Eat Fat, Lose Fat: Dr. Mary Enig, a biochemist and well known researcher on healthy fats, thinks that no- and low-fat diets have made us lethargic and overweight. In her book, (first published in 2005), she makes the case for higher consumption of saturated fats and coconut oil in particular. In addition to weight loss, she writes that it can turn around many health ailments that plague menopausal women such as low energy, thyroid imbalance, food cravings, gas and bloating. She backs up her claims and recommendations with solid resarch. It’s certainly worth considering. See my column on Healthline.com this week for a more detailed review.

Wellness Letter (Newsletter from UC-Berkeley) -Medical experts at Berkeley’s School of Public Health caution readers against taking “thyroid support” supplements to treat a suspected thyroid disorder, help you lose weight, or feel more energetic. “Such compounds should be used only under doctor supervision because they require careful dosing and can cause serious cardiac and other adverse effects.” It’s tempting to self-diagnose and self-medicate when we have so many supplements to choose from, and experts who offer advice in magazines and on the internet. But it’s wise to get good advice from a medical practitioner before you begin supplements .

And on the lighter side….

Psychology Today – “Quotes About Stress That Will Tickle Your Funny Bone.”

We all know by now that too much stress can cause a lot of maladies like belly fat and high blood pressure. So, if you feel like your stress level is peaking, take a look at these quotes about stress. Maybe one or two of them will make you laugh and ta-dah… you’ll feel less stressed!  Here’s one example:

“God put me on this Earth to accomplish a certain number of things. Right now, I am so far behind I will never die.”

I’d love to hear about what you’re reading too. Magazine articles, newsletters, books, websites you’re following. Share the knowledge!

Last summer, I wrote about a randomized, placebo-controlled study (the gold standard in research) that showed 55 percent of women, given the anti-depressant, Lexapro, saw a significant reduction in the frequency and severity of hot flashes they were experiencing daily, though the women on placebo saw an improvement as well, just not as much.

More recently, a double-blind, placebo controlled clinical trial, with 205 participants, also showed some promise. These women were experiencing at least 28 bouts of hot flashes or night sweats a week. The results of that study, published last month, found that compared to placebo, 10-20 mg of Lexapro for eight weeks improved their quality of life by reducing hot flash “interference” and helping with sleep problems.

But another study involving two trials of 36 women, found that Lexapro didn’t help at all. The difference in results might be explained by the “placebo effect.” In the first two studies described here, the women kept a diary to record their hot flash symptoms, filling out a questionnaire every month. In this last study, participants wore detectors to capture objective measures.

Apparently, our desire for something – anything – to work is so powerful that just wishing for some relief makes you feel better.

Nevertheless, researchers continue to explore the use of antidepressants, such as Paxil, Prozac and Effexor, for hot flashes, and a few studies, using these products at low doses, worked for some women, but not all.

To date, the only solution that has been proven to work for hot flashes is hormone therapy. For women looking for a hormone-free alternative, there isn’t better news on the “natural” front. Herbs such as Black Cohosh, Dong Quai and Red Clover (shown here), can help some women for some period of time, but the results are often as unreliable as anti-depressants.

I’d love to know what, if anything, has worked for you.  What have you tried that you gave up on?

Called Hot Girls Pearls, they are available in three different lengths as well as a matching bracelet; in three colors – white, blush and gunmetal- and come with a travel purse with icepack. The bracelet sells on her website for $32 and the necklace costs from $56 to $60 depending on the length.

Hot Girls Pearls would get my vote for a product of the year award. It’s a fabulous idea.

But who can we turn to for answers and guidance? The internet is rife with biased and and unreliable information. Research findings that make headlines are often contradictory from one week to the next. And a brief, 10-minute office visit with your doctor just won’t cut it. As I said, it’s just too complicated.

Dr. Lisa Larkin (pictured above), a gynecologist who is Director of University of Cincinnati Health’s Women’s Center, understands the short-comings of a brief office visit for all patients, but particularly for menopausal women who require more education. That’s why she began organizing 90-minute group appointments called shared medical visits for these women as a way to enhance and supplement the care they receive individually.

The SMV concept was first tried over a decade ago at Kaiser Permanente in San Jose, CA, and it is now used at medical facilities around the country such as Harvard Vanguard in Boston and the Cleveland Clinic. It allows patients to ask questions and learn from others who are experiencing the same thing and it’s particularly helpful to those who have ongoing, complicated health issues that require education and pro-active self-care.

