Dear Reader,
“Where’s the beef?!” That insistent query made for a memorable advertising campaign for a burger chain decades ago (featuring octogenarian pitch woman Clara Peller, pictured above). Now the issue about beef is not a shrinking burger patty, but whether we all should shrink our beef consumption down to zero.
As the year ended, food scientists and fast-food vendors were extolling the virtues of veggie burgers. To hear the hype, plant-based protein substitutes finally have become tasty and better than, well, sliced bread.
Still, fisticuffs all but broke out in kitchens and labs when researchers with seemingly sound credentials published a study that seemed to some to be nutritional heresy. The researchers said they had scrutinized mounds of previous work and found little scientific proof that eating less beef and pork — which the medical establishment long has endorsed — has measurable health benefits.
Here we go, again: Just as most of us are feeling a little hefty from holiday eating, drinking, and merrymaking, and while we’re deciding on our new year resolutions, what are we supposed to make of the many claims and counter-claims about diet, nutrition, and exercise? How can we lose some of that fat, get fitter, and feel better as we race through our lives at work and at home?
News articles on nutrition and exercise abound. But parse through the fluff and the sensational, apply common sense, and bring into focus how to have a more healthful 2020: Moderation matters. Move more. Eat well but less — more plants and nuts. Read on for more on how to bolster your wellness resolve in the coming year. Let’s dig in.
For a healthier new year, don’t be cowed by nutrition and exercise controversies
Beef. Milk. Eggs. Salt. Carbohydrates. Coffee. Alcohol. It can seem as though no day goes by without the morning news contradicting what we’re all supposed to know about our favorite staples. Are they good for us? Or bad? Should we consume more or less? Why can’t the experts get it together to stop confusing the public?
Truth be told, the “science” in too many “studies” on diet and nutrition is sadly lacking. That doesn’t seem to matter, though, to some researchers and institutions. They may be more concerned about getting public attention to boost their careers than about publishing rigorous studies that are truly scientific.
And it is complicated. It’s worth knowing why so many nutrition and exercise studies are flawed, as John Ioannidis, an M.D. and a Stanford professor of medicine and health research and policy, has sought to explain. Others have joined him in doing so, too.
It starts with the difficulty of research rooted in science’s “gold standard” — randomized clinical trials with human subjects. It’s tough to get enough subjects and to confine people, like lab rats, to manage the many variables that might sway results. It’s difficult to have multiple study groups, including some who act as neutrals or controls. So, instead, researchers pepper people with after-the-fact questionnaires about their eating and exercise habits. Or as Ioannidis told a university publication:
“We still largely depend on non-randomized studies to assess questions of nutrition. These studies are notoriously incapable of giving reliable answers due to confounding factors. In nutrition, the situation is made even worse because our ability to measure diet is still limited in accuracy, and recall biases, in which study participants remember something incorrectly, can be severe. In addition, dietary intake of a single nutrient probably has small or even tiny effects on major health outcomes, even if diet as a whole is important.
“Therefore, any potential finding is largely shaped by the noise from errors and biases of observational studies. The biggest problem is that the vast majority of studies are not experimental, randomized designs. Simply by observing what people eat — or even worse, what they recall they ate — and trying to link this to disease outcomes is moreover a waste of effort. These studies need to be largely abandoned. We’ve wasted enough resources and caused enough confusion, and now we need to refocus.”
In brief, and, as always, we all need to become more savvy consumers about health news, especially concerning diet and nutrition.
That has been driven home in news coverage about meat, whether it was the glowing articles about veggie burgers or the calumny over the experts shrugging off the potential health harms of pork and beef.
That latter research — grilled up by the likes of the American Heart Association, American Cancer Society, and Harvard’s T.H. Chan School of Public Health — involved the work of 14 experts, M.D.s and Ph. D.s, laboring in seven countries at respected institutions for three years. They published their results in the noted journal Annals of Internal Medicine. Their work included a scrutiny of “61 articles reporting on 55 populations, with more than 4 million participants. The researchers also looked at randomized trials linking red meat to cancer and heart disease (there are very few), as well as 73 articles that examined links between red meat and cancer incidence and mortality,” the New York Times reported.
