Also: Running for health, just a little is good; Alcohol and fatigue.

July 31, 2014 July 31, 2014 Want more energy? Here’s what really helps Do you sometimes feel like the Energizer Bunny with a weak battery? You start out strong, but by midafternoon you’re starting to flag. We all get tired from time to time, but fatigue tends to become more common as we get older. Assuming your doctor has ruled out medical causes for persistent fatigue, there are a few basic steps you can take to feel more energetic day to day. Get your copy of Boosting Your Energy Fatigue is a symptom, not a disease, and it’s experienced differently by different people. Fatigue from stress or lack of sleep usually subsides after a good night’s rest, while other fatigue is more persistent and may be debilitating even after restful sleep. Harvard’s Special Health Report Boosting Your Energy provides advice and information from world-renowned medical experts that can help you discover the cause of your fatigue and find the right treatment or lifestyle changes. Consider these strategies to get the most mileage from your battery: Pace yourself. Instead of burning though all your battery life in two hours, spread it out between morning tasks, afternoon tasks, and evening activities — with rest and meals in between. Take a walk or a nap. A short power nap can restore energy, but if you struggle to get enough sleep at night, napping can make insomnia worse. Rather than take a siesta, get moving. Get up and walk around the block, or just move around. If you are not an insomniac, though, enjoy that 20- to 30-minute power nap. Skip most supplements. There is no evidence that energy-boosting or “anti-aging” supplements work. In particular: DHEA. There is absolutely no evidence that that DHEA provides any benefit. And you especially shouldn’t be buying it from ads in the back of a magazine, because you don’t know what’s in it. Iron. Iron is only beneficial if you are clearly deficient, which a doctor can check with a blood test. Unless you are low in iron, you don’t need to take it, and getting too much iron can be harmful. B vitamins. It is true that B vitamins (B1, B2, B6, B12) help the body convert food into the form of energy that cells can burn, but it’s a myth that taking in more B vitamins supercharges your cells. Eat long-lasting fuel. Your body burns through sugars and highly processed carbohydrates, like white bread, white rice, or prepared bakery goods, more rapidly than protein and the carbohydrates in whole grains. Instead, try low-fat yogurt with a sprinkling of nuts, raisins, and honey. Your body will take in the carb-fiber-protein mix more gradually. To really sustain yourself over the course of the day, eat a breakfast and a lunch that include complex carbohydrates and protein. Don’t skip meals. It’s better to evenly space your meals out so your body gets the nourishment it needs all through the day. For additional advice on ways to stay energized throughout your day, buy Boosting Your Energy, a Special Health Report from Harvard Medical School. Share this story: News and Views from the Harvard Health Blog Running for health: Even a little bit is good, but a little more is probably better Marathoners are the thoroughbreds of high-performance runners, but even the draft horses of the running world — slow and steady joggers — improve their health. Just five to 10 minutes a day of low-intensity running is enough to extend life by several years. Alcohol and fatigue Many people think that a little nightcap will help them sleep soundly through the night. Although alcohol’s sedative effects can make you drowsy, they also have other effects that can interfere with quality sleep. Several hours after that nightcap, the alcohol raises the body’s level of epinephrine, a stress hormone that increases the heart rate and generally stimulates the body, which can result in nighttime awakenings. Indeed, alcohol may account for 10% of cases of persistent insomnia. Alcohol also relaxes throat muscles, and this relaxation can worsen sleep-related breathing problems and contribute to sleep apnea. What’s more, alcohol may increase the need to urinate during the night — just another way in which it can disrupt sleep. Alcohol’s sedative quality can rob you of energy in another way. Drinking wine, beer, or hard liquor during the day can make you feel drowsy or lethargic. If you didn’t sleep well the night before, even one drink can make you drowsy, especially if you drink during one of your usual low-energy times — for example, midafternoon or late evening. One beverage that can boost your energy is plain old water. One of the first signs of being short on fluids is a feeling of fatigue and weakness. Approximately 50% to 60% of your body weight is water, and you are constantly losing water through urine, sweat, and breathing. This water needs to be replenished. Consuming a sufficient amount of fluids in beverages and water-filled foods (such as fruits, vegetables, and soup) will help you maintain your energy. To learn more about an energy-boosting lifestyle, buy Boosting Your Energy, a Special Health Report from Harvard Medical School. Share this story: Featured in this issue Boosting Your Energy Featured content: • What is energy? • Energy and food • Energy and exercise • Energy and sleep • Energy and stress •  ... and more! Click here to read more » Harvard Medical School offers special reports on over 50 health topics. Visit our website at http://www.health.harvard.edu to find reports of interest to you and your family. PHONE ORDERS - please call our toll-free number: 1-877-649-9457. You are currently subscribed to HEALTHbeat as BrendaModica252@gmail.com. EDIT YOUR SUBSCRIPTION PROFILE UNSUBSCRIBE SUBSCRIBE TO HEALTHbeat VIEW HEALTHbeat ARCHIVES Visit our website at: www.health.harvard.edu Email us at: healthbeat@health.harvard.edu FOLLOW US ON:  Facebook Twitter Copyright © 2014 by Harvard University. Harvard Health Publications, 10 Shattuck Street, 2nd Floor, Boston, MA 02115, USA * Please note, we do not provide responses to personal medical concerns, nor can we supply related medical information other than what is available in our print products or website. For specific, personalized medical advice we encourage you to contact your physician.

