Month: November 2022

Busy days make it hard to put heart health on the front burner. It just feels like you don't have time for habits that keep the ticker in top shape — like exercising regularly, getting enough sleep, and eating a healthy diet. So maybe you take the stairs when you can, or you park farther away from a store to rack up a few extra steps each day. But what else can you do? Here are three things that might fit in your schedule.

Swap electronic communication for an in-person meeting

It's fine if texting, emailing, social media, or Zoom calls are your primary means of communicating with others. But it's not okay if those methods leave you feeling lonely or isolated — two problems linked to higher risks for heart disease, heart attack, or stroke, according to a scientific statement from the American Heart Association in the Journal of the American Heart Association.

To combat loneliness and isolation, try to replace some of your electronic back-and-forth with people with in-person meetings. Maybe you can find room in your schedule for a quick walk, cup of coffee, or brief lunch with a friend or colleague.

"Time spent face-to-face helps connect you to others and may make you feel less isolated," explains Matthew Lee, a sociologist and research associate at Harvard University's Human Flourishing Program. "Being physically co-present can help you feel more engaged with others, more valued, and more likely to feel a sense of shared identity — all things that may help ease loneliness. This is why some doctors are starting to engage in 'social prescribing,' including suggesting that people get involved in volunteering and other activities that build in-person social relationships."

A recent study published in the International Journal of Public Health by Lee and a team of Harvard-led researchers suggests that better social connectedness may reduce the risk of being diagnosed with depression or anxiety. Both are associated with heart disease or making existing heart conditions worse.

Swap an unhealthy breakfast for a healthier one

Is your typical breakfast something quick and full of refined (not whole) grains, processed meat, saturated fat, or added sugar? Eating that kind of food regularly may drive up calories, weight, blood sugar, or cholesterol levels — and that's not good for your heart.

Instead, choose breakfast foods rich in fiber, a type of carbohydrate that either passes through the body undigested (insoluble fiber) or dissolves into a gel (soluble fiber) that coats the gut.

Not only does fiber help digestion, it also

• traps, mops up, and lowers bad [LDL] cholesterol that can lead to clogged arteries
• controls blood sugar and lowers the risk for diabetes, which is strongly associated with heart attacks and strokes
• may help fight chronic inflammation, which plays a role in clogging arteries and causing heart attacks.

Fruits, nuts, seeds, whole grains (oats, barley, quinoa) and many other foods are rich in fiber. Try these fiber-rich breakfast ideas:

• microwaved oatmeal (heat a 1/2 cup of oatmeal with almost a cup of low-fat milk for about two minutes)
• a serving of cooked quinoa (cold, if you have it in your fridge) with a dollop of nonfat Greek yogurt, berries, and granola
• whole-grain cereal with milk (go for cereals with the highest amounts of whole grains and lowest amounts of added sugars)
• a slice of whole-grain toast with two tablespoons of nut butter (like almond or peanut butter)
• one or two handfuls of homemade trail mix (use your favorite unsalted nuts, sunflower seeds, and dried fruit such as raisins or apricots).

Swap a few minutes of scroll time for meditation time

If you ever take a break from your busy day to scroll through news on your phone or computer, chances are you can also find a little time to meditate, which is important for heart health. Research indicates that people who meditate have lower rates of high cholesterol, diabetes, high blood pressure, stroke, and coronary artery disease compared with people who don't meditate.

What's the connection? Meditating triggers the body's relaxation response, a well-studied physiological change that appears to help lower your blood pressure, heart rate, breathing rate, oxygen consumption, adrenaline levels, and levels of the stress hormone cortisol.

The great news: it doesn't take much time to reap the heart-healthy benefits of meditating — just about 10 to 20 minutes per day.

Ideas for quick ways to meditate in a busy day include sitting quietly, closing your eyes, and

• focusing on your breathing, without judging sounds you hear or thoughts that pop into your head
• listening to a guided meditation, which uses mental images to help you relax
• listening to a recording of calming sounds such as waves, a bubbling brook, or gentle rain.

Just try to calm your brain for a few minutes a day. Soon, you may find you've become better at meditating and better at practicing other heart-healthy habits, no matter how busy you are.

About the Author

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

There are warnings just about everywhere you look: The coffee you're about to drink is hot! Construction ahead! This product may contain peanuts!

In many cases, the reasons for these warnings are clear. But sometimes warnings raise more questions than they answer. When I was at the gym recently, these warnings on the exercise bike and treadmill were hard to miss in a bright red font:

• Obtain a medical exam before beginning any exercise program.
• Overexercise may result in serious injury or death.
• If you feel faint, dizzy, or have pain stop exercising immediately.

What exactly did the warning writers mean by "any exercise program"? What constitutes overexercise? Does having any pain anywhere mean you should stop working out?

Finally, I wonder: might these warnings cause unnecessary worry that actually discourages people from exercising?

Is it safe to start exercising without checking with a doctor?

A doctor's approval isn't necessary for most of us. Most people can safely begin a low-intensity exercise program and slowly increase their efforts over time. Choose activities that would allow you to carry on a conversation, such as:

• using light weights that are easy for you to lift
• walking at a leisurely pace
• biking at a leisurely pace (less than 5 mph)
• stretching and balancing activities
• light housework or yard work.

If you're starting at a low fitness level, make small increases in your workout over time. For example, if you start out walking 10 minutes a day, add one minute to your walk every week or two. Once you're walking 20 minutes a day, try picking up the pace a bit.

Who should be careful about exercising?

