Vitamin D: Fights Fat and a Whole Lot More!

Vitamin D is everywhere. You hear about it on the news, in magazines, even right here on empowher.com. Some tout it as the new super vitamin yet why are so many Americans deficient? It is fortified in milk, bread, cereals, and the sun right above our heads (unless you live in Portland like me) yet studies show even those living in the brightest spots are not receiving enough.

So let’s review…what is Vitamin D?

First of all, it is a fat soluble vitamin that is metabolized by ultraviolet light (particularly UVB) or from our diet. Vitamin D is taken into our liver where it is converted into 25(OH) Vitamin D3 (calcidiol) which is the major form in our body and the kind that we test. To become biologically active, it goes through an extra step in the kidneys where it turns into 1,25(OH) Vitamin D3 (calcitriol). This active form only hangs around for about 6 hours where as the testable form remains up to 2 weeks. Additionally, once activated, Vitamin D becomes a hormone.

But, Dr. Jones, I am a sun-bunny! I live for its’ warmth and love to be tan. Of course, but sunscreen with a SPF 8 and above eliminates 93-99% of your vitamin D absorption. This is why those living in Florida and southern California are depleted. The same holds true for people with darker pigmented skin. Melanin blocks absorption as well.

What does it do?

1) Vitamin D has a major role in calcium and phosphorus balance. This, of course, means we need enough to improve bone health, reduce fracture risk, and reduce bone pain.

2) It helps your body manage an autoimmune disorder such as rheumatoid arthritis, multiple sclerosis, lupus, and others.

3) There are receptors in the heart muscle so that it improves heart contractions and vascular tone. There are links to low levels and myocardial infarction risk.

4) It is important to your renin-angiotensin-aldosterone system which helps monitor blood pressure, electrolytes, and water balance in your body.

5) Vitamin D is potentially anti-cancer! There are receptors in your colon, brain, breast (and prostate for you male readers). Quoting directly from the research, “It has been documented that patients with the highest serum vitamin D levels had a 50% reduced risk of breast and colorectal cancer. A serum level of 52 ng/mL was associated with the greatest risk reduction of breast cancer. In colorectal cancer, it has been found that a serum 25(OH)D level of 34 ng/mL can reduce the incidence by half, and at serum levels of 46 ng/mL, the risk of colorectal cancer can decrease by two thirds.”
Wike-Malone R, Kessenich C. Vitamin D Deficiency: Implications Across the Lifespan. J Nurse Practitioners. 2008;4(6):448-456.

6) Sufficient levels are needed for those with periodontal disease in order to preserve the health of your teeth.

7) Feeling moody? There is an association between low vitamin D and PMS, seasonal affective disorder (low mood in the winter), and depression.

8) Sore Muscles? There are receptors in the muscles for vitamin D. Some patients with a fibromyalgia-like picture are actually deficient in this nutrient!

9) It is good for brain health. Migraine sufferers and epileptics have been shown to have low vitamin D values.

10) It helps fight fat! Lower vitamin D levels are associated with increased body fat in both the visceral and subcutaneous areas.

I highly recommend you request your 25(OH) Vitamin D3 levels are tested every year. The current recommendation for “sufficient” is above 30ng/ml. The research recommends higher than 50ng/ml for helping autoimmune disease and reducing cancer risk. Anything over 100ng/ml is considered too high.

Make sure you take your vitamin D3 (also known as cholecalciferol) with some fat for better absorption. Do not take it with your heartburn medication or any weigh-loss medications that blocks fat – this will reduce your vitamin D absorption.

According to the National Institute of Health, Office of Dietary Supplements, the current recommended daily allowance (RDA) of Vitamin D is 200-600 IU/day depending on your age. If your levels are low, you may need to temporarily increase this amount to 1000-4000 IU/day or more however, please make sure you are under the supervision of your doctor and repeating your vitamin D test every few months to see that your levels are increasing. Once you have reached your vitamin D goal, you can back off your dose.


References:
1.Wike-Malone R, Kessenich C. Vitamin D Deficiency: Implications Across the Lifespan. J Nurse Practitioners. 2008;4(6):448-456.
2. Murphy P, Wagner C. Vitamin D and Mood Disorders Among Women: An Integrative Review. J Midwifery Womens Health. 2008;53(5):440-446.
3. Hicks G, Shardell M, Miller R, et al. Associations Between Vitamin D Status and Pain in Older Adults: The Invecchiare in Chianti Study. J Am Geriatr Soc. 2008;56(5):785-791.
4. Wheeler S. American Headache Society 50th Annual Scientific Meeting: Abstract S33. Presented June 28, 2008.
5. Karakis I. American Epilepsy Society 61st Annual Meeting: Abstract 3.337. November 30-December 4, 2007
6. Kremer R. Vitamin D Insufficiency Linked to Increased Body Fat. J Clin Endocrinol Metab. Published online November 4, 2008.
7. Office of Dietary Supplements: http://ods.od.nih.gov/factsheets/vitamind.asp#h9

IVF and Birth Defects? Ugh!

