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Tue, Apr 7 7:28am · Mayo Clinic Q and A: Exercise is important for body, mind
DEAR MAYO CLINIC: Can I continue to exercise even if I don’t feel well, or should I hold off until I start to feel better?
ANSWER: The answer to that question depends largely on what’s wrong. For example, if you have symptoms of the common cold, it’s usually fine to keep exercising. It may even help you feel a little better. If you have a fever or other more severe symptoms, it’s best to put your exercise routine on hold until those symptoms go away.
Exercise is important for your body and mind. Regular exercise can help you maintain a healthy weight, keep your blood sugar and blood cholesterol levels in check, increase bone strength and help manage stress, just to name a few benefits.
For healthy adults, the recommendation is 150 minutes of aerobic exercise each week. That includes activities such as running, biking, jogging, swimming, brisk walking and dancing. Many people break up their weekly aerobic activity into 30-minute sessions, five days a week. In addition, your exercise routine should include at least two 20- to 30-minute sessions of strength training a week, which many people have a tendency to forget. Remember, too, that even if you don’t get to the recommended level of exercise sometimes, any amount of exercise, even if it’s just 10 minutes of walking, has benefits.
When you’re not feeling well, it’s still fine to exercise in some cases. A
good rule of thumb to follow is if you have symptoms above the neck, such as a runny nose, sneezing, nasal
congestion or a minor sore throat, you’re OK to exercise. In those cases, exercise
may even help you feel better by opening up your nasal passages. However, you
may want to reduce the intensity and length of your workout, and limit group
activities. Instead of running, for example, go for a walk.
you work out when you’re having some symptoms of illness, make sure you stay
attuned to your body’s need for fluid. Drink to your level of thirst. Be aware that
if it’s warm outside, you may need to take in more fluid than usual.
you have symptoms of illness that affect you below the neck, such as chest
congestion, a hacking cough, muscle aches, fatigue or an upset stomach, it’s
best to take a break from exercising for a few days. If you have a fever, you
also should give your body some time to rest and recover. A fever is your body’s
way of telling you to slow down, and it’s important to listen to that. As you
recover after these kinds of symptoms, go a bit slower and decrease the
intensity of your workout when you return to exercising.
Due to the current recommendations for social distancing during the COVID-19 outbreak, your fitness center may be closed. Even if it’s not, you may want consider skipping the gym and take your workout outdoors instead, or explore new exercise options that you can do at home. Regardless of where you exercise, don’t forget to wipe off equipment, including bikes, weights, benches and yoga mats, after you’re done with them.
If you exercise when you’re not feeling well, and then you experience additional pain or symptoms when you exercise — or if you have other concerns or questions about exercising when you’re ill — talk with your health care provider. — Dr. Daniel Montero, Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida
DEAR MAYO CLINIC: During the COVID-19 outbreak, I’m trying to limit trips to the grocery store. But I want to continue to eat healthy meals. What foods should I consider stocking up on, knowing that I probably won’t be buying anything fresh for a couple of weeks?
ANSWER: Most people are in the habit of stopping by the grocery store at least once a week — and sometimes more often if we run out of a favorite item, decide to make a new dish or just want something fresh. So planning a shopping trip for groceries that will cover two weeks of meals and offer lots of healthy options may be daunting. But with careful planning, and some adjustments to the way you shop for and store your groceries, it can be done.
As COVID-19 continues to spread, social distancing — putting space between yourself and others to reduce the spread of illness — has become commonplace. That, along with the need for many people to self-quarantine for several weeks and shelter-in-place orders going into effect in some areas, has eliminated most quick grocery trips. The challenge of getting all the food you need for an extended time also is compounded by the fact that many other people are trying to do the same, so supplies of certain items may be limited.
As you think about how to tackle
your grocery shopping, take time to plan. Check your pantry, refrigerator and
freezer. Consider how you can use the items that you already have, so your
shopping focuses on what you really need and will use. Confirm that you have staple
items, such as flour and sugar.
When you make your grocery list, consider
your new routines, your family and the meals you’ll eat. For example, if you have
children home from school, you’ll need more supplies for lunches than usual. Peanut
butter for sandwiches is a good staple that’s easy to store. Lunch foods such
as bread, cheese and deli meat freeze well, so buy extra and freeze what you
don’t need right away.
