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Healthwatch
How To Help Your Preschooler Sleep Alone
~2.4 mins read

A wide-awake child leaning over his sleeping mother to wake her by pulling up one eyelid

"Sleep is still most perfect… when it is shared with a beloved," wrote D.H. Lawrence, and most young children would agree. But sometimes those beloved — that is, parents — would rather have some privacy and not be woken by a kicking child all night.

So what can you do?

Sleep-alone campaign step one: Understanding

Before you do anything, be sure you understand why your child wants to sleep with you. It's most likely simply because they love you and feel most secure snuggled next to you, but before you work to change the habit, be sure that your child is ready for — and can handle — the change. If your child has been more clingy or irritable than usual, or is having difficult behaviors in any way, touch base with your doctor.

Sleep-alone campaign step two: Changing habits

Changing where your child sleeps is changing a habit. When it comes to changing habits, it helps to be practical and — this is really important — consistent. Here are some tips:

  • Make an appealing sleep space for your child. Not that anything can really take the place of you, but it is certainly easier to get them to stay in their own room or space if they like it there. Work with them to set up and decorate in a way they like.
  • As you create the space, keep in mind what keeps your child awake. If it's light, use room-darkening curtains. If it's darkness, think night lights and flashlights. If it's noise, think about getting a white-noise machine. Set your child up for success. Please: no TVs or devices in the bedroom. They get in the way of healthy sleep.
  • Have a consistent bedtime. Try not to let your child stay up late — or sleep late — on weekends. This way your child is more likely to be tired when you want them to be tired.
  • Have a consistent, calming, and nurturing bedtime routine. Try to lower the energy level, perhaps with a bath and then some snuggling and reading stories. You want to help them wind down, and also be sure they end the day feeling loved.
  • If your child has a hard time going to bed alone, it's okay to sit in the room and ease yourself out bit by bit after lights are out (you can literally move closer and closer to the door). Try to gradually shorten the time you are in the room.
  • If your child gets out of bed, bring them back to their bed. This is the hard part: your child won't like it, and it can be exhausting for you if they keep creeping out of their bed and into yours. But if you give in and let them stay in your room, they will stay in your room. Every night.
  • Use incentives. Make sure your child gets major kudos for any progress at all — and maybe earns something extra for staying in their own bed all night. Try to steer away from things, if possible, and think more about quality time (an extra story, a fun outing).
  • If nothing is working, or your child is really upset, talk to your doctor. There may be more going on, and the two of you can work together to figure things out and help your child. Both of you deserve a restful night's sleep.

    Follow me on Twitter @drClaire

    Source: Harvard Health Publishing

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    Healthwatch
    Preventing Sudden Heart Death In Children And Teens: 4 Questions Can Help
    ~3.3 mins read

    Photo of doctor and child during medical exam with mother looking on

    It's incredibly rare for a child or teen to die suddenly because of a heart problem, but it's a horrible tragedy when it does, especially because often it could have been prevented — if someone had just asked the right question.

    We tend to think about sudden deaths like these in athletes, since we commonly hear about them happening on a playing field — and because most of the prevention efforts have been aimed at athletes. But they absolutely can happen in children and teens who aren't athletes, according to a 2021 policy statement from the American Academy of Pediatrics. The guidance it offers helps primary care pediatricians better screen their patients for the heart problems that can lead to sudden death. Here's what parents need to understand and do.

    What might cause sudden cardiac arrest or death in children or teens?

    There are several heart conditions that can lead to a risk of sudden death. They include

  • Cardiomyopathies. These are problems with the muscle of the heart. There are a few different kinds, but the kind most likely to lead to sudden death is hypertrophic cardiomyopathy, in which the heart muscle becomes abnormally thick.
  • A problem with a coronary artery. The coronary arteries bring oxygenated blood to the heart muscle. If there is a problem with one or both arteries, the heart muscle may not get that needed blood supply. Called an anomalous coronary artery, this is the second leading cause of sudden death after hypertrophic cardiomyopathy.
  • Problems with the electrical conduction system of the heart. This is the system that causes the heart to contract and move blood through the body. Problems with this conduction system can lead to an arrhythmia — and the heart may not be able to move blood well or at all.
  • Congenital heart disease. When children are born with a heart defect, it puts them at higher risk of arrhythmia, either because of the defect itself or the surgery that was done to treat it.
  • Aortopathies. This is the medical term for having something wrong with the aorta that might lead it to balloon (aneurysm) and split open. (The aorta is the main blood vessel leading from the heart to the rest of the body.) Marfan's syndrome is one condition that can cause this, but there are others as well.
  • Four important screening questions can help identify cardiac risk

