Categories
NATURAL-BEAUTY POWER WORKOUT

Healthier planet, healthier people

A crystal globe with countries etched on, circled by stethoscope with red heart; Earth health and our health connect

Everything is connected. You’ve probably heard that before, but it bears repeating. Below are five ways to boost both your individual health and the health of our planet — a combination that environmentalists call co-benefits.

How your health and planetary health intersect

Back in 1970, Earth Day was founded as a day of awareness about environmental issues. Never has awareness of our environment seemed more important than now. The impacts of climate change on Earth — fires, storms, floods, droughts, heat waves, rising sea levels, species extinction, and more — directly or indirectly threaten our well-being, especially for those most vulnerable. For example, air pollution from fossil fuels and fires contributes to lung problems and hospitalizations. Geographic and seasonal boundaries for ticks and mosquitoes, which are carriers of infectious diseases, expand as regions warm.

The concept of planetary health acknowledges that the ecosystem and our health are inextricably intertwined. Actions and events have complex downstream effects: some are expected, others are surprising, and many are likely unrecognized. While individual efforts may seem small, collectively they can move the needle — even ever so slightly — in the right direction.

Five ways to improve personal and planetary health

Adopt plant-forward eating.

This means increasing plant-based foods in your diet while minimizing meat. Making these types of choices lowers the risks of heart disease, stroke, obesity, high blood pressure, type 2 diabetes, and many cancers. Compared to meat-based meals, plant-based meals also have many beneficial effects for the planet. For example, for the same amount of protein, plant-based meals have a lower carbon footprint and use fewer natural resources like land and water.

Remember, not all plants are equal.

Plant foods also vary greatly, both in terms of their nutritional content and in their environmental impact. Learning to read labels can help you determine the nutritional value of foods. It’s a bit harder to learn about the environmental impact of specific foods, since there are regional factors. But to get a general sense, Our World in Data has a collection of eye-opening interactive graphs about various environmental impacts of different foods.

Favor active transportation.

Choose an alternative to driving such as walking, biking, or using public transportation when possible. Current health recommendations encourage adults to get 150 minutes each week of moderate-intensity physical activity, and two sessions of muscle strengthening activity. Regular physical activity improves mental health, bone health, and weight management. It also reduces risks of heart disease, some cancers, and falls in older adults. Fewer miles driven in gas-powered vehicles means cleaner air, decreased carbon emissions contributing to climate change, and less air pollution (known to cause asthma exacerbations and many other diseases).

Start where you are and work up to your level of discomfort.

Changes that work for one person may not work for another. Maybe you will pledge to eat one vegan meal each week, or maybe you will pledge to limit beef to once a week. Maybe you will try out taking the bus to work, or maybe you will bike to work when it’s not winter. Set goals for yourself that are achievable but are also a challenge.

Talk about it.

It might feel as though these actions are small, and it might feel daunting for any one individual trying to make a difference. Sharing your thoughts about what matters to you and about what you are doing might make you feel less isolated and help build community. Building community contributes to well-being and resilience.

Plus, if you share your pledges and aims with one person, and that person does the same, then your actions are amplified. Who knows, maybe one of those folks along the way might be the employee who decides what our children eat from school menus, or a city planner for pedestrian walkways and bike lanes!

About the Author

photo of Wynne Armand, MD

Wynne Armand, MD, Contributor

Dr. Wynne Armand is a physician at Massachusetts General Hospital (MGH), where she provides primary care; an assistant professor in medicine at Harvard Medical School; and associate director of the MGH Center for the Environment and … See Full Bio View all posts by Wynne Armand, MD

Categories
NATURAL-BEAUTY POWER WORKOUT

Pouring from an empty cup? Three ways to refill emotionally

A dark blue paper head with orange, yellow, white cut-out flames inside against a brown background; concept is burnout

It’s hard to care about anything when you feel exhausted, burned out, or ragged around the edges. Your once-fiery enthusiasm may seem more like charred rubble due to overwhelming family responsibilities, a job that drains you, or financial struggles. Or maybe an illness, the uncertainty and disruptions of the age we live in, or a combination of factors has left you feeling as if you have precious little to give.

“What you’re experiencing is burnout. It’s real and it can lead to depression, anxiety, relationship damage, and an inability to function at home or at work,” says Dr. Marni Chanoff, an integrative psychiatrist with Harvard-affiliated McLean Hospital.

Take heart: With time and effort, you can refill your cup, slowly adding back a bit of the energy and joie de vivre you’ve been missing. Here are three ways to start.

