Screening Saves Lives

Despite advances in screening and treatment, breast cancer remains the second-leading cause of cancer deaths in women, just behind lung cancer, according to the American Cancer Society. The U.S. Preventive Services Task Force (USPSTF) recommends that women ages 50 and over undergo mammograms every other year for breast cancer screening. The guidelines emphasize the importance of regular screenings to detect breast cancer early when it is most treatable. For women ages 75 and older, the USPSTF notes that there is insufficient evidence to make a definitive recommendation, so the decision should be based on a woman’s health status and personal preferences.

While the USPSTF’s recommendations apply to women who have factors associated with an increased risk of breast cancer, such as having a first-degree relative with the disease, or having dense breasts, they do not apply to women who have a genetic marker or syndrome associated with a high risk of breast cancer, such as the BRCA1 or BRCA2 genetic variation, a history of high-dose radiation therapy to the chest at a young age, previous breast cancer, or a high-risk breast lesion on previous biopsies. “Women should be aware that screening recommendations differ among the various groups such as the USPSTF, the American Cancer Society, the American College of Radiology (ACR) and Society of Breast

Imaging (SBI), among others,” says Dr. Alan Astrow, Chief of Hematology and Medical Oncology in the Department of Medicine at New York-Presbyterian Brooklyn Methodist Hospital, an affiliate of Weill Cornell Medicine. “While the recommendations differ, the most important thing to know is that screening for breast cancer detects cancer at an earlier stage than it would be detected without screening. This leads to the need for less extensive treatment because the cancers are picked up at a less advanced stage and ultimately saves lives,” says Dr. Astrow.

Dense Breast Update

Approximately 50 percent of women have dense breasts, 10 percent have extremely dense breasts, and 40 percent have heterogeneously dense breast tissue. “Both groups are considered to be at slightly increased risk of breast cancer, and both groups are recommended to consider supplemental screening exams,” says Michele Drotman, MD, Chief of Breast Imaging, Weill Cornell Medical Center-New York Presbyterian Hospital. “The choices for supplemental screening are ultrasound, contrast-enhanced mammography (CEM), and MRI. Insurance does not always cover the costs of the additional exams.” Each of the screening options has pros and cons. “Ultrasound is easy to undergo, but has lower sensitivity and a high false positive rate; CEM and MRI have extremely high sensitivity, but require IV contrast administration, and MRI is not well tolerated by people who are claustrophobic,” says Dr. Drotman. Women who have dense breasts should discuss supplemental screening options with their health-care provider.

Important Advancements

New diagnostic tools and personalized treatments are leading to better outcomes. For instance, the HER2DX test is a diagnostic tool used to personalize treatment for HER2-positive breast cancer. It helps determine the best therapeutic approach by analyzing the tumor’s genetic profile, potentially allowing some women to avoid chemotherapy.

Innovative drugs like datopotamab deruxtecan (Dato-DXd) and patritumab deruxtecan (HER3-DXd) target specific proteins in cancer cells, with the aim of providing more effective treatments with fewer side effects. Meanwhile, trilaciclib, a new CDK4/6 inhibitor, is showing promise in treating triple-negative breast cancer, potentially improving responses to immunotherapy and reducing chemotherapy side effects.

Brighter Outlook

Regular breast cancer screenings, cutting-edge treatments, and diagnostic innovations are enhancing both outcomes and quality of life for women today. “Breast cancer is a serious disease, and too many women continue to die of it every year, but we are doing better and aim to continue to do even better as new therapeutic agents and diagnostic modalities are developed,” says Dr. Astrow.

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For example, women diagnosed with breast cancer in one breast, even at early stages, often choose to undergo a double mastectomy out of fear that the cancer might spread to the other breast. But the latest findings from a double mastectomy trial, published in the Journal of the American Medical Association, in July, show

that having both breasts removed when cancer is found in only one does not increase survival rates. (Importantly, the study notes that these results may not apply to those who test positive for the BRCA gene, which puts them at greater risk.)

