Topic: BODY

According to the Centers for Disease Control and Prevention (CDC), over 795,000 people in the United States have a stroke every year, and around 610,000 are first strokes.

In 2019, stroke was the second leading cause of mortality globally, accounting for 11% of deaths.

There are three main types of stroke. The first and most common, accounting for 87% of cases, is an ischemic stroke. It occurs when blood flow through the artery that supplies oxygen to the brain becomes blocked.

The second is a hemorrhagic stroke, caused by a rupture in an artery in the brain, which in turn damages surrounding tissues.

The third type of stroke is a transient ischemic attack (TIA), which is sometimes called a “ministroke.” It happens when blood flow is temporarily blocked to the brain, usually for no more than 5 minutes.

While stroke is very common, it is often misunderstood. To help us dispel myths on the topic and improve our understanding, we got in touch with Dr. Rafael Alexander Ortiz, chief of Neuro-Endovascular Surgery and Interventional Neuro-Radiology at Lenox Hill Hospital.

Stroke is a problem of the heart

Although stroke risk is linked to cardiovascular risk factors, strokes happen in the brain, not the heart.

“Some people think that stroke is a problem of the heart,” Dr. Ortiz told MNT. “That is incorrect. A stroke is a problem of the brain, caused by the blockage or rupture of arteries or veins in the brain, and not the heart.”

Some people confuse stroke with a heart attack, which is caused by a blockage in blood flow to the heart, and not the brain.

Stroke is not preventable 

“The most common risk factors [for stroke] include hypertension, smoking, high cholesterol, obesity, diabetes, trauma to the head or neck, and cardiac arrhythmias,” said Dr. Ortiz. 

Many of these risk factors can be modified by lifestyle. Exercising regularly and eating a healthy diet can reduce risk factors such as hypertension, high cholesterol, obesity, and diabetes. 

Other risk factors include alcohol consumption and stress. Working to reduce or remove these lifestyle factors may also reduce a person’s risk of stroke.

Stroke does not run in families 

Single-gene disorders such as sickle cell disease increase a person’s risk for stroke. 

Genetic factors including a higher risk for high blood pressure and other cardiovascular risk factors may also indirectly increase stroke risk. 

As families are likely to share environments and lifestyles, unhealthy lifestyle factors are likely to increase stroke risk among family members, especially when coupled with genetic risk factors.

Stroke symptoms are hard to recognize 

The most common symptoms for stroke form the acronym “F.A.S.T.“: 

• F: face dropping, when one side of the face becomes numb and produces an uneven “smile”
• A: arm weakness, when one arm becomes weak or numb and, when raised, drifts slowly downward
• S: speech difficulty, or slurred speech 
• T: time to call 911 

Other symptoms of stroke include: 

• numbness or weakness in the face, arm, leg, or one side of the body
• confusion and trouble speaking or understanding speech
• difficulty seeing in one or both eyes
• difficulty walking, including dizziness, loss of balance and coordination 
• severe headaches without a known cause

Stroke cannot be treated 

“There is an incorrect belief that strokes are irreversible and can’t be treated,” explained Dr. Ortiz.

“Emergency treatment of a stroke with injection of a clot busting drug, minimally invasive mechanical thrombectomy for clot removal, or surgery can reverse the symptoms of a stroke in many patients, especially if they arrive to the hospital early enough for the therapy (within minutes or hours since the onset of the symptoms),” he noted. 

“The longer the symptoms last, the lower the likelihood of a good outcome. Therefore, it is critical that at the onset of stroke symptoms — ie. trouble speaking, double vision, paralysis or numbness, etc — an ambulance should be called (911) for transport to the nearest hospital,” he continued. 

Research also shows that those who arrive within 3 hours of first experiencing symptoms typically have less disability 3 months afterward than those who arrived later.

Coffee contains many beneficial compounds for health, including caffeine, diterpenes, and chlorogenic acid. 

Studies show that habitual coffee consumption is linked to the prevention of chronic and degenerative conditions, including cancer, cardiovascular disorders, diabetes, and Parkinson’s disease.

Caffeine, the most commonly studied compound in coffee, exerts positive effects on kidney function, and daily coffee consumption is linked to a lower risk of chronic kidney disease. 

Although other compounds in coffee are less studied, compounds such as chlorogenic acid and trigonelline are known to reduce generalized inflammation and oxidative stress.

Knowing more about how coffee consumption affects the incidence of other kidney-related conditions could help policymakers take steps to reduce people’s risk of developing progressive kidney disease. 

Recently, researchers investigated the effects of coffee consumption on acute kidney injury (AKI), when the kidneys lose all or part of their function suddenly. 

AKI represents a public health problem with around 0.25% of the general population experiencing AKI, which rises to 18% among individuals who are hospitalized annually. 

From their analysis, the researchers found that higher coffee intake is linked to a lower risk of incident AKI. 

The study was published in Kidney International Reports.

The most beneficial amount of coffee 

For the study, the researchers used data from 14,207 adults ages 45 – 64 from the Atherosclerosis Risk in Communities (ARIC) study. 

The researchers assessed the participants’ coffee consumption during their first visit via a food frequency questionnaire. In total, they found:

• 27% never drank coffee
• 14% drank less than a cup of coffee per day
• 19% drank 1 cup per day
• 23% drank 2-3 cups per day 
• 17% drank more than 3 cups per day 

To define acute kidney injury, the researchers looked at rates of hospitalization, including an International Classification of Diseases code indicating AKI throughout a median period of 24 years follow-up. They noted 1,694 cases of incident AKI during the follow-up period. 

After adjusting for demographic factors, they found that individuals who consumed any amount of coffee had an 11% lower risk of developing AKI compared to individuals who did not consume the beverage.

The researchers further noted a dose-dependent relationship between AKI and coffee intake, with those consuming 2-3 cups of coffee per day experiencing the most substantial risk reduction.

Breakfast literally means “to break the fast.” It is the first meal of the day after a stretch of not eating overnight. 

Breakfast earned its title as the most important meal of the day back in the 1960s after American nutritionist Adelle Davis suggested that to keep fit and avoid obesity, one should “eat breakfast like a king, lunch like a prince, and dinner like a pauper.”

Though around 15% of people in the United States regularly skip breakfast, many still believe it to be the most important meal of the day. Breakfast provides the body with important nutrients, to start the day feeling energized and nourished. Many also believe that it can promote weight loss.

But is breakfast really the most important meal of the day?

As with most things in nutrition, the answer is complex. While some research suggests that skipping breakfast is not harmful, other research suggests otherwise.

Eating regular meals and snacks, including breakfast, allows for more opportunities throughout the day to give the body the energy and nutrients it needs to function optimally. 

However, as long as a person can fit their nutrients in during other meals, breakfast may not be the most critical meal of the day.

Here is what the science says.

Evidence in support of eating breakfast

Most of the claimed benefits of eating breakfast are primarily derived from observational studies, which cannot prove cause and effect. 

For example, one 2021 systematic review of 14 observational studies found that those who eat breakfast seven times per week have a reduced risk for:

• heart disease
• diabetes
• obesity
• high blood pressure
• stroke
• abdominal obesity
• cardiovascular-related death
• elevated low-density lipoprotein (LDL) cholesterol.

Again, this particular group of studies can only suggest that those who eat breakfast are more likely to have a reduced risk for the cardiovascular and metabolic diseases mentioned above. It cannot prove that breakfast is what is causing it.

However, an analysis of data on over 30,000 North Americans shows that people who skip breakfast may miss out on important nutrients. 

The most common nutrients those who skipped breakfast fell short on include:

• folate
• calcium
• iron
• vitamin A
• vitamins B1, B2, B3
• vitamin C 
• vitamin D.

What is more, one randomized control trial published in 2017 that included 18 participants with type 2 diabetes, and 18 healthy participants found that skipping breakfast caused disrupted circadian rhythms in both groups.

Those who skipped breakfast also experienced larger spikes in blood glucose levels after eating. The authors of the study thus suggested that eating breakfast is vital for keeping our internal clock running on time.

For middle-aged to olderpeople looking to get the best sleep possible, seven hours of consistent sleep may be the sweet spot, new research suggests.

The study, published April 28 in the scientific journal “Nature Aging,” involved 498,277 people between ages 38 and 73 from the UK Biobank, a large-scale database with genetic and health information of U.K. participants.

Participants answered questions about how long they slept, completed an online mental health questionnaire and did problem-solving and memory exercises. Brain imaging and genetic data was provided for some participants as well.

“We wanted to know what is the perfect time that you should be sleeping for most middle-aged to older-aged people,” said Barbara Sahakian, a professor in the psychiatry department at the University of Cambridge who worked on the study. “How does that relate to other measures, for instance, your brain structure and your cognition, and your mental health?”

As people sleep, their brains work to consolidate memories and process things learned during the day, particularly during what’s called deep sleep, she said. Deep sleep may also allow people to purge toxins from their brains – and reduce the harmful deposits of an abnormal protein, amyloid.

But too little or too much sleep can create chronic stress. It can also cause changes in the hippocampus, a part of the brain vital to learning and memory, Sahakian said.

Researchers found participants performed better after seven hours of consistent sleep, she said. Those who got less or more had poorer cognitive performance and smaller brain volume, area and thickness.

But the study has its limitations, including the fact that participants reported only sleep duration versus sleep timing, sleep efficiency and circadian rhythm. Participants also reported their own sleep, leaving room for bias. They also recorded sleep times by the hour, not minutes.

People’s use of supplements has increased in recent years. Many supplements may carry a certain amount of health benefits, but as they are not regulated, people should also exercise caution. 

A recent case report published in Heart Rhythm Case Reports demonstrates that the excessive use of certain substances such as hemp oil could lead to severe cardiac problems. 

Herbal supplement popularity

Supplements are readily available to consumers and can offer various health benefits. For example, dietary supplementsTrusted Source provide more of the substances found in food, such as specific vitamins or minerals. 

Unlike medications, the Food and Drug Administration (FDA) does not offer as much regulation for dietary supplements. 

Dr. Edo Paz, cardiologist and vice president of Medical at K Health, who was not involved in the study, explained the issue with supplements to Medical News Today:

“Because the FDA regulates supplements differently than medications, the supplements are not well-studied, so the precise characteristics and side effects are not well known. You may even see variations in the preparation based on the distributor and batch.”

Dr. Paz said he encourages his patients to avoid supplements, out of a lack of solid data. 

“If they do plan to use them, I do my best to research the possible side effects and drug-supplement interactions, but this is not always possible given the lack of data,” he added.

A few examples of common supplements include calcium, vitamin D, garlic, and ginkgo. Sometimes, supplements are a combination of many compounds, such as the supplement berberine, which may be helpful in the improvement of heart problems and gut health.

The CBD market

One group of supplements that have become quite popular is those derived from cannabis. A few examples of cannabis derivatives include hemp oil and cannabidiol (CBD). 

Hemp oil has many potential benefits, including helping reduce muscle tension and stress and pain relief. Similarly, CBD may help with pain relief and may even help to reduce anxiety. 

Currently, the FDA has only approved one derivative of CBD oil for medicinal use, Epidiolex, which can be used to treat seizures. Different derivatives of cannabis are still available as supplements, meaning that people can buy and use them without supervision from a medical professional.

There has been a lot of conversation — and a great deal of research — attempting to determine whether exercise or a healthy diet is more important for longevity. A new study led by researchers from the University of Sydney in Australia analyzing UK Biobank data may provide the answer.

Researchers found that people who engaged in high levels of physical activity and also ate a high quality diet had lower mortality risks.

For anyone who believed that one can exercise away poor dietary choices, this study suggests otherwise.

People who engage in one or the other lowered the risk of mortality to a lesser degree. Study corresponding author, associate professor Dr. Melody Ding, told Medical News Today:

“These groups still do better (and statistically significant) than the group with poor diet and lowest physical activity, but the group with the best diet and moderate or high physical activity levels do the best!”

The study focused on deaths due to all-cause mortality, cardiovascular disease (CVD), and adiposity-related (PDAR) cancers.

Cardiology dietician Michelle Routhenstein, who specializes in heart health, and was not involved in the study, told MNT:

“The study results are no surprise to me. Many people have come to see me in my private practice after suffering a heart attack when training for their fourth or fifth marathon, or right after doing a CrossFit exercise.”

“When I do a comprehensive evaluation of their lifestyle, it is apparent that they thought their intense daily exercise regimen would make up for their poor, unbalanced diet, and it simply doesn’t.”
— Michelle Routhenstein, cardiology dietician

The study is published in BMJ Sports Medicine.

Analyzing exercise and diet habits

The researchers analyzed existing health records for 346, 627 U.K. residents that enrolled in the UK Biobank between April 2007 to December 2010. The health of these individuals was followed for an average of 11.2 years. For this study, the UK Biobank data were linked to the National Health Service death records until 30 April 2020.

For the purposes of their analysis, researchers considered the number of minutes people engaged in walking, moderate-to-vigorous physical activity (MVPA), and vigorous-intensity physical activity (VPA). For both MVPA and VPA, they used a 1-4 ranking system.

A high quality diet consisted of 4.5 cups or more of vegetables or fruit per day, two or more servings of fish weekly, and less than two servings of processed meat or less than five servings of red meat weekly.

The selection of target foods reflects recommendations from the American Heart Association, with the authors noting:

“These food groups were selected as markers for overall diet quality because other important dietary components and/or nutrient groups, such as whole grains and dairy, were not measured during baseline assessment.”

The researchers rated the individuals’ diet quality poor, medium, or one of two levels of best.

The best results

Compared to physically inactive individuals who ate the lowest-quality diet, those engaging in the highest activity levels and eating the highest-quality diet reduced their risk of all-cause mortality by 17%. They also reduced their mortality risk of cardiovascular disease by 19% and of PDAR cancers by 27%.

Not so long ago, Atlantic salmon was an abundant wild species. Born in the rivers of northeastern United States and Canada, after a couple years in freshwater they embarked on an epic migration, navigating 2,000 miles across the Atlantic to feed and mature off western Greenland. Millions of salmon travelled up to 60 miles a day, fending off predators and feeding on zooplankton and small fish. When the time came, instinct and the earth’s magnetic fields led these magnificent fish back to spawn in the precise rivers of their birth.

Today, wild salmon are an endangered species, gone from most rivers in the U.S. There are many culprits, from polluted waterways and habitat destruction to overfishing and climate change. In the last 20 years, however, a new threat has emerged: floating feedlots on the ocean known as open-net salmon farms. The $20-billion-a-year farmed salmon industry is the world’s fastest growing food producer, and it has made farmed Atlantic salmon the most popular fish on dinner tables North America. But at what cost?

This new fish is an industrialized imposter that risks our health and damages our planet. Farmed salmon are bred to grow fast in cages so crammed that they are rife with parasites and disease. The fish eat pellets of fishmeal, vegetables, and animal byproducts; they are doused regularly with pesticides and antibiotics.

We spent more than two years investigating the global salmon farming business and the multinational companies that control it for our book, Salmon Wars. We interviewed scientists, physicians, fishers, activists, and those in the business of aquaculture. We read academic studies, court papers and previously undisclosed investigative files. We identified and tried to answer three critical questions swirling around farmed salmon.

First and most important, is eating farmed salmon healthy?

Doctors recommend salmon for protein, nutrients, and heart-healthy omega-3 fatty acids. The American Heart Association suggests consuming at least two servings of fish a week. But they rarely spell out the kind of salmon you should eat or warn of the dangers.

Many experts and scientific studies cast doubt on the blanket claim that salmon should be part of a healthy diet when the fish comes from open-net farms. Some farmed salmon may be safer than other types, but consumers rarely have enough information to make that choice. Labels are unlikely to disclose that the salmon was farmed, let alone identify the chemicals used to raise it. The U.S. Department of Agriculture doesn’t even have definition for organic salmon.

“It is confusing, and I suspect there is willful confusion out there,” Dr. Leonardo Trasande, a professor of environmental medicine at New York University, told us. “We know that every fish is a trade-off between omega-3 content and toxic content like PCBs. From the perspective of salmon in general, the balance favors consumption of that fish. Now the challenge here is that I can’t tell which salmon is farmed the right way or the wrong way.”

As early as 2004, scientists found levels of polychlorinated biphenyls, a probable carcinogen known as PCBs, seven times higher in farmed Atlantic salmon than in wild salmon. More recent studies found high levels of other chemicals and antibiotics in farmed salmon. Researchers at Arizona State University discovered increases in drug-resistant antibiotics in farmed seafood over the past 30 years, leading to concerns about increased risk of antibiotic resistance in humans. Toxins often wind up in salmon flesh and accumulate in people who eat the fish.

Some studies warn that a single meal per month of farmed Atlantic salmon can expose consumers to contaminant levels exceeding standards from the World Health Organization. The risk is greatest for infants, children, and pregnant women because of the potential harm from contaminants to developing brains.

Seafood Watch, an independent guide to fish consumption affiliated with the Monterey Bay Aquarium, recommends avoiding most farmed Atlantic salmon because of excessive chemical use and disease. Nutritionists generally recommend eating wild salmon over farmed salmon.

Second, is farmed salmon sustainable?

Salmon farmers often advertise their fish as sustainable and naturally raised. These assertions are deceptive.

Salmon are carnivores. Fish meal and fish oil from anchovies, sardines, mackerel, herring, and other small forage fish comprise 25 to 30 percent of most salmon feed. Fully a quarter of the fish harvested from the world’s oceans winds up in feed for aquaculture and pets. To meet growing global demand for salmon, huge trawlers pillage the fisheries off the coast of West Africa and Peru, robbing subsistence fishers of their livelihood and increasing food insecurity.

“You take the food from the plates of people in West Africa to feed the people of Europe and the United States and other countries,” Dr. Ibrahima Cisse of Greenpeace told us.

Salmon farmers argue that they fill the need for protein as the global population grows. Depleting fisheries in low-income countries to provide an unsustainable fish for richer countries sets a dangerous precedent.

Efforts to develop alternative protein sources are under way in university laboratories and start-ups. So far, there is no end in sight for the industry’s exploitation of small fish.

The food we eat can play a much greater role in health and longevity than many people may realize. In fact, previous research suggests that 1 in 5 deaths around the world could be prevented by improving diet. 

Now, two new studies recently published in the journal The BMJ examine the effects of ultra-processed foods on certain health conditions. 

In one study, researchers from Tufts University found that a diet high in ultra-processed foods increases the risk for colorectal cancer in men.

Another study from a research team at IRCCS Neuromed in Pozzilli, Italy says that adults with the lowest-quality diet and highest ultra-processed food consumption have an increased risk for heart disease and all-cause mortality.

What are ultra-processed foods?

Ultra-processed foods are a category of the NOVA food classification system designed by researchers from the Center for Epidemiological Studies in Health and Nutrition at the School of Public Health at the University of Sao Paulo, Brazil.

The NOVA system classifies foods into four different groups: 

• Group 1: unprocessed or minimally processed foods
• Group 2: processed culinary ingredients (oils, fats, salt, and sugar)
• Group 3: processed foods
• Group 4: ultra-processed foods

Ultra-processed foods include products made in an industrial setting from ingredients that are mostly or entirely made in a laboratory or extracted from foods. 

In general, ultra-processed foods can be identified in a product if at least one item on its list of ingredients is characteristic of the ultra-processed food group, which is defined by the following:

• ingredients commonly found in processed foods, like sugars, fats, and preservatives
• additives designed to imitate natural unprocessed foods
• flavor enhancers, colorings, and other additives
• ingredients made through the synthesis of food constituents, like maltodextrin, high-fructose corn syrup, modified starch, and hydrogenated fats

Examples of ultra-processed foods include: 

• sodas and sweetened juices
• sports and energy drinks
• energy bars
• powdered and instant soups
• margarine
• mass-produced and packaged bread and baked goods made with hydrogenated fats, sugar, and additives
• pre-prepared meals such as pizza, hot dogs, chicken nuggets, and fish sticks
• infant formulas
• meal replacement beverages 
• mass-produced ice cream
• candies
• sweetened yogurt

While artificial sweeteners may seem like a good alternative to sugar to reduce caloric intake, a study published in The BMJ suggests there may be a connection between such sweeteners and an increased risk for cardiovascular disease (CVD), including stroke. 

The research, conducted by the French National Institute for Health and Medical Research, is not the first study to suggest a connection between artificial sweeteners and increased risk for heart disease, however, it is the largest to date. The study included data from more than 100,000 participants. 

Is it OK to consume artificial sweeteners?

When people try to cut sugar out of their diets, for reasons such as trying to lose weight or trying to control their blood sugar, they may turn to artificial sweeteners. 

Artificial sweeteners have been around for more than 100 years. Saccharin, for example, which is found in the sugar substitute Sweet’N Low, was first discovered in 1879. Since then, researchers have discovered numerous other artificial sweeteners, including sucralose, aspartame, stevia, and xylitol. 

There has almost always been controversy surrounding artificial sweeteners. As the Harvard School of Public Health notes, concerns include the development of type 2 diabetes and weight gain but the evidence is varied and inconclusive.

Despite the concerns, the Food and Drug Administration considers the approved sweeteners generally safe to use, as long as people do not exceed the acceptable daily intake for each type. 

For example, with sucralose (which is found in Splenda), a 132-pound person could consume 23 packets before going over the recommended limit.

And once people began mingling more during the next flu seasons, widespread use of masks blocked influenza’s chances of infecting large numbers of people.

But that could change this flu season, as mask mandates have disappeared and more people are interacting in close quarters in school, workplaces, sports events, public transport, and more. Health experts are warning that flu cases could rise again this winter, and that the combination of influenza and COVID-19 together could pose a real public-health threat that sends more people to the hospital and in need of intensive care. Already, the flu season in the southern hemisphere—which runs from April to October and serves as a harbinger of what’s to come for the U.S.—has been severe, with cases in Australia three times higher than average compared to the past five years. That could mean influenza will sweep through North America and Europe with equally aggressive force this winter, alongside rising cases of COVID-19.

That opens the possibility that people could get the two infections at the same time—which experts believe could be both unpleasant and dangerous. “Are two viruses that cause huge inflammatory responses together going to make that response worse? Theoretically, yes,” says Dr. Khalilah Gates, a pulmonary critical care physician at Northwestern University.

Gates and others stress that there aren’t extensive data yet to be sure exactly what will happen when people are infected with both influenza and SARS-CoV-2. But the limited early data—some from people, but mostly from animals—are not encouraging. Already, doctors know that people who get both the flu and a cold at the same time tend to be sicker than those who are only infected with one virus. The same could be true when flu and COVID-19 combine; classic symptoms, including fever, chills, fatigue, and coughing, could become more intense for some people. In one 2021 study on COVID-19 co-infections, including 17 people who tested positive for both influenza and COVID-19 at King Fahad Hospital in Medina, Saudi Arabia, their rates of hospitalization and death were higher than those for people infected with COVID-19 a type of bacteria that can cause respiratory tract infections.

In the largest study so far looking at co-infection of the two viruses, published in April, researchers at the University of Edinburgh reported similar trends. Dr. J. Kenneth Baillie, professor of experimental medicine at the university, and his colleagues analyzed the health records of more than 212,000 people admitted to hospitals in the U.K. for COVID-19, who were also tested for other infections. People infected with influenza and SARS-CoV-2 were four times as likely to need mechanical ventilation, and twice as likely to die, compared to people who just had COVID-19.

