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Mistakes That Can Affect Your Cholesterol



Mistakes That Can Affect Your Cholesterol

Your Numbers

Your cholesterol levels tell your doctor about the fats in your blood. Unhealthy levels are linked to hardening of the arteries, which can cause heart disease, heart attacks, and strokes. Your numbers include “bad” (LDL) and “good” (HDL) cholesterol, and triglycerides, a common fat in your body. If you understand where your numbers are and what may affect them, you can do some things to help manage them.

You Don’t Get Tested

Unhealthy cholesterol numbers don’t typically cause any symptoms, so it’s important to get them checked. If you find out there’s a problem, diet, lifestyle changes, and medication can help. After age 20, your doctor will want to do a simple blood test every 4 to 6 years to make sure they’re in the healthy range. If your levels are off, your doctor will keep a close eye on them to see if you need treatment.

You Skip Your Workouts

Regular exercise is one of the best ways to control your cholesterol. You don’t have to run a marathon — 40 minutes of walking, swimming, cycling, or dancing 3 or 4 times a week will do the trick. If you’re short on time, you can break it into 10-minute increments throughout the day.  Resistance training — pushups, pullups, weights — may help, too.

You Park Yourself

Sitting too long can be linked to obesity, heart disease, and high blood pressure. It lowers “good” cholesterol, which helps get rid of the bad stuff, and raises triglyceride levels. This is true even if you exercise regularly. If you work at a desk, try to get up and move around every 30 minutes, or think about using a standing desk.  

You Smoke

Smoking lowers your “good” cholesterol levels, which means you keep more of the bad stuff. And it’s linked to high blood pressure, diabetes, and heart disease. Quitting can make your cholesterol levels better and help protect your arteries. If you don’t smoke, do your best to stay away from secondhand smoke.

You Ignore Your Weight

Carrying too many pounds, especially around your belly, can raise bad cholesterol (LDL) and lower the good kind (HDL). But lose just 10% of your weight, and you could really help your numbers. Talk to your doctor about the best diet and exercise program to help you lose weight. 

You Eat a Lot of Saturated Fat

This comes from beef, pork, lamb, and full-fat dairy like butter, cream, milk, cheese, and yogurt, as well as tropical oils like palm and coconut. All those things can raise your LDL, or “bad” cholesterol. It can help to trim visible fat from meats and go with skim milk and low-fat yogurt. If your LDL is high, you shouldn’t get more than 6% of your calories from saturated fat.

You Eat a Lot of Trans Fat

Sometimes called “partially hydrogenated” fats or oils, you find them in fried foods, pastries, pizza dough, doughnuts, muffins, cookies, crackers, and many prepackaged foods. They raise your bad cholesterol levels and lower the good stuff. Check food labels to limit trans fats. Eat plenty of fruits, vegetables, whole grains, low-fat dairy, poultry, fish, and nuts.

You Cut Out all Fats

They’re not all bad. Replace saturated and trans fats with healthier polyunsaturated and monounsaturated fats. You’ll find those fats in trout, salmon, herring, avocados, olives, walnuts, and liquid vegetable oils like safflower, canola, sunflower, and olive oil. But make sure no more than 30% of your daily calories come from any kind of fat.

You Forget About Fiber

There are 2 types of fiber: soluble, which dissolves in water, and insoluble, which doesn’t. Both are good for your heart health, but soluble fiber in particular helps lower your LDL levels. Add it to your diet with a bowl of oatmeal in the morning or with oat bran, fruits, beans, lentils, or vegetables.

You Drink Too Much

Overdoing it with alcohol can cause unhealthy cholesterol numbers. In particular, it can raise the level of fats in your blood. Men should have no more than two drinks per day, and women one. If you keep to that, you also might boost your HDL or “good” cholesterol numbers.

You Ignore Other Conditions

It’s important to understand and treat any medical issues linked to bad cholesterol numbers like high blood pressure, diabetes, kidney disease, liver disease, and hypothyroidism. If you have one of those conditions and manage it well, you may help your numbers, too.

You Skip Your Medication Sometimes

Follow your doctor’s directions about any prescriptions. If you do forget to take your medicine, don’t try to “make up” doses by taking more the next time. It may not work the way it’s supposed to, or it may make you dizzy or sick. Make sure to tell your doctor about any drugs you already take.  Some drugs can cause problems if they’re taken at the same time as other meds.

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What It Means When Lungs Crackle and Wheeze




A new study describes how the mechanics that produce those noises with every breath are likely a cause of injury and inflammation.

The findings, based on evidence from experiments on microfluidic chips and on animal models, could eventually change treatment of lung diseases, says James Grotberg, professor of biomedical engineering at the College of Engineering and professor of surgery at the Medical School at the University of Michigan. They also represent a paradigm shift for how doctors understand what they hear through a stethoscope.

Here, Grotberg answers explains his research, which appears in the Annals of the American Thoracic Society.


When doctors pull out a stethoscope, what are they listening for?

