Harvard Health Blog

Done just right, Thanksgiving dinner can be good for the heart. The bird at the center of the feast was once in line to be our country’s mascot. Benjamin Franklin and other turkey aficionados thought of this fowl as wild, wary to the point of genius, and courageous. When cooked, it has another excellent quality—turkey meat is much easier on the heart than many other holiday main courses. Other mainstays of traditional Thanksgiving feasts, like cranberries, sweet potatoes, pumpkin, and pecans, are healthy on their own, but tend to lose their virtue by the company they keep (butter, brown sugar, whipped cream, marshmallows, and more). If you’re set on a traditional dinner, alternative recipes abound for healthier stuffing, vegetables, and desserts. You can also start your own traditions. After all, today’s Thanksgiving dinner bears little resemblance to the original feast.

It’s easy to think of doctors as paragons of the health and wellness they try to restore in their patients or help them maintain. Some are, and some definitely aren’t. One in 10 physicians develop problems with alcohol or drugs at some point during their careers. Those who admit they have an addiction to alcohol or drugs, as well as those who slip up and get reported, usually have to go through an intense substance abuse program before they can practice medicine again. Such physician health programs are pretty effective, helping around 80% of doctors recover from their problems. But these programs raise some ethical questions, according to Harvard Medical School’s J. Wesley Boyd and John R. Knight, who wrote a review of physician health programs in the Journal of Addiction Medicine. They should know, having spent a total of 20-plus years as associate directors physician health programs.

Do you have trouble sleeping? If you’re carrying extra pounds, especially around your belly, losing weight and some of that muffin top may help you get better ZZZs. So say researchers from Johns Hopkins University School of Medicine, who presented their findings at this year’s annual meeting of the American Heart Association. In a six-month trial that included 77 overweight volunteers, weight loss through diet plus exercise or diet alone improved sleep. A reduction in belly fat was the best predictor of improved sleep. Among people who are overweight, weight loss can reduce sleep apnea, a nighttime breathing problem that leads to frequent awakenings. Exercise has also been shown to improve sleep quality. 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.

Last week, Americans reelected President Obama and returned a Democratic majority to the Senate. How that will affect the economy, foreign policy, and other aspects of government remain to be seen. One thing we can say for certain—it pulls the Affordable Care Act (ACA) out of limbo. The President’s re-election means we can expect to see the ACA implemented. Some popular elements of the law are already in place: allowing children to stay on their parent’s health coverage until age 26, and allowing for cost-free preventive services. Other more complicated aspects of the ACA remain to be realized. These include the establishment of state-run exchanges through which the millions of uninsured Americans covered by the ACE can buy health insurance; extension of eligibility for Medicaid to Americans who earn less than 133% of the poverty level; and innovations to improve the how health care is paid for and delivered while improving care and lowering costs.

Therapy dogs provide comfort and support. They must be social, gentle, and enjoy getting and giving physical affection. My therapy dog, Maps, has those qualities in spades. They also must be well behaved and respond to their handlers, neither of which applied to Map when I got him as a puppy. After many therapy dog classes and a lot of practice, we learned. After two years of training, Map became a certified therapy dog. He shines when he is in his blue training coat visiting a preschool. He loves to see the kids and to work with me. How does Map help kids? His presence somehow lets children open up to learning. He offers kids a way to feel more whole in the face of physical illness or disability. He can also help children heal from emotional pain. Like any great therapist, Map knows how to listen and how to help children help themselves.

If you take good care of yourself, you just might end up avoiding cardiovascular disease (CVD), the most common killer in this country. That’s the bottom line from a study published this week in JAMA. Researchers from Northwestern University’s Feinberg School of Medicine analyzed five long-term studies which documented cardiovascular risk factors for 120,000 individuals at ages 45, 55, 65, and 75. This time they cast a broader net and tallied up all cardiovascular events—nonfatal and fatal heart attack and stroke, angina, the need for angioplasty or bypass surgery, heart failure, and death due to cardiovascular disease. The percentages of people who experienced one of these “events” was huge, above 50% at all four ages. However, those with an optimal risk factor profile—non-smoker, no diabetes, blood pressure less than 120/80 mm Hg, and total cholesterol less than 180 mg/dL—had a much lower lifetime risk of cardiovascular disease. For example, men and women with optimal profiles at age 55 were 30% to almost 50% less likely to develop cardiovascular disease than those with two or more major risk factors. They also lived an average of 14 years longer free of cardiovascular disease.

