americans experience some type of sleep disorder. An AHA scientific statement in 2016 said insufficient and poor-quality sleep, along with sleep disorders, are linked to a higher risk for heart disease as well as to several major heart disease risk factors, such as obesity, Type 2 diabetes and high blood pressure.

The Life’s Simple 7 tool, created in 2010 to measure a person’s cardiovascular health, includes metrics on tobacco use, diet, physical activity, body mass index, blood pressure, total cholesterol and blood sugar levels.

In the new study, researchers looked at how adding combinations of different sleep metrics to this tool would impact cardiovascular health scores for 1,920 ethnically diverse middle-aged and older adults, a population considered at high risk for developing heart disease. They then compared their heart health scores, with and without sleep metrics, to see which was the stronger predictive tool.

“Even if you just add sleep duration as an eighth metric of heart health, the new heart health score would be more strongly associated with cardiovascular disease risk than the traditional Life’s Simple 7,” Makarem said.

For example, participants who got seven to eight hours of sleep a night in addition to meeting Life’s Simple 7 guidelines had up to 61% lower odds of having heart disease.

Her team also investigated adding different sleep characteristics, including sleep duration; insomnia; excessive daytime sleepiness; sleep apnea; sleep efficiency (how much time in bed is spent sleeping); and sleep variability (inconsistent sleep schedules).

WHAT YOU NEED TO KNOW ABOUT CORONAVIRUS

What began with a handful of mysterious illnesses in a vast central China city has traveled the world, jumping from animals to humans and from obscurity to international headlines. First detected on the last day of 2019, the novel coronavirus has infected tens of thousands of people — within China’s borders and beyond them — and has killed more than 2,500. It has triggered unprecedented quarantines, stock market upheaval and dangerous conspiracy theories.

Most cases are mild, but health officials say the virus’s spread through the United States appears inevitable. As the country and its health-care system prepares, much is still unknown about the virus that causes the disease now named covid-19.

The Washington Post has spoken to scores of doctors, officials and experts to answer as many of your questions as we can about the newest global health emergency. Here’s what we know so far.

What is it?

These days, “coronavirus” is often prefaced with the word “novel,” because that’s precisely what it is: a new strain in a family of viruses we’ve all seen before — and, in some form, had. According to the WHO, coronaviruses are a large family of viruses that range from the common cold to much more serious diseases. These diseases can infect both humans and animals. The strain that began spreading in Wuhan, the capital of China’s Hubei province, is related to two other coronaviruses that have caused major outbreaks in recent years: severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

Symptoms of a coronavirus infection range in severity from respiratory problems to cases of pneumonia, kidney failure and a buildup of fluid in the lungs.

How deadly is it?

Public health officials say the novel coronavirus is less deadly than SARS, which killed about 10 percent of people who were infected during the outbreak that began in 2002. But epidemiologists are still trying to determine exactly how deadly covid-19 is.

About 2 percent of reported cases have been fatal, but many experts say the death rate could be lower. That’s because early in an outbreak, mild illnesses may not be reported. If only people with severe illness — who are more likely to die — seek care, the virus will appear much more deadly than it really is because of all the uncounted people with milder symptoms.

Early in the outbreak, one expert estimated that although 2,000 cases had been reported, 100,000 people probably were sick. Under counting cases can artificially increase the infection’s mortality rate.

How does it spread?

Covid-19 spreads more easily than SARS and is similar to other coronaviruses that cause cold-like symptoms, experts have said. It appears to be highly transmissible, and since cases are mild, the disease may be more widespread than current testing numbers suggest.

There have been reports of people transmitting the virus before they show symptoms, but most experts think this is probably not a major driver of new infections. What is concerning, however, is that symptoms can be mild, and the disease can clearly spread before people realize they’re sick. SARS spread when people had full-blown illness, which is one reason it was possible to contain it — it was easier to tell who had the virus.

A report in the New England Journal of Medicine suggested covid-19 reaches peak infectiousness shortly after people start to feel sick, spreading in the manner of the flu. A study published in JAMA chronicled the case of a 20-year-old Wuhan woman who appeared to infect five relatives, even though she never showed signs of illness.

Who is most at risk of severe illness?

Similar to other respiratory illnesses, older people and those with illnesses such as diabetes and high blood pressure are at increased risk. Early studies have also suggested men are at greater risk.

But, as with other diseases, there can be tremendous individual variation in how people respond. There will be people with known risk factors who recover as well as people who develop severe cases for reasons we don’t understand.

“It may be a very specific thing about the way your immune system interacts with a particular pathogen,” said Allison McGeer, an infectious-disease epidemiologist at the University of Toronto. “It may also be just about exactly what your exposure is.”

IS SITTING THE NEW SMOKING?

What are you doing as you read this?  Having a cup of coffee?  Taking a break from work?  Getting ready for bed?  Whatever you’re up to, chances are you’re sitting down.  We get it, your feet are tired!  That chair is comfortable.  What are you supposed to do—standon the subway?

Most of us have heard the phrase “sitting is the new smoking” referring to the growing epidemic of sedentary lifestyles in the United States.  But is this true?  Is sitting in a chair that bad for you?  We decided to find out.

THE FACTS

  • Over 25% of American adults sit for more than 8 hours every day. 44% of those people get little to no exercise.
  • The average American watches approximately 3 hours of television every day.
  • The average American is active less than 20 minutes every day.
  • 60-75 minutes of moderate activity (steady walking) can counter the effects of too much sitting.

A 2011 study documented 800,000 people and their sitting habits.  The study found that people who sit the most, compared to people who sit the least, have a greater risk of disease and death:

  • 112% increased risk of diabetes.
  • 147% increased risk of cardiovascular events like heart attack and stroke.
  • 90% increased risk of death from cardiovascular events.
  • 49% increased risk of death from any cause.

All Your Questions About Intermittent Fasting

There are a lot of opinions surrounding IF, and there are different ways to do it. So you no doubt have a few questions. How effective is it? What’s the best method? What factors into the timing? How do you fit workouts around fasting? Here’s what the science actually says about it.

What is Intermittent Fasting?

Intermittent fasting has been around for centuries, since ancient hunter-gatherer times, but it’s risen to popularity in the past five years or so. There have been a few catalysts: a 2012 documentary called Eat Fast, Live Longer; as well as a slew of books including The Fast Diet,  The 5:2 Diet Book, and The Obesity Code. All of this media, combined with anecdotal success, have created a positive buzz around the trend.

IF is an eating pattern that cycles between periods of fasting and eating. It doesn’t specifically say which foods to eat or avoid, but rather when you should be eating. It’s actually more of an eating pattern than an actual diet per se. Modern IF methods can be summed up by these four types:

  1. Eat-Stop-Eat: This involves fasting for 24 hours once or twice per week.
  2. The 5:2 Method: You consume only 500 calories on two non-consecutive days of the week, but eat a normal pattern the other five days of the week.
  3. Alternate-Day Fasting: You fast every other day. This can be adjusted, but some methods allow 500 calories or fewer on the fasting days.
  4. The 16:8 method: This involves skipping breakfast and restricting your daily eating period to eight hours, then you fast for 16 hours before eating again. For example, your feeding window might be 12-8 p.m. but within that window, you can fit two or three meals, then fast until 12 p.m. the following day.

The 16:8 method is the most popular and easiest for people to stick to. Overall, no matter what method you choose, as long as you’re reducing your caloric intake, any method should cause weight loss as long as you aren’t over-consuming during the feeding timeframes.

How Does It Affect Your Body and Help You Lose Weight?

Fasting causes a number of reactions in the body that affect your cells on a molecular level. The main idea behind IF is that it helps your body access and mobilize fat stores by adjusting the hormones that influence lipolysis (the breakdown of fats). Without diving too much into the science and mechanisms of how this works, here are a couple of the changes that occur in the body during periods of fasting:

  • Increase in human growth hormone: Growth hormone, or somatotropin, is a peptide hormone that stimulates cell growth, cell reproduction, and regeneration in humans. More importantly, it stimulates the production of IGF-1, which positively impacts insulin levels and levels of body fat. Research shows that fasting can cause growth hormone levels to skyrocket, which has benefits for fat loss and muscle gain, among other benefits.
  • Insulin sensitivity can improve: Fasting can cause levels of insulin to drop dramatically, which makes your ability to burn body fat more accessible. The idea behind fasting is to allow insulin levels to drop far enough that we burn fat because we have to tap into those energy stores in times of fasting or starving.

Among those benefits mentioned, a recent review of the science of IF in the New England Journal of Medicine. does a deep dive on current research, explaining how IF can improve metabolism, lower blood sugar, decrease inflammation, and improve chronic conditions like asthma and arthritis. There’s even evidence to show it can reduce damaged cells and enhance brain function.

6 Ways to See a Doctor Without Sitting in a Waiting Room Forever

Any doctor will tell you that every guy needs a primary-care provider—a trusted physician who knows you, knows that your dad had a heart attack at age 40, helps you figure out how to tweak your life according to your health history…and heck, knows your name without looking at your chart first.

Except that for most of us, that’s not how it goes. First, the doctor never sees us, because the yearly visit has been called off. “There’s no reason for healthy men under 40, or anyone for that matter, to get annual checkups,” says Eric Topol, M.D., a professor of molecular medicine at Scripps Research in La Jolla, California, echoing the view of the Society of General Internal Medicine. Having an annual exam does not reduce your risk of death or serious disease, according to a review of 14 studies. When it comes to yearly checkups, “all the data shows the lack of value, and they should be strongly discouraged,” Dr. Topol says.

Second, we move around. “If you take a 21-year-old male in 2020 and ask, ‘Where are you going to get care today versus five, ten, or 20 years from now?’ he’s not going to know, because people change employers, health plans, and even doctors relatively frequently,” says Ateev Mehrotra, M.D., an associate professor of public health-care policy and medicine at Harvard Medical School. “So the question is: Is that relationship even possible?”

Add to that issues with cost and convenience and it’s no wonder nearly half of adults in the U. S. under age 30 don’t have a primary-care physician.

And—twist you didn’t see coming!—maybe that’s okay.

There are now many cheaper, more convenient ways to get medical help than waiting for a traditional doctor’s office to fit you in and potentially having to travel to get there. And if you’re basically healthy, you might do fine with these.

But with choice and convenience comes great responsibility. “Most millennials use urgent care, go online, talk to their friends, and think that’s health care,” says Allan H. Gorroll, M.D., a professor of medicine at Harvard Medical School. It’s not. A catch-as-catch-can health plan leads to a lot of issues not getting caught. With this approach, “some things may be overlooked or prescribed inappropriately,” he says.

So you’ve got to have a plan. Not all of these answers to medical-system frustration are equal. Some are welcome, some dodgy, some outright dangerous, and some ingenious.

Look, if you have a doctor you love, stick with them. And if you have a chronic illness like diabetes or high blood sugar that’s about to turn into diabetes, or if you’re at high risk for anything else (like heart disease), then yes, you’re going to need a main doctor.

But today, the old way is only one way to get what you need. If you’re going to bypass a PCP, then let us show you how to navigate what’s out there so that you find the best route to the best care.

Here’s the lowdown on which new ways to see the doctor spare you time, money, and scheduling hassles without endangering your health.

See a Doc by Phone

You get to talk to or videoconference with a real doctor without making an appointment or even leaving your living room/car/office/campsite. Some big insurance companies have partnered with big telehealth start-ups, including Teladoc, Doctor On Demand, and American Well, so these options may be part of your plan. In 2018, an estimated 7 million people visited a doc this way.

You can find and use a telehealth site or app yourself, but you’ll have to do some homework on your choices before dialing.

The pros: Speed. Ease. Since you’re calling or video chatting about a specific problem, such as a sore throat, you’ll likely be spared the “you need to lose weight” speech. And research has shown that people may be more honest in revealing symptoms or undesirable behaviors like alcohol consumption when disclosing to a computer.

The cons: Not all telehealth providers are equal—some have been scammy. So when choosing an app, look for one partnered with a known health-care entity, like Blue Cross Blue Shield or a hospital that you trust. Then see who the doctors are—some apps list providers’ names and contact information, so you can check them out online.

Go to Urgent Care

More than half of all millennials seek help from urgent care (like Concentra, CityMD, and MedExpress) or retail health clinics, found in drugstores, supermarkets, or “big box” stores. Retail clinics are typically manned by a nurse practitioner or physician’s assistant; they’re good at managing minor scrapes, colds, and fevers, and they can give you a flu shot. But they can’t X-ray you or stitch you up. Freestanding urgent-care centers are for pressing but non-life-threatening medical issues (so bypass them for an ER if you have chest pain) and are generally staffed by a licensed physician.

The pros: They’re cheaper and faster than the ER, they can usually send a report to you to keep on file (and to a doctor, if you have one), and they’re everywhere.

The cons: They may overprescribe meds. One recent study discovered that nearly half of people who dropped into urgent care with an ear infection, flu, allergies, asthma, bronchitis, or another viral upper-respiratory infection—none of which respond to antibiotics—got a prescription. Retail clinics had the best track record—antibiotics were inappropriately prescribed only 14 percent of the time there (and 17 percent of the time at a doctor’s office).

Get an Rx Online

If you need a prescription for an issue like ED, genital herpes, performance anxiety, or hair loss, a few finger taps can get you one from a “digital health clinic” such as Hims.

The pros: No embarrassing in-person doctor visit needed. Fill out an online form—you’ll answer a lot of questions about your issue and your health history (you’ve got to be honest)—to determine if you’re eligible for the prescription you’re after. If a doc has questions or concerns, they may call you. Your medication arrives at your door a few days later.

The cons: The idea of getting meds with little human contact ruffles the feathers of practically every careful human prescriber we know. But it might not be as sketchy as all that: Dr. Mehrotra sent college students undercover to test online prescription apps and sites. “My initial skepticism was tempered,” he says. That’s still not a ringing endorsement, by the way.

Splurge for a Medical Concierge

These fancy doctor’s offices/wellness centers are about as far as you can get from low-contact telehealth apps. Packages vary by company, but monthly fees can get you a round of initial diagnostics and a certain number of appointments with those physicians every year. The promise is that these docs have extra time to spend with you not only to solve your health problem but also to help determine lifestyle changes to keep it in check and prevent other issues. At a company called Forward, for instance, members receive genetic testing, body scans, and a personalized health plan. It considers itself a “supplement” to your insurance plan, not a substitute for it.

The pros: By virtue of the fact that they’re not bound to a 15-minute reimbursable visit, these doctors can take the time to understand patterns and concerns that aren’t just today’s problem. They also help with stress reduction and recommend healthy eating and exercise programs.

The cons: These physicians can feel like partners in your care, but they’re pricey. Forward runs about $149 a month, and Parsley Health costs about $150 to $250 a month, depending on how many visits a year you want. And the testing and blood work may not be included in the membership fees.

Want to Protect Yourself From Coronavirus?

But agency officials and other doctors have a simple message for Americans: keep doing what you’re doing to stay healthy.

“The best things that you can do are the things that we generally recommend at this time of year to prevent the spread of infectious diseases,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said during a Jan. 30 call with reporters. “Wash your hands, cover your cough, take care of yourself and keep alert to the information that we’re providing, because we’ll provide new information as it becomes available.”

In Asia, the novel coronavirus known as 2019-nCoV is spreading rapidly, and has reached far enough to warrant being designated a public health emergency of international concern by the World Health Organization. As of noon Friday, it has infected nearly 10,000 people, most of them in mainland China, and killed 213. But public health officials have emphasized that risk to the American public remains low, and spreading within the U.S. has so far been limited to one wife-to-husband transmission.

While 2019-nCoV has never been seen before, it’s part of a family of viruses that are well-known both to doctors and the public; the common cold, for example, can be caused by certain coronaviruses. And while influenza is not a coronavirus, it isn’t so different from 2019-nCoV, either. Both result in symptoms including cough and fever, and—from what scientists can tell so far—both seem to be spread mainly via respiratory droplets and close person-to-person contact.

For those reasons, experts are recommending prevention measures in keeping with those deployed during a normal flu season. The CDC has not recommended that Americans wear protective masks or take dramatic measures against coronavirus. Messonnier did emphasize during Thursday’s call that people who have been in Wuhan, China—where the outbreak originated—or spent time around people who have traveled from the area should monitor themselves for symptoms of coronavirus, such as cough, fever and respiratory distress. These people should call their health care provider and stay home from work or school if any symptoms develop.

Aside from that, though, there’s not much Americans can or should do at this point, beyond the usual measures.

“Good hand-washing helps. Staying healthy and eating healthy will also help,” says Dr. Sharon Nachman, a pediatric infectious disease specialist at New York’s Stony Brook Children’s Hospital. “The things we take for granted actually do work. It doesn’t matter what the virus is. The routine things work.”

And while the flu shot won’t protect against coronavirus—and there’s no vaccine for the new virus yet—experts are still recommending that people get vaccinated against influenza if they haven’t yet, since the likelihood of getting the flu in the U.S. is far higher than contracting coronavirus. (For context, the CDC estimates that around 19 million Americans have gotten the flu so far this season, compared to only a handful who have developed coronavirus domestically.) As long as flu virus is still circulating, it’s not too late to get a flu shot.

Blue light may aid recovery after concussion

Mild traumatic brain injury (mTBI), or concussion, can result from a range of causes, from a car accident to fights, falls, or sports. 

Following such an injury, people might see stars, become disoriented, or even lose consciousness briefly, but many come round without realizing that they have been concussed at all. 

However, for some, mTBI can result in weeks or months of symptoms, including headaches, mental fogginess, dizziness, memory loss, fatigue, and disturbed sleep. According to the researchers behind the current study, some 50% of people with mTBI complain of chronic sleep problems after the injury, which affects their ability to think and recover. 

And 15% of those with mTBI have symptoms that last for at least 1 year. 

Scientists believe that these symptoms occur due to the stretches and tears that the impact inflicts on microscopic brain cells. 

“Your brain is about the consistency of thick Jell-O,” explains lead author William D. “Scott” Killgore, a psychiatry professor at the University of Arizona in Tucson. “Imagine a bowl of Jell-O getting hit from a punch or slamming against the steering wheel in a car accident. What’s it doing? It’s absorbing that shock and bouncing around. During that impact, microscopic brain cells thinner than a strand of hair can easily stretch and tear and rip from the force.”

Such injury can also occur during explosive blasts, when shock waves hitting the soft tissue of the gut push a surge of pressure into the brain, damaging blood vessels and brain tissue. 

“Mild traumatic brain injury (mTBI), which is commonly known as concussion, is one of the most common injuries experienced by military personnel and is a major health concern worldwide,” Killgore told Medical News Today.

Sleep as a healer

“At present, there are virtually no effective treatments for concussion,” said Killgore. “We sought a nonpharmacologic (or nondrug) method to help people.” 

Killgore and his research team received funding from the U.S. Army Medical Research and Development Command to conduct the study, which features in the journal Neurobiology of Disease

The solution that they set out to prove effective was sleep. 

“Because sleep is so important for brain health and recovery, we reasoned that improving sleep timing and duration could lead to a more rapid recovery from mTBI,” said Killgore. “Considerable evidence suggests that sleep is important for brain repair processes,” he added. 

Killgore explained that scientists have shown that following an injury, sleep facilitates the production of new insulating brain cells called oligodendrocytes. 

“Without sufficient restorative sleep, the repair of brain tissue will likely be slowed or incomplete,” Killgore said.

Blue light in the morning

The recent clinical trial, which involved 32 adults with mTBI, focused on solidifying the participants’ circadian rhythm — the natural process that dictates our 24 hour sleep-wake cycle. 

The researchers achieved this by exposing the participants to blue light from a cube-like device for 30 minutes early each morning for 6 weeks. The participants in the control group used amber lights instead of blue.

Scientists have shown that blue light suppresses the brain’s production of melatonin, a chemical that makes us sleepy. 

“Blue light is one of the brain’s primary timekeepers,” explained Killgore. “Exposure to blue light, such as sunlight at sunrise, tells the body that it is morning and time to stop sleeping. That makes you more alert during the day and starts the clock ticking to tell you when to go to sleep later.” 

By using blue light, the participants reset the brain’s inner clock, helping participants fall asleep earlier and stay asleep. The most restorative, and therefore beneficial, sleep occurs when it is in tune with the body’s innate circadian rhythm. 

On average, participants using the blue light therapy fell asleep and woke up 1 hour earlier than before the trial and were less drowsy during the day. Their brain-processing speed and efficiency were improved, and they showed an increase in visual attention.

Fewer Americans Are Binge Drinking

American adults who binge drink are consuming an increasing number of alcoholic beverages per year when they binge, a new study from the U.S. Centers for Disease Control and Prevention (CDC) says.

The study, an analysis of data from the Behavioral Risk Factor Surveillance System from 2011 to 2017, found that while overall rates of binge drinking decreased slightly, going from 18.9% to 18.0%, the average number of binge drinks consumed by adults who report binge drinking rose from 472 to 529, a 12% increase.

The CDC defines “binge drinking” as consuming five or more drinks in two hours or less for men, and four or more drinks in the same span of time for women. According to the study, men who binge drink consumed an average of 666 drinks while binging in 2017, compared to 587 in 2011. For women, that number rose from 256 to 290 in the same amount of time.

These increases were largely driven by adults 35 and older. Self-reported binge drinkers between ages 35 and 44 consumed 593 binge drinks per person in 2017, an increase from 468 in 2011. For adults between ages 45 and 64, that number grew to 527 in 2017, from 428 in 2011. In comparison, the number of binge drinks consumed by 18-to-24-year-olds who report binging fell from 619 in 2011 to 545 in 2017.

5 healthful living factors extend disease-free life

On average, we are living longer lives; however, as people grow older, many live with diseases, such as heart disease, cancer, and diabetes. As lifespan extends, so does the risk of developing chronic illnesses.

Scientists have firmly established that lifestyle factors can make a significant difference to the risk of disease and length of life, overall. These factors include physical activity, smoking, alcohol consumption, diet, and weight.

The authors explain that “[s]tudies have shown that smoking, inactivity, poor diet quality, and heavy alcohol consumption contribute up to 60% of premature deaths and 7.4–17.9 years’ loss in life expectancy.”

Although this is well known, little research has examined how a combination of lifestyle factors impacts the length of time an individual will be disease-free.

To answer this question, a group of researchers took data from two sources; firstly, the Nurses’ Health Study, which included information from 73,196 female nurses. Secondly, they gained access to data from the Health Professionals Follow-up Study, which included the data from 38,366 male health professionals. They published their findings in the BMJ.

Lifestyle and health over time

The scientists calculated a lifestyle score from 0–5 for each participant. They calculated this score by assessing five low risk lifestyle factors — healthy weight, never smoking, exercising for at least 30 minutes each day, moderate alcohol intake, and a good quality diet.

Researchers had followed the participants for many years and recorded diagnoses and deaths from cancer, type 2 diabetes, and cardiovascular disease. As part of their analysis, the scientists accounted for a range of factors, including family medical history, age, and race.

The authors of the recent study found that women aged 50 who did not adopt any of the five low risk lifestyle factors could expect to live without cancer, diabetes, and heart disease for a further 24 years. However, those who followed four or five of these factors could expect an additional 34 disease-free years.

Men aged 50 who did not incorporate any of the low risk lifestyle factors into their lives could expect to live an extra 24 years free of chronic diseases. However, those whose lifestyle included four or five low risk factors had around 31 years of disease-free life.

Men who smoked more than 15 cigarettes each day, and anyone with obesity had the lowest amount of disease-free life expectancy after 50. The authors summarize:

“[W]e observed that adherence to a low risk lifestyle was associated with a longer life expectancy at age 50 free of major chronic diseases of approximately 7.6 years in men and 10 years in women compared with participants with no low risk lifestyle factors.”

Improving survival

The scientists also found that men and women with four or five low risk lifestyle factors who received a diagnosis of cancer, cardiovascular disease, or type 2 diabetes lived longer than individuals with the same diagnoses who did not have any low risk factors. As the authors explain:

“A healthful lifestyle not only decreased the risk of incident cancer, cardiovascular disease, and type 2 diabetes but also improved the survival after diagnosis of those diseases.”

The authors are quick to note that the study is observational, so it is not possible to conclude a causal relationship. Also, lifestyle factors were self-reported, which, as the authors write, means that “measurement errors are inevitable.”

Even though the scientists controlled for a wide range of factors, there is always a possibility that unmeasured factors might account for the results.

However, the scientists had access to detailed information from each participant at multiple times over a substantial followup period; overall, they conclude:

“Public policies for improving food and the physical environment conducive to adopting a healthful diet and lifestyle, as well as relevant policies and regulations (for example, [the] smoking ban in public places or trans­ fat restrictions) are critical to improving life expectancy, especially life expectancy free of major chronic diseases.”

Trying to eat more plants? Follow a flexitarian diet

Hands down, one of the best things you can do for your health (and the health of the planet) this year is to adopt a plant-focused diet. A flexitarian eating pattern emphasizes plant foods, such as veggies, fruits, nuts, seeds, pulses (beans and legumes) and whole grains, but leaves some room for meat, dairy and other animal foods. According to the latest U.S. News & World Report Best Diet Rankings, this eating pattern, specifically the one outlined in the book “The Flexitarian Diet” by registered dietitian nutritionist, Dawn Jackson Blatner, came in second healthiest overall and was considered among the easiest to follow. If you’re actively looking for ways to eat more plants and limit your meat consumption, adopting a flexitarian way of eating is a great way to go. Here’s what you need to know before you get started.

What are the health benefits of the flexitarian diet?

When you boost your intake of plant foods and reduce your intake of red and processed meats and other less healthful foods, such as heavily processed snack foods, refined grains and sweets, you’ll experience some major perks. Studies have linked a dietary pattern rich in wholesome, minimally processed plant foods with:

  • Keeping your mind sharp and preserving your memory over time
  • Improvements in body composition and weight management
  • Lowering the risk of challenging diseases, like type 2 diabetes and heart disease
  • A more positive outlook with greater creativity and deeper life satisfaction
  • Enabling you to live longer and enjoy a better quality of life as you age

You’ll get these benefits because plant foods provide the vitamins, minerals, fiber, antioxidants and polyphenols that protect your body and brain from a number of triggers that accelerate disease, aging and mood disorders. More and more, research shows that markers of health improve when you eat more plants and less meat.

I also can’t ignore that these same foods offer environmental advantages as well. Production of meat and dairy foods can drain our natural resources and these foods have a higher carbon footprint compared to plant foods. This means they contribute to climate change, which is hurting our planet and putting people at risk of food insecurity.

What else can I expect when following a flexitarian diet plan?

If you’re used to eating a lot of heavily processed foods, you might notice you fill up better on a flexitarian diet, which limits these foods and prioritizes fiber-rich veggies, fruits, pulses and whole grains. This can translate into other benefits as well. For example, feeling more satisfied with meals might mean you’re less distracted by hunger so you may be more productive at work or at home.

If you’re limiting heavily processed foods and favoring plant foods, you may also find you feel more energetic during the day and you sleep better at night. Proper sleep can have far-reaching benefits, including being less susceptible to the common cold.

All of this means that by adopting a flexitarian diet, you’ll experience some immediate benefits as well as some longer-term perks.

Are there any downsides to the flexitarian diet?

If you’re not used to eating a largely plant-based diet, you’ll need to adjust to trying new foods and limiting the ones that might currently be eaten on repeat. In Blathner’s book, “The Flexitarian Diet”, she guides newbies through making changes in a phased fashion.

If you’re currently existing on a lot of processed convenience foods, you may also have to get used to planning, prepping and cooking more than you’d like, so there could be some lifestyle adjustments to make. However, as I said earlier, this semi-vegetarian eating pattern is considered one of the easiest to follow so these drawbacks aren’t huge deterrents. And once you get used to the changes, they’ll become second nature.

You might also need to plan your diet more wisely to get certain nutrients or you may need supplements to fill in any gaps. For example, vitamin B12 and calcium are easier to come by in animal foods than plant-based ones, so you’ll need to make sure you’re still getting adequate amounts. Fortified plant-based milks and fortified whole-grain cereals can help on this front. Also, since this diet doesn’t eliminate animal foods entirely, you can still get important nutrients from them, and the truth is, by consuming more plants and adopting a flexitarian diet, you’ll boost your overall diet quality.

How much meat can I eat?

There aren’t any strict rules to follow, but in her book, Blatner offers some easy guidelines, depending on how much meat you’re currently eating. If you’re just starting out, Blatner suggests two meatless meals per week, however even when consuming meat, plant foods form the foundation of meals. Ultimately, “The Flexitarian Diet” book offers ideas on advancing the number of meatless meals you eat each week, but in truth, a flexitarian diet is by definition, flexible, so you don’t have to follow specific rules. Even if you don’t go meatless for a set number of meals, the idea is to eat smaller portions of animal-based meals, enjoy them less often, and make plant-based foods the center of your plate. With this philosophy, meat might be an accent or sized like a side dish rather than the main event.

Bring Your Fitness Resolution to Life

If home is where the heart is, your home gym is where you make sure your heart (and the rest of your body) is the absolute healthiest it can possibly be. Whether you have a big house with a separate room dedicated only to sweat sessions or you have to rearrange your studio furniture to be able to stretch out, you can get and stay fit at home. Home gyms can make it even easier on your schedule to squeeze in your training, but having the right gear can make all the difference. The Men’s Health team tested out dozens of products in all kinds of different spaces to pick out the best home gym gear for any and every type of setup and budget. Check out the list to find the best picks for your space—then get ready to get to work.

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Any gym worth its monthly membership fee has rows of cardio machines. Your home setup should have a solid station to work up a sweat and push your heart rate, too—but you only need to get the best of the best. You’ll never have to wait in line for a treadmill again. Click Read More for the best equipment.

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This gear is unmatched when it comes to building muscle. Whether you have a ton of square footage or just a tiny corner of your room, these options allow you to save space while using different implements for truly diverse workouts. Click Read More for the best equipment.

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Sick of living in the stone age with ancient fitness gear and sore muscles after your workouts? These gadgets and recovery tools will bring your space into the 21st century—and help you to get stronger with less discomfort.

Click Read More for dozens of items to make 2020 a year where your resolution falls to you.

Obesity in Middle Age Could Raise Odds for Alzheimer’s Later

Obesity in middle age is associated with an increased risk of dementia later in life, according to a study of more than 1 million women in the United Kingdom.

Those who were obese in their mid-50s had 21% greater risk of being diagnosed with dementia 15 or more years later, compared with women who had a healthy weight, a team of British and international researchers found.

The study adds to the “ever-expanding body of data that says what you do with yourself in midlife — and really even earlier — affects your risk for dementia as you age,” said Keith Fargo, director of scientific programs and outreach at the Alzheimer’s Association in Chicago. He was not part of the research.

For the study, the researchers followed about 1 out of every 4 women born in the United Kingdom between 1935 and 1950, more than 1.1 million overall. Their average age at the start of the study was 56. None had dementia.

At the outset, researchers calculated each woman’s body mass index (BMI), an estimate of body fat based on height and weight. They also asked about their diet and exercise. The women were followed for an average 18 years.

During that time, about 2.1% of obese women were diagnosed with dementia, compared to 1.6% of normal-weight women, the researchers found.

The study was published online Dec. 18 in the journal Neurology.

A lot of factors associated with obesity are bad for the brain, said Dr. Gayatri Devi, a neurologist and psychiatrist who specializes in memory disorders at Northwell Health in New York City.

These include high cholesterol, elevated levels of inflammation and increased stroke risk, said Devi, who was not involved with the study. Obese people tend to suffer poor sleep due to sleep apnea, and their brains struggle to get enough oxygen to function properly.

Fargo agreed.

“You’re essentially beating your brain up when you’re obese, because your brain requires a lot of oxygen and a lot of nutrients to function day-to-day and maintain structural integrity,” he said. “Anything that challenges the body’s ability to maintain the proper function and structure of the brain is going to increase your risk for developing cognitive decline as you age.”

The researchers also looked to see if physical inactivity or an inadequate low-calorie diet were linked to dementia. They found no significant associations.

Low calorie intake and inactivity were associated with higher dementia risk during the first 10 years of the study, but the link weakened in subsequent years until it became insignificant, the study found.

“Other studies have shown that people become inactive and lose weight up to a decade before they are diagnosed with dementia,” lead researcher Sarah Floud, of the University of Oxford, said in a journal news release. “The short-term links between dementia, inactivity and low calorie intake are likely to be the result of the earliest signs of the disease, before symptoms start to show.”

But Fargo said he doesn’t put much stock into those findings, given that the study was relatively short and the fact that diet and exercise are so closely linked with obesity.

“If you have obesity at 56, chances are your diet and physical activity pattern hasn’t been all that great for potentially decades at that point,” he said. “I think it’s a little difficult to disentangle the obesity story and the physical activity/diet story, especially given that they only measured physical activity and diet one time, right at the intake into the study. No one really knows what was happening with these individuals’ diet and physical activity levels in that intervening 15 to 20 years.”

