Down to the Wire on Obamacare Sign-Ups

By Karen Pallarito
HealthDay Reporter

MONDAY, Dec. 14, 2015 (HealthDay News) — Health officials are urging Americans considering an Obamacare health plan for 2016 to act quickly to snag coverage and avoid rising penalties for remaining uninsured.

The final sign-up deadline is Jan. 31. But, for coverage to take effect on Jan. 1, you must enroll by Tuesday, Dec. 15.

If you take more time to enroll, your coverage won’t take effect immediately. Say, if you enroll or switch plans by Jan. 15, your coverage will take effect Feb. 1. If you put it off until the latter part of January, you won’t have coverage until March 1.

In a recent blog post, Kevin Counihan, CEO of HealthCare.gov, the federal health insurance marketplace, said there will be no special enrollment period around the federal tax-filing deadline, as there was for 2015.

So, if you miss the Jan. 31 sign-up deadline, you may have to wait another year to get coverage, he said.

Cynthia Cox, associate director of health reform and private insurance at the Kaiser Family Foundation in Washington, D.C., said, “Between now and a year from now, who knows what could happen and how your health might change.”

Under the Affordable Care Act (ACA), which is also known as Obamacare, most Americans must maintain health coverage or pay a fine. And, this time around, the penalties for not getting health insurance are steeper than in the previous two open-enrollment periods.

People who can afford coverage but choose to go without it (and don’t qualify for an exemption from the law) will pay a penalty of at least $695 when they file their 2016 federal taxes in 2017.

The Kaiser Family Foundation published a brief last week showing how the penalties shake out for the remaining uninsured.

Roughly 11 million uninsured people are eligible to enroll in a marketplace health plan, either with or without federal tax subsidies to lower their monthly premiums. The average penalty for remaining uninsured in 2016 is an estimated $969 per household, an increase of 47 percent from 2015.

Among subsidy-eligible folks, the average penalty is $738 per household, the foundation estimates, while people who don’t qualify for subsidies will face an average penalty of $1,450.

However, the foundation’s analysis also shows, for 7.1 million of the 11 million uninsured, paying the penalty will cost less than buying the least expensive Obamacare plan available to them.

Cox explained that the penalties were crafted to strike a balance between encouraging people to purchase insurance and avoiding overly punitive measures for those who missed sign-up deadlines or didn’t understand the benefit of purchasing insurance.

But even if it’s cheaper to pay the penalty, having health insurance provides financial protection, she said.

“Having that coverage can mean saving money over the course of the year for doctor visits that you otherwise would have to pay out-of-pocket for, or if you were to have a significant illness or accident,” Cox said.

Michael Stahl is a senior vice president with HealthMarkets, Inc., in Dallas/Fort Worth, one of the nation’s largest health insurance agencies serving individuals. He said, “You have to factor in what going uninsured means to you from a health standpoint and financially as well.”

There are alternatives to ACA coverage, like bare-bones, limited-duration “short-term” health plans, Stahl said. But these plans don’t provide the same protections or level of coverage as Obamacare health plans do. Plus, they do not meet “minimum essential coverage” standards under the health law, so you would still have to pay a penalty, he said.

“Honestly, for most people, an ACA plan is the right plan,” Stahl said.

Since Nov. 1, more than a million new customers have selected a health plan for 2016 through HealthCare.gov, the U.S. Centers for Medicare and Medicaid Services announced on Thursday. Another 1.8 million returning customers have renewed their coverage for 2016, CMS said.

Those figures reflect enrollment in the 38 states that use HealthCare.gov. The remaining states handle their own enrollment through state insurance marketplaces.

Federal health officials are encouraging people who signed up for 2015 coverage to review their options again because they might save money by switching to a new health plan.

However, in most cases, current enrollees who do nothing will be automatically re-enrolled in the same health plan, if it’s available, or a similar health plan, if the same plan is not offered.

“There are plenty of people who are being non-renewed this year,” meaning their health plans won’t be offered in 2016 because the health insurer pulled out of the market or went out of business, Stahl added. “So plenty of people have to switch, and you want to do that without a gap in coverage,” he said.

State exchanges tend to follow the same enrollment deadlines as HealthCare.gov.

Access Health CT, Connecticut’s health insurance marketplace, for example, says people who want coverage by Jan. 1. must enroll by Dec. 15.

