Does slow running have a place in your run routine? 🏃♂️
A cardiologist (and a runner) explains how the idea of slowing your pace can prevent injuries, help you log more run miles and train your body for all the stress that comes with running: https://t.co/59Q7kSUsxmpic.twitter.com/n7a04aTE76
Here’s a medical news story that combines a common habit (drinking coffee) with a common skin condition (rosacea) — and it even has a happy ending.
What is rosacea?
Rosacea is probably something you’ve seen plenty of times and didn’t know what it was — or perhaps you have it yourself. It’s that pink or red discoloration on the cheeks some people have, especially fair-haired women. Sometimes there are small bumps that may look a bit like acne. If you look closely (after asking nicely for permission, of course), you’ll see tiny blood vessels just under the surface of the skin. In more severe cases it may involve the chin, forehead, nose, ears, and other skin surfaces. It may affect the eyes, eyelids, and cause thickening of the skin over the nose.
We don’t know what causes rosacea. However, there are theories that it may be, at least in part, a genetic condition, as it can run in families. Because the immune system seems to be involved in the inflammation of rosacea, and because other autoimmune conditions (such as type 1 diabetes and multiple sclerosis) may accompany rosacea, abnormal immune function may play a role. Medications (such as topical anti-inflammatory drugs) and antibiotics can reduce redness and inflammation but there is no cure. Many people seem to be able to reduce signs of rosacea by modifying their diet to avoid foods that trigger it.
Rosacea affects more than 14 million people in the US, including some celebrities, such as Bill Clinton and the late Diana, Princess of Wales. And while it’s not dangerous, it can have a significant cosmetic impact. Caffeine, sun exposure, spicy foods, and hormonal factors are thought to be able to trigger rosacea’s development or make it worse once present. Yet, a new study challenges the connection between caffeine and rosacea.
More coffee, less rosacea?
A recent study analyzed health data from surveys provided to nearly 83,000 women over more than a decade and found that:
Those drinking four or more cups of coffee per day were significantly less likely to report a diagnosis of rosacea than those who drank little or no coffee.
Those drinking less than four cups of coffee each day were also less likely to have rosacea, though the protective effect was smaller.
Consumption of decaffeinated coffee was not linked to a lower incidence of rosacea.
Caffeine intake from other foods or beverages (such as chocolate or tea) had no impact on the likelihood of developing rosacea.
Why is this important?
These results of this study are more than just interesting observations. If other research can confirm the findings, it could lead to a better understanding of why rosacea develops in some people and not in others. Because inflammation driven by the immune system is thought to play an important role in rosacea, insights into the development of this disease could extend to advances in other autoimmune disorders. Finally, many people with rosacea (or a family history of the disease) who like coffee may avoid it because of the widespread notion that coffee will make it worse. The findings of this study suggest that’s not true.
There are always caveats
As with all research of this type, there are limitations to consider. For example, this study
only included women, most of whom were white — we’ll need additional studies of men and other ethnic groups to know if the findings extend widely.
relied on health surveys and study participants’ memories regarding past diagnoses and diet; such survey data may not always be accurate.
found a link between higher coffee consumption with lower risk of rosacea, but it cannot determine whether coffee consumption actually caused a reduction in rosacea.
The bottom line
Coffee is one of the mostly widely consumed beverages on the planet, and it’s also among the most widely studied. While it can cause problems for some people (such as heartburn, tremor, or palpitations), it’s a source of pleasure and enjoyment for millions. In addition, coffee has been linked with a number of health benefits, ranging from reductions in type 2 diabetes and liver cancer to greater longevity. From this latest research, it appears that you can add the possible prevention of rosacea to the list.
About the Author
Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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. … See Full Bio
The invisible workload of parenting can leave you stuck in mental loops:
🍼 “Which nappy cream again?” 🥦 “Is this snack okay?” 📱 “Should I Google that rash one more time?”
Anna Mathur reminds us: decision fatigue is real, and you’re not alone. Tap the link in our bio to learn more about how you can tackle decision fatigue and how Anna’s new book The Good Decision Diary can help.
