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Behavioral Science, Health and Fitness, Nutrition, Obesity, Public Health, Research

Perceptions about progress and setbacks may compromise success of New Year’s resolutions

3336185391_60148a87fa_zMy physical therapist is constantly telling me to pause during the workday and take stretch breaks to counter act the damage of being hunched over a computer for hours on end. After every visit to his office, I vow to follow his advice, but then life gets busy and before I know it I’ve forgotten to keep my promise.

So I decided that one of my New Year’s resolutions will be to set an alarm on my phone to serve as a reminder to perform simple stretches throughout the day. Keeping in mind that a mere eight percent of people who make resolutions are successful, I began looking for strategies help me accomplish my goal. My search turned up new research about how the perception of setbacks and progress influence achievement of behavior change. According to a University of Colorado, Boulder release:

New Year’s resolution-makers should beware of skewed perceptions. People tend to believe good behaviors are more beneficial in reaching goals than bad behaviors are in obstructing goals, according to a University of Colorado Boulder-led study.

A dieter, for instance, might think refraining from eating ice cream helps his weight-management goal more than eating ice cream hurts it, overestimating movement toward versus away from his target.

“Basically what our research shows is that people tend to accentuate the positive and downplay the negative when considering how they’re doing in terms of goal pursuit,” said Margaret C. Campbell, lead author of the paper — published online in the Journal of Consumer Research — and professor of marketing at CU-Boulder’s Leeds School of Business.

Given these findings, researchers suggest you develop an objective method for measuring your progress and monitor it regularly.

Previously: Resolutions for the New Year and beyond, How learning weight-maintenance skills first can help you achieve New Year’s weight-loss goals, To be healthier in the new year, resolve to be more social and Helping make New Year’s resolutions stick
Photo by Laura Taylor

Chronic Disease, Stanford News, Videos

A primer on preventing or delaying type 2 diabetes

A primer on preventing or delaying type 2 diabetes

Diabetes affects an estimated 29 million Americans, and one in four people don’t know they have the disease, according to the latest data from the Centers for Disease Control and Prevention.

Stanford Health Library recently held a three-part lecture series about preventing or delaying the onset of type 2 diabetes. A the first event, Stanford primary care doctor Bryant Lin, MD, shared with the audience that diabetes is “a topic near and dear to his heart” and that he deals with the disease “in both his personal life and clinical life.” Lin’s family medical history puts him at high risk for the disease: His mother, her six siblings and his maternal grandparents were all diagnosed with diabetes. On the clinical side, he treats diabetic patients at Stanford Health Care.

In the above video, Lin provides an overview of the epidemiology, pathophysiology, risk-assessment and diagnosis of diabetes.

This video is the first lecture in a three-part series addressing important questions related to diabetes and lifestyle choices.

Previously: Diabetes and nutrition: Healthy holiday eating tips, red meat and disease risk, and going vegetarian, Diabetes and nutrition: Why healthy eating is a key component of prevention and management and Examining the role of exercise in managing and preventing diabetes

Nutrition, Obesity, Stanford News, Videos

Easy-to-follow tips to avoid overeating this holiday

Easy-to-follow tips to avoid overeating this holiday

‘Tis the season for overindulging. A recent report showed that we can easily consume 2,000 calories (or more) during a holiday dinner, particularly if the celebration includes appetizers and a few glasses of wine. As Neha Shah, a registered dietitian at Stanford, explains in the above Stanford Health Care video, overeating during this time of year is tied to many factors. She says, “There is so much food available at one given social setting that it’s easy to overeat and not realize it.”

There are simple techniques, however, that can help you resist the temptation to pile your plate high and go back for seconds. Watch the full video to learn easy-to-follow tips for making healthier choices this holiday season as you eat, drink and be merry.

Previously: “Less is more:” Eating wisely, with delight, during the holidays, Eat well, be well and enjoy (a little) candy, Learning tools for mindful eating and Enjoying the turkey while watching your waistline
Photo in featured-entry box by George Redgrave

Mental Health, Research, Technology

Reducing your stress level could be as simple as checking email less frequently

Reducing your stress level could be as simple as checking email less frequently

4329363938_26522735d1_zAs the end of 2014 approaches, many of us are thinking about what changes we’re going to make come Jan. 1 to be healthier and happier. Those looking for ways to reduce their stress level in 2015 may want to consider adopting a New Year’s resolution to limit how often they check their email throughout the day.

