mind-body therapy

Pomegranate seed oil and hot flashes

Posted by Liz on Feb 6, 2012 in herbal medicine, hot flash, mind-body therapy | 2 comments

Let us go early to the vineyards to see, if the pomegranates are in bloom… Songs of Solomon 7:12

Pomegranates have had a place in the bible and many religions for centuries. A shrub fruit native to the Middle East, the pomegranate is valued in culinary and in complementary and folk medicine circles. As a fruit, there is none so tempting and tantalizing as the pomegranate – its seeds, both sweet and tart, are challenging to obtain and sensual in appearance.

Pomegranate seed oil is a rich source of phytoestrogens, plant-like compounds with estrogen properties that may influence estrogen receptors and modulators in the body. Its main components include  linolenic acid (an unsaturated fatty acid that is in the omega-3 family), punicic acid (a conjugated polyunsaturated acid) and ellagic acid (an antioxidant found in many fruits and vegetables). Studies in mice suggest that pomegranate oil may be helpful in lowering blood pressure, counteracting insulin resistance and preventing prostate, colon, lung and breast cancer. Because of its estrogenic properties, it may also be useful for menopausal symptoms. Or not.

A study that appears in the online version of Menopause explores the value of pomegranate seed oil for hot flashes in 81 women. Over a 12 week period, these women received either capsules, twice daily, that contained 30 mg pomegranate seed oil or placebo capsules containing sunflower oil.  All women participating in the study were in menopause for at least a year and reported having at least five hot flashes a day. None had taken hormone therapy within 3 months of starting the study, which of course, could affect results.

Women taking pomegranate oil experienced significant benefits, reducing the mean number of hot flashes by 4.3 a day. However, women taking placebo also reported significant reductions in hot flashes by as much as 2.5 per day. After 12 weeks, the pomegranate oil group had a reduction in hot flash frequency by as much as 38.7% compared to the placebo group, who had reductions by as much as 15.6%.  Based on these numbers, it would appear that pomegranate seed oil was indeed, significantly more effective than placebo, right? However, the researchers say that the total reduction in the frequency of hot flashes was no different between women taking pomegranate oil and those taking placebo. At the same time? When they tracked the women past this time period (up to 24 weeks), they found that the differences remained, suggesting that the effects of pomegranate oil may be sustainable and even take a longer treatment time to reach its full effect. This warrants looking into its potential with larger studies of longer duration.

One thing to mention is that it did appear that pomegranate seed oil also benefited other symptoms, in particular sleeping disorders, which is in line with other studies looking at isoflavones. And, no side effects or serious adverse events were reported.

So does it or doesn’t it? Undoubtedly, the placebo effect plays a role in all clinical studies, whether or not they are focused on pharmaceutical treatments or complementary therapies. Other studies of phytoestrogens have shown mixed results and a small number have met the criteria for scientific design. Still, there is a question about the role that time plays; many herbal medicines are well known to take some time before reaching full potency in the body in order to exert any sort of intended effect.

I say that the verdict on pomegranate seed oil isn’t in yet. It’s not the panacea we’d like to see but it also isn’t a flat out failure.

Meanwhile,  I love that I once heard chef Jose Andres suggest that the best way to access its seeds is to pat it like a baby’s bottom.

Stay tuned for more news on this jewel of the fruit world.

Meditation in motion: Tai Chi and the ‘pause

Posted by Liz on Jul 11, 2011 in aging, heart disease, mind-body therapy | 0 comments

I’ve written about yoga and meditation/mindfulness training and how both may help with menopausal symptoms in terms of alleviating stress and improving overall wellbeing. However, what about Tai Chi?

Tai Chi is an ancient Chinese martial arts practice that uses a self-paced system of soft flowing movements to improve respiration and deep relaxation. It has also been shown to boost muscle strength, coordination and physical condition, improve balance and like yoga and mindfulness training, benefit overall wellbeing. On the health side, it’s been linked with better sleep quality and duration, enhanced circulation and in fact, is considered a weight-bearing exercise akin to aerobic exercise of moderate intensity. As such, it may even help prevent osteoporosis. Yet, unlike regular strength training Tai Chi appears to offer an important means by which risk of metabolic heart disease during menopause may be reduced.

For women specifically, hormonal changes – namely a steeply progressive increase in testosterone — can contribute to a risk of developing metabolic syndrome (i.e. the cluster of risk factors — abdominal fat, high blood pressure and cholesterol levels and insulin resistance –that increases the likelihood of developing heart disease and diabetes). Moreover, as women age, the ability to effectively metabolize blood fats and maintain ample antioxidant defenses in their bodies requires higher maximal aerobic capacities (which inherently decline with age). Conversely, being sedentary deteriorates the efficiency by which fats are burned or utilized by the body and also negatively affects antioxidant defense lines and their ability to adapt to sudden or chronic exposure to oxidative imbalances in our bodies that can wreak havoc on cells and lead to build up of plaques and heart disease.

