Advance care planning Archive

Grapefruit can mean danger when combined with some popular drugs used for high blood pressure, high cholesterol and depression

Grapefruit and grapefruit juice are healthful, providing enough vitamin C, potassium, dietary fiber, and other nutrients to earn the American Heart Association's "heart-check" mark. That's the good news. The bad news is that grapefruit juice can interact with dozens of medications, sometimes dangerously.

Doctors are not sure which of the hundreds of chemicals in grapefruit are responsible. The leading candidate is furanocoumarin. It is also found in Seville (sour) oranges and tangelos; although these fruits have not been studied in detail, the guidelines for grapefruit should apply to them as well.

The pleasure of eating a candy bar lasts but a few minutes. Burning off the calories it delivers can take nearly an hour. So this is definitely not a simple way to lose weight! 

To lose one pound by exercising, you need to burn approximately 3,500 calories. It can take days of moderate exercise to do this. A better strategy for weight loss involves a two-pronged approach: exercising and cutting calories.

Most plant-based diets emphasize foods associated with heart benefits. However, some plant foods, such as fruit juices, refined grains, processed cereals, and potatoes, can be harmful. The goal is to emphasize heart-healthy plants.

The shift from this condition to dementia is not necessarily inevitable.

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Will I get dementia? That common question takes on urgency if you have mild cognitive impairment (MCI), a slight but noticeable change in memory and thinking skills. But the progression from MCI to dementia is not automatic. In fact, MCI is not always permanent. "It depends on the underlying cause," says Dr. Joel Salinas, a neurologist at Harvard-affiliated Massachusetts General Hospital.

What are the causes of MCI?

MCI is not dementia (see "What is dementia?"), but it's not normal thinking, either. It often stems from disease or treatments for disease, including

Weight loss can be challenging, but there are some strategies for success.

 Image: © Wand_Prapan/Getty Images

If you're struggling to lose weight, you probably feel like the odds are stacked against you. You're not necessarily wrong.

"There is so much great-tasting food, and it's abundant and in your face all the time. To me it's kind of a miracle that people aren't even heavier than they are," says Dr. Meir Stampfer, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health. In addition to an abundance of food, most people today also have a far more sedentary lifestyle than past generations. "Even active people who exercise a lot aren't expending the calories their ancestors did," says Dr. Stampfer.

On call

Q. I have just recovered from the flu. How soon can I resume exercise again and can I go straight back to my previous routine?

A. The recommendations about when to return to exercise after respiratory infections, such as the flu, colds, or bronchitis, are vague. One major reason is that each person's response to illness is so variable. But here is my general advice.

The yoga routine "ten churnings" can be done on its own to help you get moving in the morning or to counteract stiffness after sitting for too long. In about six minutes, the routine can loosen up your joints and serve as a warm-up to a longer exercise session. To learn additional intermediate yoga exercises, visit: www.health.harvard.edu/iy

Falls can lead to pneumonia, brain injuries, or muscle breakdown. Learn the risks so you can avoid them.

It's easy to see why falls are a top cause of injury and death among older adults. Crashing to the ground with force obviously can break a bone, or worse. But are you familiar with that "worse" part? Learn about fall risks now, so you can do as much as possible to avoid injuries in the future and maintain your mobility and independence.

Fractures

In older adults, about 90% of broken bones (fractures) happen because of a fall. Breaks commonly occur in the ribs, spine, wrist, arm, ankle, or hip.

Ask the doctor

Q. What are mRNA vaccines, and could they prevent other diseases besides infections?

A. The very first vaccines approved in the United States to prevent COVID-19 are a new type: mRNA vaccines. The way any type of vaccine works is to train a person's immune system to recognize and attack a target, like a virus, when it enters the body. A vaccine does that by "showing" the immune system either a harmless (dead or weakened) virus or a critical piece of the virus' protein coat. With the COVID-19 virus, that critical piece is called the spike protein.