Staying Healthy Archive

Good balance is key to preventing potentially disabling falls. It takes active coordination of many systems in the body to achieve good balance, but beginning in your 50s, you may start noticing subtle changes that can lead to difficulties. It's important to identify factors—such as inner ear problems, illnesses, medications, changes to your gait, weight gain or loss, pain, or foot problems—that might affect your balance, and look for solutions.

How gait affects balance

Gait encompasses the many distinct features that make up the way a person walks. Gait includes pacing, the length of the stride, the swing of the leg to put the foot forward, the shift of balance from one leg to the other, how the foot is planted (toe first, heel first), and how the weight is distributed through the step. Your gait is as distinctive as your voice and fingerprints, and even subtle changes to the way you walk can increase the risk of falls.

Some drugs that contain ranitidine (best known as Zantac) have been found by the FDA to have unacceptable amounts of N-nitrosodimethylamine (NDMA), a possible cancer-causing chemical (which also triggered recalls of certain lots of the blood pressure drugs called angiotensin-receptor blockers).

On April 1, 2020, the FDA requested that all forms of ranitidine (Zantac, generic versions), including prescription and over-the-counter products, be removed from the market. They may contain unacceptable levels of a potential cancer-causing substance known as NDMA, or N-Nitrosodimethylamine. In some samples tested by the FDA, the impurity appears to increase over time, especially when stored at higher temperatures. So far, tests of other acid blockers do not show this potential increased cancer risk. 

Cannabis use among older adults has been steadily increasing, due to lessening stigma and increased interest in using medical marijuana. But there are specific concerns for older people, so anyone considering this option should have a conversation with their doctor weighing the benefits and risks.

News briefs

You've heard (in these pages, and others) that a healthy lifestyle can stave off chronic disease. But just how many extra disease-free years might you get from that healthy lifestyle? A lot, suggests an observational Harvard-led study published online Jan. 8, 2020, by The BMJ. Researchers evaluated more than 30 years' worth of health data from 111,000 people who were free of cancer, diabetes, and cardiovascular disease at age 50. Compared with those who didn't follow any healthy lifestyle habits, those who followed four or five healthy habits had an additional decade of disease-free living. The elements of a healthy lifestyle will come as no surprise: don't smoke, limit alcohol intake, eat a healthy diet, maintain a healthy weight, and exercise at least 30 minutes per day. The surprise is just how many additional disease-free years a healthy lifestyle can give you.

Image: © Ridofranz/Getty Images

Getting the right amount is really about just listening to your body.

Many experts these days are advising women to drink lots of water to stay in good health, and women seem to be listening. It's common to see people toting around voluminous bottles of water and swigging from them all day long. And there's no question that water is necessary for optimal health: it keeps your urinary tract healthy, keeps food moving along your digestive tract, helps regulate your blood pressure and body temperature, and works to cushion and protect joints, organs, and other tissues.

One recent study suggested that not drinking enough water could also affect women's cognition. The study, published online in November 2019 by the European Journal of Nutrition, found that women with lower scores on a test that measured how hydrated they were (called serum osmolarity) also scored lower on cognitive tests that measured recall, attention, mental processing speed, and verbal fluency.

News briefs

In the old days, doctors would make house calls; that rarely happens today. However, a new kind of "house call" is in the works: in many cities it's now possible to receive hospital care at home for certain conditions. Such "home hospital care" programs are gaining in popularity. A randomized controlled Harvard study published online Dec. 17, 2019, by Annals of Internal Medicine suggests that the home hospital model of care is less expensive and leads to fewer readmissions than in-hospital care.

Researchers studied about 90 people who'd been diagnosed in the emergency room with infections or flares of heart failure or breathing problems. Half of the people were admitted to hospitals, and the other half were enrolled in home hospital care. The home hospital care group received visits from doctors and nurses, intravenous medications, and video monitoring. People in the home group had 38% lower hospital costs than those in the hospital group, they were more active during care, and they were readmitted to the hospital within 30 days after their care less frequently (7% vs. 23%) than those in the hospital group. Home hospital care is not appropriate for everyone. "If someone is too sick or is in need of advanced procedures, their care may be better delivered in a traditional hospital," says Dr. David M. Levine, the study's lead author and an internal medicine specialist with Harvard-affiliated Brigham and Women's Hospital. However, if you have an illness that needs constant monitoring and treatment for several days — in other words, it can't be done in a doctor's office — yet it also doesn't require advanced procedures or constant and intensive nursing care, the home hospital care model may make sense. "If the home hospital model were offered to a member of my family, I'd encourage them to do it," says Dr. Levine.

Here's how to maintain your current active lifestyle.

Older adults want to enjoy their independent living as long as possible. Yet this can become a challenge as people face more health issues.

"Most life changes that cause older adults to lose some or all of their independence occur either gradually or suddenly," says Dr. Jennifer Rhodes-Kropf, a primary care geriatrician at Harvard-affiliated Hebrew SeniorLife's Center Communities of Brookline, Mass. "You need to stay on top of critical areas that can jeopardize your health and lifestyle."

Research we're watching

Sticking to certain healthy lifestyle habits at midlife could add disease-free years to your life, according to a study from the Harvard T.H. Chan School of Public Health. Study authors found that 50-year-old women who maintained five healthy habits — exercising at least 30 minutes a day, following a healthy diet, maintaining a body mass index in the normal range, having no more than one serving of alcohol a day, and not smoking — lived on average 10.7 more years free of diseases, including diabetes, cardiovascular disease, and cancer, compared with initially healthy women who practiced none of those habits at age 50. Their findings, published online January 8 by BMJ, were based on 34 years of data from the Nurses' Health Study and the Health Professionals Follow-up Study, which involved more than 73,000 women and some 38,000 men.

Image: © kitzcorner/Getty Images

On call

Q. More and more nutrition advice seems to be anti-sugar these days. So are artificial sweeteners a good alternative, especially when it comes to weight loss?

A. Many people consume artificial sweeteners, which include acesulfame, aspartame, neotame, saccharin, stevia plant extract, and sucralose, because they want to lose weight, avoid the "empty" (non-nutritious) calories of sugar, or avoid weight gain. Replacing concentrated sugar with products that have few, if any, calories should tilt energy balance in favor of weight loss. Some short-term studies suggest that artificial sweeteners may have that effect.