We all want to protect our kids whether it be from falls, bumps and bruises — or avoidable infections and diseases. To help your child avoid illness, it’s important to encourage good habits and take steps to boost their immune system from an early age.
“Most of what makes a child’s immune system strong is common sense,” says pediatrician Adriane Lioudis, MD. If you keep these five tips in mind, you’ll stack the deck in your child’s favor for a healthier life.
1. For newborns, consider breastfeeding
While it’s a very personal decision (that isn’t always possible), if you are able to exclusively breastfeed your child for at least six months, it may have benefits. Some research shows that breastfeeding your child might possibly reduce allergies, Dr. Lioudis says.
2. Promote regular hand washing
Eighty percent of infections are spread by touch. Teach your little one to take the time to wash their hands after sneezing, coughing and going to the bathroom. Washing hands with warm water and soap for at least 20 seconds can remove bacteria and viruses and can reduce the chance of lung infections by up to 45%.
“Get the flu shot for your child yearly, as well,” Dr. Lioudis says. This is particularly important for children with asthma and other chronic health conditions.
Also, if your family will be traveling internationally, it’s important to seek advice from your child’s healthcare provider about any needed vaccinations.
4. Make sleep a priority
To maximize immunity, children must get enough sleep.
Babies between 0 and 3 months need 14 to 17 hours of sleep. Those between 4 and 12 months need 12 to 16 hours of sleep.
Children between the ages of 1 and 2 need between 11 and 14 hours.
Kids between the ages of 3 and 5 should get from10 to 13 hours.
Children ages 6 to 12 should get between 9 and 12 hours.
Teens between the ages of 13 to 18 need 8 to 10 hours.
Not getting enough sleep limits the body’s ability to produce proteins called cytokines that help fight infection and reduce inflammation.
5. Encourage a healthy diet
A healthy diet is also important for your child’s immune system.
Dr. Lioudis recommends encouraging your child to “eat the rainbow” when it comes to fruits and vegetables. A good selection of whole grains should be part of their diet as well. Keep processed foods to a minimum. Proper food choices can help ensure that your child gets enough vitamins — such as vitamin A and E. These vitamins are needed to maintain good health and a strong immune system.
You can’t avoid all illness, but some kids need extra protection
“Even if you follow these tips, your child might still get between seven and 11 colds each year,” says Dr. Lioudis. She adds that you can expect each one to last up to two weeks.
Also, keep in mind that some things billed as common “remedies” aren’t effective in boosting immunity. For example, there’s no definitive proof that large amounts of vitamin C or echinacea help prevent colds or shorten them, she says.
However, if your child has a compromised immune system, work closely with your pediatrician to find ways to improve his or her immunity. Each child needs a personalized approach because their individual immune system varies, Dr. Lioudis says.
“There’s generally a different protocol with immunocompromised children. There are some vaccines we have to add in on top of what most children have, but it’s something that we must determine on a case-by-case basis.
Healthcare providers across the country are bracing for another season of treating respiratory viruses like the flu, respiratory syncytial virus (RSV) and COVID-19.
And while the flu might not seem like something to worry about, it’s a virus we should all be prepared for. So, you may be wondering, Should I get a flu shot?
“Influenza is a very serious disease, and during a normal flu season, around 40,000 or more people die from it,” says infectious disease specialist Kristin Englund, MD. “So, with any preventable disease, we should do everything we can to protect ourselves.”
Getting your flu vaccine is vital to not just keeping you and your family healthy, but also relieving our over-burdened healthcare system.
To learn more about the importance of getting the flu vaccine, we talked to Dr. Englund, along with infectious disease clinical pharmacist Kaitlyn Rivard, PharmD.
Why the vaccine matters
First of all, Dr. Englund notes that it’s just good practice to get a flu shot every year. She adds that the vaccine’s prevention-geared properties are key.
“When people get influenza or get the flu, it’s not only just the symptoms that they have, like a cough, fever and an infection in the lungs,” she says. “It taxes the body and really puts a lot of stress on all of the other systems.”
