Cigarettes, cigars, and the like are the most deadly product that consumers can legally buy. It’s sadly ironic that they are sold in pharmacies, which are meant to dispense medications and other things designed to heal or promote health. The American Pharmacists Association, the American Medical Association, and other groups have urged pharmacies to stop selling cigarettes. Several major pharmacy chains have been mulling whether or not to take this advice. Today, one of them has acted. The CVS chain has decided to stop selling tobacco products, and will phase out their sales over the next year. The news came in a press release from CVS and an opinion piece published today in JAMA, the journal of the American Medical Association. Pharmacists will likely cheer the decision—one survey of pharmacists showed that only 2% of them favor the sale of tobacco products in their stores.
Anthony Komaroff, M.D.
Posts by Anthony Komaroff, M.D.
On a Saturday morning 50 years ago tomorrow, then Surgeon General Luther Terry made a bold announcement to a roomful of reporters: cigarette smoking causes lung cancer and probably heart disease, and the government should do something about it. Terry, himself a longtime smoker, spoke at a press conference unveiling Smoking and Health: Report of the Advisory Committee of the Surgeon General of the Public Health Service. That press conference was held on a Saturday in part to minimize the report’s effect on the stock market. The 1964 Surgeon General’s report, and others that followed, have had a profoundly positive effect on the health of Americans, despite the tobacco industry’s concerted and continuing efforts to promote smoking. By one new estimate, the decline in smoking triggered by the 1964 report and others that followed prevented more than 8 million premature deaths, half of them among people under age 65. But we still have a long way to go. Some 42 million Americans still smoke, and tobacco use accounts for millions of deaths each year around the world.
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.
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.
The ability of today’s electronic books to display videos, images explained by a spoken voice, animations, interactive tools, and quizzes gives doctors new ways of explaining things. Harvard Health Publications and Orca Health have created a series of ten interactive iBooks focused on heart disease. Currently, these are available only as iBooks. Need to know what happens in the heart when a heart attack is underway, how doctors open up cholesterol-clogged arteries, or how to cope with the irregular heart rhythm known as atrial fibrillation? The answers are in these iBooks. They let users view the heart in ways and detail they’ve never seen before to learn about common heart conditions and procedures.
A lot is known about diabetes. But a discovery that could change how this disease is treated shows just how much more there is to learn. A team of Harvard Medical School researchers has discovered a hormone called betatrophin made by liver and fat cells that signals the body to make more insulin-producing beta cells. A report of their work appears in this month’s issue of the prestigious scientific journal Cell. In mice with diabetes, experimentally turning on the production of betatrophin inside liver and fat cells caused an increase in beta cells and a dramatic improvement in blood sugar. It will, of course, take much more research in mice—and then in humans—to determine if this newly discovered hormone can serve as a treatment for diabetes. So it’s too soon to get excited that the discovery of betatrophin will translate directly into a new treatment for diabetes. But it is another example of the human body’s power to naturally repair itself.
Beginning in March, 2013, reports started to come out of Eastern China that a new “bird flu” virus was loose and causing infections in humans. The new virus is called H7N9. Should we in the U.S. be worried? Neither I nor anyone I know can give a confident answer to that question. So far the news is reassuring. A report from the U.S. Centers for Disease Control and Prevention (CDC), and another from a team from China in this week’s New England Journal of Medicine, indicate that so far the new H7N9 virus has not clearly spread from one person to another, and has not spread outside of Eastern China. Even so, every public health agency around the world is keeping a close eye on China. That’s because a virus that cannot spread easily from one person to another can change or swap genes—and suddenly be capable of spreading easily.
In the past decade, a remarkable series of experiments from laboratories all over the world has begun to show what causes aging—and how to slow it. In the latest example of such aging research, two of my Harvard Medical School colleagues, cardiologist Richard T. Lee (co-editor in chief of the Harvard Heart Letter) and stem cell biologist Amy Wagers and their teams have found a substance that rejuvenates aging hearts in mice. The researchers joined the circulation of an old mouse with a thick, stiffened heart to that of a young mouse. After four weeks, the heart muscle of the old mouse became dramatically thinner and more flexible. The team then identified a substance called growth differentiation factor 11 (GDF11) as the probable “anti-aging” substance. It’s too soon to tell if this discovery will ever help humans with heart failure. But it reveals that there are substances naturally present in all living things that cause aging and that retard it. By understanding them, we may someday be able to slow aging.
Type 2 diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call. Unfortunately, few people ever hear the alarm. A new report from the Centers for Disease Control and Prevention shows that among Americans age 20 and older, only 10% of those with prediabetes know they have it. Given that as many as 73 million Americans have prediabetes, that’s a lot of missed opportunities to prevent the ravages of diabetes. One reason many people don’t know that they may be headed toward diabetes is they’ve never had their blood sugar tested. This simple test isn’t part of routine preventive care, but perhaps it should be.
The results of a new trial being made public today should get everyone interested in following a Mediterranean-style diet. What makes these new results so important is that they come from a randomized controlled trial, what many consider to be the gold standard of medical research. In the five-year trial, there were fewer heart attacks, strokes, and deaths from cardiovascular disease among participants who followed a Mediterranean-type diet than among those following a low-fat diet. A Mediterranean-style approach to food represents a diet of abundance, not restriction. Add not smoking and daily physical activity to this flexible eating strategy and you have a blueprint for protecting, and perhaps even improving, health.