Eliminating the Foods that are Bad for You

Eliminating the Foods that are Bad for You

By James LaValle, R.Ph, ND, CCN

Did it ever occur to you that the reason you can't lose weight may be due to the fact that you are eating foods that you're allergic to? This is a revelation to many people who have struggled unsuccessfully for years to get rid of unwanted pounds.

The prevalence of food allergies is on the rise in both children and adults.1-2 Allergies can be responsible for a number of health issues including irritable bowel type symptoms3 and migraines.4 Very few people are aware however, that immune responses to foods can go on to create a number of metabolic disruptions that can contribute to weight gain.

At LMI where we counsel people to lose weight using our Metabolic Code Diet (MCD) eating program, we see this all the time. We had one patient in our diet group who had tried a very low carb diet in the past, and lost no weight. The reason? She was sensitive to dairy and didn't know it. On her previous diet, she was eating a lot of cheese. On the MCD, which is a lower carb, low allergen eating plan, she cut out the cow's milk cheeses and dairy products, ate according to our meal recommendations, and the weight started coming off.

There are several ways common dietary allergens can keep weight on you. When the body is having an immune reactivity to food, it can cause increased stress hormone production. Increased cortisol in particular can contribute to insulin resistance — and that reduces your body's ability to process the glucose from foods high in carbs. And the increased insulin keeps you from being able to burn fat.

Increased cortisol can also go on to inhibit the body's ability to convert your primary thyroid hormone, T4, to the active form, T3. Without enough active T3, it is very difficult to lose weight. If you have developed an immune response (an allergy) to certain foods, it can also go on to cause autoimmune antibodies which can attack any tissue in the body, including thyroid tissue. Autoimmune attacks on the thyroid cause one of the most common forms of low thyroid, called Hashimoto's thyroiditis.

So, in a roundabout way, food sensitivities can slow metabolism and cause weight gain. By decreasing your consumption of any foods to which you might be sensitive, you may potentially improve insulin sensitivity, lower glucose, and promote better thyroid hormone production.

There are seven foods responsible for almost all food allergies — peanuts, other tree nuts like walnuts, fish/shellfish, soybeans, eggs, wheat and cow's milk. The only two foods we limit initially on the MCD eating program are wheat and cow's milk dairy. Why? Through years of clinical practice, we have found that wheat and dairy are usually the most problematic. So, we eliminate cow's milk products and wheat, and anything made from them.

This part of the MCD eating plan can be a challenge at first for many people. Western diets are so centered around wheat and dairy there is almost no red-blooded American who doesn't eat at least some wheat and dairy every day. But you would be surprised at the variety of breads, crackers, and chips that are available wheat-free. (You just need to be careful to eat them within your limited carbohydrate portions.) You can even find a wide array of goat and sheep's milk dairy products in most supermarkets and health food stores. What most people find is that they may miss a few of the eliminated foods at first, but their quality of life improves so much, that eventually they don't miss them at all.

We estimate that food allergies contribute to weight gain in at least 30% of our patients who come to us for weight loss. Of those, the vast majority doesn't have to go any further than eliminating wheat and dairy to jump start their weight loss.

The Metabolic Code Diet is a sensible eating plan that you can follow for the rest of your life and never feel deprived or hungry. But most importantly, since it addresses all the potential causes of metabolic disruption, it's an eating plan you can count on to get at the root causes of your weight gain, making it a better long-term solution for healthy weight loss and management.

References

1. http://www.newswise.com/articles/view/545808/
2. Kagan RS (February 2003). Environ. Health Perspect. 111; (2): 223–5.
3. Zar S, et al. (July 2005). Scand. J. Gastroenterol. 40 (7): 800–7.
4. Arroyave-Hernandez CM, et al. Rev Alerg Mex. 2007 Sept-Oct; 54(4):162-8.

Men: "Hormone Hell" is NOT Just for Women!

Men: "Hormone Hell" is NOT Just for Women!

By Layne Lowery

Can men go through menopause? Absolutely! You might not know it, but estrogen dominance, or andropause, is a major health hazard for men over 40. This hormone imbalance occurs when your body builds up too much estrogen and xenoestrogens -- which are synthetic forms of the hormone.

You've probably never heard of estrogen dominance -- and your doctor would probably misdiagnose your symptoms. But this could be the reason you suffer from...

• Memory loss and "senior moments"
• Depression and mood swings
• Sleepless nights
• Unwanted weight gain-- especially belly fat
• Muscles turning into flab
• Low sex drive and erectile dysfunction (ED)
• Enlarged prostate and other prostate problems-- and a frequent need to urinate
• Hair loss
• Male breasts or "man boobs"

There are three main reasons why these unpleasant symptoms of male menopause may be tormenting you: 1) aging, 2) environmental pollutants, and 3) your diet.

As you get older, your body doesn't make as much testosterone. The remaining testosterone gets weaker and easily converts to estrogen. Unfortunately, mid-life weight gain increases estrogen production because fat cells contain the aromatase enzyme, which changes testosterone into estrogen.

Another cause for hormone imbalances comes from xenoestrogens -- or toxins that imitate estrogen-- which are dumped into the environment by industrial, agricultural, and chemical companies. In his health newsletter, Dr. HingHau Tsang said these phony hormones are offshoots of products such as spermacides, detergent, plastics, plastic bottles, pesticides, herbicides, personal care products, and lacquers.

Dr. Tsang also said commercially raised beef, chicken and pork, as well as birth control pills and canned foods, contain xenoestrogens. He said massive amounts of hormones are regularly injected into beef and poultry, which can upset your natural estrogen levels.¹

John R. Lee, M.D., an expert in natural progesterone therapy, thinks that significant amounts of estrogen are the main cause of prostate enlargement AND prostate cancer!²

And estrogen dominance can also lead to erectile dysfunction (ED). According to Nick Delgado, Ph.D., a leading expert on anti-aging, a number of men with ED are "at greater risk for heart attacks, strokes, diabetes, or hypertension."³

So whether you call it estrogen dominance, "male menopause," or andropause -- estrogen overload is a real health hazard. And as indicated in a report titled "Manopause" by Lisa Marshall, large numbers of baby boomers are being hit with symptoms of male menopause.⁴

Therefore, Dr. John Morley, lead researcher of estrogen dominance in men and head of the geriatrics division at Saint Louis University Medical School, predicts that, "We are going to see an explosion of interest in it."⁵

What does this mean for you? Have your hormone levels checked to ensure that you don't have elevated levels of estrogen that can cause major health problems. A good naturopathic practitioner can advise you on lifestyle changes and nutritional supplements that will help keep your hormones in balance and reduce your risk of both male menopause and chronic disease.

References

1. HingHau Tsang, M.D., Dr. HingHau Tsang's Crusade on Nutrition: Newsletter #75--"Estrogen Dominance, Natural Progesterone and Men," Tsangenterprise.
   
2. John R. Lee, M.D., Natural Progesterone.
   
3. Nick Delgado, Ph.D., "Steps to Overcoming Estrogen Dominance and Slowing Symptoms of Aging," Ezine Articles.
   
4. Lisa Marshall, "Manopause," Natural Awakenings.
5. John R. Lee, M.D., Medical letter--"Prostate Disease and Hormones," March 2002.

Hot Spinach Dip

Hot Spinach Dip

By Laura LaValle, RD, LD

Spinach dipThis dip is a wonderful twist on a traditional recipe. The added chicken makes it higher in hunger-satisfying protein, while the water chestnuts add a great crunch. This is a great dip to offer your guests this holiday season. Try it out!

Time to table: 45 minutes

Serves: 12

Healing Nutrient Spotlight:
Excellent Source of vitamin A
Good source of vitamin C, calcium, niacin, vitamin B6, folate, manganese
Wheat, Dairy, and Egg Free

Ingredients*

1 10-oz. package frozen spinach, thawed, drained, and chopped
1 cup water chestnuts, chopped
2 3-oz. cooked chicken breasts, chopped (about 2 cups)
2 garlic cloves, minced or pressed
1/2 cup chopped onion
1 10-oz. package Vegan Gourmet brand mozzarella cheese
1 cup Follow Your Heart brand Grapeseed Oil Veganaise
1 tsp. liquid smoke flavoring (choose a gluten-free version and one that's been scrubbed and filtered to remove impurities; or you can add a few pieces of crumbled, pre-cooked nitrite-free bacon for a wonderful smoky flavor)

*Choose organic ingredients for optimal nutrition

Preparation

Preheat oven to 350°F. Combine spinach, water chestnuts, chicken, mayonnaise, cheese, onions, garlic, and liquid smoke in a large bowl. Mix well. Spoon mixture into a shallow glass baking dish. Bake for 30 minutes or until dip is bubbly and the edges turn golden brown. Serve with rice crackers, tortilla chips, or veggies.

Nutrition

225 calories, 6 g protein, 5 g carbohydrates, 20 g fat, 2 g saturated fat, 4 g monounsaturated fat, 2 g polyunsaturated fat, 12 mg cholesterol, .6 g sugar,
2.4 g fiber, 1840 IU vitamin A, 2.06 mg niacin, .17 mg pantothenic acid, .13 mg vitamin B-6, 30 mcg folate, 6 mg vitamin C, 65 mg calcium, .7 mg iron,19 mg magnesium, .20 mg manganese, 125 mg potassium, 4.35 mcg selenium,
240 mg sodium, .26 mg zinc

13 Eating Tips for a Healthier New Year

13 Eating Tips for a Healthier New Year

By Candace Booth, ND, PhD, CNC, SHC

Whether you need to de-stress from too much holiday partying, or simply want to kick off the New Year right, these 13 healthy nutrition tips are a great way to start.

1. Drink warm water with lemon in the morning. A cup of warm water first thing in the morning goes right through the bowels and cleans out mucus from the day before.

2. Lubricate, don't flood. Your stomach needs to be lubricated, not flooded. When you drink fluids with meals, it means you drown or destroy digestive enzymes which in turn inhibit or strain digestion. Therefore, drink fluids, juices, or preferably water, 20 to 30 minutes away from meals.