I emailed Dr. Larkin to find out how they were being received at the Women’s Center. She told me that the last one was about six months ago and “it was something that the patients found very productive.” She explained how it worked;

“I opened the visit with a ten-minute or so briefing on recent information and evidence-based protocols from the North American Menopause Society (NAMS) and other sources. Then each patient shared her reasons for the visit and what symptoms/issues she was facing, and I thought it was interesting that every one had a different concern. For example, one suffered from severe hot flashes, another had decreased libido, one had a history of breast cancer and one had been using pellets and was looking for more information. There was a very lively discussion and much interaction between the women during the nearly two-hour session.”

I think the shared medical visit is ideal for patients with chronic conditions – and I’d put menopause in that category if a woman is experiencing months of life-disrupting symptoms such as insomnia, heart palpitations, and hot flashes. I’d like to see more medical practices give it a try and I plan to recommend it to my gynecologist.

If you live in Cincinnati, Dr. Larkin has scheduled another SMV focused on perimenopause and menopause on Thursday, May 24th from 6:30p to 8:00pm. For information and registration, visit her website.

If you don’t live nearby, Dr. Larkin will be launching a monthly chat on Twitter about women’s health issues. The first one, about menopause, will be on May 16th from noon to 1pm EDT. She’ll be using the hashtag #LarkinChats and her Twitter handle is @LisaLarkinMD.

“With the right ingredients, a smoothie can deliver the nutrients you need to achieve two goals: correcting estrogen dominance…and balancing your blood sugar, which is vital for managing your weight and hormone health.”

Earlier this week, I posted the first part of my email conversation with Kristine Miles, author of the just published The Green Smoothie Bible. The first half of the book is a primer on smoothies: what they are, how to make them, and why they’re so good for you. The second half is a recipe book –  300 of them arranged by health benefit, as well as by season, so you can use ingredients that are fresh and readily available. I asked Kristine about the chapter called “Happy Hormones.”  I was curious: what makes a smoothie “hormone friendly?”  Here’s the rest of our conversation:

Please explain what makes a smoothie “hormone friendly.”

With the right ingredients, a smoothie can deliver the nutrients you need to achieve two goals:  correcting estrogen dominance, which can cause symptoms such as mood swings, migraines and weight gain; and balancing your blood sugar, which is vital for management of weight and hormone health.  My recipes thus include fiber dense foods, low glycemic carbohydrates, the minerals chromium, magnesium and zinc, as well as cinnamon, Vitamin C and coriander/cilantro.

What are some examples of foods that are especially beneficial for women?

Whenever I can, I like to include beets, spinach, goji berries, avocados and lots of leafy greens because these foods contain the compound Betaine, which can combat high levels of homocysteine, an important amino-acid, that in excess can contribute to conditions such as heart disease. There are also foods that can help remove “bad” estrogens, derived from our daily exposure to toxins and chemicals, that can lead to estrogen dominance. These foods include lemon and lime peel, apples, cruciferous vegetables and iodine-rich foods such as seaweed. In addition to a whole-food, plant-based diet, hormone health can be boosted by adequate intake of essential fats; vitamins B3 (abundant in cremini and shiitake mushrooms) and B6 (bananas, watermelon); super-foods such as maca, bee pollen and cacoa; and the minerals magnesium and zinc.

“I never drink pure fruit or root vegetable juice, as I believe it’s way too high in concentred sugars. The flood of sugar into the blood, not slowed by the lack of fiber, may result in disorders of blood sugar metabolism such as diabetes, candida overgrowth, and weight gain, particularly around the belly.”

If you’re a fan of smoothies, or if the proliferation of smoothie bars has piqued your interest, then you’ll love Kristine Miles’ new book, The Green Smoothie Bible, which contains everything you need to know about this super-nutritious, milk-shake-like drink: what they are, why they’re so good for you and how to make it. Kristine, an Australian physiotherapist, is a life-long vegetarian, and raw-food enthusiast who is passionate about nutient-packed smoothies. After years of research and experimenting, she has given us her 300 best recipes, organized according to the health benefits each one offers. So, if you’re looking for a daily dose of greens that will support cardiovascular health, weight loss, or hormone support, Kristine has a recipe for you.

In a recent email conversation, I asked Kristine about her passion for smoothies and the basics of smoothie-making. Later this week, I’ll post the second part of our conversation, in which she explains what makes a smoothie hormone-friendly.

