A breathing technique to help you relax

The practice of yoga incorporates many separate breathing techniques (above and beyond the coordinated breathing you do during yoga routines) that can help relax you and release tension. And many of these techniques can be done anytime, anywhere— not just during yoga class.

If you'd like to reap the benefits of these breathing techniques, start with the abdominal breathing technique described below. Once you've mastered abdominal breathing, you can then try others based on the unique benefits that each technique offers.

Abdominal breathing

As we go about our daily lives, most of us take quick, shallow "chest breaths" that can leave us feeling tense and drained. Abdominal breathing, also called "belly breathing," is a basic yoga breath that combats the effects of chest breathing. The technique emphasizes breathing deeply to create abdominal movement. It's essential for those beginning a yoga practice, but everyone can benefit from learning it, yogi or not.

Abdominal breathing is best learned while lying on your back, with one or both of your hands on your abdomen. To take an abdominal breath, inhale slowly and deeply, drawing air into the lowest part of your lungs so your hand rises. Your belly should expand and rise as you inhale, then contract and lower as you exhale. One way to think of this is to imagine your lungs as two glasses of water— with each breath, you should fill them from the bottom up, but empty them from the top down.

Once you're comfortable doing abdominal breathing in a reclining position, you can try it while sitting or standing. You can use this technique as you practice a yoga posture or while meditating. It is also useful at any time of the day when you need to calm down.

The physical benefits of yoga

Yoga promotes physical health in multiple ways. Some of them derive from better stress management. Others come more directly from the physical movements and postures in yoga, which help promote flexibility and reduce joint pain.

Following are some of the physical benefits of yoga that have a growing body of research behind them. In addition to the conditions listed below, preliminary research also shows that yoga may help with migraines, osteoporosis, balance and mobility issues, multiple sclerosis, inflammatory bowel disease, fibromyalgia, and ADHD.

Get your copy of Introduction to Yoga

Yoga is more than just a workout—it’s actually a combination of four components: postures (like tree pose), breathing practices, deep relaxation, and meditation that can transform your health on many different levels. To show you how easy yoga can be and how you can reap the many health benefits, Harvard Medical School experts created An Introduction to Yoga.

Back pain relief

Back pain is one of the most common health problems in the United States. Four out of five Americans will suffer from it at some point. But yoga appears to help. A 2013 meta-analysis of 10 randomized controlled trials found "strong evidence for short-term effectiveness and moderate evidence for long-term effectiveness of yoga for chronic low-back pain." In fact, since 2007, the American Society of Pain guidelines have urged physicians to consider recommending yoga to patients with long-term pain in the lower back.

While it is tempting to stay in bed when your back hurts, doctors no longer recommend extended bed rest. Although lying in bed does minimize stress on the lumbar spine, it also causes muscles to lose conditioning, among other problems. In general, the sooner you can get up and get moving, the faster you will recover. Yoga helps alleviate back pain by increasing flexibility and muscle strength. Relaxation, stress reduction, and better body awareness may also play a role.

In one study, published in the journal Spine, people with back pain who did two 90-minute sessions of yoga a week for 24 weeks experienced a 56% reduction in pain. They also had less disability and depression than people with back pain who received standard care, such as pain medication. The results also suggested a trend toward the use of less pain medication in those who did yoga. When the researchers followed up with the participants six months after the study, 68% of the people in the yoga group were still practicing yoga an average of three days a week for an average of 33 minutes per session. That's a good indicator that they found yoga to be helpful.

Less arthritis pain

Exercise has been shown to help alleviate the pain and stiffness associated with osteoarthritis; however, these symptoms can make it difficult to be active in the first place. Yoga offers a gentle form of exercise that helps improve range of motion and strengthen the muscles around painful joints.

In a 2014 study of 36 women with knee osteoarthritis, those who did yoga experienced significant improvements in their symptoms compared with women who didn't do yoga. The yoga group had a 60-minute class one day a week and then practiced at home on several other days, averaging 112 minutes of yoga a week on their own. After eight weeks, they reported a 38% reduction in pain and a 35% reduction in stiffness, while the no-yoga group reported worsening symptoms.

People with rheumatoid arthritis, an autoimmune disorder, may also benefit. In a 2015 study, women with rheumatoid arthritis reported improvements in their physical health, walking ability, pain levels, energy, and mood, and had significantly fewer swollen and tender joints, after doing two hour-long yoga classes a week for eight weeks.

