Sept. 6, 2007, Vol. V Issue 18
In one magazine last month I read that counting calories was the one and only way to lose weight, and — imagine this — another magazine offered an article headlined, “Quit counting calories!” And I’m sure you’ve noticed that these headlines are always displayed prominently on the magazine covers. Even my husband opened the magazine the other day looking for the “Lose 10 Pounds by Oct” article. This load of mixed messages that blares at us in the grocery store checkout lane, tempting us with quick fixes, is obviously about selling magazines and that’s about it. And if that isn’t enough, we get mixed messages in the news regarding health issues. It’s up to each of us to find our way through the headlines and rhetoric to credible sources.
Whether it’s diet and nutrition, heart health or hormones, I believe you have to pick your experts. I make that my business. And when I receive something from one of my speakers that feels like important and thoughtful information (not commercial), I want to share it with you. Today I’m dedicating the majority of our space to an article by Dr. Marie Savard, one of our expert women’s health speakers about menopause and hormones.
One other topic: there’s a new color on the block – it’s teal. Tomorrow, Sept. 7, has been designated as “Teal Time” to increase awareness about ovarian cancer. It is the deadliest of the gynecologic cancers. There’s no screening for it but women are being urged to know the symptoms so it can be caught earlier when it is very treatable.
And, all in the name of good healthy eating, I’ll share some of my label sleuthing experiences with you.
Hormone Update – The Good News
by Marie Savard, MD
Please note this article is by Dr. Savard.
Did you ever notice that only the so-called “bad” news about menopause and hormones seems to get our attention? Yet almost daily I am reading about new research and information about the benefits of hormones – so I thought I would share with you some of the good news for a change. (Although I am not recommending estrogen to prevent heart disease in women, estrogen is used to treat the distressing symptoms of menopause and is often the only thing that really works!)
Earlier this year we learned that the timing of hormones makes a big difference to the heart. Women who start hormones in the form of estrogen soon after menopause may actually prevent heart disease because the estrogen improves blood cholesterol and relaxes the heart arteries. Older women who start hormones 10 years or more after menopause may actually have a greater risk of heart attacks because their heart arteries already have plaque build-up, are stiffer, and adding estrogen does little if any good for the heart. In fact, taking estrogen in pill form can actually lead to increased clotting of the blood and may partly explain the higher heart attack risk in older women. (The skin patch or transdermal delivery of estrogen does not seem to cause this blood clotting effect because it bypasses the liver – and to my mind is the safest and best way to take estrogen).
In July, the New England Journal of Medicine reported again on the findings of the estrogen-only part of the large government study referred to as the Women’s Health Initiative. The women in this study who took estrogen only (that means they did not need to also take progestin because they had a hysterectomy) did NOT have a higher risk of heart disease. In fact the women who started estrogen around the time of menopause rather than many years later seemed to actually benefit from estrogen.
To understand why their hearts may have had a benefit, the women in the research study agreed to undergo an ultrafast CT scan of their hearts. This is a special scan that takes many close up pictures of the heart and counts up the amount of calcium present in the heart arteries. The more calcium you have (also called calcium score), the more dangerous plaque build-up in your heart arteries. No calcium means virtually no calcium or plaque build up and is great news. The women who took estrogen had up to a 60% lower chance of having calcium build-up in their heart arteries than the women who took the sugar pill. This is great news and helps explain exactly why younger women on estrogen had lower heart risk.
Any woman (or man for that matter) who is at high risk for heart disease should talk to her doctor about the pros and cons of a heart scan. Although insurance may not always pay for it, the scan does often give you and your doctor helpful information that assists you in making the best decisions for your heart health.
Although I wrote an entire chapter on hormones and women’s health in my last book, The Body Shape Solution To Weight Loss And Wellness, here once again is my general advice to women.
If you are in the throws of menopause and you want to give hormones a try, – don’t hesitate to talk to your doctor about the pros and cons of estrogen –given your unique medical history. There is no “one size fits all” solution but there are some general themes. If your doctor agrees hormones are okay for you to try to treat your menopausal symptoms, consider taking estrogen in the transdermal or patch form beginning at a low dose. As I mentioned earlier, research seems to suggest that the patch form of estrogen (or any estrogen delivered through the skin including the new estrogen spray recently approved by the FDA) may be preferable because it does not cause an increase in blood clotting, does not cause an increase in blood inflammation or an increase in the C-reactive protein test, and it does help to improve blood cholesterol. There are a few different skin patches available but they all deliver the same estrogen (e.g. Vivelle or Climara).
For women who still have their uterus (1/3 of women have had a hysterectomy) – then some form of progesterone (either synthetic progestin’s or natural progesterone) is necessary to balance out the estrogen in your uterus and eliminate any risk of uterine cancer. I like Prometrium because it is a natural progesterone pill that is taken up to 12 days every month or so. It has been shown to have few if any side effects or other effects on your body.
Stay tuned for more updates on hormones in the near future. Okay, I confess, I am in menopause myself and get hundreds of questions about the many different varieties of hormones. I can’t help but pay close attention.
– Dr. Marie Savard
Marie Savard, M.D. is an internationally-recognized internal medicine physician, expert on wellness and champion for patient rights. She is the author of three nationally acclaimed books, “The Body Shape Solution to Weight Loss and Wellness: The Apples & Pears Approach to Losing Weight, Living Longer, and Feeling Healthier (Simon and Schuster, January 2005),” “How to Save Your Own Life: The Savard System for Managing–and Controlling–Your Health Care (Warner Books, 2000)” and “The Savard Health Record (Time-Life Books, 2000).”