Targeted therapy with drugs such as datopotamab deruxtecan (Dato-DXd), patritumab deruxtecan (HER3-DXd), and trilaciclib (Cosela) also illustrate the value of a less-is-more approach. Dato-DXd and HER3-DXd hone in on specific proteins within cancer cells. This precision means these treatments can be more effective, while sparing women many disruptive side effects. Similarly, trilaciclib, which is a CDK4/6 inhibitor, not only enhances the response to immunotherapy, it helps reduce the harsh impact of chemotherapy. Trilaciclib shows great promise particularly for women battling triple-negative breast cancer.

These milestones are not just beacons of hope. They allow physicians to select which patients would benefit the most from certain targeted therapies, thereby saving many other women from unnecessary chemotherapy or radiation. As a result, fewer women need multiple modalities of treatment, but can still look forward to the best survival statistics.

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Scientists have developed a new, more effective cervical cancer screening method. The WID-qCIN test detects epigenetic changes in cells, significantly improving early cancer detection. Epigenetic changes in cells refer to alterations that can be influenced by factors such as environment, lifestyle, and aging. In a study of over 28,000 women, published in the June issue of the journal Nature Medicine, this test identified 100 percent of invasive cervical cancers and 93 percent of serious precancerous lesions within a year. Additionally, it predicted 69 percent of cancers and precancerous lesions up to six years later, compared with only 18 percent with current methods. The researchers reported that this advancement could reduce the need for invasive diagnostic procedures by 40 percent, potentially enhancing women’s health and quality of life.

Beetroot Juice Boosts Heart Health in Postmenopausal Women

New research highlights the heart health benefits of beetroot juice for postmenopausal women. Beetroot juice contains high levels of nitrate, which the body converts to nitric oxide. Nitric oxide helps blood vessels expand, making it easier for blood to flow through the circulatory system. The ability of nitric oxide to widen blood vessels is known to be particularly helpful during periods of limited blood flow and oxygen delivery, such as during a heart attack. A study of 24 postmenopausal women, published in the June issue of the journal Frontiers in Nutrition, showed that daily consumption of nitrate-rich beetroot juice significantly improved blood vessel function, reducing heart disease risk. The study included women considered early postmenopausal, or one to six years postmenopause, and late postmenopausal, six or more years postmenopause. Late postmenopausal women saw the same benefits as the early postmenopausal group. This non-pharmaceutical approach offers a promising way for menopausal women to support cardiovascular health naturally.

Study Links Body Fat and Muscle Strength to Alzheimer’s and Parkinson’s Risk

High body fat, especially in the abdomen and arms, increases the risk of developing Alzheimer’s disease and Parkinson’s disease, according to a study published in the July issue of the journal Neurology. Conversely, high muscle strength significantly reduces this risk. The study tracked 412,691 individuals—55 percent of whom were women—with an average age of 56, over nine years. It found that people with high abdominal fat were 13 percent more likely to develop these diseases, while those with high arm fat faced an 18 percent higher risk. High muscle strength, however, decreased the risk by 26 percent. This study highlights the potential to lessen the risk of developing these neurodegenerative diseases by improving body composition. Targeted interventions to reduce belly and arm fat while promoting healthy muscle development may be more effective for protection against these diseases than general weight control, the study’s researchers concluded.

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The good news is that heart-healthy meals don’t have to be bland or boring. In this article, we provide practical tips and strategies to help you make heart-healthy choices without sacrificing flavor. With insights from Gabrielle Gambino, MS, RD, CDN, CNSC, a senior clinical dietitian with NewYork-Presbyterian/Weill Cornell Medical Center’s Advanced Heart Failure Service, we’ll explore how to prepare delicious meals at home, dine out wisely, and plan your menus to support a healthy heart.

What Does a Heart-Healthy Meal Look Like?

A heart-healthy meal is rich in healthy fats, fiber, and lean proteins. Here’s how you can incorporate these components into your daily diet:

• Healthy fats: Use olive oil, canola oil, or flaxseed oil for cooking and dressings.

• High fiber: Include whole-grain breads, brown rice, and sweet potatoes.

• Lean proteins: Opt for chicken breast, tuna, salmon, or tofu.

Enhance the flavor of your meals with herbs and spices such as cayenne pepper for vegetable-based dishes, onion powder or garlic for egg-based recipes, and oregano or rosemary for chicken dishes. These not only add zest to your dishes, but also eliminate the need for excessive salt. “Herbs and spices are fantastic alternatives to salt, allowing you to enjoy flavorful meals while keeping your heart healthy,” says Gambino.

