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

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

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

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

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

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

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

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

The post Ask Dr. Etingin: Carpal tunnel syndrome; Ingrown toenail solutions appeared first on University Health News.

On the Increase

A study presented at the 2024 Annual Meeting of the American Academy of Orthopedic Surgeons in February pointed to a significant rise in sports-related injuries over the two-decade follow-up period, with the injury rate increasing from 55,684 in 2012 to 93,221 in 2021. The data also suggested that cycling increased in popularity between 2012 and 2021. Another recent study (BMC Geriatrics, May 27) looked at data collected from 1,109 older adults who sustained a fracture and visited a trauma center between June 2020 and July 2023. Among the participants, 144 had suffered a fracture while engaged in sports. The analysis showed that the average age of people who suffered a sports-related fracture was 74. “Sports-related fractures were most likely to happen outdoors, with men particularly susceptible,” Dr. Bloom says. “This fits with previous studies indicating that older men are more likely to participate in sports compared with older women.”

Specific Sports More Risky

In the BMC Geriatrics study, the sports most likely to be associated with fractures were outdoor walking intended as exercise (as opposed to more leisurely walking to get from one place to another), cycling, and mountain hiking, all of

which were linked with lower-extremity fractures. Having an underlying disease, such as diabetes, high blood pressure, or a heart condition, did not increase the risk of injuries. “Suffering a stroke lowered the risk,” Dr. Bloom observes. “The lower risk may reflect the fact that stroke often is followed by a decrease in muscle strength. This may limit a person’s ability to participate in sports.”

Many Benefits

Dr. Bloom says it is wonderful that more older people are getting involved in sports, since there is much trial evidence underlining the benefits of vigorous physical activity. It boosts cardiovascular health, slows age-related loss of muscle mass and bone density, can reduce your risk of falls by improving your balance, eases stress, helps you sleep better, and limits weight gain. Research also has linked high levels of physical activity with better brain function in older age. “Another great thing about sports is that many of them are sociable activities: You can walk, cycle, and play pickleball or other racket sports with friends,” Dr. Bloom adds. “It’s vital to maintain those social connections as you get older, since studies have suggested that social interaction may confer protection against cognitive impairment.”

But these data also highlight the risks associated with sports—and Dr. Bloom cautions that they also likely underestimate injury rates. “Many people who sustain sprains, strains, and lacerations while playing sports often seek medical care from their primary-care doctor or a local walk-in clinic instead of attending emergency departments and trauma centers,” she says. The data also suggest that older adults are participating in a wider variety of sports and/or participating in sports that are more likely to result in injury, especially if they require a level of strength, agility and balance that you don’t have. “It would be interesting to see data that includes an assessment of the participants’ degree of mobility and individual skill level along with other factors that may contribute to injury, such as weather conditions and whether someone was wearing suitable shoes and protective clothing,” Dr. Bloom says.

Pace Yourself

Staying safe while engaged in sports starts with managing your expectations when it comes to how much you can still do. The heart and lungs work less efficiently in older age, so less oxygen is transferred to the blood. Appetite decreases, meaning that most older adults eat less than they should. As a result of these changes, endurance, muscle mass and strength decline as you age. Your balance also may be affected by age, particularly if you have vision or hearing issues or take certain medications (including some blood pressure drugs). These factors don’t mean that you cannot or should not continue to enjoy the sports you’ve always loved, but you may have to slow down slightly to conserve your energy and avoid fatigue. One thing you might want to try is alternating between vigorous sports, such as pickleball or tennis one day and more leisurely options, such as golf, the next.

Starting from Sedentary

If you’ve been leading a sedentary life and/or have chronic underlying health issues, it’s particularly important to objectively assess your fitness level before taking up a sport. “If you need help doing this, ask your doctor to refer you to a physical therapist who can work out a safe sports regimen for you,” Dr. Bloom says. “You also might want to consult a personal trainer who works with older adults—your local gym or senior center may be able to recommend one.” Be patient—instead of launching yourself into your chosen sport, you may need to gradually build up your strength and cardiovascular fitness levels, perhaps by starting a walking program and pushing yourself farther and faster over time.

