Harvard Health Blog

Read posts from experts at Harvard Health Publishing covering a variety of health topics and perspectives on medical news.

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Don’t gauge exercise benefits on weight loss alone

If you start an exercise program, it only seems fair that you should see your hard work reflected in lower numbers on the scale. If it isn’t, don’t despair—or quit exercising. You are still helping your heart, lungs, and every other part of your body. A study in the Journal of the American College of Cardiology looked at the effects of exercise and/or weight loss on cardiovascular health among more than 3,000 men and women who were initially overweight. As I write in the July issue of the Harvard Health Letter, those who exercised consistently and lost weight had the biggest reduction in heart attack risk over six years of follow-up. Exercising without losing weight and losing weight without exercising offered smaller benefits. Although exercise and weight don’t always move in the same direction, they are both important for health.

As cancer death approaches, palliative care may improve quality of life

Although dying is a fact of life, few people want to think about it. One group that must think about dying are people with advanced cancer who are told they have just a few months to live. What helps them end their days as peacefully as possible? A new study from Harvard-affiliated Dana-Farber Cancer Center and Brigham and Women’s Hospital found that being at home instead of in the hospital, talking with a chaplain or other minister, and spending time in private religious activity helped achieve this. When it’s clear that there’s no stopping cancer, heart failure, or other conditions, palliative care can help create a situation that maintains quality of life and leads to a “good death.”

Medication errors a big problem after hospital discharge

After a hospitalization, being discharged is a key step on the road to recovery. But that road can take a dangerous turn—namely, a serious problem with one or more medications. It’s a common problem that many people experience within a few weeks of leaving the hospital. Researchers at Brigham and Women’s Hospital reported in the […]

Staying fit linked to lower breast cancer risk

Daily exercise appears to reduce a woman’s risk of developing breast cancer, according to a study published online in the journal Cancer. The type or intensity of the exercise didn’t seem to matter, as long as it was done often. How much exercise is needed to lower breast cancer risk? In this study of 3,000 women, 10 to 19 hours a week (about two hours a day) had the greatest benefit. Age didn’t seem to matter—physical activity reduced breast cancer risk in younger women during their reproductive years and older women after menopause. What did make a difference in the effect of exercise was weight gain—especially after menopause. Gaining a significant amount of weight essentially wiped out the benefits of exercise on breast cancer risk in older women.

Harvard expert urges caution for use of new prostate cancer test

The FDA has approved a new kind of PSA test for prostate cancer that its maker claims can help doctors do a better job of telling the difference between prostate cancer and less worrisome conditions such as prostate infection or benign prostate enlargement. The test, called the Prostate Health Index (PHI), should become available in the U.S. later this summer. The PHI combines measurements of three kinds of prostate specific antigen (PSA), a protein produced by the prostate gland. In theory, the combination could help reduce the number of men who undergo prostate biopsies when their PSA levels are slightly above normal, in the 4 to 10 nanogram per milliliter range. But doctors must take care not to allow use of the PHI test to worsen the existing overdiagnosis and overtreatment of low-risk cancers, according to Dr. Marc B. Garnick, an expert in prostate cancer at Harvard Medical School and editor in chief of HarvardProstateKnowledge.org.

Backyard gardening: grow your own food, improve your health

A new book from First Lady Michelle Obama, “American Grown: The Story of the White House Kitchen Garden and Gardens Across America,” details the challenges and joys the First Lady has experienced with her now-famous White House garden. It also looks at community gardens all across America, and how they can improve health. The book contains helpful hints for starting your own vegetable garden, as well as a school or community garden. This effort dovetails with Mrs. Obama’s “Let’s Move” initiative. In addition to getting more physical activity, so the thinking goes, eating more food harvested from the ground and less from packages can help kids — and adults — become healthy or stay that way. The health benefits of growing your own food range from helping you eat more fresh fruits and vegetables to deciding what kinds of fertilizers and pesticides come in contact with your food.

