I say “good” because I like to limit my carbohydrates to one meal a day—dinner, in this case. It makes me feel better than having carbs throughout the day. I’m not following any particular diet, but just trying to eat in what I think is a healthy way. That means having more protein-based meals than carb-based meals. It turns out I’m not alone.

The International Food Information Council Foundation reports that 50% of consumers are interested in including more protein in their diets and 37% believe protein helps with weight loss. A study in the May/June 2013 issue of the Journal of Nutrition Education and Behavior found that 43% of women surveyed are using the practice of eating more protein to prevent weight gain, and this strategy was associated with weight loss.

But just because people are doing something doesn’t make it healthy. I asked Dr. Michelle Hauser, a clinical fellow in medicine at Harvard Medical School and a certified chef and nutrition educator, if it’s a good idea to eat extra protein and cut back on carbs.

“If you’re eating more protein but you have a good mix of fresh fruits, vegetables and whole grains to make up the rest of it, that’s fine,” Dr. Hauser told me. One of the advantages of eating more protein-rich foods is that people who do it also tend to eliminate overly processed carbohydrates, such as white breads and prepackaged foods like cookies and crackers. Such foods are rapidly digested and turned into blood sugar, and tend to be low in healthful nutrients.

But it isn’t necessary to eliminate all carbohydrates and focus only on protein. Such an eating strategy may have a short-term payoff for weight loss, but it may also come with some long-term risks.

Understanding protein

Protein is a critical part of our diet. We need it to build and repair cells, and make healthy muscles, organs, glands, and skin. Everyone needs a minimum amount each day. The Institute of Medicine recommends 0.8 grams of protein per kilogram of body weight. For someone who weighs 150 pounds, that means 54 grams of protein per day. Another guideline is to make sure at least 15% of your daily calories come from protein.

How might more protein and fewer carbs in the diet make a difference for weight loss or weight control? “Protein takes more energy for you to digest than refined carbohydrates, and also gives your body a feeling of satiety,” says Dr. Hauser. Low-carb diets have been shown to help some people lose weight.

But over the long term, too much protein and too few carbohydrates may not be the healthiest plan. This kind of eating pattern has been linked to an increased risk of developing osteoporosis. That’s because digesting protein releases acids into the bloodstream. The body neutralizes these acids with calcium—which can be pulled from bone if necessary. Eating too much protein also makes the kidneys work harder. In healthy people, this usually doesn’t pose a problem. But those with kidney disease or diabetes (which is associated with kidney disease) need to watch their daily protein intake so they don’t overload their kidneys.

Depriving yourself of carbohydrates can also affect the brain and muscles, which need glucose (the fuel that comes from digesting carbs) to function efficiently. The fiber delivered by some carbohydrate-rich foods help bowels move. And remember that healthy sources of carbohydrates, such as fruits, vegetables, and whole grains, come with a host of vitamins, minerals, and other nutrients.

Making wise protein choices

It’s okay to cut back on carbs and eat more protein, but make sure you’re also getting some carbs in your daily diet. “If you take any healthy diet, 40% to 60% of calories should come from unprocessed carbs,” says Dr. Hauser. For someone on a 2,000 calorie-a-day diet, 40% would be 800 calories or 200 grams of carbs. (Note to self: increase servings of carbohydrates.)

But there are good carbs and bad carbs, as well as good proteins and bad proteins. Foods that deliver whole, unrefined carbs, like whole wheat, oats, quinoa, and the like, trump those made up of highly processed wheat or other grains. Lean meats, poultry, seafood, and plant sources of protein like beans and nuts are far more healthful than fatty meats and processed meats like sausage or deli meats.

The good-bad thing can be confusing, so Dr. Hauser suggests a few simple principles.

Pick the healthful trio. At each meal, include foods that deliver some fat, fiber, and protein. The fiber makes you feel full right away, the protein helps you stay full for longer, and the fat works with the hormones in your body to tell you to stop eating. Adding nuts to your diet is a good way to maintain weight because it has all three.

Avoid highly processed foods. The closer a food is to the way it started out, the longer it will take to digest, the gentler effect it will have on blood sugar, and the more nutrients it will contain.

Choose the most healthful sources of protein. Good protein-rich foods include fish, poultry, eggs, beans, legumes, nuts, tofu, and low-fat or non-fat dairy products.

