Healthy living, Hormone balancing, Women's Health

On Breast Health and Broccoli

April 13, 2012

Much as many of you hate to admit it, broccoli IS actually good for you.
A study recently presented at the Annual Meeting of the American Association for Cancer Research, looked at 4886 Chinese women with a history of breast cancer and their intake of cruciferous vegetables.
The study found that cruciferous vegetable intake during the first 36 months after diagnosis with breast cancer was associated with a decreased risk of total mortality, breast cancer specific mortality, and breast cancer recurrence.
The risk for total mortality decreased by 27%, the risk for breast-cancer specific mortality decreased by 22%, and the risk for recurrence decreased by 22%.
Cruciferous vegetables, including broccoli, cauliflower, brussel sprouts, and cabbage contain several substances which carry significant health benefits. Among them are Indole-3-Carbinol (I3C) and Di-Indole-Methane (DIM) which have shown the ability to promote the formation of the beneficial estrogen metabolite 2-hydroxyestrone while reducing the production of the stronger and more harmful estrogen metabolites 4-hydroxyestrone and 16-hydroxyestrone.
Previous studies have also shown that intake of raw cruciferous vegetables is associated with a reduced risk of bladder cancer.
Because of these and other potential positive benefits, I strongly encourage the generous intake of any and all members of the cruciferous family. I will also frequently recommend a high quality supplement which contains I3C/DIM to many of my patients.
When it comes to consuming larger amounts of this family, don’t just think about steamed broccoli. They can be eaten raw, roasted, grilled, in soup, slaw, marinated, pickled, etc. Be creative–with a little experimentation you can find something that you actually like to eat, and you will be healthier for it.

Hormone balance, Women's Health

Stopping HRT And The Risk Of Hip Fracture

April 8, 2012

In the wake of the release of the Women’s Health Initiative Study in 2002, millions of women in the US and around the World abruptly discontinued their hormone replacement therapy. Many of these women were taking hormone replacement (HRT) for bone protection. Since that time, few studies have looked at the impact of the abrupt cessation of these hormones and the incidence of hip fracture.
A study recently published in the Journal Menopause 2011;(11):1172-1177 looked at 80,955 women who were using HRT as of July 2002. They were followed through 2008 and incidence of hip fracture was recorded. In addition 54,209 of the women had a bone density scan during the study period.
The study factored in, and accounted for differences in age, race, and use of medication during the study period.
The study found that women who discontinued HRT had a 55% increase in risk of hip fracture over those women who continued HRT. The increased hip fracture risk showed up as early as 2 years after the hormones were stopped, and continued to worsen the longer the duration off of HRT.
In addition, the longer the women were off HRT, the lower their bone density was.
Observational studies have consistently reported an amazing 38%-60% reduction in the risk of fractures of the hip, wrist, and spine among women who have used HRT compared with those who have not.
This current study is very important, indicating not only that HRT is very effective in maintaining healthy bones, but that this protective effect disappears very soon after the therapy is stopped.

Healthy living

Rock-A-Bye Bagel

March 31, 2012

Have you ever noticed that when you are tired you tend to eat more? Or when you go to the grocery store tired, you tend to buy more, or just can’t resist that candy bar at the checkout counter?
While it is not an excuse to indulge, when we are sleep deprived, there is now a reason to explain why this occurs.
Research scientists looked at the effect of sleep and lack of sleep on the brain, and the perception of hunger. The study was done on normal weight individuals who were tested after a normal night of sleep and then again after a night without any sleep. For the testing, researchers surveyed the participants as to whether or not they were hungry, and then scanned their brains while looking at images of food. They then surveyed them again as to how hungry they were after the images and scanning.
After one night of no sleep, the scans showed a higher level of activity in the area of the brain responsible for hunger. This was not seen in the individuals who slept normally. The response was independent of how hungry the subject claimed that they were before scanning.
Also interestingly, after looking at the images of the food, the subjects who went without sleep reported that they were now hungrier than those who had been allowed to sleep the night before. Blood sugar levels taken before and after the participants looked at the images of food were the same.
So sleep loss resulted in what the scientists referred to as “hedonistic stimulus processing”. They had a heightened desire to eat independent of a physiologic need.
So what is the take-home message here?
Lack of sleep can increase your perceived hunger regardless of your actual need to eat. This in turn could derail any efforts you have made regarding your weight or healthy eating habits.
So the bottom line is going to the grocery store or watching food TV while you are sleep deprived will increase your perceived hunger, and will likely lead to real weight gain.
Just one more reason to make sleep a priority in your life.