The Supreme Court’s health care decision: What it does—and does not—mean

Today’s ruling by the Supreme Court that largely upholds the Patient Protection and Affordable Care Act should be viewed as a landmark event—whether one agrees with it or not. The Supreme Court’s ruling means that many more people will have health insurance; that health care will continue to be provided largely by the private sector; and that insurance companies won’t be able to deny an individual coverage because he or she has a chronic medical condition, drop coverage if an individual becomes sick, or put limits on the amount of lifetime coverage a person can get. It also means that individuals without health insurance will have to pay for it, and that many employers who do not currently offer health insurance as a benefit will be required to do so, or pay a stiff penalty.

Proposed recommendations question the value of calcium, vitamin D supplements

The U.S. Preventive Services Task Force (USPSTF) has stirred up a maelstrom of debate by proposing that healthy postmenopausal women lay off daily calcium and vitamin D supplements, which the task force says may do more harm than good. The USPSTF concluded that, based on the available evidence, supplements containing up to 400 IU of vitamin D and 1,000 milligrams (mg) of calcium don’t reduce fractures in postmenopausal women. Plus, these supplements may slightly increase the risk of kidney stones. As a result, the USPSTF says that postmenopausal women who aren’t at risk for osteoporosis shouldn’t be taking these supplements to prevent fractures. The jury is still out on whether it’s worth it for women and men to take higher doses of calcium and vitamin D to prevent fractures, or to take vitamin D to prevent cancer. Our experts say that most of your daily calcium should come from your kitchen, not your medicine chest.

Heart attack can trigger PTSD

We usually think of post-traumatic stress disorder (PTSD) as an aftermath of military combat or terrible trauma. It can also strike heart attack survivors. By the latest account, 1 in 8 people who live through a heart attack experiences a PTSD-like reaction that might be called post-traumatic stress disorder (PTSD). They experience the same key symptoms: flashbacks that occur as nightmares or intrusive thoughts. They try to avoid being reminded of the event and become hypervigilant worrying that it will happen again. As treatments for heart attack continue to improve, 1.4 million people a year are now surviving the event long enough to be discharged home. If the study is correct, 168,000 of them will be diagnosed with PTSD every year. It’s a grim reminder that as we get better at fixing the body, we must recognize the need to treat the mind.

Studies question ban on alcohol during pregnancy

Drinking alcohol during pregnancy has been taboo for some time, largely because drinking too much can cause fetal alcohol syndrome (FAS). Because no one has been able to identify a clear threshold for “safe” drinking during pregnancy, doctors tell women to steer away from alcohol entirely. A series of five studies from Denmark published in BJOG An International Journal of Obstetrics and Gynaecology found that “low” (1-4 drinks per week) to “moderate” (5-8 drinks per week) alcohol consumption in early pregnancy did not harm the neuropsychological development of children evaluated at age five. Drinking more appears to be a different story. In one of the studies, five-year-olds whose mothers consumed higher levels of alcohol (9 or more drinks per week) during pregnancy were significantly more likely to have lower attention spans. The authors of the study do not argue that drinking alcohol during pregnancy is wise or to be encouraged. In fact, most doctors will continue to advise pregnant women not to drink alcohol. is there a middle ground? Perhaps. Deciding to have a sip (or glass) of champagne at a special occasion during pregnancy may not be an unreasonable or unsafe choice–one that each woman has to make for herself, ideally after talking with her obstetrician or midwife about this issue.

Gene may explain why some smokers must fight to quit

Why is it so incredibly hard to quit smoking—even when you are desperate to do so? For some people, the answer may be in their genes. In a report published online in the American Journal of Psychiatry, a team led by Dr Li-Shiun Chen of the Washington University School of Medicine identified a “high risk” version of a nicotine receptor gene that is more common in heavy smokers. Those with the high-risk gene took two years longer to quit smoking. But there was a silver lining: smokers with the high-risk gene were three times more likely to respond to smoking cessation therapies. The study provides hope for even hardcore smokers. However long it takes, quitting is beneficial. In a study published in the Archives of Internal Medicine, quitting smoking reduced the risk of dying—even in people in their 80s. “Even older people who smoked for a lifetime without negative health consequences should be encouraged and supported to quit,” the researchers wrote.

