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alcohol use disorder<\/a>. A new <a href=https://www.health.harvard.edu/"https:////jamanetwork.com//journals//jamasurgery//article-abstract//2799697/">study finds that one type of surgery, gastric bypass, may increase the dangers of drinking much more than other weight-loss strategies.<\/p>\n \"Alcohol-related problems after weight-loss surgery are a known risk. That's one reason we require people to abstain from alcohol for at least six months — and preferably a full year — before any weight-loss surgery,\" says Dr. Chika Anekwe, an obesity medicine specialist at the Harvard-affiliated Massachusetts General Hospital Weight Center. The new findings are interesting and make sense from a biological perspective, given the differences in the surgeries, she adds.<\/p>\n <h2>How does weight loss surgery affect alcohol absorption?<\/h2>\n Weight-loss surgeries dramatically reduce the size of the stomach.<\/p>\n <ul>\n <li>For a sleeve gastrectomy, the most common procedure, the surgeon removes about 80% of the stomach, leaving a banana-shaped tube.<\/li>\n <li>For a gastric bypass, a surgeon converts the upper stomach into an egg-sized pouch. This procedure is called a bypass because most of the stomach, the valve that separates the stomach from the small intestine (the pylorus), and the first part of the small intestine are bypassed.<\/li>\n <\/ul>\n The lining of the stomach contains alcohol dehydrogenase, an enzyme that breaks down alcohol. After weight-loss surgery, people have less of this enzyme available. So drinking wine, beer, or liquor will expose them to a higher dose of unmetabolized alcohol. Some alcohol is absorbed directly from the stomach, but most moves into the small intestine before being absorbed into the bloodstream.<\/p>\n After a sleeve gastrectomy, the pyloric valve continues to slow down the passage of alcohol from the downsized stomach to the small intestine. But with a gastric bypass, the surgeon reroutes the small intestine and attaches it to the small stomach pouch, bypassing the pyloric valve entirely. As a result, drinking alcohol after a gastric bypass can lead to extra-high blood alcohol levels. That makes people feel intoxicated more quickly and may put them at a higher risk of alcohol use disorders, says Dr. Anekwe.<\/p>\n <h2>Findings from the study on weight loss surgery and alcohol<\/h2>\n The study included nearly 7,700 people (mostly men) from 127 Veterans Health Administration centers who were treated for obesity between 2008 and 2021. About half received a sleeve gastrectomy. Nearly a quarter underwent gastric bypass. Another 18% were referred to MOVE!, a program that encourages increased physical activity and healthy eating.<\/p>\n After adjusting for participants' <a href=https://www.health.harvard.edu/"https:////www.nhlbi.nih.gov//health//educational//lose_wt//BMI//bmicalc.htm/">body mass index<\/a> and alcohol use, researchers found that participants who had gastric bypass were 98% more likely to be hospitalized for alcohol-related reasons than those who had sleeve gastrectomy, and 70% more likely than those who did the MOVE! program. The rate of alcohol-related hospitalizations did not differ between people who had sleeve gastrectomy and those who did the MOVE! program.<\/p>\n <h2>The health harms of alcohol use disorder<\/h2>\n Alcohol use disorder can lead to numerous <a href=https://www.health.harvard.edu/"https:////www.niaaa.nih.gov//alcohols-effects-health//alcohols-effects-body/">health problems<\/a>. Some require hospitalization, including alcoholic gastritis, alcohol-related hepatitis, alcohol-induced <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//a_to_z//acute-pancreatitis-a-to-z/">pancreatitis, and alcoholic cardiomyopathy. As the study authors note, people who had gastric bypass surgery had a higher risk of being hospitalized for an alcohol use disorder, even though they drank the least amount of alcohol compared with the other study participants. This suggests that change in alcohol metabolism resulting from the surgery likely explains the findings.<\/p>\n <h2>Advice on alcohol if you've had weight-loss surgery or are considering it<\/h2>\n \"We recommend that people avoid alcohol completely after any type of weight-loss surgery,\" says Dr. Anekwe. A year after the surgery, an occasional drink is acceptable, she adds, noting that most patients she sees don't have a problem with this restriction.<\/p>\n People who undergo weight-loss surgeries have to be careful about everything they consume to ensure they get adequate amounts of important nutrients. Like sugary drinks, alcohol is devoid of nutrients — yet another reason to steer clear of it.<\/p>\n Gastric bypass has become less popular than sleeve gastrectomy over the past decade, mostly because it's more invasive and slightly riskier. While the new study suggests yet another downside of gastric bypass, Dr. Anekwe says it can still be a viable option for people with severe obesity, as bypass leads to more weight loss and better control of blood sugar than the sleeve procedure.<\/p>\n <\/body>","excerpt":"\n For people with obesity, weight-loss surgery can reverse or greatly improve many serious health issues, but also leaves people more likely to develop an alcohol use disorder. A new study finds that one type of surgery may increase the dangers of drinking much more than other weight-loss strategies.<\/p>\n ","short_excerpt":"\n For people with obesity, weight-loss surgery can reverse or greatly improve many serious health issues, but also leaves people more likely to develop an alcohol use disorder. A new study finds that one type of surgery may increase the dangers of drinking much more than other weight-loss strategies.<\/p>\n ","description":null,"author":null,"slug":"is-alcohol-and-weight-loss-surgery-a-risky-combination-202304242916","sort_date":"2023-04-24T04:00:00.000000Z","contentable_type":"App\\Models\\Marketing\\BlogPost","contentable_id":2916,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL042423","publication_date":"2023-04-24T14:30:00.000000Z","last_review_date":null,"imported_at":"2023-04-25T09:00:03.000000Z","last_import_type":"update","last_modified_date":"2023-04-24T04:00:00.000000Z","active":1,"created_at":"2023-04-21T16:47:22.000000Z","updated_at":"2023-04-25T09:00:03.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":44,"ecommerce_type":"CATALOG","authors":[{"id":14,"cr_id":157,"featured":1,"hhp_staff":0,"hidden":0,"name":"Julie Corliss","title":null,"first_name":"Julie","middle_name":null,"last_name":"Corliss","suffix":null,"slug":"julie-corliss","byline":"Executive Editor, <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//heart/">Harvard Heart Letter<\/em><\/a>","description":"Julie Corliss is the executive editor of the Harvard Heart Letter<\/em>. Before working at Harvard, she was a medical writer and editor at HealthNews<\/em>, a consumer newsletter affiliated with The New England Journal of Medicine<\/em>. She is co-author of Break Through Your Set Point: How to Finally Lose the Weight You Want and Keep it Off<\/em>. Julie earned a BA in biology from Oberlin College and a master’s certificate in science communication from the University of California at Santa Cruz.<\/p>","image_url":"https:\/\/d2icykjy7h7x7e.cloudfront.net\/authors\/yjasvaKFF0xhmqdSxslYrcQbI4yDn08soiRjfMAq.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T09:59:48.000000Z","updated_at":"2022-05-16T18:02:57.000000Z","deleted_at":null,"pivot":{"content_id":18025,"author_id":14,"sort_order":1}}],"contentable":{"id":2916,"comments_open":1,"created_at":"2023-04-21T16:47:22.000000Z","updated_at":"2023-04-21T16:47:22.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":13814,"model_type":"App\\Models\\Marketing\\Content","model_id":18025,"uuid":"c2105dbf-a786-47c9-9164-ae2b7ebeb716","collection_name":"contents","name":"20f66520-2f06-4c36-bd7a-8ea9a3aed517","file_name":"20f66520-2f06-4c36-bd7a-8ea9a3aed517.jpg","mime_type":"image\/jpeg","disk":"s3","conversions_disk":"s3","size":97078,"manipulations":[],"custom_properties":{"alt":"Assorted alcoholic drinks (wine, beer, cocktail, brandy, and shot of liquor) lined up on dark wood bar; blurred alcohol bottles in background"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":13772,"created_at":"2023-04-21T16:47:22.000000Z","updated_at":"2023-04-21T16:47:26.000000Z","full_url":"https:\/\/domf5oio6qrcr.cloudfront.net\/medialibrary\/13814\/20f66520-2f06-4c36-bd7a-8ea9a3aed517.jpg"}],"primary_content_topic":{"id":44,"name":"Staying Healthy","old_names":null,"slug":"staying-healthy","description":"Maintaining good health doesn't happen by accident. It requires work, smart lifestyle choices, and the occasional checkup and test.<\/p>A healthy diet is rich in fiber, whole grains, fresh fruits and vegetables, "good" or unsaturated fats, and omega-3 fatty acids. These dietary components turn down inflammation, which can damage tissue, joints, artery walls, and organs. Going easy on processed foods is another element of healthy eating. Sweets, foods made with highly refined grains, and sugar-sweetened beverages can cause spikes in blood sugar that can lead to early hunger. High blood sugar is linked to the development of diabetes, obesity, heart disease, and even dementia.<\/p>The Mediterranean diet meets all of the criteria for good health, and there is convincing evidence that it is effective at warding off heart attack, stroke, and premature death. The diet is rich in olive oil, fruits, vegetables, nuts and fish; low in red meats or processed meats; and includes a moderate amount of cheese and wine.<\/p>Physical activity is also necessary for good health. It can greatly reduce your risk of heart disease, stroke, type 2 diabetes, breast and colon cancer, depression, and falls. Physical activity improves sleep, endurance, and even sex. Aim for 150 minutes of moderate-intensity exercise every week, such as brisk walking. Strength training, important for balance, bone health, controlling blood sugar, and mobility, is recommended 2-3 times per week.<\/p>Finding ways to reduce stress is another strategy that can help you stay healthy, given the connection between stress and a variety of disorders. There are many ways to bust stress. Try, meditation, mindfulness, yoga, playing on weekends, and taking vacations.<\/p>Finally, establish a good relationship with a primary care physician. If something happens to your health, a physician you know —and who knows you — is in the best position to help. He or she will also recommend tests to check for hidden cancer or other conditions.<\/p>","is_primary":1,"additional_content":null,"created_at":"2021-03-02T16:37:04.000000Z","updated_at":"2023-05-01T14:56:22.000000Z","deleted_at":null,"canonical":"https:\/\/www.health.harvard.edu\/topics\/staying-healthy"}},{"id":18024,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Preventing ovarian cancer: Should women consider removing fallopian tubes?","short_title":"","subheading":"New recommendations highlight potential benefits.","summary":"\n Ovarian cancer, which claims about 13,000 lives each year, is hard to detect in early stages. Recent guidance from professional groups recommends removing fallopian tubes to help prevent ovarian cancer if women are undergoing gynecologic surgery and are finished with childbearing.<\/p>\n ","content":"<body>\n \n <img alt=\"3-D graphic of female reproductive system showing a fallopian tube and ovary and part of the uterus in orange and yellow\" src=https://www.health.harvard.edu/"http:////content.health.harvard.edu//wp-content//uploads//2023//04//87cf1fce-4127-4141-9714-0cf65bbbbafd.jpg/" style=\"height:337px; width:600px\" imageid=\"87cf1fce-4127-4141-9714-0cf65bbbbafd\"\/>\n <\/p>\n Should a woman consider having her fallopian tubes removed to lower her risk for developing ovarian cancer? Recent <a href=https://www.health.harvard.edu/"https:////ocrahope.org//what-if-you-could-prevent-ovarian-cancer///" target=\"_blank\">recommendations<\/a> from the Ovarian Cancer Research Alliance (OCRA), endorsed by the Society for Gynecologic Oncology, encourage this strategy, if women are finished having children and would be undergoing gynecologic surgery anyway for other reasons.<\/p>\n <h2>Why is this new guidance being offered?<\/h2>\n Ovarian cancer <a href=https://www.health.harvard.edu/"https:////www.cancer.org//cancer//ovarian-cancer//about//key-statistics.html/" target=\"_blank\">claims about 13,000 lives each year<\/a>, according to the American Cancer Society. The new guidance builds on established advice for women with high-risk genetic mutations or a strong family history of ovarian cancer.<\/p>\n This idea isn't new for women at average risk for ovarian cancer, either: in 2019, the American College of Obstetricians and Gynecologists (ACOG) floated this strategy in a committee opinion.<\/p>\n A Harvard expert agrees the approach is sound, considering established evidence that many cases of aggressive ovarian cancers arise from cells in the fallopian tubes.<\/p>\n \"We've known for a long time that many hereditary cases of ovarian cancer likely originate in lesions in the fallopian tubes,\" says Dr. Katharine Esselen, a gynecologic oncologist at Beth Israel Deaconess Medical Center. \"Although we group all of these cancers together and call them ovarian cancer, a lot actually start in the fallopian tubes.\"<\/p>\n <h2>Can ovarian cancer be detected early through symptoms or screening?<\/h2>\n No — which helps fuel these recommendations.<\/p>\n Ovarian cancer is notoriously difficult to detect. Symptoms tend to be vague and could be related to many other health problems. Signs include bloating, pelvic pain or discomfort, changes in bowel or bladder habits, feeling full earlier when eating, fatigue, unusual discharge or bleeding, and pain during sex.<\/p>\n Disappointing results from a large 2021 study in the United Kingdom reported in The Lancet<\/em> show that lowering the risks of a late-stage diagnosis isn't easy. The <a href=https://www.health.harvard.edu/"https:////www.thelancet.com//journals//lancet//article//PIIS0140-6736(21)00731-5//fulltext/" target=\"_blank\">trial<\/a> tracked more than 200,000 women for an average of 16 years. It found that screening average-risk women with ultrasound and a CA-125 blood test doesn't reduce deaths from the disease. By itself, the CA-125 blood test isn't considered reliable for screening because it's not accurate or sensitive enough to detect ovarian cancer.<\/p>\n Only 10% to 20% of patients are diagnosed at early stages of ovarian cancer, before a tumor spreads, Dr. Esselen notes. \"There's never been a combination of screenings that has reliably identified the majority of these cancers early, when they're more treatable,\" she says.<\/p>\n <h2>What does it mean to be at higher risk for ovarian cancer?<\/h2>\n Family history is the top risk factor for the disease, which is diagnosed in nearly 20,000 American women annually. A woman is considered at higher risk of ovarian cancer if her mother, sister, grandmother, aunt, or daughter has had the disease.<\/p>\n Additionally, inherited mutations in the BRCA1 or BRCA2 gene raise risk considerably, according to the <a href=https://www.health.harvard.edu/"https:////www.cancer.gov//about-cancer//causes-prevention//genetics//brca-fact-sheet#how-much-does-an-inherited-harmful-variant-in-brca1-or-brca2-increase-a-womans-risk-of-breast-and-ovarian-cancer\" target=\"_blank\">National Cancer Institute<\/a>. (These mutations are <a href=https://www.health.harvard.edu/"https:////www.cdc.gov//cancer//breast//young_women//bringyourbrave//hereditary_breast_cancer//higher_risk_brca.htm/" target=\"_blank\">more common among certain groups<\/a>, including people of Ashkenazi Jewish heritage.) While about 1.2% of women overall will develop ovarian cancer in their lifetime, up to 17% of those with a BRCA2 mutation and up to 44% with a BRCA1 mutation will do so by ages 70 to 80.<\/p>\n <h2>How much can surgery lower the odds of ovarian cancer?<\/h2>\n It's not clear that all<\/em> women — even those not scheduled for surgery — should undergo removal of their fallopian tubes to reduce this risk once they finish having children, Dr. Esselen says. This surgery can't totally eliminate the possibility of ovarian cancer — and surgery carries its own risks. She recommends discussing options with your doctor depending on your level of risk for this disease:<\/p>\n For those at average risk for ovarian cancer:<\/strong> Available data seem to support the idea of removing the fallopian tubes. Studies of women who underwent tubal ligation (\"tying the tubes\") or removal to avoid future pregnancies indicate their future risks of ovarian cancer <a href=https://www.health.harvard.edu/"https:////www.acog.org//clinical//clinical-guidance//committee-opinion//articles//2019//04//opportunistic-salpingectomy-as-a-strategy-for-epithelial-ovarian-cancer-prevention/" target=\"_blank\">dropped by 25% to 65% compared to their peers<\/a>. And if a woman is already undergoing gynecologic surgery, such as a hysterectomy, the potential benefits likely outweigh the risks.<\/p>\n Before menopause, removing the fallopian tubes while leaving the ovaries in place is preferable to removing both. That's because estrogen produced by the ovaries can help protect against health problems such as cardiovascular disease and osteoporosis. Leaving the ovaries also prevents suddenly experiencing symptoms of menopause.<\/p>\n \"The fallopian tubes don't produce any hormones and aren't really needed for anything other than transporting the egg,\" she says. \"So there's little downside to removing them at the time of another gynecologic procedure if a woman is no longer interested in fertility.