Staying Healthy Archive

Summertime, and the living is easy — if you stay healthy, that is. Most men think of winter as the "sick season," but summer's seasonal woes can creep up on you when you least expect them. Here are a few tips for staying cool, dealing with the sun's awesome radiant energy, managing poison ivy, and warding off the insects that like summer as much as you do.

Heat and humidity

Heat can turn an August day into a medical crisis. But with simple precautions, you can stay safe this summer.

Q. I really appreciate the dietary guidelines that you publish from time to time, but my wife and I find it hard to do the math in a busy supermarket. Can you give us targets that are easier to use than "percentages of daily calories"?

A. I understand the problem, and I'll try to help. The reason we use percentages of daily calories is that dietary needs vary from person to person. But let's do the math for a hypothetical person, and then give you a template so you can run the numbers for yourself.

Editor's Note: Dr. Suzanne Salamon is joining the Health Letter's editorial board. Dr. Salamon is associate chief for geriatric clinical programs at Harvard-affiliated Beth Israel Deaconess Medical Center in Boston. We interviewed her in her office.

When should someone see a geriatrician?

The vast majority of older patients are doing just fine with their own internal medicine doctor. We tend to see patients who have many medical problems, are seeing multiple specialists, and are taking many medications. This can get complicated and difficult to coordinate, so some doctors will tell their patients that they would benefit from seeing a geriatrician.

Even in our competitive globalized economy, America has retained its leadership in biomedical research and medical innovation. Although it takes years for basic research to be translated into clinical advances, patients are already benefiting from many new diagnostic tests, genetically engineered drugs, and medical devices that would have been considered fantastic just a few years ago.

Like other areas of medicine, advances in surgery are often driven by technology; laparoscopic hernia repairs and robot-assisted radical prostatectomies are just two of many examples.

Hopes that vitamin supplements can fend off cancer, cognitive decline, and other health problems keep on getting dashed. The arc is pretty familiar. Epidemiologic studies, often with animal experiments and lab-based research thrown in, suggest protective effects. But results from randomized clinical trials show no effect. The bubble of optimism pops, and the public attitude toward nutrition science and advice sours.

There are several explanations for why this happens. People inclined to take vitamins often have good health habits, and those health habits, rather than the vitamins, may be responsible for the positive effects seen in epidemiologic studies, despite good-faith efforts (and fancy statistical techniques) used by researchers to separate them out. Vitamins in food may be one thing, vitamins in pill form, another. Short trials may not last long enough for vitamins to have a pronounced effect on some of the diseases being studied. And in longer ones, compliance with taking a test nutrient often falls off, diminishing the contrast with the control group and increasing the chances that the results won't show any difference between those who took the nutrient and those who didn't.

Weight, warm skin, and the angle of the sun are among the determinants.

When an Institute of Medicine (IOM) panel made long-awaited vitamin D recommendations late in 2010, one of the messages was that most Americans probably have enough of the vitamin circulating in their blood to get its main proven benefit, protection of bones. But in 2011, the National Center for Health Statistics released data that paint a less rosy picture. According to the center's numbers, almost one in three Americans has vitamin D blood levels below 20 nanograms per milliliter (ng/ml), the threshold that the IOM panel said is needed for good bone health. Besides, many experts think the IOM panel was too cautious and that we'd be better off if our vitamin D levels were considerably higher than 20 ng/ml.

These evolving guidelines continue to get better and more helpful.

Every five years, the federal government revises the Dietary Guidelines for Americans. The 2010 edition (issued a few months into 2011) was more a facelift than a makeover — a few wrinkles removed here, some definition added there.

Q. My teenage daughter wants us to switch from sugar to honey for health reasons. Is honey really any healthier than sugar?

A. People began to use honey as a sweetener long before cane and beet sugar came into use. Despite this long history, it's not clear if honey has particular health benefits.

Researchers are exploring the many ways in which music may influence health, from stress relief to athletic performance.