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Health and Fitness

Behavioral Science, Health and Fitness, Mental Health, Public Health, Research, Stanford News

Exposure to nature helps quash depression – so enjoy the great outdoors!

Exposure to nature helps quash depression - so enjoy the great outdoors!


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Walking is good for your health. But walking somewhere natural is even better, according to a new Stanford-led study.

Study participants who walked in a natural area for 90 minutes showed less activity in a brain region associated with depression than those who walked through a city or other urban area, a Stanford News story states. From the piece:

“These results suggest that accessible natural areas may be vital for mental health in our rapidly urbanizing world,” said co-author Gretchen Daily, the Bing Professor in Environmental Science and a senior fellow at the Stanford Woods Institute for the Environment. “Our findings can help inform the growing movement worldwide to make cities more livable, and to make nature more accessible to all who live in them.”

Even further, the research supports — but does not prove — a link between urbanization and growing rates of mental illness, said co-author James Gross, PhD, a professor of psychology.

The researchers had one group of participants walk in a grassland with oak trees and shrubs. The other group walked along a traffic-clogged four-lane road. They then measured heart and respiration rates, performed brain scans and had the participants answer a series of questions. The results showed that:

Neural activity in the subgenual prefrontal cortex, a brain region active during rumination – repetitive thought focused on negative emotions – decreased among participants who walked in nature versus those who walked in an urban environment.

Evidence that supports the knowledge you’ve had since grade school: The outdoors really can make you feel better.

Previously: To get your creative juices flowing, start movingA look at the effects of city living on mental health and Out-of-office autoreply: Reaping the benefits of nature
Photo by Linda A. Cicero/Stanford News Service

Health and Fitness, Pediatrics, Research, Sports

Female high-school athletes suffer more overuse injuries than their male counterparts

Female high-school athletes suffer more overuse injuries than their male counterparts

When I was younger, the prevailing parenting advice regarding athletics and children was to identify a sport your child would enjoy early on and have them focus on it throughout adolescent so she would have a competitive edge. Which is how I ended up playing on a boys soccer team at the age of five — there were no all-girls soccer teams in Austin, Texas in 1983. Soccer continued to be my sole sport throughout high school and college. Eventually, I had to give it up because the constant ankle injuries I endured meant I spent more time in rehab mode than training mode.

Never once did a physician or a trainer suspect that the injuries were related to overuse, despite the long hours I logged on running paths, in the weight room and on the field. So I was interested to read about recent research showing that girls are at a much higher risk than boys when it comes to overuse injuries in high-school sports.

In the study, researchers at the Ohio State University Wexner Medical Center reviewed 3,000 male and female injury cases over a seven year period across 20 high-school sports including soccer, volleyball, gymnastics and lacrosse. According to a release:

[Researchers] found the highest rate of overuse injuries occurred in girls track (3.82), followed by girls field hockey (2.93) and girls lacrosse (2.73). Overuse injuries in boys were most found in swimming and diving (1.3).

“These young people spend more time playing sports both in competition and in practice. So, there’s a correlation there between the amount of time that they’re playing and the increased incidence of injuries,” said [Thomas Best, MD, PhD,] who is also a professor and Pomerene chair in Ohio State’s department of family medicine.

The participation and intensity of high school athletics has increased over the past decade. According to Best, some high school athletes spend more than 18 hours a week participating in athletics and many participate in multiple sports concurrently.

Watch the clip above to learn more about researchers’ findings and recommendations.

Previously: Researchers call for improvements to health screenings for female college athletes and Stanford physician discusses prevalence of overuse injuries among college athletes

Events, Health and Fitness, Sports, Stanford News, Videos

Stanford Football team physician shares tips for staying healthy while working out

Stanford Football team physician shares tips for staying healthy while working out

Last month, more than 750 people gathered on the Stanford Medicine campus for the annual Health Matters event. There, Jason Dragoo, MD, team physician for Stanford Football and the U.S. Olympic Committee, delivered a talk about preventing injuries and improving fitness performance. As he explains in the above video, he and colleagues dramatically changed the conditioning program for football players over the last five years: gone is the traditional weight room packed with machines and racks and in its place is a training facility stocked with kettle bells, Pilates equipment, medicine balls, wooden sticks and core boards. As a result, the injury rate dropped more than 70 percent and the team’s success has skyrocketed. 