Other fresh foods can be frozen and
used later, as well, without losing their nutritional benefits. For example,
fresh berries, bananas and other fruits can be frozen then thawed and used in
smoothies. Meats such as beef, chicken
and fish will last for about four months in the freezer.
As an alternative to picking all
fresh foods, buying frozen options from the store can be a good choice when you
want to stretch what you have over time. Frozen fruits and vegetables can be a
healthy part of your meal planning. Because these items typically are frozen at
their peak of freshness and undergo minimal processing before they are
packaged, they retain their nutritional value.
If fresh or frozen items are in limited supply in your store, try shelf-stable alternatives. You can buy egg whites in cartons if you can’t find eggs. Powdered milk, and canned fruits and vegetables, also serve as suitable alternatives that have the benefit of lasting longer over time. Eggs, for instance, often have three weeks to a month of use. Egg whites in a carton, however, can be used for about six to eight weeks. Make sure to check the expiration dates on the items you buy to see how long they can be stored before use.
As you make decisions about what to buy for an extended period at home, be realistic about what you really need. Don’t panic and purchase too many items. Buy foods you commonly use and that you know your family will eat. And even if you have to buy brands or alternatives that are different than usual for you, stay focused on the foundations of a healthy diet: fruits, vegetables, whole grains, lean proteins and healthy fats. — Debra Silverman, M.S., RDN, LD/N, Dietetics, Mayo Clinic, Jacksonville, Florida
DEAR MAYO CLINIC: Why is COVID-19 so harmful to the lungs? Are smokers more at risk of the virus causing damage? As a smoker, should I be taking more precautions than the average person?
ANSWER: COVID-19 can significantly affect the lungs. People whose lung health is affected by factors such as lung disease or smoking tend to be at higher risk for more severe symptoms from COVID-19. You can reduce your risk of getting COVID-19 by practicing infection prevention techniques and carefully following other guidelines for slowing the spread of the illness.
COVID-19 is primarily a respiratory illness that is caused by a virus. It can trigger symptoms such as fever, cough, shortness of breath and difficulty breathing. Symptoms range widely, from very mild to severe. For those whose symptoms are more severe, the illness often leads to pneumonia — an infection that inflames the air sacs in the lungs. Pneumonia may require hospitalization and use of a breathing machine, or ventilator. In some cases, breathing difficulty coupled with pneumonia makes COVID-19 life-threatening.
Poor lung health appears to play a role in deaths related to COVID-19. Although smoking isn’t the only factor that influences lung health, it does have a considerable effect. Researchers believe that smoking makes people more susceptible to the infection that causes COVID-19 and its complications because smoking damages the body’s natural defenses against some bacteria and viruses.
Data from China show the fatality rate from COVID-19 in that country overall stands at slightly above 2%. For people who had lung disease prior to the infection, that rate is much higher at 6%. Other underlying medical conditions make a difference, too. For people with cardiovascular disease who developed COVID-19 in China, the fatality rate was more than 10%. For those with diabetes, it was 7%, and in people who had high blood pressure, 6%. In addition, the older people were, the higher their risk of severe illness.
So the fact that you’re a smoker increases your risk of developing more severe symptoms if you contract COVID-19. But other factors also play a role in that risk, including your age and any underlying health concerns.
Whether you smoke or not, there are concrete steps that you can take to protect yourself from the virus. Always cough or sneeze into a disposable tissue or the crook of your arm, and then wash your hands. Don’t touch your face until you’ve washed your hands thoroughly for at least 20 seconds. Wash your hands frequently. If you don’t have soap and water, use a hand sanitizer that’s at least 60% alcohol. Stay home if you’re sick, and insist that others in your household do the same. Reduce face-to-face interaction with anyone who might be ill. Disinfect common surfaces regularly.
It’s also important to get your annual flu vaccine and check whether you have received pneumococcal vaccine. Because COVID-19 and influenza have similar symptoms, it can be difficult to differentiate between the two. When you get a flu vaccine, you greatly decrease your risk of being infected with the flu. If you develop COVID-19 symptoms, that makes it easier for your care team to determine the source of those symptoms.