Alcohol abuse linked to weight-loss surgery

For people who are obese, the operation known as gastric bypass surgery has been hailed as something of a miracle. In addition to rapid weight loss, it can reverse diabetes and reduce the risk of heart disease. A new study reveals potential darker side—an increase in alcohol abuse. In a presentation at yesterday’s annual meeting of the American Society for Metabolic and Bariatric Surgery, researchers reported that almost 11% of nearly 2,000 men and women who underwent gastric bypass surgery (the most common type of obesity surgery) got in trouble with drinking by the second year after surgery. About 7% drank too much before the operation, representing a 50% increase. This finding shouldn’t steer people who could benefit from gastric bypass surgery away from the procedure. But it should prompt them—and their doctors—to be on the lookout for changes in alcohol use or abuse afterward.

Pain relief outside the pill bottle

The idea that pain relief resides only in a bottle of pills is a common misconception. While medication often plays an important role in quelling pain, there’s a large arsenal of drug-free pain-relief therapies and techniques. The Institute of Medicine estimates that 116 million adults experience chronic pain each year. It has called for “a cultural transformation in how the nation understands and approaches pain management and prevention.” Improved pain management should include a combination of therapies and coping techniques. Other pain-relief therapies include biofeedback, ice, heat, exercise, acupuncture, hypnosis, massage, mind-body relaxation techniques, and more. These techniques can be used alone, in combination, and even in combination with drug therapy. Using non-drug therapies can be an empowering experience. Most of these therapies do not carry the risk of side effects as do most drugs. And many non-drug therapies are self-help techniques you can do by yourself or learn from a therapist.

Experimental breast cancer drug combo generates excitement

Results of a study presented at the annual meeting of the American Society of Clinical Oncology in Chicago indicates that an experimental drug combination could be effective against HER-2-positive breast cancer. The new therapy, called trastuzumab emtansine (T-DM1), combines a monoclonal antibody with a potent chemotherapy agent. The combination is exciting because Herceptin guides the cell-killing chemotherapy agent to HER-2 receptors on breast cancer cells. This focused attack targets cancer cells and largely bypasses healthy cells, which the chemotherapy drug would otherwise damage. In the study, which included nearly 1,000 women with HER-2-positive breast cancer that had spread either within the breast or elsewhere in the body, 65.4% of the women taking T-DM1 were still alive after two year, compared to 47.5% of those on standard treatment for this type of cancer. In addition, women on T-DM1 experienced far fewer side effects.

5 tips for celebrating Men’s Health Week

The run-up to Father’s Day should be about more than ties, golf balls, and deciding what to grill on Sunday. Health should also be on the agenda. Men’s Health Week was created by the U.S. Congress in 1994 to boost awareness of men’s health and ways to improve it. It’s a good time for men to contemplate their vigor, fitness, and overall health—and then do something about it. Here are five things you can you do to improve your health. 1) Get moving. 2) Get checked for colorectal cancer. 3) Know your blood pressure. 4) Cut back on sodium in your diet. 5) Don’t ignore warning signs. This week, give yourself the gift of good health. And keep it going beyond Father’s Day.

Early steps toward an Alzheimer’s vaccine

Some encouraging Alzheimer’s news from Sweden: a vaccine called CAD106 appears to be safe and ramps up the body’s immune system against a protein likely involved in Alzheimer’s. The hope is that this vaccine will slow the progression of Alzheimer’s disease, and possibly even stop it. The vaccine is designed to activate the body’s immune system against beta amyloid, a protein fragment that forms deposits called amyloid plaques between nerve cells in the brain. Three-quarters of those who received CAD106 developed antibodies against beta amyloid protein. Virtually all of them—including those getting the placebo—reported one or more side effects, ranging from inflammation of the nose and throat to headache, muscle pain, and fatigue. None, though, developed meningoencephalitis, an inflammation of brain tissue that derailed work on an earlier version of the vaccine. The next step in the development of CAD106 is a larger clinical trial to confirm the vaccine’s safety and to see if it is effective at slowing the relentless progression of Alzheimer’s disease.

