Article Category: Patient Resource

March is National Nutrition Month, prompting me to wonder how often this column focuses on the links between what we eat and our health and well-being.

The short answer is: a lot. Over the years, it’s been fairly rare that we don’t address eating in one way or another.

What we eat may play a small role in one condition or a bigger role in another, but the overall message has been that choosing healthier foods and drinks is one of the best things we can do for our health.

This not only can help us live longer, it also can help lower the risk of heart disease, stroke, high blood pressure, dementia and cancer — among other serious conditions. Healthy eating can also help us keep weight gain in control, which brings many additional benefits.

Admittedly, though, in a time of nonstop news and social media influencers, it can be hard to know what “healthy eating” exactly means.

The good news is, when we take a step back, the basics of a healthy diet are pretty simple — and they haven’t changed much over the past few decades.

Overall, the main focus is on eating more healthy foods from plants while cutting back on foods high in sugar and unhealthy protein. Try to:

Choose more fruits and vegetables — Make fruits or vegetables a part of every meal. While fresh options are great, frozen and many canned versions are good choices too, as long as they’re low-sodium and unsweetened.

Choose more whole grains — A lot of nutrients, and health benefits, get stripped from whole grains when they’re processed for foods like white rice and white bread. Try to choose 100% whole-wheat bread, whole-grain pasta, oatmeal and other foods labeled “whole-grain” or “100% whole grain.”

Choose more healthy drinks — Opt for healthy options to stay hydrated, including unsweetened tea and coffee, fizzy water or plain water flavored with a splash of lime juice. Sugary soda and similar drinks are linked to weight gain and obesity. And many specialty coffee drinks can have a lot of calories and added sugar.

Choose more healthy fats and oils — Instead of cooking with butter, lard or other oils high in saturated fats, try to choose options like canola and olive oils, which are higher in healthy unsaturated fats.

Limit fast food and other processed foods — Although convenient, fast food and processed foods are typically high in calories, salt and unhealthy fats. We don’t need to avoid them totally but cutting back is the healthiest choice.

Limit red and processed meats — Choosing healthier protein options like chicken, fish, beans and nuts, is healthier than picking red and processed meats.

Limit alcohol – zero is best — Alcohol has a lot of risks, including increasing the chances of developing several cancers. So, not drinking alcohol is the healthiest choice overall. Alcohol-free versions of beer and other drinks can be good alternatives to try – and something I’ve been enjoying lately.

It’s pretty remarkable that one of the more powerful tools we have for improving our health and lowering the risk of many diseases is something we do every day.

It’s not always easy to put healthy eating into practice, but we don’t need to tackle it all at once. Small changes to one or two areas can make a difference, and we can build from there.

It’s not a race; it’s a step-by-step journey — fueled with healthy food.

We’ve made it past Groundhog Day — again — but whether Punxsutawney Phil sees his shadow or not, winter can often feel unending this time of year.

Across the country, we’ve had long stretches of cold temperatures and bad weather. And even when things start to defrost, the days can feel too short and the nights too long. This combination can make it harder to keep up with regular routines, including being physically active.

But there are many good reasons to work on staying active through winter. On top of the health and wellness benefits, maintaining our routines can also prepare us to enjoy springtime activities when the days finally turn nicer. We’ll have energy and fitness for long walks around the neighborhood, family bike rides to check out daffodils at the local park or pick-up ball games with our kids or grandkids.

Almost any type of movement can have benefits. But given the ongoing winter weather, indoor activities and exercises can often be the simplest — and safest.

Indoor sessions can feel a bit bland compared to getting outside, especially when you’re inside week after week this time of year. That makes it important to find activities you really enjoy. If one activity doesn’t click, try another. Be creative and keep experimenting. There are many options that count as physical activity, and you’re likely to find some — and maybe many — you really like.

Local recreation centers can have stretching and cardio classes, open gym hours and exercise equipment, like treadmills, bikes and ellipticals. Malls or big box stores can offer special hours for walking groups. And streaming sites can have a huge variety of online exercise videos that can be followed at home.

If none of these sounds good, just taking regular standing breaks throughout the day can have benefits.

