Article Category: Health & Wellness

After a few months that felt like summer, we’re heading into a fall that will be different than most of us imagined. The coronavirus outbreak continues to impact our daily lives – and, unfortunately, will likely do so for a while.

So, as we keep up our efforts to stay safe from COVID-19, it’s important that we not forget to look after other aspects of our health as well. This means keeping up with things like exercising, eating healthy food, connecting (virtually) with friends and getting enough sleep. It also means getting back on track with any medical care we’ve missed.

Since the coronavirus outbreak took hold in the U.S., there’s been a major drop in the number of people getting cancer screenings, vaccinations and other key care.

That’s not surprising, of course. In March and April, doctors’ offices and hospitals across the country stopped or limited non-essential care to curb spread of the virus and to prepare to treat infected patients. At the same time, many people have avoided appointments to try to reduce their risk of infection. And, now, with new spikes in COVID-19 in parts of the country, we’re seeing some variations of this play out again.

Yet, we know that missing regular medical care can impact health, especially the longer it’s delayed. Skipped cancer screenings can lead to the disease being diagnosed later, when it’s harder to treat. Missed vaccinations can make children and adults more susceptible to serious infectious diseases. And delayed follow-up for chronic conditions like unhealthy blood cholesterol, diabetes and high blood pressure can increase the risk of heart attack and stroke.

“It’s important to make sure you still get recommended cancer screenings, even during the pandemic,” said Dr. Jean Wang, professor of medicine at Washington University School of Medicine in St. Louis. “Taking action now to prevent cancer and other serious illnesses will help keep you much safer and healthier in the long run.”

The specifics of doing that, though, can vary from person to person and from region to region, depending on the status of the COVID-19 outbreak and the capacity of facilities to see patients.

The best approach is to contact your health-care providers and, together, discuss plans for safely getting back on track with the care you need. This may mean scheduling in-person appointments, meeting remotely through telehealth, or checking back with them sometime in the near future.

Importantly, any urgent concern about your health should be addressed immediately. “If you are having symptoms, do not delay getting care,” Wang said. “Since hospitals have adapted to the coronavirus epidemic by taking necessary precautions, it is very safe to come in to get evaluated.”

If cost of care is an issue because of a lost job, lost health insurance or other reason, some resources may help. Healthcare.gov has information about eligibility for Medicaid or health plan enrollment. Another option, Wang adds, includes federally qualified health clinics, “which are available all across the country to care for people regardless of their ability to pay or their insurance status.” Contact your providers, hospital or local health department, or visit findahealthcenter.hrsa.gov, for additional information on accessing care.

While much of our focus remains on combating the coronavirus outbreak, let’s not lose sight of the important goal to stay healthy overall. Cancer screenings and regular medical appointments can be an essential part of that. So, for ourselves and our families, it’s a good time to make a plan to get back on track.

It’s your – and your family’s – health. Stay in control.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

If you feel that time has been moving at a different pace during the coronavirus pandemic, it seems you’re not alone. A study published last month in the journal PLOS ONE found that most respondents to a questionnaire reported experiencing a distorted sense of time during lockdown. For some, days and weeks seemed to pass more quickly than normal. For others, more slowly.

One factor that was linked to perception of time was participants’ satisfaction with their levels of social connection. Those who reported being more satisfied with their social interactions felt time moved faster during lockdown. Those who reported being more dissatisfied felt time moved slower.

This is one example of how social connections may affect our experiences during this prolonged disruption to our daily lives. And while it’s too early to know for certain how the pandemic has influenced the long-term mental and emotional health of people, we do know that – outbreak or not – most people generally do better when they have regular social connections and social support. We are social animals, after all.

So, as the pandemic continues to stretch on and physical distancing, work from home and other stay-safer guidelines remain in place for many parts of the country, it can be important that we also keep working to stay socially connected – safely. Below are suggestions for staying in touch with family and friends.

Keep it virtual – The safest way to socialize remains virtual, connecting through our phones and computers. That can be frustrating to read, but it’s likely to be especially important as the weather turns cold and we spend more time indoors, where we know the virus spreads much more easily.

