Winter gatherings might not seem complete without a warm crackling fire, but when a get-together includes kids, safety needs to be on everyone’s mind.
First of all, a window should be cracked open to provide proper ventilation whenever a fire is burning, advises the American Academy of Pediatrics.
Then, the group suggests, take these additional steps to help avoid fire-related accidents and injuries:
Check the damper or flue before starting a fire. This can be done by looking up the chimney with a flashlight or mirror. Make sure the flue is open. Then, keep it open until the fire is out completely so that all smoke goes outside. It’s also important to check for animal nests or other blockages in the chimney that could cause smoke to fill the house. Chimneys should also be checked at least once a year by a professional.
Avoid burning wet or green wood. Dry and well-aged wood burns evenly and creates less smoke and soot that can build up in the chimney. It’s also a good idea to burn smaller pieces of wood on a grate. They will burn more quickly and generate less smoke than larger logs.
Don’t allow ashes to build up. Once a fire is out, the ashes left behind should be removed. Ashes restrict air supply to burning wood, which produces more smoke. There should never be more than an inch layer of ashes in a fireplace.
Clear the area around the fireplace. Placing furniture, curtains, decorations, newspapers, books or other items near a fireplace could result in a house fire. Nothing flammable should be stored too close to a fireplace. Also keep a fire extinguisher handy.
Don’t leave fires unattended. There should always be an adult in the room when there’s a fire in the fireplace. Never leave children alone in a room with a fire. Children should also be taught about fire safety. And, before leaving the house or going to bed, make sure that the fire is completely out.
Use safety screens. Hot glass doors in front of a fire can cause serious burns. Installing a safety screen in front of the fireplace can reduce the chance of an injury.
Store fireplace tools out of children’s reach. Kids can be tempted to play with the tools. Also store lighters and matches out of sight.
Equip your home with smoke and carbon monoxide detectors. Check the devices monthly to make sure they’re working. Replace their batteries at least once a year.
Federal health officials have unveiled plans to allow prescription drug imports from Canada and other foreign nations.
The U.S. Food and Drug Administration is proposing a rule under which states could import some prescription drugs from Canada, U.S. Health and Human Services Secretary Alex Azar announced recently.
The agency also plans to make it easier for drug manufacturers to import their own FDA-approved drugs that are manufactured abroad and intended for sale in other countries.
“This would potentially allow for the sale of these drugs at lower prices than currently offered to American consumers, giving drug makers new flexibility to reduce list prices,” Azar told reporters.
Azar touted the proposals as “historic.”
All imported drugs would have to be FDA-approved, tested to ensure quality and relabeled to meet U.S. labeling requirements, added Admiral Brett Giroir, the assistant secretary for health.
State programs created to import medications would be limited to pills that patients would typically get from a pharmacy, Azar said.
Injectable products, controlled substances, biologic products and intravenous drugs would not be allowed.
States would create these programs, possibly in conjunction with wholesalers or pharmacies, and then submit them to FDA for approval, Giroir said.
However, drug manufacturers would be able to import any of their own products from other foreign countries, Azar said. That would include products such as insulin, which has recently been subject to steep price hikes.
“Every product is available for importation from every country by a manufacturer,” Azar said. “There is no restriction there, if a manufacturer is willing.”
The manufacturer pathway is intended to address the “bizarre” system of drug rebates that some pharmaceutical companies have blamed for high prices, Azar said.
“Even if the drug company would like to lower the list price of their drug, they may actually be precluded from doing so because of their arrangements with these middle men, where they have to funnel a certain amount of rebate money to those middle men,” Azar said.
Drug companies have said if they can get a new National Drug Code for an imported version of the exact same medicine, then they would compete against their own products at a lower list price, Azar said.
The new proposals are only aimed at brand-name drugs, Giroir said.
“The draft guidance does not address generic drugs because we are not aware of similar private market challenges for reducing the cost of generic drugs,” Giroir said.
The FDA is open to considering similar proposals for generic if warranted, he added.
The officials could not say how soon patients will benefit from these proposals, but said that the manufacturer’s guidance will likely move faster because it faces fewer regulatory hurdles.
Apart from the sheer fun of owning a pet, having a dog enhances well-being and even personal growth in many ways.
Caring for a dog teaches kids responsibility and offers everyone in the family unconditional love.
Many studies have found that the social support that dogs—and pets in general—provide boosts their owner’s emotional health.
There are also many physical benefits to dog ownership.
Walking Rover on a regular basis—once or twice every day—can help you reach your own daily exercise goals and, in turn, lower your heart disease risk.
In fact, according to one study, owners who walk their dogs on a regular basis are over 50% more likely to meet minimum exercise guidelines. Surprisingly, though, many people simply don’t walk their dogs enough for them or their pets to get in a good workout.
The advantages of having a dog extend beyond the home.
Bringing your pooch to work can reduce your stress.
And studies by researchers at Central Michigan University suggest the presence of a four-legged “co-worker” can boost cooperation, bonding and trust among employees.
That’s important because getting people to work effectively as a group is often a challenge, even when companies try to engage staffers with activities like team-bonding exercises.
For the study, researchers divided participants into groups with and without a dog and gave each group creative tasks to complete. People in the groups with a dog showed more enthusiasm and energy and felt more closeness and trust than those without a dog.
It seems that having a dog in the room encourages kind and helpful behavior, which in turn can help boost how well you do.
If your workplace morale needs a jolt, consider a canine addition to the staff.
The quest for health and fitness can be a difficult challenge with the hectic pace of busy schedules and the bustle of the holidays.
It seems that New Year’s Day offers us all a fresh new outlook and opportunity to start the year with optimism and hope to improve our lives.
Health and fitness is a journey that requires dedication and commitment.
There is no easy quick fix, patch, pill, cleanse or detox that will replace optimal nutrition and exercise.
Sometimes we can get side-tracked by injury, self-doubt, medical issues and a host of things, which complicate and derail our health goals. It is important to never give up and always continue to fight the good fight for your health. You are worth it!
Jan. 1 is a great time to start by making a resolution to strive for health.
Here’s how:
1. Schedule your annual
A physical exam with your primary care physician or provider should be first on your list. Make sure you are up-to-date on your screening labs, preventive cancer screenings and immunizations.
If you are starting an exercise regime or have weight-loss goals, this is an excellent time to discuss your options with your doctor and create a plan that will hold you accountable at future follow-up appointments.
2. Strive for 60 minutes of exercise a day
This could be broken up into smaller bits of time throughout the day. For example, you could take the stairs at work or park farther from an entrance.
3. Find a workout partner to hold you accountable
You are much less likely to let another person down. You can keep each other on track virtually through text messages or agree to meet in person to walk or exercise.
4. Add exercise to your schedule, and hold firm
Exercise either before work or on your way home from work. It is much easier to either get it done before the day starts or before you get home.
5. Prep your work-out items the night before
If you are an early morning exerciser, get all set well in advance of the alarm going off.
Sometimes sleeping in your exercise clothes might be the trick until you get into the habit of rising early. Set your shoes out, have your water bottle filled and things ready to go.
6. Get at least eight hours of sleep
Studies have shown that adequate sleep reduces stress hormones and will help with weight loss and overall health.
7. Drink enough water
Stay hydrated. This means 64 ounces for an average size adult. (Sorry, caffeinated beverages don’t count.)
8. Cut screen time
Decrease the amount of time spent in front of screens (TV, computer, tablet, phone) and move as much as possible.
Consider walking on your lunch break or taking a 10-minute walk around the house instead of checking social media posts.
9. Fill up on fruits and veggies
Make half your plate fruits and vegetables at all meals. This is an easy way to increase the amount of healthy foods without taking the time to measure anything.
10. Know the stats
Research shows it takes 21 days to make a habit. If you fall off the wagon, climb back on. The ride is much more enjoyable when you are doing positive things for your health.
Commit to just the day in front of you and make it great. Pretty soon, you might have an entire compilation of days that could add up to a new, healthier you.
Bullied teens are more likely to develop mental health problems—and people with mental health problems are also more likely to become bullies, researchers report.
Even though many studies have shown that being bullied can leave mental scars, “no studies to date” have tested the notion that mental health issues might also help drive bullying, explained study author Marine Azevedo Da Silva. She’s a postdoctoral researcher in Columbia University’s Mailman School of Public Health, in New York City.
For the study, the researchers analyzed data from 13,200 U.S. youth, aged 12 to 17, and found that:
79% said they’d never bullied others
11% said they’d bullied others over a year ago
10% said they’d bullied others in the past year
16% said they’d bullied others over a month ago
5% said they’d bullied others in the past month
Youth who said they’d been bullies were more likely to have a moderate to high rate of mental health problems than those who said they hadn’t bullied others.
The study also found that teens with moderate to high rates of mental health problems were more likely to bully others, compared to those without such issues.
In other words, the link between mental health issues and bullying “is likely to be bidirectional,” Azevedo Da Silva said in a school news release.
According to study senior author Dr. Silvia Martins, the findings suggest that efforts to stem bullying “should consider how to take into account and handle negative feelings and mental health problems” of young perpetrators.
Martins directs the Substance Abuse Epidemiology Unit at Mailman.
It’s estimated that between 18% and 31% of U.S. youth are involved in bullying, the researchers noted.
The study was published recently in the Journal of Adolescent Health.
“Baby boomers are a lot more willing to embrace hearing aids than their elders were,” said Debbie Youngsma, AuD, CCC-A, an audiologist with Spectrum Health Medical Group. “They are into their smartphones. They are into all that technology. And hearing aids are smart.” (Chris Clark, Spectrum Health Beat)
There long has been a big gap between the number of people with hearing loss and those willing to wear a hearing aid.
But tech-savvy baby boomers just might be the ones to narrow that gap.
“Baby boomers are a lot more willing to embrace hearing aids than their elders were,” said Debbie Youngsma, AuD, CCC-A, an audiologist with Spectrum Health Medical Group. “They are into their smartphones. They are into all that technology. And hearing aids are smart.”
The number of people with hearing loss is growing as rapidly as hair is graying in the baby boomer population.
According to a recent federal report, 17 percent of Americans—1 in 6—say they have trouble hearing. Not surprisingly, the number increases with age. Forty-three percent of those over 70 report hearing loss.
Those self-reported numbers likely don’t capture the full picture, Youngsma said.
People don’t always recognize when they have trouble hearing. Why? The loss may occur too gradually to notice. They may have never had their hearing checked. Or they could be in denial.
“Less than 21 percent of those with hearing impairment are wearing hearing aids,” she said.
Those who do get hearing aids wait an average of seven to 10 years to seek help. That’s a lot of missed conversations.
Accepting the technology can mean a big difference socially and emotionally, Youngsma said.
“Untreated hearing loss usually results in isolation and withdrawal from social situations,” she said. “They can get depressed, frustrated and lonely.”
“Obviously, the earlier you get (hearing aids), the easier it’s going to be to adjust and get back into the world of hearing.”
Tired of saying, ‘What?’
Rochelle Morris, 52, said she didn’t realize how much she missed before she got hearing aids two years ago.
She traces problems with her left ear to a car accident in 2004, when the air bag deployed and slammed into the left side of her head.
She started noticing problems hearing about five years ago. She often asked co-workers or family members to repeat something. She missed the punchlines of jokes.
“I felt myself not doing things because I didn’t want to say, ‘What?’ or ‘Say that again,’” she said.
Morris resisted the idea of wearing hearing aids—until she saw how small and unobtrusive they are.
“I pictured an old person and was really kind of embarrassed about it,” she said. “I didn’t need to be, because you don’t even notice it.”
Within a couple of days, she embraced the technology.
Youngsma said she is encouraged to see the stigma waning, particularly among the young baby boomers.
