Archive for December, 2011

Anthony Komaroff, M.D.

Are artificial sweeteners a healthy substitute for sugar?

Although short-term studies suggest that switching from sugar to calorie-free sweeteners can help people lose weight, the December 2011 Harvard Health Letter explores the possibility that it may actually promote weight gain. Use of super-sweet artificial sweeteners may desensitize users to sweetness. Healthful foods like fruits and vegetables may become unappetizing by comparison. As a result, the overall quality of the diet may decline. The calories removed from the diet by the sugar-for-sweetener swap may sneak back in, in the form of refined carbohydrates and low-quality fats. Another concern is that artificial sweeteners could cause weight gain by directly stimulating the development of new fat cells.

Anthony Komaroff, M.D.

Don’t let food poisoning spoil your holiday party

In the movie “Wedding Crashers,” Owen Wilson and Vince Vaughn made party crashing seem like harmless fun. A different sort of party crasher—microbes with names like Campylobacter and Salmonella (pictured to the right)—sicken nearly 50 million Americans each year. Holiday buffets and dinners are a more inviting setting for the microbes that cause food poisoning […]

Anthony Komaroff, M.D.

Coping with grief and loss during the holidays

Family and togetherness are key themes for the holidays. That can make the holidays awfully difficult for people who are grieving the loss of a loved one.  My father passed away a month before the holidays.  We still shared presents, ate large meals, visited with friends, even sang carols—but it was all pretty subdued. “If […]

Lloyd Resnick

Should kids have their cholesterol checked?

New guidelines for from the American Academy of Pediatrics recommend that all kids between the ages of 9 and 11 have their LDL (bad) cholesterol levels checked. The rationale is that atherosclerosis (the fatty gunk in arteries that causes heart attacks, strokes, and other serious problems) starts during youth. Atherosclerosis is fed by high LDL. The guidelines aren’t aimed at getting kids to take cholesterol-lowering statins. Instead, they are about getting kids, their parents, and their doctors to talk about making healthy lifestyle choices. The hope is that more doctor time spent coaching and counseling now will mean less time treating cardiovascular disease later.

Howard LeWine, M.D.

Increase in resting heart rate is a signal worth watching

Your resting heart rate is how fast your heart beats when you’ve been sitting quietly for a while. The usual range is between 60 and 90 beats per minute. A new study published in the Journal of the American Medical Association suggests that an increase in this rate over time may be a signal of heart trouble ahead. The results also suggested that lowering your heart rate over time may be beneficial, but the researchers could not say that for certain. Exercise, stress reduction, and quitting smoking can help reduce a high resting heart rate.

Peter Wehrwein

Do you want to see your doctor’s medical notes?

As paper medical records give way to electronic health records, it is becoming increasingly possible to view your medical history. Yet experts are debating whether the electronic health record should include the notes that doctors make in them. The Open Notes project is designed to test the consequences of giving patients access to doctors’ notes. Results of a survey of the expectations that doctors and patients have for note sharing, reported in the Annals of Internal Medicine, suggest that while physicians are generally optimistic about doing this, many believe it could cause patients to worry or generate unnecessary questions. Patients who filled out the survey thought that seeing their doctor’s notes would provide a clearer understanding of their medical condition, improve self-care, and give them a greater sense of control.

Patrick J. Skerrett

Studies hint at limits when reducing salt

“Limit salt” has been a key part of dietary advice for decades. Once aimed at individuals, the FDA is hoping to persuade food companies to cut back on salt added to prepared foods. That’s probably a good idea, since the average American gets more salt—and thus sodium—than needed, most of it from prepared foods. But the question of how low we should go with sodium hasn’t been answered. Two studies suggest that getting too little sodium could pose problems, just as eating too much does. Trials to determine the safest range for sodium aren’t in the offing. What to do in the interim? Aiming for the recommended target of 2,300 milligrams per day from all sources is probably good for most people.

Anthony Komaroff, M.D.

Social networks can affect weight, happiness

The new science of social networks is demonstrating how personal interconnections can affect our health. Ideas and habits that influence health for better or for worse can spread through social networks in much the same way that germs spread through communities. An article in the December issue of the Harvard Men’s Health Watch explores how social networks can affect weight and mood. A study of people taking part in the Framingham Heart Study found that among participants who had a friend become obese, their chance of becoming obese rose by 57%. A different study from Framingham showed that happiness can also spread across social networks. Research into social networks could help experts some day use them to improve public health.

Howard LeWine, M.D.

Leg clots (aka deep-vein thrombosis): an immediate and long-term health hazard

Deep-vein thrombosis (DVT) is the medical term for a blood clot that forms in a leg vein. This condition puts more than one-quarter million Americans in the hospital each year, and complications from it are responsible for upwards of 100,000 deaths. DVT can threaten health immediately if a piece of the clot breaks away and lodges in the lungs. This is called pulmonary embolism. Almost all DVT-related deaths are due to pulmonary embolism. It can also pose a long-term problem if the clot damages the vein. This is called post-phlebitis syndrome. A new study shows injecting a clot-busting drug directly into a DVT can help prevent post-phlebitis syndrome.

Lloyd Resnick

Making health decisions: mindsets, numbers, and stories

How do people make decisions about their health and medical treatment? Husband and wife doctor team Jerome Groopman and Pamela Hartzband, both faculty members at Harvard Medical School and physicians at Beth Israel Deaconess Medical Center, explore this topic in a new book called Your Medical Mind. They say three basic influences drive our medical decisions: our mindset or general approach to medical matters, numbers (medical data and how they are presented), and stories. Groopman and Hartzband interviewed scores of patients to arrive at general mindsets that shape medical decisions: maximalists and minimalists, naturalists and technologists, believers and doubters. These mindsets can change in the face of new numbers, well-framed advice from physicians, compelling stories from friends and family, and direct-to-consumer advertising.