Choose You Blog

Did you know that between the ages of 45 and 60 the human heart begins to stiffen? That gives new meaning to the phrase  ”hard hearted.”

Most people have learned by now, though, that the word “hard” in proximity to any part of the cardiovascular system is a Very Bad Thing Indeed, and that remains true for the heart.

According to HHS HealthBeat:

A healthy heart is like a rubber band. The more elastic it is, the better it works. A new study shows lifelong exercise can help your heart stay that way.

Researcher, Benjamin Levine is at the Texas Health Presbyterian Hospital in Dallas.

While starting to exercise late in life has its benefits, Dr. Levine says: “You don’t want to wait too long if you want to try to make these major structural changes.”

. . .exercise should be a conscious part of your daily routine.

“Four to five days a week we think is the right dose to make sure that you have the maximum benefits.”

The study, supported by the National Institutes of Health, was presented at the annual scientific meeting of the American College of Cardiology.

If you’re just beginning an exercise program, make sure to check with your doctor first. Then, once you have the all-clear, Livestrong recommends some great types of exercise for beginners to try:

• Cycling
• Walking
• Swimming
• Circuit training

As always, I add in yoga, too.

What exercise do you do to help keep your heart strong and elastic?

My Facebook stream is usually a list of family news and health updates. The other day, as I looked through the list, people were asking for prayers and positive thoughts for relatives stricken with various diseases, often cancer.

I stopped and wondered: they’re updating us, their Facebook friends, but are they updating their doctors?

The Department of Health and Human says:

“Family news can be important to doctors, too. Researchers say that if a patient’s close relative develops a disease that can run in families, the patient’s risk may go up, so doctors could change their recommendations for screening tests.

At Baylor College of Medicine, Sharon Plon saw this in data on close relatives of about 11,000 patients across the country. The analysis looked at colorectal, breast and prostate cancers.

Dr. Plon:

“Our hope is that physicians and patients will be more sophisticated about who needs the more intensive or earlier screening, so we can pick up cancers at an earlier age.’’

That sophistication, though, depends upon patients keeping their doctors informed. Understandably, you may not prefer to Facebook friend your doctor, but do find a quick and easy way to send them news to ensure that your chart is up-to-date.

We’ve been talking about CSAs (community supported agriculture) on the Choose You Facebook page. In case you aren’t familiar with CSAs, Local Harvest has a great definition of them:

[CSAs are] a popular way for consumers to buy local, seasonal food directly from a farmer. Here are the basics: a farmer offers a certain number of “shares” to the public. Typically the share consists of a box of vegetables, but other farm products may be included. Interested consumers purchase a share (aka a “membership” or a “subscription”) and in return receive a box (bag, basket) of seasonal produce each week throughout the farming season.

CSAs are a great way to know everything you want to know about your food, including forming a relationship with the farmer who grows it. It’s fresh, usually organic, local, and seasonal. Popular theory holds that eating seasonally can be healthier, and it definitely can be more cost effective. As can CSAs, which offer memberships on a progressive cost scale, so you can choose the one that is within your budget and will feed your family. Plus, your family gets introduced to a variety of produce that you might not otherwise have tried. Kids seem to really like the farm fresh produce, especially if they get to see where it grows or help harvest any of it.

The downside to CSAs are getting more (or less, but typically more) volume of produce than you can manage, storage of all the produce, wishing for broader variety as well as more of your favorites and less of the food you don’t prefer. It can also be challenging to figure out how to cook and serve the vegetables you aren’t familiar with.

Overall, though, it can be a great and economical way to eat right. Typically CSAs offer better and healthier produce that is usually organic, and costs less when compared to grocery stores.

So what do you do with all of the vegetables? There are some great, healthy recipe sites that can help you find recipes based on a key ingredient (such as kale) or CSA-specific recipe sites. These are the top three I recommend:

• Recipes by key ingredients with CSA notes. Great resource.
• CSA Meal Planning has a lot of good ideas.
• A Bushel of What by Nicole Kutcher has CSA recipes and eating ideas, as well as tips. Cute and appealing site.

