Past presidents’ physicals: What we learned

(CNN)President Donald Trump had a physical examination Friday at Walter Reed National Military Medical Center in Bethesda, Maryland. The exam was conducted by US Navy Rear Adm. Dr. Ronny Jackson, the same physician who performed President Barack Obama’s last two physicals while in office.

CNN gathered past reports from former presidents’ physical exams — documents that typically share basic information such as height, weight and blood pressure, but also detail skin tag removal for Obama, a cyst drained on George H. W. Bush’s finger, and how Gerald Ford’s doctor advocated for a White House swimming pool.
President aren’t obligated to release any results from their examination, but the White House said it would provide a “detailed readout” of Trump’s exam on Tuesday.
    Here’s a look at the health of past presidents, based on their physical examinations.

    President Barack Obama, 2009-2017

    Obama had four known physicals while he was in office: 2016, 2014, 2011 and 2010. The memo for each exam, written by the president’s physician, was addressed to the acting White House press secretary at the time of each report.
    Obama’s letters outline the president’s vitals — all within a healthy range — and offer brief summaries of all his major body systems and some parts such as head/ears/nose/throat. All lab results came back normal, including a PSA test for prostate cancer, which is recommended by the American Cancer Society for African-American men beginning at age 45, because they are considered at high risk for the disease.

    All four of Obama’s reports listed his current medications. In 2016, the president was advised to take vitamin D daily, Nexium “as needed for occasional acid reflux symptoms,” Nicotine gum (as needed for ongoing smoking cessation efforts), as well as Malarone “as indicated during global travel to malaria endemic areas.”

    President George W. Bush, 2001-2009

    The letter summarizing the results of George W. Bush’s 2001 physical lists 12 doctors who examined the president. His exam was supervised and reviewed by two additional doctors, including Dr. Richard J. Tubb, one of the longest-serving White House doctors.
    The report notes Bush has “a history of activity and sports-related injuries,” had benign polyps removed from his colon in 1998 and 1999 and had “mild high frequency hearing loss,” but that his speech frequency hearing was “excellent.”
    We also learned the president smoked “an occasional cigar,” didn’t drink alcohol, but did drink diet soda and coffee. That year, he also reported running “(on average) 3.0 miles, 4 times weekly” and cross-training that included swimming, free weights and the elliptical.
    The report states: “The President is in the top 2% of men his age in cardiovascular fitness. This fitness level would place him in the Excellent category for men 40-44 and Superior range for men 45 and older. He is stratified to a very low coronary risk profile.”

    President Bill Clinton, 1993-2001

    At a 1997 physical,Clinton complained he’d been having some trouble understanding people talking in crowded rooms. And following a hearing test, the 42nd president was fitted for hearing aids. He also had a benign cyst removed from the left side of his chest, which doctors said was similar to another one removed from his nose the previous year. Clinton weighed 20 pounds less than he did the year before, which he attributed to eating a healthier diet and working out more regularly.
    Following a 2001 physical, a statement by presidential physician Dr. Connie Mariano revealed “a lesion on his back suspicious for skin cancer was excised. The pathology results … confirmed that the lesion was a superficial basal cell skin cancer. Pathologists noted that the margins of the legion appeared ‘clean’ indicating that the lesion had been totally removed.”
    In 2011, CNN Chief Medical Correspondent Dr. Sanjay Gupta reported in the CNN documentary “The Last Heart Attack,” the possibilities of preventing — and perhaps even reversing — heart disease. Gupta interviewed Clinton, who spoke candidly about his personal wake-up call: a quadruple bypass operation in 2004. Clinton also had heart surgery in 2010.
    “I was lucky I did not die of a heart attack,” he told Gupta.
    In 2010, Clinton embraced a vegan diet: no meat, dairy or eggs.

    President George H. W. Bush, 1989-1993

    A 1989 physical found Bush to be in “extremely sound physical condition.” Test results showed normal X-rays, EKG, urinalysis, blood test, allergy test and dermatological exam. The president’s hips did exhibit signs of “mild degenerative osteoarthritis, which has been present for several years.”

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    A statement released by Bush’s press secretary revealed that a “sebaceous cyst on the third finger of his left hand was drained. The President is wearing a Band-Aid on the finger, which he can remove within the next few hours. This cyst has been present for many years and does not present a medical problem.”

    President Ronald Reagan, 1981-1989

    In October 1981, Reagan was examined by 14 specialists and was found to be “in excellent health,” according to a statement issued by the White House physician. Notably, he said the president had “fully recovered” from the gunshot wounds he sustained during an assassination attempt in March 1981.
    Reagan underwent another exam in May 1984, during which his doctor concluded he was in “very exceptional physical condition.” However, doctors did discover a small polyp in his colon, which they removed and determined to be benign (similar polyps were found and removed during the president’s 1985 and 1988 exams). The rest of Reagan’s tests results this year were deemed “entirely normal.”
    Following a March 1985 physical, the White House doctor said that “President Reagan continues to enjoy good health. His overall physical and mental condition is excellent. I am especially impressed with the fact that his blood pressure is lower than a year ago — this is quite remarkable.”
    Reagan received his last known exam while in office in December 1988. The president’s physician found him to be in “remarkable physical condition.”

