Beyond the usual suspects for healthy resolutions

Early in the new year, promises to reboot your health typically focus on diet, exercise, and weight loss. And by now you may have begun making changes — or at least plans — to reach those goals. But consider going beyond the big three.

Below are 10 often-overlooked, simple ideas to step up personal health and safety. And most won’t make you break a sweat.

Review your health portals

Your medical information is kept in electronic records. You have access to them through the patient portal associated with your doctor’s office. Set aside time to update portal passwords and peruse recent records of appointments, test results, and notes your doctor took during your visits.

“Many studies have shown that when patients review the notes, they remember far better what went on during interactions with their clinicians, take their medicines more effectively, and pick up on errors — whether it’s an appointment they forgot to make or something their doctor, nurse, or therapist got wrong in documenting an encounter,” says Dr. Tom Delbanco, the John F. Keane & Family Professor of Medicine at Harvard Medical School and cofounder of the OpenNotes initiative, which led shared clinician notes to become the new standard of care.

Doing this can help you become more engaged in your care. “We know from numerous studies that engaged patients who share decisions with those caring for them have better outcomes,” he adds.

Ask about health insurance freebies

Your insurance plan may offer perks that can lead to better health, such as:

• weight loss cessation programs
• quit-smoking programs
• free or reduced gym memberships.

Some insurers even offer breastfeeding counseling and equipment. Call your insurance company or take a close look at their website to find out if there’s anything that would help you.

Get rid of expired medications

Scour your cabinets for expired or unneeded drugs, which pose dangers for you and others. Look for prescription and over-the-counter medications (pills, potions, creams, lotions, droppers, or aerosol cans) as well as supplements (vitamins, minerals, herbs).

Bring your finds to a drug take-back site, such as a drugstore or law enforcement office, or a medical waste collection site such as the local landfill.

As a last resort, toss medications into the trash, but only after mixing them with unappealing substances (such as cat litter or used coffee grounds) and placing the mixture in a sealable plastic bag or container.

Invest in new sneakers

The wrong equipment can sabotage any exercise routine, and for many people the culprit is a worn pair of sneakers. Inspect yours for holes, flattened arch support, and worn treads. New sneakers could motivate you to jazz up your walking or running routine.

For example, if it’s in the budget, buy a new pair of walking shoes with a wide toe box, cushy insoles, good arch support, a sturdy heel counter (the part that goes around your heel), stretchy uppers, and the right length — at least half an inch longer than your longest toe.

Cue up a new health app

There are more than 350,000 health apps geared toward consumer health. They can help you with everything from managing your medications or chronic disease to providing instruction and prompts for improving diet, sleep, or exercise routines, enhancing mental health, easing stress, practicing mindfulness, and more.

Hunt for apps that are free or offer a free trial period for a test drive. Look for good reviews, strong privacy guardrails, apps that don’t collect too much information from you, and those that are popular — with hundreds of thousands or millions of downloads.

Make a schedule for health screenings and visits

Is it time for a colonoscopy, mammogram, hearing test, prostate check, or comprehensive eye exam? Has it been a while since you had a dermatologist examine the skin on your whole body? Should you have a cholesterol test or other blood work — and when is a bone density test helpful?

If you’re not sure, call your primary care provider or any specialists on your health team to get answers.

Four more simple healthy steps

The list of steps you can take this year to benefit your health can be as long as you’d like it to be. Jot down goals any time you think of them.

Here are four solid steps to start you off:

• Take some deep breaths each day. A few minutes of daily slow, deep breathing can help lower your blood pressure and ease stress.
• Get a new pair of sunglasses if your old ones have worn lenses. Make sure the new pair has UV protection (a special coating) to block the sun’s ultraviolet (UV) light, which can cause eye damage and lead to permanent vision loss.
• Make a few lunch dates or phone dates with friends you haven’t seen in a while. Being socially connected wards off loneliness and isolation, which can help lower certain health risks.
• Do a deep cleaning on one room in your home per week. Dust and mold can trigger allergies, asthma, and even illness.

You don’t have to do all of these activities at once. Just put them on your to-do list, along with the larger resolutions you’re working on. Now you’ll have a curated list of goals of varying sizes. The more goals you reach, the better you’ll feel. And that will make for a very healthy year, indeed.

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

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

Seeking fitspiration on social media?

Now that it’s 2024, perhaps you’ve thought about taking up a new exercise program, eating better, or some other ways to improve your health. That’s great! Or, as my grandfather would say, “there’s nothing wrong with that” — his highest possible praise.

