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Quick-start guide to nuts and seeds – Harvard Health

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Quick-start guide to nuts and seeds – Harvard Health

Nutrition

Tiny but mighty, nuts and seeds deliver a protein, fiber, and nutrient punch with every bite.

February 4, 2024

About the Reviewer

Howard E. LeWine, MD,
Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch.
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View all posts by Howard E. LeWine, MD

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A band of tissue helps secure the tongue to the front of the mouth. If it is short, it can restrict movement of the tongue. This is called a tongue-tie. Having a tongue-tie is not necessarily a problem — but there are exceptions that parents should be aware of.n “,”content”:”

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The tongue is secured to the front of the mouth partly by a band of tissue called the lingual frenulum. If the frenulum is short, it can restrict the movement of the tongue. This is commonly called a tongue-tie.

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Children with a tongue-tie can’t stick their tongue out past their lower lip, or touch their tongue to the top of their upper teeth when their mouth is open. When they stick out their tongue, it looks notched or heart-shaped. Since babies don’t routinely stick out their tongues, a baby’s tongue may be tied if you can’t get a finger underneath the tongue.

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How common are tongue-ties?

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Tongue-ties are common. It’s hard to say exactly how common, as people define this condition differently. About 8% of babies under age one may have at least a mild tongue-tie.

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Is it a problem if the tongue is tied?

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This is really important: tongue-ties are not necessarily a problem. Many babies, children, and adults have tongue-ties that cause them no difficulties whatsoever.

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There are two main ways that tongue-ties can cause problems:

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  • They can cause problems with breastfeeding by making it hard for some babies to latch on well to the mother’s nipple. This causes difficulty with feeding for the baby and sore nipples for the mother. It doesn’t happen to all babies with a tongue-tie; many of them can breastfeed successfully. Tongue-ties are not to blame for gassiness or fussiness in a breastfed baby who is gaining weight well. Babies with tongue-ties do not have problems with bottle-feeding.
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  • They can cause problems with speech. Some children with tongue-ties may have difficulty pronouncing certain sounds, such as t, d, z, s, th, n, and l. Tongue-ties do not cause speech delay.
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What should you do if think your baby or child has a tongue-tie?

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If you think that your newborn is not latching well because of a tongue-tie, talk to your doctor. There are many, many reasons why a baby might not latch onto the breast well. Your doctor should take a careful history of what has been going on, and do a careful examination of your baby to better understand the situation.

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You should also have a visit with a lactation specialist to get help with breastfeeding — both because there are lots of reasons why babies have trouble with latching on, and also because many babies with a tongue-tie can nurse successfully with the right techniques and support.

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Talk to your doctor if you think that a tongue-tie could be causing problems with how your child pronounces words. Many children just take some time to learn to pronounce certain sounds. It is also a good idea to have an evaluation by a speech therapist before concluding that a tongue-tie is the problem.

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What can be done about a tongue-tie?

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When necessary, a doctor can release a tongue-tie using a procedure called a frenotomy. A frenotomy can be done by simply snipping the frenulum, or it can be done with a laser.

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However, nothing should be done about a tongue-tie that isn’t causing problems. While a frenotomy is a relatively minor procedure, complications such as bleeding, infection, or feeding difficulty sometimes occur. So it’s never a good idea to do it just to prevent problems in the future. The procedure should only be considered if the tongue-tie is clearly causing trouble.

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It’s also important to know that clipping a tongue-tie doesn’t always solve the problem, especially with breastfeeding. Studies do not show a clear benefit for all babies or mothers. That’s why it’s important to work with a lactation expert before even considering a frenotomy.

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If a newborn with a tongue-tie isn’t latching well despite strong support from a lactation expert, then a frenotomy should be considered, especially if the baby is not gaining weight. If it is done, it should be done early on and by someone with training and experience in the procedure.

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What else should parents know about tongue-tie procedures?

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Despite the fact that the evidence for the benefits of frenotomy is murky, many providers are quick to recommend them. If one is being recommended for your child, ask questions:

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  • Make sure you know exactly why it is being recommended.
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  • Ask whether there are any other options, including waiting.
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  • Talk to other health care providers on your child’s care team, or get a second opinion.
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“,”excerpt”:”n

A band of tissue helps secure the tongue to the front of the mouth. If it is short, it can restrict movement of the tongue. This is called a tongue-tie. Having a tongue-tie is not necessarily a problem — but there are exceptions that parents should be aware of.

n “,”short_excerpt”:”n

A band of tissue helps secure the tongue to the front of the mouth. If it is short, it can restrict movement of the tongue. This is called a tongue-tie. Having a tongue-tie is not necessarily a problem — but there are exceptions that parents should be aware of.

n “,”description”:null,”author”:null,”slug”:”what-is-a-tongue-tie-what-parents-need-to-know-202402073015″,”sort_date”:”2024-02-07T05:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:3015,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”BL020724″,”publication_date”:”2024-02-07T15:30:00.000000Z”,”last_review_date”:null,”imported_at”:”2024-02-06T10:00:03.000000Z”,”last_import_type”:”insert”,”last_modified_date”:”2024-02-05T05:00:00.000000Z”,”active”:1,”created_at”:”2024-02-06T10:00:03.000000Z”,”updated_at”:”2024-02-06T10:00:03.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:null,”hide_ads”:0,”primary_content_topic_id”:24,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:46,”cr_id”:4,”featured”:0,”hhp_staff”:1,”hidden”:0,”name”:”Claire McCarthy, MD”,”title”:null,”first_name”:”Claire”,”middle_name”:null,”last_name”:”McCarthy”,”suffix”:”MD”,”slug”:”claire-mccarthy-md”,”byline”:”Senior Faculty Editor, Harvard Health Publishing”,”description”:”Claire McCarthy, MD, is a primary care pediatrician at Boston Children’s Hospital, and an assistant professor of pediatrics at Harvard Medical School. In addition to being a senior faculty editor for Harvard Health Publishing, Dr. McCarthy writes about health and parenting for Boston Children’s Hospital, Boston.com, and the Huffington Post.”,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/mvCBqecmOmDXOhy74hH3DviJmMAprZqhFgGbhTJL.jpg”,”twitter_username”:null,”sort_order”:5,”created_at”:”2021-05-11T10:23:17.000000Z”,”updated_at”:”2023-09-05T22:36:44.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:18629,”author_id”:46,”sort_order”:1}}],”contentable”:{“id”:3015,”comments_open”:1,”created_at”:”2024-02-06T10:00:03.000000Z”,”updated_at”:”2024-02-06T10:00:03.000000Z”,”deleted_at”:null,”media”:[]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:14828,”model_type”:”AppModelsMarketingContent”,”model_id”:18629,”uuid”:”f6257fb3-f46f-4a50-9fdf-d2830aafb893″,”collection_name”:”contents”,”name”:”da9a1391-819b-4d83-a877-d07a5d617d72″,”file_name”:”da9a1391-819b-4d83-a877-d07a5d617d72.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:67472,”manipulations”:[],”custom_properties”:{“alt”:”Baby with thick, dark hair lying on tummy looking at camera with hands touching, head raised, and tongue out slightly”},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:14764,”created_at”:”2024-02-06T10:00:03.000000Z”,”updated_at”:”2024-02-06T10:00:04.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/14828/da9a1391-819b-4d83-a877-d07a5d617d72.jpg”}],”primary_content_topic”:{“id”:24,”name”:”Child & Teen Health”,”slug”:”child-and-teen-health”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/child-and-teen-health”}},{“id”:18627,”content_source_id”:2,”content_type_id”:18,”content_access_type_id”:1,”title”:”Which migraine medications are most helpful?”,”short_title”:””,”subheading”:”Drugs known as triptans came out on top, based on real-world data from some 278,000 migraine sufferers.”,”summary”:”n

Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options.

n “,”content”:”n

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If you suffer from the throbbing, intense pain set off by migraine headaches, you may well wonder which medicines are most likely to offer relief. A recent study suggests a class of drugs called triptans are the most helpful option, with one particular drug rising to the top.

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The study drew on real-world data gleaned from more than three million entries on My Migraine Buddy, a free smartphone app. The app lets users track their migraine attacks and rate the helpfulness of any medications they take.

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Dr. Elizabeth Loder, professor of neurology at Harvard Medical School and chief of the Division of Headache at Brigham and Women’s Hospital, helped break down what the researchers looked at and learned that could benefit anyone with migraines.

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What did the migraine study look at?

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Published in the journal Neurology, the study included self-reported data from about 278,000 people (mostly women) over a six-year period that ended in July 2020. Using the app, participants rated migraine treatments they used as “helpful,” “somewhat helpful,” or “unhelpful.”

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The researchers looked at 25 medications from seven drug classes to see which were most helpful for easing migraines. After triptans, the next most helpful drug classes were ergots such as dihydroergotamine (Migranal, Trudhesa) and anti-emetics such as promethazine (Phenergan). The latter help ease nausea, another common migraine symptom.

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“I’m always happy to see studies conducted in a real-world setting, and this one is very clever,” says Dr. Loder. The results validate current guideline recommendations for treating migraines, which rank triptans as a first-line choice. “If you had asked me to sit down and make a list of the most helpful migraine medications, it would be very similar to what this study found,” she says.

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What else did the study show about migraine pain relievers?

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Ibuprofen, an over-the-counter pain reliever sold as Advil and Motrin, was the most frequently used medication in the study. But participants rated it “helpful” only 42% of the time. Only acetaminophen (Tylenol) was less helpful, helping just 37% of the time. A common combination medication containing aspirin, acetaminophen, and caffeine (sold under the brand name Excedrin) worked only slightly better than ibuprofen, or about half the time.

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When researchers compared helpfulness of other drugs to ibuprofen, they found:

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  • Triptans scored five to six times more helpful than ibuprofen. The highest ranked drug, eletriptan, helped 78% of the time. Other triptans, including zolmitriptan (Zomig) and sumatriptan (Imitrex), were helpful 74% and 72% of the time, respectively. In practice, notes Dr. Loder, eletriptan seems to be just a tad better than the other triptans.
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  • Ergots were rated as three times more helpful than ibuprofen.
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  • Anti-emetics were 2.5 times as helpful as ibuprofen.
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Do people take more than one medicine to ease migraine symptoms?

