Many people would probably give the answer that olive oil is the healthiest cooking oil. This cornerstone of the Mediterranean eating pattern has been showered with positive press in recent years. However, most liquid plant oils, with the exception of certain tropical oils like coconut and palm oils, have more in common than not—if you take a wide-angle view.

Beyond the hype about the health benefits of particular dietary fats, there isn’t much solid science to justify touting one specific oil as the healthiest cooking oil. Instead, let your taste preferences and food budget be your guide and try to use a variety of oils.

Jump to the nutritional information for cooking oils.

Walnuts are a worthy source of alpha-linolenic acid (ALA), an important omega-3 fatty acid. As such, walnut oil has become a popular type of oil for flavoring, as the USDA notes.

Healthiest Oil for Your Diet

The spectrum of liquid vegetable oils includes avocado, canola, corn, olive, peanut, pumpkin seed, safflower, sesame, soybean, sunflower, and walnut oil. Each contains lots of monounsaturated fatty acids and polyunsaturated fatty acids, and each remains a liquid at room temperature.

According to the 2015–2020 Dietary Guidelines for Americans, oils contribute to a healthy eating pattern because they are a rich source of essential omega-3 and omega-6 fatty acids. They’re called “essential” because your body can’t make them on its own, yet they’re necessary for good nutrition.

Oils are also an important source of vitamin E, an essential vitamin that acts as an antioxidant. This protective chemical neutralizes the free radicals formed during normal cell activity. Common causes of exposure to free radicals in the environment include cigarette smoke, air pollution, and ultraviolet light from the sun.

Fatty Acids and Oils

More than 20 types of individual fatty acids are found in food oils—and not just vegetable oils. Seafood and nuts also contain significant amounts of essential fatty acids. Vegetable and other oils vary by the amounts of saturated and unsaturated fats they contain:

• Polyunsaturated fats are most abundant in corn, cottonseed, flax, pumpkin, pine nut, sesame, soybean, sunflower, and walnut oils.
• Monounsaturated fats exist in the highest percentages in avocado, canola, olive, peanut, sunflower, and safflower oils.
• Tropical oils contain comparatively few monounsaturated or polyunsaturated fats. Palm kernel oil is about 85 percent saturated fat and coconut oil is more than 90 percent saturated fat. (Although coconut and palm oils are semi-solid at room temperature, they are considered vegetable oils.)

See the polyunsaturated fats and monounsaturated fats for cooking oils.

Oils and Heart Health

Of all these, which is the healthiest cooking oil? First, you need to decide what you mean by “healthy.” Some of the biggest and best studies have focused on heart disease—a leading cause of diet-related illness and death in developed countries. More than 17 million people die of cardiovascular disease globally. (See also What Is Cardiovascular Disease? It’s Actually Dozens of Disorders.)

Research to date points to polyunsaturated fats as an important factor in why plant-rich eating patterns are heart-healthy. Polyunsaturated fats include the two essential fatty acids your body can’t make on its own: alpha-linolenic acid (an omega-3 fatty acid) and linoleic acid (an omega-6 fatty acid). The body can transform these two “parent” fatty acids into the other ones you need for adequate nutrition.

In June 2017, an advisory panel to the American Heart Association published a report in the journal Circulation on dietary fats and cardiovascular disease. It came to several key conclusions:

• Randomized controlled trials to date show that reducing your intake of saturated fats and replacing them with polyunsaturated fats lowers the chance of cardiovascular disease by about 30 percent—roughly the same effect as taking a cholesterol-lowering statin drug.
• Long-term observational studies have shown that people who eat less saturated fats and more mono- and polyunsaturated fats are less likely to have cardiovascular disease and have a lower risk of death from heart diseases and other causes.
• Replacing saturated fats with unsaturated fats lowers “bad” LDL cholesterol, a cause of coronary artery disease (narrowed arteries to the heart). Replacement with monounsaturated fats accounts for 15 percent of the lower risk, while substitution with polyunsaturated fats brings 25 percent less risk.

“Both polyunsaturated fats and monounsaturated fats are effective in reducing cardiovascular disease,” the panel wrote in its report. “The effect is greatest for polyunsaturated fats.”

The Healthiest Types of Cooking Oil

Based on the AHA panel’s conclusions, it sounds like an obvious choice: Oils that have the most polyunsaturated fats, like corn and soybean, appear to be the healthiest cooking oil overall because they have the most benefit for heart health. But that’s not the real message. The panel’s work echoes what you’ve been hearing for years: All other factors in your diet being equal, the type of fats you consume—not the total amount of them—is the most important thing. So there is no single oil to anoint as “the winner.” The answer instead involves different types of oils and how we consume them:

• Replace some of your saturated fats from animal foods with unsaturated fats from plant oils; that practice, per research, appears to promote health.
• Remember that monounsaturated fats are still associated with good health, so olive oil consumption—relative to saturated fat intake—is beneficial.
• Try to consume a variety of oils based on your taste preferences and food budget. For example, go ahead and try some fancy extra-virgin olive or pumpkin seed oil for drizzling on salads, but corn or canola are still healthy options for general use.

See the polyunsaturated fats and monounsaturated fats for cooking oils.

Regarding the latter point, eating a variety of oils broadens the portfolio of fatty acids in your diet along with the benefits that different ones may offer. In combination with fish and nut consumption, you’ll get what you need without having to micromanage your fatty acid intake.

Tropical plant oils are the exception to the rule. Palm kernel and coconut oil are high in saturated fat, so replacing animal fats with those options doesn’t make much sense.

All other things being equal, the bottom line is that it’s best to favor oils that primarily contain monounsaturated and polyunsaturated fatty acids.

Healthiest Cooking Oils Chart: Nutrition Information

DON’T FEAR THE FAT: A COMMON-SENSE APPROACH TO VEGETABLE OILS

Oils are relatively calorie-dense. Vegetable oils contain about 120 calories and 14 grams of fat per tablespoon. But push the pause button for a moment about fats and calories—a much-misunderstood concept in healthy eating.

Before nutrition guidelines shifted focus from total fats to types of fats, a lot of people became fat-phobic. Health writers often still warn you not to overdo it on the oils, because they are “loaded” with calories.

