Another top-five book is The Sharp Brains Guide to Brain Fitness: 18 Interviews with Scientists, Practical Advice, and Product Reviews, to Keep Your Brain Sharp, which provides a macro view of the latest science, products and trends in brain health.This book is a great place to start for anyone who’s skeptical or confused about brain fitness, or wondering if there’s something that we can do to keep our memory sharp as we age.

The authors, Alvaro Fernandez and Dr. Elkhonon Goldberg, debunk 10 brain and brain fitness myths (i.e. our brain age cannot be reversed as some claim); explain neuroplasticity (the brain’s remarkable lifelong ability to change and rewire itself) and explain in detail what they see as the four pillars of brain maintenance, which are:

• Balanced nutrition
• Stress management
• Physical exercise
• Mental stimulation

In short, the latest research shows that when it comes to brain fitness, lifestyle does matter, which is good news since it suggests that we have some control over our cognitive abilities as we age.  What does this mean exactly? Read Alvaro Fernandez’ article, “The Ten Habits of Highly Effective Brains,” for a list of lifestyle options that you can follow to maintain and improve your brain.  My favorite?  ”Practice positive, future-oriented thoughts.”

If all of this piques your interest, consider participating in an upcoming, online series of Q&A sessions on Brain Fitness with the co-author of this book, Alvaro Fernandez (11/15) and two other leading thinkers on the subject of brain health:  Dr. Gary Small, author of The Memory Bible: An Innovative Strategy For Keeping Your Brain Young (11/1) ; and Dr. Paul Nussbaum, author of  Save Your Brain: The 5 Things You Must Do to Keep Your Mind Young and Sharp (11/22).  Click here for more details.

“All menopausal symptoms can be prevented or improved with a healthful lifestyle. One thing you can do is critique your caloric consumption and quit consuming crap!”

Last week, I attended the annual conference of the North American Menopause Society (NAMS), where 1500 attendees – physicians and scientists– gathered to hear the latest research findings concerning women’s health in midlife. The conference began appropriately with a full day devoted to hormone therapy:  what is known about the risks and benefits; the safety and impact of different delivery methods (transdermal vs. oral); the effects of
estrogen on mood and memory; and a look at the myths and facts about Bioidenticals.

Research presentations on subsequent days covered a wide range of health concerns including the possible link between hot flashes and cardiovascular disease; vaginal health, and hormone-free remedies for hot-flashes.  In the next few weeks, I’ll be sharing what I learned from these presentations as well as my conversations with physicians. For now, here are some of my initial take-aways:

1. Mention bio-identicals to 1500 gynecologists, as Dr. JoAnn Pinkerton, Director of the Midlife Health Center, University of Virginia, did in her presentation and you’ll hear a loud, collective groan. Suzanne Sommers and even Oprah continue to be a flash point for this group. Many of their patients want what they have without really knowing what it is they’re asking for.
2. “Adrenal fatigue” gets the same response. “It’s not a medical term,” Dr. Pinkerton explained to me. “Adrenal insufficiency, on the other hand, is a diagnosable condition that you can test for. Often, she told me, her patients self-diagnose their “constellation of conditions” such as fatigue, lethargy, and cravings for sweets, as adrenal fatigue, based on what they’re reading on the internet or in popular books.
3. There was lots of talk about vaginas:  happy ones and sad, dry ones too.  Apparently, too many 50+ women are not having sex due to the pain.  There are solutions. More on that in a future blogpost.
4. Women are at higher risk for depression than men and most vulnerable during times of hormonal fluctuations such as PMS, Peri-menopause and the early transition into menopause. In recent studies on menopause-related depression, transdermal Estradiol therapy proved to be helpful in women during the peri-menopausal phase or early post-menopause.
5. Hot flashes –  When it comes to Vasomotor research, the go-to person in this country is Rebecca Thurston Ph.D., an impressive scientist at the University of Pittsburgh, who is young enough to never have experienced one herself.  She’s investigating a potential link between hot flashes and cardio-vascular disease and if our BMI score influences the severity of hot flashes.  I spoke with her about her research and I’ll summarize what I learned in a separate blogpost.
6. There was a lively debate over whether hormone therapy, with its proven benefits for bone and vaginal health, should be recommended to women who don’t have symptoms. The arguments were compelling on both sides but the case made in favor of this approach prevailed by a hair. (so the debate doesn’t end here.)
7. The safety of estrogen is a point of contention between oncologists and gynecologists. To the former, who treat breast cancer patients, Estrogen is “the devil.”  To the latter group, it enhances a woman’s quality of life,  maintains their vaginal health (and thus their sex lives) during cancer treatments, and offers protection against  osteoporosis, if the latest research holds up.  Unfortunately, breast cancer patients find themselves  caught between conflicting recommendations.
8. More women die of cardiovascular disease than cancer yet more than 90% of the cases are preventable. Lifestyle factors such as diet, daily exercise, and getting enough sleep, can have a huge impact in the prevention of CV disease and diabetes, said Dr. Lori J. Mosca, Director of Preventive Cardiology at Columbia University.
9. Many women are taking too much Calcium, the result of overlapping doses among all the supplements they ingest. “More is not better,” said Dr. Steve Harris, an endocrinologist at University of California, San Francisco. He told the conference that the recommended dose is usually 1000-1200 mg per day, with an upper limit at 2,000 mg/day.
10. Finally, according to Dr. Patricia Sulak, Medical Director, Department of Obstetrics & Gynecology at Texas A&M College of Medicine, all menopausal symptoms can be prevented or improved with a healthful lifestyle. Her advice?  ”Critique your caloric consumption and quit consuming crap!”