Try something different – While it’s hard to replace in-person connections, one way to make virtual socializing more appealing is to mix things up. Tired of video calls? Try group message chats and phone calls. Maybe even send a handwritten note in the mail. For something more cutting-edge, host a movie night, where you and friends can individually stream the same movie and chat about it in real time. New options to stay connected launch regularly. Explore what’s available, and keep things fun and engaging.

Make it a priority – Of course, even with the latest technology, it can be easy to let our social connections slide. That’s only natural when our normal routines have been upended, and for such a long time. If staying connected is important to you, one way to make it happen is to schedule it. Set up regular times to connect with people. Maybe Sunday night is the time you call your family. Tuesday evening you play online trivia with co-workers. And Friday night you have a long video chat night with close friends. When it’s planned for a specific day and time, and someone is expecting to get together, you’re less likely to skip.

These are difficult times for many people, for many different reasons. And mental health can take a particular hit from extended periods of social isolation and loneliness. If you need help, reach out to a health-care provider, or visit the National Alliance for Mental Illness (nami.org) for resources. If you ever feel you’re in crisis, call 911 and the National Suicide Prevention Lifeline (1-800-273-8255) immediately.

Half a year into the pandemic, we’re all probably more than a little tired of it. But we need to keep doing what we can to get things under control. Even as we keep up physical distancing and other guidelines, however, we can still safely maintain our important social connections – with some creativity and patience. We’ll get through this – together.

It’s your health. Take control.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

The strange times continue. After finally getting back to a semblance of pre-pandemic life in many parts of the country, we’re seeing safety orders extended or put back in place as the coronavirus shows just how formidable it is.

Children, thankfully, haven’t been as directly impacted by COVID-19 as adults. They can still get infected with the virus but will often show little or no sign of illness. Many children, though, have been affected in other important ways. Their daily lives have changed, and in a manner not always good for long-term health.

While much of this is out of our control, there are simple steps we as parents – or grandparents or guardians – can take to support the well-being of children in our lives, on top of those steps that also protect against the coronavirus.

While each of these was important before the pandemic hit, they are even more so now as our new normal is likely to continue for a while.

Try to reduce screen time. Even as economies have opened up, many of us are still spending more time at home than we normally would, especially during summertime. Streaming videos and playing on the phone can be a fun way for kids to fill that time. Keeping such screen time to a reasonable amount, though, can give kids the chance to move around more and explore other fun activities. That variety can be good for both their mental and physical health. General health recommendations are to keep screen time to two hours or less per day. That may not make sense during this time of pandemic, with all that kids and parents are going through. Any drop in the amount of screen time, though, is a good place to start.

Stock up on healthy snacks and keep them in the open. The in-person school day can provide healthy structure for children. When that goes away in summer, we know that some children’s eating and activity habits can change for the worse. And when many schools moved to remote at-home learning this March, those summer behaviors had time to take hold even earlier in the year. One way to help children build on healthy eating habits instead is to stock up on healthy snacks and keep them where they’re easy to find – on the counter, or at eye-level in the fridge or cupboard. Good options include fruit, cut-up vegetables, whole-grain cereals and crackers, low-salt nuts and fizzy water. And try to cut way back on the unhealthy snacks in the house. This includes things like sugary soda, energy drinks, chips, cookies and ice cream. If food security is ever an issue, contact your local food pantries or feedingamerica.org.

Try to be active every day. With safety orders in place and normal schedules upended – for children and parents – it can be harder than it used to be for kids to get their recommended 60 minutes of daily physical activity. That activity, though, can be very beneficial for children’s well-being. Try to think of ways to help get your children moving during the day. Have them come with you on your morning walk, follow along with an exercise video or go to a park to play soccer with friends – if it’s safe and allowed by health orders.

Make a plan to get back on schedule with vaccines. As the nation largely shut down this spring, health-care visits for childhood vaccinations plummeted. But as we’ve learned how to get patients back into hospitals and medical offices more safely, it’s a good time to contact your health-care provider or local health department to talk about getting back on track with your child’s vaccinations, so they’re protected against measles, mumps, HPV and other serious diseases.