Relieving pain with acupuncture

The ancient art of acupuncture has been used in Asia for centuries to treat many conditions and relieve pain. It's now being used in the United States and other Western countries to ease everything from low back pain, to nerve pain (such as painful shingles rashes), to headaches, fibromyalgia, and menstrual cramps — and more.

Traditional Chinese acupuncture involves the insertion of extremely fine needles into the skin at specific "acupoints." This may relieve pain by releasing endorphins, the body's natural pain-killing chemicals, and by affecting the part of the brain that governs serotonin, a brain chemical involved with mood.

Pain relief takes many forms. This Special Health Report looks beyond the standard approaches of drugs and surgery and explores alternate pain-relief strategies, from acupuncture and mind-body therapies to chiropractic medicine, physical and occupational therapies, herbal remedies, mindfulness meditation, and music therapy among others. The report also provides specific treatments for 10 common pain conditions.

In Chinese acupuncture, the acupuncturist may turn or twirl the needles slightly or apply heat or electrical stimulation to enhance the effects. He or she may also burn a therapeutic herb near the skin; this is called moxibustion.

A Japanese form of acupuncture involves more shallow needle insertion than in Chinese acupuncture, and the needles aren't usually manipulated. Korean acupuncture focuses on applying needles to points in just the hands and feet.

The acupuncturist typically inserts four to 10 needles and leaves them in place for 10 to 30 minutes while you rest. A usual course of treatment includes six to 12 sessions over a three-month period.

(Acupressure, a similar technique to acupuncture, does not use needles. Instead, the practitioner uses his or her hands to apply deep pressure at acupressure points.)

Acupuncture is generally quite safe, and the complication rate appears to be quite low. A review of acupuncture-related complications reported in medical journals found that the most serious problem was accidental insertion of a needle into the pleural space between the lungs and the chest wall (but this is rare). The advent of single-use, sealed needle packages has all but eliminated the risks of blood-borne infections such as hepatitis B or HIV.

Does acupuncture really work to quell pain? The evidence is mixed, with some studies showing that acupuncture relieves pain and others showing that it works no better than "sham" acupuncture (procedures designed to mimic acupuncture but to have no real effect, much like a placebo, or "sugar pill," used in medication studies). One of the problems with deciphering these results is that most acupuncture studies have been small. The design of "sham" acupuncture techniques has also varied widely, which complicates any comparison. It's also possible that acupuncture works for some people and not others.

If you decide to try acupuncture, seek out an experienced acupuncturist. Licensing requirements vary from state to state. In states with no licensing requirements, your best bet is to find an acupuncturist with certification from the National Certification Commission for Acupuncture and Oriental Medicine (www.nccaom.org).

