Carrying too many pounds is a solid signal of current or future health problems. But not for everyone. Some people who are overweight or obese mange to escape the usual hazards, at least temporarily. This weight subgroup has even earned its own moniker—metabolically healthy obesity. Most people who are overweight or obese show potentially unhealthy changes in metabolism, like high blood pressure, high cholesterol, and insulin resistance. But some people who are overweight or obese manage to avoid these changes and, at least metabolically, look like individuals with healthy weights. Such individuals have near-normal waist sizes, blood pressure, cholesterol, and blood sugar, as well as good physical fitness. Metabolically healthy obesity isn’t common. And it may not be permanent.
Patrick J. Skerrett
Posts by Patrick J. Skerrett
The Harvard Health blog is taking an end-of-summer break. It will begin publishing again after Labor Day. Thanks to everyone who makes the blog possible, from our loyal readers and visitors from around the world to our contributors. See you in September!
The 30,000 cases of Lyme disease reported to the Centers for Disease Control and Prevention (CDC) each year are just the tip of the iceberg. According to a new CDC estimate, more than 300,000 Americans are diagnosed with the tick-borne disease each year. The new number was presented at the 2013 International Conference on Lyme Borreliosis and Other Tick-Borne Diseases, being held in Boston. Although the disease has been diagnosed in almost every state, most cases reported to the CDC are in the Northeast and upper Midwest—96% of cases come from 13 states. The new estimate comes from a multi-pronged approach: gathering case reports from doctors, sifting through health insurance claims, analyzing data from clinical laboratories (which do the tests necessary to diagnose Lyme disease), and surveying the public for self-reported Lyme disease.
More than 17,000 American youths end up in emergency departments each year with injuries from a falling television set. Two-thirds of them are under age 5, according to a report published online today in the journal Pediatrics. From 1996 to 2011, nearly 400,000 children under 18 years old were treated in emergency departments for TV-related injuries. In 1996, most of the injuries occurred when kids ran into television sets. By 2011, injuries from falling TVs dominated. The rate of TVs falling from dressers, bureaus, chests of drawers, and armoires nearly quadrupled. The authors of the study suggest that adding TVs to the list of furniture types that come with anti-tip devices “would be an important step in decreasing the number of injuries resulting from falling TVs.”
An old, aspirin-like drug called salsalate could help control blood sugar in people with type 2 diabetes. In the TINSAL-T2D trial, 286 volunteers took pills containing either salsalate or a placebo for nearly a year. Over the course of the trial, those in the salsalate group had lower blood sugar levels, and some were even able to reduce dosages of other diabetes medications they were taking. Experts aren’t exactly sure how salsalate helps control blood sugar, but its effectiveness supports the idea that inflammation plays a role in type 2 diabetes. Although the results are promising, what we really need to know about salsalate (or any new or repurposed drug) is how its long-term benefits and risks stack up against each other. The trial was too small and too short to determine those risks. According to the researchers, such “outcomes require continued evaluation before salsalate can be recommended for widespread use” by people with type 2 diabetes.
Summer’s heat is as predictable as winter’s chill. Heat-related illnesses—and even deaths—are also predictable. But they aren’t inevitable. In fact, most are preventable. Most healthy people tolerate the heat without missing a beat. It’s not so easy for people with damaged or weakened hearts, or for older people whose bodies don’t respond as readily to stress as they once did. There are three different levels of heart-related illness: heat cramps, heat exhaustion, and heat stroke. Some simple choices can help you weather the weather. Drinking water and other hydrating fluids is essential. Putting off exercise or other physical activity until things cool down also helps. Chilled air is the best way to beat the heat. Sticking with smaller meals that don’t overload the stomach can also help.
Depression, bipolar disorder, and other mental health problems arise when something goes wrong with brain function. What causes that malfunction is an open question. A new study from Denmark suggests that a serious infection or autoimmune disease could trigger a mood disorder. How might an infection or autoimmune disorder lead to a mood or other mental health disorder? Infection causes localized and body-wide inflammation. Inflammation generates substances called cytokines that have been shown to change how brain cells communicate. In autoimmune diseases, the body’s defense system attacks healthy tissues rather than threatening invaders. It’s possible that in some cases the wayward immune reaction could target brain cells and other nerve cells throughout the body.
During visits with your doctors or other health care providers, do you speak up and ask questions? If the answer is “yes,” congratulations. You’ve taken an important step to getting the most out of your health care visits. You’re also in the minority. Most people have trouble asking their doctors questions. It can be even harder to disagree with your doctor, or make known your preferences for care and even your worries. There are many reasons for poor patient-doctor communication. One is what Timothy J. Judson and colleagues call the asymmetry of power. Medical lingo is another key barrier. The federal Agency for Healthcare Research and Quality’s “Questions to Ask Your Doctor” campaign and the Joint Commission’s “Speak Up Initiatives” offer free information to help people ask the sometimes difficult questions needed for good health care.
“Floaters” and flashes are a common sight for many people. Floater is a catchall term for the specks, threads, or cobweb-like images that occasionally drift across the line of vision. Flashes are sparks or strands of light that flicker across the visual field. Both are usually harmless. But they can be a warning sign of trouble in the eye, especially when they suddenly appear or become more plentiful. That can be the sign of a tear in the retina, the patch of light-sensitive cells along the back of the eye that captures images and sends them to the brain. A retinal tear can lead to a retinal detachment, which can lead to permanent vision loss.
What’s the best way to remove a tick burrowed into your skin? Don’t use one of the folk remedies, like touching it with a hot match, covering it with petroleum jelly or nail polish, or freezing it. These are all supposed to make the tick “back out” of the skin on its own. But they often have the opposite effect, forcing the tick to hold tight, burrow deeper, and possibly deposit more of its disease-carrying secretions into the wound, which increases the risk of infection. Instead, do what the Centers for Disease Control and Prevention recommend: Use a pair of fine-tipped tweezers to grasp the tick as close to the skin as possible. Then pull it out with a steady motion. Once the tick has been removed, clean the skin with soap and water. Dispose of the tick, which is probably still alive, by placing it in alcohol or flushing it down the toilet. For most people who are bitten by a tick, removal ends the saga. For others, though, it is just beginning, since the bite of a tick can transmit Lyme or other tick-borne disease