Studies have linked short and poor sleep to many modern maladies: diabetes, heart disease, high blood pressure, inflammation, stroke.

Short sleep may be a factor in the obesity epidemic: sleep lab studies have shown that it alters the activity of leptin, the “fullness” hormone, and ghrelin, the “appetite” hormone.

Meanwhile, scientists are beginning to understand the sleeping brain and the role it plays in our mental lives and health. One popular theory is that we need sleep to store, and possibly attach meaning to, our memories. So if you make sleep a priority, you might improve your memory and your health.

Scientists from Unilever, the European purveyor of foods, beverages and personal products, used data from the US’ first National Health and Nutrition Examination Survey (NHANES I) to examine the relationship between food-based nutrients and skin-aging appearance. NHANES I gathered a huge amount of dietary and lifestyle information between 1971 and 1974-including bodily measurements, supplement intake, diet, physical activity and other habits-on more than 30,000 Americans. For their study, published in the American Journal of Clinical Nutrition, Unilever researchers examined NHANES I data on a total of 4,025 women, ages 40-74.

The researchers focused on dietary intake of nutrients-rather than nutritional supplements-saying that multi-ingredient supplements can make it difficult to determine which nutrient is having an effect. Furthermore, they noted, supplement studies often concentrate on short-term courses of nutrients, and in high dosages. The team claimed that this study is the first skin-aging research to concentrate on daily nutrient intake, rather than supplements.

“Skin aging appearance” was defined as having a wrinkled appearance, senile dryness (dryness as a result of aging) and skin atrophy (skin thinning). Dermatologists conducted clinical examinations of the skin to gauge women’s skin aging appearance.

Women who reported lower intakes of vitamin C in their diets were found to have the highest incidences of wrinkled appearance and senile dryness.

“Vitamin C is an antioxidant that has been shown to play a role in the synthesis of collagen, the protein that helps keep skin elastic,” said lead researcher Maeve C. Cosgrove, PhD. “Our findings add evidence to a predominately supplement and topical application-based hypothesis that what we eat affects our skin-aging appearance.”

Dietary intake of linoleic acid-an omega-6 fatty acid found in abundance in nuts, whole grains, most vegetable oils, eggs and poultry-also proved to be associated with more youthful skin.

On the other hand, higher intakes of fat and carbohydrates had the opposite association: A 17-gram increase in fat and a 50-gram increase in carbohydrate intakes increased the likelihood of a wrinkled appearance and skin atrophy.

The bottom line is good news if you’re already watching what you eat-you may be keeping your skin younger-looking at the same time. As Cosgrove and colleagues put it, “Promoting healthy dietary behaviors may have additional benefit for skin appearance in addition to other health outcomes in the population.”

“Our findings provide one potential alternative mechanism for a putative protective effect of vitamin K in the progression of cardiovascular disease and osteoporosis, since both diseases are characterized by inflammation,” noted lead author KyIa Shea, PhD, of the Vitamin K Laboratory at Tufts’ Jean Mayer Human Nutrition Research Center on Aging (HNRCA). Chronic inflammation, where the body’s natural protective mechanisms over-react or go out of control, has been associated with a range of conditions that also include arthritis, type-2 diabetes, Alzheimer’s disease and cognitive decline.

Previous research led by Sarah Booth, PhD, director of the Vitamin K Laboratory, has connected higher blood levels of phylloquinone with lower risk of osteoarthritis in the hand and knee and high dietary intake with reduced heart-dis ease risk in women.

The latest research relied on data from 1,381 participants in the Framingham Offspring Study, who averaged 59 years old. The Tufts scientists measured blood levels of vitamin K1 as well as dietary intake, and related these to 14 different biological markers (biomarkers) of inflammation.

The study also looked for relationships between vitamin D status and inflammation. While some links were found, overall the results on vitamin D were inconsistent.

The mechanism by which vitamin K1 might combat inflammation isn’t known, the researchers said, adding that further research was warranted. Vitamin K1 is a marker for a healthy diet, so this study may also indicate that other compounds also found in a healthy diet may be the factors that reduce inflammation.

Are you getting enough vitamin K to benefit from its anti-inflammatory powers?

Probably not. In a recent review of studies on vitamin K status among the elderly, Booth reported that although older adults seem to consume more vitamin K than younger adults, many seniors still aren’t getting the recommended daily amount. Vitamin K is found in leafy greens such as spinach and lettuce as well as in kale, cabbage, cauliflower, broccoli, Brussels sprouts, cereals, milk and soybeans. The recommended daily amount is 90 micrograms for adult females and 120 micrograms for adult males.