    President Gerald Ford, 1974-1977

    In January 1975, Ford’s physician said he was “happy to report he is in excellent health. The results of all medical tests were normal in every way.”
    Ford underwent another physical in July 1976, during which his doctor said, “He has had no complaints … other than mild discomfort in his knee following periods of prolonged standing. The President has maintained his physical capacity for long working hours. He sleeps very well and continues to follow his diet and weighs between 195 and 198 pounds.”
    In 1975, Ford’s doctor noted “the completion of the new White House swimming pool will provide him with short intervals for relaxation that can easily be fitted into his busy schedule.”
    “I would like to take the time to acknowledge those citizens who, by their contributions, make a swimming pool available for the President in the White House,” Dr. William Lukash said at a January 1976 press conference. “I might add that the President was reluctant to use the pool during the winter months because of his concern about energy conservation. I spoke to him about this and felt it was to his advantage to have the use of this pool because I thought it would be an improvement in his sense of well-being and make him more conducive to his feeling better the next day. … The President swims approximately 24 lengths of the pool, which adds up to about a quarter of a mile, and he does this in about 14 minutes.”

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    Stay warm! Your life may depend on it

    (CNN)Baby, it’s cold outside — really, really cold — and many of us first feel the freezing temperatures of winter in our toes and fingertips before elsewhere in the body.

    This happens as your body works to protect your vital organs from the cold, said Dr. Suzanne Salamon, associate chief of clinical programs at Beth Israel Deaconess Medical Center in Boston.
    “The blood vessels in all different parts of the body will constrict,” she said. “They’ll get smaller to try to preserve heat.
      “What the body tries really hard to do is to protect the most important organs, which are the ones deep inside: the heart and brain and lungs,” she said. “The body tries to keep those warm by redirecting heat from the fingers and toes inward, so the blood vessels in the fingers and toes get really small, and not enough blood goes through them.”
      This is important for the body to do — and to do quickly — because wintry weather has been associated with health risks for heart attacks, asthma symptoms, frostbite and hypothermia.
      Globally, more temperature-attributable deaths tend to be caused by cold than by heat, according to a 2015 study published in the journal The Lancet.

      A cold-hearted risk

      Frosty weather can affect your heart, especially if you have cardiovascular disease. “You always hear about people going out and shoveling snow and having a heart attack,” Salamon said.
      Cold weather can act as a vasoconstrictor, which means your blood vessels narrow, and that can play a role in raising the risk of heart attack, according to a 2014 Harvard Health Letter published by Harvard Medical School.
      “Snow shoveling is one example where we see people who have heart disease, or risk factors for heart disease, exerting themselves more than they may otherwise. Shoveling is hard work; people who have cardiac disease and back problems are at higher risk for injury or illness while shoveling,” said Dr. Reed Caldwell, an assistant professor in the Ronald O. Perelman Department of Emergency Medicine at NYU Langone Medical Center and an emergency department physician.
      A mere 1-degree Celsius reduction in temperature was associated with a cumulative 2% increased risk for heart attack, according to a 2010 study published in the British Medical Journal.
      The study involved data on 84,010 hospital admissions for heart attacks in England and Wales between 2003 and 2006. The researchers analyzed the data to determine any possible relationship between outdoor temperature and heart attack occurrences.
      Some other studies have also found a correlation between the winter season and heart attacks and stroke, and the phenomenon has been sometimes referred to as “Merry Christmas Coronary” and “Happy New Year Heart Attack.”
      However, the heart isn’t the only part of the body that might be vulnerable to health problems in the winter.

        Coping with asthma in the winter

      Cold weather can wreak havoc on your lungs, as dry air may irritate the airways, especially for people with lung diseases such as asthma, according to the American Lung Association.
      “Cold air causes bronchospasm, so people with asthma and COPD can find themselves having increased symptoms in the winter months,” Caldwell said.
      If you have asthma and are exposed to cold weather, “wear a scarf around your nose. That certainly helps, because then you’re breathing in your own steam from your mouth,” Salamon said.
      On the other hand, a more well-known, cold-related health issue is frostbite.