Most moderate to severe menopausal symptoms occur due to the lack of consistent self-care over the course of one’s life prior to menopause.  Investing in one’s health at an earlier age pays off when the body gets older – getting enough sleep, physical activity, eating well for one’s constitution, etc.  A Chinese medicine practitioner can identify which foods may be helping or hurting you, and point you in the right direction with activities that can support your physical and/or emotional well-being that can be easy to incorporate.  And again, stress, is a very common theme — too much work, not enough sleep, relationship issues, professional ambitions, educational goals, children later in life or using fertility technology, etc. – these all stress the body – physically, mentally and emotionally.  So, do what you can to reduce the stress and overwhelm in your life.  Get help where you can get it; otherwise, ask trained professionals to guide you on your path to easing symptoms, and feeling more whole and complete.

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Helen Ye, MS, LAC is a licensed Acupuncturist and Chinese Medicine practitioner at the Institute of Health and Healing, California Pacific Medical Center in San Francisco.

In email correspondence last week, I asked Helen Ye, an Integrative Chinese Medicine practitioner (ICM)and Licensed Acupuncturist (LAc) at the Institute for Health and Healing in San Francisco, how Eastern Medicine’s approach to wellness can help mid-life women manage the symptoms of menopause in a way that’s more healthful and sustainable:

Wendy:  First, please explain the philosophy of Chinese medicine.

Helen: Chinese medicine’s goal is to bring balance to the overall system – physical, mental, emotional and spiritual.  When the body is out of balance, symptoms occur.  In ancient times, Chinese medicine practitioners did not get paid if their patients got sick; so the emphasis of the work is to keep the individual healthy and strong, preventing the individual from getting sick, and for the patient to follow the recommendations of the practitioner. Maintaining a balanced and generally moderate lifestyle for your constitution is the key to ensuring better health.

Wendy:  Describe a woman’s initial consultation with you. What can we expect?

Helen: An initial consultation with me will be very different from a Western physician.  A comprehensive intake noting your current symptoms, health history, family history, diet, sleep habits, stress management, and current and past life situations are discussed during your first visit.  In addition, I will feel your pulses in 9 positions on each wrist and take a look at your tongue.  I will be feeling for pulse qualities and noting different positions and levels.  Pulses provide information on different organ systems, and provides information on your emotional well-being as well.  The tongue provide additional information about long-standing issues and complement the information derived from your pulses.

Other diagnostic tools include visual observation of your face and other surface regions, listening to your voice and tones, and palpating different areas on the body corresponding to acupuncture regions, meridian pathways, and organ system.  These diagnostic methods inform me of your current health status, predispositions and what may have led to your current symptoms.  This is very different from a Western medical approach which uses blood work and other diagnostic technology.

Wendy: What modalities have you found to be especially helpful to women experiencing menopausal symptoms?

Helen: Within the Chinese medicine toolbox, acupuncture, customized herb blends and/or nutritional supplements, breath work, exercise, and techniques to manage stress are all extremely helpful to reduce insomnia, hot flashes, night sweats, mood swings/irritability, and heavy or irregular bleeding.  A single acupuncture treatment will not “fix” the problem, but will support you in noticing what the body feels like at complete rest.  Most often, a series of acupuncture treatments are most beneficial for your menopausal symptoms, and the combined use of herbal remedies and lifestyle recommendations are even more helpful.

Visit Helen’s website for more information about Integrative Chinese Medicine and details about what you can expect on your first visit.

Have you tried acupuncture or other Eastern medicine treatments to help alleviate menopausal symptoms? Did they help you?

So, to find out what you can do to reduce your risk of stroke, start by reading the April issue of Consumer Reports onHealth Newsletter , which devoted its cover story to new guidelines from the American Heart Association and the American Stroke Association for preventing a first stroke. As they explain, controlling your blood pressure and keeping your LDL cholesterol in a healthful range, through lifestyle changes and/or medication, can reduce your risks by a third.  I asked Dr. Orly Avitzur, a board-certified neurologist and medical advisor for Consumer Reports Health, how diet also influences our risk of stroke:

Dr. Avitzur: Studies have shown that diet does matter when it comes to your risk of strokes. One study demonstrated that each extra daily serving of fruit or vegetables reduced the risk of stroke by 6 percent.  Other research has linked sodium rich diets to a greater risk of stroke, and high potassium diets to a lower risk of stroke.  One diet that has been shown to work in reducing high blood pressure–one of the greatest risk factors for stroke–is the DASH diet (dietary approaches to stop hypertension).  It’s a 2,000 calorie a day diet that suggests 7-8 servings of grains, 4-5 servings of fruits, 4-5 servings of vegetables, 2-3 servings of low-fat dairy products, and 2 or fewer servings of lean meats. Snacks and sweets are limited to 5 per week. Although it does not restrict salt, combining it with a salt-restricted diet can improve blood pressure lowering. Though it can be tough, try to consume no more than 1500 mg of sodium–roughly two thirds a tsp of table salt a day, the maximum recommended by the AHA. (Most Americans go quite a bit over this amount).