It’s also impossible to tell from this study whether losing weight, eating right and exercising in middle age will reduce your later dementia risk, Fargo said. Ongoing clinical trials are expected to shed light on that question.

Devi, however, said she is “absolutely” convinced that an obese person who loses weight in midlife improves his or her chances of avoiding dementia.

“I think there is never not a good time to improve general physical and cardiovascular health, improve brain health and reduce risk for Alzheimer’s,” Devi said.

Why Your 2020 New Year’s Health or Fitness Resolution Might be Proven Outdated by 2030

But “getting healthier” isn’t a fixed concept. If health advice is anything, it’s fickle. While some concepts stand the test of time—eat fruits and vegetables, get plenty of sleep, exercise when you can—other trends are over practically as soon as they begin.

As a result, resolutioners of 2010 likely had different goals than will resolutioners of 2020. Here’s a look back at prominent health advice from 2010—and how it stands up going into 2020.

Nutrition

2010

The U.S. Department of Health and Human Services (HHS) published a new version of its federal Dietary Guidelines for Americans in December 2010. Among long-standing recommendations—such as eating a variety of fruits and vegetables and plenty of whole grains—the guidelines also advised Americans to limit saturated fats to 10% of caloric intake; increase low-fat dairy consumption; and limit cholesterol to 300 milligrams per day.

But, of course, federal dietary guidelines aren’t the arbiter of how people eat. Pop culture also plays a big part, and 2010 was a banner year for fad diets. Several of them, oddly enough, involved not eating solid food. Juicing was everywhere, and the “Baby Food Diet” hit the internet, encouraging followers to replace breakfast, lunch and snacks with container after container of baby food. Plenty of people chased all that juice and mush with apple cider vinegar, in hopes of aiding digestion and suppressing appetite, according to Insider.

2020

While nutrition science changed quite a bit throughout the decade, the next version of the Dietary Guidelines, published in December 2015 and meant to last until 2020, included relatively few significant changes. For the first time, HHS suggested a specific cap on added sugars (less than 10% of daily calories), reflecting the broader war on sugar that took hold in the 2010s, sparked by rising rates of obesity and diabetes and replacing the war on fat that took place in the 1980s and 90s.

Meanwhile, the guidelines eliminated its recommended cap on cholesterol, focusing instead on the need to avoid saturated and trans fats, while continuing to push for low-fat dairy—advice that was controversial in 2015, and has only become more so. As fat phobia fades further from memory, a number of studies have suggested that a fat-rich diet may actually prevent obesity and diabetes by balancing blood sugar and boosting satiety. In step with the resurgence of fat, the pendulum has swung from one dieting extreme (juice cleanses) to the other: meat-heavy meal plans like the ketogenic diet, which all but eliminates carbohydrates so that the body can shift to drawing its energy from fat.

But perhaps the most drastic change to take hold since 2010 is the way Americans think about dieting in the first place. The 2010s saw a major shift in the way people—and the media—talk about health, as emphasis on weight-loss and thinness began to give way (albeit not completely) to ideals of strength, holistic health and body positivity. As such, new measures of dieting success began to emerge, like “clean eating” (usually defined as eating whole foods instead of processed versions) and having a healthy gut microbiome. The broader self-care revolution has extended to food, leading many people to self-soothe conditions like anxiety and burnout with adaptogens, herbs thought to help the body fend off physical and emotional stress.

Alcohol

2010

As they had for years prior, the federal dietary guidelines in 2010 recommended that adults who drink do so in moderation—which, according to HHS, meant a drink or less per day for women, and two drinks or less per day for men.Some doctors even encouraged moderate drinking, especially red wine, for its anti-aging and heart-healthy properties.

2020

On paper, that recommendation stands going into 2020, but the conversation started to change in 2018 and 2019. Several prominent studies published in those years suggest that there is no safe amount of drinking, and that the heightened risk of conditions like cancer and obesity associated with alcohol outweigh any of its possible cardiovascular benefits. The self-care, mindfulness and wellness movements also converged to produce a shift away from heavy drinking, especially among millennials. Beverage makers responded in kind, rolling out a slew of non- or low-alcohol options, such as low-alcohol-by-volume craft beers and booze-free, botanical spirits. Seltzer also continues to reign supreme.

Fitness

2010

Exercise in 2010 was about roughing it. New books and studies brought paleo fitness (a primal fitness regimen that promotes moving like early man) and barefoot running into public consciousness, and ultra-intense bootcamp classes began working their way up the American College of Sports Medicine’s annual list of fitness trends for the first time. (On a lower-key note, yoga continued its ascent after being introduced to the U.S. decades earlier.) CrossFit, the notoriously intense workout program, was also well on its way to the full-fledged phenomenon it would become a few years later. The most recent federal physical activity guidelines at the time, published in 2008, seemed to support the more-exercise-is-better mindset. Though the guidelines did say all exercise is beneficial, it encouraged 150 minutes or more of weekly moderately-intense exercise in chunks of 10 minutes or longer.

2020

While boutique fitness studios peddling ultra-intense boxing, bootcamp, rowing, running and CrossFit workouts are still trendy, the research community has other ideas. Numerous studies have found that short bouts of physical activity, even at low intensity, can prolong lifespan and prevent chronic illness, in some cases just as well as more intense, longer-duration exercise. The latest update to the federal physical activity guidelines, in 2018, agree that any exercise is better than none, even if it’s just a few minutes at a time. Not coincidentally, studios meant for napping and meditation, along with yoga, began popping up in cities all over America in the last few years of the decade.

The New Way to Know if You Drink Too Much

There’s a new way to think about how much you drink, and whether that amount is working for you or not. 

“Some people think that everything’s OK as long as alcohol isn’t affecting relationships or finances, and that isn’t necessarily true,” says researcher Ashley Linden-Carmichael, Ph.D., in the department of Biobehaviorial Health at Penn State University. 

New thinking is that problem drinking falls along a wide spectrum, from not being able to get out of bed without a drink to hitting up way too many happy hours. For this and other reasons, scientists and addiction experts would like to abolish the term “alcoholic” and use the clumsier but more accurate “alcohol use disorder” now.

That’s because you can have an alcohol use disorder even if you’re not getting hammered every day. People who don’t know that there’s more than one type of overuse don’t get diagnosed or do anything about their drinking until they hit “rock bottom.” Since the disorder is a progressive condition that easily escalates, an early ID can save you a lot of trouble.

Plus, the term “alcoholic” is not only far from being descriptive, it actually conveys the wrong description: it’s loaded with shame and stigma. “It implies that the problem is the person, and that’s not the way we view it anymore,” says Andrew J. Saxon, M.D., chair of the American Psychiatric Association’s Council on Addiction Psychiatry. It’s like being “a diabetic” rather than a person with diabetes. The disorder isn’t who you are, it’s just a brain issue that’s happening to you…and to almost 10 million other men in the U.S., according to the National Institutes of Health. 

How Do You Know If You Have Trouble with Alcohol? 

To know if you’re on the alcohol use disorder spectrum, you can take an online quiz (like this one from the National Institute on Alcohol Abuse and Alcoholism). Because even a combination of drinking more when you said you’d have just one and needing more alcohol than you used to just to catch a buzz could indicate trouble. You don’t have to wake up in bed with a stranger wondering how you got there for alcohol to have its grips on you. 

If you’re not into quizzes (or are afraid to see the results), try this: Take a 30-day break from drinking. (Might as well do it in Dry January, when everyone else is doing it, too.) If you can’t do it, it’s a hint that you may want to rethink your relationship with alcohol.

Flu Season Is Off to an Earlier-than-Normal Start

Flu season in the U.S. is off to an early start—which means a virulent winter may be impending.

Influenza activity has been higher than normal for four weeks in a row, which many experts consider the official mark of flu season. As of the week ending Nov. 30, 3.5% of visits to health care providers nationwide were related to influenza-like illness, according to the U.S. Centers for Disease Control and Prevention (CDC). Already, the country has seen about 1.7 million cases of the flu, 16,000 flu-related hospitalizations and 910 flu-related deaths, the CDC says. Six children have died so far.

So far this year, flu activity has mainly been clustered in the south, with low prevalence in most northeast and mid-Atlantic states. Diagnoses are rising in the midwest and western regions.

The last time the flu arrived this early was the 2003-2004 season, which turned into a fairly severe one; at its peak, 10% of U.S. deaths were flu-related.

The strain of influenza causing most illnesses this year is also atypical for this part of the calendar. Influenza B, which typically circulates later in the season, has been responsible for about 70% of the positive influenza tests collected so far by the CDC.

It’s possible that the early flu season means either that fewer people got early-season vaccinations this year, or that the vaccine is less effective than normal. But the CDC says it’s too soon to say how well the shot is working, and emphasizes that there’s still plenty of time to get one, since flu season typically lasts several months. A flu shot remains the best way to prevent catching and spreading illness.

The 2018-2019 flu season was long but relatively mild, especially compared to the severe year that preceded it. It’s too soon to say how the 2019-2020 flu season will compare—but doctors are bracing for a bad one.

Why You Should Add Rest to Your Workout Routine

Most fitness advice urges people to squeeze in more workouts. That’s reasonable, considering government data show that only about a quarter of American adults meet the current guidelines for adequate physical activity: 150 minutes of moderate or 75 minutes of vigorous aerobic activity per week, plus two bouts of muscle-strengthening exercise.

Meeting these guidelines is important, since getting enough exercise can improve an individual’s physical and mental health. But when it comes to exercise, it is possible to have too much of a good thing. In fact, research suggests taking strategic time off from your workout routine can maximize the benefits of physical activity, and minimize the risks.

“Rest and recovery absolutely are necessary,” says Hunter Paris, an associate professor of sports medicine at Pepperdine University in California. “Fatigue, to a degree, is beneficial [because it signifies progress]. But there comes a point where fatigue can accumulate and overwhelm a bit.”

Studies back that up. One published in 2018 argues that there’s a “Goldilocks Zone” for exercise—that is, a sweet spot between getting too little physical activity (which is linked to a higher risk of heart disease and cancer, among other chronic illnesses) and too much (which, especially for middle-aged and older adults, can increase the risk for heart issues and premature death by placing too much strain on the body). The paper advises against doing more than four or five hours of vigorous exercise per week, and recommends at least one rest day.

Other research from 2017 suggests taking days off can protect against bone loss—which is of particular concern for women—and excess inflammation, a risk factor for many chronic diseases. Working out too much could even make you sick, one 2016 study suggests. In the small study, athletes who did intense workouts on back-to-back days saw a drop in proteins that help the immune system fight disease. Over-training also robs your muscles of the time they need to recover.

Paris hesitates to offer a one-size-fits-all prescription for rest. An Olympic-level athlete will have different recovery needs than someone who walks for exercise; similarly, some people might feel best when they take a full day off, while others may prefer active recovery (like stretching or lower-intensity exercise) to keep their momentum going. Rather than rigid rules, he says he recommends people take stock of how they’re feeling physically—things like fatigue, soreness and drops in performance—and mentally, and use that information to honestly decide whether more exercise will help or hurt. 

It’s also important, Paris says, to recover with intention. “It’s possible for one to rest and recover while exercising,” he says, “and certainly it’s possible for one to not be exercising and also not be resting and recovering.” Skipping a workout to wake up extra-early and run errands, for example, might not help an athlete regain energy, while trading a high-impact workout for yoga might help gym-goers return to their normal routine feeling loose and refreshed.

Serial exercisers who feel guilty or restless on days off may benefit from reframing how they define physical activity, Paris says. Numerous studies show that activities not traditionally thought of as “exercise”—such as walking, cleaning, gardening and taking the stairs—can help prolong a person’s lifespan and reduce their risk of chronic disease. “If you’ve only got 30 seconds or one minute to get up and walk to the water cooler, that counts, he says. “That matters.”

The link between insomnia and cardiovascular disease

Insomnia is a relatively widespread problem. When a person has insomnia, they often struggle to fall asleep or stay asleep. Some people experience both.

Around 1 in 4 adults in the United States experience short-term, or acute, insomnia every year, according to research carried out at the University of Pennsylvania, PA. Acute insomnia typically means that a person experiences sleep problems for just a short period, perhaps due to stress or worry.

Approximately three-quarters of these people return to their regular sleeping patterns. Others, however, go on to develop chronic insomnia.

Chronic insomnia refers to a person who experiences problems sleeping for at least 3 nights a week for no less than 3 months.

Both acute and chronic insomnia can result in daytime drowsiness, concentration and memory problems, and a lack of energy.

But studies have found more worrying links. One recent analysis, appearing in Sleep Medicine Reviews Trusted Source, linked insomnia to the onset of depression, anxiety, and alcohol misuse. Other studies have found a relationship between insomnia and heart disease.

Now, authors of a new study, published in Neurology, point out that previous research has failed to define insomnia correctly and has included people who may not have the disorder. So they set out to find a stronger association.

Tracking insomnia

The results of the new paper suggest that identifying insomnia, particularly in young people, may reduce cardiovascular disease risk later on in life.

The researchers used data from the China Kadoorie Biobank, which investigates and tracks the leading causes of chronic diseases in China.

The participants, aged between 30 and 79, had no history of heart disease or stroke when the study commenced.

In the new study, the researchers analyzed three symptoms of insomnia, where the symptoms lasted at least 3 days a week. The symptoms were: problems falling asleep or staying asleep, waking too early, or struggling to focus during the day because of disrupted sleep.

The data show that 11% of the participants reported trouble falling or staying asleep, and 10% had problems with waking up early. Only 2% of the participants reported having focusing issues during the day.

The researchers followed all of the volunteers for about a decade. During that time, they identified 130,032 incidences of heart attack, stroke, and comparable diseases.

A higher chance of cardiovascular disease

After taking into account other risk factors, such as smoking and alcohol consumption, researchers identified several significant findings.

The new study identified that the participants who reported experiencing all three insomnia symptoms had an 18% increased chance of developing cardiovascular diseases compared with those who did not experience the symptoms.

Those who reported trouble focusing during the day were 13% more likely to develop heart attack, stroke, and comparable diseases than people who did not have problems focusing.

Researchers identified that the people who found it difficult to fall asleep or stay asleep had a 9% higher chance of developing these diseases, while those who woke up too early were 7% more likely to experience a stroke, heart attack, or similar.

Avoid a Thanksgiving Food Coma This Year

No one ever said Thanksgiving dinner was healthy. But there are certain tricks to make it a little healthier—and to avoid riding out an uncomfortable turkey-and-stuffing-induced food coma on the couch for the rest of the night. Whether you’re doling out your own portions, or you’re at the mercy of Aunt Ida passing out plates piled high with “a little bit of everything,” these delicious ideas from nutrition and fitness experts will help you make the best possible choices (and feel great) this Thanksgiving Day.

Make it a three-meal day.

Wake up on Thanksgiving with the mindset that you’re having breakfast, lunch, and dinner that day, and you’ll be less likely to stuff yourself at the big meal, says Willow Jarosh, of C&J Nutrition. “I always eat breakfast and a snack early in the day,” she says. “We usually eat around 1 p.m., so our Thanksgiving meal is like lunch. I also always plan to eat dinner, which mentally sets me up to leave the main Thanksgiving meal satisfied but not stuffed, so that I’ll be hungry again by dinnertime.”

Go ahead—splurge (on your favorites).

If appetizers are your thing, grab a plate and fill up. No sense saving yourself for the main meal if turkey and trimmings leave you cold. “I tend to go overboard on the cheese and crackers beforehand,” says Emily Dingmann, of A Nutritionist Eats. “We always have an amazing cheese board and it’s one of my favorite foods.” To balance her pre-meal indulgence, Dingmann fills her dinner plate with a healthy one-quarter protein, one-quarter starches (including squash), and one-half vegetables. “I’m always in charge of a kale dish, because no one trusts a nutritionist to bring the dessert!” jokes Dingmann, who brings her Lemon Kale Salad every year. “It’s bright and acidic, and the perfect accompaniment to a heavy meal.”

Earn the bird.

“I love planning a family hike or walk before all the fun food makes its way to the table,” says Elisha Villanueva, founder of fitness and wellness site Flex It Pink. “I call it our ‘earn the bird’ activity.” Moving during the day makes Villanueva feel better about indulging in her favorite three desserts later on: “Pumpkin pie, pecan pie, and apple pie! I don’t want to miss out on anything, so a little trio sampler will do.” While you won’t burn off all the calories from the meal no matter how many rounds of front-lawn football or neighborhood laps you log, there are other benefits to being active. Exercising before the meal puts you in the positive mindset to eat with an eye toward health, and exercising afterward can help banish that uncomfortably full feeling.

Start with soup.

Pour yourself a bowl of seasonal veggie soup, suggests Katherine Tallmadge, RD, author of Diet Simple: 195 Mental Tricks, Substitutions, Habits & Inspirations. She recommends a butternut squash soup, or a broccoli and carrot soup with potatoes and thyme. Kicking off your meal with soup will help you slow down while eating, and research has shown it may help you avoid overdoing it at the main event.

Rethink how you get your flavor fix.

Fitness expert and ACE-certified health coach Jessica Matthews loves cranberries. What she does not love is all the sugar that goes into traditional cranberry sauce. So the assistant professor of health and science at Miramar College in San Diego found a way to get that sweet-tart punch onto her plate: “I can get the cranberry taste I love by adding cranberries into braised greens like kale or Swiss chard instead of eating them from a can,” she says. “That way I fill up on greens without excessive sugar, and still enjoy a favorite Thanksgiving flavor.”

Make smart swaps.

Let’s be honest: mashed potatoes’ appeal is more about the lush, smooth texture than any standout flavor. That—and the fact that they’re a perfect vehicle for gravy. So do what nutritionist Susan Dopart does, and serve pureed cauliflower instead. The cruciferous vegetable boasts six times the vitamin C, more than twice the fiber, and nearly twice the potassium of a standard spud. “And I actually think mashed cauliflower is tastier,” Dopart says. She also makes a veggie- and whole grain-rich mushroom, squash, and wild rice dressing instead of a traditional bread stuffing.

Deep sleep may help treat anxiety

Furthermore, the new study suggests that the deep phase of sleep is a natural anxiety reliever.

These are the main takeaways of a paper appearing in the journal Nature Human BehaviourTrusted Source.

Matthew Walker, a professor of neuroscience and psychology at the University of California (UC), Berkeley, is the senior author of the new study.

Prof. Walker and colleagues set out to examine the effects of various stages of sleep on anxiety in 18 participants.

Scientists routinely divide sleep into two broad categories — rapid eye movement (REM) and non-REM sleep — and four substages.

The first two stages of non-REM sleep are periods of light sleep in which the body adjusts from wakefulness to rest.

According to the National Institutes of Health (NIH), the third stage of non-REM sleep is the deep, restorative sleep that we need to feel recharged in the morning. Non-REM sleep is typically followed by REM sleep, which is the dream filled, lighter stage before waking.

These different sleep stages reflect differently in the brain’s activity. By measuring brain activity, Prof. Walker and the team determined the effects of various sleep stages on anxiety.

Deep sleep protects against anxiety

To measure anxiety levels, the researchers asked a group of 18 young adults to watch emotionally unsettling videos after a full night of sleep and after a sleepless night.

After each viewing, the participants completed a standard anxiety questionnaire called the state-trait anxiety inventory.

The scientists used functional MRI and polysomnography to scan the brains of the sleeping participants in order to identify the stages of sleep.

The brain scans showed that a brain area called the medial prefrontal cortex was deactivated after a sleepless night. Previous studies have suggested that this brain area attenuates anxiety and stress.

The scans also revealed excessive brain activity in other regions associated with processing emotions. A sleepless night raised anxiety levels by up to 30%, report the authors.

“Without sleep,” Prof. Walker explains, “it’s almost as if the brain is too heavy on the emotional accelerator pedal, without enough brake.”

Furthermore, the study found that anxiety levels plummeted after a full night of sleep and that this reduction was even more significant in people who spent more time in the deep, slow-wave, non-REM stage of sleep.

“Deep sleep had restored the brain’s prefrontal mechanism that regulates our emotions, lowering emotional and physiological reactivity and preventing the escalation of anxiety,” reports Eti Ben Simon, a postdoctoral fellow at the Center for Human Sleep Science at UC Berkeley and the study’s lead author.

Sleep as a clinical recommendation

The researchers sought to replicate their findings, so they conducted another set of experiments in a larger sample, of 30 participants, as well as an online survey, of 280 people.

The lab experiments confirmed that people who experienced more deep sleep at night had the least anxiety the following day. The online survey confirmed that the amount and quality of sleep that people got reliably predicted their anxiety levels the following day.

The study’s lead author also suggests that good sleep should be a clinical recommendation for treating anxiety.

“People with anxiety disorders routinely report having disturbed sleep, but rarely is sleep improvement considered as a clinical recommendation for lowering anxiety,” she says.

“Our study not only establishes a causal connection between sleep and anxiety, but it identifies the kind of deep [non-]REM sleep we need to calm the overanxious brain.” 

Eti Ben Simon, Ph.D.

The study’s senior author also comments on the findings, saying, “We have identified a new function of deep sleep, one that decreases anxiety overnight by reorganizing connections in the brain.”

“Deep sleep seems to be a natural anxiolytic (anxiety inhibitor), so long as we get it each and every night,” concludes Prof. Walker.

These Foods Will Help You Live Longer

Newsflash: Eating more plants is good for you. Though this may not be mind-blowing information, a recent study published in the Journal of the American Heart Associationprovides new evidence on just how beneficial plant-forward diets can be. We all know that eating fruits and veggies is a good idea, but this study focused on how a plant-based diet affects mortality and heart health. The researchers also investigated how vegetarian diets can help reduce heart problems. Long story short: Cutting out animal proteins and replacing them with fruits and vegetables can make a big difference in your overall health.

The study analyzed a large swath of health data going back decades. Starting in 1987, 15,792 American men and women between the ages of 45 and 64 were enrolled in a study to measure the risk of atherosclerosis (fat and cholesterol buildup in the walls of arteries) in different communities. They were actively monitored for two years. This new study culls data from follow-up visits with these subjects, which occurred six times between 1989 and 2017.

The subjects self-assessed; at baseline and on their third visit (from 1993 to 1995), they filled out questionnaires concerning their food intake. Incident cardiovascular disease events—including heart disease, heart attacks, strokes, and atherosclerosis—were reported via annual telephone calls, hospital records, and death records. None of the participants had cardiovascular disease at the beginning of the study.

New Study Finds Researchers analyzed participants’ diets and scored them according to four different scoring indexes: overall plant-based, healthy plant-based, less healthy plant-based, and provegetarian. Each index varied in the kinds of foods it assessed. The overall plant-based index was the most comprehensive, and included plant-based food sources that are high in refined carbohydrates, like fruit juices and desserts. The provegetarian index was the simplest because it did not include these food sources. By using these scoring methods, the researchers could take the self-reported food intake data from the participants’ questionnaires and use it to determine if they followed a plant-based diet.

After 25 years of logging data, the researchers took stock. Among the pool of subjects, there had been 4,381 incident cardiovascular disease events (such as heart attacks or strokes), 1,565 deaths caused by cardiovascular disease, and 5,436 deaths not directly caused by cardiovascular disease (called “all-cause” deaths). Researchers found that incidence rates for these events and for mortality as a whole were lower among healthy plant-based, overall plant-based, and provegetarian dieters. After adjusting for risks like smoking and alcohol consumption and other factors, the researchers found that adhering to “diets that are higher in plant foods and lower in animal foods” led to “a lower risk of incident cardiovascular disease, cardiovascular disease mortality, and all-cause mortality.”

Put simply, the more the participants shunned animal proteins, the more their mortality rate and rate of cardiovascular issues dropped. The study showed that higher intakes of “whole grains, fruits, vegetables, nuts, legumes, tea, and coffee” consistently lowered the risk of cardiovascular issues and helped people live longer. Elsewhere, “higher intakes of eggs and red and processed meat were associated with a higher risk” of those outcomes, the researchers write. They didn’t find any significant association with dairy, fish, and seafood—but don’t interpret that as an excuse to run out and grab a Filet O’ Fish.

The plant-forward diets have a number of effects that curb cardiovascular disease, the researchers write. Eating more fruits and vegetables and skipping animal proteins helps lower blood pressure, cuts down cholesterol, reduces inflammation, and assists in regulating blood sugar. All of these factors help your heart and blood vessels stay healthy.So if you’re looking to live longer and keep your body in shape, go with a salad—or even go vegan.

Why you should care about your core

Whether you refer to it as a spare tire, a muffin top, or love handles, having a roll of fat around your waist is pretty common. But even if you’re not overweight, a bulging midriff may raise your risk of heart disease.

Despite the many ads that tout “one simple trick” to lose belly fat, there’s no getting around it: whittling down your waistline takes a bit of effort. One important step is strengthening your core, which includes the muscles in your abdomen, back, sides, pelvis, and buttocks. However, a strong core is only part of the picture.

“You can’t lose belly fat by exercising only your abdominal muscles,” says Clare Safran-Norton, clinical supervisor of rehabilitation services at Harvard-affiliated Brigham and Women’s Hospital. To lose fat anywhere on your body, you need a combination of aerobic exercise and strength training, plus a healthy, portion-controlled eating plan, she says.

Why focus on your core?

All forms of exercise help burn calories, aiding weight loss. But including core-strengthening exercises in your workout is important for several reasons. First, many sports and other athletic pursuits are powered by a strong core, including golfing, tennis and other racquet sports, biking, running, swimming, baseball, volleyball, kayaking, and rowing. Developing core muscle strength may make your exercise stints more effective — and maybe even more enjoyable.

Second, having a strong core helps improve balance, which lowers your risk of falling. It may also prevent other injuries, such as muscle strain or spasms in the lower back. Well-developed core muscles help stabilize your spine, helping to create a firm base of support for virtually all movement, including everyday moves like reaching up to a shelf or wiping up a spill on the floor. In addition, without a strong core, your leg muscles may not function in an optimal position, which often puts undue stress on the hips and knees. These common back and leg aches and pains often derail regular exercise routines, which are important for a healthy heart. Finally, core conditioning improves posture, which contributes to a trimmer appearance.

Core competence

The best exercises for your core target several groups of muscles at a time, such as the plank, which builds muscles in the abdomen, back, and side. Although traditional planks are done on the floor, you can do an easier version using a desk or table (see “Plank on table”). Safran-Norton also suggests doing simple abdominal contraction exercises and opposite arm and leg raises, pictured below.

As always, it’s a good idea to check with your doctor beforehand to address any physical limitations or other health concerns before trying new exercises. For more information and many more core exercises, see the Harvard Health Publishing Special Health Report Gentle Core Exercises.

Click Read More for a few simple exercises you can add into your day.

Chronic pain is a huge problem nationwide.

Nearly 20 million of those people have high-impact chronic pain , which is persistent and affects a person’s ability to carry out day-to-day activities, resulting in a lower quality of life. Chronic pain is also frequently associated with a higher prevalence of mood disorders such as depression and anxiety.

Though pain is nearly universal — almost everyone will deal with a bout of serious pain in a lifetime — chronic pain can be challenging to treat. “When you look at the landscape of society, the number one reason people go to the doctor is because something hurts,” says Yury Khelemsky, an anesthesiologist and associate professor at Icahn School of Medicine at Mount Sinai. Many of these patients have “underlying issues that can be corrected,” Khelemsky says. “For instance, if you have abdominal pain and gallstones, you can take the gallbladder out, and it gets better.” That is called acute pain, and it usually resolves within six months. 

Another group of people have what Khelemsky calls “vague” pain — when the source is unclear — that lasts more than six months. “Perhaps chronic muscle, joint, back or knee pain,” he says. It could be pain that continues after an illness has ended or an injury has healed, or it could involve conditions such as fibromyalgia, arthritis, neuropathy, back problems or irritable bowel syndrome. “Among this group, with some, we know what it is, and we can kind of fix it; some, we really can’t fix it, or the treatments don’t fix it a good proportion of the time. We see that much more often in our profession,” Khelemsky says. “There just isn’t a good permanent solution.” 

This is chronic pain, and treating it requires more than the occasional appointment and prescription for medication or therapy. In recognition of that fact, the medical community is turning to other approaches, including increasing patient support and education and improving overall wellness, perhaps with alternative treatments. 

Increased support 

One factor researchers are looking at is continued care outside office visits. A pilot study published in the Clinical Journal of Pain examined the impact of supportive text messages with guidance and encouragement, such as, “Make plans to spend time with a friend or family member today by phone or video chat,” or, “You are in control of your health and happiness. Don’t let the small setbacks you experience discourage you.” The researchers found these texts reduced patients’ perception of their pain and decreased the extent to which it hindered their day-to-day life. 

A  2019 study of 294 chronic pain patients examined how other out-of-office treatments might improve pain symptoms, as well as mood-related conditions such as depression and anxiety. In the research, the first group of patients were put on a Web-based self-management program with modules about coping with pain, pain medications, communicating with providers, cognitive strategies and more; the patients did regular self-reporting of symptoms and got reminders to complete their modules. 

The second group was treated with the Web-based self-management program, but the patients were also monitored by a nurse who would contact them to add and adjust medications for pain and facilitate mental-health referrals for depression and anxiety, according to study lead researcher Kurt Kroenke, professor of medicine at Indiana University and a research scientist at Regenstrief Institute. “The nurse had weekly care management meetings with the supervising physician to develop treatment plans for new patients as well as those who were not responding adequately to their current treatment regimens,” he says. 

The results of continued care were promising. “Both groups had moderate improvement in their pain and mood symptoms, and the improvement was superior what has historically been seen in primary care studies where the control arm simply received ‘usual primary care,’ ” Kroenke says. “The patient group that additionally received telecare from the nurse-physician team had further improvement beyond that experienced by the group that only received online self-management.”

More providers and health systems are implementing digital methods of care, such as patient portals, so patients can reach their physicians to communicate progress. Using technology to bolster treatment and educate patients could prove especially helpful for those who have chronic conditions. 

Kroenke says it’s critical that patients with pain receive more than a single appointment with a doctor during a busy day. “All single treatments have, on average, modest effects in reducing pain, which means that changing, adjusting or combining treatments is often necessary to optimize outcomes,” he says. That means “following up at regular intervals to monitor and adjust treatment.”

Richard W. Rosenquist, chairman of the department of pain management at the Cleveland Clinic, believes patients with chronic pain benefit from attending organized programs run by a variety of medical specialists to keep up with treatment and self-care options. “We have a program at Cleveland Clinic called Back on TREK ,” he says. “It’s a chronic back pain program with psychologists, physical therapists, spine specialists and other physicians involved. Part of chronic-pain healing is the shared experience; people with back pain find out they’re not alone in the world — there are other people with the same problem.” 

Many of these programs exist across the country for other conditions. For instance, Dan Clauw, director of the Chronic Pain & Fatigue Research Clinic at the University of Michigan, holds regular seminars about living with and managing fibromyalgia. 

There’s promising research that patient education may relieve pain symptoms or improve physical functioning. In a study of people with low-back pain, receiving one-on-one counseling with a physiotherapist increased their ability to do a forward bend and straight leg raise. There’s also evidence that public education on chronic pain, through means such as social media and education classes, can help people avoid risk factors and advocate for family members who are experiencing pain. 

Boosting overall wellness 

Another factor in managing and preventing chronic pain is overall wellness. “The first thing is to stay physically fit and physically active,” Khelemsky says. “If I could change one thing [it would be that] everyone would eat a proper diet and do some type of physical activity where you’re using your muscles. It’s not just good for the physical body, but it’s good for the emotional state, as well.”

Maintaining a healthy weight can also help long term so you are not stressing your joints. “You have to think of the downstream effect of the pain,” Khelemsky says, noting that people tend to experience more of it as they get older. “If people set themselves up to deal with pain better, disability and suffering decreases.” 

There are also more doctors and hospitals with integrative programs, such as the Duke University Medical Center, the University of California at San Francisco and the Mayo Clinic. This approach considers nontraditional therapies such as yoga, acupuncture, meditation and more as part of a holistic approach to treatment. 

“In our wellness institute, we have an integrative pain program that involves using tai chi, diet changes, therapy and other lifestyle changes,” Rosenquist says. “We have a Functional Medicine Center led by Dr. Mark Hyman, which focuses on improving access to care, looking at the role of psychology, the diet and exercise in treating chronic pain.

“All of these contribute to reducing overall levels of pain and are things that are actually important when looking at a long-term view,” Rosenquist says.” If you’re smoking, overweight or sedentary, the likelihood of good long-term outlook goes down. It’s important to talk about the lifestyle change.”