Watch Dragoo’s full presentation and learn how you can apply the workout tactics employed by Stanford Football to avoid injury and improve your own exercise regimen. And check out the Stanford Medicine YouTube channel for more Health Matters videos, including:

Previously: Stanford Medicine’s Health Matters event, in pictures and Stanford’s Health Matters happening on Saturday

FDA, Health and Fitness, In the News, Nutrition, Public Health

“They might be slightly healthier, but they’ll still be junk foods”: Expert comments on trans-fat ban

"They might be slightly healthier, but they'll still be junk foods": Expert comments on trans-fat ban

4345026096_35defbf6b0_zAs you’ve probably heard, the FDA ruled last week to ban trans-fats and phase them out of all food products over the next three years. This news has been widely covered, both heralded for its health implications and critiqued for being too long in coming. Yet either way, it is not a panacea, as Stanford Medicine professor Christopher Gardner, PhD, explained when he shared his opinion with me over the weekend:

The true impact of the FDA ban on trans-fats will not be known until we find out what substitutes the food industry finds, and what that does to the sale of junk food and the health of Americans in response to the switch. It could be beneficial. But it isn’t as if trans-fats will be gone and everyone will eat an extra two servings of vegetables in their place.

Gardner, who has spent the past 20 years researching the health benefits of various nutrition components, pointed out that “a lot of good people and excellent scientists worked on this for a long time” and “it took a great deal of effort to assemble the science to demonstrate that this is something so harmful in the American diet that it should be removed with an FDA ban.” He also offered more specifics on what food companies might do following the ban:

The companies making those products are unlikely to remove those junk food products entirely from the shelves of grocery stores across America. Instead, it is most likely that they will look for an alternate form of fat that will serve as closely as possible the same role that trans-fats served. Trans-fats act like saturated fats in terms of being solid rather than liquid at room temperature. This can help the icing on a cupcake stay solid, and it can give a “mouth feel” of solid fat that people like to taste in their food. The goal of the food industry will be to replace the trans-fat with another fat that is solid at room temperature, which likely means the replacement could very well be as bad as the trans fats themselves.

For example, palm oil or esterified stearic acid are likely to be options. For the palm oil, this will mean destruction of rain forests and biological diversity. For esterified stearic acid, this will mean another reason to grow more monocultures of soybeans from which to extract the oil. Both of these will likely have a negative environmental impact. There are likely other choices to consider.

After all this, will those junk foods now be health foods? Absolutely not. They might be slightly healthier junk foods, but still junk foods.

Previously: Want to curb junk food cravings? Get more sleep, Talking to kids about junk food ads, and Trans-fat still lurks in packaged foods
Photo by Kevin

Health and Fitness, Mental Health, Public Health

Not just for kids: A discussion of play and why we all need to do it

Not just for kids: A discussion of play and why we all need to do it

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All work and no play makes everyone a dull boy. Recognizing this, the California-based National Institute for Play focuses on shining light on the importance of the practice of play in everyday life. BeWell@Stanford recently spoke with its founder and president, Stuart Brown, MD, who here talks about play’s role in human function:

Play is a survival drive that is necessary for adaptation, flexibility and social learning. Play helps us belong in the community, develop the ability to suppress unwanted urges, and regulate our emotions.

He goes on to talk about play’s importance for adults in particular:

Most people tend to think that play is confined primarily to childhood, and my sense of the paleo-anthropological design of being human is that we are neotenist creatures.  We are designed to be juveniles until we die and that is part of our primate design as Homo sapiens. When we honor that design, we tend to be less violent, more communal and healthier.

Taking time off to play does not mean you shirk your responsibilities, or that you aren’t a good parent or a good productive citizen. In fact, it’s just the opposite: your level of agitation drops when you get playful, which tends to increase perseverance and mastery. Play has a real payoff.

