Coffee Health Benefits : Coffee may protect against disease

It’s surprising when something that was once considered questionable for your health turns out to have health benefits, usually with the proviso to use it “in moderation.” That happened with chocolate and alcohol, and now it is coffee’s turn, reports the February issue of the Harvard Health Letter. Here’s some of the mostly good news about coffee:

Blood pressure. Results from long-term studies are showing that coffee may not increase the risk for high blood pressure over time, as previously thought. Study findings for other cardiovascular effects are a mixed bag.

Cancer. Coffee might have anti-cancer properties. Last year, researchers found that coffee drinkers were 50% less likely to get liver cancer than nondrinkers. A few studies have found ties to lower rates of colon, breast, and rectal cancers.

Cholesterol. Two substances in coffee — kahweol and cafestol — raise cholesterol levels. Paper filters capture these substances, but that doesn’t help the many people who now drink non-filtered coffee drinks, such as lattes. Researchers have also found a link between cholesterol increases and decaffeinated coffee, possibly because of the type of bean used to make certain decaffeinated coffees.

Diabetes. Heavy coffee drinkers may be half as likely to get diabetes as light drinkers or nondrinkers. Coffee may contain chemicals that lower blood sugar. A coffee habit may also increase your resting metabolism rate, which could help keep diabetes at bay.

Parkinson’s disease. Coffee seems to protect men, but not women, against Parkinson’s disease. One possible explanation for the sex difference may be that estrogen and caffeine need the same enzymes to be metabolized, and estrogen captures those enzymes.

Source: https://www.health.harvard.edu/press_releases/coffee_health_benefits

Blogged with the Flock Browser

5 tips to increase HDL cholesterol

Thanks to powerful cholesterol-lowering statin drugs, driving down low-density lipoprotein (LDL), or “bad” cholesterol, has been the primary approach to improving cholesterol levels. But there’s more to the story of cholesterol and cardiovascular risk than LDL alone. Another key player is high-density lipoprotein (HDL), the “good” cholesterol. Higher levels of HDL are associated with lower cardiovascular risk. The good news about this good cholesterol is that simple lifestyle changes can help boost HDL, reports the June 2008 issue of Harvard Women’s Health Watch.

HDL removes LDL from artery walls and ferries it to the liver for processing or removal. HDL also fights potentially dangerous inflammation and clot formation. According to a recent review of research on HDL, there’s some evidence that increasing HDL can reduce the risk of heart attack and stroke—even without changes in LDL.

Harvard Women’s Health Watch suggests several things people can do to nudge up HDL levels. Most of these strategies also improve health in other ways.

1. Get aerobic exercise. Moderate to vigorous aerobic exercise can boost HDL by 5% to 10%. Aim for five 30-minute sessions per week.
2. Lose weight if you need to. If you’re overweight or obese, you can boost your HDL level by about 1 mg/dL for every seven pounds lost, although any amount of weight loss will help.
3. If you smoke, quit. HDL levels rise by as much as 15% to 20% after you quit.
4. Eat a healthy diet. Avoid trans fats, which increase bad cholesterol and decrease good cholesterol. Avoid highly refined carbohydrates, such as white-flour products.
5. Consider medications. Niacin, available over the counter, is the most effective HDL-raising medication available. Niacin can be strong medicine — work with your clinician if you want to try it.

Source: https://www.health.harvard.edu/press_releases/5-tips-to-increase-HDL-cholesterol

Blogged with the Flock Browser

High calcium intake may not help prevent fractures

For years, getting a lot of calcium has been portrayed as one of the best things you could do to prevent osteoporosis and related bone fractures. Small study results supported this view. But when researchers started to crunch the data from large, prospective studies that followed people for many years, the benefits weren’t so clear-cut, reports the March 2008 issue of the Harvard Health Letter.

The ambiguity led to trials to test what effect calcium might have on fracture rates. Two studies showed that calcium didn’t prevent fractures—even when taken in combination with vitamin D. Another study showed that postmenopausal women who took a calcium-vitamin D combination were no less likely to break their hip than women who took a placebo pill. And other researchers reported the results from a meta-analysis of studies on calcium that found no connection between high calcium intake and lower hip fracture risk.

While a certain level of calcium intake is undoubtedly important to keeping bones strong, amounts above that level might not do much good, notes the Harvard Health Letter. One reason some of these studies on supplements may not have shown a benefit is because the study participants were already getting over 1,000 milligrams (mg) of calcium daily through diet.

The bottom line: According to current recommendations, Americans over 50 are supposed to get 1,200 mg of calcium daily, but 600 mg is probably enough for most people to keep their fracture risk low. Still, because extra calcium might be protective against colon cancer, a daily intake of 600 to 1,000 mg is a reasonable goal.

Source: https://www.health.harvard.edu/press_releases/calcium-intake-and-fractures

Blogged with the Flock Browser

Influenza — it’s not “just the flu.” How to protect yourself from this annual onslaught

Although most patients recover from a bout of the flu without treatment, thousands of Americans die from it each year. Influenza is a serious infection — but it can be prevented and treated, reports the October 2008 issue of Harvard Men's Health Watch.

In the United States, the flu season runs roughly from Thanksgiving to Easter. In a typical year, up to 10% of Americans get the flu, over 200,000 are sick enough to require hospitalization, and about 36,000 die from the infection. This toll can double during epidemics, which occur every 10 to 15 years.

The best way to avoid suffering flu symptoms this winter is an ounce of prevention, starting with good hygiene:

• Wash your hands. Alcohol-based hand rubs and gels containing 60% to 95% isopropanol or ethanol are best, but ordinary soap and water will also help.
• Keep your distance. The flu is most contagious within three feet of an infected person.
• Wear a mask if you are in a high-risk group and you can’t avoid close contact with possible flu victims.
• Don’t go to work or school if you have the flu.

Another preventive step is immunization, which can reduce your risk of catching the flu by up to 80%. Scientists must develop a new flu vaccine each year because the virus is always changing, so to prevent this year’s flu, you'll need a new shot. In the United States, October and November are the ideal months to get vaccinated. And if you’re late in getting your immunization this year, two medications can help prevent infection — talk to your doctor about your options. These medications can also ease flu symptoms, if you start taking them early in the illness.

Source: https://www.health.harvard.edu/press_releases/influenza-its-not-just-the-flu

Blogged with the Flock Browser

7 tips for keeping your sinuses clear

More than 20 million Americans will have at least one bout of sinusitis this year. Blockage of the channels that drain the sinuses is the main cause of this painful condition. Keeping these channels open can reduce your chances of developing the problem, while restoring drainage if they become blocked is the key to treatment, reports the December 2008 issue of Harvard Men’s Health Watch.

Many people with sinusitis recover quickly and completely without taking antibiotics simply by promoting drainage. Harvard Men’s Health Watch offers the following tips:

• Drink lots of water. Good hydration helps keep mucus loose.
• Inhale steam three or four times a day. Boil water in a pan. Turn off the heat and bend over the pan with a towel over your head. to catch the steam. Breathe deeply through your nose.
• Sleep with your head elevated.
• Use decongestants. Tablets containing pseudoephedrine or phenylephrine are helpful, but beware that they may raise your blood pressure, speed your pulse, or make you jittery.
• Avoid antihistamines. They’re fine for allergies or a watery nose, but they make mucus thick and hard to drain—the last thing you want for sinusitis.
• Use a saline (salt water) nasal spray to loosen mucus and rinse your sinuses.
• A warm compress on your face may soothe sinus pain. Over-the-counter pain relievers such as aspirin or acetaminophen will help reduce pain and fever.

