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For Your Health: Making our way through this coronavirus marathon

For Your Health Graphic 2020



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.

Colditz

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.

For Your Health: The bottom line on preventing colon cancer

For Your Health Graphic 2020



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.

Dr. Graham Colditz

“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.

For Your Health: Watch your well-being during coronavirus distancing

For Your Health Graphic 2020



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.

Dr. Graham Colditz

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.

Fight against endometrial cancer boosted with new molecular road map

A new study that reveals the dozens of molecular changes that bring about endometrial cancer offers insight into how physicians might be able to better identify which patients will need aggressive treatment and why a common treatment is not effective for some patients.

The study appears Feb. 13 in the journal Cell.

Funded by the National Cancer Institute, the study also suggests a potential role for already approved drugs that target proteins newly implicated in this disease also commonly known as uterine cancer.

“This study reveals a new dimension of endometrial cancer and moves us closer to identifying new therapeutic targets,” said co-senior author Li Ding, PhD, a professor of medicine at Washington University School of Medicine in St. Louis and a research member of Siteman Cancer Center. “Cancer mutations affect proteins, which are the functional units inside cells. We now have the capacity to understand in detail what the genetic mutations are doing inside the cancer cells, and that can serve as a basis for new treatment strategies.”

The paper builds on work by The Cancer Genome Atlas (TCGA) which identified the genetic underpinnings of the disease in 2013.

“This is like the Google Earth of endometrial cancer,” said Karin Rodland, PhD, of the Department of Energy’s Pacific Northwest National Laboratory (PNNL). “It’s a very comprehensive portrait of this particular cancer type. We tried to measure everything we possibly could. Then we searched for patterns.”

Ding and Rodland are two of five corresponding authors of the paper; David Fenyo, PhD, of New York University School of Medicine is the senior corresponding author. Other corresponding authors are with the Baylor College of Medicine and PNNL. Overall, scientists from more than a dozen institutions contributed to the project.

The team studied 95 uterine tumors and 49 normal uterine tissue samples. Scientists measured the abundance, modifications and locations of many vital molecular players, including genes, proteins, messenger RNAs, circular RNAs, micro RNAs, and evidence of what scientists call “post-translational modifications.” The latter are key to determining when and where proteins, the molecular workhorses of cells, are turned on or off.

The scientists developed a promising new way to identify tumors that are classified incorrectly as not aggressive but that turn out to be just as invasive as a type of tumor that grows quickly and is more likely than other tumors to kill patients.

Currently, the aggressiveness of an endometrial tumor is assessed largely by viewing its cells under a microscope. The team explored a new method that shows how the activity levels of certain proteins clearly differentiate aggressive from less-aggressive tumors.

One analysis, led by co-first author Daniel Cui Zhou, a doctoral student at Washington University, showed how the protein beta-catenin, a well-known actor in many types of cancer, interacts with an important signaling pathway to evade detection and spur cells to grow out of control.

“This is the first delineation of the entire beta-catenin complex in a specific disease,” said Ding, also a research member of The McDonnell Genome Institute at Washington University. “We know it plays roles in endometrial cancer and colorectal cancer, so this is a major step forward in understanding the details of this important cancer driver.”

The team also found that a process that involves packing and unpacking genes happens more often than expected in tumor cells. With more than six feet of DNA squeezed into nearly every human cell, the body must pack it efficiently, but it also needs to unspool the DNA so that other molecular machinery can access it. Analysis led by co-author Alla Karpova, a doctoral student in Ding’s lab, found that a key part of the unspooling process, known as histone acetylation, is very active in endometrial cancer.

“Histone acetylation tends to activate genes, which can drive cancer growth,” Ding said. “In theory, we could use information about histone acetylation to predict how aggressive a tumor is likely to be.”

The team also discovered that small, often overlooked molecules known as circular RNAs seem to be involved in the transformation that cells undergo when they gain the ability to spread. The process is called the endothelial-to-mesenchymal transition and is what makes endometrial cancer deadly.

In addition, the team created a new way to determine which patients are most likely to benefit from a treatment known as checkpoint therapy, in which drugs such as pembrolizumab and nivolumab are used to dodge the barriers that some cancer cells use to evade the immune system. It’s one of many ways scientists are exploring immunotherapy to spur the body’s natural defenses to fight cancer.

Currently in endometrial cancer, physicians use a measurement known as “tumor mutation burden” to determine which patients are most likely to benefit from checkpoint therapy. Based on the measurements of immune activity in this study, the scientists have proposed a new measure focused on how well a patient’s body flags cancer cells and presents them to the body’s immune system for destruction — a key function for checkpoint inhibitors to be effective.

