Your Health Watch

1. Check it. You can't do much about your blood pressure unless you know what it is. Your doctor should check it at every visit. Measuring it at home is even better. Relatively inexpensive home monitors are available in most pharmacies.

2. Get moving. Regular exercise, even something as simple as brisk walking, improves blood vessel flexibility and heart function. It can lower blood pressure by 10 points, prevent the onset of high blood pressure, or let you reduce your dosage of BP medications.

3. Eat right. A landmark study called Dietary Approaches to Stop Hypertension (DASH) showed that you can eat your way to better blood pressure. The DASH diet emphasizes fruits, vegetables, low-fat dairy products, whole grains, poultry, fish, and nuts, and downplays red meat, sweets, sugar-containing beverages, and saturated fat and cholesterol.

4. Control your weight. If you are carrying too many pounds for your frame, losing weight can lower your blood pressure. You don't need to become rail-thin - losing 10% of your current weight, or even 10 pounds, can make a big difference.

5. Don't smoke. Nicotine constricts small blood vessels. Smoking a cigarette can cause a 20-point spike in systolic blood pressure. Quitting is tough, but there are now more aids to help.

6. Drink alcohol in moderation. A drink a day for women and one or two a day for men is good for the heart and blood vessels. Going beyond that can contribute to higher blood pressure.

7. Shake up your salts. Too much sodium and too little potassium boost blood pressure in people who are sensitive to salt. The imbalance is so great that the AMA is calling for food makers and restaurants to cut the sodium content of food by 50% by 2016. Aim for less than 1.5 grams of sodium a day, and at least 4.7 grams of potassium.

8. Sleep is good. Burning the candle at both ends night after night can contribute to high blood pressure, not to mention increase the chances of developing heart disease or a sudden cardiac arrest. How much sleep is enough? At least six hours a night, though eight hours is probably more like it for most people.

9. Reduce stress. As surely as mental and emotional stress can raise blood pressure, meditation, deep breathing, and other stress-busting activities can lower it.

10. Stick with your medications. Taking pills to keep your blood pressure in check won't make you feel any different. But it can keep you from having a stroke, heart attack, or other problem.

Some causes of fatigue are obvious, such as lack of sleep or a medical illness, but many others are harder to pinpoint. Depression or anxiety, overwork, sedentary living, nutritional factors, even a medication could contribute to fatigue or cause a feeling of low energy.

Fatigue can be due to numerous causes, such as medical conditions like congestive heart failure, hypothyroidism or diabetes. It can also be a result of sleep disturbances brought on by menopause, or by physical changes that accompany aging.

While fatigue may be an inescapable part of life, there's no need to take it lying down. Your body is geared toward generating energy as well as expending it. And there are numerous strategies to help regain the physical and mental energy needed to enjoy life to its fullest.

Eat for energy
The tried-and-true advice for healthful eating also applies to keeping your energy level high:

* Eat a balanced diet that includes a variety of carbohydrates, proteins, and fats with an emphasis on vegetables, whole grains, and healthy oils. Taking a daily multivitamin will ensure that you get the vitamins and minerals you need, but taking extra amounts of individual nutrients won't give you more energy.

* Eating certain types of foods in particular amounts can help prevent fatigue. Because different kinds of foods are converted to energy at different rates, some - such as candy and other simple sugars - can give you a quick lift, while others - such as whole grains and healthy unsaturated fats - supply the reserves you'll need to draw on throughout the day.

* Eat small, frequent meals. Where energy is the issue, it's better to eat small meals and snacks every few hours than three large meals a day. This approach can reduce your perception of fatigue because your brain, which has very few energy reserves of its own, needs a steady supply.

The most common cause of persistent fatigue is stress and the emotional response to it. People who feel fatigued most of the time don't necessarily have more stress in their lives than other people, but they may be more sensitive to its effects.

Stress-induced emotions consume huge amounts of energy. Relaxation therapy can be an effective tool for reducing stress and naturally boosting your energy, particularly when used in combination with cognitive behavioral therapy. Meditation, self-hypnosis, yoga, and tai chi are all relaxation techniques.

