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Americans are starting to eat a healthier diet, but we still have a long way to go, suggests a study (which included Harvard research) published Sept. 24, 2019, in JAMA. Researchers looked at health survey responses gathered from 1999 to 2016 from almost 44,000 American men and women. The good news: during the study, participants improved on the 100-point Healthy Eating Index, thanks to higher intakes of high-quality carbohydrates (such as whole grains), plant protein (such as whole grains and nuts), and unsaturated fats; and lower intakes of added sugars. The not-so-good news: 42% of the American diet is still coming from low-quality carbs, and about 12% is coming from saturated fat. Like turning a massive battleship, it takes time to change eating patterns. These findings confirm that a winning strategy includes swapping low-quality carbs for higher-quality ones, replacing some saturated fats (like those in red meat) with unsaturated fats (like those in nuts and fish), and reducing calories from carbs over all (fewer snacks and drinks with added sugars and refined grains). An outstanding and popular book to guide healthy eating is Eat, Drink and Be Healthy, by Walter Willett and P.J. Skerrett, from Harvard Health Publishing.

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News briefs

Want something simple to boost your health? Try looking on the bright side. A large observational study published online Sept. 27, 2019, by JAMA Network Open tied optimism to fewer heart attacks and a lower risk for premature death. Researchers combed through 15 studies that included almost 230,000 people who were followed for an average of 14 years. Being optimistic was associated with a 35% lower risk for cardiovascular events and a 14% lower risk for an early death, compared with being pessimistic. The findings don't prove that seeing the glass half-full causes better health, but many other studies have reported similar findings. "Optimistic people may have healthier habits, such as regular exercise and healthy diets; and they may be better at regulating their emotions in stressful situations, which could also contribute to lower levels of inflammation. But we need more research to confirm it," says Dr. Laura Kubzansky, a study author and co-director of the Lee Kum Sheung Center for Health and Happiness at the Harvard T.H. Chan School of Public Health.

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The diet takes vegetarianism to the extreme and poses a risk for nutrient deficiency. But it does offer health benefits.

If tofu turkey and meatless meatloaf are on your holiday menu this year, you may have made the switch to a vegetarian diet, eliminating at least some animal protein. But how much animal protein can you safely cut out of your diet?

Vegetarian diet benefits

Among the many types of vegetarian diets, three are particularly common: a pescatarian diet allows seafood; a lacto-ovo diet allows dairy products and eggs; finally, a vegan diet allows no seafood, dairy, or other animal products.

Ask the doctor

Q. I've been taking vitamin D supplements for several years because my doctor said they might help me live longer. Am I wasting my money, or even causing myself harm?

A. You're right to be skeptical. Vitamin supplements of all types repeatedly have been tested for theoretical health benefits, and often the studies have shown none. There's no doubt that vitamin D supplements can help prevent or treat osteoporosis. Theoretically, they might reduce the risk of various diseases. What about the question you asked: whether vitamin D supplements help you live longer?

A wide range of gadgets and equipment can help you avoid injury and maintain independence.

You used to hop into the tub or shower for a quick wash and rinse off, and then be on your way. These days, maybe knee arthritis makes it hard to lift your legs to get into a tub; shoulder pain makes it hard to reach up and wash your hair; or imbalance puts you at high risk for a fall, especially in a slippery setting. Take heart: lots of tools can make bathing safer and easier.

Instant upgrades

A few tools from a drugstore or big-box store can help you make immediate improvements to your bathing routine.

Simple steps can help you avoid complications that come from breathing cold, dry air.

A blast of cold air in the face as you step outside is a brisk reminder that the harshness of winter has arrived. And a deep breath of icy air can be risky for people with respiratory conditions such as asthma, bronchitis, or chronic obstructive pulmonary disease (COPD — which includes chronic bronchitis and emphysema). The cold temperatures can trigger symptoms such as wheezing, coughing, and shortness of breath.

Even in healthy people, cold, dry air can irritate the airways and lungs. It causes the upper airways to narrow, which makes it a little harder to breathe.

It's not clear that supplements are effective, but some evidence is encouraging.

Some people are wary of taking antidepressants to treat their mild or moderate depression. They may not want to deal with the hassle of prescriptions, the costs, the potential side effects (such as sexual dysfunction), or the worry that medication treatment could mean an endless commitment.

Research we're watching

Having a dog often means taking daily walks, a habit that helps stave off heart disease. But that might not be the only reason dog owners have healthier hearts, according to a new study.

The nearly 1,800 participants had no history of heart disease in 2013 when the study began. Researchers scored them based on the American Heart Association's "Life's Simple 7" factors: body mass index, diet, physical activity, smoking status, blood pressure, blood sugar, and total cholesterol. Then they compared the scores of people who owned any pet to those who did not own pets, as well as the scores of dog owners with owners of any pet or no pet.

Research we're watching

People with a positive outlook on life seem to be less likely to experience serious heart-related problems, according to a review published Sept. 27 by JAMA Network Open.

The study pooled findings from 15 studies involving a total of more than 220,000 people. After a follow-up period lasting an average of nearly 14 years, researchers found that optimism was associated with a 35% lower risk of angina, heart attack, stroke, or death from cardiovascular causes. That benefit held even when they considered studies that took into account depression, physical activity, and other possible confounding factors.

These three exercises can help make functional fitness part of your regular routine.

As part of everyday living, you spend a lot of time bending, reaching, lifting, twisting, turning, and squatting, without even thinking about it. These movements show up in everything from carrying groceries, to playing with your grandkids, to just checking if the coast is clear when you back out of the driveway.

The ability to do these ordinary activities and movements is called functional fitness, and it can determine how active, healthy, and independent you are as you get older.