Juicing fruits and vegetables - Mayo Clinic Health Letter

Changes with timeWith age, the heart’s capabilitiestypically diminish. Aging impactsthe nerves that help regulate how fastyour heart beats. As a result, maximumheart rate slows. However, peoplewho exercise regularly experienceless noticeable changes than do thosewho are sedentary. The heart’s abilityto relax and fill with blood may alsodecrease with age, especially in peoplewho have high blood pressure (hypertension).Again, though, the overall decreasein how much blood the heartcan pump with age can be affected byphysical activity.Over time, the natural elasticityof major blood vessels decreases.Move for a changeIf you’re not sure how much activity your cardiovascular system needs,consider the following recommendations from the Department of Healthand Human Services. In general, for adults up to age 64:■ Some activity is better than none — If you’ve been inactive,gradually increase your activity level. As little as 10 minutes a day ofmoderately intense physical activity will net some health benefits. Asa rule of thumb, when your activity level is moderately intense, you’reable to talk but not sing during the activity.■ More benefits are associated with increased activity — Significanthealth benefits are associated with doing at least 150 minutes ofmoderately intense physical activity a week. Or, cut that time in half ifyou opt for physical activity that’s vigorously intense or a combinationof moderately to vigorously intense. An activity is considered to beof vigorous intensity if you can’t say more than a few words withoutpausing for a breath.While any physical activity can produce health benefits, higheramounts of activity — about six to seven hours a week — probablyresults in the ideal health benefit level for most people.■ Include muscle-strengthening activities in the mix — Includeactivities that challenge your muscles — such as lifting weights, usingresistance bands, or doing yoga or heavy gardening — on two ormore days each week. The goal is to work all the major muscle groupsin your legs, hips, back, chest, abdomen, shoulders and arms.Talk with your doctor about how much physical activity is safe ifyou have a chronic condition — such as heart disease, lung disease ordiabetes — or if you’ve experienced chest pain, shortness of breath,excessive fatigue, dizziness or fainting, or palpitations when you’vetried to exercise or been more physically active than usual. In theseinstances, a stress test may be helpful in determining if it’s safe for youto exercise and how much exercise is appropriate for your condition.Otherwise, for adults age 65 and older:■ Avoid inactivity — There are health benefits to be gained withany amount of physical activity. If you’re inactive, start slowly andgradually increase your activity level.■ Don’t give up due to chronic conditions — If you can’t meet thegeneral guidelines for adults, be as active as your abilities allow.■ Reduce your risk of falling — Include balance exercises in youractivities. Try walking sideways, standing on one leg or standing froma sitting position several times in a row. You may find it helpful to dothese exercises in a corner using something to steady yourself.They become stiffer, causing a risein blood pressure. The body’s abilityto take in and use oxygen alsodiminishes. However, both of thesechanges can in part be preventedwith regular physical exercise.Time for a changeAlthough aging is inevitable,how you age can be influenced byhow you live. Choosing to live amostly sedentary life carries big risksin terms of your heart and blood vesselhealth. But making healthy lifestylechoices — such as maintaininga healthy weight, including physicalactivity in your daily routine, eatinga healthy diet and avoiding tobacco— can go a long way toward slowingthe effects of aging.The American Heart Associationidentifies inactivity as one of the fiveleading risk factors for developingMAYO CLINIC HEALTH LETTERManaging EditorAleta CapelleAssociate EditorsCarol GundersonJoey KeillorMedical IllustrationMichael KingCustomer ServiceManagerAnn AllenAdministrative AssistantJane SultzeEDITORIAL BOARDMedical EditorRobert Sheeler, M.D.Associate Medical EditorAmindra Arora, M.D.Editorial ResearchDeirdre HermanProofreadingMiranda AttleseyDonna HansonJulie MaasShreyasee Amin, M.D., Rheumatology; AmindraArora, M.D., Gastroenterology and Hepatology; BrentBauer, M.D., Internal Medicine; Julie Bjoraker, M.D.,Internal Medicine; Lisa Buss Preszler, Pharm.D.,Pharmacy; Bart Clarke, M.D., Endocrinology and Metabolism;William Cliby, M.D., Gynecologic Surgery;Diane Dahm, M.D., Orthopedics; Mark Davis, M.D.,Derma tology; Timothy Hobday, M.D., Oncology;Lois