A practical risk score tool has been developed to help people identify their potential risk for dementia, researchers reported in JAMA Network Open.
Lina Ren, MMed, of the Shenzhen Mental Health Center in China, and colleagues sought to develop a point risk score prediction model of dementia.
A practical risk score tool was developed for individual prediction of dementia risk, to help people identify their potential risk for dementia. Source: Adobe Stock
The authors used a large United Kingdom population-based prospective cohort study that was conducted between March 13, 2006, and Oct. 1, 2010. Outcomes of interest included 5-, 9-, and 13-year dementia risk.
A total of 444,695 participants (205,187 male; 239,508 female; mean age, 56 years) were included. Dementia occurrence after 13 years of follow-up was 0.7% among men and 0.5% among women.
The authors reported that men and women shared some modifiable and protective risk factors, as well as independent risk factors that accounted for 31.7% of men developing dementia and 53.35% of women.
The total point score of the risk score model ranged from –18 to 30 in men and –17 to 30 in women. In addition, the risk score model yielded nearly 100% prediction accuracy of 13-year dementia risk for both men and women, the authors reported.
“We identified some risk factors of dementia, which covered socioeconomic adversity, sleep phenotypes, physical activity, and comorbidities,” Ren and colleagues wrote. “The developed risk prediction system may help individuals to identify their potential risk profile and provide guidance on precise and timely actions to prevent or delay dementia.”
The daily use of multivitamin-mineral supplements improved global cognition, episodic memory and executive function in older adults, researchers reported in Alzheimer’s & Dementia: The Journal of The Alzheimer’s Association.
Laura D. Baker, PhD, a professor of gerontology and geriatric medicine at Wake Forest University, and colleagues assessed whether the daily administration of cocoa extract — containing 500 mg of flavanols — as well as the daily administration of a commercial multivitamin-mineral improved cognition in older adults.
Source: Adobe Stock.
Baker and colleagues conducted a large randomized two-by-two factorial 3-year trialthat included 2,262 participants (mean age, 73 years; 60% female).
Primary outcomes were assessed through a global cognition composite formed from mean standardized scores from individual tests, including telephone interviews of cognitive status, word list and story recall, oral trail-making, verbal fluency, number span and digit ordering. Secondary outcomes were evaluated by change in composite with 3 years of multivitamin supplementation.
The researchers reported cocoa extract had no effect on global cognition (mean change score, 0.03; 95% CI, –0.02 to 0.08).
However, daily multivitamin supplementation, compared with placebo, showed a statistically significant benefit on global cognition (mean change score, 0.07; 95% CI, 0.02-0.12), and was most pronounced in those with a history of cardiovascular disease (no history, 0.06; 95% CI, 0.01-0.11; history, 0.14; 95% CI, –0.02 to 0.31).
Additionally, daily multivitamin supplementation was linked to relative improvements for both episodic memory (mean change score, 0.06; 95% CI, 0.002-0.13) and executive function (0.06; 95% 0.01-0.11).
According to Alzheimer’s Association Chief Science Officer Maria C. Carrillo, PhD, this is the first positive, large-scale, long-term study that shows daily multivitamin supplementation may slow cognitive aging in older adults.
“While the Alzheimer’s Association is encouraged by these results, we are not ready to recommend widespread use of a multivitamin supplement to reduce risk of cognitive decline in older adults,” Carrillo said in a released statement that accompanied the study. “Independent confirmatory studies are needed in larger, more diverse study populations. It is critical that future treatments and preventions are effective in all populations. For now, and until there is more data, people should talk with their health care providers about the benefits and risks of all dietary supplements, including multivitamins.”
Children who played video games were shown to exhibit better cognitive function compared with those who didn’t, researchers reported in JAMA Network Open.
Bader Chaarani, PhD, of the department of psychiatry at the University of Vermont, and colleagues aimed to examine the association between video gaming and cognition in children through a case-control study.
Children who played video games were shown to exhibit better cognitive function compared with those who didn’t.Source: Adobe Stock.
Chaarani and colleagues observed cognitive performance and blood oxygen level-dependent (BOLD) signals among children aged 9 to 10 years who played video games and compared them with those who didn’t.
Children with valid neuroimaging and behavioral data were included. All participants completed a self-reported screen time survey, which included time spent specifically on video gaming.
Video gaming time, cognitive performance and BOLD signals were assessed with an n-back analysis. Working memory through stop signal tasks were assessed through functional MRIs.
