What’s in your supplements?

Originally Posted Here: https://www.health.harvard.edu/blog/whats-in-your-supplements-2019021515946

If you’re taking an over-the-counter supplement that wasn’t recommended by your doctor, you’re not alone — about half of the US adult population takes one or more supplements regularly. We spend more than $35 billion on these products each year.

While it’s important that your doctor knows what you’re taking, there are many supplements out there, and it’s likely your doctor won’t know what advice to give you about a lot of them. There are a number of reasons for this but the two biggest are:

Most supplements are not rigorously tested as a prevention or treatment for conditions for which they are promoted. The supplement industry is not regulated the way prescription drugs are. The ingredients on the label may not accurately reflect what’s actually in the supplement.

As a result, the major concerns of your doctor — is it safe? is it effective? — may be impossible to address.

Does the supplement label matter?

Of course it does! At the very least, you’d like to know that what’s on the label is what you’re actually taking. However, past studies have found that supplement labels may

inaccurately describe the dose of the supplement, so you could be getting more or less than the label says. list the correct drug ingredients but fail to mention that it could interact with other drugs or worsen a condition you have. For example, chondroitin (often taken for symptoms of arthritis) may cause bleeding if you have a condition that makes you prone to bleed, or if you take a blood thinner, such as warfarin (Coumadin). contain contaminants — often the hidden ingredient is added in order to enhance the effect of the supplement. For example, banned stimulants have been found in many weight loss supplements.

While these problems have been known about for many years, there is little oversight to confirm the purity of the ingredients or the accuracy of the label.

Studies find tainted supplements or misleading labels are common

In the past, research on a variety of supplements has found concerning discrepancies between what’s on the label and what’s in the bottle. One recent report looked at three memory supplements: two of them contained none of the active ingredient, and one of those contained unidentifiable chemicals that raise serious questions about its safety.

Another, much larger study finds that the problem of tainted supplements — and lack of oversight — is widespread. Researchers analyzed warnings issued by the US Food and Drug Administration (FDA) between 2007 and 2016. These included 776 dietary supplements that contained contaminants, including

a prescription drug, sildenafil (Viagra), in supplements sold for sexual enhancement. sibutramine (Meridia), found in weight loss supplements. This drug was approved in 1997 for weight loss but was taken off the market in 2010 when studies linked it to heart attacks and stroke. steroids or drugs with steroid effects in supplements marketed as muscle builders.

About 20% of the contaminated supplements contained more than one unapproved ingredient. In more recent analyses, more than one-third of the contaminated supplements were found by sampling products ordered online, and another third arrived by international mail delivery.

Unfortunately, the FDA announced voluntary recalls for less than half of these tainted supplements.

What’s a supplement user to do?

One option to consider is to simply stop taking the supplement. If you don’t have a condition requiring treatment with a dietary supplement and if it’s not recommended by your doctor, it might be best to rethink your use of them. Alternatively, there are organizations that certify supplements and can provide a measure of confidence in their ingredients. These include the NSF International Dietary Supplement Certification and the US Pharmacopeia (USP) Dietary Supplement Verification Program. If your doctor has recommended supplement use, check with him or her before making any changes.

Bottom line

The problem of adulterated dietary supplements is unlikely to go away anytime soon. But I am hopeful that the FDA will take a more active role on this issue and help protect consumers from dietary supplements that may contain hidden ingredients.

In the meantime, if you can’t be sure what’s in a supplement, you may be risking your health even as you’re trying to improve it. The safest thing may be to stick with the tried and true (and tested). Ask your doctor and pharmacist if you have questions. But don’t be surprised if they say little more than “buyer beware.”

Follow me on Twitter @RobShmerling

The post What’s in your supplements? appeared first on Harvard Health Blog.

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A positive mindset can help your heart

Originally Posted Here: https://www.health.harvard.edu/blog/a-positive-mindset-can-help-your-heart-2019021415999

Can being positive protect against heart disease? Yes! There is a lot of evidence suggesting that having a positive outlook — like being optimistic, cheerful, having gratitude and purpose in life — can be heart-protective. Researchers in the UK looked at psychological characteristics of over 8,000 people, and found that those who scored high on optimism and a sense of well-being enjoyed a 30% lower risk of developing heart disease. Other studies report similar findings: in a study of over 70,000 women followed for over 10 years, those who scored highest on an optimism questionnaire had a significantly lower risk of death from heart attacks (38%) and strokes (39%).