A long-term study of 88,000 middle aged women, who followed these diet guidelines showed that their risk was reduced by 18 percent compared to those who did not.  That’s a substantial reduction, and one any one can achieve.  We can’t do much about our family histories but we can control our diets and make a real difference in our health!

Wendy: How does our BMI (Body Mass Index), and belly fat in particular, increases our risk of stroke?

Dr. Avitzur: Most women are concerned about belly fat, but for all the wrong reasons.  While appearance is one thing, your health is even more important.  And that extra fat around your middle can raise your risk of dying early if you have heart disease, even if you’re at your normal weight.  Research has shown that people with extra belly fat (as measured by waist-to-hip ratio) are nearly twice as likely to die as those with normal waistlines.  In fact, the risk is similar to that of smoking a pack of cigarettes a day!  Even people with normal body mass index (BMI) are at greater risk if they carry extra weight around their abdomen. So if you look at your middle and don’t like what you see, speak with your doctor about this risk and how you can whittle it down.

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Here are some additional resources where you can read more about cardiovascular health:

National Stroke Association- Unique Symptoms in Women

Everyday Health: How Do Strokes Affect Women?

WomensHealth.gov- Frequently Asked Questions

ABC News: Strokes HIt Women Harder

Another natural approach she said is worth trying is Mindfulness Based Stress Reduction meditation, which Dr. Low Dog explained was tested in a randomized study of 100 women who experienced five or more moderate to severe hot flashes daily. Participants experienced fewer hot flashes and they slept better as a result of MBSR. In fact, three months after they stopped meditation, they still felt better. For guidance on how to practice mindfulness meditation, Dr. Low Dog recommended books and DVDs by John Kabat-Zinn or Herbert Benson.

Dr. Low Dog also enthusiastically recommended acupuncture for the relief of hot flashes and overall fatigue.  She said that her patients have reported an enhanced sense of well-being and more energy as a result of treatments.

Dr. Low Dog’s discussion was sponsored by Pharmaca Integrative Pharmacy. Her slides will be posted on the retailer’s blog in the near future.

If you have a question that you’ve been too embarrassed to ask, or didn’t know who to turn to for answers, this is your opportunity to submit your question and hear from the experts.  If you can’t make the chat, you can email Judith Graham with your question and check the archived transcript at a later date.

In searching the paper’s archive of earlier live health chats, I found a conversation with two experts on hormone therapy that you will find informative and helpful in understanding the benefits and risks of hormone supplementation.

Pharmaca is also hosting a series of Menopause Events in their stores in early April. They’ll be holding free help sessions on hot flashes, sleep and stress issues, and hormones. They’ll also be offering bHRT consultations. I’ve always found their staff to be extremely knowledgable and helpful. So if you’re not getting the answers you need from your own doctor, this might be a good resource for you if you live nearby one of their stores in California, Colorado, New Mexico, Oregon and Washington.

On Thursday, March 17th, you’ll have a chance to hear expert advice on a holistic approach to getting better sleep from Dr. Bruce Bradley, a specialist in integrative medicine with a private practice in the San Francisco Bay area. He also is on the integrative health advisory board of Pharmaca, which is sponsoring this web talk.  To register for the one-hour talk, “Better Sleep: The Holy Grail of Good Health,” and even write in your own question , visit this website.  The talk begins at 5pm EST/2pm PST.

Getting consistent, good quality sleep is the cornerstone of good health. So if you’re experiencing sleep problems, and don’t know what to do about it, Dr. Bradley’s advice might turn out to be a good place to start.  I’ve already sent him my question.

It is so interesting to me that human nature is such that we are desperate to blame our “belly fat” on an imbalance of hormones. And the suggested cure is balancing hormones with bioidenticals. What happened to common sense; that as we age metabolism changes, body fat shifts, and it takes more exercise and fewer calories to maintain our desired 30 year old bodies. There are millions of women walking around with way too much body fat and nowhere near the age of  midlife. Endocrine hormones change too at midlife – like thyroid and cortisol from the adrenals – yet if tested the levels would look normal. So my opinion is the solution is much more complicated than just balancing hormones. Even Suzanne Somers takes a gazillion vitamins and works out like a maniac everyday to maintain her body and she stills looks like she is in midlife.  Sometimes accepting the change and then doing the best we can to stay in a healthy state is a gentler way to go. We women are way too hard on ourselves.