Krahn, M.D., Psychiatry; Amy Krambeck, M.D.,Urology; Suzanne Norby, M.D., Nephrology; RobertSheeler, M.D., Family Medicine; Phillip Sheridan,D.D.S., Perio don tics; Peter Southorn, M.D., Anesthesiology;Ronald Swee, M.D., Radiology; FarrisTimimi, M.D., Cardiology; Aleta Capelle, HealthInformation. Ex officio: Carol Gunderson, Joey Keillor.Mayo Clinic Health Letter (ISSN 0741-6245) is publishedmonthly by Mayo Foundation for Medical Educationand Research, a subsidiary of Mayo Foundation, 200First St. SW, Rochester, MN 55905. Subscription priceis $29.55 a year, which includes a cumulative indexpublished in December. Periodicals postage paid atRochester, Minn., and at additional mailing offices.POSTMASTER: Send address changes to Mayo ClinicHealth Letter, Subscription Services, P.O. Box 9302,Big Sandy, TX 75755-9302.2 www.HealthLetter.MayoClinic.com February 2011

cardiovascular disease. On the flipside, taking steps to increase physicalactivity is associated with:■ Improved circulation — Increasedphysical activity creates ademand in the body’s tissues for moreoxygen and nutrients. This demandcan help improve artery health andeven encourage new capillary growthin the muscles being exercised. Thesecollateral blood vessels enhance overallcirculation, which helps improvestrength, energy, healing and otherfunctions in essentially all of yourbody’s systems. For example, if youhave peripheral artery disease, collateralblood vessels in your leg musclesmay reduce symptoms, so you’re ableto walk farther without pain. Tonedleg muscles promote blood return tothe heart by maintaining increasedforce on the veins.■ Improved heart function —Unlike skeletal muscles, the heartis always working. However, exercisehelps improve the heart’s efficiency.Regular physical activityslows your heart rate and increasesthe amount of blood pumped witheach beat. It also helps your lungsdeliver oxygen more efficiently toyour blood. With the heart able topump more blood, more oxygen isdelivered to your muscles and therest of your body during exercise.All of these changes make it easierfor your heart to do its job.■ Reduced blood pressure —Regular physical activity is associatedwith better long-term control ofblood pressure. If you’re overweightor have hypertension, the effect ofregular exercise on your blood pressuremay be even more dramatic.■ Improved blood fat (lipid)levels — If you’re concerned aboutyour cholesterol numbers or elevatedtriglycerides, then exercise isfor you. Exercise causes a reductionin triglycerides, which are small fattyparticles in blood. It also can elevatehigh-density lipoprotein (HDL), or“good” cholesterol, and may reducethe number of low-density lipoprotein(LDL), or “bad” cholesterol, particles.■ Improved blood vessel health— Improved blood-fat levels reducethe buildup of plaques insideblood vessels (atherosclerosis) anddecrease the risk of cardiovasculardisease. Reduced blood pressuremeans less stress on the inner liningof blood vessels — a thin layer ofcells called the endothelium — andless wear and tear that may otherwisepromote buildup of plaques.The endothelium secretes chemicalsthat cause blood vessels to relax orcontract. Exercise is known to improveendothelial function.Another factor in blood vesselhealth is inflammation, which canbe measured by the level of highsensitivity C-reactive protein (hs-CRP) in the blood. There’s increasingevidence that inflammationplays an important role in atherosclerosisand that elevated hs-CRPis a sign of inflammation. Physicalactivity may reduce hs-CRP.■ Improved use of oxygen (maximaloxygen uptake) — Regular physicalactivity helps your cells more easily accessoxygen from your blood, decreaingthe workload on your heart and improvingyour ability to exercise.■ Improved management of bloodsugar and insulin levels — This lowersyour risk of type 2 diabetes, which isclosely linked with problems relatedto cardiovascular disease.In addition, exercise may offerother potential benefits, such as areduced tendency for blood clots,improved immune system functionand a reduced risk of depression.The true paybackFew lifestyle choices can impacthealth as significantly as regular physicalactivity. Indeed, as little as sevenhours of physical activity a week canlower your risk of dying early by 40percent as compared with someonewhose weekly activity level is lessthan 30 minutes. ❒Health tipsGreat oilsWhen using oil, select onethat’s low in cholesterol-worseningsaturated fat and high inhealthy monounsaturated andpolyunsaturated fats. Oils thatfit these criteria include:■ Virgin and extra-virgin oliveoil — These unrefined, antioxidant-richoils work great insalad dressings and marinades.Instead of using butter, dip breadin one of these flavorful oils.