The study, published in the British Journal of Nutrition, focused on 21 healthy volunteers with normal cholesterol readings. They consumed a totally tomato-free diet for the first three weeks, then a three-week “high-tomato” diet that included 30 milligrams of ketchup and 400 milliliters of tomato juice daily. That’s about two tablespoons of ketchip and one and two-third cups of tomato juice.

The subjects’ cholesterol levels were then re-measured and found to have dropped significantly; total cholesterol levels fell nearly 6% on average. Even more encouraging, though, was the drop in LDL cholesterol levels, which decreased nearly 13%.

Further evaluation of the subjects’ blood samples revealed synergistic benefits from their elevated levels of lycopene, betacarotene and gamma-carotene. Marja-Leena Silaste, MSc, from the University of Oulu, and colleagues noted that the subjects’ circulating LDL cholesterol resisted forming oxidized phospholipids, a marker for oxidative stress.

High cholesterol levels have long been associated with a variety of diseases, notably cardiovascular disease, the leading cause of death in the US.

Tomatoes provide the nutrients betacarotene, vitamins C and E, and lycopene, the antioxidant that gives tomatoes their characteristic red color. The FDA has approved a qualified health claim for tomatoes in reducing the risk of prostate, gastric, ovarian and pancreatic cancers.

Although high intake of tomatoes and tomato products had previously also been associated with a reduced risk of cardiovascular disease, scientists didn’t understand why. The new research suggests a possible mechanism, with the tomatoes affecting the body’s cholesterol levels.

The researchers studied 101,765 men and women patients at Kaiser Permanente who’d had checkups between 1965 and 1970. The patients were then followed for an average of 12 years. The subjects were divided into four groups, or quartiles, based on SAD, and their heart-disease rates adjusted for age, race, BMI, educational level, smoking, alcohol consumption and women’s use of hormone replacement therapy.

The findings, published in the American Journal of Epidemiology, showed that men with the biggest bellies-those in the upper quartile of sagittal abdominal diameterhad a 42% greater risk of developing coronary heart disease than those in the trimmest group. Among women, the quartile with the biggest SAD measurements was at 44% greater risk than the group with the smallest SAD scores.

The authors concluded, “Standing sagittal abdominal diameter was a strong predictor of coronary heart disease independently of BMI, and added incremental coronary heart disease prediction at each level of BMI” when used in conjunction with BMI.

Previous studies have similarly suggested that waist-to-hip ratio is a better predictor of heart risk than BMI

Inflammation is an essential part of the body’s healing system. Without it, injuries would fester and simple infections could be deadly. Too much of a good thing, though, is downright dangerous. Chronic low-grade inflammation is intimately involved in all stages of atherosclerosis, the process that leads to cholesterol-clogged arteries. This means that inflammation sets the stage for heart attacks, most strokes, peripheral artery disease, and even vascular dementia, a common cause of memory loss. Think of it as friendly fire — yourself attacking yourself.

Inflammation doesn’t happen on its own. It is the body’s response to a host of modern irritations that our Stone Age genes haven’t quite caught up to. The main ones are smoking, lack of exercise, high-fat and high-calorie meals, and highly processed foods.

Medical researchers and pharmaceutical companies are hot on the trail of inflammation-busting drugs. Don’t bother waiting — they are a long way off, are bound to be expensive, and will almost certainly have side effects. Instead, you can turn to simple tools that ease inflammation. We’ll focus on diet here, but don’t forget about avoiding cigarette smoke (yours or someone else’s), exercising, watching your weight, and taking care of your teeth.

What is inflammation?

Inflammation is an intricate dance involving different types of white blood cells, the antibodies they make, and a dizzying array of chemical messengers known as cytokines. Its aim is to defend the body against bacteria, viruses, and other foreign invaders, to remove debris, and to help repair damaged tissue. Inside arteries, inflammation helps kick off atherosclerosis and keeps the process smoldering. It even influences the formation of artery-blocking clots, the ultimate cause of heart attacks and many strokes.

Simple changes

What you eat may fan the fires of inflammation. With some small changes — no crazy new foods involved — you can douse them. Here are some suggestions:

Get an oil change. Eating a lot of saturated fats and/or trans fats is linked with higher levels of inflammation. Swap them for olive oil, which has potent anti-inflammatory properties, or polyunsaturated fats, especially omega-3 fats from fish.

Don’t be so refined. The bolus of blood sugar that accompanies a meal or snack of highly refined carbohydrates (white bread, white rice, French fries, sugar-laden soda, etc.) increases levels of inflammatory messengers called cytokines. Eating whole-grain bread, brown rice, and other whole grains smooths out the after-meal rise in blood sugar and insulin, and dampens cytokine production.

Promote produce. The more fruits and vegetables you eat, the lower the burden of inflammation. Why? They contain hundreds, perhaps thousands, of substances that squelch inflammation-rousing free radicals; some act as direct anti-inflammatory agents.

Go nuts. Adding walnuts, peanuts, almonds, and other nuts and seeds to your snacks and meals is another tasty way to ease inflammation.

Cocoa lovers rejoice? In laboratory studies, cocoa and dark chocolate slow the production of signaling molecules involved in inflammation. The trick is to get them without too much sugar and fat.

Alcohol in moderation. A drink a day seems to lower levels of C-reactive protein (CRP), a powerful signal of inflammation. Too much alcohol has the opposite effect on CRP.

Spice it up. Herbs and spices such as turmeric, ginger, garlic, basil, pepper, and many others have anti-inflammatory properties.

Putting it all together

If you are a do-it-yourselfer, pick and choose foods that ease inflammation and eat them instead of those that promote it. If you’d rather follow a plan, the so-called Mediterranean diet encompasses many inflammation-fighting foods. I love this diet!

If you adopt an anti-inflammatory diet, you probably won’t see or feel any different. Angina won’t suddenly disappear or heart failure reverse itself. But you will be doing your heart, arteries, and the rest of you a huge favor that will pay off in many ways.

All it takes is a simple misstep, and suddenly you have a sprained ankle. It’s one of the most common musculoskeletal injuries in people of all ages, athletes and couch potatoes alike. The injury occurs when one or more of the ligaments in the ankle are stretched or torn, causing pain, swelling, and difficulty walking. Many people try to tough out ankle injuries and don’t seek medical attention. But if a sprain causes more than slight pain and swelling, it’s important to see a clinician. Without proper treatment and rehabilitation, a severely injured ankle may not heal well and could lose its range of motion and stability, resulting in recurrent sprains and more downtime than you’d like.

Anatomy of an ankle sprain

The most common type of ankle sprain is an inversion injury, or lateral ankle sprain. The foot rolls inward, damaging the ligaments of the outer ankle — the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament. (Ligaments are bands of fibrous tissue that connect bone to bone; see illustration.)

Ankle ligaments

Less common are sprains affecting the ligaments of the inner ankle (medial ankle sprains) and syndesmotic sprains, which injure the tibiofibular ligaments — the ligaments that join the two leg bones (the tibia and the fibula) just above the ankle. Syndesmotic sprains, which occur most often in contact sports, are especially likely to cause chronic ankle instability and subsequent sprains.

The severity of an ankle sprain depends on how much damage it does and how unstable the joint becomes as a result. The more severe the sprain, the longer the recovery (see “Grades of ankle sprain severity”).

Grades of ankle sprain severity

Severity

Damage to ligaments

Symptoms

Recovery time

Grade 1

Minimal stretching, no tearing

Mild pain, swelling, and tenderness. Usually no bruising. No joint instability. No difficulty bearing weight.

1-3 weeks

Grade 2

Partial tear

Moderate pain, swelling, and tenderness. Possible bruising. Mild to moderate joint instability. Some loss of range of motion and function. Pain with weight bearing and walking.

3-6 weeks

Grade 3

Full tear or rupture

Severe pain, swelling, tenderness, and bruising. Considerable instability and loss of function and range of motion. Unable to bear weight or walk.

Several months

Source: Adapted from Maughan KL, “Ankle Sprain,” UpToDate, version 14.3, and Ivins D, “Acute Ankle Sprain: An Update,” American Family Physician (Nov. 15, 2006), Vol. 74, No. 10, pp. 1714-20.

Immediate treatment

The first goal is to decrease pain and swelling and protect the ligaments from further injury. This usually means adopting the classic RICE regimen — rest, ice, compression, and elevation. If you have severe pain and swelling, rest your ankle as much as possible for the first 24-48 hours. During that time, immerse your foot and ankle in cold water, or apply an ice pack (be sure to cover the ankle with a towel to protect the skin) for 15-20 minutes three to five times a day, or until the swelling starts to subside.

To reduce swelling, compress the ankle with an elasticized wrap, such as an ACE bandage or elastic ankle sleeve. When seated, elevate your ankle as high as you comfortably can — to the height of your hip, if possible. In the first 24 hours, avoid anything that might increase swelling, such as hot showers, hot packs, or heat rubs. Nonsteroidal anti-inflammatory drugs such as ibuprofen can help reduce pain and swelling and may also speed recovery.

There are several great Oriental medical remedies and nutrients you need to take in order to reduce the swelling and promote healing and enhance the tensil strength of the joint.

Medical evaluation

Contact your clinician as soon as possible. He or she may want to see you immediately if your pain and swelling are severe, or if the ankle feels numb or won’t bear weight. He or she will examine the ankle and foot and may manipulate them in various ways to determine the type of sprain and the extent of injury. This examination may be delayed for a few days until swelling and pain improve; in the meantime, continue with the RICE regimen.

X-rays aren’t routinely used to evaluate ankle injuries. Ligament problems are the source of most ankle pain, and ligaments don’t show up on regular x-rays. To screen for fracture, clinicians use a set of rules — called the Ottawa ankle rules, after the Canadian team that developed them — to identify areas of the foot where pain, tenderness, and inability to bear weight suggest a fracture. A review of studies involving more than 15,000 patients concluded that the Ottawa rules identified patients with ankle fractures more than 95% of the time.

Functional treatment

To recover fully, you’ll need to restore the normal range of motion to your ankle joint and strengthen its ligaments and supporting muscles. Studies have shown that people return to their normal activities sooner when their treatment emphasizes restoring ankle function — often with the aid of splints, braces, taping, or elastic bandages — rather than immobilization (such as use of a plaster cast). Called functional treatment, this strategy usually involves three phases: the RICE regimen in the first 24 hours to reduce pain, swelling, and risk of further injury; range-of-motion and strengthening exercises within 48-72 hours; and training to improve endurance and balance once recovery is well under way.

Generally, you can begin range-of-motion and stretching exercises within the first 48 hours, and should continue until you’re as free of pain as you were before your sprain. Start to exercise seated on a chair or on the floor. As your ankle improves, you can progress to standing exercises. If your symptoms aren’t better in two to four weeks, you may need to see a physical therapist or other specialist.

Exercises to help restore function and prevent injury

Range-of-motion, stretching, and strengthening: First 1-2 weeks

Flexes. Rest the heel of the injured foot on the floor. Pull your toes and foot toward your body as far as possible. Release. Then point them away from the body as far as possible. Release. Repeat as often as possible in the first week.

Ankle alphabet. With the heel on the floor, write all the capital letters of the alphabet with your big toe, making the letters as large as you can.

Press down, pull back. Loop an elasticized band or tubing around the foot, holding it gently taut (A). Press your toes away and down. Hold for a few seconds. Repeat 30 times. Tie one end of the band to a table or chair leg (B). Loop the other end around your foot. Slowly pull the foot toward you. Hold for a few seconds. Repeat 30 times.

Ankle eversion. Seated on the floor, with an elasticized band or tubing tied around the injured foot and anchored around your uninjured foot, slowly turn the injured foot outward. Repeat 30 times.

Ankle inversion. Seated on the floor, cross your legs with your injured foot underneath. With an elasticized band or tubing around the injured foot and anchored around your uninjured foot, slowly turn the injured foot inward. Repeat 30 times.

Stretching and strengthening: Weeks 3-4

Standing stretch. Stand one arm’s length from the wall. Place the injured foot behind the other foot, toes facing forward. Keep your heels down and the back knee straight. Slowly bend the front knee until you feel the calf stretch in the back leg. Hold for 15-20 seconds. Repeat 3-5 times.

Seated stretch. Loop an elasticized band or tubing around the ball of the foot. Keeping the knee straight, slowly pull back on the band until you feel the upper calf stretch. Hold for 15 seconds. Repeat 15-20 times.

Rises. Stand facing a wall with your hands on the wall for balance. Rise up on your toes. Hold for 1 second, then lower yourself slowly to the starting position. Repeat 20-30 times. As you become stronger, do this exercise keeping your weight on just the injured side as you lower yourself down.

Stretches. Stand with your toes and the ball of the affected foot on a book or the edge of a stair. Your heel should be off the ground. Use a wall, chair, or rail for balance. Hold your other foot off the ground behind you, with knee slightly bent. Slowly lower the heel. Hold the position for 1 second. Return to the starting position. Repeat up to 15 times, several times a day. This exercise can place a lot of stress on the ankle, so get your clinician’s go-ahead before trying it.