A total of 2,217 children were included in the study (mean age, 9.9 years; 63.1% female). Of those who were included in the final sample for stop signal tasks, 1,128 children did not play video games and 679 children played them at least 21 hours per week. The final sample of those who completed the n-back analysis included 1,278 children who did not play video games and 800 children who played them for at least 21 hours per week.
Those who played video games performed better in both sample groups. Nonparametric analyses of functional MRI data demonstrated greater BOLD signals among children who played video games in the precuneus during inhibitory control.
“During working memory, a smaller BOLD signal was observed in [children who played video games] in parts of the occipital cortex and calcarine sulcus and a larger BOLD signal in the cingulate, middle, and frontal gyri and the precuneus,” the authors wrote.
In a release from the NIH, National Institute on Drug Abuse Director Nora Volkow, MD, stated that this study adds to the growing understanding of the associations between video gaming and brain development.
“Numerous studies have linked video gaming to behavior and mental health problems,” she said. “This study suggests that there may also be cognitive benefits associated with this popular pastime, which are worthy of further investigation.”
In a related editorial, Kirk M. Welker, MD, of the division of neuroradiology at the Mayo Clinic in Rochester, Minnesota, said that making any recommendations based on functional MRI studies is “challenging.”
“By the nature of their design, most [functional] MRI studies on this topic fail to establish causality between video gaming and purported brain functional alterations,” Welker wrote. “Some studies may simply be uncovering inherent brain characteristics that lead certain individuals to gravitate toward video gaming. If, in fact, video games are altering neurocognition, the longevity of any cerebral changes induced by this activity remains largely unknown.”
Laken Brooks, a 27-year-old PhD student at the University of Florida, has dealt with the skin condition psoriasis since she was a preteen. It’s always been a painful and difficult condition to manage, but over the past several years, Brooks has struggled even more. She suspects her psoriasis is worse thanks to climate change.
“Each year, the summer seems to last a bit longer,” Brooks says. “When I first moved to Florida (5 years ago), I noticed that sunburn and sweat made my skin feel even itchier than normal. I tried to alleviate some of the symptoms by wearing hats and head scarves, and I expected that I would acclimate to the new climate. But it’s difficult to acclimate when each year, the temperatures continue going up and my skin can never really get accustomed to the Florida climate.”
Brooks is onto something — climate change is having increasingly bigger impacts on health. The seventh annual The Lancet Countdown on Health and Climate Change, released this fall, confirms that. The report, authored by nearly 100 experts from over 50 academic institutions and agencies, tracks the impact of climate change on global health. The 2022 version revealed that every year, in every region of the globe, climate change is undermining health. Slideshow
The Lancet report this year identified four major harms from climate change: air quality, heat-related illness, infectious disease, and mental health.
Renee Salas, MD, of the Center for Climate, Health, and the Global Environment at Harvard’s T.H. Chan School of Public Health, is one of the report’s authors. She’s regularly sees how climate change is harming her patients’ health — especially those who cannot afford to mitigate its impacts.
“We had a patient present to the emergency room last summer with a core temperature of 106,” she explains. “He met the criteria for heat stroke. He and his wife lived in an upper story apartment with no access to A/C.”
Salas sees it as part of her responsibility to her patients to make the connections between climate change and health effects. Heat, in particular, is a palpable way for people to understand that connection, she says.
The impacts go beyond heat, however. “I have concerns about all of them,” says Salas. “And how climate change impacts a person will be impacted by how they live and the resources they have.”
Climate’s Impact on Mental Health
While heat might be the most obvious of harms people recognize from climate change, the mental health piece of the equation is likely the least. Susan Clayton, PhD, is a professor of psychology and environmental studies at the College of Wooster in Ohio. She’s been studying the link between the two for several years and has written three papers on the subject, the first in 2014.
“We’re reaching a point where people express that they’re anxious about climate change, but they don’t recognize that as a mental health threat,” she says.
In her work on the subject, Clayton has identified four categories where climate change impacts mental health:
Increasingly severe weather events: As more people experience devastating weather events, more people are also experiencing PTSD, clinical anxiety, depression, and substance abuse.
Slower changes: It doesn’t take a category 5 hurricane to dole out mental health harm. As temperatures rise higher than normal for longer periods of time, so too do the rates of suicide and psychiatric hospitalizations.