Oils may add some calories to a salad, but they also have a satiating effect, helping to make us feel “full.”

If you’re overweight and counting calories, vegetable oil intake may be something to be mindful about. But keep in mind we don’t eat our oils by the tablespoon—we eat them as part of meals and overall dietary patterns.

Although oils add calories to meals, they are also more satiating and therefore could help reduce cravings between meals. In combination with dark, leafy greens in salads, oils help the body to absorb fat-soluble nutrients like carotenoids—the pigments that make fruits and vegetables yellow, orange, or red.

Finally, fats add flavor and pleasant “mouth feel” to healthy foods. Consuming nutritious foods that you like—as opposed to ones you think you are supposed to eat for your own good—can help sustain an overall healthy eating pattern.

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• Coconut Oil: Cholesterol Villain or Health Food Darling?

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The good news is that in most cases, all you need to do about a lingering cough is to try an over-the-counter remedy to sooth symptoms, maybe sip some tea with honey, and wait. Most coughs resolve in two to three weeks. (See also 4 Natural Cough Remedies.)

How Long Does a Cough Last? It Can Be Longer Than You Think

Coughs are right up there with cold and flu as part of the soundtrack of winter, along with sneezing and nose-blowing. According to the Centers for Disease Control and Prevention (CDC), cough is the most common symptom for which adult patients visit their primary care provider, and acute bronchitis is the most common diagnosis.

How long does a cough last—or how long should a could last? You might be surprised by the answer that came out of a study conducted by several doctors in Georgia. As reported in the Annals of Family Medicine, a review of 19 past studies found that coughs last an average of 18 days.

Meanwhile, most people apparently start to worry about their cough far short of 18 days. The researchers also conducted a randomized telephone survey of nearly 500 people and asked them how long they thought coughs normally last.

The researchers described a few different types of coughs, including those producing yellow sputum versus green sputum, a dry cough, or a cough with and without fever. Overall, the people surveyed thought these coughs should last only seven to nine days.

When Coughs Are Chronic

Short-term coughs lasting a few weeks have arise from any number of causes. For example, in acute bronchitis (bad chest cold” rel=”noopener” target=”_blank”>chest cold), the airways of the lungs swell and produce lots of mucus, which the body then tries to expel by coughing. This can be very unpleasant, but rarely requires medical attention. In the meantime, over-the-counter cough and cold remedies may provide some relief.

Coughs that persist beyond two to three weeks and are causing you serious distress may require careful diagnosis and treatment with medications. In medical terms, a chronic cough is one that last eight weeks or more.

Common Causes of Coughs

Nearly 90 percent of all chronic coughs trace to three causes: post-nasal drip, asthma, and backing up of stomach acid into the throat, known as gastroesophageal reflux disorder (GERD).

• Post-nasal drip: In post-nasal drip, the nasal passages make extra mucus as a result of allergies, colds, or sinus problems. The typical symptoms are a stuffy or runny nose and a need to clear your throat frequently. As the mucus leaks into the throat—this is the post-nasal drip part—it causes irritation and triggers coughing.
• Asthma: In asthma, narrowing of the airways in the lungs cause wheezing, coughing, and (sometimes) shortness of breath. Asthma is the leading cause of chronic coughing in children and adolescents. In some people, the only symptom of the asthma is the cough. When and why asthma-related chronic coughs develop can vary. Certain odors or dry or cold air are among the factors that can set it off, or it can follow a bout with cold or flu.
• GERD: In GERD, or gastroesophageal reflux disease, the backing up of acid irritates the throat, setting off the cough reflex. Along with the cough, you may have a sour taste in your mouth and feel burning pain (heartburn) behind your breastbone. The acid can damage your throat, so don’t put off following up on these symptoms.

Figuring out what’s causing a chronic cough isn’t simple. It may involve trying different over-the-counter or prescription medications to narrow down to the most likely culprit by a process of elimination.

When Antibiotics Help

Sometimes an antibiotic can be the right option for coughs. If the trouble is inflamed and infected airways, you may cough up sputum having a yellow, green, or brown color. If the infection is in your sinuses, colored secretions may leak into the back of your throat.

The body’s defenses can clear up such infections on their own. But if it doesn’t get better on its own in 10 to 14 days, you may need to take antibiotics. If your doctor tries to steer you away from immediately taking an antibiotic, listen. The problem is usually a viral infection; antibiotics won’t help, and can actually do more harm than good (see “Unnecessary Antibiotics” sidebar).

The bottom line: Don’t be surprised if a cough lingers for weeks after a bout with cold or flu, or if your allergies are acting up. But do see a doctor if the cough gets worse, or if you experience “alarm” symptoms like high fever, bloody sputum, severe fatigue, or shortness of breath.

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Research has shown that current or former smokers may have a slightly higher risk of lung cancer from taking beta-carotene and vitamin E, which are usually among the recommended vitamins for eyesight. Smokers should not take beta-carotene or vitamin E, either alone or in any AREDS vitamin formulation. More generally, ask your doctor about potential interactions of AREDS2 with any vitamins, including vitamins for eyesight, you are taking, or if you can take them safety if you are at risk for certain conditions, such as prostate and lung cancer.

When buying AREDS formulations, check the supplement label carefully. Many supplements advertised as promoting “eye health” do not contain the same vitamins, supplements, or doses that were tested in the AREDS studies. Only the AREDS1 and AREDS2 formulations have been tested as vitamins for eyesight in large clinical trials sponsored by the National Eye Institute.

The shelves of retail drugstores offer products touted as ” vitamins for eyesight.” Should you start taking the AREDS supplements even if you are not at risk of progressing to advanced advanced age-related macular degeneration, or AMD? There’s no definitive proof yet that vitamins for eyesight prevent AMD in healthy eyes.

Instead, enrich your diet. Green leafy vegetables like spinach, collard greens, and kale are good sources of eye-healthy nutrients. Don’t forget exercise, and stop smoking if you are a smoker; it is a major risk factor for AMD. All of these lifestyle changes will have general health benefits even if they don’t preserve and protect eyesight.

