WHEN HEARTBURN IS DEADLY

Increased incidence of acid reflux appears to be linked to a spike in one form of a particularly

     Lethal cancer

 

One out of 5 Americans experience heartburn or acid reflux on a weekly basis; 40 percent of us deal with it at least once a month.  In many cases, we just blame the hot sauce and take an over-the-counter medicine to remedy it. Perhaps it’s time to think differently.

Esophageal adenocarcinoma—cancer of the lining of the soft tube that delivers food and drink from the mouth to the stomach—has increased sevenfold since the early 1970s, says Paul Oberstein, director of the gastrointestinal medical oncology program at NYU Langone’s Perlmutter Cancer Center in Manhattan.  The American Cancer Society estimates that 15,850 Americans will die of esophageal cancer this year. Eighty-five percent of esophageal cancers are found in people 55 and older; roughly four times as many men get the disease as women.

“It’s one of the fastest-growing issues we have in our population,” says David Odell, assistant professor at Northwestern University Feinberg School of Medicine and lead investigator on a study of esophageal cancer funded by the American Cancer Society.

The cancer’s increase has paralleled the rise of gastroesophageal reflux disease (GERD), the medical name for when you have bouts of acid reflux two or more times per week.  GERD has several causes, led by obesity, a tendency toward large meals and a high-stress lifestyle. But many people don’t realize that common heartburn symptoms can both lead to, and mask, something more serious.

Chronic heartburn can sometimes lead to a disorder called Barrett’s esophagus, in which the cells of the esophagus, normally squamous cells like those of your skin, begin to change into glandular cells like those of the stomach.  “When it’s exposed to stomach acid, the esophagus tries to make itself look more like the stomach.” Odell explains. “Five percent of GERD patients will develop Barrett’s, and 10 percent of those will go on to develop cancer.”

Unfortunately, it’s easy to mistake signs of cancer for simple heartburn.  That’s exactly what happened to Ellen Tauscher, 66. Her job may have been more stressful than most: Tauscher was an undersecretary of state in the Obama administration.  In 2010, during a particularly stressful time of her life (she was in Geneva, negotiating an arms control treaty with Russia), she began to experience classic symptoms of acid reflux.  “I had a pain in my chest after most meals and had difficulty swallowing,” she explains. “I wasn’t sure what I was experiencing. A moment went by, and the tight feeling began to ease.  I chalked it up to stress and left it at that.”

But over the next five months, her symptoms increased in both frequency and severity.  At times, it rendered eating impossible. When she called her primary physician, he concluded that her symptoms were unusual and asked her to come in the next day.

“If my doctor had told me that day what many patients are told when they first complain of reflux symptoms—take Prilosec for six weeks and see if the symptoms abate—I’d be dead today,” Tauscher says.  Instead, he ordered an endoscopy, a procedure in which a thin tube with a light and camera at the end is fed into your digestive tract so the doctor can inspect it. The test revealed that Tauscher’s symptoms were caused by a three-inch-long tumor that had grown nearly three-quarters of the way around the inside of her esophagus.

Part of the reason Tauscher’s cancer was diagnosed so quickly was that she didn’t have a history of GERD.  Chronic reflux sufferers aren’t likely to get such immediate care, which is part of the reason esophageal cancer has a five-year survival rate of less than 20 percent.  That’s something Oberstein wants to change.

“If someone has heartburn that is not controlled by medication or simple measures like not laying down after eating, it’s critical that they follow up with their doctor or a gastroenterologist,” he says.  Your doctor may recommend an endoscopy to see if your have signs of esophageal issues.

Bottom line, says Odell:  “If you have reflux, discuss it with your physician to make sure there’s nothing else going on.  And if you have difficulty swallowing, see your doctor immediately; it could be the first sign of a tumor.”

(by Stephen Perrine for AARP Bulletin, June 2018)

The Keys to Healthy Living:

Friendship and Purpose

(Changes in lifestyle and outlook can affect longevity)

