Friday, 14 June 2019
Health Tip: Preventing Falls on Crutches
-- To use crutches safely, be sure they fit you properly. Also use care when carrying objects, says the Ohio State University Medical Center.
To prevent falls, the center encourages those on crutches to:
Clean the crutch tips often.
Put away all throw rugs on the floor.
Take your time. Do not try to walk too fast.
Look ahead. Do not look at your feet while walking.
When Healthy Eating Turns Into a Dangerous Obsession
When eating healthy becomes an around-the-clock obsession, it could be a sign of trouble.
An extreme preoccupation with clean eating is an eating order called orthorexia nervosa. Though less well-known than anorexia nervosa or bulimia -- and not as well-documented -- a new study review says orthorexia can also have serious emotional and physical consequences.
"Orthorexia is really more than just healthy eating," said review co-author Jennifer Mills, an associate professor of health at York University in Toronto. "It's healthy eating taken to the extreme, where it's starting to cause problems for people in their lives and starting to feel quite out of control."
The review of published research from around the world on the disorder was recently published in the journal Appetite.
Mills and her colleague Sarah McComb looked at risk factors and links between orthorexia and other mental disorders. Orthorexia, unlike some other eating disorders, is not yet recognized in the standard psychiatric manuals.
Healthy eating to the extreme
No clear line divides healthy eating from orthorexia's extreme eating.
The foods someone with orthorexia might avoid are the same as those someone with healthy habits might avoid -- such as preservatives, anything artificial, salt, sugar, fat, dairy, other animal products, genetically modified foods or those that aren't organic.
It boils down to whether avoiding foods leads to obsession -- excessive time and energy thinking and fretting about what to eat. Some people may eliminate numerous categories of food and eat only a very small number of things. People with orthorexia are typically less concerned about cutting calories than with the perceived quality of their food.
"They often are taking more and more time thinking about the foods they're needing to purchase, particular foods, that makes it really difficult for them to just live their lives," said Lauren Smolar, who wasn't involved with the review. She is director of programs for the nonprofit National Eating Disorders Association (NEDA). "It can result in malnutrition or weight loss in a really difficult and potentially dangerous way."
A person with orthorexia might be so focused on types of food and how that food is prepared that it becomes impossible to eat anything not made at home.
"It can lead to all kinds of related problems, like isolation, or not being able to eat at other people's houses or not being able to eat in a restaurant for fear that the food won't have been prepared in a very pure, clean way," Mills said. "Those are the kinds of things that might lead someone to feel that it's taking over their life."
Cultural trends could be fueling those fears, Mills said. With the internet and social media, people have unlimited access to information -- some of it good and some not based on scientific evidence.
Eating trends that restrict certain foods are concerning, said Smolar, who added that dieting is one of the biggest triggers for eating disorders. All foods are good in moderation, she said, and a diverse diet is best.
Though many think of eating disorders as a problem affecting young women, orthorexia appears to be experienced equally by men and women, the study found.
People who follow a vegan or vegetarian diet or who have a poor body image are at a higher risk.
For some, the underlying cause is another eating disorder, and clean eating is seen as a socially acceptable way to restrict calories, Mills said. For others, obsessive-compulsive or anxiety disorder may manifest in the need to eat in this very rigid way.
"In that sense it is very similar to what we see in other kinds of obsessive-compulsive disorder, where somebody might be afraid that they're going to get sick or they're going to be getting exposed to germs if they don't wash their hands enough or if they don't do something in a very particular way," Mills said.
Getting help
Orthorexia should be taken seriously, Mills said. Talk to your primary care doctor about any concerns. Meeting with a psychologist who specializes in anxiety disorders, eating disorders or body image also can be helpful, she said.
NEDA offers an online screening tool that assesses risk and a helpline where you can talk through concerns and learn about resources.
"As awareness grows, more people are recognizing symptoms and seeking opportunities for help," Smolar said. "It's something that I think we still have a lot to learn about."
An extreme preoccupation with clean eating is an eating order called orthorexia nervosa. Though less well-known than anorexia nervosa or bulimia -- and not as well-documented -- a new study review says orthorexia can also have serious emotional and physical consequences.
