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Friends of the Library Offers FREE Presentation on Community Hospice

Friends of the Library is offering a FREE presentation led by Maureen Paschke, a specialist in social gerontology, who will inform participants about Community Hospice and its services for patient care and family needs.

Ms. Paschke is an expert in the non-medical aspects of aging and has led bereavement support groups for those who find themselves alone. Participants will also learn about palliative care and what that means for patients and their loved ones.

This FREE program is brought to the community by the Education Committee of the Friends of the Fernandina Beach Library. It will be held in the Fernandina Beach Library’s Meeting Room at 24 North 4th Street, on Tuesday, January 17 at 10:30 a.m. Registration is not required.

For further information regarding this event, on joining Friends of the Library or to donate, please visit the Friends of the Library website at www.fernandinaFOL.org.

Tai Chi and Your Health

You may have seen the flowing postures and gentle movements of tai chi and wondered what it’s all about. Tai chi is an ancient mind and body practice. While more research is needed, studies suggest that it may have many health benefits.

Tai chi is sometimes referred to as “moving meditation.” There are many types of tai chi. They typically combine slow movements with breathing patterns and mental focus and relaxation. Movements may be done while walking, standing, or sitting.

“At its root, tai chi is about treating the whole person and enhancing the balance and crosstalk between the body’s systems,” says Dr. Peter Wayne, a longtime tai chi researcher at Harvard Medical School. “It’s a promising intervention for preserving and improving many areas of health, especially in older adults.”

Several studies have found evidence that tai chi can increase balance and stability in older people and reduce the risk and fear of falls. Each year, more than 1 in 4 older adults falls, and 1 out of 5 of these falls causes a serious injury such as broken bones or a head injury.

“Trying to be careful can make you more prone to falls,” Wayne says. “Tai chi may help you move more confidently and safely again.” Some NIH-funded research suggests that tai chi may also improve balance and prevent falls in people with mild-to-moderate Parkinson’s disease.

Research suggests that practicing tai chi might help improve posture and confidence, how you think and manage emotions, and your quality of life. Studies have found that it may help people with fibromyalgia sleep better and cope with pain, fatigue, and depression. Regular practice may also improve quality of life and mood in people with chronic heart failure or cancer. Older adults may find that tai chi can help improve sleep quality and protect learning, memory, and other mental functions.

Further study will be needed to fully evaluate and confirm the potential benefits of tai chi. But since the practice involves moving slowly and mindfully, there’s little chance of harm when done correctly.

“Whether you’re interested in trying tai chi to help with a chronic health issue or the stresses of everyday life, tai chi—if taught properly—can be a great complement to other ways of healthy living and rehabilitation,” Wayne says. “I think we’re all looking for tools to help us live productive, long lives with a little more grace and ease.”

There are different styles and ways to practice tai chi, Wayne says. If you’re interested in trying it, you can start simply. For instance, try standing behind and holding onto a sturdy chair for support, then mindfully rock back and forth to build awareness of all the parts of your body and their connections. Eventually, you might move on to practice more complex movements or sequences.

Want to learn more? Read the Wise Choices box to consider whether tai chi might be right for you. And watch NIH’s online tai chi videos at nccih.nih.gov/video/taichidvd-full.

This article is brought to you by NIH Office of Communications and Public Liaison
Editor: Harrison Wein, Ph.D., Managing Editor: Vicki Contie, Contributors: Vicki Contie, Alan Defibaugh (illustrations), Tianna Hicklin, Anita Ramanathan, and Bonnie Tabasko.

The Benefits of Daily Cleaning Between Teeth

You may have seen or heard news stories suggesting that you can forget about flossing, since scientists lack solid evidence that you’ll benefit from cleaning between your teeth with a sturdy string. But many dentists may beg to differ. They’ve seen the teeth and gums of people who floss regularly and those who haven’t. The differences can be striking.

“Every dentist in the country can look in someone’s mouth and tell whether or not they floss,” says Dr. Tim Iafolla, a dental health expert at NIH. Red or swollen gums that bleed easily can be a clear sign that flossing and better dental habits are needed. “Cleaning all sides of your teeth, including between your teeth where the toothbrush can’t reach, is a good thing,” Iafolla says.

If dentists, and maybe even your personal experience, suggest that regular flossing keeps your mouth healthy, then why the news reports? It’s because long-term, large-scale, carefully controlled studies of flossing have been somewhat limited.

