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FEBRUARY 2022 VOLUME 34 ISSUE 2

The Truth About What’s Good for You

The Truth About Home Medical Tests Some are reliable, some may not be

Page 6

How to Ease the Winter Blues Lifestyle steps, light therapy, and more Page 10

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Quick Ways to Make Chili Healthier Page 9

Going Low-Sodium?

Cut the Salt, Not the Flavor.

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Daily Aspirin Do’s and Don’ts Page 8

The Simple Trick to Improve Your Sleep Page 12

PLUS • Spice Safety News Page 2 • Try This to Reduce Pain Page 3 • Is Your Blood Pressure Monitor Accurate? Page 12

Consumer Reports in Action

How Safe Are Spices?

Editorial Director, Print Ellen Kunes Deputy Editor, Print Diane Umansky Content Development Team Leader, Health & Food Lauren F. Friedman Deputy Content Editor Trisha Calvo Senior Multimedia Content Creator, Health Kevin Loria Multimedia Content Creator, Health Catherine Roberts Contributing Writers Teresa Carr, Sari Harrar, Hallie Levine, Sharon Liao, Sally Wadyka Director, Food Policy Brian Ronholm Copy Editing Leslie Monthan, Copy Chief; Noreen Browne, Alison France, Wendy Greenfield Fact Checking & Research David Schipper, Associate Director; Tracy Anderman, Sarah Goralski, Christine Gordon, Karen Jacob, Jamison Pfeifer Design Director Mike Smith Associate Design Director Sheri Geller Art Director Tammy Morton Fernandez Photo Editor Emilie Harjes Photographers John Powers, John Walsh Imaging Specialists Frank Collado, Mark Linder Planning & Production Eric Norlander, Manager; Letitia Hughes, Terri Kazin Consumer Reports On Health is published by Consumer Reports, a nonprofit, independent organization providing information and advice on goods, services, health, and personal finance. CR’s income comes from the sale of its publications and from services, fees, and noncommercial contributions and grants. No CR publication accepts outside advertising or is beholden to any commercial interest.

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Consumer Reports On Health (ISSN 1058-0832) is published monthly

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CONSUMER REPORTS O N H E A LTH FEBRUARY 2022

What our testing revealed about 126 products Spices add flavor to food, but some also may contain potentially dangerous substances. That’s according to Consumer Reports’ tests of 15 types of dried herbs and spices—126 individual products from brands like Great Value (Walmart), La Flor, McCormick, Penzeys, Spice Islands, and Trader Joe’s. CR’s tests found that roughly onethird had enough arsenic, lead, and cadmium combined, on average, to pose a health concern for kids if regularly consumed in typical serving sizes. Most raised concern for adults, too.

For thyme and oregano, all the products tested had amounts of these so-called heavy meals that CR experts consider concerning. In 31 products, lead levels exceeded the maximum amount anyone should have in a day, our experts say.

One serving of any herb or spice

CR tested is unlikely to cause harm, says James E. Rogers, PhD, director of food safety and testing at CR. But for adults, long-term heavy metal exposure can contribute to hypertension and central nervous system and reproductive problems, and damage kidney and immune function. In kids, it can also hike risks of behavioral problems and lower IQ. Heavy metals can show up in foods if the water or soil they’re grown in contains them naturally or is contaminated through pesticides or industrial use, says Tunde Akinleye, a CR chemist who oversaw the testing. Heavy metals may also get into food during manufacturing.

To limit risk, choose and use spices carefully. For tips and a petition that urges the government to impose stricter limits on heavy metals in food, go to CR.org/spicesafety.

This Month’s Experts We contact health authorities and medical researchers from across the country. Here are some of the experts we consulted this month: George Abraham, MD, president, American College of Physicians.

David Avery, MD, professor emeritus of psychiatry and behavioral sciences, University of Washington School of Medicine, Seattle.

Paul Desan, MD, PhD, associate professor of psychiatry, Yale School of Medicine, New Haven, Conn.

Su-Nui Escobar, RDN, adjunct professor, Nova Southeastern University, Fort Lauderdale, Fla.

Jeffrey Kullgren, MD, associate professor of medicine, University of Michigan Medical School, Ann Arbor.

Carolyn F. Ross, PhD, professor of food science, Washington State University, Pullman.

Samia Mora, MD, cardiologist, Brigham and Women’s Hospital, Boston.

Anne Thorndike, MD, associate professor of medicine, Harvard Medical School, Boston.

Sterling Ransone, MD, president, American Academy of Family Physicians.

Norman Rosenthal, MD, clinical professor of psychiatry, Georgetown University School of Medicine, Washington, D.C.

Xiang-Dong Wang, MD, director of the Nutrition and Cancer Biology Lab, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston.