Two important organs being monitored are the heart and the lungs. For the lungs, typically the patient is asked to breathe in and out deeply. There are normal sounds of air movement, but also there can be abnormal sounds, like wheezes during expiration (breathing out) and crackles during inspiration (breathing in). Both are well-known signs of disease.

These wheezes and crackles are signs of what diseases?

Typically, wheezing is found in asthma and emphysema. Patients who wheeze can be so loud you can hear it standing next to them. Crackles, on the other hand, are only heard by a stethoscope and are a sign of too much fluid in the lung. Pulmonary edema is a common example, often a byproduct of heart failure.

You’ve found that sounds could represent more than just the presence of a disease. Can you explain?

Well, for a sound to be created, a mechanical event must occur, like clapping your hands. If you clap hard enough, your hands will hurt. Ouch!
As an extreme example, the loudest sound a lung generates is a severe cough, which can cause, in rare instances, a pneumothorax (ruptured lung), i.e. tissue failure.
The physical mechanisms that cause wheezing and crackling, while smaller forces than a cough, are similar. They make the sound, and that mechanical event is also pounding away on the lung tissue. The lung cells don’t like that. Ouch again!
The cells respond with inflammation, which, itself, is a disease. So wheezes and crackles actually “cause” disease. We’ve seen evidence of this in our experiments. That is a 180-degree thought reversal from interpreting them as only a “sign” of disease.

Break this down for us a bit more. What exactly is happening when a sick patient wheezes?

Wheezing is very much like the sound from a deflating balloon when you make it squeal by stretching the outlet. An asthmatic lung airway is similar because it is constricted to a small narrow passageway. The pitch you hear is the frequency of oscillation of the balloon material, which for a lung would be the airway tube made of cells.

And how is that damaging?

Vibrating the lung cells makes them promote inflammation which damages the lung. Asthma already involves inflammation of the airway tubes in the lung, so wheezing likely just makes things worse.

And what’s going on when patients inhale and produce a crackling sound?

Crackles are ruptures of liquid plugs in the smaller airway tubes that pop open during inspiration. The sound mechanism is very similar to drinking through a straw when you get down to the last sips at the bottom of the cup.
The gurgling is a mixture of liquid and air with popping bubbles, just like a fluid-overloaded lung. The sequence is very damaging to the cells, and again they respond with inflammation and injury.

How do you see this new understanding impacting diagnoses or treatments?

Well, this is completely new territory. Since no one has ever viewed lung sounds as a cause of disease, they have not been investigating it. It’s a paradigm shift for a field that has a 200-year history with the stethoscope.
Experimental models need to be designed to include measurement of injury, from cellular to whole organ level, along with measurement of sound. Our research group in collaboration with Shuichi Takayama, a former professor of biomedical engineering now at Georgia Tech, has done that for crackles in microfluidic platforms, but that is just a beginning.
If lung crackle injury is found in congestive heart failure, therapy would likely change to treat both at the same time, perhaps adding an anti-inflammatory agent. Wheezing is often already treated with anti-inflammatory agents, but not always.
In any case, the goal of stopping the sounds by more aggressive treatment may evolve.

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Statins lack desired effect for half of patients, study finds



Statins lack desired effect for half of patients, study finds

Those who showed ‘sub-optimal’ response to cholesterol-lowering drugs also 22% more likely to develop heart disease

Around half of patients who are prescribed statins do not see their cholesterol drop to desired levels within two years, new research suggests.

Guidelines from the National Institute for Health and Care Excellence (Nice) aim for a 40% or more reduction in low density lipoprotein cholesterol from the treatment.

However a new study, published in journal Heart, found half of people (51%) had a “sub-optimal” response after 24 months on the drugs.

The researchers, from the University of Nottingham, analysed data from 165,411 patients who were prescribed statins in primary care between 1990 and 2016.

They were on average 62 years old when they began treatment.

A total of 84,609 patients had a “sub-optimal” response after two years and did not record a reduction in cholesterol of 40% or more.

The researchers note that a higher proportion of patients with a “sub-optimal” response were prescribed lower potency doses, compared with those with an “optimal” response.

Patients who did not reach the targeted levels were 22% more likely to develop cardiovascular disease than those who did respond well, the study found.

The researchers said the study provides “real world evidence” about statins.

“These findings contribute to the debate on the effectiveness of statin therapy and highlight the need for personalised medicine in lipid management for patients,” they wrote.

Professor Metin Avkiran, associate medical director at the British Heart Foundation, said: “Statins are an important and proven treatment for lowering cholesterol and reducing the risk of a potentially fatal heart attack or stroke.

“Although this study suggests that not everyone who is prescribed statins manages to reduce their cholesterol sufficiently, it doesn’t explain why.

“It may be that these people have been prescribed low dose or low potency statins, that they are not taking the medication as prescribed, or that they are not responding well to the type of statins that they have been prescribed.

“If you have been prescribed statins you should continue to take them regularly, as prescribed.

“If you have any concerns you should discuss your medication with your GP.

Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: “When we prescribe medication, we have to rely on patients to make sure that they take it, both at the recommended dose and for the duration of time that we think will benefit them most.

“There is a substantial body of research showing that statins are safe and effective drugs for most people, and can reduce the risk of heart attacks and stroke, when prescribed appropriately – but controversy remains around their widespread use and their potential side-effects.

“There are complex reasons why patients choose not to take their prescribed medication, and mixed messaging around statins could be one of these.”

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What causes high cholesterol? 5 foods to add to your low-cholesterol diet plan



What causes high cholesterol? 5 foods to add to your low-cholesterol diet plan

Here are five foods that make up a good diet for lowering cholesterol while also reducing your risk for certain conditions such as high blood pressure, heart attack, and cancer.

What causes high cholesterol? 

Having high levels of cholesterol, especially LDL (low-density lipoprotein) or bad cholesterol, is linked to an increased risk of heart disease or stroke. But medication along with lifestyle changes, including a healthy diet, can help improve your cholesterol. Studies have shown that a person’s diet can have a powerful effect on their cholesterol and other risk factors.

High cholesterol, also called hypercholesterolemia, happens when you have fatty deposits in your blood vessels. These deposits can eventually limit blood flow and form a clot that causes a heart attack or stroke. The problem is that high cholesterol has no symptoms and it can be detected by a blood test.

High cholesterol: What causes it?

This condition is often caused by a poor lifestyle although it can be inherited. Making healthy lifestyle choices can help prevent or reduce the risk of bad cholesterol. Eating a diet rich in fresh fruits and vegetables, whole grains, good fats, and beans can help keep your cholesterol levels at healthy ranges. 

Here are five foods that make up a good cholesterol diet while also reducing your risk for certain conditions such as high blood pressure, heart attack, and cancer.

Foods that lower cholesterol and improve heart health
Whole grains: Whole grain sources like oats, quinoa, and barley contain beta-glucan, a type of soluble fibre that has been shown to be effective at lowering ‘bad’ LDL cholesterol. Studies have suggested that whole grains may promote heart health.

Legumes: Legumes like beans and peas are another healthy option to add to your low cholesterol diet as they are rich in nutrients, including soluble fibre. They are a great source of plant-based protein that has been found to decrease triglycerides and blood pressure, both of which are heart disease risk factors.

Nuts: Almonds, walnuts, peanuts, and other nuts are exceptionally nutrient-dense food good for your heart. They are high in monounsaturated fats that can have a beneficial effect on the heart when consumed in moderation. Nuts are rich in cholesterol-lowering fats, fibre, and minerals that may improve heart health.

Garlic: Scientific studies suggest that garlic contains cholesterol-lowering properties that may be beneficial for people with high cholesterol. Allicin, the main active compound in garlic, and other plant compounds in the herb may help lower LDL cholesterol and reduce other risk factors for heart disease. Yet, it may be noted that the findings are conflicting as some studies dispute the efficacy of using garlic in lowering cholesterol.

Berries: Berries are a great source of soluble fibre, which helps lower cholesterol levels. A research published in the Journal of Agricultural and Food Chemistry showed that blackberries have the highest LDL inhibitory effect, followed by red raspberries, sweet cherries, blueberries, and strawberries. Adding antioxidant-rich berries to your diet can help lower cholesterol and keep your heart healthy.

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Knee Osteoarthritis Exercises



