The Fat YOU Gotta Have

The Fat That’s Good For You with Michael F. Roizen, MD

An excerpt from YOU: Staying Young.

Our basic premise is that your body is amazing: You get a do over: it doesn’t take that long, and isn’t that hard if you know what to do. In these blogs we hope to give you a short course in what to do so it becomes easy for you to do it and then to teach others.

We want you to know how much control you have over your quality and length of life. But many women make excuses for not making healthy choices. I’m too busy, the kid’s need more attention; yes we know you are busy, but taking time for yourself is showing love for those you love and who love you.

Yes, YOU have more control over the quality and the length of your life than you’ve ever imagined.

Stopping Inflammation
If you’re a regular reader of this blog, you know we’re always talking (at least we did in the first blog—I guess always fits as it is two for two) about “major agers” and how these affect your body, and the specific, practical things you can do to counteract them. Understanding aging gives you insights into the action steps for extending your own warranty.

When it comes to aging, we’re concerned with acute inflammation from immediate infections like colds or the flu, because they disturb and accentuate chronic inflammation. (Did you know that if you get the flu shot every year from age 55 on you increase your chance of surviving your 60’s by 100% compared to other women of equal risks who skipped those yearly flu shots? Your risk of dying is decreased by 50% as you do not make the chronic inflammation in your body worse. And you decrease your chance of even needing a hospital by 25% for that decade — but that is another blog). So, really we’re concerned most with chronic inflammation since that can trigger a negative response that ages your entire system.

Chronic inflammation occurs from an immune system that’s more overworked and stressed out than you are—leaving your body under equipped to deal with problems and making your system more vulnerable than a car stuck in the fast lane of a freeway. Voila – you’re more susceptible to aging processes including un-repaired nerves.

A Specific Fat to the Rescue!
There’s a fat that can decrease this inflammation and repair your nerves for you! Not the fat you get from drive throughs–that kind on croissants and hamburger and hamburger buns that can kill you. What can make you better is a fat that can prevent deterioration in your retinas by as much as 30% or more; boost the IQ of kids by 10 to 20 points (it’s present in breast milk and that’s why you’re finding this fat is almost all (99.7% in the USA) infant formulas now), prevent post-partum depression in up to 30% of post-partum women and – the real biggie – decrease deaths from heart attacks by more than 30%.

What is this amazing fat?

An Omega 3 fatty acid called DHA (docosahexanoic acid). Research in infants show that those formula fed with it in their formula score 10 to 20 points better at 6 months and 6 years. And studies of students and us grown folk from ages 4 to 80 shows it helps improve vocabulary scores (4 year olds to 6 graders) and decreases Alzheimer’s risk.

While we tend to think of fat is as troubling as a red light in the rear view mirrow, this one is like a red carpet escort. DHA is a fat that seems to be the key component of your cells’ membranes that lets it withstand the stress of inflammation and other bumps the way bumper cars survive to carry another rider. You give it preferentially to your offspring through your uterus or breast milk (DHA is the only omega-3 food additive approved for baby formula). If you don’t have enough of it, you can develop nerve dysfunction (depression in some), or deficient eyesight (dry macular degeneration) or fading memory (why did I go to the living room?).

DHA also seems to lengthen gestational periods if taken in pregnancy, preventing preterm labor in some cases. And in a recent animal study (there are some things you can’t get most humans to do), rats given DHA after traumatic concussions learned mazes better than those who ate regular rat chow. That learning difference persisted even after those rats lived longer than the human equivalent of great-grandfather.

Your brain requires DHA to grow and to create new very functional connections needed for memory and learning. DHA’s ability to keep inflammation from triggering fatal heart rhythms is thought responsible for the 30-plus percent decrease in heart attack deaths in the famous Lyon heart study.

How It Works
Want to know why this specific omega-3 is so darn good? Truth is we really aren’t sure it is DHA, but the trail of evidence is pretty strong. Omega-3 refers to its position on the carbon chain that gives the fat the ability to help your membranes withstand shocks and to latch onto stuff that fosters nerve development and regeneration. Ninety-seven (97) percent of omega-3’s in your brain and the seeing part of your eye called the retina are DHA. The three common omega-3’s are ALA (alpha lenolenic acid in foods like flax seeds and walnuts), EPA, (eicosapentaenoic acid found in cold water fishes) and DHA. Many foods, such as fish, have mixtures of ALA, EPA, and DHA. Some algae, which fish eat, have mainly DHA. That’s where the fisdh get theirs, and we prefer to get ours.

