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Healthwatch
Stepping Up Activity If Winter Slowed You Down
~4.7 mins read
Better health, better mood, better balance, and a multitude of other benefits await.
A close up of man's hand pointing a TV remote and sock-clad feet and legs in denim jeans up on a couch with TV in background showing beautiful blue skies, trees, and puffy clouds outside
If you've been cocooning due to winter's cold, who can blame you? But a lack of activity isn't good for body or mind during any season. And whether you're deep in the grip of winter or fortunate to be basking in signs of spring, today is a good day to start exercising. If you're not sure where to start — or why you should — we've shared tips and answers below.

Moving more: What's in it for all of us?

We're all supposed to strengthen our muscles at least twice a week and get a total at least 150 minutes of weekly aerobic activity (the kind that gets your heart and lungs working). But fewer than 18% of U.S. adults meet those weekly recommendations, according to the CDC.
How can choosing to become more active help? A brighter mood is one benefit: physical activity helps ease depression and anxiety, for example. And being sufficiently active — whether in short or longer chunks of time — also lowers your risk for health problems like
  • heart disease
  • stroke
  • diabetes
  • cancer
  • brain shrinkage
  • muscle loss
  • weight gain
  • poor posture
  • poor balance
  • back pain
  • and even premature death.
  • What are your exercise obstacles?

    Even when we understand these benefits, a range of obstacles may keep us on the couch.
    Don't like the cold? Have trouble standing, walking, or moving around easily? Just don't like exercise? Don't let obstacles like these stop you anymore. Try some workarounds.
  • If it's cold outside: It's generally safe to exercise when the mercury is above 32° F and the ground is dry. The right gear for cold doesn't need to be fancy. A warm jacket, a hat, gloves, heavy socks, and nonslip shoes are a great start. Layers of athletic clothing that wick away moisture while keeping you warm can help, too. Consider going for a brisk walk or hike, taking part in an orienteering event, or working out with battle ropes ($25 and up) that you attach to a tree.
  • If you have mobility issues: Most workouts can be modified. For example, it might be easier to do an aerobics or weights workout in a pool, where buoyancy makes it easier to move and there's little fear of falling. Or try a seated workout at home, such as chair yoga, tai chi, Pilates, or strength training. You'll find an endless array of free seated workout videos on YouTube, but look for those created by a reliable source such as Silver Sneakers, or a physical therapist, certified personal trainer, or certified exercise instructor. Another option is an adaptive sports program in your community, such as adaptive basketball.
  • If you can't stand formal exercise: Skip a structured workout and just be more active throughout the day. Do some vigorous housework (like scrubbing a bathtub or vacuuming) or yard work, climb stairs, jog to the mailbox, jog from the parking lot to the grocery store, or do any activity that gets your heart and lungs working. Track your activity minutes with a smartphone (most devices come with built-in fitness apps) or wearable fitness tracker ($20 and up).
  • If you're stuck indoors: The pandemic showed us there are lots of indoor exercise options. If you're looking for free options, do a body-weight workout, with exercises like planks and squats; follow a free exercise video online; practice yoga or tai chi; turn on music and dance; stretch; or do a resistance band workout. Or if it's in the budget, get a treadmill, take an online exercise class, or work online with a personal trainer. The American Council on Exercise has a tool on its website to locate certified trainers in your area.
  • Is it hard to find time to exercise?

    The good news is that any amount of physical activity is great for health. For example, a 2022 study found that racking up 15 to 20 minutes of weekly vigorous exercise (less than three minutes per day) was tied to lower risks of heart disease, cancer, and early death.
    "We don't quite understand how it works, but we do know the body's metabolic machinery that imparts health benefits can be turned on by short bouts of movement spread across days or weeks," says Dr. Aaron Baggish, founder of Harvard-affiliated Massachusetts General Hospital's Cardiovascular Performance Program and an associate professor of medicine at Harvard Medical School.
    And the more you exercise, Dr. Baggish says, the more benefits you accrue, such as better mood, better balance, and reduced risks of diabetes, high blood pressure, high cholesterol, and cognitive decline.

    What's the next step to take?

    For most people, increasing activity is doable. If you have a heart condition, poor balance, muscle weakness, or you're easily winded, talk to your doctor or get an evaluation from a physical therapist.
    And no matter which activity you select, ease into it. When you've been inactive for a while, your muscles are vulnerable to injury if you do too much too soon.
    "Your muscles may be sore initially if they are being asked to do more," says Dr. Sarah Eby, a sports medicine specialist at Harvard-affiliated Spaulding Rehabilitation Hospital. "That's normal. Just be sure to start low, and slowly increase your duration and intensity over time. Pick activities you enjoy and set small, measurable, and attainable goals, even if it's as simple as walking five minutes every day this week."
    Remember: the aim is simply exercising more than you have been. And the more you move, the better.