The researchers infuriated mainline doctors and health groups by finding this, the newspaper said:
“If there are health benefits from eating less beef and pork, they are small, the researchers concluded. Indeed, the advantages are so faint that they can be discerned only when looking at large populations, the scientists said, and are not sufficient to tell individuals to change their meat-eating habits.”
That view, of course, is 180 degrees opposite of what heart and cancer groups and others long have advised, based on their studies and other evidence they point to. The heart association, for example, tells patients this on its website:
“In general, red meats (beef, pork and lamb) have more saturated (bad) fat than chicken, fish and vegetable proteins such as beans. Saturated and trans fats can raise your blood cholesterol and make heart disease worse … Minimize processed red meats like bacon, ham, salami, sausages, hot dogs, beef jerky and deli slices. Note: Eating a lot of meat is not a healthy way to lose weight, especially if you have heart disease.”
The cancer society sounds similar cautions on its site:
“The American Cancer Society has long recommended a diet that limits processed meat and red meat, and that is high in vegetables, fruits, and whole grains. The American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention recommend choosing fish, poultry, or beans instead of red meat and processed meat.”
Vox, a news and information site, sought to explain why health experts could reach such different conclusions about so key an issue as consumption of beef and pork, which Americans set records in eating in 2018 — an estimated 200+ pounds per person. Vox reported:
“In the past, many of the groups that have set guidelines for whether or not humans should cut back on meat considered a very broad range of research, from animal evidence to case-control studies, a relatively weak type of observational research. (Here’s more on different types of study designs.) As you may have guessed, there are all kinds of problems with these kinds of study designs. Models based on animal studies don’t always bear out in humans. Case-control studies are not the most reliable, either: Researchers start with an endpoint (for example, people who already have cancer). For each person with a disease (a case), they find a match (a control) — or someone who doesn’t have the disease. They then look backward in time and try to determine if any patterns of exposure (in this case, eating meat) differed in those with cancer compared to those who don’t have cancer. But since meat eaters differ so fundamentally from those who don’t eat meat, the reasons the two groups have varying health outcomes could have nothing to do with meat.
“Researchers try to control for these ‘confounding factors,’ but they can’t capture all of them … The [new research] did something different: [Researchers] looked only at the health effects of processed and unprocessed red meat. Processed red meats — everything from hot dogs and bacon to lunch meats — are transformed by salting, curing, or fermentation. Unprocessed meats include beef, veal, pork, lamb, and venison. The [research done was] also systematic reviews and meta analyses, or syntheses of the research evidence that bring together a bunch of studies with the goal of coming to more fully supported conclusions. And the researchers used a very strict definition of what constituted reliable evidence for inclusion in their reviews.”
While the recent beef and pork study might have tried to apply the latest and strictest approaches to available nutritional information, it had its own issues: The lead researcher for the controversial study has a controversial past, the New York Times reported. He took questionable industry funding before, the newspaper said, including money for a study that purported to debunk international recommendations for reducing sugar intake.
The expert tussling over beef and pork, no doubt, will go on and on. But the latest dust-up also set the table (by coincidence) for another attention-grabbing rip at king beef: the veggie burger. Who could have figured that fast-food giants would promote a product aimed at pushing down the global prominence of their No. 1 mealtime bonanza?
Weighing risks and benefits can get complicated
Veggie burgers aren’t new, with the New Yorker magazine reporting that some of the earliest known products were peddled at the start of the 20th century. They long have been a fringe item, the province of hard-core vegetarians and, the magazine observes, those with modest demands about the taste of their edibles.
But their sudden rise, especially in pop culture (along with, it must be said, the battered and fried fast-food chicken sandwich) may be attributable to another significant global concern, which adds to the complications for consumers: the environment, specifically global warming. It’s real, and Americans have seen a host of its shocks already, including: temperature extremes; super powerful hurricanes and rainstorms; relentless drought and raging wildfires; and coastal sea rise and flooding. As the New Yorker reported:
“Meat is essentially a huge check written against the depleted funds of our environment. Agriculture consumes more freshwater than any other human activity, and nearly a third of that water is devoted to raising livestock. One-third of the world’s arable land is used to grow feed for livestock, which are responsible for 14.5% of global greenhouse-gas emissions.