Vitamin D

Some observational studies suggest that people with healthy-to-high levels of vitamin D tend to have a lower risk of AMD, potentially making it one of the vitamins for eyesight. As part of the Carotenoids in Age-Related Eye Disease Study (CAREDS), researchers compared 550 women with adequate levels of vitamin D, a group of 275 with inadequate levels, and a further 88 with clearly deficient levels. The study concluded that women with the vitamin deficiency were significantly more likely to of developing AMD. In women with certain AMD risk genes in addition to very low vitamin D, the increased risk was up to 6.7-fold higher.

In particular, postmenopausal women with high levels of vitamin D in their blood are much less likely to develop AMD than women with low vitamin D. It may be that vitamin D reduces inflammation in the retina associated with AMD or prevents the growth of new blood vessels in the retina, both of which can contribute to the disease.

We will soon have better scientific data on the relationship of vitamin D to AMD risk. The VITamin D and OmegA-3 Trial (VITAL) is a major study involving nearly 26,000 men and women. The primary goal is to investigate whether taking daily dietary supplements of vitamin D3 or fish oil supplements (omega-3 fatty acids) reduces the risk of cancer, heart disease, and stroke. But VITAL will also investigate whether vitamin D or omega-3 fatty acids reduce the incidence and/or progression of AMD.

Using vitamin D supplementation to reduce AMD risk is currently not standard practice. But because most Americans have insufficient levels of vitamin D, it is a good idea to ask your doctor if you should get your blood tested for vitamin D concentration. Normal levels of vitamin D range from 30-74 nanograms per milliliter (ng/ml), according to the National Institutes of Health.

Vitamin B

Some research suggests that supplements containing vitamins B6, B12, and folic acid might help prevent AMD. Women who take these supplements daily are at more than 30 percent lower risk of developing AMD, although a cause-and-effect relationship has not yet been established.

Calcium

Many older adults take calcium supplements to help prevent age-related decline in bone mass, or osteoporosis. However, some research suggests that such supplements are associated with increased risk of AMD in too high a dose. One recent study found that people who take more than 800 mg/day of calcium are diagnosed with AMD more frequently. The study included nearly 3,200 participants, age 40 and older, in the 2007-2008 National Health and Nutrition Examination Survey (NHANES). During the study period, 248 survey participants (7.8 percent) were diagnosed with AMD. The older the participants were, the stronger was the link between calcium intake and risk of AMD, a “dose-response” relationship that suggests that exposure to calcium over time may explain the greater chance of AMD.

This article was originally published in 2017. It is regularly updated.

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Getting too much of your protein from cured meats and processed meats—cold cuts and sausage, for example—is a no-no because those foods are strongly linked to heart disease and cancer.

Plant-Based Diet Sources

One way to skirt the issue of meat and health is to rely more on plant-based sources of protein, like nuts, whole grains, legumes, and tofu and other soy-based foods. Plant foods are a highly recommended foundation for healthy diets. They are packages for a wide range of essential vitamins and minerals along with fiber, antioxidants, and anti-inflammatory phytonutrients.

On the other hand, animal-based protein sources also have some valuable advantages. They supply all the amino acids you need, as well as certain nutrients that are hard to obtain from plant foods.

But there are some important differences you should know about when choosing plant protein vs. animal protein foods. You don’t need to choose one over the other—unless you truly want to go vegetarian or vegan. In that case, the differences between animal and plant protein become even more important.

Plant Protein vs. Animal Protein: It’s All About Aminos

When the protein you eat is digested, it gets broken down into smaller molecules called amino acids. Amino acids and proteins are the building blocks of life. The body combines 20 different amino acids to build proteins for a wide variety of uses. The body uses amino acids to make the enzymes that digest your food, the walls of your cells, and the hairs on your head—just to name a few examples.

Amino acids come in two groups: essential and nonessential. Essential amino acids are those the body cannot synthesize in adequate amounts to maintain body functions. Therefore, you need to obtain a sufficient amount of essential amino acids from food. In contrast, the body can make the 11 nonessential amino acids, either from scratch or by chemically altering other aminos.

The nine essential amino acids are histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. The branched-chain amino acids leucine, isoleucine, and valine are particularly important in building muscle—hence their popularity as dietary supplements among body builders. Branched-chain amino acids are abundant in protein foods like eggs, meat, and dairy products.

When choosing sources of protein to incorporate into meals, it’s important to obtain complete proteins, either by choosing certain high-quality proteins or by combining different protein foods. Complete proteins provide the full range of amino acids you need, and in the optimal proportions.

Animal Protein Sources

Animal proteins are complete and resemble the proteins in our bodies. Good sources of animal protein include:

• Eggs
• Dairy (milk, yogurt, cheese)
• Poultry (chicken, turkey, duck)
• Red meat (beef, pork, venison)
• Seafood (fish, shellfish)

Animal proteins are complete in terms of amino acid content, but contain other important nutrients, too. Strict vegetarians can become deficient in some of these if they don’t take a supplement:

• Vitamin B12: This essential vitamin is found in good amounts in fish, meat, poultry, and dairy products.
• Vitamin D: This is found in oily fish, eggs and dairy.
• Iron: This nutrient is found in abundance in its “heme” form in meat (particularly red meat). The body absorbs heme iron more easily than the type of iron found in plants.
• Zinc: Beef, pork and lamb are good sources of zinc in a chemical form that the body absorbs more readily than the zinc in plant foods.

Seafood is widely touted for its health benefits. Experts recommend two or more fish meals a day to obtain not only high-quality protein but heart healthy omega-3 fatty acids.

Plant Protein Sources

Most plant proteins are not complete, since they are missing one or more essential amino acids. Important exceptions include quinoa (a seed), buckwheat, and soy. Common sources of plant proteins in the American diet include:

• Grains
• Lentils
• Nuts and seeds
• Beans
• Legumes
• Avocados
• Rice
• Peas

You can obtain complete protein by blending different plant foods, such as rice and beans. Besides protein, the plant-food package contains many other valuable nutrients:

• Plant sources of protein also provide fiber. That’s important, because fiber aids digestion and is associated with healthier overall eating patterns.
• Plants also offer a chance to obtain plant-produced phytonutrients with a variety of potential benefits. Phytonutrients have antioxidant and anti-inflammatory properties which have been linked to less heart disease and cancer.