One good way to stay consistent with our activity through winter is to set an accessible and specific goal to slowly work toward. Maybe that’s building from one gym class per week up to three a week by the end of March. Or building from 20 minutes of walking on the treadmill three days a week to walking 40 minutes three days a week. Or moving from doing little or no planned activity to streaming two stretching and core classes per week. And, of course, if you ever have any questions about fitness or health, contact a health professional.

It can also really help to have the support of friends and family. This can mean going to the gym or streaming a class together or simply sharing our goals and the progress we’re making. The activities themselves can be more fun when we’re with others, and it can help keep us on track since we know others are also following our progress.

And the more regular we can be with our activities, the easier it can often be to fit into our schedules. When our treadmill time or basketball games become a normal part of our weeks, we’re less likely to skip them when work and family life get busy.

While winter may feel like it’s on a loop right now, before long the days will get noticeably longer and the temperatures will warm. And the activity we’ve put in through the coldest months will help us really enjoy some great springtime outings.

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 and the creator of the free prevention tool YourDiseaseRisk.com.

Ultra-processed foods. It’s not a term many of us heard 10, or even five, years ago. But that’s starting to change. We now see it in news stories and posts on social media. And there’s good reason for that.

Even as more ultra-processed foods fill grocery store shelves, we’re also learning more about their possible health risks.

So, what are these foods exactly? While a precise definition can vary a bit depending on who’s talking about them, there are a few simple ways to identify many ultra-processed foods.

“Put simply, if you don’t see a food’s main ingredients in their natural forms — like grain, vegetables and meat, it is highly likely to be an ultra-processed food,” said Yikyung Park, professor in the Division of Public Health Sciences at Washington University School of Medicine in St. Louis. “Ultra-processed foods are highly manipulated and contain many added ingredients and additives. In most cases, we cannot make ultra-processed foods at home.”

Examples include: soda (sugary and diet), lunch meat, instant noodles, instant soup, sausage, hot dogs, frozen meals (including pizza and burritos), many store-bought cakes and sweets, and even most breakfast cereals.

Eating higher amounts of ultra-processed foods is associated with a higher risk of several serious conditions, including obesity, diabetes, heart disease, stroke, poor sleep, poor mental health — including anxiety and depression — and premature death, Park continued.

How ultra-processed foods increase these risks likely relates to their collection of ingredients. They tend to be high in those ingredients we should limit in a healthy diet and low in those we should focus on.

They can be high in calories, salt, unhealthy fats and added sugar and sweeteners, which can cause long-term inflammation in the body, disrupt the normal function of our metabolism and impact the development and release of neurotransmitters that play roles in mood disorders, such as depression, Park said.

Ultra-processed foods also tend to be very low in fiber, another potential negative. Higher fiber diets help promote a healthy microbiome, which is the collection of bacteria and other microorganisms in our gut that helps keep many processes in the body working normally, Park said. Eating lower-fiber, ultra-processed foods can have the opposite effect.

Switching from pre-packaged or fast foods to less-processed choices is one easy way to cut back on ultra-processed foods. Instead of frozen French fries or chips, choose a bag of nuts or buy raw popcorn and pop it in a pan at home. Instead of a frozen bean burrito, buy some tortillas, beans and cheese and make your own. In place of breakfast cereals, which can have refined, processed grains and many other ingredients, choose oatmeal, which is a simple whole grain.

These switches may take some extra effort at first, but it gets easier the more we do it, and often we can find that the less-processed options taste just as good — maybe even better — than the more processed foods.

Start with a small goal of cutting back on a couple of ultra-processed foods. Then, build from there. Small changes have real health benefits and can also lead to bigger changes and improvements down the road.

Whether we’re new to cutting back on ultra-processed foods or have been doing it for a while, Park shared one quick way to identify the types of foods we should try to steer clear of to improve our overall health. And all it takes is a glance at the food label.

“If the ingredient list is very long and you don’t recognize those ingredients, it’s better not to eat that food,” Park concluded.

We’re entering one of those special times of the year — the winter holidays.

It’s a concentrated few weeks that give many of us the chance to spend extra time with friends, family and colleagues, celebrating the past year while looking toward the possibilities of the next.

