The New Superfruits

The new superfruits

Give the apples and bananas a rest and round out your repertoire with these exotic, antioxidant-packed picks


Though Americans are eating more fruit these days (go us!), more than half are the old standbys: bananas, apples, and oranges. Yes, they're good for you--but you're missing out. "Different fruits provide an array of disease-fighting vitamins, minerals, and antioxidants," says Joy Bauer, RD, author of Joy Bauer's Food Cures. In fact, broadening your horizons can measurably improve your health. Colorado State University nutritionists asked 106 women to eat 8 to 10 servings of produce daily for 8 weeks. Half the group chose from 18 different varieties, while the others ate the same 5 over and over again. Two weeks later, blood tests showed that the high-variety group reduced their rates of DNA oxidation, possibly making their bodies more resilient against disease; the other group had no change.

Ready to mix it up? Here's a quickie primer on some of the smartest "exotic" picks based on their health benefits--and how to serve them in place of common favorites.

For perfect blood pressure
Good: Bananas
Better: Fresh figs

Why: Six fresh figs have 891 mg of blood pressure-lowering potassium, nearly 20% of your daily need--about double what you'd find in one large banana. In a recent 5-year study from the Netherlands, high-potassium diets were linked with lower rates of death from all causes in healthy adults age 55 and older.

You'll also get...a boost to your bones. Figs are one of the best fruit sources of calcium, with nearly as much per serving (six figs) as 1/2 cup of fat-free milk!

Shop for figs that are dry on the surface and feel heavy in the hand. A perfectly ripe fig may have slight cracks that are bursting with the fruit's sweet syrup.

Serve by chopping and adding to yogurt, cottage cheese, oatmeal, or green salads. Or, enjoy them as a savory snack: Cut a slit in the side and stuff with 1/2 teaspoon of a low-fat version of a soft cheese such as chèvre or Brie.

To protect your heart and fight disease
Good: Red grapes
Better: Lychee

Why: A French study published in the Journal of Nutrition found that lychee has the second-highest level of heart-healthy polyphenols of all fruits tested--nearly 15% more than the amount found in grapes (cited by many as a polyphenol powerhouse). The compounds may also play an important role in the prevention of degenerative diseases such as cancer. "Polyphenols act like a force field, helping to repel foreign invaders from damaging your cells," says David Grotto, RD, author of 101 Foods That Could Save Your Life!

You'll also get...protection from breast cancer. A recent test-tube and animal study from Sichuan University in China found that lychee may help to prevent the formation of breast cancer cells, thanks to the fruit's powerful antioxidant activity.

Shop for lychee with few black marks on the rough, leathery shell, which can be anywhere from red to brown in color. Look for fruit that gives when pressed gently. Shells should be intact and the fruit attached to the stem.

Serve by peeling or breaking the outer covering just below the stem; use a knife to remove the black pit. Add to stir-fries or skewer onto chicken kebabs to add a sweet, grapelike flavor.
For beautiful skin
Good: Orange
Better: Guava

Why: One cup of guava has nearly five times as much skin-healing vitamin C (it's a key ingredient in collagen production) as a medium orange (377 mg versus 83 mg)--that's more than five times your daily need. Women who eat a lot of vitamin C-packed foods have fewer wrinkles than women who don't eat many, according to a recent study that tracked the diets of more than 4,000 American women ages 40 to 74.

You'll also get...bacteria-busting power. Guava can protect against foodborne pathogens such as Listeria and Staph, according to research by microbiologists in Bangladesh. Also, a cooperative study by the USDA and Thai scientists found that guava has as much antioxidant activity as some well-known superfoods like blueberries and broccoli (though every plant contains a different mix of the healthful compounds).

Shop for guava using your nose. A ripe guava has a flowery fragrance, gives a bit to the touch, and has a thin, pale green to light yellowish rind.

Serve by adding to fruit cobbler recipes (the tiny seeds are edible) or simmer chunks in water as you would to make applesauce. Guava also makes a super smoothie: Blend 1/2 banana, 1/2 ripe guava, a handful of strawberries, 1/2 cup soy milk, and a few ice cubes.

To lower cholesterol
Good: Apples
Better: Asian pears

Why: One large Asian pear has nearly 10 g of cholesterol-lowering fiber, about 40% of your daily need; a large apple has about half that much. People who ate the most fiber had the lowest total and "bad" cholesterol levels, according to a recent study of Baltimore adults.

You'll also get...protection from creeping weight gain. The same researchers found that people who ate the most fiber also weighed the least and had the lowest body mass index and waist circumference.

Shop for pears with a firm feel; fragrant aroma; and blemish-free, yellow brownish skin. Some pears are speckled in appearance; the markings shouldn't affect flavor.

Serve by dicing it into a salad of Boston lettuce, crumbled goat cheese, walnuts, and mandarin oranges. Or, make it a dessert: Add peeled and cored pears to a saucepan with 1 cup white wine, 1 teaspoon honey, 1 teaspoon grated fresh ginger, and enough water to cover the pears. Cover and simmer 40 minutes or until pears are soft.

To fight cancer
Good: Watermelon
Better: Papaya

Why: It is one of the top sources of beta-crypoxanthin, which research suggests can protect against lung cancer. Like watermelon, it is also a rich source of lycopene. "Although there is currently no recommendation for how much lycopene you should consume in a day, research shows that the nutrient may protect against several different types of cancer, including stomach, endometrial, and prostate," says Grotto.

You'll also get...better healing. Papayas may help speed burn recovery when used topically, thanks partly to the enzyme papain, which also aids in digestion. "Papain helps break down amino acids, the building blocks of protein," says Elisa Zied, RD, an American Dietetic Association spokesperson.

Shop for a papaya with yellow golden skin that yields to gentle pressure.

Serve by cutting lengthwise and discarding black seeds. Scoop the flesh using a spoon and sprinkle with lemon juice. Or combine chopped papaya, mango, red bell pepper, red onion, raspberries, lemon juice, and cilantro for a fruit salsa. Serve over grilled fish.

More exotic fruit ideas! For varieties you don't see here, visit our food encyclopedia at prevention.com/food.

Top 6 Antiaging Breakthroughs

Top 6 Antiaging Breakthroughs
Dozens of beauty products have hit the market, but do any of them truly deliver? We asks the experts to separate the science from the hype.

FeatureReviewed by Michael W. Smith, MD. Wanting to look young is not exactly a new idea -- the search for the fountain of youth has been going on for centuries. And while this past year didn’t deliver the perfect elixir, the year did introduce some scientifically solid, significant advances in anti-aging skin care. To home in on what can truly make a difference in your skin, WebMD asked medical experts to evaluate the cream of the crop.

Antiaging Breakthrough No. 1: Fractional CO2 Laser Skin Resurfacing
The antiaging breakthrough of the decade, according to many doctors, is a skin-resurfacing treatment known as CO2 fractional laser therapy. Combining the effectiveness of traditional carbon dioxide lasers -- long thought to be the gold standard in wrinkle removal -- with a new application technique, it delivers powerful results without the traditionally harsh side effects.

"Essentially, you are getting all the benefits of laser resurfacing, still the best way to remove wrinkles, but you’re getting it without the downtime and without the horrendous complication rate," says David Goldberg, MD, director of Skin Laser and Surgery Specialists of New York and New Jersey and clinical professor of dermatology at the Mt. Sinai School of Medicine in New York City.

How does it work? The natural aging process, combined with exposure to sun and pollution, destroys collagen -- the main protein of connective tissue that keeps skin plump and line-free. Laser resurfacing uses beamlets of energy light to bore tiny holes in the skin, which works to put the body’s natural collagen production on fast-forward. Here’s what’s new: Fractional CO2 laser resurfacing does this in a way that prevents damage to the top layer of skin, offering maximum results with minimal recovery time.

While laser resurfacing doesn’t come cheap -- the procedure will cost you about $5,000 -- it is quick, accomplished in one or two sessions, with about four days downtime. Goldberg says effects are thought to last eight to 10 years.

According to the American Society for Dermatologic Surgery, patients with darker complexions may be at risk for pigmentation loss with any laser surgery. Common minor side effects for fractional laser resurfacing include redness and swelling that lasts about two days.

Antiaging Breakthrough No. 2: The New Wrinkle Injections
Wrinkle injection technology soared to new heights last year when the FDA approved four fillers: Perlane, Juvéderm, Artifill, and Radiesse. Along with Restylane, approved in 2003, each uses a slightly different substance to fill wrinkles.

But according to Rhoda Narins, MD, professor of dermatology at NYU Medical Center in New York City, that’s just the beginning. "What’s really significant is that we can now use these fillers to volumize skin anywhere on the face, so you can really sculpt a lifted, youthful look without surgery," she says.
Antiaging Breakthrough No. 2: The New Wrinkle Injections continued...
Dermatologist Bruce Katz, MD, the director of Juva Skin and Laser Center in New York City, agrees. "Unlike a face-lift, which pulls the skin taut and tight, volumizing plumps up the skin so the look is youthful but more natural," he says.

In even more good news about wrinkle injections, studies conducted by Frank Wang, MD, at the University of Michigan Medical School found that those containing hyaluronic acid (such as Restylane and Juvéderm) led to "robust collagen production" while also interfering with collagen breakdown. So not only do you get a filling effect, says Narins, but you also have an actual increase in natural collagen production.

Currently, most fillers last up to one year, or longer. Only one -- Artifill -- offers permanent results, but not without concern. According to a published report by the FDA, it increases the risk of granulomas, bumps that form under the skin and may be permanent, as well as an increased risk of allergic reaction.

Still, Narins says all currently approved wrinkle injections have been used in Europe for several years, and the track record on safety is generally good. Most often, side effects are mild, usually limited to redness or swelling at the site of injection, she adds.

The cost of wrinkle-filling volumizers is between $600 and $1,000 per syringe.