After a three-month hiatus, the administration is making four rapid virus tests available through covidtests.gov starting Thursday, a senior administration official said. The official spoke on the condition of anonymity to discuss the program. COVID-19 cases have shown a marked increase after the Thanksgiving holiday, and further increases are projected from indoor gathering and travel around Christmas and New Year’s.

The administration is putting personnel and equipment on standby should they be needed to help overwhelmed hospitals and nursing homes, as was necessary in earlier waves of the virus. So far, there have been no requests for assistance, but surge teams, ventilators and personal protective equipment are ready, the official said.

The Biden administration is also urging states and local governments to do more to encourage people to get the updated bivalent COVID-19 vaccines, which scientists say are more effective at protecting against serious illness and death from the currently circulating variants. The administration is reiterating best practices to nursing homes and long-term care facilities for virus prevention and treatment and is urging administrators as well as governments to encourage vulnerable populations to get the new shots.

Czechian scientists say that sleep quality plays a greater role in influencing the quality of life (QoL) than sleep duration or timing.

Their study, published in the open-access journal PLOS ONE, is among the first to observe the impact of changes in sleep quality over the long term.

It is also the first study to test how social jetlag, a mismatch of internal sleep rhythms and environmental demands, may affect QoL.

Lead authors Michaela Kudrnáčová of Charles University’s Faculty of Social Sciences and Aleš Kudrnáč, Ph.D., of the Institute of Sociology, Czech Academy of Sciences concluded: 

“While when we sleep and how long we sleep is important, individuals who have better quality sleep also have a better quality of life, regardless of the time and length of sleep. In addition, by following [4,523] people for three years, we found that those whose sleep improved also had an improved quality of life.”

Previous studies have shown that sleep disruptions and low quality sleep may decrease the quality of life.

Defining quality of life

The Charles University researchers define the quality of life (QoL) as “an interplay between the perception of an internal state, such as the experience of happiness or feeling of good heath or satisfaction, and external events in the surrounding environment, which may include family and career.”

They based their analysis on the parameters of well-being, satisfaction with life, happiness, and meaning in life.

What is social jetlag?

Social jetlag is a term that describes the difference between biological time, determined by internal circadian rhythms, and social times, primarily determined by the external environment. The increasing use of artificial light and nightwork is largely responsible for this pervasive “circadian misalignment”.

Considering that the circadian clock regulates a host of physiological processes, health experts have linked social jetlag with negative health outcomes. These include poor sleep, hypertension, impaired cognitive performance, mental health conditions, and metabolic disorders.

Data on sleep quality, duration, bedtime

The Charles University team consulted data from the Czech Household Panel Study (CHPS), focusing on information collected over three years.

The survey interviewed all members of the sampled households. In each “wave” of data collection, the same members of the same households were asked to contribute.

Czech adults submitted a total of 5,132 self-administered questionnaires about sleep patterns, health, and work in 2018. Responses totaled 2,046 in 2019 and 2,161 questionnaires in 2020.

The drop in the sample between 2018 and 2019 was due to a blood draw requirement.

The experts studied the effect of sleep on the dependent QoL variables described earlier.

For instance, they measured life satisfaction according to responses to the question “All things considered, how satisfied are you with your life as a whole?” They gauged perceived happiness with responses to the question “Taking all things together, how happy would you say you are?”

Additionally, the study measured sleep duration, perceived sleep quality, and social jetlag.

Sleep duration was calculated according to the reported responses regarding sleep and wake times on workdays and free days. Perceived quality of sleep was based on answers to the question “How would you rate the quality of your sleep?”

The researchers calculated social jetlag “as the difference between the mid-sleep time on free days and workdays.”

When I was diagnosed with bone cancer in my left femur 15 years ago this summer, I thought, “I’ll never be able to walk the streets of Paris with my daughters.”

Well, I was in Paris last week, and at least some of the time, I was walking – or, more accurately, limping – along the streets with my girls. At least the garbage strike had lifted, and those streets were relatively clean!

One morning we took a Hemingway walking tour, which took us through the streets of the Left Bank, visiting sites associated with the Lost Generation – Hemingway, Fitzgerald, Joyce; Gertrude Stein, Alice B. Toklas, Sylvia Beach, and others. Along the way, our guide read us this quote from Hemingway’s posthumously published memoir, A Movable Feast:

I would walk along the quais when I had finished work or when I was trying to think something out. It was easier to think if I was walking and doing something or seeing people doing something that they understood.

That quotation is one of the more famous descriptions of an idea that goes back to the ancient world (“It is solved by walking,” the 4th-century philosopher Diogenes said) and continues until today (Aaron Sorkin added a scene into the new version of Camelot that opens on Broadway tonight in which Guinevere encourages King Arthur to walk around the castle, a move that produces the idea of the Round Table).

In effect, this reverence for ambulation has taken on near scriptural status in recent years: walking is good for the body! good for the mind! good for the soul! and good for the imagination! Like leaches and whisky in their time, walks have become the go-to tonic of modern times.

Worried about finding the funds to pay your taxes? Take a walk!

The idea that walking could have abundant side effects on mental health, creativity, and well-being goes back decades, with a series of tests on rodents. Studies showed that active animals showed greater neurological activity than sedentary ones. With the addition of several tests, largely of undergraduates, this new consensus about the power of walking began to take over popular media.

More recently, academics began pushing back – hard.

Just this February, Luis Ciria of the University of Granada and six colleagues published a major study in Nature using a metareview of existing research claiming that most studies on the benefits of walking were overstated and based on flimsy data. 

Despite most of the 24 reviewed meta-analyses reporting a positive overall effect, our assessment reveals evidence of low statistical power in the primary randomized controlled trials, selective inclusion of studies, publication bias and large variation in combinations of pre-processing and analytic decisions.

Moreover, those benefits were reduced even further when other moderating factors were considered.

These findings suggest caution in claims and recommendations linking regular physical exercise to cognitive benefits in the healthy human population until more reliable causal evidence accumulates.

As it happens, within days, more reliable evidence appeared.

A massive new study released two weeks ago by Boris Cheval from the University of Geneva and eight colleagues used a new technique of sampling the DNA of 350,000 people. They provided the best evidence yet that “higher levels of moderate and vigorous physical activity lead to increased cognitive functioning.” As one of the lead researchers summarized the finding: “Absolutely, exercise is one of the best things you can do” for your brain.

Anxiety and depression are the most prevalent mental disorders worldwide. 

Fried foods are a major part of the Western diet and are increasing worldwide. Previous studies have found that consuming fried or processed foods, sugary products, and beer is linked to a higher risk of depression and anxiety.

Research also shows that the frying process may change the nutrient composition of foods and produce harmful chemicals. Frying carbohydrates such as potatoes, for example, generate acrylamide, which has been linked to obesity, metabolic syndrome, and neurological disorders.

Until now, few studies have investigated how acrylamide may affect anxiety and depression. Further investigation of this link could inform public health policy and dietary interventions for mental health conditions. 

Recently, researchers investigated the link between fried foods consumption and depression and anxiety. They found that fried food consumption, especially fried potatoes, is linked to an increased risk of anxiety and depression. Was this helpful?

They further found that acrylamide plays an important role in the development of anxiety and depression in adult zebrafish. 

The study was published in the journal PNAS. 

Analyzing the effect of fried food 

To begin, the researchers analyzed data from 140,728 people from the UK Biobank. Data included fried food consumption and incidence of anxiety and depression during an average follow-up period of 11.3 years. 

By the end of the study period, the researchers identified 8,294 cases of anxiety and 12,735 cases of depression. 

Overall, they found that those consuming more than one serving of fried food per day had a 12% higher risk of anxiety and a 7% higher risk for depression than non-consumers. 

Frequent consumers of fried food were most likely to be males, younger and active smokers. 

Next, the researchers investigated possible mechanisms for the link between fried food and depression and anxiety. 

To do so, they observed how chronic exposure to acrylamide affected zebrafish over time. They found that exposing fish to low concentrations of acrylamide induced anxiety-like and depression-like behavior.

From further tests, the researchers found that acrylamide reduced lipid metabolism, induced neuroinflammation, and impaired the permeability of the blood-brain barrier.

Breathing exercises done for 20 minutes two times a day helped decrease peptides associated with Alzheimer’s disease in the blood, according to a study published in the journal Scientific Reports.

Researchers say the findings indicate that these daily exercises could potentially reduce the risk of developing this form of dementia.

In he study, participants used a biofeedback unit while completing breathing exercises for four weeks. Researchers clipped a heart monitor onto the ear and connected it to a laptop in front of the participant.

There were 108 participants, with half aged 18 to 30 and half aged 55 to 80.

Half the participants listened to calming music or thought of calming images, such as a beach scene or a walk in the park. They also viewed a heart rate monitor on the laptop screen to ensure their heart rate remained steady.

The second group of participants paced their breathing to match the pacer on the laptop. When a square rose, they inhaled. When it dropped, they exhaled. This exercise was designed to increase breathing-induced oscillations in their heart rate. Their heart rates rose during inhale and dipped during the exhale.

The researchers completed blood tests before the start of the breathing exercises and again after four weeks.

They looked at two peptides – amyloid 40 and 42. Scientists say that they believe an accumulation of these peptides triggers the Alzheimer’s disease process. A higher level of the peptides in the blood could indicate a greater risk of developing the disease.

What are amyloid beta peptides?

Amyloid beta peptides are the suspected “bad guy” in Alzheimer’s disease, according to Dr. David Merrill, an adult and geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in California.

They may be produced in the body due to stress. If so, it would make sense that relaxation breathing would lower the levels.

“Even better would be mitigating the stressors in the first place. Healthy body, healthy mind,” Merrill told Medical News Today.

“The accumulation of amyloid-beta peptides in the brain is the first step in Alzheimer’s disease pathogenesis,” said Dr. Martin J. Sadowski, a professor of neurology, psychiatry, biochemistry, and molecular pharmacology at NYU Langone Health in New York.

“This process takes a number of years, and it is believed to be modulated by several factors, which remain unidentified,” he told Medical News Today.

Despite spending more money per capita on health care than any other wealthy country in the world, the U.S. struggles to match other nations in life expectancy and other health outcomes. The new Harris Poll survey, which was conducted from February to March 2023 and commissioned by the American Academy of Physician Associates, shows that patient satisfaction is also suffering due to the high costs, inaccessibility, and confusing logistics of U.S. medical care.

More than half of the roughly 2,500 U.S. adults who took the survey graded the U.S. health care system a “C” or below. When asked about factors that prevent people in the U.S. from getting care, cost was the most common criticism, followed by the system’s focus on profits, inaccessibility of insurance coverage, and confusion around what is covered by insurance.

Many respondents pointed to similar problems when asked about their own personal issues with the medical system. Only 27% of people who took the survey said the U.S. medical system meets all of their needs, while the rest listed complaints including how long it takes to get an appointment (31% of respondents), high costs (26%), limitations of insurance coverage (23%), and subpar focus on preventive care and wellness (19%).

That’s a marked change from Canada’s previous national guidance on alcohol consumption, which advised women to have no more than 10 drinks per week and men no more than 15. By contrast, the new report says those who drink only one or two boozy beverages per week “will likely avoid” alcohol-related health consequences including chronic diseases, liver injury, and accidents—but the safest choice, it says, is not to drink at all.

To researchers who study alcohol, that recommendation isn’t surprising. The new report reflects a long-brewing shift in the way scientists and health-care providers think about the risks and benefits of alcohol, and follows a similar statement from the World Health Organization (WHO) released Jan. 4.

For “the past 20-plus years the evidence has been building and building that alcohol is not good for your health,” says John Callaci, a researcher with Loyola University Chicago’s Alcohol Research Program.

If you grew up believing that a glass of red wine per night is good for your heart, you’re not alone. Decades ago, lots of studies suggested that light to moderate drinking—often defined as no more than a drink per day for women or two drinks per day for men—is beneficial for cardiovascular health. That finding stuck, both among the public and policymakers.

But Callaci says more recent research has called those older studies’ findings into question. Some researchers didn’t adequately account for underlying differences between non-drinkers (some of whom abstain because they have health problems) and light drinkers (who might have healthier lifestyles overall). So while it looked like light drinkers were healthier than non-drinkers, the booze may not have been the reason.

While some modern studies have found benefits associated with small amounts of alcohol, there’s been a shift in scientific consensus over the past couple decades. Researchers reexamined some previously published data on alcohol use, this time accounting for the “abstainer bias”—the idea that some people don’t drink because they have health or prior substance-abuse issues—and found little to no benefit associated with light drinking.

In 2022, the World Heart Federation released a policy brief debunking the notion that alcohol is heart-healthy. “Contrary to popular opinion, alcohol is not good for the heart,” the report says, noting that some studies that show cardiovascular benefits from drinking are flawed and more recent research points to a host of chronic conditions linked to alcohol. In the past year alone, studies have found that alcohol consumption may accelerate genetic aging, shrink the brain, and increase the risk of cardiovascular disease.

Alcohol is also considered a known human carcinogen and has been linked to a variety of cancers, including those of the breast, liver, colon, throat, mouth, and esophagus.

The authors of a new study recently established a link between the consumption of tree nuts — almonds, cashews, hazelnuts, macadamia, pecans, pistachios, and walnuts — and a reduction in blood pressure, an important risk factor for cardiovascular disease (CVD). They’ve just published a new study that may explain the connection.

The researchers found that tree nuts increased levels of cardio-protective L-tryptophan metabolites in plasma and stool samples collected from study participants.

The study was a randomized, controlled, parallel study that involved 131 people with obesity or overweight over the course of a 24-week weight loss and weight maintenance program.

The diet of all participants included a daily 1.5-ounce snack. Of the 95 people who completed the study, 39 individuals snacked on pretzels as a control, while 56 other people ate tree-nut snacks of the same caloric value instead. At the end of the study period, the researchers analyzed fecal and blood plasma samples from each participant to ascertain the effects of their different snacks.

People who ate tree nuts experienced significant increases in levels of blood serotonin at week 12 (60.9%), and week 24 (82.2%), compared to their baseline levels. Those who ate pretzels experienced an increase in blood serotonin levels during the maintenance phase of the study, between weeks 12 and 24.

Tryptophan is the body’s only precursor of serotonin, which is credited with supporting a range of body functions, including mood, sleep, and digestion.

The study is published in the journal Nutrients.

The research was funded by the International Tree Nut Council Nutrition Research & Education Foundation, along with the U.S. Department of Defense, VA Merit Review, and VA Career Development Award.

Healthier snacks to help the heart

According to the Institute of Food Technologists (IFT), Americans eat 2.7 snacks a day, with an increasing number of young adults consuming as many as five or more. 

Children get about 27% of their daily calorie intake from snacks, according to Harvard’s T.H. Chan School of Public Health.

Snacking can lead to unwanted weight gain, and unhealthy snacks often wind up replacing more nutritious foods in one’s daily diet.

Tree nuts and tryptophan metabolism

Tree nuts contain substantial amounts of tryptophan, which is an essential amino acid that helps support growth and overall health.

Tryptophan is metabolized via three pathways, the kynurenine and serotonin pathways in body cells, and via the indole pathway in gut bacteria.

Disrupted tryptophan metabolism has been linked to metabolic diseases, including obesity and CVD.

The study’s corresponding author, Dr. Zhaoping Li, said the new study at least partially answers the question posed by her group’s earlier research: “One of the possible mechanisms is through [a] change of tryptophan metabolism.”

Dr. Li said in a press release issued by the International Tree Nut Council Nutrition Research & Education Foundation:

“We discovered some new associations between tryptophan metabolites and blood pressure, heart rate, and satiety in overweight/obese subjects, suggesting a broader impact of tryptophan metabolism in overall health, including cardiovascular health.”

“Gut microbiome and their metabolites can contribute to the regulation of our metabolism and mood,” she told Medical News Today.

There are other reasons the study makes sense, said Michelle Routhenstein, cardiology dietitian and preventive cardiology nutritionist at EntirelyNourished:

“[The authors’ interpretation of t]his study’s findings that tree nuts encourage CVD protective tryptophan metabolites and heart health makes sense due to its ability to help reduce inflammation, one of the main causes for atherosclerosis and heart disease.”

Benefits of more serotonin

Dr. Li explained the connection between eating and emotions.

“Emotional eating is a significant factor [that contributes] to obesity. Nuts may improve mood through an increase of serotonin that is one of the key neurotransmitters to regulate mood,” she said. 

The researchers were surprised to find an increase in serotonin levels in the tree nut group during the weight loss and maintenance sections of the study. Only the tree-nut group experienced increased levels of fecal serotonin.

By the end of the study, both groups had higher blood serotonin levels.

The authors speculate this final increase in blood serotonin for all participants may be evidence of the body’s response to weight loss.

“An increase in serotonin levels may be beneficial for people who are overweight or obese trying to achieve weight loss because of its role in energy expenditure and appetite suppression,” Routhenstein also noted.

Or, they can sign up for in-house yoga classes that promote mindfulness and are followed by group discussions. Kids and teenagers, meanwhile, can have their therapy appointments while shooting hoops, traversing an obstacle course, or playing soccer in one of the clinic’s movement rooms.

The idea behind this holistic approach, says co-founder and licensed clinical social worker Melissa Novack, is to supplement traditional mental-health treatment with the healing power of movement, which has been shown in numerous studies to improve psychological as well as physical health.

“Science tells us that we’re one workout away from a good mood,” Novack says. Combining that workout with therapy is especially beneficial, she says, because clients can tap into a “sense of productivity or purpose when moving.” People who feel nervous in traditional therapy sessions—particularly kids—may also feel at ease when they’re active.

The idea of mixing movement with mental-health isn’t brand new. Wilderness therapy programs combining behavioral support and outdoor adventure have been around for decades, and plenty of clinics have adopted the walk-and-talk model to get clients moving. Other therapists integrate nature into their appointments, whether by hiking, gardening, or forest bathing.

While not all of these approaches have been formally studied, some research suggests they’re onto something. Several recent studies have concluded that mental-health treatments are more effective when they’re combined with physical activity programs, supporting the idea that therapy can be about far more than just talking.

The combination of exercise and therapy doesn’t necessarily need to be simultaneous to be beneficial, says Jennifer Thomas, a health and well-being researcher at the U.K.’s Swansea University who has studied the benefits of combining exercise and therapy. Some of the studies she analyzed for a 2020 research review involved programs that mixed exercise directly into therapy sessions, while others staggered the timing of treatment and exercise. As long as people were getting both mental-health treatment and following a specific physical-activity plan during the same time period, she says, the benefits tended to build upon one another.

“Regardless of what type of exercise you do or what you’re adding it to, there is most likely going to be a benefit for patients,” agrees Jacqueline Lee, a graduate neuroscience student at the University of British Columbia and co-author of a 2021 research review on the benefits of combined exercise and mental-health treatment.

Why does exercise have such a strong effect on mental health? That’s a question researchers are still studying, but there seem to be multiple pathways. Studies have long shown that working out releases feel-good endorphins, and animal research suggests it can also increases the brain’s supply of neurotransmitters, which may improve mood and decrease stress, anxiety, and depression. Exercise has also been shown to boost blood flow to and stimulate nerve growth in the brain, which can improve cognitive health and function, potentially leading to psychological benefits including the prevention or improvement of depressive symptoms. Physical activity is also linked to better sleep, which is itself beneficial for mental health.

An increasing amount of scientific evidence now backs up this notion. Recent studies have linked reduced rates of cardiovascular disease, dementia, and cancers with Mediterranean diets. Medical News Today looked at the evidence and spoke to experts about the science behind the benefits of this diet.

Over the years, many diets have been proposed for keeping healthy or reducing the risk of specific diseases, but few of them have stood up to rigorous scientific scrutiny.

One exception, however, appears to be the Mediterranean diet.

Increasingly, studies are showing that there are significant health benefits for people who follow this eating plan. Not only has research shown that it reduces cardiovascular disease, but it may also benefit cognition, decrease diabetes risk, reduce the risk of some cancers, and alleviate symptoms of multiple sclerosis. 

What is the Mediterranean diet?

The Mediterranean diet is an umbrella term referring to diets based on the historic eating habits of people who live around the Mediterranean Sea.

According to the American Heart Association, which recommends this type of diet for cardiovascular health, its key features are: 

• high intake of vegetables, fruits, whole grains, beans, and legumes
• low-fat or fat-free dairy products, fish, poultry, non-tropical vegetable oils, and nuts
• limited added sugars, sugary beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and fatty or processed meats.

The Harvard School of Public Health adds to these recommendations, emphasizing the importance of healthy fats — olive oil, avocados, nuts, and oily fish.

It advises that people should eat red meat only occasionally, but get their protein from fish or seafood at least twice a week and eat small quantities of poultry, eggs, and dairy most days. 

Although water should be a person’s main drink, people may also drink one or two small glasses of red wine each day, as per the traditional Mediterranean diet.

Researchers add, however, that a healthy diet should also be paired up with some form of enjoyable physical activity every day.

Dr. Scott Kaiser, a geriatrician, and director of Geriatric Cognitive Health for the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA, noted:

“Research supports the benefits of adopting healthy lifestyle habits and indicates the critical importance this can play in shaping our future individual and collective health. […] Start with including lots of fresh vegetables — especially green leafy vegetables — and then enjoy fresh fruits— like berries — and other antioxidant-rich foods, along with fish, olive oil, and other foods rich in brain-healthy omega-3s.”

As research progresses, experts are finding more and more reasons for people to prioritize sleep. One area of interest is how the sleep disorder insomnia increases the risk for other health problems. 

A​ recent review published in Clinical Cardiology examined how insomnia increases the risk of a heart attack. The review found that people with insomnia were 69% more likely to experience heart attacks. Researchers suggest that insomnia should be addressed as an essential heart attack risk factor. 

How insomnia and sleep affect health

Insomnia happens when people have trouble falling asleep or staying asleep. Chronic insomnia occurs when the problem lasts for three months or more. Several factors can increase someone’s risk for insomnia, such as high-stress levels or chronic pain. 

W​hen people don’t get enough sleep, it can lead contribute to a variety of unpleasant symptoms and increase the risk for specific health problems. Non-study author Dr. Harneet Walia, director of Sleep Medicine and Continuous Improvement at Baptist Health Miami Cardiac & Vascular Institute, explained to Medical News Today:

“Insomnia is associated with impairment in quality of life ranging from fatigue, sleepiness, mood changes, increased absenteeism, and low attention. They may also have decreased cognitive function. There are studies to suggest that insomnia is associated with cardiovascular and metabolic risk such as high blood pressure, heart attack and diabetes.”

N​on-study author Dr. Wafi Momin, a cardiologist with UTHealth Houston Heart & Vascular and Memorial Hermann, further noted the following reasons for a good night’s sleep:

“Sleep is vital in helping the body repair itself. Getting at least 7 hours of sleep each night helps your body recover and allows you to function normally the following day. Regular, consistent sleep also helps regulate blood pressure, sugar levels, as well as weight. These health problems are linked to heart disease such as heart attack and stroke, so getting plenty of sleep and regulating these risk factors can be of much help.”

On average, we are living longer, but we may not be living healthier. According to European Union figures, women can expect, on average, 64.5 healthy life years (HLYs), and men, 63.5.

