Monthly Archives: December 2014

New Year’s Resolution: Get More Exercise

When people think of broken New Year’s resolutions, ones that may not have even lasted a month, one of the first things that often comes to mind is "this year, I’m going to get more exercise." Gyms often waive their initiation fees for the first two weeks of January, or the entire month, to draw in eager new exercisers—and more than make it back when people who joined in the first wave of enthusiasm continue the membership without actually ever going. Resolutions often fail, but exercise seems to be particularly—or perhaps just publicly—difficult for people to stick to.

So why do people who are initially determined not to go to the gym end up not doing so? One part of it is that exercise is boring. People generally understand that actually putting in the work to exercise is needed to see results, but when they are looking at it prospectively people tend to overestimate their determination to go to the gym, overestimate their self-discipline, and underestimate the tedium of actually exercising. In particular, what is called "impact bias," a feature of how the mind works, causes people to overestimate how strongly and for how long they will maintain the future intention to go to the gym on a regular basis. When it comes to feel like a chore, people are motivated to dodge it.

That’s why experts recommend starting slowly and building up. Many people start out intending to go every day, in order to see results as soon as possible, in the hopes of developing a habit, and in an effort to remind themselves how serious they are about this. Unfortunately, an intense workout every day is likely to backfire. For a beginner, this can quickly become overwhelming, and seem like an impossible task. It also becomes tiresome sooner, as opposed to a once or twice a week gym night or morning being something to look forward to and savor the anticipation of. Four or five workouts a day may be possible in the long run—though every day is probably a bit excessive for most people—but it’s too much right from the outset.

New Year’s Resolution: Stress Less

After the busyness and pressure of the holiday season, it’s not surprising many people are determined to conquer stress when the time to make New Year’s resolutions rolls around. It’s a good idea regardless. Stress can contribute to heart disease, by increasing the heart-rate and raising blood pressure. It worsens asthma symptoms, and the children of a stressed person have a higher risk of developing asthma in the first place—to say nothing of the fact that stressed-out people are likely to be heavier smokers and create an environment with secondhand smoke. It leads to obesity, again both directly and indirectly through association with poor eating habits.

However, managing stress presents some obstacles. A certain amount of stress is fundamentally external, meaning it comes from other people whose actions the person experiencing stress cannot control. However, there are things that can be done to reduce the impact. Smiling more can help. Just as being happy makes people smile, smiling has been shown to make people happier, and less stressed. More broadly, keeping an optimistic outlook on life trying to can help make someone more mellow and chill. Spending time with friends, and building a friend network generally, can help mitigate stress by reducing feeling of isolation. Cutting back on caffeine can have a calming effect as well.

Sometimes, people make New Year’s resolutions that are not themselves about stress, but that can support stress reduction, whether or not that is an intended outcome. Some people may decide that this will be the year they meditate more, or do yoga, or even simply carve out time for themselves. All of these things are good for relaxing and reducing stress levels. Exercise is another common resolution with a calming effect on people. A good workout burns off adrenaline and gives a person the opportunity to get out aggressions. Spending less money, another common resolution, can lessen or eliminate a major cause of stress.

Other resolutions can hurt the cause. Things like eating better, quitting smoking, or cutting back or giving up alcohol all mean lower stress levels in the long run, but trying to do these things simultaneously with reducing stress is a recipe for disaster. Smoking, drinking, and eating comfort foods—which are not always especially healthy—are all helpful in momentary, temporary destressing, and the last two in particular may actually be helpful as temporary coping methods while building a long-term strategy that is healthier.

New Year’s Resolution: Quit Drinking

The New Year is a time of new beginnings. One of the most common new beginnings for people is resoling to quit drinking. Not necessarily people who have a drinking problem, but anyone who fears they might develop one in the future, who dimly senses one on the horizon, or just someone worried about the health effects of too much alcohol consumption even in people who are not addicted and who have control over that consumption—indeed, for some the point of the resolution is to demonstrate that control.

None of these are bad reasons. In fact, someone who does have a drinking problem, and who recognizes that, and is ready to quit, shouldn’t be waiting until the New Year to do so. That, indeed, is one of the problems faced by people who do make New Year’s resolutions to stop drinking alcohol: they risk losing the motivation when the day actually comes, particularly with Champagne typically being so central to the previous night’s revelry. Conversely, they may feel pressure, if only from themselves, to stop before they are actually ready to.