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President and CEO Marta L. Tellado

Health Wire Quick Tips for Living Well

Use Your Mind to Ease Pain

Too Much Processed Food The average adult in the U.S. gets 57 percent of their daily calories from industrially produced, ready-to-eat foods like frozen meals, according to a study of 40,937 people. That’s up from 53.5 percent in 2001-2002. Older adults went from eating the least ultra-processed foods to the most. To cut back, focus on whole foods like produce, whole grains, dairy, and lean meat, poultry, and seafood.

Source: American Journal of Clinical Nutrition, Oct. 14, 2021.

COVID-19 Vaccine News If you’re among the older adults who already had COVID-19 but aren’t vaccinated because you think you have natural immunity, be warned: Reinfection is possible. And a study from the Centers

for Disease Control and Prevention found that full vaccination is up to 20 times more effective at preventing hospitalization for COVID-19 than immunity conferred by prior infection.

Two-thirds of people with chronic lowback pain in a recent study were free (or nearly free) of discomfort after talk therapy, and most remained so a year later.

They received a kind of counseling called pain reprocessing therapy (PRT), which helps people change their beliefs about pain and their brain’s response to it.

Best Ways to Stop Gum Disease Three regular habits are most effective at preventing gum disease, according to a University of Buffalo review of studies. They are brushing properly, using an interdental brush or water pick to clean between your teeth, and swishing your mouth with a mouthwash containing chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), or essential oils (such as Listerine). Flossing didn’t seem to reduce risk, but it’s still important for removing food particles that can lead to tooth decay. And electric toothbrushes were found to be no more effective at removing plaque, which can cause gum disease, than regular brushes.

Source: Journal of the International Academy of Periodontology, October 2021.

Source: JAMA Psychiatry, Sept. 29, 2021.

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Source: CDC’s Morbidity and Mortality Weekly Report, Oct. 29, 2021.

Walk to Cut Cancer Risk

Do This With Knee Surgery

Getting just 5 hours a week of moderate activity like brisk walking could cut your risk of breast, kidney, and stomach cancer, among others, according to a new report. Exercise may prevent weight gain, control levels of hormones that can fuel cancer growth, and cut inflammation.

Want to reduce the likelihood that you’ll be taking risky opioid painkillers many months after knee-replacement surgery? Go to physical therapy before and after. A study of 67,322 people who had a total knee replacement found

Source: Medicine & Science in Sports & Exercise, Oct. 4, 2021.

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that those who got outpatient PT within 90 days of the procedure were 10 to 25 percent less likely to use opioids long-term. Starting PT within 30 days after surgery and having six or more sessions cut opioid use even more.

Source: JAMA Network Open, Oct. 27, 2021.

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Nutrition Know-How guidelines, it could have a significant impact on heart health, Thorndike says.

THE SALT EFFECT

SHAKE IT OFF

Easy Ways to Eat Less Sodium 8 small changes that have big benefits and keep your food flavorful

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ou probably already know that you should keep an eye on the sodium in your diet, especially if you have high blood pressure. But the health risks of getting too much of the salty stuff are back in the spotlight. The Food and Drug Administration recently issued guidelines encouraging manufacturers to scale back the amount of sodium they use in packaged and restaurant foods.

While this guidance is voluntary, its goal is to reduce the average sodium intake by about 12 percent—from the

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3,400 mg a day that people in the U.S. typically get to 3,000 mg—over the next 2½ years. While that’s still more than the recommended threshold of 2,300 mg, it’s a step in the right direction, says Anne Thorndike, MD, an associate professor of medicine at the Harvard Medical School and volunteer chair of the American Heart Association’s Nutrition Committee.

Much of the sodium that people take in—over 70 percent—comes from packaged and processed foods and restaurant meals. So if many companies follow these

CONSUMER REPORTS O N H E A LTH FEBRUARY 2022

That said, finding a balance between less salt and tasty food can be tricky. Salt has a unique taste that’s hard to mimic, says Carolyn F. Ross, PhD, a professor of food science at Washington State University.

What’s more, sodium is found in foods where you might not expect it, like cereal and bread. These expert tips can help.

Take a tally. “Write down how much sodium you’re getting from foods throughout the day,” Zumpano suggests. This allows you to spot the top culprits and choose where to cut back. You might decide, for instance, that you can’t sacrifice salting your eggs but you’re okay snacking on unsalted almonds (0 mg of sodium per ounce) instead of pretzels (about 350 mg of sodium per ounce) or opting for reducedsodium soy sauce.

Train your taste buds. According to the FDA, people typically don’t notice small reductions—about 10 percent—in sodium.

Sprinkle a little less salt onto every meal, and gradually lower that amount even more. Over time, your tastes and preferences can change, so you won’t need as much salt to feel satisfied, Ross says.