Knee Osteoarthritis Exercises

1. Hamstring Stretch

Stretching keeps you flexible and improves your range of motion, or how far you can move your joints in certain directions. It also helps you lower your odds of pain and injuries.
Always warm up with a 5-minute walk first. Lie down when you’re ready to stretch your hamstring. Loop a bed sheet around your right foot. Use the sheet to help pull the straight leg up. Hold for 20 seconds, then lower the leg. Repeat twice. Then, switch legs.
2. Calf Stretch
Hold onto a chair for balance. Bend your right leg. Step back with your left leg, and slowly straighten it behind you. Press your left heel toward the floor. You should feel the stretch in the calf of your back leg. Hold for 20 seconds. Repeat twice, then switch legs.
For more of a stretch, lean forward and bend the right knee deeper — but don’t let it go past your toes.
3. Straight Leg Raise
Build muscle strength to help support weak joints.
Lie on the floor, upper body supported by your elbows. Bend your left knee, foot on the floor. Keep the right leg straight, toes pointed up. Tighten your thigh muscles and raise your right leg.
Pause, as shown, for 3 seconds. Keep your thigh muscles tight and slowly lower your leg to the ground. Touch and raise again. Do two sets of 10 repetitions. Switch legs after each set.
4. Quad Set
Is the straight leg raise too tough? Do quad sets instead. With these you don’t raise your leg. Simply tighten the thigh muscles, also called the quadriceps, of one leg at a time.
Start by lying on the floor. Keep both legs on ground, relaxed (left photo). Flex and hold left leg tense for 5 seconds (right photo). Relax. Do two sets of 10 repetitions. Switch legs after each set.
5. Seated Hip March
Strengthen your hips and thigh muscles. It can help with daily activities like walking or standing up.
Sit up straight in a chair. Kick your left foot back slightly, but keep your toes on the floor. Lift your right foot off the floor, knee bent. Hold the right leg in the air 3 seconds. Slowly lower your foot to the ground. Do two sets of 10 repetitions. Switch legs after each set.
Too hard? Use your hands to help lift your leg.
6. Pillow Squeeze
This move helps strengthen the inside of your legs to help support your knees. Lie on your back, both knees bent. Place a pillow between the knees.
Squeeze your knees together, squishing the pillow between them. Hold for 5 seconds. Relax. Do two sets of 10 repetitions. Switch legs after each set.
Too tough? You can also do this exercise while seated.
7. Heel Raise
Stand tall and hold the back of a chair for support. Lift your heels off the ground and rise up on the toes of both feet. Hold for 3 seconds. Slowly lower both heels to the ground. Do two sets of 10 repetitions.
Too tricky? Do the same exercise while sitting in a chair.
8. Side Leg Raise
Stand and hold the back of a chair for balance. Place your weight on your left leg. Stand tall and lift the right leg out to the side — keep the right leg straight and outer leg muscles tensed. Hold 3 seconds, then slowly lower the leg. Do two sets of 10 repetitions. Switch legs after each set.
Too hard? Increase leg height over time. After a few workouts, you’ll be able to raise it higher.
9. Sit to Stand
Practice this move to make standing easier. Place two pillows on a chair. Sit on top, with your back straight, feet flat on the floor (see left photo). Use your leg muscles to slowly and smoothly stand up tall. Then lower again to sit. Be sure your bent knees don’t move ahead of your toes. Try with your arms crossed or loose at your sides.
Too tough to do? Add pillows. Or use a chair with armrests and help push up with your arms.
10. One Leg Balance
This move helps you bend over or get in and out of cars.
Stand behind your kitchen counter without holding on, and slowly lift one foot off the floor. The goal is to stay balanced for 20 seconds without grabbing the counter. Do this move twice, then switch sides.
Too easy? Balance for a longer time. Or try it with your eyes closed.
11. Step Ups
Do this to strengthen your legs for climbing steps.
Stand in front of stairs, and hold onto the banister for balance. Then place your left foot on a step.  Tighten your left thigh muscle and step up, touching your right foot onto the step. Keep your muscles tight as you slowly lower your right foot. Touch the floor and lift again. Do two sets of 10 repetitions. Switch legs after each set.
12. Walking
Even if you have stiff or sore knees, walking may be a great exercise. Start slow, stand tall, and keep at it. You can ease joint pain, strengthen your leg muscles, improve your posture, and improve your flexibility. It’s also good for your heart.
If you’re not active now, check in with your doctor before you start a new exercise program.
13. Low-Impact Activities
Other exercises that are easy on the knees include biking, swimming, and water aerobics. Water exercise takes weight off painful joints. Many community and hospital wellness centers, gyms, and pools offer classes for people with arthritis.
Being active may also help you lose weight, which takes pressure off your joints.
For favorite activities, like golf, ask your doctor or physical therapist how to safely make painful moves hurt less.
14. How Much Exercise?
Thirty minutes a day is a good goal. Start small, like with 10 minutes every other day. If you don’t have pain, exercise more to meet the goal. 
Some mild muscle soreness is normal at first. It’s OK to work through it. Check with your doctor if you want to try over-the-counter pain relievers like acetaminophen, ibuprofen, or naproxen to ease the soreness. Ice can also help. Don’t ignore pain in your joints, though. Let your doctor know if you have any.

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Bad Habits for Your Back



Bad Habits for Your Back

The motto of Chiropractic Lane is “Motion is Health” – moving makes your body more healthy and that includes your back!  These are some suggestions to put you in the right mindset to always have a good back.

1.  Sit HunchedDo it too much, and it can flatten the natural curve of your spine and damage the cushioned disks between the bones. This can lead to early arthritis and other problems. Gently stretch and move your head and neck in all 4 directions every half hour. To ease any pain or spasm, try applying an ice pack or heating pad to the area. Be sure to cover the skin with a light towel or cloth first. See your doctor if the pain won’t go away. 

