Make new friends, but keep the old…
I’m heading West this morning. Way West. And way, way back in time. To 1961 in fact.
For the next six days, I’ll be visiting a woman who I’ve known since I was 3 months old. Long time, right? What strikes me about this particular vacation is that I am stepping back in time and yet, celebrating the now.
We lost contact in high school and reconnected after college. I used to see her regularly when I was living in NYC and she’d come for a month’s worth of painting and art classes.
She reminds of me the good things about my past. And the importance of friends and continuity as we grow older. And while we may live miles away and our daily lives are truly as different as night and day, she is a huge part of my fabric.
And she gets away with calling me ‘Lizzie Tish!’
Read MoreWednesday Bubble: Is S-equol the next big thing?
Last year I wrote a few posts about the potential of the isoflavone S-equol for addressing menopausal symptoms, including hot flashes and mood swings.
If you are unfamiliar with S-equol, it is actually a metabolite of a one of the three soy isoflavone compounds (i.e. daidzein), and is produced by bacteria that live in the intestines. One of the most interesting things about S-equol is that is one of the principal types of isoflavones that are found in soybeans and most soy foods. However, up to 80% of the U.S. population and about half of the Japanese population (who consume inordinate amounts of soy) cannot manufacture S-equol on their own and need to obtain it in supplement form.
This month’s Journal of Nutrition has devoted an entire supplement to S-equol research, and I’ve been fortunate to take a more detailed look at the evidence supporting the role of S-equol for menopausal symptoms. Notably, some of the researchers actually say that “to conduct menopausal medical care appropriately [which, in their opinion, should be geared towards a better quality of life on an individual basis), it is necessary to provide evidence-based alternative medicines as much as possible.” It is wonderfully refreshing to find such esteemed colleagues backing my view of how menopause should be approached.
Hence, without further ado, following is what you need to know about the recap of study findings, and what still needs to be explored before we all start taking S-Equol.
In three randomized studies conducted in pre-, peri- and menopausal Japanese women who were or were not able to produce S-equol naturally, researchers found specific benefits in three areas:
- Mood improvement: 134 women who produced S-equol naturally and took a 10 mg daily S-equol supplement had significant reductions in anxiety; those who took 10 mg three times a day had significant declines in tension-anxiety and fatigue, and an increase in overall energy. Note that these women also limited their daily intake of soy products to no more than 20 mg/day.
- Hot flashes and other symptoms: In 320 women taking 10 mg S-equol daily or placebo for 12 weeks, S-equol supplements reduced the frequency of hot flashes by as much as 58%. Decreases in muscle and neck stiffness were also reported.
- Bone health: In 54 women who had undergone menopause within 5 years of the study, those who were able to produce S-equol naturally and took 75 mg isoflavones daily supplement (mostly consisting of daidzein) lost a significantly lower percentage of bone in their hip area than women who were not able to produce S-equol naturally but also took the daily supplement. Researchers believe that S-equol actually mimics the action of estrogen in the body in terms of its ability to maintain bone mass and the balance between the build up of bone (bone formation) and the loss of bone (bone resorption). However, studies looking at how it acts in the body have only been conducted in mice and at relatively high doses. Information reported in the Journal supplement does show that at higher dosages, S-equol can negatively affect the tissues lining the uterus.
A few key take-away points to think about when we think about S-equol:
Researchers believe that the research in S-equol helps to show that soy isoflavones work best in individuals whose bodies are able to produce S-equol naturally. However, you’ve read the stats – the majority of people who live in the US do not produce S-equol naturally. Dosing and the exact type of S-equol may also influence outcomes. Likewise, They still aren’t sure how bacteria in the intestines influence S-equol’s effects and wonder if somehow, some other mechanism is at play. Further research is also needed to see if the beneficial effects of S-equol on menopausal symptoms can be extended to women who do not produce it naturally.
It’s too early to boost this bubble and I’m excited by this evidence-based alternative. Naysayers love to point out that alternative therapies are sham and snake oil. While this may be true of some preparations, it’s clear that researchers are taking natural substances to a higher level to see if they offer efficacy without the risks of hormone replacement.