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In this study, two-thirds of migraine attacks were treated with just one drug. About a quarter of the study participants used two drugs, and a smaller number used three or more drugs.

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However, researchers weren’t able to tease out the sequence of when people took the drugs. And with anti-nausea drugs, it’s not clear if people were rating their helpfulness on nausea rather than headache, Dr. Loder points out. But it’s a good reminder that for many people who have migraines, nausea and vomiting are a big problem. When that’s the case, different drug formulations can help.

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Are pills the only option for migraine relief?

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No. For the headache, people can use a nasal spray or injectable version of a triptan rather than pills. Pre-filled syringes, which are injected into the thigh, stomach, or upper arm, are underused among people who have very rapid-onset migraines, says Dr. Loder. “For these people, injectable triptans are a game changer because pills don’t work as fast and might not stay down,” she says.

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For nausea, the anti-emetic ondansetron (Zofran) is very effective, but one of the side effects is headache. You’re better off using promethazine or prochlorperazine (Compazine), both of which treat nausea but also help ease headache pain, says Dr. Loder.

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Additionally, many anti-nausea drugs are available as rectal suppositories. This is especially helpful for people who have “crash” migraines, which often cause people to wake up vomiting with a migraine, she adds.

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What are the limitations of this migraine study?

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The data didn’t include information about the timing, sequence, formulation, or dosage of the medications. It also omitted two classes of newer migraine medications — known as gepants and ditans — because there was only limited data on them at the time of the study. These options include

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  • atogepant (Qulipta) and rimegepant (Nurtec)
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  • lasmiditan (Reyvow).
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“But based on my clinical experience, I don’t think that any of these drugs would do a lot better than the triptans,” says Dr. Loder.

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Another shortcoming is the study population: a selected group of people who are able and motivated to use a migraine smartphone app. That suggests their headaches are probably worse than the average person, but that’s exactly the population for whom this information is needed, says Dr. Loder.

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“Migraines are most common in young, healthy people who are trying to work and raise children,” she says. It’s good to know that people using this app rate triptans highly, because from a medical point of view, these drugs are well tolerated and have few side effects, she adds.

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Are there other helpful takeaways?

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Yes. In the study, nearly half the participants said their pain wasn’t adequately treated. A third reported using more than one medicine to manage their migraines.

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If you experience these problems, consult a health care provider who can help you find a more effective therapy. “If you’re using over-the-counter drugs, consider trying a prescription triptan,” Dr. Loder says. If nausea and vomiting are a problem for you, be sure to have an anti-nausea drug on hand.

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She also recommends using the Migraine Buddy app or the Canadian Migraine Tracker app (both are free), which many of her patients find helpful for tracking their headaches and triggers.

n “,”excerpt”:”n

Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options.

n “,”short_excerpt”:”n

Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options.

n “,”description”:null,”author”:null,”slug”:”which-migraine-medications-are-most-helpful-202402053014″,”sort_date”:”2024-02-05T05:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:3014,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”BL020524″,”publication_date”:”2024-02-05T15:30:00.000000Z”,”last_review_date”:null,”imported_at”:”2024-02-06T10:00:04.000000Z”,”last_import_type”:”update”,”last_modified_date”:”2024-02-05T05:00:00.000000Z”,”active”:1,”created_at”:”2024-02-05T16:02:48.000000Z”,”updated_at”:”2024-02-06T10:00:04.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:null,”hide_ads”:0,”primary_content_topic_id”:39,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:14,”cr_id”:157,”featured”:1,”hhp_staff”:0,”hidden”:0,”name”:”Julie Corliss”,”title”:null,”first_name”:”Julie”,”middle_name”:null,”last_name”:”Corliss”,”suffix”:null,”slug”:”julie-corliss”,”byline”:”Executive Editor, Harvard Heart Letter“,”description”:”

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.

“,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/sA3ZdpCgTj4g3UoiGOBnYISWiUDAxrxi2l5SexJz.jpg”,”twitter_username”:null,”sort_order”:0,”created_at”:”2021-05-11T09:59:48.000000Z”,”updated_at”:”2023-05-12T20:42:51.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:18627,”author_id”:14,”sort_order”:1}}],”contentable”:{“id”:3014,”comments_open”:1,”created_at”:”2024-02-05T16:02:48.000000Z”,”updated_at”:”2024-02-05T16:02:48.000000Z”,”deleted_at”:null,”media”:[]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:14819,”model_type”:”AppModelsMarketingContent”,”model_id”:18627,”uuid”:”92a43219-7a59-4061-bcc2-50f48be5211c”,”collection_name”:”contents”,”name”:”86a58fef-cf16-4980-a584-708c1162bf0a”,”file_name”:”86a58fef-cf16-4980-a584-708c1162bf0a.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:54680,”manipulations”:[],”custom_properties”:{“alt”:”A head and shoulders view of a woman with eyes closed and storm clouds with lightening suggesting pain circling her head; concept is migraine “},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:14755,”created_at”:”2024-02-05T16:02:48.000000Z”,”updated_at”:”2024-02-05T16:02:50.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/14819/86a58fef-cf16-4980-a584-708c1162bf0a.jpg”}],”primary_content_topic”:{“id”:39,”name”:”Pain”,”slug”:”pain”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/pain”}},{“id”:18624,”content_source_id”:2,”content_type_id”:18,”content_access_type_id”:1,”title”:”How well do you score on brain health?”,”short_title”:null,”subheading”:”A new scorecard developed by researchers could encourage you to pare down risks for dementia and stroke.”,”summary”:”

Many efforts to improve health are also good for the brain. A study of nearly 400,000 people led researchers to develop a scorecard assessing 12 factors that contribute to the risk of dementia or stroke, making it easy to see where you're doing well and where you might do better.

“,”content”:”

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Need another jolt of motivation to shore up a resolution to shed weight, sleep more soundly, boost nutrition or exercise levels, or cut back on alcohol? Then you'll be pleased to learn that any (and all) of these efforts can also add up to better brain health.

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An international study led by researchers at the McCance Center for Brain Health at Massachusetts General Hospital devised and validated a Brain Care Score (BCS) card that makes it easy to total up what you're doing well and where you might do better. The prize is a healthier brain — specifically a lower risk for dementia and strokes.

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Designed to predict how current habits might impact future brain health, the user-friendly scorecard is apparently the first of its kind, says Dr. Andrew Budson, a lecturer in neurology at Harvard Medical School.

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"It's a real service that the researchers have developed a scale like this and completed the first study to determine if scoring worse on this scale raises your risk for dementia and stroke," says Dr. Budson, who wasn't involved in the analysis. "On one hand, no one's done something quite like this before. On the other, however, it's really wrapping together health factors everyone has known for a number of years in new packaging."

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What's included on the scorecard?

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Called the McCance Brain Care Score, the card tallies points from 12 physical, lifestyle, and social-emotional domains.

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Physical components relate to

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  • blood pressure
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  • blood sugar
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  • cholesterol
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  • body mass index (BMI).
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Lifestyle components include

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  • nutrition
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  • alcohol intake
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  • smoking
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  • aerobic activities
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  • sleep.
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Social-emotional factors inquire about

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  • stress management
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  • social relationships
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  • meaning in life.
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Each response is given a score of 0, 1, or 2, with the highest possible score totaling 21. Higher scores suggest better brain care.

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"All these physical and lifestyle factors can contribute to the risk of dementia to some extent through strokes," Dr. Budson says. "Those that aren't a risk through strokes are usually related to the fact that a healthy brain is a brain that's using all of its parts. Engaging in healthy relationships and meaningful activities helps us maintain good brain structure and function."

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What did the analysis involve?

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The study was published online in Frontiers of Neurology in December 2023. It involved nearly 399,000 adults ages 40 through 69 (average age 57; 54% women) who contributed personal health information to the UK Biobank.

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During an average follow-up period of 12.5 years, participants recorded 5,354 new cases of dementia and 7,259 strokes. Researchers found that participants with higher Brain Care Scores at the study's start had lower risks of developing dementia or strokes over time.

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These threats to health and independence take a stunning — and growing — toll on people in the US. Dementia affects one in seven Americans, a rate expected to triple by 2050. Meanwhile, more than 795,000 people in the United States suffer a stroke each year, according to the CDC.

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What did the study find?

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Each five-point step higher in the BCS rating assigned when the study began was linked to significantly lower risks of dementia and stroke, with those odds varying by age group:

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  • Participants younger than 50 at the study's start were 59% less likely to develop dementia and 48% less likely to have a stroke with each five-point higher score on BCS.
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  • Participants 50 through 59 at the study's start were 32% less likely to develop dementia and 52% less likely to have a stroke with each five-point higher score on BCS.
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But those brain disease benefits appeared to diminish for those older than 59 at the study's start. This group experienced only 8% lower odds of dementia and a 33% lower risk of stroke with each five-point higher score on BCS. Study authors theorized that some of these participants may have already been experiencing early dementia, which is difficult to detect until it progresses.

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"I feel very comfortable that the study's conclusions are entirely correct, because all the factors that go into its BCS are well-known things people can do to reduce their risk of stroke and dementia," Dr. Budson says.

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What are the study's limitations?

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However, Dr. Budson notes that the study did have a couple of limitations,. The UK Biobank fell just short of collecting all the components of the BCS in its dataset, lacking meaning-of-life questions. So its scores ranged from 0 to 19, not up to 21. "It's a practical limitation, but it should be acknowledged that so far, there have been no studies to validate the actual 21-point scale they're recommending we use," he says.

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The analysis also evaluated participants' scores at just one point in time instead of several, Dr. Budson says. Future research should determine whether people can lower their stroke and dementia risk by improving their BCS over time with behavior and lifestyle changes.

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How can you play this game at home?

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While better brain health may be the clear prize of a higher score, it's far from the only benefit. That's because improving any health component of the BCS also benefits our overall well-being.

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"By improving these factors, not only will people help their brain, but they'll also help their heart and reduce their risk of cancer," Dr. Budson adds. "These factors will absolutely also improve your psychological health, which is certainly an important part of brain health."

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The scale's simple breakdown of health factors also makes it easy to focus on tweaking one or two without getting overwhelmed.