"The CDC reports that certain birth defects -- including heart wall problems and cleft lip/palate -- may be two to four times more common among babies conceived with assisted reproductive technology (ART) than babies conceived naturally. Those findings -- published in the advance online edition of Human Reproduction -- focus on in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI)."

"The following types of birth defects were more common among babies conceived through ART:

*Septal heart defects: Twice as common among babies conceived by ART

*Cleft lip and/or cleft palate: 2.4 times as common among babies conceived by ART

*Esophageal atresia (birth defect of the esophagus): 4.5 times more common among babies conceived by ART

*Anorectal atresia (birth defect in the anal/rectal area): 3.7 times more common among babies conceived by ART

Those findings, which take into account other risk factors, only applied to single births, not to twins, triplets, or other multiple births.

But the CDC points out that multiple births are associated with ART and with birth defects."
Article pulled from, WebMDHealth, November 17, 2008

The researchers are unsure if assisted reproduction in itself is to blame for the increase in birth defects. In fact, new studies looking at men and women with sub-optimal fertility are being considered.

It is very important that men and women looking for fertility help really examine every angle of their health before doing IVF or ICSI. I say this not to divert you from these procedures but to make sure your egg and sperm are at their healthiest when you proceed.

Remember it takes about 3 months for an egg and 72-ish days for a sperm to fully mature. Plan about this far in advance for the healthiest chances!

Smoking and Hot Flashes

"Cigarette smoking is associated with hot flashes, higher androstenedione levels, a higher total androgen-to-total estrogen ratio, and lower progesterone levels in women who are not postmenopausal, according to the results of a cross-sectional study reported in the November issue of Obstetrics & Gynecology."

This means that smoking increases your hot flashes, increases your DHEA and testosterone, screws with the hormonal balance and lowers your precious progesterone levels. Not good ladies! Please keep this in mind when deciding to quit in the new year.

Food Allergy vs. Food Intolerance: Which are you?

A common question I ask my patients is, “Are there any foods that you avoid?” The answers range anywhere from “absolutely not” to a very long list. I ask this question because I find the things you put in your mouth may be affecting all of those symptoms you just described.

Fatigue? Gas and Bloating? Headaches? Constipation? Rashes? Acne? Joint pain? PMS?
Yes – they can all be food related.

As the commercials on television will tell you (and it is true) 70%-80% of your immune system lives right around your intestines. It is a smart maneuver in human design because anything you eat, breathe, swallow, and drink goes right into your gastrointestinal tract. Therefore the cereal you had for breakfast is evaluated just the same as the flu-bug you inhaled while waiting in line for coffee…then your immune system has to decide - friend or foe?

Many of us would assume the flu-bug must be destroyed and the cereal can live to see another day, right? Well, what if you put milk in your cereal and you shouldn’t have milk? What if your cereal is made up of wheat flour and you’re sensitive to wheat? What if your cereal also has soy crunchies for extra protein and soy is the enemy?
What if you didn’t know?

There are two main types of responses that can occur. One is the typical ‘food allergy.’ Most common examples are the people who eat nuts and have an anaphylactic reaction, drinking citrus juice causes their lips to swell up and dairy sends them running for the bathroom. It is an immediate response and governed by an immune antibody called, IgE.

The second type of response is non-IgE-mediated or known as IgG. This is a delayed response and may not produce a symptom for 2 hours to 48 or even 72 hours. This means if you drink a glass of milk on Monday, you may not notice any symptoms until Tuesday or Wednesday. What if you drink a glass of milk all the time? Then these symptoms could be a problem everyday because you are stringing along your delayed responses.

Remember that not all food related symptoms are intestinal problems. I commonly hear patients report no gas and bloating, no constipation and no diarrhea. Then they complain of being tired all the time, mild headaches that come and go, dry skin, bad PMS, hot flashes, chronic stuffy nose or constantly clearing their throat….this can be food related too.

A quick peak in the research shows overwhelmingly that the most common allergies (IgE) are Peanuts, Tree Nuts (cashews, almonds…etc.), Seafood, Wheat, Dairy, Egg and Soy. Interestingly enough, these are also the most common intolerances (IgG) just a slightly different order: Wheat, Dairy, Soy, Egg, Seafood, Tree Nuts, and Peanuts.

