Some small steps for healthier living in 2018

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Dear Readers,

All too predictably, millions of us will make resolutions aimed at better health in the new year, and yet too many of us will turn this key part of life into dread and drudgery.

How about trying another approach? Let’s break down that big and daunting goal — improving well-being — into smaller, easier-to-accomplish steps. Read on for some simple and do-able ideas.

Some facts to motivate change

To help keep motivated, consider some context about Americans’ health. Cardiovascular diseases and cancer are the nation’s top two killers, accounting for just under half of the deaths in each of the last five years. These diseases — and many of the other top 10 deadly afflictions — can be prevented, or their harms can be minimized.

How? Americans need to control their weight, exercise or move more, eat better and less, use care with alcohol consumption, and not smoke — or give up tobacco if they’re already hooked. We need to keep our blood pressure, blood sugar, and cholesterol measures as close as possible to norms.

The federal Centers for Disease Control and Prevention earlier found such measures could help prevent as many as 80 percent of cardiovascular disease cases. In 2017, the agency said such steps could play a big role in reducing 40 percent of cases involving 13 types of common cancers, all with major links to obesity.

We know we should take care of our health, and money shouldn’t be a prime motivator. But it’s important to know that even cancer experts now refer to the “toxicity” of the costs of care — sums that one study found to hit as high as $280,000 in each of the four years after patients’ diagnosis. Insurers see almost $40,000 in medical bills for the first 90 days of medical care for a patient who suffers a heart attack. A quarter of Americans struggle with medical debt, adding big time to their already heavy woes with chronic or catastrophic illness. Their bad health not only makes them poorer, it can leave them glum.

In contrast, taking even little actions can improve your health and make you feel better. By tracking cellphone data, researchers have found, for example, that people are happier when they move even just a bit. They said they felt more “up” when they had exercised — even in gentle fashion — in the past quarter-hour versus when they just sat or had been lying down.

To make the changes beneficial to your health this year, you need to consider your routines, possible rewards for altering them, how you get clues to act the way you doand then develop a workable plan, with deadlines, to check your progress.

Eat food. Not too much. Think less salt, sugar, and red meat. Try more fish & nuts.

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Losing weight can be tough. But simple, small steps matter.  First, know that you cannot exercise your way to fewer pounds.  Exercise is great for many other benefits, just not weight loss. Diet matters most.

Your background, knowledge, and experiences may lead you to make faulty eating decisions, even if you have a new healthy food source — like a snazzy grocery store — pop up nearby.

Common sense and moderation can be key. All that holiday feasting in December can hang around for a long time, amounting to as much as 70 percent of our annual weight gain.

So a good place to start is to commit now to reducing your meal sizes, and squeezing out excess calories, sugar, and salt (a major culprit in hypertension, or high blood pressure). You may find that cooking and eating at home — and learning about food preparation and enjoying family meals together — and avoiding highly processed foods at restaurants and fast-food joints can help.

Increasing amounts of research points to the health woes tied to our eating excess sugar. To reduce the sugar intake at your house, wean the kids — and adults — from sugary drinks, including sodas, so-called sports or athletic performance drinks, and the coffee-based concoctions that include more whipped cream, sugar, and calories than many desserts. Eat whole, real fruit instead of drinking juices or snacking on fruit products. Try an online quiz that lets you choose among various alternatives (say real fruit versus “fruit products,” or sugary breakfast cereals versus granola and low-calorie yogurt) to find ways to cut out mealtime sweets and processed sweeteners.

As for salt, at least one published study has found that an average reduction of just 400 milligrams of sodium a day by Americans could save 28,000 lives and $7 billion in health care costs a year. Salt can be hard to banish from your diet because it plays a big role in boosting food’s taste. But you can use less to season home-cooked meals. Use more spices and other flavorings instead. Consider low-sodium products, including soups and soy sauce. You may not be able to resist the occasional ball park hot dog,  juicy bacon strips, or slices of sausage at breakfast. But reducing the amount of highly processed meat, pork, chicken, and turkey products you eat can slash not only your salt but also your fat intake.

Put more plant-based and fewer animal-based meals on your table, as even Uncle Sam now recommends.  If you hate kale, it’s OK. But nutrition writers like Michael Pollan have made headway in convincing Americans they can eat better and improve their health if they will, as he suggests: Eat food. Not too much. Mostly plants. Americans can benefit by increasing their consumption of vegetables, including green, leafy varieties, and those of varying colors (yes, orange and purple). These can provide important and needed vitamins and nutrients. Meantime, there are real health risks and harms to excess consumption of meat and pork, and these are deeply rooted in the supply chains that bring animal-based foods from the farm to the home.

