March is Colorectal Cancer Awareness Month — the perfect time to talk about the importance of screening for colon cancer via colonoscopies.
When you’re ready to make an appointment, did you know there are two things you can ask the colonoscopist to make sure you will be getting a thorough exam?
During a “CBS Mornings” Facebook Live hosted by CBS News chief medical correspondent Dr. Jon LaPook, gastroenterology experts discussed the quality metrics people can ask of their doctors who are doing the procedure.
First is the adenoma detection rate, or ADR, explains Dr. Mark Pochapin, head of gastroenterology and hepatology at NYU Langone Health, who was part of the discussion.
“Adenoma is a type of polyp that we find that has the potential of turning cancerous. These are the polyps we want to make sure we find and remove,” Pochapin explained. “We should be able to have a rate that is measured.”
During a colonoscopy, a long, flexible tube with a tiny camera on the end is inserted into the rectum of the patient, allowing the doctor to view the inside of the colon and remove any polyps or abnormal tissue, the Mayo Clinic explains. Since the patient is typically under sedation or anesthesia, these removals are not felt.
“Colon polyps are common in adults and are harmless in most cases. However, most colon cancer begins as a polyp, so removing polyps early helps to prevent cancer,” the National Institutes of Health says.
For patients getting their first screening colonoscopy, a physician’s ADR rate should be 25% to 30% or even higher, Pochapin says.
“I think most of us have adenoma detection rates over 40%, meaning that 40% of the time in patients getting their first screening colonoscopy, we find at least one adenoma,” he continued. He encouraged people to ask their physician about what their ADR rate is. “See if they have a response. They really should be measuring that to make sure that their quality is good.
“If you withdraw the scope too quickly, you might miss something… it’s important that people make sure that they take their time when they’re doing the procedure,” Pochapin says.
Withdrawal time should really be around seven or eight minutes, with six minutes being the “absolute minimum” if there are no findings, he notes, adding that too long of a withdrawal time isn’t good either.
This time frame refers just to the scope withdrawal time, not the total time for the whole procedure.
“If you find a polyp, it takes time to remove that polyp… so the colonoscopy may take 40 minutes,” he explains. “You’re inserting the scope, you’re removing polyps and in addition you’re looking.”
Colorectal cancer is the third deadliest form of cancer in the United States. The American Cancer Society anticipates 153,020 new cases this year, and 52,550 deaths.
The best way to reduce your risk? Getting screened.
Do Anti-ESG States Know They’re Facing Some of the Worst Climate Change Hazards?
By The Daily Upside – March 24, 2023
Unless the data are dead wrong, it is increasingly clear that many of the U.S. states facing some of the greatest climate change hazards appear to be the ones most virulently opposed to environmental, social and governance (ESG) policies.
The data also show something else that we don’t like to talk about: Americans are already dying due to climate change and have been since around 2005. U.S. cities from coast to coast are experiencing fatalities in the double digits yearly, especially south of the Mason-Dixon line, according to an in-depth project surveying more than 24,000 regions of the world, led by the United Nations Development Program and New York-based Rhodium Group, a provider of independent research, data and analytics tackling mission-critical global topics.
In Texas, the fatality rate due to climate change – for instance, from heat stroke or other underlying causes – is estimated to be 14 people a year per 100,000 of the population in both Dallas and Austin. Those numbers will rise to 38 and 39, respectively, by 2040, and leap to 130 and 131 people a year, respectively, by 2080, according to the data.
The situation in Phoenix is even more dire, with an annual fatality rate of 17 people per 100,000 of the population, climbing to 46 by 2040 and 148 people a year by 2080. In Atlanta, the fatality rate is estimated to be around 10 people a year per 100,000, with that number at 29 by 2040 and shooting to 100 people by 2080.
“The mortality impact is some of the most striking of the data,” says Hannah Hess, associate director at Rhodium, who worked on the project. “When you look at the year 2040, it can seem really far out and distant in the future, but the people most affected by the heat are 65 and older – those are people in their 40s today who will be impacted.”
By the same token, those in their 20s and 30s will be confronting even higher temperatures, and those who are currently in their teens or younger will be forced to contend with some of the most extreme climate challenges of anyone alive.
This week, President Biden cast his first veto since taking office, rejecting a bill that would have scuttled a Labor Department rule he put in place allowing money managers to account for climate change when making investment decisions for their clients’ retirement savings. The Biden rule supplanted a Trump-era rule that sought to impede the consideration of ESG principles in investing, “even in cases where it is in the financial interest of plans to take such considerations into account.”
In issuing the veto, Biden blasted “MAGA House Republicans” and others for risking Americans’ retirement plan savings by making it illegal to weigh ESG principles. “Your plan manager should be able to protect your hard-earned savings, whether Rep. Marjorie Taylor Greene likes it or not,” he said, noting strong opposition from the Republican congresswoman from Georgia.
Two Democrats also backed the bill. Sen. Joe Manchin of West Virginia, who charged that Biden’s veto was “absolutely infuriating” and denounced the administration’s “radical” and “progressive agenda,” and Jon Tester of Montana, who voted alongside the Senate’s Republicans to overturn the Biden rule.
Both Georgia and West Virginia are forecast to sustain pronounced effects from climate change relative to northern states, like Montana.
The ESG fight, not surprisingly, is focused on money – primarily, how resources will be marshaled or redirected in anticipation of future shifts that are expected to devastate real estate, housing and jobs markets. “Without concerted and urgent action, climate change will exacerbate inequalities and widen gaps in human development,” the UNDP projected at the end of last year.
