When I was in college, every time finals would roll around, my suitemate and I had a battle cry about how we were going to get through the intensive study period before the exams. We used to say that, even though we’d be giving up the rest of our lives to study for those few weeks, we’d at least be “smart and skinny” when it was all over. After 4 rounds of studying for finals, did that ever happen? Smart, maybe yes; but never, ever skinny. In fact, despite all the hours studying and all the hours we didn’t sleep, we actually gained weight during that period.

Why did this happen? And what does this have to do with thin and chic French women? It has to do with sleep. And you might’ve guessed by now, since we try to be timely in this blog, that May is Better Sleep Month. Read on.

All those years ago when I was taking final exams, what we thought was this: that the less sleep you got, the more your metabolism was revved up and using calories, so you should be losing weight. Turns out we were way wrong. In recent years, many studies have shown that lack of sleep actually leads to weight gain as well as other health problems.

As for French women, remember in the recent bestselling book French Women Don’t Get Fat, the author, Mireille Guiliano, told of several reasons why women in France do not gain weight including eating small portions, walking everywhere daily, drinking a bit wine, and dining slowly? Well, now there’s another reason. In the Wall Street Journal of May 5, 2009, a reporter, David Gauthier-Villars, discusses a recent study that shows that the French spend the longest period of time sleeping per night than people in any of the other industrialized nations. And it’s almost a certainty that this extra time spent sleeping helps with French women’s ability to keep their weight down. So there you have yet another reason to get more sleep!

Sleep is a very important aspect of having a healthy lifestyle – not only the amount of sleep you get each night, but also the quality of sleep and how regular you are in getting it. If you’re having a problem sleeping, particularly if you’re sleeping less than five hours per night, discuss it with your primary care practitioner. Or read this recent article in U.S.News and World Report about how to sleep better; go to:

http://health.usnews.com/articles/health/sleep/2009/03/03/10-ways-to-get-better-sleep-and-maybe-cure-your-insomnia.html.

In the next blog, as we promised this past Friday, we’ll tell you how the swine flu epidemic is related to bicycle riding.

Remember those creaky joints we were just discussing in the last blog? If you have them, then you know that they can make exercise challenging. Biking is something that you can do that is a great aerobic activity, good for maintaining a healthy weight and is just plain fun. And, it will make you feel like a kid again!

Riding a bike is good for an overall workout. It is good for your legs, core and balance. If you don’t want to go outside you can use a stationary bicycle. If you want a real workout, go to your local gym club and find out about spinning classes. There you can ride a bike to music and be led up and down virtual hills with a group. It is social, fun and you can work up quite a sweat.

If you want to burn calories, biking is a good way to do it. If a 130-pound woman rides ten miles, she burns 400 calories. It is a very efficient way to stay in shape and have fun at the same time. It is also a great stress reliever that boosts endorphins.

Bicycling outside can be made easy if you find level ground. Start out slowly, and of course wear a helmet. It will feel good to get out into the fresh air. If you want to make it more competitive or social, find local bicycle races that map out rides. You don’t actually have to race. The key to incorporating exercise into your life is finding something that is fun to do.

May is National Bike Month and May 11th to May 16th is Bike to Work Week. Consider taking this opportunity to put on your bike helmet, hop on your bike and ride to work. You may have fun and notice that you feel good as well!

In the next blog, we’ll talk about biking and the Swine flu. How are they related? Tune in and find out!

May is National Arthritis Month in the U.S. Every other month it seems that there is another study saying that there is or is not benefit to using glucosamine for arthritis. So, what is the scoop? It looks as though glucosamine sulfate does help with arthritis of the knee and possibly other joints.* It is theorized that it protects the joint cartilage. Studies have found that glucosamine has an anti-inflammatory effect and improved joint function.There are some studies to suggest that injecting glucosamine along with chondroitin in lumbar disc disease can help pain in the leg that results.In addition, glucosamine has been found to improve flexibility for those in rehabilitation for joint injury.

Glucosamine is taken as 500 mgs three times a day. It is also possible to find preparations that can be taken as 1500mgs once daily.There is ongoing research to see if glucosamine used topically is effective.