A positive outlook may even be benefit people who already have cardiovascular disease, which is significant, because they are at very high risk of having heart attacks and strokes. In the US Health and Retirement study, in participants with known stable heart disease, positive psychological traits were associated with significantly lower risks of having a heart attack, and these traits included optimism (38% lower risk), positive outlook (32%), and having a purpose in life (27%). In three separate studies involving hundreds of patients with severe disease requiring either coronary bypass graft surgery or stenting, a higher level of optimism was significantly associated with a lower risk of post-procedure hospitalizations.

How does thinking positively affect your heart?

Many studies show that people prone to negative emotions have a higher risk of heart disease. Negative emotions are associated with the release of stress hormones and a physical stress response, resulting in a higher heart rate and blood pressure. Scientists hypothesize that positive people who have a “glass half-full” approach to life are less likely to experience this stress response. Basically, those who tend to look for the bright side of negative situations can avoid the damage that stress inflicts on the cardiovascular system. Another hypothesis is that people with a positive outlook are more likely to use healthy coping strategies like problem-solving to overcome obstacles and manage stressors, whereas people with a negative outlook tend toward unhealthy coping strategies like self-medicating with food and other substances.

Keeping a gratitude journal can help

Researchers have also studied gratitude in patients with heart failure. Those who kept a daily gratitude journal, where they listed three or four things for which they were thankful every day for two months, had lower levels of inflammatory hormones and a lower heart rate during a stressful exercise. This suggests that the simple daily habit of expressing gratitude can have big long-term health effects.

 Are you an optimistic person?

Some people are naturally more inclined to have a positive outlook and look for the silver lining, while others tend to view things in a more negative light. But optimism is as much as skill as a personality trait. You can train your brain to recognize and counteract negative thinking—your heart and health will be better for it.


A prospective study of positive psychological well-being and coronary heart disease. Health Psychology, May 2011.

Optimism and Cause-Specific Mortality: A Prospective Cohort Study. American Journal of Epidemiology, January 2017.

Positive Psychological Well-Being and Cardiovascular Disease. Journal of the American College of Cardiology, September 2018.

Purpose in life and reduced risk of myocardial infarction among older U.S. adults with coronary heart disease: A two-year follow-up. Journal of Behavioral Medicine, April 2013.

The Protective Role of Positive Well-Being in Cardiovascular Disease: Review of Current Evidence, Mechanisms, and Clinical Implications. Current Cardiology Reports, November 2016.

Positive psychological attributes and health outcomes in patients with cardiovascular disease: Associations, mechanisms, and interventions. Psychosomatics, July-August 2012.

Relationship between positive psychological constructs and cardiovascular outcomes: A systematic review. International Journal of Cardiology, September 2015.

Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, February 2003.

Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure. Psychosomatic Medicine, July 2016.

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Just How Bad Is Facebook For Us?

Despite its continual bad press for privacy concerns and alleged ability to influence real-world politics, Facebook remains the most popular social network worldwide. Users just can’t seem to let go of Facebook, even though, according to a huge recent study by Stanford University, it’s also having a detrimental impact on our health.

It’s long been speculated that social media, in general, has had a negative effect on our mental wellbeing. Various studies have pointed towards how it can lead to increases in depression, eating disorders, low self-esteem and anxiety. However, most of the academic work out there has been based on small scale studies, while a lot of perceived evidence from outside academia has been anecdotal.

However, a recent groundbreaking Stanford study has measured the changes in nearly 3,000 US Facebook users over a four-week period.

We explain what the Stanford report has found, plus how this builds on other evidence for the negative mental impact of being a Facebook user.

Stanford Report, Key Findings on Facebook Deactivation:

Reduced overall online activity Reduced factual news knowledge Reduced political polarization Marginal improvement to subjective wellbeing Is Facebook Bad for our Health?

The Stanford study is one of the biggest and most rigorous looks at the effects of Facebook on users. It focuses on what happened to users when they stopped using Facebook.

Can the findings be trusted? It’s already receiving a warm reception among academics. Erik Brynjolfsson, director of the Massachusetts Institute of Technology Initiative on the Digital Economy, who was not involved in the research, said of it:

“This is impressive work, and they do a good job sorting out causality,”

“This is the way to answer these kinds of questions; it’s the gold standard for how to do science. A lot of what we’ve heard before about social media’s effects was based on surveys.”