Antibiotics aren't the first step in treatment. Good as they are, they have potential disadvantages. They can trigger allergic reactions or cause side effects. Most people recover fully without antibiotics, but if your sinusitis is very severe or does not improve with two to four days of drainage therapy, ask your doctor if you should take an antibiotic.

Source: https://www.health.harvard.edu/press_releases/7-tips-for-keeping-your-sinuses-clear

Blogged with the Flock Browser

Exercise helps heal the heart and the mind

Mind and body are really two halves of the same whole. Each profoundly influences the other. Depression and heart disease are a good example of this duality. People who are depressed are more likely to develop heart disease than people who aren’t depressed, and those who have heart disease are more likely to fall into depression. But it is possible to exploit this two-way street and simultaneously heal the mind and the heart, reports the February 2009 issue of the Harvard Heart Letter.

Depression isn’t just in the mind. It causes a host of physical changes that can lead to heart trouble. It increases inflammation, which is involved in artery-clogging atherosclerosis and the rupture of plaque. It boosts the production of stress hormones, which dull the response of the heart and arteries. It activates blood platelets, making them more likely to form clots in the bloodstream.

Behavioral changes wrought by depression may be even more important. People who are depressed find it hard to exercise, to pay attention to what they are eating, and to take medicines needed to protect the heart.

Depression isn’t a passing phase. Trying to “get through” depression by slogging onward is like trying to “get over” diabetes. Fortunately, a variety of treatments—especially exercise—can fight depression. The Harvard Heart Letter notes that a regular exercise program can improve mood even as it strengthens the heart by releasing mood-altering chemicals in the brain, improving the supply of energy and oxygen to the brain, spurring the growth of new nerve cells in the brain, and reinforcing connections between existing nerves.

Source: https://www.health.harvard.edu/press_releases/Exercise-helps-heal-the-heart-and-the-mind

Blogged with the Flock Browser

Fix bad walking habits before you injure yourself

For healthy adults, walking is so automatic that it’s impossible to remember having learned how to do it. Yet it’s easy to pick up a few bad habits along the way that make our walks less efficient—and maybe even injurious. The good news is that even patterns established over a lifetime can be reversed, reports the February issue of the Harvard Health Letter.

Ideally, by adulthood a person will walk with head erect, back straight, arms bent, knees extending and flexing, and feet striking the ground with the heel and pushing off with the toes. Our upper bodies also get into the act. Unfortunately, few of us achieve the ideal gait, and fewer still maintain it. Over time, we may lower our heads and thrust our trunks forward. Instead of swinging, our arms may dangle listlessly at our sides.

Bad habits aren’t the only reason our gaits go awry. A variety of health conditions can throw us off stride, too. Arthritis is perhaps the most common. Good reflexes, healthy joints, strong muscles, and the vestibular system in the ear, which gives us a sense of spatial positioning, all play a role in keeping us upright. Take away any of them, and our balance suffers.

Here are some tips to correct bad walking habits:

Look ahead. Train your sights 10 to 20 feet ahead of you. If you need to check the ground to avoid obstacles, lower your eyes, not your head.

Stretch your spine. Your shoulders should be level and square. Tuck your buttocks in.

Bend your arms. Flex your elbows at close to 90-degree angles and let your arms swing at waist level.

Take measured steps. Too long a stride throws you off balance. Concentrate on taking shorter steps, but more of them.

Source: https://www.health.harvard.edu/press_releases/Fix-bad-walking-habits-before-you-injure-yourself

Blogged with the Flock Browser

Best steps you can take to prevent Alzheimer's

Several drugs aimed at clearing amyloid deposits from the brain—which investigators had hoped would reverse the symptoms of Alzheimer’s disease—have failed in late-stage testing. Reports on tests of other interventions to prevent or slow Alzheimer’s have also been discouraging: statins, vitamin supplements, and ginkgo biloba have failed to provide any benefit. It now appears that remaining mentally and physically fit are the best options for preventing—or at least delaying—Alzheimer’s from developing in the first place, reports the February issue of the Harvard Mental Health Letter.

For example, a study published in November 2008 provided evidence that cognitive reserve—an attribute encompassing thinking and memory abilities—may help delay Alzheimer’s symptoms. It’s not clear why, but people with more cognitive reserve may be able to compensate for any thinking deficits by using other parts of their brains. Researchers were surprised that when they compared people with the same extent of amyloid plaque, those with more education scored better on overall cognitive function than those with less education. Thus, education may create a cognitive reserve that raises the threshold for Alzheimer’s disease.

Two studies published in 2008 add to the evidence that overall cardiovascular fitness may help delay cognitive decline—possibly by keeping blood vessels healthy or by increasing blood flow to the brain. The Rush Memory and Aging Project found that the more active people were on a daily basis, the better they performed on tests of cognitive function. Likewise, the Fitness for the Aging Brain Study found that people who exercised regularly scored better on tests of cognitive function and memory than those who did not.

Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter, notes that achieving modest gains—particularly by remaining mentally and physically active—is the best option.

Source: https://www.health.harvard.edu/press_releases/Best-steps-you-can-take-to-prevent-Alzheimers

Blogged with the Flock Browser

Beyond the scale: how to measure whether you’re fat or not

Most of us have our private ways of assessing how fat we are. We feel our pants getting snug—or loose, if we’re lucky. But there are more objective ways to answer the question. The January 2009 issue of the Harvard Health Letter provides a guide to three measures of fatness.

Body mass index, or BMI, is computed by taking your weight in kilograms and dividing it by the square of your height in meters. The BMI is easy to calculate, and in most people, it correlates reasonably well with overall body fat. It’s also a good measure of health risk: as a rule, when BMIs go up, so do deaths, particularly from cardiovascular disease. But BMI doesn’t distinguish whether the pounds are from fat or from fat-free tissue like muscle and bone. BMI also doesn’t tell us about the type of fat we’re carrying—a significant shortcoming, as the type of fat that builds up in the abdomen is believed to be particularly unhealthful.

Waist measurement puts a different spin on obesity: it’s no longer about weight or total body fat, but about the metabolically active fat that collects around the organs in our abdomens. Waist circumference is a better predictor of diabetes than BMI and a good indicator of heart disease risk. Measuring it identifies the sizable group of people who pass muster when it comes to BMI but whose large waists put them at higher risk. Still, waist measurement hasn’t become part of routine medical practice for several reasons. For one thing, there’s some uncertainty about exactly where the waist should be measured, although navel-level is widely accepted. Moreover, the definition of too large a waist may need revision: some studies show that health risks start well before the current cutoffs of 40 inches for men and 35 inches for women. Finally, given all the other information that’s collected on patients—blood pressure, cholesterol levels, BMI—it’s not certain that adding a waist measurement to the mix would affect treatment decisions.