When it comes to keeping healthy and fit, living a mentally active life is as important as regular physical exercise. Just as your muscles grow stronger with use, mental exercise keeps your mental skills and memory in tone. Although any brain exercise is better than being a total mental couch potato, some kinds of “brain work” are more effective than others. The activities with the most impact are those that require you to work beyond what is easy and comfortable. Try these four basic brain-health strategies: Be a lifelong learner. Strain your brain with mentally challenging tasks. Get out of your comfort zone from time to time to challenge your mental skills. Be social. And don’t forget your body—physical activity that gets your pulse thumping helps the mind as well as the heart.

It’s Halloween—a time when we’re preoccupied with witches, ghouls, and other frightful creatures. But this year, no creature is generating as much buzz as the zombie. Zombies have inspired movies and TV shows, video games—even a bloody Pride and Prejudice takeoff. Could all this talk of the undead be foreshadowing a real-life zombie apocalypse? In fiction, yes. But not in real life. A Harvard ethnobotanist once found that a neurotoxin was the cause of several cases of zombie-like living deaths in Haiti. Oddly shaped proteins called prions have also been linked to brain diseases that vaguely resemble zombieism. In his novel The Zombie Autopsies, Dr. Steven Schlozman, a zombie enthusiast and professor of psychiatry at Harvard Medical School, imagined an infection scenario that turns normal human beings into flesh-craving monsters. Although a pandemic that creates zombie-like symptoms is theoretically possible, a real-life zombie apocalypse shouldn’t be high up on our list of worries.

Back in 2009, Dr. Andrew T. Chan and his colleagues at Harvard-affiliated Massachusetts General Hospital found that people diagnosed with colorectal cancer who took aspirin on a regular basis tended to live longer than those who didn’t take aspirin. Aspirin worked only for some people, though, so Chan and a larger team of researchers set out to learn why. Their latest work, published in the New England Journal of Medicine, indicates that people with colorectal cancer who have a mutation in a gene called PIK3CA are most likely to benefit from aspirin. (About 15% to 20% of people with colorectal cancer have this gene mutation.) The mutation permits colon cancer cells to thrive. Aspirin blocks this action. If confirmed, this work could lead to routine genetic testing for people with this common cancer, and aspirin therapy for those with the PIK3CA mutation.

The term “stroke” conjures up a frightening bolt out of the blue. It certainly feels that way when it happens. But the sudden onset hides most strokes’ decades-long development stemming from slow but steady damage to blood vessels, the growth of artery-clogging plaque, or the erratic heart rhythm known as atrial fibrillation. This long gestation means it is often possible to avoid a stroke by fighting arterial corrosion. Today is World Stroke Day—a moment to pay close attention to stroke. Worldwide, this brain-damaging condition afflicts millions of people each year, and kills more than 6 million. In the United States, about 800,000 people have strokes each year, and about 140,000 die from them. There are two main messages of World Stroke Day: Stroke can be prevented. Stroke can be treated if detection and treatment happen quickly.

One treatment that can help relieve depression and other mental or emotional problems is cognitive behavioral therapy. It guides individuals to change what they think. A related approach, called metacognitive therapy, helps individuals change how they think. Some preliminary but promising research suggests that metacognitive therapy may be useful for people with attention deficit hyperactivity disorder (ADHD). One study of 88 adults with ADHD found that metacognitive therapy led to significant reduction in ADHD symptoms in 42% of participants, compared to 12% who received supportive therapy. Keep in mind that metacognitive therapy is not yet a proven therapy. More research is needed on its effectiveness in different settings. But that means it doesn’t yet stack up to its elder cousin, cognitive behavioral therapy. And metacognitive therapy can’t be considered as a first line treatment for ADHD.

Many medical studies confirm what we know or suspect. Every once in a while, though, one surprises us, turning “conventional wisdom” on its head. That just happened with the sudden shutdown of a long-running diabetes trial called Look AHEAD (Action for Health in Diabetes). Begun in 2001 and scheduled to last another two years, Look AHEAD was designed to see if an intensive diet and weight loss program could reduce the number of heart attacks, strokes, and other cardiovascular problems in people with type 2 diabetes. An early peek at the data showed that the program had little apparent effect, and the investigators concluded it would be futile to continue. This does not mean that we should ignore diet and exercise in treating of type 2 diabetes. Instead, the details of the study results, which haven’t yet been published, are likely to reveal other explanations.

Two years ago, new research showed that American girls were hitting puberty at younger ages than ever. The same thing is happening with boys: they are starting puberty almost two years earlier than they did 30 to 40 years ago. Why this is happening isn’t clear, but it could affect social and sexual behaviors. A new study shows that the average age of puberty is now 10 years for white boys (about one-and-a-half years earlier than what has long been considered “normal”), 9 years for African-American boys (about two years earlier than expected), and 10 years for Hispanic boys, which is unchanged from before. Although early puberty is increasingly common, it can be a signal of a tumor in the brain, pituitary glands, or elsewhere; an underactive thyroid gland; or other medical problems.