Researchers have found modest benefits from flossing in small clinical studies. For instance, an analysis of 12 well-controlled studies found that flossing plus toothbrushing reduced mild gum disease, or gingivitis, significantly better than toothbrushing alone. These same studies reported that flossing plus brushing might reduce plaque after 1 or 3 months better than just brushing.

But there’s no solid evidence that flossing can prevent periodontitis, a severe form of gum disease that’s the leading cause of tooth loss in adults. Periodontitis can arise if mild gum disease is left untreated. Plaque may then spread below the gum line, leading to breakdown of bone and other tissues that support your teeth. Periodontitis develops slowly over months or years. Most flossing studies to date, however, have examined only relatively short time periods.

Another research challenge is that large, real-world studies of flossing must rely on people accurately reporting their dental cleaning habits. And people tend to report what they think is the “right” answer when it comes to their health behaviors, whether flossing, exercising, smoking, or eating. That’s why well-controlled studies (where researchers closely monitor flossing or perform the flossing) tend to show that flossing is effective. But real-world studies result in weaker evidence.

“The fact that there hasn’t been a huge population-based study of flossing doesn’t mean that flossing’s not effective,” Iafolla says. “It simply suggests that large studies are difficult and expensive to conduct when you’re monitoring health behaviors of any kind.”

While the scientific evidence for flossing benefits may be somewhat lacking, there’’s little evidence for any harm or side effects from flossing, and it’s low cost. So why not consider making it part of your daily routine?

Talk to your dentist if you have any questions or concerns about your teeth or gums. If flossing is difficult, the dentist may recommend other ways to remove plaque between teeth, such as with a water flosser or interdental cleaners. “If you need help learning how to floss, or if you don’t think you’re doing it right, your dentist or hygienist will be happy to show you how,” Iafolla says. “It helps to know the proper technique.”

Article by NIH Office of Communications and Public Liaison
Editor: Harrison Wein, Ph.D.
Managing Editor: Vicki Contie
Contributors: Erin Calhoun, Vicki Contie, Alan Defibaugh (illustrations), Bonnie Tabasko, and Carol Torgan.

Make Smart Choices as You Celebrate the Season

Mashed potatoes and gravy, Grandma’s apple pie, and other holiday favorites can be a joyous part of any celebration. But to feel your best, you know you need to eat in moderation and stay active. How can you avoid temptation when delicious foods and calories abound?

“From Halloween through New Year’s, there’s always a decision to make about food,” says Dr. Marci Gluck, an NIH psychologist who studies obesity and eating behaviors. Tasty treats tend to appear more often at work and festive gatherings, and to come as gifts. They may also tempt you when grocery shopping. “As the holidays approach, it’s important to think ahead and make a plan,” Gluck says.

Consider your health goals for the holiday season, whether it’s avoiding overeating, staying active, connecting with others, reducing stress, or preventing weight gain. You can plan to make time for buying healthy groceries, cooking at home, scheduling regular physical activity, and setting aside a little quiet time for yourself.

Gluck suggests you start by adopting a flexible mindset. “Many people have an attitude of all or nothing: either I’m on a diet or I’m not on a diet,” she says. This “either-or” thinking can lead to negative self-talk, or being hard on yourself for small indulgences, overeating, or weight gain.

“Most people just throw their plan out the window when they think they’ve slipped up, and they ‘fall off the wagon,'” Gluck says. “Celebrations don’t have to derail your lifestyle. You’ll have plenty of opportunities to follow your plan and eat healthy.”

Look for opportunities to make healthy choices and feel good about them. “Small choices really can make big changes,” Gluck says. “Each moment that you put something in your mouth or choose to exercise adds up over time. That can be true for weight loss or weight gain.”

Around the holidays, we often find ourselves with too many food options, for too many days in a row. It can be challenging to decide what to eat and when to say no.

“Eat what you love—in moderation,” suggests Jody Engel, a nutritionist and registered dietitian at NIH. Consider choosing items that are unique to the season, instead of eating foods you can have any time of the year.

When you feel the urge to splurge in unhealthy ways, Engel recommends trying something else first, like drinking a glass of water, eating a piece of fruit, or climbing a few flights of stairs. You might even consider walking around your house or office for 5 minutes or more. Such diversions might be enough to help you resist unhealthy temptations.