The waist-to-hip ratio (WHR) is a simple calculation: waist circumference divided by hip circumference. A small waist combined with big hips yields a smaller number than a big waist with small hips—and smaller is better when it comes to WHR. For women, the risk for heart disease, stroke, and other health problems starts to climb at a ratio of about 0.85, so that is often set as the cutoff for a “good” ratio. For men, the cutoff seems to be about 0.90. Waist circumference has eclipsed WHR, but the WHR may be ready for a comeback. Research shows that WHR is more strongly associated with heart disease than waist circumference alone. By taking hip circumference into account, the ratio is more sensitive to the difference between dangerous abdominal fat and the less harmful layer of fat we carry under the skin throughout the body.

Source: https://www.health.harvard.edu/press_releases/beyond-the-scale-how-to-measure-whether-youre-fat-or-not

Blogged with the Flock Browser

12 ways to cut health care costs

How you can rein in health care bills — yours and society's.

Our carbon footprints are calculations of the greenhouse gases we're individually responsible for. Reduce yours, and you can take some satisfaction in having done something, however small, to reduce emissions and slow global warming.

Now might be a good time to start thinking about our health care footprints. Reforming health care and extending medical insurance to all Americans have become national priorities, despite — or maybe because of — the weak economy. But those efforts are likely to founder unless spending on health care is brought under control.

Serious reform and belt tightening can't happen without new policies from Washington, but individual responsibility and action can both set an example and make a contribution. It all adds up. Besides, even people with good health coverage are paying a larger fraction of their health care bills these days, in the form of co-pays, deductibles, and other out-of-pocket expenses. There's a direct personal interest in reining in costs, not just a societal one.

We polled our editorial board to get some ideas about what people might do as individuals about health care spending. Dr. Soheyla Gharib suggested the term health care footprint to us. Here are a dozen suggestions for making yours a bit smaller:

1. Develop a good working relationship with a primary care physician. A primary care doctor who knows you, your medical history, and your circumstances stands a much better chance than a relative stranger of making decisions and giving you advice that will keep you healthy, out of the hospital, and in no need of specialized medical care. She or he can take care of you in context. The catch is that primary care physicians are in short supply. And primary care may be evolving into more of an ensemble approach, with the physician being the head of a large supporting cast. In a few years, the relationship you have with the physician may be less primary than, say, the one you have with the health coach — someone who works with the physician and whose job it is to cajole, remind, and motivate people to take better care of themselves.

2. Don't use the emergency department unless absolutely necessary. Call your doctor or his service and try to get some advice over the phone — or, better yet, in person. Emergency care is fantastically expensive partly because the doctors and nurses often need to order a lot of tests so they can make diagnostic and treatment decisions quickly.

3. Get — and stick — with the program. Most of American health care these days is devoted to treating chronic conditions — like arthritis, diabetes, heart disease, and high blood pressure — and to care at the end of life (see #11). Taking medications as prescribed, getting regular check-ups (regular eye examinations if you have diabetes, for example), and adhering to lifestyle changes can keep those diseases under control at relatively (we stress relatively) modest cost.

4. Don't go directly to a specialist without checking with your primary care doctor, even if your insurance allows it. Medical care is increasingly specialized, but as much as possible, you should let your primary care physician coordinate that care. If she or he doesn't know what's going on, it can lead to wasteful — and possibly harmful — overtesting and duplication of treatments.

5. Ignore the drug ads. The heyday of pharmaceutical advertising may be winding down (remember the Dorothy Hamill Vioxx ads?), but there are still plenty of slick direct-to-consumer come-ons being broadcast and published. New drugs may have real advantages over older ones, but the virtues of the old standbys, which don't have big ad budgets behind them, often get overlooked. Older drugs are frequently just as effective (if not more so) and safer — and almost certainly cheaper.

6. Go generic. Spending on pharmaceuticals has slowed down, in large part because of competition from generic drugs, which cost less than their brand-name equivalents. Most insurers have higher co-pays for brand-name drugs, so using generic medications can mean a cost savings both for you and for the health care system. But check with your doctor and your pharmacist about what's available as a generic. It can be confusing. For example, there's a generic form of mupirocin ointment, but as a cream, the antibiotic is available only as brand-name Bactroban. We've posted a list of other examples of this kind of inconsistency on our Web site at www.health.harvard.edu/health.

7. Fight inertia. If you're taking a medication, discuss with your physician how long you've been taking it, whether it's working, and if it isn't, not taking it anymore. Many people take medications for years without knowing if they are helping in any way. Antihistamines, nasal steroid sprays, and antireflux medications are prime candidates for this sort of pharmacological inertia. You can avoid this problem by talking to your doctor about a trial period when you start a drug. Get some instructions about signs that would show if the drug is working, and see the doctor if it's not.

8. Screen the screening tests. Screening tests can save lives by catching a disease at an early, more treatable stage. But a screening test can also cause a lot of mischief: false alarms, a false sense of security if a disease is missed, and unnecessary diagnostic testing and treatment. There are more doubts about some well-established screening tests than many people realize. For example, many men believe they must get the prostate-specific antigen (PSA) test for prostate cancer. Not so, say the federal government's prevention guidelines, which characterize the evidence as insufficient to recommend PSA testing. And in 2008 the guidelines were revised to say men ages 75 and older shouldn't get a PSA test. These are just guidelines: men need to discuss the pros and cons of PSA testing with their doctor — with the clear understanding that they are entering a gray area.

9. Question the need for expensive tests. Don't push to get new, expensive tests just because you think new is better. And if a doctor orders an expensive test like an MRI or CT scan, you can ask why it's necessary and how it will make a difference. The number of imaging tests being done in the United States has exploded and by some reckonings, almost a third of them are unnecessary. Some tests, like CT scans to evaluate coronary artery disease, are being debated because it's unclear how much they really add to standard tests. Health care experts Ezekiel Emanuel and Victor Fuchs have pointed out that the hospitalization rate in the United States is actually lower than in many European countries. We also go to the doctor less often on a per capita basis. It's the expensive inputs into our health care — all the drugs, tests, high-tech treatments, highly compensated specialists — that drive up the collective medical bill, not so much the volume.

10. Wait, and it may go away. Often it's critically important to get medical care straightaway. Prompt treatment of a heart attack or stroke can save your life or prevent devastating disability. But people frequently get tests and treatments for aches, pains, and other discomforts that might have gone away on their own because the illness-producing stress of work or school lets up, for example, or the immune system fights off the infection. If you are feeling sick, by all means get evaluated, but if your doctor suggests the test of time, take the test.

11. Discuss end-of-life issues with your family and physicians. Medical care near the end of life is a big-ticket item. Roughly a fifth of the money that Americans spend on health care goes for care in the last year of life. Living wills and advance directives don't necessarily save money — people sometimes want more care, not less, as they become more frail — but they may help. And so may talking about your preferences. A study published in The Journal of the American Medical Association in 2008 found that cancer patients who had discussed end-of-life care with their physicians received hospice care sooner and had lower rates of ventilation, resuscitation, and admission to an intensive care unit. Because they talked to their physicians, these people were treated the way they wanted to be and avoided a waste of precious resources.

12. Stay healthy! Not needing health care is perhaps the surest way of spending less money on it, both yours and society's. So don't smoke and get help quitting if you do. A good diet (replacing refined starches with whole grains and lots of fruit and vegetables) will lower your cardiovascular risks. Exercise helps with — well, you name it. Sleep is fast becoming the third pillar of wellness. Studies have shown that averaging eight hours a night may prevent colds and keep arteries open.