■ Canola oil — This workswell in salad dressings, plus itcan withstand higher cookingtemperatures before it begins tosmoke. Canola oil has a moreneutral taste than does olive oiland also includes a moderateamount of alpha-linolenic acid(ALA), which is the plant versionof omega-3 fatty acid.■ Safflower oil — Nearlyflavorless and colorless, thisoil makes an appealing saladdressing ingredient because itdoesn’t solidify when chilled.It also has a high smoke pointand can be used when cookingat high temperatures. Lookfor safflower that specifies it’shigh in oleic acid, which indicatesit is higher in monounsaturated,heart-healthy fat.■ Sesame oil — This is agreat stir-fry oil, as it has a highsmoke point and it gives yourstir-fry a nutty flavor.■ Walnut and flaxseed oil— Both are high in ALA omega-3fatty acids, but they don’theat well. They’re best usedfor dipping or salad dressings.Remember, even healthyoils contain lots of calories, souse them sparingly. ❒February 2011 www.HealthLetter.MayoClinic.com 3

News and our viewsStudy finds U.S. should step it upHow many steps do you take in a day? Chances are not nearly asmany as someone living in Australia or Switzerland.A study published in the October 2010 issue of Medicine & Sciencein Sports & Exercise found that the average adult in the UnitedStates takes just 5,117 steps a day. Western Australians take 9,695steps, the Swiss 9,650 steps, and the Japanese 7,168 steps. Thismeans on average, the Japanese walk about a mile — or about 2,000steps — more a day than do Americans.A sedentary lifestyle is a risk factor for heart disease and manyother diseases, including some cancers. Mayo Clinic doctors encourageincreased activity to decrease risk of these problems. Somesuggest that 10,000 steps a day is the ideal activity number, but anyincrease in activity is helpful. They note that a pedometer may be ahelpful and inexpensive tool to help track and increase your activitylevel. Importantly, adding 2,000 steps to daily activity can typicallybe done with as little as 20 minutes of brisk walking a day. ❒Mouth-to-mouth breathing isn’t always needed in CPRNew guidelines from the American Heart Association make it easier totake action if you see an adult suddenly collapse from what seems tobe the sudden, unexpected loss of heart function, breathing and consciousness(cardiac arrest).The new guidelines recommend chest compressions alone — knownas hands-only cardiopulmonary resuscitation (CPR) — for bystanderswho aren’t trained in conventional CPR or who feel uncomfortable withmouth-to-mouth contact.Several recent large studies found no survival difference in adultswho experienced cardiac arrest who were initially resuscitated by bystandersgiving them hands-only CPR, compared with those who receivedconventional CPR, which combines chest compressions withrescue breathing. The important message is that for cardiac arrest occurringoutside of the hospital setting, a person’s chance of surviving canmore than double if a bystander starts conventional or hands-only CPRbefore emergency medical services arrive.If you see an adult suddenly collapse and you aren’t trained inconventional CPR or aren’t sure of your ability to do it, the AmericanHeart Association advises that you take these steps:■ Immediately call 911 or a local emergency medical provider.■ Start chest compressions by pushing hard and fast (at least 100compressions a minute) in the middle of the person’s chest, withminimal interruptions.Hands-only CPR isn’t recommended for infants and children, foradults whose cardiac arrest stems from respiratory causes, such asa drug overdose or near drowning, or for someone whose collapseyou didn’t witness. In these cases, the person would likely benefitmore from conventional CPR. ❒Knee arthritisStaying fit and activeYou enjoy your morning walk, butyou find yourself wincing fromknee pain. If this gets any worse,you fear that you may need to drasticallyreduce your activity level.Knee arthritis is common inolder adults. It can be painful andmay cause you to stop your exerciseroutine or avoid activities thatyou once enjoyed.You may not be able to do everythingyou once did, but a wellplannedexercise routine along withother pain-relieving techniques cangreatly improve your ability to beactive with less pain and limitation.Knee geographyIn older adults, a common sourceof knee pain is osteoarthritis, oftenreferred to as wear-and-tear arthritis.Osteoarthritis involves damage orgradual wearing away of the smooth,slippery cartilage that lines a joint.Osteoarthritis pain can be feltas pain deep inside the joint oron the side of the knee. Arthritiscan also occur under the kneecap(patella). This usually causes painaround or under the kneecap.Pain from knee arthritis is oftenworse when you first start moving inthe morning or briefly after a periodof inactivity. It may also be worsewhen going up or down a step — ormay increase with overuse. Additionalsigns and symptoms may includestiffness of the joint, a feelingthat the joint is unstable, swelling,or a feeling of clicking, grinding orlocking within the joint.Talk to your doctor if you havesevere knee pain or persistent kneepain that’s bothering you or interferingwith your day-to-day life.There are many potential causes ofknee pain other than osteoarthritis.Diagnosis often requires a physical4 www.HealthLetter.MayoClinic.com February 2011