You could also try eating mindfully, Engel suggests. Slow down to really taste and enjoy your food. Eating more slowly also allows your body time to signal your brain when you’re full, which takes about 20 minutes. If you eat too much too quickly, it’s easy to gobble up as much as twice what your body needs before your brain even gets the message.

Dr. Susanne Votruba, an NIH obesity and nutrition researcher, says it’s a good idea to identify and avoid any “trigger foods”—foods that may spur you to binge or eat more than usual. Overeating can bring feelings of bloating, reflux, indigestion, and nausea.

“Some people can eat less healthy foods in moderation and be fine, or have ‘cheat days’ where they allow themselves to eat whatever they want for a day and stay on track for the rest of the week,” Votruba says. “Others may have to avoid certain ‘trigger foods’ completely, or they’ll spiral into unhealthy eating patterns for the rest of the week or abandon their plan altogether. Everyone is different.”

Because of these differences, Votruba says, it’s important not to force food on other people. “Even if you don’t have an issue with food, be aware of other people around you, and respect their choices,” she says.

What if you do fall to temptation? “Every day is a new day when it comes to eating,” Votruba says. “If you overeat one day, work to get back on track the next meal or next day.”

While food is a big part of the holidays, remember that there are other paths to staying healthy. “Don’t make the holidays be just about food,” Votruba suggests. “The key is not only what you eat, but how much you’re moving. Even little bits of extra exercise can be very helpful for everyone over the holidays.”

Plan ahead for how you’ll add physical activity to days that might otherwise involve a lot of sitting. Get the whole family involved, Engel suggests. “You have to make an effort to incorporate exercise into days of big eating,” she says. “Otherwise the day will come and go.”

Sign up to walk or run a community race. Enjoy catching up with family or friends on a walk or jog instead of on the couch. In between meals, take a family hike at a nearby park, stroll around your neighborhood, or play a game of flag football.

The emotions of winter celebrations come into this picture, too. “Joy, sadness, and stress are associated with overeating during the holidays,” Gluck says. “People who are emotional eaters may be particularly vulnerable to temptations around the holidays.”

If holiday stress causes you to derail your healthy plans, consider ways to reduce stress and manage emotions. These might include talking to a trusted friend, meditation, physical activity, or just getting outside.

“If you know you have a difficult time during holidays, plan outings once or twice a week with people who make you feel happy,” says Gluck. “If it’s in your best interest, also feel okay about declining invitations without feeling guilty.”

Support your family and friends, too. Encourage them to eat healthy during celebrations and throughout the year. If you’re serving dinner, consider baking, broiling, or grilling food instead of frying. Replace sour cream with Greek yogurt, and mashed potatoes with mashed cauliflower. Make take-home containers available ahead of time, so guests don’t feel they have to eat everything in one sitting.

Article by NIH Office of Communications and Public Liaison
Editor: Harrison Wein, Ph.D.
Managing Editor: Vicki Contie
Contributors: Erin Calhoun, Vicki Contie, Alan Defibaugh (illustrations), Bonnie Tabasko, and Carol Torgan

Identifying Learning Problems

Identifying Learning ProblemsReading, writing, and math are the building blocks of learning. Mastering these subjects early on can affect many areas of life, including school, work, and even overall health. It’s normal to make mistakes and even struggle a little when learning new things. But repeated, long-lasting problems may be a sign of a learning disability.

Learning disabilities aren’t related to how smart a child is. They’re caused by differences in the brain that are present from birth, or shortly after. These differences affect how the brain handles information and can create issues with reading, writing, and math.

“Typically, in the first few years of elementary school, some children, in spite of adequate instruction, have a hard time and can’t master the skills of reading and writing as efficiently as their peers,” says Dr. Benedetto Vitiello, a child mental health expert at NIH. “So the issue is usually brought up as a learning problem.”

In general, the earlier a learning disability is recognized and addressed, the greater the likelihood for success in school and later in life. “Initial screening and then ongoing monitoring of children’s performance is important for being able to tell quickly when they start to struggle,” explains Dr. Brett Miller, a reading and writing disabilities expert at NIH. “If you’re not actively looking for it, you can miss opportunities to intervene early.”