Silent Spring at 50: Connecting human, environmental health

Fifty years ago this week, the first installment of Silent Spring appeared in the pages of The New Yorker. The book, published a few months later, was a sustained, meticulously reported account of the toll that widespread aerial spraying of DDT, dieldrin, aldrin, chlordane, heptachlor, and other synthetic pesticides was taking on birds, raccoons, fish, bees, and even the supposed beneficiaries of spraying—humans. Silent Spring is often portrayed as a book about saving birds and other wildlife. Another important theme is the essential but fragile connections between environmental health and human health. Silent Spring was instrumental in banning the use of many dangerous pesticides. It helped spark the modern environmental movement, launch the Environmental Protection Agency, and pass the Clean Water Act and the Endangered Species Acts. It is in the Modern Library’s 100 best nonfiction books, and Discover magazine named it one of the 25 greatest science books of all time.

Some antibiotic, antifungal drugs don’t mix with warfarin

Millions of people depend on the blood thinner warfarin to prevent clots from forming in their blood. It’s an important drug, but tricky to use. One problem with warfarin (Coumadin, Jantoven, generic) is that it interacts in potentially harmful ways with other medications. Two problematic types are antibiotics and antifungal agents. As we write in the June issue of the Harvard Heart Letter, this isn’t just a problem with pills, but can also happen with ointments, creams, and suppositories. Adding an antibiotic such as cotrimoxazole, cephalexin, or penicillin, or an antifungal medicine such as itraconazole or ketoconazole on top of warfarin can heighten warfarin’s blood-thinning ability. This raises the risk of internal bleeding or sustained bleeding after an injury.

Natural “exercise” hormone transforms fat cells

Exercise makes cells burn extra energy—that’s one way it helps control weight. It also generates a newly discovered hormone, called irisin, that transforms energy-storing white fat cells into energy-burning brown fat cells. Irisin also appears to help prevent or overcome cellular changes that lead to type 2 diabetes. The hormone does this by helping transform energy-storing white fat cells into energy-burning brown fat cells. White adipose tissue, more commonly known as body fat, is the tissue that dimples thighs, enlarges waists and derrieres, and pads internal organs. Each white fat cell stores a large droplet of fat. Brown fat, in comparison, is chock full of energy-burning mitochondria. Its main function is to generate body heat by burning fat. A team led by Dr. Bruce Spiegelman, professor of cell biology and medicine at Harvard Medical School, has identified irisin in mice and humans and showed how irisin transforms white fat cells into brown ones, at least in mice.

Silent strokes can jeopardize memory

The symptoms of a stroke are sometimes obvious, like numbness or weakness on one side of the face, trouble speaking, difficulty walking, and vision problems. Some strokes, though, pass completely unnoticed—at least right away. But as reported in the June issue of the Harvard Women’s Health Watch, the damage these so-called silent strokes cause to fragile brain tissue can have significant and lasting effects on memory. Although silent strokes don’t cause any obvious symptoms, the interruption in blood flow to the brain can harm the processes needed to form or recall memories, especially if several of them occur over time. You can help prevent silent strokes the same way you others, by controlling blood pressure and cholesterol, not smoking, eating a healthy diet, and exercising.

NSAIDs—pain relief and skin cancer protection in one pill?

Aspirin, ibuprofen, and naproxen can subdue a pounding headache and ease arthritic aches. Could these and other nonsteroidal anti-inflammatory drugs (NSAID) serve double duty, protecting against skin cancer even while they relieve pain? A new study published online in the journal Cancer suggests they might. But based on the current evidence, cancer prevention alone doesn’t […]

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