      Frostbite: A danger even for the eyes

      Frostbite can occur in freezing temperatures when your blood vessels narrow, skin temperature drops and ice crystals form around and within your cells, causing damage.
      “There’s a continuum of cold-related skin injury. The first is called ‘frostnip,’ and that is a cooling of the outermost skin tissue without any actual destruction to the tissue. You know this is happening because the skin can become discolored, sometimes bright red, and can look irritated and feel extra sensitive, and that’s a good warning sign that the skin is getting too cold,” Caldwell said.
      “Then, frostbite involves actual skin destruction, and frostbitten skin usually appears pale, waxy, and can sometimes turn even purple or black as the tissue begins to die. Frostbitten skin can be numb or painless,” he said.
      Frostbite can even occur in your eyes, Salamon said. “When you’re out in the cold windy weather, you can actually get frostbite of your eyes, which is really dangerous,” Salamon said.
      “The cold starts to form little blisters in your eye or little crystals on your skin, which can turn around and damage the skin or the eye itself,” she said. “Those blood vessels really get very constricted, so there’s not much blood going through it, which cuts down on the circulation of the eyes.”
      The blood vessels are constricting in order to prevent hypothermia, a dangerous condition that occurs when your body loses more heat than it produces, causing the body’s core temperature to drop below 95 degrees Fahrenheit.
      “The most worrisome health effect from cold exposure is hypothermia, which can cause damage to vital organs, including the heart, nervous system and kidneys. In extreme cases, death can occur. This often is a result of abnormal cardiac rhythms,” said Dr. Jeahan Colletti, an emergency medicine specialist at the Mayo Clinic in Rochester, Minnesota.
      Those most at risk for hypothermia — and any cold-related health hazard — tend to be older adults, Salamon said.
      “If people have a neighbor who is an older person, when there’s weather that’s really cold, they should check up on them. When people get really, really cold, they can get very confused and not even know enough to call for help,” she said.

      Tips to stay warm and healthy

      What can people do to stay warm and healthy this winter? An important risk-reducing measure hinges on wardrobe.
      “It’s really important to dress in layers, so … put on more than one pair of gloves and then a mitten on top of that, because the air that’s trapped in between those layers help to keep you warm,” Salamon said.
      “Tight-fitting clothes are not a good thing, because you’re not able to get the benefit of the layers. You really need to have looser sweaters, shawls if you’re sitting inside, to try to layer up. It helps to have a ski mask to protect your ears and your nose,” she said. “If you get wet, like if you’re out playing in snow or shoveling snow, take off wet clothes, because the wet clothes really make it worse. They make things colder. … Boots should be waterproof.”
      Preventive measures not only involve dressing for the cold but also avoiding too many cocktails in cold weather, said Colletti, the Mayo Clinic specialist.
      “Avoid drinking alcohol when in the cold, as mental awareness is impaired, thereby limiting ability to recognize symptoms of significant cold exposure. Alcohol also causes dilatation of the body’s blood vessels, increasing heat loss,” she said.

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      Cold weather is also associated with weight gain, so another tip to stay warm and healthy this winter is to keep moving, said Dr. Luis Navarro, a physician and founder of the Vein Treatment Center in New York.
      “Weight gain is common during the colder holiday months, and this can put our legs and circulatory system under more stress. Weight gain and colder temperatures could make varicose veins and spider veins worsen, due to the fact that blood is not efficiently pumping through the body,” Navarro said.
      “Even though it’s cold, exercising and moving around helps to optimize circulation, which not only helps to keep our circulatory system healthy, but it can also help to keep us warm,” he said. “Also, if you do experience leg pain as a result of restricted blood flow, I suggest elevating the legs for periods throughout the day so that they are raised above the heart. This helps maximize circulation.”

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      A New Year, new food resolution: Meatless one day a week

      (CNN)It’s the end of December, which means there’s a good chance you are thinking of ways to live healthier in the new year. Whether you want to drop 10 pounds, improve your cholesterol or have more energy, we have five food-related New Year’s resolutions that will help you achieve your goals.

        Research consistently shows that plant-based diets are linked with a lower risk of obesity, hypertension, heart disease, type 2 diabetes and cancer,” said Sharon Palmer, a registered dietitian and author of “Plant-Powered for Life.”
        “Even going meatless one day a week can make a difference, as you increase all of those whole plant foods — beans, lentils, whole grains, nuts, seeds, vegetables, fruits — and decrease more animal foods, in particular red and processed meat. High intakes of these foods have been linked with increased disease risk,” Palmer said.
        Eating more plant-based foods increases your intake of fiber, vitamins, minerals, healthy fats and phytochemicals — plant compounds with antioxidant and anti-inflammatory properties, according to Palmer.
        Stocking your pantry and fridge with a variety of beans, whole grains, seasonal veggies, fruits, spices, herbs, healthy oils, nuts and seeds is the secret to eating more plant-based meals, she said.
        Palmer also recommends “plantifying” your favorite dishes. “Just make your favorite entrees or meals plant-based, with a few swaps. If you have a mean lasagna recipe, skip the meat and add layers of greens, broccoli and peppers and perhaps some pine nuts and cashew cheese instead of the meat and cheese. If you love taco Tuesday, make your tacos veggie by skipping the meat and serving black beans or a vegetarian mushroom tofu filling. If you love Indian food, skip the chicken masala and have chickpea masala instead. These will be foods you already love and are familiar with,” she said.