Finally, follow the guidelines in your area for social distancing — putting space between yourself and others to reduce the spread of illness — such as avoiding large gatherings and keeping contact with others in public spaces to a minimum.
Preventing COVID-19 is crucial because no antiviral medications or vaccines are available for this illness at this time. Instead, treatment focuses on controlling symptoms. Any claims that a medication, herbal supplement or other substance can effectively treat or cure COVID-19 are bogus.
As you consider ways to stay healthy, keep in mind that the COVID-19 pandemic is changing quickly. Stay informed and get your information from reliable sources, such as the Centers for Disease Control and Prevention, the World Health Organization and Mayo Clinic. — Dr. Gregory Poland, Vaccine Research Group, Mayo Clinic, Rochester, Minnesota
Fri, Mar 27 7:43am · Mayo Clinic Q&A: Blood shortage due to lack of blood donors during COVID-19 pandemic
DEAR MAYO CLINIC: Why do blood banks need more donors at this time? How will that help care providers take care of people with COVID-19?
ANSWER: At this time, the blood shortage is not due to an unusually high demand for blood products. The problem is a lack of supply. Most people who have COVID-19 don’t require blood transfusions. But the COVID-19 pandemic is triggering critical blood shortages across the country and creating challenges for health care institutions. That’s because blood collections have plummeted due to concerns about the virus. If you are a healthy adult who is not quarantined, you can help by making an appointment with your local blood collector to donate. If you cannot donate, you can help by sharing messages from your local blood bank.
COVID-19 is a respiratory illness that leads to symptoms such as fever, cough, shortness of breath and difficulty breathing. Symptoms can range widely, from mild to severe. Due to the nature of the COVID-19 pandemic, social distancing — putting space between yourself and others to reduce the spread of illness — has become common. For many people, that includes avoiding public spaces. It also has led to cancellation of community blood drives that many blood banks rely on.
Under normal circumstances, health care organizations typically keep a one- to two-week supply of blood and other blood products. Due to the disruption caused by COVID-19, the blood inventory will continue to be fragile throughout this pandemic.
That’s a big problem because the need for blood continues on as usual in many other patient populations. Emergency open-heart surgery requires blood. Trauma care frequently requires multiple units of blood. Cancer patients often depend on donated blood to make it through their chemotherapy treatments. Receiving donated blood may be the difference between life and death for some of these people.
All healthy adults who are not quarantined are strongly encouraged to make an appointment to donate blood. Giving blood by appointment, rather than as a walk-in, enables donor centers to follow social distancing best practices. A new sterile collection set, including the needle, is used for each donor. That means there is no risk of getting a disease by donating blood. And only healthy people should be at the blood donor center. Be assured that blood collection centers always are extremely clean. They have to be to ensure the quality of the blood that’s collected for patient care.
A recent study found that fewer than 5% of Americans who are eligible to donate blood actually are donors. That low number has always been a concern. But it’s even more worrisome now because some long-term blood donors fall into high-risk categories for COVID-19 due to their age or underlying health concerns, and that will make it difficult for them to continue donating. Other people will have to step up. To meet the need, it likely will require a massive turnout from people who have not donated before or those who have not donated for a long time.
To successfully get past this shortage and through the summer months ahead, when the blood supply is historically low, it’s crucial that healthy, eligible donors consider donating blood and make it a habit. Please consider contacting your local blood donation center today to make an appointment to give blood. By doing so, you could save a life.— Dr. Justin Kreuter, Transfusion Medicine, Mayo Clinic, Rochester, Minnesota
DEAR MAYO CLINIC: I’d like to keep my kids home and safe until COVID-19 is no longer an issue, but my teenager still wants to hang out with her friends. Is this safe?
ANSWER: Social distancing — putting space between yourself and others to reduce the spread of illness — is crucial when it comes to COVID-19. You and your children should avoid large gatherings and keep contact with others in public spaces to a minimum. But that doesn’t mean you need to cut your teen off from her friends entirely. Technology can help bridge the gap, and if face-to-face interaction is necessary, there are some things that can be done to reduce risks.