Many are still in the workforce, and communication is crucial to performing their jobs. They also are more likely than their elders to see a hearing aid as just one more technological device—to add to their tablet, laptop, smartphone, Kindle, FitBit or Apple Watch.
“You can act like you’re texting while you’re changing what the hearing aids are doing,” she said.
For Morris, hearings aids opened up a world of sounds she had missed—from the wind blowing through the trees to conversations with her husband, Brian, and their children, Anna and RC.
And when she could hear better, her balance improved.
Causes of hearing loss
Injuries, like the one Morris sustained, are one of several causes of hearing loss, Youngsma said. Others include aging, ear infections, cancer treatments and exposure to noise—either cumulative or one loud burst.
And remember when your parents would tell you to turn down your music? Well, they were on to something. Going to loud concerts, or listening to loud music with ear buds, can take a toll on your hearing.
Impacted ear wax also can cause temporary problems with hearing.
“Hearing loss is the third most common complaint, following hypertension and arthritis, in older adults,” Youngsma said.
Older women, beware: New research warns that drinking a lot of diet sodas or artificially sweetened fruit juices may increase your risk for stroke.
In a study that tracked nearly 82,000 postmenopausal women, those who drank two or more diet drinks per day saw their overall stroke risk rise by 23 percent, compared with those who consumed diet drinks less than once a week.
Blocked arteries were often the main culprit, with heavy diet drink consumption linked to a 31 percent greater risk for an ischemic stroke, which is triggered by a clot, the study findings showed.
Study author Yasmin Mossavar-Rahmani acknowledged that an “association does not imply causation.” But she stressed that the findings held up even after taking into account the nutritional value of each participant’s overall diet.
So, “we can’t assume these diet drinks are harmless, particularly when consumed at high levels,” Mossavar-Rahmani said.
“The take-home message is that these findings give us pause,” she added. “We need to do more research on why we are seeing these associations. What are the scientific mechanisms? Is there something about the artificial sweeteners, for example, that affect the bacteria in the gut and lead to health issues?”
Mossavar-Rahmani is an associate professor in the department of epidemiology and population health’s division of health promotion and nutrition research at Albert Einstein College of Medicine, in New York City.
The study authors pointed out that the American Heart Association has recently underscored the lack of sufficient research into the cardiovascular impact of diet sodas. Until more work is done, the AHA says the jury remains out on whether artificially sweetened beverages do or do not hasten heart disease.
Women in the latest study were between 50 and 79 when they first enrolled in the Women’s Health Initiative trial between 1993 and 1998.
Investigators tracked the general health of all the enrollees for an average of nearly 12 years. During that time—at the three-year mark—all the women were asked to indicate how frequently they consumed diet sodas and diet fruit drinks over a three-month period.
The researchers did not take note of which brands of artificially sweetened drinks the women drank and so did not know which artificial sweeteners were being consumed.
That said, nearly two-thirds of the women consumed diet sodas or drinks very infrequently, meaning less than once a week or never. Only about 5 percent were found to be “heavy” consumers of artificially sweetened drinks.
After taking into consideration a variety of stroke risk factors—including blood pressure status, smoking history and age—the study team concluded that heavy consumption of diet drinks did appear to be tied to cardiovascular risks in a number of ways.
For example, those women who drank two or more diet beverages a day saw their overall risk for developing heart disease increase by 29 percent. They were also 16 percent more likely to die prematurely from any cause.
Certain groups fared even worse: Among obese women and black women with no history of heart disease or diabetes, a diet drink habit pushed clot-driven stroke risk up by roughly twofold and fourfold, respectively, the researchers reported.
Whether or not the findings would apply to either men or younger women remains unclear, the study authors noted.
The findings were published online recently in the journal Stroke.
Lona Sandon is program director of the department of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.
She agreed that more research is needed to further explore a possible diet drink-heart disease connection. But for now Sandon offered simple advice: diet or regular, sodas offer no nutritional value other than calories.
“If they replace other drinks, such as milk and 100 percent fruit or vegetable drinks, then these women miss out on valuable nutrition for protecting the heart and vascular system,” Sandon warned.
“The nutrition you are missing because you are drinking artificially sweetened beverages instead may be the real problem,” she said.
A group representing the artificial sweetener industry offered another caveat about the findings — that many women who drink diet drinks are already struggling with weight issues.
“It is likely study subjects were already at a greater health risk and chose low-calorie sweetened beverages to manage their calorie and sugar intake as these products are proven safe and beneficial for those managing their weight and blood glucose levels,” said Robert Rankin, president of the Calorie Control Council.
“The contribution of reverse causality, meaning that individuals already at a greater risk of stroke and cardiovascular events chose low-calorie sweetened beverages, is very likely the cause of the associations presented by these researchers,” the council added in a statement.
Researchers likely have a ways to go before they’ve perfected a cat vaccine that alleviates allergic reactions in humans. (Courtesy Spectrum Health Beat)
“This is an interesting concept,” said Theodore Kelbel, MD, section chief of allergy and immunology at Spectrum Health. “However, there is much to be studied before this will translate to regular practice.”
The vaccine would be administered to cats in three doses over nine weeks, with some cats getting a booster shot six months later, Dr. Kelbel said. The injections would be administered in the cat’s hind legs. It can be given to any cat at any age, but a booster shot may be necessary. Consequently, the effect on the feline protein may not be immediate.
Purr-fect solution?
In theory, humans would benefit because the cats would only need the three shots and a booster.
People who require allergy shots, on the other hand, typically get them on a more continuing basis.
Dr. Kelbel said individuals usually receive weekly shots for a few months, returning to a physician each month for a shot over a three- to five-year period. They also require booster shots if a cat lives in the house.
Allergy shots for humans have been around for decades and they work reasonably well, Dr. Kelbel said.
Researchers have plenty of testing to do on the cat vaccine, Dr. Kelbel said. They need exposure studies in which immunized cats would come into contact with humans who have known allergies to the felines.
They also need to conduct long-term studies, he said.
If a cat is still producing the protein in smaller amounts, it could build up over time and eventually affect humans again.
Other companies continue to research new medications or shots for people, which could improve the currently available treatments. But “the research is still very, very early,” Dr. Kelbel said.
From a common sense standpoint, there remains a leading solution for a person allergic to cats: Avoid contact with the animal.
That is, until researchers fine-tune their vaccine.
“I think it will be a few years, at minimum, before they can tell us (the vaccine) will be clinically beneficial for cat allergy patients,” Dr. Kelbel said.
Many of my patients come to see me about symptoms and health issues they are experiencing, but I make it a point to help them recognize when they are at risk for something they don’t yet have.
This is especially true if they have increased risk factors for specific diseases or various health problems. There are changes they can make to help prevent these issues.
One of my patients, who I’ll call Judy, was faced with some life-changing decisions she needed to make, so we sat down and talked about what was happening in her life.
Judy’s mom had recently been diagnosed with end-stage endometrial cancer, and Judy wanted to know how she could shape her own future to be different from her mom’s. We first looked at Judy’s current health and how she was handling perimenopause.
For the most part, she was taking her perimenopausal symptoms in stride, but she struggled with weight gain (especially around her middle) and she was a smoker. She was afraid to quit smoking, fearing that she would gain even more weight.
As with all of my menopause patients, we discussed what she wanted her Picture of Self to look like at a specific point in her future and what she had planned to help her achieve her goals.
Before we discussed the changes Judy could make, we talked about some of the well-defined risk factors of endometrial cancer that she can control.
Excess estrogen increases the risk of endometrial cancer because it induces the lining of the uterus (endometrium) to grow. When this growth occurs unchecked, there is a risk of abnormal or cancerous development. Progesterone acts as a natural balance by stabilizing the endometrium and keeping it from growing out of control.
Excess estrogen can occur for two reasons: the levels can increase naturally during perimenopause, or there may be too much “unopposed” estrogen if you take estrogen-containing medications without balancing them with progesterone.
Low-dose combination oral contraceptives and appropriate doses of hormone therapy can help prevent endometrial cancer by controlling the level of circulating hormones and thus the growth of the lining of the uterus. Progesterone-releasing IUDs also help control the growth of the endometrium and decrease the likelihood of abnormal growth.
Finally, Judy and I discussed some lifestyle habits that can make a significant impact on her risk of developing endometrial cancer.
Smoking increases the risk of developing many cancers—another great reason to quit! Weight loss can help to decrease the risk, because estrogen, like many hormones, is stored long-term in body fat. Therefore, decreasing the body fat reduces the excess estrogen in your body. Other healthy changes you can make include increasing your physical activity, and eating a diet low in saturated fats and high in ruits and vegetables.
After talking with Judy, she was much more optimistic about her future. She has a clear understanding of her specific risk factors, specifically her smoking and central obesity. She has also regained a sense of control, and by making healthy choices, she is continuing to work toward her goals.
Studies have found associations between artificially sweetened beverages and increased risk of stroke and heart disease. (Courtesy Spectrum Health Beat)
The health risks of sugary drinks, from juice to soda, are well known.
They can lead to overweight and diabetes, stroke and other problems in the brain, including poorer memory and smaller brain volume.
But diet sodas aren’t the answer.
A number of studies have found an association between artificially sweetened beverages and an increased risk of stroke, heart disease, heart attack and other heart-related deaths in women.
The most recent was published earlier this year in the journal Stroke, with researchers suggesting that, even without identifying a specific cause and effect, people should seriously consider the potentially harmful effects of artificially sweetened drinks.
And there’s more.
Researchers at the Boston University School of Medicine followed 4,000 people of both sexes over 10 years.
Using MRI tests, they linked just one artificially sweetened soda a day to brain changes that can lead to dementia, as well as the type of stroke caused by a blockage in a blood vessel.
These risks were triple those of people who don’t drink diet sodas.
It didn’t seem to matter which common artificial sweetener—saccharin, aspartame or sucralose—was consumed.
While some people see diet soda as a way of weaning off regular soda, it may be healthier in the long run to skip this type of transition.
If you like soda’s carbonation more than the better option of water, flavor plain seltzer with a squeeze of your favorite citrus fruit, a few crushed berries or both.
For variety, try freshly grated ginger, chopped mint or a teaspoon of vanilla. Also consider replacing soda with a glass of milk—you’ll get important protein and a shot of calcium in the bargain.
Even if your yearly physical isn’t scheduled for several months, there are questions you should ask your doctor, physician assistant, or nurse practitioner during your appointment.
Here are five questions you should ask at your checkup:
1. What is my risk for a heart attack?
It’s important to know what factors are in your control and which ones are out of your control when it comes to your risk for a heart attack. I recently saw a patient for her annual exam and she told me she had experienced a scare with chest pain since her last yearly physical.
A visit to the ER revealed a problem with her gallbladder instead of a heart issue. She knew she had high cholesterol and her weight put her at risk for heart disease, but she wasn’t too concerned about her numbers. After her recent scare with chest pain, she began to care a great deal more. So, she asked me what she needed to do to keep her risk as low as possible.
First we looked at her family history. Her father had experienced a heart attack but not until age 72, and her mom was healthy, with no heart disease. She didn’t have pre-eclampsia during pregnancy and had not experienced gestational diabetes. All of this showed that the things she could not change were in her favor—good news!
Next, we looked at things she could change: cholesterol (overall 240—high), triglycerides (180—high), HgA1C level used to test for diabetes (5.7 percent—borderline high), CRP level (2.5—indicates an average risk for heart disease), waist circumference (39—very high), and blood pressure (142/89—high).
The reality was that the factors she could control were increasing her risk of heart disease. In addition, her health habits could be improved. She walked three days a week but didn’t do any strength training, and her diet was mostly meat and potatoes with a salad thrown in once in a while.
So, together, we mapped out a plan to include some dietary changes and add at least two Zumba classes each week, plus water aerobics on the weekend. She also promised to buy the book Sugar Busters to help her learn about healthy versus unhealthy sugars.