As we think about the prospect of living longer, millions of us are taking more responsibility for
our own health. We’re realizing that the choices we make each day are more important than
an occasional visit to the doctor’s office.
As a result, we’re seeking more and better information to help us make healthier decisions, and
tools for lifestyle changes that lead us toward physical and mental fitness and enhance our
well-being, not just treat our ailments.
But we also need to focus on things like building strong social connections and reducing
loneliness and social isolation, realizing a sense of purpose, and developing a more positive,
optimistic outlook on aging.
Social connections are important to your health. People with close friends are more likely to
get plenty of sleep, eat healthy foods, maintain peace of mind and have less stress, engage in
brain health activities and take on new challenges or hobbies.
Loneliness is the new smoking—according to one researcher, it is equally as bad for you as
inhaling 15 cigarettes a day. Studies show that loneliness can shave eight years off life
expectancy, that it has a big negative effect on quality of life, and that it’s the single largest
predictor of dissatisfaction with health care. The mortality risk for loneliness is greater than
that of obesity. Social isolation of older adults is associated with an estimated $6.7 billion in
additional Medicare spending annually.
Having a purpose in life is also important to health as we get older and is a key factor in aging
successfully. A sense of purpose for many is more important than making money, and it’s
associated with a wide range of better health outcomes including reduced risk of mortality,
stroke, heart attack and Alzheimer’s disease. People with a sense of purpose also get better
sleep, have fewer nights of hospital admission and go to the doctor less often. And they are
more likely to take care of their health—to eat healthier, exercise more, avoid abusing drugs
and alcohol, and seek out better preventive health services.
Evidence also shows that optimism about aging has an impact on our health, adding 7.5 years
to our lives. Those with an upbeat view of aging are more likely to fully recover from a severe
disability and have up to an 80 percent lower risk of a cardiovascular event.
We’re discovering that changes in lifestyle and medical advances can increase our life-span and
shrink the number of years spent with a disability. But it’s also vital that we have something to
get us up in the morning and someone to share our lives with—and that we approach each day
with a smile.

(by Jo Ann Jenkins for AARP Bulletin, June 2018)

HEALTH FADS, FAILS

(WHAT TO DO AND WHAT TO AVOID TO LIVE LONGER & BETTER, BASED ON INTERVIEWS WITH DOZENS OF DOCTORS & MORE THAN 150 STUDIES)

A Stronger Heart!      Fad: COCONUT OIL…..It sounds exotic, internet “experts” swear by it and a book called The Coconut Oil Miracle is in its fifth edition.  But, “There are no known benefits of coconut oil,” says Steven E Nissen, a cardiologist at the Cleveland Clinic Foundation.  Coconut oil is 82 percent saturated fat—30 percent more than butter.

                                    Fail: ANTIOXIDANT SUPPLEMENTS…..Eating lots of fruit and vegetables can slash your risk of heart attack by 30 percent, in part due to an abundance of antioxidants—nutrients that cool inflammation and reduce plaque in your arteries.  But research shows that antioxidants like vitamins A, C and E and beta-carotene have no heart benefits when taken in pill form. In fact, high doses could indirectly hurt heart health by messing with the natural production of antioxidants.

                                    Fail: HIGH-FIBER JUNK FOOD…..Yes, fiber helps control cholesterol and lower diabetes risk.  But if you pack fiber into snack bars and other sweets, the sugar can do more damage than the fiber does good.  Even though the Food and Drug Administration allows food with added fiber to have heart-health claims on its labels, you should also focus on the sugar level when assessing food to buy.

                                    Fail: HOMEBLOOD-PRESSURE MONITORS (Unless you do this)…..If you’re among the 51 percent of 35-to-64 year-olds who use a blood pressure monitor at home, you get an A for effort.  But 70 percent of home devices were off by at least 5 point in a 2017 University of Alberta study. For an A in your final grade, take yours to a doctor’s appointment once a year and compare results with a doctor’s monitor.  You may simply need a bigger blood pressure cuff, the researchers note.

                                   Fail: FISH OIL TABLETS…..These supplements don’t lower heart attack risk at all, according to a large Oxford University analysis involving more than 77,000 people.  Because over-the-counter supplements aren’t regulated, “It’s not always clear what you’re getting,” says David Becker, a cardiologist with the Temple Heart and Vascular Institute in Philadelphia.  Eat fish, not pills.

FIXES:  A HANDFUL OF NUTS…..The tastiest news in heart disease prevention has to be the power of nuts to help cut heart attack risk by 30 percent.  That’s what happened when people in a Spanish study added a small handful of nuts a day to an already healthy Mediterranean-style diet (plenty of produce, whole grains, lean protein).  One caveat: Nuts are high in calories, which could lead to weight gain that could undermine any heart benefits you might otherwise see.

FIXES:  SLOW-FAST WORKOUTS…..Couch potatoes in their 50s rebuilt heart strength and function with a doable exercise routine made up mostly of walking.  The weekly workout used in the UT Southwestern Medical Center study looks like this:

  • 1-2 days:  30 minutes moderate-intensity exercise like a brisk walk.
  • 1 day:  60-minute session of the same.
  • 1 day:  30 minutes of interval training (say, several four-minute bursts of high-speed walking, broken up by a slower pace to recover).
  • 1-2 days:  strength training sessions using weights or exercise machines.

A Happy Stomach! Fad:  GLUTEN FREE ‘JUST BECAUSE’…..A 2013 survey showed that nearly 30 percent of US Adults were trying to minimize or avoid gluten.  That makes sense if you have celiac disease or other symptoms of gluten sensitivity. Not for everyone else. A study published in 2017 of more than 110,000 people found that going gluten free could raise the risk of heart disease.  “Cereals and grains have important health benefits,” says Shajan P Sugandha, a gastroenterologist at the University of Alabama at Birmingham.