In my experience, I see smaller odd-ball foods too that produce large ‘Ah-ha!’ moments when discovered on testing. “Dr. Jones – I eat that everyday!” “Dr. Jones, I grew up on those.” “Dr. Jones, I take that as a supplement.”

So what do you do? First consider getting tested for both IgE and IgG food categories. Many doctors are familiar with the IgE testing but not with IgG testing so you may have to do some research. If you can not test then the easiest and cheapest is straight forward elimination. I recommend taking the top two, wheat and dairy, and get them out of your diet. I am not kidding. Go on a wheat-free, dairy-free diet for a full month and see how you feel. There are several resources on-line and many grocery stores now that offer a variety of options. You will not starve – I promise.

Of course the food you eat is probably not responsible for ALL of your symptoms but it could be perpetuating an unhealthy cycle. For example, allergies and intolerances might not be the only reason for your joint pain but the inflammations they produce make your pain that much worse.

If you are going to eat three meals a day anyway, then you might as well make them worth your while. Say good-bye to foods that are not benefiting your health and take note of the changes in your symptoms. You just might have an “Ah-ha” moment too.

The HPV Vaccine – What do you need to Know?

By now most everyone has seen the commercials on television about the most common HPV vaccine called Gardasil. HPV stands for the Human Papillomavirus and is responsible for both genital warts and abnormal changes on your pap test including cervical cancer. Even though there are hundreds of different strains, HPV-16 and HPV-18 account for 70% of cervical cancer while HPV-6 and HPV-11 cause 90% of genital warts. Therefore, these four strains are the basis for Gardasil’s protection.

The vaccine is not a live-virus but a “virus-like” particle that will still stimulate a woman’s immunity against these four strains of HPV. The company, Merk, reports girls between 9-26 years old can receive it. Lately, there are reports that women up to 45 years old are also seeing benefits.

The vaccine does not protect everyone – especially if you already have these most common strains of HPV or if you have a different, less common strain. Also, it is not meant as a treatment should you acquire genital warts or an abnormal pap. Currently, the vaccine is not recommended for pregnant women and is still being studied on men. Additionally, those who have yeast sensitivities should not receive Gardasil as it is a component of the vaccine.

The company states that girls, ideally between the ages of 11 and 12, who are not yet sexually active should start the first of the three rounds of vaccinations. The schedule of injection should occur over the next 6 months and costs about $125 per dose. A woman can still receive the vaccination up to 26 years old even if she is sexually active and has one of the common HPV strains because she could develop protection against the other three.

Once a woman has been vaccinated, it is not yet known how long the effects will last or if she will need a booster shot. Also, it is not a replacement for her yearly pap test.
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The most common side effects at the site of injection are pain, swelling, and redness. Systemically, women frequently experience fever, nausea, itching, dizziness, vomiting, headache and fainting. Additionally, when you look on the ‘Vaccine Adverse Events Reporting System,’ also known as VAERS, there are many reports of more serious effects such as anaphylaxis, neurological problems, autoimmune disease, seizures, heart problems and even death.

The ingredients in Gardasil are as reported: 225mcg of aluminum, 9.56mcg of sodium chloride, 0.78 mg of L-histidine, 50 mcg of polysorbate 80, 35 mcg of sodium borate, <7mcg yeast protein per dose, and water for injection. The product does not contain a preservative or antibiotics. It is mercury free.

Please review each ingredient and assess if they could trigger an adverse reaction in you before signing-up for the vaccine. A quick search for sodium borate, aluminum and polysorbate 80 did not bring up the healthiest information and may contribute to the reported side effects. For example, there is only 35mcg of sodium borate however the government still has it listed as ‘hazardous’ on the Material Safety Data Sheet webpage.

Before deciding on any vaccine, I urge you to do your due diligence and research what you can. Go directly to the company site and read the fine print available as product or prescribing information. Go to the VAERS website and read the adverse events reports that are made available and talk with your doctor about whether the vaccine is right for you or your daughter. Ultimately, it is your decision because it is your health.


References:
www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm
www.gardasil.com
www.vaers.hhs.gov
www.sefsc.noaa.gov/HTMLdocs/SodiumBorate.htm

HPV: The Basic FAQs You Need to Know.

HPV stands for the Human Papillomavirus and is currently the most common sexually transmitted infection worldwide.

The Centers for Disease Control estimates that nearly 20 million Americans between age 15 and 24 years old have HPV. This is the virus that causes genital warts as well as those abnormal changes on your pap test that can lead to cervical cancer.

There are many strains of HPV with some remaining dormant, not doing anything (that we know of), and others causing problems.