Involuntary displacement: Many people love and are rooted to where they live. As coastal flooding, wildfires, and other weather events displace them, they suffer deteriorating mental health.
Awareness of climate change: As everyone bears witness to climate change and become increasingly aware of its impacts, collective anxiety levels rise. For most people this is manageable, but it’s still harmful.
While talking about climate change and how it harms mental health can sometimes increase feelings of anxiety and other conditions, it’s an essential conversation to have, says Clayton. “When you’re overwhelmed and disempowered, it can be too much to cope with,” she explains. “But it can also encourage you to attend to the issue.”
Mitigation in the Meantime
As the data continues to pour out and demonstrate the link between climate change and health, it remains difficult for people to understand. For Salas, this can often be frustrating.
“I often have to walk upstream to understand what’s causing patients’ issues in the first place,” she says. “That’s why I do the work I do — I cannot just treat patients in the ER and call it good. That’s like putting a band aid on a bullet wound.”
Recognizing and pointing out that those in the line of fire are often those with fewer resources to change how climate is impacting their health is a starting point.
“We recognize that policy and higher-level decisions have drive these situations,” Salas says. “So I try to find the risks, educate patients, and then give them recommendations to protect themselves.”
This might look like suggesting a patient add an air filtration system in their home, or ensuring they have a back-up plan for using a nebulizer if the electricity is knocked out. The biggest message to get across, says Salas, is that health is harmed by what is happening “upstream.” “We need political and social will to change,” she says. “We’re beginning to see this — the health community is rising up and recognizing it as fundamental to the mission of medicine.”
For people like Brooks, who are not able to relocate now, the temporary fix is trying to minimize how climate change exacerbates existing conditions. “I have been able to mitigate some flare-ups by taking cool showers,” she says. “I don’t plan to live in Florida forever, but right now I don’t have the resources to transplant my life and move somewhere else.”
Drinking two or more cups of coffee daily is linked to double the risk of death from heart disease if you have severe high blood pressure, a new study from Japan suggests.
Previous studies have found that coffee consumption can reduce the risk of high blood pressure and death, but those studies didn’t differentiate among people with different levels of high blood pressure, according to study author Masayuki Teramoto, MD, MPH, of The University of California in San Francisco.
Symptoms of High Blood Pressure
Symptoms of hypertension (high blood pressure) are usually silent. WebMD tells you more.
“Caffeine’s harmful effects may outweigh its protective effects in persons with severe hypertension and increase the risk of mortality,” Teramoto says.
The study also looked at green tea consumption and found no link with heart disease death at any blood pressure level.
For the study, published Dec. 21 in the Journal of theAmerican Heart Association, researchers analyzed the blood pressure levels plus coffee and green tea consumption of 18,609 Japanese people ages 40 to 75. Sixty-five percent were women.
Blood pressure was categorized as:
Optimal and normal (less than 130/85)
High normal (130-139/85-89)
Grade 1 hypertension (140-159/90-99)
Grade 2 (160-179/100-109)
Grade 3 (higher than 180/110)
Grade 2 and 3 were considered “severe” high blood pressure.
Coffee consumption was categorized as occasionally or none, less than one cup, one cup, and two or more cups per day. For green tea consumption, the categories were occasionally or none, less than one cup, one or two cups, , three or four cups, five or six cups, and seven or more cups per day.
A total of 842 heart disease deaths occurred during the follow-up period at about 19 years. Coffee consumption was related to increased heart risk only among those who started the study with severe hypertension (grade 2 or 3). Compared with non-coffee drinkers, their risk of heart disease death doubled with two or more cups of coffee per day.
Green tea consumption was not associated with an increased risk of death from heart disease at any blood pressure level. Rather, frequent consumption was associated with lower total cholesterol level among those with severe hypertension.
More research is needed in different populations to confirm the study results, Teramoto says.
Avoid Additives
The study is unique in that it looks separately at risk associated with coffee and tea intake across different ranges of blood pressure, says American Heart Association Nutrition Committee Chair Christopher Gardner, PhD. But the study’s many categories for blood pressure and coffee and tea consumption made for very small subgroups for analysis. For example, only 19 (2%) of the 842 deaths were in the severe hypertension group.
The Truth About Coffee
Let’s get down to the facts: Is coffee good or bad for you?
The small subgroups also limited the researchers’ ability to accurately calculate any benefits of coffee or green tea at any blood pressure level.
