Harvard Health Blog

In a proactive effort to help stem healthcare spending, nine medical specialty organizations have published their top 5 lists of tests, treatments, or services that are unnecessary or at least should include a thorough conversation between patients and their doctors regarding the benefits and risks of before undertaking the procedure. The lists are part of a campaign called Choosing Wisely, organized by the American Board of Internal Medicine Foundation. The purpose of making these lists, says the foundation, is to help doctors and their patients talk about tests and procedures in order to choose the ones that are supported by evidence; don’t duplicate other tests or procedures; are free from harm; and are really needed.

Today is National Walking Day. Join the celebration by taking a walk. This particular health observance is sponsored by the American Heart Association (AHA). Although it applies to everyone, it’s really aimed at adults who spend most of the workday sitting. The heart association hopes to get workers out of the office, store, or factory for a 30-minute walk. And not just today, but every day. If you don’t exercise, or do it only now and then, walking is an excellent way to get more physical activity. Just 30 minutes a day of brisk walking (or other moderate exercise), helps your heart, blood vessels, muscles, brain, and the rest of your body. If you don’t usually exercise, use National Walking Day as an invitation to get started. If you do exercise, use the day to invite a friend to get on the path to better health with a walk.

Bisphenol A, or BPA, has been used for decades to make hard plastic water bottles and to coat the inside of food cans. Tiny amounts of BPA migrate from these containers into water or food, and then into people. BPA is thought to mimic the effects of the hormone estrogen, which can interfere with growth and throw off normal hormonal interactions. In 2008, the Natural Resources Defense Council petitioned the FDA to ban the use of BPA in food packaging. The FDA finally responded last week. It denied the petition, saying the organization didn’t provide compelling data to make the case for a ban. The FDA didn’t rule out further action. In the meantime, there are several things you can do to minimize your BPA exposure.

The term “personalized medicine” is still something of an abstract idea. In an audacious experiment, Stanford molecular geneticist Michael Snyder gave it a face—his own—and showed what it can do. Snyder and a large team of colleagues first sequenced his DNA, revealing his complete genetic library. Then they analyzed blood samples he gave every few weeks for two years. This was akin to taking a 3-D movie of his inner workings to observe how genes, the molecules that read and decode them (RNA), the proteins they make, and other substances interact during health and illness. The team saw how Snyder’s body responded to a cold at the very beginning of the study. Midway through, they watched as molecular changes wrought by a respiratory infection tipped him into full-blown diabetes.

For decades, the word “autism” meant an immutable brain disorder, one determined solely by genes and that was only marginally responsive to therapies. Today it is coming to mean something different and more manageable. A growing body of research is dramatically changing the face and future of autism. In The Autism Revolution, a new book from Harvard Health Publishing that I wrote with Karen Weintraub, I explain this evolution in autism science and offer strategies for families to help their children right now. One practical finding is that autism is not just a brain disorder but a whole-body condition. Treating digestive and immune system problems can make a profound difference in the family’s life, and even in the autism itself. Another finding is that autism may not necessarily be fixed for life, and that some kids improve with time and treatment.

For many people, gambling now and then is a bit of fun. For as many as two million Americans, though, gambling is addiction that can be as intense and harmful as an addiction to alcohol or drugs. “Change Your Gambling, Change Your Life,” a new book from Harvard Health Publishing, offers a guide for anyone looking to take a self-help approach to recovery from gambling addiction. The book offers a series of self-help tests to evaluate the depth of a person’s gambling problem and analyze its context. It also includes a toolbox of practical strategies and approaches to control the urge to gamble, and advice for avoiding slips and backslides. “Change Your Gambling, Change Your Life” was written by Dr. Howard J. Shaffer, a pioneer in the field of gambling addiction, with co-authors Ryan Martin, PhD, John Kleschinsky, MPH, and Liz Neporent, MA.

A trio of new studies from the University of Oxford suggests that aspirin is worth testing as a simple way to help prevent cancer. But these are preliminary findings, and you shouldn’t start taking an aspirin a day without having a conversion with your doctor. That’s because aspirin has side effects that could offset any possible cancer-fighting benefit, including stomach upset, gastrointestinal bleeding and hemorrhagic stroke (bleeding in the brain). The Oxford studies couldn’t determine cause and effect. The only way to tally up the true balance of benefits and risks of aspirin for cancer prevention is with trials specifically designed to do that. Several are underway or in the planning stages. But you can work to prevent cancer right now by avoiding tobacco in all its forms, exercising, and making other healthy changes.

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A large study from Europe does little to resolve the controversy over whether men should have a simple blood test to look for hidden prostate cancer. In the study, the number of deaths over the course of the 11-year study were the same in men tested for prostate-specific antigen (PSA) and in men who didn’t have the test. Because prostate cancer usually grows very slowly, detecting it in an older man generally isn’t helpful. Some men live with the side effects of treatment—notably impotence and incontinence—for a cancer that would have had no effect on the length or quality of their lives. This study and others suggest that we rethink the widespread use of PSA testing, especially the yearly screening that is common in the United States.

A new study from the Harvard School of Public Health suggests that a steady diet of red meat increases the odds of dying prematurely. In the study of more than 121,000 men and women, every extra daily serving of unprocessed red meat (steak, hamburger, pork, etc.) increased the risk of dying prematurely by 13%. Processed red meat (hot dogs, sausage, bacon, and the like) upped the risk by 20%. In absolute terms, the increase isn’t so scary. Among women, the death rate was 7 per 1,000 women per year among those eating about one serving of red meat a week, and 8.5 per 1,000 women per year among those eating two servings a day. The increased risk from red meat may come from the saturated fat, cholesterol, and iron it delivers. Potentially cancer-causing compounds generated when cooking red meat at high could also contribute. Sodium, particularly in processed foods, may also play a role.

