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How to reset your internal clock to combat jet lag

A few simple measures can help minimize the sleep disturbances and malaise that can occur when you cross several time zones.


Image: faithiecannoise/iStock

This month we perform the annual ritual of turning back our clocks as Daylight Savings Time ends. Most of us can handle the one-hour time change easily. However, when we travel long distances across several time zones, few of us can survive the trip without feeling a little out of whack. For holiday travelers flying from coast to coast or overseas, recovering from the symptoms of jet lag—fatigue, insomnia, digestive upsets, and headaches—can consume a day or two of precious vacation time. According to Dr. Charles A. Czeisler, director of the Division of Sleep Medicine at Harvard Medical School, jet lag is due to a misalignment between the external environment and the internal clock in the brain that drives our daily performance, alertness, and the ability to sleep.

What happens during jet lag

Minimizing jet lag

If your destination is only a zone or two away, you may need to make only minor adjustments, like eating meals, going to bed, and awakening a little earlier or later than usual. If you're crossing several time zones, you may want to try the following:

Gradually switch to the new time. For several days before you leave, move mealtimes and bedtime incrementally closer to the schedule of your destination. Even a partial switch may help.

Stay hydrated. During the flight, drink plenty of fluids, but not caffeine or alcohol. Caffeine and alcohol can dehydrate you, which worsens the symptoms of jet lag. They can also disturb your sleep.

Switch your bedtime as rapidly as possible after arrival. Don't turn in until it is bedtime in the new time zone.

Use the sun to help you readjust. If you need to wake up earlier at your destination, get out in the early morning sun. If you want to rise later than you do at home, wait to go out in the sun until late in the afternoon.

A quick fix for jet lag?

In 2009, Dr. Clifford Saper and colleagues at Harvard-affiliated Beth Israel Deaconess Medical Center identified a second "master clock" in mice that can regulate circadian rhythms when food is scarce. In essence, the body's circadian rhythms are suspended to conserve energy.

It's been theorized that humans may have a similar mechanism and that a brief fast may trigger a quick reset of circadian rhythms. Dr. Saper has suggested a 12-hour to 16-hour fast the day before and during travel. For example, if you were to take a flight from New York City to Honolulu, you would refrain from eating for couple of hours before take-off and during the flight, but would have a good meal as soon as convenient after landing. This technique hasn't been tested in clinical trials, but there are many testimonials in the media to its effective-ness.

If you want to try this, it's a good idea to check with your clinician to see if it's advisable for you. And you will still need to drink water—not caffeinated beverages, juice, or alcohol—during your flight.

 

The longer you carry extra pounds, the higher your cancer risk, study suggests

Degree and duration of overweight were linked with an increased risk of several cancers among 74,000 participants in the Women’s Health Initiative.

A new look at colon cancer screening

Don't be intimidated about screening tests. The latest guidelines suggest you can choose from multiple strategies.


Image: Bigstock

Colon cancer continues to be the country's second leading cause of cancer-related deaths and the third most common cancer in men, according to the CDC.

It almost always develops from precancerous polyps (abnormal growths). Screening tests, which are recommended for men ages 50 to 75, help find and sometimes aid removal of polyps before they become cancer. (Men older than 75 may still benefit, depending on their health.)

Step lively with healthier feet

Keep your feet strong and you'll stay more active.


Image: Gualtiero Boffi/Thinkstock

Socrates may have been the first to equate healthy feet with quality of life when he famously said, "When one's feet hurt, one hurts all over." His observation rings true even millennia later.

"As you age, healthy feet become even more important for staying mobile, active, and safe," says Dr. Kevin Reimer, a podiatrist with Harvard-affiliated Beth Israel Deaconess Medical Center. "When it hurts to walk, you cut back on activities that you enjoy and that keep you healthy."

Need to remember something? Exercise four hours later

In the Journals

Here's a possible strategy to boost memory—exercise four hours after you learn something. In a study published in the July 11, 2016, Current Biology, researchers found that exercise after learning may improve your memory of the new information, but only if done in a specific time window.

 

 

 

Should you take a drug holiday?

A break from a medication is beneficial only in certain cases.


Image: Rallef/ThinkStock

When you think of a holiday, your medicine cabinet probably doesn't come to mind. But for people who take medications long-term, a drug holiday—a break from a medication for days or even years—may be helpful, for some medicines. "For some people, it gives the body a chance to recover the systems that have been suppressed by the drug," says Dr. Michael Craig Miller, assistant professor of psychiatry at Harvard Medical School.

Why take a break?

How to take a break

You must work with your doctor if you'd like to take a drug holiday. He or she will determine if you're a candidate for a break, and consider chronic health conditions you have and other medications you take. "Everybody's experience will be different," says Dr. Miller.

If your doctor says a drug holiday is not appropriate for your medication, but you feel the drug is not working or is causing unwanted side effects, ask about switching to another drug, how to do that safely, and whether a new medication would have potential side effects or long-term risks. Remember, too, that sometimes finding the right medication takes trial and error. Don't give up; stick with it, and stick to the rules for proper use.

