Archive for 2013

Anthony Komaroff, M.D.

Do “energy boosters” work?

Stroll the aisles of any pharmacy or “health food” store and you’ll see a multitude of herbs and other supplements that claim to boost energy. Yet there is little or no scientific evidence to support such claims for most of these substances. The fact is, the only thing that’ll reliably boost your energy is caffeine or other stimulant—and their effects wear off within hours. Substances commonly touted as energy boosters include chromium picolinate, coenzyme Q10, creatine, dehydroepiandrosterone (DHEA), ephedra, ginkgo biloba, ginseng, guarana, and vitamin B12. Instead of relying on a supplement for energy, try switching to a healthful diet—more vegetables, fruits, whole grains, nuts, lean protein, and unsaturated fats—and exercising more. That’s truly a better way to beat an energy shortage, and it’s one your whole body will appreciate.

Reena Pande, M.D.

Cholesterol and statins: it’s no longer just about the numbers

Updated cholesterol guidelines released yesterday by the American Heart Association and American College of Cardiology aim to prevent more heart attacks and strokes than ever before. How? By increasing the number of Americans who take a cholesterol-lowering statin. The previous guidelines, published in 2002, focused mainly on “the numbers”—starting cholesterol levels and post-treatment levels. The new guidelines focus instead on an individual’s risk of having a heart attack or stroke. The higher the risk, the greater the potential benefit from a statin. A statin is now recommended for anyone who has cardiovascular disease, anyone with a very high level of harmful LDL cholesterol, anyone with diabetes between the ages of 40 and 75 years, and anyone with a greater than 7.5% chance of having a heart attack or stroke or developing other form of cardiovascular disease in the next 10 years.

Patrick J. Skerrett

On Veterans Day, don’t let the “invisible wounds” of PTSD remain hidden

Millions of American men and women have served in the Armed Forces, protecting and defending our nation. Although many died, most returned home to “pick up their lives.” That isn’t always easy. For some veterans, the trauma of war changes the brain in ways that can cause long-term problems. According to the American Psychiatric Association, more than 300,000 veterans of the wars in Iraq and Afghanistan have been diagnosed with PTSD. Countless others probably suffer from this condition but have never sought help for it. Even sadder, in 2012 more military deaths were caused by suicide than by combat. If you know a veteran, thank him or her for having served our nation. And if you think he or she is having trouble, bolster your courage and ask. Beginning the conversation may open the door to healing.

Patrick J. Skerrett

FDA gets with the evidence, proposes that trans fats are not “safe”

Trans fats, once seen as harmless additives that ended up in everything from Twinkies to French fries, are finally getting the reputation they deserve—bad for health. For years, the FDA has labeled trans fats as “generally recognized as safe.” That term applies to substances added to foods that experts consider safe, and so can be used without testing or approval. Yesterday the FDA proposed removing trans fats from the generally recognized as safe list, a step that would eliminate artificial trans fats from the American food supply. Oils rich in trans fats, long a workhorse of the food industry, boost harmful LDL cholesterol. They also depress protective HDL, which trucks LDL to the liver for disposal; have unhealthy effects on triglycerides; make blood platelets more likely to form artery-blocking clots in the heart, brain, and elsewhere; and feed inflammation, which plays key roles in the development of heart disease, stroke, and diabetes.

Heidi Godman

Adopt a Mediterranean diet now for better health later

It’s been a big year for the Mediterranean diet. Convincing evidence published in 2013 has shown that this kind of eating pattern is effective at warding off heart attack, stroke, and premature death. While you probably get the biggest payoff by adopting such a diet early in life, a new study shows that doing it during midlife is good, too. In the study, women who followed a healthy diet during middle age were about 40% more likely to live past the age of 70 without chronic illness and without physical or mental problems than those with less-healthy diets. The healthiest women were those who ate more plant foods, whole grains, and fish; ate less red and processed meats; and had limited alcohol intake. That’s typical of a Mediterranean-type diet, which is also rich in olive oil and nuts.

