Are your knees worn out?

Harvard doctors reveal what you need to know before you
agree to a knee replacement

Dear Reader,

Are your knees stiff and achy when you get out of bed in the morning? Is it painful to go up and down stairs? Or stand up after you’ve been sitting for a while?

Chances are you’ve got osteoarthritis caused by worn down cartilage inside your knee joint. If your knees are giving you enough trouble, you may be considering having one, or both, knees replaced.

A total knee replacement can be life-changing — helping relieve pain and restore movement. In fact, 730,000 total knee replacements are done each year, making it the most common inpatient surgery in the U.S.

But that doesn’t mean it’s for everyone. As with any surgery, there are risks. That’s why you need Harvard Medical School’s Guide to Total Knee Replacement. This report brings you everything you need to know about total knee replacement to help you make the best possible decision for your health. For example, you’ll discover...

Why your knees wear out. Few joints in the body do as much every day as the knees. They help you walk, climb, carry heavy objects, and work. In fact, every step you take on level ground puts one to one and a half times your body weight on each knee. Make that two to three times your weight, when you go up and down stairs. And if you’re a few pounds heavier than you’d like, your knees are getting hit with an extra four to six pounds of pressure for every extra pound!

Do achy, noisy knees automatically mean they’re “bad enough” for a total replacement?

When your knees hurt it’s tempting to think that having a total knee replacement will restore you to your twenty-something active self. Sadly, that’s not the case. In Harvard’s Total Knee Replacement report, you’ll get the facts about knee replacement written in easy-to-understand English. You’ll discover:

• The options you should try before you agree to surgery

• Why you may not want to have your knee replaced if you’re younger than 60

• The procedures that can help you get relief without having a total replacement

• 8 signs it’s time to consider a total knee replacement

• And much more.

Download now and start reading Total Knee Replacement

If you do need a replacement, or think it’s time to seriously consider it, Harvard’s Total Knee Replacement guide is invaluable. You’ll find a list of critical questions to ask your doctor about his or her credentials and experience — the best doctors welcome these questions — to help ensure you have the best possible surgeon. In addition, you’ll learn the basics of the various types of knee joints available (there are over 150 implant designs) so you can work with your doctor to find the best type for you. You’ll even learn why implants with special features that sound great, may actually have a slightly higher risk of complications.

And, since this is often elective surgery, Total Knee Replacement explains the many benefits of prehabilitation. This type of physical therapy may help you have a shorter hospital stay, less post-op pain, and even a faster recovery. You’ll also learn why minimally invasive surgery may sound like the best option, but could make it harder for your doctor to install the implant... common reasons implants fail and how to help avoid these problems and so much more.

 

 

 

Healthy gut, healthier aging 

By Heidi Godman, Executive Editor, Harvard Health Letter  

 

Support beneficial microbes in the gastrointestinal tract with these healthy lifestyle habits.

 

Trillions of microbes — bacteria, viruses, fungi — call your gut home. They do more than just help you digest food. They fight harmful pathogens; make vitamin K and other important chemicals; affect the way medications work; and may influence your immune system, heart health, and cancer risk. It also appears gut microbes may play a role in healthy aging and longevity. The genes of all your gut microbes are collectively called the gut microbiome.

Encouraging findings

In a study published online Feb. 18, 2021, by Nature Metabolism, scientists observed that older adults whose mix of gut microbes changed the most over time lived longer than those people with less change in their gut microbiome.

The study didn’t prove that an eclectic microbiome directly caused people to live longer. However, such a microbiome was also associated with lower cholesterol levels, faster walking speeds, and higher levels of beneficial blood chemicals — all factors that lengthen the life span.

How do you make your gut microbiome more diverse and achieve health benefits? It mainly comes down to lifestyle factors. Indeed, one of the reasons that a healthy lifestyle may protect your health is through the impact of your lifestyle on your microbiome.

Eat a healthy diet

Eating the right foods is one of the best ways. Your gut microbes like to eat, too, and their favorite foods are the ones that are healthiest for us: fruits, vegetables (especially dark, leafy greens), legumes (beans, peas), and whole grains (quinoa, whole wheat, brown rice). "Those foods contain fiber. Our bodies don’t break down fiber for food; fiber passes through to the gut and microbes feed on it. It gives them a good environment to grow," explains April Pawluk, strategic program manager at the Harvard Chan Microbiome in Public Health Center.