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Despite what you may have heard about sodium getting an unfair shake, a majority of evidence shows that cutting back protects your health. That’s because eating too much can increase blood volume, elevating blood pressure and forcing your heart to work harder, says Julia Zumpano, RD, with the Cleveland Clinic’s Center for Human Nutrition. That raises the risk for stroke and heart disease. In fact, a study published in 2014 from Tufts University in Boston showed that 1 in 10 cardiovascular-related deaths worldwide is due at least in part to a high-sodium diet. And according to a study of more than 10,000 people published in 2021 in the New England Journal of Medicine, every 1,000 mg sodium excreted in urine (which represents intake) boosts cardiovascular disease risk by 18 percent.

Upgrade your salt. Ounce glutamate (480 mg per teaspoon) came closest to for ounce, table, kosher, and passing for the real thing. sea salt have the about the same sodium count. But the Nutritional yeast imparted last two often have larger a cheesy taste. Liquid amicrystals that take up more nos worked as a replacevolume on a measuring ment for soy sauce (though spoon, so you wind up getit can have as much or more Worth Their Salt ting less sodium in recipes. sodium than less-sodium or Morton Lite Salt (50% Less Sodium) and Accent Another smart move: Use light soy sauce). Potassium (MSG) worked best as a saltshaker with smaller chloride left a bitter taste, salt substitutes in CR’s holes. That slows the flow and seaweed flakes added blind taste tests. so you’ll use less salt overa strong fishy flavor to food (think sushi). all, Ross says.

Swap in salt substitutes. These products Skip salt as you cook. Salt gets incoradd either saltiness or enough of a savory porated into the food, which means flavor called umami so you don’t miss you may not taste it that much in the the salt. In a 2021 New England Journal final product, Ross says. Instead, sprinkle it of Medicine study of almost 21,000 older on right before serving. When you add it at adults with hypertension or a history of the end, the crystals rest on top of the food. stroke, half used a substitute made from The salt hits your tongue, so you’re better 75 percent salt and 25 percent potassium able to taste it—and won’t need as much. chloride. After about five years, those who Perk up food with spices, herbs, and cooked and seasoned with the substitute aromatics. They add flavor and diseasewere 13 to 14 percent less likely to have fighting antioxidants with little sodium, a heart attack or stroke compared with Zumpano says. According to research those who used salt. But do these substi- published in 2015 in the American Journal tutes actually taste good? of Clinical Nutrition, people who cooked To find out, a Consumer Reports’ panel with herbs and spices significantly reof sensory experts did blind taste tests of duced their daily sodium intake. Experisix popular salt substitutes on eggs, rice, ment with garlic, onion, fresh and dried and popcorn. Light salt (which has about herbs, and seasoning blends. “In recipes, 1,160 mg sodium per teaspoon vs. 2,360 in a you can replace a half or full teaspoon of teaspoon of salt) and MSG, or monosodium salt with an herb blend,” Ross says. An

Good News About MSG Monosodium glutamate, or MSG, is a combination of sodium and glutamate, an amino acid (a building block of protein) found naturally in many foods, such as mushrooms, tomatoes, and Parmesan cheese. Glutamate adds umami to food. Called the fifth taste, umami is a complex, deep savory flavor that enhances salt perception.

MSG has about two-thirds less sodium than table salt.

But with restaurants and

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foods touting “MSG-free,” many people think that it’s unhealthy. The myth started with a 1968 anecdotal report in the New England Journal of Medicine that blamed MSG for symptoms like headaches, nausea, and more.

But “studies haven’t shown any consistent effects in people who say they’re sensitive, even when they consume foods with high levels of MSG,” says Taylor Wallace, PhD, CEO of the Think

acid, such as lemon juice or vinegar, can also brighten the flavor of a dish.

Spot hidden sodium sources. Manufacturers add sodium to food you might not expect it to be in to enhance flavors and textures, and act as a preservative.

“The sodium in processed and packaged foods can really add up throughout the day,” Thorndike says. A slice of bread, for instance, can have 240 mg, or about 10 percent of the daily recommended amount. Certain cereals deliver more than 300 mg in a serving, and pasta sauces contain upward of 500 mg per half-cup. When grocery shopping, check labels to see how much sodium an item is packing.

Decode claims. “Light in sodium” means a product has at least 50 percent less than its original or a competing one, while “reduced sodium” means it has at least 25 percent less. But even with the reduction, the sodium content can still be high, Zumpano says.

Better options: Low sodium (140 mg or less per serving), very low sodium (35 mg or less), sodium-free (less than 5 mg), and no salt added (no salt, but not necessarily a low-sodium food).

LEARN

Healthy Group, food science and nutrition consultants.

A research review commissioned by the Food and Drug Administration found that symptoms did occur in some sensitive people who were given 3,000 mg or more of MSG in one sitting without food. That’s more than people typically get in a meal seasoned with MSG— 500 mg or less, the FDA says.