Read MoreA bicycle built for…weight!
I’d love to be writing to tell you that researchers have discovered a bicycle specifically built to boost weight loss. However, better yet, it seems that any bicycle may be able to help you prevent weight gain during the premenopausal years. Moreover, the more you need to lose, the greater the benefits.
For some time now, experts have been telling us that daily exercise, even walking can help stave off weight gain. But is all walking created equal? And what about bicycling, which evidently, only 5% of the population over the age of 16, and mostly women, engage in?
Researchers report that among a pool of over 18,000 women studied between 1989 and 2005 (as part of the ongoing Nurses Health Study):
- Increasing the amount of biking over the study period seemed to hold weight gain to a mininum even if that biking equaled only 5 minutes a day.
- Women with normal weight who biked for more than 4 hours a week by the study weight had about a third lower odds of gaining about 5% of their body weight than women who did not bike at all.
- Women who were considered overweight and obese had about half the odds of gaining weight if they biked for at least 2 to 3 hours a week.
- Brisk walking was much better at holding off weight than slow walking — by about a half pound.
The key take-away points of this study is that exercising is not created equal as we age. In this case, more is less is the rule of thumb, meaning that if you weigh more, you may gain less over time if you start bicycling at least 2 to 3 hours a week. If you are lean and mean, well, biking can still yield some significant benefits when it comes to weight gain.
Biking is definitely built for staving off weight gain. Go for it!
Read MoreWorking through the transition? Or is the transition working you?
I ran across an interesting study examining how work affects menopause and visa versa. Initiated two years ago by Professor Amanda Griffiths of the Institute of Work, Health & Organizations at the University of Nottingham in the UK, the study aims to identify challenges that women face while working through their transition and also help raise employer awareness.
I contacted Professor Griffiths to learn more . Although she is still compiling her final data (culled from 900 women, ages 40+), she did share some interim nuggets that are pretty interesting.
The fact that menopause, or more specifically menopausal symptoms might affect life quality and work is not a novel idea. Numerous studies have shown that hot flashes in particular can significantly impact daily activities, especially when they are severe. In turn, hot flashes, night sweats and hormonal swings can significantly affect sleep and coping mechanisms. Hence it’s not surprising that among an initial group of 941 female police officers surveyed*, most agreed that the primary factors affecting their ability to function in their job were fatigue and insomnia. Nevertheless, about 2/3rds said that they wouldn’t or didn’t disclose the fact that they were going through menopause to their managers, either because their managers were men, were younger (and therefore unlikely to understand or have much empathy) or because they felt embarrassed. This point of view only changed if the symptoms were so obvious that they felt they had to explain, if they felt that their ability to cope with their symptoms was less than stellar, if their performance was somehow being affected by their symptoms or if they felt the need to justify a change in their behavior at work. However, I was heartened to read that many of the women felt comfortable sharing their experience with other colleagues who were similarly in the midst of menopause or had already gone through it.
Griffiths reports that a clear majority of women surveyed that expectations of their physical capacities did not change as they aged. Yet, less than half believed that their contributions were valued as much as their younger peers.
When asked what changes they’d like to see in their jobs to ease their way through the transition and challenges of growing older, most pointed out greater flexibility in working hours (e.g. flex time, no night shifts or since this was a police force, shifting from the front line to a desk job), access to workplace-focused health promotion, such as regular check ups and fitness program), improved awareness among managers of health-related changes in midlife and improvements in the physical working environment.
Griffiths says that more recently, she and her colleagues have surveyed women from all walks of career life, including education, administration and journalism and the final write-up of the study** will include these opinions as well. However, based on our correspondence, it appears that the difficulties that women face in the workplace during the transition are fairly universal. She explains that menopause is ‘taboo’ yet happens to 50% of workforce (I imagine that this number will only continue to grow as the population ages and we are forced due to economic constraints, to work well into retirement years.) “Evidence suggests that some women do experience a lot of difficulty – largely tiredness – much of which can be resolved with sensible line management and flexible work,” says Griffiths. However, “as with any other long-term health condition, employees should feel empowered to discuss health conditions with their line manager/supervisor, otherwise the latter are not in a position to help.”
