Life with Chronic Conditions: Watch Your Electrolytes

A few weeks ago I had a major scare when my husband began acting confused and walking very strange. I ended up rushing him to our local hospital where they quickly ruled out a stroke and identified the culprit, very low sodium. 

 My husband drinks a lot of water and on this particular day, it turned out drinking lots of water, which he was doing as he was having major diarrhea from some type of “bug,” was not helping. Diarrhea and vomiting can wipe out fluids and electrolytes. He ended up being hospitalized and on an IV drip. 

 

When I let people know what was going on, several friends reported having similar electrolyte imbalances in the last month or two. As one friend noted, “as we get older, it doesn't take much to upset the apple cart.” However, I now realize that spending very hot summer days on archeological digs and hiking, where we drink gallons of water and are profusely sweating, didn’t keep us from becoming incredibly fatigued and having headaches. 

 

Older people as well as those with with chronic conditions, cancer, and other conditions can easily slip into an unbalanced electrolyte situation. If you find yourself not eating or drinking, or drinking way more than usual, having a lot of diarrhea and vomiting, recognize you could be setting yourself up for an imbalance. 

 

While the hospitalist recommended that my husband fill his water bottle with half water and sports drink, there are a wide variety of products out there that can keep electrolytes balanced without the added sugars, food dyes etc. that many sports drinks contain.  Talk to your medical provider about the best option for you. 

 

How can you tell if you are under or over hydrating? For most people, the color of your urine can give you an indication that you’re over or under hydrating. Keep in mind that some medications and foods can change the color of your urine.  

 

Just look in the toilet as the color will give you a good indication. I should note that in VT  many households, including ours, follow the motto “If it’s yellow let it mellow, If it’s brown flush it down.” Since my husband’s hospitalization, we’ve started flushing the toilet after each use so there’s no confusion about whose hydrating sufficiently.

-       Clear: If there’s no color in your urine at all, it’s likely that you’re actually overhydrating so cut back on your drinking.

-       Light Yellow: Ideally, your urine color will be light yellow, like a glass of lemonade. That shade of yellow is a sign that you’re well-hydrated 

-       Medium Yellow: If your urine is a little darker, similar to the shade of a light beer. For most people, that’s also okay.

-       Amber If your urine is an amber color (think of the substance that the mosquito was encased in in Jurassic Park), that’s a sign that you’re starting to become dehydrated. Drink up

-       Brown: If your urine is brown or dark orange in color, that’s a sign of severe dehydration and electrolyte imbalances.

 

Learn more about Electrolyte Imbalance 

• Cleveland Clinic 

• Medical News Today 

• Healthline

Take a Break: Celebrate Earth Week with a Meditation

While there are many ways to celebrate Earth Week (April 16-22), such as planting a tree, recycle, repurpose, weatherize and so forth, consider some nature meditations:

Six Nature Meditations for Earth Day from Kripalu 

 

Guided Earth Day Clean Up Meditation

 

Celebrate Earth Day While Practicing Mindfulness Outside 

 

The Earth Day Meditation by underwatercam 

 

 

Not interested in today’s activities, try the Take a Break Pinterest Board.

Journal Watch April 2023

 

 

COVID-19 

Study Says Long COVID May Cause Face Blindness: COVID-19 is known to cause some people to lose taste and smell, and to instill "brain fog," as well.Now, new research published in Cortex, links it to face blindness – or prosopagnosia -- the inability to recognize faces."Self-report survey data from 54 respondents with long COVID showed that a majority reported reductions in visual recognition and navigation abilities," researchers wrote. "COVID-19 can produce severe and selective neuropsychological impairment similar to deficits seen following brain damage, and it appears that high-level visual impairments are not uncommon in people with long COVID."

 

COVID Raises Risk for Long-Term GI Complications: People who have had COVID-19 have a 36% overall higher risk of developing gastrointestinal (GI) problems in the year after infection than people who have not had the illness, a large new study indicates. The results were published online in Nature Communications.

