September Newsletter
September, 2022
Welcome to the September newsletter. This newsletter aims to provide information and analysis of timely topics from recent articles published in the medical literature. I hope you find this information useful and helpful in your health journey. If you have comments or questions, please let us know. I hope you enjoy these articles!

I have been getting a lot of questions in regard to the new bivalent covid booster shots. Who should get them? When should people get them? A recent study in The Lancet sheds some light on these questions. They found that hybrid immunity from prior omicron infection and at least two doses of vaccine provided the highest protection from omicron infection and this protection was not improved with additional doses of vaccine.

The current bivalent vaccine is the BA.1 variant plus the original vaccine. The study suggests that getting the current vaccine - if you have had previous vaccines and an omicron infection is not likely to be beneficial for most people (esp. younger and healthy). Omicron has been the dominant variant since mid-December so if you had a covid infection since December, it was omicron. I generally recommend at least 6 months (longer than the CDC's 3-month window) between booster vaccines and either a previous vaccine dose or infection for those who would like to get the new vaccine. This advice may change if a vaccine for current variants is released but right now I would not recommend most people rush out to get the new booster.

Vitamin For the Brain
Alzheimer’s disease and dementia affect over 46 million people worldwide. Can a simple daily multivitamin reduce our risk of dementia? Do we think better if we take a Centrum Silver or does a multivitamin just give us “expensive urine”? Who benefits the most from taking multivitamins? This study provides some provocative evidence for us to decide and my be changing my recommendation in regards to multivitamins.  
Pump You Up!
We all know that exercise is beneficial. Most studies have focused on aerobic type exercise when looking at mortality benefits. More recently, people have become more focused on strength as a predictor of future health. People with higher levels of upper and lower body strength have been shown to have a lower risk of mortality. But does strength training lower our mortality? Can we pump iron to live longer? How much strength training should we do and how often? This study provides some answers. 

It's How You Walk!
We have all heard that getting 10,000 steps daily is a good goal for health. We should try to walk and move around during the day whenever possible. Tracking total steps is easy (our phones are keeping track for us) and means that we can acquire steps both meandering around our homes or workplaces (incidental steps) or walking briskly (purposeful steps) but many apps don’t tell us the intensity of our walking. Does the number of steps matter more than the intensity of steps; are purposeful steps better than others? Is the pace of our walking important? How many purposeful steps do we need to achieve the goal of lower overall, cancer, and heart disease mortality compare to the number needed of total steps? Can we get full benefits with fewer steps? 

To Your Health...
Thank you for taking the time to read through this newsletter. We hope you have found this information useful. Feel free to pass this on to anyone you think would benefit from this newsletter.

Mark Niedfeldt, M.D.

Old-fashioned medicine with 21st Century convenience and technology