1. Carve out time for yourself

Taking time for yourself isn’t a luxury; it’s essential to self-care. “You need to slow down and give yourself the opportunity to rest and rejuvenate,” Dr. Chanoff says, “Schedule it if you have to, starting with 10 or 15 minutes, a couple of times a day.”

How can you reclaim precious minutes in an overly full schedule? “Look at your day, week, or month, and be discerning about how many things you say ‘yes’ to in one period of time. Give yourself permission to say ‘no thank you’ to things that deplete you or don’t serve you,” Dr. Chanoff says.

Make small moments count: choose what makes you feel at peace. For example, have a cup of tea, or simply lay a blanket or mat on the floor at home or work and lie on your back. Don’t look at your phone or email. “You want to tell your body to take a break. It helps you reset and back away when stress draws you in,” Dr. Chanoff explains.

2. Commit to better health

A strong body helps balance the stressful situations that have caused your burnout. The basic recipe for good health includes:

  • Exercise. Moderate intensity exercise, the kind that works the heart and lungs, releases important chemicals that help regulate mood, sleep, and many body systems. Aim for at least 150 minutes of exercise per week, which amounts to about 22 minutes a day. Start with just a few minutes a day if it’s all you can do. It doesn’t have to be fancy. “It can be any movement that brings you joy, like dancing, yoga, or brisk walking,” Dr. Chanoff suggests.
  • A good diet. Eating lots of junk food (typically full of sugar, salt, and unhealthy saturated fat) fuels chronic stress, fatigue, depression, and anxiety. Choose more unprocessed foods such as vegetables, fruits, whole grains, legumes, lean proteins (fish or poultry), and unsaturated fats (such as avocados or olive oil). If time is an issue, Chanoff suggests batch-cooking simple, healthy foods you can have several days of the week. (Lentil or bean soup is a good one-pot meal. Throw in as many vegetables as you can.)
  • Sleep. Insufficient sleep affects overall health, concentration, and mood. Try to sleep seven to nine hours per night. “It helps to wind down an hour or two before you fall asleep. And practice good sleep hygiene: turn off your phone, keep your room cool and dark, and go to sleep and wake up at the same time each day,” Dr. Chanoff advises.

3. Surround yourself with comfort

Hygge (pronounced HOO-ga) is the Danish concept of cozy comfort that brings happiness and contentment. Folks in Denmark know a thing or two about finding sunshine in cold dark months.

To practice hygge, surround yourself with people, activities, and things that make you feel cozy, loved, happy, or content. Go simple: spend time with your favorite people, add a small vase of flowers to your space, don fuzzy slippers once home, eat a treasured comfort food, or listen to a favorite song.

More ideas to try:

  • Light a candle.
  • Get under a heated blanket.
  • Frame a photo of a happy time.
  • Have breakfast in bed.
  • Use pretty table linens.
  • Indulge in art (check out various works at museums online).
  • Stand still outside to listen to the sounds of nature.
  • Curl up in a cozy chair.
  • Window-shop in your favorite store.
  • Wear a soft sweater that feels good on your skin.
  • Use a silk or satin pillowcase on your bed pillow.
  • Take a warm bath.
  • Get an oil diffuser with a scent that reminds you of a place you love, like the beach or a pine forest.

Turn up the effect by savoring cozy comfort. How does it feel, taste, smell, or sound? “Engaging the senses with soothing stimulation can be nourishing. It counteracts ongoing stress that the nervous system endures, and may help to elicit the relaxation response — the opposite of the fight or flight [stress] response,” Dr. Chanoff explains. Breathing deeply will help, too.

Eventually, these bits of hygge, health, and personal time will give you something you probably haven’t allowed yourself in a while, and that’s compassion. Be gentle with yourself. Pamper your soul and replenish your cup, so you can continue being there for the important people and tasks in your life.

About the Author

photo of Heidi Godman

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

Categories
NATURAL-BEAUTY POWER WORKOUT

How does waiting on prostate cancer treatment affect survival?

close-up photo of a vial of blood marked PSA test alongside a pen; both are resting on a document showing the PSA test results

Prostate cancer progresses slowly, but for how long is it possible to put off treatment? Most newly diagnosed men have low-risk or favorable types of intermediate-risk prostate cancer that doctors can watch and treat only if the disease is found to be at higher risk of progression. This approach, called active surveillance, allows men to delay — or in some cases, outlive — the need for aggressive treatment, which has challenging side effects.