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    Healthwatch
    Flowers, Chocolates, Organ Donation Are You In?
    ~6.1 mins read
    Gifts of life are fitting on Valentine's Day and any other day of the year.
    photo illustration of a heart shape in dark red with the words organ donors save lives on it in white
    Chocolates and flowers are great gifts for Valentine's Day. But what if the gifts we give then or throughout the year could be truly life-changing? A gift that could save a life or free someone from dialysis?
    You can do this. For people in need of an organ, tissue, or blood donation, a donor can give them a gift that exceeds the value of anything that you can buy. Fittingly, Valentine's Day is also known as National Donor Day, a time for blood drives and sign-ups for organ and tissue donation. Have you ever wondered what can be donated? Had reservations about donating after death or concerns about risks for live donors? Read on.

    The enormous impact of organ, tissue, or cell donation

    Imagine you have kidney failure requiring dialysis 12 or more hours each week just to stay alive. Even with this, you know you're still likely to die a premature death. Or, if your liver is failing, you may experience severe nausea, itching, and confusion; death may only be a matter of weeks or months away. For those with cancer in need of a bone marrow transplant, or someone who's lost their vision due to corneal disease, finding a donor may be their only good option.
    Organ or tissue donation can turn these problems around, giving recipients a chance at a long life, a better quality of life, or both. And yet, the number of people who need organ donation far exceeds compatible donors. While national surveys have found about 90% of Americans support organ donation, only 40% have signed up. More than 103,000 women, men, and children are awaiting an organ transplant in the US. About 6,200 die each year, still waiting.

    What can you donate?

    The list of ways to help has grown dramatically. Some organs, tissues, or cells can be donated while you're alive; other donations are only possible after death. A single donor can help more than 80 people!
    After death, people can donate:
  • bone, cartilage, and tendons
  • corneas
  • face and hands (though uncommon, they are among the newest additions to this list)
  • kidneys
  • liver
  • lungs
  • heart and heart valves
  • stomach and intestine
  • nerves
  • pancreas
  • skin
  • arteries and veins.
  • Live donations may include:
  • birth tissue, such as the placenta, umbilical cord, and amniotic fluid, which can be used to help heal skin wounds or ulcers and prevent infection
  • blood cells, serum, or bone marrow
  • a kidney
  • part of a lung
  • part of the intestine, liver, or pancreas.
  • To learn more about different types of organ donations, visit Donate Life America.

    Becoming a donor after death: Questions and misconceptions

    Common misconceptions about becoming an organ donor limit the number of people who are willing to sign up. For example, many people mistakenly believe that
  • doctors won't work as hard to save your life if you're known to be an organ donor — or worse, doctors will harvest organs before death
  • their religion forbids organ donation
  • you cannot have an open-casket funeral if you donate your organs.
  • None of these is true, and none should discourage you from becoming an organ donor. Legitimate medical professionals always keep the patient's interests front and center. Care would never be jeopardized due to a person's choices around organ donation. Most major religions allow and support organ donation. If organ donation occurs after death, the clothed body will show no outward signs of organ donation, so an open-casket funeral is an option for organ donors.

    Live donors: Blood, bone marrow, and organs

    Have you ever donated blood? Congratulations, you're a live donor! The risk for live donors varies depending on the intended donation, such as:
  • Blood, platelets, or plasma: If you're donating blood or blood products, there is little or no risk involved.
  • Bone marrow: Donating bone marrow requires a minor surgical procedure. If general anesthesia is used, there is a chance of a reaction to the anesthesia. Bone marrow is removed through needles inserted into the back of the pelvis bones on each side. Back or hip pain is common, but can be controlled with pain relievers. The body quickly replaces the bone marrow removed, so no long-term problems are expected.
  • Stem cells: Stem cells are found in bone marrow or umbilical cord blood. They also appear in small numbers in our blood and can be donated through a process similar to blood donation. This takes about seven or eight hours. Filgrastim, a medication that increases stem cell production, is given for a number of days beforehand. It can cause side effects such as flulike symptoms, bone pain, and fatigue, but these tend to resolve soon after the procedure.
  • Kidney, lung, or liver: Surgery to donate a kidney or a portion of a lung or liver comes with a risk of complications, reactions to anesthesia, and significant recovery time. It's no small matter to give a kidney, or part of a lung or liver.
  • The vast number of live organ donations occur without complications, and donors typically feel quite positive about the experience.

    Who can donate?

    Almost anyone can donate blood cells –– including stem cells –– or be a bone marrow, tissue, or organ donor. Exceptions include anyone with active cancer, widespread infection, or organs that aren't healthy.
    What about age? By itself, your age does not disqualify you from organ donation. In 2023, two out of five people donating organs were over 50. People in their 90s have donated organs upon their deaths and saved the lives of others.
    However, bone marrow transplants may fail more often when the donor is older, so bone marrow donations by people over age 55 or 60 are usually avoided.