Meal Planning and Preparation

Planning and prepping meals in advance can help to maintain a heart-healthy diet:

• Weekly meal planning: Plan lunches for the week to avoid sodium-packed processed foods at home or high-fat convenience foods away from home.

• Batch cooking: Cook in bulk, and freeze individual portions. This ensures that there is always a heart-healthy entrée ready to be defrosted.

“Batch cooking on Sundays can set you up for a successful week. Prepping proteins, vegetables, and grains in advance makes it easy to assemble healthy meals quickly,” says Gambino.

Dining Out and Celebrations

Even when dining out or celebrating, manage portions and choose wisely.

• Portion control: Share entrees with a friend, or save half for later.

• Healthier sides: Opt for a side salad or steamed vegetables.

• Sauces on the side: Request sauces on the side to control sodium intake.

• Read the menu in advance: Peruse the menu online and decide what you’ll order before leaving the house.

“Dining out doesn’t have to derail your heart-healthy diet,” says Gambino. “It’s all about balance and making smart choices, like choosing fiber-rich sides and limiting high-sodium condiments.”

Heart-Healthy Recipe Modifications

Include family-friendly comfort foods in your plan for days when a lean protein and vegetable seem unappetizing. For instance, with some simple modifications you can turn pasta with tomato sauce and meatballs into a heart-friendly meal:

• Homemade sauce: Use homemade, rather than jarred, tomato sauce to control the sodium level (see recipe above).

• Pasta options: Whole-wheat pasta and chickpea pasta are flavorful and heart healthy.

• Lean meat alternatives: For meatballs, use ground turkey instead of beef.

• Bake instead of frying: Bake meatballs in the oven or cook them in an air fryer instead of frying them in oil, to reduce fat content.

• Vegetable additions: Add bell peppers, onions, and other vegetables to your sauce for extra antioxidants and fiber.

• Cheese alternatives: Skip cheese, use low-sodium cheese, or try nutritional yeast, which is a vegan substitute with low sodium and probiotic benefits. Sprinkle it on foods for an added flavor similar to parmesan cheese.

Mindful Dietary Choices

Adopting a heart-healthy diet is a journey that involves making mindful choices both at home and when dining out. By incorporating healthy fats, fiber, lean proteins, and flavorful herbs into your meals, you can enjoy delicious and nutritious food. Meal planning and batch cooking can further support your goals by ensuring you have healthy options readily available throughout the week.

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Virtual Brain Exercises

Brain exercises can be an excellent way to maintain and enhance cognitive function. For instance, the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study found that older adults who engaged in cognitive training activities showed improvements in memory, reasoning, and processing speed that lasted up to 10 years.

There are numerous online brain games and exercises, such as Lumosity and BrainHQ, that are designed to help keep the aging brain limber. They are user friendly and allow people to track their progress over time, which can be motivating and rewarding. Most offer free games and puzzles, with an option to upgrade to additional activities for a fee.

Real-Life Brain Exercises

Challenging fine motor skills through hobbies like knitting or assembling jigsaw puzzles can keep the brain active. These pursuits also require hand-eye coordination, which strengthens neural connections. “These activities can improve concentration, which can be associated with improved memory. The better someone can attend to a task and acquire information, the more likely they will remember it later on,” says Lisa D. Ravdin, PhD, associate professor and director of the Weill Cornell Medicine Neuropsychology Service. Taking up painting is another example of an endeavor that bolsters creativity and aids in maintaining focus and precision. “These activities have the added benefit of reducing stress and promoting relaxation, which can also be beneficial to memory,” says Dr. Ravdin.

Learning and Socialization

Learning a new language can enhance cognitive flexibility and memory and enhance problem-solving abilities. “Continuous learning and problem-solving can enhance cognitive reserve and promote brain function,” says Dr. Ravdin. Online platforms like Duolingo https://www.duolingo.com/ or Rosetta Stone https://www.rosettastone.com/ make it easy to learn a new language at your own pace. “Learning new skills and techniques provides a cognitive challenge, which helps keep the brain active and engaged,” says Dr. Ravdin. “That said, learning a new language can be overly challenging and may not be for everyone. Studies show our ability to acquire a second language is strongest during early developmental stages when the brain is primed for learning language.”