"Orthorexia is really more than just healthy eating," said review co-author Jennifer Mills, an associate professor of health at York University in Toronto. "It's healthy eating taken to the extreme, where it's starting to cause problems for people in their lives and starting to feel quite out of control."
The review of published research from around the world on the disorder was recently published in the journal Appetite.
Mills and her colleague Sarah McComb looked at risk factors and links between orthorexia and other mental disorders. Orthorexia, unlike some other eating disorders, is not yet recognized in the standard psychiatric manuals.
Healthy eating to the extreme
No clear line divides healthy eating from orthorexia's extreme eating.
The foods someone with orthorexia might avoid are the same as those someone with healthy habits might avoid -- such as preservatives, anything artificial, salt, sugar, fat, dairy, other animal products, genetically modified foods or those that aren't organic.
It boils down to whether avoiding foods leads to obsession -- excessive time and energy thinking and fretting about what to eat. Some people may eliminate numerous categories of food and eat only a very small number of things. People with orthorexia are typically less concerned about cutting calories than with the perceived quality of their food.
"They often are taking more and more time thinking about the foods they're needing to purchase, particular foods, that makes it really difficult for them to just live their lives," said Lauren Smolar, who wasn't involved with the review. She is director of programs for the nonprofit National Eating Disorders Association (NEDA). "It can result in malnutrition or weight loss in a really difficult and potentially dangerous way."
A person with orthorexia might be so focused on types of food and how that food is prepared that it becomes impossible to eat anything not made at home.
"It can lead to all kinds of related problems, like isolation, or not being able to eat at other people's houses or not being able to eat in a restaurant for fear that the food won't have been prepared in a very pure, clean way," Mills said. "Those are the kinds of things that might lead someone to feel that it's taking over their life."
Cultural trends could be fueling those fears, Mills said. With the internet and social media, people have unlimited access to information -- some of it good and some not based on scientific evidence.
Eating trends that restrict certain foods are concerning, said Smolar, who added that dieting is one of the biggest triggers for eating disorders. All foods are good in moderation, she said, and a diverse diet is best.
Though many think of eating disorders as a problem affecting young women, orthorexia appears to be experienced equally by men and women, the study found.
People who follow a vegan or vegetarian diet or who have a poor body image are at a higher risk.
For some, the underlying cause is another eating disorder, and clean eating is seen as a socially acceptable way to restrict calories, Mills said. For others, obsessive-compulsive or anxiety disorder may manifest in the need to eat in this very rigid way.
"In that sense it is very similar to what we see in other kinds of obsessive-compulsive disorder, where somebody might be afraid that they're going to get sick or they're going to be getting exposed to germs if they don't wash their hands enough or if they don't do something in a very particular way," Mills said.
Getting help
Orthorexia should be taken seriously, Mills said. Talk to your primary care doctor about any concerns. Meeting with a psychologist who specializes in anxiety disorders, eating disorders or body image also can be helpful, she said.
NEDA offers an online screening tool that assesses risk and a helpline where you can talk through concerns and learn about resources.
"As awareness grows, more people are recognizing symptoms and seeking opportunities for help," Smolar said. "It's something that I think we still have a lot to learn about."
Health Tip: Preventing Swimmer's Ear
-- Swimmer's ear is an infection of the outer ear that is caused by water remaining in the ear canal after swimming or showering.
To help prevent swimmer's ear, the Children's Hospital of Philadelphia suggests:
Teach children to use a towel to dry their ears after water activities.
Encourage children to wear ear plugs while swimming.
Keep your child's ears clean.
Avoid excessive showering.
Can Racquet Sports Give You a Fitter, Longer Life?
When you think of effective cardio exercise, the activities most likely to come to mind are aerobics classes, running, swimming and cycling. But racquet sports like tennis may hold even greater benefits, according to research published in the British Journal of Sports Medicine.
And, as a bonus, they could also be more fun, making it easier to meet your fitness goals.
After reviewing data from 80,000 people, researchers found that participants in racquet sports reduced their risk of early death by 47%. Racquet sports beat out swimming and aerobics, the second and third most-protective exercises, by double digits. Cycling came in fourth.
The numbers were even higher for reducing the risk of death from heart disease or stroke, though swimming and aerobics were still beneficial because they work the upper and lower body, which helps train the heart. Also, whatever activity the study participants chose, the more often they exercised, the more their risk of early death dropped.