Fail:  COLON CLEANSE…..This involves putting large volumes of liquid into the rectum to detoxify the body, enhance immunity and fight disease.  “It’s based off misinformation that things sit in your colon for years, which is ridiculous,” says John Pandolfino, chief of gastroenterology and hepatology at the Feinberg School of Medicine at Northwestern University in Chicago.  Risks include cramping, pain, nausea, potentially fatal electrolyte imbalance, renal failure and gut perforations.

Fail:  PREBIOTIC SUPPLEMENTS…..These nondigestible fiber compounds promise to decrease inflammation and lower your risk of disease.  Save your money, says Stacy Sims, a senior research fellow at the University of Waikato in New Zealand. The supplements are expensive—about $20 a bottle.  And, she says, “You may not need to promote the growth of the bacteria they’re promising to promote.” Instead, eat foods that are rich in prebiotics, such as garlic, onions, asparagus, bananas, dandelion greens and Jerusalem artichokes.

Fail:  PROBIOTIC FOODS…..Stores sell bacteria-spiked foods like dark chocolate and muffin mixes, not to mention probiotic pills.  Don’t buy in. “Though supplements have large numbers of bacteria, they’re often not diverse—and the gut biome is extremely diverse,” Sims says.  You should consume naturally probiotic-rich, unpasteurized fermented foods and drinks like yogurt, sauerkraut and kombucha.

FIXES:  PEPPERMINT OIL…..A review of 121 trials found that peppermint oil is effective at treating irritable bowel syndrome.  “The menthol, its main constituent, has a very relaxing effect on the GI tract,” says Rosario Ligresti, M.D., director of the Pancreas Center at Hackensack University Medical Center in New Jersey.

FIXES:  FECAL TRANSPLANT…..Donor stool with healthy bacteria is inserted into a patient’s colon to alter the flora and treat ailments such as lupus and diabetes.  “People have pooh-poohed this idea for years,” Ligresti says. “But we now know that, for certain conditions, it can change your life almost overnight.” In a study of 30 people (average age 67) with inflamed colons from C. difficile infections, 29 recovered through this therapy.

Smoother Skin:    Fad:  MICRONEEDLING…..This beauty trend involves poking tiny holes in your skin, using a device that looks like a lint roller covered in short needles.  The procedure stimulates the production of collagen, the skin’s main structural protein, and purports to firm your face and give it a more youthful appearance.  “This is a fad that actually works,” says Tina Alster, a clinical professor of dermatology at Georgetown University Medical Center in Washington. The procedure has come to rival the use of lasers in dermatologists’ offices, but Alster, founding director of the Washington Institure of Dermatologic Laser Surgery, says home devices can also be effective.  Such dermal rollers commonly sell for about $25 and up. Makers claim the procedure is painless; reports can vary.

Fails:  COLLAGEN CREAMS…..Collagen does work as an injectable to decrease wrinkles.  However, you can rub it into the skin all day long, and there’s no science that says it’s going to do anything.

Fails:  HEMORRHOID CREAM FOR PUFFY EYES…..A lot of people swear by dabbing Preparation H around the eyes to shrink swelling.  And while it does work, you should save it for special occasions. Most hemorrhoid creams contain hydrocortisone, which can thin the skin with extended use.

Fails:  PLACENTA CREAMS…..Fillers, creams and facials containing placenta (and the stem cells inside) have become a skin rejuvenation craze, but don’t run so fast to buy them.  There’s no scientific research confirming that fillers or creams containing placenta will affect your skin. And while stem cells can be miraculous in causing cells to grow, they may also present a risk that cancer cells will grow.  “Stem cells can go rogue,” Alster says. “There has not been enough research to show the long-term safety of them.”

Fails:  WATER…..Drinking water won’t improve the look of your skin, unless you’re already dehydrated.  “If you’re hydrated and you drink more water, you just go to the bathroom more,” Alster says. “For your skin’s sake, hydrate from the outside in, not from the inside out.”  In other words: Moisturizing can be more beneficial to the skin than drinking extra water.

FIXES:  HYALURONIC ACID…..As we age, collagen and hyaluronic acid (HA) both diminish.  Collagen injections are old news; the latest procedure is to inject HA into the wrinkle.  Common brands are Juvederm and Restylane. Not only does HA plump up the wrinkle, it is a surfactant, which attracts water to the area for further lifting.  “Hyaluronic acid is what makes babies’ cheeks chubby, and aby adding it to all the right places, we can restore contour,” says Patricia Farris, a dermatologist in New Orleans.  Look for HA pills, too. A recent study showed that oral ingestion of HA for 12 weeks in people 59 and under suppressed wrinkles and improved skin luster.