 

Who Is Most Likely to Get Long COVID? Patient Data May Tell: Certain groups of people – like women, smokers, and those who had severe COVID-19 infections – are at a higher risk of long COVID, a review of more than 800,000 patients has found. Having other conditions – like anxiety, depression, asthma, diabetes, and being immunocompromised – were also connected to a higher likelihood of getting long COVID Yet, researchers also found that patients who had at least two doses of the COVID vaccine had a significantly lower risk of getting long COVID down the line. The research, published in the journal  JAMA Internal Medicine , combined 41 previously published articles. 

 

Treating Long-COVID Brain Fog With ME/CFS Guidelines: Medscape 

 

Cleveland Clinic researchers find sleep disturbances prevalent in long COVID: Study shows 41% of patients with post-acute sequelae of COVID-19 had moderate to severe sleep issues and that Black patients were three times more likely to develop these disturbances. The findings were published in Journal of General Internal Medicine.

 

You're less likely to get long COVID after a second infection than a first: The chances of long COVID — a suite of symptoms including exhaustion and shortness of breath — falls sharply between the first and second infections, according to recent research. But the risk does not fall to zero, according to the latest results of an ongoing survey of more than 500,000 people in the U.K. through March 5.

 

PAIN

Migraine and Cluster Headaches are Linked to Your Body's Internal Clock Researchers published a meta-analysis, along with an accompanying editorial,  in the online issue of Neurology, the medical journal of the American Academy of Neurology. Data on migraine and cluster headaches shows a strong correlation between these headaches and the time of day, with a circadian pattern present in 71 percent of cluster headache patients and 50 percent of migraine patients. The study’s author says the findings help illuminate why headaches happen at consistent times and potentially open the door to new circadian-based treatment options.

Patients with chronic pain value empathic doctors who validate concerns and communicate clearly:Physician empathy and physician communication were strongly associated with patient satisfaction with medical care for chronic low back pain. Researchers argue that patients with chronic pain highly value physicians who are empathic and who make efforts to more clearly communicate treatment plans and expectations. The Annals of Family Medicine 

 

Pulsed radiofrequency with steroid injection brings sciatica relief: Researchers found that a minimally invasive procedure combined with epidural steroid injection treatment led to superior pain reduction and disability improvement over one year in patients with sciatica. The results of the study were published in Radiology, a journal of the Radiological Society of North America (RSNA). The combined treatment performed better than steroid injections alone.

 

Dedicated protocol of hyperbaric oxygen therapy is more effective than the drug treatment available today for fibromyalgia caused by head injury: Researchers from Tel Aviv University compared treatment with a dedicated protocol of hyperbaric oxygen therapy (HBOT) to the pharmacology (drugs) treatment available today for patients suffering from fibromyalgia as a result of a traumatic brain injury (TBI). The researchers found that the dedicated hyperbaric oxygen therapy is much more effective in reducing pain than the drug treatment, and it even resulted in the healing of 2 out of 5 patients. PLOS One

 

Equine-facilitated therapy improved the functioning of patients with low back pain: Patients with chronic low back pain may benefit from equine-facilitated therapy (EFT), a new study from the University of Eastern Finland shows. During a 12-week intervention, the perceived amount of pain decreased, and the ability of daily functioning improved among EFT participants. The findings were published in Frontiers in Veterinary Science. 

 

New Guidelines for Cannabis in Chronic Pain Management Released: Developed by a group of Canadian researchers, clinicians, and patients the guidelines note that cannabinoid-based medicines (CBM) may help clinicians offer an effective, less addictive, alternative to opioids in patients with chronic noncancer pain and comorbid conditions. "We don't recommend using CBM first line for anything pretty much because there are other alternatives that may be more effective and also offer fewer side effects." The guidelines were published online March 27 in the journal Cannabis and Cannabinoid Research.

