Consider this. Most people can tell you the number attached to their cholesterol level, but do they really understand what it means? What’s behind all those terms, and what is cholesterol anyway?

What’s your cholesterol IQ? To help raise it a few points, here’s a quick refresher course in honor of National Cholesterol Education Month.

Cholesterol is really not that complicated. It’s basically a waxy, fat-like substance made naturally by the body, in the liver. The liver alone makes enough of it for the body to function and thrive. But we also get cholesterol from animal-based foods we eat, such as meat, eggs and full-fat dairy products. Now we have more than we need, and that can turn into a problem.

For one thing, the extra cholesterol can combine with fat and other elements in the blood to form plaque. This can build up on the sides of artery walls – a condition known as atherosclerosis – which can eventually start interfering with the smooth flow of blood through the vessels. Sometimes, a piece of plaque will even break off and form a clot that can block blood flow to areas of the body such as the heart and brain, causing a heart attack or stroke.

The thing is, cholesterol doesn’t travel through the bloodstream by itself. It has to be attached to a protein; and together, they’re called a lipoprotein. Here’s where the LDL and HDL come in.

LDL stands for low-density lipoprotein, which means there is a lower amount of protein compared to cholesterol; essentially, a low density of protein. It’s often called the “bad” cholesterol because it tends to help form the plaque that builds up in the arteries.

On the other hand, HDL is high-density lipoprotein because there is more protein than cholesterol. It’s considered the “good” cholesterol because it can help pull cholesterol out of the artery walls and send it to the liver to be excreted.

Doctors want their patients to have a higher HDL level in their blood compared to LDL, although lower cholesterol levels in general are usually the goal. If you’re cholesterol level is high – 240 is defined as “high” – your doctor might consider some interventional strategies to lower it. If you have other risk factors for heart disease and stroke, action might be taken with an even lower cholesterol level.

So, if your cholesterol level is running a little on the high side, your doctor might start by recommending a few key lifestyle changes, sometimes called Therapeutic Lifestyle Changes (TLC). Simply, TLC includes those common sense practices we should be doing anyway: eating a healthy diet, managing our weight and engaging in regular physical activity.

In some cases, lifestyle changes alone are enough to lower cholesterol to a healthy level. But if they’re not enough, your doctor might prescribe a cholesterol-lowering medication. Statins are a common type of medication used for this purpose, but they’re not the only type. Your doctor will work with you to find the drug that works best for you.

The thing to keep in mind is that there are no signs or symptoms of high cholesterol, so there’s no way of knowing you have it without a blood test. Your doctor will determine how often you need to be tested, but most healthy adults should have their cholesterol checked at least every four to six years.

A good idea is to get tested for a baseline reading so your doctor knows where you stand. That way, if you are on the high side, you can get started with the lifestyle changes that will, hopefully, get you level in check.

Reduce your risk of heart attack and stroke. Consider your cholesterol!

In 1979, the President’s Council on Physical Fitness, Sports and Nutrition founded the National Association for Health and Fitness, which in turn created Global Employee Health and Fitness Month. The aim of this annual observance in May is to promote the benefits of a healthy lifestyle to employers and their employees through worksite health promotion activities and environments.

Almost half of all US worksites provide health promotion activities through some type of employee wellness program, an initiative within the organization that fosters healthy lifestyles among its employees. Employee wellness programs vary in the types of services and activities offered, but in the long run, they all appear to benefit the employees – and the employers.

What’s included in a company’s employee wellness program generally depends on the size of the organization, its budget for wellness initiatives and which activities make the most sense for its employee population. The most successful programs address multiple dimensions of employee wellbeing, including their physical, emotional, social, occupational and financial wellbeing.

To help improve employee wellbeing across all dimensions, companies can employ a wide variety of solutions. These may include: health risk assessments, fitness classes or gym reimbursement, health coaching, health education, flu shots, financial counseling/planning, flexible work schedules, free health food, health fairs, on-site/near-site health clinics, telemedicine, tobacco cessation, weight management and wellness challenges.

In many cases, the benefits of providing an employee wellness program outweigh the cost of providing the program. Employees spend most of their time at work, so linking their wellness goals with an overall work-life balance can positively impact the company’s bottom line business outcomes.