examination and possible X-rays orother imaging tests and blood tests.To do a squat, start with feet slightly greaterthan shoulder-width apart and toes pointingahead or slightly outward. Slowly descend,bending through the hips, knees and ankles.Maintain a normal back arch. Descend tocomfort and steady yourself with somethingstable, if needed. Don’t bend your kneesmore than 90 degrees. Return to startingposition.Back in the grooveAddressing osteoarthritis of theknee often starts with:■ Strengthening — This is thecornerstone of knee joint therapy.Strengthening the muscles aroundyour knee and hip helps support thejoint. This can help make the jointmore stable and give the muscles agreater role in absorbing stresses exertedon the joint.Strengthening of the front thigh(quadriceps) muscles appears tobe of particular importance. A recentMayo Clinic-led study foundthat greater quadriceps strength resultedin less pain and better functionfor people with knee arthritis.In addition, it appeared to preventthe loss of cartilage in those witharthritis of the patella.■ Weight loss — Being overweightputs extra strain on kneejoints. Losing weight can make iteasier to walk and climb stairs.■ Low-impact exercise routine —Physical fitness is an important part ofmanaging knee arthritis. Regular aerobicexercise can improve pain andfunction and help you gain strengthand maintain a healthy weight. Yourdoctor may recommend low-impactactivities such as swimming, cyclingor tai chi, which put less strain on yourknees than do higher impact activities.Walking may be OK for some, as longas you’re aware of your limits.■ Relieving pain flare-ups —If your knee arthritis flares up, tryperiodically icing your knee witha cloth-wrapped cold pack. Totalknee rest may be fine for up to a day,but it’s usually best to keep the joint— and your body — moving in theleast aggravating way you can.■ Oral medications — Nonprescriptionpain medications, such asacetaminophen (Tylenol, others), ibuprofen(Advil, Motrin, others) or naproxen(Aleve, Naprosyn), can help ease arthritispain. Talk to your doctor if youfeel the need to take pain medicationoften. Regular or daily use can causeserious side effects for some.■ Topical medications — Theprescription gel diclofenac (Voltaren,Solaraze) is a topical anti-inflammatorydrug that can be rubbed directlyon the skin around the knee.Topical anti-inflammatory drugs appearto cause fewer side effects thando oral drugs of a similar class, suchas ibuprofen or naproxen.■ Glucosamine sulfate and chondroitin— These supplements mayprovide at least some pain relief inmoderately advanced knee arthritisin some people. Studies are conflictingabout the effectiveness of thesedrugs and whether chondroitin addsadditional benefit when taken withglucosamine sulfate.If you decide to take these supplements,consider trying them fora 12-week trial period. If it seems tobe helping by then, you may want tokeep taking it. If it’s not, you can stoptaking the supplements.■ Knee bracing — Varioustypes of knee braces can help compressthe joint and reduce swellingor realign the joint to lighten pressurein certain areas. Bracing canbe fairly effective at reducing pain,providing a feeling of “support,”and for some people, improvingwalking ability.■ Shoe selection or inserts —A shoe with a soft, cushioned heelcan help absorb some of the impactof walking. Your doctor mayrecommend placing a wedge inyour shoe heel to take pressure offthe areas of your knee that are involvedwith arthritis.When that’s not enoughWhen pain isn’t well controlledwith conservative measures, additionaloptions may include:■ Knee injections — One typeof injection uses an anti-inflammatorycorticosteroid. This may providepain relief for up to a few months.Typically, injections are limited tono more than three a year.A second type involves injectinginto the joint a thick, natural fluid (hyaluronicacid) that may help lubricatethe joint and possibly reduce inflammation.Called viscosupplementation,this can involve from one to five injectionsover several weeks. It doesn’toffer immediate pain relief, but improvementin pain and function thatmay last up to a year.■ Joint replacement surgery —This is an important option of last resortfor advanced osteoarthritis. Extensivejoint damage typically requires a totalknee replacement. However, you maybe a candidate for a partial knee jointreplacement if only certain parts of thejoint are damaged. This is usually aless extensive procedure than is totalknee replacement and often results ina quicker recovery. ❒February 2011 www.HealthLetter.MayoClinic.com 5