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"Let's say someone's nutrition isn't perfect — and they know it — but they're not willing to change their diet. Fine. They can then decide to do more aerobic exercise, for example, or to stop drinking, or to get the sleep their body needs," he says.

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What one change could put you on a path to better brain health?

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If he had to choose just one factor to improve brain health, Dr. Budson would focus on meaning of life, "which means you generally feel your life has meaning or purpose," he says. To do that, he suggests giving deep, quiet thought to what you wish your life's purpose to be, whether you expect to live a long time or just a few years.

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"Once you have a purpose, then you have a reason to follow through with assessing all the other items on the BCS scale and seeing what you can do so you'll be around longer, and be competent and capable longer, to help fulfill the meaning and purpose of your life," he says.

“,”excerpt”:”

Many efforts to improve health are also good for the brain. A study of nearly 400,000 people led researchers to develop a scorecard assessing 12 factors that contribute to the risk of dementia or stroke, making it easy to see where you're doing well and where you might do better.

“,”short_excerpt”:”n

Many efforts to improve health are also good for the brain. A study of nearly 400,000 people led researchers to develop a scorecard assessing 12 factors that contribute to the risk of dementia or stroke, making it easy to see where you're doing well and where you might do better.

n “,”description”:null,”author”:null,”slug”:”how-well-do-you-score-on-brain-health-202402023012″,”sort_date”:”2024-02-02T05:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:3012,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”BL020224″,”publication_date”:”2024-02-02T05:00:00.000000Z”,”last_review_date”:null,”imported_at”:”2024-02-02T05:00:00.000000Z”,”last_import_type”:”update”,”last_modified_date”:”2024-02-01T05:00:00.000000Z”,”active”:1,”created_at”:”2024-02-01T10:00:02.000000Z”,”updated_at”:”2024-02-02T20:48:29.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:null,”hide_ads”:0,”primary_content_topic_id”:37,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:420,”cr_id”:779,”featured”:0,”hhp_staff”:0,”hidden”:0,”name”:”Maureen Salamon”,”title”:null,”first_name”:”Maureen”,”middle_name”:null,”last_name”:”Salamon”,”suffix”:null,”slug”:”maureen-salamon”,”byline”:”Executive Editor, Harvard Women's Health Watch“,”description”:”

Maureen Salamon is executive editor of Harvard Women’s Health Watch. She began her career as a newspaper reporter and later covered health and medicine for a wide variety of websites, magazines, and hospitals. Her work has appeared in The New York Times, The Atlantic, CNN.com, WebMD, Medscape and HealthDay, among other major outlets. Maureen earned a BA in print journalism from Penn State University.

“,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/MWQyHwiFAPooqhDKsjTfFjCCCoIooqQNLj1M7LRO.jpg”,”twitter_username”:null,”sort_order”:0,”created_at”:”2022-02-24T21:39:38.000000Z”,”updated_at”:”2022-07-17T15:04:53.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:18624,”author_id”:420,”sort_order”:1}}],”contentable”:{“id”:3012,”comments_open”:1,”created_at”:”2024-02-01T10:00:02.000000Z”,”updated_at”:”2024-02-02T20:48:29.000000Z”,”deleted_at”:null,”media”:[]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:14816,”model_type”:”AppModelsMarketingContent”,”model_id”:18624,”uuid”:”9db0d1a6-5b8e-4539-bd7f-407f4e501f68″,”collection_name”:”contents”,”name”:”283a23cd-5029-4943-9bea-3d0eab84713e”,”file_name”:”283a23cd-5029-4943-9bea-3d0eab84713e.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:55198,”manipulations”:[],”custom_properties”:{“alt”:”A human brain shown in colorful triangular prisms against a gray background; concept is brain health”},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:14752,”created_at”:”2024-02-01T10:00:02.000000Z”,”updated_at”:”2024-02-01T10:00:05.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/14816/283a23cd-5029-4943-9bea-3d0eab84713e.jpg”}],”primary_content_topic”:{“id”:37,”name”:”Mind & Mood”,”slug”:”mind-and-mood”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/mind-and-mood”}},{“id”:18620,”content_source_id”:2,”content_type_id”:18,”content_access_type_id”:1,”title”:”Shining light on night blindness”,”short_title”:””,”subheading”:”Trouble seeing at night? Here’s what may help.”,”summary”:”n

Night blindness makes it hard to see in dim or dark settings, which can affect safety at home and make driving dangerous after dark. While the cause varies, there are steps people can take to address these problems.

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Animals renowned for their outstanding night vision include owls, cats, tarsiers (a tiny primate in Southeast Asia) — and even the dung beetle.

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But humans? Not so much.

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Over time, many people suffer from night blindness, also known as nyctalopia. This condition makes seeing in dim or dark settings difficult because your eyes cannot adjust to changes in brightness or detect light.

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What are the dangers for those experiencing night blindness?

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Night blindness is especially problematic and dangerous when driving. Your eyes cannot adjust between darkness and the headlights of oncoming vehicles, other cars may appear out of focus, and your depth perception becomes impaired, which makes it difficult to judge distances.

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Night blindness also may affect your sight at home by making it hard for your vision to quickly adjust to a dark room after turning off the lights. “This can cause people to bump into furniture or trip and suffer an injury,” says Dr. Isabel Deakins, an optometrist with Harvard-affiliated Massachusetts Eye and Ear.

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What happens in the eye to create night blindness?

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The ability to see in low-light conditions involves two structures in the eye: the retina and the iris.

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The retina, located in the back of the eye, contains two types of light-detecting cells called cones and rods. The cones handle color vision and fine details while the rods manage vision in dim light.

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The iris is the colored part of your eye. It contains muscles that widen or narrow the opening of your pupil to adjust how much light can enter your eyes.

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If your irises don’t properly react, the pupils can dilate and let in too much light, which causes light sensitivity and makes it hard to see in bright light. Or your pupils may remain too small and not allow in enough light, making it tough to see in low light.

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What causes night blindness?

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Night blindness is not a disease but a symptom of other conditions. “It’s like having a bruise on your body. Something else causes it,” says Dr. Deakins.

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Several conditions can cause night blindness. For instance, medications, such as antidepressants, antihistamines, and antipsychotics, can affect pupil size and how much light enters the eye.

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Eye conditions that can cause night blindness include:

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  • glaucoma, a disease that damages the eye’s optic nerves and blood vessels
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  • cataracts, cloudy areas in the lens that distort or block the passage of light through the lens
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  • dry eye syndrome.
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However, one issue that raises the risk of night blindness that you can’t control is age. “Our eyes react more slowly to light changes as we age, and vision naturally declines over time,” says Dr. Deakins.  “The number of rods in our eyes diminish, pupils get smaller, and the muscles of the irises weaken.”

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What helps if you have night blindness?

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If you notice any signs of night blindness, avoid driving and get checked by an eye care specialist like an optometrist or ophthalmologist. An eye exam can determine if your eyeglass prescription needs to be updated.

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“Often, a prescription change is enough to reduce glare when driving at night," says Dr. Deakins. “You may even need separate glasses with a stronger eye prescription that you wear only when driving at night.”

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Adding an anti-reflective coating to your lens may help to cut down on the glare of the headlights of an oncoming car. However, skip the over-the-counter polarized driving glasses sold at many drug stores. "These may help cut down on glare, but they don't address the causes of night blindness," says Dr. Deakins.

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An eye exam also will identify glaucoma or cataracts, which can be treated. Glaucoma treatments include eyedrops, laser treatment, or surgery. Cataracts are corrected with surgery to replace the clouded lens with an artificial one. Your eye care specialist can also help identify dry eye and recommend treatment.

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Ask your primary care clinician or a pharmacist if any medications that you take may cause night blindness. If so, it may be possible to adjust the dose or switch to another drug.

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Three more ways to make night driving safer

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You also can take steps to make night driving safer. For example:

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  • Wash the lenses of your glasses regularly. And take them to an optician to buff out minor scratches.
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  • Keep both sides of your front and rear car windshields clean so that you can see as clearly as possible.
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  • Dim your dashboard lights, which cause glare, and use the night setting on your rearview mirror.
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“,”excerpt”:”n

Night blindness makes it hard to see in dim or dark settings, which can affect safety at home and make driving dangerous after dark. While the cause varies, there are steps people can take to address these problems.

n “,”short_excerpt”:”n

Night blindness makes it hard to see in dim or dark settings, which can affect safety at home and make driving dangerous after dark. While the cause varies, there are steps people can take to address these problems.

n “,”description”:null,”author”:null,”slug”:”shining-light-on-night-blindness-202401253011″,”sort_date”:”2024-01-31T05:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:3011,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”BL012924″,”publication_date”:”2024-01-31T15:30:00.000000Z”,”last_review_date”:null,”imported_at”:”2024-02-02T10:00:04.000000Z”,”last_import_type”:”update”,”last_modified_date”:”2024-02-01T05:00:00.000000Z”,”active”:1,”created_at”:”2024-01-27T10:00:03.000000Z”,”updated_at”:”2024-02-02T10:00:04.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:null,”hide_ads”:0,”primary_content_topic_id”:28,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:66,”cr_id”:434,”featured”:1,”hhp_staff”:0,”hidden”:0,”name”:”Matthew Solan”,”title”:null,”first_name”:”Matthew”,”middle_name”:null,”last_name”:”Solan”,”suffix”:null,”slug”:”matthew-solan”,”byline”:”Executive Editor, Harvard Men's Health Watch“,”description”:”

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s Women Nutrition Connection and Women’s Health Advisor. Matthew’s articles on medicine, exercise science, and nutrition have appeared in Men’s Health, Men’s Fitness, Muscle & Fitness, Runner’s World, and Yoga Journal. He earned a master of fine arts in writing from the University of San Francisco and a bachelor of science in journalism from the University of Florida.