Another great way to strengthen memory skills is by playing cards— either online (cardsmania.com) or at your local senior center. “Participating in activities with others has the added benefit of socialization, which can significantly enhance quality of life and cognitive health,” says Dr. Ravdin.

Online or Pencil and Paper

Brain exercises are a fun and engaging way to promote overall mental agility. Online games and puzzles are popular and appeal to people who are comfortable using computer websites and smartphone apps. However, easily accessible pencil-and-paper crossword puzzles and Sodoku games also offer excellent opportunities to stimulate memory skills and invigorate your mind. Whether you opt for virtual brain exercises or real-life activities, Dr. Ravdin says, “choose games and exercises that you find enjoyable and engaging, as this will encourage consistent practice.”

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Symptoms, Risks, and Causes

Symptoms of pneumonia include cough, sputum or phlegm, fever, shortness of breath, and exhaustion. These classic symptoms are more apparent in individuals with a robust immune system, while immunocompromised people might experience subtler signs, such as increased fatigue, overall functional decline, or even falls. “If a chronically ill person is not feeling well, not functioning well, sleeping more, and in some instances, falling down, their doctor should have a high level of suspicion of pneumonia, and that should be verified by getting a chest x-ray,” says Michael S. Niederman, MD, Professor of Clinical Medicine in Pulmonary and Critical Care Medicine, Weill Cornell Medicine.

Pneumonia can affect anyone, but certain factors increase susceptibility. Risk factors include cigarette smoking, underlying heart and lung diseases, diabetes, alcohol abuse, and chronic liver and kidney disease. Additionally, those with a weakened immune system, such as people undergoing chemotherapy, are more vulnerable to pneumonia. “The danger of contracting pneumonia is higher if you have underlying chronic medical problems. But, even previously healthy individuals sometimes get severe pneumonia that can put them in the hospital or even in the intensive care unit. The reason: Some people have an excessive inflammatory response to the infection that can make them very sick,” says Dr. Niederman.

The Role of Vaccination

Preventing pneumonia is crucial, and vaccination plays a vital role. “The most important vaccines for pneumonia prevention are the yearly influenza vaccine and the pneumococcal vaccine,” says Dr. Niederman. There are several pneumococcal vaccines, including pneumococcal conjugate vaccines (PCV) and pneumococcal polysaccharide vaccines (PPSV). Currently, the CDC recommends that all adults ages 65 and older receive the PCV15 or PCV20 vaccine, and if the PCV15 is used, it should be followed by a dose of the PPSV23 at least one year later. People who have risk factors or conditions that make them more susceptible are advised to get vaccinated at a younger age.

Dr. Niederman points out that there is also a newly approved vaccine, PCV21, that is not included in the CDC’s current recommendations.

“PCV21 can be used interchangeably in place of PCV20. It covers more of the invasive pneumococcal strains than any other vaccine option,” says Dr. Niederman. Understanding which vaccine is right for you may be daunting, which is why it’s best to discuss pneumonia vaccination with your primary care physician or your pulmonary doctor, if you are under the care of one for respiratory issues. Your health-care provider can determine the appropriate vaccine and schedule based on your health status and vaccination history.

Pneumonia Treatment

Pneumonia is most often caused by either a viral or a bacterial infection, and typically involves treatment with antibiotics. Additional treatments include rest, hydration, and supplemental oxygen if needed. Steroids might be prescribed in severe bacterial cases, but can be harmful for pneumonia caused by viruses. Having pneumonia once increases the risk of recurrence, so adhering to the full course of prescribed medications and medical advice is critical.

Road to Recovery

Recovery from pneumonia can be prolonged, especially for older adults. Healing involves patience, rest, and a gradual return to normal activities. Follow your doctor’s advice closely to ensure a complete recovery.

By staying informed about the risks, prevention strategies, and treatment options, women can better protect themselves against pneumonia.

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Not Ready for Surgery?