Keep The Salt Away For The Same Of Your Heart

Your doctor has probably told you to cut back on salt, especially if you have high blood pressure. For years we’ve understood that excess salt raises blood pressure and increases deaths from heart disease. The guilty element is sodium, which pairs with chloride to form common salt. So when the journal Lancet recently published a study reporting that low dietary sodium was associated with an increased risk of heart disease and death, controversy was predictable.
A wealth of rigorous scientific studies supports a link between excess sodium intake and high blood pressure, heart attacks, and strokes. Yet the Lancet paper reported that people who consumed both high sodium and low sodium diets were more likely to suffer from cardiovascular disease and death. They concluded that a “moderate” intake of 4-5 grams of sodium daily was the best goal. To put this into perspective, the Food and Drug Administration (FDA) has set an upper limit of 2.3 grams (2,300 mg) daily for most Americans, while the American Heart Association recommends even less, limiting sodium to 1.5 grams (1,500 mg) daily for most people. The average American diet, considered much too high in sodium, contains around 4 grams of sodium.
It’s frustrating to read studies that seem to contradict dogma. They can undermine our faith in science altogether. Therefore, we must carefully analyze all study details to learn whether new science is being discovered, or whether bad science is being reported. And in the case of the sodium story, most experts and an enormous body of evidence support the conclusion that the recent study is flawed.
Studies that measure sodium intake use different methods. The gold-standard, with the highest level of scientific rigor, would be a randomized-controlled trial. That would mean half of a large population eats a high sodium diet and half eats a low sodium diet. Every single food item consumed over weeks, months and years would have to be measured for sodium content. Plus, no one would know which group they were in. Obviously this is not just impractical, it is impossible. So we look for short-cuts, and for indirect measures of dietary sodium.
The best available method for large groups is to measure urinary sodium as a substitute for dietary sodium. Instead of measuring what goes in, we measure what comes out. But the dietary sodium intake of most people is not at all constant. It has wide swings, ranging from very low to extremely high, depending on what we eat on a given day. And therefore the sodium in urine also fluctuates wildly.
The best way to deal with this reality is to collect urine for 24 hours on multiple days, over extended periods of time. Here’s where the problems start with the Lancet study. It did not examine multiple 24-hour urine collections, but rather one single urine collection on only one day from each participant. This resulted in a poor estimation of everyone’s daily intake of sodium.
Another major flaw resulted from a bias called “reverse causality.” It means that the high risk of death wasn’t caused by low sodium intake. Instead, the relationship was backwards. Participants in the Lancet paper were not healthy volunteers, but were enrolled specifically because they were at risk for or diagnosed with conditions like high blood pressure and diabetes. It was precisely because of their diagnoses and overall health that they may well have eaten less sodium (and less food overall).
Evidence from well-performed studies and public health strategies clearly shows that sodium reduction prevents cardiovascular disease. Recommending up to 5 grams of sodium daily would result in tens of thousands of more deaths annually. If you are interested in a rigorous rebuttal of the Lancet report, see the Sounding Board published by the New England Journal of Medicine.
Debates are healthy, but this one should not distract us from the reality that only a tiny fraction of our population eats a low sodium diet. Most of us are eating far too much sodium. It may well be that low sodium diets are harmful for small subsets of people, but for the majority it will take more convincing evidence to change current efforts at salt restriction.
You may not realize that most of the sodium we eat comes from processed foods — not from our salt shaker. This fact makes it even more difficult to cut back, because so many foods we buy are loaded with salt.
Public efforts to reduce sodium intake in America are underway. In fact, the FDA just recommended voluntary sodium reduction targets for the food industry. We are lagging behind other countries like the United Kingdom and Japan, which have set targets for sodium in processed foods and seen falls in blood pressure and deaths from stroke and heart disease.
Reducing sodium in our diets is a health strategy proven to prevent heart attacks and strokes. By paying attention to the sodium in our diet, we can take one more step towards controlling our own health.

The bladder workout: Tame incontinence without surgery

An overactive bladder (also known as urge incontinence) causes a sudden urge to urinate, even when your bladder isn't full. For some people, it's simply a nuisance. For others, the urge can't be controlled, which leads not only to incontinence but also to a potentially severe negative impact on their quality of life.

Bladder training can go a long way toward helping with urinary incontinence. This treatment strategy involves learning to urinate on a schedule (timed voiding) and doing pelvic muscle exercises.

Most people take bladder and bowel control for granted — until something goes wrong. An estimated 32 million Americans have incontinence, the unintended loss of urine or feces that is significant enough to make it difficult for them to maintain good hygiene and carry on ordinary social and work lives. The good news is that treatments are becoming more effective and less invasive. This Special Health Report,Better Bladder and Bowel Control, describes the causes of urinary and bowel incontinence and treatments tailored to the specific cause.

Here's a step-by-step bladder-training technique:

Keep a diary. For a day or two, keep track of the times you urinate or leak urine during the day.

Calculate. On average, how many hours do you wait between visits to the bathroom during the day?

Choose an interval. Based on your typical interval between needing to urinate, set your starting interval for training so that it's 15 minutes longer. So, if you usually make it for one hour before you need to use the bathroom, make your starting interval one hour and 15 minutes.

Hold back. On the day you start your training, empty your bladder first thing in the morning and don't go again until you reach your target time interval. If the time arrives before you feel the urge, go anyway. If the urge hits first, remind yourself that your bladder isn't really full, and use whatever techniques you can to delay going. Try pelvic floor exercises (also called Kegels), or simply try to wait another five minutes before walking slowly to the bathroom.

Increase your interval. Once you are successful with your initial interval, increase it by another 15 minutes. Over several weeks or months, you may find you are able to wait much longer and that you feel the urge less often. After four to eight weeks, if you think you have improved, do another diary. Compare your initial diary to your second diary to note the improvements in your intervals and the amount of urine you void. The act of reviewing and comparing actually helps reinforce the bladder training process.

The Type Of Mattress Good For People With Back pain

Back pain is one of the top reasons that people begin to lose mobility in middle age. Pain can keep people from engaging in physical activity, making it more difficult for them to maintain a healthy weight and keep up their strength, stamina, and balance as they age. So treating and managing back pain that results from injuries or health problems is crucial for staying on the path of a healthy and active life.