My passion for smoothies, green smoothies in particular, came from reading the raw food book “Green For Life,” by Victoria Boutenko, the pioneer of the green smoothie movement. The concept of blending greens to maximise nutrient assimilation and combining them with fruit for palatability, instantly resounded with me.  I have always loved just fruit for breakfast, but it never sustained me ’till lunchtime. Green smoothies solved all of these issues. 

Wendy: What’s your favorite smoothie — the one you probably have a gallon of in your refrigerator?

My favourite smoothie varies depending on the seasons. I am a big fan of seasonal smoothies. I love it in late spring and early summer when mangos are everywhere and I love combining mango with banana, or with orange. But by late summer, I am well and truly over mango smoothies! In my book I devote a chapter of green smoothie recipes each to each season.

Wendy: Do you use Smoothies as meal replacements?

I will have a green smoothie as a meal and it is always my breakfast. Half a liter sustains me to lunchtime because it is so nutrient dense and contains a high amount of fiber.  I know some people drink 1 litre/quart per day or more, but I make this amount and share it with my husband. I still like a lunch and dinner that I ‘eat’, and find drinking more smoothie between meals too much. Sometimes I blend greens into juice to get more blended greens into my day without it being so filling. I may do this before dinner which means I eat less!

Wendy: Are you juicing AND Blending?

Generally speaking I juice very little. Juicing removes the fibre from the liquid end product and blending incorporates the fiber. Most people do not eat the recommended 25 to 30 grams of fiber daily. If I use juice, it is usually freshly squeezed orange juice, which is easy with a manual citrus juicer, or I occasionally juice with my old centrifugal juicer, to juice things like celery and fennel that are very fibrous. I never drink pure fruit or root vegetable juice, as I believe its way too high in concentrated sugars. The flood of sugar into the blood, not slowed by the lack of fiber, may result in disorders of blood sugar metabolism such as diabetes, candida overgrowth, and weight gain, particularly around the belly. 

Wendy: What equipment is required?

To make green smoothies you need a blender, preferable a high speed one. Less expensive ones will work, however they will break down, because you give the blender a big workout having to break down lots of fiber. Blendtec and Vitamix are popular brands. However, my preferred blender is called a Thermomix. It’s not just a high speed blender, it is also a food processer, milling machine, cake mixer, ice-cream maker, it cooks, and more. It’s from Germany and has been around since the 1960s. It has been in Australia where I live, for 10 years and is unfortunately not available in the USA, unless you get one from Mexico or Canada.

*   *    *    *   *   *

Is it Crohn’s Disease or Lactose Intolerance?
Healthline.com

This article, which provides an important comparison between the symptoms of Lactose Intolerance and Crohn’s Disease, can be found on the front page of Healthline.com (where you’ll also find my article about “Foods to Boost Memory”). Many of the symptoms are the same and it’s possible to be misdiagnosed. Since one is harmless, and the other isn’t, it’s a good idea to be knowledgeable about the differences.

Younger Women Need Improved Awareness of Their Heart Disease Risks
Women’s Health Advisor (A subscription newsletter published by Weill Cornell Medical College) April 2012

This newsletter’s lead story reports on the need for women to be more educated about the risks of heart disease and stroke.  In general a higher percentage of women than men die as a result of heart disease and stroke.  Among women in their 30s and 40s, the cardiovascular mortality rates are rising due to manageable risk factors such as preventive care, blood pressure management and healthy eating.  They assume that heart disease and stroke are something that happens later in life.

Bottom line? Know your risk factors for heart disease and get regular check-ups.  I will be writing more about this topic in the coming weeks.

Do You Need Three Meals a Day?
Consumer Reports on Health (By Subscription, March 2012)

A recent study suggests that it’s not the number of meals you eat that matters, but the total number of calories consumed. Whether you eat three main meals, or prefer six smaller ones, the bottom line is not to over eat.  If you’re watching your weight, and opt for smaller, more frequent meals to curb hunger pangs and keep your blood sugar steady, try to limit them to 300-400 calories each and stick to those that are nutrient-dense.

**BONUS**  Whether you’re celebrating Easter or Passover this weekend, you’ll find inspiration and recipes for a plant-based, festive meal at HappyHealthLongLife.com, the blog of the Healthy Librarian.  She lives a vegan, no oil, gluten-free life and she seems to have a heck of a lot of fun.  We could learn a thing or two from her.