Look after yourself. In normal times, parenting can be challenging. These days of coronavirus can make it even harder. So, it’s important that you take time to look after your own well-being. As parents, the better we feel, the more energy we can bring to caring for our children. The pandemic has affected people in many different ways, and if you need help, seek it out. A web search or call to your local health department or human resources office at work can be a good place to start.

It’s your family’s health. Take control.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

We are beginning to see signs that our steps to curb the spread of COVID-19 are paying off. While the infection is still spreading swiftly in certain areas, in others that have adopted strong physical distancing and stay-at-home policies, the infection rate is leveling off and even dropping.

And that’s great news. If positive trends continue, some restrictions may start to be slowly lifted in certain areas. But that doesn’t mean a quick return to our pre-pandemic lives, as much as we’d like it to. Even in places that have seen good progress, the virus has not disappeared. So, we must continue efforts over the longer term to prevent new waves of infections.

Exactly what this will look like for our communities and nation, no one really knows. But it most likely means maintaining some level of physical distancing and staying at home, as well as following other safety recommendations, into summer and beyond.

As we move into this new, marathon period of pandemic response, it’s important to think about ways to adjust to our new normal – and maybe even find some silver linings. Here are a few ideas worth considering.

Try to keep parts of your day and week distinct. Spending so much time at home, we might feel the different parts of our lives blending together. And that lack of structure can be tough. To make things seem more normal, think about how you can make parts of your days and weeks feel distinct. For example, when your children’s remote school day is over, have them put away their computers and other work and do something different: play a board game, do jumping jacks, take the dog on a family walk. If you’re working from home, try setting similar boundaries. Dinnertime can be a simple way to mark the end of the “regular” work and school day. In the same way, it can be refreshing to make weekends feel different from weekdays. If possible, try to limit work and do things you might not do on a normal weekday: a big cooking or art project or a longer walk outside (staying safe). Don’t be afraid to get creative.

Unplug – when you can. Internet use has surged since stay-at-home recommendations began. And, certainly, websites, podcasts and gaming and streaming services have been a fabulous way to stay entertained during the long hours at home. Yet, it can be equally important for our mental well-being to simply unplug for part of the day – no computer, no phone, no television. Instead, pick up a book or magazine, do a puzzle, go for a walk (staying safe) or even do chores. The break can be a reset, leaving you feeling more energized.

Mix things up. Routines can help us get through our days. But with stay-at-home recommendations continuing, that structure can begin to feel monotonous. Peppering new activities into your schedule can help keep things interesting. Even little changes can be good, like making a special breakfast on Wednesdays or seeing how many days in a row you can exercise. Experiment to see what works for you, and try to make it fun when you can.

Make use of resources. Local and national organizations are working hard to get people through these challenging times. If you have a need related to food assistance, mental health, work, domestic issues, parenting, substance use, schooling, elder care or something else important, help is probably available. Local governments, local news media and workplace human resource departments offer valuable information and resources. Web searches work, too.

Be flexible. One of our best coping tools now is flexibility. As things stretch on, what has worked for us – and for businesses, schools and governments – may not work longer term. Trying to be adaptable to shifting situations can help us get through the next weeks and months as stress-free as possible. This doesn’t mean there won’t be challenges, frustrations and raw emotions, but it may help us deal more positively as they pop up.

Pat yourself on the back. We all have a lot going on – even as we spend so much time in one place. So, it’s good to stop and take a step back and celebrate our successes, big or small. Maybe your son learned a song on the guitar, your daughter received an academic award or you worked out. Take time to acknowledge those things. We deserve a pat on the back as we navigate our way through a pandemic.

COVID-19 has touched nearly everyone’s lives, some immeasurably so. As we move into the next phase of the response, it’s important to continue working together to slow the spread of the infection and to keep looking after each other and ourselves. Try to maintain activities that boost your health and well-being: connecting with friends and family (virtually), staying physically active, eating healthy food and, of course, washing your hands. We’ve got this.

It’s our health. Let’s take control.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

With the warm summer months finally here, and stay-at-home restrictions starting to ease, many of us are enjoying the chance to get outside more often. The fresh air alone can feel wonderful after many weeks of being holed up in our homes for longer than many of us imagined we’d be. Add in the physical activity and opportunity to just add something new to our days, and it can provide a real physical and mental boost.