3. Chew slowly. Chewing slowly gives the food in your mouth a chance to become liquefied as a result of mixing with enzymes from the saliva. Really learn to savor each mouthful. Feel the texture of the food and capture the flavor. The digestive process begins when your saliva comes in contact with your food as it is being chewed. The chewed food will pass more easily through the digestive tract for maximum nutrient uptake.

4. Eat when calm. Stress eating causes you to physically not be able to digest your food properly.

5. Not too hot -- not too cold. The temperature of food and drink entering your body affects the strength of your spleen, your energy battery, and other organs too. Ice cold drinks weaken the organs. Eating foods that are too hot (burn your palate) aren't much better, since they injure your mouth membranes, damage gastric stomach lining, and degrade taste buds. Room temperature water is best to drink.

6. Decorate your plate. Try and prepare meals that are attractive to your eyes -- this causes your brain to spur into action sending a message to salivary glands to secrete saliva which contains digestive enzymes.

7. Rotate your foods. Don't eat the same things every day. You don't need too much of one single food and it can often lead to food intolerance, allergies, or sensitivities. You will also nourish your body with a wider range of nutrients.

8. Listen to your body. Take note of the foods you crave. If you really want a specific food because of its color, smell, or feel, just enjoy and go with the attractions. It may be that your body needs something nutritionally contained within that food. We aren't talking chocolate cookies here! We are referring to all those healthy whole foods such as fresh herbs, fruits, vegetables, seasonings, etc. that are available at health food markets. Walk the produce aisle slowly and imagine your taste buds enjoying the flavor of each food. What looks good? What smells good? Which foods look healthy and robust? Savor the produce instead of looking at the high sugar/fat foods. Then make your choices. Notice how much difference there is in the foods you are buying compared to the week before.

9. Enzymes! Enzymes! Enzymes! Sprouted seeds, raw vegetables, raw fruits, nuts, and seeds are loaded with live enzymes, which are the key to feeding your body with living nutrition and assuring better nutrient absorption.

10. Break the fast. Always eat something healthy and substantial for breakfast. This is the time period when your stomach energies are at their strongest and your digestive juices are raring to go.

11. Don't sleep on a full stomach. Eat your last meal of the day at least 3 hours before bedtime. Try not to eat after 7 PM as a rule. When you eat too late, you stress your digestive system -- you cannot digest as effectively when you go to sleep on a full stomach. It's bad for your digestive organs, heart, and liver not to mention the sugar that will get stored as fat because you aren't burning off what you ate.

12. Choose as many colors as you can. Every color in the vegetable/fruit family -- red, orange, purple, green, yellow, dark green, etc. -- plays a role in building or detoxing the body/blood.

13. Drink your greens. Once a week, have a green juice drink made from a variety of vegetables and/or fruits. This drink will have a rejuvenating effect on your body -- it is a power surge for the blood because it will be rich in chlorophyll. It will purify the blood, build red blood cells, detoxify the body, and provide fast energy. Green juice is the perfect fuel for the body. Its high water content means it is easily assimilated, and it contains the whole vegetable except for the fiber, the digestible part of the plant.

13 Eating Tips for a Healthier New Year

13 Eating Tips for a Healthier New Year

By Candace Booth, ND, PhD, CNC, SHC

Whether you need to de-stress from too much holiday partying, or simply want to kick off the New Year right, these 13 healthy nutrition tips are a great way to start.

1. Drink warm water with lemon in the morning. A cup of warm water first thing in the morning goes right through the bowels and cleans out mucus from the day before.

2. Lubricate, don't flood. Your stomach needs to be lubricated, not flooded. When you drink fluids with meals, it means you drown or destroy digestive enzymes which in turn inhibit or strain digestion. Therefore, drink fluids, juices, or preferably water, 20 to 30 minutes away from meals.

3. Chew slowly. Chewing slowly gives the food in your mouth a chance to become liquefied as a result of mixing with enzymes from the saliva. Really learn to savor each mouthful. Feel the texture of the food and capture the flavor. The digestive process begins when your saliva comes in contact with your food as it is being chewed. The chewed food will pass more easily through the digestive tract for maximum nutrient uptake.

4. Eat when calm. Stress eating causes you to physically not be able to digest your food properly.

5. Not too hot -- not too cold. The temperature of food and drink entering your body affects the strength of your spleen, your energy battery, and other organs too. Ice cold drinks weaken the organs. Eating foods that are too hot (burn your palate) aren't much better, since they injure your mouth membranes, damage gastric stomach lining, and degrade taste buds. Room temperature water is best to drink.

6. Decorate your plate. Try and prepare meals that are attractive to your eyes -- this causes your brain to spur into action sending a message to salivary glands to secrete saliva which contains digestive enzymes.

7. Rotate your foods. Don't eat the same things every day. You don't need too much of one single food and it can often lead to food intolerance, allergies, or sensitivities. You will also nourish your body with a wider range of nutrients.

8. Listen to your body. Take note of the foods you crave. If you really want a specific food because of its color, smell, or feel, just enjoy and go with the attractions. It may be that your body needs something nutritionally contained within that food. We aren't talking chocolate cookies here! We are referring to all those healthy whole foods such as fresh herbs, fruits, vegetables, seasonings, etc. that are available at health food markets. Walk the produce aisle slowly and imagine your taste buds enjoying the flavor of each food. What looks good? What smells good? Which foods look healthy and robust? Savor the produce instead of looking at the high sugar/fat foods. Then make your choices. Notice how much difference there is in the foods you are buying compared to the week before.

9. Enzymes! Enzymes! Enzymes! Sprouted seeds, raw vegetables, raw fruits, nuts, and seeds are loaded with live enzymes, which are the key to feeding your body with living nutrition and assuring better nutrient absorption.

10. Break the fast. Always eat something healthy and substantial for breakfast. This is the time period when your stomach energies are at their strongest and your digestive juices are raring to go.

11. Don't sleep on a full stomach. Eat your last meal of the day at least 3 hours before bedtime. Try not to eat after 7 PM as a rule. When you eat too late, you stress your digestive system -- you cannot digest as effectively when you go to sleep on a full stomach. It's bad for your digestive organs, heart, and liver not to mention the sugar that will get stored as fat because you aren't burning off what you ate.

12. Choose as many colors as you can. Every color in the vegetable/fruit family -- red, orange, purple, green, yellow, dark green, etc. -- plays a role in building or detoxing the body/blood.

13. Drink your greens. Once a week, have a green juice drink made from a variety of vegetables and/or fruits. This drink will have a rejuvenating effect on your body -- it is a power surge for the blood because it will be rich in chlorophyll. It will purify the blood, build red blood cells, detoxify the body, and provide fast energy. Green juice is the perfect fuel for the body. Its high water content means it is easily assimilated, and it contains the whole vegetable except for the fiber, the digestible part of the plant.

Depression: Offering Support

Depression: Offering Support

Trying to offer support to a friend or loved one with depression can be hard. You may not know how to act. You may worry that you'll say the wrong thing. Here are some suggestions about how to offer positive support.

* Don't ask your loved one to snap out of it. Depression is a real illness. People who are depressed can't just "pull themselves together" and feel better. Recovering from depression takes time and treatment. Think about it: You wouldn't ask someone with cancer to snap out of it. Depression is just as real and just as serious an illness.

* Listen. Right now, what your loved one with depression may need most is someone to listen. Don't dismiss his or her concerns. Don't assume that you know what he or she is going through. Just listen.

* Encourage your depressed loved one to be more active. Most people who are depressed isolate themselves. Isolation can make things worse. So gently encourage your friend with depression to get out more. Suggest that you do things together. Invite your loved one out to dinner or to a walk around the neighborhood.

* Don't push too hard. Be encouraging but not forceful. Don't make demands. People who are depressed feel overwhelmed as it is. If you're always pushing, a person with depression may pull back more. So if your friend or loved one declines your invitations, don't force the issue. Instead, just give it a little time and then ask again. Be persistent but gentle.

* Encourage your loved one to stick with treatment. It's key that your loved one with depression stay on his or her medication and get regular checkups. He or she may also need encouragement to eat well, get enough sleep, and stay away from alcohol and drugs. You could also offer to go with your loved one to therapy or health care appointments.

* Create a stable environment. Reducing stress around the home can help a person with depression. Try to get your loved one on a schedule, so he or she knows what to expect each day.

* Emphasize that your loved one will feel better. Because of depression, your loved one may feel hopeless. Be reassuring. Depression distorts a person's perception of the world. But with time and treatment, your friend or loved one will see clearly again.


SOURCES: Depression and Bipolar Support Alliance: "Helping a Friend or Family Member With Depression or Bipolar Disorder," 2004. Depression and Bipolar Support Alliance: "Finding Peace of Mind: Treatment Strategies for Depression and Bipolar Disorder." American Psychiatric Association: "Practice Guideline for the Treatment of Patients With Major Depression," 2000. Fochtmann, L. and Gelenberg, A. Guideline Watch: Practice Guideline for the Treatment of Patients with Major Depressive Disorder, 2nd Edition. Focus, Winter 2005: vol 3: pp 34-42. Depression and Bipolar Support Alliance: "Psychotherapy: How It Works and How It Can Help." Depression and Bipolar Support Alliance: "You've Just Been Diagnosed ... What Now?"

Below the Belt: The Gynecology Secrets You Need to Know

Below the Belt: The Gynecology Secrets You Need to Know
Stymied by rumors and half-truths about how to take care of your V zone? See what experts have to say about the secrets of sexual health.
By Colette Bouchez
Brunilda Nazario, MD

“I can’t tell you,” says Rebecca Amaru, MD, “the number of times women come into my office in tears because they’ve read or heard something about gynecology they think applies to them – and it doesn’t.” Amaru is clinical instructor of obstetrics and gynecology at the Mount Sinai Medical Center in New York City. She tells WebMD that a lot of what you read about gynecology or about caring for your V zone is either exaggerated or “just plain wrong.”

To help you sort fact from rumor, WebMD asked some of the nation’s top experts about sexual health and V zone care — topics that many women are too embarrassed to ask their own doctor about. What they said, may surprise you. Here are the gynecology secrets you want to know.

Secret # 1: Birth control pills may cause your sex drive to wane.