A 2017 report from the European Food Safety Authority noted that symptoms rarely occur at intakes below 3,000

For more on our salt substitute tests, go to CR.org/saltsubs.

mg, and concluded that an acceptable daily intake is about 14 mg per pound of body weight (about 2,100 mg for a 150-pound person).

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Tests & Treatments

The Truth About Home Medical Tests Some might not be reliable. Here are the ones to use and the ones to avoid.

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and on the internet—many from companies like Everlywell, LetsGetChecked, and myLab Box. Some are straightforward, such as those for COVID-19, but others have squishier metrics, like “cell aging.”

No matter their goal, most of these products aren’t covered by insurance and the cost can range from less than $10 for strips to check urine for bacteria to $1,000-plus for certain genetic tests.

Some experts say the tests are convenient and their costs transparent. “In some ways this trend is positive because it can give patients more options on when and how to get care,” says Jeffrey Kullgren, MD, an associate professor in the department of internal medicine at the University of Michigan Medical School in Ann Arbor.

But the quality of these home tests can vary dramatically, and some may have confusing results, lead to unnecessary follow-up testing and treatments, and delay needed care, he adds.

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HOME TESTS TO TRY The Food and Drug Administration has authorized the marketing of 100 or so categories of home medical tests. Some have been reviewed by the FDA to make sure, for instance, that they can accurately and reliably measure what the manufacturer claims the test measures. Others may be exempt from review, in some cases because the agency considers them low-risk.

(To find the list of authorized tests, go to fda.gov, search for “in vitro diagnostics,” then click on Home Use Tests at left.)

Some companies tout their products as “FDA registered,” but that doesn’t mean the FDA has reviewed them.

The most useful home medical tests may be those that help people with chronic conditions such as diabetes, congestive heart failure, and high blood pressure monitor their health, says Sterling Ransone, MD, president of the American Academy of Family Physicians. Home

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t-home tests for detecting COVID19 have certainly been in the news recently. In late December, with the omicron variant of the coronavirus spreading quickly, the White House announced that the administration would buy 500 million rapid-result COVID-19 tests, and that, starting in January, Americans could have tests delivered to their home— at no cost. A few states and communities were already offering such tests for free.

The COVID-19 tests are only one of the many types of available home medical tests, where users generally collect a “sample”—typically blood, urine, saliva, or mucus—and get immediate results or send it to a lab the test manufacturer designates.

In the past, these over-the-counter products have been used to diagnose an illness or keep an eye on issues such as high blood glucose. In recent years, however, thousands of new tests of all types have begun showing up on store shelves

checks of measures like blood pressure can help people manage some conditions at home, saving them a trip to the doctor.

The FDA has also greenlit a handful of products for diagnosing issues such as urinary tract infections and vaginal yeast infections. And the Centers for Disease Control and Prevention now recommends that people consider using a rapid self-test for COVID-19 before joining gatherings with people outside their household.

If you have mild, straightforward symptoms, your doctor may be able to use home test results to treat you via phone or computer. “The combination of home testing and telemedicine has given us another way to take care of our patients,” Ransone says.

“I call it the house call of the 21st century.”

Also useful is an FDA-approved home test for HIV, key for people without access to a healthcare provider or who are concerned about privacy. And with your doctor’s okay, you can use a home fecal test to screen for colon cancer or a small blood sample to screen for hepatitis C.

BE WARY OF THESE Tests that the FDA hasn’t okayed can have several drawbacks, our experts say.

Lax regulation: The FDA generally doesn’t review what it considers “wellness” tests. These are used to measure criteria such as hormone levels, food sensitivities, general heart health, blood levels of vitamins, stress, and cell aging; they tend not to diagnose specific conditions.

In addition, the agency typically does not check “laboratory developed tests” (LDTs), which are developed and used by a single lab. But the FDA has been paying attention to LDTs and in a 2018 statement identified potential problems, such as claims not supported by evidence, erroneous results, and faked data.

Some home testing companies, like Everlywell, say on their website that their tests are LDTs. Unsure? If the FDA has reviewed a test, that fact is likely to be included in the company’s marketing materials, says Kathy Talkington, director of health programs for the nonprofit Pew Charitable Trusts.

Shaky evidence: Certain top-selling tests are purported to identify food sensitivities C R .O RG/ H E A LTH

by checking a user’s blood sample for IgG, an immune system antibody. But the American Academy of Allergy, Asthma, & Immunology advises against this because evidence linking IgG levels to food sensitivities and allergies is lacking. The FDA has also warned about home genetic tests that manufacturers claim will predict how your body would respond to antidepressants, heart drugs, and other medications.