And though the season’s colder weather and shorter days may make us feel like hibernating, we often find ourselves surprisingly busy. Kids are out of school. Work may have end-of-year deadlines, and there are preparations for holiday gatherings and family visits.

It’s a season to look forward to — and one that can also make it harder to look after our own health and well-being. But taking time for ourselves is still an important goal, no matter how busy we are. It’s not only good for our long-term health, it can also give us the physical and mental energy to enjoy all the holidays have to offer.

Try these four tips to help your holiday health:

1.) Focus on sleep.

It’s easy to cut back on healthy sleep when we feel a time crunch, but we really shouldn’t. Sleep is important for both our daily and long-term health, so we should do what we can to get the seven or more hours a night that most adults need. Of course, getting a healthy amount of sleep can be difficult no matter the time of year. So, don’t stress about it, but do what you can to find sleep success. Try to give yourself the time to sleep; don’t overschedule your nights or early mornings, which can easily happen during the holidays. Putting away electronics and avoiding large meals near bedtime can also help, as can keeping to a regular sleep and wake-up time.

2.) Get out for a walk — or other activity.

Along with sleep, this is another one that’s easy to skip when our days get busy. But making time to go for a walk or take a gym class has amazing benefits — providing a boost to energy and mood, and even helping with better sleep. It’s not always easy to get started, especially in winter, but those first few minutes of an activity are often the hardest; once past those, the rest usually comes easier. And, if you’re heading outside, be sure to be prepared for the weather, and go with a friend.

3.) Remember to choose healthy foods — mostly.

The holidays are a time to celebrate, and that can mean enjoying food without worrying about how healthy it is. It’s good, though, to not totally do away with our healthy eating habits this season. Still try to take an overall healthy approach to eating that focuses on fruits, vegetables and whole grains, and is low in red and processed meat. At special meals and other gatherings, choose what you enjoy but try to balance less-healthy, higher-calorie foods with healthier choices.

4.) Relieve stress in healthy ways.

As great as the holidays can be, they can also, as we know, be stressful. And that makes it important to have healthy ways to deal with moments of stress. Walking and similar activities are really good for this. So, too, are stretching, yoga and breathing exercises. Taking some time alone can be helpful, finding a quiet place to read or stream that movie you’ve been wanting to see. Spending time with friends can also provide support. While alcohol may be part of many holiday celebrations, choose healthier options for dealing with the stress of the season. And if you or anyone you know is in a mental health crisis, call 988 — the Suicide and Crisis Lifeline.

These can feel like simple things, and in many ways they are. But during such a busy season, it can be good to focus on some of the basics. And the benefits of keeping up with even small, healthy steps are real — in our daily lives and the years ahead.

That’s a great gift. Happy Holidays and Happy New Year.

Our progress against lung cancer is something to celebrate. Millions of lives have been saved in the U.S. alone since rates of smoking began to drop in the mid-1960s. And as smoking continues to become less common and treatment improves, we expect to gain even more ground against the disease.

One key tool helping to make that happen is yearly lung cancer screening with low-dose computed tomography, or low-dose CT.

A low-dose CT scan is a quick and simple screening test recommended for people ages 50-80 who are at increased risk of lung cancer because they smoke or have smoked within the past 15 years. People are eligible if they’ve smoked what amounts to one pack a day for 20 years, or half a pack a day for 40 years.

Like other recommended cancer screening tests, low-dose CT helps find cancer earlier when it’s more treatable. Studies have found that yearly screening can lower the risk of dying of lung cancer by up to 20%. That’s a large benefit — similar to what we see with mammograms and breast cancer.

It’s also a major advance. Becoming widely available for lung cancer screening about 10 years ago, low-dose CT is the only screening method that’s been found to lower the risk of dying of lung cancer. While other types of tests, like standard chest X-rays, can be good at helping find many types of health problems, they are not effective for lung cancer screening.

Even with its benefits, low-dose CT does have some potential risks that are important to know about. Potential harms can include experiencing short-term stress and anxiety about unclear scan results. There can also be the need for follow-up tests of suspicious findings that turn out not to be cancer. And there can be low amounts of radiation exposure from a scan. This amount is more than a standard X-ray but less than the level of radiation people are exposed to during a normal year.