“People are concerned about getting coverage now,” observed Melody Martin, outreach and enrollment supervisor at Southwest Community Health Center, Inc., in Bridgeport, Conn. “They’re not so much concerned with penalties or premiums,” said Martin, who helps uninsured individuals and families enroll in coverage.

More information

Are you eligible for marketplace coverage? Visit HealthCare.gov.

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Suspicious Pigment Spots More Common on Darker Skin

MONDAY, Dec. 14, 2015 (HealthDay News) — People with darker skin are about one-third more likely to have potentially dangerous pigment “spots” on their palms and soles, a new study finds.

In rare cases, these “acral pigmented lesions” turn out to be melanoma skin cancer. People with these lesions should have them checked by a dermatologist to be sure they are benign, the researchers said.

Reggae musician Bob Marley, for example, died from acral melanoma, which was diagnosed under his toenail.

“Acral pigmented lesions have not been well studied in people with darker skin,” senior study author Dr. Jennifer Stein, an associate professor in the department of dermatology at NYU Langone Medical Center in New York City, said in a center news release.

Stein’s team evaluated the palms and soles of 1,052 patients seen at dermatology clinics in New York City and Miami. The researchers detected 391 acral pigmented lesions on palms and 278 on soles.

The lesions were found on 30 percent of white patients and 40 percent of those with darker skin — about a 30 percent difference. The researchers also found that 44 percent of patients with the darkest skin had the lesions, compared with 28 percent of those with the lightest skin.

Acral pigmented lesions were also associated with a higher number of moles, especially among minority patients.

Only 54 percent of patients with these lesions on their palms and 43 percent who had them on their soles knew they had them, according to the study published online Dec. 14 in the Journal of the American Academy of Dermatology.

More information

The American Academy of Family Physicians has more about skin cancer.

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Primary Care Docs the Leading Prescribers of Narcotic Painkillers: Study

MONDAY, Dec. 14, 2015 (HealthDay News) — Americans continue to be plagued by an epidemic of prescription narcotic painkiller abuse, and a new study finds primary care physicians are by far the biggest prescribers of the drugs.

Researchers led by Dr. Jonathan Chen, of Stanford University, looked at data from 2013 Medicare Part D prescription drug coverage claims. They focused on prescriptions for narcotic painkillers containing hydrocodone (drugs such as Vicodin), oxycodone (Oxycontin and Percocet), codeine and others in this class, known as opioids.

In sheer number of prescriptions written, the largest prescribers were primary care physicians. For example, family practice doctors issued 15.3 million prescriptions, while internal medicine physicians (another type of primary care doctor) issued 12.8 million, the researchers found.

The study also found that nurse practitioners wrote 4.1 million prescriptions for narcotic painkillers while physician assistants ordered up 3.1 million.

Based solely on claims-per-prescriber, pain specialists led the way, followed by those in pain management, anesthesiology and physical medicine and rehabilitation, the researchers said.

There’s been a 10-fold increase in the abuse of narcotic painkillers in the United States over the past two decades, Chen noted in a Stanford news release. Some experts have suggested that small groups of high-volume prescribers and so-called “pill mills” are the main reasons for the narcotic painkiller overdose epidemic in the United States.

However, Chen’s team now believes that “high-volume prescribers are not alone responsible for the high national volume of opioid prescriptions,” and “efforts to curtail national opioid overprescribing must address a broad swath of prescribers to be effective.”

Two experts in drug abuse and addiction agreed that the problem of narcotic painkiller over-prescribing is a widespread one.

“Overprescribing is a national concern, and mitigation efforts should not be oversimplified or targeted to a select few prescribers, or to regions of the country, or to patient populations or communities,” said Victoria Richards. She is an associate professor of medical sciences at Quinnipiac University School of Medicine, in Hamden, Conn.

Doctors and other health care professionals need better education on proper prescribing of these painkillers, “starting very early in the process,” she added. And, there needs to be “increased oversight, follow-up and accountability in prescribing and patient care — including increased patient/community education and awareness.”

Dr. Scott Krakower is assistant chief of psychiatry at Zucker Hill Hospital in Glen Oaks, N.Y. He called the high rates of prescribing by a wide range of doctors “discouraging.”

Krakower agreed that better education and oversight of health care professionals is warranted, and “they should also consider less habit-forming treatment alternatives for pain when available.”