Exercise and Risk of Early Death
47% lower risk of early death with racquet sports
28% lower with swimming
27% lower with aerobics
15% lower with cycling
Never picked up a racquet? The U.S. Tennis Association has information to help you get started, including where to find programs in your area. Besides being a great exercise, tennis helps with balance, strength and flexibility, all essential for lifelong fitness. Whether you play singles or doubles, the social aspect of tennis is another important benefit.
Also consider squash and racquetball. These sports use different-sized racquets and balls, and the courts are enclosed. Both games are played within a smaller area than tennis, but the play is often more intense.
And, as a bonus, they could also be more fun, making it easier to meet your fitness goals.
After reviewing data from 80,000 people, researchers found that participants in racquet sports reduced their risk of early death by 47%. Racquet sports beat out swimming and aerobics, the second and third most-protective exercises, by double digits. Cycling came in fourth.
The numbers were even higher for reducing the risk of death from heart disease or stroke, though swimming and aerobics were still beneficial because they work the upper and lower body, which helps train the heart. Also, whatever activity the study participants chose, the more often they exercised, the more their risk of early death dropped.
Exercise and Risk of Early Death
47% lower risk of early death with racquet sports
28% lower with swimming
27% lower with aerobics
15% lower with cycling
Never picked up a racquet? The U.S. Tennis Association has information to help you get started, including where to find programs in your area. Besides being a great exercise, tennis helps with balance, strength and flexibility, all essential for lifelong fitness. Whether you play singles or doubles, the social aspect of tennis is another important benefit.
Also consider squash and racquetball. These sports use different-sized racquets and balls, and the courts are enclosed. Both games are played within a smaller area than tennis, but the play is often more intense.
AHA News: When Dancer Kept Fainting, an EKG Finally Revealed Why
WEDNESDAY, June 12, 2019 (American Heart Association News) -- Looking back, Daniela Leonhardt's first indication something was amiss with her heart happened in December 2010, when she fainted before an Irish dance competition.
At the time, she was 30 years old, the mother of two little boys and in jaw-droppingly good shape. Why would she have thought the dizziness and nausea that followed her fainting spell could be a sign that her life was in danger?
"I had been a competitive dancer a long time, then after having kids, I decided to go back to it," said Leonhardt, who lives in Virginia. "I wanted to prove that at age 30 I could still compete with younger women."
She was well on the way, until she fainted.
"I wrote it off as maybe being under the weather," she said. "A lot of people had gotten sick at that competition."
To be sure that's all it was, she went in for a checkup. Her doctor attributed her symptoms to anxiety or possibly a virus. Two months later, Leonhardt fainted at a conference in Louisiana. Again, her symptoms were thought to be anxiety, or maybe something hormonal.
The episodes continued, eventually occurring about once a week. Leonhardt would feel lightheaded at a grocery store and sit down in the middle of an aisle. At home, she'd hold onto furniture and try to breathe through the dizziness.
In May 2012, Leonhardt went to an urgent care clinic. The physician's assistant gave Leonhardt her first electrocardiogram.
The PA rechecked the leads, as if they might have been out of place. He then asked the nurse to run the test again.
Looking at the results, the PA said, "I'm amazed you're sitting here acting totally normal." Her heart rate was only 32. A normal rate is 60 to 100.
Doctors diagnosed her with a condition that keeps her heart rate low. A pacemaker was implanted in June 2012 to help sustain a healthy rhythm.
Waking up from that procedure, she felt better than she had in years. She looked at her husband and said, "This is what it feels like to be normal."
The next day, she told herself, "This is not happening to another woman," and began volunteering for the American Heart Association.
In February 2014, while in Atlanta for work, Leonhardt didn't feel right. She eventually was diagnosed with a type of fast heart rate called supraventricular tachycardia. She had heart surgery that November.
Four months later, Leonhardt woke up and fell out of bed. Her left side wasn't functioning. She was having a stroke.
Her son Ciaran Donovan was 8 at the time. Because of the family's involvement with the AHA, he recognized the warning signs.
"Mom," he told her, "I'm going to call 911."
She hung up the phone and called her sister instead -- a move her neurologist told her could have killed her.