Antiaging Breakthrough No. 3: Antioxidants
Topping the list of over-the-counter antiaging ingredients making the most noise these days are antioxidants. These skin-care nutrients fight aging by destroying free radicals, the unstable molecules that occur from sun exposure or pollution and that can literally gobble up the skin’s collagen supply.

"Antioxidants are nutrients that, when topically applied, disarm and neutralize free radicals before they harm skin -- so they can play an important role in antiaging skin care," says Sumayah Jamal, MD, an assistant professor of dermatology and microbiology at NYU Medical Center in New York City.

Scores of studies demonstrate the power of topical antioxidants (particularly CoQ10 and vitamins C and E) to rejuvenate and protect skin. However, the ingredient generating the loudest buzz in 2007 was clearly coffee berry, which some experts now believe is the single most powerful antioxidant discovered to date.

Two independent studies found that the same plant that gives you your java jolt in the morning is ready to provide a powerful antiaging boost to your face. The research conducted by David McDaniels, MD, at the Institute of Anti-Aging Research in Virginia, and Zoe Draelos, MD, at Dermatology Consulting Service in North Carolina, reported that coffee berry extract significantly improved the appearance of fine lines and wrinkles without allergic reactions or skin irritations.

Although Goldberg says it will be a few years before the full extent of coffee berry’s rejuvenating properties is known, he adds that it is "so powerful in its antioxidant rating that even if 1/1,000th of what’s applied gets into the skin it’s probably going to have an effect."

Dermatologist Ken Beer, MD, director of Palm Beach Esthetic in Palm Beach, Fla., says he’s seen the science and he’s impressed: "I think this is going to be a major cosmeceutical ingredient."

Other cosmeceuticals with new and powerful antioxidants include:

Prescriptives Super Line Preventor Xtreme with seven antioxidants (1 ounce, $48)
Neutrogena Antioxidant Age Reverse Day Lotion and Night Cream (1.7 ounces, $17.99 each)
Lumene Vitamin + Energy Cocktail (1 ounce, $17.99)
Clinique Continuous Rescue Antioxidant Moisturizer with eight time-release antioxidants (1.7 ounces, $39.50)

Antiaging Breakthrough No. 4: Peptides
Small proteins that stimulate the production of collagen, peptides have been on the cusp of antiaging skin care for a while. The excitement began several years ago with NIH-backed research on the ingredient Matrixyl (palmitoyl pentapeptide-3), showing its ability to stimulate collagen production in skin. Today, further studies on additional peptides continue to generate research news.

According to Jamal, studies on formulations such as Argireline (acetyl hexapeptide-3) show they can produce a mild, Botox-like effect, inhibiting the release of neurotransmitters that keep facial muscles from forming wrinkles. Even newer peptide formulations act like growth factors, stimulating skin cells to make a quicker turnover, much like young skin.

What’s new for peptides? Formulations that seem to yield overall improved results. "They are really getting the science down now, learning how to stabilize the peptides and at the same time inhibit collagenase [the breakdown of collagen] so we have better, more tailored peptide products," says Beer.

Products containing the newest versions of that peptide technology include:

Olay Regenerist Micro-Sculpting Cream with amino peptide complex (1.7 ounces, $29.99)
Lumene Premium Beauty Rejuvenating Instant Serum (1 ounce, $29.99)
Avon Anew Clinical Eye Lift (0.5 ounce, $28)
Osmotics Blue Copper 5 Face Lifting Serum (1 ounce, $75)
Emerge Bio-Peptide Night Repair Cream with 10% peptides (1.12 ounces, $43)


Antiaging Breakthrough No. 5: Vitamin A
Among the most medically studied topical antiaging treatments are the retinoids -- derivatives of vitamin A. They are offered as prescription treatments such as Retin A or Renova, but also available in weaker strengths in over-the-counter products, listed as the ingredient retinol.

Retinoids are "thought to work on aging skin by increasing collagen production and decreasing collagen breakdown," says Jamal -- and a ream of studies backs her up.

But while many doctors believed only the prescription-strength retinoids were powerful enough to cause significant change in the skin, 2007 was the year that idea changed. In a study published in the Archives of Dermatology in May, researchers from the University of Michigan found that 0.4% retinol lotion applied three times a week for 24 weeks yielded significant difference in skin wrinkling when compared with a similar lotion without retinol used on a separate group of people in the study.

Even more surprising: The average age of study participants was 87, meaning it’s truly never too late to look younger.

"For those who can’t or don’t want to have an office procedure for wrinkles, I suggest starting with retinol products, and if there are no problems, such as redness or irritation, you can work up to a prescription-strength Retin A product. But we now know that both have the power to produce measurable antiaging results," says Goldberg.

Products containing retinol include:

Vichy Reti-C Intensive Corrective Care (30 milliliters, $31)
Neutrogena Healthy Skin Anti-Wrinkle Intensives with retinol and antioxidants (Serum, 1 ounce, $16.99; Eye Cream, 0.5 ounce, $16.99)
Clinique Zero Gravity Repairwear Lift with retinol, antioxidants, and peptides (1.7 ounces, $52)
L’Oreal Advanced RevitaLift Double Lifting Gel (1 ounce, $16.99)
RoC Retinol Correxion Deep Wrinkle Serum (1 ounce, $19.99)
Antiaging Breakthrough No. 6: Antiaging Sunscreens
Among the most exciting new ways to fight skin aging are two dramatic breakthroughs in sun protection: Helioplex, a new technology that makes current sunscreen ingredients more effective, and Mexoryl SX (ecamsule), a new protective agent. Representing the first innovation in skin sun protection in more than 20 years, each is specifically designed to defend against the aging effects of short UVA rays.

"They are truly the best we have, and they are a major, major advance in terms of antiaging protection," says Katz.

Most of us know about the dangers of burning UVB rays, but you might be less aware of the damaging and aging effects of UVA. "These are the ones that go deep -- UVA rays cause the deep collagen and elastin damage that contributes to aging skin," says Katz.

While most sunscreens effectively protect against UVB rays, protection from UVA was mostly limited to the "long" waves, with ingredients that were unstable and frequently degraded in the sun.

But Mexoryl SX (ecamsule), a UVA-blocking sunscreen developed by L’Oreal, and Helioplex, a technology created by Neutrogena to stabilize traditional sunscreen ingredients avobenzone and oxybenzone, are proving not only to protect against the damaging short UVA rays, but to offer long-lasting protection without the need to constantly reapply.

"They have been available in Europe for some time now, and there is no question they work -- and from an antiaging standpoint, they can be your best friend," says Goldberg.

Even more exciting: In 2007 these sunscreen advances were combined with antioxidants and other antiaging ingredients in moisturizers and day creams that offer Fort Knox-level protection against the aging effects of the sun.

Products containing the latest Helioplex technology include:

Neutrogena Healthy Defense SPF 45 Daily Moisturizer (1.7 ounces, $11.99)
Neutrogena Ultra Sheer Dry-Touch SunBlock SPF 70 (3 ounces, $9.99)
Products containing Mexoryl SX include:

Vichy Capital Soleil SPF 15 Sunscreen Cream (3.4 ounces, $29.99)
L’Oreal Revitalift UV Moisturizer and Sunscreen (1.7 ounces, $22)
LaRoche-Posay Anthelios SX (3.4 ounces, $29)
Lancome UV Expert 20 (3.4 ounces, $35)

SOURCES: Rhoda Narins, MD, professor of dermatology, NYU Medical Center, New York. David J. Goldberg, MD, director, Skin Laser and Surgery Specialists of New York and New Jersey; clinical professor, and director, Laser Research and Mohs Surgery, Mount Sinai School of Medicine, New York. Ken Beer, MD, director, Palm Beach Esthetic, Palm Beach, Fla.; clinical instructor of dermatology, University of Miami. Bruce E. Katz, MD, director, Juva Skin and Laser Center, New York; clinical professor, dermatology; director of the Cosmetic Surgery and Laser Center, Mount Sinai Medical Center, New York. Sumuyah Jamal, MD, associate professor of dermatology and microbiology, NYU School of Medicine, New York. American Society of Dermatologic Surgery Fact Sheet on Laser Resurfacing. Kafi, R. Archives of Dermatology, May 2007; vol 143: pp 606-612. Wang, F., Archives of Dermatology, February 2007; vol 143: pp 155-163. News release, Revaléskin, Stiefel Laboratories.

Colorectal Cancer: New Treatments, Improved Prognosis

Colorectal Cancer: New Treatments, Improved Prognosis
New drugs show promise, but more research needs to be done.
By R. Morgan Griffin
FeatureReviewed by Brunilda Nazario, MD

While colorectal cancer remains one of the most deadly cancers in the U.S., researchers are making steady progress against this disease. New drugs allow people with even the most advanced metastatic disease to live longer. Admittedly, there's no cure, and the improvements -- which can add several months to a patient's life -- may seem modest.

But for people living with advanced colorectal cancer -- and their loved ones -- small improvements make a huge difference. And experts are confident that treatment will keep getting better.

"I think the attitude has changed among doctors, especially when it comes to metastatic colorectal cancer," says Paulo M. Hoff, MD, an oncologist at the MD Andersen Cancer Center at the University of Texas in Houston. "We used to have a pessimistic view. But now we're seeing more patients with metastatic cancer responding to treatment. They are also responding well for a longer time."

"We have more tools than ever before to treat colorectal cancer," says Leonard Saltz, MD, leader of the colorectal disease management team at Memorial Sloan Kettering Cancer Center in New York. "What we're doing now is learning how to use them most effectively."
A Turning Point in Treating Colorectal Cancer

For decades, medications for colorectal cancer were limited to two drugs, 5-fluorouracil and leucovorin. But in 1996, things began to change.

* In 1996, the FDA approved Camptosar (irinotecan) for people with metastatic colorectal cancer that had recurred or spread beyond the colon. (Metastatic means that the cancer has spread to other parts of the body.)

* In 2002, the FDA approved the use of Eloxatin (oxaliplatin) in combination with 5-Fluorouracil and Leucovorin.