Source: https://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2009/March/12-ways-to-cut-health-care-costs

Blogged with the Flock Browser

What to do about sinusitis

A step-by-step approach starts with a simple nasal wash.

If you've ever had a cold that just wouldn't go away, chances are it was sinusitis — an inflammation of the paranasal sinuses, the cavities within the bones that surround the nose. The sinuses are lined with a thin membrane that produces mucus, which is normally swept along by hair cells and drains through small openings into the nasal cavity. Sinusitis (also called rhinosinusitis) starts when this drainage system becomes blocked, usually from swelling due to inflammation caused by infection or allergy. Soon, your head hurts, you feel facial pressure or pain, and thick mucus clogs your nose. The symptoms may clear on their own, but often they persist or repeatedly return.

Several years ago, Dr. Ralph Metson, a sinus specialist at Massachusetts Eye and Ear Infirmary in Boston, conducted a study of the effects of chronic sinusitis on daily functioning. Dr. Metson says he and his colleagues undertook the research because so many of his patients felt that no one understood how miserable sinusitis could be. Comparing the impact of chronic sinusitis with that of other chronic illnesses — including heart failure, back pain, and chronic obstructive pulmonary disease — the Harvard researchers found that sinusitis sufferers reported the highest levels of pain and the lowest levels of social functioning, as well as significant problems with work, energy, and mental health.

Until the late 1970s, there were few tools to help pinpoint sinusitis, and treatment was difficult. Medications were limited, and surgery involved major incisions and a lengthy recovery time. In recent years, diagnosis and treatment have vastly improved. The course of sinusitis is better understood, and advances such as CT scans, minimally invasive procedures, and more powerful antibiotics are making even the balkiest cases more manageable.

Anatomy of the paranasal sinuses The paranasal sinuses comprise four pairs of sinuses that surround the nose and drain into the nasal cavity by way of narrow channels called ostia (singular: ostium). Mucus leaving the frontal (forehead) and maxillary (cheek) sinuses drains through the ethmoid sinuses (behind the bridge of the nose), so a backup in the ethmoids is likely to clog the other two types of sinuses. The sphenoid sinuses are located deep in the skull, behind the eyes. Sinusitis develops when one or more sinuses become blocked.

What triggers sinusitis?

There are millions of bacteria in our noses, and most of the time, they're harmless. Even when a few creep into the sinuses, they don't cause trouble, as long as they keep draining into the nose along with mucus. But if sinus drainage is blocked, glands in the sinuses continue to produce mucus, and the resulting pool of backed-up mucus provides what Dr. Metson calls "the perfect culture medium." The bacteria grow out of control, causing infection, and the immune system kicks off an inflammatory response. The result: swelling, which causes headache and facial pain; mucus buildup, which produces congestion; and an influx of white blood cells to fight the bacteria, which thickens the mucus and may tint it yellow or green. Other symptoms include loss of smell or taste, cough, bad breath, fever, toothache, and fullness in the ears.

Sinus blockage can have a variety of environmental, anatomical, and genetic causes, but the main culprit is swelling of the nasal passages produced by the common cold or allergies. More serious sinusitis can result from structural problems, such as a deviated septum (a crook in the partition that separates the right from left nasal cavities) or nasal polyps (small, grapelike growths in the lining of the sinus cavity).

First line of defense: Nasal irrigation One of the simplest, cheapest, and most effective ways to prevent and treat sinus problems is nasal irrigation. Using nothing more than tap water and table salt, you can often relieve sinusitis symptoms, reduce reliance on nasal sprays and antibiotics, and improve your quality of life. At least twice a day, follow these steps: Stir 1 teaspoon of salt into 2 cups of lukewarm water. Fill a small bulb syringe with the saltwater solution. (If you prefer, you can use a small pitcher called a neti pot to stream the solution through your nose. Or you can purchase an inexpensive nasal irrigation kit with a squeeze bottle, such as NeilMed's Sinus Rinse, at most drugstores.) Lean over your bathroom or kitchen sink, insert the tip of the syringe just inside one nostril, and gently squeeze the bulb. The water will run back out the nostril (or possibly the opposite nostril) and into the sink. Use at least one full bulb of solution. Repeat the procedure in the other nostril. (If the salt solution stings your nose, use less salt, or add a big pinch of baking soda to the solution, to buffer it.)

Treating sinusitis

Sinusitis is classified by how long it lasts. "Acute" sinusitis lasts a month or less; "subacute" sinusitis, a month to three months; and "chronic" sinusitis for longer than that (sometimes for years). If several acute attacks occur within a year, it's called "recurrent." Treatment begins with simple remedies, such as nasal irrigation (see the box above) and if necessary progresses to more advanced strategies, such as prescription drug therapy or surgery.

Most people with acute sinusitis get better without treatment, although you can ease the symptoms and reduce the likelihood of needing stronger medicine if you keep your nasal passages clear with a few low-tech preventive techniques (see "Preventing sinusitis"). It's hard to predict who will develop chronic sinusitis, but knowing more about the two main types can help you decide how to treat your symptoms and when to see a clinician. Here are the basics:

Acute sinusitis. Acute sinusitis usually starts with a cold. Viruses, not bacteria, cause colds, so it's useless to treat them with antibiotics. But when a cold turns into sinusitis, it means that blocked nasal passages have set off a secondary infection caused by bacteria and you may eventually need an antibiotic. Rarely, especially in people with weakened immune systems, a fungal infection is the cause.

If symptoms are severe and last for more than a week, you may want to see your primary care clinician. Based on your symptoms and a look inside your nose with a small flashlight, she or he can usually tell whether sinusitis has settled in. If you do have sinusitis, you may be prescribed an antibiotic, especially if preventive drainage strategies aren't helping. Antibiotics are usually given for 10 to 14 days, but trials suggest that in some cases, three to seven days are sufficient. The first choice is often amoxicillin or amoxicillin combined with clavulanate (Augmentin). Many clinicians have found that a five-day course of azithromycin (Zithromax) also works well.

For the pain, try a warm compress on your face, or inhale steam (see "Preventing sinusitis"). An over-the-counter pain reliever such as aspirin, ibuprofen, or acetaminophen can also relieve facial pain, as well as headache and fever.

Chronic sinusitis. If symptoms linger or keep returning, you may have chronic sinusitis, a more complex disorder that calls for evaluation by an ear, nose, and throat (ENT) specialist (also called an otolaryngologist). She or he will order a CT scan of your nose and sinuses and examine the nasal cavity with a thin lighted tube (endoscope) to look for causes of the blockage. Blood and allergy tests and bacterial cultures may also be needed.

Nasal irrigation and decongestants can help in the treatment of chronic sinusitis by keeping mucus loose and nasal passages clear. The mucus-thinning agent guaifenesin (Mucinex) is another option. (Be sure to drink a full glass of water when you take it.) Nasal steroids such as fluticasone (Flonase) or beclomethasone (Beconase) may be added to help counter inflammation. (These must be applied properly to avoid nosebleed. Ask your clinician for instructions in the correct technique.) Oral steroids are also effective, especially in reducing large polyps, but they can have serious long-term effects, such as weakened bones and greater susceptibility to infection. Bacterial infection can be complicated in chronic sinusitis and may require different antibiotics and a longer course of therapy. In some cases, intravenous antibiotics may be needed, mainly when oral antibiotics have failed and surgery isn't possible, or when infection has spread beyond the sinuses.