Volunteering or donating to charity could help ease your physical pain, study suggests: A new, first-of-its-kind study suggests that volunteering with any organisation, or donating money to charity, reduces the effects of physical pain on the ability of people to work, with volunteering having a larger effect than donating to charity.  Journal of Psychosomatic Research

  

COMPLEMENTARY AND ALTERNATIVE MEDICINE

Interested in CBD? You’re Not Alone. 30% of US Adults Are Too: Healthline recently conducted a survey among more than 8,800 US adults to find out what questions, concerns, and preferences people generally have about using CBD products.Results showed that 30% of respondents are either currently using CBD products as part of their lifestyle routine or are interested in trying them. That’s a significant number considering hemp-derived CBD was legalized in the US a little over four years ago. 

 

CBD Compounds May Help Reverse Opioid Overdoses: Researchers are studying how specific components of cannabidiol (CBD) may supplement the opioid overdose drug naloxone. The initial finding indicated that CBD derivatives made naloxone treatment more effective, even against the opioid fentanyl. This latest study adds to existing research suggesting that CBD may provide a benefit in treating opioid overdoses, addiction cravings, and withdrawal symptoms. Study presented at the spring meeting of the American Chemical Society

 

Recreational Cannabis Tied to Unintended Harms, Benefits: Recreational cannabis is associated with an increase in car crash fatalities but a decrease in opioid-related overdose deaths, according to a study published in the March issue of Social Science & Medicine. "The results suggest that a potential unintended consequence of recreational markets is increased cannabis-intoxicated driving and crash deaths, and, hence, a potential need for policies focused on reducing driving under the influence of cannabis," the authors write.

Abstract/Full Text

 

70% of Cannabis Products Have Less THC Than They Claim: Researchers have found that many of the cannabis products they tested had lower amounts of THC, or delta-9-tetrahydrocannabinol, than what was listed on the label. Cannabis flower refers to the dried flower bud of a female cannabis plant.  THC is the main intoxicating compound in the cannabis plant. PLoS ONE.

 

FDA ACTION

• Approves over the counter Narcan, opioid overdose drug

• Withdrew approval of Makena. This drug was approved to reduce the risk of preterm birth in women pregnant with one baby who have a history of spontaneous preterm birth.

 

PREVENTION

Exercise

Yoga Linked With Improved Gait Speed, Lower-Extremities Strength in Older Adults: In a systematic review published in Annals of Internal Medicine, the researchers identified 33 randomized, controlled trials of yoga-based interventions including 2,384 adults aged 65 years and older. The studies mainly involved Iyengar or chair-based yoga methods. The study population included community-dwelling seniors, nursing home residents, and individuals with chronic diseases. Overall, individuals who were randomized to engage in a yoga practice showed improved gait speed and lower extremity strength, compared with controls who were inactive or received an education intervention, with moderate-certainty evidence. The researchers also found low-certainty evidence in favor of yoga for improved balance and for a composite measure of physical function, and low-certainty evidence in favor of yoga for improved handgrip strength.

 

One or Two High-Step Days May Reduce Mortality Risks: Taking 8,000 steps or more for just 1 or 2 days a week was linked to a significant reduction in all-cause and cardiovascular mortality, according to a study of about 3,000 adults. In a study published in JAMA Network Open, the researchers reviewed 10-year follow-up data for 3,101 adults aged 20 years and older who were part of the 2005 and 2006 National Health and Nutrition Examination Survey (NHANES).

 

Physical exercise helps to improve symptoms of Parkinson’s Disease: Findings from the first Cochrane review of the available evidence found that any type of structured exercise is better than none. The review looked at 156 randomised controlled trials comparing physical exercise with no physical exercise or with different types of exercise, and it included a total of 7,939 people from around the world, making it the largest and most comprehensive systematic review to study the effects of physical exercise in people with Parkinson’s Disease. 

 

Exercise may reduce negative effects of unhealthy sleep duration on longevity: Sleeping too little or too long is linked with a shorter life, but scientists have found that physical activity counteracts some of these negative effects. The research in more than 90,000 adults is published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).1 “The study showed that increased physical activity levels weakened the mortality risks associated with short or long sleep duration. 

 

 

Diet/Nutrition

E.coli from Ground Meat May Cause Over 480,000 UTIs Every Year: According to a recent study published in the medical journal One Health, E. coli from meat products may be a major cause of urinary tract infections in the U.S. Foodborne zoonotic E. coli strains were linked with urinary tract infections, and researchers estimated it causes between 480,000 and 640,000 urinary tract infections in the United States each year.To avoid infection, wash your food and hands thoroughly, stay hydrated, take showers instead of baths and urinate after intercourse.