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        Experimenting with new meals and creating a collection of new recipes can be fun, too. “There are so many gorgeous plant-based recipes on sites, in books and in magazines these days. I like to try a brand-new recipe one day a week to keep things interesting. If you love it, make it again,” Palmer said.
        For a simple meatless recipe, Palmer recommends her spicy hummus veggie tacos.
        How to measure it:
        Picking one day of the week to go plant-based and marking it on the calendar is a good way to stick to your plant-eating plan. “I love the Meatless Monday idea, because people often start their best behaviors at the beginning of the week. … However, there may be a better day of the week for you, so just plan it,” Palmer said.

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        Parents give children alcohol ‘too young’

        Image copyright Getty Images
        Image caption Some parents give their children alcohol from an early age

        Parents could be storing up problems for their children by introducing them to alcohol too young and ordering takeaways too often, researchers warn.

        Two universities found that one in six parents gives their children alcohol by the age of 14, when their body and brain are not yet fully developed.

        Many parents may believe they are acting responsibly – but that’s not backed up by research, experts said.

        Regular takeaways were a risk to the heart, a separate study said.

        A team of researchers from St George’s, University of London, surveyed nearly 2,000 nine and 10-year-olds on their diets and found that one in four ate takeaways at least once a week.

        This group had higher body fat composition from consuming too many calories, and lower levels of vitamins and minerals than children who ate food cooked at home.

        Image copyright Getty Images
        Image caption Eating too many takeaway meals increases children’s calorie intake

        Continuing on this kind of diet could increase the risk of heart disease and other health problems later in life, the research team warned, saying takeaways should be “actively discouraged”.

        When it comes to giving adolescents a taste of alcohol, well-educated parents of white children are the main culprits, research published in the Journal of Adolescent Health suggests.

        But very few ethnic minority parents said they allowed early drinking – only 2%.

        Using data on 10,000 children from the Millennium Cohort Study, researchers from from University College London and Pennsylvania State University found that light or moderate-drinking parents were just as likely to let their children drink alcohol as heavy-drinking parents.

        Prof Jennifer Maggs, lead study author, said: “Parents of socially advantaged children may believe that allowing children to drink will teach them responsible use or may in fact inoculate them against dangerous drinking.

        “However, there is little research to support these ideas.”

        Previous research has shown that those who start drinking early are more likely to do badly at school, have behaviour issues, and develop alcohol problems in adulthood.

        Official medical advice recommends that children don’t drink alcohol until they are at least 15.

        Image copyright Getty Images
        Image caption Set clear rules for teenagers and booze, experts say

        In the survey, 14-year-olds themselves were asked whether they had ever tried more than a few sips of alcohol, with almost half saying yes.

        When they were 11, about 14% had done so.

        Katherine Brown, chief executive of the Institute of Alcohol Studies, said an alcohol-free childhood was best and this advice may not be getting to parents.

        “We need to see better guidance offered to parents via social marketing campaigns and advice from doctors and schools.

        “Parents deserve to know they can have a positive impact, and can reduce health harms associated with young people drinking.”

        Dr John Larsen, from the charity Drinkaware, said parents and guardians had an important role to play in helping children learn about alcohol.

        “While each parent or carer may choose to approach talking to their teenagers about alcohol in different ways, it is helpful to have clear rules and that the conversations are open and honest.”

        How to talk to children about alcohol

        • Get the tone right – make it a conversation, not a lecture
        • Get the timing right – don’t wait until they are going out of the door to meet friends
        • Find a hook – like a recent film or TV storyline to start the conversation
        • Be honest – it’s far better to confess to what you did at their age
        • Set rules – teenagers feel safer if there are guidelines and boundaries

        Drinkaware has more tips on strategies to prevent underage drinking.

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        Baby girl survives with heart outside her body at birth, in UK first

        Vanellope Hope Wilkins, who had her first surgery within an hour of delivery, is believed to be first baby in UK to survive with the extremely rare condition

        A baby girl born with her heart outside her body is believed to be the first in the UK to survive with the extremely rare condition after undergoing three operations, the first within an hour of her birth.

        At a nine-week scan, Vanellope Hope Wilkins was discovered to have the condition ectopia cordis, with her heart and part of her stomach growing externally.

        Her parents, Naomi Findlay, 31, and Dean Wilkins, 43, of Bulwell, Nottinghamshire, were advised termination was the only option, they said.

        But three weeks after her premature birth, by caesarean section on 22 November, Vanellope, who is named after a Disney princess, has survived three operations at Glenfield Hospital, Leicester, to move her heart back inside her chest.