Glucosamine is relatively safe, however it is often made from shellfish such as shrimp and crab. In theory, those who are allergic to shellfish could be allergic to glucosamine.There is some question as to whether glucosamine can alter blood glucose by increasing insulin resistance. Abdominal discomfort, elevated blood pressure and palpitations can also rarely occur.

If you suffer from osteoarthritis,glucosamine may be helpful.It is relatively safe and may help reduce inflammation and protect your joint cartilage.You might want to check it out.

*Frestedt JL, Walsh M, Kuskowski MA, Zenk JL.A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial. Nutr J. 2008 Feb 17;7:9.

The truth is,who of us isn’t unhappy with our weight or shape?!

So, have you ever been tempted by those products that you can get in the drugstore or in a nutrition store, like GNC, with NO prescription, that claim to “melt the fat away,” “return you to your teenage weight,” or “slim you down by 6 sizes” in no time and  with no work on your part? If you were in a crowd and asked this, you probably would not raise your hand because you think you’ll look gullible and stupid, right? But, again the truth is, who of us has not at least thought about buying and trying one of those over-the-counter miracle weight loss products?

Ok, I admit it – I sure have. And recently too – summer before last. I not only thought about it, but I bought a month’s worth of the new wonder product “Hoodia” at a time when I was so frustrated with my appetite (for simple carbs mostly) and my weight. I should know better, shouldn’t I? BUT, I never took them because every time I looked at that fancy packaging and the unbelievable claims, and remembered that the Food and Drug Administration ( FDA) has no regulatory powers at all over food products (which these are considered), so they have not been tested to see  if they work or if they are dangerous, I couldn’t take them.

What am I getting at here? One of the biggest selling weight loss products in the past few years has been “hydroxycut.”  Recently, the FDA has received at least 23 reports of people who had had bad health effects from hydroxycut, including one person who required a liver transplantation due to liver failure. Other adverse effects seen from this diet aid include heart problems and muscle problems leading to kidney failure.

The FDA is now officially warning consumers to avoid all products that contain hydroxycut. This diet aid is available in many formulations – including pills, drinks and powders – and can be the only product in a certain brand or can be combined with other diet aids into one product. So, if you have some weight loss aids at home, look at the label and do not take it if it contains hydroxycut.

Better yet, throw away any and all the weight loss products you have bought, and don’t buy anymore. What to do to decrease your appetite and to help your weight loss along? Try something novel: walk for 30 minutes per day and drink lots of fluids!

You’ve probably heard that taking a daily baby aspirin (81 mg) prevents heart attacks.But is that recommendation meant for everyone?

The answers are found in a March 2009 report by the U.S. Preventive Services Task Force (USPSTF) published in The Annals of Internal Medicine (2009, March 17;150:396.) 

The first issue of interest is that a recent study showed no benefit of aspirin in the prevention of heart attacks in women, despite preventing heart attacks in men. But, a daily aspirin has been shown to prevent strokes in women. So, a daily aspirin is recommended for women to prevent strokes, but not necessarily heart attacks, as it is in men.

The other recommendations by the USPSTF concerning who should take a daily aspirin include:

1) women between the ages of 55 and 79, and men, ages 45-79;

2) women and men, with and without risk factors for cardiovascular disease ( such as high blood pressure and high cholesterol); and

3) those people whose risk of bleeding from the gastrointestinal track is less than their risk of having a heart attack or stroke.   

How to figure out that last part of the recommendation?  We know that a daily aspirin increases the risk of GI bleeding. That risk is increased even more in men, older people (over 80 yo), people with a history of ulcer disease or upper GI pain, and those who regularly take a nonsteroidal anti-inflammatory drug, such as ibuprofen. Therefore, before simply popping an aspirin daily, you should discuss with your health care provider your risk of bleeding from the GI track; this is especially so if you are over 80 years old. Also, you should not take a daily aspiring if you are allergic to it.

Bottom line: a daily aspirin helps to prevent strokes in women and heart attacks in men, who are in the appropriate age range. If you are in the appropriate age range, and are not allergic to it, you should be taking a daily baby aspirin (81 mg) as long as the benefits outweigh the risk of GI bleeding. If you are younger than 55, but have risk factors for strokes and heart disease (a family history, high blood pressure, diabetes, high cholesterol, to name a few), then speak with your doctor about your need to take a daily aspirin.

