Friday, September 21, 2018

Crack Your Knuckles?


4 ways to keep moving with joint pain


Cracking your knuckles may aggravate the people around you, but it probably won't raise your risk for arthritis. That's the conclusion of several studies that compared rates of hand arthritis among habitual knuckle-crackers and people who didn't crack their knuckles.
The "pop" of a cracked knuckle is caused by bubbles bursting in the synovial fluid — the fluid that helps lubricate joints. The bubbles pop when you pull the bones apart, either by stretching the fingers or bending them backward, creating negative pressure. One study's authors compared the sudden, vibratory energy produced during knuckle cracking to "the forces responsible for the destruction of hydraulic blades and ship propellers."
Even if knuckle cracking doesn't cause arthritis, there's still good reason to let go of the habit. Chronic knuckle-cracking may lead to reduced grip strength. And there are at least two published reports of injuries suffered while people were trying to crack their knuckles.

Thursday, September 6, 2018

10 Superfoods

10 superfoods to boost a healthy diet

 
No single food — not even a superfood — can offer all the nutrition, health benefits, and energy we need to nourish ourselves. The 2015–2020 US Dietary Guidelines recommend healthy eating patterns, “combining healthy choices from across all food groups — while paying attention to calorie limits.”
Over the years, research has shown that healthy dietary patterns can reduce risk of high blood pressure, heart disease, diabetes, and certain cancers. Dietary patterns such as the DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean diet, which are mostly plant-based, have demonstrated significant health benefits and reduction of chronic disease.
However, there are a few foods that can be singled out for special recognition. These “superfoods” offer some very important nutrients that can power-pack your meals and snacks, and further enhance a healthy eating pattern.

Superfoods list

Berries. High in fiber, berries are naturally sweet, and their rich colors mean they are high in antioxidants and disease-fighting nutrients.
How to include them: When berries are not in season, it is just as healthy to buy them frozen. Add to yogurt, cereals, and smoothies, or eat plain for a snack.
Fish. Fish can be a good source of protein and omega-3 fatty acids, which help prevent heart disease.
How to include it: Buy fresh, frozen, or canned fish. Fish with the highest omega-3 content are salmon, tuna steaks, mackerel, herring, trout, anchovies, and sardines.
Leafy greens. Dark, leafy greens are a good source of vitamin A, vitamin C, and calcium, as well as several phytochemicals (chemicals made by plants that have a positive effect on your health). They also add fiber into the diet.
How to include them: Try varieties such as spinach, swiss chard, kale, collard greens, or mustard greens. Throw them into salads or sauté them in a little olive oil. You can also add greens to soups and stews.
Nuts. Hazelnuts, walnuts, almonds, pecans — nuts are a good source of plant protein. They also contain monounsaturated fats, which may be a factor in reducing the risk of heart disease.
How to include them: Add a handful to oatmeal or yogurt, or have as a snack. But remember they are calorically dense, so limit to a small handful. Try the various types of nut butters such as peanut (technically a legume), almond, or cashew. Nuts are also a great accompaniment to cooked veggies or salads.
Olive oil. Olive oil is a good source of vitamin E, polyphenols, and monounsaturated fatty acids, all which help reduce the risk of heart disease.
How to include it: Use in place of butter or margarine in pasta or rice dishes. Drizzle over vegetables, use as a dressing, or when sautéing.
Whole grains. A good source of both soluble and insoluble fiber, whole grains also contain several B vitamins, minerals, and phytonutrients. They have been shown to lower cholesterol and protect against heart disease and diabetes.
How to include them: Try having a bowl of oatmeal for breakfast. Substitute bulgur, quinoa, wheat berries, or brown rice for your usual baked potato. When buying breads at the supermarket, look to see that the first ingredient is “100% whole wheat flour.”
Yogurt. A good source of calcium and protein, yogurt also contains live cultures called probiotics. These “good bacteria” can protect the body from other, more harmful bacteria.
How to include it: Try eating more yogurt, but watch out for fruited or flavored yogurts, which contain a lot of added sugar. Buy plain yogurt and add your own fruit. Look for yogurts that have “live active cultures” such as LactobacillusL. acidophilusL. bulgaricus, and S. thermophilus. You can use yogurt in place of mayonnaise or sour cream in dips or sauces.
Cruciferous vegetables. These include broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale, kohlrabi, mustard greens, radishes, and turnips. They are an excellent source of fiber, vitamins, and phytochemicals including indoles, thiocyanates, and nitriles, which may prevent against some types of cancer.
How to include them: Steam or stir-fry, adding healthy oils and herbs and seasonings for flavor. Try adding a frozen cruciferous vegetable medley to soups, casseroles, and pasta dishes.
Legumes. This broad category includes kidney, black, red, and garbanzo beans, as well as soybeans and peas. Legumes are an excellent source of fiber, folate, and plant-based protein. Studies show they can help reduce the risk of heart disease.
How to include them: Add to salads, soups, and casseroles. Make a chili or a bean- based spread such as hummus.
Tomatoes. These are high in vitamin C and lycopene, which has been shown to reduce the risk of prostate cancer.
How to include them: Try tomatoes in a salad or as a tomato sauce over your pasta. You can also put them in stews, soups, or chili. Lycopene becomes more available for your body to use when tomatoes are prepared and heated in a healthy fat such as olive oil.