A smattering of top money managers and private equity firms have begun to prepare for the transition, touting pro-ESG investing principles that aim to capture a profit. But they have also warned adopting these strategies poses heightened financial and reputational risks with the growing anti-ESG backlash.
The world’s biggest private-equity firm, Blackstone, disclosed in a recent filing that pushback from states across the country over so-called “boycotts” of investments in the fossil fuel industry could affect the company’s fundraising and revenue and will be perceived negatively by some stakeholders. Others signaling similar headwinds include KKR & Co., State Street, Carlyle Group, T. Rowe Price, TPG Inc., Ares Private Equity Group, Raymond James, and BlackRock.
While partisanship seems to be ruling the debate, it’s worth looking closely at what is forecast for some of the states that are most assiduously pursuing anti-ESG legislation, many of which are expected to experience some of the most serious fallout of climate change. Among them are Texas, Arizona, Oklahoma, Idaho, Louisiana, Arkansas, Tennessee, Kentucky, West Virginia, South Carolina and Florida.
Over the past few years, these states have sought to introduce or pass legislation barring companies from discriminating against investing in fossil fuel developers or energy companies contributing to climate change. Those succeeding in passing legislation against so-called “woke capitalism” include Texas, Arizona, Oklahoma, Idaho, Louisiana, Tennessee, Kentucky, West Virginia, South Carolina and Florida.
Other states that have tried or are still trying to pass anti-ESG legislation include North Dakota, South Dakota, Colorado, Wyoming, Montana, Arkansas, Nebraska, Minnesota, Pennsylvania and New Hampshire, according to the National Conference of State Legislatures, a Denver nonpartisan research organization. Meanwhile, Arizona, Texas, Oklahoma, South Carolina, Tennessee and Florida have more anti-ESG legislation pending, in addition to what they’ve already enacted, even though all of them are now dealing with fatalities from climate change.
Hess says research shows that some states’ attitudes may change on climate change as “those places start to feel the impact,” but, until then, states suffering the ongoing fatalities of climate change while fighting to ban ESG-friendly policies, sustainability practices and “social credit scores” to protect investments in fossil fuels is “an odd reality.”
Worth noting are the states that have pursued anti-ESG legislation, but will not feel the impact of climate change as strongly as some of the states mentioned above. They are Pennsylvania, New Hampshire, Indiana, Missouri, Kansas, Nebraska, Utah, Wyoming, Montana, Minnesota, North Dakota, South Dakota and Alaska.
The one state that will be hard hit by climate change but is working to bolster pro-ESG initiatives – and block any attempts to stop it from doing so – is California. According to the UNDP-Rhodium data, the state’s cities are already sustaining some of the highest annual fatality rates in the country due to climate change. At present, the death toll is estimated to be around a dozen people per 100,000 of the population in San Francisco and Sacramento, but is seen rising to 30 and 33, respectively, by 2040, and 104 and 113 people a year, respectively, by 2080.
Other cities that are being impacted by climate change include Los Angeles, Houston, San Antonio, Las Vegas, Nashville, Memphis, New Orleans, Miami, Virginia Beach, Raleigh, Charlotte and Washington, DC, according to the data.
Interestingly, the data show a handful of states will see some benefits from climate change, at least in theory. Rising temperatures likely will contribute to fewer mortality rates in cooler cities such as Seattle, Portland, Denver, Kansas City, Minneapolis, Milwaukee, Chicago, Indianapolis, Louisville, Cincinnati, Pittsburg, Philadelphia, New York and Boston. These benefits stem from the fact that, as temperatures rise, annual fatality rates resulting from cold weather will ease, Hess says.
Even with fewer fatalities in some regions, by the end of the century, the effects of climate change will eventually overtake much of the U.S., whether through rising temperatures, changes in precipitation, droughts, serious weather patterns, or what is expected to be an influx of displaced populations – also known as “climate refugees” – who will need to migrate to safer locations to survive. That means anyone living in safe zones will find their regions more and more crowded.
“Income will matter a lot in how people will be able to adapt and respond to the impact of climate,” Hess says.
‘Gerbil banking’ preceded the Great Depression. We’re seeing it again today
Maureen O’Hara – March 23, 2023
The recent action by a consortium of banks to deposit money in First Republic Bank harkens back to an earlier attempt to counter bank runs: the U.S. Postal Savings system.
Banking in the 19th century was notoriously unstable, with bank runs or “panics” coming all too frequently. By the turn of the 20th century, such runs were almost seasonal, prompting depositors to withdraw in advance of what might be a coming run, thereby, of course, precipitating liquidity crises at banks. This came to a head in the Panic of 1907, the granddaddy of panics, when the banking system collapsed.
Congress at that time considered an array of solutions to bank instability such as deposit insurance (favored by the Democrats), postal savings (favored by the Republicans), and a central bank (favored by almost none of them but viewed as something to study). Republican William Howard Tafts’ election in 1908 sealed the deal, and we got a Postal Savings system.
The idea of Postal Savings was simple. There were post offices everywhere and they would take deposits from individuals, paying them a slightly lower interest rate than the banks offered (a maximum deposit of $2,000 was also imposed to reduce competition with the banks). Now, when individuals became concerned about bank solvency and withdrew their funds, they could put the money in Postal Savings instead of under their mattresses. And what would the Postal Savings system do with the funds? Put the money back into the banks!
This gerbil-like treadmill would thus keep the funds in the banking system, while giving the Postal Savings system interest on its bank deposits to pay the system’s depositors. The circularity of flows out of and then back into the banking system at the heart of the Postal Savings system did have a certain cleverness to it.
