Overall well-being among U.S. adults has declined substantially this year. The Gallup-Sharecare Well-Being Index score so far in 2017 is 61.5, down 0.6 points from 62.1 in 2016 and on par with the lower level recorded in 2014. This decline is both statistically significant and meaningfully large.

These data are drawn from more than 135,000 interviews with U.S. adults across all 50 states from Jan. 2-Sept. 30, 2017, and more than 176,000 interviews each year in 2014, 2015 and 2016.

The <a href="http://www.well-beingindex.com/about" target="_blank">Gallup-Sharecare Well-Being Index</a> is calculated on a scale of 0 to 100, where 0 represents the lowest possible well-being and 100 represents the highest possible well-being. The Well-Being Index consists of metrics drawn from each of the five essential elements of well-being:

<ul>
	<li>Purpose: liking what you do each day and being motivated to achieve your goals</li>
	<li>Social: having supportive relationships and love in your life</li>
	<li>Financial: managing your economic life to reduce stress and increase security</li>
	<li>Community: liking where you live, feeling safe and having pride in your community</li>
	<li>Physical: having good health and enough energy to get things done daily</li>
</ul>

Democrats&#39; Well-Being Drops Sharply; Republicans&#39; Unchanged 
Democrats have suffered a significant decline in overall well-being so far in 2017 compared with 2016. The 0.9-point drop in Democrats&#39; Well-Being Index score is at least triple the decline seen among Republicans and independents. Independents had a statistically significant decline of 0.3 points, while Republicans&#39; well-being is statistically unchanged. The decline among Democrats comes after a notable improvement in 2016, and their well-being is now below 2014 levels.

Women, Blacks, Hispanics, Low-Income See Large Drops 
The overall decline in well-being is concentrated among demographic groups that tend to align with the Democratic Party. Women have had a substantial 1.1-point drop in their Well-Being Index score, while the score for men is unchanged. Across the four major racial and ethnic groups, well-being has dropped the most among blacks and Hispanics, although it has also come down to a lesser degree among whites and Asians. Americans living in lower-income households saw a significant drop in well-being, while their higher-income counterparts saw a smaller decrease, no change or a slight increase.

Emotional Health, Social and Purpose Well-Being All Worsen 
The overall decline in well-being in 2017 is driven by dips in emotional health, social well-being and purpose well-being.

In terms of emotional health, the percentage of adults who report experiencing significant worry on any given day is up, as is the percentage who report having little interest or pleasure in doing things at least some of the time.

Social well-being shows similar declines. Fewer Americans agree that their friends and family provide them with positive energy every day and that someone in their life always encourages them to be healthy, while more disagree with the statement.

Purpose well-being indicators have also receded. Fewer agree and more disagree that there is a leader in their life who makes them enthusiastic about the future and that they like what they do each day.

All of these metrics were highly stable from 2014 through 2016, and in each case the negative movement so far in 2017 is highly statistically significant.

The remaining three elements, financial, physical and community well-being, have had much smaller changes thus far in 2017. Community well-being is unchanged, while financial and physical well-being are both down slightly.

Implications 
After rising in 2016, the Gallup-Sharecare Well-Being Index score has reversed course this year. This drop comes even as key economic metrics closely related to well-being have improved, including <a href="http://news.gallup.com/poll/189068/bls-unemployment-seasonally-adjusted.aspx.aspx" target="_blank">unemployment</a>, perceptions of <a href="http://news.gallup.com/poll/218981/americans-ratings-standard-living-best-decade.aspx?g_source=&amp;g_medium=&amp;g_campaign=tiles" target="_blank">standard of living</a>,&nbsp;<a href="http://news.gallup.com/poll/125735/economic-confidence-index.aspx" target="_blank">confidence in the economy</a> and <a href="http://news.gallup.com/poll/221060/americans-best-holiday-shopping-mood-years.aspx" target="_blank">optimism about spending</a>.

Other signs of worsening well-being in the U.S. include an <a href="http://news.gallup.com/topic/category_wellbeing.aspx" target="_blank">uptick in the uninsured rate</a> for three quarters in a row and reports of elevated <a href="http://news.gallup.com/poll/204590/daily-worry-sharply-presidential-election.aspx?g_source=&amp;g_medium=&amp;g_campaign=tiles" target="_blank">daily worry</a>, particularly among <a href="http://news.gallup.com/opinion/polling-matters/215657/hispanics-emotional-during-trump-era.aspx" target="_blank">Spanish-speaking Hispanics.</a>

This drop in well-being is important for leaders to monitor and address because research shows the Well-Being Index predicts <a href="http://info.healthways.com/hubfs/Science_and_Research/Well-being-5_Science_Paper.pdf" target="_blank">key health, business and social outcomes</a>.

Read more about the decline in social well-being this past year on the new website, <a href="https://quartzy.qz.com/1121777" target="_blank">Quartzy</a>.

Survey Methods 
Results are based on 135,426 telephone interviews with U.S. adults across all 50 states and the District of Columbia, conducted from Jan. 2-Sept. 30, 2017. In 2016, 2015, and 2014, a total of 177,192, 177,281 and 176,702 interviews, respectively, were conducted from Jan. 2-Dec. 30 of each year. Gallup conducts 500 telephone interviews daily, resulting in a sample that projects to an estimated 95% of all U.S. adults.

The Well-Being Index margin of sampling error for the reported groups will range from about &plusmn;0.2 points for the U.S. and for whites to about &plusmn;0.3 points for blacks and Hispanics to about &plusmn;0.6 points for Asians. The margin of error for demographic groups will be no larger than &plusmn;0.3 points. All reported margins of sampling error include computed design effects due to weighting.

Each daily sample of national adults for data collected between Jan. 2, 2014 and Sept. 1, 2015, comprised 50% cellphone respondents and 50% landline respondents. Each daily sample from Sept. 1, 2015-Dec. 30, 2016, comprised 60% cellphone respondents and 40% landline respondents. Daily samples in 2017 comprise 70% cellphone respondents and 30% landline respondents. Additional minimum quotas by time zone and within region are included in the sampling approach.

Learn more about how the <a href="http://www.gallup.com/209189/gallup-sharecare-index-work.aspx" target="_blank">Gallup-Sharecare Well-Being Index</a> works.

This content originally appeared on <a href="http://news.gallup.com/poll/221588/americans-declines-2017.aspx" target="_blank">Gallup.com</a>.

News: Americans' Well-Being Declines in 2017

A funny thing happened on Dr. Mike&rsquo;s way home from watching a last-second playoff victory by the Cleveland Cavaliers over the Chicago Bulls; he thought about eating a Cinnabon (didn&rsquo;t, wouldn&rsquo;t ever, but&hellip;). True Cleveland fans know that rooting for the Cavs usually elicits a heightened stress response.

Then, two days later, he noticed how exhausted he was from the stress of watching the game and yet how much he was looking forward to the next one. That made him realize how important it is to stay healthy (he exercises three days a week, walks 10K a day and eats well) if he were to keep going to these stressful games! And that made him wonder if we could come up with a similarly immersive experience that creates enthusiastic participants for Team Wellness&mdash;participants who would come back season after season for more physical activity and good nutrition, participants who would then be able to manage the stress that emotional attachments cause without resorting to the consolation of a sugary, fatty treat.&nbsp;

So we&rsquo;re asking you to join Team Wellness. You only need to play by five rules.

<ol>
	<li>Ditch: all trans and most sat fat, any added sugar or syrup and any grain that isn&rsquo;t 100% whole.</li>
	<li>Walk 10,000 steps a day.</li>
	<li><a href="https://www.sharecare.com/health/healthy-sleeping" target="_blank">Sleep</a> 7-8 hours nightly and meditate daily.</li>
	<li>Avoid toxins like tobacco and BPAs (wash your hands after touching receipts).</li>
	<li>Share laughter and love with friends and intimate partners.</li>
	<li>The rewards? A healthier, happier and longer life. That&rsquo;s the ticket!</li>
</ol>

Medically reviewed in March 2019.

Are You A Fan of Team Wellness?

Q: My eight-year-old daughter and I got our flu shots and then got sick anyway. I think next year we&rsquo;ll skip it. What&rsquo;s the use? 
&mdash; Carolina B., New York, NY

A: It&rsquo;s not fair to blame the flu vaccine. There are several viruses out there that are not influenza: respiratory syncytial virus (or RSV), rhinovirus, croup and the common cold. You may have had one of those common infections and your flu vaccine may be protecting you and your daughter even now. Plus, it has many remarkable benefits&mdash;including, but not limited to, preventing the flu or lessening its impact.

