What are Phytonutrients? Phytonutrients are bioactive compounds produced by plants as part of their defense mechanisms against environmental challenges such as pests, UV radiation, and diseases. Unlike essential nutrients required for basic bodily functions, phytonutrients are not necessary for survival but can significantly enhance health and reduce the risk of chronic diseases.

There are thousands of different phytonutrients, each with unique properties and health benefits. These compounds can be categorized into several classes, including carotenoids, flavonoids, phenolic acids, and glucosinolates, among others.

Major Classes of Phytonutrients.

Carotenoids: Carotenoids are pigments found in brightly colored fruits and vegetables, such as carrots, sweet potatoes, spinach, and tomatoes. They are responsible for the red, orange, and yellow hues of these foods. Some well-known carotenoids include beta-carotene, lycopene, and lutein.

Beta-Carotene is a precursor to vitamin A, essential for vision, immune function, and skin health.

Lycopene is linked to a reduced risk of prostate cancer and cardiovascular disease.

Lutein and Zeaxanthin are important for eye health, reducing the risk of age-related macular degeneration and cataracts.Flavonoids: Flavonoids are a diverse group of phytonutrients found in a wide variety of plant-based foods, including berries, apples, onions, tea, and red wine. There are several subtypes of flavonoids, such as flavonols, flavones, flavanones, and anthocyanins.

Quercetin, a flavonol, has anti-inflammatory and antioxidant properties, helping to reduce the risk of chronic diseases like heart disease and cancer.

Catechins, found in green tea, are associated with improved heart health and weight management.

Phenolic Acids: Phenolic acids, such as caffeic acid and ferulic acid, are found in coffee, whole grains, fruits, and vegetables. These compounds have strong antioxidant properties, helping to neutralize harmful free radicals and reduce inflammation.

Caffeic Acid is linked to anti-inflammatory and antidiabetic effects.

Ferulic Acid has been shown to protect against UV radiation and reduce the risk of chronic diseases.

Glucosinolates: Glucosinolates are sulfur-containing compounds found in cruciferous vegetables like broccoli, Brussels sprouts, and cabbage. When these vegetables are chopped or chewed, glucosinolates are broken down into biologically active compounds such as isothiocyanates and indoles.

Sulforaphane, an isothiocyanate, has anticancer properties and may enhance detoxification processes in the body.

How They Work. Phytonutrients exert their health benefits through several mechanisms:

1. Antioxidant Activity: Many phytonutrients have strong antioxidant properties, which help neutralize free radicals—unstable molecules that can damage cells and lead to chronic diseases. By reducing oxidative stress, phytonutrients protect against conditions such as cancer, cardiovascular disease, and neurodegenerative disorders.

2. Anti-Inflammatory Effects: Chronic inflammation is a common underlying factor in many diseases. Phytonutrients like flavonoids and phenolic acids can modulate inflammatory pathways, reducing inflammation and the risk of associated diseases.

3. Modulation of Detoxification Enzymes: Some phytonutrients enhance the activity of detoxification enzymes in the liver, helping to eliminate carcinogens and other harmful substances from the body. For example, sulforaphane in cruciferous vegetables boosts the production of phase II detoxification enzymes.

4. Hormonal Balance: Certain phytonutrients can influence hormone metabolism and activity. Indole-3-carbinol from cruciferous vegetables, for example, helps balance estrogen levels and reduce the risk of hormone-related cancers.

How to Get Phytonutrients. Given their significant health benefits, it is important to include a variety of phytonutrient-rich foods. Here are some practical tips:

Eat a Rainbow: Consume a wide range of colorful fruits and vegetables to ensure you get a variety of phytonutrients.

Choose Whole Foods: Whole grains, nuts, seeds, and legumes are excellent sources of phytonutrients.

Keep it Fresh (as Possible): Fresh, raw, or lightly cooked foods tend to retain more phytonutrients compared to heavily processed ones.

Experiment with Spices and Herbs: Many spices and herbs, such as turmeric, ginger, and garlic, are rich in phytonutrients and can enhance the flavor and nutritional value of meals.

