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The holidays are famously a time of celebration, and where there is celebrating, there is usually too much alcohol, too many rich foods, and not enough sleep.
Here are some basic tips on not overdoing it — and how to manage when you have.
Common sense rules
You know the saying “Don’t go to the grocery store hungry”? The reason is pretty obvious. If you’re famished, you may not make the best food choices. Well, the same applies to holiday parties. If you are truly hungry, have something healthy and filling beforehand, like a beautiful salad. Pressed for time? Eat an apple.
Already there? Look at the appetizers. Is there anything reasonably healthy? Pick up a small plate and choose from the healthier options, like crudités (vegetable slices), shrimp cocktail, even fruit and cheese (no crackers). Avoid fried snacks and processed carbohydrates. Enjoy! Take the edge off your hunger, then walk away from the table.
Are you the host? Serve delicious hors d’oeuvres that also happen to be healthy. Some ideas: make or purchase fresh guacamole, sprinkle with red pepper flakes, and serve as a dip with crisp sweet red pepper slices. Or try red pepper hummus sprinkled with crushed toasted pistach Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Follow me on Twitter @drClaire
Holidays are best when they are spent having fun with friends and family — not spent in an emergency room. Yet every year that’s where thousands of people end up, due to holiday-related injuries and illnesses. Here are some tips to help keep your children safe and well this holiday season, from the American Academy of Pediatrics.
Holiday decorations
They make everything more festive, that’s true, but they can be dangerous.
If you buy a live tree, make sure it’s not dried out. Cut a few inches off the bottom, and keep the stand filled with water.
If you use an artificial tree, be sure it’s fire resistant.
Be careful about where you put a tree. Don’t put it near something hot, don’t put it somewhere it’s likely to get knocked over, or where it blocks people walking.
If there are small children in the house, don’t use decorations that children could choke on, or that could break easily and cause cuts. If you want to put them on a tree, keep them up high.
Avoid decorations that look like food. Children might try to eat them.
Check lights for loose or frayed wires before putting them up.
Before putting lights outside, be sure they are meant to go outside ( Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Follow me on Twitter @RobShmerling
Picking a health insurance plan can be maddeningly complicated. It may seem that no matter what you do, you’re picking the wrong plan. Should you go with the one with high monthly premiums that covers just about everything and even pays for medications? Or maybe it’d be best to go with one with lower premiums but that covers fewer expenses. Picking the one that’s best depends on your medical conditions, the medications you take, and, to some degree, your ability to predict future medical expenses. And it only gets more difficult as costs rise and medical care gets more complex.
Enter the “high deductible health plan” (HDHP). While these health insurance plans have relatively low monthly premiums and cover catastrophic illness, they have high deductibles — the out-of-pocket payments charged before the insurance plan kicks in. For example, a typical HDHP might require you to pay out of pocket for health care expenses up to $1,300/year (or $2,600/year for families), in addition to your monthly premiums, before insurance covers most medical expenses.
HDHPs are often chosen by young, healthy people who don’t anticipate the need for a lot of healthcare Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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The winter holidays are almost universally experienced as a time of joy, and of familial togetheess. For many they are the highlight of the year, a time of relaxation, gift-giving, spiritual renewal, and reflection on a year of skirmishes fought on behalf of one’s family.
But for people in recovery from substance use disorders, such as from opiates or alcohol, the holidays can be a time of unique and profound stress. Part of this stress is related to the freely flowing alcohol that can be found at many holiday events, and another aspect is often related to complex interactions with family members who can be “triggers” for dark and uncomfortable feelings that can even threaten one’s hard-won sobriety.
