Month: July 2023

Summer is an ideal time to take a hike, especially if you have the opportunity to explore one of our country’s many state and national parks. But if you venture far from home, it’s essential to make sure you’re prepared for the local climate and other conditions you may encounter on the trail, especially if you’re not an experienced hiker. Higher temperatures than you’re accustomed to or other extreme weather can be deadly.

“If you’re taking a hike in mid-July in the Arizona desert, there’s a very different list of considerations than if you’re in the mountains of Montana or the forests of North Carolina,” says Dr. N. Stuart Harris, chief of the Division of Wilderness Medicine at Harvard-affiliated Massachusetts General Hospital. Here’s a run-down of what to consider before you hit the trail.

Traveling companions, safety notifications, and orientation

First, it’s safer to travel in pairs or a group of people. But always tell someone not on your hike where you’re going, your anticipated route, and when you expect to return. National parks often require reservations or permits for overnight stays or treks to certain locales, and keep a record of day-hikers, so sign up as requested. If you end up getting injured or lost, the information can make a huge difference in locating you more quickly.

Remember to bring a map and know how to orient yourself. In many wilderness areas, cell service may be spotty or nonexistent, so don’t count on using your phone’s GPS.

In the desert, you may be able to see for 50 miles in the distance. But if you’re in a steep, wooded area, you might not be able to see 100 yards ahead and it’s much easier to become disoriented, says Dr. Harris.

Be ready for heat, humidity, and other weather hazards

Check forecasts first. Always check the forecast so you can be prepared for weather changes. Temperatures may drop and wind may increase as you climb higher. If you’re in an area prone to thunderstorms, lightning injury should definitely be on your radar, says Dr. Harris. Learn these lightning safety tips from the Centers for Disease Control and Prevention. Because these storms usually strike in the afternoon, you can minimize your risk by hiking in the earlier part of the day.

Hydrate well. During any type of exercise — especially hiking, which often demands a fair bit of exertion — be sure to drink extra water to replace the fluid you lose from sweating. On a warm day, you might not notice you’re sweating if it’s breezy. Pay attention to any signs or alerts advising hikers on how much water is best to carry.

Consider humidity. Temperature isn’t the only consideration, however. “If you’re in Arizona and the temperature is over 100° F, your body may be better able to release heat by sweating than if you’re in a very humid area,” says Dr. Harris. In the Great Smoky Mountains, for example, the temperature in July may be only in the high 80s. But humidity levels usually hover around 75% or higher. That means your sweat will evaporate more slowly, so your body’s natural cooling mechanism doesn’t work as efficiently. Be sure to rest and hydrate if you start feeling overheated.

What to wear and bring

Many park websites offer detailed safety tips specific to the terrain and weather you may encounter on a hike, so check before you go. Five basics to consider are as follows:

• If your hike involves rocky or uneven terrain, hiking boots will offer more support than tennis shoes.
• You’ll be more comfortable in lightweight, moisture-wicking clothing, but bring extra layers and rain gear, if the weather forecast suggests this is appropriate. Temperature drops can be surprising in some places when the sun wanes, so be prepared to layer up as needed if you’re out longer than expected.
• Wear a wide-brimmed hat and sunglasses to shield you from the sun’s glare — and don’t forget to apply sunscreen to all exposed skin before you set off.
• Along with plenty of fluids, bring high-energy snacks. If you get off course or encounter a problem, you’ll be glad you did.

Additionally, depending on where you’re hiking, you may need to dodge rash-inducing plants, including stinging nettles, poison oak, or poison ivy. Bring insect repellent to fend off biting insects and follow prevention strategies for ticks, which may harbor bacteria responsible for Lyme disease and other illnesses. Finally, carry a first aid kit with bandages for cuts and scrapes and moleskin for blisters.

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

I admit it: I’m not a fan of drug ads. I think the information provided is often confusing and rarely well-balanced. Plus, there are just so many ads. They show up on TV and streaming programs, on social media, on billboards and the sides of busses, on tote bags, and in public bathrooms. Yes, there’s no refuge — even there — from the billions spent on direct-to-consumer ads in the US.

I’ve often wondered how highly-promoted, expensive new drugs stack up against other available treatments. Now a new study in JAMA Network Open considers exactly that.

Many advertised drugs are no better than older drugs

The study assessed 73 of the most heavily advertised drugs in the US between 2015 and 2021. Each drug had been rated by at least one independent health agency. Researchers tallied how many of these drugs received a high therapeutic value rating, indicating that a drug had at least a moderate advantage compared with previously available treatments.

The results? Only about one in four of these heavily advertised drugs had high therapeutic value. During the six years of the study, pharmaceutical companies spent an estimated $15.9 billion promoting drugs on TV that showed no major advantage over less costly drugs!

Why drug ads are not popular

Only the US and New Zealand allow direct-to-consumer medication marketing. The American Medical Association recommended a ban in 2015. While I’ve often written about reasons to be skeptical, let’s focus here on three potential harms to your wallet and your health.

Drug ads may

• raise already astronomical health care costs by increasing requests for unnecessary treatment and promoting much costlier medicines than older or generic drugs.
• create diseases to be treated. Everyday experiences, such as fatigue or occasional dryness in the eyes, may be framed in drug ads as medical conditions warranting immediate treatment. Yet often, such symptoms are minor, temporary experiences. Another example is “low T” (referring to low blood testosterone). While it’s not a recognized illness on its own, ads for it have likely contributed to increased prescriptions for testosterone-containing medicines.
• promote new drugs before enough is known about long-term safety. The pain reliever rofecoxib (Vioxx) is one example. This anti-inflammatory medicine was supposed to be safer than older medicines. It was withdrawn from the market when evidence emerged that it might increase the risk of heart attack and stroke.

Four questions to ask your doctor if you’re curious about a drug ad

Wondering whether you should be taking an advertised drug? Ask your doctor:

• Do I have a condition for which this drug is recommended?
• Is there any reason to expect this drug will be more helpful than what I’m already taking?
• Is this drug more expensive than my current treatment?
• Do my health conditions or the medications I already take make the drug in the ad a poor choice for me?

The bottom line

The AMA recommended banning drug ads nearly a decade ago. But a drug ad ban seems unlikely, given strong lobbying by the pharmaceutical companies and concerns about violating their freedom of speech.

Still, cigarette commercials were banned in 1971, so it’s not an impossible dream. Meanwhile, my advice is to be skeptical about information in drug ads, and rely on more reliable sources of medical information, including your doctor. Consider contacting the Federal Communications Commission if you have complaints about these ads — a step few Americans seem to take. And try this: mute the TV, fast-forward your podcast, and close pop-ups as soon as drug ads appear.

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

Remember childhood summers when you climbed monkey bars, swung from ropes, and jumped over streams? Rain just added to the fun, leaving you soaked and muddy.

You can relive those adventures by signing up for a mud run. These outdoor team events focus on navigating through military-inspired obstacle courses and getting good and dirty in the process.

Tough Mudder and Spartan races are the most well-known mud races. But similar mud runs are available in most states. Some offer shorter distances and levels of difficulty. Others are designed just for women, kids, or families.

How do mud runs work?

Usually these events follow the same basic concept: participants traverse a course that covers anywhere from three to 10 miles (or longer), and tackle 10 to 25 obstacles.

While some mud races can be done solo, most are designed as team-oriented events. Teams are often coed and consist of five to 10 people. There is no time limit, but depending on the distance and number of obstacles, most teams complete the course in anywhere from less than an hour to three-plus hours.

The obstacles are challenging enough that most people need help — physically and emotionally — to navigate over, under, and across them. This is where a “we’re-all-in-this-together” comradery comes into play.

What sort of obstacles are featured in mud runs?

Common obstacles include

• climbing over spider web-like cargo nets
• scaling walls of various heights
• swinging from ropes with handles
• keeping your balance while walking across beams or logs
• carrying logs or sandbags
• slithering under barbed wire.

And then there’s all the mud. Be prepared to trudge through sticky mud pits, crawl through muddy tunnels, and shoot down mud-slick slides.

What are the health benefits of a mud run?

According to Dr. Aaron Baggish, founder of the Cardiovascular Performance Center at Harvard-affiliated Massachusetts General Hospital, the benefits of these events come from how they are constructed.

“Obstacle racing combines large-muscle, whole-body resistance exercises superimposed on a long-distance endurance race,” he says. “They are a snapshot of all-around conditioning, as you need strength, stamina, and mobility.”

Besides the physical benefits, mud races offer psychological challenges, and the emotional rewards, of conquering tasks that require planning, coordination, and strategy.

How can you prepare for a mud run?

Mud races require strenuous exercise, so discuss your safety and capabilities with your doctor before signing up for an event. While almost anyone of any age can participate in these events, they require a certain level of conditioning to complete and to reduce the risk of experiencing injury.

“Training for obstacle races incorporates many aspects of fitness and performance,” says Dr. Baggish. “So it’s best to prepare with a coach or trainer who understands the fundamental skills needed to complete these races.”

Whether or not you work with a trainer, you’ll want to focus on:

• Aerobic fitness. While you won’t consistently run as you do in a traditional road race, such as a 5K or a half marathon, you do have to hustle from obstacle to obstacle. “Optimal training for such obstacle races involves a combination of steady-state aerobic base training like jogging or cycling, coupled with interval work that simulates the start-and-stop nature of competition,” says Dr. Baggish.
• Grip strength. You will have to grab, hold, and pull yourself against gravity. Exercises that can help include pull-ups and farmer carries (where you hold dumbbells or kettlebells in each hand while you walk back and forth). Good form is essential during these exercises to help you avoid injury. Remember to start low when working with weights and go slow.
• Plyometrics. Many obstacles require explosive jumps and quick movements. Exercises like box jumps, burpees, and jump squats can help replicate these moves.

How to stay safe in the mud

While being physically prepared can help reduce the risk of injury, you should take other precautions to stay safe. For instance:

• Choose your race depending on level of fitness. Be sure you know what you’re getting into before you go.
• Wear lightweight, moisture-wicking clothing. Avoid cotton, which gets heavy with mud and sweat.
• Wear a headband, protective eyewear, or visor to keep mud out of the eyes.
• Wear long shorts or pants that cover your knees to prevent scraping, or opt for knee pads.
• Consider gloves to protect your hands and provide extra grip.
• Cover your feet with petroleum jelly or an anti-chafing cream before putting on socks to protect wet feet from chafing and blisters.
• Tie shoelaces tightly (but not so tight that they cut off circulation). Mud creates suction and you can quickly lose a shoe.
• Pace yourself. Walk or take a break when needed.

Where can you find a mud run?

It depends on the level of challenge that you seek. Are you ready for a Tough Mudder or Spartan race? Looking for a family first mud run, or a Muddy Princess or Muddy Kids event?

These additional sites also can help you find mud races in your area:

• Mud Run Finder (US)
• Run Guides (Canada and the US)
• Savage Race (US)

About the Author

Matthew Solan, Executive Editor, Harvard Men's Health Watch

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s … See Full Bio View all posts by Matthew Solan

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