Category: THE-BEAUTY

Infertility is a remarkably common problem. It affects up to one in five people in the US who are trying to become pregnant, and 186 million people worldwide. A thorough medical evaluation can spot key contributing issues in many cases — whether in a woman, a man, or both partners — that might respond to treatment, or call for assisted reproductive tools like in vitro fertilization (IVF).

But in a substantial number of cases, no cause is found for infertility. Could inflammation be to blame for some of those cases, as recent research suggests? And if so, will an anti-inflammatory diet or lifestyle boost fertility?

Exploring the connection between inflammation and infertility

Chronic inflammation has been linked to many health conditions, such as cardiovascular disease, stroke, and cancer.

While its importance in infertility is far from clear, some evidence supports a connection:

• The risk of infertility is higher in conditions marked by inflammation, including infection, endometriosis, and polycystic ovary syndrome.
• Bodywide (systemic) inflammation may affect the uterus, cervix, and placenta, thus impairing fertility.
• Women with infertility who had IVF and followed an anti-inflammatory diet tended to have higher rates of successful pregnancy than women who did not follow the diet.

Could an anti-inflammatory diet improve fertility?

It’s a real possibility. Decades ago, researchers observed that women following a prescribed fertility diet ovulated more regularly and were more likely to get pregnant. Now a 2022 review of multiple studies in Nutrients suggests that following an anti-inflammatory diet holds promise for people experiencing infertility. The research was done years apart, but the diets in these two studies share many elements.

The 2022 review found that an anti-inflammatory diet may help

• improve pregnancy rates (though exactly how is uncertain)
• increase success rates of assisted reproductive measures, such as IVF
• improve sperm quality in men.

The authors add that improving diet might even reduce the need for invasive, prolonged, and costly fertility treatments. However, the quality of studies and consistency of findings varied, so more high-quality research is needed to support this.

Will adopting an anti-inflammatory lifestyle improve fertility?

While recent research is intriguing, there’s not enough evidence to show that an anti-inflammation action plan will improve fertility. A plant-based diet such as the Mediterranean diet, and other measures considered part of an anti-inflammatory lifestyle, improve heart health and have many other benefits.

It’s not clear if this is directly due to reducing inflammation. But this approach comes with little to no risk. And abundant convincing evidence suggests it can improve health and even fight disease.

What is an anti-inflammatory lifestyle?

Health experts have not agreed on a single definition. Here are some common recommendations:

• Adopt a diet that encourages plant-based foods, whole grains, and healthy fats like olive oil while discouraging red meat, highly processed food, and saturated fats.
• Stop smoking or vaping.
• Lose excess weight.
• Be physically active.
• Get enough sleep.
• Treat inflammatory conditions, such as rheumatoid arthritis or allergies.
• Avoid excessive alcohol consumption.
• Control stress.

Anti-inflammatory medicines may help in certain situations — for example, treatments for autoimmune disease. However, they are not warranted for everyone. And for people trying to conceive, it’s far from clear that any potential benefit would exceed the risk of side effects for parent and child.

The bottom line

It’s possible that inflammation plays an important and underappreciated role in infertility and that an anti-inflammatory diet or lifestyle could help. But we need more evidence to confirm this. Until we know more, taking measures to improve your overall health and possibly reduce chronic inflammation makes sense.

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

Feeling rooted in community and socializing with neighbors may strongly contribute to better cardiovascular health by improving diet, exercise habits, and weight control, new research among Black adults in Georgia suggests. And better cardiovascular health may add up to fewer heart attacks and strokes, two leading causes of disability and death.

“There’s a range of interactions within the community that can improve one’s cardiovascular health, not to mention the effect on mental health — the sense of belonging, of being seen — which is tightly related to cardiovascular outcomes in the long run,” says Dr. Dhruv Kazi, director of the cardiac critical care unit at Beth Israel Deaconess Medical Center (BIDMC) and associate director of the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology.

“Another way to put it is that these unique sources of resilience in communities may directly affect diet, exercise, weight, and mental well-being, all of which lead to improved cardiovascular health,” he adds.

