Tag Archives: health

New Advice to Move More After a Concussion

When young athletes sustain concussions, they are typically told to rest until all symptoms disappear. That means no physical activity, reading, screen time, or friends, and little light exposure, for multiple days and, in severe cases, weeks.

Restricting all forms of activity after a concussion is known as “cocooning.” But now new guidelines, written by an international panel of concussion experts and published this month in the British Journal of Sports Medicine, question that practice. Instead of cocooning, the new guidelines suggest that most young athletes should be encouraged to start being physically active within a day or two after the injury.

“The brain benefits from movement and exercise, including after a concussion,” says Dr. John Leddy, a professor of orthopedics at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, and one of the co-authors of the new guidelines.

There has long been controversy, of course, about the best ways to identify and treat sports-related concussions. Twenty years ago, athletes who banged their heads during play were allowed to remain in the practice or game, even if they stumbled, seemed disoriented, or were “seeing stars.” Little was known then about any possible immediate or long-term consequences from head trauma during sports or about the best responses on the sidelines and afterward.

Since then, mounting evidence has indicated that sports-related concussions are not benign and require appropriate treatment. The question has been what these appropriate treatments should be.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Wellness Efforts Need to Address Five Important Risk Factors

Employer-sponsored health plans cover more than half of the country’s nonelderly population, which is approximately 147 million people. Half to 70 percent of employers now offer high-deductible health plans, which encourage employees to take an active role in deciding the type of care they need. This requires employers to educate employees to become smarter healthcare consumers and to become motivated to take action.

Workplace wellness programs have the ability to help employees take action in the right direction toward healthy living. They have the potential to keep employees healthy and productive, avoid illness and absenteeism, and save them money by consuming fewer healthcare resources. Workplace health promotion programs that can do all that will provide value to employees and now just need to be cost-effective at the same time.

Many small and mid-size companies are unsure if they have resources to support a comprehensive program. However, more and more experts suggest looking to scientific evidence to gain a best practices approach to developing company-wide wellness initiatives. By focusing on five major risk factors, it is believed that employers of all sizes can positively impact overall health and productivity at work.

Five Wellness Initiatives to Target in 2017

According to the 2015 From Evidence to Practice: Workplace Wellness that Works Study an effective wellness program needs to address the following five basic health concerns through creative and empowering strategies: exercise, nutrition, tobacco cessation, stress management and sleep.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

 

You Can Take Steps to Lower Your Breast Cancer Risk

Fear of breast cancer is widespread, yet many women don’t realize that adopting protective living habits may help keep it at bay. The habits described below may also help to ward off other life-threatening ills, like heart disease and diabetes.

Certainly, women have ample reason to worry about breast cancer. The disease is very common. One woman in eight in the United States will develop it in the course of a lifetime. The American Cancer Society estimates that this year 252,710 new cases of invasive breast cancer will be diagnosed, and 40,610 women will die from the disease.

Regular screening is touted as the most effective way to reduce breast cancer deaths, although experts continue to debate who should be screened, how often and at what ages. But not nearly enough is said about what women can do on their own to lower their risk of getting breast cancer in the first place.

One of the most important actions is an inaction: not smoking. The incidence of smoking has fallen significantly in the last half century, yet every day on the streets of New York I still see young women and teenage girls smoking. A decades-long study conducted among 102,098 women in Norway and Sweden found that, compared with nonsmokers, those who smoked 10 or more cigarettes a day for 20 or more years had a third higher risk of developing invasive breast cancer, and girls who started smoking before age 15 were nearly 50 percent more likely to get breast cancer.

An editorial in The Journal of Clinical Oncology last year stated that as many as 20,000 women in the United States continue to smoke even after a diagnosis of breast cancer. The authors, Dr. Barbara A. Parker and John P. Pierce of the University of California, San Diego, said breast cancer patients who quit smoking can add significantly to the benefits of postoperative chemotherapy and radiation.

Another important factor under personal control is weight. As body mass index, or B.M.I., rises, so does a woman’s risk of developing breast cancer, especially if she carries much of her excess weight around her waist. That’s because abdominal fat is particularly metabolically active, producing growth factors and hormones, including estrogen, that can stimulate the growth of breast cancer cells.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

 

An Hour of Running May Add 7 Hours to Your Life

Running may be the single most effective exercise to increase life expectancy, according to a new review and analysis of past research about exercise and premature death. The new study found that, compared to nonrunners, runners tended to live about three additional years, even if they run slowly or sporadically and smoke, drink or are overweight. No other form of exercise that researchers looked at showed comparable impacts on life span.