That can cause some serious complications, she continues. “You can have a heart attack or even a stroke as a side effect from having influenza. So, we want to make sure that we’re keeping everybody healthy from all of these complications.”
Dr. Englund says that a flu shot is especially important this year because other respiratory viruses like COVID-19 and RSV will be circulating.
“We’re going to have influenza, RSV and COVID-19 coexisting and there’s a lot of overlap between the symptoms,” she states. “We also anticipate that there will be some people who have co-infections, which could be difficult.”
When to get the flu vaccine
We bet you’re now wondering: So, when should I get a flu shot?
Dr. Englund and Dr. Rivard advise getting a flu vaccine as soon as it becomes available. Many healthcare providers, including the Cleveland Clinic, begin offering the flu vaccine at the beginning of September.
And in case you were wondering, the flu vaccine doesn’t interfere with the COVID-19 vaccine or the RSV vaccine.
“All available COVID-19 and RSV vaccines can be given at the same time as the flu vaccine,” clarifies Dr. Rivard. “If someone is coming in for their flu shot and they’re eligible for a COVID-19 vaccine or RSV vaccine but haven’t received it yet, we can offer that. In fact, both the CDC [U.S. Centers for Disease Control and Prevention] and the Advisory Committee on Immunization Practices recommend co-administering almost any two vaccines together.”
She adds that there are very few instances in which certain vaccines can’t be administered at the same time, noting that children often receive multiple vaccines during one visit to their pediatrician.
And there’s no concern about overloading our immune systems with multiple vaccines.
“We’re exposed to things that stimulate our immune system all the time,” Dr. Englund says. “Our immune system is constantly responding to various exposures even if you don’t realize it.”
Why it’s important to get a flu shot every year
One reason it’s so important to get your annual flu shot is this: Protecting yourself is a lot easier than treating the flu.
“There are some treatments available for the flu that are evolving,” Dr. Englund says. “But to avoid the disease altogether or to only have a mild case because you’ve been vaccinated is much better than trying to treat it. Prevention is best.”
And that goes equally for kids — it’s also crucial to get them vaccinated for the flu.
“It’s important for children to get the flu vaccine, too, because the circulation of flu in children, if nothing else, puts adults at risk, too,” emphasizes Dr. Englund.
“Influenza is a serious disease and it’s unpredictable, and otherwise healthy children are unfortunately hospitalized and die every year because of it. So, even for normal, healthy children, it’s really important to get vaccinated every year.”
We all want to protect our kids whether it be from falls, bumps and bruises — or avoidable infections and diseases. To help your child avoid illness, it’s important to encourage good habits and take steps to boost their immune system from an early age.
“Most of what makes a child’s immune system strong is common sense,” says pediatrician Adriane Lioudis, MD. If you keep these five tips in mind, you’ll stack the deck in your child’s favor for a healthier life.
1. For newborns, consider breastfeeding
While it’s a very personal decision (that isn’t always possible), if you are able to exclusively breastfeed your child for at least six months, it may have benefits. Some research shows that breastfeeding your child might possibly reduce allergies, Dr. Lioudis says.
2. Promote regular hand washing
Eighty percent of infections are spread by touch. Teach your little one to take the time to wash their hands after sneezing, coughing and going to the bathroom. Washing hands with warm water and soap for at least 20 seconds can remove bacteria and viruses and can reduce the chance of lung infections by up to 45%.
“Get the flu shot for your child yearly, as well,” Dr. Lioudis says. This is particularly important for children with asthma and other chronic health conditions.
Also, if your family will be traveling internationally, it’s important to seek advice from your child’s healthcare provider about any needed vaccinations.
4. Make sleep a priority
To maximize immunity, children must get enough sleep.
Babies between 0 and 3 months need 14 to 17 hours of sleep. Those between 4 and 12 months need 12 to 16 hours of sleep.
Children between the ages of 1 and 2 need between 11 and 14 hours.