For one thing, employee wellness programs lower the employees’ elevated health risks, such as high blood pressure and high cholesterol, which can lead to heart disease and stroke. Managing risk translates into improved overall health. This ultimately reduces use of medical services and lowers medical costs to the employee and employer.

In addition, organizations with good wellness programs can experience reduced absenteeism for a number of reasons. Employees with good general health typically don’t miss work. Employees who can manage stress well have lower absenteeism. Employees with normal blood pressure, cholesterol and glucose are less likely to miss work, and those who are not overweight or obese are less likely to get sick and miss work.

Poor employee productivity at work is called presenteeism. That’s when you’re at work but not really working, and it’s been linked to poor health. Employee wellness programs that impact employee lifestyles and improve health eliminate presenteeism and increase employee productivity. These programs also help to retain and recruit employees to the company, as many workers today look for factors beyond salary when choosing an employer.

Not so fast! Researchers reported conflicting results in a study published in the April 2019 edition of JAMA. In their study, researchers analyzed data from 160 worksites employing nearly 33,000 people. About 10 percent of the employers in the study offered wellness programs that addressed topics such as exercise, nutrition and stress.

The researchers compared employees with and without access to a wellness program over 18 months and discovered that those who had access to a wellness program reported significantly higher rates of exercise and weight management efforts.

BUT, those with and without wellness programs had similar self-reported health behaviors and outcomes; similar results on 10 heath measures, including blood pressure, cholesterol and body mass index; similar use of medical resources; and similar absenteeism and job performance.

So what’s the bottom line when it comes to employee wellness programs? Do they work or don’t they? It’s clear more research is needed to determine the true effectiveness and benefit of these programs. For example, a study lasting longer than 18 months might yield much different results.

If you started exercising more, lost weight, quit smoking and/or began eating healthier because of what you learned though an employee wellness program, you’ll definitely reap benefits that will positively impact your overall health. That’s the true bottom line.

The holidays are marked by festive celebrations with family, friends and coworkers. Typically, alcohol flows freely at these celebrations, and it’s not uncommon to drink more at these events than you do during the rest of the year. But binge drinking has negative physical and emotional effects, and puts you – and others – at risk.

Most people know that drinking too much is bad for your liver. Consistent heavy drinking causes different types of inflammation in the liver, such as fatty liver, alcoholic hepatitis, fibrosis and cirrhosis. And any damage to the liver, including damage caused by alcohol, can lead to liver cancer.

Drinking affects other parts of your body as well. A single episode of binge drinking can damage your heart and throw off your heartbeat. In fact, the rate of deadly heart attacks spikes during the winter holiday season. This phenomenon is known as holiday heart syndrome. Binge drinking can also lead to high blood pressure and even stroke.

Further, a night of binge drinking can impair your immune system’s ability to fight infection for up to 24 hours, putting you at increased risk for colds, flu and other infections. Too much alcohol can also worsen medical and psychiatric conditions. Alcohol is a depressant and can exacerbate symptoms of depression and anxiety. It can also affect blood sugar levels in the blood of people with diabetes.

And that’s not all. Alcohol lowers inhibitions, and for some people, drinking too much releases pent-up anger and frustration. After drinking, these people may act on the their anger, which can result in violence and physical injury. And with lowered inhibitions, you’re more likely to engage in risky sexual behaviors, which can result in contracting a sexually transmitted disease.

Drinking too much can also be deadly. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), an estimated 88,000 Americans die from alcohol-related causes annually. That makes alcohol the third leading preventable cause of death in the US.

In addition to having negative effects on your health and wellbeing, binge drinking is expensive. NIAAA notes that alcohol misuse costs the US $249 billion a year, and 75 percent of those costs are related to binge drinking. These costs include lost productivity, health care costs and criminal justice costs.

Another serious concern related to holiday drinking is the increase in people drinking and hitting the road. NIAAA reports that drunk drivers play a role in 40 percent of traffic deaths over Christmas and New Year’s. The institute notes that this figure is an increase of 12 percent over the rest of December.

The US Department of Transportation elaborates on NIAAA’s statistics. They report that 300 Americans die each year in the handful of days surrounding the Christmas and New Year holidays. They go on to report that an average of 27 people die each day in December due to drunk driving accidents. NIAAA notes that there is a 155 percent increase in DUI violations on New Year’s Eve alone.