    Many of these conditions can and do go unrecognized for years. However, the AAP says that these four questions can help identify which children may be at risk:

  • Have you ever fainted, passed out, or had an unexplained seizure suddenly and without warning, especially during exercise or in response to sudden loud noises such as doorbells, alarm clocks, or ringing telephones?
  • Have you ever had exercise-related chest pain or shortness of breath? Most of the time, this is just from a pulled muscle or asthma. But it may be related to the heart, especially if the pain feels like pressure; radiates to the neck or arm; is associated with sweating, nausea, or fainting; or happens with exercise, straining, or stress.
  • Has anyone in your immediate family (parents, grandparents, siblings) or other more distant relatives (aunts, uncles, cousins) died of heart problems or had an unexpected sudden death before age 50? (This includes unexpected drownings, unexplained car accidents in which the relative was driving, and sudden infant death syndrome, or SIDS.)
  • Are you related to anyone with hypertrophic cardiomyopathy, hypertrophic obstructive cardiomyopathy, Marfan syndrome, arrhythmogenic cardiomyopathy, long QT syndrome, short QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT), or anyone younger than 50 years with a pacemaker or implantable defibrillator?
  • The last question underlines the importance of knowing details of your family history. We don't always like to pry, but knowing the details can be crucial for the health of others in the family. So don't be afraid to ask family members about the exact diagnosis they have been given by a doctor — and then share that diagnosis with your doctor. This is true of all health problems, not just heart problems. Of course, some people may not have access to their family health information.

    How often should this screening be done?

    Ideally, according to the AAP, your child's doctor should ask these questions at routine checkups at least once every three years, or on entry to middle or junior high school and on entry to high school. If the answer is yes to any of the questions, the child should be referred to a cardiologist (or to a cardiologist that specializes in arrhythmias) for further evaluation. Until they are cleared, they shouldn't participate in sports.

    Families don't need to wait for a pediatrician to ask the questions, though. If the answer to any of them is yes, or might be yes, talk to your child's doctor right away. You could literally save your child's life.

    Source: Harvard Health Publishing

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    Healthwatch
    Is The Portfolio Diet The Best Diet Ever?
    ~4.2 mins read

    White table with healthy plant-based foods including Buddha bowl, lettuce wraps, colorful vegetables, grains, legumes, and dips

    News flash: What we eat can play a pivotal role in warding off — or treating — disease and enhancing quality of life. You may already believe this, and certainly mounting evidence supports that idea. But on the cluttered shelf of diets claiming top health benefits, which one ranks as the absolute best?

    That's a trick question. In fact, there is no single best diet. A good diet for me may be different from what's best for you. And for either of us, there may be several good choices with no clear winner.

    How can you choose the right diet for you?

    When thinking about what diet might be best for you, ask yourself:

  • What goals are most important? A goal might be weight loss, improved health, avoiding disease, or something else.
  • How do you define "best"? For some people, best means the diet with the highest number of health benefits. For others, it may focus on one specific health benefit, such as lowering cholesterol. Still other people may prefer a diet that delivers the greatest benefit for the lowest cost. Or a diet that is healthy and also easy to stick with.
  • What health problems do you have? One diet may have an advantage over another depending on whether you have cancer, cardiovascular disease, diabetes, or none of these.
  • Which foods do you like best? Your tastes, culture, and location may shape your dietary preferences, and powerfully affect how likely you are to stick with a specific diet.
  • Which diets are high in health benefits?

    Two very well studied diets demonstrate clear benefit, including lowering risk for heart disease and stroke and reducing high blood pressure: the Mediterranean diet and the DASH diet.

    But the portfolio diet may be as good as or better than these plans, at least for combatting cardiovascular disease that contributes to clogged blood vessels, heart attacks, and stroke. What? You've never heard of the portfolio diet? You're not alone.