The Bottom Line. Phytonutrients are vital, bioactive compounds found in plants that offer a multitude of health benefits. By incorporating a diverse array of phytonutrient-rich foods into your diet, you can support overall health, reduce the risk of chronic diseases, and promote longevity.

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“I have so many patients who were surprised to learn they have advanced glaucoma because they didn’t sense any problem with their vision,” says JoAnn Giaconi, MD, Vice Chair for Affiliate Hospitals, Stein Eye Institute, and Professor of Ophthalmology, David Geffen School of Medicine. “Glaucoma can be without symptoms until very late in its development. It is much better to catch it early and start treatment to slow it or stop it from getting worse, so you can enjoy doing what you want to do and need to do late into life.”

Like many conditions, the risk for glaucoma increases with age.

Glaucoma Defined

Glaucoma is a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. This damage is often caused by abnormally high pressure in the eye. Many, but not all, cases of glaucoma come with above-average eye pressure.

The two most common types are open-angle glaucoma and angle-closure glaucoma. In older adults, open-angle glaucoma accounts for the majority of cases. With open-angle glaucoma, eye fluid drainage is reduced due to a malfunction in the trabecular meshwork, a spongy structure that drains the clear fluid from the front of the eye. This causes pressure in the eye to rise and can gradually damage optic nerve cells. It commonly impacts peripheral vision and eventually extends to central vision, potentially resulting in total blindness. In some patients, central vision can be affected early during the course of the disease.

“Development of open-angle glaucoma cannot be prevented, but early diagnosis can lead to early treatment so that vision can be maintained throughout life,” explains Kouros Nouri-Mahdavi, MD, MS, Chief of Glaucoma at UCLA’s Stein Eye Institute. “Glaucoma with narrow or closed angles is more common in people from East Asia and the Middle East.”

In angle-closure glaucoma (also called narrow-angle glaucoma) the wedge-shaped drainage angle of the eyes becomes blocked, causing a rise in eye pressure. Like the open-angle type, you may not realize this increase in eye pressure is occurring.

Eye Exams Can Save Sight

Routine eye exams do pick up all types of glaucoma, but both the front and the back of the eye must be examined. The air-puff test is a simple screening test for detecting high intraocular pressure. However, the gold standard for detecting optic nerve damage associated with glaucoma is a comprehensive dilated eye exam.

“Dilating the pupil allows the doctor to do a careful examination of the optic nerve,” explains Dr. Giaconi. “The optic nerve shows unique patterns of damage as it thins out in glaucoma. However, there are some patients with narrow angles, in whom pupil dilation must be delayed until after the narrow angles are treated.”

It is recommended that people age 65 and older have a comprehensive eye exam every one to two years.

Treatments to Preserve Vision

There is no cure for glaucoma, but a variety of treatments can slow the disease and prevent severe vision loss. The treatment depends on disease type, but in general glaucoma can be treated with eyedrops, laser treatments, and surgery. When medications don’t adequately control eye pressure, surgery can help. In some cases, early surgery may be the best first option. “There are good surgical options for early stages of glaucoma that are often done at the time of cataract surgery,” says Dr. Giaconi.

Conventional surgery is usually offered when medications and laser surgery have failed. A new drainage system replaces the natural meshwork, and sometimes a tiny valve is implanted into a new drainage hole.

Early detection and treatment are crucial to prevent optic nerve damage. If you are diagnosed with the disease, you will need to be vigilant about seeing your doctor in order to preserve your eyesight. “Glaucoma is a lifelong disease,” says Dr. Nouri-Mahdavi. “People with glaucoma can maintain their vision as long as they closely follow their treatment as instructed by their eye doctors and come back for regular monitoring.”

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Modified Options

Functional foods include conventional foods and foods that have extra bioactive ingredients added to them. Mount Sinai nutrition consultant Fran Grossman, RD, MS, CDCES, CDN, notes that many Americans buy these modified functional foods without giving it much thought. “Commonly purchased options include yogurts formulated with probiotics, bread and cereal enriched with folic acid, margarine that contains specific plant compounds, and milk with added vitamin D,” she says.