Of course, exercise is riskier if you have certain health conditions. It makes sense to ask a health care professional to make exercise recommendations if you're concerned about your health or have any of these conditions:

• Coronary artery disease, including symptoms of angina or a previous heart attack. Exercise that's too much too soon could stress the heart and trigger a heart attack or dangerous heart rhythm. Lower-intensity workouts (such as short walks at a comfortable pace) may be preferable, at least until it's clear that you can tolerate more.
• Exercise-induced asthma. Your doctor may recommend inhaled treatment to open up airways in your lungs just before or during exercise.
• Muscle disease, such as a metabolic myopathy. Your doctor may discourage you from engaging in certain exercises, such as sprinting or long-distance running.
• Back pain. Low impact exercise, such as biking or swimming, may be a better choice for people with back pain than higher-impact options, such as jogging or basketball.

If exercise is so good for you, why the warnings?

Let's review possible reasons for certain warnings:

• Having a medical examination before starting an exercise program might uncover a condition that makes exercise risky. The best example is probably coronary artery disease, which could trigger a heart attack during intense exercise. Fortunately, sudden heart problems during exercise are relatively rare (though you might think otherwise based on TV and movies, including an episode from the Sex and the City reboot).
• Overexercise is not a well-defined medical term. But it's true that suddenly exercising at high intensity when you're not used to it might be hazardous.
• Stopping exercise if you're feeling faint or dizzy presumably refers to concerns about severe dehydration or other causes of low blood pressure.
• Warnings about pain could refer to chest pain that might be a sign of heart trouble. Or it could be a warning about a type of severe muscle damage called rhabdomyolysis (which may complicate prolonged or intense exercise).

Of course, it's also possible these warnings have little to do with your health and everything to do with lawyers! That is, the equipment manufacturers might hope these warnings will ward off lawsuits from people who suffer a medical problem while using their equipment.

Are these warnings helpful?

Probably not.

All the warnings, alerts, and cautions in our everyday lives can become background noise. Despite red letters and bold fonts, warnings like these are easily overlooked.

Nor do they add much. My guess is that most people experiencing significant dizziness or pain during a workout will stop what they're doing even without reading a warning label. And serious medical conditions arising during exercise are rather rare, so the impact of warning everyone about them is likely small.

The bottom line

Don't be overly alarmed by alerts slapped on exercise equipment. True, it's best not to drop weights on your foot or exercise way too hard or long. If you are worried about workout risks or have been advised to be especially careful about exercising, it's reasonable to talk about it with your doctor.

But that conversation isn't necessary for most people, including those with well-controlled chronic illness such as high blood pressure, diabetes, or coronary artery disease. In fact, regular exercise helps treat many illnesses.

Exercise is among the most important things you can do to improve your health. And inactivity is a generally a much bigger risk than exercising.

So, if you see warnings on the gym equipment at your next workout, keep this in mind: there are much riskier things to worry about. Like hot coffee.

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

The first thing to know about ringworm is that there are no worms involved.

This generally harmless skin infection is caused by a fungus. The fungus causes a raised rash usually shaped like a ring, almost as if a worm was curled up under the skin (but again: no worms are involved).

The medical name for ringworm is tinea corporis.

Are there other types of tinea infections?

There are many different kinds of tinea skin infections, named in Latin for the part of the body they affect, such as the

• scalp (tinea capitis)
• groin (tinea cruris)
• feet (tinea pedis)
• body (tinea corporis).

Tinea infections can look a bit different depending on what part of the body they affect, but they are usually pink or red and scaly.

How do you get ringworm?

Tinea infections, particularly ringworm (tinea corporis), are very common. People catch them from other infected people and also from infected animals, particularly dogs and cats. They can also spread from one part of the body to another.

What does ringworm look like?

It usually starts as a pink scaly patch that then spreads out into a ring. The ring (which is not necessarily perfectly round) usually spreads wider with time. It can sometimes be itchy, but most of the time doesn’t cause any discomfort.

There are other rashes that can have a ringlike shape, so it’s always important to check in with your doctor, especially if the ring isn’t scaly. But most ringlike rashes are tinea.

How is ringworm treated?

Luckily, tinea corporis and the other kinds of tinea are very treatable. Most of the time, an antifungal cream does the trick.

When the rash is extensive (which is rare) or doesn’t respond to an antifungal cream (also rare), an antifungal medication can be taken by mouth.

As is the case with many other germs these days, there are some drug-resistant cases of tinea related to overuse of antifungal medications. But the vast majority of fungal infections go away with medication.

What should you do if you think a family member — or a pet — has ringworm?

If you think someone in your family has ringworm, call your doctor. The sooner you get started on treatment, the better.

If someone in the family has been diagnosed with ringworm, make sure that others don’t share clothing, towels, or sheets. Have everyone wash their hands frequently and well.

If your pet has a scaly rash, call the vet. Vacuum the areas your pet frequents, and have everyone wash their hands after touching the pet.

Can you prevent ringworm?

To prevent tinea corporis and other kinds of tinea:

• Keep skin clean and dry.
• Change clothes (particularly socks and underwear) regularly.
• Wash your hands regularly (this helps prevent all sorts of infections).
• If your child plays contact sports, make sure they shower after practice, keep their uniform and gear clean, and don’t share gear with other players.

To learn more about ringworm, visit the website of the Centers for Disease and Prevention.

Follow me on Twitter @drClaire

About the Author

Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing

Claire McCarthy, MD, is a primary care pediatrician at Boston Children’s Hospital, and an assistant professor of pediatrics at Harvard Medical School. In addition to being a senior faculty editor for Harvard Health Publishing, Dr. McCarthy … See Full Bio View all posts by Claire McCarthy, MD