When you go for your pap test, you can have your healthcare practitioner include a ‘high-risk HPV test’ for greater accuracy about whether you have HPV in your cervical area. It’s the ‘high-risk’ HPV that causes abnormal cells to occur on your cervix and can lead to cervical cancer.

How likely are you to acquire HPV?
Well, the lifetime risk in sexually active people is about 80-85%...which is a lot.

Does this mean you will automatically develop cervical cancer? Absolutely not!

The prevalence of HPV infections is greatest in young, sexually active women between the ages of 20 – 24 years old with the next highest rate being 15-19 years old.

The kicker though is figuring out exactly where your HPV infection came from if you’ve had 2 or more sexual partners. The virus can lay dormant for many years before causing an abnormal pap test. Because men are often asymptomatic, you could be well into your 30’s, 40’s and even 50’s before something comes up and it may be from a sexual encounter during your teen years.

Here’s the great thing – 80% of HPV infections are transient, asymptomatic and resolve without any treatment. In fact, the average length of infection is about 4-6 months. However, there are many risk factors that promote HPV you can prevent.

1)Stop smoking!! Research shows that the link between smoking and HPV is extensive. The number of cigarettes per day and number of years smoking correlates with the severity of your HPV infection.

2)Re-think your hormonal contraception. The estrogen in your pill, ring or patch is contributing to your HPV infection.

3)Having sex at an early age (before 16) exposes your cervix to HPV sooner.

4)Multiple sexual partners increase your risk of HPV exposure. Even if your numbers are low, what are the numbers of your partner?

5)Watch your waistline – some studies are linking obesity with increased chances of cervical adenocarcinoma – a type of cancer.

6)HPV is a contact sport – it is spread when skin touches skin. If you use condoms 100% of the time you are 70% less likely to acquire HPV.

7)Get other testing – having HIV or Chlamydia greatly increases your chance of a more invasive HPV infection.

8)Get your pap test! Have your healthcare provider include the high-risk test for HPV.

To see more visit: www.empowerher.com

References:
1 .www.cdc.gov/std/hpv/.htm
2. J Midwifery Womens Health 49(1):4-13,2004 © 2004 Elsevier Science, Inc
3. Tolstrup J, Munk C, Thomsen BL, et al. The Role of Smoking and Alcohol Intaqke in the Development of High Grade Squamous Intraepithelial Lesions Among High Risk HPV Positive Women. Acta Obstet Gynecol Scand 2006;85(9):1114-9.
Cancer. (Medscape Ob/Gyn & Snyder U. A Look at Cervical Women’s Health 2003;8(1).
4. Montero JA, Larkin JA, Houston SH, Toney J. Examining the Complex Relationship of Human Papilloma Virus to Cervical Dysplasia and Carcinoma. Medscape General Medicine 1(2). 1999.
5. Santelli JS, Brener ND, Lowry R, Bhatt A, Zabin LS. Multiple Sexual Partners Among U.S. Adolescents and Young Adults. Family Planning Perspectives 1998, 30(6):271-275.
6. Winer RL, Hughes JP, Feng Q, et al. Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women. N Engl J Med 2006;354(25):2645-54.
7.Lacey JV, Swanson CA, Brinton LA, et al. Obesity as a Potential Risk Factor for Adenocarcinomas and Squamous Cell Carcinomas of the Uterine Cervix. Cancer 2003; 98(4):814-21.
5) Windstar, K, Jones, C. Risk Factors potentiating HPV Pathogenesis; and Evidence of Natural Treatment Options. Lecture August 2008, American Association of Naturopathic Physicians.

Slow down there speedy!

Are you the first one done at a meal?
Wiping your mouth in satisfaction while others are still cutting their meat?
Do people make fun of the fact that you "inhale" rather than "chew?"

Well keep reading and start chewing...s-l-o-w-l-y!
A recent study in the British Medical Journal found that eating quickly until full tripled your chances of being overweight! They cited cheap, fast food and eating in front of the television as major contributors to absent eating.

Chewing your food starts the digestion process. What you don't chew up into itty-bitty tiny pieces from your mouth makes more work for your stomach then small intestines. This leads to indigestion, malabsorption, gas and bloating plus all those other unpleasant intestinal problems.

Here's a little trick - chew each bite at least 30 times! I'm not kidding. Put your fork down between takes or set the burger/sandwhich back on the plate while you chew.

And stop drinking a lot of fluids with your meals - this dilutes your digestive juices! Take a few sips if you need to but pounding a large soda, glass of water or iced tea makes it that much harder to digest those large pieces into tiny particles for absorption.