Each learning disability has its own signs. A child with a reading disability may be a poor speller or have trouble reading quickly or recognizing common words. A child with a writing disability may write very slowly, have poor handwriting, or have trouble expressing ideas in writing and organizing text. A math disability can make it hard for a child to understand basic math concepts (like multiplication), make change in cash transactions, or do math-related word problems.

Learning difficulties can affect more than school performance. If not addressed, they can also affect health. A learning disability can make it hard to understand written health information, follow a doctor’s directions, or take the proper amount of medication at the right times. Learning disabilities can also lead to a poor understanding of the benefits of healthy behaviors, such as exercise, and of health risks, such as obesity. This lack of knowledge can result in unhealthy behaviors and increased chances for disease.

Not all struggling learners have a disability. Many factors affect a person’s ability to learn. Some students may learn more slowly or need more practice than their classmates. Poor vision or hearing can cause a child to miss what’s being taught. Poor nutrition or exposure to toxins early in life can also contribute to learning difficulties.

If a child is struggling in school, parents or teachers can request an evaluation for a learning disability. The U.S. Individuals with Disabilities Education Improvement Act requires that public schools provide free special education support to children, including children with specific learning disabilities, who need such services. To qualify for these services, a child must be evaluated by the school and meet specific federal and state requirements. An evaluation may include a medical exam, a discussion of family history, and intellectual and school performance testing.

Many people with learning disabilities can develop strategies to cope with their disorder. A teacher or other learning specialist can help kids learn skills that build on their strengths to counter-balance their weaknesses. Educators may provide special teaching methods, make changes to the classroom, or use technologies that can assist a child’s learning needs.

A child with a learning disability may also struggle with low self-esteem, lack of confidence, and frustration. In the case of a math learning disability, math anxiety may play a role in worsening math abilities. A counselor can help children use coping skills and build healthy attitudes about their ability to learn.

“If appropriate interventions are provided, many of these challenges can be minimized,” explains Dr. Kathy Mann Koepke, a math learning disability expert at NIH. “Parents and teachers should be aware that their own words and behavior around learning and doing math are implicitly learned by the young people around them and may lessen or worsen math anxiety.”

“We often talk about these conditions in isolation, but some people have more than one challenge,” Miller says. Sometimes children with learning disabilities have another learning disorder or other condition, such as attention deficit hyperactivity disorder (ADHD).

“ADHD can be confused with a learning problem,” Vitiello says. ADHD makes it difficult for a child to pay attention, stay focused, organize information, and finish tasks. This can interfere with schoolwork, home life, and friendships. But ADHD is not considered a learning disability. It requires its own treatments, which may include behavior therapy and medications.

“Parents play an important role in treatment, especially for children in elementary school,” Vitiello says. Medications and behavioral interventions are often delivered at home. Teachers can usually advise parents on how to help kids at home, such as by scheduling appropriate amounts of time for learning-related activities. Parents can also help by minimizing distractions and encouraging kids to stay on task, such as when doing homework. Effective intervention requires consistency and a partnership between school and home.

Many complex factors can contribute to development of learning disabilities. Learning disorders tend to run in families. Home, family, and daily life also have a strong effect on a child’s ability to learn starting from a very early age. Parents can help their children develop skills and build knowledge during the first few years of life that will support later learning.

“Early exposure to a rich environment is important for brain development,” Mann Koepke says. Engage your child in different learning activities from the start. Before they’re even speaking, kids are learning. “Even if it’s just listening and watching as you talk about what you’re doing in your daily tasks,” she says.

Point out and talk with children about the names, colors, shapes, sizes, and numbers of objects in their environment. Try to use comparison words like “more than” or “less than.” This will help teach your child about the relationships between things, which is important for learning math concepts, says Mann Koepke. Even basic things, like getting enough sleep and eating a healthy diet, can help children’s brain development and their ability to learn.

NIH is continuing to invest in research centers that study learning challenges and their treatments, with a special focus on understudied and high-risk groups.

Although there are no “cures,” early interventions offer essential learning tools and strategies to help lessen the effects of learning disabilities. With support from caregivers, educators, and health providers, people with learning disabilities can be successful at school, work, and in their personal lives.

Article by NIH News in Health, Office of Communications and Public Liaison
Editor: Harrison Wein, Ph.D.
Contributors: Vicki Contie, Alan Defibaugh (illustrations) and Tianna Hicklin.