One of the easiest techniques to use is progressive muscle relaxation, which involves systematically tightening and releasing sets of muscles, beginning with your toes and progressing up your legs, torso, hands, and arms. You might also consider other relaxation therapies, including aromatherapy and massage.

No matter what age you are, there are things that you can do to feel more energetic. Harvard Health Publications' Boosting Your Energy report will help you take the first steps toward discovering the causes of your fatigue.

Click here to subscribe to the Harvard Health BEAT

The healing power of honey: From burns to weak bones, raw honey can help by Kelly Joyce Neff

The big vitamin scare: American Medical Association claims vitamins may kill you (opinion) by Mike Adams

The Dietary Supplement Pyramid from the Council for Responsible Nutrition

Dietary Supplement Fact Sheet from the World Cancer Research Fund - UK

Dietary Supplements: Do You Need Them? from the Mayo Clinic

Dietary Supplements: Using vitamin and mineral supplements wisely
from the CNN Health Library / Mayo Clinic

Here is a controversial article on type 2 diabetes from the National Center for Complementary and Alternative Medicine - NCCAM and the National Institutes of Health - NIH : Treating Type 2 Diabetes with Dietary Supplements

Do I Need To Take Supplements? from Health Castle

Dietary Supplements: Facts vs. Fads from Kids Health / Teens Health

From the Center for the Advancement of Health:
Elderly Dietary Supplement Users May Not Need Them by Becky Ham,
Staff Writer of the Health Behavior News Service

National Institute on Aging

How the Dietary Supplement Health and Education Act of 1994 Weakened the FDA by Stephen Barrett, M.D.

The Need for Vitamin D from the National Institutes of Health

The Need for Regulation of Dietary Supplements from the Journal of the American Medical Association - JAMA

Tips for Older Dietary Supplement Users from the FDA / Center for Food Safety and Applied Nutrition

In June of 2002, one of the most respected fournals in medicine, the Journal of the American Medical Association, published a comprehensive review of almost 40 years worth of scientific research on the relationship between vitamins and certain diseases.

This review, which was conducted by two Harvard researchers, clearly illustrates how vitamin deficiencies are associated with chronic diseases such as cancer, coronary heart disease and osteoporosis.

The researchers located many studies that prove taking folic acid during pregnancy helps prevent certain birth defects. Folic acid has also been proven to help prevent heart disease and several types of cancer when taken on a regular basis.

Regarding the intake of vitamin E, the researchers located evidence that it is an important antioxidant necessary for immune function. They also found that vitamin E has a role in the prevention of heart disease and prostate cancer in some people. Vitamin D and its relation to bone mass appeared in the review as well as supportive evidence for the value of vitamins B6 and B12.

Based on these findings and the recognition that Americans are not receiving enough vitamins from their diets, the Harvard researchers recommend that all adults take one multivitamin daily.

For more information, go to the Journal of the American Medical Association, June 19, 2002.

In 1998, the Journal of Nutraceuticals, Functional & Medical Foods published an evaluation on liquid vitamins and minerals. The purpose of the evaluation was to look at the evidence surrounding whether or not there were benefits to vitamin and mineral supplements delivered in liquid form.

A wide variety of research studies were reviewed and it was determined that liquid supplements contain nutrients that are highly bioavailable, can be gentler to the stomach and are sometimes more suitable for children and elderly people.

For more information, go to the Journal of Nutraceuticals, Functional & Medical Foods, Volume 2, Number 3 page 207.

USDA statistics show the average American diet is significantly lacking in the essential minerals needed for energy production and protection from free radical damage as well as other vital functions. This is according to statistics from the USDA's 1994-96 Continuing Survey of Food Intakes by Individuals and 1994-96 Diet and Health Knowledge Survey.

Additional information is available from The Council For Responsible Nutrition Recommended Intakes of Vitamins and Essential Minerals. www.crnusa.org

Five thousand patients with angina pectoris were studied over a five-year period of time. Angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease.