If you want to try a new sport, find out about it. “You’ll need background information about whether it’s important to wear special types of footwear, a helmet, and/or safety goggles, about the level of endurance and/or agility the sport requires, whether it’s a sport that involves rapid acceleration and deceleration and relies on you having good balance,” Dr. Bloom says. “Even if you’re very fit and want to challenge yourself, you don’t want to risk injuries that might have been highly preventable with a bit of preparation.” See What You Can Do for other strategies that will help you stay safe while playing sports.

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You may not be able to eradicate all of your individual stroke risk factors, but you likely can mitigate some of them enough to significantly reduce your chance of suffering a stroke. Along with any medications you may be prescribed to lower your blood pressure, cholesterol, and blood sugar, a healthy diet and plenty of exercise are cornerstones of stroke prevention. Eat plenty of fruits, vegetables, and whole grains, and substitute fish and poultry for red meat. Cut back on your salt intake, since too much salt raises blood pressure. Get at least 30 minutes of physical activity each day (you can break this up into smaller segments). If you’ve already had a stroke, eating more healthfully can help prevent another, and exercise can help you regain your cardiovascular fitness and cognitive function, as well as combat the depression that often follows stroke. Stroke rehabilitation programs focus closely on diet and exercise, so ask your doctor to refer you to one of these programs if he or she has not already done so.

Another crucial element of stroke protection is knowing the symptoms that can red-flag a stroke. The American Stroke Association recommends learning the “BE FAST” rubric:

• B for Balance. Do you have a sudden loss of balance or coordination? To check, walk in a straight line or touch your finger to your nose.

• E for Eyes. Are you noticing sudden vision changes, such as double vision, or loss of vision in one eye?

• F for Face drooping. Is there drooping or numbness on one side of your face? Is your smile uneven?

• A for Arm weakness. Look for weakness in one arm (raise both arms and see if one arm drifts downward).

• S for Speech difficulty. Is your speech slurred or otherwise hard to understand?

• T for Time to call 911. If you have any of the above symptoms, call 911.

Keep in mind that women may experience additional stroke symptoms, including confusion and disorientation, nausea and vomiting, and fatigue.

As our article emphasizes, time is brain. Recognizing possible stroke symptoms and seeking medical help immediately can make a huge difference to post-stroke function, since treatment with a clot-busting drug is most effective within 4.5 hours of symptom onset if your stroke is caused by a blood clot.

The post Address Your Stroke Risk appeared first on University Health News.

Dry Mouth

Dry mouth is not a normal part of aging, but it is a common concern for many older adults. Saliva is an unsung hero of digestion—it coats food particles with enzymes that initiate the breakdown of carbohydrates into smaller food molecules and moistens and softens food so that it is easier to swallow. Chewing stimulates saliva secretion from the salivary glands in the mouth, but your production of saliva can decrease in older age due to medications, including some drugs that treat high blood pressure and urinary incontinence; certain diseases, such as diabetes, Parkinson’s disease, and the autoimmune condition Sjogren’s syndrome (you are at greater risk for this if you have rheumatoid arthritis); and having had treatments for cancer, including radiation therapy. Environmental conditions, like dry heat, also can cause dry mouth.

Dry mouth is uncomfortable, and not having enough saliva to moisten food can make it more difficult to swallow. Dry mouth also increases the risk of tooth decay and other oral infections because another one of saliva’s primary jobs is to kill bacteria. For this reason, it is important to see your doctor or dentist to determine what might be causing dry mouth. Self-help measures include sucking on sugar-free lozenges or chewing sugarless gum to stimulate saliva production—you also may want to try Salivart, an “artificial saliva,” that is available over the counter at pharmacies. Avoid mouthwashes that contain alcohol, as these can worsen dryness.

Coughing While Eating

Coughing during a meal is a sign that you’re having to clear your throat while you eat or drink. You’re doing this to avoid aspirating food or fluids into your lungs.

Eating and breathing share space in the back of the throat, or pharynx (see image, right). Food enters the esophagus (the muscular tube that leads to the stomach) through the pharynx while air is diverted into the trachea (windpipe) and lungs. The epiglottis—a small flap of cartilage attached to the larynx—plays a key role in this process of diversion by staying open during breathing and closing during swallowing. You need intact neuromuscular reflexes for the epiglottis to function correctly, but with aging, some of these reflexes become less effective. They also may be impacted by esophageal dysphagia (difficulty swallowing food due to inflammation or narrowing of the esophagus), stroke, dementia, and Parkinson’s disease. The result is that it becomes easier for food and drinks to “go down the wrong pipe.” The coughing and sputtering that accompanies this is uncomfortable and embarrassing if it occurs when you are eating out. But aspiration also can cause inflammation of the lungs (pneumonitis), pneumonia, and choking, so it is important to get evaluated by an ear, nose and throat specialist if you think you may be aspirating food. Interventions that may help include exercises, dietary modifications, or adopting different eating positions.