In many instances it’s clear that the added ingredients in fortified foods can and do benefit health. “For example, there is evidence that probiotics may benefit people with bowel disorders and those taking antibiotics, which can destroy beneficial bowel bacteria,” Grossman says. “Folic acid—a synthetic form of the B vitamin folate—has been shown to prevent birth defects, adding plant compounds to foods may reduce the risk of coronary artery disease, and fortifying milk and fruit juice with vitamin D and calcium may help preserve bone health in older age.” However, she adds that there may be little or no solid study data saying we need these added ingredients, and that people may expect too much from them. “For example, some cereals are marketed as helping to lower cholesterol,” she says. “While they may be beneficial to people with slightly raised cholesterol levels, people with high cholesterol may rely on them even though statin medications might be a better option.”

Look Out for Unhealthy Ingredients

The U.S. Food & Drug Administration carefully regulates health claims on food labels and packaging and authorizes them only after extensive review of the scientific evidence in their favor. However, a less stringent standard also exists that enables food manufacturers to market foods using qualified health claims based on less scientific evidence as long as the claims don’t mislead consumers. There is evidence that people find it difficult to distinguish between the different types of health claim. Such claims also may distract people from checking the overall content of some functional foods. This is a must-do, since some functional foods contain unhealthy ingredients—for example, some fortified cereals are high in sugar, while a probiotic-rich yogurt also may be packed with artificial flavoring and coloring. “Don’t just assume that all modified functional foods are healthy,” Grossman says.

Keeping It Conventional

As far as conventional functional foods go, these are natural, unmodified whole foods. Examples that Grossman recommends include:

• Vegetables that contain sulforaphane, which may protect against cancer (found in broccoli, Brussels sprouts, and cauliflower); lutein, which may benefit eye health and lower the risk of cataracts and macular degeneration (kale, spinach); and lycopene, which may reduce the risk of cardiovascular disease and cancer (tomatoes).

• Avocados, which are packed with nutrients and have been shown to help improve the absorption of nutrients from other foods consumed at the same time.

• Berries, including blueberries, strawberries, blackberries, and raspberries. These are packed with compounds that may reduce inflammation and protect cardiovascular health.

• Fatty fish. Mackerel, salmon, trout, herring, light tuna and sardines are high in omega 3 fatty acids, which are associated with a reduced risk for cancer, cardiovascular disease, diabetes, and arthritis.

• Whole grains. High in fiber, these may lower both blood sugar and cholesterol. Choose from wheat, oats, buckwheat, barley, and farro, among others.

• Legumes. This category includes beans, lentils, peas, and chickpeas. All are good sources of dietary fiber and contain protein, potassium, and folate.

• Nuts and seeds, including cashews, almonds, walnuts, and sunflower seeds. These are high in vitamins, minerals (magnesium), and healthy fat, and are associated with heart-health benefits such as decreasing “bad” LDL cholesterol and reducing the risk of heart disease.

• Fermented and cultured foods. These contain both probiotics and prebiotics that are considered important for gastrointestinal health. Examples include kefir, yogurt, tempeh, kimchi, sauerkraut, and kombucha.

• Herbs and spices, including cinnamon, garlic, ginger, and turmeric, all of which are known for their anti-inflammatory properties.

Not a Magic Bullet

Above all, keep in mind that your diet is just one aspect of a healthy lifestyle. “To get the most from functional foods, team them with daily exercise and forgo bad health habits like smoking and excess alcohol consumption,” Grossman advises.

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Vision Correction Options

The most basic glasses—single vision—are a good choice if your distance vision is good and you need glasses only for reading or computer use. But if your distance vision also needs correction, multifocals may be the most practical option since they save you from constantly switching between two separate pairs. “Multifocal glasses can be bifocal, trifocal, or progressive,” says Dr. Chen. “Depending on which type your eye doctor recommends, they correct for two or three distances in one lens.”