October 17th is National Mammography Day!

Mammograms detect 80 percent to 90 percent of breast cancers in women without symptoms, and all women 40 and older should get a yearly mammogram, says the American Cancer Society.

Many of my patients are concerned about the radiation exposure to their breasts and often question whether they need to go EVERY year.

"Dr. Jones - I don't feel a lump."
"Nobody in my family has breast cancer."
"I'm pretty healthy, I think I would know if I had breast cancer."

These are quotes I hear all the time. Then, of course, they want to know my opinion.

Well here goes.

Yes, I know you do not have breast cancer in your family and yes I realize you will be exposing very sensitive tissue to some radiation however right now there is no perfect test and if you do not have a palpable lump yet mammogram picks it up and it's cancer...there is a very very good 5 year survival rate.

For example, a Stage 1 breast mass is about 2 centimeters or less. If you have larger breasts, there is a good chance you will not feel it when you do your breast exam. A stage 1 breast mass that is addressed has a near 100% 5 year survival rate.

Here's the other kicker, 70% of women diagnosed with breast cancer had NO KNOWN RISKS other than being a woman. How's that for statistics!

I also realize that not all breast masses are cancerous and may show up on a mammogram causing some concern...but what a relief when it's just a cyst or fibroadenoma!

There are other additional breast options such as thermography. It's a pretty neat tool to be used along with mammograms and may be able to detect hormonal changes or cancer years before traditional screening.

I'm also going to advocate for healthy diets and lifestyles, good functioning livers and bowels to clear out toxins and stress reduction to save your sanity.

That's my opinion and I'm sticking to it.

Mayan Abdominal Massage: Love it!

What is this wonderful technique of massage? And why is it called Mayan Abdominal? Well, this Massage is founded on the ancient Mayan technique of abdominal massage. It is an external, non-invasive manipulation that repositions internal organs that have shifted, thereby restricting the flow of blood, lymph, nerve and chi.

For women, it specifically helps all kinds of symptoms such as: painful periods, heavy periods, tilted uterus, irritable bowel, constipation, fertility challenges, endometriosis, low back ache and many others.

Normal or Tilted?
Normally the uterus leans slightly over the bladder in the center of the pelvis, about one and a half inches above the pubic bone.

Uterine ligaments are made to stretch in order to accommodate a growing fetus inside and to move freely when the bladder or bowel are full. Due to a variety of reasons, the ligaments and muscles can weaken and loosen, causing the uterus to fall downward, forward, backward or to either side.

Often times women are told their uterus is “tilted” or “prolapsed” and that it is normal. Unfortunately this change in position causes many uncomfortable symptoms and most doctors do not have a way to shift the uterus back into place. This results in a list of drugs and pills to stop the symptoms.

What about the cause?
This is where the massage comes into play! By shifting your uterus into the correct spot - blood, lymph, nerve conduction and energy are able to freely flow back into the places they are suppose to be.

This massage is wonderful for almost everyone! As I said before, it is external and non-invasive. You lay on a regular massage table and enjoy the benefits of having your core worked.

To learn more about this great technique, visit www.arvigomassage.com

It's September Already?? Let's be Empowher'd!

Things have been busy this summer in Oregon but I vow to stay focused on my writing and informing you of all the latest and greatest on women's health. To help me do this, I have just been asked to be a weekly contributor to the women's health website, www.empowher.com.

The site is for you and all about you! How cool is that? Plus it ranks right up there with my philosophy about women's health - you need to be properly informed in order to make any decisions.

The site is going through some changes as it's relatively new so stay on the look-out for my articles coming in October 2008 AND a new updated, more user friendly look.

Thyroid and Heart Disease - beyond the basics.

Do you feel as if you have many symptoms of a thyroid disorder but every time you have the lab test done, you're told it's "fine."

You've got it all - the cold hands and feet, the inability to lose weight despite a healthy diet AND exercising at least 30 minutes most days of the week, tendency towards constipation, dry hair, dry skin, feeling sluggish and tired.... yet why are you considered "normal" or "fine?"

It's my opinion that a complete thyroid test should be run on everyone (men too) every couple of years especially after major events such as birth, menopause, trauma, stresses...etc.

What do I mean by complete?

I mean running the TSH (thyroid stimulating hormone) plus the two free hormones - Free T4 and Free T3. In addition, I always would run an adrenal salivary test (www.salivatest.com) because the adrenals and the thyroid talk non-stop like teenagers on myspace!

This may help to uncover sub-clinical hypothyroidism as well. That means you aren't exactly overt hypothyroid but you're almost there.