Leonhardt was fortunate; the stroke seemed to have "resolved itself." While her left hand doesn't grip as strong, and she occasionally mixes the three languages she speaks -- English, German and French -- there are no other long-term effects. Doctors determined the stroke was caused by atrial fibrillation, a common irregular heartbeat, so they put her on blood thinners.
Ciaran is now 12; his brother Landen Donovan, 9. They keep an eye on her, making sure she rests and doesn't overdo it.
"There are a lot of doctor trips and worrying about our mom," Ciaran said. "The pros are that we learned a lot from this. We know heart disease is out there and it can do to others what it did to my mom."
Said Landen: "The positive is that we know about heart disease and we get to go to the Heart Walk, which is really fun. The negative is that at any moment it could happen again."
But like their mother, the boys are optimistic. And, like her, they've gleaned lessons from the ongoing experience.
"They're more aware. They have a little more mitgefühl, as they say in German," said Leonhardt. "It's an understanding of a situation and having true empathy, even if you're not living it."
Drug ODs, Suicides Soaring Among Millennials: Report
So-called "deaths of despair" are skyrocketing among millennials, with thousands of 18- to 34-year-olds losing their lives to drugs, alcohol and suicide each year, a new report says.
During the past decade, drug-related deaths among that age group increased by 108%, alcohol-induced deaths by 69%, and suicides by 35%, according to the report from the Trust for America's Health and Well Being Trust.
Millennials are more heavily affected than older generations by each of these causes of death, the report states:
In 2017, there were nearly 31 drug overdose deaths for every 100,000 18- to 34-year-olds, but fewer than 23 drug deaths per 100,000 across all age groups.
Alcohol-induced death rates doubled for millennials between 1999 and 2007.
Young adults experienced a 35% increase in suicide rates between 2007 and 2017, compared with a 14% increase for 35- to 54-year-olds; a 24% increase for those 55 to 74; and 14% uptick for people older than 75.
"We lost over 150,000 lives last year to drugs, alcohol and suicide. When we dive down deep into those data, the millennial generation just pops out," said Benjamin Miller, chief strategy officer of Well Being Trust, a national foundation focused on mental, social and spiritual health.
"This is a call to action," Miller said of the new report. "It's unacceptable for us to continue to lose as many lives as we are losing to preventable causes. We have to do something different. What we are doing is simply not working."
The opioid epidemic cannot be overlooked as a contributing factor, Miller said.
Opioid overdose death rates among millennials increased by more than 500% between 1999 and 2017, and deaths caused by synthetic opioids increased by a staggering 6,000%.
It's a terrible coincidence that millennials came of age "at a time when the medical profession was led down the wrong path in terms of opioid prescribing," said Dr. Andrew Saxon, director of the Addiction Psychiatry Residency Program at the University of Washington in Seattle.
But the increases in alcohol deaths and suicides point to something darker within the psyche of millennials, who typically are defined as people born between 1981 and 1996.
They grew up with a succession of shattering events for the United States -- the 9/11 terror attacks, the Iraq and Afghanistan wars, and the Great Recession prompted by the housing bubble, Saxon said.
They graduated college saddled with heavy student debt at a time "our economy was near collapse," he said. "The expectations that they would have jobs waiting for them and their skills would be wanted -- sort of suddenly all of those prospects disappeared."
Since then, they've had to grapple with the exploding costs of education and housing.
"We can track economic trends with suicides, and as long as we've been studying it, suicides have gone up during times of economic dislocation," Saxon said.
Miller, meanwhile, said the rise of social media likely has also had an impact on millennials' sense of their prospects.
Social media can "make them feel more lonely -- how come I don't have that, or how come no one likes my picture?" he said. "In those cases, the negative effects of social media are seen."
At the same time, mental health services continue to be doled out in a way that makes it unlikely many will get the help they need, Miller said.
"We know that 6 in 10 folks are seeking mental health care, yet if you look at the data, 96 million Americans last year had to wait over a week to get access to a mental health provider," Miller said.
"When someone says to you that you're going to have to come back next week or tomorrow or in two weeks, the likelihood you show up is relatively small," he added.
To help stem these deaths of despair, the report recommends:
Making mental health care, including screenings for substance use and depression, a routine part of primary care.
Improving insurance coverage for medication-based treatments for substance abuse.