Isn’t it time for change? Rather than let the transition work us, shouldn’t we be looking for empowering ways to work through it? In the early days of this blog, I wrote that science has confirmed what women have known all along: social support networks are one of the strongest weapons we have against the aging process. Griffiths’ research confirms that by engaging female peers who are going through similar experiences, we have a stronger experience overall. Yet, she also points out very clearly that men need to be brought into the equation as well. The only way to foster understanding is to share and educate, right?
The research shows that women want their managers to be more aware the menopause doesn’t simply affect their personal lives but also their occupational health. Although sharing may be risky, we really need to ask ourselves how much we are risking by allowing the transition to work us. Time for change, don’t you think?
*The initial research was funded by the British Association of Women in Policing. **Dr. Griffiths’ larger study is funded by the British Occupational Health Foundation.
Read MoreWednesday Bubble: is weight loss all in your head?
It appears that weight loss, might indeed be in your head. But not the way that you think. This week’s bubble focuses on the brain and how it helps to regulate weight gain. In fact, researchers from the University of Texas Southwestern Medical Center are reporting that an enzyme in the brain, better known as P13 kinase, may help burn extra calories after eating a high-fat meal. Mind you, these findings are from a study conducted in mice so it is too early to assume that if there was a way to enhance the activity of P13 kinase in humans, then it would be easier to lose or maintain weight.
In the current study, researchers examined mice who had reduce P13 kinase activity and then fed them a high fat diet but did not alter their physical activity levels. When they compared them to normal mice, they found that their body heat did not increase and they became more likely to become obese. regardless of physical activity level. (Evidently, when we eat too many calories, the body tries to assist by expending more energy, in order to balance out our calorie intake. )
Interestingly, brown fat, or brown adipose tissue, is a key tissue that appeared to generate enough body heat in the mice to help them burn off excess calories. Two other important factors that appear to play a role include the hormones leptin which help regulate how the body uses energy.
Brown fat?
I contributed a post to MizFit Online last October that provides a bit more information about brown fat and I’m reposting it here to provide a bit of background to make the current study findings easier to understand:
What you need to know…
In mammals, fat (known among the medical set as “adipose tissue”) comes in two varieties: white and brown.
* White adipose tissue (or “WAT”) is used for energy storage and to provide warmth. It also protects the organs by acting as a cushion. Most of the fat in our bodies is white.
* Brown adipose tissue (or “BAT”), is mostly found in newborns and tends to diminish as a person ages. Brown fat is used by the body to regulate temperature and quickly burns sugar to keep infants warm, meaning that exposure to cold activates brown fat cells. This last point may be important when it comes to weight loss.
For decades, brown fat was believed to significantly decline as we grew older, mainly because as we become more able to regulate our body temperatures, we no longer solely rely on biology. However, PET scanning has shown that healthy adults actually have stores of brown fat scattered throughout the front and back of the neck and chest areas.
So, is brown fat an equal opportunist? NO!
In fact:
* Women with lean body mass have at least twice the ratio of brown fat compared to men.
* Exposure to temperatures of around 61º F appears to kick off brown fat cell activity, at least in leaner people.
* The higher your body mass index (BMI), the lower the amount of brown fat in your body.
Turning down the thermostat can help lose weight, right? Well yes. And no.
In controlled situations, volunteers left “chilling” for at least two hours were shown to have a surge in brown fat activity. However, keep in mind that the body is fine-tuned to maintain equilibrium, so, what goes out often goes right back in.In other words, expend more energy, eat more food. And the “chill factor” hasn’t been extensively tested in people under normal, everyday conditions. Still, based on what researchers are able to learn from animal studies, they believe that having as little as 1 to 2 ounces of brown fat in your body could potentially burn about 20% of the average daily caloric intake, that is, if brown fat cells were properly activated.
If you combine the information from the mouse study with the information on brown fat, it seems that the combination of brown fat plus activating P13 kinase may produce a way to burn calories more efficiently. And, leptin and estrogen help regulate the process.
The question however, is how do we get there from here?
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