Functional medicine physicians may look through a different lens than your primary care physician. Yeral Patel, a family medicine physician and integrative specialist in Newport Beach, Calif., says she sees lots of patients for chronic pain syndromes, injury recovery, back and neck pain, and carpal tunnel. “Functional medicine doctors try to dig deeper and look at the root causes of the pain,” Patel says. “We try to identify the possible causes of inflammation, such as gut dysfunction, micronutrient deficiency, insulin resistance and inflammatory markers.” 

After taking an extensive history and doing a battery of tests to look at smaller contributing factors that might be preventing recovery, you’ll get an integrative plan “that utilizes nutrition, exercise and diet, supplements, and mediation for stress management,” Patel says. 

24 Ways to Help You Become Happier, Healthier, and More Fit Today

Managing a household of little kids is a full-time occupation: Wake, wash, dress, feed, repeat. With all that needs to be done, finding time to take care of your own physical and psychological wellness can feel impossible. These quick and easy wellness tips can help you help yourself.

1. Commit to 27 minutes of daily mindfulness. That’s the amount researchers found resulted in measurable changes in the gray matter of people’s brains, increasing density in areas responsible for feelings of compassion and decreasing it in areas related to stress and anxiety. You don’t have to practice mindfulness for 30 minutes straight — sit quietly and contemplate your breathing for 10 minutes in the morning and a few more at night.

2. Walk in the woods. One study shows that a 20-minute stroll through your local park can lower your heart rate and blood pressure, and increase the feeling of happiness. Scientists have found that natural environments activate our parasympathetic nervous system (feelings of relaxation) while suppressing the sympathetic system (fight-or-flight feelings). If the park is too far, consider filling your favorite reading nook with more plants.

3. Add turmeric to your cooking. You might know it as the spice that turns curry dishes yellow, but turmeric also helps with life’s ills. To wit: Studies have found it to be a powerful anti-inflammatory (good for sore muscles), antioxidant (can help you feel and look younger), and a protector against heart disease. Whew.

4. Sprinkle lavender essential oil on your pillow. Just a drop or two can help induce a sense of calm.

5. Set up a relaxation zone in your home. It’s important to have a stress-free space in your life, so make sure there’s a comfortable, distraction-free space in your home where you can exercise, nap, and relax.

6. Limit blue light before bed. If you’re checking texts and email right up until lights out, you’re setting yourself up for a lousy night of sleep — and not necessarily because you’re stressing about work. The blue light emitted by your tech devices sends signals to your brain that inhibit the production of melatonin, a chemical that makes you feel drowsy. Put away your phone and laptop an hour before bed to help your night be a restful one.

7. Carve out your own space. Contrary to what early 21st-century architects thought, it turns out that open seating plans can inhibit productivity. Workers in open offices spend an undue amount of time making phone calls from stairwells and empty conference rooms instead of sitting at their desks, research shows. Find yourself a little piece of personal space at work or home where you can take a minute for yourself to just breathe.

8. Build the perfect breakfast bowl. Oats + walnuts + berries + cinnamon + milk = Awesome way to start your day.

9. Do the plank. Planks are an essential, effective workouts move, if you do them right: Start lying face-down on the floor, torso propped up on your elbows. Engaging your core, raise your body up onto your forearms and toes, making sure your body forms one long line from shoulders to feet. Hold this position as long as you can, working your way up to 90 seconds.

10. Manage your money. Money worries are one of the biggest sources of stress for parents. Saving for college, home mortgages, and big-ticket items like a new family car can cause serious angst. Create a priority list with your partner of purchases you want to make this year, then figure out how much of the household budget you’ll need to set aside each week to help you reach your goal. While you’re at it, make sure your credit card works harder for you.

Click Read More for 14 additional tips.

Omega-3 fish oil rises to top

People who received omega-3 fish oil supplements in randomized clinical trials had lower risks of heart attack and other cardiovascular disease (CVD) events than those who were given placebo, according to a new meta-analysis from Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital.

Researchers found an association between daily omega-3 supplementation and reduced risk of most CVD outcomes, including heart attack, death from coronary heart disease, and death from CVD, but did not see benefit for stroke. In addition, higher doses of omega-3 fish oil supplements appeared to provide even greater risk reduction.

The study was published today online in the Journal of the American Heart Association.

“This meta-analysis provides the most up-to-date evidence regarding the effects of omega-3 supplementation on risk of multiple CVD outcomes. We found significant protective effects of daily omega-3 supplementation against most CVD outcome risks, and the associations appeared to be in a dose-response manner,” said first author Yang Hu, a postdoctoral research fellow in the Department of Nutrition at Harvard Chan School.

While observational studies have shown an association between fish consumption and lower heart disease risk, results from randomized controlled trials have been inconsistent. Two reviews published last year did not find clear evidence for benefit.

In this new analysis, the researchers did an updated meta-analysis that included three recently completed large-scale trials, which increased the sample size by 64 percent. The total population analyzed by Hu and colleagues included more than 120,000 adults in 13 randomized trials worldwide. The analysis included the VITAL trial, the largest randomized trial of omega-3s to date.

The findings showed that people who took daily omega-3 fish oil supplements, compared with those who took a placebo, lowered their risk for most CVD outcomes except stroke, including an 8 percent reduced risk for heart attack and death from coronary heart disease (CHD). The association was particularly evident at higher doses of omega-3 fish oil supplementation. This finding may suggest that marine omega-3 supplementation dosage above the 840 mg/day used in most randomized clinical trials may provide greater reductions in CVD risk. Given that several million people experience these CVD events worldwide each year, even small reductions in risk can translate into hundreds of thousands of heart attacks and CVD deaths avoided, according to the researchers.

“Although public health recommendations should focus on increasing fish consumption, having an overall heart-healthy diet, being physically active, and having other healthy lifestyle practices, this study suggests that omega-3 supplementation may have a role in appropriate patients,” said senior author JoAnn Manson, chief of the Division of Preventive Medicine at Brigham and Women’s Hospital and professor in the Department of Epidemiology at Harvard Chan School. Manson is also the director of the large-scale VITAL trial.

Other Harvard Chan School authors included Frank Hu.

Struggling to Get Back Into a Workout Routine?

Between work commitments, family obligations and social events, it may seem daunting — and downright impossible — to add anything else to your plate. As a result, people tend to sacrifice the one thing they might enjoy doing the least — exercise. 

Perhaps it started with a busy week, and then one week turned into two and then before you knew it, you hadn’t visited the gym in a series of months. Whatever the culprit, there are ways to pull yourself out of a workout rut and create a lasting routine.

Here, health and wellness experts provide five strategies that will get you back on track. 

Find your motivation, then talk to a doctor 

The thing about fitness is, you have to want it for yourself. Finding the motivation to get back to the gym and get healthy must come from within, says Jonathan Leary, founder of Remedy Place, a social wellness club. And it’s not just about finding the motivation, but about having the right kind of motivation to get in shape. Forget external motivators like looking nice in an outfit and dig a little deeper, Leary says.

“Too often people focus on the common [motivators] in terms of weight, or they have a health scare, or they want it for someone else,” says Cedric Bryant, president and chief science officer at the American Council on Exercise. “You have to start examining why. Ask, ‘why do I want to make, this switch?’ It really has to be focused on things that are really meaningful for you as the individual and finding your right why.” 

Once you figure out why you want to get healthy, your first stop shouldn’t be at the gym. Rather, it should be at your doctor’s office, according to Karen Litzy, a physical therapist and spokesperson for the American Physical Therapy Association. 

“It’s a good idea to see your physician or your physical therapist before going back to the gym,” she says. Your doctor will likely perform a quick evaluation of where you’re at in terms of strength, flexibility and cardiovascular health, she adds. In doing so, a doctor can ensure you’re healthy enough for physical activity and can guide you on how to remain safe at the gym. 

“It’s a reassurance that everything is okay,” she says. “Getting that physical evaluation and allowing people to feel strong in their bodies is the first step.” 

Take your time getting back into a routine

Just a short amount of time off from the gym can undo some of the health gains you’ve made, according to Bryant. 

“A week of full inactivity is going to cause some detriment in your physical performance,” he says. A 2015 study published in the Journal of Rehabilitation Medicine, for example, found that taking a break from physical activity for just two weeks can result in a rather substantial reduction of muscle strength and mass — and it can take even longer to gain it back.

In other words, if you were diligent about your routine a month or two ago, don’t expect to hop back into it right away like nothing has changed. Instead, health professionals suggest taking it one step at a time. “When reentering the gym, remember the point is to fix the body, not break it,” says Leary. “Really analyze each type of workout because some of them could increase your risk for injury.” 

It’s about taking a metered approach, experts suggest, starting with just a few minutes a day of cardio, then working up to longer workouts, incorporating weights and even hiring a health coach or personal trainer. Ultimately, a healthy adult should be working their way toward 150 minutes of exercise a week, according to the Department of Health and Human Services.

Don’t change everything at once

When getting back into a fitness routine, you may be tempted to overhaul your eating habits, too. Oftentimes, people tend to fixate on making too many changes at once, says Bryant. Instead, “focus on one thing at a time,” he says. “Focus on just trying to re-establish an activity habit. The reason why I tell people to focus on how they feel is that too often people are focused on the wrong metric.”

Just like those metered workouts, health professionals suggest slowly changing your nutrition patterns over time so you don’t feel overwhelmed and then give up out of frustration. But if you do want to make some changes to your diet, Leary says to start adding more water to your daily routine to ensure you’re hydrated as a first step. 

“The more active you are, the more you sweat,” he says, so replenishing your water levels will ensure your body isn’t depleted of key minerals, and in turn, can help you recover faster. 

Take a holistic approach to your workouts 

Rather than logging a certain number of miles and then calling it a day, it’s crucial to start thinking about your workouts holistically — that includes your cool down, stretching and recovery, too, experts say. 

“You want to be functional and pain-free,” Leary says. “Unless you are a professional athlete who has to be strong and powerful, your number one focus should be mobility and flexibility.”

A recovery routine is vital, says Leary. That should include daily stretching and adequate cool down time after workouts. And, if you can, try to incorporate regular massages or an occasional visit to a physical therapist to ensure every part of your body is working just the way it should, he adds. These tactics will help mitigate injury risk, so you won’t have to take weeks off from your workout routine again.

Redefine what exercise means 

Perhaps the best news of all: you don’t necessarily have to join a gym or spend hours a day running outside to get a good workout. Rather, you can do it all in the comfort of your own home. 

“Let’s say your schedule is packed, and you’ve got family responsibilities. Just find something you can do for five or 10 minutes,” says Bryant. “That’ll help reduce the amount of workout decline that you may experience.”

There are simple ways to start thinking outside the box when it comes to workouts, according to Bryant. 

“Look into how you can incorporate more activity into your normal day,” he says, suggesting to avoid taking elevators and escalators when possible, and trying to log as many steps as you can each day. It could also be as simple as getting up and walking to a coworker’s desk to chat instead of sending them an email, or taking a five-minute break to stretch your legs, he adds.

“Think in terms of incorporating activity into your family life too,” Bryant suggests, whether that’s doing squats with your relatives during the commercials of television shows, taking family walks, or playing soccer with your kids rather than sitting on the sidelines. “Try to make moving your new mission,” he says.

Hearing Aids Can Reduce Depression and Dementia Risk

Hearing aids can improve a person’s ability to hear — plus, they may reduce the risk of dementia, depression, and falls, a University of Michigan study found.

Older adults who are newly diagnosed with hearing loss and use hearing aids have a lower risk for getting a diagnosis of dementia, depression, or anxiety for the first 3 years. 

They also have a decreased chance of experiencing fall-related injuries compared to those who don’t use hearing aids, according to the study in the Journal of the American Geriatrics Society.

About 40 million Americans have some type of hearing loss, the Centers for Disease Control and Prevention reports.

This isn’t the first piece of research to confirm health benefits associated with hearing aid use. 

That said, there’s no evidence of a causal link between hearing aid use and preventing these health conditions. 

“Older people with hearing loss who wear hearing aids may be better educated or may socialize more, factors which are also associated with a reduced risk of dementia,” said Dr. David Loughrey, a research psychologist specializing in hearing and cognition. 

Of those with a diagnosis of hearing loss, only 12 percent of people under 69 use hearing aids. Even if they have insurance to cover all or some of the cost, most people don’t use the devices. 

Understanding hearing aid users

The study found gaps among who will use hearing aids based on gender, ethnicity, and location.

Researchers used data from nearly 115,000 people over the age of 66 who had hearing loss and insurance coverage through a large, private insurance company between 2008 and 2016. 

The team tracked participants 1 year before their diagnosis and 3 years after. 

Men with hearing loss were more likely to get a hearing aid. In fact, 13.3 percent of men got hearing aids, while 11.3 percent of women did the same. 

And 6.5 percent of people with Latino heritage got a hearing aid, while 9.8 percent of African Americans and 13.6 percent of white people did the same.

According to location, almost 37 percent of people with hearing loss who used hearing aids lived in the north-central part of the country, compared to 5.9 percent of people in the mountain states.

The risk of getting a dementia diagnosis (including Alzheimer’s disease) within 3 years of a hearing loss diagnosis was 18 percent lower in those using hearing aids. 

The risk of getting a diagnosis of depression or anxiety by the end of 3 years was 11 percent lower for hearing aid users, while the chance of being treated for fall-related injuries was 13 percent lower.

People with hearing loss had significantly higher rates of dementia, depression, and fall injuries compared to the general population.

“We already know that people with hearing loss have more adverse health events and more coexisting conditions, but this study allows us to see the effects of an intervention and look for associations between hearing aids and health outcomes,” Dr. Elham Mahmoudi, a health economist and lead author, said in a statement.

The researchers plan to continue studying the population to assess future outcomes.

Hearing hardships

Multiple studies have reported that age-related hearing loss is associated with changes in the brain, Loughrey says. 

Loss of stimulation may lead to parts of the brain responsible for memory or regulating mood becoming less active and inefficient. 

There’s also evidence that the brain undergoes changes after hearing loss to compensate and to help maintain understanding of speech. 

“Difficulties in following conversation in noisy environments may cause adults with hearing loss to withdraw and become more socially isolated, which is associated with a higher risk of depression and dementia,” Loughrey said.

Hearing aids make sounds louder, which forces damaged cells in the ear to relay the sounds to the brain in a way that couldn’t happen without the hearing aid, says Dr. Kelly Tremblay, a professor of speech and hearing sciences at the University of Washington.

“Physically this is good, because it keeps the brain stimulated and neural networks flowing,” Tremblay explained. 

Some research points to a loss of neurons in the brainstem and cortex following hearing loss, but the medical community doesn’t fully understand all of the mechanisms involved.

“When we are born with normal hearing, the brain develops over a lifetime using sound as part of its neural networks,” Tremblay said. “When we lose our sense of sound, the networks we once used don’t get activated. And, if we don’t use them, we lose them.”

“Lack of hearing can definitely be isolating if one cannot follow what is being said around them,” agreed Nancy Gilston, Au.D., an audiologist at the New York Eye and Ear Infirmary of Mount Sinai.

Not all hearing issues are the same. Some people may benefit from amplification, while others with impaired cochleas still don’t hear clearly with sound amplification, Gilston says. 

“Some people with hearing loss are not necessarily [needing] hearing aids, as they may need other intervention, such as a cochlear implant,” added Dr. Asri Maharani, a researcher at The University of Manchester.

Hearing aid hesitation

The high cost of hearing aids may deter some people from getting them, but Gilston says it’s a wise investment. 

“Patients perceive hearing aids as a sign of aging, and they are resistant to address their symptoms simply because they are fearful of how it will look to the outside world,” Gilston said. 

“By hearing what is being said, you bring less attention to yourself than by asking for endless repetition,” she said.

Preventing falls

The American Academy of Audiology recently presented recommendations to a U.S. Senate committee, urging it to give Medicare beneficiaries direct access to audiologist services. 

They referenced research from Johns Hopkins University School of Medicine that found people with untreated mild hearing loss were nearly three times more likely to have a history of falling.

In 2016, approximately 3 million older adults went to the emergency room as a result of a fall. Fall-related injuries in older adults cost about $50 billion annually, the committee noted.

Next year, over-the-counter hearing aids approved by the Food and Drug Administration will be available to treat those with mild to moderate hearing loss. This could make hearing aids more accessible, and therefore result in more users.

Though it’s hard to think insurers will cover the cost, Gilston says insurers should consider the welfare of their patients’ ability to be more successful in daily activities as an incentive to retain more patients.

“Less expensive hearing aids and mobile hearing technology are emerging in the marketplace, so the hope is that more people will have access to affordable hearing help,” Tremblay added.

New “Veggie” Burgers Storm the Market.

If you’re looking for a vegetarian burger instead of a beef-based burger, you’re in luck these days. Two popular options include the Impossible Burger, in over 5,000 restaurants in the United States, Hong Kong, Macao, and Singapore, and the Beyond Burger, available at more than 35,000 locations, including the meat aisles in supermarkets.

These burgers are the makings of food chemistry at its finest, and include ingredients that attempt to mimic the flavor, aroma and even the “bleeding” color of meat. (One of the Impossible Burger’s ingredients is a genetically modified version of heme, an iron-containing molecule from soy plants, like the heme from animals — which is what gives it its uniquely meaty flavor, according to the company’s website).

But though these plant-based burgers are certainly a healthy option for the environment, you might be wondering: are they any better for your body than regular beef burgers?

An analysis of ‘alternative meat’ nutrition

As a nutritionist, I would say this: If you enjoy the taste of these faux meat burgers, and part of your food philosophy includes vegetarianism or eating to sustain the environment, then by all means, you should feel free to enjoy an Impossible Burger or Beyond Burger. 

But if you are choosing to eat these burgers solely for their health value, you may want to reconsider.

For example, the Impossible Burger has 240 calories, and 8 grams of saturated fat, thanks to coconut oil. By comparison, an 80% lean beef burger has 280 calories and 9 grams of saturated fat. That’s not a whole lot of difference. (The plant burgers are cholesterol free, however).

The Beyond Burger has less saturated fat than the beef or Impossible Burger (6 grams), but a similar calorie count, with 250 calories per patty. But a turkey burger has only 4 to 5 grams of saturated fat, and 220 to 240 calories, depending on the brand. And a grain-based veggie burger that’s not attempting to mimic meat has only 150 to 160 calories, and only about 1 gram of saturated fat, and is therefore healthiest overall from a fat standpoint. What’s more, depending on the brand, these burgers are made with real veggies, like onions, carrots, mushrooms, zucchini, green and red bell peppers, quinoa and brown rice.

The protein content of the burgers is similar as well; the Impossible Burger has 19 grams of protein from soy and the Beyond Burger has 20 grams, from peas. The beef and turkey burgers each have about 19 to 21 grams of protein, depending on the brand. But the grain-based veggie burgers are lowest, with only 9 grams of protein. 

The faux meat burgers also rank higher in sodium than the beef and turkey burgers, with the Impossible Burger containing 370 milligrams of sodium, and the Beyond Burger containing 390 milligrams. The beef patty contains only 65 to 75 milligrams of sodium, depending on the brand, and the turkey burger has 95 to 115 milligrams. The grain patties have over 400 milligrams, however, thanks to salt as an ingredient. At least one does have double the fiber — 6 grams — compared to the faux meat burgers, though.

Personally, if I want a plant-based burger, I want a really delicious veggie patty — not one with fake “blood,” but one that is comprised of real vegetables and tastes totally different from a burger made from meat. Like LT Burger’s veggie burger, which has beets, brown rice, red pepper, quinoa, black beans and jalapeño, and topped with wheatgrass, tomato, onion, avocado and sprouts. 

So I would say if you’re going to savor these meat-mimicking burgers, then it’s a win-win, because you’re contributing to the well-being of the planet while enjoying what you eat. But if you’re eating these burgers simply in the name of saving calories, or sodium, or saturated fat, you might want to rethink your decision.

Heart attack risk higher in those who sleep too little or too much

New research tracks sleep duration and a person’s risk of a heart attack.

In a recent Journal of the American College of Cardiology paper, scientists from the United States and the United Kingdom describe how they analyzed sleep habits and medical records of 461,347 people aged 40–69 years living in the U.K.

The data, which came from the UK Biobank, included self-reports of how many hours participants habitually slept per night and health records covering 7 years. It also included results of tests for risk genes.

The analysis revealed that those who slept less than 6 hours per night had a 20% higher risk of a first heart attack in comparison to those who slept 6–9 hours. Those who slept more than 9 hours had a 34% higher risk.

The researchers also found that keeping sleep duration to 6–9 hours per night can reduce the risk of a first heart attack by 18% in those people with a “high genetic liability” for developing heart disease.

“This [study],” says senior study author Celine Vetter, Ph.D., an assistant professor of integrative physiology at the University of Colorado at Boulder, “provides some of the strongest proof yet that sleep duration is a key factor when it comes to heart health — and this holds true for everyone.”

Sleep duration is an independent risk factor

Studies have been finding links between sleep habits and heart health for some time now. However, most of those findings have come from observational studies: these studies that can only confirm links but cannot establish the direction of cause and effect.

Because many factors affect both sleep and heart health, it is not easy to determine whether poor sleep makes for poor heart health or poor heart health leads to poor sleep.Regular sleep schedule likely benefits metabolic healthPeople who keep to the same bedtime and waking time are less likely to develop obesity, high blood pressure, and high cholesterol, study finds.READ NOW

Vetter and her colleagues sought to meet this challenge by using data from a vast number of individuals, combining it with genetic research, and ruling out dozens of potential influencing factors.

Altogether, they adjusted the results to remove the potential effect of 30 factors that can influence both heart health and sleep. These factors include physical activity, mental health, income, education, smoking, and body composition.

The researchers’ results showed that sleep duration was an independent risk factor for heart attack.

The researchers found that the risk of heart attack increased the further that people’s habitual night sleep diverged from 6–9 hours.

Individuals who slept 5 hours each night, for example, had a 52% higher risk of a first heart attack than those who slept 7–8 hours. Individuals who slept 10 hours per night had double the risk.

Sleep is key to heart health

According to the Centers for Disease Control and Prevention (CDC), more than one-third of adults in the U.S. sleep less than the recommended 7 hours per night.

The CDC recommend the following tips for good sleep:

  • Go to bed and rise at the same time every day, even at the weekend.
  • Get enough natural light — especially earlier in the day.
  • Avoid exposure to artificial light, particularly in the hours up to bedtime.
  • Get enough daily exercise and avoid exercising near bedtime.
  • Avoid eating and drinking in the hours before bedtime — especially alcohol and high fat and sugar-rich foods.
  • If difficulties persist, seek medical advice to help identify obstacles to sleep, including other health conditions.

The latest research team hopes that its findings will raise awareness among doctors, the public, and policymakers about the impact of sleep on heart health.

“It’s kind of a hopeful message,” says first study author Iyas Daghlas, who is studying medicine at Harvard Medical School in Boston, MA, “that regardless of what your inherited risk for heart attack is, sleeping a healthy amount may cut that risk just like eating a health[ful] diet, not smoking, and other lifestyle approaches can.”

“Just as working out and eating health[fully] can reduce your risk of heart disease, sleep can too.”

Celine Vetter, Ph.D.

Deaths from heart disease and conditions are on the rise

Death rates in the United States due to cardiometabolic diseases — heart disease, stroke, diabetes and high blood pressure — have either plateaued or climbed in recent years, new research reveals.The rates of death from those health conditions were declining but then hit a concerning inflection point in 2010, and either remained unchanged or increased thereafter, according to research published in the medical journal JAMA on Tuesday.

“We are losing ground in the battle against cardiovascular disease. Understanding what is contributing to these alarming trends may help direct specific strategies for prevention,” said Dr. Sadiya Khan, an assistant professor of cardiology at Northwestern University’s Feinberg School of Medicine in Chicago, who was the senior author of the research.

“Even more alarming are the persistent disparities with higher death rates among black Americans compared with white Americans,” Khan said. The research found that black adults consistently had higher cardiometabolic-related death rates than white adults, and black men had the highest rates.

“We need to reduce deaths from cardiometabolic diseases and we need to find strategies to reduce disparities,” she said.

Separately, in a written statement on Tuesday, Khan pointed out how the majority of the cardiometabolic deaths are preventable.

“Our findings make it clear that we are losing ground in the battle against cardiovascular disease,” she said in the statement. “We need to shift our focus as a nation toward prevention to achieve our goal of living longer, healthier and free of cardiovascular disease.”

The new research involved analyzing data from death certificates in the US Centers for Disease Control and Prevention’s WONDER database. The death certificates dated from 1999 to 2017.

The data showed that in 1999, total deaths by cause were 725,192 from heart disease, 167,366 from stroke, 68,399 from diabetes, and 16,968 from hypertension.

In 2017, total deaths by cause were 647,457 from heart disease, 146,383 from stroke, 83,564 from diabetes, and 35,316 from hypertension, the data showed.

From 1999 to 2017, 12.3% of fatal cardiometabolic events occurred in black individuals and 85.1% in white individuals, and 51.3% occurred in women, the data showed.

The researchers also found that the death rate for heart disease declined between 1999 and 2010 — and during those years there were 8.3 fewer deaths per 100,000 people annually versus the years following 2010.

The death rates also were going down for stroke and diabetes before 2010 but did not significantly change between that year and 2017, the data showed.

As for hypertension or high blood pressure, there was an inflection point in 2003 and the death rate tied to that condition increased less rapidly thereafter, the researchers found.

The best workout for every travel scenario, according to the experts

How you focus on fitness within the routine of life at home doesn’t always translate well to the reality of travel. You’re out of your element on the road, faced with new stresses and responsibilities, away from your usual gear, running route, classes or gym membership. Even if you can do it when you’re traveling for work or for fun, tackling your home workout might not make the most sense on your trip.

To help you pick the best workout for every travel situation, we interviewed fitness experts on which types of exercises to turn to.

The best exercise when you get off a long flight 

Long flights — or long bus, car and train rides — are terrible on your body. You’re stuck in a sedentary position for hours. Our experts point to mobility training to reset your spine after being crammed so awkwardly on a flight.

“Travel is one of the most beautiful parts of life but also just feels so detrimental to your body,” says Kirsty Godso, Nike Master Trainer. “Do something like [mat or tower] Pilates, where you’re really rolling your spine and mobilizing. Taking away a lot of that tightness in the hips that you feel from sitting on a flight is a great way to do it.”

Chris Perrin recommends doing a short workout to get you moving and functional again.

“The best thing to do is a dynamic stretch to stretch out the hip flexors and get the spine moving,” says the co-owner and operator of the sports conditioning gym Cut Seven, in Washington.

Try a reverse lunge with a spine rotation to stretch your hip flexor and get your back moving. Perrin recommends moving until you start to feel relief, and feel more loose. That time frame may depend on the length of your flight, drive or ride.

And before you start any post-flight workout, grab some water.

“That’s critical,” says Janine Delaney, a psychologist and fitness influencer. “If your joints are dehydrated, you’re not going to help them move as well. So you want to definitely hydrate.”

The best workout to fight jet lag 

When you’ve jumped across time zones and your body is feeling weary, a workout can ease the pain. If your goal is to stay awake and push through a jet-lagged morning or afternoon, go big.

“You should shock your body and wake it up,” Perrin says. “Do something super intense as hard as you can, and your body essentially won’t know what hit it. You’re fully awake afterwards, and it won’t matter what time of day it is; you’ll feel that your heart rate will be raised.” 

Perrin recommends 30 to 45 minutes high-intensity interval training (HIIT) with active rest built into your time. Work hard for 30 seconds with moves like burpees to get your heart rate up, then spend 45 seconds to a minute doing things like push-ups, squats and curls (if you have access to weights) to keep your blood moving.

The best workout in between big vacation meals

You’re in Italy going to town on every incredible pasta, gelato and Barolo opportunity that comes your way. Although your heart may be full, your body may feel horrible. Exercise could be the answer to your bloated woes; at the very least, it could ready you to eat again later.

“Most people are going to want to be sedentary, but it’s good to get up and start moving,” Delaney says. “Avoid doing anything too intense. The last thing you want to do is make yourself nauseous.” 

In between meals, Delaney recommends spending 30 to 45 minutes doing yoga, walking in the pool or light weight training. Perrin is also on the weight-training train.

“What you want is to go slow and work out with a heavy weight,” he says. “You may want to start with upper body, because doing things lower body — those kind of body movements may upset your stomach.” 

The best workout when you only have 15 or 20 minutes to spare 

A travel workout doesn’t have to be long. It’s about quality, not quantity.

“A big deterrent for people is they think a workout has to be super long,” Delaney says. “If you can find time to work out, even doing 20 minutes a day is amazing.”

When you don’t have a ton of time to spare on your trip, Delaney recommends grabbing a jump rope. It’s one of her favorite workouts at home and on the road.

“Aside from the convenience that you can do it anywhere and the affordability, it is the best overall conditioning exercise,” she says. “You get cardio, you get upper body training. It’s also a great endorphin release.” 

If you’re new to jumping rope, Delaney stresses the importance of moving just your wrists (vs. your arms), and not trying to jump super high. When shopping for the right rope, make sure you pick one that’s the appropriate length for your height.

For Godso, Tabata HIIT training (a type of high-intensity interval training) and EMOM (or every minute on the minute) workouts are best for crushing 10- to 15-minute openings.

“You can really fry yourself in 15 minutes,” she says. “Pick a few drills, or keep it so simple, and do two exercises.” 

Try tackling Godso’s signature “hot sauce” burpees (or one of its many variations) coupled with something like mountain climbers, or following a workout from the Nike Training Club app.

The best workout when you don’t have access to a gym 

Hotel gyms are a luxury. Not every hotel has one, and not every person stays at a hotel when they travel. But there’s plenty to do without weights and cardio equipment to get a good workout in.

“I would take it back to basics,” Perrin says. “Do a one-minute plank. Ten push ups, then a one minute wall sit, then 10 squat jumps. One minute of crunches and 10 reverse lunges each leg. You don’t need a ton of room. You don’t need any equipment.” 

Take your workout outside, when possible. Go for a run around town.

“I hate running, and I’m very open about it,” Godso says. “But when I travel to Europe and I go places like Paris, it’s such a gorgeous city to run around and a great way to see all of the monuments.”

The best workout before your flight home 

When the party’s over and you have to fly, drive or take the train home, squeeze a workout in beforehand to save your body a little transportation-related pain. Because your gluteus maximus muscles will be dormant for a while, Perrin suggests focusing on exercises that will fire up those glutes ahead of time.

“After you get off the plane, you’re going to be less sore,” Perrin says.

Before a big flight, Godso prefers well-rounded hybrid exercises, like combining boxing with strength training. She tries to find exercises that will activate her glutes and core before locking in for a sedentary flight.

“I love to do a bit of a combination between strength and HIIT. That is my ideal,” Godso says. “Everyone is different, but what you want to do is get your body moving. You definitely want to sweat.”

The best workout when you don’t want to work out 

Don’t feel like it when you’re on vacation? Then don’t bother.

“I never work out on vacation. My wife always works out on vacation. Everyone is different,” Perrin says. “Do whatever you want to do, and don’t feel bad. Get rid of the ‘I need to work out’ mentality.” 

Godso stresses that being on vacation is about being happy — not beating yourself up over missed gym time or indulgent foods.

“Your body isn’t going to remember if you have two meals off script,” she says. “It’s about mental relaxation.” 

The experts’ advice is a little different for the business traveler, though. Road warriors can struggle to create or maintain a workout routine in a routine-less life. When you’re really struggling to overcome the urge to flop down on the hotel bed, but you still want to get a sweat session in, Perrin suggests going in with low expectations.

“All [business travelers] need to do is move,” Perrin says. “Plan to walk into the gym and do your favorite exercises. It doesn’t have to be heavy, doesn’t have to be your best workout. Continue the habit of moving.”

The “Secret” to Successful Weight Loss

Apologies if this sounds like some kind of gimmicky pitch, but I lost 40 pounds and kept them off—and you can too!

I never expected to be writing those words. Like many adults, however, I saw my weight creep up over the years, until eventually, about three years ago, I was tipping the scale at an unhealthy 208 pounds. My doctor informed me that I was 25 pounds over the high end of my healthy weight range, setting myself up for serious health issues going forward. Clearly, I had to do something.

Rather than turn to the latest popular diet, I decided to take a reason-based approach. That is, instead of following the dictates of some trendy diet prescription—”eat this, don’t eat that,” etc.—I tried to understand the subject in a more holistic way. Why had my weight crept up over the years? What should I be eating? I looked at the established facts surrounding weight control and healthy eating, and tried to apply rational thinking to my situation. No fads, no miracle diets. The result was not a quick fix to deliver temporary weight loss, but changes in thinking about food and diet that resulted in sensible lifestyle adjustments.

That was in early 2017. Almost immediately I started losing weight slowly but steadily, a couple of pounds or so per week at first, a bit slower as time went on, until I leveled out six months later at about 170. I’ve hovered around that weight for the last two years, weighing in this morning at 168. 