These three strategies fit in with the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets. The DASH diet includes 2 or fewer servings of protein per day, mostly poultry or fish. “The Mediterranean diet uses protein from fish as a centerpiece of a meal, and other meats as more of a component of a meal,” says Dr. Hauser.

I had to ask if it’s important to spread carbs throughout the day or if it’s okay to limit them to one meal, the way I do. “If it makes you feel better to eat carbs at one meal a day versus spreading them throughout the day, that’s fine. You can scatter the carbs as you see fit,” says Dr. Hauser.

So I learned that while I was “good” yesterday when it came to eating, I now know that I can be better.

I posed the question to Dr. Scott McGinnis, an instructor in neurology at Harvard Medical School. As I write in the April issue of the Harvard Health Letter, he said it was a difficult question to answer because few solid studies have addressed it.

That may be changing. A study published yesterday in JAMA Internal Medicine tried to tease out whether physical or mental activity was better for brain health. Researchers recruited 126 older adults who felt that their memory or thinking skills had recently gotten worse, and divided them into four groups. All were asked to do an hour of mental activity three times a week and an hour of physical activity three times a week. What differed were the intensities of these activities:

• intensive computer work plus aerobics
• intensive computer work plus light stretching and toning
• watching educational DVDs plus aerobics
• watching educational DVDs plus light stretching and toning

After 12 weeks, scores on thinking tests improved across the board. The big surprise was that there weren’t any real differences in improvement between the groups. The researchers concluded that the amount of activity is more important for stimulating the brain than the type of activity, because all of the participants both exercised and engaged in mental activities each week.

Benefits from both

There’s some evidence that exercise alone protects the brain. One study of people in their seventies published in Neurology showed that those who exercised the most had the least brain shrinkage and fewer white matter brain lesions, which can be signs of dementia. People who engaged in mental activities had more brain shrinkage and white matter brain lesions. Another study published recently in Stroke showed that older adults who exercised regularly reduced their risk of vascular-related dementia by 40%.

It’s likely that regular exercise can increase the volume of brain regions important for memory and thinking. “There are a number of possible mechanisms for this,” says Dr. McGinnis, “such as stimulating production of growth factors, blood vessels, and new brain cells, which may provide a buffer against brain changes that cause dementia.”

Mental activity alone can also protect the brain. In one 2012 study, published in Neurology, researchers demonstrated a direct link between the amount of cognitive activity, such as reading the newspaper or playing chess, and the level of cognitive function in the following year. As I wrote in the August 2012 Harvard Health Letter, another study found that engaging in meaningful activities such as volunteering or a treasured hobby promotes cognitive health in old age.

“Exercising a specific cognitive function will improve that function. If one engages in tasks requiring working memory, such as holding and manipulating material in the mind for short periods of time, one will usually become stronger in that area,” says Dr. McGinnis.

What you can do

Take advantage of the brain protection that both physical and mental activities provide. On the physical side, start or keep moving. A good goal is 150 minutes of moderate intensity exercise a week, but any activity is better than none. On the mental side, Dr. McGinnis suggests doing something you already enjoy. “It might be crossword puzzles, reading, participating in a club, building models, or any number of activities. The guiding principle is that the activities require active engagement, not passive engagement such as watching television.”

Me? I’ll stick to my funny-looking walking and crosswords, although I’ve recently become rather obsessed with a Scrabble game on my smartphone. Next question: Can I walk and play Scrabble at the same time? While it might be better for my brain, I don’t need a medical study to give me that answer. It’s spelled N-O!

“Sure,” you might say, “Who wouldn’t be happier in Hawaii?” As a graduate of West Virginia University, I admit that there were times as a student in Morgantown when I longed for sunshine and balmy breezes instead of gray winter days and rural towns covered in coal dust (although I loved my school and I loved those country roads). But well-being is not a simple matter of palm trees versus coal mines.