One thing you should know about alcohol; it sneaks up on you. Typically, people don’t realize that their critical decision-making abilities and driving-related skills are already diminished long before they show any overt signs of intoxication. You may think you’re “okay to drive,” but you’re just fooling yourself. Your reflexes and judgment are impaired by the alcohol even if you don’t “feel” it.

Impairment is not determined by what you drink, but by the amount of alcohol you drink over time. Binge drinking is when you drink enough alcohol to bring your blood alcohol level up to the legal limit for driving, which is 0.08 in most states. Generally, this works out to about five alcoholic drinks for men and four drinks for women in less than two hours.

And don’t think that you’ll sober up and be able to drive once you’ve stopped drinking and had a cup of coffee. In reality, alcohol continues to affect your brain and body long after you’ve finished your last drink. The alcohol in your stomach and intestines continues to enter your bloodstream, resulting in impaired judgement and coordination for hours.

Coffee isn’t the answer. Caffeine may help with drowsiness in the short-term, but it does nothing to counter the effects of alcohol on decision-making and coordination. And then, when the caffeine wears off, you’ll feel post-caffeine sleepiness, which only compounds the depressant effects of the alcohol. Then, you can easily nod off or lose attention if you get behind the wheel.

You don’t have to skip the holiday party or abstain from alcohol altogether, but consider these tips for safer drinking:

• Have a snack before you leave for the party. When you drink on an empty stomach, the alcohol quickly passes from your stomach into your small intestine, where it is absorbed into the bloodstream and begins to affect your body.
• Make your first drink nonalcoholic. It keeps you from gulping down your first alcoholic drink.
• Alternate alcoholic and nonalcoholic drinks. Nonalcoholic drinks help counter the dehydrating effects of alcohol.
• Eat throughout the night. Food can slow the absorption of alcohol and reduce the peak level of it in your body by about one-third.
• If you are in an awkward situation, don’t escape by making a beeline to the bar. Walk around the room, mingle with other guests, check out the decorations, etc.
• Establish a designated driver who isn’t drinking or take a ride-share home and to the party.

You can still enjoy alcohol during the festivities, just use wisdom and moderation to keep yourself – and others – safe this holiday season!

One of the biggest problems that health care providers have to deal with pertains to health literacy, which is a person’s ability to understand health care information and navigate the health care system. Currently, health literacy in the United States is woefully deficient.

So what exactly is health literacy?

There are many definitions out there, but the concept behind them is essentially the same. An example comes from the American Medical Association Foundation, which defines health literacy as: “the ability to obtain, process and understand basic health information and services needed to make appropriate health decisions and follow instructions for treatment.”

The Center for Health Care Strategies puts it more simply. In their definition, health literacy refers to “the skills necessary for an individual to participate in the health care system and maintain good health.” The skills they identify are reading and writing, calculating numbers, communicating with health care professionals, and using health technology such as electronic diabetes monitors.

The Network for the National Library of Medicine agrees that health literacy involves using a certain set of skills. The network suggests that “health literacy requires a complex group of reading, listening, analytical and decision-making skills, as well as the ability to apply these skills to health situations.”

According to the US Centers for Disease Control and Prevention (CDC), anyone who needs health information and services also needs health literacy skills. You can use those skills to find appropriate information and services, communicate your needs and preferences, and respond to the information and services.

Health literacy skills also enable you to understand the choices, consequences, and context of the information you receive. With such understanding, you can make decisions based on which information and services match your needs and preferences.

But there’s a big problem. An estimated 90 million Americans, nearly 36 percent, have low health literacy. And it affects certain populations more than others.

For example, Hispanic adults have lower health literacy skills overall than any other ethnic or racial group. Low health literacy is also more common in people who speak another language or speak English as a second language, as well as in older people, people with lower socioeconomic status or education, and people who are uninsured or on Medicare or Medicaid.

It’s imperative that we improve health literacy in this country because low health literacy is having a negative effect on how Americans use the health care system and on overall health outcomes. And as a result of increased use of services and poor outcomes, low health literacy is making an enormous impact on the nation’s health care costs.

The authors of a report titled “Low Health Literacy: Implications for National Health Policy” estimate the impact of low health literacy on the nation’s economy to be between $106 billion and $238 billion annually. That amount, the authors point out, represents between 7 percent and 17 percent of all personal health care expenditures.