Adopting pricing strategies to reduce alcohol consumption among teens and young adults.
Offering suicide prevention programs throughout the health care system.
Making sure hospitals connect patients in crisis with behavioral health services in a timely manner.
During the past decade, drug-related deaths among that age group increased by 108%, alcohol-induced deaths by 69%, and suicides by 35%, according to the report from the Trust for America's Health and Well Being Trust.
Millennials are more heavily affected than older generations by each of these causes of death, the report states:
In 2017, there were nearly 31 drug overdose deaths for every 100,000 18- to 34-year-olds, but fewer than 23 drug deaths per 100,000 across all age groups.
Alcohol-induced death rates doubled for millennials between 1999 and 2007.
Young adults experienced a 35% increase in suicide rates between 2007 and 2017, compared with a 14% increase for 35- to 54-year-olds; a 24% increase for those 55 to 74; and 14% uptick for people older than 75.
"We lost over 150,000 lives last year to drugs, alcohol and suicide. When we dive down deep into those data, the millennial generation just pops out," said Benjamin Miller, chief strategy officer of Well Being Trust, a national foundation focused on mental, social and spiritual health.
"This is a call to action," Miller said of the new report. "It's unacceptable for us to continue to lose as many lives as we are losing to preventable causes. We have to do something different. What we are doing is simply not working."
The opioid epidemic cannot be overlooked as a contributing factor, Miller said.
Opioid overdose death rates among millennials increased by more than 500% between 1999 and 2017, and deaths caused by synthetic opioids increased by a staggering 6,000%.
It's a terrible coincidence that millennials came of age "at a time when the medical profession was led down the wrong path in terms of opioid prescribing," said Dr. Andrew Saxon, director of the Addiction Psychiatry Residency Program at the University of Washington in Seattle.
But the increases in alcohol deaths and suicides point to something darker within the psyche of millennials, who typically are defined as people born between 1981 and 1996.
They grew up with a succession of shattering events for the United States -- the 9/11 terror attacks, the Iraq and Afghanistan wars, and the Great Recession prompted by the housing bubble, Saxon said.
They graduated college saddled with heavy student debt at a time "our economy was near collapse," he said. "The expectations that they would have jobs waiting for them and their skills would be wanted -- sort of suddenly all of those prospects disappeared."
Since then, they've had to grapple with the exploding costs of education and housing.
"We can track economic trends with suicides, and as long as we've been studying it, suicides have gone up during times of economic dislocation," Saxon said.
Miller, meanwhile, said the rise of social media likely has also had an impact on millennials' sense of their prospects.
Social media can "make them feel more lonely -- how come I don't have that, or how come no one likes my picture?" he said. "In those cases, the negative effects of social media are seen."
At the same time, mental health services continue to be doled out in a way that makes it unlikely many will get the help they need, Miller said.
"We know that 6 in 10 folks are seeking mental health care, yet if you look at the data, 96 million Americans last year had to wait over a week to get access to a mental health provider," Miller said.
"When someone says to you that you're going to have to come back next week or tomorrow or in two weeks, the likelihood you show up is relatively small," he added.
To help stem these deaths of despair, the report recommends:
Making mental health care, including screenings for substance use and depression, a routine part of primary care.
Improving insurance coverage for medication-based treatments for substance abuse.
Adopting pricing strategies to reduce alcohol consumption among teens and young adults.
Offering suicide prevention programs throughout the health care system.
Making sure hospitals connect patients in crisis with behavioral health services in a timely manner.
Exercise Rates Rising for Urban, Rural Americans: CDC
The trend towards Americans getting off their couches and into gyms is hitting city and country folk alike, according to a new report.
Overall, the percentage of all adults who now meet or exceed federal exercise guidelines rose from 18.2% in 2008 to 24.3% by 2017, researchers at the U.S. Centers for Disease Control and Prevention said.
And the study finds that trend in both rural and urban areas. Among adults living in rural America, 13.3% were exercising in 2008 at recommended rates, but by 2017 that number had risen to 19.6%. And in cities, rates went even higher -- from 19.4% to 25.3%.
Federal physical activity guidelines advise at least 150 minutes of moderate aerobic exercise per week, or 75 minutes of vigorous aerobic exercise, as well as at least a moderate-intensity muscle-strengthening workout two days per week.