If your desire for canoodling hasn’t seemed quite the same since you started taking “the Pill,” it’s not your imagination says Amaru. “It’s 100% true that birth control pills can reduce the desire for sex in many women,” she says.

This is true not only for women in their reproductive years. It’s also true for women going through menopause who may use a low dose pill to control symptoms such as hot flashes and mood swings.

What can you do to get your sex drive back? Amaru says switching pill brands or formulations sometimes helps. “If it doesn’t,” she says, “consider switching to another form of birth control such as an IUD — if you’re in a monogamous relationship — or condoms,” she says. Another option is to take the Pill less frequently and use another method of protection to prevent pregnancy. If you’re using the Pill for relief of symptoms such as hot flashes, talk to your doctor about cutting back the dosage.

Secret # 2: To reduce some side effects of birth control pills — including nausea — insert them vaginally.

“Inserting the Pill vaginally is not harmful,” says Steve Goldstein, MD, professor of obstetrics and gynecology at NYU Medical Center in New York City. “And,” he says, “it can be very effective, particularly if you are suffering with any nausea or vomiting for any reason, including from taking the Pill.”

This little known secret came to light thanks to an Israeli study published in the journal Contraception. Doctors compared two groups of women using the Pill. One group took the pill by mouth; the other inserted it into the vagina and let it dissolve. The result? The women who used the vaginal route had less nausea, vertigo, headache, breast tenderness, period pain, and stomach upsets than the ones who took the Pill orally.
Secret # 3: Migraine headaches may increase your desire for sex — and orgasms may stop headaches and menstrual cramps.

Having sex may be the last thing on your mind while you have a headache. But don’t be surprised if you feel stronger urges to get intimate in the time leading up to a migraine — as much as 24 hours before. Doctors aren’t sure why this occurs. According to researcher James Couch, MD, of the University of Oklahoma Health Sciences Center, it may have something to do with an increase in the levels of serotonin. This brain chemical may be linked to sexual appetite.

Moreover, recent research has shown that for up to 20% of women, having an orgasm may stop a migraine in its tracks, immediately relieving the pain. But this isn’t the first time orgasm has been linked to pain relief. Goldstein says some women find it helps menstrual cramps — possibly because of a release of bio-chemicals that flood the body and relax the uterus, relieving pain.

Secret # 4: Avoiding sex will make painful sex hurt more.

Many women believe that avoiding intercourse and giving their vagina a “rest” is the best antidote to painful sex. Experts say the exact opposite is true. “There is some measure of truth to the axiom that if you don’t use it, you lose it,” says women’s health expert Christiane Northrup, MD. Northrup is the author of Women’s Bodies, Women’s Wisdom. Stop having sex, she says, and resuming it may be that much harder — both physically and in terms of desire.

At the same time, she says, pain with intercourse is not normal. It often occurs when your partner simply isn’t arousing you enough. In other instances, hormonally driven vaginal dryness — like the vaginal dryness some women feel when nursing a baby or going through menopause — can also cause sexual discomfort. A little dollop of a lubricating product or an estrogen cream applied directly to the vagina, Northrup says, is all you need to eliminate discomfort from painful intercourse related to hormones.

If arousal is the problem, Northrup says talk to your partner about increasing foreplay. Then do whatever it takes to get you through the excitement phase and make your body ready for intercourse.

Secret # 5: It’s easier to contract an STD if you have sex during your period.

While having sex during your period is the least likely time to get pregnant, it’s also the most likely time to catch an infection. The reason? “Changes in the acid/alkaline balance of your vagina during your menses make it easier for bacteria to proliferate,” says Nanette Santoro, MD. Santoro is director of reproductive endocrinology at the Montefiore Medical Center and Albert Einstein College of Medicine in New York City.
Secret # 5: It’s easier to contract an STD if you have sex during your period. continued...

“Normally the vagina is acidic, [a condition bacteria don’t like]. But blood raises the pH substantially, making it a more alkaline environment,” says Santoro. And that’s a condition that can allow bacteria to thrive.

Goldstein says, “If you’re not 100% certain of your partner’s sexual health, always use a condom.”

Secret # 6: Wearing cotton underwear and changing your laundry detergent really do work to reduce your risk of vaginitis.

Doctors say these long-standing axioms are not just an old wives tale. Vaginitis is an irritation of the vagina. It causes excess vaginal discharge, burning, and itching. Wearing cotton underwear and using a different laundry detergent can reduce the risk of vaginitis. Another way to avoid the risk is not to use perfumed soaps, intimate deodorants, or other fragrant products around your vagina.

If you don’t see at least some reduction in symptoms of vaginitis soon after you make these changes, Goldstein says talk to your doctor. Your problem could be bacterial vaginosis, a yeast infection, a sexually transmitted disease, or another infection that needs medical care.

Secret # 7: To reduce the risk of developing toxic shock syndrome when traveling abroad, bring a supply of US made tampons.

The potentially deadly infection known as toxic shock syndrome is on the rise again. It’s still linked to highly absorbent tampon use. These tampons are no longer sold in the United States, but depending on where you travel out of the country, you might still find them on store shelves right next to safer, less absorbent type. If you aren’t very familiar with the language in another country, you could easily come away with the wrong type. “To be safe,” says Goldstein, “bring your own from home, and never leave them in your body for an extended period of time."

Secret # 8: Avoid the use of tampons to protect against incontinence leaks.

Because a tampon in the vagina also exerts pressure on the urethra (the tube where urine passes out of the body), it can act as a kind of “stopper.” This may help control leaks, drips and dribbles. Doctors say it’s okay to use this method once in a while — for example if you tend to “leak” urine while exercising. However, Goldstein warns not to make a habit of it and says to remove the tampon as soon as you’re done working out. A tampon inside a dry vagina, he says, can cause significant irritation as well as microscopic tears in the skin. The irritation and tears can later open the door to infection. To help control everyday leaks, drips, and dribbles, you can use one of the new ultra thin incontinence pads. They are more absorbent than a typical menstrual pad and safer than a tampon.
Secret # 9: Intercourse won’t increase your risk of recurring yeast infection — but oral sex might.

Studies conducted at the University of Michigan Health System showed that men do not generally pass a yeast infection to a woman during intercourse. According to study author Barbara Reed, MD, MSPH, it appears that the risk for recurrent infections “is related to something else — perhaps the woman’s immune response to the yeast.”

Interestingly, however, the study, which looked at over 200 men and women, came to another rather surprising conclusion. Women who receive oral sex seem more likely to suffer from recurring vaginal yeast infections. This was the case whether their partner showed signs of yeast infection in their mouth or not.

“We’re not saying that oral sex is a problem for everyone, but if a woman is experiencing recurrent yeast infections, these activities put her at an increased risk,” Reed says. The CDC reports that up to 80% of women will have at least one yeast infection in their lifetime. A hormone imbalance, high blood sugar levels, certain antibiotics, birth control pills, or stress can also cause a yeast infection.

Secret # 10: That “urine-like” odor around your vulva may not be urine at all, but sweat — and there is something you can do about it.

Because secretions from sweat glands have some of the same components as urine, it’s common for some women who perspire a lot to experience a urine-like odor in the area of their vulva or even on their panties. But before you jump to the conclusion that you have an incontinence problem, Goldstein says try washing your V zone more frequently using a mild soap and water. Add a dusting of cornstarch-based powder to absorb moisture. Avoid nylon panties and panty hose, which tend to hold in heat and increase sweating. If the smell disappears then it was likely sweat and not urine. If it continues, talk to your doctor.

SOURCES: Rebecca Amaru, MD, clinical instructor of obstetrics and gynecology at the Mount Sinai Medical Center in New York City. James Couch, MD, PhD, professor of neurology, University of Oklahoma Health Sciences Center. Ziaei S. et al. Contraception, November/December 2002; vol 65 pp 329-331. MedicineNet: “Migraine Sufferers: Are They Sexier?” Steven R Goldstein, MD, professor of obstetrics and gynecology at NYU Medical Center in New York City. News release, University of Michigan Health System. Northrup, C. Women’s Bodies, Women’s Wisdom, Bantam, 2006. Nanette Santoro, MD, director of reproductive endocrinology at the Montefiore Medical Center and Albert Einstein College of Medicine in New York City. MedlinePlus Medical Encyclopedia: “Toxic Shock Syndrome.” News release, University of Minnesota.

2008's 12 Major Cancer Advances

2008's 12 Major Cancer Advances
Cancer Doctors' Picks for Year's Biggest News in Cancer Treatment
By Daniel J. DeNoon
Louise Chang, MD

Dec. 15, 2008 - Twelve major advances made cancer treatment and prevention a lot better in 2008, according to the American Society for Clinical Oncology.

ASCO today announced its annual list of major advances in cancer treatment and prevention. They're impressive accomplishments.

But there's a lot more to do: In 2008, an estimated 1.4 million Americans learned they had cancer. Half a million died from the disease.

The 12 choices come from the 21 cancer specialists who make up ASCO's editorial board.

"Only studies that significantly altered the way a cancer is understood or had an important impact on patient care were included," the editors note.

ASCO's 12 major advances:
Erbitux for Lung Cancer

Advanced non-small-cell lung cancer is a grim diagnosis. A 2008 study showed that adding Erbitux to standard chemotherapy increased survival by up to 21% in patients whose tumors carried a molecule called epidermal growth factor receptor or EGFR.
Gemzar for Pancreatic Cancer

Only 5% of people with pancreatic cancer are still alive five years after their diagnosis. In 2008, a large study of patients with early pancreatic cancer showed that, after surgery to remove their tumor, Gemzar chemotherapy doubled disease-free survival and increased overall survival.
Treanda for Chronic Lymphocytic Leukemia (CLL)

In March 2008, the FDA approved Treanda for first-line treatment of chronic lymphocytic leukemia or CLL.

It was an unusual approval, as Treanda has been available in Europe for some 30 years. Researchers had thought it was just another member of a similar class of drugs -- but then they learned it had a different mode of action that might work against a wide range of cancers of the blood.

Astonishing news came from an international study that showed Treanda completely eliminated cancer in 30% of CLL patients.
Avastin for Metastatic Breast Cancer

Avastin starves tumors by making it hard for them to grow the new blood vessels they need for nourishment. It's been used in colorectal and lung cancer. Last February, the FDA approved Avastin for use in combination with Taxol in patients with previously untreated metastatic breast cancer that does not carry the HER2 marker.