Nancy Ferrari

Home score for strep throat in adults could avoid unnecessary doctor visits

Telling the difference between run-of-the-mill sore throat caused by a virus, which doesn’t require medication, from bacteria-caused strep throat, which should be treated with antibiotics, is a tricky thing at any age. Physicians from Harvard Medical School, MIT, and the Skaggs School of Pharmacy in California have come up with a scoring system that could save adults a trip to the doctor for what would most likely turn out to be a garden variety sore throat (it hasn’t been tested in kids yet). It’s based on symptoms, age, and the percentage of people in your area who have tested positive for strep within the last two weeks. If your score is high, then head to your doctor’s office. If it indicates that you are unlikely to have strep, there’s little need for you to rush in for an exam or throat culture. The researchers estimate that use of this kind of score could prevent 230,000 office visits in the United States each year and keep 8,500 men and women from getting antibiotics they don’t need.

Anthony Komaroff, M.D.

Daylight Saving Time “fall back” doesn’t equal sleep gain

Daylight Saving Time officially ends at 2:00 am this Sunday. In theory, “falling back” means an extra hour of sleep this weekend. But it doesn’t usually work out that way. Many people don’t, or can’t, take advantage of this weekend’s extra hour of sleep. And the focus on gaining or losing an hour of sleep overlooks the bigger picture—the effect of Daylight Saving Time transitions on the sleep cycle. This seemingly small one-hour shift in the sleep cycle can affect sleep for up to a week. It’s difficult to side-step the effects of Daylight Saving time on sleep. So be aware that it can take your sleep rhythms a week or so to get adjusted to the new clock.

Howard LeWine, M.D.

Balance training seems to prevent falls, injuries in seniors

Most people take balance for granted. They navigate without thinking, effort, or fear. For millions of others, though, poor balance is a problem. Some struggle with long-term dizziness or imbalance. Others suffer balance-related falls and injuries. A new study concludes that exercise can reduce not only the odds of falling but the odds of sustaining fall-related injuries. In many urban areas, there’s no shortage of classes aimed at improving balance. You can find them at senior centers, Y’s and Jewish Community Centers, health clubs, and the like. There’s also a lot you can do at home. The American College of Sports Medicine Standing recommends standing with one foot in front of another, lifting a foot off the floor, and shifting weight in various directions as three examples of home exercises.

Stephanie Watson

Radiation for breast cancer can increase heart risks

Radiation, on its own or coupled with other treatments, has helped many women survive breast cancer. Yet radiation therapy can cause the appearance of heart disease years later. New research published in JAMA Internal Medicine estimates that the increased lifetime risk for a heart attack or other major heart event in women who’ve had breast cancer radiation is between 0.5% and 3.5%. The risk is highest among women who get radiation to the left breast—understandable, since that’s where the heart is located. The heart effects of radiation begin emerging as soon as five years after treatment. However, future heart risk should not be the reason to abandon this important component of treatment. Cancer experts are doing more and more to minimize the amount of radiation the heart receives.

Howard LeWine, M.D.

World Stroke Day: stroke is common, disabling, and often preventable

Today is World Stroke Day. It offers a good reminder of the profound impact that stroke has on individuals and communities. Nearly 800,000 Americans have strokes each year. Worldwide, one in six adults will have a stroke during their lifetime. Although most survive, stroke is a leading cause of disability in the United States and many other countries. A report published last week in The Lancet documents a troubling trend: more and more young people are experiencing strokes. Between 1990 and 2010, the number of strokes among people aged 20 to 64 years increased 25%. This age group now accounts for one-third of strokes worldwide. Some stroke survivors recover fully and regain their previous levels of function. Others don’t. Keys to full recovery include rapid identification of stroke symptoms, immediate evaluation and treatment, early rehabilitation, and support