I’d love to hear about what you’re reading too.  Magazine articles, newsletters, books, websites you’re following.  Share the knowledge!

“Less than 24 hours after publication, there were already 443 ‘chocolate makes you thin’ stories on the newswire to further misinform an already nutritionally confused world.”

Eat Chocolate and Get Thinner. Chocolate Makes You Fitter. Those were the headlines last week, based on the findings of a study published in the Archives of Internal Medicine and an a University of Calif.-San Diego press release titled “Regular Chocolate Eaters are Thinner.”  What delicious news! We all so wanted to believe that chocolate was a “free” food. But was it believable? I think deep down, we knew it must have been one of those PR type things. But heck, an ounce a day of chocolate can’t hurt anyway. There seem to be so many studies showing that chocolate is good for you!  We’ve even know about the benefits of Resveratrol thanks to a 2008 study by Hershey’s Center for Health and Nutrition.

But one doctor, Yoni Freedhoff MD, the founder of a nutrition and weight management center in Ottawa, has blown the whistle in an article that appeared last week on his blog, “Weighty Matters.”  He argues that there’s no growing body of evidence suggesting that chocolate is magically calorie neutral (or calorie negative). Moreover, he wrote, the study that these headlines were based on was grossly flawed (my words, not his);

“Basically here we have a study with no controls whatsoever rendering conclusions impossible, authors who rather than mention their study’s pretty much insurmountable methodological limitations instead made up a “growing body of literature” on magic calorie neutral or negative foods, a press release that spins it all as fact and as a result, as of early this morning, less than 24 hours after publication, there were already 443 ‘chocolate makes you thin’ stories on the newswire to further misinform an already nutritionally confused world.”

I’m sure that chocolate sales soared this past weekend as a result of last week’s news headlines. But sadly, the truth has come out, as it always does sooner or later. Dr. Freedhoff did us a favor, really. He weighed in on this study quickly, so we didn’t gain too much weight from all the chocolate we began eating.  And he also reminded us to not believe everything you read, especially when it comes to  health claims.  There may be merit to other claims about chocolate’s powers, but weight loss apparently isn’t one of them.

Related Reading (Studies that confuse or mislead, rather than educate, the public)

The Latest Bad Rap on Supplements

Vitamin Studies Spell Confusion for Patients

Permalink:  http://www.menopausetheblog.com/2012/04/02/consuming-chocolate-makes-you-thinner-i-knew-it-was-too-good-to-be-true/

“Montclair Soaps are made without parabens, wax or synthetics. And they use 100 percent pure essential oils for scent. Or not. They’re available without fragrance too.”

For several years, I’ve been making an effort to reduce my exposure to chemicals in my food, my home and especially in the products I use on my body.  When you consider just how many personal care products women typically use just to get out the door in the morning, it makes sense to switch to brands that contain only natural or organic ingredients whenever possible.

This explains my ongoing quest for finding the perfect, hand-crafted soap: chemical and synthetic free, not sweet or overly scented, moisturizing, with a pretty good lather. I seek them out at farmers markets and boutiques wherever I go, near and far. I’ve found some good ones over the years, but I really hit the jackpot last Fall with a soap made by Montclair Skin Care, a start-up company located in the San Francisco Bay area where I live.

The founder, Kim Emanuel, an engineer by trade, started making soaps for his wife, who had become ultra-sensitive to the chemicals found in commercially-made, personal care products when she hit the menopause years. He was soon making soaps for her friends, and friends of friends, then selling them, along with additional skin-care products he developed, at local farmers markets on weekends, where they were a big hit. Keeping up with orders from his website and now, four Bay-area Whole Foods Markets, has become more than a full-time day job for Kim.

Montclair’s cold-process soaps are made without parabens, wax, or synthetics. And they use 100 percent pure essential oils for scent. Or not. They’re available without fragrance too. I love the creamy lather they produce and they’re gentle and moisturizing enough to use on my face and even shave with. My favorites are Lemon Verbena, Pear and Fresh Tangerine. They’re yummy.

You can see the complete line of Montclair Skin Care products (including body butters, face creams and lip balms) and an explanation of the ingredients used to make their products, on their website. And, thanks to Kim, if you see something you want to buy, be sure to enter this code KUKUINUTS for a 15 percent discount – good through the end of April.

Do you also have a favorite soap?

“The small intestine is simply not designed to digest large amounts of processed carbohydrates.”