But life expectancy in the EU is just over 83 years for women and 77.5 for men. So, on average, a person can expect to spend around 15-20 years with some sort of health problem. 

And most of those years of ill health are likely to be the later years of life, and many people will develop a neurodegenerative disease.

Estimates indicate that 14–18% of people over the age of 70 years in the United States have some form of cognitive impairment. And some 10% of people in the same age group in the U.S. have dementia, a number that rises to 33% of those over 90.

But there are ways to help extend your HLYs, and evidence is increasingly suggesting that regular physical activity may be one of the most effective ways to help your body and brain stay healthy for longer.

Exercise for mental and physical health

Exercise makes us feel better — higher levels are associated with lower levels of depression, and it is thought this is due to a natural “high” from the release of endorphins and endocannabinoids, which can last for some time after exercising — but the physical effects last longer.

According to the Centers for Disease Control and Prevention(CDC), regular physical activity is “one of the most important things you can do for your health.”

Medical experts everywhere agree with that statement. Speaking to Medical News Today, Dr. Emer MacSweeney, CEO and consultant neuroradiologist at Re:Cognition Health, emphasized:

“Being physically active is one of the best things you can do for your body. Exercise helps protect against many diseases and keeps the heart, muscles, bones, and brain in optimum condition. Exercise promotes [the] oxygenation of the brain and stimulation of multiple neurochemicals.”

Exercise can reduce the risk of, among other conditions, cardiovascular disease, several types of cancer, and type 2 diabetes.

And, together with a healthy diet, it is a key part of maintaining a healthy body weight — another way to lower the risk of disease.

Research has shown that endorphins can relieve pain, and may reduce both inflammation and stress responses. Additionally, exercise can increase the beneficial effects of medications and other therapies for mental health conditions, such as depression.

“Exercise is particularly beneficial for mental health due to the chemical changes which occur in the brain and body, including the release of ‘feel-good’ chemicals, endorphins and serotonin,” Dr. MacSweeney explained.

Cardiovascular diseases (CVD) are a major cause of global mortality and disability. Although the CVD burden is declining in those aged over 50, current rates of CVD below this age have either remained steady or increased.

In high-income countries, lifestyle factors, such as obesity, lack of physical activity, and poor diet, are all increasing the incidence of CVD.

Studies have shown that cardiovascular risk factors may contribute to late-life cognitive decline and dementia but, until now, there has been little evidence that CVD might speed cognitive decline in middle age. 

Now, new research, part of the Coronary Artery Risk Development in Young Adults (CARDIA) study, has found that premature CVD — at or below the age of 60 — may affect brain health and increase cognitive decline in midlife.

The research appears in Neurology, the journal of the American Academy of Neurology. 

Long-term study

This prospective cohort study enrolled people aged between 18 and 30 years, and followed them for 30 years. Participants had follow-up examinations every 2–5 years during the study.

The participants were from four cities in the United States, just over half were female and just under half were Black. 

Dr. Sandra Narayanan, board-certified vascular neurologist and neurointerventional surgeon at Pacific Stroke & Neurovascular Center at Pacific Neuroscience Institute in Santa Monica, CA, who was not involved in the study, commented for Medical News Today: 

“The longitudinal, prospective study design over 30 years limits bias. The number and forms of cognitive assessments applied to this large cohort during this period also enabled a thorough evaluation of brain health in multiple domains such as executive functioning, processing speed, and verbal learning and memory.”

At the 30-year point, 3,146 participants, with a mean age of 55 years, underwent a range of cognitive assessments. In total, 147 (4.7%) had developed one or more premature CVD events, 126 of which were coronary heart disease or stroke. The mean age of the first CVD event was 48.4 years.

Those who had premature CVD were more likely to be male, older, Black, have had access to less education, have lower household income, and have more risk factors for CVD, such as poor diet and low levels of physical activity.

Wide-ranging cognitive assessments

Researchers tested participants in verbal fluency, global cognition, verbal memory, processing speed, and executive function.

They adjusted for demographics, education, literacy, household income, depressive symptoms, physical activity, diet, and APOE — a gene that is linked to an increased risk of dementia — when analyzing their findings.

In addition, they assessed 5-year cognitive decline in 2,722 people who underwent testing at both the 25- and 30-year points.

At the end of the study, 663 participants also underwent MRI brain scans to assess white matter hyperintensities (WMH), which are associated with cognitive impairment. The researchers also used diffusion tensor imaging to assess participants’ brain health.

Only a small proportion of those undergoing MRI scans had early CVD, as lead author Dr. Xiaqing Jiang, a postdoctoral scholar in the Department of Psychiatry and Behavioural Sciences at the University of California, San Francisco, told MNT.

“Among those with MRI, 16 participants had premature CVD. More people will develop premature CVD events as they age as most participants were still under 60,” she said.

A new study from Columbia University in New York reports that just 5 minutes of walking every half-hour can offset some of the most harmful effects of sitting for long periods. 

The research team, led by Keith Diaz, PhD, an associate professor of behavioral medicine at Columbia’s Vagelos College of Physicians and Surgeons, tested five different exercise “snacks.”

They included 1 minute of walking after every 30 minutes of sitting, 1 minute after 60 minutes, 5 minutes every 30 minutes, 5 minutes every 60 minutes, and no walking. 

“If we hadn’t compared multiple options and varied the frequency and duration of the exercise, we would have only been able to provide people with our best guesses of the optimal routine,” Diaz said in a statement.

The need to sit less

There’s plenty of research that concludes that prolonged sitting, like that done in office settings, is a health hazard, even for those who exercise regularly. 

Doctors advise adults to move more and sit less. 

The question then becomes how to mitigate all that sitting while it happens.

And, according to the new study’s researchers, there hasn’t been much research giving office workers a satisfactory answer.

How the sitting and walking study was conducted

The new study was small – only 11 adults participated in Diaz’s laboratory.

Participants sat in an ergonomic chair for 8 hours, rising only for their prescribed exercise period of treadmill walking or a bathroom break.

Researchers said they made sure each participant didn’t over-exercise or under-exercise. They also periodically measured the study subjects’ blood pressure and blood sugar (key indicators of cardiovascular health). 

Participants were allowed to work on a laptop, read, and use their phones during the sessions and were given standardized meals.

What researchers discovered about walking and sitting

Researchers reported that 5 minutes of walking every 30 minutes had the best results. It was the only amount that significantly lowered both blood sugar and blood pressure.

The walking regimen dramatically affected how participants responded to large meals, reducing blood sugar spikes by 58% compared with sitting all day, the researchers reported. 

Taking a walking break every 30 minutes for 1 minute also provided modest benefits for blood sugar levels throughout the day.

Walking every 60 minutes (either for 1 minute or 5 minutes) provided no benefit. 

All amounts of walking significantly reduced blood pressure by 4 to 5 mmHg compared with sitting all day.

“This is a sizeable decrease, comparable to the reduction you would expect from exercising daily for six months,” Diaz said. 

All the walking regimens, except walking 1 minute every hour, significantly decreased participants’ fatigue and showed mood improvements.

None of the walking regimens, however, influenced cognition.

Regular consumption of fruits and vegetables may help reduce the risk of developing certain health conditions.

Despite government guidelines to increase fruit and vegetable intake worldwide, consumption in Europe, the United States, and across the globe remains low. 

Recently, researchers from the University of Bournemouth released a new app called “SMART 5-A-DAY” to help users track and increase their fruit and vegetable intake. 

Prof. Katherine Appleton, professor of psychology at the University of Bournemouth and one of the app’s creators, told Medical News Today:

“The app is based on the U.K. 5-a-day recommendations, and fruit and vegetable recommendations can vary around the world based on the local fruits and vegetables available, local portion sizes, and other local nutritional concerns. Recommendations to consume lots of fruits and vegetables, however, apply everywhere.” 

The app was released in the Google Play Store for Android phones on December 29, 2022.

Why aren’t people eating enough fruits and veggies?

Research shows that knowledge about the benefits of fruit and vegetable consumption is lacking and directly linked to lower overall consumption.

Potential factors impeding fruit and vegetable intake may include:

• poor knowledge or confusion around nutritious fruits or vegetables 
• portion sizes for fruits and vegetables
• the number of portions needed per day 
• the need for a variety of fruit and vegetables
• benefits of high fruit and vegetable consumption

Increasing awareness around what constitutes adequate fruit and vegetable consumption could help individuals improve their overall health.

‘SMART 5-A-DAY’ app: How it works 

To use the app, users input what fruits and vegetables they’ve eaten after each meal and how much.

The app then converts consumption to correspond with U.K. guidelines of five portions of different fruits or vegetables per day. The app allows users to track their daily consumption over time. 

“The app only includes fruit and vegetables that count toward the U.K. recommendations, so those that do not count toward the U.K. recommendations, such as potatoes, cannot be added,” Dr. Appleton explained.

She added that one of the app’s key benefits is that it will help users recognize how few fruits and vegetables they consume, which may alert them to improve their diets. 

“Our hope is that use of the app over a number of weeks will increase understanding of these elements such that the app is not required further, but people have the knowledge themselves of what they need to do,” she said.

Possible benefits

A 2019 study on the SMART 5-A-DAY app found a modest increase in participants’ knowledge of fruit and vegetable intake recommendations.

Since that time, researchers have incorporated several updates based on user feedback and expect this will have a positive impact on the overall consumption of fruits and vegetables.

“Research has also found tracking a health-related goal is linked to a greater chance of achieving the goal,” Debbie Fetter, Ph.D., assistant professor of teaching nutrition at the University of California, Davis, not involved in the study, told MNT. 

“Using an app can give consumers a place to document their efforts and see their progress add up. However, it’s not a requirement to use an app; tracking a health-related goal with pencil [and] paper also works great,” Dr. Fetter added. 

How food tracking apps help improve diet 

To understand more about how the SMART 5-A-DAY app might help individuals improve their diet, MNT spoke with Sara Kostelnick, MS, RD, a sports performance dietitian at the University of Kansas Health System (not involved in the study).

“As a dietitian, I often see fruit and vegetable intake is forgotten about when making healthy lifestyle changes,” Kostelnick said. 

“Many studies have investigated tracking as a means of increasing accountability and reaching health goals that you’ve set for yourself. Translating this to meet fruit and vegetable needs can help users increase their daily fruit and vegetable consumption,” she added.

MNT also spoke about the new app with Dena Champion, MS, RDN, a registered dietitian at the Ohio State University Wexner Medical Center: 

“This app appears colorful, simple to use, and interactive. It includes a calculator which gives a target of 5 servings of fruits and veggies a day. This may be a helpful visual for people trying to increase their fruit and veggie consumption but aren’t sure of serving sizes or how close they are to meet this goal.”

Champion noted, however, that not everyone may find the app helpful. 

“Everyone learns differently and is motivated differently. Some people thrive on this kind of app that requires tracking foods and provides feedback, while others find this annoying or unhelpful,” Champion said.

The tests are easy to use, and for now, paid for by insurance if you’ve got it. If you don’t have insurance, you can still get the kits for free from some community health centers.

If the test shows that you’re positive, you know to stay home and mask up, and ask your doctor about taking antiviral medications that can minimize the symptoms and keep you from getting seriously ill. If you’re a parent and testing your kids, the kits can signal when to keep them at home from school.

It’s a win-win, since knowing your status means you can protect not only yourself but your community by not spreading the virus when you stay home and get treated.

COVID-19 has set a new standard of expectations for testing, and knowing whether you’re sick, that is starting to make the way the U.S. traditionally manages winter season diseases look archaic. Why don’t we have the same self-tests for other common illnesses that spread during the colder months—such as flu and RSV? Each year flu leads to between 300,000 and 800,000 hospitalizations in the U.S., while RSV sends up to 80,000 young children under five years old to the hospital annually.

“The pandemic shifted people’s expectations,” says Dr. Michael Mina, chief science officer at eMed, a digital health company that offers at-home testing and telemedicine options to help with those tests for a range of illnesses. “It’s driving people to ask, ‘why do I need to go to the doctor when COVID-19 testing has shown me that it’s totally safe and okay for me to [use self-tests to determine] if I’m positive for a respiratory illness?’”

Until the pandemic hit, at-home testing was a health trend struggling for respect. While convenient, the medical community and health regulators at the Food and Drug Administration (FDA) weren’t convinced that people could reliably test themselves at home for things like flu, and interpret the results accurately. Decades earlier, home pregnancy test kits battled through similar validation issues, as health care experts raised concerns about releasing a test that wasn’t always completely accurate and about the need to educate women about interpreting the results. Ultimately, regulators decided that the level of uncertainty was an acceptable tradeoff for arming women with knowledge about their pregnancy status and the tests became available in 1978 over the counter.

With similar reasoning, and this time driven by the urgent need during the pandemic to limit the spread of SARS-CoV-2, the FDA authorized the first at-home rapid tests for COVID-19 in spring 2020. Millions of people have since tested themselves or their children, without a medical professional, effectively and responsibly. “The COVID-19 pandemic led to a shift in empowering citizens with the ability to test themselves for respiratory infections,” says Dr. Chaz Langelier, associate professor of medicine in the division of infectious diseases at University of California San Francisco. “The average person in the U.S. now has a working knowledge of the public health implications of respiratory infections on a level that wasn’t there pre-pandemic.”

The barriers to self-testing

Studies conducted on at-home COVID-19 tests showed that people don’t need a medical degree to insert a swab up their nose, swirl it around, and then insert the swab in a pre-made solution and read the resulting lines. In fact, that technology is essentially the same one that doctors and nurses use in doctors’ offices, emergency rooms and health centers to test for influenza, RSV, and strep. “The average person thinks that when they go to the doctor and he or she uses a rapid strep or flu test, that the doctor is doing something complicated behind the scenes,” says Mina. “But no, it’s just the same swabbing of the nose or throat and the same lateral flow antigen test [as in the home kits]. The COVID-19 self tests have demystified how some of these medical tests are performed. And opened to door to people asking, ‘why don’t I have access to that?’”

The reason they don’t yet has to do with a number of factors, from cultural bias to the economics of the flu-testing market. The medical community has historically been reluctant to entrust self-tests in the hands of the public because of concerns about how well the people without medical expertise can collect the samples and perform the chemical reaction required to detect the presence of a virus or bacteria. But streamlined ways to contain reagents and present them in a straightforward way, such as the easy-to-use COVID-19 test kits, have made the process nearly mistake-proof, Mina says.

While that may be true of the COVID-19 self tests, the self-tests for flu that are still being developed aren’t quite there yet. Doctors have relied for years on so-called point-of-care testing that provides results within minutes about whether their patients have flu, but they have also known that the false negative rate of these tests can range up to 40%. “You trade accuracy for speed,” says Dr. Lisa Maragakis, professor of medicine at Johns Hopkins University School of Medicine. Such rapid antigen tests, which pick up proteins made by viruses like SARS-CoV-2 or influenza, are relatively good at detecting people who are positive, leading to low false positive rates, but a negative result doesn’t always mean the person is free and clear. Doctors take other factors into consideration, such as the patient’s symptoms and exposures, when interpreting negative results. And if needed, they repeat the test to confirm the result.

A new large-scale clinical intervention trial found that a modified Mediterranean diet — called the green Mediterranean diet — is more effective at reducing visceral fat that can surround and damage organs than the standard Mediterranean diet or a generally healthy diet.

All three diets resulted in a reduction of visceral fat, but the green Mediterranean diet doubled the benefit of the “traditional” Mediterranean diet.

The study was conducted by the DIRECT-PLUS trial research team. It was led by Prof. Iris Shai of Ben-Gurion University of the Negev, Israel, and Dr. Hila Zelicha, now at the University of California, Los Angeles, aided by colleagues from Italy, Germany, and the United States.

The study appears in BMC Medicine.

The green Mediterranean diet

The green Mediterranean diet differs from the original Mediterranean diet in its emphasis on polyphenols.

Polyphenols are plant compounds that have been linked to protection from type 2 diabetes, some cancers, and heart disease. They also appear to support brain health and digestion.

Polyphenols are found in dark chocolate, berries, red wine, and tea, as well as some nuts, such as walnuts.

On the green Mediterranean diet, as envisaged in this study, a person consumes 28 grams of walnuts — about seven nuts — 3 to 4 cups of green tea, and 100 milligrams of the aquatic plant Wolffia globosa (Mankai) — also known as “duckweed” — in a smoothie or shake each day. All are rich in polyphenols.

Otherwise, the diet is the same as the original Mediterranean diet, but without the consumption of red and processed meats.

For the 18-month randomized controlled trial, researchers divided the 294 participants into three groups:

• one group followed a standard Mediterranean (MED) diet
• one followed a green Mediterranean (green-MED) diet
• a final group one strictly followed healthy dietary guidelines (HDG).

All groups were offered lifestyle educational sessions and physical activity recommendations, along with a free gym membership.

Researchers supplied the walnuts, tea, and Mankai, along with recipes for green smoothies.

Salt is known to improve the taste of many foods, which may tempt consumers to buy more processed, salt-laden products. Common processed foods include commercially packaged bread, cereals, deli meats, soups, cheese, and instant noodles.

Increasing evidence shows that too much salt in the diet can wreak havoc on the body’s cardiovascular and renal systems. 

Recently, scientists at the University of Edinburgh in Scotland theorized that high salt consumption might also impose stress on the brain. The results from the experiment showed that high salt intake could elevate stress hormone production.

The study linked the consumption of large amounts of salt-rich food to the activation of the hypothalamic-pituitary-adrenal (HPA) axis, the body’s stress response system. The researchers also noticed a high-salt diet led to increases in glucocorticoids, naturally occurring hormones that help regulate stress response and cardiovascular, cognitive, immune, and metabolic functions.

Matthew Bailey, Ph.D., lead author of the study and professor of renal physiology at the University of Edinburgh’s Centre for Cardiovascular Science, told Medical News Today:

“We are what we eat, and understanding how high-salt food changes our mental health is an important step to improving well-being. We know that eating too much salt damages our heart, blood vessels, and kidneys. This study now tells us that high salt in our food also changes the way our brain handles stress.”

The research team hopes that their work will encourage more public health policies that promote the reduction of salt in processed foods.

The findings appear in Cardiovascular Research.

Salt consumption is above healthy levels

Sodium is an essential element that helps regulate the movement of nutrients in and out of cells. The human body requires only a small amount of sodium, which combines with chloride to make up common table salt.

According to the 2020–2025 Dietary GuidelinesTrusted Source, Americans should consume less than 2,300 milligrams (mg) of sodium daily. But the Centers for Disease Control and Prevention (CDC)Trusted Source estimates Americans eat over 3,400 mg every day.

Evangeline Mantzioris, a dietitian and program director of nutrition and food sciences at the University of South Australia, discussed the epidemic of high salt in an April 2022 podcast. She was not involved in the present study.

When we eat too much salt, Mantzioris explained: “It gets absorbed into our intestine and our blood […] It draws fluid into the blood vessels [and] increases the blood pressure against the blood vessel wall — and this is what we call high blood pressure.”

She added that aging and certain health conditions, including preeclampsia, low birth weight, and chronic kidney disease, can increase salt sensitivity. In turn, “our body is less able to deal with all the processes that it needs to keep healthy,” she noted.

The link between carbs and type 2 diabetes (T2D) is well-established, but new research suggests that cutting carbs could help minimize risk for those who may be susceptible to developing the condition.

The study, a random clinical trial (RCT) recently published in JAMA Network Open Diabetes and Endocrinology, found that a low carbohydrate diet promoted weight loss and improved fasting glucose levels in subjects who were at risk for developing T2D.

Lead author and epidemiologist Kirsten S. Dorans of Tulane University in New Orleans, LA, told Medical News Today:

“While low carb diets are often recommended for those with type 2 diabetes, little evidence has existed for whether eating fewer carbs can impact the blood sugar of those with mild diabetes or prediabetes who aren’t treated by medications. This study was conducted in people with blood sugar that ranged from prediabetes to mild diabetes levels who were not on diabetes medications.”

Lowering blood sugar with a low carb diet

Hemoglobin A1C is a widely used clinical term to measure long-term blood sugar levels.

According to the American Diabetes Foundation, a person who has prediabetes has A1C levels between 5.7 and less than 6.5%. Higher A1C levels may signify diabetes.

Dr. Dorans explained that subjects enrolled in the study had a hemoglobin A1C range of 6.0 to 6.9%. 

“This range chosen as the lower bound aligns with the World Health Organization’s lower cutoff point for prediabetes and the upper bound with less than the 7.0% American Diabetes Association hemoglobin A1C target,” she said.

For the study, 150 adults were recruited at a New Orleans academic center. The 6-month trial ran from September 2018 to June 2021. Participants ranged in age from 40 to 70 years old and were divided into two groups.

The first group was tasked with reducing their daily carbohydrate intake to less than 40 grams for the first 3 months and less than 60 grams from month 3 to the end of the trial.

“We found that nutritional counseling promoting a low-carbohydrate diet lowered hemoglobin A1C over 6 months,” Dr. Dorans said.

“In line with prior work, the low-carbohydrate diet group also lost substantial weight compared with the group of people who stayed with their usual diet.”

At the end of 6 months, Dr. Dorans and her research team found that A1C levels reduced by 0.23% more in the low carb group than the usual diet group.

I know that this year Thanksgiving will be like no other. Whether you are celebrating with your immediate family or close friends, I truly hope that you are safe and well and can find some comfort in cooking at home. 

Delicious & Healthy Thanksgiving Recipes for Everyone

Like I do every year, below I put together a round-up of over 35 appetizers, salads, soups, vegetable sides, and desserts that I make every year for Thanksgiving. This list includes one of the most popular healthier Thanksgiving dishes on the blog, Butternut Squash and Quinoa Salad.

Thank you from the bottom of my heart for being a part of this community and supporting my blog. Wishing you and your loved ones a happy Thanksgiving.

Click “Read More” below to see all the recicpes.

At first it seemed like a routine call—something the paramedics had dealt with countless times before. A man in his mid-50s was having a heart attack, and his physician had called for emergency support. But when the paramedics arrived, the physician pulled them aside and told them something peculiar: the man had no cardiovascular symptoms whatsoever.

The man had come to his doctor’s office because he’d woken early the previous morning sweating and with a sharp pain in his left wrist. These symptoms had quickly subsided and he’d gone back to sleep. Later, after going about his day, he’d visited his doctor to report the episode. The man showed no outward signs of heart trouble; he was breathing and acting normally—asking what “all the fuss was about”—and his heart rate and blood pressure weren’t elevated. However, when his doctor performed an electrocardiogram—a test that measures the electrical activity of the heart—it showed plainly that the man had experienced a heart attack. The paramedics repeated the test and came to the same conclusion. Later, at the hospital, further tests confirmed the attack and revealed a partial blockage of one of the man’s coronary arteries. Surgeons stented the blocked artery and, after a few days in the hospital, the man returned home.

The man’s experience was documented in a 2017 medical case report in the Irish Journal of Paramedicine, and it illustrates something experts call a “silent heart attack.” This is a type of attack that doesn’t cause typical or obvious symptoms. “Crushing chest pain that radiates down the left arm is the classic symptom,” says Dr. Amgad N. Makaryus, a professor of cardiology at the Zucker School of Medicine at Hofstra/Northwell in New York. “With silent ischemia, which is more common in diabetics, people develop atypical symptoms, or they might not develop symptoms at all.”