2.  Too Many “Treats”: Choosing the wrong foods too often can lead to inflammation and leave out nutrients you need to be strong. Your body needs lean protein, whole grains, fruits and veggies, and healthy fats like those from avocado and salmon to build strong muscles, bones, and soft tissue in your back. Be sure to get nutrients like calcium, phosphorus, and vitamin D, too.
3. Sleep on the Wrong MattressIt should be firm enough to support your back, but soft enough to fit the shape of your body. Your ideal mattress can depend on how you sleep and whether you already have back pain. Want to see if a firmer one might help? Put yours on the floor for a couple of nights without the bedsprings. Some stores let you return a mattress, even after several weeks, if it causes back pain or other problems. 
4.  Sleep on Your Back … For some people (not all people), this position can cause low back pain or make it worse. But it can be hard to change how you sleep, since it’s a habit you’ve probably had for a long time. It may help to put a rolled towel or pillow under your knees to keep the natural curve of your back. You also can try different pillow heights for your neck to find what’s comfortable.
5.  How Should You Sleep?  Side sleepers seem to have the most luck avoiding back pain. Slip a pillow between your legs to take pressure off your hips and lower back, and tuck your legs slightly toward your chest. This position can be especially comfortable for people who already have back pain and for pregnant women.
6.  Sit Too Long.  It stresses your back muscles, neck, and spine. Slouching makes it worse. Sit straight in a chair that supports your back, and set the height so your feet rest naturally on the floor. But no matter how comfortable you get, your back won’t like sitting for long stretches. Get up and move around for a couple of minutes every half hour to give your body a break. 
7.  Skip Exercise.  You’re more likely to have back pain if you’re not active. Your spine needs support from strong stomach and back muscles. Lifting weights can help. So can everyday activities like climbing stairs and carrying groceries. Low-impact exercises like walking, biking, or swimming can help protect the disks between the bones in your spine. Make it a habit for most days. Don’t be a “weekend warrior” who overdoes it and gets injured.
8.  Smoke.  Do it, and you’re 3 times more likely to get lower back pain. It can curb blood flow, including to your spine. That can make the cushioning disks between your bones break down quicker. It also can weaken bones and give you osteoporosis, and it can slow healing. Even coughs from smoking can cause back pain. If you smoke, make quitting your top health priority and ask your doctor for help.
9.  Overeat.  Extra pounds can strain the bones and muscles in your back, especially if you gain weight quickly. Eat slowly so that your body has a chance to let you know it’s full. Pick nutrition-packed munchies and meals so you feel satisfied with fewer caloriesSo if you snack on cheese or chips, try eating some veggies and plain yogurt instead.
10.  Overload Your Bag.  Heavy weights can strain your back and tire out muscles that you need to support your spine. This can affect kids who lug many books. Your child’s backpack shouldn’t weigh more than 20% of their body weight. Large, padded, adjustable shoulder straps help spread the weight evenly. But only if you use both straps. Slinging your pack or heavy purse over only one shoulder can cause strain.
11.  Ride the Wrong Bike.  Or just a badly adjusted one. It’s bad for your back if you have to hunch over to grab your handlebars the way pro cyclists do. (They train hard to do it safely.) You also may have back pain if you’re too stretched out or cramped up on your bicycle. A physical therapist can help you find a bike that’s a good fit and suggest exercises to help if you have lower back pain. 
12. Wear High Heels.  You may overuse muscles in your lower back and harm your posture and your spine, especially as you age. If you wear them at the office, you might bring a pair of walking shoes for your commute. Regular foot and leg stretches, like rolling your foot on a tennis ball, can help prevent pain and strengthen muscles.
13.  Should You Do Yoga?  Too much of any exercise — including yoga — can cause back pain (over-exertion or straining muscles). But in some cases, yoga can help relieve low back pain. There are lots of online resources and videos to help you get started. A yoga instructor can ensure that you use the proper form. Just 10-20 minutes a few times a week of this mind-body exercise might make you feel better. But don’t overdo it, and stop if it hurts.
14. Do Situps Incorrectly.  Never let them flatten the natural curve in your spine. You don’t want to let your hip flexor muscles, which connect your thighs and lower back, do the work. When those muscles are too strong or too tight, they pull the lower spine, which can cause pain. Front and side planks — where you support your stiff body on your hands, elbows, and feet — are easier on your back and build core strength better.

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Breathe Better at Home



Breathe Better at Home

I am not going to list the things that are obvious, such as pets, cockroaches, leaks, and so on.  These should be on your list by the simple fact that it makes sense to clean a home and look for these things.  I will list things you may forget or not know what to do with.

1. Cleaners: Some cleaners have harsh chemicals that can cause breathing problems or trigger an allergy or asthma attack. Read labels carefully and stay away from ones that have volatile organic compounds (VOCs), fragrances, or flammable ingredients. You can make your own cleaners with plain soap and water, vinegar, or baking soda.

2.  Houseplants: These can be more than nice to look at, especially if your home is energy-efficient or not well-ventilated. In addition to getting rid of carbon dioxide and boosting oxygen levels, some can even help clear the air of chemical vapors. Of these, the easiest to grow and keep healthy include English ivy, ficus trees, peace lilies, and certain types of palms.