The rise in exercise rates is heartening, the CDC team said, but of course more progress is needed, because "in 2017, only 1 in 4 urban residents and 1 in 5 rural residents met the combined [exercise] guidelines."
The new study was based on 2008-2017 federal health data involving sample sizes of up to 37,000 adults surveyed nationwide each year. Researchers were led by Geoffrey Whitfield of the CDC's National Center for Chronic Disease Prevention and Health Promotion.
Two health care experts offered theories on why more Americans are getting more active.
It could be due to "increased stress with social, political and financial strains increasing over last few years," suggested Dr. Theodore Strange, associate chair of medicine at Staten Island University Hospital in New York City.
"Additionally, more gyms have popped to meet that need as well as other group exercising facilities, like martial arts centers, CrossFit and spin classes," he said. "Even employers are encouraging wellness and well-being by offering their employees opportunities to exercise daily and even offering financial/perk incentives."
But another expert noted that not everyone is benefiting equally.
"In particular, Americans who live in rural areas exercise less than Americans that live in urban areas," noted Dr. Teresa Amato. She directs emergency medicine at Northwell Health's Long Island Jewish Forest Hills in New York City. She also noted that the study found lower exercise rates in the U.S. South versus other regions.
Amato agreed that sometimes workplaces can play a big role in boosting exercise rates. Large employers often sponsor "employee wellness and employee well-being initiatives," she said.
"Many of these come in the form of forming exercise "teams" that have friendly competitions and awards for meeting certain exercise goals," Amato added.
"Studies do conclude that individuals are more likely to begin and sustain exercise habits when they are done with an additional partner or 'exercise buddy.' In addition, exercise in a group may lead to longer exercise times and more mental well-being," she said.
The study was published June 14 in the CDC journal Morbidity and Mortality Weekly Report.
Overall, the percentage of all adults who now meet or exceed federal exercise guidelines rose from 18.2% in 2008 to 24.3% by 2017, researchers at the U.S. Centers for Disease Control and Prevention said.
And the study finds that trend in both rural and urban areas. Among adults living in rural America, 13.3% were exercising in 2008 at recommended rates, but by 2017 that number had risen to 19.6%. And in cities, rates went even higher -- from 19.4% to 25.3%.
Federal physical activity guidelines advise at least 150 minutes of moderate aerobic exercise per week, or 75 minutes of vigorous aerobic exercise, as well as at least a moderate-intensity muscle-strengthening workout two days per week.
The rise in exercise rates is heartening, the CDC team said, but of course more progress is needed, because "in 2017, only 1 in 4 urban residents and 1 in 5 rural residents met the combined [exercise] guidelines."
The new study was based on 2008-2017 federal health data involving sample sizes of up to 37,000 adults surveyed nationwide each year. Researchers were led by Geoffrey Whitfield of the CDC's National Center for Chronic Disease Prevention and Health Promotion.
Two health care experts offered theories on why more Americans are getting more active.
It could be due to "increased stress with social, political and financial strains increasing over last few years," suggested Dr. Theodore Strange, associate chair of medicine at Staten Island University Hospital in New York City.
"Additionally, more gyms have popped to meet that need as well as other group exercising facilities, like martial arts centers, CrossFit and spin classes," he said. "Even employers are encouraging wellness and well-being by offering their employees opportunities to exercise daily and even offering financial/perk incentives."
But another expert noted that not everyone is benefiting equally.
"In particular, Americans who live in rural areas exercise less than Americans that live in urban areas," noted Dr. Teresa Amato. She directs emergency medicine at Northwell Health's Long Island Jewish Forest Hills in New York City. She also noted that the study found lower exercise rates in the U.S. South versus other regions.
Amato agreed that sometimes workplaces can play a big role in boosting exercise rates. Large employers often sponsor "employee wellness and employee well-being initiatives," she said.
"Many of these come in the form of forming exercise "teams" that have friendly competitions and awards for meeting certain exercise goals," Amato added.
"Studies do conclude that individuals are more likely to begin and sustain exercise habits when they are done with an additional partner or 'exercise buddy.' In addition, exercise in a group may lead to longer exercise times and more mental well-being," she said.
The study was published June 14 in the CDC journal Morbidity and Mortality Weekly Report.
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