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Treatment versus monitoring of prostate cancer: Survival rates the same after 10 years

Two new studies add to the evidence that for many men with prostate cancer, if it is detected early and has not metastasized beyond the prostate gland, monitoring the cancer will lead to the same chance of survival after 10 as choosing surgery or radiation. Men treated with surgery or radiation often experience significant side effects. The rates of depression and anxiety were the same in men who opted for monitoring and those who opted for treatment.

Ask the doctor: Is placing an IUD immediately after delivery safe?

A long-acting reversible contraceptive inserted or implanted immediately after a woman gives birth is safe, effective, and convenient.

How to cut back on sugar and salt

Most Americans consume much more than the recommended levels of sugar and salt. However, you can retrain your palate to be satisfied with less of both.


 Image: tsvibrav/iStock

If you own a sugar bowl and a saltshaker, you may be wondering if you should ever fill them again. The panelists crafting the 2015–2020 Dietary Guidelines for Americans emphasized that we're consuming much more sugar and salt than is healthy for us and have advised us to pare our intakes of both considerably. That said, they have acknowledged that the sugar bowl and saltshaker aren't the principal villains at the dining table. About 80% of the sugar and salt we eat is added to packaged and commercially prepared foods.

What are added sugars?

Reducing your sugar intake

Although beverages are the most important source of added sugars, they aren't the only ones. There are additional ways to reduce your intake of added sugars, and it doesn't have to mean giving up desserts. Here are several ideas for reducing the amount of sugar in your diet, targeting sugary drinks just as a first step:

Give your taste buds time to adjust. If you're in the habit of having two spoonful's of sugar in your coffee or tea, for instance, start by going to one-and-a-half for a week, then down to one. If sodas are part of your regular routine, cut your consumption by one a week, then two.

Adapt your recipes. You can make your favorite recipes less sugary by reducing a little bit at a time—try using one-quarter less sugar than the recipe calls for, then one-third—right up until you notice the difference. You may come to prefer the less-sweet variation.

Reach for fruit rather than juice. Squeezing fruit breaks down the cells and releases sugar into the juice, so that it enters the bloodstream more rapidly. Moreover, a glass of juice is usually the caloric equivalent of three whole fruits. Instead of drinking fruit juice, eat a piece of fresh fruit. You can make fruit drinkable and still preserve its fiber by blending it with almond milk or low-fat yogurt in a smoothie. If you just can't give up juice, make it 100% fruit juice that is not sweetened and limit the amount to a 4-ounce glass.

Check your cereal box. If you enjoy cold cereal or instant oatmeal for breakfast, look at the labels and choose one with minimal added sugar. It's also worth noting that cereals made with refined grains are quickly broken down into sugars in the body. To wean yourself off your favorite cereal, try combining it with a whole-grain, high-fiber cereal, and add fruit.

What about salt?

Cutting down on salt

Even if you ban salt from your table, it is still easy to exceed the sodium limit. To avoid doing so, try the following:

Eat mostly fresh foods. Most of the sodium we eat comes from restaurant meals and processed foods, including canned vegetables and soups, pasta sauces, frozen entrées, lunch meats, and snack foods. If you start with unsalted, fresh foods and prepare them yourself, you can exercise better control over your sodium intake.

Take care with condiments. Sodium is found in many condiments besides ordinary table salt—including soy sauce, Worcestershire sauce, salad dressings, ketchup, seasoned salts, pickles, and olives. Baking soda, baking powder, and monosodium glutamate (MSG) also contain sodium.

Read the labels. The Nutrition Facts label on packaged food lists milligrams of sodium per serving, so it's important to note how many servings the container holds. The percent daily value is based on 2,300 mg, so if your own daily sodium limit is lower, the amount of sodium in a serving is actually a higher percentage than the label indicates. Be aware that some over-the-counter drugs also contain sodium.

Speak up. When dining out, ask to have your food prepared with less salt. You can also ask for a lemon or lime wedge to add more flavor to your food.

Spice it up. Cut back on salt by using more herbs and spices like basil, coriander, cumin, cayenne, powdered mustard, oregano, rosemary, sage, thyme, and turmeric. You might try making your own blends of spices and herbs to use along with lemon or lime juice or flavored vinegars.

Seek out specialty salts. Some kosher and gourmet salts contain less sodium than standard iodized table salt; check the Nutrition Facts label to make sure.

The good news

Mobile app reduces stress incontinence episodes in small trial

Women who used Tät, a smartphone app, did more pelvic floor exercises and had greater reductions in episodes of stress incontinence.

Weight-related stroke risk varies for different stroke types, analysis finds

In an observational study of 1.3 million women, excess weight was linked to an increased risk of strokes caused by blood clots but a lower risk of strokes caused by bleeding. 

HDL cholesterol: How much is enough?

Research suggests that raising good cholesterol beyond a certain point doesn't offer any extra benefit for the heart.


Image: designer491/Thinkstock

When it comes to cholesterol, it's mostly about the numbers. You want less of the "bad" low-density lipoprotein (LDL) cholesterol and more of the "good" high-density lipoprotein (HDL) kind. This combination is often associated with a lower risk of cardiovascular disease. Sounds simple—and it is, for the most part. But while most attention is spent on driving down bad LDL, you still have to keep your eyes on the good HDL, as some research suggests that after a certain threshold, higher levels don't offer extra protection.

The role of cholesterol

Balancing act

One reason higher HDL may not always be effective is that it needs help to do its job. Another study found that HDL's protective role depends in part on the levels of both LDL and triglycerides (another type of blood fat that helps make up your total cholesterol).

The research, published online May 10, 2016, by Circulation: Cardiovascular Quality and Outcomes, analyzed data over 25 years on about 3,500 people. Researchers looked at people with both low and high HDL levels and those with normal and high levels of LDL and triglycerides.

They found that for optimal protection against cardiovascular disease, there needs to be a balance among all three. Higher HDL (40 mg/dL or higher) helped to reduce cardiovascular disease only when LDL and triglycerides were low (100 mg/dL or less). When LDL and triglycerides rose above 100 mg/dL or 150 mg/DL, respectively, higher HDL had no effect.

The ideal numbers

Men: talk with your doctor about resuming sex after a heart attack

A majority of men do not talk about resuming their sex life after a heart attack, which may lead to sexual problems like lack of interest and erectile difficulties. Researchers say that before being discharged from the hospital, men should expect to have a conversation with their physician about when it’s okay to resume all regular activities, including sex. If the topic does not come up, men should take the initiative.

Throughout life, heart attacks are twice as common in men than women

Throughout life, men seem to be twice as likely to have a heart attack as women. This risk appears to persist even after accounting for risk factors such as high cholesterol, high blood pressure, and diabetes. 

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