For example, a recent Danish study found that kids who experience a bad enough infection to require hospitalization are at an 83 percent higher risk of developing a mental disorder and a 42 percent higher risk of using psychotropic medications. The flu qualifies as one of those potentially hospital-serious infections. You want to help your child dodge those risks for sure! And we wonder&hellip; could that be related to another study from the UK that identified a rise in anxiety among British children, where many kids don&rsquo;t receive flu vaccines?

Adults are also at risk if they skip the shot&mdash;and a survey shows over half of all adults are not currently vaccinated against the flu, and four in ten don&rsquo;t intend to get vaccinated. That&rsquo;s a shame. A 2013 study of randomized clinical trials published in JAMA showed that &ldquo;influenza vaccine was associated with a lower risk of major adverse cardiovascular events&hellip; The greatest treatment effect was seen among the highest-risk patients with more active coronary disease.&rdquo;

So, young and old, remember the saying: &ldquo;For want of a horseshoe nail, the kingdom was lost.&rdquo; It means if you ignore first steps, one thing leads to another, until the end result is not what you want. The same thing can be said about skipping your flu shot. It&rsquo;s not too late to get yours.

Q: My dad has a rifle, a shotgun and a few pistols. He&rsquo;s 82 and was a competitive marksman back in the day. But I just heard about a healthcare worker who was shot by an 80-year-old in her care. She&rsquo;d been with him five days a week for several months. Should I ask him if I can have his guns?&nbsp; 
&mdash; Jack K., Seattle, WA

A: As our population grows older, the problem that comes along with the combination of dementia and guns needs attention. Forty-five percent of people 65 and older have guns in their household, according to a 2017 Pew Research Center survey, while nine percent of Americans 65 and older are diagnosed with <a href="https://www.sharecare.com/health/dementia/article/what-need-know-about-dementia">dementia</a>&mdash;and many others suffer from reduced cognition and mobility issues. The combination has become such a problem that a non-profit Alzheimer&rsquo;s volunteer group in San Diego has decided not to send volunteers into homes with weapons after discovering that 25 to 30 percent of the households their &ldquo;helpers&rdquo; visited had guns.

Security is one of biggest reasons why people own guns. But when older people start to experience cognition and other physical challenges, imagined threats can seem all too real. Remember the episode on The Sopranos in which Junior (Dominic Chianese) walks into the kitchen and shoots his nephew Tony (James Gandolfini) while he&rsquo;s making pasta, thinking he&rsquo;s an intruder?

An article published in the Annals of Internal Medicine voiced doctors&rsquo; concerns about the risk of suicide by gun owners with dementia. According to the CDC, the suicide rate in the US is highest among those 65 and older, and firearms are the most common method.

AARP suggests families draw up an advance directive (sort of a healthcare proxy) for a firearm retirement date. Another suggestion is to put any ammunition under (your) lock and key. So, now that you&rsquo;re armed with this information, sit down with your dad and have a frank discussion about his guns.

Ask Oz and Roizen: Why You Need a Flu Shot and the Dangers of Gun Ownership With Dementia

Ready for an intensive, all-encompassing process to change your life?&nbsp;

Yeah, me neither. Kind of tough to fit in, between prepping the presentation for your boss, last-minute runs to Costco and making goodies for the bake sale you somehow signed up to chair. Besides, can I remind you that you&rsquo;re already pretty awesome? Don&rsquo;t go&nbsp;changin&rsquo; that much.&nbsp;

But, we all have improvements that we&rsquo;d like to make&ndash;-and what if I said that you could still get the impact, in barely more time than it takes to shimmy into your Spanx? Research shows that even 10 minutes a day can have a surprisingly significant effect.&nbsp;

Let&rsquo;s face it&mdash;none of us have time to waste&mdash;so here are a few of my favorite powerhouse activities.&nbsp;

Move it. If you only have 10 minutes, exercise is one of the best activities for you physically, mentally and emotionally.&nbsp;<a href="https://www.sharecare.com/health/benefits-regular-exercise/article/how-two-minutes-of-walking-can-save-your-life">Walk</a>. Run. Dance. Stomp. In one study published in the International Journal of Obesity and Related Metabolic Disorders participants who were asked to exercise in 10-minute spurts two to four times a day, five days a week, stuck to the program and exercised more than those who were asked to exercise in single 20- to&nbsp;40-minute chunks over the same time period. I&rsquo;d love you to get&nbsp;20 to 30 minutes total, but if you&rsquo;ll start with a 10-minute workout, you&rsquo;ll notice a difference.  &nbsp;

10 minutes of meditation or mindfulness. Studies show that regular&nbsp;<a href="https://www.sharecare.com/health/meditation/article/starting-a-meditation-practice">meditation or mindfulness exercises</a> cannot only improve heart health,&nbsp;they&nbsp;cut down on mind wandering (such as obsessing over that catty remark from a coworker or how you could have handled a challenge better), and lowers levels of depression and anxiety. One study published in Psychological Science found the effect of improved focus in as little as two weeks of mindfulness practice.&nbsp;

Play. Adults don&rsquo;t get recess anymore. (We don&rsquo;t get naptime either, which is something I&rsquo;d like to address with management at a later point.) Whether with your children, your dog or your best friends, let out your inner child. Host game night. Take a friend to one of those indoor trampoline gyms. When you&rsquo;re at brunch, put the orange peel across your teeth and smile at a stranger. Let out your inner 12-year-old.&nbsp;

Prepare meals with the freshest, brightest fruits and veggies. You get home, you&rsquo;re exhausted, and you reach for whatever leftovers are in the fridge, right? Take 10 extra minutes to saut&eacute; that fresh asparagus or chop up the papaya and squeeze on a little lime. Taking a few minutes to&nbsp;<a href="https://www.sharecare.com/health/healthy-foods-cooking/slideshow/autumn-inspired-upgrade-morning-oatmeal">spruce up your meal</a>&nbsp;not only makes it healthier with fewer calories and higher antioxidants, it will make your veggie a little more appealing at the same time.&nbsp;

Two times a day, stop interacting and start connecting. You take your groceries from the clerk. You swipe your ID card for the security guard at work. Those are transactions. But what if you took two minutes to say hello, ask how they&rsquo;re doing and learn about them? In Talk to Strangers, author David&nbsp;Topus&nbsp;writes that replacing an &ldquo;efficient&rdquo; transaction with a true connection will not only improve your mindset and day, but the other person&rsquo;s as well.   
A successful journey needn&#39;t start with huge sweeping changes. It&rsquo;s the small, daily decisions that accumulate and forge our lives.

How 10 Minutes Can Change Your Life

We know that carrying some extra weight can increase the risks of conditions like heart disease, high cholesterol, elevated blood pressure, diabetes, stroke and even death. But is being slightly overweight really so unhealthy? The answer might surprise you.

Excess weight and a laundry list of health concerns are not always synonymous. But, don&rsquo;t be so quick to ward off a healthy diet and exercise&mdash;this subgroup of overweight people, dubbed the metabolically healthy obese, fit some very specific criteria.

Defining the risks 
Body mass index: An individual&rsquo;s risks for these conditions don&rsquo;t depend solely on the numbers that appear on the scale, nor on any other single measure, like body mass index.&nbsp;

Body mass index (BMI) is a measure used to determine body fat based on a person&rsquo;s height and weight, and is typically used to assess the risks your weight has on your health, but even that is an imperfect measure.

&ldquo;I use risk to define everything,&rdquo; Neil McDevitt, MD, a bariatric surgeon with <a href="https://www.sharecare.com/group/summerville-medical-center">Summerville Medical Center</a> says. &ldquo;There&#39;s a lot of social issues that go into what people feel comfortable with, so we use a BMI chart to give us an overall gestalt of what your general risk is, based on your weight,&rdquo; he adds.

By definition, overweight and obese people have a BMI greater than 25 or 30, respectively, but, &ldquo;there&#39;s a weakness inherent in BMI charts,&rdquo; McDevitt says. &ldquo;It doesn&#39;t take into consideration muscle mass.&rdquo;

That&rsquo;s not all. The healthiest BMI for longevity might not fall within the normal range (18.5 to 25), although the jury is still out on the optimal BMI for lowest mortality. In fact, one study suggests the &ldquo;sweet spot&rdquo; for longevity is a BMI of 27, which you&rsquo;ll find right in the middle of the overweight range. Other studies, still, suggest the lowest rates of mortality are among those with a BMI between 20 and 24. &nbsp; &nbsp;

Waist-to-hip ratio: Concerns over weight may not be directly related to how much fat a person is carrying, but where on the body they&rsquo;re carrying it. One major risk factor of metabolic syndrome is a large midsection, often described as <a href="https://www.sharecare.com/health/live-to-one-hundred/article/what-your-body-shape-says-about-longevity">an &ldquo;apple-shaped&rdquo; figure</a>.

