Harvard Health Blog

A landmark clinical trial done in Spain, known by the acronym PREDIMED, continues to support the health benefits of following a Mediterranean-style eating pattern. Last year, PREDIMED researchers reported that Mediterranean-style eating—rich in fruits, vegetables, and healthy plant oils—prevents heart attacks, strokes, and death from heart disease. This week in The Journal of the American Medical Association, they report that a healthy Mediterranean-style diet can also help prevent peripheral artery disease (PAD), a form of “hardening of the arteries.” It’s an important finding, since as many as 12 million Americans have PAD. It can cause leg pain when walking that goes away with rest (called intermittent claudication); a weakening of the aorta, the main pipeline that delivers blood to the body; pain after eating; erectile dysfunction; and other problems.

For some people, like those with an addiction, any amount of alcohol is too much. For others, drinking alcohol is something of a balancing act — a little may be healthful, while more than a little may be harmful. A new report in the journal Neurology highlights the dual effects of alcohol in men. As part of the Whitehall II study in Britain, researchers assessed the drinking habits of middle-aged men and women three times over a 10-year period. The study participants also took a mental skills test three times over the next 10 years. Compared with men who didn’t drink or who drank moderately, mental decline began to appear one to six years earlier in men who averaged more than 2.5 drinks a day. (There weren’t enough heavy drinkers among women to show any clear differences.) How does a person know if he or she is drinking too much? The CAGE and AUDIT tests can help.

Diverticulitis, an unpleasant condition that occurs when tiny pouches inside the large intestine become inflamed, can cause intense lower abdominal pain, diarrhea, constipation, a fever, and sometimes a good deal of rectal bleeding. Following a liquid diet for a while can help treat it, but antibiotics, and sometimes even surgery, may be needed. A new study in JAMA suggests that these treatments may be overused.
University of Michigan researchers reviewed the results of 80 studies of diverticulitis and its treatment. While the team agreed that antibiotic use and surgery are sometimes necessary, it concluded that there should be a lesser role for aggressive antibiotic or surgical intervention for chronic or recurrent diverticulitis than was previously thought necessary. Some studies suggest that exercising, controlling weight, and eating a high-fiber diet can prevent diverticular disease. It can also bring relief from constipation, better cholesterol control, and make for more filling meals. Adults should get 25 to 30 grams of dietary fiber every day. It’s best to get it from high-fiber foods, such as beans, whole grains, vegetables, and fruits. Some people need a fiber supplement.

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.

Many people practice meditation in hopes of staving off stress and stress-related health problems, even though the evidence for doing so is spotty. A new study that analyzed the results of nearly 50 solid clinical trials of meditation shows that mindfulness meditation can help ease psychological stresses like anxiety, depression, and pain. One way it does this is by training you to experience anxious thoughts or stresses in completely different and less emotionally disturbing ways. Mindfulness-based stress reduction training, developed by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical School in Worcester, MA, is now widely available in cities throughout the United States. You can also learn it yourself from books or online recordings. Or try this short meditation, from the Zen Buddhist monk Thich Nhat Hahn: “Breathing in, I calm my body. Breathing out, I smile. Dwelling in the present moment, I know this is a wonderful moment.”

A recent article in Parade magazine caught my eye because it has lessons for us all. The article was about Olga Kotelko, a 94-year-old woman, who is a competitive runner and track star. Her age alone is impressive. The fact that she didn’t enter her first Master’s competition until she was 77—an age when many people are hanging up their sneakers—is amazing. The article offers six lessons that anyone can learn from Ms. Kotelko’s daily life. She can be an inspiration for anyone, at any age, who wants to start exercising or to exercise more. You are never too old or too frail to start exercising. Start out with a safe, easy program. Gradually add more and harder exercise. Who knows where you might end—possibly in an event challenging the likes of Olga Kotelko.

When it comes to your “health numbers,” your two blood pressure values are important to know—and keep under control. New guidelines for managing high blood pressure in adults, released this morning in a report in JAMA, aim to help doctors know when to start treating high blood pressure and how best to do it. The new guidelines recommend different treatment targets for individuals age 60 and older and those under age 60. They also offer doctors advice on the best medications to start with to control high blood pressure. Although the new guidelines address an area of controversy—how low should blood pressure go—they don’t change the basics: Know your blood pressure. Consider high blood pressure to be a reading of 140/90 or greater. Lifestyle changes are important. And tailor treatment to your needs.