\"<\/p>\n For those at high risk for ovarian cancer:<\/strong> \"In a world where we don't have good screening tools for ovarian cancer, it makes sense to do something as dramatic as surgery to remove both ovaries and fallopian tubes when a woman is known to be at higher risk because of a strong family history or a BRCA gene mutations,\" Dr. Esselen says.<\/p>\n Currently, preliminary evidence suggests it may be safe to proactively remove the fallopian tubes while delaying removal of the ovaries to closer to the time of menopause to avoid an early menopause. However, it's unclear how much this procedure lowers the odds of developing ovarian cancer.<\/p>\n \"Generally, the findings so far have focused on the safety of the surgery itself and women's quality of life,\" Dr. Esselen says. \"Long-term data in high-risk women takes a great number of years to accumulate. We need this data to know whether removing the fallopian tubes alone is equally effective in preventing ovarian cancer as removing the tubes and ovaries.\"<\/p>\n <h2>Discussing your options is key<\/h2>\n Ultimately, Dr. Esselen says that she advocates OCRA's new recommendations. \"For anyone who's completed childbearing, if I'm doing surgery that wouldn't necessarily include routinely removing their fallopian tubes, I'm offering it,\" she says. \"A woman and her doctor should always discuss this at the time she's having gynecologic surgery.\"<\/p>\n <\/body>","excerpt":"\n Ovarian cancer, which claims about 13,000 lives each year, is hard to detect in early stages. Recent guidance from professional groups recommends removing fallopian tubes to help prevent ovarian cancer if women are undergoing gynecologic surgery and are finished with childbearing.<\/p>\n ","short_excerpt":"\n Ovarian cancer, which claims about 13,000 lives each year, is hard to detect in early stages. Recent guidance from professional groups recommends removing fallopian tubes to help prevent ovarian cancer if women are undergoing gynecologic surgery and are finished with childbearing.<\/p>\n ","description":null,"author":null,"slug":"preventing-ovarian-cancer-should-women-consider-removing-fallopian-tubes-202304212915","sort_date":"2023-04-21T04:00:00.000000Z","contentable_type":"App\\Models\\Marketing\\BlogPost","contentable_id":2915,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL042023","publication_date":"2023-04-21T10:30:00.000000Z","last_review_date":null,"imported_at":"2023-04-21T09:00:02.000000Z","last_import_type":"update","last_modified_date":"2023-04-20T04:00:00.000000Z","active":1,"created_at":"2023-04-20T20:40:42.000000Z","updated_at":"2023-04-21T09:00:02.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":46,"ecommerce_type":"CATALOG","authors":[{"id":420,"cr_id":779,"featured":0,"hhp_staff":0,"hidden":0,"name":"Maureen Salamon","title":null,"first_name":"Maureen","middle_name":null,"last_name":"Salamon","suffix":null,"slug":"maureen-salamon","byline":"Executive Editor, <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//womens/">Harvard Women's Health Watch<\/em><\/a>","description":"Maureen Salamon is executive editor of Harvard Women’s Health Watch<\/em>. She began her career as a newspaper reporter and later covered health and medicine for a wide variety of websites, magazines, and hospitals. Her work has appeared in The New York Times<\/em>, The Atlantic<\/em>, CNN.com, WebMD, Medscape and HealthDay, among other major outlets. Maureen earned a BA in print journalism from Penn State University.<\/p>","image_url":"https:\/\/d2icykjy7h7x7e.cloudfront.net\/authors\/MWQyHwiFAPooqhDKsjTfFjCCCoIooqQNLj1M7LRO.jpg","twitter_username":null,"sort_order":0,"created_at":"2022-02-24T21:39:38.000000Z","updated_at":"2022-07-17T15:04:53.000000Z","deleted_at":null,"pivot":{"content_id":18024,"author_id":420,"sort_order":1}}],"contentable":{"id":2915,"comments_open":1,"created_at":"2023-04-20T20:40:42.000000Z","updated_at":"2023-04-20T20:40:42.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":13813,"model_type":"App\\Models\\Marketing\\Content","model_id":18024,"uuid":"c04b666d-e2d5-4953-b9dd-f6d24151e7d8","collection_name":"contents","name":"87cf1fce-4127-4141-9714-0cf65bbbbafd","file_name":"87cf1fce-4127-4141-9714-0cf65bbbbafd.jpg","mime_type":"image\/jpeg","disk":"s3","conversions_disk":"s3","size":104036,"manipulations":[],"custom_properties":{"alt":"3-D graphic of female reproductive system showing a fallopian tube and ovary and part of the uterus in orange and yellow"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":13771,"created_at":"2023-04-20T20:40:42.000000Z","updated_at":"2023-04-20T20:40:44.000000Z","full_url":"https:\/\/domf5oio6qrcr.cloudfront.net\/medialibrary\/13813\/87cf1fce-4127-4141-9714-0cf65bbbbafd.jpg"}],"primary_content_topic":{"id":46,"name":"Women's Health","old_names":"Menopause","slug":"womens-health","description":"Women have many unique health concerns — menstrual cycles, pregnancy, birth control, menopause — and that's just the beginning. A number of health issues affect only women and others are more common in women. What's more, men and women may have the same condition, but different symptoms. Many diseases affect women differently and may even require distinct treatment.<\/p>Treatments for breast cancer include removal of the affected breast (mastectomy), removal of the tumor and small amount of surrounding tissue (lumpectomy), radiation therapy, chemotherapy, and hormone therapy.<\/p>","is_primary":1,"additional_content":null,"created_at":"2021-03-02T16:37:04.000000Z","updated_at":"2023-04-13T15:17:57.000000Z","deleted_at":null,"canonical":"https:\/\/www.health.harvard.edu\/topics\/womens-health"}},{"id":17981,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Healthier planet, healthier people","short_title":"","subheading":"Five small steps toward better health for you and planet Earth.","summary":"\n As the impacts of climate change on Earth threaten our well-being, the concept of planetary health acknowledges that the ecosystem and our health are inextricably intertwined. While individual efforts may seem small, here are five small steps that help make a difference when taken collectively.<\/p>\n ","content":"<body>\n \n \n <img alt=\"A crystal globe with countries etched on, circled by stethoscope with red heart; Earth health and our health connect\" src=https://www.health.harvard.edu/"http:////content.health.harvard.edu//wp-content//uploads//2023//04//1528cc88-71f7-4707-a95f-912b757db835.jpg/" style=\"height:400px; width:600px\" imageid=\"1528cc88-71f7-4707-a95f-912b757db835\"\/>\n <\/em>\n <\/p>\n Everything is connected.<\/em> You've probably heard that before, but it bears repeating. Below are five ways to boost both your individual health and the health of our planet — a combination that environmentalists call co-benefits.<\/p>\n <h2>How your health and planetary health intersect<\/h2>\n Back in 1970, Earth Day was founded as a day of awareness about environmental issues. Never has awareness of our environment seemed more important than now. The impacts of climate change on Earth — fires, storms, <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//blog//respiratory-health-harms-often-follow-flooding-taking-these-steps-can-help-202211092848/" style=\"text-decoration:underline\">floods<\/a>, droughts, <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//blog//extreme-heat-staying-safe-if-you-have-health-issues-202108062563/" style=\"text-decoration:underline\">heat waves<\/a>, rising sea levels, species extinction, and more — directly or indirectly threaten our well-being, especially for those most vulnerable. For example, <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//blog//even-low-level-air-pollution-may-harm-health-202202212692/" style=\"text-decoration:underline\">air pollution<\/a> from fossil fuels and fires contributes to lung problems and hospitalizations. <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//blog//tick-season-is-expanding-protect-yourself-against-lyme-disease-202108052564/" style=\"text-decoration:underline\">Geographic and seasonal boundaries for ticks<\/a> and mosquitoes, which are carriers of infectious diseases, expand as regions warm.<\/p>\n The concept of planetary health acknowledges that the ecosystem and our health are inextricably intertwined. Actions and events have complex downstream effects: some are expected, others are surprising, and many are likely unrecognized. While individual efforts may seem small, collectively they can move the needle — even ever so slightly — in the right direction.<\/p>\n <h2>Five ways to improve personal and planetary health<\/h2>\n \n Adopt plant-forward eating.<\/strong>\n <\/p>\n This means increasing <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//blog//what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760/" style=\"text-decoration:underline\">plant-based foods<\/a> in your diet while minimizing meat. Making these types of choices lowers the risks of heart disease, stroke, obesity, high blood pressure, type 2 diabetes, and many cancers. Compared to meat-based meals, plant-based meals also have many beneficial effects for the planet. For example, for the same amount of protein, plant-based meals have a lower carbon footprint and use fewer natural resources like land and water.<\/p>\n \n Remember, not all plants are equal.<\/strong>\n <\/p>\n Plant foods also vary greatly, both <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//staying-healthy//the-right-plant-based-diet-for-you/" style=\"text-decoration:underline\">in terms of their nutritional content<\/a> and in their environmental impact. <a href=https://www.health.harvard.edu/"https:////www.fda.gov//food//new-nutrition-facts-label//how-understand-and-use-nutrition-facts-label/" style=\"text-decoration:underline\">Learning to read labels<\/a> can help you determine the nutritional value of foods. It's a bit harder to learn about the environmental impact of specific foods, since there are regional factors. But to get a general sense, Our World in Data has a collection of eye-opening interactive graphs about various <a href=https://www.health.harvard.edu/"https:////ourworldindata.org//environmental-impacts-of-food/" style=\"text-decoration:underline\">environmental impacts of different foods<\/a>.<\/p>\n \n Favor active transportation.<\/strong>\n <\/p>\n Choose an alternative to driving such as walking, biking, or using public transportation when possible. Current health recommendations encourage adults to get 150 minutes each week of moderate-intensity physical activity, and two sessions of muscle strengthening activity. Regular physical activity improves mental health, bone health, and weight management. It also reduces risks of heart disease, some cancers, and falls in older adults. Fewer miles driven in gas-powered vehicles means cleaner air, decreased carbon emissions contributing to climate change, and less air pollution (known to cause asthma exacerbations and many other diseases).<\/p>\n \n Start where you are and work up to your level of discomfort.<\/strong>\n <\/p>\n Changes that work for one person may not work for another. Maybe you will pledge to eat one vegan meal each week, or maybe you will pledge to limit beef to once a week. Maybe you will try out taking the bus to work, or maybe you will bike to work when it's not winter. Set goals for yourself that are achievable but are also a challenge.<\/p>\n \n Talk about it.<\/strong>\n <\/p>\n It might feel as though these actions are small, and it might feel daunting for any one individual trying to make a difference. Sharing your thoughts about what matters to you and about what you are doing might make you feel less isolated and help build community. Building community contributes to well-being and resilience.<\/p>\n Plus, if you share your pledges and aims with one person, and that person does the same, then your actions are amplified. Who knows, maybe one of those folks along the way might be the employee who decides what our children eat from school menus, or a city planner for pedestrian walkways and bike lanes!<\/p>\n <\/body>","excerpt":"\n As the impacts of climate change on Earth threaten our well-being, the concept of planetary health acknowledges that the ecosystem and our health are inextricably intertwined. While individual efforts may seem small, here are five small steps that help make a difference when taken collectively.<\/p>\n ","short_excerpt":"\n As the impacts of climate change on Earth threaten our well-being, the concept of planetary health acknowledges that the ecosystem and our health are inextricably intertwined. While individual efforts may seem small, here are five small steps that help make a difference when taken collectively.<\/p>\n ","description":null,"author":null,"slug":"healthier-planet-healthier-people-202304182914","sort_date":"2023-04-18T04:00:00.000000Z","contentable_type":"App\\Models\\Marketing\\BlogPost","contentable_id":2914,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL041923","publication_date":"2023-04-18T14:30:00.000000Z","last_review_date":null,"imported_at":"2023-04-23T09:00:06.000000Z","last_import_type":"update","last_modified_date":"2023-04-22T04:00:00.000000Z","active":1,"created_at":"2023-04-19T09:00:02.000000Z","updated_at":"2023-04-23T09:00:06.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":44,"ecommerce_type":"CATALOG","authors":[{"id":62,"cr_id":458,"featured":1,"hhp_staff":0,"hidden":0,"name":"Wynne Armand, MD","title":null,"first_name":"Wynne","middle_name":null,"last_name":"Armand","suffix":"MD","slug":"wynne-armand-md","byline":"Contributor","description":"Dr. Wynne Armand is a physician at Massachusetts General Hospital (MGH), where she provides primary care; an assistant professor in medicine at Harvard Medical School; and associate director of the <a href=https://www.health.harvard.edu/"https:////www.massgeneral.org//environment-and-health/" target=\"_blank\">MGH Center for the Environment and Health<\/a>. She is a faculty editor for MGH Primary Care Office InSite (PCOI), a website that provides patient information as well as guidelines for practicing physicians and health care staff. Dr. Armand earned her medical degree from the University of California, San Francisco (UCSF) School of Medicine, where she also completed her internal medicine residency in a program dedicated to training physicians to become leaders in the care of the underserved. She has an interest in promoting climate-smart health care.<\/p>","image_url":"https:\/\/d2icykjy7h7x7e.cloudfront.net\/authors\/vYWboPeVUIvkPnzcpIhr2aiLeEmHyl7PqGqRNfiq.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T10:25:52.000000Z","updated_at":"2022-09-22T17:44:37.000000Z","deleted_at":null,"pivot":{"content_id":17981,"author_id":62,"sort_order":1}}],"contentable":{"id":2914,"comments_open":1,"created_at":"2023-04-19T09:00:02.000000Z","updated_at":"2023-04-19T17:04:14.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":13765,"model_type":"App\\Models\\Marketing\\Content","model_id":17981,"uuid":"b3fee2eb-ba16-4873-8dbe-ee3552e7f1df","collection_name":"contents","name":"1528cc88-71f7-4707-a95f-912b757db835","file_name":"1528cc88-71f7-4707-a95f-912b757db835.jpg","mime_type":"image\/jpeg","disk":"s3","conversions_disk":"s3","size":68469,"manipulations":[],"custom_properties":{"alt":"A crystal globe with countries etched on, circled by stethoscope with red heart; Earth health and our health connect"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":13723,"created_at":"2023-04-19T09:00:03.000000Z","updated_at":"2023-04-19T09:00:04.000000Z","full_url":"https:\/\/domf5oio6qrcr.cloudfront.net\/medialibrary\/13765\/1528cc88-71f7-4707-a95f-912b757db835.jpg"}],"primary_content_topic":{"id":44,"name":"Staying Healthy","old_names":null,"slug":"staying-healthy","description":"Maintaining good health doesn't happen by accident. It requires work, smart lifestyle choices, and the occasional checkup and test.<\/p>A healthy diet is rich in fiber, whole grains, fresh fruits and vegetables, "good" or unsaturated fats, and omega-3 fatty acids. These dietary components turn down inflammation, which can damage tissue, joints, artery walls, and organs. Going easy on processed foods is another element of healthy eating. Sweets, foods made with highly refined grains, and sugar-sweetened beverages can cause spikes in blood sugar that can lead to early hunger. High blood sugar is linked to the development of diabetes, obesity, heart disease, and even dementia.<\/p>The Mediterranean diet meets all of the criteria for good health, and there is convincing evidence that it is effective at warding off heart attack, stroke, and premature death. The diet is rich in olive oil, fruits, vegetables, nuts and fish; low in red meats or processed meats; and includes a moderate amount of cheese and wine.<\/p>Physical activity is also necessary for good health. It can greatly reduce your risk of heart disease, stroke, type 2 diabetes, breast and colon cancer, depression, and falls. Physical activity improves sleep, endurance, and even sex. Aim for 150 minutes of moderate-intensity exercise every week, such as brisk walking. Strength training, important for balance, bone health, controlling blood sugar, and mobility, is recommended 2-3 times per week.<\/p>Finding ways to reduce stress is another strategy that can help you stay healthy, given the connection between stress and a variety of disorders. There are many ways to bust stress. Try, meditation, mindfulness, yoga, playing on weekends, and taking vacations.<\/p>Finally, establish a good relationship with a primary care physician. If something happens to your health, a physician you know —and who knows you — is in the best position to help. He or she will also recommend tests to check for hidden cancer or other conditions.