“,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/meFkQGpweKNzK8THXHlIORQI3ZZ68ShyfSRQykZN.jpg”,”twitter_username”:null,”sort_order”:0,”created_at”:”2021-05-11T10:26:17.000000Z”,”updated_at”:”2022-08-03T16:49:53.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:18620,”author_id”:66,”sort_order”:1}}],”contentable”:{“id”:3011,”comments_open”:1,”created_at”:”2024-01-27T10:00:03.000000Z”,”updated_at”:”2024-01-27T10:00:03.000000Z”,”deleted_at”:null,”media”:[]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:14810,”model_type”:”AppModelsMarketingContent”,”model_id”:18620,”uuid”:”993affb9-fda4-4b68-be5a-5449d5edf3e3″,”collection_name”:”contents”,”name”:”778f3d8c-0b73-420c-8d03-e8542d49660d”,”file_name”:”778f3d8c-0b73-420c-8d03-e8542d49660d.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:81452,”manipulations”:[],”custom_properties”:{“alt”:”A dangerously blurry view of cars, streetlights, headlights through a car window at night; concept is night blindness”},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:14746,”created_at”:”2024-01-27T10:00:03.000000Z”,”updated_at”:”2024-01-27T10:00:12.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/14810/778f3d8c-0b73-420c-8d03-e8542d49660d.jpg”}],”primary_content_topic”:{“id”:28,”name”:”Diseases & Conditions”,”slug”:”diseases-and-conditions”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/diseases-and-conditions”}},{“id”:15608,”content_source_id”:2,”content_type_id”:18,”content_access_type_id”:1,”title”:”Can watching sports be bad for your health?”,”short_title”:””,”subheading”:”There’s evidence that for some the answer is yes.”,”summary”:”n

Can watching sports –– not just the rough and tumble of playing them –– be harmful to your health? Whether you're at a live event or clicking through channels, it may be riskier than you think when weather, stress, and racing heart rates are factored in. Here's a game day plan that can help.

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As the new year rolls on, sports fans rejoice! You’ve had the excitement of the college football bowl games and the national championship game, the NFL playoff games are winnowing teams down to the Super Bowl contestants, and basketball and hockey seasons are in full swing. Spring training for the upcoming Major League Baseball season is around the corner.

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But hold these thoughts a moment. Watching sports — not just playing them — can be hazardous to your health. I’ve seen it firsthand while working in a walk-in clinic near Fenway Park, where people would show up bleeding from cuts that needed stitches (from trips and falls at the stadium), broken bones (from trying to catch a foul ball or an altercation with another fan), and dehydration.

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Most of these injuries weren’t life-threatening. But there’s evidence that the health impact of sports spectatorship can be far more serious for some of us — and, perhaps, underappreciated.

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What are the health risks of watching live sports?

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When you’re watching games in person, some risks are related to the weather and other fans. For example:

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How could watching sports on TV boost health risks?

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Doctors and nurses often describe how quiet things get in the emergency room during a World Series game or the Super Bowl. But once the game ends, it tends to get much busier. One theory is that people with chest pain, trouble breathing, or other symptoms of a potentially serious problem who ordinarily would have reported to the emergency room right away may delay seeking care until after the game.

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Of course, there’s another possibility: the game itself — especially if a game is close and particularly exciting — might cause enough stress on the body that heart attacks, strokes, or other dangerous conditions develop.

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Research supporting the idea that watching sports can negatively affect your health includes:

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Together, these studies suggest that watching sports can be stressful enough to trigger dangerous cardiovascular events.

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It’s worth emphasizing that most people watching sports enjoy it and do not experience any health problems related to the game. But these studies suggest that spectating may carry some small risk, similar to what might accompany moderate or vigorous exercise. This may be most relevant for people who are older or who already have cardiovascular disease.

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What’s a sports fan to do?

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One common recommendation is to remember that it’s only a game. Of course, if you care a lot about sports or a particular team, that advice is unlikely to help. A second is to get regular exercise. Staying physically active strengthens the heart and lowers blood pressure, which could help ward off some of the health risks described above.

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Five additional game-day precautions are:

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  • Avoid overeating, especially salty junk food. For some, overindulging in food, drink, and salt can stress the heart or trigger heart failure.
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  • Be prepared for the weather. Check the forecast. If you’re planning to watch a game in the cold, dress in layers, use hand warmers, and drink warm fluids. If you’re going to be out in the sun, use sunscreen liberally, wear a hat, and hydrate well.
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  • If you have cardiovascular disease, don’t forget to take your medications, especially if there’s a big game coming up. And if you develop worrisome symptoms, such as chest pain or trouble breathing, seek medical attention right away. Don’t wait till the game ends!
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  • Stay hydrated and moderate your alcohol intake. Stay well-hydrated by drinking water, especially if you’re out in the heat for hours. Although beer is a liquid, it’s also a diuretic, meaning it can make you urinate more and lose more fluids than other beverages.
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  • Stay alert at live events. Give yourself a fighting chance of getting out of the way of a line-drive foul ball or an errant bat that’s slipped out of the batter’s hands during a swing.
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The bottom line

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I can attest to many upsides of watching sports: the excitement of competition and the bonding and camaraderie with likeminded friends, family, and other fans. And perhaps watching sports might improve your health if sports spectatorship sparks sports participation.

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While watching sports has been linked to certain health risks, the overall risk is likely low for most people. And you can take steps to reduce this. The health risks of spectatorship only rarely require giving up watching a favorite team. So, put on your team jersey, cheer your team on to victory, and stay healthy while you’re at it. Oh, and watch out for outraged fans or flying bats.

n “,”excerpt”:”n

Can watching sports –– not just the rough and tumble of playing them –– be harmful to your health? Whether you're at a live event or clicking through channels, it may be riskier than you think when weather, stress, and racing heart rates are factored in. Here's a game day plan that can help.

n “,”short_excerpt”:”n

Can watching sports –– not just the rough and tumble of playing them –– be harmful to your health? Whether you're at a live event or clicking through channels, it may be riskier than you think when weather, stress, and racing heart rates are factored in. Here's a game day plan that can help.

n “,”description”:null,”author”:null,”slug”:”can-watching-sports-be-bad-for-your-health-2019011115751″,”sort_date”:”2019-01-11T05:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:1780,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”BL011119″,”publication_date”:”2019-01-11T05:00:00.000000Z”,”last_review_date”:”2024-01-22T05:00:00.000000Z”,”imported_at”:”2024-02-03T10:00:03.000000Z”,”last_import_type”:”update”,”last_modified_date”:”2024-02-02T05:00:00.000000Z”,”active”:1,”created_at”:”2019-01-11T11:30:13.000000Z”,”updated_at”:”2024-02-03T10:00:03.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:15751,”hide_ads”:0,”primary_content_topic_id”:44,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:23,”cr_id”:2,”featured”:1,”hhp_staff”:1,”hidden”:0,”name”:”Robert H. Shmerling, MD”,”title”:null,”first_name”:”Robert”,”middle_name”:”H.”,”last_name”:”Shmerling”,”suffix”:”MD”,”slug”:”robert-h-shmerling-md”,”byline”:”Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing”,”description”:”

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. As a practicing rheumatologist for over 30 years, Dr. Shmerling engaged in a mix of patient care, teaching, and research. His research interests center on diagnostic studies in patients with musculoskeletal symptoms, and rheumatic and autoimmune diseases. He has published research regarding infectious arthritis, medical ethics, and diagnostic test performance in rheumatic disease. Having retired from patient care in 2019, Dr. Shmerling now works as a senior faculty editor for Harvard Health Publishing.

“,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/OdKCKaVzyx3xPsUxIBc9zJz8m3zvysnJa3UJsGOd.jpg”,”twitter_username”:”RobShmerling”,”sort_order”:4,”created_at”:”2021-05-11T10:05:10.000000Z”,”updated_at”:”2023-09-06T15:33:18.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:15608,”author_id”:23,”sort_order”:1}}],”contentable”:{“id”:1780,”comments_open”:1,”created_at”:”2021-05-11T10:51:05.000000Z”,”updated_at”:”2021-05-11T10:51:05.000000Z”,”deleted_at”:null,”media”:[{“id”:9670,”model_type”:”AppModelsMarketingBlogPost”,”model_id”:1780,”uuid”:”cc64ae25-dcc8-48b0-adc9-35c11aac637f”,”collection_name”:”featured”,”name”:”iStock-492678255″,”file_name”:”iStock-492678255.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:495051,”manipulations”:[],”custom_properties”:[],”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:9670,”created_at”:”2021-05-11T10:51:05.000000Z”,”updated_at”:”2021-06-23T14:35:57.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/9670/iStock-492678255.jpg”}]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:14799,”model_type”:”AppModelsMarketingContent”,”model_id”:15608,”uuid”:”b0717f9f-0e00-4105-9a12-f219cf350dbe”,”collection_name”:”contents”,”name”:”07b47be7-c23f-4a0f-b162-e23329acfa41″,”file_name”:”07b47be7-c23f-4a0f-b162-e23329acfa41.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:28580,”manipulations”:[],”custom_properties”:{“alt”:”photo of a hand holding a remote control at the left edge of the image; behind it is a TV that is out of focus, but a soccer game can be discerned on the screen”},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:14735,”created_at”:”2024-01-23T20:06:55.000000Z”,”updated_at”:”2024-01-23T20:06:57.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/14799/07b47be7-c23f-4a0f-b162-e23329acfa41.jpg”}],”primary_content_topic”:{“id”:44,”name”:”Staying Healthy”,”slug”:”staying-healthy”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/staying-healthy”}},{“id”:16758,”content_source_id”:2,”content_type_id”:18,”content_access_type_id”:1,”title”:”Icy fingers and toes: Poor circulation or Raynaud’s phenomenon?”,”short_title”:””,”subheading”:”Drops in temperature may trigger blood vessel spasms in some people.”,”summary”:”n

Some people have poor circulation, but if your fingers pale and go numb when exposed to quick changes in temperature, it could be Raynaud’s phenomenon, a different kind of circulation problem. Generally, avoiding sudden exposure to cold and other factors that cause blood vessels to constrict, and being prepared with gloves and extra layers of clothing, helps.

n “,”content”:”

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If your fingers or toes ever turn pale (or even ghostly white) and go numb when exposed to cold, you might assume you just have poor circulation. That’s what I used to think when I first started noticing this problem with my own hands many years ago.

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It usually happened near the end of a long hike on a spring or fall afternoon, when the temperature dropped and I didn’t have any gloves handy. My pinkie, third, and middle fingers would turn white, and the fingernails took on a bluish tinge. As I soon discovered, I have Raynaud’s phenomenon, an exaggeration of normal blood vessel constriction.