As a Naturopathic Physician, I believe it's important to pull you away from the cliff before you get too close and fall off. That's the difference between sub-clinical and overt.

Why is this important? Well, you can have all those symptoms as described above and only be "sub-clinical" or edging closer to the cliff.

Plus, in the April 28, 2008 issue of the Archives of Internal Medicine they reported that sub-clinical hypothyroidism can have a higher risk of coronary heart disease (CHD) death than women with normal thyroid function.

Does this mean you will have to go on thyroid replacement? Not necessarily but it's important you talk with your health care practitioner about your options.

Women and Heart Attacks - Differing Symptoms?

What happens if you suddenly start to feel tired, nauseated, and jaw pain? What would you think?

According to a recent study on 25,755 men and women in 14 different countries, women often presented with 'atypical symptoms' and 'invisible' blood vessel blockages yet other test results confirmed they were having a heart attack, according to the study published online in the journal Heart.

To compound this, women often receive less work-up and less treatment than men!

The following is from the article:
Women with the same level of coronary artery disease as men were significantly less likely to receive drugs or statins that help prevent future heart attacks, the study said.

Women were also less likely to get an angioplasty or a stent to open up their blood vessels, no matter the gravity of their blockages, it said.

The women in the study with more advanced coronary artery disease were more likely than men to have suffered another heart attack or died within six months of their initial heart or angina attack.

Female patients also often described different symptoms than men when first reporting to hospital.

While 94 percent of men and 92 percent of women reported feeling chest pain, female patients with no chest pain were more likely to describe "atypical" symptoms such as nausea and jaw pain, the study said.

What do you do? First, if you experience any strange symptoms that sound like the ones in this article, either have someone take you to a hospital or call 9-1-1.

Second, demand equal health care. Make sure you receive an appropriate work-up for a heart attack and then the appropriate treatment!

It's your health that is at risk here no matter what sex you are!

Diet determines gender? Read on...

As some of you may know, I get all of my worldly news from the Yahoo! front page. If it's not on there I might not know about it....

Having said that I woke up this morning and found the following title, "Mother's diet can help determine sex of child: study"

I have been saying for years that there is a trend towards female babies but my friends and fellow doctors thought I was crazy. This study looked at 740 women in Britain who did not know the sex of their unborn baby and asked them details about their diet.

What they found is very cool!

*Fifty-six percent of the women in the group with the highest energy intake had sons, compared to 45 percent in the least-well fed cohort.

*Beside racking up a higher calorie count, the group who produced more males were also more likely to have eaten a wider range of nutrients, including potassium, calcium and vitamins C, E and B12.

*The odds of an XY, or male outcome to a pregnancy also went up sharply "for women who consumed at least one bowl of breakfast cereal daily compared with those who ate less than or equal to one bowl of week," the study reported.

They report that previous research has shown -- despite the rising epidemic in obesity -- a reduction in the average energy uptake in advanced economies. The number of adults who skip breakfast has also increased substantially.

They say this is a built-in evolutionary mechanism...because women traditionally can handle the tougher times and can still reproduce then female babies are more commonly born.

The author says, if a mother has plentiful resources, then it can make sense to invest in producing a son because he is likely to produce more grandchildren than would a daughter, thus contributing to the survival of the species.

What does this mean?

It means that your diet will 'potentially' influence the gender of your baby. It means, while you are trying to become pregnant to eat a healthy diet, do not skip breakfast, avoid alcohol, smoking and coffee completely and take care of your body!

It means that if you take care of yourself through your diet then evolution recognizes that you are healthy...and that is ultimately what you want to be.

Plastic - Potentially Toxic?

The federal National Toxicology Program said Tuesday that experiments on rats found precancerous tumors, urinary tract problems and early puberty when the animals were fed or injected with low doses of the plastics chemical bisphenol A.

This is something that environment groups have known for years...but what is it?

Bisphenol A is a chemical found in shatter-proof hard plastics such as baby bottles, storage containers, water bottles, food containers...etc. The idea is that it is an "endocrine disruptor" in that it mimics the actions of estrogen.

Eek! The world does not need more estrogen! Our kids do not need more estrogen!

According to the article, the CDC reports that more than 90 percent of Americans are exposed to trace amounts of bisphenol. The chemical leaches out of water bottles, the lining of cans and other items made with it.

One state, New Jersey, has already passed a bill banning the sale of plastic with bisphenol in it. Canada's health system is also doing similar research and looking to report their findings soon.

What can you do?

Don't use plastic. If you must use plastic then absolutely do not store anything hot in it. Do not put hot food or liquid in the plastic because it will leach out 55 times faster!

Use glass containers to both drink out of and store your food.