Difficulty Taking Medication

Pill esophagitis, which is when a drug gets stuck in the esophagus, occurs more often in older adults and can cause inflammation, injury, and pain. You may be able to prevent it by taking medications with plenty of water, while sitting up—also avoid lying down for about 30 minutes afterward. If you’re still having trouble it may be possible to split pills in half, but check with your doctor or pharmacist, since some tablets should not be split. If you get the go-ahead, use a proper pill-splitter (you can purchase them at most pharmacies). If your medication comes

in capsule form only, or tablets cannot be safely split, ask your doctor or pharmacist if a liquid version of the drug is available. If none of these approaches help, you may need to see a specialist who can check that your esophagus is functioning correctly.

Can’t Go, Won’t Go

The frequency of bowel movements considered normal ranges from three times a day to three times a week. In general, bowel transit time—the time it takes for food to move through the digestive tract—is about three days. But if you have chronic constipation, transit time can increase to four to nine days, and, if you are bedridden, up to two weeks. This increase in transit time is common in older adults due to a decline in peristalsis (involuntary muscle contractions that propel food through the intestines). If peristalsis is sluggish, stool moves too slowly through the colon. Slow passage means that more water is absorbed from food, and this results in hard, dry stools that contribue to constipation.

If you frequently suffer from constipation, eating more fiber and drinking plenty of fluids will help your colon make bulkier stools that are easier to pass. Also get plenty of exercise, since this can help food move through the gastrointestinal tract. Whenever you have the urge to move your bowels, go to the bathroom. Ignoring the urge allows stool to remain in the colon for longer and this means that more water will be absorbed from it, resulting in hard stools that are more difficult to expel. Also try to have a bowel movement after you’ve eaten a meal. After you eat, your stomach stretches, triggering what is known as the gastrocolic reflex. This reflex increases the movement of ingested food toward the rectum, increasing rectal pressure and stimulating a bowel movement.

If these measures don’t bring relief, ask your doctor if an undiagnosed health condition (for example, untreated thyroid disease—see last month’s issue for more on thyroid disease) might be contributing to your constipation. He or she also will be able to check if you take any medications that raise the risk of constipation (opioids are known to worsen constipation, and laxatives should always be prescribed when opioids are prescribed). Your doctor may suggest using a laxative and can advise on which option will suit you best.

Burning Fluid at the Back of the Throat

If you get this often, you likely have gastroesophageal reflux disease (GERD), a condition in which stomach acid refluxes (flows backward) from the stomach into the esophagus. The lower esophageal sphincter (LES), a muscular valve that separates the esophagus from the stomach, should prevent reflux, but if it has decreased resting pressure, it may not close properly between meals. LES pressure naturally decreases with age and may be affected by excess weight and a range of medications often taken by older adults, including some blood pressure drugs, statins, antidepressants, and bisphosphonates (used to treat osteoporosis).

GERD typically causes heartburn (a burning sensation in the chest), but older adults may not experience this because the older esophagus is less able to feel pain. Instead, they taste stomach acid at the back of their throat. Other GERD symptoms often reported by older adults include difficulty keeping food down after meals, a dry cough at night, a persistent sore throat, and a repeated need to clear their throat when they get up in the morning.

GERD is associated with potentially serious complications, so if you think you may have the condition, tell your doctor. He or she may prescribe drugs to ease the symptoms and should review your regular medications to ensure they aren’t contributing to the problem. Self-help strategies include eating smaller, more frequent meals instead of fewer large ones, avoiding foods that may trigger symptoms (such as fatty and spicy foods, citrus fruits, garlic, chocolate, and peppermint), limiting your alcohol intake, and not eating in the two to three hours prior to bedtime. Minimize pressure on your stomach by wearing loose-fitting clothing and avoiding tightly belted outfits. If you are overweight, losing weight may help, since excess belly fat places pressure on the stomach.