Try Muscle Release Oil for a Natural Frozen Shoulder Remedy

The frozen shoulder condition is characterized by pain and stiffness. Shoulder movements are minimized and may be completely still, hence the term ‘frozen’. Frozen shoulder is generally caused by scar tissue forming within the capsule of the shoulder. Without proper treatment, symptoms may last for years.

Symptoms and Phases
Natural treatment solutions such as muscle release oil help to ease pain and make it easier for you to move your shoulder. The main symptoms of the condition are stiffness, pain and restricted mobility within either of your shoulders.

• The first phase of frozen shoulder typically features pain that may last for a couple or more months. Stiffness and limited movement begin gradually and the pain is usually more severe during the night. Pain may also worsen when you place pressure on the affected side.
• The second phase lasts for a varying number of months. Pain may ease but the stiffness and limited movement persist or worsen. All the shoulder movements may be adversely affected; especially the ability to rotate the arm in outwards motion. Since the shoulder muscles are not being used, they may begin to waste away.
• The third phase of the condition usually lasts for one or more years during which stiffness and pain gradually subside. At this point movement will start to normalize.

The symptoms of frozen shoulder make it harder to carry out daily tasks such as dressing and driving. Even simple tasks such s reaching into your back pockets may be interfered with. Your ability to work may also be compromised. The severity of symptoms and the duration of the condition vary among different people.

Importance of Treatment
If the condition is no treated, symptoms may last for a much longer time before they start to subside. In some cases, lack of treatment causes the symptoms to remain for several years. Muscle release oil is a natural frozen shoulder remedy that many people use as a pain reliever.

A significant proportion of adults over 40 are affected by frozen shoulder. Each of the shoulders may be affected but the shoulder that is less frequently used is more vulnerable. In some cases the condition affects the other shoulder.

Muscle Release Oil
The aim of using muscle release oil is to reduce stiffness and pain. This helps to maximize the shoulder movement range while you wait to recover from the condition. Natural remedies are recommended for easing pain and preventing other symptoms.

Muscle release oil is specially formulated to control pain and reduce inflammation in the shoulder. It is always important to use the product appropriately for the best results. Muscle release oil relieves symptoms effectively and you can look forward to your shoulder becoming functional and improving with natural treatment.

Shoulder Exercises
Shoulder exercises prevent the shoulder from becoming stiff and enhance movement as much as possible. These types of exercises should be performed regularly and within your abilities. You can consult a specialist who will advise regarding the most suitable exercises. Lack of movement prolongs the recovery process.

When will we see Warning Labels on Processed Meats?

When I was diagnosed with colon cancer less than a year ago, I thought it would be a good idea to immediately stop eating processed meats. As a kid who grew up on bologna sandwiches, Vienna sausages, and summer sausage, it was much easier to give up than I thought. A few years ago, we gave up fast foods, TV dinners, and most canned vegetables in an attempt to lose weight and eat healthy. When I began managing the local farmers market in September 2012, eating fresh, local and seasonal produce became second nature. Apparently, our changes in diet didn’t come soon enough for me.

Processed meat
In October 2015, the month after my diagnosis, the media reported that processed meat was classified as Group 1, carcinogenic to humans. Tobacco smoking and asbestos are also placed in this same class. Group 1 classification means there is sufficient and convincing evidence that the agent causes cancer.

So, why is there not a warning label on our lunch meat, hot dogs, canned meats, corned beef, and ham? Other meats are included, too, such as meats that have been transformed through processing ie: curing, salting, fermentation, smoking etc… they are all considered “processed meat”.

Red meat
Red meat is now classified as Group 2A – this means it is probably carcinogenic to humans. Health officials have long been telling the public to reduce their red meat consumption for a variety of health concerns, but now they suspect that red meat probably causes cancer, too?

If the World Health Organization says red meat probably causes cancer, and processed meats do cause cancer, I think there should be a warning label on these packages just like we see on cigarettes.

What if we just cook the Hell out of our meats, will that make it okay to eat? Nope – in fact, if you expose your meats to flame and high temperatures, it may even increase the risk – but the factual evidence leaves the experts with mixed opinions on that topic.

At the risk of repeating myself, please let me be perfectly clear, the World Health Organization says that epidemiological studies have shown eating processed meat causes colorectal cancer in humans. Period! Yet, they hesitate to make new recommendations regarding nutritional guidelines. The current recommendation is to moderate consumption of processed meats mostly to reduce the intake of fat and sodium, which are risk factors for obesity and cardiovascular disease. New guidelines aren’t expected until 2021!