However, the issue isn’t always an easy one for doctors to solve, said Chen, who is an instructor of medicine at Stanford.

“Being a physician myself, I am acutely aware of the emotional angst that can occur when deciding whether to prescribe opioids to a patient who may have simultaneously developed a chronic pain and substance-dependence problem,” he said.

The study was published online Dec. 14 in the journal JAMA Internal Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more about painkiller prescribing.

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Genetic Abnormality May Explain Health Complications of Down Syndrome

By Alan Mozes
HealthDay Reporter

MONDAY, Dec. 14, 2015 (HealthDay News) — People with Down syndrome have long been known to face a higher risk for a range of other illnesses, including heart disease, diabetes and immune disorders.

Now, a new study has honed in on a possible cause: too much of a specific gene that disturbs the peripheral nervous system.

The peripheral nervous system is involved in basic organ-related activities. These activities include heartbeat, blood pressure and blood sugar levels, the Johns Hopkins University researchers explained.

They looked at tissue samples from both mice and people with Down syndrome. They found that those with Down syndrome carry three times the normal amount of a certain gene called RCAN1. This particular gene helps regulate a protein known as “nerve growth factor.”

Excess amounts of RCAN1 lower the activity of nerve growth factor, the researchers observed.

And that change led to impaired development of the peripheral nervous system.

“There’s been a whole aspect of the nervous system that has been ignored in Down syndrome, and perhaps in other neurological disorders,” study co-author Rejji Kuruvilla, an associate professor in Hopkins’ department of biology, said in a news release from the Baltimore-based university.

“[And] when you think about therapeutic interventions that could affect life quality, it’s important to not ignore this important aspect of the nervous system,” Kuruvilla added.

The finding of a genetic smoking gun could, in theory, help direct researchers towards new therapies that might lower the specific health risks caused by Down syndrome-related peripheral nervous system damage, Kuruvilla said.

The findings also raise additional questions as to what other health issues might be attributable to abnormally high amounts of RCAN1, she said. For example, RCAN1 also plays a role in regulating nerve growth factor in an area of the brain linked to Alzheimer’s disease.

Findings from the study were published in the Dec. 14 issue of Nature Communications.

More information

There’s more on Down syndrome at the National Down Syndrome Society.

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Abuse of Prescription Painkillers, Stimulants Ups Sexual Risks for Teens

By Tara Haelle
HealthDay Reporter

MONDAY, Dec. 14, 2015 (HealthDay News) — Teens who use abuse prescription drugs such as narcotic painkillers are more likely to have sex or to participate in risky sexual behaviors, a new study suggests.

These risky behaviors included having sex with multiple partners, using drugs or alcohol before having sex or having sex without the use of a condom, the research revealed.

The study looked at a variety of prescription drugs that might be used recreationally by teens. These included the prescription painkillers Oxycontin, Vicodin, Percocet or codeine; sedatives such as Xanax or Ativan; or stimulant drugs used to treat attention-deficit hyperactivity disorder (ADHD), such as Adderall or Ritalin.

“About 1 out of every 5 high school students reported non-medical use of prescription drugs,” said study author Heather Clayton, a health scientist in the division of adolescent and school health at the U.S. Centers for Disease Control and Prevention.

“This behavior is very concerning, as overdoses and deaths related to non-medical use of prescription drugs is on the rise,” Clayton said. Deaths from prescription painkillers have quadrupled since 1999, she noted, with more than 16,000 people dead due to prescription painkillers in the United States in 2013.

And now, researchers link recreational use of prescription drugs to risky sexual behaviors.

But, the study couldn’t show that recreational use of prescription drugs caused the risky sexual behaviors. “Non-medical use of prescription drugs and sexual risk behaviors are likely to be part of a constellation of risk-taking behaviors,” Clayton said.

The findings were published online Dec. 14 in the journal Pediatrics.

For the study, the researchers reviewed surveys about risky behaviors completed by more than 29,000 high school students. Specifically, the survey asked, “During your life, how many times have you taken a prescription drug [such as Oxycontin, Percocet, Vicodin, codeine, Adderall, Ritalin or Xanax] without a doctor’s prescription?”