Could tea be a health beverage? Eleven new studies in the American Journal of Clinical Nutrition highlight the many ways that tea may improve health: Tea drinking appears to lower the risk for heart disease and stroke, may strengthen bones, and appears to improve mood, concentration, and performance. Natural compounds called polyphenols in tea might protect against several cancers, including those of the prostate, GI tract, lungs, breast, and skin, and may also increase metabolism and promote weight loss. Those possible benefits apply to tea, not tea extracts condensed into pills. If you’re a tea drinker, enjoy your favorite brew with the added satisfaction that it may be good for your health. If you aren’t, there’s no reason to start.

A longer lifespan can be a double-edged sword. You live for more years, but the later years may not necessarily be what you had in mind. We’ve known for some time that about 25% of older Americans can’t perform some activities of daily living without help. But we don’t know much about the other 75%. A new study suggests that two-thirds of Americans over age 65 need help doing everyday activities such as eating, bathing, and getting in and out of bed or a chair. Things you can do to help ward off becoming frail or disabled include staying active, managing weight and eating a healthy diet, preventing falls, making connections with others, and seeing your doctor(s) regularly.

Sleep apnea—pauses in breathing while sleeping followed by snoring-like gasps for breath—can cause daytime drowsiness and mental fatigue. It can also boost blood pressure and the risk for developing heart disease. A new study suggests that treating sleep apnea by using a breathing machine during sleep can make a difference for people with hard-to-treat high blood pressure. Although blood pressure medications offer a bigger bang for the buck to reduce blood pressure, treating sleep apnea can help, and offers other benefits as well. Getting used to using a breathing machine, which delivers continuous positive airway pressure (CPAP), may take some work. One key is to find a mask that works, which may be a trial-and-error process.

If you have trouble finding the motivation to break away from the television and exercise, try couchersizing—staying on or near your couch and exercising during commercial breaks. Why bother? A growing body of evidence links the amount of time spent sitting to illness and even death. And just minimizing long periods of inactivity, like exercising during commercial breaks, can help reduce the risk of injury and may even help you live longer. You can work many different muscle groups while seated upright on a couch. Want to get your heart rate up, work the oblique muscles on the sides of the abdomen. To whittle your waist, try twisting your torso from side to side for the length of a commercial break. You can even exercise while lying on the couch.

Overeating during the holidays is practically a tradition. But overindulging can lead to weight gain, fatigue, and guilt. There are several tactical strategies you can employ to get you through the season of eating. Plan ahead: Find out when you’ll be eating, and plan your day around the meal; if you can bring a dish for the buffet, bring something healthy. At the buffet: Grab a salad plate instead of a dinner plate, and choose wisely; don’t waste calories on foods that aren’t special. At the table: Pace yourself by taking small bites, chewing slowly, and sipping water in between bites. Slowing down helps your brain get the message that you’re full. If all else fails: Don’t beat yourself up. Just get back to a healthy eating plan as soon as possible.

In many ways, women are different from men. One way in which they are alike is how they “feel” a heart attack: with similar kinds of chest pain. Other heart attack symptoms may differ, but chest pain is pretty standard, according to European study of nearly 2,500 men and women. Few differences in chest pain were seen between the sexes. What’s more, the kind or duration of chest pain didn’t help tell a heart attack from some other problem. The conclusion? A careful medical history, an electrocardiogram, and blood tests are the best way to diagnose a heart attack in men and women. During a heart attack, more than three-quarters of men and women experience chest pain or discomfort. In the run-up to a heart attack, chest pain with exertion is a more common warning sign in men, while women often have other types of symptoms, such as fatigue and disturbed sleep.

If you smoke, you’ve probably heard that quitting is beneficial at any age. It’s good for your health, can make you feel and look better, and saves you money. But you also know, from personal experience or the experiences of friends, that quitting is hard. Take heart. Today, there are more ex-smokers than smokers in the United States. There are also more and better tools to help people quit. Each year on the third Thursday of November, the American Cancer Society sponsors the Great American Smokeout. It aims to make smokers and their loved ones more aware of the benefits of quitting and the tools available for achieving that goal. In support of the Great American Smokeout, Harvard Health Publishing is giving away free electronic copies of the Harvard Medical School Guide: How to Quit Smoking. This offer ends at midnight tonight (Nov. 21, 2013).