Results with little use: Home tests for male, female, and thyroid hormones are plenty popular. But knowing your hormone levels doesn’t necessarily pinpoint why you feel, say, unusually tired. Numerous health issues, including anemia, depression, infections, and sleep apnea, can all cause fatigue, Kullgren says.

OTC genetic tests that screen for risk of Alzheimer’s disease, cancer, and other serious conditions are particularly concerning, says George Abraham, MD, president of the American College of Physicians. They can’t tell you whether you will develop a disease or give advice other than to follow existing health guidelines. “It just leads to unnecessary worry and anxiety,” he says.

KEEP YOUR DOC IN THE LOOP In general, our experts recommend consulting your doctor before using a home medical test. Some manufacturers make healthcare professionals available to recommend tests, counsel users, and even prescribe medications. But they can have a vested interest in the testing company they work for, Kullgren says. They also lack the full scope of information about you and your medical history. And factors such as your age and the medications you take can affect a home test’s results.

A doctor who is familiar with you is likely to have a fuller understanding of how to identify what’s amiss than a single home medical test can: “It’s like looking at a photograph,” Ransone says. “If you are just looking at one pixel, it’s hard to understand the whole picture.”

LEARN

For the lowdown on other types of medical tests, go to CR.org/medtests.

Before You Buy One …

1. Determine whether the

test is authorized to be marketed by the Food and Drug Administration. For tests you send out, check the label or description to make sure the lab is “CAP accredited” or “CLIA certified.” This means that the test meets quality standards and that the lab undergoes regular inspections.

2. Ask your doctor if home testing is the best way to get the information you want.

“There might be an alternative approach that could help you more effectively and quickly get to the bottom of what you are experiencing,” says Jeffrey Kullgren, MD. Plus, tests your doctor orders are typically covered by insurance; most you can buy yourself are not.

3. Check expiration dates and storage directions.

Some tests are sensitive to temperature and humidity.

4. Follow instructions.

Factors such as time of day, food and drink consumed, and supplements you take can affect results. Many test providers have tutorials or trained personnel to guide you.

5. Know that no test is perfect.

COVID-19 tests that provide immediate results are generally less sensitive than those you send to a lab, and home tests for a urinary tract infection can’t detect less common types of bacteria.

6. Talk with your healthcare provider about results and next steps.

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Healthcare Savvy

What to Know About Using Aspirin Now For some, a small daily dose may be a lifesaver.

But for others, it can cause serious side effects.

may see a small benefit to daily aspirin, and should make an individual decision on use along with their physician. The American Heart Association (AHA) and the American College of Cardiology (ACC) go further, saying people 40 to 70 at an increased risk of heart attack or stroke may want to consider a daily aspirin.

WHO SHOULD SKIP IT?

to a study published in the American Journal of Preventive Cardiology, based on a sample of about 50,000 people. It’s a slightly smaller share than a decade prior, and may be in part due to recent research that has suggested that for many people, the risks of a daily aspirin may actually outweigh the benefits.

The newer data is why the U.S. Preventive Services Task Force (USPSTF), a widely respected independent panel that develops recommendations on preventive healthcare, has proposed new guidelines that sharply limit who should partake.

It’s hard to know exactly what to do— especially because there are slightly different guidelines from different expert groups, and because this advice has changed over time. Here, we cut through the confusion and explain what you need to know about who should take a daily aspirin, and how to use it safely if it’s recommended for you.

WHO SHOULD TAKE IT? For people with established cardiovascular disease, especially those who have already had a heart attack or stroke, there’s strong evidence that taking a daily low-dose aspirin significantly lowers the risk of a second cardiovascular event. According to the proposed USPSTF guidelines, people 40 to 59 with a 10 percent or higher risk for a cardiovascular event 8

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HOW TO USE IT SAFELY “The best approach is to have a discussion with your healthcare provider about the potential risks and benefits of aspirin therapy for you specifically,” says Samia Mora, MD, a cardiologist at Brigham and Women’s Hospital in Boston.

Because the risk of bleeding rises with dosage, if aspirin is recommended for you based on your personal risk factors, take the lowest possible amount. “For most people, that’s an 81 mg ‘baby aspirin,’ ” Mora says. And if you experience any stomach pain, talk to your doctor.

You can also ask your doctor about a proton pump inhibitor (PPI). These help safeguard against gastrointestinal bleeding, but long-term use has been tied to an increased risk of hip fracture and bacterial infections, such as Clostridioides difficile and pneumonia.

LEARN

For more tips on keeping your heart healthy over time, see CR.org/healthyheart.

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spirin has long been Americans’ go-to pill to ward off cardiovascular disease. The popular overthe-counter pain reliever—first created

by Bayer 125 years ago—can indeed be a lifesaver, especially among those who have already been diagnosed with heart disease. But regular use may cause serious side effects, notably internal bleeding, which makes its benefits less clear for anyone who is not at a high risk for a heart attack or stroke.