Gas and Stool Leakage

The tone and strength of the internal anal sphincter (a ring of muscle that prevents stools from leaking through the anus) decline in older age. The pelvic floor (a group of muscles that support the bowel and bladder) also may weaken, particularly in women who have experienced pregnancy and childbirth. These factors make flatulence and stool leakage more likely.

You may be able to reduce your production of gas by cutting back on certain gas-producing foods, such as onions, broccoli, cabbage, and beans. As to stool leakage, the more completely you empty your bowels the less there will be to leak, so be sure to take sufficient time on the toilet. Raising your feet eight to 12 inches (rest them on a pile of books or a box) while going to the bathroom may help you empty more completely.

Kegel exercises, which can help prevent urinary incontinence, also may help with stool leakage, since they strengthen the pelvic floor muscles. Your pelvic floor muscles are the same ones you may have been using to keep you from passing gas. To exercise them, slowly pull them up (imagine they are an elevator stopping on every floor of an apartment block), hold for three seconds, and then release them equally slowly. Work up to a set of 10 contractions and repeat each batch of 10 three times a day. Also reduce your intake of caffeine, lactose, and artificial sweeteners, as these can loosen stools. If these strategies don’t work, mention the problem to your doctor (try not to be embarrassed— we really have heard it all before!).

The post Gut Feelings: Your Digestion in Older Age appeared first on University Health News.

Troubling Shortfall

The research, led by a team from the University of Michigan Health Frankel Cardiovascular Center, tracked nearly 150,000 people who were seen at hospitals for serious heart conditions (including heart attack and heart failure) between late 2015 and early 2020. The analysis (Journal of the Academy of Nutrition and Dietetics, July) showed that clinicians documented providing dietary counseling in just 23 percent of cases within 90 days of hospitalization. Women, adults ages 65 and older, and people with chronic kidney disease were least likely to receive counseling.

Getting Help

Nutrition counseling is included in cardiac rehabilitation programs, and also can be obtained via a separate kind of care called medical nutrition therapy. “Cardiac rehabilitation programs counsel participants on diet, exercise and behavior modifications, with the aim of improving health outcomes in people with cardiovascular disease,” Dr. Darrow says. “These programs have been shown to boost physical function and reduce the risk of hospitalization and death for older adults with heart failure.” Medicare Part B covers cardiac rehabilitation for enrollees who have had a heart attack in the previous 12 months and those who have stable angina (chest pain caused by blocked heart arteries) or chronic heart failure. People who have undergone cerain heart procedures also are covered—the Medicare website has details (www.cms.gov). “Medical nutrition therapy involves working with a registered dietitian to build an eating plan tailored to your individual health needs,” Dr. Darrow says. The therapy is covered by Medicare Part B for certain individuals (check at the Medicare website). You need a doctor’s referral to utilize the program.

Eating to Support Heart Health

Dr. Darrow provides nutrition guidance to his patients just in case they are not able to attend a cardiac rehabilitation program or get medical nutrition therapy. He recommends people who have cardiovascular disease or have suffered a heart-related event follow an eating plan that is low in sodium and fat, such as the Mediterranean diet (see our chart) or DASH (Dietary Approaches to Stop Hypertension) diet. “Both diets are high in fruits, vegetables, whole grains and healthy fats, and limit the saturated fats that can contribute to elevated blood pressure and cholesterol,” he says. “They also permit enough of what you enjoy that it doesn’t feel like you are depriving yourself at every meal.”

The post Dietary Counseling Helps After Serious Heart Issues appeared first on University Health News.

Defining Superfoods. Superfoods are nutrient-dense and considered beneficial for supporting health. Rich in vitamins, minerals, antioxidants, and other compounds, they support various functions and help protect against diseases.