        Experts, including the consultant cardiologist, have said they do not know of another case in the UK where a baby has survived such a condition.

        Describing their emotions on first being told of her chances, Findlay said: I burst into tears. When we did the research, we just couldnt physically look because the condition came with so many problems.

        Wilkins said: We still didnt know what we were looking at when we saw the scan, it looked like a little hamster with a hat on.

        They decided against termination, preferring to leave it to nature, and worried throughout the whole pregnancy.

        Vanellope Wilkins undergoes corrective surgery, in what is believed to be a UK first, at Glenfield Hospital. Photograph: University Hospitals of Leiceste/PA

        The couple said they were told the first 10 minutes after birth were crucial as her ability to breathe would be essential. But when she came out and she came out crying, that was it. The relief fell out of me, said her mother. Her father said: Twenty minutes went by and she was still shouting her head off it made us so joyful and teary.

        Vanellope has undergone three operations carried out by a team of 50 staff at Glenfield Hospital. Immediately after her birth, she was wrapped in a sterile plastic bag. Consultant neonatologist Jonathan Cusack said: At around 50 minutes of age, it was felt that Vanellope was stable enough to be transferred back to the main theatre, where she had been born, to the waiting anaesthetists, congenital heart disease and paediatric surgical teams who began the task of putting her entire heart back inside her chest.

        She was transferred to the paediatric intensive care unit where she was due to stay for at least several weeks while she got strong enough and big enough for her heart to be placed fully within her chest and covered with her skin.

        After seven days, her chest was opened a bit more to create space to allow her heart to fit back in. In the average baby, there is an indent on the left lung which leaves space for the heart, but she did not have this. Over two weeks, her heart naturally made its way back into her chest as a result of gravity.

        The latest operation involved taking skin from under her arms and moving it to join in the middle of her body. Surgeons had created a mesh that protected her heart as she did not have ribs or a sternum. As her organs fight for space inside her chest, she is still attached to a ventilation machine.

        Babies born with the condition one estimate is five to eight per million have less than a 10% chance of survival.

        Branko Mimic, the lead surgeon at the East Midlands Congenital Heart Centre, said: Cases such as Vanellopes, where everything else appears essentially normal, are even rarer, and whilst it would seem more hopeful she will do well, it is therefore almost impossible to be confident of this.

        Frances BuLock, a consultant paediatric cardiologist at Glenfield Hospital, said she had described the chances of the baby surviving as remote. I had seen one in foetal life around 20 years ago but that pregnancy was ended.

        Findlay said all the way through her pregnancy that she was warned the chances of survival are next to nothing. After the birth, she said, I felt guilty for thinking negative thoughts because here she is fighting, and there was I, about to give up. Im glad I stuck to my guns not to terminate though, Im so glad.

        Wilkins said: I lost hope a few times, if she didnt move Id say: Has she moved today? and then, the next thing, shed suddenly move and youd go: Oh shes heard me.

        They named their daughter after a character in the film Wreck-it Ralph. Vanellope in the film is so stubborn and she turns into a princess at the end, so it was so fitting. The Hope part of her name is the fact that she has brought us hope, and my mum and dad, because even they, as grandparents, thought they would never get to see their granddaughter, said Findlay.

        Wilkins said: Some mums still terminate and if we can get out there that there is a hope, and that it can be done, then its giving all those mums out there a chance. His daughters name was a reminder, he said, that there is that hope.

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        Why your diet should include more fat

        Think back to the ’80s and ’90s when buying anything that didn’t don a low-fat label was simply taboo. Back then, butter and egg yolks topped the “do not eat” list, while refined carbs and packaged foods weren’t given a second thought. But times have definitely changed.

        These days, experts tout fat as a must-have macro and full-fat products, like whole milk, avocado, ghee and coconut oil, join the ranks of superfoods.
        Yet, some people still question what kinds of fat they should eat and exactly how it affects the body. That’s why we called on Mark Hyman, MD, author of the “Eat Fat, Get Thin Cookbook,” to help us wipe clean the greasy mess of info and lay down the facts on fat.

