Dragonfly Health

09/30/2026

There are so many reasons to offer a varied colorful diet to children starting at 4 months of age. Eat the rainbow!

But caution not to get into food struggles with children either. Offer healthy foods and adults also eat snd enjoy varied foods

Lower Dietary Diversity During First Year Of Life Is Associated With Increased Risk For AD Later In Life, Study Finds
“Lower dietary diversity during the first year of life is associated” with an “increased risk for atopic dermatitis (AD) later in life,” researchers concluded in a study of data from the Korean National Health Insurance Service database. The researchers found “the low- and moderate-diversity groups had a significantly increased risk for AD compared with the high-diversity group (adjusted hazard ratios, 1.08 and 1.11, respectively). There was no significant interaction seen by infant s*x or maternal history of asthma or AD.” The findings were published in Pediatric Allergy and Immunology.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/pai.70487

In a nationwide cohort of 267,935 Korean infants, low dietary diversity during the first year of life was associated with an increased risk of atopic dermatitis, independent of maternal atopic histor...

09/28/2026

Healthy diets do make a difference in so many ways.

Although this was a very small study it is consistent with my clinical experience. Everything improves when the diet does—mood, energy, pain etc.

People have less depression, anxiety after cutting ultraprocessed food intake
“People had less depression and anxiety after cutting their ultraprocessed food intake by more than 85%,” according to a new pilot study. “For the study, researchers recruited 20 participants diagnosed with depression. Among them, 14 also had anxiety.” Researchers found “that when people cut down on ultra-processed food, they scored significantly lower on three measures for depression. They also had modestly improved anxiety scores.” The results were published in JAMA Psychiatry.

This pilot crossover trial assesses the feasibility and acceptability of removing ultraprocessed foods from the diets of patients with major depressive disorder.

09/27/2026

Im very excited to focus on high-quality medical skills this weekend while taking the Harvard Medical School Ultrasound course.
Learning a ton and meeting amazing medical colleagues from all over the country.
Huge amount of detailed anatomy review which is waking my brain

09/27/2026

Every time I attend a sports medicine conference there are warnings about supplements but Creatine always comes out to be both safe and effective.
I take it myself and really believe I have more energy for workouts. Just look out for what is added. I take one without any flavor or sweeteners and do not exceed 5 grams a day.
And get to the gym!!

The "Health vs. Hype" AMA podcast explores what creatine is, its association with bodybuilders, and whether it's safe for the general public.

09/25/2026

Written by a physician colleague.
Measles is one of the scariest illnesses without treatment once you have it. Please vaccinate:

From Dr Ian Goodman

Two years ago I wrote about measles. It's easy to believe that scary things happen elsewhere and cannot happen here. Here is where things are now.

Pennsylvania is in the middle of the worst measles outbreak in the US in decades. As of September 22 there were 792 confirmed cases in 38 counties, 155 people hospitalized, and 4 deaths. Two of the deaths were infants too young to be vaccinated. The others were an 18 year old and a 40 year old woman. All four were unvaccinated. Nationally there have been 3,471 cases so far this year. That is the most since 1991, and we passed last year's total in July.

The deaths tell us something about how big the outbreak really is. Measles has a .1 to .3% fatality rate. That means 4 deaths would be expected from somewhere around 1,300 to 4,000 infections, not 792. The numbers are small and more deaths may still come from recent cases, but the official count is probably missing a lot of cases. One in five cases in Pennsylvania has been hospitalized, about double the national rate. That is what you would expect if the mild cases are not getting tested and only the sick ones are being counted.

It's easy to believe that scary things happen elsewhere, so I looked at the state's kindergarten vaccination data for our area. To prevent an outbreak, about 95% of people need to be protected.

Northampton's public schools are mostly there. Finn is at 100%, Bridge Street 98%, Leeds 98%, and Jackson Street 94%. 7th graders at JFK are at 100%.

The rest of the area is a different story. In Hampshire County, 2.8% of kindergartners have a vaccine exemption, compared with 1.8% statewide. 1.6% have no vaccines at all, more than twice the state rate. One Hadley private school is at 82% with 13% exempt. Hatfield, Shutesbury, and Whately elementary schools are each at 93%. In Franklin County, 5.1% of kindergartners have an exemption, almost three times the state rate.

Measles doesn't stop at town lines. Our kids share soccer fields, camps, the Y, and waiting rooms. It can happen here.

There are no really good treatments for measles. 1 in 1000 people infected will develop inflammation of the brain and nervous system, and many of those will be left with brain damage. Measles can cause immune amnesia, where your body forgets it has ever met other viruses and bacteria and is at risk for other infections for years. And there is a condition called SSPE where years after someone recovers from measles they develop a devastating and fatal decline in behavior and intellect followed by seizures. For children infected before age 5, it happens in roughly 1 in 1000 to 1400. There is no treatment. Imagine years after your child recovers from measles watching them slowly and irreversibly decline.

The measles vaccine is safe, effective, and available. Two doses are about 97% protective. If your child is behind, or you are not sure about your own vaccination, call your doctor.

And measles is only what's showing up first. Kids with exemptions usually aren't missing just one vaccine. As one of my former trainees put it: if you think measles is bad, wait until you see polio.