COVID-19 is a respiratory illness that leads to symptoms such as fever, cough, shortness of breath and difficulty breathing. Symptoms can range widely, from mild to severe. The virus that causes COVID-19 is transmitted through respiratory droplets generated when an infected person coughs or sneezes. The droplets can extend up to 3 to 6 feet from that person and land on the surfaces around that person. If you breathe in the droplets, or they land in your eyes, nose or mouth, or are carried there by your hands, you are at risk of infection.
If you stay at least 6 feet from people who are infected, the risk of being exposed to the virus drops dramatically. Because there is growing evidence to suggest COVID-19 can be transmitted even before someone feels sick, it’s important to practice social distancing even with people do not seem sick.
Social distancing has been shown to effectively slow the spread of infection. It includes avoiding public spaces where you may come in close contact with others as much as possible. This includes malls; theaters; houses of worship; public transportation; or anywhere with large crowds, such as concerts or festivals. For public spaces that you have to visit, like grocery stores, limit visits to only those that are absolutely essential, leave kids and other family members at home, and go when crowds may be smaller. Wash your hands well before and after the visit. Assign someone else in the family to go if you are sick.
As part of social distancing efforts, many states are closing schools. As in your situation, that can leave children and teens eager to find activities to ward off boredom. For teens, the typical activities they may enjoy with their friends — like shopping at the mall, going to a movie theater, meeting at a coffee shop or gathering at a private home in large groups — all are strongly discouraged in a time of social distancing.
That doesn’t mean that they need to be cut off from each other completely, however. And social interaction is important. Encourage your teen to stay connected with friends in a way that doesn’t increase the risk of infection. For example, many teens are savvy with technology. There are a host of apps that offer easy communication in real time for groups to stay in touch.
If a gathering of two or three people is absolutely necessary, then going for a walk outside in the fresh air — in an area where you will not come in close contact with others, such as a large park — is less risky than meeting inside someone’s home. Getting fresh air and exercise also can be a mood booster, which is important for everyone during this time. But it will take some diligence on your teen’s part ― and yours ― to keep those get-togethers safe. Check to make sure no one in either family is sick or is showing signs of illness.
Your teen and his or her friend should wash their hands thoroughly with soap and water for at least 20 seconds before and after their interactions. They need to avoid hugs, handshakes, fist bumps or any other physical contact, and keep space between them. Teens should be reminded to clean their phones and other devices regularly, following manufacturer recommendations.
Transmission within households has been one of the primary drivers of spread in this outbreak. If meeting within a household is felt to be necessary, then disinfection of commonly touched surfaces, such as countertops and doorknobs is recommended.
Recommendations regarding the COVID-19 pandemic are ever-changing. Stay informed and get your information from a reliable source, such as the Centers for Disease Control and Prevention, the World Health Organization and Mayo Clinic News Network. — Nipunie Rajapakse, M.D., Pediatric Infectious Diseases, Mayo Clinic, Rochester, Minnesota
DEAR MAYO CLINIC: I have read that COVID-19 spreads from person to person, but can it also live on objects? Should I be concerned about catching the virus from things I buy at the grocery store or while filling up my car with gas?
ANSWER: Your highest risk of catching COVID-19 is being exposed to a person ill with COVID-19. COVID-19 is a respiratory illness that leads to symptoms such as fever, cough, shortness of breath and difficulty breathing. The virus that causes COVID-19 is transmitted through respiratory droplets generated when someone infected coughs or sneezes. If you breathe in the droplets, or they land on your eyes, nose or mouth, you are at risk of infection.
You’re also at risk if you touch a surface where the droplets have landed, and then touch your eyes, nose or mouth. At this time, expert estimates are that the virus may live on a surface anywhere from a few hours to up to nine days, depending on the type of surface, as well as the surrounding temperature and environment. When possible, disinfect surfaces in your house, in public spaces that you touch, and wash your hands thoroughly after being out in public.
There are steps that you can take to reduce your risk of getting COVID-19 from surfaces. In your home, clean and disinfect high-touch surfaces routinely, including doorknobs, light switches, faucets, countertops, tables, toilets and sinks. Household cleaners and disinfectants that you can buy in your local stores work well. Wash your hands when you’re done.