Part of the problem with giving up alcohol, particularly on one’s own, is that it doesn’t always feel good, even when the newly abstinent person recognizes on an intellectual level that they are doing the right thing. The immediate if temporary unhappiness may seem realer than the abstract reality that alcohol is causing problems or has the potential to cause problems. Similarly, while for many people, drinking may be negatively affecting their relationships with friends, family, and partners, what they see in the moment is only that a number of their social relationships involved alcohol, or interaction happened in bars, which can be an obstacle to quitting.

That’s why it’s important for someone who is trying to quit to look for ways to stay on track. Avoiding temptation is one of the most obvious—not keeping alcohol at home or at the office, and avoiding recreational activities in bars or other places whee alcohol is part of the environment, even if that means skipping a season of sports or a few months of pub trivia. Exercise and healthy eating—frequent resolutions themselves—can help with this one. The number one tip for sticking with all resolutions is this: it shouldn’t be all-or-nothing, one slip ends the whole thing. Acknowledge, it, try not to do it again, and move on.

New Year’s Resolution: Lose Weight

One of the most common—possibly the most common—New Year’s resolutions people make is "this year, I will lose weight." It is also one of the most commonly abandoned. People go into it full of good intentions, but somehow it doesn’t seem to happen. It’s not a problem of lack of discipline or will; often, it’s simply a matter of the words being easy to say—particularly in the heat of holiday overeating—but actually following through turns out to be a lot more difficult.

There are things someone can do that make it easier. Setting a specific target is one. Rather than a vague "lose weight," a better resolution is "lose X pounds" or "get under X pounds by a certain date, and stay there". Alternatively, the goal can be not a number, but a practice. The idea is something concrete and measurable, providing a specific course of action and a way of knowing if the resolution is indeed being worked on. Accountability is another motivator. Writing down the resolution, or better yet, telling a friend, lessens the temptation to cheat.

There are also some things it is important no to do. Setting unrealistic goals, or unrealistically strict regimens, can hamper efforts to be healthier by encouraging cheating, or abandoning the resolution entirely. Someone who falls short of a goal is likely to simply give up on the project entirely, and not be motivated to attempt to reach a target they know they won’t be able to. Things like constant weigh-ins or cutting out junk food—anything that makes weight loss a drag or a chore—also do more harm than good.

In fact, some experts suggest that making weight loss a resolution—even with a specific goal weight—may be one of the worst ways to develop healthier habits, for that very reason. By making weight loss seem like a burden and a mandate, someone who makes this resolution gives unhealthy behavior a forbidden-fruit appeal while instilling in themselves exactly the sort of negative emotions that lead people to turn to unhealthy comfort foods. Far better to just decide to eat better and develop a plan for that.

Sleepless Nights

There are a number of things that can keep a person up at night. Some of these things are thankfully rare, such as fatal familial insomnia, a genetic brain disease in which sufferers—about 100 in the two and a half centuries since it was discovered, from 40 families around the world—sleep progressively less over the course of 18 months, ending in delirium and death.

Most insomnia, however, comes from more prosaic causes. It might be neurological problems, such as traumatic brain injury, or mental illnesses, such as depression, anxiety, schizophrenia, bipolar disorder, or others. It might be a physical illness, such as rheumatoid arthritis, or a side effect of medications such as corticosteroids. Excessive caffeine intake, or consumption late in the day, might be the culprit. It might be simple stress.

Unfortunately, insomnia can also cause stress. The vicious cycles are one of the most frustrating aspects of insomnia. Another example: insomnia can exacerbate depression or anxiety disorders. Moreover sleeplessness has a number of undesirable effects on a person’s daytime life. Being tired after being up all night means poor decision making aptitude, lack of concentration, and unhealthy eating habits. If one person in a couple is sleeping badly, and especially if both are, they will be worse at managing conflict within the relationship and will snap at each other more often and more viciously.

Treating insomnia generally focuses on environmental factors. Avoiding light, noise, and excitement late at night. Restricting caffeine and alcohol—which can interfere with sleep cycles—late in the day. Avoiding the bedroom except for sleeping, to strengthen the mental association. Maintaining a regular sleep schedule without naps. Using light to keep the brain’s circadian rhythm on track. Medications can be prescribed, but they can be habit-forming and can cause the patient to become accustomed to using drugs in order to sleep. Additionally, some of these drugs have worrying side effects.

Recently, a Harvard University neurologist proposed another potential solution to the problem, involving an area of the brain stem called the "parafacial zone." This is one of the structures responsible for automatic bodily functions such as breathing. The scientist says it is also responsible for sleep, and suggests targeted insomnia treatments that operate on the region directly may in the future treat insomnia without side effects or addition.