In 1999, British researchers launched a clinical trial comparing outcomes among 1,643 men who were either treated immediately for their cancer or followed on active surveillance (then called active monitoring). The men’s average age at enrollment was 62, and they all had low- to intermediate risk tumors with prostate-specific antigen (PSA) levels ranging from 3.0 to 18.9 nanograms per milliliter.

Long-term results from the study, which were published in March, show that prostate cancer death rates were low regardless of the therapeutic strategy. “This hugely important study shows quite clearly that there is no urgency to treat men with low- and even favorable intermediate-risk prostate cancer,” says Dr. Anthony Zietman, the Jenot W. and William U. Shipley Professor of Radiation Oncology at Harvard Medical School, anda radiation oncologist at Massachusetts General Hospital who was involved in the research and is a member of the Harvard Medical School Annual Report on Prostate Diseases editorial board. “They give up nothing in terms of 15-year survival.”

What the results showed

During the study, called the Prostate Testing for Cancer and Treatment (ProtecT) trial, researchers randomized 545 men to active monitoring, 533 men to surgical removal of the prostate, and 545 men to radiation.

After a median follow-up of 15 years, 356 men had died from any cause, including 45 men who died from prostate cancer specifically: 17 from the active monitoring group, 12 from the surgery group, and 16 from the radiation group. Men in the active surveillance group did have higher rates of cancer progression than the treated men did. More of them were eventually treated with drugs that suppress testosterone, a hormone that fuels prostate cancer growth.

In all, 51 men from the active surveillance group developed metastatic prostate cancer, which is roughly twice the number of those treated with surgery or radiation. But 133 men in the active surveillance group also avoided any treatment and were still alive when the follow-up concluded.

Experts weigh in

In a press release, the study’s lead author, Dr. Freddie Hamdy of the University of Oxford, claims that while cancer progression and the need for hormonal therapy were more limited in the treatment groups, “those reductions did not translate into differences in mortality.” The findings suggest that for some men, aggressive therapy “results in more harm than good,” Dr. Hamdy says.

Dr. Zietman agrees, adding that active surveillance protocols today are even safer than those used when ProtecT was initiated. Unlike in the past, for instance, active surveillance protocols now make more use of magnetic resonance imaging (MRI) scans that detect cancer progression in the prostate with high resolution.

Dr. Boris Gershman, a surgeon who specializes in urology at Harvard-affiliated Beth Israel Deaconess Medical Center, and is also an Annual Report on Prostate Diseases editorial board member, cautions that the twofold higher risk of developing metastasis among men on active surveillance may eventually translate into a mortality difference at 20-plus years.

“It’s important to not extend the data beyond their meaning,” says Dr. Gershman, who was not involved in the study. “These results should not be used to infer that all prostate cancer should not be treated, or that there is no benefit to treatment for men with more aggressive disease.” Still, ProtecT is a landmark study in urology, Dr. Gershman says, that “serves to reinforce active surveillance as the preferred management strategy for men with low-risk prostate cancer and some men with intermediate-risk prostate cancer.”

Dr. Marc B. Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of the Annual Report, points out that nearly all the enrolled subjects provided follow-up data for the study’s duration, which is highly unusual for large clinical trials with long follow-up. The authors had initially predicted that patients from the active monitoring group who developed metastases at 10 years would have shortened survival at 15 years, “but this was not the case,” Dr. Garnick says. “As with many earlier PSA screening studies, the impact of local therapy on long-term survival for this class of prostate cancer — whether it be radiation or surgery — was again brought into question,” he says.

About the Author

photo of Charlie Schmidt

Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases

Charlie Schmidt is an award-winning freelance science writer based in Portland, Maine. In addition to writing for Harvard Health Publishing, Charlie has written for Science magazine, the Journal of the National Cancer Institute, Environmental Health Perspectives, … See Full Bio View all posts by Charlie Schmidt

About the Reviewer

photo of Marc B. Garnick, MD

Marc B. Garnick, MD, Editor in Chief, Harvard Medical School Annual Report on Prostate Diseases; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Marc B. Garnick is an internationally renowned expert in medical oncology and urologic cancer. A clinical professor of medicine at Harvard Medical School, he also maintains an active clinical practice at Beth Israel Deaconess Medical … See Full Bio View all posts by Marc B. Garnick, MD

Categories
NATURAL-BEAUTY POWER WORKOUT

Natural disasters strike everywhere: Ways to help protect your health

A powerful, destructive storm producing a tornado crosses through fields and roads, throwing debris up into the air as lightening forks down in the distance

Climate change is an escalating threat to the health of people everywhere. As emergency medicine physicians practicing in Australia and the United States, we — and our colleagues around the world — already see the impacts of climate change on those we treat.