Katherine D. McManus, MS, RD,

Thursday, August 30, 2018

Small tricks to help you shed pounds and keep them off

Weight loss can be challenging, but there are some strategies for success.


If you're struggling to lose weight, you probably feel like the odds are stacked against you. You're not necessarily wrong.
"There is so much great-tasting food, and it's abundant and in your face all the time. To me it's kind of a miracle that people aren't even heavier than they are," says Dr. Meir Stampfer, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health. In addition to an abundance of food, most people today also have a far more sedentary lifestyle than past generations. "Even active people who exercise a lot aren't expending the calories their ancestors did," says Dr. Stampfer.
So, while losing weight is simple in theory — reduce your calorie intake — it's not easy in practice. "If you put people into a locked metabolic ward and feed them only 60% of their usual caloric intake, they will lose weight. But for free-living people that's really hard," says Dr. Stampfer.
But as hard as it is to shed pounds, the bigger challenge may await if you are successful. "It is relatively more difficult to maintain the loss," says Dr. Lu Qi, adjunct professor of nutrition at the Harvard T.H. Chan School of Public Health.
This is particularly true for women after menopause. "When people get older, it becomes difficult to dissipate the energy from foods. They need to modify their eating habits — to follow healthier patterns," says Dr. Qi. "It's challenging to change any habits, including eating habits."
People today view food as far more than just sustenance. Eating is a source of gratification; it's a social activity; it's a reward. This is why many diets work in the short term but fail later on. "Many diets are a radical shift from what people normally eat, and this is not sustainable," says Dr. Stampfer.
But don't throw your hands up and resign yourself to keeping those extra pounds. There are strategies that can help you chip away at excess weight. Below are some simple tips that you can use to get the scale moving in the right direction — and keep it there.
Don't diet; improve your diet. Don't focus your eating solely on weight loss; focus on overall health. Follow a diet that is rich in fruits, vegetables, and healthy fats. "Even today, after all the data that we have, people still think that eating fat makes them fat, and they try to find low-fat products," says Dr. Stampfer. "That has been very well debunked. Eating fat doesn't make you fat. There are good studies that show eating healthy fats helps people control their weight better than diets than exclude them."
Over all, choosing a sustainable diet that is focused on health and not just weight can help you make lasting improvements. "Adopt a healthy diet, and eat just a little bit less," says Dr. Stampfer.
Exercise regularly. This has been said a million times, but it can't be emphasized enough: boosting your activity level can help you lose weight and keep it off. "For most people, long-term weight control is hard without some physical activity," says Dr. Stampfer.
Your metabolism slows with age, which means you burn fewer calories to keep basic body functions going. At the same time, bone and muscle mass decline and fat mass increases. This insidious pattern happens naturally as you get older unless you take steps to avoid it.
"I'm a strong advocate of not just aerobic activity but also weight training and calisthenics," says Dr. Stampfer. "Muscle building can not only bring up your body's metabolic rate, but also bring its own distinct health benefits that are often not as well appreciated as those associated with aerobic activity."
Try a variety of strategies. Different diets work for different people. Sometimes finding the right strategy takes trial and error. One approach that holds promise for many is mindful eating — taking the time to stop and really focus on and enjoy your food. "The scientific evidence to my eye is meager, but I like the concept," says Dr. Stampfer. "We've all had that experience of eating a bowl of something and not even remembering having eaten it."
Another simple trick is to put your fork down between bites instead of holding it in your hands. Pick it up when you are going to take the next bite.
Persevere. Losing weight is really hard to do, and many people fail many times before they succeed. Don't give up. Each day, commit to eating a little bit less, says Dr. Stampfer. If you go off track, recommit the following day and keep at it over time.

