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One key instruction in the operating manual for healthy aging is remaining ever vigilant about osteoporosis. The quest to identify osteoporosis early has led to widespread testing of bone mineral density (BMD), the key measure of bone strength. Medicare pays for the gold-standard test, dual-energy X-ray absorptiometry (DEXA), every two years, regardless of whether their previous scan was normal or not. A study published today found that repeat bone-density testing after four years improved the ability to identify those at higher risk by only 4%. This study raises the fundamental question: Is repeating testing of older people with normal bone strength every two years too much?

Carrying too many pounds is a solid signal of current or future health problems. But not for everyone. Some people who are overweight or obese mange to escape the usual hazards, at least temporarily. This weight subgroup has even earned its own moniker—metabolically healthy obesity. Most people who are overweight or obese show potentially unhealthy changes in metabolism, like high blood pressure, high cholesterol, and insulin resistance. But some people who are overweight or obese manage to avoid these changes and, at least metabolically, look like individuals with healthy weights. Such individuals have near-normal waist sizes, blood pressure, cholesterol, and blood sugar, as well as good physical fitness. Metabolically healthy obesity isn’t common. And it may not be permanent.

Checking seemingly healthy people for cancer—what doctors call screening—seems like a simple process: Perform a test and either find cancer early and cure it or don’t find it and breathe easy. It works for colon, breast, and cervical cancers, but not for others. For colon cancer, there are several effective screening tests: colonoscopy, sigmoidoscopy, and stool testing. Two new studies in yesterday’s New England Journal of Medicine help further quantify their benefits. In the studies, all three types of test reduced the risk of developing or dying from colon cancer. Colonoscopy worked best, followed by sigmoidoscopy and then stool testing. The biggest challenge for colon cancer screening is getting people to have the available tests. About 50,000 Americans die of colon cancer each year—many of these can be prevented with early screening.

Antibiotic-resistant bacteria sicken more than two million Americans each year and account for at least 23,000 deaths. The main cause? Overuse of antibiotics. A new report from the Centers for Disease Control and Prevention, Antibiotic Resistance Threats in the United States, 2013, details the health and financial costs of antibiotic resistance in the United States. In terms of health, antibiotic resistance should be in the CDC’s top 15 causes of death. It also adds as much as $20 billion in direct health-care costs. And the problem could get worse before it gets better. Antibiotic resistance is a problem because commonly used antibiotics will become less able to treat common infections. The CDC identified three types of bacteria as urgent hazards: Clostridium difficile, Enterobacteriaceae, and Neisseria gonorrhoeae. Decreasing the use of antibiotics and preventing infection in the first place are two key steps to halting the problem.

No time in your busy schedule for a long workout? No problem. Combining brief bouts (less than 10 minutes long) of moderate to vigorous exercise over the course of the day also add up to good health, an interesting new study suggests. The findings reinforce suggestions that people should look for simple ways to get short bouts of moderate to vigorous exercise: for example, by parking at the far end of the lot and walking briskly to the entrance, by taking the stairs quickly instead of riding the elevator, or by plugging in your earbuds and dancing energetically to a favorite song. If you are a professional working a desk job at a computer, set a timer and every half hour get up and do a minute or two of something energetic.

Savvy shoppers know that it’s a bad idea to shop for food when they are hungry. It’s a formula for filling your cart with high calorie foods, and likely spending more money than expected. Shopping while sleep deprived may have the same effect. That finding came from an interesting experiment done by a team of Swedish researchers. Sleep-deprived men bought more food, and more high-calorie foods, the morning after sleep deprivation than the morning after sleeping well. We’ve known for some time that not getting enough sleep is linked to weight gain. It’s possible that shopping may contribute to this phenomenon. For years, research on weight gain and obesity has focused on genes, foods, diets, and physical activity (or the lack of it). This study from Sweden, along with many others, are showing that our behaviors also play important roles in weight maintenance and weight gain.

The Ì첩ÌåÓý blog is taking an end-of-summer break. It will begin publishing again after Labor Day. Thanks to everyone who makes the blog possible, from our loyal readers and visitors from around the world to our contributors. See you in September!

