Dark Chocolate: The Perfect Snack for Stress Relief and Heart Health

cleve chocolate

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.

https://www.everydayhealth.com/columns/jared-bunch-rhythm-of-life/dark-chocolate-for-stress-relief-and-heart-health/?xid=tw_everydayhealth_sf

December 8, 2025

8 Vitamins & Minerals You Need for a Healthy Immune System @ClevelandClinic

Who doesn’t want a healthy immune system? (Raise your hand. No one?) But did you know the role your diet plays in keeping it in top shape to protect you from toxins and infections?
Sadly, too many of us don’t eat enough of the fresh fruits, vegetables and other foods we need to keep ourselves healthy year-round. Healthy foods provide many substances including vitamins and minerals to keep us strong and healthy. You can’t just eat an orange or grapefruit or pop a vitamin pill and expect one quick burst of vitamin C to prevent a cold and to boost your immune system.
“A truly healthy immune system depends on a balanced healthy diet over time,” says registered dietitian Maxine Smith. “It’s like training for a battle and preparing your body ahead of time so it can through a good punch when attacked by viruses, bacteria and toxins. Other lifestyle practices such as regular exercise and good sleep will better prepare you for the battle.”
With some exceptions, it’s best to get your vitamins and minerals from your food rather than in pill form. Smith shares some tips for some of the top vitamins and minerals your immune system needs to perform:

1. Vitamin C
Vitamin C may help prevent infections or shorten their stay. Citrus fruits are a standout, but did you know there are other good sources? It’s true! Smith recommends the following:
Spinach.
Kale.
Bell peppers.
Brussels sprouts.
Strawberries.
Papaya.
Fun fact: vitamin C is in so many foods that most people may not need to take supplements unless a doctor advises it. Consult with your doctor before taking any vitamin C supplements

2. Vitamin E
Like vitamin C, vitamin E can be a powerful antioxidant that helps your body fight off infection. This important vitamin — part of nearly 200 biochemical reactions in your body — is critical in how your immune system functions. To get your vitamin E, think high-fat plant foods such as:
Almonds.
Peanuts/peanut butter.
Sunflower seeds.
Oils such as sunflower, safflower, and soybean oil.
Hazelnuts.

3. Vitamin A#

Vitamin A is an infection-fighter and comes in two forms: preformed such as in animal foods such as fish, meat and dairy or from plant carotenoids. Tuna is a great source of preformed vitamin A. When it comes to carotenoids, go colorful:
Carrots.
Sweet potatoes.
Pumpkin.
Butternut squash.
Cantaloupe.
Dark green leafy vegetables.

4. Vitamin D
Known as the sunshine vitamin, it’s one of the most important and powerful nutrients for supporting the immune system. Food sources are limited but include:
Salmon.
Mackerel.
Tuna.
Sardines.
Vitamin D fortified like milk, orange juice and cereals.
In general, it’s best to get most of your vitamins from food, but vitamin D may be the exception to that rule. Talk with your doctor to find out if you need a supplement.

5. Folate/folic acid
Folate is the natural form and folic acid is the synthetic form, often added to foods because of its health benefits. To get more folate, add more beans and lentils to your plate on a regular basis, as well as leafy green vegetables. Avocado is another tasty source. You can also get folic acid in fortified foods (check the label first).
Enriched pasta.
Enriched bread.
Enriched rice.

6. Iron
Iron, which helps your body carry oxygen to cells, plays a part in many of the immune system processes. It comes in different forms. Your body can more easily absorb heme iron (aka iron from animal products), which is abundant in:
Red meat (limit to smaller amounts and less often).
Chicken.
Turkey.
Canned sardines.
Oysters.
Clams.
Mussels.
Canned light tuna.
If you’re a vegetarian, have no fear. You can still find iron in:
Beans.
Broccoli.
Kale.
Iron-fortified cereals.

7. Selenium
Selenium seems to have a powerful effect on the immune system being important for preventing infections. Animal foods are the best sources, with the exception of Brazil nuts, that offer a whopping greater than 100% daily value in one nut. However, too much can be a problem, so keep to no more than one to two of these in a day. Look for selenium in:
Seafood (tuna, halibut, sardines).
Meat and liver.
Poultry.
Cottage cheese.