Chocolate And Health

Possibly one of the greatest inventions in culinary history, chocolate possibly seems to have health benefits over and beyond spreading happiness. In fact, perhaps counter-intuitively, dark chocolate has he power to help fight obesity and type 2 diabetes. The key is a type of antioxidant—a compound that helps prevent certain kinds of cell damage—called a flavonol, in particular flavonols of a type referred to as "oligomeric procyanidins." In a study, these flavonols helped keep weight down even in experimental specimens given diets high in fat. Preventing obesity is an important part of avoiding type 2 diabetes, but dark chocolate has a direct effect on that as well. The same compounds were found to improve insulin utilization, meaning the body processes glucose more efficiently, avoiding type 2 diabetes.

While the compound was studied in laboratory animals, there is evidence that it works in human beings as well. In particular, teenagers who eat lots of chocolate generally have lower levels of body fat than their diets (beyond chocolate) might be expected to lead to. Adolescents in Europe who reported on surveys high levels of chocolate consumption were found to have lower BMIs and smaller waists regardless of how much exercise the were getting. An earlier study had found similar results among adults, that regular chocolate-eaters are leaner than those who indulge only rarely. The teen years, however, are where eating habits often develop, and overall health during that period often has lasting effects.

Researchers say the secret to why chocolate is so healthful is in the stomach. Humans have bacteria called gut microbiota to thank for making chocolate something so beneficial. These bacteria, which line the intestinal tract and other parts of the digestive system, play a vital role in digestion in general, and some of them eat chocolate. When they do, they ferment it, seizing on the sugars and producing anti-inflammatory chemicals. The also make it possible for the flavonols to be digested.

The anti-inflammatory compounds mean dark chocolate is also good for hear health. These chemicals make the blood vessels wider and more flexible, and preventing blood cells from adhering to the walls, lowering stroke risk.

Who Is At Risk For Renal Disease

Chronic kidney disease often is not felt or recognized until kidney function is almost completely gone. Although it gets progressively worse over a period of months, symptoms don’t generally appear until around three-fourths of the function has already been lost. However, even though there are no noticeable symptoms of renal disease in the early stages, there is still damage occurring. While generally the value of screening is negligible in people who don’t already show signs of kidney trouble, regular screening is recommended for people who are at risk. That means obese people, smokers, people with high blood pressure or heart problems, people with a family history of kidney failure, people over 60, diabetics, and black, Asian, and Native American people.

Not only are people from racial minority backgrounds more prone to kidney disease due to genetics, studies now suggest that socioeconomically disadvantaged people—poor people and members of racial minorities—are more prone to kidney disease and tend to have worse outcomes when they do have kidney disease, with it being far more likely to lead to complete kidney failure than for the population overall. The researchers say this study is a first step towards shrinking this gap by improving outcomes for these population.

Treating renal disease is next to impossible, especially in the later stages. Most patients who progress all the way to kidney failure are forced to manage the disease by periodically using a dialysis machine, essentially a mechanical kidney. Instead of treatment, the primary focus is on prevention. Quitting smoking lowers risk of kidney disease, as does moderation in alcohol and over-the-counter pain medications—these can affect the digestive system, kidneys included, if taken too much. Maintaining a healthy weight can help, with one study suggesting the "Mediterranean diet," high in plant foods and low in red meat, lowers kidney disease risk.

However, possible treatments are being investigated, particularly to arrest the progress of the disease before the kidneys shut down entirely. Statins, used to lower cholesterol, are now being recommended to kidney patients as well. A separate research team found tat kidney disease is associated with poor metabolism, and fixing the metabolism might stop the disease from worsening.

Preventing And Treating Ovarian Cancer

As is often the case with the various forms of cancer, ovarian cancer, which is diagnosed in around 21,000 Americans each year, generally has no clear symptoms at first. This presents a major challenge to health care professionals, because early diagnosis is vital to treatment. Indeed, the survival rate in the early stages, before the tumor has spread, is more than double the overall survival rate for the disease, according to the Centers of Disease Control and Prevention.

While it is called "the silent killer," ovarian cancer is not wholly asymptomatic, but the symptoms are not always strongly felt and are not specific to cancer—heartburn, back pain, frequent urination, gastrointestinal difficulties, and other symptoms could be any of a number of conditions, though gastrointestinal symptoms that grow steadily worse as opposed to fluctuating may indicate cancer.