Of course, in our excitement to get outside, it’s important not to forget the physical distancing and other coronavirus safety measures that have helped keep infections in check in many parts of the country. Another step that will help keep you and your family healthy when heading outdoors after so much time inside: protecting yourself from the sun.

This can feel like a small thing in the face of a pandemic, but we shouldn’t neglect our overall health even while working to curb the spread of the coronavirus. And sun safety is no exception. More than three million people in the U.S. each year are diagnosed with skin cancer caused primarily by exposure to sunlight and other ultraviolet light, including about 100,000 with deadly melanoma. And even less-serious skin cancers can require treatment that leaves scars and impacts quality of life.

Steps that help protect against skin damage from the sun will no doubt sound familiar: use sunscreen, find shade and wear sun-protective clothing, like hats and long-sleeved shirts. But, with this spring and summer unique in so many ways, it may be important to keep a few additional things in mind to help you and your family stay safe in the sun.

In a usual year, springtime provides us a slow transition to outdoor activities. By the time the long, sunny days of summer arrive, we’ve had a chance to build our sun-safety routines. This spring has been very different. After so much time spent sheltering in place, many of us are essentially skipping spring and heading outside straight into peak summer sun. So, try to be aware of this and take extra care. Think about all the things you’ll need. Find those hats and long-sleeved shirts, and make sure you have enough sunscreen, checking expiration dates for good measure.

Being in the shade is one of the best ways to protect yourself from the sun. But shade may be harder to come by this summer with physical distancing. Staying six feet apart from others can limit free space under shade trees or park pavilions. Also, some outdoor areas remain open only for exercise, meaning relaxing in the shade isn’t officially allowed. Plan accordingly. You may need to shorten your time outside, so you’re less exposed to direct sun, or you may need to get out early or late in the day, when the sun is low in the sky and less intense.

With daycare closed and most schools moving to remote instruction this spring, many families have had a lot of together time already this year. And that trend is likely to continue this summer as childcare, summer camps and other programs are canceled or offering reduced services. Heading outside with the family is a great way to help fill the day with antsy kids. At the same time, it’s important to be mindful of protecting them from the sun, particularly if they’re taking more trips outside than they might normally.

Sun damage in youth plays an outsized role in skin cancer risk later in life. So, be sure to slather kids up with sunscreen, reapplying when needed, and having them wear sun-protective hats and clothes. And nearly as importantly, try to be a good sun-safe role model yourself.

While our daily lives are not back to where they were pre-coronavirus, the joy of getting outside during the summer months certainly helps things feel more normal. And with just a few easy steps, we can help make those outings as sun-safe as they are enjoyable.

It’s your health. Take control.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

March is National Colorectal Cancer Awareness Month, and while that may not be the first thing that pops to mind in this month of March Madness and the first days of spring, it’s worth paying attention to. Really.

Colon cancer is the third most common cancer in men and women in the U.S. About 145,000 people are diagnosed each year, and a growing number are younger than 50. Yet, countering such sober statistics is the fact that colon cancer is also one of the most preventable cancers.

The most important step you can take to lower your risk? Getting screened.

“It’s estimated that 75 percent of colon cancers could be prevented if everyone had the recommended screening tests,” said Dr. Jean Wang, professor of medicine at Washington University School of Medicine in St. Louis.

Screening not only can catch colon cancer early, when it’s more treatable, it also can help prevent it in the first place – by finding and removing growths that could turn into cancer.

Screening typically starts at ages 45 to 50. Some people at increased risk, including those with a family history of cancer, may start earlier and be screened more often.

There are many effective screening tests available. Some are quick and easy but need to be done more often, like the FIT stool test. And some are more involved but need to be done less often, like colonoscopy.

Which test a person chooses can depend on a number of different factors. These can include the cost, the distance to a screening facility and the amount of time needed to prepare for and then complete the test.

“The number of choices available for screening can sometimes be confusing, so definitely talk to your doctor about which one would be the best option for you,” Wang said.

Ultimately, the best screening test is the one that gets done.