“Razing forests to graze cattle — an area larger than South America has been cleared in the past quarter century — turns a carbon sink into a carbon spigot … When the world’s [1.5] billion beef and dairy cows ruminate, the microbes in their bathtub-size stomachs generate methane as a by-product. Because methane is a powerful greenhouse gas, some twenty-five times more heat-trapping than carbon dioxide, cattle are responsible for two-thirds of the livestock sector’s [greenhouse gas] emissions. (In the popular imagination, the culprit is cow farts, but it’s mostly cow burps.) Steven Chu, a former Secretary of Energy who often gives talks on climate change, tells audiences that if cows were a country their emissions ‘would be greater than all of the [European Union], and behind only China and America.’ Every four pounds of beef you eat contributes to as much global warming as flying from New York to London—and the average American eats that much each month.”
The New Yorker suggests it wouldn’t be too crass to think that Big Agriculture, along with giant fast-food chains and, yes, of course, well-intentioned environmentalists, might all see advantages in veggie alternatives to meat. Especially when it comes to hamburgers — the ground-up form in which 60% of beef ends up.
The magazine says beef producers aren’t worried for now about competition because, as economies advance around the globe, more people are eating more meat, maybe as much for status as taste or nutrition. Beef also is entrenched in the American diet. And as close as the new alternatives may come, they have their own issues.
Veggie burger proponents say the product — the result, for example, of “extracting proteins from soy and yellow peas and combining them with starches, oils and juices to produce patties that convincingly sizzle, brown and bleed” — contain as much protein as their animal counterparts, but with less cholesterol than traditional meat and … less risk of foodborne illness arising from slaughterhouse contaminants,” the Wall Street Journal reported. The plant-based products also contain less saturated fat than beef burgers.
But veggie burgers typically also have higher sodium content than do beef versions. That’s necessary to get the generally blander plant product to taste better. Consumers and some restaurant chains are balking, too, at the flavorings and other additives needed to make plant foods taste different and more like beef or pork. If anyone has concerns about the soy in veggie products, by the way, researchers have been busting the myth that eating soy has links to cancer. The public is sure to learn lots more, though, about heme, a key ingredient in the product called the Impossible Burger, the New Yorker reported, saying of its developers and their claims:
“They made their burger sustainable: The Impossible Burger requires 87% less water and 96% less land than a cow burger, and its production generates 89% less [greenhouse gas] emissions. They made it nutritionally equal to or superior to beef. And they made it look, smell, and taste very different from the customary veggie replacement. Impossible’s breakthrough involves a molecule called heme, which the company produces in tanks of genetically modified yeast. Heme helps an Impossible Burger remain pink in the middle as it cooks, and it replicates how heme in cow muscle catalyzes the conversion of simple nutrients into the molecules that give beef its yeasty, bloody, savory flavor.”
Beyond Meat, a plant-based protein competitor, believe that’s the wrong way. The magazine reported that the firm “builds its burgers and sausages without genetically modified components, promoting that approach as healthier.” The magazine noted that “Several dozen other startups have taken an entirely different approach: growing meat from animal cells.”
Well, yum? To be fair, figuring in foodstuffs’ environmental impacts — along with their nutritional values — may be a lot to ask of American eaters, who only recently found themselves in the fray over requirements that restaurants post basic information like the calorie counts of menu items. This is not to downplay the gravity of climate change, nor to doubt how crucial sustainability has become to how the world raises what it eats.
Still, for various reasons, industrialized production of all kinds of foods — including many that people may think of as “healthy” — can be deemed somehow to be problematic. Besides the already mentioned issues with beef, it and pork both are under fire because of the way the animals are raised, slaughtered, and processed, and how byproducts create big health and pollution hazards. The Trump Administration has created a furor by relaxing livestock oversight, allowing more pork producrs, in particular, to “self-inspect” more steps in their processes — a move that advocates say reduces bureaucracy but that critics say creates hazards in hygiene and safety of the nation’s food supplies.
Big Agriculture also has been condemned for its indiscriminate dosing with antibiotics of livestock of many different varieties, a practice that scientists say has helped to destroy the effectiveness of one of medicine’s breakthrough ways to defeat disease. Antibiotic overuse, which also occurs with growers of cash crops (!), is fueling the rise of resistant microbes and illnesses.