Approval came after a 2007 study showed the Avastin/Taxol combo doubled disease-free survival compared to Taxol alone.
Long-Term Hormone Therapy for Breast Cancer

It used to be that all doctors could do to prevent breast cancer recurrence was to give women five years of tamoxifen treatment. New studies changed that, showing that women can reduce their risk of breast cancer recurrence even more by taking tamoxifen or an aromatase inhibitor (such as Femara) for several years.
Zometa for Breast Cancer

Researchers last year learned that Zometa, a bone-strengthening drug, reduces the risk of breast cancer recurrence if given to premenopausal women undergoing hormonal-suppression therapy with tamoxifen or Arimidex plus Zoladex.
Pegylated Interferon for Melanoma

A European study showed that a year of treatment with pegylated interferon -- a newer, more active form of interferon -- cuts the risk of recurrent melanoma by 18% in patients who had the deadly skin cancers surgically removed.
Targeted Erbitux for Colon Cancer

Studies showed that Erbitux only works in patients whose tumors carry a normal KRAS gene. While this means that patients with KRAS-mutant tumors won't benefit from Erbitux, there's an upside. It means these patients won't unnecessarily suffer from side effects of the chemotherapy.
The Pill Cuts Ovarian-Cancer Risk

A review of data from 45 studies showed that for every five years they're on the pill, women who take oral contraceptives cut their risk of ovarian cancer by 20%.
HPV Vaccine May Cut Oral Cancers

A 2008 study showed that oral cancers linked to human papillomavirus (HPV) went up in the U.S. -- even though oral cancers not linked to HPV went down. That might be because of an increase in oral sex. If so, the HPV vaccine -- now approved for prevention of cervical cancer -- might have a role in preventing oral cancers, too.
Oncologist Shortage Looms

ASCO estimates that by the year 2020, the U.S. will have 4,000 too few cancer specialists. By then, the number of cancer patients will increase by 55%. The number of oncologists is increasing at a much slower rate.
Caring for Childhood Cancer Survivors

One of the wonderful successes in the fight against cancer has been an increase in the number of kids who survive childhood cancer. But a chilling new study shows that 30 years after their cancer diagnosis, these kids are five to 10 times more likely than other kids to develop heart disease. The reason: side effects of cancer treatments. Patients and families must be aware of this fact. Their doctors must carefully monitor these survivors for heart problems and target them for prevention efforts.

For continued advances in cancer treatment and prevention, ASCO calls for increased federal spending on clinical cancer research and for removing barriers to participation in clinical trials of new cancer treatments.


SOURCE:

American Society of Clinical Oncology: "Clinical Cancer Advances 2008."

Gene Test Better Predicts Breast Cancer Risk

Gene Test Better Predicts Breast Cancer Risk
New Tool Looks for Gene Variations linked to Increased Risk
By Charlene Laino
Brunilda Nazario, MD

Dec. 12, 2008 (San Antonio) - A new genetic test is much better at predicting breast cancer risk than the standard model, researchers report.

The new test, known as OncoVue, looks at variations in 19 genes associated with breast cancer risk, says Kathie Dalessandri, MD, a breast cancer researcher at the University of California, San Francisco.

Currently, doctors use the Gail model to determine a woman's chance of developing breast cancer. It evaluates five personal and family predictors of breast cancer risk -- age, age at first period, number of breast biopsies performed, age at the birth of first child, and number of immediate relatives who have had breast cancer.

"We know the Gail model is good at predicting risk of breast cancer within a population, but on an individual level, it's not much better than a flip of a coin," says Jennifer Eng-Wong, MD, a breast cancer specialist at Georgetown University Hospital. She was not involved with the work.

"One way to improve on the Gail model would be to incorporate an individual's own genetic assessment," she tells WebMD.
OncoVue vs. Gail Model

The researchers theorized that the OncoVue model, which incorporates the influence of genetic variation with information evaluated by the Gail model, would better accurately estimate breast cancer risk.

So they put OncoVue to the test in 177 women without breast cancer and 169 women diagnosed with breast cancer between 1997 and 1999 in Marin County, California. Marin County has higher than average breast cancer rates. Cell samples from the mouth were used to examine genetic patterns.

The research was presented at the annual San Antonio Breast Cancer Symposium.

Results showed that OncoVue was 2.4 times more accurate than the Gail model in identifying which women had breast cancer. It identified 56 cases of breast cancer vs. 37 for the Gail model.

"Put another way, OncoVue found 19 additional cases of breast cancer, translating to a 51% improvement over the Gail model," Dalessandri tells WebMD.

So why didn't the test identify even more women with breast cancer? "At this point, no test is going to be 100% accurate as we don't know all the risk factors, all the genes, involved in breast cancer," says Eldon Jupe, PhD, vice president at InterGenetics Inc., which developed the test.

He says the company hopes to gain FDA approval for OncoVue in the near future.
Breast Density Predicts Response to Tamoxifen

Also at the meeting, researchers reported that a change in breast density, as determined by mammography, can predict which women will respond to preventive therapy with tamoxifen.

Researchers studied 1,063 women and found that those with at least a 10% reduction in breast density after 12 to 18 months of treatment with tamoxifen had a 66% reduced risk of developing breast cancer.

In contrast, women who did not have a decrease in breast density gained no benefit from tamoxifen.

"For the first time, we have found a biomarker that predicts who will and who will not respond to a preventive therapy for breast cancer," says Jack Cuzick, PhD, of the Centre for Epidemiology, Mathematics and Statistics at Cancer Research UK in London.

While he says he would like to see the findings replicated in other studies, "they suggest that if there is no reduction in breast density after a year or two of tamoxifen, there may be no benefit to continuing treatment," he says.

Tamoxifen, along with Evista, is approved by the FDA for the prevention of breast cancer in high-risk women.

SOURCES:

31st Annual CTRC-AACR San Antonio Breast Cancer Symposium, San Antonio, Dec. 10-14, 2008.

Kathie Dalessandri, MD, University of California, San Francisco.

Jennifer Eng-Wong, MD, assistant professor of hematology/oncology, Georgetown University Hospital, Washington, D.C.

Eldon Jupe, PhD, vice president, InterGenetics Inc., Oklahoma City.

Jack Cuzick, PhD, Centre for Epidemiology, Mathematics and Statistics, Cancer Research UK, London.

Romance and Multiple Sclerosis

Romance and Multiple Sclerosis
Adults with multiple sclerosis find that self-acceptance and open communication can unlock the door to dating and intimacy.
By Elizabeth Heubeck
Reviewed by Louise Chang, MD

Navigating the rocky road of dating and relationships is challenging enough when you're perfectly healthy. Having a degenerative disorder like multiple sclerosis (MS) can throw up additional barriers at every turn, from deciding whether to disclose your status on a first date to grappling with issues of intimacy down the road.

Though the path to a satisfying relationship may require unexpected U-turns and alternate routes, make no mistake: People with MS can and do date, experience intimacy, and thrive in long-term relationships.

For a glimpse of what adults with MS can expect en route to building and maintaining relationships, we turned to the experts: adults living with MS, and the professionals who help them along the way.
How Soon Do You Tell?

We all have skeletons in our closet. But we don't always know when to let them out.

"I don't think secrets are a good thing. But when you go out with someone for the first time, you don't owe that person much of anything," says clinical psychologist Rosalind Kalb, PhD, director of the National Multiple Sclerosis Society's Professional Resource Center. "But as soon as you've decided that this person is worth more of your time and attention, I think it's important to start sharing all kinds of information about yourself."

Even then, you can't guarantee what kind of response you'll get. That's what 28-year-old Michele Mullis, who's had MS for five years, has learned.

"Telling someone about your MS is a struggle for many reasons. When you're first getting to know someone, it's not a discussion that's pleasant or fun. There are a lot of education-type questions that are asked. It's a big process to go through with someone you may or may not like," Mullis says.

That's why she waited three months to tell someone she was dating about her MS.

"He was completely offended that I would hide it from him. I think he felt like I was being deceitful. Subsequently, he didn't want to date me anymore," Mullis tells WebMD.

Now, she handles things differently.

"As I've matured, I've become more comfortable with myself and who I am, and sometimes I've told people on the first date. I also date people significantly more mature and educated," Mullis says.

She also admits to having a different view of dating, which she attributes to both a growing maturity and an acceptance of herself as someone who has MS.

"I definitely feel like I am more comfortable with who I am and, subsequently, I have fewer expectations from others. I realize I have to make the decision to make myself happy," Mullis tells WebMD. "I'm not seeking a man to fulfill those needs."
Self-Acceptance Eases Disclosure

As Mullis points out, having the maturity to accept your own diagnosis of MS makes it easier to share it with others.
Self-Acceptance Eases Disclosure continued...

Rick Steinhaus who, at 46 years old, has lived with MS for 12 years, recalls the impact the diagnosis originally had on him. "My perception of myself was that I was lesser of a person. You end up asking yourself, 'What's wrong with me? How could this be?'" he says.

"We [men] have this bravado: We're going to be the caregiver, the breadwinner," Steinhaus acknowledges.

Had he maintained this attitude, Steinhaus may have opted out of the dating scene altogether. As it was, he was engaged when he learned he had MS. The marriage ultimately ended in divorce. While he says MS wasn't the sole reason for the marriage's failure, Steinhaus admits, "It contributed to my marriage's demise."

When Steinhaus told his present girlfriend about his MS, he wasn't concerned about it compromising his masculinity in her eyes. At the time, he had no intention of dating her. "We worked together. I confided in her because, as I told her, 'You're my friend, and I want you to know about this.'"

Out of an understanding friendship grew something more. Presently, Steinhaus and his former co-worker have been dating for more than seven years. "I think one of the things that drew me to her was how incredibly compassionate she was," Steinhaus says.

Squelching his male bravado has helped him maintain the relationship. "It's taken me a long time to relinquish some control; to say, when I'm too tired to drive, 'Will you take over?'" he tells WebMD.
Issues of Intimacy

"I have to know and respect my own limitations; conversely, so does the other person in the relationship," Steinhaus says. For him, that means accepting the fact that he can't always maintain the same pace as his partner as they walk through the streets of New York, despite having once jogged together at an even pace.