 - Dr. Robynne Chutkan, Gastroenterologist and founder of the Digestive Center for Women, Chevy Chase, Md.

A common, but uncomfortable symptom of menopause is bloating of the abdomen. It’s so prevalent among women in their 40s and 50s that Dr. Robynne Chutkan, a Gastroenterologist and founder of the Digestive Center for Women near Washington, D.C., is writing a book about it. In a recent telephone conversation she told me that bloat is one of the most frequent complaints she hears from her patients. So, I asked her to explain the causes of bloat and why so many women (and so few men) experience it. Here’s an excerpt of our conversation.

First, what motivated you to spend the time to write a book about bloat?

Dr Chutkan: There isn’t a cocktail party, yoga class or school meeting that I go to when I don’t get asked about this condition. Every woman I meet seems to suffer from bloat at some point in her life and there are many causes, besides just constipation, that people don’t know about.

Why is bloat more common in middle age and why don’t you hear men complaining about it too?   

Dr. Chutkan: To begin with, the problem is linked to motility (how fast food moves through the digestive tract). This tends to slow down around the time of perimenopause in women, most likely due to fluctuating hormones.  It happens to men much later in life – usually in their 70s and 80s.

Then, there are the significant anatomical differences between the male and female colon. For example, it takes me three times longer to do a colonoscopy on a woman than a man. That’s because the female colon is 10 cm longer and much like a slinky- all tangled up with lots of redundancy. By contrast, a man’s colon is shaped like a gentle horse-shoe.

Also, the female pelvis is wider to accommodate a fetus, so the colon falls deeper down into the pelvis and must compete for space with other organs. Thus, the colon ends up wrapping around the uterus, ovaries, and Fallopian tubes and blockages, backups and bloating occur in all those twists and turns.

Are there certain foods that typically cause bloating?

Dr. Chutkan:  Yes. Three types of foods in particular can be troublesome:

Dairy Products

Seventy-five percent of the world’s population is lactose intolerant and many develop it as they get older. It’s often the case that we do okay with a small amount, say a few nibbles of cheese.  But a couple of slices of pizza will cause distress. Things that have less lactose in them, like hard cheeses and yogurt, are generally better tolerated in small amounts.

Fatty Foods

Receptors in the stomach can distinguish between fat, carbohydrate and protein. Of those three food substances, by far, fat is the most difficult to digest. So when the chemical receptors in the stomach sense that there is something of a high fat content, like dairy, it slows down the emptying of the stomach to have more time for digestion.

Gluten

The small intestine is simply not designed to digest large amounts of processed carbohydrates. It’s not that Gluten is the devil. Certainly if you have celiac disease, you have to avoid it. But if all you’re eating is gluten-free substitute breads, pancakes, and brownies, it doesn’t make much sense. Fruits and vegetables and lean protein are all naturally gluten-free and should be the mainstays of our diet.

Is the timing of meals a factor?

Dr. Chutkan: Yes. The GI tract is tied in with the light/dark cycle, so it is much less active after sunset. So many people starve themselves during the day, then eat 1200 calories in the evening. That certainly contributes to bloating.

How do you know if its bloat or belly fat? 

Dr. Chutkan: Measure your waist circumference every couple of days. If it’s fluctuating, it’s more likely that you’re bloated. If it’s the same every day, maybe it’s because you’re gaining weight in the middle.

What do you suggest as a remedy for bloat?

Dr. Chutkan: If increased gradually, fiber can be very beneficial for bloating, particularly if part of the cause is constipation since fiber helps with laxation. But remember, too much fiber, too quickly, can worsen bloating. Some people need to use an osmotic cathartic type of remedy like Miralax initially to help with elimination as they increase the fiber.

When should a woman consult a doctor about bloating? Could it be a sign of a more serious medical condition?

Dr. Chutkan: Bloating can be a symptom of several diseases that you may not know you have.  Hypothyroidism is just one example.  Fibroids, fibromyalgia and even parasites can also cause bloating.  However, If you just feel off, and you’re fatigued,  listen to that inner voice.  Consult your GI doctor. I’d also recommend having a thorough exam by your gynecologist and ask your internist to check your thyroid function.  

* * * * * * * * * * * * * * * * * * * * * * *

Additional Reading:

Recently Dr. Chutkan discussed the importance of fiber in our diets in a webinar that I attended. I summarized her comments in a blogpost last month.