What’s more, Gardner notes that the researchers didn’t look at what people put into their coffee and tea.
“Black coffee and a ‘mocha-frappa-cappuccino’ might both qualify as ‘coffee,’ but the latter is a sugar-and-saturated fat delivery vehicle. Green tea and boba/bubble tea are similar in terms of both possibly qualifying as ‘tea,’ but the latter is more of a tea-flavored-beverage, with sugar and dairy and other additives.”
People need to know that even if they don’t have high blood pressure or if they have mild hypertension, they should not feel free to increase their consumption of coffee-like and tea-like beverages, which could be harmful because of the additives, Gardner says.
And if you have severe high blood pressure, limit your coffee consumption to less than two cups per day until more research results are available, Gardner advises.
Whether it’s an old injury that keeps flaring up or the start of arthritis, you’re more likely to feel a few aches more often as you age. Regular movement can ease pain and make your joints more flexible. Try low-impact exercises like swimming, yoga, and tai-chi. Heating pads or ice packs can help, too. If those don’t give you enough relief, talk to your doctor about over-the-counter or prescription medicines, like nonsteroidal anti-inflammatory drugs (NSAIDs).
Wrinkles
2/12
These show up as your skin gets thinner, drier, and less elastic. But some things can make them worse, like smoking and ultraviolet rays from the sun or a tanning bed. To ease these signs of aging, protect your skin from the sun, and if you smoke, quit. Some skin products, like moisturizers or prescription retinoids, might make wrinkles less noticeable. But you’ll need to give them time to work — most need 6 weeks to 3 months to show results. A dermatologist can help you know what would work best for you.
Dry Skin
3/12
Sun protection and quitting smoking will help this problem, too. So will watching how much alcohol you drink — it can dehydrate you. It’s a good idea to keep showers or baths to less than 10 minutes and to use warm water instead of hot. Then put a heavy, oil-based moisturizer all over your body right away.
Loss of Muscle
4/12
Many people lose strength and endurance as they get older, but the reason isn’t really about the aging process. Many people just stop working key muscles. The phrase “use it or lose it” applies here, so see if you can start weight training to build up your strength. Regular exercise, like walking, gardening, or swimming, can help, too. Aim for at least 30 minutes a day — you can split it into two 15-minute sessions if that works better for you.
Sleep Changes
5/12
Your need for shut-eye doesn’t change as you age, but your ability to get it can. Older people tend to have a harder time falling asleep, have shorter stretches of deep sleep, and wake up more often in the middle of the night. Coffee and alcohol can cause those issues, so cutting back on those can help. And it’s important to keep health conditions that can affect your sleep, like high blood pressure or GERD, under control. Talk with your doctor if you often have trouble sleeping.
Memory Glitches
6/12
They might feel alarming, but they’re part of the normal aging process. Your brain changes as you get older, which can affect how well you remember things. You may need to lean on a few tricks, like keeping lists, following a routine, and putting items in a set place. But some habits also help you keep your memory sharp. For example, being around friends and family often has been shown to boost your brain power. Regular exercise and eating healthy foods are key, too.
Weight Gain
7/12
As you get older, you don’t burn calories like you used to. But you can counter that slower metabolism by being more active and watching what and how much you eat. Make fruits, vegetables, and leaner protein key parts of your diet. Also, limit sugar and foods that are high in saturated fat. And keep an eye on portion sizes.
Changes in Your Sex Life
8/12
Erectile dysfunction, vaginal dryness, and other conditions that become more likely with age can make sex a challenge. Talk with your partner about how you’re feeling and if you want to try different ways to be intimate. Over-the-counter products like vaginal lubricants can help some issues. You can also ask your doctor if there are medications you should try. But keeping yourself healthy overall will help, too. Exercise boosts blood flow and sex hormones, and it helps you feel good about yourself.
Peeing More Often
9/12
Your bladder and pelvic muscles get weaker with age. Other health problems, like an enlarged prostate, can make the issue worse. Strengthen the area with Kegel exercises — squeeze your muscles as if you’re trying to hold in urine — 10 to 15 times, three times a day. Your diet makes a difference, too. Get plenty of fiber, and limit sugary, carbonated drinks and caffeine. If you’re having trouble with holding urine, leaking, a sudden, urgent need to pee, or pain when you go, see your doctor.