For many couples with MS, it means being up front about problems of sexual dysfunction, which affect up to 80% of all adults with MS.
Causes of Sexual Dysfunction

"There's no relationship between disability and sexual function," says Marie Namey, RN, MSN, a clinical nurse specialist at The Cleveland Clinic's Mellen Center for Multiple Sclerosis Treatment and Research. "It can affect individuals with no visible symptoms."

While it's sometimes difficult to tease out the exact origin of sexual dysfunction, professionals have categorized MS-related sexual dysfunction into three types.

Primary sexual dysfunction can result from the formation of MS lesions on the spinal cord affecting nerve pathways. "There are so many pathways along the spinal cord that mediate different aspects of sexual function -- drive, orgasm, arousal. Because there are so many, there's a good probability that there's going to be a lesion somewhere along the way," says Frederick W. Foley, PhD, a neuropsychologist and expert on sexual dysfunction in people with MS.
Then there's secondary sexual dysfunction. That's when MS symptoms or medical interventions interfere with sexual function or expression. For instance, many people with MS suffer from bladder dysfunction, an inability to control urination. "Concern about having bladder problems during sex is common," says Namey. Fatigue, another common symptom of MS, also zaps people's interest in sex.

Tertiary sexual dysfunction -- a cluster of psychological, social, and cultural issues -- can also play a role. "Some people have an altered body image. They may lack self-esteem due to a change of status in life, whether it's a professional change or something else," Namey tells WebMD.
Help for Sexual Dysfunction

Despite the high incidence of sexual dysfunction among adults with MS, experts say it's often reversible. They advocate honest, open communication to jump-start the process.

"Most people have inhibitions when it comes to talking about sex. In our country, sex is either framed as pornographic or highly medicalized. There's not a good in-between language for people to comfortably talk about sexuality," Foley tells WebMD.

"If you can get people to talk about sexuality, they can sometimes solve their own problems," he adds.

Others find help through formal counseling interventions.

"The vast majority of people with MS and their partners can find help in a relatively short period of time," Foley says, recalling a young female patient of his. Prior to being diagnosed with MS, she enjoyed a healthy sex life with her partner. Shortly after being diagnosed with MS, she lost all interest in sex. "Her sudden loss of libido was very distressing for her," Foley says. Even more distressing, her medical team found no specific psychological or medical cause to her sexual dysfunction. But they didn't give up on treating her.

"Even if the multiple pathways that mediate drive and libido are shot, teaching patients and their partners how to touch each other differently can enable them to experience orgasm," Foley says. That approach was effective for the young woman whose situation he described.

"The single most important thing in the rehabilitation of sexual dysfunction is getting people to get over inhibitions about their bodies and talk about sexuality, and the mechanical problems they may have," Foley tells WebMD.

That same advice applies to all aspects of a relationship, not just to intimacy.

"Relationships with good communication and a solid commitment can weather all sorts of challenges," Kalb notes.

Article Sources:
Published March 28, 2006.

SOURCES: Rosalind Kalb, PhD, clinical psychologist; director, National Multiple Sclerosis Society's Professional Resource Center. Marie Namey, RN, MSN, clinical nurse specialist, The Cleveland Clinic, Mellen Center for Multiple Sclerosis Treatment and Research. Frederick W. Foley, PhD, neuropsychologist; expert on sexual dysfunction in people with MS. Zorzon M., Multiple Sclerosis, 1999; vol 5: pp 418-427.
Reviewed on March 28, 2006

12% of Kids Use Complementary/Alternative Medicine

12% of Kids Use Complementary/Alternative Medicine
Echinacea Most Common Complementary and Alternative Treatment Given to Children
By Salynn Boyles
Reviewed by Louise Chang, MD

Dec. 10, 2008 -- Thirty-eight percent of adults and 12% of children use complementary and alternative medicine, new data from a nationwide government survey show.

The survey marks the first time information on the use of complementary and alternative medicine (CAM) by children has been collected at the national level.

Researchers with the National Institutes of Health and the CDC asked more than 23,000 adults about their use and 9,400 adults about their children’s use of 36 non-vitamin or mineral CAM therapies, including herbal supplements, acupuncture, visits to chiropractors, massage therapy, mediation, and even yoga.

“I think this study highlights the growing acceptance of many of these therapies,” pediatrician Kathi Kemper, MD, MPH, of Wake Forest University School of Medicine, tells WebMD.

Author of the book, The Holistic Pediatrician, Kemper says many treatments considered alternative just a few years ago, including probiotics for gastrointestinal complaints, are now widely recommended for children.
12% of Kids Use CAM

According to the survey findings:

* 38% of adults and 12% of children 17 and under used some form of complementary and alternative medicine in 2007.
* Children whose parents used CAM were five times more likely to use the therapies (24%) than children whose parents did not use them.
* Echinacea, often used for colds, topped the list of oral supplements most often given to children, followed by fish oil, omega-3, or DHA; combination herb pills; and flaxseed oil or pills.
* Children’s use of CAM increased as their parents' education level increased.

Use of CAM was higher among teenagers (16.4%) than among younger children (10.7%), and white children were more likely to use CAM (12.8%) than black (5.9%) and Hispanic (7.9%) children.

Regionally, children living in Western states were most likely to use CAM (14.4%); those living in the South were least likely to use them (8.8%).

“Children are generally much healthier than adults, so 12% usage can be seen as quite high,” says study co-author Richard L. Nahin, PhD, MPH, acting director of the National Center for Complementary and Alternative Medicine’s (NCCAM’s) Division of Extramural Research.
CAM Usage Among Adults

The latest survey suggests that use of most complementary and alternative medicine has neither increased nor declined significantly among adults over the past six years, Nahin tells WebMD.

An exception was mind-body therapies like acupuncture, deep breathing, meditation, massage therapy, and yoga, which were used by more adults in 2007 than in 2002.

As seen in earlier surveys, women were more likely than men to use CAM therapies, and higher education and higher income was associated with higher CAM usage among adults.

The survey also revealed that:

* CAM usage increased with the number of chronic health issues. Adults who reported the most health problems were about 2.5 times more likely to use CAM therapies than adults who reported no health problems.
* Fish oil, omega-3, or DHA topped the list of oral supplements used most often by adults, followed by glucosamine (used for joint pain), echinacea, flaxseed oil/pills, ginseng, combination herbal products, and ginkgo biloba.
* About 13% of adults said they practiced deep breathing, 9% practiced meditation, and 6% practiced yoga. About 8% reported having therapeutic massages or seeing a chiropractor during the previous year.
* Adults were more likely to use CAM when they could not afford conventional treatments.
* Back pain was the most frequently cited reason for using CAM among adults (17%), followed by neck pain (6%), joint pain (5%), and arthritis (3.5%).
Nahin says conventional medicine often has little to offer people living with chronic pain conditions like back pain, arthritis, and fibromyalgia.

“People use CAM for many different reasons -- philosophy of wellness, cost, or to treat chronic conditions that are not helped by conventional treatments,” he says. “As we study these therapies it is important to keep this in mind.”

Fibromyalgia Pain at Night

Fibromyalgia Pain at Night
10 Tips for Better Sleep
By Jeanie Lerche Davis
Reviewed by Brunilda Nazario, MD

Do you toss and turn at night because of fibromyalgia pain or discomfort?

"People with fibromyalgia tend to have very disturbed sleep," says Doris Cope, MD, director of Pain Management at the University of Pittsburgh School of Medicine. "Even if they sleep 10 hours a night, they still feel fatigued, don't feel rested."

Research shows that with fibromyalgia, there is an automatic arousal in the brain during sleep. Frequent disruptions prevent the important restorative processes from occurring. Growth hormone is mostly produced during sleep. Without restorative sleep and the surge of growth hormone, muscles don’t heal and neurotransmitters (like the mood chemical serotonin) are not replenished. The lack of a good night’s sleep makes people with fibromyalgia wake up feeling tired and fatigued.

The result: The body can't recuperate from the day's stresses -- all of which overwhelms the system, creating a great sensitivity to pain. Widespread pain, sleep problems, anxiety, depression, fatigue, and memory difficulties are all symptoms of fibromyalgia.

Insomnia takes many forms -- trouble falling asleep, waking up often during the night, having trouble going back to sleep, and waking up too early in the morning. Smoothing out those sleep problems -- and helping people get the deep sleep their bodies need -- helps fibromyalgia pain improve significantly, research shows.

Medications can help enhance sleep and relieve pain. But doctors also advocate lifestyle changes to help sleep come naturally.
Tips to Get Better Sleep With Fibromyalgia

Creating a comfort zone at home is key to better sleep, whether you have fibromyalgia or not. It's all about easing into bedtime feeling relaxed -- and staying relaxed so you sleep through the night.

These 10 tips can help people sleep better:

* Enjoy a soothing (warm) bath in the evening.
* Brush your body with a loofah or long-handled brush in the bath.
* Ease painful tender points with a self-massage device (like a tennis ball).
* Do yoga and stretching exercises to relax.
* Listen to calming music.
* Meditate to tame intrusive thoughts and tension.
* Sleep in a darkened room. Try an eye mask if necessary.
* Keep the room as quiet as possible (or use a white-noise machine).
* Make sure the room temperature is comfortable.
* Avoid foods that contain caffeine, including teas, colas, and chocolate.

Therapies to Treat Insomnia When You Have Fibromyalgia

If you're still having sleep problems, several therapies can help, including biofeedback, relaxation training, stress reduction, and cognitive therapy. A psychologist who specializes in sleep disorders can discuss these therapies with you.

The therapies help people handle stress better, which helps control fibromyalgia episodes, Cope says. "Fibromyalgia comes and goes," she tells WebMD. "When you're stressed out, that's when it's worse." That's when you're most likely to have insomnia, too.

Medications can also help ease fibromyalgia pain at night, or directly treat insomnia. Medications to ease fibromyalgia at night include antidepressants, anticonvulsants, prescription pain relievers, and sleep aids.

No one therapy will control fibromyalgia pain 100%, Cope adds.