A positive perspective on health within Black communities

The new analysis is part of the ongoing Morehouse-Emory Cardiovascular Center for Health Equity (MECA) study in Atlanta. MECA builds on prior research indicating that living in disadvantaged areas is associated with higher rates of having heart disease or dying from it. But unlike much of that research — which focused on negative aspects of Black neighborhoods that may contribute to poor cardiovascular health — the new study fills a gap. It zeroes in on positive neighborhood features, especially social interactions, that can promote ideal cardiovascular health despite higher risks related to race or socioeconomic status.

“Typically, researchers are identifying factors that result in health disparities on the negative side, such as deaths or co-existing diseases, or that cause increased rates of a particular disease,” explains Dr. Fidencio Saldana, dean for students at Harvard Medical School and an attending physician in medicine and cardiology at Brigham and Women’s Hospital (BWH), whose research interests include racial disparities and outcomes in cardiovascular disease. “It’s quite unique to be able to look for solutions, or to look at these positive attributes of communities and think about how to replicate them.”

Measuring social environment and heart health

The study included 392 Black men and women between the ages of 30 and 70 living in the Atlanta area. None had existing cardiovascular disease. About four in 10 participants were men.

Social environment includes perceptions of neighbors and any support system, as well as how often neighbors interact. Participants answered questions about seven neighborhood features: aesthetics, walking environment, availability of healthy foods, safety, social cohesion, activity with neighbors, and violence.

Heart health was measured using Life’s Simple 7 (LS7) scores, developed by the American Heart Association to determine ideal cardiovascular health. LS7 calculates seven elements that influence cardiovascular health: self-reported exercise, diet, and smoking history, as well as measured blood pressure, sugar level, cholesterol level, and body mass index (BMI). Researchers also gathered information about annual income, education, and marital and employment status, and physical exams that included blood tests.

What did the researchers learn?

After controlling for factors that could skew results, researchers found participants who reported more social connection and activity with neighbors were about twice as likely to record ideal LS7 scores. The association was even stronger among Black women than men.

“Our health is more closely related to these social networks than we appreciate,” Dr. Kazi says, noting that individual efforts to combat obesity and smoking, for instance, are more likely to gain steam “when shared by neighbors.”

“The more we’re able to engage with our neighbors and the communities we live in, the better it probably is for our cardiovascular health,” he says.

The study was observational, so it cannot prove cause and effect. It’s also possible that those who are already healthier are more likely to engage with their neighbors, Dr. Kazi notes. Other limitations are the location of all participants in a single metropolitan area, and the self-reported nature of neighborhood characteristics. Another key area that went unexamined, Dr. Kazi says, involves a “missing piece” in LS7 scores: mental health.

“Living in a community where you feel safe and know your neighbors — where you feel part of the social fabric — is critically important to mental health, and therefore cardiovascular health,” he explains. “If anything, this study underestimates the health benefits of feeling part of a cohesive neighborhood.”

What are a few takeaways from this study?

Social environment and feeling rooted within a community matter to health, and may even help counter negative risk factors. However, long-term lack of investment and the effects of gentrification threaten many Black neighborhoods in cities throughout the US.

“When a neighborhood gets gentrified and longstanding residents are forced to leave, the community is gone forever,” Dr. Kazi adds. “Simply offering the departing residents housing elsewhere doesn’t make up for what is lost. Going forward, we need to be cognizant of the value of community, and invest in our neighborhoods that allow people to safely engage in physical and community activities.”

Dr. Saldana agrees. “Our system is not set up for some communities to have those advantages. It’s important to look to the positive aspects of our communities, and as a system encourage those positive traits in other communities.”

About the Author

Maureen Salamon, Executive Editor, Harvard Women's Health Watch

Maureen Salamon is executive editor of Harvard Women’s Health Watch. She began her career as a newspaper reporter and later covered health and medicine for a wide variety of websites, magazines, and hospitals. Her work has … See Full Bio View all posts by Maureen Salamon

It’s hard to care about anything when you feel exhausted, burned out, or ragged around the edges. Your once-fiery enthusiasm may seem more like charred rubble due to overwhelming family responsibilities, a job that drains you, or financial struggles. Or maybe an illness, the uncertainty and disruptions of the age we live in, or a combination of factors has left you feeling as if you have precious little to give.

“What you’re experiencing is burnout. It’s real and it can lead to depression, anxiety, relationship damage, and an inability to function at home or at work,” says Dr. Marni Chanoff, an integrative psychiatrist with Harvard-affiliated McLean Hospital.

