Vitamins, minerals & supplements Archive

Timing may improve potency and help you cope with side effects.

We all want our medicines to be as effective as possible, and that requires effort on our part. It may be necessary to avoid taking pills with certain foods or drinks, and to check that medications won't interfere with each other.

And in some cases, it may be important to take a drug at a particular time of day. This approach, known as chronotherapy, is gaining attention as research suggests a relationship between when we take medications and how well they work.

Ask the doctor

Q. I've taken blood pressure medicines every morning for many years, and they keep my pressure under control. Recently, my doctor recommended taking them at bedtime, instead. Does that make sense?

A. It actually does make sense — based on recent research. For many years, there have been at least three theoretical reasons for taking blood pressure medicines before bedtime. First, a body system that strongly affects blood pressure, called the renin-angiotensin system, has its peak activity during sleep. Second, circadian rhythms cause differences in the body chemistry at night compared with daytime. Third, most heart attacks occur in the morning, before medicines taken in the morning have a chance to "kick in."

Look for whole-grain breads with the fewest ingredients possible.

It takes just four ingredients to create bread: flour, yeast, water, and salt. After a little kneading and some time in the oven, they transform into a hearty dietary staple that can add texture to your breakfast or structure to your sandwich. But the type of flour, plus additional ingredients, can make or break bread's nutritional value.

What makes bread healthy?

Healthy bread starts with flour that comes from whole grains, such as whole wheat, oats, brown rice, rye, or barley.

News briefs

As we've reported before, eating or drinking heavily processed foods — like sugary drinks, chicken nuggets, frozen dinners, or sweetened cereals — is associated with an increased risk for weight gain, heart disease, and even early death. Now a large observational study published online Dec. 16, 2019, by JAMA Internal Medicine links the consumption of such "ultraprocessed" food to an increased risk for developing diabetes. Researchers evaluated the questionnaire responses of more than 100,000 diabetes-free people (average age about 43) over six years. People who ate the most ultraprocessed foods (about 22% of their diet) had a higher risk for developing diabetes compared with people who ate the least amount of ultraprocessed foods (about 11% of their diet). The risk for developing diabetes went up 15% for a 10-percentage-point increase in the amount of ultraprocessed food in the diet. The connection held up even after scientists accounted for known risk factors for diabetes, such as weight and physical activity. The takeaway: Skip processed foods in favor of whole foods, including lots of vegetables, fruits, legumes, and whole grains.

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They can offer temporary pain relief, but are they right for you?

If you're battling with a flare-up of arthritis, bursitis, or tendinitis, you may find relief from an injection of cortisone (a type of steroid).

"People turn to injections when conservative treatments like over-the-counter and prescription pain medication or physical therapy no longer work, and their pain begins to interfere with quality of life," says Dr. Rob Shmerling, clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center.

In the journals

People with heart disease also have a higher risk of developing cancer, according to research presented at the American Heart Association's Scientific Sessions in November 2019.

Researchers evaluated data from 12,712 people from the Framingham Heart Study who did not have heart disease or cancer at the study's launch. They used a risk estimator that predicts a person's chance for getting heart disease within 10 years.

Ask the doctors

Q. I've heard a lot recently about inflammation being a health risk, but I'm not sure I really understand what it is. Can you explain?

A. When people talk about inflammation, they're actually talking about your immune system's response to a perceived injury or infection. When you're injured, this inflammation is actually a good thing. The area you injured will become red and swell as an army of beneficial white blood cells flow in to fight infection and help you heal. The same response occurs in other parts of your body when you encounter a virus or infection. But sometimes this immune response occurs when it shouldn't. It can be triggered, for example, when you are exposed to toxins, and by other causes such as chronic stress, obesity, and autoimmune disorders. In these cases, instead of moving in, healing the problem, and then returning to normal, the inflammation persists over time. It's thought that this chronic state of inflammation can lead to numerous health problems, including heart disease, arthritis, depression, Alzheimer's disease, and even cancer.

Ask the doctors

Q. I recently started experiencing a lot of pain in my hand from osteoarthritis. Can I reverse this condition?

A. You can't reverse osteoarthritis, but there are things you can do to manage your pain and improve your symptoms. Osteoarthritis occurs when the protective cartilage that acts as cushioning between your bones starts to fray and wear down over time. Eventually this enables the bones to rub together, which causes the pain you are experiencing as well as swelling and stiffness that makes it difficult to move your hand freely. Typically, when you have arthritis, the pain and symptoms will be worse at some times than at others. You may experience a flare-up one day and feel better the next. To help reduce the discomfort of a flare-up, talk to your doctor about medication to relieve pain. She or he may recommend an over-the-counter pain reliever. Some people also get symptom relief using a topical pain reliever that is rubbed into the skin. Other strategies that can ease pain are splints or braces, heat or cold therapy, activity modification, and exercises or physical therapy to increase flexibility and strengthen your hand muscles.

As long as the nutrient profile is the same, choosing one or the other is really about preference.

Plant-based milks line the shelves in the refrigerator section of most supermarkets these days: soy milk, almond milk, cashew milk, even milk made from rice, oats, or peas. Choosing a plant-based product seems like it would be a healthy option. But is it always? And is it better for you than drinking cow's milk?

We asked Vasanti Malik, adjunct assistant professor of nutrition at the Harvard T.H. Chan School of Public Health, for some advice on how to choose the best product.

Your salt shaker usually isn't the worst culprit. Instead, check your condiments, sauces, and spice blends, many of which are high in sodium.

For decades, health experts — especially cardiologists — have been telling people to eat less sodium, one of the main components of salt. Most Americans still consume far too much of this mineral, which raises blood pressure and the risk of heart disease.

Despite these warnings, the average sodium intake in this country is around 3,200 milligrams (mg) per day. That's about 30% more than is recommended by the federal dietary guidelines, which advise people to limit their daily sodium to 2,300 mg. And it's more than twice the target suggested by the American Heart Association of 1,500 mg per day.