Considering that most people spend roughly a third of their lives lying in bed, choosing the right mattress is essential for managing low back pain. It can make the difference in whether you can sleep at night and function the next day.

In the past, doctors often recommended very firm mattresses. But one survey of 268 people with low back pain found that those who slept on orthopedic (very hard) mattresses had the poorest sleep quality. There was no difference in sleep quality between those who used medium-firm and firm mattresses.

Soft mattresses, on the other hand, can also be problematic. While a soft mattress that conforms to your body's natural curves may help the joints align favorably, you might also sink in so deeply that your joints twist and become painful during the night.

If you want to find out whether a firmer mattress would feel better than the one you're currently using, try putting a plywood board under your mattress to dampen the movement from the bedsprings, or try placing your mattress on the floor.

Of course, you can also go to a mattress showroom and test a variety of models. But keep in mind that what feels comfortable for a few minutes in a store might not translate into a good night's sleep. A more reliable test is to observe how you feel after sleeping on different types of mattresses while away from home — for example, at a hotel or a friend or relative's house.

High blood pressure and diabetes##double trouble??

Do you have high blood pressure, also known as hypertension? If so, you should be tested for diabetes.

That recommendation comes from the U.S. Preventive Services Task Force, an independent panel of experts that reviews the evidence for prevention strategies. The task force's recommendations usually become guidelines for primary care doctors and some specialists.

High blood pressure and diabetes often travel together. Treating them simultaneously is a win-win approach. For example:

Among people with diabetes, controlling blood pressure cuts in half the chances of having a heart attack or stroke or dying of heart disease.Among people with high blood pressure, controlling blood sugar reduces the chances of:losing visionlosing feeling in the fingers or feetlosing a limbsuffering kidney damage.

Key points

If you have high blood pressure, make sure you are tested for diabetes.Controlling blood pressure and diabetes with lifestyle changes can substantially decrease your chances of having a heart attack or stroke. Lifestyle changes include:exerciselosing weight if neededstopping smoking if you're a smoker.

Testing for diabetes

The diabetes test endorsed by the American Diabetes Association is the fasting blood sugar test. It involves having a small sample of blood drawn first thing in the morning, before you have had anything to eat or drink.

If your blood sugar is 126 milligrams per deciliter (mg/dL) or higher, and it's confirmed by a second test a few days later, you have diabetes. Some doctors check for diabetes by testing your blood sugar two hours after you drink a sugary beverage or by testing for the percentage of sugar-coated hemoglobin in the bloodstream (known as hemoglobin A1c).

Diabetes that appears in adulthood is usually type 2 diabetes. It begins years earlier as a slowly smoldering condition known as insulin resistance. Insulin is a hormone needed to move sugar from the bloodstream into muscle and other cells. Some people become progressively resistant to insulin's "open up for sugar" signal. The longer sugar lingers in the bloodstream, the more insulin the body makes. Over time, the insulin-making cells in the pancreas begin wearing out. This dual problem leads to higher and higher levels of blood sugar after meals and between them.

Too much sugar in the bloodstream affects tissues throughout the body. It damages the inner walls of small blood vessels, causing them to thicken and leak. The vessels may eventually clog, impeding blood flow to vital tissues. This process can:

damage nervestrigger heart attacks and strokesharm the kidneyslead to vision loss.

Keeping blood sugar levels as close to normal as possible can prevent these disabling or deadly complications.

Taking control

Diabetes and high blood pressure may be different diseases, but both respond to the same lifestyle changes:

Daily exercise is an excellent way to lower blood pressure and keep blood sugar in check.For folks who are overweight, losing weight is good for both blood pressure and blood sugar.Stopping smoking works for both.So does adopting a healthier diet.

Medications are usually needed to control blood pressure and blood sugar. Statins are helpful for both, regardless of cholesterol level. But lifestyle changes should be the bedrock of treatment, not add-ons after medications.

How to lower your cholesterol without drugs

You can begin to reduce your “bad” LDL cholesterol by making a few simple changes in your diet.

If your cholesterol is creeping upward, your doctor has probably told you that diet and exercise — the traditional cornerstones of heart health — could help to bring it down. And if you’d prefer to make just one change at a time, you might want to begin with your diet. A major 2012 analysis of several controlled trials involving hundreds of men and women found that dietary changes reduced LDL and total cholesterol while exercise alone had no effect on either. (However, adding aerobic exercise did enhance the lipid-lowering effects of a heart-healthy diet.)