Here's to a healthier you and a healthier environment!

Vitamin D - Much More than a Sunny Day!

Did you know that Vitamin D is really a super powered steroid hormone with multiple functions in your body beyond correcting rickets disease?

Did you know that even if you stand outside in the sun chances are you don't absorb very much because you're wearing sunglasses and SPF sunblock which limits Vitamin D from entering your body?

Did you know common symptoms of vitamin D deficiency are muscular weakness, feeling of heaviness in the legs, chronic musculoskeletal pain, easy tiring, fatigue, and low mood in the darker/dreary seasons?

Did you know that optimal levels of Vitamin D 'may' help with some cancers, the flu, autism, asthma, multiple sclerosis and cardiovascular disease in addition to curing rickets and osteomalacia?

Do you know what your Vitamin D levels are?

A most brilliant article came out in the March 2008 Alternative Medicine Review entitled, Use of Vitamin D in Clinical Practice by Dr. John Cannell and Dr. Bruce Hollis. According to the authors, healthy humans should be supplemented with enough vitamin D or exposed to enough ultraviolet B (UVB) radiation to achieve 25(OH) vitamin D levels of 40-70 ng/mL year-round.

But I get plenty of sun-time, you say?

Factors affecting UVB exposure and the skin's production of Vitamin D include latitude, season of the year, time of day, air pollution, cloud cover, melanin content (how dark is your skin), use of sunblock, age, obesity, and the extent of clothes covering your body.

Because melanin in the skin acts just like a sunscreen, dark-skinned individuals need much longer UVB exposure than fair-skinned folks. Also, body fat absorbs vitamin D right into those fat cells without letting the rest of the body use this great hormone.

Okay, I get it so what type of lab-work should I have done?

Ask your doctor for a 25,OH Vitamin D test (do NOT get the 1,25,OH vitamin D test). Optimal levels are between 40-70 ng/mL although many researchers and clinicians aim for above 50 ng/Ml.

What if I am deficient?

Many health providers who do not know about vitamin D will worry about vitamin D toxicity which is second to an elevated level of calcium in your body. This is VERY uncommon but begins to occur when your vitamin D levels reach and exceed 150 ng/ml. Remember, you want to be somewhere between 40-70 ng/mL.

Keeping in mind your risk of skin cancer, getting outside and enjoying the sun in small increments without sunblock is a great way to increase your levels. Once you get a bit of unblocked sun...you can rub on your SPF sunscreen and/or cover-up and continue with your activity.

If you plan on taking vitamin D supplements, always do so under the supervision of a healthcare provider and make sure you are monitoring your vitamin D and serum calcium levels every 3-4 months when taking higher levels. Make sure your supplement is D3 or cholecalciferol and NOT the inferior form D2 or ergocalciferol. D2 (ergo) is not human vitamin D, acts much weaker, is not normally present in humans, and produces metabolic by-products not normally found in humans.

Before you go supplementing with vitamin D above 2000 IU/day, get your labs done and talk with a healthcare provider who is skilled at the ins and outs of this powerful vitamin hormone.

Three cheers for Vitamin D!

Big belly? No memory? How they are connected.

Everyone knows that having the typical "apple" shape where your belly is larger than your hips is worse for your health down the road. All that fat centered around your organs and hanging over your pants can lead to heart disease and blood sugar problems like insulin resistance and diabetes. But can it cause dementia as well? Researchers say "yes!"

In the March issue of Neurology, they found that total body weight is a strong predictor of dementia, conferring a 75% increased risk among those with the highest BMI! Eek!
They also found that individuals who were both obese and who had a large belly were 3.6 times more likely to develop dementia than those of normal weight and belly size.

The thing is, visceral fat (there in your belly) is actually quite active! It produces hormones and inflammatory markers AND is a storage place for toxins. Now they are finding it can really play havoc on your brain.

Dementia is the loss of mental skills that affects your daily life. It can cause problems with your memory and how you plan. According to Wikipedia, it's the progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging.

Alzheimers is the most common form of dementia but stroke, tumors, head injuries, hypothyroidism and low Vitamin B12 can also be the cause.

If you find your memory isn't what it used to be, make an appointment with your doctor and start healthy habits that will get rid of that belly fat!

Stopping HRT - Are you still at risk for cancer?

After the big Women's Health Initiative (WHI) study that came out a few years ago, women around the world have been wondering, am I still at risk for breast cancer? I stopped my estrogen and I stopped my progestin (fake progesterone) so now what?