A study (subscription required) recently published in Computers in Human Behavior suggests that there are psychological benefits to easing up on the number of times you click your inbox. For the experiment, researchers at the University of British Columbia instructed half the participants to read emails no more than three times a day for a week, while a second group was allowed to check their inbox as often as they wished. The groups’ instructions were then reversed the following week. New York Magazine reports:

Overall, “limiting the number of times people checked their email per day lessened tension during a particularly important activity and lowered overall day-to-day stress,” the researchers write, and was associated with various other positive measures of psychological well-being. Those who checked their email a lot also didn’t perceive themselves as any more productive than those who were on an email diet.

…This study, combined with a lot of prior research into things like the distractions imposed by task-switching, paint a pretty clear picture: Ceaselessly checking your email probably isn’t making you more productive, and it probably is making you more stressed.

Previously: What email does to your brain
Photo by Ian Lamont

Cancer, Mental Health, Research, Women's Health

Women with mental illness less likely to be screened for breast cancer

Women with mental illness less likely to be screened for breast cancer

Previous research has shown that women are up to 40 percent more likely to experience a mental-health condition than men. Now findings published in the British Journal of Psychiatry caution that women with depression, anxiety or other mood disorders are likely missing out on important breast-cancer screenings.

In the study, British researchers conducted a systematic review and meta-analysis and comparing rates of mammography screening between women with mental illness and those without. PsychCentral reports:

Researchers found that there were significantly reduced rates of mammography screening in women with mental illness, depression, and severe mental illness such as schizophrenia.

The effect was not present in women with distress alone, suggesting distress was not the explanation.

“In this study, we found that mental ill health was linked with 45,000 missed screens which potentially could account for 90 avoidable deaths per annum in the UK alone. Clearly patients with mental illness should receive care that is at least comparable with care given to the general population. Every effort should be made to educate and support women with mental illness called for screening,” [said Alex Mitchell, MD, who led the study.]

Previously: A new way of reaching women who need mammograms, Despite genetic advances, detection still key in breast cancer, Medicine X explores the relationship between mental and physical health: “I don’t usually talk about this”Examining link between bipolar disorder, early death and Examining the connection between mental and physical health

Ask Stanford Med, Chronic Disease, Nutrition

Diabetes and nutrition: Healthy holiday eating tips, red meat and disease risk, and going vegetarian

Diabetes and nutrition: Healthy holiday eating tips, red meat and disease risk, and going vegetarian

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Despite greater awareness about diabetes in recent years, a recent study found that nearly three in 10 Americans have the disease but don’t know it. The findings also showed that among those who were diagnosed with diabetes, a significant percentage weren’t meeting goals to control their blood sugar and blood pressure or lower their LDL cholesterol.

This Thursday, Kathleen Kenny, MD, a clinical associate professor at Stanford, and Jessica Shipley, a clinical dietitian at Stanford Hospital & Clinics, will discuss why eating healthy is a key component of diabetes management and prevention. The Stanford Health Library event will be held at the Arrillaga Alumni Center on campus; those unable to attend the event can watch a live webcast of the discussion.

In the final installment of our two-part Q&A with Kenny, she offers tips to avoid overindulging on sugary treats during the holidays, explains why you should consider limiting your consumption of red meat, and outlines the benefits of a vegetarian diet.

Many of us have a hard time refraining from indulging in high-calorie foods during the holidays. What’s your advice to those trying to make healthy choices during holiday season?

The holidays don’t have to be a stressful or trying time for patients with diabetes. Patients can adhere to a few simple strategies to help prevent weight gain and hyperglycemia. Some people will find it beneficial to eat a nutritious snack, particularly one that is high in fiber, and to drink lots of water in advance of a holiday party, rather than arriving hungry.

Buffet tables and appetizer trays can be problematic. Count toothpicks and stop snacking when you reach a certain number of toothpicks in your pocket. It is always a good idea to find the smallest plate available, when there are options, so as to reduce portions. Another tip is to limit alcohol intake; not only will this itself reduce liquid calories, but it will help individuals to make smarter choices. Substitute sparkling mineral water with lemon or lime. Eat lots of veggies at snack tables. Avoid calorie and sugar-dense sweets, or limit to one.

The most important aspect is to devise a plan in advance of a holiday gathering, and stick to it. Set your predetermined limits. Spontaneous choices will tend to be less healthy ones. Finally, if you are going to indulge a bit more, try to take a brisk walk afterwards to help reduce the glycemic impact of your meal.

