Posts made in March, 2010

WISHFIT: women’s research takes a village.

Posted by on Mar 19, 2010 in exercise, heart disease, menopause, weight gain | 3 comments

I was heartened to read that the folks at Rush University Medical Center in Chicago have partnered with a community of local women to fight obesity and promote a healthier menopausal transition. What’s especially novel about this program, which is called WISHFIT (Women in Southside Health FIT), is that during the first year of the five-year study, it will be relying on “pioneers” for guidance in designing and testing the program and subsequently spreading the word. One of the program’s primary researchers, Dr. Sheila Dugan, who is an Associate Professor in the Department of Physical Medicine and Rehabilitation at Rush University Medical School, characterizes the approach as “community-based participatory medicine,” with a critical grassroots component. I would go one step further and call it a health 2.0, social media approach to medical research.

The goals of WISHFIT are to ultimately change the behavior of women who are sedentary or engage in physical activity only occasionally in order to help reduce the fat rolls around the midsection (called visceral fat). If you’ve been reading Flashfree for awhile, you will recall that visceral fat is a common problem in menopausal women that is likely related to fluctuating hormone levels as we age. Not only is it unattractive, but the development of fat around the midsection is dangerous because it has been linked with metabolic syndrome, a variety of symptoms that in concordance, increase the risk for heart disease.

Importantly, the National Institutes of Health, National Cancer Institute, National Institute of Diabetes, Digestion and Kidney Diseases are joining forces with Rush to take the study out of the laboratory setting and into the community. In fact, Dr. Dugan explains that research has shown that “there are millions of studies out there that show if we bring women into the University and have them exercise, they will lose weight and improve their fat composition. But when they are left to their own devices, they go back to themselves.”  She says that by having a community of postmenopausal women involved in developing a ‘tool kit’ of physical and stress-reducing activities or activities that help them to embrace healthier eating habits, the researchers are hoping that they can help their premenopausal peers incorporate new ways of thinking and acting so that they can get through menopause in healthier ways. She also points to data showing that change is better maintained not only by motivating the individual but also through the support of friends and social networks, which are needed for change to last.

Dr. Dugan notes that two Southside Chicago communities- Beverly and Morgan Park – have been the subject of prior research (Study of Women’s Health Across the Nation or SWAN) that identified the link between hormonal changes and visceral fat. In fact, some of the data also firmly established the link between markers of chronic disease and stress and sedentary lifestyles. The 30 Pioneers selected to lead the project will be women who participated in SWAN.

The five-year program also includes two studies examining 1) how social networks play a role in influencing health behaviors, and 2) if positive reinforcement works as well as financial incentives in getting women to change their lifestyle and become more physically active. An additional component entails before and after ‘person on the street’ interviews to educate and engage the community about what happens during menopause, heart disease and other risks and steps that can be taken to combat it.

“Midlife women already have all sorts of concerns on their minds. They need to have support around allowing themselves to take care of themselves and give themselves the freedom to actually step out of all their roles to do so. Our goal,” she emphasizes,”is to bring energy — spiritual and financial — to the community because we truly believe that the only way that these women will have a chance to take care of themselves is by everyone around them buying into how important it is.”

Noting that they are taking a three-pronged attack that entails community, social and individual level interventions, Dr. Dugan adds that community and social support are the links that have been missing in obesity research in particular.  I’d like to believe that these links have also been missing in gender research that focuses on women; in fact, perhaps this model isthe breakthrough  that is needed to change some gender inequities in our healthcare.

It really does take a village, doesn’t it? Only time will tell.

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Wednesday Bubble: Bedfan – the real deal

Posted by on Mar 17, 2010 in nightsweats | 4 comments


Seriously, when I wrote about the Bedfan last May, I thought it was a joke, a perfect topic for a futuristic Friday.

Guess what? I’m bursting my own bubble. Because evidently the Bedfan Personal Cooling System is the real deal. In fact, Texas-based Thompkins Research has just announced that Columbian women who suffer from menopausal night sweats will soon have access to the legendary cooler. Seems sort of random, Columbia, but hey, I’m sure that Columbian women sweat as much as their American peers.

Meanwhile, here’s a nifty video of the Bedfan, which the manufacturer says, was developed to keep individuals comfortable at night by eliminating the body heat that builds up between the sheets (sometimes that heat is desirable; just sayin!) Developer Kurt Thompkins explains that the whole idea behind the Bedfan was to deliver a gentle breeze that would float between the sheets to push the hot air out.” Although he developed the concept with his own needs in mind, evidently it’s taken off.

One satisfied consumer is quoted as saying that the device is “analogous to standing under a waterfall without getting wet.”


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Just breathe

Posted by on Mar 15, 2010 in Paced respiration/deep breathing | 2 comments


Are you having hot flashes? If you are like about 75% of menopausal women, you’re likely to experience a hot flash in some form or the other. In fact, researchers say that some women only have 5 a year while others might have as many as 50 a day. Yikes – that’s some serious flashing.