By some estimates, roughly 1 in 4 heart attacks is “silent.” This is likely an undercount because many of these heart attacks go unrecognized and unreported; most are only identified after the fact using an electrocardiogram or other test. While roughly half of silent heart attacks involve atypical symptoms, the other half are believed not to cause symptoms at all. And research has found that people with Type 2 diabetes may be up to twice as likely to have a silent heart attack compared to those who don’t have diabetes.

Silent heart attacks are dangerous precisely because they often occur undetected. Some studies have found that people who have experienced a silent heart attack are at greater risk of death than those who have a heart attack with recognized symptoms. “Compared to those without a heart attack, those who have had a silent heart attack have a three-fold greater likelihood of dying from heart disease in the future,” says Dr. Nathan Wong, director of the Heart Disease Prevention Program at the University of California, Irvine.

How can those with Type 2 diabetes protect themselves from silent heart attacks? Here, Wong and others explain everything you need to know—whether you have Type 2 diabetes yourself or are caring for someone with the condition.

Some of us leap out of bed eager to get on with the day; for others, emerging from under the covers is left until the last possible minute—often because we have been awake until the small hours. 

And most of us know that we either function better in the morning or the afternoon and adapt our working schedules to suit our ‘early bird’ or ‘night owl’ tendencies. But can our chronotype affect not only our functioning, but also our health?

Research studies have suggested that chronotype, and particularly chrononutrition—what times of day we eat — may indeed affect health, but the findings are not yet conclusive.

Now, a study published in Experimental Physiology has found that our sleep/wake cycles are associated with our body’s metabolism, with night owls having a reduced ability to use fat for energy. This may increase their risk of type 2 diabetes and heart disease.

Early and late chronotypes

A team of researchers from Rutgers University, NJ, and the University of Virginia, VA, divided a group of 51 adults into early or late chronotypes based on their answers to a questionnaire. 

All participants were non-smokers, free of cardiovascular disease, cancers, and metabolic diseases, and were sedentary, exercising less than 60 minutes a week. 

Using imaging techniques, researchers assessed the participants’ body mass and body composition. They also tested insulin sensitivity.

Participants wore an accelerometer on the right hip, during the day, for 7 days to record what times of day they were most active. Researchers compared this data with the chronotype from the questionnaire to determine whether chronotype was influencing activity patterns during the day.

After making them fast for 12 hours, researchers tested participants at rest and during exercise to assess what they were metabolizing to provide energy. They then took breath samples to calculate their fat and carbohydrate metabolism at rest and when exercising.

“Measuring metabolism during rest and exercise allowed us to see how changes in movement throughout the day could impact or relate to health.”

— Dr. Steven K. Malin, lead author, associate professor of kinesiology and health at Rutgers University, NJ

Comparing early birds and night owls

The researchers noted no significant differences in age, body mass, or metabolic syndrome between the groups. However, they did find differences in how energy sources were used by those with early and late chronotypes.

Early birds used more fat for energy than night owls. They were also more insulin sensitive— their cells used glucose more effectively, reducing blood sugar. 

Night owls tended to be more insulin resistant, meaning they required more insulin to lower blood glucose levels, and they tended to use carbohydrates as an energy source rather than fat. 

Insulin resistance indicates a greater risk of type 2 diabetes.

Dr. Malin told Medical News Today: “A key finding was that individuals with later chronotype were indeed less able to respond to insulin by promoting glucose uptake towards storage. And that observation related to how much fat was used for energy. This aligns with ideas that low fat metabolism relates to insulin resistance by either defects in the mitochondria […] or accumulation of fat metabolites that impair insulin action on tissues like muscle.”

Differences in muscle quality

The researchers found no significant difference in muscle mass between the two chronotypes, although muscle mass was slightly higher in those with late chronotypes. 

They suggest that their finding of greater fat oxidation in early chronotype may be due to differences in skeletal muscle quality rather than quantity.

Dr. Malin explained: “Based on our work so far, our sense is something is dysregulated in skeletal muscle quality. […] The ability to use fat was directly related to maximal aerobic fitness, which is partly linked to mitochondrial function. Indeed, people of later chronotype had lower fitness when measured by VO2max [maximum amount of oxygen the body is capable of using during high-intensity activities], in addition to being more sedentary through the day.”

“That lower amount of fat metabolism was directly related to how well insulin promoted glucose uptake towards storage. That is critical because stored glucose, known as glycogen, helps fuel muscle for physical activity,” he added.

It’s no secret that regular exercise has many benefits. It protects against developing chronic conditions, such as diabetes and heart disease, and in some cases can improve mental health. But what effect does it have on specific functions, like memory? Can a workout regimen help you remember the scores from last night’s Yankees game, where you went on your first date with your significant other or where you left your keys?

It’s possible. Studies over the years have suggested that a single workout can improve recall, and that engaging in regular exercise over the course of years or decades not only improves memory, but also helps fortify against future memory problems. Now, a recent study from Dartmouth focuses on how the intensity of exercise, over a period of time, may play an important role in bolstering different types of recall.

“We know that exercise works, but we don’t know which variables of exercise make the exercise more effective,” said Marc Roig, a physical and occupational therapy professor at McGill University who studies the effect of exercise on cognition and was not involved with the study. “We believe intensity is one of those factors.”

Different exercise intensities appear to affect different types of memory.

One of the major challenges with studying the link between regular exercise and memory is that the changes are hard to measure. This is complicated by the fact that many other factors affect memory, like working a sedentary office job or chronic sleep deprivation. Furthermore, there are different types of memory — which explains how a person might constantly lose their keys (poor spatial memory) but have a knack for remembering birth dates (strong semantic memory).

Activity trackers can offer one solution to these issues. In the recent paper, published in the journal Nature Scientific Reports, researchers were able to look at a year’s worth of Fitbit data from 113 participants, who also completed a series of memory tests, like recalling details from a short story, spatial details, foreign language terms and lists of random words.

The advantage of this method is that it linked a full year of information about participants’ activity patterns — how much exercise they got, how intense, how often — to their performance on memory tests.

Other studies have tracked patterns of activity through self-reported data, which is often less reliable than activity tracker data, as people tend to underestimate how much time they are sedentary and misremember their total activity levels.

“You can get a much more nuanced picture from activity tracker data,” said Jeremy Manning, a professor at Dartmouth College and one of the authors of the study.

Dr. Manning and his colleagues found that active people had better memories overall compared to those who were sedentary, but also found that the types of tests they did well on varied depending how intensely they exercised.

For instance, participants who engaged in light to moderate activity, such as going for regular walks, had better “episodic” memory. Think of episodic memory as “mental time travel,” Dr. Manning said, or the ability to remember details about everyday events, like meeting a friend in a coffee shop or watching for the school bus on your first day of kindergarten.

This tracks with a number of previous studies that have shown the more people are active, the better, on average, their episodic memory is.

Participants who regularly exercised more intensely — such as going for a run or doing a HIIT workout — were more likely to perform better on spatial memory tasks. Spatial memory is the ability to remember physical relationships between objects or locations in space, like where you put your keys. This mirrors a number of other studies that show high-intensity exercise improves memory, but goes further, suggesting it might be more helpful for this type of memory over another.

More study needs to be done to solidify these associations and determine what is causing them, the researchers said.

“The more that we can connect everyday patterns of activity to cognitive performance, the closer we are getting to thinking about lifestyle,” which includes how active you are during the entire day and sleep patterns, said Michelle Voss, a cognitive neuroscientist at the University of Iowa, who was not involved in the study.

In a survey conducted in July of 2,000 adults, released Sept. 13 by the Harris Poll on behalf of The Ohio State University Wexner Medical Center, about 18% of respondents said they get less sleep now than they did before the pandemic, while 19% said they struggle to sleep because they’re worried or stressed (about COVID-19, politics, or other factors). At the university, at least, this has led to a surge in demand for help; in 2021, Ohio State’s medical center received about 29% more referrals for insomnia treatment compared to 2018, says Dr. Aneesa Das, a sleep specialist and professor of internal medicine there.

Stress can disrupt sleep, says Das, since it can boost heart rate and blood pressure, upset stomachs, and make muscles tense. However, the survey also points to another problem: bad sleep habits, including using phones before bed, sleeping at irregular hours, and spending too much time in the bedroom. The challenge, says Das, is that these habits threaten important drivers of healthy sleep, including being exposed to light at the correct times and maintaining a regular sleep schedule.

Some of this, says Das, is because many people do the wrong things to help wind down for sleep. In the survey, 47% of respondents say they use their phone before bed, and 37% fall asleep with the TV on. “Both of these are things that folks often do to try to distract their mind,” says Das. “But bright light is actually stimulating and decreases the association of the bedroom with sleep.”

The pandemic’s disruption of people’s daily schedules may have also had a knock-on effect on sleep, says Das. COVID-19 forced many people out of work or to work from home, giving them more control over when they go to sleep or get out of bed. But not sleeping the same hours every night can make it harder to fall asleep, Das says. During the pandemic, people may have also started spending too much time indoors without enough exposure to sunlight (although the survey did not measure this). This becomes especially problematic, Das says, if they spent more time in their bedrooms. “Waking up, putting your laptop on the bed, and working from home are probably the worst things we can do for causing insomnia.”

If you’re struggling to sleep, Das suggests rethinking your sleep habits. Your bedroom should be cool (ideally with a temperature in the upper 60s) dark, and quiet, and it should only be used for sleep and intimacy. Your daily schedule can also have a big impact on your sleep: getting exercise, spending time in the sun during the day, stopping caffeine consumption after 2 p.m., and keeping regular sleep and wake schedules can help, says Das. To help her own sleep, Das says that she likes to create a to-do list so she feels prepared for the next day, and she takes a daily two-mile walk.

While it can be hard to change habits (or give up your afternoon latte), improving your sleep can have major benefits on your physical and mental health. Poor sleep has been linked to a range of conditions, from a higher risk of stroke and heart disease, to increased vulnerability to obesity and depression. 

And while the pandemic has messed with sleep schedules, good sleep could help people become more resilient to its effects. After getting a bad night’s sleep, studies have shown that people even have a poorer immune response to vaccines, says Das. While this hasn’t been studied with the Omicron booster,Das notes, “I can assure you that I tell my kids, ‘Before you get your vaccine booster, we want to make sure you’re getting good sleep.’”

In the years following World War II, physicians in the U.S. and Europe noticed a surprising phenomenon: rates of heart attack and stroke fell dramatically in many places. Autopsies from this period also revealed reduced rates of atherosclerosis, which is a buildup of fatty arterial plaques that causes cardiovascular disease.

At first, experts were perplexed. But as time passed, many concluded that wartime food deprivations and the forced shifts in people’s diets—namely, big reductions in the consumption of red meat and other animal products—contributed to the heart-health improvements. Later work, particularly the famous Framingham Heart Study, helped establish that blood cholesterol levels, driven in large part by a person’s diet, tended to overlap closely with cardiovascular disease.

The idea that the foods a person eats could raise or lower their risks for unhealthy cholesterol levels and disease was, at first, a radical and controversial one. While there’s ongoing debate about the relationship between red meat and poor health, the links connecting diet, cholesterol, and cardiovascular disease are beyond doubt.

Cholesterol is a waxy compound that your body uses primarily to make hormones and to firm up the walls of cells. “Our body needs some cholesterol for day-to-day functioning, but the amount our body needs is relatively small,” says Dr. Laurence Sperling, the founder and director of the Heart Disease Prevention Center at Emory University in Atlanta.

Different parts of the body, including the brain and the blood, contain cholesterol. It’s the oversupply of cholesterol in the blood, specifically, that causes problems—specifically low-density lipoprotein (LDL), which is also known as “bad cholesterol. Too much LDL in the arteries can “form a fatty streak, which is the precursor of atherosclerotic plaque,” explains Dr. Francine Welty, a cardiologist at Beth Israel Deaconess Medical Center in Boston and former chair of the American Heart Association’s lipid committee. LDL, therefore, is the primary building block of arterial plaque.

The two main diseases associated with clogged arteries—coronary artery disease and cerebrovascular disease—are both among the top three causes of death worldwide. More than 1 in 4 deaths are caused by one of these two conditions, and managing or lowering your blood cholesterol levels is a proven way to prevent these diseases. Sperling says ideal or “target” cholesterol levels vary depending on a person’s age, sex, and health status. But, optimally, you want to keep your LDL cholesterol below 70 mg/dL. While drugs can help people get there—and in some cases may be necessary—he says that non-pharmacological approaches are just as important. “Lifestyle and behavioral approaches are the foundation of cardiovascular prevention for all,” he says.

Here, experts detail the most impactful lifestyle changes to make to lower your cholesterol. A proper diet, they all agree, tops the list.

How to eat to lower your cholesterol 

One of the biggest trends in diet and nutrition advice is a movement away from talking about specific micronutrients and optimal daily servings of this or that food group. Instead, nutrition experts now talk a lot more about broad patterns of healthy eating. This means limiting certain foods while prioritizing others, rather than trying to hit narrow targets.

“Something I tell a lot of my patients is that the Greek derivation of diet is diaeta, which means a way of life,” Sperling says. “Dieting shouldn’t be torture, or something you maintain for a month. It should be a meaningful and purposeful change you can extend throughout your life.”

In this spirit, he says one of the most important changes you can make is to pack your meals with lots of fresh fruits, vegetables, nuts, and whole grains. Many of the most effective and evidence-backed cholesterol-lowering eating plans—like the Mediterranean diet—prioritize these foods, he says.

Meanwhile, reducing your intake of animal products—especially red meat and processed dairy foods—is a move that research has repeatedly tied to cholesterol improvements. “I’ve run the lipid prevention clinic at my hospital for 31 years, and the first thing we tell people is to lower their intake of saturated fats,” Welty says. She mentions red meat, butter, and dairy as foods people should aim to cut down on—not eliminate necessarily, but reduce—if they want to improve their cholesterol. Many Americans consume saturated fats, from eggs and dairy products to red meat, with almost every meal. This sort of immoderation is a problem. “The Japanese have some of the lowest rates of cardiovascular disease in the world, and that may be because they eat much less red meat and saturated fat than we do in America,” Welty says.

It’s worth noting that saturated fat is a controversial topic in nutrition research. Some experts have argued that saturated fats get blamed for health problems that are likely caused by processed meats, refined carbohydrates (like those found in sugary or packaged foods), and the trans fats in fast foods and some packaged snacks. Others have argued that if people avoid meat and dairy but end up eating more processed or refined carbs, that’s an unhealthy trade. On the other hand, experts generally agree that trading saturated fats for some of the healthy foods mentioned above—such as fruits, vegetables, and nuts—is a highly effective way to improve your cholesterol scores and heart health. “If you decrease the saturated fat in your diet, that’s one of the best ways to lower LDL,” Welty says.

She adds that protein-rich soy-based products—from tofu to soy milks and yogurts—may also be good substitutes for meat, butter, milk, and other conventional saturated fat sources. “People in America are fixated on protein, but Americans don’t really like to eat soy products,” she says. This is unfortunate because research stretching back several decades has linked soy to improved heart health and lower blood cholesterol levels. “If you need to replace saturated fats with other proteins, soy would be a good option,” she says.

According to the World Health Organization (WHO), around 5% of adults around the world live with depression.

While there is no available cure for depression, symptoms are often manageable through treatments including psychotherapy and prescription antidepressants. 

Prior research has explored the causal relationships between vitamin D, inflammation, and depression. For instance, a 2013 study linked low levels of vitamin D to depression. Another study from 2011 suggested that vitamin D levels may help regulate inflammation, which is linked to depression. 

Until now, however, systematic reviews and meta-analyses investigating the link between vitamin D levels and depression have delivered mixed results. 

But a new study has systematically reviewed and meta-analyzed randomized controlled trials (RCT) that examined the efficacy of vitamin D supplements in reducing depressive symptoms compared to a placebo. 

The researchers found that vitamin D supplementation equal to or exceeding 2,000 individual units (IUs) per day may help reduce depressive symptoms, although they noted their results have “very low certainty.”

The study was recently published in Critical Reviews in Food Science and Nutrition. 

The impact of vitamin D supplementation on depressive symptoms

For the study, the researchers examined 41 RCTs including 53, 235 people in their analysis. They looked at data including age, vitamin D levels at baseline and post-treatment, and data on depressive symptoms. 

They also included details of vitamin D supplementation, including: 

• duration
• dose
• type
• frequency
• possible calcium supplementation or add-on medications 

Overall, the researchers found that vitamin D supplementation had a small to moderate effect on depressive symptoms. 

Effect sizes were slightly larger among people with baseline vitamin D levels below 50 nanomoles per liter (nmol/L) — the borderline for low vitamin D levels — than those with vitamin D levels above this threshold at baseline. 

The researchers also noted that while doses up to 2,000 IU daily had a small to moderate effect, those who took over 4,000 IU daily had a larger effect. 

What’s more, vitamin D supplementation appeared to have a larger effect when taken for less than 12 weeks compared to longer periods of time.

Have you been slacking in the posture department? 

Thanks to our smartphones, iPads and more, many of us spend our days with our necks craning down to stare at our devices. Working from home has also created complications, affectionately referred to by experts as “pandemic posture.”

Fixing your posture can not only relieve back or neck pain, “it can also have a significant impact on all things related to our respiratory function, core and pelvic health,” explained ­­­­Trista Zinn, a trainer and founder of Coreset Fitness.

Taking tiny steps toward improving your posture is the best way to go. Here are 16 exercises to try to help get you standing and sitting straighter.

Seated Row

“This exercise works all the muscles of the back, and helps counterbalance the weight of the chest and support the spine,” explained Sebastien Lagree, a trainer and founder of Lagree Fitness. 

Sit cross-legged or straddle a bench with cables or bands wrapped around a doorknob or floor mount in front of you. Next, pull the handles back toward your rib cage. 

“As you continue to pull the handles toward you, focus on lifting the spine or sitting taller,” Lagree said. “Each time you pull the handles in, aim to sit higher.”

Bent-Over Rows

If you don’t have a cable system at home, or access to a gym, grab some free weights and perform bent-over rows. 

“Strengthening the muscles that retract the scapula leads to better posture,” said Dr. Alejandro Badia, an orthopedic surgeon in Miami. “This also helps avoid shoulder pain, which often occurs when we slouch or work in a slumped position.” 

Bend your knees and lean your upper body forward, keeping a straight spine. Start with your arms straight down in front of you with your palms facing your body, then pull the weights back, squeezing your shoulder blades together at the top. Try not to over-extend the movement: Stop right when you get to where your pockets would be on your pants ― i.e., near your hips. Lower your weights and repeat the movement.

Cat-Cow

This is an equipment-free exercise, and a popular yoga move. Get into an all-fours position on your hands and knees. From here, arch your back, bringing your chest and head up while your stomach drops down. 

“You then move the opposite way, round your back towards the ceiling, bring your stomach in and your chin to your chest,” said Joy Puleo, a pilates instructor and Balanced Body Education Program Manager. Hold each position for a second or two and repeat eight to 10 times. 

It is well known that being physically active can help you lead a healthier and happier life. People who exercise regularly have a lower risk of developing several long-term (chronic) conditions, such as heart disease, type 2 diabetes, and some cancers. Studies show that physical activity also boosts self-esteem and mood, and can also help people to have better quality sleep. However, while getting enough exercise is important, the intensity of the exercise should also be considered.

A recent analysis published in Circulation investigated the link between long-term physical activity intensity and the risk of death. 

The study found that adults who perform two to four times the currently recommended amount of moderate or vigorous physical activity per week had a significantly reduced risk of death.

The 2018 physical activity guidelines recommend that adults engage in at least 150 to 300 minutes of moderate physical activity per week, and 75 to 150 minutes of vigorous physical activity per week. However, a growing number of people are performing higher levels of more vigorous exercise to maintain health and improve fitness. For example, high intensity interval training (HIIT) has become increasingly popular. 

However, there have concerns about the potentially harmful effects on the cardiovascular health of an excessive amount of vigorous physical activity. Although, there is limited and sometimes conflicting evidence to support this.

This new research, conducted by Lee et al., involved analyzing data from 2 large cohorts of participants: the Nurses’ Health Study and the Health Professionals Follow-up Study, collected from 1988-2018. 

In these cohorts, participants completed questionnaires about their physical activity up to 15 times during the follow-up period. They were asked to report the average hours they spent on various activities, including walking, jogging, running, swimming, bicycling, aerobic exercise, playing squash/racketball or tennis, while also logging low intensity exercise and weightlifting.

Study author Dr. Dong Hoon Lee explained to Medical News Today the implications of this research for people who want to increase their own activity levels.

“Our study showed that many people can get significant health benefits by performing the recommended physical activity (150 minutes per week of moderate activity or 75 minutes per week of vigorous activity) so it is important to stay active. For those who are looking for the optimal health benefits from exercise, they can aim for higher levels of activity (2+ times the recommended level).”

– Dr. Dong Hoon Lee

Benefits of moderate and vigorous exercise

The analysis showed that the greatest benefit for reducing the risk of death was observed among people who reported around 150 to 300 minutes per week of vigorous physical activity, 300 to 600 minutes per week of moderate physical activity, or an equivalent combination of both. 

Prof. Becca Krukowski of the University of Virginia, who was not involved in the study, explained to Medical News Today how this research has real-world implications for people looking to improve their own health.

“These results indicate that either moderate and vigorous physical activity can have positive benefits for longevity and health. These results are consistent with previous research indicating that 300 minutes or more of moderate-to-vigorous physical activity may be necessary for those who wish to maintain a weight loss,” said Prof. Krukowski.

More than 36% of U.S. adults experienced symptoms of anxiety or depression in August 2020, according to the U.S. Centers for Disease Control and Prevention. By January 2021, the number was above 40%.

It’s not hard to see why. A novel and scary virus was spreading without vaccines to slow it. Cities and states were in various degrees of lockdown for much of 2020, with many people forgoing special occasions and visits with friends and family. Isolation and fear were widespread, and people had every reason to feel acutely stressed.

But even as lockdowns lifted, people got vaccinated, and life resumed more of its normal rhythms, many people continued to feel…off. In an American Psychological Association survey published in October 2021, 75% of people said they’d recently experienced consequences of stress, including headaches, sleep issues, fatigue, and feeling overwhelmed.

Now, more than two years into the pandemic, many people still haven’t bounced back. One reason could be “ambient stress”—or “stress that’s running in the background, below the level of consciousness,” says New York-based clinical psychologist Laurie Ferguson, who is director of education development at the Global Healthy Living Foundation, a nonprofit that supports people with chronic illnesses.

“There’s something amiss, but we’re not registering it all the time,” Ferguson says. “We’re always just a little bit off balance. We kind of function at a level like everything’s fine and things are normal, when in fact, they’re not.”

In a 1983 article published in the journal Environment and Behavior, researcher Joan Campbell described ambient stressors as those that are chronic and negative, cannot be substantively changed by an individual, usually do not cause immediate threats to life (but can be damaging over time), and are perceptible but often unnoticed. “Over the long run,” Campbell wrote, these stressors could affect “motivation, emotions, attention, [physical] health, and behavior.”

