“As we age, changes in collagen occur that may account for age-related skin changes… and also contribute to deterioration in bone quality and quantity.”

Is it possible that deep brow furrows are an early indicator of osteoporosis later in life? The findings of a recent study suggests that the more wrinkles a woman has in her early menopause years, the lower her bone density, putting her at risk for bone fractures. The association may seem like a stretch at first. But Dr. Lubna Pal, an endocrinologist who led the research at Yale’s School of Medicine, explained:

(Bones and skin) share common building blocks — a group of proteins called collagens. As we age, changes in collagen occur that may account for age-related skin changes… and also contribute to deterioration in bone quality and quantity.

In this study of 114 women in their late 40s and early 50s, none of whom were on HRT, skin wrinkles at 11 sites on the face and neck were measured and participants underwent DEXA scans. The researchers found that women with the worst wrinkles had the lowest bone density scores. Conversely, those with firm skin and the fewest wrinkles, particularly in the forehead area, had greater bone density.

If this research is further substantiated, and skin does in fact provide a glimpse into the status of the skeleton, it may be possible to determine our bone strength by simply looking in the mirror.

The debate over when and how often to get screened for breast cancer surfaced again this week following the release of a study by researchers at the University of California San Francisco that concluded that annual mammograms aren’t necessary for most women.  The timing of these latest findings, during Breast Cancer Awareness Month, when screening for early detection is being promoted, left a lot of women confused and angry. We reacted the same way in 2009, when federal guidelines recommended mammograms every two years starting at the age 50.

What makes annual screening such a hot button is the prevalence of false positives in mammography.  Besides causing a lot of fear and anxiety, these can led to more harmful and expensive interventions than required, according to those who favor less frequent screenings.  As explained in a UCSF statement released this week, ”more than half of cancer-free women will be among those summoned back for more testing because of false-positive results and about one in 12 will be referred for a biopsy.”

The study also looked at nearly 4500 women who had been diagnosed with invasive breast cancer and found that roughly a quarter of all breast cancers detected by mammograms were late-stage whether women were screened every year or every other year.

Once we set aside the emotion (as in “I don’t care what these studies show, I’m going to have my annual screening!) consider what Dr. Susan Kutner, Chair of the Kaiser Permanente Northern California’s Breast Care Task Force had to say about this latest study on a local San Francisco Public Radio Program .

“It’s a general recommendation, but it really needs to be personalized. That’s what the information is telling us.  It’s not a one size fits all. You need to consider family history, the breast exam, and what a previous mammogram tells you about the value of mammography.  It’s important to individualize each woman’s set of preventative recommendations that would really help and encourage them to have screenings that’s appropriate for their risk factors, their previous physical examinations and for their own sense of risk.”

In other words, consider what the recent evidence shows and review with your own doctor how these latest findings pertain to your own situation.  That’s the best way to determine how often you should be screened.

Have the federal guidelines and these new findings changed your view of how often you should be screened?  One of my friends told me she’d rather have a false positive than risk having an undetected breast tumor.  Do you agree?

“Just thinking that Flaxseed will help seems to do the trick for many women”

Hot flashes and night sweats are the number one complaint of menopausal women.  For most women they last four to six years. For others, they can persist well into their 70s. That’s why, if there’s a glimmer of hope that something – anything – can help reduce their frequency, it’s worth a try.  Flaxseed falls into that category.  Some women find that adding a couple of tablespoons to their cereal every day helps cool them off.  Is it the estrogenic effect of the plant’s phytoestrogens that’s helping? Or is it just wishful thinking? And, as long as it helps, does it really matter? Consider these latest research findings:

Researchers at the Mayo Clinic randomly assigned 188 women to eat either a daily flaxseed bar containing 410 milligrams of lignans or one that was flax-free. Many of the study participants experienced hot flashes at least four times a day. Over six weeks, more than one third of the women in both groups had a 50 percent reduction in the frequency and severity of their hot flashes and they said that their symptoms were moderately to “very much” improved. Yet, according to the study’s senior researcher, Dr. Debra Barton, they concluded that “there’s little compelling information to try flaxseed if the objective is to reduce hot flashes.”

There’s obviously a strong placebo effect, but isn’t that the case with all medicines whether they’re prescribed or “natural?”  To me, this study suggests that just thinking that Flaxseed will help seems to do the trick for many women and that could mean getting a solid night sleep once in a while.

Interestingly, a small pilot study, without a control group, but also conducted at the Mayo Clinic earlier this year, found that crushed flaxseed worked very well for 29 women who had at least 14 hot flashes a week. The women said it really helped them, according to the director of the Mayo Clinic’s Breast Clinic.

Today’s news reports about this study will leave menopausal women very disappointed if they don’t read beyond a headline like the one that appeared in The Vancouver Sun: “Study Throws Cold Water on Hot-Flash Benefits of Eating Flaxseed Daily.” IMHO, Flaxseed is worth a try if you haven’t found anything else that’s helped.  You just have to think positively!

What’s your experience with Flaxseed?  Has it helped you?