In the March 8th issue of the Journal of the American Medical Association (big deal to get published in here!) the news was not so good. Immediately stopping these hormones lowered cardiovascular risks such as heart attacks and blood clots. This is a good thing. However, they also found that women who took HRT remained at a higher risk for breast cancer even up to 3 years after stopping!

The study happened between 2002 and 2005. Being that it is 2008, the study does not say if it was ongoing and the effects of HRT after 3 years, ie. from 2002 - 2008.

What can women do? Be diligent! Go get your breast exams and mammograms! Eat healthy, exercise, limit your alcohol intake, limit your estrogen exposure, drink plenty of filtered water and perform monthly breast self exams (or have your partner do it!)

I have a good friend who went to the doctor for her yearly check-up. She brought her husband for moral support. During the breast exam, the doctor found a lump and remarked if my friend had ever felt it? Was it new? Had it been growing? How long had it been there? My friend was at a loss for words...she didn't know.

Suddenly her husband piped in, "I've been feeling that lump for awhile now. It hasn't grown. It hasn't changed."

The moral of the story is communication!! The lump turned out to be normal but had he told her about it, she would have been in for evaluation much sooner. I now tell all of my patients this story so they will let their significant others know a breast exam can be both fun AND medical at the same time!

Born earlier than 37 weeks? How it affects the future!

When you're pregnant, sometime it seems like that baby is never going to come out! Your friends, family and even doctor will tell you that when the time is right it will happen as it should. However, there are instances when you may go into labor prematurely and not have a choice in the matter. And then you hear of moms scheduling their c-section 'out of convenience' either for them or for the doctor.

Has anyone looked at what happens long-term when a baby is born pre-maturely? Were you or your partner born pre-maturely?

In the March 26th issue of the Journal of the American Medical Association (this is a big-deal place to get published!) researchers looks at 1,167,506 singleton births (not multiples like twins) to establish what happens long-term with their health and future reproduction. Of those millions kids, 5.2% were born early (before 37 weeks).

What they found was astonishing! Mortality rate (number of deaths in a given population) was highest for a shorter gestation which in this study was anything between 22 - 36 weeks. Infant mortality rates (age < 1 year) were increased in all age categories of preterm girls and boys vs term children. Girls born at 28 to 32 weeks' gestation vs term had higher mortality rates through age younger than 1 year while boys born at 28 to 32 weeks' gestation vs term had higher mortality rates through age 12.9 years!! That's almost 13 years old for boys!

Girls and boys born at 33 to 36 weeks' gestation vs term had higher mortality rates up to age younger than 1 year.

What about future fertility? How does a pre-term birth affect their ability to reproduce when they are grown-up and ready (or not)?

Unfortunately, reproduction rates were lower for preterm vs term women of 22 to 27 weeks' gestation (25%) and 28 to 32 weeks' gestation (59.2%) while reproduction rates were lower for preterm vs term men of 22 to 27 weeks' gestation (13.9%) and 28 to 32 weeks' gestation (38.6%).

If you are planning a pregnancy and finding fertility difficult, find out if you or your partner were born early...it may play a major factor.

If you are pregnant - take it from the researchers and allow your baby to stay in the bun unless medically necessary.

The Fertility Diet and Lifestyle Factors

In the November 2007 issue of Obstetrics and Gynecology, the researchers looked at 17,544 women ages 25 to 42 years old to see how diet and lifestyle affected their fertility...especially when it came to an ovulation disorder. What they found supported the recommendations that I have been making in my practice for my fertility patients.

First of all, fertility concerns affects 1 in 6 couples and ovulation problems are the cause 18-30% of the time. In order for sperm to meet egg and create a baby the egg must first be released from the ovary and travel into the tube. If the egg is not released (no ovulation) then the sperm are unfortunately out of luck.

The Fertility Diet as described by the article includes higher amounts of mono saturated fats (olive oil, olives, avocados, and many nuts and seeds), vegetables and higher fiber/low-glycemic carbohydrates (actual whole grains).

The article also found that women who had a healthy Body Mass Index (BMI) of 20-24.9 had a lower risk of infertility than those women with a BMI below 20 or above 30. To calculate your BMI, visit www.cdc.gov/nccdphp/dnpa/bmi. You will need your height and current weight.

The risk for ovulatory infertility was lower for each additional low-risk lifestyle habit followed, up to 69% lower risk for women adhering to 5 or more habits. This includes smoking, exercise, alcohol consumption, coffee consumption, weight control and diet.

They did conclude that diet composition had a greater impact on fertility than either BMI or vigorous physical activity alone.

***In order too maximize your fertility outcome, why not incorporate all 3 into your lifestyle? 69% lower risk are pretty good odds. While you're at it...make sure you include your partner in these changes to improve their fertility as well.