It is inescapable, too, to talk about food-chain concerns without significant worry about the pesticides, fertilizers, herbicides, and other chemical and biological products in which Big Ag soaks the plants we devour. This is different environmental damage from climate change. But it threatens the planet, too. Pollutants combine with climate and overuse to damage the air and oceans and the foodstuffs we extract there. As consumers, we need to know about and mitigate the harms we do by polluting aquaculture and overfishing. We need to make sustainable choices instead.
Eat less – and with intention. Move more. Careful with the intoxicants.
It’s too easy to get paralyzed about diet, nutrition, and exercise, and then do nothing. But that’s the wrong answer. Yes, we need to battle an overload of information — or misinformation. But common sense, moderation, and resolve can help us all carry the day.
We all hope in the days ahead to be fitter and less fat, and to eat in healthful ways. The stakes are high, as U.S. News and World Report has found:
“Obesity has become a public health crisis in the United States. The medical condition, which involves having an excessive amount of body fat, is linked to severe chronic diseases including type 2 diabetes, cardiovascular disease, high blood pressure and cancer. It causes about 1 in 5 deaths in the U.S. each year – nearly as many as smoking, according to a study published in the American Journal of Public Health. The financial cost of obesity is high as well. According to the U.S. Centers for Disease Control and Prevention, ‘The estimated annual medical cost of obesity in the United States was $147 billion in 2008 U.S. dollars; the medical cost for people who have obesity was $1,429 higher than those of normal weight.’”
If you’re looking for dependable information, the federal government has solid online nutrition resources (click here for nutrition.gov), including the U.S. Department of Agriculture’s “choose my plate” dietary guidelines (click here for choosemyplate.gov), other federal dietary information (click here for health.gov dietary guidelines), and the Federal Trade Commission’s weight loss and fitness information (click here for FTC page).
The giant federal Health and Human Services (HHS) agency has published online, through the JAMA Network, the helpful Physical Activity Guidelines for Americans (click here to ready the study). It provides evidence and suggestions for all age groups about the benefits of exercise of various types and intensity.
Over the years, this newsletter and our law firm’s patient-safety blog have contained lots of ideas and information, too, on eating well and wellness (click here, here, or here for some of the newsletters). Don’t feel overwhelmed by the ample information. Consider it a smorgasbord of ideas to help you tailor a big push, built on many small steps, to better your wellness.
The terse, often witty, and well-researched suggestions of journalist Michael Pollan seem to be standing up well over time. As he has urged: “Eat food. Not too much. Mostly plants.”
He also has observed in his dietary “rules”: “If it’s a plant, eat it. If it was made in a plant, don’t.” Or: “It’s not food if it arrived through the window of your car.” And: “Buy smaller glasses and plates” — your portions will seem larger. Also: “Do all your eating at a table” and “Try not to eat alone” because this will help you slow down and enjoy your meals more.
Eating with intention makes sense, doesn’t it? Too many of us gulp meals on the run. This often occurs late at night, just before bedtime. That’s not good. The harried meal deprives us of the joys of food and drink. These pleasures include cooking at home — maybe as a grand, continuing, and delicious science experiment, as suggested by cooking expert Kenji Lopez-Alt and his “Food Lab” approach, notably for the Serious Eats website. But they also mean spending quality time with friends and loved ones, enjoying the taste of meals and beverages. We teach our kids early by example, and help shape their habits about eating healthfully, not by eating separately or alone but by shared dining. It need not be an ordeal.
By the way, if weight loss is a key goal, it may be important to know that diet plays an oversized role. Though exercise enthusiasts may try to persuade you differently, “when it comes to reaching a healthy weight, what you don’t eat is much, much more important” than exercise, according to Dr. Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine, health policy expert, and writer for the evidence-focused New York Times “Upshot” column. As he reported:
“Think about it this way: If an overweight man is consuming 1,000 more calories than he is burning and wants to be in energy balance, he can do it by exercising. But exercise consumes far fewer calories than many people think. Thirty minutes of jogging or swimming laps might burn off 350 calories. Many people, fat or fit, can’t keep up a strenuous 30-minute exercise regimen, day in and day out. They might exercise a few times a week, if that.”
He also added this:
“… I can’t say this enough: Exercise has a big upside for health beyond potential weight loss. Many studies and reviews detail how physical activity can improve outcomes in musculoskeletal disorders, cardiovascular disease, diabetes, pulmonary diseases, neurological diseases and depression. The Academy of Medical Royal Colleges declared it a ‘miracle cure’ recently, and while I’m usually loath to use that term for anything in medicine, a fairly large evidence base corroborates that exercise improves outcomes in many domains.”