Kids between the ages of 3 and 5 should get from10 to 13 hours.
Children ages 6 to 12 should get between 9 and 12 hours.
Teens between the ages of 13 to 18 need 8 to 10 hours.
Not getting enough sleep limits the body’s ability to produce proteins called cytokines that help fight infection and reduce inflammation.
5. Encourage a healthy diet
A healthy diet is also important for your child’s immune system.
Dr. Lioudis recommends encouraging your child to “eat the rainbow” when it comes to fruits and vegetables. A good selection of whole grains should be part of their diet as well. Keep processed foods to a minimum. Proper food choices can help ensure that your child gets enough vitamins — such as vitamin A and E. These vitamins are needed to maintain good health and a strong immune system.
You can’t avoid all illness, but some kids need extra protection
“Even if you follow these tips, your child might still get between seven and 11 colds each year,” says Dr. Lioudis. She adds that you can expect each one to last up to two weeks.
Also, keep in mind that some things billed as common “remedies” aren’t effective in boosting immunity. For example, there’s no definitive proof that large amounts of vitamin C or echinacea help prevent colds or shorten them, she says.
However, if your child has a compromised immune system, work closely with your pediatrician to find ways to improve his or her immunity. Each child needs a personalized approach because their individual immune system varies, Dr. Lioudis says.
“There’s generally a different protocol with immunocompromised children. There are some vaccines we have to add in on top of what most children have, but it’s something that we must determine on a case-by-case basis.
Why not try your hand at making homemade tomato sauce? The freshness of the tomatoes and the smokiness of the roasted vegetables make this a great topping for spaghetti. If you don’t have your own garden, use canned Roma tomatoes for a tasty dish that includes roasted mushrooms, broccoli and peppers.
Ingredients
Tomato sauce
Olive oil cooking spray 2 garlic cloves, minced 1 small carrot, minced 1 shallot, minced 4 cups peeled, seeded, and diced ripe tomatoes or one 28-ounce can no-salt-added diced tomatoes, drained 1/4 cup dry red wine 1 1/2 tablespoons balsamic vinegar 1/4 teaspoon crushed red pepper flakes, optional 1/4 cup chopped fresh basil
Pasta
1/2 pound whole wheat spaghetti 3/4 pound broccoli florets and stalks, peeled and cut into bite-size pieces 2 portobello mushrooms, halved and thinly sliced 1 red, yellow or orange bell pepper, seeded and coarsely chopped 1 1/2 tablespoons extra-virgin olive oil 1 1/2 tablespoons balsamic vinegar Freshly grated pepper 2 tablespoons freshly grated Parmesan cheese
Directions
Preheat oven to 400° F. Line a rimmed baking sheet with aluminum foil.
To make the sauce, coat a large pot with cooking spray and saute the garlic, carrot and shallot over low heat until they begin to wilt, about 5 minutes. Stir in the tomatoes, wine, vinegar and red pepper flakes (if using). Cover and simmer slowly for 30 minutes.
Stir in the basil and simmer for 10 minutes more. (To make a smoother sauce, cool and process in batches in either a blender or food processor.) Set aside.
Place the broccoli, mushrooms and bell pepper on the prepared pan. Toss with oil and vinegar. Roast about 10 minutes until crisp or done to your taste. Sprinkle with pepper.
Cook the pasta according to package directions. Drain.
In a large serving bowl, toss the pasta with 2 cups tomato sauce. Top with the roasted vegetables and sprinkle with Parmesan cheese.
Nutrition information (per serving)
Makes 4 servings
Calories: 363 Total fat: 4 g Protein: 15 g Carbohydrate: 71 g Dietary fiber: 4 g Cholesterol: 0 mg Sodium: 100 mg Potassium: 93 mg
Muscles in your body are a use-or-lose proposition. You need to use them to keep them strong!
You may not realize it, but we all start losing 1 percent of muscle mass each year after age 30. That’s why your diet in later years should not look the same as it did when you were younger, says endocrinologist Susan Williams, MD.