If you are in recovery from a substance use disorder, be it drugs or alcohol, and the holidays do cause you emotional distress, it is critical to have plans and strategies in place for dealing with the realities of the holiday season, to minimize any risks to your sobriety. As it is commonly said in recovery parlance, “The first thing you put ahead of your sobriety will be the second thing you lose.” Even if you have to be, for lack of a better word, ruthless, and step on a few toes, Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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If you are like me, when you get the flu you head straight to the pharmacy and grab the most powerful over-the-counter medicine you can find. But is that really the best approach? After all, your condition, symptoms, and reaction to the virus may be quite different from someone else’s, so why use the same medicine? Instead, you may benefit more from a treatment specifically designed just for you and your ailment.
That’s the philosophy behind precision medicine (sometimes referred to as personalized medicine), an approach to cancer prevention and treatment that takes into account a person’s genes, environment, and lifestyle and eliminates the one-size-fits-all concept.
“As you get older, you are more likely to battle diseases and ailments, like cancer, and you do not want to waste your time with trial-and-error treatments that may not work and could expose you to various side effects,” says Dr. Paul Avillach, assistant professor of biomedical informatics at Harvard Medical School. “Precision medicine can help take out the guesswork.”
The principle behind precision medicine
It works like this: doctors rely on family history, lifestyle habits (like diet, exercise, and smoking), and en Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Follow me on Twitter @RobShmerling
Some called it the Katie Couric effect. Soon after her husband died of colon cancer in 1998, the joualist and television personality had a televised colonoscopy to promote the test. Rates of screening colonoscopies soared for at least a year. Or, call it the Angelina Jolie effect. In 2013, the actress wrote an editorial in the New York Times about the tests she had for genes (called BRCA) linked with breast and ovarian cancer, and how the positive result led her to have a double mastectomy. Soon after, rates of BRCA testing jumped.
Whatever you call it, the effect is real. When it comes to matters of health, celebrities can have an enormous impact.
It’s good when celebrities do good
The impulse to take a challenging or tragic medical experience and tu it into something that helps others is commendable. It may be easier to keep such matters private or avoid talking about them in public. But time and again, we see celebrities joining forces with health-promoting organizations, speaking out, and sharing their stories to help others avoid what they’ve experienced. Many have credited Katie Couric with removing the embarrassment associated with colo Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Follow me on Twitter @RobShmerling
When it comes to serious health problems, you might think a game would be unlikely to help. But a recent study of people with diabetes could change your mind.
Researchers publishing in the September 2017 issue of Diabetes Care describe a study in which people with diabetes joined a competitive online game aimed at educating participants about ways to improve blood sugar control. The results were encouraging.
How a game led to improved blood sugars
In this new research, 456 patients with poorly controlled diabetes were randomly assigned to one of two groups:
Group 1 participated in an online or phone-based educational game that asked two questions about managing diabetes each week for six months. Later, answers and explanations were provided. This group also received a booklet about civics, including questions about citizenship in the US.*
Group 2 received online or phone-based questions about civics each week for six months along with a booklet about diabetes self-management.*
(*The researchers wanted to have a control group that was just like the diabetes management game group, except instead of diabetes information they provided information on c Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Follow me on Twitter @drClaire
A new study tells us that 57% of today’s children will be obese by the time they are 35. And if a child is obese when they are young, chances are overwhelming that they will stay that way.
Obesity is a real problem in our country, not just for adults but also for children. There are many reasons for this. For lots of families, it has to do with economics: healthier foods, such as fresh fruits and vegetables, are more expensive than processed, unhealthy foods. Getting children to be active can be hard, too, when families don’t have access to safe play areas or don’t have the time to take them there; when sports teams are expensive or logistically challenging; and when schools are cutting back on recess to meet academic demands. The fact that screens and screen time have become so pervasive in our culture has also made children less active.
What can make it harder, too, is that many families I talk to don’t really think it’s a problem if their child is overweight, even obese. They think that it’s “baby fat,” and that their child will slim down later. They don’t see the point in making the changes I want them to make, many of which they see as hard for t Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Follow me on Twitter @RobShmerling
When it comes to heart disease, there’s lots of advice. There are heart-healthy diets and exercise programs to follow. Of course, if you smoke, you’re urged to stop. For those at highest risk or who already have heart disease, there are medications to take and monitoring of your condition to keep track of.