Sometimes the main problem is anatomical, such as nasal polyps, a deviated septum, congenitally narrowed paranasal passages, or tissue thickened by years of infection. In this case, minimally invasive surgery may help, reducing the number and severity of sinus infections and sometimes restoring normal sinus function. Surgery isn't a cure-all: polyps, for example, may grow back. Every situation is different, so it's important to discuss the options with an ENT specialist.

Selected resources American Academy of Otolaryngology — Head and Neck Surgery703-836-4444www.entnet.org American Rhinologic Society845-988-1631www.american-rhinologic.org National Institute of Allergy and Infectious Diseases866-284-4107 (toll-free)www3.niaid.nih.gov The Harvard Medical School Guide to Healing Your Sinuses, by Ralph B. Metson, M.D., with Steven Mardon (McGraw-Hill, 2005).

Preventing sinusitis

There are many things you can do to reduce your chance of developing sinusitis or to relieve early sinusitis symptoms. One of the most important is to promote drainage and keep nasal passages clear. Here are some suggestions:

Bathe your nasal passages daily. Run water gently into the nasal passages to help clear excess mucus and moisten membranes. (See "First line of defense: Nasal irrigation.") Good times to do it are in the morning and at night, when you brush your teeth. "Brush, then flush," is Dr. Metson's motto. During the day, use nasal saline spray to moisten nasal passages.

Drink lots of water. Good hydration helps keep the mucus thin and loose. Have a bottle of water at your desk at work, or put a glass near the kitchen sink to remind you to drink water throughout the day.

Inhale steam. Linger in a hot shower. Or bring water to a boil, and pour it into a pan; place a towel over your head, and carefully bend over the pan to inhale the steam. To avoid burns, keep your distance at first and move in gradually to a comfortable zone.

Avoid dry environments. A humidifier in your home (in particular, by your bed) and where you work can help prevent nasal passages from drying out. Keep humidifiers clean and free of bacteria and mold.

Sleep with your head elevated. Mucus pools in your sinuses at night when your head is down, so have your head propped up with pillows or a wedge during sleep.

Be nice to your nose. Blow your nose gently, one nostril at a time. Forceful blowing can irritate the nasal passages and propel bacteria-laden mucus back up into your sinuses.

Avoid antihistamines unless prescribed. Antihistamines make mucus thick and hard to drain. But if your sinusitis is triggered by allergies, your clinician may still want you to take an antihistamine along with other medications.

Be careful with decongestants. Tablets containing pseudoephedrine act on blood vessels to shrink membranes and keep nasal passages open. Nasal sprays containing phenylephrine or oxymetazoline also work well — and quickly. But using topical nasal decongestants for more than a day or two runs the risk of setting off a spiral of dependency as a result of rebound — increased swelling after the medication wears off. (According to Dr. Metson, a shorter-acting spray, such as 0.25% or 0.5% Neo-Synephrine, is less likely to cause rebound than longer-acting ones like Afrin.) Oral decongestants can cause jitters and increase blood pressure, so if you have high blood pressure, don't use them without consulting a clinician first.

Source: https://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2009/March/What_to_do_about_sinusitis

Blogged with the Flock Browser

Allergic rhinitis: Your nose knows

It's easy to dismiss hay fever as a minor nuisance. But call it by its proper name, allergic rhinitis, and you'll be on the way to recognizing it as a legitimate medical problem. Add the fact that it affects about one of every five Americans and drains the economy of about $2 billion a year, and you'll see that it's an important problem indeed. Fortunately, it's also a problem that responds very well to treatment.

Nosing around

If a man thinks about his nose at all, he's likely to think of it as a simple organ of smell. It's true, of course, that the nose is responsible for the sense of smell, but smell means much more than the ability to enjoy pleasing scents. Because smell contributes importantly to taste, it plays a central role in maintaining good nutrition. Smell can also warn us of dangers ranging from toxic fumes and smoky fires to spoiled food.

Allergic rhinitis can blunt the sense of smell, and it can also interfere with the other important functions of the nose. When your nasal passages are functioning normally, about five to eight quarts of air pass through them each minute. Your nose has the job of conditioning that air before it reaches the sensitive tissue of your lungs. Your nose adds moisture, but to do that, it must produce large amounts of mucus. It also warms the air, with help from a large network of blood vessels. Finally, the nose traps small particles, keeping them out of the lungs.

If you have allergies and your nose traps pollen or other particles to which you are sensitive, an inflammatory process starts right in your nose. Immune system mast cells in the nasal tissue release chemicals such as histamine and leukotrienes. Blood vessels swell, causing nasal congestion, and mucus production soars, creating a runny nose. Just like that, you've developed some of the symptoms of allergic rhinitis — and some of your nose's normal functions have been compromised.

Types of rhinitis

Allergic rhinitis is the most common. Seasonal allergic rhinitis comes and goes as various plants come into bloom. If your symptoms occur in the spring, you are probably allergic to tree pollen; in the summer, grass and weed pollens are the likely culprits; in the late summer and fall, ragweed is the most likely cause. But if your symptoms occur year-round (perennial allergic rhinitis), you are probably allergic to indoor allergens such as dust mites, mold, or animal dander.

Rhinitis can also occur without allergies. Examples include viral rhinitis (the common cold); drug-induced rhinitis (possible culprits include Viagra and the other ED pills, the alpha blockers used for benign prostatic hyperplasia, the ACE inhibitors and beta blockers used for hypertension, and aspirin and nonsteroidal anti-inflammatory drugs); and hormonal rhinitis (including the "pregnant nose" experienced by some women). In some people, exercise, eating, and exposure to cold or dry air, air pollutants, or strong smells can trigger rhinitis. Inflammation is absent in nonallergic rhinitis, and the symptoms are limited to a runny, stuffy nose.

A final category of rhinitis can be particularly tricky. It's rhinitis medicamentosa, irritation of the nasal membranes caused by overuse of decongestant nasal sprays such as phenylephrine and oxymetazoline that some people use for quick relief of allergic rhinitis.

Symptoms

Nearly everyone with allergic rhinitis complains of a stuffy, runny nose. Sneezing is nearly as common, and a postnasal drip can trigger coughing. Typical symptoms extend beyond the nose to include an itchy or sore throat and itchy, burning, watery eyes that may look red due to allergic conjunctivitis.

Associated ailments

Between 20% and 40% of patients with allergic rhinitis also have asthma. Other allergy-related disorders such as eczema may also be present. Some patients have nasal polyps, a deviated nasal septum, or sinusitis.

Diagnosis

Most people with allergic rhinitis can diagnose the problem themselves simply by recognizing typical symptoms. In complicated cases, an ENT (ear, nose, and throat) specialist can check for polyps and other nasal abnormalities. If it is important to identify specific allergic triggers, allergists can perform skin tests; the so-called RAST blood test can also help pin down the culprits.

Treatment

Three strategies are available: avoiding triggers, using medications to reduce symptoms, and getting immunotherapy ("allergy shots").

Avoiding triggers. Here are the steps to take for seasonal rhinitis:

• Limit your outdoor activities when pollen counts are high. Ragweed counts usually peak in early midday, grass pollen in late afternoon and early evening. If you have to do yard work during pollen season, wear an N95 mask. Shower, wash your hair, and change your clothes afterwards.

• Keep your windows and doors closed as much as possible during pollen season.