I wrote about her apples and pears body shape insights in an earlier issue of For Your Well Being.
To bring Dr. Savard’s expertise about women’s health to your community, please give me a call at 503-699-5031 or Barbara@speakwellbeing.com
Each year, approximately 20,000 women are diagnosed with ovarian cancer and about 15,000 women die. The overall five-year relative survival rate for women with ovarian cancer is 45 percent. However, survival rate improves greatly – to 93 percent – if the cancer is diagnosed at an early stage, before it has spread. Right now, only 19 percent of ovarian cancer cases are diagnosed in this early stage.
Partner Member organizations (local and state ovarian cancer groups) of the Ovarian Cancer National Alliance want to change these statistics. To raise awareness of ovarian cancer and its symptoms, these organizations are sponsoring “Teal Time” on Friday, September 7. Alliance Partner Members across the United States will wear the color teal and encourage others to do so as a focal point during Ovarian Cancer Awareness Month activities.
Teal is the ovarian cancer community’s color – like pink is for breast cancer – and a reminder that ovarian cancer is the deadliest of all the cancers of the reproductive system and a leading cause of cancer death among women. The idea for “Teal Time” was conceived by Alliance co-founder Bonnie Donihi, executive director of the Ovarian Cancer Alliance of Florida in Orlando. “It’s time to get loud about a disease that will again take 15,000 women’s lives this year,” Ms. Donihi said.
Ovarian cancer’s symptoms are subtle, difficult to diagnose and often misdiagnosed. Contrary to popular opinion, a Pap smear does NOT test for ovarian cancer – it is a screening for cervical cancer. Because there is not a reliable screening test, less than one in five women will be diagnosed in the early stages of ovarian cancer. However, with early diagnosis, more than nine out of 10 women will survive for more than five years.
Many people mistakenly believe that there are no symptoms. However, the research shows that at least 80 percent of women with early-stage ovarian cancer have symptoms for several months prior to diagnosis. While certain factors – including a personal or family history of ovarian, breast or colorectal cancer – can increase a woman’s risk, every woman is susceptible to the disease.
The following symptoms are much more likely to occur in women with ovarian cancer than women in the general population. These symptoms include:
* Pelvic or abdominal pain
* Difficulty eating or feeling full quickly
* Urinary symptoms (urgency or frequency)
Women with ovarian cancer report that symptoms are persistent and represent a change from normal for their bodies. The frequency and number of such symptoms are key factors in the diagnosis of ovarian cancer. Several studies show that even early-stage ovarian cancer can produce these symptoms.
Women who have these symptoms almost daily for more than a few weeks should see their gynecologist. Prompt medical evaluation may lead to detection at the earliest possible stage of the disease to improve their prognosis.
The Ovarian Cancer National Alliance, the nation’s voice for ovarian cancer issues, is a survivor-led umbrella organization uniting activists, women’s health advocates and health care professionals in the effort to increase public and professional understanding of ovarian cancer and to advocate for more effective diagnostics, treatments and a cure.
Lessons from Labels
I have four cans of garbanzo beans sitting on my desk. It kind of reminds me of a science experience but they’re unopened because this is as much about what’s on the outside of the can as what’s on the inside.
I’ve been more alert about reading labels since the National Wellness Conference this summer, when Zonya Foco, RD, CSP, pointed out that there are more important things to look at on a food label than the calories and fat grams (which is where my focus has always been!) We need to pay more attention to the ingredients list for one thing. I came home and was most dismayed to learn that my favorite low calorie salad dressing has MSG in it! I was shocked. It’s not my favorite anymore. She also made me cautious about artificial sweeteners. I looked at my favorite low fat yogurt store brand that’s often on sale and there was a logo on the front of it — “Sweetened with Splenda” — as if that was a good thing! So, I did some more label reading at the grocery store and lo and behold, I found a local low fat brand that is fruit juice sweetened, and just 10 calories more than the store brand. And today, I noticed in the newspaper that they are two for a dollar this week at Wild Oats. Zonya says that the jury is still out on Splenda: while it’s approved by the FDA, there’s still plenty of controversy. I’m choosing to go natural (and local!) with the fruit juice sweetened brand.
But, I digress, back to the beans. We use a lot of canned beans at our house. I put garbanzo beans on my salads and we enjoy a southwestern chicken chili recipe in the fall and winter that uses cannelini beans. My husband makes fresh hummus so we have it around for dipping fresh veggies. As Zonya would say, it’s a sneaky way to get beans in your diet. I have become aware that I want to watch the salt in my diet, so I decided to start reading sodium content. I’ve been buying Trader Joe’s organic garbanzo beans. I am a big fan of TJ’s but I won’t be buying these beans anymore. They clock in at 390 mg of sodium. I picked up Eden Organic – the ones that Zonya recommends – at Whole Foods and the label declares, “No Salt Added.” The sodium is 30 mg. S & W Premium with 50% Less Sodium (less than what is not explained!) has 220 mg and Westbrae came in at 140 mg. Those are pretty impressive differences. (They also differed in fat and calories). Have you read any labels lately? Any surprises? I’d love to hear about it.
In our next issue, I’ll share the most wonderful, delicious organic, all natural, handmade chocolate treat I’ve ever discovered. And I didn’t even have to line up four dark chocolate bars (in the name of your good health) on my desk to find it. Darn!
Until next time, be good to yourself for your good health and those you love.