Healthy living, Hormone balance, Women's Health

Improving Menopausal Symptoms With Exercise

March 24, 2012

A study recently published in the journal Menopause, looked at a small group of Finnish women and the association between exercise and menopausal symptoms. The study included women ages 45 – 63 who had recently begun to experience symptoms of Menopause. The women were divided into two groups. One group was asked to exercise four days per week for 24 weeks, and the other group attended health lectures during the same time period. After six months, the women in the exercise group reported less mood swings, irritability, and night sweats than the non-exercising group.
There certainly are many reasons that exercise may have decreased the exercising women’s symptoms. Regardless of the reasons for the improvement in symptoms I am sure that the relief was welcome. In addition to the improvement in the menopausal symptoms I am sure that the women’s health improved in many other ways as well.
So, if you are having menopausal/perimenopausal symptoms and need one more excuse to start exercising more, here it is.

Healthy living, Hormone balance

“Not Till You Finish Your Fries!”—-The Childhood Obesity Epidemic

March 14, 2012

I was sitting with my kids at one of the “buffet” style restaurants. At the table next to us was a child sitting with a “my eyes were bigger than my stomach” plate full of french fries. He asked his mother if he could go up to get some dessert and she said “Not until you finish all your fries”. Now I suppose that it could have been the mother using this as a teaching moment about not wasting food, but unfortunately it was not.
What bothered me most was that this young child was already moderately obese, and from his weight and eating behavior he was clearly following (or being led) in the footsteps of his parents and older siblings.
By the way, food quality aside, it is possible to make good food choices at buffet type restaurants, and it can also be a nice venue to teaching children about trying different things, and making good nutritional choices.
So why did this bother me so much?
Child and adolescent obesity in the United States is a major and growing problem, more than tripling in the past 30 years. Nearly 20% of all children and adolescents in this country are categorized as obese, which is not just “a little heavy”. The causes? Bad food, too much food, advertising, poor dietary habits, lack of physical activity, lack of education, stress, environmental factors etc. Unfortunately the most easily influenced among us are now suffering from the immediate consequences of being obese, and unless something changes they will begin to develop the long term complications that follow chronic obesity.
Obese youth are beginning to develop things that up to this point were associated with adults. They are more likely to have risk factors for cardiovascular disease, have pre-diabetes (or even “adult onset” diabetes), bone and joint problems, and sleep apnea.
Obese children are at higher risk for poor self esteem and other social and psychological problems.
Obese children and adolescents are much more likely to be obese adults with the subsequent higher risk for developing heart disease, strokes, diabetes, arthritis, and an increased risk of developing many types of cancer including breast, colon, cervix, endometrium, prostate and many others.
There are even hormonal concerns. Obesity in both male and female adolescents is associated with increased levels of estrogen and the stress hormone cortisol. Because of the increase in estrogen, males are more likely to experience breast development. In females, periods are more likely to start earlier, and they are at higher risk for endometriosis, polycystic ovarian syndrome, PMS, and fibrocystic breasts. Girls who are obese at puberty are at risk for higher levels of testosterone which is associated with development of acne, facial hair, and abnormal periods.
I know that as a father, the fewer of these issues that I have to contend with, the better my life will be.
So how do we correct this? Unfortunately both the cause and the solution boils down to one simple thing–US. It is an uphill battle, but our children can’t be expected to make the right decisions on their own. They need our support, they need us to be role models, they need us to counter the unhealthy messages and advertising that they are exposed to, and they need us to set limits and expectations. We need to engage our schools to make sure that healthy choices are offered at lunch and that physical activity is encouraged. We need make sure they stay as physically active as possible. We need to explain to them that this is about more than just “not getting fat”.
We can prevent this epidemic from worsening. By doing so we will improve the quality of not only their lives, but ours as well. Think about this—as we age we would like our children and grandchildren sitting at our side, helping to care for us, not sitting with us suffering from the same problems that we have.