When I was pregnant with my oldest daughter, I read What to Expect When You’re Expecting. Well, tried to read it. I brought it with me on a trip to see friends married, and I lay on a chaise lounge in gorgeous Sarasota reading this book and I cried. I was going to read it like a normal pregnant woman. I was going to read it to convince myself I was pregnant. We’d fought for years to be pregnant, my husband and I, to be healthily pregnant with a baby born live and healthy after 40 weeks. I spent the first two months trying to be hopeful and positive with this pregnancy, while my doctor told me to not get attached. Right. When we finally cleared the mark–the place where the doctor said it was okay to hope, that this was a strong baby and things looked good, while I gave myself daily injections to keep that part true–we still could not bring ourselves to say the words: we’re having a baby. We’d learned to not take anything for granted, we’d learned to not expect, even when expecting. And so I read this book and I cried because nothing–nothing–in that book was me, or my pregnancy. All the things hormones bring to other pregnant women–nausea, fatigue, moods, cravings, glowing–all the things that are the by rights humble brags of the gravid, none of these were mine.

In beautiful Sarasota, my husband gently took the book from my shaking fingers and said, “They don’t know us, they don’t know this, they don’t know, it’s just a general idea, it’s a stupid book. We don’t need it.” And he threw it away, that book, all the way away. Outside our room in a dumpster. At a shower, in a store, my office, with friends, with family, everyone wanted me to read that book, everyone wanted to give me their copy. Everyone thought I was having the same experience they did, and all it did was make me feel more isolated.

My body kept me isolated for years after my baby was born, healthy and live and perfect and beautiful albeit only at 38 weeks. My breastfeeding wasn’t quite right. My recovery wasn’t quite right. Getting pregnant the second time wasn’t quite right, nor was that recovery. When I looked back, my teens weren’t quite right either. Other girls talked about all the signs of womanhood, all the symptoms, and I never knew really what they meant. But I laughed or groaned in all the right places and felt lucky, because hey, I never had any of those troubles. No breakouts, no PMS, no cramps, no bloating. Lucky? Or a symptom?

It strikes me that my hormone levels may never have been quite right.

In my late 30s, things got a little crazy. Suddenly, I did feel like a teenager. I brought a sense of humor to it and laughed about my youthful renaissance, but after a while, it wasn’t so funny. I suffered breakouts, PMS, cramps, bloating and more. My peers were experiencing it too, and for once, I felt like the typical woman. But where their symptoms stopped at mildly annoying, for the most part, mine kept going all the way forward to overwhelming and intrusive. Some days, the cramping pain was so bad I couldn’t get out of bed, on those days, the migraines would have kept me laid low even without the cramps. Days of exhaustion, lack of focus, wild variations in hunger and cravings, horrific bloating that took me up two dress sizes, and so on. My entire life was negatively affected. Lately, it doesn’t matter how much I cut back on food or increase dieting, my weight is creeping up. Once again, I feel my body is out of control.

If you’ve never been there, you might not understand. But when you feel out of control of your own body, it creates a soul-wrenching baseline for living. It affects my mind and spirit, and that creates a vicious cycle.

Because I believe in choosing myself and taking care, I sought medical help.

I was treated for various things in various ways–at the worst, with a horrific round of medication to treat an pituitary tumor; at the easiest, with dietary and exercise changes. The standard fixes, such as “eat more soy” that my GP and OB/GYN suggested never helped, and now research says that’s because it never could help. I tried it all, including a year of different hormone therapy. I think I know what it is and so do most of the doctors I’ve seen: perimenopause.

This statement by Eric Honing, MD, pretty much sums up how I feel about it all now:

Eating right, exercising and de-stressing will also help your hormone balance, but you need to have the energy and motivation to get there — and for that, you need hormone balance.

I’ve tried, honestly I have, but it’s maybe time for that next level. I’ve been deeply concerned about it, though, because of so much I’ve read that links hormone replacement and cancer. The difference, as one magazine article pointed out when it deconstructed the statistics, is that I am not in the age range or group evaluated for risk. I am under 50 and not menopausal. Maybe I don’t currently need a long-term pharmacological fix. Maybe I just need a little reset. My body has been through a lot the last ten years.