In fact, a new study suggests those with a normal BMI who tend to carry weight around their middle have an elevated risk of death from any cause compared to people who are overweight or obese, and carry weight elsewhere.

&ldquo;We look at something called the waist-to-h ratio,&rdquo; McDevitt says. &ldquo;The World Health Organization says that abdominal obesity is significantly more of a risk factor than obesity of the periphery of the body.&rdquo;

The measure used to determine fat distribution is known as waist-to-hip ratio&mdash;a comparison between the smallest part of the waist and largest part of the hip. A ratio of one or greater for men and .8 or greater for women, is considered an apple shape, and thus carries a greater potential for obesity-related health risks and death. &nbsp;&nbsp;

In combination with BMI, waist circumference gives a good picture a person&rsquo;s risk of obesity-related mortality&mdash;even if you fall within a healthy BMI range.

Other factors: Exercise tolerance and genetics play a role in determining the risks of your weight on your health, as well. &ldquo;There&#39;s a huge difference between somebody who has a higher BMI, who is only able to walk one thousand steps a day, versus somebody who is capable of walking nine or ten thousand steps a day,&rdquo; McDevitt says.

Good genes can very well bless an overweight individual with normal cholesterol and blood pressure levels, thereby relieving some pressure to shed the pounds.

Extra pounds may be OK 
&ldquo;What I look at is sustainability&mdash;if somebody has a BMI of 27 or 28, but they&rsquo;re healthy, making good food choices, exercising and they&rsquo;re able to maintain that BMI, then I don&rsquo;t really foresee an issue,&rdquo; McDevitt says. &ldquo;Why should we push them any harder, unless they want to be a lighter weight?&rdquo;

The bottom line? A BMI that is indicative of being overweight or obese doesn&rsquo;t innately make in individual unhealthy. &ldquo;So, it is very possible, and very acceptable, to be overweight and still be healthy,&rdquo; McDevitt says.

Before you run to the pantry, keep in mind, metabolically healthy obesity isn&rsquo;t common&mdash;about one in every seven people&mdash;and it might not last forever. Age, lack of exercise and other factors can turn that excess weight into a dangerous health concern.

One study with a 10-year follow up period found that men who started out metabolically healthy and obese were three times more likely to develop heart disease than metabolically healthy men of a normal weight. The risk doubled&nbsp;for metabolically healthy obese women when compared to healthy, normal-weight women.

Results from another study of more than 3.5 million men and women suggest a similar outcome. Obese individuals who began the study free of obesity-related conditions like diabetes, high blood pressure and high cholesterol were at a higher risk of developing heart disease, stroke and heart failure than normal weight people without these initial complications.

When compared with healthy normal weight people, obese, but otherwise healthy individuals, were 49 percent more likely to develop heart disease, at a 7 percent higher risk of stroke and at a 96 percent increased risk of heart failure, after an average of 5 years and 4 months.

Although extra baggage is OK for some, excess weight is a problem for many&mdash;two out of three Americans are considered <a href="https://www.sharecare.com/health/obesity-overweight-condition/article/whats-the-latest-obesity">overweight or obese</a>, and many of them are unhealthy.

What if your weight is an issue? 
There are certainly some people whose bodies aren&rsquo;t built to handle excess weight. In these cases, they may develop metabolic syndrome&mdash;a group of risk factors that up your chance of developing issues like heart disease and diabetes.

Excess weight can also take a toll on your knee and hip joints, your ability to sleep and has been linked to respiratory issues and even some cancers. Don&rsquo;t sweat (or do)&mdash;many of these conditions can be managed with weight loss. In the simplest terms, losing weight is a matter of burning more calories than you consume. &nbsp; &nbsp;

The only sure fire way to assess these risks is to visit your doctor. Work with your healthcare provider to create a diet and exercise regimen that works with your lifestyle. &ldquo;Adjust your lifestyle, so that you don&#39;t have to work harder,&rdquo; McDevitt says. &ldquo;If you make better food choices consistently, you don&#39;t necessarily have to make up for it at the gym.&rdquo;

Can You Be Overweight and Healthy?

Q: My grandmother recently suffered a &ldquo;minor&rdquo; heart attack followed with a stent placement. She&rsquo;s scared about a recommended cardio rehab program. What can I say to get her to go? &mdash;Laura G., NY, NY

A: Recovering from a <a href="https://www.sharecare.com/health/circulatory-system-health/article/heart-attack-cardiac-arrest-heart-failure">heart attack</a> can be challenging, not just physically but emotionally. Cardio rehab helps with both aspects. Unfortunately, only about two-thirds of diagnosis-appropriate patients are referred to cardio rehab and only about a quarter of those folks enroll in a rehab program. Even at the Cleveland Clinic where everyone with an appropriate diagnosis is approached separately by a doc and a nurse, only about 22 percent of patients join rehab. This is despite the fact that the program is almost totally covered by every insurance company, Medicare and Medicaid. Clearly, patients need to better understand the enormous benefits.

Explain to your mom that cardio rehab is a wide-ranging wellness program that promotes good health and a good mental attitude by offering everything from exercise to nutritional advice, emotional counseling and stress reduction. It&rsquo;s individualized and can include help with other lifestyle changes (<a href="https://www.sharecare.com/health/quit-smoking/slideshow/how-quit-smoking-once-all">smoking cessation</a>?) she wants to make. Here&rsquo;s what she can expect.

Evaluation: Her program will start with a face-to-face evaluation with the professionals at her rehab center. An accompanying friend or family member would be welcome here. After that, she&rsquo;ll probably have a stress test during which her heart rate and her blood pressure will be monitored. Then, they&rsquo;ll review her medications and she and the cardio-rehab team will decide on the next steps.

Her Program: She will set up a schedule for attending lectures/discussions about healthy eating, classes in meditation or chair yoga, and workouts on exercise machines. There are also intensive cardiac rehab programs, which increase frequency and incorporate programs such as Ornish or Pritikin. They reduce the incidence of recurrence and restore a more active and normal lifestyle.

We hope you can convince your grandmother to go. We&rsquo;ve seen so many people benefit from these programs&mdash;they restore physical and emotional self-confidence along with physical strength.

Q: I tell my 16-year-old son that he&rsquo;s missing out on a lot by spending too much time on his computer and phone. What else can I say to get him to get out more? &mdash;Karin B., Tulsa, OK

A: How about making him aware of the threat to his eyesight that <a href="https://www.sharecare.com/health/kids-teens-health/article/how-screen-time-too-much-kids">screen time</a> poses? We remember when moms would tell kids, &ldquo;Get out of the house and don&rsquo;t come back until dinner!&rdquo; Yes, times have changed, but past generations of kids who played outside more frequently didn&rsquo;t end up nearsighted as often.

Recent studies have shown that adolescents and teens who are glued to their computer screens and phones don&rsquo;t use their long-range sight and end up developing myopia (nearsightedness). One BBC report claims that 90 percent of young people in China are currently myopic. In Seoul, South Korea, it&rsquo;s estimated that more than 95 percent of kids need glasses for distance. One study estimates that by 2050, 4.8 billion people worldwide will be affected by nearsightedness, which is 2.4 billion more than in 2010.

Theory #1: Lack of long-range focus 
Getting children outside and away from their devices changes how they use their eye muscles and how the lens in the eye focuses on objects. Whether looking down the soccer field or down the street, gazing into the distance lets eyes move from near to far and focus more easily and accurately.

Theory #2: Lack of Sunshine 
Several studies over the past seven or eight years have shown that kids who spend more time outside are less likely to develop nearsightedness both as adolescents and by the time they reach age 65. One study in China found that 40 more minutes of recess daily reduced myopia rates by 23 percent.

So tell your son it&rsquo;s shortsighted to make yourself nearsighted when there&rsquo;s so much fun to be had doing sports, hiking, walking and <a href="https://www.sharecare.com/health/healthy-habits/slideshow/nature-keeps-you-healthy">enjoying nature</a>.

Ask Oz and Roizen: Cardio Rehabilitation and Risks of Screen Time

Have you ever suspected that actual sunlight could make you physically lighter? Your body clock responds to the daily light cycle of dawn, daylight, dusk and dark. It influences your metabolism, your hormone secretion, your brain waves, and your mood, including your interest in sex.

<a href="https://www.sharecare.com/health/vitamin-d/what-are-health-benefits-sunlight" target="_blank">Related: The Health Benefits of Sunlight</a>

Now, it seems, if you&rsquo;re regularly exposed to 20-30 minutes of sunlight between 8am and noon, your BMI will be lower than someone who misses those early rays -- even if all other variables are the same. The effects are due to light&rsquo;s influence on your <a href="https://www.sharecare.com/health/endocrine-system/which-hormones-affect-my-appetite" target="_blank">appetite control hormones</a>, your glucose control systems, or something we don&rsquo;t know about yet. But here&rsquo;s how decipher the quality of your light exposure:

You need exposure to light that&rsquo;s rated at 500 Lux. A cloudy day serves up more than 1,000, while direct sunlight delivers around 32,000 to 100,000 (so don&rsquo;t over do it!). A bright office only serves up around 400 Lux. Moonlight? 1 Lux. A moonless night away from city lights --you&rsquo;re out of Lux.

So take time in the early morning to go outside for 20 minutes; then take a midmorning break and head into the light for another 10 minutes or more. If you&rsquo;re also exercising in the gym or getting your 10,000 steps a day at the mall, you&rsquo;ll get double benefits -- and soon feel very en-lightened!

<a href="https://www.sharecare.com/health/types-exercise/what-benefits-exercising-morning" target="_blank">Related: The Benefits of Morning Exercise</a>

Medically reviewed in May 2019.

Early Burst of Sun Can Boost Your Whole Day

NBA locker rooms are dripping with more than sweaty jerseys these days. Water-fanatics like the Sixers&rsquo; T.J. McConnell (he and his teammates favor Ph-adjusted alkaline water), Golden State&rsquo;s Steph Curry (filtered water) and LeBron James (he masks his bottled water&rsquo;s label) have embraced the health benefits of plain water over sports drinks. That&rsquo;s a good practice each of you could follow to improve your digestion and muscle function as well as your skin, heart and brain health.

According to the American Academy of Family Physicians, some folks need fewer than eight glasses of water daily, some more. You should always drink when thirsty (more often while exercising or in extreme weather). You can tell if you&rsquo;re hydrated by the color of your urine&mdash;pale yellow or colorless means you are doing well.

But all your hydration should not only come from water&mdash;you can rely on <a href="https://www.sharecare.com/health/diet-nutrition/slideshow/foods-help-stay-hydrated">water-soaked fruits and veggies</a> for around 20 percent of your daily dose:

<ul>
	<li>Cucumbers&mdash;97.9 percent water</li>
	<li>Grapefruit&mdash;91.5 percent water</li>
	<li>Celery&mdash;95.4 percent water</li>
	<li>Strawberries&mdash;90.9 percent water</li>
	<li>Summer squash&mdash;96 percent water</li>
	<li>Watermelon&mdash;91.4 percent water</li>
	<li>Tomatoes&mdash;95.2 percent water</li>
	<li>Casaba&mdash;91.8 percent water</li>
	<li>Rhubarb&mdash;93.6 percent water</li>
	<li>Lettuce&mdash;95.6 percent water</li>
</ul>

These water-soaked fruits and veggies provide moisture to lubricate your system, fiber to improve your digestion and phytonutrients that allow well-hydrated muscles to become more energetic and powerful. Your brain needs them to receive oxygen and their nutrients keep you clear-thinking. So drink in all the <a href="https://www.sharecare.com/health/wellness-healthy-living/slideshow/ways-drink-more-water">benefits of staying hydrated</a> with water and water-enriched food.

Medically reviewed in January 2020.

Eat Your Water: How to Stay Effectively Hydrated

If you&#39;re looking for a healthy place to take a vacation, consider heading for the hills.

People who live in mountainous regions appear to have lower mortality rates than people living in low-lying areas, a study determined. Researchers believe this may be due to the physical demands of <a href="https://www.sharecare.com/health/running/why-should-i-run-hills">walking on hilly terrain</a> with less oxygen. If you live in the lowlands, make your power hikes high-altitude workouts by heading for local hills.

A study of roughly 1,200 men and women who lived in either lowland or mountainous regions revealed that mountain dwellers experienced lower total and coronary mortality than people who lived closer to sea level. Researchers speculate that mountain dwelling may boost heart health because it requires people to walk on uneven, hilly terrain in high-altitude, low-oxygen conditions. Working out at a higher altitude where there&#39;s less oxygen forces your heart and lungs to work harder, strengthening them more than if you were exercising closer to sea level. If you live in the mountains or regularly exercise at high altitude, you also may increase your number of red blood cells and use oxygen more efficiently. However, if you are working out for the first time or have a medical condition, the strain of high-altitude hikes may be too much. Consult your healthcare provider first.

Head for the Hills

It was about eight years ago. I was 33 years old, with a BMI considered <a href="https://www.sharecare.com/health/body-mass-index-bmi/what-body-mass-index-reading">clinically obese</a> and a family history of diabetes and heart disease. I knew I was at risk. I was sedentary, I ate poorly and I was depressed with very low energy. I felt awful.

To add to the mix, my girlfriend (now my loving wife), diagnosed with brain cancer, was undergoing chemo and radiation. She had a life expectancy of three years. She really needed me to be strong for her. I knew it. And at some point the question arose in my mind&hellip;

How can I possibly take care of her if I&rsquo;m not well.

I started with a simple piece of advice from a good and healthy friend: Start by doing things you like to do and modifying things you like to eat.

So, what were my passions? Well, I knew I Ioved trail running. And hiking. And mountain biking. I started with short walks and slower rides and worked up doing more each week. As I began to get stronger, I enjoyed these things even more. Eventually I added&nbsp;bodyweight workouts,&nbsp;doing push-ups, lunges and pull-ups for more strength.

Once I started exercising more, I realized I had to eat better or I couldn&rsquo;t get through my workouts without feeling lightheaded and nauseated. I found that when I&nbsp;ate well, my workouts were better and I&nbsp;felt much better. This sparked a strong interest in nutrition. I discovered what different foods really cost in terms of calories &ndash; that I could take in half the&nbsp;<a href="https://www.sharecare.com/health/calories/calories-need-per-day">calories I need in a day</a>&nbsp;with just a few slices of pepperoni pizza, without even thinking about it. That enjoying a bowl of ice cream after the pizza was pushing me to almost 75 percent of my actual need for that day. Wow.

Something had to change.

I changed my diet and just started feeling better. More energized. Less lethargic, less likely to crash. As I read about what good nutrition really is, I ate less junk food,&nbsp;<a href="https://www.sharecare.com/health/protein-and-weight-loss/protein-help-me-lose-weight">more proteins</a>,&nbsp;vegetables and&nbsp;<a href="https://www.sharecare.com/health/healthy-athlete-diets/why-healthy-snacks-important-athletes">healthy snacks</a>.

I drastically improved the macronutrient makeup of the foods I ate and it was easier than I thought it would be.

<ul>
	<li>I began to pack my lunches for work, favoring fresh veggies, lean protein, and brown rice.</li>
	<li>I reduced my&nbsp;white starch&nbsp;and fat intake. So, ice cream became&nbsp;light&nbsp;ice cream and eventually yogurt with fresh fruit and granola.</li>
	<li>Side orders of chips and fries became&nbsp;baked chips or baked fries.</li>
	<li>Pizzas got&nbsp;smaller and less calorie-dense&nbsp;and vegetables were added.</li>
	<li>Popcorn servings had much less butter, and eventually I used misted olive oil instead.</li>
</ul>

Over time, the foods I once loved started to taste different. Rich foods started to taste&nbsp;too rich&nbsp;and sweet foods,&nbsp;too sweet. Whole grains took on a whole new level of flavor and I started craving clean, vitamin-rich foods. It still blows my mind that now I like vegetables more than the fatty starches I used to crave.&nbsp;

I didn&rsquo;t&nbsp;try&nbsp;to force this shift in taste, it just happened.

These days, at 41, progress of my health is more evident. I have a very healthy&nbsp;BMI, I&rsquo;ve dropped many pant sizes and my cholesterol levels have improved dramatically. I run and ride further, with more energy. I embrace new challenges in my life with confidence.

Above all, I naturally climbed out of depression. I now feel useful in my relationships &ndash; and to my wife. And her cancer? It&rsquo;s been eight years of &ldquo;no change&rdquo; MRIs. We&rsquo;re both healthier than we have ever been. I have a lot to celebrate these days, and as I set new and higher goals for myself, I know I&rsquo;ll always be a work in progress &ndash; and I look forward to every minute.

Take the first steps to growing younger and healthier with the <a href="https://www.sharecare.com/static/realage">RealAge Test</a>.

Medically reviewed in September 2019.

Health: A Work in Progress

Want to improve your overall health? Lose weight? Quit smoking? You&rsquo;re not alone. However, change is hard and sustaining behavior changes for the long-term is even harder. That&rsquo;s why many people work with a health coach, a professional &ldquo;buddy&rdquo; who can help you achieve your health and wellness goals&mdash;whatever they may be.

Here are a few of the ways a health coach can help you.

Help prevent or manage chronic conditions 
Did you know that many chronic conditions&mdash;such as diabetes and heart disease&mdash;may be prevented by eating a healthy diet, getting regular physical activity, avoiding obesity and not smoking? Translating these simple lifestyle goals into realistic daily activities is easier said than done. However, health coaching can help.

For example, the Diabetes Prevention Program used lifestyle coaches (who were mostly dietitians) to help participants lose weight. Over three years, the study found a 58 percent reduction in new cases of diabetes for those who were at high risk.

Often, clients have a condition, such as pre-diabetes, or they want to lower their blood glucose levels into the normal range, or they have high cholesterol and want to bring it down without going on medications, says Flavia Magoba, a Sharecare coach in Silver Spring, Maryland. &ldquo;We&rsquo;ll talk about lifestyle changes they can make to help prevent progression to full-blown diabetes or heart disease.&rdquo;

Magoba says, based on her experience, people with prediabetes are normally not referred to a registered dietitian until they&rsquo;re actually diabetic. &ldquo;It&rsquo;s harder to reverse it then, whereas if you have prediabetes, it&rsquo;s easier to prevent crossing over,&rdquo; she says. A coach can help you change the way you eat. &ldquo;We don&rsquo;t provide [fad] diets. We provide solutions for lifetime changes,&rdquo; she says.

Be an active participant in your own health 
A coach helps you focus on why you&rsquo;re motivated to change and encourages you to set your own health and wellness goals. After all, you&rsquo;re much more likely to be committed to goals you set for yourself rather than those someone else dictates.

Magoba says good coaches learn as much as they can about their clients. &ldquo;Are they looking for information? Do they need a lot of handholding? Are they resistant to change, or do they just need praise to maintain what they are already doing? I meet them where they are, but I don&rsquo;t impose what I think they should be doing.&quot;

While a coach can be an invaluable source of information, support and accountability, ultimately, clients are the experts of themselves, Magoba says. &ldquo;They are the drivers of the process. They know themselves more than anybody does.&rdquo;

Achieve sustainable results 
If you&rsquo;ve ever tried to quit smoking or lose weight and didn&rsquo;t succeed (or relapsed), you know it&rsquo;s hard to get change to stick. A review of the literature found that when individuals have someone to collaborate with, someone who recognizes their individuality and encourages them to learn, they are more likely to change their behavior. This, in a nutshell, is health coaching. It&rsquo;s also really a version of the &ldquo;teach a man to fish&rdquo; parable; coaching helps you develop the tools you need to make the long-term changes you want.

Bridge between your physician&rsquo;s office and real life 
Your physician recommended you lose weight. Now what? A health coach can help you figure out what you actually need to do to lose the weight and keep it off. &ldquo;We&rsquo;re not trying to replace what you&rsquo;re doing with your doctor, but rather, we are an extra layer of support between doctor visits,&rdquo; says Magoba. Your doctor gives you an instruction and coaches help you identify your personal vision, set actionable goals and then take small, bite-size steps to reach those goals, she says.

Anyone can benefit from having a health coach if you want to make sustainable lifestyle changes to achieve long-term wellness goals. &ldquo;Our demographics vary widely, from legislators to CEOs to the average Joe,&rdquo; says Spaller. &ldquo;These are the people working 9 to 5 who are busy with their kids and have let their health go. They want to set goals and get back on track,&rdquo; Spaller says. Ask your doctor or fitness club to recommend a health coach who&#39;s right for you.

Medically reviewed in June 2018.

What Are the Benefits of Having a Health Coach?

These simple, expert-approved health tips could save your life.

5 Things GPs Wish Their Patients Would Do

These are tense times for many Americans who are concerned about healthcare reform. Many of us are asking what the new terms could mean for our families and ourselves. As we listen to pundits unpack the overall impact of the changes, there&rsquo;s an immediate way to relieve our stress. We can turn our attention to wellness. We can ask what we and our families can do now to stay healthy?

Healthcare is more disease care than health care. While we need and deserve to be cared for when we become ill, there are practices we can use to optimize our health and well being before we get sick. They include many of the practices used in Ornish Lifestyle Medicine. Dr. Dean Ornish and his colleagues have spent over 35 years researching how lifestyle choices can preserve and protect our health, and even reverse disease. The best part is that you can take an active role in these practices.

The Four Pillars of Our Wellness 
Nutrition, fitness, social support and stress management are four very powerful pillars of lifestyle medicine that can help us reclaim our health. Research continues to support that they improve our lives.

<ul>
	<li>Choosing a low-fat vegetarian diet reduces heart disease&nbsp;and some cancers.</li>
	<li>Thirty minutes a day of moderate exercise is associated with less anxiety and depression.</li>
	<li>People with strong social support have longer life spans.</li>
	<li>Yoga and meditation reduce stress, which plays a major role in most chronic illness.</li>
</ul>

Rather than waiting for the doctor to heal us, the nurse to care for us, the surgery to fix us, we can turn inward and use these four pillars to begin to participate in our own care.

What Does Wellness Look Like? 
If we develop an internal locus of control, we are more likely to feel empowered to care for ourselves by seeing the relationship between what we do and how we feel. In contrast, if we are relying on factors outside of us to make us well, this supports an external locus of control and leads to feeling helpless, hopeless and disconnected.

How to Develop An Internal Locus of Control 
Stress management and yoga gives us the tools to massage the muscle of self-reliance. There are five stress management techniques that can be used daily to help us take our health into our own hands.

1. Postures 
These slow gentle movements improve flexibility and strength while they articulate the joints. These practices also help to embody awareness so we become better listeners when our body is offering us important signals about our health.

2. Relaxation 
These techniques help us to rest in a way that is deeper than sleep. Through them, we can restore a sense of balance to our body and mind so healing can occur.

3. Breathing 
How we breathe affects how we think and feel and how we think and feel affects how we breathe. When we slow down our breathing, it has a powerful impact on our sympathetic nervous system by up regulating the relaxation response.

4. Meditation 
A regular practice improves concentration and allows the mind to rest. It cultivates creativity, meaning and joy.

5. Imagery 
Using guided imagery, you use the mind to support healing or to imagine a positive outcome. It can also reverse negative thought patterns that can have an adverse affect on health.

A Daily Practice to Strengthen Your Internal Locus of Control

<ul>
	<li>Sit in a chair or lie on the floor. Allow yourself to be comfortable.</li>
	<li>Begin to relax your body.</li>
	<li>Draw attention to your own heart.</li>
	<li>Breathe as if your heart is breathing and just relax into the safety and comfort of your own heart.</li>
	<li>Quietly and internally begin to ask your heart a few simple questions.</li>
	<li>Is there something I can do to support my own health and well-being?</li>
	<li>What do I need to be healthy and whole?</li>
	<li>Is there something I need to be aware of that I might be overlooking in regards to my own health?</li>
	<li>You may have other questions to ask as well</li>
	<li>Repeat all or some of these questions several times, and then pause and listen. Even if there is no answer right away be patient and sincere. It is the practice of asking and listening that strengthens your relationship with your own inner wisdom and inner healer.</li>
</ul>

This article originally appeared on <a href="https://www.ornish.com/zine/the-tools-to-participate-in-your-own-well-care/" target="_blank">Ornish Living</a>.

Yoga, meditation, mindfulness and reduced stress levels are not only good for your heart. Read about additional benefits in <a href="https://www.ornish.com/zine/feeling-sluggish-yoga-can-stoke-your-digestive-fire/" target="_blank">Feeling Sluggish? Yoga to Improve Your Digestion and Energy</a>.

Medically reviewed in February 2019.

The Tools to Participate in Your Own Well Care

Are you considering working with a health coach? Good for you. Health coaches take a holistic approach to helping individuals like you make important lifestyle changes to improve their physical and emotional wellbeing.

A coaching relationship requires a commitment on your part and open communication between both parties. Knowing what to expect from your health coach will go a long way towards assuring you have a successful experience.

Health coaches are non-judgmental accountability partners. A health coach helps you create long- and short-term goals based on the changes you want to make in your life, explains Addie Spaller, a Sharecare coach manager in Ann Arbor, Michigan. However, goals are meaningless unless you take steps to reach them. &ldquo;We&rsquo;re here as accountability partners to really support clients and aid them in creating healthy lifestyle behaviors so they can reach their goals, but also maintain good health for the rest of their life,&rdquo; she says.

Flavia Magoba, a Sharecare coach in Silver Spring, Maryland, says a common misconception of coaching is that a coach will tell you what to do and give you a specific plan. Not true. &ldquo;We like to empower [clients],&rdquo; she says. &ldquo;Furthermore, we don&rsquo;t judge. We start [every coaching session] with a clean slate. We&rsquo;re here to be a support and another resource for individuals.&rdquo;

Health coaches provide helpful resources. Coaches don&rsquo;t direct clients, but they do offer resources, such as tips and recipes, to help them reach their goals. They also point clients to approved and vetted online sources of health information, such as the US Centers for Disease Control and Prevention, the American Diabetes Association or the American Heart Association, where they can learn more about their particular health challenges.

It&#39;s believed that people who have chronic conditions have better outcomes when they have disease-specific knowledge and skills. Furthermore, coaching encourages patients to take an active role in their own care.

Health coaches maintain a structured (but flexible) format. Whether your session is in-person or on the telephone, health coaches set an agenda for each appointment to respect each other&rsquo;s time constraints. Generally, the first order of business is to follow up from the last appointment, to see where the client has done well and identify areas where they can continue to improve. Then, it&rsquo;s on to discuss where the client wants to go next.

&ldquo;We hone in on successful goal-setting at the end of the call,&rdquo; says Sharecare coach Rachel Potter, based in Franklin, Tennessee. &ldquo;This is the next step you want to take, so how can we make that happen? We help set clients up for success.&rdquo;

At Sharecare, for example, most coaching calls take place about every four weeks. However, if a client needs more frequent contact (or less), that&rsquo;s okay. If they need to adjust the length of a call, which averages about 15 minutes, that&rsquo;s okay, too. Coaching should be flexible enough to accommodate clients&rsquo; specific needs.

Health coaches will listen. Coaches find that clients often want someone to vent to, says Kelsey Storey, another coaching manager at Sharecare in Franklin. She described a discouraged client who had several challenging circumstances in her life. When her coached asked her, &ldquo;If your friends gave you a medal for something, what would it be?&rdquo; the client reflected and then listed several of her strengths. That simple exercise gave her a new perspective and something to feel good about. Sometimes, a simple mindset change can be just as life changing&mdash;and good for your health&mdash;as a tangible goal, such as losing weight.

Health coaches ask the right questions. &ldquo;When we talk about weight loss, healthy eating and such, we also talk about all the lifestyle factors that might be [roadblocks to] behavior change,&rdquo; says Magoba. Often, clients are surprised to find that stress or lack of sleep (or both) is getting in the way of them achieving other goals. Coaches help you uncover obstacles you might not have been aware of. Once you&rsquo;ve identified these road blocks, your coach can help you identify steps to overcome them.

&ldquo;People just don&rsquo;t know how much lack of sleep affects their physical and mental awareness,&rdquo; Magoba says. It&rsquo;s the same with stress. She adds that a little bit of stress is good, but if you have a lot of consistent stress, it can contribute to chronic illnesses, like heart disease and diabetes.

Health coaches have intangible benefits. Losing weight, eating right and quitting smoking are among coaching clients&rsquo; most common goals, and they can make a profound difference in your overall health. However, individuals get other, less tangible benefits as well.

&ldquo;Having open communication with a coach is really important,&rdquo; says Potter. &ldquo;You can tune into the benefits from behavioral changes that aren&rsquo;t visible, such as number on a scale. [We find that] clients become happier, they have more confidence, they&rsquo;re more outgoing and willing to try new and different things. It can be life changing.&rdquo;

Medically reviewed in June 2018.

What to Expect From a Health Coach

As we kick off the 2021 Sharecare Awards, CNN&rsquo;s Dr. Sanjay Gupta, along with award-winning actor Courtney B. Vance and other influencers, join us to share the best health advice they wish they could give their younger selves.

Sleep more, create better habits: Dr. Sanjay Gupta and others offer their younger selves key health advice 

If you find yourself nodding off at 10 p.m. despite your best efforts to stay awake, or routinely opening your eyes at 7 a.m.&mdash;even on mornings when you could sleep in&mdash;you have your circadian rhythm to thank. This self-sustaining 24-hour internal body clock responds to daylight and darkness to tell us when it&rsquo;s time to be sleepy and when we should be fully awake. Fending off these messages is tough. Your rhythm is based on a roughly 24-hour day, and once it&rsquo;s there, it can be hard to shift.

Circadian rhythms are determined mainly by genetics, but they&rsquo;re also influenced by external factors, such as exercise, meal times, sleep deprivation and exposure to artificial light, particularly the glow emitted by smartphones, tablets and computer screens. Your environment or lifestyle can derail your internal clockwork, which, in addition to sleep, helps regulate your metabolism, blood pressure, body temperature, and hormone levels.

When you stay up too late, sleep too little or constantly change your sleep&ndash;wake schedules, you&rsquo;re disrupting your body&rsquo;s natural circadian rhythms. This can not only leave you feeling tired or groggy during the day, but also have longer term health consequences.

Learning more about circadian rhythms and how they can be disrupted could help you sleep more soundly and improve your overall quality of life.

How circadian rhythms work 
Circadian rhythms are controlled by &quot;clock genes&quot; that code for certain proteins. Many different types of cells throughout the body have their own internal clock, but the &ldquo;master clock&rdquo; that regulates these 24-hour cycles (and helps control a number of processes in the body through hormones and the nervous system) is found in the hypothalamus&mdash;the part of the brain that helps regulate body temperature and appetite as well as sleep and emotions.

Your body clock helps keep you asleep throughout the night and helps you feel wakeful during the day. Light is one of several external factors that can affect circadian rhythms. Minus some midafternoon energy dips after lunch, it keeps the awake messages coming, while darkness brings on that familiar sleepy feeling.

When it&rsquo;s dark, the hypothalamus sends a signal to the nearby olive-shaped pineal gland. Once this gland receives the &ldquo;it&rsquo;s dark&rdquo; message,&rdquo; it releases the hormone melatonin, which makes you sleepy. The result? Mentally, your mind starts tucking itself in for the night. Then, as sunrise approaches, your melatonin levels should naturally drop, letting you know it&rsquo;s time to wake up and start a new day.

So, what is a normal sleep-wake cycle? This really varies from one person to the next. Some people naturally prefer to get to bed early and rise with the sun, while others, including so-called &ldquo;night owls,&rdquo; tend to be most alert or energetic later in the day.

Typically, in modern-day work week, &ldquo;normal&rdquo; is going to sleep at around 10 or 11 p.m. and waking up at around 6 or 7 a.m., according to Ali Najar, MD, a sleep medicine specialist at <a href="https://www.sharecare.com/group/saint-joseph-mercy-health-system">St. Joseph Mercy Oakland</a> in Auburn, Michigan. Rapidly changing your sleep-wake routine&mdash;like staying up extra late on weekends, thinking we&rsquo;ll just sleep in&mdash;&ldquo;goes against our fundamental biology&rdquo; and should be avoided, if possible, cautions Dr. Najar.

Why your body clock may be out of sync 
Circadian rhythms are powerful, but they&rsquo;re not set in stone. They can adapt to a new schedule over time. But if you&rsquo;re constantly changing your sleep patterns, you&rsquo;re not allowing your internal body clock to adequately adjust. Shift work that involves a rotating schedule, staring at a bright screen until the wee hours and abruptly changing time zones are all ways you could throw your body clock out of whack.

The body&rsquo;s sleep-wake cycle is complex so its disruption can trigger a cascade of effects. For example, adenosine, a naturally occurring chemical that plays a role in why you feel drowsy, may build up if you&rsquo;re sleep deprived. Your melatonin levels may also rise and fall at the wrong times, leaving you drowsy when you&rsquo;re trying to work or alert when you&rsquo;re trying to sleep.

Keep in mind there are some circadian rhythm disrupters that you can&rsquo;t control, such as getting older. As you age, the way your body responds to body clock messages changes. As time passes, you may find yourself sleeping less and waking more often&mdash;even in the dark. Your ability to sleep soundly can also be disrupted by the hot flashes of menopause or underlying health issues, such as arthritis pain or migraine.

Sleep apnea, which occurs when breathing is repeatedly interrupted during sleep, and insomnia, a distressing inability to fall and stay asleep, are two sleep disorders that can disrupt your sleep-wake cycle, according to Najar. These conditions, jet lag, aging, and shift work are the most common disrupters, but researchers have realized that certain sleep-wake disorders also affect circadian rhythms.

Disorders of the circadian rhythm 
Young people can have what&rsquo;s called delayed sleep-wake phase disorder, in which they tend to go to bed and wake up later than what is considered normal or than they&rsquo;d like. It&rsquo;s unclear what causes this disorder, but it may be related to developmental changes, ultra-sensitivity to light at night and other environmental factors.

On the opposite end of the spectrum, older people tend to have advanced sleep-wake phase disorder, in which age-related weakening of their circadian rhythms cause them to wake up much earlier than normal, or than they&rsquo;d prefer.

There are other sleep-wake conditions that typically affect people who are blind (non-24-hour sleep-wake rhythm disorder) and those with dementia or other neurodegenerative diseases (irregular sleep-wake rhythm disorder).

How sleep-wake disorders are diagnosed 
To determine whether or not a person&rsquo;s problems meet the threshold for a sleep disorder, the first step is to keep a sleep diary, Najar explains. The patient records their sleep patterns for a couple of weeks, and clinicians then use that as a tool to find out what kind of sleep disorder, if any, is present. Another tool is actigraphy, a device (usually a wrist wearable) that automatically tracks a person&rsquo;s sleep-wake patterns.

What therapies are available if your doctor identifies a problem? Depending on the disorder, treatment may include carefully managing set sleep and wake times.

Melatonin supplements and light therapy may also be recommended, says Najar. The two approaches have opposite effects. Taking melatonin an hour before the target bedtime in the evening will help shift sleepiness to an earlier time. Exposure to bright light will have the opposite effect, promoting alertness. Be sure to talk to your doctor before taking melatonin for any reason to ensure it&rsquo;s safe and appropriate for your situation.

Practicing good &lsquo;sleep hygiene&rsquo; 
For those with a sleep-wake rhythm disorder, their sleep hygiene, or certain habits and behaviors that promote quality sleep and keep your body clock running smoothly, will also be examined. It&rsquo;s important for everyone&mdash;even those without a sleep disorder&mdash;to have <a href="https://www.sharecare.com/health/sleep-health/slideshow/simple-habits-sleep-soundly#slide-1">healthy sleep habits</a>.

This includes creating a clean path to sleep, advises Najar. It&rsquo;s important to avoid exposure to stimulating artificial lights&mdash;particularly the blue light emitted by many electronic devices, such as smartphones and tablets&mdash;which can suppress melatonin production and keep you awake. This light-based mind clutter includes late-night TV binges. So, best to remove electronics from your bedroom and avoid streaming a new Netflix series until 2 a.m.

It&rsquo;s also a good idea to avoid lengthy naps and to get outside during the day. Greater exposure to sunlight can help you realign your body clock. A 2015 study published in Chronobiology International found that not getting enough natural light exposure during the day is associated with lower levels of melatonin and higher levels of the stress hormone cortisol at night (this should be the case in the morning when people are waking up).

As bedtime approaches, steer clear of alcohol and stimulants, such as caffeine. Establishing a relaxing bedtime routine can also help prepare your mind and body for sleep. This may include taking a warm shower or bath, reading a book and keeping your bedroom cool, quiet and dark.

How shift workers can adapt 
Of course, some professions require shift work, with its odd schedules that constantly switch up sleep-wake cycles. This type of rotating shift work&mdash;and the resulting disruption of circadian rhythms&mdash;has been associated with serious health consequences, including an increased risk for obesity, type 2 diabetes, depression, multiple sclerosis, heart disease and cancer.

Still, there are jobs that require people, such as doctors, nurses, pilots, police officers and flight attendants, to work nights. There are strategies&nbsp;that these and other shift workers could use to minimize some of the drowsiness caused by disruptions to their 24-hour body clock.

&ldquo;We recommend taking a brief nap at nighttime during the shift work, not lasting more than 15 minutes,&rdquo; Najar adds. If the napping goes on longer, grogginess may become a problem.

Adding in some light therapy, which involves deliberate exposure to very bright light that should end two hours before a shift can help mitigate the drawbacks of shift work, he notes. The U.S. Food and Drug Administration has approved the use of modafinil (brand name, Provigil) for shift workers to help them stay alert, Najar points out, but caffeine is another option.

Keep in mind, coping with shift work won&rsquo;t necessarily reduce the health risks associated with chronic disruptions of your circadian rhythms. If you struggle with daytime sleepiness, disrupted sleep or if you&rsquo;re having trouble adjusting to rotating shift work, talk to your doctor about the lifestyle adjustments and possible treatment options that may be right for you.

Medically reviewed in March 2019.

What May Be Wreaking Havoc on Your Body Clock

We all feel tired from time to time, but if walking to the bathroom wipes you out, there may be a reason.

6 Times Your Fatigue Is Something More Serious

What is afterburn? 
The afterburn effect has been intensely debated in the fitness and medical communities for over a century, with countless studies attempting to measure and explain the phenomenon. Afterburn, or excess post-exercise oxygen consumption (EPOC), refers to the period of increased oxygen uptake following exercise. It may last for hours or even longer than a day, depending on the type of exercise performed. During that time, one&rsquo;s <a href="https://www.sharecare.com/health/metabolism-and-weight-loss">metabolism</a> is believed to speed up, causing additional calories to burn. But some lingering questions have long teased scientists: exactly how many calories are we talking about? And can those bonus points contribute to weight loss?

Expert opinions vary since study results have conflicted due to factors like the weight, gender and training levels of participants. However, most reliable studies agree on one key point: there&rsquo;s a relationship between exercise <a href="https://www.sharecare.com/health/types-exercise/what-does-intensity-mean-exercise">intensity</a> and the amount of afterburn that people tend to experience. After a certain intensity level is reached, that relationship turns into a direct correlation, meaning the harder you work, the more you burn.

How do you know if you&rsquo;ve reached the right level of intensity? 
Research suggests that the target intensity level is around 50-70% of a person&rsquo;s VO2max, or the maximum amount of oxygen used by an athlete while performing an activity. At around 70% VO2max, it&rsquo;s generally too difficult to both breathe and carry on a conversation at the same time. That level of exertion is supported by the work of researchers from Appalachian State University and UNC Chapel Hill. Their methods, which account for many of the weaknesses of prior studies, also helped to shed new light on the age-old question of calorie burning potential.

Their study took place in a controlled environment called a metabolic chamber, or a room that automatically monitors the calories burned by those inside. Young male participants were asked to spend two 24-hour days in the chamber. On the first day, they performed the bare minimum of activities of daily living to measure their calorie expenditure at baseline. On the second day, they repeated their routine, but added a 45-minute session on a<a href="https://www.sharecare.com/health/cycling/effective-train-on-stationary-bike"> stationary bike</a>. They cycled at about 70% VO2max and initially burned around 519 calories. Then, remarkably, over the next 14 hours, they continued to burn an additional 190 calories!

Planning your next workout 
Numerous additional studies emphasize the importance of intensity level when aiming to increase afterburn. For example, other research demonstrates that it has a greater impact on calorie usage than the duration of a workout. In fact, one study attributed five times more EPOC to intensity level than both workout duration and total work performed. This is consistent with evidence showing longer afterburn periods following <a href="https://www.sharecare.com/health/types-of-exercise-programs/what-is-interval-training">interval training</a>. These rules apply to <a href="https://www.sharecare.com/health/resistance-training">resistance training</a> (i.e. dumbbells, weight machines, rock climbing) as well -- the higher the difficulty level, the greater the amount of afterburn.

So when it comes to planning your next cardio session, consider alternating between intense sprints and short bursts of moderate-intensity running, rather than jogging at a consistent pace over a longer period of time.

Medically reviewed in February 2019.

