June 2024

Q: I used to have a lot more get-up-and-go than I do now. It's not that I've gained weight or have some serious chronic condition. At age 57, I want to feel more energetic! What will work? -- Gayle T., Burlington, VermontA: There is no doubt that life is more enjoyable when you have the energy you need to deal with whatever comes your way. That calls for both emotional and physical reserves. When it comes to overcoming physical weariness, you want to banish sedentary behavior. Getting more physical activity can improve respiration, enhance bone strength, tone muscles and increase stamina -- and it does triple duty by also helping quell energy-zapping inflammation, chronic stress and depression. There are other energy-zappers you want to avoid. Nicotine is a stimulant that can promote insomnia, leaving you tired day after day. And even moderate alcohol intake can s-l-o-w you way down. Lousy nutrition is also an energy thief. Empty calories in ultra-processed foods and sugary beverages do not give you the nutrients you need to get going and keep going. You want to concentrate on eating high-fiber 100% whole grains and vegetables, nuts like walnuts and almonds, and healthy oils such as olive oil. You also want to work on building emotional strength that can give you the energy to live fully. That comes from cultivating a posse and a purpose. A posse helps you manage stress and buddies can inspire you to be more active. Join a walking group or get a cycling or pickleball partner. A purpose energizes your spirit and that also relieves stress. To prevent emotional turmoil from wearing you down, it can also be helpful to get talk therapy, join a support group, practice meditation or yoga, and/or talk with friends or relatives about your feelings. And to increase your energy even further, check out iHerb.com's blog, "4 Natural Ways to Enhance Energy Levels." * * *Q: I frequently eat too much -- but at the time it doesn't feel that way. As a result, I am putting on weight. What's going on? -- Jossie R., Hanover, New HampshireA: That's a good -- but complicated -- question. Overeating happens because of an unchecked impulse to eat and a lack of being able to feel satiated. One reason may be that you aren't getting the necessary regulation you should from a hormone designed to help control hunger: Leptin is made by and released from white fat in your body. It alters food intake, controls energy expenditure and helps you recognize when you're full. But it takes time for the message to get to your brain, so eating slowly helps. Also, you can develop leptin resistance if you have obesity. It causes your body to stop responding to its signals so that you overeat. Depression and nonalcoholic fatty liver disease (it affects almost a quarter of U.S. adults) can also lead to leptin resistance. Certain medicines can also cause overeating. For example, if you have Type 2 diabetes, insulin (and associated insulin resistance) and sulfonylureas like glipizide can boost appetite. But many times, overeating has a psychological component. The Mayo Clinic says stress, anger, fear, boredom, sadness and loneliness can lead to eating when you are not physically hungry. Depression can also trigger overeating and bingeing. And a new study in the Journal of Personality and Social Psychology offers another intriguing psychological reason for overeating: distraction. Because of constant interaction with our phones and social media platforms, few folks focus on the bite they're taking. They're more interested in what's biting online. As a result, folks enjoy their meal less, want more to eat and snack more later in the day.Whatever the cause, you can help keep your overeating in check by keeping a food diary -- it actually helps curb your appetite; addressing stress using exercise, meditation/yoga, and talk therapy; and clearing bad-for-you, hard-to-resist foods out of the house. Also, check out "From Resetting Appetite to Blood Sugar Control" at iHerb.com.* * *Dr. Mike Roizen is the founder of www.longevityplaybook.com, and Dr. Mehmet Oz is global advisor to www.iHerb.com, the world's leading online health store. Roizen and Oz are chief wellness officer emeritus at Cleveland Clinic and professor emeritus at Columbia University, respectively. Together they have written 11 New York Times bestsellers (four No. 1's). (c)2024 Michael Roizen, M.D. Distributed by King Features Syndicate, Inc.

DEAR DR ROACH: I'm a 68-year-old female with osteopenia. My doctor wants me to take a bone medication such as Boniva or Fosamax. I've read that folks with esophageal issues may be harmed by taking these. Can you explain why? -- C.M.C.ANSWER: First off, we don't usually treat isolated low bone mass (osteopenia) with powerful medicines like the ones you mention, which are both bisphosphonates. These medicines have the potential for harm and should only be used when the benefits clearly outweigh the risks.A person with low bone mass and a history of a fragility fracture has osteoporosis, regardless of their bone density. Some people with low bone density may be at such a high risk for fracture (based on their FRAX score) that treatment is indicated. Many authorities recommend a 10-year risk of a fracture to be 20% or higher (or a risk of a hip fracture to be 3% or higher) before treating someone with medication. You should find out your FRAX score.The issue with the esophagus is that if pills get stuck in the esophagus, they can cause severe damage to it. So, people with esophageal disorders -- such as achalasia, esophageal stricture or varices, or Barrett's esophagus -- should not take these types of medicines by mouth. People with reflux without these complications can take oral bisphosphonates as long as they can comply with staying upright for 30 minutes after taking them.DEAR DR. ROACH: My boyfriend got cancer from HPV. He was successfully treated. Is he capable of transmitting it to me? -- S.ANSWER: HPV causes different types of problems. Warts are all caused by HPV, but only a few strains of HPV can predispose people to cancer.The most common HPV-related cancer in men is head and neck cancer. HPV is now the leading cause of head and neck cancer. Most of these cases in men occur from sexually-acquired HPV infection. Men are at a higher risk for HPV-related head and neck cancer than women, even though women are at a much higher risk for the overall HPV-related cancers, since cervical cancer unfortunately remains common.Once a person has had HPV, they can potentially spread the virus, even without any visible signs of infection. Condoms reduce but do not eliminate the risk of transmission. Close skin-to-skin contact is necessary for transmission, and although sexual contact is a common way of transmitting HPV, it is not necessary. Most people cure themselves of the virus within a few years.By far, the best way to prevent HPV transmission (apart from never having close contact with anyone) is vaccination. The HPV vaccine is highly effective at preventing infection if it is given before the onset of sexual activity, but it may still be fully or partially effective after the onset of sexual infection.The HPV vaccine prevents infection but it is not recommended for treatment. The recommendation from the Advisory Comittee on Immunization Practices (ACIP) is to vaccinate at the age of 11 or 12, up to the age of 26. But it is approved up to the age of 45. I have rarely given individual patients the HPV vaccine even after that age, based on their particular circumstances, but insurance typically will not pay for it in the United States.* * *Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803. (c) 2024 North America Syndicate Inc.All Rights Reserved