Your risk of getting colorectal cancer increases with the amount of processed meats you consume. “An analysis of data from 10 studies estimated that every 50 gram portion of processed meat eaten daily increases the risk of colorectal cancer by about 18%.”

Well, how much is a serving compared to a 50 gram portion? A serving size of beef, considered to be 2 to 3 ounces of cooked, lean meat, by the American Heart Association, equals 75 grams, which is more than the 50 gram portion described above… not good news, huh?

In a January 2016 interview, Syndicated Columnist and Investigative Reporter Amy Goodman (host of Democracy Now!) reported, “Dr. Richard Wender, chief cancer control officer of the American Cancer Society, recently commented ‘The science on the link between cancer and diet is extensive. By omitting specific diet recommendations, such as eating less red and processed meat, these guidelines miss a critical and significant opportunity to reduce suffering and death from cancer.'”

Personally, I want anyone who reads this to know, I had colon cancer, and I remember very specifically saying, “I wouldn’t wish this on my worst enemy.” It was a horrible experience!

Some are even blaming the Obama administration for keeping this issue out of the spotlight. While many of the lobby donations to candidates have been to republicans, the highest presidential recipient, from meat processing and products donations, has been to Hillary Clinton.

Should you stop eating processed meats? Red meats? That is your decision, but I won’t wait for the government to publish new nutritional guidelines before I choose what to feed to my family.

Psoriasis

Psoriasis - Patches of Itchy, Sore SkinYou may have heard of psoriasis, but do you know what it is? Psoriasis is a long-term, or chronic, skin disorder that affects more than 6.7 million U.S. adults. Symptoms can vary, but it’s usually recognized by itchy or sore patches of thick, red skin with silvery scales. There’s currently no cure, but treatment often helps.

Psoriasis occurs when skin cells quickly rise to the surface of the skin and build up into thick patches, or plaques. Ordinarily, skin cells mature as they rise from their origins below the surface of the skin. In psoriasis, these cells pile up before they’ve had a chance to properly mature.

Psoriasis actually begins in the immune system, which normally protects the body against infection and disease. In psoriasis, the immune system becomes misdirected and overactive. This can cause redness and swelling (inflammation) and lead to the rapid buildup of skin cells.

Plaques are most often found on the elbows, knees, or scalp. But they can also affect the face, fingernails, toenails, soft tissues of the genitals, or any skin-covered region.

“Patients can have a lot of symptoms like itching, cracking, and bleeding that can disrupt their sleep and their social relationships,” says Dr. Joel Gelfand, a skin specialist (dermatologist) at the University of Pennsylvania. People with moderate to severe psoriasis may feel self-conscious or have a poor self-image, which can lead to depression or social isolation.

Some people with psoriasis also experience joint inflammation that produces arthritis-like pain. This condition is called psoriatic arthritis. Gelfand and other NIH-supported researchers have found that psoriasis, especially severe psoriasis, is linked to certain other disorders as well, such as heart conditions, obesity, high blood pressure, and diabetes.

Psoriasis can occur at any age, but it typically first appears in young adulthood. Many people with psoriasis have a family history of the disorder. Researchers have been able to identify certain genes linked to the disease, but they still don’t fully understand the disease process. They do know that it isn’t contagious. You can’t “catch” psoriasis by touching someone who has it.

Psoriasis can be hard to diagnose, because it can look like other skin diseases. Your doctor might need to look at a small skin sample under a microscope. It’s often best to make an appointment with a primary care doctor or a dermatologist to get an accurate diagnosis.

There are many approaches for treating psoriasis. Safe and proven treatment options include creams, light therapy, and medications given as pills or a shot.

“Treatment decisions in psoriasis need to be highly individualized and tailored toward the patient’s clinical condition and underlying health status, as well as their preferences and goals,” Gelfand says. Be sure to ask your doctor about the best treatment options for you.

Psoriasis symptoms may briefly worsen, or flare. These flares can arise when people are stressed or experience a traumatic event like the death of a family member or friend. Smoking, heavy alcohol use, and being overweight can also aggravate psoriasis.

Gelfand and other NIH-funded researchers have been working to develop better therapies. “It’s a great time to be hopeful and optimistic about this disease,” Gelfand says. “Most of the therapies coming out now seem to be well-tolerated and have impressive effectiveness.”