Nutrient Density and Health Benefits. The main characteristic of superfoods is their high nutrient density. This means they provide a significant amount of nutrients for relatively few calories, making them an excellent choice for those looking to maintain a healthy weight and support health. Some of these key nutrients include:

1. Antioxidants: These compounds help neutralize harmful free radicals in the body, reducing oxidative stress and inflammation. This can help lower the risk of chronic diseases like heart disease and cancer. Berries, such as blueberries and strawberries, are well-known for their high antioxidant content.
2. Dietary Fiber: Essential for digestive health, fiber can help prevent constipation and promote regular bowel movements. It can also aid in controlling blood sugar levels and lowering cholesterol. Foods like oats, beans, and whole grains are excellent sources of fiber.
3. Omega-3 Fatty Acids: Found in foods like fatty fish and walnuts, omega-3s are known for their heart-protective properties. They can help reduce inflammation, reduce blood pressure, and improve overall heart health. Omega-3s are also beneficial for brain health, potentially lowering the risk of cognitive decline and dementia.
4. Vitamins and Minerals: Superfoods are often packed with essential vitamins and minerals. Leafy greens like spinach and kale provide vitamins A, C, and K, as well as calcium and iron, which are vital for bone health, immune function, and overall energy.

Adding Superfoods Into Your Diet. If you’re interested in incorporating superfoods into your daily meals, this can be both simple and enjoyable. Here are some tips to help you get started:

Start Your Day with Berries: Add a handful of blueberries or strawberries to your morning cereal or yogurt for flavor and an antioxidant boost.

Snack on Nuts: A small handful of almonds or walnuts makes a satisfying and nutritious snack, providing healthy fats and protein.

Choose Whole Grains: Opt for brown rice or quinoa to boost fiber intake and help support heart health.

Try Fatty Fish: Aim to include fatty fish, like salmon or sardines in your diet at least twice a week for a good dose of omega-3s.

Conclusion. While superfoods are not a cure-all, they can play a valuable role in a balanced diet. Focusing on nutrient-rich foods can help support overall health, prevent chronic diseases, and enhance quality of life. Remember, it’s important to combine superfoods with other healthy lifestyle choices, such as regular exercise and adequate hydration. Always consult with a healthcare provider or dietitian when making significant dietary changes to ensure they meet your individual health needs.

The post What Are “Superfoods?” appeared first on University Health News.

According to the American Heart Association, women should have no more than six teaspoons of added sugar a day and men no more than nine teaspoons (which is equal to about 100 calories for women, or 150 calories for men). Many people are blowing past these numbers, and that is concerning. A 2023 review of 73 meta-analyses, published in The BMJ, found that a diet high in added sugar was linked to 45 poor health outcomes, including diabetes, cancer, gout, hypertension, cardiovascular disease, asthma, and depression. “In essence, added sugar contributes “empty energy” or calories without the benefits of key nutrients like fiber, protein, or vitamins,” says Debbie Petitpain, MBA, RDN, spokesperson for the Academy of Nutrition and Dietetics.

The good news is you can make a few simple changes to the way you eat to decrease (not eliminate!) your added sugar intake. Here’s how to cut back on the sweet stuff without feeling deprived.

Read the Fine Print. Now that the Nutrition Facts panel on packaged foods requires producers to list the grams of added sugar in their products, it is easier than ever to spot how much is being steathfully added to everything from granola to ketchup to jerky. Petitpain says this lets you compare the nutrition numbers on products so you can choose those with fewer grams of added sugar. Another good move is to look for labels such as “no added sugar” or “unsweetened” on items like almond milk and applesauce.

Natural Selection. To help quell a sweet tooth, try eating more foods that are naturally sweet. Sugars in vegetables, like beets or sweet potatoes, and fruit, such as apples don’t count as added sugars, and research is bereft of any data linking natural occurring sugars with health woes. “Naturally occurring sugars in vegetables, fruits, and dairy are part of a complex food matrix which alters how the body digests, breaks down, and uses these sugars, which changes the effects on the body,” notes Petitpain. “There also tends to be a lot less sugar, bite for bite, compared to foods with added sugars.” So buy plain versions of items like yogurt and oatmeal and sweeten them with naturally sweet foods such as berries.

Make the Cut. If you are keen on baking, keep in mind that many recipes including those for muffins and cakes call for more sugar than what is necessary. So, you can try reducing the amount of sweetener called for by about 25 percent. Petitpain suggests including sweet tasting items like mashed banana, dates, and applesauce in your baking in place of some of the added sugar.

Embrace Other Tastes. Sweet is one of the five main tastes, with others being salty, sour, bitter, and umami. To reboot your taste buds, gradually increase your intake of unsweetened sour (such as plain yogurt or tart cherries), bitter (like arugula and radicchio), and umami (such as parmesan and mushrooms) foods. As a payoff, you’ll net more nutrients.