          5 Myths About Fat — Debunked

          1. Myth: Fat on my plate equals fat on my body.
          Reality: Even though this myth is the basis for low-fat diets and food products, it’s far from the truth. Eating fat won’t make you fat. Completely eliminating or limiting fat from your diet can actually make you gain weight, often because it leaves you feeling so deprived. Conversely, some studies have found that fatty foods can aid in weight loss.
          “The problem with most diets is that they lack the key ingredient that makes food taste good and cuts your hunger,” says Dr. Hyman. And you guessed it, that’s fat. “Healthy fats are the best source of energy for your body, and they keep your metabolism and fat-burning mechanisms running as they’re meant to,” Dr. Hyman explains.
          Research supports this, showing that a low-fat diet could slow down metabolism. So now you have permission to enjoy a spoonful of nut butter with an apple before your next workout or a satiating piece of steak for dinner every once in a while.
          2. Myth: Saturated fat should get a big fat “I’ll pass.”
          Reality: Not so fast. While saturated fat has long been known as public health enemy number one, recent research proves it’s not so scary. Of course, you shouldn’t always opt for a meal full of red meat and butter, but having them occasionally won’t wreck your health (or your waistline).
          In fact, Dr. Hyman whips some butter into his coffee in the morning. Although it’s higher in saturated fat, he says butter is a more wholesome ingredient, particularly the grass-fed variety.
          What’s worse than eating high-fat foods: replacing them with loads of sugar. Refined carbs can increase your chances of developing coronary heart disease and diabetes.
          3. Myth: All fat causes health problems.
          Reality: Eating different sources of fat can actually boost your health. Omega-3 fatty acids (those found in fish and some nuts and seeds) can help strengthen your heart and possibly your mental well-being, too. And the monounsaturated fats in olive oil (as well as nuts and avocados) can also cut your risk of heart disease.
          Dr. Hyman has even seen some of his patients reverse type 2 diabetes by eating a high-fat diet.
          4. Myth: High-cholesterol foods raise your LDL cholesterol levels.
          Reality: Previous thinking also cautioned against foods high in cholesterol (a type of fat), but that’s no longer the case. Dietary cholesterol doesn’t necessarily raise the “bad” cholesterol levels in your body, Dr. Hyman explains. Instead, it can elevate HDL or the “good” kind.
          One caveat: Trans fats and linoleic acid (found in vegetable oils) can harm your health. So steer clear of partially hydrogenated and hydrogenated oils, like canola, as well as packaged foods like cream-filled candies, frozen pizza and margarine. Sometimes, the nutrition label doesn’t show trans fat, so look for hydrogenated oils on the ingredients list.
          5. Myth: Fat will keep me from my fitness goals.

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          Reality: Some endurance athletes actually embrace what’s known as the ketogenic diet. This plan involves getting about 70 to 75 percent of your daily calories from fat and just five to 10 percent from carbs. Though researchers are still looking into the proven (dis)advantages of the diet, it can help your body adjust to running off fat stores, rather than carbs, explains Pam Nisevich Bede, RD, dietitian with Abbott’s EAS Sports Nutrition.
          (The mechanisms for this work similarly to intermittent fasting: When you run out of glycogen for energy, your body turns to other sources, like fat.) “Since most of us exercise to burn off that internal fat storage, it can be a win-win,” Bede says.
          The typical high-fat foods in a ketogenic diet aren’t cheeseburgers and fries, though. It’s more like avocados, fish, peanut butter, meat and eggs. Note that it also takes the body about three to five weeks to adapt to a low-carb, high-fat diet, especially if you regularly chow down on foods like pizza and pasta. And because your body digests fat more slowly than carbs (like bagels), it keeps you fuller for longer and provides a steadier source of energy levels to help you power through a long run or fitness class. If you do have a high-fat meal, wait about two hours before working out, Bede says.

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          Working out on polluted streets bears minimal benefit for older people

          (CNN)Going for a long walk on polluted, traffic-laden streets in an attempt to get fit has negligible benefits on your health, a new study has found.

          UK researchers explored the benefits of walking in people over the age of 60 and compared the impact on their health when they walked along polluted urban streets versus in the open spaces of a park.
          It perhaps comes as no surprise that people walking in the park fared better. The surprise was that benefits of walking were negligible, in terms of boosting heart and respiratory health, when walking along polluted streets.
            The findings, published Tuesday in the journal The Lancet, suggest that short-term exposure to traffic pollution prevents the cardiorespiratory — heart and lung — benefits of physical activity during that time.
            “When you walk, your airways open up … and your blood vessels dilate, or open up… and these effects can last for a few days. When you do this in a polluted place, these effects are much smaller, so you’ve lost the benefits of exercise,” said Dr. Fan Chung, professor of respiratory medicine at Imperial College London, who led the study.
            “When you exercise in polluted areas, you breathe in more, and you get more of the particles and gases getting to your lungs,” he said.