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Harvard Health Publications Focus On Blood Pressure: Part 4

Focus On: Blood Pressure — How to measure your blood pressure at home In this Issue: How to measure your blood pressure at home View this e-mail as a Web page » To ensure delivery of our e-mails, add healthbeat@mail.health.harvard.edu to your address book. Please note this is for outgoing mail only. If you need help, please contact healthbeat@health.harvard.edu. Share with a friend » | Unsubscribe »

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Featured Report Get your copy of Exercise: A program you can live with This report answers many important questions about physical activity, from how your body changes through exercise to what diseases it helps prevent. It will also help guide you through starting and maintaining an exercise program that suits your abilities and lifestyle. Throughout, you'll find advice on being a savvy consumer when it comes to Blood Pressure products, as well as useful tools and tips designed to help make exercise work for you. Click here to read more » In the Next Issue Should you worry about blood pressure that's high from time to time? Additional Resources •   Strength and Power Training: A guide for adults of all ages How to measure your blood pressure at home Last week's issue of Focus On: Blood Pressure discussed the many benefits of measuring your blood pressure at home. This article gives you the practical tips you need to make sure you do it right. Picking the right machine There are dozens of different home blood pressure monitors on the market. For best accuracy and ease of use, buy one with a cuff for the upper arm that automatically inflates and automatically records the pressure. The American Heart Association doesn't recommend wrist or finger home blood pressure monitors. Models that store readings for a week or two can simplify record keeping. The British Hypertension Society lists machines they recommend on their Web site: http://www.bhsoc.org/blood_pressure_list.stm. And the September 2008 issue of Consumer Reports compared home blood pressure and blood sugar monitors. The ReliOn HEM-74CREL ($50) got a "best buy" rating, while the Omron Elite 7300W ($75 to $100) was the top-rated machine. Do it right When it comes to measuring blood pressure, technique matters. Doing it wrong can give you a reading that's too high or too low. (See a brief video on using a home blood pressure monitor.) Taking your blood pressure at home To get the most accurate blood pressure reading, support your arm at heart level, wrap the cuff around your bare upper arm, and follow the directions on your machine. There are two things to do before you start. First, check your machine against the one in your doctor's office. Second, make sure you have the right size cuff—the inflatable part should encircle at least 80% of your upper arm. When you first start to check your blood pressure at home, measure it early in the morning, before you have taken your blood pressure pills, and again in the evening, every day for a week. After that, follow the plan your doctor recommends, or check it one or two days a month. Each time you take a reading: Avoid caffeinated or alcoholic beverages, and don't smoke, during the 30 minutes before the test. Sit quietly for five minutes with your back supported and feet on the floor. When taking the measurement, support your arm so your elbow is at the level of your heart. Push your sleeves out of the way and wrap the cuff over bare skin. Measure your blood pressure according to the machine's instructions. Leave the deflated cuff in place, wait a minute, then take a second reading. If the readings are close, average them. If not, repeat again and average the three readings. Don't panic if a reading is high. Relax for a few minutes and try again. Keep a record of your blood pressure readings and the time of day they are taken. Checking blood pressure at home won't cure hypertension, but it will help control the most common cause of stroke and a big contributor to heart attack, heart failure, and premature death.