Disruptedblood cellsCure is elusive formyelodysplastic syndromeBeing tired is one thing, but latelyyou feel exhausted after doing basicthings, such as getting dressedin the morning. Could it be fatiguedue to anemia?Tests reveal the problem isn’tsimply iron deficiency. Your doctorsays you have a condition known asmyelodysplastic (mi-uh-lo-dis-PLAStik)syndrome.Myelodysplastic syndromes are agroup of disorders caused by poorlyformed or dysfunctional blood cells.Because a cure remains elusive forthe majority of people with theseprogressive blood disorders, treatmentfocuses on controlling symptoms,improving quality of life anddelaying worsening of the disease.Out of controlNormally, blood cells are producedin an orderly, controlled fashionwithin bone marrow. The maintypes of blood cells produced are:■ Red blood cells that carryoxygen throughout the body■ White blood cells that helpprotect you from infection■ Platelets that help your bloodto clot normallyMyelodysplastic syndromes occurwhen the controlled production ofblood cells is disrupted. The result is immatureblood cells that don’t functionnormally and either die in bone marrowor just after entering your blood.Myelodysplastic syndromes differ fromone another depending on which typeor types of healthy blood cells arelacking in bone marrow or blood.Myelodysplastic syndromes oftendon’t cause symptoms early on. Sometimes,routine blood tests detect theproblem. Over time and with fewerand fewer healthy blood cells, myelodysplasticsyndromes may cause:■ Fatigue or tiredness■ Shortness of breath■ Unusually pale skin■ Easy or unusual bruising orbleeding■ Pinpoint red spots just beneathyour skin from bleeding■ Fever or frequent infectionsRisk of myelodysplastic syndromeis higher for men. Most people whohave it are 60 or older, but it can occurin younger people. For the majorityof people, the cause isn’t clear.Diagnosis and treatmentDiagnosis of myelodysplastic syndromeusually involves blood testsand a bone marrow biopsy.How myelodysplastic syndromeprogresses depends on several factors,such as additional molecular andchromosome markers. Some peopledo well for many years. Others whodevelop more-aggressive forms ofthe disorders may require intensivetreatment, including chemotherapy.In a small fraction of people, myelodysplasticsyndromes may developinto acute leukemias.There are treatments for myelosdysplasticsyndromes, but it’s difficultto achieve a cure. Generally, treatmentranges from supportive care thathelps relieve symptoms to more aggressivetreatments that possibly slowor prevent disease progression. Someoptions include:■ Blood transfusions — Thesemay help replace red blood cellsor platelets that are lacking.■ Growth factor injection therapy— Hematopoietic growth factors, suchas erythropoietin or darbepoetin, areproteins that promote production ofred blood cells. Growth factors thatspecifically stimulate white bloodcells — such as filgrastim (Neupogen)or sargramostim (Leukine) — can begiven as well.■ New drug therapies that modifygene function — The medicationsazacitidine (Vidaza) and decitabine (Dacogen)may improve quality of life andsurvival time. These drugs help modifygene function and can be successfultreatment options. Lenalidomide (Revlimid)is another effective new drug,especially for anemia and in myelodysplasticsyndromes that have a particularchromosome marker missing.■ Immunosuppressive drugs —In rare forms of myelodysplastic syndromes,an immune dysfunction cancause and contribute to slow productionof blood cells. In these instances,medications that suppress the immunesystem may be used.■ Chemotherapy — This is oftenused for younger people and those withaggressive disease. For some, intensivechemotherapy can make the diseasego into remission. Others mayencounter a return of the disease andthe need for more therapy.■ Bone marrow transplant —This is the only treatment with potentiallong-term remission or possiblecure. However, for most, therisks outweigh the benefits. The procedurerequires a matched donorand high doses of chemotherapy toprepare for a transplant. Bone marrowtransplant can be done at anyage, but risks go up with age.Hope for the futureNew advances are contributingto the development of therapies formyelodysplastic syndromes. Advanceswith drug therapies — notably,azacitidine, decitabine and lenalidomide,which may reduce the need forblood transfusions — have improvedoutcomes and quality of life.Ongoing clinical trials continueto explore the latest treatment optionsfor myelodysplastic sydromes.Resources with clinical trial informationinclude the Leukemia & LymphomaSociety, American Cancer Society andlarge, academic medical centers. MayoClinic has several clinical trials underway for people in various stages of myelodysplasticsyndrome. ❒6 www.HealthLetter.MayoClinic.com February 2011