FIXES:  CONED SUTURES…..A decade ago, dermatologists and plastic surgeons inserted permanent barbed sutures under the skin to create lift in sagging jawlines and other facial areas.  But the sutures were prone to infection. “After a while, you could see some of the strings too, and people looked like marionettes,” Alster says. The sutures soon fell out of favor, but their new and improved cousin, InstaLift, is all the rage now.  These coned sutures, which doctors slide under the skin using a local anesthetic, dissolve in about two years. While under your skin, they also stimulate collagen production so that, even after they dissolve, your face shouldn’t come crashing down.

FIXES:  LASERS FOR LIVER SPOTS……People are increasingly using pigment-specific lasers—the kind usually used to remove tattoos—to treat liver spots.  These lasers can be effective at blasting away a liver spot or two without a big recovery. If your liver spots are plentiful, more intensive ablative laser treatments are renowned for producing fast and excellent results, but recovery takes up to three weeks.

Relief from Pain:   Fad:  Cupping…..Much of the world discovered cupping when swimmer Michael Phelps revealed large circular bruises on his back during the 2016 Olympics.  This pain-relief fad has only grown since. Used in traditional Chinese medicine, hot glass cups are placed along sensitive trigger points on the body to create suction.  “It increases blood flow and can reduce muscle tension, which causes an increased sense of overall well-being,” says Stacey Simons of Simons Physical Therapy in Tucson AZ. However, “many patients will say that they have had no relief with it at all.”

Fails:  DAITH PIERCINGS…..Some people who have found acupuncture helpful as a short-term treatment for reducing migraines are now getting their daith (the innermost cartilage fold of the outer ear) pierced, in the hopes that this will provide a more permanent end to their headache hell.   While it may have a placebo effect, there is no research to indicate that this sometimes-painful piercing will affect the symptoms or frequency of chronic headaches.

Fails:  SOFT NECK COLLAR…..If you’ve thought of purchasing a soft neck collar to wear during the day for neck pain, you should think again.  While they do provide some support to the spine, the collars are best used at night. Extended daytime usage can actually weaken supporting muscles and structures in the neck, leaving you with less stability and ongoing neck problems.  

FIXES:  DRY NEEDLING…..Although it looks similar to acupuncture, dry needling has been around for only a decade.  Whereas acupuncture is designed to remove blockages and restore chi (healing energy), dry needling is used to reduce muscular pain and has shown short-term success.  The theory goes that the needle, inserted into a trigger point, causes biochemical changes that help reduce pain and create twitch responses that help the muscle to relax.

FIXES:  ROLLERS…..It may feel silly, but getting down on the floor and rolling out those kinks in your back with a tennis ball or a long foam roller can make you feel better if you’re aching.  Simons says these items release sensitive spots in the muscles or connective tissue, also known as trigger points. Do you have difficulty getting down on the floor? Put that tennis ball or foam roller between you and the wall and get rolling for up to five minutes.  

(as written in AARP Bulletin, May 2018)

 

Caprese Macaroni and Cheese

An easy-to-prepare caprese mac and cheese recipe is made entirely in the oven and topped with tomatoes, basil pesto and crispy crumbs. 

Ingredients

  • PAM(R) Original No-Stick Cooking Spray
  • 1 (14.5 ounce) can Hunt’s(R) Diced Tomatoes, drained
  • 1/3 cup refrigerated basil pesto
  • 1 (16 ounce) package dry elbow macaroni, uncooked
  • 4 ounces fontina cheese, shredded
  • 2 cups shredded part-skim mozzarella cheese, divided
  • 6 tablespoons butter, divided
  • 4 cups whole milk
  • 3 tablespoons all-purpose flour
  • 1 teaspoon salt
  • 1/4 teaspoon ground black pepper
  • 1 cup panko bread crumbs

Directions

  1. Preheat oven to 400 degrees F. Spray 13×9-inch or shallow 3-quart baking dish with cooking spray. Stir together drained tomatoes and pesto in small bowl; set aside. Combine uncooked macaroni, fontina cheese and 1 cup mozzarella cheese in large bowl. Place in dish in an even layer.
  2. Microwave 4 tablespoons butter in large microwave-safe bowl on HIGH 30 seconds or until melted. Whisk in milk, flour, salt and pepper until blended. Pour over macaroni mixture. Spoon tomato mixture evenly over macaroni. Cover dish with aluminum foil; bake 40 minutes.
  3. Meanwhile, microwave remaining 2 tablespoons butter in small microwave-safe bowl on HIGH 20 seconds or until melted. Stir in bread crumbs. Top macaroni with remaining 1 cup mozzarella cheese and bread crumb mixture. Bake uncovered 10 to 15 minutes more or until golden brown on top. Let stand 5 minutes before serving.