            Pollution versus park

            Chung’s team set out find out the effects of pollution on people with heart and lung disease, most of whom are over the age of 60, he said.
            For a fair comparison, a healthy control group was included, but to the researchers’ surprise, they saw a significant impact from pollution on everyone.
            The team recruited 119 adults over the age of 60 and divided them into three groups, based on whether they were healthy or had heart disease or chronic obstructive pulmonary disease, known as COPD.
            Participants were randomly assigned to walk for two hours on London’s Oxford Street, a major road and shopping district in the city, or in the open spaces of the 350-acre Hyde Park, just a mile away.A few weeks later, they walked in the other location.
            Traffic along Oxford Street is restricted to allow mainly buses and taxis, which typically run on diesel fuel. Overall, London breached air pollution limits for 2017 just five days into the new year.
            For all the participants, walking in Hyde Park led to improvements in lung capacityand function as well as reduced stiffness of the arteries, which is otherwise a risk factor for cardiovascular disease, for up to 26 hours afterward.
            However, when people walked along Oxford Street, the researchers found a minor increase in lung capacity and a rise in arterial stiffness, which could be attributed to exposure to black carbon soot and ultrafine particles from diesel exhaust, they said.
            “In a polluted place, the (positive) effects are much smaller,” Chung said.
            People with COPD fared the worst along Oxford Street, with both their airways narrowing and their arteries stiffening. They also reported more coughing, shortness of breath, sputum and wheezing.
            The team highlighted that some of the benefits from walking in the park could be impacted by more pleasant surroundings and reduced stress, but they believe this does not account for the significant difference they saw.
            “If people cannot find a green place or a park to exercise, I think they probably should exercise indoors,” Chung said.

            To walk or not to walk

            “We’re not talking about very high levels of pollution that you see in India or China. We’re talking about pollution you get on an ordinary day walking up and down the high street,” Chung said. “At that level, we are seeing effects that are negating the benefits of walking.”
            He believes it’s most important for people with heart and lung disease avoid these areas and adds that despite being conducted in London, the study has global relevance.
            “These would apply to European cities and North American cities where the pollution levels are more similar,” Chung said.
            Asian pollution is one or two orders of magnitude greater, and similar studies should be done at that level of pollution, he said.
            However, recent studies across a range of age groups have found physical activity to be beneficial, even in the face of high pollution levels.
            One piece of research, by teams at the Centre for Diet and Activity Research at the University of Cambridge, found that the benefits of walking and cycling outweigh the negative effects of air pollution — the converse of this new study.
            “Our model indicates that in London, health benefits of active travel always outweigh the risk from pollution,” lead author of the research Marko Tainio said when it was published in 2016. “Even in Delhi, one of the most polluted cities in the world — with pollution levels 10 times those in London — people would need to cycle over five hours per week before the pollution risks outweigh the health benefits.”
            In response to the new findings, Tainio said, “it is also important to notice that this study looked at the short-term impacts. … These findings need to be confirmed with empirical long-term studies examining tradeoffs over months and years. Also, Professor Chung and colleagues noticed that health benefits of walking were attenuated, not completely negated, among the healthy participants.
            “The authors suggest that people should avoid walking in busy streets and should instead walk in parks or in green space. We agree that this is good advice for recreational walking for people who can make that choice,” he added. “But for people commuting or shopping, even in a city as polluted as London, we would still encourage walking and cycling.”
            “This paper highlights the risks to health by walking along polluted roads for the over-60s with specific pre-existing medical conditions,” added Ian Colbeck, professor of environmental science at the University of Essex. “However, we know from other research that for the vast majority of the population, the benefits of any physical activity far outweigh any harm caused by air pollution, except for the most extreme air pollution concentrations. It’s important to that people continue to exercise.”
            Professor Stephen Holgate, special adviser on air quality to the Royal College of Physicians in the UK, believes that “we can be quite confident from this (new) study that it is the pollution that is the factor responsible for changes in lung function.”

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            Holgate, who was not involved in the new research, added that the sample sizes were small but that “the study deliberately selected COPD and ischemic heart disease at-risk patients, and … overall, the findings add to evidence of the importance of pollutant effects in vulnerable groups and have implications for pollution in general from vehicles (diesel, petrol, brakes and tires) as sources of pollutants.”
            Tainio highlighted that encouraging people to exercise could in turn reduce pollution levels.
            “The authors are right to highlight that policies should aim to reduce air pollution and noise levels in streets to protect vulnerable population from potential harm. For example, the planned removal of buses and taxis from Oxford Street should help to achieve this,” he said.
            “However, it is important to remember the role that walking and cycling can play in helping to reduce air pollution and noise by removing motorized transport from the streets.”

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            America Crowns a New Pollution King

            For the first time in 40 years, power plants are no longer the biggest source of U.S. greenhouse gas pollution. That dubious distinction now belongs to the transport sector: cars, trucks, planes, trains and boats.  

            The big reversal didn’t happen because transportation emissions have been increasing. In fact, since 2000 the U.S. has experienced the flattest stretch of transportation-related pollution in modern record keeping, according to data compiled by the U.S. Energy Information Administration. The big change has come from the cleanup of America’s electric grid. 

            The chart below shows carbon dioxide emissions from transportation exceeding those from electricity production in 2016 for the first time since 1978. The pollution gap has continued to widen further in 2017, according to a Bloomberg analysis.