"Medications help some. Exercise helps some. Stress reduction helps some. Cognitive behavior therapy helps some... If you can get restful sleep, you're going to function better when you're awake."
View Article SourcesSources

SOURCES:

Doris Cope, MD, director of Pain Management at the University of Pittsburgh Medical School.

Tiffany Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine.

WebMD Feature: Diagnosing Fibromyalgia.

WebMD Medical Reference in collaboration with The Cleveland Clinic: Sleep and Chronic Illness. WebMD Feature: Good Sleep: Can It Still Be Simple?
Reviewed on April 29, 2008

Metabolism Myths--Busted

Metabolism Myths--Busted
By Julie Upton, RD

Learn the truth behind the folklore and use it to your weight loss advantage.


Google the word metabolism and you'll find nearly 45 million results--advice on how to "speed-up," "ignite," "kick-start," and "boost" your body's fat-burning capacity. Truth is, there are probably more myths about metabolism than there are about the Loch Ness Monster and Bigfoot combined. The reality: Your body does burn 2 to 5% fewer calories with each decade after age 40, and women tend to put on about a pound a year as a result, but these changes are not inevitable, says Matt Hickey, PhD, director of the Human Performance Clinical Research Lab at Colorado State University. Simple tweaks to your daily routine can up your calorie burn and compensate for the deficit, keeping you from succumbing to age-related weight gain. Take our quiz and learn the truth about harnessing your metabolism to keep off unwanted pounds.
Your body burns more calories digesting ice-cold beverages and foods (T/F)

True. But before you give yourself an ice-cream headache, there's more. "The small difference in calories probably won't make a significant dent in your diet," explains Madelyn Fernstrom, PhD, CNS, founder and director of the UPMC Weight Management Center in Pittsburgh. On the bright side, different studies have suggested that five or six ice-cold glasses of water could help you burn about 10 extra calories a day--equaling about 1 pound of nearly effortless weight loss each year.

Tip Although the metabolism-boosting effects are small, it can't hurt to pour no-cal drinks--water, tea, coffee--on the rocks to maximize your body's calorie-burning potential.
Drinking the right amount of water can help you burn more calories (T/F)

True. All of your body's chemical reactions, including your metabolism, depend on water. If you are dehydrated, you may be burning up to 2% fewer calories, according to researchers at the University of Utah who monitored the metabolic rates of 10 adults as they drank varying amounts of water per day. In the study, those who drank either eight or twelve 8-ounce glasses of water a day had higher metabolic rates than those who had four.

Tip If your urine is darker than light straw in color, you may not be drinking enough fluid. Try sipping one glass before each meal and snack to stay hydrated.
Dieting drops your resting metabolic rate, making it harder to keep weight off (T/F)

True. For every pound you lose, your resting metabolism drops by about 2 to 10 calories a day. Lose 10 pounds, and you now have to eat 20 to 100 fewer calories to maintain your trimmer physique, not factoring in exercise. However, you can prevent your metabolic rate from slipping while you get slim. One way is to lose fat but maintain muscle. You can do this by reducing calories and increasing aerobic and resistance exercise, says Hickey. Crash diets (fewer than 1,000 calories a day) may result in a higher percentage of muscle loss.

Tip Lose weight by cutting 250 calories a day and burning 250 calories per day through exercise. That will help you retain--or even gain--muscle while you lose a greater percentage of body fat.
Hot foods will fire up metabolism (T/F)

True. Capsaicin, the bioactive compound that makes chile peppers exude heat, can turn your metabolism up a notch while also enhancing satiety and reducing hunger. Studies show that eating about 1 tablespoon of chopped red or green chile pepper--which is equal to 30 mg of capsaicin--resulted in up to a temporary 23% boost in metabolism. In another study, 0.9 g of red pepper was given in capsule form or naturally in tomato juice before each meal. The researchers noted that the individuals reduced their total calorie intake by 10 or 16%, respectively, for 2 days after and still reported being full.

Tip Sprinkle red-pepper flakes onto pasta dishes and into chilis and stews; fresh chile peppers work well in salsas and add a fiery flavor to many other dishes.
Eating more protein will rev up your metabolism (T/F)

True. Protein provides a metabolic advantage compared with fat or carbohydrates because your body uses more energy to process it. This is known as the thermic effect of food (TEF). Studies show that you may burn up to twice as many calories digesting protein as carbohydrates. In a typical diet, 14% of calories come from protein. Double that (and reduce carbs to make up for the extra calories), and you can burn an additional 150 to 200 calories a day, explains Donald Layman, PhD, a professor of nutrition at the University of Illinois.

Tip To reap protein's rewards, strive for between 10 and 20 g at each of your meals, says Hickey. Try an 8-ounce cup of low-fat plain yogurt with breakfast (about 13 g), a 1/2-cup serving of hummus with lunch (about 10 g), and a 3-ounce salmon fillet for dinner (about 17 g).
Eating a grapefruit before every meal speeds metabolism (T/F)

False. Grapefruit won't work miracles for your metabolism, but it can help you lose weight. Half a grapefruit before meals helped individuals lose about 4 pounds in 12 weeks, according to a study published in the Journal of Medicinal Food. The reason: Its fiber and water fill you up on fewer calories, so you eat less at your next meal.

Tip Instead of soup or salad, try a juicy piece of fresh fruit--half a grapefruit, a tangerine--before your main course.
Lifting weights boosts your metabolism more than a cardio workout (T/F)

True. When you strength-train enough to add 3 pounds of muscle, you increase your calorie burn by 6 to 8%--meaning that you burn about 100 extra calories every day. Aerobic exercise, on the other hand, doesn't significantly increase your body's lean muscle mass. "The best way to gain muscle mass is to do resistance training," notes Ryan D. Andrews, RD, a certified strength-training specialist in Colorado.

Tip "You want to focus on exercises that recruit the largest muscles and use two-part movements, because they will help you build more lean mass," Andrews says. His favorites include squats, push-ups, and any exercise that combines upper- and lower-body movements. For a metabolism-boosting strength-training workout, visit prevention.com/burnfat.
Celery is a "negative calorie food" because digesting it uses up more calories than it provides (T/F)

False. The thermic effect of food does cause your body to burn up calories as it processes meals, snacks, and beverages. But this process accounts for anywhere from 0 to 30% of the calories you eat (protein, for example, takes more calories to digest than fat or carbohydrates; see p. 86). A medium-size rib of celery has only about 6 calories; its TEF is approximately half a calorie. In reality, "negative calorie foods" are nothing more than wishful thinking.

Tip Include celery as a low-cal but filling addition to salads, stir-fries, and soups; you can't depend on it to magically melt away your trouble spots. But it is healthful: Celery has phthalides, compounds that can help reduce blood pressure.
Tea revs your natural calorie burn (T/F)

True. Catechins found in green and oolong teas can boost the body's fat-burning fire. One study of Japanese women compared the effects of drinking green tea, oolong tea, or water on various days. Just one large cup of oolong tea increased calorie burning by up to 10%, a boost that peaked 1 1/2 hours later. Green tea raised metabolism by 4% for 1 1/2 hours. Other studies show that drinking two to four cups of green or oolong daily (about 375 to 675 mg of catechins) may translate into an extra 50 calories burned each day--about 5 pounds' worth in a year.

Tip Try a cup of green or oolong tea in place of your morning coffee for a dose of caffeine that will wake up your metabolism as well. Instead of milk or sweetener, add a squeeze of lemon, which may help your body absorb more catechins.
PMS cravings are related to the boost in metabolism before your period (T/F)

True. If there is a silver lining to PMS, it's that our resting metabolic rate may increase during the part of the menstrual cycle known as the luteal phase (the day after ovulation to the first day of your period). The metabolic boost we get from being "hormonal" can equal as much as 300 calories a day--which is why our appetite increases during this phase.

Tip Keep a journal of what you eat the week before and the weeks after your period. Try to maintain your eating pattern over the course of the month so that you can take advantage of this hormone-driven calorie burn. If you give in to cravings, make sure that you keep portions in check.
If you have limited time, exercise at a higher intensity for a metabolic afterburn. (T/F)

True. People who exercise at very high intensities experience a postexercise boost in resting metabolic rate that is larger and lasts longer compared with those who work out at a low or moderate level. Up the effort of your workout and you can expect to burn at least 10% of the total calories used during the workout in the hour or so after exercising. So, if you do a combo of walking and jogging for 4 miles (about 400 calories) instead of just walking, you may burn an extra 40 calories in the next few hours.

Tip Infuse your workout with bursts of speed. Gradually work your way up to 2-minute intervals, 3 days a week.



Originally published on October 1, 2008

Advancing Prostate Cancer: Combo Treatment Best

Advancing Prostate Cancer: Combo Treatment Best
Radiation + Hormone Treatment Doubles Survival in Locally Advanced Prostate Cancer
By Daniel J. DeNoon
Louise Chang, MD

Dec. 15, 2008 - Adding radiation to hormone therapy doubles survival of patients with advancing prostate cancer that hasn't yet spread through the body, a Swedish study confirms.

Lingering questions have remained about the best way to treat men whose prostate cancer has breached the wall of the prostate gland but hasn't spread much farther (technically, stage T3,N0,M0 prostate cancer).

Hormone therapy -- that is, drugs that cut off the tumor's supply of male hormones -- increases survival. Clinical trials suggest that at this stage of the disease, surgical removal of the prostate (radical prostatectomy) -- offers a smaller survival advantage.

In the U.S., this combination of radiation and hormone therapy is often a first treatment choice for locally advanced prostate cancer. That's a good call, suggests a long-term study of the treatment by Anders Widmark, MD, of Umea University, Sweden, and colleagues.

Ten years after starting treatment, about 24% of men treated with hormone therapy alone had died of prostate cancer. Only about 12% of men treated with the hormone/radiation combination had died of their cancer.

"The improvement was achieved without excess long-term toxicity," Widmark and colleagues note.

Four years after treatment, patients treated with the radiation/hormone combination had significantly more diarrhea than those treated with hormone therapy alone. But 85% of patients said the side effects were acceptable.