Being in a Rut
10/12
It’s easy to get bored if you fall into a predictable routine, especially if it doesn’t change much for years. To shake things up and keep your mind engaged, try breaking out of your daily schedule. Take some time to do something you like or learn a new skill. If you’re retired, you might think about getting a part-time job or some temporary work. It can boost your mental health and your bottom line at the same time.
Feeling Lonely
11/12
Whether your kids move out or you retire from your job, you may spend more time around fewer people as you age. To avoid feeling isolated, make it part of your daily routine to talk with friends, family, and neighbors. Volunteer for a charity or a faith-based group. Simply writing a letter can give your social life a boost. A pet can be good for companionship, too — a daily dog walk is good exercise and a chance to meet people.
Stay on Top of Your Health
12/12
Most older adults have at least one health problem, like heart disease or diabetes. If you do, it’s important to go for regular checkups, keep your prescriptions filled, and follow all your doctor’s instructions. Checkups are key even if you don’t have a health condition so you can spot any issues early and get tips for staying healthy.
Your body will often let you know if something suddenly goes drastically wrong. If something feels really off — like changes in being able to see, talk, walk, think clearly, or communicate, or having chest pain or shortness of breath — call 911. Don’t wait to see if you feel better. If it’s a stroke or heart attack, you need medical care right away.
Do You Need A Rest Day?
2/15
You don’t feel up to your regular workout. Should you pass? Tune in. Do you feel sore and worn out? Then you may need a lighter day. Or are you feeling tempted by your favorite show and your couch? How often you need rest depends on how hard you work out and what you do, and how you feel. If you’re not in pain, some movement is usually a good idea. A certified personal trainer can give you a training schedule that builds in recovery.
Is It Aging?
3/15
Some pain from wear and tear on your body is natural as you get older. Or you may notice that you’re not as flexible or strong as you used to be. The cushion at your joints and between the bones of your spine can start to break down. That could hurt and limit your movement. It helps to stay active, but when the pain doesn’t go away, your doctor might suggest a specialized “rehab” exercise routine to manage it.
Your Heart Rate Feels Off
4/15
You may feel lightheaded or dizzy with a racing, fluttering, or slowed pulse. If it lasts more than a few minutes or happens often, it might be from an illness or heart rhythm problem. Serious chest pain or trouble walking or speaking could mean a heart attack or stroke: Get to a hospital. An easy workout that suddenly seems hard and raises your pulse longer than usual may mean you’re overdoing it. Talk to a doctor about your symptoms.
Burned Out?
5/15
If you’re under stress that doesn’t let up, it can really get to you. You might notice that you’ve got less energy, headaches, an upset stomach, or other symptoms. Little things that you used to be able to shake off now bother you. These may be signs that you need to step up your stress management. What helps: exercise, positive relationships, meditation, smiling and laughing, and taking breaks from whatever causes you stress.
Mood Matters
6/15
Everyone has times when they feel down or anxious. But if you have depression or anxiety, those conditions can affect you physically as well as emotionally. You might notice that you cry a lot, isolate yourself, avoid doing things you normally love, have tense muscles, find it hard to concentrate, and sleep or eat more (or less) than normal. These are cues to talk to your doctor or a therapist to get help.
Appetite Changes
7/15
If you find that you eat a lot more, or a lot less, than usual, your body may be telling you that something isn’t quite right. It might be that you’re stressed out and are eating for emotional reasons. Or you might be depressed, and that’s dimmed your appetite. Some conditions, and even getting older, can also affect your appetite. It helps to be active and to favor flavorful, healthy food. If that doesn’t help, let your doctor know.
Injured or Just Sore?
8/15
A good gym session might make you mildly sore. But muscle pain that lasts several days could mean you overdid it — too much, too soon, or too hard — and have an injury. It’s best to wait until you’re back to normal to exercise again. So to stay healthy and keep to your routine, keep your intensity low and ramp up slowly.
Put on the Brakes
9/15
When you’re working out and your body screams “Stop!” listen. You may have broken a bone or torn a muscle or ligament. Try RICE:
Rest: Lie down and keep your weight off
Ice: 20 minutes at a time
Compression: Use a bandage for support
Elevation: Raise the hurt area (above your nose if you can)
Go to an ER or clinic if the pain is intense, it worsens, or you also have fever and chills. Call your doctor if it still hurts after 2 weeks.