To paraphrase Pollan, Eat food — but maybe less of it. Skip the trendy diet and talk to your doctor before you launch any serious weight-loss plan. We all may wish to slash our intake of empty calories, fats, salt, and sugar, especially from sweets and sweet drinks (sodas, workout beverages, and the like). We all may want to be mindful about not wasting precious food. We may wish to consider, too, the results of an $8-million, year-long study conducted at Stanford University with more than 600 test subjects. As the New York Times reported of this work’s key findings:
“[P]eople who cut back on added sugar, refined grains and highly processed foods while concentrating on eating plenty of vegetables and whole foods — without worrying about counting calories or limiting portion sizes — lost significant amounts of weight over the course of a year. The strategy worked for people whether they followed diets that were mostly low in fat or mostly low in carbohydrates. And their success did not appear to be influenced by their genetics or their insulin-response to carbohydrates, a finding that casts doubt on the increasingly popular idea that different diets should be recommended to people based on their DNA makeup or on their tolerance for carbs or fat.”
It also is vital, experts say, to keep moving. Not all of us will be Olympic athletes. Many of us will struggle to be weekend sports warriors. Trends in exercise and fitness may shift, as they have in the recent decade, The benefits can be measurable, though, for adding even a little more movement to your day — no matter your age or current fitness level. So, take the stairs instead of the elevator at work. Grab colleagues and walk to a nearby park or open space for a congenial lunch. Stroll down the hall to talk to a co-worker — don’t email, phone, or message by computer. If you’re obsessing about racking up steps or miles as tallied by that expensive new electronic device you got over the holidays, just stop. The devices are meant to help your quest for fitness, not to give you anxiety. For seniors, too, the metrics often suggested for fitness wearables aren’t useful. The idea of 10,000 steps per day sprouted as a Japanese marketing pitch, and the sweet spot for older women, for example, more realistically may be 4,500 steps per day.
While you’re tackling various ways to make yourself healthier in the new year, a few more ideas always merit consideration: You may wish to be sparing in your use of alcohol and other recreational intoxicants (like marijuana). If you don’t smoke or vape, don’t start. If you do, consider stopping, perhaps with professional support, e.g., from your doctor. Vaping may be trendy, and it may seem like a nifty high with nicotine or tetrahydrocannabinol, the intoxicant in grass. Thousands of cases of patients with serious lung damage and dozens of deaths may convince you otherwise about e-cigarette use in vaping.
As you make your beneficial resolutions, don’t forget this top one from me and the firm: Here’s hoping you and yours stay as healthy as possible in 2020 and beyond!
While politics may roar in ’20, keep the anxiety in check
It’s not only a new year, it’s a new decade. This also happens to be an important political time, with the nation riven by the impeachment of the president and by extreme partisan battling. This has left Americans struggling more than usual with the already significant problems of anxiety, stress, and depression, experts say.
The American Psychological Association, in its 2019 nationwide survey conducted last fall with more than 3,000 respondents in a national, representative sampling, found that 56% of adults said the 2020 election already was a “significant stressor, a year out from Election Day — an increase from the 52% who said the 2016 presidential election was stressful. (The election is proving to be a more stressful topic for survey respondents identifying as Democrats, versus those identifying as Republicans, by almost 25%.)”
The professional group also reported that “this year’s survey also cites 69% of adults pointing to health care, specifically the costs thereof, as a notable point of stress. And 71% cited mass shootings as stressful — the most common source of stress among those surveyed, with a rise of almost 10% from the APA’s 2018 survey.”
Political scientists, separately, also have found in a study that U.S. politics has become toxic to their research subjects’ health. Kevin Smith, at the University of Nebraska, Lincoln, told NPR about his work, published in the scientific journal “PLOS ONE”: Americans “are suffering some pretty negative consequences because of their attention to and engagement in politics. I think most people have heard of, or experienced, or at least read a news story about losing a girlfriend or boyfriend or arguments” over political matters.