Tuesday, April 3, 2018

Health Quiz

True or False health quiz for a healthier heart...
Taking blood pressure in both arms may reveal a higher heart attack risk.
TRUE: You should measure blood pressure in both arms. A difference of 10 points or more means a 38% greater chance of having a heart attack — something you should talk to your doctor about.
Coated aspirin is better if you are taking it daily for your heart.
FALSE: If you’re taking daily aspirin for your heart, don’t use coated aspirin. It won’t protect your stomach AND not all the aspirin will get into your blood stream. You’re better off with chewable “baby aspirin.”
Dietary fat wreaks havoc on your heart and your memory.
FALSE: Not all dietary fat wreaks havoc on your heart and memory. Saturated fat (in butter and red meat) can harm both memory and artery health while monosaturated fats (in olive oil and fish) actually improve both memory and heart health.

Friday, November 17, 2017

Where to turn for low back pain relief

In most cases, a primary care doctor or chiropractor can help you resolve the problem.

back pain reliefLow back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. "In most cases, you won't need a specialist," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.

When pain strikes

There are many causes of low back pain. Some of the most common include an injury to a muscle or tendon (a strain), an injury to a back ligament (a sprain), and a herniated or "slipped" disc (when the soft material inside of a disc between spinal bones leaks and irritates nerves). Many of these issues will eventually resolve on their own.
But some causes of low back pain, such as a narrowing of the spinal canal (spinal stenosis), may require a specialist. "A referral makes sense when conservative measures have failed to address your back pain, symptoms aren't improving or are getting worse, or there's a suspicion that surgery might be needed," says Dr. Shmerling.

Where to turn

Since you shouldn't try to diagnose your own back pain, make your first call to a professional who can assess your problem, such as a primary care physician or a chiropractor. "Both can serve as the entry point for back pain," says Dr. Matthew Kowalski, a chiropractor with the Osher Clinical Center for Integrative Medicine at Harvard-affiliated Brigham and Women's Hospital. "And 35% to 42% of people with their first episode of back pain will consult a chiropractor."
Chiropractors use posture exercises and hands-on spinal manipulation to relieve back pain, improve function, and help the body heal itself. They often work in conjunction with other doctors, and they can prescribe diet, exercise, and stretching programs. "A well-trained chiropractor will sort out whether you should be in their care or the care of a physical therapist or medical doctor," Dr. Kowalski explains.

The next step

If you do need a specialist on your team, there are many experts who can help, depending on your needs. You may be referred to any of these:
  • A neurologist, a doctor specializing in treatment of the nervous system. "Back pain is commonly associated with lower-extremity symptoms, such as numbness and tingling. These symptoms can also be caused by neurological conditions that are not spine-related, such as multiple sclerosis. Neurologists are great at sorting this out and offering solutions," says Dr. Kowalski.
  • A physiatrist, a doctor with expertise in physical medicine and rehabilitation. "This may be helpful for back pain related to a sports injury, if surgery is not needed, and when medications are not working," says Dr. Shmerling.
  • A rheumatologist, a doctor who treats diseases of the joints, muscles, and bones. "Referral is most appropriate when there is inflammation of the joints in the back, or if the back pain might be related to an inflammatory disease, such as psoriatic arthritis," explains Dr. Shmerling.
  • A physical therapist, a licensed therapist who can help you strengthen back and core muscles to absorb pressure on the spine.
  • A pain management physician, a doctor who can prescribe medications, provide injections, and consider other approaches. "People with symptoms that aren't responding to treatment are great candidates for pain management, such as injections or procedures to smaller joints in lower back," says Dr. Kowalski.
  • An orthopedic spinal surgeon or a neurosurgeon who primarily does spine surgery, if surgery is likely needed for severe, unrelenting pain that may be due to a disc or spinal column problem.

Keep in mind

It may take several types of tests, such as x-rays, MRIs, and blood tests, to determine the exact cause of your back pain.
And you may need more than one expert managing your back pain. It just depends on the situation. "Most people who see more than one expert have more than one problem or have not improved with prior treatments," says Dr. Shmerling.
But for back sprains, strains, and herniated discs, a visit to your primary care physician or chiropractor may be all it takes to feel better. Make that initial call if back pain is interfering with your day.

Saturday, November 12, 2016

11 Reasons You’re Not Losing Belly Fat




Belly fat won’t budge? Genetics, hormones or easy-to-fix mistakes could be to blame.


Getting rid of your belly bulge is important for more than just vanity’s sake. Excess abdominal fat—particularly visceral fat, the kind that surrounds your organs and puffs your stomach into a “beer gut”—is a predictor of heart disease, type 2 diabetes, insulin resistance and some cancers. If diet and exercise haven’t done much to reduce your pooch, then your hormones, your age and other genetic factors may be the reason why.