Where does Tai Chi fit in?

Yogic pranayma breathing has been linked to improvements in antioxidant capacity and in lower oxidative stress markers. Moreover, it may also improve cardiorespiratory function. Tai Chi combines postures with slow, deep breathing (i.e. 6 breaths per minute) and may also convey the same benefits. In a recent study published in the Journal of Aging Research, 8 premenopausal and 7 post menopausal sedentary women were asked to participate in an 8-week Tai Chi program that involved the following:

• 75 minute training sessions twice weekly consisting of  a 5 minute check in, 10 minutes of stretching/warm-up, and 60 minutes of a modified 18-posture Tai Chi and Tai Chi fan style. The Tai Chi routines coupled breathing to music, took a minute to a minute and a half per motion. The women learned five to 10 postures per week and the complete set was practiced for two weeks. Instructors were also sure to monitor and correct postures during each class.
• Twice-weekly, 60 minute at-home practice that also included completion of a log that detailed the practice (to insure compliance).
• Measures of body weight, diet, physical fitness, balance, flexibility, muscle strength, maximal aerobic capacity and blood samples.

Not only did 8 weeks of Tai Chi practice significantly improve balance, muscle strength and flexibility in both groups, but also produced as much as an 18% decline in a major marker for heart disease risk (i.e. plasma total homocysteine). Additionally, Tai Chi combined with measured, slow deep breathing improved the activities of antioxidant markers in the bloodstream that play a role in defending cells against damage from oxidative stress.

Although this study is quite small and bears repeating with significantly higher numbers of women, the findings do imply that Tai Chi and slow deep breathing have the potential to play an important role in improving functional/physical declines that occur during menopause and equally if not more importantly, improve antioxidant defenses against metabolic diseases, especially heart disease. Tai Chi is not only low impact, low-velocity and safe, but within the framework of menopause, it may prove to be a golden ring amongst alternatives to prevent disease. Meditation in motion, indeed.

I got all my sisters with me…redux

Posted by Liz on May 27, 2011 in Inspiration, mind-body therapy | 0 comments

Wednesday Bubble: Hot flashes? Try a little mindfulness…

Posted by Liz on Mar 16, 2011 in mind-body therapy | 1 comment

[youtube=http://www.youtube.com/watch?v=dael4sb42nI]

No bubble bursting or woo woo. I’m talking the real deal. And if mindfulness doesn’t lead to a wee bit of tenderness, well, I don’t know what will. But enough of me taking poetic license with Otis.

Back in January, I wrote about a piece about the relaxation response and how a daily relaxation practice can actually alter gene structure and induce cellular changes believed to promote health. In the post, I said that “both inner and outer psychological states and environmental factors play a role in how women experience peri and post-menopause, their self-esteem, attitudes and severity of symptoms. If a daily practice of some sort of relaxation strategy can actually alter genes in a way that improves health and well-being, why can’t that daily practice also improve the menopausal/midlife experience?”

Guess what?

It appears that I might have been correct.

Writing in the Advanced Online edition of Menopause, researchers say that women who learn to recognize and more accurately discriminate the components that make up an experience, e.g. thoughts, feelings and sensations, or more specifically, the degree of bother and stress related to hot flashes, may be able to reduce the impact of the flashes on wellbeing.

In this 20 week study, women who were late into the transition into full menopause or in early menopause who reported experiencing, on average, 5 or more moderate to severe hot flashes/night sweats a week were assigned to 8 weekly mindfulness-based stress reduction classes  plus one, all day weekend class or to a waiting list. These classes, which lasted 2.5 hours at a time, involved the following:

• Focused awareness of gradually moving thoughts through one’s body from the feet to head while lying down, paying close attention to bodily sensations
• A sitting meditation focusing on breathing
• Mindful stretching
• Learning materials that discussed how to apply mindful stress reduction practice to everyday life and specifically in response to distressing symptoms and situations.

All participants also completed daily hot flash diaries to rate how bothersome their hot flashes were throughout the study period. Additionally, the researchers analyzed the intensity of hot flashes, quality of life, sleep quality, anxiety and perceived stress, as well as medical history, smoking, previous experience with mindfulness practices, and factors directly related to flashes such as smoking, body mass index, alcohol use and physical activity.

Granted, this study is a small one. But the researchers found that mindful stress reduction practice significantly reduced hot flash bother over time by almost as much as 15% after nine weeks and by almost 22% by 20 weeks, compared to at least half as much in women who were on the wait list. Moreover, sleep quality improved considerably!