This weekend, most Americans will follow the annual ritual of setting their clocks ahead one hour—and lose an hour of sleep in the process. We pay for it on Monday. According to sleep expert Dr. Charles Czeisler, U.S. researchers have seen increases of 6% to 17% in motor vehicle crashes on the Mondays after we […]

Active-play videogames, also known as exergames, are a high-tech approach to fitness that could help some people become more active and stay that way. As described in the March 2012 Harvard Heart Letter, exergames offer muscle-strengthening workouts, balance and stretching games, aerobic exercises and dancing, martial arts, and simulated recreational activities such as golf, skiing, and more. Current exergames deliver moderate workouts at best. Some fitness and senior centers now incorporate exergames into their facilities. For a home system, you’ll probably spend about $250 for the basics — console, accessories such as handheld controls or balance board, and software.

More and more parents are “redshirting” their young ones. That’s the practice of not starting a child in kindergarten until after his or her sixth birthday. Ann Densmore, EdD, an expert in language and social communication skills in children and co-author of Your Successful Preschooler, said parents do this to gain competitive advantages for their children and as a response to the shift in what kindergarten is. You can help prepare your children for kindergarten by ensuring there is adequate facilitated play in preschool. On the community level, talk with teachers, principals, and other parents. Challenge school committees. And realize that starting kindergarten is a new beginning for a child and his or her parents.

Children who snore, or sometimes stop breathing during sleep for a few seconds then recover with a gasp (a pattern known as sleep apnea), are more likely to become hyperactive, overly aggressive, anxious, or depressed, according to a new new study in the journal Pediatrics. How could snoring or apnea contribute to behavioral or emotional problems? It is possible that nighttime breathing problems during the brain’s formative years decrease the supply of oxygen to the brain. That could interfere with the development of pathways that control behavior and mood. It is also possible that breathing problems disturb sleep, and it’s the interrupted or poor sleep by itself that may cause trouble in the developing brain.

Drinking in the workplace may be an emerging trend, but it isn’t necessarily a healthy one. Although drinking on the job may not be as widespread as portrayed on the hit TV show Mad Men, it is still with us. About 8% of full-time employees report having five or more drinks on five or more occasions a month, and one survey showed that 23% of upper-level managers reported drinking during work hours in the prior month. In the United States, excessive drinking costs $223 billion a year. Some of these costs are generated by the nearly 18 million Americans who are alcoholics or have alcohol-related problems. But some also comes from a nearly invisible group, “almost alcoholics.”

Games are meant to be fun and exciting. Some involve the body, some the mind. Others do both. Researchers are tapping into this engagement to use games to heal an ailing mind or body. Researchers are testing virtual reality to help people with mental and physical problems ranging from post-traumatic stress disorder and stroke rehabilitation to smoking cessation and stuttering. Exergames may also help people become more physically active. Although they won’t help you lose weight or train for a marathon, many meet the American Heart Association’s criteria for “moderate-intensity daily activity,” meaning they could stand in for taking a walk.

An epileptic seizure is a frightening thing to experience, and almost as frightening to watch. Fortunately, most seizures stop on their own after a couple minutes. Any that last longer than five to 10 minutes (doctors call a long-lasting seizure status epilepticus) are a medical emergency and must be halted with medication. A new study shows that delivering anti-seizure medication with a hand-held auto-injector—much like the epi pens used by people with life-threatening allergies—is better than delivering them intravenously. This study could pave the way for home treatment of epileptic seizures.

Most of the changes that come with pregnancy—growing a belly “bump,” being tired, mood swings, cravings for particular foods, and the like—are normal, temporary, and harmless. Two other changes, pregnancy-related high blood pressure and diabetes, may have long-lasting implications for heart health. The development of high blood pressure during pregnancy is known as preeclampsia; pregnancy-related diabetes is called gestational diabetes. They are different from “regular” high blood pressure and diabetes because both are “cured” by delivery. A new study published this week in the journal Circulation suggests that these complications boost a woman’s risk of cardiovascular disease during middle age.

I’m a big fan of diet soda. I like the taste, and I love that it doesn’t have any calories. I can drink two or three diet sodas a day and not worry about gaining weight. But a new study has me wondering if enjoying the sweetness of soda without the sugar and calories is such a good thing after all. University of Miami and Columbia University researchers found that daily diet soda drinkers were more likely to have had a stroke or heart attack over the course of a 10-year study, or to have died from vascular disease, as folks who didn’t imbibe diet soda. My husband gently (but persistently) tells me there is nothing good about drinking diet soda, not even the taste I claim to enjoy so much. The evidence seems to be backing him up.

Worrisome shortages of important medications—from drugs to manage the symptoms of ADHD to standard cancer drugs—have been in the headlines lately. A shortage can be frightening to the people who need a hard-to-get medication, and frustrating for the clinicians who prescribe it. Manufacturing and quality control issues are among the primary reasons for drug shortages. The FDA can sometimes help ease a drug shortage. What can you do if you are affected? Ask your doctor if another medication might work for you. Be especially wary of Internet or faxed advertisements for alternatives (often highly priced and sometimes counterfeit).

It’s hard for someone who has never battled an addiction to understand how or why a person can’t break free of one. An exchange on the radio about pop star Whitney Houston’s addictions underscores the misconceptions many people have about addiction. Addictions retrain the brain in a way that couples liking something with wanting it. There are important gender differences in addiction. Although men are more likely than women to become addicted to drugs or harmful behaviors, women who have an addiction face tougher challenges.