The index calculates overall well-being based on six quality of life categories, each of which is made up of several components:

• Life evaluation (are you thriving, struggling, or suffering?)
• Emotional health (such as happiness, worry, being treated with respect, stress)
• Work environment (such as job satisfaction or supervisor’s treatment)
• Physical health (such as obesity, feeling well rested, sickness)
• Healthy behaviors (such as not smoking, eating healthy food, exercising frequently)
• Basic access (such as to clean water, medicine, enough money for food, shelter, healthcare)

Poll respondents in Hawaii had the highest scores in the emotional health and work environment indexes, and were most likely to say they were thriving. People in West Virginia were most likely to say they were not thriving, and had the worst emotional health, the worst health habits, the most diagnoses of depression, and high rates of obesity. People in the other 50 states fell in between. Check out how your state fared online.

Do people in low well-being states, like West Virginia, Kentucky, Mississippi, Tennessee, and Arkansas, have to stay that way? Is it hard to change?

“There’s good news and bad news about our ability to change our sense of well-being or happiness,” says Dr. Ronald D. Siegel, assistant clinical professor of psychology at Harvard Medical School. “It turns out that, just like for weight, we have genetically determined happiness set-points. So if we’re not taking steps to improve our sense of well-being, we tend to gravitate back to the same level.” Depending on your genes, that level may be pretty happy or pretty unhappy, says Dr. Siegel, who is also the faculty editor of Positive Psychology, a Special Health Report from Harvard Medical School.

About 40% of what determines happiness is under our control. In contrast, only about 10% has to do with good and bad fortune. “It’s not mostly events, but our responses to events, that determines our level of well-being,” says Dr. Siegel.

He offers several steps you can take to improve your emotional well-being, no matter what state you’re in:

1. Live in the moment. When you’re fully engaged in activities, you will enjoy them more and be less preoccupied by concerns about the past and the future.

2. Be grateful. Keeping a daily gratitude journal promotes positive feelings, optimism, life satisfaction, and connectedness with others.

3. Do things for others. Happiness comes most reliably from connecting with others and not being overly self-focused. Try to do things that benefit someone or something other than yourself.

4. Take inventory of your strengths, then apply them in new ways in your daily life. For example, if you count curiosity as a strength, read about a new subject. If you consider yourself brave, try something that makes you nervous, such as public speaking.

5. Savor pleasure. Reminisce about good times, celebrate good moments with others, be happy when you accomplish something.

Overall well-being also includes physical health. People who reported experiencing overall better health, such as those who live in Hawaii, Colorado, Minnesota, Utah, and Vermont, tend to exercise more, smoke less, and like their jobs more than folks in other states.

If poor health or unhealthy behaviors are dragging down your well-being, addressing these issues is one way to improve well-being. That may seem daunting, but it doesn’t have to.

“Two-thirds of all illness is the result of our lifestyle choices,” says Dr. Edward Phillips, founder and director of the Institute of Lifestyle Medicine at Harvard Medical School. The Institute is dedicated to teaching health care professionals how to help their patients make healthy changes.

Dr. Phillips shared some of the key tips that help improve health one small step at a time:

1. Take responsibility for your health. That means going to your doctor and actually following his or her advice.

2. Apply your personal strengths to your health. If you’re a disciplined, organized professional, what can you apply from your work life to the change you want to make now?

3. Come up with reasonable and small first goals. “Find something that’s a 2% change, like walking ten minutes a day. Go for a walk at lunch, walk while you’re talking on the phone. What’s the smallest change you can make and be confident you can do it? I’ve met very few patients who can’t do that,” says Dr. Phillips, who is also the faculty editor for Simple Changes, Big Rewards, another Harvard Medical School report.

4. Be accountable for your changes. You’ll do much better if you track and report your progress to a loved one or friend, or to a program on a website or an app.

5. Pay attention to the benefits. The value of the change, such as sleeping better from exercising, can become the motivation to continue that change and make others. When you see that change is possible, you’ll be encouraged to make more changes.

Is it really that simple? Make a small change and your well-being will improve? “Absolutely,” says Dr. Phillips. “People can make reasonable changes and achieve them. And then improved behavior begets improved behavior.”

That’s a plan that can rank high on anyone’s list.

Case in point: my son, who is majoring in economics in college, recently informed us that he could reduce his expenses at school by 32% if he could eat at fast food restaurants daily and ditch the dorm meal plan. While I was impressed by his math skills and economic reasoning, I warned him that fast food often could lead not only to weight gain but also to other medical problems. Then I resorted to my own weapons: the latest research. Knowledge is power, after all, and two new studies gave me the confidence to hold my ground. They may work for you, too.