Depression can strike at any age. Children can develop it, as can octogenarians. No matter when it starts, depression can drain the joy and pleasure from life. The first appearance of depression later in life may also be a signal of memory loss or dementia down the road. According to a study in the Archives of General Psychiatry, dementia is more common among people who become depressed in middle age or later in life than among those who aren’t depressed. Depression is often overlooked in older adults, so it’s important to be on the lookout for warning signs, like feelings of hopelessness, loss of interest in activities, trouble sleeping, and more. It’s important to treat depression in individuals with the beginning of dementia, and older individuals who are depressed should be evaluated for dementia.

Americans’ love affair with vitamins—more than half of us take one a day—isn’t well supported by science. Trials of single vitamins, like E, C, and beta carotene, have been a bust. Whether multivitamins offer any health benefits has been something of a mystery. Now a new report indicates that taking a standard multivitamin-multimineral pill every day for more than a decade reduces the odds of developing cancer by 8%. The finding comes from the Physicians’ Health Study II, a Harvard-based trial in which nearly 15,000 male physicians took a daily pill containing 31 vitamins and minerals (Centrum Silver) or a placebo. The reduction could be due to fixing micronutrient deficiencies. It’s also possible that low doses of several vitamins and minerals might work together in other ways to prevent cancer. A daily multivitamin-multimineral supplement can provide some nutritional insurance, but it’s no replacement for vegetables, fruits, whole grains, and other healthful foods.

For all too many people, using a tablet computer is a pain in the neck, shoulders, and back. Why? Widely popular tablets like the iPad, Nook, Kindle Fire, and Xoom are so light and easy to handle that you can hold one on your lap or in your hand. That can put you in a position that’s bad for your neck, shoulders, and back. In a study of 15 experienced tablet users, Harvard School of Public Health 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. Next time you expect to be working with a tablet computer for more than a few minutes, place it on a table and use a case that holds it at a comfortable viewing angle. Shift your hands, your weight, or even stand up when you can. And take a break every 15 minutes.

Succulent tomatoes are far more than just a delicious fruit. Eating them may also help lower your risk of stroke, likely due to the lycopene they contain. Lycopene is a powerful antioxidant that eliminates dangerous free radicals that can damage DNA and other fragile cell structures. Past research 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 higher lycopene levels in the blood to protection against stroke. 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. It’s best to get lycopene from food—tomatoes and watermelon are excellent sources—not supplements.

Sometimes, the Nobel Prize in Physiology or Medicine is awarded for a discovery or invention that already is improving the practice of medicine and saving lives. Sometimes it is awarded for very basic research that might someday affect medical practice and human health. Such is the case with this year’s Nobel Prize in Physiology or Medicine, which was awarded to Sir John Gurdon of Great Britain and Dr. Shinya Yamanaka. If I had to put into one sentence the message of today’s Prize, it would be this: our cells are a lot smarter and more flexible than we once imagined, and capitalizing on that fact could greatly improve the treatment of many human diseases. The work of Gurdon and Yamanaka led the way to today’s work on stem cells, which could someday be used to treat human diseases. The 2012 Nobel Prize in Medicine, like many before it, demonstrates that people with the curiosity and courage to ask what appear to be ridiculous questions, and a society that supports their work, can change our world for the better.

October is Breast Cancer Awareness Month. Sponsored by national public service organizations, professional medical associations, and government agencies, it aims to make sure women all across America have the information they need to identify breast cancer early and take all of the steps needed to fight it. This year, Harvard Health Publishing, where I am the Chief Editor of Books, offers a unique contribution to Breast Cancer Awareness Month: our newest book, Hope and Healing for Your Breast Cancer Journey. This book, part of the Chicken Soup for the Soul Health series, weaves the stories of more than 25 women diagnosed with breast cancer and their family members with practical information about managing a support team, getting through treatment, healing body and soul, and more. In this post, I share a moving story from the book, “I Miss My Breasts,” written by Linda A. Fiorenzano, a project and risk management professional who was diagnosed with breast cancer at age 36.

As part of its 200th anniversary celebration, today’s New England Journal of Medicine carries an article called “The Past 200 Years in Diabetes.” It describes some of the advances made in understanding and treating this disease, like the discovery of insulin and the development of personal blood-sugar monitors. But it doesn’t tell much about how living with diabetes has changed. Just 50 years ago, checking blood sugar and administering insulin were big ordeals, and people with diabetes weren’t expected to live more than a few years after their diagnoses. today, it’s a cinch to check blood sugar with a quick finger prick, and pen-like devices almost painlessly deliver insulin, and people with diabetes who take care of themselves have almost normal life expectancies. Advances in protecting and treating the heart, eyes, kidneys, and limbs have helped reduce complications from diabetes.