Compared to their peers who didn’t use prescription drugs for recreational reasons, teens who used prescription drugs for non-medical reasons were:

• 16 percent more likely to have ever had sex,
• 26 percent more likely to be currently sexually active,
• 14 percent more likely to not have used a condom the last time they had sex,
• 32 percent more likely to have used drugs or alcohol before they had sex,
• 45 percent more likely to have at least four previous sexual partners.

The surveys also found that the more teens used prescription drugs recreationally, the more likely they were to engage in all of these risky behaviors.

Clayton said the researchers were surprised that the link between recreational use of prescription drugs and risky sexual risk behaviors remained even after the researchers adjusted the data to account for other factors, such as the use of illicit drugs and alcohol.

The findings highlight the challenges of adolescent brain development, said Moe Gelbart, a psychologist specializing in alcohol and chemical dependency at Torrance Memorial Medical Center in California.

The brain takes about 25 years to fully develop, Gelbart said. The parts of the brain focused on sensory experiences and emotions develop first while the frontal cortex, which controls judgment, develops last, he explained.

“In other words, we have teens who have hormones and needs for excitement and physical stimulation, but who lack the maturity and understanding of the consequences of their behaviors,” Gelbart said. “When any substance use is thrown in the mix, the judgment aspect of the brain is severely affected. Thus, we have adolescents engaging in very high-risk behaviors.”

While most teens won’t become addicted to drugs or alcohol, earlier use does increase the risk of addiction in adulthood, Gelbart said. Drug use can also lead to legal problems, school problems, health issues and sexual behavior that may result in sexually transmitted infections, pregnancy and a poorer reputation, he said.

“The worst consequences involve imprisonment or death,” he added. “The leading causes of death for teens are related to substance use.”

Teens may choose to abuse prescription drugs at least in part because they are easier to access and may be cheaper than other drugs, said Dr. Scott Krakower, assistant unit chief of psychiatry at The Zucker Hillside Hospital in Glen Oaks, N.Y.

Teens can get them from friends or relatives who may have gotten them from health care practitioners, said Krakower. He recommended that parents make sure teens don’t have access to these medications. That may mean removing them from the home or storing them in lock boxes, he said.

“If parents discover that their child is abusing prescription drugs, they should seek help immediately and should discuss this with their pediatrician or with a mental health professional,” Krakower added.

He also said it may be worthwhile to consider implementing more sex education and HIV education into schools and improving teens’ access to contraceptives.

More information

For more about teen drug use, visit the National Institute of Drug Abuse.

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Bodily Changes Don’t Always Signal ‘Precocious’ Puberty in Kids

By Amy Norton
HealthDay Reporter

MONDAY, Dec. 14, 2015 (HealthDay News) — Children who develop certain signs of puberty at an early age are commonly referred to specialists for an evaluation. But most of the time it’s nothing to worry about, says a new report from a leading group of U.S. pediatricians.

It’s not uncommon for young children to show certain traits associated with puberty, including some pubic hair, underarm hair and the beginnings of breast development, said Dr. Paul Kaplowitz, who led the American Academy of Pediatrics report.

He said early signs of sexual maturation are one of the most common reasons that children are referred to pediatric endocrinologists — specialists in treating hormone-related disorders.

But the vast majority of those kids do not have so-called “precocious puberty,” said Kaplowitz, an endocrinologist at Children’s National Medical Center in Washington, D.C.

In general, precocious puberty is defined as puberty that sets in abnormally early — before age 8 for girls, or age 9 for boys. But children can have certain signs of early sexual maturation that are not truly precocious puberty, Kaplowitz said.

In “true puberty,” a brain area called the hypothalamus sets off a hormonal cascade that triggers the production of estrogen and testosterone, which then triggers breast growth in girls and testicular enlargement in boys, said Dr. Brenda Kohn, director of pediatric endocrinology at NYU Langone Medical Center in New York City.

But there’s also a secondary component to puberty called “adrenarche,” said Kohn, who was not involved in the academy report.

During adrenarche, the adrenal glands, which sit on the kidneys, begin to churn out weak “male” hormones. That, in turn, can cause kids to develop some pubic hair, underarm hair and body odor.

Those adrenal-related changes can happen in the absence of “true” puberty, Kohn explained. And that, she said, “is a variant of normal growth.”

Kaplowitz said “it’s not at all unusual to see early pubic hair development,” noting it even happens in infants. While parents often find that alarming, Kaplowitz said, it is usually benign — especially if the child is showing no genital enlargement, and body growth is on a normal pace.