The new drugs improved survival to an extent. For example, one study published in the New England Journal of Medicine in 2004 found that adding Eloxatin to standard chemotherapy boosted survival among patients with advanced disease by 11%.
Advances in Targeted Therapies for Colorectal Cancer

Next, in 2004, came targeted therapies. Avastin (bevacizumab) and Erbitux (cetuximab) are monoclonal antibodies, a new generation of cancer drugs that can specifically target cancer tumors.

The problem with traditional chemotherapy is that it can't be focused. The drugs go through the body, affecting both cancerous cells and healthy cells alike. Targeted therapies affect the specific mechanisms that allow cancer cells to grow. As a result, they may have fewer side effects.

Avastin is modeled after the antibodies that naturally protect the body. It blocks the effects of a substance in the blood that helps tumors grow new blood vessels. This substance is called vascular endothelial growth factor (VEGF.) By preventing the creation of new blood vessels in the tumor, the cancer is "starved." Erbitux blocks the effects of a different growth factor called epidermal growth factor (EGF).

Studies have shown that these drugs do help. A 2004 article published in the New England Journal of Medicine found that Avastin, when combined with 5-Fluorouracil and Leucovorin and Camptosar for metastatic cancer, could increase life expectancy by about five months. Another 2004 article in the New England Journal of Medicine looked at people who were no longer responding to Camptosar. By adding Erbitux to Camptosar, the doctors were able to significantly slow down the progression of the disease, compared to using Erbitux alone for treatment.

But there are some drawbacks to these new drugs. For one, they are both only approved for people with metastatic cancer. They haven't yet been shown to work in earlier stages of the disease. And, they are still associated with side effects. In addition, Avastin seems to increase the risk of heart attacks and strokes, which makes it unsafe for some people, and prompted the FDA to request an additional warning to be added to the product labeling.
Fine-Tuning Chemotherapy for Colorectal Cancer

With more drugs to use for colorectal cancer, doctors are now trying them in new combinations and sequences.

Experts have developed a number of regimens that combine the benefits of different drugs. For some time, IFL or the "Saltz Regimen" (Irinotecan, 5-Fluorouracil and Leucovorin) was a primary treatment. But new regimens have eclipsed it, Hoff tells WebMD.

"IFL has largely been abandoned in the U.S.," says Hoff, "It's considered a little more toxic and less effective than FOLFOX (Folinic Acid, Fluorouracil, Leucovorin, and Oxaliplatin) and FOLFIRI ( Folic Acid, Leucovorin, Fluorouracil, and Irinotecan)."

In people with metastatic cancer, these regimens may be combined with Avastin or Erbitux. Many other combinations, including the use of Avastin and Erbitux at the same time, are being tested in clinical trials.

Researchers are also studying whether Avastin and Erbitux could be used in earlier stages of the disease, when the chances of actually curing the cancer are much higher. However, the results of those trials are a ways off, says Hoff.
A Dramatic Rise in Costs

The key problem with the new targeted therapies is their price.

"Avastin and Erbitux are outrageously expensive," says Anthony Back, MD, an oncologist at the Fred Hutchinson Cancer Research Center in Seattle.

The numbers show an explosion in the cost of treating colorectal cancer because of these drugs. One year's worth of treatment with the combination of Erbitux and Camptosar for metastatic colon cancer would add up to $161,000, according to an article published in the New England Journal of Medicine in 2004. Overall, the article noted that the costs for the first eight weeks of standard treatment for advanced colorectal cancer have risen 340 times over the past 10 years.

For people with insurance that covers medication, the actual costs may seem irrelevant. But even the co-payments for these drugs add up.

"Some people have 20% co-pays for these medications," says Back. "Over the course of therapy for metastatic cancer, that adds up to tens of thousands of dollars out of their own pockets." The high cost of drugs could force a person to make the impossible choice between extra months of life and financial ruin for his or her family.

"The benefits of these drugs are so dramatic that we can't deny people from getting them," says Damian Augustyn, MD, spokesperson for the American Gastroenterological Association. "But the costs will put an enormous strain on the health care system."

Saltz agrees. "It doesn't take an economist to see that these prices are unsustainable," he tells WebMD.

Although your insurance company may bear the brunt of these costs now, experts worry that even insured patients may be affected eventually. As the drugs become more widely used, their price tag could make insurance companies attempt to limit their use.
A Dramatic Rise in Costs continued...

"With prices this high, I'm sure the insurance companies will start erecting barriers to patients trying to get these drugs," says Back. "These companies just can't afford it."

Saltz worries that it's already happening. He says some insurance companies are relying on "debunked" science -- namely, the EGF receptor test, which was thought to predict whether a person would be helped by Erbitux.

"The EGF receptor test is a bad test," he says. "Studies have shown that it has no predictive or prognostic value and should not be marketed. But insurance companies are using it as a way to deny people treatment with Erbitux."

Hoff agrees that the current test is a problem. "It's just not sensitive enough," he says. "We just don't have the data to justify using it to exclude people from treatment."

Augustyn, who is also chief of gastroenterology at California Pacific Medical Center in San Francisco, hopes that competition from other pharmaceutical companies might drive the prices down. But it will still be many years before any similar drugs can be tested, approved, and sold.
Surgery Remains the Standard of Care for Early Colorectal Cancer

While new drugs may get the most attention, surgery remains the standard treatment for people in the earlier stages of colorectal cancer. In recent years, minimally invasive -- or "keyhole" -- surgery has become a popular choice.

With this approach, the procedure is done by the surgeon through a small incision using special instruments and a laparoscope, a long flexible tube with a camera and light attached. The surgeon performs the operation while looking into a monitor. This minimally invasive approach allows for smaller incisions, less pain after surgery, and quicker recovery.

A 2005 study published in The Lancet found that laparoscopic surgery worked as well as traditional open surgery for some colon cancer patients, but more studies looking at long term outcomes are needed.

"There's definitely a trend toward using laparoscopic surgery for colon resection," says Augustyn. "We're finding that 80% or more of colon cancers can be done that way."

However, The Lancet study also found that for rectal cancer, laparoscopic surgery has not been shown to be as effective as open surgery.

Hoff points out another problem with the keyhole approach. "While we have evidence that laparoscopic colon surgery is safe and probably as good as open surgery, that's only true if the surgeon is experienced with the technique," he says. "Not all surgeons are."

Hoff also thinks that people can have inflated ideas about the benefits of keyhole surgery. "Laparoscopic surgery is still surgery," he tells WebMD. "You're still getting a piece of the colon removed and you'll still need recovery time. While the hospitalization may be a little shorter, it's not a big difference."
Treatment Before Surgery for Colorectal Cancer

Traditionally, chemotherapy and radiation have been used after surgery. This approach is called adjuvant therapy. The goal is to kill any cancer cells that might have survived the operation.

But doctors are also using an approach called neoadjuvant therapy -- treatment before surgery. The advantage is that the treatment can make the tumor smaller and easier to remove surgically.

"There's growing acceptance that using chemotherapy and radiation before surgery is more convenient and gives better results," Hoff says. "It's a trend that's gaining momentum around the world, but especially in the U.S."
Keeping Treatment Advances in Perspective

While these advances in treatment are cause for enthusiasm, none of them are the magic bullet that researchers hoped to discover.

Saltz points out that the average life expectancy for someone with metastatic colon cancer in 1995 was about 11 months. Now in 2006, using the best treatments, it's about two years.

"There are two ways to look at those numbers," says Saltz. "You could say that it's great that over the last decade, we doubled the life expectancy of someone with metastatic colon cancer. On the other hand, you could also say that over the last ten years, all we managed to do was add about twelve months. Both statements are true."

But experts agree that while the steps may be frustratingly small, we are still moving forward. They may not be flashy, but some of the most important advances may come in the details -- tinkering with different dosages, treatment regimens, and combinations of drugs. Hopefully, with time and research, all of these smaller steps may add up to something big.

SOURCES: American Cancer Society web site. American Gastroenterological Association web site. Damian Augustyn, MD, American Gastroenterological Association spokesperson; chief of gastroenterology, California Pacific Medical Center in San Francisco. Anthony Back, MD, affiliate member of the Fred Hutchinson Cancer Research Center, Clinical Research Division; associate professor, University of Washington. Cunningham, D., New England Journal of Medicine, July 22, 2004; vol 351: pp 337-345. Erlinger, T. The New England Journal of Medicine, June 3, 2004; vol. 350: pp 2335-2351, Andre et al. JAMA, 2004; vol 291: pp 585-590. Paulo M. Hoff, MD, associate professor, GI Medical Oncology, MD Andersen Cancer Center at the University of Texas; deputy chair, GI medical oncology. Hurwitz, H., New England Journal of Medicine, June 3, 2004; vol 350: pp 2335-2342. Guillou, P. The Lancet, May 14-20, 2005; vol 365: pp 1718-26. Levin, B., "Colorectal Cancer," ACP Medicine: Oncology V, January 2006. National Cancer Institute web site. Leonard Saltz, MD, attending physician and leader of the colorectal disease management team, Memorial Sloan Kettering Cancer Center. Schrag, D., New England Journal of Medicine, July 22, 2004; vol 351: pp 317-319. FDA web site.

How Do You Start Eating Healthy

Help Your Child Grow Up Healthy and Strong
Healthy Lifestyles: A Family Affair!

Give your children building blocks for a healthy lifestyle by teaching them the importance of good nutrition and regular physical activity. Eating well and being physically active every day are keys to your child's health and well-being. Eating too many high calorie foods and getting too little physical activity can lead to excessive weight gain and physical health problems, such as type 2 diabetes and high blood pressure, now being diagnosed in children. Obesity also is associated with an increased risk of other health problems such as depression.

You play an important role in helping your child, and the entire family, learn about healthy eating and regular physical activity. Parents have the power to set examples. Make healthy eating and daily physical activity fun, to help children learn good habits to last a lifetime. This brochure provides some tips on how you can promote healthy eating habits and encourage active lifestyles in your family.