The latest findings

One study, published online in the journal Thorax, looked at possible connections between consuming different types of food and the development of asthma, rhinitis (chronic stuffy nose) and eczema, a skin condition. The researchers surveyed 500,000 kids from 31 countries in two age groups: ages 6 to 7 and ages 13 to 14. In both groups, kids who ate fast food three times a week or more had increased risks of asthma, rhinitis, and eczema—as much as a 39% increase in severe asthma risk for teens and 27% for younger kids. And wouldn’t you know—just three or more servings of good old fruit appeared to reduce the severity of symptoms for all three conditions.

Another study, published in this month’s Archives of Pediatrics and Adolescent Medicine, found that teenagers and kids consumed far more calories in fast-food and other restaurants than they did at home. The numbers were alarming: eating out was associated with taking in as many as 160 extra calories daily for younger kids and as many as 310 calories daily for teens. That information is troubling because obesity is a serious problem for children in the U.S. and around the world.

Potential weight gain is just one consequence of eating out often. Fast and restaurant foods are often heavy on fat and sugar, both of which can lead to the development of chronic disease when consumed in large quantities.

Fighting back

So what’s a parent or grandparent to do? I turned for advice to Stacey Nelson, a registered dietitian who is a clinical nutrition manager at Harvard-affiliated Massachusetts General Hospital. She says it’s not realistic to ban children from eating out, but to be careful when you choose to do so. “Fast food is not health food and never will be, so the idea is never to make it a habit. But when it seems like that’s all that is available, there are always ways to make the best of a less than ideal situation,” she told me.

Here are some of Nelson’s top tips:

• Don’t let kids drink their calories. Order water or fat-free milk instead of a soda, juice, milkshake, frappe, or smoothie.
• Watch the side dishes. Get a side salad or baked potato if possible instead of French fries and onion rings, which can be laden with saturated fat.
• Don’t super-size. Instead, order smaller portions, such as items on the snack menu.
• Choose grilled foods instead of fried foods.
• Hold the cheese. This eliminates extra calories and fat.
• Use mustard and ketchup instead of the “special sauce.”
• Model good eating behaviors. That means following all of the rules yourself.

Good choices

Most fast-food and other restaurants offer many dining options, some of which are better than others. For example:

• A Burger King Double Whopper has 830 calories and 50 grams of fat (17 grams of saturated fat, nearly the daily limit) while a hamburger has only 240 calories and 9g of fat (3.5 grams saturated).
• An Angus Bacon and Cheeseburger at McDonalds has 790 calories and 39 grams of fat (18 grams saturated) while the Chipotle BBQ Snack Wrap has 250 calories and 8 grams of fat (3.5 grams saturated).
• A Wendy’s medium fries delivers 420 calories with 21 grams of fat (14 grams saturated), while a garden salad is 210 calories and 13 grams of fat (only 2 grams saturated).

In other words, look at the nutrition information that many restaurants make available these days and make choices with fewer calories and less saturated fat and sugar.

Kids won’t necessarily cotton to these rules. Choosing—or avoiding—fast food will be a matter of negotiation. But what part of parenting and grandparenting isn’t? We negotiate bedtimes and homework and playtime. Food choices shouldn’t be any different.

I employed this tactic myself when I spoke with my son about eating fast food daily. I told him about the risks of these foods, then laid down the law: Stick to the college meal plan and indulge in fast food only once in a while, using his own allowance. I was happy to hear him agree enthusiastically. It was a little surprising, actually—until I heard his next economic discovery. He said that if he didn’t spend his allowance eating out, he’d be able to save up for a fabulous spring-break trip to Mexico. I’ll let you know when I’ve figured out how to negotiate that deal!

Avoiding the flu

Flu is short for influenza, a highly contagious and potentially deadly respiratory disease. Some years the outbreak is relatively mild, other years it is severe. Deaths range from 3,000 a year to nearly 50,000, and about 200,000 people end up in the hospital each year. Symptoms include fever, cough, sore throat, runny or stuffy nose, muscle aches, fatigue, and sometimes vomiting and diarrhea.

The viruses that cause the flu are spread when an infected person coughs or sneezes tiny droplets into the air, and you come into contact with those droplets. You may also become infected if you touch a surface with a flu virus on it and then you touch your mouth or eyes.