<\/p>","is_primary":1,"additional_content":null,"created_at":"2021-03-02T16:37:04.000000Z","updated_at":"2023-05-01T14:56:22.000000Z","deleted_at":null,"canonical":"https:\/\/www.health.harvard.edu\/topics\/staying-healthy"}},{"id":17980,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Is snuff really safer than smoking?","short_title":"","subheading":"The FDA says yes, but only in regard to the risk of lung cancer.","summary":"\n The FDA authorized a brand of smokeless tobacco to use language in its advertising claiming that using snuff reduces risk of lung cancer compared to smoking cigarettes. Technically this is true, but it's not the health advantage the product's maker would like consumers to think it is.<\/p>\n ","content":"<body>\n \n <img alt=\"An open tin of dark brown smokeless tobacco known as snuff on right; fingers of a hand cupping pouches of snuff on left \" src=https://www.health.harvard.edu/"http:////content.health.harvard.edu//wp-content//uploads//2023//04//fab90b23-ec20-40b8-b6ba-de903fcc2d4e.jpg/" style=\"height:400px; width:600px\" imageid=\"fab90b23-ec20-40b8-b6ba-de903fcc2d4e\"\/>\n <\/p>\n Snuff is a smokeless tobacco similar to chewing tobacco. It rarely makes headlines. But it certainly did when the FDA authorized a brand of snuff to market its products as having a major health advantage over cigarettes. Could this be true? Is it safe to use snuff?<\/p>\n <h2>What did the FDA authorize as a health claim?<\/h2>\n Here's the <a href=https://www.health.harvard.edu/"https:////www.fda.gov//news-events//press-announcements//fda-authorizes-copenhagen-classic-snuff-be-marketed-modified-risk-tobacco-product/" style=\"text-decoration:underline\">approved language<\/a> for Copenhagen Classic Snuff:<\/p>\n If you smoke, consider this: switching completely to this product from cigarettes reduces risk of lung cancer.<\/p>\n While the statement is true, this FDA action — and the marketing that's likely to follow — might suggest snuff is a safe product. It's not. Let's talk about the rest of the story.<\/p>\n <h2>What is snuff, anyway?<\/h2>\n Snuff is a form of tobacco that's finely ground. There are two types:<\/p>\n <ul>\n <li>Moist snuff.<\/strong> Users place a pinch or a pouch of tobacco behind their upper or lower lips or between their cheek and gum. They must repeatedly spit out or swallow the tobacco juice that accumulates. After a few minutes, they remove or spit out the tobacco as well. This recent FDA action applies to a brand of moist snuff.<\/li>\n <li>Dry snuff.<\/strong> This type is snorted (inhaled through the nose) and is less common in the US.<\/li>\n <\/ul>\n Both types are available in an array of scents and flavors. Users absorb nicotine and other chemicals into the bloodstream through the lining of the mouth. Blood levels of nicotine are similar between smokers and snuff users. But nicotine stays in the blood for a longer time with snuff users.<\/p>\n <h2>Why is snuff popular?<\/h2>\n According to CDC statistics, <a href=https://www.health.harvard.edu/"https:////www.cdc.gov//tobacco//data_statistics//fact_sheets//smokeless//use_us//index.htm/" style=\"text-decoration:underline\">5.7 million adults in the US<\/a> regularly use smokeless tobacco products — that's about 2% of the adult population. A similar percentage (1.6%) of high school students use it as well. That's despite restrictions on youth marketing and sales.<\/p>\n What accounts for its popularity?<\/p>\n <ul>\n <li>Snuff may be allowed in places that prohibit smoking.<\/li>\n <li>It tends to cost less than cigarettes: $300 to $1,000 a year versus several thousand dollars a year paid by some smokers.<\/li>\n <li>It doesn't require inhaling smoke into the lungs, or exposing others to secondhand smoke.<\/li>\n <li>Snuff is safer than cigarettes in at least one way — it is<\/em> less likely to cause lung cancer.<\/li>\n <li>It may help some cigarette smokers quit.<\/li>\n <\/ul>\n <h2>The serious health risks of snuff<\/h2>\n While the risk of lung cancer is lower compared with cigarettes, snuff has <a href=https://www.health.harvard.edu/"https:////www.cdc.gov//tobacco//data_statistics//fact_sheets//smokeless//health_effects///" style=\"text-decoration:underline\">plenty of other health risks<\/a>, including<\/p>\n <ul>\n <li>higher risk of cancers of the mouth (such as the tongue, gums, and cheek), esophagus, and pancreas<\/li>\n <li>higher risk of heart disease and stroke<\/li>\n <li>harm to the developing teenage brain<\/li>\n <li>dental problems, such as discoloration of teeth, gum disease, tooth damage, bone loss around the teeth, tooth loosening or loss<\/li>\n <li>higher risk of premature birth and stillbirth among pregnant users.<\/li>\n <\/ul>\n And because nicotine is addictive, using any tobacco product can quickly become a habit that's hard to break.<\/p>\n There are also the \"ick\" factors: bad breath and having to repeatedly spit out tobacco juice.<\/p>\n <h2>Could this new marketing message about snuff save lives?<\/h2>\n Perhaps, if many smokers switch to snuff and give up smoking. That could reduce the number of people who develop smoking-related lung cancer. It might even reduce harms related to secondhand smoke.<\/p>\n But it's also possible the new marketing message will attract nonsmokers, including teens, who weren't previously using snuff. A bigger market for snuff products might boost health risks for many people, rather than lowering them.<\/p>\n The new FDA action is approved for a five-year period, and the company must monitor its impact. Is snuff an effective way to help smokers quit? Is a lower rate of lung cancer canceled out by a rise in other health risks? We don't know yet. If the new evidence shows more overall health risks than benefits for snuff users compared with smokers, this new marketing authorization may be reversed.<\/p>\n <h2>The bottom line<\/h2>\n If you smoke, concerns you have about lung cancer or other smoking-related health problems are justified. But snuff should not be the first choice to help break the smoking habit. <a href=https://www.health.harvard.edu/"https:////www.cdc.gov//tobacco//quit_smoking//how_to_quit//index.htm/" style=\"text-decoration:underline\">Commit to quit<\/a> using safer options that don't involve tobacco, such as nicotine gum or patches, counseling, and medications.<\/p>\n While the FDA's decision generated news headlines that framed snuff as safer than smoking, it's important to note that the FDA did not<\/em> endorse the use of snuff — or even suggest that snuff is a safe product. Whether smoked or smokeless, tobacco creates enormous health burdens and suffering. Clearly, it's best not to use any tobacco product.<\/p>\n Until we have a better understanding of its impact, I think any new marketing of this sort should also make clear that using snuff comes with other important health risks — even if lung cancer isn't the biggest one.<\/p>\n Follow me on Twitter <\/em>@RobShmerling<\/p>\n <\/body>","excerpt":"\n The FDA authorized a brand of smokeless tobacco to use language in its advertising claiming that using snuff reduces risk of lung cancer compared to smoking cigarettes. Technically this is true, but it's not the health advantage the product's maker would like consumers to think it is.<\/p>\n ","short_excerpt":"\n The FDA authorized a brand of smokeless tobacco to use language in its advertising claiming that using snuff reduces risk of lung cancer compared to smoking cigarettes. Technically this is true, but it's not the health advantage the product's maker would like consumers to think it is.<\/p>\n ","description":null,"author":null,"slug":"is-snuff-really-safer-than-smoking-202304172913","sort_date":"2023-04-17T04:00:00.000000Z","contentable_type":"App\\Models\\Marketing\\BlogPost","contentable_id":2913,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL041723","publication_date":"2023-04-17T14:30:00.000000Z","last_review_date":null,"imported_at":"2023-04-23T09:00:07.000000Z","last_import_type":"update","last_modified_date":"2023-04-22T04:00:00.000000Z","active":1,"created_at":"2023-04-15T09:00:02.000000Z","updated_at":"2023-04-23T09:00:07.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":44,"ecommerce_type":"CATALOG","authors":[{"id":23,"cr_id":2,"featured":1,"hhp_staff":1,"hidden":0,"name":"Robert H. Shmerling, MD","title":null,"first_name":"Robert","middle_name":"H.","last_name":"Shmerling","suffix":"MD","slug":"robert-h-shmerling-md","byline":"Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing","description":"Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. As a practicing rheumatologist for over 30 years, Dr. Shmerling engaged in a mix of patient care, teaching, and research. His research interests center on diagnostic studies in patients with musculoskeletal symptoms, and rheumatic and autoimmune diseases. He has published research regarding infectious arthritis, medical ethics, and diagnostic test performance in rheumatic disease. Having retired from patient care in 2019, Dr. Shmerling now works as a senior faculty editor for Harvard Health Publishing.<\/p>","image_url":"https:\/\/d2icykjy7h7x7e.cloudfront.net\/authors\/OdKCKaVzyx3xPsUxIBc9zJz8m3zvysnJa3UJsGOd.jpg","twitter_username":"RobShmerling","sort_order":30,"created_at":"2021-05-11T10:05:10.000000Z","updated_at":"2023-05-01T13:28:11.000000Z","deleted_at":null,"pivot":{"content_id":17980,"author_id":23,"sort_order":1}}],"contentable":{"id":2913,"comments_open":1,"created_at":"2023-04-15T09:00:02.000000Z","updated_at":"2023-04-15T09:00:02.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":13764,"model_type":"App\\Models\\Marketing\\Content","model_id":17980,"uuid":"c839e19d-44e4-40ee-8c63-968f0a285d86","collection_name":"contents","name":"fab90b23-ec20-40b8-b6ba-de903fcc2d4e","file_name":"fab90b23-ec20-40b8-b6ba-de903fcc2d4e.jpg","mime_type":"image\/jpeg","disk":"s3","conversions_disk":"s3","size":75298,"manipulations":[],"custom_properties":{"alt":"An open tin of dark brown smokeless tobacco known as snuff on right; fingers of a hand cupping pouches of snuff on left "},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":13722,"created_at":"2023-04-15T09:00:02.000000Z","updated_at":"2023-04-15T09:00:03.000000Z","full_url":"https:\/\/domf5oio6qrcr.cloudfront.net\/medialibrary\/13764\/fab90b23-ec20-40b8-b6ba-de903fcc2d4e.jpg"}],"primary_content_topic":{"id":44,"name":"Staying Healthy","old_names":null,"slug":"staying-healthy","description":"Maintaining good health doesn't happen by accident. It requires work, smart lifestyle choices, and the occasional checkup and test.<\/p>A healthy diet is rich in fiber, whole grains, fresh fruits and vegetables, "good" or unsaturated fats, and omega-3 fatty acids. These dietary components turn down inflammation, which can damage tissue, joints, artery walls, and organs. Going easy on processed foods is another element of healthy eating. Sweets, foods made with highly refined grains, and sugar-sweetened beverages can cause spikes in blood sugar that can lead to early hunger. High blood sugar is linked to the development of diabetes, obesity, heart disease, and even dementia.<\/p>The Mediterranean diet meets all of the criteria for good health, and there is convincing evidence that it is effective at warding off heart attack, stroke, and premature death. The diet is rich in olive oil, fruits, vegetables, nuts and fish; low in red meats or processed meats; and includes a moderate amount of cheese and wine.<\/p>Physical activity is also necessary for good health. It can greatly reduce your risk of heart disease, stroke, type 2 diabetes, breast and colon cancer, depression, and falls. Physical activity improves sleep, endurance, and even sex. Aim for 150 minutes of moderate-intensity exercise every week, such as brisk walking. Strength training, important for balance, bone health, controlling blood sugar, and mobility, is recommended 2-3 times per week.<\/p>Finding ways to reduce stress is another strategy that can help you stay healthy, given the connection between stress and a variety of disorders. There are many ways to bust stress. Try, meditation, mindfulness, yoga, playing on weekends, and taking vacations.<\/p>Finally, establish a good relationship with a primary care physician. If something happens to your health, a physician you know —and who knows you — is in the best position to help. He or she will also recommend tests to check for hidden cancer or other conditions.<\/p>","is_primary":1,"additional_content":null,"created_at":"2021-03-02T16:37:04.000000Z","updated_at":"2023-05-01T14:56:22.000000Z","deleted_at":null,"canonical":"https:\/\/www.health.harvard.edu\/topics\/staying-healthy"}},{"id":17979,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Will miscarriage care remain available?","short_title":"","subheading":"New laws and lawsuits threaten safe, effective care for miscarriage in the US.","summary":"\n Miscarriage describes a pregnancy loss before 20 weeks. It happens in as many as one in three pregnancies, although the risk gradually decreases as pregnancy progresses. What causes miscarriage? How is it treated? And why is appropriate health care for miscarriage under scrutiny?<\/p>\n ","content":"<body>\n \n <img alt=\"A abstract red heart breaking into many pieces against a dark blue background; concept is miscarriage during a pregnancy\" src=https://www.health.harvard.edu/"http:////content.health.harvard.edu//wp-content//uploads//2023//04//9cc8762c-825e-40a7-b466-0e084207ea96.jpg/" style=\"height:480px; width:600px\" imageid=\"9cc8762c-825e-40a7-b466-0e084207ea96\"\/>\n <\/p>\n When you first learned the facts about pregnancy — from a parent, perhaps, or a friend — you probably didn't learn that up to one in three ends in a miscarriage.<\/p>\n What causes miscarriage? How is it treated? And why is appropriate health care for miscarriage under scrutiny — and in some parts of the US, getting harder to find?<\/p>\n <h2>What is miscarriage?<\/h2>\n Many people who come to us for care are excited and hopeful about building their families. It's devastating when a hoped-for pregnancy ends early.<\/p>\n Miscarriage is a catch-all term for a pregnancy loss before 20 weeks, counting from the first day of the last menstrual period. Miscarriage happens in as many as one in three pregnancies, although the risk gradually decreases as pregnancy progresses. By 20 weeks, it occurs in fewer than one in 100 pregnancies.<\/p>\n <h2>What causes miscarriage?<\/h2>\n Usually, there is no obvious or single cause for miscarriage. Some factors raise risk, such as:<\/p>\n <ul>\n <li>Pregnancy at older ages.<\/strong> Chromosome abnormalities are a common cause of pregnancy loss. As people age, this risk rises.<\/li>\n <li>Autoimmune disorders.<\/strong> While many pregnant people with <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//blog//considering-pregnancy-and-have-lupus-plan-ahead-202206012754/" target=\"_blank\">autoimmune disorders like lupus<\/a> or Sjogren's syndrome have successful pregnancies, their risk for pregnancy loss is higher.<\/li>\n <li>Certain illnesses.<\/strong> Diabetes or thyroid disease, if poorly controlled, can raise risk.<\/li>\n <li>Certain conditions in the uterus.<\/strong> Uterine fibroids, polyps, or malformations may contribute to miscarriage.<\/li>\n <li>Previous miscarriages.<\/strong> Having a miscarriage <a href=https://www.health.harvard.edu/"https:////www.ncbi.nlm.nih.gov//pmc//articles//PMC6425455///" target=\"_blank\">slightly increases risk for miscarriage in the next pregnancy<\/a>. For instance, if a pregnant person's risk of miscarriage is one in 10, it may increase to 1.5 in 10 after their first miscarriage, and four in 10 after having three miscarriages.<\/li>\n <li>Certain medicines.<\/strong> A developing pregnancy may be harmed by certain medicines. It's safest to plan pregnancy and receive pre-pregnancy counseling if you have a chronic illness or condition.<\/li>\n <\/ul>\n <h2>How is miscarriage diagnosed?<\/h2>\n Before ultrasounds in early pregnancy became widely available, many miscarriages were diagnosed based on symptoms like bleeding and cramping. Now, people may be diagnosed with a miscarriage or early pregnancy loss on a routine ultrasound before they notice any symptoms.<\/p>\n <h2>How is miscarriage treated?<\/h2>\n Being able to choose the next step in treatment may help emotionally. When there are no complications and the miscarriage occurs during the first trimester (up to 13 weeks of pregnancy), <a href=https://www.health.harvard.edu/"https:////jamanetwork.com//journals//jama//article-abstract//2803836/" target=\"_blank\">the options are<\/a>:<\/p>\n Take no action.<\/strong> Passing blood and pregnancy tissue often occurs at home naturally, without need for medications or a procedure. Within a week, 25% to 50% will pass pregnancy tissue; more than 80% of those who experience bleeding as a sign of miscarriage will pass the pregnancy tissue within two weeks.<\/p>\n What to know:<\/strong> This can be a safe option for some people, but not all. For example, heavy bleeding would not be safe for a person who has anemia (lower than normal red blood cell counts).<\/p>\n Take medication.<\/strong> The most effective option uses two medicines: mifepristone is taken first, followed by misoprostol. Using only misoprostol is a less effective option. The two-step combination is 90% successful in helping the body pass pregnancy tissue; taking misoprostol alone is 70% to 80% successful in doing so.<\/p>\n What to know:<\/strong> Bleeding and cramping typically start a few hours after taking misoprostol. If bleeding does not start, or there is pregnancy tissue still left in the uterus, a surgical procedure may be necessary: this happens in about one in 10 people using both medicines and one in four people who use only misoprostol.<\/p>\n Use a procedure.<\/strong> During dilation and curettage (D&C), the cervix is dilated (widened) so that instruments can be inserted into the uterus to remove the pregnancy tissue. This procedure is nearly 99% successful.