When it comes to treating stroke, time is brain and every minute counts. That tenet was supported yet again by an international study showing that the sooner clot-busting treatment is begun—preferably within 90 minutes of the onset of stroke symptoms—the greater the chances of surviving a stroke without a disability. This finding makes it even more important to recognize the warning signs of stroke. Think FAST: Face (when the person smiles, does one side droop?), Arms (when the person lifts both arms, does one drift down?), Speech (is the person’s speech slurred or incomplete?), and Time (if one or more stroke signs are present, call 911 right away and get the person to the nearest hospital with an emergency department—better yet, to one with a stroke center).

Nearly a third of Americans will develop osteoarthritis of the knee before age 70. With no “cure” beside knee replacement on the horizon for this painful joint condition, relief often has to come from pain pills. Assistive devices such as wedge insoles are often prescribed as a less drastic, side effect-free treatment option. But do they really work? A review of research published today in JAMA indicates that these shoe inserts do little—if anything—to relieve arthritis pain. The findings echo new osteoarthritis treatment guidelines released by the American Academy of Orthopaedic Surgeons (AAOS) in May. Based on current research, the AAOS said it couldn’t recommend lateral wedge insoles for people with medial knee osteoarthritis.

The 30,000 cases of Lyme disease reported to the Centers for Disease Control and Prevention (CDC) each year are just the tip of the iceberg. According to a new CDC estimate, more than 300,000 Americans are diagnosed with the tick-borne disease each year. The new number was presented at the 2013 International Conference on Lyme Borreliosis and Other Tick-Borne Diseases, being held in Boston. Although the disease has been diagnosed in almost every state, most cases reported to the CDC are in the Northeast and upper Midwest�96% of cases come from 13 states. The new estimate comes from a multi-pronged approach: gathering case reports from doctors, sifting through health insurance claims, analyzing data from clinical laboratories (which do the tests necessary to diagnose Lyme disease), and surveying the public for self-reported Lyme disease.

Metformin—the drug that millions of people with diabetes take to control their blood sugar—may be on the brink of a second career. Evidence from a variety of studies suggests that metformin may delay or slow the progression of prostate cancer. Metformin does not, however, appear to prevent the development of prostate cancer in the first place.

For some children, beginning kindergarten represents a scary transition. They wonder about making new friends and getting used to a new teacher—will they be able to find the bathroom, where will they eat snack, how will they fit in? There are several ways to help make the transition a smooth one. These include acknowledging the child’s fear as real and appropriate while offering reassurance, talking about the transition in a positive way, doing play therapy at home, visiting the school beforehand if possible, and reading to the child about starting kindergarten.

In many men diagnosed with prostate cancer, the cancer cells grow so slowly that they never break free of the gland, spread to distant sites, and pose a serious risk to health and longevity. In others, cancer is fast growing and aggressive from the beginning. A new Harvard study shows that the aggressiveness of prostate cancer at diagnosis remains stable over time for most men.

In many men diagnosed with prostate cancer, the cancer cells grow so slowly that they never break free of the gland, spread to distant sites, and pose a serious risk to health and longevity. Instead of embarking on immediate treatment, a growing number of men choose active surveillance, in which doctors monitor low-risk cancers closely and consider treatment only when the disease appears to make threatening moves toward growing and spreading. A new Harvard study shows that the aggressiveness of prostate cancer at diagnosis remains stable over time for most men. If confirmed, then prompt treatment can be reserved for the cancers most likely to pose a threat, while men with slow-growing, benign prostate cancer—which is unlikely to cause problems in a man’s lifetime—can reasonably choose active surveillance.

There are many reasons to keep your blood sugar under control: protecting your arteries and nerves are two of them. Here’s another biggie: preventing dementia, the loss of memory and thinking skills that afflicts millions of older Americans. A study published today in the New England Journal of Medicine shows that even in people without diabetes, above normal blood sugar is associated with an increased risk of developing dementia. The study does not prove that high blood sugar causes dementia, only that there is an association between the two. For that reason, don’t start trying to lower your blood sugar simply to preserve your thinking skills, cautions Dr. Nathan. There’s no evidence that strategy will work, although he says it should be studied. But it is still worth keeping an eye on your blood sugar. Excess blood sugar can lead to diabetes and a variety of other health problems, including heart, eye, kidney, and nerve disease.