Move over, apples: A handful of nuts a day keeps the doctor away—and might help you live longer, according to new results from two long-running studies. Writing in tomorrow’s New England Journal of Medicine, Harvard researchers showed that daily nut-eaters were less likely to die from cancer, heart disease, and respiratory disease. Overall, the daily nut-eaters were 20% less likely to have died during the course of the study than those who avoided nuts. (Peanuts, which are actually legumes, counted as nuts in this study). While everybody is searching for the perfect nut, the health benefits hold true for variety of nuts.

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.

Updated cholesterol guidelines released yesterday by the American Heart Association and American College of Cardiology aim to prevent more heart attacks and strokes than ever before. How? By increasing the number of Americans who take a cholesterol-lowering statin. The previous guidelines, published in 2002, focused mainly on “the numbers”—starting cholesterol levels and post-treatment levels. The new guidelines focus instead on an individual’s risk of having a heart attack or stroke. The higher the risk, the greater the potential benefit from a statin. A statin is now recommended for anyone who has cardiovascular disease, anyone with a very high level of harmful LDL cholesterol, anyone with diabetes between the ages of 40 and 75 years, and anyone with a greater than 7.5% chance of having a heart attack or stroke or developing other form of cardiovascular disease in the next 10 years.

Millions of American men and women have served in the Armed Forces, protecting and defending our nation. Although many died, most returned home to “pick up their lives.” That isn’t always easy. For some veterans, the trauma of war changes the brain in ways that can cause long-term problems. According to the American Psychiatric Association, more than 300,000 veterans of the wars in Iraq and Afghanistan have been diagnosed with PTSD. Countless others probably suffer from this condition but have never sought help for it. Even sadder, in 2012 more military deaths were caused by suicide than by combat. If you know a veteran, thank him or her for having served our nation. And if you think he or she is having trouble, bolster your courage and ask. Beginning the conversation may open the door to healing.

Trans fats, once seen as harmless additives that ended up in everything from Twinkies to French fries, are finally getting the reputation they deserve—bad for health. For years, the FDA has labeled trans fats as “generally recognized as safe.” That term applies to substances added to foods that experts consider safe, and so can be used without testing or approval. Yesterday the FDA proposed removing trans fats from the generally recognized as safe list, a step that would eliminate artificial trans fats from the American food supply. Oils rich in trans fats, long a workhorse of the food industry, boost harmful LDL cholesterol. They also depress protective HDL, which trucks LDL to the liver for disposal; have unhealthy effects on triglycerides; make blood platelets more likely to form artery-blocking clots in the heart, brain, and elsewhere; and feed inflammation, which plays key roles in the development of heart disease, stroke, and diabetes.

It’s been a big year for the Mediterranean diet. Convincing evidence published in 2013 has shown that this kind of eating pattern is effective at warding off heart attack, stroke, and premature death. While you probably get the biggest payoff by adopting such a diet early in life, a new study shows that doing it during midlife is good, too. In the study, women who followed a healthy diet during middle age were about 40% more likely to live past the age of 70 without chronic illness and without physical or mental problems than those with less-healthy diets. The healthiest women were those who ate more plant foods, whole grains, and fish; ate less red and processed meats; and had limited alcohol intake. That’s typical of a Mediterranean-type diet, which is also rich in olive oil and nuts.

Telling the difference between run-of-the-mill sore throat caused by a virus, which doesn’t require medication, from bacteria-caused strep throat, which should be treated with antibiotics, is a tricky thing at any age. Physicians from Harvard Medical School, MIT, and the Skaggs School of Pharmacy in California have come up with a scoring system that could save adults a trip to the doctor for what would most likely turn out to be a garden variety sore throat (it hasn’t been tested in kids yet). It’s based on symptoms, age, and the percentage of people in your area who have tested positive for strep within the last two weeks. If your score is high, then head to your doctor’s office. If it indicates that you are unlikely to have strep, there’s little need for you to rush in for an exam or throat culture. The researchers estimate that use of this kind of score could prevent 230,000 office visits in the United States each year and keep 8,500 men and women from getting antibiotics they don’t need.

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.

Most people take balance for granted. They navigate without thinking, effort, or fear. For millions of others, though, poor balance is a problem. Some struggle with long-term dizziness or imbalance. Others suffer balance-related falls and injuries. A new study concludes that exercise can reduce not only the odds of falling but the odds of sustaining fall-related injuries. In many urban areas, there’s no shortage of classes aimed at improving balance. You can find them at senior centers, Y’s and Jewish Community Centers, health clubs, and the like. There’s also a lot you can do at home. The American College of Sports Medicine Standing recommends standing with one foot in front of another, lifting a foot off the floor, and shifting weight in various directions as three examples of home exercises.