Overall, the benefits of lung cancer screening are thought to outweigh the harms, though it is a personal balance. This makes it important for people thinking about screening to discuss the benefits and drawbacks with a doctor — and together decide if it’s right for them. If it is, the doctor can then make a referral for a screening appointment.

Most health insurance plans cover low-dose CT screening, but it’s good to check with your plan, medical center or doctor’s office. Those without insurance can contact their local or state health department about possible options to help with the cost of testing.

Once you get screened, it’s also important to keep getting tested each year for as long as you’re eligible. This increases the chances of catching a cancer early – again, when it’s more treatable.

And getting smoke-free or staying smoking-free is another key step to look after lung health. Quitting smoking lowers not only the risk of lung cancer but also many other diseases, including stroke, diabetes, heart disease, bronchitis, emphysema, macular degeneration and many other cancers. The benefits begin soon after stopping and build over time. For tips and resources on quitting, call 1-800-QUIT-NOW (1-800-784-8669), or visit smokefree.gov.

Even with the progress we’ve made against lung cancer, it remains all too common, killing more people each year than any other cancer. Annual lung cancer screenings help save lives. Plus, it’s quick, easy and painless. That’s a great combination and, if you think you’re eligible, a great reason to call your medical center or doctor’s office to schedule an appointment.

It’s your health. Take control.

Just in time for Breast Cancer Awareness Month, many women will begin to see important new information about their breast health on their mammogram reports.

A new federal rule now requires that women be informed about the density of their breasts following their mammograms. Breast density is a measure of how much breast tissue and connective tissue is in the breast compared to how much fat tissue. Higher-density breasts have higher amounts of breast and connective tissue. Lower-density breasts have more fat tissue.

“Having dense breast tissue is very common, affecting almost half of women getting screening mammograms,” said Dr. Debbie Bennett, chief of breast imaging at Washington University School of Medicine in St. Louis. “And dense breast tissue is not a cause for worry or concern. It can, however, mean your mammogram is harder for the radiologist to read, and it also slightly increases your overall risk for developing breast cancer at some point.”

With the new rule, women will get a message on their mammogram results that says either, “Your breast tissue is dense” or “Your breast tissue is not dense.”

Because denser breasts may make it harder to see abnormal areas on a mammogram, some women may get extra screening tests that can provide other images of the breasts.

“Depending on how dense your breast tissue is and whether you have any other risk factors for developing breast cancer – such as family history of breast cancer – your doctor may recommend that you have additional imaging tests done to screen for breast cancer,” Bennett said. “This could include MRI, ultrasound or contrast-enhanced mammograms.”

Such testing can be covered by insurance, but it can vary from plan to plan. So, it’s important to talk to your insurance company or health-care provider about specific costs.

Mammograms, and any additional screening tests, can help find breast cancer early when it can be more effectively treated. While breast cancer is the second most deadly cancer in women, when found and treated in its earliest stage, it can have a very high rate of survival, with over 99% of women living at least five years after being diagnosed.

No matter their level of breast density, all women should get a mammogram every year, with most starting at age 40. Women at higher risk of breast cancer may need to begin screening earlier, so it’s important to talk to a doctor about your risk factors for breast cancer. There are benefits of doing this at any age, but ideally it should be done by age 30.

Taking healthy steps to help prevent breast cancer is also important, regardless of breast density, Bennett said.

Around half of breast cancer cases could be avoided with healthy behaviors. Most of these may sound familiar, but they can have an important impact on risk – and even small changes can lead to large benefits over time. These healthy behaviors include:

• Keeping weight gain in check
• Eating a diet rich in fruits, vegetables, whole grains and beans
• Not drinking alcohol
• Being physically active
• Staying smoke-free or getting smoke-free
  

Breast cancer touches many of us to some degree, whether it’s personally or through family or loved ones. A positive note, though, is that there are steps to help manage or lower the risk. And Breast Cancer Awareness Month is a great reminder of that and the benefits of working toward better breast health.

It’s your health. Take control.