Healthy living, Hormone balance, Women's Health

Hormone Replacement and Vascular Health

February 24, 2012

Vascular (vessel) disease is relatively rare in the early decades of a female’s life, but by the time a woman enters her 50′s cardiovascular and cerebrovascular diseases become leading causes of death. It has long been suspected that a female’s hormones play an important role in these age related cardiovascular changes.
A recent study in the journal Fertility and Sterility (2011;96:1445-1450) looked at markers of vascular disease in relationship to factors including hormone use. Researchers found that carotid artery thickness and carotid pulse pressure were both lower in women who used hormone replacement. Arterial thickness and increased pulse pressure are both indicators of diseased vessels. They found that although both of these factors increased with age, they worsened more slowly in the hormone replacement users.
So the take away from this study is that hormone replacement seemed to lower the risk of developing vascular disease, and also slowed the rate at which it occurs. With life expectancy now exceeding 70 years, minimizing any risk that we can is even more important to keeping ourselves healthy for as long as possible, so that we can enjoy all of those extra years.


Healthy living

Jamaica Mistaica

February 18, 2012

My apologies to Jimmy Buffet for borrowing one of his song titles, but it was so applicable that I could not help myself.
I saw a patient this week who reminded me again of the potential interaction between topical hormones and other products which are applied to the skin.
She had previously been doing very well on a stable dose of progesterone cream. She called our office saying that a couple of days after arriving in Jamaica all of her previously well controlled symptoms came rushing back with a vengeance, making for a miserable vacation. After she returned home we had her hormone levels checked and saw a her for a visit. At her visit we noted that her progesterone level had dropped so much that it was almost identical to her level before she started using progesterone. She also noted that about 10 days after getting home (and a few days after the testing was performed) her symptoms completely resolved. She now felt “back to normal”.
The cause?
Being a fair skinned Minnesota girl, she was careful to apply a waterproof sunscreen multiples times during the day. She noticed that even after her shower at night her skin still felt “greasy”. The sunscreen had created a barrier on the skin preventing her progesterone cream from being absorbed while she was on her trip. After she returned home and stopped using the sunscreen, her progesterone could again be absorbed. Her levels returned to normal and she felt better.
Having regained her sense of humor, she told me that next year she will make sure that she puts her progesterone “where the sun doesn’t shine.” I would settle for under her swim suit.
Although this was an extreme case caused by sunscreen, the same thing can happen with moisturizers, body lotions and other similar products. Because of this, I recommend that hormone creams not be applied in areas where these products are consistently used.


Healthy living, Hormone balance

Work Got You Down?

February 2, 2012

A recent study performed by the Finnish Institute of Occupational Health showed a link between longer work hours and increased risk of depression.
The study followed over 2000 male and female British Civil Service workers between the ages of 35-55 for an average of 5.8 years. All of the participants were healthy, reported no symptoms of depression at the start of the study, and were asked about their work hours.
At the end of the survey period, the workers were screened again and the previously healthy participants who worked 11 or more hours per day at the beginning of the study were almost 2.5 times more likely to have a diagnosis of clinical depression than those who worked more normal hours.
Certainly there are many potential factors at work here. Spending more time at work can create stressors at home. There is less time to exercise, sleep, relax, and enjoy ourselves. We may eat less well. We feel guilty that we have to work such long hours and sacrifice other things in our life, yet feel guilty or have other stressors if we do not work the long hours. This I understand–as I write this, I am missing my daughter’s school conference.
It is important to find balance in all things. Work, play, joy, sadness, hunger, satiety, and yes our hormones too.


