Harvard Health Blog

The bone-thinning condition known as osteoporosis can be a big problem for older people. That’s why older folks are urged to have their bones checked with a test that measures bone density. Exactly how often to have the test hasn’t yet been set. By following 5,000 older women for almost 17 years, researchers found that the timing of the next bone mineral test should depend on the result of the current one. People who get a normal result can wait 15 years, those with moderate osteopenia should have the test every five years, while those with severe osteopenia should have it every year.

By the year 2050, experts estimate that 16 million Americans will be living with this Alzheimer’s disease. In an effort to head off the explosion, President Obama has signed into law the National Alzheimer’s Project Act. This ambitious project aims to attack Alzheimer’s disease by improving early diagnosis, finding effective prevention and treatment strategies, providing better support for family caregivers, and more. A newly released draft of the project, which a panel of experts is reviewing this week, sets a 2025 deadline for achieving these and other goals. One big drawback—the act doesn’t provide concrete details about how to fund the research and implementation efforts needed to meet the goals.

It is normal for children at some points in their development to be concerned about sameness and symmetry and having things perfect. But when such beliefs or behaviors become all-consuming and start interfering with school, home life, or recreational activities, the problem may be obsessive-compulsive disorder (OCD). Obsessions are irrational thoughts, images, and impulses that a person feels as unrealistic, intrusive, and unwanted. To relieve the anxiety caused by these obsessions, a youth may engage in compulsive rituals. Two main types of treatment are used to help youths better manage OCD: a form of talk therapy known as cognitive behavioral therapy, and medication. The ideal approach is to try cognitive behavioral therapy before turning to medication.

A bold initiative called Million Hearts aims to prevent one million heart attacks and strokes from happening over the next five years. As explained in the Harvard Heart Letter, the initiative is spearheaded by the federal Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services. Its main focus is to encourage more widespread and appropriate use of simple, effective, and inexpensive heart-protecting actions, dubbed the ABCS. These include taking daily low-dose Aspirin, if prescribed; managing Blood pressure and Cholesterol levels; quitting Smoking. The Harvard Heart Letter adds D for Diet and E for Exercise.

Most store-bought muffins deliver the same wallop of highly processed flour and sugar as donuts. Low-fat versions may actually be worse, since they contain extra sugar and salt. To restore the muffin to its rightful place as a healthy breakfast or snack option, chefs and dietitians from the Culinary Institute of America worked on a muffin makeover with nutrition experts from the Harvard School of Public Health (HSPH). They created recipes for five muffins: blueberry, cranberry orange, jalapeno cheddar corn, lemon chickpea, and banana nut. The team replaced half of the white flour with whole wheat or other whole-grain flours, used heart-healthy oils in place of some or all of the butter, added nuts when possible, and cut the size of the muffins.

The U.S. Food and Drug Administration has ruled that farmers must limit the use of antibiotics called cephalosporins to prevent infections in seemingly healthy cows, pigs, chicken, and turkeys. According to the FDA, 24.6 million pounds of antibiotics are used each year in cattle, pigs, chickens, and turkeys purely for the sake of prevention. This practice has contributed to the development of antibiotic-resistant bacteria, which are a growing threat to human health. Doctors often prescribe cephalosporins to stop common infections such as pneumonia and urinary tract infections. They are also used before surgery. Unfortunately, more and more infections are resistant to cephalosporins. Doctors are being asked to prescribe antibiotics only when they are most needed. Farmers should do the same thing. Otherwise, antibiotics lose their power. Bacteria strains become drug-resistant. And people suffer.

Everyone has moments of forgetfulness—misplaced keys, a forgotten errand, the name of that movie you want to recommend but can’t get off the tip of your tongue. A certain amount of forgetfulness seems to be a normal byproduct of aging. But how do you know is forgetfulness signals something more serious, like Alzheimer’s disease or another form of dementia? According to “A Guide to Alzheimer’s Disease,” an updated Special Health Report from Harvard Medical School, by exploring several questions you may be able to get a clearer sense of normal versus worrisome forgetfulness: Is my loved one worried about the memory loss? Is he or she getting lost in familiar territory? Are word-finding problems common? Is your loved one losing the ability to socialize, or interest in it?