A recent study suggests that for people who are at high risk for heart disease or who already have it, there’s a bit of new advice: don’t shovel snow.
Shoveling snow and heart attack
According to past estimates, about 100 people — mostly men — die during or just after shoveling snow each year in the US. Many more are admitted to the hospital with chest pain or other heart problems. This latest research further explored the details of this connection. Researchers correlated admissions to the hospital and deaths due to heart attack the day after it snowed in Canada during the years 1981 to 2014. This included more than 128,000 hospital admissions and more than 68,000 deaths due to heart attack. Here’s what they found:
The deeper the snow, the more men were admitted for heart attacks. For example, for snowfalls of more than eight inches, there was Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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A while back, I covered the updated evidence-based treatment guidelines for acute (less than four weeks) and subacute (less than twelve weeks) low back pain. I promised a post on chronic (more than twelve weeks) back pain.
Well, as I write this, I am suffering from a recurrence of my own low back pain, which radiates down my right leg at times. This has been literally and figuratively a pain in my rear end, for years.
Being a doctor who practices what I preach, I am putting all the advice I dispense to good use.
First, look for possible triggers
This fall, I had gotten away from my regular core-strengthening routine (nighttime planks, pushups, and abdominal exercises, on the carpet as the kids are going to sleep). At about the same time, I increased the consecutive hours spent sitting at my desk, typing away. Weakened core plus prolonged time seated at an ergonomically challenging workspace equals exacerbation of my chronic low back pain.
This situation is exceedingly common. I have both short-term and long-term solutions. For now, I get up and stand when my Fitbit buzzes (which is every 20 minutes). At least once an hour, I do toe-touches, side and back bends. I’m also adding in r Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Patients are always elated when you can recommend an enjoyable, health-improving, recreational activity. As a runner, my favorite “prescription” while pregnant was exercise! However, more often than not, pleasurable activities are not what’s best for one’s health. But as a dermatologist who specializes in skin cancer, I am generally the bearer of bad news when I tell patients to never get another tan.
This November, alcohol came into the spotlight. The Cancer Prevention Committee of the American Society of Clinical Oncology recommended minimizing drinking alcohol, as it is thought to be a “modifiable risk factor for cancer.” Alcohol is estimated to be responsible for 3.5% of all cancer deaths in the United States.
Does alcohol influence skin cancer risk?
The short answer is that alcohol may be associated with skin cancer.
Several studies have tried to answer this very question with varying results. However, two meta-analyses, which combine results from a number of other studies, found that alcohol intake was associated with the development of basal cell carcinoma and squamous cell carcinoma (the two most common types of skin cancer) and melanoma. One of the studies found that the r Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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The American College of Cardiology and the American Heart Association certainly grabbed the attention of us busy primary care physicians with the recent release of their updated blood pressure guidelines. These organizations had piqued interest by declaring the release date and labeling it as “highly anticipated.” I pooh-poohed all that drama, but upon reading through the 114-page executive summary PDF with 21 authors and almost a thousand references, I have to say, I am duly impressed.
The definition of the diagnosis of high blood pressure and the decision-making process surrounding treatment have traditionally been quite individualized (read: all over the place). Personally, I invite these Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Follow me on Twitter @dianewshannon
My 18-year-old daughter recently moved to a university about 1,500 miles away to study theater. Tears, texts, and several care packages later, she settled in, only to develop a hamstring injury that prevented her from participating in required dance classes. In short, she needed several months of physical therapy.
After searching for options near the university, she told me that visits would cost as much as $200 each. Our health insurance plan only covers urgent or emergency care outside of our local area, and physical therapy was not considered urgent. When she enrolled, we had assumed she would get preventive care when she was at home and use a local wal Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Follow me on Twitter @drClaire
Stomachaches are incredibly common in children. Most of the time they are nothing serious at all. Most are just from a mild stomach bug, or some constipation, or hunger — or are a child’s way of getting out of something they don’t want to do. But a stomachache can sometimes be a sign of a more serious problem.