Feed Your Head
So here’s what we recommend: get 600 milligrams of DHA form of Omega-3 in food or supplements each day — that’s the equivalent of 2 grams of distilled fish oil. ( I just even bought you can even bought some Cannola Oil with DHA as an additive—so it is becoming more common. And whatever way you do it, I recommend you get 600 mg of DHA daily—Mehmet and I and the family members we care about do). And by the way, some swear that 600mg of DHA a day decreases the pain and inflammation of minor arthritis—and the scientific evidence says they’re as right on as your spouse was when he proposed to you. (He clearly was right on—you may not have been to accept—but that is another blog).

That’s how good DHA-omega-3 is for you. That’s why we take it, and recommend it to all of our family members as well. So for now, enjoy understanding what DHA is doing as you walk 30 minutes a day, knowing that both choices are keeping your brain, heart, eyes, and joints a whole lot younger than they are today.

About Dr. Roizen
Michael F. Roizen, MD, is a professor of anesthesiology and internal medicine, Chief Wellness Officer, and chair of the Wellness Institute at the Cleveland Clinic.. Mike and Dr. Mehmet Oz have written 3 #1 NYTimes Bestsellers together, the latest: YOU:The Owner’s Manual, Updated and Expanded. You can find the supplement list they recommend on page 367 of that book or a more detailed list on pages 356-358 of YOU Staying Young.

Improving the Doctor-Patient Relationship: Top Tips from a Real Woman

Have you ever visited a doctor's office to discuss a diagnosis or some treament options, only to have your brain ambushed by fear or confusion?

Once I read Sheryl's advice to women who are undergoing breast cancer diagnosis and treatment, I got connected to my own vulnerabilities in speaking to "the doctor".

It absolutely mirrors the top three mistakes women make when speaking with doctors, regardless of how educated we might be!

In Sharon's voice, here's what she has to tell us from her experience as a breast cancer survivor:

Below, I offer some tips garnered from various sources, including the excellent information offered by Dr. Marisa Weiss, president and founder of www.breastcancer.org, the U.S. Department of Health and Human Services' Office on Women's Health (www.womenshealth.gov) and http://www.networkofstrength.org/.

1. Write down questions or issues ahead of time. Don't forget to prioritize these. Many of us tend to save the most important question for last. When the doctor has one foot out the door is not the right time to ask any question, much less your most important one.

2. It it's a diagnostic visit, come prepared with a detailed description of your symptoms. Note when the problem began, how it makes you feel, what sets it off or triggers it and what works/doesn't work to make you feel better.

3. Bring a list of your medications and dosages. Include both prescription and over-the-counter medications, as well as vitamins, herbs and any other supplements. Make sure you also understand the implications of any medications your doctor prescribes: what to do if you miss a dose; if there are any foods, drugs or activities that you should avoid while taking the medication; if there is a generic brand of the drug you can use; what side effects to expect.

4. Ask for support materials. If your doctor is discussing things like treatment options, things can get pretty complicated and confusing. Many times, there are pamphlets you can take home. Ask the doctor about reliable Web sites, too; there's a wealth of information out there. Remember, the more information you have—assuming it's reliable and current—the more able you are to participate in your treatment and understand your condition.

5. Don't be afraid to ask questions or ask for clarification. A study from the University of Washington found that doctors rarely (only 1.5 percent of the time) ask patients whether they understand what was discussed during an appointment. So it's important to be your own advocate and make sure you understand everything. This will avoid unnecessary worry and follow-up phone calls to your doctor. It doesn't hurt to say something like, "So, if I understand correctly, you are telling me XXXX" and reiterate what your understanding of the conversation is.

6. Check ahead to make sure the doctor has your test results and/or reports from other labs or doctors. This gives you the opportunity to discuss those results in person, rather than over a rushed phone call (if you're lucky enough to even get your doctor on the phone).

7. Bring a trusted friend or family member with you. In the beginning, I rarely went to a visit without my husband. Thankfully, he was able to adjust his schedule to accommodate me. The few times he couldn't, my mother or a close friend accompanied me. Another set of ears is always helpful. Many times, as a patient, you may be too consumed with worry or fright to fully comprehend what the doctor is saying. And sometimes another person thinks of questions to ask that would not even occur to you. A tape recorder (with your doctor's OK, of course) can also serve as a backup for you, as will a pad of paper to jot down some notes.

8. And lastly, there are a couple more things I have experienced that I'd like to include.
- Make sure you find out how to reach your doctor between visits. Some doctors might use e-mail; others have a designated time of day for returning calls. You may even be able to talk to a nurse to get the information you need.

- Keep a folder with copies of your test results (yes, you are entitled to this information). With copies in hand, I could share them with my internist, if need be, or just feel secure knowing that I had a stack of papers that conferred my continued good health.

Have Fun with Pink Power

With October peeking around the corner, main streets across America will be filled with runners, racers and pink party-goers, joined together in raising money for a cure and access to treatment for breast cancer.