Featured In This Issue Exercise: A program you can live with Featured Content: • Creating a personal exercise plan • 12 strength training exercises • 10 basic stretches • Choosing exercise equipment wisely Click here to read more »

Harvard Medical School offers special reports on over 50 health topics. Visit our Web site at http://www.health.harvard.edu to find reports of interest to you and your family. Copyright © 2010 by Harvard University. E-mails from our "Focus On" series are sent to individuals who have subscribed via the Harvard Health Publications Web site. You are currently subscribed to this series as BrendaModica252@gmail.com Your privacy and security matter to us. Read our privacy policy to learn more. PHONE ORDERS To order a subscription or special health report by phone, please call our toll-free number: 1-877-649-9457. UNSUBSCRIBE This e-mail is being sent to you as a subscriber to the "Focus On Blood Pressure" e-mail newsletter series. If you would like to be removed from this list, please use this link to unsubscribe. SUBSCRIBE TO OTHER FREE E-MAIL NEWSLETTERS Subscribe to other free e-mail newsletters from Harvard Medical School. SUBSCRIBE TO HEALTHbeat Sign up to receive HEALTHbeat, our free weekly e-newsletter. Harvard Health Publications 10 Shattuck Street, 2nd Floor Boston, MA 02115, USA Visit our Web site at: www.health.harvard.edu E-mail us at: HEALTHbeat@health.harvard.edu Follow us on: * Please note, we do not provide responses to personal medical concerns, nor can we supply related medical information other than what is available in our print products or Web site. For specific, personalized medical advice we encourage you to contact your physician.

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Harvard Health Publications Focus on Cholesterol: Part 4

Focus On: Cholesterol — Should you take a statin even if you have normal cholesterol? In this Issue: Should you take a statin even if you have normal cholesterol? View this e-mail as a Web page » To ensure delivery of our e-mails, add healthbeat@mail.health.harvard.edu to your address book. Please note this is for outgoing mail only. If you need help, please contact healthbeat@health.harvard.edu. Share with a friend » | Unsubscribe »

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Featured Report Get your copy of Harvard Heart Letter The Harvard Heart Letter provides eight pages of monthly heart news for readers who may already suffer from heart disease (or their family members) and for people concerned about their risk who wish to take steps towards positive change. The Harvard Heart Letter is your trustworthy source of heart health information. It will put you in closer touch with everything that's happening right now in the frontiers of cardiac medicine. With every issue the focus is on the latest medical advances that can help you live a longer, healthier life. Click here to read more » In the Next Issue A change in thinking about atherosclerosis—how it forms, how it's treated Additional Resources •   Living with Heart Failure •   Healthy Eating: A guide to the new nutrition •   Beating Heart Disease: Strategies for a healthy heart •   Healthy Eating for a Healthy Heart Should you take a statin even if you have normal cholesterol? The statin drugs are best known for their ability to lower LDL ("bad") cholesterol. High levels of LDL cholesterol can lead to heart disease. If your LDL cholesterol is not high, you probably think you don't need to take a statin. But a study nicknamed JUPITER may make you—and your doctor—question that assumption. The JUPITER trial The JUPITER trial was a large international study that found that the statin drug rosuvastatin (Crestor) slashed the rate of heart attacks and strokes in people with normal LDL cholesterol who had elevated levels of C-reactive protein (CRP). CRP is a marker of inflammation, and there is increasing evidence that low-grade inflammation raises heart risk. The study involved 17,802 apparently healthy people from 26 countries. There were slightly more men than women—about a 60%-40% split. Here are some of their stats: The men were 50 and over and the women were 60 and over—the ages when cardiovascular risk begins to rise. Participants had no history of heart attacks or strokes, and their LDL cholesterol levels were below 130 milligrams per deciliter (mg/dL). The average LDL cholesterol was 108 mg/dL, a level considered excellent for people with no cardiovascular risk factors. The participants had high CRP levels, ranging from 2 to 7 milligrams per liter (less than 1 milligram per liter is considered normal). Subjects were randomly assigned to take either 20 mg of Crestor or a placebo pill daily. They were monitored for cardiovascular events—heart attacks, strokes, bypass surgery or angioplasty, hospitalization for unstable angina, and death from a cardiovascular cause. The results JUPITER was designed to last for four years, but it was halted just short of two years because the statin takers were doing so much better than those taking the placebo. For example, people taking a statin: were 54% less likely to have a stroke were 48% less likely to have a heart attack were 44% less likely to have any serious cardiovascular event, including cardiovascular death lowered their LDL levels by an average of 50% lowered their CRP levels by an average of 37%. In the placebo group, CRP levels and LDL levels did not change. Side effects, such as muscle pain and problems with liver or kidney function, were the same in the two groups. However, there may have been an increase in diabetes among those taking Crestor. Results of the study were published in The New England Journal of Medicine (online Nov. 9, 2008, and in print Nov. 20, 2008). Some caveats First, it's important to note two areas of potential conflicts of interest: The study was funded by Astra Zeneca, the maker of Crestor. The patent rights to the hsCRP test are owned by the lead investigator, Dr. Paul M. Ridker, and Harvard-affiliated Brigham and Women's Hospital in Boston. Next, although Crestor reduced the risk of cardiovascular events to a statistically significant degree, the numbers involved were small. Among 17,802 participants, only 393 cardiovascular events occurred. There were 142 in the Crestor group (a 1.6% rate) and 251 in the placebo group (a 2.8% rate). With these results, about 95 people would need to be treated for two years to prevent a single cardiovascular event. Public health experts have to consider such numbers because they must weigh the absolute benefits against the costs and risks. Crestor, which is not available in a generic form, costs about $1,200 a year. Most people who take a statin take it for more than two years. Since the JUPITER study lasted only two years, it leaves questions about the long-term safety of people with above-normal CRP levels but normal LDL levels taking Crestor. The dose used in this study was higher than the typical starting dose of Crestor. Again, this raises questions about safety. The people taking Crestor in this study attained very low LDL levels. We don't know if maintaining them for longer than two years would be healthy, or continue to reduce cardiovascular risk as much as it did in the study. The possible small increase in diabetes risk found in study participants taking Crestor could mean trouble: diabetes is a major risk factor for heart attack, stroke, and death from cardiovascular disease. What this means to you Should you get an hsCRP test? The answer depends on your overall cardiovascular risk. The time-honored Framingham model uses age, cholesterol levels, blood pressure, smoking status, and diabetes to calculate a person's 10-year chance of having a heart attack. To calculate your Framingham risk score, go to www.nhlbi.nih.gov/guidelines/cholesterol/risk_tbl.htm. If your risk is high... You probably don't need the hsCRP test because you should be taking a statin anyway. If your risk is low... You probably don't need the test because it's still not clear that the benefit outweighs the cost and possible risk. If your risk is moderate... HsCRP results might help determine whether a statin, in addition to lifestyle changes, could reduce your risk of a heart attack or stroke. Talk to your doctor about it. If you do get a CRP test, you can then reassess your cardiovascular risk using the newer Reynolds model (www.reynoldsriskscore.org). Unlike the Framingham tool, the Reynolds model adds hsCRP and some other factors to predict cardiovascular risk. The model reclassifies many people whose Framingham scores place them at moderate risk—sometimes into a higher risk category, sometimes into a lower risk one. Your reason for taking a statin should still be your risk of having a heart attack. To find out about current LDL cholesterol goals and when you should consider taking a statin, consult the Adult Treatment Panel III Guidelines developed by the U.S. National Cholesterol Education Program, available at www.nhlbi.nih.gov/guidelines/cholesterol/atglance.htm. Statins have revolutionized cardiovascular disease prevention, and you should certainly take one if you have the appropriate risk factors. But also do everything you can to keep your statin dose low through exercise and diet to lower your LDL cholesterol.