Healthy Choices Start With You!
Help your children develop healthy eating habits at an early age. Nutritious food is something to enjoy. It helps children grow strong and gives them energy.


Set an example for active living by moving with your kids. Your kids pay attention to you, they really do!


Teach your children that good health depends on the right balance between what they eat and how much they move.
It's never too late! Small steps make a big difference.

Body Mass Index: A Useful Tool

Body Mass Index, or BMI, is used to assess overweight and risk for overweight. Children's body fatness changes over the years as they grow, and boys and girls differ as they mature, so it is important to use a BMI measure specifically designed for children. Many schools have begun routine BMI measurement for students as one tool to help identify those at risk of obesity. If you are concerned about your child's weight, ask your pediatrician or school clinic about the BMI for children. For more information on BMI for children, see www.cdc.gov/nccdphp/dnpa/bmi.

Keys to a Healthy Diet
The keys to healthy eating are variety, balance and moderation. Be sure your family eats a variety of foods, including plenty of vegetables, fruits and whole grain products. Also include low-fat and nonfat dairy products, lean meats, poultry, fish and legumes (lentils and beans). Drink water to quench your thirst, and go easy on the salt, sugar and saturated fat.

Good nutrition should be part of an overall healthy lifestyle that also includes regular physical activity. To maintain weight, both kids and adults must balance the calories they eat with the calories they burn through physical activity. If you eat more calories than you use up in physical activity, you gain weight. If you eat fewer calories than you use up, you lose weight. Make a commitment to helping your family eat sensibly and move more often.

Here are some tips for healthy eating to help you get started.

Try to keep track of your children's meal/snack and physical activity patterns so you can help them balance the amount and types of food they eat with the amount of physical activity they perform.


Encourage your family to eat at least 5 servings of brightly colored vegetables and fruits a day. You can start the day with 100% fruit or vegetable juice. Slice fruit on top of cereal. Serve salad with lunch and an apple as an afternoon snack. Include vegetables with dinner.


Leave the candy, soft drinks, chips and cookies at the store. Substitute them with fruits, vegetables, nuts, and low-fat or nonfat milk products. Your child will soon learn to make smart food choices outside your home as well.


Serve children child-sized portions, and let your child ask for more if still hungry. Don't force children to clean their plates. Try measuring food items to learn to estimate the amount of food on a plate.


Choose a variety of foods. No single food or food group supplies all the nutrients in the amounts that you need for good health. If you plan for pizza one night, balance your meal with salad, low-fat or nonfat milk and fruit.
Eat Smart!
Sharing meals is an ideal way for the family to spend time together. Whether you're eating at home or eating out on the go, it's important to eat smart.

Be consistent. Establish a family meal routine, and set times for breakfast, lunch, dinner and snacks. Eat together whenever possible.


Take charge of the foods your children eat. When you serve a meal, your child can choose to eat it or not; but don't offer to substitute an unhealthy alternative when your child refuses to eat what you've served.


Restrict children's access to the refrigerator and snack cupboards.


Turn off the TV during meals, and limit kids' snacking when watching TV.


Serve a vegetable or fruit with every meal and at snack time.


Reward your kids with praise and fun activities rather than with food.


Involve your children in meal planning and food preparation. They are more likely to eat what they help to make.


While shopping and cooking, teach your children about the food groups and the importance of a balanced diet. Throughout the day, choose the types and amounts of foods you need from the five food groups.


Teach your children how to read food labels and use the 5%-20% guide to Daily Values to make better food choices. See www.fns.usda.gov/tn/Resources/Nibbles/readit_session.pdf for more information.


Limit foods that are high in saturated fat, cholesterol, sodium, and added sugars, and make sure to get enough fiber and calcium.


Use low-fat cooking methods such as baking, roasting and grilling, and choose healthy fats when you use them, such as olive or canola oils.


Serve water, low-fat or nonfat milk with and between meals. Only children under two years always need to drink whole milk.


Teach your children how to make wise food choices away from home, at school cafeterias, restaurants, and vending machines. Teach them to pay attention to both the quality and quantity of their food choices. More food is not always better for them; appropriate portion sizes need to be understood.
Get Moving!
Physical activity is good for children and adults. It strengthens muscles, bones and joints, and it gives children the opportunity to gain confidence while having fun. Children need at least 60 minutes of physical activity every day. Playing hopscotch, tossing a ball back and forth, and dancing are some good ways for your child to be active. Some children are good athletes, but all need many opportunities to be active, including but not limited to sports.

Be a physically active role model and have fun with your kids. Adults need at least 30 minutes of daily physical activity.


Walk with your child at every available opportunity — if possible to school or to the store on errands. Take a family walk after dinner instead of watching TV or playing computer games.


Plan active weekends. Include biking, hiking, skating, walking or playing ball. Take a trip to the park, skating rink, zoo, or swimming pool.


Offer to join your child in his/her favorite physical activity, or enroll your child in a group exercise program.


Include children in active chores such as dog walking, house cleaning, car washing, and yard work.


Limit inactive behavior such as television watching and computer time. Do physical activity with your kids during commercials, such as marching in place or stretching. This helps reinforce the importance of movement in your child's life.


Avoid using TV as a child sitter or pacifier. Offer active alternatives to screen time — jumping rope, playing hide-and-seek or running an errand. Children love when you are active with them and involve them in what you do.


Keep TV's out of children's rooms.


Give your children gifts that encourage physical activity — active games, sporting equipment, or a Frisbee.


Take the President's Challenge as a family. You can track your individual physical activities together and earn awards for active lifestyles at www.presidentschallenge.org.


Talk with your schools about ways to incorporate noncompetitive physical activity during the day.
Money-Saving Ideas for Better Health
Good nutrition doesn't have to mean expensive grocery bills!

Plan ahead. Make a list of meal ideas for the coming week. Keep in mind the days you'll have time to cook from scratch and the days you'll be pressed for time. Then make a grocery list and stick to it.


Buy in-season fruits and vegetables. Use local farmers' markets when possible — the foods are fresher and tend to cost less.


Purchase canned (in water or in their own juice, not heavy syrup) and frozen fruits and vegetables when fresh ones are not available or affordable. They're healthy, too, and will last longer.


Never shop for food when you're hungry.


Review store ads and clip coupons before shopping.


Sign up for your grocer's bonus/discount card for additional savings.


Stock up on sale items you can use in a timely manner. Buy in bulk for quality and value, but serve healthy portions.


Look for items on the top and bottom shelves at the grocery store. The most costly brands are often placed at eye-level. Store brands that may be cheaper and just as good are often placed higher or lower.


Assemble snacks at home in small baggies and use foods such as nuts and seeds, low-fat cheese and fresh veggies and fruits, rather than buying less healthy and more expensive prepackaged and processed snacks.


Use your food budget wisely. For the price of a large bag of chips and a box of cookies, you can buy a lot of apples, bananas, carrots, potatoes, peppers and other healthy foods.
A Healthy Week-at-a-Glance
An easy and fun way to keep your family active and eating right is to create a weekly calendar of healthy lifestyle activities. Use some of the ideas below to get yourself started on building a healthy life that works for your family and your schedule.

Monday
Start a daily log of what your family eats and how they keep active; review it with them at the end of each week.

Tuesday
Go to your local community center and find out what physical activity or sports programs are available.

Wednesday
Make frozen juice pops instead of buying popsicles . They're healthier and cheaper!

Thursday
Encourage your family to use safe and accessible stairs as an active alternative to elevators and escalators.

Friday
Involve your kids in cooking and take a walk after dinner.

Saturday
Take your children food shopping and let them pick out a new fruit or vegetable to try.

Sunday
Review the coming week's school lunch menu with your kids, and talk about making healthy meal choices.

Purple Tomatoes May Help Prevent Cancer

Purple Tomatoes May Help Prevent Cancer
Researchers Test New Breed of Tomatoes Loaded With Antioxidants
By Caroline Wilbert

Health NewsReviewed by Louise Chang, MDOct. 27, 2008 -- A new breed of tomatoes that are specially engineered to have extra antioxidants may help prevent cancer, according to a new study.

Scientists in Europe transferred certain genes of snapdragons to tomatoes, creating a tomato with a dark purple color and loads of antioxidants. Researchers tested the tomatoes on cancer-prone mice; they found that a diet supplemented by purple tomato powder increased the life span of the mice compared to mice eating a standard diet or a diet supplemented with red tomato powder.

The study, by Eugenio Butelli of the John Innes Centre in England and colleagues from Germany, Italy, and the Netherlands, was published in Nature Biotechnology.

For the test, there were three groups of mutant mice, all prone to cancer. These mice typically get tumors and die young.

The first group ate a standard diet. The second group ate a powder taken from freeze-dried regular, red tomatoes. The third group ate powder from freeze-dried dark purple tomatoes.

The dark purple tomato group lived an average of 182 days, compared to 142 for the standard diet group and 146 days for the red tomato group. The maximum life span of mice who ate the standard diet was 211 days; the maximum life span of mice with the diet supplemented with purple tomato was 260 days.

The engineered tomatoes were richer in anthocyanins, which are pigments produced by plants. They are common in grapes, blackberries, blueberries, and other fruits. Research has suggested that anthocyanins are potent antioxidants and may provide a variety of health benefits, from promoting a healthy heart to fighting cancer.

"These figures argue strongly for the development of strategies to increase the levels of health promoting bioactive compounds such as anthocycanins in the fruits and vegetables people consume in substantial amounts," the researchers write.

Natural Relief for Seasonal Allergies

Natural Relief for Seasonal Allergies
by J.William LaValley

Every year with the arrival of spring, I see many patients with bothersome seasonal airborne allergies. The usual symptoms are irritation and redness to the eyes, nose, sinuses, and throat. Many of these people also suffer from respiratory wheezing and mild to moderate allergic asthma symptoms.

From years of experience, I have found that blending the best of conventional and natural medicine seems to be the safest, most effective treatment for relieving these symptoms in most people. If you are plagued by seasonal airborne allergies, the following Medical Wellness ProtocolTM that I prescribe for my patients may provide much-needed relief for you as well.

