Focus more to ease stress

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Positive Psychology: Harnessing the power of happiness, mindfulness, and personal strength
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Positive emotions have been linked with better health, longer life, and greater well-being in numerous scientific studies. On the other hand, chronic anger, worry, and hostility increase the risk of developing heart disease, as people react to these feelings with raised blood pressure and stiffening of blood vessels. But it isn't easy to maintain a healthy, positive emotional state. Positive Psychology: Harnessing the power of happiness, mindfulness, and personal strength is a guide to the concepts that can help you find well-being and happiness, based on the latest research.

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Traffic jams. Job woes. Visits from the in-laws. Life is full of stress, and more often than not, people feel it physically as well as mentally.

Although the stress response begins in the brain, it is a full-body phenomenon. When someone encounters a threat — real or imagined — the brain triggers a cascade of stress hormones. The heart pounds, muscles tense, and breathing quickens.

One of the best ways to counter stress is to pay attention to what is going on. That may sound counterintuitive, but paying attention is the first step toward cultivating mindfulness — a therapeutic technique for a range of mental health problems (and physical ones).

The opposite of multitasking

Multitasking has become a way of life. People talk on a cell phone while commuting to work, or scan the news while returning emails. But in the rush to accomplish necessary tasks, people often lose connection with the present moment. They stop being truly attentive to what they are doing or feeling.

Mindfulness is the opposite of multitasking. The practice of mindfulness, which has its roots in Buddhism, teaches people to live each moment as it unfolds. The idea is to focus attention on what is happening in the present and accept it without judgment.

Dr. Jon Kabat-Zinn, professor of medicine emeritus at the University of Massachusetts Medical School, developed a mindfulness-based stress reduction program for people with major depression (since adapted for other disorders). Another adaptation of mindfulness to clinical practice is mindfulness-based cognitive therapy, which combines mindfulness techniques with cognitive behavioral therapy.

However it is practiced, mindfulness is a powerful therapeutic tool. Studies have found, for example, that mindfulness techniques can help prevent relapse in people who have had several past episodes of major depression. Other research suggests that mindfulness techniques can help alleviate anxiety and reduce physical symptoms such as pain or hot flashes.

Do-it-yourself methods

One of the best things about mindfulness is that it is something people can try on their own. Here's how to get started:

Center down. Sit on a straight-backed chair or cross-legged on the floor. Focus on an aspect of your breathing, such as the sensations of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.

Open up. Once you've narrowed your concentration, begin to widen your focus. Become aware of sounds, sensations, and ideas. Embrace and consider each without judgment. If your mind starts to race, return your focus to your breathing.

Observe. You may notice external sensations such as sounds and sights that make up your moment-to-moment experience. The challenge is not to latch onto a particular idea, emotion, or sensation, or to get caught up in thinking about the past or the future. Instead you watch what comes and goes in your mind, and discover which mental habits produce a feeling of suffering or well-being.

Stay with it. At times, this process may not seem relaxing at all, but over time it provides a key to greater happiness and self-awareness as you become comfortable with a wider and wider range of your experiences.

You can also try less formal approaches to mindfulness by trying to become more aware while you are doing activities that you enjoy. Playing the piano, juggling, walking — all can become part of your mindfulness practice as long as you pay attention to what is happening in the moment. Listen to the sounds of the music, feel the weight of the balls as they fall into your hand, or really look at what you are walking past.

Practice makes perfect

Mindfulness is something to cultivate and practice, on a regular basis.

Make a commitment. Aim for doing 20 to 45 minutes of mindfulness practice, most days of the week. (If that sounds like a lot, remember that a key part of mindfulness means letting go of expectations. Just commit to trying to become more mindful, and do the best you can.)

Make small changes. It's hard to make big changes. It's better to start slow and build gradually. The famous Alcoholics Anonymous motto is "one day at a time." Mindfulness involves taking it less than one day at a time — aim for one moment at a time.

Mindfulness really does not have to be more complicated than learning to pay attention to what is going on around you. But this "simple" advice is often hard to sustain in a busy world. Try making the effort to become more mindful — and you may find the results make it worth it.

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Boosting Your Energy
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Fatigue is a symptom, not a disease, and it's experienced differently by different people. For example, the fatigue you feel at the end of a long day or after a time zone change might feel similar to the fatigue resulting from an illness. The difference is that fatigue from stress or lack of sleep usually subsides after a good night's rest, while other fatigue is more persistent and may be debilitating even after restful sleep. Harvard's Special Health Report, Boosting Your Energy, provides advice and information from world-renowned medical experts to help you discover the cause and find the right treatment or lifestyle changes.

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Does creatine improve strength in postmenopausal women?

Q. Could you discuss the benefits of creatine supplements for postmenopausal women? Are there any drawbacks?

A. Creatine is a substance made in our bodies from the amino acids arginine, glycine, and methionine. Amino acids are the chemical building blocks of protein; we get them from dietary protein. The body makes 1 to 2 grams of creatine a day, and we also get creatine from certain foods, such as fish and meat. Most (95%) of the body's creatine is located in muscle, though some is found in other tissues, including the brain and retina.

Creatine increases energy by producing adenosine triphosphate, a high-energy compound released in muscle during intense, anaerobic exercise. Creatine supplements promote protein manufacture and provide a quick source of energy for muscle contraction.

Some studies suggest that supplemental creatine can help young athletes increase muscle mass and strength and improve their athletic performance during brief, high-intensity activity that requires short bursts of energy — one reason why it's incorporated in various nutritional supplements used by bodybuilders and by adolescent and professional athletes. But most of these studies have found that creatine doesn't enhance performance in older men and women, and doesn't improve endurance at any age.

There are a few exceptions to that conclusion. In a 2003 Canadian study of men and women ages 65 and over participating in a six-month strength-training program, those who took creatine had a twofold increase in lean muscle mass compared with a placebo group. In a small European study published in 2008, creatine seemed to confer a short-term benefit on postmenopausal women. At the start of the study, the women were evaluated for muscle performance (bench press, hand grip, tandem walking, and leg press). After one week, women who took creatine, compared with those taking a placebo, showed significant increases in bench-press and leg-press strength (measures of upper- and lower-body strength) and improvement in tests of coordination and balance.

These studies and others, while informative, have involved only a small number of participants. Moreover, there are no studies of the long-term effects of creatine supplementation. Its most common known side effects include weight gain, stomach upset, diarrhea, muscle cramps, headache, anxiety, nervousness, sleepiness, and dizziness. Less common but potentially serious side effects include liver problems, kidney damage, and interaction with insulin. Women with diabetes or kidney or liver disease should not take creatine supplements.

Grams of protein in certain foods


Grams of protein

Meat and poultry, 3 ounces


Fish, 3 ounces


Dried beans, cooked, 1 cup


Yogurt, 8 ounces


Milk, 1 cup


Cheese, 1 ounce


Egg, 1 large


Source: USDA National Nutrient Database for Standard Reference, Release 23, available at

My conclusion is that there's not yet enough evidence that creatine can help women your age build muscle or increase strength. And even if creatine isn't harmful, other substances used in making the supplements could be. The FDA doesn't regulate supplements and their ingredients. So your best way to build and maintain your muscle strength is to exercise and get the recommended amount of dietary protein. Healthy women ages 19 to 70 need 46 grams of protein per day (see the chart "Grams of protein in certain foods"), and they should perform regular strength training and aerobic exercise.

— Celeste Robb-Nicholson, M.D.
Editor in Chief, Harvard Women's Health Watch

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