It’s easy to bump into an invisible, floating flu virus, or to get some on your hands. So getting vaccinated—and washing your hands often—are your best bets against getting flu. The vaccine isn’t an anti-flu guarantee, but it can reduce your risk by up to 80%.

Most of the flu cases so far this season are the three types included in this year’s flu vaccine: two influenza A viruses (H3N2 and H1NI) and the influenza B virus.

Many avoid the vaccine

So far this year, barely one-third of Americans have been vaccinated against the flu. Why aren’t more people getting a flu shot? Some people worry about the safety of the vaccine. Others say the flu shot makes them sick.

Part of the worry comes from the 1976-77 flu season, when that year’s vaccination was linked to several cases of Guillain-Barre syndrome. This painful nerve disease can cause paralysis, breathing difficulties, and death. A study from Canada published earlier this year in the Journal of the American Medical Association demonstrated a small risk of Guillain-Barre syndrome—about two cases per million doses of vaccine—with vaccination against H1N1 in the 2009 season. The researchers concluded that the benefits of the flu vaccine outweighed the risks.

Does the flu vaccine give you the flu? “Placebo studies show the vaccine doesn’t really cause the flu,” explains Dr. Paul Sax, clinical director of the division of infectious diseases at Brigham and Women’s Hospital and a professor of medicine at Harvard Medical School. “And while all vaccines may rarely cause side effects, the fact that essentially all infectious disease specialists get the vaccine shows that the benefits outweigh the risks.”

In fact, health care workers at a number of Harvard-affiliated hospitals are not only strongly encouraged to get flu shots, but are required to wear masks on the job if they don’t. It’s to protect patients from becoming infected with flu.

Understanding flu vaccines

The flu vaccine can be given by injection (shot) or as a nasal spray.

Nearly everyone can receive the shot, except those who are allergic to eggs or to the vaccine itself. The shot contains inactivated (killed) viruses. If side effects occur, they include fever and aches as well as soreness, redness, or swelling where the shot was given.

The nasal spray contains live, weakened viruses. It is appropriate for anyone between the age of 2 years and 49 years who is healthy and isn’t pregnant. If side effects occur, they include runny nose, nasal congestion or cough, chills, tiredness, weakness, sore throat and headache.

After getting vaccinated, your body develops antibodies that protect you against the viruses included in the vaccine. It takes a few weeks for full protection to develop, and lasts about a year.

What you can do

Flu season typically peaks in January, February or later, so you still have time to get vaccinated.

Everyone aged 6 months and older is urged to get a flu shot, especially pregnant women, young children, people age 65 and older, and those with chronic medical conditions such as heart, lung, or kidney disease or weakened immune systems. The more people who get the vaccine, the better it is for everyone—even those who haven’t been vaccinated. This is called herd immunity. A Harvard Health video shows how herd immunity works.

The Hopkins researchers recruited 77 overweight volunteers with either prediabetes or type 2 diabetes. Many reported sleep problems such as sleep apnea, daytime fatigue, insomnia, and restless or interrupted sleep. Half of the volunteers went on a weight-loss diet with supervised exercise training. The other half did just the diet. After six months, participants in both groups had lost an average of 15 pounds and reduced their belly fat by 15%. Sleep quality improved in both groups. A reduction in belly fat was the best predictor of improved sleep.

The results of this trial are in line with other studies exploring how weight affects sleep and sleep affects weight.

Linking weight loss, belly fat, and sleep

Excess weight and body fat increase the likelihood of developing obstructive sleep apnea. This condition occurs when the airway becomes blocked, either completely or partially, during sleep. These temporary blockages causes frequent awakenings which, in turn, increase the risk for conditions such as high blood pressure, stroke, and heart disease.

“So one possibility with the results of this study is that weight loss reduced sleep apnea and improved sleep quality,” says sleep expert Dr. Lawrence Epstein, an instructor in medicine at Harvard Medical School. Weight loss also improves blood sugar control which, in people with diabetes or prediabetes, could reduce restless legs syndrome and periodic limb movement disorders, two sleep disorders that people with diabetes are prone to having.

Exercise has also been shown to improve sleep quality. For example, Oregon State University researchers found that people who exercised at least 150 minutes a week slept better and felt more alert during the day than those who didn’t exercise much. (Don’t exercise right before bedtime, however. That can make it difficult to fall asleep.)