A stomachache worries doctors when…
1. The pain is severe. By severe, I mean that the child cannot be distracted from it, and is crying or otherwise showing that they are extremely uncomfortable. Any severe pain warrants a trip to the doctor, whether it’s unrelenting or it comes and goes.
2. There is blood in the stool. Most of the time, we see blood in Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Information is knowledge, and big tech companies know how important it is to collect and track data. When it comes to your health, it is now easy to measure and track all kinds of information. In the comfort of our homes we can check our weight, blood pressure, number of steps, calories, heart rate, and blood sugar. Recently some researchers have started to use an interesting marker for resilience and behavioral flexibility. It is called heart rate variability (HRV).
Have you ever wondered what the health impact of a stressful day was? Will you perform well during your long run tomorrow moing? Is there anything you can do today that would improve your ability to have a better day moving fo Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Every day, millions of people swallow fish oil capsules, many of them lured by the promise that the pills will help them cast off heart disease. In fact, the label of one popular brand includes the line, “May reduce coronary heart disease risk.”
Don’t take the bait: these bold marketing claims haven’t caught up with the latest science. Earlier this year, the American Heart Association (AHA) issued an updated advisory about fish oil supplements and their cardiovascular benefits. Their verdict: fish oil supplements may slightly lower the risk of dying of heart failure or after a recent heart attack. But they do not prevent heart disease.
Angling for advice?
“It’s probably not wise for any midd Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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“Take the cookies, bring them home to the kids!” Craig always insists, as he pops a few into my lunch bag. It’s a heartwarming gesture that I love about his Sarasota deli — in addition to the killer turkey on whole wheat. You may not be surprised when local businesses throw in a freebie; they often go the extra mile to thank customers.
But you may be surprised to know that there are lots of free things out there that can help your health. Okay, not cookies, but things with real value when it comes to improving everything from chronic disease to diet and fitness.
Free prescription drugs
Some stores (such as Publix and Harris Teeter chain stores in the southeaste United States, and Meijer st Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Follow me on Twitter @drClaire
The holidays can be hectic — and tense. Between buying presents (expensive and nerve-racking), holiday events (how many holiday concerts can there be?), entertaining (so much cooking), traveling, and family gatherings (which are not always as pleasant as we might like), what should theoretically be fun has a way of becoming stressful. It can be stressful for kids, too.
Okay, they aren’t driving long distances, dealing with office parties, or managing a credit card bill. But it is stressful nonetheless. Routines are off, there are so many expectations, and the ambient stress has a way of affecting children too.
Here are seven ways to prevent and reduce holiday s Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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At the end of a long workday, my husband and I will often trade texts figuring out who will pick up the kids at my mother’s, and who will deal with dinner. Thankfully, we’re equal partners in all responsibilities (except spider-killing, which is strictly Hubby’s job) and dietary preferences. We’re both health-conscious foodie types. We want good food that’s good for us.
An unvaished look at family dinner
The kids, on the other hand… I’m not sure how this happened, but we somehow raised creatures with tastes vastly different from ours, and each other. We’ve never tried to cook an evening family meal that everyone would eat, because such a meal does not exist. Instead, we stock up on parent- Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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Every once in a while, I’ll have a terrible shift in the emergency department (ED) in which I have to pronounce yet another young person dead from an opioid overdose. I typically have to call their parents, who usually express sorrow but not surprise at the horrific news, as we all know how deadly opioid use disorder can be. But more frequently, the overdose patients I care for survive. Typically, they were found unresponsive by a friend or family member — 911 is called, the person is given the reversal agent naloxone, and is brought to the ED where my colleagues and I take over.
How naloxone works
Here’s the problemNaloxone is, in many respects, a wonder drug. It inhibits the opioid recepto Harvard Health...ما را در سایت Harvard Health دنبال می کنید
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