During the five-year period, the patients' diets were supplemented with aloe vera and psyllium husks. What was then observed were numerous indicators showing an improvement in cholesterol balance, such as a reduction in total serum cholesterol.

At the same time, the clinical profile of these patients showed reduction in the frequency of anginal attacks and a gradual reduction in the use of drugs. The patients most benefitted were diabetics (without adding any diabetic drug).

According to the study's author, the exact reason behind why the above two substances work is unknown, but may be due to their fiber contents. Both substances need further evaluation.

For more information, go to the Journal of Angiology, Volume 36, Issue 8.

A study was recently conducted to see whether or not the polyphenols found in tea might slow the growth of prostate cancer cells. Polyphenols are compounds found in plants and possess antioxidant properties. Antioxidants are substances that protect cells from oxidative damage caused by molecules called free radicals. Based on several types of findings, researchers did see evidence linking green and black tea to the slowing of prostate cancer cell growth.

For the full article go to: www.healthy.net

Stomach cancer patients in a randomized clinical study were less likely to expand liver cancer when treated with D-galactose, a glyconutrient. A glyconutrient is a sugar molecule that is useful to the body in a variety of ways, including support of the body's natural defenses.

The study, conducted in Poland, showed that patients treated with D-galactose (most easily found in aloe vera) showed "significant effect on survival free of hepatic metastases [spread of cancer to the liver]" compared to the control group.

For more information, go to www.nutritionhealthinfo.com

Although many dietary methods can lead to weight loss, a recent study found that high carbohydrate diets with a low glycemic index may be the ideal for weight loss and reduction of cardiovascular risk factors.

A recent study compared the relative effects of several diet methods on weight loss and cardiovascular risk.

A total of 129 overweight or obese young adults were assigned to 1 of 4 reduced-fat, high-fiber diets for 12 weeks. Diets 1 and 2 were high carbohydrate (55% of total calories), with diet 1 carbohydrates being high-glycemic and diet 2 being low-glycemic. Diets 3 and 4 were high protein (25% of total calories), with high and low glycemic index carbohydrates respectively.

The glycemic load was the highest in diet 1 and the lowest in diet 4. Changes in body composition and blood chemistries were then studied. The average weight loss from each group was similar, but those on diets 2 and 3 lost approximately 80% more fat mass than those on diet 1. LDL cholesterol levels declined significantly in diet group 2, but increased in diet group 3.

Therefore, both high-protein and low-GI diets increase body fat loss, but cardiovascular risk reduction is enhanced by a high- carbohydrate, low-GI diet (diet 2).

For more information, go to the Arch Internal Medicine July 2006, 24;166(14):1466-75

Vitamin D deficiency early in life is associated with rickets, a disorder characterized by soft bones. New research has shown that despite taking a prenatal vitamin, vitamin D deficiency is very common in pregnant women and newborn infants. Higher-dose supplementation and increased sun exposure is needed to improve maternal and infant vitamin D status.

Even among those taking prenatal multivitamin supplements, vitamin D levels were found to be insufficient or deficient in pregnant women, particularly in African-American women and women living in northern regions, according to new research published in the Journal of Nutrition. Researchers took blood samples from 400 pregnant women - 200 black women and 200 white women - before 22 weeks gestation and again after delivery.

More than 80% of African American women and nearly half of white women tested at delivery had levels of vitamin D that were insufficient, even though more than 90% of them used prenatal vitamins during pregnancy.

In addition, umbilical cord blood from newborns showed 92.4% of African American babies and 66.1% of white infants had insufficient vitamin D levels at birth, leaving them at risk for rickets and other health problems. A newborn relies completely on its mother for its vitamin D stores.

These results suggest that black and white pregnant women and newborns residing in the northern US are at high risk of vitamin D insufficiency, even when mothers regularly take prenatal vitamins. Higher-dose supplementation is needed to improve maternal and infant vitamin D status.

For more information, go to the Journal of Nutrition 137:447-452, February 2007

Johns Hopkins Researchers recently reported that the intake of vitamins E and C in combination reduced both the prevalence and incidence of Alzheimer's disease.