I’ve spent a lot of time in search of alternatives to hormones for you women out there who are flashing regularly. And more alternatives. The one consistent factor in all of these solutions, whether it’s yoga, black cohosh, acupuncture or hops, is that some women respond and others don’t. What’s also consistent is that there are few really well designed clinical trials examining alternative therapies.

The latest strategy that I’ve run across is slow, deep breathing (also called “paced respiration”). In three separate studies, women who practiced slow, deep breathing over a period of six to eight weeks experienced a decline in the frequency of their hot flashes by as much as 50% compared with biofeedback or muscle relaxation exercise. Another study showed that when deep breathing was combined with mental focusing, the intensity of the flash also declined.

About paced respiration

Paced respiration, slow, deep, controlled breathing from one’s diaphragm is a painless, relaxing approach to controlling hot flashes. Experts recommend that women find a quiet, private place.

1) Keep the rib cage as still as possible and inhale slowly for five seconds using the stomach muscles.(You should notice your abdominal muscles extending and distending, not your rib cage or shoulders.)

2) Exhale slowly over five seconds, again, using the stomach muscles.

3) Practice twice daily, preferably in the morning and evenings for at least 15 minutes. The focus should be on the breathe and nothing else.

When you feel a hot flash coming on, start inhalation and then exhalation slowly until the flash passes.

Interestingly, experts who have studied this technique are unsure why it works in some women. However, I do like the idea of using relaxation and focus to stave off a hot flash. Have you tried this? Does it work? I’d love to know!

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Every breath you take…lung cancer and HRT

Posted by on Mar 12, 2010 in HRT, lung cancer | 3 comments

Remember last year’s post on hormone replacement therapy and increased risk of deaths from lung cancer? Researchers now report that HRT that combines estrogen and progestin can increase the risk for developing lung cancer, especially when used for long time periods.

In the latest nail in the HRT coffin, researchers evaluated 36,588 peri- and postmenopausal women between the ages of 50 and 76 over six years. During the study, 344 women developed lung cancer. Overall, the findings showed that the longer women took HRT, the higher their risk for developing lung cancer, with use of 10 years or more associated by as much as a 50% increased risk. Note that while an increased risk for developing lung cancer was also seen in women used HRT for up to 9 years, it was about half as much, or 27%.

While the researchers are quick to point out that this study does not prove that HRT causes lung cancer, it does show that taking HRT for certain periods of time can significantly increase the risk for lung cancer, even when other important factors are removed from the equation. Similar increased risk has not been observed in women taking estrogen alone.

In the latest position statement on hormone replacement therapy from the North American Menopause Association, a panel of experts currently conclude that the evidence shows that both smoking and age played an important role in promoting growth of existing lung cancers in women taking HRT, in particular among older women. On the other hand, they say that other studies suggest that HRT theoretically lends some protection against lung cancer in younger women.

Clearly these data are at odds. However, as a wonderful report in Reuters points out, the latest study ‘sheds light on the question’ because it looks at HRT use over a longer period of time.

Every breath you take…could eventually be your last. It all depends on your decision about HRT. Is the short-term gain worth the long-term risk? Only you and your doctor can evaluate your individual risk and determine if HRT is the right choice.

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Wednesday bubble: one drink makes you smaller…

Posted by on Mar 10, 2010 in diet, weight gain | 6 comments

Can one drink make you smaller? According to a study that appears in this week’s Archives of Internal Medicine, light to moderate amounts of alcohol may help you gain less weight. Sounds too good to be true, right?

Intuition tells me that drinking alcohol can lead to weight gain because you end up taking in more calories than you burn (as well as the fact that those calories are carbohydrates). However, in over 19,000 women (aged 39 and older) with a normal body mass index (i.e. 18.5 to 25), women who reported not drinking any alcohol had the most weight gain over approximately 13 years. What’s more, women who reported drinking about 40 grams of alcohol daily were less likely to become overweight or obese. Women drinking less than 30 grams a day had a 30% lower risk of becoming overweight or obese than women who did not drink at all. In this study, the link between alcohol intake and overweight or obesity was seen for red or white wine, beer or liquor. The strongest association was seen for red wine.

In a separate analysis, the researchers also observed an association between declines in the amount of weight, increases in alcohol intake and older age. Comparatively, the magnitude of the weight gain was smaller in older versus younger women!

Importantly, the results seen in the study remained even after researchers made adjustments for lifestyle, clinical and dietary factors such as physical activity, the presence of chronic disease and consumption of other beverages (e.g. coffee, soft drinks, tea).

Granted, 40 grams is about 1.4 ounces or about half of a normal 5 ounce glass of wine. That may not meet the craving for a glass of wine. However, perhaps the larger take-away message is that a little wine can go a long way towards staving off weight gain. My RD friends might disagree but it’s an interesting ponder.

What do you think? Can one drink (or a half a drink) make you smaller?

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