Drug holidays: Don't try them on your own

In general, stopping a medication abruptly can be risky and even life-threatening. For example, if you suddenly quit taking a proton-pump inhibitor, such as lansoprazole (Prevacid) or omeprazole (Prilosec), used to reduce acid reflux and heartburn, you can suffer a rebound effect—a relapse marked by a surge of stomach acid. People with advanced Parkinson's disease who stop taking the often-prescribed drug combination of carbidopa and levodopa (Sinemet) may experience severe rigidity, fever, a change in consciousness, and even death. "In the 1980s, a drug holiday was thought to reduce the side effects of the medication by resetting the brain receptors. But the evidence does not show a difference in long-term improvement. We now know there can be severe complications from abruptly withdrawing.

I feel that drug holidays have no role in treating Parkinson's disease," says Dr. Albert Hung, a Parkinson's disease specialist at Harvard-affiliated Massachusetts General Hospital.

Other medications you must never stop on your own include those to treat high or low blood pressure, diabetes, high cholesterol, severe pain, anxiety, or insomnia.

What if you're experiencing side effects from your medication, or you feel it isn't working? "That's not time for a holiday, but it may be time to switch to another drug. But, with your doctor's advice, be sure to taper one while starting another," says Dr. Michael Craig Miller, assistant professor of psychiatry at Harvard Medical School.

 

Is eating dried fruit healthy?

Ask the doctor


 Image: lola1960/iStock

Q. I love dried fruit and thought it was healthy. But I hear that you gain a lot of weight eating dried fruit, which is not healthy. What's the truth?

A. The truth is that the actress and comedian Mae West was wrong when she allegedly said "Too much of a good thing ... can be wonderful!" Food contains calories, and eating too many calories-even of healthy foods-leads to weight gain. But there are healthy calories and unhealthy ("empty") calories, and fruit is a healthy source of calories. That's as true of dried fruit as fresh fruit.

Why will the new food labels highlight added sugars?

The new Nutrition Facts labels will list “added sugars” in a serving of food. Until the labels appear, one should look for sugars such as dextrose and sucrose on a label’s list of ingredients.

Easy ways to build better bones

Strength training, weight-bearing exercise, a healthy diet, and medication can help.


Image: Tatomm/iStock

An estimated 10 million people in the United States are coping with the brittle, fragile bones of osteoporosis—a disorder that causes severe bone loss. It's most common in women, and the risk is higher in those who are thin, age 50 or older, or of Caucasian or Asian descent. It also occurs in men, who make up about 20% of osteoporosis cases. The condition puts a person at a high risk for bone fractures, disability, loss of independence, and even death. That's why it's important to make your bones as strong as possible. "There are many ways to build bone mass, and the people who do tell us they feel stronger and more capable on their feet," says Rachel Wilson, a physical therapist at Harvard-affiliated Brigham and Women's Hospital.

There isn't one magic way to build bone mass. It takes a number of the following strategies.

How to avoid the health risks of too much salt

Stick to fresh foods, and fill your salt allotment from healthy sources like whole-grain breads.


 Image: Michael Carroll Photography

As we reported in August 2016, the FDA is encouraging the food industry to cut back on added sodium in commercially processed and prepared food. It's a good reminder for all of us that too much salt in the diet is risky for health. How much is too much? "It's controversial, although I don't think anyone is in favor of unlimited salt intake," says Dr. Randall Zusman, a cardiologist with Harvard-affiliated Massachusetts General Hospital.

Salt risks

How much is too much?

So what's the controversy about? It centers on how much salt is safe for consumption, and it's still being debated. The American Heart Association recommends a limit of 1,500 milligrams (mg) per day. The FDA recommends a limit of 2,300 mg of sodium per day. The U.S. Dietary guidelines used to recommend a limit of 1,500 mg per day for a wide swath of people (everyone 51 and older, all African Americans, and anyone with high blood pressure, kidney disease, or diabetes), but this year changed it to 1,500 mg per day only for people with high blood pressure, and 2,300 mg for everyone else.

Common sources of sodium

What you should do

It's best to avoid processed food. Choose fresh, frozen (no sauce or seasoning), or no-salt-added canned vegetables, and opt for fresh poultry, seafood, and lean meat, rather than processed meat and poultry.

Krivitsky recommends limiting sodium to 500 or 600 mg per meal, and making sure it comes from healthy sources, like whole-grain breads and cereals.

How can you find out about sodium content? Start reading Nutrition Facts labels. You really can find low-sodium options. For example, one cup of Post Shredded Wheat has no sodium, and half a cup of Prego No Salt Added pasta sauce has just 40 mg of sodium.

Krivitsky also recommends ditching saltshakers and flavoring food instead with spices, such as cumin, rosemary, basil, ginger, or dill; flavored vinegars; and lime or lemon juice. "Low salt doesn't mean less flavor," points out Krivitsky. "It just means less salt."

How about a salt substitute?

When you want to add something salty to food, a salt substitute may do the trick. Substitutes are made from potassium chloride, which is similar to table salt (sodium chloride).

Substitutes fall into two categories: low-sodium or "light" salt, which replaces up to half of the sodium chloride with potassium chloride, and no-sodium or "salt-free" salt, which contains only potassium chloride.

For some people, potassium chloride can leave a bitter aftertaste. People with certain types of heart or kidney disease, or taking certain potassium-retaining medicines, may be told to avoid potassium-based substitutes. For others, potassium chloride is advisable: it not only helps avoid excess sodium, but also helps lower blood pressure.

 

 

 

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