Using data gathered from a large group of respondents age 65 and older, the researchers' investigation revealed that high doses of certain antioxidants may mitigate age-related cognitive deterioration by protecting neurons from free radical damage. Free radicals are unstable oxygen molecules that can damage the body from exposure to environmental toxins, intake of chemicals found in processed foods, overexertion, etc.

Because of the results of this study researchers suggest that antioxidant supplements merit further study as agents for the primary prevention of Alzheimer's disease.

For more information, go to the Archives of Neurology, Volume 61, January 2004.

Elderly adults are increasingly susceptible to infections, oxidative stress and immune dysfunction. According to new research, supplementing with zinc for one year decreased the incidence of infections and lowered markers of oxidative stress in a group of adults aged 55-87 years.

Adults over the age of 55 years are more susceptible to infections, immune dysfunction, increased oxidative stress, and zinc deficiency. Since zinc has anti-inflammatory and antioxidant properties, new research sought to determine the effect of zinc on the incidence of total infections in the elderly.

Researchers also tested the effect of zinc on markers of oxidative stress. A randomized, double-blind, placebo-controlled trial of zinc supplementation was conducted in 50 healthy subjects of both sexes aged 55-87 years.

The zinc- supplemented group received 45 mg of zinc orally for 12 months. Incidence of infections during the supplementation period was documented. Plasma zinc concentrations and markers of oxidative stress were measured at the beginning and after supplementation.

After zinc supplementation, the incidence of infections was significantly lower, plasma zinc was significantly higher, and generation of oxidative stress markers was significantly lower in the zinc-supplemented than in the placebo group.

For more information, go to the American Journal of Clinical Nutrition, Vol. 85, No. 3, 837-844, March 2007

In a study conducted at the Gifu Pharmaceutical University in Japan, an in-vitro study showed that some of the xanthones from garcinia mangostana (mangosteen) had strong antibacterial activity. Xanthones are plant nutrients or phytochemicals that have been studied for their medicinal and antioxidant potential.

For more information, go to the Journal of Pharmacy and Pharmacology, Volume 48, Issue 8.

Research in the 1990's seemed to indicate that beta-carotene supplements may increase lung cancer risk in smokers. However, a new analysis of dietary records from one of these studies led researchers to a different conclusion. Male smokers with the highest overall antioxidant intake, including beta-carotene, actually had a reduced risk of lung cancer.

In observational studies, a high intake of individual antioxidants was related to increased lung cancer risk in male smokers. However, data from many experiments suggest that there are interactions among antioxidant nutrients; therefore, consideration of multiple antioxidants simultaneously may be important in terms of assessing risk.

Yale University researchers evaluated dietary records of participants in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC). A group of over 27,000 Finnish male smokers aged 50-69 had food records analyzed along with intakes of carotenoids, flavonoids, vitamin E, selenium, and vitamin C. After evaluating the overall intake of antioxidants in this group, the conclusion differs somewhat from the original study.

According to this new analysis, the men with higher overall intakes of antioxidants had lower relative risks of lung cancer, regardless of their assigned study group (beta-carotene or placebo). While researchers of the ATBC study concluded that high-dose beta-carotene supplementation may increase lung cancer risk in male smokers, these findings support the hypothesis that a combination of dietary antioxidants reduces lung cancer risk in men who smoke.

For more information, go to the American Journal of Epidemiology July 2004, 1;160(1):68-76

Proanthocyanidins are a specific class of phytonutrients with numerous health giving properties. This class of flavonoids earned their primary reputation as being powerful antioxidants or free radical scavengers.

Free radicals are damaging unstable oxygen molecules that get into the body as a result of over-exercise, stress, being exposed to dirty air and other environmental pollutants.

Proanthocyanidins also help in the stabilization of collagen and elastin. These are two critical fibrous proteins found in the connnective tissues that support organs, joints, blood vessels and muscle. Proanthocyanidins can be found in numerous plant and food sources including mangosteen

Proanthocyanidins have been reported to possess a wide range of biological properties against oxidative stress. For this reason, a recent study was conducted using proanthocyanidins to see if they hold potential for helping to protect against periodontopathogens.