8. Zinc
Zinc is needed for the production of new immune system cells. It’s found primarily in animal foods but can be also found in some vegetarian food like.
Oysters.
Crab.
Lean meats and poultry.
Baked beans.
Yogurt.
Chickpeas.
Choose frozen when you can’t get fresh
Depending on where you live and what time of year it is, you can’t always get your hands on high-quality fresh produce. Keep in mind that buying frozen is a good option and can be quite convenient in our time-crunched world. Frozen food can still boost your immune system.
“Manufacturers freeze frozen fruits and veggies at ‘peak’ ripeness, which means they’ll pack a similar nutritional value as their fresh counterparts,” she says. “Just choose plain frozen foods rather than those with added sugars or sodium.”

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December 4, 2025December 4, 2025

Make coffee part of your morning routine.@HarvardHealth

Coffee may help your skin stay healthy

By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

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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

View all posts by Robert H. Shmerling, MD

December 1, 2025

Biking is a good way to get your blood flowing..😍😃@ClevelandClinic #physicalactivity

Screenshot_2020-07-27 #biking hashtag on Instagram • Photos and Videos

Cleveland Clinic

@ClevelandClinic

You know exercise builds muscles, strengthens bones, keeps your heart healthy and your mind sharp. But it also does something that you might not think much about: It helps keep your immune system — your internal defenses against infection — in tip-top shape.

If you take time for some physical exertion each day, it helps get your body ready to attack bacteria, viruses and toxins that can sneak in and make you sick.

But how much exercise is effective? Do too little or too much, and it won’t have the best effect on your immune system.

Clinical immunologist Leonard Calabrese, DO, answers common questions about how exercise can impact your immunity and how to use your workouts to shut out a world of would-be invaders.

Q: How does breaking a sweat boost immunity?

A: If you exercise moderately on a regular basis, it tunes up the immune system in many ways. It enhances your broad-based defenses against viral infections, such as those causing upper respiratory infections.

Working out regularly also reduces the risk of many chronic diseases such as cardiovascular, respiratory illnesses and metabolic diseases, such as type 2 diabetes.

Q: How much exercise do you need?

A: Fortunately, you don’t have to push yourself to the limit to rev up your immune system. In fact, your immune system needs less of a workout than you get with your average cardio routine.

Focus on getting 20-30 minutes of moderate exercise, five days a week, and your immune system will thank you.

Q: What types of exercise are most helpful?

A: Moderate exercises, including biking or walking briskly in your neighborhood, are good ways to get your blood flowing. Swimming is also a good option for non-weight-bearing exercise for your joints.

Also try mind-body exercises such as Tai-Chi, Qi Gong and yoga, which are all options that help keep your joints flexible. These exercises also reduce chronic stress, which in itself is a powerful immune booster. These exercises can also help alleviate osteoarthritis and fibromyalgia symptoms.

Q: Can too much exercise set your immune system back?

A: Yes, though, the level to which it can slow your system down is still up for debate.

Research shows that exercising for more than 1.5 hours without refueling your body or giving it enough time to recover suppresses your immune responses for up to a few days. During that time, your cortisol levels rise, your white blood cell count drops and you’re more likely to develop a respiratory infection.

This problem usually affects elite athletes, such as marathon runners, most.

On the flip side, staying sedentary also increases your risk of infection, inflammation and chronic disease.

Q: Can exercise make an illness worse?

A: Yes, it can. This is a complex issue, but I like to tell my patients to do a “neck check.” If your symptoms are mostly of a mild cold without fever or lower respiratory symptoms, such as a productive cough, wheezing or shortness of breath, mild exercise can actually reduce congestion and may make you feel better.

If your symptoms are primarily in your lungs or you have a significant fever its better to rest until things settle down. Regardless, good hydration is important.

December 1, 2025

5 Ways to Boost Your Child’s Immune System for Life @ClevelandClinic Adriane Lioudis, MD.

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%.

3. Don’t skip immunizations

Follow your pediatrician’s advice when it comes to the childhood vaccination schedule. Immunizations start in infancy and continue to adulthood and prevent measles, mumps, chickenpox, rotavirus and other infections.