Juicing fruitsand vegetablesA better way to eat?If you’ve spent your life munchingfruits and vegetables because they’regood for you — but have never reallyliked them — the thought ofquickly swigging produce from acup may pique your interest.That’s one essential appeal ofjuicing, which involves using anappliance that can turn most rawfruits and vegetables into liquid.Juicing has its advantages andcan add zest to your diet. However,claims made by juicing proponentsare often far-fetched. Take time toseparate the truth from the pulp beforeyou decide if juicing is for you.What is juicing?The idea of juicing has manyvariations, including trendy juicebars, juicers sold on television infomercials,and a simple glass offreshly squeezed juice. Home juicingappliances may cost anywherefrom $30 to more than $300. Theyinclude a fairly simple citrus juicer,designed to ream out only thejuicy insides of, for example, anorange to make orange juice.Juice extractors are generallywhat you see advertised on television.These involve whirling bladesthat chop the food into tiny pieces,which are then spun or pressedto separate the juice from the dietaryfiber of the plant. When thejuicing process is over, you’re leftwith a glass of liquid and varyingamounts of pulp, which is dietaryfiber. Some juice extractors canbe adjusted so that you can filterout more or less pulp. With highamounts of pulp, the juice willhave a more pudding-like consistency.With less pulp, the juicewill be more watery.Carrot orange juiceJuice and enjoy:3 medium carrots2 medium celery stalks1 large orange, peeled1 inch of ginger root(about 1 1/2 tablespoons)Analysis:Calories 165Carbohydrates37 gramsProtein4 gramsFattraceCholesterol0 milligramsSodium190 milligramsPotassium 1,068 milligramsCalcium146 milligramsFiber10 gramsContains 625% of recommendationsfor vitamin A, 139% for vitamin C,and 25% or less for most other vitaminsand mineralsThe claimsMany people enjoy juice andthe flavor combinations that can bemade with a home juice machine.Juicing can be a way to add to yourdiet all or part of fruits or vegetablesthat you normally wouldn’t eat.For people who don’t like to eatfruits and vegetables — and don’teat very many in a day — juicingcan be a great way to supplementfruit and vegetable intake. Fruitand vegetable juices contain manyof the vitamins, minerals and plantchemicals (phytonutrients) foundin whole fruits and vegetables.However, there’s no convincingevidence that juicing is healthier thaneating whole fruits and vegetables. Insome respects, it may be less healthy.Fiber is one of several healthy componentsof fruits and vegetables, andjuicing removes at least some —and often most — of the fiber from afruit or vegetable.In addition, claims made by juicingproponents often don’t stand upto scrutiny, including claims that:■ Your body adsorbs morenutrients from juice — The theoryhere is that fiber is tootaxing on your digestivesystem and that itimpairs digestion of fruit and vegetablenutrients. Your digestive tractis designed to handle fiber and toextract nutrients from a wide varietyof foods. Your digestive tractalso needs fiber in order for it tofunction and to remain healthy.■ Juices can help cleanse toxinsfrom the body — There’s no convincingevidence to support this.The kidneys and liver are efficientprocessors and eliminators of toxins.■ Juicing helps with weight loss— Weight gain or loss hinges on thenumber of calories you consume, andthe number of calories you burn.Juicing may contribute to greatercalorie intake. Some homemadevegetable juices can contain significantamounts of natural sugarsand may contain more caloriesthan you think. In addition, it’seasier to drink a lot of liquid calorieswithout realizing how muchyou’ve taken in. If you eat wholefruit and vegetables in place of theirequivalent in juice, you may feelfuller longer.■ Juicing is economical — If youalready drink a lot of juice, the cost ofbuying a juicing machine and juicingat home may be lower over time thanis regularly buying bottles of 100 percentfruit or vegetable juice.But the money you spend mayactually increase, because youneed a lot of produce to makejuice. It’s possible that you maysave money and have better healthbenefits by purchasing the usualamounts of fruits and vegetablesand eating them whole.A few tipsIf you make your own juice, tryto include as much plant fiber in thejuice as you can. In addition, makeonly as much as you can consume atone time. Juice that isn’t consumedright away can harbor bacteria. ❒February 2011 www.HealthLetter.MayoClinic.com 7