2. What is my risk for breast cancer?
We use a scale called the Gail Model to measure breast cancer risk. It includes your family history, your age when you started your period, whether or not you have been pregnant, whether you ever had breast biopsies, and how old you were with your first pregnancy.
Other risk factors we study include your alcohol intake, Body Mass Index (BMI), and current activity level. I recently had a patient who had a significant risk of developing breast cancer based on the following factors: her sister had breast cancer, she had early onset of periods, and she had chosen to not have children. She made an appointment at the high-risk breast clinic and made the personal choice to have a mastectomy. The results revealed extensive DCIS (Ductal Carcinoma In Situ), which indicates pre-cancer in many women.
For this patient, understanding her risk saved her life and early treatment allowed her to continue taking hormones. Even if your risk of developing breast cancer is low, it’s important to talk to your physician about the risks and follow the guidelines suggested for mammograms. If it’s time, get it done.
3. What is my risk for osteoporosis?
Bone health starts early—in the womb, to be exact.
Our bones begin to be formed based on the amount of Vitamin D and Calcium our mothers take when they are pregnant. After we are born, our bone health depends on our diet and activity level. By age 32 our bone mass reaches its peak, and we experience overall loss the rest of our lives.
Our bones are constantly being remodeled. Over time, breakdown occurs more rapidly than buildup. During menopause, if there is no estrogen replacement, the bone loss accelerates to a rate that increases the risk of fracture.
Several factors can make us lose bone even faster than normal aging: smoking, inactivity, consuming large amounts of soda water or pop, drinking more than two alcoholic beverages per day, hyperthyroidism, and conditions such as rheumatoid arthritis.
Long-term use of birth control hormones such as Depo, as well as taking drugs used to fight breast cancer, can also increase bone fragility. Of course, there are medications to improve bone strength, but the most important way to prevent fracture is to live a healthy lifestyle and eat a balanced diet.
4. What is my risk for colon cancer?
Colon cancer is very common, and the strongest risk factor is aging. Everyone needs a screening colonoscopy at age 50, but some of us need it sooner. If you have a family member who has had large colon polyps or colon cancer before 50, you are at high risk of having the same. Ask your doctor about early screening if you fit into this category.
Also, if you are experiencing persistent, unexplained symptoms such as lower pelvic or abdominal pain, a persistent change in bowel habits (lasting more than two weeks) or blood in your stool, you might need a colonoscopy to see what is causing these issues.
You can reduce your risk by living a healthy lifestyle: consuming less than two alcoholic drinks a day; eating a maximum of two servings of red meat per week; eating a high fiber diet; and exercising at least five days per week. Remember—a colonoscopy is much less stressful than colon cancer. If it’s time, get it done.
5. What immunizations do I need?
There are several immunizations that are recommended, and I encourage you to discuss these with your healthcare provider:
A flu shot before winter arrives.
The Hepatitis A and Meningococcus vaccines if you are heading off to college soon.
The Gardasil vaccine if you are under 29 and have not had this series yet.
The Gardasil vaccine if you are newly single, over 29, and HPV negative.
The Tdap (including Pertussis) once in your lifetime.
A Td (tetanus) vaccine every 10 years.
The Shingles vaccine at age 60.
The Pneumococcal vaccine at age 65.
Be sure to ask your doctor to look at your immunizations record and confirm that you are up to date on all of these.
The bottom line is that it is your responsibility to maintain your health and keep a journal or record of your health history. As you send your kids off to school each year, use that time as a reminder to pull out your book and make sure you are on track.
The rise in colon cases among younger adults that’s been seen in the United States is also occurring in wealthier nations worldwide, new research shows.
In the decade leading up to 2014, the number of cases of colon cancer among people under 50 increased by 3% a year in Denmark, New Zealand, Australia and Canada and by 1% per year in Britain.
The increase was most pronounced among those aged 20 to 29, noted a team led by Dr. Marzieh Araghi, from International Agency for Research on Cancer in Lyon, France.
Among twenty-somethings, colon cancer cases rose by 18% a year in Denmark and 11% in Norway, according to the study published in The Lancet Gastroenterology & Hematology.
“Although the incidence of colorectal cancer in adults younger than 50 years remains much lower compared with that in older age groups, our findings are of concern and highlight the need for action to counteract the rising burden of the disease in younger people,” Araghi said in a journal news release.
The increase in cases among the young runs counter to declines in colon cancer among people over 50, the researchers pointed out.
For example, between 2004 and 2014 cases of colon cancer fell each year among people over 50—by 2% in Australia and Canada, 3% in New Zealand and 1% annually in the U.K.
Colon cancer remains a huge global killer.
According to the research team, in 2018 alone nearly 2 million cases of colon cancer were diagnosed and the disease claimed 881,000 lives worldwide.
But why the surge among the young? According to Araghi, the increase is likely driven in part by increases in certain risk factors, specifically obesity and poor diet.
On the other hand, he said, the decrease in colon cancer among people over 50 is most likely due to better screening stool tests or colonoscopy that catches tumors early.
Dr. David Bernstein is chief of hematology and a gastrointestinal specialist at Lenox Hill Hospital in New York City. Reviewing the new report, he said similar data has already changed medical practice in the United States.
“The U.S. findings have led to updated (American Cancer Society) colon cancer screening guidelines, which now recommend the initiation of colon cancer screening at age 45, as opposed to previous guidelines recommending the initiating of screening at age 50,” Bernstein noted.
Early screening and detection could bring colon cancer numbers down again among the young, he said.
Dr. Elena Ivanina is a gastroenterologist at Lenox Hill Hospital in New York City. She believes younger Americans need to pay more heed to avoiding colon cancer risk factors.
“This includes things like obesity, diet, smoking and other carcinogens,” she said. “Patients should discuss their colon cancer risk with their physician and not ignore any symptoms like rectal bleeding, no matter what their age.”
In the meantime, Bernstein said, “perhaps the more important question is ‘why in high income countries is the incidence of colorectal cancer increasing among young adults, and what factors are leading to this?’” Bernstein said. “Significant work needs to be done to answer this critical question.”
In experiments using mice, researchers found some populations of fungal species increased at a higher rate in a cancerous pancreas. (Courtesy Spectrum Health Beat)
Fungi living in the gut can move into the pancreas, triggering changes to normal cells that can result in cancer, a new study suggests.
The finding could advance the prevention and treatment of pancreatic cancer, which is usually fatal because it’s often detected too late.
The disease has been in the news lately because “Jeopardy!” host Alex Trebek is waging a battle against an advanced form of the illness.
The new research focuses on a particular form of the cancer, called pancreatic ductal adenocarcinoma, which can be fatal within two years.
While the exact causes of pancreatic cancer remain unclear, the American Cancer Society has long recognized that viruses, bacteria and parasites can help spur pancreatic tumors, the authors of the new study noted.
But fungi haven’t been shown to play a role—until now.
“While past studies from our group have shown that bacteria travel from the gut to the pancreas, our new study is the first to confirm that fungi, too, make that trip and that related fungal population changes promote tumor inception and growth,” study co-author Dr. George Miller said in a news release from NYU Langone Health.
Miller is co-leader of the Tumor Immunology Research Program at Perlmutter Cancer Center at NYU Langone Health, in New York City.
Pancreatic ductal adenocarcinoma is cancer of the tube in the pancreas where digestive juices drain into the intestines.
This exchange causes fungal populations in the gut and pancreas—the “mycobiome”—to become abnormal, the NYU team explained. That change may cause pancreatic cells to turn malignant.
In the new study, the researchers first looked at fungal transfer from the gut to the pancreas in mice that already had pancreatic tumors.
In those experiments, the researchers found that treating the rodents with an antifungal drug shrunk the weight of tumors from between 20% to 40% over 30 weeks.
Investigating further, the team catalogued the species of fungi in the poop of mice with or without pancreatic cancer. They even tagged the fungi with “glowing” proteins to watch the microbes travel from the gut to the pancreas.
Certain patterns emerged, with some populations of fungal species increasing at a far higher rate in the cancerous pancreases versus the non-cancerous ones.
One such cancer-linked species is called Malassezia.
“We have long known that Malassezia fungi—generally found on the skin and scalp—are responsible for dandruff and some forms of eczema, but recent studies have also linked them to skin and colorectal cancer,” study senior co-author Deepak Saxena noted in the news release.
“Our new findings add evidence that Malassezia is abundant in pancreatic tumors as well,” said Saxena, who is professor of basic science and craniofacial biology at NYU College of Dentistry. Pancreatic cancers in the mice grew about 20% faster when Malassezia was allowed to grow unchecked, the team noted.
The researchers theorized that fungi spur growth of the cancer by affecting immune system mechanisms that lead to abnormal tissue growth.
Study co-first author Smruti Pushalkar, a research scientist at NYU College of Dentistry, added, “Moving forward, one goal for our team is to determine which species are most relevant to cancer, as doing so could guide future attempts to slow tumor growth with targeted antifungal medications, and to avert side effects.”
The results of the study add evidence to the theory that fungi increase the risk for cancer by activating an ancient part of the immune system, the researchers said.
This immune response fights infections but also increases cell growth as the infection is cured. Past studies have shown that aggressive tissue growth can cause cancer when it’s combined with genetic flaws.
The report was published recently in the journal Nature.
Finances are often a source of misery at the holidays. To save money, try giving one meaningful gift to someone, rather than a barrage of soon-forgotten items. (Courtesy Spectrum Health Beat)
Stress abounds during the holiday season, but you can ease it, an expert says.
The way to manage stress is to recognize it and take steps to minimize it so it doesn’t overwhelm you, according to Cinnamon Stetler, an associate professor of psychology at Furman University, in Greenville, S.C.
One way to ease holiday stress is to avoid unrealistic expectations, such as believing the holidays will change people and family relationships.
“If your stress stems from other people’s actions, that’s largely out of your control. What you can do is limit your exposure,” Stetler said in a university news release.
Don’t obsess about family holiday traditions.
“Reflect on why that tradition is so important to you and what about it carries the meaning. See if there’s a way to adapt the tradition while still maintaining the important pieces of it,” Stetler said. “While it is good to maintain traditions, they can cause extra stress if you feel you have to do it the same way no matter what.”
Change your approach to gift-giving, which can cause financial worries.
For example, instead of buying a person several gifts, choose just one or two that will be especially meaningful.
And remember that material things provide only short-term happiness, while doing things for others and appreciating what you have can bring lasting happiness.
Take care of yourself during the holidays.
Get plenty of sleep, watch your diet, exercise regularly and find some time for yourself each day.
“Try to maintain as much of your normal routine as you can. You can treat yourself and indulge in small ways. The holidays are not the time to make big changes,” Stetler said. “Try to get a little bit of physical activity in, even if it’s a 10-minute walk around the neighborhood.”
A little pinot noir now and then might help keep the bacteria in your tummy healthy and happy.
As little as one glass of red wine a week can increase the diversity of the good bacteria in your microbiome, which can help lower bad cholesterol and keep your weight down, researchers say.
“The more people drink, the higher the diversity. But even small amounts, such as one glass of red wine every week, shows a benefit,” said study first author Caroline Le Roy. She’s a research associate in the department of twin research and genetic epidemiology at King’s College London.
Le Roy cautioned that while the findings in the study were robust, they can’t prove that red wine improves the microbiome, only that the two are associated.
It’s not the alcohol that has this effect, but rather the polyphenols in red wine. Polyphenols help feed the good bacteria in the microbiome, the researchers explained.
Polyphenols are also found in fruits and vegetables, and include antioxidants.
For the study, Le Roy and her colleagues looked at the effect of beer, cider, red wine, white wine and whiskey on the gut microbiome of 916 female twins.