As David Easley and I showed in a research paper, this system worked pretty well until the onset of the Great Depression. Faced with growing numbers of bank failures, even the Postal Savings system lost faith in the banks, and so shifted its investments from deposits to government bonds. While certainly not the major cause of banking’s problems, we showed that this action contributed to the liquidity problems undermining the banking system. With the collapse of the banking system in 1933, the view that the Postal Savings system could restore stability to the banking system similarly vanished, setting the stage for the establishment of FDIC deposit insurance.
The latest banking woes demonstrated once again that when concerns arise, depositors flee–but this time to the largest banks which are viewed as “Too Big to Fail”. And what did they do with the money? Already awash with deposits, they made the decision to put some back into First Republic. The gerbil lives again!
The actions of the large banks are admirable, but clearly, this is only a short-run answer. Is a new U.S. Postal Savings System the answer? No. Deposit insurance has proven its worth in protecting retail depositors, who, if they have amounts above the insurance cut-off can simply open accounts at multiple banks.
Corporations also qualify for deposit insurance and they face the same $250,000 limit–but is this the appropriate level? The reported inability of some companies to make payroll payments following Silicon Valley Bank’s closure and the need for a larger scale to meet basic corporate banking needs suggests it’s not.
The argument for insurance limits is based on limiting moral hazard at banks. But where this cut-off limit should be is debatable, and the FDIC’s willingness to deviate from its stated level when the need arises underscores the arbitrary nature of this guarantee limit. SVB’s corporate customer-driven bank run underscores why it is time to re-examine this important aspect of our banking system protection.
Maureen O’Hara is the Purcell Professor of Finance at the Johnson College of Business, Cornell University, and a former President of the American Finance Association.
The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.
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Women are skipping marriage and becoming a force in the workplace
Megan Leonhardt – March 22, 2023
Hero Images/Getty Images
The number of single, unmarried women in the workforce has grown three times faster than the overall pool of workers in the past decade.
Women today are spending a larger portion of their lives single, many of whom are waiting longer to marry or start families, while others are opting to remain permanently unattached. It’s a global trend, according to Dinah Hannaford, associate professor of anthropology at the University of Houston. In the U.S., the median age of first marriage for women has risen from a low of 20.1 in 1956 to an estimated age of 28.2 last year, according to the Census Bureau.
More than half (52%) of women are unmarried or separated as of 2021, according to a recent report from Wells Fargo Economics. “As women spend a greater portion of their lives as a single economic unit, it is ushering in changes to their relationship with the labor market,” the report notes.
Although the reasons behind delaying or skipping marriage vary, careers play a large role—as the numbers show. Single, unmarried women, as it turns out, are a rapidly growing segment of the labor force, holding the highest participation rate of all women. The participation rate for married women, for example, is about 7 percentage points lower than that for single women, according to research from the Federal Reserve Bank of Cleveland. Unmarried single women now account for 16% of workers, up from 13.9% in 2012, according to the Wells Fargo research.
These unmarried women are increasing their share of the labor force not only because of their growing population numbers, but also because they tend to have a greater financial need for work. Single women, particularly those who have never married, usually only have their own earnings to rely on, creating more of an imperative to hold down employment. Researchers found that the labor force participation rate of never-married women has increased 1.9 percentage points over the last 10 years—higher than the rate of never-married men.
The growing labor force participation rate among unmarried women also stands in contrast to an overall steady decline in the total U.S. participation rate (even prior to the COVID-19 pandemic). “The rising number of single women in the United States has thus provided some much-needed support to the U.S. labor force over the past decade,” the report says.
The labor force participation rate of working women (ages 25 to 54) has finally, fully rebounded after 13.6 million women lost their jobs during the onset of the COVID-19 pandemic three years ago. In February, 77.2% of prime-age women were working or actively looking for a job, on par with the pre-pandemic rate of 77%.
But women—even single unmarried women—are still employed at lower rates in the U.S. than men due to a number of headwinds, including a lack of childcare, wage disparities, tax policies, and even government benefits. The latest data shows men’s workforce participation is still roughly 12 points higher than women.
So while single women who have never married are increasingly a critical labor source—particularly as employers continue to struggle with recruiting—there are still challenges to overcome to see continued financial and economic improvement for this sector of the population.
MIT neuroscientist Li-Huei Tsai said it boils down to routine and discipline.
It comes down to discipline.
That’s according to MIT Professor Li-Huei Tsai, a neuroscientist who focuses on diseases like Alzheimer’s and directs The Picower Institute for Learning and Memory. She told Insider that the keys to maintaining healthy brain function and memory as you age are no secret.
Li-Huei TsaiCognito Therapeutics
“I think people actually know what they should be doing to stay healthy and to preserve their memory,” Tsai said.
She said that common expert advice — exercise, be socially and intellectually active, and maintain a healthy diet — are important to implement into our lives. The harder part is maintaining those habits.
“I think that if you just keep a routine, you know, you do it,” Tsai said. “I mean, I think that’s the only way to do it.”
A recent study published in The BMJ that followed almost 30,000 people in China for 10 years found that those who followed more “healthy lifestyle factors” had slower memory decline than those who did not.
Researchers in the study looked at many of the same factors that Tsai called out: a healthy diet, regular exercise, regular social contact, cognitive activities, and abstaining from both smoking and alcohol.
Tsai said she knows it’s important to maintain her routine even when conditions are less than favorable.
“I just have to really discipline myself,” she said. “For instance, exercise in the winter: it’s really painful when you look at outside temperature below zero and there’s ice and snow on the ground. I just try to discipline myself.”