I realize that this kind of weight loss—40 pounds—is far from miraculous. Yet I frequently see others struggle to lose weight, and I’m often asked about my “secret.” For those who may be interested, here’s a rundown on the thinking and actions that I applied:

Calories in, calories out. A well-balanced diet requires lots of careful consideration, but the narrow science of weight loss is fairly straightforward: You simply need to burn more calories than you consume. Absent a medical condition that is causing weight gain or obstructing weight loss, the “secret” to losing weight is to live a lifestyle that has you ingest fewer calories than you burn.

It’s diet, not exercise. Exercise burns calories, and there’s no question that exercise is important to overall health, but it’s not the key to losing weight. A two-mile jog might burn about 200 calories—fewer calories than one bagel. If you are seriously overweight, it would take an enormous amount of jogging to burn away all those excess pounds. From a practical standpoint, the effective way to shed calories is at the point of entry: Develop good eating habits. Exercise for your health, but look at your diet to address weight loss.

“Discipline” isn’t the solution. Psychologically, if you are convincing yourself that “discipline” will be your means of eating well, you might be setting yourself up for failure. A “discipline” mindset suggests that there is something truly desirable that we can resist only with great effort. Discipline is imposed on us by authority figures, or we impose it on ourselves. As such, we can sometimes be disciplined for a period of time, but eventually we tire of it and we break down and return to our undisciplined ways. Therefore, don’t psych yourself up to be disciplined—instead, approach food with an attitude of being informed and intelligent, and having a sincere desire to develop healthy eating habits for life.

Recognize the obstacles to good habits. While good habits are more effective than discipline in leading to long-term dietary success, it’s nevertheless important to recognize the obstacles we face, biologically and culturally, in developing those good habits. Some of the major ones include:

  • We are wired to overeat. We are the product of millions of years of evolution, and we carry the same genes that helped our ancestors survive in the wild amidst famines and droughts. Those genes, unfortunately for us, encouraged our ancestors to gorge. We, like our forebears going back millennia, carry a natural biological impulse to pack on calories when they become available. When you sit on the sofa and inhale a bag of potato chips or box or crackers, licking your lips to enjoy every last grain of salt, you are only doing what kept your ancestors alive in an environment of scarcity. The overeating impulse had survival value in such conditions, but it’s important to understand that the impulse is truly dangerous in a society that makes caloric overload possible on a daily basis.
  • The double-edged sword of abundance. If obesity is partly the result of our success as a society in making food abundant despite our natural inclination to overeat, that problem is magnified by the nature of our economic system, which makes poor-quality foods such as processed foods with added sugars, salts, and preservatives the most readily available and heavily marketed. We should admire our success as a society in making food abundant, but it’s important to recognize our individual responsibility to consume the good stuff and not the junk.

Next steps. Armed with this knowledge, I considered my specific situation and analyzed my typical daily diet. What I found is that I had several bad habits that were causing me to ingest too many calories almost every day. I was actually pretty good most of the day, but my dinners were generally too excessive. Worse yet, I also had a bad habit of continuing my high-calorie eating with unhealthy snacks after dinner. Looking even closer, I found that most (but definitely not all) of my excessive calories tended to be carbohydrates—cereals and breads at breakfast and lunch; piles of rice, potatoes, pasta, and more breads at dinner; and sugary and salty processed snacks. If you’re seriously interested in weight loss, a similar honest assessment of your own typical diet is a must, for this will help you see where your problems lie.

After the assessment, I made a simple decision to alter my diet to eat less and to eat healthier. This latter point meant fewer low-quality sugars, starches, processed foods and fried foods, and more fruits, vegetables, nuts and seeds. It also meant that, despite carbs being a bigger caloric problem than proteins, I should cut back on meat consumption as well. Though I didn’t feel that I was in a position to go completely vegetarian, I did make a conscious decision to eat less meat (and no red meat or processed meats). Fish and chicken are the meats of choice.

A typical day will start with a cup of black coffee upon waking, then a small glass of juice with a multivitamin before I head out the door. Maybe a handful of raisins too. I have breakfast itself—two or three pieces of fruit (always rotating the types)—when I get to the office. This will often carry me right through the morning without another thought being given to food. I’ll usually have a some water nearby, which tends to satisfy any small pang of hunger I might experience during the morning. And if I still get hungry before lunch, I have a stash of almonds and other assorted nuts and seeds (never salted) nearby to snack on, always delicious in the late morning and effective in keeping the appetite under control. 

For lunch, my favorite is nothing exotic—a peanut butter sandwich on whole grain bread, with a glass of either cashew, almond, or low-fat dairy milk. I’ll also enjoy another handful or two of raisins, and this normally carries me through the day. Again, if a pang of hunger hits during the afternoon, it is easily assuaged with some water and some nuts and seeds. Nothing fancy, but healthy and satisfying.

Dinner can vary quite a bit, but fish, good salads, and plenty of vegetables are common. A little rice, potatoes, or pasta is fine, but the portions must be kept small, and absolutely no seconds on those. Seconds on veggies and salads, however, are always good. Meatless meals, such as eggplant dishes or vegetarian burgers or sausages, can be great when done right. 

If you eat well all day, you can even enjoy a snack before bedtime—a small sandwich, a Greek yogurt, or maybe even a scoop or two of ice cream or a few crackers with cheese or hummus. Your body can handle the snack without gaining weight because your caloric intake has not exceeded what you’ve burned, especially if you’ve been active during the day. (And you should be active, not so much for weight-loss reasons, but for your health.)

Things to keep in mind. When you really start analyzing your food intake, you come to better understand your cravings. One thing I learned is that it really doesn’t take much to satisfy hunger. Small portions are usually enough, because if we are mindful of our cravings and take appropriate steps, huge quantities of food at the dinner table and elsewhere are not needed to extinguish hunger. If we step away after just modest eating and focus on activities that take our minds away from food, we find ourselves quite satisfied and not at all hungry. 

For this reason, habits such as keeping your original portions modest in size, and keeping pans that are filled with additional servings off the table and out of reach, will help you avoid overeating. Also, when you’ve finished eating your original portion, get up right away and do something else. Start doing the dishes and talk to your family from the dishwasher. Dinner conversations can continue, but you aren’t heaping more food onto your plate and into your mouth.

Another thing that you will likely discover in monitoring your eating habits is that excess calories are often consumed for comfort in times of boredom. For this reason, having activities to engage yourself can be important. Coaching a softball team might not actually burn many calories, but it gets you out of the house and away from the refrigerator. The same with a book club or any just about any other activity. If you do find yourself sitting in front of the TV, remember the healthy snacks—fruits, vegetables, and nuts are fantastic—and avoid the bowl of chips or sweets.  

Throughout this process, and perpetually into the future, you will be more likely to stay on track if you remember that you are not on some fad diet, but that you have rationally assessed your lifestyle and made permanent adjustments based on sound evidence. You understand yourself, your biology, your psychology, and your culture, and you have intelligently addressed a key health issue—your choices about food intake. Sure, you may still have occasional days when you eat poorly, because our culture will almost inevitably make that happen from time to time, but you will not “fall off the wagon” and return to your old habits. You will lose weight, you’ll feel better about yourself, and you’ll keep it off.

All of this, of course, assumes otherwise good health, and it’s always smart to discuss dietary issues with your doctor before embarking on any course that will radically change your habits. But recognizing the importance of your thinking and your habits is the first step to making real, permanent changes that can greatly improve your health and your life. If you are taking these steps, I wish you success and I invite you to share your story with me.

How Do Brain Health and Heart Health Go Hand in Hand?

Dementia is a progressive disease caused by multiple factors that begin developing over a lengthy preclinical period—that could be 15 to 20 years long—before dementia symptoms appear. Unfortunately, most studies only assess dementia risk factors later in life and don’t examine the harbingers of cognitive decline during the decades leading up to potentially debilitating dementia.

The latest study led by Séverine Sabia is noteworthy because it examines the association between cardiovascular health and dementia risk in 7,899 British men and women during midlife and over the next 25 years. Sabia is a research associate from the Department of Epidemiology and Public Health at University College London (UCL) and the Université de Paris.

For this study, Sabia, along with senior author Archana Singh-Manoux and colleagues, examined cardiovascular health scores during midlife based on The American Heart Association’s Life’s Simple 7 guidelines in relation to cognitive decline and dementia later in life.

The AHA describes Life’s Simple 7 as “the seven risk factors people can improve through lifestyle changes that help achieve ideal cardiovascular health.” Although these guidelines were initially designed for the prevention of cardiovascular disease (CVD), they are increasingly being viewed as having dementia-preventing potential.

Life’s Simple 7  is broken down into four behavioral metrics (physical activity, diet, smoking, body mass index) and three biological metrics (blood pressure, blood cholesterol, fasting glucose). Rating scores are categorized as “poor” (scores 0-6), “intermediate” (7-11), and “optimal” (12-14) cardiovascular health.

Of note, each incremental movement towards “optimal” on the 14-point cardiovascular health scale during midlife was associated with a similar reduction in the risk of dementia later in life. Higher cardiovascular health scores at age 50 were also correlated with higher gray matter brain volumes two decades later.

“Reductions in risk of dementia were evident across the continuum of the cardiovascular health score, suggesting that even small improvements in cardiovascular risk factors are likely to be beneficial for cognitive health,” Sabia and coauthors write. “Our results showing cardiovascular health assessed at age 50 to be associated with dementia and brain volume 20 years later are in agreement with previous studies based on shorter follow-up. These results highlight the importance of the cardiovascular health score in promoting brain health at older ages.”

After taking potentially influential factors into account, the researchers conclude that adherence to Life’s Simple 7 cardiovascular health recommendations in midlife is associated with a lower risk of dementia later in life.

What’s the best time of day to exercise, morning or evening?

Does it make a difference? Several recent studies suggest that it does. But it’s complicated.

One recent paper indicates that morning exercise may activate certain genes in the muscle cells, boosting their ability to metabolize sugar and fat. While scientists say this finding requires further study, they think it ultimately might help those who are overweight or suffering from Type 2 diabetes.

An evening workout, on the other hand, uses less oxygen, making workouts more efficient and improving athletic performance, potentially a boon for serious competitors.

“Human exercise performance is better in the evening compared to the morning, as [athletes] consume less oxygen, that is, they use less energy, for the same intensity of exercise in the evening versus the morning,” said Gad Asher, a researcher in the Weizmann Institute of Science’s department of biomolecular sciences, and author of one of the studies.

“It means, for example, if a person needs to go for a run, he will reach exhaustion earlier in the morning compared to the evening,” Asher said. “In other words, he will be able to run for a longer duration in the evening compared to the morning under the same running conditions.”

So which is the better time to exercise — morning or evening?

It depends on your goals.

Elite and otherwise serious athletes — marathon runners, basketball and soccer players seeking a competitive edge, for example — might choose evenings to train or compete. Similarly, those who schedule important sports events might consider holding them at night to ensure optimal performances. (Not to mention that this also would probably be more compatible for TV coverage.)

“If you wish to break the world record, or your personal time, I assume [evenings would be better],” Asher says.

Those who worry more about their weight and controlling their blood sugar — and less about shaving a minute or two from their marathon time — might go for mornings, when post-workout cell responses that influence metabolism are much stronger.

Jonas Thue Treebak, associate professor at the Novo Nordisk Foundation’s Center for Basic Metabolic Research at the University of Copenhagen and co-author of a third study, agrees.

“At this point, we can only conclude that the effects of the two appear to differ, and we certainly have to do more work,” he says.

Moreover, there are other things beyond performance and weight loss to take into account.

“Exercising late at night may interfere with sleep as it tends to energize you and enhance alertness, although some people like to exercise at the end of the day to help relieve the stresses of the day and prepare for evening activities, which is fine,” says Edward R. Laskowski, co-director of the Mayo Clinic Sports Medicine and professor in the department of physical medicine and rehabilitation. “Morning exercise has the advantage that no matter what else happens during the day, you have incorporated your physical activity. It also increases alertness and helps cognitive functioning.”

Millions of people take a daily aspirin for heart health. They might not need to

About 29 million people 40 and older took an aspirin a day in 2017 despite not having heart disease, according to a study by Harvard University and Beth Israel Deaconess Medical Center that was published Monday.

The study found about 6.6 million of those people used aspirin even though a doctor never recommended it to them. Nearly 10 million people older than 70 who didn’t have heart disease took daily aspirin for prevention, the researchers reported in Annals of Internal Medicine.

Multiple, extensive studies last year found that only a marginal benefit, if any, could be found from routine aspirin use – especially among older adults. 

A study published this year in the journal JAMA Neurology found that taking low-dose aspirin is associated with an increased risk for bleeding within the skull for people without heart disease. 

The studies run counter to what doctors had recommended for decades: taking 75 to 100 milligrams of aspirin daily to prevent strokes or heart attacks.

“Many patients are confused about this,” said Colin O’Brien, a senior intern medicine resident at Beth Israel who led the most recent study. 

The studies prompted the American Heart Association and American College of Cardiology to change their guidelines in March:

  • People over 70 who don’t have heart disease – or are younger but at increased risk of bleeding – should avoid daily aspirin for prevention.
  • Only certain 40- to 70-year-olds who don’t have heart disease are at high enough risk to warrant 75 to 100 milligrams of aspirin daily, and that’s for a doctor to decide.

Cutting Calories May Improve Your Health

The latest study, published July 11 in the Lancet Diabetes & Endocrinology, suggests that cutting just 300 calories a day, while maintaining an otherwise healthy diet, can significantly improve cholesterol, blood pressure and blood sugar levels, potentially reducing the risk of developing chronic diseases like diabetes and heart disease in the future.

The study was small but rigorous. Researchers asked 218 healthy, non-obese adults ages 21 to 50 to go through a range of medical tests. At the beginning of the study, most people were eating around 2,400 calories per day, according to self-reported food logs.

After baseline testing, almost 150 participants were for a month put on a regimented diet that reduced their normal calorie intake by 25%, while the rest acted as a control group. People in the diet group ate three meals per day at a study center and received nutrition counseling, while people in the control group continued their normal diets and did not receive any counseling. After the first month, the groups were told to maintain these eating patterns on their own for two years, while undergoing periodic health testing.

People in the calorie-restriction group didn’t follow directions perfectly—only 82% of them completed the full study and, on average, they maintained a calorie reduction of about 12% over the two years, rather than 25%. But the researchers found that even that drop, which translated to about 200-300 fewer calories per day compared to baseline, was associated with “persistent and significant” improvements in cholesterol, blood pressure, blood sugar markers and overall metabolic health, all of which are associated with a lower risk of chronic disease. Individuals in the control group didn’t see the same benefits.

Participants in the diet group also lost about 10% of their body weight on average. But the authors write that the cardiometabolic improvements observed in the study were “over and above” what could be expected from that amount of weight loss, suggesting there’s something uniquely beneficial about modest calorie restriction.

There’s a growing movement to shift away from calorie counting as a measure of health, and instead focus on the overall quality of the diet. One recent study, for example, showed that highly processed meals can affect the body differently than unprocessed meals with a nearly identical nutrient profile, which points to the difficulty of assessing a diet based on numbers alone. There are likely also mental health and lifestyle benefits associated with so-called “intuitive eating,” versus rigid calorie counting.

But at the same time, quite a few studies suggest that calorie moderation may be associated with health benefits beyond weight loss. A 2016 study, for example, found that slashing calories was associated with improvements in mood, sexual function and overall health. Studies in rhesus monkeys have found links between calorie restriction and longevity, and intermittent fasting—alternating calorie restriction with normal eating—has been linked to improved weight loss and lower chronic disease risk.

Extreme calorie restriction is dangerous, and any substantive dietary change should be discussed with an expert. But for most people, it’s relatively easy to cut 200 or 300 calories per day without a drastic change, or any obsessive monitoring.

Federal data also shows that snacks make up almost a quarter of the calories consumed by Americans each day. Since snack foods tend to be processed and packed with additives like salt and sugar, eliminating or improving the quality of snacks is a good target for a modest calorie reduction.

Sitting Is Bad for Your Health

The countless recent studies and articles about the health risks of a sedentary lifestyle likely haven’t sat well with desk workers, for whom standing desks and walking meetings are some of the only ways to avoid near-constant sitting during the workday.

But a new study published in the Journal of the American Heart Association has some encouraging findings for the desk-bound. Sitting at work, it says, may not be as bad for your heart and longevity as sitting and watching television during your free time.

“There’s been a lot of talk about how sitting is the new smoking,” says first author Jeanette Garcia, an assistant professor of sport and exercise science at the University of Central Florida. “But is all sitting created equal? The results from our study suggest that, no, perhaps it’s leisure-time sitting that’s more of a risk than occupational sitting.”

For the study, almost 3,600 African American adults reported the amount of time they’d spent sitting at work, watching television and exercising over the previous year. They also provided demographic, lifestyle and health-history information. The researchers monitored the participants’ health over eight years, during which 129 had a cardiovascular issue and 205 died.

After adjusting for health and lifestyle factors, the researchers found that “often or always” sitting at work was not associated with a heightened risk of death and heart disease. But those watching four or more hours of television per day had a 50% higher risk of heart issues and death, compared to those watching two hours or less per day.

The study only involved African American adults, who report disproportionately high rates of cardiovascular issues, but Garcia says the results likely apply to other populations too. Demographic factors did play a role in the study, though—namely with regards to the type of person who has a desk job versus a more active job. Compared to those who rarely sat at work, people in the study with sedentary jobs were more likely to exercise outside the office regularly, have a high school degree, make more money and eat a healthy diet; they were also less likely to drink heavily and smoke. Previous studies have also suggested that the physical strain associated with active jobs may shorten workers’ lifespans.

Exercise outside of work, on the other hand, is nearly always good for health. And people who spend a good chunk of their free time watching television likely do so at the expense of exercising, Garcia notes, which research has shown can mediate some of the harmful effects of a sedentary lifestyle. In the new study, for example, those who got at least 150 minutes of moderate or vigorous physical activity per week had a lower risk of health problems, even if they also watched a lot of TV. A separate recent study also found that replacing just 30 minutes of daily sitting with any other activity reduced mortality risk by 17%.

Vegging in front of the TV may also inspire other unhealthy habits, Garcia says. “Leisure-time sitting and television-viewing is usually linked with other behaviors, such as snacking” or consuming alcohol, she says. “Or if you’re watching television late at night that could disrupt sleep patterns, which is also linked with cardiovascular disease.”

65 Easy 4th of July Recipes for Exceedingly Chill Vibes

The 4th of July is about spending time outside, day drinking (if you’re of age), swimming (if you’re lucky), and an all-around lazy time in the best way possible. So you shouldn’t have to work too hard for the food. These 65 easy 4th of July recipes celebrate the best of summer, but you can still throw together them without holing up in the kitchen all day.

Party Steak with Grilled Scallion Salsa Verde

Skirt steak is our favorite choice when grilling for a crowd for two reasons: it feeds many and cooks in a jiffy. VIEW RECIPE

Potato Salad with Old Bay and Potato Chips

VIEW RECIPE

Grilled Corn Salad with Hot Honey–Lime Dressing

Bright and light, this grilled corn salad with avocado will go with everything else at your summer barbecue. VIEW RECIPE

Grilled Pork Chops with Pineapple-Turmeric Glaze

The sugars in this glaze caramelize the pork chops, resulting in deep, complex flavor.VIEW RECIPE

The Basically Burger

It’s all about that special sauce.VIEW RECIPE

Click Read more for the full list of recipes!

Poor sleep may hinder weight loss

According to data that the National Institute of Diabetes and Digestive and Kidney Diseases have cited, in the United States, more than one in three adults are overweight.

The same is true for obesity — more than one in three U.S. adults live with this condition, which can predispose them to other health problems, including diabetes and heart disease.

An unhealthy weight, however, is not the only problem that threatens the well-being of people in the U.S. and elsewhere. Lack of good quality sleep also causes problems for people around the world.

Although adults need at least 7 hours of uninterrupted sleep per night to feel rested, many individuals are unable to achieve this ideal. Statistics show that in the U.S. alone, in 2017, as many as 36% of surveyed respondents did not feel rested upon waking up in the morning, which suggests that they were not getting enough — or good enough — sleep.

Insufficient sleep, recent studies argue, may affect circulation, aspects of memory, and even our social relationships.

Now, a study that features in the International Journal of Obesity has found a link between insufficient or disrupted sleep and another issue — weight loss. The results showed that overweight people who did not sleep well lost less weight than their peers who had no sleep problems.

The research comes from the Human Nutrition Unit of the Rovira i Virgili University in Tarragona, Spain, and other collaborating institutions.

Good sleep is part of successful weight loss

“The rise in obesity prevalence rates over the past decades parallels an epidemic of sleep disturbances,” Prof. Jordi Salas-Salvadó and colleagues write.

“In this context, the PREDIMED-Plus, a new ongoing primary cardiovascular prevention trial based [on] an intensive weight-loss lifestyle intervention program, provides an unprecedented opportunity to examine the 12 month changes in weight and adiposity measures between those participants with short or adequate sleep duration and between those with low or high sleep variability,” they continue.

PREDIMED-Plus is a clinical trial that studies the health effects of following a Mediterranean-style diet in a Spanish cohort. The results of the current research are part of this ongoing trial.

In the current research, Prof. Salas-Salvadó and colleagues analyzed the medical data of 1,986 individuals with a mean age of 65 years over the course of a year.

All of these participants were overweight or had obesity at baseline, and they also had metabolic syndrome, a cluster of health risk factors that include high blood pressure (hypertension), increased levels of insulin (hyperinsulinemia), low glucose tolerance, and abnormal levels of blood lipids (dyslipidemia).

For the entire year, these volunteers participated in an intensive weight loss program that included following a low calorie Mediterranean-type diet, boosting levels of physical activity, and participating in behavioral support sessions that aimed to improve habits and lifestyle.

Midlife Diabetes Can Raise Your Stroke Chances Later

In a finding that further confirms the link between type 2 diabetes and stroke, a new study shows that having the blood sugar disease during middle age may boost your risk of having the most common type of stroke later in life.

In addition to a 30% greater chance of an ischemic stroke, the researchers also found that people who had type 2 diabetes in their 40s or 50s were twice as likely to have narrower blood vessels in their brain in their 60s and beyond.

“Our findings highlight the need for controlling midlife type 2 diabetes mellitus to help prevent [ischemic stroke and narrowing of the blood vessels in the brain],” said study author Rongrong Yang. Yang is a Ph.D. candidate at Tianjin Medical University in China.

An ischemic stroke, which is the more common type of stroke, is caused by a blockage in a blood vessel in the brain. This damages the area of the brain that’s no longer receiving enough blood. The less common type of stroke is known as a hemorrhagic stroke. That type of stroke occurs when a blood vessel bursts, causing blood to leak into the brain and cause swelling and tissue damage, the National Stroke Association says. 

Type 2 diabetes has long been associated with the risk of stroke, but it’s been hard to know if an increased risk of stroke comes from the diabetes or from other genetic and environmental factors, according to background information in the study.

To better tease out if diabetes itself was a likely culprit, the researchers reviewed data from the Swedish Twin Registry. More than 33,000 twin individuals met the criteria for the study. 

The study participants were all born before 1958. None had evidence of narrowed brain blood vessels or stroke before age 60. 

Just under 4% of the group had diabetes in midlife. More than 9% had late-life (after 60) strokes or narrowed blood vessels in their brain, the study authors said. 

After adjusting the data to account for other stroke risk factors, such as smoking and obesity, the researchers noted the increased risk of ischemic stroke, but didn’t find an increased risk of hemorrhagic stroke.

Yang said that genetic and environmental factors didn’t appear to account for the increased risk of ischemic stroke, but noted that more research needs to be done. This study wasn’t designed to prove a cause-and-effect relationship.

So why might diabetes lead to more ischemic strokes? 

“The mechanisms underlying the association of type 2 diabetes mellitus with stroke are complex and not completely understood,” Yang said. But, people with type 2 diabetes have abnormal cholesterol levels and that might contribute to the narrowed blood vessels in the brain. 

Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City, said the Swedish population has significantly less type 2 diabetes than would be found in the United States. 

Zonszein was not, however, surprised to see a higher risk of stroke and narrowed blood vessels in people with diabetes.

Summer is Here. Get Your Body Ready.

Summer is coming. And you know what that means. Beach season is here, and that means shirts are optional. If you’ve been putting in your gym work throughout the winter, you just may be all ready to show off your hard-earned muscle. But if you haven’t, don’t sweat. There’s still time to build your best body ever. 

That’s where this page comes in. Before you dive into the ocean, dive deep into these workouts, which are optimized to push you toward your best summer body. You’ll find everything you need here, conveniently categorized by muscle group. That means arm workouts for bulging biceps, ab moves that’ll make your six-pack pop, chest moves for beefy pecs, back builders that’ll finish out your V-taper, and leg sessions to deliver major glute gains. Just need a good sweat? We’ve got that covered, too, with a series of full-body routines. 

These workouts will get you where you want to be, pushing you toward your muscle goals in the most efficient ways possible. And if you’re already in fun-in-the-sun shape, they’ll push you to another level, etching details onto the muscle you’ve already built. 

Enough yapping. Your summer of muscle awaits. Click Read More for a full list of the exercise plans.

Energy drinks may have unintended health risks

A study published Wednesday in the Journal of the American Heart Association found that caffeinated energy drinks altered the heart’s electrical activity and raised blood pressure. 

The extent of these electrical changes — which signal the heart’s chambers squeezing and relaxing — is “generally considered mild,” according to study author Sachin Shah, a professor of pharmacy at the Thomas J. Long School of Pharmacy and Health Sciences at the University of the Pacific. However, people who take certain medications or have a specific type of heart condition could be at increased risk of a fatal arrhythmia, or irregular heartbeat, he added.

“Unlike drugs, supplements and consumer products do not necessarily get tested for safety,” Shah said in an email.

The American Beverage Association stands by the safety of energy drinks, indicating that many of their ingredients are also found in common foods and have been rigorously studied for safety.

But health experts like the World Health Organization say they “may pose danger to public health.” Children “should not consume” them, cautions the American Academy of Pediatrics. 

Still, the global energy drink market continues to grow. It was worth $39 billion in 2013 and is forecast to reach $61 billion by 2021. So what exactly is inside these drinks, and how do they impact your body?

‘A black box’

Over the years, concerned experts have been getting closer to answering those questions, said Dr. John Higgins, a sports cardiologist with McGovern Medical School at the University of Texas Health Science Center in Houston. 

Most energy drinks typically contain large amounts of caffeine; added sugars; vitamins, such as B vitamins; and legal stimulants, such as guarana, a plant that grows in the Amazon; taurine, an amino acid that’s naturally found in meat and fish; and L-carnitine, a substance in our bodies that helps turn fat into energy.

“Overall, the concern is that these vitamins, amino acids and herbals are often in higher concentrations than naturally in food or plants, and the effects when combined especially with caffeine may be enhanced,” Katherine Zeratsky, a clinical dietitian at the Mayo Clinic in Rochester, Minnesota, previously told CNN.

Higgins, who has led multiple studies on energy drinks and health impacts, agreed.

With the caffeine, sugar and stimulants, Higgins previously told CNN that more research is needed to determine how those ingredients could interact to cause negative health effects.

“They’re sort of a black box. We really don’t know a lot about them,” Higgins said of energy drinks. 

“People need to be aware of that,” he said. “For certain groups, it could be potentially dangerous, like for those under 18, women who are pregnant, people who have a caffeine sensitivity, people who don’t consume caffeine on a regular basis and people who are taking certain medications, like Adderall for attention deficit (disorder).”

Coffee and the Health of Your Heart

Aficionados have been getting mixed messages about their favorite drink, with some research suggesting that drinking coffee can improve health while other studies advise people to cut down on their consumption. Previous studies suggested that coffee can cause a stiffening of the arteries, putting pressure on the heart and increasing the likelihood of stroke or heart attack. 

But a new study, funded in part by the British Heart Foundation, found that drinking five cups of coffee a day was no worse for the arteries than drinking less than one cup. The study of more than 8,000 people across the United Kingdom also found that even those who drank up to 25 cups a day were no more likely to experience stiffening of the arteries than someone drinking less than a cup a day.

In the latest study, which is being presented Monday at the British Cardiovascular Society conference, scientists from Queen Mary University of London divided 8,412 people into three groups, with each self-reporting its coffee consumption. The first group was made up of people who said they drank less than one cup of coffee a day; the second included those who drank between one and three cups; and the third group included those who drank more than three, with some in the group drinking up to 25 cups a day. People who consumed more than 25 cups of coffee a day were excluded.

All the participants in the study were given MRI heart scans and infrared pulse wave tests. Researchers corrected for factors such as age, gender, ethnicity, smoking status, weight, blood pressure, diet and how much alcohol a person drinks.

“What we found was that drinking more than three cups of coffee a day did not significantly increase the stiffness of blood vessels compared to people who drink one cup or less a day,” Kenneth Fung, who led the data analysis at Queen Mary University of London, told CNN. 

“The main message for people to take away from this is that coffee can be enjoyed as part of a healthy lifestyle, and coffee lovers can be reassured by this result in terms of blood vessel stiffness outcomes.” 

Although some participants in the study drank 25 cups a day, the average intake among the highest coffee consumption group was five cups a day.

“We’re not telling people to drink 25 cups a day per se. If anything, if you drink within recommended guidelines, then we don’t expect to see an increase in arterial stiffness compared with those who drink one cup or less a day,” he added. 

The research also showed that moderate and heavy coffee drinkers were most likely to be male, smoke and consume alcohol regularly. 

Professor Metin Avkiran, associate medical director at the British Heart Foundation, said in a press release: “There are several conflicting studies saying different things about coffee, and it can be difficult to filter what we should believe and what we shouldn’t. This research will hopefully put some of the media reports in perspective, as it rules out one of the potential detrimental effects of coffee on our arteries.”

11 foods that lower cholesterol

Changing what foods you eat can lower your cholesterol and improve the armada of fats floating through your bloodstream.

Add these foods to lower LDL cholesterol

Different foods lower cholesterol in various ways. Some deliver soluble fiber, which binds cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation. Some give you polyunsaturated fats, which directly lower LDL. And some contain plant sterols and stanols, which block the body from absorbing cholesterol.

1. Oats. An easy first step to lowering your cholesterol is having a bowl of oatmeal or cold oat-based cereal like Cheerios for breakfast. It gives you 1 to 2 grams of soluble fiber. Add a banana or some strawberries for another half-gram. Current nutrition guidelines recommend getting 20 to 35 grams of fiber a day, with at least 5 to 10 grams coming from soluble fiber. (The average American gets about half that amount.)

2. Barley and other whole grains. Like oats and oat bran, barley and other whole grains can help lower the risk of heart disease, mainly via the soluble fiber they deliver.

3. Beans. Beans are especially rich in soluble fiber. They also take a while for the body to digest, meaning you feel full for longer after a meal. That’s one reason beans are a useful food for folks trying to lose weight. With so many choices — from navy and kidney beans to lentils, garbanzos, black-eyed peas, and beyond — and so many ways to prepare them, beans are a very versatile food.

4. Eggplant and okra. These two low-calorie vegetables are good sources of soluble fiber.

5. Nuts. A bushel of studies shows that eating almonds, walnuts, peanuts, and other nuts is good for the heart. Eating 2 ounces of nuts a day can slightly lower LDL, on the order of 5%. Nuts have additional nutrients that protect the heart in other ways.

6. Vegetable oils. Using liquid vegetable oils such as canola, sunflower, safflower, and others in place of butter, lard, or shortening when cooking or at the table helps lower LDL.

7. Apples, grapes, strawberries, citrus fruits. These fruits are rich in pectin, a type of soluble fiber that lowers LDL.

8. Foods fortified with sterols and stanols. Sterols and stanols extracted from plants gum up the body’s ability to absorb cholesterol from food. Companies are adding them to foods ranging from margarine and granola bars to orange juice and chocolate. They’re also available as supplements. Getting 2 grams of plant sterols or stanols a day can lower LDL cholesterol by about 10%.

9. Soy. Eating soybeans and foods made from them, like tofu and soy milk, was once touted as a powerful way to lower cholesterol. Analyses show that the effect is more modest — consuming 25 grams of soy protein a day (10 ounces of tofu or 2 1/2 cups of soy milk) can lower LDL by 5% to 6%.

10. Fatty fish. Eating fish two or three times a week can lower LDL in two ways: by replacing meat, which has LDL-boosting saturated fats, and by delivering LDL-lowering omega-3 fats. Omega-3s reduce triglycerides in the bloodstream and also protect the heart by helping prevent the onset of abnormal heart rhythms.

11. Fiber supplements. Supplements offer the least appealing way to get soluble fiber. Two teaspoons a day of psyllium, which is found in Metamucil and other bulk-forming laxatives, provide about 4 grams of soluble fiber.