Article by NIH Office of Communications and Public Liaison
Editor: Harrison Wein, Ph.D.
Managing Editor: Vicki Contie
Contributors: Vicki Contie, Alan Defibaugh (illustrations), Claire Donnelly, and Tianna Hicklin.

Your Sense of Smell and Your Health

Your Sense of Smell and Your HealthYour sense of smell enriches your experience of the world around you. Different scents can change your mood, transport you back to a distant memory, and may even help you bond with loved ones. Your ability to smell also plays a key role in your health. If your ability to smell declines, it can affect your diet and nutrition, physical well-being, and everyday safety.

Whether coffee brewing, pine trees in a forest, or smoke from a fire, the things we smell are actually tiny molecules released by substances all around us. When we breathe in these molecules, they stimulate specialized sensory cells high inside the nose. Each of these sensory cells has only one type of odor receptor—a structure on the cell that selectively latches onto a specific type of “smelly” molecule. There are more smells in the environment than there are odor receptors. But a given molecule can stimulate a combination of these receptors, creating a unique representation in the brain of a particular smell.

“It’s estimated that the number of odors that people can detect is somewhere between 10,000 and 100 billion, or even more,” says Dr. Gary Beauchamp, a taste and smell researcher at Monell Chemical Senses Center in Philadelphia. We all have different combinations of odor-detecting cells in our noses, he explains, so people vary greatly in their sensitivity to smells. “In fact, when you or I smell the same physical thing, our perceptions may be very different,” Beauchamp says.

Because smell information is sent to different parts of the brain, odors can influence many aspects of our lives, such as memory, mood, and emotion. For thousands of years, fragrant plants have been used in healing practices across many cultures, including ancient China, India, and Egypt. Aromatherapy, for example, aims to use essential oils from flowers, herbs, or trees to improve physical and emotional well-being.

To date, there’s little scientific evidence supporting aromatherapy’s effectiveness for most health issues. Yet memories of smell can be vivid and long lasting, which may have a positive effect.

“Lavender is a good example, which is touted as a relaxation odor,” Beauchamp says. “But the question is: Is that a relaxation odor because we’ve had past experience with this particular odor where we’ve been relaxed, and so we’ve learned the association?” Scientists continue to examine how different types of aromatherapies might affect our health and well-being.

Smell is also important for your perception of taste. Chewing your food releases aromas that travel from your mouth and throat to the nose. Without smell, we can detect only 5 basic tastes: sweet, salty, bitter, sour, and umami (savory). But our brains incorporate information from both taste and smell receptors to create the perception of many different flavors.

Some people may think they’ve lost their sense of taste if food begins to taste bland or slightly “off.” But in fact, they may have lost their ability to smell.

Many things can cause smell loss. A stuffy nose, or a harmless growth in the nose (called a polyp) can block air and thus odors from reaching the sensory cells. Certain medications, like some antibiotics or blood pressure pills, can alter smell. These effects are usually temporary. Your smell should come back once you’ve recovered or stopped the treatments.

But some things can cause a long-lasting loss of smell. A head injury or virus, for example, can sometimes damage the nerves related to smell. And your ability to smell may naturally fade as you get older.

“A good sized majority of people don’t know they have a problem with their sense of smell,” says Howard Hoffman, a public health expert at NIH. A national health and nutrition survey recently revealed that 12% of adults have a smell dysfunction. The problem increases with age, with 39% of those ages 80 and older showing a deficit.

“Quality of life issues from smell loss affect people differently depending upon their situation,” Hoffman says. “The effects can be enormous.” Food can become less enjoyable. You may lose interest in eating or change your eating habits, consuming a less healthy diet.

People who’ve lost their sense of smell sometimes try to boost flavor by adding more salt or sugar to their foods. But these additions might cause problems for those at risk for certain medical conditions, such as high blood pressure, kidney disease, or diabetes. Talk with your doctor if you think a smell deficit might be affecting your quality of life.

Smell loss can also put you in harm’s way if you don’t notice a “warning” smell. The recent national health and nutrition survey found that 1 in 10 people couldn’t identify the smell of smoke, and about 15% couldn’t identify the smell of natural gas. “As people get older, those rates go up,” Hoffman says. For those ages 70 and older, 20% couldn’t identify the smell of smoke, and 31% couldn’t recognize gas odor.