Before considering surgery, it is advisable to try conservative measures such as avoiding prolonged periods of walking or standing, and taking frequent breaks to rest and elevate your feet. “In addition to altering their activities, I advise patients to wear wide shoes that have a high toe box so the foot is not squeezed,” says John J. Doolan, DPM, FAC-FAS, clinical assistant professor of podiatry in surgery at Weill Cornell Medicine. “I usually recommend sneakers, and also suggest that the person consider an orthotic, which can reduce pressure and pain on the affected area,” says Dr. Doolan.

By making these adjustments, women can help manage bunion symptoms, reduce pain, and potentially slow the progression of the condition, thereby delaying or avoiding the need for surgery. “When conservative measures fail to alleviate pain or the pain interferes with your ability to function, surgery should be considered,” says Dr. Doolan.

Traditional Bunion Surgery

Bunions are caused by a deformity between the first and second metatarsal bones in the foot.

Traditional bunionectomy surgery involves a sizable incision—2 inches to 4 inches—to access the bone and joint. This approach provides a direct view of the entire joint to ensure that all aspects of the bunion are corrected. The comprehensive correction offered by traditional surgery often yields lasting results, significantly relieving pain and improving foot function. This method can be adapted to various bunion severities, making it particularly effective for advanced cases requiring significant bone realignment.

However, traditional bunion surgery also has drawbacks. The large incision and extensive manipulation of the foot structures required in this surgery mean that recovery can be lengthy. People need to be non-weight bearing—meaning they need to stay off their feet—for several weeks, and they may experience swelling and discomfort for months. “It is important for the patient to understand the recovery time associated with the procedure and for the expectations of both the patient and the surgeon to be aligned,” says Dr. Doolan.

Minimally Invasive and 3D Surgery

“Traditional bunion surgery works fine; however, advances in surgical techniques and understanding over the last few years have resulted in two new methods. One is minimally invasive surgery (MIS), and the other is 3D Lapidus,” says Dr. Doolan.

The MIS procedure involves smaller incisions and less disruption to the surrounding tissues, resulting in a faster recovery time. People can often walk immediately after the procedure and return to normal activities sooner than they would with traditional bunionectomy. The smaller incisions and less invasive nature of MIS generally lead to reduced postoperative pain and swelling. MIS is most effective for mild-to-moderate bunion deformities and may not provide sufficient correction for more severe cases. Furthermore, due to less direct visualization of the joint because of the smaller incision, there is a risk of incomplete correction, and this could require additional procedures in the future.

3D Lapidus is the newest bunion surgery technique. With this procedure, the surgeon rotates the metatarsal bone back into proper alignment and secures it with titanium plates. The 3D Lapidus procedure results in significantly less postoperative pain and much faster recovery than a traditional bunionectomy. And, people can often bear weight on their foot within just a few days, compared with the weeks or months it takes with traditional surgery. This new method also lowers the risk of a bunion recurrence and the need for additional surgery by correcting the underlying deformity.

Different Techniques; Same Goals

Deciding among traditional, MIS, and 3D Lapidus procedures should take into account the severity of the bunion, a person’s overall health, your lifestyle, and your personal preferences. Consulting with a foot and ankle specialist can provide valuable insights tailored to your specific condition. However, regardless of which type of surgery you choose, the goal is the same—you want to alleviate pain, improve function, and enhance your overall quality of life.

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If tingling, numbness, or pain in your hand, as a result of carpal tunnel syndrome, is affecting your ability to sew, garden, or do other hands-on activities, there are several treatment options to consider. The primary goal is to relieve pressure on the median nerve, which runs through the carpal tunnel in your wrist.

Conservative treatments are usually recommended first. Splinting with a wrist brace, especially at night, prevents further irritation of the median nerve. The brace looks like a fingerless glove that has a rigid support that keeps the wrist in a neutral position. You can buy one at your local drug store, which makes it an excellent first step. However, it may take weeks to see improvement, and the relief might be minimal. Corticosteroid injections offer a more direct approach by reducing inflammation and swelling in the carpal tunnel. These injections can provide significant relief; however, the effects can be temporary, and repeated injections are generally not recommended due to potential side effects like weakening of the surrounding tissues. Acupuncture can also be an effective alternative for managing carpal tunnel syndrome; however, it is generally considered less predictable compared with traditional methods.

For persistent or severe cases, surgical intervention might be warranted. Carpal tunnel release surgery involves cutting the ligament pressing on the median nerve, thereby relieving pressure. This procedure has a high success rate and can provide long-term relief, but it may take several months for full strength and sensation to return.