I’m going to explore various options, see what’s out there, what can help and I’m willing to try things that I decide, with my doctor, will offer benefits that outweigh risks, things that are the right approach for me. I don’t know yet what that is, but I’m checking.

I’ve called a doctor that I found through a site a friend put me on to, and after asking around a bit, I’ve found several people I know who have seen this doctor and given this approach a try. One friend who went through the treatment with this doctor described it as a whole body approach that used diet and exercise as cornerstones. That sounds promising. Mayo Clinic says bioidentical isn’t any safer, then claims FDA says it’s riskier. Oprah, who listed symptoms very similar to mine, says she benefitted greatly from it.

I agree with her position: “she urges women to “take charge of your health” and says it’s time to “start the conversation” about menopause and bioidentical hormones.”

So here’s to taking charge of health and starting the conversation: have you tried any treatments for perimenopause and menopause symptoms? What are your thoughts?

A new study shows that yoga can help women undergoing radiation treatment for breast cancer:

At the University of Texas MD Anderson Cancer Center, Lorenzo Cohen saw this in women who did yoga or stretching. He says the stretching group reported feeling less tired, but the yoga group got this plus less stress and lower levels of the stress hormone cortisol.

Dr. Cohen says it’s best to do yoga regularly:

“It’s constantly exposing yourself to the positive benefits and the relaxation that we feel after a mind-body practice that can be quite useful.’’

The study presented at a meeting of the American Society of Clinical Oncology was supported by the National Institutes of Health.

I’m a big fan of yoga, so this doesn’t surprise me but it does delight me. I use yoga to relieve muscle pain and tension, release stress, build my core, improve my muscle strength, center my emotions, and okay, biggest use is to help deal with hormonal fluctuations those of us easing into middle years often experience. The best help? It can ease my night sweats and insomnia. That’s an anecdote, by the way, not a scientific study.

But consistently, lowering the cortisol seems to help. And science does bear that out.

Yoga is an exercise that cancer patients can usually manage, and being active is important, as Colleen Doyle. M.S., R.D., explained in a recent Choose You blog post about managing exercise during cancer treatment (make sure to read that and check with your doctor before adopting any exercise routine).

Have you tried yoga? What did it do for you?

Consistently, health and cancer research shows that early detection and intervention greatly increases the chance of a positive outcome.

But what do people who lack health insurance or income do to get health checks? And what if someone does have insurance but it doesn’t cover preventive health checks such as mammograms?

The Department of Health and Human Services announced on Monday, August 1, 2011:

Historic new guidelines that will ensure women receive preventive health services at no additional cost were announced today by the U.S. Department of Health and Human Services (HHS). Developed by the independent Institute of Medicine, the new guidelines require new health insurance plans to cover women’s preventive services such as well-woman visits, breastfeeding support, domestic violence screening, and contraception without charging a co-payment, co-insurance or a deductible.

“The Affordable Care Act helps stop health problems before they start,” said HHS Secretary Kathleen Sebelius.  “These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need.”

Before health reform, too many Americans didn’t get the preventive health care they need to stay healthy, avoid or delay the onset of disease, lead productive lives, and reduce health care costs.  Often because of cost, Americans used preventive services at about half the recommended rate.

Last summer, HHS released new insurance market rules under the Affordable Care Act requiring all new private health plans to cover several evidence-based preventive services like mammograms, colonoscopies, blood pressure checks, and childhood immunizations without charging a copayment, deductible or coinsurance. The Affordable Care Act also made recommended preventive services free for people on Medicare.

This adds on top of other services now guaranteed without cost sharing, including

• well-woman visits;
• screening for gestational diabetes;
• human papillomavirus (HPV) DNA testing for women 30 years and older;
• sexually-transmitted infection counseling;
• human immunodeficiency virus (HIV) screening and counseling;
• FDA-approved contraception methods and contraceptive counseling;
• breastfeeding support, supplies, and counseling; and
• domestic violence screening and counseling.

This means that preventive health checks should be accessible to all, not just those with insurance that provides good coverage.

The regulations also directs the Institute of Medicine to do a full scientific review to determine how to help keep women healthy.