On top of screening, healthy behaviors also can play an important role in lowering your risk of colon cancer, she added. These include keeping weight in check, not smoking, exercising regularly, eating more whole grains and limiting red meat, processed meat and alcohol.

It can feel like a bit of a laundry list, but as with many of the positive habits we try to work on, they don’t need to be tackled all at once. You can start small and build on your successes. Make a call to your doctor about screening. Skip the bacon on tomorrow’s sandwich. Go for a 10-minute walk at lunchtime. These single steps can make a real difference, laying the foundation for further positive changes.

So, during this National Colorectal Cancer Awareness Month, celebrate your health by keeping this bottom line in mind: “Colon cancer is much more common than you think, but you can take simple steps to help prevent it, with screening being the most important,” Wang said.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

Daily life has changed to an amazing degree in the last few weeks. As individuals and communities work to contain the spread of COVID-19, one major adjustment for most of us personally is that we now spend much more time at home. This form of physical distancing, or sheltering in place, limits contact between people, which can help curb the infection’s spread.

As necessary as this distancing is, it is a change that can also be stressful, tedious and isolating, among many other things. So, as we all work to get used to our new and, ultimately, temporary reality, here are eight ways to look after your health, your well-being and yourself during these unique times.

Be kind to yourself. The great thing about physical distancing is that by doing nothing — just staying inside — we’re doing something really important. Despite what you may see on social media, you don’t need to be writing a novel, conducting your children in a symphony or even reorganizing your sock drawer — unless you really want to. Be kind to yourself, and just take time to figure out what works best for you and your family.

Take a break from the news. Even in normal times, the sheer volume of news can feel overwhelming. These days, it’s even worse. So, be sure to carve out chunks of the day when you take a rest and shut off the news and pandemic-related social media feeds. Pick up a book. Stream a TV show. Play a board game. The news will still be there when you get back to it.

Keep up healthy food choices. When our regular routines are upended, our food choices can be, too — and often not for the better. A healthy diet can be a good way to maintain some normalcy, help keep the immune system working well and keep calories in check during these times when we’re less active and may feel urges to eat because of stress or boredom. When stocking up at the grocery store, focus on nourishing and filling foods, such as whole-grain breads and cereals, brown rice, fruits and vegetables (frozen, canned or fresh) and beans. And if you buy sweets and less-healthy foods, store them out of sight so they’re less tempting. With the economy hard hit, food insecurity can also be an issue for many. For food assistance, or to donate, contact food banks in your area, or visit feedingamerica.org.

Keep moving. Although gyms are closed and exercise classes canceled, it’s still important to stay physically active. It can take a little extra creativity and more planning than before, but the payoff in energy, mood and overall well-being make it well worth it. YouTube is a great source for free yoga, dance and cardio videos. Exercise apps are another option. And, for most people, getting outside for a walk or bike ride is still allowed (while keeping a safe distance from others). Don’t worry about hitting specific goals, just try to fit something in on most days. You’ll be happy you did.

Stand more. This can sound a bit odd. But, on top of staying active, try to make an effort to stand more than you normally would when you’re at home. In our normal days before COVID-19, it’d be rare to sit for most of the day. Going to class, walking to meetings, doing errands or spending time with the kids, we were on our feet a good amount. Now, while most of us are spending much more time at home, we’re probably also spending much more time sitting. Long term, sitting too much is bad for health, and short term, it can sap some of our energy and just make the long days at home feel even longer. So, try to work some standing breaks into your schedule. Set a timer that chimes every half hour to remind you to get up for a short leg stretch. Or try standing when watching TV shows, working on your computer or playing with your pet.

Stay connected —virtually. While we may no longer be able to meet up with friends and colleagues in the real world, we can still stay connected through technology. Host a trivia game over group video chat, share recipes via text message or email, or just pick up the phone and have a long talk with your best friend. The options are wide open for making connections.

Check in with your health-care provider if you have an existing medical condition such as  heart disease, diabetes or cancer. See if there are any changes you should make during this time, such as rescheduling appointments, extending prescriptions or connecting remotely by telehealth rather than in person. Because COVID-19 can be more serious in some people with pre-existing diseases, it’s also especially important to follow recommendations for keeping safe, such as staying at home, avoiding groups and close contact with others, keeping surfaces clean and washing hands frequently.