What’s Causing Your Gut Inflammation? These Common Triggers Might Be to Blame
Amanda Lauren – March 21, 2023
You have more control over gut inflammation than you think.
Fabian Montano/Getty Images
Most of us are aware of gut health, but it’s probably not something we think too much about until it becomes a problem. Then one day something starts feeling off—maybe you’re constantly bloated, constipated, or struggling with another form of digestive discomfort—and gut health suddenly has to come to the forefront of your mind. Or it’s possible you may experience other, seemingly unrelated symptoms, such as bad breath, breakouts, fatigue, or headaches and wonder if somehow it could be connected to poor gut health.
“Numerous studies have shown that the gut microbiome is a powerful driver behind the body’s inflammatory status and gut dysbiosis—a broad term that describes an imbalance of the gut microbiota—is thought to trigger inflammatory responses that can lead to chronic gut inflammation,” says Jordyn Gottlieb, MS, expert in nutrition science and food and agricultural policy, and contributor for January AI and Eden’s.
“Gut inflammation is an immunological state that occurs when the body senses an irritant somewhere along the digestive tract and signals to the immune system to repair it, resulting in swelling, pain, and impaired functions,” Gottlieb explains.
But gut inflammation isn’t just one thing—it’s an umbrella term that covers a wide range of issues, diseases, and syndromes associated with a disturbed digestive system including IBS, IBD, and leaky gut syndrome.
“Symptoms [of gut inflammatory issues] often start out with stomach aches, digestive pain, diarrhea, constipation, fatigue, bloating, and cramping,” she says. “But longer-lasting, chronic inflammation can lead to problems that extend beyond the digestive tract.”
Gut inflammation can stem from several factors, and since gut health is such a complex and multifunctional thing—affected by and affecting so many other facets of our health—it can be tricky to pinpoint the source of gut issues and find solutions without some knowledge. Here are five common causes of gut inflammation and the best ways to keep it at bay and prevent flare-ups.
Routinely eating inflammatory foods and drinking alcohol.
While most of us enjoy foods and drinks that aren’t the most nutritious for our bodies, at least on occasion (and we should!), if the food you eat regularly doesn’t support a thriving, diverse, and healthy microbiome, then gut inflammation often isn’t far behind.
If gut inflammation is an issue, it’s smartest to limit (or better, avoid) certain things that trigger inflammation, disrupt the ratio of good-to-bad gut bacteria, and send our systems on a metabolic roller coaster. This includes drinking alcohol and highly processed, sugary drinks, says Chris Damman, MD, MA, clinical associate professor of gastroenterology and medicine at the University of Washington, and the chief medical and scientific officer of Supergut.
“Some foods that might adversely impact gut health, but not necessarily be associated with an increase in gut inflammation include processed meats, baked goods containing refined sugars, sugary drinks, and alcohol,” he says. “Baked goods containing refined sugars and sugary drinks (including diet drinks without sugar) have been linked to imbalances in the gut microbiome and dysregulation of blood sugar.”
Neglecting gut-healthy foods and nutrients, like fiber.
Your gut health is impacted just as much by what you don’t put into your body. A diet lacking in certain things your body craves will have its consequences. Fiber, antioxidants, prebiotics, and probiotics are a few of the best things to eat regularly for a happy gut microbiome.
When it comes to keeping gut inflammation at bay, don’t approach nutrition from a mindset of deprivation, because the idea of depriving yourself of the foods and cocktails is a huge bummer. Instead, think about it in terms of what you can add to your diet. Experts strongly suggest prioritizing adding more fiber into your diet. “Increased fiber intake helps produce gut-healthy short chain fatty acids (SCFAs) and other bioactives that promote metabolic and immune health, which is important not only for optimal blood glucose regulation, but also for appetite suppression, immunity enhancement, reduced intestinal inflammation, and other beneficial effects,” Gottlieb says.
How can you up your fiber intake?
Focus on eating lots of veggies, such as acorn and butternut squashes, kale, broccoli, carrots, spinach, sweet potatoes, and asparagus. Fruits are also packed with gut-beneficial fiber. Some of the best high-fiber fruits include avocados, raspberries, blackberries, pears, kiwi, pomegranate, oranges, and tangerines. Beans and legumes are excellent sources of fiber, too. Enjoy chickpeas (hello, hummus!), lentils, and edamame as well as nutrient-dense beans like kidney, pinto, navy, and black beans. Whole grains such as bulgur, quinoa, buckwheat, and whole oats are another essential fiber-filled food group for reduced gut inflammation.
If all of this has you worried about your grocery bill (good-quality produce can be pricey, for example), know there are affordable ways to integrate more gut-beneficial foods into your everyday meals. Wendy Lopez, MS, RD, and Jessica Jones MS, RD, cohosts of The Food Heaven Podcast, recommend stocking up on canned tomatoes, which are inexpensive and a great way to reduce gut inflammation.
“We already know tomatoes, particularly canned, are rich in the anti-inflammatory antioxidant lycopene, which gives tomatoes their beautiful red hue,” they say. “Lycopene has been shown in hundreds of studies to have a positive impact on breast cancer, heart disease, and prostate cancer, plus, a recent small animal study also suggests tomatoes are great for gut health.”
“Beyond [what you eat], lifestyle factors can impact the gut,” Dr. Damman says. The two big culprits here are sleep and stress. “Poor sleep and high stress can lead to changes in the tight junctions that stitch the cells of the gut together. Opening of tight junctions causes shifts in gut fluid balance and looser stools.”