Be Wary of Free. Be especially skeptical of products like peanut butter, frozen yogurt, and salad dressings advertised as “reduced-fat” or “fat-free,” “When fat is removed from a product, sugar is usually added as a replacement to improve mouthfeel and flavor” Petitpain says. A serving of fat-free, fruit-flavored yogurt typically has three times as much sugar as a serving of two percent plain yogurt.

Spice it Up. Research suggests amping up the flavor of your cuisine with spices may allow you to cut back on the amount of sugar added to foods while still preserving acceptable overall liking. So, go bigger on spices like cinnamon and nutmeg in items like baked goods, oatmeal, and hot chocolate.

Don’t Fall for Health Halos. Sugar now comes in many guises, some of which, such as honey and maple syrup, are marketed as being better-for-you “more natural” ways to get your sweet fix. But for the most part, they don’t live up to their hype. “While they may offer extremely minimal nutritional benefits over refined sugar, they should still be consumed in moderation,” says Petitpain. No matter how virtuous it might sound, “organic sugar” is still sugar.

Walk Away from Cravings. The next time you’re about to give into candy bar temptation, lace up your running shoes. Research shows the simple act of taking a 15-minute brisk walk is enough to tame cravings for sugary snack foods. “Exercise releases endorphins and can improve mood and reduce stress, which are common triggers for sugar cravings,” notes Petitpain.

Order Water. Soft drinks, even the smallest sized ones, sold at top-earning restaurant chains in the U.S., have greater amounts of added sugar than the suggested daily limit, according to a report from the Center for Science in the Public Interest. When dining out, look for unsweetened beverage options. Many chain restaurants now have added sugar numbers for their foods and drinks listed on their websites, making it easier to tailor your order so it’s less sweet.

The post How Sweet it Isn’t appeared first on University Health News.

Grief can be like that. It also can manifest as deep sorrow, hostility, guilt, confusion, and fatigue. It’s a process that waxes and wanes and an experience that varies from person to person. There’s no absolute timeline or way to grieve, but most people start to return to a sense of normalcy in about six to 12 months.

Grief occurs not only when a loved one passes but also can happen with a terminal diagnosis, such as cancer or Alzheimer’s disease. Known as “anticipatory” grief, it affects both the diagnosed person and loved ones.

Grief’s Impact on Health

The grieving process can lead to everything from bodily pain and a weakened immune system to stomach upset and insomnia. According to George Slavich, PhD, director of the Laboratory for Stress Assessment and Research at the Semel Institute for Neuroscience and Human Behavior at UCLA, the root of these symptoms can be traced back to our evolutionary response to the loss of a social connection.

“As humans, we are strongly motivated to seek out social bonds that are warm, dependable, friendly and supportive,” says Slavich. “Losing someone close to us terminates that bond and the social and physical protection they provided, which historically could have put the body at an increased risk of physical danger.”

When you lose someone that you’ve been with for a long time, the body and brain go on high alert to protect you from potential dangers. Your immune system ramps up and sends immune cells throughout the body to deal with possible physical wounds that might occur. At the same time, however, your immune system lowers its antiviral defense system, making your body more vulnerable to viral infections. “If you’ve ever come down with a cold after a stressful time, you may have experienced this response,” says Slavich.

The grieving process can cause prolonged inflammation and lead to psychological and behavioral symptoms such as fatigue, loss of pleasure, and social withdrawal. If these symptoms persist beyond six months, it may indicate prolonged grief, which can have serious health implications.

Prolonged Grief

This type of grief is marked by persistent and pervasive feelings of longing, sadness, and preoccupation with the deceased. It can significantly interfere with a person’s daily functioning and quality of life. Common symptoms include an inability to accept the loss, numbness, bitterness, difficulty engaging in life, and a feeling that life is meaningless without the deceased.

Prolonged grief is associated with increased cancer risk, cardiovascular problems, and early mortality. It may lead to heart attacks, especially in people who already have a higher risk of heart disease.

Takotsubo cardiomyopathy, also known as broken heart syndrome or stress cardiomyopathy, can be triggered by intense grief. This condition temporarily weakens the heart’s left ventricle and can mimic a heart attack, even in those who do not have cardiovascular disease. It tends to affect postmenopausal women much more than men. Recovery from this transient condition can take days or weeks. However, this doesn’t mean the condition should be ignored or untreated, because there can be long-term consequences.