To achieve optimal health, you must be an active participant in your health care. But people with low literacy often don’t have the skills necessary to clearly describe their symptoms to their health care provider, or fully understand their diagnosis and follow the instructions for their treatment. Many are simply unable to play an active role in their care.

And that affects the way they use the health care system. Many avoid going to the doctor, and when they have a health concern, they go to the emergency room for care instead. Studies show that people with low health literacy are 2.3 times more likely to visit the emergency room. And with that comes an associated increase in hospital admissions.

Health literacy affects overall health and mortality as well. Low health literacy has been linked to increased frequency of depression, physical limitations, and chronic diseases such as heart disease, stroke, diabetes, and asthma.

Making matters worse, people with low health literacy often have little understanding of their chronic disease. And because they are less engaged in their health care, they are less likely to use preventive services or follow instructions for managing their chronic disease. As a result, people with low health literacy have a much higher risk of complications and death.

Health care providers, health educators, and patients all have roles to play if we’re going to boost health literacy in America. Patients must be willing to engage with their providers and listen to what they say. Providers and educators can do their part by following these Four Simple Strategies for Improving Your Patients’ Health Literacy:

• Use plain language in both verbal and written communication
• Use visual aids
• Recommend and use technology – Research shows that nearly 90 percent of Americans use the internet and 81 percent own a smartphone. Using these technologies can be a good way for providers to get their message to patients.
• Use effective teaching methods – Some techniques include talking slowly, asking open-ended questions, and asking patients to repeat instructions given to them.

Why is health literacy important? It’s important because it allows you to make good decisions about your health. Health literacy also enables you to get appropriate medical care, take your medications correctly, and manage chronic diseases. And most importantly, it helps you lead a healthy lifestyle so you can live a full and healthy life.

National Alcohol & Drug Addiction Recovery Month was created by the Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of the US Department of Health and Human Services. With SAMHSA, we observe Recovery Month every September to increase awareness of substance use disorders and celebrate individuals in recovery.

Alcohol and drug addiction are also referred to as substance use disorders. Whether the substance is alcohol, opioids, stimulants or sedatives, substance abuse has a widespread impact on life in this country. Research has found that almost 21 million Americans have at least one addiction, and drug overdose deaths have more than tripled since 1990.

What’s more, substance use disorders take an enormous economic toll. One study calculated that drug and alcohol use in the US costs $1.45 trillion in economic loss and societal harm annually. That total includes $578 billion in economic loss and $874 billion in societal harm, which includes quality of life declines and premature death.

For years, many considered addiction to alcohol or drugs to be a moral failing, but that line of thinking has changed. The National Institute on Drug Abuse (NIDA) defines “addiction” as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use despite harmful consequences.”

Research has discovered that substance use disorders actually change the way the brain works. The substances affect communication pathways in the brain, which changes thought processes, emotions and behaviors. These brain changes can be long-term, lasting well after you stop using drugs or alcohol.

Drugs and alcohol affect the brain by hijacking its reward system. In a healthy brain, positive behaviors such as exercising or spending time with family turn on the brain’s reward system. This system rewards the behavior by making you feel good so you want to repeat the behavior. The brain does this by producing large amounts of the feel-good chemical dopamine.

The brain’s reward system works when you use drugs or alcohol as well. But after repeatedly using the substance, your brain can’t produce normal amounts of dopamine on its own any longer. As a result, you can’t enjoy activities you normally find pleasurable unless you’re using drugs or alcohol.

Further, you develop a tolerance to the number of drugs or alcohol you’re currently using and have to use more to achieve the same reward response.

Addiction can also send your emotional danger-sensing circuits into overdrive. When that occurs, you might become anxious or stressed when you’re not using drugs or alcohol. At that point, you may start using the substance to avoid negative feelings rather than to achieve a “high.”

In addition to changing your brain chemistry, drugs and alcohol can have other negative effects on your life. You can develop an abnormal heart rate and experience heart attacks. Injecting drugs can result in collapsed veins and infections in your heart valves. You can also develop problems with your muscles, kidneys or liver.

When you’re under the influence of drugs or alcohol, you may forget to practice safe sex and become infected with a sexually transmitted disease. Substance use disorders have legal and financial consequences as well if you drive under the influence of drugs or alcohol. Or you may lose your job if your employer requires a drug test and you fail.