Campbell cited examples like pollution and traffic noise, but it’s also an apt description of this stage of the pandemic. In March 2020, the pandemic was an in-your-face stressor—one that, at least for many people, felt urgent and all-consuming. Two years later, most people have adapted, to some degree. Most people are vaccinated, the news isn’t broadcasting the latest case counts 24/7, and life looks closer to 2019 than 2020. But, whether we’re conscious of it or not, we’re still bearing the psychic toll of two years of death, disease, upheaval, and uncertainty, as well as smaller disruptions like changes to our social or work lives, Ferguson says.

Even ambient stress can have health consequences, as Campbell pointed out. Humans evolved to deal with short-term stressors, but we’re not as good at coping with chronic stress, explains Laura Grafe, an assistant professor of psychology at Bryn Mawr College. Chronic stress has been linked to conditions including high blood pressure, diabetes, sleep issues, and mental health and cognitive disorders.

Colorectal cancer (CRC) is any cancer affecting the colon, hence “colo,” and rectum, hence “rectal”. It is the third most common and second deadliest diagnosed cancer in the United States, claiming over 50,000 lives every year.

Researchers from Brigham and Women’s Hospital in Boston, MA recently observed that CRC tumors with high levels of pks+ E. coli bacteria correlate with diets rich in red and processed meats and empty calories.

They believe that unhealthy foods may stimulate the cancer-inducing activity of colibactin, a substance deriving from E. coli, in the gut.

Their findings appear in Gastroenterology.

Dr. Shuji Ogino, chief of the Molecular Pathological Epidemiology Program in the Department of Pathology at Brigham and Women’s Hospital, was the study’s corresponding author.

E. coli, colibactin, and diet

E. coli is a normal part of the gut microbiome. However, certain strains of this bacterium hold a distinct cluster of genes known as the polyketide synthase (pks) island.

These pks+ E. coli strains produce colibactin, a toxic metabolite that can damage DNA and trigger cellular mutations that promote CRC.

Consumption of a typical Western diet — also sometimes called an “American diet” — consisting mainly of red and processed meats, sugar, and refined carbohydrates, can cause intestinal and systemic inflammation, precursors to colorectal tumors.

A poor diet is also tied to an imbalance of intestinal microbiota, another factor related to CRC. Furthermore, prior studies have linked E. coli and other bacteria to this cancer.

Consequently, Dr. Ogino and his team suspected that a Western diet might induce a stronger risk for tumors with considerable amounts of pks+ E. coli. Up to this point, though, they did not know whether the diet’s correlation with CRC varies by gut bacteria.

These plans involve going without caloric foods or drinks for an extended period of time—anywhere from 16 hours to several days—and they have become increasingly popular. Research has also found them to be effective for weight loss.

Doctors often advise people with Type 2 diabetes to lose weight, which can have beneficial effects on blood glucose and insulin sensitivity, as well as on the progression of the disease. For this and other reasons, experts are actively looking at the effects of intermittent fasting among people with Type 2 diabetes. However, there are some safety concerns. “People with diabetes should be those who benefit most from intermittent fasting,” says Benjamin Horne, director of cardiovascular and genetic epidemiology at Intermountain Healthcare in Utah. “But these diets also present some of the greatest potential safety issues because of the medications that people with diabetes are typically taking.”

Horne has co-authored several recent papers on the effects of intermittent fasting among people with diabetes. One of them, which appeared in the Journal of the American Medical Association in 2020, looked specifically at the risk profile of these practices. “It’s so easy to start an intermittent fasting regimen on your own, so our main focus was on the safety issues surrounding fasting when you have a diabetes treatment plan already in place,” he says. Based on his and others’ work, Horne says that for most people with Type 2 diabetes—particularly those who are not taking medications to control their blood sugar—the research indicates that intermittent fasting is both safe and likely to be beneficial. However, intermittent fasting isn’t right for everyone. Here, Horne and other experts explain the possible risks of intermittent fasting plans, as well as the benefits and best approaches.

The risks of intermittent fasting 

Low blood sugar, a.k.a. hypoglycemia, can cause a rapid heart rate, sweating, shakiness, and other symptoms. If severe, it can induce weakness, seizures, or even death. People with Type 2 diabetes are at increased risk for hypoglycemia—especially if they go long periods without eating—and this was one of the first dangers experts looked at when assessing the safety of intermittent fasting. “If you are taking medications that are aimed at reducing the amount of glucose in your blood, together with fasting these can cause potentially fatal hypoglycemia,” Horne says. “It’s not a minor safety risk.”

The Alzheimer’s Association will be observing Alzheimer’s & Brain Awareness Month this month to increase awareness about Alzheimer’s disease (AD) and other dementias. 

To mark this event, the Alzheimer’s Association recently published an article describing some of the common misperceptions about the condition as described by individuals with early-stage AD.

Dementia describes a group of symptoms characterized by memory loss, language problems, changes in mood, and deficits in thinking and reasoning that interfere with daily life activities. AD is the most common form of dementia, affecting over 6 million individuals in the United States.

AD is a progressive disease involving a steady worsening of dementia symptoms over time. Individuals with AD are often able to function independently in the early stages of the disease but have to increasingly rely on their caregivers for daily activities as the disease progresses. 

Individuals with a recent diagnosis of Alzheimer’s disease may have a difficult time coping with their diagnosis and need support. Although friends and family members often have the desire to be supportive, they may avoid interacting with the individual with AD due to the fear of negatively impacting their mood.

Avoiding engagement with individuals with AD promotes a sense of isolation and stigma, and can harm their feeling of self-worth. Below are some of the common misperceptions about AD held by friends and family members according to individuals with early-stage dementia.

Recognizing autonomy

Due to better surveillance, individuals are increasingly diagnosed at earlier stages of AD. 

It is important to recognize that such individuals with early-stage AD are still capable of living independently and continue to have goals that they might want to accomplish.

Caregivers and family members could help individuals with AD plan for their future and maintain a good quality of life as their disease progresses.

An AD diagnosis does not define a person

Individuals with AD maintain a sense of self until the final stages of dementia and family members should be careful not to view them simply through the prism of their illness. 

AD does not alter the individual’s preference for activities or relationships. Individuals with AD continue to relish meaningful daily life activities, including meeting friends and family members, until the later stages of the illness. 

Dr. Peter Rabins, professor emeritus at the Johns Hopkins University School of Medicine in Baltimore, MD, told Medical News Today: “In the early phases of Alzheimer’s disease, many people can maintain their usual level of social and personal interactions. As the disease progresses this may become harder if friends and long-term acquaintances distanced themselves from the person.”

“At every stage of the disease, it is more important that a person interacts with others and less important exactly what is said.” 

“People sometimes worry that they will say the ‘wrong thing.’ The key, though, is to talk with the person at whatever level they are able to interact. Talk about old times, good memories, and how their favorite sports team is doing. Go on walks, bring the grandchildren over, or perhaps just sit and hold hands. Even at the end stage of the disease communication through touch can be powerful and rewarding.” 

– Dr. Rabins

According to a national survey conducted in early May 2022 in the United States, one-third of men do not think they need annual health screenings.

Close to two-thirds of the individuals surveyed believe they are “naturally healthier than others in general.” Furthermore, almost two out of five of the participants shared that they often turn to social media for medical advice.

The Harris Poll conducted this online survey for Orlando Health in Orlando, FL. The market research and consulting firm interviewed 893 U.S. adult males aged 18 and older.

Dr. Thomas Kelley, family medicine specialist at Orlando Health Physician Associates, is certain that most of these men are deceiving themselves. He notes that “[i]t is statistically impossible for the majority of men to be healthier than the majority of men.”

According to Dr. Kelley: “Even if you think you’re healthy and you’re not experiencing any symptoms, there can be developing issues that often go unnoticed and can also be life-threatening if left unchecked [including] rising blood pressure that can be a ticking time bomb for a heart attack or stroke, as well as colon cancer, which is one of the most deadly yet preventable cancers that exist.”

The real picture

Although a substantial proportion of the men surveyed believe that they are healthier than most other men, the facts tell a different story.

As Dr. Kelley warned, the National Vital Statistics Reports say that heart disease and cancer are the leading causes of death among men in the U.S.

And according to the Centers for Disease Control and PreventionTrusted Source (CDC):

• 13.2% of men in the U.S. aged 18 and older are in “fair or poor” health
• 14.1% of men aged 18 and older smoke cigarettes
• 40.5% of men aged 20 and older have obesity
• 51.9% of men aged 20 and older have high blood pressure and/ or were taking medicine for hypertension
• men in the U.S. die an average of 5 years earlier than women.

Reduced sleep quality affects human mental health and cognitive functioning. 

Some retrospective, self-report studies suggest that sleep quality reduces during warm weather. However, they may lack reliability due to their basis on memory instead of objective measures. 

As a result, whether outside temperatures affect sleep quality remains unknown. 

Recently, researchers analyzed a global sample of sleep data from sleep-tracking wristbands. 

They found that increased outdoor temperatures are linked to lower sleep duration.

“Studies from multiple disciplines have repeatedly shown that poor sleep is implicated in a range of negative health outcomes, from reduced immune function to worsened cardiovascular outcomes to poorer mental health,” said Marshall Burke, Ph.D., Associate Professor of Earth System Science at Stanford University, who’s not involved in the study. 

“Poor sleep also erodes performance at work and at school. The fact that temperature effects are so widespread and that hot nighttime temperatures will become increasingly common in coming decades, make these findings very important,” Prof. Burke told Medical News Today. 

The study was published in One Earth. 

Sleep quality and temperatures

The researchers examined 10 billion sleep observations for their study, comprising over 7 million repeated daily sleep records from 47,628 adults across 68 countries on every continent, excluding Antarctica. These observations included nighttime sleep duration and sleep timing: sleep onset, midsleep, and offset. 

The researchers then compared this data with geolocated meteorological and climate data. 

They found that increases in nighttime temperature reduce sleep duration regardless of location and that effects intensify as temperature increases.

They noted that the probability of sleeping less than 7 hours increases gradually up to 10°C, and when the temperatures exceed 10°C, the chance of reduced sleep increases at an elevated rate.

Nighttime temperatures higher than 25°C were linked to 14 minutes less sleep than those sleeping at temperatures below 10°C. 

Certain demographics were more affected than others. A one degree Celcius increase in minimum temperature affected the elderly twice as much as other groups. 

Those living in poorer countries were almost three times more affected than those in wealthier countries, and women were significantly more affected than men. 

They further found that people do not adapt to sleeping in warmer temperatures meaning that sleep quality is generally poorer in warmer climates than in cooler ones.

The Insomnia Diaries: Year Three

29th June

Sleep statistics: 0 hours, 0 minutes: a ‘white night’ (or nuit blanche, as they call it in France)

Eleven forty-seven PM. A door slams as the neighbour’s teenage son comes home from the pub. An hour later, the last Tube rumbles past and I thump my pillow over to find a cool spot. I refuse to open the window because of my fear of hearing the first bird of morning, confirmation that the next day is about to start and I have failed, yet again. Failed. In my quest to sleep, which one would think is a basic human right.

But I am not a POW whose captors breach the Geneva convention. No-one has stolen my sleep from me. I am not wired up to electrodes, a neon light is not shining in my face all night long. I have black-out blinds, and a king-size bed, all to myself. My enemy is my brain, and a body that has forgotten how to shut down.

I turn over again, pulling the duvet with me until it twists up like a chewed stick of Wrigley’s. Where shall I put my thoughts now? I’m too exhausted to read: the words dance in front of my eyes, and it’s physically tiring even holding up the book. Some nights I write novels in my head, with whole character arcs. But I’m too tired to put pen to paper.

Tonight, I switch on the radio station TalkSport, where there is an early-hours show featuring two acerbic DJs called ‘The Two Mikes’. I have no idea why I listen to this, but something about their banter about things so irrelevant to my own life is comforting and nixes the guilt I feel about ‘abandoning’ my family, friends, and work.

Now it’s 03.56: Just me, and the red numbers on my alarm clock. I see some grey light poking under the blinds. Planes start circling overhead. The milkman delivers his cargo (who still gets milk delivered in this day and age?). And now, the kicker: the birds start the dawn chorus that signals the start of another interminable day. 

People the world over salute the sun, and I absolutely hate it.

As a pain management specialist at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., he didn’t anticipate leaving behind the short-term use of opioids altogether, since they work so well for post-surgical pain. But he wanted to recommend a remedy that was safer and still effective.

That turned out to be acupuncture.

“Like any treatment, acupuncture doesn’t work for everyone, but the majority of my patients who have tried it have found relief,” he says. “When I started looking into studies, I discovered how much evidence there was behind this treatment, and that made me feel comfortable suggesting it as an alternative or a complement to pain medication and other treatments.”

That blend of anecdotal success, research-backed results, and growing level of openness from the medical community are all driving the popularity of acupuncture as a therapy. According to a 2021 World Health Organization report, acupuncture is the most widely used traditional medicine practice globally, and it’s gaining traction in the U.S. In 2020, the Centers for Medicare & Medicaid services began covering acupuncture for the first time for chronic low back pain.

Although scientists don’t yet understand all the nuances of how it works, research indicates it can have a significant effect on certain conditions, and it shows promise for others.

What is acupuncture?

The goal of acupuncture is the same now as it was thousands of years ago when it was first developed in China: restoring balance to the body, says Kevin Menard, a sports medicine acupuncturist and Traditional Chinese Medicine practitioner in Sag Harbor, New York.

The practice is based on how energy, or qi, flows through the body along a series of channels called meridians—similar to the way nerves and vessels carry messages and blood throughout every system.

“According to Chinese medicine theory, each meridian is related to a specific organ, and placing thin needles at certain points along these meridians can effect certain changes in the body to restore homeostasis,” says Menard. The needles aren’t the type you’d use to draw blood; they’re very thin and flexible, almost like bits of wire.

Placement along the meridians is believed to cause reactions like sending more blood or lymphatic fluid to specific organs or allowing muscles to release in a way that reduces tension on joints and bones. The needles may also stimulate nerves and tweak nervous system regulation to result in a relaxation response, which relieves pain, Mikhael says.

Acupuncture is also thought to stimulate the immune system and control inflammation, Menard says, two effects that can bring benefits throughout the body. Depending on the condition or injury, relief might happen with just one treatment, but it usually takes a series of sessions, Menard says, especially if an issue is complex or chronic.

What the research says

Research on acupuncture has been extensive, and so far, robust evidence supports its effectiveness for some, but not all, conditions. According to one analysis published in February 2022 in the BMJ that analyzed more than 2,000 scientific reviews of acupuncture therapies, the science is strongest behind acupuncture’s efficacy for post-stroke aphasia; neck, shoulder, and muscle pain; fibromyalgia pain; lactation issues after delivery; lower back pain; vascular dementia symptoms; and allergy symptoms.

The National Institutes of Health (NIH) finds that acupuncture for pain relief tends to have the most evidence, especially for conditions that have become chronic like osteoarthritis and lower back pain, as well as tension headaches. A review of 11 clinical trials also suggests that acupuncture may help with symptoms associated with cancer treatment, the NIH notes.

That’s been a booming area of interest for the field, says Sarah Weaver, an acupuncturist and massage therapist at Northwestern Health Sciences University in Minnesota, which focuses on integrative health professions, such as acupuncture, chiropractic, and Traditional Chinese Medicine. For cancer patients, sessions there can focus on reducing nausea, numbness, and tingling (called neuropathy), brain fog, low appetite, acute and chronic pain, and mood challenges that come with cancer care.

“Often, people with cancer want to add complementary treatment that doesn’t affect their chemotherapy or radiation, and that’s where an option like acupuncture can be helpful,” she says. “It’s the reason more healthcare systems are bringing this treatment into their integrative care options.”

What’s next in the field

Acupuncture is far from a proven and accepted therapy for most conditions—even for the ones that show promise. That’s in part because the studies that support it are sometimes not high quality, and the field lacks standardized protocols that would better allow it to be scientifically evaluated, the recent WHO report finds.

For instance, one 2016 research review analyzed studies looking at acupuncture for substance abuse and addiction. Among the 83 research articles included in the review, the researchers found substantial variations in study quality, acupuncture frequency, how long needles were left in the body during treatment, which points along the meridians were used, and other potentially important factors. That made it difficult to evaluate how effective the acupuncture really was. The field also lacks clear terminology and universally accepted agreement about the location of acupuncture points, researchers argue.

A new study investigates the mechanisms involved in the relationship between exercise and brain health. 

Previous research had shown that larger gray matter volume can help protect against dementia by improving brain function.

The new study shows that insulin resistance and BMI mediate the relationship between larger and smaller brain gray matter volumes (the part of the brain involved in processing information).

The research is published in the April 2022 online issue of Neurology, the medical journal of the American Academy of Neurology. 

The corresponding author of the study was Dr. Geraldine Poisnel, of the Inserm Regional Research Center, in Caen, Normandy, France.

Studying glucose metabolism and brain volume

The study involved 134 people with an average age of 69 who had no memory problems. The participants filled out a physical activity survey covering the past 12 months. They also had brain scans to measure glucose metabolism and brain volume.

The metabolism of glucose in the brain provides fuel for the brain by generating adenosine 5′-triphosphate (ATP) — a key molecule for maintaining the health of neurons and other cells. ATP is also key for generating neurotransmitters. Reduced glucose metabolism in the brain can be seen in people with dementia.

Gray matter development peaks at age 2–3 years. It begins to decrease afterward in some areas of the brain, but the density of the gray matter increases. From an evolutionary perspective, the higher processing ability of the human brain and its development are due to this increase in density.

In some studies, larger total brain volume, estimated by magnetic resonance imaging (MRI), has a weak correlation with higher intelligence in men and a very weak correlation in women with the ability to do well in intelligence tests.

In contrast, brain tissue deterioration and loss of volume is a significant contributor to lower cognitive ability later in life.

In the new study, researchers included 134 people with an average age of 69 who had no memory problems. The participants filled out a physical activity survey covering the past 12 months. They also had brain scans to measure glucose metabolism and brain volume.

Body mass index and insulin levels affect brain health

In the new study, researchers gathered formation on cardiovascular risk factors including BMI and insulin levels, as well as cholesterol, blood pressure, and other factors.

The researchers examined the relationship between insulin and cardiovascular disease. The metabolic abnormalities that insulin causes raise the risk of cardiovascular complications, which in turn affect brain function.

Researchers found that insulin and BMI levels did not affect the metabolism of glucose in the brain. 

Alzheimer’s disease marker not affected

The research demonstrated that the amount of amyloid plaque in the brain that contributes to Alzheimer’s Disease was not affected by exercise.

Medical News Today contacted Dr. Raeanne Moore, associate adjunct professor of psychiatry at UCSD in La Jolla, CA. 

Dr. Moore, who was not involved in the study, was asked about the study results. She shared with MNT:

“This study adds to the growing body of research on the positive benefits of staying active on brain health, especially as we age.” 

“[T]here is an urgent need to identify markers of cognitive decline,” added Dr. Moore. “Decreasing insulin levels and losing weight are modifiable factors that can be improved with a healthy diet and exercise.”

She added, “It was not surprising that higher physical activity was not associated with how much amyloid plaque people had in their brains. There is growing evidence that vascular risk factors on cognitive function are mediated by the amount of tau pathology in the brain and not an amyloid burden

Cardiovascular disease (CVD) is the leading cause of death worldwide. However, it can be prevented through lifestyle factors like diet. 

The American Heart Association (AHA) recommends limiting 5- 6% of calories intake from saturated fatty acid (SFA), and replacing SFA and trans-fats with monounsaturated fats (MUFA) and polyunsaturated fats for better heart health. 

Avocados are rich in MUFAs and polyunsaturated fats. Studies have found that their regular consumption reduces triglycerides, low-density lipoprotein (LDL) cholesterol, and total cholesterol level. 

Most studies on avocado consumption have focused on cardiovascular risk factors. Studies investigating the link between avocado consumption and cardiovascular events could improve understanding of the fruit’s health benefits. 

Recently, researchers have investigated the link between avocado consumption and cardiovascular events. 

They found that higher consumption of avocados was linked to a lower risk of CVD and coronary heart disease (CHD). 

“The […] results are significant and strengthen previous findings of avocados’ association with a lower risk of cardiovascular disease [as well as] reducing heart outcomes such as fatal and nonfatal myocardial infarction,” Bhanu Gupta, MD, cardiologist at The University of Kansas Health System, not involved in the study, told Medical News Today.

“Point to be noted: avocado consumption does not lower the risk of stroke in the study. Another point to be noted: avocado is not a replacement for healthy dietary fats such as olive oils, nuts, and other plant oils.” 

– Dr. Gupta

The study was published in the Journal of the American Heart Association (JAHA).

Data analysis

For the study, the researchers used data from the Health Professionals Follow-Up Study (HPFS)and the Nurses’ Health Studies (NHS). Both studies are ongoing and began in 1986 and 1976 to examine the effects of health and lifestyle on the incidence of serious illness in male and female healthcare professionals. 

For the present study, the researchers included 62,225 females and 41,701 males who did not have a history of heart disease, stroke, or cancer. 

The researchers examined their medical records for incidence of myocardial infarction and stroke, dietary surveys taken once every 4 years, and risk factors such as hypertension and type 2 diabetes from self-reports and physician diagnoses. Participants were tracked for 30 years. 

By the end of the study period, the researchers noted 14,274 incident cases of CVD including 9,185 CHD events and 5,290 strokes. 

The researchers noted that males and females with higher avocado intake tended to have higher total energy intake and a healthier diet with more fruits, vegetables, whole grains, nuts, and dairy products such as yogurt and cheese. 

After adjusting for major dietary and lifestyle factors, the researchers found that having two or more servings of avocado per week was linked to a 16% lower CVD risk and 21% lower CHD risk compared to those who did not eat avocados. 

They further found that replacing half a serving per day of mayonnaise, margarine, butter, egg, yogurt, cheese, or processed meats with the same amount of avocado was linked to a 19–31% lower risk of coronary heart disease. 

They reported no significant association between stroke risk and avocado consumption. However, they noted that replacing half a serving per day of plant oils with an equivalent amount of avocado was linked to a 45% higher stroke risk.

Doctors have long recommended decreased salt intake for heart failure or other cardiac problems. However, research is still ongoing about how effective low sodium intake is in reducing events of hospitalization or emergency room visits. 

A recent study published in The Lancet found that while low sodium diets might help improve the quality of life for people with heart failure, they did not reduce clinical events like hospitalization or emergency room visits. 

Heart failure and low salt diet recommendations

Heart failure is when the heart cannot effectively pump blood to meet the body’s demands. As a result, the body cannot get the nutrients and oxygen it needs. Heart failure is chronic. 

People with heart failure can experience a variety of symptoms, including the following:

• Shortness of breath, persistent coughing or wheezing
• Swelling because of the buildup of excess fluid
• Feeling tired or fatigued
• Increased heart rate, feeling heart palpitations

The New York Heart Association (NYHA) Functional Classification is one standard used to classify heart failure. This system places people in one of four categories based on how much their heart failure interferes with their ability to do things and their symptoms brought on by activity. 

Many organizations and doctors encourage people who have heart failure to reduce the amount of salt in their diets. In theory, reducing the amount of sodium helps to prevent fluid overload in people with heart failure. 