Bifocals contain separate zones for near and distance vision, while trifocals have separate zones for distance, intermediate (looking at a computer screen, for example) and close-up tasks. “Both bifocals and trifocals typically have a line or lines separating their different zones, and some people don’t like this for cosmetic reasons,” Dr. Chen notes. “Progressive lenses don’t have lines but tend to be more expensive.”

Progressive lenses sound ideal, but some studies have suggested that older adults who use them may be at greater risk of falls, particularly when they first start wearing progressives. With these lenses, it’s important to pitch your head so that you are seeing through the correct portion of the lens for whatever task you’re doing—otherwise your vision will be blurred. That means tilting your head up slightly for near vision, so that you don’t bump into things or trip over obstacles at floor level.

Other Options

You may want to talk to your eye doctor about monovision correction, which involves wearing contact lenses that correct for different distances. Monovision works because people tend to have a dominant eye that sends more accurate information to the brain. “In monovision, a lens correcting for distance vision is used in the dominant eye, and a lens correcting for near vision is used in the nondominant eye,” Dr. Chen explains. “This approach can be a good alternative to reading glasses, but it’s a good idea to try it out first at your eye doctor’s office before you commit.”

It also is possible to have multifocal contact lenses implanted in your eyes. These intraocular lenses (IOLs) replace the natural lens of the eye, which is removed during the implant procedure. “If you are interested in using IOLs, your eye doctor will do some imaging to make sure you are a good candidate, depending on the anatomy of your eye and your vision prescription,” Dr. Chen says. While IOLs can eliminate the need for glasses, some people who have them report side effects, including a “halo” effect around lights and difficulty seeing in low light.

Practicalities

Select frames made from lightweight, flexible titanium instead of heavy plastic. Frames should fit snugly, but not too tightly, and the bridge should feel comfortable. Check that it doesn’t slip down your nose, as this could reduce the corrective effect of the lens. You also may want to consider getting an anti-reflective, ultraviolet (UV) coating. This protects your eyes against UV radiation from the sun and improves contrast, making it easier to read and distinguish certain objects (it may add a slight green or purple tint to the lenses).

If you’re more sensitive to glare now that you’re older, you can opt for transition lenses that darken when exposed to the sun. Protecting your eyes from strong sunlight is important as you age, since UV light can damage the cornea and lens. Some studies have suggested that exposure to bright sunlight may increase the risk of developing cataracts and age-related macular degeneration. “Transition lenses may take a few moments to lighten when you come indoors from being outside in the sun,” Dr. Chen says. “If you choose these lenses, be cautious until you can see clearly.”

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If cataracts are detected early—at stage 1 or 2—you’ll have some time before surgery is necessary. But if cataracts have developed—or ripened—to stage 3 or 4, where they affect your ability to drive, read, or work, it’s time for cataract surgery.

Safe Surgery

Cataracts affect more than 25 million Americans, 61 percent of whom are women— and cataract surgery is among the most frequently performed and safest surgeries worldwide. Cataract surgery involves removal of the clouded lens and replacement with a clear artificial intraocular lens (IOL). This is done as an outpatient procedure that takes less than 30 minutes, and in most instances is covered by Medicare and most private insurance. “Today, cataract surgery is safe in more than 95 percent of patients,” says Ana Alzaga Fernandez, MD, assistant professor of ophthalmology at Weill Cornell Medicine.

Standard IOL vs. Premium IOL

In most cases, a monofocal IOL is used to replace the clouded lens. This is the standard lens that has been successfully implanted for decades and is 100 percent covered by Medicare and private insurance. The monofocal IOL is designed to provide the best possible vision at one distance. Most people who choose a monofocal IOL have it set for distance vision, and they use reading glasses for near-vision tasks, such as reading and crafts. “In some instances, however, patients decide to have the IOL set for near vision so they don’t need glasses for reading. In those cases, the patient is fit for prescription eyeglasses for driving and other activities that require distance vision,” explains Dr. Fernandez.