And, surprisingly, the study found that Facebook has a range of benefits, as well as the more predictable downsides.

Facebook deactivation reduced overall online activity

The study found that when people deactivated their Facebook account, they spent more time offline as a whole, rather than substituting Facebook for another social media service.

This may come as a surprise to some, not least Matthew Gentzkow, a Stanford economist who helped lead the research:

“I would have expected more substitution from Facebook to other digital things — Twitter, Snapchat, online browsing. That didn’t happen, and for me, at least, it was a surprise.”

Instead, former users watched more TV on their own, and spent more time with friends and family. The subjects did not see more friends and family members, only more of the ones they already see regularly.

Facebook deactivation reduced factual news knowledge

The social network site has long grappled with issues of fake news on its platform. But, the Stanford study found that users who switch off Facebook were actually less well informed about current affairs.

Again, it shouldn’t come as a surprise that users aren’t as in-the-know when abandoning Facebook. Big media companies throw significant resources at promoting content on Facebook, even creating Facebook-specific content. As part of the study, participants were quizzed on current events. Those that deactivated Facebook were significantly more likely to score poorly on the quiz or be unsure of the issues they were quizzed on.

This might suggest that regular Facebook users are less likely to seek out news coverage of current events, relying on Facebook to keep them informed.

“The political-knowledge findings suggest that Facebook is an important source of news that people pay attention to,” said David Lazer, a professor of political science and computer and information science at Northeastern University. “This is not a trivial finding. It could have gone either way. You could imagine that the other chatter and information on Facebook was crowding out news consumption.”

Facebook deactivation reduced political polarization

One of the biggest issues supposedly affecting the US voting base at the moment is political polarization — this is the idea that Democrats and Republicans are unwilling to compromise on issues that affect the entire country.

The study found that deactivating Facebook pulls former users more into line with the average position in their respective political parties. Essentially, this means that Facebook deactivation brings users closer to the political center. But, has social media actively led to the increase in polarization, or have the parties and voters drifted further apart of their own volition? According to the study:

“The figure shows that deactivation moves both Democrats and Republicans visibly towards the center. In the control group, the issue opinions of the average Democrat and the average Republican differ by 1.47 standard deviations. In the treatment group, this difference is 1.35 standard deviations — about eight percent less.

“Are these polarization effects large or small? As one benchmark, we can compare these effects to the increase in political polarization in the US since 1996, well before the advent of social media. Using data from the American National Election Studies… [another academic] calculates that the change in a different index of polarization… increased by 0.38 standard deviations between 1996 and 2016. The 0.16 standard deviation effect of Facebook deactivation on political polarization in our sample is about 42 percent as large as this increase.”

“It’s hard to know what to make of this,” Gentzkow said. “It may be that seeing a lot of news and politics on Facebook tends to polarize people. But once they’re off Facebook, it doesn’t necessarily mean they’re using the extra time to read The New York Times.”

Facebook deactivation marginally improves subjective wellbeing

Perhaps the most interesting revelation from the study is that Facebook “does indeed have adverse effects on subjective well being.” However, the effect of removing Facebook appears slight. Some Facebook users reported positive feelings:

“I was way less stressed. I wasn’t attached to my phone as much as I was before. And I found I didn’t really care so much about things that were happening [online] because I was more focused on my own life… I felt more content… I thought I would miss seeing everyone’s day-to-day activities… I really didn’t miss it at all.”

However, others found the experience of deactivating Facebook difficult:

“I was shut off from those [online] conversations, or just from being an observer of what people are doing or thinking… I felt very cut off from people that I like… I didn’t like it because I spend a lot of time by myself anyway, I’m kind of an introvert, so I use Facebook in a social aspect in a very big way.”

Others also described sadness at not being able to post for special events such as birthdays and not being able to participate in online groups.

This mixed reaction to Facebook deactivation is likely to be indicative of the different ways in which people use Facebook. Are you constantly checking it to see what the people on your friends list are doing? Or are you using Facebook as a communications tool with people you actually want to spend time with and talk to?

This difference in the use of Facebook is significant and shouldn’t be underestimated.

So Facebook Isn’t All Bad Then?