 

A Daily Coffee May Reduce Your Type 2 Diabetes Risk Drinking coffee every day may help lower your risk of type 2 diabetes, according to new research. The report, published in the journal Clinical Nutrition Wednesday, found that having one additional cup of coffee each day was linked to a 4 to 6% lower risk of type 2 diabetes.

 

The Harvard Diet May Increase Your Chances of Living Longer by 20%: A new study has found that four specific eating plans were all linked to greater longevity. One plan in particular, the Harvard Diet, is gaining attention. It was developed for the study and includes aspects of MyPlate as well as the Mediterranean diet. the Harvard Diet, or Healthy Eating Plate, is almost identical to MyPlate, which was developed by the USDA in June 2011. However, there are a few important differences. “Both concepts recommend 1/2 of your plate/meal serving should consist of fruits/vegetables, 1/4 from whole grains, and 1/4 from proteins.  The difference is that the Harvard Diet advises a larger proportion of vegetables versus fruit than MyPlate does. 

 

Eating Sugary, High-Fat Foods Can Rewire Your Brain to Crave Sweets: The study, published in the journal Cell Metabolism, found that foods high in fat and sugar activate the dopaminergic system — a region in the brain responsible for motivation and reward.  As a result, the brain begins to seek out those unhealthy treats.

 

Magnesium-Rich Diet Linked to Lower Dementia Risk: Investigators studied over 6000 cognitively healthy individuals, aged 40-73, and found that those who consumed more than 550 mg of magnesium daily had a brain age approximately 1 year younger by age 55 years, compared with a person who consumed a normal magnesium intake (~360 mg/day). The study was published online March 10 in the European Journal of Nutrition.

 

Low-Volume, Daily Alcohol Consumption Not Protective Against Death: Daily low or moderate alcohol intake is not significantly associated with all-cause mortality risk, but risk increased at higher consumption levels, particularly for women, according to a review published online March 31 in JAMA Network Open. Abstract/Full Text

 

Mediterranean, Low-Fat Dietary Programs Beneficial for Elevated Cardiovascular Risk: Mediterranean and low-fat dietary programs seem beneficial for reducing mortality and morbidity among patients with elevated cardiovascular risk, according to a review published online March 29 in The BMJ. The researchers found that at last reported follow-up, Mediterranean dietary programs proved superior to minimal intervention for prevention of all-cause mortality, cardiovascular mortality, stroke, and nonfatal myocardial infarction (odds ratios, 0.72, 0.55, 0.65, and 0.48, respectively) based on moderate-certainty evidence. In addition, low-fat programs proved superior to minimal intervention for prevention of all-cause mortality and nonfatal myocardial infarction (odds ratios, 0.84 and 0.77, respectively) based on moderate-certainty evidence. For both dietary programs, the absolute effects were more pronounced for high-risk patients. For mortality and nonfatal myocardial infarction, there were no convincing differences seen between Mediterranean and low-fat programs. Little or no benefit was seen for the remaining five dietary programs versus minimal intervention. Abstract/Full Text

 

How Wild Blueberries May Help Lower Blood Pressure and Boost Your Brain: People who consumed a drink made out of freeze-dried wild blueberry powder once a day for 12 weeks saw a reduction in their systolic blood pressure of 3.59 millimeters of mercury (mmHg), compared to people who consumed a drink made from a placebo powder. Wild blueberry powder drinkers also saw improvements in their blood vessel function. Other studies have also found that eating blueberries — or blueberry compounds known as anthocyanins — improves vascular function. The study was published March 25 in The American Journal of Clinical Nutrition.