Take heart: With time and effort, you can refill your cup, slowly adding back a bit of the energy and joie de vivre you’ve been missing. Here are three ways to start.

1. Carve out time for yourself

Taking time for yourself isn’t a luxury; it’s essential to self-care. “You need to slow down and give yourself the opportunity to rest and rejuvenate,” Dr. Chanoff says, “Schedule it if you have to, starting with 10 or 15 minutes, a couple of times a day.”

How can you reclaim precious minutes in an overly full schedule? “Look at your day, week, or month, and be discerning about how many things you say ‘yes’ to in one period of time. Give yourself permission to say ‘no thank you’ to things that deplete you or don’t serve you,” Dr. Chanoff says.

Make small moments count: choose what makes you feel at peace. For example, have a cup of tea, or simply lay a blanket or mat on the floor at home or work and lie on your back. Don’t look at your phone or email. “You want to tell your body to take a break. It helps you reset and back away when stress draws you in,” Dr. Chanoff explains.

2. Commit to better health

A strong body helps balance the stressful situations that have caused your burnout. The basic recipe for good health includes:

• Exercise. Moderate intensity exercise, the kind that works the heart and lungs, releases important chemicals that help regulate mood, sleep, and many body systems. Aim for at least 150 minutes of exercise per week, which amounts to about 22 minutes a day. Start with just a few minutes a day if it’s all you can do. It doesn’t have to be fancy. “It can be any movement that brings you joy, like dancing, yoga, or brisk walking,” Dr. Chanoff suggests.
• A good diet. Eating lots of junk food (typically full of sugar, salt, and unhealthy saturated fat) fuels chronic stress, fatigue, depression, and anxiety. Choose more unprocessed foods such as vegetables, fruits, whole grains, legumes, lean proteins (fish or poultry), and unsaturated fats (such as avocados or olive oil). If time is an issue, Chanoff suggests batch-cooking simple, healthy foods you can have several days of the week. (Lentil or bean soup is a good one-pot meal. Throw in as many vegetables as you can.)
• Sleep. Insufficient sleep affects overall health, concentration, and mood. Try to sleep seven to nine hours per night. “It helps to wind down an hour or two before you fall asleep. And practice good sleep hygiene: turn off your phone, keep your room cool and dark, and go to sleep and wake up at the same time each day,” Dr. Chanoff advises.

3. Surround yourself with comfort

Hygge (pronounced HOO-ga) is the Danish concept of cozy comfort that brings happiness and contentment. Folks in Denmark know a thing or two about finding sunshine in cold dark months.

To practice hygge, surround yourself with people, activities, and things that make you feel cozy, loved, happy, or content. Go simple: spend time with your favorite people, add a small vase of flowers to your space, don fuzzy slippers once home, eat a treasured comfort food, or listen to a favorite song.

More ideas to try:

• Light a candle.
• Get under a heated blanket.
• Frame a photo of a happy time.
• Have breakfast in bed.
• Use pretty table linens.
• Indulge in art (check out various works at museums online).
• Stand still outside to listen to the sounds of nature.
• Curl up in a cozy chair.
• Window-shop in your favorite store.
• Wear a soft sweater that feels good on your skin.
• Use a silk or satin pillowcase on your bed pillow.
• Take a warm bath.
• Get an oil diffuser with a scent that reminds you of a place you love, like the beach or a pine forest.

Turn up the effect by savoring cozy comfort. How does it feel, taste, smell, or sound? “Engaging the senses with soothing stimulation can be nourishing. It counteracts ongoing stress that the nervous system endures, and may help to elicit the relaxation response — the opposite of the fight or flight [stress] response,” Dr. Chanoff explains. Breathing deeply will help, too.

Eventually, these bits of hygge, health, and personal time will give you something you probably haven’t allowed yourself in a while, and that’s compassion. Be gentle with yourself. Pamper your soul and replenish your cup, so you can continue being there for the important people and tasks in your life.

About the Author

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

Key safety tips as legal medical and recreational marijuana evolve.

It’s fair to say that society’s views on cannabis have been evolving. Today, adult recreational use is legal in 21 states and medical use is legal in most other states, to varying degrees. The use of cannabis doesn’t seem to be going away. Given that, here is what you need to know to make using cannabis safer.