• Use air conditioners instead of fans, which bring in outside air. Drive with your windows and vents closed and your air conditioner on.

For year-round allergic rhinitis:

• If you have a dog or cat that triggers symptoms, have it bathed weekly and do your best to keep it off furniture and out of the bedroom.

• Put pillows, box springs, and mattresses in sealed plastic covers (allergen encasements) to keep out dust mites. Wash bedding in hot water (above 120° F) to kill dust mites.

• Remove carpets from your bedroom.

• Use a dehumidifier to keep relative humidity below 40%.

Medication. Many treatments are available. Here's a quick summary of the major types.

Antihistamine tablets will help most patients. For the majority of people, one of the newer, less sedating preparations will be best. Some are available over the counter, such as loratadine (Alavert, Claritin, generic) and cetirizine (Zyrtec), while others such as fexofenadine (Allegra, generic) and desloratadine (Clarinex) require a prescription. High doses can produce sleepiness and dry mouth; men with benign prostatic hyperplasia (BPH) may have difficulty urinating.

Nasal steroid sprays are very effective but usually take several days to kick in. Like the oral antihistamines, these prescription drugs can relieve eye symptoms as well as nose symptoms. Examples include beclomethasone (Beconase AQ) and triamcinolone (Nasacort AQ). Side effects may include nasal irritation and headaches; long-term use may slow growth in children.

Antihistamine nasal sprays are as effective as oral antihistamines. Azelastine (Astelin) and olopatadine (Patanase) are available by prescription; some patients experience a bitter taste or drowsiness.

Leukotriene blockers, such as the oral prescription drug montelukast (Singulair), relieve most symptoms of allergic rhinitis. Side effects may include headache and, perhaps, personality changes.

Decongestants are available without prescription as tablets (pseudoephedrine, phenylephrine) or nasal sprays (phenylephrine, oxymetazoline) and can relieve nasal congestion but have little effect on other allergic rhinitis symptoms. Side effects may include nervousness, racing heart, elevated blood pressure, and insomnia. Men with BPH may have difficulty urinating. Decongestants should not be relied on for primary treatment but can be combined with a first-line drug for temporary use. You should not use a decongestant nasal spray for more than a few days.

Other medications include an anticholinergic nasal spray called ipratropium (Atrovent), which is effective only for runny noses; an intranasal mast cell stabilizer (Cromolyn) and various anti-allergic eye drops can be used to treat eye symptoms. In rare cases, patients with severe rhinitis may need a short course of oral steroids.

Immunotherapy, or "allergy shots," can help achieve long-term control of allergic rhinitis. The regimen usually involves skin testing to identify the responsible allergens followed by weekly injections of gradually increasing doses of the allergen, and then maintenance injections every two to six weeks for several years. Most doctors reserve immunotherapy for patients who do not respond well to medication.

Nothing to sneeze at

For many men, allergic rhinitis is a temporary seasonal woe, but for others, it's a year-round hassle. And for some, it can be linked to asthma, sinusitis, or other more serious problems. Because allergic rhinitis is so very common, it also adds up to an expensive proposition for American society.

If you are one of the unlucky many with allergies, you'll have to learn to deal with the problem. Avoid exposure to things that trigger symptoms. Experiment with medications to control symptoms; nonsedating antihistamines, antihistamine nasal sprays, and steroid nasal sprays are among the first-line treatments. Some men may prefer one of the many other drugs that are available, and others need combination therapy. Immunotherapy is available for particularly difficult cases.

The many options for treating allergic rhinitis can be confusing at first, but if you take the time to nose around, you'll find a way to keep your nose working smoothly — without running!

Source: https://www.health.harvard.edu/newsletters/Harvard_Mens_Health_Watch/2009/May/Allergic-rhinitis-Your-nose-knows

Blogged with the Flock Browser

The 10 commandments of cancer prevention

About one of every three Americans will develop some form of malignancy during his or her lifetime. This year alone, about 1,437,000 new cases will be diagnosed, and more than 565,000 people will die of the disease. Cancer is the second leading cause of death in America, and as deaths from heart disease decline, it's poised to assume the dubious distinction of becoming our leading killer.

Despite these grim statistics, doctors have made great progress in understanding the biology of cancer cells, and they have already been able to improve the diagnosis and treatment of cancer. But instead of just waiting for new breakthroughs, you can do a lot to protect yourself right now.

Get regular check-ups, including the screening tests that can help detect cancer before it causes any symptoms. For men between 15 and 35, that means a periodic doctor's testicular exam along with regular self-exams. All men older than 50 should have regular screening for colon cancer, and they should make an informed decision about testing for prostate cancer. Men with risk factors should begin both processes even earlier, and every man should routinely inspect himself for signs of melanomas and other skin cancers.

Screening tests can help detect malignancies in their earliest stages, but you should always be alert for symptoms of the disease. The American Cancer Society developed this simple reminder years ago:

• C: Change in bowel or bladder habits

• A: A sore that does not heal

• U: Unusual bleeding or discharge

• T: Thickening or lump in the breast or elsewhere

• I: Indigestion or difficulty in swallowing

• O: Obvious change in a wart or mole

• N: Nagging cough or hoarseness

It's a rough guide at best. The vast majority of such symptoms are caused by nonmalignant disorders, and cancers can produce symptoms that don't show up on the list, such as unexplained weight loss or fatigue. But it is a useful reminder to listen to your body and report sounds of distress to your doctor.

Early diagnosis is important, but can you go one better? Can you reduce your risk of getting cancer in the first place? It sounds too good to be true, but it's not. Scientists at the Harvard School of Public Health estimate that up to 75% of American cancer deaths can be prevented; the table below summarizes their research on the causes of cancer in the United States. The American Cancer Society is only slightly less optimistic about prevention, estimating that about 60% of America's cancer deaths can be avoided. And a 2005 study argues that over 2.4 million of the world's 7 million annual cancer deaths can be blamed on nine potentially correctable risk factors.

The causes of cancer
Risk factor	Percentage of cancer deaths
Smoking and tobacco use	30
Obesity and diet (red meat vs. fruits and vegetables)	30
Lack of exercise	5
Carcinogens in the workplace	5
Viruses (hepatitis, human papillomavirus)	5
Family history of cancer	5
Body size (taller, bigger people get more cancer)	5
Women's reproductive factors (late or no childbearing, late menopause, early periods)	3
Excessive alcohol consumption	3
Poverty (aside from bad diet)	3
Environmental pollution	2
Excessive exposure to sun	2
Medical procedures, drugs	1
Salt, food additives, contaminants	1
Source: "Harvard Report on Cancer Prevention, Vol. I: Causes of Human Cancer" (1996), Vol. 7, pp. 53–55.

You don't have to be an international scientist to understand how you can try to protect yourself and your family. The 10 commandments of cancer prevention are:

1. Avoid tobacco in all its forms, including exposure to secondhand smoke.

2. Eat properly. Reduce your consumption of saturated fat and red meat, which appears to increase the risk of colon and prostate cancers. Limit your intake of charbroiled foods (especially meat), and avoid deep-fried foods. Increase your consumption of fruits, vegetables, and whole grains. Although other reports are mixed, two large 2003 studies found that high-fiber diets may reduce the risk of colon cancer. And don't forget to eat fish two to three times a week; you'll get protection from heart disease, and you may reduce your risk of prostate cancer.