“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.

Sleep requirements for each night vary by age:

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.

November 29, 2025

Colorful fruits and vegetables are packed with phytonutrients that help calm inflammation — by Tamara Soerense @MayoClinic

Can eating the rainbow help to reduce inflammation?

11/6/2025 by Tamara Soerense

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Inflammation is a natural process initiated by the immune system in response to illness, trauma, toxins, physical stress and chronic disease. While acute inflammation is protective and allows our bodies to heal, it can become harmful if it persists, leading to chronic inflammation. Chronic inflammation, in turn, can lead to conditions such as arthritis, heart disease, and diabetes.

Several foods can contribute to inflammation. These include highly processed foods, refined carbohydrates, or foods high in added sugars. Conversely, other foods can help calm the immune system, decreasing inflammation.

Let’s explore which foods help lower inflammation and how they can be incorporated into an anti-inflammatory diet.

Fruits and Vegetables: Colorful fruits and vegetables naturally contain various phytonutrients and bioactive compounds that help keep inflammation in check. These foods form the foundation of the anti-inflammatory diet and can be enjoyed in abundance. For an extra boost of protection, try drizzling antioxidant-rich olive oil on your veggies..
Protein: Choose primarily from plant-based sources such as legumes, soy, nuts, and seeds, with smaller amounts from lean cuts of animal protein and fatty fish. The fats in these proteins, mainly monounsaturated and omega-3, play a significant role in combating inflammation. The American Heart Association recommends 6 to 8 ounces of fatty fish and 5 ounces of legumes, nuts, and seeds per week.
Whole grains: Whole grains contain all parts of the grain, whereas refined grains remove the germ and bran, eliminating important inflammation-reducing compounds. Of these, fiber is a bit of a superstar, shown to help reduce blood sugar and cholesterol levels. Aim for at least 50% of your grains from whole grain sources, such as rolled oats and brown rice.
Herbs and Spices: Herbs and spices add flavor to your food and help reduce oxidative stress, which can trigger inflammation. Add ginger, turmeric, clove, cinnamon, oregano, and garlic to your next meal.

What change can you make today to shift your body into a less inflamed state?

Consider adding one colorful fruit or vegetable to your diet each day. Suggestions include tomatoes, oranges, yellow bell peppers, arugula, blueberries, pumpkin and broccoli.

Tamara Soerensen completed her bachelor’s degree in biology at the University of California, Santa Barbara and her master’s in nutrition at Bastyr University. She is currently a dietetic intern at Mayo Clinic in Rochester, Minnesota. Special interests include digestive health and the utilization of diet for disease prevention.

November 26, 2025November 27, 2025

Yes, alcohol affects hormones in women by increasing estrogen and cortisol, and decreasing progesterone, Source: AI

Yes, alcohol affects hormones in women by increasing estrogen and cortisol, and decreasing progesterone, which can lead to issues like irregular menstrual cycles, worsened menopause symptoms, and an increased risk for certain health conditions. The liver prioritizes metabolizing alcohol, disrupting the body’s normal hormone regulation, and its effects are seen across all stages of a woman’s life.

Specific hormonal effects

Estrogen: Alcohol can increase estrogen levels by increasing its production or decreasing its breakdown. This is a concern because elevated estrogen is linked to an increased risk of certain cancers, such as breast cancer.
Progesterone: Moderate to heavy drinking can lead to lower progesterone levels, which is particularly relevant for premenopausal women and can disrupt the menstrual cycle and affect fertility.
Cortisol: Alcohol consumption increases cortisol, the body’s primary stress hormone. Chronically high cortisol levels can negatively impact bone growth, digestion, reproduction, and immune function.
Other hormones: Alcohol can also affect other key hormones, such as Anti-müllerian Hormone (AMH), gonadotropins (like FSH and LH), and thyroid hormones, which can impact fertility and other bodily functions.

Effects on reproductive function

Menstrual cycle: Alcohol can cause irregular periods and, in some cases, complete cessation of menses.
Menopause: For menopausal and postmenopausal women, alcohol can worsen symptoms like hot flashes and night sweats and may increase the risk of conditions like osteoporosis and heart disease.
Fertility: Studies show women who drink more than 7 alcoholic drinks per week while undergoing fertility treatment are less likely to achieve pregnancy.