Many people with substance use disorders deny that they have a problem with alcohol or drugs. Your doctor uses specific criteria to diagnose addiction. These criteria are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. These criteria include:

• Lack of control – The substance is used in larger amounts or over a longer time than the person originally intended.
• Desire to limit use – The person wants to cut back on use but is unable to do so.
• Time spent — A considerable time is spent trying to acquire the substance.
• Cravings – The user experiences an intense desire or urges to use their drug.
• Lack of responsibility – Substance use takes priority over work, school or home obligations.
• Loss of interest – The user stops engaging in important social or recreational activities in favor of drug use.

If any of these criteria apply to you, consider seeking treatment, which varies by person and substance being abused. There are many types of drug and alcohol rehabilitation, but inpatient rehabilitation programs are typically the most effective.

Some inpatient rehabilitation programs require stays of 30, 60 or 90 days, while other, long-term programs require stays of 120 days or longer. Rehabilitation programs typically include counseling, behavioral therapy and medications to manage cravings and withdrawal symptoms.

If you don’t know where to find treatment, contact SAMHSA’s National Helpline: 1-800-662-HELP (4357). The Helpline is a free, confidential treatment referral and information service for individuals and families facing mental or substance use disorders. Helpline staff can direct you to the help you need. If you suspect you have a problem, call today!

Infections. Deaths. Racism. Brutality. Rioting. Looting. Shooting. Killing. It seems today’s headlines herald terrible news that the world we live in is in utter chaos. If you’re like me, you’re probably feeling somewhat frazzled by it all. And if you’re a news junkie, you may even be feeling downright depressed! There’s actually a name for that feeling.

Psychologist Steven Stosny originally coined the term election stress disorder to describe the feeling of anxiety caused by the onslaught of news surrounding the 2016 presidential election. Stosny later renamed the condition headline stress disorder when the anxiety persisted past the election. The term is pretty fitting for what’s happening today as well, don’t you think?

Headline stress disorder reflects the fact that to grab attention, news headlines often use words that create fear or anger in readers. Stosny recommends reading past the headline. Typically, once you read on and get all the facts, the situation being reported is not as awful as the headline portends.

But today’s news is stressful beyond the headlines. And we must learn to deal with stress in our lives because it can have a profound effect on our physical and mental health.

Stress is a natural response to life experiences. In potentially threatening situations, your central nervous system reacts to stress by initiating the “fight or flight” response. Your CNS triggers your adrenal glands to release the stress hormones adrenaline and cortisol, which increase heart and breathing rates and send blood to your organs and muscles to prepare them for action.

Ideally, when the threat is over, your body returns to a normal, relaxed state called homeostasis. But with chronic stress, your body remains hyped up on stress hormones. This can lead to symptoms such as irritability, anxiety, depression, headaches and insomnia.

Chronic stress can also elevate blood pressure, cause chest pain and sexual problems and worsen symptoms of existing diseases, including heart disease, cancer and lung disease. It’s also been linked to low back pain, inflammatory bowel disease, changes in women’s menstrual cycles and structural changes in the brain leading to memory, thinking and learning difficulties.

Some people living with chronic stress develop unhealthy behaviors as a way of coping. They may misuse food, alcohol, tobacco or drugs, or gamble compulsively, engage in sex, shop or use the internet excessively. Unfortunately, these behaviors tend to cause more stress rather than relieve it. It becomes a vicious cycle.

Today, we’re bombarded with a nearly constant flow of news about COVID-19 and the riots surrounding the George Floyd protests. And the bad news is keeping some in a state of chronic stress beyond headline stress disorder. The American Psychological Association notes that a few lessons learned from past disasters are applicable to what’s happening now.

We’ve learned that social media may escalate anxiety more than traditional media, but too much media of any kind can undermine mental health. Also, it was found that trustworthy information sinks in. The bottom line: you can stay informed of events, but be sure to find authoritative sources and be mindful of how much time you’re absorbed in the news.

To help you tune out the bad news for a while, set a limit on how much time you spend looking at the news on TV or on your social media on your phone or computer. This can give you a chance to relax from headline stress disorder and allow your body’s stress response to return to homeostasis.

You can also benefit by engaging in stress management. Regular exercise is a good way to manage stress in your life, as is spending time with your friends and family. Practicing relaxation techniques such as meditation, deep breathing and yoga can also help with stress. If you find that you can’t handle stress on your own and it’s affecting your health, seek professional help.