Only red wine resulted in a more diverse microbiome, the investigators found.
The microbiome is a collection of bacteria in the gut that has an important role in health. A healthy microbiome helps digest food and keeps some diseases at bay.
An unhealthy microbiome can lead to poor functioning of the immune system, weight gain and high cholesterol, Le Roy said.
A microbiome with lots of different bacteria is a healthy microbiome, she added.
Le Roy’s team found that red wine improved the number of different bacteria in the microbiome, compared with those who didn’t drink wine.
The researchers were able to confirm their findings in three other groups in Britain, the Netherlands and the United States, which brought the total number of participants to nearly 3,000.
Moreover, the results remained constant even after accounting for factors such as diet, socioeconomic status and age.
Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City, thinks that drinking red wine may be a marker of a healthy lifestyle, so the health benefits may be due to other factors.
“Do they, in general, lead healthier lives, such as not smoking, eating more of a plant-based diet and exercising?” she asked.
Wine comes from grapes, which like a lot of plant foods, are rich in polyphenols, Heller said.
But polyphenols are also found in vegetables, fruits, grains, nuts, legumes and teas that don’t contain alcohol, she noted.
“In addition, plants are our only source of dietary fiber, which is the favorite food for the microbes that live in our gut. When they are healthy, they help keep our bodies healthy,” Heller said.
While drinking small amounts of red wine has apparent health benefits, there are also unhealthy effects of drinking too much, such as liver disease, certain cancers, pancreatitis and a depressed immune system, she said.
“Guzzling red wine, or any alcoholic beverage, is not the miracle we have been led to believe,” Heller said.
For those who drink, the American Heart Association recommends an average of one to two drinks per day for men, and one drink per day for women (one 12-ounce beer, 4 ounces of wine, 1 ounce of 100 proof spirits).
“Let’s be honest, most of us probably drink more than that. If you do not drink alcohol, there is no reason to start,” Heller said.
The report was published recently in the journal Gastroenterology.
Humanity has been drinking it for thousands of years. And based on the ever-growing evidence of its health benefits, there’s no reason to think we should let up anytime soon.
As Chinese legend has it, the Emperor Shennong discovered tea some 4,700 years ago when a strong wind tossed falling tea leaves into his bowl of boiling water. The emperor noticed the leaves change the water’s color and aroma. When he drank it, it soothed him.
It’s been doing that to legions of folks, princes and paupers, for eons.
The main benefits of tea are its antioxidant properties from flavonoids and catechins, but it also has other characteristics that can reduce inflammation and help with regulation of blood sugar and other systems.
Two cups of freshly brewed tea each day may protect against the development of chronic disease, while larger quantities—say, four cups a day—may lower glucose and lipid markers.
So sip away and enjoy the benefits.
Here’s what the research says:
Heart health
The most compelling evidence
is related to heart disease. As it relates to green tea and heart
health, there’s an association between lower levels of cholesterol, LDL
and triglycerides and higher levels of HDL—the “good” cholesterol.
There’s also evidence of significant lowering of systolic and diastolic
blood pressure associated with tea-drinking. Black tea in particular could contribute to a decreased incidence of heart attack.
Weight loss
Research has shown that green tea contains the ideal combination of caffeine and catechins, which work in tandem to stimulate thermogenesis. Green tea has been known to provide numerous health benefits, including the prevention of cancer and cardiovascular disease.
Glycemic control
Regular consumption of green tea and black tea has been shown to
decrease fasting blood glucose, insulin levels and hemoglobin A1C. This
can lead to an increase in antioxidants and a reduction in inflammatory
cytokines that cause insulin resistance. It may also cut down on fat
accumulation from carbs.
Arthritis
Research has shown tea’s antioxidant properties cause an anti-rheumatic effect
that may improve the physical abilities of aging populations. This
includes improvements in muscle strength, balance and performance of
daily activities.
Depression
While many Americans may not be looking at tea for its health benefits, perhaps they should. There’s even been some evidence of tea’s possible role in combatting depression.
The next time you’re in a public place, look around.
Notice how many people are hunched over using mobile devices.
Poor posture while constantly looking down at a cell phone places a lot of strain on the neck, or cervical spine. It’s called ‘text neck.’
And, according to a recent reports, it can result in permanent harm.
“When the head is upright, the upper part of the spine is correctly aligned for minimal stress on the muscles, bones and discs in the neck,” explained Nuala Crotty, MD, a physical medicine and rehabilitation specialist with the Spectrum Health Medical Group. “But when you drop the chin to the chest for long periods, you increase stress on the cervical spine and strain the muscles at the back of your neck.”
Just how much wear and tear does this constant downward gaze put on the neck muscles?
The head weighs about 10 to 12 pounds. For every inch the head tilts forward, the weight or pressure on the cervical spine increases. Bending your head forward at a 60 degree angle, for example, results in almost 60 pounds of stress weight on a neck structure that’s designed to handle much less. That’s like carrying a small child around on your neck all day.
With smartphone users now spending an average of two to four hours a day with their heads dropped down, this results in 700 to 1,400 hours a year of excess wear and tear on the cervical spine, according to the research.
Over time, this much stress can do a lot of damage. Muscles and tissues become strained, sore and inflamed, causing headaches, neck, upper back, shoulder and arm pain.
According to Dr. Crotty, if left uncorrected, text neck can lead to chronic neck pain and an increased risk of disc herniation and neck arthritis. Poor posture also decreases lung volume, interfering with the ability to breathe deeply.
“The first step is to be aware of how you hold your body while using technology,” she said. “And then, take steps to prevent problems by practicing good posture and neck alignment.”
Dr. Crotty offers these tips to avoid feeling the crunch:
Hold devices up, at eye level, as much as possible.
Take regular breaks from phones and laptops throughout the day.
Draw your shoulder blades together gently. This will naturally pull your head back and align your spine.
Tuck in your chin and gently lengthen your neck. Imagine a string at
the top or crown of your head, pulling it straight up to the ceiling.
Roll or shrug your shoulders a few times and move your neck in different directions to prevent muscles from becoming tight.
See a doctor if neck pain does not go away or if it’s associated with pain, numbness, tingling or weakness in your shoulder, arm or hands.
A great way to avoid double-dipping: Place utensils in the dip bowl so guests can scoop a dollop directly onto a plate. (Courtesy Spectrum Health Beat)
Double-dipping with a dance partner? A skillful move marked by grace and beauty.
Double-dipping with a snack at a party? Not quite so beautiful or graceful.
But definitely risky.
Using partially eaten food items such as vegetables or chips to scoop dip from a container can deposit bacteria from the double dipper’s mouth into the dip, which can make people ill if they dip into that same container, said Jessica Corwin, MPH, RDN, community nutrition educator for Spectrum Health Healthier Communities. Especially if the individual is sick.
Even a small amount of bacteria introduced by saliva can grow rapidly, perhaps to more than 100 times the initial level, potentially leading to serious illnesses such as a norovirus or herpes if the person has those viruses.
Even if the party guest is not sick, the bacteria they introduce can lead to foodborne illnesses.
While hosts and guests can take steps to protect partygoers from those who act carelessly with food, most of the precautions rest with the host.
Danger zone
For starters, dips that need to be kept cool should be placed on ice.
Dips that need to be kept warm should be placed over the proper heating
source, Corwin said.
“Forty-one to 140 degrees Fahrenheit is the danger zone,” she said. “That’s when bacteria can thrive.”
An extra-thorough host can use a thermometer to check temperatures.
The general rule: Leave food out no longer than two hours. If food is sitting outdoors, limit the time to one hour or less, depending on the temperature.
Also, set out smaller amounts of dip and replace them regularly with chilled dip stored in a refrigerator or cooler.
Some dips will grow bacteria more quickly than others, Corwin said. Runny dips, such as salsa and varieties made from sour cream, pose more of a threat than solid dips such as hummus.
And while it may be more tedious to prepare pre-portioned dip in containers, it could also be a wise move—especially if children are expected to attend the gathering.
“Kids are notorious for double-dipping,” Corwin said. As a mom of three, she speaks from experience.
Hands-free
At day’s end, there isn’t much that guests can do to protect themselves from double-dippers. One option is to bring your own food, or even abstain from eating, but that’s neither fun nor practical.
Still, precautions can be taken.
“If you’re dipping from something more solid, like hummus, take your helping from a portion not touched yet,” Corwin said.
Also, aim for dips that have serving utensils. If the host has set out serving spoons and dishes, people won’t need to double-dip—they can use the utensils to place an adequate amount of chips and dip on their plates.
Corwin emphasized the tried-and-true food safety mantra: “When in doubt, throw it out.
“As a host, anything you can do to take those extra precautions would be advisable,” she said. “You wouldn’t want any of your guests to leave sick, because you want them to come back.”
Having a type of inflammatory arthritis called gout may worsen heart-related outcomes for people being treated for coronary artery disease, according to new research.
The study, published in The Journal of the American Heart Association, sought to clarify older research on the link between cardiovascular disease and gout, which occurs in people with high levels of uric acid in the blood.
In the U.S., gout affects nearly 6 million men and 2 million women, or about 4 percent of the population, according to the Arthritis Foundation.
The buildup of uric acid can form needle-like crystals in a joint and cause sudden pain, tenderness, redness, warmth and swelling, often in the big toe. But it’s also associated with a greater risk of kidney disease, diabetes, cancer and sleep apnea.
Researchers from Duke University studied data from more than 17,000 patients, including 1,406 who had gout at the start of the study and were being treated for cardiovascular risk factors. After following patients for an average of 6.4 years, researchers found that “in spite of aggressive medical therapy,” the gout was linked to worse outcomes and death.
“Among patients who had gout at the beginning of the study or who developed it during follow-up, their risk of either dying of cardiovascular disease or having a heart attack or stroke was 15 percent higher than patients who never developed gout,” said the study’s lead author, Dr. Neha Pagidipati, a cardiologist and assistant professor at Duke University School of Medicine in Durham, N.C.
Patients who had gout at any point during the study had a twofold increased risk of heart failure death compared to people who never developed gout.
While past research showed people with gout have an increased risk of cardiovascular disease, “a lot of those studies were done decades ago, before modern preventative therapy like statins became extremely common,” Pagidipati said. “We wanted to take a more contemporary look at the relationship between gout and future heart disease in patients with known coronary artery disease.”
Many patients don’t even realize a link exists between gout and heart problems, she said, and the new findings show the need for patients to talk to their physicians about added risks.
“Also, from a physician’s perspective, it’s important to consider that patients with gout may be at increased risk for cardiovascular disease even if they’re already treating them with all the standard therapies. It’s something to have on their radar,” Pagidipati said.
Although it’s unclear why gout might increase the risk of cardiovascular disease, she said possible reasons include increased oxidative stress and inflammation.
“We know that people who have a high level of inflammation are at an increased risk for cardiovascular disease, and we also know gout is characterized by periods of acute inflammation: The link may have to do with that,” she said.
Dr. Jasvinder Singh, who was not involved in the study, said the new research may help the public understand how insidious gout can be.
“Gout is not just a disease of the joints: It’s a disease that causes inflammation in the joints and in the body. It’s not just a pain in the toe, it affects other organs, too, including the heart,” said Singh, a gout researcher and professor of medicine and epidemiology at the University of Alabama at Birmingham.
Singh said the new study underscores the potential dangers of ignoring even occasional episodes of gout.
“Patients may say, ‘I have an attack every two years, so shouldn’t I wait (for treatment) until it becomes more frequent?’ But in light of studies such as this one,” he said, “patients might want to take that into account and know that leaving gout untreated might be affecting their cardiovascular health.”
Federal health guidelines urge us to spend half an hour each day moving with enough vigor to boost the heart rate. But half the U.S. population fails to squeeze in time for it.
