The story of your life and the power of memoir

I play poker in a weekly game hosted by an 80-year-old man named Mort. During a recent game, I noticed a stack of composition books, scribbled-over yellow pads, and Bic pens spread over his dining table.

What was he up to? Mort said he had lost his sense of purpose and identity, so he turned to something he knew a lot about — his life story — and began to write his memoirs.

Mort’s reaction is quite common among older adults, as is his response. As people age, they may begin to feel irrelevant to those around them, especially their families, which often leads to low self-esteem, greater isolation, and a higher risk of depression.

But engaging yourself in an endeavor like writing your memoirs can be rewarding for you and others.

“You would be surprised at how interested your peers and family members are in your stories and personal history,” says Brendan Kearney, Vitalize 360 Wellness Coach at Harvard-affiliated Hebrew SeniorLife. “You have a unique firsthand account of your culture and history that others don’t, and leaving a recorded history of your life can be an important gift to both you and your descendants.”

Words of wisdom

Writing your memoirs offers many benefits beyond simple storytelling. For instance, they can be an opportunity to pass along specific wisdom and life lessons. “Even if you write about parts of your life that you have never told anyone because they were unhappy or painful memories, revisiting them can show others the strength it takes to overcome life barriers when they face their own,” says Kearney.

The actual writing aspect also can be a therapeutic tool as you explore issues that may still trouble you. A study published in the March 2018 JAMA Psychiatry found that writing about a specific upsetting memory was just as effective as traditional cognitive processing therapy in treating adults with post-traumatic stress disorder.

A walk down memory lane

Where should you begin your life story? You don’t have to follow a straight year-by-year account. Instead, Kearney recommends creating a timeline of your life based on the places you have lived. “Begin with writing about your homes,” says Kearney. “Think about the house you grew up in, or the first house you owned. The places you’ve lived often invoke a wealth of visual memories and long-forgotten stories that are tied to those places.”

Another way to trigger ideas is to look through photo albums. Focus on a single picture and write about the story behind it. Or use writing prompts, by asking yourself questions such as, “One of my fondest memories of my best friend was …”; or “The time I was happiest or most scared was …” Or write about your favorite hobbies or sports.

Mort’s first chapter? His love of poker.

The write stuff

Writing can be tough for some people. Here are some strategies to help you find your rhythm.

• Write at the same time each day to establish a routine. Choose a specific time to write, whether it’s in the morning while you drink coffee, or before bed, or any time in between.
• Write for a set period. In the beginning, set a timer and write for 10 to 15 minutes. Gradually extend the time to 20 minutes or longer.
• Don’t worry about spelling and grammar. Your writing is about record keeping and not publication, so write the way you speak, and don’t focus on correcting mistakes.
• Use a recorder. If you aren’t comfortable writing, then record your stories on a tape recorder or your smartphone. There are many speech recognition programs that can convert audio into text documents, such as Sonix, InqScribe, and Dragon NaturallySpeaking.
• Try writing longhand. Research has found that handwriting, especially in cursive, can activate parts of the brain associated with short- and long-term memory. The slower process also can help improve attention and information processing, since you have to focus on forming letters and words.
• Look for writing groups. Some community centers offer memoir-writing workshops that can offer further support and give you a chance to share your writing with other people. Or reach out to friends about forming your own writing group.

The post The story of your life and the power of memoir appeared first on Harvard Health Blog.

From: Matthew Solan https://www.health.harvard.edu/blog/the-story-of-your-life-and-the-power-of-memoir-2018031713496

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What patients — and doctors — need to know about vitamins and supplements

A recently published clinical guideline on vitamin and mineral supplements reinforces every other evidence-based guideline, research review, and consensus statement on this topic. The bottom line is that there is absolutely no substitute for a well-balanced diet, which is the ideal source of the vitamins and minerals we need.

The brief article, co-authored by nutrition guru Dr. JoAnn Manson, cites multiple large clinical trials studying multiple nutritional supplements’ effects on multiple end points. The gist of it is, our bodies prefer naturally occurring sources of vitamins and minerals. We absorb these better. And because commercially available vitamins, minerals, herbs, etc. are lumped together as “supplements,” the FDA doesn’t regulate them. When we ingest processed, concentrated, and artificially packaged “supplements,” we may be doing ourselves harm. They may be toxic, ineffective, or contaminated (all of which are not uncommon).

In other words: Most people who eat a healthy diet are unlikely to benefit from nutritional supplements.

Note the very important qualifiers. We’re talking about most people (not all) who eat a healthy, well-balanced diet.

Does anyone need vitamin and mineral supplements? Well, yes

There are medical conditions that put people at high risk for certain nutritional deficiencies, and there are medical conditions that can be treated with certain nutritional supplements. This is important, and is why the authors support targeted supplementation. But who needs what and where to acquire these are important discussions to have.

There are guidelines for specific groups, such as pregnant women. Folic acid is especially important for healthy fetal development, and a deficiency can cause spina bifida, a neurologic condition. I advise my patients to start either a prenatal vitamin with folic acid, or at the very least folic acid itself, ideally before they begin trying to conceive. As pregnancy advances, mom needs to provide her growing fetus with everything, and so she will benefit from a prenatal vitamin (either by prescription or a well-vetted over-the-counter one) which contains things like iron and calcium.

Older adults can have difficulty absorbing vitamin B₁₂, and I have a low threshold when checking this level; if someone is taking an acid-reducing medication, it is very likely that they will become deficient in B₁₂, as well as iron, vitamin D, and calcium, among other things. These folks may very well benefit from a quality multivitamin.

Of course, there’s a long list of medical issues that predispose people to vitamin deficiencies. For example, people who have had weight-loss surgery may require a number of supplements including A, D, E, K, and B vitamins, iron, calcium, zinc, copper, and magnesium, among other things. People with inflammatory bowel disease (like Crohn’s or ulcerative colitis) may have similar requirements. People who have or are at risk for osteoporosis may greatly benefit from vitamin D and, depending on the quality of their diet and other factors, possibly also calcium supplements.

There are other medical conditions that can be treated with supplements. One that immediately comes to my mind is inflammatory arthritis (or other inflammatory conditions) and turmeric. While quality scientific studies are lacking, there are plenty of smaller studies as well as historical experience suggesting that turmeric has anti-inflammatory properties, and I see some of our rheumatologists routinely recommending this to patients for pain relief. Then there’s prediabetes/diabetes and cinnamon, which has blood sugar-lowering properties. With these compounds, I advise that people use the regular spice in normal culinary amounts, not a processed/concentrated packaged supplement.

Not all vitamins are created equal

And here is another key point that bears repeating: Manson suggests choosing vitamins that have been tested by independent labs such as US Pharmacopeia, Consumer Lab, and NSF International, and certified to have the labeled dosage of the correct ingredient, and not have toxins or contaminating organisms. Many commercially available supplements here in the US will bear a label from one of these labs.

On that point, gummy vitamins are often not certified and often do cause cavities. Yes, everyone loves them, because they’re basically candy. I do not recommend gummy vitamins for anyone, but especially not for pregnant women.

I’ll also add in a warning: I often hear about providers who are selling supplements or other products directly to their patients. This is a conflict of interest, and it’s unethical, as well as fraught with all sorts of potential problems. Please use caution if purchasing anything directly from the provider who is prescribing it.

The bottom line

In summary, enjoy a varied, colorful, healthy diet, consider supplements when they may be needed or helpful, and choose your sources carefully.

Sources

Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine, April 2014.

Dietary supplements and disease prevention — a global overview. Nature Reviews: Endocrinology, May 2016.

The post What patients — and doctors — need to know about vitamins and supplements appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH https://www.health.harvard.edu/blog/patients-doctors-know-vitamins-supplements-2018031613418