Important considerations

Risk increases with consumption: The more alcohol a woman consumes, the greater the impact on her hormones and overall health.
Short-term vs. long-term: The liver’s priority is processing alcohol, which disrupts hormone regulation. For women who are heavy or long-term drinkers, the long-term effects on hormone levels and associated health risks can be significant.
Seek professional advice: It is important to discuss any concerns about alcohol, hormones, and reproductive health with a healthcare provider.

November 24, 2025

How To Exercise Safely When You Have Advanced Prostate Cancer. @ClevelandClinic

Check-in with your care team, and focus on low-impact exercises and walking for good gains

If you’re living with advanced prostate cancer, you might be wondering exactly how far you should push yourself when it comes to physical activity and exercise. Should you take it easy and hold back? Or should you try to maintain your exercise routine?

And if you’ve had your prostate surgery or your prostate removed (prostatectomy) you may be concerned about any sort of limitations or restrictions on specific exercises to avoid further pain or injury.

Occupational therapist Maria Pickston, OTR/L, CLT, reminds us that each person’s medical history and cancer treatment is unique. So, before beginning any exercise program during recovery, it’s essential to obtain clearance from your oncologist or healthcare team.

Pickston shares some additional insight on how exercise can help with the process of recovery and why exercise is so important overall.

Importance of exercise for prostate health

Your prostate is part of your pelvic floor, an area densely populated with a group of muscles and connective tissues that support the functions of your bowel, bladder and reproductive organs. Your pelvic floor muscles also aid your abdominals (core muscles) and back muscles in providing structural stability to your spine.

When we talk about prostate health, we’re most often talking about modifiable risk factors, which are the things you can do to reduce the likelihood of developing prostate cancer. But if you’re living with prostate cancer, focusing on your overall health is key and exercise is a big part of that.

“When you put the words ‘cancer’ and ‘exercise” together, it can feel like such a road block because it sounds counterintuitive to be exercising when you’re going through cancer treatment,” says Pickston.

“Years ago, people were told not to exert themselves and to take it easy. But in the last 20-plus years, we’ve had an explosion of research supporting the benefits of physical activity for cancer survivors and how exercise can improve the symptoms and side effects of chemotherapy and radiation therapy.”

Exercise can have a huge impact on your physical, mental and emotional health and increase your energy levels — all things that tend to be affected when you have surgery or are going through cancer treatments.

“Prostate cancer treatment can lead to several side effects like loss of muscle mass and physical strength, sexual dysfunction, reduced bone density, increased fatigue, and a higher risk of heart disease and diabetes,” explains Pickston.

Exercise plays a vital role in tackling these challenges and enhancing the physical outcomes of treatment.

“Current research demonstrates that exercise is safe and beneficial before, during and after cancer treatment as it improves energy levels and the overall quality of life, enabling individuals to continue enjoying the activities they love,” notes Pickston. “A physically active lifestyle not only helps in lowering the risk of various cancers, but also reduces the risk of recurrence in some cancers, including prostate cancer.”

Translation: Once you check in with your care team, don’t let your cancer diagnosis stop you from working out.

How often should you exercise to promote prostate health?

If you’re living with prostate cancer, are going through cancer treatment or have had a prostatectomy, you want to talk to your healthcare provider first to before you begin any exercise program as you may need to adhere to certain precautions during those first few weeks of recovery.

There’s no one set exercise that specifically focuses on prostate health — but if you focus on improving your overall health, increasing your heart rate, improving your blood flow and getting those endorphins going, you’ll find that those things will have significant positive impact on how you’re feeling overall and your ability to recover from your condition and treatment.

“Individuals who are physically fit or active before their cancer diagnosis are more likely to regain their previous level of functioning compared to those who lead a more sedentary lifestyle,” says Pickston.

“In oncology rehabilitation, personalized programs are designed to cater to each individual’s unique circumstances. Special considerations are taken into account, including your medical history, current fitness level, the type and stage of your cancer, and the specific cancer treatment you are having to ensure that the rehab process is both safe and effective.”

Everyone responds to cancer and cancer treatments differently. What works for someone else might not come as easily for you — and that’s OK.