The people in the studies followed a variety of diets, from Mediterranean to low-fat to low-calorie. However, the most effective diets substituted foods with cholesterol-lowering power for those that boost cholesterol. According to Kathy McManus, director of the Department of Nutrition at Brigham and Women’s Hospital, eating with your LDL in mind doesn’t have to be an exercise in self-deprivation. While you may have to say goodbye to a few snacks and fast foods, you can replace them with others that are equally satisfying. “You don’t have to follow an all-or-nothing approach. It’s really a matter of common sense,” she says. She suggests a few ways to start getting your cholesterol under control.

This week-by-week plan will help you transform your eating habits into a program of nutritious and delicious food choices that can last a lifetime. Applying the latest results from nutrition science, Harvard experts take you by the hand and guide you to create an eating plan to improve heart health, longevity, energy, and vitality.

Weed out the worst fats

There is so much evidence implicating trans fats in heart disease that the FDA has proposed removing the “generally recognized as safe” designation from them. “The first thing we do when I’m counseling patients is to go over all the sources of trans fats in their diet and make substitutions,” McManus says.

Trans fats are created by adding hydrogen to a liquid fat to help it solidify. Food manufacturers started using trans fats because they extend the shelf life of packaged baked goods. Fast-food purveyors took to them because they can be reused again and again. Although public pressure has forced the food industry to phase out trans fats, they haven’t disappeared entirely. To avoid eating them inadvertently, scrutinize the labels on food packages before you put them in your shopping cart. If you see “partially hydrogenated” in the list of ingredients, pass that product by. If trans fats aren’t banned from restaurants in your area, ask if the cook uses partially hydrogenated oil before you order.

Saturated fats and dietary cholesterol, which are derived primarily from animal products, aren’t exactly heart-healthy, but it’s all right to eat them in small amounts. McManus says that because eggs are such a good source of nutrients, it’s okay to have as many as four yolks a week and whites as often as you like. She also gives a nod to red meat, shrimp, lobster, high-fat cheeses, butter and organ meats — but only to small portions of each one every couple of weeks or so.

Eat more of the better fats

Both polyunsaturated and monounsaturated fatty acids help lower LDL. Most plant-derived oils, including canola, safflower, sunflower, olive, grapeseed, and peanut oils, contain both. Fatty fish (such as salmon, tuna, trout, herring, and mackerel), seeds, nuts, avocados and soybeans are also great sources.

Go crazy with color

Fruits and vegetables have scads of ingredients that lower cholesterol — including fiber, cholesterol-blocking molecules called sterols and stanols, and eye-appealing pigments. The heart-healthy list spans the color spectrum — leafy greens, yellow squashes, carrots, tomatoes, strawberries, plums, blueberries. As a rule, the richer the hue, the better the food is for you.

Don’t be too refined

Whole grains are another good source of fiber. Instead of refined flour and white rice, try whole-wheat flour and brown or wild rice. Old-fashioned oatmeal is also a good choice, but not the quick-cooking versions, which have had much of the fiber processed out.

And don’t substitute sugar for fat. “It’s one of the worst choices you can make,” McManus warns. Food manufacturers may boost the sugar content of low-fat salad dressings and sauces to add flavor. If you see sugar, corn syrup, or any word ending in “ose” near the top of the list of ingredients, choose a higher-fat version without trans fats instead.

Remember: Calories still count

All fats, whether good or bad, have nine calories per gram — about 100 calories a tablespoon. While you switch to a heart-healthy diet you may need to keep tabs on your calorie intake for a while.

End Of Life Issues And It's Myth

Some people don’t have a health care power of attorney or living will because they don’t realize how important these documents are. Others worry that such documents mean they are signing their lives away. Not so.

Living wills and health care proxies — documents known as advance care directives — give you a voice in decisions about your medical care at the end of life. Without these documents, choices may be left up to a doctor or a judge — someone who does not know your values, beliefs, or preferences. This Special Health Report, Living Wills: A guide to advance directives, health care power of attorney, and other key documents, will help you plan ahead and create legal documents to guide decision makers at this important time.

These powerful documents make sure that you get the treatment you would want for yourself if you couldn’t communicate your wishes. Here are a few myths that shouldn’t get in the way of creating a health care power of attorney or living will:

Myth: More care is always better.

Truth: Not necessarily. Sometimes more care prolongs the dying process without respect for quality of life or comfort. It’s important to know what interventions are truly important. It’s often impossible to know that in advance. That’s where the advice of a healthcare team is invaluable.