To encourage us to make exercise a priority, Thomas Boyden, MD, a Spectrum Health Medical Group preventive cardiologist, details the many ways physical activity can make our lives better.
His top 10 reasons to exercise can provide a little motivational boost to put down the smartphone and pick up the pace.
Routine exercise:
Lowers blood pressure
Lowers blood sugar
Helps control cholesterol
Builds bone strength
Helps prevent dementia
Fights depression, stress and anxiety
Improves balance
Reduces risk for heart attack and stroke
Aids weight control
Helps you sleep better
Exercise does not have to mean running a marathon, Dr. Boyden said. But it should involve activity more vigorous than a leisurely stroll.
“I say walking the dog doesn’t really qualify as exercise,” he said. “I have a dog and I know how often they stop.
“We want the heart rate to increase and we want it increased for sustained periods of time. That’s proven by research to lower your risk of events like heart attack and stroke.”
Those with physical limitations, because of weight, arthritis or other health issues, can still be active, he added.
“Particularly when you get older and have joint problems, I encourage people to figure out ways to do seated exercises, so they can take the weight off the joints and exercise without pain,” he said.
The Centers for Disease Control and Prevention advises people to exercise at least 150 minutes a week (two hours and 30 minutes). Doctors often recommend breaking it into 30-minute sessions because it sounds less daunting, said Dr. Boyden.
“It’s possible and usually easy to do 30 minutes of anything,” he said.
Sedentary sickness
More than 70 percent of Americans are overweight or obese, which can
lead to a number of health problems, Dr. Boyden said. These include:
Diabetes and high blood pressure, which can lead to cardiovascular disease
Increased risk of cancer, blood clots, depression and early-onset dementia
Problems with menstruation
Gastrointestinal issues
Sleep apnea
Joint problems, leading to a need for hip and knee replacements
“We are getting sicker as a country because we are getting bigger and more sedentary,” he said.
Excess weight and a sedentary lifestyle drive heart disease, which is the No. 1 killer of both men and women, according to the CDC.
“The strongest data shows if we all maintained a healthy weight, ate healthy, did just a little bit of exercise and didn’t smoke, at least 80 percent of our country would likely never have a heart problem,” Dr. Boyden said.
“I’m a big lifestyle advocate,” he said. “Everything we do for ourselves is as meaningful, if not more meaningful, than the services provided by a health care system.”
Following the recipe for food safety is a must anytime you’re in the kitchen—and it starts with clean hands, the Academy of Nutrition and Dietetics says.
“Always wash your hands with soapy water for at least 20 seconds before and after handling food,” spokeswoman Isabel Maples advised in an academy news release. “Don’t forget to wash your hands after handling raw meat and poultry to avoid spreading germs through the juices.”
Wash fruits and vegetables, but don’t wash meat and poultry before cooking. Doing so could spread harmful bacteria to your sink and surrounding kitchen areas, she explained.
“Clean your countertops with hot, soapy water. Use paper towels or disinfectant wipes, instead of washcloths or sponges, which can harbor bacteria,” Maples said.
Take apart small appliances—such as can openers and blenders—to clean them, then air dry completely before storing, she recommended.
“Clean your refrigerator every few weeks to rid it of potentially dangerous residue from raw foods. Rid your refrigerator of leftovers after four days. When in doubt, throw it out,” Maples said.
Use a food thermometer when cooking meat—it’s the only real way to know if it’s done, she suggested.
“Insert the thermometer into the thickest part of the meat, without it touching the bones or the bottom of the pan, to avoid getting a false reading. Then clean your thermometer with hot, soapy water after each use,” Maples said.
Keep hot foods hot and cold foods cold and refrigerate perishable foods within two hours, or within one hour during warmer weather.
Thaw frozen foods in the refrigerator, in cold water or in the microwave—not on the counter. Pathogens multiply fast when foods are in the “danger” zone between 40 degrees and 140 degrees.
“Store foods in the correct area of the refrigerator,” Maples said. “To minimize the risk of raw juices dripping into other foods, put cooked and ready-to-eat foods at the top and raw meats and poultry at the bottom. Plus, place raw meats in a container to catch any drips.”
While the biological processes are still a bit murky, researchers suspect a proper night’s rest gives your brain a chance to rid itself of toxic molecules. (Courtesy Spectrum Health Beat)
The deep stages of sleep may give the brain a chance to wash itself free of potentially toxic substances, a new study suggests.
Researchers found that during deep sleep, the “slow-wave” activity of nerve cells appears to make room for cerebral spinal fluid to rhythmically move in and out of the brain—a process believed to rinse out metabolic waste products.
Those waste products include beta-amyloid—a protein that clumps abnormally in the brains of people with dementia, said researcher Laura Lewis, an assistant professor of biomedical engineering at Boston University.
Lewis stressed that the findings, reported in a recent issue of Science, do not prove that deep sleep helps ward off dementia or other diseases.
But the ultimate goal of research like this is to understand why poor sleep quality is linked to higher risks of various chronic conditions, from dementia to heart disease to depression, she said.
Researchers have known that cerebral spinal fluid helps clear metabolic byproducts from the brain, so that they do not build up there.
They’ve also known that the process appears to amp up during sleep.
But various “hows” and “whys” remained.
So the investigators recruited 11 healthy adults for a sleep study using noninvasive techniques: advanced MRI to monitor fluid flow in the brain and electroencephalograms to gauge electrical activity in brain cells.
Sleep is marked by REM and non-REM cycles.
During REM sleep, breathing and heart rates are relatively higher and people often have vivid dreams.
Non-REM sleep includes stages of deep—or slow-wave—sleep. During those stages, there’s a slow-down in brain cell activity, heart rate and blood flow, and research has found that deep sleep may aid memory consolidation and allow the brain to recover from the daily grind.
“There are all these fundamental things your brain is taking care of during deep sleep,” Lewis said.
Her team found that housecleaning may be one.
When study participants were in deep sleep, each pulse in slow-wave brain activity was followed by oscillations in blood flow and volume, which allowed cerebral spinal fluid to flow into fluid-filled cavities in the central brain.
The spinal fluid moved in “large, pulsing waves” that were seen only during deep sleep, Lewis explained.
Based on what’s known about the work of cerebral spinal fluid, experts said it’s reasonable to conclude that slow-wave sleep promotes the flushing of waste from the brain.
The study “elegantly” illustrates the importance of deep sleep, according to Dr. Phyllis Zee, a sleep medicine specialist not involved in the work.
It “helps to explain how and why sleep is important for keeping neurons healthy—facilitating the removal of toxic molecules,” said Zee, a professor of neurology at Northwestern University Feinberg School of Medicine, in Chicago.
“One can think of sleep as a top way to take care of your brain,” she said.
Another sleep medicine specialist agreed.
“There is growing evidence, with this study and others, that sleep plays a role in clearing toxins from the brain,” said Dr. Raman Malhotra, an associate professor of neurology at Washington University in St. Louis.
Other research has suggested that sleep loss can promote the buildup of “unwanted proteins” in the brain, said Malhotra, who also serves on the board of directors of the American Academy of Sleep Medicine.
A recent government study, for instance, found that one night of sleep deprivation triggered an increase in beta-amyloid in the brains of healthy adults.
“As we learn more about this role of sleep,” Malhotra said, “it may help explain why individuals who don’t get enough sleep, or suffer from sleep disorders, are at higher risk of certain chronic health conditions.”
The latest study involved younger adults with no health problems.
Lewis said that it will be important to find out whether healthy older adults, or people with certain health conditions, show any differences in cerebral spinal fluid dynamics during deep sleep.
A big question for future research, she said, will be whether alterations in those dynamics precede the development of disease.
Reprinted with permission from Spectrum Health Beat.
Researchers say even a few extra minutes off the sofa each day can add years to your life span.
“If you have a job or lifestyle that involves a lot of sitting, you can lower your risk of early death by moving more often, for as long as you want and as your ability allows—whether that means taking an hour-long high-intensity spin class or choosing lower-intensity activities, like walking,” said study lead author Keith Diaz.
He’s assistant professor of behavioral medicine at Columbia University in New York City.
The new study involved nearly 8,000 American adults, aged 45 and older. Each wore physical activity monitors for at least four days as part of research conducted between 2009 and 2013. The investigators then tracked deaths among the participants until 2017.
The results: People who replaced just 30 minutes of sitting per day with low-intensity physical activity lowered their risk of an early death by 17 percent, according to the recent study published online in the American Journal of Epidemiology.
More intense exercise reaped even bigger rewards, the researchers said.
For example, swapping a half-hour per day of sitting for moderate-to-vigorous exercise cut the risk of early death by 35 percent.
And even just a minute or two of added physical activity was beneficial, the findings showed.
“Physical activity of any intensity provides health benefits,” Diaz said in a university news release.
His team pointed to a recent study that found that one in every four U.S. adults sit for eight-plus hours per day.
Two experts in heart health believe that level of inactivity can be a killer.
“Exercise, at any risk level for cardiovascular disease, is shown to improve not only how long one lives, but also lowers the risk of heart attacks and strokes,” said Dr. Satjit Bhusri, a cardiologist at Lenox Hill Hospital in New York City.
And heart specialist Dr. Guy Mintz said there are many ways Americans can change their slothful ways. He directs cardiovascular health at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, N.Y.
The American Heart Association currently recommends “moderate aerobic activity for 150 minutes per week or vigorous aerobic activity for 75 minutes per week,” Mintz said.
“Some American companies, like Google, are taking note of the importance of exercise and the deleterious consequences of a sedentary existence, including increases in obesity, diabetes and heart disease,” Mintz added. “Employees are encouraged to get up from their desks and exercise—whether that is in the form of stretching, ping pong, walking, jumping jacks, treadmill or stationary bicycle.”
He believes other companies could follow that example.
“Employers with tight work schedules should carve out mandatory time daily for their staff to exercise and make it fun,” Mintz said. “Both the employer and employee benefit. Companies also win with higher productivity, less sick days, lower health costs and improved morale.”
For his part, Diaz said future research will “look at the risk of specific cardiovascular outcomes, such as heart attack, heart failure and cardiovascular-related deaths, associated with physical activity versus sedentary behavior.”
South Vietnam’s Central Highlands was no place to be in 1969.
Double-rotored Chinook helicopters delivered Army Sgt. Scott Chesser, 19, and his soldiers into the enemy mountains, where they fired 33-pound Howitzer shells to support U.S. troops.
“When bullets were zinging around the LZ, when bullets bounced off (the helicopter), it was kind of disconcerting,” deadpans Chesser, now 70, Texas in his voice.
There was another unseen enemy: Agent Orange, a notorious defoliant, now known to cause numerous long-term disorders.
Chesser’s type 2 diabetes is presumably caused by dioxin, the problematic ingredient in the jungle defoliant.
On this summer afternoon, the retired oil industry design technician weighs 210 pounds and is 6 feet, 1.5 inches in height. “I used to be 6’3” before gravity took over,” he wryly notes. His A1C—a long-term blood sugar measure—is 5.6, the upper range of normal. He no longer takes insulin shots. His blood sugar readings average 100 to 110. About normal.
The diabetes connection
Among Vietnam veterans, combat-related diabetes passed post-traumatic stress disorder as the No. 1 cause for disability payments to Vietnam veterans eight years ago.
Courtesy Scott Chesser
Because Chesser was in combat where Agent Orange was used, he is “presumed” by the U.S. Department of Veterans Affairs to have been in contact with the toxic defoliant. Harmful effects from Agent Orange were not known until years later.
About 270,000 Vietnam veterans are compensated for having diabetes, according to the Department of Veterans Affairs. Chesser does not receive payments.