<\/p>\n What to know:<\/strong> If someone is having life-threatening bleeding or has signs of infection, this is the safest option. This procedure is typically done in an operating room or surgery center. In some instances, it is offered in a doctor's office.<\/p>\n If you have a miscarriage during the second trimester of pregnancy (after 13 weeks), discuss the safest and best plan with your doctor. Generally, second trimester miscarriages will require a procedure and cannot be managed at home.<\/p>\n <h2>Red flags: When to ask for help during a miscarriage<\/h2>\n During the first 13 weeks of pregnancy:<\/strong> Contact your health care provider or go to the emergency department immediately if you experience<\/p>\n <ul>\n <li>heavy bleeding combined with dizziness, lightheadedness, or feeling faint<\/li>\n <li>fever above 100.4° F<\/li>\n <li>severe abdominal pain not relieved by over-the-counter pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil). Please note: ibuprofen is not recommended during pregnancy, but is safe to take if a miscarriage has been diagnosed.<\/li>\n <\/ul>\n After 13 weeks of pregnancy: <\/strong>Contact your health care provider or go to the emergency department immediately if you experience<\/p>\n <ul>\n <li>any symptoms listed above<\/li>\n <li>leakage of fluid (possibly your water may have broken)<\/li>\n <li>severe abdominal or back pain (similar to contractions).<\/li>\n <\/ul>\n <h2>How is care for miscarriages changing?<\/h2>\n Unfortunately, political interference has had significant impact on safe, effective miscarriage care:<\/p>\n <ul>\n <li>Some states have banned a procedure used to treat second trimester miscarriage. Called dilation and evacuation (D&E), this removes pregnancy tissue through the cervix without making any incisions. A D&E can be lifesaving in instances when heavy bleeding or infection is complicating a miscarriage.<\/li>\n <li>Federal and state lawsuits, or laws banning or seeking to ban mifepristone for abortion care, directly limit access to a safe, effective drug approved for miscarriage care. This could affect miscarriage care nationwide.<\/li>\n <li>Many laws and lawsuits that interfere with miscarriage care offer an exception to save the life of a pregnant patient. However, miscarriage complications may develop unexpectedly and worsen quickly, making it hard to ensure that people will receive prompt care in life-threatening situations.<\/li>\n <li>States that ban or restrict abortion are less likely to have doctors trained to perform a full range of miscarriage care procedures. What's more, clinicians in training, such as resident physicians and medical students, may never learn how to perform a potentially lifesaving procedure.<\/li>\n <\/ul>\n Ultimately, legislation or court rulings that ban or restrict abortion care will decrease the ability of doctors and nurses to provide the highest quality miscarriage care. We can help by asking our lawmakers not to pass laws that prevent people from being able to get reproductive health care, such as restricting medications and procedures for abortion and miscarriage care.<\/p>\n <\/body>","excerpt":"\n Miscarriage describes a pregnancy loss before 20 weeks. It happens in as many as one in three pregnancies, although the risk gradually decreases as pregnancy progresses. What causes miscarriage? How is it treated? And why is appropriate health care for miscarriage under scrutiny?<\/p>\n ","short_excerpt":"\n Miscarriage describes a pregnancy loss before 20 weeks. It happens in as many as one in three pregnancies, although the risk gradually decreases as pregnancy progresses. What causes miscarriage? How is it treated? And why is appropriate health care for miscarriage under scrutiny?<\/p>\n ","description":null,"author":null,"slug":"will-miscarriage-care-remain-available-202304142912","sort_date":"2023-04-14T04:00:00.000000Z","contentable_type":"App\\Models\\Marketing\\BlogPost","contentable_id":2912,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL041423","publication_date":"2023-04-14T10:30:00.000000Z","last_review_date":null,"imported_at":"2023-04-23T09:00:07.000000Z","last_import_type":"update","last_modified_date":"2023-04-22T04:00:00.000000Z","active":1,"created_at":"2023-04-14T09:00:03.000000Z","updated_at":"2023-04-23T09:00:07.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":46,"ecommerce_type":"CATALOG","authors":[{"id":455,"cr_id":815,"featured":0,"hhp_staff":0,"hidden":0,"name":"Sara Neill, MD, MPH","title":null,"first_name":"Sara","middle_name":null,"last_name":"Neill","suffix":"MD, MPH","slug":"sara-neill-md-mph","byline":"Contributor","description":"Dr. Sara Neill is a physician-researcher in the department of obstetrics & gynecology at Beth Israel Deaconess Medical Center and Harvard Medical School. She completed a fellowship in complex family planning at Brigham and Women's Hospital, and received her master of public health degree from the Harvard T.H. Chan School of Public Health. She specializes in care for patients with miscarriage, and patients with complex medical conditions that may complicate their use of birth control.<\/p>","image_url":"https:\/\/d2icykjy7h7x7e.cloudfront.net\/authors\/Zv8R1PbRdQv88F5PXvemyux4QpafZlN1dXW7KgPe.jpg","twitter_username":null,"sort_order":0,"created_at":"2023-01-24T22:21:30.000000Z","updated_at":"2023-02-08T17:54:09.000000Z","deleted_at":null,"pivot":{"content_id":17979,"author_id":455,"sort_order":1}},{"id":121,"cr_id":630,"featured":0,"hhp_staff":0,"hidden":0,"name":"Scott Shainker, DO, MS","title":null,"first_name":"Scott","middle_name":null,"last_name":"Shaniker","suffix":"DO, MS","slug":"scott-shainker-do-ms","byline":"Contributor","description":"Scott Shainker, D.O, M.S., is a maternal-fetal medicine specialist in the Department of Obstetrics and Gynecology at Beth Israel Deaconess Medical Center (BIDMC). He is also a member of the faculty in the Department of Obstetrics, Gynecology, and Reproductive Biology at Harvard Medical School (HMS).<\/p>\r\n\r\nDr. Shainker is the co-founder and director of the New England Center for Placental Disorders, an international referral center for women with invasive placentation and other complex placental disorders. At BIDMC, he serves as the associate medical director of Labor and Delivery.<\/p>\r\n\r\nDr. Shainker’s research focuses on process improvement and clinical outcomes in the management of invasive placentation. His clinical interests are in abnormal placentation, complex maternal disease, critical care obstetrics and medical education.<\/p>\r\n\r\nDr. Shainker has lectured around the world focusing his efforts on reducing maternal morbidity \/ mortality, as well as placental disorders. Dr. Shainker is a national expert in critical care obstetrics and serves as faculty at both national and regional meetings. In addition, he was awarded the prestigious Association of Professors of Gynecology and Obstetrics Faculty Teaching Prize at HMS.<\/p>","image_url":null,"twitter_username":null,"sort_order":0,"created_at":"2021-05-11T10:43:03.000000Z","updated_at":"2022-07-25T16:52:03.000000Z","deleted_at":null,"pivot":{"content_id":17979,"author_id":121,"sort_order":2}}],"contentable":{"id":2912,"comments_open":1,"created_at":"2023-04-14T09:00:03.000000Z","updated_at":"2023-04-14T09:00:03.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":13763,"model_type":"App\\Models\\Marketing\\Content","model_id":17979,"uuid":"2a5f018c-fbc0-4a4c-9ceb-5d14bc8b870f","collection_name":"contents","name":"9cc8762c-825e-40a7-b466-0e084207ea96","file_name":"9cc8762c-825e-40a7-b466-0e084207ea96.jpg","mime_type":"image\/jpeg","disk":"s3","conversions_disk":"s3","size":81767,"manipulations":[],"custom_properties":{"alt":"A abstract red heart breaking into many pieces against a dark blue background; concept is miscarriage during a pregnancy"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":13721,"created_at":"2023-04-14T09:00:03.000000Z","updated_at":"2023-04-14T09:00:11.000000Z","full_url":"https:\/\/domf5oio6qrcr.cloudfront.net\/medialibrary\/13763\/9cc8762c-825e-40a7-b466-0e084207ea96.jpg"}],"primary_content_topic":{"id":46,"name":"Women's Health","old_names":"Menopause","slug":"womens-health","description":"Women have many unique health concerns — menstrual cycles, pregnancy, birth control, menopause — and that's just the beginning. A number of health issues affect only women and others are more common in women. What's more, men and women may have the same condition, but different symptoms. Many diseases affect women differently and may even require distinct treatment.<\/p>Treatments for breast cancer include removal of the affected breast (mastectomy), removal of the tumor and small amount of surrounding tissue (lumpectomy), radiation therapy, chemotherapy, and hormone therapy.<\/p>","is_primary":1,"additional_content":null,"created_at":"2021-03-02T16:37:04.000000Z","updated_at":"2023-04-13T15:17:57.000000Z","deleted_at":null,"canonical":"https:\/\/www.health.harvard.edu\/topics\/womens-health"}},{"id":17978,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Considering collagen drinks and supplements?","short_title":"","subheading":"Are collagen products worthwhile for skin, nails, and hair?","summary":"\n Celebrities and influencers claim that consuming collagen could have miraculous benefits for skin, hair, and nails. But what does the science say?<\/p>\n ","content":"<body>\n \n <img alt=\"A red-colored drink being poured from a bottle into a glass with ice; concept is collagen drinks\" src=https://www.health.harvard.edu/"http:////content.health.harvard.edu//wp-content//uploads//2023//04//18c7ad2e-6599-4671-b9c5-c2af6e4f9188.jpg/" style=\"height:400px; width:600px\" imageid=\"18c7ad2e-6599-4671-b9c5-c2af6e4f9188\"\/>\n <\/p>\n A tremendous buzz surrounds collagen drinks and supplements, as celebrities and influencers tout miraculous benefits for skin, hair, and nails. Since the collagen in our bodies provides crucial support for these tissues, it seems plausible that consuming collagen might lead to lush locks and a youthful glow. But what does the science say?<\/p>\n <h2>What is collagen?<\/h2>\n Collagen is a major structural protein in our tissues. It's found in skin, hair, nails, tendons, cartilage, and bones. Collagen works with other substances, such as hyaluronic acid and elastin, to maintain skin elasticity, volume, and moisture. It also helps make up proteins such as keratin that form skin, hair, and nails.<\/p>\n Our bodies naturally produce collagen using the amino acids from protein-rich or collagen-rich foods like bone broth, meat, and fish. But aging, sun damage, smoking, and alcohol consumption all decrease collagen production.<\/p>\n Collagen drinks and supplements often contain collagen from many different sources, such as fish, cattle, pigs, or chicken. Typically, they contain peptides, short chains of amino acids that help make up essential proteins in the body, including collagen itself and keratin.<\/p>\n <h2>What does the science say about collagen drinks and supplements?<\/h2>\n Research on skin includes:<\/p>\n <ul>\n <li>A <a href=https://www.health.harvard.edu/"https:////pubmed.ncbi.nlm.nih.gov//33742704///" style=\"text-decoration:underline\">review and analysis<\/a> of 19 studies, published in the International Journal of Dermatology<\/em>, that had a total of 1,125 participants. Those who used collagen supplements saw an improvement in the firmness, suppleness, and moisture content of the skin, with wrinkles appearing less noticeable. That sounds promising, but it's unclear if these skin improvements were actually due to collagen. Most of the trials used commercially available supplements that contained more than collagen: vitamins, minerals, antioxidants, coenzyme Q10<\/sub>, hyaluronic acid, and chondroitin sulfate were among the additional ingredients.<\/li>\n <li>A few randomized, controlled trials (see <a href=https://www.health.harvard.edu/"https:////pubmed.ncbi.nlm.nih.gov//26840887///" style=\"text-decoration:underline\">here<\/a> and <a href=https://www.health.harvard.edu/"https:////www.researchgate.net//publication//282266135_Clinical_effects_of_ingesting_collagen_hydrolysate_on_facial_skin_properties_-A_randomized_placebo-controlled_double-blind_trial-#:~:text=Results%3A%20Significant%20improvements%20in%20facial,adverse%20effects%20during%20the%20study\" style=\"text-decoration:underline\">here<\/a>) show that drinking collagen supplements with high amounts of the peptides prolylhydroxyproline and hydroxyprolylglycine can improve skin moisture, elasticity, wrinkles, and roughness. But large, high-quality studies are needed to learn whether commercially available products are helpful and safe to use long-term.<\/li>\n <\/ul>\n Hardly any evidence supports the use of collagen to enhance hair and nails. One small <a href=https://www.health.harvard.edu/"https:////onlinelibrary.wiley.com//doi//abs//10.1111//jocd.12393/" style=\"text-decoration:underline\">2017 study of 25 people<\/a> with brittle nails found that taking 2.5 grams of collagen daily for 24 weeks improved brittleness and nail growth. However, this small study had no control group taking a placebo to compare with the group receiving collagen supplements.<\/p>\n There haven't been any studies in humans examining the benefits of collagen supplementation for hair. Currently, no medical evidence supports marketing claims that collagen supplements or drinks can improve hair growth, shine, volume, and thickness.<\/p>\n <h2>Should you try collagen supplements or drinks?<\/h2>\n At this time, there isn't enough proof that taking collagen pills or consuming collagen drinks will make a difference in skin, hair, or nails. Our bodies cannot absorb collagen in its whole form. To enter the bloodstream, it must be broken down into peptides so it can be absorbed through the gut.<\/p>\n These peptides may be broken down further into the building blocks that make proteins like keratin that help form skin, hair, and nails. Or the peptides may form collagen that gets deposited in other parts of the body, such as cartilage, bone, muscles, or tendons. Thus far, no human studies have clearly proven that collagen you take orally will end up in your skin, hair, or nails.<\/p>\n If your goal is to improve skin texture and elasticity and minimize wrinkles, you're better off focusing on sun protection and using topical retinoids. Extensive research has already demonstrated that these measures are effective.<\/p>\n If you choose to try collagen supplements or drinks, review the list of ingredients and the protein profile. Avoid supplements with too many additives or fillers. Products containing high quantities of prolylhydroxyproline and hydroxyprolylglycine are better at reducing wrinkles and improving the moisture content of skin.<\/p>\n Consult your doctor before starting any new supplements. People who are prone to gout or have other medical conditions that require them to limit protein should not use collagen supplements or drinks.<\/p>\n <h2>The bottom line<\/h2>\n Large-scale trials evaluating the benefits of oral collagen supplements for skin and hair health are not available. If you're concerned about thinning or lackluster hair, brittle nails, or keeping skin smooth and healthy, talk to your doctor or a dermatologist for advice on the range of options.<\/p>\n It will also help to:<\/p>\n <ul>\n <li>Follow a healthy lifestyle and eat a balanced diet that includes protein-rich foods.<\/li>\n <li>If you smoke, quit.<\/li>\n <li>Limit alcohol to two drinks or less in a day for men or one drink or less in a day for women.<\/li>\n <li>Apply sunscreen daily and remember to reapply every two hours.<\/li>\n <li>Wear wide-brimmed or UV-protective hats and clothing when you're spending a lot of time in the sun.<\/li>\n <\/ul>\n Follow Payal Patel on Twitter <\/em>@PayalPatelMD<\/p>\n Follow Maryanne Makredes Senna on Twitter<\/em> @HairWithDrMare<\/p>\n <\/body>","excerpt":"\n Celebrities and influencers claim that consuming collagen could have miraculous benefits for skin, hair, and nails. But what does the science say?<\/p>\n ","short_excerpt":"\n Celebrities and influencers claim that consuming collagen could have miraculous benefits for skin, hair, and nails. But what does the science say?<\/p>\n ","description":null,"author":null,"slug":"considering-collagen-drinks-and-supplements-202304122911","sort_date":"2023-04-12T04:00:00.000000Z","contentable_type":"App\\Models\\Marketing\\BlogPost","contentable_id":2911,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL041223","publication_date":"2023-04-12T14:30:00.000000Z","last_review_date":null,"imported_at":"2023-04-23T09:00:08.000000Z","last_import_type":"update","last_modified_date":"2023-04-22T04:00:00.000000Z","active":1,"created_at":"2023-04-12T09:00:03.000000Z","updated_at":"2023-04-23T09:00:08.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":44,"ecommerce_type":"CATALOG","authors":[{"id":396,"cr_id":769,"featured":0,"hhp_staff":0,"hidden":0,"name":"Payal Patel, MD","title":null,"first_name":"Payal","middle_name":null,"last_name":"Patel","suffix":"MD","slug":"payal-patel-md","byline":"Contributor","description":"Dr. Payal Patel is a dermatology research fellow at Massachusetts General Hospital. Her clinical and research interests include autoimmune disease and procedural dermatology. She is part of the Cutaneous Biology Research Center, where she investigates medical applications of laser technology.