The findings come as a follow-up to a study done three years ago, in which a group of distinguished exercise scientists scrutinized data from a large trove of medical and fitness tests conducted at the Cooper Institute in Dallas. That analysis found that as little as five minutes of daily running was associated with prolonged life spans.

After that study was released, the researchers were inundated with queries from fellow scientists and the general public, says Duck-chul Lee, a professor of kinesiology at Iowa State University and a co-author of the study. Some people asked if other activities, such as walking, were likely to be as beneficial as running for reducing mortality risks.

High-mileage runners wondered if they could be doing too much, and if at some undefined number of miles or hours, running might become counterproductive and even contribute to premature mortality.

And a few people questioned whether running really added materially to people’s life spans. Could it be, they asked rather peevishly, that if in order to reduce your risk of dying by a year, you had to spend the equivalent of a year’s worth of time on the trails or track, producing no discernible net gain?

So for the new study, which was published last month in Progress in Cardiovascular Disease, Dr. Lee and his colleagues set out to address those and related issues by reanalyzing data from the Cooper Institute and also examining results from a number of other large-scale recent studies looking into the associations between exercise and mortality.

Over all, this new review reinforced the findings of the earlier research, the scientists determined. Cumulatively, the data indicated that running, whatever someone’s pace or mileage, dropped a person’s risk of premature death by almost 40 percent, a benefit that held true even when the researchers controlled for smoking, drinking and a history of health problems such as hypertension or obesity.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

 

Should 15,000 Steps a Day Be Our New Exercise Target?

Taking 10,000 steps per day is often suggested as a desirable exercise goal for people who wish to improve their health. But a new study of postal workers in Scotland suggests that that number could be too conservative and that, to best protect our hearts, many of us might want to start moving quite a bit more.

It has been almost 70 years since the publication of the London Transit Workers Study, a famous work in which researchers tracked the heart health of London bus drivers and conductors. They found that the conductors, who walked up and down bus aisles throughout the workday, were substantially less likely to develop or die from heart disease than the drivers, who sat almost constantly while at work.

This study was one of the first to persuasively show that being physically active could lower someone’s risk for heart disease, while being sedentary had the opposite effect.

Since then, countless large-scale studies have substantiated that finding, and at this point, there is little doubt that moving or not moving during the day will affect the health of your heart.

So for the new study, which was published this month in The International Journal of Obesity, researchers at the University of Warwick in England and other institutions decided to refer back to but also advance and expand upon the results of that foundational Transit Workers Study by examining another group of employees whose workdays involve mostly walking or sitting. They turned to postal workers in Glasgow, Scotland.

The Glaswegian mail carriers generally cover their routes on foot, not by driving, and spend many hours each day walking, the scientists knew. But the mail service’s office workers, like office workers almost everywhere, remain seated at their desks during the bulk of the workday.

This sharp contrast between the extent to which the workers move or sit during the day could provide new insights into the links between activity and health, the scientists felt.

They began by recruiting 111 of the postal-service workers, both men and women, and most between the ages of 40 and 60. None had a personal history of heart disease, although some had close relatives with the condition.

The researchers measured volunteers’ body mass indexes, waist sizes, blood sugar levels and cholesterol profiles, each of which, if above normal, increases the chances of cardiac disease.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Pop a Pill for Heartburn? Try Diet and Exercise Instead

Many Americans would rather take a drug than change their habits to control a persistent ailment. Yet, every medication has side effects, some of which can be worse than the disease they are meant to treat. Drugs considered safe when first marketed can turn out to have hazards, both bothersome and severe, that become apparent only after millions of people take them for a long enough time.

Such is the case with a popular class of drugs called proton pump inhibitors, or P.P.I.s, now used by more than 15 million Americans and many more people worldwide to counter an increasingly common ailment: acid reflux, which many people refer to as heartburn or indigestion.

These medications are now linked to a growing number of complications, ranging in seriousness from nutrient deficiencies, joint pain and infections to bone fractures, heart attacks and dementia. While definitive evidence for most of the risks identified thus far is lacking, consumers plagued by acid reflux would be wise to consider an alternative approach, namely diet and lifestyle changes that can minimize symptoms and even heal damage already done.