THE DOCTOR DIARIES

(What Physicians Wish Patients Knew)

Joanne Jarrett, M.D. polled dozens of doctors to find out what they’d tell you, if only they could……

  • WE ARE WORKING ON YOUR CASE, EVEN IF IT LOOKS LIKE WE HAVE DISAPPEARED

 

Physicians often forget how scary being in the hospital can be.  Rest assured that when the doctor is not at your bedside, he or she is writing up your evaluation, the plan and the orders outlining what needs to be done for you, all the while checking for test results and recalculating the diagnosis and plan.  You may not see him or her until the next day, but your doctor, or the physician on call, is available by phone continuously to address your concerns.

  1. WHEN WE KEEP YOU WAITING, IT’S NOT BECAUSE WE THINK OUR TIME IS MORE VALUABLE THAN YOURS…..But if the patient before you mentions blood in his or her stool or talks about suicidal impulses, your appointment needs to wait.  Your best bet is to schedule the first appointment of the day.
  2. WE NEED COMPLETE HONESTY FROM YOU…..This means telling us what drugs you’ve taken, legal and illegal, so we can help you avoid interactions.  It means answering honestly about sexual function and behavior, even if you fear we wouldn’t approve. We think no less of patients who struggle with mental or emotional issues.  
  3. WE KNOW LIFESTYLE CHANGE IS HARD…….And boring.  We try and fail often ourselves.  But sometimes diet, exercise and/or alcohol abstinence really are the best treatments.
  4. MANY OF US HAVE PTSD…..I have nightmares about patients down an infinite hall, each with a problem worse than the last.  In my short career, I’ve seen a baby take her last breaths. I’ve watched a woman, bleeding uncontrollably after giving birth, lose consciousness as I worked, a pool of her blood expanding at my feet.  I’ve heard a woman, after having both legs traumatically severed, saying goodbye to her father, assuming she wouldn’t survive. I could go on. We know we signed up for it. But keep in mind, when you’re tempted to be angry with your doctor, that we are under stress, too.
  5. WE WISH HAD BETTER ADVICE FOR WEIGHT LOSS….Medical schools don’t spend much time on nutrition.  Although body weight has significant, holistic health implications, the field of medicine is at somewhat of a loss here.  Out best advice, however vague might be, is to increase your physical activity, avoid processed foods and eat vegetables at most meals.
  6. SOMETIMES THE INTERNET IS RIGHT…..There, I said it.  You can find useful health information online.  We love a well-read, inquisitive patient, and we’ll be happy to touch on any of your internet-fueled fears.  Just be careful. The internet can lead you to unnecessary panic or to dismiss something that shouldn’t be ignored.  And be wary or discussion boards; incorrect advice can be very convincing. Remember, there is no substitute for medical training, experience and complex analysis.
  7. WE KNOW YOU’VE ANSWERED THIS QUESTION ALREADY…..And we’re sorry to ask again.  When you call for an appointment, you’re asked what’s going on.  Then, when you’re checked in, you’re asked again. So when you finally get to see the doctor, you’re sick of the story.  But we can’t help it. We have to hear it with our own ears.
  8. YES, SOME OF US ARE JERKS…..Most doctors mean well and are doing their best.  But if you are not getting a sense that your physician, although human and harried, has your best interests at heart, find one who does.  
  9. WE WORRY ABOUT YOU…..We lie awake worried sick about you more often than you’d imagine.  We may wonder about you for years after you leave our care. The stakes are so high, and we know it.  
  10. WE MAKE MISTAKES…..Our fear of screwing up is exhausting, weighty and ever present—it’s the hardest thing about doctoring.  We do make mistakes. Be wary of anyone who won’t admit that.
  11. WE WANT THE VERY BEST FOR YOU…..Just know that.  It’s the bottom line.

 

A BETTER BRAIN!

FAD:  Omega-3 Supplements

We’ve been hearing about the seeming magical powers of these essential fatty acids for a while now.  But the science is complicated: Omega-3 fatty acids, particularly those called EPA and DHA, are essential for normal brain function.  But dietary supplements aren’t a quick fix. “It takes two and a half years to build up an adequate supply of omega-3s in your brain cells.  You may need to take them before symptoms of memory loss begin,” says Richard Isaacson, M.D., founder of the Alzheimer’s Prevention Clinic at New York-Presbyterian/Weill Cornell Medical Center.  “And you can’t just go and buy a bottle of fish oil and call it good. For age-related memory loss, you need 900 milligrams daily of DHA.”

 

FAILS:  Nootropics or “Smart Drugs”

The brain-health supplement market is poised to top$11.6 billion by 2024.  One of the hottest categories is nootropics, or “smart drugs,” aimed at older adults.  An example is Prevagen, a dietary supplement derived from a protein in jellyfish, often advertised on TV as a memory enhancer.  The New York state attorney general and the Federal Trade Commission (FTC) sued the manufacturers and charged the company with fraud.  Experts say that supplements like these can have adverse side effects and bad reactions with prescription medicines.