Sleep Problems
10/15
Do you often toss and turn at night? Your body may be saying you need more sleep. First, try simple things, like going to bed and getting up at the same time every day, sleeping at least 7 hours a night. Keep your bedroom cool, and don’t watch TV or check your phone after bedtime. Being active during the day also helps. Avoid big meals and caffeine too close to bedtime. If that’s not enough, ask your doctor what the problem might be.
Pain That Doesn’t Quit
11/15
Are you noticing twinges and aches that happen over and over again? Don’t try to cover them up with medication or just “work through” them. You want to stop a minor ache from turning into a major problem that won’t go away. A doctor can help you pinpoint the source of the problem and treat it. You might need physical therapy so you start to feel it better.
A New Lump
12/15
Whether you’re a woman with a lump in their breast or a young man with a testicular lump, these are good things to get a doctor to check. You really can’t tell what they are, just based on how they feel. They aren’t always cancer, but it’s important to find out about new lumps for sure, and as soon as possible, in case you need treatment.
A Bad Reaction
13/15
Maybe you think you’re starting to get allergies to pollen, or that your gut can’t handle lactose or gluten. Or you notice that your skin is itchy and dry all of a sudden. These are things that are easy to jump to conclusions about. But it’s a good idea to see a doctor to find out if you really do have an allergy or if something else is causing your symptoms. That way, you’ll know what you need to avoid and how to treat your triggers.
Trust Yourself
14/15
You know yourself inside and out: how you feel on a good day, what feels “off,” when you’re sick, when you’re rested. It can all show up in your body, from a clenched jaw from stress, to a sore calf muscle after hiking all weekend, to something serious. Sometimes it’s hard to tell on your own, so never hesitate to ask your doctor, who’s there to help.
What Helps Your Doc
15/15
When you go to your doctor to find out what’s causing the problems you’ve noticed, there are a few things that will help. Bring a list of your symptoms, when they started, what seems to help, what makes them worse, and how you tried to fix the problem. Tell your doctor about all the things you take, including vitamins, herbal products, over-the-counter medicines, and prescriptions. And bring a list of questions that are on your mind.
Do you exercise? That’s great. But if you sit down for most of the rest of your day, that’s a problem. You need to be active all day long. Little bursts count. If you have a desk job, take a short walk every hour to boost your circulation, even if it’s just to your break room and back. Binge-watching your favorite show? Get up and dance, or do push-ups during the commercials.
2. You Say ‘I’m Too Young’
2/8
Don’t wait to work on keeping your heart healthy. Exercise, eat a healthy diet, and know your numbers — blood pressure, cholesterol, and blood sugar. The ideal time to do your heart a favor is now.
3. One Drink Too Many
3/8
For most people, moderate drinking (one a day for women, up to two daily for men) is OK. A daily drink may even have some benefits for the heart. But more than that can raise levels of certain fats in the blood, and raise blood pressure, too. That’s especially true if you have several drinks at a time. So stick to your daily limit.
4. You Dis a Good-for-You Diet
4/8
You may think it’s going to be all oat bran, all the time. Surprise! There’s no reason for your food to be bland and boring. A Mediterranean-style diet has delicious foods like olive oil, nuts, fruit, whole grains, fish, lean protein, and red wine. It helps keep your heart healthy, thanks to the “good” fats, fiber, and nutrients. Plus, you’ll actually want to stick to this diet because it tastes so good!
5. You Don’t Know Your Numbers
5/8
Pop quiz: What’s your cholesterol level? How about your blood pressure? No clue? That’s risky. They could be too high without you knowing. (You could feel just fine and have high cholesterol or high blood pressure.) So protect yourself. Starting at age 20, make sure you see your doctor regularly and create a plan to check and track your numbers.
6. Waist Not
6/8
Belly fat is particularly bad for your heart. So get your tape measure and size up the inches around your waist. It’s a red flag if it’s more than 35 inches around for women or 40 inches for men. Need to slim down? Take it step by step. Even losing a small amount of weight is good for your heart.
7. You Ignore Your Blues
7/8
When you feel low, it’s hard to do things that are good for you, like exercise. If you have felt down for more than a few weeks, talk to your doctor or a mental health professional. Talk therapy, exercise, and medication (if needed) can improve your mood so you have more energy to take care of yourself.
8. You Blow Off Secondhand Smoke
8/8
Someone else’s smoke could hurt your heart and blood vessels. You need to avoid it. If you spend a lot of time with someone who isn’t ready to quit smoking, insist that they at least not smoke around you, whether it’s at home, work, or in your car. Your tough love may be the nudge they need to kick the habit, which will be good for both of you.