    Finding a good match: Immune compatibility

    For many transplants, the best results occur when there is immune compatibility between the donor and recipient. Compatibility is based largely on HLA typing, which analyzes genetically-determined proteins on the surface of most cells. These proteins help the immune system identify which cells qualify as foreign or self. Foreign cells trigger an immune attack; cells identified as self should not.
    HLA typing can be done by a blood test or cheek swab. Close relatives tend to have the best HLA matches, but complete strangers may be a good match as well.
    Fewer donors among people with certain HLA types make finding a match more challenging. Already existing health disparities, such as higher rates of kidney disease among Black Americans and communities of color, are worsened by lower numbers of donors from these communities, an inequity partly driven by a lack of trust in the medical system.

    The bottom line

    You can make an enormous impact by becoming a donor during your life or after death. In the US, you must opt in to be a donor after death. (Research suggests the opt-out approach many other countries use could significantly increase rates of organ donation in this country.)
    I'm hopeful that organ donation in the US and throughout the world will increase over time. While you can still go with chocolates for Valentine's Day, maybe this year you can also go bigger and become a donor.

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    Healthwatch
    A Low-tech School Vacation: Keeping Kids Busy And Happy Without Screens
    ~3.5 mins read
    Nine ways to encourage children to connect, create, and play off-screen.
    Father, daughter, and son playing soccer on the grass in a park;
    School vacation coming up? Wondering how to spend that time? Given how tiring holidays can be — especially for parents who are working — it's understandable why children are often allowed to spend hours with the TV, tablet, or video games. After all, happy, quiet kids make for happy parents who can finally get stuff done — or relax.
    Except kids are spending way too much time in front of screens. According to the American Academy of Child and Adolescent Psychiatry, kids ages 8 to 12 are spending four to six hours a day watching or using screens — and tweens and teens are spending nine hours.
    Given how enticing devices and social media can be, those numbers can easily go higher during unscheduled times like weekends and school vacation. That's why it's good to be proactive and come up with other activities. Below are some ideas for parents and caregivers to try. These are mostly good for kids through elementary school, but tweens and teens may enjoy some of them too.

    Spending time off the screen

    Go outside. This sounds obvious, but spending time outdoors is something kids do less than they used to — and it can be really fun. If you have a yard, go out into it and play hide-and-seek or build a fort from snow or anything else that's around. If you don't have a yard, go to a local park or just go for a walk. A scavenger hunt up and down the block or game of I Spy may be a good enticement.
    Go to the library. Do this early on in vacation, so that your child has lots of books, puzzles, and games to pass the time. Check out as many as they allow and you can carry. Ask if a Library of Things is available at a branch near you: crafts, tools, musical instruments, birding kits, telescopes — even metal detectors may be checked out for free.
    Build a fort in the living room. Use blankets or sheets over chairs; if you have a small tent, set it up. Bring in pillows, sleeping bags, and flashlights; let the kids sleep in it at night. Let it stay up all vacation.
    Build a city in the living room. Use blocks, Legos, boxes (or anything else), and add roads, cars, people, animals, trains, and other toys. Let it stay up all vacation, and make it bigger every day.

    Getting creative off the screen

    Get creative. Go to the craft store and stock up on inexpensive supplies. Buy things like poster board, huge pieces of paper (you could use those for your city, too, to make parks, roads, and parking lots), paints, and markers. You can make a paper mural, a comic book, a story, posters, or whatever catches your child's imagination. If you know how to knit or sew, think about teaching your child or making a simple project together.  Play music while you create.
    Read out loud. There are so many books that are fun to read aloud. When my children were younger, we read the Harry Potter series out loud, as well as the Chronicles of Narnia and books by E.B. White and Roald Dahl. Act out the voices. Have some fun.
    Have a puppet show. If you don't have puppets, you can make some with socks — or you can hold up dolls or action figures and do the talking for them. You can make a makeshift stage by cutting out the back of a box and taping cloth (like a pillowcase) to fall over the front.
    Get out the games. There are so many that work across the ages, like checkers, chess, Uno, Connect 4, Sorry, Twister, Clue, Scrabble, or Monopoly. We forget how much fun these can be.
    Bake. You don't have to get fancy — it's fine to use mixes or pre-made cookie dough. There's nothing better than baked goods straight from the oven, and adding frosting and decorations makes it even more fun. Turn on music and dance while things bake.
    While parents or caregivers need to be involved with some of these activities (like the ones involving the oven, or reading out loud), kids can do many of them independently once you have it started. Which, really, is what children need: time to use their imagination and just play.
    But you just may find that once you have things started, you'll want to play, too.