Skipping breakfast, eating fast food and being inactive in your 20s and early 30s might not hurt your health in the short term. However, poor nutrition and lifestyle habits take their toll over time.
People who embrace good habits early on really get ahead of the game, Dr. Williams says. But it’s never too late to start eating better and taking better care of your body.
Whether you’re 30 or 50, Dr. Williams offers three important tips to get started in eating right when you are thinking about your long-term health.
A roller coaster of weight gain and loss can change your body composition and leave you with more fat mass and less lean muscle mass.
2. Eat three balanced meals a day
You also want to limit your snacks in between. The word “balanced” is especially important because eating a wide variety of foods will help you prevent nutritional deficiencies.
Dr. Williams suggests this simple shopping list:
Lean proteins. Choose chicken, white fish, oily fish like salmon, eggs, tuna fish and red meat (less frequently than other protein).
Whole grains. This includes multigrain breads, and long-cooking rice or oats.
Veggies. Go for fresh or fresh frozen. Choose what’s in season and enjoy a variety to get the vitamins and minerals your body needs.
Fruit. Fresh fruit is best, followed by frozen. Canned fruit can be OK, but choose options in light syrup or water. Check the label and avoid added sugar.
Dairy. Choose milk, yogurts, cheeses and cottage cheese that are low-fat or fat-free.
Steer clear of cookies, cakes, pies, ice creams, juices and rich desserts. If that sounds like no fun, Dr. Williams advises treating these foods as treats. Save them for dining out or special occasions, but don’t make them part of your daily diet.
Eating protein and being physically active are equal partners in the quest for maximum health, Dr. Williams says. Muscles are made of protein, but simply eating protein is not enough to save them.
“Muscles in your body are a use-or-lose proposition,” she says. “You need to use them to keep them strong.”
Can’t carve out time for the gym? Try this daily routine:
After dinner, spend 10 minutes with stretch bands or light weights.
Even a half hour of physical activity can make a world of difference, especially if you make it a habit in your 30s. “Don’t let your weight creep up while your muscle mass creeps down over your 30s and 40s,” Dr. Williams says. The longer you wait, the harder it will be to get started — and the more muscle you will have already lost.
Multiple cardiac benefits result from frequent consumption of dark chocolates rich in flavanols, including our response to stress.
Recently when talking with my 7-year-old daughter, I asked her what was the best food she could eat for a snack. As the daughter of a cardiologist you may imagine that she would have been taught the enduring virtues of eating fruits and vegetables and how these are the best foods to use as snacks. She told me that my question was easy and replied, “the best snack is chocolate.” I asked her where she learned that and she told me her mother told her so. How can you really argue against that logic?
This question posed to my daughter then led to more investigation during my clinic. I asked many patients informally what were their favorite snacks. Since they were in a cardiologist’s office they would often say some sort of fruit or vegetable and then add they only consume it in a small quantity.
I then would ask, “now what really is your favorite snack?”
I particularly enjoyed the response of a couple in their mid 70s. I have seen both of them both for atrial fibrillation for over 5 years. She said, “my true favorite snack is chocolate.” Then almost immediately after, as if there was a sense of guilt in admitting this, she said, “but chocolate is healthy right? I try to eat dark chocolate.” Her husband laughed at her and said she eats more than dark chocolate. He then replied, “my favorite snack is anything you put in front of me.” In my informal poll of true favorite snacks, chocolate was mentioned in about two thirds of my patients. Most of my patients felt dark chocolate in particular was healthy.
Dark chocolate and other cocoa products have gained a lot of attention worldwide as dietary supplements to improve heath. These products are rich in in flavanols. Flavanols are felt to mediate some of the heart healthy properties of chocolate. Flavanols are also found in many other food sources felt to be heart healthy such as grapes, apples, blackberries, legumes, red wine, and green tea. But of all of these food sources, the relative concentration of flavanols is highest in chocolate. As you may have guessed, dark chocolate contains much higher concentrations of flavanols compared to milk or white chocolate. In some chocolates the production process all but eliminates flavanols.