But when you eat an unhealthy diet with lots of processed, fatty, sugary foods, it makes it harder for helpful microbes to survive. "In the absence of diversity-promoting nutrients like fiber in our diets, the genes of our gut microbiome can produce chemicals that could increase our risk for developing different diseases," Pawluk says.

Exercise

Exercising appears to promote gut microbiome diversity, but the way it works is a matter of speculation, ­Pawluk says. Several ways are plausible. "It could be that exercise changes the rate at which material moves through the intestines. Or perhaps exercise reduces inflammation in the gut. Or exercise might alter our appetite, and alter the way that our bodies process the food we eat. All of these could affect the microbiome environment," Pawluk says.

Get a dog

Dogs are always tracking things in from outside — like dirt, grass, and insects — exposing their human families to more microbes. That might help counteract the effect of a modern world on the microbiome.

"Over the past century, there’s been a decrease in the diversity of the human microbiome, possibly because of sanitation and modern medicine," Pawluk says. "Studies looking at young children growing up in a house with a pet show their microbiome becomes more diverse and they have less risk of allergies. We don’t know if this helps older adults, but it wouldn’t hurt."

Don’t smoke

Cigarettes contain lots of chemicals and toxins that are harmful to the whole body, including your gut and its residents. "Smoking can kill some microbes and decrease microbe diversity. Smoking also puts physical stress on the body, including microbes. And when microbes are under stress, they change their function; they sense that they’re in a bad situation and in some cases attack each other — or us. That can cause imbalance in the gut microbiome," Pawluk says.

Consider probiotics

One last suggestion that may affect the gut microbiome is to ingest colonies of "good" bacteria known as probiotics, which come in pills or powders or occur naturally in fermented foods (such as yogurt, kefir, and sauerkraut). "The intention is to boost the amount of beneficial bacteria in the gut," Pawluk says. "If you’ve recently taken antibiotics, which kill both harmful and beneficial bacteria, probiotics may help re-establish a diverse microbiome. The thing is, if you already have a diverse gut microbiome, adding more of one species probably isn’t going to promote any significant change."

But Pawluk says there’s no evidence probiotics are harmful, especially when they come from food. And there are many reasons why you might want to eat healthy probiotic-rich foods like yogurt, which has lots of calcium, or try any of the lifestyle habits we’ve laid out here. They all benefit health in numerous ways.

 

 

 

 

 

               Self-Help for Atrial Fibrillation 

Diet, exercise, and other lifestyle factors are known to affect your risk of heart disease. The major risk factors for heart disease, as well as the condition itself, are all closely linked to the risk of developing atrial fibrillation. Can a heart-healthy lifestyle prevent atrial fibrillation? Can it reduce symptoms?

 

 There's preliminary evidence that managing the risk factors for heart and blood vessel disease may improve the long-term outlook for people with atrial fibrillation. On a practical level, that could mean fewer episodes of a-fib and improvements in symptoms—in short, a better quality of life for you.

Focus on heart health

The ability of lifestyle change to reduce the burden of atrial fibrillation remains an active area of research. In the meantime, take steps to live a healthy and active lifestyle, in addition to medication and other standard a-fib treatments:

• If you smoke, quit.
• Control high blood pressure.
• Get treatment for sleep apnea if you have it.
• Maintain a healthy weight.
• Don't drink alcohol, or consume only in moderation.
• Keep your cholesterol and triglycerides within a healthy range.
• Get regular exercise.
• Get recommended vaccinations for the flu and pneumonia, especially if you have heart disease.

Make sure to also ask your doctor or pharmacist about any new medications, including over-the-counter remedies and herbal supplements. Sometimes these can interact in a harmful way with warfarin, direct oral anticoagulants, or rhythm-controlling drugs.

Although your ability to prevent or treat atrial fibrillation with a healthy lifestyle has limits, most people are able to control bothersome symptoms long-term with medication, procedures, or both. That said, some people run out of safe or effective options, in which case the a-fib will become permanent. But with proper anti coagulation, you can still minimize your risk of stroke, the most dangerous complication of this abnormal heart rhythm.