  

Sleep

Strong Support for CBT as First-Line Treatment for Insomnia in Seniors: Cognitive behavioral therapy (CBT) should be the first-line therapy for insomnia in seniors, but many clinicians are unaware of its benefits, experts say. American Association for Geriatric Psychiatry (AAGP) 2023 Annual Meeting 

 

Disordered Sleep Tied to a Marked Increase in Stroke Risk: Results of a large international study show stroke risk was more than three times higher in those who slept too little, more than twice as high in those who sleep too much, and two to three times higher in those with symptoms of severe obstructive sleep apnea (OSA). The study also showed the greater the number of sleep disorder symptoms, the greater the stroke risk. The 11% of study participants with five or more symptoms of disordered sleep had a fivefold increased risk for stroke.  The findings were published online April 6 in the journal Neurology.

 

Obstructive sleep apnea (OSA) may directly cause early cognitive decline: Researchers from the UK, Germany, and Australia have shown for the first time that in middle-aged men, OSA can also cause early cognitive decline, even in patients who are otherwise healthy and not obese. The results are published in Frontiers in Sleep.

New national indicator report details importance of prompt sleep apnea diagnosis and treatment: The Count on Sleep partnership, a collaboration between several professional and patient-focused organizations, has released a national indicator report for obstructive sleep apnea through a grant awarded to the American Academy of Sleep Medicine by the Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion. The report provides an in-depth analysis of the symptoms, risk factors, prevalence, and burden of obstructive sleep apnea and serves as a resource for both the public and the health care communities on the importance of diagnosis and long-term treatment.

Poor sleep may bolster genetic susceptibility to asthma, potentially doubling risk: Poor quality sleep may bolster a person’s genetic susceptibility to asthma, potentially doubling their risk of being diagnosed with the condition, suggests a large UK Biobank study, published in the open access journal BMJ Open Respiratory Research. 

 

 

Vitamins/Supplements

Prenatal Supplements Fail to Meet Nutrient Needs: In a new study published this month in the American Journal of Clinical Nutrition, investigators observed what many physicians have long suspected: most prenatal vitamins and other supplements do not adequately make up the difference of what food-based intake of nutrients leave lacking. Despite patients believing they are getting everything they need with their product purchase, they fall short of guideline-recommended requirements.

 

Do B Vitamins Reduce Parkinson's Risk? Increasing intake of folate and vitamin B6 beyond recommended daily levels offers no protective benefit against Parkinson's disease (PD), a new study shows.Though there was some evidence that vitamin B12 early in life was associated with decreased PD risk, the findings were inconsistent and were only observed in people whose daily intake was 10 times the recommended level. The findings were published online March 20 in Movement Disorders.

 

Other

Losing Any Amount of Weight is Good for Your Heart — Even if You Gain Some Back: A new analysis from the American Heart Association showed that weight loss reduced certain risk factors of cardiovascular disease even if some weight was regained later. The protective effects of weight loss appear to benefit heart health for several years. People who participated in behavioral weight loss programs also saw improvements in blood pressure, cholesterol, and certain risk factors for type 2 diabetes. These findings were part of a new research analysis on heart health and behavioral weight reduction programs published in Circulation: Cardiovascular Quality and Outcomes

 

Hormonal Birth Control, No Matter Which Kind, Linked to Breast Cancer, Study Finds: Past research has shown that hormonal contraceptives containing both estrogen and progestin are linked to a slight increase in breast cancer risk. Now, a new study reports that progestin-only birth control has a similar breast cancer risk. Experts, however, say the overall risk from both types of birth control remain relatively low. study  PLOS Medicine.

 

The 5 Biggest Changes in the 2023 Adult Vaccine Schedules This year’s five most important changes from the ACIP's new adult schedule for 2023, published in the Annals of Internal Medicine include: COVID vaccines now front and center. New emphasis on polio vaccination and Inclusion of some nonvaccine products (such as monoclonal antibody products)

 

Time out: We all need a three-day weekend:  new empirical research shows that the extra time off is good for our health. Assessing changes in daily movements before, during and after holidays, researchers found that people displayed more active, healthy behaviours when they were on holiday, even when they only had a three-day break. “In this study, we found that movement patterns changed for the better when on holiday, with increased physical activity and decreased sedentary behaviour observed across the board. “We also found that people gained an extra 21 minutes of sleep each day they were on holiday, which can have a range of positive effects on our physical and mental health. For example, getting enough sleep can help improve our mood, cognitive function, and productivity. It can also help lower our risk of developing a range of health conditions, such as obesity, diabetes, cardiovascular disease, and depression.