Yesterday, the CDC announced that the number of people with swine flu in the U.S. reached 64, with 5 people needing hospitalization. The acting director of the CDC stated that he is very concerned about the evolving epidemic. Rather than use this space to update you with numbers of new cases each day, I will again summarize what you can and should do.

1) The symptoms of swine flu are exactly like other influenza illnesses – fever, cough, lack of appetite, fatigue; the incubation period, or that period of time between when you are exposed and when you will have symptoms is between 2 and 7 days. Some people do not get symptoms or get sick at all even after being exposed.

2) If you get these symptoms, stay home. If you begin to feel very ill – especially if you are having trouble breathing, have a high fever that will not come down even with Tylenol, or cannot take in fluids by mouth – call your doctor to be seen. Trying to avoid the emergency room – especially if your symptoms are mild – is a good idea to limit your and other people’s exposure, BUT if you can’t breathe, call 911.

3) The swine flu virus is thought to be spread person to person by the coughing or sneezing of infected people. Therefore, always cover your mouth  with a tissue, your hand or even your forearm when you cough or sneeze. Throw the tissue away immediatlely.

4)Wash your hands (and arms if used to cover a cough) with soap and water frequently. Alcohol based hand cleansers are also good.

5) Stay home if you are not feeling well; limit contact with others.

6) The CDC recommends that you avoid nonessential travel to Mexico.

7)If your immune system is suppressed -for instance if you have active cancer, are taking chemotherapy or radiation therapy, have AIDS or HIV with a low CD4 count, are on steroids chronically, or have had an organ transplant – you are more susceptible to getting sick. Check with you doctor about having a medication to prevent swine flu illness in the event you are exposed. Try to avoid being in crowded places.

8)There are two medications available which are effective against the swine flu virus: Relenza and Tamiflu. These can be taken to prevent illness after you’ve been exposed but before you get sick. They can also be taken once you develop symptoms but must be taken within the first 48 hours after your symptoms start in order to be effective. When taken after symptoms have begun, the medications can shorten the duration of the illness, and make the symptoms milder.

9) Don’t panic. Follow the above recommendations. The CDC updates the information on the Swine flu epidemic regularly. Stay informed by regularly visiting http://www.cdc.gov/swineflu/.

The World Health Organization (WHO) raised the pandemic alert level for the swine flu epidemic to Phase 4, which means that the virus is getting better and better at spreading among humans in at least one country. This was done yesterday because of the steadily increasing number of people in Mexico suspected of being infected with the swine flu virus, now up to nearly 2000 there, and with the number deaths there up to 149. In addition, the number of cases in the U.S. doubled when – through further testing yesterday – officials found more infected people at a school in New York City in which the original cases were found; the total number of cases in the U.S. now stands at 48, with only one person needing hospitalization and no deaths.

What does this mean? The WHO has 6 phases of alert that can be used during an epidemic, phase 6 meaning that there is a full blown pandemic with outbreaks in at least 2 countries in the entire world. Being at Level 4 worldwide means that preventative measures are rapidly being put in place. In this country, it is now advised that no one travels to Mexico unless it is absolutely essential; checking people for infection at the borders is now in effect as well. You can find out more at: http://www.msnbc.msn.com/id/30398682/

If you, or someone you know, is having flu-like symptoms, such as fever and a new cough, you should get checked out by your healthcare provider. It is generally advised that you not go to an emergency room (unless you are seriously ill) for this because of the risk of the virus spreading to uninfected people (and your risk of catching it from someone else). In addition, re-read the recommendations for preventing its spread on the CDC page about the swine flu epidemic at the link given in yesterday’s blog. That page will be continually updated.

In case you haven’t heard or read the news, U.S. health officials declared a national public health emergency regarding Swine flu yesterday. This action was taken because of the discovery of 20 people with documented Swine flu infection in the United States; these cases were found in the following states: New York, California,Kansas, Ohio, and Texas. All twenty of the patients recovered. Suspected cases have been recently found in Mexico,where 1600 cases were reported, with 100 deaths. Six cases have been found in Canada. Infection with the swine flu virus is known to spread from person to person.