Better insight into exactly who would benefit from the drugs would allow physicians to avoid their use in patients who are unlikely to benefit, sparing them unnecessary side effects.

“Now that we have this insight into proteins, we can start thinking about better therapeutic options at the molecular level for patients who have endometrial cancer,” Ding said. “Drugs target proteins, so this was not possible before we acquired this understanding of tumor proteins. We are much closer to effective personalized treatment with this new study.”

For Your Health – The buzz on coffee and health

For Your Health Graphic 2020



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.

Dr. Graham Colditz

“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.

Siteman Cancer Center director, benefactor named 2019 citizens of the year

Timothy Eberlein, Md

Two people who shared the vision to build what is now Siteman Cancer Center have been recognized as citizens of the year.

Timothy J. Eberlein, MD, Siteman’s director, and Alvin J. Siteman, the benefactor for whom the center is named, were recognized by the St. Louis Post-Dispatch after being selected by a committee of past recipients. The honor, typically given to one person, highlights the partnership the pair have developed since the cancer center’s naming in 1999.

“It has been a shared mission, a labor of love for our patients and our region,” said Eberlein, who also is the Spencer T. and Ann W. Olin Distinguished Professor and Bixby Professor and chairman of the Department of Surgery at the School of Medicine. “This honor is a recognition of the tremendous work and dedication of the many people – our Washington University physicians and researchers, nurses, staff and others – who have helped make Siteman the top-tier cancer center it is today.”

In 1999, Alvin J. and Ruth Siteman committed $35 million to the development of Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. The commitment was the largest gift ever received by Barnes-Jewish and Washington University in support of cancer research, patient care and services, education and community outreach, and it built upon decades of research and therapeutic advances on the Washington University Medical Campus.

Since then, Siteman Cancer Center has grown to include five satellite locations, including two that recently moved into new facilities, on the campuses of Memorial Hospital East in Shiloh, Ill., and Northwest HealthCare, part of Christian Hospital, in Florissant, Mo. The other satellites are at Barnes-Jewish St. Peters Hospital in St. Charles County, Mo.; Barnes-Jewish West County Hospital in Creve Coeur, Mo.; and the Center for Advanced Medicine-South County in south St. Louis County, Mo. An inpatient tower opened on the Washington University Medical Campus in 2018.

In 2015, the National Cancer Institute (NCI) awarded Siteman an “exceptional” rating, based on a rigorous review of the cancer center’s research programs. The rating is the highest possible by the NCI, the principal federal institute that funds cancer research.

Siteman’s reach has extended beyond the St. Louis region, as well. In 2017, the cancer center launched the Siteman Cancer Network, an affiliation with regional medical centers that is aimed at improving the health of individuals and communities through cancer research, treatment and prevention. Network affiliates are: Boone Hospital Center in Columbia, Mo.; Phelps Health and its Delbert Day Cancer Institute in Rolla, Mo.; and Alton Memorial Hospital in Alton, Ill.

“Tim has worked so hard to execute what Al has provided support for,” David H. Perlmutter, MD, executive vice chancellor for medical affairs and the George and Carol Bauer Dean of Washington University School of Medicine in St. Louis, told the Post-Dispatch. “It’s the combination of philanthropy and generosity and execution of a plan, and it’s a great story for St. Louis.”

For Your Health: Celebrate your 2019 accomplishments


For Your Health Graphic 2020



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.

Dr. Graham Colditz

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 Your Health: Getting help for seasonal affective disorder

For Your Health Graphic 2020








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.

Colditz

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.

For Your Health: Please pass the turkey, stuffing and family health history

For Your Health Graphic 2020








It’s that time of year. We’re moving quickly toward late autumn, with its falling leaves and longer nights. And that means one thing: Thanksgiving is right around the corner.

It’s a holiday that brings family and friends together around a festive meal. Sure, it may not always go off without a hitch. Families aren’t perfect, after all, and your uncle Charlie is always trying to stir things up. But, even so, it can be a rare time to sit down with those close to us and just catch up.

Dr. Graham Colditz

And that also makes it a great opportunity to do something really important for your family’s health: collect a health history.

“Knowing family health history can help people understand their risk for cancer and other diseases,“ said Dr. Kimberly Kaphingst, director of cancer communication research at the University of Utah’s Huntsman Cancer Institute. “And this can help their doctors personalize cancer screening recommendations and other recommendations to reduce disease risk.”

Yet, studies show that only about one in three people actually spend any time connecting with their family about their health history. Thanksgiving or other family gatherings throughout the year are ready-made to fix this by breaking out our smartphones or notepads and gathering what’s known about diseases that may run in the family.

Doing a bit of homework beforehand can help you get the most from the family’s time together. Jotting down the health history you already know and then bringing this to Thanksgiving can help spark people’s memories and entice them to share.

“There are a number of helpful online guides on collecting family health information,” noted Kaphingst. “The U.S. Surgeon General’s My Family Health Portrait takes you step-by-step through the types of information to collect. Common diseases, such as cancers, cardiovascular disease and diabetes, are a good place to start.”

It’s likely not everyone will want to take part in the process, and that’s OK. Health is a very personal issue that can bring with it varied concerns and emotions. Whatever information people are willing to share, though, helps build a more complete story. And the more details you piece together and share with your family, the more likely other family members are to share what they know at some point.

Once you’ve recorded a health history – even if it has some holes – the most important thing is to then share it with your health-care provider, and encourage family members to do so with theirs, Kaphingst said. If a disease runs in the family, especially if it’s diagnosed at earlier ages, individual family members may be at greater risk. The good news is there could be steps you can take to help protect yourself. This can include earlier and extra screening tests for some cancers and heart disease risk factors, like blood cholesterol, diabetes and hypertension; medications to help lower the risk for certain diseases, like heart disease and breast cancer; and regular check-ups to help keep track of any important changes to your health.

While most people won’t have a health history that puts them at a greatly increased risk of a disease, it’s important to highlight any potential red flags. The process can take some effort but is a gift you can give to your loved ones. That’s something the whole family can be thankful for.

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.

For Your Health: Simple steps to lower breast cancer risk

For Your Health Graphic 2020








For a disease as scary as breast cancer, one positive and very important message that deserves to be heard more often during Breast Cancer Awareness Month is that it’s a disease that can be prevented.

Research shows that about half of all breast cancer cases could be avoided with healthy steps most women can take. That translates to around 130,000 fewer cases each year in the U.S.

And it’s almost never too early, or too late, to take steps that can lower risk. The teen and young adult years are ideal, since it’s an important period in growth and development that can have a pronounced impact on cancer risk later in life. Still, healthy habits picked up in midlife and beyond can have significant benefit, too.

Get started with these behaviors, which are also great for the overall health of the entire family.

Colditz

Add movement to your days and keep it fun –dance, garden, play or walk.

One of the many benefits of regular physical activity is a lower risk of breast cancer. If you’re new to activity – or haven’t done it regularly in a while – take the pressure off and just choose something fun that gets you moving more than you normally would. After a while, you can do more if you want, building up to around 30 minutes of moderate activity a day. For families: Be active together. Walk to the grocery store, play ball in the park or tend a plot in a community garden.

Skip the alcohol.

We now know there’s really no risk-free amount of drinking when it comes to cancer, especially breast cancer. The best choice for your health and otherwise is simply not to drink. Choose healthy, alcohol-free drinks instead, bringing your own to gatherings if you need to. For families: Talk with your children about the risks of alcohol and binge drinking, and don’t center family meals and parties around alcohol.



Eat more plants.

Healthy, plant-based eating has many benefits, including lowering one’s risk of breast cancer. Being plant-based doesn’t mean you need to drop meat altogether. But it does mean adding more whole grains, beans, fruits and vegetables to your meals and snacks – and cutting back on meat, especially red and processed meat. For families: Ease into plant-based eating by looking up vegetarian recipes as a family and going meatless one day a week.

Keep weight steady.

We hear so much about weight these days that it’s easy to become numb to its importance to our health. But overweight and weight gain in adulthood increases the risk of at least 13 different cancers. Keeping your weight steady – just not gaining weight – is a great goal that can have big health benefits, even if you’re overweight. For families: Keep high-calorie, low-quality snacks out of the house. Replace things like sugary soda, chips and cookies with fruits and vegetables, air-popped popcorn and fizzy water.

Stay smoke-free or get smoke-free.

We can now add breast cancer to the list of many diseases caused by smoking. So, if you smoke, quitting is the most important thing you can do to improve your health. Visit smokefree.gov or call 1-800-QUIT-NOW (1-800-784-8669) for help. For families: Talk with your kids from an early age about the dangers of smoking – and vaping. And be a good smoke-free role model.

Behaviors like these can’t erase a woman’s chances of getting breast cancer. A lot of different factors come together to cause the disease, many of which are out of a woman’s control. But healthy choices can help lower risk, and that applies to pretty much all women – younger, older, those with a family history of cancer and those without.

And that is a really positive, empowering message.

It’s your health. Take control.

For more ways to lower your risk of breast and other cancers, visit 8ightways.org.

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.