3. Your HVAC: A dirty filter on your heating and air conditioning unit can keep air from flowing the way it should and lead to mold growth if it gets damp. Change it at least every 3 months and make sure it fits well. If you have asthma or allergies — or you have pets or a large family — you might want to check it once a month. It’s also a good idea for a professional to inspect the unit once a year.
4. Bathrooms: If there’s mold in your house, the tiny spores can float into your nose and even your lungs. That can lead to allergy symptoms, like coughing or sneezing, or other breathing issues. The fungus loves damp areas, so keep bathrooms dry. Turn on a fan or open a window to help move air after you shower, and hang up wet towels and washcloths. If you see mold in the tub or other areas, you may need to clean more often to help keep it at bay.
5. Forgotten Areas: Cabinet tops and vent hoods are a couple of places people sometimes forget to clean, along with behind toilets and under bathroom sinks. Wipe them down every so often with warm, soapy water. Give your pets’ dishes a daily wash, too, and check around for other areas that might collect grease, food, grime, or water.
6. Linens and Rugs: Wash sheets, pillowcases, blankets, and area rugs once a week in 130-degree F water to help get rid of dust, mold, mites, and other things that can affect your breathing. And get rid of throw pillows that don’t have zip-off covers. They collect dust mites and pet dander and can be hard to clean.

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What Exactly Is Metabolism—and Can You Speed Yours Up?



What Exactly Is Metabolism—and Can You Speed Yours Up?
(I did not write this but it does answer many questions)

The word “metabolism” is often paired with terms like “diet,” “exercise,” and “weight loss.” But rarely is the buzzword thoroughly explained. As a result, there’s a lot of metabolism misinformation floating around out there.
The medical definition of metabolism? “The bodily processes needed to maintain life,” according to the Mayo Clinic. “Through the process of metabolism, your body turns the food you eat into the energy it needs. It’s a vital process for all living things, not just humans.” The term encompasses all continual chemical processes that keep you alive, including breathing, digesting food, and repairing cells.
In other words, without your metabolism you wouldn’t feel the energy boost you get from eating a meal. Health spoke to registered dietitian nutritionist Nancy Farrell Allen, a spokesperson for the Academy of Nutrition and Dietetics, to set the record straight on some of the most popular claims about metabolism thrown around these days.
MYTH: Skinnier people have faster metabolisms
It’s more about body composition than body size when it comes to metabolism, Allen says. “[Metabolism] depends on the composition of protein mass you have—muscle is more metabolically active,” she says, meaning the more muscle you have, the more calories you burn when you’re resting. It’s not true that the thinner you are, the faster your metabolism. It instead comes down to how muscular you are.
This is why lifting weights is one of the best ways to speed up your metabolism. “You’re going to have more muscle on you,” Allen says, and muscle burns more calories. Focusing solely on cardio won’t have the same effect.
MYTH: Your metabolism is genetic and can’t be changed
Your genes do influence your metabolism—but they don’t affect it as much as the lifestyle habits you practice, according to Allen. The amount of exercise you get and the choices you make when you feed yourself are more important factors, and you (fortunately) are in of control them.
However, some genetic conditions can affect your metabolism. For example, Hashimoto’s disease, an often-hereditary condition that can result in an underactive thyroid gland, can slow your metabolism and lead to weight gain, according to the Cleveland Clinic.
FACT: If you have a slow metabolism, you’re more likely to gain weight
This is true, Allen says. Here’s why: If your metabolism is on the slower side, your body isn’t as quick to burn through the calories you’re consuming.
But your metabolism isn’t the only thing to consider when you’re trying to shed a few extra pounds. “Contrary to common belief, a slow metabolism is rarely the cause of excess weight gain,” according to the Mayo Clinic. “Although your metabolism influences your body’s basic energy needs, how much you eat and drink along with how much physical activity you get are the things that ultimately determine your weight.” In other words, even if you have a slow metabolism you can (thankfully) still control your weight by eating clean and working out.
MYTH: If you have a fast metabolism, you can eat whatever you want
Allen notes that people with a condition called Graves’ disease have overactive metabolisms and often lose weight even when they’re following an ordinary diet.
While it’s true that people with faster metabolisms don’t necessarily put weight on as quickly as those with slower metabolisms, a fast metabolism is not an excuse to throw traditional dietary advice out the window, Allen says. A balanced diet comes with seriously consequential health benefits unrelated to weight maintenance, including good heart health and the prevention of certain cancers.
FACT: Spicy foods boost your metabolism
Whether your preferred spice is chili pepper or ginger, “there is some interesting thought that they can boost the heat production in our bodies, leading to more calories being burned,” Allen says.
The effect is short-term, and how significant it is depends on “how hot the peppers are,” Allen says. “Lots of times, it’s uncomfortable,” she adds.
Adding just one tablespoon of chopped green or red chili pepper to your lunch or dinner could speed up your metabolism. Granted, the effect won’t last forever, but it could be worth that extra ingredient.
MYTH: Eating multiple smaller meals throughout the day is better for your metabolism than eating three regular meals a day
“A lot of times we tell people to eat five or six small meals a day, but there’s some research coming out saying maybe it’s better to eat two or three modest meals a day. When people hear they can eat five or six small meals they’re not eating small meals,” Allen says. She explains that often people don’t keep track of just how much they’re consuming on any given day.
The bottom line on this one, she notes, is that you must be mindful of how much you’re eating and what you’re eating. Don’t think only in terms of calories, she warns. “It’s not necessarily a simple calorie equation. Are you eating a 250-calorie donut for a snack, or a 250-calorie protein and produce snack?”
MYTH: Supplements can speed up your metabolism
Over-the-counter products that claim to boost metabolism are bound to disappoint. “They don’t have energy or calories,” Allen says, adding that they’re not going to directly impact your metabolism. The potentially dangerous side effects of supplements have been well documented, and you should keep in mind that supplements don’t always play well with prescription drugs.
FACT: Your metabolism slows down as you age
While this is a sad truth of aging, the news isn’t all bad: Your metabolism doesn’t hit a wall right when you turn 30, like some people might think. “You can control it a little bit,” Allen says, with the same lifestyle habits that always factor into the metabolism equation.
A slowing of your metabolism might be most noticeable around menopause in your 50s. “Once they go through menopause, [women] tend to have the most difficulty,” Allen explains. Hormonal changes that affect women when they go through menopause could increase their chances of putting on weight around their abdomens, hips, and thighs.