Whether you choose to fun-raise with Susan G. Komen, Avon, The Breast Cancer Foundation or other grassroots groups to support, fun-raising couldn't be easier today.

Here's a couple of ideas:

Roll the Dice and Beat the Odds. Turn your living room into Bunco night. See the video bar to your right with Naomi Judd talking about the fun she had in Vegas and turn your living room into a bunco night with your friends. The Breast Cancer Research Foundation has put together a Bunco tool box that will have your event up and running with a couple of hours of planning.

Have you seen "The Women"? Bring your friends and plan a pre-movie pot luck dinner with a donation to your favorite breast cancer research charity.

(Yes, I'm planning on an October night out with my own galpals and sending out invitations this week!)

From Empowerment to Results: A Survivor's Story

What is this blog about anyway?

I am blogging is to help marketers see how they can find ways to support, encourage and speak with women in ways that convey authenticity and transparency.

The result will allow marketers to meet the many unmet needs in the area of women's health and wellness, motivate new health behaviors and improve women's quality of life.

If you know of someone who can inspire us with their story please let me know and I will work with them to blog their story.


Here's an example of a real woman, an intelligent woman, with an inspiring story that might jumpstart your fundraising efforts, found on the Breast Cancer Research Foundation website:

Meet Tami Agassi

Former Executive Director for the Marsha Rivkin Center for Ovarian Cancer Research

Q. Tell us a little about yourself and your lifestyle.

A. I am 34. I live in Seattle, Washington and am the Executive Director for the Marsha Rivkin Center for Ovarian Cancer Research.

A. BCRF Note:
Since this profile was received, Tami has married, become the mother of a baby girl and retired to be a full-time mother.

Q. Describe how you found your cancer, were you on 'watch' or did it sneak up on you?

A. I found my cancer through self examination at age 30. When I first found a lump, I was told by a doctor that there was a 98% chance it was benign. It was suggested that I go back to the doctors in 6 months to see if the lump had grown. Fortunately, I didn't accept 98% as a good enough answer. I sought a second opinion which allowed me to detect my cancer in its earlier stages.

Q. Following diagnosis, what helped you cope the most, and gave you strength?

A. My faith in God and passion for life gave me tremendous strength and inner peace.

Q. How has breast cancer changed your outlook on life?

A. Breast cancer has taught me how precious life is. Each day I am alive is a glorious day for me. Instead of being excited or worried about the future, I am ever grateful for today.

Q. What advice would you give to someone who is newly diagnosed with breast cancer?

A. The greatest gift you can give to yourself and to your loved ones is to take care of yourself first and foremost. As women, we tend to take care of others first and put our needs second. This is the one time in your life where your needs must come first. Always remember that allowing others to care for you is the greatest gift you can give them, especially during this time.

Q. How has The Breast Cancer Research Foundation been helpful to you?

A. I credit organizations like the BCRF for saving my life. Without the awareness created by organizations like this, I would have never had the knowledge needed to conduct self breast examinations, especially at the age of 30. This awareness also gave me wisdom to challenge my doctor and seek a second opinion, which resulted in early detection for me.

The Women's Sexual Health Foundation Weighs In

This is a great article that I found on an excellent web site for women, The Women's Sexual Health Foundation (http://www.twshf.org/). It's a well written article on the subject that seems "to wax and wane" to paraphrase Julia Heiman, Director of the Kinsey Institute in Bloomington, Indiana

No Fem a gra
A decade after Viagra, there's no equivalent for women, but treatments for sexual problems are promising.

By Shari Rudavsky
shari.rudavsky@indystar.com

T en years ago, American found themselves talking about sex. A new HBO show, "Sex and the City," instantly sparked controversy for the I- can't-believe-they-said-that girl talks among its leading ladies. And a little blue pill called Viagra landed on U.S. shelves, with pitchman Bob Dole helping to usher the phrase "erectile dysfunction" into common parlance.

Fast forward a decade. Turns out "Sex and the City," a movie version of which arrives in theaters on Friday, made a lot of real-life women feel OK about discussing sexual issues. And while no pink pill has emerged from the laboratories to play the role for women that Viagra played for men, that doesn't mean the drug hasn't had an effect for women, experts say.

"That's opened the door for women feeling and believing that they really have a right to a satisfying, intimate life with their partner," says Lisa Martinez, executive director of The Women's Sexual Health Foundation. "What we've heard is, 'Men have Viagra and Cialis and penile implants, and what do we women have?' "

Interest in women's sexuality "seems to wax and wane," says Julia Heiman, director of the Kinsey Institute in Bloomington. "For now, it seems to be coming back some."