There are also advanced IOLs—known as premium IOLs. While premium IOLs aim to reduce dependence on glasses after cataract surgery, the extent to which that occurs varies from patient to patient. They are more expensive than monofocal IOLs and are rarely covered by insurance. Examples of premium IOLs include multifocal IOLs, which enable near and distance vision and the Light-Adjustable Lens (LAL), which allows for the prescription of the lens to be tweaked after the eye heals. The healing process can microscopically change the patient’s vision prescription, and this lens gives the surgeon the ability to compensate for that. The surgeon uses ultraviolet light to adjust the lens strength during a postoperative office visit. Sometimes more than one visit is necessary to get the strength just right.

How Cataract Surgery Is Performed

In most cases, the patient receives a mild sedative that is administered intravenously along with numbing eye drops. “The intravenous medication allows for the patient to feel more at ease while still remaining awake and able to follow directions during surgery,” explains Dr. Fernandez.

Phacoemulsification is the predominant method of performing cataract surgery. The surgeon makes a tiny incision in the eye and then inserts the phacoemulsification probe, which uses ultrasound vibrations to break the clouded lens into small pieces, and suction to remove the fragments. Once the fragments are gone, the surgeon implants the IOL.

A newer surgery technique—femtosecond laser-assisted cataract surgery (FLACS)—uses a laser to perform several of the surgery’s steps, but the surgeon still uses the phacoemulsification probe to remove the pieces of the cataract. Enhanced precision and reduced healing time are two possible benefits associated with FLACS, but studies show there is no advantage as far as visual outcome. Also, FLACS is not covered 100 percent by Medicare or private insurance.

Restoring Youthful Vision

Cataract surgery is a highly effective procedure that can make everyday activities easier and safer by restoring the visual function that you enjoyed in your younger years. An annual eye exam can help your ophthalmologist diagnose your cataract early, which will give you the option to wait and schedule the procedure when you are ready to have it.

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Vision and Cognition

Many older adults develop vision issues as they age. Cognitive issues also are a risk—and a study from Kellogg Eye Center at Michigan Medicine, the University of Michigan’s academic medical center, adds to the evidence that maintaining your eye health and visual acuity in older age may help your memory and thinking abilities. A 2022 study by the same research team calculated that 1.8 percent of all dementia cases are vision-related, equating to more than 100,000 of the 6 million Americans with dementia.

The new study (JAMA Ophthalmology, August 2023) included 2,967 older adults, average age 77. All had their near and distance vision, and their ability to see letters that didn’t contrast strongly with their background, tested. They also took memory and thinking tests and provided health information, including any existing diagnosis of dementia.

Overall, about 12 percent of the participants had dementia. However, the rate increased to nearly 22 percent in those who had impaired near vision. In addition, 33 percent of participants with moderate or severe distance vision impairment (including those who were blind) had signs of dementia, along with 26 percent of people who had trouble seeing letters that didn’t contrast strongly against a background. Even among participants with a mild distance vision issue, 19 percent had dementia. Those who had more than one kind of vision impairment were 35 percent more likely to have dementia than those with normal vision.

Impaired Memory Formation

Mount Sinai neurologist Sam Gandy notes that poor vision may interfere with a person’s ability to interact socially with others, follow a healthful diet, and get sufficient physical activity, all of which are associated with a reduction in dementia risk. “Any sensory impairment that distracts from the main topic at hand can impair memory formation,” he adds. “If memories are not properly formed, then they are not there to be retrieved, and that manifests as memory trouble.” While further studies are needed to determine whether optimizing your vision may reduce your risk of dementia, previous research showed lower rates of dementia over time in older adults who had their distance vision restored by having cataract surgery.

Falls and Fractures

The second study we reference (JAMA Ophthalmology, Dec. 28, 2023) looked at three leading disease causes of age-related vision loss: cataracts, age-related macular degeneration (AMD), and glaucoma. A team from the University of Manchester, United Kingdom, used medical record data to compare 410,476 older adults who had cataracts with 2,034,194 controls (people without the condition); 75,622 who had AMD with 375,548 controls; and 90,177 who had glaucoma with 448,179 controls. The participants and controls were followed for a median of four years.