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Raynaud’s phenomenon: Beyond poor circulation

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When you’re exposed to a cold environment, your body reacts by trying to preserve your core temperature. Blood vessels near the surface of your skin constrict, redirecting blood flow deeper into the body. If you have Raynaud’s phenomenon, this process is more extreme.

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Is wintry weather the only trigger for Raynaud’s phenomenon?

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“Cold weather is the classic trigger for Raynaud’s phenomenon," says rheumatologist Dr. Robert H. Shmerling, senior faculty editor at Harvard Medical School's Harvard Health Publishing.

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"But it can occur any time of year — for example, when you come out of a heated pool, walk into an air-conditioned building, or reach into the freezer section at the supermarket. Even slight changes in air temperature can trigger an episode.”

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What happens when an episode occurs?

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During an episode, the small arteries supplying the fingers and toes contract spasmodically, hampering the flow of oxygen-rich blood to the skin. Some of these vessels even temporarily collapse, and the skin becomes pale and cool, sometimes blanching to a stark white color.

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In addition to the hands, Raynaud’s can also affect the feet. Less often, the nose, lips, and ears.

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Is Raynaud’s phenomenon a circulation problem?

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Technically, Raynaud’s phenomenon is a circulation problem, but it’s very different than what doctors typically mean by poor circulation, says Dr. Shmerling. Limited or poor circulation usually affects older people whose arteries are narrowed with fatty plaque (known as atherosclerosis). This condition is often caused by high cholesterol, high blood pressure, and smoking.

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In contrast, Raynaud’s usually affects younger people (mostly women) without those issues. And the circulation glitch is generally temporary and completely reversible, he adds.

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How can you prevent episodes?

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As I can attest, the best treatment for this condition is to prevent episodes in the first place, mainly by avoiding sudden or unprotected exposure to cold temperatures. I’ve always bundled up in the winter before heading outside, but now I bring extra layers and gloves even when the temperature might dip even slightly, or the weather may turn rainy or windy. Preheating the car in winter before getting in, and wearing gloves in chilly grocery store aisles, can also help.

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Generally, it’s best to avoid behavior and medicines that cause blood vessels to constrict. This includes not smoking and not taking certain medications, such as cold and allergy formulas that contain pseudoephedrine and migraine drugs that contain ergotamine. Emotional stress may also provoke an episode of Raynaud’s, so consider tools and techniques that can help you ease stress, such as mindfulness techniques.

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If necessary, your doctor may prescribe a medication that relaxes the blood vessels, usually a calcium-channel blocker such as nifedipine (Adalat, Procardia). If that’s not effective, drugs to treat erectile dysfunction such as sildenafil (Viagra) may help somewhat. Other treatment options include losartan (Cozaar), fluoxetine (Prozac), and topical nitroglycerin. You may only need to use these medications during the cold season, when Raynaud’s tends to be worse.

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What steps may help during an episode?

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Once an episode starts, it’s important to warm up the affected extremities as quickly as possible. For me, placing my hands under warm running water does the trick.

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When that’s not possible, you can put them under your armpits or next to another warm part of your body. When the blood vessels finally relax and blood flow resumes, the skin becomes warm and flushed — and very red. The fingers or toes may throb or tingle.

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Is Raynaud’s phenomenon linked to other health problems?

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Some people with Raynaud’s phenomenon have other health problems, usually connective tissue disorders such as lupus or scleroderma. Your doctor can determine this by reviewing your symptoms, performing a physical exam, and taking a few blood tests. But most of the time, there is no underlying medical problem.

“,”excerpt”:”n

Some people have poor circulation, but if your fingers pale and go numb when exposed to quick changes in temperature, it could be Raynaud’s phenomenon, a different kind of circulation problem. Generally, avoiding sudden exposure to cold and other factors that cause blood vessels to constrict, and being prepared with gloves and extra layers of clothing, helps.

n “,”short_excerpt”:”n

Some people have poor circulation, but if your fingers pale and go numb when exposed to quick changes in temperature, it could be Raynaud’s phenomenon, a different kind of circulation problem. Generally, avoiding sudden exposure to cold and other factors that cause blood vessels to constrict, and being prepared with gloves and extra layers of clothing, helps.

n “,”description”:null,”author”:null,”slug”:”icy-fingers-and-toes-poor-circulation-or-raynauds-phenomenon-202110152618″,”sort_date”:”2021-10-15T04:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:2618,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”BL101521″,”publication_date”:”2021-10-15T10:30:00.000000Z”,”last_review_date”:”2024-01-22T05:00:00.000000Z”,”imported_at”:”2024-01-25T10:00:07.000000Z”,”last_import_type”:”update”,”last_modified_date”:”2024-01-24T05:00:00.000000Z”,”active”:1,”created_at”:”2021-10-14T18:50:51.000000Z”,”updated_at”:”2024-01-25T10:00:07.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:null,”hide_ads”:0,”primary_content_topic_id”:28,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:14,”cr_id”:157,”featured”:1,”hhp_staff”:0,”hidden”:0,”name”:”Julie Corliss”,”title”:null,”first_name”:”Julie”,”middle_name”:null,”last_name”:”Corliss”,”suffix”:null,”slug”:”julie-corliss”,”byline”:”Executive Editor, Harvard Heart Letter“,”description”:”

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.

“,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/sA3ZdpCgTj4g3UoiGOBnYISWiUDAxrxi2l5SexJz.jpg”,”twitter_username”:null,”sort_order”:0,”created_at”:”2021-05-11T09:59:48.000000Z”,”updated_at”:”2023-05-12T20:42:51.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:16758,”author_id”:14,”sort_order”:1}}],”contentable”:{“id”:2618,”comments_open”:1,”created_at”:”2021-10-14T18:50:51.000000Z”,”updated_at”:”2021-10-20T18:01:35.000000Z”,”deleted_at”:null,”media”:[]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:11800,”model_type”:”AppModelsMarketingContent”,”model_id”:16758,”uuid”:”218d1e69-1d3c-4e22-bff0-d7bed8118043″,”collection_name”:”contents”,”name”:”6d70cb40-e097-4fd5-a97b-eedd5c277472″,”file_name”:”6d70cb40-e097-4fd5-a97b-eedd5c277472.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:80731,”manipulations”:[],”custom_properties”:{“alt”:”A person’s hands clenched in fists, their sweater sleeves cover most of their hands, indicating that they are cold”},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:11797,”created_at”:”2021-10-14T18:50:51.000000Z”,”updated_at”:”2022-06-29T09:00:04.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/11800/6d70cb40-e097-4fd5-a97b-eedd5c277472.jpg”}],”primary_content_topic”:{“id”:28,”name”:”Diseases & Conditions”,”slug”:”diseases-and-conditions”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/diseases-and-conditions”}},{“id”:18619,”content_source_id”:2,”content_type_id”:18,”content_access_type_id”:1,”title”:”Beyond the usual suspects for healthy resolutions”,”short_title”:””,”subheading”:”10 often-overlooked, simple ideas for better health.”,”summary”:”n

By now many people have started working on –– or at least thinking about –– healthy changes they want to make in the new year. Here are 10 simple ways to move beyond typical resolutions about losing weight, eating better, and exercising more.

n “,”content”:”n

n n

n

Early in the new year, promises to reboot your health typically focus on diet, exercise, and weight loss. And by now you may have begun making changes — or at least plans — to reach those goals. But consider going beyond the big three.

n

Below are 10 often-overlooked, simple ideas to step up personal health and safety. And most won’t make you break a sweat.

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Review your health portals

n

Your medical information is kept in electronic records. You have access to them through the patient portal associated with your doctor’s office. Set aside time to update portal passwords and peruse recent records of appointments, test results, and notes your doctor took during your visits.

n

“Many studies have shown that when patients review the notes, they remember far better what went on during interactions with their clinicians, take their medicines more effectively, and pick up on errors — whether it’s an appointment they forgot to make or something their doctor, nurse, or therapist got wrong in documenting an encounter,” says Dr. Tom Delbanco, the John F. Keane & Family Professor of Medicine at Harvard Medical School and cofounder of the OpenNotes initiative, which led shared clinician notes to become the new standard of care.

n

Doing this can help you become more engaged in your care. “We know from numerous studies that engaged patients who share decisions with those caring for them have better outcomes,” he adds.

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Ask about health insurance freebies

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Your insurance plan may offer perks that can lead to better health, such as:

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    n

  • weight loss cessation programs
  • n

  • quit-smoking programs
  • n

  • free or reduced gym memberships.
  • n

n

Some insurers even offer breastfeeding counseling and equipment. Call your insurance company or take a close look at their website to find out if there’s anything that would help you.

n

Get rid of expired medications

n

Scour your cabinets for expired or unneeded drugs, which pose dangers for you and others. Look for prescription and over-the-counter medications (pills, potions, creams, lotions, droppers, or aerosol cans) as well as supplements (vitamins, minerals, herbs).

n

Bring your finds to a drug take-back site, such as a drugstore or law enforcement office, or a medical waste collection site such as the local landfill.

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As a last resort, toss medications into the trash, but only after mixing them with unappealing substances (such as cat litter or used coffee grounds) and placing the mixture in a sealable plastic bag or container.

n

Invest in new sneakers

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The wrong equipment can sabotage any exercise routine, and for many people the culprit is a worn pair of sneakers. Inspect yours for holes, flattened arch support, and worn treads. New sneakers could motivate you to jazz up your walking or running routine.

n

For example, if it’s in the budget, buy a new pair of walking shoes with a wide toe box, cushy insoles, good arch support, a sturdy heel counter (the part that goes around your heel), stretchy uppers, and the right length — at least half an inch longer than your longest toe.

n

Cue up a new health app

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There are more than 350,000 health apps geared toward consumer health. They can help you with everything from managing your medications or chronic disease to providing instruction and prompts for improving diet, sleep, or exercise routines, enhancing mental health, easing stress, practicing mindfulness, and more.

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Hunt for apps that are free or offer a free trial period for a test drive. Look for good reviews, strong privacy guardrails, apps that don’t collect too much information from you, and those that are popular — with hundreds of thousands or millions of downloads.

n

Make a schedule for health screenings and visits

n

Is it time for a colonoscopy, mammogram, hearing test, prostate check, or comprehensive eye exam? Has it been a while since you had a dermatologist examine the skin on your whole body? Should you have a cholesterol test or other blood work — and when is a bone density test helpful?

n

If you’re not sure, call your primary care provider or any specialists on your health team to get answers.

