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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

Health and Fitness, In the News, Sleep, Videos

“Father of Sleep Medicine” talks with CNN about what happens when we don’t sleep well

"Father of Sleep Medicine" talks with CNN about what happens when we don't sleep well

Dement - smallA good night’s sleep is often the first thing to go when we have an important work deadline or health issue. I know this from firsthand (and recent!) experience: I let a foot injury kept me up until 4 a.m. today even though I know that cheating sleep – or getting a poor night of sleep – is bad for my health.

But is skimping out on sleep now and again really that bad? As Chief Medical Correspondent Sanjay Gupta, MD, and Stanford sleep expert William Dement, MD, PhD, explain in a recent CNN feature: yes. When we rest, our bodies go to work, Gupta explains: “When your head hits the pillow, your body doesn’t shut down. It uses that time to heal tissue, strengthen memory, even grow.”

Dement, who founded the Stanford Center for Sleep Sciences and Medicine in the 1970s and has devoted his career to understanding sleep, has lots of experience with patients who miss out on these benefits because they don’t sleep well – due to obstructive sleep apnea. (The disorder, he says, affects 24 percent of adult males in the U.S.) In the piece, he and Gupta discuss the risk factors, such as excess weight and large tonsils, linked to sleep apnea and what can be done to alleviate the problem.

If you have a few minutes, this video is worth a watch. Dement makes his first appearance at the 2.5-minute mark.

Previously: Stanford doc gives teens a crash course on the dangers of sleep deprivationWilliam Dement: Stanford Medicine’s “Sandman”Stanford docs discuss all things sleep, Why untreated sleep apnea may cause more harm to your health than feeling fatigued and What are the consequences of sleep deprivation?
Photo, which originally appeared in Stanford Medicine, by Lenny Gonzalez

Autoimmune Disease, Chronic Disease, Health and Fitness, Nutrition, Obesity, Research

Study clarifies link between dieting, exercise and reduced inflammation

Study clarifies link between dieting, exercise and reduced inflammation

4503404991_13da58b6e6_bIf you’ve ever wondered how dieting and exercise reduce inflammation, read on. According to new research, a compound that our bodies crank out when energy supplies are low could be the link between diet and exercise, and reduced swelling in the body.

When diet, fasting and exercise starve the body for calories, the body increases production of a compound called beta hydroxybutyrate (BHB). This compound has long been known as an alternate source of energy; the new research suggests that BHB can also block the inflammatory response.

In their study, published this week in Nature Medicine online (subscription required), a team of scientists co-led by Yun-Hee Youm and Kim Yen Nguyen at the Yale School of Medicine, discovered that the compound BHB reduces swelling in the body by inactivating a group of proteins, called the inflammasome, that drive the inflammatory response.

The research team used human immune cells and mice to explore the effects of BHB in the body. They found that mice given BHB directly, and mice fed a low-carbohydrate diet (that prompted their bodies to synthesize their own BHB), both benefited from reduced inflammation.

These results are noteworthy because a better understanding of the mechanism that links diet, exercise and inflammation could help scientists develop more effective treatments for inflammatory disorders such as Type 2 diabetes, atherosclerosis and Alzheimer’s disease.

Previously: Newly identified type-2 diabetes gene’s odds of being a false finding equal one in 1 followed by 19 zeroesImproving your health using herbs and spices, Exercise may alleviate symptoms of arthritis regardless of weight loss, Study points to inflammation as cause of plaque buildup in heart vessels and Examining the role of exercise in managing and preventing diabetes
Via ScienceDaily
Photo by Dave Nakayama

Cardiovascular Medicine, Health and Fitness, Public Health, Research, Women's Health

Even moderate exercise appears to provide heart-health benefits to middle-aged women

Even moderate exercise appears to provide heart-health benefits to middle-aged women

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It’s no secret that exercise offers a plethora of health benefits; tons of research has established that. But I was still heartened to read about a new study showing that physically active middle-aged women had lower risks of heart disease, stroke and blood clots than did their inactive counterparts. (I read about the work on my phone as I walked home from a barre class last night, which made me feel especially happy about having had just worked out.)