You’re doing the wrong exercises
Doing crunches until the cows come home? Stop it! When you’re down to your final inches of belly fat, the dreaded crunch won’t be the exercise that finally reveals your six-pack. “You can’t spot reduce,” Jill says. Instead, she suggests doing functional exercises that use the muscles in your core—abdominals, back, pelvic, obliques—as well as other body parts. “These exercises use more muscles, so there is a higher rate of calorie burn while you are doing them,” she says. Planks are her favorite functional exercise—they activate not just your core muscles but also your arm, leg, and butt muscles.


You’re unmotivated

Are you committed to the work needed to lose belly fat? “Reducing belly fat takes a combination approach of a low-calorie diet that is high in fiber and low in carbohydrates and sugar along with cardiovascular and weight training,” Dr. Kashyap says. “If you are willing to do the work, you can move past genetics and lose it.


You’re eating the wrong fats
The body doesn’t react to all fats in the same way. Research correlates high intake of saturated fat (the kind in meat and dairy) to increased visceral fat, says Patton. On the other hand, monounsaturated fats (the kind in olive oil and avocados) and specific types of polyunsaturated fats (mainly omega-3s, found in walnuts, sunflower seeds, and fatty fish like salmon) have anti-inflammatory effects in the body, and if eaten in proper portions may do your body good. But Patton warns that eating too much fat of any kind increases your calorie intake and could lead to weight gain, so enjoy healthy fats in moderation.


You’re doing the wrong workout
A daily run or spin class is great for your heart, but cardio workouts alone won’t do much for your waist. “You need to do a combination of weights and cardiovascular training,” says Sangeeta Kashyap, M.D., an endocrinologist at Cleveland Clinic. Strength training increases muscle mass, which sets your body up to burn more fat. “Muscle burns more calories than fat, and therefore you naturally burn more calories throughout the day by having more muscle,” says Kate Patton, a registered dietitian at Cleveland Clinic. Patton recommends 250 minutes of moderate-intensity exercise or 125 minutes of high-intensity exercise a week.


You’re sick
If your testosterone levels are high—something that can occur with polycystic ovary syndrome (PCOS)—you might have difficulty losing weight. “If you’re an apple shape and overweight, it’s a good idea to see your doctor,” Dr. Kashyap says, since there may also be a chance that you are prediabetic or diabetic.


You’re stressed
Tight deadlines, bills, your kids—whatever your source of stress, having too much of it may make it harder for you to drop unwanted pounds, especially from your middle. And it’s not just because you tend to reach for high-fat, high-calorie fare when you’re stressed, though that’s part of it. It’s also due to the stress hormone cortisol, which may increase the amount of fat your body clings to and enlarge your fat cells. Higher levels of cortisol have been linked to more visceral fat.


You’re eating too many processed foods
“Refined grains like white bread, crackers and chips, as well as refined sugars in sweetened drinks and desserts, increase inflammation in our bodies,” says Patton. “Belly fat is associated with inflammation, so eating too many processed foods will hinder your ability to lose belly fat.” Natural foods like fruits, vegetables, and whole grains are full of antioxidants, which have anti-inflammatory properties and may therefore actually prevent belly fat, Patton says.


Your workout isn’t challenging enough
To banish stubborn belly fat, you have to ramp up your workouts. In a study published in the journal Medicine and Science in Sports and Exercise, people who completed a high-intensity workout regimen lost more belly fat than those who followed a low-intensity plan. (In fact, those completing the low-intensity exercises experienced no significant changes at all.) “You need to exercise at full intensity because the end goal is to burn more calories, and high intensity exercise does just that,” says Natalie Jill, a San Diego, Calif.-based certified personal trainer. High intensity workouts mean you’re going all out for as long as you can. If this sounds intimidating, think of it this way: you’ll burn more calories in less time.


You’re skimping on sleep
If you’re among the 30% of Americans who sleep less than six hours a night, here’s one simple way to whittle your waistline: catch more Zs. A 16-year study of almost 70,000 women found that those who slept five hours or less a night were 30% more likely to gain 30 or more pounds than those who slept seven hours. The National Institutes of Health suggest adults sleep seven to eight hours a night.


You’re apple shaped
If you tend to pack the pounds around your middle rather than your hips and thighs, then you’re apple shaped. This genetic predisposition means ridding yourself of belly fat will be harder, Dr. Kashyap says, but not impossible.


You’re getting older
As you get older, your body changes how it gains and loses weight. Both men and women experience a declining metabolic rate, or the number of calories the body needs to function normally. On top of that, women have to deal with menopause. “If women gain weight after menopause, it’s more likely to be in their bellies,” says Michael Jensen, M.D., professor of medicine in the Mayo Clinic’s endocrinology division. In menopause, production of the hormones estrogen and progesterone slows down. Meanwhile, testosterone levels also start to drop, but at a slower rate. This shift in hormones causes women to hold onto weight in their bellies. The good news: You can fight this process.