He and his colleagues conducted an online survey of 800 people from a nationally representative sample and asked respondents a range of questions about how engaged they are in politics and how it is affecting their lives, health, and well-being. As NPR reported last fall:
“Nearly 40% of respondents said that politics was a cause of stress in their lives. About 20% reported losing sleep, feeling fatigued, or being depressed owing to politics. Between 10% and 30% of the respondents said that politics took an emotional toll on them, by causing anger, frustration, hate, or guilt, or caused them to make comments they later regretted. About 20% reported that politics had damaged their friendships. And, says Smith, ‘16% say that politics has made my home life less pleasant.’ He isn’t surprised that people are stressed out by politics. But ‘what I felt was kind of eye-popping was simply the sheer numbers of people saying that they experienced this.’”
With heavy-duty politics likely throughout 2020, experts have offered suggestions for how we all can get through potential differences and get along with each other.
Lynn Bufka, a psychologist and the associate executive director of practice, research, and policy at the American Psychological Association, told NPR that people should “think carefully about whether to and how to participate in a political discussion with friends and loved ones. Going into any kind of situation expecting to win or to convince somebody of your point of view is unlikely to result in a non-stressful approach. If you think a discussion will be ‘too emotionally laden’ … it may not be worth it. She recommends that people make sure to get enough sleep [see sidebar] and eat well to help their bodies be more resilient to the effects of stress. It’s important to reduce your exposure to stressful [situations] and make time for things that help you unwind, she says.”
Other experts, quoted by the information website Pop Sugar, advised Americans to avoid getting too caught up by the news, consider getting involved in campaigns rather than feeling helpless, keep social media in perspective, and set boundaries with friends and family. The experts also said individuals should know their rights, so they don’t feel run over by others’ assertions on difficult political topics. They may need, too, to seek support from the like-minded.
While we all need to exercise our rights and privileges as Americans, become informed about critical concerns, vote, and perhaps campaign for our views, we also need to breathe, be civil, fair, and reasonable, and remember: We’re all valued citizens of the United States.
A top-ranking that neither Baltimore, nor nation’s capital wants to retain
Get to sleep! That may require more resolve than ever in the new year. But it is a key way to feel better, improve and maintain your health — and lose weight and look good and not haggard.
As the experts at the RAND Corporation have reported:
“The Centers for Disease Control and Prevention (CDC) in the United States has declared insufficient sleep a ‘public health problem,’ with more than one-third of American adults not getting enough sleep on a regular basis … Some evidence indicates the proportion of people sleeping less than the recommended hours of sleep is rising. This has been associated with lifestyle factors related to a modern 24/7 society, such as psychosocial stress, alcohol consumption, smoking, lack of physical activity and excessive electronic media use, among others. Sleep is considered essential for health, productivity, and wellbeing. A lack of sleep has been found to be associated with a range of negative health and social outcomes, and it has an influence on health status as well as success in school and the labor market. Because of the potential adverse effects of insufficient sleep on health, wellbeing, and productivity, the consequences of sleep deprivation have far-reaching and expensive economic consequences ….”
RAND researchers have estimated that the U.S. “sustains by far the highest economic losses (up to $411 billion a year, which is 2.28% of its GDP)” due to sleeplessness among its people. Its studies have found that small changes to sleep duration could have a big impact on the economy … if individuals that slept under six hours started sleeping six to seven hours, then this could add $226.4 billion to the U.S. economy.” Further, researchers say that “sleep deprivation is linked to lower productivity at work, which results in a significant amount of working days being lost each year. On an annual basis, the U.S. loses an equivalent of around 1.2 million working days due to insufficient sleep.”
The health harms of poor and too little sleep can be significant. As the researchers found: “Sleep deprivation is linked to a higher mortality risk. An individual that sleeps on average less than six hours per night has a 13% higher mortality risk than someone sleeping between seven and nine hours. An individual sleeping between six to seven hours per day still has a 7% higher mortality risk.”
The causes for the nation’s sleep problems are clear, the researchers reported, including “obesity, excessive alcohol, and sugary drink consumption, smoking, lack of physical activity, mental health problems, stress at work, shift work-irregular working hours, financial concerns, and long commuting.”
To improve your sleep, experts suggest that you:
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Shut off electronic devices as much as two hours before your regular bedtime. This means no intense television watching, as well as eliminating stressful video game play and extensive work or communication on laptops, smart phones, and e-tablets. The blue light from e-devices has been blamed by some experts for disrupting sleep.