Researchers from University of Oxford looked at data from 1.1 million women in the United Kingdom, who were followed for an average of nine years. From an American Heart Association release:

In the study:

  • Women who performed strenuous physical activity— enough to cause sweating or a faster heart beat — two to three times per week were about 20 percent less likely to develop heart disease, strokes or blood clots compared to participants who reported little or no activity.
  • Among active women, there was little evidence of further risk reductions with more frequent activity.

Physical activities associated with reduced risk included walking, gardening, and cycling.

Lead author Miranda Armstrong, MPhil, PhD, commented that “inactive middle-aged women should try to do some activity regularly,” but then noted that the results suggest that “to prevent heart disease, stroke and blood clots, our results suggest that women don’t need to do very frequent activity.” That’s good news, ladies!

The study appears in the journal Circulation.

Previously: Lack of exercise shown to have largest impact on heart disease risk for women over 30, Exercise is valuable in preventing sedentary death, Study shows regular physical activity, even modest amounts, can add years to your life, CDC report shows exercise becoming a popular prescription among doctors and Brisk walking reduces stroke risk among women
Image by Thomas Hawk

Health and Fitness, Nutrition, Public Health

Why establishing a health baseline is a “critical starting point for achieving future health goals”

Why establishing a health baseline is a "critical starting point for achieving future health goals"

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Raise your hand if you want to be more successful at achieving health goals, such as losing weight or lowering your cholesterol levels, and maintaining a healthy lifestyle. Perhaps it’s time to consider creating a health baseline. “A health-care baseline is essentially where you are “at” on the broad, complex spectrum of physical, mental and emotional health,” explains Mary James, MD, an internal medicine physician at Stanford. “This can be a critical starting point for achieving future health goals.”

On Thursday, James will deliver an in-depth talk on the benefits of partnering with your primary care provider to establish a health baseline as part of the Stanford Health Library lecture series. Those unable to attend can watch the presentation online here.

In anticipation of the event, I contacted James to learn more about why its important to have a basis for comparison, beyond the ever-fluctuating number on your bathroom scale or if you’re able to fit into your skinny jeans, to use in measuring progress in meeting your health goals. Below she discusses how assessing the state of your health now can pay off in a longer, more active life in the future.

What is a health baseline?

Your baseline has two basic components: existing illness and potential future illness. Your current baseline has been shaped by your medical, social and family history and is constantly being influenced by common factors in everyday life. Although some components of your healthcare baseline are more modifiable than others, it is important to have an accurate understanding of your current health status.

Why is it important to determine your personal health baseline?

You may be thinking, “I’m healthy – I take no medications and never go to the doctor. Why should I start now?” There are two fundamental components to good health. They are: appropriate treatment for current illness and appropriate preventative care to reduce health decline in the future. While most people actively seek care for the former, we often forget about the latter. Although the data is mixed on whether “routine check ups” are beneficial, there is strong evidence behind many of the preventative maneuvers that are typically discussed and ordered at these visits. Taking appropriate preventative health-care steps can help you avoid the need for prescription medications, hospitalizations and procedures and can help ensure a longer, healthier life.

How can establishing a health baseline help you be more successful in reaching personal wellness goals?

Many wellness goals start with changes in diet and exercise. Your primary care provider can help determine how to start making these changes in a safe, effective manner. Are there exercises you should avoid due to chronic back pain? Is it okay to start running if you have high blood pressure? Is it safe for you to start a vegan diet? What is a safe amount of weight to lose?

Wellness also includes mental and emotional health. Your primary provider can help determine what treatment is most appropriate for common conditions such as depression and anxiety. Maybe you’ve been feeling “down” lately – is this true depression that warrants medical treatment, or is it safe try a new yoga or meditation class first? These are just a few of the many things that can be assessed and addressed as part of your health baseline. Together, you and your primary care provider can prioritize health problems and determine effective interventions.

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