Anticipatory Grief

Anticipatory grief is the emotional response experienced when a loss is expected but has not yet occurred, such as with a terminal illness diagnosis. Key characteristics of anticipatory grief include feelings of sadness, anxiety, anger, and helplessness. It affects both the diagnosed and loved ones. For example, loved ones can become consumed with imagining life after the loss and worrying about how to cope. It may change how an individual interacts with the dying person, such as increased closeness or emotional distancing as a protective measure.

Stress and anxiety can lead to physical symptoms like fatigue, changes in appetite, and sleep disturbances. Feelings of relief or guilt also can be part of anticipatory grief, especially if the loved one has been suffering. Understanding and acknowledging anticipatory grief can help in the processing of emotions and better prepare for the eventual loss.

Patience, Acceptance, and Self-Care

It’s important to accept that it is normal to grieve and give yourself permission to experience the full range of emotions. Surrounding yourself with supportive friends and family with whom you can share your feelings can provide comfort and validation. Support groups, both in-person and online, can also offer a sense of community and understanding. Sometimes, the intensity of grief requires professional intervention. Therapists or counselors specializing in grief can provide strategies and support to navigate the emotional turmoil.

After losing a loved one, thoughts can constantly drift between the past and the future. Practicing mindfulness meditation is one way of becoming aware of your thoughts, grounding your awareness in the present, and reducing overall psychological stress.

Sleep may become challenging. It may be difficult to fall and stay asleep. And a sense of purposelessness can make it hard to get out of bed up in the morning. However, “sleep is one of the strongest drivers of immune activity,” Slavich says, and “having a standard sleep schedule is really important for properly regulating your immune system.”

Along with quality sleep, a healthy diet and regular exercise are recommended for self-care. Choose nutritious foods daily. Include lean proteins, fruits, vegetables, healthy oils and leafy greens. These choices help reduce inflammation. Likewise, moving your body regularly supports brain and immune health. Breaking a sweat helps decrease feelings of stress and anxiety. Exercise triggers the release of dopamine and serotonin; two brain neurotransmitters that play a pivotal role in maintaining positive mood. Exercise also slows the release of cortisol, the hormone that can wreak havoc when it flows unabated under chronic stress.

“Each of these strategies can help promote resilience following interpersonal loss,” Slavich says, “but the most important thing is to begin with the strategy that you know you’ll actually follow through with.” He also recommends telling your healthcare provider about your loss. This will enable your provider to take your personal situation into consideration and to understand how your grief may be involved in any symptoms you may be experiencing.

Coming up with the best strategy for dealing with grief needs to be a team effort between you and your healthcare provider, Slavich says, but “if they don’t know what’s going on in your life, they won’t be able to help.”

Creating a memorial or engaging in rituals to honor the person you’ve lost can help with healing and acceptance. This could be through a dedicated space in your home, a scrapbook, or participating in activities that the deceased loved. It helps keep their memory alive and allows you to celebrate their life.

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Similarly, the buildup of beta-amyloid plaques in the brain is associated with a greater risk of Alzheimer’s disease (AD). Beta­amyloid, often referred to simply as “amyloid,” is a type of protein that can form clumps or plaques in the brain, disrupting communication between brain cells (neurons) and triggering neuroinflammation—a condition that sets the stage for AD and other types of dementia.

But unlike cholesterol, which can often be controlled through lifestyle modifications and statin therapy, amyloid buildup is a more complicated and challenging health problem to manage. One reason is that an individual’s risk for amyloid accumulation can be greatly influenced by genes that predispose a person to abnormal amyloid buildup.

Though variants of many genes are associ­ated with amyloid buildup, the APOE4 gene is among the most significant and well-studied when it comes to AD risk. It’s associated with a higher density of amyloid plaques. Inheriting one copy of the APOE4 gene increases your AD risk threefold (compared with not having the gene), while inheriting two copies increases your AD risk by about 14­ fold, says Alzheimer’s researcher Rudolph Tanzi, PhD, director of the Genetics and Aging Research Unit at Massachusetts General Hospital (MGH) and co-director of the Henry and Allison McCance Center for Brain Health at MGH.