After controlling for possible confounders, such as chronic conditions and drugs that may boost fall risk, the researchers reported that 30 percent of study participants with cataracts fell compared with 14 percent of their respective controls. About 37 percent of people with AMD fell versus 21 percent of controls, and 25 percent of those with glaucoma fell versus 13 percent of controls. When it came to fractures in people who had eye diseases compared with their respective control groups, the rates among people who fell were 14 percent versus 8 percent for cataracts, 18 percent versus 12 percent for AMD and 12 percent versus 7 percent for glaucoma.

Routine Vision Checks are Key

Cataracts are highly treatable, and both AMD and glaucoma are preventable. “However, people with these conditions often are not aware they have a problem because their vision impairment develops slowly, and if one eye is not affected it may compensate for vision loss in the other eye,” says Dr. Bloom. Cataract symptoms you can look out for include clouded, blurry vision, colors appearing less bright than usual, and increased sensitivity to glare from oncoming headlights when you drive at night. AMD affects your central vision and may cause straight lines to appear wavy and interfere with your ability to read and recognize familiar faces, while glaucoma causes blind spots in your peripheral (side) vision. “But don’t rely on noticing these symptoms,” Dr. Bloom cautions. “Instead, schedule vision checks annually—or more often if your eye doctor recommends this—so that your eye health can be thoroughly evaluated.”

Overall, both studies underline how important it is to get problems with visual acuity and/or underlying eye diseases diagnosed so they can be managed in ways that correct an impairment or prevent it from worsening. “The eye disease study also suggests that people with these conditions may benefit from improved advice on fall prevention tactics and better access to fall prevention programs,” Dr. Bloom adds. See last month’s issue for strategies that can help prevent falls in your home. Our Resources box has information on fall prevention programs.

Resources

You can find out about local fall prevention programs via your local Area Agency on Aging and online at the National Council on Aging website.

The post Studies Underline the Risks Presented by Vision Problems appeared first on University Health News.

While the risk of falls may increase with age due to factors such as changes in balance, vision, and muscle strength, frequent falls are not considered a normal or inevitable part of the aging process.

Here are some common factors that could contribute to frequent falls in older adults:

Balance and Gait Issues: Changes in balance and walking patterns can occur with age. Conditions such as muscle weakness, joint problems, or neurological issues may affect your ability to maintain balance.

Vision Problems: Poor vision or eye conditions, such as cataracts or glaucoma, can increase the risk of falls. Regular eye checkups are important for identifying and addressing vision issues.

Medications: Some medications cause dizziness, lightheadedness, or other side effects that can contribute to falls.

Foot Problems: Issues with your feet, such as pain, numbness, or poor footwear, can affect balance and increase the risk of falling.

Neurological Issues: Conditions such as peripheral neuropathy or Parkinson’s disease may affect coordination and balance.

Environmental Factors: Clutter, uneven flooring, and poor lighting in your home can contribute to falls. Making your living environment safer can help prevent accidents.

Dehydration: Not getting enough fluids can lead to dizziness and weakness, increasing the risk of falls.

Lack of Physical Activity: Insufficient physical activity can lead to muscle weakness and reduced flexibility, making it more challenging to maintain balance.

Schedule an appointment with a physician for a thorough physical assessment. Taking proactive steps to address the underlying causes of your symptoms can help improve your safety and quality of life.

I’ve heard about blood tests that can detect cancer before symptoms appear. Should I get tested?

There are around 20 multi-cancer early detection (MCED) tests in development, and at least two that are available—though not yet approved by the FDA—including the Galleri test (GRAIL) and the OneTest (2020 Gene Systems). There are pros and cons associated with these tests. One of the biggest advantages is that it is possible for cancer to be detected early, and when cancer is found early, it’s often easier to treat and has a higher chance of being cured. If you have a family history of a specific type of cancer, the option to be tested can offer peace of mind, by either determining that no cancer is detected or by catching a potential problem early. Another benefit associated with these early detection tests is that if the test shows that you have cancer, it can help your doctors plan the best treatment for you because knowing the type and stage of cancer is crucial for creating an effective plan.