            Electricity use in the U.S. hasn’t declined much in the last decade, but it’s being generated from cleaner sources. A dramatic switch away from coal, the dirtiest fuel, is mostly responsible for the drop in emissions. Coal power has declined by more than a third in the last decade, according to the EIA, while cleaner natural gas has soared more than 60 percent. Wind and solar power are also increasingly sucking the greenhouse gases out of U.S. electricity production. 
            This is good news, and not just because carbon dioxide emissions are the biggest contributor to global climate change. The shift to cleaner energy also has immediate local improvements to health by reducing the burden of asthma, cancer and heart disease.

            The transportation sector is also entering a critical period of reformation. Cars are becoming more efficient under aggressive pollution rules passed under President Barack Obama, but that’s so far been offset by an ever-rising American appetite for SUVs, crossovers and pickup trucks. Even the nation’s clean-air policies could soon change. The Trump administration is considering rolling back the toughest fuel-efficiency standards, which are set to take effect in the early 2020s. 

            Investments in electric cars may soon begin to do to the transportation sector what wind and solar have done to the power sector: turn the pollution curve upside down. The price of battery packs has been plummeting by about 8 percent a year, according to Bloomberg New Energy Finance, and electric cars are now projected to become cheaper, more reliable, and more convenient than their gasoline-powered equivalents around the world by the mid-2020s.

            When the electrification of the U.S. auto fleet begins in earnest, pollution from the two biggest energy sectors—electricity and transportation—may ultimately converge. Those electric cars are going draw their power from the grid.

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              The FDA just cleared an Apple Watch band that measures your heart’s electrical activity

              The AliveCor Kardia Band
              Image: Alivecor

              The Federal Drug Administration just cleared a new band for the Apple Watch that monitors the electrical rhythms in your heart. 

              After a two-year process to satisfy the FDA’s stringent requirements, AliveCor announced today that the Kardia Band is now available for purchase for $199. It’s a mobile electrocardiogram (EKG), which measures a heart’s electrical activity and has traditionally been used by doctors to identify abnormal cardiac rhythms. 

              “It’s a regulated measure of physiology by the FDA. Doctors can recognize over 100 conditions when they see an EKG,” AliveCor CEO Vic Gundotra told Mashable

              But unlike conventional EKGs, this is one that you wear on your wrist. The heart rhythms display on the Apple Watch, and it takes about 30 seconds to collect the electrical signals. What’s more, the watch will notify the user when they might potentially be experiencing a common heart arrhythmia called Atrial fibrillation, or AFib. 

              “It used to take a cardiologist, and you’d have to take off your shirt,” said Gundotra. “Now you can do it while at your kid’s soccer game. You can know in half a minute what’s going on in your heart.”

              After being scrutinized by the FDA, Gundotra is confident the device accurately and reliably measures electrical heart activity.

              “We had to prove that our algorithms are effective as a board of human cardiologists,” he said, noting that the stack of FDA regulatory papers “might be taller than me.”

              We had to prove that our algorithms are effective as a board of human cardiologists

              The Kardia Band can be especially useful for patients who suffer from AFib, Gordon Tomaselli, chief of the division of cardiology at John Hopkins University, told Mashable. “AFib may not be dangerous, however, it is associated with increased risk of blood clots in hearts,” he explained. “It also turns out to be a common cause of stroke that occurs for no obvious reason.”

              “I think it’s a useful adjunct and useful for some patients,” he added. “And there are some people that want to know [they’re experiencing AFib] — and for those folks this is a great solution.”

              Still, Tomaselli cautioned the Kardia Band might not be the best option for every single patient. 

              “I think if you have a serious cardiac disease you should not be completely reliant on this to make a diagnosis,” said Tomaselli. “It is always best to make sure that your health care provider has a look at the rhythms.”

              Most of all, he emphasized,If you don’t feel well, you need to see someone. Symptoms trump any recording.”

              Besides watching for AFib, the Kardia Band is also infused with AI technology, a deep-learning tool the company calls “SmartRhythm Monitoring.” This program, however, doesn’t monitor heart rhythms. Instead, it watches your heart rate. The AI system checks your heart rate every five seconds, and will, based up your activity over the previous 30 minutes, notify you when your heart rate is pumping abnormally fast. 

              For instance, the Kardia Band will alert you if your heart rate spikes, even though you might be idly sitting in a car.

              “It worked on me when a cop pulled me over,” said AliveCor’s CEO, Gundotra. “We’re looking for things that don’t match our predictions.”

              So for anyone that’s interested in better understanding their heart — both it’s rhythms and heart rate behavior — the Kardia Band can serve as a helpful tool. 

              “It’s neat technology and there’s going to be more and more of this,” said Tomaselli. “I think some of this is going to be very useful not just in diagnosing things but helping, for those interested, to maintain their best cardiovascular health and fitness.”

              And AliveCor’s Gundotra, after working through a tedious FDA approval process, feels the system validates this new technology. “We are very lucky to have such a strict regulatory body,” he said. “You can’t make ridiculous claims in this country.”

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