Eating Guidelines

Keep a dietary journal of what foods you eat over a 2-3 week period. It should be set up like this: Each page has a line drawn down the middle. On the left side of the page record in chronological order all the different foods you have eaten during the day. Breakfast is at the top of the page, lunch in the middle, and the evening meal is at the bottom. On the right half of the same page, keep a daily record of how you feel throughout the day and overnight. At the end of the 3-week period, tally how often each food was eaten. For example: dairy products 28 times, cereal 18 times, apples 14 times, broccoli 4 times, etc.

During the allergy season reduce or eliminate the top two or three most commonly eaten foods. This is particularly helpful if the most commonly eaten foods contain dairy products, grains, or soy products.

Recent findings suggest that certain foods are can cause cross-reactions with pollen allergies in allergy-prone people. By changing your diet to reduce or eliminate the most common food in your diet, you can hopefully reduce the likelihood of the most common cross-reactions. The goal is to reduce your “allergen-load” during “allergy season”.1

Conventional Medications

For short duration allergy symptoms, a non-drowsy antihistamine is a safe choice for most people. One of my favorites is loratidine (Claritin) because it is quite safe, generic (therefore low cost), and works to lower histamine without provoking drowsiness.2

Since it has a high safety profile, you can take it twice a day with slightly better results and nearly no increase in side effects. While it may not be quite as effective as desloratidine (Clarinex), it is cheaper and works well. For some people, the short-term use of a nasal steroid inhaler like Flonase can also be very effective with few adverse or risky side effects.

Natural Supplements

Your immune system has a variety of T cells — some of which produce inflammatory chemicals called cytokines. While T cells are necessary to fight infection and disease, in some people with allergic reactions, their T cells go into overdrive. For seasonal allergies, especially allergic rhinitis (runny nose), the inflammation caused by cytokines can be reduced by taking a natural product called beta-glucan.3

A specific water-insoluble form of this supplement (made from the cell walls of baker’s yeast) supports the immune system while reducing the effects of allergic inflammation. I recommend the particular form of beta-glucan distributed by Transfer Point because of this superior quality.

Homeopathic Medication

A virtually risk-free therapeutic choice is the use of homeopathic medications prepared from common plant airborne allergens from trees, flowers, and grasses in your region of the country. Often these are available from local health food stores in liquid dropper bottles.

These dilute preparations (taken under the tongue) have been shown to reduce allergic symptoms without any adverse effects.4 I recommend locally derived homeopathic preparations of grass, flower and tree pollens (depending on the allergy season) to reduce symptoms.

Outdoor Activity

I recommend that patients think about the timing of their outdoor activities to limit exposure to the allergens that bother them. If you have tree, grass and pollen allergies, watch the weather forecasts to learn the patterns of allergen release in your local community.

Cool, dry windy days will often have a different allergen profile than wet, muggy days. The air may likely have more or less pollen right after a soaking rain depending where you live. Likewise, rainy or damp days are likely to have increased mold spores released in the air.5

Become an expert in your local weather-related allergen pattern and modify your outdoor activity accordingly.

Special Products and Procedures

Indoor air filters can be very helpful to reduce allergen exposure.6 You can also eliminate or reduce sources of unnecessary indoor air pollution including strong detergents with heavy scents, scented cleaning products, and scented so-called “air-fresheners” (that are in fact, airborne inhalant chemicals). These all play a role in contributing to allergies in today’s modern communities.7-8 I also encourage you to use natural and scent-free soaps, shampoos and cosmetics.

Unfortunately, your pet may be a significant additional cause for worsening seasonal allergies. Allergens can come directly from your pets (cat and dogs especially) and they may also bring allergens from the outdoors back into the house. There are non-toxic low-allergen pet shampoos that can reduce the allergen exposure caused by your pets.9

By following this Medical Wellness ProtocolTMfor Seasonal Allergies you should feel significant relief that is safe, beneficial, low cost, and easy to implement.

References

Ronchetti R, et al. Adv Med Sci. 2007;52:98-103.
Kakutani C, et al. Arerugi. 2006 May;55(5):554-65.
Kirmaz C, et al. Eur Cytokine Netw. 2005 Jun;16(2):128-34.
Kim LS, et al. Ann Pharmacother. 2005 Apr;39(4):617-24.
Schappi GF, et al. Clin Exp Allergy. 1999 May;29(5):633-41.
Hacker DW, et al. Indoor Air. 2005 Dec;15(6):420-31.
Mosges R, et al. Allergy. 2007 Sep;62(9):969-75.
Singer BC, et al. Indoor Air. 2006 Jun;16(3):179-91.
Avner DB, et al. J Allergy Clin Immunol. 1997 Sep;100(3):307-12.

Bison Steak with Horseradish Sauce

Bison Steak with Horseradish Sauce
By Laura LaValle, RD, LD

There is nothing like a delicious red meat with horseradish sauce for a pleasing taste combination. Try this old favorite using the new and popular red meat alternative, bison. As an alternative to conventionally raised beef, bison is lower in fat and cholesterol and even though grass-fed, it is not wild tasting, but has a very pleasing rich flavor.

Serves: 4
(A serving equals one bison steak plus one tablespoon horseradish sauce.)

Healing Nutrient Spotlight
Excellent source of iron, zinc, selenium
Good source of riboflavin, niacin, magnesium

Ingredients*
4 6- to 7-oz. bison filets
1 T. grapeseed oil
Grilling seasoning -- choose any favorite
Horseradish Sauce
1/2 c organic mayonnaise
1/4 c fresh parsley, chopped
1 T. prepared white horseradish

*Select organic ingredients for optimum nutrition.

Preparation
Bison meat is very lean. For leaner meats like this you'll get better results cooking at lower temperatures and cooking a little longer. Mix the oil and grilling seasoning together and rub into filets. If you have time, it is good to let the meat marinate in the oil and seasonings for 30 minutes or so. Sear the filets first, then lower the heat and cook to desired doneness.

To prepare the horseradish sauce, in a small bowl stir together mayonnaise, parsley, and horseradish. Season with your favorite salt and pepper, if desired.

Nutrition
360 calories, 20 g total fat, 3 g saturated fat, 2 g monounsaturated fat, 3 g polyunsaturated fat, 130 mg cholesterol, 0 g carbohydrate, 45 g protein, 100 IU vitamin A, 4 mg niacin, .2 mg riboflavin, 4 mcg folate, 5 mg iron, 700 mg potassium, 180 mg sodium, 50 mg magnesium, 54 mcg selenium, 6 mg zinc, .2 mg copper

What Can You Do To Fight Fatigue

Multiple Sclerosis: MS-Related Fatigue

Medically speaking, fatigue is not the same thing as tiredness. Tiredness happens to everyone -- it is an expected feeling after certain activities or at the end of the day. Usually you know why you are tired and a good night's sleep solves the problem.

Fatigue is a daily lack of energy; unusual or excessive whole-body tiredness not relieved by sleep. It can be acute (lasting a month or less) or chronic (lasting from one to six months or longer). Fatigue can prevent a person from functioning normally and affects a person's quality of life.

According to the National Multiple Sclerosis Society, 80% of people with MS have fatigue. MS-related fatigue tends to get worse as the day goes on, is often aggravated by heat and humidity, and comes on more easily and suddenly than normal fatigue.

What Can I Do to Combat Fatigue?
The best way to combat fatigue is to treat the underlying medical cause. Unfortunately, the exact cause of MS-related fatigue is often unknown, or there may be multiple causes. However, there are steps you can take that may help to control fatigue. Here are some tips:

1. Assess your personal situation.
Evaluate your level of energy. Think of your personal energy stores as a "bank." Deposits and withdrawals have to be made over the course of the day or the week to balance energy conservation, restoration, and expenditure. Keep a diary for one week to identify the time of day when you are either most fatigued or have the most energy. Note what you think may be contributing factors.
Be alert to your personal warning signs of fatigue. Fatigue warning signs may include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety, or impatience.

2. Conserve your energy.
Plan ahead and organize your work. For example, change storage of items to reduce trips or reaching, delegate tasks when needed, and combine activities and simplify details.
Schedule rest. For example, balance periods of rest and work and rest before you become fatigued. Frequent, short rests are beneficial.
Pace yourself. A moderate pace is better than rushing through activities. Reduce sudden or prolonged strains. Alternate sitting and standing.
Practice proper body mechanics. When sitting, use a chair with good back support. Sit up with your back straight and your shoulders back. Adjust the level of your work. Work without bending over. When bending to lift something, bend your knees and use your leg muscles to lift, not your back. Do not bend forward at the waist with your knees straight. Also, try carrying several small loads instead of one large one, or use a cart.
Limit work that requires reaching over your head. For example, use long-handled tools, store items lower, and delegate activities whenever possible.
Limit work that increases muscle tension.
Identify environmental situations that cause fatigue. For example, avoid extremes of temperature, eliminate smoke or harmful fumes, and avoid long hot showers or baths.
Prioritize your activities. Decide what activities are important to you, and what could be delegated. Use your energy on important tasks.

3. Eat Right
Fatigue is often made worse if you are not eating enough or if you are not eating the right foods. Maintaining good nutrition can help you feel better and have more energy.

4. Exercise
Decreased physical activity, which may be the result of illness or of treatment, can lead to tiredness and lack of energy. Scientists have found that even healthy athletes forced to spend extended periods in bed or sitting in chairs develop feelings of anxiety, depression, weakness, fatigue, and nausea. Regular, moderate exercise can decrease these feelings, help you stay active, and increase your energy.