BRAIN STIMULATION:   What if you could zap your brain with an electrical current to improve your memory, learn to play piano or master a foreign language?  You can try commercial headset devices such as Halo and Foc.us—but don’t get your hopes up. A study published in Experimental Brain Research in 2016 found that people who got such treatments performed worse on cognitive tests than those getting fake treatments.  And possible negative side effects include dizziness, as well as altered sight, hearing or taste.

 

FIXES:  Cocoa Flavonols

To flavor your coffee, swirl in a tablespoon of pure dark cocoa powder.  One study published in Nature Neuroscience found that taking high doses (900 mg) of cocoa flavonols daily for three months improved brain function.  Sixty-year-olds then performed pattern recognition tests as well as people half their age.

 

CURCUMIN

We have new insight into why older adults in India have a lower prevalence of Alzheimer’s disease:  The secret is in the (curry) sauce. Curcumin, the anti-inflammatory substance that gives curry its vibrant hue, improves brain health.  Researchers at the University of California, Los Angeles, found memory and attention improvements in adults ages 51 to 84 who consumed 90 mg of curcumin twice daily for 18 months.  PET scans showed healthier brains, too. “When you cook with it,” Isaacson says, “you can absorb it and have a lot of it over your lifetime—and it probably protects the brain.” Don’t want to eat curry every day?  You can also try a highly absorbable supplement such as Theracurmin, which was taken by subjects in the UCLA study and, Isaacson says, is likely even more effective than curcumin.

(As written in the AARP Bulletin, May 2018)

BODY & MIND HEALTH COACH

MYTH:  YOU SHOULD STICK TO FEWER THAN 1,200 CALORIES.

TRUTH:  THERE’S NO MAGIC NUMBER THAT WORKS FOR EVERYONE—BUT 1,200 IS ALMOST ALWAYS TOO LOW.

 

Your body needs fuel (food!) to burn fat, but how much depends on a number of factors, like your age and your weight.  Fad diets—with their big promises—can make you feel like you have to eat as little as possible to shed pounds, but they’re called fads for a reason.  One thing that’s always true: Eating a very low-calorie diet can quickly cause your body to feel starved, slowing your metabolism. Instead, use a tool like our app Transform or a fitness wearable to determine the number of calories your body uses per day and aim to eat 150 to 250 calories less than that number.  Or, find your sweet spot for weight loss with my rough guide below:

 

YOUR WEIGHT LOSS CHEAT SHEET:

IF YOU WEIGH:   100 – 150 pounds

TRY:  Eating 1,500 calories

IF YOU WEIGH:    151-180 pounds

TRY:  Adding a zero to your weight—that’s your daily calorie count

IF YOU WEIGH:  181 pounds or more

TRY:  Adding a zero to your weight, then multiplying that number by 0.9

 

MYTH:  YOU MUST MAKE TIME FOR THE GYM

TRUTH:  YOU’LL SLIM DOWN FASTER WITH SHORT WORKOUTS THAT CAN BE DONE ANYWHERE.

 

Research suggests that just four minutes of high-intensity intervals can improve fitness levels and burn fat more effectively than slogging through an hour of running or climbing hills on a stationary bike.  So try doing just one exercise—like sit-ups, air squats, or burpees—as intensely as you can for 20 seconds, then rest for 10, and repeat eight times total. If you can, try another exercise for four minutes after that, then another.  You’ll spend at most 16 minutes on this, and the payoff is huge.

 

MYTH:  NEVER EAT IN THE EVENING

TRUTH:  IF YOU STILL NEED ENERGY AFTER DARK, YOU STILL NEED FOOD.

 

Your metabolism doesn’t clock out when the workday is over, and neigher do you, so there’s no need to skip meals.  I think it’s smart to eat five small meals a day, every three hours; for instance, if you eat breakfast at 7 am, your last meal would be around 7 pm.  That should keep you going until you wind down for bed. (You still don’t want to have a big meal super close to bedtime, because digestion works better when you’re up and about.)  For dinner, stick with lean proteins, healthy fats, and nutrient-rich vegetables—veggies are carbs, but their fiber will help curb your cravings for the sugary, processed kind. My go-to meal is 4 oz cooked and shredded chicken and ½ avocado, sliced, served on a bed of greens and veggies, with low-fat dressing.

 

MYTH:  ABS ARE MADE AT THE GYM

TRUTH:  ABS ARE MADE IN THE KITCHEN

 

You can do all the crunches and planks in the world and never see a six-pack.  Here’s why: Abdominal exercises can help build the bricks below the surface, but they won’t do anything to reduce the fat on top.  To lose that, you need to eat well and exercise. The two food rules below will give you results!

 

EAT MORE PROTEIN.Protein is the building block of muscle.  A simple rule of thumb for healthy adults: Calculate 80% of your body weight—that’s how much plant-based and lean protein I recommend you eat each day, in grams.

