OCTOBER 11 2019
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LIVING A HEALTHY LIFESTYLE
ALCOHOL AND HEART HEALTH: SEPARATING FACT FROM FICTION INSIDE THIS ISSUE:
MOST COMMON MENTAL HEALTH ISSUES
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10 OF THE BEST BRAIN FOODS
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EDITOR’S TIPTALK
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4 WAYS TO BOUNCE BACK STRONG AS YOU AGE
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SEVEN WAYS TO GET A HEALTHIER NIGHT'S SLEEP
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THE TRUTH ABOUT TAKING VITAMINS & SUPPLEMENTS
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help to slightly raise levels of “good” HDL cholesterol. Researchers have also suggested that red wine, in particular, might protect the heart, thanks to the antioxidants it contains.
Does a glass of wine a day keep the doctor away? There’s a popular belief that alcohol — especially red wine — is good for the heart. But the truth isn’t so clear-cut, says Johns Hopkins cardiologist John William (Bill) McEvoy, M.B.B.Ch., M.H.S. Here’s what you should know before you raise a glass to your health. Does Alcohol Protect Against Heart Problems?
SPECIAL POINTS OF INTEREST: • MODERATE DRINKING IS DEFINED AS AN AVERAGE OF ONE DRINK PER DAY FOR WOMEN AND ONE OR TWO FOR MEN • There is some evidence that moderate amounts of alcohol might help to slightly raise levels of “good” HDL cholesterol.
Some studies have shown an association between moderate alcohol intake and a lower risk of dying from heart disease. But it’s hard to determine cause and effect from those studies, says McEvoy. Perhaps people who sip red wine have higher incomes, which tend to be associated with more education and greater access to healthier foods. Similarly, red wine drinkers might be more likely to eat a heart-healthy diet. There is some evidence that moderate amounts of alcohol might
But you don’t have to pop a cork to reap those benefits. Exercise can also boost HDL cholesterol levels, and antioxidants can be found in other foods, such as fruits, vegetables and grape juice How Much Alcohol Is Too Much? Whether or not moderate drinking is good for your heart is open to debate. However, for most people, it doesn’t appear to be harmful to the heart, McEvoy says — but the key word is “moderate.” Moderate drinking is defined as an average of one drink per day for women and one or two for men. A drink might be less than you think: 12 ounces of beer, 4 ounces of wine or 1.5 ounces of 80-proof spirits. Some people should avoid even that much, McEvoy adds. He advises patients not to drink at all if they have certain heart rhythm abnormalities or have heart failure. “There are certain
situations where it’s best the patient doesn’t drink any alcohol,” he says. Does Excessive Drinking Contribute to Heart Disease? Heavy drinking, on the other hand, is linked to a number of poor health outcomes, including heart conditions. Excessive alcohol intake can lead to high blood pressure, heart failure or stroke. Excessive drinking can also contribute to cardiomyopathy, a disorder that affects the heart muscle. What’s more, alcohol can contribute to obesity and the long list of health problems that can go along with it, McEvoy says: “Alcohol is a source of excess calories and a cause of weight gain that can be harmful in the long term.” The takeaway, McEvoy says, it’s what you probably already know: If you choose to drink alcohol, stick to moderate levels of drinking, and don’t overdo it. “We’re not talking about going out and drinking yourself merry and then expecting good heart outcomes,” McEvoy says.
WEEKLY REPORT
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SEVEN WAYS TO GET A HEALTHIER NIGHT'S SLEEP turbed sleep—or keep you from sleeping at all, researchers have found. In a 2018 study, researchers learned that consuming 400 mg of caffeine (the amount in two to three cups of coffee or one 20-ounce coffee drink) six hours before bed cut total sleeping time by more than an hour.