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Four more simple healthy steps

n

The list of steps you can take this year to benefit your health can be as long as you’d like it to be. Jot down goals any time you think of them.

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Here are four solid steps to start you off:

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    n

  • Take some deep breaths each day. A few minutes of daily slow, deep breathing can help lower your blood pressure and ease stress.
  • n

  • Get a new pair of sunglasses if your old ones have worn lenses. Make sure the new pair has UV protection (a special coating) to block the sun’s ultraviolet (UV) light, which can cause eye damage and lead to permanent vision loss.
  • n

  • Make a few lunch dates or phone dates with friends you haven’t seen in a while. Being socially connected wards off loneliness and isolation, which can help lower certain health risks.
  • n

  • Do a deep cleaning on one room in your home per week. Dust and mold can trigger allergies, asthma, and even illness.
  • n

n

You don’t have to do all of these activities at once. Just put them on your to-do list, along with the larger resolutions you’re working on. Now you’ll have a curated list of goals of varying sizes. The more goals you reach, the better you’ll feel. And that will make for a very healthy year, indeed.

n “,”excerpt”:”n

By now many people have started working on –– or at least thinking about –– healthy changes they want to make in the new year. Here are 10 simple ways to move beyond typical resolutions about losing weight, eating better, and exercising more.

n “,”short_excerpt”:”n

By now many people have started working on –– or at least thinking about –– healthy changes they want to make in the new year. Here are 10 simple ways to move beyond typical resolutions about losing weight, eating better, and exercising more.

n “,”description”:null,”author”:null,”slug”:”beyond-the-usual-suspects-for-healthy-resolutions-202401243010″,”sort_date”:”2024-01-24T05:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:3010,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”BL012424″,”publication_date”:”2024-01-24T15:30:00.000000Z”,”last_review_date”:null,”imported_at”:”2024-01-27T10:00:03.000000Z”,”last_import_type”:”update”,”last_modified_date”:”2024-01-26T05:00:00.000000Z”,”active”:1,”created_at”:”2024-01-24T10:00:03.000000Z”,”updated_at”:”2024-01-27T10:00:03.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:null,”hide_ads”:0,”primary_content_topic_id”:44,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:31,”cr_id”:117,”featured”:0,”hhp_staff”:0,”hidden”:0,”name”:”Heidi Godman”,”title”:null,”first_name”:”Heidi”,”middle_name”:null,”last_name”:”Godman”,”suffix”:null,”slug”:”heidi-godman”,”byline”:”Executive Editor, Harvard Health Letter“,”description”:”

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow of the American Academy of Neurology, and has been honored by the Associated Press, the American Heart Association, the Wellness Community, and other organizations for outstanding medical reporting. Heidi holds a bachelor of science degree in journalism from West Virginia University.

“,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/jmHxTqYhe8m1bTrPQJnvY8odf8gsq1y1Q0i6Wp6Y.jpg”,”twitter_username”:null,”sort_order”:0,”created_at”:”2021-05-11T10:08:08.000000Z”,”updated_at”:”2022-08-03T17:04:41.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:18619,”author_id”:31,”sort_order”:1}}],”contentable”:{“id”:3010,”comments_open”:1,”created_at”:”2024-01-24T10:00:03.000000Z”,”updated_at”:”2024-01-24T10:00:03.000000Z”,”deleted_at”:null,”media”:[]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:14803,”model_type”:”AppModelsMarketingContent”,”model_id”:18619,”uuid”:”89978604-df8d-474a-a687-496d98982dd6″,”collection_name”:”contents”,”name”:”43574ce7-fda6-4af9-be74-385e775fbc5e”,”file_name”:”43574ce7-fda6-4af9-be74-385e775fbc5e.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:71438,”manipulations”:[],”custom_properties”:{“alt”:”A new pair of white and orange trimmed sneakers in a box on an angled white and orange background”},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:14739,”created_at”:”2024-01-24T10:00:03.000000Z”,”updated_at”:”2024-01-24T10:00:06.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/14803/43574ce7-fda6-4af9-be74-385e775fbc5e.jpg”}],”primary_content_topic”:{“id”:44,”name”:”Staying Healthy”,”slug”:”staying-healthy”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/staying-healthy”}},{“id”:18615,”content_source_id”:2,”content_type_id”:18,”content_access_type_id”:1,”title”:”Dialectical behavior therapy: What is it and who can it help?”,”short_title”:””,”subheading”:”Grounded in mindfulness and behavioral therapy, DBT teaches skills to manage intense emotions.”,”summary”:”n

Emotional dysregulation is a hallmark of many mental health conditions. A treatment known as dialectical behavior therapy (DBT) focuses on teaching people to manage intense emotions, cope with challenging situations, and improve their relationships.

n “,”content”:”

n n

n

Feeling sad, anxious, or angry at times is a normal part of the human experience. But do you — or someone you’re close to — seem to experience these and similar emotions more quickly, more frequently, and more intensely than most people?

n

This problem, known as emotional dysregulation, is a hallmark of many mental health conditions, but especially borderline personality disorder. The most effective treatment for borderline personality disorder is dialectical behavior therapy (DBT), which has also been shown to help people experiencing other issues. What is DBT, who might benefit from this form of therapy, and how is it applied?

n

What is DBT?

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DBT focuses on teaching people skills to manage intense emotions, cope with challenging situations, and improve their relationships. It encourages people to learn and use mindfulness training in practical ways.

n

During individual and group sessions, therapists encourage a nonjudgmental attitude and emphasize acceptance, compassion, and other aspects of mindfulness.

n

Who may benefit from DBT?

n

DBT has a proven track record for addressing the most debilitating symptoms of borderline personality disorder: self-injury and suicide threats or attempts. It is now also used to treat depression, post-traumatic stress disorder, eating disorders, and substance use disorders.

n

In fact, the cornerstone of DBT — the skills training — can help anyone navigate emotionally charged situations with more ease.

n

How can mindfulness change how people experience strong emotions?

n

Many people in therapy have very strong emotions that lead to negative thoughts, says Dr. Blaise Aguirre, a psychiatrist who founded the 3 East Dialectic Behavior Therapy Continuum at Harvard-affiliated McLean Hospital. “They say things like, ‘I’m stupid,’ or ‘I can’t control my anger,’ or ‘No one will ever love me,'” he says.

n

The mindfulness aspect of DBT teaches people to pay careful attention to the nature, quality, and volume of their thoughts. The idea is to observe these thoughts as separate from yourself without identifying with their meaning. This is the first step to addressing the impact of those thoughts, Dr. Aguirre explains.

n

How does DBT differ from cognitive behavioral therapy?

n

DBT is derived from cognitive behavioral therapy (CBT). CBT assumes that certain negative thoughts (cognitions) are distortions, and if you learn how to swap those distorted thoughts with more productive ones, you’ll be less depressed or anxious.

n

“But for someone with very deep emotions and convictions, telling them that their thoughts and feelings are somehow ‘wrong’ feels very invalidating,” says Dr. Aguirre. A DBT-trained therapist would instead acknowledge that the person’s thoughts make sense, given who they are and their experiences. This practice, known as validation, is a central tenet of DBT. It’s key to know that you can validate a person’s thoughts even if you don’t agree with them.

n

That concept touches on the core of DBT — the dialectical part. It refers to the idea that two opposite things can be true at the same time. Rather than viewing things in extremes of black and white, DBT encourages people to recognize there’s more than one way to view a situation and to try to “walk the middle path.” A classic DBT mantra is “I’m doing the best that I can in this moment, and I want to and can do better.”

n

What other skills does DBT rely on?

n

In addition to mindfulness, DBT teaches three other main skills:

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    n

  • Distress tolerance is the ability to manage emotional distress in the moment, using techniques such as distraction.
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  • Emotion regulation involves recognizing, accepting, and managing intense emotions.
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  • Interpersonal effectiveness focuses on improving communication with other people to strengthen relationships and improve your self-esteem.
  • n

n

What does DBT entail?

n

Ideally, DBT includes one-on-one sessions with a therapist (who is also available between sessions for phone or text coaching). The one-on-one sessions are combined with weekly group sessions led by a therapist who teaches the specific, interconnected skills and gives homework that helps to reinforce the skills. Participants are encouraged to keep a daily diary to track their emotions, behaviors, reactions, and examples of how they’re practicing their skills.

n

DBT has been shown to be effective for people ranging from adolescents to older adults with a range of mental health conditions. It appears to be especially useful for adolescents, perhaps for the same reason that it’s easier to learn a language or how to play an instrument when you’re younger rather than older, says Dr. Aguirre.

n

Are there different options for gaining access to DBT?

n

Accessing the full DBT experience can be challenging for many people. The skills groups meet for one to two hours weekly for six to 12 months, which is in addition to weekly, hour-long sessions with an individual therapist. Individual therapy may cost as much as $250 to $300 per hour, and the groups are often around $100 per hour. Not all DBT providers accept insurance.

n

“We’re starting to recognize that the majority of people can improve just doing the skills groups and don’t need the full DBT,” says Dr. Aguirre.

n

But for teens who are suicidal or harming themselves, intensive DBT can help keep them out of the hospital and potentially save their lives. “If your child had cancer, you wouldn’t think twice about taking them in for chemotherapy infusions twice a week,” says Dr. Aguirre.

n

Another problem is that there aren’t many DBT-trained providers in less populated parts of the country. Online DBT therapy may be an option, although its effectiveness hasn’t been studied.

n

Is there one simple DBT tool I can try?

n

If a family member struggles with very strong emotions, Dr. Aguirre offers this mini-DBT lesson about validation. Situations that trigger intense emotions are often rooted in a perception of abandonment, neglect, or rejection, he says. For example, if a person believes that someone at work is avoiding them, or a romantic partner doesn’t show up on time, it can trigger a rapid rise in emotional distress.

n

n n Here’s what to avoid saying:n n

n

“You have to calm down.”

n

“You are making a big deal over nothing.”

n

“When I am upset, I make myself a nice cup of tea and that should help you, too.”

n

n n Here’s what you can say instead:n n

n

“You seem really upset. Do you want to talk about it, or do you want some time by yourself?’

n

“You seem very sad. I am around if you want to talk.”

n

“Is there anything that I can do to help?”

n

“These types of statements validate the person’s feelings and convey that you’re listening and open to helping, if that’s what they want,” says Dr. Aguirre.

