Harvard Health Blog
The standard recommendation for exercise is at least 150 minutes of moderate-intensity activity each week. But that may not be the best recommendation for everyone, especially those who are older and have trouble exercising, or those who don’t exercise at all. If we think of exercise as a spectrum, with no activity on one end and 150 minutes or more a week on the other end, there’s a continuum in between. Getting individuals to move along that continuum, from no exercise to a little, a little to more, and so on, is an important goal. New research on the hazards of sitting for prolonged periods should get all of us to sit less and stand or move more.
More than half of the average person’s waking hours are spent sitting: watching television, working at a computer, commuting, or doing other physically inactive pursuits. But all that sitting could be sending some to an early grave. That’s the conclusion of a Canadian study published in this week’s Annals of Internal Medicine. People in the study who sat for prolonged periods of time had a higher risk of dying from all causes — even those who exercised regularly. The negative effects were even more pronounced in people who did little or no exercise. In addition to premature death, the study documented higher rates of type 2 diabetes, cancer, and cancer-related deaths in very sedentary people. If you sit for work, try standing or moving around for one to three minutes every half hour. Better yet, think about working at a standing desk. At home, stand when watching TV or talking on the phone.
Opioid painkillers like hydrocodone and oxycodone offer blessed relief from pain. But the body gets used to them, requiring ever-higher doses. They are also addictive, cause side effects, and can kill. A report in the New England Journal of Medicine says prescription painkiller abuse accounts for about 17,000 deaths a year. Doctors are learning to say no to opioids, but have limited scientific guidance on when and how to best use them for chronic pain. Ideally, these drugs should prescribed for the shortest time possible and, if pain persists, a transition made to a non-addictive form of pain control. This may be other medications or specialized counseling from a pain specialist that might include complementary and alternative treatments, like acupuncture and meditation.
Ninety years ago, type 1 diabetes was a death sentence: half of people who developed it died within two years; more than 90% were dead within five years. Thanks to the introduction of insulin therapy in 1922, and numerous advances since then, many people with type 1 diabetes now live into their 50s and beyond. But survival in this group still falls short of that among people without diabetes. A Scottish study published this week in JAMA shows that at the age of 20, individuals with type 1 diabetes on average lived 12 fewer years than 20-year-olds without it. A second study in the same issue of JAMA showed that people with type 1 diabetes with better blood sugar control lived longer than those with poorer blood sugar control.
Feeling young may be one way to keep getting older. In a new study, a pair of researchers from University College London found that older people who felt three or more years younger than their actual age were more likely to be alive eight years later than those who felt more than one year older than their actual age. Does a youthful feeling keep people alive? Possibly: feeling younger may lead to better health habits, like exercising and eating healthfully. Feeling younger may also inspire a sense of resilience that keeps people young.
Getting up at night to use the bathroom is often thought of as a problem mainly for older men. Not so—two in three women over age 40 wake up at least once each night because of a full bladder. And nearly half of them make two or more nighttime trips to the bathroom. Factors that increased the likelihood that a woman woke at night to urinate included older age, having had a hysterectomy, having hot flashes, and using vaginal estrogen. Many of the women had no other urinary problems, such as an overactive bladder or leaking urine when coughing, and many weren’t especially bothered by having to get up at night to urinate. Getting up once or more each night to urinate may not be “bothersome,” but it can still cause problems. It can interfere with sleep. It can also lead to falls and injury.
One way to avoid adding extra pounds over the holiday season is by relying on the glycemic index to choose your foods and snacks. The glycemic index is a measure of how fast carbohydrates are turned into sugar. The higher a food’s glycemic index, the faster your body turns that food into sugar, and the sooner the “hunger bell” rings again. This can set into motion the cycle of holiday overeating. One way to go low glycemic: Choose foods your grandmother used to eat—ones that resemble things in nature, and don’t come with long lists of ingredients.
If your fingers turn ghostly white and numb when they get cold, you may have Raynaud’s syndrome (or disease or phenomenon). This common condition Raynaud’s is an exaggeration of the body’s normal response to cold. It usually affects fingers and toes, but may also affect the nose, lips, ears, and nipples. Named after the French physician who first described it in 1862, Raynaud’s is a problem in the body’s arteries. They spasm and collapse in response to cold or stress. Without a steady supply of warm blood circulating through them, the affected body part becomes pale. When the spasm ends and the arteries reopen, allowing blood to flow again, the finger, toe, or other body part turns pink or red. It may throb or tingle. Prevention—staying warm—is the best medicine. It’s possible to cut an attack short by running your hands under warm water, putting them in your arm pits, or waving your arms in circles to get the blood flowing. Other options include thermal feedback and relaxation techniques. More experimental options include Botox injections and sildenafil (Viagra).
Over the past decade, a barrage of reports linking low vitamin D levels to cancer, heart disease, diabetes, and a host of other ills led many doctors to routinely test vitamin D levels in their healthy patients. But there is no good reason to do that, according to a new recommendation from the U.S. Preventive Services Task Force (USPSTF) published in this week’s Annals of Internal Medicine. The task force concluded that it isn’t helpful for most people to know their vitamin D level, and that even if you have a “low” vitamin D level there’s little evidence that taking a vitamin D supplement will do most people any good.
Nearly one-third of American adults are “excessive” drinkers, but only 10% of them have alcohol use disorder (alcoholism). Those numbers, published yesterday in a national survey, challenge the popular idea that most people who drink too much are alcoholics. The new study, done by researchers with the CDC and the Substance Abuse and Mental Health Service Administration, found that about 70% of all American adults drink alcohol at least now and then, about 30% report excessive drinking, and 3.5% have alcohol use disorder. It is higher among heavy drinkers (10%) and binge drinkers, ranging from 4% among those who report binge drinking once or twice a month to 30% among those who binge drink 10 times or more in a month. The knowledge that only 10% of heavy drinkers are alcoholic may be reassuring, but that doesn’t mean the other 90% aren’t have problems with drinking. Some are what Drs. Robert Doyle and Joseph Nowinski call “almost alcoholics.”