Brown also speaks about the importance of play in childhood development, and how we can learn about play’s impact on behavioral patterns from other animals such as social rats. Lastly, he provides advice as to how to reconnect with the childlike fun of play and incorporate it into adult life.

The piece is an intriguing conversation that might make readers slow down, think about their life, and remember that fun isn’t just for kids.

Alex Giacomini is an English literature major at UC Berkeley and a writing and social media intern in the medical school’s Office of Communication and Public Affairs.  

Previously: Workaholics vs work engagement: The difference is playExercise and relaxation techniques may help ease social anxiety, study finds and Exercise may boost heart failure patients’ mental and physical health
Photo by kilgarron

Health and Fitness, Research, Sleep

Jogging vs. chasing after your kids: Which one will help you sleep better?

Jogging vs. chasing after your kids: Which one will help you sleep better?

playgroundLast weekend, I raced after my toddler around the park for an afternoon and was shocked that my fitness tracker showed I walked the equivalent of 3.5 miles. Exhausted, I decided to count the mother-son outing as fulfilling my daily fitness requirement. But new research shows that when it comes to reaping the full health benefits of exercise, my park play date may not be the optimal form of physical activity.

As most of us know, scientific evidence shows that regular exercise can help us manage weight, improve mental health and mood, boost brain power, strengthen bones and muscles and reduce our risk of cardiovascular disease, Type 2 diabetes and some cancers. Research has also suggests that individuals who clock at least 150 minutes of physical activity a week sleep better and are more alert during the day.

But a University of Pennsylvania School of Medicine study found that forms of exercise such as running, yoga, biking are associated with better sleep habits than housework or child-care activities. To better understand how various forms of physical activity affect sleep, researches analyzed data on nearly 43 adults from the 2013 Behavioral Risk Factor Surveillance System and calculated the relationship between 10 different types of activities and the typical amount of sleep. According to a university release:

Compared to those who reported that they did not get physical activity in the past month, all types of activity except for household/childcare were associated with a lower likelihood of insufficient sleep. To assess whether these effects are just a result of any activity, results were compared to those who reported walking as their main source of activity. Compared to just walking, aerobics/calisthenics, biking, gardening, golf, running, weight-lifting and yoga/Pilates were each associated with fewer cases of insufficient sleep, and household/childcare activity was associated with higher cases of insufficient sleep. These results were adjusted for age, sex, education level, and body mass index.

“Although previous research has shown that lack of exercise is associated with poor sleep, the results of this study were surprising,” said Grandner. “Not only does this study show that those who get exercise simply by walking are more likely to have better sleep habits, but these effects are even stronger for more purposeful activities, such as running and yoga, and even gardening and golf. It was also interesting that people who receive most of their activity from housework and childcare were more likely to experience insufficient sleep – we know that home and work demands are some of the main reasons people lose sleep.”

Researchers will present their findings this week at SLEEP 2015, the 29th annual meeting of the Associated Professional Sleep Societies LLC.

Previously: Can regular exercise improve your quality of sleep?, Superathletes sleep more, says Stanford researcher, The high price of interrupted sleep on your health and Why your sleeping habits may be preventing you from sticking to a fitness routine
Photo by eyeliam

Ethics, Health and Fitness, Medicine and Society, Orthopedics, Patient Care, Sports

Thinking through return-to-play decisions in sports medicine

Thinking through return-to-play decisions in sports medicine

2913800550_7fc291c915_zIn an opinion piece appearing in the AMA Journal of Ethics today, two Stanford physicians – Michael Fredericson, MD, and Adam Tenforde, MD – explore the ethics of how doctors should advise patients recovering from an injury.

Consider this scenario, the case which opens the piece:

Jordan is a 17-year-old senior in high school who has been his football team’s star quarterback, led his team to two state championships, and has a real possibility of receiving a full scholarship to a top college sports program next year. In his last session of summer training camp, Jordan took a fierce hit… [an MRI] showed that Jordan had a torn labrum in his right shoulder that would require surgery and months-long recovery, meaning that he would miss the rest of his final season.