Bonus Calories or Fitness Myth? The Truth About Afterburn

Driving through Honolulu on July 20 or 21, 2018, you may have noticed something strange about Aloha Tower and the IBM Building&mdash;they were both glowing red. It wasn&rsquo;t a fire, but a celebration of people with intellectual disabilities. The Light Up for Inclusion campaign marked Special Olympics International&rsquo;s 50th anniversary by illuminating monuments around the world. It&rsquo;s one of the many Special Olympics initiatives that spotlights an often-underserved community.

50 years of changing lives 
Founded in 1968, Special Olympics is an international sports training and competition program designed for athletes of all ages and physical abilities with an intellectual disability. In 2017, Special Olympics Hawaii served over 3,400 athletes (at no cost to them) on six islands.

Through sports, Special Olympics aims to help its athletes uncover inner strengths and empowers them to grow socially, mentally and physically. As a result, according to research done by the organization, they&#39;re 200 percent more likely to be employed than non-participating individuals with intellectual disabilities. They develop improved motor skills and physical fitness, and tend to have a more positive self-image, as well.

The organization also strives to end stigmas associated with intellectual disabilities. &ldquo;Some of our athletes have had vision problems, and the assumption is that they can&rsquo;t catch a ball because they have a disability,&rdquo; says Dan Epstein, COO for Special Olympics Hawaii. &ldquo;And then all of a sudden they go through an eye exam and you realize they need glasses.&rdquo; Through working with medical professionals and the community at large, Special Olympics aims to curtail these common misconceptions.

Let the games begin 
Special Olympics Hawaii has year-round sports competitions divided into three seasons: spring, summer and fall. There are over 45 individual contests across Hawaii, including three state-wide events&mdash;Summer Games, Aukake Classic and Holiday Games.

<a href="http://www.specialolympicshawaii.org/sports/sports-offered.html" target="_blank">Sports offered</a> include:

<ul>
	<li>Basketball</li>
	<li>Bocce</li>
	<li>Bowling</li>
	<li>Flag football</li>
	<li>Golf (exhibition only)</li>
	<li>Power Lifting</li>
	<li>Soccer</li>
	<li>Softball</li>
	<li>Swimming</li>
	<li>Track and field</li>
</ul>

Any person age 8 and older with an intellectual disability can compete in Special Olympics events. For keiki aged 2 to 7, Special Olympics offers a <a href="http://www.specialolympicshawaii.org/get-involved/young-athletes-program.html" target="_blank">Young Athletes Program</a> focusing on pre-sports skills.

Athletes can also participate representing Hawaii in the Special Olympics USA Games, a national competition that welcomes thousands of athletes from all 50 states. In 2018, athletes from Oahu, Kauai, Maui and Hawaii Island competed in soccer, track and field and basketball at the Seattle USA Games. Costs for airfare, training, equipment and uniforms were covered by Special Olympics Hawaii through donations and local fundraising efforts.

&ldquo;Everything we provide is free of charge to our athletes and families, and all monies raised in Hawaii stay in Hawaii,&rdquo; says Healthy Communities Manager Jennifer Ernst. That includes the regular costs of flying athletes from neighbor islands to Oahu for the three annual competitions.

Focusing on health 
Special Olympics Hawaii is, at its core, a sports program, but like many nonprofits, its mission has grown over time. One of its current major initiatives is <a href="http://www.specialolympicshawaii.org/special-olympics-hawaii-initiatives/healthy-athlete-initiatives.html" target="_blank">Healthy Athletes</a>. Each year, athletes are provided free health screenings at the Summer Games held at the University of Hawai&lsquo;i, Mānoa. In 2017, over 500 exams were performed.

Health disparities are common among individuals with intellectual disabilities. According to statistics provided by Special Olympics, they&#39;re twice as likely to die before the age of 50 than those without intellectual disabilities. Many have poor or almost no access to healthcare, putting them at increased risk for medical and dental conditions. Diagnostic overshadowing is also common, where a physician may assume that physical symptoms are caused by a disability, instead of an underlying medical condition.

&ldquo;See the person, not the disability,&rdquo; says Ernst about diagnostic overshadowing. Through Healthy Athletes, Special Olympics Hawaii trains volunteer healthcare professionals who then go back to their practices with increased knowledge of and compassion for people with intellectual disabilities.

Next steps with Sharecare 
Sharecare and HMSA are working together to donate up to $100,000 to Special Olympics Hawaii, but we need your help! For each Hawaii-based new user who creates a profile and takes the RealAge Test, Sharecare will donate $5 across five Hawaii charities, including Special Olympics. From there, log your green days. Every green day earned&mdash;up to 30 days a month&mdash;is another $1 to charity through November 2018. Help your health and Special Olympics Hawaii this fall with Sharecare and HMSA.

Sharing Care With Special Olympics Hawaii

Every July, local keiki enjoy lots of warm sunshine and sandy beaches, but as the month draws to a close, the new school year looms. For many children, this means back-to-school shopping&mdash;picking out new pens, folders and notebooks to reflect their unique personality. Unfortunately, not all of our keiki have that option. Thousands lack the financial resources for even basic school supplies, which is why, each year, Helping Hands Hawai&lsquo;i (HHH) works hard to equip kids in need with educational necessities through its Ready to Learn program.

But Ready to Learn is just one of HHH&#39;s many initiatives. The community-based nonprofit provides a plethora of supportive services throughout Hawaii, focusing on three major divisions: human services, behavioral health and language access.

What is HHH? 
HHH has deep roots in Hawaii. It began after the 1941 bombing of Pearl Harbor as a volunteer placement bureau and became incorporated as Helping Hands Hawai&lsquo;i in 1974. Now, communications and development specialist Dorian Nakamichi estimates HHH helps at least 30,000 people a year, which includes the 5,000 students served by Ready to Learn.

Ready to Learn falls under the human services division at HHH, along with the Community Clearinghouse, Adopt A Family, SNAP Outreach and Emergency Assistance Program. Among the services each program offers:

<ul>
	<li>The <a href="http://helpinghandshawaii.org/programs/community-clearinghouse/" target="_blank">Clearinghouse</a> takes in donations from businesses and individuals then distributes items to referred clients free of charge.</li>
	<li>During the holidays, <a href="http://helpinghandshawaii.org/programs/adopt-a-family-aaf-program/" target="_blank">Adopt A Family</a> connects individuals and families in need with community donors who help brighten the season and inspire them for the new year.</li>
	<li>The <a href="http://helpinghandshawaii.org/programs/supplemental-nutrition-assistance-program-snap-outreach/" target="_blank">SNAP Outreach</a> team helps people sign up for and maintain their SNAP benefits (formerly food stamps) to help them have enough to eat.</li>
	<li>The <a href="http://helpinghandshawaii.org/programs/emergency-assistance-program/" target="_blank">Emergency Assistance Program</a>, including its Native Hawaiian-focused <a href="http://helpinghandshawaii.org/programs/emergency-assistance-program/punawai-program/" target="_blank">Punawai Program</a>, offers one-time financial assistance for housing or utilities to those in crisis who may be facing eviction or are already homeless and trying to get into permanent housing.</li>
</ul>

In addition to human services, HHH has divisions in behavioral health and language access. Behavioral health services include case management and representative payee services, both of which assist adults diagnosed with severe and persistent mental illness who may be struggling with poverty, homelessness and substance use. Language access is a unique division that is vital to Hawaii residents. Through the <a href="http://helpinghandshawaii.org/programs/bilingual-access-line/" target="_blank">Bilingual Access Line</a>, those with limited English proficiency can request interpretation or translation services. &ldquo;We have about 19 languages that we serve 24/7,&rdquo; says Nakamichi. Interpreters may help in medical, financial, educational or legal appointments.

HHH and Sharecare 
With so many programs aimed to aid Hawaii residents, it&rsquo;s easy to see how HHH touches tens of thousands of lives a year. Its critical mission and dedication to the community are why Sharecare and HMSA chose to partner with HHH as our first featured nonprofit in the Sharing Care initiative.

Nakamichi says that HHH takes a holistic approach to serving the community, which she feels the Sharecare app echoes in its holistic approach to health management. &ldquo;It mirrors that kind of philosophy of having a whole spectrum of what can make you feel better and what will improve your health.&rdquo;

If you&rsquo;re in Hawaii and want to make a difference for HHH, the easiest thing to do is register for Sharecare and take the RealAge test. For every Hawaii resident who registers for Sharecare and takes the RealAge Test through November 30, 2018, Sharecare will donate $5 to Hawaii charities. From there, log your green days and for each green day earned, Sharecare will donate an another $1. At the end of November, all of the funds generated will be evenly divided between our five partner charities, including HHH.