Related blogposts you might be interested in:

Designer Flaxseed form a North Dakota Farm
Flaxseed for Hot Flashes?

Yesterday, I set out to write about the latest findings of a government-funded research study that concluded that in older women, several commonly used dietary vitamin and mineral supplements may do more harm than good; even, in some cases, causing a small increase in the risk of death.

Death?  Really?  From Vitamin B6 and multivitamins?

There must be more to this than was being reported, so I decided to go to the source, The Archives of Internal Medicine, where the findings were published,  and read the study myself.   Here’s what I learned.

First: The Facts

Researchers assessed the use of 15 vitamin and mineral supplements (including multivitamins, Vitamins B6, C and D, folic acid, magnesium, Iron and Calcium) in relation to total mortality in nearly 39,000 women in the Iowa Women’s Health Study. The participants were just under 62 years of age when they began the study in 1986.  Supplement use, which was self-reported via a health questionnaire three times over 19 years, was widespread among these women and increased over the years.

In yesterday’s news reports about this study, we learned that the researchers found a small increase in the risk of death among older women who took dietary supplements compared with those who didn’t.  However, what wasn’t reported in many news accounts was the fact that the women in the study who took supplements tended to be healthier, more physically active and had lower rates of diabetes and high blood pressure, with a lower BMI and waist-to-hip ratio than women who didn’t. Their diets were healthier too.  Nevertheless, the women who took an iron supplement or multi-vitamin showed an increased risk for early death. Those who self-reported that they took Vitamin B complex, Calcium and Vitamins C, D, E had significantly lower risk of death compared with non use.

Over the 19 year period that these 39,000 women’s histories were tracked, about 16,000 – or 40 percent – died. Yet, the research did not explore whether supplements contributed to their deaths.  That’s because they didn’t know why the women were taking the supplements in the first place.

Conclusions 

So, can we conclude that vitamin and mineral supplements are a waste of money and even harmful. Does this study prove that the “try it, it can’t hurt,” attitude is old thinking?

The study’s first author, a researcher in nutrition at the University of Minnesota’s School of Public Health said, “this paper contributes to the growing amount of studies showing no benefits for supplement use in the prevention of chronic diseases. Millions of Americans take these, but there just don’t appear to be a lot of benefits.”

Bonnie Jortberg, a registered dietitian and senior instructor at the University of Colorado School of Medicine in Denver, said the research “bolstered arguments against using supplements other than in cases of known nutritional deficiency.”

Dr. David Heber, director of the UCLA Center for Human Nutrition, speaking to the  L.A. Times said, “I wouldn’t recommend anyone change what they’re doing based on this study. It’s very hard to conclude cause and effect.”

The Alliance for Natural Health, a non-profit organization self-described as “committed to protecting access to integrative medicine,” called this study “junk science.”  “To say the data is “unreliable” would be a generous description,” they wrote on their website yesterday. “In the study, all of the relative risks were so low as to be statistically insigificant. This kind of “data” has no place in a valid scientific study.”

IMHO, the findings of this study didn’t convince me that I should stop taking supplements. On the contrary, I feel better knowing that at least two of them, Vitamin D and Calcium, won’t likely be the cause of my death. Magnesium, which was among the 15 supplements assessed,  has helped reduce the frequency of leg cramps that wake me up at night.  So with a clear benefit for me, why should I stop taking this?

As with all studies, it makes you think about our own behaviors.  With so much money being spent on supplements — $11.8 Billion just last year, according to the Nutrition Business Journal –  maybe we should heed the advice of those scientists and medical professionals who say we should get all the nutrients we need from food whenever possible and only use supplements to correct diagnosed deficiencies.

What’s your take on this? Do you plan to cut back on the number of supplements you’re taking?

Related stories you might be interested in:

Use of Vitamins, Supplements Up
Vitamin Studies Spell Confusion for Patients 

A new research study is about to get underway that will investigate whether taking daily supplements of Vitamin D and fish oil reduces the risk for developing cancer, heart disease and stroke.  The study’s co-director, Dr. JoAnn Manson of Harvard Medical School, told me during the recent conference of the North American Menopause Society, that their goal is to enroll 20,000 men and women across the U.S. and they will be recruiting participants until the end of the year. Would you like to enroll in this important research study?  Here are some additional details:

The VITAL study (VITamin D and OmegA-3 TriaL) is being funded by the National Institutes of Health and is being run by Harvard Medical School and Brigham and Women’s Hospital in Boston. Everything you need – the pills and forms to be filled out – will be mailed to the participants, so it doesn’t matter where you live. No clinic visits will be required. And each year that you are in the study, you’ll receive a questionnaire that takes only 15-20 minutes to complete.

Here’s a link for more information and instructions for how to enroll.

Drinking coffee not only helps you start your day, it just might make you feel better too, according to a recent study that found that depression risk decreases with increasing caffeinated coffee consumption. How much did it take to see a difference?  The women who consumed as much as 4 cups a day saw the greatest results — a risk reduction of 20 percent.