Previous research has shown that decreasing your red meat consumption can lower your type 2 diabetes risk. Why does eating red meat influence a person’s diabetes risk? 

A study published in the Journal of the American Medical Association last year found an association of higher-diabetes risk with increased intake of red meat (about 30 percent higher with average increased red meat intake of ½ serving daily, adjusted for weight and BMI), and the converse, a lower risk in those who decreased their red meat consumption over a four-year period in the subsequent four years (14 percent reduction in diabetes risk by reducing consumption by more than ½ red meat serving daily over the baseline measure, some of which was mediated by reduced BMI with lower red meat intake).

This data was based on food questionnaires, and was a compilation from three prospective cohort studies involving almost 150,000 men and women. One of these cohorts, the Women’s Health Study, showed a 28 percent increased risk of developing diabetes in women in the highest quintile of red meat intake.  On further analysis, this seemed to be largely mediated by higher intake of processed meats such as hot dogs and bacon. Note that these studies do show an association, but not clear causation in terms of red meat and diabetes risk.

One theory of causality proposed is that compounds such as nitrates and nitrites added in meat processing  (sandwich meats, hot dogs, bacon), can be converted to “N-Nitrosamines”, which are thought to be toxic to the pancreas insulin-secreting beta cells. Thus, eating a bologna sandwich may be different in risk than eating grass-fed organic beef. But we don’t have enough data at this time to be clear on this.  Regardless of the nitrate content, red meat is still high in saturated fats, and this in and of itself is associated with higher cardiovascular disease risk. Additionally, higher red meat intake was associated with more weight gain and higher BMI in this analysis.

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Aging, Neuroscience, Stanford News, Stroke, Videos

Examining the potential of creating new synapses in old or damaged brains

Examining the potential of creating new synapses in old or damaged brains

Synapses are the structures in the brain where neurons connect and communicate with each other. Between early childhood and the beginning of puberty, many of these connections are eliminated through a process called “synaptic pruning.” Stroke, Alzheimer’s disease, and traumatic brain injury can also cause the loss of synapses. But what if new synapses could be created to repair aging or damaged brains?

Stanford neurobiologist Carla Shatz, PhD, addresses this question in the above Seattle+Connect video. In the lecture, she discusses the possibility of engaging the molecular and cellular mechanisms that regulate critical developmental periods to regrow synapses in old brains. Watch the video to learn how advances at the neural level around a novel receptor, called PirB, have implications for improving brain plasticity, learning, memory and neurological disorders.

Previously: Drug helps old brains learn new tricks, and heal, Cellular padding could help stem cells repair injuries and Science is like an ongoing mystery novel, says Stanford neurobiologist Carla Shatz and “Pruning synapses” and other strides in Alzheimer’s research

Ask Stanford Med, Chronic Disease, Events, Nutrition

Diabetes and nutrition: Why healthy eating is a key component of prevention and management

Diabetes and nutrition: Why healthy eating is a key component of prevention and management

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The prevalence of type 2 diabetes is expected to rise sharply over the next three decades. Recent data from the Centers for Disease Control and Prevention shows that if current trends continue, an estimated 1 in 3 adults will be diagnosed with the disorder by 2050. Eating healthy is a key component of managing diabetes and reducing one’s risk for developing the disease. But what does eating right for diabetes actually mean?

Kathleen Kenny, MD, a clinical associate professor at Stanford, and Jessica Shipley, a clinical dietitian at Stanford Hospital & Clinics, will answer this question during a talk focused on diabetes and nutrition on Dec. 4. The Stanford Health Library event will be held at the Arrillaga Alumni Center on campus, where attendees can also have their blood glucose checked. The conversation will also be webcasted for those unable to attend in person.

To promote discussion on the topic in advance of the lecture, I reached out to Kenny and asked about nutrition principles and guidelines for patients with diabetes and others interested in how healthy eating can prevent or delay onset of the disease. In the first installment of a two-part Q&A, she explains the advantages of eating a Mediterranean diet and the importance of eating fiber-rich foods.

Are there any ways to reverse or slow the progression of pre-diabetes? Are there specific diets that may be useful to help prevent or control diabetes?

One of the most common questions my diabetic patients ask is how they can reduce or eliminate diabetes medications. Others are found to be pre-diabetic on the basis of an “A1c” or an impaired fasting glucose, and want to know how to prevent diabetes. Several randomized trials have shown that healthy diet and exercise can reverse and also delay the onset of diabetes.