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Metformin (Safe and Cheap) Prevents Type 2 Diabetes Over 15 Years



Metformin (Safe and Cheap) Prevents Type 2 Diabetes Over 15 Years

Metformin continues to reduce the likelihood of developing type 2 diabetes among those at high risk for it over 15 years, particularly among those with higher baseline glycemia and women with a history of gestational diabetes mellitus (GDM).
Findings from the long-term follow-up of participants in the landmark Diabetes Prevention Program (DPP) were recently published online in Diabetes Care by the DPP Research Group.

The diabetes prevention benefit of metformin was seen in both relative and absolute risk reduction and regardless of whether the diagnosis was made by oral glucose tolerance testing, fasting blood glucose, or HbA1c (which was analyzed post-hoc as HbA1c wasn’t recommended for diagnosing diabetes when DPP started). 
“Whichever method you use, you get this persistent and durable benefit with metformin. To me, that’s the most important message,” lead author David M. Nathan, MD, director of the Diabetes Center at Massachusetts General Hospital, Boston, told Medscape Medical News in an interview. He added, “It’s not just 3 or 10 years, as we reported before, but goes on for 15 years. That’s a pretty powerful effect.”
Cheap, Well-Tolerated With Powerful Effects, Especially in Subgroups
“Metformin remains this incredibly safe, inexpensive [agent], that’s well-tolerated by most patients and it’s really one of the few drugs in the world that makes sense for [diabetes] prevention, just because we know so much about it and have been using it for so long. That’s why we selected it in the first place,” Nathan explained.
Moreover, the current analysis identified two groups of high-risk patients who experienced even greater risk reduction with metformin: those with blood glucose measures on the higher glycemic end of the “prediabetes” ranges and women with a history of GDM. “That doesn’t mean that others with prediabetes criteria don’t benefit, but that some subgroups have even more benefit,” Nathan noted.
However, he emphasized that use of metformin for diabetes prevention is off-label and because it’s been off-patent for more than a decade it’s unlikely that any pharmaceutical company would seek the indication. On the other hand, its low cost and safety record make it a desirable option as an adjunct to lifestyle approaches.
“There’s certainly an overall resistance to taking medicine for disease prevention. But on the other hand, how is this different from taking statins or blood pressure medications to prevent heart disease?” he wonders.
“It really isn’t different at all…This prevents diabetes, which is important because it leads to vision loss, renal failure, amputations, and heart disease. I think we would argue that preventing or delaying or reducing the risk for diabetes is, in and of itself, important.”

Diabetes Prevention Seen at 15 Years, Regardless of Analytic Method

In the original DPP trial, 3234 participants aged 25 years or older at high risk for type 2 diabetes were randomized to intensive lifestyle modification, metformin, or placebo. Of those, 1073 participants received metformin 850 mg twice daily and 1082 received masked placebo.
After DPP ended in 2001, all participants were offered a lower-intensity group version of the lifestyle intervention and those who had been randomized to metformin continued to take it during the observational follow-up, the Diabetes Prevention Program Outcomes Study (DPPOS).
All participants who develop diabetes during the DPPOS were referred back to their personal physicians, and many of those patients were again prescribed metformin.
Over the 15-year follow-up, the incidence of diabetes development was 17% lower among those in the original metformin group compared with the placebo group (hazard ratio, 0.83), with a rate difference of 21.25 cases/100 person-years, and diagnosis was based on a fasting and/or 2-hour glucose tolerance test.
When HbA1c was used for diagnosis, metformin was associated with a 36% relative risk reduction (hazard ratio, 0.64) and an absolute rate difference of 21.67 cases/100 person-years (all statistically significant.)
The effect of metformin versus placebo didn’t differ among those with baseline HbA1c below 6% (hazard ratio, 0.61 vs 0.63).
But among those with HbA1c 6.0% to 6.4%, metformin prevented significantly more cases of diabetes compared with those with an HbA1c below 6% (rate difference, –3.88 vs –1.03 cases/100 person-years; = .001).
And for women with a history of GDM, there was a significant 41% reduction in diabetes development with metformin versus placebo (hazard ratio, 0.59; P = .03). This relationship was even stronger by absolute rate difference (–4.57 vs –0.38/100 person-years, respectively; P = .01).
However, for parous women without a history of GDM the 6% difference between metformin and placebo wasn’t significant (HR, 0.94).
No major differences in metformin’s effect were seen by body mass index (BMI), and the benefit of metformin was lower in older age groups.