“Each individual’s journey is different, and your focus should be on finding an approach that suits your specific needs and abilities, fostering progress and overall well-being,” encourages Pickston.

And don’t feel like you have to push yourself too hard — you can, and should, rest when you need it the most. Exercise doesn’t always have to be a one-hour routine, either. It can be as simple as standing up and stretching during commercial breaks, walking to the end of your driveway and back, or making sure you keep up with your daily living activities around the house like laundry, cleaning and showering.

“Just the act of walking or going up and down the stairs is something you can immediately do when you get home after prostate surgery,” says Pickston. “Be patient with yourself and avoid pushing to the point of pain or excessive discomfort or fatigue. If it’s been a while since you’ve been active or your overall fitness level is low, start slowly and gradually build. The key is to be as physically active as your current condition and abilities allow.”

Aerobic exercise for prostate and sexual health

Specifically, aerobic exercise (also known as cardiovascular exercise) has wide-ranging full-body benefits that can impact your heart, brain, joints, skin and muscles. It not only extends your life expectancy, but it can also decrease your blood pressure and heart rate, and increase your blood flow, which has a direct impact on your sexual function, mood, digestion and more.

The American Cancer Society recommends engaging in moderate-intensity aerobic exercise such as brisk walking, jogging, swimming, cycling for 150 to 300 minutes per week. Additionally, you’ll want to perform strength training exercises two days per week using body weight, resistance bands, dumbbells or fitness machines.

Again, if you can’t hit the ground running that fast, you can do small things to work your way back up to that routine.

“Think about all the physical activity you can do like playing with your grandkids, dancing, gardening, carrying groceries or doing chores around the house. But it’s even better if you begin to incorporate intentional exercises like brisk walking, swimming and weightlifting,” says Pickston.

“It’s crucial for those undergoing treatment to understand that exercise is the best way to treat cancer-related fatigue. As your strength and fitness improves, you can engage in meaningful activities more easily.”

One specific side effect mentioned earlier is loss of bone density, which can lead to osteoporosis, a condition where the bones become weak, less dense and more likely to increase your risk of fractures. Weight bearing exercises such as weight training, yoga, Pilates and climbing stairs are ideal for preventing bone density loss.

“Starting slowly with light weights and gradually increasing the load is key to avoid pushing too hard and experiencing pain or exhaustion,” advises Pickston. “With time and consistency, you will notice improvements in your fatigue, strength and overall health, fitness and endurance.”

Caution for cycling as exercise

Cycling is an excellent aerobic exercise, but it’s one you might want to hold off from doing at least in the early weeks after having prostate surgery. The reason is because you tend to put a lot of pressure on your sit bones and your pelvic area while cycling, and this can cause discomfort, pain and swelling if you’re not fully healed.

“You need to be sure you are cleared by your physician before initiating cycling for any amount of time first,” says Pickston. “Once you receive clearance, there are various bike seats and bike shorts available to help cushion or accommodate the perineal area, alleviating some of that pressure.”

Kegel exercises

After having prostate surgery, it’s common to experience side effects like urinary leakage and erectile dysfunction. Kegel exercises specifically are designed to help strengthen your pelvic floor muscles and reduce the likelihood of those side effects from happening as well as help quicken recovery from those side effects. These exercises are also often recommended for some people before even having surgery so their pelvic floor muscles start off having a strong foundation before going into surgery.

“Your pelvic floor is often compromised after prostate cancer treatment because surgical or radiation treatment can damage the surrounding tissues, including the muscles of the pelvic floor,” explains Pickston. “When the pelvic floor muscles are compromised, it can lead to weakness, pain and dysfunction. Seeking help from a pelvic floor physical therapist can address these issues.”

It’s also common to experience muscle tightness in your pelvic floor and surrounding muscles after treatment, and doing Kegels without proper guidance can worsen this tightness.

“A pelvic floor therapist will help to make sure you are performing your Kegels correctly and help guide you in managing areas of muscle tightness in your pelvic floor,” says Pickston. “Learning how to engage the pelvic floor muscles correctly during daily activities can significantly reduce leakage. Sometimes, just a few simple adjustments in movement can lead to dramatic improvement.”

