Staying Healthy Archive

Q. My doctor says I should switch to the generic version of Lipitor, but is it really the same as Lipitor?

A. Many of my patients are asking the same question. My answer to them and to you is pretty much the standard advice: the generic version of Lipitor, called atorvastatin, is highly likely to be just as safe and effective as Lipitor, but also cheaper. And under most health insurance plans, that means cheaper for you, because of lower co-pays, not just for the insurance company.

A good night's sleep is remarkably powerful. It restores mind and body, preparing both for the challenges that lie ahead. Without restful sleep, mood, concentration, and mental performance suffer. Sleep deprivation is a major cause of car crashes and other accidents, and it has been linked to important medical problems ranging from hypertension, obesity, and diabetes to heart disease, erectile dysfunction, and possibly even prostate cancer.

Health-conscious men don't take sleep for granted, and scientists don't either. In fact, research suggests that even a brief nap may help boost learning, memory, and creative problem solving — all while your head is on the pillow.

Oversimplification is something to be leery of, maybe especially when it comes to health and medicine. Treatments have drawbacks, pills have side effects, and promises of prevention fall short and don't apply to everyone. But it's also possible to get bogged down in the details of study findings. So we thought we'd cut through the clutter and pick out three concrete things that you can do for your health. No, you won't find any guarantees here, but improving your odds is worth the effort.

1. Keep a lookout for sodium

Some people may be more sensitive to sodium than others, but harmful health effects are the rule, not the exception. Dozens of studies have shown an association between high sodium intake and high blood pressure. Others have linked sodium to heart disease and stroke.

Harvard Health Publications, publisher of the Harvard Health Letter, and the Harvard School of Public Health's nutrition department developed the Healthy Eating Plate as an alternative to the federal government's MyPlate eating guide. We conferred with Dr. Walter C. Willett, chair of the nutrition department and a member of the Health Letter's Editorial Board, to answer your questions about it. You can find the full version of the plate at www.health.harvard.edu/plate/healthy-eating-plate.

Why aren't eggs included as a healthy protein on the Healthy Eating Plate?

Overdoses and drug interactions are to blame.

Some medications are notorious for having potentially serious side effects. Barbiturates, muscle relaxants, certain antihistamines — take too much of them, or take them with certain other medications, and you can wind up in serious trouble and possibly in the hospital. The risk is especially high for older people. With age, medications tend to have a more pronounced effect and linger in the body longer.

But researchers at the federal Centers for Disease Control and Prevention (CDC) and Emory University found that the medications typically flagged as having serious effects are not the ones that most commonly result in emergency hospitalizations among older Americans.

Ideally, the weather would stay just at 80.6 degrees F. At that temperature, the naked, resting human body is "thermoneutral": the heat it generates matches the heat lost to the air around it.

But rare is that kind of Eden, so the human body adapted. In the heat, the evaporation of sweat cools us off. In the cold of northern latitudes this time of year, blood vessels near the surface squeeze tight so blood is shunted deeper into the body. That transfer has several effects. The brain, the heart, and other important organs stay toasty, albeit at the expense of the now blood-depleted hands and feet. The lack of superficial blood flow greatly increases the insulating properties of the skin, the subcutaneous layer of fat just underneath it, and nearby muscles. And, of course, there's shivering. It may not be comfortable, but those shaking muscles generate extra heat.

Obesity is a complex problem that scientists are still struggling to understand. In some cases, genetics seem responsible; in others, various combinations of hormonal, metabolic, and behavioral factors appear to play a role. But in most cases, it's hard to determine the exact cause of obesity.

It's difficult enough for a doctor to figure out why an individual patient has accumulated excess body fat. But what accounts for a worldwide epidemic of obesity? It's hard to understand how human genetics, hormone levels, or metabolic activity could change rapidly and simultaneously in millions of people, yet obesity has been increasing sharply throughout the industrialized world. In less than 40 years, the prevalence of obesity in the U.S. has increased by over 50%, so that two of every three American adults are now overweight or obese. Even worse, the obesity epidemic is rapidly spreading to our children.

Q. I do my best to exercise every day, either walking two miles in good weather or riding my exercise bike for 30 minutes on wet or cold days. Should I keep going when I catch a cold, or would I be better off resting?

A. Congratulations on your fine exercise program. Since you are working out at a moderate level, it is important for you to exercise nearly every day — but it's also important for you to obey the first commandment of exercise: Listen to Your Body.

Q. When I awaken in the morning, I have terrible bad breath. My breath seems okay during the rest of the day, but I worry about developing halitosis. What causes bad breath?

A. Bad breath is a common problem, especially first thing in the morning ("morning breath"), but also during the day (halitosis).

A book outlines what you can do to heal as well as possible.

During the year or two after surgery or treatment for a serious medical problem, many people find they need help to feel better emotionally and physically but don't know where to turn. In You Can Heal Yourself (St. Martin's Paperbacks, 2012), Dr. Julie Silver, assistant professor of physical medicine and rehabilitation at Harvard Medical School and chief editor of books at Harvard Health Publications (which publishes Harvard Women's Health Watch), details practical steps you can take for optimal healing. Her recommendations are based on research and, says Dr. Silver, "years of listening to my patients tell me what helps them and what doesn't." We talked to her about some of the ideas behind You Can Heal Yourself.