Dr. Damman also recommends getting at least 30 minutes of moderate exercise every day. Regular exercise has been shown to help boost good gut bacteria, diversify the microbiome, and improve the relationship between types of bacteria in the gut. Research has found that moderate exercise, in particular, benefits gut health by decreasing intestinal permeability (making it harder for harmful pathogens to enter the bloodstream), which helps reduce systemic inflammation. And even more simply, moving your body regularly helps keep your whole system moving regularly, if you catch our drift. Whether it’s walking, jumping rope, dancing, gardening, or yoga, finding a movement practice or exercise routine you can stick to consistently is an underrated habit for keeping gut inflammation under control.
If you’re dealing with chronic inflammatory gut issues such as diarrhea, constipation, excessive gas, pain, or excessive bloating that simply won’t go away even after adopting these gut-healthy lifestyle changes, Lopez and Jones recommend making an appointment with a gastroenterologist or your primary care doctor to make sure it isn’t something more serious.
These Sleep Habits Are Putting Your Heart Health At Risk
Jillian Wilson – March 21, 2023
In addition to eating nutritious foods and exercising, sleeping is important for your heart health.
In addition to eating nutritious foods and exercising, sleeping is important for your heart health.
While it’s well known that exercise, healthy eating and managing things such as high blood pressure and cholesterol are crucial for your heart health, it turns out your sleep habits play a big role, too.
The study looked at people with obstructed sleep apnea, people with fragmented sleep and people with short sleep duration. Participants wore a wrist tracker for seven days to measure their sleep and completed a sleep journal; the study also measured their heart rate, breathing and sleep stages.
People who had irregular sleep ― which means sleep that varied by 90 minutes to 2 hours each week ― were 1.4 times more likely to have high coronary artery calcium scores, which is the amount of plaque in your arteries.
The study underscored data found by other recent sleep-and-heart research, according to Dr. Manesh R. Patel, the chief of the division of cardiology and the division of clinical pharmacology at Duke University School of Medicine.
Patel said that other studies have explored this topic and also found that low-quality sleep (like waking up frequently in the night) or not getting enough sleep can put folks at risk for other cardiovascular conditions beyond atherosclerosis. This includes high blood pressure and irregular heart rhythms, Patel noted.
What do these findings about sleep mean for you?
Unfortunately, even just short durations of poor sleep can impact your heart health.
Dr. Virend Somers, a cardiologist at the Mayo Clinic, recently led a randomized controlled study that focused on sleep deprivation and its impact on high blood pressure. The study was made up of healthy young people.
“We looked at their blood pressure and their sympathetic nervous system … over 24 hours,” he explained. When study participants were sleep-deprived (in this case, researchers reported they got four hours of sleep a night for nine days), their blood pressure went up both during the daytime and when they were asleep. These results were more common in women than men, Somers said, which surprised researchers.
“When they’re sleep deprived … the endothelial function — the ability for their blood vessels to dilate — was also impaired,” Somers explained. The inability of blood vessels to dilate is a predictor of future cardiovascular disease, he noted.
This shows that if you take people who are otherwise young and healthy and deprive them of sleep, you create risk factors for the development of heart disease, Somers said.
Additionally, in a small, 21-day study that also followed young, healthy people, Somers found that participants who did not get enough sleep ate an extra 308 calories of food per day. For 14 days, participants got just four hours of sleep per night, which led to this finding. Researchers conducted scans to find that the extra calories went right to the belly and were converted into visceral fat, the dangerous type of fat deep in the abdomen that produces toxins that can make our cardiovascular systems sick, Somers said.
Normally, in healthy, young people, fat goes to a safe storage spot under the skin, which is known as the subcutaneous level, he said. But this was not the case when those young people were sleep-deprived.
“Something about not sleeping enough, that did two things. One, it made them eat more calories, and two, those calories were sent to the worst place — the visceral fat,” Somers said.
Even after a few nights of recovery sleep, the visceral fat continued to accumulate, which shows that recovery sleep doesn’t make up for even a short period of not enough sleep, he added.
If getting more sleep is not a realistic option for you, prioritize other heart-healthy habits like exercise or eating healthy foods.
If getting more sleep is not a realistic option for you, prioritize other heart-healthy habits like exercise or eating healthy foods.
What You Can Do If You Have Poor Sleep
“It’s hard to tell people to sleep better,” Patel explained. Someone who works an overnight shift or has young kids and a busy schedule may just not be able to commit to the recommended seven to nine hours of sleep per night. And if you have trouble staying asleep, you can’t just decide to start sleeping through the night.
Patel said one dangerous potential reason behind not sleeping through the night is obstructive sleep apnea, which is when “you have an obstruction and you’re actually at times startling, or your oxygen can get low at night and you’re just not getting restful sleep and you have periods of apnea where you’re just not breathing because you’re obstructing your airway.”
Snoring, waking up with a headache or waking up tired are all signs of this condition; if you notice these issues, let your doctor know so they can run tests to determine if this is the cause of your bad sleep, Patel added. There are treatment solutions available for those with this condition.
But if you are not suffering from sleep apnea and are able to go to bed earlier, do so. “The more you can get regimented about getting yourself and everyone to bed, the better your health will be,” Patel said.
There are many ways to create a more restful and peaceful sleep environment. “Keep the bedroom cool and very, very dark … even light from a clock can be disruptive to your sleep,” Somers said.
He added that the bedroom should be for sex and sleep, not for watching TV or working. Additionally, if you get up in the middle of the night to go to the bathroom, for example, avoid looking at your cell phone.
“The light from the cell phone can shut down melatonin, and melatonin helps us get to sleep at night,” Somers said. And even if you have a blue light filter on your phone (which is supposed to be better for sleep), just the arousal from reading emails or texts can wake you up, he added.