It’s important that you take care of yourself, especially if you feel stressed about the latest headlines. Self-care enhances your nervous system’s response to stress, and that improves your physical health and overall wellbeing. And when you feel good, you can better handle the negative impact of headline stress disorder and whatever crises are in the news.

America’s Obesity Crisis Intensifies.

The number of people in the United States who are overweight or obese has been climbing for years, and that excess weight has serious and costly health consequences. So, the projections from a highly respected team of scientists about obesity in America’s future are disconcerting at best.

After conducting national surveys and correcting for our tendency to underestimate our weight in surveys, the scientists discovered that in as many as 29 states, the prevalence of obesity will exceed 50 percent by 2030. In addition, they project that no state will have less than 35 percent of its residents who are obese.

The bottom line is that within the next ten years nearly one in two adults in the US will be obese. Further, the team projects that nearly one in four Americans will be severely obese by 2030.

The team’s report, Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity, was published in The New England Journal of Medicine in December and suggests that the prevalence of severe obesity is expected to be higher than one in four in 25 states. Further, severe obesity is projected to be the most common weight category among the nation’s women, non-Hispanic, black and low-income adults.

Obesity will exceed 50 percent by 2030. – The New York Times

This study’s results mirror those of a study presented in the September 2012 “F as in Fat” report. That report, released by the Trust for America’s Health and the Robert Wood Johnson Foundation, also predicted that half of US adults will be obese by 2030.

Obesity is dangerous. It is linked to a substantial number of negative health effects, including high blood pressure, type 2 diabetes, heart disease and stroke, sleep apnea and breathing problems, osteoarthritis, gallbladder disease, mental illnesses such as depression and anxiety and certain cancers, including endometrial, breast, colon, kidney, gallbladder and liver cancer.

The “F as in Fat” report projected that there will be as many as 7.9 million new cases of diabetes a year by 2030, compared with 1.9 million new cases a year in 2012. They suggest there could also be 6.8 million new cases of chronic heart disease and stroke each year, compared with 1.3 million cases in 2012.

Obesity is also expensive. A study conducted in 2013 estimated that the medical cost of obesity totaled $342.2 billion per year. The study also determined that the indirect cost of obesity due to lost productivity came to another $8.65 billion per year. And that was in 2013. Those amounts are likely much higher in 2020.

Obesity is a leading cause of preventable illness, disability and life-years lost in the United States. It is responsible for about one in five deaths, nearly as many as smoking. That makes it an official public health crisis in this country. But what makes us obese?

In general, we’re considered overweight or obese when our weight is higher than a normal weight adjusted for height. Body Mass Index, or BMI, is the tool used for measuring this. BMI, which is related to the amount of fat in our bodies, is defined as weight in kilograms divided by height in meters squared. A BMI of 30 to 39 is considered obese. A BMI of 40 or higher is extremely obese. The higher our BMI, the greater our risk for developing the health problems associated with obesity.

There are several factors that contribute to obesity, but the bottom line is that we become obese when we consistently consume more calories than we burn through normal daily activity. What we eat also plays a role. Foods that are high in fat, sugar and salt cause weight gain. And most of us eat portions that are larger than necessary to satisfy our hunger.

Our genes also play a role. Genetics is a factor in how much body fat we store, where it’s distributed and how efficiently our bodies metabolize the food we eat into energy.

Medical disorders such as Prader-Willi syndrome, a genetic condition, Cushing’s syndrome, a hormone disorder, and arthritis can lead to decreased activity and weight gain. In addition, certain medications including some antidepressants, anti-seizure drugs, steroids and beta-blockers can cause an increase in weight.

Lifestyle and behavioral factors such as a lack of physical activity, smoking, lack of sleep and an unhealthy diet also contribute to the development of obesity. Social and economic factors include not having enough money to buy healthy foods or access to stores that sell healthier food options. Another socioeconomic factor is not having access to a safe place to exercise.

Obesity is a major public health crisis in America that impacts more than 100 million adults and children and is projected to increase dramatically by 2030. Fortunately, obesity and the health and financial consequences associated with it are largely preventable, and that should be our goal.

Steps we can take to help prevent obesity include limiting calorie intake from total fats, shifting away from saturated fats to unsaturated fats. In addition, we can increase our intake of fruits and vegetables, legumes, whole grains and nuts and limit our intake of sugar. We also have to boost the number of calories we burn each day by increasing our physical activity. Health officials recommend at least 30 minutes of regular, moderate-intensity activity on most days.