Acid reflux is more than just a nuisance. It involves the backward flow of stomach acid into the tissues above it. It results when the lower esophageal sphincter, a ring of muscle between the esophagus and the stomach, fails to close tightly enough to prevent the contents of the stomach from moving up instead of down. Sometimes the upper sphincter, between the esophagus and the throat, malfunctions as well.  Acid reflux is a serious disorder that can and must be treated to prevent symptoms and stave off potentially life-threatening consequences. Known medically and commercially as GERD, the acronym for gastroesophageal reflux disease, repeated bathing of the soft tissues of the esophagus with corrosive stomach acid can seriously damage them and even cause esophageal cancer, which is often fatal.

Contrary to what many believe, heartburn is but one of the many symptoms of GERD, and failure to recognize the others when heartburn is not among them can result in harmful untreated reflux. In addition to indigestion, GERD can cause a persistent dry cough, sore throat, frequent throat clearing, hoarseness, burping or hiccups, bloating, difficulty swallowing and a sensation of a lump in the throat.

If, when faced with such an otherwise unexplainable symptom, your doctor fails to think of GERD as a possible reason, you might suggest it yourself. An examination of the esophagus may be the only way to find out if someone without obvious heartburn has acid reflux but doesn’t know it.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Lower Back Ache? Be Active and Wait It Out, New Guidelines Say

Dr. James Weinstein, a back pain specialist and chief executive of Dartmouth-Hitchcock Health System, has some advice for most people with lower back pain: Take two aspirin and don’t call me in the morning.

On Monday, the American College of Physicians published updated guidelines that say much the same. In making the new recommendations for the treatment of most people with lower back pain, the group is bucking what many doctors do and changing its previous guidelines, which called for medication as first-line therapy.

Dr. Nitin Damle, president of the group’s board of regents and a practicing internist, said pills, even over-the-counter pain relievers and anti-inflammatories, should not be the first choice. “We need to look at therapies that are nonpharmacological first,” he said. “That is a change.”

The recommendations come as the United States is struggling with an epidemic of opioid addiction that often begins with a simple prescription for ailments like back pain. In recent years, a number of states have enacted measures aimed at curbing prescription painkillers. The problem has also led many doctors around the country to reassess prescribing practices.

The group did not address surgery. Its focus was on noninvasive treatment.

The new guidelines said that doctors should avoid prescribing opioid painkillers for relief of back pain and suggested that before patients try anti-inflammatories or muscle relaxants, they should try alternative therapies like exercise, acupuncture, massage therapy or yoga. Doctors should reassure their patients that they will get better no matter what treatment they try, the group said. The guidelines also said that steroid injections were not helpful, and neither was acetaminophen, like Tylenol, although other over-the-counter pain relievers like aspirin, naproxen or ibuprofen could provide some relief.

Dr. Weinstein, who was not an author of the guidelines, said patients have to stay active and wait it out. “Back pain has a natural course that does not require intervention,” he said.

In fact, for most of the people with acute back pain — defined as present for four weeks or less that does not radiate down the leg — there is no need to see a doctor at all, said Dr. Rick Deyo, a spine researcher and professor at the Oregon Health and Science University in Portland, Ore., and an author of the new guidelines.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Getting Older, Sleeping Less

Insomnia is like a thief in the night, robbing millions — especially those older than 60 — of much-needed restorative sleep. As the king laments in Shakespeare’s “Henry IV, Part 2”: O sleep, O gentle sleep, Nature’s soft nurse, how have I frightened thee. That thou no more will weigh my eyelids down, And steep my senses in forgetfulness?

The causes of insomnia are many, and they increase in number and severity as people age. Yet the problem is often overlooked during routine checkups, which not only diminishes the quality of an older person’s life but may also cause or aggravate physical and emotional disorders, including symptoms of cognitive loss.

Most everyone experiences episodic insomnia, a night during which the body seems to have forgotten how to sleep a requisite number of hours, if at all. As distressing as that may seem at the time, it pales in comparison to the effects on people for whom insomnia — difficulty falling asleep, staying asleep or awakening much too early — is a nightly affair.

A survey done in 1995 by researchers at the National Institute on Aging among more than 9,000 people aged 65 and older living in three communities revealed that 42 percent reported difficulty with both falling asleep and staying asleep. The numbers affected are likely to be much larger now that millions spend their pre-sleep hours looking at electronic screens that can disrupt the body’s biological rhythms.

Insomnia, Dr. Alon Y. Avidan says, “is a symptom, not a diagnosis” that can be a clue to an underlying and often treatable health problem and, when it persists, should be taken seriously. Dr. Avidan is director of the sleep clinic at the University of California, Los Angeles, David Geffen School of Medicine.