The options? Eat more sustainable fish, and do so safely and wisely. You can get needed daily protein from soy and other bean products or by eating healthful whole grains and nuts. Don’t gulp down nut snacks laden in salt, sugar, or added oils. Eating walnuts, almonds, pistachios, peanuts, pecans, and other nuts can change your snacking in healthful ways and provide you with important nutrients. Nuts also are a key component, with olive oil, in the “Mediterranean diet,” which studies have shown can be a healthy option.

As you change your diet, of course, talk to your doctor, and discuss any shifts in eating with friends and loved ones. Be wary of fad dietsthat make wild claims. You’ll hear an earful about these around the water cooler at work or at the gym. These crazy eating plans can harm you. With thought and care, you can, instead, find the customized diet and ways of eating that work best for you and yours — and be healthier as a result.

Take a big step for health: Get moving!

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Few of us will resolve this year to win Olympic Gold. But in 2018, we all need to get up and move more, whether in formal, robust exercise, or in easy walks, relaxing swims or bike rides, and climbs up the office stairs.

Too many of us now live too sedentary lives, trapped for long hours in chairs at the office. Sitting that much hurts our health, boosting, for example, our measurable troponins, proteins that muscles like the heart release when damaged or dying.

Physical activity of all kinds can be beneficial, adding to our energy, stamina, and feeling of well-being, as well as helping to control our weight and avert diseases. Even a gentle bit of it can make us healthier. You can get your workouts without necessarily forking over big bucks to a fancy gym or health club. Such facilities remain popular, but they experience a lot of churn, especially when members’ start to abandon their New Year exercise resolutions.

Getting moderate exercise — say, a total of 150 minutes per week — can boost the cardiorespiratory system, increase “good” or HDL cholesterol and lower triglycerides, fats that circulate in the blood. It can reduce the blood pressure and heart rate, while lowering inflammation and improving blood-sugar control.

Younger, more athletic people can get greater health benefits from 75 minutes a week of vigorous, aerobic exercise. These workouts can be broken up into separate sessions that raise participants’ heart and breathing rates. This might include weekend warriors’ spirited touch football, soccer, volleyball, tennis, and basketball games, or demanding bike rides or tough skates or swims. Adding intensity to your workout may improve its health benefits.

But don’t overdo it. Some studies show that strenuous exercise exceeding 150 minutes per week may increase athletes’ risk of heart harms. Increasing numbers of overzealous young athletes are finding themselves hobbled by sports-related injuries as they age. Spinning novices who tax themselves beyond their capacities are turning up in emergency rooms for treatment of “rhabdo,” aka rhabdomyolysis, a rare but life-threatening condition often caused by extreme exercise. Accidents and injuries on regular bikes are becoming more common, especially for men, as more Americans try to beat traffic jams and get some exercise with two-wheeled commutes. Even older yoga enthusiasts are suffering more injuries when they stretch in unaccustomed ways.

Take it easy. Know your limits. An easy walk may be all you need and want. Or you may want to build your sporting skills and accomplishments. Do it with the right coaching or guidance. Be sure to give yourself time to warm up, stretch, and cool down. You don’t need fancy concoctions to stay hydrated during exercise. Drink lots of water, before and after.

And get yourself the appropriate gear, whether it’s goggles for basketball, or helmets and padding for football or softball, or other safety equipment for equestrian enthusiasts. In my practice, I see not only the huge harms that patients suffer while seeking medical services but also the major damage that can be inflicted on them by brain and spinal cord injuries. Concussions have become a big, real concern in a range of sports, and for everyone from pro to youthful players. Head injuries can take time to show up and to heal, so we need to take every precaution to minimize and prevent them now.

By the way, be sure your regimen stays balanced. Training for flexibility and strength needs to be part of your plan. It will help prevent injury, and taxing muscles with weights builds them in ways that aerobic exercise alone cannot. It can improve bone health and posture. It can help you be leaner. Maintaining muscle mass and tone can be as important for healthy seniors as for young jocks.

While you may find exercise and fitness become a core part of your day, keep it all in perspective, too. Exercise often revolves around games — not kill-or-be-killed contests. Yes, competition can be energizing, but a big part of athletics should be its relaxation, pure fun, and social benefits — hanging out and having a good time with people who not only challenge you but whom you like. Include your family in your activities, too, whether it’s a walk together in the park, a fun bike ride, or maybe a birdwatching stroll. If you’ve got a four-footed companion. Fido can be a great motivator to get outside and to move around.