“With age, there is a decline in the ability to smell to some extent in the nose, but much more in the brain itself,” says Dr. Davangere Devanand at Columbia University, an expert on neurodegenerative diseases and smell loss. “The main reason appears to be that the functioning of the brain regions involved in smell and memory become impaired as we grow older.”

But problems with your ability to smell may be more than normal aging. They can sometimes be an early sign of serious health conditions, such as Parkinson’s disease, Alzheimer’s disease, or multiple sclerosis. Devanand’s group is currently studying the relationships between smell dysfunction and Alzheimer’s disease.

If your food doesn’t smell or taste the way you think it should, talk to your doctor. Health care providers can give you a “scratch and sniff” smell identification test to help assess the kind of smell disorder you might have. This test alone can’t diagnose more serious health problems, but it can be informative when used alongside other tests.

Smell may be the most mysterious of our 5 senses, Beauchamp says. “We know quite a bit about smell loss and can diagnose this fairly well. But, for the most part, we have no treatments that are reliable and widely accepted” for long-lasting cases of smell loss. Some studies suggest that smell training may help you improve your ability to discriminate and identify odors. It may stimulate growth of new receptors or improve your brain’s ability to interpret low levels of odors, Beauchamp explains. But researchers are still learning how and whether this works.

Like all of your senses, your sense of smell plays an important part in your life. If you think you’re experiencing a loss of taste or smell, see your health care provider. There may be ways to help fix the problem. If not, your doctor can help you learn to cope with the changes in smell and taste.

If you’ve lost your ability to smell, it’s important to find other ways to detect:
-Smoke. Check your smoke detectors once a year to make sure they work.
-Gas leaks. Make sure you have a gas detector in your home.
-Spoiled food. Throw out food that’s been in the refrigerator too long and practice other basic food safety. Learn more at www.foodsafety.gov.
-Household chemicals. Make sure there’s fresh air where you live and work.

Article by NIH Office of Communications and Public Liaison
Editor: Harrison Wein, Ph.D.
Managing Editor: Vicki Contie
Contributors: Vicki Contie, Alan Defibaugh (illustrations), Claire Donnelly, and Tianna Hicklin.

Arthritis Mechanisms May Vary by Joint

Press release – Molecular differences between knee and hip joints with rheumatoid arthritis may inform more personal treatment strategies. Sebastian Kaulitzki/Hemera/Thinkstock

Knee and hip joints with rheumatoid arthritis have differing genetic markers linked to inflammation, suggesting that different joints may have varying disease mechanisms. These new findings may lead to more effective, personalized therapies for rheumatoid arthritis.

People with rheumatoid arthritis have swelling and pain in joints throughout the body. These problems arise when the immune system, which protects the body from germs and infections, mistakenly attacks the joints. For unknown reasons, different joints are affected differently in people with rheumatoid arthritis.

An NIH-funded research team previously found that certain cells in joints have unique patterns of chemical tags—called epigenetic markers—that differ between rheumatoid arthritis and osteoarthritis. Such tags can affect when genes turn on or off and can regulate immune function.

In the new study, the scientists examined epigenetic patterns in joint cells from 30 people with rheumatoid arthritis and 16 with osteoarthritis. Rheumatoid arthritis and osteoarthritis cells had differing patterns of epigenetic tags as expected. But unexpectedly, in patients with rheumatoid arthritis, the patterns in knee joint cells differed from cells in hip joints.

The scientists next assessed the affected biological pathways that distinguish different joints. Knee and hip joints with rheumatoid arthritis had differing activated genes and biological pathways. Many of these pathways were related to immune system function.

The team also found that new drugs for treating rheumatoid arthritis may affect some of these pathways. Their findings might offer an opportunity for developing more precise approaches to treating different arthritic joints.

“We showed that the epigenetic marks vary from joint to joint in rheumatoid arthritis,” says study coauthor Dr. Gary S. Firestein of the University of California, San Diego. “This might provide an explanation as to why some joints improve while others do not, even though they are exposed to the same drug.”

Article contributed by NIH Office of Communications and Public Liaison
Editor: Harrison Wein, Ph.D.
Managing Editor: Vicki Contie
Contributors: Vicki Contie, Alan Defibaugh (illustrations), Claire Donnelly, and Tianna Hicklin.