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Are you denying yourself medical care?

Fear of catching COVID-19 may keep you away from doctors' offices and emergency rooms. Will that hurt or help your health?

For many people, it's a daily debate: Do you risk getting COVID-19 by venturing outside your home and being around others — even if you wear a mask, observe social distancing, and use hand sanitizer? Or do you play it safe and stay inside? The answer is complicated, especially when the reason for leaving home is health-related.

People are understandably concerned about catching COVID while making a medical visit. But avoiding medical treatment because of this kind of thinking can be dangerous, and it appears to be taking a deadly toll.

Stop counting calories

Put the focus on food quality and healthy lifestyle practices to attain a healthy weight.

Most people have been taught that losing weight is a matter of simple math. Cut calories — specifically 3,500 calories, and you'll lose a pound. But as it turns out, experts are learning that this decades-old strategy is actually pretty misguided.

"This idea of 'a calorie in and a calorie out' when it comes to weight loss is not only antiquated, it's just wrong," says Dr. Fatima Cody Stanford, an obesity specialist and assistant professor of medicine and pediatrics at Harvard Medical School.

Reinvent your walking regimen

Switch the type of walking in your routine to stay motivated and active.

Putting one foot in front of the other is a simple way to trigger a cascade of health benefits. Regular brisk walks help lower LDL (bad) cholesterol; control blood sugar; and reduce the risk for high blood pressure, heart disease, stroke, and diabetes. Brisk walks also strengthen muscles, burn calories, and lift mood.

Just one problem: some people find walking boring. Boredom may diminish your motivation and interest in exercising. Before that happens, mix up your regimen with different types of walking that maximize physical, mental, and emotional health benefits.

Vaccination update

We don't yet have a vaccine to prevent COVID-19, but it's still important to get your regularly scheduled shots.

You're not alone if you're avoiding doctor visits because of concerns about COVID-19. But forgoing medical care means you may be skipping needed vaccinations. "That's a huge problem already. Possibly over a hundred million people the world over have missed their vaccinations because of the pandemic," says Dr. Shiv Pillai, an immunologist and professor of medicine at Harvard Medical School.

Going without vaccinations may increase your risk for illness, such as influenza. "We still are just as vulnerable to infection, and we need vaccines to be protected; COVID-19 doesn't change that," says Harvard Health Letter editor in chief Dr. Anthony Komaroff.

COVID-19 and flu season: What to expect

How can you protect yourself from both viruses?

With flu season here and the COVID-19 pandemic ongoing, what can people expect when these two illnesses meet?

It's anyone's guess.

"While we're in the midst of the COVID pandemic, there's a lot of uncertainty about what will happen when this collides with our yearly flu epidemic," says Dr. Mary Watson Montgomery, an infectious disease expert at Harvard-affiliated Brigham and Women's Hospital.

Identifying prediabetes may present opportunity to reduce heart disease risk

Research we're watching

People with prediabetes — a condition in which blood sugar is elevated but not high enough to be considered diabetes — often go undiagnosed. That may put them at higher risk of cardiovascular disease and even early death, according to an analysis of 129 studies published in the July 18, 2020, issue of The BMJ.

The analysis, which combined data on some 10 million people, found that prediabetes raised the risk of dying from cardiovascular disease by 15% and from any cause by 13% over a median follow-up period of about 10 years. The mortality risk was even higher in people with prediabetes who also had coronary artery disease: they had nearly a 40% increased risk of dying within a median follow-up period of just three years. The study authors suggest that finding and addressing more cases of prediabetes could lead to a lower risk of future cardiovascular disease.

Fall prevention program comes up short

Research we're watching

A specialized fall prevention program managed by nurses wasn't able to significantly reduce the rate of serious falls among high-risk adults over age 70, according to a study published July 9, 2020, in The New England Journal of Medicine. The STRIDE program (the name stands for Strategies to Reduce Injuries and Develop Confidence in Elders) was tested by the Patient-Centered Outcomes Research Institute and National Institutes of Health as a means of reducing falls among high-risk seniors.

Falls are a leading cause of injury in people 65 and older, with some three million adults heading to the emergency room each year with a serious injury caused by a fall. Program staff worked with individuals at least 20 months to identify and modify such risk factors as problems with walking or balance, hazards in the home that made a fall more likely, a history of low blood pressure when standing, and low vitamin D levels.

The best way to measure your blood pressure at home

Get an approved blood pressure device and follow these steps.

Monitoring your blood pressure at home has always made good sense. Blood pressure is one of the main indicators of cardiovascular health, and taking measurements is an important way to manage chronic conditions between doctor visits.

Now, with a pandemic under way and fewer people visiting their doctors, the case for monitoring blood pressure at home has never been stronger. Home monitoring yields valuable information for you and your physician, who'll be counting on you to provide accurate blood pressure measurements when you talk on the phone or in a video chat.

Even a small apple a day may help keep diabetes away

News briefs

A modest uptick in the amount of fruit and vegetables you eat can help ward off type 2 diabetes, according to a study published online July 8, 2020, by The BMJ. From a much larger study involving some 340,000 people from eight European countries, scientists selected 9,754 participants who were newly diagnosed with diabetes over a decade. Researchers compared the fruit and vegetable intakes of these people to those of about 13,000 participants who remained diabetes-free during the study period. Researchers also measured blood levels of seven key plant-derived nutrients, including vitamin C and brightly colored antioxidant pigments called carotenoids. People with the highest intakes of fruit and vegetables and the highest blood levels of the plant-derived nutrients were 25% to 50% less likely to get diabetes during the study period, compared with those who ate the least of these food groups or had the lowest nutrient levels. Even better, it didn't take a whole lot of extra green, red, yellow, and orange on the plate to make a dent in diabetes risk. The equivalent of only two-thirds of a medium apple or just over one-third of a cup of mixed fruit each day offered protection.

Image: © RomoloTavani/Getty Images

Leg stretching may improve blood flow and prevent strokes

In the journals

Not only can regular leg stretching help reduce cramps and muscle strains, it also may be another way to protect against heart disease and stroke. A study published online July 1, 2020, by The Journal of Physiology found that performing simple leg stretches can help improve blood flow throughout the body.

Researchers split 39 healthy people into two groups. One group didn't do any stretching. The other group performed four types of leg stretches five times a week for 12 weeks. The stretches focused on the hip, knee, and ankle. Each stretch was done for 45 seconds with a 15-second recovery. Afterward, the researchers found that the arteries in the lower legs of the stretching group had better blood flow and less stiffness. The stretching group also had lower blood pressure at the end of the study compared with their initial readings.

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