So-called transient insomnia that lasts less than a month may result from a temporary problem at work or an acute illness; short-term insomnia lasting one to six months may stem from a personal financial crisis or loss of a loved one. Several months of insomnia are distressing enough, but when insomnia becomes chronic, lasting six months or longer, it can wreak serious physical, emotional and social havoc.

In addition to excessive daytime sleepiness, which can be dangerous in and of itself, Dr. Avidan reports that chronic insomnia “may result in disturbed intellect, impaired cognition, confusion, psychomotor retardation, or increased risk for injury.” Understandably, it is often accompanied by depression either as a cause or result of persistent insomnia. Untreated insomnia also increases the risk of falls and fractures, a study of nursing home residents showed.

There are two types of insomnia. One, called primary insomnia, results from a problem that occurs only or mainly during sleep, like obstructive sleep apnea, restless leg syndrome (which afflicts 15 to 20 percent of older adults), periodic limb movements or a tendency to act out one’s dreams physically, which can be an early warning sign of Parkinson’s disease.

Unless noted by their bed partners, people with primary sleep disorders may not know why their sleep is disrupted. An accurate diagnosis often requires a professional sleep study: spending a night or two in a sleep lab hooked up to instruments that record respiration, heart rate, blood pressure, bodily movements and time spent in the various stages of sleep.

The other, more common type of insomnia is secondary to an underlying medical or psychiatric problem; the side effects of medications; behavioral factors like ill-timed exposure to caffeine, alcohol or nicotine or daytime naps; or environmental disturbances like jet lag or excessive noise or light — especially the blue light from an electronic device — in the bedroom.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

‘Weekend Warriors’ Show Survival Benefits

Working out only on the weekends or otherwise compressing your total physical activity into one or two prolonged runs or a single vigorous basketball or soccer game each week could lessen your risks of dying prematurely almost as effectively as more frequent, shorter workouts spread throughout the week, according to an interesting new study of the so-called weekend warrior phenomenon.

As most of us have heard by now, the standard recommendation about how much exercise we should complete each week for health purposes is 150 minutes of moderate or 75 minutes of vigorous physical activity. Moderate exercise consists of activities like brisk walking or easy cycling that raise heart rates while still allowing us to talk to training partners, and vigorous activities are those like running, fast-paced cycling, and many team sports, including basketball and soccer, that raise heart rates into a zone where speaking is difficult.

Meeting these guidelines is associated with a substantially reduced risk of developing a wide range of diseases and dying too young.

The guidelines also suggest that, for practical purposes, people consider breaking the 150 minutes into five moderate 30-minute sessions each week or a comparable number of shorter, more vigorous workouts.

But many people apparently do not have the time or inclination to exercise five times per week. About a third of American adults engage in zero weekly exercise and others pack their workouts into one or two sessions on Saturday or Sunday, when they have more free time.

There has been little information, though, about whether the weekend warrior pattern of exercise lowers the risk for premature death as effectively as more frequent and generally shorter workouts.

So for the new study, which was published on Monday in JAMA Internal Medicine, researchers at Loughborough University in England and other institutions decided to delve into the exercise routines of tens of thousands of men and women already participating in the Health Survey for England and the Scottish Health Survey.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Work. Walk 5 Minutes. Work.

Stuck at your work desk? Standing up and walking around for five minutes every hour during the workday could lift your mood, combat lethargy without reducing focus and attention, and even dull hunger pangs, according to an instructive new study.

The study, which also found that frequent, brief walking breaks were more effective at improving well-being than a single, longer walk before work, could provide the basis for a simple, realistic New Year’s exercise resolution for those of us bound to our desks all day.

There is growing evidence, of course, that long bouts of uninterrupted sitting can have undesirable physical and emotional consequences. Studies have shown that sitting motionless reduces blood flow to the legs, increasing the risk for atherosclerosis, the buildup of plaques in the arteries.

People who sit for more than eight or nine hours daily, which for many of us describes a typical workday, also are at heightened risk for diabetes, depression and obesity compared with people who move more often.

In response, researchers and some bosses have proposed a variety of methods for helping people reduce their sitting time at work, including standing workstations and treadmill desks.

But such options are cumbersome and costly, making them impractical for many work situations.

Some experts have worried, too, that if people are physically active at the office, they might subsequently become more tired, grumpy, distracted or hungry, any of which could have an undesirable effect on work performance and long-term health.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary