Quit smoking today—and start looking better tomorrow

Fewer wrinkles. Better-smelling breath, hair, and clothing. Healthier teeth and gums. More money in your pocket. An improved sense of taste and smell. A reduced risk of heart disease, stroke, chronic obstructive pulmonary diseases, and cancer of the lungs, cervix, pancreas, throat, intestine, kidneys, and bladder. Most important, up to 10 years added to your life span. Despite these convincing reasons to quit smoking, Americans are not getting the message that smoking can not only shorten your life, but also increase the risk of death in those who come into contact with your secondhand smoke—including your children.

According to a recent study by the Centers for Disease Control, the rate of U.S. smokers in 2008 (20.6 percent) has remained virtually unchanged since 2004, when 20.9 adults reported being smokers. And 20.6 percent translates to 46 million U.S. smokers, 443,000 preventable deaths each year, and $96 billion in annual health-care costs. Hardest hit by the tobacco epidemic are vulnerable populations, including people with lower levels of education.

If you smoke cigarettes, choose to quit today as part of the 34th Great American Smokeout. It’s true that quitting is no simple task—and you may have made several honest attempts before. But considering the damage cigarette smoke does to your looks, on top of your health and the health of those around you, it’s worth another try. Consider these practical ways to help you get started:

Avoid dangerous combination: Blood thinner Plavix with some heartburn drugs

The Food and Drug Administration warned today that people who take the blood thinner clopidogrel (Plavix) should not take the heartburn drugs omeprazole (Prilosec, Prilosec OTC, and generics) and esomeprazole (Nexium) because two new studies confirm that the combination could have dangerous consequences. The studies show that omeprazole and esomeprazole—both members of a class of stomach acid-reducing drugs called proton pump inhibitors, or PPIs—can lower the effectiveness of Plavix , putting people at risk of heart attacks or strokes.

Plavix is given to people after a heart attack to help reduce the risk of blood clots that can trigger another attack. The drug can be hard on the stomach and cause gastrointestinal bleeding, so people are often prescribed a PPI treatment, which reduces the amount of acid in the stomach and lowers the risk of stomach bleeding. But previous studies suggested this drug combination may actually increase the risk of having another heart attack. The FDA’s warning is based on two new studies from the makers of Plavix that show that both omeprazole and esomeprazole reduce the drug’s effectiveness because they block an enzyme in the body called CYP 2C19.

The agency said it does not have enough information to draw a conclusion about whether any other PPIs can be safely used with Plavix, but studies into this issue are being conducted. However, a different type of acid-reducing drug called cimetidine (Tagamet, Tagamet HB, and generics) also inhibits the CYP 2C19 enzyme and should not be taken with Plavix.

What your walking speed can tell your doctor

Doctors are trained fortune-tellers of sorts. But instead of divining the future through tea leaves or Tarot cards, they look to our bodies for clues. If our blood pressure is high, they may warn of heart and circulation problems that could be down the road. Ditto for high cholesterol. But doctors can also draw upon subtler signs — even, for example, our walking speed.

As odd as it may sound, studies show that healthy older adults who walk slowly are at higher risk of falls, disabilities, frequent hospital visits, and other health problems. And, according to a new study, slow walkers also have triple the chance of dying from heart disease, although the reasons aren't yet clear.

The study included 3,208 seniors ages 65 to 85 in France. Each person's walking speed was clocked over 6 meters (almost 20 feet). The researchers then checked on the participants every couple of years. All were in reasonably good health at the start of the study, and didn't have any conditions that could have substantially affected how fast they walked, such as Parkinson disease, dementia, or a disabling stroke.

After five years, 209 people had died, including 99 from cancer, 59 from heart disease, and 51 from other causes (such as infections and respiratory failure). The researchers found that the slowest walkers were three times more likely to have died of heart disease than those who walked at a faster clip. However, they didn't find a link between slow walking and other causes of death, including cancer.

Consumers who took Zetia or Vytorin may get refund

If you took the cholesterol-lowering drugs Zetia or Vytorin in recent years, you may be able to get some of your money back. The manufacturers Merck and Schering-Plough have agreed to a proposed $41.5 million class action settlement over charges they violated consumer protection laws by marketing the drugs as being superior to other cholesterol drugs and selling them at higher prices when, in fact, they are not more effective. Merck and Schering-Plough deny any wrongdoing.

Vytorin has been under fire since last year, when two studies cast doubt on the benefits of the drug, which is a combination of Schering-Plough’s Zetia and Merck’s Zocor. The first was a 2-year study that showed Vytorin was no better than Zocor alone in reducing plaque build-up in arteries. The second was a five year study that showed Vytorin did not reduce strokes or heart attacks compared to placebo, and more alarmingly was associated with a higher incidence of cancer and death from cancer. Earlier this year, the Food and Drug Administration said in a controversial decision that people should continue to take Vytorin because it lowers LDL or "bad" cholesterol more than Zocor alone.

Q&A: Can a low diastolic pressure be harmful?

You recently said that lower-than-normal systolic blood pressure is safe as long as it causes no symptoms. Can a low diastolic pressure be harmful? —C.W., by e-mail

Probably not if your systolic level is normal. But if that level is high, the wide pulse pressure—or the difference between the diastolic and systolic levels— can indicate heart-valve problems, a weakened heart muscle, severe anemia, an overactive thyroid, and other problems. And some research suggests that a low diastolic, by itself, might be dangerous in people with coronary disease. A study of more than 20,000 such people found that a diastolic of 60 millimeters of mercury (mm Hg) or less tripled the risk of death compared with pressures between 71 and 90 mm Hg, independent of the pulse pressure. Diastolics between 60 to 70 mm Hg doubled the risk. If your diastolic is 70 or less, ask your doctor if you should be concerned, especially if you also have a high systolic level or are being treated for coronary disease.

It’s about time for a school lunch makeover

When I read that the Institute of Medicine (IOM) had released new guidelines to improve the nutrition of school lunches, my first reaction was "It’s about time!" The guidelines include setting a maximum number of calories in a meal, lowering the sodium, saturated fat and starchy vegetables, and increasing the amount of fruit, vegetables and whole grains.

Having lived through school lunches of chicken fried steak with cream gravy, mashed potatoes, and a big cup of ketchup as the "vegetable" (thank you Ronald Reagan), I realize that many school cafeterias have made some strides. But placing a largely ignored bowl of apples at the end of the line does little to negate the greasy pizza, and fried chicken patties that usually precede that bowl. And my children have been known to throw at me that a meal of macaroni and cheese with French fries can’t be that bad, since it’s served at the school cafeteria.

One of my brothers tells me that I worry too much. We ate it, and it didn’t kill us. But it is killing us. And it’s setting up our children for a lifetime of poor health. A new national survey released by the Preventive Cardiovascular Nurses Association found that most Americans don’t realize that heart disease risk doesn’t wait until adulthood. The American Heart Association even held a conference this year looking at the dangers of the growing girth of our children. And they are growing—some estimates say that 1 in 3 of our kids are overweight.

Want to quit smoking? Don’t switch to low-tar

It’s amazing the ways in which we sabotage our best intentions. How many bursts of enthusiasm have been lost with the thought "but I’ll just do this first"? If you’ve tried to start an exercise routine, you’ll know how it goes. I’ll start jogging, but I need to buy new running shoes first. I’ll go to the gym, just as soon as I get these chores finished.

Some smokers think that a great first step to quitting smoking is to switch to a lower tar brand first. After all, that means less addictive nicotine, fewer harmful substances, and shows they’re serious about change, right?

Wrong. Studies show that smokers draw more deeply on lower tar cigarettes, so they inhale about the same amount of harmful substances as smokers of higher tar brands. Not only that, but smokers who switch to a lower tar brand are much less successful when they try to quit altogether.

A recent study looked at the smoking behavior of more than 30,000 Americans. The study found that smokers who switched to lower tar brands were more likely to attempt to quit, but less likely to succeed. Only 9 in 100 people managed to quit after switching brands, compared to 17 in 100 who quit without switching first.

Q&A: Can particular foods lower bad cholesterol?

Can particular foods or dietary strategies lower "bad" LDL cholesterol? —A.S., via e-mail

Yes, several. Foods that can help lower LDL include those high in fiber (particularly oat bran, psyllium, and barley) and foods containing added or natural stanols or sterols—plant substances that inhibit the absorption of cholesterol—such as Benecol and Take Control margarines, Minute Maid Premium Heart Wise orange juice, and certain nuts and seeds. Eating two to three servings of soy foods each day may also help. Researchers have found that combining those foods increases their benefits: A diet high in soy protein, fiber, and plant sterols can reduce LDL levels as much as a low-dose statin drug. Other LDL-cutting dietary strategies include reducing saturated fat intake to less than 7 percent of calories, minimizing trans fat, and losing excess weight.

Q&A: Is a noisy heartbeat a sign of something serious?

I’m often awakened by the sound of my own heartbeat. Is that serious? —B.F.S., Niles, Ill.

Probably not. The most likely cause is simply that your mattress is amplifying the sound, especially if you sleep on your left side. If so, try a different position, with your ear not pressed against the pillow or mattress. If that doesn’t help, ask your doctor about anemia or heart-valve disease, both of which can cause an unusually loud pulse as the heart struggles to supply enough blood and oxygen.

Read more on how to keep your heart healthy, and see our information on the benefits and risks of anemia drugs.

8 core reasons to eat more apples

This weekend, I’m headed to the annual apple festival in my city to do my part in honoring this highly-acclaimed fruit. That means tasting as many varieties as my stomach will allow. And that shouldn’t be a problem, since apples are an excellent source of digestion-aiding fiber. Fiber in apples and other fruits provides bulk in the intestinal tract, holding water to cleanse and move food quickly through the digestive system. And just one apple provides as much dietary fiber as a serving of bran cereal.

And the healthful reasons to indulge in this fat-free, tasty fruit don’t end there. Several studies have linked apple nutrients to an impressive range of health benefits. Here are 7 more reasons to bite into an apple this weekend, or whenever:

• Prevent disease. Apples are a natural source of health-promoting phytochemicals that have been found to lower blood pressure and protect against circulatory problems caused by diabetes. Study have also shown the phytochemicals found in apples help keep LDL (bad) cholesterol levels under control.

• Strengthen bones. Apples and apple juice contain the mineral boron, which has been shown to strengthen bones—a good defense against osteoporosis.

• Protect your heart. Apples are a rich source of soluble fiber, such as pectin, which helps to prevent cholesterol buildup in the lining of blood vessel walls, thus reducing the risk of atherosclerosis and heart disease.

Study: Smoking bans cut nonsmokers’ heart attack risk

A new report released this week by the Institute of Medicine confirms that smoking bans do indeed reduce the risk of heart attacks and heart disease associated with exposure to secondhand smoke. In addition, the report, based on data from 11 key studies on heart attack rates, confirms that breathing secondhand smoke increases nonsmokers' risk for heart problems. Those studies found that the incidence of heart attacks dropped anywhere from 6 percent to 47 percent after cities, states, or even whole countries like Italy or Scotland banned indoor smoking.

Exposure to secondhand smoke appears to increase the risk of heart disease by about 25 to 30 percent among nonsmokers, the IOM concluded. And in the United States alone, secondhand smoke is estimated to be responsible for approximately 46,000 deaths from heart disease, 3,400 lung cancer deaths, 150,000 to 300,000 lung infections, including pneumonia and bronchitis in children, an increase in the severity of asthma attacks from about 200,000 to 1 million in children with asthma, and more than 750,000 middle ear infections in children.

Back when Consumer Reports investigated the risks associated with secondhand smoke in 1995, the idea that secondhand smoke could cause heart disease was still under debate. At the time, just five states had outlawed smoking in the workplace. Today, 25 states, plus the District of Columbia have such laws, and the connection between secondhand smoke and heart disease is no longer in doubt--thanks in large part to the ability of researchers to track the incidence of heart attacks and heart disease before and after such bans.

Flax facts: Get more, get heart-healthy

Dry. Gritty. Joyless. These are just a few of the words that came to mind when I recently read several blog headlines touting the taste and health benefits of flax. Normally, I’d consider this just another under-researched food craze making waves on the Internet, but my curiosity got the better of me and I opted to give it a try. I was wrong in judging this friendly seed. One large bag of flaxseed tortilla chips later, all my doubts about its taste and snack-ability went out the window. But what about the health benefits?

Flax is the seed of the flax plant, also called linseed. If you think you heard of it being used to make clothing, you’re right. The stems of flax plants are often used to make linens and clothing, but the seed is edible and can also be purchased in oil and supplement forms.

Flax, like fish oil, contains omega-3 fatty acids that help your heart by decreasing inflammation and keeping your blood thin and mobile. Studies have also shown that omega-3s lower your triglyceride levels. Omega-3s have also been found to help prevent mild depression, Alzheimer’s disease, and macular degeneration. And because flaxseed is almost one-third fiber, by eating more of it you’ll be helping to ward off obesity, type 2 diabetes, and heart disease. And the benefits don’t stop there. Flax is also a rich source of lignans, compounds that alter the way the body handles estrogen. Preliminary research hints that flaxseed can lower the risk of breast cancer. And one small study of women with mild menopausal symptoms found that about 3 tablespoons of flaxseed a day eased their hot flashes and night sweats as effectively as supplemental estrogen.

7 creative ways to beat vegetable boredom

Green beans. Spinach. Peas. Green beans. Spinach. Peas. We all know that vegetables are a staple of a healthful diet, but getting them on your plate everyday can be a challenge—and eating the same ones day-in and day-out can be downright boring. We don’t always have the time, know-how, or budget to perk up a simple salad or side of broccoli. And it’s hurting us. According to a recent report by the Centers for Disease Control and Prevention, fruit and vegetable consumption is down. Only 27 percent of Americans get the recommended 3 or more servings of vegetables per day.

A diet rich in colorful vegetables can help you live longer and fight heart disease, stroke, some types of cancer, and type 2 diabetes. Vegetables can keep you looking your best, too. Vitamin A in carrots, spinach, sweet potatoes, red peppers, winter squash, kale, and collard greens can help keep eyes and skin healthy, and protect against infections.

Our staff came up with some creative ways to beat veggie boredom. Here are seven of my favorites—one for everyday of the week:

• Off to a good start. Make a Spanish omelette for breakfast, with onions, peppers, tomatoes, mushrooms, and asparagus—or any other vegetable you have on hand. Half a cup of chopped vegetables equals one serving.

• For stew lovers. A good pressure cooker is a must-have. Throw in squash, carrots, celery, parsnips, lentils—you name it, and you can create your very own one-of-a-kind meals. One staffer is fond of his Israeli couscous and one-pot chicken-and-rice dish.

• Add some crunch. Serve risotto or mashed potatoes with romaine leaves. Try wrapping the potatoes in the lettuce leaf to add texture and color to your starch of choice. Or mix arugula or spinach into the potatoes.

Turning into your mother can be good for your health

Not all of the changes are good (I still can’t believe I actually used the "If all your friends jumped off a bridge…" speech on my daughter), but it turns out that on the nutrition front, she may have been ahead of her time. Although it pains me to admit it, my mom was right about some things.

Drink your milk. In my earlier years, milk was about as exciting as, well, milk. By my twenties, I only drank a few glasses per month. Now I find myself pushing it on my daughter with all the fervor of an infomercial salesman. Milk gets an "A" grade because of the strong link shown between calcium and healthy bones. But I also think "D" with milk, or rather the lack of vitamin D in our diets. In a recent study published in the journal Pediatrics, researchers found that seven out of ten U.S. children may be vitamin D deficient. Fast becoming haled as a "miracle" vitamin, D has recently been associated with a reduced risk of hypertension and heart disease, preventing bone ailments and maintaining muscle strength. It also lowers the risk of being overweight or obese, prevents cognitive impairments later in life, gives possible protection from colds and flu, and some evidence even suggests vitamin D may protect against some cancers. And if that weren’t enough, having low levels of vitamin D has been linked with an increased risk of death overall. 

According to the USDA, my teenage daughter should be drinking at least 3 cups of low-fat milk a day (although ice cream is made from milk, I have yet to have bought into her argument that the government wants her to eat three bowls of ice cream a day). And with all these potential health benefits, a glass of moo juice (or fortified soymilk or OJ, if you prefer) positively glows with good health.

Don’t even think about leaving this house until you’ve eaten some breakfast. For years I’ve told myself that coffee was a perfectly good breakfast option (coffee’s made from beans, beans are vegetables—so I was having vegetables for breakfast). Yet now I find myself spouting that dreaded phrase from my childhood: "Breakfast makes you smarter." Turns out moms are right on that as well. Several studies have shown that regularly eating breakfast may improve memory, test grades, and even school attendance. There’s also some evidence that kids who regularly eat breakfast are less likely to be overweight as teenagers.

Soda pop is a treat, not a drink. This past summer, the American Heart Association recommended that Americans reduce the amount of added sugars we all consume. And let’s face it, a significant source for many of us, especially teenagers, comes with those luscious little soda bubbles or in the form of an energy or sports drink. Not only are these beverages loaded with calories, for some people they may be replacing more nutritious options (no dear, just because it’s orange doesn’t make it juice).

You don’t need a big piece of meat to have a good meal. Although done for economical reasons (trying to feed four teenagers on a limited budget), my mother was a master at making a small amount of meat "stretch" by using it more as a flavoring than as a main course. There were many "guess what’s in the casserole" nights. Although derided by many as a sign of being economically impoverished, it turns out that the reduction of meat in our diets is yet another way that my mother was ahead of her time. Associated with heart disease, high blood pressure and cholesterol, and even some forms of cancer, a diet high in red meat has been linked to a higher mortality rate. In an article published this past year in the Archives of Internal Medicine, people who ate the equivalent of a ¼ pound burger or a small steak every day had about a 27% higher risk of dying over a 10-year period. So in Mom’s best tradition, break out the casserole recipes and serve up some stew, but keep the meat to a minimum.

—Erin Gudeux, sensory senior project leader

Should sugar-sweetened beverages be taxed?

Not many people want to entertain the thought of new taxes during tough economic times (in truth, many of us don't like the idea in the best of times either). But a group of public health experts make a persuasive case for one in a recent issue of the New England Journal of Medicine.

They recommend putting a tax on sodas, energy drinks, and other beverages with added sugar (diet drinks would be exempt). They argue that such a tax would help curtail Americans' consumption of sugar-sweetened drinks, while raising funds to promote good nutrition, and help cover health costs related to regularly imbibing these beverages.

Americans' demand for sugary drinks has doubled in the last 30 years, and recent studies have linked consumption of these calorie-infused beverages to a higher risk of obesity, diabetes, and heart disease— conditions that exact a huge toll on individuals, families, and the health care system overall. Medical costs associated with being overweight or obese alone are estimated at $147 billion (9.1 percent of total U.S. health care expenditures), with Medicare and Medicaid picking up half of this tab. These are complex public health issues with many causes and no easy solutions. But might taxing sugary drinks help?