Some of the cons associated with these tests include false positive and false negative results. Sometimes, the test might show that you have cancer when you actually don’t. This can be stressful and lead to unnecessary treatments and diagnostic tests. On the other hand, the test may not detect cancer even if it’s there. This can give a false sense of security, delaying the start of necessary treatment. MCED tests do not detect all cancers or measure your genetic risk of developing cancer in the future. Specialists say these new blood tests should be used in addition to, not in place of, other cancer-screening tests recommended by your physicians. Ultimately, the decision of whether to have your blood tested for the presence of cancer is one that should be made in conjunction with your doctors based on your medical history and individual circumstances.

The post Ask Dr. Etingin: Falling; Blood Tests appeared first on University Health News.

A: The word steroid can refer to different substances. Anabolic steroids are lab-made versions of testosterone that some people use illegally to increase their muscle mass and enhance athletic performance. The steroids prescribed for pain and inflammation are in a class called corticosteroids or glucocorticoids. These are powerful anti-inflammatory medications that include cortisone, hydrocortisone, prednisone, and prednisolone. They come in various forms, such as pills, creams, and injections, with the choice depending on the underlying cause of inflammation. Generally speaking, taking a low dose for a short period of time is best. For example, physicians may prescribe a seven-day course of prednisone for acute back pain injuries. Not everyone experiences side effects from short-term courses, but some people do. Minor side effects include nausea, difficulty sleeping, and restlessness. Tell your doctor if you experience serious side effects such as muscle pain or cramps, swelling of hands, feet, or ankles, and irregular heartbeat. The concerns about side effects are more likely to rise with more prolonged or high-dose usage for systemic diseases such as rheumatoid arthritis or other autoimmune or inflammatory conditions which may require frequent dosages or high-potency steroids. Serious side effects with higher-dose and/or longer-term steroid use include bone thinning, cataracts, high blood pressure, and type 2 diabetes. There’s little need to worry if you are treated occasionally with steroids for conditions like poison ivy, bronchitis, or occasional knee or back pain. However, it’s always wise to consult with your doctor or pharmacist if you experience any concerning side effects. When it comes to back pain, the most common cause is a muscle-related injury such as the one you described. Most back pain gradually improves within a few weeks with home care and perhaps some help from anti-inflammatory medications, as well as heat and ice treatments. Physical therapy can also be very helpful. Learning how to properly lift loads as well as strengthening core muscles may prevent future back injuries. However, if pain persists despite conservative management, contact your health-care provider to rule out other conditions or injury.

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Age-related changes play a major role in this increased susceptibility to car accidents. Common eye conditions like cataracts can make you more sensitive to headlight glare at night. Medical conditions that impede strength and flexibility, such as arthritis, can make the physical aspects of driving more challenging—for example, you may find it difficult to turn your head to check your blind spot when changing lanes or merging. Certain drugs (including antihypertensives, antidepressants, and painkillers) can make you less alert and affect your coordination.

Compensating for these limitations can help you keep driving for longer. Get regular eye exams to keep your glasses prescription current and address cataracts and other eye diseases. If you take medications, talk to your doctor about dosage or drug adjustments that could aid safe driving. Use less busy routes, and schedule journeys during daylight hours. Other defensive driving approaches include upgrading to a newer car with more safety features or modifying an older car by adding larger wide-angle side and rear-view mirrors that minimize blind spots. Also consider getting evaluated by a driving rehabilitation specialist who can assess your ability to drive safely. You can find a specialist through the Association for Driver Rehabilitation Specialists (https://tinyurl.com/EvalDrive).

Cognitive changes also can affect driving, yet many older adults who have cognitive impairment continue to drive, according to one of this month’s Newsbriefs. Conversations about giving up driving are particularly difficult to tackle with older adults who may not be aware of their diminished driving skills. If you are caring for a spouse or family member who has cognitive impairment and still drives, it is important to broach the topic with them while they are able to participate in the discussion. They also likely will benefit from getting their driving evaluated by a specialist.

If you’ve decided to hang up your car keys for good, it’s important to keep getting out and about to ensure that you aren’t socially isolated. Your local senior center may offer a transportation service or contact details for volunteer drivers in the community. Many counties operate an on-demand service for older adults, and Rides in Sight (www.ridesinsight.org) can connect you with information on transportation alternatives.

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Is Pumpkin a Fruit? Oddly enough, pumpkin is a fruit, at least botanically speaking. Pumpkins and other members of the Cucurbita family of plants that includes not only squashes, like pumpkin, and gourds, but also watermelons, honeydew melons, and cucumbers. They all grow from a flower and have seeds in the middle, which technically makes them fruits. However, we categorize them as vegetables because they are less sweet and more savory from a culinary perspective. Pumpkins, like other winter squashes, are a natural when roasted or stuffed and in a variety of savory dishes like soups, chilis, pasta, and casseroles.

There are hundreds of pumpkin varieties, so go ahead and enjoy the basic orange Halloween carving varieties, such as the Appalachian, but explore the many others. From a decorative perspective, they range from very large to tiny and come in myriad colors and textures and shapes. Fun as a green, blue, or white turban shaped pumpkin may be in a centerpiece cornucopia, try a variety bred for cooking. Any pumpkin is edible, but you’ll find some are better suited to pumpkin pie, such as sugar pumpkins, which have a sweeter flesh. No matter which types you choose, the entire thing, minus the stalk, is edible: skin (mostly in smaller varieties), flesh, and seeds.

Rich in Nutrients. Pumpkins are rich in carotenoids, the plant compounds responsible for the beautiful yellows, oranges, and red hues in squash and other fruits and vegetables. Those most notable include beta-carotene, a precursor to vision-protecting vitamin A, lutein, and zeaxanthin, which research suggests may help reduce progression of age-related macular degeneration and cataracts, improve cognitive function, cardiovascular health, and may help prevent some types of cancer. Winter squash, such as pumpkin, are also a good source of dietary fiber, vitamins A, B, and C, several minerals, and other elements including calcium, potassium, and zinc.

Health Benefits of Pumpkin. For centuries, pumpkins have been enjoyed as a part of the diet, but also used medicinally for their anti-inflammatory, antioxidant, antiviral, and antidiabetic properties. Research, which has been conducted on pumpkin peel, flesh, and seeds, for their health impacts, have demonstrated the above-mentioned properties as well as anticarcinogenic and antihypertensive traits. Studies have also linked pumpkin with brain health and treatment for depression, protection against liver disease, reduced risk of cardiovascular disease, and more.

Save the Seeds! All pumpkin and winter squash seeds are edible and have nutritional value. Made up of mostly healthy monounsaturated and polyunsaturated fats, including omega-3 fatty acids, and protein, pumpkin seeds (also known as pepitas) are healthy and satisfying as a snack or substitute for any seed you’d add to salads or other dishes. A one-ounce serving (about 85 seeds) contains 153 calories, 14 percent DV (DV=Daily Value, based on 2,000 calories/day) of protein, 18 percent DV of vitamin K, and several minerals, including iron, magnesium, and zinc.

Rather than toss the seeds the next time you prepare pumpkin, roast them at home.

1. Cut the pumpkin in half, use a spoon to scoop out the seeds and stringy pulp into a bowl or colander.

2. Separate seeds from the pulp. Don’t worry if some strings remain; they will shrivel when roasted.

3. Spread seeds in a single layer on a rimmed baking sheet.

4. Drizzle to just coat with olive oil (or cooking spray), if desired, and season with salt or other herbs and seasonings, such as cumin, garlic powder, chili powder, or cinnamon.

5. Roast in a 300° F oven for 20 to 30 minutes, stirring every 10 minutes or so, until golden brown.

6. Cool, remove outer hull, and enjoy.

Eat More Pumpkin. Savory or sweet, pumpkin is easy to add into almost any recipe. You can buy canned pureed pumpkin, but it’s simple to bake or microwave at home and then puree in a blender or food processor. Use this in baked goods or pie, as well as soup or to boost mashed potatoes. Try roasting pumpkin slices or cubes just as you would butternut squash and enjoy a twist on flavor. Pumpkin makes a great stuffing or you can fill smaller varieties with a whole grain stuffing. 

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