<\/p>","image_url":"https:\/\/d2icykjy7h7x7e.cloudfront.net\/authors\/EYqQtY7IT4sHjHSCm6liuuklmvBg2G9YswPfregR.jpg","twitter_username":"PayalPatelMD","sort_order":0,"created_at":"2021-10-13T12:57:36.000000Z","updated_at":"2022-07-19T17:05:26.000000Z","deleted_at":null,"pivot":{"content_id":17978,"author_id":396,"sort_order":1}},{"id":284,"cr_id":701,"featured":0,"hhp_staff":0,"hidden":0,"name":"Maryanne Makredes Senna, MD","title":null,"first_name":"Maryanne","middle_name":"Makredes","last_name":"Senna","suffix":"MD","slug":"maryanne-makredes-senna-md","byline":"Contributor","description":"Dr. Maryanne Makredes Senna is a board-certified dermatologist at at Beth Israel Lahey Health, and assistant professor of dermatology at Harvard Medical School. Dr. Senna founded and directs the Lahey Hair Loss Center of Excellence and serves as principal of the research unit. Prior to this role, she founded the MGH Hair Loss Clinic and clinical trials unit, which she ran for nearly 10 years. She has held a number of pharmaceutical, device, and foundation appointments.<\/p>\r\n\r\nWidely published and recognized for her clinical expertise, teaching, and research, Dr. Senna is frequently invited to speak and give lectures nationally and abroad, and has been quoted in top-tier media publications such as The New York Times<\/em> and The Atlantic<\/em>. She has also been featured on multiple news outlets including Good Morning America<\/em>, and in the HBO Max documentary series Not So Pretty<\/em>.<\/p>\r\n\r\nDr. Senna is an esteemed member of several professional societies and committees, and is on the board of directors of the Scarring Alopecia Foundation, the American Hair Research Society, and on the medical advisory task force for the National Alopecia Areata Foundation.<\/p>","image_url":"https:\/\/d2icykjy7h7x7e.cloudfront.net\/authors\/91HGHSslDkuvy5VVOXkwIWGDHatKbhCW4vWdtx5P.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T11:03:25.000000Z","updated_at":"2023-03-30T14:21:33.000000Z","deleted_at":null,"pivot":{"content_id":17978,"author_id":284,"sort_order":2}}],"contentable":{"id":2911,"comments_open":1,"created_at":"2023-04-12T09:00:03.000000Z","updated_at":"2023-04-12T20:05:25.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":13753,"model_type":"App\\Models\\Marketing\\Content","model_id":17978,"uuid":"e8c9934d-45de-4e1e-aff8-e3eadeed52b5","collection_name":"contents","name":"18c7ad2e-6599-4671-b9c5-c2af6e4f9188","file_name":"18c7ad2e-6599-4671-b9c5-c2af6e4f9188.jpg","mime_type":"image\/jpeg","disk":"s3","conversions_disk":"s3","size":64357,"manipulations":[],"custom_properties":{"alt":"A red-colored drink being poured from a bottle into a glass with ice; concept is collagen drinks"},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":13711,"created_at":"2023-04-12T09:00:03.000000Z","updated_at":"2023-04-12T09:00:04.000000Z","full_url":"https:\/\/domf5oio6qrcr.cloudfront.net\/medialibrary\/13753\/18c7ad2e-6599-4671-b9c5-c2af6e4f9188.jpg"}],"primary_content_topic":{"id":44,"name":"Staying Healthy","old_names":null,"slug":"staying-healthy","description":"Maintaining good health doesn't happen by accident. It requires work, smart lifestyle choices, and the occasional checkup and test.<\/p>A healthy diet is rich in fiber, whole grains, fresh fruits and vegetables, "good" or unsaturated fats, and omega-3 fatty acids. These dietary components turn down inflammation, which can damage tissue, joints, artery walls, and organs. Going easy on processed foods is another element of healthy eating. Sweets, foods made with highly refined grains, and sugar-sweetened beverages can cause spikes in blood sugar that can lead to early hunger. High blood sugar is linked to the development of diabetes, obesity, heart disease, and even dementia.<\/p>The Mediterranean diet meets all of the criteria for good health, and there is convincing evidence that it is effective at warding off heart attack, stroke, and premature death. The diet is rich in olive oil, fruits, vegetables, nuts and fish; low in red meats or processed meats; and includes a moderate amount of cheese and wine.<\/p>Physical activity is also necessary for good health. It can greatly reduce your risk of heart disease, stroke, type 2 diabetes, breast and colon cancer, depression, and falls. Physical activity improves sleep, endurance, and even sex. Aim for 150 minutes of moderate-intensity exercise every week, such as brisk walking. Strength training, important for balance, bone health, controlling blood sugar, and mobility, is recommended 2-3 times per week.<\/p>Finding ways to reduce stress is another strategy that can help you stay healthy, given the connection between stress and a variety of disorders. There are many ways to bust stress. Try, meditation, mindfulness, yoga, playing on weekends, and taking vacations.<\/p>Finally, establish a good relationship with a primary care physician. If something happens to your health, a physician you know —and who knows you — is in the best position to help. He or she will also recommend tests to check for hidden cancer or other conditions.<\/p>","is_primary":1,"additional_content":null,"created_at":"2021-03-02T16:37:04.000000Z","updated_at":"2023-05-01T14:56:22.000000Z","deleted_at":null,"canonical":"https:\/\/www.health.harvard.edu\/topics\/staying-healthy"}},{"id":17977,"content_source_id":2,"content_type_id":18,"content_access_type_id":1,"title":"Does less TV time lower your risk for dementia?","short_title":null,"subheading":"Television viewing is associated with increased risks of Alzheimer's disease and dementia.","summary":"More physical activity and less time watching TV is best for the body. But how does television time affect risk for declines in memory and problem-solving ability or risk for developing dementia? Researchers have been digging into these questions.<\/p>","content":"<img alt=\"Smiling couple sitting on couch watching TV; man with short brown hair points remote, woman has white hair; bowl of popcorn rests on blanket \" height=\"400\" imageid=\"a0d7f2b7-bbfa-46ff-b9b7-48f516870e02\" src=https://www.health.harvard.edu/"http:////content.health.harvard.edu//wp-content//uploads//2023//04//a0d7f2b7-bbfa-46ff-b9b7-48f516870e02.jpg/" width=\"600\" \/><\/p>\r\n\r\nBe honest: just how much television are you watching? One study has estimated that half of American adults spend <a href=https://www.health.harvard.edu/"https:////www.ncbi.nlm.nih.gov//pmc//articles//PMC6311612///" style=\"text-decoration:underline\">two to three hours<\/a> each day watching television, with some watching as much as eight hours per day.<\/p>\r\n\r\nIs time spent on TV a good thing or a bad thing? Let's look at some of the data in relation to your risks for <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//topics//dementia/">cognitive decline and dementia<\/a>.<\/p>\r\n\r\n<h2>Physical activity does more to sharpen the mind than sitting<\/h2>\r\n\r\nFirst, the more time you sit and watch television, the less time you have available for physical activity. <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//blog//can-physical-or-cognitive-activity-prevent-dementia-202109162595/" style=\"text-decoration:underline\">Getting sufficient physical activity<\/a> decreases your risk of cognitive impairment and dementia. Not surprisingly, if you spend a lot of time sitting and doing other sedentary behaviors, your <a href=https://www.health.harvard.edu/"https:////pubmed.ncbi.nlm.nih.gov//28962854///" style=\"text-decoration:underline\">risk of cognitive impairment and dementia<\/a> will be higher than someone who spends less time sitting.<\/p>\r\n\r\n<h2>Is television actually bad for your brain?<\/h2>\r\n\r\nOkay, so it's better to exercise than to sit in front of the television. You knew that already, right?<\/p>\r\n\r\nBut if you're getting regular exercise, is watching television still bad for you? The first study suggesting that, yes, television is still bad for your brain was published in 2005. After controlling for year of birth, gender, income, and education, the researchers found that each additional hour of television viewing in middle age <a href=https://www.health.harvard.edu/"https:////pubmed.ncbi.nlm.nih.gov//15919546///" style=\"text-decoration:underline\">increased risk for developing Alzheimer's disease 1.3 times<\/a>. Moreover, participating in intellectually stimulating activities and social activities reduced the risk of developing Alzheimer's.<\/p>\r\n\r\nAlthough this study had fewer than 500 participants, its findings had never been refuted. But would these results hold up when a larger sample was examined?<\/p>\r\n\r\n<h2>Television viewing and cognitive decline<\/h2>\r\n\r\nIn 2018, the <a href=https://www.health.harvard.edu/"https:////journals.plos.org//plosmedicine//article?id=10.1371\/journal.pmed.1001779\%22 style=\"text-decoration:underline\">UK Biobank study<\/a> began to follow approximately 500,000 individuals in the United Kingdom who were 37 to 73 years old when first recruited between 2006 and 2010. The demographic information reported was somewhat sparse: 88% of the sample was described as white and 11% as other; 54% were women.<\/p>\r\n\r\nThe researchers <a href=https://www.health.harvard.edu/"https:////academic.oup.com//aje//article//187//3//441//3964401/" style=\"text-decoration:underline\">examined baseline participant performance<\/a> on several different cognitive tests, including those measuring<\/p>\r\n\r\n<ul>\r\n\t<li>prospective memory (remembering to do an errand on your way home)<\/li>\r\n\t<li>visual-spatial memory (remembering a route that you took)<\/li>\r\n\t<li>fluid intelligence (important for problem solving)<\/li>\r\n\t<li>short-term numeric memory (keeping track of numbers in your head).<\/li>\r\n<\/ul>\r\n\r\nFive years later, many participants repeated certain tests. Depending on the test, the number of participants evaluated ranged from 12,091 to 114,373. The results of this study were clear. First, at baseline, more television viewing time was linked with worse cognitive function across all cognitive tests.<\/p>\r\n\r\nMore importantly, television viewing time was also linked with a decline<\/em> in cognitive function five years later for all cognitive tests. Although this type of study cannot prove that television viewing caused the cognitive decline, it suggests that it does.<\/p>\r\n\r\nFurther, the type of sedentary activity chosen mattered. Both driving and television were linked to worse cognitive function. But computer use was actually associated with better<\/em> cognitive function at baseline, and a lower likelihood of cognitive decline over the five-year study.<\/p>\r\n\r\n<h2>Television viewing and dementia<\/h2>\r\n\r\nIn 2022, researchers analyzed this same UK Biobank sample with another question in mind: Would time spent watching television versus using a computer result in different risks of developing dementia over time?<\/p>\r\n\r\n<a href=https://www.health.harvard.edu/"https:////www.pnas.org//doi//10.1073//pnas.2206931119/" style=\"text-decoration:underline\">Their analyses<\/a> included 146,651 people from the UK Biobank, ages 60 and older. At the start of the study, none had been diagnosed with dementia.<\/p>\r\n\r\nOver 12 years, on average, 3,507 participants (2.4%) were diagnosed with dementia. Importantly, after controlling for participant physical activity:<\/p>\r\n\r\n<ul>\r\n\t<li>time spent watching television increased the risk of dementia<\/li>\r\n\t<li>time spent using the computer decreased the risk of dementia.<\/li>\r\n<\/ul>\r\n\r\nThese changes in risk were not small. Those who watched the most television daily — more than four hours — were 24% more likely to develop dementia. Those who used computers interactively (not passively streaming) more than one hour daily as a leisure activity were 15% less likely to develop dementia.<\/p>\r\n\r\nStudies like these can only note links between behaviors and outcomes. It's always possible that the causation works the other way around. In other words, it's possible that people who were beginning to develop dementia started to watch television more and use the computer less. The only way to know for sure would be to randomly assign people to watch specific numbers of hours of television each day while keeping the amount of exercise everyone did the same. That study is unlikely to happen.<\/p>\r\n\r\n<h2>The bottom line<\/h2>\r\n\r\nIf you watch more than one hour of TV daily, my recommendation is to turn it off and do activities that we know are good for your brain. Try physical exercise, <a href=https://www.health.harvard.edu/"https:////www.pnas.org//doi//10.1073//pnas.2206931119/" style=\"text-decoration:underline\">using the computer<\/a>, doing <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//blog//have-you-done-your-crossword-puzzle-today-202211292857/" style=\"text-decoration:underline\">crossword puzzles<\/a>, <a href=https://www.health.harvard.edu/"https:////www.health.harvard.edu//blog//why-is-music-good-for-the-brain-2020100721062/" style=\"text-decoration:underline\">dancing and listening to music<\/a>, and participating in social and other cognitively stimulating activities.<\/p>","excerpt":"More physical activity and less time watching TV is best for the body. But how does television time affect risk for declines in memory and problem-solving ability or risk for developing dementia? Researchers have been digging into these questions.<\/p>","short_excerpt":"\n More physical activity and less time watching TV is best for the body. But how does television time affect risk for declines in memory and problem-solving ability or risk for developing dementia? Researchers have been digging into these questions.<\/p>\n ","description":null,"author":null,"slug":"does-less-tv-time-lower-your-risk-for-dementia-202304102910","sort_date":"2023-04-10T04:00:00.000000Z","contentable_type":"App\\Models\\Marketing\\BlogPost","contentable_id":2910,"replacement_content_id":null,"landing_page_landing_page_group_id":null,"ucr_content_id":"BL031023","publication_date":"2023-04-10T04:00:00.000000Z","last_review_date":null,"imported_at":"2023-04-23T04:00:00.000000Z","last_import_type":"update","last_modified_date":"2023-04-22T04:00:00.000000Z","active":1,"created_at":"2023-04-07T18:35:08.000000Z","updated_at":"2023-04-25T20:25:55.000000Z","deleted_at":null,"images_remapped":0,"old_product_id":null,"old_content_id":null,"hide_ads":0,"primary_content_topic_id":null,"ecommerce_type":"CATALOG","authors":[{"id":209,"cr_id":538,"featured":1,"hhp_staff":0,"hidden":0,"name":"Andrew E. Budson, MD","title":null,"first_name":"Andrew","middle_name":"E.","last_name":"Budson","suffix":"MD","slug":"andrew-e-budson-md","byline":"Contributor; Editorial Advisory Board Member, Harvard Health Publishing","description":"Dr. Andrew E. Budson is chief of cognitive & behavioral neurology at the Veterans Affairs Boston Healthcare System, lecturer in neurology at Harvard Medical School, and chair of the Science of Learning Innovation Group at the Harvard Medical School Academy. Graduating cum laude from Harvard Medical School in 1993, he has given over 750 local, national, and international grand rounds and other talks; published over 125 scientific papers, reviews, and book chapters; and co-authored or edited eight books.<\/p>\r\n\r\nHis book Seven Steps to Managing Your Memory: What’s Normal, What’s Not, and What to Do About It<\/em> explains how individuals can distinguish changes in memory due to Alzheimer’s versus normal aging; what medications, vitamins, diets, and exercise regimens can help; and the best habits, strategies, and memory aids to use; it is being translated into Chinese and Korean. His book Memory Loss, Alzheimer’s Disease, and Dementia: A Practical Guide for Clinicians<\/em> has been translated into Spanish, Portuguese, and Japanese. His book Six Steps to Managing Alzheimer’s Disease and Dementia: A Guide for Families<\/em> teaches caregivers how they can manage all the problems that come with dementia — and still take care of themselves. His latest book, Why We Forget and How to Remember Better: The Science Behind Memory<\/em>, explains the science of memory and how to use that knowledge to improve our ability to remember in daily life. \r\n \r\nWebsite: <a href=https://www.health.harvard.edu/"http:////www.AndrewBudsonMD.com/" rel=\"noopener noreferrer\" target=\"_blank\">Andrew Budson, MD<\/a> \r\n \r\nFacebook: <a href=https://www.health.harvard.edu/"https:////www.facebook.com//AndrewBudsonMD///" rel=\"noopener noreferrer\" target=\"_blank\">Andrew Budson, MD<\/a> \r\n \r\nTwitter: <a href=https://www.health.harvard.edu/"https:////twitter.com//abudson/" rel=\"noopener noreferrer\" target=\"_blank\">@abudson<\/a><\/p>","image_url":"https:\/\/d2icykjy7h7x7e.cloudfront.net\/authors\/1LrXGP2mmMihd5vMLhBqDR3KpvVGOmwufvdTbAgq.jpg","twitter_username":null,"sort_order":0,"created_at":"2021-05-11T10:55:26.000000Z","updated_at":"2023-02-28T18:13:49.000000Z","deleted_at":null,"pivot":{"content_id":17977,"author_id":209,"sort_order":1}}],"contentable":{"id":2910,"comments_open":1,"created_at":"2023-04-07T18:35:08.000000Z","updated_at":"2023-04-25T20:25:55.000000Z","deleted_at":null,"media":[]},"content_type":{"id":18,"name":"blog","slug":"blog","created_at":"2021-05-11T08:30:32.000000Z","updated_at":"2021-05-11T08:30:32.000000Z","deleted_at":null},"media":[{"id":13748,"model_type":"App\\Models\\Marketing\\Content","model_id":17977,"uuid":"93476235-1b72-42c9-91d0-9d16ca1250f8","collection_name":"contents","name":"a0d7f2b7-bbfa-46ff-b9b7-48f516870e02","file_name":"a0d7f2b7-bbfa-46ff-b9b7-48f516870e02.jpg","mime_type":"image\/jpeg","disk":"s3","conversions_disk":"s3","size":107803,"manipulations":[],"custom_properties":{"alt":"Smiling couple sitting on couch watching TV; man with short brown hair points remote, woman has white hair; bowl of popcorn rests on blanket "},"generated_conversions":{"micro":true,"thumb":true},"responsive_images":[],"order_column":13706,"created_at":"2023-04-07T18:35:08.000000Z","updated_at":"2023-04-07T18:35:11.000000Z","full_url":"https:\/\/domf5oio6qrcr.cloudfront.net\/medialibrary\/13748\/a0d7f2b7-bbfa-46ff-b9b7-48f516870e02.jpg"}],"primary_content_topic":null}], currentIndex: 0 }" x-on:slide-change.window="currentIndex = $event.detail.currentIndex" >
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COVID-19 basics