In an editorial accompanying the study, Alex Tan, MD, and Chris Parker, MD, of the Institute of Cancer Research, Sutton, Surrey, England, note that the combination treatment may slow progression of "micrometastases." These are existing metastases too small to detect at the time of diagnosis, but which would grow into fatal tumors if left untreated.

Tan and Parker join the Widmark team in recommending that radiation plus hormone therapy become the standard first-line treatment for locally advanced prostate cancer.

The Widmark study, and the Tan/Parker editorial, appear in the Dec. 16 issue of The Lancet.


SOURCES:

Widmark, A. The Lancet, early online edition, Dec. 16, 2008.

Tan, A. and Parker, T. The Lancet, early online edition, Dec. 16, 2008.

FDA Panel Urges Restrictions on 2 Asthma Drugs

FDA Panel Urges Restrictions on 2 Asthma Drugs
Serevent, Foradil Inhalers Should Not Be Used Alone, Experts Urge
By Todd Zwillich
Michael W. Smith, MD

Dec. 11, 2008 - An expert panel said Thursday that the benefits of two inhaler drugs are not worth the risks and should no longer be used to treat asthma.

The vote does not mean the two drugs, Serevent and Foradil, will be pulled from the market. Instead, the panel strongly urged the FDA to tell doctors not to prescribe the drugs to children or adults as a standalone asthma treatment.

The drugs are also widely prescribed for chronic obstructive pulmonary disease. That use was not affected by Thursday's deliberations of a 27-member FDA advisory committee.

At the same time, the experts backed two other popular asthma drugs, saying their benefits outweigh their risks.

Serevent and Foradil are in a class of drugs known as beta-agonists. They help control and prevent airway spasms during asthma attacks. But the drugs have also been associated with a small but significant increase in the risk of hospitalization and death from asthma.

Medical guidelines and the drugs' labeling recommend that beta-agonists only be used in combination with inhaled steroids that cut down on airway inflammation leading to attacks. The combination lowers the risks to a level most experts believed is justified by their benefits.

But studies show that many patients do not use inhaled steroids as directed when taking them separately from beta-agonists. At the same time, patients often feel physical relief from labored breathing when they use their beta-agonist inhaler. The difference can lead to many patients using the beta-agonist alone (called monotherapy), which raises the risk of dangerous side effects, according to FDA analyses presented this week.

"I think the label should be greatly strengthened to say that monotherapy for asthma should basically be contraindicated" for Serevent and Foradil, said Daniel Notterman, MD, a member of the advisory panel from the department of molecular biology at Princeton University.

The rest of the advisors agreed. In a 17-to-10 vote, the panel said the risks of long-term Serevent and Foradil use outweigh the benefits when used alone. The panel cast a similar vote for adolescents with asthma and voted unanimously that the drugs are not worth the risk in children 4 to 11 years old.

"The data is that single use is dangerous," said David Schoenfeld, PhD, a panelist and professor of medicine from Massachusetts General Hospital.

The panel gave broad backing to two other asthma drugs, Advair and Symbicort, in adults. Those products contain a combination of beta-agonist and steroid drugs, thus guaranteeing that patients get both drugs each time they take a puff.

The group was split on whether Advair should be used in children. Thirteen panelists said Advair's benefits outweigh its risks in children, while 11 said they did not. Three abstained.

Experts said they were uneasy with how few studies had been performed showing Advair's safety and efficacy in children.
"I think there's a paucity of data," Notterman said.

Symbicort is generally not used in children.

John Jenkins, MD, who heads FDA's Office of New Drugs, said the agency would consider ordering manufacturers to conduct more safety studies in children, which it can do under new authority granted by Congress.

Ellen Strahlman, MD, the chief medical officer of GlaxoSmithKline, which makes both Advair and Serevent, said the company was pleased with the committee's backing of Advair. But she also said the company was "concerned" that the panel's vote to restrict Serevent could "deny patients needed treatment for optimal care of their asthma."

A statement from Novartis and Schering-Plough said the companies "strongly disagree" with the panel's rejection of Foradil, which they market in a joint venture.

"We believe this opinion is inconsistent with clinical evidence supporting the benefit/risk profile of Foradil in patients not adequately controlled on other asthma-controller treatments," the statement read.

The FDA now has to go back and consider whether to change product labeling or indicated uses for Serevent and Foradil. It will also consider ordering new safety studies, Jenkins said.

Jenkins emphasized that patients currently taking Serevent or Foradil "should not stop taking your asthma medications without talking to your physician."
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SOURCES:

Daniel Notterman, MD, department of molecular biology, Princeton University; member, FDA advisory panel.

David Schoenfeld, PhD, professor of medicine, Massachusetts General Hospital; member, FDA advisory panel.

John Jenkins, MD, director, FDA Office of New Drugs.

Ellen Strahlman, MD, chief medical officer, GlaxoSmithKline.

News release, Novartis Pharmaceuticals Corp. and Schering-Plough

21 Look-Great Shortcuts

21 Look-Great Shortcuts
By Leesa Suzman
Expert tips, tricks, and products - most under $10 - to save you 50+ valuable minutes, morning and night.

Maybe you were having a dream about George Clooney that continued, thrillingly, well past the trilling of your alarm clock. Or perhaps your kids begged you to make homemade pancakes (which left you with three minutes to get the flour out of your hair, and no time for concealer). When your day feels like a mad dash instead of a walk in the park, these tweaks to your morning routine, shower, and bedtime prep can help you at least appear to have your life under control. If you've ever wished you could squeeze a few more minutes out of your busy day, now you can.
Morning-Rush Makeover

Yikes! You overslept, and now you have to get ready and out the door at warp speed. These tips eliminate almost an hour of prep time — and you'll still emerge looking fresh and pulled together.

Instead of: A time-consuming shower
Speedy solution: Splash cold water or spray a hydrating mist on your face to energize your skin. Store the mist in the fridge, or quickly run it under the tap; it will feel more invigorating as it hits your complexion. "Cold water instantly tones and tightens your skin," says Ann Marie Cilmi, director of education and development at Bliss. Try The Body Shop Vitamin C Energizing Face Spritz. Minutes saved: 10

Instead of: Multistep skin prep
Speedy solution: Jump right to moisturizing. Skip cleanser and toner, and give yourself more even-toned, hydrated, and protected skin by slathering on a tinted moisturizer with SPF. "Go over any discolored areas a second time," says Blair Patterson, a global makeup artist for Estée Lauder. You can also add another layer to cheekbones to help contour the face when it's puffy from sleep. Try CoverGirl Aqua Smoothers Tinted Moisture SPF 15. Minutes saved: 5

Instead of: Elaborate eye makeup
Speedy solution: Stick with three express moves. Tame brows, apply highlighter, and slick on black mascara. You can quickly smooth unruly brows using a brow gel or a pencil-and-comb combo such as Prestige Browliner. Then add a pop of white or bone shimmer shadow just below the browbone. "It draws attention upward and gives your face a more awake, lifted look," says Ramy Gafny, a New York City celebrity makeup artist. Finish by applying black mascara from the base to the tips of lashes to give them maximum length. Minutes saved: 10

Instead of: Blush and lipstick and shadow
Speedy solution: Choose one triple-duty product. A creamy blush that also works on lips and lids is ideal. Whatever you do, don't skip blush; makeup artists say it's the most underrated beauty product for waking up the face. Just smile and use the heat of your fingers to dab color on the rounds of your cheeks and across your lips, suggests Marcia Kilgore, creator of Soap & Glory. Use the same shade to brighten lids. Try E.L.F. All Over Color Stick in Persimmon. Minutes saved: 5

Instead of: A styling marathon
Speedy solution: Stash your blow-dryer and brush, and try some quick "detailing." Pull slept-on hair back into the Tonytail, a faux-hair ponytail holder that creates the illusion your strands have been expertly wrapped around the base of the pony. Or give a cropped style instant polish by smoothing out bangs and short layers with one of the new purse-size flattening irons. "It's easier to control than a full-size version and costs less," says Joelle Dunrovich, a hairstylist at Rita Hazan Salon in New York City. Try Slik Stik Mini. Minutes saved: 20-plus
The Ultimate Time Saver

Surprise! It's beauty sleep. You may be off in dreamland, but your skin is working overtime. "Inflammation is down and stress hormones reach their lowest levels by the middle of the night," says Amy Wechsler, M.D., a New York City dermatologist. This relaxed state can improve breakouts, fine lines, dark circles — the works. Here's how to boost your looks while your body rests.

Take years off your face: "Nothing works better at night to prevent and correct wrinkles than a topical retinoid," says Doris J. Day, M.D., clinical assistant professor of dermatology at NYU Medical Center. With regular use, this potent antiaging ingredient helps speed cell turnover and ratchet up collagen production, so you awake with smoother, more radiant skin. If a prescription retinoid is too harsh for your skin, try retinol, a gentler, over-the-counter cousin. (We like Roc Retinol Correxion Deep Wrinkle Night Cream.) Since they both can dry out skin, layer a hydrating lotion or cream over serums containing either ingredient (but wait five minutes to let the active ingredient sink in).

Slough off the rough spots: Slather on a body cream laced with glycolic acid before bed to loosen dead skin. Try Lubriderm Advanced Therapy Triple Smoothing Body Lotion. Apply a second layer to extra-dry areas like feet, elbows, and hands. In the morning, use an exfoliating body wash to send those loosened cells down the shower drain.

Reduce puffiness: The flip side of all the good things that happen to your skin while you sleep? "Lying flat for hours causes fluid to accumulate in your face, especially around your eyes," says Dr. Wechsler. Minimize puffiness by keeping your head elevated on at least two pillows and skipping salty foods like sushi with soy sauce for dinner.

Get softer, shinier hair: Deep conditioning can rescue hair that lacks shine or softness. Still, most women don't have the time to sit still while a messy, goopy formula sinks into strands. Instead, look for hair masks meant for nighttime use. Try John Frieda Frizz-Ease Crème Serum Overnight Repair Formula, which is formulated to go on dry hair, so you won't have to sleep with a wet head. It's also lightweight enough not to leave residue on your pillow.