Dr. Edo Paz, cardiologist and vice president of Medical at K Health, who wasn’t involved in the study, explained to Medical News Today:

“We have long instructed patients with congestive heart failure to limit consumption of sodium, as sodium can lead to fluid retention, which can result in heart failure exacerbations.”

Researchers in the current study found that reducing sodium intake can benefit people with heart failure. 

However, they found it might not help prevent hospitalizations and other adverse clinical outcomes. Their findings offer more insight into the recommendation for sodium intake for people with heart failure.

Improved quality of life

The study in question was a randomized trial that included over 800 participants in six different countries. Participants were adults that met a specific definition of chronic heart failure (NYHA class 2-3). 

Researchers placed participants randomly into one of two groups. The intervention group went on a low sodium diet where they consumed less than 1,500 mg of sodium daily. The control group received the standard of care for the region where they were located.

Researchers specifically looked at the incidence of three main events over 12 months:

• Hospitalization related to cardiovascular problems
• Emergency room visits related to cardiovascular problems
• Death from all causes

They also looked at a few other outcomes, including if following a low sodium diet improved the quality of life and NYHA classification among participants. 

The researchers saw that the hospitalizations, emergency room visits, and all causes of death were not reduced for participants in the low sodium diet group compared to the control group. 

However, they did discover a moderate benefit on quality of life and in the NYHA scale classification in the group that had reduced sodium intake. 

Dr. Paz offered the following summary of the study’s results:

“[F]ollowing a low salt diet did not reduce death or trips to the hospital in people with congestive heart failure. Despite this fact, there still was a signal for benefit in some key endpoints favoring a low salt diet, including functional assessments.”

Study limitations and continued research

Study author Professor Justin A. Ezekowitz explained to MNT that this was “the largest trial of its type testing whether or not dietary sodium reduction for patients with heart failure alters the risk for future clinical events.” 

However, he pointed out that they did not have “the opportunity to test this strategy before in a large pragmatic trial that is driven by clinical events.”

The study had several other limitations. First, the study authors note that they only followed up with participants over 12 months. Therefore, it is possible that reducing sodium in the diet could have long-term impacts that the researchers did not observe. 

Due to the nature of the study, there was potential bias because researchers knew who was in the control and intervention groups. 

The researchers also acknowledge that participants in the control group might have reduced their sodium intake independently. 

As the trial was ended early, results might also overestimate the risks and efficiency related to the interventions. Finally, the study may have included patients with varying health risks because of how participants were selected. 

These results indicate that reduced sodium intake doesn’t significantly impact clinical events. So, researchers recommend that medical professionals look at it like other medical treatments and weigh the benefits based on each patient’s unique needs.

Next month, I’ll be 64 years old and I’m still trying to figure out what I want to be when I grow up.

What am I doing wrong?

Short answer: Nothing. 

Long answer: Everything. And also nothing.

I’m not really doing anything wrong. I pack my days with obligations that include work, taking care of my multi-generational family, taking care of myself, and every now and then I dabble in the thing that I feel impassioned about, inspiring others to engage in their art.

Through it all, I remain positive.

How I can turn the lens of self-help on My-self. One way to achieve this goal is through disassociation. Basically, it’s the golden rule in reverse. Do to yourself what you would do unto others. Or more simply, treat yourself with the same love and care that you would a good friend, colleague, family member, or anyone other than yourself.

It’s not easy though. Especially when you wake at 3 AM and begin to run down the laundry list of shortcomings from the day.

“You didn’t finish writing that chapter. You still haven’t called about that appointment. You forgot that credit card bill. Again.”

The more that you think of what you didn’t do, the more disappointed you are in yourself. And that disappointment opens the floodgate for more berating.

Believe me. I’ve wasted many pre-dawn hours admonishing myself not only for the shortcomings of that day, but also for the past week, month, years, and more.

All the while, I tell myself, “You can’t change the past.” Even though I really wish that I could. (Don’t you sometimes?)

But then, another doom dart stabs me in the heart. I recoil. I tense. I am filled with remorse.

Dissociation gives you permission to step out of yourself and see yourself as others see you.

“Via an active process of valuation, self-reflection, and self-dialogue, and by creatively embodying and empowering the other, the self promotes innovative versions of itself to overcome distorted self-narratives” (Barani, 2019, p. 391).

I began to see myself through a kinder gentler lens.

• When coaching a client, would I ever admonish them for their mistakes of the past?
• Would I pick at that wound?
• Would I bring up those shortcomings over and over again?

The answer is simple. No. I would never do that. What good would it do?

Focusing on the errors of the past, no matter how recent or not, does no good except to keep the errant trespasser suffering from their own transgressions. The downward spiral of this self-degradation keeps that person pushed down, continuing to feel bad.

The only time that we can take any action is now. We cannot change that past. The time machine exists only in science fiction.

We can plan for the future. And we can dream of what could be, but without taking action, there is no action, no forward movement.

Avoid the mentality of one strike and you’re out

• Zero tolerance never allows for growth. It is unforgiving and stagnant.
• Rehabilitation can work, even for the most horrific of criminals.
• Forgive yourself of your past. You know better today than you did yesterday.

Scramble your memories

• Replay that recording over and over and over until the memory becomes warped and even comical.
• Memories are faulty. They tend to fixate on the negative.
• Use today’s brushes to paint over the most embarrassing scenes with a vibrant, rosy tone.

See yourself and others as caricatures

• What positive features can be exaggerated?
• What negative aspects can be obscured?
• Make the portrait so comically ridiculous that you cannot help but smile at the artifice of the scene.

Take a baby step forward toward your new, kinder future.

Again, what would you tell your client? Make a small plan. What’s one thing that you can do right now to progress toward that future goal that you envision?

Here’s my pledge: The next time that I wake in the idle of the night and start to list out my shortcomings, I will forgive my mistakes, I will not replay the tape but scramble the video until it breaks. I will see the cartoon of myself and smile. 

Sixty-four is going to be amazing!

t’s common knowledge that eating a balanced diet is key to living a healthy lifestyle. It reduces the risk of diseases such as stroke, Type 2 diabetes and heart disease, helps you maintain a more positive mood and promotes more energy. Among other things, good nutrition essentially helps us look and feel like our best selves. Funny enough, a full night’s sleep also offers a lot of the same benefits. 

Good sleep and conscious eating go hand in hand, and each has the ability the other. Eating the wrong foods at the wrong time can be harmful to your sleep quality, which plays an important role in maintaining your physical and mental health. Below, learn how you can tweak your eating habits to get higher-quality rest, including the best foods for sleep and the foods you want to avoid.

How poor sleep affects your health

The recommended amount of sleep for adults is seven to nine hours each night. During that time, your brain cycles through the four stages of sleep: three stages of NREM (non-rapid eye movement) and one stage of REM (rapid eye movement). 

• NREM sleep: The quiet sleep stages where your brain is working to retain memories and knowledge, in addition to repair, refresh, and restore your body. 
• REM sleep: The active sleep stage where your body is working to repair cells and muscle tissue, promote bone and muscle growth and helps strengthen the immune system. 

If you’re waking up often in the middle of the night or have trouble getting a full night’s sleep, you prevent your body from running through its necessary processes that keep you healthy and productive. Continuous poor sleep puts you at risk for:

• Heart disease
• Stroke
• Weight gain
• High blood pressure
• Bad memory
• Weakened immune system

Unbalanced nutrition tends to be a common culprit for poor sleep, especially if you’re eating certain foods too close to bedtime. 

Nutrition for quality sleep

There seems to be a clear link between nutrition and your quality of sleep. To find out more, I spoke to Stephanie Nelson, a registered dietitian who works as a nutrition expert at the tracking app MyFitnessPal. Nelson explained, “The relationship between sleep and nutrition is very complex and we don’t know everything about all the associations between sleep and food. However, a good general summary is that any biological process, including sleep, is influenced by getting the right amount of nutrients. “

“For example, having high blood sugar impacts your energy in the moment, which can prevent you from sleep,” Nelson continued. “Other nutrients impact neurotransmitters that make it easier to relax and turn your brain off for sleep.” 

While food affects sleep, the amount of quality sleep you get can also impact your eating habits. Nelson said, “Interestingly, the relationship goes both ways. There’s research showing that poor sleep can negatively impact hormone balances that affect your hunger, and people who sleep less tend to eat more overall.”

Making more conscious choices about food and when you’re eating it can make a big difference in your sleep quality.

The do’s and don’ts on eating for better sleep

Here are Nelson’s tips on how to eat for better sleep. 

Do’s

1. Eat a balanced dinner 

“The building blocks of a balanced dinner are a protein source, high-fiber carbohydrate source, and a vegetable. This might look like a grilled marinated chicken breast, some quinoa, and roasted veggies,” said Nelson. “You could also get more creative with it, like a coconut curry made with tofu and sauteed veggies, served over brown rice, or tacos made with the protein of your choice, some beans, and cabbage and onions (and all your other favorite toppings).” 

Eat foods that promote serotonin production

Serotonin is required for your body to make melatonin, the hormone responsible for regulating sleep. But Nelson also warns that too much serotonin is associated with poor sleep. 

“In order for your body to produce the right amount of serotonin, you need to consume tryptophan, an amino acid you can find in most animal-based foods, oats, nuts, and seeds,” Nelson explained. “You also need to have a carbohydrate source, which allows for tryptophan to be used for serotonin rather than other processes. Other nutrients like vitamin B6, present in sweet potatoes among other foods, are also needed for the right amount of serotonin production.”

3. Eat around three hours before bedtime

You might have heard that you shouldn’t eat right before bedtime if you want a good night’s rest. But how soon, exactly, should you stop eating? “It’s different for everyone,” said Nelson. “Most experts recommend to eat three hours before bedtime for best sleep results, so start there, but definitely play with it. Some people can eat closer to bedtime and still have a good night’s sleep,” she said.

Don’ts

1. Avoid caffeine, sugary drinks and alcohol before bed

You probably know that caffeine isn’t the best nighttime beverage, but what about alcohol or juices? Nelson says you should try to avoid those in the hours right before bed too.

“Being hydrated is key to a good night’s sleep,” she said. “Alcohol dehydrates you, so for the first step, reduce alcohol consumption near bedtime. High sugar drinks also can interfere with sleep, and anything with caffeine.” 

“If you’re having trouble sleeping, definitely check when your most recent caffeinated beverages are consumed before bed,” she noted.

2. Don’t eat dessert close to bedtime

For individuals with a sweet tooth, don’t eat foods like ice cream, cookies or chocolate before bedtime. Nelson explains that “low-fiber, high-sugar snacks before bed can cause a spike and then a drop in blood sugar.” These irregular blood sugar levels can disrupt your sleep in multiple ways, making it hard for you get deep rest.

Leveraging the vast breadth of people receiving care in the Veterans Health Administration (VHA), first author Dr. Edward Zamrini and his colleagues studied 649,605 military veterans ages 30–95 years. 

These individuals had not received a diagnosis with ADRD and had performed an Exercise Treadmill Test (ETT) as part of their routine care. 

The scientists analyzed these individuals’ charts for the diagnosis of ADRD over an average of 8.8 years.

Dr. Zamrini, principal author Prof. Qing Zeng-Teitler, and their colleagues compared ETT results and the incidence at which ADRD developed in these individuals. 

Metabolic equivalence

Exercise tolerance tests help quantify fitness levels using a standard of measure called METs, or metabolic equivalence of task. 

In this study, the authors divided participants into five groups based on the METs they could achieve from lowest to highest fitness: on average, about 3.8 to 11.7 METs. 

For comparison, 1 MET is equivalent to sitting quietly, yoga requires 3.2 METs, and backpacking at 3.63 miles per hour would demand 11.6 METs.

The scientists found that less fit individuals were at the highest risk of experiencing ADRD. Conversely, highly fit people were the least likely to develop ADRD.

Dr. Zamrini, director of neurology at Irvine Clinical Research, adjunct professor of clinical research and leadership at George Washington University, and adjunct professor of neurology at the University of Utah, explained to Medical News Today:

“Our study found a strong, graded inverse association between cardiorespiratory fitness and reduction of risk of [Alzheimer’s Disease]. This means that the more fit a person is, the more likely that if they were to develop AD, they would develop it later.”

Specifically, the researchers found that, compared with the least fit participants, the fittest were 33% less likely to develop ADRD. Similarly, the second most fit group was 26% less likely to develop ADRD, the third most fit group was 20% less likely, and the fourth most fit was 13% less likely.

“There are two main factors that influence cardiorespiratory fitness: genetics and exercise. We cannot change our genetics,” he continued, “but we can improve our cardiorespiratory fitness through a sensible exercise program. Our study also demonstrates that we don’t have to become marathon runners to reduce our risk. Even small increases in cardiorespiratory fitness can help!”

Dr. Scott Kaiser, MD, a board certified geriatrician and Director of Geriatric Cognitive Health for the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA, elaborated for MNT:

“You cannot prove that it was the low fitness that caused dementia. But, that said, the association was so clear, not just in the strength of the association but in the nature of the association. The way it so neatly correlated with rising fitness levels lowering dementia risk. It’s a very convincing association.”

“There are many other studies that have looked prospectively to affirm this link between physical fitness and risk of dementia and confirm that regular and recommended exercise can reduce [a person’s] risk of developing dementia,” continued Dr. Kaiser.

“So, studies like the [worldwide] FINGER study, out of Finland, where they are actually looking prospectively at populations over time — there is just mounting evidence […] that if you want to reduce your risk of dementia and maintain a healthy brain, you should exercise regularly and pursue other activities to improve your cardiorespiratory fitness.”

Climate scientists believe that one of the most impactful things that people can do for the environment is to reduce their consumption of meat and dairy products. 

Research notes that global production of animal-based foods — including livestock feed — accounts for 57% of total greenhouse gas emissions from agriculture, whereas production of plant-based foods accounts for only 29%.

Another study estimates that if everyone became vegan, this would reduce the amount of land worldwide that farmers need to grow food by 3.1 billion hectares or 76%.

In addition to cutting emissions from food production, say the authors, rewilding the freed-up land would remove around 8.1 billion tonnes of carbon dioxide from the atmosphere every year for the next 100 years. 

Of course, the idea that billions of people worldwide would voluntarily give up their steaks, sausages, and cheeseburgers simply to curb climate change may seem far-fetched. 

But perhaps they would think twice if they knew how much it would benefit their own health.

Recent research suggests that people who eat little or no meat tend to have a lower risk of cancer, in particular colorectal cancer and prostate cancer in men. 

Diets that combine a reduction in meat and dairy consumption with increased intake of fruits, vegetables, whole grains, and healthy fats, bring further health benefits.

People who eat a typical Mediterranean diet, for example, have a lower overall mortality rate and a lower risk not only of cancer but also cardiovascular and metabolic diseases.

A series of clinical trials now suggests that eating a “green” Mediterranean diet, or green Med diet, may provide additional benefits on top of those provided by the regular Mediterranean diet. 

The diet, which adds extra plant foods rich in polyphenols and aims to avoid meat completely, is also better for the planet.

“[E]liminating meat intake — beef, pork, lamb — is by far the most important single way to reduce the carbon footprint from diet,” said Dr. Meir Stampfer, Ph.D., professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health in Boston, and one of the authors of the green Med studies. 

“The contribution of meat to greenhouse gas emissions is enormous compared with other foods,” he told Medical News Today.

Biodiversity and human health

Dr. Stampfer pointed out that the total area needed for meat production includes a lot of land for growing crops to feed livestock. 

So by reducing the amount of land around the world that is devoted to producing meat, the green Med diet could play a major role in the preservation of biodiversity.

In its 2020 report “Biodiversity for Nutrition and Health”, the World Health Organization (WHO) describes a virtuous circle that links varied, plant-based diets, human health, biodiversity, and sustainability. 

“The significance of pressures generated by human activity on both climate change and biodiversity loss, and their impacts on nutrition and health outcomes, cannot be overstated,” the authors conclude.

What is the classic Mediterranean diet?

A traditional Mediterranean diet contains the following elements:

• vegetables, fruits, and whole grains
• sources of healthy fats, such as nuts, seeds, and olive oil
• moderate amounts of dairy and fish
• less red meat than a traditional western diet
• fewer eggs
• red wine in moderation

The diet provides an abundance of polyphenols, monounsaturated and polyunsaturated fatty acids, and plant fiber.

Importantly, the classic Med diet also avoids refined grains, highly processed foods, and products with added sugars.

Scientists believe that, in combination, these features help lower levels of bad cholesterol, reduce oxidative stress and inflammation, and improve insulin sensitivity.

Green Mediterranean or ‘green Med’ diet

Scientists in Israel, Germany, and the United States reasoned that replacing all the remaining meat in the diet with plant-based proteins could supercharge these health effects.

Over the past few years, they have conducted three clinical trials of their green Med diet on a cohort of 294 people with abdominal obesity. Participants’ average age at the start of the trials was 51 years. 

Over the course of their studies, they were all given free gym membership and advice about physical activity. 

The researchers randomly assigned them to three diets: 

• Healthy dietary guidance — basic advice on how to achieve a healthy diet.
• A calorie-restricted traditional Med diet, with advice to reduce red meat consumption, plus 28 grams (g) of walnuts each day.
• A calorie-restricted green Med diet, which incorporated 28 g of walnuts per day, plus 3–4 cups of green tea, and 100 g of Mankai duckweed in a shake. They were asked to avoid red and processed meats completely and discouraged from consuming poultry. 

People in Thailand and other Southeast Asian countries eat Mankai as a “vegetable meatball.” Previous research by the same scientists showed that Mankai provides all the essential amino acids plus vitamin B12, making it an ideal meat substitute. 

Cardiovascular benefits

In the first study, the researchers examined possible extra heart health benefits of eating a green Med diet.

They report that after 6 months, both Med diets led to greater weight loss and metabolic benefits than standard dietary advice.

However, the green Med diet led to a greater reduction in waist circumference and several other measures of cardiovascular risk. 

For example, participants who ate this diet had improved insulin sensitivity, lower blood pressure, lower levels of bad cholesterol, and less inflammation compared with those on a standard Med diet.

Fat storage in the liver

For their next study, the researchers compared the amount of fat in the liver of subjects after 18 months on the three different diets.

They discovered that people who ate the green Med diet lost more fat in their liver than those on the regular med diet.

This may reduce their risk of nonalcoholic fatty liver disease, which affects around 25% of people worldwide and can lead to potentially fatal cirrhosis and liver failure.

It is widely known that excess body weight is associated with many health conditions. Now, researchers have found an association between adiposity — having too much fatty tissue in the body — and cognitive impairment. 

At the start of a new study, which appears in JAMA Network Open, Canadian researchers determined the adiposity of more than 9,000 participants. They measured both total body fat and visceral adipose tissue (VAT) — the fat that predominantly sits around organs in the abdominal cavity. 

Previous studies have associated VAT, or visceral fat, with increased morbidity and a higher mortality risk. Visceral fat increases the risk of many conditions, such as:

• heart disease, including heart attacks
• type 2 diabetes
• raised blood pressure
• stroke
• breast and colorectal cancer
• Alzheimer’s disease

This latest study suggests that excess fat may have mental as well as physical effects.

Cognitive tests

All participants undertook two cognitive tests — the Digital Symbol Substitution Test (DSST) and the Montreal Cognitive Assessment (MoCA) — to assess a range of cognitive functions. 

The researchers adjusted the scores for cardiovascular risk factors, educational level, and MRI-detected vascular brain injury, which is known to be associated with cognitive impairment.

The researchers found that higher total body fat and higher VAT were both significantly associated with lower DSST and MoCA scores. The association was greater on the DSST, which assesses processing speed, than on the MoCA, which is a multidimensional cognitive test. 

Compared with those in the lowest quartile (25%) of adiposity, the performance of those in the highest quartile was equivalent to an additional 3 years of cognitive aging.

These results are not unexpected, as Dr. Anton Porsteinsson, professor and director of the Alzheimer’s Disease Care, Research and Education Program (AD-CARE) at the University of Rochester Medical Center, told Medical News Today:

“It is well-known that greater adiposity and body fat are associated with increased cardiovascular risk factors and that those are associated with increased risk of cognitive decline. This cross-sectional study found that excess adiposity was a risk factor for reduced cognitive scores, independent of cardiovascular risk factors, educational level, and MRI-detected vascular brain injury.”

This study reinforces findings from a previous study of older adults in Dublin, which found an association between adiposity, particularly central adiposity, and reduced cognitive function.

Wild demand swings have been a subplot in the pandemic, from vaccines to hand sanitizer, along with tests. On the first day of the White House test giveaway in January, COVIDtests.gov received over 45 million orders. Now officials say fewer than 100,000 orders a day are coming in for the packages of four free rapid tests per household, delivered by the U.S. Postal Service.

Still, the White House sees the program as a step toward a deeper, yet more elastic, testing infrastructure that will accommodate demand surges and remain on standby when cases wane. “We totally intend to sustain this market,” Dr. Tom Inglesby, testing adviser to the COVID-19 response team, told The Associated Press. “We know the market is volatile and will come up and down with surges in variants.”

The White House says Americans have placed 68 million orders for packages of tests, which leaves about 46% of the stock of tests still available to be ordered.

Testing will become more important with mask requirements now easing, say some independent experts. “If infection control is still our priority, testing is central,” said Dr. Leana Wen, a former Baltimore health commissioner and commentator on the pandemic. “Four tests per household for one family will only last you one time. There should be enough tests for families to test twice a week.”

Inglesby maintains that the pieces are falling into place to accommodate that.

Private insurers are now required to cover eight free rapid tests per person, per month. Medicare coverage will start in the spring. The administration has also been making free at-home tests available through libraries, clinics and other community venues. Capacity for the more accurate PCR tests performed by labs has been built up. The White House recently put out a request to industry for ideas on how to sustain and expand domestic testing for the rest of this year.

Wen says people still need a guide for when to test and how often. “Right now it is still unclear,” she said.

President Joe Biden’s pivot to testing came under duress as the omicron variant gained force just before Christmas. Tests were frustratingly hard to come by, and expensive. The White House is sensitive to criticism that help may have come too late.

“There is no question some people found out they were positive from taking one of these tests and were able to keep other people from getting infected,” said Tim Manning, supply coordinator for the COVID-19 response team.

Around mid-December, with omicron projections grimmer by the day, White House officials began discussing how to make free tests available for anyone who wanted one. But if the government started siphoning up tests on the market, that would just make the shortage worse.

The study, published in the journal Nature Medicine, is the first comprehensive look at the cardiovascular outcomes that can occur following a COVID-19 diagnosis, regardless of severity.

“Until now we had data that COVID infection could affect the heart in the short term,” Saurabh Rajpal, MBBS, a cardiologist and assistant professor in the Division of Cardiology at The Ohio State University Wexner Medical Center, tells Health. Dr. Raipal, who was unaffiliated with the new research points to issues like heart inflammation or blood clots in the acute stage of the disease. “However, this research shows that COVID can have lingering effects on the heart,” he says.

And the effects of COVID-19 on long-term heart health aren’t insignificant. “Consequently, COVID-19 infections have, thus far, contributed to 15 million new cases of heart disease worldwide,” Ziyad Al-Aly, MD, one of the study’s co-authors, and chief of research and development service at the VA Saint Louis Health Care System said in a press release. “This is quite significant. For anyone who has had an infection, it is essential that heart health be an integral part of post-acute COVID care.”