If you get shortchanged on shut-eye, you might get moody, cranky, anxious, or depressed. You also might find it harder to think straight or to remember things. In the long run, lack of sleep can lead to conditions like obesity, high blood pressure, diabetes, and heart disease. So it’s well worth your while to figure out how to get some good quality, uninterrupted ZZZs.
Major Life Events
2/16
It’s normal for something unusually stressful, like a recent car accident or losing your job, to wake you up during the night. These effects should fade as you come to terms with the situation. Talk to your doctor if your sleep problems stick around for a while after a serious life event. Medication and talk therapy might help.
Everyday Woes
3/16
Workaday worries can bust up your sleep, too. Did I pay the power bill? Are my property taxes due this week? Is it my turn to do carpool tomorrow? A to-do list can keep you on track and cut down the stress. And that could mean a better night’s sleep.
Your Bedroom
4/16
Is it hot and stuffy? Does your bed have sinkholes the size of basketballs? Does your partner snore like a hippopotamus with a stuffy nose? Any of these things can interrupt your sleep. A doctor might help with snoring. After that, look for a place to sleep that’s dark, quiet, safe, comfortable, and cool — 60 to 67 F is just about right.
Alcohol
5/16
It might make you sleepy at first, but drinking alcohol can wake you up soon afterward, sometimes repeatedly. It disrupts the important REM stage of sleep, and it could interfere with your breathing. It also makes you pee more, which typically means you have to get up to go to the bathroom more often. For a better night’s sleep, avoid drinking alcohol in the late afternoon and evening before bed.
Caffeine
6/16
It’s in tea, coffee, chocolate, and many energy drinks, too. Even in normal doses, it can wake you up and lessen the quality of your sleep, especially as you get older. Up to 8 hours before bedtime could still have an effect. Avoid it in the afternoon and evening to see if you wake less often after going to sleep.
Late-Night Eating
7/16
The later you eat that foot-long chili dog with extra onions and a side of fries, the more likely it is to interrupt your sleep later. For a more restful night, try a lighter dinner with less fat and salt and fewer calories — like grilled chicken and vegetables. Eat it earlier in the evening so it has time to digest. If you’re hungry later, snack lightly on easy-to-digest foods like toast or yogurt.
Medication
8/16
Stimulants like the pseudoephedrine found in many over-the-counter decongestants can interrupt your sleep. There are other culprits, too, like drugs for allergies, heart disease, hypertension, ADHD, and Parkinson’s disease. Talk to your doctor about adjusting or changing your medicine if you think it affects your shut-eye.
Anxiety and Depression
9/16
If everyday events worry you more than they should, you may have some form of anxiety disorder. This kind of worrying can interrupt your sleep. People with bipolar disorder and other mood disorders can also have problems with sleep, including waking in the middle of the night. Talk to your doctor to get the right treatment for you.
Menopause
10/16
If you’re a woman, your period stops naturally around middle age, and your body slowly stops making the hormones progesterone and estrogen. This often causes hot flashes, where a surge of adrenaline raises your body temperature and makes you sweat. This can wake you up, sometimes many times each night. Your doctor may be able to prescribe hormones or other medications to stop these flashes and help you sleep.
Medical Problems
11/16
Arthritis and back pain can wake you up. Allergies and asthma might interfere with your breathing at night. Parkinson’s disease can cause body movements that disrupt your shut-eye. Alzheimer’s agitates some people during normal sleeping hours. When you treat your illness, you might improve your sleep problems as well.
Sleep Apnea
12/16
If you have this condition, your breathing starts and stops frequently when you sleep. This can wake you up, sometimes many times a night. Though you may not remember it, you could be groggy and grouchy the next day from lack of sleep. Excess body weight sometimes leads to sleep apnea, but there are other causes. A doctor can test to see if you have it and help you manage and treat it.
Exercise Before Going to Sleep
13/16
In general, physical activity makes you sleep better. But if you work out too close to bedtime, your body makes more cortisol, a hormone that helps you stay more alert. This could wake you up when you’re trying to stay asleep. It doesn’t affect everyone this way, but if you notice sleep problems after exercise, try to get it done in the morning, or at least finish up 3 hours or more before you go to bed.