Why reducing belly fat might be a key to improved sleep remains a mystery. We do know that fat deposited around the abdomen, called visceral fat, is associated with heart disease, diabetes, dementia, breast and colon cancers, and other chronic health conditions. Losing belly fat, then, seems like a logical way to improve not only sleep but also overall health. Unfortunately, it isn’t that simple.

“Where you lose weight is partly determined by genetics,” says Dr. I-Min Lee, professor of medicine at Harvard Medical School and an expert on physical activity’s role in promoting health and preventing chronic disease. “Generally, if you lose weight, some of this will occur in belly fat. You just can’t predict how much.”

Improving sleep

Despite what thousands of websites want you to believe, there are no exercises or potions that “melt away” belly fat. Instead, the solution is old-fashioned exercise and a healthy diet.

If you are serious about losing weight and sleeping better, aim for 150 minutes of moderate-intensity physical activity (like swimming or brisk walking) each week. You don’t have to do five 30-minute workouts. More but shorter exercise sessions, such as three 10-minute brisk walks instead of one 30-minute walk, will have the same impact, says Dr. Lee.

Exercise alone generally doesn’t lead to substantial weight loss. That requires cutting back on daily calories.

The lasting effects of combining exercise and weight loss will go far beyond improving your long winter’s nap and well into a healthy future.

You may have used trial-and-error to find tablet positions that work for you. Dr. Jack Dennerlein and his colleagues at the Harvard School of Public Health have brought technology to bear on the problem. Using a sophisticated infrared 3-D motion analysis system, they tracked how different tablet positions affect the body.

They asked 15 experienced tablet users to perform various tasks on an iPad or a Xoom. The tablets had special cases that could be adjusted to prop them up at specific angles. Each volunteer browsed the Internet, responded to email, played games, and watched a movie with the tablet on his or her lap and on a table at different angles. (You can see the positions here.)

The researchers found that working with a tablet held on the lap or placed flat on a table makes the neck bend much more than does working with a desktop or notebook computer. Neck-wise, the best tablet orientation was having it propped up on a table. (Whether this will be good for the hands and wrists is grist for future work.)

Dr. Dennerlein offers several tips for easing neck strain while working with a tablet computer.

• Place the tablet on a table.
• Use a case that holds it at a comfortable viewing angle.
• Shift your hands, your weight, or even stand up when you can.
• Take a break every 15 minutes.

As I write in the October issue of the Harvard Health Letter, good posture is equally important when using a notebook or desktop computer. You can read the full story on the Harvard Health Letter website, www.health.harvard.edu/health.

Lycopene is a carotenoid—a family of pigments that give fruits and vegetables their brilliant red, orange, and yellow coloring. Lycopene is also a powerful antioxidant that eliminates dangerous free radicals that can damage DNA and other fragile cell structures.

“The shape of the lycopene molecule makes it very effective in being able to quench free radicals,” says Dr. Edward Giovannucci, a professor of nutrition and epidemiology at the Harvard School of Public Health. “We don’t really understand it entirely yet, but lycopene may have specific properties that protect the cell in a way other antioxidants may not.”

Past research, some of it done by Dr. Giovannucci, has shown that a diet rich in lycopene-containing foods may help lower the risk of prostate and other cancers. Now, in a report just published in the journal Neurology, a team of Finnish researchers has linked lycopene levels in the blood to stroke protection. They made this connection after following more than a thousand middle-aged men for 12 years. Men with the greatest amounts of lycopene in their blood had a 55% lower chance of having any kind of stroke. The lycopene connection was even stronger (59%) when it came to protecting against strokes due to blood clots (the most common kind).

The finding came as a surprise—the researchers initially wanted to know if other antioxidants affected strokes, such as alpha carotene, beta carotene, vitamin A, and vitamin E. But they didn’t.

Lycopene-stroke connection

The researchers suggested that lycopene, in addition to its ability to attack free radicals, may also reduce inflammation and cholesterol, improve immune function, and prevent blood from clotting. All of these may help reduce ischemic strokes, which are caused by clot-caused blockages in blood flow to the brain.