What Are the Heart and Vascular Benefits of Eating Dark Chocolate?
Lower Blood Pressure. Consumption of cocoa increases nitric oxide, studies show. For a good review of benefits, see Cocoa and Cardiovascular Health. Nitric oxide is a naturally occurring chemical in our bodies. Nitric oxide acts on small receptors in our blood vessels and prompts the vessels to dilate. This process lowers blood pressure. High blood pressure as discussed in many of my prior columns is associated with many types of heart disease including heart failure, atrial fibrillation, and atherosclerosis. High blood pressure is also associated with cognitive decline, dementia, and stroke.
Coronary Artery Health and Stability. As our arteries become diseased from atherosclerosis, plaques grow and over time begin to impair blood flow. If the surface of these plaques becomes disrupted or inflamed the plaques may ulcerate. The body responds to the ulceration by forming a clot in an effort to heal the wound. This process can lead to a heart attack. Cocoa may help stabilize plaques and minimize their risk of rupture by reducing smooth muscle cell proliferation (a process that causes plaques to grow), platelet adhesion (a process that results in clot formation in the artery), and preventing leukocyte adhesion and migration (processes that causes these plaques to become inflamed and unstable).
Lower Cholesterol. People with elevated total cholesterol with increased levels of low-density lipoprotein (LDL) cholesterol have a higher risk of cardiac disease, in particular coronary atherosclerosis and heart attacks. Flavanols reduce cholesterol absorption in our gastrointestinal track and also the synthesis of LDL cholesterol, research shows. They may also help raise high-density lipoprotein (HDL) cholesterol, the part of our cholesterol that is felt to be protective of heart disease, a clinical trial reported. Lower LDL and higher HDL levels after cocoa consumption were seen in people with both normal cholesterol levels to begin with and those with elevated levels that needed treatment. Multiple medications reduce LDL cholesterol, but very few things and essentially no medications raise HDL cholesterol consistently.
Dark Chocolate Changes Our Body’s Response to Stress
My wife often says, “I eat chocolate when I am stressed.” As I mentioned in a prior column, stress and our response to it can be a very potent risks of heart disease. In this regard, what if chocolate can improve how we respond to stress?
This brings me to the newest study regarding dark chocolate that I found very interesting. When we are stressed our body signals out chemicals that raise our blood pressure and help us fight the stressor. These chemicals or hormones are stored in the brain (pituitary gland), the adrenal glands, and other parts of the nervous system. A rececent study looked at how the body responded to stress by measuring these chemicals (cortisol, epinephrine, adrenocorticotropic hormone [ACTH], and norepinephrine) in 31 men consuming dark chocolate (“Noir 72 percent”; Chocolat Frey AG, Buchs/Aargau, Switzerland) versus 34 men that received a placebo chocolate that did not contain flavanols. The men then underwent a significant stress.
The stress was a 5-minute mock job interview and then a 5-minute mental arithmetic task in front of an audience. It is probably easy for most of us to imagine feeling very stressed if we had to try to solve a complex math problem in our head in 5 minutes while others watched, or we had to receive an intense job interview.
What these researchers found about the effect of chocolate was significant. Those men consuming dark chocolate had lower levels of cortisol and epinephrine after the stress. Although their brain response to stress was similar (ACTH levels were identical in both groups) the body’s response to the brain signals of stress was blunted. In particular, the response of the adrenal gland, which produces cortisol, was much less. Less released cortisol and epinephrine with stress is important as these are strong stimulants of the heart and blood vessels. With repetitive stress over time, both the heart and blood pressure have be negatively effected. Finally, since the body response was less significant, men consuming dark chocolate reported having less feelings of stress during the process.
My daughter was right, dark chocolate or chocolate rich in flavanols is a healthy food choice. The benefits of dark chocolate need to be carefully considered with the calories consumed, but in general there are multiple heart-related advantages with frequent consumption. In addition, as my wife mentioned to me, dark chocolate also may help you deal with stress, not only how you perceive it mentally, but also how your body responds to it.