What does the declaration of a national public health emergency mean for you and yours? Should you panic? No. Right now, whether this virus causes mostly mild or serious infections is not known for sure. Although there is a fear that infection with this virus will lead to an epidemic globally, the good news is that it is still early for this possibility. By declaring a national health emergency, health officials are raising awareness of this infection and its potential to spread quickly, which will hopefully lead to proper actions by all of us (see below for more on this), and thus, is a step in the prevention of its spread.  

For everything you need to know about this, go to the page that the Centers for Disease Control and Prevention (CDC) has set up; especially read the section on the steps you can take to avoid, or lessen your risk of, becoming infected with this virus. 

http://www.cdc.gov/swineflu/

Because any part of the GI track can contract in an unpredictable manner in people with IBS, the regularity of bowel movements is disrupted, resulting in diarrhea or constipation, or an unpredictable combination of the two. In addition, abdominal pain can occur due to the extra contractions, or spasms.  These spasms can occur not only in the lower part of the GI track, the bowel, but also in the upper part, the esophagus. Spasms of the esophagus can cause chest pain, which can be severe and mimic a heart attack.  Any of these symptoms can be quite mild, or very severe. In fact, some people with IBS have such severe symptoms that it can disrupt their daily lives.

How is IBS diagnosed? This can be a problem because there are other diseases that can cause the exact same symptoms. For instance, you can get a viral or bacterial infection of your bowel that causes diarrhea and abdominal cramping.When these symptoms are due to an infection, however, they usually do not last long, and generally do not recur as does IBS.

Also you can get similar symptoms with a group of diseases known as Inflammatory Bowel Disease (IBD), which includes Crohn’s disease and Ulcerative Colitis. Some of the differences between IBD and IBS (besides that one letter at the end!) are:

·        IBD results in inflammation of the GI track which is thought to be due to one’s body attacking itself, the bowel in this case ; therefore, IBD is thought to be an autoimmune disease. IBS does not cause inflammation and is not autoimmune in nature.

·        IBD can lead to long term complications including bowel obstruction and cancer; IBS does not lead to either.

·        People with IBD can have recurrent episodes that may include high fever, dehydration, and loss of appetite requiring hospitalization; IBS does not include symptoms other than those of the GI tract

·        IBD may lead to surgery of the bowel; IBS does not require surgery.

As you can see, the diagnosis of IBS can be tricky, and should be done in consultation with your clinician. If your bowels become irregular for more than a couple of weeks, or if you develop abdominal pain seemingly out of nowhere that recurs or persists, don’t try to make your own diagnosis.  And never treat yourself without seeing your clinician first.

Although the symptoms of IBS can get severe, most can be controlled with medications. In addition, there are many lifestyle changes you can make that will lessen the effects IBS has on your daily life. In other words, you can definitely manage this disease.

If you haven’t, please read the section in our book on IBS to learn more. (Sorry for that shameless plug!) In that chapter, you’ll read some actual cases histories of patients with IBS, including yours truly.  Also for more information, go to: www.aboutibs.org

April, like March, is another one of those months during which there are many diseases highlighted. Almost too many – not easy to keep up with all of these!

If you’ve read our book, then you know that we devote a lot of space to the topic of Irritable Bowel Syndrome (IBS). Why? Because one of our goals in our book is to discuss those diseases that are common in women our age. IBS is one of these.

What exactly is IBS? It is commonly thought of as a motility disorder, or a malfunction of the movement (contractions) of the entire GI tract. The purpose of these contractions is to keep food moving down the entire GI tract so that parts of it can be absorbed and used by the body, and the rest can be expelled through a bowel movement. IBS results in the loss of the GI track’s ability to regulate its own contractions.

IBS has also been called “spastic colon,” “spastic colitis,” and “nervous stomach.” But, nerves or stress do not cause IBS. The cause is unknown. There is no cure, but there are medications available to help control the symptoms.

IBS is quite common. It affects between 10- 15% of the US population, or between 25 and 45 million people. Women are affected more commonly than men are; it can affect all age groups.

In Part II, we’ll talk about how you can tell if you have IBS.