Will we be seeing you one day soon? Hopefully not. Yet an ever-growing number of us will face climate-related emergencies, such as flooding, fires, and extreme weather. And all of us can actively prepare to protect health when the need arises. Here’s what to know and do.

How is climate change affecting health?

As the planet warms, people are seeking emergency medical care for a range of climate-related health problems, such as heat exhaustion and heat stroke, asthma due to air pollution, and infectious diseases related to flooding and shifting biomes that prompt ticks, mosquitoes, and other pests to relocate. News headlines frequently spotlight physical and emotional trauma stemming from hurricanes, wildfires, tornadoes, and floods.

We care for people displaced from their homes and their communities by extreme weather events. Many suddenly lack access to their usual medical team members and pharmacies, sometimes for significant periods of time. The toll of extreme weather often lands hardest on people who are homeless, those with complex medical conditions, children, the elderly, people with disabilities, minoritized groups, and those who live in poorer communities.

On a recent 110º Fahrenheit day, for example, a woman came to an emergency department in Adelaide, Australia complaining of a headache, fatigue, and nausea, all symptoms of heat exhaustion. She told medical staff that she had just walked for two hours in the sun to obtain groceries, as she had no car or access to public transportation. While health advisories in the media that day had advised her to stay inside in air conditioning, walking outside was only the only option she had to feed her family. For this woman and many others, well-intended public health warnings do little to reduce the risk of illness during extreme weather. Achieving safe, equitable health outcomes will require addressing access to shelter, access to transportation, and other societal factors that put people at risk of bad health outcomes.

Extreme weather contributes to large-scale health and safety issues

Increasingly, climate-related extreme weather is leading to interrupted access to medical care, contributing to later illness and death. Extreme weather can damage key infrastructure like the electrical grid, so that those relying on home medical equipment cannot use it. It may shut down health care facilities like a dialysis center or emergency room, or slow care in facilities that stay open.

People fleeing a fire or hurricane can be displaced into settings where they may have difficulty getting medical care or obtaining much-needed medicine, such as insulin, dialysis, high blood pressure treatments, and heart medicines. Such factors can worsen chronic conditions and may even cause death, particularly in people with existing medical conditions like heart failure, lung disease, and kidney disease.

How can you be ready to protect your health?

We all have a part to play in keeping ourselves and our communities well in the face of increasing dangers from climate change. Taking these steps will help.

If you or a loved one has health issues:

  • Keep a printed summary handy listing all medical conditions, medications and dosages, and phone numbers for your health providers.
  • If you have to leave your home, try to bring all medications with you — even bringing empty pill bottles will help a doctor trying to restart your medications.
  • Store medicines in a waterproof bag in a place where you can easily find them. This will help if you need to evacuate quickly.

Think about what to do if you need to leave home quickly. Now is the time to figure out your basic emergency plan:

  • Where will you go if you need to evacuate?
  • How will you get there?
  • How could you communicate with others if there is no electricity or phone service?
  • Do you have written contact info for a few family members and friends, in case you lose your phone or the battery dies?

Finally, we all need to look out for others in our community. Check in on elderly neighbors and those around you who may be socially disconnected, and make sure that they are safe where they live and are able to access the medical care they may need when the weather turns hot, cold, smoky, fiery, snowy, wet, or windy.

Climate change is here. It is already having tangible and significant impacts on our communities and the health of people around the world. Moreover, the increased risk of climate-related extreme weather is here to stay for the foreseeable future, and we must prepare for the threats it poses to our health, both now and in decades to come. We all have a part to play — health professionals, communities, and individuals — in keeping ourselves and each other healthy and safe.

About the Authors

photo of Kimberly Humphrey, MD, MPH

Kimberly Humphrey, MD, MPH, Contributor

Dr. Kimberly Humphrey is an emergency physician, a current Fellow in Climate Change and Human Health at Harvard C-CHANGE at Harvard's T.H. Chan School of Public Health, and a visiting scholar at the Harvard FXB Center. Her research focuses on the … See Full Bio View all posts by Kimberly Humphrey, MD, MPH photo of Caleb Dresser, MD, MPH

Caleb Dresser, MD, MPH, Contributor

Dr. Caleb Dresser is an emergency physician and assistant director of the Climate and Human Health Fellowship, cohosted by Beth Israel Deaconess Medical Center, the Harvard FXB Center, and Harvard C-CHANGE. His research focuses on understanding the health implications of climate-related … See Full Bio View all posts by Caleb Dresser, MD, MPH