When you’re out in public, many stores provide disinfectant wipes to use on carts and baskets. Wipe the handles of those items before you use them. You may want to consider carrying a small supply of disinfecting wipes with you to use if they are not provided in a store, or to use on surfaces, such as gasoline pumps, where wipes are less likely to be nearby. Use an alcohol-based wipe rather than baby wipes, which may not be effective at getting rid of the virus.
While items you buy at the grocery store could harbor COVID-19 if someone who’s infected coughs or sneezes on them, the overall risk is low. And it isn’t practical to disinfect each item you purchase, although you should continue to wash all produce thoroughly before you eat it. Instead, wash your hands after you return home from the grocery store or any other public space. As an extra precaution, wash them again after you’ve put all your grocery items away.
Both washing your hands with soap and water and using hand sanitizer are good options. To effectively wash your hands, first get them wet with clean, running water. Apply soap and lather well. Rub your hands vigorously for at least 20 seconds. Remember to scrub all surfaces, including the backs of your hands, your thumbs, wrists, between your fingers and under your fingernails. Rinse well and dry your hands with a clean towel, or let them air-dry. Alcohol-based hand sanitizers should contain at least 60% alcohol. Use enough hand sanitizer that it takes about 15 seconds for it to dry with rubbing. To further reduce your risk of catching the virus, avoid touching your eyes, nose and mouth, particularly when you’re out in public or if your hands are not clean.
As you think about ways to stay healthy, keep in mind that guidance regarding the COVID-19 pandemic is ever-changing. Stay informed and get your information from reliable sources, such as the Centers for Disease Control and Prevention, the World Health Organization and Mayo Clinic. — Mayo Clinic Infectious Diseases staff, Rochester, Minnesota
DEAR MAYO CLINIC: Are herbal products for erectile dysfunction safe? Do they work? What about over-the-counter creams? Are there any other nonprescription medications that can safely and effectively eliminate this problem?
ANSWER: Products available without a prescription that claim to treat erectile dysfunction are frequently cited by the Food and Drug Administration (FDA) as containing hidden ingredients that can be harmful. Do not use any of these products. Instead, talk with your health care provider about treatment for erectile dysfunction. In some cases, an underlying medical condition could be causing erectile dysfunction, and treatment for that disorder may resolve the problem. If not, there are a number of prescription medications that are approved as safe and effective to treat erectile dysfunction.
Erectile dysfunction — the inability to get and keep an erection firm enough for sex — is a complex problem. A host of factors can contribute to the development of erectile dysfunction. They include a variety of physical causes, such as a health condition like heart disease or diabetes; lifestyle choices like tobacco and alcohol use; and medical treatment like radiation therapy or surgery. Psychological issues, such as stress, depression, anxiety or relationship problems, can play a role, too.
Age is another factor that can
contribute to erectile dysfunction. As you get older, it’s common for erections
to take longer to develop or to not be as firm. This can happen at any age, but
it’s still important to talk with your health care provider to determine a
cause. The younger you are, the more likely that erectile dysfunction signals a
risk of heart disease. Research suggests that men with erectile dysfunction who
have no obvious cause, such as trauma, and who have no symptoms of heart
problems should be screened for heart disease before starting any treatment.
Men younger than 50 are at especially high risk. In men older than 70, erectile
dysfunction is much less likely to be a sign of heart disease.
Due to the complicated nature of
erectile dysfunction — and the fact that it may be a symptom of another health
problem that requires attention — it’s important to be evaluated by a medical
professional who can thoroughly and accurately assess erectile dysfunction, and
help you decide on treatment.
Because erectile dysfunction can be an
uncomfortable topic to talk about, many men opt to avoid a medical appointment
and instead turn to the type of nonprescription remedies that you mention.
That’s not a good idea.
The Food and Drug Administration has
discovered that dozens of these products — often marketed as dietary supplements
— contain varying amounts of prescription drug ingredients, untested and
unapproved active ingredients, and controlled substances. Typically, none of
these ingredients are disclosed on the label or packaging.