And while breast development is a sign of true puberty, it’s not always clear-cut. With the rising rate of childhood obesity, more and more girls are being evaluated for what appears to be breast tissue, but is often excess body fat, according to the academy.

The report appears in the Dec. 14 online issue of the journal Pediatrics.

The academy pointed to a few signs that a child’s development might be out of the range of normal: testicular enlargement in a boy younger than 9 and progressive breast development in a girl younger than 8. Kohn said rapid growth in pubic hair or acne at a young age are also possible warning signs.

Another red flag is when children with breast or testicular growth are also shooting up in height, said Kaplowitz.

What causes precocious puberty? Most of the time, it’s unexplained, Kohn said. In rare cases, a brain tumor is the cause, so children with true precocious puberty should have an MRI of the brain, she added.

One of the main concerns with precocious puberty is that children will be significantly shorter than average as adults. That’s because the rapid early development can cause the bones’ growth plates to fuse too soon.

“Treatment with a long-acting gonadotropin receptor analogue on a monthly basis — or every three months — will safely suppress puberty until the desired age,” Kohn said.

Of course, some children can suffer emotionally when they develop much faster than their peers. So a child’s emotional state should always be part of the evaluation, Kohn said.

The good news is that most kids with some early signs of puberty just have a variant of normal growth, said Kaplowitz. He estimated that of the children he evaluates, only 10 percent have true precocious puberty.

More information

The U.S. National Institute of Child Health and Human Development has more about precocious and delayed puberty.

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How to Clear Snow Without Getting Hurt

SUNDAY, Dec. 13, 2015 (HealthDay News) — Snow removal is a major cause of winter-related injuries, but there are several ways to reduce your risk, an expert says.

“Individuals tend to haste through snow shoveling to avoid being outside in the cold for long periods of time,” orthopedic surgeon Dr. Joseph Abboud, spokesman for the American Academy of Orthopaedic Surgeons (AAOS), said in an academy news release.

“Unfortunately, rushing through this task can lead to injuries. It should always be done at a slow and steady pace because of the energy and focus that’s required. Always check with your doctor before shoveling snow and consider hiring someone to do it for you if you’re unable to,” he advised.

In 2014, more than 203,000 Americans required treatment for injuries suffered while manually clearing snow, and nearly 27,000 were injured using snow blowers or throwers, according to the U.S. Consumer Product Safety Commission.

When shoveling, try to push the snow instead of lifting it, experts say. If you must lift, keep the amounts of snow small and lift with your legs, without bending at the waist. Don’t throw snow over your shoulder or to the side, which requires a twisting motion that puts stress on your back. Instead, walk to where you want to dump the snow.

Clear snow early and often, take frequent breaks and drink water to prevent dehydration. If you develop chest pain, shortness of breath or other signs of a heart attack, get immediate emergency care, the AAOS said.

If you use a snow blower, read the instruction manual before use, the experts said in the news release. If your snow blower gets jammed, turn off the engine and wait at least five seconds. If it has a cord, unplug it. Use a solid object to clear wet snow or debris from the chute. Never stick your hands or feet in a snow blower.

In addition, never leave a running snow blower unattended. If you have to walk away from the machine, turn it off.

If you’re using an electric snow blower, always be aware of where the power cord is so you do not trip and fall.

More information

The U.S. Centers for Disease Control and Prevention has more about winter health and safety.

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Ways to Beat the Holiday Blues

SATURDAY, Dec. 12, 2015 (HealthDay News) — Celebrating is the last thing some people feel like doing during the holiday season.

“The holidays can be an especially difficult time for people who are depressed or grieving,” Dr. Jeffrey Borenstein, president and CEO of the Brain & Behavior Research Foundation, said in a foundation news release.

“People who are sad or lonely often feel out of sync when everyone else seems to be celebrating, and the holidays can exacerbate these feelings,” he explained.

If you are depressed, don’t try to deal with it on your own. If you are not in treatment, seek help. If you are already receiving treatment, it’s especially important to continue during the holidays, he said.

“The holidays are challenging for many people, but symptoms of depression are a sign to seek professional help. The most important take-home message is that depression is treatable and people should not suffer in silence; they should seek help,” Borenstein said.