As noted in the study’s commentary, the effects of caffeine – both good and bad – has been explored in previous studies relating to cardiovascular disease, inflammation and certain types of cancers.   This is the first large-scale study of coffee consumption to evaluate a mental health outcome in women, who are particularly vulnerable to depression during periods of hormone changes such as peri- and post-menopause.  And while the results are promising, the researchers cautioned that more research is needed to confirm this finding and to determine whether usual caffeinated coffee consumption can contribute to depression prevention.

As Dr. Scott Bea, a psychologist at the Cleveland Clinic commented on Twitter, “we shouldn’t rush to the conclusion that I should drink more coffee if I don’t want to be depressed.”

The study, which was led by researchers at the Harvard School of Public Health, followed more than 10,000 women, average age 63, for more than 10 years.   All of the participants were enrolled in the ongoing Nurses Health Study, which commenced in 1976 and has led to many new insights on health and disease.

In evaluating three large studies that tracked 120,000 men and women for up to 20 years, they discovered that a few foods in particular “absolutely” contributed to weight gain, while others did not. “It’s not just eat less of everything.  It’s eat more of the foods that help you feel full and less of other things,” explained Dr. Dariush Mozaffarian, associate professor in the Harvard School of Public Health, who led the research.  So, what are the five foods that were most strongly associated with weight gain?

• Starches, namely potatoes and potato products — chips were the biggest culprit. People who increased their intake of these products gained weight
• Meats – processed and unprocessed came in second
• Refined grains and sweets- bagels and white bread act just like sweets suggesting that sugars and carbohydrates have the same relationship with weight gain if they’re refined

The researchers also found that sweetened drinks were most strongly associated with weight gain followed by 100% fruit juice. Dairy drinks – low fat or whole milk, didn’t impact weight gain either way.

Now the good news. Several foods were associated with less weight gain when their consumption was actually increased.  Dr. Mozaffarian said this suggests that when you increase your portions of these more healthful foods, you will likely decrease your intake of calories elsewhere:

• Fruits and Vegetables
• Nuts
• Yogurt
• Whole grains

To prevent long-term weight gain, “we have to pay more attention to the quality of our diet not just the quantity of what we’re eating and drinking,” sad Dr. Mozaffarian, who discussed the study’s findings in a video posted online here.

The study appeared in the New England Journal of Medicine (6/23/11)

The study – a randomized, placebo-controlled trial involved 205 women over eight weeks of treatment. Half  took 10-20 mg/day of Lexapro. The others were given a placebo.  The result? 55% of the women in the active treatment group and 36% of the women in the placebo group experienced half as many hot flashes.  And the hot flashes they did have were less severe.

Dr. JoAnn Manson, Professor of Medicine at Harvard Medical School, Brigham and Women’s Hospital, who explains the findings on the video, said though more research is needed,  the study suggests that SSRI (serotonin-reuptake inhibitor) anti-depressants like Lexapro “appear to be an important option to add to our arsenal of treatments for hot flashes and vasomotor symptoms.”She also urged physicians to remind patients that “lifestyle modifications, such as layering clothing, lowering thermostats and avoiding hot flash triggers such as hot coffee, alcohol, spicy foods and cigarette smoking can help reduce symptoms.”

In this study of 248 women ages 45 to 60, half were were given 200 milligrams of soy isoflavones daily (a much bigger dose than you or I would ever consume) and the other half were given a placebo.  At the outset, nearly all complained of the most common menopausal symptoms; hot flashes, night sweats, insomnia, loss of libido and vaginal dryness.

After two years, the study participants were tested for changes in bone mineral density and in menopausal symptoms. Despite the large dose of soy isoflavones, researchers found no difference in the rates of bone loss between the two groups.  There also was no significant change in other symptoms such as hot flashes.  In fact, by the end of the study, more women in the soy group reported hot flashes compared to the placebo group, 48 percent to 32 percent. Moreover, almost all of the participants (those taking the soy tablets as well as the placebo) reported adverse effects such as constipation, bloating and vaginal bleeding.

Many women who fear hormone therapy, or just want to try natural remedies, turn to soy tablets or a diet heavy in soy, thinking that it will prevent the common symptoms of menopause.  But this study showed that soy isoflavones are too weak an estrogen to make a difference. “Soy supplements can’t be considered a remedy for menopausal symptoms or prevention of bone loss,”  Nancy Strickman-Stein Ph.D., the epidemiologist and analyst for the study told me today. “Women will need to reach out to more traditional modalities to prevent bone loss and hot flashes, including the use of FDA approved drugs and exercise.”

The median duration of moderate-to-severe hot flashes was 10.2 years.  If the hot flashes began at the onset of menopause, they lasted a year longer. But if they occurred during the late transition or post menopause, they lasted just short of 4 years. Big difference!   Surprisingly, hot flashes persisted slightly longer in non-obese women than obese women and in black women more than white women.

Experts have told us that the most effective treatment for hot flashes is hormone therapy, but for the shortest possible time, due to the health risks associated with HRT. So, if hot flashes can last a decade or more, where does that leave us?  Very hot and miserable! You might want to stock up on those pretty fans (shown above) from The Bitty Breeze before they close shop on June 1st.