“,”excerpt”:”n

Emotional dysregulation is a hallmark of many mental health conditions. A treatment known as dialectical behavior therapy (DBT) focuses on teaching people to manage intense emotions, cope with challenging situations, and improve their relationships.

n “,”short_excerpt”:”n

Emotional dysregulation is a hallmark of many mental health conditions. A treatment known as dialectical behavior therapy (DBT) focuses on teaching people to manage intense emotions, cope with challenging situations, and improve their relationships.

n “,”description”:null,”author”:null,”slug”:”dialectical-behavior-therapy-what-is-it-and-who-can-it-help-202401223009″,”sort_date”:”2024-01-22T05:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:3009,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”BL012224″,”publication_date”:”2024-01-22T15:30:00.000000Z”,”last_review_date”:null,”imported_at”:”2024-01-25T10:00:06.000000Z”,”last_import_type”:”update”,”last_modified_date”:”2024-01-24T05:00:00.000000Z”,”active”:1,”created_at”:”2024-01-19T10:00:03.000000Z”,”updated_at”:”2024-01-25T10:00:07.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:null,”hide_ads”:0,”primary_content_topic_id”:37,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:14,”cr_id”:157,”featured”:1,”hhp_staff”:0,”hidden”:0,”name”:”Julie Corliss”,”title”:null,”first_name”:”Julie”,”middle_name”:null,”last_name”:”Corliss”,”suffix”:null,”slug”:”julie-corliss”,”byline”:”Executive Editor, Harvard Heart Letter“,”description”:”

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.

“,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/sA3ZdpCgTj4g3UoiGOBnYISWiUDAxrxi2l5SexJz.jpg”,”twitter_username”:null,”sort_order”:0,”created_at”:”2021-05-11T09:59:48.000000Z”,”updated_at”:”2023-05-12T20:42:51.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:18615,”author_id”:14,”sort_order”:1}}],”contentable”:{“id”:3009,”comments_open”:1,”created_at”:”2024-01-19T10:00:03.000000Z”,”updated_at”:”2024-01-19T10:00:03.000000Z”,”deleted_at”:null,”media”:[]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:14807,”model_type”:”AppModelsMarketingContent”,”model_id”:18615,”uuid”:”8c62e2cf-6245-4df8-bd38-5c33fb887a78″,”collection_name”:”contents”,”name”:”756165a3-3ae0-4a9f-bbc5-fdd3a7fcb6b3″,”file_name”:”756165a3-3ae0-4a9f-bbc5-fdd3a7fcb6b3.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:73923,”manipulations”:[],”custom_properties”:{“alt”:”illustration centering the words dialectical behavior therapy in light blue, surrounded by small line-drawing icons indicating concepts like mindfulness, balance, a range of emotions, and therapy against a purple background”},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:14743,”created_at”:”2024-01-25T10:00:06.000000Z”,”updated_at”:”2024-01-25T10:00:07.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/14807/756165a3-3ae0-4a9f-bbc5-fdd3a7fcb6b3.jpg”}],”primary_content_topic”:{“id”:37,”name”:”Mind & Mood”,”slug”:”mind-and-mood”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/mind-and-mood”}},{“id”:17847,”content_source_id”:2,”content_type_id”:18,”content_access_type_id”:1,”title”:”A mindful way to help manage type 2 diabetes?”,”short_title”:””,”subheading”:”Mindfulness practices like yoga may help people with diabetes control blood sugar.”,”summary”:”n

Lifestyle changes like regular exercise, a healthy diet, and sufficient sleep are cornerstones of self-care for people with type 2 diabetes. But can mind-body practices help people manage or even treat type 2 diabetes? An analysis of multiple studies suggests they might.

n “,”content”:”n

n n

n

Lifestyle changes like regular exercise, a healthy diet, and sufficient sleep are cornerstones of self-care for people with type 2 diabetes.

n

But what about mind-body practices? Can they also help people manage or even treat type 2 diabetes? An analysis of multiple studies, published in the Journal of Integrative and Complementary Medicine, suggests they might.

n

Which mindfulness practices did the study look at?

n

Researchers analyzed 28 studies that explored the effect of mind-body practices on people with type 2 diabetes. Those participating in the studies did not need insulin to control their diabetes, or have certain health conditions such as heart or kidney disease. The mind-body activities used in the research were:

n

    n

  • n yogan
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  • qigong, a slow-moving martial art similar to tai chi
  • n

  • mindfulness-based stress reduction, a training program designed to help people manage stress and anxiety
  • n

  • n meditationn
  • n

  • guided imagery, visualizing positive images to relax the mind.
  • n

n

How often and over what time period people engaged in the activities varied, ranging from daily to several times a week, and from four weeks to six months.

n

What did the study find about people with diabetes who practiced mindfulness?

n

Those who participated in any of the mind-body activities for any length of time lowered their levels of hemoglobin A1C, a key marker for diabetes. On average, A1C levels dropped by 0.84%. This is similar to the effect of taking metformin (Glucophage), a first-line medication for treating type 2 diabetes, according to the researchers.

n

A1C levels are determined by a blood test that shows a person’s average blood sugar levels over the past two to three months. Levels below 5.7% are deemed normal, levels from 5.7% to less than 6.5% are considered prediabetes, and levels 6.5% and higher are in the diabetes range.

n

How can mind-body practices help control blood sugar?

n

Their ability to reduce stress may play a big part. “Yoga and other mindfulness practices elicit a relaxation response — the opposite of the stress response,” says Dr. Shalu Ramchandani, a health coach and internist at the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital. “A relaxation response can lower levels of the stress hormone cortisol. This improves insulin resistance and keeps blood sugar levels in check, thus lowering A1C levels.”

n

A relaxation response can help people with diabetes in other ways, such as by improving blood flow and lowering blood pressure, which protects against heart attacks and strokes.

n

What else should you know about this study?

n

The results of studies like this suggest a link between various mind-body practices and lower A1C levels, but do not offer firm proof of it. Levels of participation varied widely. But because all mindfulness practices studied had a modest positive effect, the researchers suggested that these types of activities could become part of diabetes therapy along with standard lifestyle treatments.

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Could mind-body practices protect people against developing type 2 diabetes, especially for those at high risk? While this study wasn’t designed to look at this, Dr. Ramchandani again points to the long-range benefits of the relaxation response.

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“Reducing and managing stress leads to improved moods, and greater self-awareness and self-regulation,” she says. “This can lead to more mindful eating, such as fighting cravings for unhealthy foods, adhering to a good diet, and committing to regular exercise, all of which can help reduce one’s risk for type 2 diabetes.”

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Trying mind-body practices

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There are many ways to adopt mind-body practices that can create relaxation responses. Here are some suggestions from Dr. Ramchandani:

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  • Do a daily 10-minute or longer meditation using an app like Insight Timer, Calm, or Headspace.
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  • Attend a gentle yoga, qigong, or tai chi class at a local yoga studio or community center.
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  • Try videos and exercises to help reduce stress and initiate relaxation responses.
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  • Practice slow controlled breathing. Lie on your back with one or both of your hands on your abdomen. Inhale slowly and deeply, drawing air into the lowest part of your lungs so your hand rises. Your belly should expand and rise as you inhale, then contract and lower as you exhale. Repeat for several minutes.
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n “,”excerpt”:”n

Lifestyle changes like regular exercise, a healthy diet, and sufficient sleep are cornerstones of self-care for people with type 2 diabetes. But can mind-body practices help people manage or even treat type 2 diabetes? An analysis of multiple studies suggests they might.

n “,”short_excerpt”:”n

Lifestyle changes like regular exercise, a healthy diet, and sufficient sleep are cornerstones of self-care for people with type 2 diabetes. But can mind-body practices help people manage or even treat type 2 diabetes? An analysis of multiple studies suggests they might.

n “,”description”:null,”author”:null,”slug”:”a-mindful-way-to-help-manage-type-2-diabetes-202302062885″,”sort_date”:”2023-02-06T05:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:2885,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”Bl020623″,”publication_date”:”2023-02-06T15:30:00.000000Z”,”last_review_date”:null,”imported_at”:”2023-04-23T09:00:19.000000Z”,”last_import_type”:”update”,”last_modified_date”:”2023-04-22T04:00:00.000000Z”,”active”:1,”created_at”:”2023-02-04T10:00:02.000000Z”,”updated_at”:”2023-04-23T09:00:19.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:null,”hide_ads”:0,”primary_content_topic_id”:28,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:66,”cr_id”:434,”featured”:1,”hhp_staff”:0,”hidden”:0,”name”:”Matthew Solan”,”title”:null,”first_name”:”Matthew”,”middle_name”:null,”last_name”:”Solan”,”suffix”:null,”slug”:”matthew-solan”,”byline”:”Executive Editor, Harvard Men's Health Watch“,”description”:”

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s Women Nutrition Connection and Women’s Health Advisor. Matthew’s articles on medicine, exercise science, and nutrition have appeared in Men’s Health, Men’s Fitness, Muscle & Fitness, Runner’s World, and Yoga Journal. He earned a master of fine arts in writing from the University of San Francisco and a bachelor of science in journalism from the University of Florida.