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Determine if and when you can exercise or consume certain drinks (including coffee, tea, and alcohol) in the evening without disrupting your sleep. Exercise can help relieve the stress that keeps people awake. But it can make them restless if done too close to bedtime. Avoid snacking before bedtime, though some people find warm, non-caffeinated drinks can help them slumber. Many people find that using drugs (prescription and illicit) or booze to help them sleep doesn’t work — they get fitful rest and maybe not the deep sleep that refreshes.
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Aim for at least six or eight hours of sleep, not much more or less. Learn what bedtime works best for you, as well as what hour works well for you to awaken.
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Work with your employer and your youngsters’ schools to optimize schedules for sleep. If you are an early bird and struggle to work late, perhaps your duties can start earlier. Teenagers, with the way their minds and bodies grow and develop, may struggle if school starts too early. The state of California recognized this recently and will phase in later start times for public schools statewide.
If you’re struggling with your sleep, failing to get the rest and resuscitation that deep slumber can provide, seek professional help. Disorders like sleep apnea are serious and should be treated promptly.
Recent Health Care Blog Posts
Here are some recent posts on our patient safety blog that might interest you:
- If department stores, car mechanics, or restaurants billed their customers in the same way that hospitals and doctors do, prosecutors might have their hands full. That’s because what patients now accept in sheepish fashion as simple “errors” or misstatements or curious charges on their medical bills more correctly ought to be called something else: fraud. That’s the reluctant but tough view now taken by Elisabeth Rosenthal, an editor, journalist, and onetime practicing doctor. She has written an Op-Ed for the New York Times, her former employer, in which she recounted how she long has reported on health care costs and economics, including in her much-praised book, “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.”
- A widely prescribed drug, formally approved only for limited uses but now dispensed for many nerve-related conditions, can put patients at serious risk of breathing problems, especially if they are aged, suffer from all too common chronic obstructive pulmonary disease, or may also be taking opioid pain killers or other medications that depress the central nervous system. That’s a toughened new warning about gabapentin and pregabalin from the federal Food and Drug Administration, which says it will require new packaging and cautions for the drugs. They may be better known in their branded versions as Neurontin, Gralise, Horizant (gabapentin) or Lyrica and Lyrica CR (pregabalin). The nerve meds have been subject to “growing” medical “use as well as misuse and abuse,” the FDA said in a statement.
- Profit-hungry nursing home operators persist in throwing out vulnerable seniors and disabled patients from needed care, too often because the facilities find they can get higher-paying patients to fill their already costly beds. Thousands of complaints about potentially improper discharges or transfers from nursing homes and assisted living facilities dominate the work of ombudsmen, whose work is federally required, and state supported, an NBC News investigation found.
- Insurers feast on uncertainty the way most of us attack a holiday spread. They can relish risk because they know it can mean higher premiums and profits for their dealing with clients’ risks. This is one point to keep in mind while reading the abundant coverage of the latest step in Republicans’ decade-long assault on the Affordable Care Act, aka Obamacare. A federal appeals court has struck down the zero-penalty piece of Obamacare, what many call a key part of the ACA (which, effectively, didn’t exist anyway). The judges also sent back this ACA challenge to their extremist colleague in Texas to parse which parts of Obamacare he thinks can stand up now that the sweeping health care law no longer has its “unconstitutional” individual mandate — the legal requirement that Americans must carry health insurance.
- Fans of marijuana and its related products may want to take careful note of developments regarding their health and safety effects. Federal researchers are racing to trace thousands of cases of lung damage and dozens of deaths to so-called smokeless consumption of tetrahydrocannabinol or THC, the ingredient that produces the marijuana high. Other federal officials also are warning about cannabidiol or CBD — a derivative of marijuana or its cousin hemp — and its burgeoning and unapproved use in an array of products on the market. To be sure, because blue-nose attitudes blocked rigorous research on marijuana and other drugs, medical scientists have been scrupulous in declining to make sweeping declarations about grass and its potential benefits or harms.While weed itself may be just another botanical, neither necessarily evil nor good, the embrace of marijuana and its derivatives, especially as commercial enterprises have refined and promoted these, are posing greater challenges. These are getting big public attention.
Sincerely,
Patrick Malone
Patrick Malone & Associates
