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Shoveling snow may be a necessity if you live in a cold climate — and it’s good exercise. But you can also hurt yourself if you don’t do it properly.

The American Academy of Orthopaedic Surgeons offers these snow shoveling tips:
Consult your doctor before you start shoveling snow, as it strains the heart.
If you have a health problem or you don’t exercise often, consider hiring someone to shovel for you.
Wear several layers of lightweight clothing that repel water. Be sure to cover your head, and wear gloves, warm socks and sturdy boots.
Warm up your muscles before you start shoveling, drink plenty of fluids while you work, and take frequent breaks.
Make sure your hat and scarf don’t block your vision. Be wary of ice patches and uneven surfaces.
Push, rather than lift, the snow. If you do have to lift, make sure you use your legs to lift instead of your back.

Count staying slim as one of the apparent benefits of light-to-moderate alcohol consumption, at least for women.

New research found that women who drank the equivalent of one to two drinks a day were least likely to gain weight — 30 percent less likely, in fact, than teetotalers.

“Our study results showed that middle-age and older women who have normal body weight initially and consume light-to-moderate amounts of alcohol could maintain their drinking habits without gaining more weight, compared with similar women who did not drink any alcohol,” said study author Dr. Lu Wang, an epidemiologist with the division of preventive medicine at Brigham & Women’s Hospital in Boston.

The findings are published in the March 8 issue of Archives of Internal Medicine.

Previous evidence on the health benefits of alcohol have been mixed. Some research has found that men and, to a lesser extent, women who drink moderately over the long-term have a lower risk for heart disease.

But another study found that even moderate drinking might raise the risk for breast, liver and other cancers in women.

Wang and her colleagues followed 19,220 women, 39 years or older, for an average of 13 years. All participants started the study with a normal body-mass index.

Although, on average, the women all tended to gain weight as time progressed, abstainers gained the most. The amount of weight gained decreased as alcohol consumption went up, the study found.

The researchers said they were unable to draw conclusions about heavy drinkers because there were so few in the study and because these women also tended to smoke, indicating they had very different lifestyles from the other participants.

There could be any number of reasons for the findings, including different ways that women metabolize alcohol, compared with men.

Also, the researchers pointed out, women tend to substitute alcohol for other foods, whereas men tend to simply add alcohol to everything else they’re ingesting.

“The impact of alcohol consumption on body weight needs to be considered in the context of energy balance,” Wang explained. “Among women, those who regularly consume light-to-moderate alcohol usually have a lower energy intake from non-alcohol sources. On the other hand, alcohol intake tends to induce increased energy expenditure beyond energy contents of the consumed alcohol in women. Taken together, regular alcohol consumption in light-to-moderate amount may lead to a net energy loss among women.”

Marianne Grant, a registered dietitian and health educator at the Texas A&M Health Science Center’s Coastal Bend Health Education Center in Corpus Christi, said that “it’s possible that women who are of healthy weight are not as efficient in metabolizing alcohol.”

“But, as always, the message is to enjoy alcohol in moderation,” she warned. “Don’t go with this as a weight-loss method. The keystones of healthy nutrition still hold.”

SOURCES: Lu Wang, M.D., Ph.D., associate epidemiologist, division of preventive medicine, Brigham and Women’s Hospital, and instructor, medicine, Harvard Medical School, Boston; Marianne Grant, R.D., registered dietitian and health educator, Coastal Bend Health Education Center, Texas A&M Health Science Center, Corpus Christi, Texas; Archives of Internal Medicine.

Increasing consumption of sugary soft drinks contributed to 130,000 new cases of diabetes, 14,000 new cases of heart disease and 50,000 more life-years burdened with heart disease in the last decade, a new U.S. study finds.

“The finding suggests that any kind of policy that reduces consumption might have a dramatic health benefit,” said senior study author Dr. Kirsten Bibbins-Domingo, an associate professor of medicine at the University of California, San Francisco, who was to present the finding Friday during the American Heart Association’s Cardiovascular Disease Epidemiology and Prevention annual conference, in San Francisco.

The study used a computer simulation of heart disease that has been applied to other cardiovascular risk factors, such as obesity and dietary salt, Bibbins-Domingo explained. “We probably underestimated the incidence, because the rise is greatest among the young, and our model focuses on adults 35 and older,” she said.

One plausible explanation is that the increased incidence of cardiovascular problems is due to a rising incidence of diabetes, Bibbins-Domingo said, while an increase in obesity might also be responsible.

“Whatever the mechanism, large population studies do suggest an effect of drinking large lots of sweetened beverages,” she said. “No one argues that these drinks are not fine in moderation, but over the past decade their consumption has been on the rise, while consumption of other beverages has declined.”

A statement by Maureen Storey, senior vice president for science policy for the American Beverage Association, noted that the study had not yet been published in a scientific journal, and therefore had not undergone review by outside, qualified scientists.

“What we do know is that both heart disease and diabetes are complex conditions with no single cause and no single solution,” Storey said in the statement, which noted that consumption of sugar-sweetened beverages is not listed as a risk factor by the American Heart Association. “Rather, we need to continue to educate Americans about the importance of balancing the calories from the foods and beverages we eat and drink with regular physical activity.”

But the study does suggest that any kind of policy that reduces consumption might have a health benefit, Bibbins-Domingo noted. One such policy is a proposed tax on sugar-sweetened drinks, she noted. “The reason why there is a current debate about a tax is that scientific evidence in populations has consistently shown that more than one drink a day increases your risk,” she said.

The American Heart Association recommends limiting consumption of sugar-sweetened drinks such as soda pop, while “alternative choices are available,” said Dr. Robert H. Eckel, a professor of medicine at the University of Colorado and a past president of the association.

“Juice from fruit itself is nutrient-rich, and its nutritional value goes beyond the carbohydrate content,” Eckel said.

The recommended daily sugar intake amounts to just one can of sugar-sweetened soda a day for a man and slightly less for women, he said.

SOURCES: Kirsten Bibbins-Domingo, M.D., associate professor, medicine, University of California, San Francisco; Robert H. Eckel, professor, medicine, University of Colorado, Denver; presentation, American Heart Association’s Cardiovascular Disease Epidemiology and Prevention annual conference, San Francisco.

Medications can reduce the level of the AIDS virus in the blood to zero, but HIV doesn’t disappear and often roars back when patients stop taking their pills. Now, research is giving scientists new insight into how the virus manages to hide and avoid the killing powers of medicine.

In a new study, researchers report that the virus lurks in certain bone marrow cells and “reawakens” only under certain circumstances.

The research provides a new target for scientists, but it also presents new challenges because killing off bone marrow cells is a dicey proposition.

Overall, the findings provide “a better understanding of how HIV hides in the body” and could lead to better strategies to kill or control it, said study co-author Dr. Kathleen Collins, an associate professor of internal medicine at the University of Michigan.

Doctors have long known about the ability of HIV — the AIDS virus — to avoid being killed off completely by medications. Drugs may prevent the virus from infecting new cells, “but they don’t get rid of cells that contain the virus and have potential to make new viral particles,” Collins said.

This helps explain why HIV isn’t curable. The immune systems of patients may be able to control the virus for a time but later fall victim to a renewed attack and, ultimately, to AIDS.

“A patient cannot be cured of HIV until all sources of infection are eliminated,” said Jerome A. Zack, director of the UCLA Center for AIDS Research in Los Angeles.

But where does the virus hide when it’s not in the blood? Researchers have suspected that the bone marrow — which creates blood cells — could serve as the hiding place.

In the new study, published in the March 7 online edition of Nature Medicine, researchers examined bits of AIDS virus and cells from infected people in the laboratory.

The investigators found that the virus can infect certain kinds of bone marrow cells that are the parents (”progenitors”) of blood cells, Collins said.

So why not use a medication to kill all those parent cells, thereby perhaps ridding the body of HIV?

It sounds simple, but killing all of these blood-producing marrow cells would be lethal to humans, Collins said. However, “maybe we could find ways of targeting only the latently infected bone marrow cells,” she added.

Zack, the UCLA researcher, said the study findings are convincing, but “we as yet do not have easy ways to eliminate these dormant sources of virus. The challenge to the field is to find all sources of virus — this study identifies one — and identify ways to eliminate them. Only by developing strategies to eliminate all the different sources can we purge HIV from the body.”

In the long run, study co-author Collins said, the findings could help scientists develop ways to eradicate HIV or turn lifelong medication therapy “into a therapy that might last for a defined period of time.”

SOURCES: Kathleen Collins, M.D., Ph.D., associate professor of internal medicine, University of Michigan, Ann Arbor; Jerome A. Zack, Ph.D., director, UCLA Center for AIDS Research, Los Angeles; Nature Medicine, online

A good diet and regular exercise may help the mind function better, a new study suggests.

“It looks like exercise and diet improve the range of cognitive function,” said Patrick Smith, an intern in clinical neuropsychology and a member of a Duke University team reporting the finding online in the March 8 issue of Hypertension. “It helps executive function, learning and psychomotor speed.”

The researchers followed 124 men and women with high blood pressure who were 52 and a minimum of 15 pounds overweight, on average.

Led by James Blumenthal, a professor of psychology and neuroscience at Duke, the study was designed primarily to determine the effect of diet and exercise on blood pressure and included people with mild to moderate high blood pressure.

The mental studies were included because “some previous data linked exercise and diet to better cognitive function,” Smith said. The new results verified those findings, he noted.

A third of the participants went about eating and exercising as they usually did. Another third followed the DASH — Dietary Approaches to Stop Hypertension — diet, which emphasizes low-fat dairy products, fruits and vegetables, in combination with regular exercise. The final third were in a program that combined the DASH diet with a weight-management program and aerobic exercise.

Two strategies were used in the weight-management program: One centered on reducing portion size and changing habits, such as snacking. The other used an approach called appetite awareness training, which provides guidelines on how much to eat, not just what to eat.

Smith said the exercise part of the program wasn’t drastic — “workouts of 30 minutes three to four times a week, enough to put the heart up to 75 to 80 percent of its maximum rate.”

To assess the effects on mental function, the participants were asked to do certain paper-and-pencil tests, such as crossing off specific digits on a page of numbers as quickly as possible.

The group that ate well and exercised regularly had an overall 30 percent improvement in mental function by the end of the four-month period, the researchers noted.

Physical activity does seem to have a direct effect on brain cells, Smith said. “There are neurochemical changes that happen with exercise, he said. There is increased production of brain-derived neurotrophic factor, which stimulates connection with other brain cells, he said, but also there is some evidence that it helps grow new brain cells.”

And the combination of good eating and exercise also produced the expected physical advances. Diet-and-exercise participants lost an average of 19 pounds and lowered systolic blood pressure (the higher of the 120/80 reading) by 16 points and diastolic pressure by 10 points by the end of the four-month program.

Some experts believe the study has shortcomings, however. It’s a well-done study, but one that has flaws, said Dr. Donald LaVan, a clinical associate professor of medicine at the University of Pennsylvania and a spokesman for the American Heart Association.

“Its entirely too small,” LaVan said. “I would call it a keyhole study, suggestive but nothing definitive. Also, it did not have a control group to look at the effect of exercise alone. We need a bigger study with a longer duration and a control group for exercise alone.”

Nothing in the study should deter anyone from exercising for the sake of the mind as well as the body, LaVan said.

“Exercise is great,” he said. “But how much exercise itself contributes to mental function is not clear.”

SOURCES: Patrick Smith, M.A., intern, clinical neurophysiology, Duke University, Durham, N.C.; Donald LaVan, M.D., clinical associate professor, medicine, University of Pennsylvania, Philadelphia; Hypertension, online.