Will Metformin’s Label Be Changed?

Nathan noted that another trial taking place in the United Kingdom, the Glucose Lowering in Non-diabetic Hyperglycaemia Trial (GLINT), is examining whether metformin prevents cardiovascular outcomes in people at high risk for type 2 diabetes. Results are expected in December 2024.
But even if that trial combined with other data show further benefit for using metformin in people at high risk for developing type 2 diabetes, there’s no financial incentive for any pharmaceutical company to seek a label change by the US Food and Drug Administration or any other regulatory body worldwide.
However, there is another avenue in the United States: a “citizen’s petition” to the FDA.
This was used by three academic institutions and, in April 2016, the agency loosened the chronic kidney disease (CKD) restrictions for metformin, allowing it to be used in patients with moderate CKD (30-60 mL/minute/1.73m2).
“There is a movement underfoot to do the same for metformin as a preventative for diabetes,” Nathan said. “The cost of medicines is in the headlines every day. Here’s a drug that’s generic and incredibly inexpensive that may be appropriate for repurposing…If more data come out, it may be just what the drug companies hate — a drug that costs 10 cents a pill.”
However, he also cautioned, “remember what happened with aspirin…wonder drugs still need careful consideration of the data.”
During the DPP and DPPOS, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health provided funding to the clinical centers and coordinating center for the design and conduct of the study and collection, management, analysis, and interpretation of the data. Bristol-Myers Squibb and Parke-Davis provided additional funding and material support during the DPP. McKesson BioServices, Matthews Media Group, and the Henry M. Jackson Foundation for the Advancement of Military Medicine provided support services. Nathan has reported receiving study funding from Alere, now part of Abbott. 
Diabetes Care. Published online March 15, 2019. Full text

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Spinal manipulation can help ease low back pain



Spinal manipulation can help ease low back pain

Spinal manipulation therapy isn’t routinely recommended as the initial treatment for low back pain, but a research review suggests this approach may work as well as interventions that doctors typically prescribe first.

Based on data from 47 previously conducted trials involving a total of 9,211 mostly middle-aged adults, spinal manipulation eased lower back pain as much as exercise, non-steroidal anti-inflammatory drugs (NSAID) and painkillers. Spinal manipulation also appeared better for improving short-term function.

“At the moment, spinal manipulation is considered a second-line or adjunctive treatment option in international guidelines,” said lead study author Sidney Rubinstein of the Vrije Universiteit in Amsterdam.

“These results would suggest that spinal manipulation is certainly on-par with these other recommended therapies, and can be considered an option,” Rubinstein said by email.

Lower-back pain is one of the leading causes of disability and doctor visits for adults worldwide. It often goes away within a few weeks. But when it persists, lower-back pain might be treated with spinal manipulation, medications like painkillers or muscle relaxers, heat, exercise or physical therapy.

Spinal manipulation is often done by chiropractors but may also be offered by physical therapists or physicians. It can include manually moving joints, massage and exercise. This type of treatment is designed to relieve pressure on joints and curb inflammation and it’s often used for back, neck or shoulder pain as well as for headaches.

For the current study, researchers focused on the gold standard for determining the effectiveness and safety of medical treatments: randomized controlled trials that compare outcomes for patients who are randomly assigned to a specific treatment or to a dummy treatment or no treatment at all.

Spinal manipulation worked better for pain relief than non-recommended interventions like light tissue massage, the current analysis found.

It also worked better than sham manipulation treatments, but the evidence was low-quality, Rubinstein’s team notes in The BMJ.

About half of the studies looked at side effects of spinal manipulation and found little evidence to conclude whether or not this is safer than other approaches. In one study, researchers found one serious adverse event that could potentially have been associated with spinal manipulation.

One limitation of the analysis is that the studies of spinal manipulation were done in different settings, tested different techniques and measured the effectiveness of this intervention in different ways, the study authors note.

“Spinal manipulation may decrease pain from muscle strain, inflammation and spasm in your back muscles and/or impact the way that your body perceives pain through either the brain or the spinal cord,” said Christine Goertz, chief executive officer of the Spine Institute for Quality in Oskaloosa, Iowa.

“The most common side effects resulting from spinal manipulation are mild to moderate joint or muscle pain and/or stiffness,” Goertz, who wasn’t involved in the study, said by email. “These symptoms generally go away on their own within a day or two.”

SOURCE: bit.ly/2I7Y1as The BMJ, online March 13, 2019.

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