Plant Protein vs. Animal Protein: What Should You Do?

When it comes to choosing animal vs. plant protein, you don’t need to pick one or the other. Each has different merits, which can be complementary if you combine both types of protein.

To be sure, large studies have linked red meat, particularly processed red meat, to higher rates of heart disease, cancer, and other chronic illnesses. Raising large numbers of animals for meat can be harmful to the environment and poses animal cruelty concerns for some people. If you want to reduce reliance on red meat for your protein, plant sources can be a part of that.

Diets based mainly on fruits, vegetables, and whole grains are associated with lower risk of chronic disease and longer life. However, research on vegetarian diets vs. diets with animal foods are inconclusive as to whether one is healthier than the other.

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But it’s important to understand that taking daily “eye vitamins” won’t help prevent age-related macular degeneration unless you already have signs of the disease. If your vision is fine for the time being, skip the supplements and just eat a nutritious diet.

Dry vs. Wet AMD

Macular degeneration vitamins help slow the progress of “dry” AMD. In dry AMD, residue slowly builds up in the eye from breakdown of the macula, part of the retina responsible for sharp central vision. Tiny spots of yellow, fatty protein called drusen build up.

The more drusen that form, the greater the chance that AMD will get worse and begin to damage your vision. Drusen on their own don’t appear to cause blindness, though people with dry AMD may have slightly blurred vision. Usually, dry AMD often has no early warning symptoms that you notice.

Dry AMD is so named because it does not involve the growth of abnormal, leaky blood vessels beneath the macula—the hallmark of “wet” AMD. Wet AMD can be treated with injected medications but cannot be fixed.

Who Should Take Macular Degeneration Vitamins?

Only people with intermediate or advanced AMD stand to benefit from macular degeneration vitamins.

• Intermediate AMD means that you have developed relatively numerous drusen, or one very large drusen.
• Advanced dry AMD means that in at least one eye, cells in the retina have started to waste away and die—a condition called geographic atrophy.

We know that macular degeneration vitamins help people with intermediate or advanced dry AMD because of the Age-Related Eye Disease Study, or AREDS, a randomized clinical trial led by the National Eye Institute.

AREDS established that people with intermediate-stage dry AMD who took a cocktail of high-dose vitamin and mineral supplements were 25 percent less likely to develop more advanced AMD over five years and 19 percent less likely to lose visual acuity. Here’s what the AREDS cocktail contains:

• 500 milligrams (mg) vitamin C
• 400 International Units (IU) vitamin E
• 10 mg lutein (a pigment normally found in the macula)
• 2 mg zeaxanthin (also found in the macula)
• 80 mg zinc
• 2 mg copper

In 2017, health experts with the prestigious Cochrane Collaboration published a review of 19 studies on the use of macular degeneration vitamins for treating AMD. The review confirmed that supplements can slow the progression of AMD and prevent vision loss—but only if caught early.

Should You Take Macular Degeneration Vitamins Just In Case?

You’ll see many “eye vitamin” products on store shelves. If you’re an older person concerned about AMD—and you should be—it’s tempting to take eye vitamins just in case.

But the research to date suggests you’d be wasting your time to take macular degeneration vitamins without a diagnosis of intermediate to advanced dry AMD. AREDS showed that if you have less than an intermediate amount of AMD, the chance of it progressing to advanced disease is very low—around 1 percent over five years—with or without taking macular degeneration vitamins.

But you are far from powerless to preserve your vision as you age. In other words, to lower your risk of macular degeneration, vitamins shouldn’t be your first thought. Here are two steps any older person can take:

1. Get regular eye exams. If you could do just one thing, get regular eye exams. It should be a dilated eye exam, which allows the ophthalmologist or other vision specialist to closely inspect the retina. Early signs of AMD that may appear in a dilated eye exam include drusen as well as a mottled appearance of the macula, which normally appears uniform.

The American Academy of Ophthalmology (AAO) recommends that adults with no symptoms or risk factors for eye disease still get a baseline eye exam at age 40. Then, your doctor will tell you how often to have dilated eye exams, based on family history of eye disease and other risk factors. By age 65, have an exam every one to two years with an ophthalmologist.

2. Eat an eye-healthy diet: For general health and possibly preventing eye diseases, the AAO recommends that you eat a nutritious diet with dark leafy greens (like broccoli, kale, peas, and spinach) along with yellow, orange, and other colorful fruits and vegetables. These healthy foods have high levels of antioxidants, including lutein and zeaxanthin.

In fact, certain diets may help to stave off AMD. One of them is the Mediterranean-style diet. Some studies have found that the more closely people adhered to a Mediterranean eating pattern, the lower the odds of developing AMD. Mediterranean-style diets tend to be heavy in fruit, vegetables, legumes, whole grains, fish, and lean meats.

What about fish oil? Preliminary studies found that people with a relatively high intake of omega-3 fatty acids are less likely to develop advanced AMD. But the AREDS clinical trial did not find that adding omega-3s to macular degeneration vitamins had any effect.

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What’s Social Drinking?

Social drinking is characterized by controlled, moderate drinking. Social drinkers can choose how much alcohol they drink and when.

Health and nutrition experts often advise the public to drink “moderately.” According to the USDA’s 2015-2020 Dietary Guidelines for Americans, moderate drinking means up to two drinks per day for men and one drink per day for women.

That could mean a standard serving of beer (12 ounces) or wine (5 ounces) with dinner—and a “No thanks” to a second. While out of the home, it means handing over the car keys to a friend when you feel tipsy—or not drinking at all if you have to drive.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines normal or low-risk drinking as follows:

• In men, no more than four drinks on any single day and no more than 14 drinks per week.
• In women, no more than three drinks on any single day and no more than seven drinks per week.

NIAAA research shows that only about 2 percent of people who drink within these limits have a serious drinking problem.

When Does Alcohol Abuse Become Problem?