Look after your mental wellness. This can be a time of stress, anxiety and loneliness for many people. So, as you’re looking after your physical health, it’s extremely important to also look after your mental and emotional health. Try to keep up with those things that can help with mood: physical activity, mindfulness and meditation, and connecting with friends using technology. Many people also need professional help. So, don’t be shy about calling a health-care provider or visiting the National Alliance on Mental Illness (nami.org) for resources. If you ever feel you’re in crisis, call 911 and the National Suicide Prevention Lifeline (1-800-273-8255) immediately.

We’ll get through this together, even as we’re safely distancing ourselves for now.

It’s our health. Let’s take control.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

For something that so many people love, coffee has a bit of a bad reputation when it comes to health. Even among coffee drinkers themselves, surveys have found that a large majority believe their regular habit is, to some degree, unhealthy.

And that perception is puzzling because good evidence actually shows the exact opposite. Studies have linked coffee drinking with a lower risk of heart disease, diabetes, Parkinson’s disease and a number of cancers, including breast, colon, liver and endometrial cancer. Some studies even suggest it could lower the risk of dying prematurely.

“We can’t say for sure that coffee is a direct cause,” said Dr. Ed Giovannucci, a professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health. “But, overall, it seems linked with good health outcomes.”

While it’s not perfectly clear what about coffee would provide such benefits, there are many solid possibilities. Coffee has more than 1,000 bioactive compounds that could help lower disease risk. These include anti-inflammatories, which reduce inflammation in tissue; anti-oxidants, which slow damage to cells; and others that help with DNA repair and the regulation of sugar in the bloodstream. Together, these different compounds could account for the broad range of benefits that have been linked to coffee. There’s good news for drinkers of decaf, too – it likely has many of the same benefits as caffeinated coffee.

To date, there seem to be very few dangers linked with coffee drinking. Pregnant women, though, may be one exception. “Some studies show a slightly increased risk of outcomes like low birth weight, pregnancy loss and childhood leukemia,” Giovannucci said. “So, some caution by pregnant women is warranted.”

How much coffee is OK to drink, then? The federal Dietary Guidelines for Americans say that three to five 8-ounce cups (or up to 400 milligrams of caffeine) a day can be part of a healthy diet. For pregnant women, the World Health Organization recommends staying under 300 milligrams of caffeine a day. An 8-ounce cup of brewed coffee can have around 95 to 180 milligrams of caffeine, depending on the type of coffee and how it’s made.

“Most health benefits probably come with two to three cups a day,” added Giovannucci. That happens to be about the average amount that U.S. coffee drinkers consume.

At the same time, it’s important to be mindful of the type of coffee you’re drinking. Specialty coffee drinks are increasingly popular, and some can be high in sugar, unhealthy fats and calories. If you don’t want to offset your coffee’s potential health benefits, unsweetened black coffee is the best choice.

As we move further into winter, warming up with a cup of coffee can really hit the spot. “And most people can enjoy it guilt-free,“ Giovannucci said.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

It’s that time of year when social media feeds and news sites are filled with stories about New Year’s resolutions. And that’s fantastic. It’s great to look ahead and set personal health goals for the coming year – whether it’s getting more sleep, snacking less or taking the dog for more walks.

At the same time, let’s not move past last year just yet. There can be real value in heading into 2020 by taking a look back on the positive things we accomplished for our health in 2019.

The journey to better health is made up of many steps – often, small steps – that we string together over time.

Taking stock of what we’re proud of from the past can lay a positive foundation for the future.

So, get out your smartphone, or good old pen and paper, and jot down the healthy behaviors you worked on in 2019. They can be big or small or in between. Think about things like diet and physical activity, and also sleep and mental health or anything else you did to improve your well-being. And don’t forget things you may have done for the whole family.

Write down as many items as you can think of – even if you just did them a couple of times. Don’t focus on goals you may have missed – for example, “Tried but didn’t lose 20 pounds.” Instead, focus on the things you did – maybe, “Kept weight steady.”