Myth: Refusing life support invalidates your life insurance, because you are committing suicide.

Truth: Refusing life support does not mean that you are committing suicide. Instead, the underlying medical problem is considered to be the cause of death.

Myth: If medical treatment is started, it cannot be stopped.

Truth: Not starting a medical treatment and stopping a treatment are the same in the eyes of the law. So you or your health care agent can approve a treatment for a trial period that you think may be helpful without fear that you can’t change your mind later. However, be aware that stopping treatment can be more emotionally difficult than not starting it in the first place.

Myth: If you refuse life-extending treatments, you’re refusing all treatments.

Truth: No matter what treatments you refuse, you should still expect to receive any other care you need or want — especially the pain and symptom management sometimes called intensive comfort care.

Myth: Stopping or refusing artificial nutrition and hydration causes pain for someone who is dying.

Truth: Unlike keeping food or water from a healthy person, for someone who is dying, declining artificial nutrition or intravenous hydration does not cause pain.

Back Pain And It's Choice Of Treatment

Whether this is your first round of back pain or your fifth, it’s always important to check in with your doctor. There are many ways to deal with low back pain — and the choices range from waiting it out to surgery. And before you can get an idea of which treatments to try, you’ll need to find out what is causing your pain. With your doctor’s guidance, you can develop a plan to ease your pain and try to make sure it doesn’t recur.

Although you may consult a number of experts (from physical therapists to neurologists) about your back pain, you are perhaps the most important person involved in your care. Be as informed as possible about the risks and benefits of any therapies you’re considering. Be very clear on your goals for treatment. Perhaps you don’t intend to hike up a mountain, but you do want to be able to comfortably do long walking tours on your next vacation. And don’t be afraid to seek out a second or even third opinion, particularly when invasive, experimental, or very expensive treatments are on the table.

Treatment of low back pain has undergone a recent sea change. Experts now appreciate the central role of exercise to build muscles that support the back. This Special Health Report, Back Pain: Finding solutions to heal your aching back, helps you understand why back pain occurs and which treatments are most likely to help. This report describes the different types of back problems and the tailored treatments that are more likely to help specific conditions.

Just as there is no single cause of back pain, there is no “one size fits all” solution. Once you and your doctor have evaluated the medical issues, discussed treatment goals, and narrowed down the options, how you proceed will depend largely on your personal preferences.

Pain relief is the first priority for most people with back pain. But the long-term strategy that’s right for you will depend on what triggered the pain in the first place. For example, if your back pain is the result of an injury, you might work with a physical therapist to find ways to avoid a similar injury in the future. If weak back and core muscles contributed to your back pain, you may want to start a regular exercise program to improve your fitness. If there is an anatomical problem — for example, a compressed disc — you might also need more intensive medical treatment.

Regardless of the source of your back pain, a combined approach — exercise or physical therapy, pain relief, lifestyle changes — usually yields the best outcome.

Joint pain...##osteoarthritis?

Your knee aches from time to time. Or maybe your fingers don't seem as nimble as they used to be. Could it be osteoarthritis?

Osteoarthritis, the most common form of arthritis, develops when cartilage, the flexible tissue lining the joints, deteriorates. As a result, the space between bones gradually narrows and the bone surfaces change shape. Over time, this leads to joint damage and pain.

This report focuses primarily on osteoarthritis — the most common type of arthritis — which affects 27 million Americans. Many people believe it’s a crippling and inevitable part of growing old. But things are changing. Treatments are better, and plenty of people age well without much arthritis. If you have osteoarthritis, you can take steps to protect your joints, reduce discomfort, and improve mobility — all of which are detailed in this report. If you don't have osteoarthritis, the report offers strategies for preventing it.

People with osteoarthritis often have it in more than one joint. It is most common in the knee, hip, lower back, and neck, and in certain finger joints. The symptoms of osteoarthritis usually develop over many years, and many of the early symptoms are the same no matter which joint it starts in. The first sign is often pain in a joint after strenuous activity or overusing the joint. The joint may be stiff in the morning, but loosen up after a few minutes of movement. Or the joint may be mildly tender, and movement may cause a crackling or grating sensation. Some people have continual joint pain that interferes with sleep.

But some telltale signs of osteoarthritis are specific to certain joints. If you're experiencing any of the types of joint pain listed below, ask your doctor to check you for osteoarthritis.

Knees. When osteoarthritis affects the knee, the result is pain, swelling, and stiffness of that joint. What starts out as some discomfort after a period of disuse can progress to difficulty walking, climbing, bathing, and getting in and out of bed.