 

TREATMENT

ECT for Severe Depression Tied to Improved Cognition in Seniors: Electroconvulsive therapy (ECT) in older patients with refractory depression and bipolar disorder has been linked to improvement in some key cognitive measures, allaying fears that the treatment could have a deleterious impact in this patient population, new research shows."The current findings suggest older adults of more advanced age — 70-79 vs 50-59 years old, may actually show greater improvement in attention and executive function after undergoing ECT for refractory depression." American Association for Geriatric Psychiatry (AAGP) 2023 Annual Meeting 

 

Advanced Prostate Cancer: Experts Say This Double Therapy Can Help: Results of a clinical trial, published March 27 in The Lancet OncologyTrusted Source, support the use of the drug enzalutamide alongside androgen deprivation therapy for men with metastatic prostate cancer. This trial, known as ENZAMET, was carried out by researchers around the world 

 

A Better, Lower-Cost Option for Mild to Moderate Depression? A mindfulness-based cognitive therapy self-help (MBCT-SH) intervention in which patients were supported by a trained practitioner led to better clinical outcomes at lower cost than practitioner-supported cognitive-behavioral therapy self-help (CBT-SH), new research shows. The study was published online March 22 in JAMA Psychiatry.

 

Is It Time to Stop Treating High Triglycerides? Recent trial evidence has failed to show a cardiovascular benefit to treating high triglycerides. The publication of the PROMINENT trial, where pemafibrate successfully lowered high levels but was not associated with a lower risk for cardiovascular events, reinforced the point. Is it time to stop measuring and treating high triglycerides? Medscape https://www.medscape.com/viewarticle/990126

 

Transcatheter Arterialization Safe for Limb-Threatening Ischemia: Transcatheter arterialization of the deep veins is safe for patients with chronic limb-threatening ischemia and no conventional surgical or endovascular revascularization treatment options, according to a study published online March 29 in the New England Journal of Medicine. 

 

ECT vs Ketamine for Major Depressive Disorder: New Data: Electroconvulsive therapy (ECT) appears to have a small advantage over ketamine for improving depressive symptoms in adults with a major depressive episode, results of a new review show. Findings suggest that the therapeutic advantage may be smaller than what was demonstrated in prior analyses." The study was published online  in JAMA Psychiatry.

 

Phototherapy a Safe, Effective, Inexpensive New Option for Dementia? Phototherapy is a safe, effective, noninvasive, and inexpensive way of boosting cognition for patients with dementia, new research suggests. It may be "one of the most promising interventions for improving core symptoms" of the disease. A new meta-analysis shows that patients with dementia who received phototherapy experienced significant cognitive improvement, compared to those who received usual treatment. However, there were no differences between study groups in terms of improved depression, agitation, or sleep problems. The study was published online April 5 in Brain and Behavior.

 

OTHER

How Bone Density May Be Linked to Dementia Risk: Researchers say a loss in bone density may be linked to an increased risk of dementia.They aren’t sure why there may be a connection, but they note that low bone density and dementia tend to occur in older age. Daily activity and a healthy diet are two ways to improve overall bone health.  study published in Neurology, 

 

The Abortion Pill: Mifepristone Remains Available After Latest Court Ruling

Cancer, Heart Disease Vaccines May Be Ready by 2030, Moderna Says: Vaccines for the world's most deadly diseases, like cancer and heart disease, will likely be ready by 2030 and could save millions of lives, according to the top doctor at one the world's leading drug companies. The announcement is yet another sign of what many are calling "the golden age" of vaccine development, which is largely credited to the pandemic's use of mRNA technology to create COVID-19 vaccines. Medscape 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Take a Break: Listen to 1491

One of my favorite ways to relax is to listen to podcasts, books on tape etc. If you’ve ever wondered what the Americas were like before Columbus happened to bump into the Caribbean, you’ll find Charles C. Mann’s 1491: New Revelations of the Americas Before Columbus very interesting. The full audiobook is available for free. Obviously this is a long audio, but you can start and stop as you have time. 