Overall, the researchers say that their findings truly highlight the role that stress in general, and mental stress in particular, play in how we perceive hot flashes, how much we are bothered by them, and even their severity and frequency. However, they also say that the fact that mindfulness practice did not affect the intensity of hot flashes shows that it might simply help women cope better with them. Less clear is how the degree to which the placebo effect played a role; studies of pharmaceutical treatments report a subjective placebo effect of up to 30% so it’s not out of the realm of possibility.

Still, they believe that their data show that mindfulness stress reduction may be a significant resource for reducing the bother of hot flashes. Overall, it’s a win-win. Calm the mind; calm the body. Why not try a little tenderness with yourself?

Imagine there’re no….flashes

Posted by Liz on Jul 18, 2010 in hot flash, mind-body therapy | 0 comments

It’s easy if you try?

Wow! What a concept, eh? Well, it might not be so far-fetched, at least according to researchers at Baylor University. Writing in the International Journal of Clinical and Experimental Hypnosis, they say that cool imagery might actually reduce the incidence of hot flashes.

Two years ago, I wrote about Baylor research that showed that hypnosis could reduce hot flashes up to 68% in breast cancer survivors. This time, the investigators asked women who had survived breast cancer to participate in five weekly  hypnosis sessions and also, to describe mental images they would use for reducing hot flashes before undergoing hypnosis. Women who participated in the study were also taught self-hypnosis techniques and were encouraged to practice daily using their preferred imagery.

The results?

Overwhelmingly and not surprisingly, the women preferred cool over warm images. In fact, more than a quarter visualized something cool water-related such as a waterfall or rain or shower. Other images included cool air or wind, cool mountains, leaves and forests and snow.

The researchers say that while more study is needed, the findings might actually help to equate certain parts of the brain that are activated through imagery to those activated by perceived events.  Conversely, it is possible that in the case of hot flashes, “think” cool equals “feel” cool although I remain less convinced of this personally.

Regardless, I’d love to see more on this as Baylor researchers continue to delve into the brain mechanisms that control hot flashes with their minds. Imagine that…

Wednesday Bubble: just the facts, Jack.

Posted by Liz on Jul 29, 2009 in hot flash, mind-body therapy | 0 comments

Today’s Bubble carries a warning that we all need to heed: results of one study cannot be applied to another.

Repeat after me: results of one study cannot be applied to another.

Last year, I wrote about an interesting study out of Baylor University showing that hypnotic therapy was effective for decreasing the frequency and severity of hot flashes among women with breast cancer. Because the results were so favourable, researchers received a sizable grant from the National Institutes of Health for a much broader study to examine the potential role of hypnosis in post-menopausal women experiencing hot flashes, but in comparison to another mind-body intervention.

Now mind you, there is evidence that hypnosis is a promising intervention among non-breast cancer patients but the studies that have been conducted have been small and have not specifically examined its therapeutic role in women entering menopause naturally.

Let’s look at the facts, shall we?

The Baylor study enrolled 51 breast cancer survivors, 25 of whom received hypnosis for their hot flashes and 26 who did not. Women receiving treatment experienced an impressive 68% reduction in a hot flashes while women receiving no treatment did not experience any relief. Expectations of relief, better known as a placebo effect, cannot be ruled out in terms of skewing the results, which is why the larger study is comparing treatments. Again, this study showed that women who experienced chemotherapy-induced menopause experienced some relief from hot flashes by undergoing hypnosis.

That brings me to the extrapolation part.

The Hot Flash Relief program is an audio program that theoretically relieves hot flashes; all that you have to do is listen to a 20 minute audio CD for 21 days. It claims to based on results of the Baylor study, and tested under questionable study conditions. Hot Flash Relief bills itself as an amazing breakthrough to help you get relief from hot flashes and night sweats without pills, hormones or risk. If you are not entirely satisfied, Hot Flash Relief will refund your money.

I’d like to point a few things out:

• The Baylor study was conducted under controlled conditions
• The Baylor study was not carried out among women who had undergone natural menopause
• Hypnosis was carried out in person and under the guidance of a trained professional
• The efficacy of hypnosis looks good but further study is required

Let’s look at Hot Flash Relief:

• Hot Flash Relief claims that it can help any woman with hot flashes
• Hot Flash Relief bases its effectiveness on a “study” in which women were sent the CD and then asked to report back on it via testimonials
• Hot Flash Relief was developed by a top US hypnotist, Tom Nicoli, whose voice you will hear on the audio CD. Although he is certified and is reputable in the weight loss field, research is not his game
• Audio hypnosis has not proven as effective as self-hypnosis for women with menopause

I want to believe, I really do. But the folks at Hot Flash Relief may be considerably more out of their minds than most of us menopausal midlifers. Before you drink kool aid, on this or any other strategy, just take a look at the facts. Money guarantee or not, you will be glad that you did!