[His physiatrist] had known instances in which this particular type of injury ended a quarterback’s athletic career. She had also read about a few cases in which athletes recovered fully from the injury. Since so much of recovery depends on the injured person’s following the rehabilitation and physical therapy plans, [she] wanted Jordan to approach his injury with the optimism that adherence to the plan would enable him to return to athletics. At the same time, she did not want to hold out false hope that might keep Jordan focused exclusively on football when, in the long term, that might not be the best use of his senior year.

The most important part of what we’re trying to convey when treating athletes is that as team physicians our goal is the health and well being of the athlete

When college scholarships and admissions decisions are on the line, a doctor’s recommendations affect more than her patient’s physical health. How to weigh the different interests at stake? Fredericson and Tenforde make clear that medical decisions must prioritize the long-term health of the athlete. When I interviewed him, Fredericson, a professor of orthopedic surgery, director of PM&R Sports Medicine, and team physician for Stanford Athletics, told me:

The most important part of what we’re trying to convey when treating athletes is that as team physicians our goal is the health and well being of the athlete. Ultimately, we are the ones who are trying to protect their health. Sports physicians have gotten a bad rap; people think we’re trying to help coaches, or help athletes at the expense of their overall or long term well being. We might push the process to help try to get them better more quickly, but ultimately we have their long-term best interests in mind.

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Behavioral Science, Health and Fitness, Obesity, Public Health, Sleep

How insufficient sleep can lead to weight gain

How insufficient sleep can lead to weight gain

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I don’t think I’ve ever met a person who hates sleep and can’t wait to get less of it. Yet, even though most people want more sleep and know it’s important for their health, few people get as much shut-eye as they need. If you’re one of the many who needs a bit more motivation to get to bed earlier, a recent BeWell@Stanford article on how sleep can affect your weight may do the trick.

In the Q&A, sleep expert Emmanuel Mignot, MD, PhD, director of the Stanford Center for Sleep Sciences and Medicine, explains why and how insufficient sleep can increase your risk of weight gain:

It is very clear that if you’re not sleeping enough, you’re putting yourself at risk for increasing your weight.  If you sleep less than six hours a night, you’re likely to have a higher BMI (body mass index). Longitudinal data — and the evidence is quite strong — shows that if you sleep more over time, you’ll lower your BMI, which correlates with weight reduction.

In the first centuries of human life on earth, if humans weren’t sleeping they were probably looking for food or fleeing a predator. Not sleeping enough was a sign that we were in danger or that we were under stress. When we are sleep deprived, we feel hungry. Data indicates that if you sleep less, you eat more, and it disrupts your hormones. This problem is magnified in today’s world because food is too available!

Mignot also discusses the top reasons why people sleep so little, the importance of naps, and how being sleep-deprived skews our perception of doing and performing well. “[W]e have to make sure we don’t burn the candle at both ends, Mignot said. “Sleeping brings creativity, productivity and the ability to perform at a higher level.”

The piece is a quick, and informative, read.

Previously: Exploring the history and study of sleep with Stanford’s William Dement“Father of Sleep Medicine” talks with CNN about what happens when we don’t sleep wellStanford doc gives teens a crash course on the dangers of sleep deprivation, Narcoleptic Chihuahua joins Stanford sleep researcher’s family and More evidence linking sleep deprivation and obesity
Photo by Goodiez

Events, Health and Fitness, Nutrition, Obesity, Stanford News, Women's Health

Women’s health expert: When it comes to prevention, diet and exercise are key

Women's health expert: When it comes to prevention, diet and exercise are key

16262076932_96f8309b43_zThis Monday was the sixth annual Stanford Women’s Health Forum, hosted by Stanford’s Women and Sex Differences in Medicine center (WSDM), and I was happy to have been present for the lively talks. The forum focused on prevention, and the keynote, delivered by Marcia Stefanick, PhD, professor of obstetrics and gynecology and WSDM director, highlighted physical activity and weight management as the key preventative actions for women to take.

High blood pressure remains the number one preventable cause of death in women, with physical inactivity and high BMI, both of which contribute to high blood pressure, in third and fourth place. (For the curious readers, smoking comes in second.) Because prevention requires changes in behavior, behavior was what Stefanick focused on. Rather than reinforcing many women’s feelings of embarrassment about their weight, she said, providers should help women feel that they can do something about it.

Healthier behaviors must include diet and exercise. Both fatness and low fitness cause higher mortality; realistic expectations about how to change both should factor into care. Stefanick emphasized that weight loss should be slow: 10 percent of one’s body weight baseline over six months, or one pound per week for moderately overweight people, and no more than two pounds per week. And we need to stop being so sedentary, Stefanick exclaimed. The classic principles of exercise apply – gradually increase the frequency, intensity, and/or duration of exertion. Adults should be getting at least two and a half hours of moderate-intensity aerobic physical activity per week, in addition to doing muscle-strengthening activities at least twice a week, the conference flyer read.

However, citing the problems of eating disorders and older women losing weight without trying, Stefanick stressed that “weight management is a spectrum; there are extremes at both ends.” In describing variations on mesomorphic, endomorphic, and ectomorphic body types, she stated that “we don’t know what the optimal body type is.” It probably varies for each person.

Something I found particularly interesting was Stefanick’s description of gynoid vs android fat distribution patterns (which I learned as “pear” and “apple” body shapes, respectively). Gynoid distribution around the hips, thighs, and butt is more common in women, and includes more subcutaneous fat, while in android distribution, which is more common in men, fat collects around the belly and chest and is actually dispersed among the organs. Such intra-abdominal fat is more damaging to health, as it affects the liver and lipid profile and can cause heart disease, but it’s also much easier to get rid of through exercise (which is one reason men overall have less trouble losing weight than women).

In the spirit of more personalized care, Stefanick also discussed how recommended weight changes during pregnancy should vary according to the person’s prenatal BMI. Someone underweight could gain up to 40 pounds and be healthy, she pointed out, while obese people might actually lose weight during pregnancy for optimal mother-baby health.

Previously: Why it’s critical to study the impact of gender differences on diseases and treatmentsWhen it comes to weight loss, maintaining a diet is more important than diet typeApple- or pear-shaped: Which is better for cancer prevention?A call to advance research on women’s health issues and To meet weight loss goals, start exercise and healthy eating programs at the same time
Photo by Mikaku

Events, Health and Fitness, Medicine and Society, Stanford News

Stanford Medicine’s community open house happening on May 16

Stanford Medicine's community open house happening on May 16

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Mark your calendar for Health Matters, Stanford Medicine’s community open house, being held this year on Saturday, May 16. There will be wellness dogs and a helicopter, chair massages, tasty food and plenty of informative presentations on topics ranging from breast cancer and dementia to exercise and diet.

And, it’s all free (except for the tasty food).

A few of the presentations include:

  • “Dispelling the myths: Realistic strategies for maintaining cognitive health and preventing dementia” with Frank Longo, MD, PhD
  • “Tips for safe workouts: How to stay healthy and injury-free” with Jason Dragoo, MD
  • “Anti-inflammatory foods” with Kylie Chen, RD
  • “Approaching the second half of life with health and vitality: The latest research on longevity and aging” with Anne Brunet, PhD
  • “Teen mental health and your family — Practical information and insights”, a panel presentation

Throughout the day, the Life Flight helicopter is expected to be available, as will be the canine stars of the Pet-Assisted Wellness (PAWs) program. The pavilion will also feature a look at the MyHeart Counts heart-health app, cooking demonstrations, emergency preparation information and Stanford experts available to answer your health questions.

The event will be held at the Li Ka Shing Center for Learning and Knowledge. If certain talks particularly strike your fancy, register here to reserve a space. Some events, such as the medical school session for high school students, will or have already filled up.

Previously: Stanford Medicine to open its doors to community during Health Matters event, An ounce of action is worth a ton of theory: Med student encourages community engagement and Stanford Medicine community gathers for Health Matters event

Stanford Medicine Resources: