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VOLUME 48
NUMBER 1
NOVEMBER 2022

INSIDE
6 myths about dementia Ask the Doctor���������������������� 2
Learn the facts so you can be proactive about your cognitive health. ϐ Can these approaches really
improve memory?

D
Winterizing heart health. . .   3
ementia is so widely discussed that you can vary. For example, primary progressive
The best exercises for your
might feel you know a bit about it. But aphasia starts with language problems, and
warm-up . . . . . . . . . . . . . .   4
there are many misconceptions about the dementia with Lewy bodies can start with ϐ AND: Move of the month
condition, and believing visual hallucinations of
© Westend61 | Getty Images

Programs to sharpen your

them could potentially little people or animals. driving skills ���������������������� 5
affect your health. For
Steak and burger substitutes
the real story on six Myth #3: Dementia is to satisfy a carnivore . . . . .   6
common myths about a natural part of aging ϐ AND: What’s in your burger?
dementia, we turned Dr. Budson: Dementia News briefs�������������������������� 8
to Dr. Andrew Bud- is not part of normal ϐ Over-the-counter hearing aids are
son, chief of Cognitive aging. It is simply more finally available
and Behavioral Neu- common as people get ϐ Black tea linked to longevity
ϐ Doing any aerobic activity
rology at the Veterans older—just like heart
Affairs Boston Health- disease, stroke, and regularly may help you live longer
Dementia has varying effects on memory.
care System, lecturer in Earlier memories are often retained. cancer. Research pub- FIVE THINGS TO DO
neurology at Harvard lished in 2022, from THIS MONTH
Medical School, and the co-author or editor scientists who studied the U.S. adult popu-
of eight books about memory loss. lation, found that about 41% of dementia
risk might be preventable. In this study, the
1 Meditate daily. Get into the
habit now, so you’ll be ready to
cope with holiday stress. (page 3)
Myth #1: Dementia is a disease most important ways to reduce your risk of
Dr. Budson: Dementia is not a disease. It’s a dementia were to treat your blood pressure,
general term to describe thinking and mem- control your weight, and engage in regular
2 Change your warm-up. Add
slow versions of moves you’ll do
in your daily workout. (page 4)
ory skills that have deteriorated to the point physical activity.
that you experience problems with daily
activities. A number of conditions can cause Myth #4: Dementia is always genetic
3 Take a driving refresher
course. It can help keep you
safe on the road. (page 5)
dementia; Alzheimer’s disease is the most Dr. Budson: Dementia is not always genetic.
common. Other types of dementia include We think that dementia is probably genetic
vascular dementia due to strokes, primary about half the time. But we don’t have solid
4 Have a veggie “steak.” Cut
back on red meat by eating
plant versions. (page 6)
progressive aphasia, frontotemporal demen- evidence about it. We do know that some
tia, and Lewy body dementia. people in South America carry rare genes
that almost guarantee a 100% likelihood of
5 Start drinking black tea.
Research suggests it may help
you live longer. (page 8)
Myth #2: Memory loss is the first sign of developing young-onset Alzheimer’s disease
SPECIAL HEALTH REPORT
dementia between ages 35 and 65. For the rest of us,
Healthy Hands
Dr. Budson: Memory loss is generally the first having a family history of dementia makes Strategies for strong, pain-free
sign of Alzheimer’s disease, but not always. getting it two to four times more likely. And hands
A 2021 study found that Alzheimer’s disease there is a common genetic variant that about www.health.harvard.edu/hands
often shows up as word finding difficulty, 25% of the population has called the ApoE- Aim your
trouble seeing clearly-not explained by eye e4 allele, “e4 allele” for short. If you have that mobile phone’s
camera at this
issues such as outdated corrective lenses-or gene, your risk of developing Alzheimer’s is code for more
trouble balancing your checkbook. Ini- about four times greater. But genetics are not information >>
tial symptoms of other types of dementia continued on p. 7 „„
 ASK THE DOCTOR
by ANTHONY L. KOMAROFF, M.D., Editor in Chief

Can these approaches really improve

memory?

Q
Editor in Chief Anthony L. Komaroff, MD
Executive Editor Heidi Godman I’m 70, and my memory isn’t what it used to be.
Dean of External Education David Roberts, MD I’ve been seeing news about procedures to improve
Managing Director Nancy Ferrari
memory, like injecting young blood or stimulating the
Chief Medical Editor Howard LeWine, MD
brain with electrical currents. Is any of this true?
Editorial Board

A Believe it or not, it could be. But don’t hold your

Board members are associated with Harvard Medical School
and affiliated institutions.
Bones and Joints Scott Martin, MD breath waiting for this research to produce a treat-
Cardiology Deepak L. Bhatt, MD, MPH ment that helps you and me. What you see in the news
Peter Zimetbaum, MD
is part of a growing body of research on slowing aging.
Dermatology Suzanne Olbricht, MD
Endocrinology David M. Nathan, MD We’ve talked about this before (see “Can we slow the aging process?” in the May
Exercise I-Min Lee, MBBS, MPH, ScD 2021 Health Letter). We used to assume that aging, like death, was inevitable. But
Gastroenterology Lawrence Friedman, MD increasing evidence indicates that it may become possible someday to slow, if not
Geriatrics Suzanne E. Salamon, MD
Infectious Disease Michael Starnbach, PhD
eliminate, the aging process.
Integrative Medicine Darshon Mehta, MD, MPH That’s even true of the aging brain. Between the ages of 50 and 60, various aspects
Lifestyle Beth Frates, MD of thinking (including memory) begin to wane. A little less than 10 years ago, experi-
JoAnn E. Manson, MD, MPH, DrPH
Neurology Joel Salinas, MD
ments showed that when blood of young mice was introduced into old mice, memory
Nutrition Theresa Fung, ScD improved in the old mice. And a study published online May 11, 2022, by the presti-
Eric B. Rimm, ScD gious scientific journal Nature showed that when spinal fluid (the liquid that bathes
Men’s Health Adam Kibel, MD
Oncology Marc Garnick, MD
the brain) from young mice was infused into the brains of old mice, this also improved
Psychiatry Michael Miller, MD memory. More important, these studies have identified specific molecules in the blood
Women’s Health Karen Carlson, MD and spinal fluid that appear responsible for the improved memory, knowledge that
• might someday lead to medicines that can prevent or even reverse memory loss.
Customer Service
For several decades, scientists also have been trying to improve mem-
Call 877-649-9457 (toll-free)
Email harvardHL@ strategicfulfillment.com
ory by exposing the brain to electrical currents, with very mixed
Online www.health.harvard.edu/customer-service results. The studies have focused on both working memory
Letters Harvard Health Letter and long-term memory. Working memories are temporarily

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stored in one part of our brain when we experience an event,
and then transferred to another part of the brain for
long-term storage.
In contrast to past mixed results, a study in
humans (not mice) published online Aug. 22, 2022,
by the journal Nature Neuroscience reported on
specific types of electrical stimulation directed at
specific areas of the brain. The stimulation lasted for
20 minutes each day for four days, and it improved
both working memory and long-term memory for at least a month. The electrical
stimulation involved no surgery and no pain. These encouraging results need to be
reproduced by other scientists, studying other people, before they can be considered
true. If they are confirmed, it will remain to be determined how long the benefits last
and whether there are any adverse effects.
So, like I said, don’t hold your breath. But I think that science is finally beginning
to understand the aging process well enough to offer the hope that we will someday
be able to slow it—even the effects of aging on the brain.
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2 | Harvard Health Letter | November 2022www.health.harvard.edu

Winterize your heart health
Take steps to thwart the seasonal challenges that can jeopardize
your heart.
© Halfpoint Images | Getty Images
A re you preparing for winter? Perhaps
you’re retrieving heavy coats
from their summer slumber, getting a
check-up for your home’s furnace, and
stocking up on road salt for snowy days.
You might also add your health to the
list of items to be “winterized,” espe-
cially your heart, which faces increased
risks during the winter. In addition to
the basics—eating a healthy diet, doing
moderate-intensity exercise (such as
brisk walking) for at least 150 minutes
per week, and getting enough sleep
(seven to nine hours per night)—take
the following steps to protect your heart.
Stay up-to-date on vaccinations
Make sure you get this year’s influ-
enza (flu) shot and any recommended
COVID-19 vaccinations or boosters.
Flu and COVID surge in the winter,
and both can harm your heart. “You
can develop cardiovascular problems
after COVID, even if you don’t have
any heart disease risk factors,” says Dr.
Deepak Bhatt, a cardiologist and edi-
tor in chief of the Harvard Heart Letter.
“And while the flu increases your risk for
a heart attack, our research has shown
that getting a flu shot is associated
with significantly reduced heart attack
risks—as much as 45%.”
Check your medicine cabinet
Lots of people have cold and flu rem-
edies on hand for the winter, but these
often contain ingredients that pose
heart risks. Common culprits include
decongestants (such as phenyleph-
rine and pseudoephedrine) and cough
suppressants (such as dextrometho-
rphan), which can raise your heart rate
and blood pressure. “Stay away from
cold remedies containing deconges-
tants if you have high blood pressure,
heart disease, or a history of stroke,”
Dr. Bhatt advises.
www.health.harvard.edu
CARDIOVASCULAR HEALTH
Cold remedies may also contain
ibuprofen (the ingredient in the pain
relievers Advil and Motrin) to reduce
fever or relieve aches and pains. Ibupro-
fen is a nonsteroidal anti-inflammatory
drug (NSAID), which may increase the
risk for a heart attack or stroke.
Make an exercise plan
Aerobic exercise—the kind that works
your heart and lungs—is crucial for
heart health, a healthy immune system,
and much more. But it’s easy to stop
exercising when the weather turns cold.
Figure out now where you’ll exercise
indoors this winter and which types of
exercise you’ll do. Perhaps you’d like to
work out at home, following an online
exercise video. YouTube is a rich source
of free exercise videos. Look for one
geared toward people in your age group.
Other options for exercising indoors
include working out at a gym, walking
indoors at a local mall, or taking classes
at a YMCA.
Prepare for snow removal
Shoveling snow or pushing a heavy
snow blower makes your heart work
overtime, especially in cold weather
(which narrows blood vessels). It also
increases risk of a heart attack, partic-
ularly if you are deconditioned from
infrequent physical activity.
Avoid the risk by asking friends,
family, or neighbors if they might be
available to help you shovel snow this
winter, or by hiring a snow removal
company if finances allow (call now,
since they book up quickly).
If you want to shovel snow on
your own, remember that the activ-
ity requires the same precautions as a
strenuous workout, such as preparing
the heart and muscles with a warm-up
(see “The best exercises for your warm-
up” on page 4), staying hydrated, going
Figure out now where you’ll exercise during the
winter months. An indoor pool is a great choice.
slowly, and stopping if you feel dizzy or
you’re out of breath.
Start managing stress
Get into a regular practice of managing
stress now, before the winter holidays
arrive with their many pressures. Stress
triggers the body’s fight-or-flight
response, which sends stress hormones
throughout the body and makes the
heart beat faster, breath quicken, and
muscles tense. It’s not harmful if it’s tem-
porary, but chronic stress contributes to
clogged arteries and high blood pres-
sure and can lead to heart attacks and
strokes. Manage stress by practicing
yoga, tai chi, meditation, or deep breath-
ing exercises, and by getting enough
sleep and exercising.
Come up with winter eating and
drinking strategies
The winter brings many opportuni-
ties to go off a healthy diet or drink too
much alcohol, and both affect the heart.
Eating lots of food that’s fatty, salty, sug-
ary, or high-calorie may add pounds or
increase your blood sugar or cholesterol
levels, which can raise cardiovascular
disease risk. Drinking too much alcohol
can cause a temporary or even perma-
nent irregular heartbeat condition called
atrial fibrillation.
Plan now to avoid overindulging.
Enjoy holiday or comfort foods only
occasionally, in small portions. Limit
alcohol to no more than one drink per
day, if your doctor says it’s okay. Where
can you find the resolve to stick to the
rules? Think of the harms you risk if you
don’t. “It often takes a heart attack before
people get serious about heart health,”
Dr. Bhatt says. “It’s much better to be
proactive than reactive.”
November 2022 | Harvard Health Letter |3
EXERCISE SAVVY
The best exercises for your warm-up
Tailor a warm-up to the type of physical activity you’ll be doing.
A warm-up is essential before a
workout. Sometimes, just march-
ing in place and moving your arms
around for a few minutes is enough to
prepare your body for what it’s about
to endure. At other times, it takes
more work to get your body ready for
activity. “Many people think that a
warm-up before playing golf, pickle-
ball, or tennis means taking a couple
of practice swings with the club or rac-
quet. In reality, it should include five to
10 minutes of warm-up activities,” says
Christina Ruggeri, a physical thera-
pist specializing in sports medicine at
Harvard-affiliated Spaulding Rehabili-
tation Hospital.
What does the warm-up do?
Warm-up activities accomplish several
tasks:
ϐ They get blood pumping, which
sends oxygen and energy to your
tissues and muscles, so they’re ready
for activity.
ϐ They put muscles and joints through
their range of motion, gently stretch-
ing them so they can accommodate
broad movements.
ϐ They prepare the joints for forward
and backward movement, side-to-
side movement, and rotation.
For moderate-intensity activity
The type of warm-up you need depends
on your activity. For a strengthening
routine or moderate-intensity activ-
ity (such as brisk walking or riding
a bike on level ground), marching in
place for a few minutes makes an effec-
tive warm-up. Swing your arms as
you march.
“Alternating leg activity can quickly
raise the heart rate, which is important
in a warm-up,” Ruggeri says. “March-
ing also works your leg and buttock
muscles. The leg you lift works the hip
flexor. Your stationary leg works the
4 | Harvard Health Letter | November 2022
MOVE OF THE MONTH:
ALTERNATING HAMSTRING
CURLS
Stand with your feet
hip-width apart.
Bend your left knee
to bring your left
heel toward your
buttocks as you
balance on
your right leg.
Immediately
return
to the
starting position.
Repeat with your
right leg. Continue
this left-right sequence
for a total of 10 times
on each leg. Let your
arms swing forward
and back as you move.
gluteal muscles [in the buttocks] and
the quadriceps [in the thighs].”
For more intense activity
For vigorous physical activity, such
as swimming or playing tennis, or for
activity involving strenuous physical
movements, such as golf, you’ll need
a more extensive warm-up. For exam-
ple: “Golf requires that you swing your
arms and turn your trunk. Tennis
and pickleball require those move-
ments, plus lateral shuffles. So you’ll
want to prepare the muscles for that,”
Ruggeri says.
One way to warm up is by practic-
ing moves you’ll perform later. “Do
the movement repeatedly, in a slow
and controlled manner, to allow the
body to adjust to the activity,” Ruggeri
says. “For example, for tennis, stand in
place and slowly perform a backhand
swing to warm up the shoulder and
core muscles.”
Other warm-up activities to per-
form before vigorous exercise include
marching in place, arm sweeps
(sweeping your arms overhead), torso
rotations (turning your torso left and
then right), and the following moves.
Step-ups. Facing the lowest step in a
staircase, take one full step up and then
step back down. Repeat the exercise 10
times, take a break, then do another 10
step-ups. “This targets your quadriceps
muscles when you step up, and your
gluteal muscles when you step down.
Photo by Michael Carroll
When you step up with one leg at a
time, you also activate your core and
back muscles to help keep your body
upright,” says Ruggeri.
Arm circles. Put your arms out to
the sides and move them in circles of
varying size (small, medium, and then
large). Move them in forward circles
for 30 seconds, then backward circles
for 30 seconds. “This helps the shoul-
der muscles and the rotator cuff, a
group of muscles and tendons at the
shoulder,” Ruggeri says. “The shoulder
is the most mobile joint in the body,
and these circles allow for the full
range of shoulder movement.”
Air punches. Punch the air in front
of you, alternating right and left arms,
for 30 seconds. Then do 30 seconds
of cross-body punches: punch your
right hand to the left, and then your
left hand to the right. Try some upper-
cuts, too (punching upward). “Punches
increase your heart rate and get more
blood flowing through the arm,” Rug-
geri says.
Stretching after activity
After the warm-up, do your workout.
Finish the activity with stretches—
gently holding each stretch for about
30 to 60 seconds. Ruggeri recommends
stretching the shoulders, buttocks
and hip muscles, upper leg muscles
(the hamstrings and quadriceps), and
calves. This will keep muscles long and
supple, and ready to respond the next
time you call on them for a workout or
everyday activity.
www.health.harvard.edu

Programs to sharpen your driving skills
Improve your chances of maintaining your independence and
staying safe on the road for as long as possible.
W
© Blake Little | Getty Images
e have more reason than ever
to be cautious on the road.
The latest numbers from the National
Highway Traffic Safety Administra-
tion show that traffic deaths have been
steadily increasing in the United States
among people ages 65 and older. While
the numbers dipped slightly during the
pandemic lockdown in 2020, they more
than made up for it in 2021, jumping
14%. Whether you’ll be on the road for
a trip to the grocery store, a holiday
gathering, or a warmer climate for the
winter, you need to make sure you’re
driving as safely as possible. A few
types of programs can help you do that.
Car-Fit evaluations
Once we reach a certain age, it can be
difficult to reach the gas and brake ped-
als or see above the dashboard. This
could be because you’ve gotten a little
smaller with age or you’re unfamiliar
with the vehicle’s high-tech tools that
can tailor your fit.
A program called Car-Fit can help.
It’s a check-up from AAA, AARP, and
the American Occupational Therapy
Association, designed simply to help
you fit better in your vehicle. You can
attend an in-person Car-Fit event or
watch a workshop online.
During a Car-Fit check-up, an
occupational therapist will guide you
through a list of 12 areas in your vehi-
cle that require the proper fit, show you
how to use equipment to make changes
(such as buttons that can move the gas
pedal or steering wheel), and make rec-
ommendations for adaptive equipment
if you need it.
Cost: Free. Visit Car-Fit online (www.
car-fit.org) for more information.
A driving “refresh”
A driving refresher course helps you
stay up to date on the latest driving
www.health.harvard.edu
PROTECTING INDEPENDENCE
techniques, laws, and vehicle safety
technology. It can also provide you
with workarounds for challenges such
as fighting glare at night or navigating
around aggressive drivers.
You can take a driving refresher
course online, in a classroom, or with
a local driving instructor. To find a
refresher course, just call your local
AAA branch or visit AAA online (www.
health.harvard.edu/ard). The AARP
also offers a driving refresher course
(www.health.harvard.edu/ads).
Cost: Less than $30 for online classes
through AAA or AARP; $100 or more
for local driving instruction. Taking a
course may even save you money on
your car insurance; call your insurance
company to find out for sure.
A formal driving assessment
If you’ve noticed changes in your driv-
ing ability lately, consider getting a
formal driving assessment. Ask your
doctor to refer you to a hospital-affil-
iated program that includes both a
clinical evaluation and a road test.
In the clinical evaluation, health
professionals will ask about medi-
cal conditions you have, medications
you’re taking, and more. “We assess all
of the things that affect your driving
skills—your vision, cognition, range of
motion, strength, coordination, sen-
sation in your arms and legs, hearing,
and medication side effects,” says Amy
Donabedian, an occupational therapist
and certified driving rehabilitation spe-
cialist at Harvard-affiliated Spaulding
Rehabilitation Hospital.
For the driving evaluation, you’ll
get in a car and demonstrate your abil-
ity on the road. A health professional
and a certified driving instructor will
go along for the ride. “We look at your
control of the gas pedal, brake, and
steering wheel,” Donabedian says, “and
A formal driving assessment includes a road
test and a clinical health evaluation.
we have a lot of questions we need to
answer. Can you stay in your lane? Are
you following the rules of the road? Are
you aware of pedestrians, stop signs,
and other cars? What’s your reaction
time? Can you park the car and back
out of a space safely?”
After the road assessment, the team
recommends steps to improve driving
ability. “We may suggest that you take
a driving refresher course or practice
certain habits such as driving only dur-
ing the day, at times when roads aren’t
congested, and driving with a spouse or
friend who can be an extra set of eyes
for you. Or it might be that you need
driver rehabilitation, occupational ther-
apy for grip strength, or modifications
that make you more comfortable in the
car—such as a dense foam seat cushion
to improve your fit in the seat, or other
adaptive equipment,” Donabedian says.
“The goal is to keep you on the road.”
Cost: About $600 or more out of
pocket. Medicare doesn’t cover it.
Driver rehabilitation
Some hospitals offer programs that not
only assess your driving ability, but also
provide additional training to keep you
behind the wheel. A certified driving
rehabilitation specialist (usually an
occupational therapist) will help you
learn to use adaptive equipment if you
need it, practice driving in challenging
conditions, and develop safe driving
habits. These programs are helpful for
people who have a condition (such
as neuropathy or Parkinson’s disease)
affecting their ability to drive and those
who’ve had a stroke or another injury
that affects driving.
Costs: About $100 or more per hour.
Medicare doesn’t cover it.
November 2022 | Harvard Health Letter |5
DIET AND NUTRITION

Steak and burger substitutes to satisfy contain ingredients that were changed
dramatically from their original plant
a carnivore forms. Also, they can include lots of
salt, oil, sugar, flavoring, and preserva-
Plant-based “meats” offer ways to reduce animal fat in your diet.
tives, which (in high amounts) increase
But eat them in moderation. risks for chronic diseases (such as heart
disease, diabetes, inflammatory bowel

D iets high in red meat

are associated with
many health problems, such
disease, obesity, and cancer), chronic
inflammation, and premature death.
PBMA fat content varies. Some newer
as chronic inf lammation, PBMAs are higher in saturated fat than
heart disease, diabetes, can- traditional PBMAs, and not that differ-
cer, dementia, and premature ent from red meat.
death. While those risks may Some PBMAs have extra iron. Some

© SimpleImages | Getty Images

be enough to keep you from PBMAs from Impossible Foods contain
digging into a juicy burger or heme iron. Heme is an iron-containing
steak, they may not stop your molecule found naturally in animal
craving for meaty textures on Plant-based meat alternatives have health benefits and a foods, especially red meat. The heme
the plate. few potential risks as well. in Impossible Foods is genetically
Plant-based burgers or engineered from soy roots. “Iron is
steaks (now being featured in grocery when cooked. But they’re usually lower important for body function. But our
stores, vegan food shops and restau- in total and saturated fat and cholesterol research has shown that too much
rants) might fill the bill, if you keep than the real thing. heme iron in the diet is associated with
some caveats in mind. Also, they contain about the same increased risks for diabetes, especially
amount of protein as red meat and are in older adults,” says Dr. Frank Hu,
Traditional plant-based “meat” fortified with vitamins—including B12, the Frederick J. Stare Professor and
Plant-based meat alternatives (PBMAs) which is often missing in plants. Chair of the Department of Nutrition
have been around for decades. They’re and Epidemiology at the Harvard T.H.
made of flours, concentrates, or isolates The caveats Chan School of Public Health.
(protein drawn from plants) that come All PBMAs can help you reduce red
from such foods as soybeans, black meat in your diet. But note the follow- PBMAs in your diet
beans, mushrooms, or whole grains. ing caveats. Despite the potential risks of PBMAs,
PBMAs (such as black bean burg- PBMAs are processed foods. They they may have a place in your diet.
ers or tofu steaks) don’t always look or may be minimally processed, such as “I think it’s okay to include PBMAs
taste like red meat, but they may provide tofu steaks, or ultra-processed, such as as a replacement for red meat. How
enough flavor and texture to satisfy the newer PBMAs. Ultra-processed foods often you eat them is still a question.
sensory experience you want in a meal.
They may also have a few health What’s in your burger?
perks: they typically contain less total BURGER TYPE PROTEIN TOTAL FAT SATURATED SODIUM
and saturated fat and cholesterol than (GRAMS) (GRAMS) FAT (GRAMS) (MILLIGRAMS)
red meat, and they may be rich in pro- 80% lean ground beef 19 23 9 75
tein and fiber. (4 ounces)
Beyond Burger Plant- 20 14 5 390
Plants that mimic meat based Patty (4 ounces)
The newest generation of PBMAs (such Impossible Burger Patty 19 14 8 370
as those from Beyond Meat and Impos- (4 ounces)
sible Foods) is engineered to replicate Amy’s Organic 6 5 0.5 550
the taste and texture of red meat. California Veggie Burger
The products—made from puri- (2.5 ounces)
fied soy or pea protein—are thick and Giant brand portabella 2 0 0 8
savory. They smell, taste, and look like mushroom (1 whole cap)
meat, with pink centers that ooze juice Source: USDA and manufacturer websites.

6 | Harvard Health Letter | November 2022 www.health.harvard.edu

 A couple of times per week might be
fine,” Dr. Hu says.
Why don’t we have definitive
answers as to whether diets empha-
sizing PBMAs are healthier than diets
© Roxiller| Getty Images
rich in red meat? “While many studies
that have shown that there are health
benefits to replacing red meat with min-
imally processed plant foods, very few
studies so far have compared eating red
meat with eating PBMAs. Some recent
evidence has been encouraging. But at
this point, we don’t know how PBMAs
will influence health long-term,” Dr. Hu
explains.
Until we have more answers about
the long-term effects of PBMAs, eat
them only in moderation, and go for
the ones with the fewest ingredients and
lowest levels of salt and saturated fat.
Don’t pair them with unhealthy foods,
like French fries, soda, or refined grains
(white bread or buns).
And if PBMAs with heme are on the
menu (look for an ingredient called soy
leghemoglobin), reduce other sources
of heme (especially meat) in your diet.
Other substitutes
As for other substitutes for red
meat, actual plants—vegetables and
Dementia myths ... from p. 1
always destiny. Studies have shown that
by engaging in good lifestyle behav-
iors—such as eating a Mediterranean
diet and doing aerobic exercise that
strengthens your heart and lungs—
you can reduce your risk of developing
© FatCamera | Getty Images
Alzheimer’s disease, even if you have
an e4 allele.
Myth #5: Dementia causes the loss
of all memories
Dr. Budson: Alzheimer’s disease does
cause the loss of memories, but gener-
ally not all memories, at least not until
the end of life. People with Alzheim-
er’s begin having trouble remembering
what happened recently, in the prior
www.health.harvard.edu
legumes—are great options. Both are
low in calories, they have little or no
fat, and they’re rich in vitamins, min-
erals, fiber, and antioxidants that fight
free radicals (molecules that dam-
age cells). Legumes (beans, lentils) are
also excellent sources of protein. These
options cost a lot less than red meat or
PBMAs, too.
For example, for burger alternatives,
try a large portabella mushroom cap;
thick (three-inch) slices of eggplant, cut
crosswise (from side to side); or home-
made bean burgers (made of sturdy
beans such as chickpeas or black beans).
For steak alternatives, you can use
thick slices of eggplant cut lengthwise
(from root to stem) or slices of a large
head of cauliflower, broccoli, cabbage,
or romanesco (an unusual-looking
broccoli with a mild flavor).
It’s okay to roast or grill plant steaks
and burgers, and even get grill marks on
them. “Just don’t burn them. You want
to maintain their nutrient content,”
Dr. Hu says.
To flavor them, brush them with a
marinade made of your favorite spices
and a healthy oil (such as olive oil)
before grilling or roasting them. Avoid
topping them with salty, sugary, or
hours, days, weeks, or months. Things
that happened years ago, from child-
hood through age 35 or so, are
generally remembered. This is because
the hippocampus, one part of the brain
that is damaged in Alzheimer’s, over-
sees recent memories and not older
Sometimes treating an underlying condition
can reverse dementia-like symptoms.
Consider grilling large slices of eggplant as
substitutes for steak or other grilled meats.
creamy sauces, but do go for healthy
versions of the toppings you like on
burgers (such as tomato, onion, and
mustard) or steaks (such as sautéed
mushrooms on a cauliflower steak).
Is it ever okay to eat red meat?
For generally healthy people, red meat
doesn’t have to be off the menu entirely,
“And it’s especially important to mini-
mize processed red meat like bacon,
hot dogs, and sausages, particularly
if you have or you’re at high risk for
diabetes, heart disease, cancer, or cog-
nitive decline,” Dr. Hu says. “With the
many steak and burger alternatives
available, hopefully, you’ll find other
meals to enjoy.”
memories. Other types of dementia
might not cause memory loss at all.
Myth #6: Dementia-like symptoms
are never reversible
Dr. Budson: Memory loss and other
problems with thinking aren’t always
caused by Alzheimer’s or another type
of dementia. Sometimes there’s another
cause, such as depression or another psy-
chiatric disorder, medication side effects,
alcohol or cannabis use, thyroid disease
or another medical disorder, or vitamin
deficiency. In many cases, treating the
condition may reverse the dementia-like
symptoms. So, if you’re having problems
with thinking and memory, see your
doctor to find out if the issues can be
treated and even eliminated.
November 2022 | Harvard Health Letter |7
 NEWS BRIEFS

Over-the-counter hearing aids are finally available

If you have difficulty hearing and you’ve been putting at a store or pharmacy. They are
off doing anything about it, this is a good time to take “self-fitting,” which means you’ll
action. In August 2022, the FDA finally approved a new adjust them yourself. But note:
category of safe, regulated hearing aids sold over the the devices are meant only for

© peakSTOCK | Getty Images

counter. You can get them without a prescription for
thousands of dollars less than traditional prescription
hearing aids (which can cost $5,000 or more per pair).
The move is meant to make hearing aids more widely
available to people who otherwise couldn’t afford them
or who can’t get to a doctor or an audiologist for a hear-
ing evaluation and fittings. Instead, you can simply
order over-the-counter hearing aids online or buy them
people with perceived mild-to-
moderate hearing loss who need to amplify the volume
of sounds around them. If you’re not sure how serious
your hearing loss is, it’s a good idea to get an evaluation
from an audiologist. And since getting the right fit and
effectiveness takes trial and error, you might also want
to consult an audiologist for advice on the right over-
the-counter hearing aids for you.

Drinking black tea linked to longevity

Break out the teacups: it may be time for a toast to
black tea, one of the most popular beverages in the
world. A large study published online Aug. 29, 2022, by
Annals of Internal Medicine found that drinking black
tea was associated with a longer life. Researchers eval-
uated the self-reported tea-drinking habits of about
half a million middle-aged people in the United King-
dom and followed them for more than 11 years. Most
of the participants (85%) said they regularly drank
tea, and 89% of the tea drinkers said they drank black
tea. Compared with people who didn’t drink black
tea, those who had two or more cups of black tea per
day had a 9% to 13% lower risk of premature death
from any cause, including lower rates of death from
cardiovascular disease or stroke. The results weren’t
affected if tea drinkers added milk or sugar to their
tea; if the tea was warm, hot, or very hot; if tea drink-
ers also drank coffee; or if tea drinkers were extremely
sensitive to caffeine.
The study was observational and therefore can’t
prove that drinking black tea caused people to live
longer, but we do know that black tea is rich in plant
chemicals (phytochemicals), especially theaflavins,
which are associated with health benefits.

Doing any aerobic activity regularly may help you live longer
Any kind of activity that gets your heart and lungs golf; or walking. Doing any of those activities for the
working is good for you. But does one type of exer- recommended amount of time each week was associ-

© Westend61 | Getty Images

cise help you live longer than another? Not really,
according to research published online Aug. 24,
2022, by JAMA Network Open. The observa-
tional study involved more than 272,000 adults
(average age 70) who answered questions about
their health and activity levels in 1995 and again
in 2005, and were followed for another 12 years.
Participants reported how much time they spent
jogging or running; cycling; swimming laps;
doing other aerobic exercise (such as taking an
aerobics class or using an exercise machine);
playing tennis, squash, or racquetball; playing
ated with a 13% lower risk for premature death from
any cause, compared with not exercising. Playing rac-
quet sports and running produced the greatest risk
reductions (16% and 15%), probably because they are
more demanding, say study authors. But since all of
the activities were linked to a longer life, the authors
say it’s most important to simply choose an exercise
you enjoy and can sustain over time. The Physical
Activity Guidelines for Americans recommends doing
2.5 to 5 hours per week of moderate-intensity activity
(like brisk walking), or 1.25 to 2.5 hours per week of
vigorous-intensity activity (like playing tennis).

Engage your heart and brain, even when sitting Brought to you by

What’s coming up: How to spot arthritis in your fingers

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8 | Harvard Health Letter | November 2022 www.health.harvard.edu