April 11, 2023

Symptoms, spread and other essential information about the coronavirus and COVID-19

As we continue to learn more about coronavirus and COVID-19, it can help to reacquaint yourself with some basic information. For example, understanding how the virus spreads reinforces the importance of prevention measures. Knowing how COVID has impacted people of all ages may reinforce the need for everyone to adopt health-promoting behaviors. And reviewing the common symptoms of COVID-19 can help you know if it's time to get tested and self-isolate.

community levels of COVID-19 infection<\/a> are moderate or high, or if you are at increased risk for severe infection.<\/li>\r\n\t<li><a href=https://www.health.harvard.edu/"https:////www.cdc.gov//coronavirus//2019-ncov//prevent-getting-sick//prevention.html#ventilation\">Improve indoor ventilation<\/a>.<\/li>\r\n\t<li>Get tested for COVID-19 if needed.<\/li>\r\n\t<li>Stay home if you have suspected or confirmed COVID-19.<\/li>\r\n\t<li>Avoid contact with people who have suspected or confirmed COVID-19.<\/li>\r\n\t<li><a href=https://www.health.harvard.edu/"https:////www.cdc.gov//coronavirus//2019-ncov//prevent-getting-sick//prevention.html/">Follow recommendations<\/a> for what to do if you have been exposed.<\/li>\r\n\t<li>Seek treatment if you have COVID-19 and are at high risk of getting very sick.<\/li>\r\n<\/ul>"},{"order":1,"title":"What is coronavirus?","content":"Coronaviruses are an extremely common cause of colds and other upper respiratory infections. SARS-CoV-2, short for severe acute respiratory syndrome coronavirus 2, is the official name for the coronavirus responsible for COVID-19.<\/p>"},{"order":2,"title":"What is COVID-19?","content":"COVID-19, short for "coronavirus disease 2019," is the name of the disease caused by the SARS-CoV-2 coronavirus.<\/p>"},{"order":3,"title":"How many people have COVID-19?","content":"The numbers are changing rapidly.<\/p>\r\n\r\nThe most up-to-date information is available from the <a href=https://www.health.harvard.edu/"https:////www.who.int//emergencies//diseases//novel-coronavirus-2019//situation-reports///" target=\"_blank\">World Health Organization<\/a>, the <a href=https://www.health.harvard.edu/"https:////www.cdc.gov//coronavirus//2019-ncov//cases-in-us.html/" target=\"_blank\">US Centers for Disease Control and Prevention<\/a>, and <a href=https://www.health.harvard.edu/"https:////urldefense.proofpoint.com//v2//url?u=https-3A__www.arcgis.com_apps_opsdashboard_index.html-23_bda7594740fd40299423467b48e9ecf6&d=DwMF-g&c=WO-RGvefibhHBZq3fL85hQ&r=7DVYAyfgxYC9a8hZlpV7pHQav5syXVQFU6Wt6FNPLGA&m=gjg2Esgb2K3_z_T8A06LJe_bhEkFI2PHfBwPrEqlsQ8&s=AN5Hf6qM7XqjwnR1dOTA0lf3HnOXMCA0tzTakQ489CE&e=\%22 target=\"_blank\">Johns Hopkins University<\/a>.<\/p>\r\n\r\nIn March 2020, the World Health Organization declared COVID-19 a pandemic (a term indicating that it has affected a large population, region, country, or continent).<\/p>"},{"order":4,"title":"What are the symptoms of COVID-19?","content":"Symptoms of COVID-19 infection have evolved over time. Common symptoms of the XBB.1.5 Omicron variant include fever, chills, fatigue, muscle or body aches, and sore throat. In some people, COVID-19 causes more severe symptoms like high fever, severe cough, and shortness of breath, which may indicate pneumonia. Some people infected with the virus have no symptoms.<\/p>\r\n\r\nPeople infected with the newer COVID-19 can also experience neurological, muscular, and\/or gastrointestinal (GI) symptoms These may occur with or without respiratory symptoms. Similar to respiratory symptoms, these other problems have also tended to be less severe than those caused by the original virus. Neurological and muscular symptoms seen in people with COVID-19 include muscle weakness and tingling. Loss of smell and diminished taste have become less common with more recent variants. GI symptoms from all COVID-19 variants include loss of appetite, nausea, vomiting, and diarrhea.<\/p>"},{"order":5,"title":"Do adults younger than 65 who are otherwise healthy need to worry about COVID-19?","content":"Yes, they do. Although the risk of serious illness or death from COVID-19 increases steadily with age, younger people can get sick enough from the disease to require hospitalization. And certain underlying medical conditions may increase the risk of serious COVID-19 for individuals of any age.<\/p>\r\n\r\nEveryone, including younger and healthier people, should get the vaccine once they are eligible, to protect both themselves and their community. Vaccines offer excellent (though not complete) protection against moderate to severe disease, hospitalization, and death.<\/p>\r\n\r\nIn addition, the CDC advises everyone — vaccinated and unvaccinated — to wear masks in public indoor places in areas of the country with substantial or high transmission of the virus. The CDC also advises anyone at increased risk to wear a mask indoors, regardless of the level of community transmission. For people who are not fully vaccinated, the CDC continues to recommend mask wearing and other preventive measures such as physical distancing in some outdoors settings and in most indoor settings.<\/p>\r\n\r\nTo check the level of virus transmission in your area, <a href=https://www.health.harvard.edu/"https:////covid.cdc.gov//covid-data-tracker//#county-view\" target=\"_blank\">visit the CDC's COVID Data Tracker.<\/a><\/p>"},{"order":6,"title":"To what extent have younger adults been impacted by COVID-19?","content":"According to the CDC's <a href=https://www.health.harvard.edu/"https:////covid.cdc.gov//covid-data-tracker//#datatracker-home\" target=\"_blank\">COVID Data Tracker<\/a>, through mid-November 2021, about 38% of COVID cases in the US have been in adults aged 18 to 39 years. However, younger adults are less likely than older adults to die of COVID-19: Adults in the 18 to 39 age range account for about 2.4% of COVID deaths, compared to 76.8% for people older than 65.<\/p>\r\n\r\nBut younger people can<\/em> get sick enough from the disease to require hospitalization or to die. And they may be among the long haulers — people who continue to experience fatigue, brain fog, shortness of breath, or other symptoms weeks and months after their illness.<\/p>\r\n\r\nAnd as is true in other age groups, COVID illness and death has a disproportionate impact on younger adults of color.<\/p>\r\n\r\nEveryone, including younger and healthier people, should get the vaccine once they are eligible.<\/p>"},{"order":7,"title":"How soon can a person exposed to the virus expect symptoms to start?","content":"The time from exposure to symptom onset (known as the incubation period) for XBB.1.5, the most commonly circulating variant as of April 2023, is usually within three to five days. Importantly, a person infected with the virus is already contagious one to two days before symptom onset, and remains contagious for at least two to three days after symptoms begin.<\/p>"},{"order":8,"title":"Can COVID-19 symptoms worsen rapidly after several days of illness?","content":"Common symptoms of COVID-19 include fever, dry cough, fatigue, loss of appetite, loss of smell, and body ache. In some people, COVID-19 causes more severe symptoms like high fever, severe cough, and shortness of breath, which often indicates pneumonia.<\/p>\r\n\r\nA person may have mild symptoms for about one week, then worsen rapidly. Let your doctor know if your symptoms quickly worsen over a short period of time. Also call the doctor right away if you or a loved one with COVID-19 experience any of the following emergency symptoms: trouble breathing, persistent pain or pressure in the chest, confusion or inability to arouse the person, or bluish lips or face.<\/p>"},{"order":9,"title":"One of the symptoms of COVID-19 is shortness of breath. What does that mean?","content":"Shortness of breath refers to unexpectedly feeling out of breath, or winded. But when should you worry about shortness of breath? There are many examples of temporary shortness of breath that are not worrisome. For example, if you feel very anxious, it's common to get short of breath and then it goes away when you calm down.<\/p>\r\n\r\nHowever, if you find that you are ever breathing harder or having trouble getting air each time you exert yourself, you always need to call your doctor. That was true before we had COVID-19, and it will still be true after it is over.<\/p>"},{"order":10,"title":"Is a lost sense of smell a symptom of COVID-19? What should I do if I lose my sense of smell?","content":"A lost sense of smell, known medically as anosmia, is a common symptom of COVID-19. This is not surprising, because viral infections are a leading cause of loss of sense of smell, and COVID-19 is a caused by a virus. Still, loss of smell with COVID-19 appears to occur much more often compared to other viral infections. So, this symptom may help doctors identify people who do not have other symptoms, but who might be infected with the COVID-19 virus — and who might be unwittingly infecting others.<\/p>\r\n\r\nIn addition to COVID-19, loss of smell can also result from allergies as well as other viruses, including rhinoviruses that cause the common cold. So anosmia alone does not mean you have COVID-19.<\/p>\r\n\r\nTell your doctor right away if you find yourself newly unable to smell. He or she may prompt you to get tested and to self-isolate.<\/p>\r\n\r\nA November 2021 report published in JAMA Otolaryngology – Head and Neck Surgery<\/em> found that between 700,000 and 1.6 million people in the US have experienced COVID-related loss or impaired sense of smell that lasted more than six months.<\/p>\r\n\r\nIn nearly all cases, however, sense of smell returns within one year. A study of nearly 100 COVID patients who lost their sense of smell found that 86% recovered their sense of smell by six months after infection, and 96% recovered their sense of smell within 12 months after infection.<\/p>"},{"order":11,"title":"What are cytokine storms and what do they have to do with COVID-19?","content":"A cytokine storm is an overreaction of the body's immune system. In some people with COVID-19, the immune system releases immune messengers, called cytokines, into the bloodstream out of proportion to the threat or long after the virus is no longer a threat.<\/p>\r\n\r\nWhen this happens, the immune system attacks the body's own tissues, potentially causing significant harm. A cytokine storm triggers an exaggerated inflammatory response that may damage the liver, blood vessels, kidneys, and lungs, and increase formation of blood clots throughout the body. Ultimately, the cytokine storm may cause more harm than the coronavirus itself.<\/p>\r\n\r\nA simple blood test can help determine whether someone with COVID-19 may be experiencing a cytokine storm. Many doctors, including those in the United States, have been treating very ill COVID-19 patients with dexamethasone and other corticosteroids (prednisone, methylprednisolone). Corticosteroids are potent anti-inflammatory drugs and thus make biologic sense for those patients who have developed an exaggerated inflammatory response to the viral infection.<\/p>"},{"order":12,"title":"Does COVID-19 cause strokes? What about blood clots in other parts of the body?","content":"Strokes occur when the brain's blood supply is interrupted, usually by a blood clot. There have been reports of a greater-than-expected number of younger patients being hospitalized for, and sometimes dying from, serious strokes. These strokes are happening in patients who test positive for coronavirus but who do not have any traditional risk factors for stroke. They tend to have no COVID-19 symptoms, or only mild symptoms. The type of stroke occurring in these patients typically occurs in much older patients.<\/p>\r\n\r\nCOVID-related strokes occur because of a body-wide increase in blood clot formation, which can damage any organ, not just the brain. A blood clot in the lungs is called pulmonary embolism and can cause shortness of breath, chest pain, or death; a blood clot in or near the heart can cause a heart attack; and blood clots in the kidneys can cause kidney damage requiring dialysis.<\/p>\r\n\r\nOne possible reason for COVID-related blood clots may be a disturbance in the levels of a protein, called factor V, that is involved in blood clotting.<\/p>"},{"order":13,"title":"Can COVID-19 affect brain function?","content":"COVID-19 does appear to affect brain function in some people. Specific neurological symptoms seen in people with COVID-19 include loss of smell, inability to taste, muscle weakness, tingling or numbness in the hands and feet, dizziness, confusion, delirium, seizures, and stroke.<\/p>\r\n\r\nOne study that looked at 214 people with moderate to severe COVID-19 in Wuhan, China found that about one-third of those patients had one or more neurological symptoms. Neurological symptoms were more common in people with more severe disease.<\/p>\r\n\r\nNeurological symptoms have also been seen in COVID-19 patients in the US and around the world. Some people with neurological symptoms tested positive for COVID-19 but did not have any respiratory symptoms like coughing or difficulty breathing; others experienced both neurological and respiratory symptoms.<\/p>\r\n\r\nExperts do not know how the coronavirus causes neurological symptoms. They may be a direct result of infection or an indirect consequence of inflammation or altered oxygen and carbon dioxide levels caused by the virus.<\/p>\r\n\r\n"New confusion or inability to rouse" is on the CDC’s list of emergency warning signs that should prompt you to get immediate medical attention.<\/p>"},{"order":14,"title":"How does coronavirus spread?","content":"The coronavirus spreads mainly from person to person. A person infected with coronavirus — even one with no symptoms — may emit aerosols when they talk or breathe. Aerosols are infectious viral particles that can float or drift around in the air for up to three hours. Another person can breathe in these aerosols and become infected with the coronavirus.<\/p>\r\n\r\nWhen people are in close contact with one another, droplets that are produced when an infected person coughs or sneezes may land in the mouths or noses of people who are nearby, or possibly be inhaled into their lungs.<\/p>\r\n\r\nTransmission is less likely to happen outdoors, where air currents scatter and dilute the virus, than in a home, office, or other confined space with limited air circulation.<\/p>\r\n\r\nThe risk of spread from contact with contaminated surfaces or objects is considered to be extremely low. According to the CDC, each contact with a contaminated surface has less than a 1 in 10,000 chance of causing an infection.<\/p>\r\n\r\nThe virus may be shed in saliva, semen, and feces; whether it is shed in vaginal fluids isn't known. Kissing can transmit the virus. Transmission of the virus through feces, or during vaginal or anal intercourse or oral sex, appears to be extremely unlikely at this time.<\/p>"},{"order":15,"title":"I\u2019m vaccinated but got a breakthrough COVID infection. Can I still spread the infection to others?","content":"Yes, you can. That's why the CDC recommends that everyone who tests positive for COVID-19 should isolate from others for at least five days, regardless of their vaccination status.<\/p>"},{"order":16,"title":"Can people without symptoms spread the virus to others?","content":""Without symptoms" can refer to two groups of people: those who eventually do have symptoms (pre-symptomatic) and those who never go on to have symptoms (asymptomatic). During this pandemic, we have seen that people without symptoms can spread the coronavirus infection to others.<\/p>\r\n\r\nA person with COVID-19 may be contagious 48 hours before starting to experience symptoms. In fact, people without symptoms may be more likely to spread the illness, because they are unlikely to be isolating and may not adopt behaviors designed to prevent spread.<\/p>\r\n\r\nBut what about people who never go on to develop symptoms? A study <a href=https://www.health.harvard.edu/"https:////pubmed.ncbi.nlm.nih.gov//33410879///" target=\"_blank\">published in JAMA Network Open<\/em><\/a> found that almost one out of every four infections may be transmitted by individuals with asymptomatic infections. The proportion of asymptomatic transmission appears to be even higher with the Omicron variant.<\/p>\r\n\r\nGetting vaccinated and boosted once you are eligible is important for protecting not just yourself but others as well; evidence suggests that you're less likely to infect others, or may be contagious for a shorter period of time, once you've been vaccinated.<\/p>"},{"order":17,"title":"Are kids any more or less likely than adults to spread coronavirus?","content":"Most children who become infected with the COVID-19 virus have no symptoms, or they have milder symptoms such as low-grade fever, fatigue, and cough. Early studies suggested that children do not contribute much to the spread of coronavirus. But more recent studies indicate that children are capable of spreading the infection.<\/p>\r\n\r\nThough the studies varied in their methods, their findings were similar: infected children had as much, or more, coronavirus in their upper respiratory tracts as infected adults. And a November 2021 study conducted by Harvard researchers again confirmed that children carry live virus capable of infecting others.<\/p>\r\n\r\nThe amount of virus found in children — their viral load — was not correlated with the severity of their symptoms. In other words, a child with mild or no symptoms may have just as many viral particles in their nose and mouth as a child that has more severe symptoms. So, the presence of a high viral load in infected children increases the likelihood that children, even those without symptoms, could readily spread the infection to others.