But it will take more than willpower to change the future. There are already federal and state programs in place to educate about making healthy food and exercise choices and to counter fast food and soda marketing. Additional education and more firepower against the big-money fast-food conglomerates is still needed. Our country’s health, now and in the future, depends on it!

The US was on the upswing for a while. Between 1959 and 2014, life expectancy for Americans, which is the average length of time we are expected to live, increased by nearly ten years, from 69.9 years to 78.9 years. But something started happening in the 1980s, and the increase slowed considerably. By 2010, it plateaued.

Then in 2014, life expectancy in America began reversing, and by 2017, the latest year for statistics, life expectancy in the US had decreased for three straight years to 78.6 years. Our decline persisted despite the fact that the US spends more dollars per capita on health care than any other industrialized nation.

The findings of a comprehensive study that explored the nature of life expectancy in America as well as possible causes for its decline were released at the end of November and published in the Journal of the American Medical Association (JAMA).

For the study, the researchers reviewed more than a half-century of data from the US Mortality Database and the US Centers for Disease Control and Prevention’s WONDER database. That’s an integrated information and communication system for public health practitioners and researchers.

One key finding of the study was that adults ages 25 to 64, or working-age Americans, saw the largest increase in death rates, a rise of six percent. The increase in death rate in this age group was seen in nearly every state in the US.

According to the study, the death rate in working-age Americans from all causes increased from 328.5 deaths per 100,000 people in 2010 to 348.2 deaths per 100,000 people in 2017. The statistics showed this increase occurred across all racial and ethnic groups.

Dr. Steven Woolf, one of the study’s authors, noted this increase in mortality was driven, in part, by “deaths of despair.” Those include deaths from drug overdoses, which reflect the opioid crisis in this country, as well as those from alcohol abuse and suicide.

The study found that between 1999 and 2017, fatal drug overdoses by working-age Americans increased by 386.5 percent. Deaths linked to alcohol use, including those from chronic liver disease and cirrhosis of the liver, rose 40.6 percent during those years. And suicide rates by that population rose 38.3 percent.

The study also pointed to health conditions such as diabetes, high blood pressure and heart disease as other causes for the death rate increase. It noted that these conditions are exacerbated by unhealthy behaviors such as smoking, being overweight or obese, eating a high-fat diet and living a sedentary lifestyle, problems that are rampant in our society.

And these problems impacted the death rates for working-age Americans. For example, deaths in this age group linked to obesity increased 114 percent between 1999 and 2017. The majority of American adults, about 71 percent, are overweight or obese. And obesity increases the risk for cancer, diabetes, heart disease and other chronic conditions.

Deaths related to high blood pressure increased by 78.9 percent in the 25 to 64 age group during the same time period. And about 80 percent of American adults don’t meet the physical activity guidelines. If we don’t manage chronic conditions better and change our unhealthy behaviors, our life expectancy will continue to decline.

And according to the new study’s findings, the increase in working-age death rates coincided with major shifts in the US economy dating back to the 1970s and 1980s. It was during those years that the US started to lose manufacturing jobs, and the middle class began to shrink, Dr. Woolf noted.

These loses hit certain areas of the country harder than others, and that is reflected in the statistics. The Ohio Valley, which includes Ohio, West Virginia, Indiana and Kentucky, is part of the  nation’s “Rust Belt.” This area was highly stressed economically with the closing of steel mills and auto plants.

The Ohio Valley, as well as northern New England, which includes New Hampshire, Maine and Vermont, experienced the largest relative increases in working-age mortality rates in the US. Both of these areas were hit hard by the opioid crisis and by declines in their economies

Dr. Woolf said it’s noteworthy that the largest increases were seen in these areas. The people living there have gone through long periods of economic stress, which can lead to a set of consequences that can affect health in many ways.

People struggling financially are more likely to turn to drugs, alcohol or suicide, he said. In addition, they may not be able to afford routine or emergency medical care, prescription medications or healthy food. And they are less likely to effectively manage chronic conditions such as diabetes and high blood pressure. These factors can lead to increases in mortality rates.

It’s pretty clear that reversing the downward trend in life expectancy will take a combined effort on the individual, community and national levels. As individuals, we must commit to changing unhealthy behaviors and eat healthier, exercise more and pay closer attention to our overall health. And we need to put our pride aside and seek help for substance abuse disorders.