These regulations go into effect on August 1, 2012.

For more information on the HHS guidelines for expanding women’s preventive services, please visit: http://www.healthcare.gov/news/factsheets/womensprevention08012011a.html. The guidelines can be found at: www.hrsa.gov/womensguidelines/.

Maya Angelou once said, “Life is not measured by the number of breaths we take, but by the moments that take our breath away.” She believes that sentiment applies to each action we take, including eating. Recently, Angelou told Nate Berkus that she believes many of our eating issues come about because we aren’t really eating what we want. “Yes I’ll have that second helping, yes I’ll take more potatoes,” she says we decide, when instead what we really want is a small slice of that chocolate cake. In her book, Great Food All Day Long: Cook Splendidly, Eat Smart, she wrote:

Angelou shares her health story: she had found herself suffering from health problems because she was overweight. She tried many diets and solutions, to no avail. Then she decided portion control was the secret to success, but portion control of good food. She cooked her favorites, ate small portions frequently, and threw out the window rules about what to eat and when.

On NPR, she said too many rules and too much rushing are crushing good cooking, and more importantly, the place of meeting we’ve had over good food. From that interview came this great quote:

Eating good food, she says, should be a time to enlighten the spirit.

Nourish. We should eat nourishing foods, and Angelou reminds us that the food and the experience of eating should also be nourishing…to your mind and spirit as well as body.

Angelou lost thirty-five pounds, which she has kept off, and did so while eating what she loved.

Her book, Great Food, All Day Long, shares recipes that don’t omit but also don’t overdo usual diet no-nos such as sugar and butter, and each dish could be used for breakfast, dinner or lunch. She hopes the food is nourishing and fulfilling, which equals delight.

The recipes are for “down home” delicious food that includes a lot of nutrition.

What foods nourish your body, mind and spirit while helping you eat right?

I remembered that sunscreen isn’t truly waterproof or sweat proof when I read this from HHS HealthBeat:

“Even if sunscreens say they’re waterproof, they’re not. Sunscreens can wash off with sweat, or just being in the water. When this happens, their sun protection washes off, too, leaving users at greater risk for burns, premature skin aging and possibly even skin cancer. So the Food and Drug Administration has set new rules to help people know what they’re getting and when to use it.”

I specifically buy sunscreens that say waterproof or sweatproof because if we’re outdoors, we’re likely either in the water or sweating! Sometimes those sunscreens even cost more. I can’t seem to wean myself away from those; my mind feels sure they are more effective. They must have some basis for saying it, right?

That’s a little true, but not quite accurate, as FDA dermatologist Jill Lindstrom explains, “Sunscreens may only use the term `water resistant,’ and must clearly indicate how long water resistance actually lasts.’”

So the sunscreen currently marked “waterproof” and “sweat proof” are actually only able to withstand water and sweat a little better than regular sunscreen. How much is a little? Well the new FDA guidelines only approved two lengths of time for water resistance claims: 40 minutes and 80 minutes.

That means you really ought to reapply sunscreen every half hour or so, especially if you are in full sun during the main hours of maximum sun exposure: 10 a.m. to 4 p.m.

How can you tell whether your sunscreen can resist water and sweat for 40 or 80 minutes? You might not know until the new label requirements take effect next summer, June 2012.

As you probably know, the FDA recently issued new guidelines for sunscreen. Those new requirements are to improve clarity and honesty in labeling:

• You should be able to read any sunscreen label and clearly know the depth of its protectiveness (5 versus 15 versus 50) and the breadth of its protection (e.g., broad spectrum).
• Sun screens cannot claim to work longer than two hours without special FDA approval.
• The new requirements also stipulated truth and straightforward information about how it works in the water or with sweat: “Water resistance claims on the product’s front label must tell how much time a user can expect to get the declared SPF level of protection while swimming or sweating, based on standard testing.”
• Most importantly, the new FDA guidelines state that manufacturers cannot make claims that sunscreens are “waterproof” or “sweatproof, or identify their products as “sunblocks.”

You can check manufacturers sites to see if they offer any more detail about claims of time they work in water or with sweat.