5. Learn to manage stress
Managing stress can play an important role in combating fatigue. Here are tips to help keep stress in check:

Adjust your expectations. For example, if you have a list of 10 things you want to accomplish today, pare it down to two and leave the rest for other days. A sense of accomplishment goes a long way to reducing stress.
Help others understand and support you. Family and friends can be helpful if they can "put themselves in your shoes" and understand what fatigue means to you. Support groups can be a source of comfort as well. Other people with MS understand what you are going through.
Relaxation techniques. Audiotapes that teach deep breathing or visualization can help reduce stress.
Participate in activities that divert your attention away from fatigue. For example, activities such as knitting, reading, or listening to music require little physical energy but require attention.

If your stress seems out of control, talk to your doctor. They are there to help.

When Should I Tell My Doctor About My Fatigue?
Although fatigue is a common and often expected symptom of MS, you should feel free to mention your concerns to your doctors. There are times when fatigue may be a clue to some other underlying medical problem. Other times, there may be medical interventions that can prevent fatigue.

What's Causing Those Freaky Dreams?

Freaky Dreams: What Do They Mean?
Whether it’s falling off a cliff or public nudity, find out what may be causing those vivid, crazy dreams.
By Suzanne Wright
FeatureReviewed by Matthew Hoffman, MD

Consider this freaky dream. You're at a black-tie gala in a fancy hotel banquet room with lots of other people. You're all having a good time eating dinner, dancing, and talking. When it's time to go, you look for your purse, but it's gone. As you anxiously search for it, a fast-moving river appears out of nowhere, bisecting the room. Your purse is floating on the river, but you can't reach it. It is moving too swiftly. When you awaken, you're filled with a sense of panic.

Now if you plugged the dream into an online dream analyzer, such as you might find at Freakydreams.com, you'd learn that a purse is a symbol for wealth and resources, a hotel represents transition, and a river connotes emotion. Since you have been living through a kitchen remodeling -- with its attendant financial stresses and upheavals -- this dream echoes and amplifies what's going on in your waking life.

What Are Dreams?
Human beings dream, and so do, scientists believe, most mammals and some birds. On the most basic level, a dream is the experience you have of envisioned images, sounds, or other sensations while you sleep. They are an internal mental process. But dreams are actually much more than that.

Sigmund Freud's theory was that your dreams are an expression of what you're repressing during the time you are awake. And Carl Jung believed that dreams provide messages about "lost" or "neglected" parts of our selves that need to be reintegrated. Many dreams simply come from a preoccupation with the day's activities. But some offer rich, symbolic expressions -- an interface between the conscious and the unconscious that can fill in the gaps of our self-knowledge and provide information and insight.

In his book The Three "Only" Things: Tapping the Power of Dreams, Coincidence, and Imagination, Robert Moss writes, "Dreams are open vistas of possibility that take us beyond our everyday self-limiting beliefs and behaviors. Before we dismiss our dream lover, our dream home or our dream job as unattainable -- 'only a dream' -- we want to examine carefully whether there are clues in the dream that could help us to manifest that juicy vision."

Why Do We Dream?
Everyone dreams every night -- even if we don't remember our dreams.

Tom Scammell, MD, associate professor of neurology at Harvard Medical School and Beth Israel Deaconess Medical Center, says no one knows why we dream. "There is a strong movement in the research community to research how sleep improves memory and learning," Scammell says. "One speculative possibility is that dreaming allows you the opportunity to practice things you may or may not ever have to do, like running away or fighting off a predator."

Three or four times a night, you have a period of sleep that lasts approximately 90 minutes called REM -- rapid eye movement -- sleep. It is during REM sleep that your brain is more active. And according to Scammell, it's then that conditions are right for "story-like" dreams that are rich in action, complexity, and emotion.

"You are most likely to recall dreams if you wake at the end of a REM episode," says Scammell. "Americans, who are chronically sleep-deprived, probably miss out on some REM sleep. This builds up pressure for REM sleep. So when you're catching up on your sleep, you may have more REM sleep with more intense dreams."

The Value of Dreams
Scientists have long debated whether dreams have meaning. But those who work with their dreams, either independently or with the aid of dream interpreters, believe that understanding dreams can provide meaningful clues to feelings, thoughts, behaviors, motives, and values.

Artists, entrepreneurs, inventors, and scientists often get creative ideas from dreams. Jeff Taylor dreamed up monster.com. Jack Nicklaus had a dream of a new golf grip. And Nobel laureate and scientist Wolfgang Pauli called dreams his "secret laboratory."

Kelly Sullivan Walden is a certified clinical hypnotherapist and dream coach. In her book I Had the Strangest Dream...: The Dreamer's Dictionary for the 21st Century, she divides dreams into eight categories:

Processing
Venting (nightmares)
Integration
Breakdown/breakthrough
Recurring
Precognitive
Prophetic
Wish fulfillment
The most common, she says, are recurring and venting dreams.

Moss gives an example of a predictive dream: "One of the biggest oil discoveries in history ... resulted from a dream of a retired British colonial official living in Kuwait in 1937. Colonel Dickson's dream revealed a specific location near an unusual sidr tree in the Burqan hills. The Kuwait Oil Company, which had been drilling dry holes far away, was persuaded to move a rig to the location identified from the dream and hit a gusher."

Processing dreams can be used to diagnose and solve physical and emotional problems.

"Some of our dreamscapes are living dioramas of what is going on inside our bodies," explains Moss. "The ancient Greek physician Galen used dreams to diagnose patients' complaints. A friend of mine was alerted to a problem when her dead father appeared to her in a dream, accompanied by a doctor and yelled 'Get to a doctor at once! You have breast cancer!' She acted on that dream and believes that it helped save her life."

Eva Van Brunt is the West Coast media manager at the law firm DLA Piper. She thinks pregnancy is contributing to the intensity and vividness of her dreams. "It's been remarkable -- and a little annoying. Last night I dreamt I was in the security line at an airport and couldn't find my license. I woke up in an utter panic, and it took a few moments to realize the dream was not real."

But she's also found her vivid dreams helpful.

"A few days ago, I couldn't find my camera anywhere in my house. I grew quite anxious and ended up looking for it until bedtime without success. Eventually I got to sleep. Next thing I know, I am having a very vivid dream." The dream, she says, was about a concert she and her husband were at a month earlier. She was walking up to the gate and saw a no cameras sign and found herself getting flustered because she had one in her purse. Her husband suggested she put the camera in an inside zipper pocket of her purse because it likely wouldn't get searched. "In the dream, that's what I did. And it's also what I had done on the night of the concert." The next morning, she found the camera in the inner pocket of her purse. "The only thing I can think," she says, "is that my body triggered the memory to alleviate the anxiety."

Worrying About Weird Dreams
What are we to make of the crazy dreams of adults?

Cognitive scientist and Duke University professor Owen Flanagan is the author of Sleep, Dreams & the Evolution of the Conscious Mind. He has written that "Bizarreness will increase ... the more you have on your mind."

Bert. O. States, professor emeritus of dramatic arts at the University of California, Santa Barbara, agrees. In a paper called "Dream Bizarreness and Inner Thought," he writes, "Dreams are a psychical prism through which reality somehow gets refracted -- as opposed to reflected."

Deidre Barrett is the immediate past president of the International Association of the Study of Dreams and author of Committee of Sleep. She says all dreams are a little strange by waking thought standards. "But artists and scientists report dreams we call bizarre or weird as quite positive or interesting or having creative potential."

Moss tells WebMD, "Crazy dreams may actually be crazy like a fox, using wild dramas and special effects to get us to remember and pay attention to something we have been blocking out -- or simply to lighten up."

Decoding Dreams
All of us can recall strange dreams. But interpreting and understanding them can be tricky.

Some of the most common dreams include teeth falling out (indicating a possible fear of aging or death), falling (loss of confidence or threat to security), or public nudity (feelings of vulnerability or exposure of weakness). These are examples of archetypal dreams that exist across time, culture, and people.

But most dreams are intensely personal. They reflect the underlying thoughts and feelings of the dreamer. Symbols -- images or objects with obvious meaning in daily life -- serve as metaphors, representing something partially known. A lion in a dream, for example, can mean something different to a circus performer than to a teen who claims it as her favorite stuffed animal. By examining each dream element and looking for parallels between associations, you can decipher a dream's meaning.

"Even if it doesn't initially make sense to you, contemplate the dream, meditate on it, marinate in it," suggests Sullivan Walden. "Pretend you are on a treasure hunt. Your interest in uncovering the mystery of what your dreams are telling you will lead you to the gold that is waiting for you."

Barrett says that you can explore dreams on your own, with a peer-led dream group, or with friends. "We are often blind to our own issues and associations. But someone else can see things objectively."

Moss recommends you play the 'What Part of Me' game -- pretending that everything in the dream is a part of you and notice what its condition or behavior may be saying to you about yourself. "In your dream house, for example, if there's a problem with the plumbing or a room you have never explored, what could that be saying about a part of you that needs some TLC or a part of your potential that is waiting to be recognized and opened up."

Another technique he offers is to listen for puns and double entendres. "If there's a train on the tracks in your dream, could it be prompting you to think about what 'track' you are on, what 'line' you are following? Say your dream features shoes. A shoe has a 'sole,' which sounds like 'soul,' so maybe the condition of your footwear in a dream says something about the state of your vital energy."

Recurring Dreams
Recurring dreams can continue for days, weeks, months, and even years.

Barrett says the majority of people over a lifetime have recurring dreams. "They are more important, on average, than other dreams. They are probably your unconscious trying to tell you something, a more significant issue."

She says there are two key clusters of recurring dreams. Most of them are nightmares, though some are positive or neutral in nature.

"The single likeliest [dreams] to get locked in are posttraumatic dreams, where you are reliving something that happened while you were awake," she says. Soldiers or victims of violence may experience such recurring dreams. "The details unfold like they do in real life but often go one step further. The thing you are most afraid of in real life presents in the dream."

The other type of recurring dream is one where you haven't experienced the trauma in your waking life. "These dreams include monsters and surreal, impossible settings," she says. "They are much more metaphoric. Sometimes symbolism is obvious, sometimes it's quite a puzzle."

Should we be concerned about recurring themes? Barrett says only if the content is troubling. In the case of disturbing posttraumatic stress dreams, she recommends seeking help from a therapist. "They will diminish over time."