Speaking of birds, check out my photos from a recent expedition to a wildlife refuge in southeastern New Mexico. And while you’re at it, here are some water fowl closer to home: on the C&O Canal Park next to the Potomac River north of DC.

To curb stress and anxiety, consider the “off” switch on e-devices.

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One more vital wellness area is mental health.

Though the economy has improved since the Great Recession and more Americans are working than in recent memory, these continue to be stressful, anxious times. Our divisive national politics plays a part, but so do our technological advances.

Chronic stress can be as debilitating as many physical ailments. Exercise can help, as can the socializing and relationship building that can and should be a part of healthful athletics. Americans also may need to just say no to their packed schedules and unceasing demands— at work and at home. They may need to go far from the madding crowd and its angry mentality, with retreats, meditation, spirituality, and religion, to try to calm the damaging anxiety that’s all too prevalent these days.

Although the young people in your life may be dazzled with their new electronic devices, adults and kids alike may want to look at their benefits and harms with much more wariness. Mounting research is raising concerns that e-screens and teens 24/7 access to social media is fueling big woes with depression, bullying, self-harms like cutting, and suicide.

Studies show that smartphones and tablets disrupt too many Americans’ sleep. Sleep is critical to our health — if you don’t get enough of it, you still may not drop those pounds, no matter how carefully you’re dieting and exercising. Inadequate sleep not only costs the United States more than $400 billion annually and puts our wellness at risk, it also wreaks special havoc on teens and their mental and physical development, leading many school systems to reconsider high school start times.

We all may need to give our devices and ourselves constant and regular breaks. We need to shut off all electronics not only in the important wind-down period before sleeping but also for long spells on weekends, holidays, and vacations. We could restore more civility to our homes and offices if we all weren’t cell gazing, poked and prodded as well by incessant and not necessarily true or well-informed flashes of information.

Humans are social animals, and studies show that it’s crucial for us to live long, well, and happily with good, strong relationships with friends and family. In contrast, loneliness can be harmful to us and our well-being. But relationships can be tough to build and sustain. They take work and commitment — something we may wish to resolve to do better in the new year?

Just think, in the months ahead, we could talk to each other, face to face and more often, about actual books, music, and sports — not Tweets or Facebook posts about them. We could rely on real knowledge and memories rather than scouring Google. We could eat healthy lunches with colleagues, maybe with a walk around the block, instead of jamming a burger down at our desk while multitasking. We could enjoy a family meal at home with lots of laughter, instead of dashing through fast-food joints or stopping in at pricey restaurants where servers, appropriately upset, wait for us to Instagram the chef’s creation. We could get the kids to bed at a reasonable hour, then spend a day with them discovering exciting outdoor recreation spots.

Our friends and family may pull us through tough spots in the days ahead, so fewer of us resort, reflexively, to solutions pushed by Big Pharma (including painkillers that fuel the opioid drug epidemic). The nation lacks the professional resources we need for good mental health care for all, advocates say. But maybe this will be a year when, through calls, emails, and letters to elected officials we get better legislative support for this and other critical mental and physical needs.

But maybe, too, we find strength and wisdom in long, deep talks and relationships with traditional religious figures in our lives, as well as with our elders, and our significant others, children, friends, and family. Here’s hoping these and the many other steps I’ve just touched on see that you and yours have a great and healthy 2018!

IN THIS ISSUE

Facts to motivate change

Eat food. Not too much. Think less salt, sugar, and red meat. Try more fish & nuts.

Take a big step for health: Get moving!

To curb stress and anxiety, try the “off” button.

Adults need vaccinations, too

How to save a fast $100


BY THE NUMBERS


80%

Percent of U.S. cardiovascular disease cases that could be prevented by lifestyle changes.


~50%

Percent of U.S. cancer cases that could be prevented by lifestyle changes.


$30 billion

Estimated U.S. spending on dietary supplements with doubtful health benefit

Adults need shots, too

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Although measles killed as many as 2.6 million people a year as recently as 1980, its global toll fell below 100,000 for the first time in 2017 for a vital reason: vaccinations.