According to the National Institutes of Health (NIH), alcohol abuse is marked by excessive consumption of alcoholic beverages that causes problems in your life—personal relationships, work, school, legal, financial, and social.

Binge drinking is a form of alcohol abuse. NIAAA defines binge drinking as consuming enough alcohol in a two-hour period to raise your blood alcohol level to the legal limit, which is 0.08 grams per deciliter. That means five or more drinks in two hours for men and four or more for women.

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines “heavy” drinking as “binge drinking on five or more days in the past month.”

What Is Alcoholism?

Alcohol abuse (including binge drinking) and full-blown alcohol addiction are now categorized by scientists as alcohol use disorders (AUDs). The NIH estimates that 17 million Americans 18 or older may fit the criteria for diagnosis of AUD.

The current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) explains that a person meets the diagnostic criteria for AUD if they answer yes to any two of the following questions. In the past year, have you:

• Had times when you ended up drinking more, or longer than you intended?
• More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
• Spent a lot of time drinking? Or being sick or getting over the after effects?
• Experienced craving (a strong need, or urge, to drink)?
• Found that drinking (or being sick from drinking) often interfered with taking care of your home or family, or caused you trouble at work or school?
• Continued to drink even though it was causing trouble with your family or friends?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

Symptoms of Alcohol

With continued alcohol abuse, a person can cross the line from abuse to addiction. The symptoms of alcoholism include:

• Craving: A strong desire or need to consume alcohol.
• Loss of control: Not able to stop or moderate drinking once you start.
• Physical dependence: Experiencing withdrawal symptoms such as anxiety, irritability, sweating, and other physical problems.
• Tolerance: It takes more and more alcohol over time to get the same effect.

Alcoholism Treatments

There are a number of treatments for alcohol use disorder. They include individual and group therapy, medication, and self-help groups and other social support. Many people combine different approaches to create a recovery program that works for them. The root causes of alcohol abuse vary, so what works for one person may not work for another.

• Counseling: Psychotherapy and other behavioral treatments can help some problem drinkers to change their harmful drinking behaviors. An approach that has shown general effectiveness is cognitive-behavioral therapy (CBT). CBT helps a person identify feelings and situations (cues) that lead to heavy drinking, and also manage stress that can lead to relapse.
• Medication: Three medications are approved by the U.S. Food & Drug Administration (FDA) to help people reduce drinking or reduce the chance of relapse once they become abstinent. The drugs can be used in combination with therapy and social support groups.
  • Acamprosate (Campral) helps to prevent return to drinking (relapse) in problem drinkers who have stopped consuming alcohol. (There is also an injected form called Vivitrol.) A review by the prestigious Cochrane Collaboration found good evidence that Campral prevents relapse.
  • Disulfiram (Antabuse) has been in use since the 1950s. The drug prevents the breakdown of alcohol in the body. A person who drinks alcohol while on Antabuse will become very ill, with nausea, vomiting, skin flushing, racing heart, and other very unpleasant symptoms.
  • Naltrexone (Revia) suppresses cravings and blocks the effects of alcohol on the brain. In studies, people on naltrexone slightly decreased daily drinking, heavy drinking, the number of drinking days, and the amount of alcohol consumed.

An anti-seizure medication called topiramate (Topamax) has also shown promise in research, though it’s not specifically approved by the FDA for alcohol problems. Some, but not all, randomized clinical trials found that Topamax decreases number of drinking days, heavy drinking days, and drinks per day based on two randomized trials.

As with all medications, drugs used to treat symptoms of alcohol use disorder have side effects, some potentially serious.

The post Alcohol Abuse: When Drinking Becomes a Problem appeared first on University Health News.

The foundation of treatment is lifestyle change—such as eating a healthy diet and exercising regularly—to keep blood pressure in the recommended healthy range. But sometimes lifestyle change falls short and you may need to consider taking a pressure-lowering medication.

A wide variety of blood pressure medications are available to consumers. Various types of blood pressure medication work in different ways. Depending on the severity of your high blood pressure, it may take more than one medication.

Combining multiple drugs at lower doses helps to limit side effects while achieving your blood pressure goals.

Blood Pressure Medication Choices

Blood pressure medications fall into separate groups, or classes, based on how they act in the body to lower blood pressure. The body has a variety of ways to regulate blood pressure—continuously tweaking your system to keep the pressure neither too high nor too low. Some blood pressure medications act directly on the heart or nervous system, while others target the arteries or kidneys.

Below are the five most commonly prescribed blood pressure medications. If you are diagnosed with high blood pressure, your doctor likely will choose from one or more of these categories to start your therapy.

ACE inhibitors: Angiotensin-converting enzyme (ACE) inhibitors prevent the body from producing a hormone, angiotensin converting enzyme, which normally tightens and narrows the arteries. Turning down the tap on ACE lowers blood pressure (and can also prevent kidney damage in people with diabetes).

Side effects of ACE inhibitors include a dry, hacking cough that goes away if you stop taking the drug. Less common side effects include dry mouth, nausea, rash, muscle pain, and elevated potassium. A rare but dangerous side effect of ACE inhibitors is angioedema, or swelling of the lips, tongue, and throat that can interfere with breathing.

Examples of ACE inhibitors include benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), Quinapril (Accupril), Ramipril (Altace), and Trandolapril (Mavik).

ARBs: Angiotension II receptor blockers (ARBs) block a hormone (angiotensin) that normally narrows blood vessels, thus lowering blood pressure. Doctors generally use ARBs to substitute for an ACE inhibitor (if the ACE causes side effects). Potential side effects of ARBs include abdominal pain, dry mouth, headache, and nausea. They are less likely to cause angioedema than are ACE inhibitors.

Examples of ARBs include azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesarten (Avapro), losartin (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan).

Beta blockers: These medications make the heart beat slower and with less force, which lowers blood pressure. Common side effects may include fatigue, cold hands and feet, or weight gain. Beta blockers can have a variety of effects on heart and lung function, which makes them potentially risky for people with certain health conditions, such as asthma and peripheral vascular disease.