Improving Dream Memory
Some people can remember several dreams a night. Others recall dreams only occasionally or not at all.

"People differ greatly in dream content, both the intensity and recall," says Scammell. Interestingly, according to Barrett, women and younger people report greater dream recall, as do those who sleep for longer periods of time.

Dreams are by their nature, uncontrollable. But there are things you can do to increase your dream retention:

Get enough sleep. Those who sleep for longer periods of time enjoy more REM sleep, resulting in more dreams and possibly greater memory of them.
Employ the power of suggestion. Experts recommend that before you go to sleep, remind yourself that you want to remember your dreams.
Keep a journal. Have a pen and paper or a recorder at your bedside so you can log your dreams when you awaken before hopping out of bed. If not immediately recorded, dreams become elusive and difficult to retrieve.
Get curious. When you first wake up, lie still, stay quiet, and see if you can recall a dream. It may flood over you. Mull it over. Having an open mind, reading about dreams, and discussing them actively with friends and family may encourage future dreaming.
Limit drug and alcohol intake. Sleep and, by extension, dreams are affected by alcohol. And medications, including antidepressants, can induce crazy dreams or even nightmares. Talk to your doctor about the effects of drugs on your dreams.

Let's make Healthy Muffins!

Make Me Some Muffins!
Try these recipes for an easy, versatile treat that Mom (and everyone else) will love.

What can you make in one bowl, with using any electrical device or sharp cutlery? Muffins! What can be whipped up in less than 10 minutes and ready to serve 20 minutes after that? Muffins! What never gets boring because there are so many possible flavors and combinations to behold? Muffins!

Muffins are one of the most versatile breads in America, and the simple fact is, people love them. What's not to like? If you don't like banana, choose another type of muffin. If you want fiber, use whole wheat, oats, or bran in your muffins. If you don't have blueberries, stir in raspberries or any other chopped fruit. If you don't want nuts, leave them out.

Muffins are members of the "quick bread" family because they use baking powder or baking soda to add air bubbles (instead of yeast) and, well, because they're quick to make. Anyone can make muffins; they don't require candy thermometers, double boilers, or sifters.

All that means they're perfect for little ones wanting to make mom breakfast in bed (say, on Mother's Day) with a dad or a grandparent supervising. To personalize the muffins, add her favorite fruit and nuts. If mom likes coffee, try the Mocha Chip Muffins below. If she goes bananas for bananas, make the Banana Coconut Macadamia Muffins. If her favorite cookie is oatmeal-raisin, try the Oatmeal Raisin Cookie Muffins.

Muffins fit perfectly into an on-the-go lifestyle, too. Make a batch of muffins over the weekend; pop them into the freezer in a zip-lock bag, and you're a microwave minute away from breakfast or a snack.

Of course, I can't talk about any food without mentioning ways to make it healthy. Here again, muffins score big with potential. Because you're creating air bubbles with baking powder, instead of by whipping the fatty ingredient with sugar (as you do with a cookie or pound cake), you can add the fatty ingredient in liquid form. That means you can use canola oil instead of margarine or butter. Right away, this makes your muffin lower in saturated fat and higher in two "smart" fats: monounsaturated fat and plant omega-3s.

Here are some other tips for making healthful muffins:

Use a "smart" fat when possible (like canola oil or Take Control margarine)
Use a minimum of fat - say, 2 to 3 tablespoons of oil or 4 tablespoons of less-fat margarine -- per 12-muffin recipe.
Reduce the sugar, or substitute Splenda sweetener for a third or a half of the sugar.
Substitute whole-wheat flour for half the white flour
Use higher omega-3 eggs. If the recipe calls for two eggs, you may use one egg and 2 egg whites, or one egg and 1/4 cup egg substitute.
Add nutrient-rich ingredients, like bananas, shredded carrots, nuts, fruit, ground flaxseed, etc.

And now for those recipes …

Lemon-Blueberry Corn Muffins

Journal as: 1 small muffin

Bake the batter in a nonstick mini angel food pan (or similar) for a pretty presentation. This is a great way to work some fruit, whole grains, and plant omega-3 fatty acids (from canola oil) into your morning.

1/2 cup unbleached white flour
1/2 cup whole-wheat flour
1 cup yellow cornmeal (finely ground works best)
1/3 cup granulated sugar
1/3 cup Splenda (or other sugar alternative for baking)
1 tablespoons baking powder
1/2 teaspoon salt
Zest from 1 lemon, finely chopped (about 1 1/2 teaspoon)
1/4 cup canola oil
4 tablespoons lemon juice
1/4 cup fat-free sour cream
3/4 cup fat-free half-and-half or low-fat milk
1 large egg
1/4 cup egg substitute
2 cups frozen or fresh blueberries


Preheat oven to 400 degrees. Line 15 muffin cups with paper or foil liners.
Whisk together the flours, cornmeal, sugar, Splenda, baking powder, salt and lemon zest in a large bowl.
Add canola oil, fat-free half-and-half, egg and egg substitute to a large mixing bowl and beat on medium until well blended. Gradually add flour mixture to the batter in the mixing bowl, while beating on low speed, until just combined.
Gently stir in blueberries and spoon batter into prepared muffin cups using a 1/4-cup-measuring cup. Bake until a tester inserted in center of largest muffin comes out clean (about 18 minutes).
Yield: around 15 muffins

Per muffin: 145 calories, 4 g protein, 23 g carbohydrates, 4.4 g fat, .4 g saturated fat, 15 mg cholesterol, 2 g fiber, 198 mg sodium. Calories from fat: 27%.

Oatmeal Raisin Cookie Muffins
Journal as: 1 small muffin

1 cup old-fashioned rolled oats
1 cup low-fat buttermilk
1 large egg (higher omega-3 if available), beaten lightly
1/4 cup dark brown sugar, packed
1/4 cup lite pancake syrup
1 teaspoon vanilla extract
1/4 cup canola oil
1/2 cup whole-wheat flour
1/2 cup unbleached white flour
1/2 teaspoon salt
1 teaspoon baking powder
1 teaspoon ground cinnamon
1/2 teaspoon baking soda
2/3 cup raisins


Add oats and buttermilk to large mixing bowl. Let stand for 1 hour.
Preheat oven to 400 degrees. Line 12 muffin cups with paper or foil liners.
Add egg, brown sugar, syrup, vanilla, and canola oil to oat mixture in mixing bowl. Stir until just combined.
In another large bowl, whisk together flours, salt, baking powder, cinnamon, and baking soda. Stir into oat mixture until just combined. Fold in raisins.
Spoon batter into prepared muffin cups using a 1/4-cup measuring cup and bake until golden (about 20 minutes).
Yield: 12 muffins

Per muffin: 165 calories, 4 g protein, 26 g carbohydrate, 6 g fat, .6 g saturated fat, 18 mg cholesterol, 2 g fiber, 229 mg sodium. Calories from fat: 30%.


Banana Coconut-Macadamia Muffins

Journal as: 1 small muffin

3/4 cup whole-wheat flour
3/4 cup unbleached white flour
1 1/2 teaspoons baking soda
1/4 teaspoon salt
1/8 teaspoon ground nutmeg
1 1/4 cups mashed ripe bananas (about 3 large)
1/3 cup Splenda (or other sugar alternative for baking)
1/3 cup dark brown sugar, packed
3 tablespoons cup canola oil
1/2 cup + 1 tablespoon low-fat milk or fat-free half-and-half
1 large egg (higher omega-3 if available)
1/2 cup coarsely chopped roasted or toasted macadamia nuts
1/2 cup flaked or shredded coconut


Preheat oven to 350 degrees. Line 12 muffin cups with paper or foil liners.
Whisk whole wheat and white flours, baking soda, salt, and nutmeg together in a large mixing bowl; set aside.
Add bananas, Splenda and brown sugar, canola oil, milk, and egg to another large mixing bowl and beat or stir until completely blended. Pour banana mixture into the dry ingredients in mixing bowl and stir until just combined.
Fold in macadamia nuts and coconut. Fill each muffin cup using a 1/4-cup measuring cup. Bake until muffins are golden brown and tester inserted in center comes out clean (about 25 minutes).
Yield: 12 muffins

Per muffin: 194 calories, 4 g protein, 26 g carbohydrate, 9 g fat, 2 g saturated fat, 18 mg cholesterol, 2.2 g fiber, 222 mg sodium. Calories from fat: 42%.

Mocha Chip Muffins (with pecans)
Journal as: 1 small muffin

1/4 cup hot water
4 tablespoons instant decaf coffee (or 1 tablespoon instant espresso powder)
1/2 cup low-fat buttermilk
3 tablespoons canola oil
1/3 cup fat-free sour cream
1 large egg (higher omega-3 type, if available)
1/4 cup egg substitute
1 teaspoon vanilla extract
1 cup unbleached white flour
3/4 cup whole-wheat flour
1/2 cup Splenda (or other sugar alternative for baking)
1/2 cup dark brown sugar, packed
3 tablespoons unsweetened cocoa powder
1 teaspoon baking powder
1 teaspoon baking soda
1 teaspoon salt
1/2 cup milk or semisweet chocolate chips or chunks
1/2 cup coarsely chopped pecans or pecan pieces, toasted (about 3 ounces)


Preheat oven to 375 degrees. Line muffin pan with paper liners.
Stir hot water and instant coffee together in a large mixing bowl. Add buttermilk, canola oil, fat-free sour cream, egg and egg substitute, and vanilla. Whisk until well blended.
Add flours, Splenda, brown sugar, cocoa, baking powder, baking soda, and salt to another large bowl and whisk to blend well. Stir in the buttermilk mixture, stirring only until just combined. Mix in chocolate chips and pecans.
Spoon the batter into the prepared muffin cups using a 1/4-cup measuring cup. Bake until tester comes out clean (about 25 minutes).
Yield: 12 muffins

Per muffin: 206 calories, 5 g protein, 27 g carbohydrate, 9 g fat, 2 g saturated fat, 18 mg cholesterol, 2.5 g fiber, 355 mg sodium. Calories from fat: 38%.