In fact, few medical treatments rival the massive health benefits of regular exercise. But how do you decide which type of exercise is best for you? Well, you could get advice from your doctor or a personal trainer. You might read books on fitness or sample exercise classes. It turns out, though, that many people are simply scrolling through tons of engaging “fitspirational” posts on social media. If you do that regularly — more often, say, than taking a brisk walk — a new study suggests you should rethink that strategy.

What exactly is fitspiration?

Fitspiration describes social media posts intended to inspire physical fitness and promote health. You can find fitspirational posts on TikTok, Instagram, Facebook, and other popular social media sites. Typically, they feature glossy photos and videos packaged with exercise and diet recommendations, accompanied by encouraging messages and quotes.

On Instagram alone, a search for #fitspiration (or related hashtags such as #fitspo) currently lists nearly 100 million posts. Most of them display images of attractive, lean, and fit women as they exercise and talk about fitness and optimizing health.

What’s the problem with fitspiration?

The potential benefits of a pro-fitness message reaching millions of people are obvious. But the message has to be credible and valid. And, importantly, posts should not convey inaccurate, unhelpful, or even harmful information. That’s where the problems start.

Clearly, social media posts about fitness can have positive effects, according to some research, especially when focused on realistic exercise goals rather than appearance. However, fitspirational posts may have downsides for viewers, including

• increased body dissatisfaction
• negative mood
• decreased perception of attractiveness
• embracing thinness as the ideal
• a limited range of diverse body shapes and types, suggesting that beauty is defined by being ultra-fit and thin
• a focus on appearance rather than function and capability.

A study of #fitspiration: Do these social media posts actually inspire fitness?

A recent study assesses the quality of content with fitspiration hashtags posted by Instagram influencers. The results were disappointing, though not surprising.

The authors identified 100 Instagram accounts of the most popular fitspiration influencers. Each of these accounts’ last 15 posts was analyzed. Posts were not considered credible if they

• displayed nudity or revealing clothing, such as wearing a bikini at the gym
• sexualized the person exercising, such as focusing on a woman’s breasts
• included images of extreme body types, such as people who are severely underweight or extremely muscular
• conveyed messages encouraging thinness or other negative messages rather than emphasizing health
• contained fitness information in three or fewer posts out of 15.

Here’s what the researchers found:

• 26% portrayed sexualized images
• 22% posted nudity or images of people exercising in revealing clothing not appropriate for exercise
• 15% featured people with extreme body types
• 41% posted fitness-related content in three or fewer posts.

A quarter of these accounts failed the credibility test on more than one of these criteria. Even among the accounts considered credible, only half were posted by people with credentials related to fitness or health, such as certification as a physical therapist or personal trainer.

While this study did not examine whether the posts had an actual impact on fitness outcomes, the findings raise questions about the quality of fitspiration content.

What does this mean for you?

If you’re looking for fitness-related health content, seek out the best information you can. Be skeptical of any sources lacking credentials related to fitness. Be especially wary of posts selling a product or service.

The authors of this study established certain criteria for fitness-related content they reviewed. You could apply this to posts you see online.

The bottom line

It should be no surprise to find that when it comes to health information, social media may not always be the best place to start.

While taking steps to improve your health is commendable — truly, there’s nothing wrong with that! — getting motivated to be more physically active is just a start. Information you rely on to improve your physical fitness shouldn’t just look appealing. It should be well-vetted for safety and backed by solid evidence that it can actually improve your health.

Here’s to better fitness in the New Year!

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, 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

Dialectical behavior therapy: What is it and who can it help?

Feeling sad, anxious, or angry at times is a normal part of the human experience. But do you — or someone you’re close to — seem to experience these and similar emotions more quickly, more frequently, and more intensely than most people?

This problem, known as emotional dysregulation, is a hallmark of many mental health conditions, but especially borderline personality disorder. The most effective treatment for borderline personality disorder is dialectical behavior therapy (DBT), which has also been shown to help people experiencing other issues. What is DBT, who might benefit from this form of therapy, and how is it applied?

What is DBT?

DBT focuses on teaching people skills to manage intense emotions, cope with challenging situations, and improve their relationships. It encourages people to learn and use mindfulness training in practical ways.

During individual and group sessions, therapists encourage a nonjudgmental attitude and emphasize acceptance, compassion, and other aspects of mindfulness.

Who may benefit from DBT?

DBT has a proven track record for addressing the most debilitating symptoms of borderline personality disorder: self-injury and suicide threats or attempts. It is now also used to treat depression, post-traumatic stress disorder, eating disorders, and substance use disorders.

In fact, the cornerstone of DBT — the skills training — can help anyone navigate emotionally charged situations with more ease.

How can mindfulness change how people experience strong emotions?

Many people in therapy have very strong emotions that lead to negative thoughts, says Dr. Blaise Aguirre, a psychiatrist who founded the 3 East Dialectic Behavior Therapy Continuum at Harvard-affiliated McLean Hospital. “They say things like, ‘I’m stupid,’ or ‘I can’t control my anger,’ or ‘No one will ever love me,'” he says.

The mindfulness aspect of DBT teaches people to pay careful attention to the nature, quality, and volume of their thoughts. The idea is to observe these thoughts as separate from yourself without identifying with their meaning. This is the first step to addressing the impact of those thoughts, Dr. Aguirre explains.

How does DBT differ from cognitive behavioral therapy?

DBT is derived from cognitive behavioral therapy (CBT). CBT assumes that certain negative thoughts (cognitions) are distortions, and if you learn how to swap those distorted thoughts with more productive ones, you’ll be less depressed or anxious.

“But for someone with very deep emotions and convictions, telling them that their thoughts and feelings are somehow ‘wrong’ feels very invalidating,” says Dr. Aguirre. A DBT-trained therapist would instead acknowledge that the person’s thoughts make sense, given who they are and their experiences. This practice, known as validation, is a central tenet of DBT. It’s key to know that you can validate a person’s thoughts even if you don’t agree with them.

That concept touches on the core of DBT — the dialectical part. It refers to the idea that two opposite things can be true at the same time. Rather than viewing things in extremes of black and white, DBT encourages people to recognize there’s more than one way to view a situation and to try to “walk the middle path.” A classic DBT mantra is “I’m doing the best that I can in this moment, and I want to and can do better.”

What other skills does DBT rely on?

In addition to mindfulness, DBT teaches three other main skills:

• Distress tolerance is the ability to manage emotional distress in the moment, using techniques such as distraction.
• Emotion regulation involves recognizing, accepting, and managing intense emotions.
• Interpersonal effectiveness focuses on improving communication with other people to strengthen relationships and improve your self-esteem.

What does DBT entail?

Ideally, DBT includes one-on-one sessions with a therapist (who is also available between sessions for phone or text coaching). The one-on-one sessions are combined with weekly group sessions led by a therapist who teaches the specific, interconnected skills and gives homework that helps to reinforce the skills. Participants are encouraged to keep a daily diary to track their emotions, behaviors, reactions, and examples of how they’re practicing their skills.

DBT has been shown to be effective for people ranging from adolescents to older adults with a range of mental health conditions. It appears to be especially useful for adolescents, perhaps for the same reason that it’s easier to learn a language or how to play an instrument when you’re younger rather than older, says Dr. Aguirre.

Are there different options for gaining access to DBT?

Accessing the full DBT experience can be challenging for many people. The skills groups meet for one to two hours weekly for six to 12 months, which is in addition to weekly, hour-long sessions with an individual therapist. Individual therapy may cost as much as $250 to $300 per hour, and the groups are often around $100 per hour. Not all DBT providers accept insurance.

“We’re starting to recognize that the majority of people can improve just doing the skills groups and don’t need the full DBT,” says Dr. Aguirre.

But for teens who are suicidal or harming themselves, intensive DBT can help keep them out of the hospital and potentially save their lives. “If your child had cancer, you wouldn’t think twice about taking them in for chemotherapy infusions twice a week,” says Dr. Aguirre.

Another problem is that there aren’t many DBT-trained providers in less populated parts of the country. Online DBT therapy may be an option, although its effectiveness hasn’t been studied.

Is there one simple DBT tool I can try?

If a family member struggles with very strong emotions, Dr. Aguirre offers this mini-DBT lesson about validation. Situations that trigger intense emotions are often rooted in a perception of abandonment, neglect, or rejection, he says. For example, if a person believes that someone at work is avoiding them, or a romantic partner doesn’t show up on time, it can trigger a rapid rise in emotional distress.

Here’s what to avoid saying:

“You have to calm down.”

“You are making a big deal over nothing.”

“When I am upset, I make myself a nice cup of tea and that should help you, too.”

Here’s what you can say instead:

“You seem really upset. Do you want to talk about it, or do you want some time by yourself?’

“You seem very sad. I am around if you want to talk.”

“Is there anything that I can do to help?”

“These types of statements validate the person’s feelings and convey that you’re listening and open to helping, if that’s what they want,” says Dr. Aguirre.

About the Author

Julie Corliss, Executive Editor, Harvard Heart Letter

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She … See Full Bio View all posts by Julie Corliss

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD