Despite the fact that over 80% of Americans fear losing their eyesight more than any other sense, a recent study has found that an even greater percent do not get eye exams even though they may be at risk for eye disease. Unfortunately, due to hard times with the economy many people are skipping them.

Neglecting to have eye exams is a problem because they can easily pick up signs of glaucoma and macular degeneration two eye diseases that have no symptoms until they have caused serious damage. Glaucoma is the second leading cause of blindness in the world. Age related macular degeneration is the most common cause of blindness in those over 55 in the US. Early treatment can prevent blindness.

Glaucoma can be treated by drops or surgery to relieve pressure in the eye. There are treatments for both age related and wet macular degeneration that include injections, laser treatments and vitamins and supplements.

Regular eye checks not only help to prevent eye diseases but often times eye doctors can find other problems such as diabetes, autoimmune diseases, multiple sclerosis and even brain tumors. That is why it is so important to make sure that a trip to the eye doctor is on your health maintenance calendar.

The new blush of love is exciting and can be all consuming. It turns out in addition it can reduce pain. Scientists at Stanford and The State University of New York at Stony Brook have been able to quantify the power of love as it relates to pain.

They took 15 students who were in romantic relationships within the previous 9 months.
They brought pictures of their significant other and a friend. When looking at the pictures they were given a painful stimulus. They also distracted the students. They found that distraction and looking at the loved one (but not looking at a friend) decreased pain but by different mechanisms. Distraction required the thinking part of the brain and love used opiate receptors to relieve pain.

Love stopped pain processing before it reached the brain. Pain reached the brain before the distraction stopped it. Love lights up the part of the brain that is triggered with cocaine or winning a lot of money.

It would be great if we could bottle that feeling, and it could happen some day. In the meantime, we might be able to access the benefits with hypnosis or guided imagery.

October is National Breast Cancer Awareness Month in the U.S., and this is our third year of celebrating/discussing it in this blog.  In the blog about this during the past two years *, I’ve given a general summary about what is known about breast cancer – risk factors, diagnostic methods, recommendations for screening and prevention – but this year, I’m going to give you some new information. Information that will hopefully clear up the confusion from the past year.

What confusion am I referring to? Since last October, the US Preventive Services Task Force (USPSTF) came out with some recommendations about screening for breast cancer that created outrage in the medical community and confusion in the non-medical community. We were very strongly against several of their recommendations, as were all of the expert committees and organizations specializing in breast cancer, from the radiology societies, to the surgical societies to the major universities to the cancer societies. The recommendation that offended the most was the one that advised women to start having regular screening mammograms at age 50, rather than at age 40. We also disagreed with their recommendation that women should stop doing breast self-exam. (See Robin’s blog about this**)

Now comes a study that breast cancer experts believe should end the debate of when a woman should start having screening mammograms. A large and well done Swedish study*** showed that mammography screening in women ages 40-49 resulted in a much greater reduction in deaths from breast cancer than previously thought.  Considered to be the largest epidemiologic study of mammography in women in this age group, the study found that there was a 29% reduction in deaths from breast cancer due to mammographic screening.

The USPTF stated in their report/recommendations that there was only a 15% reduction in deaths from breast cancer, and therefore, screening efforts were not cost-effective. Most experts questioned that estimate, and many more (including us) questioned the appropriateness of the argument.

So, to all of you out there in the 40-49 year old age group, experts in breast health and breast cancer agree: the confusion should end.  You should start getting your regular mammograms at age 40 (or younger if you have certain risk factors, and your doctor recommends it). If you’re in this age group and were relieved by the USPTF’s recommendations, and planned not to start mammographic screenings until you were 50, please discuss this with your doctor. We and experts in the field do not believe that this is a wise decision.

*To read our blogs from the prior Octobers on general info about breast cancer:

http://www.smartwomanshealth.com/horn_miller_blog/?p=435

** http://www.smartwomanshealth.com/horn_miller_blog/?p=688

 ***Cancer. Published online September 29, 2010.

Food is one of those things we cannot live without. There are those of us who are addicted to certain types of food. For some it is fat, and for others it is sugar. It is impossible to completely eliminate either of these from our diet and thus we cannot treat it like we treat other addictions. You just can’t avoid food. So, for those of us fighting the battle of the bulge, and our cravings for fat, sugar or other types of food what do we do? Diets don’t work. What we have to do is make small changes that we can maintain for life. That is what can make a difference.

For some it may be avoiding the “white” food such as bread, pasta, potatoes and rice. For others, it may be eliminating red meat. It may be as simple as only eating whole foods and skipping anything processed. It is important for anyone who is struggling to maintain a healthy weight that (as Curly said in the movie City Slickers) you find that one thing that can make a big difference, make the change and you will be amazed at the results.

We’re all aware of the importance of regular physical activity in maintaining good health.  Put another way, not getting regular physical activity can lead to many health problems, including heart disease, strokes, memory problems, and obesity, among many other health effects. 

But would it surprise you to find out that simply sitting – as opposed to standing and walking around  – for prolonged periods is also bad for your health?

A recent large prospective study* sponsored by the American Cancer Society of over 53,000 adult men and over 69,000 adult women – all disease-free at the time of enrollment – looked at the relationship between the amount of leisure time spent sitting and mortality over a 14 year period.  Women who reported sitting for over 6 hours per day had an approximately 40% higher death rate than those who reported sitting for less than 3 hours per day; men who reported sitting over 6 hours per day had a 20% higher death rate than those who reported sitting less than 3 hours per day.

These findings are consistent with those of at least three other studies that looked at the relationship of time spent sitting and mortality.

The researchers also looked separately at the amount of vigorous physical activity each of the participants got.  As you would expect, those participants who got the highest level of physical activity had a lower mortality than those who got little physical activity. Very interesting, however, is the fact that the association of increased sitting time and higher mortality was independent of how much regular physical activity the subject got.  This means that sitting for prolonged periods of time – even if you get in regular physical activity – can be damaging to your health. And the converse is also true: even if you don’t get in much regular exercise, your health can benefit by limiting the amount of sitting you do in a day.

As you might expect,  the combination of sitting more (greater than 6 hours per day) and being less physically active (less than 24.5 MET- hours per week)** was associated with the highest increases in death rates – 94% increase in death rates for women, and 48% increase in death rates for men – when compared to those who sat the least amount (less than 3 hours per day) and had the highest level of physical activity (greater than 52 MET-hours per week).

Do yourself a favor and notice how many hours per day you sit without getting up, including your marathon of watching your favorite television shows, sitting at your desk at work, or getting caught up in that book you’re reading for hours at a time. If you are sitting for longer than 3 hours at a time, change it! If in fact you can’t help how many hours you have to sit at work, do two things: 1) get up and walk around once every hour or two; and 2) know that it is even more important for you to get in regular physical activity in order to offset the damage to your health done by sitting.

Remember: you should be reducing your time spent sitting per day in addition to getting regular vigorous physical activity each week.

* Alpa V. Patel; Leslie Bernstein; Anusila Deka; Heather Spencer Feigelson; Peter T. Campbell; Susan M. Gapstur; Graham A. Colditz; Michael J. Thun. Posted: 09/14/2010; American Journal of Epidemiology. 2010;172(4):419-429. © 2010 Oxford University Press.

** “MET-hours” is a measurement of how vigorous physical activity is over a certain period of time.

For many years I was having trouble both getting to sleep and staying asleep. Even though I am a doctor, I have a problem taking medications. So, I thought I would try hypnosis. My only experience with it at the time was watching hypnotists perform at my friend’s sweet sixteen parties. I wasn’t impressed.

However, as I got older I realized that there are some great hypnotherapists out there and perhaps one of them might be able to help me. I found a wonderful person who taught me the art of self-hypnosis. She made a tape for me that I listened to every night. In the tape she had me visualize myself going down ten steps. With each step I became more relaxed. The steps led to the beach that was calm and peaceful. I walked in the sand and felt the water on my feet and then relaxed in a comfortable lounge chair. At this point, I was asleep.

After listening to the tape several times, I no longer needed it. I could play the scenario in my head. Since that time I have had no problems going to sleep or staying asleep. In fact, I rarely make it down the third step. The funny thing is that despite the fact that it works every time, each time I do it I still have a moment of anxiety thinking that this might be the one time it doesn’t work. But, it does!

In this day and age it would be easy to get a pill to help with sleep. However, using self-hypnosis is self-empowering, safe and the price is right. I highly recommend it.

Remember Popeye? And his massive deltoid muscle that literally popped up every time he ate a can of spinach? Turns out he was on to something good.

We already know from many studies that a high dietary intake of fruits and vegetables causes you to be at lower risk for heart disease, strokes, and cancer. Now comes a study attempting to show that eating fruits and vegetables also put you at lower risk for Type II diabetes.* This paper was based on an analysis of six prospective studies looking at this question, lasting well over 15 years, and involving more than 220,000 people aged 30- 74.

The results? Interestingly, eating high levels of fruits only, vegetables only, or fruits and vegetables did not show a decrease in the risk of getting Type II diabetes. But in the four studies that looked specifically at leafy green vegetables (spinach, kale, and lettuce), those people who ate at least 1.4 servings of these per day had a 14% less chance of getting Type II diabetes than did those who ate only 0.2 servings or less of leafy green vegetables. This finding was statistically significant.

Despite a couple of problems with the design of the analyzed studies, this large analysis does show that basing your diet on plants in general, and leafy green vegetables specifically, is a definite way to promote good health and prevent certain diseases. Leafy green vegetables have this effect probably due to the high levels of antioxidants contained in them.

BOTTOM LINE: Have a fresh green spinach, kale, or lettuce salad every chance you get. Maybe with a bit of “Olive Oyl”?!  (sorry, couldn’t resist)

* Carter P et al. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: Systematic review and meta-analysis. BMJ 2010 Aug 19; 341:c4229. (http://dx.doi.org/10.1136/bmj.c4229)

As we are currently in a period of time of huge changes in our healthcare system, it’s no wonder if you’re confused about how the Affordable Health Care Act is going to impact on you and your loved ones. 

Knowing that this is the case, Katherine Sebelius – the Secretary of Health and Human Services – and her department have launched a new website to explain the recent reforms to our healthcare system.  Quite comprehensive, it:

1)    Explains the basics of the new law

2)    Helps you to find insurance options

3)    Helps you to learn about disease prevention

4)    Allows you to compare quality of care at different healthcare sites

5)    Gives specific health information based on the group you are in

(ie, families with children, individuals, seniors, young adults, employers)

Since it’s so new, it may have some kinks in it yet, but it still is an excellent resource. Here’s the link:

www.healthcare.gov

My mother always wore a girdle. In fact, she was absolutely rabid on the subject. She thought that all women – skinny minnies or not – needed to wear them in order to look ladylike. In her view, jiggling was not only not sexy (a word she never used), it was downright tacky (a word she used a lot).

So it was that when I came of age and began to jiggle*, the topic of girdles was an ever-running battle between us. For me, coming of age in the late 60s like the rest of you, wearing one was not even in the realm of the possible. After all, we didn’t even wear bras some of the time.

Fast forward to the present time. You can’t pick up a catalogue, turn on a shopping channel on TV, or hear an interview with a celebrity on the Red Carpet without hearing about Spanx.**  I won’t be totally surprised if you haven’t heard of Spanx because when we were writing our book a couple of years ago, our editor – who lives in California – asked what they were when she came upon a reference to them in our book. (I just figured that maybe California gals don’t jiggle).

Spanx is the popular brand of the underwear item now known as “shapewear.” They come in all styles from regular panties to those that are long-legged or high-waisted; to tights and stockings; to bras (that get rid of back fat) and slips; to actual clothing items such as tee shirts,turtlenecks, pants and skirts.  And exactly what does shapewear do? It shapes, compresses,firms,tightens – you get the picture – those places on your body that jiggle. (It can also make you look happily thinner).

In other words, Spanx is the modernday version of the girdle.

Since this is a blog on health, I would be remiss not to say something about any health effects of shapewear.  It’s rather obvious that knowing that you look better in your clothes leads directly to a positive self-image, and you know how important that is and how powerful that makes you feel. 

As for negative health effects, there are two. The first may occur when wearing shapewear for the bottom half of your body. If the elastic band where the shapewear ends -be it on your thighs or on your calves – squeezes so much that it actually causes a constriction in the area, this may lead to swelling and even blood clots below the elastic area. I can only speak to Spanx shapewear, but  these pieces are made so well that they don’t cause the constrictions mentioned above, especially if you wear the proper size.  

The other potential negative health effect is that you may stop exercising regularly because you look so good in your shapewear! Just remind yourself that you need to exercise for health reasons other than looking great.