    What is the portfolio diet?

    Just as a financial advisor may recommend having a diverse investment portfolio — not just stocks, not just bonds — the portfolio diet follows suit. This largely plant-based diet focuses on diverse foods and food groups proven to lower harmful blood lipids, including LDL (so-called bad cholesterol) and triglycerides.

    If you choose to follow this eating pattern, you simply need to learn which foods have a healthy effect on blood lipids and choose them in place of other foods. For some people, this only requires small tweaks to embrace certain foods while downplaying other choices. Or it may call for a bigger upheaval of longtime eating patterns.

    Which foods are encouraged in the portfolio diet?

    Below are the basics. Eating more of these foods regularly may help lower levels of harmful blood lipids:

  • plant-based proteins such as soy, beans, tofu, peas, nuts, and seeds
  • high-fiber foods such as oats, barley, berries, apples, and citrus fruit; other examples include bran, berries, okra, and eggplant
  • phytosterols, which are a natural compound in plant-based foods such as whole grains, fruits, vegetables, and nuts (other sources are foods fortified with phytosterols or dietary supplements)
  • plant-based oils high in monounsaturated fat such as olive oil, avocado oil, safflower oil, and peanut oil.
  • See? Some of your favorite foods make the cut. That's a major strength of this approach: the list of recommended foods is long. So, it's likely that you're already eating and enjoying some of the recommended foods.

    Which foods are not part of the portfolio diet?

    It's worth highlighting foods that are not on this list, such as

  • red meat
  • highly processed foods
  • refined grains and added sugar, which may contribute to chronic inflammation
  • butter, cream, and other dairy products high in saturated fat and cholesterol.
  • What can the portfolio diet do for you?

    Researchers have shown that the portfolio diet can improve blood lipids. But can it also lower the risk of heart attack, stroke, and other cardiovascular problems?

    Yes, according to a 2023 study published in Circulation. More than nearly 17,000 people kept careful food diaries for 30 years. Those who most closely followed the portfolio diet, compared with those who followed it the least, were more likely to have favorable lipids and inflammation. They were also 14% less likely to have a heart attack, and 14% less likely to have a stroke.

    This was true even after accounting for factors that could affect cardiovascular disease risk, such as taking cholesterol-lowering medications, exercise, smoking, or having diabetes or a family history of cardiovascular disease.

    Because this was an observational study, it can't conclusively prove that the portfolio diet, rather than another factor, was responsible for the observed cardiovascular benefits. And we don't know how much benefit came from reducing or eliminating certain types of foods, rather than from the specific foods eaten.

    Does the portfolio diet help people lose weight or deliver other health advantages?

    What about the portfolio diet for weight loss? Although some people lose weight on the portfolio diet, it's not billed as a weight-loss diet. Understanding its potential benefit for other conditions such as obesity, cognitive decline, diabetes, and cancer awaits further research.

    Go beyond diet to boost health

    Of course, diet is not the only way to improve cardiovascular health and your overall health. You'll stay healthier by

  • not smoking
  • getting regular exercise
  • maintaining a healthy blood pressure and weight
  • preventing diabetes when possible, or getting good medical care to treat it if necessary
  • taking prescribed medications such as cholesterol-lowering drugs.
  • The bottom line

    It's probably best to move past the idea of there being a single best diet. The overall pattern of your diet and your portion sizes are probably more important. For most people, it's also a good idea to move away from restrictive diets that are nearly impossible to stick with and toward healthier overall eating patterns. The portfolio diet checks both those boxes.

    There's a lot of overlap between the portfolio diet and other healthy diets. So, no one should be suggesting it's the best diet ever. But if you're trying to eat healthier, it's a great place to start.

    Source: Harvard Health Publishing

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    Healthwatch
    Finding Omega-3 Fats In Fish: Farmed Versus Wild
    ~0.0 mins read
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    Source: Harvard Health Publishing

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    Healthwatch
    Feel Like You Should Be Drinking Less? Start Here
    ~3.3 mins read

    White notebook with a yellow sticky note that says Drink Less! pinned to the page by a red thumbtack.

    When experts talk about the dangers of excessive drinking, we often assume those warnings apply mostly to people with alcohol use disorder, a health issue sometimes referred to as alcoholism.