Most of that is plausible, says Dr. Giovannucci. But we still need larger studies to confirm the findings and to figure out if the stroke protection is due to lycopene or healthy lifestyle habits. “Remember, a high lycopene consumer is likely to eat more vegetables and not be a smoker,” says Dr. Giovannucci. Still, he says the benefits of lycopene for both cancer and stroke protection are very promising.

Personally, this makes me want to increase my tomato intake. Slice of tomato on my turkey sandwich? So yesterday. Hello, glass of tomato juice at every meal.

But hold that order. Overdoing it on lycopene isn’t necessary, says Dr. Giovannucci.

He recommends at least 10,000 micrograms of lycopene per day—from food. That sounds staggering, but it’s actually easier to get than you might think, especially since lycopene is found in other foods than tomatoes. Tomato-based products do, of course, give you the most bang for your buck.

Keep in mind that lycopene is better absorbed in the body when it’s combined with some fat, points out Dr. Giovannucci. “That’s because lycopene is fat soluble,” he explains, “and oil in tomato sauce, for example, makes it ideal for absorbing lycopene.”

But don’t go eating fatty foods with tomatoes because you want the lycopene absorption. Dr. Giovannucci says it’s better to eat a variety of healthy foods and shoot for the daily intake recommendation.

He also cautions that you don’t try to beat the system by popping a lycopene supplement. “Supplements may give you a purified form of lycopene, but you’re not sure you’re getting what you get from food. You may be getting the wrong form of lycopene in a supplement. There are also a lot of compounds in food that aren’t lycopene but that are similar, and some of those molecules may be part of what makes lycopene so beneficial,” says Dr. Giovannucci.

So stick to a diet that includes some lycopene-rich foods. It’s cost effective, it’s easy, and it’s not dangerous if you overdo it. There’s no evidence of lycopene toxicity from diet. Best of all, lycopene is likely in many of your favorite foods. And that makes the succulent tomato far more than a food; that makes it almost a nutraceutical.

Top lycopene-containing foods

 Source: USDA National Nutrient Database

“It is a very interesting study with provocative findings,” says Dr. Deepak Bhatt, a cardiologist and professor of medicine at Harvard Medical School. I would like to believe the results. Of course, it is a small study with a limited duration of follow-up, so the findings do need to be confirmed in other, larger studies that follow patients for a longer period of time.”

In vino veritas

In wine there is truth, said Pliny the Elder in the first century AD. One truth about red wine is that too much can raise blood pressure and increase the risks of cancer, liver disease, and car accidents if you get behind the wheel after drinking.

In moderation, however, drinking red wine increases HDL (“good” cholesterol). It also protects against artery damage, which may lower blood pressure and help prevent heart disease. Polyphenols, in particular, may protect the lining of blood vessels in the heart. But most studies about red wine’s antioxidants have been conducted on animals, and were not able to sort out the contribution from alcohol.

The study

A team of Spanish researchers recruited 67 men between ages 55 and 75, all with diabetes or cardiovascular risk factors. Each man drank red wine daily for four weeks, then drank non-alcoholic red wine daily for four weeks, then drank gin daily for four weeks. The daily amounts were moderate: 10 ounces of wine or three ounces of gin. That’s about two drinks a day.

When the men drank non-alcoholic red wine, their systolic blood pressure (the top number of a blood pressure reading) decreased on average by 6 points. That’s enough to reduce heart disease risk by 14% and stroke risk by as much as 20%, according to the researchers. There was no change in blood pressure when the men drank gin, and only a small reduction in blood pressure when they drank regular red wine.

Researchers also found that the men’s plasma nitric oxide levels went up when they drank non-alcoholic red wine. That’s a good thing, because nitric oxide relaxes blood vessel walls, allowing better blood flow. The NO levels went up only slightly when the men drank regular red wine, and not at all when they drank gin.

The results of the study look like something to toast: you can get polyphenol and nitric oxide benefits without having to drink alcohol and risk the dangers that come with it. Not so fast, says Dr. Bhatt. “It makes scientific sense, but these findings really need to be confirmed in other studies,” he reminds us.

What the study doesn’t tell us is how non-alcoholic red wine stacks up against regular red wine for preventing heart attacks or other cardiovascular problems. An excellent discussion of the benefits and risks of drinking red wine and other alcoholic beverages is available on The Nutrition Source, a website published by the Harvard School of Public Health’s Department of Nutrition.