People who are depressed tend to isolate themselves. Instead, they should try to go to a party or family gathering even if they’re not in the mood, he suggested.

Don’t have unrealistic expectations about the holidays, because that can lead to disappointment, Borenstein said. Holidays can also bring up long-standing family issues. Try to set them aside, he suggested. Instead, try to focus on things that make you happy and be thankful for the good relationships you have.

It’s also important to get regular exercise, which can help improve your mood.

Some people who feel sad during the holidays turn to alcohol, but that’s a mistake. Alcohol is a depressant and can increase depression, anxiety and stress.

Another potential problem at this time of year is seasonal affective disorder (SAD), a form of depression triggered by the lack of sunlight in winter. Treatments for SAD include light therapy, counseling and medications.

More information

The National Alliance on Mental Illness has more about dealing with the holiday blues.

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Stress May Boost Risk for Alzheimer’s-Linked Thinking Problems

By Tara Haelle
HealthDay Reporter

FRIDAY, Dec. 11, 2015 (HealthDay News) — Increased stress could be a risk factor for the kind of thinking difficulties that can lead to Alzheimer’s disease, a new study suggests.

However, the research did not prove that stress caused cognitive impairment or Alzheimer’s.

“We know that, in general, stress makes it harder to think clearly,” said Dr. Gayatri Devi, a neurologist at Lenox Hill Hospital in New York City, who was not involved in the study. “But here’s data showing that stress may put us at risk for developing diseases like Alzheimer’s.”

The findings were published online Dec. 11 in the journal Alzheimer Disease and Associated Disorders.

The study authors gave questionnaires to just over 500 adults, aged 70 and older, asking about how much stress they experience. None of the adults had signs of dementia at the study’s start.

The researchers followed these adults for more than three years. Each year, the adults underwent a series of tests related to their daily living, their memory and their ability to think clearly.

Adults who perceived themselves to be under the most stress had a 30 percent greater risk of early cognitive impairment, according to the study. This risk remained after accounting for participants’ depression symptoms, age, sex, race, education level and genetic risk of Alzheimer’s disease.

“The evidence suggests that perception of events is more important than the events themselves in predicting biological consequences and future health,” said study co-author Dr. Richard Lipton, vice chair of neurology at Montefiore Medical Center and Albert Einstein College of Medicine in New York City. “This is good news because perception of stressful events is amenable to intervention.”

Some approaches to reducing stress include cognitive behavioral therapy, mindfulness-based meditation, yoga and biofeedback, Lipton said.

Another way to reduce stress is to get a good night’s sleep, Devi added.

“We all undervalue sleep, but it’s very important,” she said. “Sleep is probably the single most effective, efficient, inexpensive and widely available method of reducing stress, and we were all born experts at it.”

Although the study did not show stress causes thinking difficulties, Devi described several ways stress and cognitive problems could be linked. Stress increases the hormone cortisol in the body and reduces the density of nerve cells in the brain, she explained.

“Stress also raises the levels of certain neurotransmitters in the brain and lowers others so the brain works less efficiently, and stress may play a role in laying down plaques responsible for cell death in Alzheimer’s disease,” she said. “When we’re more stressed, we’re more likely to have infections, and it affects our immune functioning. Immune functioning is thought to be related to developing Alzheimer’s.”

The study findings did not surprise Dr. Luca Giliberto, an attending neurologist at North Shore-LIJ’s Cushing Neuroscience Institute in Manhasset, N.Y.

“Cardiovascular consequences of stress, including increased heart rate and blood pressure, may underlie increased cardiovascular risk in stressed subjects, leading to vascular dementia,” Giliberto said. “Stressed subjects also often engage in unhealthy habits, such as smoking and low levels of exercise, all known risk factors for cognitive decline in general, not necessarily Alzheimer’s disease.”

The researchers also explored whether stress results from cognitive decline instead, but that doesn’t appear to be the case, said study co-author Mindy Katz. She is a senior associate in the department of neurology at Albert Einstein College of Medicine.

“We think this is unlikely for several reasons,” Katz said. For example, the authors measured stress before the development of cognitive impairment, she said. “Several analyses to test this hypotheses all concluded that this theory did not prove to be correct using data from this study,” she said.

There is no magic recipe for reducing stress, but people must first recognize they have it, Giliberto said.