In 2001, type 2 diabetes was named by the VA among a list of maladies believed tied to Agent Orange. Veterans no longer have to prove contact or a direct link. Service must be from Jan. 9, 1962, through May 7, 1975.
Chesser says Agent Orange was not as widely used in his area, and there is no evidence he or his firing battery came into contact with any.
That is a point of controversy. One in four Americans 65 or older has type 2 diabetes; that compares to one in eight overall. Once called “adult-onset” diabetes, a body’s blood sugar is consistently too high. It can lead to amputations, blindness, heart disease, stroke, kidney damage and nerve damage.
In 2001, the VA added diabetes to its Agent Orange complications after the National Academy of Sciences found “limited/suggestive” evidence due to increased insulin resistance. It was the year after Chesser’s diagnosis.
Life after Vietnam
In 1969, the Army’s storied 1st Cavalry Division (Airmobile) was
mounting a counter-attack after North Vietnam’s surprise Tet New Year
offensive.
Chesser’s was the Vietnam of combat movies. Heavy-lifting Chinooks, with their distinctive rotors front and aft, sped 7,000-pound Howitzers over perilous mountains. He was based near the demilitarized zone, the contested border between North and South Vietnam. (“You know why it’s called the DMZ? he asks. “Dead Marine Zone.”)
From landing zones hacked into the jungle, artillery batteries fired the cannons at targets miles away to support foot soldiers searching for the enemy. Sometimes they targeted ammo dumps and harassed enemy patrols. Chesser’s landing zone was LZ Action, just below Mang Yang Pass. The steep, narrow choke point was known for enemy snipers and ambushes on US convoys.
Chesser survived the jungle, Viet Cong guerrillas and North Vietnamese soldiers for 365 days. But No. 366 and 367? His return flight on Flying Tiger airway was grounded.
Enemy missiles targeted the Cam Rhan Air Base runway.
“Now, those two days really irritated me,” he said, his humor dry as a Texas oil well.
After the war, Chesser learned electrical and mechanical engineering. He designed and oversaw equipment used to find oil, from the swamps of Louisiana to the remotes of Oklahoma. A test hole was bored. Measuring equipment looked for tell-tale hydrocarbons. Oil.
“We’d break them or make them heroes,” Chesser says.
The Ohio native worked 30 years before retiring in 2010 from Schlumberger Oilfield Services, in Sugar Land, Texas, near Houston.
Photo by Chris Clark
One summer Monday morning, Chesser arrived at his office in Sugar Land. He had spent an uncomfortable weekend, thirsty, urinating at all hours and generally feeling unwell.
A co-worker entered Chesser’s office to review drawings. The worker, a friend, told Chesser, “You know, you got symptoms of diabetes,” Chesser recalls.
The co-worker knew the symptoms well. “When he retired, he was only 59. Within a year he had passed. It was related to diabetes.”
Dr. Deines knew of the Agent Orange and Vietnam connection. He did not know the dramatics behind it. “It sounds like you are hearing the other side of the story,” said Dr. Deines, a specialist in endocrinology, diabetes and metabolism.
Initially, Chesser was prescribed oral metformin, a first-defense pill, Dr. Deines said. That worked for about 13 years, but Chesser steadily gained weight. He reached 280 pounds. He was officially obese. His blood-sugar levels were high altitude. And injections?
“I worked myself all the way up to eight insulin shots a day. Every time I ate a bite, I had to take a shot,” Chesser recalls. “I went to my endocrinologist. I said, ‘I’m really tired of this. I think it’s time to finally face it and lose some weight.’”
Physician assistant Gail Friedrick worked closely with Chesser.
“It seemed like the more weight he lost, the more motivated he became,” Friedrick said. “He did an excellent job of logging everything he ate on an app on his phone, along with his exercise, and when he reached his calorie limit for the day, he quit eating. …I don’t see a lot of patients that have the self-discipline to do this.”
Between appointments, Chesser and Friedrick communicated by email on MyHealth, Spectrum Health’s secure patient portal. “This allowed us to have a conversation about adjusting his medications as he lost weight, without the burden or cost of frequent appointments,” Friedrick said.
Chesser’s wife, Janna, 59, showed Chesser the way. She had seen Scott’s struggle.
“I knew if I didn’t lose the weight I was headed there and I didn’t want that,” said Janna, who began her own weight-loss plan before her husband.
Already 20 pounds lighter toward her planned 70, she and Scott ate healthier and exercised more. They paid attention to portion and diet. He used a free smart phone app “religiously” to monitor calories, consumed and burned, toward his weight goal.
Chesser’s insulin shots became smaller and less frequent.
Coming home
Chesser and Janna moved to 3.5 acres south of Lowell, Michigan, the year he retired.
Not long ago, Chesser stepped out of his pickup into his favorite repair shop, just as he had countless times in the small farm town, population 3,800.
“I said, ‘How you guys doing?’” Chesser recalls. “A worker responds, ‘Can I help out, sir?’ “And I say, ‘You gotta be kidding. I got a bay here with my name on it, I’ve been coming here so long.’
“A lot of people don’t recognize me,” he says.
Photo by Chris Clark
On Day 580 of Chesser’s campaign, his blood-sugar levels averaged near normal. He lost the equivalent of a bag of concrete mix, 76 pounds. He consumes 1,700 calories a day.
“It’s a tremendous feeling,” Janna said. “I don’t have to watch him stick himself all the time.”
Chesser figures he had an advantage or two. “I don’t smoke or drink. Those things probably get me out of harm’s way.”
With his weight-loss goal met, the retiree now turns to monitoring and maintaining.
“If it helps anyone, even one person realize they can do it, then it’s worth it,” Chesser said. “There is nothing special about me. I finally got the gumption to do it.
“My cousin died of complications of diabetes. It was a horrible death, horrible way to go, and all because she didn’t take care of herself,” Chesser said. “If you see that and it doesn’t inspire you, I don’t know what will.”
Another motivator? “I just don’t want to lose my eyesight, a leg or a foot.”
Xylitol, an artificial sweetener found in some ice cream and a host of other products, can cause your dog to have problems with blood sugar levels. (Courtesy Spectrum Health Beat)
The sugar substitute xylitol may help you lose weight, but it can be deadly for your dog, the U.S. Food and Drug Administration warns.
Xylitol is present in many human foods and other products. The FDA’s Center for Veterinary Medicine has received a number of reports over the past several years of dogs being poisoned by xylitol.
The most recently reported case involved sugar-free ice cream, said FDA veterinarian Dr. Martine Hartogensis.
Other products that may contain xylitol include sugar-free chewing gum, breath mints, baked goods, some peanut and nut butters, sugar-free desserts, cough syrup, children’s and adult chewable vitamins, mouthwash, toothpaste, over-the-counter medicines and dietary supplements.
When dogs eat something containing xylitol, the sweetener is quickly absorbed into the bloodstream and can trigger a surge of insulin from the pancreas.
This could lead to a rapid, severe drop in blood sugar levels that can be life-threatening, according to the FDA.
Symptoms of xylitol poisoning in dogs include vomiting, decreased activity, weakness, staggering, lack of coordination, collapse and seizures.
If you think your dog has eaten xylitol, take it to a veterinarian or an emergency animal hospital immediately, Hartogensis advised.
There are a number of things you can do to reduce the risk that your dog will consume xylitol.
“Check the label for xylitol in the ingredients of products, especially ones that advertise as sugar-free or low sugar. If a product does contain xylitol, make sure your pet can’t get to it,” Hartogensis said in an FDA news release.
Keep products that contain xylitol—including non-food products such as toothpaste—where your dog can’t get them.
Only use pet toothpaste for pets, never human toothpaste.
If you give your dog nut butter as a treat or to give your dog pills, check the label first to make sure it doesn’t contain xylitol.
If you have a hard time remembering names or what to get at the supermarket, there are ways to boost your memory.
According to a study in the journal Consciousness and Cognition, one of the best things you can do is say the information you want to remember out loud—and it’s even stronger if you repeat the information to another person. That means not just mouthing the words.
This could explain why you can recite your child’s favorite book unaided—read it out loud enough times and you can have near total recall.
An everyday example is to repeat the name of a new acquaintance out loud as soon as you’re introduced.
Instead of just saying, “It’s nice to meet you,” add their name and say, “It’s nice to meet you, Mary.”
Making word and number associations is effective, too.
Break down a phone number you want to memorize into digits you can associate with special dates or the ages of your kids, for example.
You might try dividing almost any type of information into chunks that you learn one by one.
Other research explains why making lists is so effective.
The human brain is better at recognition—or seeing words—on a to-do list rather than trying to mentally recall errands you’re supposed to run.
Finally, make friends with technology if you haven’t done so already. Use the apps on your phone to make lists and add the names of people you meet to your contacts as soon as you meet them—this gives you the opportunity to repeat their name and write it down digitally.
Offering more vegetarian choices in school cafeterias significantly cuts meat consumption without hurting overall sales, British researchers report.
In more than 94,000 college cafeteria choices studied, doubling vegetarian options (from 1 in 4 choices to 2 in 4) reduced purchases of meaty meals by 40-80%.
“Replacing some meat or fish with more vegetarian options might seem obvious, but as far as we know no one had tested it before,” said lead author Emma Garnett, a conservationist at the University of Cambridge in England. “Solutions that seem obvious don’t always work, but it would appear that this one does.”
Shifting to a more plant-based diet is one of the most effective ways to reduce the environmental impact of food production, she said.
When more vegetarian choices were available, they were popular at every meal and meat eaters who ate vegetarian dishes at lunch didn’t go all-meat at dinner, the researchers found.
Vegetarian options have been an “afterthought” on menus for too long, Garnett said in a university news release.
“Flexitarianism is on the rise,” she said, referring to the eating style emphasizing plant-based foods but also allowing for occasional meat and animal products. “Our results show that caterers serving more plant-based options are not just responding to but also reshaping customer demand.”
Simple changes such as increasing the proportion of vegetarian options could be “usefully scaled up, helping to mitigate climate change and biodiversity loss,” Garnett said.
The report was published recently in the Proceedings of the National Academy of Sciences.
It’s that time of year again—time to start thinking about what boots you’ll wear when you’re trudging through snow, slopping through slush and traversing the ice.
Your feet are not immune from the effects of aging.
As we get older, our arches tend to collapse, causing our feet to get longer and wider. With seasonal footwear like winter boots, it’s easy to end up in the wrong size. Don’t assume you’re the same shoe size as last year.
“Getting measured is very important,” Dr. Buchanan said. “This is potentially a big issue as people do more shoe shopping online.”
2. Too small equals cold feet.
If your winter boots (or ski boots) are too tight or too small, your feet get cold faster, which can become a serious issue. There should be room for air to circulate within the boot.
When you go to be measured at a full-service shoe store, try to go mid-day or mid-afternoon. As the day goes on, our feet swell, so a shoe that fits at 9am might be very tight at 6pm.
3. Boots with any size heel do not mix with ice.
Take this advice straight from a doctor who sees a lot of ankle fractures and foot injuries from slips and falls on the ice.
“With a winter boot, a heel is dangerous because it’s more unstable,” Dr. Buchanan said. “You have to be very, very cautious.”
4. Good tread equals good traction.
Make sure your boots are going to grip the ground.
The flat, slippery sole of fashion boots can be treacherous in slippery outdoor winter conditions, Dr. Buchanan said. The best tread will be on boots that are marketed for outdoor winter walking.
5. Boots with a pointed toe might look good, but they’re not good for you.
Boots that come to a point at the toe increase the rate of foot problems for women.
A sharp-pointed boot pushes the toes together, increasing bunion deformities and pressure points on the foot, Dr. Buchanan said.
6. Wrap your feet in warmth.
A winter boot should have the appropriate liner to keep your feet warm and dry. Look for waterproof, wool or sheepskin liners.