    But people who don't meet formal criteria for this disorder can still experience toxic effects and suffer other serious harms from alcohol, says Dr. John F. Kelly, professor of psychiatry in addiction medicine at Harvard Medical School. And as research turns up new evidence about alcohol, many people are considering the benefits of drinking less, even if they're not ready to stop imbibing entirely.

    How does alcohol affect the body?

    That depends on how much you drink. Drinking more than moderate amounts of alcohol (defined as one drink per day for women and two for men) increases your risk for developing

  • liver disease
  • several types of cancer including breast, liver, and colon cancer
  • cardiovascular problems such as high blood pressure and atrial fibrillation.
  • What if you're not drinking daily? "Even people who only drink on weekends can have serious accidents if they become intoxicated — for example, by falling or driving under the influence," says Dr. Kelly.

    What's more, growing evidence suggests that even small amounts of alcohol may harm your health.

    How could cutting down on alcohol help you?

    If you're not ready to give up drinking entirely, cutting back can lower the likelihood of all of these harms. For example, cutting down on alcohol, or stopping entirely, is linked with lower cancer risks, according to a report from the American Association for Cancer Research.

    You might also notice some immediate benefits, like sleeping more soundly, memory improvements, and generally feeling more mentally sharp. And because you'll be taking in fewer calories, you may also shed some weight.

    Ready to try cutting back on alcohol? Start here

    These five suggestions are a great way to start cutting back.

    Keep a drinking diary

    Tracking how much alcohol you drink and when can help you target your efforts to drink less. It's also a good idea to put your reasons for cutting back in writing: for example, "I'd like to sleep better," "I feel sharper," "Better heart health is important to me." That practice can reinforce your resolve to follow through with your plan.

    Try alcohol-free days — or even a month of not drinking

    Taking a break from alcohol can be a good way to start, allowing your brain and body to recalibrate. Decide not to drink a day or two each week. You may want to abstain for a week or a month, to see how you feel physically and emotionally without alcohol in your life. Consider doing Sober October — a variation of Dry January.

    Drink slowly and with food

    Sip your drink. Alternate alcoholic drinks with nonalcoholic alternatives like sparkling water, soda, or juice. Don't drink on an empty stomach, because you'll feel intoxicated more quickly. That can lower your inhibitions and break your resolve to stick to lower amounts of alcohol, Dr. Kelly says. Drinking with a meal slows alcohol absorption and appears to minimize the drug's health risks.

    Try low-alcohol or zero-alcohol substitutes

    Alcohol-free beer, nonalcoholic distilled spirits, and similar products have become more widely available in recent years. It's a result of the alcohol industry's response to stay profitable, as health harms of small amounts of alcohol have been confirmed and the sober curious movement gains momentum.

    If you drink beer, wine spritzers, hard seltzer, or similar products, check the alcohol content

    While light beers have fewer calories, they don't necessarily have much less alcohol than regular beer. The average light beer is about 4.3% alcohol, versus 5.0% in regular beer.

    Also, be aware that some craft or specialty beers contain far higher amounts of alcohol — up to 12% or 14% or even higher. Beverages that combine wine or hard liquor with seltzer or other mixers also vary widely in their alcohol content.

    Cut down on temptation

    Two more tips can help you meet success when changing drinking habits.

    Don't keep alcohol in your house. Making your home an alcohol-free zone takes away the risk of immediate temptation.

    Avoid temptation. Steer clear of people and places that make you want to drink. If you associate drinking with certain events, such as holidays or vacations, make a plan for managing these situations in advance. Check in with your feelings. When you're worried, lonely, or angry, you might be tempted to reach for a drink. "Think about other ways you might alleviate those feelings, such as going for a walk or calling a friend," Dr. Kelly suggests.

    Finally, try this interactive tool from the CDC, which can help you make a personalized plan to drink less.

    Source: Harvard Health Publishing

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    Healthwatch
    Home Cooking: Good For Your Health
    ~3.1 mins read

    iStock-891629998

    Can you imagine if you went to your primary care doctor's office for cooking classes? What if your visit included time spent planning meals, discussing grocery lists and the benefits of home cooking, and learning culinary techniques?