Featured In This Issue Harvard Heart Letter Featured Content: • hypertension guidelines: how low should your blood pressure be, and what can you do to lower yours • the good and the bad of cholesterol and steps you can take to manage your cholesterol levels–and just low your cholesterol target should really be • how best to prepare for a cardiac emergency • does eating fish really help prevent heart disease Click here to read more »

Harvard Medical School offers special reports on over 50 health topics. Visit our Web site at http://www.health.harvard.edu to find reports of interest to you and your family. Copyright © 2010 by Harvard University. E-mails from our "Focus On" series are sent to individuals who have subscribed via the Harvard Health Publications Web site. You are currently subscribed to this series as BrendaModica252@gmail.com Your privacy and security matter to us. Read our privacy policy to learn more. PHONE ORDERS To order a subscription or special health report by phone, please call our toll-free number: 1-877-649-9457. UNSUBSCRIBE This e-mail is being sent to you as a subscriber to the "Focus On Cholesterol" e-mail newsletter series. If you would like to be removed from this list, please use this link to unsubscribe. SUBSCRIBE TO OTHER FREE E-MAIL NEWSLETTERS Subscribe to other free e-mail newsletters from Harvard Medical School. SUBSCRIBE TO HEALTHbeat Sign up to receive HEALTHbeat, our free weekly e-newsletter. Harvard Health Publications 10 Shattuck Street, 2nd Floor Boston, MA 02115, USA Visit our Web site at: www.health.harvard.edu E-mail us at: HEALTHbeat@health.harvard.edu Follow us on: * Please note, we do not provide responses to personal medical concerns, nor can we supply related medical information other than what is available in our print products or Web site. For specific, personalized medical advice we encourage you to contact your physician.

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