How Sleep, Mood, and Age Impact Working Memory

A team of psychologists has found strong associations between working memory—a fundamental building block of a functioning mind—and three health-related factors: sleep, age, and depressed mood. The team also reports that each of these factors is associated with different aspects of working memory.

Working memory is the part of short-term memory that temporarily stores and manages information required for cognitive tasks such as learning, reasoning, and comprehension. Working memory is critically involved in many higher cognitive functions, including intelligence, creative problem-solving, language, and action-planning. It plays a major role in how we process, use, and remember information.

The researchers, led by Weiwei Zhang, PhD, an assistant professor of psychology at the University of California, Riverside, found that age is negatively related to the “qualitative” aspect of working memory—that is, how strong or how accurate the memory is. In other words, the older the person, the weaker and less precise the person’s memory. In contrast, poor sleep quality and depressed mood are linked to a reduced likelihood of remembering a previously experienced event—the “quantitative” aspect of working memory.

“Other researchers have already linked each of these factors separately to overall working memory function, but our work looked at how these factors are associated with memory quality and quantity,” Zhang says in a release. “All three factors are interrelated. For example, seniors are more likely to experience negative mood than younger adults. Poor sleep quality is also often associated with depressed mood. The piecemeal approach used in previous investigations on these relationships—examining the relationship between one of these health-related factors and working memory—could open up the possibility that an observed effect may be influenced by other factors.”

The researchers are the first to statistically isolate the effects of the three factors on working memory quantity and quality. Although all three factors contribute to a common complaint about foggy memory, they seem to behave in different ways and may result from potentially independent mechanisms in the brain. These findings could lead to future interventions and treatments to counteract the negative impacts of these factors on working memory.

Click Read More for the full study.

The 7 Secrets of Staying Fit After 40

I’m not an elite athlete. I’m just a guy on the precipice of middle age who enjoys running, biking, soccer, and tennis. If I can push myself to my physical limit a couple of times a week and still have the energy to crawl around with my daughter, then I’m satisfied.

That makes me a useful filter. The pros have unlimited budgets and few demands on their waking hours beyond making themselves fitter. If you want to spend thousands —or tens of thousands — to sleep in an oxygen pod wearing infrared pajamas, then knock yourself out. But chances are you care only about things that work, are safe, and fit your schedule and budget. So trust the guy with a day job, a bad back, and a new baby. Here’s what I learned in two years of reporting for my book Play On

Periodize Your Regimen 

The importance of periodizing and the risks of not doing so have been drilled into my head by the likes of soccer coach Raymond Verheijen and exercise scientist Trent Stellingwerff, Ph.D. 

For an elite athlete, periodizing can mean creating a structured program of buildup and tapering that yields peak fitness at a precise time. For me, it’s more about the principles: ramping up training gradually, preparing my body for specific demands, and avoiding fatigue. If you invite me to play soccer and I haven’t been keeping in soccer shape, or if I’m nursing an injury I could play through, I say no. Benching yourself sucks, but it doesn’t suck as much as missing an entire season because you got hurt. 

Emphasize Recovery 

Elite lifters end their workouts differently than the rest of us do. Strength coaches talk about loading and unloading–that is, the former should always be followed by the latter. I now think in those terms. “Unloading” for nonlifters can mean yoga, foam-rolling, ice tubbing, running in water, or meditating. It encompasses both recovery and range-of-motion work that prevents the sorts of movement limitations and compensations that can build up over time and lead to injuries. 

I used to consider happy hour a valid cooldown routine. Now I’m a fanatic about stretching and self-massage and have a closet full of straps, bands, foam rollers, and lacrosse balls to show for it. Committing to this is tough if your schedule is packed, which could tempt you to extend your workout and skip the stretching. That’s a bad tradeoff.

Go Hard (and Easy)

A percentage of your workouts should be high intensity, and the balance — say, 80 percent — should be performed at very low intensity. Again, I don’t stick to any formal program of polarization, but I try to avoid what Stellingwerff says is the most common mistake athletes make: going too hard on easy days and then not being able to go as hard as you want the next time out. 

Instead, I make my hard workouts both shorter and more intense than I used to. Elite older athletes stay competitive by being more deliberate in their training, focusing their limited time honing specific skills, and correcting their fitness weaknesses. For me, this often means taking two minutes before I start to write up a plan on a sticky note. A little intentionality goes a long way.

Eat for Muscle 

Much of the nutrition “science” peddled to athletes is bunk. If you’re eating a healthy diet–lots of different fruits and vegetables, proteins, and whole grains, not too much sugar or processed stuff–you’re probably fine. But if you want to avoid losing muscle as you age, it’s worth making a couple of tweaks. I’ve increased the protein in my diet as well as the number of times I consume it during the day, following the advice of triathlete and nutrition scientist Asker Jeukendrup, Ph.D. A side benefit: Adding protein to anything you eat effectively lowers its glycemic index, says Chris Jordan, M.S., C.S.C.S., director of exercise physiology for the Johnson & Johnson Human Performance Institute. 

So if I want to have an oatmeal chocolate chip cookie without feeling a sugar crash, I’ll put a smear of almond butter on it. I also try to consume 3 to 5 milligrams of creatine powder a day, usually in a smoothie or a glass of milk, just before or after a workout. It’s had a noticeable effect on my ability to build and maintain muscle.

Click Read More for the rest of the tips.

Americans Are Sitting at Record Rates. Here’s Why That’s So Dangerous

Every day, we modern humans stay comfortably seated on our behinds for hours at a time: binge watching shows on Netflix, pecking away on keyboards at work, scrolling through social media feeds. But do people really sit more than they used to?

That’s what Yin Cao and an international group of colleagues wanted to find out in their latest study published in JAMA. While studies on sitting behavior in specific groups of people — such as children or working adults with desk jobs — have recorded how sedentary people are, there is little data on how drastically sitting habits have changed over time. “We don’t know how these patterns have or have not changed in the past 15 years,” says Cao, as assistant professor in public health sciences at the Washington University School of Medicine.

The researchers used data collected from 2001 to 2016 by the National Health and Nutrition Examination Survey (NHANES), which asked a representative sample of Americans ages five and older how many hours they spent watching TV or videos daily in the past month, and how many hours they spent using a computer outside of work or school. The team analyzed responses from nearly 52,000 people and also calculated trends in the total time people spent sitting from 2007 to 2016. Overall, teens and adults in 2016 spent on average of an hour more each day sitting than they did in 2007. And most people devoted that time parked in front of the TV or videos: in 2016, about 62% of children ages five to 11 spent two or more hours watching TV or videos every day, while 59% of teens and 65% of adults did so. Across all age groups, people also spent more time in 2016 using computers when they were not at work or school compared to 2003. This type of screen time increased from 43% to 56% among children, from 53% to 57% among adolescents and from 29% to 50% among adults.

That’s worrisome, says Cao, because sitting too long is linked to chronic diseases that can lead to early death. “Many studies show that TV or video watching time is most strongly associated with chronic disease and increases risk of obesity, cardiovascular disease, cancer, Type 2 diabetes and overall mortality,” says Cao. “We found that a lot of people, around 60%, are watching two hours or more [every day].”

From 2001 to 2016, TV-watching habits did not change significantly, despite the fact that in that time, more research about the dangers of sedentary behavior started emerging and doctors began discussing the hazards of sitting too much with their patients. “The results were a little disappointing in general,” says Cao. “They are definitely a signal that we need to increase public awareness and knowledge about the health impact of prolonged sitting. And we are not there yet — from our data, we haven’t even started yet.”

The increase in total sitting time is likely largely driven by the surge in time spent in front of a computer. As eye-opening as the trend data are, they may even underestimate the amount of time Americans spend sedentary, since the questions did not specifically address time spent on smartphones. While some of this time might have been captured by the data on time spent watching TV or videos, most people spend additional time browsing social media and interacting with friends via texts and video chats — much of it while sitting.

Some positive signs appear in the data, however. Among younger children ages five to 11, the trend of TV and video watching for two hours or more daily decreased slightly from 2001 to 2016, especially among white children, which suggests that their parents are encouraging their kids to be more active and spend less time on the couch.

The data also point to specific groups that may benefit from more targeted education and support for changing sedentary habits. Among all ages, males, African-Americans, people who are obese and those who are physically inactive consistently showed higher prevalence of TV and video watching compared to females, white Americans, people with normal range BMI and those who exercised more. “Our study helps set up a baseline for developing interventions for different subgroups and for understanding how much impact those interventions can have,” says Cao. “It calls for system-level changes if possible, whether they involve issues with the environment, education at school or circumstances that make it hard to be physically active. These are hard questions, but from these data, it’s clear it’s something we need to think about.”

Plant-based diets can be effective in reducing heart failure risk

Plant-based diets are associated with a lower risk of heart failure in adults without known heart disease, while Southern diets consisting of more fried and processed foods and sweetened drinks are associated with greater risk, according to a study published in the Journal of the American College of Cardiology that looked at the association between five dietary patterns and risk of heart failure. 

Heart failure affects more than 5.7 million adults and that number is expected to rise. Heart failure prevention strategies currently emphasize quitting smoking, managing high blood pressure and maintaining a healthy diet and weight to prevent heart disease, but research is limited on dietary patterns and incident heart failure in patients without heart disease.

Researchers in this study looked at five major dietary patterns that were identified within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study population and examined the association between those patterns and incident heart failure hospitalizations in REGARDS participants without known heart disease or heart failure at baseline. Within the REGARDS study, researchers narrowed their sample size to 16,608 black and white adults aged 45 years old and older. Participants were sent a 150-question survey based on 107 food items, which were categorized into the five pre-determined diets:

  • “Convenience” (heavily meat dishes, pasta, Mexican dishes, pizza and fast food) 
  • “Plant-based” (vegetables, fruit, beans and fish)
  • “Sweets/fats” (heavy on desserts, bread, sweet breakfast foods, chocolate and other sugar)
  • “Southern” (heavy on fried food, processed meats, eggs, added fats and sugar-sweetened beverages)
  • “Alcohol/salads” (heavy on wine, liquor, beer, leafy greens and salad dressing)

After 8.7 years of follow up on average, there were 363 new heart failure hospitalizations. Researchers saw a 41 percent lower risk of new heart failure hospitalization for participants who were most adherent to the plant-based diet, compared to the least adherent. 

The highest adherence to the Southern diet was associated with a 72 percent higher risk of heart failure hospitalization. However, when the Southern diet was adjusted for BMI, waist circumference, hypertension, dyslipidemia and other factors, the association was no longer statistically significant. Researchers said this could mean that the Southern dietary pattern could increase heart failure risk through factors such as obesity and excess abdominal fat, among the other adjusting factors.

Researchers found no statistically significant associations among the remaining dietary patterns and risk of heart failure.

Researchers also looked at incident heart failure stratified by heart failure subgroups. There were 133 cases of heart failure with preserved ejection fraction and 157 cases of heart failure with reduced ejection fraction. Researchers found no significant differences in associations with heart failure by ejection fraction with any of the dietary patterns.

“The need for population based preventive strategies for heart failure is critical,” said Kyla Lara, MD, lead author of the study and a cardiology fellow at Mayo Clinic in Rochester, Minnesota. “These findings support a population-based dietary strategy for lowering the risk of incident heart failure.”

One of the study’s major strengths was the large, diverse sample size that included people from all demographics and socioeconomic backgrounds. Limitations include potential misclassifications from inaccurate dietary intake reporting and, since diet was only assessed at the beginning of the study, dietary changes may have occurred after the initial assessment.

In a related editorial comment, Dong Wang, ScD, MD, a research fellow at Harvard T.H. Chan School of Public Health, said heart failure prevention should be prioritized considering how difficult it is to treat, the severe debility heart failure patients experience and the high cost of heart failure care.

“This study represents an important step forward in establishing a robust evidence base for the dietary prevention of heart failure,” he said.

Strength training for the lungs

Do you need to strengthen the muscles you breathe with? According to the latest research, the answer is a resounding yes. Just five minutes of “strength training” for the lungs could improve everything from heart health to your memory – and it could even be a more effective tool for lowering blood pressure than aerobic exercise.

This week, the preliminary results of a clinical trial of 50 subjects trying a breath workout known as “Inspiratory Muscle Strength Training” (IMT) were presented by the University of Colorado at Boulder. They showed that as well as boosting brain function and breathing new life into athletic performance, breath resistance training can improve artery function and reduce the risk of heart attack.

And all without having to get changed for the gym.

How do you ‘lift weights’ for your lungs? The answer is a hand-held device known as an ‘inspiratory muscle training device’. You hold it to your mouth and it provides resistance to airflow, making you breathe in and out with more force. The sensation has been described as “sucking hard through a straw which sucks back”.

The novel gadget was developed in the 1980’s and used for low-resistance, daily 30 minute sessions to improve the lung capacity of people with lung diseases or asthma.

More recently, there have been experiments in heavier weight ‘lung lifting’. In 2016, the University of Arizona trialled it to find out if 30 inhalations a day with greater resistance might help sufferers of obstructive sleep apnea (snoring, to you and me), who tend to have weak breathing muscles.

The results were more than promising: not only did the participants enjoy a more restful sleep, but after six weeks, they noticed a few unexpected side effects. These included performing better on cognitive and memory tests – and, perhaps most significantly of all, their systolic blood pressure plummeted by 12 millimeters of mercury.

For context, that’s twice as much of a decrease in blood pressure that can be achieved via aerobic exercise, and far more effective than some medicines.

Systolic blood pressure creeps up as we age and as the arteries stiffen, and is associated with a risk of heart attack, cognitive decline and kidney damage (for the record, systolic blood pressure, is pressure in your blood vessels when your heart beats, whereas diastolic blood pressure, measures the pressure in your blood vessels when your heart rests between beats). Anyway, aerobic exercise is one way to decrease it – but few of us do enough.

Last year, research led by the London School of Economics and Political Science, found that exercise programmes, such as walking, jogging, or gym sessions, were often more effective at lowering blood pressure than medicines and drugs.

Running, walking, cycling, swimming and strength training are particularly effective – but for those of us who break out in a cold sweat at the very idea of physical exertion, IMT could be a solution to high blood pressure. It’s a positive cycle, too, because in turn, breath training should also make aerobic exercise easier in the first place.

And IMT appears to be easy to keep up: participants of the study were able to stick to their regime (fewer than 10 per cent of study participants dropped out, which is seen to be “high compliance rate”.) 

Very Low Cholesterol May Increase Stroke Risk

Having extremely low cholesterol may increase the risk for stroke, a new study suggests.

Researchers found that very low LDL, or “bad” cholesterol, and very low triglycerides are associated with an increased risk for hemorrhagic stroke, the type caused by a ruptured blood vessel in the brain.

For the report, in Neurology, researchers reviewed data on total cholesterol, LDL, HDL (“good” cholesterol) and triglycerides for 27,937 women. During an average follow-up of 19 years, there were 137 hemorrhagic strokes.

They found that women with LDL levels below 70 were more than twice as likely to have a hemorrhagic stroke as those with readings between 100 and 129. Under 100 is generally considered normal.

Women with triglyceride readings below 75 had twice the risk for stroke compared with those with levels above 156. A triglyceride level below 150 is considered healthy.

There was no association of stroke with HDL or total cholesterol. The study controlled for hypertension, smoking, physical activity, body mass index and other factors.

“If you have these low levels, you’re often considered low risk,” said the lead author, Pamela M. Rist, an assistant professor of medicine at Brigham and Women’s Hospital in Boston. “But that doesn’t mean you should ignore the other factors that we know are risks for hemorrhagic stroke — hypertension, smoking and so on.”

Bad Diets Are Responsible For More Deaths Than Smoking, Global Study Finds

About 11 million deaths a year are linked to poor diets around the globe.

What’s driving this? As a planet we don’t eat enough healthy foods including whole grains, nuts, seeds, fruits and vegetables. At the same time, we consume too many sugary drinks, too much salt and too much processed meat.

As part of a new study published in The Lancet, researchers analyzed the diets of people in 195 countries using survey data, as well as sales data and household expenditure data. Then they estimated the impact of poor diets on the risk of death from diseases including heart disease, certain cancers and diabetes. (They also calculated the number of deaths related to other risk factors, such as smoking and drug use, at the global level.)

“This study shows that poor diet is the leading risk factor for deaths in the majority of the countries of the world,” says study author Ashkan Afshin of the Institute for Health Metrics and Evaluation at the University of Washington. Unhealthy diets are “a larger determinant of ill health than either tobacco or high blood pressure,” he says.

Which countries do best when it comes to diet? Israel, France, Spain and Japan were among the countries with the lowest rates of diet-related disease. The U.S ranked 43rd, and China ranked 140th. It should be noted that there were data gaps for intake of key foods in some countries, so some estimates could be off.

“Generally, the countries that have a diet close to the Mediterranean diet, which has higher intake of fruits, vegetables, nuts and healthy oils [including olive oil and omega-3 fatty acids from fish] are the countries where we see the lowest number of [diet-related] deaths,” Afshin says. And as we’ve reported, the Mediterranean pattern of eating is linked to a reduced risk of  heart attacks and memory decline.

I asked Afshin which ranking surprised him and why. “Mexico is interesting,” Afshin told me. The country ranked 11th on the list. On the one hand, people in Mexico consume a lot of whole grain corn tortillas, he says — and whole grains are beneficial. But on the other hand, “Mexico has one of the highest levels of consumption of sugar-sweetened beverages.” It’s hard to say how the benefits of whole grains may influence the risks of too much sugar, but Afshin says it underscores a problem seen in many countries: The overall pattern of eating could be improved. 

Of course, there are obstacles to eating well, including access and affordability. As the Trump administration and U.S. lawmakers debate whether able-bodied people who don’t work should be entitled to public food assistance, it’s clear that many people around the globe struggle to afford healthy foods. 

And at a time when 800 million people around the globe don’t get enough to eat, and 1.9 billion people weigh too much, it’s important to remember that hunger and obesity are both forms of malnutrition. And the costs are staggering. Consider a recent report from the Center for Strategic and International Studies, which notes: “Worldwide, malnutrition costs $3.5 trillion annually, with overweight- and obesity-related noncommunicable diseases, such as cardiovascular disease and type 2 diabetes, adding $2 trillion.”

Globally, these findings may serve as a reminder that when it comes to ending hunger and improving health, people don’t just need food. They need nourishment. If you fill up on a diet of packaged snacks made from refined-carbohydrates and sugary sodas, you may get the calories you need, but those calories will put you on a path toward disease.

What would happen if everyone around the globe began to eat a healthy diet, filling three-fourths of their plates with fruits, vegetables and whole grains? We’d run out. Yep, that’s right. A recent study published in the journal PLOS One by researchers at the University of Guelph found that there would not be enough fruit and vegetables to go around. 

“We simply can’t all adopt a healthy diet under the current global agriculture system,” says study co-author Evan Fraser, director of the Arrell Food Institute at the University of Guelph. Fraser says we produce too much fat, too much sugar and too many starchy products. So, food companies and farmers play a role, too. “At a global level, we have a mismatch between what we should be eating, and what we’re producing,” Fraser says. 

Perhaps that’s why the authors of the new Lancet study say their findings point to the need for coordinated, global efforts. Improving diets won’t be easy: A range of initiatives may be needed, including nutrition education and increased access to healthy foods, as well as rethinking agricultural production.

When to consume protein: The facts

There is some evidence that consuming protein can help a person lose weight, and there is clear evidence that it can help people build muscle mass if they also exercise.

However, research, as yet, does not make it unclear when is the best time to have protein. It is also unclear if there is any best time at all, why this is the case, or whether it is the case for everyone.

Most people in the United States get enough protein in their diet. Still, the United States Department of Agriculture (USDA) say many people should vary the types of food containing protein that they eat.

If a person is trying to build muscle mass, they may also take protein in the form of supplements to help them build muscle tissue after exercise.

When you are trying to lose weight

There is some evidence that eating protein can help a person lose weight.

Evidence suggests protein does this in part by increasing satiety. Satiety is the feeling of being full.

Currently, there is little solid evidence regarding when the best time to eat protein might be to encourage weight loss.

For example, researchers published a study in the journal Advances in Nutrition suggesting that eating snacks that contain protein may reduce the number of calories a person consumes at their next meal.

However, the research paper also points out that studies demonstrating this are scarce and sometimes conflicting. They suggest more studies are needed to confirm their findings. This was also the conclusion of a study in the Journal of the Academy of Nutrition and Dietetics.

In contrast, a study in the American Journal of Clinical Nutrition suggests that a diet generally higher in protein can improve body weight management. The classification of higher protein in the study was 1.2 to 1.6 grams of protein per kilogram of body weight per day.

Research is still evolving about the relationship between protein and weight loss, including when is the best time to eat protein for this purpose.

When you are trying to build muscle

Various studies have looked at whether there is a link between the time a person consumes protein and hypertrophy, which is how much muscle a person builds after exercise. However, the results are unclear.

Two studies in the International Journal of Sport Nutrition and Exercise Metabolism and the Journal of the International Society of Sports Nutrition suggest there is no relationship between building muscle and the timing of consuming protein.

More research is necessary to establish if there is a link between the timing of protein intake and the amount of muscle a person builds.

A small, older study in the Journal of Physiology found that skeletal muscle grew in older adult males who took a protein supplement soon after exercise.

A recent meta-analysis in the Journal of the International Society of Sports Nutrition suggests that while evidence is conflicting about the best time to consume protein after exercising, if athletes eat protein soon after working out, they are more likely to consume enough protein over the course of a day to build their muscles.

The researchers conclude that there are no known downsides to eating protein before or after a workout. Also, if that helps an athlete get sufficient nutrients for their body to recover, then there is no issue.

The most explicit message from current research is that if a person wants to build muscle, then consuming enough protein is more important than the timing of when they consume the protein.

Importantly, many of these studies assume that the person consuming the protein is an athlete doing many hours of intense exercise a week. For the average person, what is necessary is that they consume a balanced diet, supplementing this with more protein than usual if they are focusing their exercise on building muscle.

Summary

Research shows that increasing the amount of protein in a person’s diet is good for better weight management and is important for building muscle mass after exercise. However, research has not yet been able to determine when the best time to consume protein might be or if there is any best time.

For professional athletes, where marginal differences in muscle development may result in small but significant performance improvements, experimenting with different times to have protein may be worthwhile to achieve their goals.

For most people, however, what is essential is that a person consumes enough protein to keep them in good overall health as part of their everyday, balanced diet.

Eating More Whole Grains Is the Easiest Way to Protect Your Heart

At breakfast, order a side of whole-wheat toast—for your heart. University of Eastern Finland scientists found that whole grains contain compounds that improve glucose metabolism—how sugar is processed—which can help stave off illness, including cardiovascular disease and type 2 diabetes.

In the study, 123 people at risk for heart issues ate a diet either high or low in whole grains for 12 weeks. The high group had more betaine compounds in their blood, which improves cell function. One compound acts similarly to the way certain heart drugs do—and eating whole-grain pasta is more fun than popping a pill.

Diabetes: Could muscle strength lower risk?

Recently, researchers have been looking into the effects of exercise on the risk of type 2 diabetes, asking what kind of physical activity might help decrease it the most.

These researchers hail from Iowa State University in Ames, the University of South Carolina in Columbia, the Pennington Biomedical Research Center in Baton Rouge, LA, and the Ochsner Clinical School at the University of Queensland School of Medicine in Brisbane, Australia.

Their findings — which appeared earlier today in the journal Mayo Clinic Proceedings — indicate that people with moderate muscle strength, maintained and consolidated through resistance exercise, may be at a considerably lower risk of type 2 diabetes.

This effect, the scientists note, is independent of other factors such as cardiorespiratory fitness. They also point out that moderate muscle mass seems to be enough to provide this benefit — increasing it does not lower risk any further.

Associate professor Duck-chul Lee, from Iowa State University, explains that the current findings suggest that even moderate resistance training can be beneficial in this respect. However, he cautions that it is difficult to establish how much is enough.

“Naturally, people will want to know how often to lift weights or how much muscle mass they need, but it’s not that simple,” notes Lee.

“As researchers, we have several ways to measure muscle strength, such as grip strength or bench press. More work is needed to determine the proper dose of resistance exercise, which may vary for different health outcomes and populations,” he continues.

For this study, the scientists used the data of 4,681 adults aged 20–100, none of whom had diabetes at baseline. They accessed this information through the Aerobics Center Longitudinal Study. All the participants agreed to do chest and leg presses to allow the researchers to measure individual muscle strength.

To provide more accuracy, the investigators also adjusted these measurements for several potentially confounding factors, including age, biological sex, and body weight. All the participants also completed relevant health exams both at baseline and at the follow-up stage.

The researchers found that those who exhibited moderate muscle mass had a 32 percent lower risk of type 2 diabetes. This effect appears independently of other lifestyle factors, such as frequent drinking and smoking, as well as of obesity and high blood pressure — both of which are risk factors for diabetes.

Still, the investigators were unable to obtain detailed information about all the participants’ resistance training habits. However, the data they managed to collect from one small group suggested that there may be a moderate association between a person’s muscle strength and how often they participate in this type of exercise.

“You’re not necessarily going to see the results of resistance training on your bathroom scale,” cautions study co-author Angelique Brellenthin, “but there are several health benefits.”

She adds that “[i]t may help lower your risk for type 2 diabetes even though you do not lose body weight, and we know maintaining muscle mass helps us stay functional and independent throughout life.”

Brellenthin acknowledges that so far, it remains unclear just how often, and at what intensity, a person should engage in resistance training to lower their diabetes risk. Future studies will need to address this gap.

Despite this, she points out that the recent findings suggest that even a little resistance training is, most likely, better than none at all, and that people should not feel as though they have to jump right into the most difficult exercises to reap the benefits.

“We want to encourage small amounts of resistance training and it doesn’t need to be complicated. You can get a good resistance workout with squats, planks, or lunges. Then, as you build strength, you can consider adding free weights or weight machines.”

PAF Community Champions: HearStrong

A non-profit organization based in Syracuse, New York, the HearStrong Foundation searches for ways to challenge how hearing loss and its solutions, such as hearing aids, are viewed. It tells the stories and honors the accomplishments of those who have overcome hearing loss and inspire others to do the same.

Founded in 2013 by Ed Keller, the President/CEO of EarQ, a nationwide network of hearing aid providers, HearStrong participated in the NFLPA’s annual Smocks & Jocks, the invitation only art auction and jazz brunch, which was held this year in Atlanta prior to Super Bowl LIII. 

“There’s an issue in our country where there’s 30 million people with untreated hearing loss, and it has serious effects on the quality of life,” Keller said. “And with all the noise and head trauma associated with professional football, football at any level, we theorized many, many years ago that this problem would only be more likely to happen with football players.

“So, we’ve been working on this project with them and that’s how we got to know these guys, by testing their hearing and trying to identify the issue.

“The HearStrong Foundation was created because 80 percent of the people with hearing loss just don’t do anything about it. There’s just a negative stigma about it. We wanted to share empowering stories and we were thankful that the (NFL) Players Association and its members have always stepped up when we have an opportunity to recognize an individual.”

HearStrong has stepped up itself by administering hearing tests on former players at NFLPA events around the country.

“We test their hearing and they’re provided with hearing devices that helps them to get re-connected. It happens to members of the NFLPA of all ages,” Keller said. “The great news is that the NFLPA is such a great organization that they provide the devices through the programs so there is no cost. So, getting the word out on that is really important.

“We’re in a different world nowadays. It’s time to do progressive thinking. Think about your future and your quality of life and join the technology generation. If you have a problem, let us check it out for you and we’ll provide you with those devices. There’s just a whole world to get engaged with and it’s very satisfying. The technology is incredible.”

This sleep disorder puts people at ‘very high risk’ of Parkinson’s

Data from the National Institutes of Health (NIH) indicate that every year, approximately 50,000 people in the United States learn that they have Parkinson’s disease, a neurological condition that affects a person’s motor function and exposes them to other neurodegenerative problems, such as Alzheimer’s disease.

Researchers still do not fully understand exactly what causes Parkinson’s disease, but they have identified a few risk factors that can predispose a person to develop this condition.

These include a person’s age and sex as well as some genetic factors. Still, it remains a challenge to establish early on who is likely to develop Parkinson’s disease at some point in their life.

However, a team of researchers from McGill University in Montreal, Canada decided to see if one particular factor — a sleep disorder called REM sleep behavior disorder (RBD) — could be a good predictor of risk.

This sleep problem is called RBD because it occurs during the REM phase of sleep, in which a person’s body becomes effectively paralyzed. This inability to move prevents the person from physically acting out any dream that they may be experiencing and thus stops them from potentially harming themselves or others.

People with RBD do not have this paralysis, which means that they end up acting out their dreams without any notion that they are doing so.

Research has shown that many people with RBD go on to develop Parkinson’s disease, so the McGill University team decided to find out whether an RBD diagnosis could accurately predict Parkinson’s risk.

As lead author Dr. Ron Postuma and colleagues explain, establishing that this sleep disorder is a good predictor of Parkinson’s could, in the future, allow specialists to identify at-risk people and offer them experimental therapies that could delay or prevent the onset of this neurological condition.

‘Ultraprocessed’ Foods Linked To Greater Risk Of Death

Processed foods’ claim to fame mostly comes from their ease of preparation and affordability (and, perhaps, their engineered, bordering-on-addictive taste). But according to the research in recent years, they’ve become a major health hazard. And those known as “ultraprocessed” foods, which have even less in common with actual food, may be the worst yet for our health and longevity. A new study in JAMA Internal Medicinefinds that people who eat more of these highly processed foods have a significantly greater risk of death from multiple causes over the years.

The team looked at data from almost 45,000 French participants, who were about 57 at the start of the study and tracked for over 7 years on average. They filled out questionnaires about their typical food and drink intakes, along with other information, including physical activity, sociodemographic, lifestyle, weight/height, and other body measurements.

The researchers were most interested in a group of foods designated “ultraprocessed” in the NOVA food classification system. The authors summarize these foods as being “manufactured industrially from multiple ingredients that usually include additives used for technological and/or cosmetic purposes. Ultraprocessed foods are mostly consumed in the form of snacks, desserts, or ready-to-eat or -heat meals.” According to the NOVA authors, ultraprocessed foods are “formulated from industrial ingredients and contain little or no intact foods.”

The team correlated a person’s consumption of these ultraprocessed foods with their risk of dying from all causes. Overall, for each 10% increase in the intake of ultraprocessed foods, there was a 14% greater risk of all-cause mortality.

“To our knowledge, this prospective study was the first to investigate the association between ultraprocessed foods consumption and mortality risk in a large population-based French cohort,” the team writes in their paper.

Marijuana may be risky for those with heart disease

In recent years, the legalization of marijuana has become more widespread.

Some people use the drug recreationally, while some use it to relieve chronic pain and the impact of some mental health issues.

However, experts state that there needs to be more research into the effects of marijuana in older people.

Specifically, the scientific community needs to focus on educating the public on aspects such as potential effects and recommended dosages.

Canadian Journal of Cardiology case report goes some way toward that. It examined a 70-year-old man who had a heart attack after eating a lollipop that was infused with 90 milligrams (mg) of tetrahydrocannabinol (THC) — which is largely responsible for marijuana’s psychological effects.

The man lived with stable coronary artery disease, and he was taking cardiac medication. He ate most of the lollipop and did so to help minimize pain and improve sleep.

Dr. Alexandra Saunders — who works in Horizon Health Network’s Department of Cardiology in New Brunswick, Canada — described the man’s 90-mg dose as “inappropriate.”

Smoking a typical joint would expose a person to just 7 mg of THC, while a starting dose of a synthetic THC called dronabinol is only 2.5 mg. People with AIDS or cancer tend to use this version, and it can also combat nausea and encourage appetite.

“Marijuana can be a useful tool for many patients, especially for pain and nausea relief. At the same time, like all other medications, it does carry risk and side effects.”

Dr. Alexandra Saunders

A cardiovascular link

The large amount of THC the man consumed caused him to experience anxiety and hallucinations. The strain that these effects put on his body is what likely caused his heart attack, by triggering a response in the sympathetic nervous sytem.

Previously, there had been reports of similar incidences showing a relationship between cannabis consumption and acute cardiovascular adverse events. These have ranged from an irregular heartbeat to stroke, and even sudden death.

However, Dr. Robert S. Stevenson — who also works at Horizon Health Network’s Department of Cardiology — says, “Most previous research on marijuana-induced myocardial ischemia focused mostly on younger patients and did not focus on its different formulations and potencies.”

A word of warning

The doctors examining the most recent case have issued advice, particularly for older people who use marijuana.

They advise people to use the smallest dose possible for their chosen benefit. Anyone who has a cardiovascular condition or is at high risk of developing one should steer clear of THC. Instead, they can try cannabidiol, which is a nonpsychoactive alternative.