Buy it legally

If you live in a state with legal cannabis — whether medical or recreational — go through the legal market rather than the illicit market, despite the temptation of lower prices. While many state programs are less than perfect, buying cannabis through the legal market generally offers some advantages and protections:

• The product is tracked throughout its entire cycle “from seed to sale.” It’s tested for potency and to ensure it is free of contaminants. Legally bought cannabis should be free of heavy metals, disallowed pesticides, fungus, and lead.
• Labeling is increasingly accurate and helpful, showing what is actually in the cannabis you are purchasing. Different types of cannabis have different effects. You need to be able to understand what you are and aren’t consuming.
• In states where its use is legal, it is still illegal to purchase marijuana from illicit sources.
• If a contaminated product is discovered, there can be a recall.
• Keeping transactions aboveboard helps to facilitate communication with health care providers and to lessen stigma that harms medical users.

Some things to watch out for in the legal market:

• Safety and monitoring are by no means foolproof. This will get better once there are consistent federal standards.
• Do not rely on well-intentioned dispensary employees (known as budtenders) to make medical suggestions when you are purchasing. Health care providers should be answering these questions — though many are still getting up to speed on the cannabis issue.
• Be extremely careful of dosages. Don’t be upsold into buying a product that is too strong for you.
• Not all products are safe to have around the house, such as THC-infused sodas, chocolates, or gummies that any child or pet would gladly overconsume.

Pay attention to potency

The most straightforward way to get into trouble with cannabis is by consuming too high a dosage of the main active ingredient, THC. As with any medicine or drug, it is safest to use the lowest effective dose for the shortest time permitted.

Cannabis flower is far more potent than it was back in the 1970s. People who haven’t used cannabis in the modern era may inadvertently overconsume, assuming it is the same weed that they had back in the day.

Taking too much cannabis, or using cannabis that is too strong for you, can cause a severe anxiety attack, possibly landing you in the emergency department. You do not want this! Too high a dosage can also potentially trigger other medical conditions, such as cardiac arrhythmias and syncope.

Some people develop cannabis hyperemesis syndrome — uncontrolled vomiting in response to cannabis use — which can only be treated by ceasing use. Start low, go slow, and stay low is good advice, especially if you’re new to (or newly back to) using cannabis. Be careful with all edibles, especially any you make yourself: licking batter off the spoon means you’re consuming the marijuana.

Concentrates (called wax, shatter, or crumble) feature extremely high levels of THC. They often don’t have other medicinal cannabinoids such as CBD, which can mitigate some of the unwanted effects of THC. It is much easier to overconsume with these concentrates, as the THC content ranges from 40% to 90%.

Who should not use cannabis?

As with all things in medicine (including medical cannabis), there are exceptions to all rules, but generally:

• Teens should absolutely avoid using cannabis due to concerns about the effects it can have on brain development.
• Women who are pregnant or breastfeeding should abstain from cannabis due to safety concerns about its effects on a newly developing brain.
• People with certain psychiatric conditions, such as any type of psychosis, or those with a family history of schizophrenia, should avoid using cannabis, as this can worsen their condition.

If you are having trouble controlling your cannabis use or if you find it is escalating, seek professional help.

What else to know

• Don’t smoke cannabis, which can inflame your lungs. Use an under-the-tongue tincture, an edible, a topical product, or a dry herb vaporizer.
• If you do smoke cannabis, don’t hold it in your lungs for more than a second or two; holding it in longer doesn’t give you more effect, it just irritates your lungs.
• Don’t drive for at least four hours after smoking cannabis, even if you feel you are able to drive safely sooner than that. After an edible, wait eight to 12 hours before driving.
• Communicate with all of your health care providers about your cannabis use. Open dialogue helps coordinate care and avoids drug interactions.
• Avoid using cannabis for 24 hours before your shift if you work in a safety-sensitive job. You should also abstain if are on call for your job or a sick relative, or if you are in charge of children.

About the Author

Peter Grinspoon, MD, Contributor

Dr. Peter Grinspoon is a primary care physician, educator, and cannabis specialist at Massachusetts General Hospital; an instructor at Harvard Medical School; and a certified health and wellness coach. He is the author of the forthcoming book Seeing … See Full Bio View all posts by Peter Grinspoon, MD