 

….AND LESS SODIUM……Even if those bricks are there, and even if your body fat is low enough to show them, too much sodium can leave a layer of water on your belly.  Aim to keep your intake under 2,300 mg per day—that’s good for your heart too.

WHAT’S YOUR TROUBLE SPOT?

BACK:  Pain here affects women at a greater rate than it does men.  It’s not just that we’re constantly lifting babies, laptops, and groceries—after all, guys do that too—or that we carry two things men don’t:  pregnant bellies and breasts. It’s that our bones’ strength peaks earlier, around age 30, putting us at higher risk for osteoporosis, compression fractures, and more, explains Kimberly Sackheim, D.O., clinical assistant professor of rehabilitation medicine at NYU Langone’s Rusk Rehabilitation.  You can help shore up your bones at any age by eating a calcium-rich diet and doing weight-bearing exercise such as running and dancing, which forces the bones to repair themselves, making them stronger. With rest, back pain should get better in six weeks, but if yours last longer or you develop weakness, numbness, or tingling or have trouble controlling your bowels or bladder—which could be a sign of nerve compression—check with a doctor.

 

WRIST:  Women are three times more likely to develop carpal tunnel syndrome simply because of the way we’re built.  The median nerve runs from the forearm to the palm of your hand, passing through a tunnel of ligaments and bones.  A slender wrist can allow it to become compressed more easily, causing numbness, itchiness, or pain in your thumb, pointer, and middle fingers and down your arm.  Eventually, it may be difficult to text or grip a pen. To help your wrist heal faster, try to avoid repetitive movements, like scrubbing the tub (let someone else take a turn!).  You can also ease the pain with ibuprofen or topical gels and patches and a simple wrist brace from your local drugstore. “Wear the brace while you’re sleeping and when you’re being very active,”  Sackheim says.

 

THYROID:  Women are up to eight times more likely than men to have thyroid problems.  Your thyroid produces two hormones that together control a wide array of things than can make you feel A-OK or totally rotten.  If it either trickles to a half or goes into overdrive, you might feel cold or overheated, be constipated or have diarrhea, feel listless or be anxious.  Fortunately, the treatments—replacing the hormones you’re missing with synthetic ones, or tamping down overproduction with medication or, in some cases, surgery—are usually effective, says Antonio Bianco, M.D., Ph.D., a professor of medicine at Rush University Medical Center in Chicago.  Ask your M.D. for a simple blood test.

 

HEART:  Though men develop heart disease just as frequently, women’s cases are often more complicated.  “In women, heart disease tends to be more diffuse, occurring throughout the arteries rather than in one spot, making it more of a challenge to fix,” says cardiologist Suzanne Steinbaum, D.O., spokeswoman for the American Heart Association’s Go Red For Women.  Catching heart disease before it lands you in the ER is crucial.  Have your doctor check your blood pressure, cholesterol levels, blood sugar, BMI, and waist circumference annually, and go over your family history of heart disease.

 

BELLY:  Irritable bowel syndrome is a mysterious disease—experts aren’t sure what causes it or why twice as many women as men are diagnosed with it, though there are a few theories, says Elana Maser, M.D., director of the Mount Sinai Women’s Gastrointestinal Center in New York City.  IBS in women is likely a nerve issue, much like migraines or fibromyalgia, she explains, and bouts might also be driven by hormones during your period or pregnancy. If you’ve had cramps along with constipation or diarrhea (or, if you hit the IBS jackpot, both!) for at least three months, you should see help.  A doctor can help you identify your triggers and prescribe medications to help ease the symptoms.

 

KNEES:  You don’t have to be doing any crazy marathon training to be more prone to knee injury than a guy.  You can thank the estrogen-fueled laxity in our joints, and our wider-set hips, which create a sharp angle where the leg bones meet.  The first step to saving your knees is simple: “If you’re doing an exercise that hurts your knees, don’t do it,” Sackheim says. (Squats, got it.)   Your next move is to strengthen your quads and hamstrings—they’ll support your leg so you don’t put as much pressure on your knee.

 

(Written by Marisa Cohen for Redbookmag.com, April 2018)

ARE YOU THE BOSS OF YOUR MONEY?

All the tools you need to feel less stressed and more confident about your finances are right here—but first, you have to be totally honest in this quiz from money expert Nicole Lapin.  Then follow her perfectly tailored advice: Financial Security Awaits!

 

DO YOU SPEND MONEY ON YOURSELF?     A) Of course! I deserve it.

  1.                                                                            B) Oh, no, I can’t do that.
  2.                                                                            C) Of course! I deserve it and I can afford it.

 

ARE YOU PAID WHAT YOU DESERVE?         A) I wish. But who is, amirite?

  1.                                                             B) I guess my salary is fair, but let me tell you the 10

                                                                  don’t think I can get more money right now.

  1.                                                             C) Yep, with benefits and perks.

                                  

WHEN IT COMES TO MY MONTHLY BUDGET, I…..