Hands. Osteoarthritis of the hand often starts with stiffness and soreness of the fingers and in the base of the thumb, particularly in the morning. You may find that it becomes harder to pinch, and that your joints crackle when moved. People with hand osteoarthritis may have difficulty doing routine movements, like opening a jar, turning a key, or typing.

Hips and spine. When osteoarthritis affects the hip, pain may be felt in the groin, down the inside thigh, or even as far away as the knee. Osteoarthritis of the cervical spine (in the neck) can cause pain in the shoulders and arms. When it affects the lower spine, pain can spread to the buttocks or legs.

An Easy Way To Eat Healthier This Period## find a farmer's shop

June 23 is circled on a lot of calendars at Harvard Medical School. It’s the day the Mission Hill Farmers’ Market will open for the summer, just a couple of blocks from the campus. For the last several years we’ve looked forward to the arrival of the trucks laden with leafy greens, succulent fruit, and fresh flowers. Like the residents of the Mission Hill neighborhood, we know how fortunate we are to have the market.

April Bowling, a doctoral student at Harvard T.H. Chan School of Public Health, sums up the benefits we’re getting: “When you attend a farmers’ market, you can have exposure to all kinds of fruits and vegetables that you may not see in your local grocery store. You may try things that you would not normally eat.”

Bowling and her colleagues have studied the effects of farmers’ markets on residents of inner city neighborhoods similar to Mission Hill. In an article published online by Health Promotion Perspectives, they reported the results of a study conducted with Farm Fresh Rhode Island — a food system that supports 11 farmers’ markets in cities across the state. Farm Fresh Rhode Island enrolled 425 families in a program to see whether providing a financial incentive — $20 to spend at a farmers’ market at every third visit to the market — would encourage them to shop at the markets more frequently and to consume more healthful foods.

The research team surveyed a representative sample of 146 people when they entered the program early in the summer and at the completion of the season in late fall. On average, the people reported that they had lowered their daily soda consumption by 25% and increased the amount of vegetables they ate by 12%. More than a third of the participants cited their kids’ willingness to eat more vegetables as the most important reason they stuck with the program. Almost a quarter mentioned the financial incentive.

It’s not surprising that farmers’ markets are steering people toward healthier eating. They are tailor-made for people who are serious about following the 2015–2020 Dietary Guidelines for Americans, which advise a gradual shift to a plant-based diet centered around vegetables, fruits, and whole grains. Moreover, produce may even be less expensive than at the supermarket, and an increasing number of farmers’ markets participate in the federal Supplemental Nutrition Assistance Program and accept electronic benefit transfer (EBT) cards.

The bonus benefits

Farmers’ markets do more than offer a unique selection of fresh produce; they also provide an environment that’s conducive to smart shopping. “There’s a culture that’s specific to farmers’ markets,” Bowling says. “You’re surrounded by other customers who are making healthy choices and by farmers who have grown the produce and know how to prepare it.” Many farmers’ markets offer cooking and educational programs for children. You may find local musicians playing, activists circulating petitions, and people handing out notices of upcoming events. They’re great places to cement a connection with your community, which has its own health benefit.

The next time you’re about to head to a supermarket or big-box store to stock up on groceries, you may want to consider the advantages of making a detour to the nearest farmers’ market:

Freshness. Just-picked produce is at its peak in flavor and nutrition.Variety. You may find some fruits or vegetables you haven’t seen before or new versions of old standards.Information. You can learn a lot at a farmers’ market because the people who sell the produce are likely to have had a hand in growing it. They should be able to tell you the kind of farming methods used and offer suggestions on preparing the food.Samples. If you’re wondering if the cherries are sweet or tart or if the apples are crisp, ask for a sample. Most vendors are happy to comply.Fewer temptations. There are no “center aisles” filled with processed foods and snacks at farmers’ markets, and no candy-stocked checkout counters.Sustainability. Eating locally or regionally grown produce means less energy is expended bringing it to your table. And supporting regional agriculture is good for your community.

How To Cope With An Enlarged Prostate

When a man reaches about age 25, his prostate begins to grow. This natural growth is called benign prostatic hyperplasia (BPH) and it is the most common cause of prostate enlargement. BPH is a benign condition that does not lead to prostate cancer, though the two problems can coexist.

Although 50% to 60% of men with BPH may never develop any symptoms, others find that BPH can make life miserable. The symptoms of BPH include:

1.A hesitant, interrupted, weak urine stream

2.Urgency, leaking, or dribbling

3.A sense of incomplete emptying

4.More frequent urination, especially at night.