They should also take factors such as tolerance and consumption method into consideration. For example, a person who has smoked marijuana over a long period of time is likely to experience fewer distressing side effects than someone who is not used to the drug.

Similarly, eating a THC-infused brownie or lollipop would expose a person to more THC than if they had used a vaporizer. 

With further decriminalization, it is hoped that scientists will work on conducting more research into the potential side effects of marijuana. For now, educating the public — especially aging members — should be a priority.

“For better or worse,” concludes Dr. Neal L. Benowitz, chief of the Division of Clinical Pharmacology and Experimental Therapeutics at the University of California, “providing advice and care to such patients who are using cannabis is now necessary for the provision of optimal medical care to these patients.”

Sleep apnea may stop you from forming life memories

Obstructive sleep apnea (OSA) is a sleep disorder that affects more than 18 million adults in the United States and over 100 million people worldwide.

Those with the condition often have fragmented sleep because OSA interrupts their breathing briefly but repeatedly.

OSA also lowers a person’s oxygen levels, and the combination of poor sleep and oxygen deprivation raises the risk of cardiovascular problems, mood disorders, and memory problems.

New research zooms in on a potential consequence of OSA — depression. Previous studies have found that the rates of depression are higher among people with OSA, but the mechanisms behind this association were unclear.

The new study, which was led by Melinda Jackson, a senior research fellow at the Royal Melbourne Institute of Technology (RMIT) University in Melbourne, Australia, investigates the relationship between OSA and autobiographical memory.

What is autobiographical memory?

Autobiographical memory refers to a person’s ability to memorize specific episodes and retain information about their personal lives. Research has previously linked impaired autobiographical memory with depression.

“We know that overly general autobiographical memories — where people don’t remember many specific details of life events — are associated with the development of persistent depression,” Dr. Jackson explains.

She goes on to lay out the motivation for her research. “Sleep apnoea is also a significant risk factor for depression, so if we can better understand the neurobiological mechanisms at work, we have a chance to improve the mental health of millions of people.”

In the new study, Dr. Jackson and colleagues examined the link between OSA and autobiographical memory; the researchers published their findings in the Journal of the International Neuropsychological Society.

‘Overgeneral’ memories and sleep apnea

Dr. Jackson and team examined 44 adults who had OSA but were not actively treating it and 44 healthy adults without OSA. The researchers looked at the individuals’ abilities to remember various kinds of memories from their childhoods, early adult lives, and recent events.

The study revealed that people with OSA had considerably more “overgeneral memories” than people without OSA. Overgeneral memories describe memories that people cannot recall in much, specific detail.

In the current study, more than 52 percent of those participants with OSA had overgeneral memories, whereas less than 19 percent of participants in the control group had overgeneral memories.

Moreover, the study compared semantic memory with episodic memory. The former describes detailed facts and information about someone’s personal history, whereas the latter describes the ability to remember broader events or “episodes.”

The researchers found that while the episodic memory of people with OSA was intact, their semantic memory was impaired.

Also, they established a correlation between a higher number of autobiographical memories and worse semantic memory across both groups.

“Our study suggests sleep apnea may impair the brain’s capacity to either encode or consolidate certain types of life memories, which makes it hard for people to recall details from the past,” explains Dr. Jackson.

“Brain scans of people with sleep apnoea show they have a significant loss of grey matter from regions that overlap with the autobiographical memory network,” the scientist continues.

Dr. Jackson, a senior research fellow at RMIT’s School of Biomedical and Health Sciences, goes on to outline some directions for future research.

“We need to look at whether there’s a shared neurobiological mechanism at work — that is, does the dysfunction of that network lead to both depression and memory problems in people with sleep apnoea?”

In the future, Dr. Jackson and her team plan “to determine whether successful treatment of sleep apnoea can also help counter some of these memory issues or even restore the memories that have been lost.”

Nearly half of US adults have cardiovascular disease

Nearly half of all adults in the United States have some type of cardiovascular disease, according to the American Heart Association, defining the condition as coronary heart disease, heart failure, stroke or high blood pressure. And after decades of declines, deaths from cardiovascular disease are on the rise again, with 840,678 deaths recorded in 2016, up from 836,546 in 2015, according to the association’s annual report Heart and Stroke Statistics, published Thursday in the medical journal Circulation.

“Cardiovascular disease produces immense health and economic burdens in the United States and globally,” the authors wrote.The 48% prevalence of cardiovascular disease — nearly 121.5 million adults — is a significant uptick over the rate cited last year, although this was mainly driven by the way high blood pressure is defined. Hypertension guidelines were updated so that people whose blood pressure is 130/80 or above are now considered “hypertensive”; previously, the definition was 140/90.

Excluding high blood pressure, prevalence of cardiovascular disease among US adults is 9% overall, a decline from 11.5% in 2015.

Dr. David Zhao, chief of cardiology medicine and executive director of the Heart and Vascular Center at Wake Forest Baptist Health in Winston-Salem, North Carolina, described the new report as a “painful reminder” that heart disease is still the No. 1 cause of death and disease in the nation.”

Overall, we have made a lot of progress,” said Zhao, who was not involved in the report. Still, “we have not yet made substantial advancement in obesity, diabetes, and unhealthy behavior,” which includes smoking, not exercising, poor diet and being overweight. About 8 of every 10 cases of cardiovascular disease can be prevented by controlling high blood pressure, diabetes and high cholesterol and maintaining a healthy lifestyle, according to the heart association.

The scorecard also shows some terrific gains. Self-reported inactivity among adults has been declining since 1998, with the trend escalating in recent years. Passivity plummeted from 40.1% to 26.9% between 2007 and 2016, the report shows.

Over the past five decades, smoking rates have also declined: About 51% of males and 34% of females smoked in 1965, compared with just 16.7% of males and 13.6% of females in 2015. 

The new report includes a new recommendation that adults get at least seven hours of sleep per night to promote optimal health. One recent study found that too much or too little — more than eight hours or less than seven hours per night — was linked with a greater risk of death from all causes.

“We really have to work harder to reduce all the risk factors in order to reduce rates of cardiovascular disease,” Zhao said, highlighting obesity. Nearly 4 out of 10 US adults and nearly 1 out of 5 youths is obese, while 7.7% of adults and 5.6% of youth are severely so, the report finds. Additionally, not all groups have made equal strides in quitting or never smoking cigarettes.

“Substantially higher tobacco use prevalence rates are observed in American Indian/Alaska Natives and lesbian, gay, bisexual, and transgender populations, as well as among individuals with low socioeconomic status, those with mental illness, individuals with HIV who are receiving medical care, and those who are active-duty military,” the report notes. “Over the past 6 years, there has been a sharp increase in e-cigarette use among adolescents.”

Overall, Zhao believes that “lots of work still needs to be done.

“We may be seeing downward trajectory in some risk factors and cardiovascular disease itself, “but we’re not there yet,” he said. “That’s something all of us need to start to think about: What can we do together to really improve our health, our healthy behavior, and reduce 

Looking for Motivation in 2019?

No matter where you are, you can always feel like you’re ready to hit the gym for a killer workout if you have a smartphone and an Instagram account. 

The social media platform is the go-to space for everyone when they want to post about their health and fitness. Pro trainers and amateur jocks alike can share pics and videos of their workouts, training plans, fails, and triumphs. Gym buddies aren’t just for spotting anymore—since everyone wants their best shot for the ‘Gram, your training partners might double as photographers and videographers, too.

On those tough days when the demands of life make it impossible to get a workout in, or the difficult times when you struggle to fire up the willpower to work out, it helps to get some extra motivation from the pros. With that in mind, we’ve lined up the best fitness accounts you should be following on Instagram. 

You’ll find a healthy mix of bodyweight exercises, cardio, mobility moves, strength training, and a whole lot of abs and sweat. These men and women don’t just show off their jaw-dropping muscle definition for their own gratification—they’ll inspire you to get moving, too.

DWAYNE “THE ROCK” JOHNSON

Simply put, The Rock is one of our fitness heroes. His workouts are brutal (and sometimes they include chains), he motivates his fans to work as hard as they can, and sometimes, he even shares his bonkers workout routines for those brave enough to give them a try. Look no further than his Instagram account if you need a kick in the ass today.


EBENEZER SAMUEL

Eb is worth a follow beyond the fact that he’s our Fitness Director—although that certainly doesn’t hurt his case. He’s also a top-tier trainer who posts multiple new workouts per week (which you can find in our Eb & Swole series) and a Men’s Health program, New Rules of Muscle, under his belt.

LAUREN FISHER

Lauren Fisher’s CrossFit workouts will give you plenty of reason to go pick up a barbell. The six-time CrossFit Games competitor fills her feed with pics and videos of her training, competitions, and travels.

DON SALADINO

Ever wonder who helps to push celebrities into the ridiculously good shape needed to play a superhero at the movies? Don Saladino, an NYC-based fitness master, is one of the trainers behind the transformations of Ryan Reynolds, Blake Lively, Sebastian Stan, David Harbour, and others. He shares workout moves to his account daily to give his followers a chance to suit up for their own superhero bodies, too.

EMILY SKYE

Meet Emily Skye—Australian trainer, fitness model, mom, and one of our favorite women in fitness. Her determination, positive attitude, and killer circuits go a long way when all you want to do is veg out on the couch. Don’t believe us? Try one of her bodyweight workouts for yourself.

GUNNAR PETERSON

If there’s a bangin’ celebrity body out there, Gunnar Peterson probably had something to do with it. He’s worked with countless NFL and NBA athletes and big name celebrities like Khloe Kardashian. Also, J Lo says he’s the best trainer she ever had—and who are we to argue with those results?

JOE HOLDER

For NYC-based Nike trainer Joe Holder, fitness isn’t about the glory, it’s about pushing other people to achieve their goals, which genuinely makes him happy. That’s a trainer we can appreciate.

Click “Read More” for links to accounts.

Intermittent fasting boosts health by strengthening daily rhythms

While the modern world appears awash with fad diets, people seem to be giving a fair bit of attention to intermittent fasting.

As its name implies, intermittent fasting involves eating nothing for extended periods of time.

Some studies have found that this type of diet is beneficial, but exactly why it benefits health is not yet clear.

Recently, a group of scientists at the University of California, Irvine investigated the impact of fasting on our circadian clock.

Daily sleep–wake cycles, or circadian rhythms, drive the ebb and flow of human life; they control much more than just our sleepiness levels. Our 24-hour cycles involve metabolic, physiological, and behavioral changes that impact every tissue of the body.

Perhaps the most well-known way to influence the clock is via exposure to bright lights, but this isn’t the only way; food intake also impacts the clock.

We are slowly beginning to understand how eating plays a role in modulating circadian rhythms, but we know even less about how a lack of food might affect rhythms.

Fasting and circadian rhythms

The authors of the new study were particularly interested in learning about how fasting influenced circadian rhythms in the liver and skeletal muscles. The researchers published their findings in the journal Cell Reports.

Fasting is a natural phenomenon for most animals, because food is not always readily available. In times of hardship, certain metabolic changes occur to allow the body to adapt.

As an example, one study split mice into two groups; the researchers put one on an intermittent fasting regime, and they allowed the second to eat whenever it liked.

Both groups consumed the same amount of fat and calories; however, despite having the same energy intake, mice in the fasting group did not develop obesity or metabolic disorders as the other mice did.

Also, importantly, the authors noted that the animals’ circadian oscillations were more robust in the fasting group.

As the authors of the recent study point out, “[F]asting appears to be a strong metabolic cue to entrain rhythmic gene expression.”

Scientists believe that having more clearly defined cycles might be part of the reason that fasting promotes good health.

How might this benefit us?

Having assessed the gene changes that occur with fasting, the scientists now need to explain how they might benefit health.

Prof. Sassone-Corsi suggests that “the reorganization of gene regulation by fasting could prime the genome to a more permissive state to anticipate upcoming food intake and thereby drive a new rhythmic cycle of gene expression.”

He adds, “In other words, fasting is able to essentially reprogram a variety of cellular responses. Therefore, optimal fasting in a timed manner would be strategic to positively affect cellular functions and ultimately benefitting health and protecting against aging-associated diseases.”

Over the years, it has grown increasingly clear that disrupting circadian rhythms can increase the risk of obesity and metabolic disorders, such as diabetes. This new work brings us closer to understanding why that might be.

Though understanding the influence of fasting on circadian rhythms and gene expression is still in its infancy, the authors hope that one day, their work will help find the optimum fasting regime for health.

Giving up alcohol for just 1 month has lasting benefits

Dry January is an initiative of the charity organization Alcohol Change United Kingdom, which encourages people to try giving up alcohol for 1 month at the start of the year.

Although the charity that promotes this effort is UK-based, thousands of people around the world pledge to take part in this campaign each year.

It is fairly logical to assume that giving up alcohol for 31 days can only benefit health, since drinking regularly is a major risk factor for cancer, liver disease, and cardiovascular diseases, among other issues.

Now, a study by researchers from the University of Sussex in Falmer, UK, shows just how much skipping alcohol for 1 month can improve your life and concludes that these benefits are long-lasting.

The research, which Dr. Richard de Visser from the University of Sussex led, found that people who took part in Dry January in 2018 reported higher energy levels and healthier body weight. They also felt less need to drink alcohol, even several months after participating in this initiative.

1 alcohol-free month boosts long-term health

Dr. de Visser and team analyzed data that they collected from Dry January participants in three online surveys. A total of 2,821 people filled in a survey upon registering for the campaign at the beginning of January. In the first week of February, 1,715 participants completed a survey, and 816 participants submitted additional data in August 2018.

The researchers found that giving up alcohol for a month helped the participants reduce their number of drinking days later in the year. The number decreased from an average of 4.3 days per week before taking part in Dry January to an average of 3.3 days per week afterward.

Moreover, people who went teetotal for a month also got drunk a lot less frequently later on in the year. Rates of excessive drinking fell from an average of 3.4 times per month at baseline to 2.1 times per month on average.

In fact, Dry January participants also learned to drink less. They went from consuming an average of 8.6 units of alcohol per drinking day at baseline to 7.1 units of alcohol per drinking day later on.

“The simple act of taking a month off alcohol helps people drink less in the long term; by August, people are reporting one extra dry day per week,” notes Dr. de Visser.

“There are also considerable immediate benefits: nine in 10 people save money, seven in 10 sleep better, and three in five lose weight,” he adds.

Important benefits, however, are also available to those who give up alcohol for shorter periods. An alcohol-free month would be better, but even less than that can still boost a person’s health, Dr. de Visser says.

“Interestingly, these changes in alcohol consumption have also been seen in the participants who didn’t manage to stay alcohol-free for the whole month — although they are a bit smaller. This shows that there are real benefits to just trying to complete Dry January,” the researcher emphasizes.

A long list of benefits

The people who took part in Dry January last year noted numerous mental and physical health benefits as well as a “healthier” bank account. More specifically:

93 percent of participants reported experiencing a sense of achievement at the end of the alcohol-free month
88 percent had saved the money that they would otherwise have spent on drinks
82 percent of participants reported an enhanced awareness of their relationship with alcohol
80 percent felt more in control of their drinking habits
76 percent understood when they felt more tempted to drink and why
71 percent of participants learned that they did not need alcohol to have fun
71 percent said that they enjoyed a better quality of sleep
70 percent reported better overall health
67 percent had higher energy levels
58 percent of participants lost weight
57 percent reported improved concentration
54 percent said that they noticed better skin health
“The brilliant thing about Dry January is that it’s not really about January. Being alcohol-free for 31 days shows us that we don’t need alcohol to have fun, to relax, to socialize,” says Dr. Richard Piper, the CEO of Alcohol Change UK.

“That means that for the rest of the year, we are better able to make decisions about our drinking and to avoid slipping into drinking more than we really want to,” Dr. Piper notes.

Is Snoring Dangerous? Here’s When to Worry

Winston Churchill was a notorious snorer. So, allegedly, was Queen Victoria. They have plenty of company. Roughly 1 in 3 men and 1 in 4 women snore every night or almost every night, according to statistics from the National Sleep Foundation.

Why do people snore? “When we’re asleep, we tend to lose muscle tone—meaning the tongue flops back and the tissues and muscles in the throat and nose relax,” says Dr. Brett Comer, a head and neck surgeon and associate professor of otolaryngology at the University of Kentucky. As you inhale and exhale, the air passing over and between these relaxed tissues causes them to vibrate, which in turn causes noise. That’s snoring.

Comer says a bunch of factors play into a person’s propensity for snoring. Being overweight is one. “We all have fat beds at the base of the tongue and along the upper throat,” he explains. “When those are taking up more space, they can push in the muscles and block things off.” Drinking alcohol can further relax the muscles and tissues of your airways, and so promote snoring. Back-sleeping, too, can cause your tongue to sag into your throat where it may constrict air flow and increase the vibrations.

Several structural factors also lead to snoring, he says. One is a deviated septum, which is when the wall inside your nose that separates your nostrils is askew, and so pinches off air circulation. And you know that dangly thing that hangs down in the back of your throat? That’s called your uvula. If it’s on the long side, it can relax and rest on your tongue, making snoring more likely, he says.

The good news is that in most cases, snoring isn’t a problem. (At least, not for the person who’s sawing logs.) But there are exceptions.

A 2016 study in the journal Sleep and Breathing found that snoring, combined with extended breathing stoppages (also known as obstructive sleep apnea), was associated with a two-fold increase in cardiovascular disease risk.

Why? Snoring and sleep apnea may lead to “intermittent hypoxia,” says Dr. Teemu Niiranen, first author of the study and a researcher with Finland’s National Institute for Health and Welfare. Hypoxia is a medical condition in which the tissues of the body don’t receive enough oxygen. This can lead to arterial damage or blockages, inflammation and unhealthy pressure changes inside the chest.

There’s no easy way to monitor yourself for obstructive sleep apnea. But if someone can keep tabs on your snoring, they should be on the lookout for a “complete lack of breathing” for around 10 seconds or longer, Comer says. The treatment for sleep apnea usually initially involves losing weight and sleeping with a breathing device known as a continuous positive airway pressure (CPAP) ventilator, though there are also some surgical interventions that can be done.

Some other snoring patterns may also be cause for concern. “If it sounds like a person often quits breathing or has very shallow breathing for three or four seconds, and then there’s gurgling or choking accompanied by a sort of startled shaking—like the body is trying to wake itself up—I’d have that checked by a doctor,” Comer says. These could all be signs of hypopnea, a sleep-breathing disorder similar to apnea that is also linked to some heart and vascular concerns.

In sum, if a sleeper seems to be breathing normally—albeit loudly—snoring isn’t a concern. The one exception, Comer says, is if a former non-snorer suddenly develops a “heroic” snore. “New-onset severe snoring can be sign of an obstruction forming in an airway,” he says. Tell your doctor.

Lay off the booze and try to sleep on your side, and both you and your bedmate should rest easier at night.

How does yo-yo dieting affect our heart health?

As we roll into 2019, many people will be trying out new diet regimes.

For many of us, sticking to a nut-filled, burger-free, fish-heavy Mediterranean-style diet will only last a matter of days before we return to the realms of cheesecake and cheese boards.

Though eating right over the long-term reduces the risk of cardiovascular problems, we know much less about how a fluctuating dietary regime impacts our heart health.

Because so many people choose a diet and then gradually stray from it, researchers are interested in how yo-yo dieting might influence markers of cardiovascular disease.

A team led by Prof. Wayne Campbell, of Purdue University in West Lafayette, IN, set out to investigate. The scientists recently published their findings in the journal Nutrients.

Altering eating patterns periodically

To investigate, the scientists inspected data from two previous studies into dietary interventions carried out by the same group of researchers at Purdue University.

The participants of these studies followed one of two eating patterns: a Mediterranean diet or a Dietary Approaches to Stop Hypertension (DASH) diet.

Lead study author Lauren O’Connor explains these two eating patterns, saying, “Our DASH-style eating pattern focused on controlling sodium intake, while our Mediterranean-style focused on increasing healthy fats. Both eating patterns were rich in fruits, vegetables, and whole grains.”

Following the 5–6 weeks of dieting, participants went back to their standard eating patterns for a further 4 weeks. Then, after another cardiovascular assessment, they were restarted on DASH or Mediterranean diet plans for an additional 5–6 weeks. Finally, they had one more checkup at the end of this period.

A cardiometabolic ‘rollercoaster’

The analysis showed that, as expected, the cardiovascular markers improved when the individual stuck to the diet. Then, once they had returned to a less healthful eating regime, the biomarkers became less favorable again.

Then, once the healthful diets were restarted, the metabolic markers once again improved.

The key message is that only a few weeks of healthful eating can make measurable improvements to markers of cardiovascular health, but at the same time, it does not take long before they return to their unhealthy state once a person terminates their healthful diet.

“These findings should encourage people to try again if they fail at their first attempt to adopt a healthy eating pattern,” Prof. Campbell says. “It seems that your body isn’t going to become resistant to the health-promoting effects of this diet pattern just because you tried it and weren’t successful the first time.”

More research will be needed to explore whether yo-yo dieting has an impact on long-term health.

Some studies have shown that losing and gaining weight again in a cycle, or weight cycling, could cause stress to the cardiovascular system. However, the evidence is certainly not overwhelming, and some scientists question whether weight cycling has any adverse effects at all.

Overall, the results are bittersweet; they show that just a few weeks of dietary change can produce measurable improvements in health markers. On the flip side, after just a few weeks following the abandonment of a new diet, those benefits are lost.

However, if a person restarts their healthful eating plan, the benefits can be won back in the same short amount of time. As such, Prof. Campbell’s message is one of stubborn persistence:

The best option is to keep the healthy pattern going, but if you slip up, try again.”

The 5 Worst Health and Fitness New Year’s Resolutions You Can Make

While setting goals that are focused on your health is important, it’s equally important to make them more realistic rather than extreme. There’s nothing wrong with desiring washboard abs, but you also want to ensure you’re working towards your fitness goals in the most healthy way possible.

Which is why we’ve come up with the five worst health and fitness New Year’s resolutions you can make.

1. Trying the Latest Fad Diet

From paleo to keto, many people want to try the latest fad diet without investing their time and energy into eating whole, nutritious food, and a long-term healthy diet. While a fad diet might promote “fast results,” those results seldom last.

Traci Mann, who teaches psychology at the University of Minnesota, and has studied eating habits and diets for 20 years, and wrote the book, “Secrets from the Eating Lab,” told the Washington Post that dieting causes “many biological changes happen in your body that it becomes practically impossible to keep the weight off.”

For one, “Your metabolism slows down. Your body uses calories in the most efficient way possible. Which sounds like a good thing, and would be a good thing if you’re starving to death. But it isn’t a good thing if you’re trying to lose weight, because when your body finds a way to run itself on fewer calories there tends to be more leftover, and those get stored as fat, which is exactly what you don’t want to happen.”

Which is why focusing on balancing your diet with a variety of fresh and whole foods is best.

2. Working Out Every Day

Sure, you might be super pumped to hit the gym often in January but what happens when you inevitably slack off in February? And then you get so frustrated and disappointed in yourself that you end up quitting the gym altogether in March? Because that’s what usually happens when people set such extreme goals for themselves; they often set themselves up for failure.

Instead, be more realistic with your goals. If you haven’t worked out before, or haven’t been to the gym in ages, setting a goal of attending two to three times a week is more than enough. If you end up meeting those goals, then you can consider adding in another day or two in a few months. Setting realistic goals make them more achievable, which, in turn, promotes more success.

3. Swearing Off All Junk Food

Here’s the thing: if you completely cut out those afternoon cookies from your diet, chances are, you’ll crave them more, which means you’re more likely to overindulge. Instead of one or two cookies a day, you’ll probably finish off the box.

So treat yourself! Cheat meals are important to a well-balanced diet because they allow you to satisfy cravings, while also giving you the opportunity to live a little. In fact, recent research has found that giving yourself an incentive or reward, like a slice of your favorite cake, can be an effective strategy for weight loss goals.

4. Losing “X” Amount of Pounds

Committing to losing a certain number of pounds by, especially by a certain date, is just adding another stressor to your life, and rarely works. Here’s why: a scale is rarely an accurate barometer of our health and fitness. Tracking your body composition, like body fat versus lean muscle, is a far more accurate assessment of your weight loss.

Additionally, it’s important to keep in mind that, while a pound of muscle weighs the same as a pound of fat, twenty pounds of fat looks different than ten pounds of muscle. Muscle is more dense than fat, so it will take up “less space,” resulting in a leaner look.

Focusing on getting fitter and stronger with a new exercise regime, including a mix of cardio and weightlifting, is a far more effective game plan.

5. Starting on January 1st

Okay, this might defeat the purpose of New Year’s resolution, but let’s be real: who’s actually raring to hit the gym after New Year’s Eve? And then when you don’t end up eating a healthy salad or working up a sweat on January 1st, you’ll probably feel guilty about your new resolutions, which isn’t the best mindset to start with. Instead, give yourself a break. Start on the 2nd, or start now. You should begin a new lifestyle change because you want to; not because you think you “have” to by or on a certain day.

Because leading a healthy lifestyle is a lifelong journey; not just for one year but for always.

Red meat raises heart disease risk through gut bacteria

They found that people who ate red meat as their main source of protein for 1 month had levels of trimethylamine N-oxide (TMAO) that were two to three times higher than those in people who got their protein primarily from white meat or non-meat sources.

Gut bacteria produce TMAO as a byproduct when they feed on certain nutrients during digestion.

Previous studies have implicated high circulating levels of TMAO in the development of artery-blocking plaques and raised risk of heart-related conditions.

In the recent research, scientists at the Cleveland Clinic in Ohio uncovered two mechanisms through which a diet rich in red meat raises TMAO levels.

It appears that not only does frequent consumption of red meat enhance gut bacteria production of TMAO, but it also reduces elimination of the compound through the kidneys.

The European Heart Journal has published a report on the study and its findings.

“This is the first study of our knowledge,” says senior study author Dr. Stanley L. Hazen, who chairs the Department of Cellular and Molecular Medicine in the Cleveland Clinic’s Lerner Research Institute, “to show that the kidneys can change how effectively they expel different compounds depending on the diet that one eats — other than salts and water.”

TMAO as a predictor of heart disease risk

In previous work, Dr. Hazen and his team had found that TMAO alters blood platelets to raise the risk of thrombosis, or blood clots.

Their work revealed that TMAO modifies calcium signaling in blood platelets. In addition, it showed that platelets respond differently to blood-clotting triggers when blood levels of TMAO are high.

The team proposed that the compound could be a powerful predictor of the risk of heart attack, stroke, and death — even when cholesterol and blood pressure levels are healthy.

Others have since replicated the findings and, like Dr. Hazen and his team, have continued to investigate TMAO and its impact on health.

Research from the University of Leicester in the United Kingdom, for example, demonstrated that people with acute heart failure fared worse if they had higher circulating levels of TMAO.

Clinical trials are also underway to test TMAO as a predictive marker of heart disease risk.

Red meat diet compared with other diets

The recent study assigned 113 individuals to follow three tightly controlled diets in a random order for 4 weeks each with a “washout diet” preceding the changeover.

The diets differed according to their main source of protein. In the red meat diet, 12 percent of the daily calories came from lean red meat in the form of pork or beef, while in the white meat diet, these calories came from lean white poultry meat.

In the non-meat diet, 12 percent of the daily calorie intake came from “legumes, nuts, grains, [and] isoflavone-free soy products.”

In all three diets, protein accounted for 25 percent of the daily calories, and the remaining 13 percent of this protein came from “eggs, dairy, and vegetable sources.”

After 4 weeks on the red meat diet, “the majority of” the individuals had raised levels of TMAO in their blood and urine.

On average, compared with levels during the white meat and non-meat diets, blood levels of TMAO during the red meat diet were up to three times higher. For some individuals, the levels were 10 times higher. Urine samples revealed a similar pattern.

9 Hacks for Heart-Healthy Holidays

Holiday tips for heart health

  • Fill up with healthy foods before holiday parties. “Plan out your concept so you’re not just starving yourself all day and then go to a party and gorge yourself silly,” Weinberg said.
  • Toss the white rice. Bennett said brown rice or quinoa can be used instead of white rice in dishes.
  • Up the veggies without the fat and starch. Zucchini or squash can be substituted for pasta and cauliflower for potatoes, said Bennett.
  • Chew while you cook. “Chew sugar-free gum or chew on veggies while cooking to avoid eating a meal’s worth of calories while cooking,” Bennett said.
  • Keep stress down. “Stress plays a role during the holidays too,” Bennett said. “Set a time limit on visitors. Take a walk. Enjoy a holiday movie or book, [or a] holiday coloring book. Light a comforting-smelling candle. Name three things you are grateful for. Holiday-themed puzzles are fun for the entire family.”
  • Get creative with leftovers. “Share leftovers with family and friends,” said Bennett. “Use leftovers to jazz up a salad or make a soup and add more veggies. Lettuce wraps make great leftover tacos.”
  • Use pineapple for baking. “The AHA article mentioned using unsweetened applesauce in baking,” said Yalvac. “I would add the ‘hack’ of substituting sugar in baking with pureed fresh pineapple. The pineapple is a natural source of sweetness — and the secret ingredient to the carrot cake my wife and I make every year.”
  • Weigh yourself every day. “It is amazing what this one trick can do,” Yalvac said. “If you go for four days of partying and drinking and eating, you could end the weekend with 5 to 10 extra pounds. By weighing yourself every day, you establish a feedback loop between the food and drinks you consume and your weight. If you overdo it on Thanksgiving, and you get on the scale Friday morning to find you’ve gained 3 pounds, you’re going to hold back on that piece of pie Friday night.”
  • Go for a walk after dinner. “Be sure to maintain exercise however you can get it in,” Yalvac said. “Just because you’re going to parties doesn’t mean you can’t keep moving and taking care of yourself.”

Working America: Open Enrollment

Even if you already have a plan, it’s worth checking to see if your rates have changed.

Check your rates now. Log on to WorkingAmericaHealthCare.org/NFLPA or call (855) 907-9683 to find out more about your plan options.

With assistance from our recommended licensed professionals, Working America Health Care makes the process easier. We can help you:

  • Review state or federal marketplace plan options
  • Sort through all of your plan options – at no extra cost
  • Save money on dental and vision coverage

As a member of Working America or a labor union, by enrolling in a qualified health plan through the Working America Health Care program, you and your family will have access to unique health-related member benefits such as a complimentary personal Health Advocate* with services to:

  • Help coordinate all care
  • Answer questions about coverage Understand benefits and insurance plan details
  • Recommend and find the right providers / hospitals
  • Explain conditions and treatments through Nurse Helpline
  • Untangle medical bills and, as appropriate, resolve claims

*See website for eligibility requirements.

Get started today. Visit WorkingAmericaHealthCare.org/NFLPA or call (855)907-8683 for 1-on-1 assistance with your decision.

Study finds 5 types of alcohol use disorder that vary with age

According to the National Institutes of Health (NIH), approximately 16 million individuals living in the United States have alcohol use disorder (AUD).

Experts describe AUD as a “chronic relapsing brain disease” where a person drinks compulsively, often to the point of it interfering with their daily life.

However, AUD is more complex than a person simply drinking excessively.

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), 11 criteria help a professional decide if someone has an AUD. If the person meets two of these criteria during a 12-month period, a doctor will consider they have the condition.

New research has now added even more nuance to the issue of problematic drinking. There are five types of excessive drinking within AUD, concludes the new study, which appears in the journal Alcohol and Alcoholism.

Furthermore, each distinct profile has its own set of symptoms and tends to be more common at certain ages, the paper shows.

Ashley Linden-Carmichael led the new study. She is an assistant research professor of biobehavioral health and faculty affiliate at the Edna Bennett Pierce Prevention Research Center at Pennsylvania State University in State College, PA.

5 age-related AUD profiles revealed

Linden-Carmichael and her colleagues examined the data on 5,402 participants, aged between 18 and 64 years old, who were enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions and had met the criteria for an AUD in the past year.

The researchers applied a new method called latent class analysis to study subtypes or “profiles” of people with an AUD, clustering together those who shared the same symptoms, as well as drinking too much. The analysis revealed five AUD classes:

  • “Alcohol-induced injury” characterized 25 percent of the participants. People with this profile engaged in risky behavior and got into dangerous situations that might have caused injury.
  • “Highly problematic, low perceived life interference” characterized 21 percent of the participants. This group said that their alcohol consumption did not have any adverse effect on their lives and did not affect their family, work, or social obligations, despite also reporting that they experienced many AUD symptoms.
  • The “Adverse effects only” profile included 34 percent of the participants, who reported hangovers or alcohol withdrawal symptoms.
  • “Difficulty cutting back” was a profile prevalent among 13 percent of the participants. People in this category struggled or were unable to cut back on their drinking.
  • “Highly problematic” was the final category, which made up 7 percent of the total number of participants who had every symptom of AUD.