Also, once you’re taking a beta blocker, you can’t suddenly stop taking it, since this could cause a heart attack. On the plus side, beta blockers can be helpful in people with certain health conditions, like angina (chest pain) or atrial fibrillation (abnormal heart rhythm). In such cases, your doctor may include a beta blocker in your blood pressure medication therapy.

Examples of beta blockers include atenolol (Tenormin), bisoprolol fumarate (Zebeta), carvedilol (Coreg), esmilol (Brevibloc), labetalol (Trandate, Normodyne), metoprolol (Lopressor), metoprolol (Toprol), nadolol (Corgard), nebivolol (Bystolic), penbutolol (Levatol), propranolol (Inderal), and sotalol (Betapace).

CCBs: Calcium channel blockers (CCBs) keep calcium from entering the muscle in the heart and arteries. The arteries relax and widen, causing blood pressure to fall. The possible side effects of calcium channel blockers depend on the type used and the dose. Possible side effects of dihydropyridine-type CCBs include dizziness, flushing, headaches, nausea, swelling in the legs, and overgrowth of gum tissue. For nondihydropyridine-type CCBs, potential side effects include headache, nausea, and slowed heart rate.

Examples of calcium channel blockers include amlodipine (Norvasc, Lotrel), clevidipine (Cleviprex), diltiazem (Cardizem, Dilacor, Tiazac), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia) nimodipine (Nimotop, Nymalize), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan, Covera).

Diuretics: These medications, also known as “water pills,” make the kidneys excrete more water and sodium. As a result, the total fluid in circulation falls and, with it, blood pressure. A type called thiazide diuretics are most commonly used for high blood pressure. Potential side effects of thiazide diuretics is temporary low blood potassium, which can cause leg cramps, fatigue, constipation, and changes in blood sugar levels.

Examples of thiazide diuretics prescribed for high blood pressure include chlorothiazide (Diuril), the hydrochlorothiazide (HCTZ) medications (such as Esidrix, Hydrodiuril, and Microzide), and indapamide (Lozol).

Combination pills: Pharmaceutical manufacturers have developed pills that combine blood pressure medications often prescribed together. Adhering to multi-drug regimens can be challenging, and many patients are unable to take their medications as directed. Combination pills can make it more convenient to stick to a daily regimen of multiple drugs, helping to improve control of blood pressure.

Which Blood Pressure Medication Is Best for You?

It’s hard to predict which blood pressure medication (or medications) will work best for you. The five categories that doctors use most often to treat high blood pressure—ACE inhibitors, ARBs, beta blockers, CCBs, and diuretics—are equally effective. Overall, they’re known to lower blood pressure in up to 50 percent of patients. Still, the responses of individuals vary considerably. That means a drug that falls short for another person may work better for you.

The ultimate goal of treatment is to find the blood pressure medication (or medications) that gets your high blood pressure under control but is “well tolerated.” That means that the side effects (if any) of the medication are acceptable to you and are not a major impediment to you sticking to therapy.

In selecting medications, your doctor will consider any existing health conditions you have and other medications you are taking. Depending on these factors, some blood pressure medications may not be a good fit for you. For example, if you already struggle with constipation, taking a diuretic could make it worse. Factors such as age, race, other health conditions, and gender can also influence drug choices.

What If You Have Mildly High Blood Pressure?

For mild high blood pressure, it’s common to start with a single drug—either a thiazide diuretic, a CCB, or an ACE inhibitor. (Beta blockers are usually not the first choice, but may be added later.) If the response is inadequate, the can raise the drug dose a bit.

If that doesn’t work, it may be necessary to add a second type of medication. In cases of treatment-resistant high blood pressure, it can take three or even four medications to get pressures under control.

What About Side Effects?

Anyone can experience a side effect from any blood pressure medication. It’s difficult to predict. The number of different kinds of side effects are numerous, although some are more common than others. Your doctor will tell you what to watch out for and instruct you what to do if you have a bad reaction to a new medication. Fortunately, there are many different medications to choose from.

The post Blood Pressure Medication: Which Is the Right One for You? appeared first on University Health News.

Organic food products are different because they are grown and processed with organic farming methods, which exclude certain practices that are normal in the mass production of non-organic foods.

Proponents of organic farming point to benefits for the environment, like less water pollution and better soil quality. Organic meats come from livestock raised under more humane conditions. Organic produce and meat also may have higher levels of certain nutrients and fewer pesticide residues.

Qualifications for Organic Produce and Grains

Organic plant farming practices include:

• No use of synthetic fertilizers, which may contain chemicals manufactured from fossil fuels. Instead, organic farmers rely on mulching, composting, and animal manure to enrich the soil.
• No fertilizers derived from sewage sludge, which is the residue left over after human waste is processed.
• No synthetic herbicides. Weeds are controlled with crop rotation, mulching, tilling, and hand weeding.
• Avoid use of synthetic pesticides. Instead, organic farmers use organic approaches like insects that eat pests, traps, and naturally-produced pesticides. But there is a loophole: organic farmers may use certain chemical pesticides in small amounts, following regulations for USDA-certified organic foods.
• No genetically engineered crops, more commonly known as genetically modified organisms, or GMOs. Some GMO crops are designed to produce natural pesticides or to be resistant to synthetic weed killers so farmers can apply more of them and increase crop yields.
• No irradiation to kill diseases or pests, or to extend shelf life. Irradiation means exposing the food, dairy, or meat to ionizing radiation.

Qualifications for Organic Meat

USDA-certified organic livestock production follows its own set of rules. This includes:

• No use of growth hormones or antibiotics in cows, chicken, pigs, or other animals.
• Animals are not fed with animal by-products, like fat, flesh, and blood from animals. The animals only eat organic feed or graze on natural grasses.
• Animals raised for meat, eggs, and milk are provided access to outdoor space for fresh air, exercise, shade, shelter, and clean drinking water.
• The livestock are raised on certified organic land meeting all organic crop production standards.

How to Shop for Organic Food

Any food producer can claim its products are organic, but how do you know it’s the real stuff? Here are a few suggestions on how to be a savvy shopper.

1. Don’t confuse “natural” and “organic.”

Though the word “natural” on a food label may mean that the product does not contain artificial flavorings, preservatives, or other additives, this does not mean the product fits all of the qualifications of “organic.”