7. Two socks are better than one.
To keep your feet warm during extended periods of time in cold
temperatures, consider wearing two pairs of thin socks rather than one
thick pair to help prevent blistering, Dr. Buchanan said.
8. Keep an eye on your kids’ boots during the winter.
Children’s feet grow so fast that something that fits in November might not fit in February. Add to this the fact that kids tend to push the limit of how long they stay outside in the cold, and it can be a recipe for disaster.
Make sure their boots are big enough for air to circulate and keep their feet warm.
9. Outdoor conditions call for outdoor boots.
Wear fashion boots inside, for shorter periods of time during which you will not do much walking. Before going outside, change into winter boots designed for outdoor use.
“It really becomes a question of function of the shoe,” Dr. Buchanan said.
10. Happy feet lead to a happy body.
Robbing your feet of the support and care they need can lead to bigger issues in your knees, hips and back.
Start with a firm foundation with your winter boots, and you can ward off other ailments, according to Dr. Buchanan.
Low-carb, vegetarian, Mediterranean—whatever your diet, it’s important to get enough protein.
Although research hasn’t yet pinpointed one perfect formula, experts say that the typical “recommended” daily minimums aren’t optimal and that it helps to factor in your weight and activity level to determine how much protein you personally need.
A good baseline for people who exercise at a moderate level is between one-half and three-quarters of a gram of protein per pound of bodyweight.
If you weigh 150 pounds, for example, eat between 75 and 112 grams of protein per day.
To lose weight, diets with higher amounts of protein—between 90 and 150 grams a day—are effective and help keep you from losing muscle along with fat.
Since the body uses protein most effectively when you have it at regular intervals, divide your daily intake into four equal amounts for breakfast, lunch, a snack and dinner.
If you work out at a high level, consider eating another 50 grams of protein before you go to bed to help with overnight muscle repair.
You might be familiar with calorie counting, but it’s also important to know how to tally your protein intake.
While one ounce of chicken weighs 28 grams, it contains only about 9 grams of protein. So it takes a 3-ounce portion to deliver 27 grams of protein, or about one-quarter of the average daily need.
27-gram protein portions
3 ounces of fish, turkey, chicken or lean beef
7 ounces plain Greek yogurt
3/4 cup cottage cheese
You can also get high-quality protein from some plant-based foods.
These include tofu, whole grains, legumes and nuts—all better options than eating extra red meat or any processed meats.
The nation’s top nutrition panel may be changing its tune when it comes to an earlier recommendation of avoiding eggs and other cholesterol-rich foods, but not all doctors agree.
A preliminary report released in 2014 noted that “cholesterol is not considered a nutrient of concern for over-consumption,” meaning it might matter less how much cholesterol is in the foods we eat.
That doesn’t mean people should go wild with a pound of bacon each morning.
Thomas Boyden, MD, a Spectrum Health cardiovascular physician, said he believes diet and exercise are two of the most important components of cholesterol management.
“I am 100 percent for patients doing everything they can for themselves and ultimately taking responsibility for their own health,” Dr. Boyden said. “If patients were more focused on diet and routine aerobic activity, many would realize they have the opportunity to improve their overall health and reduce their chance of heart disease and stroke, potentially without the need for medications.”
Dr. Boyden said some people have inherent genetic risks or other illnesses and are at higher risk than others. These patients oftentimes cannot fix their cholesterol numbers with diet and exercise alone, so he advocates for medication in these cases.
If you have high cholesterol, here’s what you need to know:
Worst foods
Avoid fatty foods, but know that not all fat is bad fat. The worst are trans fats and saturated fats, which are mostly found in processed foods and fatty meats. Eating less of each of these will benefit a patient’s cholesterol levels. Beef and red meats should be consumed in moderation.
Best foods
Try to eat a balanced diet rich in fruits and vegetables and non-animal based proteins. Soy products, beans and fish (which has a better fat composition than other animal products) are all great to incorporate into your diet. Introducing fish into your diet a couple times per week can make a noticeable difference.
Activity
The more aerobic activity you can work into your routine, the better. Moderate aerobic activity is less likely to affect weight loss, but it can lower cholesterol and blood pressure, and helps control blood sugar. Exercise improves mental capacity, makes bones strong and improves mood. Any exercise is helpful, so don’t feel that you need to train like an athlete. Just 20–30 minutes per day of moderate activity has proven benefits. The key is to get your pulse and breathing elevated, but there is no need to push yourself to extremes.
Family history
It is important to know family history and whether you have a higher
disposition to illnesses and risk factors. Are you overweight? Do you
have diabetes or high blood pressure? And do any of these conditions run
in your family? Talk to your doctor about how your genetics
could affect your health now and in the future.
Treatment
If you have high cholesterol, high blood pressure and/or diabetes, it’s important to speak with a physician to create a personalized treatment plan that works for you. Your doctor can conduct an individualized risk assessment and help you determine what might work best for you.
Screenings
Learn about the effects of cholesterol on your health at a free vascular screening. To qualify for a free screening, you must have at least two of the following risk factors:
There’s no definitive proof coffee drinking lowers the risk of gallstones, but there is an association that merits further study. (Courtesy Spectrum Health Beat)
To the many ways in which coffee seems to confer unexpected health benefits, add a lowered risk of painful gallstones.
After tracking nearly 105,000 Danes for an average of eight years, researchers found that those who downed more than six cups per day of the world’s most popular beverage saw their gallstone risk drop by 23%.
“High coffee intake is associated with a lower risk of gallstone disease,” said study author Dr. A. Tybjaerg-Hansen. She’s chief physician of Rigshospitalet’s department of clinical biochemistry at Copenhagen University Hospital in Denmark.
That’s good news for Danes, 6% of whom drink six or more cups of coffee every day, she said.
But what about the average Dane, who knocks back just two cups a day? Or the average American or Brit who consumes between one to two cups daily? The study has good news for them, too. It turns out that even small amounts of coffee appeared to lower gallstone risk.
Compared to those who abstained from coffee, participants who drank just one cup of Joe a day saw the risk of gallstones dip by about 3%. Meanwhile, those who consumed three to six cups per day saw their risk lide by 17%.
The findings were published recently in the Journal of Internal Medicine.
Gallstones are hard pebble-like pieces that can accumulate in the gallbladder, where they can sometimes block bile ducts. When that extremely painful condition develops, surgery to remove them is often the treatment of choice.
So what is it about coffee that seems to diminish risk? Tybjaerg-Hansen said that, for now, “we can only speculate on that.”
But she noted that because caffeine is excreted via the bile, it’s possible that it reduces the amount of cholesterol found in the bile. That could reduce gallstone risk, given that “the development of gallstones depends on a balance largely between cholesterol and bile acids,” Tybjaerg-Hansen explained.
Coffee also stimulates the muscle contractions that move contents though the gastrointestinal tract.
As to whether it’s the caffeine content that serves as coffee’s silver bullet, Tybjaerg-Hansen said, “yes, that is a possibility.” That raises the prospect that tea or chocolate might also lower gallstone risk.
But whatever’s behind coffee’s power, she believes that the team’s subsequent genetic analyses indicate that it’s coffee itself—rather than lifestyle factors common to coffee drinkers—that is at play.
Another expert is not so sure.
Dr. Anthony Bleyer is a professor of nephrology at Wake Forest School of Medicine in Winston-Salem, N.C. He was not involved in the Danish study and was not previously aware of any link between coffee and gallstone risk.
“(But) it seems every week there is a new story about how coffee may or may not be associated with some benefit,” he cautioned. “Information on coffee is collected in many big databases. It is easy to do a comparison with just about any factor: osteoporosis, weight gain, weight loss, sleep, ulcers, cancer, mortality. You get the picture.”
And Bleyer acknowledged that many people will find studies like this interesting, given that coffee drinking is such a common habit.
“But from a scientific standpoint, I am not a big fan,” he added.
“For one thing, consuming six cups of coffee is quite a lot,” he said, “and the (high level of) caffeine could have big effects on sleep, gastric reflux and on arrhythmias.”
But most importantly, said Bleyer, the things that drive people to drink a lot of coffee in the first place “may also cause other changes in diet.” And it could very well be those dietary changes, rather than coffee itself, that end up affecting gallstone risk.
His bottom line: don’t place too much stock in the power of coffee to reduce gallstone risk.
For now, he said, “these studies show only an association, that is not causative.”
Although the slopes might not be ready just yet, it’s never too early to begin preparing your body for ski season.
Here’s a look at the most common injuries and the best ways to prevent them:
Head injuries
Falls account for 75 to 85 percent of ski injuries, according to the American College of Sports Medicine, and nearly all ski-related head injuries are the result of falling.
The best way not to fall is “making sure you’re in shape,” said Jason Lazor, DO, who specializes in sports medicine for Spectrum Health Medical Group Orthopedics. To do that, start preparing weeks or months before you actually get on the slopes.
The time to start prepping for skiing is yesterday. Prepare your core, muscles and joints for the rigors of skiing and you’re less likely to injure yourself. (Courtesy Spectrum Health Beat)
“You don’t really want to ski yourself into shape,” Dr. Lazor suggested. “When you’re skiing, you’re putting a lot of forces on the body. …The body can best handle those forces when you’ve done some prepping.”
Dr. Lazor recommends a combination of stretching, cardiovascular training like running, cycling and/or swimming, and resistance training focused on the lower extremities to best prepare for ski season. In terms of weight and resistance training, he suggests focusing on quads, hamstrings, abdomen and pelvic stabilizers.
Strong muscles and flexibility increase stability and muscle control, as well as decrease muscle fatigue, which all help to prevent serious falls.
“The more in-shape you are and the more body control you have, the better you can avoid accidents, and when accidents do happen, the better you can protect yourself,” Dr. Lazor said.
The other key for protecting your head is wearing a properly-fitted helmet. You’ll look great.
Sprains and fractures
Two other common injuries when skiing are sprains and fractures.
Collisions with objects and other skiers account for between 11 and 20
percent of ski injuries, according to the American College of Sports
Medicine, and are the primary cause of fractures.
Skiing “in control” is the best way to avoid those collisions, says Dr. Lazor. Almost every resort posts a Responsibility Code, which reminds skiers to keep an eye on the skiers in front of them, stop in safe and visible places, always look uphill while stopped, and other basic tips for avoiding collisions and ensuring safety.
It’s also important to know your limits, says Dr. Lazor, and not to ski on trails that are above your ability level.
Thumb and wrist injuries
About 30 to 40 percent of skiing injuries are to the upper extremities, according to the American College of Sports Medicine, and “the most vulnerable joint of the upper body is the thumb.”
Skier’s thumb, which is a tear in the ulnar collateral ligament of the thumb, happens when skiers fall on an outstretched hand while still gripping their ski poles.
The best way to avoid this injury—which can lead to pain and weakness when grasping objects—is to avoid falling (see above advice). A second helpful tip is to use ski poles with straps rather than fitted grips.
“(Straps) are associated with fewer injuries,” the American College of Sports Medicine reports.
When to see a doctor
“In general, if you’re questioning an injury, go seek out help,” Dr. Lazor advised.
Signs of serious head injuries are people acting outside their normal character, behaving more emotionally than normal, a sudden sensitivity to light and lingering headaches.
Another advantage to working out before winter arrives, Dr. Lazor said, is people who work out can tell the difference between general soreness following physical activity and pain from an injury. He frequently reminds people that the Orthopedic Urgent Care clinic stands at the ready to assist them as they encounter any sort of orthopedic injuries—on or off the slopes.
Dr. Lazor has a simple mantra for those wondering when to see a doctor: “When in doubt, get checked out.”
David Stults stood in front of a packed auditorium at Lowell High School, sharing his medical journey with students.