They’re an imperfect way to protect your health, and they carry their own risks — which palecompared with their factually proven favorable outcomes in protecting people from serious and potentially deadly diseases. Some parents may resist them, though there’s a well-established regimen recommended for youngsters. Experts say it’s vital for these to be followed because of “herd immunity,” the greater protection afforded when most members of a group are inoculated against specific diseases.

Grown-ups, particularly seniors, may not realize they need vaccinations, too. Adults, the federal Centers for Disease Control and Prevention says, should get the yearly flu shot. They also should talk to their doctors about periodically (every 10 years or so) re-upping their shots for tetanus, diphtheria, and whooping cough — that pertussis inoculation can be important if they haven’t gotten it before and will be around vulnerable youngsters.

Seniors also may wish to get vaccinated against pneumonia and shingles. Talk to your doctor about the varieties of one-time vaccines for these diseases. You may need to be a bit persistent because some physicians have experienced challenges getting health insurers to cover these slightly pricey shots. They also can require special handling (refrigeration), so that your doctor may refer you to a pharmacy, clinic, or hospital to get these shots.

Pneumonia can be deadly for the young and seniors, and the shots for it can provide a needed, added protection. Shingles, caused by a virus that many adults acquired along with childhood chickenpox, can be painful, debilitating, and long lasting. Public health officials have expressed rare excitement about Shingrix, a new and highly effective vaccine for shingles. They’re recommending that adults get it at age 50, a decade earlier than its predecessor shot, Zostavax.

Depending on your individual circumstance, your doctor may recommend additional inoculations for you — especially if you travel extensively and in areas where infectious diseases are still common or if you have youngsters in the house. Most adults got their shots at a time when vaccination programs in schools were common, widespread, and required. But some may have missed getting key vaccines, which they now will need, particularly if their kids attend schools or colleges and universities with outbreaks, say, of mumps or measles.

Measles, mumps, and rubella shots typically are given still to most school kids. But public health experts have found value in a later doubling up of their vaccinations to increase the protections against, say, mumps.

You can read more about vaccinating youngsters by clicking here.

Want to save a fast $100?

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Reading this newsletter could save you $100. That’s the average sum Americans spend on dietary supplements that don’t work.

More than half of us take at least one or more vitamins, minerals, or herbal products daily, creating a supplement business that amounts to more than $30 billion annually.

But even the attention-getting products don’t prove out. Vitamin E? It hasn’t shown its touted heart benefits, nor has taking fish oil capsules. High-dose selenium for prostate health? Nope, the studies don’t support this claim. Glucosamine-chondroitin for joint health? Nah. How about taking calcium and Vitamin D for stronger bones? Um, no.

The numbers of patients undergoing testing for deficiencies of Vitamin D and getting prescriptions for high doses has soared in recent years — but this is a classic case of overuse for an under-supported therapy, federal experts have concluded. Vitamin D is essential to maintain bone health and strength. It contributes to nerve, muscle, and immune function and to moderating inflammation.

Most of us can get the amount of Vitamin D we need from sunshine or eating healthfully, with this nutrient easily available in milk, yogurt, breakfast cereals, and orange juice.

Meantime, Americans’ appetites for downright wacky dietary nostrums keeps watchdogs at the Federal Trade Commission and the Food and Drug Administration hopping. They must deal with everything from stomping out false claims that products can help with opioid drug addiction to warning patients that Vitamin B7, sold as biotin, a high-dose hair and nail growth aid, can interfere with common lab tests  (including a common check for heart attacks).

Look at your kitchen counter: Is it filled with bottles of pills, including for that multivitamin that most nutritionists and physicians say is unnecessary? What kind of message are you sending to the kids about seeking spurious, even risky, shortcuts to health?

Keep in mind that not only must authorities spend time chasing dubious supplement claims, they also struggle to warn consumers that many of these products are made in sketchy settings and may include risky ingredients, including aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and Yohimbe. Users often don’t tell their doctors which dietary supplements they’re taking, at what (excess) dosages, and if they’re mixing them. That means doctors and pharmacists can’t determine if supplements may react with or cancel prescription medications or cause other health harms.

Save yourself money in 2018 and reconsider not only what dietary supplements you’re taking — and could do without— without negative effect. And while you’re at it, really give a hard look at avoiding bunko “health” remedies of the homeopathic variety, the $3 billion worth of junk that has included teething rings for tots that also had deadly nightshade in them or the nasal cold remedy that had smell-deadening zinc as an ingredient.

HERE’S TO A HEALTHY 2018!

Sincerely,

Patrick Malone
Patrick Malone & Associates