Err on the side of caution to best prevent skin damage, premature aging, and skin cancer.

Weight gain is not inevitable as you age, alleged a Mayo Clinic article that hit my inbox today. I decided to click through and read what miracles I was missing yet .

I closed my eyes and ticked off my lifestyle list to see how it measured up from another article from the experts:

• only whole grains
• small portions
• healthy, fresh food choices
• strong limits on junk
• “eat this, not that” choices such as fat free sorbet instead of ice cream
• no sodas, juices or drinks other than water except in rare cases
• daily exercise
• healthy sleep (6-8)

and so on.

Okay…here’s their magic formula:

• Don’t eat: Potato chips, Potatoes, Unprocessed red meats, or Processed meats. Or see pounds creep on despite otherwise good habits.
• Do eat: vegetables, nuts, fruits and whole grains. And see less weight gain.
• “Alcoholic beverages and fruit juices were associated with a small but gradual increase in weight. Sugar-sweetened beverages were a major contributor to weight gain.”
• Limit TV.
• Get a good night’s sleep.

No surprises, and I see that I’m on the right path, although I still have a few things in my life it appears good medical science would rather me leave behind: the sitting in the desk chair job, meat, wine (and sometimes margaritas), and an addiction to Bravo.

So I paused and wondered whether I’d be willing to utterly give up any of that, cold turkey, to be healthier? I decided I’m willing to cut back further. But not quite to eliminate.

What about you? What do you still have in your life that medical science would rather you leave behind? Are you willing to do it?

Or…what have you cut, bad habit-wise, out of your life already?

On the Choose You Facebook page, a few wonderful Choose You folks started a really important conversation about appearance. One lady said she needed to exercise, because she hated how she looked. Another said it’s really about being happy because you’re healthy, not how you look.

What I think? They’re both right.

When I look in the mirror and see bags under my eyes, I know I’m tired. I dislike looking that way, and I know what I need to do is make an early (or on time) bedtime a priority, because sleep matters to my health. I know I feel tired, but sometimes, seeing it written on my face has a stronger impact, maybe because it’s visual, it’s on the outside. Feeling tired on the inside, I can drink more coffee, power up, power through. But nothing, no matter what the ads say, can hide those exhausted, bag-laden, red-rimmed, strained eyes.

I see my poor health choice. I see I need to make a change.

When I get back from a rich food indulgent vacation, and my pants are tight, my belt squeezes an unwelcome lump of flesh around my middle, and my favorite clothes pull uncomfortably, my vanity pricks me, but it also tells me I lost sight of my healthy eating priorities and overdid it for my body. I need to rededicate myself to my health and exercise commitments and nudge that number on the scale down and those inches on my waist back to a healthy BMI.

I see my poor health choice. I see I need to make a change.

The original discussion came from a post about the link between diet, exercise and cancer:

“How much do daily habits like diet and exercise affect our risk for cancer? Much more than you might think. Increasingly, researchers agree that poor diets and sedentary lifestyles are among the most important contributors to cancer risk.”

Bottom line, it’s true, it’s about health, it’s about cancer prevention.

But sometimes how you look, how clothes fit an be an insight, a temperature gauge, in to how you’re doing, caring for yourself. Not always, but it can be.

The key also, and in my opinion this is crucial, is to only measure yourself against yourself. And I mean your adult self, not your youthful self. They key is to know what your body, at your age, needs, and how it looks at its best. Your doctor can help with this, help you find ideal weight and BMI for you.

Cosmo? Not so much.

Don’t get confused between looking healthy and being healthy, either. Remember the bottom line? Choosing You and making healthy choices.

As Choose You fan Cathy said, “. . .it’s really not about how you look-it’s about being happy because you are healthy-you will look and feel better just because you made healthy choices.”

That’s the real bottom line. You want to eat right, get active, do health checks, protect your skin and let go of harmful habits such as smoking…for your health. In fact, this motivation is more likely to be successful overall and is less likely to have negative consequences. Focusing on health benefits and realistic goals for yourself are, actually, proven to be the best factors for success.

But getting an eyeful might be just what it takes to make you sit up and pay attention.