Here are some questions that may help spark your memory:

• Did you try some new healthy vegetarian meals?
• Did you get out regularly for walks?
• Did you cut back on alcohol?
• Did you get enough sleep most nights?
• Did you pack healthy snacks in your kids’ lunches?
• Did you take your kids to the playground more often?
  
  

After just a few minutes of thinking and writing, you’re likely to have a fairly long list. When you can’t think of anything else to add, review it line by line, mentally checking off each as you go.

More than likely, this list should make you feel pretty good about what you’ve worked on and accomplished over the past year. Sure, you may not have been successful with as many of the behaviors as you would have liked. That’s natural. We’re only human.

But, it’s important for both our physical and mental well-being to take a step back, be kind to ourselves and reflect positively on those things we’ve accomplished. It took time and effort to tackle them. And those successes – even if modest – can support and stoke future positive behaviors. Small steps, over time, turn into big accomplishments.

So, early in 2020, take some time to celebrate what you did for your health in 2019 – and keep up the good work. There’s a great year ahead.

It’s your heath. Take control.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

For all its holidays and celebrations, winter can be a tough time for many people. The long nights and cold, gray days can knock us off our regular routines and just leave us feeling a bit down. And that’s to be expected from time to time. For some people, though, the changes in mood they experience in winter can be more severe and lasting, pointing to a serious condition called seasonal affective disorder.

Seasonal affective disorder, or SAD, is an illness that is tied to other mood disorders, such a depression and bipolar disorder, and it can significantly impair daily living. As the name implies, it has a clear pattern of coming on and then going away during specific seasons. “The most common form of seasonal affective disorder is major depressive disorder with a major depressive episode in winter,” said Dr. Emily Mukherji, adult psychiatry clinic director at Washington University School of Medicine in St. Louis.

About 1-3 percent of people in the U.S. will at some point experience an episode of seasonal affective disorder. Typical symptoms for the condition most often mimic those for depression, including decreased mood, lack of interest or pleasure in activities, difficulty concentrating or thoughts of suicide. Some symptoms, though, can be more specific to seasonal affective disorder, such as lower energy levels, an increased appetite with carbohydrate cravings and an increased need for sleep.

“It’s almost like a form of hibernation in the winter months,“ Mukherji said.

The good news, though, is that seasonal affective disorder can be treated. So, it’s important to talk to a health-care provider if you’re concerned about how you’re feeling. The worse you feel and the worse your symptoms, the more imperative it is to get help. “Anyone at imminent risk of hurting themselves or others should call 911 and go to an emergency room right away,“ said Mukherji.

Treatment for seasonal affective disorder most often involves a combination of antidepressant medication and light therapy, which is the use of a special lamp that simulates exposure to sunlight. Someone with only mild symptoms may use light therapy on its own, without medication.

Light therapy lamps are available online and at specialty stores and can cost around $30 and up. Some provide continuous bright light that you can sit in front of while reading, eating breakfast or watching your favorite show. Others act more like a natural alarm clock, simulating the light of the rising sun over a 90-minute period or so.

“Most people will use light therapy from mid-October through March and will bring their lamps out every year around the same time to try to prevent a winter depressive episode,” Mukherji said.

When buying a lamp, look for a bright-light lamp that provides around 10,000 lux of brightness or a dawn simulator that provides around 250 lux. Light therapy can have some side effects, like eye strain, insomnia and irritability, so it’s important to follow the recommendations of a health-care provider. In general, bright-light sessions should be kept to mornings and under 90 to 120 minutes a day.

Other steps that can help with seasonal affective disorder include counseling in cognitive behavioral therapy and following certain healthy behaviors, like exercising regularly, getting outside during the day, eating a healthy diet and limiting alcohol.

Whatever season it is, it’s important to look after your physical and mental health. Winter, though, can bring unique health issues. And although it may seem in line with the harshness of the weather, you shouldn’t feel the need to hunker down and endure through an episode of seasonal affective disorder on your own. You can feel better.

“SAD can be significantly impairing but it is a very treatable illness,” Mukherji said. “So please seek out help.”

It’s your health. Take control.

---

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.