The study, conducted in Canada, demonstrated that proanthocyanidins have potent antioxidant properties and should be considered a potential agent in the prevention of periodontal diseases. Periodontal diseases are dental diseases involving bone loss, pockets and recession of the gums. More research is needed to confirm these findings.

For more information, go to the Journal of Periodontology, Volume 77, August 2006.

Weight loss and reduced waist circumference are related to an improvement in heart health and factors related to metabolic syndrome. According to a new study, supplementing with calcium and vitamin D during weight loss enhances heart health benefits in women with typically low calcium intake.

Recent research has shown that overweight individuals with low calcium and dairy consumption are at increased risk of developing metabolic syndrome. The findings suggest that adequate calcium intake could create a healthier metabolic profile similar to a balanced diet and regular exercise.

In a new study, researchers investigated this issue by testing cardiovascular benefits of long-term calcium supplementation in women with usual low calcium intake. Healthy, overweight or obese women with a daily calcium intake of less than 800 mg/day were randomly assigned to 1 of 2 groups: the group consuming 2 tablets/day of a calcium + vitamin D supplement (600 mg elemental calcium and 200 IU vitamin D/tablet) or the group consuming placebo. Both groups completed a 15-week reduced calorie weight-loss program.

Significant decreases in LDL cholesterol levels, as well as the ratios of Total to LDL and LDL to HDL were seen the calcium +D group. These changes were independent of the changes due to fat loss and reduced waist circumference. A tendency for more beneficial changes in HDL cholesterol, triglycerides, and total cholesterol was also observed in the calcium +D group.

This was the first study to show that consumption of calcium +D during weight- loss enhances the beneficial effect of body weight loss on cardiovascular risk factors in overweight women with typically low calcium intake.

For more information, go to the American Journal of Clinical Nutrition, Vol. 85, No. 1, 54-59, January 2007

A recent research study in Canada looked at whether or not there were any benefits to taking a multivitamin and trace element supplement. Twenty-two people between the ages of 50-65 were given a supplement for one year and an equal group was given a placebo.

The supplement group showed a stronger immune system response in a variety of tests. The total number of sick days taken by the placebo group was 24 versus 11 in the supplement group. Half the subjects on the placebo product were round to have low blood levels of at least one of the nutrients, while no one in the supplementing group had deficiencies.

For more information, go to Nutrition Research, January 2002.

Increasing dietary fiber intake to at least 25 grams per day from varied sources provides a significant protective effect against cardiovascular disease. Researchers presumed that fiber intakes of 30- 35 grams per day would likely provide an even greater protective effect.

Increased dietary fiber intake is associated with reduced levels of a number of cardiovascular disease risk factors. The results of a study published in the American Journal of Clinical Nutrition add to a growing body of evidence linking higher dietary fiber intake with a lower risk of heart disease. Nearly 6,000 men and women were selected from participants in an ongoing trial designed to evaluate the effect of antioxidants on cancer and heart disease incidence over an eight-year period.

The highest total of insoluble dietary fiber intakes were associated with reductions in the risks of overweight and elevated waist-to-hip ratio, blood pressure, cholesterol, triglycerides, and homocysteine. Fiber from cereals was associated with a lower body mass index, blood pressure, and homocysteine concentration; fiber from vegetables with a lower blood pressure and homocysteine concentration; and fiber from fruit with a lower waist-to-hip ratio and blood pressure. Fiber from dried fruit or nuts and seeds was associated with a lower body mass index, waist-to-hip ratio, and glucose concentrations.

The findings of this study illustrate the significance of increasing fiber intake from various dietary sources. The results also indicate that 25 grams total dietary fiber per day is the minimum intake required to attain a significant protective effect against cardiovascular disease, and that total dietary fiber intakes of 30-35 grams/day will likely provide an even greater protective effect.

For more information, go to the American Journal of Clinical Nutrition, Vol. 82, No. 6, 1185-1194, December 2005