Digital Devices
14/16
Too much of any artificial light after the sun goes down can mess up your sleep. But the blue light from your smartphone, laptop, and other electronics is especially bad because it can lower your melatonin levels. Specialized glasses or screens filter out the light, and some devices have “night shift” settings that help remove it. The best solution is to put the electronics down as early in the evening as possible.
Napping
15/16
A 20-minute nap in the middle of the day can help sharpen your attention and motor skills, especially if you’re feeling tired. But naps in the late afternoon or evening can make it harder to stay asleep at night. That can lead to an unhealthy cycle that disrupts your normal sleep routine and leaves you craving another nap the next day.
Primary Insomnia
16/16
Sometimes there’s no obvious reason why you wake up during the night. This is called primary insomnia. It may be that your brain stays more alert — too alert — when it should be sleeping. This could be because of some physical difference in the brain, possibly due to your genes. But doctors aren’t yet sure and continue to study the problem.
A study from the Cleveland Clinic and Tufts University found a 22 percent greater risk for heart disease for every 1.1 serving of meat per day (3.3 oz. cooked lean meat). This study followed more than 4,000 men and women older than 65 for an average of 12.5 years, and the increased heart attack risk was directly related to blood levels of TMAO and its precursors (Arteriosclerosis, Thrombosis, and Vascular Biology, Aug 1, 2022;42(9):e273–e288). TMAO comes from L-carnitine found in red meat. TMAO blood levels were a far better predictor of heart disease than high blood pressure or high cholesterol levels. This study found that fish, poultry, and eggs were not associated with increased risk for heart disease.
The same group of researchers found that higher levels of TMAO were associated with significantly increased risk for death from any cause, and death from heart attacks in particular (JAMA Network Open, May 20, 2022;5(5):e2213242). Other associated risk factors for heart disease included high blood sugar, high insulin and markers of inflammation.
Dozens of earlier studies have shown that eating mammal meat is associated with increased risk for heart attacks, strokes, certain cancers, diabetes and premature death (Circulation, April 22, 2019). The association between TMAO levels and heart disease may be stronger than with dietary saturated fat, cholesterol, sodium, nitrites, or high-temperature cooking.
TMAO and Heart Attack Risk Meat is loaded with choline and carnitine, which pass to your colon where bacteria there convert them to a gas called trimethylamine (TMA) that is absorbed into the bloodstream and passes to the liver where liver enzymes convert TMA to TMAO. Choline and carnitine are found in large amounts in meat, in significantly lower amounts in poultry, fish, dairy, and egg yolks, and in very low amounts in plants. Mammal meat raises blood levels of TMAO much higher than poultry, and it also changes the bacteria in your colon to the ones that make TMA. When you switch from eating mammal meat to eating primarily chicken, fish and plants, blood levels of TMAO drop markedly as do the concentrations of colon bacteria that make TMA (Eur Heart J , Feb 14, 2019;40(7):583–594). The amount of saturated fat eaten had no effect on blood levels of TMAO (Am J Clin Nutr, 2021 May; 113(5): 1145–1156).
TMAO may increase risk of heart attacks by: • reducing cholesterol clearance from the bloodstream, • increasing cells that deposit cholesterol in plaques, • increasing the cytokines that promote inflammation to form plaques, and • increasing clotting that is the ultimate cause of heart attacks (Cell, March 24, 2016;165(1):111-124).
Other foods and supplements that contain the chemicals that can form TMAO include: • Processed foods that contain phosphatidylcholine, also known as lecithin • Dietary supplements that include choline or carnitine • Energy drinks and protein supplements that contain lecithin or choline
Fish also contain carnitine and choline, and may slightly raise blood levels of TMAO. However, eating fish is not associated with increased risk for heart attacks (Microbial Ecology in Health and Disease, May 19, 2017:28(1)), possibly because the omega-3 fatty acids in most fish help to reduce inflammation and clotting that increase heart attack risk.
My Recommendations In the United States and many other parts of the world, cardiovascular disease is the leading cause of death and meat is a major risk factor. While the risk of developing cardiovascular disease (including heart attacks and strokes) increases with age, other risk factors are influenced by lifestyle at any age. Lifestyle and behaviors that are known to improve cardiovascular health include: • eating healthful foods –fruits, vegetables, whole un-ground grains, beans and seeds • exercising regularly • getting sufficient sleep • maintaining a healthy body weight • stopping smoking • restricting or avoiding alcohol • controlling high blood pressure, high cholesterol and high blood sugar
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