Posts Tagged "menopause"

Cocoa loco? The lowdown on chocolate and heart disease

Posted by Liz on Jun 17, 2011 in heart disease | 0 comments

[youtube=http://www.youtube.com/watch?v=RZ-uV72pQKI]

If you are a chocoholic, I bet you’ve noticed the headlines linking chocolate to a reduced risk of heart disease. In fact, data from the Kuna Indians (a tribe indigenous to Panama) have shown that cocoa and in particular dark chocolate are associated with declines in blood pressure. More recently, a large government study showed an even greater benefit in terms of a significant reduction in coronary heart disease prevalence. And in women, who have an increased risk for heart disease as they age (not only due to the increase in abdominal fat or changes in their blood fat levels but also to loss of ovarian function), chocolate has ben shown to slightly lower the risk of dying from heart disease.

Sounds promising and quite frankly, awesome, right?

Well…before you run out to the grocery or chocolate shop, you may want to read further…

Researchers have long been interested in flavonoids and in particular (at least in so far as menopause goes) in isoflavones. (See soy posts for more on isoflavones). The specific compound or molecule of interest in cocoa (the non-fat component cocoa bean extract or liquor) are flavanols, which are also found in lower concentration in apricots, peaches, apples, green and black tea, red wine and cider). Note that the quantity of flavanols in chocolate depends on manufacturing, including fermentation and roasting, and how much treatment is given to reducing bitterness and improving consistency. What this means is that dark chocolate has the highest concentration of flavanols and milk, the lowest.

What have researchers learned so far?

• Flavanols found in cocoa and cocoa powder may be powerful antioxidants and as such, help to mitigate certain factors that contribute to atherosclerosis, such as the formation of plaques in the arteries that lead to stroke and other coronary events. Thus, as antioxidants, they may actually neutralize toxic oxygen species circulating in the bloodstream.
• Experimental data suggest that ingestion of flavanols may help to regulate proteins and other compounds that encourage an inflammatory response to leads to heart disease.
• Flavanols may also help to stabilize the lining and muscular tone of the arteries and prevent them from narrowing.
• Additionally, flavanols may moderately protect against high blood pressures, although studies have been mixed.
• Finally, flavanols may help to maintain blood sugar levels and improve the ratio of good to bad fats in the blood.

Wow, this sounds fantastic! And all it takes is a daily diet of dark chocolate?

Here’s the great news. Researchers are devoting increasing amounts of time toward learning how certain foods affect (and benefit) health. However, in so far as chocolate goes? In a thorough review published online in Maturitas, they write that of the studies that have been conducted, it’s truly difficult to determine whether or not there is a causal relationship, i.e. eating A causes B, or eating chocolate prevents heart disease. In the case of chocolate in particular, factors like manufacturing can influence study findings. Moreover, researchers still aren’t sure if they should be focusing on flavanols or some other component of cocoa. It is also possible that only people who already have some sort of problem or condition will benefit  from eating more chocolate.

The bottom line? Dark chocolate in moderation, won’t hurt you and may actually help you. However, you may want to temper expectations. At least a wee bit. Dare to dream though…perhaps cocoa will ultimately defy explanation!

Wednesday Bubble: Depression and midlife – “overmedicalizing” the menopause

Posted by Liz on Jun 15, 2011 in depression, menopause | 4 comments

What’s the lowdown on depression, midlife and women? And how does the menopause come into play?

I written previously that depression may affect as many as 20% to 40% of women during menopause. However, gender differences in depression evidently begin well before the menopause and women are 1.5 to 3 times likelier than men to report a lifetime history of depression. Moreover, these distinctions start as early as the teen years and continue until the mid 50s, which researchers say, corresponds to female reproductive. Hence, experts have connected waning and altered hormone levels to high rates of mood and anxiety disorders in women.

Is this hypothesis valid? And, where did it originate?

According to a review in the early online edition of the Journal of Affective Disorders, some research has suggested that premenstrual, post partum and menopausal mood disorders are linked and that women are especially vulnerable during certain time periods. This has led to a proposal that reproductive-related depression have its own classification, and that during midlife in particular, all women should be routinely screened for symptoms. Interestingly enough, however, it has also led some researchers to question if we are “overpathologizing the menopause?” Hallelujah! (If you want to read more on medicalizing the menopause, check out one of my favourite Flashfree posts.)

The key finding?

Although studies demonstrate that significant numbers of women in midlife report depressive symptoms, menopause is only one of a range of factors purported to lead to depression during this timeframe. Others include stress, family life, general health issues and a lack of exercise, as well as a history of some sort of anxiety disorder. What’s more is that how women perceived the effect of menopause on their physical health almost doubled the risk that they would first develop depression at the onset of menopause.

The researchers say that although women might score high on self-reported mood scores, these scales or instruments tend to exaggerate the rate of depression in women in midlife and menopause. They also note that if a score is only taken at one time point that is might indicate temporary distress rather than a long-term problem. They add that during menopause, certain symptoms, such as sleep disturbance and fatigue, may be easily confused with depression even though they have nothing to do with a mood disorder and everything to do with hormones.