Additionally, the analysis revealed how common each profile was when people were at different ages.

“The adverse effects only and highly problematic, low perceived life interference classes were particularly prevalent among younger adults,” write the authors, whereas “the difficulty cutting back and alcohol-induced injury classes were more prevalent as age increased.”

The main implication of the findings, says the study’s lead author, is that we need tailored treatments for people with AUD.

“We need to think beyond whether someone has an alcohol use disorder, yes or no, and take a look specifically at what they’re struggling with and whether they’re in a particularly risky class,” says Linden-Carmichael.

“Additionally, while young adults are most at risk for an alcohol use disorder, it’s clear that it’s also an issue for people in middle age or in older adulthood, too. But it might look different, and they may be struggling with different aspects of drinking.”

Therapists could consider, for example, that when someone is a young adult, they should be looking for that person experiencing withdrawal symptoms […] Conversely, if someone is older, they could look for struggles with cutting back their drinking or alcohol-related injuries.”

Ashley Linden-Carmichael

The lead author also shares some of her directions for future research. “I’m interested in seeing, for example, if someone has a certain profile at a younger age, what happens to them later?” Linden-Carmichael says.

“If a person is in the adverse effects only class at 21, what does their drinking look like at age 60? Do they escalate or slow down? If we could have a similarly large study but follow them across age, that would be the most intuitive and most beneficial for practice,” concludes the researcher.

Best foods for increasing low testosterone

Testosterone is a male sex hormone that plays a role in fertility, sexual function, bone health, and muscle mass.

A person’s testosterone level will fall naturally with age — by 1 to 2 percent per year — but some medical conditions, lifestyle choices, and other factors can influence the amount of this hormone in the body.

Some medical treatments can raise low testosterone levels, especially in younger men, but a person can also encourage the body to produce more by making some changes to the diet and lifestyle.

In this article, we list the best foods for increasing testosterone levels. We also describe products to avoid and other ways to increase testosterone production.

Top 8 testosterone-boosting foods

A person with low testosterone may benefit from trying:

1. Ginger

People have used ginger for medicinal and culinary purposes for centuries. Modern research indicates that this root may improve fertility in men.

According to the findings of a 2012 study, taking a daily ginger supplement for 3 months increased testosterone levels by 17.7 percent in a group of 75 adult male participants with fertility issues. The authors suggested that ginger may also improve sperm health in other ways.

Authors of a study from 2013 report that ginger increased testosterone and antioxidant levels in a diabetic rat model in just 30 days.

2. Oysters

Oysters contain more zinc per serving than any other food — and zinc is important for sperm health and reproductive function.

Males with severe zinc deficiency may develop hypogonadism, in which the body does not produce enough testosterone. They may also experience impotence or delayed sexual maturation.

People can also find the mineral in:

  • other shellfish
  • red meat
  • poultry
  • beans
  • nuts

It is important to note that zinc and copper compete for absorption. Take care when choosing supplements to avoid consuming too much of either mineral.

3. Pomegranates

The pomegranate is an age-old symbol of fertility and sexual function, and its antioxidant levels may support heart health and stress reduction.

Also, results of a study from 2012 indicate that pomegranate may boost testosterone levels in men and women. Sixty healthy participants drank pure pomegranate juice for 14 days, and researchers tested the levels of testosterone in their saliva three times a day.

At the end of the study period, both male and female participants displayed an average 24 percent increase in salivary testosterone levels. They also experienced improvements in mood and blood pressure.

4. Fortified plant milks

Vitamin D is an essential nutrient, and results of a study from 2011 suggest that it may increase testosterone levels in men.

It is important to note that the dosage in this study was 3,332 international units (IU) of the vitamin per day, which far exceeds the 400 IU recommended daily for healthy people.

While sun exposure is one of the best ways to get vitamin D, not everyone can spend enough time outdoors in sunny weather. In the average American diet, fortified foods provide the majority of the vitamin D.

How to eat healthfully: Double your portion size

If somebody gives us a huge bowl of candy, we are likely to eat more of it than if someone gives us a smaller bowl of candy.

Scientists have studied the so-called portion size effect in some depth.

One review of the research found that when a portion size is doubled, people consume an average of 35 percent more.

Food outlets often advertise larger portion sizes to attract customers, and many health professionals believe that this tactic might play a role in the rise of obesity in the United States.

For this reason, health-conscious people around the world make sure to only give themselves small portions of foods that some may call unhealthful.

Despite a great deal of research into the negative consequences of portion size, very few studies have focused on the potential benefits. Could increasing portion size of healthful snacks increase their consumption?

With this in mind, researchers from Deakin University in Australia recently set out to see whether the effect would work in reverse.

The study, which Prof. Chris Dubelaar led, was a coordinated effort between scientists in Australia and France. Their findings now appear in the journal Food Quality and Preference.

Portion size revisited

In order to investigate, the team designed two complementary experiments. The first involved 153 university students in a laboratory setting. The scientists gave them large or small portions of healthful apple chips or unhealthful potato chips.

As expected, the participants to whom the team gave the larger portions of snacks — even the healthful versions — ate significantly more than the group with the smaller portions.

The second phase took place at a film festival. In total, the researchers gave 77 participants a small or a large bag of baby carrots. They watched either a film about a restaurant, which included many scenes involving food, or a romantic comedy with no particular food references.

Again, those with the larger bag ate more of the healthful snack. Interestingly, the effect was less pronounced in the group that watched the film about the restaurant; this demonstrates the significant impact that the environment can have on our eating behavior.

Prof. Dubelaar thinks that this could provide an “opportunity for those seeking to control intake to consider their environment when they’re eating to help reduce the effects of portion size.”

Real-life implications

Overall, the study’s results give an interesting insight into the convoluted world of food psychology. They might also offer some new ways to improve our eating habits.

He continues, “For example, parents trying to get their children to eat more veggies could serve up larger portions. This would also work for healthy snacks such as fruit or any food you want someone to eat more of.”

The authors suggest that beginning a meal with a large portion of healthful food before a smaller plate of unhealthful food might be a useful approach.

Because obesity is a growing concern in the U.S. and elsewhere, understanding the nuances of our relationship with food is more important than ever. Though this study used a relatively low number of participants, it offers fresh insight and is likely to spur future investigations in a similar vein.

There is a myriad of variables that scientists could analyze in follow-up work. For instance, healthful and unhealthful snacks often have very different flavor and texture profiles, so understanding how each of these subtle differences impacts the portion size effect will be interesting.

Until more studies are carried out, the take-home message is: Don’t worry how large the portion is, worry about what you are apportioning.

The Top Fitness Trends of 2019

Even though the cornerstones of health and fitness are fairly concrete (consume fewer calories than you burn—and make sure those calories are derived from nutritious, whole foods), we like to shake up our methods. We’ve seen trends change over the decades from fat-burning DVDs to sport-specific training. Don’t deny it: You’ve probably searched for workouts that’ll turn you into Tom Brady.

Wolters Kluwer Health just released its 13th annual Worldwide Survey of Fitness Trends for 2019, comprising intel from more than 2,000 health and fitness professionals.

“The survey was designed to confirm or to introduce new trends (not fads) that have a perceived positive impact on the industry according to the international respondent,” Walter R. Thompson, Ph.D., FACSM, of Georgia State University, Atlanta, and Immediate Past-President of ACSM says in a press release.

The top 20 include workplace health and fitness promotions (No. 15), as well as a boom in employment of certified fitness professionals (No. 6). However, trends that have fallen from the list include circuit weight training, sport-specific training, and core training.

Check out the top five fitness trends of 2019 below.

5. Bodyweight Training
Bodyweight training can be overlooked by gym maniacs who prioritize how much metal they can press over the quality of their movements. But using your own bodyweight as resistance is a killer way to safely build muscle. Training smarter, not necessarily harder is taking precedence in personal and group training, so it’s no surprise this hits the list at No. 5.

4. Fitness Programs for Older Adults
Fitness programs for older adults have made some serious headway, surging to the top 10 in recent years. It’s not always easy to build muscle over the age of 40, but regimens that emphasize flexibility, mobility, and strength can help minimize the risk of injury and keep older adults healthier in the long run.

3. High-intensity Interval Training (HIIT)
Our inclination to torch calories as efficiently as possible hasn’t faltered: HIIT is still incredibly popular among fitnesss enthusiasts, ranking third on the list. High-intensity interval training includes any short bouts of rigorous exercise, followed by minimal rest periods. They rev your heart rate and turn workouts metabolic, meaning you burn fat long after you finish the workout.

2. Group Training
Fitness classes are still booming, holding the No. 2 spot for the second year in a row. There’s a distinction, though. The survey classified group training as classes with more than five participants. Small group personal training hit lower on the list (No. 19).

1. Fitness Trackers
Wearables reign supreme for 2019. Interestingly enough, they were at the top of the ranking for two years before dropping to No. 3 in last year’s survery. It “may be the result of manufacturers correcting some monitoring inaccuracies of the past,” Thompson guesses.

Open Enrollment is Underway.

Today is the day.

Even if you already have a plan, it’s worth checking to see if your rates have changed.

Check your rates now. Log on to WorkingAmericaHealthCare.org/NFLPA or call (855) 907-9683 to find out more about your plan options.

With assistance from our recommended licensed professionals, Working America Health Care makes the process easier. We can help you:

  • Review state or federal marketplace plan options
  • Sort through all of your plan options – at no extra cost
  • Save money on dental and vision coverage

As a member of Working America or a labor union, by enrolling in a qualified health plan through the Working America Health Care program, you and your family will have access to unique health-related member benefits such as a complimentary personal Health Advocate* with services to:

  • Help coordinate all care
  • Answer questions about coverage Understand benefits and insurance plan details
  • Recommend and find the right providers / hospitals
  • Explain conditions and treatments through Nurse Helpline
  • Untangle medical bills and, as appropriate, resolve claims

*See website for eligibility requirements.

Get started today. Visit WorkingAmericaHealthCare.org/NFLPA or call (855)907-8683 for 1-on-1 assistance with your decision.

 

Intermittent fasting: Surprising update

There’s a ton of incredibly promising intermittent fasting (IF) research done on fat rats. They lose weight, their blood pressure, cholesterol, and blood sugars improve… but they’re rats. Studies in humans, almost across the board, have shown that IF is safe and incredibly effective, but really no more effective than any other diet. In addition, many people find it difficult to fast.

But a growing body of research suggests that the timing of the fast is key, and can make IF a more realistic, sustainable, and effective approach for weight loss, as well as for diabetes prevention.

The backstory on intermittent fasting

IF as a weight loss approach has been around in various forms for ages, but was highly popularized in 2012 by BBC broadcast journalist Dr. Michael Mosley’s TV documentary Eat Fast, Live Longer and book The Fast Diet, followed by journalist Kate Harrison’s book The 5:2 Diet based on her own experience, and subsequently by Dr. Jason Fung’s 2016 bestseller The Obesity Code. IF generated a steady positive buzz as anecdotes of its effectiveness proliferated.

As a lifestyle-leaning research doctor, I needed to understand the science. The Obesity Codeseemed the most evidence-based summary resource, and I loved it. Fung successfully combines plenty of research, his clinical experience, and sensible nutrition advice, and also addresses the socioeconomic forces conspiring to make us fat. He is very clear that we should eat more fruits and veggies, fiber, healthy protein, and fats, and avoid sugar, refined grains, processed foods, and for God’s sake, stop snacking. Check, check, check, I agree. The only part that was still questionable in my mind was the intermittent fasting part.

Intermittent fasting can help weight loss

IF makes intuitive sense. The food we eat is broken down by enzymes in our gut and eventually ends up as molecules in our bloodstream. Carbohydrates, particularly sugars and refined grains (think white flours and rice), are quickly broken down into sugar, which our cells use for energy. If our cells don’t use it all, we store it in our fat cells as, well, fat. But sugar can only enter our cells with insulin, a hormone made in the pancreas. Insulin brings sugar into the fat cells and keeps it there.

Between meals, as long as we don’t snack, our insulin levels will go down and our fat cells can then release their stored sugar, to be used as energy. We lose weight if we let our insulin levels go down. The entire idea of IF is to allow the insulin levels to go down far enough and for long enough that we burn off our fat.

Intermittent fasting can be hard… but maybe it doesn’t have to be

Initial human studies that compared fasting every other day to eating less every day showed that both worked about equally for weight loss, though people struggled with the fasting days. So I had written off IF as no better or worse than simply eating less, only far more uncomfortable. My advice was to just stick with the sensible, plant-based, Mediterranean-style diet.

New research is suggesting that not all IF approaches are the same, and some are actually very reasonable, effective, and sustainable, especially when combined with a nutritious plant-based diet. So I’m prepared to take my lumps on this one (and even revise my prior post).

We have evolved to be in sync with the day/night cycle, i.e., a circadian rhythm. Our metabolism has adapted to daytime food, nighttime sleep. Nighttime eating is well associated with a higher risk of obesity, as well as diabetes.

Based on this, researchers from the University of Alabama conducted a study with a small group of obese men with prediabetes. They compared a form of intermittent fasting called “early time-restricted feeding,” where all meals were fit into an early eight-hour period of the day (7 am to 3 pm), or spread out over 12 hours (between 7 am and 7 pm). Both groups maintained their weight (did not gain or lose) but after five weeks, the eight-hours group had dramatically lower insulin levels and significantly improved insulin sensitivity, as well as significantly lower blood pressure. The best part? The eight-hours group also had significantly decreased appetite. They weren’t starving.

Just changing the timing of meals, by eating earlier in the day and extending the overnight fast, significantly benefited metabolism even in people who didn’t lose a single pound.

So is this as good as it sounds?

I was very curious about this, so I asked the opinion of metabolic expert Dr. Deborah Wexler, Director of the Massachusetts General Hospital Diabetes Center and associate professor at Harvard Medical School. Here is what she told me. “There is evidence to suggest that the circadian rhythm fasting approach, where meals are restricted to an eight to 10-hour period of the daytime, is effective,” she confirmed, though generally she recommends that people “use an eating approach that works for them and is sustainable to them.”

So here’s the deal. There is some good scientific evidence suggesting that circadian rhythm fasting, when combined with a healthy diet and lifestyle, can be a particularly effective approach to weight loss, especially for people at risk for diabetes. (However, people with advanced diabetes or who are on medications for diabetes, people with a history of eating disorders like anorexia and bulimia, and pregnant or breastfeeding women should not attempt intermittent fasting unless under the close supervision of a physician who can monitor them.)

4 ways to use this information for better health

  1. Avoid sugars and refined grains. Instead, eat fruits, vegetables, beans, lentils, whole grains, lean proteins, and healthy fats (a sensible, plant-based, Mediterranean-style diet).
  2. Let your body burn fat between meals. Don’t snack. Be active throughout your day. Build muscle tone.
  3. Consider a simple form of intermittent fasting. Limit the hours of the day when you eat, and for best effect, make it earlier in the day (between 7 am to 3 pm, or even 10 am to 6 pm, but definitely not in the evening before bed).
  4. Avoid snacking or eating at nighttime, all the time.

Treating sleep apnea may improve stroke outcomes

If you are a former NFL player and believe you are suffering from sleep apnea, reach out to the PAF to discuss potential available resources.

Treating a common sleep disorder immediately after a stroke or mini-stroke may improve patients’ neurological symptoms and daily functioning, a small study suggests.

At least 25 million adults in the U.S. have obstructive sleep apnea, which causes their airway to close, briefly halting breathing, for a few seconds multiple times during sleep. The condition has been linked with increased risk for heart attack, hypertension, sudden death, stroke and faster progression of cardiovascular disease. Sleep apnea sufferers can use CPAP machines to keep their airway open during sleep.

In the study, researchers found that stroke patients diagnosed with sleep apnea saw greater improvements in both neurological symptoms and daily ability to function when they used CPAP compared to patients with apnea who only received usual medical care.

“I think the implications of the study are that patients with stroke and TIA should receive early diagnostic testing with a sleep study. If they have sleep apnea then we should treat them before they leave the hospital,” said lead author Dawn M. Bravata, research scientist at the Regenstrief Institute and Richard L. Rouedeush VA Medical Center in Indianapolis, Indiana.

For the new analysis, researchers studied 252 adults hospitalized for an ischemic stroke or a mini-stroke, known as a transient ischemic attack (TIA). They screened everyone for sleep apnea and found that roughly three-quarters of patients had the sleep breathing disorder.

About two-thirds of patients with sleep apnea were assigned to one of two interventions that included receiving a CPAP machine as well as training and encouragement in its use. The other third with sleep apnea served as a control group and received usual medical care, plus a recommendation at the end of the study to seek CPAP treatment.

Patients’ neurological symptoms and their ability to function in normal activities like walking and self-care were assessed at the beginning of the study and six months to one year later.

At follow-up, all of the patients showed improvement in both neurological symptoms and functional status, however 59 percent of the patients who used CPAP had neurological symptom scores at or close to normal, in contrast with just 38 percent of controls.

“All the evidence suggests if you treat sleep apnea early, the better your stroke outcome will be. But it would be hard for a hospital to do. They would have to reconfigure their sleep services to be acute,” Bravata said in a phone interview.

“If physicians could reduce some disability due to post-stroke events it would be huge,” said Michael Twery, director of the National Heart, Lung and Blood Institute’s Center on Sleep Disorders Research, who wasn’t involved in the study.

One of the limitations of the new analysis, which was published in the Journal of the American Heart Association, is that it was conducted at only two sites.

A new, Phase Three multicenter study conducted by the National Institute of Neurological Disorders and Stroke will be more representative, Twery noted. “It will establish which patients benefit from a new treatment and how much do they benefit across many hospital locations.”

New designs in CPAP machines have become streamlined and are smaller than a shoebox. The mask comes in different styles, Bravata said. “It’s sort of like shoe shopping. It’s a matter of finding things you like that fits you very well.”

“Treating stroke or TIA patients with CPAP will never replace traditional therapies. But patients should be asking their physicians to be tested for sleep apnea if they have symptoms of it,” said Larry Goldstein, chairman of neurology and co-director of the Kentucky Neuroscience Institute in Lexington, who wasn’t involved in the study.

Yo-Yo Weight Gain May Increase Your Risk of Heart Attack

Many people struggle with yo-yo dieting, and a new study says those weight fluctuations could be bad for your heart – even if your measurements improve.

Published in the American Heart Association’s journal Circulation, a new paper concludes that fluctuations in your weight, blood pressure, cholesterol, and blood sugar are linked to a higher risk of heart attacks, strokes, and early death.

Compared to people with stable measurements, those with dramatically fluctuating numbers were:

  • 127 percent more likely to have died in the study period
  • 43 percent more likely to have had a heart attack
  • 41 percent more likely to have had a stroke

For the study, researchers looked at data on more than 6 million people who had no history of heart attacks, diabetes, high blood pressure, or high cholesterol. They documented participants’ body weight, blood sugar, blood pressure, and cholesterol in three separate health exams, which took place every two years between 2005 to 2012.

Then, researchers looked at data collected in 2015, and found that people whose weight, blood pressure, cholesterol, or blood sugar changed by more than five percent — in other words, people whose measurements fluctuated — were more likely to die early or suffer a heart attack or stroke. Surprisingly, researchers found that this was true no matter which direction people’s numbers fluctuated.

Of course, this does not mean that yo-yo dieting can cause heart attacks — only that researchers observed a correlation between fluctuating metabolic measurements and the aforementioned health problems. However, researchers believe doctors should put more emphasis on maintaining stable measurements.

“Healthcare providers should pay attention to the variability in measurements of a patient’s blood pressure, cholesterol and glucose levels as well as body weight. Trying to stabilize these measurements may be an important step in helping them improve their health,” study co-author Dr. Seung-Hwan Lee, professor of endocrinology at the College of Medicine of the Catholic University of Korea in Seoul, South Korea, said in a statement.

Alcohol and your health: Is none better than a little?

That’s the best way to describe the relationship between alcohol and health. As I’ve written about before, a number of studies have demonstrated health benefits with lower amounts of drinking. But if you drink too much alcohol (especially at inopportune times), there may be significant harms as well. Just how these balance out remains a matter of some debate and controversy.

While it’s easy to say “too much alcohol is bad for you” (and then point out the litany of harms caused by alcohol, such as liver disease and motor vehicle accidents), it’s harder to answer these simple but important questions:

  • Just how much is too much?
  • Is there a health benefit to some drinking compared with none?

These are more than just interesting questions for researchers to study. The answers could guide recommendations of doctors, public health officials, and policy makers throughout the world — and they could save millions of lives.

But so far, the answers vary depending on the study. And perhaps that should not be too surprising since study methods differ widely. For example, the definition of “one drink” in the US is 14 grams of alcohol, as found in a 12-ounce bottle of beer, 5-ounce glass of wine, or 1.5-ounce shot glass of distilled spirits. In other countries, and in many research studies, a different definition is used.

Recent studies on alcohol and health

In June of 2018, a study published in the journal PLOS Medicine found that among older adults, light drinking (in the range of one to four drinks per week) was associated with a slightly lower risk of death compared with zero consumption.

In August of 2018, two larger studies examined the impact of alcohol. The first one, published in The Lancet, included only people who drank at least some alcohol. It concluded that common recommendations regarding “moderate” drinking (one drink a day or less for women, and two drinks per day or less for men) might be too much.

The second study, also published in The Lancet, was even bigger. It examined data from hundreds of studies and other sources (including sales of alcohol, home-brewed alcoholic beverage consumption, and even estimates of tourist consumption) in 195 locations. And it analyzed the overall health impact related to alcohol consumption, including death and disability due to automobile accidents, infectious diseases, cancer, and cardiovascular disease. It concluded that the best option for overall health was no drinking at all. Of note, the definition of “a drink” in this study was 10 grams of alcohol — that’s 30% less than a standard drink in the US, but 25% more than a standard drink in the UK.

Here are more details about what they found:

  • Alcohol use was the seventh leading cause of death and disability worldwide in 2016; about 2% of female deaths and 7% of male deaths (2.8 million deaths in total) were considered alcohol-related.
  • For those ages 15 to 49, alcohol was the leading risk factor for death and disability worldwide. Tuberculosis, road injuries, and self-harm were the top causes (the risk of each of these conditions is higher if you drink enough).
  • For older adults, cancers related to alcohol use were the top causes of death.
  • In general, health risks rose with rising amounts of alcohol use. However, some protective effect related to light drinking (less than one drink/day) was observed for heart disease and diabetes in some groups. For example, the risk of heart attack and related cardiovascular disease was 14% lower for men drinking 0.8 drinks/day, and 18% lower for women drinking 0.9 drinks/day compared with none.

From this, the study’s authors concluded that while light drinking might have a modest protective effect for certain conditions among certain people, “Our results show that the safest level of drinking is none.”

Is there another way to look at this?

As I look at the study data, I interpret it differently. True, the data does not confirm a protective effect of light drinking. But the health risks were low, and quite similar at levels between zero to one drink per day. That suggests that zero consumption may not necessarily be best, or any better than several drinks per week. In addition, this study (and others like it) is based on a large number of people, which is helpful to detect trends but can overlook important individual factors. In other words, some people may be harmed or helped more by alcohol consumption than others.

Is zero alcohol a realistic option?

It’s worth acknowledging that regardless of how you interpret this study or whether researchers encourage “zero alcohol” as the best health option, the findings are quite unlikely to lead to zero alcohol consumption. After all, many people are more than willing to accept some health risks associated with drinking because they like to drink! Alcohol can encourage social interaction (which is why it’s often called a “social lubricant”), it is part of many religious traditions, and it’s a source of regular enjoyment for millions of people. And the fact is, most people “get away” with moderate drinking without suffering any major health consequences. As one expert said when interviewed about this study: “There is no safe level of driving, but governments do not recommend that people avoid driving.”

Should you stop drinking?

My take on these new studies is this: if you don’t like to drink alcohol, this latest research gives you no “medicinal” reason to start. But, if you drink lightly (and responsibly) and you have no health problems related to it, this study and other recent research is reassuring.

Clearly there are good reasons to discourage excessive alcohol consumption, driving drunk, and other avoidable alcohol-related trouble. But is “zero consumption” really where we should be aiming? I’m not so sure. I think it’s much more complicated than that.

Joint Pain + Insomnia + Depression = Doctor’s Appointment

Pain was the main factor for people with osteoarthritis (OA) who sought medical care, according to a study published online in Arthritis Care & Research last week. In addition to pain, insomnia and depression also drove people living with osteoarthritis to visit a doctor.

In the study, which consisted of 2,976 people, half the participants presented with at least one of three symptoms: pain, insomnia, and depression. Approximately 34 percent of the patients studied experienced insomnia, while 29 percent had depression, in addition to moderate to severe pain.

The Osteoarthritis, Insomnia, and Depression Connection

“Our study showed that among patients with osteoarthritis, about 47 percent of them reported moderate to severe pain, 17 percent clinical insomnia, and 21 percent clinical depression,” says Minhui Liu, PhD, RN, a research fellow at Johns Hopkins School of Nursing in Baltimore and the lead author of the study. “Moreover, about 13 percent of them had concurrent moderate to severe pain and clinical insomnia, and 13 percent presented concurrent moderate to severe pain and clinical depression.”

There Is a Pain, Sleep, and Mood Link, but Not Necessarily a Synergistic One

According to Dr. Liu, parts of the research revealed surprising results. “From previous research, we know that OA pain, insomnia and depression interact with each other, and that one symptom may exacerbate the other,” says Liu. “Given these complex interactions, we expected that some synergistic effects of these symptoms on healthcare use might exist in patients with OA. Our study did not detect such synergistic effects, which was surprising, but it is good from the patient’s perspective.”

Osteoarthritis Is a Common Problem for Adults

Osteoarthritis is considered the most common joint disorder in the United States, but the prevalence of the condition varies slightly from one study to the next. According to research published in Arthritis & Rheumatism, nearly 27 million adults in the United States have clinical osteoarthritis. More recently, a study published in August 2015 in the journal Arthritis Care & Research estimated that as many as 30.8 million U.S. adults (13.4 percent of the adult population) had osteoarthritis between 2008 and 2011.

4 Workout Tips From Pittsburgh Steelers All-Pro Antonio Brown

It’s not easy trying to pack on the muscle you want. It means working out when you barely have the time, avoiding injuries, and maintaining focus and intensity when you’d rather take it easy.

Pittsburgh Steelers All-Pro Antonio Brown’s secret for doing it: Never relax. It’s how he went from sixth-round draft pick to six-time Pro Bowler, and he doesn’t slow down in the off-season. “You don’t build yourself up and come into the season and drop off,” Brown, 30, says. No, you train hard all year round. Follow Brown’s advice and you’ll find a way, too.

1) Master the basics.

Brown focused his off-season training on three key body parts: “my glutes, my shoulders, and my core.” Each plays a key role in helping the body generate speed. Brown does 3- to 5-rep sets of bench presses once a week, and he squats all the time—although not the way you might think. “For the most part, I squatted lighter weight, a lot of reps, did a lot of endurance training,” he says. “Aim for 20 reps a set.” That will improve your squat technique and rev your heart rate more than you’d expect.

2) Crush your core.

A strong core cushions your ribs against the blows that come from defensive players. Brown knows that well, which is why he’ll do 1,000 reps of ab movements daily. But that doesn’t mean hours of situps. Brown does a variety of ab movements, like V-ups, hanging leg lifts, oblique situps, and plank shoulder-taps. “Don’t worry about what they are,” he says. “Just mix it up, get it in.”

3) Baby your shoulders.

Brown’s go-to shoulder routine isn’t about size or a badass military press; it’s about joint-bulletproofing and endurance. “We call it 5-5-5’s,” he says. Grab a pair of light dumbbells, stand up, and then do 5 reps of lateral raises, raising the weights straight out to your sides. Next, bend at the waist and do 5 reps of “Y” raises, keeping your elbows straight and raising the weights in front of you, thumbs pointing up. Finish with 5 “T” raises, staying bent over and raising the weights out to your sides. “Do 3 to 4 sets,” Brown says. “Just go nonstop.”

4) Stretch your legs.

Bad news: To move all over the field like AB, you’ve got to just run. (Worse news: You’ll also have to run to pass our NFL conditioning test below.) The best receiver in football won’t shrug off a 5-mile run every few days. “I’ll go running for distance consistently,” he says. “That stuff keeps me healthy.”

7 Grilling Recipes That Are Perfect for Labor Day Weekend

With the outdoor cooking season in full swing and Labor Day weekend just around the corner, you’re experiencing the thrill of the grill. But if you define “grilling” as just melting aged provolone on a burger, you’re selling yourself short. Instead, you should start eyeing everything in the supermarket and your kitchen and ask yourself one simple question: “Will it grill?” You’ll quickly realize that practically anything edible can benefit from some time under the dome.

“Grilling can be an easy, delicious, and nutritious way to fit in more health-protective plant foods into your diet,” says Sharon Palmer, RDN.

Time to think outside the bun and send these unlikely yet very grill-worthy foods onto the flames. Your grill game will never be the same.

1 Tempeh.

Made from whole soy beans which are soaked, cooked, fermented and then formed into a firm patty, tempeh is downright meaty and performs beautifully when placed over the fiery coals. Every 4-ounce serving of tempeh delivers 20 grams of satiating plant protein (more than twice the amount in tofu), making it a viable alternative to steak and hot dogs.

Plus, an investigation in the British Journal of Nutrition found that guys who replace just one percent of their calories from animal protein with calories from plant protein can slash their risk for type 2 diabetes by up to 18%. “Plant proteins like tempeh, beans and lentils are also filled with fiber, vitamins, minerals, healthy fats, and phytochemicals that work to reduce your disease risk,” Palmer says.

Fire it up: Treat a block of tempeh like you would a hunk of steak. Season liberally with salt and pepper or bathe it for a few hours in your favorite meat marinade. Or skip the marinade and instead use a thick, sloppy sauce while grilling, just as you would with ribs. Place tempeh on greased grill grates and cook, turning over once, until darkened with some grill marks, about 8 minutes total.

2 Halloumi.
It’s grilled cheese: literally. Originating from Cyprus, the magic power of semi-hard halloumi cheese is that it doesn’t melt through the grill grates. Instead, the outside becomes flecked with crispy pieces while the inside turns velvety, all the while holding its shape. Try that with a slab of cheddar.

Traditionally made with a combo of sheep and goat milk, the dairy import offers up bone-friendly calcium and muscle-building protein – about 6 grams in each ounce serving, or nearly the same amount you get from chicken breast. One cautionary point: halloumi tends to be salty, so ease up nibbling on those pretzels while you man the grill.

Fire it up: Upend a block of halloumi and slice lengthwise into 2 big slabs. Brush with oil and heat until browned with grill marks appearing on both sides, 1 to 2 minutes per side. Or cut halloumi into 1-inch chunks and skewer kebab-style.

3 Romaine lettuce.

How to take a salad from an afterthought into something delicious? Toss romaine hearts on your red hot grill grates. The lettuce stays crisp with slightly charred edges, and every bite is imbued with a smoky flavor from the grill. You can also do the same with sturdy Tuscan (dinosaur) kale leaves.

A study in the journal Neurology found that people who ate the most leafy greens per day (an average of 1.3 servings daily) had brains that showed reduced signs of aging. “Greens are extremely rich in a variety of essential nutrients, such as B vitamins, and carotenoid antioxidants that can help sharpen your mind,” says Palmer.

Fire it up: Halve heads of romaine lengthwise, lightly brush with oil and season with salt and pepper. Place lettuce halves cut-side down on grill and cook over medium heat, turning once, until leaves are charred in a few places and slightly wilted, about 4 minutes. Use to upgrade Caesar salad or place grilled wedges on a plate and top with other chopped vegetables, toasted nuts and dressing.

4 Grilled peaches.

Tune into a Bobby Flay episode where he’s cooking in the great outdoors, and it seems like that guy is always grilling fruit. That’s because he is wise to something that more novice grillers overlook – sending fruit to the flames encourages their natural sugars to caramelize, making them an even sweeter summer treat.

A great place to start: juicy peaches, which are chock full of vitamin C, a nutrient shown to help lessen the risk of stroke. Plums, pineapple, mango, and even skewered strawberries can also benefit from being flame-licked.

Fire it up: Slice peach in half, remove pit and lightly coat both sides with oil. Grill over medium heat, turning once, until tender and a few dark marks appear, about 5 minutes total. For a healthier dessert, top with dollops of Greek yogurt and chopped pistachios. Or chop grilled peaches and add to salsas.

Should You Work Out Twice a Day?

Thanks to the constant presence of #fitspo Instagram and celebrities like Mark Wahlberg touting the benefits of jamming as much fitness into a day as possible, two-a-day workouts are quickly becoming more common for normal, everyday exercisers.

You might be thinking that double sessions are overkill, unless you’re working toward a specific goal, but it turns out there myriad benefits for anyone to commit to working out twice a day — just as long as you’re doing it the right way to avoid injury.