 

 

Not interested in today’s activities, try the Take a Break Pinterest Board.

Life with Chronic Conditions: The Big Three (Diet, Exercise & Sleep)

In compiling the monthly Journal Watch, which is posted the third Saturday of the month, I continue to notice how many studies are finding that better health and longevity can be obtained by what we eat, if we exercise (both physical and mental) and get sufficient sleep. 

Many different groups have compiled their “lists” of “to do.” For example the Blue Zones Project has the “Power Nine,” while the American Heart Association has the Life Essential 8. Even Phil Stutz, a psychiatrist who has gained a lot of publicity recently for the documentary “Stutz,” points out that these three factors are critical in treating psychiatric conditions such as depression. Interestingly, more and more medical groups are encouraging life style modifications before placing people on medications.

 

 In August 2022, the Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce were published in the World Journal of Biological Psychiatry. They came up with nine recommendations. The recommendations with the highest ratings to improve MDD [Major Depressive Disorder] were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies.

 

AHA’s Life’s Essential 8 includes: Not smoking; regular physical activity; healthy weight; healthy diet; Healthy sleep (defined as an average of 7-9 hours nightly); Blood pressure, glucose and non-HDL cholesterol all in a healthy range. Basically, with the exception of smoking, the big three, help to control weight and the other markers. 

 

Before launching into the “big three,” it’s important to note two things: 

-       Talk to your medical provider to assist you in making changes. They are in the best position of what will work best in your situation. 

-       There is a role for medications and if your provider things that the right approach for you, please take that seriously. 

 

THE BIG THREE

DIET: There are lots of diet trends out there, but the research continues to support that the best diet is plant slant with the Mediterranean diet leading the pack in helping with depression, heart health, dementia and a reduction in factors that can lead to heart disease, diabetes, cancer etc. 

 

With lots of options for fruits, nuts, whole grains, vegetables (yes to potatoes), and fish, there are lots of nutritious yet enjoyable foods to choose from. If you aren’t familiar with the diet, check out Cleveland Clinic’s Mediterranean Diet.

 

EXERCISE: The Physical Activity Guidelines for Americans from the Office of Disease Prevention and Health Promotion Health states the following:

 

Key Guidelines for Adults 

• Adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits. 

 

• For substantial health benefits, adults should do at least 150 minutes least (2hour sand 30minutes)to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week. 

 

• Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week. 

 

• Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits. 

 

Key Guideline for Older Adults The key guidelines for adults also apply to older adults. In addition, the following key guidelines are just for older adults: 

• As part of their weekly physical activity, older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. 

 

• Older adults should determine their level of effort for physical activity relative to their level of fitness. 

• Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely. 

 

• When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow. 

 

Key Guidelines for Adults With Chronic Health Conditions and Adults With Disabilities Adults with chronic conditions or disabilities, who are able, should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week. 

 

• Adults with chronic conditions or disabilities, who are able, should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits. 

 

• When adults with chronic conditions or disabilities are not able to meet the above key guidelines, they should engage in regular physical activity according to their abilities and should avoid inactivity. 

 

• Adults with chronic conditions or symptoms should be under the care of a health care provider. People with chronic conditions can consult a health care professional or physical activity specialist about the types and amounts of activity appropriate for their abilities and chronic conditions. 

 

Exercises for the Mind

• Use relaxation techniques-such as guided breathing. Check out Cyclic Breathing & Sighing Improves Mood from a few weeks ago

• Mindfulness and meditation 

• Activities like yoga, Qigong and Tai Chi can exercise mind, body and spirit 

 

SLEEP: In a study presented Feb. 23 at an annual meeting of the American College of Cardiology, researchers identified five healthy sleep habits: getting seven to eight hours of sleep each night; falling asleep easily most nights; staying asleep most nights; waking up rested most mornings; and not using any sleep medications. To learn more about getting better sleep, check out the Sleep Foundation.