3. Exercise regularly. Physical activity has been linked to a reduced risk of colon cancer, and it may even help prevent prostate cancer. Exercise also appears to reduce a woman's risk of breast and possibly reproductive cancers. Exercise will help protect you even if you don't lose weight.

4. Stay lean. Obesity increases the risk of many forms of cancer. Calories count; if you need to slim down, take in fewer calories and burn more with exercise.

5. If you choose to drink, limit yourself to one to two drinks a day. Excess alcohol increases the risk of cancers of the mouth, larynx (voice box), esophagus (food pipe), liver, and colon; it also increases a woman's risk of breast cancer. Smoking further increases the risk of many alcohol-induced malignancies.

6. Avoid unnecessary exposure to radiation. Get medical imaging studies only when you need them. Check your home for residential radon, which increases the risk of lung cancer. Protect yourself from ultraviolet radiation in sunlight, which increases the risk of melanomas and other skin cancers. But don't worry about electromagnetic radiation from high-voltage power lines or radiofrequency radiation from microwaves and cell phones. They do not cause cancer.

7. Avoid exposure to industrial and environmental toxins such as asbestos fibers, benzene, aromatic amines, and polychlorinated biphenyls (PCBs).

8. Avoid infections that contribute to cancer, including hepatitis viruses, HIV, and the human papillomavirus. Many are transmitted sexually or through contaminated needles.

9. Consider taking low-dose aspirin. Men who take aspirin or other nonsteroidal anti-inflammatory drugs appear to have a lower risk of colon cancer and possibly prostate cancer. It's an unproven benefit, and aspirin can produce gastric bleeding and other side effects, even in low doses. On the plus side, though, low-dose aspirin does protect men from heart attacks and the most common type of stroke; men at the highest risk reap the greatest benefits.

10. Get enough vitamin D. Many experts now recommend 800 to 1,000 IU a day, a goal that's nearly impossible to attain without taking a supplement. Although protection is far from proven, evidence suggests that vitamin D may help reduce the risk of prostate cancer, colon cancer, and other malignancies. But don't count on other supplements. Careful studies show that selenium, vitamins C and E, beta carotene, folic acid, and multivitamins are not protective, and that some may do more harm than good.

These lifestyle changes will yield another cancer-preventing benefit: if you stay healthy, you won't need cancer treatments (chemotherapy, radiotherapy, drugs that suppress the immune system) that have the ironic side effect of increasing the risk of additional cancers.

As always, prevention is the best medicine.

Source: https://www.health.harvard.edu/newsletters/Harvard_Mens_Health_Watch/2009/April/The-10-commandments-of-cancer-prevention?utm_source=mens&utm_medium=pressrelease&utm_campaign=mens0409

Blogged with the Flock Browser

Putting the joie de vivre back into health

The eat-your-peas mode of staying healthy is changing to include chocolate, sleep, and a few other things most people enjoy.

No one likes to be nagged, but that's often what health advice seems to do. There are all those don'ts (as in smoke, eat too much, gain weight). And the dos (exercise, eat fruit and vegetables) are predictable, even for people who don't mind them. Live longer, live healthier, you say? Okay, but what a chore and a bore!

Lately, however, health researchers are reporting results that suggest maybe we can have our health and enjoy ourselves, too. Studies have elevated coffee to health-drink status by linking it to a reduced risk of dementia and Parkinson's disease. Dozens of findings have shown that alcohol and chocolate may have cardiac benefits. Sex, sleep, and a social life seem to have all-around benefits.

Never has high living looked quite so healthful, although it's high living on a leash. The permission to indulge almost always comes with a reminder about doing everything in moderation.

So here is a rundown of research we ran across thumbing through our dog-eared copies of The Archives of Hedonism and Health (fine, the journal name is fictitious, but the research cited below is not). Enjoy and be healthy — in that order!

Alcohol

Dozens of studies have shown that moderate alcohol consumption protects against heart disease and stroke. Drinking increases "good" HDL cholesterol, reduces factors in blood that make it more likely to clot, and may directly affect blood vessels, keeping the linings smooth and pliable and thus less vulnerable to atherosclerosis. European researchers reported interesting findings in 2008 that show a connection between alcohol intake and higher blood levels of omega-3 fats. Indeed, temperate tippling has been associated with everything from greater bone density to less risk for Alzheimer's disease and vascular dementia.

Moderation gets mentioned rather immoderately in the pro-alcohol medical literature because drinking too much is patently ruinous. Triglycerides and blood pressure go up. Binge drinking can lead to stroke. The myriad troubles associated with alcoholism don't need to be recounted here. Moderation is flexibly defined, but the American Heart Association guidelines are often cited: for men, one to two drinks a day; for women, just one. The limit is lower for women because they tend to be smaller and break down alcohol more slowly than men. A drink is defined as a 12-ounce beer, 4 ounces of wine, or 1.5 ounces of 80-proof liquor.

Women do need to worry about alcohol increasing breast cancer risk. Alcohol may drive up estrogen levels, and estrogen seems to play an integral part in the development of many breast cancers. Epidemiologic studies have consistently found an association between alcohol consumption and breast cancer risk, although at moderate amounts (the drink-a-day level), the risk is small. The good news: folic acid may help offset the breast cancer risk posed by alcohol, so women who drink are encouraged to get an extra 400 micrograms per day.

Chocolate

Woody Allen saw it coming with his joke in Sleeper about researchers deciding that hot fudge was good for us after all. A steady stream of studies has won chocolate cardiovascular laurels by showing that it improves blood flow through arteries that supply the heart and the brain (which Allen said is his second favorite organ). Chocolate's winning ways continued in 2008. Harvard researchers found that two weeks of enhanced chocolate intake (now that's our type of study!) quickened blood flow through the middle cerebral artery. And Italian researchers reported a possible connection between eating dark chocolate and low levels of C-reactive protein, a marker for inflammation.

Not every study has been a thumbs up: researchers at the National Institutes of Health concluded that chocolate did not decrease blood pressure or improve insulin sensitivity in a two-week study of people with high blood pressure. Moreover, the chocolate-as-healthful dream needs a couple of reality checks. The most likely explanation for chocolate's good effects is that cocoa beans contain substances called flavonols (specifically, catechin and epicatechin, which are also found in tea) that stimulate production of nitric oxide, a chemical that relaxes blood vessels. In the studies cited above, researchers have used "flavonol-rich" chocolate. But typically, the processing of cocoa beans into chocolate removes flavonols. Dark chocolate may have more flavonols than other types, but you can't go just by darkness. Some companies have started to market products advertised as preserving the cocoa bean's flavonol content (for example, the Cocoavia bars made by Mars, a company that has funded a lot of the pro-chocolate research).

Another caveat: the sugar and fat content of chocolate candy translates into calories (over 200 in a 3.5-ounce bar of expensive dark chocolate). And some of the fat in many chocolate bars is the unhealthful saturated variety.

Coffee

For the health conscious, a cup of coffee was once a somewhat perilous pleasure. Early studies showed a connection between coffee and heart attack, a worry that seemed to be validated by coffee's ability to quicken the pulse. Some other studies cast the gloomy shadow of cancer risk.

But the cancer research was flawed or overturned by more definitive findings. Not all the evidence has been exculpatory, however. A Harvard study published in 2008 found no overall association between caffeine consumption and breast cancer risk, but there were hints of a connection in women with a history of benign breast disease and those whose tumors were estrogen- and progesterone-receptor negative.