It’s All About Balance

For starters, while you probably shouldn’t be doing two fully intense workouts per day, splitting up your workout — doing half of your workout in the morning and the other half later in the afternoon or evening — is actually a pretty good idea. It helps give your body rest, allowing you to work at your highest level of intensity, LA-based trainer Mike Donavanik, CSCS, told MensHealth.com.

“Think about it like work. The reason people take breaks or lunch breaks is in an attempt to give their mind and body a rest…so when they get back into their shift — they are hopefully more clear-headed and productive,” he said.

While the exact duration of your workouts depends on your activity level and fitness goals, you can try exercising for 30 minutes in the morning, and then 30 again in the evening. (It’s also important to keep in mind that some workouts might take longer for others — for instance, lifting might take longer than straight cardio — so they don’t have to be evenly split up.)

“For that 60-90 minutes when you’re going all out, it can be both physically and mentally draining,” he said. By splitting up your exercise, you can be more focused and have greater energy and strength output, he advises.

Another effective way to jam more work into a day is to split you AM and PM sessions by body parts or style of workout. Men’s Health Fitness Director Ebenezer Samuel, C.S.C.S., separates his doubles in that method.

“The way I break it up now is skills/athleticism/conditioning/flexibility in the morning, body part strength split in the evening,” he said.

How Your Body Handles Doubles

As you’re raising your heart rate, boosting circulation and blood flow to the muscles, and getting a sweat on, your body undergoes stress and those muscles begin to get tired. But once you’ve finished that first workout, getting a few hours of rest allows your body to recover and bring itself back to homeostasis levels.

“Heart rate, blood flow, hormones — they all start to balance back out, so your body is not in a ‘stressed’ state,” according to Donavanik. In that time, you’re able to reboot for another workout, particularly if you eat a post-workout snack or use a foam roller beforehand.

As an added benefit, if you hit the gym twice a day, your muscles can actually increase in mass and strength over time, according to Dr. Paul Mostoff, Chief of Physical Therapy at the NYC-based All Sports Physical Therapy. “By hitting each muscle twice a day, you literally double the amount of stimulus that your muscle receives. Every time you train, you provide your body with a stimulus, which promotes greater protein synthesis and muscular adaptation,” he said. “So by training twice per day, you’re giving your body the signal to ‘grow and get stronger’ twice as often.”

What’s more, you may also reap the benefits of Excess Post-Exercise Oxygen Consumption (EPOC), known as the “afterburn effect,” which means your metabolism spikes for the next few hours. With EPOC, you’ll burn more calories in the body. When you’re doing two-a-day workouts, you get that afterburn twice. That doesn’t, however, give you an excuse to gorge yourself on mac and cheese balls post-workout; some research indicates that the afterburn effect is relatively small.

Plus, if you have a busy day filled with work and social obligations, splitting your workout in two for a morning energy boost and an evening refresher could be a smart idea. “Any time you work out, hormones kick in to make you more alert and productive in that time. Your body will also fight fatigue for some time after the workout,” said Donavanik.

If you’re struggling to get to sleep, your rest might also improve if you work out in the evening, too. “Most people will find it easier to fall asleep because they’re placing a greater demand on their body, so they’ll naturally feel more exhausted and be able to fall asleep easier.”

Don’t Burn Out

There is, however, one caveat: If you’re not used to training hard and you go right into two-a-day workouts, you might be more sluggish than usual. This can happen even if you’re splitting one workout in half, as your body isn’t used to all that work. Either way, seek guidance from your doctor before diving in.

It’s also important to note that you shouldn’t just stick to the same workout for every session. There is a chance you could overtrain and burn out, which isn’t only counterproductive to your goals but can also be dangerous.

Don’t try to jam too many HIIT workouts into a short period of time, for example, and listen to your body when it’s telling you enough is enough. Continuing to push yourself beyond your limits is a recipe for disaster.

So should you try out a routine built around two a days? That all depends on your goals, and how much time you can commit to each session. But if you’re smart about your rest and recovery when you’re not training, anyone can use two-a-day workouts to ramp up their fitness.

“Paying special attention to proper warm-ups, hydration, sleep, nutrition, and giving yourself enough rest between training sessions in the same day (at least 4 to 5 hours), will help avoid the pitfalls of over-training,” said Mostoff.

5 Signature Moves for a Crowded Gym

Necessity, they say, is the mother of invention. For Bodybuilding.com Signature athlete Julian Smith, that was definitely the case. As Smith explained in The Bodybuilding.com Podcast, he was frustrated as a young lifter by training at busy gyms where everyone seemed to be doing the same thing, at the same time. This led him to start looking for innovative alternatives, often using old-school bodybuilders as his guide.

Today, Smith is known for sharing all kinds of unique movements on social media, in articles like “Julian Smith’s Signature Moves for Legs,” and in his Bodybuilding.com All Access program 30 Days to Your Best Arms. But he’s not just changing things for the sake of changing things; on the contrary, he finds that it dials in his technique and increases the mind-muscle connection.

“When something is new and exciting, when you’ve never done it before, you’re going to put a little more focus on your technique to make sure you’re doing it the right way,” Smith says.

Here are five twists on some old standby exercises that will keep your mind and gains fresh, while also helping you make the most of the limited equipment available in a busy weight room.

1. Heels-Elevated Dumbbell Goblet Squat

When there are lots of people in the weight room, the squat racks can be the first place to fill up. You have a choice: sit and wait, or look for alternatives.

So, what makes his version of the goblet squat a worthy alternative to the almighty barbell front squat?

“A lot of people who do front barbell squats have a hard time stimulating their quad muscles,” Smith says. “They tend to support the weight on shoulder muscles that are a lot smaller than their quads, so it limits how much weight they can handle.”

Smith addresses that situation by swapping out the barbell for a dumbbell, and upping the reps to where few people brave to go with barbell front squats.

What’s more, he recommends performing this squat variation with your heels—and only your heels—touching, and elevated about the width of a plate. Point your knees out as you would in a normal squat stance. Keep the weight pressed against your chest, keep the lowering half of the rep slow, and you’ll definitely feel it in your quads.

“This variation is basically a front squat because this also keeps the weight centered close to your body as it would be if you were doing a normal front barbell squat,” Smith explains.

Sets and reps: 4 sets of 20, 15, 10, 10 reps

2. Good Morning Into A Squat

Good mornings and squats are both great exercises on their own. So why do them together? For one, it’ll help you hit every part of your legs without having to use a heavy weight. You’ll feel your hams and glutes getting stretched to the max on the good morning, and then they and your quads will power you through the squats. It’ll also allow you to maximize the precious time you have in the squat rack, if you were planning on doing squats first and then a hamstring-focused movement like RDLs or stiff-legged deads afterward.

A good morning is very difficult to do with a lot of weight on the bar, so you want to use 20-25 percent of your normal squat weight. You may be able to squat 315 pounds for 8 reps, but you’re not going to be able to carry that much in a good morning.

To be clear, you’re not doing a full rep of a good morning followed by a full rep of a squat. You’ll bend forward into the good morning, then drop your butt down into the bottom of a squat. For your back’s sake, you’ll definitely want to position your feet wider than you would for a good morning.

Sets and reps: 4 sets of 12, 10, 8, 8 reps

3. Seated Cable Row Wide-Grip Lat Pull-Down

If you’re working out in a crowded gym and the lat pull-down machines are taken, your back day doesn’t have to come to a grinding halt. Just find an open seated cable row machine and do your pull-downs while lying facedown on the cable row bench.

“What I like more than anything about this variation,” Smith says, “is that since you’re lying down on your stomach and your chest is flat on the pad, you can take a lot of the torso momentum out of this movement, which helps you give your lats a better workout.”

Sets and reps: 4 sets of 10 reps

4. Bodyweight Leg Extension

This is another perfect variation for a day at the gym when everyone seems to be on the same split as you.

“Bodyweight leg extensions are basically the exact same movement as a leg extension,” Smith says, “but you can do them without a leg extension machine just by using the floor and your body weight.”

Kneel on the floor with your legs straight out behind you and your upper body erect. Keeping your back straight, lean back, lowering your butt down to your heels, then bring yourself back up again. That’s it. But, like anyone who has tried Smith’s popular take on the sissy squat can attest, your quads will burn like a raging inferno for days afterward.

Sets and reps: 4 sets to failure

5. Wrestler’s Bridge

Wrestling bridges used to be a staple of strength training, but you don’t see them much anymore. But if you’re simply doing shrugs in the hopes that it’ll give you that “strong like a bull” look, this may be just what you need. (Keep doing those shrugs too, though.)

“A lot of people think this is a pretty barbaric exercise, but it’s an old-school move,” says Smith. “Not a lot of people want to lie on their back and lift their entire torso off the ground by their head and neck support, but it’s actually a very safe exercise. A lot of people do it for wrestling and MMA-style training.”

The best part? All you need is a bit of floor space and a towel or pad for your head. Train these along with shoulders and traps, and get ready to stretch that T-shirt neck hole.

Sets and reps: 4 sets to failure

Forehead wrinkles – an early sign of cardiovascular disease?

In atherosclerosis, plaque builds up inside the arteries, making them less elastic and narrowing them down over time.

This limits the supply of oxygen-rich blood to the body’s major organs, which, in turn, may lead to a range of diseases — depending on which organ is affected.

When plaque accumulates inside the coronary arteries, coronary heart disease and even heart attacks may ensue.

Some of the main risk factors for atherosclerosis include smoking, high cholesterol levels, insulin resistance, high blood pressure, physical inactivity, age, and a family history of heart disease.

New research adds another risk factor to the list — and one that may be more easy to detect than high blood pressure or insulin resistance. Deep forehead wrinkles, say the authors of the new study, may signal atherosclerosis.

The new research was presented at the 2018 annual conference of the European Society of Cardiology, held in Munich, Germany.

Study author Yolande Esquirol, who is an associate professor of occupational health at the Centre Hospitalier Universitaire de Toulouse in France, shares what motivated the research. “You can’t see or feel risk factors like high cholesterol or hypertension,” she says.

“We explored forehead wrinkles as a marker because it’s so simple and visual. Just looking at a person’s face could sound an alarm, then we could give advice to lower risk.”

This is not the first time that facial features are explored as a potential marker of cardiovascular health. For example, male pattern baldness and prematurely gray hair have been found to raise heart disease risk by fivefold in previous studies.

Cardiovascular death risk 10 times higher

Esquirol and colleagues examined forehead wrinkles in 3,200 healthy adults, aged 32–62 at baseline. The researchers assessed the participants’ wrinkles by applying a score ranging from 0 (“no wrinkles”) to 3 (“numerous deep wrinkles”).

Why Sitting May Be Bad for Your Brain

Sitting for hours without moving can slow the flow of blood to our brains, according to a cautionary new study of office workers, a finding that could have implications for long-term brain health. But getting up and strolling for just two minutes every half-hour seems to stave off this decline in brain blood flow and may even increase it.

Delivering blood to our brains is one of those automatic internal processes that most of us seldom consider, although it is essential for life and cognition. Brain cells need the oxygen and nutrients that blood contains, and several large arteries constantly shuttle blood up to our skulls.

Because this flow is so necessary, the brain tightly regulates it, tracking a variety of physiological signals, including the levels of carbon dioxide in our blood, to keep the flow rate within a very narrow range.

But small fluctuations do occur, both sudden and lingering, and may have repercussions. Past studies in people and animals indicate that slight, short-term drops in brain blood flow can temporarily cloud thinking and memory, while longer-term declines are linked to higher risks for some neurodegenerative diseases, including dementia.

Other research has shown that uninterrupted sitting dampens blood flow to various parts of the body. Most of those studies looked at the legs, which are affected the most by our postures, upright or not. Stay seated for several hours, and blood flow within the many blood vessels of the legs can slacken.

Whether a similar decline might occur in the arteries carrying blood to our brains was not known, however.

So for the new study, which was published in June in the Journal of Applied Physiology, researchers at Liverpool John Moores University in England gathered 15 healthy, adult, male and female office workers.

The scientists wanted to recruit people who habitually spent time at a desk since, for them, long hours of sitting would be normal.

The researchers asked these men and women to visit the university’s performance lab on three separate occasions. During each, they were fitted with specialized headbands containing ultrasound probes that would track blood flow through their middle cerebral arteries, one of the main vessels supplying blood to the brain.

Too much sleep could be worse for health than too little

An analysis of pooled data from dozens of studies covering more than 3 million people finds that self-reported sleep duration outside of 7–8 hours each night is linked to a higher risk of death and cardiovascular diseases.

The study — which scientists at Keele University in the United Kingdom led and which is now published in the Journal of the American Heart Association — found a “J-shaped” relationship between duration of sleep and deaths. The same relationship was observed with incidents of cardiovascular illness.

The authors say that their findings suggest that sleeping for more than 7–8 hours “may be associated with a moderate degree of harm” compared with sleeping less.

The J-shaped relationship showed that the size of the risk rose in line with greater duration of sleep. Sleeping for 9 hours, for example, carried a 14 percent higher risk of death, while 10-hour sleeps carried a 30 percent higher risk.

The results also showed that poor-quality sleep was linked to a 44 percent higher risk of coronary heart disease.

“Our study,” says lead study author Dr. Chun Shing Kwok, a clinical lecturer in cardiology at Keele University, “has an important public health impact in that it shows that excessive sleep is a marker of elevated cardiovascular risk.”

10 Knee-Saving Lower Body Moves for Men Over 40

Everybody has to squat.

The exercise is one of the most basic and functional movement patterns you can do, and it builds total-body muscle and strength like nothing else. But who says you have to do it with a barbell on your back? If you’ve been avoiding squats — along with lunges and other leg exercises because they hurt your knees — get ready: “leg day” is coming back, in full force. You’re about to learn 10 ways to train your lower body hard, and pain-free.

“One of the reasons guys have knee pain is because they squat wrong,” says David Jack, creator of the Men’s Health Muscle After 40 (MA40) program. “The way to learn to do it right is to use a self-correcting exercise.” That means a type of squat that automatically helps fix your form while you do it.

Jack offers the dumbbell squat to curl as an example of a self-correcting exercise. Hold a dumbbell in front of your chest and squat down. Then extend your elbows, curl the weight back up, and stand up.

“This move helps you keep your trunk upright, engages your core, and gets you to drive your knees outward so you can drop into a deep squat,” says Jack. If you don’t stay vertical and push your knees out, you’ll bump into them when you extend your arms, so it’s almost impossible not to squat properly — keeping proper alignment of your joints to avoid the bad mechanics that cause pain.

Another trick for taking pressure off your knees is keeping your shins vertical. While back squats and forward lunges might make your shins drift over your toes, putting shear forces on the knees, moves like the RDL, split squat, and deadlift variations shift more of the load to your hips, so you can work your quad, ham, and glute muscles without feeling it in your joints.

Directions

Create your own lower-body workout using the exercises listed. The movements are categorized by the muscle groups that they emphasize most (quads, hamstrings, or glutes). To build your own workouts, simply choose one exercise from each category (any order is OK).

Perform reps for one move for 40 seconds straight, going at your own pace. Rest 20 seconds, and then repeat twice more. Do the same thing for each exercise. On exercises that are done one side at a time, work for 20 seconds on one side and then 20 seconds on the other.

The next time you train, choose different exercises from each list. To finish each workout, perform the half-kneeling hinge and quad stretch as a cooldown.

Quads

Bottom Up Split Squat
Dumbbell Squat to Curl
Banded Lateral Lunge
Iso Kickback
Squat Hold
Rock Back

Hamstrings

Modified Single Leg RDL
Single Dumbbell Deadlift

Glutes

Glute March

Cooldown

Half Kneeling Hinge & Quad Stretch

(Check out instructions for each by clicking “Read More”)

Getting fit in midlife: how long does it really take?

“I’m going on holiday in a couple of weeks, so I need to get to the gym”. Or “I’ve just signed up for six boot camp classes this week, so by next month I’ll be in amazing shape!” We’ve all heard sayings like these, and perhaps said them ourselves. But how often does it actually pan out that way?

Because despite the promises, there is no such thing as a quick fix when it comes to fitness and health – especially if you’ve been inactive for a while. So how long does it actually take to transform your strength, fitness and physique? And more importantly, what’s the best way to go about it?

The good news is studies show it’s never too late to take up exercise and eating well – even after years of inactivity, it quickly pays dividends. One study found getting fit in middle age halves the risk of suffering a stroke later in life and men who start getting fit in their forties and fifties can see their stroke risk drop to levels seen among those who had exercised throughout their youth.

However, avoid the quick fixes which are demanding, miserable to go through and, crucially, not sustainable. The general rule of thumb is that the more extreme the exercise or diet approach, the greater the likelihood that you’ll gravitate back to where you started in a matter of weeks. So avoid an all-or-nothing approach, and instead find a way of exercising and eating you can easily and happily sustain, which will keep you in shape all year round.

So how long does it take to lose fat? Everything from your hormones to neurologic system and signals adapt to every little change in your diet and exercise routine. People often do drastic things in the short term like severely cutting calorie intake or “smashing” multiple hour long HIIT (high intensity interval training) classes every week. But this puts a lot of stress on the body, potentially doing more harm than good.

Your body reacts by lowering its BMR (Basal Metabolic Rate – the number of calories you burn at rest) which means you may lose weight in the short term, but as soon as you go back to eating normally you can often put on even more weight than before.

When it comes to improving strength and increasing muscle – something you want to do in midlife to counter the fact that muscle mass naturally declines with age – low fat diets work against you by decreasing your body’s ability to synthesise new, metabolically active muscle. It will also reduce your overall energy which will make your workouts feel harder.

It’s also important to remember your muscles don’t get stronger or faster during your workouts, but rather you get fitter between sessions because your muscles repair and adapt to the stimulus. So if you go from doing nothing, to training five or six times a week, you aren’t going to give your body the time to appropriately recover, which is counter productive.

So how long does it take to lose weight and get fit in midlife? The quick answer is around three months of eating whole foods, cooked from scratch, coupled with consistent, intelligent training and proper recovery. However, this is completely dependent on the individual and the more unfit you are to begin with, the more profound your results will be.

MARIJUANA: SLEEP AID OR SLEEP STEALER?

Prohibition and legalization

For a long time, marijuana (cannabis, pot, weed, or a thousand other names) has suffered under prohibition in the United States. Although many individual states had already instigated their own legislation, it was the 1937 Marijuana Tax Act that effectively prohibited all use of cannabis on a federal level.

But fast forward to the present, and society’s attitudes toward weed have made some dramatic u-turns.

2012 was the real turning point, when Colorado and Washington became the first ever states to legalize the recreational use of marijuana for adults aged 21 years or older.

Today, smoking weed is broadly legal in 30 states in the US, however, the majority only allow the consumption of marijuana for medicinal purposes.

Public opinion on marijuana
American public opinion on whether marijuana should be legal. Image: Altas.com

Why the change in attitudes towards marijuana?

Laws have to adapt to the needs of society as a whole. For many citizens, a total prohibition on marijuana made no sense – for many reasons.

First, there’s classification. Why should marijuana classed as a harmful substance when statistics have failed to find a single recorded instance of anyone dying from a fatal dose of marijuana alone. On the other hand, alcohol-related deaths total 88 thousand every year, the figure for prescription drugs is even higher.

Secondly, the decades-long war on drugs has been hailed by experts as a set of “failed policies and failed practices”, tackling neither the issues of drug trafficking nor drug-related violence. Contrast this with Portugal a country that decriminalised all drug use 15 years ago, and has not seen a significant increase in drug use during that time.

There’s also the issue of money. Marijuana is a huge growth industry right now. North American marijuana sales topped $6 billion in 2016 and are forecasted to hit $20 billion by 2021. And money is very good at changing people’s attitudes.

But lastly, and perhaps most importantly, there’s the growing widespread acknowledgement in medical and scientific communities of the huge potential benefits of cannabis derived medical products.

Although it’s still extremely hard for scientists to conduct effective research into the potential medical benefits of marijuana, current evidence points to a myriad of uses for medicinal marijuana, from chronic pain, multiple sclerosis, seizures, Cron’s disease and much more.

The effect of cannabis on sleep

Although cannabis has a number effects on sleep architecture, many studies have shown cannabis to be an effective sleep aid due to its effect on the body’s endocannabinoid system to relieve stress and produce a sedative effect.

The number, as well as the availability, of cannabis-based medications increases, but are they really as effective as the labels suggest?

Some suggest that cannabis-based medications have several advantages compared with traditional prescription sleeping pills, such as Behadryl, Lunesta, and Ambien, citing cannabis as being less addictive and more effective for long-term use, promoting muscle relaxation, and improving mood.

Early investigations of the effect of cannabis on sleep gained momentum in the 1970s. Even though they produced mixed results, the interpretation of findings was considered unreliable due to small sample sizes.

More recent investigations have provided data on various qualitative and quantitative sleep-related measures. According to them, the current understanding is still clouded by mixed findings. However, there are some important patterns emerging.

Cannabis and sleep stages

Sleep has five stages, and cannabis affects all of them. Specifically, it can change the duration and intensity of these stages.

stages of sleep

The Stages Of Sleep

The First Stage of Sleep

The person finally falls asleep. The stage typically lasts for 7-10 minutes, but could take longer if the person experiences pain and stress. Given that cannabis can relieve both of them by providing the relaxation feeling, its impact on this stage is positive.

The Second Stage of Sleep

The sleep is still light at this stage and the person could wake up very easily. According to the research, cannabis provides the least impact on it.

The Third and Fourth Stages of Sleep

Often, these stages are viewed as a single one. They are the most restorative and cannabis prolongs them. Therefore, it can provide a positive impact here as well.

The Fifth Stage of Sleep

This is the most important stage during which dreaming occurs. The research claims that cannabis use decreases REM sleep, so a frequent marijuana user has a lower occurrence of dreaming. This effect is explained by the fact that cannabis blunts response to dopamine.

A complex relationship

However, even though cannabinoids have the potential for promoting sleep, the studies on their effect caused contrasting findings.

For example, studies using high doses of tetrahydrocannabinol tended to produce an activating response in participants, while the ones using low dose reduced sleep latency.

The reason that explains different findings is the nature of tetrahydrocannabinol’s influence. According to scientists, this component produces excitatory effects while the sedating mechanism activates later.

But does the science has the solution for reducing stimulating effects and promoting sleep in those who suffer from sleep disturbances?

Enter cannabidiol otherwise known as CBD. This is another interesting cannabis constituent that has been known to counter stimulating effects of tetrahydrocannabinol. It is the second most active component that is used in a variety of cannabis-based medicines (CBM) designed to treat various health problems, including sleep disorders.

Although the administration of CBMs containing CBD has been shown contrasting effects as well, the dose and the timing of administration were critical factors to increase the effectiveness of treating insomnia and related disturbances.

Click Read More for more information.

One-month sugar detox

If you’ve read about the latest wellness trends, you may have entertained the idea of a diet detox.

But whether you’ve considered juicing, fasting or cleansing in an effort to lose weight or improve your well-being, you’re probably aware that drastically cutting out foods is not effective as a long-term lifestyle approach to healthy eating.
In fact, strict detoxing can cause issues including fatigue, dizziness and low blood sugar.
But there is one kind of sustainable detox that is worthwhile, according to some experts. Reducing sugar in your diet can help you drop pounds, improve your health and even give you more radiant skin.
“Sugar makes you fat, ugly and old,” said Brooke Alpert, a registered dietitian and co-author of “The Sugar Detox: Lose the Sugar, Lose the Weight — Look and Feel Great.” “What we’ve discovered in the last couple of years is that sugar is keeping us overweight. It’s also a leading cause of heart disease; it negatively affects skin, and it leads to premature aging.”

Sugar addiction

Here’s more bad news: We can’t stop consuming sugar. “People have a real dependency — a real addiction to sugar,” Alpert said. “We have sugar, we feel good from it, we get (the feeling of) an upper, and then we crash and need to reach for more.”
About 10% of the US population are true sugar addicts, according to Robert Lustig, professor of pediatrics and member of the Institute for Health Policy Studies at the University of California, San Francisco. What’s more, research suggests that sugar induces rewards and cravings that are similar in magnitude to those induced by addictive drugs.
One of the biggest concerns is the amount of added sugars in our diets, which are often hidden in foods. Although ice cream cake is an obvious source of sugar, other foods that may not even taste sweet — such as salad dressings, tomato sauces and breads — can be loaded with the white stuff.
“People don’t realize that seemingly healthy foods are loaded with sugar — and so we’re basically eating sugar all day long, from morning till night,” Alpert said.

How to sugar detox: Going cold turkey for three days

The good news is that even if you’re not a true sugar “addict,” by eliminating sugar from your diet, you can quickly lose unwanted pounds, feel better and have a more radiant appearance.
“There is no one person who wouldn’t benefit by eliminating added sugars from their diets,” Lustig said.
Children can benefit, too. Lustig’s research revealed that when obese children eliminated added sugars from their diets for just nine days, every aspect of their metabolic health improved — despite no changes in body weight or total calories consumed.
But going cold turkey is what works best, at least in the beginning.
“Early on in my practice, when I would notice that people had real addiction to sugar, we’d start trying to wean them of sugar or limit their intake or eat in moderation … but the word ‘moderation’ is so clichéd and not effective,” Alpert said. “It was just ineffective to ask people to eat less of something when they’re struggling with this bad habit. You wouldn’t ask an alcoholic to just drink two beers.
“What was so successful in getting my clients to kick their sugar habit was to go cold turkey. When they would go cold turkey, I wasn’t their favorite person — but the number one positive effect was that it recalibrated their palate,” she said. “They could now taste natural sugars in fruits, vegetables and dairy that they used to be so dulled to.”
So for the first three days on a sugar detox, Alpert recommends no added sugars — but also no fruits, no starchy vegetables (such as corn, peas, sweet potatoes and butternut squash), no dairy, no grains and no alcohol. “You’re basically eating protein, vegetables and healthy fats.”
For example, breakfast can include three eggs, any style; lunch can include up to 6 ounces of poultry, fish or tofu and a green salad, and dinner is basically a larger version of lunch, though steamed vegetables such as broccoli, kale and spinach can be eaten in place of salad. Snacks include an ounce of nuts and sliced peppers with hummus. Beverages include water, unsweetened tea and black coffee.
Though they don’t contribute calories, artificial sweeteners are not allowed on the plan, either. “These little pretty colored packets pack such a punch of sweetness, and that’s how our palates get dulled and immune and less reactive to what sweetness really is,” Alpert said.
Consuming artificial sweeteners causes “you not only (to) store more fat,” Lustig explained, “you also end up overeating later on to compensate for the increased energy storage.”

How to sugar detox: When an apple tastes like candy

Once the first three days of the sugar detox are completed, you can add an apple.  Click Read More for the full plan.

Belly Fat Is Dangerous. Here’s How to Get Rid of It.

Guys who carry extra weight in their bellies don’t need another article berating them for their physical condition — they’re quite aware of what they look like, thank you, and many have developed enough self-confidence to not care.

What they (or, potentially, you, since 33.7 percent of US adults can be classified as obese) should know is that there are some legitimate medical reasons to consider losing some of that weight, specifically from the gut. There’s more cause to be concerned than how you look in the mirror.

Belly fat is is different from fat elsewhere in your body. The extra weight some people carry around their waists, arms, and love handles isn’t the same — that’s subcutaneous fat, which sits beneath the skin and is relatively harmless, according to Harvard Medical School. The stuff in your belly, visceral fat, lodges deeper down, around your abdominal organs. It’s metabolically active tissue that actually functions like a separate organ, releasing substances into the rest of your body that, in excess, can increase your risk of disease.

Yeah, you got it: Your own belly could be poisoning you.

Gut-Check Time

The notion that abdominal obesity is the most dangerous kind isn’t new. Back in the 1940s, the French physician Jean Vague observed that some obese patients had normal blood chemistry, while some moderately overweight patients showed serious abnormalities that predisposed them to heart disease or diabetes. Almost always, the latter patients carried their fat around their middles. And, almost always, they were men.

Multiple studies since then have shown that belly fat can be an insidious threat, not just the harmless byproduct of a sedentary lifestyle or genetic predisposition. It’s a sign that your body chemistry is out of whack.

There are a number of substances your larger belly secretes to your heart, liver, and other vital organs. Among them:

• Free fatty acids. Released directly to the liver, they impair your ability to break down insulin, which over time can lead to diabetes.

• Cortisone. High levels of this hormone are associated with diabetes and heart disease.

• PAI-1. This blood-clotting agent increases your risk of heart attacks and strokes.

• CRP. This protein inflames blood vessels, making them more susceptible to artery-clogging plaque.

The upshot of all these chemicals floating around is big trouble for big-bellied guys. In a study at the University of Alabama at Birmingham, researchers took 137 men of all ages and sizes and used seven different measurements to determine their risks of cardiovascular disease. The single best sign of multiple heart-disease risks? No, it wasn’t the guys’ family histories or their cholesterol profiles. It was the amount of abdominal fat they carried.

By the way, heart disease, diabetes, and cancer are only three of the ways belly fat can ruin your health. If you count them all up, you’ll find at least 39 different diseases associated with abdominal obesity.

If you’re looking to cut some of that dangerous belly fat after learning about the risks, never fear. Follow this advice, and you’ll start losing the pounds — and the dangers from visceral fat — once you can make it your daily routine.

The Food Plan

Diets generally fail for one of two reasons: Either they’re too restrictive about the kind of food you put in your belly, or they too frequently leave you feeling as if you haven’t put any food in your belly. In either case, it’s usually not long before you break from the plan and go back to your old bad habits.

You won’t be sabotaged by either of those problems with the Belly-Off Program Diet, which was created for us by the trainer and nutritionist Thomas Incledon, Ph.D., R.D. Incledon built our program around three simple weight-loss principles built around the three types of macronutrients:

Pack In The Protein
If you want to shrink your gut, get enough protein in your diet. In this case, about 25 percent of calories. Why? For starters, protein makes you feel full and helps you build muscle (which increases metabolism, thereby making it easier to lose weight). Just as important, high-protein diets have been shown to be the best way of attacking belly fat. In one study, published in the International Journal of Obesity, Danish researchers put 65 people on either a 12 percent protein diet or a 25 percent protein diet. The low-protein dieters lost an average of 11 pounds, which isn’t bad. But the high-protein subjects lost an average of 20 pounds–including twice as much abdominal fat as the low-protein group.

Fat Isn’t All Bad
Get enough fat — about 30 percent of your calories. First, fat helps you feel more full between meals, slowing your appetite. Second, it provides essential fatty acids needed for optimal health. Above all, fat makes you feel that you’re eating real food, not starving in the land of plenty.

Count Up The Carbs
If you get enough protein and fat, your total calorie intake should take care of itself. Because you feel full, you won’t binge on a can of Pringles and blow your calorie count for the day. The remaining 45 percent of calories in our plan comes from carbohydrates — enough to give your palate a full range of tastes and your body a combination of fast- and slow-burning fuel.

How To Use The Diet
The meals shown here are “templates” that you can vary any number of ways to please your tastebuds and avoid eating the same old thing every day. Follow them and you’ll get between 2,400 and 2,800 calories per day. That should provide plenty of calories for all but the most severely obese, while allowing most guys to lose fat around their middles at a steady pace. (Don’t worry about hitting the numbers on the nose every time. If you exceed your fat quota during lunch, for instance, just cut back a little during dinner.)

25 Healthy Cookout Recipes

Sirloin Steak with Horseradish Sour Cream

An abundantly healthy, well-rounded meal in the time it would take you to call for takeout, this simple steak is balanced by a pungent, fresh horseradish cream for dipping.

Get the recipe

Chicken Bruschetta Burger Recipe

Chicken Brushcetta Burger

Looking for a chicken burger to throw on the grill. Try this Italian version topped with creamy mozzarella.

Get the recipe

CobbSalad

Red, White and Blue Cheese Cobb Salad

Cobb salad is an American favorite, but clean eaters usually steer clear of its heavy, fatty dressing. Our version has all the same great taste of a traditional chopped salad, but with a lightened-up dressing that won’t disappoint!

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Potato-Rounds

Potato Rounds with Fresh Lemon

Fingerling potatoes make perfectly poppable tater coins – and we keep this 28-minute side light by lacing it with lemony zest!

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SmokedSalmonBurger

Smoked Salmon Burger with Lemon Aioli

Ditch the meat and try out the last salmon burger recipe you’ll ever need! We take the flavors that typically accompany smoked salmon – red onion, lemon, cream, tomato, lettuce, dill – and turn them into a summer favorite!

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RosemarySweetPotatoFries

Quick Sweet Potato Fries

Find an extra dose of fiber by using sweet potatoes, baked with a hint of rosemary to an irresistibly crispy state – perfect alongside burgers and fish sandwiches!

Get the recipe