2. If you buy at farmer’s markets, talk to the producer about their farming practices.

Many producers enjoy and welcome this sort of interaction with customers. Some questions you can ask about the produce or meat include:

• What types of pesticides do you use when farming?
• What type of environment is your livestock living in?
• Are your chickens caged or free-range?

3. Look for USDA organic-certified labels.

The USDA allows foods to be labeled organic if they pass with the agency’s certification process. The agency allows four types of organic food labels. Here are the basics of what the labels mean:

• • 100 Percent Organic: All ingredients and processing are organic. No GMOs. Complies with the national list of ingredients and processing allowed in certified-organic foods.
  • Organic: 95 percent of ingredients are certified organic. No GMOs. Complies with the national list of ingredients allowed in certified-organic foods.
  • Made with Organic: Organic seal not allowed. At least 70% of ingredients are certified organic. No GMOs. Complies with a list of ingredients allowed in certified-organic foods.
  • Organic Ingredients: Organic seal not allowed. No specific percentage of ingredients is required to be organic. They may contain GMOs. Not required to comply with the national list of ingredients allowed or not allowed in organic foods. Does not have to undergo USDA certification process.

Organic vs. Non-Organic: Choose “Cleaner” Produce

The Environmental Working Group (EWG), a nonprofit organization, publishes an annual report, the Shoppers Guide to Pesticides in Produce. The report is based on USDA pesticide residue testing.

According to the EWG, the following 15 fruits and vegetables have the least residues relative to other options: avocados, sweet corn, pineapple, onions, papaya, frozen sweet peas, eggplant, asparagus, broccoli, cabbage, kiwi, cauliflower, mushrooms, honeydew melon, and cantaloupe.

The following 12 fruits and vegetables have comparatively higher amounts of pesticide residues: strawberries, spinach, kale (collard, mustard greens), nectarines, apples, grapes, cherries, peaches, pears, bell and hot peppers, celery, and tomatoes.

The post Organic vs. Non-Organic Foods: What’s the Difference? appeared first on University Health News.

The Heart’s Natural Pacemaker

The heart is a fist-sized pump made out of muscle. To pump blood efficiently, two upper chambers (atria) and two larger, lower chambers (the ventricles) have to contract in the right order and at the proper rate.

The heart has its own internal pacemaker. It’s called the sinus node, and it lies near the top of the heart. Cells in the sinus node generate electrical impulses that travel downward along specialized cells in the heart.

The impulses help maintain the proper timing or “pacing” of the heart to pump blood through the heart’s four chambers. Normal pacing includes both the right heart rate (how fast the heart beats) and the proper rhythm.

Pacemaker insertion involves a roughly 2-inch incision in the upper-left chest area, under the shoulder. (Photo: Photo 47955864 © Jfspic – Dreamstime.com)

How a Pacemaker Is Implanted

Pacemakers are implanted just below the skin surface in the left upper chest. The typical incision required is about 2 inches long. You’ll normally be awake for the implant, with local anesthesia to numb the area where the pacemakers will be inserted. You’ll take a sedative to relax you during the procedure, though you will remain otherwise conscious.

If you experience complications after the implant procedure, it usually will be one of these:

• Swelling, bleeding, bruising, or infection around the implant
• Damage to blood vessels or nerves
• Collapsed lung
• Adverse reaction to medication used during the procedure

What Does a Pacemaker Do?

Pacemakers do not replace the heart’s natural pacing system. They just help to keep the heart’s natural rhythms on track if they’re not working properly.

Electrical impulses from the pacemaker make sure the different chambers of the heart contract (squeeze inward) in a coordinated way. This keeps blood flowing to the rest of the body despite abnormalities in the heart’s natural rhythms.

How Does a Pacemaker Work?

A typical pacemaker is roughly the width of a half-dollar and several times thicker. The device includes a tiny pulse generator, a battery, wiring, and a computer.

Insulated wires, called leads, are run from the pacemaker, through veins, and into the heart. Pacemakers can have one, two, or three leads, depending on the type of arrhythmia and the therapy needed. Most pacemakers implanted today have two leads—one to the right atrium and the other to the right ventricle.

The pacemaker’s circuits monitor your natural cardiac rhythm and deliver tiny jolts to where they are needed to make the heart operate properly. Most pacemakers also can sense your breathing and physical motion, allowing them to tune your heart rate to the body’s needs.

The pacemaker’s battery is internal, so the entire device has to be swapped out when the battery runs out. Pacemaker batteries can last five to 15 years, though the average is around six to seven years.

Who Needs a Pacemaker?

Pacemakers help people with abnormal heart rhythms (arrhythmias) that can’t be treated adequately with antiarrhythmic drugs. Arrhythmias take many forms. The three general types are:

1. Premature, or extra, heartbeats, also called palpitations. These can occur in the atria or the ventricles and are usually harmless, though they can be unpleasant.
2. Fast heartbeat, or tachycardia, in which the resting heart rate is faster than 100 beats per minute. One of the most well known is atrial fibrillation, which can cause blood clots to form in the atria. Other, more dangerous, forms of fast heart beat are ventricular tachycardia and ventricular flutter. These can cause sudden cardiac death.
3. Slow heartbeat, or bradycardia, in which the resting heart rate is less than 60 beats per minute. A condition called sick sinus syndrome can cause slow heartbeat (with symptoms), which is the most common reason people get pacemakers. (See also our post Is a Low Heart Rate Dangerous?)

Arrhythmias cause some distinctive types of symptoms. The most common that people report include:

• Weakness
• Fatigue
• Lightheadedness
• Dizziness
• Temporary loss of consciousness (syncope)

Pacemakers and Heart Disease

People sometimes develop slow heartbeats after a heart attack, which temporarily interrupts the supply of oxygen-rich blood to heart muscle. Bad reactions to medications and physical trauma to the heart (as during a car accident) also can cause bradycardia. In such cases, a pacemaker might be installed temporarily until the function of the heart returns to normal.