Even though the cause of his irreversible lung damage is, of all things, microwave popcorn, Stults has learned that vaping can cause similar damage. And he wants students to know it. Before they suffer a similar fate.
Stults, now 59, started feeling short of breath about 10 years ago when he’d go up and down the stairs at his house.
“Your initial thought is, OK, it’s time to push away from snacks and do some exercise, which I began to do,” the Walker, Michigan, resident said. “The symptoms only became worse. I went to my PCP. He listened to my lungs and said, ‘Something doesn’t sound right.’”
The doctor referred him to Michael Harrison, MD, a Spectrum Health pulmonology disease specialist.
In late 2009, lung function tests put Stults in the 70% to 80% range.
“For a healthy 49-year-old man, that was alarming,” Stults said. “Imaging showed some very ugly air trapping. He did all the breathing testing and put me on a pretty aggressive regimen of prednisone and inhalers.”
But time would not be a healer.
By February 2010, his lung function had worsened, dipping to the 60% range.
“It’s heading south quickly,” he said. “I was taking 60 to 80 milligrams of prednisone a day, as well as other inhalers. I started doing breathing treatments a couple of times a day.
Photo by Taylor Ballek, Spectrum Health Beat
“By March or April, I was down to 30%,” he said. “I couldn’t walk up half a flight of stairs without stopping to catch my breath. Any kind of incline was a challenge. Even the gentle incline of the drive walking from the mailbox to my home, I’d have to catch my breath.”
By May, he continued to slide downhill, requiring weekly pulmonology appointments.
Medical mystery
Dr. Harrison suspected Stults may be suffering from an autoimmune issue. A rheumatologist started aggressive treatment with Rituxan, a drug normally used to fight cancer.
“I felt great afterwards,” he said. “I had more energy. I didn’t feel as short of breath.”
The diagnosis came in May 2010: bronchiolitis obiliterans, a severe lung inflammation that is both progressive and irreversible.
Doctors confirmed the diagnosis after three days of intense testing.
He returned home on oxygen.
“They said, ‘You need to go home and get your affairs in order,’” Stults said. “My wife (Barb) and I are both very committed and devoted Christians. We reached out to our family and friends and let them know we were asking for prayer. I can tell you from that day forward, my lung capacity has increased from 41% to 43% and has never gotten worse.”
Still, Stults wondered how he could have contracted this untreatable condition.
Dr. Harrison asked if he had been exposed to insulation, factory or foundry chemicals.
No. Stults had always worked white collar jobs.
He launched a massive internet search on his condition.
“Up popped this article on popcorn lung,” Stults said. “It told the story of these plant workers at various microwave butter-flavored popcorn manufacturers who were dying at this incredibly crazy rate. It was only the employees in these cities, working at these plants. A dozen employees died over six months. It was ridiculous.”
Federal agencies such as OSHA and NIOSH launched an investigation and learned the chemical used to create the butter flavoring, diacetyl, when it’s heated, creates a potentially toxic vapor.
Photo by Taylor Ballek
“My wife and I loved microwave butter-flavored popcorn,” he said. “My secretary at the office would make me a bag every day. I really enjoyed it, almost to an addictive level—opening the bag and sniffing in the fumes. I was breathing in the diacetyl on a daily basis. We had done that for 30 years.”
Stults’ condition may be irreversible and incurable, but he’s trying his best to reverse the actions of students who vape.
“We were talking with some friends of ours who are 20 years younger than we are and they have high school age boys,” Stults said. “She’s kind of the cool mom of Hudsonville. They have a nice home with an indoor basketball court. All of the guys in her son’s class hang out there.
“Because she’s so cool and engaging, the boys started to confess to her that a lot of them were vaping and couldn’t stop,” he said. “They were reaching out to an adult that they trust.”
She did some research and found that diacetyl is one of the many chemicals used to create different flavors in vaping pods.
“She knew my story and called me,” Stults said. “Besides nicotine, which is incredibly addictive, there’s asbestos and formaldehyde. You wouldn’t live with it in the attic and you’re going to suck it into your lungs?”
Snuffing out vaping
According to a series of national surveys recently released by the federal government, about 40% of high school seniors have vaped, double from the year prior.
Stults teamed up with Spectrum Health Medical Group pulmonologist Shelley Schmidt, MD, to set up talks at schools, with the goal of shining a light on the dangers of vaping pod chemicals and nicotine addiction.
“I get at least a phone call a week from a principal saying, We don’t know what to do. It’s out of control,’” Stults said. “Students are addicted. They don’t know how to stop.”
Stults aims to portray the real-life picture of what the chemicals do.
“I tell them, ‘Here’s what you’re setting yourself up for—40% lung capacity,’” he said. “Dr. Schmidt explains addiction and what’s going on in your lungs.”
Stults said they’ve only done a handful of presentations so far, but as principals talk to each other, engagement requests are growing.
“These kids do it walking down the hall in the school,” Stults said. “They do it in the classroom. They sneak it. Other than kind of a fruity smell, there are no fumes.”
Glenn VanOtteren, MD, a Spectrum Health Medical Group pulmonary disease specialist, said popcorn lung is rare but it could become more of an issue as vaping data becomes available.
“With the removal of diacetyl from heated food, we saw it rarely,” Dr. VanOtteren said. “We don’t have data on the rates of vaping-induced lung disease because the use of vaping has accelerated in the last two to three years.”
Dr. VanOtteren said Stults is doing well, despite limitations.
Photo by Taylor Ballek, Spectrum Health Beat
“His lung disease is stable,” Dr. VanOtteren said. “He is short of breath with stairs. He requires daily medicine and has flares of his disease about two times a year when he gets worse and needs additional medications. His lungs can continue to decline because of these flares.”
Dr. VanOtteren said he’s impressed Stults and Dr. Schmidt are sharing lung lessons with students.
“This is such a contemporary and important topic,” he said. “Providing education at this early age is super impactful.”
In 2017, more than 85,000 people were treated in U.S. emergency rooms, doctors’ offices and clinics for injuries related to luggage. Know your limits before you pack that suitcase. (Courtesy Spectrum Health Beat)
With holiday travel comes the risk of injury from toting heavy luggage.
In 2017, more than 85,000 people were treated in U.S. emergency rooms, doctors’ offices and clinics for injuries related to luggage, according to the Consumer Product Safety Commission.
“Hurting your neck, back, or shoulders can put you out of commission for a long time,” Dr. Charla Fischer, an American Academy of Orthopaedic Surgeons spokesperson and orthopedic spine surgeon, said in an academy news release.
“You can prevent that by packing lightly, using sturdy luggage with wheels and handles, and using good form when carrying or lifting bags,” she suggested.
Here are some luggage safety tips, courtesy of American Academy of Orthopaedic Surgeons.
Don’t buy luggage that’s too heavy or bulky when empty. Try to place items in a few smaller bags instead of one large one. When lifting luggage, stand alongside it and bend at the knees, lifting the luggage with your leg muscles. Once lifted, hold luggage close to your body.
Don’t twist when lifting and carrying luggage. Point your toes in the direction you’re going and turn your entire body in that direction. Don’t carry bulky luggage for long periods of time. When possible, use the airline’s baggage service when you have heavy luggage.
Carry luggage in both hands, rather than one hand off to the side. This can decrease stress to the spine and reduce the risk of developing elbow problems.
Carry, don’t drag, rolling luggage when climbing stairs.
If you’re using a backpack, it should have two padded and adjustable shoulder straps to equally balance the weight. Pack heavier items low and towards the center.
When using a duffel or shoulder bag, switch sides often.
Odds are you know the feeling: You wake up from a nap and your arm is asleep. Or your foot’s gone numb.
As you move it around, it starts to prickle and tingle. Gradually it wakes up, and a minute or two later you’re back to normal.
What’s this uncanny sensation all about? Is it normal or something to be concerned about?
The short answer is: It depends.
If it’s fleeting and infrequent
The medical term for this feeling of numbness or tingling is paresthesia, and its cause is the compression of a nerve, according to Paul Twydell, DO, a fellowship-trained neuromuscular medicine specialist with Spectrum Health Medical Group.
Paresthesia typically happens if you lie on a nerve while asleep or hold the same position for too long while sitting—like when you’re driving or reading.
If the feeling goes away quickly, this phenomenon is called transient paresthesia, and it’s typically nothing to worry about.
People will wake up with tingling in their hands and think they have a circulation problem, Dr. Twydell said, but that’s not the case.
“It’s just that a nerve is being compressed in the wrist or elbow. And the reason it happens at night is we often sleep with our wrist or elbow flexed or underneath us, or in a strange position.”
A nerve is a bundle of “wires” surrounded by a layer of insulation called myelin, Dr. Twydell explained. Myelin helps speed the movement of electricity along the nerve.
“When that myelin is compressed, that means the messages aren’t getting through very well,” he said. “A lot of times it’s when the compression is released that (the tingling) happens”—as communication is being restored along the nerve.
The nerves most prone to compression are found in the wrist, elbow, knee and upper arm.
If it’s persistent or abnormal
So when might numbness or tingling be a cause for concern? Dr.
Twydell recommends that people talk to their doctor if they experience
any of the following:
Persistent numbness or tingling in the hands. This is often a sign of carpal tunnel syndrome, which is treatable—the sooner the better to avoid severe damage and the need for surgery.
Tingling in the feet, especially at night. This might be an early sign of a degenerative nerve disease called peripheral neuropathy,
which is most often caused by diabetes or heredity. Neuropathy isn’t
reversible, but it can sometimes be slowed down, Dr. Twydell said.
Weakness of a limb in conjunction with numbness. This can be a sign of more severe damage to a nerve.
Numbness or tingling that ascends up the legs or into the abdomen.
This can be a sign of spinal cord inflammation or compression.
Numbness involving half of the body or face. This can be an indicator of stroke, which requires emergency care. Call 911.
If you have persistent symptoms of numbness or tingling, your doctor may order a test of the nerves called electromyography, or EMG. This nerve study can help pinpoint the source of a problem and help guide treatment.
Carpal tunnel syndrome is the most common problem investigated by Spectrum Health Medical Group Neurology in the EMG lab, Dr. Twydell said.
Tips for good nerve health
Your best bet is to avoid activities that cause prolonged nerve
compression, Dr. Twydell said. Change positions frequently. Get up and
walk around throughout your workday.
“If nerves are compressed over and over again, you can have more persistent symptoms that can eventually lead to weakness or disability,” he said.
Here are Dr. Twydell’s tips for preventing that numb or tingling feeling in your extremities:
Wear wrist splints at night to ease problems with carpal tunnel syndrome.
Avoid lying on your elbow while sleeping, and try wearing an elbow pad to bed to keep the elbow straight.
Don’t cross your legs, with one knee draped over the other. That can compress the fibular nerve, which can lead to foot drop, a cause of tripping.
Avoid the habit of sleeping with your arm stretched out or
underneath your partner. Over time this can damage the radial nerve,
leading to wrist drop.
Avoid leaning on your elbows for extended periods. Try adding gel pads to the armrests of chairs, wheelchairs or cars.
If you do a lot of computer work, use a gel wrist rest. Avoid
holding the wrists in either a flexed or an extended position, which can
damage the median nerve.
Eat a well-balanced, low-carb diet. This is especially important for people with diabetes, who are more prone to neuropathies.
Avoid alcohol in excess, which can cause neuropathy.
Avoid taking zinc and vitamin B6 in excess, which can cause nerve problems.
Dr. Twydell admits that some of these tips are easier said than done.
For example, it’s hard to change the way you sleep, he said. Yet,
people who sleep in a way that compresses the ulnar nerve in their elbow
“can cause some pretty significant weakness in the hand.”
And if you’re one of those people who rarely experiences numb or prickly limbs, consider yourself lucky. Some people are more prone to nerve compression than others, Dr. Twydell said.