Communities must work harder to increase local access to health education and services. And as a nation, we must continue to focus on battling the opioid crisis, tackling the obesity epidemic and increasing economic opportunities, especially in distressed areas. There’s a lot more to be done, but these steps are a good starting point. After all, our lives depend on our action.

The benefits of exercise on physical health are pretty well established. It’s been shown in study after study that regular physical activity helps prevent heart disease and stroke, reduce high blood pressure and cholesterol, control glucose levels associated with diabetes, manage weight and prevent obesity, avoid osteoporosis, and relieve many types of pain, including back pain.

Regular exercise also helps us manage the stress in our lives.

But have you given as much thought to the benefits of routine physical activity on your mental health? It actually has a huge impact. For one thing, exercise releases “feel-good” chemicals such as endorphins and serotonin. These chemicals work to improve mood and reduce feelings of loneliness and isolation. Exercise helps relieve symptoms of mental health conditions such as depression and anxiety and helps with recovery from mental health issues.

In some studies, regular exercise appears to be as effective as existing medication therapy in treating a wide range of mental health conditions, including mild to moderate depression, dementia and anxiety. It has also been shown to help reduce the cognitive issues related to schizophrenia.

Exercise is effective because it works directly on the brain. It increases the volume of certain regions of the brain by pumping extra blood to them. That improves the health of the brain’s nerve cells, or neurons, because more blood means more that oxygen and nutrients are supplied to the neurons. Improved blood flow also increases certain factors that support neuronal functioning.

For some adults, poor mental health may be linked to their lack of exercise as kids. A new study, released February 12 in Lancet Psychiatry, shows that young people who were sedentary between the ages of 12 to 16 had a higher chance of developing depressive symptoms at age 18 and beyond.

During this study, researchers followed 4,257 adolescents for six years starting at age 12. Participants wore accelerometers for seven days at a time that tracked the amount and intensity of their physical activity, and the information was gathered every two years from age 12 to age 18. Participants were screened for depressive symptoms every two years during that time.

Study results showed that higher amounts of time spent doing sedentary activities, such as watching TV, playing video games and surfing the net, were associated with higher depression scores by age 18. The study found that one additional hour of sedentary behavior per day increased depression scores by ten percent.

On the other hand, the study shows that time spent engaging in moderate-to-vigorous physical activity protected adolescents against developing depression later in life.

At this point, most of you are probably thinking, All of the physical and mental health benefits of exercise are great, but how much do I really need to work out to reap them? The answer may surprise you.

The Physical Activity Guidelines for Americans, issued by the US Department of Health and Human Services (HHS), recommends that for substantial health benefits, adults should perform at least 150 to 300 minutes of moderate intensity or 75 to 150 minutes of vigorous aerobic activity per week. The exercise can also be an equivalent combination of moderate intensity and vigorous activity spread throughout the week.

But in its second edition of the guidelines, HHS recognized the value of shorter intervals of exercise as well. And studies conducted over the past several years have borne that out. A French study from 2015 looked at exercise’s effect on the elderly. It found that even low levels of exercise have a protective effect. It led researchers to recommend 15 minutes of “light” activity five days per week to help improve health and longevity in seniors.

In another study on the benefits of short intervals of activity on health, researchers at the University of Utah School of Medicine found that individuals who got up and moved around for at least two minutes for every hour of sitting had a 33 percent lower risk of dying.

The researchers in that study defined “light-intensity” exercise as activities such as walking around the office, using the stairs instead of the elevator, or taking a short walk at lunchtime or while on a coffee break.

Finally, a January 2019 study suggested that short but intense bursts of physical activity offers cardiovascular health benefits. In this study, healthy but sedentary young adults were asked to climb three flights of stairs three times per day three days per week for six weeks. After six weeks, the participants’ aerobic fitness improved by five percent, and they had 12 percent more strength on a cycling test.

Don’t dismiss the health benefits of walking. The results of a 13-year study of 139,000 adults showed that people who fit in just two hours of walking per week were 26 percent less likely to die than sedentary people. Walking can be an excellent way to explore and enjoy your neighborhood as well.

So, don’t fret if you’re not a gym rat. You can still reap the physical and mental health benefits of exercise by simply getting up and moving more. Why not give it a try!