One of the largest trials is the often-cited Diabetes Prevention Program, which randomized more than 3,000 patients to diet/lifestyle versus metformin versus placebo. The most effective strategy was diet and lifestyle, showing a dramatic 58 precent reduction in the rate of developing diabetes. This surpassed the drug therapy with metformin. Approximately 5 percent of patients in the lifestyle group developed diabetes annually, as compared to 11 percent in the placebo arm. Notably, there was a 16 percent reduction in diabetes risk with every 1 kg reduction in weight. This seems attainable for many patients.

There was also meta-analysis last year looking at different diets for patients with known diabetes, in terms of weight loss and improving their diabetes control. In this data compilation, the Mediterranean diet had the greatest weight loss, followed by the low carbohydrate diet. In terms of A1c reduction, the Mediterranean diet had a reduction of -0.47 percent, and the low carbohydrate -0.12 percent. But all the diets studied resulted in better glycemic control. Many studies have shown that diets high in glycemic load are linked to higher diabetes risk (particularly in overweight women), and contribute to central body fat , so it is recommended that diabetics or those at risk limit their intake of high glycemic index foods both to delay and to help control their diabetes. Additionally, there are some data suggesting that adherence and success rate may be higher for low-carbohydrate diets in patients with diabetes and insulin resistance.

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Emergency Medicine, Global Health, Stanford News, Videos

Improving global emergency medicine to save lives

Improving global emergency medicine to save lives

In July 2013, Stanford physician S. V. Mahadevan, MD, and colleagues conducted a study at the largest children’s hospital in Karachi, Pakistan to understand the kinds of medical emergencies that doctors treated at the facility. “What we found was astonishing,” he says in this Stanford+Connect video. “By fourteen days 10 percent of [the 1266 children enrolled in the study] were dead.” Mahadevan saw more children die during the one week he spent in the Pakistan hospital than in his entire 22-year-career in the United States.

Despite such dire statistics, there is hope. Mahadevan, founder of Stanford Emergency Medicine International, explains in the video how important early interventions can be made in the chain of survival to save thousands of lives in low-resource countries. Watch the full lecture to learn more about his efforts to establish Nepal’s first ambulance service, India’s first paramedic training program and his ongoing work to improve emergency care in Cambodia.

Previously: Stanford undergrad uncovers importance of traditional midwives in India, Providing medical, educational and technological tools in Zimbabwe and Saving lives with low-cost, global health solutions

Aging, Neuroscience, Research

Being bilingual "provides the brain built-in exercise"

Being bilingual "provides the brain built-in exercise"

Spanish_booksWith less than two months left in 2014, many of us will soon begin the annual ritual of selecting our New Year’s resolutions. Those who are looking to boost their brain power may want to consider learning a second language in 2015: Research published today in the journal Brain and Language shows that being bilingual makes the brain more efficient at processing information.

In the study, researchers used functional magnetic resonance imaging (fMRI) technology to examine participants’ brains as they performed language comprehension tests. For example, researchers would say the word “cloud” to individuals while showing them four pictures, including one of a cloud and others of similar-sounding objects, like a clown. To complete the exercise, participants had to recognize the correct photo and ignore the irrelevant images. According to a release, study results showed:

The bilingual speakers were better at filtering out the competing words because their brains are used to controlling two languages and inhibiting the irrelevant words, the researchers found.

The fMRI scans showed that “monolinguals had more activation in the inhibitory control regions than bilinguals; they had to work much harder to perform the task,” [said lead author Viorica Marian, PhD.]

“Inhibitory control is a hallmark of cognition,” said Marian. “Whether we’re driving or performing surgery, it’s important to focus on what really matters and ignore what doesn’t.”

The fact that bilinguals are constantly practicing inhibitory control could also help explain why bilingualism appears to offer a protective advantage against Alzheimer’s and dementia, said Marian.

“That’s the exciting part,” she said. “Using another language provides the brain built-in exercise. You don’t have to go out of your way to do a puzzle because the brain is already constantly juggling two languages.”

The findings add to the growing body of scientific evidence showing that being bilingual can have profound impacts on your brain.

Previously: Study shows bilingualism may enhance attention and working memory and ¿Habla Español? How bilingualism may delay the onset of Alzheimer’s symptoms
Photo by Megan Morris

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