Do I wear them? Absolutely. What changed my mind from my younger days? I no longer think that jiggling is sexy, perhaps because nowadays everything seems to jiggle as opposed to the discrete jiggling areas when I was younger. I’ll take that firm look anyday.

So, it looks like I finally gave in and wear a girdle. My mother would be so pleased.

*Please excuse the recurrent and relentless use of the word “jiggle.” Try as I might, I could find no synonym that worked.

**DISCLAIMER: As with the personally-used products that are mentioned in our book, neither of us has been paid – or otherwise convinced or asked – to mention any brand-name products.  We actually use the brands we mention.

Do you remember the Stillman Diet? It was an early form of the high-protein, low-carbohydrate diet that was created by Dr. Irwin Stillman in 1967. Unlike the still-popular Atkins diet, it was also low-fat, so that your food choices were really limited; you could only eat lean meats, eggs, cottage cheese, and coffee, tea, or noncaloric soft drinks on this diet. Condiments such as butter or any kind of oil were forbidden. Talk about feeling like you were eating cardboard after a few days! AND, you had to drink at least eight 8 oz glasses of water a day.

This diet was quite popular when I was in college. You wanted to lose 5 pounds in the 5 days before your hot date? Go on the Stillman diet. I remember one college friend whose version of this diet was a quart of lowfat cottage cheese and several Tabs for each meal, in addition to the requisite water.

But… it did work. And we all thought that there was something magical about drinking all that water.

Now comes a recent study showing again that drinking water can aid in weight loss; although the directions for drinking water in this study are much more reasonable (and doable) than in the diets of old.  Funded by the Institute for Public Health and Water Research, a nonprofit, independent science and education organization, this study was presented at the 2010 National Meeting of the American Chemical Society held in Boston on Aug. 22-26, 2010, by its lead author and researcher, Brenda Davy, PhD, on faculty at Virginia Tech.

The study followed adults ages 55-75 who were placed on a low calorie diet. One group drank two glasses of water before each meal, and the other group did not; both groups were on the same low calorie diet. At the end of 12 weeks, the group that drank water before meals had lost nearly 5 pounds more, and kept it off for 12 months, than did the group that had not drank water before meals. The author noted that those who drank sugary drinks before each meal, and not water, did not lose the same amount of weight as those who drank water.

The hypothesized reason for this “magical” property of water on weight loss? The author says that other of their studies have shown that those who drink 2 glasses of water before each meal consumed between 75 and 90 fewer calories during the meal, leading to the assumption that people who drink water before meals are actually fuller when they begin to eat food, and thus eat less. Nothing magical about that!

The next question that always follows any discussion of the role of water in good nutrition is exactly how much water should you be drinking daily? The truth is that there is not a set amount that every person should drink per day; in other words, it depends on many things, such as how much activity you do, how much you sweat, and how balanced your fluid intake and output has been over the prior few days. What makes up your “output”? It includes how much you urinate, how much fluid there is in your stool (this occurs only with diarrhea), how much you’ve sweat, and how much you bring up if you vomit.  So you can see that how much fluid you need depends on what your day has been like. If you’ve worked out a lot and sweat heavily, obviously, you need more fluid than you do on days you haven’t worked out. Same goes for if you’ve had diarrhea. And in the specific case of menopausal women (us), we almost automatically need more fluids than earlier in our lives because of those hot flashes and night sweats.

So, again, how much fluid do you need in your diet? Some experts say that you should let thirst be your guide.  But thirst is not always the best indicator because some people may not notice their thirst until they are very dehydrated. Other symptoms of mild dehydration may occur before thirst, such as dizziness, headache, or very concentrated urine.

What do I usually recommend? I tell my patients that they should get in about 8  eight ounce glasses of fluid per day – including water, coffee, tea and other non-sugary beverages. Can you drink too much pure water? Not usually IF you have normal kidney and heart function; although with excessive amounts of pure water (more than about 8 glasses a day), even with normal kidneys and heart, one can get an unusual syndrome known as “water intoxication.”

Bottom line: Do drink fluids before your meals and do try to get in around 8 eight ounce glasses of fluids per day. This intake should include water, but not be limited to water. Drink more than this only if you are thirsty or if you have recently been very active or sweating a lot. And know that the added benefit of drinking water before you eat is that it can help you to lose or maintain your weight by causing you to eat less, especially if you are watching your calories.