The data varies widely, but studies suggest that about 40 percent of women will have a problem with sexual function at some time in their lives, says Martinez, whose nonprofit organization aims to educate doctors and women about sexual health.

Decreased desire is women's most common complaint. Finding a remedy, however, may not be as simple as developing Viagra, originally developed for angina, not male sexual dysfunction.

In the flurry of interest after Viagra hit the market, scientists wondered whether it might also work for women. But after initial trials in this area failed, efforts to find such a drug waned.

One of the challenges is that men and women are completely different when it comes to sexual arousal. For men, arousal is a biological phenomenon. For women, sexual arousal is tied more to their emotional and mental state.

Women, who often have multiple responsibilities, may have other priorities that push sex lower on their to-do list.

"Women's sexual functioning is by and large above the neck," says Dr. Lynda Smirz, a gynecologist with Women's Health Alliance in Carmel. "Therefore, to find a medication that is able to produce the same results that Viagra does in a male is going to be virtually impossible."

There's one proven thing to improve a woman's libido, Smirz says: a new partner. While she's not advocating adultery, this offers proof of the power of women's minds.

Studies have also shown that women respond to placebos, testifying further to the link between the mind and sexual satisfaction, Smirz says.

"The guys can take a pill and immediately they're ready for sexual activity," she says. "Well, we're not ever going to have something like that for women."

Not that the drug companies aren't trying to find the female Viagra equivalent.

In many European countries, Intrinsa, a patch that dispenses testosterone and aims to increase sexual desire in surgically menopausal women, is already on the market.

Products being tested

LibiGel, a testosterone gel, is in trials here. If approved, this product could become the first on the market to treat all women with a low sexual drive. BioSante Pharmaceuticals says it hopes to have LibiGel approved and launched by 2011.

One nonhormonal product in the pipeline, flibanserin, is, like Viagra, a drug that was originally tested for one purpose (as an antidepressant) and is now being tested for its effect on sexual desire. But unlike Viagra, flibanserin would need to be taken regularly, not just when one planned on sexual intercourse.

Such a product might prove useful for women whose libido has dropped and who have a history of some cancers, such as breast cancer, that would make taking hormones risky for them, Martinez says. "Certainly we're headed in the right direction with options."

And some options already exist, such as Zestra, an over-the-counter topical product made of natural oils that's billed as a female arousal fluid.

But drugs or topical applications are not the only answer for women with low sexual desire, experts agree. Because so much of sex is mental for women, those who lack desire may benefit from either couples or relationship therapy, they say.

"Sex is not just a medication-treatable problem," the Kinsey Institute's Heiman says. "It's something that also responds to other kinds of intervention."

When love hurts

Some women, however, suffer from a decreased interest in sex because they find it painful.

About 6 million women of reproductive age suffer vulvodynia, pain that lasts at least three months without any known cause. Some women may experience it just upon penetration, even with a tampon. For some, the pain comes on suddenly; for others, it's gradual.

"Women describe the pain as sitting on shards of glass," says Christin Veasley, associate executive director of the National Vulvodynia Association.

While the cause of vulvodynia is unknown, there are some treatments available. Topical estrogen creams may help, as may antidepressants to control the pain. Alternative techniques such as biofeedback or acupuncture may also ease the pain.

For some women, a surgical procedure similar to an episiotomy that removes excess nerve fibers in the region will address the condition. Women with this condition have about 10 times as many nerve fibers in this area as women who are not affected.

Diagnosing this condition can be tricky, Veasley says. Many women are told they have recurrent yeast infections. Others are told it's psychological. Even once it's diagnosed and treated, however, vulvodynia can have a dramatic effect on a woman's sexuality.

"There's this loop that takes place. Women start to avoid sexuality," Veasley says. "When you have pain when you're having sex, that can be very difficult to reverse even once the pain has gone away."

With another rare condition, vaginismus, the woman's muscles contract involuntarily whenever penetration is attempted. Often associated with past trauma or pain, this condition can be addressed with treatment, which may include pelvic floor exercises and the use of insertable dilators.

Far more common, and more easily treated, is vaginal dryness, which can make sex more painful than enjoyable. Problems with lubrication affect about 70 percent of all women at some point in their sexual lives, according to statistics from Trigg Laboratories, which makes a range of lubricant products. While it's a common problem among menopausal women, dryness also can stem from other hormonal changes, dehydration, alcohol or certain medications and childbirth.

Despite signs that women are now more comfortable talking about their sexuality, too many who suffer do not raise the issue with their physicians, says Martinez. Nor are doctors asking their patients about their sex lives, but that is slowly changing, she adds.

"If you have a concern, you absolutely must raise it," Martinez says. "There's more help out there than there was five or eight years ago."