“Humans are essentially the only mammals that willingly deprive themselves of sleep,” says sleep expert Rachel Salas, M.D. And plenty more people wake up feeling tired, thanks to insomnia or more subtle sleep disturbances caused by problems like nighttime reflux and sleep apnea. “But our need for sleep is still there,” Salas says. In fact, missing out on your fair share of high-quality sleep can boost your risk for depression, becoming overweight or obese, type 2 diabetes, high blood pressure, heart disease, and memory and concentration problems— and can even make you look older. Yet research suggests that many of us are still taking wrong turns that keep us from getting the sleep we need and deserve. Here are proven solutions that can put you on the right path to better sleep. Know when to watch the clock. It’s normal to take 10 to 20 minutes to fall asleep after lights-out. If you’re dropping off within five minutes or find yourself falling asleep during the day, you’re likely not getting enough sleep. But if you’re still tossing and turning after 20 to 30 minutes, get up. Go read a book or listen to relaxing music until you feel sleepy, then return to your bed. It’s one way to train your mind to associate your bed with sleeping instead of struggling, research has shown. Don’t underestimate caffeine. It takes nearly six hours for half of the caffeine from your favorite coffee, tea or cola to exit the body. Caffeine too late in the day can cause lighter, more dis-
Skip the nightcap. An estimated 10 percent of older adults use alcohol to overcome insomnia. It seems to help ... but is actually harmful. A recent review confirms that an alcoholic drink before bed can help you fall asleep faster. But it reduces the amount of time you spend in deeper sleep stages that affect memory, concentration and even physical coordination. Trade sleep aids for sleep hygiene. One in five older adults turn to drugstore sleep remedies, which often contain antihistamines that can cause dangerous daytime drowsiness (and can mask a fixable sleep problem). Instead, try upgrading your sleep habits. Salas suggests these steps for natural, high-quality sleep: A bedtime ritual: Put on your pajamas. Relax. Avoid stressful activities, like working or having tense discussions. A peaceful bedroom: “Some people have a desk in their bedroom with bills on it and constant reminders of all the things they need to do,” Salas says. Instead, keep this room free of distracting clutter.No electronics at least 30 minutes before bed: Darkness in the evening helps our brains prepare for sleep. Staring at the light from your phone, computer or television throws off your brain’s internal clock.
Rule out health problems. Conditions like gastroesophageal reflux disease and obstructive sleep apnea can rob you of quality sleep. If you have heartburn, talk with your doctor about reflux treatments that can ease nighttime reflux. You may have sleep apnea if you snore loudly and gasp or seem to choke at night as tissue in your throat blocks your airways, causing you to momentarily stop breathing. If you share a bedroom, ask, “Do I snore loudly or gasp for breath at night?” Treatments, including weight loss and wearing a pressurized mask for better breathing, can reverse apnea. Still tossing and turning? Cognitive behavioral therapy (CBT) for insomnia retrains your body and mind for deep sleep. In one study, CBT was more effective than prescription sleeping pills at helping people with insomnia fall asleep faster and stay asleep with fewer interruptions. A year later, they were still sleeping well— without drugs. Ask your health care provider how to give it a try. Consult with a sleep expert. If you’re struggling with lack of sleep, talk to your health care provider. However, Salas’s research as a Johns Hopkins sleep expert has found that doctors often get little training on sleep problems during medical school. If you can’t resolve your problems with your health care provider’s help, consider visiting a sleep specialist. This expert can help figure out if such problems as restless legs syndrome or chronic pain are keeping you from sleeping well. Definitions Sleep apnea (ap-ne-ah): A disorder in which your breathing repeatedly stops or becomes very shallow as you sleep. Your breathing may pause anywhere from a few seconds to a few minutes.
This ongoing condition disrupts your sleep, making you tired during the day and increasing your risk for heart problems, diabetes, obesity and driving or workrelated accidents. Restless legs syndrome (RLS): A disorder that creates a strong urge to move your legs often because you notice strange or unpleasant sensations: creeping, crawling, pulling, itching, tingling, burning, aching and even electric shocks. When you move your legs, it relieves the strange sensations. The unpleasant feelings are strongest when you are resting or inactive, and they can make it difficult to fall or stay asleep. Gastroesophageal (gas-tro-e-soph -a-ge-al) reflux disease (GERD): A condition in which some of the contents from your stomach flow backward, up into your esophagus, causing heartburn. (Usually, food and beverages travel in one direction: down the esophagus and into the stomach.) Because some of the stomach’s digestive juices contain acid, this condition is also sometimes called acid reflux or acid indigestion. Cognitive behavioral therapy (CBT): Two different psychotherapies—cognitive therapy and behavioral therapy— in one. Cognitive therapy can help you improve your mood by changing unhelpful thinking patterns. Behavioral therapy helps you identify and solve unhealthy habits. When used in conjunction with each another, these therapies have been shown to improve problems such as depression, anxiety, bipolar disorder, insomnia and eating disorders.