  1. Budget? I don’t really have an “official” one, but I’m ballparking
  2. Stick to it about half the time, but it’s not always practical.
  3. Set it at the beginning of the month based on my salary, making sure to allow for fun spending.

 

DO YOU WANT TO RETIRE SOMEDAY, AND HAVE A PLAN TO GET THERE?

  1. Retirement is not something I can think about right now.
  2. I’m trying: I’ve got a little extra money stashed away in a  Savings Account
  3. I’m maxing out my 401(k) contributions, have an IRA, and am feeling prepared…provided there are no zombies, of course.

 

Give yourself 1 point for every A

2 points for every B

3 points for every C

 

4-6 POINTS

 

JUST STARTING OUT:  You do deserve to spend money on yourself—I like your spirit!  But let’s expand your notion of what it means to do that.

YOUR BUDGET:  I know a budget sounds like a horrible diet where you only eat grapefruit.  But think of it as your “spending plan,” and you’ll realize it’s not about deprivation at all.  Write down the money you having coming in every month and where it’s going. Next, bundle your expenditures into “Essentials,” “Endgame” (15% toward savings and retirement), and “Extras” (15% for lattes, yoga, pedis, whatever).  Then stick to this plan: Being broke is worse than budgeting!

YOUR RETIREMENT:  If you’re burying your head in the sand about this, I’m not going to try to guilt you into doing better (though you know I could).  Instead, think about something amazing: the $1 million—plus you’ll have if you put $5,000 into a 401(k) or IRA for 40 years. Compound interest is your BFF because you earn interest on the interest, which is basically free money.  Doesn’t that make you want to start saving?!

YOUR PAY:  Do you know what the market rate for your job and industry is?  You should. Glassdoor.com and the ladders.com can help, but also ask trusted friends or colleagues what they make.  Then prepare a killer presentation on why you should get a raise. Showcase yourself: I’m talking full-on charts and graphs.  If you work for yourself, the same goes for getting a great rate from clients. There are people who are paid what they deserve, and you should be one of them.  

 

7-9 POINTS

 

BOSS-IN-TRAINING:  A lot of busy women thin, I’ll figure out all that money stuff when I have more time/cash/knowledge.  No!  You’ll have more time/cash/knowledge when you figure out the money stuff.

YOUR BUDGET:  If yours isn’t working for you, I have two solutions.  One is to make sure you’re figuring in everything, not just your mortgage and utility bills, but your Netflix and all those Amazon purchases.  You’ve got to make space for fun extras—just be sure the ones you’re spending money on are worth it. My other idea is to ramp up your savings a bit—that might give you the peace of mind you need to stick to the rest of the budget.  Don’t forget how even 1% to 2% more each month adds up over time thanks to our BFF, compound interest!

YOUR RETIREMENT:  I want you to be carefree Betty White, not the little old lady out looking for a job.  If your employer offers a matching 401(k), max out those contributions. If you already have, consider opening a Roth or traditional IRA too (nobody gets rich with their eggs in one basket).  I like the Roth because you pay taxes on your contributions now—I’m betting you you’ll be making more money by the time your retire, putting you in a higher tax bracket. So pay the tax now when it won’t be as much.

YOUR PAY:  I have two words for you: no excuses.  Don’t just think of a raise as a little bump that’s not worth the stress and headache to ask for.  That bump can grow if you invest it, and it can help you make more money at your next job. So stop with your reasons why not and plan to ask for more; if you don’t, the answer is always no.

10-12 POINTS

 

BOSSDOM:  Oh, hey, boss, hey!  As a fellow boss, I know you’ll always be looking for ways to maintain and improve your status.

YOUR BUDGET:  You probably have down what I call the “3 E’s” of your spending plan (Essentials, Endgame, and Extras).  Now, look closely at your goals for the 3 F’s: family, finance, and fun. Look at your one-, three-, five-, seven-, and 10-year goals (smaller chunks are easier to digest)  in all aspects of your life. What’s on your family plan? Another kid? A second home? What about your life plan? Want to take time off to travel? Switch careers? Expand your spending plan to include these things now.

YOUR RETIREMENT:  If you’re regularly maxing out your 401(k) and Roth IRA and you have some savings on the side, start contributing to a health savings account (HSA).  They money doesn’t get taxed and you can use it for out-of-pocket health expenses. That means your contact lens solution is tax-free. Then, check out apps and sites like Digit, Acorns, and Aspiration to help you save even more without changing your habits.  

YOUR PAY:  If inflation is growing at, say, 3%, then you need to make that much more a a year just to maintain the same lifestyle.  How about thinking about a side gig? What do you love that could bring in some cash? What are people always saying you’re so good at?  Start charging for it, sister! That’s being a boss!

 

(written by Nicole Lapin for April 2018 of Redbook Magazine)