Meanwhile, the coffee–cardiovascular disease research has done an about-face: now the gist is that coffee drinkers seem to be less likely to have heart attacks and strokes and develop diabetes than nondrinkers. The caffeine in coffee does constrict blood vessels (that's why it can help with headaches caused by vessels that have dilated) and may increase your heart rate a little, but those are transitory effects. Coffee has other ingredients (specifically, phenolic compounds) that seem to cancel out whatever negative effects chronic exposure to caffeine might have. Those other ingredients might explain why decaffeinated coffee has shown benefits similar to the caffeinated version in several studies.

Study results indicate that coffee drinking may tamp down the risk of developing Parkinson's disease. No one is sure why, although it's been suggested that caffeine affects receptors in the basal ganglia, the part of the brain most damaged in Parkinson's. Other studies are brewing hopes that coffee may affect our brain cells in ways that diminish risk for dementia and Alzheimer's disease.

The good healthkeeping seal of approval for coffee comes with cautionary notes. Pregnant women are still advised to limit, if not avoid, caffeine intake, although the American College of Obstetricians and Gynecologists' position is confusing. Its patient brochure says "some studies suggest drinking three or more cups of coffee per day may increase the risk of miscarriage," but adds "there is no proof that caffeine causes miscarriage." Another caution: unfiltered coffee — which includes coffee drinks made with espresso — may increase "bad" LDL levels because some harmful substances in the coffee don't get filtered out. There's nothing wrong with the occasional latte or cappuccino, but overdoing it may mean a return to the bad old days when coffee was cardiovascularly suspect.

Sex

Obviously sexual arousal and orgasm is a source of great pleasure and a sense of well-being, but even after the immediate glow fades, there may be residual health benefits. Sexual activity can cause heart attacks, but it's been estimated that chances are only one in a million that a man who has had a heart attack will have another during or immediately after sex. Meanwhile, other research has suggested that frequent sexual intercourse (twice a week) is associated with reduced heart attack risk, even after making the statistical adjustments necessary to account for the fact that men who have sex that often are healthier over all. Conventional sexual activity revs up the metabolism, but only so far: orgasms, minute for minute, create the same exercise workload as walking at a pace of three miles per hour. The cardiovascular demands of sex have been compared to walking up two flights of stairs. Even if sex isn't great aerobic exercise, exercise may make for better sex: several studies have shown that moderate exercise increases genital response to erotic stimuli in women.

Marvin Gaye sang about it, but you can also find bits and pieces of evidence in the medical literature of the power of sexual activity to fix medical problems. An Israeli neurologist published a case report about two male patients whose headaches went away after sexual intercourse or orgasm (although sexual activity as a cause of headaches is far more common). Researchers have reported that women who have intercourse regularly are more likely to have regular menstrual cycles. And sex may be a pretty good germ fighter. German investigators reported that white blood cell counts went up in men after sexual activity (in this case, masturbation-induced orgasm). That's in keeping with other research suggesting that sex gives the immune system a boost.

Granted, these studies are too small or short to be anything but speculative and suggestive. The fact is that much of the research into health and sexual activity has focused on how illness adversely affects sexuality, a worthy topic, but it might be revealing to turn the tables and pay a little more attention to the vice versa: how sexual activity may have ameliorating effects on illness.

Sleep

We're resting easier (sometimes longer) these days because of the laurels that sleep is winning for its health benefits — or, more precisely, because of the evidence of all the bad things that can happen when we don't get enough of it. Several epidemiologic studies — the kind that involve following thousands of people over many years — have shown that "short sleepers" put on more pounds than people who sleep seven to eight hours a night, which is the amount that seems optimal for most adults. Other studies have linked skimping on sleep to the high-risk pool for heart attacks, diabetes, and early death. The risks are more pronounced for people who sleep less than five hours a night, but the danger seems to extend to those averaging less than six. It's easy to poke holes in epidemiologic evidence, but short-term experiments in sleep deprivation have lent credence to these findings. When healthy volunteers stay awake for long stretches, it wreaks hormonal havoc: levels of cortisol, a stress hormone, go up, and leptin and ghrelin, hormones that influence appetite, get thrown out of whack.

Of course, lack of sleep has a very direct effect on the brain, influencing memory, mood, and attention. We've all experienced grogginess after not getting enough sleep. Dr. Charles A. Czeisler, a Harvard sleep expert who has campaigned for limiting the working hours of medical residents, says averaging four hours of sleep a night for four or five days results in the same level of cognitive impairment as being legally drunk.

Can you sleep too much? Several of the epidemiologic studies of sleep show that long sleep (nine hours nightly or more) is associated with just as many health problems as short sleep, if not more. But it's probably more often the case that an underlying illness (depression is a prime example) causes people to sleep more, not the other way around.

Social life

We could all use a little help from our friends, but just having them may also help us stay healthier. A slew of studies has shown an association between social networks and good health. Cognitive decline, high blood pressure, the risk of dying after a heart attack — they've all been linked to social isolation and loneliness. Sorting out cause and effect is difficult. Ill-health itself can strain social ties, although it's also true that coworkers, friends, and relatives tend to rally around people who have strong social networks prior to getting ill. Teasing apart the objective (not having someone to take you to the doctor, for example) and subjective (being lonely) aspects of isolation is yet another conundrum. Regardless, tending to friendships, family, and community life is a good habit to cultivate for health and other reasons.

Source: https://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2009/April/Putting-the-joie-de-vivre-back-into-health?utm_source=health&utm_medium=pressrelease&utm_campaign=health0409

Coffee Health Risks: For the moderate drinker, coffee is safe

Despite 20 years of reassuring research, many people still avoid caffeinated coffee because they worry about its health effects. However, current research reveals that in moderation—a few cups a day—coffee is a safe beverage that may even offer some health benefits. The September issue of Harvard Women's Health Watch weighs the pros and cons of this popular beverage and eases the concerns of moderate coffee drinkers.

The latest research has not only confirmed that moderate coffee consumption doesn't cause harm, it's also uncovered possible benefits. Studies show that the risk for type 2 diabetes is lower among regular coffee drinkers than among those who don't drink it. Also, coffee may reduce the risk of developing gallstones, discourage the development of colon cancer, improve cognitive function, reduce the risk of liver damage in people at high risk for liver disease, and reduce the risk of Parkinson's disease. Coffee has also been shown to improve endurance performance in long-duration physical activities.

For those who drink coffee to stay alert, new research suggests that you'll stay more alert, particularly if you are fighting sleep deprivation, if you spread your coffee consumption over the course of the day. For instance, if you usually drink 16 ounces in the morning, try consuming a 2-3 ounce serving every hour or so. Again, moderation is the key.

However, as the September issue notes, coffee is not completely innocent. Caffeine, coffee's main ingredient is a mild addictive stimulant. And coffee does have modest cardiovascular effects such as increased heart rate, increased blood pressure, and occasional irregular heartbeat that should be considered. Studies have been largely inconclusive regarding coffee and its effect on women's health issues such as breast health, cancer, and osteoporosis. But, the negative effects of coffee tend to emerge in excessive drinking so it is best to avoid heavy consumption.

Source: https://www.health.harvard.edu/press_releases/coffee_health_risk