As medical research and healthy living continues to extend life, the Pew Research Center asked more than 2,000 Americans if they would take advantage of medical treatments to slow the aging process and let them live to age 120. More than half (56%) said they would not, but 65% thought that other people would want it. The Pew survey did not ask why most adults would not want life extending treatment. Previous work has identified what people fear about getting too old. These include loss of independence, running out of money, not being able to live at home, pain, and more. But there are ways to minimize the problems that come with age. The strategies, like exercising and not smoking aren’t sexy, nor do they rely on medical breakthroughs. But they can maximize one’s “healthspan” as well as lifespan.

A new report suggests that skin cancer can sometimes hide in a tattoo. Writing in JAMA Dermatology, three German clinicians describe the case of a young man who wanted to remove large, multicolored tattoos on his arms and chest. During the removal process, his doctors discovered a suspicious mole inside the tattoo. It turned out to be cancerous—stage II melanoma. Tattoos may make it difficult to evaluate moles. Laser removal therapy is also problematic when moles are present. If you are considering getting a tattoo, either make sure it will be applied to skin that is free or moles or birthmarks, or have your doctor check any moles in the to-be-tattooed area beforehand. If you are planning to have a tattoo removed, check for moles within the tattoo. If you see any, ask your doctor or dermatologist to check them out before starting laser therapy.

The omega-3 fats in fish have been linked to all sorts of health benefits, including protection against prostate cancer. But for the second time in two years, researchers have found a link between high levels of omega-3 fats in the blood and prostate cancer. Researchers at the Fred Hutchinson Cancer Center in Seattle men with high levels of omega-3 fats were 43% more likely to have been diagnosed with prostate cancer than men with low levels. The finding were published online in the Journal of the National Cancer Institute.

What doctors call “routine” back pain can really, really hurt. Surprisingly, the best treatment is usually quite conservative—over-the-counter pain relievers, ice and heat, and gentle exercise. Yet for decades, many doctors have been ordering more and more unnecessary tests, narcotics, and referrals to surgery. A new study of 24,000 people treated for back pain from 1999 through 2010 shows that many were not treated according to established guidelines, which promote treatment with over-the-counter pain relievers and physical therapy when appropriate, and advise against early referral for MRI or CT scans, the use of narcotics, or early referral to other physicians for injections or surgery. For a first-time bout with low back pain, or another go-round with it, try cold and heat, rest followed by gentle exercise, and over-the-counter pain relievers, such as acetaminophen or an NSAID like aspirin, ibuprofen, or naproxen.

Have you ever been so immersed in what you were doing that all distractions and background chatter just fell away? Nothing existed except the brush and your painting, your skis and the slope, your car and the road. Mihaly Csikszentmihalyi, a renowned professor of psychology at Claremont Graduate University in Claremont, Calif., calls that state of intense absorption “flow.” Flow experiences lead to positive emotions in the short term, and over the long term people who more frequently experience flow are generally happier. Flow experiences have several common characteristics. These include losing awareness of time, not thinking about yourself, working effortlessly, and wanting to repeat the experience. They are more likely to occur when there is a balance between the challenge of an activity and the skill you have in performing it.

A heart attack can be a frightening wake-up call with long-lasting aftereffects. It’s no surprise that women often tread gently after having a heart attack—and many don’t tread back into the bedroom for sex. Up to 60% of women are less sexually active after a heart attack, often due to worries that sex could trigger a repeat heart attack. A new study suggests that although women believe sex is important for resuming a sense of normalcy and intimacy with their partners, many are fearful that it would be too much for their hearts to take. Reassurance from a doctor is sometimes all that’s needed to ease those fears. How does a woman know if she’s physically ready for sex after a heart attack? It’s safe to have sex if you can work up a light sweat without triggering symptoms like chest pain or shortness of breath.