For those reasons, Dr. Tanzi sug­gests individuals with a known genetic risk should prioritize man­aging the AD risks that are within their control. That includes regular exercise, a plant-based diet, and mental stimulation. “If you have one or two copies of APOE4, incorpo­rating those steps in your life goes from a good idea to almost obliga­tory,” he says. He adds that just as it’s better to target cholesterol control earlier in your life rather than later, when arterial plaques have formed and put you at risk for heart disease, it’s worth giving amyloid buildup that same attention throughout your life.

Is Genetic Testing Right for You? A study published earlier this year in Nature Communications garnered a lot of media attention, as it reaf­firmed the risks associated with inheriting two copies of APOE4. It also prompted a lot of discussion about genetic testing.

Should you be tested for the APOE4 gene or any of the others associated with AD risk? This is the million-dollar question, and the right answer depends on the indi­vidual, and often that person’s family, too. You can find out, through testing, whether you’ve inherited one or two APOE4 genes or whether you’ve escaped that genetic misfortune. But if you get an answer you don’t want, what then?

“Do you really want to know?” Dr. Tanzi says. “And do you want your kids to live with that stress? It’s a pretty big decision.”  Often, people are advised to consider genetic test­ing if they have a family history of  early-onset AD, generally considered to be AD that takes hold before the age of 60. An individual who devel­ops early-onset AD may also want to be tested, even if there is no known family history of the disease.

Attacking Amyloid

As concerning as amyloid is, Dr. Tanzi notes that amyloid buildup does not guarantee that AD will follow. Research has shown that people can have a significant amount of amyloid in the brain, but have no AD symptoms.

One reason, Dr. Tanzi explains, is that there can be a lag of many years between the accumulation of amyloid in the brain and the development of neuroinflammation and subsequent AD. Other studies have shown that some people who preserve cognitive health despite the presence of amy­loid plaques have a unique protein makeup within their synapses (con­nections between neurons) that may offer some protection.

Rather than take a chance that you’ll be spared the potential compli­cations of amyloid plaques in the brain, you may want to follow some basic lifestyle behaviors that may help prevent amyloid buildup and reduce your risk for AD. Dr. Tanzi refers to these behaviors with the acronym SHIELD.

• Sleep: While you sleep, your brain can clear out some amyloid.

• Handle stress: “Stress causes cell death, which activates neuroin­flammation,” Dr. Tanzi says.

• Interact with others: Interacting with other people on a regular basis stimulates the brain to create new brain cells, a process called neurogenesis.

• Exercise: “Exercise induces neuro­genesis. Think of it as getting your reserves in place,” says Dr. Tanzi. He adds that exercise also triggers the muscles to produce a hormone called irisin, which in turn induces the release of an enzyme called neprilysin, which helps break down amyloid in the brain.

• Learn new things: Like socializ­ing, learning fosters the produc­tion of new neurons and strength­ens the synapses, Dr. Tanzi says.

• Diet: “If your microbiome is healthy in your gut, it will help reduce amyloid and reduce neu­roinflammation,” Dr. Tanzi explains.

Blood sample for ATN (Amyloid-Tau-Neurodegeneration) profile test, to diagnosis of Alzheimer’s disease. Alzheimer’s test.

Your microbiome is the collection of all bacteria, fungi, and other microorganisms and their genes living inside and outside of your body. Studies have demonstrated a strong connection between gut health and brain function. Dr. Tanzi’s research and that of others suggests that a plant-based diet may be opti­mal for a healthy gut microbiome and, by extension, better brain health.

Takeaway

As with so many diseases and medi­cal conditions, AD can develop through a combination of genetic, environmental, and lifestyle factors. While you can’t control the genes you inherit, you can pursue the life­style behaviors that appear to offer some protection.

And, of course, regular exercise, a balanced diet, mental stimulation, good sleep, and stress management won’t just help protect against dementia. Those traits make up the recipe for good overall health and well-being.

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Annals of Internal Medicine, may be helpful for clinicians and their patients when starting an antidepressant for the first time. Researchers suggest that weight gain could affect an individual’s long-term metabolic health and self-esteem, leading some people to stop taking a medication that might otherwise lead to a positive outcome. It’s also worth noting that some people respond better to one antidepressant versus another. If you are having success with a particular medication and weight gain is a problem, talk with your health-care team about ways  to offset that side effect, perhaps through increased exercise or dietary changes.

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