<\/p>\r\n\r\nThe bottom line? Public health measures are as important for kids and teens as they are for adults.<\/p>"},{"order":18,"title":"What does the CDC's definition of \"close contacts\" mean for me?","content":"The CDC defines a close contact as someone who spends 15 minutes or more within six feet of a person with COVID-19 over a period of 24 hours<\/em>.<\/p>\r\n\r\nClose contacts are at increased risk of infection. When a person tests positive for COVID-19, contact tracers may identify their close contacts and notify them that they have been exposed.<\/p>\r\n\r\nMany factors can affect the chances that infection will spread from one person to another. These factors include whether or one or both people are wearing masks, whether the infected person is coughing or showing other symptoms, and whether the encounter occurred indoors or outdoors.<\/p>"},{"order":19,"title":"How could contact tracing help slow the spread of COVID-19?","content":"Anyone who comes into close contact with someone who has COVID-19 is at increased risk of becoming infected themselves, and of potentially infecting others. Contact tracing can help prevent further transmission of the virus by quickly identifying and informing people who may be infected and contagious, so they can take steps to not infect others.<\/p>\r\n\r\nContact tracing begins with identifying everyone that a person recently diagnosed with COVID-19 has been in contact with since they became contagious. In the case of COVID-19, a person may be contagious 48 to 72 hours before they started to experience symptoms.<\/p>\r\n\r\nThe contacts are notified about their exposure. They may be told what symptoms to look out for, advised on when to get tested for the virus, whether and for how long to isolate themselves, and to seek medical attention as needed if they start to experience symptoms.<\/p>"},{"order":20,"title":"How long can the coronavirus stay airborne? I have read different estimates.","content":"A study done by National Institute of Allergy and Infectious Diseases' Laboratory of Virology in the Division of Intramural Research in Hamilton, Montana helps to answer this question. The researchers used a nebulizer to blow coronaviruses into the air. They found that infectious viruses could remain in the air for up to three hours. The results of the study were published in the New England Journal of Medicine<\/em> on March 17, 2020.<\/p>"},{"order":21,"title":"Can the COVID-19 virus spread through air conditioning?","content":"We don't know for certain if the COVID-19 virus spreads through air conditioning. But we do know that when it's hot and humid, people are more likely to stay indoors, with the windows closed — giving the virus more opportunity to spread.<\/p>\r\n\r\nCoronavirus spreads through droplets that an infected person emits through coughs or sneezes and through smaller, infectious viral particles that can drift around in the air for several hours. Outdoors, air currents can scatter and dilute the virus, making transmission less likely. You're more likely to inhale the virus indoors, with the windows closed, whether or not you have the air conditioning on.<\/p>\r\n\r\nIf you are indoors with anyone outside of your household, increase air circulation by keeping the windows open as much as possible.<\/p>"},{"order":22,"title":"Can I catch the coronavirus by eating food handled or prepared by others?","content":"According to the CDC, the risk of getting COVID-19 by handling or consuming food from a restaurant, takeout, or drive-through is very low.<\/p>"},{"order":23,"title":"What is the naming system for COVID-19 variants?","content":"The WHO announced a new naming system for COVID-19 variants in May 2021. The new names are intended to be easier to pronounce and will remove the stigma of a variant’s being associated with a particular country.<\/p>\r\n\r\nUnder the new system, the variants will be named using letters of the Greek alphabet. For example:<\/p>\r\n\r\n<ul>\r\n\t<li>Alpha is the new name for the B.1.1.7 variant, first documented in the United Kingdom.<\/li>\r\n\t<li>Beta is the new name for the B.1.351 variant, first documented in South Africa.<\/li>\r\n\t<li>The P.1 variant, first documented in Brazil, will now be known as Gamma.<\/li>\r\n\t<li>The B.1.617.2 variant, first documented in India, will be called Delta.<\/li>\r\n<\/ul>\r\n\r\nFor a complete list of new SARS-CoV-2 variant names, <a href=https://www.health.harvard.edu/"https:////www.who.int//en//activities//tracking-SARS-CoV-2-variants///" target=\"_blank\">click here<\/a>.<\/p>\r\n\r\nScientists will likely continue referring to variants by strings of letters and numbers, which provide information about a variant’s lineage.<\/p>"},{"order":24,"title":"What do we know about the Omicron variant?","content":"The Omicron variant, also known as B.1.1.529, is now the most common SARS-CoV-2 variant in the US. This variant has about 50 mutations, including more than 30 mutations on the spike protein, the region of the virus that binds to and allows the virus to enter human cells. Here’s what we know about it.<\/p>\r\n\r\nHow transmissible is Omicron?<\/strong><\/p>\r\n\r\nDr. Anthony Fauci, Chief Medical Advisor to the President of the US, said in a White House press briefing, "…we know now incontrovertibly that this is a highly, highly transmissible virus…" A report from the United Kingdom found that someone infected with the Omicron variant is three times more likely to infect a member of their household than someone infected with the Delta variant. According to the CDC, most transmission occurs in the one to two days before symptoms begin and the two to three days after.<\/p>\r\n\r\nHow well does Omicron evade protection from vaccines?<\/strong><\/p>\r\n\r\nSeveral studies, including some presented at a <a href=https://www.health.harvard.edu/"https:////www.who.int//news-room//events//detail//2021//12//15//default-calendar//who-global-consultation---what-evidence-do-we-have-that-omicron-is-evading-immunity-and-what-are-the-implications/" target=\"_blank\">WHO meeting<\/a> in mid-December, have shown that two doses of an mRNA vaccine like Pfizer\/BioNTech or Moderna do not protect as well against infection with Omicron as they did against previous SARS-CoV-2 variants.<\/p>\r\n\r\nOne small laboratory study conducted by researchers in South Africa, for example, found a 41-fold decrease in neutralization (the ability of antibodies to prevent the virus from infecting cells) with Omicron compared to the earlier coronavirus variant. Pfizer\/BioNTech also released data from a laboratory study showing a significantly decreased antibody response to Omicron after two vaccine doses.<\/p>\r\n\r\nThis all suggests that Omicron is more capable of causing breakthrough infections (in people who are vaccinated) and reinfections (in people who were previously infected).<\/p>\r\n\r\nMore promising findings from Pfizer\/BioNTech showed that after three vaccine doses (two doses plus a booster), the neutralizing antibody response was much stronger. Preliminary research from the National Institute of Allergy and Infectious Disease’s Vaccine Research Center, conducted in the lab using the Moderna vaccine, similarly showed that boosters increase antibody-derived protection.<\/p>\r\n\r\nThe benefit of boosters is also being seen in the real world. In one preprint study (not yet peer-reviewed or published), researchers in the United Kingdom showed that protection against infection and mild disease increased from about 40% four months after two Pfizer\/BioNTech shots to about 75% within two weeks after a booster dose. This study took place during a time when Omicron cases were rising in the UK.<\/p>\r\n\r\nHow might boosters help? Booster-generated antibodies are not more specific to the Omicron variant. But the sheer increase in antibody levels helps enhance our immunity.<\/p>\r\n\r\nWhat’s more, the vaccines continue to significantly protect against severe symptoms, hospitalization, and death, especially for people who have received a booster. That’s because in addition to stimulating an antibody response, vaccines also stimulate production of T cells, a type of immune cell that attacks infected cells. In a preprint study, an international team of researchers showed that the T cell response holds up well in people who are vaccinated or were previously infected with SARS-CoV-2. Specifically, the researchers found that CD4 and CD8 T cells retained 70% to 80% of their response to Omicron.<\/p>\r\n\r\nIs Omicron more or less virulent than previous variants?<\/strong><\/p>\r\n\r\nLab studies, animal studies, and epidemiological data all indicate that Omicron may cause less severe disease than previous variants, and a few of the studies provide clues as to why that may be the case. A team of researchers in Hong Kong, for example, wrote in a preprint study that the Omicron virus replicates more quickly in the bronchi (tubes that deliver air from the windpipe to the lungs) than it does in the lungs themselves. This is significant because once in the lungs, the virus can lead to scarring and difficulty breathing, and trigger widespread inflammation. The Hong Kong study was conducted in a laboratory on human tissue. Animal studies in mice and hamsters also show more viral replication in the upper airway compared to the lungs, and less clinical illness (in these animals, that means less weight loss, lung damage, and death).<\/p>\r\n\r\nIn real-world findings, data from the United Kingdom show significant reduction in the risk of hospitalization from Omicron compared to Delta, and data from the US show that even after accounting for a time lag, hospitalizations and deaths are not increasing in proportion to the increased number of infections.<\/p>\r\n\r\nThere are probably many reasons for the reduced disease severity we’re seeing, including some protection from vaccines and previous infections, as well as the likelihood that this variant inherently causes less severe disease than previous variants.<\/p>\r\n\r\nStill, two things are important to consider: First, this variant is more transmissible, so even if it is not as dangerous, it will lead to a larger number of severe illnesses, hospitalizations, and deaths, based simply on the increased number of people it infects. And second, the risk of severe disease with Omicron is much higher in people who are not vaccinated.<\/p>\r\n\r\nWhich preventive health measures are effective?<\/strong><\/p>\r\n\r\nFirst and foremost, get vaccinated and boosted. The evidence is clear that booster shots sharply increase antibody levels, which helps fend off infection and illness.<\/p>\r\n\r\nPreventive health measures build upon one another, and the same measures that helped protect against previous variants protect against Omicron. In addition to getting vaccinated, everyone should<\/p>\r\n\r\n<ul>\r\n\t<li>wear a well-fitting, high-quality mask<\/li>\r\n\t<li>wash hands frequently<\/li>\r\n\t<li>physically distance from others<\/li>\r\n\t<li>improve indoor ventilation (open windows, etc.)<\/li>\r\n\t<li>avoid crowded spaces.<\/li>\r\n<\/ul>"},{"order":25,"title":"What do I need to know about the Delta variant?","content":"The Delta variant is different from previous SARS-CoV-2 variants that have made their way to the US. It’s highly contagious and may cause more severe disease. It is also more likely than previous variants to be spread by vaccinated people experiencing breakthrough infections.<\/p>\r\n\r\nEvidence presented to the CDC showed the Delta variant to be much more contagious than previous variants, with a risk of transmission similar to chickenpox. It also appears that people who are infected can spread the virus for longer periods of time.<\/p>\r\n\r\nIn addition, people who are vaccinated and then get infected (breakthrough infections) can also spread the virus to others, perhaps to the same extent as those who are unvaccinated. However, people with breakthrough infections appear to be contagious for a shorter period of time.<\/p>\r\n\r\nFinally, international studies point to the Delta variant being more likely to cause severe disease.<\/p>\r\n\r\nThe good news is that while vaccination may be less effective at preventing infection and spread of the Delta variant, it is still highly protective against severe disease, hospitalization, and death. Get the COVID-19 vaccine if you have not already done so.<\/p>\r\n\r\nIn July 2021, the CDC advised all people — vaccinated and unvaccinated — to wear masks in public indoor places, in areas of the country with substantial or high transmission of the virus. Given the threat posed by the Delta variant, it’s reasonable for everyone to start wearing a mask in indoor public spaces, regardless of the level of virus in your area.<\/p>\r\n\r\nMasks reduce the amount of virus we breathe in, and breathe out. Combined with the vaccine, masks provide a one-two punch that reduces the risk of spread — to children who are not yet eligible for vaccines, to people with weakened immune systems, and to others who are unvaccinated. Masks also provide additional protection for the wearer, including who are fully vaccinated.<\/p>"},{"order":26,"title":"What do I need to know about the AY.4.2 (Delta Plus) variant?","content":"As viruses replicate, they may mutate, or slightly alter their genetic sequence. If a mutation is advantageous — making the virus more transmissible or able to sidestep immune protection — it’s more likely to survive and thrive. That’s what happened with the Delta variant, which was many times more contagious than the original SARS-CoV-2 virus and quickly became the dominant variant around the globe. A new variant called AY.4.2 (or Delta Plus), a descendent of the Delta variant, is now gaining attention.<\/p>\r\n\r\nThe AY.4.2 variant makes up about 11% of sequenced cases in the United Kingdom. It has also been identified in a handful of US states, but at present is responsible for less than 0.1% of COVID-19 cases in the US. The WHO has not classified AY.4.2 as a variant of concern or a variant of interest.<\/p>\r\n\r\nPreliminary evidence from the United Kingdom suggests that AY.4.2 is not more likely to lead to hospitalization or cause severe disease. And in a White House briefing, the CDC director said there is no evidence that this variant is less susceptible to current vaccines and treatments. It also does not appear more adept at evading immune protection.<\/p>\r\n\r\nHowever, there is a lot we still don’t know about the AY.4.2 variant, including whether and to what extent it is more transmissible than the original Delta variant. At this point, it appears to be only slightly more contagious (10% to 15%). Its spread may also be influenced by human behaviors, such as whether people are masking indoors and the degree to which people in a community are vaccinated.<\/p>\r\n\r\nIt seems very likely that we will be living with this virus, and its variants, for some time to come. The best way to minimize the emergence of new variants, and to protect ourselves from variants that already exist, is to vaccinate as many people around the world as possible. Why? Because the less the virus spreads, the less opportunity it has to replicate and mutate. For the same reason, it’s vital to mask indoors, optimize ventilation, get tested if you have symptoms or are exposed to someone with COVID-19, and isolate if you test positive.<\/p>"},{"order":27,"title":"Which vaccines has the FDA approved and authorized for COVID-19?","content":"The FDA has granted full approval to the mRNA COVID-19 vaccines developed by Pfizer\/BioNTech and Moderna, and has granted emergency use authorization (EUA) to Johnson & Johnson's adenovirus vaccine. In May 2022, the FDA limited use of the Johnson & Johnson vaccine to adults who cannot get, or refuse to get, one of the mRNA vaccines.<\/p>\r\n\r\nThe Pfizer\/BioNTech and Moderna vaccines have also been authorized for children ages 6 months and older.<\/p>\r\n\r\nIn addition, booster doses of the Pfizer\/BioNTech and Moderna vaccines have been authorized for eligible children ages 5 years and older.<\/p>"},{"order":28,"title":"Should I get a flu shot?","content":"While the flu shot won't protect you from developing COVID-19, it's still a good idea. Most people older than six months can and should get the flu vaccine. Doing so reduces the chances of getting seasonal flu. Even if the vaccine doesn't prevent you from getting the flu, it can decrease the chance of severe symptoms. But again, the flu vaccine will not protect you against COVID-19.<\/p>"},{"order":29,"title":"Is it safe to use steroids to control allergy and asthma symptoms during the COVID-19 pandemic?","content":"Yes, it is safe to use corticosteroid nasal sprays to control nasal allergies or inhaled corticosteroids to control asthma symptoms during the COVID-19 pandemic.<\/p>\r\n\r\nThe American College of Allergy, Asthma and Immunology (ACAAI) issued a statement emphasizing the importance of controlling allergy and asthma symptoms during the pandemic. They said there is no evidence that intranasal or inhaled corticosteroids increase the risk of getting the COVID-19 infection or lead to a worse outcome if you do get infected.<\/p>\r\n\r\nThe ACAAI statement was a response to concerns over reports warning against the use of systemic steroids to treat hospitalized COVID-19 patients with specific respiratory complications. However, those reports did not refer to healthy individuals using corticosteroid nasal sprays or inhalers to manage allergies or asthma.<\/p>"}])" >
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Podcasts