During a recent check-up, my doctor snuck a look at her phone a couple times. I don’t think it had anything to do with my health or care, so it was mildly annoying—but I didn’t say anything. After reading a report about a man who almost died because of a doctor’s “multitasking mishap,” next time I’ll speak up. But new research suggests some big downsides to multitasking. According to the authors of Organize Your Mind, Organize Your Life, a new book from Harvard Health Publishing, multitasking increases the chances of making mistakes and missing important information and cues. Instead try set shifting. This means consciously and completely shifting your attention from one task to the next, and focusing on the task at hand.

For many years, nutrition research focused on the benefits and risks of single nutrients, such as cholesterol, saturated fat, and antioxidants. Today, many researchers are exploring the health effects of foods and eating patterns, acknowledging that there are many important interactions within and among nutrients in the foods we eat. The result is a better understanding of what makes up a healthy eating plan. The January 2012 issue of the Harvard Women’s Health Watch offers 12 ways to break old dietary habits and build new ones. These include eating breakfast, piling on the fruits and vegetables, choosing healthy fats, replacing refined grains with whole grains, and eating mindfully.

Although short-term studies suggest that switching from sugar to calorie-free sweeteners can help people lose weight, the December 2011 Harvard Health Letter explores the possibility that it may actually promote weight gain. Use of super-sweet artificial sweeteners may desensitize users to sweetness. Healthful foods like fruits and vegetables may become unappetizing by comparison. As a result, the overall quality of the diet may decline. The calories removed from the diet by the sugar-for-sweetener swap may sneak back in, in the form of refined carbohydrates and low-quality fats. Another concern is that artificial sweeteners could cause weight gain by directly stimulating the development of new fat cells.

In the movie “Wedding Crashers,” Owen Wilson and Vince Vaughn made party crashing seem like harmless fun. A different sort of party crasher—microbes with names like Campylobacter and Salmonella (pictured to the right)—sicken nearly 50 million Americans each year. Holiday buffets and dinners are a more inviting setting for the microbes that cause food poisoning […]

Family and togetherness are key themes for the holidays. That can make the holidays awfully difficult for people who are grieving the loss of a loved one.  My father passed away a month before the holidays.  We still shared presents, ate large meals, visited with friends, even sang carols—but it was all pretty subdued. “If […]

New guidelines for from the American Academy of Pediatrics recommend that all kids between the ages of 9 and 11 have their LDL (bad) cholesterol levels checked. The rationale is that atherosclerosis (the fatty gunk in arteries that causes heart attacks, strokes, and other serious problems) starts during youth. Atherosclerosis is fed by high LDL. The guidelines aren’t aimed at getting kids to take cholesterol-lowering statins. Instead, they are about getting kids, their parents, and their doctors to talk about making healthy lifestyle choices. The hope is that more doctor time spent coaching and counseling now will mean less time treating cardiovascular disease later.

As paper medical records give way to electronic health records, it is becoming increasingly possible to view your medical history. Yet experts are debating whether the electronic health record should include the notes that doctors make in them. The Open Notes project is designed to test the consequences of giving patients access to doctors’ notes. Results of a survey of the expectations that doctors and patients have for note sharing, reported in the Annals of Internal Medicine, suggest that while physicians are generally optimistic about doing this, many believe it could cause patients to worry or generate unnecessary questions. Patients who filled out the survey thought that seeing their doctor’s notes would provide a clearer understanding of their medical condition, improve self-care, and give them a greater sense of control.