How Diabetes Can Affect A Woman Sexual Health

Women, Sex, and Diabetes
Men aren't the only ones who experience sexual problems as a result of diabetes.
By Colette Bouchez

FeatureReviewed by Louise Chang, MD

When most people hear the words “diabetes and sexual dysfunction," they automatically think it's the man's problem. But women with diabetes can also experience sexual problems related to their blood sugar levels.

For diabetes educator Ann Albright, PhD, RD, that’s not only a medical fact, it’s a fact of life.

Living with type 1 diabetes for 41 years, Albright says that when glucose isn’t under good control, a woman’s sex life can suffer.

“It’s not diabetes per se that harms your intimate life. It’s the complications of uncontrolled blood sugar levels that cause problems for both men and women -- the only difference is that many women simply aren’t as aware of this complication as men are,” she tells WebMD. Albright also is the president of health education for the American Diabetes Association.

Albright says women are getting better at coming forward with intimacy issues, but when it comes to diabetes, most are still reluctant to talk to their doctor.

Endocrinologist Loren Wissner Greene agrees. “Women aren’t talking to their doctors about it, doctors aren’t talking to women about it, and so for many it remains a silent problem that goes undiagnosed and untreated.” Greene is a clinical associate professor at NYU Langone Medical Center in New York City.

When Glucose and Intimacy Collide
Although women with diabetes may be slow to admit there is a problem between the sheets, the medical community has been even slower to study the issue. It wasn’t until 1971 that a groundbreaking study was published on this subject in the journal Diabetes.

In the study, 35% of women with diabetes reported being unable to have an orgasm during intercourse, compared to just 6% of the women who didn't have diabetes.

Albright says one reason women with diabetes may have trouble achieving orgasm is that high blood sugars can affect vaginal lubrication.

“The lubrication issues not only can impact sensation, they also can make sex very uncomfortable, even painful,” she says.

In a 1986 study now considered a cornerstone of research on the topic, nearly half the women in the study had a sexual problem. Of these, 32% of women reported experiencing problems with lubrication. Eighty-nine percent said the problems started after their diabetes diagnosis.

Albright says there are many health benefits of good blood sugar control, but many women don’t realize that better lubrication, and, ultimately, a better sex life may be among them.

Blood Sugar and Sexual Desire
Lubrication can be a huge intimate issue, but it's not the only one women with diabetes may have. Endocrinologist Spyros Mezitis, MD, says there are also important links between glucose levels and genital stimulation -- a factor that affects not only how pleasurable sex feels, but also a woman’s desire

Blood Sugar and Sexual Desire
“It all comes down to microcirculation,” says Mezitis, an endocrinologist at Lenox Hill Hospital in New York City. “When blood glucose is uncontrolled, it impacts the tiny blood vessels that feed our nerves and allow a woman to experience the full spectrum of intimate sensation.”

When microcirculation is impaired in men, erectile dysfunction occurs -- so the impact is obvious to both partners, he tells WebMD. In women, the effect isn't as apparent. It’s all about arousal and sensation in the genital area, which frequently no one but the woman herself must acknowledge.

Greene says the longer sugar levels remain uncontrolled, the more likely it is for circulation problems to interfere with intimacy.

“Over time, increased glucose in the blood begins to destroy myelin -- a protein that covers nerves,” Greene says. When this happens, it leads to neuropathy -- a type of nerve damage.

The most frequent type is peripheral neuropathy. It commonly results in foot problems such as numbness and tingling. Another type of neuropathy -- autonomic neuropathy -- affects nerves in areas such as the stomach and urinary tract and may also impact the nerves in the pelvis -- nerves that are directly connected to sexual stimulation.

“Again, it’s damage to the tiny blood vessels supplying the nerves that are at the root of the problem,” she says.

“Some people believe only those with type 1 diabetes, which develops at an early age, are at risk for these kinds of problems, but in reality many people with type 2 diabetes have it for many years before they are diagnosed, and when they are diagnosed, most of the time some damage has already occurred,” Greene says.

Women, Sex, and Diabetes: The Role of Infections
In addition to problems related to blood supply and nerve function, doctors say women with diabetes are also prone to two types of medical problems that also can interfere with intimacy: Yeast infections and urinary tract infections.

“The vagina is a moist, warm place that favors the overgrowth of yeast anyway -- add excess sugar into the mix and you have the ideal breeding ground for yeast, one reason women with uncontrolled blood sugars frequently develop chronic yeast infections,” Mezitis says.

What many may not recognize is the impact these infections have on delicate vaginal tissue -- and the role they can play in making sex very uncomfortable, even after the infection has cleared.

“It can leave the vaginal tissue raw and irritated, particularly if the infections are chronic and keep coming back -- the irritation continues, and combined with a lack of lubrication, this can make sex extremely uncomfortable, even painful,” Greene says.

Urinary tract infections can have the same effect, Mezitis says. “The burning and pain can make sex very uncomfortable -- and when there is chronic infection, there is chronic discomfort that can cause a woman to avoid sex for long periods of time,” he says.

And avoiding sex may only make the problem worse.

“The longer a woman goes without having sex, the more difficult and sometimes painful it can be for her to begin again," Greene says.

Women, Sex, and Diabetes: A Complex Issue
Experts have suggested that one reason there is so little research on women, sex, and diabetes is that for women, achieving sexual satisfaction is a complex and multi-faceted issue. That means finding a single “smoking gun” becomes a daunting, and some say, impossible, task.

Albright believes the complexity of a woman’s sexuality is one of the main reasons the impact of diabetes can be so devastating.

“Sometimes sexual problems can be clearly glucose related, but sometimes it’s also the demand that diabetes itself takes on a woman’s life and how coping with the disease can ultimately impact sexual functioning,” she says.

“The demands of the diabetes itself can affect you emotionally and if you’re a woman the stress of those demands is simply more likely to play out in the bedroom."

Greene adds that for many women with diabetes, depression is also a factor. “In and of itself," she says, "depression can impact your intimate life, but so can many of the medications prescribed to women who do develop depression as a result of their diabetes."

Women, Sex, and Diabetes: Getting Help
Although there may be no single answer for every woman whose sex life is affected by her blood sugar, there are two tactics experts say works for every woman:

Bring your problem out into the open. Telling the doctor about problems in the bedroom may not only help your sex life, it could clue in the doctor that your blood sugar isn't under control. "It’s important to bring that aspect of your life into the examining room," Mezitis says. "It can help you work with your doctor to fine-tune both your medication regimen and the suggested lifestyle changes so you do get the best possible control of your blood sugar."
Keep your doctor in the loop. Don't be shy about asking your doctor about specific treatments for sex-related problems, Mezitis says.
“If it’s a lubrication issue, for example, or even a sensation issue, there are localized hormone treatments that might be a huge help,” he says.

Likewise, if you’re suffering with chronic yeast infections that you’re treating with over-the-counter preparations, Greene says to share that with your doctor.

“This is important because chronic yeast infections can be a sign that your blood sugar is not being well controlled during certain times of the month,” Greene says. He says studies have shown many women need more insulin when they're premenstrual.

“Telling your doctor about chronic infections, or any lingering vaginal soreness that interferes with your sex life may actually lead to better control of your sugar levels," Green says, "while at the same time helping to reduce intimate problems."

The bottom line: If you’re experiencing problems between the sheets, don’t pull the covers over your eyes and hide.
"Talk to your doctor, either your endocrinologist or your gynecologist," Albright says, "very often there are treatments or lifestyle changes that can make a difference.”

Why Osteoporosis is On the Rise?

Why Osteoporosis is On the Rise
By Jim LaValle, R.Ph, ND, CCN

Recently, I did some radio and TV interviews on the topic of osteoporosis. Rates are increasing, especially in men; 55% of people over the age 50 have osteoporosis; and another 34 million or so have low bone density.

As a pharmacist, I feel obligated to warn people that one of the contributing factors to these increased rates is taking prescription and over-the-counter drugs that reduce or block the production of gastric acid. I'm talking about proton pump inhibitors (PPIs) and other acid blocking drugs like H2 antagonists for heartburn and ulcers.

Besides lowering B12 absorption which influences red blood cells and homocysteine levels, these drugs reduce stomach acid so effectively, they keep your body from absorbing calcium, and therefore can reduce bone density.

In people aged 50 and over, PPIs are associated with a 2.6 times increased risk of hip fracture when taken for over one year. The longer you use PPIs, the greater your risk of fracture.1 In 2003, one PPI became available over the counter. Needless to say, this tremendously increased the use of this class of drug. Used short term, acid blockers and PPIs are not a problem, but many people use them for much longer than the recommended few months.

The next thing we know, we see headlines that osteoporosis rates are increasing, and what used to be a condition seen mostly in women is now being seen more frequently in men.

But the question is, do you have to live with chronic gastric distress to protect your bones? The answer is a resounding No!

Rather than taking calcium-depleting drugs, try natural measures to reduce or neutralize the production of gastric acid. Start by making dietary changes. The best way to reduce acid load from the diet is to reduce your intake of sugary foods and drinks (especially soft drinks which contain phosphoric acid), along with grains. Instead, eat a diet high in vegetables and greens.2

Next, try gentle, natural products to control acid production and provide support to your gastrointestinal system. At LMI, we recommend DGL licorice, mastic extract, probiotics, and digestive enzymes.

We also advise limiting coffee and other caffeine, colas, and alcohol until the problem resolves, with limited use as tolerated after that. If you do use acid blockers more than occasionally, make sure to supplement with nutrients they deplete like calcium and vitamins B12 and D.

References

Yang, YX et al. Dec 27 2006 JAMA. 296 (24): 2947-53; doi:10.1001/jama. 296.24.2947. PMID 17190895.
Sebastian et al. Dec. 2002 Am J Clin Nutr. 76 (6): 1308 - 1316