Healthy weight and prostate health

Having overweight or obesity increases your risk for prostate cancer — but it can also provide additional complications during the recovery process in some cases.

“If you’ve had a prostatectomy, it’s normal to experience emotional ups and downs, but the important thing is that you focus on what small things you can do each day, to feel better every day,” says Pickston. “Physical activity improves both your physical and emotional health. It’s important for managing weight, maintaining or building muscle, reducing your risk of heart disease and keeping your bones strong.”

Mindfulness and meditation can improve your mood and motivation, while flexibility-focused exercises like yoga can provide additional benefits for stretching and getting your muscles moving and activated. By focusing on these low-impact exercises along with daily walking habits, you can develop an increased focus on your overall health while slowly ramping up your physical activity all in an effort to speed up your recovery from cancer.

“You want to get up, go outside and see what’s going on in your neighborhood,” encourages Pickston. “When you start exercising, your sleep improves. When your sleep improves, you’re able to heal better. And the more you can do early on, the more long-term effects you’ll experience along the way.”

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November 23, 2025

Heavy Alcohol Use Linked to Earlier, More Severe Strokes, Mass General Researchers Find

Alcohol bottles in Broadway Marketplace.

Alcohol bottles in Broadway Marketplace. By Grace E. Yoon

By Noor Ali, Alma T. Barak, and Christopher Schwarting, Contributing Writers

November 17, 2025

Heavy alcohol consumption may lead to earlier and more severe brain bleeds, according to a study published by researchers at Massachusetts General Brigham earlier this month.

Using data from patients admitted to MGB between 2003 and 2019 who had brain bleeds, the researchers found that people who drank heavily — defined as three or more alcoholic drinks a day — were 11 years younger, on average, when their bleeds occurred.

Strokes can be categorized into two types: ischemic strokes, which occur when blood flow to the brain is blocked, and hemorrhagic strokes, which result from a ruptured blood vessel. The researchers focused on the latter, which typically lead to more severe damage.

“Hemhorrhagic strokes, or brain bleeds, are less common, but they are a lot more dangerous,” said Edip Gurol, an associate professor of neurology at Harvard Medical School and author of the study. “50 percent of people who have a brain bleed die within the first month.”

The study, published in Neurology, tracked 1,600 patients over the course of 16 years, of which seven percent reported heavy alcohol consumption. The median age of brain bleeds for heavy drinkers was 64, compared to 75 in those who did not report heavy alcohol consumption.

“There was a very, very significant difference, which is telling us that one way or the other, heavy drinking is accelerating the brain bleeds,” Gurol said.

Using CT scans to determine the size and location of bleeds, the authors found that heavy drinkers experienced 70 percent larger bleeds and were twice as likely to have a bleed deep inside their brain.

“The brain bleeds in those patients were more likely to be deep and more likely to open inside the spinal fluid-filled spaces, the ventricles of the brain,” Gurol said.

Patients who reported heavy alcohol usage had higher blood pressure and lower blood platelet counts when they were admitted to the hospital, the study found. Those patients also showed greater evidence of small vessel damage in the brain, which is linked to several other health conditions such as dementia and heart failure.

“Despite their younger age, very probably because of the excessive alcohol use, these people had more severe small vessel disease-related brain damage, which is called white matter disease,” Gurol said.

Alvin S. Das, an assistant professor at Beth Israel Deaconess Medical Center, said the finding that heavy drinkers experienced larger brain bleeds would prompt him to stress the importance of cutting back on alcohol to his patients.

“What it might compel me to do is in a patient that comes to my office and they’ve had a deep hemorrhage, not only counsel them on aggressive hypertension management down the road to prevent another hemorrhage, but this study also would push me to counsel alcohol cessation,” Das said.

Because the number of heavy drinkers in the study was small and the data came from a single hospital, the researchers noted that future work should use larger datasets to examine how varying levels of alcohol use affect brain aging and stroke risk.

Gurol, for his part, said the findings underscore the importance of limiting alcohol consumption broadly, even in individuals without pre-existing health conditions.

“Even for people without known risk of alcohol damage, it is probably best to not to exceed three glasses per week and not to exceed one glass in over 24 hours,” Gurol said.

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