What you should do

If you’re interested in lowering your blood pressure, Dr. Bhatt says drinking non-alcoholic red wine won’t hurt. “I wouldn’t ever make a clinical recommendation based on just one small study. However, if you happen to like non-alcoholic red wine and drink it anyway, it might be worthwhile to see if it helps your high blood pressure,” he says.

But don’t count on non-alcoholic red wine to lower high blood pressure, also known as hypertension, cautions Dr. Bhatt. Most people need a combination of exercise, a healthy diet, and medications to control high blood pressure.

Moderate exercise for 150 minutes per week and following the Dietary Approaches to Stop Hypertension (DASH) diet can powerfully lower blood pressure, sometimes making medicines unnecessary. DASH is an eating plan featuring more fruits, vegetables and whole grains; foods with nutrients known to help reduce blood pressure, like calcium, potassium and magnesium; and reduced sodium and saturated fat intake.

High blood pressure is a big problem. The Centers for Disease Control and Prevention reported last week that a third of all Americans have high blood pressure, and the majority of them don’t have it under control.

Those are sobering facts. If the Spanish study pans out, one possible solution won’t be too hard to swallow.

For many people, migraines are debilitating events. As Harvard Health editor Christine Junge wrote in this space last year about her battle with migraine:

“On the good days, the pain was just a mild throbbing sensation. Other times, there was a general sense of an ever-tightening pressure. On the days when I couldn’t get out of bed, it felt like someone was tightening screws into the sides of my head and pounding a hammer above my left eye. The pain never went away, unless I was asleep.”

Most migraine sufferers long to prevent these painful episodes. As I write in this month’s Harvard Health Letter, about one-third of migraineurs could benefit from taking a preventive pill. But only a minority of them actually take advantage of this option. New treatment guidelines from the American Academy of Neurology and the American Headache Society profile the best preventive medications, and an herbal preparation, for migraine.

“These drugs can reduce the frequency and severity of migraine attacks, and may require different doses over time to achieve these benefits,” says Dr. Lee H. Schwamm, vice chairman of the neurology department at Massachusetts General Hospital and professor of neurology at Harvard Medical School. “They must be taken daily. They are different from pain-relieving medicines—drugs that halt a migraine once it has started.”

Pills for prevention

The guidelines include two categories of preventive medications. Those with proven effectiveness for preventing migraine include

• the antiseizure drugs divalproex (Depakote), valproate (Depacon), and topiramate (Topamax)
• the beta blockers metoprolol, propranolol, and timolol
• the triptan drug, frovatriptan (Frova), for short-term menstruation-associated migraine

Drugs that are probably effective include

• two antidepressants, amitriptyline (Elavil and others) and venlafaxine (Effexor)
• two other beta blockers, atenolol and nadolol
• two other triptans, naratriptan (Amerge) and zolmitriptan (Zomig)

The guidelines also include an herbal remedy made from butterbur, a plant in the daisy family. Butterbur contains chemicals called pyrrolizidine alkaloids (PA) that can damage the liver and cause other problems. If you want to use a butterbur-based treatment, choose a product that is certified as PA free.

Daily use, side effects may limit use

Since it’s impossible to predict when a migraine will happen, these medications must be taken daily. But the more often you have to take a medicine, the less likely you are to take it faithfully. “If you don’t have the symptom right away when you skip a dose, then you are even more likely to skip doses,” says Dr. Schramm.

All medications, and herbal remedies, have the potential to cause side effects, cautions Dr. Schwamm. Antiseizure medicines can reduce concentration and may cause drowsiness. Beta blockers can slow the heart rate and sometime cause depression or sexual dysfunction. “Topiramate can cause weight loss, so some patients are more compliant with this drug,” says Dr. Schramm.

Personalizing prevention

Migraine prevention doesn’t necessarily require medication. Getting enough sleep, reducing stress, and paying attention to diet and exercise can help. So can identifying whether you have any migraine triggers, like chocolate, caffeine, or alcohol. Keeping a migraine diary that includes your stress level, what you’ve eaten and drunk, and the like can help identify triggers.

Tell us your story

Do you live with migraines? If so, let us know what your migraine triggers are. If you’ve tried medications, herbal remedies, or other preventive efforts, please tell us if they worked for you.