“Leading a stressful life is neither healthy nor productive,” he said. “Eating right, performing daily exercise, avoiding excessive self-medication and getting enough sleep may do the trick. Often, the best remedy is to go back to what makes us happy: a song, a walk in the park or spending time with friends or grandchildren.”

More information

Visit the U.S. Centers for Disease Control and Prevention for more on Alzheimer’s disease.

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21 Simple Tips for Finding Balance Through the Holidays

Photo: Giphy

In every issue of Health magazine, we crowdsource sage life advice from our readers: You’ve shared your personal tips on everything from curbing stress and staying motivated to keeping it all in perspective when life gets hectic. Much of that guidance feels especially useful right now during the holiday season. The 21 tips below bear repeating as many of us strive to find balance through the most wonderful-slash-overwhelming time of the year.

Quiet self-doubt.

“I remind myself of how strong I really am, even when I tend to forget.” —Amanda D., via Facebook

Know what you can change.

“The two things that you can control in life are your effort and your attitude.” —Linda D., via Facebook

RELATED: 12 Worst Habits for Your Mental Health

Process your emotions.

“When I’m down, I always feel better after I get it out. Have a good cry, talk it out, and go do some intense cardio.” —Elizabeth K., via Facebook.

Snap out of fix-it mode.

“Always remember: not your circus, not your monkey. Never take responsibility for a mess that wasn’t yours to begin with.” —Beth Ann J., via Facebook

Sleep when you need it.

“I owe everything to my 20-minute nap breaks.” —@gracewmurray

RELATED: A Sleep Meditation for a Restful Night

Let go of guilt.

“When life gets crazy, I accept that I can’t do it all, and I focus on what’s important—because vacuuming can wait!” —@hmebodiesdesign

Stay active.

“My grandmother, who lived to be 94, said, ‘Never stop moving or you will get rusty.’” —Diane T., via Facebook

Carry a reminder of where you’re headed.

“I have a smooth, shiny purple stone I keep in my purse or pocket. It is my anchor and reminds me of the beach where I found it after losing 206 pounds. When I hold it, I think of all my success and why I need to keep focused and never go back to where I came from.” —Annemarie K., via Facebook

Invest in the important stuff.

“Buy good shoes and a good bed because if you’re not in one, you’re in the other!” —Melissa W., via Facebook

Own your greatness.

“Approach each day with confidence. You are more beautiful than you think and more intelligent than you realize.” —Michelle C., via Facebook

RELATED: 22 Ways to Get Happy Now

Stick with what makes you feel good.

“Don’t quit anything that makes you happy, and don’t do anything so much that it becomes bad for you.” —@catella18

Stick to your values.

“It’s nice to be important, but it’s more important to be nice.” —Melissa A., via Facebook

Seize the day.

“I always tell myself that today I’m privileged to be able to work out. You may not always have your health or be physically able to exercise. Do it while you can!” —Kerry A., via Facebook

Don’t let pride get in the way.

“Never be afraid to ask for help when you need it. Even the bravest sometimes need a helping hand or listening ear.” —@stylinstar 53

Take breaks.

“I love to go in the garden and pull weeds. I admire what beautiful things I’ve created; it’s my way of clearing my head.” —Katherine M., via Facebook

Do what it takes to get to the gym.

“I sleep in my workout clothes and go to the gym first thing in the morning. If I’m sleeping in them, I hate to change out of them if I don’t work out.” —Constance M., via Facebook

RELATED: 25 Genius Ways Fitness Trainers Stay Motivated to Exercise

Push yourself from time to time.

“If it doesn’t challenge you, it doesn’t change you!” —Lori K., via Facebook

Be prepared.

“Always bring a book.” —@RachelOnandOn

Treat yourself… in a healthy way.

“I love using fresh slices of cucumber when my eyes look tired. Plus the downtime helps me feel really zen.” —Christie A., via Facebook

Protect your joy.

“Happiness is circumstantial, but joy is internal. Never allow anyone to steal your joy.” —Darlita S., via Facebook

Love your body.

“It took me a while to realize how sexy confidence is, but no matter how big or small I am, I feel sexy. And that makes my workout more about health and less about losing weight.” —Momo P., via Facebook

RELATED: The Top 10 Body Positive Moments of 2015

 

from Health News / Tips & Trends / Celebrity Health http://ift.tt/21W8KqT