Pacemakers also are used to treat heart failure. Heart failure is when the heart is unable to pump enough blood to meet the body’s needs. In such cases, a special type of pacemaker can provide cardiac resynchronization therapy (CRT). This is for people with heart failure experiencing moderate to severe symptoms, and whose left and right heart chambers do not beat in unison.

In CRT, a special pacemaker pacemaker helps the ventricles on both sides of the heart to work together. The device that does this is called a biventricular pacemaker. One lead goes to the right atrium and the other two go to the right and left ventricles.

Some people with heart failure are at significant risk of sudden cardiac death caused by fast or uneven beating in the heart’s main pumping chambers. In such cases, a person can get an enhanced pacemaker called an implantable cardioverter-defibrillator, or ICD.

The ICD provides pacing to maintain optimal cardiac rhythms and also can shock the heart back to normal rhythm if it develops dangerous ventricular rhythms. The device is larger than a normal pacemaker—about the size of a cell phone. It is implanted either under your collarbone or in the abdomen.

You have probably seen the full-size equivalent of an ICD hanging in boxes on the walls of public buildings. The boxy device is an automated external defibrillator, or AED. These can be used to save a person’s life if they go into cardiac arrest from ventricular arrhythmia.

Living with a Pacemaker

Pacemakers are reliable and safe but you need to make certain adaptations once you have one:

• After the pacemaker is installed and programmed in the hospital, you’ll need to return for a follow-up visit so your doctor can make sure the device is functioning correctly.
• Longer term, you will receive equipment to take home that can wirelessly connect to the pacemaker, collect information, and send it to your cardiologist.
• A pacemaker can trip metal detectors. When passing through security checkpoints in airports and other public spaces, tell the security screener you have a pacemakers. The screener should not pass a handheld metal detector “wand” close to the pacemaker, since it has a magnet inside. Full-body scanner should not cause any problems with your device, but check with your doctor.
• Inform any doctor you see that you have a pacemaker, if they don’t already know.
• You will need to avoid having an MRI or take special precautions. Medical staff are trained to handle this risk.
• Radiation therapy for cancer can damage a pacemaker, so you will need to take special precautions. Again, medical staff are trained to handle this issue.
• A large variety of electric and electronic devices can interfere with a pacemaker. Make sure your healthcare providers have educated you fully about this. Mainly, you need to avoid or stay a safe distance from electrical equipment that can send out signals that could interfere with the pacemaker. That includes cell phones or magnets (if held too close to the pacemaker), electric blankets, high-voltage transformers, welding equipment, electrical generators, and some electric tools.
• If you have an ICD and it trips, it can feel like a kick in the chest. This can be alarming and upsetting, but the alternative might have been sudden death.

The post The Pacemaker: Our Primer Explains How It Keeps Your Heart’s Rhythm In Step appeared first on University Health News.

How They Make Kombucha

Kombucha was developed in China in the 2nd century BC. It’s also known as Manchurian tea. It can be made from either black or green tea. Kombucha is a living beverage, produced by a “biofilm” of yeast and bacteria floating on top of the brewing liquid. Kombucha insiders call it a SCOBY: symbiotic culture of bacteria and yeast.

The SCOBY resembles a wrinkled, fleshy pancake floating on the fermenting “soup.” This explains why the beverage is sometimes called “mushroom tea”—even though no actual mushrooms are used to make it.

A piece of existing SCOBY can be used, like a pinch of sour dough bread starter, to initiate fermentation of the tea-and-sugar mix. After fermentation, kombucha is bottled and allowed to build up some of its fizz. Kombucha brewers cool the tea to put the brakes on fermentation.

Store-bought kombucha may have a trace of alcohol. If it’s 0.5 percent or higher by volume, kombucha must be regulated as an alcoholic beverage in the United States. If you’re avoiding alcohol for health or other reasons, be advised: Home-brewed kombucha may contain more than a trace of alcohol.

The wrinkled, fleshy “pancake” you see floating in fermenting kombucha is often referred to as a mushroom, but there are no mushrooms (or pancakes!) used in making this healthy brew.

Kombucha Sugar Facts

The basic nutritional content of kombucha is fairly benign, including a moderate amount of sugar. Most products listed in the USDA Food Composition Databases contain between 2 and 4 grams of total sugar per 1-cup (8-ounce) serving. A few outlier products reach 9 or 10 grams (equivalent to 5 teaspoons of sugar).

Now compare kombucha’s sugar content to that of bottled or sweetened retail coffee drinks. Some of those pack up to 20 grams of sugar per 8-ounce serving (40 grams in a more typical 16-ounce serving).

Concerned about calories and sugar in commercial kombucha? Read the Nutrition Facts label.

Beware of Speculative Health Claims

Kombucha is touted to have many medicinal properties. Some are based on credible research on human health, but others are a bit of a reach.

Kombucha contains probiotics—live, active bacteria, like the bacteria in yogurt. Probiotics have been linked to better heart health, less risk of obesity, lower rates of diabetes, and other health benefits. These claims are not proven beyond doubt, but are at least credible based on research on humans.

Other kombucha claims are less credible—that kombucha clears toxins from the body, cures cancer, lowers blood pressure, boosts immune function, fights acne, soothes arthritis pain, reduces wrinkles, and restores gray hair. There are more, too—click here.

Unfortunately, many of these “too good to be true” health claims are based on preliminary laboratory studies and research on rats. Bench-top and animal research are essential preliminary steps before human studies, but you can’t use them to confidently make decisions about your diet.

Home-Brew Cautions

Producers of processed kombucha products are accountable for the safety of their products, which are regulated by the U.S. Food and Drug Administration (FDA). But there is also a thriving home-brew community outside the reach of federal regulations. Although most kombucha home brewers practice their hobby safely, a small number of studies have linked serious illness to drinking kombucha, including allergic reactions, liver and kidney toxicity, dizziness, nausea, and vomiting. The problems may have stemmed from improper brewing or handling of the kombucha.

If you want to make your own kombucha, get the recipe from a reputable source and follow directions carefully. One credible source is The Big Book of Kombucha (2016) by Hannah Crum and Alex M. LaGory. Crum, a national kombucha expert, cofounded the leading industry trade organization, Kombucha Brewers International.

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