    If that sounds odd to you, it shouldn't.

    We already know that the more people cook at home, the healthier their diet, the fewer calories they consume, and the less likely they are to be obese or develop type 2 diabetes. A growing body of scientific evidence supports teaching patients how to cook meals at home as an effective medical intervention for improving diet quality, weight loss, and diabetes prevention.

    In fact, research is turning to studying the value of nutrition programs that include cooking instruction. These programs have been shown to help people adhere to a healthier diet, eat smaller portions, and lose weight — improvements that lasted as long as a year after the study ended. These programs can even help patients with type 2 diabetes to eat healthier, lower blood pressures and blood sugars, and lose weight. Hard to believe it, but time in the kitchen can be as valuable as medication for some people with diabetes.

    I recently met with a lovely patient of mine,* She has type 2 diabetes, and has trouble eating a healthy diet. Most of her meals are frozen dinners or takeout, which is all highly processed food with little nutritional value. I asked her if she would like to consult with a nutritionist.

    "I have, many times," she laughed. "They're all very nice and everything, and it's all good information, but I can't cook. I get to the produce section of the grocery store, and I don't know where to start." Aha. No surprise, then, that multiple studies have shown that home cooking instruction significantly increase a person's confidence in his or her food preparation skills, which translates into eating a healthier diet.

    Diet and lifestyle interventions have already been shown to be quite effective for weight loss and prevention of type 2 diabetes, and adding a home cooking instruction component could be even more powerful.

    Let's get cooking!

    *True story, details changed to protect the patient's identity.

    Grilled Zucchini with Red, Green, and Yellow Pepper Sauce

     

    Zucchini

  • 6 firm medium zucchini, sliced diagonally into thin rounds
  • 1/4 tsp Atlantic sea salt
  • 1/4 tsp Ground black pepper
  • 2 Tbsp Unrefined canola oil
  • Sauce

  • 2 Tbsp Extra-virgin olive oil
  • 2 Tbsp Fresh lemon juice
  • 1/4 cup Unsweetened white rice vinegar
  • Pinch Atlantic sea salt
  • Pinch Ground black pepper
  • 1 Tbsp Unsweetened date honey
  • 1 Small clove of garlic, crushed
  • 1 Medium onion, finely chopped
  • 2 Tbsp Chopped fresh parsley
  • 1/2 Medium yellow bell pepper, seeded and cut into 1/4-inch cubes
  • 1/2 Medium red bell pepper, seeded and cut into 1/4-inch cubes
  • 1/2 Medium green bell pepper, seeded and cut into 1/4-inch cubes
  • Prepare zucchini

  • Place zucchini rounds in a medium bowl, mix with salt and pepper, and toss with oil to coat.

  • Heat a grill pan over medium-high heat. Working in batches, roast zucchini rounds for about 1 to 2 minutes on each side, until dark lines appear. Transfer to a large bowl.

  • Prepare sauce

  • In a small bowl, mix together olive oil, lemon juice, and vinegar until combined.

  • Add salt, pepper, and date honey, and mix until combined. 

  • Add garlic, onion, and parsley, and mix well.

  • Add peppers and mix again.

  • Finish dish

  • Pour pepper mixture over zucchinis, and let sit for about 30 minutes, to allow flavors to blend.

  • Serve at room temperature.

  •  

    Additional information and selected sources

    Additional free and simple recipes from Dr. Rani Polak

    Free cooking at home cooking videos from the American Collage of Preventative Medicine (ACPM)

    Dr. Rani Polak's Harvard Medical School Talk@12: "What to Eat: The Emerging Field of Culinary Medicine"

    Is cooking at home associated with better diet quality or weight-loss intention?Public Health Nutrition, June 2015.

    Consumption of Meals Prepared at Home and Risk of Type 2 Diabetes: An Analysis of Two Prospective Cohort Studies. PLOS Medicine, July 2016.

    Impact of cooking and home food preparation interventions among adults: outcomes and implications for future programs. Journal of Nutrition Education and Behavior, July-August 2014.

    Impact of cooking and home food preparation interventions among adults: A systematic review (2011-2016). Journal of Nutrition Education and Behavior, February 2018

    Source: Harvard Health Publishing

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