Healthy living

All Those In Favor Of Good Health–Say Eye

January 27, 2012

As Functional Medicine Physician Dr. Pamela Smith likes to stress, there are three things that we should strive to maintain as we age—-Vision, Memory, and Mobility. So what is the hands down, undisputed, most effective way to hold on to all three as we mature? EXERCISE !!!
Let’s look at vision for a minute.
Almost all of us will have some evidence of cataract formation after the age of 65, with both the incidence and severity increasing with age. By the age of 80, the majority of people will either have cataracts that are visually symptomatic or have already had cataract surgery.
Age related Macular Degeneration is the leading cause of irreversible vision loss in older Americans.
Can regular physical exercise really help you to avoid these conditions and maintain your vision? Absolutely.
A study of 41,000 runners over 7 years found that these men and women had significantly lower rates of these two diseases than the general public. In addition, the higher the level of physical activity, the greater the effect.
A study from the University of Wisconsin followed 4000 men and women over 15 years and monitored visual health and level of exercise. They found that those with an active lifestyle were 70% less likely to develop degenerative eye diseases than those with a sedentary lifestyle. Regular walkers were 30% less likely to develop disease.
A third study found that those people who exercised the most had a 54% lower risk of developing Macular Degeneration when compared to those who exercised the least. When exercise was combined with healthy eating habits in non-smokers the risk was reduced by 71%.
This is about more than just maintaining our vision. With good vision there is a positive effect on our memory and long term mental functioning. With good vision we are able to read, see what is going on around us, and it allows us to be more mentally and socially engaged in our lives. It also has a positive effect on fitness, as we are less likely to get out and walk or engage in other forms of exercise if we can’t see well.
So if you needed one more reason to kick your activity level up a notch–here it is.


Healthy living

Resolution Review

January 21, 2012

So here we are, a few weeks into the new year, which is a good time to take note of where you are at with regard to your New Year’s Resolutions. By now you should be able to see if you have:
—Embraced your resolution, made it a “habit”, and are seeing some progress. Maybe you could even make an additional change in your life.
—Let the resolution and your good intentions fall by the wayside. No guilt here, January 1st is only a date on the calendar and you can make changes any day of the year.
—Not made a resolution, but you realize that you really do need to change something for the positive, and should do it before another year goes by.

For all three groups, I do have a suggestion for an easy, inexpensive, life and health changing addition that you can make in your life——Keep a Food Journal.

Simply carry a slip of paper in your pocket, and each time you eat ANYTHING, write down what and how much. No need to look at calories etc–you are only keeping a list. Just be honest. Then at the end of the day, enter everything in a notebook or on your computer.

The life and health changing part of this comes through our conscience and self awareness. Most of us do not realize how much, what, and how often we eat. Faced with the black and white reality of what we are actually consuming in our day, many of us will find it easier to eat differently and make better choices. The difference between eating 2 and 4 cookies does not seem like much, until you know you have to write it down and look at it along with everything else you ate that day. It does work, and can help create a positive change in your life and health with very little effort.

“Be moderate in everything, including moderation.” – Horace Porter


Healthy living, Supplements

Vitamin D And Depression

January 11, 2012

This winter has certainly been an odd one. Imagine–over 50 degrees, sunny, and no snow on the ground in Minnesota on January 10th. Two of my patients were going out golfing just to say that they had played in Minnesota in mid-January. Today I watched many people walking outside my office enjoying the weather, and I myself noticed a little lift in my mood being outside for the few minutes that I managed to squeeze in. Despite this, we are still in the time of year when many of our Vitamin D levels are beginning to drop to symptomatic levels. It is likely a bit less noticeable with the nice weather we have been having, but nonetheless, it is still happening. As I have mentioned before Vitamin D is very important for many reasons, not the least of which is mood support.

A study published in the November 2011 edition of Mayo Clinical Proceedings monitored 12,594 men and women between 2006 and 2010. In this study they found a significant association between higher Vitamin D levels and a decreased risk of depressive symptoms, especially among those with a history of depression.

All the more reason to make sure that you know what your Vitamin D level is during the months, when exposed skin is more likely to freeze rather than tan.


Hormone balance, Men's health

Testosterone And Lean Body Mass

January 6, 2012

A study published in December 2011 in the Journal of Clinical Endocrinology and Metabolism examined testosterone level and its association with loss of lean body mass and lower extremity function in 1183 men 65 years and older.

Researchers found that men with higher baseline testosterone levels lost less lean body mass, and had a slower decline in lower extremity strength over time.

They state in their conclusion that “Endogenous testosterone may contribute to healthy aging”.
Although this study did not examine the effect of treating men with testosterone, it did clearly show that men who have a higher level of testosterone as they age maintain muscle mass and lower extremity strength better than men who have lower testosterone levels. In my opinion, it is not much of a leap of faith to believe that by keeping a man’s testosterone within a healthy range as he ages, we will produce the same positive findings, clearly impacting long term health and the aging process.


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