The bottom line is that symptom overlap and environmental factors can confuse a diagnosis, and that depression is not necessarily more prevalent during menopause than during other periods in a woman’s life. Consequently, like many things, the studies that are out leave more questions than provide definitive answers. Hence, the call for all women to be screened for depression during menopause may be an example of extreme assumption and not based in true necessity.

Is it possible that depression is just the tipping point in the medicalization of menopause?

What do you think?

Women’s health: “it’s a spiral, not a bulls-eye.”

Posted by Liz on Jun 6, 2011 in Inspiration, women's health | 3 comments

“A spiral is the path; it is the journey.  I walk it with you, and do not do it to you.  It represents life.  It represents women…”

My friend and colleague Regina Holliday wrote these words about a jacket that she has painted on my behalf, a jacket that represents women’s struggles to overcome the restrictions that challenge their right to adequate healthcare and a jacket that I will be honoured and privileged to wear this coming Tuesday during The Walking Gallery. She has depicted this struggle within the framework of a triskelion symbol, three interlocked spirals that is used to depict three reproductive cycles in a woman’s life  (maiden, mother, crone). In the Celtic belief system, the three-legged triskelion represents:

• personal growth
• human development
• spiritual expansion

as well as the phases of the moon, i.e. waxing, waning and full. I relate to this concept mostly because of its fluidity and the creative way in which Regina has characterized a woman’s struggle throughout her lifetime.

The jacket that I will wear is dedicated to all of my readers and to women everywhere who are under attack strictly because of their gender and their ability to reproduce. It seems sort of ridiculous doesn’t it? And yet, as I wrote last year in Disruptive Women in Healthcare, the other side of the aisle is not a political party but rather, women, gender bias and reproductive rights biases.

If you are local, I hope that you will come out and support the event (there are free tickets available), a wake up call that the patient struggle is very real and affects all of us. Regina describes this as follows:

If you can’t make it, I do hope that you’ll start paying attention to Regina because she is a patient advocate of the first degree and her generosity of spirit and pureness of heart is virtually unsurpassed. Trust me; she is someone you want fighting for you when the healthcare chips are down.

Thank you Regina…from my heart. I can’t wait to represent!

Wednesday Bubble: is there a connection between dry mouth and osteoporosis?

Posted by Liz on Jun 1, 2011 in bone health, dry mouth, osteoporosis | 0 comments

This week’s bubble is neither burstable or good news. But it is important:

Dry mouth and bone mineral density appear to be related.

Say what?!!!

A bit of background is needed…

Osteoporosis is fast becoming a major health problem and as I’ve written time and again on this blog, is a significant characteristic of menopause, namely as the result of waning estrogen levels that lead to an imbalance between the build up and turnover of bone cells. Parathyroid hormone and cortisol have also been linked to bone turnover.

Dry mouth (i.e. a feeling of dryness in the mouth and need to use liquids while eating) and burning mouth syndrome (i.e. burning in the tongue or oral mucus membranes and taste alterations) are also common during menopause, affecting up to 40% of women. Until now, experts have not been able to adequately determine why these symptoms occur and more importantly, effective management strategies.

The link? Recent data have shown that estrogen levels may be significantly lower and both parathyroid and cortisol levels significantly higher in menopausal women who complain of dry mouth. Moreover, as the results of a new study in Menopause show, there may be a true relationship between these two conditions and that bone loss may be the actual cause of oral dryness and related symptoms. In this study, researchers evaluated 60 women in menopause (mean age 56) for the presence and severity of dry mouth and then based on their results, divided them into two groups. Dry mouth was confirmed by responses to a scientific questionnaire and collections of saliva. The researchers also measured bone mineral density at the spine.

Importantly, the participants were not particularly active and none engaged in any sports activity, except walking. The women were also matched by body mass index, age, or years of menopause. And yet, women with low bone mineral density, including relationship to other women in the same age group and 30 years younger, were significantly more likely to experience dry mouth and had significantly less saliva when their appetites were not stimulated.

Clearly, more research is needed. However, there are some things you can do now. The first strategy to combat osteoporosis and bone loss is to get measured for bone loss and disease markers. Steps like calcium supplementation, a healthy diet and regular exercise are critical. And if you suffer from dry mouth? You may want to speak to your dentist about a referral for a bone mineral density scan or better yet, have him or her contact your gynecologist or regular health practitioner for a pow wow. Not only may you help your bones, but you may actually change that dry feeling.

Monday Musings: crank this one up for size

Posted by Liz on May 30, 2011 in Uncategorized | 1 comment

Stumbled across this silly headline in my weekly perusing of interwebz:

Dr. Oz Explains Why We Get Cranky

A few gems in this article, menopausal-worthy, probably bubble bursting too but it’s not Wednesday.

My favourites?

Stay away from fatty foods. Get more sleep. Avoid too much caffeine.

Sound medical advice or bollocks?

p.s. “Progesterone is like valium for the brain.”