Staying Healthy Archive

Ask the doctor

Q. My smartphone tells me how many steps I take each day, but I don't know how many I should shoot for. What should my goal be?

A. You've read in these pages and elsewhere that regular physical activity reduces the risk of heart disease, type 2 diabetes, obesity, and possibly several types of cancer. Regular exercise also reduces the risk of premature death. No medicine yet invented can claim such benefits. Probably the advice you've heard most often is that moderate exercise — like a brisk walk (at about 3 mph) for 30 minutes at least five times a week — will bring all of the above health benefits.

Bacteria and mold can accumulate in various parts of the device. But regular equipment cleaning reduces risks.

Continuous positive airway pressure (CPAP) can be hard to get used to. The mask may feel bulky, or it may feel strange to have air blowing in as you try to breathe. That keeps many people from using a treatment that may, in fact, be a lifesaver (see "What is CPAP?").

People also can be put off because they've heard that a dirty CPAP machine can make you sick. Is that true? "Yes, if you don't clean the machine regularly," says Dr. Lawrence Epstein, a sleep expert at Harvard-affiliated Brigham and Women's Hospital.

The proper warm-up, equipment, and health considerations are key to maintaining an outdoor routine.

You've grabbed a hooded jacket, and you're ready for a brisk walk in the great outdoors. But is that enough to keep you safe in cooler temperatures? An outdoor exercise routine at this time of year brings unique risks and benefits. You need a little planning and preparation to keep exercising outside in the weeks or months to come.

Know the risks

Being exposed to long periods of cold weather poses numerous health risks.

Simple swaps like whole grains instead of white rice maintain flavor while boosting health benefits.

There's nothing quite like coming in from the cold and sitting down to a hot, hearty meal. The icy temperatures seem to make us yearn for foods that will warm us up inside, stick to our bones, and soothe the soul. "We are warm-bodied creatures, and as the weather cools we actually crave more calories so we can stay warm," explains Sandra Allonen, a registered dietitian with Harvard-affiliated Beth Israel Deaconess Hospital.

But digging into comfort foods all winter — like a savory beef stew, spicy spaghetti and meatballs, macaroni and cheese, fluffy pancakes, gooey pizza, or buttery mashed potatoes — comes with health risks.

News briefs

Sugary drinks are becoming more plentiful at large restaurant chains, and some drinks are getting sweeter. That's according to a study published in the August issue of the American Journal of Preventive Medicine. Harvard researchers analyzed the beverage offerings of 63 fast-food, fast-casual, or full-service restaurant chains from 2012 to 2017. Over that period, the number of sugary beverages available at the restaurants increased by 82%. Among newly introduced sugary beverages such as sodas, fruit drinks, and sports drinks, from 2012 to 2016 the number of calories per drink increased by about 50, and the average amount of sugar per drink reached a whopping 63 grams. Newly introduced sweetened teas roughly doubled in sugar and calories from 2012 to 2016, jumping from an average of about 140 calories per drink to about 300, and from 25 grams of sugar to 56. But remember: the American Heart Association recommends limiting added sugar to 25 grams per day for women and 36 grams per day for men. If you want to splurge on a sugary drink, try not to consume all of it, or chose a lower-sugar option.

Image: LiliGraphie/Getty Images

News briefs

Falls are among the biggest killers of older adults. And a pair of studies published June 4, 2019, in JAMA sheds light on the problem and a possible solution. The first study suggests that from 2000 to 2016, death rates among U.S. adults (ages 75 or older) more than doubled, from 52 to 122 per 100,000 people. This result is consistent with many earlier studies. The second study offers a potential way to help prevent falls. Researchers randomly divided 345 older adults who'd suffered a fall into two groups. The people in one group took part in a home-based program involving strength and balance exercises three times per week and a 30-minute walk twice a week. They also received some visits from a physical therapist. The people in the comparison group were asked not to exercise, and they saw their doctors only occasionally. After one year, the exercise group experienced 36% fewer falls than the non-exercise group. The findings support the benefits of exercising to prevent falls. Still, you should talk with your doctor or a physical therapist about whether and how you might try a home-based program.

News briefs

Red light, green light — we all know what those mean. And when Harvard researchers added traffic-light symbols to packages and menus in a hospital cafeteria, they found that diners bought healthier foods with fewer calories. The findings were published online July 10, 2019, by JAMA Network Open. Scientists first tracked the cafeteria purchases of hospital employees for a few months. Then they labeled foods with symbols indicating if a food was healthy (green), less healthy (yellow), or unhealthy (red); moved unhealthy foods to less accessible locations in the cafeteria; and tracked purchases for another two years. About 5,700 people bought food during that time. When researchers linked calorie information to purchases, they found a 6% decrease in calories per purchase over two years, including a 23% decrease in calories from the least healthy foods. This builds on previous research that found sales of red-stickered items dropped by 4% and sales of green-stickered items grew by 5% during the study. Can you try this at home? Maybe not the traffic-light stickers. "But making it harder to access unhealthy foods gives you enough time to think about your choice before eating something that is not consistent with your goals," says lead author Dr. Anne Thorndike, who specializes in obesity treatment and prevention at Harvard-affiliated Massachusetts General Hospital. "Strategies include having a drawer for the unhealthy foods, placing unhealthy snacks high on a shelf, and having a goto' shelf for healthy snacks."

Image: lcs813/Getty Images

Smart choices for your midday meal may help set the stage for healthier eating throughout the day.

The classic American lunch — a deli sandwich, potato chips, and a soda — isn't exactly heart-friendly fare. Even salad bars can be tricky to navigate when you're trying to choose a nutritious but satisfying lunch. In fact, more than half of employed Americans who usually eat lunch on the job find it hard to eat a healthy lunch, according to a recent survey from the American Heart Association.

"Helping people understand what makes a healthy lunch may help them eat fewer calories and maybe even inspire them to make healthier food decisions the rest of the day," says Dr. Anne Thorndike, associate professor of medicine at Harvard Medical School. In a study of nearly 5,700 hospital employees, she and colleagues found that labeling cafeteria foods with simple "traffic light" symbols that reflected their relative health value was linked to healthier choices by employees. They ate fewer calories, mostly by eating fewer high-fat, high-calorie "red light" foods and more "green light" foods (in which the main ingredient was fruit, vegetable, whole grain, lean protein, or low-fat dairy). What's more, these dietary shifts lasted over a period of two years. For employees who visited the cafeteria most frequently, the estimated drop in calories could translate to a weight loss of up to 4.4 pounds over time, says Dr. Thorndike. The study was published July 10 in JAMA Network Open.

The extract from the cannabis plant is the hot new treatment for all kinds of ailments, but don't buy into it just yet.

Cannabidiol (CBD), extracted from the cannabis or hemp plant, has been promoted as the latest miracle cure for everything from aches and pains to anxiety and sleep disorders. There is a good chance you've heard a friend share his or her story about the wonders of CBD.

But is it miraculous — or just a mirage?

"CBD is being used over the counter in a range of ways that is not supported by the science," says Dr. Jordan Tishler, instructor of medicine at Harvard Medical School and president of the Association of Cannabis Specialists. "There is still much we don't know. But aggressive marketing, hype, and word of mouth have made CBD like a drug version of the emperor's new clothes. Everyone says it works, but lab studies suggest that it's really not what people think."

On call

Q. Are there any particular reasons why men should get a routine blood test to check for a vitamin D deficiency?

A. The importance of sufficient vitamin D for bone health has a long history. In the past few decades, several studies have suggested that vitamin D might have other health benefits as well.