No, it certainly isn’t. If the results of the Stanford study prove anything, it’s that Facebook is simply a tool that users interact with in multiple ways. The key for using Facebook (or any social media) is understanding and being mindful about the platform. According to Dr Elena Touroni, Consultant Psychologist and Clinic Director ofThe Chelsea Psychology Clinic:

“It is possible to have a positive experience if one is interacting with real friends or even in the event where one builds a community of virtual connections. Social media offers both great opportunities for developing new avenues for contact with others but also equally significant risks in triggering low self esteem and feelings of exclusion, the key is about how to relate to social media and make sense of the experience.”

One of the key aspects for making sense of the experience of social media is understanding the difference between real friends and connections that you have on social media:

“Having thousands of connections is something human beings might be less equipped [to deal with] plus the need for [someone to have] so many connections in an online space could indicate that one is feeling disconnected in a more intimate way from other people in their life”

Some studies have also suggested that social media platforms can improve the relationships between families. More than half of British people say that the internet has allowed families to remain in contact, and social media naturally plays a huge role in online communication. What’s more, 36% of British 18-24 year olds state that the internet has brought their family closer together.

It’s All About How You Use It

Again, it appears that the way platforms such as Facebook are being used is perhaps the most important factor to ensuring a positive experience.

Of course, Facebook isn’t the only social media platform to have perceived negative effects on its user base. According to data gathered in the UK, some 67% of Instagram users felt that the (Facebook-owned) photo and video-sharing app had negatively impacted their mental health at some point.

However, as Dr Touroni explains, the key to interacting with social media is being mindful about the sort of content you’re seeing on screen:

“Some of the time our response to social media is heavily influenced by us comparing ourselves to other people rather than being mindful that the images of people’s experiences on social media might not be reflective of real life.”

If users can remember that what they’re viewing isn’t real life, then many issues are likely to be alleviated.

Corporate Responsibility Remains

It’s important to note, though, that users being careful about the way they consume content on and interact with social media platforms doesn’t absolve the companies from responsibility. Facebook, Instagram, Twitter and other platforms all have the moral obligation to protect their users — particularly younger ones — from content that could distress them or lead to other negative outcomes.

So far, the response from sites has been piecemeal and disjointed. Facebook has consistently struggled to deal with politically-motivated campaigns, from campaigning around Brexit and the US 2016 Presidential election, to data-lifting by Cambridge Analytica, to the genocide of Rohingya Muslims in Myanmar.

Instagram has a notorious problem with fake followers and phoney engagement, which can lead to companies being hoodwinked into working with fraudsters and young people failing to discern adverts from genuine posts.

However, any expectation that these companies can be trusted to self-regulate is illusory. Action needs to be taken by governments and supranational bodies, such as the EU, to make companies accountable for the content on their platforms.

This might seem like an extreme approach, but when such a vast proportion of the online population has a Facebook account, an extreme response needs to be taken.

What Can You Do to Make Your Facebook Experience Better?

Of course, these responses are a long way off. So, what can you do to improve your experiences of Facebook in the short term?

Again, Dr Touroni has some answers “Mindfulness techniques and challenging negative thoughts could be helpful in relieving anxiety,” for example.

“Try and focus on yourself and your real relationships, making time for people that matter to you. Spending time with real friends make you feel happier, less stressed and motivated” notes Abbas Kanani, a pharmacist at online pharmacy Chemist Click.

However, being able to identify that social media is having a detrimental effect on your mental health is likely to be the first step in improving your relationship with social media and imposing your own temporary Facebook deactivation might be a great way to start.

Is Facebook Here to Stay?

Social media has undoubtedly been one of the most transformative technologies of the past two decades. Yes, that’s right, twenty years. MySpace, for example, was launched back in 2003 and MSN Messenger debuted even earlier in 1999.

Though its popularity has arguably waned with younger generations, Facebook has led the charge. Everyone has a Facebook profile: Your mom and dad use Facebook, so do your colleagues, all your friends from school, heck, even grandparents (for better or worse) have Facebook accounts too.

In fact, Facebook recorded 2.32 billion monthly active users on December 31, 2018. According to the International Telecommunications Union, some 48% of the world’s population is online – about 3.6 billion people. Scratch off a billion or so for the people who can’t access Facebook in China and the enormity of Facebook becomes clear – almost 90% of those who can access Facebook do indeed have an account with it. By comparison, MySpace, at its peak, had 100 million users.

But, perhaps the most unprecedented thing about Facebook is its staying power. Mark Zuckerberg’s former hot-or-not college game was founded in 2004.

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