How COVID-19 affects long-term heart health

To investigate the potential long-term cardiovascular effects of having COVID-19, researchers looked at data from national health care databases curated by the US Department of Veteran Affairs (VA). The information was split into three separate groups: people who had been diagnosed with COVID-19 (153,760 individuals), people who did not catch the virus (5,637,647 individuals), and people whose data was collected pre-pandemic (5,859,411 individuals).

Across the board, COVID-19 survivors were at an increased risk for cardiovascular diseases across several categories, including cerebral vascular disorders, dysrhythmia, inflammatory heart disease, ischemic heart disease, thrombotic disorders, and other cardiac disorders. More specifically, being diagnosed with COVID-19 increased a person’s risk of heart attack by 63%, stroke by 52%, and heart failure by 72% in a 12-month period, compared to those without the illness.

The findings did not discriminate against age, race, gender, or pre-existing conditions—according to study authors, even people without a history of cardiovascular disease before a COVID-19 diagnosis were at a higher risk after having the illness. Researchers also found that people were affected despite severity of their COVID-19 infection, and cardiovascular risks were evident even in people who weren’t hospitalized during the acute phase of their illness, which reflects the majority of people who have COVID-19.

Still, researchers say the study has its limitations: In using data from the VA—which was from mainly white men—the demographics of the study weren’t necessarily representative of the US population. It’s also possible that those who were part of the control group actually had COVID-19 but didn’t know or weren’t officially diagnosed with the illness, which could throw off results. And as the COVID-19 pandemic continues, new variants and greater vaccine adherence could lead to a change in these cardiovascular issues.

Anxiety is linked to several cardiometabolic conditions, including coronary heart disease, stroke, diabetes, and hypertension. The reasons behind these links and how they develop, however, remain unclear. 

Some studies have shown that people who are anxious develop increased cardiometabolic risk factors, such as a steeper rise in body mass index (BMI), as they age. 

Other research suggests that deterioration in cardiometabolic health occurs relatively early in the life of anxious individuals and that this lasts into older age. 

Establishing how exactly this link works is difficult, as few cohort studies have recorded longitudinal data on anxiety alongside a broad range of cardiometabolic outcomes. 

In a recent study, researchers at the Boston University School of Medicine led a team of scientists investigating the link between cardiometabolic outcomes and indicators of anxiety. 

“Our findings indicate [that] higher levels of anxiousness or worry among men are linked to biological processes that may give rise to heart disease and metabolic conditions, and these associations may be present much earlier in life than is commonly appreciated — potentially during childhood or young adulthood,” said Lewina Lee, Ph.D., lead author of the study and assistant professor of psychiatry at Boston University School of Medicine. 

The study was published in the Journal of the American Heart Association (JAHA). 

Data analysis

The researchers obtained data from the Normative Aging Study, which the Department of Veterans Affairs established in the 1960s. 

They selected a sample of 1,561 individuals from an ongoing adult male cohort. Each person had submitted assessments of seven cardiometabolic biomarkers every 3–5 years since 1975. These included: 

• systolic and diastolic blood pressure as indicators of hypertension
• fasting triglycerides as an indicator of dyslipidemia, meaning unhealthy levels of fat in the blood
• fasting total cholesterol as an indicator of high cholesterol 
• BMI as an indicator of obesity 
• fasting glucose as an indicator of high blood glucose 
• erythrocyte sedimentation rate (ESR) as an indicator of inflammation

Alongside cardiometabolic biomarkers, all participants completed a nine-item questionnaire based on the Eysenck Personality Inventory at the start of the study alongside a 20-item questionnaire asking how much they worry about various issues on a scale of 0 to 4.

Although the Eysenck Personality Inventory is not a standard test for anxiety, it assesses for neuroticism, which refers to sensitivity to negative emotion. Experts consider neuroticism a causal factor for anxiety disorders and see worry as a major facet of anxiety and a coping method to prepare for future threats. 

The researchers also obtained demographic information from the participants, including: 

• age 
• race 
• socioeconomic status based on father’s profession
• marital status
• family history of congenital heart defects (CHD)
• current smoking status
• exercise levels 
• alcohol consumption 

At the beginning of the study, the average age of the participants was 53 years. Between 1975 and 2015, they underwent an average of 6.6 cardiometabolic examinations. In the same period, 1,067 individuals died. 

The researchers noted that higher neuroticism levels were linked to fewer years of education, a higher degree of CHD family history, lower socioeconomic status, and higher levels of smoking and drinking. 

After analyzing the data, they found that the participants who scored higher in neuroticism had a greater number of high risk cardiometabolic risk factors at all ages. 

After adjusting for demographic factors, the scientists found that higher neuroticism was linked to a 13% higher chance of having six or more cardiometabolic disease risk factors. 

They also found an association between higher worry levels and a 10% higher risk of having six or more cardiometabolic disease risk factors. 

Altogether, they say that the effects of neuroticism and worry on cardiometabolic health are similar to those of long-term heavy drinking.

Diabetes, both types 1 and 2, are potentially life threatening and certainly life changing conditions that affect people worldwide. Case numbers increased nearly fourfold between 1980 and 2014 according to the World Health Organization (WHO), with associated increases in mortality and disability caused by the disease. 

The majority of those cases are type 2 diabetes, caused by excess visceral fat, though the interaction between genetic susceptibility, environment, obesity, and sedentary lifestyle is complex. It is not uncommon for people to have a moderate body mass index (BMI) and type 2 diabetes, though they still respond to weight loss.

Case numbers of type 1 diabetes are also growing. The reasons for this are not well understood, but some have compared the increase in type 1 diabetes cases to those of other autoimmune diseases such as multiple sclerosis. Both are more common in the northern hemisphere, as is vitamin D deficiency.

In fact, estimates suggest that as many as 40% of Europeans are vitamin D deficient, and 13% may be severely so — and the situation is worse still for individuals with dark skin. It is also difficult to ascertain how many people are deficient, as debate rages over the definition of deficiency. 

Dr. Victoria Salem, a consultant endocrinologist and clinical scientist based at Imperial College London, told Medical News Today in an interview: “We know that type 1 diabetes is much more prevalent in the northern hemisphere and that’s usually put down to the fact that we get less sunlight and therefore have less vitamin D levels. That’s true also for multiple sclerosis. But it’s essential that that’s an association.”

While it is just an association, the links do not stop there. “[There is] quite good data showing that vitamin D deficiency, frank deficiencies — so children who’ve got rickets — are much more likely later in life to develop type 1 diabetes. But equally, people who are given a high dose of vitamin D […] are also less likely to get type 1 later on,” she explained.

Of course, suggesting vitamin D, or lack of it, is responsible for disease or susceptibility to it, is rife with controversy. Particularly with the heavily racialised discussion over the role of vitamin D deficiency in susceptibility to COVID-19. 

The controversy over the role of vitamin D in diabetes is most likely due to poorly designed trials that have failed to adequately measure the impact of vitamin D supplementation on groups that can be generalized, a recent update in the European Journal of Clinical Nutrition argued. 

Vitamin D and the pancreas

Type 2 diabetes is typically diagnosed when high blood glucose levels are detected. This is ultimately caused by low insulin sensitivity in the tissues which makes it hard for the body to take glucose out of the blood.

To compensate for this lack of sensitivity, the body creates a larger amount of insulin until eventually the beta cells in the pancreas give up, and the affected individual cannot produce enough insulin to transport glucose into their cells, resulting in high blood sugar. It is often at this point that people receive the diagnosis of type 2 diabetes. 

Dr. James Brown from Aston Research Centre for Healthy Ageing, Aston University in Birmingham, United Kingdom, studies type 2 diabetes and metabolism and explained the theory to MNT in an interview:

“If you look at the basic biology of vitamin D and what happens in diabetes, there is evidence that vitamin D improves what we call insulin sensitivity, which is a key part of type 2 diabetes. And also evidence that vitamin D increases insulin secretion, and those two things are what effectively go wrong in type 2 diabetes as you become insulin resistant and your insulin doesn’t work as well […] So there is, if you like, a theoretical basis for these studies being done.”

Dr. James Brown

In the recent study, researchers obtained data from ten cycles of the National Health and Nutrition Examination Survey (NHANES)Trusted Source, covering the years 1999 through 2018. This study included 55,021 adults, 52% of whom were women. The participants had a mean age of 47.5 years. 

The results showed that in 2018, adults in the United States took more than twice the amount of this sleep aid than they did a decade earlier, which may pose a health risk in some individuals. 

The study revealed that melatonin use increased from 0.4% in 1999–2000 to 2.1% in 2017–2018, with the increase beginning in 2009–2010. 

The study was published in the Journal of the American Medical Association (JAMA), and the lead author is Dr. Jingen Li, Ph.D., of Beijing University of Chinese Medicine. 

The study

The study evaluated adults who took melatonin at the recommended dosage of 5 milligrams per day (mg/d), as well as those who exceeded that dosage. Before 2005–2006, the authors found that users did not report taking more than 5 mg/d, but the prevalence of taking more than 5 mg/d went from 0.08% in 2005–2006 to 0.28% in 2017–2018.

Although the overall use of melatonin in the U.S. is still relatively low, the study does “document a significant many-fold increase in melatonin use in the past few years,” according to sleep specialist Rebecca Robbins, Ph.D., who is an instructor in the division of sleep medicine at Harvard Medical School and was not involved in this study.

Dr. Robbins told Medical News Today:

“Taking sleep aids has been linked to prospective studies with the development of dementia and early mortality Melatonin is one such sleep aid.”

Vital regulatory functions and rhythms

The body’s biological clock regulates hormonal fluctuations, which evolve over a person’s lifespan. As a result, aging often affects activities such as sleep and wake patterns, which, in some cases, become increasingly disrupted and fragmented.

Melatonin is a key hormone that governs the body’s circadian rhythms. Circadian rhythms play an influential role in certain aspects of our bodily functions and behaviors. They also play a significant part in sleep regulation and overall good health in humans, and their disruption can have numerous consequences. 

The negative consequences of sleep deprivation can include lower vigor, a less positive mood, and feeling stressed, cold, or sleepy. These effects can occur in people of any age.

MNT spoke with Dr. Richard Castriotta, a sleep medicine specialist at Keck Medicine of USC in Los Angeles who was not involved in the study. When we asked what the real-world implications of this study are, he stated:

“Not much, except that the increasing use of melatonin, like any non-FDA-approved medication sold as a ‘nutritional supplement,’ increases the risk of untoward side effects from a ‘bad batch’ of unsupervised manufacture or extraction (e.g., L-tryptophan). In reality, low dose (1–3 mg) melatonin is safe and effective in certain circumstances in managing circadian rhythm disorders but is not a very good hypnotic.”

“In higher doses (6–12 mg),” Dr. Castriotta continued, it may be useful in REM behavior disorder and may play a role in cancer prevention/treatment.” 

Untoward effects 

Several unpleasant side effects may occur with regular melatonin use, including dizziness, stomach cramps, headaches, nausea, confusion or disorientation, depression, irritability, anxiety, low blood pressure, and tremors. 

An older study that also appeared in JAMA suggested a link between mutations in the melatonin receptor sites and both insulin resistance and type 2 diabetes development. The study found that lower melatonin levels in the study participants may have been a precursor for type 2 diabetes. However, it could not establish direct causality. 

MNT spoke with Dr. Christopher Schmickl, Ph.D., a sleep medicine specialist at UC San Diego Health in California and an assistant professor of medicine at UC San Diego School of Medicine. Dr. Schmickl stated:

“Patients may use it to self-treat ‘poor sleep’ and thus delay or forego evaluation and thus proper/proven treatments of the underlying cause — e.g., obstructive sleep apnea may cause insomnia-like symptoms and if left untreated may lead to serious long-term health problems. Even for actual insomnia, the first-line therapy is in general (nonpharmacological) cognitive behavioral therapy for insomnia (CBT-I), which is similarly effective as sleep medications short term and more effective long term.”

Unreliable standards and measures 

Currently, the Food and Drug Administration (FDA) does not regulate the manufacture of melatonin supplements. There is concern that the quantities of melatonin in OTC preparations may exceed what the label displays by up to 478%.

According to Prof. Schmickl: 

“This raises concerns about ‘overdoses’ — i.e., flooding the body with levels that interfere with melatonin’s many important biological functions — and makes it hard to assess melatonin’s effect on sleep in a given patient, since the actual dose may vary substantially from tablet to tablet or at least bottle to bottle.” 

“OTC melatonin products may also contain varying levels of other substances like serotonin (a precursor of melatonin, which, in excess, can cause even life threatening side effects), which may further contribute to varying effects/side effects.”

He continues, “[b]ased on my clinical practice, many patients consider melatonin ‘natural’ since it is a supplement and thus don’t worry much about taking even very high doses (>5 mg), which are concerning from a medical perspective. Similarly, many people have a low threshold to give OTC melatonin products to their children, who may be even more vulnerable to adverse consequences.”

“Of note, melatonin-receptor agonists, e.g., ramelteon, have been developed and require a prescription, which, in theory, could overcome some of these problems. However, these patented drugs are very costly, which means that few insurances cover these medications. Thus, in clinical practice, these medications are rarely being used.”

On the bright side

Evidence shows that melatonin has beneficial anti-inflammatory and antioxidant properties and may have other therapeutic potential. It is currently under investigation for its value in treating medical conditions unrelated to sleep. 

It is also important to note that there were several limitations to the study. These include: 

• self-reporting of use
• heterogeneity of preparations
• the small number of melatonin users in some subgroups
• no reliable estimates of trends across diverse ethnic and racial groups 
• scarce data on the long-term and high-dosage use of melatonin

Vitamin D helps the body absorb calcium, which improves bone strength. Among other roles, it also contributes to the functioning of muscles, nerves, and the immune system.

Many scientists have set out to understand how vitamin D deficiency and supplementation may influence disease. According to the World Health Organization (WHO), there is some evidence that vitamin D may help protect against respiratory tract infections, for example.

Over the past 2 years, researchers have also explored whether vitamin D reduces the risks associated with COVID-19. Although investigations are ongoing, there seems to be some evidence that these supplements might improve intensive care unit admission rates.

Two other areas of particular interest are vitamin D’s potential effects on cardiovascular disease and cancer risk. However, few RCTs have looked into this. These types of studies are the gold standard for identifying causal relationships in scientific research.

A recent study, which appears in The American Journal of Clinical Nutrition, goes some way toward addressing this knowledge gap.

Cancer and heart disease

Speaking with Medical News Today, Vimal Karani, a professor of nutrigenetics and nutrigenomics at the University of Reading, in the United Kingdom, confirmed that there has been a gap between the initial research and findings from clinical trials. 

Prof. Karani was not involved in the recent study but has worked with some of its authors.

He explained that past large epidemiological studies “have established a link between vitamin D deficiency and the risk of [cardiovascular disease] traits in various ethnic groups.” This, he said, suggests that vitamin D supplements might lower cardiovascular risk.

“However,” he continued, “clinical trials have not provided convincing evidence of the blood pressure-lowering effect of vitamin D supplementation.”

Prof. Karani said that there could be a wide range of reasons for this, including “differences in the sample size, duration of supplementation, dose of the supplementation, age of the participants, geographical location, sun exposure, and the outcome measures. Further research is required to replicate the findings in multiple ethnic groups.”

If companies tried to bring it to market for the first time today, however, U.S. regulators would almost certainly forbid it. More than 200 health conditions—from cancer to dementia to cirrhosis— are linked to alcohol; it contributes to 3 million deaths globally each year, many via auto accidents and suicides; and in the U.S. alone, more than 14 million people struggle with alcohol-use disorder. It’s dangerous stuff, even though billions of people ingest it with hardly a second thought.

But what if you could get the buzz of a good drink without the buzz-killing side effects? That’s the marketing hype bubbling up from startups around the world making beverages that promise to make you feel tipsy using the magic of plant extracts, not alcohol. These companies claim that after a botanical beverage, you’ll feel more sociable and relaxed without getting drunk, eliminating the hangover (and bad decisions) that sometimes follow a boozy night.

One such startup, the U.K.-based GABA Labs, launched its first product, an “active botanical spirit” called Sentia, earlier this year in Europe. Sentia is made from plant extracts that can mimic the effects of alcohol, and is meant to top out around the feeling of having a glass or two of wine. But its founders want to go even further: They have also created a (not-yet-for-sale) synthetic alcohol molecule that they say can be used to create dupes of any booze on the market, from beer to rum to champagne. The company’s founders don’t yet have enough evidence to legally make claims about their products’ health effects, but the implication is clear: synthetic alcohol could capture the good parts of drinking while ditching the death and disease associated with it.

But experts aren’t convinced. Things that sound too good to be true usually are, says Dr. Anna Lembke, medical director of addiction medicine at Stanford University School of Medicine and author of Dopamine Nation. “There’s always the promise of some new molecule that’s going to do exactly what the old molecule did but not have the harmful effects,” she says. “Every single time, that has not panned out.” Heroin, for example, was intended to be a safer form of morphine. E-cigarettes were pitched as a less dangerous way to smoke. Neither has worked out as planned.

Can alcohol really be faked in a healthy way, or would a synthetic version introduce new risks? Is it possible to create a product that imitates alcohol without introducing the possibility of addiction or dependence? And could fake alcohol make people already struggling with alcohol-use disorder more likely to relapse? “Given the significant harms caused when alcohol is misused, this is an interesting approach,” says Patricia Powell, deputy director of the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA). “However, it raises a series of questions that we don’t have the answers to yet.”

In recent years, intermittent fasting has gained popularity as a way to lose weight, improve health, and enhance performance.

Some studies suggest that this dietary approach may even extend healthy lifespan without the need for the severe caloric restriction that classic anti-aging diets entail.

People who practice intermittent fasting eat few or no calories for anything from 12 hours a day to 1 or more days every week. The former technique is known as time-restricted feeding, whereas the latter is known as periodic fasting.

A recent review of the evidence suggests that this type of diet may help people with type 2 diabetes safely reduce or even remove their need for medication.

However, people should seek the advice of a diabetes professional before embarking on such a diet. 

The review, by Dr. Michael Albosta and Jesse Bakke, Ph.D., of Central Michigan University College of Medicine in Mount Pleasant, appears in Clinical Diabetes and Endocrinology.

Insulin resistance

According to the Centers for Disease Control and Prevention (CDC), diabetes affects 34.2 million people in the United States, which equates to about 1 in every 10 people. In 2017, it was the seventh leading cause of death in the country.

People with type 2 diabetes have abnormally high concentrations of glucose in their blood, known as hyperglycemia.

Several factors may contribute to hyperglycemia in type 2 diabetes. These include reduced secretion of the hormone insulin, which regulates blood sugar levels, and reduced sensitivity of the body’s tissues to the hormone. Doctors refer to this reduced sensitivity as insulin resistance.

The condition can cause a range of severe complications, including kidney failure and blindness.

The goal of treatment for type 2 diabetes is to prevent or delay these complications and maintain the person’s quality of life.

Healthcare professionals encourage people with type 2 diabetes to exercise regularly, reach a moderate weight, and eat a well-balanced diet. However, most individuals also need to take drugs to lower their blood glucose levels.

Most of these drugs raise insulin levels, which the authors of the review say can have an unintended negative consequence.

“While this works to reduce hyperglycemia in these patients, the idea of treating a disease of insulin resistance by increasing insulin may be counterproductive, leading to the requirement of increasing amounts of medication over a long period of time,” they write.

People who take the drugs can gain weight and develop increased insulin resistance. 

In addition, they can have raised levels of a hormone called leptin, which normally reduces appetite. This may suggest that they become increasingly resistant to this hormone, too.

They also have lower levels of a third hormone, called adiponectin, which usually counters diabetes and inflammation.

Struggles with calorie restriction

Some people with diabetes could minimize their need for diabetes medication by continually restricting their calorie intake, which scientists know reduces body weight and improves metabolic health.

However, the authors of the review note that people can struggle to sustain daily calorie restriction for extended periods.

Some people may find it easier to practice intermittent fasting, which shows promise as a way to improve metabolic risk factors, reduce body fat, and promote weight loss in obesity.

To assess the evidence, the authors searched databases for review articles, clinical trials, and case series related to type 2 diabetes and intermittent fasting published between 1990 and 2020.

They concluded that this type of diet may improve several key features of the disease. The improvements include:

• reduced body weight
• decreased insulin resistance
• lower levels of leptin
• increased levels of adiponectin

“Some studies found that patients were able to reverse their need for insulin therapy during therapeutic intermittent fasting protocols with supervision by their physician,” they write.

For example, a case study followed three people with type 2 diabetes for several months after they started an intermittent fasting diet, which involved three 24-hour fasts per week.

Over the course of the study, all participants had significantly reduced levels of HbA1c, which is a measure of the average amount of glucose in the blood.

All three individuals lost weight and were able to stop their insulin therapy within 1 month of the start of the diet.

Crucially, they reported that they found the diet easy to tolerate, and none of them chose to stop the diet at any point.

“Within less than a month, they had significantly reversed their type 2 diabetes,” says one of the authors of the case series, Dr. Jason Fung, a kidney specialist who is an advocate for intermittent fasting. 

“Even a year later, I think two of them are off all meds […], so doing ridiculously well for an intervention that is actually free, available to anybody, and has been used for thousands of years,” Dr. Fung tells the Weight Loss Motivation podcast.

The review authors also cited a clinical trial that randomly assigned 137 people with type 2 diabetes to either a continuous calorie-restricted diet or an intermittent fasting diet.

After 12 months, the two groups had similar reductions in their HbA1c levels. However, those in the intermittent fasting group lost more weight on average.

We have always been told that breakfast is the most important meal of the day, since, in addition to giving us enough energy to start our day, it helps our brain to function better.

Dr. Randall Wright, a neurologist at Houston Methodist Hospital , explains that breakfast is the time of day when we have the opportunity to fill our bodies with foods that give us a high-octane boost, providing energy, cognition and clarity to the brain for hours.

“Eating a variety of fresh fruits, vegetables, grains, nuts, and seeds for breakfast, and all the nutrition these foods offer, gives your brain the fuel it needs for the day. The brain is the organ that uses the most energy in our body, so if we feed it correctly, we will really be doing it a great favor, ”explained the specialist in a statement.

However, according to the doctor, waiting to eat is also correct. Dr. Wright points out that intermittent fasting, meaning skipping midnight snacks and going 12 to 14 hours without eating allows glucose levels in the body to drop, giving a “break” from eating and allowing brain transmitters are cleared and reset. However, this type of practice should be supervised by a nutritionist or a doctor specialized in nutrition, since uncontrolled fasting can lead to other metabolic problems.

Dr. Wright stated that it is fine to drink coffee and water in those early hours of the morning before hunger begins, but be careful not to be tempted to eat anything, as this will lead us to try bread of sweet or cereals whose caloric content is higher than recommended.

The brain is not designed to handle too much sugar

The brain is not designed to handle large volumes of glucose as glucose can start a vicious cycle of cravings and tempt people to eat a couple of donuts, then quickly feel hungry again. Glucose levels in the brain rise, then fall, and then rise again.