09/23/2026

Another reason to consider menopausal hormone treatment(MHT)

Menopausal hormone therapy may reduce CVD (heart disease) risk in women

“Menopausal hormone therapy (MHT) initiation in perimenopausal or recently postmenopausal women with vasomotor symptoms may reduce cardiovascular disease (CVD) risk, with more pronounced benefits in women who initiated MHT within 10 years of menopause, according to a study.” Investigators came to this conclusion after estimating “the effect of MHT on CVD risk among perimenopausal and recently postmenopausal women with vasomotor symptoms using cohort data from the Study of Women’s Health Across the Nation (1997 to 2017).” The findings were published in JAMA Internal

This target trial emulation evaluates the effect of menopausal hormone therapy on cardiovascular risk among perimenopausal and recently postmenopausal women with vasomotor symptoms.

09/21/2026

People keep asking when is the best time to get flu shots. The answer is NOW!

I personally already received my Flu and Covid boosters because I need the protection and dont want to chance it.

The sweet spot is late September through October. The CDC's Advisory Committee on Immunization Practices recommends September or October as ideal for most adults — early enough to be protected before flu takes off, but not so early that your immunity fades before the virus peaks. Vaccinating in July or August is generally discouraged for most adults (especially those 65+), because protection wanes by roughly 6–11% per month. Getting your shot too soon can leave you underprotected exactly when you need it most.

Background Seasonal influenza infects 5-20% of people every year in the United States, resulting in hospitalizations, deaths, and adverse economic impacts. To mitigate these impacts, influenza vaccines are developed and distributed annually; however, growing evidence suggests that vaccine effectiven...

09/20/2026

What about caffeine intake and your heart?

For most of us caffeine is actually good for us unless you have uncontrolled anxiety, high blood pressure or heart irregularities.
Both coffee and tea have many health benefits.
Its what you put into them that is the problem.

The American Heart Association just published a scientific statement in JAMA (July 2026) reviewing the evidence on caffeine and cardiovascular disease. It's a more nuanced picture than most headlines will give it, so here's the substance.

The topline finding: Moderate caffeine intake — up to about 400 mg/day, roughly 3–5 8-oz cups of coffee — appears safe for most adults and is associated with lower risk of coronary heart disease, stroke, heart failure, atrial fibrillation, hypertension, and type 2 diabetes. Lead author Gregory Marcus, MD (UCSF, chair of the AHA's Committee on Drugs, Alcohol, and To***co) was careful to frame this as a statement on current evidence, not a clinical practice guideline.

Important caveats worth knowing:

• Most of the supporting evidence is observational — correlation, not proven causation. Whether caffeine itself drives the benefit, or other compounds like polyphenols (also found in tea and coffee) deserve credit, is still unresolved.
• Brew method matters. Unfiltered coffee — French press, Turkish/Greek, Scandinavian boiled — raises LDL cholesterol in randomized trials, due to a compound called cafestol. Paper-filtered and instant coffee don't have this effect.
• What you add to it matters. Sugar, flavored syrups, and heavy cream can offset any cardiovascular benefit.
• Long-term effects on blood pressure remain unclear, though risk may rise with high intake, especially in people with severe hypertension or high caffeine sensitivity.
• Genetics drive substantial variation in how individuals metabolize caffeine — there's no universal "safe dose."

Timing may matter too. A separate 2025 study (not part of the AHA statement itself, but coauthored by the statement's vice chair, Frank Hu, MD, of Harvard) followed nearly 41,000 adults and found that morning coffee drinkers (roughly 4 am–noon) had lower cardiovascular and all-cause mortality a decade later than all-day drinkers or non-drinkers — possibly related to caffeine's effect on sleep.

Energy drinks are a different story. The statement is explicit that these findings apply to naturally occurring caffeine in coffee and tea — not synthetic, high-dose products. Available data on energy drinks generally suggest cardiovascular harm, and they often combine caffeine with other stimulants (taurine, L-carnitine) and added sugar. This is a particular concern for children and teens, who are more vulnerable to caffeine's effects and haven't built tolerance the way long-term adult users have.

What this doesn't mean: Marcus was explicit that this is not a reason for non-caffeine-drinkers to start, or for light drinkers to increase intake. There isn't sufficient data to recommend initiating caffeine consumption for cardiovascular benefit.

Bottom line: For adults who already enjoy coffee or tea in moderation, naturally occurring caffeine is unlikely to harm cardiovascular health and may offer some protection. It's not a green light to start, and how you brew and what you add still matters.

Source: JAMA, published online September 18, 2026 (doi:10.1001/jama.2026.16716)

09/20/2026

Very concerning results from survey of teens using social media

Results The weighted sample included 472 adolescents (mean [SE] age 14.9 [0.1] years; 46.8% female) from 47 states. Across online and offline contexts, 44.7% witnessed harassment and 29.8% reported experiencing it directly in the past 4 weeks. Online exposure exceeded offline exposure for several harms, including reported exposure to violent imagery (10.7% vs 1.6%), unwanted s*xual images (13.4% vs 2.0%), and content encouraging self-harm (9.7% vs 5.2%), while direct harassment was reported at similar rates offline and online (18.5% vs 16.4%). More than half (51.5%) self-reported sleep disruption due to technology use. Prevalence varied by platform.

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2854310?guestAccessKey=492e862a-9153-437d-b781-5ee4df4c6417&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jamapediatrics&utm_content=olf-tfl_&utm_term=091826

09/18/2026

My favorite meals—nearly over for the season