While sleep is clearly an important factor in heart health, it also is not the only factor. Somers said you can create other good habits to help cut your risk of issues like atherosclerosis and high blood pressure.
“If you want to maintain your heart health, just follow the American Heart Association’s Life’s Essential 8 guidelines,” Somers said. These guidelines include eating better, exercising, quitting smoking, managing your weight, and controlling your blood pressure, cholesterol and blood sugar — in addition to getting good sleep. (It’s worth noting that good sleep was just added to the guidelines in June 2022, which underscores its newfound importance for heart health.)
So, if you do have to cut your sleep short for the time being, whether due to your work schedule or other commitments, focus on other behaviors like exercise or making sure your plate is loaded with fruit and veggies. Or make an appointment to get bloodwork to determine if you need to manage your cholesterol.
“If we can’t fix the sleep component, let’s try and emphasize some of the others until we have the opportunity to get more sleep,” Somers said.
Man diagnosed with stage 4 colon cancer at 29 shares symptoms: ‘It hit me pretty hard’
Meghan Holohan – March 21, 2023
When Brendan Menapace ate, he felt “terrible” and wanted to nap. He noticed blood in his stool and visited his doctor.
Having the support of his partner, family and friends made it easier for Brendan Menapace grapple with his stage 4 colorectal cancer diagnosis at age 29. (Courtesy Brendan Menapace)
“I just turned 29, so I didn’t really think colon cancer,” the now 30-year-old tells TODAY.com. “All the symptoms really got worse, so I knew something was wrong, and (I needed) to find an answer.” After testing, Menapace learned he had stage 4 colorectal cancer.
“It was definitely surprising,” he says. “It hit me pretty hard.”
“Textbook” symptoms
In the summer of 2021, Menapace experienced pelvic pain, constipation, bloating and fatigue.
“I would eat and then pretty much immediately would want to lay down,” he says. “I felt terrible.”
He also noticed blood in his stool and couldn’t sit for more than an hour and a half, which he noticed while driving to vacation. After eating, he would feel so awful that he felt drowsy.
“In retrospect, it was pretty much the textbook things they say to look out for,” he says.
He visited a doctor who sent him for a colonoscopy in early October 2021. As soon as Menapace woke, he knew it was bad.
“They told me as I was waking up,” he says. “There was a plan pretty much immediately.”
Two weeks after his test, he started chemotherapy from the end of October until January. Then he underwent 20 radiation sessions to his pelvis until March.
“From there, basically things had shrunk enough that surgery was viable,” he says. “But chemo and radiation take a toll on your body, so I was in pretty rough shape.”
In May, doctors surgically removed his rectum, part of his colon and lymph nodes, and he received a temporary ileostomy bag as his colon recovered. In July, doctors reversed his ileostomy, and by October, a PET scan showed no evidence of disease.
“Until you hit that five-year mark, you’re not considered cured or cancer-free,” Menapace says. “Because of the way it spread, it wasn’t as simple as just cutting out the tumor or declaring me cancer-free.”
Brendan Menapace underwent chemotherapy, radiation and extensive surgery to treat his stage 4 colorectal cancer. (Courtesy Brendan Menapace)
“Rates were globally going down in older patients with screening, and we also thought this was one of those cancers that are cancers of aging, which is why you didn’t screen somebody until they were 50,” Dr. Ursina Teitelbaum, a medical oncologist at Penn Medicine, tells TODAY.com. “Now we’re seeing this trend towards younger and also more left-sided — the descending colon, sigmoid colon and rectum particularly — and we don’t really know why.”
Teitelbaum says older patients tend to have more cancer on the right side, which is the ascending colon. It’s unclear why younger patients see more left-sided problems. But it leads to certain symptoms.
“If it’s on the left side or in the rectum, you may have pain with bowel movements or abdominal pain in general. You might have a change in what we see in the caliber of your stool. Instead of a normal-formed stool, you might have a skinny stool,” she says. “This is a funny point of conversation because people get uncomfortable talking about their bowel movements. But it’s actually really important to pay attention.”
“I have one younger patient who was a very competitive biker who noticed instead of 100 miles a week, he could only bike 50 miles a week,” she says. “It turned out he had rectal cancer and (was) slowly losing blood, and that was the reason.”
Brendan Menapace’s last chemotherapy treatment lasted for 46 hours and he carried it around in a fanny pack. (Courtesy Brendan Menapace)
Some people feel embarrassed to talk about their bowel movements, even with their doctors, meaning they don’t get help as quickly as possible. Other barriers can make it tough for younger people to get a colonoscopy, too, further delaying treatment.
“A lot of younger patients, people in their 30s, 40s, might not even have a primary care physician. They don’t have any medical problems. They are perfectly healthy,” Teitelbaum explains. “There are other things that are difficult with (colonoscopies). You have to find someone to give you a ride. … You have to take a day off work. You have to have insurance. You have to be able to afford a prep. So, there are a lot of barriers.”
Current screening recommendations for colon cancer are, starting at 45, people need to undergo a colonoscopy every 10 years, which recently changed from 50. Teitelbaum believes that both patients and primary care physicians need to be aware that colorectal cancer can occur to younger people.
“The key for now is education and that’s not just educating people that are younger, but educating their health care providers that if someone comes in with blood in their stool or some of the symptoms, they might need to move screening for colorectal cancer higher on the differential,” she says. “Part of the problems is that hemorrhoids (are) really a common condition.”
Finding colon cancer earlier often means surgery alone can remove it. As it metastisizes, it becomes harder to treated.