Ultimately, the best treatment depends on the severity of your symptoms and how they affect your daily life. Discuss your options with an orthopedic specialist, who can tailor a treatment plan that’s best for you, ensuring that you can continue to enjoy your activities pain-free.

I generally take care of my feet, but no matter what I do I cannot escape an ingrown toenail on the third toe of my left foot that keeps coming back. What can I do?

A recurring ingrown toenail despite a diligent foot-care routine can be frustrating and painful. The primary reason for this persistent issue often lies in the way the nail grows or how pressure is applied to the toe. Factors like tight-fitting shoes, improper nail trimming, or even genetic predispositions can contribute to the problem. In some cases, repeated activities that put stress on the nails—such as an exercise routine that includes running—can exacerbate the condition.

First, ensure proper nail care. Trim your nails straight across, avoiding rounded corners, which can encourage the nail to grow into the skin. Opt for comfortable, well-fitting shoes that provide ample toe space. If these measures do not resolve the problem, soak your foot in warm water several times a day to help reduce swelling and alleviate pain.

If you have tried all of these measures and none are effective, it’s probably time to consult a foot specialist. A podiatrist can assess the situation and may recommend procedures like lifting the nail to allow it to grow out properly or, in more severe cases, removing part or all of the nail in a minor surgical procedure called a partial nail avulsion. This involves removing the problematic section of the nail and sometimes the underlying nail bed to prevent regrowth in that area. The procedure is quick and done under local anesthesia, providing long-term relief with minimal risk. Consistent follow-up care and adhering to your podiatrist’s advice can help prevent future occurrences.

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Frozen Foods.

A well-stocked freezer can keep you and your family fed for a long time! Frozen vegetables and fruits are a great choice. They are at least as nutritious as their fresh counterparts, if not more so, and they are far more convenient and timesaving because they’re pre-washed and pre-cut. You can use only what you need and seal up the packaging until the next use, which reduces food waste. Steam or sauté frozen veggies for a quick and tasty main or side dish, toss them in a soup, or add them to a pot pie or casserole. Frozen fruit thaws quickly for adding to yogurt or breakfast cereal. Or blend it into a smoothie straight from the freezer.

Onions and garlic add flavor to almost any savory dish, and fresh bulbs last well on the counter for quite a while, but frozen diced onions (with and without green peppers) and jarred minced garlic may be worth keeping on hand. If you enjoy foods made with fresh ginger, store a root in the freezer and grate it into dishes as needed.

Frozen fish fillets, scallops, and shrimp thaw quicky in their packaging in a pot of water. Frozen chicken and beef can be thawed in the fridge overnight, in a pot of water (well wrapped), or in a microwave (although this can affect texture). The smaller the portions, the quicker they thaw.

Canned Cadre.

Canned foods last for years, so you can stock up without fear of waste. Canned beans like pintos, chickpeas, black beans, kidney beans, and black-eyed peas are great plant protein options that require minimal time, particularly compared to cooking dry beans. Just open the can, rinse, and toss into salads, stir into soups, fold into wraps, or mash into dips. Season to taste and dish up satisfying flavor, protein, and fiber. Canned lentils are also available in some locations.

Canned tomatoes are a pantry musthave. Whole, diced, crushed, and pureed are all useful, but if you have whole canned tomatoes on hand, you can easily turn them into any of the other forms. Other canned vegetables are also an option, although somewhat different in texture from frozen or fresh.

Canned tuna, chicken, sardines, kippers, shrimp, and salmon are quick ingredients to enhance a recipe. Try them in sandwiches or salads, tossed with whole grain pasta or leftover whole grains, or mixed with canned beans. Canned clams, oysters, and mussels are great options for pasta recipes.

And don’t forget canned or boxed reduced sodium chicken, vegetable, and beef broths as a great base for soups and stews and a flavorful medium for cooking whole grains.

Whole Grains.

The dried seeds of grasses, grains keep well in sealed bags or containers. If you’re short on time, meal prep with whole grains can be surprisingly speedy. Whole wheat couscous only takes five minutes to cook. Quinoa is ready in around 15 minutes, which makes this complete protein another great go-to option when time is short. Bulgur takes 12. For longer-cooking grains, like barley, wheat berries, and brown rice, try cooking a large batch and freezing portions. Two minutes the microwave and they’re ready to go (or put the bag or container in some warm water for a quick thaw).