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    Healthwatch
    A Muscle-building Obsession In Boys: What To Know And Do
    ~4.2 mins read
    Body dysmorphic disorder in boys and young men focuses on bulging muscles.
    A shadowy, heavily-muscled superhero in a red cape strikes an action pose against a red and orange background; concept is body dysmorphic disorder
    By the time boys are 8 or 10, they're steeped in Marvel action heroes with bulging, oversized muscles and rock-hard abs. By adolescence, they're deluged with social media streams of bulked-up male bodies.
    The underlying messages about power and worth prompt many boys to worry and wonder about how to measure up. Sometimes, negative thoughts and concerns even interfere with daily life, a mental health issue known body dysmorphic disorder, or body dysmorphia. The most common form of this in boys is muscle dysmorphia.

    What is muscle dysmorphia?

    Muscle dysmorphia is marked by preoccupation with a muscular and lean physique. While the more extreme behaviors that define this disorder appear only in a small percentage of boys and young men, it may color the mindset of many more.
    Nearly a quarter of boys and young men engage in some type of muscle-building behaviors. "About 60% of young boys in the United States mention changing their diet to become more muscular," says Dr. Gabriela Vargas, director of the Young Men's Health website at Boston Children's Hospital. "While that may not meet the diagnostic criteria of muscle dysmorphia disorder, it's impacting a lot of young men."
    "There's a social norm that equates muscularity with masculinity," Dr. Vargas adds. "Even Halloween costumes for 4- and 5-year-old boys now have padding for six-pack abs. There's constant messaging that this is what their bodies should look like."

    Does body dysmorphic disorder differ in boys and girls?

    Long believed to be the domain of girls, body dysmorphia can take the form of eating disorders such as anorexia or bulimia. Technically, muscle dysmorphia is not an eating disorder. But it is far more pervasive in males — and insidious.
    "The common notion is that body dysmorphia just affects girls and isn't a male issue," Dr. Vargas says. "Because of that, these unhealthy behaviors in boys often go overlooked."

    What are the signs of body dysmorphia in boys?

    Parents may have a tough time discerning whether their son is merely being a teen or veering into dangerous territory. Dr. Vargas advises parents to look for these red flags:
  • Marked change in physical routines, such as going from working out once a day to spending hours working out every day.
  • Following regimented workouts or meals, including limiting the foods they're eating or concentrating heavily on high-protein options.
  • Disrupting normal activities, such as spending time with friends, to work out instead.
  • Obsessively taking photos of their muscles or abdomen to track "improvement."
  • Weighing himself multiple times a day.
  • Dressing to highlight a more muscular physique, or wearing baggier clothes to hide their physique because they don't think it's good enough.
  • "Nearly everyone has been on a diet," Dr. Vargas says. "The difference with this is persistence — they don't just try it for a week and then decide it's not for them. These boys are doing this for weeks to months, and they're not flexible in changing their behaviors."

    What are the health dangers of muscle dysmorphia in boys?

    Extreme behaviors can pose physical and mental health risks.
    For example, unregulated protein powders and supplements boys turn to in hopes of quickly bulking up muscles may be adulterated with stimulants or even anabolic steroids. "With that comes an increased risk of stroke, heart palpitations, high blood pressure, and liver injury," notes Dr. Vargas.
    Some boys also attempt to gain muscle through a "bulk and cut" regimen, with periods of rapid weight gain followed by periods of extreme calorie limitation. This can affect long-term muscle and bone development and lead to irregular heartbeat and lower testosterone levels.
    "Even in a best-case scenario, eating too much protein can lead to a lot of intestinal distress, such as diarrhea, or to kidney injury, since our kidneys are not meant to filter out excessive amounts of protein," Dr. Vargas says.
    The psychological fallout can also be dramatic. Depression and suicidal thoughts are more common in people who are malnourished, which may occur when boys drastically cut calories or neglect entire food groups. Additionally, as they try to achieve unrealistic ideals, they may constantly feel like they're not good enough.

    How can parents encourage a healthy body image in boys?

    These tips can help:
  • Gather for family meals. Schedules can be tricky. Yet considerable research shows physical and mental health benefits flow from sitting down together for meals, including a greater likelihood of children being an appropriate weight for their body type.
  • Don't comment on body shape or size. "It's a lot easier said than done, but this means your own body, your child's, or others in the community," says Dr. Vargas.
  • Frame nutrition and exercise as meaningful for health. When you talk with your son about what you eat or your exercise routine, don't tie hoped-for results to body shape or size.
  • Communicate openly. "If your son says he wants to exercise more or increase his protein intake, ask why — for his overall health, or a specific body ideal?"
  • Don't buy protein supplements. It's harder for boys to obtain them when parents won't allow them in the house. "One alternative is to talk with your son's primary care doctor or a dietitian, who can be a great resource on how to get protein through regular foods," Dr. Vargas says.

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