“Limit salt” has been a key part of dietary advice for decades. Once aimed at individuals, the FDA is hoping to persuade food companies to cut back on salt added to prepared foods. That’s probably a good idea, since the average American gets more salt—and thus sodium—than needed, most of it from prepared foods. But the question of how low we should go with sodium hasn’t been answered. Two studies suggest that getting too little sodium could pose problems, just as eating too much does. Trials to determine the safest range for sodium aren’t in the offing. What to do in the interim? Aiming for the recommended target of 2,300 milligrams per day from all sources is probably good for most people.

The new science of social networks is demonstrating how personal interconnections can affect our health. Ideas and habits that influence health for better or for worse can spread through social networks in much the same way that germs spread through communities. An article in the December issue of the Harvard Men’s Health Watch explores how social networks can affect weight and mood. A study of people taking part in the Framingham Heart Study found that among participants who had a friend become obese, their chance of becoming obese rose by 57%. A different study from Framingham showed that happiness can also spread across social networks. Research into social networks could help experts some day use them to improve public health.

How do people make decisions about their health and medical treatment? Husband and wife doctor team Jerome Groopman and Pamela Hartzband, both faculty members at Harvard Medical School and physicians at Beth Israel Deaconess Medical Center, explore this topic in a new book called Your Medical Mind. They say three basic influences drive our medical decisions: our mindset or general approach to medical matters, numbers (medical data and how they are presented), and stories. Groopman and Hartzband interviewed scores of patients to arrive at general mindsets that shape medical decisions: maximalists and minimalists, naturalists and technologists, believers and doubters. These mindsets can change in the face of new numbers, well-framed advice from physicians, compelling stories from friends and family, and direct-to-consumer advertising.

For neck and shoulder pain, doctors once recommended rest, maybe the use of a neck brace, and waiting until the pain had ebbed away. Today there are recommending movement instead of rest. As described in Neck and Shoulder Pain, a newly updated Special Health Report from Harvard Health Publishing, there is mounting scientific evidence for the role of stretching and muscle strengthening in treating people with neck and shoulder pain. After a whiplash injury, for example, people heal sooner and are less likely to develop chronic pain if they start gentle exercise as soon as possible. For those with long-term pain (called chronic pain) results from controlled studies show that exercise provides some relief. Exactly how much exercise to do, what types are best, and how often it should be done have yet to be completely hashed out.

Type 1 diabetes, once called juvenile-onset diabetes, takes a toll on health and longevity. Some people, though, have managed to live with the disease for decades. Since 1970, almost 3,500 men and women who have lived with type 12 diabetes for a half century have been recognized by the Joslin Diabetes Center in Boston with bronze 50-year medals. Forty-five of them have passed the 75-year mark. A study that includes several hundred 50-year Medalists is changing experts’ understanding of type 1 diabetes. Many of the 50-year Medalists have no signs of diabetes-induced eye or kidney damage, and some still continue to make small amounts of insulin. This work may uncover new ways to protect people from the damage diabetes can cause and point ways to new treatments for it.

Many prostate cancers grow very slowly and never escape the prostate. They cause no symptoms, and never threaten health or life. Yet almost 90% of men told they have prostate cancer opt for immediate treatment with surgery or radiation therapy—which often cause trouble getting or keeping an erection and an assortment of urinary problems. Yesterday, a panel of experts convened by the National Institutes of Health recommended that many men with localized, low-risk prostate cancer be closely monitored, and that treatment be delayed until there was evidence that the disease was progressing.

At least for men, being more fit may have a bigger health payoff than losing weight, according to a new study of more than 14,000 well-off middle-aged men who are participating in the Aerobics Center Longitudinal Study. Researchers followed their health, weight, and exercise habits for 11 years. Compared with men whose fitness declined over the course of the study, those who maintained their fitness levels reduced their odds of dying from cardiovascular disease or any other cause by about 30%, even if they didn’t lose any excess weight. Those who improved their fitness levels saw a 40% reduction. For optimal health, being fit and maintaining a healthy weight are best. But if you are overweight and inactive, this study and others suggest that getting more activity is the best place to start to improve your health.