“Once it spreads beyond to the liver, the chance of it being curable is much lower,” she says. “That said, I am happy to say most of the time, even when it’s not curable, it’s treatable.”
With colonoscopies, doctors can detect precancerous polyps and remove them before they become cancer.
“You can intervene and remove a polyp before it becomes cancerous,” she says. “That said, not every polyp will become cancerous. So, it’s a balancing act.”
Brendan Menapace experienced neuropathy when he underwent chemotherapy but is lucky that it stopped after treatment ended. (Courtesy Brendan Menapace)
‘Huge learning curve’
While Menapace received chemotherapy, he experienced neuropathy, numbness and tingling from nerve damage. As soon as treatment stopped, these symptoms went away. He has had to adjust to not having a rectum.
“It has been a huge learning curve and just the trauma to my colon and lower digestive system — things are never going to be the same,” he says. “There’s a new normal that I’m working toward and that takes a lot of work in its own right. I have to be careful eating.”
He returned to work and exercise, resuming as much of a “normal life” as he can.
“When I leave the house, I have to know where a bathroom is. … It’s something in the back of my head, and I have to think about something that I never had to before,” he says. “It’s hard to fathom the idea of something being different forever.”
With the help of his partner, friends, family and therapy, Menapace is trying to grapple with the changes he faces due to cancer. He encourages others to talk about their symptoms with their doctors, no matter how strange it might feel.
“You’re trained not to talk about your poop. You’re trained not to talk about your butt. This is not (what you talk about) in polite society. At first, I would rely on euphemisms and be kind of fake and make jokes,” he says. “If you’re not detailed on what you’re going through, you’re not going to paint the right picture for your care team. You’re not going to get the right care.”
This Is the One Thing You Should Do Every Night if You Want To Lose Weight, According To Registered Dietitians
Kaitlin Vogel – March 21, 2023
Plus a few easy-to-implement tips.
When it comes to weight loss, many of us first think of diet and exercise. However, there’s one thing you can do every night that can be a game-changer when it comes to weight loss.
In particular, it’s a habit that improves sleep—which is key to weight loss. “Sleep deprivation leads to decreased alertness, reaction time and ability to store memories,” saysJoel Totoro, RD, Director of Sports Science at Thorne HealthTech. “Sleep deprivation can also lead to a decrease in immune function and a reduction in the release of growth hormones, as well as the hormones leptin and adiponectin—both of which have roles in fat gain and loss.”
Here’s the habit to practice if you want to sleep better and, as a result, lose weight.
Practice This One Sleep Habit To Lose Weight
If you want to manage your weight, stop eating (or at least don’t eat a big meal) a few hours before bedtime.
Going to bed on a full stomach may interfere with getting restful sleep which upsets the hormones that tell us we’re hungry and when we are full. As a result of poor sleep, you may be hungrier during the day, Elizabeth Ward, MS, RDN, explains. Also, poor sleep can make you gravitate toward foods that provide a quick energy boost, which are often filled with added sugar or other highly refined carbohydrates and add calories to your day.
“Eat a satisfying, balanced dinner with at least 25 grams of protein and stop eating after dinner,” says Ward. “Though calories consumed close to bedtime don’t automatically prevent weight loss, it’s easier to go overboard on food when snacking after dinner especially when these foods are high in fat and calories.”
Routine snacking every night can lead to a lack of interest in breakfast because you’re still full from the night before. As a consequence, you repeat the cycle of eating too few calories during that day and too many at night, which can keep you from shedding pounds in the long run, Ward concludes.
“If you want a snack, make it a modest portion of a high-protein food, like a handful of roasted edamame, Greek yogurt or a handful of pistachios,” says Ward. “Try to eat dinner as early as you can comfortably fit it into your lifestyle.”
Try to go to bed and wake up at the same time each day. Yes, even on weekends. This will let your body get into a natural rhythm. Aim for a full seven to nine hours each night.
Make it consistent.
It’s common to think of sleep as something you can “make up.” But human bodies aren’t like bank accounts; we can’t make withdrawals and deposits whenever we want. We need plenty of rest as consistently as possible.
Limit distractions
Give your devices a rest! Texts, TV shows, games and funny cat videos will all be there for you the next day. Set a bedtime alert on your phone or stick a note to your TV reminding you of your bedtime—and theirs.
Ask for help
Overwhelmed with to-do lists? Delegate. Ask your kids to help wash dishes or enlist your partner for evening chores. See if a coworker can share the load on a big deadline. That way you don’t have to stay up late finishing other tasks.
Accept the unexpected
Interruptions and sleepless nights will come up from time to time. When they do, don’t dwell on your frustration—that stress can make it even harder to get back into your sleep rhythm. Just accept the interruption, think of it as a temporary lapse, and try again for better sleep the next night.
If these interruptions end up becoming a trend, think of what you can do to change the pattern and make it work for you.
Exercise therapy is safe, may improve quality of life for many people with heart failure
NewMediaWire – March 21, 2023
Statement Highlights:
A new scientific statement indicates supervised exercise therapy may help improve symptoms for people with one of the most common types of heart failure, known as heart failure with preserved ejection fraction (HFpEF), in which the heart muscle’s pumping strength is intact.
Exercise therapy had comparable or better results on improving exercise capacity for people with preserved EF compared to those who have heart failure with reduced EF.
The statement advises that Medicare and health insurers expand coverage of cardiac rehabilitation to include people with heart failure with preserved ejection fraction.
DALLAS and WASHINGTON D. C. For many people who have heart failure, supervised exercise training is safe and may offer substantial improvement in exercise capacity and quality of life, even more than medications, according to a new, joint scientific statement from the American Heart Association and the American College of Cardiology. The statement is published today in both the American Heart Association’s flagship journal Circulation and in the Journal of the American College of Cardiology.