In 2019, 28 percent of U.S. adults 40 and older who had not had heart disease, a heart attack, or a stroke were taking a daily aspirin to try to prevent it, according

People who are 60 and older—without established cardiovascular disease—who do not currently take a daily aspirin to prevent heart disease should not start now, according to the draft guidelines from the USPSTF. If they already take a daily aspirin, they should ask a doctor about how to proceed, because there may be serious risks to suddenly stopping.

That advice is more conservative than guidelines released by the AHA and ACC in 2019. Those groups advise against the daily use of aspirin to prevent a first heart attack or stroke in people older than 70, as well as in adults of any age who are at an increased risk of internal bleeding.

Food Sense

Is Chili Good for You? 5 ways to turn this classic comfort food into a highly nutritious dish

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hili just may be one of the world’s most userfriendly meals. It’s easy to make, it freezes well, and there are enough variations to please just about every palate.

And with a few tweaks, you can turn any bowl of chili into a nutritional superstar.

vegetables also increases the volume of food without significantly increasing the calories,” says Su-Nui Escobar, RDN, adjunct professor at Nova Southeastern University in Fort Lauderdale, Fla. Try adding cubed winter squash or sweet potatoes and topping it with chunks of raw avocado. Or sauté some diced cauliflower or mushrooms at the start of your recipe to sneak in extra veggies.

SPICE IT UP Chili’s namesake ingredient, the chili pepper, adds a flavorful kick and may offer some health benefits. Capsaicin— the component that gives chili peppers their heat—may have anti-inflammatory, anticancer, and blood glucose regulating effects.

RETHINK THE MEAT

ANTIOXIDANT BOOSTER

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Most recipes for chili include tomatoes—and there’s good reason to add them even if a recipe doesn’t.

Cooked tomatoes are among the best sources of the potent antioxidant lycopene, which has been linked to reduced risk of prostate, colorectal, and other cancers; type 2 diabetes; heart disease; and memory loss. “Cooking (and canning) releases the lycopene from the flesh of the tomato, and also changes the chemical shape of the lycopene,” says Xiang-Dong Wang, MD, director of the Nutrition and Cancer Biology Lab at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston. “Those changes make it easier for the body to absorb lycopene.”

BRING ON THE BEANS Including just 1 cup of beans in your recipe (in place of, or in addition to, meat) adds about 15 grams of protein and up to 15 grams of fiber, plus potassium, folate, and other nutrients. And according to C R .O RG/ H E A LTH

a review of 28 studies published in the journal Advances in Nutrition, daily bean consumption lowers heart disease and high blood pressure risk by about 10 percent compared with not eating beans.

PUMP UP THE VEGGIES No matter what kind of chili you’re making, pack it with plenty of vegetables to raise the fiber (and antioxidants). “Adding

Ground beef is probably the least healthy ingredient in a classic chili. If you can’t bear the thought of chili without it, opt for 90 percent lean beef instead of 70 percent lean.

“You’ll get a similar taste with a third less fat,” Escobar says. (Or try CR’s Healthy Meat Chili recipe, below.) Better yet, substitute a plant protein for at least half the meat in your chili recipe. Many veggies make surprisingly good stand-ins. Chopped portobello or shiitake mushrooms add a meaty texture. So can tofu, jackfruit, or even whole grains, such as bulgur wheat.

Whatever you choose, you’ll add extra fiber and other nutrients to your dish.

CR’s Healthy Meat Chili In a large, heavy pot, cook 1 lb. 90% lean ground beef with 1 minced garlic clove, 1 finely chopped onion, and 1 finely chopped green bell pepper on medium-high heat until meat is browned. Add a 16-oz. can of lowsodium kidney beans

(drained and rinsed) and a 28-oz. can of no-salt-added diced tomatoes. Stir in 2 to 4 Tbsp. chili powder, 1 Tbsp. apple cider vinegar, ¼ tsp. allspice, ¼ tsp. coriander, 1 tsp. cumin, and ½ tsp. salt. Bring to a boil,

cover, and reduce heat. Simmer, stirring frequently, for 45 minutes. Makes about 7 cups.

Nutrition information per cup: Calories 250, Fat 7 g, Saturated fat 2.5 g, Carbs 29 g, Fiber 7 g, Sugars 8 g (0 g added), Protein 19 g, Sodium 315 mg

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Medical Matters antidepressant such as sertraline (Zoloft or generic), or bupropion (Wellbutrin or generic), along with light therapy. Lighttherapy users should sit in front of a box that emits a very bright light (10,000 lux, the equivalent of sunlight on a midsummer day) before 8 a.m. each morning for at least 30 minutes during the winter months. “This can often fool your eyes and brain into thinking the sun is up,” Avery says, “and as a result it helps regulate serotonin and melatonin levels.”

Also consider cognitive behavioral therapy, which may reduce negative thoughts you may have about winter and help you change behavior that can worsen depression, like isolating at home, Desan says.

How to Ease the Winter Blues It may be more than the chilly weather. What to do about seasonal affective disorder.

too much, slowed movements or speech, fatigue, feelings of guilt or worthlessness, trouble concentrating or thinking, and thoughts of death or suicide. (Call your doctor or get other help right away in the case of the latter two.)

Typically, a doctor will diagnose SAD if you have five or more of those symptoms.

But many people may have “subsyndromal SAD.” “These are the people who find that they’re not completely disabled by winter, but they’re not at their best, either,” says Norman Rosenthal, MD, a clinical professor of psychiatry at the Georgetown University School of Medicine and author of “Winter Blues” (Guilford Press, 2012).

“For example, it’s hard for them to focus on work and get it done on time.”

THE BEST TREATMENTS The first-line therapy for SAD is usually a selective serotonin reuptake inhibitor, an

SPOTTING THE SIGNS SAD’s symptoms may be similar to those of other types of depression, says Paul Desan, MD, PhD, an associate professor of psychiatry at the Yale School of Medicine. They include feeling down most of the day, having little interest in activities you usually enjoy, a weight gain of about 5 percent within a month or so, sleeping 10

CONSUMER REPORTS O N H E A LTH FEBRUARY 2022

BEFORE YOU USE LIGHT THERAPY Light-therapy boxes are available over the counter. But “you don’t want to treat yourself without a doctor’s diagnosis, since some conditions that can mimic depression, like bipolar disorder, can actually be worsened by [these] treatments for SAD,” Avery says.

If your doctor agrees that light therapy is right for you (check with your eye doctor as well if you have retinal disease), make sure the box you choose produces at least 10,000 lux at what Desan calls “a reasonable distance” (more than 11 inches). That way, you can use it while going about activities like eating breakfast. A 2019 study of 24 light boxes, coauthored by Desan, found several that met the criteria, including the NorthStar 10,000, the SunRay II, the Day-Light Classic Plus, the Day-Light Sky, and Sun Touch Plus.

3 Lifestyle Steps That Help Whether you’re diagnosed with seasonal affective disorder or you simply feel a bit blue throughout the winter, a few lifestyle steps are important.

1. Go outside regularly.

This allows you to soak up more sunlight, says

Norman Rosenthal, MD. And that will help keep your internal clock and your mood in sync.

2. Get exercise, daily if you can. A study published in the journal Depression and Anxiety in 2020 found that about 45 minutes of daily physical activity

significantly reduced depression risks.

3. Connect with others.

Try to push yourself to be social, even if you don’t much feel like it.

“Anything that makes you feel good, like lunch with a friend, will help,” Rosenthal says.

PHOTO: GET T Y IMAGES

T

he days are short and cold, and as David Avery, MD, professor emeritus of psychiatry and behavioral sciences at the University of Washington School of Medicine notes, many of us are experiencing dips in mood.

This is often due to the effects of winter’s reduced hours of sunlight on our internal clock. Sunlight helps regulate serotonin (which helps set mood) and melatonin (key for a normal sleep-wake cycle). When these are thrown off, it can affect both mood and sleep, Avery says.

For about 5 percent of adults in the U.S., the disruption is significant enough to cause seasonal affective disorder (SAD).

This form of depression usually appears in late fall but tends to be most severe in January and February, according to the American Psychiatric Association. Older adults may experience SAD’s effects more intensely. With age, it’s harder for eyes to absorb blue light from the sun, which is important for regulating circadian rhythms, Avery says.

CR’s Expert Advice

The Healthier Way to Shop for Groceries Steps to reduce your risk of foodborne illness

F

rom the minute you walk into a supermarket and grab a cart that’s been touched by a lot of people to the end of your trip when you’re packing your bags, grocery shopping can present a few surprising health and food safety

MASK UP WHILE YOU SHOP With COVID-19 cases continuing to surge in various places across the country, it’s still wise to wear a mask in indoor spaces like grocery stores.

Make sure your mask forms a close seal around your nose and mouth. Layering a well-fitting cloth mask over a surgical mask is one good strategy to try.

risks. Fortunately, a little planning plus some simple steps can help prevent a surprise case of food poisoning. Here, CR’s chief scientific officer, James Dickerson, PhD, provides his science-based tips for shopping safely.

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CLEAN YOUR REUSABLE BAGS Replacing paper or plastic bags with totes can help you reduce the amount of trash you generate, but totes can become contaminated by bacteria or mold that builds up over time from the foods you place in them. To prevent this from happening, periodically wash your reusable bags. If they can’t be tossed in with a load of laundry, use soap and hot water and rinse thoroughly. Let them dry completely before using them again.