Second opinionQ: It’s not too often that I get agood night’s sleep. Can this bebad for my health?A: Yes, it can. Most people associatea lack of sleep with feeling tiredor irritable, having difficulty focusingon a task, and slowed reactiontimes. But ongoing lack of sleep orinsomnia may lead to other, lessobvious health consequences.One recent study found that peoplewho regularly slept less than sevenhours a night were almost threetimes more likely to catch a coldthan were study participants whoslept eight or more hours a night.In addition, people who tossed andturned at night or had trouble fallingasleep were 5 1/2 times more likelyto catch a cold than were those whoslept most soundly.It’s also thought that regularly sleepingless than six hours a night mayincrease risk of worsening or developinghigh blood pressure. This mayincrease the risk of cardiovascular diseasessuch as stroke and heart problems.It’s believed that poor sleep canprevent a nightly decline in bloodpressure that typically occurs in thosewho sleep well. Lack of sleep mayalso hurt your body’s ability to managestress hormones, over time contributingto increased blood pressure.Frequent migraines or tensionheadaches are common amongthose who don’t sleep well. But therelationship may be tricky to sortout. For example, headaches mayprevent you from sleeping wellor sleep apnea may be a cause ofheadaches. Sleeping either fewerthan six hours or more than eightalso can be bad for headaches.If you don’t sleep well, talk to yourdoctor. Seven to eight hours of reasonablysound sleep a night is consideredideal for most adults. Strategies to improvesleep may include adjustmentsin sleep hygiene, behavior changes,pain management, judicious use ofsleeping pills or treatment of a sleepingdisorder. ❒Q: A friend recently spent a weekin the hospital with what shecalled broken heart syndrome.What is it?A: Broken heart syndrome is a temporaryheart condition that may occurin the wake of a highly stressfulemotional situation, such as theunexpected death of a loved one,or receiving bad news. Sometimes,it occurs after physical stress, suchas a car accident. The syndrome ismuch more likely to affect women,primarily postmenopausal women.It also is referred to as takotsubo cardiomyopathy,stress cardiomyopathy,stress-induced cardiomyopathyor apical ballooning syndrome.For many, broken heart syndromemimics a heart attack, causingsudden chest pain and shortnessof breath. But unlike a heart attack,blockages in the heart’s coronary arteriesaren’t the source of the chestpain. Instead, part of the heart —typically the left ventricle, or theheart’s main pumping chamber — istemporarily weakened.What causes the condition is unclear.It’s thought that a surge in stresshormones may be responsible fortransient changes in the heart’s function.A recent Mayo Clinic studyfound that in women diagnosed withbroken heart syndrome, blood vesselsreact abnormally during mental stress.Recovery usually includes ahospital stay of less than a week.Although there’s no specific therapyfor broken heart syndrome,standard heart failure medications— such as angiotensin-convertingenzyme (ACE) inhibitors,beta blockers or diuretics — aretypically prescribed to reduce theheart’s workload during recovery.Typically, the left ventricle fullyrecovers within one to four weeks.Because recurrence of brokenheart syndrome is possible, longtermtreatment with beta blockersmay be recommended to block theeffects of some stress hormones. ❒Have a question or comment?We appreciate every letter sent to SecondOpinion but cannot publish an answer to eachquestion or respond to requests for consultationon individual medical conditions. Editorialcomments can be directed to:Managing Editor, Mayo Clinic Health Letter,200 First St. SW, Rochester, MN 55905, orsend email to HealthLetter@Mayo.eduFor information about Mayo Clinic services,you may telephone any of our three facilities:Rochester, Minn., 507-284-2511;Jacksonville, Fla., 904-953-2000;Scottsdale, Ariz., 480-301-8000 or visitwww.MayoClinic.orgCheck out Mayo Clinic’s consumer healthwebsite, at www.MayoClinic.comCopyright© 2011 Mayo Foundation for MedicalEducation and Research. 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