Most men eventually develop some type of prostate problem, and when they do there are usually no easy solutions. More than a primer on prostate conditions, the Annual Report on Prostate Diseasesincludes roundtable discussions with experts at the forefront of prostate research, interviews with men about their treatment decisions, and the latest thinking on complementary therapies. This report will provide you with the information you need to understand the current controversies, avoid common pitfalls, and work with your doctor to make informed choices about your prostate health.

As a result, many men seek treatment. The good news is that treatments are constantly being improved. Patients and their physicians now have more medications to choose from, so if one doesn't do the trick, another can be prescribed. And thanks to some refinements, surgical treatments are more effective and have fewer side effects than ever before.

But there are some things men dealing with BPH can do on their own. When symptoms are not particularly bothersome, watchful waiting may be the best way to proceed. This involves regular monitoring to make sure complications aren't developing, but no treatment. For more troubling symptoms, most doctors begin by recommending a combination of lifestyle changes and medication. Often this will be enough to relieve the worst symptoms and prevent the need for surgery.

Tips for relieving BPH symptoms

Four simple steps can help relieve some of the symptoms of BPH:

1.Some men who are nervous and tense urinate more frequently. Reduce stress by exercising regularly and practicing relaxation techniques such as meditation.

2.When you go to the bathroom, take the time to empty your bladder completely. This will reduce the need for subsequent trips to the toilet.

3.Talk with your doctor about all prescription and over-the-counter medications you're taking; some may contribute to the problem. Your doctor may be able to adjust dosages or change your schedule for taking these drugs, or he or she may prescribe different medications that cause fewer urinary problems.

4.Avoid drinking fluids in the evening, particularly caffeinated and alcoholic beverages. Both can affect the muscle tone of the bladder, and both stimulate the kidneys to produce urine, leading to nighttime urination.

What are the symptoms of heart failure?

Despite the name, heart failure does not mean the heart has failed completely. Instead, it means the heart isn't pumping efficiently enough to meet the body's need for blood.

When the body first detects that it's not getting an adequate blood supply, it tries to compensate. Stress hormones rise, pushing the heart to beat faster and harder. Blood vessels narrow in an effort to keep blood pressure stable. To keep blood flowing to the heart and brain, the body diverts blood away from less important tissues. The body also retains sodium and fluid in an attempt to supplement the volume of circulating blood.

This Special Health Report brings you important information on various conditions that affect the heart, along with their causes, symptoms, diagnosis, and prevention. You’ll learn about major cardiovascular problems such as hardening of the arteries, peripheral artery disease, coronary artery disease, and more. You’ll get details on atrial fibrillation, tachycardia, valve problems, aneurysms, and infections and inflammation of the heart, as well as rare conditions and congenital defects.

In the short run, these fixes enable the heart to deliver a near-normal level of blood to the tissues. But over time, these compensatory measures can't keep up, and the heart weakens further.

Heart failure symptoms: 

Heart failure causes two major problems for the body: 

(1) the tissues and organs don't get enough oxygen, and

 (2) fluid builds up in the lungs and tissues. Each of these spawns a series of distinct complaints. Lack of oxygen, for example, can lead to fatigue and mental confusion, while fluid buildup can cause weight gain and swelling in the feet and ankles. If you're unfamiliar with heart failure, you could easily interpret these as isolated symptoms. People often mistakenly attribute the early signs of heart failure to being out of shape, being overweight, or just getting old. Adding to the confusion is the fact that the symptoms can wax and wane over the course of the illness.

At first, heart failure generally affects only one side of the heart. The side of the heart where the weakness begins influences which early symptoms predominate:

When heart failure mainly affects the left side of the heart, blood backs up into the lungs, causing shortness of breath and coughing.

When mainly the right side is affected, blood backs up into the veins and builds up in body tissues, often leading to swelling in the legs.

What you can do about heart failure

Heart failure affects an estimated 5.8 million adults in the United States, and people over age 40 have about a one-in-five chance of developing the condition in their lifetime. In the past, people with heart failure tended to live an average of five years after diagnosis. But thanks to earlier diagnosis and rapid advances in treatment, many people diagnosed with heart failure today go on to enjoy many more years of fulfilling life than that.

So, if you're experiencing any of the symptoms listed above, don't hesitate to see your doctor. As with so many heart-related conditions, early diagnosis makes a world of difference.