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KEEP PERISHABLE ITEMS COOL Bring at least one insulated shopping bag, plus cool packs, to use for your fresh meat and fish. This will allow you to keep them at a safe temperature until you can get them home and into your fridge.

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DISINFECT THE CART Use a disinfecting wipe to clean the handle and seat of the cart or other areas you might touch.

This helps get rid of any stray bacteria, such as E. coli, that might be clinging to the cart.

ILLUSTR ATION: CHRIS PHILPOT

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SHOP IN THE RIGHT ORDER Plan your route through the grocery store so that you’re shopping for your items in reverse order of how fast they’ll spoil.

First, visit the inner aisles C R .O RG/ H E A LTH

PROTECT AGAINST CONTAMINATION Juices can leak from packages of meat, poultry, and fish. When choosing from the case or taking them from the butcher or fishmonger, use an insideout produce bag to pick them up, then turn it rightside-out around the item. This adds a layer of protection between you and any contaminants on the package. Plus, it protects the other foods in your cart from crosscontamination, as well as the item from any germs that might be on your hands or in your shopping cart.

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HANDLE PRODUCE WITH CARE Before placing wet produce in a plastic bag, give it a little shake. In the store, the water helps keep produce fresh. But once it’s in a bag in your fridge, excess water can speed up spoilage. Try to store your produce in the top seat area of your cart, rather than in the cart’s main compartment, to help protect it from being jostled by other heavy items like boxes and cans.

The bruising from this can shorten the shelf life of produce.

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to pick up any dry goods you need—the things that have a shelf life of months or years. Next, hit the frozen food aisle.

After that, you can visit the fresh foods and produce sections. Finally,

save items like raw meat and fish, including cuts you get from the butcher or fishmonger counter, for your last stop.

That’s because those items are most sensitive to temperature.

JAMES DICKERSON, PhD, is Consumer Reports’ chief scientific officer.

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On Your Mind QUESTION OF THE MONTH

I like to read in bed. If I fall asleep with the light on, will I sleep less soundly?

Maybe. Unlike incandescents, today’s energy-efficient LED lightbulbs contain more intense blue light (the primary wavelength in smartphones, tablets, laptops, and TV screens).

Blue light can block melatonin, a sleep-promoting hormone.

LED bulbs don’t put out as much blue light as electronics (and we don’t stare directly at them for long periods), says Jakoah Brgoch, PhD, an associate professor of chemistry at the University of Houston. But in some studies, they have reduced melatonin levels. So in your bedroom, use LED bulbs whose packages say “warm” light or “low blue light.”

Water just doesn’t taste good to me. What can I do?

Punch up the flavor with a squeeze of lemon, lime, or orange, cucumber slices, or fruits like berries, suggests Angel Planells, MS, RDN, a spokesperson for the Academy of Nutrition and Dietetics. Or eat more water-rich food, such as yogurt and cottage cheese, juicy fruits like melons and strawberries, and vegetables like spinach, lettuce, celery, and cooked

Talk to Us have questions? We’ll answer those of general interest.

Write to CRH, 101 Truman Ave., Yonkers, NY 10703 or go to CR.org/crh to contact us by email.

squash. Older participants in one study got 30 percent of their daily fluids from foods like these.

How do I know if my home blood pressure monitor is right?

If you recently bought a home blood pressure monitor or have never had yours checked by a doctor, take it along to an upcoming medical appointment so that your primary care provider can compare

The information in Consumer Reports On Health should not substitute for professional or medical advice. Readers should always consult a physician or other professional for treatment and advice.

to purchase a back issue Send

the results with an in-office equipment reading, the American Heart Association recommends. After that, have it rechecked once a year. If the doctor finds that your monitor is not accurate, your best bet is to buy a new one. Choose a monitor with a cuff that fits your upper arm well and meets validation standards set by U.S. medical organizations. (Find a list at validatebp.org.) CR members can find blood pressure monitor ratings at CR.org/bpmon.

I’ve read that tai chi is relaxing.

Can I learn it at home?

Yes. Research suggests this slow, flowing exercise helps lower stress and may reduce fall risk, ease depression and pain, and improve heart health. You can learn some basic moves through DVDs and online videos for beginners. But it’s best to take an in-person or live online class where the instructor can see you and suggest adjustments, says certified tai chi instructor Bill Douglas, co-author of “The Complete Idiot’s Guide to T’ai Chi and QiGong Illustrated” (Alpha Books, 2012). Find certified instructors at americantaichi.org. If you are frail or have balance problems, check with your doctor first.

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CONSUMER REPORTS O N H E A LTH FEBRUARY 2022

How to Snack Smart Wise choices for your health.

Protect Your Hearing Now Strategies that really help.