Thoughts on COVID-19 during this year's flu season (recorded 10/9/2020)

With the COVID-19 pandemic still ongoing, and the annual flu season fast approaching, what can people expect when these two illnesses collide? Are we at greater risk for getting either virus? And could this encounter change how we approach health care now and in the future? Matthew Solan, executive editor of the Harvard Men's Health Watch, talks to Dr. Amy Sherman, an infectious disease expert with Harvard's Brigham and Women's Hospital, about what we may expect when COVID and the flu season meet. To learn more check out our Harvard Medical School Guide, COVID-19, Flu and Colds.

Coronavirus Update: We're facing the start of a second wave (recorded 6/11/2020)

Dr. Ashish K. Jha, head of the Harvard Global Health Institute, offers information on where we are where we're going with the COVID-19 outbreak. Some take-aways:

Communications missteps by the WHO regarding asymptomatic transmission have been quickly corrected. Yes, you can catch COVID-19 from people who are not showing symptoms.

A second wave has begun, particularly in the south and Midwest. And calculations show we'll reach more than 200,000 COVID-19 related deaths by September.

Jha offers advice for parents, teachers and administrators on workable back-to-school scenarios.

We know you don't want to hear it, but COVID-19 will be a fact of global life for the rest of the year until a vaccine becomes widely available.

A Harvard infectious diseases doctor looks at COVID-19 (recorded 3/3/20)

Dr. Todd Ellerin is on the front lines of infectious disease containment and mitigation as the director of infectious diseases at South Shore Health in Weymouth, Massachusetts. He's an instructor at Harvard-affiliated Brigham and Women's Hospital. We spoke to him this week to get an update on the rapidly developing story surrounding the coronavirus Covid-19.

Coronavirus status report: Harvard public health expert Dr. Ashish K. Jha fills us in on where we are headed (recorded 3/19/20)

The COVID-19 outbreak has caused markets to collapse and worldwide health systems to become overwhelmed. When there's a global pandemic, it's nice to hear from the steady, transparent and yes even reassuring voice of experts on the front lines. We spoke to Dr. Ashish K. Jha, faculty director of the Harvard Global Health Institute. Dr. Jha's recent appearance on the PBS Newshour caused reverberations throughout the federal and state response system. Here's his update.

Visit our Coronavirus Resource Center for more information on coronavirus and COVID-19.

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