These hidden ingredients pose significant health risks. Some may interact with other medications an individual takes and trigger dangerous side effects. Active ingredients that are not FDA-approved may lead to serious health problems, particularly in men who have medical conditions such as diabetes, high blood pressure and high cholesterol.
In addition, the active ingredients of
the prescription medications routinely used to treat erectile dysfunction — a
category of drugs knows as phosphodiesterase
5, or PDE5, inhibitors — often are found in the
nonprescription products. But in those products, the medications are not tested
or regulated, so they may be tainted with contaminants.
The bottom line is that there is no way
for a consumer to reliably know what nonprescription erectile dysfunction products
contain. They are not safe.
The good news is that if you require medication to treat erectile dysfunction, generic versions of two medications often prescribed for the disorder ― sildenafil and tadalafil ― now are available in the U.S. That has helped decrease the cost of treatment, as has the option to compare the prices of generic medications using new tools such as online apps. To find out whether prescription medication is right for you, though, you first need your health care provider to evaluate your condition. After that, you can decide on the appropriate treatment that is effective and safe for your situation. — Dr. Gregory Broderick, Urology, Mayo Clinic, Jacksonville, Florida
DEAR MAYO CLINIC: Is intermittent fasting for weight loss safe? What are the risks of short-term diets that are very low-calorie?
ANSWER: Recent research has found that using intermittent fasting for weight loss may have some benefits in the short term. But at this point, the long-term effects of this type of diet or other diets that severely restrict calories are not known. To lose weight and keep it off, the best strategy is to adopt healthy eating and exercise habits that you enjoy so you can stick with them over time.
Intermittent fasting currently is a
popular trend in dieting. There are several fasting methods people employ for
weight loss. Some dieters decrease the
amount of time they eat each day to, for example, only six hours in a 24-hour period.
Others fast every other day. Another approach is called the 5:2 diet, which involves
gradually decreasing daily calories to the point that you’re only consuming 500
calories a day for two days each week.
A recently published article assessed a variety of research on
intermittent fasting. It found that there are some benefits, at least in the
short term, to fasting as opposed to just decreasing calories overall.
It appears that fasting for a short
time can produce ketosis — a process that occurs when the body doesn’t have
enough sugar for energy, so it breaks down stored fat instead, causing an
increase in substances called ketones. Fasting also affects metabolic processes
in the body. These processes trigger a number of responses, including decreased
inflammation, improved blood sugar regulation and better response to physical
stress. The research shows
intermittent fasting could have other health benefits, as well, but more study
It is crucial to note, however, that little long-term research has been done
on intermittent fasting to examine how it affects people over time. So at this
point, it’s unclear if there are any long-term health benefits or risks related
to this diet technique.
We do know that there are risks involved with certain types of
intermittent fasting. For example, a technique called dry fasting that includes
restricting fluid intake as well as food intake is dangerous because it can
cause severe dehydration and pose serious health concerns. And if you take
caloric restriction too far, that can lead to malnutrition.
As you consider weight loss and diets, keep in mind that no one approach works for everyone. But there are some basic principles that you should follow as you decide how to best achieve and maintain a healthy weight. At its core, your diet should support your health overall. There are a variety of diets that can do that, including the Mediterranean diet; the vegetarian diet; the Dietary Approaches to Stop Hypertension, or DASH diet; and the Mayo Clinic diet. All of these diets have similarities that are greater than their differences. They are based on real food and focus mainly on plant products, such as fruits, vegetables, beans, nuts, whole grains, and healthy fats like olive oil.
In addition, as you incorporate a new diet into your life, it needs to be practical, so that you can sustain it over time. If it is drudgery, or if you feel like you’re suffering, it won’t work in the long run. Eventually, you’re likely to slide back into old habits. If you’re considering a new approach to your diet — especially if it’s something that could be risky if you don’t do it correctly, like intermittent fasting — talk to your health care provider first for guidance on how you can manage it in a healthy way. Keep in mind, too, that choosing to adopt healthy lifestyle choices can and should be an enjoyable way to live. — Dr. Donald Hensrud, General Internal Medicine and Endocrinology, Mayo Clinic, Rochester, Minnesota