"Work" on your tan: Applying self-tanner before bed lets you wake up looking sun kissed and sidesteps the issue of its potentially unappealing scent. Most self-tanners contain DHA, which gives off the odor of uric acid for hours as the color develops. But if you apply it before bed, the smell will be gone by morning, explains Cilmi. (Just be sure the product no longer feels tacky when you hit the sheets.) An alternative: Try lavender-infused Olay Touch of Sun Overnight.
Makeup Multitaskers

Five cosmetic overachievers that save you time — and purse space — by offering at least three beauty benefits in one small package.

* Foundation + makeup brush + sun protection = Neutrogena Mineral Sheers Liquid Makeup SPF 20
* Nail file + cuticle softener + cuticle pusher = 5 Second 3-in-1 Manicure Pen
* Concealer + wrinkle smoother + sun protection = L'Oréal Paris Visible Lift Line-Minimizing & Tone-Enhancing Concealer SPF 20
* Eyebrow tamer + skin softener + blister blocker + more = Bliss Problem Salved 20-in-1 Wonder Balm

Lip gloss + tooth whitener + breath freshener = Tarte Enbrightenmint BriteSmile Whitener & Tarte Lipgloss
Speedier Showering

Could you get in and out any faster — and still emerge with clean, soft skin and hair, and a refreshed spirit? Absolutely, say the experts. Here are six ways to make your time under the spray deliver more.

1. Simplify sudsing: "Just focus shampoo on the roots instead of lathering up the whole head," suggests Cilmi. "As the shampoo slides down your hair shaft during the rinse, the rest of your hair will get clean." Quickly squeeze out the excess water before you put in conditioner to prevent diluting the moisturizing ingredients. Then you can leave conditioner in for less time.

2. Get a brighter smile: Stash an extra toothbrush and toothpaste in your shower caddy. "I'm a firm believer that brushing my teeth in the shower saves time," says Los Angeles aesthetician Angela Nice. Makeup artist Ramy Gafny swears by Arm & Hammer Whitening Booster, a peroxide gel you put on top of toothpaste to brighten teeth in a hurry.

3. Steam-clean your complexion: Slap on a hydrating facial mask to deep-clean your skin. The treatment ingredients will penetrate further when they work in conjunction with the shower's pore-opening steam. Try Clean & Clear Soft In-Shower Facial, and rinse after one minute.

4. Eliminate stubble: "Never shave dry," says Dr. Day. Instead, use a moisturizing body wash in conjunction with your razor to get your skin clean, soft, and stubble-free. Try Weleda Sea Buckthorn Creamy Body Wash. If you wax, lather up with an exfoliating wash that will help reduce ingrown hairs made worse by waxing. Try: Johnson's Softwash Gentle Exfoliating 24 Hour Moisturizing Wash. New Veet In Shower Hair Removal Cream features a water-resistant formula that stays put under the spray. After two minutes, whisk the depilatory cream away with the accompanying sponge.

5. Clear your cuticles: Once your hands have been in the water for a couple of minutes, use a washcloth to gently push back cuticles. Doing this every time you shower will prevent cuticle buildup, so your nails look clean and well cared for, even when you don't have time for regular manicures.

6. Smooth your soles: Sally Hansen La Cross Foot Smoothing Disk is a palm-size, easy-to-grasp disk with exfoliating ridges that remove dead skin as you slide it back and forth across your feet. For spa-worthy results, wait until the end of your shower, when the warm water makes skin easier to slough off. If you shower in a tub, plug the drain and sprinkle in some bath salts for an instantly soothing foot soak that will also help soften any rough spots on your soles.

The Truth About Belly Fat

The Truth About Belly Fat
What's the best way to trim your tummy?
By Kathleen M. Zelman, MPH, RD, LD

Having a flat belly or so-called "six-pack abs" is a dream of most adults. If you're middle-aged, have ever been pregnant, or sometimes indulge in too much food or one too many beers, you probably have a spare tire you'd like to get rid of. So what's the best strategy for banishing belly fat? Is it as simple as adding certain foods to your diet, or doing particular exercises?

WebMD turned to the experts for answers on belly fat -- and the best ways to lose it.
The Answer to Flatter Abs

Don't despair; you can lose that spare tire, experts say. But there's no secret formula.

"There is no magic bullet, diet plan, specific food, or type of exercise that specifically targets belly fat. But the good news is belly fat is the first kind of fat you tend to lose when you lose weight," says Michael Jensen, MD, a Mayo Clinic endocrinology specialist and obesity researcher.

Whether you're an "apple" shape with excess belly fat, or a "pear" with wide hips and thighs, when you lose weight, you'll most likely lose proportionately more from the abdominal region than elsewhere.

"Ninety-nine percent of people who lose weight will lose it in the abdominal region before anywhere else -- and will lose proportionately more weight from the upper body," says Jensen, also a professor of medicine.

And why is that? "Visceral fat, the kind tucked deep inside your waistline, is more metabolically active and easier to lose than subcutaneous fat under the skin, especially if you have plenty of it," explains Penn State researcher Penny Kris-Etherton, PhD, RD.

And the more weight you have to lose, the more quickly you're likely to start losing your belly fat, experts say.

"People who are significantly overweight may see quicker results in their belly than someone who has less to lose in that area, such as a postmenopausal pouch," says Georgia State University nutrition professor, Christine Rosenbloom, PhD, RD.
Can Whole Grains Help You Lose Belly Fat?

A recent study in the American Journal of Clinical Nutrition showed that a calorie-controlled diet rich in whole grains trimmed extra fat from the waistline of obese subjects.

Study participants who ate all whole grains (in addition to five servings of fruits and vegetables, three servings of low-fat dairy, and two servings of lean meat, fish, or poultry) lost more weight from the abdominal area than another group that ate the same diet, but with all refined grains.

"Eating a diet rich in whole grains while reducing refined carbohydrates changes the glucose and insulin response and makes it easier to mobilize fat stores," says study researcher Penny Kris-Etherton, PhD, RD, a distinguished professor of nutritional sciences at Penn State University.

"Visceral fat is more metabolically active and easier to lose than subcutaneous fat, especially if you have plenty of it and the right conditions are met, such as the ones in our study."
When you eat refined foods like white bread, it triggers a series of events, starting with elevated blood sugar levels followed by an increased insulin response, which can cause fat to be deposited more readily. But eating a diet rich in whole grains (which also tend to be higher in fiber) helps improve insulin sensitivity. This, in turn helps the body more efficiently use blood glucose, lowers blood glucose levels, and reduces fat deposition.

The U.S. Department of Agriculture's 2005 Dietary Guidelines recommends that half of your grain servings come from whole grains.

"Eating whole grains exclusively may be difficult and unrealistic for many people," says Rosenbloom. Instead, she recommends, "work toward consuming more whole grains, as they tend to be high in fiber, which satisfies hunger for longer periods and helps you eat less than refined grains."
Can Monounsaturated Fats Banish Belly Fat?

A recent diet book called The Flat Belly Diet posits the idea that you can lose belly fat by eating a 1,600-calorie diet rich in monounsaturated fats.

Most people will lose weight on a 1,600-calorie diet. And there is little question that when it comes to choosing fats, the monounsaturated fatty acids (MUFAS) found in avocados, nuts, seeds, olives, soybeans, chocolate, olive and canola oils are among the best choices, with proven health benefits, such as reducing the risk of heart disease.

But these are not magic foods capable of targeting belly fat, experts note. While the MUFAS are healthy fats, they are still fats, with nine calories per gram -- more than twice that of carbohydrates and proteins, which have four calories per gram.

"Fats have to be controlled, because it is easy to overeat nuts or guacamole -- which can undo the health benefits by packing on the pounds," cautions Rosenbloom.
Can Exercise Flatten Your Abs?

Hundreds of crunches each day won't flatten your belly if you need to lose weight. If your abdominal muscles aren't covered with excess fat, strengthening them can help you look tighter and thinner. But spot exercises won't banish belly fat.

"If you want to lose weight and keep it off, you must eat a healthy, controlled-calorie diet and get regular exercise -- around 60 minutes a day of moderate activity, like brisk walking," says Rosenbloom.

And the harder you exercise, the more belly fat you may lose. Jensen suggests that people who engage in high-intensity aerobic exercise tend to be leaner around the abdomen.
The Risks of Excess Belly Fat

Why is it important to lose belly fat? Carrying around extra pounds in your midsection is serious business. Extra weight in your midsection is more dangerous than fat around your hips and thighs, as visceral fat is worse for your health than the subcutaneous fat that sits under the skin.

"Extra weight around the midsection is associated with inflammation and a higher risk of health problems such as cardiovascular disease, diabetes, metabolic syndrome and more," Jensen says.

According to a recent study in Circulation, belly fat appears to boost inflammation and is linked to hardening of the arteries.
Is Your Middle Too Big?

Beyond the body mass index (BMI), waist circumference has been touted as a simple and reliable test to measure health, weight status, and hidden fat, says Rosenbloom.

To assess your risk, use a soft tape measure. Lie down and wrap it around your natural waistline, located above your hip bone and below your belly button. Take the measurement without holding your breath or holding your stomach in.

If your waist is larger than 40 inches (for men) or 35 inches (for women), you have too much belly fat and are at risk for heart disease and other conditions. And one of the best things you can do for your health is to lose weight, says Rosenbloom.
The Bottom Line About Belly Fat

So what's the bottom line about belly fat?

Most scientific evidence suggests that a calorie-controlled diet rich in fruits, vegetables, whole grains, low-fat dairy, beans, nuts, seeds, lean meat, fish, eggs, and poultry is the foundation for a diet that provides all the nutrients you need while helping to whittle your waistline.

The real secret to losing belly fat is to lose weight on a balanced, calorie-controlled diet and exercise at least an hour a day.
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View Article Sources Sources

SOURCES:

Penny Kris-Etherton, PhD, RD, distinguished professor of nutritional sciences, Penn State University, State College, Pa.

Christine Rosenbloom, PhD, RD, nutrition professor, Georgia State University, Atlanta.

Michael Jensen, MD, professor of medicine, Mayo Clinic, Rochester, Minn.

Katcher, H.I. American Journal of Clinical Nutrition, January 2008; vol 87: pp 79-90.

WebMD Medical News: "Why Belly Fat Hurts the Heart."

WebMD Medical News: "Whole Grains Fight Belly Fat."
Reviewed on March 04, 2008