“,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/meFkQGpweKNzK8THXHlIORQI3ZZ68ShyfSRQykZN.jpg”,”twitter_username”:null,”sort_order”:0,”created_at”:”2021-05-11T10:26:17.000000Z”,”updated_at”:”2022-08-03T16:49:53.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:17847,”author_id”:66,”sort_order”:1}}],”contentable”:{“id”:2885,”comments_open”:1,”created_at”:”2023-02-04T10:00:02.000000Z”,”updated_at”:”2023-02-04T10:00:02.000000Z”,”deleted_at”:null,”media”:[]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:13519,”model_type”:”AppModelsMarketingContent”,”model_id”:17847,”uuid”:”54138109-6bd9-4015-ac0f-8bc0621bfe10″,”collection_name”:”contents”,”name”:”fe21ef10-617e-4094-8055-0354586b549e”,”file_name”:”fe21ef10-617e-4094-8055-0354586b549e.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:71024,”manipulations”:[],”custom_properties”:{“alt”:”A group of people doing a standing pose in a yoga class; a woman wearing a pink top and dark purple leggings in the foreground along with a blurred paire of hands”},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:13489,”created_at”:”2023-02-04T10:00:02.000000Z”,”updated_at”:”2023-02-04T10:00:04.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/13519/fe21ef10-617e-4094-8055-0354586b549e.jpg”}],”primary_content_topic”:{“id”:28,”name”:”Diseases & Conditions”,”slug”:”diseases-and-conditions”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/diseases-and-conditions”}},{“id”:18571,”content_source_id”:2,”content_type_id”:18,”content_access_type_id”:1,”title”:”Why do your prescription drugs cost so much?”,”short_title”:””,”subheading”:”How can you minimize your costs — and what state or national steps could make a difference?”,”summary”:”n

The cost of a prescription drug can be very high, and several factors contribute to this. What can consumers do to reduce their drug costs, and what changes need to be made to make medications more affordable?

n “,”content”:”n

n n

n

I was in line at a pharmacy recently as the customer ahead of me was picking up her prescription. The pharmacist matter-of-factly said: “that’ll be $850.” All she could say was “really?” She left without her prescription, telling the pharmacist she’d have to call her doctor about a less costly alternative.

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Many of us routinely experience sticker shock over drug costs. And ever more dramatic examples suggest there’s no limit. So, let’s talk about ways to minimize what we spend on prescription drugs; how we got to this juncture where some medicines cost more than a million dollars per dose; and what changes are needed in our pricey medication-industrial-complex.

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7 ways to minimize your spending on prescription drugs

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Consider these seven strategies to pare drug costs. Savings will vary depending on insurance, donut holes, deductibles, and cost-sharing.

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  • Ask your healthcare provider three questions: Is every medicine you take truly necessary? Is it safe to reduce the dose of any medicines you take? Could a lower-cost or generic drug be substituted?
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  • If you have health insurance, check the list of preferred medications (the formulary), which tend to cost less than other similar medicines.
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  • Split pills: In some cases, a prescription will cost less if each pill contains more than your needed dose and can be divided. For example, if you usually take a 25-mg pill, taking half of a 50-mg pill may help you save on drug costs and copays. Ask your pharmacist if the math works for you.
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  • Ask if a 90-day supply rather than a 30-day supply would reduce copays.
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  • Look for prescription drug discount programs that offer savings. Restrictions apply and availability varies by location. Also, paying through a discount program might not count toward your insurance deductible or maximum out-of-pocket costs, so it isn’t always less expensive to use these programs.
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  • Compare prices at different pharmacies and review your options with a pharmacist. Sometimes the price is lower if you don’t use your insurance.
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  • Consider using an online mail-order service (such as Blink Health or Cost Plus Drug Company). However, spending through these sites may not count toward your insurance deductible. And the prices are not always lower online.
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These measures will help some people more than others and can take up a lot of time. The sad truth is that even if you did everything you could, the impact on your wallet might be small.

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Why are medicine costs so high in the US?

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My top five contenders are:

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Drug makers’ profit motive. Pharmaceutical companies routinely reject this idea. They say it’s expensive to develop new drugs and run the required clinical trials to prove safety and effectiveness. Many promising drugs fail, and the FDA drug approval process is difficult and costly.

n

Yet one recent study published in JAMA Network Open found no connection between how much a drug company spends on research and development (R&D) for a drug and the drug’s price. Even after accounting for R&D spending, most of the top 30 pharmaceutical companies make billions of dollars in profit. And in Europe, where drug prices are negotiated, the very same drugs made by the same companies for the same health problems typically cost far less than in the US.

n

Pharmacy benefit managers (PBMs) handle drug benefits for large employers, Medicare, and health insurance companies. PBMs negotiate prices with health insurers and pharmacies. They help decide which drugs to cover and how much patients pay. Their fees and incentives — often a share of total spending on medicines, which might encourage approval of higher-priced drugs — contribute to the costs health consumers wind up paying. A flurry of state and federal legislation is intended to limit what PBMs can do and the transparency of their operations.

n

Cost-sharing. In recent years, insurers have increasingly shifted costs to patients through higher copays, deductibles, and premiums. Sometimes this is justified by the notion that this incentivizes patients to seek care only when truly necessary; of course, it could also discourage people from seeking care even when warranted.

n

Legal maneuvers. Many drug makers file numerous patents and sue potential competitors to extend their time holding a monopoly on a particular drug (see example). Or they create “me too” drugs by slightly tweaking an existing drug so they can patent it as a brand-new drug. Some pharmaceutical companies acquire patents for older drugs and then jack up the price. Others have bought or merged with another drugmaker to avoid price competition.

n

Direct-to-consumer advertising. Drug companies spend billions on ads (nearly $8.1 billion in 2022). Marketing costs raise the price of drugs while boosting demand for newer, heavily promoted drugs. Advertised drugs tend to be far more expensive (and not always better) than older drugs. Perhaps this is why such advertising is banned in most other countries.

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What might slow rising drug costs?

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Although prescription drug prices are likely to remain high for the foreseeable future, three developments could help slow rising drug prices in the coming years:

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The bottom line

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Let’s face it: our complex, broken healthcare system incentivizes those who develop and distribute drugs to set the prices well above what many can afford. And the amount you can chip away on your own is limited. What we really need is an overhaul to remove middlemen who contribute to added cost without always adding value.

n

Until we get there, do what you can, even if the impact is small. Trying your best to stay healthy could be the most important step you take. After all, the best way to limit how much you spend on prescription drugs is to have no reason to take them.

n “,”excerpt”:”n

The cost of a prescription drug can be very high, and several factors contribute to this. What can consumers do to reduce their drug costs, and what changes need to be made to make medications more affordable?

n “,”short_excerpt”:”n

The cost of a prescription drug can be very high, and several factors contribute to this. What can consumers do to reduce their drug costs, and what changes need to be made to make medications more affordable?

n “,”description”:null,”author”:null,”slug”:”why-do-your-prescription-drugs-cost-so-much-202401183007″,”sort_date”:”2024-01-18T05:00:00.000000Z”,”contentable_type”:”AppModelsMarketingBlogPost”,”contentable_id”:3007,”replacement_content_id”:null,”landing_page_landing_page_group_id”:null,”ucr_content_id”:”BL011824″,”publication_date”:”2024-01-18T15:30:00.000000Z”,”last_review_date”:null,”imported_at”:”2024-01-19T10:00:24.000000Z”,”last_import_type”:”update”,”last_modified_date”:”2024-01-18T05:00:00.000000Z”,”active”:1,”created_at”:”2024-01-17T10:00:03.000000Z”,”updated_at”:”2024-01-19T10:00:24.000000Z”,”deleted_at”:null,”images_remapped”:0,”old_product_id”:null,”old_content_id”:null,”hide_ads”:0,”primary_content_topic_id”:28,”ecommerce_type”:”CATALOG”,”authors”:[{“id”:23,”cr_id”:2,”featured”:1,”hhp_staff”:1,”hidden”:0,”name”:”Robert H. Shmerling, MD”,”title”:null,”first_name”:”Robert”,”middle_name”:”H.”,”last_name”:”Shmerling”,”suffix”:”MD”,”slug”:”robert-h-shmerling-md”,”byline”:”Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing”,”description”:”

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. As a practicing rheumatologist for over 30 years, Dr. Shmerling engaged in a mix of patient care, teaching, and research. His research interests center on diagnostic studies in patients with musculoskeletal symptoms, and rheumatic and autoimmune diseases. He has published research regarding infectious arthritis, medical ethics, and diagnostic test performance in rheumatic disease. Having retired from patient care in 2019, Dr. Shmerling now works as a senior faculty editor for Harvard Health Publishing.

“,”image_url”:”https://d2icykjy7h7x7e.cloudfront.net/authors/OdKCKaVzyx3xPsUxIBc9zJz8m3zvysnJa3UJsGOd.jpg”,”twitter_username”:”RobShmerling”,”sort_order”:4,”created_at”:”2021-05-11T10:05:10.000000Z”,”updated_at”:”2023-09-06T15:33:18.000000Z”,”deleted_at”:null,”pivot”:{“content_id”:18571,”author_id”:23,”sort_order”:1}}],”contentable”:{“id”:3007,”comments_open”:1,”created_at”:”2024-01-17T10:00:03.000000Z”,”updated_at”:”2024-01-17T10:00:03.000000Z”,”deleted_at”:null,”media”:[]},”content_type”:{“id”:18,”name”:”blog”,”slug”:”blog”,”created_at”:”2021-05-11T08:30:32.000000Z”,”updated_at”:”2021-05-11T08:30:32.000000Z”,”deleted_at”:null},”media”:[{“id”:14740,”model_type”:”AppModelsMarketingContent”,”model_id”:18571,”uuid”:”6132d264-f4d8-4332-a696-09e591852381″,”collection_name”:”contents”,”name”:”704b865b-1c89-4fb6-a4e6-a6c87b70cdd3″,”file_name”:”704b865b-1c89-4fb6-a4e6-a6c87b70cdd3.jpg”,”mime_type”:”image/jpeg”,”disk”:”s3″,”conversions_disk”:”s3″,”size”:73369,”manipulations”:[],”custom_properties”:{“alt”:”Orange plastic prescription drug bottle tipped on its side with several rolled $100 bills tucked inside peeking out; a few white oval pills & glass marble globe lie next to it”},”generated_conversions”:{“micro”:true,”thumb”:true},”responsive_images”:[],”order_column”:14678,”created_at”:”2024-01-17T10:00:03.000000Z”,”updated_at”:”2024-01-17T10:00:05.000000Z”,”full_url”:”https://domf5oio6qrcr.cloudfront.net/medialibrary/14740/704b865b-1c89-4fb6-a4e6-a6c87b70cdd3.jpg”}],”primary_content_topic”:{“id”:28,”name”:”Diseases & Conditions”,”slug”:”diseases-and-conditions”,”is_primary”:1,”canonical”:”https://www.health.harvard.edu/topics/diseases-and-conditions”}}], currentIndex: 0 }” x-on:slide-change.window=”currentIndex = $event.detail.currentIndex”>

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