Whole grain crackers and baked (reduced salt) tortilla chips are also useful to keep on hand. They go well alongside soup or salad, dipped in bean dip, salsa, or tuna or egg salad, or on their own as a snack. Plain popcorn is also an excellent whole-grain snack or side in place of chips or pretzels.

Keeping the right ready-to-use ingredients in the freezer and pantry makes it easy to prepare healthy home cooked dishes any time.

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In a relatively small randomized, crossover, controlled trial, time-restricted eating (also known as intermittent fasting) did not lead to improvements in weight or other selected health parameters compared to participants’ regular eating patterns. For four weeks, the 12 women and five men (average age of 26 years) with overweight or obesity ate whatever they wanted from 7:00 am to 3:00 pm and fasted the rest of the day. For another four weeks, they ate as they wanted.

The researchers measured body weight, waist and hip circumference, body composition, and blood pressure, and did blood tests to measure fasting blood glucose, cholesterol, triglyceride, and insulin concentrations. They also asked the participants to rate their hunger.

Overall, the researchers found no significant changes in body weight or other parameters, however, when analyzed separately, the women did lose some weight (about two pounds) during the intervention.

Some studies have reported benefits of time-restricted eating on weight, blood sugar control, blood triglyceride levels, and appetite, but others (like this study) have not. There are a lot of variables to consider when conducting research like this (including age, weight, and health of participants, the length of the study, and the length and timing of the fasting period). Currently, it appears that time-restricted eating patterns are pretty much equivalent to traditional caloric restriction for weight and health. Some people may find the approach helpful, while others may not. As with most approaches to achieve your health goals, find something that’s right for you.

Recurrent Low Back Pain? Try Walking

A randomized controlled trial in Australia found an intervention that encouraged walking reduced the occurrence of low back pain compared to no intervention. The study enrolled 701 participants 18 and older (81 percent female, with an average age of 54 years) who were not already engaging in regular physical activity. In the previous six months, each participant had recovered from an episode of lowback pain that interfered with daily activities but did not have a specific, diagnosable cause (such as vertebral fracture or cancer).

The intervention group met with a physical therapist six times over a six-month period to develop a personalized progressive walking program and receive some education on pain science and low-back care. The goal was to be walking five times a week for at least 30 minutes a day by six months. Participants kept a walking diary and wore a pedometer, which measures step counts. At the three-month mark, they were asked to wear an accelerometer for seven days to measure daily step count, daily briskwalking steps, and minutes of moderate to vigorous physical activity.

The intervention group reported less episodes of low back pain (including activitylimiting pain) compared with the control group. The control group also sought the help of massage therapists, physical therapists, and chiropractors more often than the walking group.

If you suffer from recurrent low-back pain, regular walking may be helpful and is beneficial for overall health. (Make sure your healthcare provider approves.) Start slowly and work your way up to walking on most days.

Join the Trend—Improve Your Diet Quality

A survey of 51,703 adults from 1999 to 2020 found that diet quality in the U.S. improved a bit, at least in people who don’t struggle to get enough to eat.

Participants were surveyed on their typical dietary intake. Their responses were compared to the American Heart Association (AHA) 2020 continuous diet score (which is based on higher intake of vegetables, fruits, legumes, whole grains, nuts/seeds, and fish and shellfish). Less than 40 percent adherence to the AHA score was considered poor diet quality, 40 to 79.9 percent was intermediate, and at least 80 percent adherence was ideal.

The proportion of U.S. adults with poor diet quality decreased from 48.9 percent in 1999 to 37.4 percent in 2020. The proportion with intermediate quality diets increased from 50.6 to 61.1 percent. The proportion of U.S. adults reporting eating an ideal diet more than doubled (from 0.66 percent to 1.58 percent) but is still extremely low. Diet quality did not improve for people experiencing food insecurity.

We are headed in the right direction but have a long way to go. You can choose low or minimally processed plant foods and fish/ shellfish in place of less healthy, more processed choices more often. Let’s keep those percentages improving!

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