Heart failure is a progressive condition in which the heart is unable to pump enough blood to the body either due to the heart muscle stiffening or from it losing pumping strength. Treatments are focused on reducing symptoms, such as shortness of breath and fatigue, and minimizing or delaying the consequences of the condition, which includes decreased quality of life; frequent hospitalizations; loss of functional independence; high health care costs; and increased risk of death.
The statement is a review of the latest evidence-based research to better understand the potential impact of supervised exercise therapy for the more than three million people in the U.S. living with chronic, stable heart failure with preserved ejection fraction or HFpEF. This condition occurs when the heart is stiff and does not relax normally to fill with enough blood to pump to the body, yet the heart muscle is still strong enough to pump well. In comparison, heart failure with reduced ejection fraction occurs when the left ventricle can’t pump with the force needed to push enough blood into circulation. In the U.S., heart failure with preserved ejection fraction is one of the most common forms of heart failure, with women disproportionately affected compared to men, according to the scientific statement.
“The prevalence of heart failure with preserved ejection fraction continues to increase due to aging of the population and the growing prevalence of risk factors such as obesity and Type 2 diabetes,” said Vandana Sachdev, M.D., chair of the scientific statement writing committee. “Improved management of this large population of patients who have HFpEF, many of whom may be undertreated, represents an urgent unmet need.”
Sachdev is a senior research clinician and the director of the Echocardiography Laboratory in the Division of Intramural Research at the National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health, as well as the scientific lead for the new NHLBI heart failure program HeartShare.
In April 2022, recommendations were released by the American Heart Association and the American College of Cardiology for supervised exercise training for people with heart failure, regardless of the type. Sachdev clarified that, currently, Medicare only reimburses cardiac rehabilitation for people with heart failure with reduced ejection fraction (HFrEF).
“Exercising helps improve the heart’s pumping ability, decreases blood vessel stiffness and improves the function and energy capacity of skeletal muscle,” Sachdev said. “Exercise capacity is an independent, clinically meaningful patient outcome, and research has indicated that guided exercise therapy is actually more effective at improving quality of life for people who have HFpEF than most medications.”
Members of the writing committee critically examined research published since 2010 to assess the most current data on the impact of exercise-based therapies for HFpEF.
The studies evaluated various types of exercise, including walking, stationary cycling, high-intensity interval training, strength training and dancing in both facility settings and home-based training. Supervised exercise therapy generally occurred three times per week for each of the studies, and the duration of the programs varied from one month to eight months.
In the studies, researchers measured peak oxygen uptake, which is a way to assess exercise capacity by measuring the total amount of oxygen a person can breathe into the lungs during physical exertion. For people living with HFpEF, their peak oxygen uptake is often about 30% lower than that of a healthy person and considered below the threshold required for functional independence (and performing normal daily living activities such as carrying groceries).
The statement writing committee determined that supervised exercise training may lead to:
Increased peak oxygen uptake 12-14% an increase of more than 6-7%, is considered clinically meaningful.
Increased total exercise time by 21% a 10% increase is considered clinically meaningful.
Improved quality-of-life scores on the Minnesota Living with Heart Failure questionnaire by 49 points. The questionnaire has 21 items, each scored on a 0-5 scale. Total score is derived from adding the scores from each item.
The statement acknowledges there were variations in the baseline characteristics of people in the trials reviewed. Some of the studies excluded patients with some co-existing health conditions, and many groups of people in whom heart failure is prevalent including older adults, women, persons with low socioeconomic status and people from diverse racial and ethnic groups were under-represented in some research. Additionally, many of the studies were smaller, single-center studies, and most were relatively short term, so there isn’t enough information to assess long-term adherence, which the committee suggests should be addressed in future research.
“Overall, we did find that in people with chronic, stable heart failure and preserved ejection fraction, supervised exercise training is safe and provides substantial improvements in exercise capacity and quality of life,” Sachdev added. “Future work is needed to improve referral of appropriate patients to supervised exercise programs, and better strategies to improve long-term adherence to exercise training is needed. Hybrid programs combining supervised and home-based training may also be beneficial. Further, implementation efforts will need to include coverage by Medicare and other insurers.”
This scientific statement was prepared by a volunteer writing group on behalf of the American Heart Association and the American College of Cardiology. It is endorsed by the Heart Failure Society of America; the American Association of Cardiovascular and Pulmonary Rehabilitation; and the American Association of Heart Failure Nurses.
American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.
Co-authors are Vice Chair Kavita Sharma, M.D.; Steven J. Keteyian, Ph.D.; Charina F. Alcain, D.N.P., A.C.N.P.-B.C.; Patrice Desvigne-Nickens, M.D.; Jerome L. Fleg, M.D., FAHA; Viorel G. Florea, M.D., Ph.D.; Barry A. Franklin, Ph.D., FAHA; Maya Guglin, M.D., Ph.D.; Martin Halle, M.D.; Eric S. Leifer, Ph.D.; Gurusher Panjrath, M.D., FAHA; Emily A. Tinsley, Ph.D.; Renee P. Wong, Ph.D.; and Dalane W. Kitzman, M.D. Authors’ disclosures are listed in the manuscript.
The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers, and the Association’s overall financial information are available here.
The content of this press release and the associated manuscript is solely the responsibility of the authors and does not necessarily reflect the official views of the National Heart, Lung, and Blood Institute, National Institutes of Health or the U.S. Department of Health and Human Services.