Dr. Wright also warned about staying well hydrated, since “sometimes we confuse hunger with thirst and we only need 180 to 250 milliliters of water to resume any activity. Our brains are made mostly of water, so even a little dehydration can affect our thinking. “

Plus, the best breakfast for your brain needs two key ingredients that only you control: exercise and sleep. Both are critical to brain health.

7 perfect breakfasts for the brain

• Monday: Toast or wholemeal bread with avocado and egg, accompanied by a plate of red fruits.
• Tuesday: Oatmeal prepared with blueberries and walnuts.
• Wednesday: Salmon with diced fruit on the side.
• Thursday: Cottage cheese or cottage cheese with peaches, seeds, and nuts.
• Friday: Two or three slices of panela cheese, grapes, almonds, accompanied by whole wheat crackers and hard-boiled egg.
• Saturday: A two-egg omelette with a rainbow of vegetables including red, green, orange and yellow bell peppers, onions and tomatoes.
• Sunday: Natural Greek yogurt accompanied by your three favorite fruits and topped with walnuts.

The delta and omicron variants of the coronavirus are trying to spoil the holiday spirit, but there still are ways to enjoy the festivities.

The explosive spread of the omicron variant is causing many to wonder if they should cancel their holiday plans. The omicron mutation is expected to overtake the delta variant in the United States within weeks.

Health experts know that people need to spend time together, so they are offering advice. Above all, getting vaccinated remains the best defense and getting a booster shot further increases protection.

Dr. Anthony Fauci, the nation’s top infectious disease expert, skipped gathering for the holidays last year with his three adult daughters. But this year, Fauci, his wife and his daughters are all vaccinated with boosters, and they plan to spend the holidays together, even seeing a few friends who also are vaccinated and boosted.

“We can feel safe,” Fauci said this week on NBC’s “Nightly News.” “Nothing is 100% risk-free.”

A look at strategies to enjoy the holidays as safely as possible.

IS IT SAFE TO ATTEND A HOLIDAY PARTY?

It depends. Large parties aren’t as safe as small ones. Indoor parties aren’t as safe as outdoor gatherings.

At a large, indoor party, one person without a mask can result in many people infected, said Dr. Celine Gounder of the NYU Grossman School of Medicine.

“Some of these are turning into superspreader events,” Gounder said.

Even if everyone is vaccinated and boosted, breakthrough infections can happen, including with omicron, which has shown the ability to sidestep the protection of vaccination in lab tests.

And don’t count on symptoms to tell you who’s carrying the virus, said Dr. Jeff Duchin, health officer in Seattle and King County.

“Half or more of infections are spread from people before they have symptoms, so symptom screening remains important, but doesn’t identify everyone who can spread COVID-19,” Duchin said.

Masks, opening windows, running an air purifier with a HEPA filter are strategies recommended by health experts for gatherings during the holidays.

WHAT ABOUT HOME TEST KITS?

Home test kits can add a layer of safety by providing on-the-spot results. The tests are not as accurate as the PCR tests done in hospitals and at testing sites. But they have the advantage of giving results within minutes instead of days.

In some places, testing demand is high, rapid tests are hard to find and waits at testing centers are long.

If you’re searching for a home test kit, check online and at drugstores. A box with two tests typically costs about $25. If you have health insurance, save your receipt. You may be able to get reimbursed for the cost next year, although it’s unclear whether new rules about that will be retroactive.

Residents of some parts of the U.S. can receive free home test kits through a public health effort called Say Yes! COVID Test.

“It’s been a phenomenal program,” said Matt Schanz, administrator of the Northeast Tri County Health District in northeastern Washington state, where households can get up to eight tests delivered.

“We’re social people. We want to gather together and have joyous times during the holiday,” Schanz said.

Some health experts are recommending testing twice: Take a test three days before and on the day of a holiday gathering.

“So if you’re gathering Christmas Eve, test a few days before and on Christmas Eve as well,” said Dr. Kiran Joshi, senior medical officer at the Cook County Department of Public Health in Illinois.

WHAT ABOUT TRAVEL?

Check the rules of your destination country if you’re planning to travel abroad. Nations are adding new rules in response to omicron.

People traveling by air should be extra careful about wearing masks in crowded airports, Fauci said.

“Wear your mask all the time,” Fauci told a Wall Street Journal podcast. “It will be required to wear a mask when you’re on the plane, but don’t get careless in the airport with all the crowds that are in the airport and take your mask off.”

IS THERE ANY GOOD NEWS?

Kids often catch viruses at school and there’s some evidence with flu that school breaks can slow the spread. So it might be lucky that omicron is emerging during the holidays, said virus expert Elodie Ghedin of the National Institute of Allergy and Infectious Diseases.

“Going into the holidays where kids are staying home from school is actually a good thing,” Ghedin said. “If this had occurred in the fall, it probably would have been worse with transmission. That’s the one silver lining going into the holidays.”

In a new study, researchers have found that blood pressure increased in adults in the United States during the pandemic compared with previous, non-pandemic years.

The research, published in the journal Circulation, makes clear that the health effects of the pandemic include not just the COVID-19 disease but also other, indirect health issues.

Blood pressure

According to the Centers for Disease Control and Prevention (CDC), blood pressure describes the pressure blood exerts against a person’s arterial walls.

Doctors measure blood pressure at two points: when a person’s heart is pumping, known as systolic blood pressure, and when a person’s heart is resting between beats, known as diastolic blood pressure.

If a person has high blood pressure, also known as hypertension, they are at a greater risk of stroke or heart disease. Hypertension can also damage a person’s liver, eyes, and brain.

The CDC state that 47% of U.S. adults have hypertension, and in 2019 hypertension was the primary or contributing cause of more than 500,000 deaths.

A person can help maintain healthy blood pressure levels by eating a diet low in salt and high in fruit and vegetables, exercising regularly, avoiding smoking, and limiting alcohol intake.

However, the COVID-19 pandemic significantly disrupted people’s behavior and access to regular medical care.

Researchers are interested to see if this disruption had an effect on people’s blood pressure levels.

Almost half a million participants

To look at blood pressure levels during the pandemic relative to previous years, a group of scientists studied data from an employee wellness program in the U.S covering 2018–2020.

This involved 464,585 participants, 53.5% of whom were women, with an average age of 45.7 years in 2018. The paper offered no information regarding the racial or ethnic makeup of the participants.

The scientists compared blood pressure levels before the pandemic in 2018, 2019, and until March of 2020, when most U.S. states gave stay-at-home orders. They then compared these levels with those recorded from April–December 2020 during the pandemic.

Blood pressure levels increased

The researchers found that before the pandemic, there was no significant change in blood pressure between years.

However, each month during the pandemic, blood pressure increased by an average of 1.1 to 2.5 millimeters of mercury (mmHg) for systolic blood pressure and 0.14 to 0.53 mmHg for diastolic blood pressure. This was the case for both women and men of different ages.

Women, on average, had greater increases for both systolic and diastolic blood pressure. Older participants had greater systolic blood pressure increases, whereas younger participants had greater diastolic blood pressure increases.

Cause?

Speaking to Medical News Today, Dr. Luke Laffin, co-director of the Center for Blood Pressure Disorders at the Cleveland Clinic in Ohio and the study’s lead author, said that “[d]ietary indiscretion, lack of exercise, central obesity, excessive alcohol consumption, and not taking prescribed blood pressure medications can all drive high blood pressure.”

“Other research demonstrates that lifestyle habits like excessive alcohol intake worsened during the pandemic, so it is not surprising that a blood pressure elevation followed.”

“We also know that patients hesitated to see their doctor, particularly in the early part of the pandemic, and that may have contributed to increased blood pressures,” said Dr. Laffin.

Prof. Matthew Bailey, who leads hypertension and renal research at the Centre for Cardiovascular Science at the University of Edinburgh, Scotland, and was not involved in the study, told MNT that the findings were significant and had global implications.

“This paper has examined almost half a million people and clearly shows that the societal changes [and] restrictions imposed in response to the pandemic have increased blood pressure. The effect is particularly large in women, and there is also an unanticipated increase in young people.”

“A rise in blood pressure of this size increases the risk of debilitating heart attack or stroke. For individuals and their families, cardiovascular disease can be devastating. [F]or governments, these conditions are costly to treat and manage. Health budgets are already overstretched.”

“This study is based in the U.S. but is relevant globally. It provides an early warning signal that poor cardiovascular health might be a big problem a few years down the line,” said Prof. Bailey

From turkey—or tofurkey—to Thanksgiving side dishes like mashed potatoes, green bean casseroles, sweet potatoes, and cranberry sauce, bread, drinks, and a bakery-worthy array of pies, the Thanksgiving meal is one marked by rich food and more frequently than not, overindulgence.

While it’s important to enjoy the holiday and the time and special meal with your loved ones if you’re on a diet or working hard on specific weight and health goals, navigating Thanksgiving without completely sabotaging your progress can feel impossible. However, with a little careful planning and mindful decisions about what you’re going to eat—and skip—it is completely possible to enjoy Thanksgiving without derailing your diet and weight loss goals. Keep reading for our top tips for having a happy and healthy Thanksgiving this year.

Don’t Skip Meals

One common fallacy whenever it comes to dieting is trying to bank calories for later by skipping meals. However, this usually ends up backfiring because it can lead to overeating. By skipping breakfast on Thanksgiving, your blood sugar levels will drop, which can cause an urge to binge or overeat once you finally allow yourself to dig in. Eat a healthy, protein-rich breakfast like Greek yogurt with nuts and fruit or a protein shake, and a light lunch with plenty of fiber and fresh vegetables. Be sure to have filling, nutritious snacks on hand like hummus and fresh vegetables or cottage cheese.

Make Time to Exercise

Start your Thanksgiving off right with some exercise. Consider walking or running in a Turkey Trot or getting in a workout before you host or hit the road to head to Thanksgiving dinner. If your gym is closed for Thanksgiving, try an at-home workout instead.

Plan Your “Spending”

Imagine your Thanksgiving meal like visiting the candy store as a kid. You have a certain amount of “money” (calories) to spend on Thanksgiving. Before sitting down at the table, look around at all the various dishes available and consider how you want to budget your calories and partition them accordingly. Choose the foods you really want, avoid the ones you can do without, and plan one or two special “indulgences” like your favorite slice of pie or sweet potato casserole.

Halloween is the time of the year when many fall enthusiasts drink pumpkin spice lattes, watch favorite horror flicks, and go trick-or-treating.

Every year, people around the U.S. and the world throw costume parties to celebrate this holiday, taking the opportunity to spend some quality time with friends and family.

This year, however, the COVID-19 pandemic has made celebrating Halloween more complicated, as social gatherings can facilitate the spread of SARS-CoV-2, the virus that causes the disease.

Despite this, some data suggest that many people in the U.S. have not let the pandemic deter them from their yearly Halloween preparations.

According to a Statista projection from September 2021, planned nationwide expenses for Halloween costumes amount to $3.3 billion. Estimates also indicate another $3.2 billion on Halloween decorations and $3 billion on candy.

So how can people stay safe while still enjoying this favorite fall holiday? In this Special Feature, we look at some best practices and offer tips for health, safety, and fun.

We have based our suggestions on official guidelines from the Centers for Disease Control and Prevention (CDC).

Handling and offering treats

Trick-or-treating and costume parties may be the best-loved Halloween activities, but they typically involve close contact with many people from different households. This can facilitate the transmission of the coronavirus.

For example, if someone who has unknowingly contracted SARS-CoV and has not experienced any symptoms engages in regular social activities, they might be putting others at risk.

The first and most important step to protect yourself and others against COVID-19 is by getting vaccinated, and the CDC advises everyone who is able to receive a COVID-19 vaccine to do so.

The best way to stay safe this Halloween is to avoid contact with people from other households, which might mean avoiding trick-or-treating and attending parties with individuals you do not share a living space with.

However, there are some ways people who want to make the most of this fall festivity can mitigate the risks.

If children go treat-or-tricking, they must avoid coming into direct contact with other treat-or-trickers or with any adults offering them treats.

They must also try to keep at least 6 feet away from other children and adults who do not live with them and carry hand sanitizer with at least 60% alcohol content to use frequently.

Adults may want to supervise children as they use hand sanitizer and use it frequently themselves.

If these images are motivating you to action and you’re looking for someone to be your nutrition adviser, how do you find the person that best suits your needs? Are you interested in someone to help you with meal planning, guidance for particular nutrition-related health concerns, weight management, recipe ideas, smart shopping guidance or advice on how to eat well on a budget? A registered dietitian/nutritionist can help with all of the above and more.

Certification and Specialization

As you begin your search, do look for individuals with the RDN – registered dietitian/nutritionist – credential. A registered dietitian/nutritionist (formerly known as RD for registered dietitian) is a board certified food and nutrition expert. This individual has successfully completed an accredited nutrition and dietetics program and internship. Although there are some nutritionists who are board certified and credentialed and are also registered dietitians, not all who use the term “nutritionists” are qualified to provide nutrition advice. In addition, you’ll want to find out if that individual has additional expertise in areas of interest to you such as diabetes management, eating disorders, digestive diseases or performance nutrition.

Philosophy and Audience

Before you contact a nutrition expert, do your homework. Look at websites to get an idea of the person’s nutrition philosophy. Does it seem inclusive or exclusive? Do they tend to talk more about what to exclude or include? Does their social media platform prioritize foods that are affordable and readily available or foods that are more expensive? 

Read their blogs and watch their interviews to get an idea of where they stand and what they recommend when it comes to eating guidelines and food choices. Ideally, talk to other clients/patients to get their feedback. You’re making this investment in yourself but you want to work with someone who will meet you where you are. Look beyond the visuals to the verbal to see if what they say resonates well or rubs you the wrong way.

Qualifications

It’s important that you work with someone who’s an expert in food and nutrition, but also presents their expertise in a way that is approachable, engaging and appealing to you. Does this person listen to your concerns, show empathy and compassion and customize their recommendations to meet your needs? Do they ask about your food beliefs, food preferences, relationship with food and your body, food traditions, body goals, eating habits, culinary ability, proximity to grocery stores and your finances? The questions asked and the guidelines they provide need to respect what is important to you and reflect practical application.

Some recent studies have linked moderate alcohol consumption to health benefits, such as lower risk of cardiovascular disease. Other studies tout potential health benefits of drinking wine and tequila.

However, results of a new study from the University of Greifswald in Germany contradict the idea of drinking alcohol to protect health.

Earlier studies have shown an increased mortality risk in people who abstain from alcohol, compared with individuals who consume low to moderate alcohol amounts. However, the authors of the recent study chalk this up to risky behaviors that people abstaining from alcohol engaged in earlier in their lives.

The study appears in the journal PLOS Medicine.

Alcohol and health

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in 2019, 85.6% of individuals in the United States aged 18 years or older reported that they had consumed an alcoholic beverage at one time in their life.

The NIAAA also reports that 14.5 million people in the U.S. aged 12 years or older are living with alcohol use disorder (AUD). According to the NIAAA, AUD is “characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.”

The NIAAA also notes that about 95,000 people in the U.S. die each year from alcohol-related causes. This makes alcohol the third largest preventable cause of death in the country.

Previous research suggests that people drinking alcohol in moderation live longer than those who do not consume it. Another, older study concludes that men who drink moderate amounts of alcohol have a higher life expectancy than individuals who drink alcohol occasionally or heavily.

Prof. Dr. Ulrich John and his team believe their research shows that the lower life expectancy for those who do not drink alcohol compared with those who do can be due to other high risk factors.

This contradicts the idea that consuming low to moderate amounts of alcohol confers health benefits.

“It is a problem […] that medical students and patients are given the advice that it might [improve] health if they drink low to moderate amounts of alcohol,” Dr. John told Medical News Today.

“For many years, epidemiological data seemed to reveal that low to moderate alcohol consumers live longer than alcohol abstainers. This was the scientific base for the attitude in medical care that alcohol consumption might support health, in particular cardiovascular health.”

“In the last few years, more and more shortcomings of the former research became known,” Dr. John continued. “So, we tried to prove what kind of subgroups are among the abstainers, subgroups perhaps with risk factors that might explain the seemingly higher likelihood to die early compared with low to moderate drinkers.”

To a certain degree, stress is inevitable. Still, it should be manageable, and if you feel like you’ve been spread too thin, there are ways to fight back. 

There’s no magic, fix-it-all solution to stress—rather, there are a bunch of different things you can do to handle it. And that’s only logical, seeing as stress doesn’t come from a single source. Your finances, relationship troubles, work, family life, and many other situations can all contribute to your stress levels and cause everything from depression and anxiety to premature aging, chronic migraines, heart disease, and a bunch of other things you really don’t want. 

So, what can you do about it? Don’t worry, here are a few tips help you find your inner calm. 

KEEP A JOURNAL 

Pop culture would have you believe that only sullen teenagers keep journals, but it really is an excellent tool for stress management. It helps you with the first step of battling stress, which is recognizing that it exists and where it comes from.

Taking the time to think about your stressors long enough to put them “on paper” is often all you need to realize the root of your problems. Plus, the act of writing has long been one of the most effective emotional releases.  

FIND A FRESH PERSPECTIVE 

Sometimes, it’s important to take a step back from your thoughts and feelings and try to view them objectively. By nature, nothing is stressful on its own, it’s simply a mental state that shows how you perceive certain events and/or emotions.  

Of course, this doesn’t mean your stress isn’t real or valid—just looking at its source from a new point of view or “cognitive reframing” can be enough to lower your stress levels. 

GET BETTER SLEEP  

Cortisol is the primary “stress” hormone and levels are increased when your sleep is disrupted. Ensuring you’re getting enough sleep, and ensuring it’s good-quality sleep, is a relatively simple way to allow your body to recover from stress. 

EAT MORE OATMEAL 

There’s a reason why breakfast is the most important meal of the day, and it’s a good practice to eat something filling and hot before you start a day that you expect to be stressful. 

Oatmeal is great for this because it takes just a couple of minutes to make, and it’s jam-packed with the complex carbohydrates that you need for sustained energy throughout your morning. Additionally, slow-burning carbs help with serotonin release, bringing you a sense of calmness and lowering stress. 

REMOVE SIMPLE SUGARS 

Of course, people who are into fitness know that all types of carbohydrates aren’t that great for your diet—but did you know they also influenced your stress levels? Simple carbs are the worst offenders here. Refined sugar, white flour, and processed drinks and food trigger a blood glucose spike—soon followed by an inevitable crash. This always leaves you with a considerable energy low, making it harder to make it through your day and raising your stress levels.  

PERFORM DEEP BREATHING EXERCISES 

One of the most common symptoms of stress is shallow, rapid breathing—which is precisely what you don’t need to alleviate stress. Considering that, you should practice more controlled, deeper breathing for the next time you’re feeling overwhelmed by stress.  

A minute of deep breathing will allow more oxygen to enter your brain and body, resulting in a calm sensation—one that puts you in the right state to overcome your current emotions.  

TAKE A WALK 

You’ve probably realized this already, but regular exercise is an excellent (and productive) stress remedy. Don’t be intimidated by exhausting, intense workout sessions if you’re not used to them. Start small. Even a brisk, 10-minute walk will be enough to get you into a more relaxed state of mind.

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.)

According to Our World in Data, nearly half of the world’s population have received at least one dose of the vaccine against SARS-CoV-2, the virus that causes COVID-19.

Scientists have shown that COVID-19 vaccines reduce the severity of illness but do not confer complete protection against COVID-19.

At the beginning of the pandemic, some jurisdictions, including those in the United Kingdom and Sweden, pursued a policy of herd immunity, which assumed that allowing enough people to catch the virus would confer enough immunity on the population to end the pandemic.

While there have been some reports of people developing COVID-19 more than once, these numbers are too small to carry out an epidemiological study. This means that it is difficult to determine how long immunity conferred from a SARS-CoV-2 infection lasts.

In the present study, researchers have conducted an analysis of previously published data on viruses similar to SARS-CoV-2. They set out to determine how long immunity following COVID-19 might last.

The research, which appears in The Lancet Microbe, shows that unvaccinated people can expect immunity against reinfection to last 3–61 months after developing COVID-19 — if the virus is still circulating in the community.

This study could help encourage people to get vaccinated, said Dr. Ajay Sethi, associate professor of population health sciences at the University of Wisconsin-Madison, who was not involved in the research. He told Medical News Today,

“The study underscores the importance for the public to understand that immunity from natural infection is not as long lasting as some may perceive, and certainly not lifelong.”

He also explained that “research has shown that vaccination following natural infection produces an even more robust immune response as compared [with] vaccination without any prior history of COVID-19. Hopefully, more people who’ve had infection in the past will choose to get vaccinated.”

Analyzing the data

A team from Yale School of Public Health in New Haven, CT, and the University of North Carolina at Charlotte looked at the genes of 177 coronaviruses known to affect humans. The researchers then determined which were the closest viral relatives of SARS-CoV-2.

They identified five viruses that met this criterion. They included SARS-CoV, responsible for the SARS outbreak in 2003, and MERS-CoV, which was first detected in 2012. They also included viruses that cause the common cold.

The researchers then analyzed existing data on how antibody levels decline over time — from 128 days to 28 years after infection. They also looked at the risk of reinfection at different antibody levels for those viruses.

Using this information, they predicted that natural immunity conferred by contracting SARS-CoV-2 would likely last less than half as long as the immunity due to contracting related coronaviruses.

They found that reinfection with SARS-CoV-2 in people who had not received a vaccine could occur as soon as 3 months after initial infection, with a median risk of reinfection within 16 months, under endemic conditions.

Co-leader of the study Alex Dornburg, assistant professor of bioinformatics and genomics at the University of North Carolina, says:

“As new variants arise, previous immune responses become less effective at combating the virus. Those who were naturally infected early in the pandemic are increasingly likely to become reinfected in the near future.”

The study authors conclude that as novel variants could evade existing immunity, it is important to focus efforts on accelerating global vaccine programs to reduce the likelihood of variants emerging in the first place.

Minimizing risk

It is of note that the study had certain limitations. For instance, it did not look at how severity of initial SARS-CoV-2 infection or immune status of an individual might affect how long their natural immunity would last.

Speaking on this point, Dr. Alexander Edwards, associate professor in biomedical technology at the University of Reading in the U.K., who was not involved in the study, told MNT:

“Reinfection isn’t really the critical problem for COVID-19. Instead, the most important point is severity of infection. If previous infection protects from serious disease developing, it becomes less important to the individual if they get infected a second time.”

“However,” he continued, “for COVID-19, we still don’t know if previous infection will fully protect from severe disease and death for everyone.”

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.

“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.”

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.

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.

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.

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.

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.”

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.”

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.

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.

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.

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.

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.

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 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.

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 year, albeit 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.

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.

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.”

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.

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. 

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.

“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

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 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. 

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.

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.

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.

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.”

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.

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.

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.

2. 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.

3. 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.

4. 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.

5. 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.

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 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.

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.

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.”

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.

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.

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.

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.

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

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.

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.

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.

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.

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. 

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.

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!

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

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.

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.

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.

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.”

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.

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.

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.

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.  

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.

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.”

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.

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.

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.

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.

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.

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

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.”

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.”

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).

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.

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.

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.

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.

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.

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.”

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.

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.

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.

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.

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.

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.

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.

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.

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.”

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.

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.

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.

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.

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.

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. 

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.

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.

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