Genetically, ovarian cancer is linked with breast cancer; the same genetic mutations that cause someone to be prone to one also indicate a heightened risk of the other, and a family history of either means risk of contracting both. Beyond that, ovarian cancer risk is tied to ovulation. Earlier menarche, later menopause, and not having children are all risk factors, though hormonal birth control can reduce the risk, as can breastfeeding. For similar reasons, fertility treatments and hormone treatment after menopause make ovarian cancer more of a threat.

Researchers have found that a diet high in vitamin A and fiber can help prevent ovarian cancer, as well as compounds called flavonols found in black tea and in citrus. One study also found that women who went up a skirt size in adulthood were one-third more likely to develop caner after menopause. Eating habits are also linked to mortality in people who do get ovarian cancer. In another study, people who had been eating healthily before being diagnosed had a 27 percent lower mortality rate over five years.

A new form of chemotherapy could help doctors fight ovarian cancer more effectively. The approach helps deliver chemo drugs with greater efficiency, making them better at shrinking tumors and allowing lower doses. This approach is expected to also be particularly effective on late-stage ovarian cancer.

Metabolic Syndrome And Diabetes

"Metabolic syndrome" is a medical term referring to a confluence of symptoms that may not always cause distress themselves but that do indicate poor health and a dangerously high risk of other, serious problems later on. The syndrome occurs when someone is obese and has high blood pressure, high blood glucose, or a poor cholesterol profile. In particular, "central obesity," when fat is carried in the abdomen, is a diagnostic criterion. Elevated blood glucose itself indicates a diabetes precursor called insulin resistance. The relevant factors of the cholesterol profile ae triglycerides—high in metabolic syndrome—and HDL cholesterol, low in patients with the condition.

There is strong evidence of a genetic component to the risk of metabolic syndrome, meaning someone with a family history of the condition or of any of the diseases for which it is a risk factor should be careful, but there are a number of risk factors that can be controlled. Diet and exercise are factors; people who eat poorly—foods high in sugar or fat—and a sedentary lifestyle raise the risk of the condition the latter in women especially. People with certain medical conditions, such as polycystic ovarian syndrome or sleep apnea, are especially prone to metabolic syndrome as well.

Because of the insulin connection, people with metabolic syndrome are likely to get type 2 diabetes. Many people with metabolic syndrome have what is called insulin resistance, wherein the body produces insulin normally but the cells are unable to respond to it properly, leading to elevated blood glucose levels. This is a factor in the diagnosis of metabolic syndrome, but it is also a factor in the diagnosis of diabetes, the symptoms of which result from too much glucose in the blood. People with metabolic syndrome are also prone to getting heart disease.

The most common recommendation for people who have or are at risk of metabolic syndrome is to loose weight and exercise more—to address the causative factors of obesity and high blood pressure. It is particularly important for older people and people with a hereditary risk of the condition. A recent study found that eating a healthy breakfast can help avoid cravings for high fat foods later in the day, and help ward off metabolic syndrome.

Addressing Holiday Stress

Holiday time is a time for gathering and celebrating with loved ones, but for many, the joys of the season are not unmixed. Whether hosting or visiting, or a little of both, gatherings at this time of year can bring stress and worry. Add in the heightened expectations, the frantic preparations, and the multiple responsibilities, and it all ends up anything but a storybook celebration. The constant barrage of parties and holiday activity can take a toll on anyone. Despite the joy of the season, tempers often flare as people find themselves with seemingly too much to do and not nearly enough time to do it in or energy to do it with.

For many people, family is a source of stress. Even in happy families, the rush and confusion of holiday preparations can shorten tempers and stretch nerves. On top of that, far flung families—either living in different places or simply people who don’t talk to each other a lot—get together this time of year, and that means logistics of travel, as well as arguments and disagreements that can be suppressed during the year come ti the surface. More complex families have conflict about who’s spending time where. Even friends can have delicate balancing acts to walk this time of year.

So how to deal with this stress? One way is to simplify. There are always traditional dishes, but not everything on the holiday table needs to be made from scratch, and the traditional dishes don’t need to be made by the host. In fact, "have to"s should be kept to a minimum overall, though there will be some. Spread visits to family and friends as much as possible to avoid being overwhelmed, perhaps seeing people the weekend or evening before the holiday, or the day after.

Not every source of tress during the holidays is family. Indeed, for some people, loneliness is the problem. Holiday time is when expectation are highest, and when being alone is perhaps most keenly felt. This may be a time to avoid social media—while people are entitled to their happy holidays, someone who is alone may not want to watch. It’s also a time for self care. Being alone during the holidays means not having to have anyone else’s idea of a proper celebration.